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HomeMy WebLinkAbout3221 TAFT HWY (3)MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State ofCalifornia Authority Cited: Chapter 6.', Health andSafety Code: Chapter 16 Division 3, Title 23, California Code ofRegulalions This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitornte system control panel by the technician who performs the work. A copy of this form must be provided to the tank system ownerroperator. 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: HAPPY GAS Site Address: 3221 TAFT HWY Facility Contact Person: AMITA Make/Model of Monitoring System TLS -350 B. Inventory of Equipment Tested/Certified Cheek the annrnnriate hnrPS to indientP snerifie wudnmont ingnertPd/aPrvirPd- Bldg. No.: City: BAKERSFIELD Zip: Contact Phone No.: ( ) Date of Testing/Servicing: 8/29/2011 Tank 1D: RED DIESEL rank ID: UNL87 Z In -Tank Gauging Probe. Model: MAG Z In -Tank Gauging Probe. Model MAG Annular Space or Vault Sensor. Model: Annular Space or Vault Sensor. Model: Z Piping Sump / Trench Sensor(s). Model 208 Z Piping Sump /Trench Sensor(s). Model: 208 Fili Sump Sensor(s). Model: 208 Fill Sump Sensor(s). Model. 208 Mechanical i.ine Leak Detector. Model: RED JACKET Mechanical Line Leak Detector. Model: RED JACKET 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 kspeeify equipment type and model in Section E on Page 2). Other (specify equipment type and model in Section E on Page 2). Tank ID: PREM91 Tank ID: DIESEL In-Tank Gauging Probe. Model: MAG Z In -Tank Gauging Probe. Model: MAG Annular Space or Vault Sensor. Model: Annular Space or Vault Sensor, Model: Z Piping Sump / Trench Sensor(s). Model: 208 Piping Sump / Trench Sensor( ,,). Model: 208 Z Fill Sump Sensor(s). Model: 208 Fill Sump Sensor( ,,). Model: 208 Z Mechanical Line Leak Detector. Model: RED JACKET Z Mechanical Litre leak Detector. Model: RED JACKET 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 (.speciA, equipment type and model in Section E on Page 2). Other (specify equipment type and model in Section F.. on Page 2). Dispenser ID: 1/2 Dispenser ID: 314 Z Dispenser Containment Sensor(s). Model: BEAUDREAU Dispenser Containment Sensor(s). Model. BEAUDREAU Z Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: 516 Dispenser ID: 7/8 ES Z Dispenser Containment Sensor(s). Model: BEAUDREAU Dispenser Containment Sensor(s). Model: SEAUDREAU Z Shear Valve(s). Shear Valve(s). Dispenser Containment Floa[(s) and Chain(s). Dispenser ContainmentFloat(s) and Chain(s). Dispenser ID: 9 Dispenser ID: Z Dispenser Containment Sensor(s). Model: BEAUDREAU Dispenser Containment Sensor(s). Modei: Shear Valve(s). Shear Valve(s). Dispenser Containment Floats) and Chain(s). Dispenser Containment Floats) 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 of generating 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: Certification No.: 5297857 -UT License. No.: CD40 809850 Testing Company Name: RICH ENVIRONMENTAL Phone No.: k6 61) 326 -8402 Testing Company Address: 3305 BRITTAN RD. BAKERSFIELD, CA. 93308 Date ofTesting/Servicing: 8129/2011 Page 1 of 5 t -V -036 - V4 www.unidocs.org Rev. 01117i08 LE3 i Z Monitoring System Certification I% I D. Results