HomeMy WebLinkAbout3300 PLANZ ROAD (6)MONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the Stale of California
Aulhority 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 ofmonitoring 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 of this date.
A. General Information
Facility Name: #776 Howard's Market
Site Address: 3300 Planz Road
Facility Contact Person: Omero Garcia
Make /Model of Monitoring System: Veeder -Root TLS 350
B. Inventory of Equipment Tested /Certified
Check the appropriate boxes to indicate specific equipment inspected /serviced:
City: Bakersfield
Bldg. No.:
Zip: 93309
Contact Phone No.: 661 - 393 -7000
Date ofTesting/Servicing: 8 -12 -2011
Tank ID: 12000 gal. Regular Tank ID: 12000 gal. Diesel
X] In -Tank Gauging Probe. Model: 847390 -107 Lx] In -Tank Gauging Probe. Model: 847390 -107
Annular Space or Vault Probe. Model: Annular Space or Vault 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: Mechanical Line Leak Detector. Model:
x] Electronic Line Leak Detector. Model: WPLLD L] Electronic Line Leak Detector. Model: wPLLD
U Tank Overfill / High Level Sensor. Model:847390 -107 x] Tank Overfill / High Leval Sensor. Model: 847390 -107
Other (specify equip. type and model in Sec. E on Pg. 2) Other (specify equip. type and model in Sec. E on Pg. 2)
Tank ID: 12000 gal. Super Tank ID:
x] In -Tank Gauging Probe. Model:847390 -107 In -Tank Gauging Probe. Model:
Annular Space or Vault Sensor. Model: Annular Space or Vault Sensor. Model:
Piping Sump / Trench Sensor(s). Model: Piping Sump / Trench Sensor(s). Model:
Fill Sump Sensors(s). Model: Fill Sump Sensor(s). Model:
Mechanical Line Leak Decector. Model: Mechanical Line Leak Detector. Model:
X] Electronic Line Leak Detector. ModeI:WPLLD Electronic Line Leak Detector. Model:
Lx] Tank Overfill / High Level Sensor. Model:847390 -107 Tank Overfill / High Level Sensor. Model:
Other (specify equip. type and model in Sec. E on Pg. 2) Other (specify equip. typs and model in Sec. E on Pg. 2)
Dispenser ID: 1 & 2 Dispenser ID: 3&4
Fx] Dispenser Containment Sensor(s). Model: 794380 - 208 X] Dispenser Containment Sensor(s). Model: 794380 -208
X] Shear Valve(s). Lx] Shear Valve(s).
Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s)
Dispenser ID: Dispenser ID:
Dispenser Containment Sensor(s). Model: Dispenser Containment Sensor(s). Model:
Shear Valve(s). Shear Valve(s).
Dispenser Containment Float(s) and Chains(s). Dispenser Containment Float(s) and Chain(s).
Dispenser ID: Dispenser ID:
Dispenser Containment Sensor(s). Model: Dispenser Containment Sensor(s). Model:
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 -1 certify that the equipment identified in this document was inspected /services in accordance with the
manufacturers' guidlines. Attached to this Certification is information (e.g. manufacturers' checklist) necessary to varify that
this information is correct and a plot plan showing the layout of monitoring equipment. For equipment capable of generating
such reports, 1 have attached a copy of the report; (check all that apply) x System Set -up x Alarm history eport
Technician Name (print): Bradley Seykora Signature: ,
Certification No: B40738 License No: 804904
Testing Company Name: Confidence UST Services, Inc. Phone No: 800 - 339 -9930
Site Address: 3300 Planz Road , Bakersfield, CA 93309 Date of Testing/Sery icing: 8 -12 -11
D. Results of Testing /Servicing
Software Version Installed: 15.01
Complete the following checklist:
x] Yes No* Is the audible alarm operational?
Yes Is e Visua a arm operations ? grx]
Yes
No
Were all sensors visually inspected, functionally tested, and confirmed operational'?
Yes Were all sensors installed at the lowest point of secondary containment and positioned so that other
equipment will not interfere with their proper operation?
Yes No* Ifalarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) Hx N/A operational?
Ix I Yes No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary
N/A containment monitoring system detects a leak, fails to operate, or is electrically disconnected? Ifyes:
which sensors irritate positive shut -down? Sump/Trench Sensors [x] Dispenser Containment Sensors
Did you confirm positive shut -down due to leaks and sensor failure /disconnected? [X] Yes; No;
U 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 visual and audible at
the tank fill point(s) and operating properly? If so, at what percent oftank capasity does the alarm
trigger? 90 %
Yes* x-1 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?
