The URL can be used to link to this page

Home My WebLink About1501 TRUXTUN AVENUE (2)11000 N. MoPac Expressway, Suite 500 Austin, Texas 78759 Phone: (512) 451 -6334 Fax: (512) 459 -1459 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECIO 1501 TRUXTUN AVE. BAKERSFIELD, CA. 93301 Test Date: 01/05/2012 Order Number: 3188937 . Dear Regulator, Date Printed and Mailed: 02/03/2012 Enclosed are the results of recent testing performed at the following facility: CIRCLE K 2708605 5600 AUBURN ST @FAIRFAX RD. BAKERSFIELD, CA. 93306 Testing performed: Leak detector tests Monitor Certification Secondary Containment -Spill Container Sincerely, Dawn Kohlmeyer Manager, Field Reporting dai TANKNOLOGY CERTIFICATE OF TESTINGJlpTJ3nk7x)k3gy 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 TELEPHONE (512) 451-6334 FAX (512) 459-1459 PURPOSE: COMPLIANCE TEST RESULT SUMMARY REPORT TEST DATE: 01/05/12 WORK ORDER NUMBER: 3188937 CUSTOMER PO: Joel Lindquist CLIENT: CIRCLE K STORES SITE: CIRCLE K 2708605 495 E. RINCON, STE. 150 5600 AUBURN ST CORONA, CA 92879 @FAIRFAX RD. BAKERSFIELD, CA 93306 TRISHA YAHNER SCOTT - MANAGER 951)270-5108 (661)871-6273 TEST TYPE: TLD-1 Dr^ehie4 Dinn Tinhfnacc Tact Pacidto 1 1* LikEIR M_ 'k LINEW I LINE'r I __ , M, oft 4. T,,ECTOR? 2,, W, N" NE'', r a VERY TEST,RES LT FINAL LEAK whf`,(6ph) VALVEIlDPRODUCT,," L, TYPE 4 FUNCTION VRE W. k7 q T1 91 1 T1 91 1 PREMIUM DW FIBERG PRESSURE T2 2 PLUS DW FIBERG PRESSURE 308118758 P T3 3 REGULAR I DW FIBERG I PRESSURE I I I I 9:viafinfi I inn I n2it notai-few Tact Maw Danint-arnanf I inn I n2ie nafad•fnr Tact N EXISTINOILEAKrDETEC,,TOR A CED LEAK'QE l',W,y EXISTING"LEA T,,ECTOR? 2,, W, NE'', r a MANUFkd'TU F ER, I 01' M 6D'E A IANUFACTURER MODEL4 SEIRIAL# •RESULT VRE T1 91 1 VEEDERROOT FX1V 105113034 P T2 2 VEEDERROOT Fx1V 308118758 P T3 3 VAPORLESS LD2000 09121223 P Maw Danint-arnanf I inn I n2ie nafad•fnr Tact N A CED LEAK'QE MANUFACTURER AESU_if-MA MODEL'4`SERIAL RESULDT VRE roT owner uetaiteu repon inrormation, visit www.tanKnoiogy.com ana seiect un-Line Keports-wKAv, or contact your jocai i anKnoiogy orrice. Tester Name: EDWIN PINEDA Technician Certification Number: 8026748 Printed 02/03/2012 07:38 IVITUTTLE INDIVIDUAL TEST DATE:01 /05/12 CLIENT:CIRCLE K STORES TANK INFORMATION AND TEST RESULTS MOP Tar*nology 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3188937 AUSTIN, TEXAS 78759 (512) 451 -6334 SITE:CIRCLE K 2708605 Q TANK ,'.INFORMATION Tank ID: T1 91 1 Tank manifolded: No Bottom to top fill in inches: 92.0 Product: PREMIUM Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 9,864 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW FIBERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TANKTEST RESULTS LEAK,,DETECTORTESATRESULTS_ Test,;method F'rA7e5tMethodvacuTeot Start (in) End (in) Dipped Water Level: New /passed Failed /replaced New /passed Failed /replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: Probe Water Level: Make: VEEDERROOT Ingress Detected: Water Bubble Ullage Model: axle Test time: S /N: 105113034 Open time in sec: 2.00 Inclinometer reading: Holding psi: 25 VacuTect Test Type: NOT Resiliency cc: 110 NOT TESTEDVacuTectProbeEnt , Point: Test leak rate ml /m: 189.0 TESTED Pressure Set Point: Metering psi: 10 Tank water level in inches: Calib. leak in gph: 3.00 Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS LINE typesiESTNExuLTA B Y, Test Material: DW FIBERG Diameter (in): 2.0 Length (ft): 100.0 Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: UNKNOWN Printed 02/03/2012 07:38 INDIVIDUAL TANK INFORMATION AND TEST RESULTS 11110 TA3nknoilogy TEST DATE:01 /05/12 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3188937 CLIENT:CIRCLE K STORES AUSTIN, TEXAS 78759 (512) 451 -6334 SITE:CIRCLE K 2708605 xd '.. , :'.Ti4NKNFORMAT.ION ... Tank ID: T2 2 Tank manifolded: No Bottom to top fill in inches: 92.0 Product: PLUS Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 9,864 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW FIBERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TANK TEST RESULTS T- jit,Method —V ^'4-T- t LEAFC:DETECTOR TEST RESULTS `; = TeStafiiBthOC1 FTA z ° ; Start (in) End (in) Dipped Water Level: New /passed Failed /replaced New /passed Failed /replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: Probe Water Level: Make: VEEDERROOT Ingress Detected: Water Bubble Ullage Model: Fx1v Test time: S /N: 308118758 Open time in sec: 3.00 Inclinometer reading: Holding psi: 18 VacuTect Test Type: NOT Resiliency cc: 85 NOT ry TESTEDVacuTectProbeEntPoint: Test leak rate ml /m: 189.0 TESTED Pressure Set Point: Metering psi: 11 Tank water level in inches: Calib. leak in gph: 3.00 Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS 4 Test`type .xr n 1 xaSNETESLINELTSArs .„ r B , C. A- Material: DW FIBERG Diameter (in): 2.0 Length (ft): 100.0 Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: UNKNOWN Printed 02/03/2012 07:38 INDIVIDUAL TANK INFORMATION AND TEST RESULTS i 7anknoilogy TEST DATE: 01 /05/12 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3188937 CLIENT:CIRCLE K STORES AUSTIN, TEXAS 78759 (512) 451 -6334 SITE:CIRCLE K 2708605 Printed 02/03/2012 07:38 TANK- INFORMATION , Tank ID: T3 3 Tank manifolded: NO Bottom to top fill in inches: 92.0 Product: REGULAR Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 9,864 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL. Material: DW FIBERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TANK'TESTrR SULTS «Test MBthOd „.. 7t:EAK D,•E -T 6R TEST,RESULTSea_ VacuTeat SPYiP . <, y,;,,„ „h, ;T85i,rriethbd, Start (in) End (in) Dipped Water Level: New /passed Failed /replaced New /passed Failed /replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: Probe Water Level: Make: vAPoRLEss Ingress Detected: Water Bubble Ullage Model: LD2000 Test time: S /N: 09121223 Open time in sec: 4.00 Inclinometer reading: Holding psi: 27 VacuTect Test Type: NOT Resiliency cc: 80 NOT ry P TESTEDVacuTectProbeEntPoint: Test leak rate ml /m: 189.0 TESTED Pressure Set Point: Metering psi: 17 Tank water level in inches: Calib. leak in gph: 3.00 Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS 33T Lh TEST`RESULTS a'St type Material: DW FIBERG Diameter (in): 2.0 Length (ft): 100.0 Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: UNKNOWN Printed 02/03/2012 07:38 MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within 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. If more than one monitoring system control panel is installed at the facility, 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 of test date. A. General Information Facility Name: CIRCLE K 2708605 Site Address: 5600 AUBURN ST City: BAKERSFIELD CA Zip: 93306 Contact Phone No: 871 -6273 @FAIRFAX RD. Date of Testing /Service: 01/05/2012 Facility Contact Person: SCOTT - MANAGER Make /Model of Monitoring System: B. Inventory of Equipment Tested /Certified Check the appropriate boxes to indicate specific equipment inspected /serviced Work Order Number: 3188937 Tank ID: T1 PREMIUM Tank ID: T2 MID 71 In -Tank Gauging probe. Model: MAG PROBE ZI In -Tank Gauging Probe. Model: MAG PLUS X Annular Space or Vault Sensor. Model: VR-409 Annular Space or Vault Sensor. Model: VR -409 X Piping Sump/Trench Sensor(s). Model: VR -208 Piping SumprTrench Sensor(s). Model: VR -208 Fill Sump Sensor(s). Model: Fill Sump Sensogs). Model: X Mechanical Line Leak Detector. Model: VR -FX1 V X Mechanical Line Leak Detector. Model: VR -FX1 V Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: X Tank Overfill /High -Level Sensor. Model: PROBE /FLAPPER Tank Overfill /High -Level Sensor. Model: PROBE /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: Tank ID: In -Tank Gauging Probe. Model: MAG PROBE In -Tank Gauging Probe. Model: X Annular Space or Vault Sensor. Model: VR-409 Annular Space or Vault Sensor. Model: X Piping SumprTrench Sensogs). Model: VR -208 Piping Sump/Trench Sensogs). Model: Fill Sump Sensors). Model: Fill Sump Sensogs). Model: X Mechanical Line Leak Detector. Model: VL -LD 2000 Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill /High -Level Sensor. Model: PROBE /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 : 1 -2 Dispenser D: Dispenser Containment Sensors) Model: BE -406 Dispenser Containment Sensor(s) Model: X Shear Valve(s). Shear Valve(s) Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: 3-4 Dispenser ID: Dispenser Containment Sensor(s) Model: BE -406 Dispenser Containment Sensor(s). Model: XD Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chaln(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: Dispenser ID: Dispenser Containment Sensors) Model: Dispenser Containment Sensor(s). Model: ShearValve(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 Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the (Check all that apply): r_j System set -up r-1 Alarm history report Technician Name (print): EDWIN PINEDA Signature: Certification No.: License. No.: 743160 (Class'A' General Enginering Contractor License) Testing Company Name:Tanknology Phone No.: (800) 800 -4633 AVV ' Site Address: 11000 N. MoPac Expressway, suite 500, Austin, TX 78759 Date of Testing /Servicing: 01/05/2012 Monitoring System Certification Page 1 of 3 Based on CA form dated 03/08 Site Address 5600 AUBURN ST FAIRFAX RD. D. Results of Testing /Servicing Software Version Installed: 328.03 Complete the following checklist: Monitoring System Certification Date of Testing /Service: 01/05/2012 X Yes No ` Is the audible alarm operational? a Yes No • Is the visual alarm operational? O Yes No Were all sensors visually inspected, functionally tested, and confirmed operational? Q 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 7 No ` x N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? x YesQ No • N/A For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment 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; X Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks and sensor failure /disconnection? X Yes No FX Yes No' N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.: no mechanicaloverfillpreventionvalveisinstalled), is the overfill warning alarm visible and audible at the tank fill points(s) and operating property? If so, at what percent of tank capacity does the alarm trigger? 90 y/, Yes* FE 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* Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) Product; Water. If yes, describe causes in Section E, below. X Yes Was monitoring system set -up reviewed to ensure proper settings? Attach set -up reports, If applicable. Yes Is all monitoring equipment operational per manufacturers' specifications? In Section E below, describe how and when these deficiences were or will be corrected. E. Comments: Page 2 of 3 Based on CA form dated 03/08 Monitoring System Certification Site Address: 5600 AUBURN ST @FAIRFAX RD. F. In -Tank Gauging / SIR Equipment Check this box if no tank gauging or SIR equipment is installed. Date of Testing /Service: 01/05/2012 0 Check this box if tank gauging is used only for inventory control. 