HomeMy WebLinkAbout3200 PANAMA FMC APP 2014]MONITORING SYSTEM CERTIFICATION
ror Uver Bv.411 - hu1scherior."5 H'ir h in V'w -S1Wfe qCCa1ffiw-.f
A wthorily QW., Charwr 6. 7, Health and.'?W'e-): (Aja'ea- Cfparfer 16, Divi'sibri 1. Tiffe "'Li. Co.? 'fij'-Vofia Coale
J'IIJS f0M MU SL be USW 110 dOCUMew wsfing zintl wrvicirwl of moftitoring ccjiOptoent / — ist be ged
-Lse trzll�'Sgn�jrjc Llrk)� J;xr each
2z -- — k,,-! _RNpL-
h the L%�chnici= who I)crlornis III work. A ctTy cpfflii.s Jaxiii rnwa 1,,c pi-ovilded TO the Wok syiwin
Me. owvcr�opera-tor intist submit a wpy r3foiis lbrin to tl-w- local, ag gjjjLLjjfTQ L:S i%,rjCjjj_-, 3o kh-LVS Of wsc dwc.
97
A. General Information
Facility Namie.- #3351 ward ®S *4
'�7-nama
Btdg.
Site, A&Jress: 326 a Lane
Ciw- Bakersfield CA Zip: 93342
P'acility Contact Person., Omero Garcia
ConUwll Phone No.: (800) 393-7000
MakeJMDdel c)f VlonitoHng Sy-.stcrn 'Veeder-Root TLS 350
Daic of Testing,'Stn4cing: 91912014
B. InventoU of Equipment Tested /Certified
Check the a'111 [ III PrOpriale baxes to WiCIIIII&II :111111F, 1:1,11, 1 ICCOUJI pirn1, in `w I c dis d:
Tank ID: 12r000 1. Regular Tank I.D. 12T000 gal. Regular 2
v
jwb-],Snk fiauging Pr-,ibj�- 1141 8473130-107
In- Iank 6.11.11.1161111ttPrDhL:. 'Oodcl: 847390-1107
Amiular SpaLr Of Vault Nds s�l:
Ann iihir Sp of V-xfl I -`,*,�Iilsi It N'lotIVI:
P ipiew Sump i Tienob SciisnIr(s M
l'i P i 11- N U113p, i T.ralch sells'lly(." 'N"lodel:
1111 Sump Sunsorl'si. Ntsdcl:
Fill Mod L' 1;
nMQcNwicW Line Uxik 1-')o-wor. Nfod--A:
:1, Lin c, Laik Dqwvw. Modcl-.
Dwr-III Liew, Leikk- Daccow t%-1- o d e I -. WPLLD
Elcwonic urw I citk Dervaor 1,I WPLLD
to J'ank ovafitl ffigh-lxwel S-ciisor, N1 riikl: 84T390-1 07
OTwilk, Ovatill " Higli-L.c.-cl 'Sciimir, Nrhidel: 847390-107
001cr (slxcify equipilleRl lvpe 313141 imidO In CLion E k�lri 11'M1t'2.K
12,000 wal, S
TaA ID--;� - Uper
Ta n k I 12,000 u al. Diesel
in-Twok Chagging? Protw: Nindro- 847390-107
lji-`r- n, - (jangi tig Prok 1,4odcl- 1147390-107
[].Amtulax Spa;x or Vau1r%Lmwr. Modcl•
ApillitarsjuLcu
I'lipute Stinip,,-1'nmcf& Siom"'Irtn'l. 'Modc]:
Q Pipit g, S urnp Modcl
Fill swnp scilsor("j. Modzi:
fill NlUnp.Scn-wris). Mod
Slucluatical Linc b4A Detector NNW,,&
[JMcchanical kin c Lcak D%;wccQr Mokl:
Owwrtic Lien: l-cak l rik tiffs. Modd: WPLLD
1:71ceyonic Linc Leek Detector, M ada I .- WPI-LD
STank 0%,arfill I 1-figh-LUvO Sensor. Modd: 847390-107
'T.unk Ovarill s 111--gh-1xvid --S mczir. Madel. 847390-1,07
El (Ahcr Osvwzify cquip✓ern qypc wad ffravgM tri Sedf-,leb E-oli Vary:
C? Othvj Npc �wd'?vMIL4 ie? Eon?
Wipen serED: 1 &2
Dispenser 10: 3 & 4
Pispe mer Cosuainoictu Sen-aafk-s). NIWO: 7,94380,208(2)
9 Dkirens. r Corklaitlnwnt Sim-uu(s y. J4.tLkJC1.r 7914380-208 (21'
Shcar Vulvc(s).
[9 -Sh-tpr Valvc(,,$).
Dispawser Owainiiicnt Ffitzo(s) and
0 lk)putiser Conrommew fltxntt(�Iarad (,ha-iilfs).
&
7 & 8
Dislw=-a C'ontainracm Scrrsui(s). Vokl• 794380-408 (2)
I DispciI (-ojAzjiaErv:I Svn or(,%), %Aodel- 7W380-208 f2l
Sheaf Valvc(s)
DispenscT Contaimneiii 11II and Chaiii$si,
Dispenwr Hoa(5) and C-1i iiii W -S-)
-
Dispenser ID:
---------
Dispenser ID:
j)ispen,-,,--T f nmeni Scnsori si Mockil
r-1 Dkp�;Twx Comal i iman. 54,=iprisi- %Nlodcl:
CT "N'Tit=r Va(wcrs).
0 Nikar
Disperiset containnicni Floate, 5 '� and Chailh(" J'.