of Testing/Servicing Sotirware Version Installed: 14.01 Complete the followine 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 vx ith their broiler operation? Yes No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) N/A operational? Fj 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) ® Sumpn'reneb Sensors; Dispcnser Containment Sensors. Did you confirm positive shut -down due to leaks and sensor failure /disconnection? ® Yes; No. D 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 oftank 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, if applicable Yes No* 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: 87 FILL SUMP SENSOR WAS BAD I REPLACED WITH NEW AND RETESTED. RED DIESEL WAS OUT OF ORDER UNABLE TO TEST POSITIVE SHUTDOWN AND LEAK DETECTOR Page 2 of 5 UN -036 — 2/4 www.unidoes.org Rev. 01117'08 Monitoring System Certification F. In -Tank Gauging/ SIR ]Equipment: L(bl- i 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 if in -tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: Yes j No* Has al l 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 ofsystem water level readings tested? Yes No* Were all probes reinstalled properly? Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? J In Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): Comnletp the fhUnwina ehpi-Wkth Check this box if LLDs are not installed. Yes E) `No* i 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: ® : g.p.h.; 0.1 g.p.h; 0.2 g.p.h. Yes Z No* Were all LLDs confirmed operational and accurate within regulatory requirements? Yes NO Was the testing apparatus properly calibrated? 0 Yes No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? 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 NA or disconnected? Yes No* For electronic LLDs. does the turbine automatically shut off ifany portion of the monitoring system malfunctions NA or fails a test? Yes No* For electronic LLDs, have all accessible wiring connections been visually inspected? 4 N/A I i 0 Yes No* I 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. Page 3 of. 5 1a -036 - 3!4 www.unidnes.org Re%. 01/17/08 14")_7 _ _1 Monitoring System Certification Form: Addendum for Vacuum/Pressure Interstitial Sensors 1. Results of Vacuum/Pressure Monitoring Equipment Testing 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 Fonn to the local agency regulating UST systems within 30 days oftest date. Manufacturer: N/A Model: System Type: Pressure, Vacuum Sensor ID d 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: T 1 Sensor Functionality Test Result: Pass; Fail Interstitial Communication Test Result: Pass; Fail Components) 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 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 How was interstitial communication verified? 9 Leak- Introduced at Far End of Interstitial Space;' Gauge; Visual Inspection; Other (Describe in Sec. J, below) Was vacuum /pressure restored to operating levels in all interstitial spaces? Yes No (Ifno, describe in Sec. J, belou) J. Comments: NONE OF THESE SENSORS ARE PRESENT AT THIS SITE. Page 4 of 5 If the sensor successfully detects a simulated vacuum/pressure leak introduced in the interstitial space at the furthest point from the sensor, vacuum /pressure has been demonstrated to be communicating throughout the interstice. UN-036A - 1/1 www.unidoes.org Rev. 01/26/06 431 -t1 /y I' System Certification ST Monitoring Site-Plan tU r •'1j3 ------------- •--- -..... t-------- - - - - -1 - 3 - - -- -- - - - - - - - - - - - - - - ° - r r - . • . - . . - r - • • - - - - - - - - w - • - . . • . r - - - - . • r - r Date map was drawn: 19, )V/ A s'-vctions 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 oftanks and piping. Clearly identifylocationsofthefollowingequipment, if installed: monitoring system control panels; sensors monitoring tank annularspaces, 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. Page r- of S 05100 i SWRCB, January 2006 Spill ]Bucket 'Vesting 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 /operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: HAPPY GAS Date of Testing: 8/29/2011 Facility Address: 3221 TAFT HWY, BAKERSFIELD Facility Contact: AMITA Phone: Date Local Agency Was Notified of Testing: 7/19/2011 Name of Local Agency Inspector (ifpresent during testing): ERNIE MEDINA 2. TESTING CONTRACTOR INFORMATION Company Name: RICH ENVIRONMENTAL Tec ician Conducting Test: RICHARD MASON Credentials': L CSLB Contractor X 1CC Service Tech, G SWRCB Tank Tester G 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 MEW= Identify Spill Bucket (By Tank Number, Siored Product, etc. TM0MM==MMTT 2 PREM 91 -FILL 3 4 DIESEL RED DIESEL 1 REG 87 -FILL Bucket Installation Type: Direct Bury X Contained in Sump Direct Bury X Contained in Sump L Direct Bury X Contained in Sump I E Direct Bury X Contained in Sum Bucket Diameter: 12" 12" 12" 12" Bucket Depth: 14" 14" 14" 14" Wait time between applying vacuum /water and start of test: 30 MIN 30 MIN 30 MIN 30 MIN Test Start Time (Ti): 1:00PM l :00PM 1:00PM 1:00PM Initial Reading (Rj): 9" 9" 9" 9" Test End Time (Tr): 2:OOPM 2:OOPM 2:00PM 2:OOPM Final Reading (RF): 9" 9" 9" 9" Test Duration (Tr' — Tj): 1 -HOUR 1 -HOUR 1 -HOUR I -HOUR Change in Reading (Rr- Rj): 0_ 0 0 0 Pass /Fail Threshold or Criteria: r'_ 0.00 0.00 0.00 0.00 i i 7 h11.F Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certo that all the information contained in this report Is true, accurate, and infull compliance with legal requirements. Technician's Signature: Date: 8/29/2011 State laws and regulations do not current!,,' require testing to be performed by a qualified contractor. However, local requirements may be more stringent. RICH ENVIRONMENTAL 3305 BRITTAN ST. BAKERSFIELD, CA. 93308 OFFICE (661)326 -8402 FAX (661)326 -8934 PRODUCT LINE LEAK DETECTOR TEST WORK SHEET W /0 #: FACILITY NAME: HAPPY GAS FACILITY ADDRESS: 3221 TAFT HWY, BAKERSFIELD PRODUCT LINE. TYPE: PRESSURE LA 1nl PRODUCT LEAK DETECTOR TYPE TEST i TRIP PASS BELOW P.S.I. OR j SERIAL NUMBER 3 G.P.H. FAIL UNL87 I LID TYPE: RED JACKET i YES i2 j I PASS SERIAL # MECHANICAL PREM91 LID TYPE: RED JACKET YES 12 PASS SERIAL # MECHANICAL i DIESEL L/D TYPE: RED JACKET YES 12 i i PASS SERIAL # MECHANICAL RED LID TYPE: RED JACKET NO 0 NOT DIESEL TESTED SERIAL #MECHANICAL I 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: t DATE: 8/29/2011 IN -TANK SETUP T 1:DIESEL