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Home My WebLink About6100 DISTRICT BOULEVARD (3)z5S MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions VYlthin the State of California Authority Cited. Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations 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 forth to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: Fed Ex Bldg. No.: Site Address: _6100 District Blvd City: _Bakerefleid Zip: _93313 Facility Contact Person: _Chris Contact Phone No.: (_681 _)_837 -0995 Make/Model of Monitoring System: _Vaeder Root TLS -300c Date ofTesting /Servicing: 06 / 12!_2012 B. Inventory of Equipment Tested /Certified Check the appropriate boxes to Indicate specific equipment Inspectediserviced; Tank ID: Diesel Tank ID: In -Tank Gauging Probe. Model: X In -Tank Gauging Probe. Model: _847390 -109 X Annular Space or Vault Sensor. Model: 794390 -420 El Annular Space or Vault Sensor. Model: X Piping Sump / Trench Sensor(s). Model: 794380 -208 Piping Sump / Trench Sensor(s). Model: X Fill Sump Sensor(s). Model: 794380 -208 Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: X Tank Overflll / Hlgh -Level Sensor. Model: 847390 -109 D Tank Overfill / High -Level Sensor. Model: Other (specify equipment and model in Section E on Pa 122). Other (a22cIfy equipment a and model in Section E on Pe 2). TanklD: TanklD: In -Tank Gauging Probe. Model: In -Tank Gauging Probe. Model: D AnnularSpace or Vault Sensor. Model: Annular Space orVault Sensor. Model: Piping Sump / Trench Sensor(s). Model: Piping Sump /Trench Sensor(s). Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: D Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill / High -Level Sensor. Model: Tank Overfill / Hlgh -Level Sensor. Model: Other (specify e u men} and model In Section E on Pa 2). Others a ui ment a and model In Section Eon Pa e 2). Dispenser ID: _Diesel Dispenser ID: X Dispenser Containment Sensor(s). Model: 847390 -109 Dispenser ContainmentSensor(s). Model: X Shear Valve(s). Shear Valve(s). X Dispensw Containment Floats and Chain(s). Dispenser Containment Flost s and Chain(s). Dispenser 10: DiepenserID: DispenserContainment Sensor(s). Model: Dispenser Containment Sensor(s). Model: Shear Valve(s). Shear Valve(s). D Dls nserContainment Floats and Chain a . Dis er Containment Floats and Chaln s . Dispenser ID: Dispenser ID: DispenserContainment Sensor(s). Model: Dispenser Contalrmenl Sensor(s). Model: Shear Valve(s). ShearValve(s), Dispenser Containment Flost B 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 atthe facility. C. Certiflcatlon - 1 ce" that the equipment Identified In this document was Inspectedlserviced 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 of generating such reports, I have also attached a copy of the report; (check all that apply): X System set -up X Alarm history report Technician Name (print): Jerry Rancel Signature: Certification No.: ICC: 5309489. Veeder Root: 635460 Llcense24 .: 9261733A. Hez Testing Company Name: _Cal-Valley Ecuipment Phone No.:(_861,_327 -9341 Testing Company Address: 3500 Gilmore Avenue. Bakerafleld. CA. 93308 Date ofTeatirg/Servicing: 08 / 12 /_2012 Monitoring System Certification Page 1 of 4 12107 2/21/07 D. Results of Testing/Servicing Software Version Installed: 421.00 Comolate the followlno checklist: X Yes No' Is the audible alarm operational? X Yes No' Is the visual alarm operational? X Yes No' Were all sensors visually Inspected, functionally tested, and confirmed operational? X Yes No' Were all sensors Installed at lowest point of secondary containment and posMoned so that other equipment will not interfere with their proper operation? X Yes No' If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? N/A