Di,:�LWIIISLT CoriTau-imen I Floaii(s) Mid Chuiatsl'
*If 1hu Rwility coillains rn-oxe tanks or disperlsons, cop • this forin hwIqj,-,h, . inli-williltir)JI fi�r eVer-L' Lank aInd dispenser w flic lllcility-
C. Cerfification - 1. curtifythal the equipment Identifittl in this dacument %I in accorchincII WLitkt tho wanuflacturers'
guidelines. Attaclacit to this Cel-rifir'.ition i's informatJon (e.g. manufacturers' elleckli at
1!% sts) necessary to verify tbat this inforw inn is
correct and a Plot Plan showing the Invout (of numitoring equipment. Forany equipment, cupable ofgener-oting such reports, I have also
-ittached a copy of the report; (elm A- a/7 Iblot upp4g): System, NIII rin his )Iuv
TecKnician Name (print): Dustin Reese SiAtlatU
Certification No.: 843426 Lieense,�' 904
Testing Company hi e: Confidence LIST Services Phone No'.. (800) 339-0930
Site Addrcss-: 3200 Panama
_Lane, Bakers_fietld, CA 9,3312 Dwe t)f Tc-ming-,'Setvicirjg: 919120U
Pace I of 3
Monitoring System Certification
D. desalts of Testing/Servicing
Soffivare Version l�stalled: 327.04
Cnmnletf.- the ffilinvOna cheeklixt-
0 Yes
❑ No*
is the audible alarm operationat.il
I
0 Y es
N-S
❑ No*
Is Lhe visual alami openaliorial"
e -
No
livere all seasc'-srs visaalhv in'.51vued, les red, and coofirinud operationa-P?
19 Yes
❑ No*
Were all sensors i'nstal led at lo%vek;t point ofsecojtdary cDntaiament and poohion.-d so that offit-C equipment will
not irnterfere wi ffi their prope r operal io nr?
❑ Yes
❑ No*
if alarms are relayed to a i,e,,inote numnIONT1,LT StULICIII. is all coinnuinications equipnient (e.g., niodem)
0 IN; 1� 11
Openrlional?
Yes
0 Yes
❑ No*
For pressuri7ed piping sysivns. does tbQ UIrbineautoniaticaily shuE down if die piping secondary COMaIngnent
[D N /A
yes b s so rs
SV51CM dewets a taak� ft ils to operale-, or is ellectrically disconrlix-,red9 Er, _: whic -en i'm itiate.
flosi tive Amu -down ? (Oyeck all thal qpp�v) ❑ Suni p,rrrenc h Sens(.v,%-. [3 D isjxn:;,�er Contai n nI ent sen-so I-,
Did you confirm posftive. shtil-down due to feakis -,112d Sensor 0 Ycs; ❑ No.
0 Yes
❑ No*
'For tank systenis thal tidllizt the inonitoring systeni, as Ilhe primary tank overfill w rn-inn de-vice (17C., 7na
0 NA
meeftani-LRI OWI-fill prtvevion valve is installed) i,% the overFill warning akarm visibic -,md audible at the tank
III Lpervervt �[Mnk capacity does the 11�alrni 9094
M, point(s)and operafing properly? H'so- at w1w
Yes*
❑ No
F
if c:s, identtf�spe,,t;( -ic or ot p
Was anv nionitoring Lquiptnent repfaced' ( sev,5ors, fimbes hercqujiP,"mt iL 0, )&Cod
a rb y
and list the rnwwfacrurer tio.nte and inodel f�i!r a] I rej-flzacemenE pai-ts iD SVC-fi4Q)tj E, bQIm-
D Ycns*
0 No
Was liquid tbitnd inside any sec(indary cDntahmu�nL sysivnis ill" si'gyied as dry systenis? '(.-heck aff rhal afydyl
❑ Product, ❑ Water. if -ves. describe causes in Section E, belovv.
z , es
0 No*
Was nionitoring .system set-up revievved to ensure properseaiiigs) Attach su Lfla reports. il'appficablo
,(0 Yc�s
i ❑ No`
Is all nionitoring equipmen.L oper-aflonal per rnanuhcwrer's spec i 11 cation- s"
In Section E below, describe 11(jkv and when these delriciencires were oz- will be correcud.
E. Comments:
Station was in a. Degradation Collect Warn on H-1, found a kink- in the 8' toot hose. I replaced T hose
with firand new heal y hose
Page 2 o IF 3
Monitorina System Certification
F. In-Tank Gauging / SIR Equipmetit: 0 Check this Nix if Early gaugging is used only for inveritory control.
❑ Check this box if no twikeau-ing, or SIR equipmeRn is installed.
Z$ Z!
This section must be Qompleted if in- teak. oau Oing equipmeilL is Lased to, perforin lezdc detecEion m, onitodticy-
Complete the following cliecklist:
®R Yes
FOX
❑ No*
_
Has all —inpoul vviring been inspected for pro-per entry and termialalion, including testing Ibrgvround faults?
2 Yes
❑ NO
Were aU tankg puging Probe ViSk-111V inspected for darnage andresdue Lxji[pup?
(9 Yes
El No*
Was accuracy of system Droduct Lvel rt%ditig
0 testaV
Yes
❑ No*
Was accuracy off stem water lcvd readkigoss tcsLed?
''e5
El No*
Were all probes reinstalled prx)perlv','
0, Yes
0 No
❑ NO
a Larn [eted'
Were all it-erns c,)nllice-cluipmeitti,iiaiiuf onaintew.ace checkti% 1)
In the Section H, below, describe ho and wit en these deficieneses weveor will bt. corrected,
G. Line Leak Detectors (L.T.,D):
comnlete lite fillIftwirl-g Checklist-
0 Check this bob if LLE)s are not instalic(l.
0 Yels
❑ No*
For equiplllenll start-up or annual equ,ilamni CeFLification. was a `lcak simulated to verif: LLD pedorniamce?
all Sim ulaLcd leak rate: 0 3 g.pJu ❑ 0_1 MT-h: ❑ C12 tp.11-
0 Yes
❑ NO
Were all LLD5 confimied operational and accuraile ry requirements?
Yes
❑ No
Was the teginer apparatus properly calibriued?
T-1 yles
❑ NO* I
For mechanical] L does the LL D restrict prod uel f! ow i F i t detects a leak?
