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HomeMy WebLinkAbout4200 ASHE ROAD (12)fv3"lb MONITORING SYSTEM CERTIFICATION For Use ByAll: Jurisdictions Within the State ofCalifornia Authority Cited. • Chapter 6.7; Health and Safety 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 iCD A Rlt t, be pramEgg for each monitoring system contrDl Mel by the technician who performs the work. A copy ofthis form must.be provided to the tank system owner /operator. The owner /opemor must submit a copy ofthis.form to, the local agency regulating UST`systems within 30 days oftest date. 4 A. General Information Facility Name: PANAMA BUENA VISTA U.S.D. Site Address: 4200 ASHE RD. City: BAKERSFIELD Zip: 93313 Facility Contact Person: VICKI 'STALNAKER Contact Phone No.: ) Make/Model of Monitoring System: TLS.350 INSP.- ESTER AND ERNIE Date ofTesting/Servicing: 3/412011 Bldg. No.: B. Inventory of Equipment Teste&Certified rh"k the annrnnrisatp hmpt to in&"tp sneeIrw enninment tnmeeted /aprviovd: Tank ID: REGULAR 87 Tank 1[D: DIESEL In-Tank Gauging Probe. Model: MAG in -Tank Gauging Probe. Model: MAG Annular Space or Vault Sensor. Model: 420 AnnularSpace;or VaultSensor. Model :_ 420 Piping Sump/ Trench Smsor(s). Model: 208 Piping Sump / Trench Sensor(s). Model; 208 Fill Sump Sensor(s). model. Fill Sump Sensor(s). Model• Mechanical Line leakDeuoctor. Model: FX1V Mechanical Liao LeakDetector. Model: FX1 D1/ Electronic Line Leak Detector. Model: Electronic LineLeak Detector.. Model: 0-Tank Overfill / Hiigh -Level Sensor. Model: MAGI E.OA Tank Overfill / High -Level Sensor. Model: MAGI E.O.A. Other (specify equipment type and model in Section E on Page,2). Other. (specify equipment type and model in,Section E on Page2). Tank ID: WASTE OIL TankID: In -Tank Gauging Probe. Model: MAG In-Tank Gauging Piobi:. Model: . Annular Space or Vault Sensor. Model: 420 Annular Space orVaultSensor. Model: Piping Sump / TrenchSensor(s). Model: Piping Sump / Trench Sensor(s). Model: THFSump Sensor(s). Model: 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: Tank Overfill /.High-Level Sensor. Model: WA Tank Overfill / High -Level Sensor. Model: Other (specify equipmenttype and model in Section E on Page4 Other (specify equipment type and model in Section E,on Page 2). Dispenser ID: 112 Dispenser ID : 314 Dispenser ContainmentSensor(s). Model: 208 Dispenser Containment Sensor(s). Model: 208. Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s). DispenserContainment Float(s) and Chain(s). Dispenser ID: Dispenser ID: Dispenser Containment Sensor(s). Model: DispenserContainment Sensor(s). Model: C] ShearValve(s). ShearValve(s). C] Dispenser Containment Float(s) and Chain(s). Dispemsor Containment Float(s) and Chain(s). Dispenser ID: Dispenser ID: Dispenser Containment Sensor(s). Model: Dispenser Containment Sensor(s). Model: Shear Valve(s). ShearValve(s). DispenserContainment.Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s).. Ifthe 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 PlotPlan showing the:layout of monitoring a uipment. For any. equipment capable of generating: such reports. I have also attached a copy of the report; (chmk allthat apply): System set -up , Alarm history report Technician Name (prim): STEVEN OBERT Signature: Certification No.: A2M1 18029980 -UT License. No.: C611 D40 '809850 Testing Company Name: RICH ENVIRONMENTAL Phone No.: (661) 326.8402 Testing Company Address: 3305 BRfTTAN RD. BAKERSFIELD, CA. 93308 Date ofTesting/Serdicing: 3/4/2011 Page 1 of 6. UN -036 — 114 www.unidocs.org Rev. 01117/08 Monitoring System Certification D. Results ofTesting/Servicing Software Version Installed: 329.01 rmmnlete the tntlnwino ehoekl st! o3lb 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 ofsecondary containmcnt_and positioned so that other equipment will not interferemith 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 —and 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 operatingproperly? Ifso, at what.percent oftank capacity does.the alarm trigger?. W/o Yes* No Was any monitoring equipment replaced? Ifyes, 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,_if applicable Yes 1.0 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 5 UN -036 — 2/4 www.unidoes.org Rev..Ot/17/08 Monitoring System Certification tJo31b F. In -Tank Gauging / SIR Equipment: ®Check.this box if tank gauging is used only for inventory control. Check this box if no tank gauging or SIR equipment is installed. This section must be completed ifin -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 p No* Were all tank gauging.probes visually inspected for,damage . and residue buildup? Yes No* Was accuracyofsystem 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 Sectiowl%. below, describe bow and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): [] Check :this•box ifLLDs are not installed Comnlete the fnlinwina eherkliat! 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: 19 3 g.p.h.; [:10. 1 : g p.h ; 02 g.p.h. Yes No* Were all LLDs confirmed operational.and accurate within regulatory. requirements? Yes No* Was the testing apparatus properly calibrated? g Yes No* For mechanical LLDs, does theLLD restrict product -flow ifit detects a leak? N/A Yes No* For electronic. LLDs, does -the turbine automatically shut offifthe LLD detects a leak? g NIA Yes No* For electronic LLDs,.does the turbine automatically shut off if any portion ofthe monitoring:system is disabled g N/A . or disconnected? Yes No* For electronic LLDs, does the turbine automatically shut off ifany portion ofthe monitoring system malfunctions g N/A or fails a test? Yes No* For electronic LLDs; have all accessible wiring connections been visually inspected? g N/A Yes No* Were all items on the equipment manufacturer'smaintenance checklist completed? In Section H, below, describe how and when these •deficiencies .were or will be corrected: H. Comments: Page 3 of 5 UN-036 -314 www.unidomorg Rev. 01/17/08 Monitoring,System Certification Form: Addendum for Vacuum/Pressu"re Interstitial Sensors I. Results of Vacuum/Pressure Monitoring Equipment Testing 90110 This page should be used to document testing and 'servicing of vacuum and pressure interstitial sensors. A. copy of this form must be included with the Monitoring System Certification Form, which must be provided to the tank system owner /operator: The owner /operator must submit a copy of the Monitoring System Certification Form to the local agency regulating UST systems within 30. days oftest date. Manufacturer: NIA Model: System Type: Pressure; [] Vacuum Sensor ID Component(s) Monitored bythis Sensor: Sensor Functionality Test Result: Pass; Fail Interstitial Communication T est:Result Pass; Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Result :. []'Pass; [ Fail Interstitial Communication TestResult: Q Pass; Fail Component(s) Monitored, by this Sensor: Sensor Functionality Test Result: Pass; Fail:. Interstitial Communication Test Result: Pass; Fail Component(s) Monitored by this Sensor:, Sensor Functionality Test Result: Pass; Fail Interstitial Communication Test Result: Pass; Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Result: Pass; Fail Interstitial Communication Test Result: Pass; Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Result: Pass; Fail Mterstitial Communication Test Result: Pass; Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Resul Pass; [:].Fail Interstitial Communication Test Result: Pass; Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Result: Pass; Fail Interstitial Communication Test Result: . Pass; Fail Component(s) Monitored by this Sensor: Sensor Functionality Test Result[] Pass; . Fail Interstitial'Communication Test Result: Pass; Fail Component(s) Monitored by this Sensor. Sensor.Functionality Test Result:. Pass; E] Fail Interstitial Communication Test. Result El Pass; El Fail How was interstitial communication verified? Leak Introduced at Far End.of Interstitial Space;' Gauge; Visual Inspection; Other (Describe 1h Sec. J, below) Was vacuum/pressure restored to operating levels in all interstitial spaces? Yes No (Ifno, describe in Sec. J, below) J. Comments: NONE OF THESE.SENSORS ARE PRESENT AT THIS SITE. Page 4 of 5 If the sensor succcessfully detects a simulated vacuum /pressure; leak introduced in the interstitial space at the fiirthest point from thesensor, vacuumtpressure has been demonstirated to be communicating throughout the interstice. UN -036A -4/1 www.unidocLorg Rev. 0112GJ06 UST Ntbo MWIYU4 U ", R A ) 04L i 40: WOt -A t. It". T t, i hi Fa .1 1: 'F f it f:; a 0. P! J, Y lz }x Y -'s 7, :,J: 4 A 14 c A 'w K tf. J, Jt I I Ai wi i`j .. ,r i 41, liy J' N. :1 fit -M 't r I A if IL it r. I P v A wC;i 4' il, I :v ;Z: Z7 io, el 6 71! S j V, if. if it il K A 4 W K V9 4 K- 71. t it ui it 1 1, e t4t. te I v It w 3 %i,; Z t Ji Ti t w j" O,A, t it 1; yv it :t wo 4 1 A 4 all ME t RICH ENVIRONMENTAL 3305 BRITTAN ST. BAKERSFIELD, CA. 93308 OFFICE (661)326 -8402 FAX (661)326 -8934 PRODUCT LINE LEAK DETECTOR TEST WORKSHEET W /0#• FACILITY NAME: PANAMA BUENA VISTA SCHOOL DISTRICT FACILITY ADDRESS: 4200 ASHE RD. BAKERSFIELD, CA. PRODUCT LINE TYPE: PRESSURE PRODUCT LEAKDETEC"rOR TYPE TEST TRIP PASS BELOW P.S.I. OR SERIAL NUMBER 3 G.P.H. FAIL UNL$7 L/D TYPE : FX1V 10 P.S:I. PASS SERIAL # 1783S DIESEL L/D TYPE • FX1DV YES 10 P.S,L PASS SERIAL # 7883 LID TYPE:..- PASS YES SERIAL # FAIL L/D TYPE: PASS YES SERIAL # FAIL I CERTIFY THE ABOVE TESTS WERE CONDUCTED ON, THIS DATE ACCORDING TO.RED JACKET PUMPS FIELD TEST APPARATUS TESTING PROCEDURE AND'LEMTATIONS. 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 THATALLDATA COLLECTED IS TRUE AND CORRECT TO "THE BEST OF MY KNOWLEDGE. TECHNICIAN: STEVENOBERT SIGNATURE: DATE: 314111 403516 t SWRCB, January 2006' Spill Bucket Testing Report Form Thisform is intendedfor use by contractors performing annualtesting ofUSTspill containment structures. The completedform and printoutsfrom tests (ifapplicable); should beprovided to thefacility owner /operatorfor submittal to the local regulatory agency. 1: FACILITY INFORMATION Facility Name: PANAMA BUENA VISTA U:S.D. Date ofTesting: 3/411011' Facility Address: 4200 ASHE RD. BAKERSFIELD, CA. 93313 Facility Contact: VICKI STALNAKER: Phone: Date Local Agency Was Notified ofTesting: 1!27/2011 Name ofLocal Agency Inspector (rfpresent duringtesting}: ERNIE AND ESTER 2. TESTING CONTRACTOR INFORMATION Company Name: RICH ENVIRONMENTAL Technician Conducting Test: STEVEN OBERT Credentials: CSLB Contractor X ICC Service Tech. SWRCB Tank Tester Other (Specify) License Number(s): :80299MUT 3. SPILL BUCKET TESTING INFORMATION Test Method Used: X Vacuum ,Other Test Equipment Used: VISUAL Equipment Resolution: 0 Identify Spill Bucket (By Tank Number, Stored Product, etc. 1 REGULAR 87-FELL 2 WASTE OIL 3 DIESEL FILL 4 Bucket Installation Type: X Direct Bury Contained in Sum X Direct Bury Contained inSum X -Direct Bury Contained in,Surnp 0,Direct.Bury Contained in Sump, Bucket Diameter. 12" 12" 12" . Bucket Depth: 14" 14" 14" Wait: time between applying vacuum/water and start oftest: 30 MIN 30 MIN 30 MIN Test Start Time (TO: 0900 1100 0900 Initial Reading (IQ: 12" 12" 12" Test End Time (TF): 1000 1200 1000 Final Reading (RF): 12" 12" Test Duration (TF — TO: 1 -HOUR 1 -HOUR 1 -HOUR Change in Reading (RF - R 0 1.1 ' /:" 0 Pass/Fail Threshold or Criteria: 0:00 0.00, 0.00 CERTMCATION OF TECHMCIAN RESPONSIBLE FOR CONDUCTING TMS TESTING Ihereby certify that all the injornurtlon contained in this report . true, accurate,.and infull conWfiance with legal requirements. Technician's Signature: Date: 3/4/11 State laws and regulations do not currently require testing.to be performed by a qualified contractor. However, local requirements may be more stringent. T I:DIESEL 1000 PRODUCT CODE 1THERMALCOEFF000450TANKDIAMETER 90% 95:00TANKPROFILE20PTS 11 10% 10% FULL VOL 121 -5390.3 INCH VOL 1192885.5 INCH VOL 1152080.8 INCH VOL 1:101676.0 INCH VOL 1042371.2 INCH VOL 977066,5 INCH VOL 908761.7 INCH VOL 835557,0 INCH VOL 761452.2 INCH VOL 684147.5 INCH VOL 607642.7 INCH VOL 529538.0 INCH VOL 4539 33,2 INCH VOL 378228.5 INCH VOL 306623,7 INCH VOL 236819.0 INCH VOL 173014.2 INCH VOL 1136' 9.5 INCH VOL 633 4.7 INCH VOL 224 FLOAT SIZE: 4.0 IN. WATER WARNING 1000 