Product; Water. If yes, describe causes in Section E, below.
x No Was monitoring system set -up reviewed to ensure proper settings? Attach set -up reports, if applicable.
x yeS No* Is all monitoring equipment operational per manufacturer's specifications?
In Section E below, discribe how and when these deficiencies were or will be corrected.
E. Comments:
F. In -Tank Guaging / SIR Equipment: E Check this box if tank guaging is used only for inventory control.
Check this box if tank guaging or SIR equipment is installed.
This section must be completed if in -tank guaging equipment is used to perform leak detection monitoring.
Complete the following checklist:
X] Yes No* Has all input wiring been inspected for proper enter and termination,including testing for ground faults?
Yes No* Were all tank guaging probes visually inspected for damage and residue buildup?
Yes M No* Was accuracy of system product level readings tested?
x Yes No* Was accuracy of system water level readings tested?
Fxj Yes D No* Were all probes reinstalled properly?
Yes No* Were all items on the equipment manufacturer's maintenance checklist completed?
In the Section H, below, describe how and when these deficiencies were or will be corrected.
G. Line Leak Detectors (LLD): Check this box if LLD's are not installed.
Complete the following checklist:
L] Yes No* For equip. start-up or annual equipment certification, was a leak simulated to varify LLD performance?
Check all that apply) Simulated leak rate: [x]3 g.p.h.: . 0. I g.p.h.; 0.2 g.p.h.;
Yes x No* Were all LLD's confirmed operational and accurate within regulatory requirments?
x Yes 0 No Was the testing apparatus properly calibrated?
Yes No* For mac anica LLD's, does the LLD restrict product flow if it detects a leak?
x N/A
x] Yes 7 No* For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak?
N/A
x Yes No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is
N/A disabled or disconnected?
L] Yes No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system
N/A malfunction or fails a test?
Yes No* For electronic LLD's, have all accessible wiring connections been visually inspected?
N/A
x Yes No Were all items on the equipment manufacturer's maintenance checklist completed?
In the section H, below, describe how and when these deficiencies were or will be corrected.
H. Comments: The WPLLD on the super failed and needs to replaced and re- tested. All other WPLLD's passed.
HOWARDS 776
3300 PLANZ
13AKEPSFIELD 93309
AUG 12. 2011 9:07 AM
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
INVENTOR`! REPORT
T 2:UNLEADED
VOLUME - 6653 C:ALS
ULLAGE a 5347 GALS
90: ULLAGE- 4147 GALS
TC VOLUME a 6504 GALS
HEIGHT - 52.11 1NCHES
WATER VOL n 38 GALS
WATER - 1.46 INCHES
TEMP - 92.0 DEG F
T 3:PREMIUM
VOLUME - 3074 GALS
ULLAGE - 8926 GALS
90'S ULLAGE- 7726 GALS
TC VOLUME - 3007 GALS
HEIGHT - 29.12 INCHES
WATER VOL - 0 GALS
WATER 0.00 INCHES,
TEMP 90.9 DEG F
T 4:01ESEL
VOLUME - 2775 GALS
ULLAGE = 9225 GALS
90% ULLAGE- 8025 (::ALS
TC VOLUME - 2734 GALS
HEIGHT = 27.05 INCHES
WATER VOL = 0 GALS
WATER - 0.00 INCHES
TEMP - 93.0 DEG F
A is A x X END* i x X w
SOFTWARE REVISION LEVEL
VERSION 15.01
SOFTUAREn 346015 -100 -B
CREATED — 97.10.23.08.56
S— MODULEn 330160 -012 -A
S`,'MM FEATURES:
PERIODIC IN -TANK TESTS
ANNUAL IN -TANK TESTS
CSLD
PRECISION PLLD
SYSTEM SETUP
AUG 12. 2011 9:07 AM
SYSTEM UNITS
U.S.