Z N, rA
0 Yes
❑ No* i
For electronic 1.1,13s, does the turbine automatically Shut off if the LLD detecis a ICA?
❑ N�A
0, Yes
❑ No*
Far electronic LLM, dot,,, thC ILM-bine auiorriaticallys'llut ciffif 4-111V portion ()J'tjae rya Ojtit ,jJ'jjjL' 5V ( 'mi is disabled
❑ N,,A
or disconnected?
Yes
[0] N o
[:or electr0iiie LLDs, does the turbine aittomaticalfiy shul aff"if any portion of t: e moniloring systern, Malfiln.ttions
N, A
or fiails a test?
Yes
❑ N<)*
For electronic t-L)s, fiavc,.-all accessible w iii-In a corn ecdo ns been visuall , inspecteV
El NIA
Yes
F-1 No*
Were all items oil the oquipimew manu l'acturer's, mainterjance checklist coniplelvd?
* In die Section H, below, describe how and When these dericlencles Avere or will be corrected.
H. Comments.-
Page 3 of 3
Customer Address: Work Order: 33081 Site Address:
Jaco Hil Test Date: 9/9/2014 #3351 Howard's #4
P.O. Box 825,15 3200 Panama Lane
Bakersfield, CA 193380-2515 Bakersfield, CA 93313
Site Contact: Ornero Garcia
Technician-. Dustin Reese
Phone; 661-393-700ti)
Phone: 800-339t-9930
tCC, No.: 8216722
Product Type I LLD Type
Model
Serflal No. i Check
Valve
Bleed
Of ML..
Leak
Rate
--- -- -----
Pass/Fall
Holding
Tested:
Pressure
Regular U
Electronic
WPPLD
NA
14 PSI
70 ml 3 gph (a
Pas
10 psi
Regular UNL
Electronic ! WPPLD
NA
12 PSI
62 mi 3 gph @
Pass
J
10 Psi
Premium L
Electronic WPPLD
NA
12 PSI
60mi
3 g -ph @
Pass
10 psi
Diesel
Electronic
WPPLD
NA
13 P51.
58 M1
3 gph @
Pass
10 psi
3 gph @
10 per
J
3gph @
10 psi
3 gph @
10 psi
3 gph @
10 psi
Technician Name. se Technician No.: 8216722
ignatu re: Date: 9)�9/2014
S
HOWARDS 141JR.] HAFrj'
3200 IPA14AM
9w=zvTzLD 93312
S' S. 2054 S1.22S t�M
SYSTS4 STATLe REPORT
Imia(row REPORT
T I *NL
5451 BLS
VOLR -
2532 GALS
ULLAGE "
90,98, -C;ALS
50% W.LP#aE-
7864 GALS
TAG VOLU4E -
2926 GALS
HElow -
2R. 14 1 HCHM
UPVTV. VOL -o
16 CAM
WAM
0.84 1 1c
TE"
90.2 Dm r
7 2: UNL I
5451 BLS
VOLUME 0
60?6 �,CALS
ULLAGE a
5924 CAM
%M Ua$M-
4724 +LS
TC VOLUME -
5957 GALS
KICHT -
4a.4B 11CHW
WATER VOL -
'D GALS
bATER w
0,00 ItCHES,
TRIP •
a7.9 DM F
T 30.DSL
5451 BLS
VOLUME "
4995 GALS
U,LtArAF- -
7005 CRIS
9= ULLAGE-
5805 GALS
TO VOLtM -
49n CAM,
mlow -
41.67 IMHES
[AMR VOL -
25 rALS
WATER
1.11 INCHES
TE*
90.9 DE O F
T 4*UAL 2
VOLUME 6549 CALS,
IJILIAW E w
5451 BLS
bftj4de�
4251 , s
TO VOLUME -
641 a GALS
HEIGHT a
St., 45 114olms
%�llm VOL •
I A SALS t,
L%TZR -
INCHES-
TEMP 1
89. a DEG F
x x x x x pw x w x w x
SOF7LIARE M.1,StON LOfM
VEM,10ftl a-97,04
SOFT11*REM
9-MDULSO =160-066-a
SYSTEK FEATUM'*
PSRIODT-C th-TAro'., ISSI
UAL IWTANX TESTS
cs
p
PLLD
0.10 AUTO
0.20 REP ErITIV
i4pLLD
0. 1 a PLUTO
0.20 REPETITIV
SYSTEN 92-rW
- - - - - - - - - - - -
la�� S. 2-01A 9*12% w
A ,Ys
*-TEN wflTs
U.S.
SYSTEM LATMOAGE
0 L15
SMSM DATFrTIME FOP44RT
"OWPID VM'Hk4.*K4:SS ),.I
HO"diRDS Hi NI HA"
3200 FWAHR -
RAKEWIELD 93312
RZ - 1�
5r'HJFT TtME I 6 W AM
SRIFT TIME 2 DISABLED
SHIFT TIME 3 DISRKM
SHIFT TIME a DISAS M.
TAW FE R TST KrOED URN
DISAKM
TPA: ARN TST RErEDED Wgtf
FILED
LINE IRE-EtNBLE tiZr=
'PFrzS LIKE TEST'
LINE PER TST NEEDED URN
DISABLED
LINE AUN TST NEEDED URO
DISA4Q.:0
PICRINT TG V12LUIRE
EaqsLso
Tvtp COmpriwATION
VALIE (DM, P > 4 60.0
STICK HEIGIrr OFFEET
DIEVIBLED
U11AGE.- SVI.
K-PROTIOCOL URTA FaWAT
flalcl#
PIREcislorl TE67 OURATION
Holm : 1-2
0,20 GPH 1. 1 tr= TB"7t
AMO-CONFIRMt EMULM
o,10 GPH LINE TEST
AUM-0OHFljam: tWSLED
PAINT PIRECiSlON LIKE
TM RESU "j' DTSA5L60
DAYLIGHT SAVttr. TINE
EoASLED
START DATE
MAR WEEK 2 suet
STARr TIME
VOO AN
END DATE
hdv L' I SUN
:Ep Tum---
20woo Am
Rj:-DIREST LOCAL PRIffrOUT
DjSA'E:L`2D
EUn ?,R07000L PRENX
SYSTEM mom py
CODE -. 000000
mAl1ffENAt4Cv- -Ht STDRY-
DISABLED
TAWASLED K C14ART SECIIRITv-
WS
cuSTOM ALPJitS
DIZAMED
PAW/DEtair;
DISABLED
FLOAT SIZE*. 4.0 l H.