RED pPRODUCTCODE1.000470THERMALCOEFF TANK DIAMETER 95.00TANKPROFILE FULL VOL : 11783 FLOAT SIZE: 4.0 IN. 8496 WATER WARNING : 2.0 HIGH WATER LIMIT: 4.0 MAX OR LABEL VOL: 11783 OVERFILL LIMIT 97% 11429 HIGH PRODUCT 95% 11193 DELIVERY LIMIT 17% 2003 LOW PRODUCT 330 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 0 00TA14KTILT MAN IFOLDED TANKS TO: NONE LEAK MIN PERIODIC: 0°i LEAK MIN ANNUAL : 01/0 0 PERIODIC TEST TYSTAPJDAkD ANNUAL TEST L ALARM DISABLED PERIODIC FARMAIL GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK :OFF DELIVERY DELAY 3 MIN BAUD RATE 9600 PARITY : ODD STOP BIT : I STOP DATA LENGTH: 7 DATA AUTO TRANSMIT SETTINGS AUTO LEAK ALARM LIMIT DISABLED AUTO HIGH WATER LIMIT DISABLED AUTO OVERFILL LIMIT DISABLED AUTO LOW PRODWT DISABLED AUTO THEFT LIMIT DISABLED AUTO DELIVERY START DISABLED AUTO DELIVERY E14D 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 SECURITY 000000 SYSTEM SETUP AUG 29, 2011 11:39 - - SYSTEM UNITSU.S. SYSTEM LANGUAGEENGLISH SYSTEM DATEITIME FORMATMONDDYYYYHH:MM:SS PUNKIN CENTER3221TAFTHwyBAKCA.93313 SHIFT TIMESHIFTTIME 2 . 4:35.AM SHIFT TIME 3 DISABLED SHIFT TIME q DISABLED DISABLED PERIODIC: TEST WARNINGSDISABLED ANNUAL TEST WARNINGSDISABLED PRINT TC VOLUMESENABLED TEMP C :OMPENSATIONVALUECDEGF ) : 60.0 H- PROTOCOL DATA FORMATHEIGHT P,E- DIRF'CT LOCAL PRINTOUTDISABLED SYSTEM SECURITYCODE : 000onn ainl4vmr%L 1. 6_'1"7 NORMALLY CLOSED 11 11 IN -TANK ALARMS T 1:LEAK ALARM LIQUID SENSOR ALMS L 2:FUEL ALARM L 2:SENSOR OUT ALARM L I:SHORT ALARM L 2 :SHORT ALARM R 2:REG UNLEADED TYPE: STANDARD NORMALLY CLOSED IN--;TANK ALARMS " "'" :• T 2 :LOW PRODUCT ALARM ALL:HIGH PRODUCT ALARM T 2:INVALID FUEL LEVEL LIQUID SENSOR ALMS L 3:FUEL ALARM L 4:FUEL ALARM L 3:SENSOR OUT ALARM L 4:SENSOR OUT ALARM L 3:SHORT ALARM L 4:SHORT ALARM R 3:SUPER UNLEADED TYPE: STANDARD NORMALLY CLOSED IN -TANK ALARMS T 3:LOW PRODUCT ALARM LIQUID SENSOR'ALMS L 6 :FUEL ALARM L 6:SENSOR OUT ALARM L 5:SHORT ALARM L 6:SHORT ALARM R 4:DIESEL 2 TYPE: STANDARD NORMALLY CLOSED IN -TANK ALARMS T 4:LOW PRODUCT ALARM LIQUID SENSOR ALMS L 8:FUEL ALARM L 7:SENSOR OUT ALARM L 8:SENSOR OUT ALARM L 7:SHORT ALARM L 8:SHORT ALARM R 5 :COUNTER LIGHT TYPE: STANDARD. NORMALLY OPEN IN -TANK ALARMS ALL :LEAK ALARM ALL:LOW PRODUCT ALARM ALL:INVALID FUEL LEVEL ALL:PROBE OUT ALL:DELIVERY NEEDED LIQUID SENSOR ALMS ALL:FUEL ALARM ALL:SENSOR OUT ALARM ALL:SHORT ALARM ALL:WATER ALARM UU l BODE 3 THERMAL COEFF 000470 TANK DIAMETER 95.00 TANK PROFILE 1 PT FULL VOL 11783 FLOAT SIZE: 4.0 IN. 8496 WATER WARNING 2.0 HIGH WATER LIMIT: 410 MAX OR LABEL VOL: 11783 OVERFILL LIMIT 97% FULL VOL 11429 HIGH PRODUCT 95% 20 IZ 11193 DELIVERY LIMIT 17% 2003 LOW PRODUCT 330 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT 0.00 MANIFOLDED TANKS TO: NONE LEAK MIN PERIODIC: 0% 0 LEAK MIN ANNUAL 0% 0 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIf TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY 3 MIN T 3:0UPER UNL 92 PRODUCT CODE 6 THERMAL COEFF 000700 TANK DIAMETER 95.00 TANK PROFILE 1 PT FULL VOL 11783 FLOAT SIZE: 4.0 IN. 8496 WATER WARNING 2.0 HIGH WATER LIMIT: 4.0 MAX OR LABEL VOL: 11783 OVERFILL LIMIT 97% 11429 HIGH PRODUCT 95n 11193 DELIVERY LIMIT 171, 2003 LOW PRODUCT 330 