SYSTEM LANGUAGE
ENGLISH
SYSTEM DATE TIPIE FORMAT
MON DD YYYY HH : MM : S:3 xM
HOWARDS 776
3300 PLAN-7
BAK.EPSFIELD 93309
SHIFT TIME 1 6:00 AM
SHIFT TIME 2 DISABLED
SHIFT TIME 3 DISABLED
SHIFT TIME 4 DISABLED
TANK PERIODIC WARNINGS
DISABLED
TANK ANNUAL WARNINGS
DISABLED
LINE PERIODIC WARNINGS
DISABLED
LINE ANNUAL WARNINGS
DISABLED
PRINT TC VOLUMES
ENABLED
TEMP COMPENSATION
VALUE (DEG F ) : 60.0
BT113K HEIGHT OFFSET
DISABLED
H- PROTOCOL DATm FORMAT
HE i f:,HT
PRECISION TEST DURATION
HOURS: 12
DAYLIGHT SAVING TIME
ENABLED
START DATE
MAR WEEK, I SUN
START TIME
2:00 AM
END DATE
NOV WEEK 1 SUN
END TIME
2:00 AM
RE- DIRECT LOCAL PRINTOUT
DISABLED
SYSTEM SEi_URITY:
CODE : 000000
COMMUNICATIONS SETUP
PORT SETTING'S:
COMM BOARD : 3 (RS -232)
BAUD RATE : 9600
PARITY : NONE
STOP BIT : 1 STOP
DATA LENGTH: 8 DATA
AUTO TRANSMIT SETT 1 NG'S :
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
RS -232 SECURITY
CODE : 000000
RS -232 END OF MESSAGE
DISABLED
IN -TANK SETUP
T 2:UNLEADED
PRODUCT CODE 2
THERMAL COEFF :.000700
TANK DIAMETER 96.00
TAN): PROFILE 1 PT
FULL VOL 12000
FLOAT SIZE: 4.0 IN. 8496
WATER WARNIN s' 2.0
HIGH WATER LIMIT: 3.0
MAX OR LABEL. , VOL : 12000
OVERFILL LIMIT 90%
10800
HIGH PRODUCT 95.0
11400
DELIVERY LIMIT 101141
1200
LOW PRODUCT 1200
LEAK ALARM LIMIT: 99
SUDDEN LOSS LIMIT: 99
TANK TILT 1.00
MANIFOLDED TAMS
TO: NONE
LEAK MIN PERIODIC: IV
120
LEAK MIN A14NUAL : I X
120
PERIODIC TEST r,!PE
STANDARD
A1414UAL TEST FAIL
ALARM DISABLED
PERIODIC TEST FAIL
ALARM-, D I SABLED
GROSS TEaf FAIL•
ALARM''DISABLED
ANN TEST AVERAG:l Np : OFF
PER TEST AVERAGING: OFF
TANK TEST NOT I F1' : OFF
TNK. TST SIPHON BREAK :OFF
DELIVERY DELAY I MIN
0
T 3 :PREMIUM
PRODUCT CODE 3
THERMAL COEFF :.000700
TA14K DIAMETER 96.00
TANK PROFILE i PT
FULL VOL.: 12000
FLOAT SIZE: 4.0 IN. 8496
WATER WARNING 2.0
HIGH WATER LIMIT: 3.0
MAX OR LABEL VOL: 12000
OVERFILL L1MIJT is 90%
10600
HIGH PRODUCT 95%
11400
DELIVERY LIMIT ,: 10:
h 1200
LOW PRODUCT 1200
LEAK ALARM LIMIT: 99
SUDDEN LOSS L I M`I'T : 99
TANK TILT 4.00
MANIFOLDED TANKS
TO: NONE
LEAK. MIN PERIODIC: 1s:
120
t..
LEAK MIN ANNUAL: IV.
120
PERIODIC TEST iT' 'PESTANDARD
ANNUAL TEST FAIL
ALF R1l'`,DISABLED
PERIODIC TEST FAIL
ALARM, D I SABLED
C
GROSS TEST Fa11-
ALARI °1; (,D i SABLE
ANN TEST AVERAG;NG: OFF
PER TEST AVERAGING: OFF
f
TANK TEST NOTIFY' OFF
TNK TST S I PH611 'IREA); OFF
DELIVERY DELAY I MIN
j
i
T 4:DIESEL
PRODUCT CODE. 4
THERMAL COEFV :.000450
TANK DIAMETER 96.00
TANK, PROFILE I PT
FULL VOL': 12000
I
FLOAT SIZE: 4.0'IN. 13496
WATER WARNING 2.0
HIGH WATER LIMIT: 3.0
MAX OR LABEL 1VOL : 12000
OVERFILL LIMIjT 90%
10800
HIGH PRODUCT 95 %.