WA71M UARNI 03
I NTW -A Szrup
COMMUNICATIONS SEA-up
- - - - - - - - - - -
THERRAL GOEFF .00070-0
:*
T I Phl.
TAW DTAMSTER
PRODLcr COOS I
PORT SMIKS:
Tfim�mt. COEFF 00,00,70
COM BOARD - I (EDIN
TAW DIAMETER 5,6-00
TAT49 PRQFI t-r I PT
M,-=2 SECURITY
FULL—VOL t 21100
OODE : ViaiijEb
I Im.,
Collil BOARD m 2 (FS-232)
MOAT SIZE+ in.
EAR L RATP 9600
PARITY m RONE
STOP BIT I STOP
UATERL LMNINO 12.0
HIGH WAM, LIMIT*' 3.0
DATA IXNM 8 DATA
99
RS-232 SECURITY
COOS ; WSABLED
h4X OR LABEL VOLt 120130
PROBE OFMZI-
OVERF11-L LIMIT sm"
CWV DWI) - (M-485)
HtGH, PRODUCT' 9SX,
BAUD RATE : 9600
11400
PARITY 1. NOUBE
STOP BIT I STOP
]DELIVERY LIMIT
12013
DATA, LE =14: 9 DATA
RS-232 SEWRITY
GODE * DISABLED
LCYJ PROULCT
LEAK ALAN LIMIT: 59
COM BOARD M 6 (R3-232)
SUDDEN t4W LIMIT* 99
2.71
aqI0 RATE 9600
PARITY WNE
TAW TILX
PROBE OFFErr 0.00
I I f�rrop
BT
S70rA
MP LEWTH; $ DATA
1 O-232 SECMITY
SIP' 014 MANI FOLDED TAtIO
=R ' D ISAWM
TO-4 NONE
LINE MANIFOLDED TANKS
To: NONE
AUM TRA011T -cZrrJNGS-'
- -i - - lt4�
AUTO LEU' ALAAH LIMIT
LFAX TITH PERIODIC: 19
DISABLED
120
AWO HIGH WATE R
DISABLED
LEAR MIN ANNUAL 19
AUTO OVERFtl-L LIMIT
1,20
DM13=
AWO LOW PkVl3Wr
DISABLED
PERIODIC TFffr TYPE
AUTO THEFT LIMIT
STANDARD
DISABLED
AVr0 DELIVERY START
ANAWL T�97 FAIL
DI ISLED
PO4Ri D I SABLED
AUTO DELIVERY END
D-ISARLM
PERIODIC TFZT FAIL
AtMO MMROAL 1,111P UT ON
ALAEti DISABLED
DISABLIM
AUTO SMRtjAt, f "PUTL OFF
GFO5$,TF5T FAIL
DISABLED
M D ISARL51)
AUTO SE? 0R FUEL ALARM
'ALP
DISABLED
AM SETS OR WAM ALA.141
ANN T= AVEPAWM'.' OFF
PEP. T2ST AVERAGING.* OFF
DISABLED
AUTO SEMR OUT AL
TANK TEST NOTIFY*. OFF
DISABLED
TNR TST SIPHON Rp.E*.,ZOFF
DELIVERY DELAY I MIN
P 9 TflRESHOLD 10,004
RS-202 END OF M
DISABLED
FLOAT SIZE*. 4.0 l H.
WA71M UARNI 03
2.0
PROnLW-ooDr - '
— 2
THERRAL GOEFF .00070-0
:*
12030
TAW DTAMSTER
56. Go
TANK PROFILE If
f, PT
FULL WL :
12000
FLOAT SIZE*. 4.0 l H.
WA71M UARNI 03
2.0
HIGH UAl"ER LIMIT."
3.0
MAX OR L L VOL:
12030
OVERFILL LIMIT
9110%
•
I OsDo
HIGH PROD=,
9514
11400
MI'VEW LIMIT
I Im.,
LW PRODICT
LAID AR AI LIMIT:
99
SUDDEN LOSS LIMIT:
99
TAN!". TILT M
2.16
PROBE OFMZI-
BIPHO14 MANIFOLDED TARS
TO * NONE
LINT PANIFOLDED TANX-S
LEA9 MIN PERIODIC., 119
120
LEAR MlPf ANINIAL 1%
PERIOD10 7EE;r TYPE
STAW)ARD
At HUAL "I 1P FAIL
ALAI 1 DIMLED
PERWDIC 7MT FAIL
At-A7't DISABLED
GROG TEST FAIL
AtARM D ISA81.9D
Atitl 71ST AVEW43NO", OFF
PEP. 7EST AVERAGIUG: OFF
TAW TF-1311- WTIFY: OFF
T :OFF
i NK TST Sl Vi011 BREA).
DEL I VEW DVAY I
PUMP THRaHOLD m 10.001
T 3"D.SL
2-0
PRODW.T CODE
3.0
TH00AL COEFF
IDD04 50
TAW -DIAM9TER
96.()D
TAW. PROFILE
I PT
FULL VOL
1,200.0
FLOAT SIZE: 4.0 IN.
WAUR URWI I tr.
2-0
HIGH WATER, WHIT'-
3.0
MAX OP. LABEL VOL.
$200G,
OVE3WILL, LIMIT
9W
TANK PROFILE
I PT
HMR PRDWOT
12000
114 00
DELlume LIMIT
4 Ws-
Q-00
LOW PROD= t, 1.200
Lm. AL14VI LIMIT.* 99
SME14 LOSS LIMIT*. 59
TANX Tt4T
PRO-Im OFFSET
SIPHON tMNIFOLDED TAUX'S,
TO 4 NONE
LINE MANIFOLDED TAIIINS
T4ft NONE
PERL j
,dl
LEX.IN , M IODIC: #I.