Yes No' For pressurized piping systems, does the turbine automatically shut down If the piping secondary containment monitoring system X WA detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors Initiate positive shut -down? (Check all that apply) Sumpr'rrench Sensors; Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks Ing sensor faifureldisconnedlon? Yes; No. X Yes No' For tank systems that utllize the monlloring system as the primary tank overfill warning device (Le. no mechanical overfill prevention WA valve Is installed), is the overfill waming alarm visible and audible at the tank fill point(s) and operating property? If so, at what percent oftank capacity does the alarm ftner? 90% Yea' X No Was any monftorft 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* X No Was liquid found inside any secondary containment systems designed as dry systems? (Check allthat apply) Product 0 Water. If es describe causes In Section E, below. X Yes 0 No' Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, If applicable X Yes 0 No' Is all monitoring equipment operational per manufacturer'sspedficatlons? In Section E below, describe how and when these deficiencies were or will be corrected. Comments: Monitoring System Certification Page 2 of 4 12107 2/21/07 F. In -Tank Gauging/ SIR Equipment: Check this box if tank gauging is used only for inventory control. 0 Check this box If no tank gauging or SIR equipment is Installed. This section must be completed If In -tank gauging equipment is used to perform leak detection monitoring. Cemnlafa tha fnllewinn chackllat X Yes No' Has all Input wiring been Inspected for proper entry end termination, including tearing for ground faults? X Yes No` Were all tank gauging probes visually inspected for damage and residue buildup? X Yes No' Was accuracy of system product level readings tested? X Yes No' Was accuracy of system water level readings tested? X Yes No` Were all probes reinstalled properly? 11E es No' I Were all items on the equipment manufacturer's maintenance checklist completed? In ale aecilon h, Delaw, oescriDe new ana when inese aenclencies were or Win De correctea. G. Line Leak Detectors (LLD): X Check this box if LLDs are not installed. Cmmnlpfn fha fnllnudnn rhackilaf, Yes No' For equipment start -up or annual equipment certification, was a leek simulated to verify LLD performance? (Check all N/A that apply) Simulated leak rate: 3 g.p.h.; 0.1 g.p.h ; 0.2 g.p.h. Yes No' Were all LLDa 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 if it detects a leak? WA 0 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 or 0 WA disconnected? Yes No' For electronic LLDs, does the turbine automatically shut off If any portion of the monitoring system malfunctions or N/A fails a test? Yes No' Forelectronic LLDs, have all accessible wiring connections been visually inspected? NIA Yes No' Were all items on the equipment manufacturer's maintenance checklist completed? In ine aecaon n, D61aw, oescnae new ana wren mass aenciencles were or mu De correctea. H. Comments: Monitoring System Cartlflcatton Page 3 of 12/07 3 2/21/07 Monitoring System Certification UST Monitoring Site Plan Site Address: %100 il6+t ,Gfi ry ( v,n . ric.60. . %A.r4A ...... ............ Monl r . . . . . . . . . . . . . SFAS-. . . . . . . . .I . . . . . . . . . . . . 79y o.: Z'.. i/o( . . . . . . . . . . . . . . . . . . . . . . I.......... I . . . . . . . . . . . . I.................. to .. . .. . . . . . . . . . . . . . 1%4).3q R (.. -'I . . . . . . . . . . . . . . . SLry+S'ot. ..... ......................... 7q.y3yo..y,, . I........... Fm ..................... 4 . . . A ^.^ .•u tom . . . . . . . . . . . . . . . . i4y -346 y 7;,7. . . . . . . . . . . . . . . I ........... I................ I ....................... Date map was drawn: 00/1212012. Instructions If you already have a diagram that shows all required Information, you may Include it, rather than 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 pane, 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. Monitoring system Certificatlon Page 4 of 4 12/07 4 2/21/07 SYSTEM -SETUP - - - - - - COMMUNICATIONS SETUP - - AUTO DIAL TIME SETUP: JUN 12, 2012 8:19 AM SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH SYSTEM DATE /TIME FORMAT MON DD YYYY HH:MM:SS xM 265022 FEDEX FREIGHT 6100 DISTRICT BLVD BAKERSFIELD CA SHIFT. IME I DISABLED SHIFT TIME 2 DISABLED SHIFT TIME 3 DISABLED SHIFT TIME 4 DISABLED TANK PER TST NEEDED WRN DISABLED TANK ANN TST NEEDED WRN DISABLED LINE PER TST NEEDED WRN DISABLED LINE ANN TST NEEDED WRN DISABLED PRINT TC VOLUMES ENABLED TEMP COMPENSATION VALUE (DEC F ): 60.0 STICK HEIGHT OFFSET DISABLED H- PROTOCOL DATA FORMAT HEIGHT DAYLIGHT SAVING TIME ENABLED START DATE MAR WEEK 3 SUN START TIME 2:00 AM END DATE NOV WEEK 1 SUN END TIME 2:00 AM RE- DIRECT LOCAL PRINTOUT DISABLED EURO PROTOCOL PREFIX 8 SYSTEM SECURITY CODE : 000000 PORT SETTING;: COMM BOARD 1 (FXMOD) BAUD RATE 2400 PARITY ODD STOP BIT : 1 STOP DATA LENGTH: 7 DATA RS -232 SECURITY CODE : DISABLED DIAL TYPE TONE ANSWER ON I RING MODEM SETUP STRING DIAL TONE INTERVAL: 32 COMM BOARD 2 (RS -232) BAUD RATE 1200 PARITY ODD STOP BIT 1 STOP DATA LENGTH: 7 DATA RS -232 SECURITY CODE : DISABLED AUTO TRANSMIT SETTINGS: AUTO LEAK ALARM LIMIT DISABLED AUTO HIGH WATER LIMIT DISABLED AUTO OVERFILL LIMIT DISABLED AUTO LOW PRODUCT DISABLED AUTO THEFT LIMIT DISABLED AUTO DELIVERY START DISABLED AUTO DELIVERY END DISABLED AUTO EXTERNAL INPUT ON DISABLED AUTO EXTERNAL INPUT OFF DISABLED AUTO SENSOR FUEL ALARM DISABLED AUTO SENSOR WATER ALARM DISABLED AUTO SENSOR OUT ALARM DISABLED RECEIVER SETUP: D 8:VEEDER ROOT (FMS) 1- 866 - 743 -8379 RCVR TYPE: COMPUTER PORT NO: 1 RETRY NO: 5 RETRY DELAY: 5 CONFIRMATION REPORT: OFF D 8:VEEDER ROOT (FMS) DIAL WEEKLY FRI DIAL TIME : 4:44 PM RECEIVER REPORTS: RS -232 END OF MESSAGEDISABLED AU'P'0 DIAL ALARM SETUP D B:VEEDER ROOT (FMS) IN -TANK ALARMS ALL:LEAK ALARM ALL :HIGH WATER ALARM ALL:OVERFILL ALARM ALL :LOW PRODUCT ALARM ALL:SUDDEN LOSS ALARM ALL:HIGH PRODUCT ALARM ALL:INVALID FUEL LEVELALL:PROBE OUT ALL:HIGH WATER WARNING ALL:DELIVERY NEEDED ALL:MAX PRODUCT ALARM ALL:GROSB TEST FAIL ALL:PERI D1C TEST FAIL ALL:ANNU L TEST FAIL ALL:NO CSLD IDLE TIME ALL:CSLD INCR RATE WARN ALL :ACCU_CHART CAL WARNALL:RECON WARNING ALL:RECON ALARM ALL :LOW TEMP WARNING ALL:GROSS FAIL LINE TNK LIQUID SENSOR ALMS ALL-:FUEL ALARM ALL:SENSOR OUT ALARM ALL:SHORT ALARM, ALL:WATER ALARM ALL :WATER OUT ALARM ALL:HIGH LIQUID ALARM ALL:LOW LIQUID ALARM ALL:LIQUID WARNING EXTERNAL INPUTS ALL:EXTERN INPUT ALARM RECEIVER ALARMS SERVICE REPORT WARN ALARM CLEAR WARNING IN -TANK SETUP T I:DIESEL 5.0 PRODUCT CODE 1 THERMAL COEFF 000450 TANK DIAMETER 109.50 TANK PROFILE 1 PT FULL VOL 12000 FLOAT SIZE: 4.0 IN. WATER WARNING 5.0 HIGH WATER LIMIT: 5.0 MAX OR LABEL VOL. 12000 OVERFILL LIMIT 909 10800 HIGH PRODUCT 950/0 11400 i DELIVERY LIMIT 5% 600 LOW PRODUCT 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT 0.00 MANIFOLDED TANKS TO: NONE DELLIVERY DELAY : 5 MIN LIQUID SENSOR SETUP L 1:ANNULAR TRI -STATE (61NGLE FLOAT) CATEGORY : ANNULAR SPACE L 2:DISPENSER TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L 3:BOUTH.SUMP TRI -STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 4:NORTH SUMP TRI -STATE (SINGLE FLOAT) CATEGORY : STP SUMP EXTERNAL INPUT SETUP NONE OUTPUT RELAY SETUP - - - R 1:REMOTE ALARM TYPE: STANDARD NORMALLY OPEN IN -TANK ALARMS ALL:OVERFILL ALARM ALL:LOW PRODUCT ALARM ALL:HIGH PRODUCT ALARM ALL:PROBE OUT ALL:HIGH WATER WARNING ALL :DELIVERY NEEDED ALL:MAX PRODUCT ALARM LIQUID SENSOR ALMS ALL:FUEL ALARM ALL:SENSOR OUT ALARM ALL:SHORT ALARM ALL :WATER ALARM ALL:HIGH LIQUID ALARM ALL:LOW.LIQUID ALARM ALL:LIQUID WARNING R 2:POSITIVE SHUTOFF TYPE: STANDARD NORMALLY OPEN NO ALARM ASSIGNMENTS - SOFTWARE REVISION LEVEL VERSION 421.00 SOFTWARE# 346421 -100 -A CREATED - 00.11.15.13.40 NO SOFTWARE MODULE ALARM HISTORY REPORT SYSTEM ALARM - - - -- PAPER OUT APR 13. 