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT 0,00 MANIFOLDED TANKS TO: NONE 83)171 T 2 :REG UNLEADED 87 PRODUCT CODE THERMAL COEFF :.000701 TANK DIAMETER 95.0i TANK PROFILE 1 P1 FULL VOL 1178: FLOAT SIZE: 4.0 IN. 849E WATER WARNING 2.i HIGH WATER LIMIT: 4.1, MAX OR LABEL VOL: 1176. OVERFILL LIMIT 97 % 11429 HIGH PRODUCT 95% 11193 DELIVERY LIMIT 171 2003 LOW PRODUCT 330 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99, TANK TILT 0.00 MANIFOLDED TANKS TO: NONE LEAK MIN PERIODIC: 0% LEAK MIN PERIODIC: 0: 0 0 LEAK MIN ANNUAL : 0°o LEAK MIN ANNUAL : 01% 0 0 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON.BREAK:OFF DELIVERY DELAY 3 MIN PERIODIC TEST TYPE STANDARD AN14UAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNX TST SIPHON BREAK:OFF DELIVERY DELAY 3 MIN I FCY E^•DG F FCk F E"' F r> O 20 IZ Qo Z ra] Z T iVli Ism01ws c a lino cno mina riio avc amino m' u.• W „w`, wow.. nw.. w•• a1 w.. aw w Fd FOI A JACKi Ll CPC WaC DC CU F- O mmu 3GC 4. C7 Q UJ C7 C4J] FU2 (n ill I W m I W w w cCC I uJ D'F I W m F 1 aQ jR F J CJ JET - U J , 3FLN 1F»0 1F 4 ALARtj HISTORY REPORT L 7:plSE OR ALARMOTHERSENSORSDSL2 A G 29. 201 ALARM FUEL ALARM 1 I3:54 AUG 29. 2011 12:55 FUEL ALARMDEC19. 2010 14:13 HISTORY RRPoRT LARM CEOR ALARM tT_ SENSORS R ,A1:AR4...,... AG. 29"'. . 23+ 1 13' AUG 29 A011 12:55 FU'E" ALAR<21010 1 g . 03DBC19' ... ALARM F,ISTOR'z REPORT SENSOR ALARM - - -- 1, - ;3.FEG FILL OTHER SENSORS ARr1 SENSOR 2011 13:54AUGHUG49• FUEL ALARIQ11 13:46AUG 'gig SENSOR OUT ALARM AUG 29, 2011 13:30 gLAF,M HISTrjRY REPORT L 4:TpENSOR ALgRh1 ___ OTHER REG oft - SENSOR S NSORS AUG 29, UT ALARM L 2011 1 4 92pHUB2, 112: 52 AUG L qALARMM9' 201I 12:;8j ALARM HISTORY REPORT SENSOR ALARM - -- -- L5:FILL SUPER UNL OTHER SENSORS SENSOR OUT ALARM AUG 29. 2011 13 :54 FUEL ALARM AUG 29. 2011 13 :06 FUEL ALARM FEB _26. 2011. . 1 : 04 , ... ALARM HISTORY REPORT SENSOR ALARM L 6:STP SUPER SUMP OTHER SENSORS SENSOR.OUT ALARM HUG 29. 2011 13:54 FUEL ALARM AUG 29. 2011 12:53 SENSOR OUT ALARM SEP 29. 2010 9:29 LEAK TEST METHOD "i n i TEST WEEKLY ALL TANK SUN START TIME 1 :00 AM TEST RATE :0.20 GAL; ,HR DURATION : 2 HOURS LEAK TEST REPORT FORMAT ENHANCED r'TWAREVER REVISION LEVELSION14.0ISOF'nIARE# 346014 - 100 -13CREATED - 97.03.12.20.41 NO SOFTWARE MODULESYSTEMFEATURES: PERIODIC IN -TANK TESTSANNUALIN -TANK TESTS ALA41 HISTORY REPORT SENSOR ALARM L 1:FILL RED DSL OTHER SENSORS SENSOR OUT ALARM AUG 29. 2011 13:54 FUEL ALARM AUG 29, 2011 13:02 FUEL-- ALARtl DEC 25, 2010 22:50 ALARM HISTORY REPORT SENSOR ALARM L 2 :STP RED DSL 01 HER BE N$9F 1SENSOR ,OUT AUG-Z9,- :201.1 FUEL ALARM AUG 29, 2011 bs.. SENSOR OUT ALARM SEP 29, 2010 9:29 " Lk51 *`1 MONITOR CERT. FAILURE REPORT SITE NAME : HAPPY GAS DATE: 8/29/2011 ADDRESS: 3221 TAFT HWY TECHNICIAN: RICHARD MASON THE FOLLOWING COMPONENTS WERE REPLACED /REPAIRED TO COMPLETE TESTING. REPAIRS; 87 FILL SUMP SENSOR WAS BAD I REPLACED WITH NEW AND RETESTED NEW ONE PASSED. RED DIESEL WAS OUT OF SERVICE I WAS UNABLE TO TEST POSITIVE SHUTDOWN AND LEAK DETECTOR LABOR: PARTS INSTALLED : 1- VEEDEROOT 208 SENSOR FOR 87 FILL SUMP. 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 ENVIRONMENTAL 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.