1 2D
LPA,,' M114 AtifWAL
PERtODIC TEST TYPE
ISTANDARD
ANNUAL TEST FAIL
ALARM DISABIED
PERIODIC E4ff FAIL
ALARM Dj-$A3LED
GROM TEW FAIL
ALAP-0 1) 1�5�0,
ANN TMr AVERACIN-' OFF
PER AVEPAGIWo: OFF
T Ail' . TEST 'NOTIFY: OFF
TfX TW SIPHON V.M-'OFF
DEL[VERIV vajW I MIN
PUKIP THRESHOLD R 10-43M,;
-j 4 **WLE 2
2.0
PRODIXT CODE w
4
THrRMAL COEFF
000700
TANK DIAMMR
96.00
TANK PROFILE
I PT
FULL VOL
12000
FLOAT SIZE: 4.0 IN.
1ACER WARNI 14
2.0
HIGH MTER LIMIT.
3.0
WX OR LAML VOL*
12000
OVERFILL LIMIT
90%,
PROBE OFFSET
I IM100
HIOU PRODUCT
SF&
114 00
DELIVEW. LIMIT A,
4 Ws-
Q-00
Lm PRODUOT 1.
12010
LM ALM LIMIT.
99
SUDDEU LOSS LIMIT:
99
TANK TILT
PROBE OFFSET
0.00
SIPIQU 11ANIFOLDED TAWS
Tit: NONE
LUISS MANI FOLDED TArll:S
TO -* NONE
LELEIS HIR PERIODIC: In
120
jdp
LFAK Mitt ANNUAL U,
120
PERIODIC TIC" TYPE
STANIDARD
ANVAIAL TEST FAIL
ALARM DISABLED
PERIODIC ljl�gr FAIL
ALARM DISABLED
ORM TEST AWL
AE D ISABLED
ArIN TM AVERAGING: OFF
PER TWr AVEXAC;l Nei OFV
TANX TEST N0r[FV*" OFF
TNK 7ST SIPHON BREAl,%,QFF
DELIVERY DELAY' : I MIN
,PUMP THRESHOLD : 10.(J0%
LEAVII TES71 "E:rkiol)
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SM 2. 2014 12:19 PM
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X X )k x s E04D x X X x W,
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14PLLD LINE NE LEAX
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JUL
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MAY
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APR
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MR
S. 201d 3042 AN
FEB
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JAN
2- '2014 12 r26 A01
DEC
2012 12:133 M
NOV
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OCT
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FIRST 0.10 GAI-/NR MS
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x x x w x fon x x x k x
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JUL
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APR
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T I. **PNL
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LAS-r 2,0 CAL41R PASS:
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SEP 9, 2044 9;05 AM
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SEP 61 2014 11 36 PM
:-:03
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AUC& 5, 2014 4 All
JUL 5, 20,14 1°2.49 AM
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JUN 2. 2014 1, 1.52 Ph
MAY 2. 20W 12**11.0 AM
110 TEST PASSED
.APR 3. 2414 1.0`56
MAR 2. 2014 1211.1? AM
LAST PERIODIC TEST PASS-"
SM 1* 2014 12:31 Al"I
SEP 9 p 2014 4:21 AM
TEST LEI'S"" H 30 HOURS
JAN S.. 2014 12 * 19, &M
DEC 1* 20-13 12: 19 A;l
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FL 4= PERIODIC Tml
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= LENGTH 28 HOURS
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LAST GROSS TEST PASSED;
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LAST PERIODIC TEST Pic
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MAR 25« 2014 2 55 AM
APP. 15• 2,014 3» 13 JAM
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MIGHT Sa.57 INCRES
9-09-14 S*S2AM
WAT D "Es
ER .00 lic