11400
DELIVERY LIMIT 1: 10%
r ;: 1200
U
LOW PRODUCT 1200
LEAK ALARM LIMIT: 99
SUDDEN LOSS LIMIT: 99
TANK TILT 0.00
MANIFOLDED TLKS
TO: NONE 1
LEAK MIN PERIODIC: Is:
2' 120
LEAK MIN ANNWAL : IX
120
PERIODIC TEST TIPS
STANDARD
ANNUAL TEST FAIL
ALARMIDISABLED
PERIODIC TEST Fr IL
ALARM DISABLED
GROSS TEST FAIL fALARMID I SABLED
i
ANN TEST AVERAGING: OFF
PER TEST AVERAGING: OFF
TANK TEST NOTIFYI: OFF
I TNK TST SIPHON 8PEAK:OFF
f
DELIVERY DELAY I: 1 MIN
1
1
LEAK TEST METHOd
TEST CSLD ALL TAN)'
Pd - 95 %:
CLIMATE FACT0R:MOD'ERATE
LEAK TEST REPORT, FORHmT
NORMAL
I
WPLLD L1PIE LFAX SETUP LIQUID SENSOR SITUP
L ):UDC 1 -2
W 1:91 TRI- STATE (SINGLE FLOAT)
CATEGORY : DISPENSER PAN
PIPE TYPE: ST'EE
L 114E LENGTH: 15+j FEET
0.20 CPH TEST: PNABLED
SHUTDOWN RATE: '3.0 GPH L 2:UDC 3 -4
0. 10 GF'H TEST Mt DD TR 1 -STATE (S I NGI,E FLOAT' ) DATE : ? ?? U 1 CATEGORY : DISPENSER PAN
T 3:PREMIUM
DISPENSE MODE:
STANDARD
i
OUTPUT RELAY SETUP
W 2:87
PIPE TYPE: STEEL
R ):OVERFILL ALARM
PIPE TYPE : S(`EE1 TYPE:
LINE LENGTH: 15[ FEET
NABLED
STANDARD
0.20 GPH TEST: NORMALLY OPEN
SHUTDOWN RATE: 3.0 GPH
LIQUID SENOR ALMS
0.10 GPH TEST' P1i DD
ALL:FUEL ALARM
DATE : ? ?ri (1 IN -TANK ALARMS
TANK: NONE I ALL:OVERFILL ALARM
I ALL:HIGH PROGUOT ALARM
I ALL:MAX PRObUO'P ALARM
W 3:DSL
WPLLD LINE DISABLE SETUP
PIPE TYPE: STEEL
LINE LENGTH: 150 FEET
0.20 CPH TEST: ENABLED W 1:91
SHUTDOWN RATE: 3.0 GPH
0.10 GPH TEST ltl/DD LIQUID SENOR ALMS
DATE : ??? D ALL:FUEL ALARM
T 4:0IESEL ALL:SENSOR OUT.ALARM
DISPENSE MODE: ALL:SHORT ALARPI
STANDARD
W 2:67
LIQUID SENSOR ALMS
ALL:FUEL ALriRM
ALL:SENSOR OUT ,ALAR1.1
ALL:SHORT ALARM
W 3:DSL
LIQUID SENSOR ALMS
ALL:FUEL ALARM.