7 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. Complete the following checklist: 0 Yes No • Has all input wiring been inspected for proper entry and termination, including testing for ground faults? X Yes No • Were all tank gauging probes visually inspected for damage and residue buildup? EYes No • Was accuracy of system product level readings tested? X Yes No • Was accuracy of system water level readings tested? El Yes No • Were all probes reinstalled properly? X Yes No • Were all items on the equipment manufacturers' maintenance checklist completed? In the Section H, below, describe how and when these defciencles were or w ll be Corrected. G. Line Leak Detectors (LLD) : Check this box if LLDs are not installed. Complete the following checklist: O Yes No • N/A For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? Check all that apply) Simulated leak rate: X 3 g.p.h 0.1 g.p.h 00.2 g.p.h X Yes No • Were all LLDs confirmed operational and accurate within regulatory requirements? X Yes No • Was the testing apparatus properly calibrated? X Yes No • N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? Yes No • N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? Yes j No M N/A j For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system Is disabled or disconnected? Yes No • M N/A For electronic LLDs, does the turbine automatically shut off If any portion of the monitoring system malfunctions or fails a test? Yes No • M N/A For electronic LLDs, have all accessible wiring connections been visually inspected? EYes No* Were all items on the equipment manufacturers' maintenance checklist completed? In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: L____ Page 3 of 3 Based on CA form dated 03/08 S WRCB, January 2002 Secondary Containment Testing Report Form Page 1. Thisform is intendedfor use by contractors performing periodic testing of UST secondary containment systems. Use the appropriatepages ofthis form to report results for all components tested. The completedform, written test procedures, and printoutsfrom tests (ifapplicable), should be provided to the facility owner /operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: CIRCLE K 2708605 DateofTesting: 01/05/2012 Facility Address: 5600 AUBURN ST @FAIRFAX RD., BAKERSFIELD, CA, 93306 Facility Contact: SCOTT — MANAGER Phone: ( 661) 871 -6273 Date Local Agency Was Notified of Testing: Name of Local Agency Inspector (if present during testing): ESTHER DURAN 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Pass Fail Technician Conducting Test: EDWIN PINEDA Component Credentials: X CSLB Licensed Contractor El SWRCB Licensed Tank Tester License Type: A- UT License Number: 743160-8026748 Manufacturer Manufacturer Training Component(s) Date Training Expires OPW SPILL BUCKET 02/03/2013 E Spill Box 2 PLU FILL 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Repairss Made Spill Box 1 PRE FILL E Spill Box 2 PLU FILL X Spill Box 3 REG FILL a E1 El El El El 7 E] D 7 El F-1 0 0 El El El El 0 El El El El E El 0 El El 0 El 1:1 El El F-1 0 El El 1:1 El 1:1 El El El El- El El El El 7 El El 0. El El 0 0 E El El El El El If hydrostatic testing was performed, describe what was done with the water after completion of tests: WATER WAS PUT IN FIVE GALLON BUCKETS AND PLACE IN TRUCK FOR NEXT SITE CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my knowledge, thefacts stated in this document are accurate and infull compliance with legal requirements Technician's Signature: Date: 01/05/2012 SWRCB, January 2006 9. Spill Bucket Testing Report Form This form is intendedfor use by contractors performing annual testing of UST spill containment structures. The completedform and printouts from tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: CIRCLE K 2708605 DateofTesting: 01/05/2012 Facility Address: 5600 AUBURN ST @FAIRFAX RD., BAKERSFIELD, CA, 93306 Facility Contact: SCOTT - MANAGER Phone: ( 661) 871 -6273 Date Local Agency Was Notified of Testing: Name of Local Agency Inspector (if present during testing): ESTHER DURAN 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: EDWIN PINEDA Credentials I : a CSLB Contractor X ICC Service Tech. SWRCB Tank Tester Other (Specify) A -UT License Number: 743160-8026748 3. SPILL BUCKET TESTING INFORMATION Test Method Used: a Hydrostatic Vacuum Other Test Equipment Used: TAPE MEASURE Equipment Resolution: VISUAL Identify Spill Bucke By Tank Number, Stored Prod 1 1 PRE FILL Z 2 PLU FILL 3 3 REG FILL 4 Bucket Installation Type: 0 Direct Bury Contained in Sump Q Direct Bury Contained in Sump 0 Direct Bury Contained in Sump Direct Bury Contained in Sump Bucket Diameter: 1111 1111 ill, Bucket Depth: 12" 12" 12" Wait time between applying vacuum /water and starting test: 10 min 10 min 10 min Test Start Time (Tj ): 0900 0900 0900 Initial Reading (RI 91, 7 7 Test End Time (TF ): 1000 1000 1000 Final Reading (RF 911 7 Test Duration: 1 hr 1 hr 1 hr Change in Reading (R F - RI ): 0 0 0 Pass/Fail Threshold or Criteria: 0 0 0 Test- :Result: f Y X Pa's's YFatl X assi±ailt- X Pass Fail Pass .Fair Comments - (include information on repairs made prior to testing, and recommendedfollow -up forfailed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true, accurate, and in full compliance with legal requirements. Technician's Signature: n A,V t?.Uc; Date: 01/05/2012 1 Q+. ft L...,.. —A A7 -^+ .,r.o tl., .o., ;— roof;.,.. +. 1— —f ....,0.7 1... ,.,,..1;r,.A ,M t U...., -- 1....,1 Work Order: 3188937 ESO) & (ESV) Testing Fonn - Version 1- 625/2007 Emergency Shut Off (ESO) & Dispenser Emergency Shutoff Valve (ESV) ANNUAL TEST RECORD LOCATIONS AND TEST DATA Testing Company: 1 Date: 5 1 Z Location Name: rC Q, VA Store #: N Statc m #: Address: S { City: State: Emmency Shut 0. ff SO Tesfin2 Results On 01 t in accordance with "ESO Vendor Letter (3- 21- 05).doc ", from Valero's Retail Compliance Department, as a part of annual compliance testing, this representative tested the Emergency Shut Off (ESO) switches indicated on this sketch. Findings listed below: Emergency Shut Off (ESO) IfNo, Provide Operational) N Maintenance Log # Date Called: u On o ti 2 in accordance with NFPA 30A this representative tested the automatic - closing feature of the Dispenser Emergency Shutoff VALVE(S) (ESV) located in the supply lines at the base of each individual island type dispenser indicated on the diagram below. Each device ( #) _ 6 in all, would automatically close. Findings listed below: Disp. Emergency Shut Off IfNo, Provide Valve (ESV) Operational? y N Maintenance Log # Date Called Tanknology Inc. 11000 N. MoPac Expressway, Suite 500, Austin, Texas 78759 i Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 512) 451 -6334 FAX (512) 459 -1459 TEST DATE:01 /05/12 WORK ORDER NUMBER3188937 CLIENT:CIRCLE K STORES SITE:CIRCLE K 2708605 COMMENTS Conduct the Witness Annual Monitor Certification Testing with Inspector Ernie Medina Bakersfield Fire Dept.. Site contacted and e- mailed on 12/27/11 and confirmed with "JOHN ". veeder Root light bulb was also replaced today as well. All tests passed. PARTS REPLACED r QUANTiTIf tW ' 41, ESCRIPTION ,,ffv 3 LAMP— TLS350 HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) d - v d's T EIT _ gq y® S`y n PINPOINT`I.EAKT, 8ULTSE5TRHELIUM yq,, b k'll Printed 02/03/2012 07:38 MTUTTLE SITE DIAGRAM JP' Tar*rtoll )gy 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 512) 451 -6334 FAX (512) 459 -1459 TEST DATE: 01/05/12 WORK ORDER NUMBER3188937 CLIENT:CIRCLE K STORES SITE: CIRCLE K 2708605 W V/R DUMP- S N C -STORE STER ATGs in STP sumps ICE L SO 1 PROPANE L3 L5 g O #1 #3 O F O A CANOPY O v V NTS #2 #4 on 1 F 4 q C nopy Dispensers contain CAS R/ O beaudreau stand - AIH20 alone sensors Printed 02/03/2012 07:38 MTUTTLE