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Home My WebLink AboutFMC 2013HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: 3 a Date Received: - - 3 Address: 'gyp f =—= . Ca Y"3 k-9-- Bakersfield, CA 933 Business Name: S &'-A25 C-- Other -74- tTit L. Comments: 1. 2. 3. 4. INSPECTION LOG Date Time Signature SYSTEM: BUILDING SQUARE FEET: New Mod. Commercial Hood System Building Sq. Feet: Fire Alarm System Calculation Bldg. Sq. Ft: Fire Sprinkler System Spray Finlsh System Aboveground Storage Tank Underground Storage Tank minor modification Underground Storage Tank removal Underground Storage Tank C-- Other -74- tTit L. Comments: 1. 2. 3. 4. INSPECTION LOG Date Time Signature BAKERSFIELD CITY FIRE DEPARTMENT - INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work Inspection Request Phone No. (661) 326 -3979 UST NEW INSTALL DESCRIPTION DATE SIGNATURE BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENI" SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF I "` - ° =' _ _ TANK TESTING REMARKS: UST REMOVAL DESCRIPTION DATE SIGNATURE AST NEW INSTALL DESCRIPTION DATE SIGNATURE I MODIFICATIONS MINOR / MAJOR I AST REMOVAL DESCRIPTION DATE SIGNATURE EVR UPGRADE PRIOR-TO OPERATION OF ANY SYSTEM, ALL UST AND /OR AST SYSTEMS SHALL BE INSTALL, COMPLETE AND ACCEPTED BY MISC. ACTIVITY THE BAKERSFIELD CITY FIRE DEPARTMENT. l FIRE DEPARTMENT (FINAL) 4D- n BUILDING ADDRESS: c nJ,° JOB DESCRIPTION: ,4-144 c_ OCCUPANCY TYPE: OWNER: 444 ` 1. cJcl r- PERMIT NO. - 660 a 12 CONTRACTOR: , ' ,, PHONE #` ?,2— n 'e2 FD 1743 BILLING & PERMIT STATEMENT PERMIT NO.: B HNS., D 4 FIRE 4Frr Fir BAKERSFIELD FIRE DEPT. Prevention Services 1600 T ruxtun Ave Ste 401 Bakersfield CA 93301 Tel.: (661) 326 -3979 • Fax: (661) 852 -2171 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT. Rl PERMIT TYPE Alarms - New & Modifications - (Minimum Charge) FEE CALCULATION 280.00 SITE INFORMATION LOCATION OF PROJECT S , b L) 0 PROPERTY OWNER STARTING DATE COMPLETION DATE NAME PROTECT NAME ,^ ^ `/ lQ' ADDRESS l '^ ` PHONE V v ` NO. PROJECT ADDRESS n` 143F`TV \ CI STATEt PA ZIP CODE CONTRACTOR CONTRACTOR NAME CA LICENSE NO. J t'1'1ficS C- o SO INFORMATION TYPE OF LICENSE. IXPIRATION DATE f vl HA 3C 20) PHONE NO. g 2 -8(0'877 CONTRACTOR COMPANY NAME ` ' C V FAX NO. go ADDRESS - i CITY ZIP wut c All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT. Rl PERMIT TYPE Alarms - New & Modifications - (Minimum Charge) FEE CALCULATION 280.00 TOTAL TREASURY DUE ACCT NO 84 98 Over 10,000 Sq. Ft. Sq. Ft, x.028 = Permit fee 84 98 Sprinklers - New & Modifications - (Minimum Charge) 280.00 84 98 Over 10,000 Sq. Ft. Sq. Ft. x.028 = Permit fee 84 98 Minor Sprinkler Modifications (< 10 heads) 96.00 [Inspection Only] 84 98 Commercial Hoods — New & Modifications 470.00 8 Additional Hoods 58.00 84 98 Spray Booths - New & Modifications 470.00 98 Aboveground Storage Tanks (Installation/Insp. -i" Time) 180.00 82 Additional Tanks 96.00 82 Aboveground Storage Tanks (Removenspection) 109.00 82 Underground Storage Tanks (Instal/atlon./Inspection) 878.00 (per tank) 82 Underground Storage Tanks (Modification) 878.00 (per site) e2 Underground Storage Tanks (Minor Modification) 167.00 82 Underground Storage Tanks (Remove!) 573.00 (per tank) 84 Oilwell (Installation) 96.00 Mandated Leak Detection (Testing) / Fuel Monit.Cert/S8989. Note: $96.00 for each type of test /per site (even if scheduled at the same time) 98'69 (persiteC d 82 Tents 96.00 (per tend 84 Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour) 96.00 + (5 hrs. min. standby tee /Inspection) -- $576..00 84 After hours inspection fee 121.00 i 84 RE- INSPEC77ON (S) / FOLLOW -UP/NSPEC77ON(S) 96.00 (per hour) 84 Portable LPG (Propane): NO. CAGES? _ 96.00 84 El Explosive Storage 266.00 Copying & File Research (File Research Fee $50.00 per hr) 252 per page 84 Miscellaneous 84 FD 2021 (Rev. 06107) 1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1 -PINK (to Customer) 1 '+ BILLING & PERMIT STATEMENT PERMIT NO.: t. BAHERSFIELD FIRE DEPT. B R S P D Prevention Services FINE 1600 Trtaxtun Ave Ste 401ARSM Bakersfield CA 93301 Tel_- (M11 32R -3979 • Fax- (RRI1 A52 -2171 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT. 1 Alarms - New & Modifications - (Minimum Charge) 1$280-00 98 SITE INFORMATION LOCATION OF PROJECT Sc srns PROPERTY OWNER STARTING DATE r \ COMPLETION DATE U NAME C) PROJECT NAME ,^ ^ ADDRESS lV ,1 V ` PHONENO. PROJECT ADDRESS Q' /1 I 1 CITY 1 STATE ZIPCODE CONTRACTOR CONTRACTOR NAME CA LICENSE NO. J IQm S tc r O O INFORMATION TYPE OF LICENSE IXPIRA" DATE tvRNA 30 20! PHONE NO q 2 -S CONTRACTOR COMPANYNAME t TE V FAX NO. O ADDRESS CITY ZIP wut 8 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT. 1 Alarms - New & Modifications - (Minimum Charge) 1$280-00 98 FD 2021 (Rev. 06/07) 1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1 -PINK (to Customer) Underground Storage Tanks (Modification) 878.00 (per site) 82 Underground Storage Tanks (Minor Modification) 167.00 82 Underground Storage Tanks (Removal) 573.00 (per tank) 84 Oilwell (Installation) 96.00 84 Mandated Leak Detection (Testing) /Fuel Monit.Cert/SBSBS. Note. $96.00 for each type of test /per site (even ifscheduled at the same time) 38:66-(}er- site,L / 9 , ,o n 82 Tents 96.00 (per tent) 84 Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour) 96.00 + (5 hrs. min. standby fee /Inspection) -- $576..00 84 After hours inspection fee 121.00 84 RE4NSPECTION(S) /FOLLOW -UP INSPEC770N(S) 96.00 (per hour) 84 Portable LPG (Propane): NO. OF CAGES? _ 96.00 84 Explosive Storage 266.00 B4 Copying & File Research (File Research Fee $50.00 per hr) 250 per page 84 Miscellaneous 84 FD 2021 (Rev. 06/07) 1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1 -PINK (to Customer) r BAKERSFIELD FIRE DEPARTMENT UNDERGROUND STORAGE TANKS 4 Prevention Sendm ot101 t-t SZREE.T APPLICATION " It Bakerstield, CA 93301 TO PERFORM ELD /l1NE TESTING / Phone: 661 -326 -3979 • Fax: 661- 852 -2171 SB989 SECONDARY CONTAINMENT TESTING/TANK TIGHTNESS TEST AND P i of i FUEL MONITORING CERTIFICATION Please note that these are separate individual tests and will be clurged per separaft type test accordingly.) PERMIT # ENHANCED LEAK DETECTION TANK TIGHTNESS - FLlEL MONITORING CERTI TION SS-989 SECONDARY CONTAINMENT FD2095 (Rev 03/08) FACILITY NAME $ PHONE A OF CONTACT PERSON ADDRESS V1 (- JUCJ \ CL, J K3 OWNER NAME OPERATOR NAME PERMIT TO OPERATE OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? YES NO TANK VOLUME CONTENTS TANK TmTDik3 COMPANY TESTING COMPANY fir. GIJV VE2GIJ U NAME PHONES OF CONTACT FUSON MAILING ADDRESS L-l3 lB2oO*,% GT. — V6XYE9SF t'Et-O % CA °133c>e NAME & PHONE A OF TESTER OR SMPAL INSPECTOR cam, OLO- O f\ FICATION t S09 8C vJ DATE & TIMETESTTO N CONDUCTED ICCC * Q52 O S`1 TEST METHOD SICNA RE _ - DATE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED APPROVED DATE FD2095 (Rev 03/08) MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State ofCalifornia Authority Cited: Chapter 6 7, Health andSafety Code; Chapter 16, Division 3, Title 23, California Code ofRegulations This form must be used to document testing and servicing of monitoring equipment A separate certification or report must be Prepared for each monitoring system control Panel by the technician who performs the work. A copy of this form must be provided to the tank system owner /operator. The owner /operator must submit a copy of this form to the local agency regulating UST systems within 30 days oftest date. A. General Information Facility Name: SAM'S LIQUOR Site Address: 801 EAST CALIFORNIA AVENUE Facility Contact Person: SAM Make /Model of Monitoring System: INCON TS 1001 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected /serviced: Bldg. No.: City: BAKERSFIELD Zip: 93307 Contact Phone No.: (661) 861 -1614 Date of Testing/Servicing: 5/10/2013 Tank 1D: REGULAR 87 Tank ID: PREMIUM 91 In -Tank Gauging Probe. Model: MAG In -Tank Gauging Probe. Model: MAG Annular Space or Vault Sensor. Model: LS -3 Annular Space or Vault Sensor. Model: LS -3 Piping Sump / Trench Sensor(s). Model: LS -3 Piping Sump / Trench Sensor(s). Model: LS -3 Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: FX1V Mechanical Line LeakDetector. Model: FX1V Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill / High -Level Sensor. Model: FLAPPER Tank Overfill / High -Level Sensor. Model: FLAPPER Other (specify equipment type and model in Section E on Page 2). Other (specify equipment type and model in Section E on Page 2), Tank ID: DIESEL Tank ID: In -Tank Gauging Probe. Model: MAG In -Tank Gauging Probe. Model: Annular Space or Vault Sensor. Model: LS4 Annular Space or Vault Sensor. Model: y® Piping Sump /Trench Sensor(s). Model: LS-3 Piping Sump / Trench Sensor(s). Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: FX1DV Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill / High -Level Sensor. Model: FLAPPER Tank Overfill / High - Level Sensor. Model: Other (specify equipment type and model in Section E on Page 2). Other (specify equipment type and model in Section E on Page 2). Dispenser ID: 112 Dispenser ID: 314 Dispenser Containment Sensor(s). Model: LS -3 Dispenser Containment Sensor(s). Model: LS -3 Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: 5/6 Dispenser ID: 718 Dispenser Containment Sensogs). Model: LS -3 Dispenser Containment Sensor(s). Model: LS -3 Shear Valve(s). Shear Valve(s). Dispenser Containment Floats) and Chain(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: Dispenser ID: Dispenser Containment Sensor(s). Model: Dispenser Containment Sensor(s). Model: Cl Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification - I certify that the equipment identified in this document was inspected /serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information ^is. correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable ofgenerating such reports, I have also attached a copy of the report; (check all that apply): ® System set -up ® Alarm history report Technician Name (print): RICHARD MASON Signature: 1 _ Certification No.: 5297857 -UT / 636880 License. No.: C61/D40 809850 Testing Company Name: RICH ENVIRONMENTAL Phone No.: (661) 392 -8687 Testing Company Address: 5643 BROOKS CT. BAKERSFIELD, CA. 93308 ' Date of Testing/Servicing: 5/10/2013 Page 1 of 4 IJN -036 —1/4 www.unidoes.org Rev. 01/17/08 1 Monitoring System Certification D. Results of Testing/Servicing Software Version Installed: Comalete the following checklist: Yes No* Is the audible alarm operational? Yes No* Is the visual alarm operational? Yes No* Were all sensors visually inspected, functionally tested, and confirmed operational? Yes No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? Yes No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) N/A operational? Yes No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut -down? (Check all that apply) ® Sump/Trench Sensors; ® Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks gnd sensor failure /disconnection? ® Yes; No. Yes No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e., no N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? % Yes* No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. Yes* No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) Product; Water. Ifyes, describe causes in Section E, below. Yes No* Was monitoring system set -up reviewed to ensure proper settings? Attach set up reports, ifapplicable Yes No* I is all monitoring equipment operational per manufacturer's specifications? In Section E below, describe how and when these deficiencies were or will be corrected. E. Comments: Page 2 of 4 UN -036 — 214 www.unidomorg Rev. 01/17/08 Monitoring System Certification F. In -Tank Gauging / SIR Equipment: Check this box if tank gauging is used only for inventory control. Check this box ifno tank gauging or SIR equipment is installed. This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: Yes No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Yes No* Were all tank gauging probes visually inspected for damage and residue buildup? Yes No* Was accuracy of system product level readings tested? Yes No* Was accuracy of system water level readings tested? Yes No* Were all probes reinstalled properly? Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? In Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): Comnlete the fnllnwinv eheeklict• Check this box ifLLDs are not installed. R Yes No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? N/A Check all that apply) Simulated leak rate: ® 3 g.p.h.; 0.1 g.p.h ; [10.2 g.p.h. Yes No* Were all LLDs confirmed operational and accurate within regulatory requirements? Yes No* Was the testing apparatus properly calibrated? Yes No* For mechanical LLDs, does the LLD restrict product flow ifit detects a leak? 1 N/A Yes No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? N/A Yes No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled N/A or disconnected? Yes No* For electronic LLDs, does the turbine automatically shut off if any portion ofthe monitoring system malfunctions N/A or fails a test? Yes No* For electronic LLDs, have all accessible wiring connections been visually inspected? N/A Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? I In hection H, below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 4 UN -036 — 3/4 www.unidecs.org Rev. 01/17/08 5o b5p Monitoring System Certification UST Monitoring Site Plan Site Address; 801 EAST CALIFORNIA AVE. BAKERSFIELD, CA. 93307 Date map was drawn: Instructions If you already have a diagram that shows all required information, you may include it rather tfum this page, with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly Identify locations of the following equipment, if installed. monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. UN-036-4/4 Page 5 of 5 www.unidoeaorg Rev. 01!19!08 E : C ti`oiZr tzf N1 E.. ............. u S TN : :: : :': L Lr F.. U fn-- M Rco p2ocac... . a rnPd.,Ri?(2 .. . S . . s•3 se Date map was drawn: Instructions If you already have a diagram that shows all required information, you may include it rather tfum this page, with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly Identify locations of the following equipment, if installed. monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. UN-036-4/4 Page 5 of 5 www.unidoeaorg Rev. 01!19!08 5ob36 RICH ENVIRONMENTAL 5643 BROOKS CT. BAKERSFIELD, CA. 93308 OFFICE (661)392 -8687 FAX (661)392 -0621 PRODUCT LINE LEAK DETECTOR TEST WORK SHEET W /0 #: FACILITY NAME: SAM'S LIQUOR FACILITY ADDRESS: 801 E. CALIFORNIA AVE, BAKERSFIELD PRODUCT LINE TYPE: PRESSURE PRODUCT LEAK DETECTOR TYPE TEST TRIP PASS BELOW P.S.I. OR SERIAL NUMBER 3 G.P.H. FAIL REG87 L/D TYPE: FXIV YES 10 PASS SERIAL # 5514 PREM91 LID TYPE: FX1V YES 10 PASS SERIAL # 5513 DIESEL L/D TYPE : FX1DV YES 10 PASS SERIAL # 0268 LID TYPE YES PASS SERIAL # NO FAIL I CERTIFY THE ABOVE TESTS WERE CONDUCTED ON THIS DATE ACCORDING TO RED JACKET PUMPS FIELD TEST APPARATUS TESTING PROCEDURE AND LIMITATIONS. THE MECHANICAL LEAK DETECTOR TEST PASS / FAIL IS DETERMINED BY USING A LOW FLOW THRESHOLD TRIP RATE OF 3 GALLONS PER HOUR OR LESS AT 10 P.S.I. I ACKNOWLEDGE THAT ALL DATA COLLECTED IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. TECHNICIAN: RICHARD ((MASON SIGNATURE: V Yom-- DATE: 05/10/13 ol Sob3l SWRCB, January 2006 Spill Bucket Testing Report Form This form is intendedfor use by contractors performing annual testing of USTspill containment structures. The completedform and printouts from tests (ifapplicable), should beprovided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: SAM'S LIQUOR Date ofTesting: 5/10/13 Facility Address: 801 E. CALIFORNIA AVE. BAKERSFIELD Facility Contact: SAM I Phone: (661) 861 -1614 Date Local Agency Was Notified of Testing: 4/20113 Name ofLocal Agency Inspector (fpresent during testing): ESTHER 2. TESTING CONTRACTOR INFORMATION Company Name: RICH ENVIRONMENTAL Technician Conducting Test: RICHARD MASON Credentials': CSLB Contractor X ICC Service Tech. SWRCB Tank Tester Other (Specify) License Number(s): 5297857 -UT 3. SPILL BUCKET TESTING INFORMATION Test Method Used: X Hydrostatic Vacuum Other Test Equipment Used: VISUAL Equipment Resolution: 0.00 Identify Spill Bucket (By Tank Number, Stored Product, etc.) 1 REG87 -FILL 2 PREM91 -FILL 3 DIESEL FILL 4 Bucket Installation Type: X Direct Bury Contained in Sump X Direct Bury 0 Contained in Sump X Direct Bury 7 Contained in Sump 0 Direct Bury Contained in Sum Bucket Diameter. 12" 12" 12" Bucket Depth: 12" 12" 12" Wait time between applying vacuum/water and start oftest: 30 MIN 30 MIN 30 MIN Test Start Time (T,): 9:15 9:15 9:15 Initial Reading (Rj): 10" 10" 10" Test End Time (TF): 10:15 10:15 10:15 Final Reading (RF): 10" 10" 10" Test Duration (TF — Ti): 60 MIN 60 MIN 60 MM Change in Reading (RF- Ri): 0 0 0 Pass/Fail Threshold or Criteria: 0.00 0.00 0.00 Test Result: X Pass Fail X Pass Fail X Pass Fail D Pass Fait Comments — (include information on repairs made prior to testing, andrecommendedfollow -upforfailed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true, accurate, and infull compliance with legal requirements. Technician's Signature:_ f/ Date: 5/10/13 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. SPECIAL TANKS 8:22 AM SPECIAL 1 DIESEL DIAMETER 111.098 LENGTH 288-000 CORRECTION PTS. 0 PROBES PRODUCT USAGE DETAIL PROBE 1 NONE TYPF. STD 125 GRADIENT 9.08724 RATIO 1:1 TIP TO HEAD FLOATS 2 FLOATS FLOAT TYPE OIL PROBE 2 TIME 3 12:00 TYPE STD 125 GRADIENT 9.08348 RATIO 1:1 TIP TO HEAD FLOATS 2 FLOATS FLOAT TYPE GASOLINE PROBE 3 SCHEDULE ' TYPE. STD 125 GRADIENT 8.99232 RATIO 1:1 TIP TO HEAD FLOATS 2 FLOATS FLOAT TYPE GASOLINE PRODUCTS DELIVERY HISTORY PRODUCT J. SCHEDULE NAME DIESEL TYPE DIESEL PRODUCT 2 SCHEDULE NAME. PROD 91 TYPE UNLEADED SUP PR=!CT 3 ALARM HISTORY NAME 87 TYPE UNLEADED REG REPORT SCHEDULES INVENTORY 8:22 AM PRODUCT DETAIL DIESEL SCHEDULE NONE PRODUCT SUMMARY PRODUCT PRODUCT 1 SCHEDULE NONE PRODUCT USAGE DETAIL SCHEDULE NONE PRODUCT USAGE SUMMARY SCHEDULE NONE TANK DETAIL 95.0% SCHEDULE SHIFT TIME 1 5:00 AM TIME 2 12:00 AM TIME 3 12:00 AM SEND TO FAX NO SEND TO PRINTER YES TANK SUMMARY LOW LOW 04 SCHEDULE NONE R£. NCILIATION WATE.P 0/0 SCHEDULE ' HONE DELIVERY NAME' PRODUCT DETAIL TANK SHAPE HORIZONTAL SCHEDULE NONE PRODUCT SUMMARY PRODUCT PRODUCT 2 SCHEDULE NONE DELIVERY HISTORY 3.500 SCHEDULE NONE ALARMS 200 ACTTVE ALARMS 95.009 SCHEDULE NONE CLEARED ALARMS 98.000 SCHEDULE NONE ALARM HISTORY 1200.0 SCHEDULE NONE SENSOR STATUS 580.0 SCHEDULE NONE REGULATORY 4.M SCHEDULE NONE TANKS NUMBER OF TANKS TANK 1 8:22 AM NAME DIESEL TANK SHAPE HORIZONTAL TANK TYPE SPECIAL i PROBE PROBE 1 PRODUCT PRODUCT 1 MANIFOLD NOW PROD OFFSET 1.000 WATER OFFSET 1.000 DEL THRESHOLD 200 HIGH HIGH LIM 95.0% HI(;H HIGH 0/6 NONE HIGH LIMIT 90.080 HIGH LIMIT 0/0 NONE LOW LIMIT 1200.0 LOW LIMIT 0/6, NONE LOW LOW LIMIT 500.0 LOW LOW 04 NONE WATER LIMIT 3.m WATE.P 0/0 NOW TANK 2 NAME' PREMIUM TANK SHAPE HORIZONTAL TANK TYPE SPECIAL 1 PROBE PROBE 2 PRODUCT PRODUCT 2 MANIFOLD NONE PROD OFFSETS 3.500 WATER OFFSET 1.000 DEL THRESHOLD 200 HIGH HIGH I_IM 95.009 HIGH HIGH 0/G NONE HIGH LIMIT 98.000 HIGH LIMIT 0/6 NONE LOW LIMIT 1200.0 LOW LIMIT O/G NONE LOW LOW LIMIT 580.0 I.OW LOW 016 NONE WATER LIMIT 4.M WATER 0/0 NONE TANK 3 NAME UNL TANK SHAPE HORIZONTAL TANK TYPE SPECIAL 1 PROBE PROBE 3 PRODUCT PRODUCT 3 MANIFOLD NONE PROD OFFSET 2.500 WATER OFFSET 1.080 DEL. THRESHOLD 200 HIGH HIGH LIM 95.M HIGH HIGH 0/6 NONE HIGH LIMIT 90.080 HIGH LIMIT 0/0 NONE LOW LIMIT 1200.0 LOW LIMIT 0/6 NONE LOW LOW LIMIT 500.0 LOW LOW 0/G NONE WATER LIMIT 4.000 WATER 0/0 WhNF Soto3tn SAMS GAS LIMOR 801 E CALIF AVE BAKERSFIELD CA 93307 661 -961 -1614 05/10/2013 8:22 AM SYSTEM SETUP REPORT SYSTEM INFO DATE STYLE FTWARE DAYLI)HT SAV PART TIP /4 VERSION 5.000 RELEASED 0705/2006 SYSTEM ID SEE ABOVE MEASUREMENT UNITS CORRECTION TEMP 60.0 USAGE PERCENT 95 VOLUME GALLONS LEVEL INCHES TEMPERATURE FAHRENHEIT PRERSURE PSI CL.00K/CALENDAR TIME STYLE 12 HOUR DATE STYLE MM/DD/YY DAYLI)HT SAV ENABLED SET TIME 8 :23 AM SET DATE 05/10/2013 SENTINEL MODE MODE SCHEDULED START TIME 1:00 AM END TT.MF 3:00 AM REPORT PRINT ENABLES DE'L.TVERIES ENABLED ALARMS ENABLED LEAK TESTS ENABLED LIMITS LEAK LIMIT 2.00 LEAK LIMIT-O/G NONE THEFT- L.IM7T ' 50.00 THEFT LIMIT 0/6 NONE MISCELLANEOUS SYSTEM FAIL ALL GROUPS DELIVERY DELAY 15 HISTORY LENGTH 50 PRINT INTERVAL 1 BUSY SUPPORTED NO USER THRESHOLD 0 CATHODIC PROTECTION ENABLED NO ADDRESS 112 CURRENT LIMIT 10.8 CURRENT 00 NONE AUXILIARY INPUTS INPUT 1 ACTIVE CLOSED NAME AUXILIARY 1 Ali{ INPUT O/G NOW INPUT 2 ACTIVE CLOSED NAME AUXILIARY 2 AUX INPUT 0/0 NONE TS-ROM GRACE PERIOD 0 CHANNEL 1 OUTPUT GROUPS A -P —YY Q--FF CHANNEL 2 OUTPUT GROUPS A-P -YYY- QfF CHANNEL 3 nUTPUT rAnn A -P Y —Y - Q-FF CHANNEL 4 OUTPUT GROUPS A-P QfF CHANNEL 5 OUTPUT GROUPS A -P — QfF CHANNEL 6 OUTPUT GROUPS A-P QfF CHANNEL 7 OUTPUT GROUPS A-P ----- Q-FF CHANNEL S OUTPUT GROUPS Q-FF RELAYS RELAY 1 TIMEOUT 15OUTPUTGROUPS A -P Q-PF RELAY 2 TIMEOUT 15OUTPUTGROUPSA-P Q-FF SENSORS NUMBER OF SENSORS 12 EN 1 AY NAME STD Oro FOR 2 NAME STD OrG SENSOR 3 RELAY NAME STD O/G SENSOR 4 RELAY NAME STD OrG SENSOR 5 RELAY Nw STD as SENSOR 6 RELAY NM STD SENSOR7 RELAY NAME STD Ors SENSOR B RELAY NAME STD Oro SENSOR 9 RELAY NAME STD o/o SENSOR 10 RELAY NAME STD oiG SENSOR 11 RELAY NAME STD OIG SENSOR. 