ALL:SENSOR OUT 'ALAR111
ALL:SHORT ALARM
LINE LEA): LOCKOUT SETUP
LOCKOUT SCHEOULE
DAILY
START TIME: DISABLED
STOP TIME : UISHBLED
ALARM H1STORY,RgPORT
SENSOR ALARM - - - --
L I :UDC 1 -2
DISPENSER PAN
FUEL ALARM
AUG 10. 20111, 11:12 AM
FUEL ALARM
AUG 10, 2010 +10 "34 AM
SENSOR OUT A ARM
r AUG 10, 2010 9:28 AM
i
x x PtxA END t x x x x
11
ALARM HISTO r 4EPORT
SENSOR ALARM - - - --
L 2 :UDC 3 -4
DISPENSER PAN
FUEL ALARM
DEC 25. 2010 8:36 PM
FUEL ALARM
DEC 19, 2010 12:22 AM
SENSOR OUT ALARM
AUG 10. 2010 9:28 AM
A x R A x END ^ R w k )e
IN -TANK ALARM - - ---
T 2 : U11ILEADED
PROBE OUT
AUG 12, 2011 936 All
T 3 : PREIi I UM
INVENTORY INCREASE
INCREASE START
AUG 12, 2011 9:33 All
VOLUME - 1674 GALS
HEIGHT - 18.93 INCHES
WATER o 0.00 INCHES
TEMP a 90.9 DEC F
INCREASE END
AUG 12. 2011 9:37 AM
VOLUME = 8864 GALS
HEIGHT - 66.46 INCHES
WATER . 1.01 INCHES
TEMP - 93.7 DEC: F
GROSS I PdCkE(iSE 7190
TC NET INCREASE- 7017
IN -TANK ALARM - - - --
T 2:UNLEADED
LOW PRODUCT ALARM
AUG 12, 2011 9:37 AM
IN-TAN), ALARM - - - --
T 2:UNLEADED
DELIVERY NEEDED
AUG 12. 2011 9:37 AM
IN -TANI; ALARM - - - --
T 2:UNLEADED
INVALID FUEL LEVEL
AUG 12, 2011 9:38 AM
T 2:UNLEADED 1
INVENTORY INCREASE
INCREASE START
AUG 12. 2011 9:38 All
VOLUME 897 GALS
HEIGHT - 12.30 1110HES
WATER = 0.00 INCHES
TEMP - 91.0 DEG F
INCREASE END
AUG 12, 2011 9:40 All
VOLUME - 5422 GALS
HEIGHT - 44.36 INCHES
WATER - 37.35 INCHES
TEMP - 91.1 DEG F
GROSS INCREASE- 4525
TC NET INCREASE- 4426
SENSOR ALARM
L I:UDC 1 -2
DISPENSER PAN
FUEL ALARM
AUG 12, 2011 9:41 AM
WPLLD LINE LEAK ALARM
W 1:91
WPLLD SHUTDOWN ALM
AUG 12'. 2011 9:41 All
WPLLD LINE LEAK ALARM
W 3:DSL
WPLLD SHUTDOWN ALM
AUG 12. 2011 9:41 AM
T 4:DIESEL
INVENTORY INCREASE
INCREASE START
AUG 12, 2011 9:38 AM
VOLUME o 1579 GALS
HEIGHT - 18.17 INCHES
WATER a 0.00 INCHES
TEMP - 93.0 DEG F
INCREASE END
AUG 12, 'Oil 9:41 All
VOLUME o 6335 GALS
HEIGHT m 50.11 INCHES
WATER . 0.00 INCHES
TEMP - 95.1 DEG F
GROSS I Nt,P.EASE- 4756
TO NET INCREASE= 4679
SENSOR ALARM
L 2: UDC 3-4
DISPENSER PAN
FUEL ALARM
AUG 12. 2011 9:41 AM
IN -TANK ALARM - - - --
T 4:DIESEL
OVERFILL ALARM
AUG, 12, 2011 9:42 All
IN -TANK ALARM - - - -- WPLLD LINE LEAK ALARM - - -- IN-TANK ALARII -- - --
T 4:DIESEL W 2:67 T 4:DIESEL
PROBE OUT WPLLD SHUTDOWN ALM PROBE OUT
AUG I_'. 2011 9 :38 All AUG 12. 2011 9:41 All AUG 12, 2011 9:43 AM
IN-TANK ALARM -- --- IN -TANK ALARM - - - -- T 2:UNLEADED T 3:PREMIU9
END
T 2:011LEADED
INVALID FUEL LEVEL PROBE OUT
AUG 12.
INVENTOR', INCREASE
AUG 12. 2011 9:44 AM AUG 12. 2011 9:47 All
I1177 GALS 3300 PLANZ
INCREASE START
84.41 INCHES BAKEPSFIELD 93309
AUG 12, 2011 9:43 AP(
WATER 0.00 INCHES
T 2:INVALID FUEL LEVEL
TEMP 94.3
VOLUME - 5422 GALS
AUG 12. 2011 9:49 AM
HE113HT a 44.36 INCHES
SYSTEM STATUS REPORT
WATER = 37.35 INCHES
INCREASE-
TEMP = 89.2 DEC F
IN -TANK ALHRM ----- IN- TAM: ALHRhI -
SYSTEM STATUS REPORT
T 2:UNLEADED T -:PREMIUM INCREASE END
OVERFILL ALARM HIGH PRODUC ;T ALARM AUG 12. 201) 9:49 AM
AUG 12. 2011 9:45 All AUG 12. 2011 9:48 All
W I:WPLLD SHUTDOWN ALM
VOLUME - 10756 GALS
HEIGHT = 80.60 INCHES
W 3 :WPLLD SHUTDOWN ALM
WATER = 73.55 INCHES
W 3:WPLLD SHUTDOWN ALM '
TEMP = 90.1 DEG F
GROSS INCREASE- 5334
TC NET INCREASE= 5218
T 4 :DIESEL IN-TANK ALARM - - - -- INVENTORY INCREASE T 3:PREMIUM
INCREASE START MAX PRODUCT ALARM
AUG 12. 2011 9:42 AM AUG 12, 2011 9:48 AM
VOLUME - 6335 GALS
HEIGHT - 50.11 INCHES
WATER = 0.00 IM,HES
TEMP = 94.0 DEG F
1N -TANI: ALARM - -- --
T 2:UNLEADED
PROBE OUT
AUG 12. 2011 9:45 AM
HOWARDS 776
3300 PLANZ
BA):EPSFIELD 93309
AUG 12, 2011 952 All
I N -TANI: ALAR11 - -- -
T 3:PREMIUM
HIGH PRODUCT ALARM
AUG 12, 2011 9:46 AM SYSTEM STATUS REPORT
W I:WPLLD SHUTDOWN ALM
W 2 :WPLLD SHUTDOWN ALM
W 3:WPLLD SHUTDOWN ALM
HOWARDS 776
INCREASE END 3300 PLANZ
AUG 12. 2011 9:45 AM HOWARDS 776 BAKEPSFIELD 93309
VOLUME I1177 GALS 3300 PLANZ
HE It' HT 84.41 INCHES BAKEPSFIELD 93309 AUG 12. 2011 9 :49 AM
WATER 0.00 INCHES
TEMP 94.3 DEG F AUG 12. 2011 9:49 AM
SYSTEM STATUS REPORT
GROSS INCREASE- 4842
TC NET INCREASE- 4766 SYSTEM STATUS REPORT T 3:H1GH PRODUCT ALARM
T 3 : H I GH PRODUCT ALARM T 3 : h1AX PRODUCT ALARM
T 3:MAX PRODUC•C ALARM W I :WPLLD SHUTDOWN ALh1
W I:WPLLD SHUTDOWN ALM W 2:WPLLD SHUTDOWN ALM
W 2:WPLLD SHUTDOWN ALM W 3 :WPLLD SHUTDOWN ALM
W 3:WPLLD SHUTDOWN ALM '
1N -TANI: ALARM - -- --
T 2:UNLEADED
PROBE OUT
AUG 12. 2011 9:45 AM
HOWARDS 776
3300 PLANZ
BA):EPSFIELD 93309
AUG 12, 2011 952 All
I N -TANI: ALAR11 - -- -
T 3:PREMIUM
HIGH PRODUCT ALARM
AUG 12, 2011 9:46 AM SYSTEM STATUS REPORT
W I:WPLLD SHUTDOWN ALM
W 2 :WPLLD SHUTDOWN ALM
W 3:WPLLD SHUTDOWN ALM
SENSOR ALARM - - - --
L 2:UDC 3 -4
DISPENSER PAN
SENSOR OUT ALARM
AUG 12. 2011 9:54 AM
SENSOR AL1iR19 - - - --
L I:UD 1 -2
DISPENSER PAN
SENOR OUT ALARM
AUG 12. 2011 9:54 AM
HOWARDS 776
3300 PLANE
BAKEPSFIELD 93309
AUG 12, 2011 9 :55 AM
SYSTEM STATUS REPORT
W I:WPLLD SHUTDOWN ALM
W 2:WPLLD SHUTDOWN ALM
W 3:WPLLD SHUTDOWN ALM
WPLLD LINE LEAK ALARM
W 3:I,SL
GROSS LINE FAIL
AUG 12, 2011 10:23 AM
WPLLD LINE LEAK, ALARM
W 3:1761-
WPLLD SHUTDOWN ALM
AUG 12. 2011 10:23 AM
HOWARDS 776
3300 PLANE
BAKEPSFIELD 93309
wUG 12. 2011 10:26 AM
SYSTEM STATUS REPORT
W 3:6ROSS LINE FAIL
W 3:WPLLD SHUTDOWN ALM
WPLLD LINE LEAK ALARM
W 2:87
GROSS LINE FAIL
AUG 12. 2011 10!30 AM
WPLLD LINE LEMK ALARM
W 2:87
WPLLD SHUTDOWN ALM
AUG 12. 2011 10:30 AM
HOWARDS 776
3300 PLAN2
BAKEPSFIELD 93309
AUG 12. 2011 10:49 All
SYSTEII STATUS REPORT
W 2:GROSS LINE FAIL
W 2:WPLLD SHUTDOWN ALM
W 3:GROSS LINE FAIL
W 3:WPLLD SHUTDOWN ALM
9
HOWARDS 776
3300 PLAN?
BAKEPSFIELD 93309
AUG 12. 2011 11:20 AM
S^ISTEM STATUS REPORT
ALL FUNCTIONS NORMAL.
INVENTORY REPORT
T 2:UNLEADEG
VOLUME o 6582 GALS
ULLAGE o 5418 C:ALS
90% ULLAGE 4218 GALS
TC VOLUME . 6434 GALS
HE113HT - 51.66 INCHES
WATER VOL o 0 GALS
WATER m 0.00 INCHES
TEMP o 92.0 DEC F
T 3 : PREF'I I UM
VOLUME o 3060 GALS
ULLAGE e 8940 GALS
90%i ULLAGE 7740 GALS
TC VOLUME a 2993 GALS
HE I GHT - 29.02 114CHES
WATER VOL ° 0 GALS
WATER = 0.00 INCHES
TEMP . 91.0 DEG F
T 4:DIESEL
VOLUME = 2748 GALS
ULLAGE v 9252 GALS
90%.. ULLAGE- 8052 GALS
TO VOLUME o 2707 GALS
HEIGHT a 26.86 INCHES
WATER VOL - 0 GALS
WATER - 0.00 INCHES
TEMP d 93.0 DEG F
R x x x R E14D X A x x P(
SWRCB, January 2006
Spill Bucket Testing Report Form
Thisform is intendedfor use by contractors performing annual testing of UST spill containment structures. The completedform and
printoutsfrom tests (if applicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: #776 Howard's Market Date of Testing: 8 -12 -11
Facility Address: 3300 Planz Road , Bakersfield, CA 93309
Facility Contact: Omero Garcia I Phone: 661- 393 -7000
Date Local Agency Was Notified ofTesting: 7/13/2011
Name of Local Agency Inspector (rfpresent during testing): Ernie Medina
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Bradley Seykora
Credentials: 0 CSLB Contractor 0 ICC Service Tech. SWRCB Tank Tester Other (Spec)
License Number(s): CSLB #804904 ICC #81 1 1231
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: 0 Hydrostatic Vacuum Other
Test Equipment Used: Lake Test Equipment Resolution: 0.0625"
Identify Spill Bucket (By Tank
Number, Stored Product, etc.
1 Regular 2 Super 3 Diesel 4
Bucket Installation Type: Direct Bury
0 Contained in Sump
Direct Bury
0 Contained in Sump
Direct Bury
OContained in Sump
Direct Bury
Contained in Sum
Bucket Diameter: 12.00" 12.00" 12.00"
Bucket Depth: 11.25" 11.501, 1 1.50"
Wait time between applying
vacuum /water and start of test:
5 min. 5 min. 5 min.
Test Start Time (Ti): 9:45 A.M. 9:45 A.M. 9:45 A.M.
Initial Reading (Rj): 9.50" 9.50" 9.25"
Test End Time (TF): 10:45 A.M. 10:45 A.M. 10:45 A.M.
Final Reading (RF): 9.50" 9.50" 9.25"
Test Duration (TF — Tj): 1 hour 1 hour 1 hour
Change in Reading (RF - Ri): 0.00" 0.00" 0.00"
Pass /Fail Threshold or
Criteria: 0.0625" 0.0625" 0.0625"
Test Result: x Pass Fail 0 Pass Fail 0 Pass Fail Pass Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -upfor failed tests)
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
hereby certify that all the information contained in this report is true, accurate, and infull compliance with legal requirements.
Technician's Signature: Date: 08/12/2011
State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
1
2
L1
3
4
L2
LJV
Overfill
Alarm
L1 - Disp. 1 -2 UDC, Veeder -Root 208 sensor
L2 - Disp. 3-4 UDC, Veeder -Root 208 sensor
1 - Mag Probe
2 - WPLLD
Diesel
12,000 gal
Regular
12,000 gal
Super
12,000 gal.
STP STP STP
2 2 2