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 12153OVERFILLLIMIT90% HIGH PRODUCT 10937 95 %; DELIVERY LIMIT 11 10% 10% 121.5 LOW PRODUCT 1000LEAKALARMLIMIT: 50SUDDENLOSSLIMIT: 50TANKTILT0.25PROBEOFFSET0.00 SIPHON MANIFOLDED TANKST#: NONE LINE MA'NIFOLDED TANKSTtt: NONE LEAK MIN PERIODIC: .33% OW LEAK MIN ANNUAL 50,E 6076. PERIODIC TEST TYPE STANDARD ANNUAL EST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST OFFPERTESTAVVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY 3 MINPUMPTHRESHOLDc10.00.0 COMMUNjCATIONS SETUP — — PORT SETTINGS: COMM BOARD : 5 (RS -485) BAUD RATE :•.2400 PARITY EVEN STOP BIT 1,STOP DATA: LENGTH: 7 DATA RS -232 SECURITY. CODE : DISABLED COMM BOARD : 5 (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 LIMITDISABLED 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 RS -232 END OF MESSAGEDISABLED SYSTEM :SETUP MAR 4. 2011 10:57 AM SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH SYSTEM DATE /TIME FORMAT MON DD YYYY HH:MM:SS xM PANAMA..BUENA VISTA 4200 ASHE RD BAKERSFIELD CA SHIFT TIME .1 1:00 AM SHIFT TIME 2 ; DISABLED SHIFT TIME 3 DISABLED SHIFT TIME A : DISABLED TANK PER TST NEEDED WRN DISABLED TANK ANN TST NEEDED WRN DISABLED LINE RE— ENABLE METHOD PASS LINE TEST LINE PER TST NEEDED WRN DISABLED LINE ANN TST NEEDED WRN DISABLED PRINT TC VOLUMES ENABLED TEMP COMPENSATION VALUE (DEG F ): 60.0 STICK HEIGHT OFFSET DISABLED ULLAGE 90% H— PROTOCOL DATA FORMAT HEIGHT DAYLIGHT SAVING TIME ENABLED START DATE MAR WEEK 2 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 SYSTEM SECURITY CODE : 000000 MA I NTENANCE HISTORY DISABLED TANK CHART SECURITY DISABLED CUSTOM ALARMS DISABLED SERVICE NOTICE DISABLED ISO 3166 COUNTRY CODE: MASS /DENSITY DISABLED c • uiva.cn+va.0 CODE 5.0 ERMMAAL 000700 MAX OR LABEL VOL: aNK DIAMETER OVERFILL LIMIT 95.00 NK PROFILE 20 PTS HIGH 4ODUCT FULL VOL 12153 90.3 INCH VOL : 11928 85.5 INCH VOL : 11520 80.8 INCH VOL : 11016 76.0 INCH VOL 10423 71.2 INCH VOL 9770 66.5 INCH VOL 9087 61.7 INCH VOL 8355 57.0 INCH VOL 7614 52.2 INCH VOL 6841 47.5 INCH VOL 6076 42.7 INCH VOL 5295 38.0 INCH VOL 4539 33.2 INCH.VOL 3782 28.5 INCH VOL : 3066 23.7 INCH VOL 2368 19.0 INCH VOL 1730 14.2 INCH VOL 1136 9.5 INCH VOL 633 4.7 INCH VOL 224 LOAT SIZE: 4.0 IN. 4TER WARNING : 2.0 IGH WATER LIMIT: 3.0 AX OR LABEL VOL: 12153 VERFILL LIMIT. : 90% 10937 IGH PRODUCT 11545 ELIVERY LIMIT 111 OW PRODUCT : 1000 EAK ALARM LIMIT: 50 UDDEN LOSS LIMIT: 50 ANK TILT 1.25 ROSE OFFSET 0.00 IPHON MANIFOLDED TANKS NONE INE MANIFOLDED TANKS NONE 1 J ;wm '!t V1L PRODUrm CODE I 3 THERM Is COEFF :.00'0470 TANK .DIAMETER 46.00 TANK PROFILE 1 PT. FULL VOL '550 FLOAT SIZE: 4.0 IN. WATER WARNING 5.0 HIGH WATER LIMIT: 5.0 MAX OR LABEL VOL: 550 OVERFILL LIMIT 90'% 495 HIGH 4ODUCT 95% 522 DELIVERY LIMIT 1% 5 LOW PRODUCT i LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99. TANK TILT 0.00. PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS T#: NONE LINE MANIFOLDED TANKS T#: NONE LEAK MIN PERIODIC: 0%. LEAK MIN ANNUAL 0% 0 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL. ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL: ALARM DISABLED EAK MIN PERIODIC: 4010 'PER TEST AVFRAGING: OFF EAK MIN ANNUAL 509 6076 ERIODIC TEST TYPE STANDARD NNUAL TEST FAIL ALARM DISABLED ERIODIC TEST FAIL ALARM DISABLED ROSS TEST FAIL ALARM DISABLED NN TEST AVERAGING': OFF ER TEST AVERAGING: OFF ANK TEST NOTIFY: OFF NK TST SIPHON BREAK:OFF SLIVERY DELAY 3 MIN UMP THRESHOLD 10.00% TANK, TES14,,NOT I FY: OFF TNK TST SIPHON BREAK :OFF DELIVERY DELAY . 1 MIN PUMP THRESHOLD : 10.00% ALARM HISTORY REPORT SENSOR ALARM L 3:DIESEL ANNULAR ANNULAR SPACE SENSOR OUT ALARM MAR 4, 2011 9:22 AM FUEL ALARM MAR 4, 20.11 9:10 AM FUEL ALARM.. MAR 4, 2011 9:10 AM x x x END x x x x x ALARM HISTORY REPORT SENSOR ALARM - - - -- L 4:DIESEL STP SUMP STP SUMP SENSOR OUT ALARM MAR 4, 2011 9:22 AM FUEL ALARM MAR 4, 2011 9:17 AM SENSOR OUT ALARM. MAR 18. 2010 9:32 AM i r END ALARM -HISTORY REPORT SENSOR ALARM -- L 5:DTSPENSER 1. 2 DISPENSER PAN SENSOR OUT ALARM MAR 4, 2011 9:22 AM FUEL ALARM MAR 41: 2011 9:21 AM SENSOR OUT ALARM MAR 18, 2010 9:32 AM LARM HISTORY REPORT SENSOR ALARM{- 6 :DISPENSER 3 4 lISPENSER PAN TENSOR OUT ALARM IAR 4, 2011 9:22 AM UEL ALARM 1AR 4. 2011 9:20 AM TENSOR OUT ALARM 1AR 18, 2010 9:32 AM xx*xx END *.*xx ALARM FIISTORY REPORT SENSOR ALARM - -- L,7:WASTE OIL OTHER SENSORS. FUEL ALARM MAR' 4, 2011 10:59' AM SENSOR OUT ALARM MAR 4. 2011 9:22 AM SENSOR OUT ALARM MAR L8. 2010 9:32 AM xx *:x x. END xxxx ALARM HISTORY REPORT SENSOR ALARM - -- L 8: OTHER SENSORS x*xxx END xx*x EAK TEST METHOD ST ON DATE : ALL TANK AN 29, 2009 CART TIME : DISABLED ST RATE :0.20 GAL /HR JRATION 2 HOURS 3T EARLY STOP-.DISABLED OAK TEST REPORT FORMAT NORMAL IQUID SENSOR'SETUP 1:UNLEADED ANNULAR RI -STATE (SINGLE FLOAT) 4TEGORY : ANNULAR SPACE 2:UNLEADED STP SUMP RI -STATE (SINGLE FLOAT) 4TEGORY :.STP SUMP 3:DIESEL ANNULAR RI -STATE (SINGLE FLOAT) ATEGORY : ANNULAR SPACE 4:DIESEL STP SUMP RI -STATE (SINGLE.FLOAT) ATEGORY STP SUMP 5:D PENSER 1 2 RI -S TE (SINGLE FAT) ATEG : DISPENEi PAN b: RI - 0 iL.YS I S T E. 9:0 AV MI NI I' SHUTDOWN. 00bL 1 HISTORY REPORT I1 .44 -- I'N -TANK ALARM T 2:UNLEADED TESTS HIGH PRODUCT ALARMZ $ MAR 4, 2011 9::08 PJ1 MAR 18, 2010 9:20 AM PROBE OUT MAR 4, 2011 9:09 AM MAR 4. 2011 9:08 AM l DELIVERY NEEDED MAY 24, 2010 4:.09 PM MAX.PRODUCT ALARM MAR 4, 2011 9:08 AM MAR 18, 2010 9:20 AM X x x x* END * x x* X XXXx * END * *** ALARM HISTORY REPORT SENSOR ALARM -- L 1. :UNLEADED ANNULAR ANNULAR SPACE , SENSOR .OUT ALARM MAR 4, 2011 9:22 AM FUEL ALARM MAR 4, 2011 9:07 AM SENSOR OUT ALARM. MAR .18. 2010 .9:32 AM Xx*x * END **xx ALARM HISTORY REPORT SENSOR ALARM -- L 2:UNLEADED STP SUMP STP SUMP SENSOR OUT ALARM MAR 4. 2011 9:22 AM FUEL ALARM MAR 4, 2011 9:18 AM SENSOR OUT ALARM MAR 18, 2010 9:32 AN MONITOR CERT. FAILURE REPORT SITE NAME: PANAMA BUENA VISTA U.S.D. DATE: 3/4/11 ADDRESS: 420WASHE.RD. TECHNICIAN: STEVEN OBERT THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TESTING. REPAffl : 11 WASTE OIL BUCKET TORN NEEDS TO BE REPLACED. . LABOR: NONE PARTS INTALLED • 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- SITEFOR YOUR CONVIENENCE.