TEST HANUALLY CLEARED
TFJlP S9.1 DEG F
owammarr cRm &DaRD
9-02-14
M-TANK ALPMt%
I IMMSE Eflo
TWj- rANUALLY CLEARED
COLLEM ITEM "" Izi
T 4;UNL 2
1TM", PROD01"I"T MAW
SEP 9,, 2014 tO:06 AM
SEP S. 2Ot4 10:04 MM
vlomas - 11sus CALS
9-02-14 8*57M
HEICK 85.67 1 =M5
TEST MMUAE CE RE
COMAIMENr GROSS A WRD
WATER D.76 INCHES,
90.4 DEG V
GROSS I t,'!,-.AEASfm- 3949
To jj JNCPZAGE- S-1857
--- I N-TAHY. ALARtl
T 2*UM I
H1014 PRO= ALARM
'SEP S. 2014 10: 07 AM
-- SN-Tmg FALAR" ----
T 2:UtJL I
PROBE our
SEP 9. 200 1008 04
M-TiAtd" AIARM
T 1'.0POL
Hic" PRODW"T ALpai
SM 9', 2014 10,*59 f44
--- IN-TAM ALF01
T I '.PNL
PROBE ow
SEP 9- 2014 10*91ra AM
-- M-TANK ALAEM
T I 1"PUL
IWALID FUEL LEVEL
SER 9. 20 t 4 10w 10 AM
T 2:UNL I
IfFiEfaORY INCREASE
]MREJ;9E START
SEP 91 2014 10:03 Am
VOLME - 5424 GALS
HEIGIC - 44.37 INCHES
WATER Ift, 0.00, DCHES
TEMP mc 218.19 om F
r,jEASjE Eja)
SIEP 9* 2014 10:12 AM
VoLtRIE 6072 GALS
HEIGNr 48.45 ItCHES
MTEP. Mu Mum
MP 08.6 DEC F
' MMSS lNtREASEd- 6413
17C NET I rMEASra- 635
MWARDS MINI MR.r
1
130200 PAMMAI
EAKERSFIELD 9:3-312
SEP, 9. 20,14 10:13 AM
MSTMI STATLS REFORT
- - - - - - - - - - - -
T 3:PROBE OUT
T 1, :PUL
INVENTORY lfr.RZ4S-;:
INCREASE START
SEEP 9. :21014 10:11 AM
VOLIL"E - 2599 CALS
HEIGHT - 25.81 INCHES
URTIER. w 0.00 IRCHES
TEM w 891.3 11a-01 F
I WMFAq-�: ERD
SEP 9. M4 1,01iS Aft
VOLAM- a 2925 GALS
HEICHr - 28.10 1T 0
WATER p 0.00 ZICHER
T-EMP . 9x.2 DEC F
CROSS OMEME- 327
Tl ` 1 r ItJC*?ME- 026
WK-11) LINE LEAK ALAPJI
tj 144PNL
WPLLD SHUTD%WN ALM
o
SEP 51 12014 91
WPLLD LINE LrAK AL 'G
W 2;UNL I
WPLLD SHUMMU ALM
StP 9. 2014 10; 16 A"
Wi PLLD LtN5 LM ALRPA
l a:DqL
UIPLLD SMUMOWN ALM
SEP, 9 � 201.4 t 0.116 A4
UPLLD LIVE- L ALAM
U, 419.1UHL, 2
WPLLD SHUTDOWN ALM
SEP 9. 2014 10t1S SM
---- SEMOR ALARM
L O:Dlsp S-6
DISPSIN'SER PAN
FUEL AEAM
SEP S. 2014 10-b'16 AM
SEtMR ATLAF.Ni
L I *18P 1-2
D ISPENSER PAN
FUEL ALAF41
SEP 9. 2,014 1 rrj,-*16 AM
UPLLD LIM LrAK ALARM
SMOR ALARM ----- SENSOR ALArdi W t."PlIL
L I -'DISP 1-2 WPLLD SWTVCmjq ALM
DISPENSER FAW 1.4 1.1=52 AM
Dispemm PAN FUEL ALARM SEP 5, 20
FUEL ALARM SEP ge 2014 10:31 Art
SEP S. 2014 10:16 AN I l'
- M40k
L 2"D'ISP 3-4
15siry.Mbi pm
SCR Olrl ALARM
CEP qW 2D14 1 o:t6 AK
UPUM LINE LW.* AUIP.4
WLLD SHLqDDWN ALM
S M- 9,- 2014 10*1 AS
WPLLD LltfF- LUX ALAPH
X 2:UNL I
WLLD SHUMOWN ALM
SEP 9. 2014 10 *N:31 R4
LIPUD LINE LEAR ALARM,
ti 3:11I.DaL
up
, LLD StrUTMWN AL"
SEP 9. 2014 10*1 AM
44PLLD LIKE LEA R' ALARM
W 4:UNL 2
UPLLD SHUTWWN ALM
EEP 9. 2014 1 a: M AM
WPLLD LINE LEAX ALAPJi
w I I PUL
WLLB sHaDown, Aw
SEP 9. 2W4 10:52 AM
UPLLD L1115 LEAK' SILAPM
tj 2: UHL I
UPLLD SHUTDOW11 ALM
SEP 9- 2014
WPLLD LIKE LEAR ALARPI
w Q *.DBL
WPLLD SRUTDOWN AL"
SEP 9- 2014 10:3 'AM
WPLLD L114E LEAR ALARM
U 4111 IL 2
WPLLD SHUTDOUN AL"
'SEP 0. 2014 10:02 At,
--- SEt-SOP. ALAFjl
L I:DISP 1-2
wtpbd� . pm
M ALABI
$m S. sla$4 Vztl�z
WPLLD UNS LEAK ALAFIM
W 21411UNL t
WPLLD SHUTDOWN ALM
SEP 9i. 2014 JD:32 AN
WPLLD LINES LEAK ALAFN
w 3.1 1.
WPLLD SHM'MWU ALtj
SEP So 2014 10:32 f-64
tJPLLD LINE LFAV. ALARM
:U. 4.,UNL 2
LJPLLD SHUTDOWN ALM
SEP 5� 2014 loi32 X4
SDSOR ALARtl,
,L 2:Dl SP 3-4
DISPENSM PATI
SENMR OUT ALAFJI
SV 9, 2014 10*2 AM
CJPLLD LIRE L ALAR3
Q 1:3*.
UPLLD SBUMUO ALM
SEP 9. 2014 10*$23 AH
WFLLD LIVE LM ALARM
UPLLID Li NE LEAr. ALAM WIPLLD L114E LEAK ALA W 4:.tJNL 2,
1J 2:WL 14 W !a: ML 0LlZ'SR9MUV ALM
WLLD SHLrEVOWN ALM WPUD SliUTKMV ALM. sp 9. 2014 lo*.84 P4f
SEP
9. 2014 10 **3 Ali SEP 9# 2a14 10*4 AM
EJPLLD LINE LEAR ALARM
U 3* 09L
WPLLD SHUTDOWN AW
SEP -9. 2014 10 *3 AM
UPU.D LI CIE LM ALARM
W 4-*UtlL 2
bWLtD SHlffDDW4 ALM
SEP S# 2Z14 IS= M
SMSOR ALARM
L 24*DISP 3-4
DISPBWER PAN
FUEL ALARK
SEP 9. 2014 1134 33 AM
UP= LINE L� AlAFM
u I ZpM
CJPLLD SHUTWWI ALM
SEP 9. 2214 10,,34 AH
IJPLLD LINE LEAK ALARM:
11
tJ 21*'Utg. 1
IWPLLD SRapwi ALM
SEP 2014 10*4 AM
UPLLD LINS LrAX ALARM
UPLLV SHUTDOWN Attt
SEP 9m 2034 10:34 AM
---- SENSOR ALARM
L 41WSP 7-8
DISPEMIER PAN
ML AWN
SEP S., 2014 10V3-1 AM
tjPLLD Lit-fe LEW ALARM
U I *PVL
UPLb SHUTDOWN ALM
SEP S. mtg; 10":04 Am
tA?LLD L tF- LEM RMA
u :2!. U14L I
QPLLD SHUT DOUR ALM
SEP 9, 2014 $0:34 AM
UPLLD LIM L ALAF21
L$ 3*SL
WP U SHMOUIC ALM
SEP 9. 2DI4. 10:3.4 AM
SEU80R
L 4:DISP 7-8
,01SPENSER: PAIR
FVEL ALALM
SM P 9. 2014, 10:�Ll PUM
WPLLD LINE LEAK ALFiR-n
01 1** P14L
tjVLLD SRutl)w rl A!ji
SAP 9- 2014 10:25 Ni
CJVLLEO LVIE LEAr ALKIRIM
tj 2: U14L I
UPLLD Sicutmit Aul,
SEP' S. 2,014 1 G-.35 't-41
upLL9 L I N= LEAK ALAR44
u :30ODSL
laLW SHUTODUU ALM
SEP, 9. 2014 3,0:25 AM
wpLLD LUCE Lr-.W. AtAPtl
ti 4 *1 UNIL 2
IJVLLD sliortDouil ALM
t=-P 9, 2014 W35 AM
HO-WAMS Midi MART
6200 PANAMA
awlEnFIELD 93312
SEP 9. 2014 H121 AN
SVbTEH STAT16 TA
2*.GROM LINS FAIL
14 z**wpLW SH.MXQtl A'-Jl
W 3.1171JEL, 0 U'r
H MINI r-ART
WOO P.AlkViA
IL
BAXBl?SF 'ELD 93,312
SfP 9 � 2014 11 Z25 AM
SYSTEM STATUS REPORT
T 1:;P-01SE
U 2: GROSS LINE FAIL
VJ 24*WPLLD SHUTDOWN ALM
W 33.FUSEL OUT
HO WARDS Mitil VAR'
3200 NOMA
BAKE FIELD 93312
S,9P 9. 2014 11:20 W
SYSI'D$ STA REPORT
- - - - - - - - - - - -
T W-PROSE WT
W 2'.'GROW LINE FAIL
tj 2:WPLLD— SHUT MU AUl
w SI.F'UEL OUT
DII.SPEfSER ALARM
&WIUNICATIOn ALAPJI
DISPEWER FAN
-9W. 9. 2014 10241 An
FUEL ALARM
SEP 9. 2014 1'0:35 AM
WPLLD LIKE L ALARM
W 3'.DSL
WFLLD 4INF: LEAK LAM
FUIEL OUT,
W 11*NPNL
SEP So 2DI4 11:09 AM
WPLLD SHUTDWl ALM
SEA' So 2024 10*.35 AM
4t
#L . I
.D
jifWAp
; 0200 pAtmm
WPLLV LIfrr. LM AI ARM
, RAXERSFIELD 933V2
W 2 --UN I
WNPLLD SHUTDOWN ALK
�SEP
SEP S- 2014 100025 AM
9. 2014 11 410, AM
S% EH STATUS PEPORT
T a'PR OOE OUr
W 3:,,FUEL
UMLD L114E LEAK ALFRi
W, 3:DSL
UPLLD SHUT00WI ANJ
SEP go 21314 10.35 AM
WPLLD LINE LEAX ALqRM
U 2:UNL I
CR08S LUM FAIL
W= Lt W LtW A�
2-D14 11:20 AM
U 4'.'UNL 2
UPLLD SHUrWWN ALM
SEP So 2D14 JOV35 A"
IWPLLO L E LFAX ALARM
t$ 2: UNL I
UPLLD SHUTDWH ALM
SEtGOR ALAMI
SEP 9,. 2014 11 *.20; &M
p. MZDISP 5-6
IDISPOISER PAN
FUEL PAL
SEP 9. 2014 10:35 Pol
HO-WAMS Midi MART
6200 PANAMA
awlEnFIELD 93312
SEP 9. 2014 H121 AN
SVbTEH STAT16 TA
2*.GROM LINS FAIL
14 z**wpLW SH.MXQtl A'-Jl
W 3.1171JEL, 0 U'r
H MINI r-ART
WOO P.AlkViA
IL
BAXBl?SF 'ELD 93,312
SfP 9 � 2014 11 Z25 AM
SYSTEM STATUS REPORT
T 1:;P-01SE
U 2: GROSS LINE FAIL
VJ 24*WPLLD SHUTDOWN ALM
W 33.FUSEL OUT
HO WARDS Mitil VAR'
3200 NOMA
BAKE FIELD 93312
S,9P 9. 2014 11:20 W
SYSI'D$ STA REPORT
- - - - - - - - - - - -
T W-PROSE WT
W 2'.'GROW LINE FAIL
tj 2:WPLLD— SHUT MU AUl
w SI.F'UEL OUT
--- I ti-TANK ALAPil
T U:ESL
LOU TEMP WARNIM
SM' -9. 2D14 I J.*32 A"
wpLLEI LINE LZW. ALARtl
U 30SL
UPLU), SHWDUN AUI
Sep 9. 2014 1i.37 AM
•OUARDS Hitli "ART
V 0 0 PA W#,A
OAORSFIELD 93312
U:,pLLD L141C I-FAK ALARM
tj 4 ;WL 2
GRos LINE FA
SEP 9,- 2014 11:23 AM
:SEP 9, 201-1 tl:.-St Ah
SmEm STATIS RmRr
w 2++GROSS MNE FAIL
W. 2:tJPLLD SHInTOM ALM
WPLL,V L I (IS LEAK ALArdl
14 4:uHL 2,
WLLD SHUT DMJII ALK
9, 2014 1A.- 51 AM
I t Mn STM
UPLLD ME LFJ41' AtAPA
VEP 9, =4 10:05 Am
u 1:pm,
CROSS, LINE ;FA II.
..VOLUS, - 7-099 OALS
SEA 9, 2014 11*064,A"
tl3:-Ic;lff - ItCHM
�*TR
Tvilp • 92.7
I "CREASE WO
M So ts,!,ss M
VOLUME t 1403 :GALS
WIGHT 86.69 WDRES
wpLLD LINE LEW. ALA&I
WATER 0.0 incom-
T" 990.1 DEG F
tA I :PNL
unu HUT ALM
,SEP 9. 20:14 12:54 A44
4ROW I WREASE- 430'S
TO IMT WREASE4 423 r
3200 piiv"
IBA WE 93312
SEP 9, 2014 124417 PH
UPLW LME LEAK AIAPJ4
U 3+.,IDM
ag= LiVE FAIL
SYSIM STATUS XMRT
Sp S., 2EIJ4 11 'pool? J41'i
ALL FLIWTIOIS HORML
SWRCB, January "2006
Spill Bucket Testing R�eport Form
35
-rhisjbrin is 37itende4(fcyr inve by cf.,nvraafors pe)fiornfing aninval xestin ,, '7'.spfil containment siriedures. The conal-des-edfi J
qfUS arm tint
primroutsfiwm fesis (Y'app-licah 141. should be prD Wded to thel-.0;WWo Mr, sub, 111itled 1.0 file h:wal n, g?dcufvy, qgN� my.
i. FA H.ITY INFORMATION
� awl uVreff](11M, 1%,1111010"114
Compa, ny Name: Confidence IJST Services. Inc.
TedinicianConductin- Tost-
Duslin Reese
4
e jj
Cxedentiafs': 21 CSLJ3, Conixactor P. ]CC ,-'�rvice Tecli. SWRCBL Tank Tester L:* Ottl r, (Spoecf
-i.Tc—ense Number(s):
CSLB 4804904 WC fi8216722
3. SPILL BUCKET TESTING INFORMATION
U%e&,
Ox T-Ndrastatic N. Vacki-J'Al
7 Other
ITP-5t
,re;j7EqUjPM,enj Used: Lake Test
'S I
' :IdentiN
Equipinent Resolution: 0.0625"'
Spill BuckeE (4y, 7�mk I Regular #1 2 Regular #2
3 Super
4 Diesel
,Number, Slor rye' Proclavt, etc-)
Bucket Ims-tallation Type:
Direct BuTy
--1 Dimel Sury
-D Direct Bur.
'Contained
0 Contained in Suinp 21 Conotined in Sump
OContajn�ed in Sump
Z in Sump
Bucket Diameter:
12.00"
12.0V
12-0W.
12.00"
Bucket Depth:
10.50"
10.00 �1
1 OMI ..
—lloo-
Wait time between applying
vacuum/water and start. or te%t,,
5 min.
5 min.
Test Stars: Time (TI):
9 :1 Will
9:1 Data
i 9: 1 0an'l
9: 1. Oam
Jn-itial Reading (kj).,
10,25" 11
9-75"
9.50"
10,50"
End
Test End Time (Tr;):
10:f(,)PM
10: 1 0-pl-11
10-, 1 opil'i
10, fl opm
ac
n .01 Read-inet (11,F
j
FJi,.,R L0,25-
Tes5TDuration
Te -(Tr To;
I hotir I ti our
hour
1, hotir
Change in Reading (Rr -RE):
0.0W,
OAXV
+t. .00 yy
0.or
Threshold or
G.0625-
0.0625"
0.0625"
Criteria:
Te5t Rtsxft—
19 1,11a&% G Fail
7-
91 Pass 0 Fail
19 'Pass ❑ P -1
R
L, Pass, 0 Fail
CoMments— (includehij bon ation on repairs fesl�v) -
C-I.WTIT-WATION OFTECHNICIANRESI"ONSIBLE FOR CONDUCT ING TH jr S TESTING
I here-by eerl#j --, accurate, atid in full campUance with Iggal requirement v.
J, Aar all the inforniation evnialned its this report is trut,
-rechn i ci an's
Date- WW2014
' State laws and re.,gulations do not currently require, tesdng to be perfion-ned by a (ILialified contracter-However, local requiremants
may be More stringent.
4 - 1ZMD(1 GALL M USTs
i
87
8.7
sgg FLOTILM for,
Ll UDC I - 2
'
#M HOWARVS MM MART
L3 UDC 5 - 8
3200 Panama Laws
L4 UDC 7 - 8
Bakersfield,
166-1)833-1,561
WS WATER SHUT -OFF @ STREET
�W
'4 -B ATER SHUT @ SLOG.
TLS VAR- ROOT MGMTOR
P PRE LRENACUUa!'GENTS
R RECER
H HFALY CAS
ESO EMERGENCY SIMT -OFF
,,
87
8.7
Toll #; 1-800-339-9930
Name.,
street: 1. 6250 3N4&acfaam Road
city. akers,tteld, t:"A 933 14
Terns:
Descsipfign of work erformed: R ky
....._ —+
1�.
w�Y
z
,
�y ,�
'ate �4. �
Sice- Nerne:
Street:
ciity -
Store No-
t
„y
W
r
r 4
^ 1.0 I k i 4
': "
�gy�
State: 0/,Z .dip:,
~° �) A , �; _y tt)�
%` `Y ... ;
'•dam w•f
ya
�
jam{ n.
L. • `.j ea
TRA'V'EL and LABOR
Dates Technician(s) Marne _.
Travel
X0.5 Flour h9inirrau n Later Chafge i
�t�rt End Towl
OVERTIME (5-,00 'FPM .- 7:00 AM
OT Start OT End
OT Total
Labor
Travel
Dam `rectinician s rh
a aITI
Travel
Labor
Travel
Do t e.. Technician(s) Plaexic
Travel
Labor
SUPPLIES - MATERIALS
L
r
e
.Mart:
Ens
Trxtal
OT Mart. � T End
OT Total ,
c
_
S Mrt
c1
Total
T ?irk OT Ere
OT Total
•- RENTALS
Check
One
UST g.
Stie Parts
,�,, t ::: 1 %,,,,s ,vrari.I