12 NAME RELAY STD OIG TPZ ENABLED ADDRESS STD NO DIESEL SL p GROUP A NO RELAY 91 STP GROUP B STD NO RELAY 67 STP GROUP C STD NO RELAY SENSOR NONE STD NO RELAY DIESEL ANN GROUP E STD NO RELAY 87 ANN GROUP E NO RELAY 91 ANN GROUP E STD NO RELAY SENSOR NONE 8 REL SSTD cRU'$ STD NO RELAY DISP 3-4 GROUP D NO RELAY DISP 5-6 GROUP D STD NO RELAY DISP 7 -8 GROUP D NO 80 COMM PORTS M S 1 DE BAUD NATIVE DATA BITS 9600 BAUD STOP BITS 8 BITS 1 STOP BITPARITY SECURITY NO PARITY OM PORT 2 MODE BAUD NATIVE DATA BITS 9600 BAUD BITSSTOPBITS PARITY Sr8 t OP BIT SECURITY NO PARITY PHONE 11 REDIAL 1 ACCESS 2 DISABLED PHONE 2 REDIA_ 2 ACCESS 3 DISABLED PHONE i REDIAL 3 ACCESS 4 DISABLED PHONE 4 REDIAL 4 DIAL DELIU DISABLED DIAL ALARM DIAL LEAK LEAK TERTS CONFIDENCE 95.8/ MIN TEST TIME 2MAXTESTTIME4LEAKTEST TANK 1 0.28TANK28. TANK 3 0.28TESTSCHEDULESTANK1 TSIC14DULE 28TH DAY TANK 2 199 AM TS DULE 28TH Djw TAM( 1:00 AM SCHEDULE 28TH DAY ALARM ON TEST FAIL b No ANNUNCIATORS- MODULATED ANNUNCIATORTIMEOUT 9 POUTPUT GROUPSA— __• —, SOLID ANNUNCIATORTIMEOUT 8OUTPUTGROUPS Q-FF - SAMS GAS LICILIQRpwFcm- IP K17 RAKERSFIELD CA 93367 661-861 -161.4 95/10/20 1 3 *-;.. 315 AM SENSOR ALARMS P5/10/201' 9:23 AM F7,ANDARD SENSOR cASOR 40. OF%/19/20113 9:20 AN, STANDARD SENSOR 9:22 AN. DTS-P 1-2 SENSOR NO. 9 1-11?/21013 9:16 AM STANDARD SENSOR 9:21 At,: DTESEL ANN SENSOR NO. 5 P9/10/2013 9:16 PT'll STANDARD SENSOR 9:20 ple 9.,, ANN SENSOR NO. 7 05/1 A/201 ' ' I 4;14 AM STANDARDD ESOR 9:20 FIPi P-? ANN SENSOR NO. 6 P5 /IA/?pi3 9:13 Am STANDARD SENSOR 20 P7 qTV SENSOR F40. 3 05/10/2iB13 5:12 AM STANDARD SENSOR Sl STP l:rESWR NO. 2 O5 /I A1,;44 t7 921? AM STANDARD SENSOR DTrs,. SFi- STP SENSOR NO. 1 09/10/2013 q:!-? pm RD SESSENSORSTANDI, qTP SFNSOR NO. 1 SAMS GAS LICILIQRpwFcm- IP K17 RAKERSFIELD CA 93367 661-861 -161.4 95/10/20 1 3 *-;.. 315 AM SENSOR ALARMS P5/10/201' 9:23 AM F7,ANDARD SENSOR f.)!SP 7—P SENSOR NO. 12 99/io/2013 9:22 AN. STANDARD SENSOR SENSOR N0, ti P5/10/2013 9:21 At,: STANDARD SENSOR SENSOR NO. 10 915/1,0/2013 9:20 ple STANDARD SENSOR D?SP '.-2 SENSOR NO. 9 A5lli0/?915 9:20 FIPi STANDARD SENSOR SENSOR NO. 9 95/10/2013 20 STANDARD SENSOR DTSP C506,5i. a. IA74 5010310 MONITOR CERT. FAILURE REPORT SITE NAME: SAM'S LIOUOR DATE: 5110113 ADDRESS: 801 E. CALIFORNIA AVE. TECHNICIAN: RICHARD MASON CITY : BAKERSFIELD SIGNATURE: yr~ _ THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE TESTING. REPAIRS: NONE LABOR: NONE PARTS INSTALLED: NONE NAME: TITLE: SIGNATURE THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON - COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN LEFT ON -SITE FOR YOUR CONVIENENCE.