2012 10:10 AM PRINTER ERROR APR 13, 2012 10:10 AM BATTERY IS OFF JAN 1. 1996 8:00 AM x x x x x END x x x x x ALARM HISTORY REPORT IN -TANK ALARM. - T I:DIESEL OVERFILL ALARM JUN 12. 2012 8:51 AM DEC 13, 2010 12:57 PM SEP 16. 2009 1:21 PM LOW PRODUCT ALARM MAR 6. 2008 12:25 AM HIGH PRODUCT ALARM JUN 12. 2012 8:51 AM APR 8. 2011 4:03 PM MAR 15, 2010 1:35 PM INVALID FUEL LEVEL JUN 12, 2012 . 8:14 AM APR 8, 2011 4:03 PM MAR 15, 2010 1 :35 PM PROBE OUT JUN 12, 2012 9:16 AM JUN 12, 2012 8:12 AM APR 8, 2011 4:04 PM DELIVERY NEEDED MAR 6, 2008 12:15 AM MAX PRODUCT ALARM JUN 12, 2012 8:51 AM APR 8. 2011 4:03 PM MAR 15. 2010 1 :35 PM LOW TEMP WARNING JUN 12, 2012 9:18 AM xxxXX END * *x *x ALARM.HISTORY REPORT SENSOR ALARM - - - -- L 1:ANNULAR ANNULAR SPACE FUEL ALARM JUN 12, 2012 9:00 AM FUEL ALARM JUN' 12": 2012 E:54 AM FUEL ALARM JUN 12, 2012 8:54 AM END ALARM HISTORY REPORT SENSOR ALARM - - - -- I L 2:DISPENSER DISPENSER PAN FUEL ALARM JUN 12, 2012 9:01 AM FUEL ALARM`% APR B. 2011 4:09 PM SENSOR to ALARM MAR 15. 10 1:44 PM Axxxx END xxxxx ALARM HISTORY REPORT., SENSOR ALARM - - - -- L 3 :8OUTH SUMP STP SUMP FUEL ALARM JUN 12. 2012 9:00 AM FUEL ALARM MAY 3, 2011 10:46 AM FUEL ALARM MAY 3. 2011 10 :43 AM xxxAX END xxxxx ALARM HISTORY REPORT; SENSOR ALARM L 4 :NORTH SUMP STP SUMP FUEL ALARM JUN 12. 2012 9:00 AM FUEL ALARM APR 8, 2011 3:59 PM FUEL ALARM MAR 15. 2010 1:32 PM x x x x x END x x x x x SWRCB, January 2006 Spill Bucket Testing Report Form Thisform is intendedfor use by contractors performing annual testing of USTspill containment structures. The completedform and printoutsfrom tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: Fed Ex Date ofTesting: 06/12/12 Facility Address: 6100 District Blvd., Bakersfield, CA. 93313 Facility Contact: Chris I Phone: 661 - 837 -0995 Date Local Agency Was Notified of Testing: 06/01/12 Name ofLocal Agency Inspector (ifpresent during testing): Esther Duran 2. TESTING CONTRACTOR INFORMATION Company Name: Cal- Valley Equipment Technician Conducting Test: Jerry Rangel Credentials': CSLB Contractor X ICC Service Tech. SWRCB Tank Tester Other (Specify) License Number(s): 5309489 -UT 3. SPILL BUCKET TESTING INFORMATION Test Method Used: X Hydrostatic Vacuum Other Test Equipment Used: Measuring Tape Equipment Resolution: '/4" Identify Spill Bucket (By Tank Number, Stored Product, etc. 1 Diesel till 2 3 4 Bucket Installation Type: Direct Bury X Contained in Sump Direct Bury Contained in Sump Direct Bury Contained in Sump Direct Bury Contained in Sump Bucket Diameter: 11" x 12" Bucket Depth: 11" Wait time between applying vacuum/water and start oftest: 15 minutes Test Start Time (TO: 8:30 am Initial Reading (R): 5%11 Test End Time (TF): 9:30 am Final Reading (RF): 53 /," Test Duration (TF — TO: 1 hour Change in Reading (RF - R4): None Pass/Fail Threshold or Criteria: No Ioss of level Comments — (include information on repairs made prior to testing, andrecommendedfollow -upforfailed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING Ihereby certo that allthe information contained in this report is true, accurate, and In fill compliance with legal requirements. Technician's Signature: ( /.,r — A"- -,—.., f `- Date:-06/12/12 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent.