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Home My WebLink AboutMikuls UST Test results07/15/2014 14:57 IFAX EH@CO.KERN.CA.US 07/15/2014 01:54PM 6616349233 3 Dept Main KERN CONSTRUCTION @001/005 PAGE 01/05 SWRCB, January 2002 Page of Secondary Containment Testing Report Form Thisform is intendedfor use by contractors performingperiodic testing of UST secondary containment ystems. Use the appropriate pages of thisform to report resultsfor all components tested. ne completedform, written testprocedures, and printoutsfom tests (Iyapplicable), should beproMded to thefacilih owner/operatorfor submittal to the local regulatory agenCy. I. FACILITY INFORMATION Facility Name:Mikul's Truck Stop Date of Testing:6-26-2014 Facility Address:2201 Taft hwy Facility Contact:Allan Mikul Phone: Date Local Agency Was Notified of Testing :6-12-2014 Name of Local Agency Inspector (ifpresent during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: Kern Kern County Construction, Inc. Technician Conducting Test:Cloy Richards Credentials:X CSLB Licensed Contractor License Type:AHAZ B SWRCB Licensed Tank Tester License Number:481053 Manufacturer Manufacturer Training Component(s)Date Trajnine Expires 3. SUMMARY OF TEST RESULTS .Not Repairs .Not RepairsComponentPass Fail Component Pass FailTestedMade Tested Made DSLSEC X O ¶B a Q B R DSLSTPSump X a 13 D B D B u - ,DSLANN Q CI X n B D 13 R - UDC1/2 B X CI a D a O a UDC3/4 X D a B a B O Q UDC5/6 X O D D CI a B D " CI A Q O B [J 13 a O a a O a a n a D a a O D B B O [J u a n D [J a u " D CI D D a B [J a a n O a O a a O If hydrostatic testing was performed, describe what was done with the water after completion of tests: Water retumed to test tank for re-use. 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:,9~@ Date:6-26-2014 07/15/2014 14:57 IFAX EH@CO.KERN.CA.US 07/'15/2014 01: 54PM 6616349233 3 Dept Main KERN CONSTRUCTION @002/005 PAGE 02/05 SWRCB, January 2002 Page of 4. TANK ANNULAR TESTING Test Method Developed By:O Tank Manufacturer X Industry Standard a Professional Engineer n Other (SpecY) Test Method Used:D Pressure X Vacuum a Hydrostatic a Other (SpecY) Test Equipment Used:Equipment Resolution: Tank # DSL Tank #Tank#Tank # " Is Tank Exempt From Testing?'n Yes X No D Yes O No a Yes a No D Yes n No Tank Capacity: Tank Material: Tank Manufacturer: Product Stored:Diesel , Wait time between applying pressure/vacuum/water and starting test: Test Start Time: Initial Reading (Pi): Test End Time: Final Reading (Rf): Test Duration: Change in Reading (RrRi): Pass/Fail Threshold or Criteria: Test Result:D Pass a Fail D Pass a Fail a Pass U.Fail n Pass ' U Fail - Was sensor removed for testin '7 X Yes [j No D" g'-NA RYes ONO DNA OYes DINO RINA [JYes ONO UNA Was sensor properly replaced and X Yes a No D verifiqd functional after testing?NA,nYes UNo DNA OYes QNO QNA BYes BNO DNA Comments — (include information on repairs madeprior to testing and recommendedfollow-upforfailed tests) ' Secondary containment systems where the continuous monitoring automatically monitors boUh the primary and secondary containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt fiom periodic containment testing. {California Code of Regulations, Title 23, Section 2637(a)(6)} 07/15/2014 14:57 IFAX EH@CO.KERN.CA.US 07/15/2014 01:54PM 6616349233 3 Dept Main KERN CONSTRUCTION @003/005 PAGE 03/05 SWRCB, January 2002 Page of 5. SECONDARY PIPE TESTING Test Method Developed By:Q Piping Manufacturer X Industry Standard n Professional Engineer O Other (Specj@ Test Method Used:X Pressure n Vacuum n Hydrostatic Q Other (SpecW) Test Equipment Used:Equipment Resolution: Piping Run #"1 Pip,!ng Run #,Piping,Run #Piping Run # Piping Material:. Fiberglass Piping Manufacturer:A.O. Smith Piping Diameter:3 inch Length of Piping Run:55 ft Product Stored:Diesel Method and location of Secondary test boot in piping-run isolation:STP Sump Wait time between applying pressure/vacuum/water and 30 min. starting test: Test Start Time:" 9:00 Initial Reading (Ri):5.1 Test End Time:10:00 Final Reading (Rf):5.1 Test Duration:1 hr. Change in Reading (RrRi):0.0 Pass/Fail Threshold or 0.0 Criteria: Test Result:X Pass n Fail a Pass a Fail a Pass . [j Fail D Pass a Fail - Comments — (include information on repairs made prior to testing and recommendedfol/ow-upforfailed tests) 07/15/2014 14:57 IFAX EH@CO.KERN.CA.US 07/'15/2014 01:54PM 6616349233 3 Dept Main KERN CONSTRUCTION @004/005 PAGE 04/05 SWRCB, January 2002 Page of 6. PIPING SUMP TESTING Test Method Developed By:D Sump Manufacturer X Industry Standard B Professional Engineer [I Other (specitj') Test Method Used:a Pressure a Vacuum X Hydrostatic A Other (Spe@') lest Equipment Used:___ E,quip,ment Resolution: SumP q,,DsL STP , Sump #Sump #Sump # Sump Diameter:42" - Sump Depth:58" Sump Material:- Fiberglass Height Hom Tank Top to Top of 20" Highest Piping Penetration: Height from Tank Top to Lowest 18" Electrical Penetration: . Condition of sump prior to testing:Clean Portion of Sump Tested'25" - Does turbine shut down when XYes IjNO Asump sensor detects liquid (both O Yes U No DNA a Yes D No a NA [j Yes Q No UNA product and water)?*NA Turbine shutdown response time 2 sec. Is system programmed for fail-safe X Yes a No D shutdown?*NA OYes ONo IJNA QYes jNo UNA nYes ONo ONA Was fail-safe verified to be X Yes D No n operational?*NA OYes QNO BNA OYes QNO QNA DYes nNo QNA = Wait time between applying presswe/vacuudwater and starting 30 min. test: Test Start Time:11:00 Initial Reading (Ri)'3.756 Test End Time:11:15 Final Reading (Rf):3.756 Test Duration:15 min. Change in Reading (RrRi):0.000 Pass/Fail Threshold or Criteria:.002 Test Result:X Pass a Fail .a Pass n Fail D Pass a Fail u Pass a Fail Was sensor removed for testing?X Yes U No BNA OYes BNo DNA OYes QNO QNA OYes ONO ANA Was sensorproperlyreplacedand 'XYes CJNo B OYes BNo QNA nYes DINo UNA OYes ONO aNA verified hinctional aher testing? ,Nf\ Comments — (include information on repairs made prior to testing, and recommendedfollow-upforfailed tests) l If the entire depth of the sump is not tested, specifj' how much was tested. If the answer to any of the questions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (See SWRCB LG-160) 07/15/2014 14:57 IFAX EH@CO.KERN.CA.US 07/15/2014 01:54PM 6616349233 -3 Dept Main KERN CONSTRUCTION @005/005 PAGE 05/05 SWRCB, January 2002 Page of Test Method Developed By:O UDC Manufacturer X Industry Standard CI Professional Engineer O Other (SpecY) Test Method Used:B Pressure a Vacuum X Hydrostatic n Other (specttj') Test Equipment Used:Equipment Resolution: UDC # '44 MIMI ' UDC Manufacturer:unknown unknown UDC Material:FRP FRP FRP UDC Depth:24"24"24" Height from udc Bottom to Top 16"16"16" of Highest Piping Penetration: Height Hom UDC Bottom to 8"8"8" Lowest Electrical Penetration: Condition of UDC prior to Clean Clean Clean testing: Portion of UDC Tested'-Entire UDC Entire UDC Entire UDC Does turbine shut down when UDC sensor detects liquid (both D Yes X No a - productandwater)?*NA OYes XNo DNA OYes XNO ONA nYes IjNO XNA Turbine shutdown response time N/A N/A N/A Is systemprograrnmedforfail-XYes QNO O XYes QNo ONA XYes nNo ONA OYes ONo XNA safe shutdown?"NA WasfM-safeverihedtobe XYes QNO a XYes BNO nNA XYes IjNO EJNA OYes BNo XCINA operational?*NA , Wait time between applying 30 min.30 min.30 min. pressure/vacuum/water and starting test TestStartTime:11:00 11:00 11:00 Initial Reading (N):5.237 4.381 4.113 TestEndTiine:11:15 11:15 11:15 Final Reading (Rf):5.089 4.381 4.112 Test Duration:15 min.15 min.15 min. Change in Reading (Rf-Ri):-0.148 0.000 0.001 Pass/Fail Threshold or Criteria:0.002 0.002 0.002 Test Result:d Pass X Fail X Pass a Fail X Pass a Fail"a Pass a Eail . Was sensorremovedfortesting?"XYes DNO a XYes QNO ONA XYes DNO UNA OYes IJNo XNA NA Was sensorproperlyreplaced and X Yes [j No n XYes QNo QNA XYes QNO ANA QYes DNo XNA verified nIIlctional aher testing?NA 7. UNDER-DISPENSER CONTAINMENT (UDC) TESTING Comments — (include information on repairs made prior to testing and recommendedfollow-upforfailed tests) ' If the entire depth of the UDC is not tested, specify how much was tested. If the answer to any of the questions indicated with an asterisk (*) is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG-160) 06/02/2014 12:20 IFAX EH%O.KERN.CA.US 06/02/2014 11:17AM 6616349233 -g Dept Main KERN CONSTRUCTION @002/007 PAGE 02/61 D. Results of Testing/Servicing 4wp¶jUuYEgw 'Lm Ilqh.r wgllv~·r·F···n ¶6·· ·Y¶b·r·¶hl ·YhN X Yes 0 Nq*is the audible alarm operational? x Yes u No"Is the visual alarm operationap - x Yes v No*Were ail sensors visually inspected, functionally tested, and confinned Dpemtignal? X Yes u No"Were all sensors installed at lowest point or secondary containment and posItioned so that other equipmeM wit) not interfere with their proper operation? a Yes a No"If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? X N/A X Yes a Nd*For pressurized piping systems, does the turbine automatically shut down if the pIping secondary containment monitohng system u N/A detects a leak, fails tv operate, cir is electrically disconnected? If yes: which s=c>rs mitiate pQsitive shut-dowri? (Check all that apply)x Sump/Tremh Sensors; a Dispenser Containment Sensors. Did you comm positive shut-down due to teaks and sensor faikjre/disconnection? X Yes; d No. q Yes D No*For tank systems that utilize the monitoring system as the primary tank ovedill warning device (i.e. no mechanical overM prevention X n/a valve is installed), is the overfill warning alarm visibk and audible at the tank fill pdnt($) and operating properly'? If so, at what percent of tank capadN does the alarm trigger?, % u Yes*X No was any monitdrrg equipment replaced? if yes, wentity specific senscrs, probes, or other equipment replaced and list themanufacturer name and model for all replacement parts in Section E, below. 0 Yes"X No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) O Product; a Water. Ifyes, describe causes in Section E, below. X Yes D Nd*Was moMtoring system set-up reviewed to ensure proper settings? Auach set up reports, if applicable x ,Yes d Nd"is all monitcring equ,ifment operational pet manufacfurets specifications? Ft^ #_ .LP _ ., r'l l. —a _. . ..dl jm. M^.. . ^ .Ah .J m..h~ir. Ql^^j% a^AEL.qµ:^lrqL^:^e t1bjr^r& ^w ntrE9 E ha 1r'b^~mdr;mrq i SoHare Vetsion {nstalled: firmrh njcdPo fhd frjlrmui nry rkackt i.d' " in becuon = oexow, cwsgntje now qekl WJWfl Lue>e ugugluwkau3 ¶rirgFg ye wFu yw ~7 3au4w¶m E.Comments:3/21/14 Sensors alarmed but did not shutdown. Corrected proqramminq on 3/28/14 and tested. Monitoring System Certification Page 2 of4 12/07 ?~2/21/07 0§/02/2014 12:20 ifax eh@co.kern.ca.us '06/02/2014 11: 17am 6616349233 ?ai i' ' t'h' ':':mikulstruck stop 'ii 2201 TR.FTFltN ! bakersfield, ca" 933!3 ,,, ·,2 £ite # 000u .A .· ;. ./,5/22/20[4 01:!4 rm'":,alarm report l :"' i ':4/22/2014 01:14 aw !iD!esel sum? ~ Dept Main KERN CONSTRUCTION @007/007 PAGE 07/07 mikuLstruck "stop 2209 tafthiay bakersfield, ca 93313 'site # 000Ql .,. .. .N.¥.z:s3.mgm '' 4 '. "'5i2b'20l4 , 0}:"15'M '.'. .alarm rEpOrt . 'Diesel sump ':mikulst?.uc'k e:tijp 2291,tafth!9y ,' 8ai(er$f!el6· ,ca 933!3 site # aui 9/22/20!4 o!:i6 am M6~sat~:KF- ?k:? l,.. . . i "i m'" '"'""""'m"' ^' ' 1¶" :l'lIK:jL:3TRUCK stqp, ij',229 i TAFTHbl'l bakersftzld, ca 93313 :""SITE # Ei000l . , 7"22/20!4 01:16 At'l r. iSi'2Z"3-20!4 Et:i6 am ::7:'"' '· , . Y .mikulstruck stop"'2201 TAFTH'd'? C' -· bakersfield. cr 93313'site # 00001 7 · ml22/20l4 'OZ: 15 api .alarm report 5/22120µOi:i5 Al'l bIEsEL Sump M.'" .j 220! TA7'y:j:'l "bakersfield, ca m'i'3 site' 't- 0%'7::. -5/z2/zo14 oi: is 'At4 '·-:alrrw ¶epurt 5/22/2@|4 0!:15 am Annular _ .v _ . AppendixVl ' _ 'A I I (Copies of Monitoring System Certification form and UST Monitoring Plot Plan available at http://www.waterboards.ca.qov.) I MONITORING SYSTEM CERTIFICATION‘ - - For Use By All Jurisdictions vifithin the State of Califomia Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, Califomia Code of Regulations ~ ' This fonn must be used to document testing and servicing of monitoring 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 fonn must be provided to the tank system owner/operator. The ownerloperator must submit a copy of this fonn to the local agency regulating UST systems within 30 days of test date. A. General information' Facility Name: Mlkuis Truck Stop ‘ Bldg. No.: . Site Address: 2201 Taft Hwy. .City: Bakersfield Zip: Facility Contact Person: Allen Mlkul Contact Phone No.: ( )_ Makellvlodei of Monitoring System: lncon 2001 Date ofTestingIServicing: 3/ 7 I 2013 B. inventory of Equipment Tested/Certified r :_ Q Chec fl - _f ri idites cifi e uimet ins- 1 Tank ID: DSL ‘ X in-Tank Gauging Probe. ; X Annular Space orVault Sensor. X Piping Sump I Trench Sensor(s). i‘ D Fill Sump Sensor(s). .. X Mechanical Line Leak Detector. D X Model Model Model Model Model Model Model Electronic Line Leak Detector. ‘ Tank Overlill I High-Level Sensor. l TSP-LL2 TSP-ULS TSP-ULS VMI LD 2000 OPW61SO . D Other (specify equipment type and model in Section E on Page 2).- Tank ID: ctdIs_erviced:_____7 7_*_;__hl“* T_ D in-Tank Gauging Probe. Model:_ D Annular Space or Vault Sensor. Model: __ U Piping Sump I Trench Sensor(s). Model: __ Cl Fill Sump Sensor(s). Model D Mechanical Line Leak Detector. Model Ci Electronic Line Leak Detector. ' Model D Tank Overfill I High-Level Sensor. Model D Other equipment type and model in Section E on Page 2) Tank ID: “ 0 in-Tank Gauging Probe. “ Model » D Annular Space or Vault Sensor. Model Ci Piping Sump I Trench Sensor(s). Model U Fill Sump Sensor(s). Model T El Mechanical Line Leak Detector. Model Ci Electronic Line Leak Detector; - Model: ” D Tank Overfill I High-Level Sensor. ‘Model: ‘ D Oth >_- euimet e odei in Seion E on Pae2 . V Dlspenser ID: 1-2. X Dispenser Containment Sensor(s). Model: X Shear Valve(s). - _ D Dispenser Containment Fioat@ and Chain@. BEI 406 Tank ID: Model Model in-Tank Gauging Probe.. Annular Space or Vault Sensor. D Piping Sump I Trench Sensor(s). Model D Fill Sump Sensor(s). _ Model D Mechanical Line Leak Detector. Model D Electronic Line Leak Detector. El Tank Overfill I High-Level Sensor. Pu Dispenser ID: 3-4 Model: Model: D Other se' euiment e and model in Section E on Pa e2 X Dispenser Containment Sensor(s). Model: X Shear Valve(s). Ci Dlspenser Containment Fieat@ and Chain@. BEI 406 Dlspenser ID: . 5-6 D Dispenser Containment Sensor(s). Model i El Shear Valve(s). D Dispenser Containment Fioatis) and Chalnis). li BEI 406 Dlspenser ID:. D Dispenser Containment Sensor(s). Model D Shear Valve(s). El Dispenser Containment Float@ and Chainis). DispenserlD: Ci Dispenser Containment Sensor(s). Model U Shear Valve(s). D Dispenser Containment Fioat@ and Chain(s Dispenser ID:. D Dispenser Containment Sensor(s). Model D Shear Valve(s). D Dispenser Containment Float@ and Chainis). ‘lithe facility contains more tanks or dispensers. copy this ionn._ include information for every tank-and dispenser at the facility. C. Certification - i certify that the equipment identified in this document was lnspectedlservlced in accordance with the manufacturers’. guidelines. Attached to_ this Certification is Information (e.g. manufacturers‘ checklists) necessary to verify that this information is conect ' and a Plot Plan showing the layout of monitoring equipment For any equipment capable of generating such reports, I have also attacheda copy of the report, (check all that apply) D System set up U Alarm history repe- Technician Name (print): Stewart Bradly Q. _ _. Certification No.: 55200340-UT License. ' 1053- Testing Company Name: Kem County Constniction, inc Phone No._:_( 661 ) 634-9950 Testing Company Address: PO Box 6096, Bakersfield, CA 93386 ~ Date of TestingIServicing: 3 I 7 I 2013 Monitoring System Certification Page 1 of 4 12/07 1 2/21/07 Y 1 _; D. Results of Testinglservicing Software Version Installed: Complete the following checklist: X Yes Ei.No’ ls the audible alarm operational? X Yes El No’ is the visual alarm operational? ' Were all sensors visually inspected, functionally tested, and confimed operational?. IX Yes |Cl No’ X Yes‘ Cl No‘ Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? XD D Yes N0’ NIA if alanns are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? DU X Yes No‘ N/A For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system deteas a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) X Sump/Trench Sensors; CI Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks m sensor failure/disconnection? X Yes; El No. El Yes El 'No' . X N/A For tank systems that utilize the monitoring system as the primary tank overfill waming device (i.e. no mechanical overfill prevention valve is installed), is theoverfill waming alarm visible and audible at the tank fill point(s) and operating property? If so, at what percent of tank capacity does the alann trigger? ‘ %. D Yes’ X. 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. Cl‘ Yes’ X No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) El Produa; El Water. If yes, describe causes in Section E, below.. X Yes D No‘ Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable X Yes D No’ ls all monitoring equipment operational per manufacturer's specifications? E. Comments: " in Section E below, describe how and when these deficiencies were or will be corrected. \ Monitoring System Certification Page 2 of 4 12/07 2 2/21/07 'r '¢ . V‘ . ‘ s* I D\ i. . \ _v . ,’ .. '’\ F. ' In-Tank Gauging I SIR Equipment: _ ' X Check this box if tank gauging is used only for inventory control._ ' v t V D 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. ‘_ 1. u , .~ ' Completethefollowlng checklist: . . ' ' rr Cl Yes El ' No’ Has all input wiring been inspected;for proper entry and tenninatiornincluding testing for ground faults? 'ElYes‘El No‘ Were all tank gauging probes visually inspected for damage and residue buildup?l U Cl YGS No’ Was accuracy of system product levelreadings tested? ClU Yes‘ No‘ Wasaccuracy of system water level readings tested? _S YES CID N0‘ Were all probes reinstalled property?. -YES Cl C] No‘ Were all items on theiequipment manufacturers maintenance checklist completed?_ . G." Line Leakpetectors (LLD): ‘ El Check this box if LLDs are not installed. ' ' .. I¢ . X-.Yes 1' i 'U N/A I 't Complete the following checklist: .l ' ‘ - -- D No‘ For equipment start-up or annual equipment certification; was a.leak simulated to verify LLD performance?r(Check all that apply) Simulated leak rate: X 3 g.p.h.; U 0.1 g.p.h ; D 0.2~g.p.h.4 X Yes 1:: No’ Were all LLDs_ confinned operational-and accurate within regulatory requirements? X- Yes Cl No‘ Was the testing apparatus properly calibrated? ' » CICI X Yes No’ N/A For mechanical LLDs, does the LLD restrict product flow if it detects_a leak?- U YES XE] No‘ N/A For electronic LLDs, does the turbine automatically shut off if the LLD‘detects a leak?‘ U Yes XD For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? g_ El Yes. XE] No‘ N/A No’ N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or failsatest? _ ‘ '1 ' »» '~ Cl YES XE] For electronic LLDs, haye all accessible wiring connections been yisually inspected?. XYes,D No’ N/A No’ Were all items on the equipment manufaaurers maintenance checklist completed?. ll ' ln the Section H, below, describe how and when these deficiencies were or will be corrected. ‘ -I ' In the Section H, bel_ow,_ describe howtand when these deficiencies were or will be corrected. _ - r H. Comments: - I _ _ _ n. . - .J Q1 ,v rr ¢_0 »1\ ~w Q- 0 ," '1 O ' i J‘ I . _, ’1 o , ' '~ I _,, 1 , . ,. 0 I i v _ ._ 'P Pt ' ‘ _- 4'. ' 4. Monitoring System Certification Page 3 of 4 v ‘ 12/07 - _ ~t 1, -1-‘ I Q I ‘ ' ' 3 _ ‘ 2/21/or 41 System Certification g UST Monitoring Site Plan Site Address: '27-03 "3 ‘ ' ' ' ' ' ' ' '1Q11..1i1....IfIIIiI"IIIIII§IIIIIIIIIIIII ""‘1II1IIIIIIq5'€I1.....IIIIIIIIIIIIIIIlIIIIIIIIIII . . . . .. A l i ' * Q 1 .r...jiif1ZZZ}§§§§§§§§§§§§§§§§§§§§§ ;::;;;.;;;;;;;;§§§§§§§§;ij%"§§§E§§§§§i§§§§§§§§§§§ .....:1;1;YZZZ{ZIEI§§EZZZ§;;,i:i£§§§§§§§§§§§§§§§§§Ifi ~~iZZZZZZi§i§§§};ZEZZZZZ;;i;5%§§§§§§E§§§§§§§§§§§§§§ . . . . .. . . . . . . . . . . . . . . . .. Date map was drawn: <5 I 4 lj__@_< Instructions 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 of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, 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. Monitoring System Certification . Page 4 of 4 l 12101 4 2/21/07 2?? I ; af‘-fr- .'.. ,_,.,‘ » ~ -‘,4/,;~ ifii /2911 04: 04 PM - /~w~w ‘.33» 1:5:-r .. :»4&%%*J4‘ ’flE£§;;LJUER oowu 1», §§§%f%§P12/1/2@11» ¢~'fi¢’ -1.1, '." . _11"' 7" .. _ y. , I .- 1» ,-Tr’. \. '5;‘ ,, women us 12/2/2811‘ U0 TIMEOUT 12/25/2811 SVSTEM FQIL NO PROBE TQNK NO. 1‘ 12/26/2811 SVSTEM_F8IL NO PROBE TQNK NO.1 12/29/2811T POUER vouuA 12/29/2011 pause up 1/13/2012I POUER DOUN 1/13/2812- POUER UP 1/21/2812 UD_T1MEOUT 2/3/2812 POMER DOUN 2/3/2812~ POUER UP 2/9/2812 SVSTEM FRIL MEMORY ERROR 2/9/2812 U0 TIMEOUT 3/1/2812 DIESEL sump s/1/2812 DIESEL sump 3/1/2812' DIESEL SUMP 3/1/2812' DIESEL SUMP 3/1/2812 POUER DOUN 3/1/2812 POUER UP 84:84 85:33 11:38 84:25 84:48 84:48 85:44 85144 88136 18:11 18:12 88113 88113 as=22 88122 88:22 88123 88:27 88:23 PM, 7/28/2811 HIGH LIMIT TQNK NO.1 7/26/2811 POUER DOUN 7/26/2811 POUER UP 8/24/2811 POUER DOUN s/24/2811~ POUER UP 9219/2811 wo‘11msour 18/4/2811 POUER DOUN 18/4/2811 POUER UP 1a/6/2811 POUER oowu 1a/6/2011 PUMER UP, 18/15/2811 MD TIMEOUT 18/28/2811 UD TIMEOUT 11/11/28:1 UDVTIMEUUT 11/1s/2811 svsrzm FQIL NO PROBE TQNK NO.1 11/18/2811 SVSTEM FQIL PROBE SYNC TQNK NO.1 11/24/2811 SPSTEM FQIL PROBE SYNC TQNK NO.1 11/38/2811 SYSTEM FQIL NO PROBE TQNK NO.1 11/38/2811 PUUER DOUN 11/38/2811 POUER UP' 18183 88:11 88:12 87:25 87:25 18:14 95:84 86:85 81184 81185 82:87 86129 88:31 85:13 85:14 85181 84125 84182 84:82 MIKULSTRUCK STOP 2281 TQFTHUV BAKERSFIELD, C8 93 LII r- L/-I » sxrs a seam: 3/1/2812 QLQRM HIST 6/22/2811 POUER DOUN 6/22/2811 POUER UP 4 6/25/2811 SvsTEM»FQ1L NO PROBE TANK N0.1 6/28/2811 PUMER DOUN 16/28/2811 ,POUER UP 6/28/2811 Pquea noun s/29/2011 POUER UP 6/28/2811 POUER noun Is/2a/2811 POUER UP 7/16/2811 POUER DOUN 7/16/2811 POUER UP .18:83 PM ORV REPORT 83:5? PM @3:57'PM 12:14 QM 87:48 QM 87:48 QM 87:55 RM 87155 QM 89:17 RM I _ 29:1? an 89122 PM ‘ 89:22PM MIKULSTRUCK STOP 2281 TQFTHUV' BQKERSFIELD, CQ 93313 . SITE # 88881 3/1/2812 QLQRM HISTORV 6/16/2811 POUER UP 8/1?/2811 POUER DOUN 6/17/2811 PUUER UP 6/19/2811 SVSTEM FQIL NO PROBE TQNK NO.1 e/21/2011 SVSTEM FQXL no PROBE TQNK N0.1 s/21/2811 SYSTEM FQIL as PROBE TQNK N0.1 s/22/2811 POUER DOUN 6/22/2311 POUER UP 6/25/2811 SYSTEM FQIL NO PROBE TQNK NO.1 6/28/2811 POUER DOUN 6/28/2811 POUER UP 6/28/2811 POUER DOUN e/2s/2811 POUER UP 6/2s/2811 POUER DOUN 6/28/2811 POUER UP n1 87157 REPORT 83:56 85151 85:52 88:12 84131 85111 83157 83:57 12:14 87:48 87:48 87:55 87:55 89:1? 89:17 PM PM PM PM QM QM QM PM PM QM QM QM QM QM QM QM 7/16/2811 POUER DOUN 7/16/2811 POUER up 7/28/2811 HIGH LIMIT TQNK no.1 7/26/2811 POUER oowu 7/26/2811 POUER UP s/24/2811 POUER oowu s/24/2911 POUER UP 9/19/2811 mo TIMEOUT 18/4/2811 POUER DOUN 18/4/2811 POUER UP 18/6/2811 POUER DOUN 18/6/2811 POUER UP 18/15/2811 UD TIMEOUT 18/28/2811 UD TIMEOUT 11/11/2811 UD TIMEOUT 11/18/2811 SYSTEM FQIL NO PROBE TQNK NO.1 11/18/2811 SYSTEM FQIL PROBE SYNC‘ TQNK NO.1 11/24/2811 SYSTEM FQIL PROBE SYNC TQNK NO.1 11/38/2811 SVSTEM FQIL NO PROBE TNNK NO.1 89522 89:22 18:83 88:11 88:12 87:25 87:25 18:14 86:84 86:85 81=84 81:85 8218? 86:29 88:31 85:13 85:14 85:81 84:25 11/38/2811 POUER DOUN 11/38/2811 POUER UP 12/1/2811 POUER DOUN 12/1/2811~ POUER UP 12/2/2811 UD TIMEOUT 12/25/2811 SVSTEM FQIL N8 PROBE TQNK NO.1 12/26/2811 SYSTEM FQIL N0 PROBE TQNK N0.1 12/29/2811 POUER DOUN 12/29/2811 POUER UP 1/13/2812 POUER DOUN 1/13/2812 POUER UP 1/21/2812 MD TIMEOUT 2/3/2812 Pouea oowu 2/3/2812 POUER UP 2/9/2812~ svswsm FQIL msnoav ERROR 2/9/2212 I mo TIMEOUT 84:82 PM 84:82 PM 84184 PM 84:84 PM 85:33 PM 11:38 PM 84525 QM 84:48 QM 84:48 QM 85:44 PM 85:44 PM 88:36 QM 18:11 QM 18:12 QM 88:13 PM 88:13 PM 7 /I IP m,. /> I '\ 1' ~/. ,:-1-‘ / 1, .. ~ X55; 8 MIKULSTRUCK STOP 2281'TfiFTHUV BQKERSFIELD. CA 93313 SITE # 88881 3/1/2812 . 88181 PW TANK SETUP REPORT TANK NO. 1 58L . DIESEL TQNK TVPE TQNK DIMS TANK SIZE TQNK SHQPE DIQMETER LENGTH PRODUCT. OFFSETP OFFSETU MRNIFOLD PROBE FLOQTS FLORT TYPE GRQDIENT SENSOR LENGTH HIGH LIMIT LOU LIMIT' HIGH HIGH LOU LOU" URTER LIMIT TEMP COMP QPI GRQUITY QLPHQ “NO. RTDS RTD LOC1 RTD LOC2 RTD LOC3 RTD LOC4 RTD LUC5 87114854 113.75 -458.88 015951_ 8.88‘ 8.88_ nous 810 125 2 811 8.9489 125 188.88 18.88 114.88 8.88 '4.88 QPI 68/54B 32.88 45.88 5 14.43 38.73 57.33' 75.65 96.54 . STRQPPING DQTQ 180458 ’ ~ 8411048 8.888 1.888 2.888 3.888‘ 4.888 5.888 8.888 7.888 8.888 9.888 18.888 11.888 12.888 13.888 14.888 15.888 18.888 17.888 18.888 19.888 28.888 8.8 28.8 79.8 144.7 222.2 389.7 486.8 518.3 ' 621.7 739.8 864.1 994.1 1129.4 1269.9 1415.2 1565.8 1719.8 1877.2 2839.3 2285.8 2374.3 21.888 22.888 23.888 24.888 25.888 26.888 27.888 28.888 29.888 38.888 31.888 32.888 33.888 34.888 35.888 36.888 37.888 38.888 39.888 48.888 41.888 42.888 43.888 44.888 45.888 46.888 47.888 48.888 49.888 58.888 51.888 52.888 53.888 54.888 .55.888 56.888 57.888 58.888 59.888 68.888 61.888 62.888 63.888 64.888 65.888 66.888 67.888 68.888 69.888 78.888 71.888 72.888 73.888 74.888 75.888 76.888 77.888 78.888 79.888 88.888 81.888 82.888 3.888 .888 85.888 4-.r Ar-' _ I‘ 2548.9 2722.8 2981.7 3883.5 3288.2 3455.5 3845.4 3837.7 4832.3 4229.2 4428.1 4829.1 4832.8 5838.8 ‘5243.2 5451.4 5661.8 5872.2 6884.7 6298.6 6513.6 6729.8 6947.1 7165.4 7384.6 7684.7 7825.5 8847.8 8289.1 8491.8 8715.8 8938.5 9182.5 9388;8 -9811.8 9835.5 18888.1 18284.7 18589.2 18733. 18957. 11181.5 11485.8 11628.8 11858.6 12872.5 12293.9 12514.5 12734.3 12953.3 13171.4 13388.4 13684.3 13819.1 14832.6 14244.8 14455.6 14664.9 14872.6 15878.7 15283.8 15485.4 15685.9 15884.3 16888.6 5 6 .87.888 18488.4 88.888 18855.7 89.888 18842.3 98.888 17828.3 .91.888 17287.4 92.888 17385.8 93.888 17588.8 94.888 ’ " 417732.4 95.888 17988.8 98.888 18885.7 97.888 18228.8 98.888 18384.8 - 99.888 A 18537.8 188.888 18885.7 181.888 18829.7 182.888 18989.8 183.880 19183.8 ' 184.888 ' 19231.8 19354.4 185.888 186.888 19478.9 _187.888 1 19588.6 188.888 19682.9 189.888 19777.1 118.888 19862.2 111.888 19937.8 112.888 _19999.4 113.888 »28845.9 MIKULSTRUCK STOPA ~ 2281 TRFTHUV' BQKERSFIELD» CA 93313 -SITE # 88881 3/1/2812 88:64 PM 898158 s51ue 555041 80518455 UERSION _8.9911 ,10c411ou 1 " NIKULS 10841184 2 TRUCK STOP 814551 1 2281 1451 814551 2 HUV c11v 1 54154951510 811v 2 - -1 81415 c4 ZIP 0085 ' ‘ 93313 9115 8 88881 uo1 UNITS 5411048 ’15u51 UNITS 140458 TEMP uu11s 5448584511 1185 s1v15 12 noun 0415 81715 mm/on/vv 84911841 s4u 5448150 851 1185 8:85 Pm 851 8415 83/81/2812 NO. TQNKS ‘ 1 LEQK LIMIT 2.88 THEFT LIMIT 18.88 o511u 1 _ 288.88 8111111 11’ _ 855 ' STQRT RNTNI 19:88 QM ._ -71 If. ‘Y; /-Ll %Lf§ fZ¢;. 1 74,‘ . “=3. '7';/‘J ""7 <1 11.3.41, __1 3%; 1-32 .5, -. Mi, ;.' ‘_'=\‘ 11¢’?-7'. . ,._ ..,._. . ~i.~-%8?%»3 7-. £7-(};»,‘.._‘_i :1 ‘ - gt; 1 451*’-'1' 75‘, ~15’ , .".“.’..."_~._'/V‘ 0_ 1/» 1 1 1 L 1 1 ....... .1...-|_ -. END SNTNL 12:00 QM DELIU DELQV 15 REPORT DELIU ENQBLED REPORT QLRMS ENQBLED REPORT TESTS ENQBLED NO. OF QLQRMS 50 PRINT INTERUQL 1.00 none cunu 1 _ NQTIUE sauo cunu 1 12aa onrn BITS 1 Es STOP BITS 11 PARITV 1 NONE sscuexrv1 access1 PHONE1 REDIQL1 access2 PHONE 2_ REDIQL 2 DISQBLED access3 PHONE3 REDIQL3 access4 PHONE4 REDIQL4 DIQL DELIU DIQL QLQRM DIQL LEQK DISQBLED DISQBLED DISQBLED SOHD INUTR? NONE TIME1 INUTR 12:00 QM TIME2 INUTR 12:00 QM TIMES INUTR 12:00 QM SCHD INURC NONE TIME1 INURC 12:00 QM TIME2 INURC 12:00 QM TIMES INURC 12:00 QM SOHD DLHST ' NONE TIME1 DLHST 12:00 QM TIME2 DLHST 12:00 QM TIMES DLHST 12:00 QM SOHD QLHST NONE TIME1 QLHST 12:00 QM TIME2 QLHST 12:00 QM TIME3 QLHST 12:00 QM SCHD QCT QL NONE TIME1 QOTQL 12:00 QM TIME2 QCTQL 12:00 QM TIME3 QCTQL 12:00 QM SOHD QLST NONE TIME1 QLST' 12:00 QM TIME2 QLST 12:00 QM TIME3 QLST 12:00 QM CONFIDENCE 99.02 LEQK TEST 0.10 SCHD'TEST TQNK 1 NONE TIME TEST TQNK 1 12:00 QM QLQRM TIMEOUT HIGH LIM LOU LIM HIGH HIGH LOU LOU UQTER LIM LEQK LIM SYSFQIL THEFT RELQV S S S S TIMEOUT HIGH‘LIM LOU LIM HIGH HIGH LON LOU UQTER LIM LEQK LIM SVSFQIL THEFT TD QLQRM QLQRM 1 ' QLQRM2 QLQRM3 QLQRM4 QLQRM5 QLQRMs QLQRM7 QLQRM s, TD RELQV QLQRM1 QLQRM2 QLQRM3 QLQRM4 QLQRMs QLQRM3 QLQRM7 QLQRM TD QLQRM1 QLQRM2 QLQRM3 QLQRM4 QLQRMs QLQRM6 QLQRM7 QLQRMs eusoa rvpe SENSOR1 SENSOR2 ssusoa3 sznson4 ssusoa5 sensoae sensoa7 seusoas 0 OFF OFF OFF OFF . OFF OFF ON OFF 15 OFF OFF OFF OFF OFF OFF OFF OFF ON ON OFF OFF OFF OFF OFF OFF ON ON OFF OFF OFF OFF OFF OFF DIESEL SUMP QNNULQR STD3 STD4 STD5 STD6 STD7 STD8 STD STD STD STD STD STD STD STD C ONTROL OUTPUT GRQCE PERIOD LOU LOU1 LOU LOU2 LOU1 LOU2 HIGH UTR1 HIGH UTR2 HIGH1 HIGH2 HIGH HIGH1 HIGH HIGH2 SVSTEM FQIL no-.|o~¢.n.:>wr~J-~ STD STD STD STD STD STD STD STD 0 NONE NONE NONE NONE n0u£ NONE , NONE NONE‘ NONE NONE OUTPUT2 OUTPUT1 OUTPUT1 NONE NONE NONE NONE - NONE NONE $1 4* 9 {~11 ,1»? , .,1 -1 -1 (E 12/1/2011 POUER oowu 12/1/2811 POUER UP‘ 12/2/2811 U0 TIMEOUT 12/25/2811 SVSTEM FQIL N0 PROBE TQNK NO.1 12/26/2811 ‘SVSTEM FQIL NO PROBE TQNK NO.1 12/29/2811 POUER DOUN 12/29/2811 POUER UP" 1/13/2812 POUER DOUN 1/13/2812 POUER UP 1/21/2812 MD TIMEOUT 2/3/2812 POUER DOUN 2/3/2812 POUER UP 2/9/2812 SVSTEM FRIL MEMORY ERROR 2/9/2812 UD TIMEOUT 3/1/2812 DIESEL SUMP 3/1/2812 DIESEL SUMP 3/1/2812 DIESEL SUMP 3/1/2e12_ 015351 sun? 3/1/2812 POUER DOUN 3/1/2812 POMER up 84:84 84:84 85:33 11:38 84:25 84:48 84:48 85:44 85:44 88:36 18:11 18:12 88:13 88:13 88:22 88:22 88:22 88:23 88:27 88:28 7/20/2811 HIGH LIMIT TANK NO.1 7/26/2811 POUER noun 7/2522911 POUER up 8/24/2811 POUER DOUN 8/24/2811 POUER UP 9/19/2811 UD TIMEOUT 18/4/2@11_ POUER DOUN 18/4/2811_ POUER UP 18/Q/2811 POUER DOUN 1@/s/2@11/ POUER UP 18/15/2811 MD TIMEOUT 18/28/2811 UD TIMEOUT 11/11/20:1 wo TIMEOUT 11/1s/2011 svsrem FQIL NO:PROBE TANK NO.1 11/18/2811 SVSTEM FAIL PROBE svuc TPNK NO.1 11/24/2811 SVSTEM FAIL PROBE SVNC TANK NO.1 11/3a/2911 SVSTEM FAIL NO PROBE TANK NO.1 11/36/2811 POUER oow~~ 11/sa/2811 POUER up 18:83 88111 88:12 87:25 87:25 18:14 86:84 @s=@s 81:84 81:85 82:87 ’86?29 88:31 85:13 85114 85:81 84:25 84:82" 84:82 vMIKULSTRUCK STOP 2281 TQFTHUV BQKERSFIELD, C8 93313‘ SITE # 88881 3/1/2912 QLQRM HISTORV 6/22/2811 POUER DOUN 6/22/2811 POUER UP’: 6/25/2811 SVSTEM FQIL NO PROBE TQNK NO.1 6/28/2811 POUER DOUN 6/28/2811 POUER UP- '6/28/2811 PQUER DOUN 6/28/2811 POUER UP 6/28/2811 POUER DOUN s/2s/2811 POUER UP 7/16/2811 POUER DOUN 2/16/2811 POUERTUP 18:88 PM REPORT 83:5? PM 8315? PM 12:14 HM 87:48 RM 87:48 QM 87:55 QM 87:55 AM 89:17 QM 89:17 HM 89:22 PM 89:22 PM 0 I ; 4,:-:,' .iér%% .'»,—-.":' 12; ~'/1.1 1,, _,-1* .,-Hf »; 4 _.,{.<=:: 4,1"-,_‘.,W_ »Z£QFW§' . 1;:/1,-‘ *‘§¢:?',: 3;, ,“'4¢" ~21 ,>'~-I 7&1??? 1- #§ :1-“ '1 ‘ /éf-1%.’:-.‘,1' . 11' r‘. 7,» 'fY"7i~P.1. » ' ' I.-.4 '5; ._*fr ;.{1:;-. _, 1-~ 1 ,33»1": "-'<‘ -3' 5"'»»- ‘$5? 2P .» 1:?!0 ,- / '3'. -mi-,=.}.;> ‘~ .. ., _ , .,, , _Q »1 I Qkfi :f}§§§f1 - ,' - SWRCB, January 2006 Spill Bucket Testing Report Form V ' This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1 . FACILITY INFORMATION I _Facility Name: Mikuls Truck Stop _ I Date of Testing: 3-7-13 V Facility Address: 2201 Taft hwy. Facility Contact: All an Mikul I Phone: Date Local Agency Was Notified of Testing : 3-1-13 Name of Local Agency Inspector (if present during testing): l Lydia Von Sydow 2. TESTING CONTRACTOR INFORMATION Company Name: Kern County Construction, Inc. PO Box 6096, Bakersfield, CA 93386 Technician Conducting Test: Stewart Bradly ’: Credentials‘: X CSLB Contractor X ICC Service Tech. "U SWRCB Tank Tester _ El Other (Specify) License Number(s): 481053 55200340-UT: 3. SPILL BUCKET TESTING INFORMATION Test Method Used: XHydrostatic U Vacuum El Other Test Equipment Used: Visual Equipment Resolution: 0.0” pi, -7 I, Number, Stored Product, etc.) Identify Spill Bucket (By Tank 1 nsr. 2‘ 34 Bucket Installation Type: X Direct Bury El Direct Bury El Direct Bury El Direct Bury El Contained in Sump El Contained in Sump U Contained in Sump Cl Contained in Stunp Bucket Diameter: 11”- Bucket Depth: 1591 Wait time between applying vacuun1/water and start of test _ 15 Min. Test Start Time (T1): 8:00 Initial Reading (R|): 777 ' Test End Time (Ty-‘)1 9:00 7 Final Reading (RF): ‘ 7”‘ Test Duration (T; — Tl): ll-Ir. Change in Reading (R; - R,): 2.0” Pass/Fail Threshold or Criteria: 0.0” ~Te'§t"Res'ult£7 i I, :,;'- :5 ;-'1;_»i*'5(TPass'a‘_’II|:Fail',§ _"_ '=';_ UPass'_'. ’|'j‘r1*ai|'f ~°-I ' "313 Pass"=|‘i|Fa‘i|7" [_;-’n'ii55§§“fb’i55i|: _'. ‘ Comments — (include infor mation on repairs made prior to testing, and recommended follow-up for failed tests) r I r l i l CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the informati contai in this report is true, accurate, and in full compliance with legal requirements. \ J ~ Date: 3’ 7"’) l Technician’s Signature: may be more stringent. ' State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements ‘ cl I 4| p or/02/2012 15:3? Irilx EH@CU.KERN.[3Il.US ~ ' ~. ‘ or/.132/2o12_ 15:13 - ' 3 Dept Mal" 002/0“ . * rice l erect Regulations _ " _ cocoa/'o x oeeeeeeeeeeee‘ PAGE 62,11 ‘t Appendix VI- (Copies of Monitoring System Certification form and UST Monitoring Plot Plan available at hit ~I/www waterboards ea gov.) MONITORING SYSTEM CERTIFICATION. 4 For Use By All Jurisdictions Within the State ofCaIifomia Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23,~CaIifomia Code of This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each mqnllnnng system control panel by the technician who performs the work. A copy of this forrn must be provided to the tank system ownerloperator. The ovlmerloperetor must submit e copy of this form to the local agency regulating UST systems within 30 clays of test date. _ A. General lnforrnatiori. FacliltyName: ml1tulsTruci_t_S3gp . , _ Bids-No.;__i._____.... A sire /.\q¢;e55;_ _zzo1'r;rfU1wy_ V __ __ __ ___ Gity:_ _Beker~sflol_d Zip: Fagilily contact Person; Allen iliiilt Contact Phone No.1 (____) lvlalteIModel of Monltorlniit System: lgcon 2001 Date of Testing/Servicing: 3 1 I 202 inventory of Equipment TestedICertified v - di t ifi l ti tedlserviced -, vtwfl Z!!!-f anlt ID DBL‘ in-Tank Gauging Probe Annular space or Vault Sensor Piping Smnp I Trench Sensorisl Fill Sump Sensor(s) Mechanical Line Leak Detector Electronic Line Leak Detector Model TSP LL2 Model TSP ug§ Model TSP LJLS Modal Model VM! LP Model Model _Q,FlI 6180 2000 er a ecr ul nt _and_model rnSection_§_orl Page 7)_ in Tank Gauging Probe Model_ Annular Space or Vault Sensor Model ______ Piping Sump I Trench Sensor(s) Model ___ Fill Sump Sensor(s) Model Mechanical Line Leak Detector Model Electronic Line Leak Detector Model Tank Overflll I High Level Sensor Model imher gspecliy aqulpmenttyfi and model In Serlon Qn Page 2) __ ' Tank Dverfili I High-Level Sensor T mo f_a I in-Tank Gauging Probe. ll Annular Space or Vault Sensor. i.i Piping Sump/Trench Sensor(s). rl Fill Sump Scnsoris). l i‘ Mechanical Line Lealt Detector. ii Electronic Line Leek Detector. II Model: Model: Model:— Model: Model: Model: Model Tank ID ' in Tank Gauging Probe. Model: TT :;l Annular Space or vaull Sensor. ' Model: -".1 Piping Sump I Trench Sensor(s). Model: El Fill Sump Sensor(s). . Model: El Mechanical Line Leak Detector. Model:-_p El Electronic Line Leak Detector. Model:- Tank Overllll I High-Level Sensor. 1 _____;__}_ l'l Other s eci e ui entl e and model_in Section E on Peg 22._ ii r. . .. ,, _ ..__...Iii--_.~i-X-o --—-- _ L _ TX: . .. . _, Dlgpenggr it); . >_1;g_ _ g - _. _ V - Dispenser ID: ___._ S-4__ _ g_ X Dlspensercontalnment Sensor(s). X Dispenser Containment Sensor(s). Model: BEI 408 x Shear Vaive(s). _. - X $hear\/aIve($l- U Dispenser Contelr_lr_n_gnt Floslig) ar£§heln@.__ _ _ _ __ _ 0__ DlspensergfionteinnlentFloatis) and Qhain(:-3). Tj:__ W wV B. T : A ' _, V . . T1It‘lklD:_ .4 .4 c .. ' X _ .' : - |;| - - ~: X . I _ v ; - ill __ _ . :. X ‘ . : .. - Cl .: it . . : ' l_i .: X g . 3 l;.l .: i |_l ' - . ' : El ~ ' .: X . 1 El - . <: ll U - ‘ El Tanlt Overfillll-ilgh-Level Sensor. Model: g B 2 g pi: yg ‘Q Other ‘spew egulgment type and model In Section Eon Page 22. 'r>r=..m.rr>fi“"‘_i" fr>i;»@»=eFn=. El Dispenser Containment Sansone). Model: BF, 4,0§ ri Dispenser Containment Sensor(s). Model: i'i Shear Valvc(t\)- ' I] Shear Valve(s_). g ~ Ail. Pl§R€"§§.i.°°"!?"'L'*3°"* F'<?=,'.l§l.*."¢ <¥"*=i_ll§).: ._ _ _ ,,_,.,_ _l1_.@5.P°."*§-L9°l1l?!"'"°"l“Wei@!"2.QlE:!ll'l§>:-.e...................i_- o|§prm$eFip: ' g , _ .. 7 - Dlsnensvrlvri , ‘ p i! Dlspensorcontsinmentsensorisl. Model: [J Dlspensel'ConlalrlmerltSensoris). Model: -' :_',ShearVglve(s)_ . l'.| SheerVaive(s). .T ......_.e_u De mgr <==>r\ei_"'\;1="ll~1<>=\tl.i.$ rwrlcleilli. ' .. .7..- D,..Pl5£'l52€P9ll!°s...l"“‘°"!.Fl9?l@)Fm“°i'@"nl,_1,,_,,,,H_.,.__*"- i ,, ‘if the taHlty'Eonta|n_s more tanks or dispensers. copy lhTs form. include infonnatlon for every tank and dispenser at the facility. - ' "’" ~ C. Certification - t certify that theedulpment identified ln this document was lnspectodlservlcod In accordance with the manufacturer's‘ guldollnos. Attached to this Certification is inforrnzrtion (o.g. manufacturers‘ checklists) necessary to verify drat this information is correct I and ia Plot Plan showing tho layout of monitoring equipment. For any equipment capable of generating such reports, I have also attacheda copy of the report; (check all that apply): Ci System set-up lJ Alarm history report Technician Name (print): Stev,ra_r1_l;redly _ 4 Signature: ___ Certification No.::_ 552003_4_01LD- . I _ License. No.;_t1§1053 ._ g __ - _ Testing Company Name: Kern CountL<_;onslr.u_c_tlon.lnc,_ _ Phone No,;_i Q _ l 634_-9950_ Testing Company Address: PO_B_o__5_6_Q96._B_s§ersfleid._CA_9_Q§86 Date of TestlngI5ervlclng: 3 I 1' /2012 Monitoring System Certification Page 1 of 4 p 1;;/Q7 I serene \ilD 2/21/O7 or/o2/2012 15:3? Irllx EH@ClJ.i<FPt~' nrrus + Dept l-lain oos/on av/22/2912 15:13 5666661 aeeeeeeeeeeeeeé PAGE as/11 p D. Results of Testing/Servicing Softwareversionlnstaliedr A_ Complete the following checklist: _ kw r___ _um_ _ IM x Yes l.'J No’ is the audible aiamt operational? '75 “ Yes ~n El No‘ is the visual alann operotionél? x_ Yes No’ _Lwere all sensors visually inspected, iu_nctloné§i_iy_te§ted. andmconflrrried operational?| X Yes N0‘ Were all sensors installed at lowest point of secondary containment and positioned so that other equifient will not interfere with their PF9i.=§t9i?§'W°"'? . . . _ .,,a_ .. , . - .. ii Yes El X No‘ N/I_\_ if alamns are relayed to a remote monitoring station, is all communications equipment (a.g. modem) operational? . X Yes !.| i'i No" NIA For pressurized piping systems, does tho turbine automatically shut down if the piping secondary containment monitoring system detects a leak, iails to operate, or is electrically disconnected? if yes: which sensors initiate positive Shut-down? (Check all that apply) X Sump/Trench Sensors: l;l Dispenser Containment Sensors. Did you oonflnn positive shut-down due to leaks ggg sensor failure/disconnection? X Yes; __l'J No. _ y __ _ __ 1| YES II X No“ N/A “For tank systems that utiiiza the monitoring system as the prlmtiry tank overiiii warning device (i.e. no mooiténifiil Ovflffitl i‘>l'9VBI'ltl0I1. vatva ls installed), is the overfili warning aiann visible and audible at the t9flK 5" iJ°|m(5) and Oiiorating property? if so. at what percent oftank capacity does the alarm trigger’? _ _ _ 7_y " i'i Yes‘ X No Was any monitoring equipment replaced? If yes, identify specific sensors, probes. or other equipment replaced and list the manutaoiurernamo angntodat iorail replacement pang: in Section E. tzeloyy. _ _‘ _____,_r U Yes’ X No was liquid founrt inside enysooondary containment systems designed ea dry systems? (Check all that apply) i'| Product; l'i Water. If yes. describe causes in Section E, below. M __ _A ‘X W Yéé miji‘WNo* l Was monitoring system set-_uo__revEvlled to ensure pmpersettlngs? Attach setup reports, it applicable -____ y_ y_ __ ‘ IX wt; rj tit; is alimonitonnooqulpmem 0P@|"¢"1°"a|Pelmflfli-ifB¢iU'E"'$ specifications?~ “J % ' 7 -—' “W 7' i '' ' In Section E belowpdescrlbo how and when these deficiencies were or will be corrected. E. Comments: Monitoring System Certification Page 2 of 4 12/07 f ' 2 2/21/07 I _ B?/B2/2812 15: 13 @6668 B ' Qéééééééééééé PAGE B4/11 F_ |n.Tan|; Gaugin I $|R Equipment: X Check this box lf,tank gauging ls used only for inventory oontrol; . _ Check this box if no tank gauging or SIR equipment l5 installed. This section must be completed if in-tank gauging equipment is used iv P9|‘f°"'i'i leak <i==l=<=ii°" "\_°"ii°'i"9- _ ' Yes |_1 ‘ Nor wen; §|]1an'k gauging-probes visually ingpeoled for damage and residue buildup’? “|§!"“‘Yés H " My ' wag accuracy of eyetem product level readlngstestedj‘ __'V _ _ HV 5; Yes _ Q No; M gccuracyofsystem waterleyelreatlingsieeted?_ “Yes 0?/02./2012 1533? IFAX EH@C0.KiiN.C.°-.US r -> Dept Main 004/011 " in Seotion H."t;oiow, descrilaehow and when these deficienoies W:; or will be ¢0rfe¢ted- G. Line Leak Detectore (LLD):~ U Check this box if LLDs are not installed. Complete tho foilowln X Yes No‘ N/A i‘i |'J checklist: __ _ " =_ >_ ____________ fl__A:___ ___» ’ Corn iete tho following ,checl<iist:: ' ‘ '' U Yes _' U No’ Has all input wiring been inepected for proper entry andtermination. inciudingtesting for groui1ii_fe_ults? Yes ij Nb' were ell probes reinétéflegl properly? _ 4 ‘_ _ M ‘ "W 1* _ I1‘: l_| ' No‘ Were all itei-hs on the equipment manufactuiere maintenance <=i1E¢i$li$l O°fl1P|9i6d? For equipment start-up or annual equipment certification. W85 B leflk simulated to verify LLD performance? (Check all that apply) Simulated leak rate: X 3 g.p.h,; i] 0.1 g.p.h; El 0.2 g.p.h. X Yes Iii “ No’ were all |_|:Ds confirmed operational anq|‘acourate"within regulatory requirements? Yes i.'l No‘ Wes tho testing apparatus properly calibrated] " 7 l _ X Y€S r1 No’ ,_L1 ~_NlA' Fonmedhanical L[Ds, does the LLD restrict product flow if it detects a leak?. -'.l YES No‘ N/A ifl X For electronic LLDs, does the turbine automatically Shut off if the LLD detects a leak? Fl Vés l"i No‘ X N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? _ ‘ ‘ E1 Yes No’ ll X N/A For electronic LLDQ, does tho turbine automatically shut off if any ponion of the monitoring system malfunctions or fails a test? - ' ID Yes |.J No‘ A); N/A For electronic LLDs, have all accessible wiring connections been visually Inspected? ' . ’X Yes Were all items on the equipment manufacturers maintenanceoiieokllst completed?V No’ ' ' ' " "“‘“" in H h‘”’~'4"A‘ A if 7 @, ""|n tnésection H, below, describe now and when these deficiencies were or will be corrected. H. Comments: Repiac_ev_d_Line Leak Detector _ “ 4. Ir Monitoring System Cerfification Page 3 of 4 _ 12107 3 2/21/07 or/02/2012 15:3? IF.ll>< EH@CU.KEl1ll mus -> Dept Main A 005,011 0?/a2/2@12 1-s=1s aaaaeat aeeeseeeeseessls PAGE] Q5/11 1 Monitoring System Certification _- . UST Monitoring Site Plan »-—"» l = r ll1 Site Address: ?__.:Z-£73 |5"c. L 4“-1 ' .7 ..- . . - ' - - v - - I - ' -' _ _ _ _ _ _ _ I , _ . , . . . | - » - - . . . - - ~ \ - l -- 7?73"iiQ7777:ifY§§§§§§§§§§E§§§§§§§§§§E§§ PPVEF EiinaleqéiiiiijI111jiijliilljiiiiijlflilllll . . . . - . . . t . . . . - . - . - l - - - - - - \ ' - ‘ ' l ‘ ‘ ‘ ' ' ' ' ' ‘ ' ‘ ‘ ' ' ' ‘ ‘ ' ' '' . . . . . . ,. , . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . - -- ~l . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., l . - n a | ~ . | 1 \ ' ' ' ' ' '" - - - . - . . . . . . . . - - - - - - ~ ~ - - -v . . . . . . i - - - - . , . . . - - , . - - I1l _ I . I _ ‘ _ ' ' _ _ ‘ _ _ _ _ I _ _ _ ‘ _ ‘ _ _ _ _ , , _ _ , , . . . . . . 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Date map was drawn: "-5 /_l'___/L2,:-r ‘ Instructions 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 of tanks and plplfl9- Cloorlv ldoylllfv looollorls of lho followlrls oqulnmenl. if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps. dispenser pans. $PI|| containers, or other secondary containment areas; mechanical or electronic line -leak detectors; and in-tank llquld level probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared.A Monitoring System Certification ~ Page 4 of 4 12ID7 4 2/21/07 . oi/02‘/2012 15:3? mix EH@C0.KERN.C.°..US ' _ ‘é Bent Main 4 _ 006/011 av/o2/2012 15:13 @oaoa‘o oi§::i:es:i:é:ei2' PAGE as/11 l . 1 ‘ » ~ . - SWRCB, January 2006 - Spill Bucket Testing Report Form Thisform i's_intended for use by crmrracmrs performing annual testing of U.S‘7'.spill containment struclririgs. T he compleredform and prinloutsfram tests (if applicable), should be provided to the facility owner/operator for submitml to the local regulqrory agency. A _lf;icility Name: _ 1 Date 0fT<-:stinAgA: V 3-1-1,2 ‘ T " ' facility Address: __ H 2201 Tafi hwy. u T " _ T 7 - H i facility ciiiiim; __ Allan Mikul '_ ' | Pii'<iné;_ T_Date Local Xgzoncyllwas Notifiod of Testing: __ 2-22-1'2 A Nome of Local Agencyloéoector iiuring testing); 7 Q H l.:ydiaVoE_§X£1ow _'___K -» -__ r:_t;__....__: ~ W31 TESTmQ§Q§TBA9T°R!17iF93MATI°N.. M, ,....__» YT Company Name: _ __l§or"ii___(Z_o}ii1_iy__C§_cli1_struction, CA 93386 - A 1 Technician Conducting Test: I Stewart Bradly - ~ _ " _.. ‘__ _,_________ N . _t. _.. _ .. .._ Crodentials : X CSIZB Contractor ' X ICC Service Tech. U SWRCB Tank Tester ljpther (Specifv) _A JU License NUl1‘lb€T(S)Z ' 481053 ‘ "‘ __._.____~__..._~ _ ._._ -_-v-_-_--~4v-muj‘->--- ~____. . _~-_~- — “ruin ._. ._-—-I __. .. 4'“.-Z» ________,i.._____v___|.'i '3.» SPILL BUCI(ET;'[‘]§§Tfl\{G_Il:il_T_QRMATION _v_ ' Test Mctliod Used: _ ‘ Xl-lydrostatic _ C|Vacuum __ E|Otb§r _ __ 7_7_ ' Test Equipment Used: Visual u , ’ Equipment Resolution: 0.0" l .-._ - . .t ..—~- '1"'""""' " . ' ‘:'7.‘"' €.'.::".'..5.'T-T -*"">‘-""'.'--".-‘.""""'? .. — ff: ..: i 3 n4 identify Spill Bucket (By TON/C 1 DSL -2 -Number. $1v"¢4-P59!"-<=5§{9;)_ . ,. _T . i XDire<=tBwy Hbiieci Bury ~ W moirectéii Z i ”m0ii~¢¢i'i§T,' J.” B \k T 3 _ _Y _ _ TY TY ubftlnsmllatlon .ype , El Contained in _Sump V i El Contained in__Sump lI|~Containedii1 Sump U Contained in Sump - Bucket Diameter: II" ' , A ‘ ' - \ ' }__l3ucitet Dugth: ' T i I5” _ V - W7 Wait time between applying 15 Mm i vacuiim/water and start oftgstzfl _ _ T_ i Test Start Time (T,)_;_ 5 . 9:30 i ‘ ]n'itial§eadii“1’1;V(iii)T _ 7" A T T§§tEm|'ldTi1'lE(TP)ZM i 10:30 T * ‘ Final R=aaih§E'ii§j§' > ~ 7" i _ A _ _ " ‘ i Test Dtitation (T; — Ti): I Hr. _ __»__ _ _A _\ _”Change in’_Readin g (R; - Ri): 2.0” T _ ’ Pass/Fail"'l‘hresho1d or 5 00,, W ‘ F V . . .. .\. ' ' l ‘_ T T. TestResult: _ x.Pm E|Fail El_Pass l:|F£li| - - El Pass l:|FElil 1:1 Pass l:|Ffli| T‘ Comments 7 (im.-lu_de information on repair; mode prior to te.§{t'L1,g;7qnd recommendqiifolloui-iiiiyorfiinied _te;'t.i)w 7 _ T .—.--~ — —~—_=—‘ :.—"-' _—»-» . CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING" I hereby cerli_/)1 that all the information contained in tlult report is true, accurate, and in fldl compliance with legal requirements. ~Techni<:ian’s Signatuie: “__ _ Dam; >_ ' State laws and rcgulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. A 0?/02/2012 1533? IFAX EH@CU.KEPN PA.US . + U ept Main A Q00?/011 67/62/2612 15:13 6666662 ggégfi PAGE 67/11 12/1/2911 PUMER nnww 12f1f2@11 PUMER UP 12/2»2@11 Tub TIMEOUT 12/25/2911 SVSTEM FAIL no PROBE TRHK H0.1 12/26x2@11 STSTEN FHIL H0 PROBE TQNK NU.1 12/29/2911 PUMER DOMN 12/29/2611 PDMEE UP 1/13/2612 POUER DUNN 1/13/2612 PUMERTUP 1/2i/2612 MD TIMEOUT 2/3/2912 POMER DOMN 21362912 POMER UP 2/9/2812 SvSTEM FAIL HEMURV ERROR 2/9/2912 MD TIMEOUT 3K1/2612 DIESEL SUHP 3/{x2812~ DIESEL SUN? 3/1/2612 DIESEL 5UMP' 3/1/2612 ‘DIESEL SUNP 3/1/2612 POUER DUNN 3/1/2012 'P0uER UP 64:@d 54:64 X (J1 *1] O-I 11535 64:25 @4146 64548 @5344 95:44 98:36 16111 16112 68:13 68113 68:22 ‘D 0) -*0 PO SD I20 N) Pm) 68:23 E wMu 68:28 PM PM ‘U Z! PM QM AH RN EM PM HM QM QN. PM PM PM U I3 “U3 PM '733 PM (|'Ll1|~" ,g',".'JJ.1 HIGH LIMIT TQNK NU.1 ?/25/2@11V PUMER nowu 7/26/2611 POWER UP S/24/2@11 PomEn nowu 6X24/2611 PUMER UP’ 9/19/2611 MD TIMEOUT 16/4/2611' POMER DUNN 16/4/2611 PDMER UP 18/6/2611 PDMER DUMN 18/6/2611 PQHER UP 16/15/2611 MD TIMEOUT 16723/2611 MD TINEDUT 11/11/ZQ11 MD TIMEQUT 11/18/2611 SYSTEM FQIL N0 PROBE TANK N0.1 11f18/2611 SVSTEM FQIL PRUBE SYNC TQNK N0.1 11/24/2611 SVSTEM FQIL PROBE SVND TRNK NU.1 11/36/2611 SYSTEM FAIL N0 PRUBE TQNK ND.1 11/36/2611 PUMEQ DUNN‘ 11/39/2611 PUMER UP $$F 63111 @ CI) n-~ NJ 6?i25 sa ~1 >1 an 15:14 66€@4 65:65 81:64 91:65 62:6? 66129 88:31 65:13 @s;14 95:61 54:25 94:92 64:62 PM E an ‘U3 PM QM QM QN QM QM QM PM PM PN QN ééééééé MIKUL3TRUEK BTUP E261 TQFTHHV L BQKERSFIELU» E6 93313 GITE 8 @6551 3/1/2612 fiLfiRM HIQTURV 6/22f2@11 POWER onmu $/2212611 POMER UP 6/25/Z511 SHSTEM'FHIL NU PROBE TQNK HQ-1 5/28/2611 PUUER UUUN ' 5x28r2@11" FUUER UP “ 6/23/2611 PUMER QUUH $/28/2611T PDmER UP 6/ZBIEBI1 PUMER DUNN ' 5/23/2611 PDMER UP 7/lé/2611 PQUER QQNH F/15f2@l1» POWER UP QM PM PM 16168 PN REPORT 83:5? PM 63:5? PM 12:14 QN @?:48 RH @?:48 AM @?:$S GM B?;55 QM @921? QM 39:1? AH 69522 PM 69122PM ~ MIKULSTHUCK ZTUP H-22m: TQFTHMV _BfiKERSFIELD, cn'9:sis srrs # a@@@14- 311/2812 RLRRN HISTURV Eflé/2511 PUUER UP 611?/2811 POWER DUNN 6/1?/2911 PUUER-UP 6/19/2511 EVETEH FQIL N0 PROBE TQNK NU;1 6/21/2811 SVQTEN-FRTL H0 PROBE. TANK Nu.1 6/21/2611 $VSTEM-FQIL HO PROBE TRNK NU.1 6/ZZFZUII PUUER DUNN 6/22/2811 HOMER up 6/25;2@11 SUSTEN FQIL NU PRUBE TRNK no,1 6/28/2911I PUUER DDUN 6/2312811 PUUER UP s/as/2a11 PDUER onwu s/25/zarm PUUER UP 6/28/2@1L PUUER DDUN 5/2s»2@11 PUNER up IT/89 39Vd LLO/800 av=s?‘PM REPORT 63:56 85$51 C) U1 l'_fl {~,_\ S" OI‘ r‘ I-J @a=3; @5:Ti 03:5? SIv an "-J 12:1% 6?=4S 6 -J -P 0: ‘a?=55 en —u (J1 ua '@9=1r @9i17 Pm PM IE an HM an PM PM hm QM E an I?3 fin QM ?x16/2511 PONERTDUUN 7/xs/2@11’ PUUER UP ?@2b»2a11 HIGH LIMIT TflNK~HU.1 7/is/2811 PUwER DUUN 7/ZSXZU11 PUUER UP~ 3/24/2@11 POWER Dflmfl .v 3/24#2@1l POWER UP 9/49/2811 MD TIMEUUT 18/4/ZUII PUUER DUNN 1U/4/2511 POUER UP 1@>6i2@1i PUUER DUNN 16/6/2911 PUUER UP 18/15/2811 MD TIMEOUT 16/Z3f2611 UD TINEUUT Iifli/2611 UD_TINEUUT 11/IQ/2511 QVSTEN FQIL no Panes THNK NUT1 11/13/2511 BVSTEN FHIL PRUBE SYNC TflNK'HO.1 11/24/2611 svsTEm FAIL TQNK'NU.*1 11/30/2fi11 svswam FRIL N0 PROBE' TQNK ND.1 ' .3333 ~ A .. U12“ luau G .» 333333339»; -_ 3 . @922’ at-st ZIBZ/Z8/LG 3U V3 NH3X'0U@H3 X331 LSIQL ZLOZ/Z0/L0 89:22 89:22 16563 @s=i1 BS=12 @7525 \E\ -___| DJ U! 19:14 B6:@4 fl6;B5 91=fi4 Birfifi 0216? B652? 68:31 95:13 85:14 95:61 B4325 ii/36/2011 PUUER DUNN 11/sa/2211 PUUER UP 12/112211-i PUUER DUUH 1‘ PUUER UP 12/2£261i U0 TIMEOUT 12/as/2a11 BVSTEH FQIL no PRUSE TQNK go.1 13/26/2611 ,"BVSTEN‘FHIL N0 PROBE TQNK ND.1 12/29/2@11 POMER DUNN I2/29/2911. -PUUER UP~ 1/13/2312' PUUER DUUN 1/£3/2812 PDUER UP. 1/21/28122 MD TIMEOUT‘ - 2/3/2612 PUUER DUNN 2/3/2912. PDUER UP » 2/9/2812 _ SVSTEM FQIL ,MEMORV ERROR 2/9/2812 ND TIMEUUT u4:u2 B4;@2 @4=@¢ @4:94 »@5:33 11:35 94125 Q4:4@ 84:4? 95:44 65:44 68:36 16:11 19:12 '@B:13 88;13 MIKULSTRUEK 8T8P 2281 THFTHU? B8KERSFIEL8= C8 93313 SITE # 88881 3/1/2812 89181 PM THNK SETUP REPORT TRNK NU. 1 88L U1E$EL THNK TVPE TQNK DIM$ TRNK QIZE TRNK SHQPE CVLINDER DIQNETER LENGTH PRUDUCT UFFSETP UFFSETU MRNIFULD PROBE FLDQTE FLUQT T?PE ERRDIEHT SENSOR LENGTH HIGH LIHIT L88 LIMIT HIGH HIGH L88 L88 URTER LIMIT 113.75 456.88 DIESEL 8.88 8.88 NONE‘ STD 125 2. OIL 8.9469 125 188.88 18.88 114.88 3.88 4.88 TEMP COMP RPI 68/543 'fiP1 ERQUITV QLPHR ND. RTDS 8T8 L881 RTD LOB2 ETD L883 ETD LDC4 RTD LUC5 32.88 45.88 5 14.43 38.73 57.33 ?5.65 96.54 STRQPPINE DQTA INCHES 8.888- 1.aa@ 2.@ma s.a@@' 4.206 5 888 6.888 7.888 3.888 9.888 18.888 11.888 12.888 13.888 14.888 15.888 16.888' 17.888 18.888 19.888 28.888 n .1, TI/68" 39Vd 110/8008 GQLLONS 8.8 28.8 ?8.8 144.7 222.2 389.7 486.8 518.3 621.7 739-8 864.1 994.1 1129.4 1269.9 1415.2 1565.8 1719.8 1B??.2 2839.3 2285.8 2374.3 21.888 22.888 23.888 24.888 25.888 26.888 27.888 28.88! 29.888 38.888 31.888 32.888 33.888 34.888 35.888 36.888 3?.6m8. . ‘ 68.888 39.888 48.888 41.888 42.888 43.888 44.888 45.888 46.888 47.888 48.888 49.888 58.888 51.888 52.888 53.888 54.888 55.888 56.888 57.888 58.888 59.888 68.888 61.888 62.888 63.888 64.888 65.888 66.888 67.888 68.888 69.888 78.888 71.888 72.888 73.888 74.888 75.888 76.888 77.888 78.888 ?9.888 88.888 81.888 82.888 83.888 84.888 85.888 333333333333338 _ 3888888 ET3ST ZI8Z/Z8/L8 U198 ldafi + Sfl'Vu nu3X'038H3 XVdI 18391 Z103/Z0/L0 2546.9 2722.8 2981.? 3883.5 326°' 345 I64 393 483 422 442 4629.1 4332.8 5836.8 5243.2 5451.4 5661.8 58?2.2 6084.? 6298.6 6513.6 6729.8 6947.1 ?165.4 ?3&4.6 7684.? ?825.5 B64?.8 8269.1 8491.8 3?15.8 8938.5 9162.5 9386.6 9611.8 9835.5 18868.1 18284.? 18589.2 18?33.5 18957.6 11181.5 11485.8 11629.8 11858.6 128?2.5 12293.9 12514.5 12?34.3 12953.3 131?1.4 13388.4 13684.3 13819.1 14832.6 14244.8 14455.6 14664.9 14872.6 15878.7 15283.8 15485.4 15685.9 15884.3 15890.6 CO\O!~J‘-\IU'lLflC - - I - . 1 q |- 53 (=4 '\] 4'1 UI Ix 87.888 88.888 89.888 98.888 91.888 92.888 93.888 94.888 95.888 96.888 97.888» 98.888 99.888 188.888 181.888 182.888 183.888 184.888 185.888 186.888 187.888 188.888 189.888 118.888 111.888 112.888 113.888. 16466.4 16655.7 16842.3 17826.3 17287.4 17385.6 17568.6 17732.4 17988.3 13865.7 18226.8 13384.8 18537.8 18685.? 18829.7 18969.8 19183.8 19231.6 18354.4 19478-9 19588.6 19682.9 19777.1 19862.2 19937.8 19999.4 28845.9 MIKULSTRUBK STOP 2281 TRFTHUV 88KERSFIELD. C8 93313 SITE # 88881 3/1/2812 ~ 88184 PM SYSTEM SETUP REPORT 30FTUfiRE UERSIUN 8.9911 LOCQTIDN 1 NIKULS LOCQTIDN 2 TRUCK STOP STREET 1 2281 TQFT Hwv 5TREET2 CITY 1 BRKERSFIELD CITY2 STHTE ZIP CODE SITE# CH 93313 88881 UUL UNITS 'GQLLDNS LEUEL UNITS INCHES TEMP UNITS FHHREHHEIT TIME STYLE. 12 HOUR DRTE QTVLE HM/DD/V9 Dfi?LIGHT SAU ENABLED SET TIME ‘ 8185 PM SET DfiTE 83/81/2812 NU. TflNKS_1 LEfiK LIMIT 2.88 THEFT LIMIT 18.88 DELIU LIMIT 288.88 SHTNL MODE. UFF \'.‘ThEv'I‘ _"—"!l 18217111 fibi l2#1/2611 PUUEP DUNN l2f1?2B11 PUUER‘UP 12/2/2311 up rzmeuur 12/25/2@11 $VSTEM FQIL ‘H0 PROBE THNK NU.1 12/26/2811 SVSTEM FQIL N0 PROBE ,- TQNK NO.1 12/29/2911 PUUEP PUUN 12/29/2511 POWER UP 1/13/2612 PUUEP DUUN 1/13/2912 PUMER UP A 1/21/2612 MD TIMEUUT 2/3/2612' PUUER DOWN E/3/2012 POWER UP 2/912812 SYSTEM FQIL MEMURV ERROR 2/912812 UU TIMEUUT 3/112012 DIEEEL SUMP 3/i/2012 DIESEL BUMP 3/1/2&1; DIESEL $UMP~ 1/1/2912 DIESEL sump 3x1/2@12 Fumes ooww 3/1/2812 PUMER UP IT/II 39Vd Ll0/LLOEM 'B4=@4 @4:fi4 65:33 11:39 84:25 64:46 @§:4@ '@5=44 85:44 68:36 10:11 1@$12 @3313 68:13 58:22 89:22 68:22 98:23 A 68:2? f'_;v CD- ?-J CC‘ UIBH luau+ PM PM' PM' PM QM HM QM PM PM QM MM QM PM PM PM PM PM PM PM "UZ ?/2Q#2B11 HIGH LIMIT THHK-H0. 1' ?f26f2Bl1 POWER UOHN 7/2E/2611 POWER UP- s/34/2@11 POMER noun 8/24/2611 POWER-UP 9/19/2911 mo rrmzour '1a/4/2@11 POMER wmmu 1@i4f2Q11 POWER UP 18/6/2911 POWER DUNN 1916/2611 PUUER UP 18/15/2611 UDATIMEUUT 18/2s/2211' uo rrmzour 11/11fi2611 . UD TIMEOUT 11/18/2911 SVSTEM FQIL NU PROBE THHK H0.Y 11#1$/2911 8V5TEM_FfiIL PROBE SYNC TMHK HO.1 11/24/2911 $V8TEM FMIL PROBE SYNC TMNK NU.1 11/39/2@11 $VSTEM‘FmIL NU PRUBE TMNK NU.1 11/38/2611‘ PUMER DUNN 11/SM/2811 PUUER UP ‘aaasaaasaase 1@=B3 U8=11 68:12 Q __J I-J U1 @?:25 1@=14 66:64 66:85 B1554 81P@5 B2=B? 86:29 u8:$1 85:13 @5114 fi5:Bl 64:25 @¢:@Q 94:92 PM PM PM PM PM PM am MM PM AM QM MM PM PM PM RM QM PM PM N9 MIKULSTRUCK'STDP 2221 TQFTHUV BAKERSFIELD» tn 93313 A SITE a @a@a1 ". ‘Z/1/2312 PLQRM HISTURM 5/22/2@11 PUUER DUNN 5/22/2@11 PUMER up Q/25/2911 SYSTEM FMIL NU PROBE TQNK H0.1 6/as/i@11 PUUER ouwu 6f2B/2611 .PUMER UP 6/28/EUIY POUEP DUNN 5128/2311 "PUMER UP~ 6/28/2@l1 PUNEE DUUN 5/QBKZBI1 PUUER UP A?/15/2@11 rowan oowu ?11e/3611 PUUER UP 1@=@8 PM REPORT sM U1 -4 T‘2 25:5? PM. 12:14 HM. B7143 HM @7:43 PM @?=55'nm U?:S5 PM @9=1? an 99:1? MM @9822.PM @9222 PM ‘ _ @989 E1151 ZIBZ/EB/L Sfl'V3' 'U3@H3 X$dI L8?9l Zl0Z/Z0/L0 END SNTNL 12:86 ON DELIU DELOV REPORT DELIU REPORT HLRN REPORT TEST NO. OF OLORNS PRINT INTERUQL MODE CHHN1 BOUD CHNN1 Id ENHBLED ENHOLED ENHBLED < Bu 1.00 NOTIUE IZOO OOTH BITS 18 STOP BITS1 PHRITV 1* SECURITYI HCOESS1 PHONE1 REOIOL1 OCCESS2 PHONE2 REDIOL2 ACCESS PHONE3 REDIOL3 OCCESS4 PHONE4 EEDIHL4 DIHL OELIU OIOL OLQRN DINL LERK 1_A SOHD INUTR? TINE1 INUTR TINE2 INUTR TINE3 INUTR SCHD INURC TINE1 INURO TIHE2 INURC TINE3 INURC SCHD DLHST TINE1 DLHST TINE2 DLHST TIMES DLHST SCHD RLHST TINE1 HLHST TINE2 RLHST TINE3 OLHST SOHO ROI HL TINE1 OCTQL TINEZ OCTHL TINE3 OCTOL SCHD HLST IINE1 HLST TIHE2 RLST TINE3 OLST CONFIDENCE LEON TEST SEND TEST TNNK1 TINE TEST THNKI F .7: \ II/OI 39Vd ]33333333333333O IOOOOOOO EIISI ZIOZ/ZO/LO LLO/OHOE UIQN 1530 + SO UO'NH3N'OOOH3 XVdI LSIQL ZLOZ/Z0/I0 1 NONE DISOBLED OISOOLEO OISOBLED DISOBLED NONE 12:09 OH 12:56 OM 12:08 ON NONE 12:06 RN 12:68 ON 12:OO4RH NONE 12:OO HM 12165 ON 12:OO ON _ NONE 12:68 OM 12:OO ON 12:68 HM NONE 12=OO ON 12:OO RN 12=OO ON NONE 12:68 ON 12:86 RN 12:88 ON 99.82 U.IU NONE 12:OO ON HLORM TIMEOUT HIGH LIN LOU LIM HIGH HIHH LON LON HATER LIN LEHH LIN SVSFOIL THEFT RELRV TINEOUT HIGH LIN LOU LIN HIGH HIEH LOU LON UHTER LIN LEOK LIN SVSFHIL THEFT STD OLORN HLHRN"1 OLORH2 OLORN3 NLONN4 HLORN5 HLQRNO QLORN7 HLHRNO STD RELHV RLHRN1 QLHNN2 OLHRM3 OLORN4 HLHNN5 OLHRN6 NLHRNP OLHRN9 STD NLORN1 HLHRN2 OLONN3 OLORH4 HLHRH5 OLHRM6 HLORH? HLHRHO SENSOR TVPE SENSOR1 SENSOR2 SENSOR3 SENSOR4 DSENSOR5 SENSOR6 SENSOR? SENSORS O OFF OFF OFF OFF OFF OFF ON OFF 15 OFF OFF OFF OFF OFF OFF OFF OFF l ON ON OFF OFF OFF OFF OFF OFF ON ON OFF OFF ‘ OFF .OFF OFF OFF DIESEL SUNP HNNULHR STD3 STD4 STD5 STD6 STDF STD3 STD STD STD STD STD I STD STD STD CONTROL OUTPUT GRQCE PERIOD LOU LOU1 LON LOO2 LOU1 LOU2 HIGH UTR1 HIGH UTR2 II Nu-=~ HIG HIE HIGH HIGH1 HIGH HIGH2 EN FOIL (.0 ~C U’: —I q(,-.;q\t,n-L>(.=l!\\'~‘ srrw A ~ STD 910 STO am aw sw sw O NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE OUTPUT2 OUTPUT1 OUTPUT1 NONE ' NONE NONE NONE NONE NONE l‘ ‘' 5. 4 Dispenser ID: §- Q ' Dispenser ID:‘ - MONITORING SYSTEM CERTIFICATION. For Use By AllJw'ls11u.l10n.l Within the Stale ofCullfurnia Aulhorny Cried Chapler 6 7 Health and Safely Code, Chapter I 6 Drvzrron 3 Title 23 California Code ofkegulanons This form mun1 be used to document tostlng and servicing of monltollng equlpment gauge cenllleauolt or report must he nrepnred lnrfigh by the technlclan who pertorms the work A copy of this form muslibe provided to the tank system owner/operator 171$ °Wl1=1'/°P°1‘fl!°l‘ mus! Swim" 1 °°PY or this form lo the local agency regulating UST systems wllhln 30 days of test dnre A General Information FacllltyName l Bldg No $1wA<1¢~>= Z2;Q1 7:25!’ Clo .Es1£EZ§_F!E-(,9 Zip Faclllty Contact Person _ Contact Phone No iI Make/Modelof Monltorlng System Ml] * Date ofT¢>llng/Servlclng 2 Z2-[ . - ~ , v _ l r . . - -- In - - ~ ~ , _ _ . . . ‘ I . ._ , ' '- . ' ' ' ' . . . Z W l _, . . . _: _l B. Inventory of Equipment Tested/Certified -Q p Clleckthca ro rialckgggs to indicate sijjg cguiplneng il1§g_8_&I§d/i\1l'Vi£elll I I _ I ,_______G_;___ , _ M ' Tank ID: ( EQ EL. ' Tank ID:_ E In-Tank Gauging Probe. _ Model: a Z U ln-‘Punk Gauging Probe. Model: I] Annular Spaoe or Vault Sensor . Q Annular Space or Vault Sensor. Model: ‘ - . Model:. K Piping Sump / Trench Sensor(s). Model: U Piping Sump I Trench Sensur(s). Model:: E] Fill Sump Sensor(s). - - |:| Fill Sump Sel1.wr(s). '' - Model. _ Mildel. .4 Mechanical’ Line Leak Deoector. Model: £2 &% E] Mechanical Line Leak Detector. Model: ' ' ‘ E] Electronic Line Leak Detector. Model: ' El Electronic Line Leak Detector. Model:. _ E] Tank Ovcrfill / nigh-leiel Sensor. Model: I] Tank Overfill 1 l-ligh-Level Selwflh Model:1 U 0lller(specify,equipn1ont typo and model in Section E on Page 2). El Other (specify equipment lype and model in Section B on Paige 2). - ‘— ~ e --—-\uln~;' " ~-~-\-~- ~- »- VT Tank ID: " Tank ID:' E] ln-Tank Gauging Probe. Model: El ln-Tank Gauging Probe." Model. . B Annular Space or Vault Sensor. Model: [:1 Annulnr Splu.-e ur Vnnll Sensor. Model: V ' . El Piping Sump I Trench Sensor(s). Model: Q Piping Sump I Trench Sens0r(8)- Modvli i________,___. I U Fill Sump Sell5Vl'(5)i Model: EI Fill Sump Senl~;ot(s). Model: I E] Mechanical Line Leak Deleumr. Model: E].Mcl:hanical Linc Leak Detector.‘ Model:- E] Electronic Line Leak Deloelor. Model: ' E] Electronic Line Leak Deleclor. Model: ' El Tank Overfill / High-llevel Sensor. Model; _ El Tank Overfill / High-Level Sensor. Model:. I] Odie: (specify equipmfll! type und model in Seclinrl E an Page 2). l] Ol.her(lipel:il'y equipmant lype and model in Section E on Page 2)-' fl—fl~—=‘ n-_.._..-=__~____ _A.’,,,,,,,‘_.l........_._.---»- ._ _...........___.._ Dispenser lD:_/-"Z, ‘ ’ Dispenser ID:V E Dispenser Containment SenwI(s). Model: £24 £11 ~ E] Dispenser Containment Sensor(s). Model: E Shear Valvc(s). ' El sll».-ar Valvcls). ' _ I] Dispenser Conminrnenl Floul.(s) and Chain(s). B Dispenser Contailmlcnl Floods) and Chain(ll).‘ Dispenser ' ‘ > I Dis ensel'ID: I . , _ -4 P ._. E Dispenser Containment Sensor-(s). Model: p U Dispenser Containment Sensor(s). Model:. E Shear Valve(s). . _ E] Shear Vulve(ls). U Dispenser Containment Float(s) and Chuin(s), [:1 Di$penser Corltainmenl Float(s) and Chnin(s).- = —=|==—— ---- Q Dispenser Cwlluinmenl $ensnr(s). Model: E 1 El Dispenser Containment Senwr(s). Model: 'V 13sl-rear Valve(s). El Shear Vulve(s). D- Dispenser Containment Fioalls) unll Chuirl(s). » U Dispfenslar Containnlent FIOHI-(5)8115 Ci1llil\(5)- _ W ‘ A __ 'lfthc facility contains more tanks or dispensers, copy this form. include infommlivn T01’ every tank and dispenser at the Futility.‘ C- C€l'tifi¢iifi0ll - I certify thaltllu equipment idontificd in this document was inspestedlservicod in accordance with the manufacturers’ _ guidelines. Attached m on Certification is inforlnation'(e.g- m=uur=muwrs' checklists) nwwww to verify that this i'=l’"'="="i°" is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, l have also » attached a copy of the report; (check all thal apply): - System Set-UP E Alarm hi5t°"Y “PortL Tech.nicianName (prim): §l'El/H\/ ;&¢4§§ V< "CerrifieationNo.: “E416 License.No.:‘ T<=nngc<>mpo=yNam== gage 41,, 4mmm¢m,.¢ Testlng Company Address. Date of TestlngJ ervlclng. 2- Z2 ._£5 I i , h Page 1 of I - ‘ D . UN-U36-1/4 V www.unidoes.org . R“-01/17/U3 SB/TB 39Vl:l _ . NUIJ.OfiElJ.SNUO NEi3>i EEZBVEQIQS B§5€v'[ UB3/ZZ/ZB 900/L00 .'u'!39l‘l 1-d_3[] <5 _ S - Sl1'VIJ'Ni:i3>i'UIJflH3 XVdI 90317l H03/ZZ/Z0 . I _. 0 I '/ _ ' » /\ _ ~ ' - Monitoring System Certification ,. D. _Results of Testing/Servicing Sofiv/are Version installed:. JU Yes [1 0* Complctgtge following checklist: 1 E, N ' . ' . .i Is the audible alarm operational? - _ 'fi,Yes El No‘ ls the visual alarm operational? _ 7 K’ __ /Z Yes El No‘ Were all sensors visually inspected, functionally tested, and confirmed operational? " - ' Q Yes El No‘ Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? -_ 7E1 Yes E] No‘ If alarms are relayed to a remote monitoring station,‘ is all communications equipmenl (9-8-, modem) operational?_ ’EfYes U No‘ E1 NA ' IZN/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) D'5ump/'I‘rerlch Sensors; l§Di5P¢"$¢1' c°\’\t3iI1m@"l 5315013- Did you confirm positive shut-dovyn due to leaks gm sensor failure/disconnectionfifl Yes; El No:~ El Yes D No* [Bl N/A i i . p _fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger‘? 1 For tank'systems that utilize the monitoring system as the primary tank overi‘ill~waming device (i.e., no mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank ii] Yes’ H 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 Secliml E, b¢1<>w~ An E] Yes‘ Now Was liquid found inside any secondary containmentpsystems designed as dry systems? (Check all that apply) D Product; E] Water. lf yes, describe causes in Section E, below. ,i Was monitoring system set-up reviewed to ensure proper settings‘? Attach set up reports, if applicable Z] Yes E! No“ Yes _ U N0* ls all tnonitoring equipment operational per rnanuliacturerg specifieutiorls? >_ . _ " In Section E below, describe how and when these deficiencies wereor will be corrected. E. Comments:1 - 1 UN—036¢ 2/4 SB/Z2 ' 3EJVd Page 2 of4 _ www.unidocs.or~,; ‘ , . |““- 0‘/17/03 NDIIQHELLSNUQ NEi3>'| . sezsvsataa: soo/zoo V ute da . . . B5 st, H93/Z3/Z8 ). . l‘l 1- Uf Sll V3 NU3>l lJIJElH3_XV:lI 90-bl LL03/Z3/Z0 v r ___” A W r WM‘;_ O _ _ _ __ i V. r 4 i X, t ._ . .h l r \v »¢ l '1 M0nit(iring System Certification _ ' F. In-Tank Gauging / SIR Equipment: Q Check this hm; iftank gauging is used only for inventory controll ‘i El 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 leakdetection 1'-nonitoring. Complete the following checklist: i ' 4 i I] Yes El No‘ Was accuracy of system water level readings tested? El Yes El ' No‘ Were all probes reinstalled properly? '‘ U Y65 El N0‘ Has all input wiring been inspected for proper entry and termination, including testing for ground faults?‘ - - C] Yes nblow‘ Were all tank gauging probes visuallyinspected for damage and residue buildup?- El Yes U N0‘ , Was accuracy ofsystem product level readings tested? ' _ .. El Yes, E] No* Were all items on the equipment ma.nufacturer’s maintenance checklist completed?’ r—-" ~ ' ___ _ __ " In Section H. below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): _ lj Checkithis box ifLLDs are not installed. ‘ _ >.a Complete the l‘ollowin§_clgecklist: A . ' 1 E Yes I] No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? Q N/A (Check all that apply) Simulated leak rate:,@| 3 g.p.h.; El 0.1 g.p.h; El 0.2 g.p.h. _ . ' B'Yes El No* V IE Yes Were all LLDs confirmed operational and accurate within regulatory requl|en’1€nI$'-’_ E]t.No"' Was the testing apparatus properly calibrated?‘ ' _ ‘" J2] _Yes El No‘ For mechanical LLDs, does the LLD restrict product flow if it detects aleak? ". El N/A 4 . - 't U Yes For electronic LLDs, does the turbine automatically shut oii’ iffthe LLD detects a leak? El No“ H 13 N/A . ‘ V . ~ ~- Cl Yes 1] Not i For electonic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled El N/A ordisconnecled? "I ' Unlles For electronic LLDs, does the turbine automatically shut ofl"_if any portion of the mOnitt)ring system malfunctions U No‘ t V. & N/A or fails a test? - ' . ‘ |f_‘1 Yes El N0‘ For electronic LLD§;l1avg all accessible wiring connections been visually inspected? M N/A i ' _. B2’Y_<-=5 El No; Were all items on the equipment manufacturer's maintenance checklist completed’? Ai " In Section VH, below, describehow nlndwhen these deficiencies were or will be corrected., H. Comments:t v v I l 4 w . ' Page 3 of 4 ”' . UN,°36 _ 3/4‘ m.,W_,,,,;,;m,°,g . Rev. 01/11/as QB/EB 3EJVcl ' ' I ' NDIJ.O|'lElJ.SNUD NEl3>| , y -‘ EEZSVESIQQ ‘BS1811 TIBZ/Z3/Z9 900/30°-V » “Tali W90 <' i . Sfl'V0'NH3>l’UCIfilH3 X'v‘;lI 803M LL03/Z3/Z0 1 1. 4 .' ~ "1 it W | a 6 \. \ - Monitoring'System Certification _ ~ p UST Monitoring Site Plan p site Adm’ _ . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . .. _ . . . . . . . . . . . . . , , . . . . . . . . . . . . - - ~ - - - - - - - - - < - - - - >' . . . , . .. :~T6‘_i_~—:~: ' ' ' ‘ ' A A A ' ' ' ' ' ’ ’ ’ ' ' ' ' ' H ;;»;@;;';q@_;@:;;:iiii1 1 e . , . p . . . . , p . . . . I4 “':Z€€@€€'Q€€€_@~3::~EIIiEEE_geé_;!é~’_}'€€Z€€ , , _ _ _ _ _ _ _ _ e . . . . . . . . _ . . . . . . . . . . , , , . , . . . . . . . . . . . . . .. ~---~~-~-~~-~~~~~~~-"""""M1111111111;;ti.::;tSm2piiiiiIl ieeeew \ . . . . . . . . . . . . . . . . . . . . . . . . - - - - - - - - - - - ‘ - ‘ - ' - '- - ' ' ' ' ' *- __,‘ , , , _ _ _ , . , , , . . . .._....v . . . . . . . . . . . . . . . . . . . . . . . . . - . -- " Dane map was drawn! > Instructmnsv “ 1r air a h -- <11‘ am 1115: shows all required inromfion, you nwyi-1'clu'¢1eit, rather than this P“B°» with Y°“' M°““°“?‘g you eay avea agr __ _H ‘ Sygtem Certification. On your site plan, show the general layout of tanlfs end plpmg. Clearly ldentlfy locat_1o.n_>.of the fo evfuzfi equipment, if installed: monitoring_ system control panels; Sens(|)rS mo_r11:<_>nni*; Cid containers, or other secondary comamment areas; mechan}cal_or e ecvoplc me ea e ec V , _.L for leak detection). In the space provided, note the ‘date th1s Sue Plan was pI'¢P*1\‘°¢ . , ~' ‘ Page4ot’4_- UN—l)36 — 4/4. ’ ' ' www_uni¢0¢5_ku,-g ' ' Kev. 01/l7/U8 SB/V2 3E)Vd NDILOFIELLSNUO N83)! EEZBPEQIQB B5181 IIBZ/ZZ/Z 900/‘V00 “FEW ldafl <- _ S|'l"v‘fJ'NH3)l‘D1]flH3 XV;|I 903M l'|.0Z/ZZ/Z0 02/22/2011 14108 II-'A'X EH@CD.KEHN.C‘A.US -> Dept Main 005/005 -B2/22/2611 13:58 5516349233 KERN CONSTRUCTION PAGE B5/B5 _ ‘ ‘ - 'J\'l'Qfi1$§.T.}S '-IJKYIU aq MYTH $_|“a{u;;_|'!-"bay [mo] ‘,m,_\9MnH ~,1o;1\\;.quo0 p:.>§_m'unb F: £q‘pa|.u.ro;.md aq 04 Buflsaz @.\!t_1b'-.1-Y Kl1l.I=.=.ur\:> J01! 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Health and Safety Code; Chapter 16, Division 3, Title 23, Calilbr ia Code qfkegulatiow This funn be used to document testin d s' g an ervicing of monitoring equipinent. A jsgpnrate certific tion or reporl must be prgpared for h '' -?" 93¢ ,1110I11i0!'_11._11;'. syficrn control pam;_l_ by the teclnfician who performs the work. “.5. coiiy of forlrn niust to tlicizink system owner/operator. The owncr/opemtor mnst submit a“ copy of this fonn to the local agency re ting UST systems Wiihin 30 days oftest date. A. General Inform:_it'on ac1liqINami: fl Tgflgé/ W‘? __ Bldg No.:____ Site Address: gig ‘City; 64 Zip: bacllity (,o1itnctPcr>,on. _____ ___A _ __, _v_ Contact Phone No.: Make/Model o1’Mo1ntoi'i"11gSystem: - _ f A Daté of T6S'll'HlySe1'VlCll1'lgZ /_v 1 B. Inventory ofEquipment Tested/Certified r iium D. cs Cliccic !1]))I‘0 r boxes to iiidluitu hi-SI“ i. ui me-nt in» eel ln-Tank Gauging Probe. Annular S cc or Vault Sensor El Fill Sump S8l‘lSOl‘(S). l1lE0l‘l‘0l'll0 Line Leak Detector. pa. Piping‘ Sump / 'l'i'encli St3'I1SOl'(S). EMccl1an'ical Lino Leak Detector. Cl Tank Oveifill I High-Level Sensor; _§,l,,9,¢l1“'f.§§k!E9if¥ "?¢l11_lj1'31°"‘.iZP§j*'1°l niq<l<=.! in Sszqlion Ban .P§is=2)-,, Model: 74151519 Model: 2;;-“Z- Model: 114;“;' Model:_____ Model:. Model: Model:- edlservlced N Tunlc ID V _ __ ____ CI In-Tank Gauging Probe. El Annular Space or Vault Sensor. Piping Sump I Trench Sensor(s). U Fill Sump Scnor(s ). Cl Mechanical Line Leak Detector.~ Cl Electronic Lino Leak Detector. Cl Tank Overfill I High-Level Sensor. _E_\__9¥h._<=iiL$ Bqilfx vi m~'"£1 >_~:,==11d l _._-» - -\-.-_-- Model: ____u______ ; Model: T Model: Model‘' Model: ___i___i_____ Model: Model:. inoglel in Suction E on P4 Q 21._>_>_» 'i'aiiii ll): _ F" El Fill Sump Sonsor(s). . __»..¢ . -— _-- Cl 1n-T‘:-inl< Giiugiiig Probe. "Model:A i U Annular Space or Vault Scnsor. El Piping Sump I "Wench Sensoi-(s). Model: Model:' Model: 'l‘nnl(_lI): _A _ M Cl In-Tzinlc Gauging Prob?» ‘CI Annular Space or Vault Sensor. Model: i______i_____ Model: CI Piping'Sun1p/ Trench Sens0r(s). Modal: N~ El Fill Sump Sensor(s). " Model: 49- ql Cl Mechanical Line Leak Detector. Model: El Electronic Lint: Leak Dctcctoi". Model:\ Cl Tank Ovcrfill/High-Level Sensor. Model: ' ‘ - III Mechanical _LineLeak'Detecloi'. l Model: C] Elcclronic Linc Leak Detector. i ‘ Model! ._______.i____i El Tanlc Ovcrfill/H' l'| Lt: ISM __. ' " lg - "vi: cnlioru odel:_ .9_.....=!.. -<S_:__g’igi."%si1£..*z L =:*_=*m°9g.' __i1\ _.r*<>_=\,_= on P; 1911- .. ._,_ .9 9"i<=,_=",$§ii.. i‘ ~* .=....¢. no d==1,i_ >=*1_,9..*1_1’_=_...i-=>.-....,._ Dis|Jensei- ID: I Z»‘ \ Shear Valvc(s). , ' ifsno-ir va|§;¢(g)9 _. ._ _, __ Dispenser ID: .Z.§'_Y V i __ . ...- %DlGpL*2llSCI'COlIlElllTl‘l1€l’ll£Sl!IlSDl‘(S)- Model: ’h'i’Dispeiiser ConrainmenlSonsor(s).l Model: 5_'&;¢gfiii\:=v i 5,_Q..Dl§l2EEl§9[Q‘?B?§l!1'11°'1{fl°¥*§(§),9'14Cl!§!l!1§$l- r, Z Ell Di§n¢n§§r_C9ni=ain'in§ni Fl<>§»gg' S1 v5l<1.<3l!@i!1§J,- ibispenser ID: Q _ _ J 1)i5;;g||;;;:I_]): M A -if -mu-M in l A vets) £1 I>i§B.*t:iW_<;_<,>;1_v_glnm.¢1\I Els>.fl_¥£S) =1I\§,Ch=fln_§,§)-__,_ _ _ ___ El Dig " ' ‘Q Dispenser Coi1mli1mentScncor{s). Moclel:' iflhn i El Dispenser Contoinmorit Si:nsor(s). l\"/l'o¢lcl: __»_; l ' i Ksim-ir'va|vo(i;). E] Shag’ val ,i §er_C~>nmi\1111r=rJLlll9_@_I,§,§) and .<3i1~"" S- '____._ » H, _ _ Dispeufisr ID: 7 > i Cl Dispenser Containment Sensor(s) Model _ -1" . : .' ' r ~_ ~ ~ —— -‘~_— Pun, __— ' -~ ——__—~ -A Dispenser llD' l Vl .i.-M _ _ W" F..._¢!i?i§2<zI1%=1i.C°nI4inm21I199-.S *1 V - : El Dispenser Containment Serisor(s). El Slwiir \/=1v@(s)- - ' El Shear Valve(s).1 ClDispenser Containment Flo.it(s) id Cl' M0d€l: 1.1 §l1ai" -l-I1 lho fi1L.llll1y OOl‘llZ4Il‘|S more tanks or dispeiiseni, c0Pyil1iS fomi. lnclude ln'l’orination fDI::;¢l’y tank and dicpenaci at the facility. l H Ml—_w HA C. Certification - i i:ei'til§"tl1fliflu: equipment Identified lll this imuniiiiii was inspected/sei'vii:ed in aciliordanco with the nmnufactiirei-s’ guidelines. Altnclicd to this Certifiuiflon is 1nl’oi'nmtion (e.g. nIa1itIf:icturers' checldisoi) necessary 0 verify flint this information is correct and Pl P " ' ' ' '‘ a ot Ian 5ll0WllIQ the layout of monitoring uipmont. For any oqul ' ment capable of g 'neratlng such reports, 1 have also _ =1‘?-'_=|""1 =1 WP? of "19 "°|>°I'i; (check all um: Qp I )= _ %9ystem set-up in or rage ‘t Technician Naine (print): sigmim-e;i Certification No.: £7 ‘LU 3 3 76 _ 7_ _ Licenm-,_ No_;' “Sang c°“‘P"“>' N‘“"°‘_K¢u/ , ~&ii4:.'£r"¢.Z~¢l*~'/ _ .Ph N‘ >-I ___ oneo Sin": Aclclrcss: - .. _ H .__ _ , ~ _ _, _ Dateof'I'estin'Servicing: 42;/L/[0 _ _ Page 1 of3 Monitoring System Certification i .. ; ~' ;.i V9/I8 ElE)Vcl Nolionaisnoo i~iei3>i 9836959199 U 03/oi @1715 BT83/QB/Z9 900/|_()(] uieii wag é . SH"o'CI'HH3>l'l]I]flH3 XHI osiso oioz/so/zo’ ' ‘ I "I _ _ _ ,2 v at 4 \1 Scijrisqare Version installed: ' _ . .C1>;_l1IpLe_te the fohgwifi checklist: D l gt? l DN “Yes ju No,*_f_1'S thcya1Jjd1'bEInlani’1o}€<-?ratioi;|a1‘?_‘ f -'"1_J“" joy 5'” " W itF 95 __ ' 0”‘ 1I$the,visi:alalarrno§e1'ational? W _ V 7 7’ ' H VH Yes _. _ El No* Wereallsensors visually insgeeted, fi1Ln‘<:_i:i0Ii;1£$j_teSied._lnnd confirmed operational? d y it n _ 7 w l ___, V_ not interfere with thcir,_go-per operation?_ ‘ ‘ % Yes U No‘ V Were all sensors installed at lowest pointof secondary containment and positioned so that other equipment will— fin. 1: Yes‘ No“ If alarms are relayed to a remote monitoring station, is all connriunications equipment (e.'g. modem)“ El N/A y operational? » t A -F-‘Yes t El iNo* -For pressurized piping systems, does the turbine da'utomatica1ly’shnt_do\vn if the pining secondary containment EYes C] Nd? D N/A i momtonng system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate _ positive shut-clown‘? (Check all that apply) Cl Stimp/Trench Sensors; El Dispenser Containment Sensors. Did yon confirm positive slmt-down clue to leaks and sensor failure/discoxmeciion? El }{es;__ El No. 1 _ __ For tank systems that utilize the monitoring system as the primary tank overfill warning device -(i.e. no m¢°hfl11i°31 °"¢f1'fi11=P1'QV§1nfi0n valve is installed), is the overfill warning alarm visible and audible at the tank _ fill point(s)_and gger-stin'g_prop_er1y‘? lfso, atwhatgrcont of tank capacity does the alarm trigger? M % l . ~ UN/A ‘l r _ o , V , . _ _ is . as ,E| Ycs* fi.No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replacedr _ __\_ ' " and list the manufacturer name and rnodel for all replacement parts in Section E, below. l CI -Yes* §CI§To Was liquid found inside any secondary containment systems designed as dry systcins‘? “(Checlc“ull t/ml".(1pply)AU 1i1‘0* IS 3111110i11tOr1_11ng e€@_;pm<-snt operational per manufacturer’s eciiicatioris? ‘ ' 1 7 ii‘ __ _- 4 __ Product; Water. lfyes; describe causes in Section E, below. _A V so 7 y ~_ Yes E] No* A Was monitoring system set-up reviewed to ensure prgoer settings? Attach set up reports, if agplicable J glee Ci ‘ _ ' ' VW *' In Section E below _ . _ . __Hf'— __ Z Mi fi in . . 9' _._i' ._illZ- , describe how and when these deficiencies were or will be corrected. E. Comments: _ I i 1.1 4J \ - .?__ _ ___ __~ 03/01 Page 2 of3 | \ \. ~ eszeveetss ewe etez/se/ze W/Z8 39% dag NUHOHHLSNDO New Sl'I'\='I]'NH3>l'UU@H3 X‘o':lI osrso OLOZ/90/Z0 voo/zoo "Te" 1 ‘-' I ~i q I 5 * “ F‘; In“Tank Gauging / SIR QPMQDF t A Cl Check this box if tziggauging is used only for inventory control. U Check this box if no 121111: gauging or SIR equipment is installed. i f3.{Tl1is section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. " Complete the t'ollowin_g§hec_klist: ‘ 4" —l' .7 _l‘ __| ._:: _o 2: nu Y El No* Has all input wiring been inspected for proper enu;y_:r1-'nd_teBnnmatrion,7inclTihding' Fl} ground l:aults'? It J7 '" Yes El No“‘ Were ell tank gauging probes visually inspected for damage and residue buildup? i W I N.7 Ye Cl No* Was accuracy of systemproduct leycl readings tested? ' L MI W Ye CI No* Wes accuracy of system water level resdings tested? w _ Yes D No" Were all probes reinstalled properly? i t H l Vi Yes N*.,W ,a“_m_ V _ .. _ _ _ _. _. ere 1 ms on the equipment nmnufnotmer s mamtenance checklist completed"E U 0 - ’ _ ~ '- . * In the Section H, below:-describe howirindivirilien Ergo deficiencies \;ere:r will’be»ooi~r::tcd." E 5 iA G. Line Leak Detectors (LLD): L11 Check this box if LLDs are not installed. '1 cu +¢°lE2'“FZl"°_@!'°“i'l§ c1r..e*<1is_¢.=r _It _Il _I— ii ‘ tr t J .. N‘ r BB-=1 -. g Yes U No* For'_equipment‘s‘tart-up or -unnual equiprnent certification, was a leak simulated to verify LLD performance‘? N/A (Check (Z11 that apply) Simulated leak rate: pf; g.p.h.; El 0.1 g.p.h; El 0.2 g.p.n _4 -t: F» Yes Cl N05‘ '1 Were all LLDs confirmed operational and accurate within regulatory re§_uireinents? W Cl Yes Cl Nof Was the testing apparatus properly calibrated‘? V , i A ¢'Yes El I\lo* 1 For mechanical LLDs, does the LL15 restrict product flowif it detects a leak‘?' __l D N/A ;_ ._ ii El Yes III No"‘"' For electronic LLDs, does the turbine sutornatically shut o§if‘ the LLD 'detects a leak? iU EN/A’1 _K U Yes CI No* For electronic Li.Ds, does the turbineiautoniatically shut off if any portion of the monitoring system is disabled T6 N/A or disconnected? Ell Yes A U Noflm For electronic LLDS,‘C1C6S the turbine automatically shut ofl' if tiny portion of the nionitoring system rnalfunctions_ r X N/A or fails a test? 15| El» Yes lg No" i For electronic LLDs, have all accessible connections been visually inspected‘? N/A Yes 'No* W Were 511 items on the equipment ma1iufacti;crer’s maintenance checklist completed? V W p _\ H. ~ * In the S:cl!i0ll H, below, desci-ib'e hwow and when theszdeficionieies weie or will been;-acted. Comments :__ -... woo/coo - “Tell luau Page 3 of 3 03/01 ouonauswoo N&El>| sszsvsstss 81> =66 @195/9/39N "W99 39%‘ ' Sl'l"dI]‘NH3>|'UIJ@HEl xvsr 09:80 otoa/so/zo(- v . .------'1' vnu gar» "I uppucnfllwlollld beprmlided to . /opehuo. -7- -. .l.. ..v--I-yo»-».n_1v| III ulna vi _ Hug? e OCH T8814 Q1013) agar“-_:y_ {L » M . ~1. FACILITY I1_!_FORl\/IA'I'ION V _ MAM; " "7 1jaci1§ryAady;ss=4Z'1_e( Hy ~ 1 .. . .. J: .. . i _, V i1 Fag1lgtyQonract: _ _ ‘ A ~ - — ‘- _ - .. IV 1 \ Dam ”*' _- °~fI'9°"lA$cm¥§'5Peqt<>I firesek; iesting): N _ H 7 ' it" __ _.> 2, TESTING CONTRA -, C°mpmyNme: -- - A _CfE9RI1XFOR1y1ATIJg;_~1___ W __i '1‘gchnicianConduc|5ngTesr; “ '* “ .» — " - . . - Z_M cy<=d<mfia1s'; _c1 CSLB Contractor A Seivice "rem H 0 Qvmcn rm DOE’; kspémfl) *‘ ; ¥—i9=9_§¢_1*_{1_w_nb@r(s)= ' ‘ ' ‘* - ‘ ~~ - ~~- .4. 3- TESTING Irwonwmnon. \T¢$fMethodU-ad; . - . - -_ ~ .4.._*_1_~.W_ ‘E - . _ ._ __ W _ __ U i rm V V W- F‘ -+* .. _ ._ .. _ Bqflawmlm -mm‘ ol ' -‘ Idflmfy $11111 Buckzt (Ey Tank“: 1 J """“ - -' WW 55 ~ — 1 '1 ‘ __A_{gI1__1be1-, SI{)l'€d 31% D fur,‘ Z 2 3 ’ 4 H“ ‘ 1’ Bucket Ins!nl1at1onType; %)11'°°T_B1-11'? |]Dm:ct_Bm3_: 1 UDu'ectBury I3 Direct Bury , A C tajngd . ._ A 9-“ ~“*$"mP D-AC°*1P!'1==‘!,nS"¥13a‘.. UQ<m!=1n§dmSu_1gg \lIlCq{1_ta|ncdi1:;Sump_\ Wait apAp]y1_ 'ng> ‘ ' V" ' _ " _ ~ . ‘,_V£\1}UlJI31/§_»IatBIflfl£1S!fl.rtv0fic3t; _' \T~=:¢_S1=mTim~<r.>= M ; — ~ - Mi _‘_1nin'a1 (R0; - ~~ _ __ y wT($§t Y _ _». ‘ V___ -,.. __ ._ Final Reading (RF): 1 ’ ' ' — * ..i ‘ Test D““_*"i°!_1_(T.=—'I])= K _ 7 _ “ V Change Reading (R; -_ R1)= ‘ V Pass/FailThmsh01t1"or ' ’ V ‘ _§*"?.£i== - A j - - ‘ i Testllesult: ' V '_’ ' - ' A‘ " - - ~ ~ -- ~ H; coinmm-. 47;-§.Zzude:»;} F PM 5' ml D ms BF“ P U2?" 7 11!?“ BF=-I1 , ~ ,_ __ _ . __fi",':"tlfian 91! (§pa1ralmad;§§rza:-90 lfiébng, qnd*rqcay;1Ip|¢;;d¢dji;[_lg;p.“2f0rf§"-154'!e_m-) _ i H 7i ' "‘, " ' --~ > . — - __ 1._ CERTIFICA " ' Cm- I husky MW M an thefiglxggmcadnamed M FOR CONDUCTING Tms TESTING. . D rs rue, accurate, and in full compliance with Legal rgquirgmgms, TecW@’s Signauu-e:A Y V. ~*_ ' _ Dam: l-d | ' " -' ‘ t— .. State laws and regulations do t fl - . _ > may be mm‘: stringent ' no cun/en Y Wqmre tefmug to be pezfornmd by a qughfied cpntractor. However, local requirements V9/PB 3E)Vcl NDIJ.OfiEilSNUO NEi3>i EEIZBYPEEIIQQ 817558 '9T@Z/S/Z8 V00/V00 VIEW 15130 <- Sfl'VCI'NH3)|'UOElH3 X'o‘;1I 09380 OLOZ/90/Z0 \ _ ’ " NI~ 7 = swncs, January 2002 “ ' Page oil iI 10/2?/2010 15352 IFAX EH@CU.KD3CA.US “Dept Main 002/016 ‘ 18/.27/2816 15:36 551634 KERN CUNSTRUCTI PAGE .92/16 _/- (,1? ‘iT'.@”7 \./\l Secondary Containment Testing Report Form \ _ His form is mzergded for use by contractors performing periodic testing of UST secondary conzaimnenz syszems. Use the appropriate pages of this form to report resulzsfor all components tested. We completed form, written test procedures, and .. print0ut.sfi'om tests (if applicable), should be provided to the facility owner/opzmtnrfor submittal to the local regulatory agency. 1- FACILITY I1~1F0RMAT1Q1§L__ _ ____ 1=»i1iwNme= Big TRUCK 1 ., TD=*#?°f.T=~<“'41s= 3-5—L<:> II I I ‘ - ‘ _ V t. .._. t __..... .t. ‘__ Fac111ty Addre _ Z/1' 7_' //Ag ___ Faci.l.ity Contacts _ 7 1 | Ph°n":‘§ '1 K32--5'39O l:)ate Loaél Agency Was Notified Of Testing 2_ M V WI M _ __ __ Name of Local. Agency Inspector (if present during testing): '' 2. -Tnsrmg CONTRACTOR INFORMATION 41.. _CompanyNamc: I I 7' Technician Conducting Test: I /V A / I A \ Credentials: CSLB Licensed Contraotor SWRCB Li ed Tank Tester Manufactu er Trainin ‘ ‘ Manufacturer _ Z Comp0n¢m($) ‘> Date. .Tmining EXpir¢8 \ .\ " '" W _ mi‘: We t V 1| 3-. SUMMARY on TEST RESULTS ~ I 1 Component Pass‘ Fall N“ en rs ‘- Component Pass Fail N” R°p“i" Re} ___A Tested 1v1m¢ _ Tested Made i> /x Y~ no T“N% I A 3< oz 1, AA _>(\E Xe» 5Q hydrostatie testing was performed, describe what was done with the water aficr completion of tests: o ‘ CERTIFICATION OF ‘TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING T 0 the ban ofmy lcmpwledge e facts stated i ' e accurate and in full compliance with legal requirements 'I‘echnician’s Signature: W Q _ » _ Date: _5-, S' ) . , F- {(9)('9)L€9Z vows ‘sz Hm --~»!W1“i‘=‘¢I 1° °P°O ‘F‘"°Ifl"°9} '5“¥°“* maunrgmuoo ogpopod meg )cI1:uaX9 are ‘I1I\'lnoBA1I!B1$‘U00 Japan :0 pa.10;}1XOD1 K['[G:)p\91S0.!p.&I.[ am wtp sweasfls Se ‘qans ‘ll-IQIUIIWJIIO0 Ampuoaas ptm mmxd em moq sxomxom Afinopauxoalxe fiduomlom snonupuoo org araqm swezsfli IIIQIIIIIWWOQ /UPP1'1'°°3S \I 11 ‘_ (ma; palgnf .40] dn-m011q[papuaunaoaa4 pub ‘Sims; 0; .4o;.4dapEi1kIs4guJ5.¢ u0 u0;umeZ1q/u_z apnpug) — Slliiiiiiilidj) vu °N 5°}. ‘vn on ===A vn QN @=->2L VM °l\I @ PM ands; Apodoxd Josuas sum *4" '" H ‘-""7 1,9F"g1§'5T1a1;a{'l5'cTopcun;}pa§'g.1a/\ . P9 '' VN" ON §aX""' 'QN 59;; V1.1 0N Liupssm .10; P9/X01891 msuas Sum < * I " i‘ }§l'!_1$a)1 15411_ F-191?-YO -1° PI°‘I5°‘llII. I!Y5[/“Ed .2400 =(‘H~*‘&) BWPBQH II? QEWPIO 2iW;'// '" 7 zuorwmq 1sa_[_ ,9/A/0/_ =(*x) iwvml lama w 1”” 3% i9'U(ILL PIIH 1801 fv Ff _ //0/.-_ 5(‘2{) 3'lY!P'~?9‘¢I WFJWI9 W/5§59> I3III'_l_L 1-IBIS 1501 M " ' /v/HQ Z1801 firm-ms pm: xamm/mnnam/aanssaxd fiupqdde uaameq own mm * jfij/0" " :ps.151_§ i'<>"np5i; »//MW/1 :x=\m1:>u_;nuap\[ >[uu_L *l'eF1°WI/\I XWL J H9/fléls o<><’__ 2/ v<1!‘=$B'iIé:> >i1ivi“ ojllm 0N ea], 0N M s:>_,\_ ‘ sagg J #>nw.1. # rum. # >a'u==1 H # »v"=J. j A 7 W:uDpn'|OS9}'[ mawdynbg > q __ .pasf1 1ss_"L 1. wflu‘ aduiéiiié 5iiI§.f§i' (4/wads) wmo opmsoxpfi;-1 ’ Qmfifmd =1><>sn P0111-Qw mm _ (<\7.==>=>¢1's‘)1°=no xsougfiug 1wo}sso;o1,1 pmpumg ,(.nsnpu1 Iamzovgnuem >11'm1 :53 p_a§q1oAaq poxpaw ;sa_L V ' “ :)r<[1J'.'§é|.fiWr1r~1r~Iv>n~1vm"i» if ?o 7 eggd zooz MW! ‘aoms QT/EB 39Vd NCIILOHHLSNUO NEi3>1 EEZBPEQIQQ 981911 BIBZ/LZ/BI SLO/800 U19?! ldall <- Sfl'VCI'NU3>l'UI]E!H3 XV;II Z9391. 0LOZ/13/0|, 10/2?/2010 15352 IFAX EHECELKD CA.US " D Dept Maih 004/018 16/27/2618 15:35 561634 3 KERN CONSTRUCTI . PAGE_ B4/15 _I 4 A Page5__0f_Z , 5- SECONDARY PIPETES1‘ING 7' _- _. Téimmfloa 1>;'/Zxoved 1§y_. ' Pibing Mfl11“f@=mY@r - 1'—‘d“’"Y S““‘d“"* P”°f""“‘°”“1 Ewe“ ‘ Other (Speclfil). . V < Test Method Used: Pressure "8°““m _ HY‘“°"““° Other (Sgeci/31) ' A ' ' SWRCB, January 2002 Test Equipment Used: Equipment Resolution: .. " ‘ — 4 l . . ‘ ' I ‘ripmll # ' Pig R1; _ Piping Run # Piping Run # I \ Pigjng Material: \ _ V » \ _ ~» Pipigg_1\4anufaCfl{r€f§ _ t 1/V . > 1 ._.__ _ r \_ Piping Didqeter: A_ - A 3 3 ’f_ Length of Piping Run: ' _ _Product Stored: _ > ___ __Q[¢{§¢F'A Methodand location of' _£i£iV11g-nm isolation; M - //\/ Kfi Wait time between applying pressure/va’cuum/water and '* staniugtest - - . ‘ —'1Test Time: K _ P _ _ _/ i J Initial Rqading (11,): _ fly 25 r A _ _Z _ _\ Test End Time: _ F. Final Reading (RF): ' _ Test Duration: Change in-Reading (R;.—R|): __ - A ___ Péés/Fail Thrwhold or ‘ ' . "Tg§tRg§fi1tE' _ I “ . -'._Ps'|'ss;, _ '- Pass Fail: '-Pass _<:~Fsul~'- ;:1’:m. Fail . . .|. . H - - __ -_____%¢_*_-ml‘ '1' “Mu-4' 0_I_\_1!11ents - (inglyde information on repa_1_Irs made grior to zening, and recommended follow-ug 15>)" failed tests) ,4 4112:-A ./pma/5 E‘/Q1546‘/¥ //v _¢@'s,1 Q ‘v 10/2?/2010 15152 IFAX EH@CU.KERN.CA.US -> Dept Main 005/018 16/27/2818 15:36 6616349233 KERN CONSTRUCTION ’ PAGE 65/16 ~ SWRCB, January 2002 . Page 5€°f-- 6. PIPING SUMB TESTING .6 ____ ‘ Test Method ficveloved B:/1 Sum? Ma"“f“°““°‘ 6 1"“d“"“*>' S"“‘d“’d 1* A P'°f‘”si°“l E“gin°°' L Other (spmfy) Z/;/60/V mt Method Uséd: A ‘Pwssum Vawum ‘ _ _ Othor (Speczfi_:_) __ Tesrfiqnipmenrvwh 4 . ._ 1 ' pg fi/ A_Sump# __ __ Sumptf *_ V V Sump# _7 _ _ _P Sump Diamgtej: >_ _§_ 3? ”_ _ ’ \\ Sump Depth: ZQ H 6\ 6."'sm6 6 fiaaeqvss6 Height from Tank Top to Top of ‘ , I\ Highest Rjp‘ Pcnetgat1'on' 6__A mg _ __ .. Height from Tank Top :0 Lowest Z ‘/_rr Electrical, Penetration: Cofigifion of suTn1§ p1'i0rt0 i¢<fi§£§ Tl/ _ ~ : L20?' Portion of§u1np Tes§<§<_i‘ _ __ " 6 Does tuxbine shut down when 4 mA sump sensor dctscts liquid (both @ N0 _product and water)?’ NA Yes No NA Yes No NA Yes No NA r:sp_c§1se time _ Z. (QC, _ ..,__ Is Qyszéfiflamgmmmcd for faiksafc _' N shutdown?'0 NA You No NA Ycs No NA You No NA Was fail-safe verified to be operationalf 6 6} @ No NA Yes No NA Ya: No NA Yes NoNA Wait time between applying AA pressure/vacuum/water and starting _, test: MIA, _ ' Test_StanTimo: H __ A 6 Qj-gag_ Initial Reading (Rr): /‘/{.01 \ A- Test End Time}: K _ 6 7 A (R-,-)A:____ _ -. . /flu TestDu1'ation: 7 _ ljfllu my _ _ ____ flC_ljange in’Rcading (Ry-R1): _ ,0QZ_, .°¢\Z_, _ 7_ _A V 6 Pass/Fail Threshold or Criteria:. Te“ Emmi " Q4 :i:.f-$Fa;i61=!.--'ff' 1; Pm ” 3_!~‘T~§$_'1 I . arm ‘1*-1=.=’1ilji_ _5i. .=;-Pfi§s"6 6-W5. Was sensor removed for. testing? M > N0 NA_ Y“ N° NA Y""4‘ N9 NA .Y°3 . 6-NQ__6_6l\IA Was sensor propérly replaced and ' A — A Q 77 77 efifidfimt,a1fltest.2§l‘ No NA Yes No NA‘ Yes No NA Yes No NA mu 1 ._6 _ A .6 - 6 A- Commcnts - (include informalion gn repairs made prior to zeszing. ""4 "=6vmmendqqgfollvw-mfqrfailed 16-FY-F) W W“ 1 If the enhre depth of-the sump 1s not tested, specify how much was tested. If the answer to _a1_g of the questions inclicated with an asterisk ("‘) is "NO" or "NA", the entim sump must be tested. (See SWRCB LG-160) _ ¢ '. ‘. I Ib u 10/2?/2010 15:52 IFAX EH@Cl].l:a.C"P..US 1‘ Dept Main 005,013 I 1e/27/2211-5 15:35 55153 3 KERN CUNSTRUCT PAGE 95/15 ' SWFLCB, January 2002 ~'~’=8° §l °f_.'Z' ‘ Tmod Develoiaediyz ' UI?Manufac Other (Specij/$1) 7. UND§._l-DISPENSER TESTING turer Industry Standard Professional Engineer Test Method Used: Pressure Other (511 116’) Vacuum Test Er Used- Re \imc#5— solution UDC# UDC (4A!kA/vwA/ E L»z:[fi~@*W'~/ Ul3C II:/Iaterial: t l kl § '4§§-- \ Height from UDC Bottom to Top v of Highest Piping Peiietration: _ % _UDCDej,§t11: ' _3_?"_ ' .5'7"_ ,. /01! Z0/I /Q”. Lowest Electrical Penetration: I-Ieiglit from iT>c Bottom to 1 / ‘ g ,, 8"’ Conclitio1iofUDC prior to t t<=8tins:_ 3 i_ Portion of UDC Tested‘ __[2’ .. Lfi/L?/1 t_ /2'4 es Does turbine shut down when __produet and water)?‘ _ __ UDC sensor detects liquid (both No NA N0 NA I @No NA Yes No NA 'l.‘m'bit1esliutdowii,respo1;se time L {E5 .5 j_ {E1. Is system programmed for fail-- safe shutdown?‘ A _ H @) N° NA l N° NA z_.2>c @No NAY es No NA —‘:V.p:.:F;";i(;sazg‘evet‘ified to be I . No NA No NA . No NA Yes No NA Wait time between applying pressure/vacuum/Water and starting test ty ‘ L ' -% MIM @ M/M_ TestStartTi_me: A _ ‘ - ___ H . A: i 9 M‘ ' Initial Reading (R1): P _ ' ,_ Q_ ‘.E 1Test._End Time? I , ‘ ‘ _ _,_ 1='1R'<i‘ (R)! " _ , .4"! A '._ F - ~ it vF >ChangeinReadgg(R;.-R1): _ __ i A t_ __ Pass/Pail Threshold o.r_Crite1-ia: ___ L _ __Q Tei‘~Reimr=- * = _. ‘I-.‘:.‘_-:'_.‘;¥ass ; ,-rm=:;oii§;3.": 5* 3 = is A * r=etttt1;51rai1="=‘ ‘Was sensor removed for testing? __ Yes _No NA_ Ycs No NA Yes No NA Ya No NA Was sensor properly replaced and_ v vcrifiedfimcfionalafiertmm Yes No NA_‘ Yes. Yes No NA Yes No NA Qqtttments — (include information on reliairs made ppfior to testing, and recommended follow-ua for failed tests) ___ fl// 72%?’ 5%-»~:rt £86 o/-7-" /M :4¢>c's.5 tlL76’5., z.z/~/ZZ[/ ézffififlpe Z5 /~s.>*e_// /'?=r/T./3<=o'Fs' to :7 an uczeis Qu6'77v /\/¢> l3<z:>Ti 01>! L.eMF§ ' If the entire depth of the UDC is not tested, specify how much was tested. If the answer to Qy of the questions indicated with an asteiisk (*) is “NO” or “NA”, the entixe UDC must be tested. (See SWRCB LG-1.60) 10/2?/2010 15:52 max EH@CU.KERN.EIP..US 3 Dept Main 00?/015 15/27/2515 15:35 5515343233 KERN CONSTRUCTION PAGE av/15 SWRCB, January 2002 ‘ » Page _Q ofZ 5 > 8_. FILL RISER CONTAINMENT SUMP TES__':,[‘_;I_§G ___? __ _ _ 7__ paemiy is 195? 5qu@15pJ?/Em Fill Riser Qonthiu|vn‘ent7Sunips 5 __ F111 R135; __(EQnLqipmen£Sun5gE_'Q?r_§;§£l1t, but were blot Tested ___ _ A _ _ ____>__ TestMetl,1oclDevelo;;ecl'By: Sump Manufacturer Industry Standard Professional Engineer ' A Other (Specz:fj1)W __ '71-est Method Uscd; P1-Qssu;-g Vacuum Hydrostatic Other (Speczfv) ’ A A A V __ l Test Equipmem U565; A A l __ Equipment Reolution: j 5 5 % Fill Sump # 5 Fi!!S_"m_P # __F..*.!1.sw1z* # 5 5_ 5""? #. Sump Dlaterz‘ __ H 5 5 .5 _ 5 .5 Sump Depth: 5 5_ __ _ 5 5._ 55_ Height fi'o.m Tank Top to Top of ljlgliest Piping Penetration: _5_ 5.5___ Height from Tank Top to Lowest Electrical Perletration: _ __ __ Conclitien of sump prior to ‘ testing: _ in 5_ Pbrtion of Sllillp Tested _ _ ___ _ 5"‘ Sdiinp Mgterial: A 5 5 _ Wait time between applying pnfessure/vacuum/water and sth.rting_test: ' 5 it5 Test Start Time: Initial Reading _(R1); W ‘ _ ~ 5 __, Test End Time: ___ 5 ..__. Fina_l_Reading (gg; W l 5 _ 5 \ Test Duration; ’ _ _ ' _5W 5l _Q}1_agge in Reagi3g_§R,—R;): 5 _ 55__,1_ Pass/Fail Threshold or Criteria: 5_ 5 55 5 -5 _5 55 .. 1’ .'.'5i;'L3__»-.5‘_1’5S‘s"' j5Feii~;*- jl’.ass. 5'; I 'F.fiil_I':' P1€!§§45.'.:="..j1i'#iil1=. 7’1’i_!'9S. -:,1"-'F§iilf- Is thereasenserimzhe sump? __ Yes_ No A__V Yes Ne _>_ Yes _ N0 __ Y65 Ne Does the sensor alarm when either product or water is detected?_ Yes No ‘NA Yes No NA Yes No NA YOS No NA Was sensor removed for tcfiting? Yes 1_\lq_ NA Yes No NA Yes N!§ Yes '1~i5 NA Was gensgr properly 1'6p130¢d and‘ verified functional a:fiAe_1_'tes\ting'l____ Yes No NA Ya No NA YES N0 NA Yes l No NA Comments — (include ilzformation on rfgpairs made pnfqr to testing, and for failed tests) l Qfi D66 /var fie’!/6-' Q//723 it \ T0/2?/2010 15252 IFAX EH@CU.K .CR.US D Dept Main 008/016 16/27/2616 15:35 66163 3 KERN CUNSTRUCT PAGE 68/15 ' SwRcB,Jmm1-yzooz . _ _ . P*‘g°-2+°f£ NTBO 9 SPQL/OVERFILL XES Facility is Ngnquippcd with Spill/Ovflfill C°1mi11m°*1* B°"°S 1 ~ -' - -~ Spill/Overfill Containment Boxes are Present, bmwere Not T°s"=d A ‘ 1' f - -. I_ \ Test1Qfe¢_hod Devélopod W Spiil1T3T1cketMmuf§ctfimr l Industry Standard Profcsaiona1En.gineer_ Other (Specify) _ _ H __ i ’ » f Tggt Uséd: ‘ _ > I P1-3551;;-3 Vacuum ( H5'_(1fO$fBtic l ‘» Bucket Diameter: / Z N h V ' U~=ed- 4 Equipment Resolution‘: Spill Box #4, ~_ 6x # ' Spill Box Spill Box # “ Hliuckct Défitlli -V _/7'/{ _ " -—»—- Wait time bgztween applying pressure/vacuum/water and startjpg test: _ ~ VTe5:StartTi1i1c: i “ _ 9L/my‘ Iriitial Reading‘ (R1)I _ 3 . /IJ _TestEndTim¢: ' ’ *- Pm1“Réedmg<RF>= 3-- 3-$sfom . ~- A ‘ ‘Change in Rcadi:ug(Rv-R01 _ _ 0-0,619 \ -~ l Pass/Fail. T}m>;sho1c/1 or '_ Criteria: _ _ '00L,[)\/ l ' ' - - 1 ‘‘ t » "1 Co1_n_g_1ents - (igclude information qn repairs made prior to tqsting, an_d recommended foIl0w—_gq.1 for failed tests) Q??? Q/V /7/z=§¢=/ /-2// ,5m/<€ZI Q/‘W ~# <1;w=<¢ _ .- /Mm‘ Q‘-*1”-‘?~ £7” ! ,. E ~ ,_- v 10/2?/2010 15252 IFAX E_H@CU.KERN.CP-.U8 ~> Dept Main 009/018 16/27/2618 15:36 6515349233 KERN CONSTRUCTION PAGE B9/16 - SWRCB, January 2002 ' PageLof? Secondary Containment Testing Report Form This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (lfapplicable), should be provided to the facility owner/operator for submitlal to the local regulatory agency. __ 1. F AC_[__L__ITY INFORMATION ______y_H ifaciiity Name: /{dis W5 i 3 V 1 Date ofTcsting: 3» ._ /Q A 3 "'7 Facility Adcjressz Z101 7745~7-‘£5/M, y ~ _ _ "' Facility Contact:;( /I/23 ,-‘En Phone: f. ‘K3 Q__~ 5 0 3 Date Local Agency Was Notified of Testing 1 y yW Name of Local Agency Inspector (if pre.ser:t_oi1_4r_ing testing):- 2. TESTING CONTRACTOR INFORMATIONL “few” J-IIIII-1 -— ——‘— ’ If’ '7 ' " '' ._Q<>.m1>m=y Namf=t1__/¢c‘/Q/V COAl_$'Z7€’°i<;Z70/$/ ._ ,3 -t . . ,. Technician Co.n.ducti.ng Test: S1211/f-/V Dfll/6K _ _ ___ _Crcdcntials: CSLB Licensed Contractor "___ 7 _ N SWRCB Licen_s_ed Tank Tester License Type: .< /CC _ H License Nbor; 5'_ MC M Manufacturer Tralnmg Manufacturer Component(§) H V Date Training jfépil-¢_5‘ :_>______7_____~_-~ ~~~-;___ __ ~_;__.__ ___ ~ "-- '"-11-1" _ ___‘ ___- e,§:_e$W1MAR¥m9£TE$T RESULTS R_ . Not epmrs 3 No;R Component fess’ Fail Tested Made Component W}?a5g‘ Fail Te 132:1?‘ Quad ewe/ee to AX _ _ \. Alger, )1 -. xi l exec /-2. ‘_ _ ,2‘- Lz.u2c§—‘f ei4l2C.,5—(a.. X_ e,DL&$1_-‘/ H// Buztééf ><><'>< X ----- J _-M _ 1 _\_t ‘ ___ ________ .... .._,___ __ _J_ __t__i- V _ .___ H _ _ _ _y_ Hi ‘hydrostatic testing waeperformed, ciescifibe what was done with the water afler completion of tests: ietzocep <7‘ gage ti//tttsrr /52/Q. zztrm/e3 CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best ofmy knowledge, the facts stated in this document are accurate and in full compliance with legal requirgyngygfg . ' ‘ 2 * .' Tcchn1c1ansS1gnaturc. i - 7 _ Date; 3-/52/O 1 0/27/2010 15152 IF-°-X EH@CU.K .‘CA.US r Dept Main 010/018 18/2?/2916 15:36 B5153 3 ‘ KERN CUNSTRUCTD PAGE 16/16 swacs January 2002 Page Z-— °fl , - 2' " 4. TANK ANNULAER TES'I;1_NG_ __ l 7 Women Developed By: 1“ fank Manufaoturet ‘ lnduflify Smdmd P"°f°39i°~'“*1 Engineer ' Other (Specifil) ’ U. --12 Test_l\/lethod Used: Pressure Vacuum Hydrostatic Other (5P?¢iJ3’) IA ‘ ‘ l Test mem Used: " Equipment Resolution: _ _ ak i- _ _ Ta;§#|"|‘ # _ _ Tanltfl Tn # _,, IQ Tank Exempt From Tes"' Yes _No 1-Yes No Yes N‘! Y“ _ N° Ten—l;VCapa'cit'y:V — _ w _‘_ _ V i t V ,_ , .. V, _' Tank Matcrial: . U A_ A ' c l— Tank Mzmufact1uor:_ --_' Product$tored: - A _ .. Wait time between applying- pressure/vacuum/water and start_i_u_g test: _ _ _ l e l Test Start Time:5 Initial Reading (R1)¢ M _- Tcst End Time: A _ l ‘I ,. ,..._ l Final Reading (RF): >'l:e_§t Duration: _ A __ l Qhauge in Reading (R;-R1); - _ V M \_ _ _ _. Pass/Fail Threshold or Criteria: _ __ __ '' in= was sensor removed for testing? ‘ YC8 NO NA YOS N0 NA YES NO NA Y8-S NO NA W“ égnsor pmpcrly replaced and Ycs No" NA Ycs No NA Yes No NA Yes N0 NA Lvefifiedamcuonalaamwsaqgv W y "__ 7 . " Comments - (include information an repairs mqajgprior zo testing and req9mm@P1d¢df0ll0W-"Pf°"f9il@d 16’-91$‘) N121" TC£€TE.D- ‘IFS?’ /%"Eff?£/450,, 0/v &@/t/212fi?~,Pfi/PP 4&0’ upcgy l9%fi. £_§47/;1L§§ Mag;-'-J_1@0E. Z/7//S___L_ ‘ Sccondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such as systems that are hydrostatically monitored or tmdcr constant vacuum, arc exempt from periodic containment testing. {California Code of Regulations, Title 23, Section 2637(a)(6)} 10/2?/2010 15252 IFAX EH@CU.KERN.CP..US ' -> Dept Main 011/016 16/27/2619 15:35 5615349233 KERN CONSTRUCTION PAGE 11/15 5. SECONDARY PIPE ‘TESTING “ Omar (szmify) T¢gtM¢1_hod Developed By: 1>1n.ingMnnnrnnnnZr nnnnn Standard Professional Engineer SWRCB, January 2002 Page 3_ Ofl Other >(§£ec;fv) Test Method Used: EGEEB va°““m HYd1’°5Wi° Tm Equipment Used; Equipment Resolution: lhpmg Run # Pupmg Run # Plpmg Run # Plpmg Run# \ Piping Mgnufaqtilrerz __V L 5' 3/21§¢’i " » " - Piping Mater.iaI,: _ ‘ANNA U Piping Diameter: \ Lepgth 0f.Pipii1g Run: V IL all\ 59! ' p;Oinn¢;nonn= if 1 Methdd and location of 800+ //J $04? LRiping~run isolatiqn:W Wait time between applying pressure/vacuum/water and. starting test: _ A ______ __ Test Start Time: Initial Reading (R1): T°S£15P4 Tiw Final Reading (Rn):_ Test Duration: _A_ _>_> ‘Changein Reading (Rn-R1)r O-0135] , 00/’§'. A, Pass/Fail Thrcshold or criteria: - ’ I . . . . »» . * . V . . “TC” 4. §'Ies'§_»Résfilt£_;_ * "mm" " Pass" 3'11 ”'P:i§s ' Phéé" if -|—| in-nn~AvuI_ 101 -_-_ ____V___?_~ 3M .' '- ‘ = _ -F 1' 32 " L, ,;:§_,=,,= ;'i,§,;._.s_,. ,-;';.‘§I Cmllments’ ¢_(incIude information on repairs made prior to renting, and recommended jfillmylugfor [qiled te.st.v)_A _*_ A A_ w /»// 3 nqzzzrs.3 , _, _ 3|_ éflgg//2 in ‘ 68$ to/2?/2010 15:52 IFAX EH@BU.K .cs.us ' Dept Main 012,016 15/27/2515 15135 5515333 KERN CUNSTRUCT1’ PAGE 12/1s swtacs, January 2002 _ A P=s<= it of .21 p 6. 1=1_g11~1G SUM!’ Esme __ i ._ _____ Other (Specifl) A Tostftt/Iethoii>Z3L<>7ve]o|1F173y: H‘ E5 Manufacturer Industry Standard _ , 15rofession.alEnginecr Other (5'11-wlfi/) Test Method Used: _ Pressure Vwmm H)'*‘31'°8Wi° Test Et1\1ipmcntUsed: A Resolution: _ Slump #‘ ump # Sump # - A_ Sump Diameter: p_ Sump Depth: _. Sump Msterialr A ' _ Highest Piping Penetration:_ Height Tank Top to Top of Electrical. Penetration:_ ' Height from Tank Top to Lowest‘ \ Condition of sump prior to testing: Portion of Sump Tested‘ Does turbine shut down when __groduet and water)7'A sump sensor detects Iiquid (both Yes No NA Yes No NA Yes No NA Yes No NA Turbine shutdown response time _ shutdown? Issystem p_xogrannn.ed for fail-safe 7 Yes No NA Yes No NA Yes No NA Yes \' No NA Was fail-safe verified to be' operational? .. Yes No NA Yes No NA Yes No NA Yes No NA Wait time between applying test:' pressure/vacuum/water and starting Test Start Time: ‘ was Reading (11,): mt End Time; ' _ Final Reading (Rs)!_ Test Duration: change in Reading (R;-R1): A _l5ess/Fail Threshold or Criteria: T¢st@Ré§!1!¢'sJ.." 1111; t. .7 ». Was sensor retnovod for testin ~Yes No NA Yes No NA Yes No ANA Yes No NA A @554 fmstisfls! sflsrtsstiv g7 Was sensor properly replaced and 81 \\ C_0_[t1_g_1ents — (include inform ation on repairs made prior to testigg, and recommended follow-up for fqiled tests)_ Yes Nd NA Yet N0 NA Yes No NA Yes No NA -1-_ w_.~- H , _____ W , ,__,_,_ ~_ . fl¢=n=5f Fm? {pea/@587 }z70_1.-‘— s” 4/Q<{§ a/\/§-/ tor u 1 . asterisk (*) is “NO” or “NA”, the entire sump must be tested. (See SWRCB LG-160) If the entire depth of the sump is not tested, specify how much was tested. If the answer to guy of the questions indicated withan 10/2?/2010 15:52 IFAX EH@CU.KERN.CP..US —> Dept Main 013,018 1/27/2810 15:35 ss1s349233 KERN CONSTRUCTION PAGE 13/15 swncs, January 2002 Page id '7. UNDER-DISPENSER c0NTA_yMEN1_‘ (UDC) TESTING V ___ Deve1opeci_By: l _ UDCE/Iamnfacttxrer > Ifldusify Standard PY°f°$$i°fla1E118i'l°°T Other (.S)2ecify) _ _V Test Memod Used; pl-essum V A Vacuum l l (flydrostatié V V_ V _ 0fl1°1'(3P@¢i/5’) A _ V _ _ 1. V_ . is_ -1-est Equipment U§ed- Ncofl Equipment Resolution: , QQ4)" _ UDC# .. _c # - UDC # V» unc # ' UDCMan_\_1facwre.r." V 1 ,;4g¢1,vr\/ V 1J¢/ 41>/W/A/‘ . /-5 i I.IDCMateria.l.: W tggggg-,M§ A aggz;//4<s_ /?@ee-14:: 1-A Height from UDC Bottom to Top ' of Highest Piping Penetration: ‘A UDCDepth. A CZ} V , <25 1..__a‘i‘/-V // " // // Lowest Electrical PVenctration.: __ Height fiom ITDC Bottom to 1 9” 9 I’ 9" ‘ Condition of UDC prior to testing: V‘ A \ Does turbine shut down when‘ Lproduct and water)?’ __ , _1 PortioriofU_DCTested' [§" _ _ /3" V /5" _ ,,1__ unc sensor detects liquid (both @@ No NA fié No NA No NA Yes No NA 'I‘u.tbine shutglown response time \; L§€‘Cl ZSFC-' 1____ zsec; safe shutdown’? _ V V_ 1-"Issy$t6mpr0gr§mmedf01'fai1- NO NA No NA @ No NA Yes No NA Vglgzgsrjgggsfiievcrifiedtooc Vi(f3s ' No NA V @ No VV NA QQ No NA Yes“ NOV NA Wait time between applying pressure/vacuum/water and V stert.-ing testV \ 50M/M so M/M 30/4/M Test Start Time: J Initial Reading (1111: A i'— Qannq 0 l ‘_ ZmI 1,§lgEi'f 7--450" ;5¢2K1" 4-ii?" ” _._,_ Test End Time: .. 1, ._ 521.21% 421014 .8521 3QL6M_ WM. iwliinal Reading (Rn 14-5°"..J"~‘/50" 1&5 1- 56->"*&,.5.'5.3" - 58" )=1 Test Duration: _ _ I/U IV ,. __‘ I ’ Mm" Mom”1 _” _ _‘-.1--"F»il> xi‘ F I->?."?§1é€3f.‘i;-;E=iil_1‘:1 _Cha.ngc inReading (RF-R1): _ V. pol _ V 1.a;_,y " _ -002.’ Pass/Fail 1'hrosho1d or Criteria: _-O " _ .002" ‘V VV V .n ¢TestResi1lt:=,. :. 7-1.3 :f' ‘ F5" 1 Fm':>1_:E- .. \ .. verifieci fuqctionalgfter _ _ No NA FIVOM NA Was se_nso'r remoyed for testing? ' No _ NAV Yes_ No NAV 51$ No NA _Ye_s No NA Was sensor properly replaced and ® NA Yes No NA@ Comments -— (include information on repairs made prjior to resting and recorygmendedfollow-upforfailed tests) A _zuir_7 E05 ‘ If the entina depth of the UDC is not tested, specify how much was tested. If the answer to §_._111 of the questions indicated with an .agt1e['iAs]<, (*) is “NO” qr “NA”, the entire UDC must be tested. (See SWRCB LG-160) > t._ 10/2?/2010 15352 IFAX EH@CU. .CA.US ' D Dept Main ~ 014/.018 1/27/2910 15136 BBISBMB KERN CUNSTRUCT PAGE 14/16 . swncs, January 2002 5 Page 115:1 _ 8. I<]_LL RISER CQ1$IfrA11~nvI1g§{'_1‘ sU1y1_r 1jr;_sT1NG Facility is Not Etipped With Fill Riser Conteinment Sumps __ Y __> _pt p Fill Riser Containment Sumps_ i are Present, but were Not Tested V 7 H W pp Test Method Developed By: Sump Manufacturer Industry Standard Professional Engineer Other (Specifl) _ ' J Test Method Used: ' D Presstue ‘ Vacuum Hydrostatic '”” ‘ ' ' Other (Spec;/3») ' p " ' - " Test Equipmerit Used: ' _ __ ‘ ~ _ Equipment Resolution: D— ' ’ FiJ.lSum # FillSum D Fill ' ‘ riusm' . . . ‘ “ ~ ‘ ....--; —-- P _ __ T Sumppiametér: __A ', _ 7_ ' . ___H V'_- _ _ _ V_ Sump Depth: Height from Tank Tbpk to Top of Highest Piping Penetration:_ D Height from Tank Top to Lowest' Elecg1'ea1Pen§tration_: _p__ _p_ __ __ Condition of sump prior to testing: A __ ___ V _ _ _ __ “Portion of Sump Teted ‘ if _~__p___>___ _ - Sump Materifl Wait time between applying pressure/vacuum/water and stm-ring_§est;_ - A p__ Test Start Time: l ' 'Inifis1R¢aéi11slR1)_=__, .. .. ’ \ , ffest End Time: __ Finfl1R9sdi11s_(I$e);._.'ll —:_._ ' __ Test Duration: " » Change in Reading (‘Ry-R1): Pass/Fail Threshold or Criteria: 'R¢§.!11§5.‘,. 1.: I I . .. :HPas§_-. . ..= i--..4. .. . >._ ' \ Is there a sensor in the sump? Yesr B88511» Fail"-._'%‘-‘%,'1'-ra‘ss':_ _:'1'afss_j No Y No Y No r O8 I C3 Yes ._ No Docs the sensor alarm when either product or water is detected? Yes No NA Yes No NA YCS N0 A NA Yes No NA ‘ Was sensor removedfortesting? Yes ___ N0 NA Yes No NA ‘ Yes No NA Yes No NA Was sensor properly replaced and lm Y NO NA Y N NA ~Y NO V NA e verified functional afiértostingz es " __p__7_*es " ° as Yes No NA Comments -— (include iriformazion on repairs fnadeprior :0 zeszing. and recommpndedfollow-ugfqrfziléd tests) 1 ' 5/Zétfif /D726 0/k//7 ' __,. ¢- _ _.-. _ . .. - ____1 '¢ r 0 a w- \< 4‘ 10/2?/2010 15253 IFAX EH@CU.KERN.CP-.US ~> Dept Main 015/018 16/27/2918 15:35 6515349233 KERN CONSTRUCTION PAGE 15/15 SWRCB January 2002 P8g°i°f3_ » 9. ’SPILL/OVERFILL CONT_.g._INMENT BOXES is Notfiggggm with Supill/Ovcrfilkl Containment Boxes A W 1 , W. _ "1 Spill/Overfill Containment Boxes are Present, but were Not Twcd _ __ 1 Tm Mei-h°<fl)ev¢{§pcd By; spill }§1.1¢1<et71\7/_lianufacu1rer Standard Professional Engineer M M Other (sgecijjl) A ~ Test Method Used: Pressurc Vflwum Hvdvvsmi-¢ _7 H_ Other (Specij5{)_ Test Bucket Diameter: Used. Equipment Resolution: pm: 1 sp;un<>#_ Bucket Depth:_ \ starting test: Wait tinfihbletween applying pressure/vacuum/Water and Test Start Time: \ Initial Readiqg (R1): Test End Time: 1 Final Reading (RF): Test Duratiqn; Change in Reading (RF-R1): Pass/Fail Threshold or 1 Criteria: Test ’Re'sii1i'" “' =. ~. .. 1 ,~ " ~- - . 5+ ‘:1 isfll». F" '3“1?flS$i -,15‘~@~\'=I.~",. 1-"'-‘"" ' '-' "I-' I"-*--'-"'--'-*-'~ .~1'>m= "ma i>m"'n=:1 ' "" Pa " m“ " - " Comments - (include information on repair-5‘ made prior lo twins, and rwmm¢mi¢df<>llvw-vpfvrfailed __ @€f6S'[ QM iggggggy /2726 i.._@c'§_1 * .v~ 10/2?/2010 15253 IFAX EH@CU. ~ ‘n -> ¢- \ lj.CA.US ‘ ~ 10 Dept Main 2 "016/018 19/27/2619 15:36 < 66163 3 KERN CUNSTRUCT E PAGE 16/16 I [ TRANSMISSION VERIFICATION REPoRT—} TIME NAME FAXI TELV SER.# 1 '4- @6/B4/2@1@ 112@5 KERN CONSTRUCTION 6616349233 6616349959 @@@F6J137146 DATE!TIME FAX NU./NAME ' DURATION PAGE(S) »RESULT MODE- \.. » - as/04 11 an ee2sv@1 ~ @a:a4:as ~ 14 UK.’ STANDARD ‘ ECM r I \ s / r 1 '¢ \ :- 1 , 47 I K W _ Q ‘_ V2 in ’ "”K’ VK i l l I 1 l l > l I 2 ,2 .,-__ _ -I-'-l\I-Nil-J-\.I1\-I.J.‘\-I u1u.L1.'.i1v1 \.,I.u1\L.l."l.?4llk,£-\l1\JlY» " <~ ' Use By AlIJurisd1k:riorzs Within the State of i " ornia '- /Iwiwrio» Ciléd: Chapter 6. 7, with and Safety Code; Chapter 16, Division 3,‘£23, Califomia Code of Regulations _ This form must be used to document testing and servicing ofmonitoting equipment. A"sep_orate_vcertifi_cation or report must be prepared - Jfo1'ea_ch monitoring system. control Jgnel-by the technician who performs the work. A copy of this fO+D must be provided to the tank system owner/operator. The ownerIopcrator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A A. General Information l Ffltilllty Name: Q1, gag ¢,;,“- g _ e V n Y1 Bldg. No.;____i Site Address: Q3 Q1 '/“Z - City: lg’ l (g. Zip: 2E Facility Contact Person: flféfllg, M‘ A " W__ Contact Phone No.:( l _)___ _,__A A ' » Make/Model of Monitoring System: - __ . H Date of Testinlg,/Servicing: Z HQ/1 B. Inventory of Equipment Tested/Certified 1 - ACLQ‘ l .“' __ ., . ‘ ' __._._- T kll) _ idfv __ _ _, '1ankID,__ V __V ln-Tani: Gauging Probe. Model: gggml El In-Tank Gauging Probe. M06611 ___,___,__ii__________ Annular Space or Vault Sensor. Model: » Cl Annular Space or Vault Sensor. l Model: Piping Sump I Trench Sonsoi(s). Model: E El Piping Sump I Trench Sensor(s). I Model:I l. U Fill Sump $ensor(s). Model: - E] Fill Sump Sensor(s). ‘ Model: l jt Mechanical Line Leak Detector. Model: E C [II Mechanical Lino Leak Detector. ‘ El El cctronic Line Leak Detector. , Model: El Electronic Line Leak Detector. Model:M Cl '1‘ ank Ovorfill I High-Level Sensor. Model: El Tank Overiilll High-Level Sensor.» Model: El Other (specify guipumcnt type and moc__lgl_ in Sectioinfi on Pane 22. El Other guigment gge and model in Section E on Page 2). Tank ID: M H __ A Tank ID: _ ____ .__-. D In-Tank Gauging Probe‘. Model: Cl ln-Tank Gauging Probe. Modcl: ‘ . Q Annular Space or Vault Sensor. Model: ‘ ' - Cl. Annular Spac or Vault Sensor. Model:I Cl Piping Sump I Trench Sensor(s). Model: . El Piping Sump I Trench Scnsor(s). Model: - ' Cl Fill Sump Scnsor(s). C] Fill Sump Sensor(s). " Modlz Ci Mechanical Line Leak Detector. Model: Cl Mechanical Line Leak Detector. 1 Model: El Electronic Line Leak Detector. Model: U Electronic Line Leak Detector. I Model: ___ I E1 Tank Overiilll l—iigh~Level Sensor. Model: Cl Tank Overfilll High-Level Sensor» Model: °1*~.n=,,.i§_ Pare 23- 5" 3 w12_%i#nm _=,~1,_d_ ___.....°.. ....P__=_<=_1__>-_. 3 Dispenser lD:_A , _ _ _ ,_ e Dispenser ID: _. Dispenser Containment Sensor(s). Model: gk %Dispenscr Containment Scnsor(s). Model: ' hear Valve(s). Shear Valve(s). El D‘ ____1§p_enser Containment Iflo§t(§)_ and Chginis). ___ p .1 _U Dispenser Containment Floitlsl and Chaints).M Dispenser ll): _ __ _ V __ W J Dispenser ID: __ ______V 7 __ , < V_ EDispcnser Containment Sensor(s). Model: D Dispenser Containment Sensor(s). Model:' Shear Valve(s). . D Shear Valvc(s). . iA Cl Dis nser Containment Float s) and Chain s . Q Dis cnser Containment Float(s and Chain s. a*'_ ' "‘ “'7' ' "’ * . 1--‘" mt l._.... _ Dispenser m_ c__....>.. F.Q Model:l Dispenser ID: l _ in ; Cl Dispenser Containment Scnsorfs). Modclzl l l Cl Dispenser Containment Sensor(s). Model: __ \ L Cl Shear Valve(s). El Shear Valve(s). Floa_t@ and Chants . ‘ El Di onset Containment Float 8 a d Chai_n§s)._ _ __ ‘If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispense at the Facility. C- Celfificafifill - 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 ¢0I‘rml and ii Plot Plan Showing the I out of it ‘ I‘ ay rnon orutg ulpment. tor any equl cut capable of generating such reports, l have also attached a copy of the report; (check all that ply): %Systom set-up fill: , ¢-- his ry r ‘ rt Technician Namfi _ , _ ‘ii '17- Certification No.: $2 2 2 1 Z ,3 Z Zé Z - License. No.: __§'f_¢£Z,1i(7 1141]’ _. Testing CompanyName: V_ ,PhoneNo.:(_ ) ;_V_ _ .’ SneA<1<1wss= £52 iii £424 . g4Z;,;(Zg,Q Date ofTesli1g/Servicing: _/_/Q;/Q . » Pogo 1 of 3 03/01 Monitoring System Certification 4. "1' - '‘ ‘i. ~"l pg/‘[9 good Nononatsnoo NEl3>| eszsvestss asrot sooz/It/so "°'So'l‘t\;/are Version Installed:‘ Co_|nple;§e_ the following checklist;» ‘Yet. q_qDfi§.,v _I_s d1wdTs1¢‘;12Frs speiessmif " “'1 i‘ " ’ lM Yes Cl N‘0'1‘ ls the visugla1nrrn__operational? q _ “A 7 H MH Yes V Cl .N'o'l‘ W “Were all sensors visually inspeciti-:51, fimctjonally tested, and confirmed opemtional? i H '__y Yes W q i _ not interfere with their proper operation? j H' es El it El No‘ Were all sensors installed at lowest point of secondary contzlinment and positionedfso that other eqiiipment will No* If alarms are relayed to a 1-emotemrrionitoiing station, isflall communications‘ equipment (cfg. rnodeni) El N/A operational‘? _ A~ “nave Ct No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment l monitoring system detects a leak, fails to o rate, or is electrically disconnected? Ifyes: which sensors initiate -positive shut-down‘? (Check all that apply)%.Sump/Trench Sensors; Cl Dispenser Containment Sensors. l_)_id;@u conlfirrnpositive shut-down due to leaks gl sensor failure/disconnection? El Yes; Cl No. El N/A El Yei t:| ‘No* For tank systems that utilize. the monitoring system as" the primary tank overfill warning device 7(i.e. ‘no M N/A mechanical overfill prevention valve is installed), is the overfill Warning alann visible and audible at the tankl fill point(s)w _&11d opeifatingproperly? If so, lii_V)!_113t percent of tank canncity does the alann trigger? _ _m____P% U Yes“ W10 i"Was any monitoring equipment replaced? Ifyes, identify specific sensors. probes, or other eqmpnient replaced , a11<1_1i$t the Imnllfacturer name 1-node] for all replacement parts in Section E. below._ . _ ‘- Cl Yes“ KN'o Was liquid found inside any secondary containment systems designed as dry systems‘? (Check all that apply) Cl _ t Product; El Water. If yes, describe causes in Section E, below. HA 1 H Yes gs Cl No"‘__y W as rnonitoring system set-_up reviewed__toeiisiirc proper setfings? Attach set tyyrepbrts, if agpliicablei HZ ElmNo* liall monito=1;;ig eqgment ogiuional per n1anufich.1rer’s sgecifications? _ - W W “' In Section E below,E describe how and when these deflcienciwmwero or will be correctetlfm l Z ZW E. Comments: 1.", _ t..Y ___ >_ _ ._v.__... i_,_,_ .~ . ..-_ _ _ - 1.4 _ - -»--u-— -————— - -=- --- .._.- ._ I Page 2 of 3 ' 03/01 178/Z9 3EJVd NOI.LDl'lE|.LSNUO NEi3>i 4 EEZ6l?E9'[99 9E1BT 6983/II/EB "rm. -t—f-3-1 mm wuuglug I out Equipment: . Cl Ciomiplete the ilgllowlngshecldiet: E. ~ ‘ El Check this box if 11.1: gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Check this box if tank gauging is used only for inventory control. Has all input Wiring been inspectcdtor proper entry and terniinafion, includin ~' testin for 7' Vd rims?“ 9* ¥5‘°“‘?__,_, "‘ .7 " - ---- ~-~ i’ . ___ _ E _, _ Were all tank gauging probes visually inspected for damage and residue buildup? i sy p mgs este Was accuracy ofsystern Water level readings tested‘? H" _ _ll ytfvts In No* Were all ptobes reinstalled properly?” Q ' W— L ‘iii-Yes No* Were all items on the equipment manuf~acturer’s niaintenance chcclclist élifiiiéiéiié M §Yes Cl No“ Yes U No* Cl No‘ Was accuracy of steni roduct level'te:1icl‘_' t cl?‘ ' Hl §§fYesH “El l~lo* u7 * In the Sectionwli, belowpdescribe how and when tliese dcficienere oriwill=lT:c?:'eetedi.m _ WH G. Line Léflk Detectors (LLB): U Check this box if LLDS are not installed. i Complete the t‘ollo\J§_g checldistzgh U __ i ...._.__% 1 Yes CI N/A No‘; * For equipment start-upnor annual equipment cerlificadoilmwas a leak simulated to vei5lf?_l.§I"..DlperfonIii:nce‘.' (Check all that apply) Simulated leak rate: §fB g.p.h.; Cl 0.1 g.p.h; El 0.2 g.p.h. WY% Fl No* Were all Cqntztrmedmopetational and acc'urateWitl1.in regulatory requirements? W W"l Iglfes Yes 0 N9 Was the testing apparatus properly calibrated? W Z H V W WZ U No‘ For mechanical Ll:l)s, does the l.ID restrict product flour if it detects a leak‘? 1" u M V H_ Cl Yes Cl N/A C1 ;t@N/A ‘ No*m For ‘electronic LLDs, a<;5?me tuibine automatically shut off if the detects a leak? Z l 7 in \ClYes Cl No* fin/A or disconnected? For electronic does turbine autornaticnliy shut off pers¢3ofih?nomi@rmg system is disabled ;UYes U No"‘ NIA Lot fails a test? ' _ For electronic LLl§s, does the turbine automatically slmt off if ‘;3<>n'i'bn‘¢f the monitoring system malfimctions Cl Yes VN/A ‘W ;%No For electronic‘l,LDs, have all accessible wiring connections been visually initialed?" H“ K7Yes El No* ___ Kl _ . _...._._._____. * , s I. In the Section H, bfllvw, describe how and iuhen these deficiencies were or will be coti'ected-' H. Comments: _g _v__ V _ pppp __ Were all itemsiou the equipment ruaiiufacturer’s maintenance checklist completed? M_ ( I I Page 3 of3 03/01 VB/EB El9Vcl NUILOHELLSNUO NEl3>I EEZBPEQISQ 983811 BBEIZ/Tl/EB ~ -v -\ AIMWLI, Ill-lA\-LQCIJ auvu v~.'' 4 -' _ @111 Bucket Testing Report ‘rm Thisfom is 5"”-’"ded/9' 1-‘W by can actors performing annual testing of UST spill containment structures. The aompleredform and printouts from tests (zfappliwblw. sh.011ld be provided to the facility Owner/opemlor for submittal to zhe local regulatory agency. -._. 9.... A ___,. .l=.J*é.‘£'..l~L;!I_‘£mF°R1‘44Tl.(£“._ ' ..- 9 9 ..-._ Facilil-‘Y N1*"1“?mg_/ §' $9 __ _| Dam of Testing: ___ __M .Fa:.ilityAd<'11'e>:. ' —--"' __l__)ate Local_AAgcncy Wa5_N'otifiéd q£T}asrmg_=_ R “lg 9 fl‘ H 9- _L ' _ ___ _ ‘- _Name of_I_.§>:ia1Agux1cy_h1spector (;‘]"pré§ent durirr testing) Q Q l _ u — M_ 9,. g =, - _ 2. TESTING CONTRACTOR INFO_RMATI_QN_ A_ *¢°_‘F*PmYN“““?; _ Z :3:/2.- Ge/»=s¢,Z%/.917 H l__ Tcch§uc1anC0n_§luct1ngTcst 5,1,3,/,,,_A H M __ _r A * cr951mna1s‘= P csua Cfqntmctor _ __ cc selyie mu |:| swgcs Tank Tesfér El'Other (sp@¢:;;»)*:T1___4 ____ _ ¥*°%"S°“"#1b<1'<$>= .4- -£2 £23.12?-”f¢> :4/IA __, __ ___§_i_ §1_’_II_»,L BUCKET T}:3,ST_I_1\T§i11‘TF0i1!lVIA-TION _'_I‘est l§l.l_etl1od Uscglz _- firlydrostgtic _ __U.Y&¢uun1 __ U ther O -— .... ._...___. ..... '1 est Egluxprnent Used: )L¢-;£/ 3 Equipment Resolution- H _l _V_V_ » -__,_,_...-.n._..l.l....-.__-""_;;CiI_ Identlfi! Spill Bucket (By T cmlc 1 Z 2 34 i Number, Stored Product, etc4)_ al D/'6_$'€ _. >--—"—'*..._ ‘--2‘ ._ —~-~~"~'*-~-‘- _ . - En " '- -~ _ uect Bury U Dlrect Bury E] Dlrcct Bury \ El D1rect.Bury ;\_Buck?F Inwllanon 99°" “El Conta_in__e_d in Sump ~_ M _E_1_ Qontained in Suxnp 1 U'Contained in l3_CVo_g1§1_i1A1ed in Sump __ 1 Bucket Diameter: ‘ . ._ ._... W "777 l ..__ .__ _,.l _ ___ _ _ ,,, _. _l._.l___ _.A Wait fifiae be1wce1i'applying W ‘ , vgcuum/water and start of test: _ ~ “ __ _. 9 - - \ . ____ ___ um sqm Time ("1‘,);A_ $130 ;@¢a1R=@@g@.>; 7 ;ffTjjI 9 r 8 ‘ 8 " 4 iWWW®= fl$W- 1 9“ -- Fix1:;1'l§cadi11g(R,=); M A. f 7%, 1/ M if __ TestH[_)uration(Tp-T|):_‘AA 1 /#511 *_____>____A _ ____L C_{1fi_n_5¢h1R°fldiflB_§RF~R1)= J1/u/1/{____ 9 A H * l—4 Pass/Fail Threshold or * _ F __Criterig; _ ’ )0(3$'5 A_ » ‘ 8; Tostlkesultz Q55; um; 0 Paés "uIv}Li1 :1 Pass llll E inn u ms UFail C Ql’l]!'l'!6I'lfS -_- (z'_1z_¢lud@ir|}'0rm¢_1l”l0r§pn repair?‘ rpqdé fcllqyk11!g_fQFf<1l/‘W1 ¢¢'~\'¢~\')_ _ __ _. ....___'_. ____ - ___ . ,._ . 11- -~ __~ _‘__, . .— _ -v .. . .,____ __._,....‘ ._ CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING TIHS TESTING " _ I hereby certzfy that all the infornnuian comainad in this report is true, acnuraze, and in full compliance with legal reqlurenlents. Teclmicizufs Signature: K _ _A _ _ ' ' State laws and regulations do not currently require tea ' g to be performud by a qualified contractor. However, local mquirements may be more Stringimt. ' . VG/P8 3E)Vd NUILOHEILSNUO NEEl>| 8836989199 985@'[ SUEZ/II/88 .‘ ~-. " ' 77 "W I . .- "‘11/14/2668 14:21 . E>E>1E>3492i' KERN CONSTRUCTION ‘ _ PAGE 61/97 1/=I *1 =- - 1' . ' ,_ ’ KERN COUNTY CONSTRUCTION; INC} - P.0.: BOX 6096' BAKERSFIELD, CA 93386 . - ' (661)634-9950 FAX(661)634-9233. F M A-I I- =' SJK E R Nv.§3_Q_,U NTYACNO N @ B AMK. RIR . c 0_M_ >4}f -COMPANY"- N;*;; _ __ FROg;,»» I _ ~ DATE > --_l£lJ%§§ - MN A # OF PAGES ’ _ . _ - v_ , _ El URGENT U FOR REVIEW III PLEASE COMMENT El PLEASEREPLY ' . ' ==. —.|mzmf""" H "'—“-"---'77 — —~~—~—~-— - - - V infirm q NOTES/COMMENTS; A A _ ' <;N 1Mig1QM@ »/L» M‘N \ 5 7 ‘ __Ei““' . .__=II—' .= ~ '7 ~ V __.m_ | .‘, O J. >11/14/2688 14: 21 561534923 KERN CONSTRUCTION PAGE 132/ E17 , ‘I I-. uuuun|uaunn-u- - - __—~- n: B'|| bl r » r r - KC MAINTENANCE C, F(|j|c?Qf>?Wqff_ 1 PETROLEUM MAINTENANCE ~ Z N\C1'ini‘Emc|nce 1 A 9.0. Box 6096~Bakersfie.ld, CA93386-6096 “ _ C1 Nor Billublej q (661)634~0218'Fax(661)634-9233 |;;-,3 Bid Jgb_ Q . V,/1; _’ »» Name: if/-5-“W23 ' # H H , s rvi W if , i , ~ Agdrggs: _v___ ___ _ __ Dale; " J2’ City» _ Zip: ~Phone:___.i.__ Work0rdar# Dispenser Make: i __ . v_ (ust. 0rdar# ' Dispenser Model: __._...._ .. U088 filliiil # ' Dispenser Serial #: M- __ __V ‘_ >_ _ P039 0"iBT#i _E,l1fqPTe$?=G_?!!°"§= _,_r____ ff ____ _ - _ DOIWAMI; , ~ W _ H if -. .- ~~ - .--. .-'~ .. 17."'*"." '.' 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' .D __r if .. .. .. .. . . s _, ,..__ , * "3'/:"f ~"" _,:.¢1.LIi7 .‘+ ‘? . r:z‘@__l~_ 35- 'A,,_ .-Z‘ ,-M ,1 -ii: --- 1' ‘;"n,4,'_.V_-_,~¢.1_ -6., v ,‘.;_? ,) _ \ 5 /:+~~ ~ -»/».»r<~~»<r__ii:>irii w/@@~ ;»:r@Irr% W __ .. ,.,r5’_W 1’ ~ " m (I ii L‘ V "qt 5"» .47-' "1 / -~"»/ //'~ ( ‘> /12,’\ I _ __H__A_Q:/ / P U,/_,;,Lj'.,\,_f ii"‘ 2 * - 71"] '11‘ "o H. 7 1 “Ex /'\ I; — W ~ _ L.» i . L; r_., r‘ /' D , ATE COMPLETE V ' __ H12 /1» gnaw H ' ' r ~ * V '""r Jlniassolharvd mm by! ,|h allerhstoiry xnmssiydisdni all ii0$,Bil|m =1 - rddr im'ad rm |, '1 '~7_~'¢_';. ._' ;_- 1-‘ "~3n“‘-.:;‘i._‘:,_¢_:Ij';r . .1. vv -~', <-. ¢---~33 .r_~.~..~. . 4 _ ~-- - ~--—. .» ‘.- .- <,,, _ _ ,, , . .._- ~.1- ..=_. ., __-_ .4 ,, _,,_-. -.-_ - ~ ~11." <-Z’<-~.- ~- ~~ " -- .- - -.;- ~ - -- ~-".-~. 11¢ 1 ,r V . ~ ~ <. '. >11." -' -- “:-J-: - '~.‘:L"'=*?~','; H-If -__ 3 ._ .4 --. ~ -- ~ » r - -_--A ~-, - . , . . y..r4 . . . _ ' .,,', . - .- "4-— * . id. -~ _,. ' - '-» ‘.- _, -.-|-,. '~ " " " .~-.4" ». '. -, -- g, . -' ' ' " ' » ~ '» ' 4-"; .. .. -'-.:- .'*..f - -~-~—<.~-~'--' u.-~-~-—u—’-a-r - -— ~ - - -»'*-_~'6JLb-1 - - - - --_. »- ~_ ~_~_ nu .-.--_.....,‘,. _._;-,. . 1] .i ; - r ~a.,_“.-,.¢;., .~ .'~“~'; __ Q; -. 3,’. Ei E3‘5 £1“ *1Y \ *'W _ _ .. .. , _ ca e__A _ _..-:» _, ____:_.__> __ ____‘ T_Z','7' -ii" J. ' |.Z'w;“: \ H, 7 7 I ‘ sublet -- —- V - — _ .. r__ SaIesTax ,_ __\ -J" -.:.‘W,§rJ§@1_r“_. »,~lZ:Ij,'.=;1<:¢r__ .1, gliésznrrrt Démmi Step. BIT, Q " i \ _ ,. r-~-Y 1 . ~_.___-»__W1-_A_~ u . _ > _ r T9_r§iILni>or _ "71" 1"/I - v<./7/F? Z¥"‘/"<>‘_,, ;;‘g1<"'W_/1:-fT:‘>,e1 4:5’? Totalfazts i ‘ . /"1 J’ -i Mil '2" Mf ‘W 1" \ '- . " ~/"'/' '"’ -' 21 F” //- ' 'ii __ . ~11/14/2555 14:21 55153492 ' KERN consreucrrou PAGE es/or 1 3' : MONITORING SYSTEM CERTIFICATIN For Use By All Jurisdictions Within the Stare of California Authon-ty_cited_. Chapter 6_ 7' Health qmi safety Code; Chapter I6, Division 3. Title 23, Colifor ia Code ofkegularions This {om-1 must be used to ‘document testing and servicing of monitoring equipment. fl separate certific lion or report mus_t_b_<;_ptepared for each monitoring svste1n.,co_ntrol panel by the technifiiall W110? 6 . . . ' system owner/operator. The owner/operator must submit a copy o 's e c agency r» ' g sy days of test date. ' A. General In formation _,_ I __ H Bldg. No.: Facility Name: My / (‘0\.C*l§,\__SJl/f Zip: 1-forms the work A copy of this fo must be provided to the tank f tlu form to th lo al c atm UST stems within 30 Site Address: ‘Z’:’1- it/Q‘/‘1 _ Facility Contact Person: A _”¢n kl/_|_/lC.l4 /5 ,,H City:i_,£¢_g;~\f>'/c...ll’l Ce/uél'l"A ContactPhoneNo.:( ) ,._. Make/Model. of Monitoring System: 3'5 _&_-__/ 0 t" B. Inventory of Equipment Tested/Certified Chcckthca rn fin" l’°"°"“l“‘“"‘"°s “me “I '“mi'“°°'°'°°"‘ , .. . .. Tankl_o:_P5L 1 Tanklflr .. .._ Date of Testiul;/Servicing: __f1,_/___Z_/_6_7_ Mo_del:'J,;Q_* gag“ Model.-11:3.‘ am Model:"""|;q¢,gg Model; D Fill Sump Scnsor('S). Model: Um him dwvi gm E] Mechanical Line lieak Detector. Cl Electronic Linc Leak Detector. ‘ Model: El Electronic Linc Leak Detector. D Tank Ovcrfill / High-Level Sensor. Model:‘ Cl In-Tank Gauging Proliel Cl Annular Space or Vault Sensor. El Piping Sump I Trench Sensor(s). . )3 In-Tank Gauging Probe. l B Annular Space or Vault Sensor. .3 Piping Sump I Trench Sensor(s). Cl Fill Sump Sensor(s).< B Mechanical Line Leak Detector. Tank 1]); I __ A Tank ID:- El Tank Overfill / l-Ii'gh-Level Sensor. E1 other gfiooig aq uipment typo and model in Section E on Page 22. El Other lapecify, Quipment type and model in Section E on Pg 22. Model: Model: Model: Model: Model: Model‘. Model: Model: U In-Tnnk Gauging Probe. Model: D Annular Space or Vault Sensor. Model: El Piping Sump / Itench Scnsor(s). Model: p U Fill Sump Scnsor(s). '- Model: III Mechanical Linc Leak Detector. Model: Cl Electronic Linc Leak Detector. CI ln-Tank Gauging Probe. "El Annular Space or Vault Sensor. El Piping Sump / Trench Sensor(s). El Fill Sump Scnson(s). [J Mechanical Line Leak Detector. El Electronic Linc Leak Detector. El Tank Ovcrfill / High-Level Sensor. Moclol: El Tank Overfill I High-Level Sensor. El Other gaeeifi __ in-ment we an cl in Sec o Peg Cl hcifl c: uipmeltz B dlodel in Section E on Paie 22. Model: Model: Model: Model: Model: Model: Model: E Di cnser Containment Sensor(s). Modol: rt U Dispenser Conlainmcnt Scnsor(s). Sp I K Shear Valve(s). Q ShcerVo1v=(s)- Dlspcnscrlbz '3/‘J I p Dl§P9\‘l891‘lDI__ __ Model: Dlspcnscrlb: l /-4, A V ‘ Dispenser ID: , ., 1__.____- 1 Cl Dispenser Containment Floagsl and_Choinsl.y “W ”__ _£l_Dispeqser Qontaininent Eloatlsl afi Chainlsl.' H Dispenser Containment Sensor(s). Modcl:_B¢,‘=~-Lug/b Cl Dispenser Containment Scnsor(s).T Model: l q Shear Valve(5), D Sll83.l' vl1lVC(S).1 Dispenser [Dz 5-L1,. __ H .. __ Dispenser ID: Cl Dispenser ContainmcntFloat§sznnd Cl\_;iin@y;__y____ _ _ _ V _ o Cl Di§g¢_n_S_er Contlqinment _1jo§l$gfind‘§hninv(§);__vV WW_ y ____»__ ‘. U Dispenser Containment Sensor(s). Model: Cl Dispcnscr Containment Scnsor(s). Q Shear \/g1ve[5)_ ' - D Shear Valve(s). ‘ |IlDispenscr Containment Float@_and Clialnlsln - , " Dispenser Containment l=loat@ and (I_J_l_1ain@. _»___Q Model: 'lf‘the facility contains more tanks or dispensers, copy this fonn. Include information for cvcry tank and dispcnsclr 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 o verify that this information ls correct and a Plot Plan snowing the layout of monitoring equipment. For any equipment capable of g crating such reports, l have also attached n copy of the r ort; (chock all that apply): AZ System set-up ff Al istory rc ort Technician Name (print): Signature: W ___ CcrtificationNo.: A _ _ H V License,No.: Testing Companyhlame: ll:gZ»’l/\ y . . ._ _, Pl\on.e Site Address: KC)- ¢:-0'-74 l9), (.114 .,____. ,____A Date ofTesting/Servicing: l'7"=Zl/_4J " Page 1 of 3 03/01 Monitoring System Certification ‘ 1 I i 1 i i i l . D. Results of Testing/Servicing ' Software Vcrsionlnstalled: ~11/14/2oos 14:21 55153492‘ KERN constsuctron F’A—GE _e4/or E Yes No“‘ Is the audible alarm operational? - H ,p COLi__iplete the follggving ¢he¢kli§!= _h , _w . ,, i M ,,..v y ~ D ms Is the visual, alarm operational? _ ' 7 _ __ ___ QXPE‘ Q No"‘ U N0‘ Were all sensors visually inspected, fnnetionafly tested, and confirmed opemtionitl? p . ‘4¥Yes El Not notinterfere with their prop_erwgpera1ion?__ p ' -- —W<-are all sensors installedlat lowest point of secondary contaimnent and positioned so that other equipment will bi Yes ' El No* _I:t N/A If alarms are relayed to a remote monitoring station, is all communications equipmenti(e.g. modem) operational? __ p_ Cl Ycs Q" No‘“ CI" N/A monitoring system detecw at leak, fails to operate, or is electrically disconnect ;? "If yes: which sensors initiate positive shut-down? (Check all that apply) Cl Sump/Trench Sensors; U Dispenser Containment Sensors." ‘EIYes Cl No* R N/A I2r_d_you confirm p_os1t1ve slintgiown ducto leaks grdpsensor farltnie/.cli§_g_onnecnoia? Cl Yes; W No. \ For‘ tank systems that utilize the monitoring system as the primary tanko mechanical overfil] prevention valve is installed), is the ovcrfill warning al ti1lpoint(§) and opemfinapiopetiy? If so, at whet -perge_11t_of tank capacity does For pressurized piping systems, does the turbine automatically shut down if tsj piping secondary containment arm ierfill warning device (i.e. no visible and audible at the tank die alarm trig_get?__ __ ___% El Yes* W No and list the mannfacttirer name and model for 2t]1Vtf€§1J18.0_BI__Xl_§'Qi’J)&l‘tS in Section E, elow.. ' Yes* 1 G<'No Was any monitoring equipment replaced? If yes, identify speeifiesensois, probF, or other equipment replaced Was liquid found inside any secondary containment systems designed as dry sysems? (Check all that apply) El Product; W Water. Ifles, describe causes in Sectiong, below. H" Yes?‘ El No” monitoring system set-up reviewed to ensure pt'op_e_r_s§*ttings? Attach set ugtgports, if appiieable ; _ p _p __k I El‘ Yes M No" is all monito,r;inE: equipment gg§_a_m;ona1 per rnanu£1_etm'er’s specifig_ati_ons‘_?_p "H "' In Section E below, describe how and when these deficiencies were or will be corrected. E.pCotnment.s:_. I i “I . pl, ‘U and _' _ Q- Ptwl _tiv\ Zita an tfi‘-=1\ 7 " ’:|'*’*"'é’\‘\/\&_ dd‘? Mt ,5’!--i' snow» w*-~> .....__§..'.,?_.F. '/""’Z"pede=tn.#/ as->=~/' -iflaei-J» _W \ J I - If _ v 7 — —— — ‘ » —~ W__7__W~~ .__- —— I ._ L; A I -r . 4.444 ,4» ' #4] ~ $1 _ :_ / I » -- 44d Page 2 of3 03/01 ll/14/2668 14:21 551634923 , KERN CONSTRUCTION F- In-Tank ‘Gauging / SIR Equipment: if Check this box if nink gouging is ' 4 D 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 perforrn leak Co lctc the following checklist: ,_____r A _ 7* ‘ o_ PAGE B5/67 used only for inventory control. detection monitoring. ~ l Has all input wiring been inspected for proper entry and termination, including teslting for ground faults?~ Were all tanlr gauging probes visually in_spcc1:ed._t'or damage and residue buildup? Was accuracy of system product level readings tested? 7* wit Was accuracy of system wster leyelreadings tested? t ‘ . - probes reinstalled properly?" A_ CI Yes Cl No* El Yes D No‘; CI Yes Cl No" _ :1 Yes El No"' Yes El No* i YcsW_El"No* \\' Were all items on the equipment rnanufacturer’s maintenance checklist completedl? In the Section H, below, describe how and when tbesc deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ‘ ‘ D Check this boxif LLDs are not installed. Complete the follo»r!ng_c_h=¢l<Ii=;;=_,_, 5: =____ ; ,,,,,W N Yes ‘El No* For equipment start-up or annual equipment certification, ‘was a leak simulatcil to verity LL15 perfonniincci ‘ El N/A (Check all that apply) Simulated leak rate: El 3 g.p.h.; O 0.1 g.p.h; El 0.2 g.p. JET Yes Cl No* Were all LLDs confirmed operational and accurate within regulatory requircmcnni? W Q Yes.’ El No* M testing epparstiis properly calibrated’? ' V ml. 7* at Yes. El N/A "i=o£i£s=1mmcn LLDs, docs the LLD restrict product flow if it detects a leak? Q’ N/A Cl Yes E] I;lo* *i=£{{é1¢¢eomc l.LDs, does the turbine automatictllly shut off if the LLD dretectsesilbak? i WM o_,.!?\_'?“/A :1 Yes"? El 140*‘ For electronic LLDs, does the turbine au.tornatical.ly shut ofi‘ if any portion efiflé lnlollitorinésystern is disabled or disconnected? Q’ N/A ‘U Yes CI No‘? For electronic LLDS, does the turbine automatically shut off if any portion of the in or fails a test? A ~ _ A , p . onitoxing system. malfunctions fill Yes ‘ C1 No‘; For electronic LLDs, 156$ all ac¢;=;s'.€fb1e wiring connections been visually inspcctiid? N/AH WE’ Yes‘ Ell No‘ _ —~ ’_._ ..___.___ Were all items on the equipment manufacturer s maintenance checklist completed‘? W H ; =:w,=c-.1’, '“‘ 5*. ' ""“““"*” """_"'“’ * In the Section H, below, describe how and when these deficiencies were or will be corrected. s | l H. Comments: . IPIQIL-\QN:_—_ —_ .._____ _._.. =—— Page 3 of3 03/01 I l x | I r i .11/14/was 14:21 s|51s34923i KERN CONSTRUCTION PAGE as/7 SWRCB, Januarjy 2006 y Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of UST spill containmeat .vtruc_tures. The compleffldfvfm find pr!-m0u,sfi.om ‘em (ifapplicable), should be provided to Ihefaciliry owner/operator for submmal mthe local regulatory agency. Q . C 1-," 1?AC1LI’1'YE‘._.F‘?lRlY.1_./’~T1°N , 1 - _. . - _ C» l Flacilliz-yL'Na:1qe: C _ , C .c—-TD“-tc °f_T°§fil"‘g‘ !"7»_ - ‘X _F§ci1it.}' Addfcs_s:7 -Z_;,_L C M - v_ . H I Z ‘ » 7 minty ¢¢»mw-=l Mg, pl/l__J I¢_\~1.§ A >7 ‘ C ., ,l P1=<>n=_= ,_66_1- <2 ?t~_ \ Rate Local Agencyjlias Notiijefl of_Testing ‘£nl7 _ __ __ Q “Q-l>h4I Name oFLqcz11Ag¢n¢y“1I1$P6GI0T(b'P?'@$e"'¢W'i" I@~ agli Em./I .? £4D , #___ __ Z-_. TESIFNG ¢QN.I~RAC’LQRnYFQ.R1‘4AT1°N A Y7 ll C lJ.__.,....._...._ Comp;g;Nam&r'kb;qq _ _ , _ ‘T _ .. _,_ ~Techm'cian C9nducfing_Testé3;_-IL,’ n:~-“~<>*"~3 V _ __ __ _ . _- \ cr@dmi§51s'= %£,_csLB c<>mmm;_ mcc Seryicc Tech. cs syynca Tan1gTesrt§1f I3 i.L.iccnse Nu_mber(§)tL//‘Z|0§ _:~» __ _____ ___' ’ Li_____ ‘_ _H _ ____ s.__$_Pn.L VI‘ TE_§’_I‘lNG _1_1_~r_;v0R1vn@_TIo1~1__ ' ‘;_‘l‘_cst Metllqd ~ fl{l‘lYdI°5t§@° __ - _ _,_U Qther. _ . >1 _ v>A>>i Vf Test Equipment Used: C M 51,6, 1 _ Eq\1iPm°I1tR§5°11"i°"-7 i P-11 if 1; _ _ ‘ glrf ..._ ii ___ _ vw" 1...-v ST" 1;? i ‘ ‘ I‘ Identify Spill B1.lCk€t (By Tank 1 0 A . Z 34 l-mé@*» $¢2"=d P"@d%£¢?- 61611:‘ Q "7 {fir A A .,~ _ - _ )3 Direct B\n'y, D Direct Bury 4 II] Direct B5? . \ Direct Bury B“°k°‘ h“‘?“‘°‘“°“ AH 0 Contaiqged in Q Contai.nedTi_n Sump 1:: Containegljg gsump \ :1 Cqpmigcd in Sump Bucket Diameter: __[2_ " ____ ‘ A _ 4 “__ M A W _ _A_ “ Bucket DEW .12" 77 ' __ 7 " I ll ' Wait time between applying . u ‘ - J vacuum/wate_r and start ofjcstz _>__'§'U W !}"\ - i_ ' _ Z \_ Icst Start Time (T1): > V122) __ - ‘ A W W V V __ ' IniI:i—a1'R'eading M ' " 7 , A _> Test E.11_q\_Tixne (IE): D ; ‘ _ \ __ Final Reading (RF): __ 3 “ _ _ _ AN _ __ 1 Test Dur'atipn(TF—T1);fi V [_'|,\ f , AAAA M \ _ "‘f’__w\____ __ Change in~Rcading-(RP-IQ): H J) r/ _’___ _ _ \ _ __ Pass/I? ail Threshold or 6. ¢1_i£;'2¥"'.=*.=_ - C 0 VG W '7 1 A1 Test Result“ ' Pass E!Fail E1 Pass lZlFaiI III l_’_as<: Fai * D Pass 4§lFall _ _ ‘l H - 33 - 1 ..\ Comments - (include ipjlmnaziqn on repairs made priag znleszing. aad_rcgq;a_gr_@_r11_¢5if¢>_Ilo1y_-u or failed tests) ______’_____: - _ L P\*'\c-_f-ac--=4 Ww» @~/all _L..e~‘ 1&2 s~@"~ _ ' CER'I'IFICA'I‘ION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING EH8 TESTING f ' I hereby cerufy that all the infor ion contained in this report is true, accurate, aad in full co pliancc with legal mquircmcm Tm:hnician’sSig11aturc: " ,_ 1” " =' WA v______ _[)at¢; . __ _ .. ' State laws and regulations do not currcnfly rcquim testing to be performed by a qualified conu-actor. However, local requirements may be more stringent. _ _ ' _ 1 V % Technician-Performing Test_ I -11/14/20218 14:21 s_s1s3492i_ KERN CONSTRUCTION " Pies ea?/av I. VEEDER-ROOT“ ~ ," " Leak Detector \. ‘ FXT EVALUATION CHART me-Locafi(;n,Z-,'ZaivI " - élervicé COmpany__5f/1_ . ‘4 -‘ 4‘ V‘ / ' — * Date [Z1 Z1:-1 Z ut l V» H -. C.__.. 91, .3 /\ ____-HM In/u-»"\7> __A __ TECH Number , __'__' TYPES OF LEAK DETECTORSTESTED V " ” ~- » ' '‘ U BFL0011-1s2~s) ' " _‘ FX2\!!(115-05‘!-5) - f:|Fx2tfv(11e~0s9-5) .E|‘FX1v(11s-osaqs) A A _ _ .|:| |=x1ov(11s-use-s) ‘‘ TEST INFORMATION I - .~ - “ _ ~ _ Approximate ‘ Pass/Fail_ ' - ‘- ' Pressure Relief Test Leak Rate‘ Tpst Leak Rato _ _ Pump , ‘ < 5e;|5| Openlng ' Metering Holding » rnl/Mln ml/Mln sl/kPa e I _ __ Product Number Tim ' psi/kPa * psi/We awn smh V Iaessum' ' _ _ -~-———»————--—- -, W "' — =——,", '- ' o ' “‘o"“" H‘ __ '_'3Z~ ' €‘§3‘*/ "§%”'3Z I 2 \ ' . . ‘ ' ‘ ., ¢ \ I I . \ ._ .3-.: 4 ._ .-.- ‘5 _A.__’.__ ‘ ‘ _-_ ,,\,, ' 6 __ _ V ‘ _‘._. .... __‘_ 1 \ _ _ ‘‘ Owner/Opéfator ‘ t 5» ___ *7; /vf/7‘ (Signature) i’ A q‘ ' l 4 ~~ I (Date)- j I < > \ \ \ r b I i 1 r r x cI I l l -; i RECEIVED iii‘ =1?» -»-»-.1-i . ._ ." E -iI . , _. ,, It NOV -7 2006 MONITORING SYSTEIW CERTIFICATION A For Use~B_v All Jurisdictions Within the State of California" I‘ f" ‘- iv i'i=""n' Cited: Chapter 6. Health and Safari‘ Code." Chapter I6. Division 3, Title 33. -1. I his i-.-irn must he used to document testing and servicing of monitonng equipment. A separate certification or _r_c;port must be prepared for eacli monitoring system control panel by the technician who perfomis the work. A copy of this form must be provided to the tank system owner/operator. The owneroperator must submit a copy of this form to the local agency regulating L-ST systems within 30 da 's of test d' y ate. V tX A. General lnforma ‘on _.__-a—-' Facility Name: _____ I _/_,_,{ ___-_.._..__ Bldg N°-3 ...___ Site Address: __ City: __ __ _ _ _ .. Zip: Facility Contact Perggng __& __v ____________ CODIBCI Ph0Il€ N05 lA£l____l_,____________i_______ Make"Model of i\/lonitoring System: fl_____CQ _/_1_ /5 /OQ 2_;'f'( __ Date of Testing ‘Sen-"icing: B. Inventory of Equipment Tested/Certified ("heck the a ro I riatc boxes to indicate s i ecific - ui - ment insected/serviced: TanklD: II 1§/ in _ _ kID“‘ J_ L. 1 ln-Tank Gauging Probe.T 3//‘mnular Space or Vault Sensor. U'Piping Sump : Trench Sensort_s). U Fill Sump St-risortsi. El Mechanical Linc Leak Detector. U Electronic Linc l.cak Detector. D Tank Oicrfzll High-Level Sensor._ Cl Other (spot-ii;__t-gutpnient tzpe and model in Section E on Page 2). __T M53751 In Model: __';~ Model: “____L Model: _______ ~ ____ Model:_£ Z_ Model: _______________i_ Model; ______ l El CI ID 3 Tank O\'€lfill High-Level Sensor. C] in~Tarik Gauging Probe. :1 Annular Space or Vault Sensor. Cl Piping Surnp Trench Sensor(s) Fill Sump Sensortsl. Mechanical Line Leak Detector. Electronic Line Leak Detector. \-1 Od c l‘ ____ ____ ‘_v____________ Modcl: Model: _____‘_______i__ Model: _____ Model: Model: - Model: ___________ _______ Cl Other (speciiiy equipment type and model in Section E on Page 2). l 1 I l Tank ID: U lnifank Gauging Prohci Cl -\.ii-iular Space or \"at;lt Sensor. C] Pipin. '~ .'tit_- Trench Sens0r(s). U Fill Siimp §t'H‘>'0l’(S). U Mechanical Line Leak Detector D Electronic Line Leak Detector. Cl Tank Overfill F High-Level Sensor. Model: _________________ Model: Model: _ ' “ - Model: ___ Model: _________________ Model: __________________ Model: _______________ Cl Other (secif ' euiment l\ e and model in Section E on Pae 2). gispenser ID: __ __ I ____ ____?? Dispenser Containment Scrtsortsi. Model: E43 Q “C12, Q1 l2'Shcar \'alve(s). U Dispenser Containment Float(s) and Chain(s). . __ Tank ID: D ln-Tank Gauging Probe. C] Annular Space or Vault Sensor. C] Piping Sump -" Trench Sensorts). l U Fill Sump Sensotts). D Mechanical Line Leak Detector. Cl Electronic Line Leak Detector. E] Tank Overfill .' High-Level Sensor. U Other tsecif ' euiment we and nodel in t E _‘_’e M0del:4 _ _ 4_‘_____ Model:_ Model: Modei: ______________ Model: ______ ___ ___ Model: __________v___________ Model; __ _______ DispenserlD: v__ '5 {___‘[_'_______v_____ ___,___ yispenser Containment Sensortst. f\lodel:1§ZT34(Q3_____ Shear \/‘alve(s).t Cl Dispenser Containment Floattsi and Chaintsl._ l l Di penserlD: _ §_ _____ __ zfs ispcnser Containment gnsor» J . ' (Tl. MOdcl:_ _a___ Shear Valvc(s_). Cl Dispenser Containment Float(_s) and Chain(s). Dispenser ID- Cl Dispenser Containment Sensorts). Model O Shear Valvets). U Dispenser Containment Float(s) and Chaintsi. ____ l Dispenser ID: ________________ __ _ __m____,__ _‘_‘______'________ Dispenser ID: O Dispenser Containment Sensor(s). Model: _____ ____’______“_4_ Cl DispenscrCo‘niz;nment Sensor(sT Cl Shear Val ' ~' ‘ i ‘ \€(a). . D Shear \’al\<e(s). ClDispenser Containment Floattisi and Chaints’). _ W Z D Dispenser Containment Floattst and Chaints). il ‘If the facility contains more tank_s_,_Qr dispeiisers, CQ_p)_' this fomi, lnNi:_.lude inforpnation for ever)-'__tank and dispenser at thepfacility. __ C. C8I'IlfiC3tl0lI - 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 eq 'pmcnt. For any eq ' ment capable of generating such reports. l have also attached a C0p_\' of the report; (check all that a 15;: El’Systein set-up El history repor 1% Technician Name (print): ___,i 253 Q_fl_;+ 1 f~_K_‘_____ Signature: __ _ / .- Certification =\’o.: /'7 ~g (/6 T __ _____ License. No.1 __y _ __ Tesiingcompanyivame: n..s;_‘l£.4¢.¢e..f P1i<>n@No-:(4zéL).@.L<L._7j:@ Site Address: ___P/D _ _ Date oi'Te'stingi.-Servicing: Page I of 3 ' 03/01 Monitoring System Certification *1: us. I I 6u ¢~ ~<:: D. Results of Testing/Servicing~ Software Version Installed: 6, [_W Complete the following checklist: - ' ‘ > LI _ Cl Yes fNo‘ ls the audible alarm ope at' rial‘. /I B/Yes U No‘ I’ IO »4 Is the visual alami operational? iyYe_s U No"‘ Were all sensors visually inspected, functionally tested, and confirmed operational? U Yes U No‘ Were all sensors installed.at low'est point of secondary containment and positioned so that other equipment will not interfere with their proper operation? ‘Cl Yes Cl No"‘ tn’ N/A If alarms are relayed to a remote monitoring station, is all commimications equipment (e.g. modem) operational? ,. 6/ Yes Cl No‘ Q 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) Cl Sump./Trench Sensors; D Dispenser Containment Sensors. 4 Did you confirm positive shut-down due to leaks @ sensor failureldisconnection? CI Yes; Cl No.A Cl Yes U No‘ U N/A For tank systems that utilize the monitoring system as the primary tank overfill waming device (i.e. no mechanical overfill prevention valve is installed), is the overfill vvaming alarm visible and audible at the tank fill point(s) and operatingprogrly? lfyso. at what Ercent of tank capacig" does the alarm trigger‘?% U 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. U Yes‘ 3/N0 Was liquid found inside any secondary containment systems designed as dry systems? (C heck all that apply) Cl Product; Cl Water. lfyes, describe causes in Section E, below. -- CI No‘ Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if "applicable Yes U No*d ls all monitoring equipmelit operational p_er manufacturer’s ~sRe‘cifications? ' ln Section E below, E. Comments: describe how and when these deficiencies were or will be corrected.\ .- \ \. _ Page 2 of3 os/0| 1 ~ 1 ~~- [_IO l l .1 -N F. ln-Tank Gauging / SIR Equipment: {Check this boit iftank gauging is used only for inventory control. _ C] Check this box if no tank gauging or SIR equipment is installed. This section mus! be completed ifin-tank gauging equipment is used to perform leak detection monitoring. C in lete the following checklist: t i D Yes Cl No‘ Was accuracy of system water level readings tested? _ Cl Yes Cl No‘ Were all probes reinstalled properly? .. - E] Yes Cl No Were all items on the equipment manufacturefs maintenance checklist completed? * In the Section H. below. describe how and when these deficiencies were or will be corrected. 'es Q No‘ Has all input wiring been inspected for proper entry and temiination, including testing for ground faults?, Cl Yes Cl No‘ Were all tank gauging probes visually inspected for damage and residue buildup‘? I CI Yes U No‘ Was accuracy of system product level readings tested? "i ~ I G. Line Leak Detectors (LLD): Cl‘ Check this box if LLDs are not installed.- Co lete the following checklist: W ' Yes D C] No‘ N/A For equipment start-up or annual equipmetyértification. was a leak simulated to verify LLD performance‘? (Check all that apply) Simulated leak rate: 3 g.p.h.: U 0.l g.p.h ; Cl 0.2 g.p.h_ @Yes_ 5 - '3 No‘ Were all LLDs confirmed operational and accurate within regulatory requirements? Id Yes \%o‘ Was the testing apparatus properly calibrated? _ ' W Yes L.) U U No‘ .\‘./A‘ For mechanical LLDs, does the LLD restrict product flow if it detects a leak? U Yes U Z] No‘ N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? t ' U Yes Cl El No‘ N/A For electronic LLDs. does the turbine automatically shut off if any portion of the ;= »-‘!Yll\.':,";i“l*:‘, system is disabled or disconnected? .A Cl YesU CI No’ N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monit» mg sys:_=~:n malfunctions or fails a test? El Yes In YCI No‘ N/A For“ electronic LLDs, have all accessible wiring connections been visually inspected" 'Q -U YesU No‘ Were all items on the equipment manufacturefs maintenance checklist completed?- _1 ,i ~H. Comments: issue l r' _ . , -. —-—? In the Section H, below, describe how and when these deficiencies were or will be corrected. _ 1 _ ._.... ___- - _ \ ____.,_ __ __ ___ .____ ._. s .- l l _ Page 3 of 3 . 03/0| . Q\ ‘ Q7‘ ‘. - . Spill Bucket Testing Report Form, SWRCB, January 2006 Tliisform is intended for use by contraciors ;>er_/orniing annual testing’ of US T spill containment structures. The completed form and printouts from tests (if applicable), should be ;:-/-.'»\~i'i!t=-<1 to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION /ilracility Name: /W7 7 27’ I Date of Testing:j L Facility Address: 23:2 (7 ' I Facility Contact: Q Z6“ U ' I __ A I Phone:I Date LocalA enc Was Notified of Testin ' %// Q; 8 Y 4 8- ‘>iName of Local Agency Inspector (ifpresent during testin: 4 _g _ 2. TESTING CONTRACTOR INFORNIATION C°mpa”y Nam“ 1 L Technician Conducting Test: Da?A_L£ Q7 [er _ _, Cl’¢d¢Ill1'fl1$]_I W./CSLB Contractor - ICC ervic-e Tech. SWRCB Tank Tester Z] Other (Specify) _ ______, License l\lumber(sl: Q Q’ 3 _W 3. SPILL BUCKET TESTING INFORMATION Tat Method Used: tzfiydrosauc I £;Vacuum G Other Test Equipment Used: _ V f £2 Equipment Resolution: E»" W " '"' ' W — _ 1 ’ gH ' I 2 34 Identify Spill Bucket (By Tank i,__ _I _ Number, Stored Product, etc.) i laaikl pf Bkket lnsmnation Twé: /3IDirect;Bur)t C] Direct. Bury ‘ I G Direct Bury I I Direct.Bm-3.; , -_g__ D Contained in Sump D Contained ui Sump \_ E» Contained lIl Sump :_= Contained III Sump Bucket Depth:- *1 Bucket Diameter: /B ” \ L2" Wait time between applying vacuum/water and stan of test:I Test Start Time (11); E3sl |l Initial Reading (R1): if Test End Time (TF):§s _ Final Reading (11,); ‘» Bi I Test Duration (T; - T, )1é ‘Change in Reading (R; - R|): ‘Q 1 I Pass/F ail Threshold or Criteria:O ,' 0c):' l 1l | _ i I Test Result: I )1 Pass amt 0 Pass mm: 0 Pass ElFail El Pass cmiii COIIIIIIQIIIS — (include infonnation on repairs made prior to testing. and recommended follow-uefor failed tests} CERTIFICATION l TECHNICIAN RESPON SIBLE FOR CO‘\DUCTI\G THIS TESTl\G I hereby cemj_'v that all the Inf on contained in this report is true, accurate, and in full compliance with legal requirements. T°°hni¢lan'$ Slgmmrc Date:- ' State laws and regulations do not curr ntly require testing to be performed by a qualified contractor. However, local requirements ‘may be more stringent. -1 0 Q .0 ~ \ ¢ 4 Q I 0,, ' 0*’ Q -l 4i Z) A - “‘?€Z>§<b\_@§‘: swRc’B,Januaiy§;o_n2 -' ' i ‘Page ._l__ ofZ Secondary Containment Testing Report Form ‘- ®_¢/R This form is intended for use by contractors performing periodictesting of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. A 1 FACILITY INFORMATION Facility Name: KULS ' ' \ Date of Testing: 1-acility Address: Facility Contact Phone: Date Local Agency Was Notified of Testing 1 ' Name of Local Agency Inspector (if present during testing):I 2. TESTING CONTRACTOR INFORMATION Company Name: Technician Conducting Test: mq Credentials: El CSLB Licensed Contractor El SWRCB Licensed Tank Tester License Type: N License Number: ,, IIMUQIIN lMfl)‘ \1t\_wl\..t.m\;1xt mrtgr 1 r 1' I -'=“;?‘5.‘l‘-'l‘»".'!‘ifi‘|‘-'!%1'l"-?"l='1"5?35?¥1T%33"l;"J"f‘*§5~!;!{3“l‘L-"P 'I'f'.‘fi'E"f-" 3‘-‘-'1'13151""‘¢!.‘2$‘7J:t‘A';'!;.¢;{'Ii;:'.E1?;7;,}Lyvqy;1*; ;..j:;,+_-,2w:1:::.>-:'1-=‘-W131;l:,."1=)‘t?2"-{i‘tli"§§1I5““ “S 3‘1%?.'i‘il.'1'!1'l‘5:";'i.1ll\'.‘l‘I'!l3"!”1!’?}'JE1JPH‘ Wit 141'!-I Ii! IZIH Mangfacturer Training ' Manufacturer V Component(s) Date Training Expires 3. SUMMARY OI? TEST RESULTS Component Pass . 4 . ;. F .l Not Repairs C t P F .l Not ‘ Repairs M Tested Made ' omponen ass m Testedi Made D3 1,115-\\ii\\\1\l.t\Q ClU El ElD El El r *3? El ElU El El U El e Cl El El El U El Cl $55‘? %'l1*?“”j P one ta MA? Cl ElD El Cl Cl Cl mt. 5%Q D ClU Cl El El [I1 ILDL §tlflQ C] El El II El D III » f‘_\ \_: ElE El E3 ElU El -*6 III ElD D El D El S El El III Cl El ElD B El C]U U L] Cl El P1 \_-I Cl Cl El El CI El Cl D El Cl EJ El [I] El E] If hydrostatic testing was performed, describe what was done with the water afler completion of tests: t CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING T o the best of my knowledge, tlte facts st~£':ted in this document are accurate and in full compliance with legal requirements Technician’s Signatur , Date: /OS’ - v u &\ ~ _. x1 ’-/‘| ~ SWRCB,January2002 vs '. Page Z oil 4. . TANK AN TESTING Test Method Developed By: _ El Tank Manufac r El Industry Standard El Professional Engineer- FLIIB El Other (Specifil)g Test Method Used: - ‘D Pressure U Vacuum -_ U Hydrostatic El Other (Specify) ' Test Equipment Used ta x ‘-1’ _R aée Qtfl % 3% _t__.,11.gj t nit ls Tank Exempt From Testin g?‘ W u0 ' - ~ ' - Equipment Resolution" 8' ; tiliiliii A . A ’ »»-it -, ; ,-.;,:' Tan k'i# Tank # Tank #t Tank# _.. '_. ‘ . .'_ *'-i‘_»_\i'> >“~':..!'.--"L" .::_".-L’"*!*‘£'."':"'"§‘-' “"'.':‘"';":'i"' '3" '_ .l]Yes fiNo ElYes BNO -i ElYes ElNo' ElYes BNO Tank Capacity:' Tank Material: EXQL- Tank Manufacturer: - \.t.\\§>N'ww@~ Product Stored: D'\‘<'bZL Wait time between applying pre_ssure/vacuum/water and starting test:. u IA I ’\. Test Start Time:. lnitial Reading (R1): Test End Time: \_2'.\§p.,A _ . Ma. \ ‘\§fi4 ~ F est Duration Change in Reading (R;-R1) ()\:\@‘ _ - Pass/F ail Threshold or Crite 31 Test Result: - - . §P'I’ass;_%lFaiil D Pass DFaiI El Pass DFail - D Pass lTlFail W85 SBHSOT l'6Il'lOV€d fOl' t€S ‘I _§0Yes UNO UNA lIlYes UNO UNA E|Yes BNO UNA iIlYes UNoi UNA Final Reading (RF):' r ri tm 111 8 - Was sensor properly replaced and pves UNO UNA lI1Yes UNO UNA lI1Yes DNO UNA ElYes UNO UNA Comments —- (include inf verified functional after test' g? or mation on repairs made prior to testing, and recommended follow-uafor failed tests) '' 1 I .w a 'Q v 1I 1 4 u ;_ .\..' ' Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt fi'om periodic containment testing. {Califomia Code of Regulations, Title 23, Section 2637(a)(6)} ' .A 4 \O~iy;\,\l‘ _l"l'| _ ‘ ‘ I _ _ ‘ J SWRCB, January 2002 I O' - s. SECOND_ARY PIPE TESTING -- Pageiorl Test Method Developed By: Cl Piping Manufacturer U Industry Standard D Professional Engineer l El Other (s 15»). - , T T V peci : El Pressure - El Vacuum _ ' - U Hydrostatic % Test Method Used . . . V El Other (Specifiz) Test Equipment Used: _ Equipment Resolution:_ I it H _ Piping Run # Piping Run # i . Piping Run # Piping Run #4 _ ,5 Piping Material: '- \. Piping Manufacturerzy q\:¢>\mow is Piping Diameter: 8” Length of Piping Run: <0‘ ~- Product Stored: b:\.(§‘(’L_’ Method and location of _@ping-run isolation: ' ' HM Wait time between applying pressure/vacuum/water and_ starting test: l O' Test Start Time: ' \Z'_\§- Initial Reading (11,): . \.g_>23-,_,‘ \.‘57,3;_,. Test End Time: X5i50pw\: Final Reading (RF): " I-559'/.4' Test Duration: A J ,__J Change in Reading (R;-R‘): _. Pass/F ail Threshold or- Criteria: ' ®W Test Result: '' pPass ElFail ‘ El Pass ElFail El Pass ElFail El Pass ElFail Comments — (include in rmation on repairs made prior to testing, and recommended follow-uefor failed tests) "I4 4. \ C \ 0 II l i, ‘ - -A ~ 3. ? » | .'-v w¢ it 3» I.. I ¢'~ ~ v» 6. PIPING SUMP TESTING SWRCB, January 2002 ‘ ' . . Page H of B Other (Specify)- Test Method Developed By: A B Sump Manufaeturer B Industry Standard B Professional Engineer I' B Other (Specify)- Test Method Used: B Pressure B Vacuum, B Hydrostatic Sump Diameter: %; >-’§== wail: $32." Test Equipment Used: ‘ _ __ M __ _ ‘__ __~W uipnt Resltioz _ __ _g xv: {__ —___ Sump Depth: ' ;=‘.'. ' ‘ ‘V. ‘ , ~ " '-’ , 5215‘..§5%=5l‘»r»i*;,'§it3.-"i'-'i; I4 it-; Sum» # P h Sump # Sump # T Sump #r Sump Material: Height from Tank Top to Top of Highest Piping Penetration: 1'?“ Height from Tank Top to Lowest Electrical Penetration:- 3).. Condition of sump prior to testing: U (;lnA~ Portion of Sump Tested‘ Does turbine shut down when sump sensor detects‘liquid (both _product and water)? BYes BN0 ;€NA BYes BN0 UNA BYes BNO UNA 0. B Yes B No; B NA Turbine shutdown response time ls system programmed for fail-safe shutdown?’ BYes No @NA BYes BNO BNA BYes BN0 BNA BYes BNO; BNA Was fail-safe verified to be operational? I. BYes BN0 pNA BYes BNO BNA BYes BNO BNA BYes BNoi BNA Wait time between applying pressure/vacuum/water and starting ICSII 0/14/~ Test Start Time: Initial Reading (R1): _§-0\-'(i/ Q}.-1 Test End Time: Final Reading (RF): 11%: -om {J3-ogfl ti Test Duration: /ink /§Z~1/»/ Change in Reading (RF-R1): ;l2201~ - 0//~* A ’ Pass/Fail Threshold or Criteria: = i~ - l Test Result:U w Pass BFai| B Pass BFail B Pass BFail B Pass li]Fail Was sensor removed for testing? Was sensor properly replaced and verified functional after testing? dyes BNO BNA BYes BN0 BNA BYes BN0 UNA BYes UNO§ BNA ‘BYes BNO BNA BYes BNO BNA BYes BNO BNA BYes BNO§ BNA II Comments — (include informatio n on repairs made prior to testing and recommended follow-up for failed tests) 1 V . ./ ' if the entire depth of the sump is not tested, specify how much was tested. If the answer to Q1 of the questions indicated with an asterisk (*) is “NO” or “NA”, the entire sump must be tested. (See SWRCB LG-160) SWliCB,January 2002 ' Page ii ofl _ 7. UNDER-DISPENSER CONTAINMENT (UDC) TESTING Test Method Developed By: B UDC Manufacturer B Industry Standard B Professional Engineer B Other (Speczfiz) Test Method Used: B Pressure B Vacuum B Hydrostatic B Other (Specify) Test Equipment Used: Equipment Resolution: ~~--are ”"‘T”\ 4 .~"*r-->r-"»- ‘-1'.-"21-'1’-"~°-Kit"-'-17 : " Ii ii’?-l1Zi‘_i")‘ "Wii”-M:3W45s?=t=§i:§¢=tt¥~3i5i —~‘—e- - ' ' - ~~~ -*~—~ e ~~— " ~ e e -~ U1>¢# ‘"2 U1>¢# % _l‘ UDC #<-51¢ v1><:# 1g UDC Manufacturer: Qgkmqkm \AN\u~wwu,i \u\lk~o .,,, ,4 5% fir UDC Material: \LQ&kI\\fim\H“-> \/\§\¢4\\g§Q,q \_g,_Q\l~N OwN Z30" Bin‘ HP" UDC Depth: Height fiom UDC Bottom to Top of Highest Piping Penetration: lip’ [W Ira" Height from UDC Bottom to Lowest Electrical Penetration: M" /4' /7“ Condition of UDC prior to testing: Portion of UDC Tested‘ Does turbine shut down when UDC sensor detects liquid (both _product and water)?' BYes UNO laiINA BYes BNO ' to _ 4 N T /J 'Quirv.‘iA -as -.1 J..‘rJ// as 0 . - r -1 QJNA émiuu r, BYes EINO /QNA BYes BNO BNA Turbine shutdown response time Is system programmed for fail- safe shutdown?‘ BYes 2N0 @NA BYes No ')fiNA flNA BYes BNO; BNA Was fail-safe verified to be operational? BYes BN0 )hNA om BN0 pNA BYes BNO FNA BYes BNO; BNA Wait time between applying pressure/vacuum/water and starting test Oi, I\J /OMJ-J // Test Start Time: _\‘¢0 Initial Reading (R1): .I ‘AA -‘I /A fa) 1' /11 » ZZZ, Test End Time: Final Reading (RF): ‘° 3*” if 7 11 "11 71 I A ./ 1/ ‘\ \\ \: I’/11 -.\ §\\k Test Duration: Change in Reading (RF-R1): Pass/F ail Threshold or Criteria: Test Result: M//f . ./ // /1 /4 _@717,,-/ mo)» -2224’ ea; .@a2@~ £22» Ail Pass BFail Pass BFail Pass BFail B Pass BFail IF Was sensor removed for testing? fits B No B NA \@Yes BN0 BNA fies BN0 BNA B Yes BN0; BNA Was sensor properly replaced and Verifiedfuncfionalafienesfing? pies BNO BNA Wires BNO BNA pres BN0 BNA BYes BNo= BNA C0mm€lltS — (include information on repairs made prior to testing and recommended follow-up for failed tests) ' If the entire depth of the UDC is not tested, specify how much was tested. If the answer to g of the questions indicated with an asterisk (*) is “NO” or “NA”, the entire UDC must be tested. (See SWRCB LG-160) _ _ _ _ ‘ "",_ ‘ I _‘ _ _ _ “D N SWliCB,Janua1y 2002 “ n _ ' l l Page _([<>f;Z - . - 8. FILL RISER CONTAINMENT SUMP TESTING Facility is Not Equipped With Fill Riser Containlnentsulhps B ' Fill Riser Containment Sumps are Present, but were Not TestedB B Other (Speczjjx) _. Test Method Developed By: B Sump Manufacturer B Industry Standard B Professional Engineeri B Other (Specifl) Test Method Used: B Pressure - B Vacuum B Hydrostatic' »e=“% ti Zn iés W ii‘ Sump Diameter: Test Equipment Used: - * Equipment Resolution: 4 ' Bi. ' W" "$1" ' '.'E1*f-'l';‘-’~‘fj{=!‘§@3{'-1*:‘-{i§3Ei‘ji"“YiPf"“"2E?fi=?£-}“¢\’!fif”!“f‘i7’f‘?§f5FF§i@$fi§§?%iiIf'jli'iff§_’!§1;E*:i1./3*’-ii?!!9I:f:!‘%f£‘§‘i5:’Iffiliiii-Q!i§i§'?§fi§f{€’??3E’?F;‘f’§:i3§f%'iF!-!1!??i"iY1"§{fi!ilt'l it - I ' " ‘ A ‘ ‘ . ' _. ‘ ~i Q, ji*§~\*:<\ ‘ ‘ ‘ “A FllISump # Fill ump # Flll Smp # Fm Sump # ' Sump Depth: Height from Tank Top to Top of Highest Piping Penetration:' Height from Tank Top to Lowest Electrical Penetration: Condition of sump prior to testing: II Portion of Sump TestedC Q Smnp Material: Wait time between applying pressure/vacumn/water and starting test:‘ Test Start Time:. Po £L(_(§,3,,,4,f Initial Reading (R1):' Test End Time: Final Reading (RF): ' Test Duration: Change in Reading (RF-R1): Pass/F ail Threshold or Criteria: _ Test-Result: i B Pass BFail ' B Pass BFail B Pass BFail B Pass BFail Is there a sensor in the sump? BYes BNO BYes BNO BYes BNO B Yes LB No Does the sensor alarm when either product or water is ‘ . detected? BYes BNO BNA BYes BNO BNA BYes BNO BNA BYes BNO UNA Was sensor removed for testing? BYes BNO BNA BYes BNO BNA BYes BNO BNA BYes BN6 BNA Was sensor properly replaced and verified fimctional after testing? BYes BNO BNA BYes BNO BNA BYes BNO BNA BYes_ UNQ BNA Comments — (include information on repairs made prior to testing, and recor-nmended follow-up for failed tests) w61LZsW¢_< 0 IP i s ». 1 S u m '2 '||. 7. »r “r . 1. 0 ~ 0 ' '. i A . ,- : V »0 SWRCB, January 2002 ' _ ' ‘ Page -of_2 . , . 9.' SPIIQL/OVERFILL CONTAINMENT BOXES‘ Facility is Not Equipped With Spill/Overfill Containment Boxes El ;_ . ._ A‘ Spill/Overfill Containment Boxes are Present, but were Not Tested El . _ _ _ -' A Test Method Developed By: Cl Spill Bucket Manufitcturer D Industry Standard El Professional Engineer,' ' El Other (Speczfil) - - g ' Test Method Used: [I Pressure ' . D Vacumn El Hydrostatic -_ ' i ‘ 0 Test Equipment Used: ' _ _ - ' Equipment Resolution: - ‘ <4; . Spill Qox # [)5], Spill Box # Spill Box # _ Spill Bo}# , _ , Bucket Diameter: "54 V . g ‘- 5&- =§~ie» £5?- 33:2- Bucket Depth: L3” Wait time between applying4 pressure/vacuum/water and Y‘ starting test: _ . \' Hgpflll 4 '' Test Stan Time: ' |Q'.|§ A "'50?n Initial Reading_(R[): ~ _'go1_E~ '_5d-[W ‘ Test End Time 9 \, Final Reading lRF): -ii _. ,- Test Duration: ' lg/N N " |§1m~’ change in Reading <R.=-Ro= -00014 A oi,». ' - , DOther %Speci]j1) V ' . * Pass/Fail Threshold or , . ‘ _ _ _ S» Criteria: . ' ,, 692/rJ ~ ' -. -‘ Test Result: :*"wPass_< DFail 0 Pass ' um: - D Pass .'ElFail-‘ E1'Pass film] 5 _ _ I. -. fa. Comments — (include inforrhation on repairs made _pri0r to testing, and recommended follow-up for failed tests) ‘1 l t -0 I .~ l '¢ \ \-A‘ u " ,5 ,v ‘t ‘ \ 1' 1 ‘r I l 5 9 \ 0 1 € 1/1a >I 1- "2 '\ “F ‘A 4 . Q ‘D, ». \ v I Q 3 t " r4 - lvI J |cu ‘. 1¢ ‘ . 4\ ‘\ A‘ SB989 TESTING FAILUREYREPORT 4 -' 4 ADDRESS: . TECHNICIAN: Qflgyg7 4 ' I I ‘- SH-=-NATm= SITE "CONTACT: ‘ » ' - ‘ ‘. THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE THE SB989- TESTING. ‘ ‘' 0 r -n LI§T OF PARTS REPLACEO/REPAIRED: ‘ RE;PjkIRS.:. i\FO\\&\g {. a I. '1 n 1¢I0 O ' \- \ =s I. I2O 5 1' LABOR: NDQZ = l-' 0 (\' | ,1 fi')'K\)(.k-4_fi)_? ‘ DATE:_ 4 wf ¢ I \- J1 ’4 -I ; \ ‘x ~ wk.vI ,o Q n 0 Q1 Ir / ' 1 PARTS INSTALLED= ~ y 1- I1 I '4 Ql I u04 » '4 0 0 I ' ‘1 I‘ v1 0 t .1 Feb O8 03 02:27p Franzen Hill ‘ 55988815-87 , p.2 1, - ~~ \. '0 _, SWRCB, January 2002 " V Page l of7 . Secondary Containment Testing Report Form T his form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested The completed form, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORIYIATION Facility Name: MIKULS "muctc TERMINAL | Date of Testing: 2-3-03 Facility Address; 2201 TAFT HWY BAKERSFIELD ,CA Facility Contact: ALLEN I Phone: 661-832-S390 Date Local Agency Was Notified of Testing : 01/30/03 Name of Local Agency Inspector (if present during testing): 2. TESTING CONTRACTQR_]NFORMATION __g__ Company Natne: Franzen-Hill Corp 1100 North J Street Tulare, CA 93274 Technician Conducting Test: _ FELIX MENDES V A L Credentials: x CSLB Licensed Contractor El SWRCB Licensed Tank Tester, License Type: A,B,C-61/D40 HA2 I License Number: 3041 M_ '" '~»-~ ---- -A =-U--.~ n~- ‘$8335! “ 151-“L. __ v—-- A -- _.fliL1UII-I LHl‘t't IN ,X‘k-$1‘-i-D"‘_ 5'2. -C-.~i-. Manufacturer Training ‘ - Manufacturer Component(s) Date Training Expires Environ Piping and Testing 10/03 Total Containment Piping and Testing 10/03 I Incon Testing 09/04 A Cadwell Testing 10/03 ‘ 3. SUMMARY OF TEST RESULTS . Not Repairs . Not Repairs Component Pass Fail Tested Made Component Pass1Fa|I Tested Made ANNULAR U III ElU >4 :1 |:1 1: SECONARY#1 X [1 :1 5 1 sum? #1» unc 1-2 UDC 34 UDC 5-6 r:|m|::xD><><!><><Ei DUEJCIUUEIEJEIU UDEIEIEIEIDEJCJ |:1i:1mt:1|:11_it_1\_1u IIIIIIIIIEIEIIIJCICIUEI 1:1|:1i:1m|-||-is-1m13|:_1 EIIIIEIEIDDEJIIIEI IIIDEIIIIIIIEICJUEI ’ Cl El El E] Cl D El III If hydrostatic testing was performed, describe what was done with the water afler completion of tests: LEFT 55 GALS ON SITE, CUSTOMER WILL PICK UP AND DISPOSE CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING Tl-IIS TESTING To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements Technician’s Signature: FELIX MENDES Date: 1-3-03 r _ _ ____ _____ \ \ \ u Feb 08 03 02:27p Franzen Hill I 0 ~0 ,.,. u SWRCB, January 2002 TANK ANNULAR TESTING _ u - i 5598881467 p.3 Page 2 of7 Test Method Developed By: ' B Tank Manufacturer I B Other (Specifiw) X Industry Standard - El Professional Engineer Test Method Used: s ' B Pressure El Oth (S X Vacuum El Hydrostatic fir . Pewfiv) _ ' ‘ 0 E Equipment Resolution A P _P_ 7~=“‘Zi-:~“53.:~“§..—=*" B -J‘ wt .c~:1=_.“ -~*~'I’.- 'l.\i1ll’¢F ‘ —_t :2 it " '» e ~*€~ x...'J=_‘* ‘L -"'"7.§ "“'ll’~—l:l'..=-eilitcx 'T est Equipment Used: VACUM GAUG g _ A ’_ g H 7A _ ' _ H I HA s ~ ~ .~* T=="k# 1 T*vsk# "‘="'<# Tm”a ls Tank Exempt From Testing?' "I1 Yes X No E Yes B No '3 Yes B No l i P B Yes B No Tank Capacity:_ '- g ' 20,000 Tank Material: A F-IBERGLAS STEEL’ Tank Manufacturer: » MODERN WELD Product Stored: DIESEL Wait time between applying pressure/vacuum/water and 10 MIN starting test: Bi Test Start Time: 1:00 Initial Reading (RL): -14 P Test End Time: l:3O Final Reading (RF): " -14 Test Duration: A _ 30 MIN P . Change in Reading (R;-R,): O_. Pass/Fail Threshold or Criteria:. Test Result: “ X Pass U Fail B Pass BFail 4' 0 mi BFail B Pass BFail Was sensor removed for testing? X Yes NEXNOU BYes BNO NA BYe5 BNO DNA BYes BN6 BNA Was sensor properly replaced and X Yes C NoB verified functional after testing? ' NA 'I|Yes BNO BNA BYes BNO BVNA BYes BNO ENA Comments — (include information on repairs made_pri0r to testing, and recommended f0ll0w—upf0r failed tests) * .\. _ r.,_ , . . -nl ' Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt fiom periodic containment testing. {California Code of Regulations, Title 23, Section 2637(a)(6)} _ ' _AA-was I I Feb O8'O3 O2:28p _ SWRCB, January 2002 Fr‘anZen Hill ~ 5598881487 , |O.4 0. :- _ Page 3 of7 4. SECONDARY PIPE TESTING i Test Method Developed By: ‘ Ci Piping Manufacturer X Industry Standard El Professional Engineer El Other flS‘pe'cijj1) I - * Test Method Used: ‘X Pressure El Vacuum D Hydrostatic _ _ El Other (Specifir) g ' Test Equipment Used:PRESSURE GAUGE I - g V _ _ Equipment Resolution: W _A ;:- A - - T * - - . - < . -V ,1 Piping Run # 1 Piping Run # Piping Run Piping Run# Piping Material: FIBERGLASS ‘ . Piping Manufacturer: AMERON Piping Diameter: I 1” Length of Piping Run: 40*» Product Stored: DIESEL Method and location of _p_iping-run isolation: Wait time between applying pressure/vacuum/water and starting test: Test Start Time:I - Initial Reading (R1): Test End Time: ‘ Final Reading (RF): Test Duration: ‘ Change in Reading (RF-R1): Pass/F ail Threshold or Criteria: Test Result:' - El Pass AU-Fail ElgPass ElFail- 4 El Pass "EiFaiI. El Pass 1I|Fail Comments —— (include information on repairs made prior to testing, and recommended follow-up for failed tests) UNABLEITO TEST SECONDARY PIPING. WAS UNABLE TO REACH TEST BOOTS IN UDC 1-2. 3—4. AND 5-6. NEED TO REMOVE DISPENSERS A as __ ._ .. ,3-M - -.\ 5 SWRCB, January 2002~ .~ 5. PIPING SUMP TESTING Feb 08 03 02:28p Ffanzen Hill 5598881487 . ' 0 Other (Specijjl)_ Test Method Developed Byi B Sump Manufactmer X Industry Standard B Professional Engineer Test Method Used: A B Pressure B Vacuum C B Other (Speczfl) Test Equipment Used: INCON A ‘ _ Equipment Resolution c,.,_?;§ ._ _= _ Bf‘ "**~ -is- §tififlH1="l;; vi ;¢**1'@:“’lli:"“;T=“"‘l§l@§@~ ‘ " sum #1 Sum # sum # sum# - P P ' PP ‘ Sump Diameter: - . 36”~ Sump Depth: ‘ - y 73”' Sump Material: l FIBERGLASS Height from Tank Top to Top of 31,, Highest Piping Penetration: Height fiom Tank Top to Lowest 27,, Electrical Penetration:Z Condition of sump prior to testing: DIRTY Portion of Sump Tested‘ FULL Does turbine shut down when sump sensor detects_liquid (both _product and water)? X Yes BN _ NA~ ° '3 BYes nuu BNA BYes BN0 BNA BYes om BNA Turbine shutdown response time 5 SEC ls system programmed for fail-safe X Yes B NoB shutdown?' NA BYes BNO BNA BYes: BNO BNA [Yes BNO BNA Was fail-safe verified to be X Yes B No B' operational? NA BYes BNO BNA BYes BNO BNA BYes BNO BNA Wait time between applying' pressure/vacuum/water and starting 10 MIN test: I Test Start Time: 9:50 Initial Reading (R1): 3.9375 Test End Time: 10:05 Final Reading (R|:)I 3.9383 Test Duration: I 15 MIN Change in Reading (RF-R1): .0008 Pass/Fail Threshold or Criteria: .002 Test Result: » ' - i "Pass BFail B Pass Bl-‘ail B Pass IlFail B Pass [3FaIl Was sensor removed for testing? XYes BNO BNA BYes BNO BNA BYes BNO BNA [Yes BNO BNA Was sensor properly replaced and XYes BNO BNA BYes BN0 BNA BYes BNO BNA EYes BNO BNA _ verified functional after testing? Hg 0 Comments — (include informali n on repairs made prior to testing, and recommended follow-ua for fdlléd tests) ' If the entire depth of the sump is not tested, specify how much was tested. If the answer to aly of the questions indicated vmh an asterisk (*) is “NO” or “NA”, the entire sump must be tested. (See SWRCB LG-l 60) X Hydrostatic .~ Feb O8 O3 -O2:28p Franzen Hill 5598881-487 p.6 SWRCB, January 2002 ' Page 5 of7 6. UNDER-DISPENSER CONTAINMENT (UDC) TESTING Test Method Developed By: B UDC Manufacturer X Industry Standard B Professional Engineer B Other (Specrfv) Test Method Used: B Pressure B Vacuum X Hydrostatic B Other (Specifiw) Test Equipment Used: INCON i _ Equipent Resolutin _ _p -_ I2... _ ,.. ,",:_,-.-_- -vi‘ . '- _;;' —..- .. '_ 1:2.‘- . . .=. ' -- 1 . E" _._t.,"~'2‘='""- ‘ -ii _ __ _ ' 1 -»_. x :‘ it =1‘ § :'~'-*‘~ Q51-la|1l47l,tt. “ ¢_.i._?“‘i “’;;“"-‘i‘7*'i'_Hrl.E __ """"' _ _.__A ~ _- _ " '~ -_|_u _; -;__ .E1!z I .__u§l.i. --‘=2. '5: ‘-~- ~ UDC # l-2 UDC # 3 4 UDC # 5-6 UDC# UDC Manufacturer: I ' NA NA NAi UDC Depth:" uoc Material: FIBERGLASS FIBERGLASS FIBERGLASS 35’ as" 35” Height fi'Om UDC Bottom to Top of Highest Piping Penetration: 91! 9! 9! Height from UDC Bottom to Lowest Electrical Penetration: 5” 5!! 4” Condition of UDC prior to testing:- DIRTY DIRTY DIRTY Portion Of UDC Tested‘ BOTTOM BOTTOM BOTTOM Does turbine shut dovm when UDC sensor detects liquid (both _product and water)?’ BYes BNO XNA BYes BNO XNA BYes BNO XNA B Yes B NO UNA Turbine shutdown response timel ls system programmed for fail- safe shutdO\\m?'' BYes BNO XNA BYes BNO XNA BYes BNO XNA B Yes BN0 El NA Was fail-safe verified to be Operational?' BYes BNO XNA BYes BNO XNA BYes BNO XNA BYes BNO Cl NA Wait time between applying pressure/vacuum/water and starting test IOMIN i ‘l0 MIN 10 MIN Test Start Time: 1 1:29 10:30 10:30 lnitial Reading (Rl): 1.1087 1.0450 .9692 Test End Time: 11:44 I 0:45 10:45 Final Reading (RF): 1.1099 1.0459 .9694 Test Duration: 15 MIN 15 MIN 15 MIN Change in Reading (R;.—R,): .0012 .0009 .0002 Pass/F ail Threshold or Criteria: .002 .002 .002 Test Result: 1 X Pass BFail X Pass EFail X Pass BFail BPassB Fail Was sensor removed for testing? E] Yes 3 No X NA E Yes UNO XNA BYes IINO XNA BYes BNO B NA Was sensor properly replaced and verified fimctional after testing? ‘BYes BNO XNA lIYes BNO XNA BYes -3NO- XNA BYes BNO B NA Comments — (include information on repairs made prior to testing, and recommended follow-uefor failed tests) NO SENSERS IN UDC’S UNABLE TO.DO A FULL UDC TEST WAS UNABLE TO REACH TEST BOOTS AT THE BOTTOM OF THE uDc’s. NEED TO REMOVE DISPENSERS TO GAIN ACCSESS. AND RETEST. ‘ if the entire depth of the UDC is not tested, specify how much was tested. If the answer to Qy of the questions indicated with an asterisk (*) is “NO” Or “NA”, the entire UDC must be tested. (See SWRCB LG-160) Feb U8 O3 O2:2Sp Fr‘anz<e'r\ Hill 5598881487 _ p.7 ~< " SWRCB, January 2002 i Page6of7 _ 7. FILL RISER CONTAINMTQNT SUMP TESTINGy Facility is Not Equipped With Fill Riser Containment Sumps El Fill Riser Containment Sumps are Present, but were Not Tested D‘ Test Method Developed By: ~ El Sump Manufacturer D Industry Standard El Professional EngineerV El Other (Sp€C!f}') Test Method Used: [J Pressure I1 Vacuum El Hydrostatici U Other (Specifiz) 1 -P Test Equipment Used:< ‘I V Equipment Resolution:V will Fill sump # Fill sump # Fill Sump # p S Fill sump# it‘ E l ta” , l_ , Sump Diameter: -_ Sump Depth:* Height from Tank Top to Top of Highest Piping Penetration: Height from Tank Top to Lowest Electrical Penetration: p Condition of sump prior to ' * testing:- Portion of Sump Testedy Sump Material: Wait timevbetween applying _ pressure/vacuum/water and- starting test: Test Start Time;S \ Initial Reading (R1): Test End Time: Final Reading (RF): Test Duration: ' Change in Reading (Rp-R,): Pass/Fail Threshold or Criteria:, Test Result: . U Pass‘ DFail u E] Pass -E]Fail El Pass . l3Fail [Z Pass ElFail l ls there a sensor in the sump? I] Yes El No U Yes Cl No El Yes El No D Yes U No l Does the sensor alarm when either product or water is detected?' l]Yes ZlNo DNA- UYes BNO EINA EYes [No DNA lIlYes lI|No [INA Was sensor removed for testing? ljYes IlNo DNA ElYes -IlNo DNA [Yes lINo, [INA DYes .ElNo UNA Was sensor properly replaced and verified functional afier testing? ElYes "3No DNA ElYes'_ElNo [NA lJYes_ BNO ENA EYes BNO IIINA Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) l :_--\. 'o- ,» W. §.( ..’ .,m Feb O8 O3 02:30}: Ffanzen Hill 5598881487 SWRCB, January 2002 A Page 7 of7 V ‘ \, 0. 8. SPILL/OVERFILL CONTAINMENT BOXES _ ~ Facility is Not Equipped With Spill/Overfill Containment BoxesU Spill/Overfill ContainmentBoxes are Present, but were Not Tested El Test Method Developed By: - ~ g - U Other (Specifiz) El Spill Bucket Manufacturer U Industry Standard I3 Professional Engineer Test Method Used: - U Pressure T El Other (Specify) El Vacuum ' E Hydrostatic Test Equipment Used: ' ' - ' Equipment Resolution: - .......::._.y- ::::*;--.... Llii. ,,~, _ :..:::::::::::-;@1111!-is-=gt=1;".i‘§l351!=*1Llg“""‘“ =1, 93'!_ rewrote‘: ' = T;;§l;¥L§§~@=§==P==-==-=§=%=e-'?~75?=-ll-5l§E“l*-fill ' Spill Box # Spill Box # Spill Box # I Spill Box# I \ Bucket Diameter: ' ~ Bucket Depth: ' Wait time between applying pressure/vacuum/water and starting test:, Test Start Time: lnitial Reading (R1): Test End Time: Final Reading (RF): Test Duration: Change in Reading (R;-R;):_ Pass/Fail Threshold or. . Criteria: V Test Result: E! Pass EFail Cl Pass ElFail U Pass UFail El Pass E|Fail Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests) l . v . \ _./-,A;‘_;';,~_-¢;_,, ',_r_w\_.\\:-- Signature of Company Representative Date: r_~-' ll ‘ __ ,7 _W s.‘ Vc }¢ ..;., TIGHTNESS TESTING REPORTS * EVALUATION FORM . Q’ Specialist reviewing the tightness test report: La»!/"@ Z / U//Vé Date tightness test reports were submitted: /Qfq “OK” Date tightness tests were completed: / 2 "S19/L0 Facility Permit Number: Q Oé L0' Number of Tanks Tested at the site: 7/ (list the tanks by their tank numbers if provided) 3}*zé%§ Was the method a test of piping alone, or just the facility tanks? . , L’/ (describe) p Did the facility pas: 1"! tests: Yes ~.~ ',',"No (if no, provide the leak rate and a description of the tank(s) that failed the test) (failure is > 0.1 gal per hour) The facility will do the following to investigate the failed test: The test method certification that is submitted to the state specifies that each test method be completed in a certain manner. Is there anything within the results which would suggest that the tank test was improperly completed? Yes i No (describe) Information has been reviewed and placed within the database: ~’/ YES NO Date entered within the database: - / <51/X/91/4 id ' ‘Ems Entered by (name) \ 3‘ . - ' ‘ 3 H’ ' (Bfifi) 631~387@ Q ¢ TRES — SYSTEM II » ' "H 1\ * I _ PRECISION TQNK 0. LINE TESTJQESULTS summnavf ! DEC’? 9l996 E C¥;h";1["EB":E: L“51' E“ER\’I(:E!u’IJ“CB ' “l' 1&1? IWDFFTCLIQIR $3TRE§§T ‘ »@ ~ wl ~ ‘ ' “‘. BQKERSFIELD, Cg 933@9 f MIHULS TRUCK TERMINQL A ' MIKULS TRUCK TERMINQL I-D. Number: N/Q < P.O. BOX 7B197p’ ’ EEQI TfiFTcHIGHWQY‘ 1 : TechnicianaD.YGUNG {Q A " V -. ' ' :H-V.»-c,;_¢ ' } Vbgfioj 1a-@s>ee T1m»;sca»c;.ms£@w~,;}gfiu= m9=wm County: we‘ ? Contact:-QLLEN‘ _ - _ Datn\T}m¢ systom was filled: 6+ HOURS ' ' ., . V . , l.. ,— ’ .. ¢ . -a . -. ‘ a T ,}-_ . . ._ . .__ 5 , *_.~ Tank F111/Vint _Pgpdqct. Typo Of Vapor Inchls of Pump . Tdpk Capacity Product. Tank Uap?rku1fii€ L£pf;:>_ Rocovery Nata»/Tank Type .' 4' amen V DIESEL Pass ¢§§s*~+-*~Pnss . _ IOBQG _ DIEQEL PQSS' P998 PASS ‘ N/Q' IUQQW DIESEL P985 P983 _ PQSB ‘ N/Q ' f@@@Q1 DIESEL 'PRSS PQSS Q V ‘PQS5 ' N/Q Ukflfi" ATURB. .".~ V -» _.I -U*.i_£)Ij~b0~I I0 M N/Q U.0@" TURB. $.06" " TURB. $.00“ -TURB. = Additional Informhttpnl TEST TECHNICIQNI nous vouus O.T.TQL. <90-1m7a> _¢ *" QtL MECHQNICQL LINE LEQK DETECTORS WERE TESTED QND QRE UPERQTIONQL.- . '7 SXTE LQ@ , TIMEp : » Set Up Equip: ~ m5:@@A' .;_ B306 Product Lines: A*YE8- Blqd Upper Lihg3mL~*b"“N[Q c Bled Vent llnepu ; Bled Turbine: f, YES _ V V ’ f~‘ i ‘Bled Buctifln Pump: N/Qc" % ~Rtsevs Ingtalloda YES v' \ 1% -=4-+..._' "<¢'I\I%i'fQfl-';--.5-lO'<4_i'hJ‘,' -.... .. - ~ ,. __ __ iv1 . .. I -._ . ‘ I' 1 - ‘’ ‘. » a) This system and mnthod meets or exceeds the criteria in USEPQ 40CFRV L part 28$, NFPQ 329~B7 and all applicable stata and local codes. 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ChanQe(FZh> ,1 e@.m@42 = _ v+ 1 . ~ -_. , - __ . » 1 , . -. 5 -Laval vQIqme<gph)|- 4m;@1 .‘ 'v_ .- {gp‘T§mp;.Vq}ufieKgph);f --q;@1_ vprqducfi Lihofgphrj N/Q> ;g.yN¢tjchgng§&gpfiX’ I: ,_@.@@= 3 f”- ” ' # ' =" I VI ._‘_f~:_‘ ‘._‘ I I ‘_ .1,‘ _~ ‘ ‘ __ J I, ’ ‘J’ ‘R ‘F . MI kfv-". ??R@$flL#H++®Pfi$$.§1 ?l‘§CbQyr$ghtjYcYf1?89-byvQE$¢ 1n¢;¢ - i "-" =:‘» _j;V ¢. _ Z > _ Q . .‘ ~ . ‘ _ _ -_ , _ » . ' I ’ . ' . ** Notes ** ' - . _» - . ' . ’ IYIIKULS F'UMF'KIN CENTER TRUCK TERMINQL. , EfE’(Z|1' TQFT HIGH!/JQY, , -F‘UMF‘l"sIN CENTER, CQ.' “THIS 18.?! HIGH LEVEL TEST WITH=F¥ E'lZ|lZ1 ML. CQLIKHRQTIUN QDDED PRIOR TO THESE VDQTQ. 9 THIS TQNK IS MQNIFDLDED T_D TQNK 4', THE CORRECTED NEIT CHQNGE. (C-'i.F~". H.) = :1-12%. I211 V _ I . ‘< r '. _ 7 7_ ___ __ __. I ,.‘ —.,_(.*,,~"~—--—. _" .—. _ . _ . . ‘_ I fl ~ >v ,,. x . ‘ _ . . ‘ > ,, .\ V, ~$m¢ comwxnzmmg usT 8EHUIQE&@INC@ =- % '41? MDNTCpQIR aTREaT.snKsRB#1Epn; cm eaame ‘<azs>~&a1~aavw ~‘, . ;' ‘QE8/Systém_II Precision leak Test Graph (0verFi11)‘ ’ §HQoicé D§i6a'127®S/96 1" t W Time n @5:5§:38; =- Tééhniciafik.DMY* ‘-~' Tank: 4 l‘ V - f Tank Diametér(in):;95: .,-~‘_» f-~p9-$5;->.~:-<1' ,-§b¢§if1=?@§§Y%§§§fJ%7”YWi5*7“*'*?}f§¢9§£fl3?i§hfi¥Qf1€wb&fi;rbny§¢a@@@*“6Y~> ;<;CalifiPfl$#flW;V§1uQKm11IT£@@Q'- ¥§qBh&hH§1qz1;;7'%x3*"=Tj».' ”¢ »' I ,V .'L§v§1§Segq§fitfFF6m1;}=T@;3@®- _' Tpmp7B§g@Qnfi“Frbmp ‘1 To.3@@.* : > - . ' . rs! ‘iii’ In-QR U ';ui 1|‘ ‘mu Fr"J II _’' ' . . , '. hi ~|u uni, qr? u _ ‘up 14» nu 5:3‘ ml nu '"l"_' _' ‘Y ‘- ' ’> . .- V. nunuuu: M~ V.»~~w ,. rmtmr~ =:.= - :..="= ‘ L. &. , 2 3%Q {.2 -/*5# »@£;§§ww3¢@¥@gm$§wwr&§@%%@gwm§5wMf¢%w@§m#,» ~§§- v-%¢“ ~~ ‘\'! _ -1 . ' '* 1.. \ Y ' .~ I v ,-'_ . » . ~ _ ‘ - .- ‘ - . P . ,. - --~. " :.1 " ‘" ‘ ‘ ' '" "IlI§I“"1 _ ;_< ,~‘ _ > _ _. ‘,; h 1~1 , . 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J :_: 3"" 5.‘ H, ‘ L ». .1 - . “1J _ .4» ~. . - A ,- , » _ ,1_|1 , > ‘_ _ .. » 1: 1 A»._»~~l ;;- -£0 __/V: _ 9 -{---all ,._. "~ q‘;\(-". ' . . , . - ’- ‘ '' u “G TX!“ -u 4' 1 ~- ""\“.v-. .' - ' ‘ ~ ' ' .J . '-‘ v‘ - l ‘ > '. "Q '"*- .‘ ,‘ '-qpmnga In cmizbvatian Zdne =~4a 4'jC&1ib§@i{on u51v<§§1}un1£>‘s @.@$11@ ;8tart1hg_Tempevatuwo <?); 66.§31 _ -Heéd Prassure$b§1{RBtm))iih.55 ~§ »»Surfaeo:Rvéa(sq.Iin>:'E1,9 -A, ," ‘ UT@mp;'Change&F/h) :~@\m03_'-’ . »~Eeve1 v01gm9(gph)n --m;m1 ».» .' . . ‘ j 41 (IffTémp;'vQ1upQ(gbh){ ,@¢@1i~;' ’ - { Phoduct L;qQ&gph): —@.@@7‘ :%3N@@vchqngéTgphy_':»_~+@;m2_ , =»,._f, r " __'\- {_4. -A YWfk'€¥5Y@§$@7 ‘i‘{CQPVF§Qh§7fi¢9 1ese"bv 9E5;-Ihfiéwu “,,»,-»" t,f f"¥*‘NpteB **>~ j,~' 2 ~1 f .kl ' ' ~. '_ ~-‘ ' . ; MIKULS‘PUMPKIN CENTER TRUCK TERMiNfiL ,-a2m&ffQFT_H1eHwQv , numwxxw céNTE@, sq.- "THIS IS-Q HIGH LEVEL TEST WITH Q=E@@ ML. cngLBB9r10N-nonen-PRIOR T0 THESh onwn ,. THIS TQNH 1s MQNIFOLDED T0 TANK 3,-THE CORRECTED NET cnmwea (G.P.H.) = ~@.w1 . V - ._ ', _‘ 1-.. 1'. . "_'-1,1“ ‘ ~ .. - -\.,_.§~_‘-¢.~.w.,\,,-W , ‘, ._,,, . .. ‘ _ 4. ,. ~ _ _ ‘ _’ . » _‘ I , _ ‘_- _ r*¥.'1‘;-:».*fi'§.’#M‘,-‘.--r,.':¢1 1*‘ 2’:'_'1r~.‘;».'="."-'.~€,..-5-:35."..¢v._A 1- ‘= 3 _-_,.». _-¢-_-,,,-7- fly-.r.t_~@‘ 0 n -., ".. ‘<4- cw .\, ’I \ .,_- Y‘ . .. ,7 _ if I j 7 77” _ i 7 7 _ 7i _ L711: X - . - ?@ fiaama» ””\ ' - ¢*" '" - -I )' 4 " . \ ‘__\ . ,_ ‘W * ,':. <71 Pate; W. 39 ‘\- Z _ 1- _¢ . v"; Q".- .' 1.. 0 :_q .4‘ \ ; \3'9?~\‘» .‘.’ _, . ‘<‘§‘ .. l - ’ ‘ I ‘ “',m ' _ _< _ . ‘_‘-‘.p‘~ .\ ">1 ' ‘ ‘ _ 2 aw’ '> . ' 4 <‘-,Q»"Hy0R0sTnT1c.pao0UCT pzhe TEST wdnx saegf‘ 4 ’r I ‘ \» ‘ ‘J ' ~ E - :1 '. ' ‘ ' ' IA .,‘ ._- ‘ /2'5.” A ‘ ~, In_vo|i';ce Ndmber Y I ' o nee PLf»10eR 4"’, .' -- u " _ " ~' > CDNF1DENDE UST SERVICES, INC V 417 MONTCLQIR STREET BQKERSFIELD, CH 933@9 (BQS) 631-3870 ._- - '_. -\,f'1" - ,. - . ' .r . - . " - ‘ - -_-. ~. ->1-¢_¢--.--¢-_-»._--_--_--.---_.¢-.--->-. > ..-. TEST”I-P§bbUCTE no; START TIME END TIME --_ SIQRT 1.-. _ _j _ __~ _.;, VDL.(ML) _ _ ._ ._v END TEST VOL. UOL.(ML) DIFF.(ML) --¢ --- _ E/-E '~o 1 i EO2e'3<>» 07:1/6’ ~e 1/if -1---_.-_- 7_ _-L 1‘ W »- _ -.- 'Q»fjfZ%‘;L(9;w6‘$fiE!2&24xD:?J!70%__-'l,X@az_w E N-“ uL$»§- .:¥ ii‘ z 1- 7*- ...‘;N it ‘§-' . J- . “ I. Tnzif‘ ..'\l__ - I’ “ I 3.1- '5" E Iv ' ‘hr ._1 ~/ fl;/>ri4r4*i€f1.Q7:'Z@e ‘vfi‘:7':f;Sk$' L /Ni/E /3!-E E_8 T E:@§§>;<e H 1 Q‘Zé?$' ' 1 0f we --a- ._- -0 ?/J?2l in I ‘ l| '_ ' | 1-. 0 - _-- \~ - u r?’ 1 1- an '1 .‘_/{.7-' I I ._7€7,v_ nu.- Q-- ‘a . _._-_..- K 2-A no -~~ ,6 <5" ‘ ya‘ 51 Q‘; 2/i;* L Zl€3" *1 ’<' ‘ ". 4-’ 8;?!L ._ ...'..k . Q“ ~,v -p L‘. l", I?/£3 2/91E q-0 ~' .J.~. .». :%£Z%g9i§m%i£%T__ ‘ I 1’- .- _1 ,~ . -. 1.W -. '~,-| _ -'1 X '.=-.. a-—' iv‘ 1 Q - ~ 1; .. § ,1 .- ._ 3- '4 \'_~ y.. .-. _ I . ‘_ 0- 1‘; ~ 4 .- - .~':;:‘ .v 9 .. ~~»~~;~_ .-. , »~,~ , I e , -e . , V ,<,j,, ~ , T - , ,_ ’ ‘K -r 4-. P. 3.4 '9. -.- --n 1 1 —» ¢- Q- - - =-“ ' '31."? ??¥ ‘8 an §€, .-- __._.-.— ‘ , \ .—_- '-.-r -1- -> -- ‘\- 9;" _..... - 4 ‘IQ1 —‘ ~14E -1 ml’ ,, ‘ ~.'_. s’ 7' I U fl ," ..-. _._ _ Xv A‘ R‘ <, . It I. . w Ii _ ‘Q 5" -_.. - - . ‘ ' -1 ‘ J :- .AFb.: -. ;‘, I 3‘ n , ‘-‘ -»- . V ‘T ‘Q _,n '~.‘NJ"- ‘-,3-__’..‘.2-‘-‘.._-_-‘~ _, ,' 7.‘ ; . _‘ ‘-I “ .. ‘ v‘ ‘I ~' -. _ -4‘I'.' , -‘ 1‘ E V‘ ‘ e. _ .> _U“- Q ' m .“ + ‘. , . 1 -_ ... _ __ - .... -L .- ‘ o ‘ ':€ f . "*.‘ “ Q11 > \ v ~ ; '. “ \ ' -~ ‘ 1' ‘v"‘ ‘ ‘ .‘ "." ~ ‘ H .1 '- \\ _i J ‘ . X *9 O ~ J \ ‘CJE 1e'1 -_ ._ .... _. .__ _. _. .- 7"-‘$ 13 . .--¢-9;-.1 "93*“"~<*"?'%‘§‘t-»*»#1':’1‘»¥~é,¢<$“5>T# we‘ * ~._ .--_ *€\-IA W;- KJ "? ‘I. ‘Q @1-i lie -§~| "x. -‘ii Q w. -»,.,1 -> ¢I -W,ee,;e L;,_ Ae e|”;,~~ rm';e;i Jee-_|--,.”-n 1%“ 1¢ - 1.1 . _!? - ..- ‘. -.‘ . ‘. ‘ 1 1‘,- \ \\ ;"‘M\3 ‘_\ 1 - ,“._ . “= - - . ‘a R‘1 .¢' "Divide the vblume di?ferentie1 by the test time ( 15 ¢{fi;te=> ene. ,mu1tip1y by 0.0158311, which will qonvort the volume differential f%om milliliters per minute to gallons pefi'hou+U __ E,e - _ The ¢ofiyers1on cofiktqntifls found by : I 's.- . _' , -xéq5m&p/n»>/<z7§0 m1/g¢1>-é~@.@1sé3111<}1n/nr>_(Q81/m1) - The cohvere1on'conetant causes the milliliters and-minutes_to_ '4 cancel out Ex. 3/15 ml./min. X @.@158311 (min/hr) (ga1<mL) = @.D@3 gal/hr.‘ ,, . ' -I » If the level dropped_3m1 in I5 minutes then: ~ RESULTS OF THIS WORK SHEET TD BE COMPILED ON RESULTS SHEET. **** ii - ~*~ ~ i -—' A iii '1 \ \ 1 » 1 _\ 1 K .\ \ . ' ’; \ " _\.\. . -' ~' ‘ .¢ < .I . _ _ ' .. s ‘ " -. ,. - .‘ i , rm _- ~~ ‘._ , 1 .\ . - . A» . _ ' _- _\ 'I _ ~_. | ' _o. ,- , *5 ~ 1‘. n , ... ‘_. ¢_ » -. u- . '\ \ -; '. » f <. ~‘~ \ * .t Z‘ G. . \. \ ' W N;--' Q,-‘a._» 2.:.3';_'.', L'}.L’ "‘ " -‘;,:;£-,:§J;}',I‘ ,' > . . ,1 ‘ xv, _ \,* __ \\ .--'_'.\ _ ~~ ‘. > r~ .'. ~ ’~" ‘I ‘.3 . -- .- ‘. ~\ _\ -,,..' \ 0‘ .‘1. ~. ,. |1 7 _ ,,_ _____ . ENV|RONMEI\lq'AL ‘H EALTH SERVICEQDEPARTMENT ‘$6 . 7”, '8 ~? _.4’I,4 . <9/4_//y C rm ¢'Ii _ ~_ , , ., .- . _ , M. - . WT “fix. .1 Q v _‘ v‘ CA\’\Q,l,I; - ,- 1-M , .a-_- _ ,. _ H ,_ _ ___ ,_~_ t 4 ...._ , ... .. ,,_,. ........,..---._ -~ TANK INTEGRITY TESTING INSPECTION FORM . '. t '11.: 3"‘ -"--:1 _ V A , ' 4 ‘If _ __ff~ _ G . \ 1.: .. . ‘\ w . _ ‘ 4 1, , ¢‘._"___“'. . V }\ ,, ,.~ ,~__¢.| ,, ¢\ . ._ STEVE McCALLEY, R.E.H.S. . ~ /‘Qt _ ,, 2"/op "M‘ sum, Suite aoo v ‘ D|Rg¢;;QR, ,_ ._-.w_,.. _ "*'<""' .~-- ~--1--»~:& "J -15 '-. - -' = .' Bakersfield, CA 93301 , 4- it », ;_~_\ agr. .uJ 9. - t ,\ .': A —~— 861 3636. _ = - I ,.;-.-W, win .V ‘ p__ _ ‘____fir__‘ - I __. ____ ,_.___,_,__. _, __ :.e,~r."""""‘~ '"‘ 7" “T " '" " ' ' "‘“""“‘ >"<'|-_<§;'ff.-*§.":'.-‘ I-'l1‘*I"~>'-‘”: . .- (aos) e61-3429 FAX " ' -7), ‘,9 \ - ~ ' ~- _* '~ v ,,:. Q. ..-\.,,,,._ -.-_-._.,,,, . .,>- t--.3 _‘_,. ,_- =.,-. --¢ .__l.,:TT'_:'_‘__.-to H’ __ ~, >»v -< -n v~ - - -. :.- ... $2”; N T ,M " /”/ ' THIS FORM MUST BE COMPLETED AT TIME OF INTEGRITY TEST BY THE TECHNICIAN ON SITE AND SUBMITTED WITH THE TANK INTEGRITY TEST RESULTS TO THE KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT‘ -3* ..,.':e‘.-. "¢£l.l'.1.,.'.. -..\ .- . . - '3' _ ‘ _ , , , {'7 _ ._ _ 1 . F. ,.Ni.. t _’ ..» t p. Facility Permit -to Operate Number ' .53 00 ~“ Facility Permit to Tightness "rest Number Tl 055? Facility Name Mikuls Pumpkin Center Truck Terminal~ . Ffwility cs i Facility .TelephQneLNu‘mber‘N 8"32-§>9_.§30_ Yd" ~ 1, ‘_ IQ . - -. - .-. _. 1‘ Have you complied with the foll0wing.safety requirements s"tated"in UT-20, Section 25? I *._.~ -_~*_ (9:31 yr 3-;;__ ; K-7 z;-_~ ;>;_ ~,?»,_: .r I .\,‘ '" ' I' Y’ “Jr? _ IQ» -- " ~ " -“.'.§ ‘ ’ u .-P‘ '- '31; " , " ’,_'_-- 1 ‘ -1 1 i _1- r" ' ltflwa‘-Y! ‘ -T.">i? \~ _?Z':~¢_‘»/it .'I"‘. \.a“"-1! . 1"" U i-'1” "' I ' ' “- ‘ p The area within 25 feet of any underground storage tank opening, is free of f~‘- e A smoking, open flames, and any other source of ignition. ' S Legible signs with the words "NO SMOKING" are posted in conspicuous ' 3 ‘ locations around the testing aiea. The general public is restricted from the testing area by rope, flags, cones,'and "if dark" a fluorescent barrier.. Fire protection in the form of a 2A/ZOBC fire extinguisher is located within the restrictedtareamj . - ~ " . \ r‘r’c; _ . . . »_ .|.. '1: . 2%»- , Z55‘ Vehicles utilized during the testing period, or within 25 feet of the underground . storage tank opening, have adequate ventilation, and the tester has equipment 1 which can be utilized to monitor the concentration of flammable vapors within l the vehicle._ l 1- l . 5r T€,§' Personal protective equipment, an eye wash and gloves, and a site safety plan are within the testing area. . .. IE7; I Equipment/matefials islavailable to absorb and contain any small release of . " testinguliquid which is‘ discharged as a result ‘of"t_he~"test. ‘ (Examples include ”*‘ -'",;'f“‘f_ ;,4ff;l‘)%OT-ac§re'p_tablej_ ‘co_r_1_tainer_s__f“or "_s_to_r'fag<-': _“o=f_,; éabsorbent .__and' an adequate _i rt» supply of absorbent). ' I ' I 'I If the answer to any of the_above questions is @, stop the testing procedure IMMEDIATELY - until compliance is obtained. . .~a . _ .< COMPLETE REVERSE SIDE' p as. - -v, .< - TANK INTEGRITY TESTING INSPECTION FORM continued~ Is the following data consistent with the information submitted on the application for Permit To Perform Integrity Testing (PTT)?A YES[NO I. _ Ii t § The number of tanks being tested I i Testing company P ___ ‘ \ / ' F 7P 1n\ so -, .fl .I . 4Lj¢5'§' Test method used V A °* Pi @(l’ P "v@*# 2:5 State Licensed Technician 65 sitg|!g“*'3 s v- -:;\~ .. R 5&3’ State Licensed TechnicianZs_#m_ ‘ ~ '-= ,1: 5/, Zr; Is the site layout consistent with the application plot plan? State exceptions for any NO answers to the above questions: I CERTIFY THAT THE AFOREMENTIONED FACTS ARE TRUE AND CORRECT UNDER PENALTY OF PERJURY. (Not valid if not signed and dated.) Signed this 5 day gf , 19 96, 31 Bakersfield, CA dale monlh city and state /%é/4€?:;”// T‘P ,-',,~ I 4, ~_ (stow. ¢’- ician on Site . ' ; DO‘ -s M. YOUNG -* ' (PRINT) - State Licensed Technici Site SI-IM54 Kern County ' Qtemal Use Qy Environmental Health Services Dept PT!‘ No [(97 # Tanks to Test 2700 M Street Suite 300 ' Test to include Tank only Bakersfield, CA 93301 Tank/Pipin (sos) 861 3636 PTO No @020 Appl Date[v'/ 0 jg ‘ APPLICATION FOR PERMI'I‘ TO TEST UNDERGROUND HAZARDOUS SUBSTANCES STORAGE TANK POST ON PREMISES \ t» ciligg I formation Kern County Environmental I-IealtiLServices Dem, PCUTIII to Operate# (If there is no permit number. an application for a penmt to operate must be subitutted and approved before the permit to test can be processed) Proposed Test Date: 2/5/I 95 Faculty Nam¢ -Mikuls Pumpkin C_enter Trick T€"_Lfl“1I1al - Aqufgss ..20l .Taft H1,,‘i*:ay, » i.."ip"1:" CenterA -buJNt- SIZE PRODUCT AGE OF TANK COMMENTS 10K 1OK- 10K ~ ‘8K Contact Person Day Allen Mlk11lS phone (805 )832-5390 Unleaded U Night ‘ Phone () Tank Ovimer Information Owner Name Allen Mlkuls PhQn¢( ) Same Mamng Addfgsg P. O Box 78197 _Pumpk1n Center, CA ZipCode 93383 Testing Company Information - Company Némg‘-‘Confidence 'UST Serl/'_1ces,__lnc:__ Addmss 417 Montclalr Street, Bakersfleld CA 93309-179'6 Contact Pgrson Day Cheryl YOUHQ Phone) Night Phone (____ ii Worker s Compensation Insurance # 1 3 O 8 3 71 Liability Insurance #- ASR1 00502-1 Test Method Used AES System II Overflll " State Licensed Tester Dvuqlas M Ywng' State Licensed Testerh# 90- 1075 TH|$ APPL|CAT|QN BECQMES A PERM|T WHEN APPROVED ,_I p'1'r# //@§-IQ .2 . . . . . . . . . . . . . . . . . . . . . . ..POSTON PREMlSES....... . . .. commons AS 1=ou.ows=I 1. It is the responsibility of the Permittee to obtain permits which may be required by other regulatory agencies prior to beginning work (i.e., City Fire and Building Departments). 2. Pennittee must gig the Hazardous Materials Management Program at (805) 861-3636 twenty-four hours pg; to tank integrity rest to allow the Hazardous Material Specialist the option of performing an inspection.h 3. Tank integrity test must be per Kern County Environmental Health and Fire Department approved methods as described in Handbook UT-20. 4. It is the state-licensed tester’s responsibility to know and adhere to all applicable laws regarding the handling of hazardous materials. 5. The tank integrity testing company must have the state-licensed tester listed on the permit on site performing the test. 6. If any tester other than the one listed on the permit and permit application is to be utilized, prior consent must be granted by the approving specialist on the permit. Deviation from the submitted application is not allowed. 7. A modification permit must be obtained from the department prior to exposing the tank to retest or investigating a release or failed integrity test. ' I I 8. - The following timetable lists pre- and post-tank integrity test requirements: iacrnant. _ naantma . .-- . . . - ~ ~- r'- ~-'-. .~ , .. . _,...‘v->-¢-24----"cu;--Q » \ - .a_¢...¢ . —_ - “ _ “' "_‘,, ,, * ,,-v -\ v<|l M ‘P Complete permit application submitted to ' _ ‘ ' ‘At least one week prior to tank the Hazardous Material Management Program integrity test , < Notify the approving specialist At least 24 hours before test of date and time of the tank integrity test Send written results of a test to the No later than 30 days after testing approving specialist is completed_ Notify the approving specialist No later than 24 hours after‘ of the results of a failedfinconclusive test completion of analyst l I RECOMIVEENDATIONS/GUIDELINES FOR THE PERFORMANCE OF A TANK INTEGRITY TEST ON UNDERGROUND STORAGE TANKS' This depanment is responsible for enforcing the state laws pertaining to underground storage tanks. Representatives from this departirnent perform inspections to ensure that the job performance is consistent with permit requirements, applimble laws, and safety standards. The following guidelines are offered to clarify the interests and expectations of this department. l. Job site safety is one of our primary concerns. Tank integrity tests are inherently dangerous. It is the tester's responsibility to know and abide by CAL-OSHA regulations. ‘Die state-licensed tester is responsible for any other testing company employees on the job site. Tools and equipment are to be used only for their designed function. p 2. Properly state-licensed testers are assumed to understand the requirements of the permit issued. The tester is responsible for knowing and abiding by the conditions of the permit. Deviation from the permit conditions may result in a stop-work order. 3. The testing company will be held responsible for the post-test paperwork. Analyses documentation is necessary for each site in order to close a case file or move it into mitigation. When testers do not follow through on necessary paperwork. an unmanageable backlog of incomplete cases results. If this continues, pro':ess‘mg time for -sopleting new tank integrity tests will increase. " W _ 4 , -. ,__.. . M -- .-,\._... -—'.a.\_.‘,_ _4 THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WHH THE ABOVE CONDITIONS OF THIS PERMIT AND ANY OTHER STATE, LOCAL AND FEDERAL REGULATIONS. THIS FORM I-{AS BEEN COMPLETED UNDER PENALTY OF PERJURY AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT. Owner's Authorized I Signature Date Representa' ' Date 1 0 '9 96 INTERNAL usa ONLY / ,_ -_‘ ~ TotalFee QC PaldOn /0 /0 /" . /rt Permit 5.2- Receipt # Cash /_ eck# Date 441'///760 Fee Received By M’ I Permit Btpirarion Date / '//— L THIS APPLICATION BECOMES A PERMIT WHEN APPROVED z F I-[M44 ». I I _____ 7 -_7 *7 '7r 'I ‘h - _Kern County‘ i Use Ugly4 1 .. Environmental Health Services Dept. PTI‘ Now # Tanks to Test 2700 M Street, Suite~300 J Test to include: Tank only A ’‘ B8kCl'SfiCld, CA 93301 I Tank/Pipin , (805)861-3536, ‘ %" ' t>'ro'No.@flZ0App|._Dat¢ZZ'/vfifi » . . APPLICATION FOR PERMIT TO TEST UNDERGROUND HAZARDOUS SUBSTANCES STORAGE' . .‘ POST ON PREMISES _» ‘ . s )._ _ ~». ' A. " Facility Information ' t ' ' . -V . ~ - I», v~_ \\" Kem County Environmental Health_Services Dept Permit to Operate -#“ Y (If there is no permit number. an application for a permit to operate must be submitted and approved before the permit to test can be processed).4 Proposed Test Date: A1 2/5/95 . ' ' y ' 1=a¢i1i;yNam¢ Mikuls Pumpkin Center Truck Terminal‘ ‘ Address 2201 _11‘aft Highway, Pumpkin Center, CA~_ sh TANK # SIZE PRODUCT AGE OF TANK COMMENTS J>wt\>»- C iese _ ’ .t Q ' . 10K 1' Unleaded.Sup. 10K Unleaded Prem.. 8K D' l A' ‘Contact Person Day "Allen' Night » Y Phone( ) '‘ B. -t Tank Owner Information is Owner Name Allen Mikuls Phone (__) Same ]\/[ailing Addf¢53_P. O. BOX 78197 » 4 Pumpkin Center, CA ZipCode 93383’ C. Testing Company Information " A » Company Name Confidence UST Services, Ino.. Address 417 Montclair Street, Bakersfield, CA 93309-(L796~ Contact Person Day Cheryl Young ‘ Phone(§305) 634-9501 Night ‘ Phone (____) sWorker’s Compensation Insurance # 1 3 0 8 3 7 ll u ‘ » ' Liability Insurance # ASR100502-1‘ Test Method Used AES System II Overfill State_Licensed Tester D0‘-19185 M- Young State Licensed Tester # .. 9 0 — 1 0 76 THIS APPLICATION BECOMES A PERMIT WHEN APPROVED Ix“ ‘ _;1'\§ 5, i. \ \\ -“‘- ~ a_, -_ l I l p'1'r# 779$-Q _. 5222.2 .2 . . . . . . . . . . . . . . . . . . . . . . ..POSTON PREMISES... . . .. CONDITIONS AS FOLLOWS: _ ' ' ‘ . ' __ , ‘,- ' ,_ g_ 1: It is the responsibility‘ of the Permlttee to obtain permits which may be required by other regulatory agencies prior to beginning work (i.e., City Fire and Building Departments). 2. Permittee mung the Hazardous Materials Management Program at (805) 861-3636 twenty-four hours pgg to tank integrity test to allow the Hazardous Material Specialist the option of performing an inspection. '' 3. Tank integrity test must be per Kern County Environmental Health and Fire Department approved methods as described in Handbook - UT-20.- 4. It is the state-licensed tester's responsibility to know and adhere to all applicable laws regarding the handling of hazardous materials. 5. The tank integrity testing company must have the state-licensed tester listed on the permit on site performing the test. 6. If any tester other than the one listed on the permit and permit application is to be utilized, prior consent must be granted by the approving specialist on the permit. Deviation from the submitted application is not allowed. ' 7. A modification permit must be obtained from the department prior to exposing the tank to retest or investigating a release or failed integrity test. 8. The following timetable lists pre- and post-tank integrity test requirements: ACEZIH DEADLINE Complete permit application submitted to At least one week prior to tank the Hazardous Material"Management Program integrity test~ Notify the approving specialist At least 24 hours before test of date and time of the tank integrity test Send written results of a test to the No later than 30 days after testing approving specialist _ is completed Notify the approving specialist No later than 24 hours after of the results of a failedfinconclusive test completion of analysis RECO1\rIMENDATIONS/GUIDELINES FOR THE PERFORMANCE OF A TANK INTEGRITY TEST ON UNDERGROUND STORAGE TANKS - . " This department is responsible for enforcing the state laws pertaining to underground storage tanks. Representatives from this department perform inspections to ensure that the job performance is wnsistent with permit requirements, applicable laws, and safety standards. ‘Hie following guidelines are offered to clarify the interests and expectations of this department. _ -- 1. Job site safety is one of our primary concerns. Tank integrity tests are inherently dangerous. It is the tester's responsibility to know and abide by CAL-OSHA regulations. ‘Hie state-licensed tester is responsible for any other testing company employees on the job site. Tools and equipment are to be used only for their designed function.~ Z Properly state-licensed testers are assumed to understand the requirements of the permit issued. The tester is responsible for knowing and abiding by the conditions of the permit. Deviation from the permit conditions may result in a stop-work order. 3. The testing company will be held responsible for the post-test paperwork. Analyses documentation is necessary for each site in order to close a case file or move it into mitigation. When testers do not follow through on necessary paperwork, an unmanageable backlog of incomplete cases results. If this continues, processing time for completing new tank integrity tests will increase. THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ABOVE CONDITIONS OF THIS PERMIT AND ANY OTHERI STATE, LOCAL AND FEDERAL REGULATIONS. TI-IIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT. Owner's AuthorizedK Signature Date Representat ' Date 1 0/ 9/ 96 INTERNAL USE ONLY ma] Fee 0 / Paid on /0 ,/0 Permit $7/A Receipt # Cash K eck # Q 756 [fie///750 F R 41/’' Date _ ' ee eceived By I 1' ‘' Permit Expiration Date /’//" . - ‘A ~ 1'1‘; u .1 rms APPLICATION BECOMES A PERMIT wt-ten Aabaovéb 2 HM44 CONFIDENCE‘ _ ~ “Compliancewith Confidence" _ ,. _SERVlCES,lNC: ‘ ‘ .3 " » ‘ ‘’ ' -A ' ' Clctober 9, 1 996 ya}, 3, -' ~_*e-v- -»~,§q_ 9 '1-;~ n -_-..~ ;_- .;_.\ -1---‘ . _, <‘-“'*¥'-i"*.’ i=.¢;._.i3i>,<i%3}5<- .= * . T “ \ M *-- Hazardous Materials Management Program _ KERN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 2700 —M~ Street, Suite 300‘ Bakersfield, California 93391 r*' __~-u. a. .3 ‘ .$- ~._--a ‘-_, ~ .-A ~ '—-‘ ~ ' ' 1 . 4 -\ \. an To Nhom It Nay Cbncern: ~ Enclosed for "approval; please £ind- original of Application for Permit to’ Test Underground Hazardous .Substances -Storage 9Tank, along with aur check in_ the amount.o£-$32@.Q@, as and for your permit fees herein, ' The fecility to be tested is: Q Mikuls Pumfikin Center Truck Terminal‘ 2201 Taft Highuey é ' ' _ Pumpkin Center, CA V$ Attn: Allen Mikuls' Tele:_1 532:5) 92.32-539:2»A December 5, 1996, at 5:09 a.m. 5‘ - Please reflurn £he\ approved fierfiit and iee receifit to . our office. '' t , .» .= ~w<v-;~-.- v*“u -;. -. . _,_-....~— < -I.‘ _‘_'. v ~ . ‘ ' ~ _ ~' ' »Thahk you for your attention heteifil"'“' . v“Yours truly,‘ _CONFIDENCE UST SERVICES; INC. By - ~v ,7 _f .. .9 ' Che yl A. Y ng, Vi'Presidnt ="Enclosuresr. ' ‘ H 3 M f"" "ei* "" i 417 Montclair street . Bakersfield, CA 93309 (805) 631-3870 0r~(800) 339-9930 > ' FAX(805)63138723 ,\ .--,- ,_ .-u ~< ‘-_ cg» S‘: ».~....».-. . --1. . M» ¢.. -- ><~- "'- »»\ - -. .» _ ‘ . .; .|..-...-.,.- < 1. -1-- .; J :1 .=. -§,‘ UIA -0 .\ _. ‘~. ‘ ',“_'\‘..:-‘ . - ¢ - .1 f ., , ~» -\ 1 p. .,. ..n¢\ -~\~-- 1- - - -‘ "' . . , ..¢ . _ r ___’_ .‘- - . .- ,-1 '-.. _ _ ,_ 4 .. .. .. .,,, .---_ ¢ * ~ 4--¢'" i _ _ ,_ _ . . . ‘- _ . § - -w ...»| *'-1 p .. -w . L '\I‘ .. >~ __ .), - . _ - ..' - " *‘ .. . _.-,-‘.-....-<»‘.. ....,vr»..».-.,.._-_ . ,-- - .-.. >..<.- , .- .., . ‘I-. ‘x 1 '. 4‘ - __ . l. 1‘ ' ~ g4 ’1 ,.... ..... ... . ~»*--‘--*""‘ - ‘"'“"*""*’ ““" ""'“ “U' _"¥' \ ,. ' . . ’ Q - I' - _| .. b 0 ' '- ,r..-.?.-_.-_. I-Q‘ . |', 4 y .,., ‘ '_ I .. \.. .-\ ...- - 1 ' ' “ ' '17" _ Y _ -‘ ’_k >.~ " '.‘ .4» .... . . ¢-- '-- ~ ~- 4» - -_--_v--"" "-P- 1.~\r~" "‘ 1 . . / , 1,] , . ,_..,.,, ... ___-. -~-1....» -.-.-. »- ~>-~ -~ -~ - ‘ '\ .~‘.\- . /- 1 - -_ », 1 . . i w. - 1~ . ..>‘. ‘ . .1 _ _ _ .-. < -. ' _,¢, ‘ ' 4 ¢V\.’_v,_‘..§". . ,v: 1 A. 4.,“ ‘ vi, A ’,_@ -A f, _. _/ l M =1’ Z: 3» .6 ' r _', K“ ‘ ~~.v .... ' ~ '9' -. ' < l '_'.':~'Q . , » .. .- ___ dI‘- . 1,; ... ...-\~ ‘r__ ___ >M____ _ ‘ I 0 .. -....~... _ ' 1 14 .<.- ‘- _ ' ._ . -0 .. _ z~.' P 1 v _ _ 1.-1 1 ' ‘ . 4 x 1 | 1 i I 1 3 I \ 1, ~ ' 7. Jr.-1-PAL M A-llhllx A »' 1 ‘\1 4 -' ' ' V l.'.-»:- l4...L.<“'..--'.- 1... Li».-slflii-53-M-d$';Z1.iIfl'-UN‘! --‘*1-I?’ .-—-- — Y-~ ~-~= *1-.———— ~- —- ---=_-——— ;~_..,_,.._.-. .._ .4 -, -. . lx -"- vf1 . . I ' .. “1 1TAkDil( I?l\(3]II.]I1T§( A\I€liIJl\Ii flI3I?C)I§TP Facilityi/7A7/K/v[.>"?V§)£’v_5‘7é9f Permit”? Z.700'£0Q:,'_Month'('\iIr.‘v I 4; 4 J 1. *1“, I i . . 4 _ I ' {£1 I-".==1'-.. 41.’, .f..= L n..-‘5,~- ;_~‘;p'r~; ’3.~‘:, :7 I have not done any major modifications to this facility during the last112 months. - - ~» < 1 -‘- - -1-~ ~. .J ~.»--1 ‘-' -,1 2 “*2-2--,..-.-g.~.-s.' ,, ~.:r' 1";.'\' ‘ _ Signature J V , - _ I .\ ,-- .~a...- Note: All -major modifications require a Permit 'to Construct from‘ 2. I have done major modifications for which I obtained Permit(s) to the Permitting Authority. . ' Construct from Permitting Authority ' e 3. ‘ Signature ' . - ' Permit to Construct # Date ~; Repair and Maintenance Summary Attach a summary of all: P Routine and required maintenance .done to this facility's tank. piping, and monitoring equipment.~ Repair of submerged pumps or suction pumps. Replacement of f1ow—restricting leak detectors with same. Repair/replacement of dispensers. meters. or nozzles. Repair of Velectronic leak detection components. or replacement with same. ,~.». ..' . ¢ 1 ~" 'Installation of ball float valves.;‘ _ - ._ ,-.u 4 ;4 ,LOL Installation or repairgof vaporirecovery/vent4lines¥415if?:il33%~ flnglude theqdate of each repair or maintenance activity. i‘5"1” “’*: l-L.-" ":'*. '“. P ‘ C I ,L,--"1" -;' .¢_ -3.. 1 is vs "T “ @:u."‘ ..Q NOTE: All repairs or replacements in response to a 1e£k require a A' . »v"“Permi "to Construct from the Permitting Authority asmdo all ' 4. other modifications to tanks. piping or monitoring equipment not listed here.' Fuel Changes - Allowed for Motor Vehicle Fuel tanks Only. List all fuel storage changes in tanks. noting: "A' Date(s), tank number(s), new fuel(s) stored. 11 '9 5. Inventory control monitoring is required for this facility on the Permit to Operate, and I have not exceeded any reportable limits as listed in the- appropriate inventory control monitoring handbook during the last twelve months (if not applicable. disregard). I6. ‘ Signature C ‘ Trend Analysis Summary ' 1 Please attach Annual Trend Analysis Summary for the last 12 periods. Meter Calibration Check Form - -I Please attach current, completed Meter Calibration Check Form* 1 ,,: 1.‘ '‘ -q 5 _\ \ -. ‘1 _ _ _ __ ___ ,___ ____fi___ ___. , --,... A ,_-~--_V,.--2-/....¢-__._-¢ -__» -‘;_..:\_’7.;~.__._........_.-__-..___,_ r' s . .. ¢_ .~ » » -.- -_ .» _._-... I. _-- . _-.._ _ ._ ,.. --J‘--Y ._ _ 1- _4. --__~\ \. - \. k ‘ ' I.‘ ' . . . _ _ \ _ ._ \‘ . .' ‘._.' ~ r -\-\ ‘ I .15 ~ \~ ‘ 3,‘ '..Q"""' 0*’ -r'*3§?~§ ~‘ ~ -I .. ~~-*<,.— DEPARTMENT or WEIGHTS ‘argausunes 4:! I. t..,,, . _- 1?" ‘ STATE OF CALIFORNIA °;§¢< I ' ' “ ‘COUNTY OF KERN ., :7. u ;.; - 0 - "- 1116 Eat Calltornla Avenue, Bakenfleld-93307 ;'r'~. _ - Telephone (805) 861-2418 - ' Certificate‘ of Inspection K 22014’ , - This is to certify that, in accordance with the law, I have tested the weighing w - and/or measuring instruments said to be the property of or used by: 1 *1 R O6///fi 1. '§,_‘ _ DIATE 7 0_19_ _ NAME ~/\’LLL/,u/ 5’ W//_u .1/up/Q4; CZ§»?§Z° 4”’, ..A00nsss%7"/99¢),/, _/ .b~"'I T/i§_4_,.fi14,4 V ‘ 13/ ‘ FORMER ' NAME: ' ' /"/§p-»*i43- 506 f‘-3» 0E8Cl\lPTlON_ . IN our ml» 1'01’. ans. ii/“¢’?iV¢»<,.é ;'I\'E'5~e»Q $e'_*.“_/‘ Q" ,;_i.[ge/’A1’/'>,QFIp"5/.&</1/1§.e <\ ' J A 1‘r if - J W ‘ ’ V /\ K/(Al: XL I"/Q 175*. -£0 1&1}-/Q1 um/_ / S79. t Q‘ 4i0r;»,Vr’ J * R‘J Lila/* fly/,J,.;’,» téeil/X4/Ht] mi”,k ‘C4-/Z1; r¢,,’;‘71s;'A//‘é 4§'*v(.e/it /it 6|’!/v ‘Z ’ <2) f/if.‘ ya. VR ~ Q °' V' ,-__;'_2'€’D( Gala. [9/es;/i) ZISJQ/:7 _: /1/1 #66, "pm?!-Ti i/bug? 4/QMLQQ//. 1/-I 3;-_Ix 1 I 4-- . V , I '\ 3%/@<Z,'j '/ Q jlejé’ Q&,l¢’Tf7( TO; as 9/5;/;;|@J€>§,o'ei=ii:jQTvr§o_Yliia_$i_~e7@R2‘%/5 i _'r~i'.o.vI'"\_//.Yesi1- 1 ‘ 4 .1 .'; ' “ . 'i~.","' I.» » 4 ' » . ,_- ._~-t ,_ t - —. ,r= ‘-‘ ' .' " ' ' "v \ ' 5 . ' . “‘ , ". 1~ - *'1 _ , c _ ‘ . 1 . iv-t->1 - " '1 .‘ - ‘' O,WNER OR AGENT MONTY H HOPPER DIRECTOR J _.. - "'1 .14 . :t~..=t; ¢;.;:;;>:4>.=;.i;-»u;i’W¢wvis;@_'Me=¢-2:9'=¢=g.o10@<néy».;4s2>.-¢t ,.-H.-.1 ..>1 4'-ti 54'..>4-1.:=»se.21;mite-.w:»t>:.¢»a+2:;’r§~¢gL,‘#*§§ea»»;-14»$>¢Z~2~.¢.t\.¢=¢r;w:a¢_¢>'1:;»1u.='>.m;=..u=i:s. ¢-- v -. , . -,. .. J ‘ .- 1 V "‘ \ - _-. . -~ _-. . . -- - --- » - '- . ..;.. . .1 I. . _ . _ . . ‘ * I .\. \.u\-\._ , ‘ - __ - ' '\ :*:“- L-' . ‘F ‘ ~. .\ ' ' _. . , . ,. . I '\ \ .,1 .. - . ' ' ‘I _,K _ ' DEPARTMENT or WEIGHTS 'A|.nEAsunss ’¢¥/ ' ' couuw OF KERN STATE OF CALIFORNIA ~ ; 1116 East Calllomla Avenue. Bakersfield-93307 1“ ' . Telephone (805) 881-2418 2 2 0 19 ' Certificate of InspectionK This is to certify that, in accordance.with the law, I have tested the weighing 1 _ and/or measuring instruments said to be the property of or used by: 1-4, Q" __ . ‘ » jDA"l’E ‘*4’ 19? 1‘: I ‘ . _ __ H NAME M1t,K/M 15 7‘:/Lin Lgjfi-'~’L\ ,.. - :1, ii ADDRESS M4} * 11>}; ' Wl_:t,_ut)€ /CC/<»<j,i4_ 4’ §‘Z'§i'€;EB » 1 M619» $4’ 3<x?\a DESCRIPTION IN OUT 9'7"" TOT. NR8. \ 4‘t_pi-;iZ</i/I‘§J/'1___./' H V ., /1 i K//(,1 AAII7) M1410.’ </6’.-A‘/{,4?(~£‘) __ V v mi .s ‘ _ '1 t§Z> <34/~44, . ipflpxe O L u HZ, .,/\,;diM/i»uj/ . ] ‘--n I ‘*1 ‘A .. ~ /x/1_?/Cue, pd Ti/1 /25-4 1 Y 4%r ' REPAlRED/CO§§ECTiE'D'.BY-' " ~.o.v. ‘YES N-Ot_4"B&P‘/CCH sec, I- tr ' .‘ ». - QWNER OR AGENT , MONTY H. HOPPER. DIRECTOR ,-liswecwon e as M -1-.',.1)h;, t I _ 11 /»'~ 0 . .1" \t ~w~,. ' »_ » .4. -.- 1:;1 ‘I' \> é. ,. I vr_ *3’' :3, -'7,‘ r?;‘,-. :51 1E Eu? . is-*. DEPARTMENT OF WEIGHTS ANQEASURES .. _. __._._’, ._.- _.J ___,’-__..’_ L.’-.7; . ._._.I_-In__.__ .\ I ‘_ V _/ T. . . _ _ ._ _ r _‘ coumv OF KERN ' STATE OF CALiFORNlA 1116 East Calltornla Avenue, ‘Bakerstleld—93307 Telephone (B05) 861-2418r 4 Certificate’ of Inspection K 2§394 ~T his is to certify that. in accordance with the law, I have tested the weighing and/or.measuring instruments said to be the property ot or used by: DATE Q” 1?} NAME /Z21 t/>/14575/vi (c(,17\@i/~ urk. -ADDRESS/J7 ?fl1.‘>/ V ,/ "W ~ //j~Q4;, E», %A>/pt/wji ' A T 535%?“ M6/Q-4 500 A oescmrrrou ' m our O1H=R1'o1'.m\s. E’;~ Mmm 45 i*.»‘- . "L Awe pee,“//2 /<a.»,.1.7,5im 7[</1/1/Q1—i— /J6 rim. 23,:- I i,»A .\' ii._ 5?»: iii,‘. 15$‘-'7) f _¢ I4 fi _ \i K.t fir;= 2,= '1". K Ir‘!V fl°' 1r =j___ - 4;-Vb. _. ;i.-, -I‘ ">$N in.“V 9 ) \‘rQ' 3'31’. ryr‘. ' ?.1 -'t*% . ;,\ fl c “To BE.'REPAILRED/CQRFIECTED=,lBY - , , "Q Jr‘- :J"‘ '~ _. .> “ _.,\ -N.O;V.‘s'.-,L,YES_, ."NO_-1.-=B&P'/CCB,SEC.'-7 _ , *4. - . -‘ti, 1-» ‘ 5. ‘ ~' "' 1‘: . \"" '. ~ \ ‘_ .v.r; ,» » -. -- - ,1 ’- ,._- ‘-_ "-.|' M, - . ,»-.' ‘ . . ~".~ . ., -. -~2 OWNER iota‘ MONTY H HOPPER DIRECTOR \A F" \"r A“ Y 2 ‘$4-)/...'~-I~sPE¢T0nt , I, . . ' , 5"’ xi A‘ ‘Q .‘.?Wéig‘rits=&' Meas. grip/‘ésao 010"i(Rev.t3l'92')“ t 1",-=1’.-'13‘; ‘J.-'--_‘~l"% "-I-if-'._'1 ~‘.' -,v “- .4, y ————_ ‘r,>/;»’fl7 791 P319917’? Z'9/ /0?1'£'§;jZ"I¢'¢7Y“7§/?'3Q"'9I7?97?9;4' apwnf-fr); *777)Z/”"7'6;5/.é" k M é “I “ “ “ " *‘ vi'”’”"""'"73mW Q5/"F1"/2'12-;/» ‘“' "*"'““‘“**"“9‘—*;§“ '/WW4’“'§,i>YHw“"9i9a7a;y*"?;-/;.@/ 9'2/ra ' ‘W N n z ‘ "-<3’./Wfiiw‘ Will £'!"f'5'_/'90 ““""“'“'a “""“ y/¢Q‘:“?;'i/2'7§vI>‘ ‘rm?/v]"j":a’uiW‘d’>*j "9? 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OUARTER1 3'/I‘/"if H to 2’/0'91)’ , PERIOD 1: Total Minuses Action Number PERIOD 2: Total Minuses I Action Number -PERIOD 3: Total Minuses x . ». ~~l A Action Number ' I QUARTER g TIME PERIOD: This Period (Line 3) [3 for this Period (Line 4) 16 This Period (Line 3) /4 for this Period (Line 4)’ This Period (Line 3) I _ for this Period (Line 4) -i » &'\V 94-//~91 to / 444 ‘PERIOD 4: Total Minuses Action Number 4 PERIOD 5: Total Minuses Action Number PERIOD 6: Total Minuses Actfion ‘Number §.:n“1:I'ZGJ iv %~*.r1==-"I QUARTER 3 ~TIMEnPERIOD£? This'Period (Line rs) [14 ‘_ for this Period (Line 4) This Period (Line 3) for this Period (Line 4) This Period (Line 3) for? nus‘ Pei--ma? (L-‘i'rie"=‘ 41¢! ' ‘Z' _ _ - _ ‘ 4» ... _-.>=.‘ -~..‘.... HS ..»~_¢ ».~.<. 1-- ;;.7t 5,1‘. .;-,.',e- ,,~. - . ;_ - Y A .\ '» ?'.?<+ 4-*4) Mclow-1v ' PERIOD 1;: - Total Minuses 4 Action Number PERIOD 8: Total Minuses Action Number PERIOD 9: Total Minuses { - Action Number QUARTER 4 TIME PERIOD: PERIOD 10: ~*Total Minuses ‘ Action Number _:PER-IOD' 11; Total '.Mi'nuses .,.\.7.4\ )1’ _, i.w..= J a: .. »:A'c.t§.’.i On? : Nlinibe I‘ ‘ PERIOD 12: -Total Minuses 1.Act i*"o'n L Number This Period (Line 3) '" [Q ‘E for this Period (Line 4) This Period (Line '3)' for this Period (Line 4)“ D This Period (Line 3) I for this 'Period (Line 4)2 .§-'3/45 ts /0'7"ZK This Period (Line 3) "I for this Period (Line 4) u' This ‘Period (Line 3.) K‘ M' r‘o€ thi-s“Period u.=:1"ne” 4)_.§. "‘"['.Q'0"“~" This Period 3) for i-thiiis '.Peri‘o,d zunsne <14») ""'”-'-:[ Q.'é“““""' _ _ (.0. -...v ._ .1’;-.‘..@=..» ..-H,-...--..~ 1- . . I u _ N , ~. I hereby certify this is a true and accurate report". l _ , . . . ¢. >~ _ vsignature ; Date. 1- ,_ * .. "' E 1§.<;"" X3 ‘ I ! 1 'w i ) 3... ::- *2?~ 4» .. Z3 ,_ .-_ . II L’, -.\ J .-'-3‘ >,, Y ;vg < ,. ~ 1'.-1>;_r»': v' ... ._ ... .>.. _.\ -',',_~,', ... .1 ‘ !vs'--.r\ ‘M I . £3, _ . e,s:,. .1; \ " 1‘ 7.. .. - .\_ ¢ \ . ,3._ . . .. .. .....- . - . . . _ . .- - \. __.~ -‘. .3. . ._ --_-A<- .‘, . ._ =_,1-_r. . .. -"¢;':==. _; g . ~ .> \ .\ 1» I _‘ _.. w - ,. .-< \ n . . .-¢ ._"-=1,‘ 1'1; -- ' ‘,' - -.- §~< ‘M- ;‘L‘ :‘..-' ‘;!_-: _ H vi-_"E_ .,_1..‘ |_i\?|_‘_:_ Q) “H|;Jl|1_d .. 1;; §_1:=1 ' " .1» ' - " \_ .... ..-._ .. . .._ ~..~ ..~.‘ ,.1~‘- ~~ :1 ;, *, 1. '- 4 ~- l _'.. .\~» _ -I.-1‘...-.. -< \.! . .. ‘ * 7. Z: ‘\ ‘E \ ml‘ \n -' ." ._ \> 5... 0< ‘r. ~‘\_ _. \. 0|!- ‘ 1.. | - <. -s \~ @':'.“:.-: ."‘ wfili *~\‘- .~ 1~- .-_-.-. .-.. .._ q_-...... __ ~.~- _h_~fil'; -. . ._... .-.- . . .> -... .~_ . , . -_ ~ ' ' ' Lu _ II 7. _ , . \.’\, ‘\ -\ '. .‘ _' ' -.1‘-1 iALhB§1dI$l7Ilv¢]\‘S=’13&’I\-All‘£'\‘:\'_"JI!i 1- -L1 '°"""""""'-“'““" ' ‘ "" "um-“ u‘ M ’>_’__ ) ) ANNUALTTREND ANALYSIS SUMMARY TANK # 3 TIME PERIOD: 5”/‘/ '75 to =/‘:0-7-74‘ )l ) 1 ) WI QUARTER1 PERIOD PERIOD <PERIOD QUARTERE 'PERIOD PERIOD PERIOD QUARTER3 PERIOD PERIOD PERIOD QUARTER4 PERIOD PERIOD PERIOD 2: '3: 4: 5: 6: 7: 8: 1: 10 11 12 ’ . TIME PERIOD: 3-/4-9:” to 2-/so-gr ’ Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number < TIME PERIOD: . .I This Period (Line 3) > A for this Period (Line 4) 30‘I This Period (Line 3) - /:2. for this Period (Line 4)A This-Period (Line s) _/3’A for this Period (Line 4) ’ $rj' 5' A _' . =1 »~" 8~//'95" t_o A/»a-94"§ Total Minuses Action Number Total Minuses Action Number Total Minuses Action'Number TIME_PERIOD: This Period (Line'3)‘ '[Q This Period (Line 3.) 1 1'?"' for this Period (Line 4)‘ 8-S’ This Period (Line s_)' /"/V' for‘t‘his Period (Line 4') A -' ,. /-'3"-94', to. ‘5"~.?_O-9S Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total_Minuses Action Number This Period (Line 3) l“Z~ for this Period (Line 4) [1Z This Period (Line 3) 1;; for this Period (Line 4) [3:? This Period (Line 3) ' for Enid Period (Line 4-) ~/'-I II This Period (Line 3) /4] for this Period (Line 4) [A7 This Period (Line a) A [ii for this Period (Line 4) [93 This Period (Line 3) ‘ " //~ for this Period (Line _4) 1 I hereby certify this is a true-and accurate reoort. Signatures Date 44» Qrfé I - _e ,‘ . .‘) V \. for this Period (Line 4) 59 "' ‘. 1 if-2/Jjét to /0-72% 1 ' 4. v-1 1 1 4- 1 ,_¢- . » -1. - - - -.: tr “ LI .-Q-, .- ' "'!f1,Q ~ L-sf ' -' _ Q-:J'_ A ’_-. J} \ .__...-_-¢_»._ .~v... _-.c '¢ . ,4 ._ ._ : /. _ _ .1; "I-, I '\~ ‘ _ ,. 1\ _1 *. U. I, -.u< .3 *l- , - ' L". -I \~ . ~ ,. ¢ - _ -In "um!-*1 \.{.1F. $¢.‘.~I.. . ». .II;.'4fi=v ,',:--7_<- . I‘-i *\~k Z _< _; 2. '5 cw 4' . I '2) 'n'\u: [I :a‘ . -if4-- '- ,‘<1 .. ._...__~-. .__._.-. ~ -- -. .~\ .. .'."\_'.'.. . . . ...t ‘w, \ =~- .~ ;. -. r. .- _~. -. ..-¢_. -;.~. -.-» 0' s .‘ - Iv ,~ ;~- L _ _ _ _,,_ TANK# ‘TIME PERIOD: 7’/‘/'9?’ to /0-=7’)?! 0 QUARTER1 _ PERIOD PERIOD PERIOD QUARTER3 'PERIOD ‘ PERIOD PERIOD QUARTER3 PERIOD ' PERIOD PERIOD QUARTER4 PERIOD PERIOD PERIOD F-sud¢Dh~ Ii7.7'v\L\.L\ A3 \£\i.uJ.!;~ ..'.'; '1. $.~4nl-'4.¢.h._'.¢r....~n.2 air.-a_w,“q-4 ~_--o_--I -- --»——--i-— --— —-——s=_.~.u-- —-» (--— —— 7 '7 _ ‘vflél TIME PERIOD: I l\I§IQIJ1\IL_-UFIQEZDQIJ l\D¢1\IL\{E3]IE5 €3IJDdDdJ\IZ\? 3’-/4-er ’ ‘to. 2»/Mr Total Minuses Action Number Total Minuses Action'Number Total Minuses Action Number TIME PERIOD: This Period (Line 3) 13 for this Period (Line 4) Q0' This Period (Line 3) forlthis Period (Line 4) 32 ' This Period (Line s) fjO for this Period (Line 4) {Q 2'-//-<3; to /-'1-62¢= Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: _This.Period (Line 3) . ‘ for this Period (Line 4) This Period (Line'3) [ Z' for this Period (Line 4) 8.3’ This Period (Line 3) 112-s for this Period (Line 4) /€7/ /*7??4 to §~*90-'?.C Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action'Number Total Minuses Action Number This Period (Line 3) Z?' for this Period (Line 4) i// Z I This Period (Line a)_ /1. for this Period (Line 4)T This Period (Line 3) /it for this Period (Line 4) ' [H 9_ Y-2!-94~ to /0-7'?é This Period (Line 3) [Y2 ' for this Period (Line 4) 145* This Period (Line 3) /:2 for this Period (Line 4) A [36 This Period'(Line 3) -' [:3 for this Period (Line 4) 1 7%; I hereby certify this is a true and accurate report. Signature I Date - 4 d’ é’" _o \ I . U) l ! 7 ! 2 I\ ) -.- .~~ . » .' , =,_u --0 -~ ' . ' so \ . V "8)\4 K‘: ¢ \§§ \.\ »> ~ -1 “. ..\ \ .’ \ 1 _\ -_ _~... _/ fl-e A s -‘ 4 " '. * 0‘ ‘ v1 \-. 1 \\» (\" \ .. 1 "I~ \ ‘is 1 ‘ x\ \ * . \‘~. ".0 “\‘\\ .“ ~ ._ .. _ _,_ --A ~;{‘ _. \*-~_ I \“ whl-. ‘Q \ \. 5 ~"'~ \\ . ‘ '¢ ~. 2 v0s TIGHTNESS TESTING REPORTS - - EVALUATION FORM ' ’ » Specialist reviewing the tightness test report: ‘ ' I Z Z4/Q/L Date tightness test reports were submitted: /a2’!/52/Z}; V / Date tightness tests were completed: p Facility Permit Number: ., <5“ D " . v I PP’ Number of Tanks Tested at the site: 2/ _ (list the tanks‘ by their tank numbers if provided) be ~§, ,°*\9)' {' Was the method a test of the ervjgge tank syste , Or just the facility tanks? (describe) yd/.»( wk Q/are f6_.: Did the facility pass all tests: Ci Yes No (if no, provide the leak rate and a description of the tank(s) that failed the test) (failure is > 0.1 gal per hour) The facility will do the following to investigate the failed test: The test method certification that is submitted to the state specifies that eachitest method be completed in a certain manner. Is there anything within the results which would suggest that the tank test was improperly completed? Yes X No (describe) Information has been reviewed and placed within the database: YES NO Date entered within the database: /Q1- HM25 Entered by (name).3 -® F_'»érLL1NG"0RDER@ ,_. \ ——— ::_ wan» \ _ __ _ _; _ 4+1 ___ ‘ _1 P ‘I 0‘ - 4.4%:-;..v .' ' -_ V .Inv0ice Numb§v_m22iliiéwm~__ 1 INVOICE QDDRESS:' -a-.--_-_._._._...._....-_........__.._..._._. /"4//<u.L3 /‘%mPk//./75772 "7’?0,¢~K E/3/14//l//4c‘i ; P05@< 72/97 f‘ € P Q)/1»/P/8/.-/u'_?€6A~'1 — -..__ -~-_ _ ~ _' V - _ :- ‘_,____/_ Contact“ —_ _ '_ _ .7 __ V’ > ——_ _— — — _ _.=~~;_——- __,.___._-.= ____ ___-...___—_ V F... .-__...,..,-..-._f ,__ 1. YfiNK“LQBfiTION: V §—_W_““_ 1.2.2.0! ,’!"H .) '- ¢‘@*v*~»’- .- w.’ "qf'%‘~‘\v-ix?»-. ' " l'- . ‘V -“ L n n _ n ‘.\ J@4wfl§Q§Lf~<f;;;;»fi:f:' kJ COflfact:“ / *f;;;?*~'°fW§ ' _I§ken~by: J, “‘.__‘___ , DatéW r ~ / L//~2~ 25% hv, 1' A Sélgéflahi T1;-.~+~"=' A5 -/ _ _ h _ __;V~Te&hn£E£a h; W' w“ A- »-P"m‘ éx mg. -1> { L;¢j.f‘e;».= ¢ \ I‘ \_, -5;»‘./<> 9’/V4 \ Not1f ied:_ :;§;?U %%3*~ ~§§; ».\'~ Tfi 0;‘-I s __o& »- — .-—-.-__._-.. 4-P*__ — ' 7 ""‘ """' 'T@st'0é¥é T Eh_ _ hPhone _ ' ~;_ ->- v ---~~—»—-.-,___ WWM ‘ 7Téét flfié §. '~_’h= /-Q-_ -- 7? /Eiilgfiil; 5031.0 0. »_ 1 'EMERGENCY CONTQCT ’ . ’. = » . ("“ » 4 PHONE:\ I. ‘ _ , , 4 V . . . A ... =1‘~ I I I U’ . 1 , _ =_ ,,_W_-+——, _-, J .__ . ;~~ '_' —.;_.,_;;_<---~-»-»-_-gr _ _ I -__ , v- ~ V; '_ \ ‘ ‘ , ‘ ' 4 I-_ I, ~~ 1.. 1 -~~‘, _‘, 4-, ( .,, ._ > i HvnRfisTQT1c PRODUCT Laws féér RESULT SHEET. “ HES ;PLT~1m@R' _ J __ I \. STQRT VOLUME --A--— . bnooucr ---_v END» _. TEST‘ UDLUME_V uopume PRESSURE DIFF.(GPH) _-._—- .._- _— -— _. 4 ' l PQSS/FDILI '1 t ',l ~ Iii)/£551! 3 7 1, 1v.. 4...: ___ __;, ;=_._-_ I ,- - , _. W 1200;: ¢' .:z%mmn1w§fTy. 3",V V |;ZQ@;g;c%Qm' gag; '§ 52> :§QQ§? %‘%; 14 (S; N. -~_p 1-_ 50¢ ‘Q6293 .- I 5§;_! "0 \ _. I. Q, 1- fivfliQ,\ ." ray 5 | /Y1T~;" '»‘~,r% *~ ' ‘ ""'-- ’,,. ‘, 4»-v _ 1* \ M :" , M i ._ ‘M\ ,,\ V ,. ~.-'-at» . -»:"‘ , 15,.‘ i i*A I .,.‘_._‘.J 1* “" .;-;". v .' r13;, ' l’;tvr\'."v r ,\‘ _--' fl - Q...‘-.\ . . 1|~ . *z -_.-.- 1 *- "0' —-L -p » w -'41‘. ‘HQ 5.,’J Y‘ ' ,;,.¢'-r-'_, I -14” - "_‘;*:-1,; . »~- . 7 '__ ‘—.-—;---M1. ‘ ' . » V» . H' _._.._._ . 3'1 , a‘ . 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H '3, ;..- :. ‘ ,,'._ '- ~.~ ' . ~i'_ _ ‘.“_§,;';‘.",;; ,;\ ~-;__, ,_:'.,=.“_ j_ ..;:I\_- _} V» " ' _A _ .7, ; _ fl ,. _r,»¢:_..},| 1‘:-M--’.-er._V.)_»__ . ‘.5 j ‘R ' 5;‘ _ .‘.. : M, Vv.:1_-.,.,‘?i_x V . ._;,:..» _ . - -_. ». ---~ -,.=-.—_-=r--ap-,-, ' -_¢—¢— —_ ._---._-__ _ —=>- .v '.<;:...~a-~..¢,-"--¢»»_';--4.-.¢-.; — _ -1... I <._ ———.;._';_—<¢'=__.___ ~——¢'—s:_-:— I =-?-__: V»-_—~; -_-4;; _: Ix‘ I ‘_ 5‘ ‘,~,:_‘ __:v-1 ._f;;:\_::I_' . ,. ,~ _.‘_~ VH5 ‘A. _ V ~ \_v\-..v_M_ ‘ ..~-,:,_ . . E‘ 1. :~- .v, ’ ..;,3. - .\ 7 < , ‘Au .,“ .¢ . *-'7,»;,»‘ - .‘v »;‘ 4 - - L- 1-7,;,_fl@-h;;¢;P~+<%~-¢flfw1** J1,1a;¢;“j;iw~ 14. L.v._.,v ,1 B“. 1‘ _—‘-I . .¢~'w ' v ’. '1 .-.. _. <'\ ... ...._ 4 \~ —.- ~_ 1 - ~‘¢.‘ ' 1 TI --4 -- ._ .;,._>."-12;?» T -’ * " >W =_—'—— _~_- ,7 ';==-_—,_—_' ~ ___ —~_-»-, . Divide fihe volume diffevehtial by the tésf §i@e»('15 mifiutes) ana.A f I multiply by @.@158311, which will conveft the_vo1ume diffenential . . - . ' _r ‘ "F*‘9"1 mg1.1.1_-.i»1.-~‘1*=.§~=*‘*3§:- P‘"?»‘f";!-‘J ;P~s'=_1;%;; -*=_9_,;~s§A1_~1V;¢q!@§ . J;-4 yr '\\\ ‘ ." cancel out.- ' ~ “~1~":wH F.-‘ =- w',: * , ~9¥J3A15§m1}/min»flX;@@@1 II E .3-1' .i ~ The conversion constant Causes thé milliliters ahd minutés to >.-'1»;~¢w¢4&m#gH;‘ .“'§fl’~.~€f$§w@ 3*‘*‘“%“4hF#?*9a1““1°¢*;@i??3;#é#{b¢€%§a@'~~ /:3. ~.._ ‘ i _ . -I ~‘ I '“"7"*FfT#5fiL~r~i?*P“¢*7”@f~§%WQ?%T?$m@”~Q f “RESULTS GFKTHQS NQRKQSHEET iq $$,cQM@1gsp§‘ Jf" N "- 1 W i’, ‘ I H0} V ‘ :_.,_~_‘."" . . . I _/ The conversion constant is fpund;by ;' ~ 5, \1 '--~:. ' - t ‘ " " 3» . ' ' . ¢ '..' " ' ~- \ .‘. "A »If»~$_h@*-‘lfiv-‘B-1<;.¢1<"QPP@-§i"§3m'l @111. “1*_5::m-'lU~'.M11F3-15~.1;»|'39II,3»?/2'?’"; ' -, 1’ "r fl ,,'\ ‘ ' )‘’ . Iv‘ ;.‘-‘Y2\ __ .1H.. ’;>mg (em min/hr)/(379QYm1/gal) @“Q;p;5e311 (min/hr) (gal/ml) ,.§ ‘ ; 1 » ‘i1 .1... .».»:‘_ >_~;1-- _~,;fw»'1‘»-' ‘~,._'. '_ @mwfl§#%#~#"6w¢m@®fi%@mw;““ ~ - _;{ ; e" 's.' ;~k."','~., -' Mu‘r . , _. ,' -‘ A 1,,» .3 1? ;é-;;'~ ».. rI _¢,,. an _._.-...._-_-.-.-_.._.._._..-__..._._.._....._--_,,“ 4. _. >~ ‘ ~.. .“ ‘.5. 4!_ ., . ..4 ‘ _l-. ;.\., ' ' _;- ‘Ls 1;; » :1.» w-2 *~ ..-- =»_;-~~;'..-. " --"»‘:-"-‘T 4" . - - 3’. Q’. m“ \ 1: W -- ‘ I R ‘ > ‘ 1‘, 7 _ _,.‘,vr., r . ‘av _ 7,. . H”, 4 1:3’,-j '1‘. -:‘ , :2}?-_¢1:r,-,v1-‘;> S“-_l,_.. .r1t,-£4" M_“.;._¢-_.~ _.__,__..._; 1. ’. n 1. 1» 1 ¢-r “~11 K. -. ‘ ._.~ 1» Y“~;'@l¢Q@g@U~f;@§;@Q@@L@Qfl@fi;@@§KQ@@P@?%iQ1@@gQ§§@if_,,‘. NO.» a A ‘ I~TIME?” I ‘ ~* ': ~~ 2 k \ 1 _’ 1 k 1 i ,_...._,._ ..__...a¢. ..._ .._..___...._ _,....__.-.._...__. _.__._._ _.~.,___ 4 l l .>..# 1.. E. A- .L ,-4 ..__n-h¢>ul&i'z>AJu;~u.n.u'L\;a;_:4.:_;¢;;;,g_-__\_|_(_gQ; ~ 5511»-U-1.; ~ A-r--|—--R ~--we ---- <—-t->7-n_ _ -—— -—~—— -77 §Q0 1Tl\Iil( Pacility»_/47/'/kdlj APermit{#"Z..7§QZuZQ~;l\jonth/Yr. 1. I have not done any major modifications to this facility during the last 12 months. '‘ 9 Signature Note: All major modifications require a Permit to Construct from the Permitting Authority. I have done major modifications for which I obtained Permit(s) to Construct from Permitting Authority' Am‘ Signature Permit to Construct # Date Repair and Maintenance Summary ' H _ " Attach a summary of all: '' Routine and required maintenance done to this facility's tank. piping, and monitoring equipment. Repair of submerged pumps or suction pumps. Replacement of flow-restricting leak detectors with same. Repair/replacement of dispensers. meters. or nozzles. Repair of electronic leak detection components, or_ replacement with same. Installation of ball float valves. Installation or repair of vapor recovery/vent lines. Include the date of each repair or maintenance activity.‘ NOTE: 4. All repairs or replacements in response to a leak requirea Permit to Construct from the Permitting Authority as do all other modifications to tanks. piping or monitoring equipment not listed here.' Fuel Changes — Allowed for Motor Vehicle Fuel tanks Only. List all fuel storage changes in tanks. noting: Date(s). tank number(s), new fuel(s) stored. 5. Inventory control monitoring is required for this facility on the Permit to Operate, and I have not exceeded any reportable limits as listed in the appropriate inventory control monitoring handbook during the last twelve months (if not applicable, disregard).. 6. 7; Signature @441 Trend Analysis Summary Please attach Annual Trend Analysis Summary for the last 12 periods. Meter Calibration Check Form Please attach current, completed Meter Calibration Check Form" _._//'3/7‘/Z 7?_5'7L’4f0/U67/'.Z//'\/5;. //7/95' 7551‘ 771/uks a/6 .-‘$2’ . . - ...=§¢?*‘=§:€i@g1= ILITY ANNUAL PORT ~¢£%% - . » - .'.' "'»-.1 . r . ¢ - ;__ _.4 -A. ‘ IL _ t (-1 ‘ swig)! ¢ . _ g ‘ , _ ">r_.~ _1 1}“ .1 _ V __ ..... " -'. =,~ =- .-,>- ;._ AQ xi‘ ~ 3 '_-" in“. ‘7.;f;§?f3»§'."' g ;. ' a'»=;-".15 A _. _3,_. , . .~ »::§§~—‘ I fikr 3% -23 ml 1 ,1 . _ 1:. ’ . ,3 ‘- ~_r,.' 31; if ,.- >0 wv .. ,-:- n .. -, §1 -- * .419...-“ .wr§ jg . R; ?.'_ we ‘A Q} dz -.~ " .1 . .,-. \ ,; \ - ».,. 6 1' , -.2. :1 "' Pu .,1 v. . a. ,. ;~ 1 .‘¢; - "w .." _ \: : T? J, I \§ ,4‘ .. ._.§1_ ,- .' > ' ‘- . ' -4, . 3:. ~‘ ~ x2 .1 .3; -'~" <1 '1 .1.» A 1|‘ “n .n .9 ‘Y :"_’ 4. \—. 1. 3:1‘ v .;. ;I fa i. n. 0:’)! .__ ‘§T¢ I4‘ ., if ~ .. - '.<;.st ’\1)_ I‘; ‘F :5 *5 * ‘q.\_}’ .. -2 ..:<.=~ “ 3Z ' fi9 -1 _ 1- .» >' \ n 6. n1 4 1 q\ v .’R - iu L¢"A .' "41 ' "51..’. *s2~ wig K‘-**.= .1 ~ * .s~ ' '€'A‘. n ‘_ iv . ,‘ .<-I4; 'E -. E . »\ x ,v. av" '- -.-‘§_\‘ ' '1-( , 4. \ ,. -' ‘. if’' <m4’.-'*'?.=>§i-.~,=7 . . --.»;f.'~_H I .> .. -’u;‘ 7§@? - m— ‘»;‘r-- -,.1. \‘. 1 lg-. ;,~;a 'g,,~*¢;§;1€;%-.» "...l.'5i§?r'.‘v.' L‘‘ L H __ _, _,M,..=,_,_.. "215: aw 5 ,. '1 1_ 4 I 1:!‘ I rt I1 2 .._ ‘. .4 ,‘. 1;‘- ‘: I i _ ' v- ,4-gm. . .5‘, Q '5;Y ->1 IY 1. > \ L , ‘ < . v. _ ‘I -‘ . § . _. N _ . 4. \ -~ ‘ . ' ' ' ‘ ‘ n n‘. ‘ . .., 5 _ _ \ \ __ - x , =- 1 ‘ -.' '1.--\ .~ \'\ ’~<\;\ _\0 1 w‘ | 2». , ‘ ’\'\ ' \ -X » \ _ \. , - .\‘ \ .- | ' .- *\ ... \ n J‘ t\ l_4v -H-.‘ u-- _‘\;_$ Q nv . .‘v '- ,. ,t [Y ,_ r v ._ 4 V . - " \‘./ . >, , .. - ' ’1 \' ~ ‘ ‘ \-*. ~ !"'¥ - 1~ .}~ ' _'‘ ' ’ F ,'_ _:'i_,_ \ , .I“'\' qt 1' ~_\ '1‘‘ v h 3 I \i -osPAn'r|v|éniil~i6#';'WEieH¥s¥Zno "_MEAS'URES"h.' ' ~ 3 ' ‘_5,couN11Y!,QF-i<Er3N‘iW1! _# _ ._ ~ . STATE OFiCALlFQFiNlA'-". i ,.i~’ _ ' 4 _I 1116 East CailIornla"Av6hue, Bakef§lleld+93307 "1, - . - .Telephone(805)'861gZ418»~’.' ._ - " '~ . ' Certificate of /nspectibni K 1 9 1 533v A, ' This is to certify that, in accordance with the law. I have tested the weighing ' and/or mfisuring instruments said to be the property of or used by:" r _, r. ,- <3?)\ W? X 4 3 DATE “°/(‘<1 19¢‘? -v\ ’0 NAME rig; mitt; ~ Qwpw ¢,¢rz.~;m,t,§,;/_ Aomss »2<>»a<§» ~\'4»F"'<“~w_~t ‘W . ' - !SA* |<E%9_-QFq;i—:,D' FORMER -- NAME: “‘ DESCRIPTION IN OUT 9'7"" TOT. HRS. »*¢:-(») L»0 < 1-" ' A 1’\(_I 3 <1? w~*@=¢~> t<-~<»'>~_i><@--,¢1(»>~L~t;i¢\ £1r.>'e-’)~ U D5-1 0‘--47$! ' 9111'? Q\t\/</"fbi.-. \ V / ‘-" ’ . .1 <3 . ’/ , ~// _/, //I' .,/ / /O 1'_ ./A. , ‘ .1 - . ; I t ,.>‘ F ' - - > "V TO BE REPAIRED/CORRECTED BY . ' ' _ N.O.V. §rEs"\ NO--B&P/“OCR séchfi-~ r < J l ' I \— _ F ' . ~ ' ' 9 ' ¢' , . ' _ " - 1.. . _. - . ‘ , . _, _ 1 . V ~ > ,1 _ I. _ OWNER OR AGENT _ MONTY H. HOPEER, DIRECTOR / L‘ I""gPE¢T°£?_Ei§ liLt>w;,< " K ‘Y/1.» .1) /- 1 - -/ ’ ~’ ‘ '“ _ I Weights 5 Meas. ssoiésao 010 (Rev. a/92) ' . 2 I . .4. . ‘ _ v-..";.1_,.= ...,..‘ ,\..> - .»t1.A.. 1- ~ V. Pil ..- .-_ ;_- ...‘. Q ._,._ ~.» 4-._ -_-. '_. -¢--_ ----. ___ ,~ - -__~-_’__ ~n-'- I ..._f-.- ‘\- \. -- . : . - u . .- . ._ _ ¢. _. ._.._._.~ . - - .. -rN ..-- +»- .- . v 4.- . -_, . . .., .\.= _ Y-V .. - - »4 -"O '' ,. _ HI ‘I, T ‘,‘.». ,, ‘ '7 V - - - -. .- _ --_.,...-.. 1. _ --.. . ..-w .~_-- <-- v- Q. I _ _. ¢_.- -..-. »~ 0 _ ¢ 9 ._ .-. ..‘~ 2' -" 4-‘ -- QI ‘ Ir I » \.. 1» r- -I r -. .4 '. I| l ;' ’\'_ - ‘ _. ~ 4 I "J_;"- -.'' __l.l___-_.._~_ 1 1 II i 4 s i 1 5 -1 »..=-;,~. -"-- J - .77. . " : ' ‘Y '»- F ‘ . -.4 _' METER CALIBRATION C‘HECK_ FORM '- ' Facility: ‘ig Permitf' A Note: ' 4 .. ' 4 , , 4 H .V /1_H All meters must have clafl-ibration‘ checks-a minimum of twice a_ year, which may include checks done by the Department of-Weights and .I*_iea'sures. _ Before starting calibration runs‘, wet the calibration can with product and return‘ product to storage.~ . ' _~ - ' .- . 3. Run,5 gallons with nozzle wide open into the can. iNote gallons and cubic inches drawn, and return product tostorage. ' _ . _ _ __ , 4._ Run Sigallons with theqnozzle one~half open into the can. Note gallons ‘and 4 cubic inches drawn, and return product to storage. I iA A 5. After all product for one calibration check is returned to storage, remember _'‘ . 2. to record the volume returned to storagew in column 9' of the Inventory . . Recording Sheet.__ ' 1 -- 6. If the volume measured in a 54g-allon calibration can is more than 6 cubic e inches above or below the 5—gallon_ ma-rk_, the -meterorequires calibration bya registered device repairman. 4 ~ -~ . _;:_;__*'w _[2-',Zb_,»(~ o i t i » Date/Timé Hose or Tank Fast Flow‘ ' i , Slow Flow Volume Returned Calibration Device Repairman ‘ Date of‘ Pump # Product 5—.Gall0n Draftg 5—Gallon Draft to Storage Req_ui'red? ‘ ' Used for ‘Calibration’ "i ___Q~$‘96 F t _§ "Gals Cu. Inches Galsp‘Cu.,In~ches\' ' Gallons Yes ; No. ‘Calibration i A = ' gel You r*/ ‘/0 "/< dam J V i‘ D'L6$d.’i4S_wi4‘/ W94’ i i “/5; ' 53¢//on §‘es‘/' i 5" 9"/A :5. I h ‘ . . /ya, S’ i-3 > 43/ *i"“/s'- 0 /D-X use '5'?!' 5 \/l 6'-7*’/' .6’ ~'/ /0" » X' Owner or operator‘ Signature ' _ ,¢-4.4 Calibr-ator'_s Signature Registrationwt ,29fiD.>>O SUBMIT_A COPY OP TH§5 FQQM WITH ANNUAL R )RT_A ' , _/ Ti {?'___ !_ I K y ‘ l f __ W I ii |l\_|| I I|\‘|‘|‘ III ".__§ ‘D W / ' / ) ' I P I ._ ‘I I ' _ f I /I ‘ I \_ l_ I _ ‘ __‘‘ J : ‘ ' I _ ‘ ' ’ I . f _’ _ ‘I V COMPANY I / ‘ STATION uo, one __ _ -_» ' DISPATCHNO. R- ,:_ _ $ L _ T, gt ___>_§g§>M, c0MPuTER cnmee CALIBRATION -Record of Computer Change, Metér Change, or Calibration k ‘ ‘METERCHANGE W/MNUTIFIED 0)1(’S~€ \Y\ 'f¢/Y‘/L<)<l_:1¢“\g I PUMPM ) X ITI >U .-.Ti~ ooev. ‘SERIAL uumasn = CAL|BRAT|QN ' "’:2'§'g§;_,4, '* "~;. $3}? "j/ ~ ' ' ‘ CHECKED ADJUSTEDTO* 5» ~>i “ii ‘VJ MONEY 1 GALLONS I FA$T_', . ‘ SLOW FAST SLOW ‘Q FINISH V - ~ “-fl-.1!‘ .' * -~ »\ E7!-;~; TOTALIZER ’) ‘j’;/ 7 4/ L -r? READINGS MONEY GALLON - TOTALIZER SEALED - METER SEALED- START ' ' ' Elves E!~o'_~ '7 "UYES‘ Duo‘ PRODUCT PUMP# ToT ' L ' GALLONS RETURNED] TORAGE ’ .~ _ - - . " ‘ ~ ‘i "' ‘ _; ‘ c-’:;<~:/ / 7' -K‘ ~ _ »‘ A ~ \\ PUMP MAKE AND MODEL . SERIAL NUMBER. CA|_|BRAT|QN ~ CHECKED ' ADJUSTED T0 MONEY ‘= GALLO:S . I FAST SLOW FAST 1 SLOW~ TOTALIZER WISH I ’l\ @ -fl’ READINGS MONEY eA|.Lo£ - TOTALIZER SEALED . METER SEALED START . _ - 70 7' L ClYEs Emo _ O C!YEs Duo PRODUCT PUMP 8 TOTAL GALLONS RETURN_El@STORAGE '., - - l 1 I . PUMP MAKE AND MODEL SERIAL NUMBER _ CA|_|BRAT|QN CHECKED -A H .,ADJUSTED'TOu MONEY GALLONS FAST SLOW FAST“ E l‘|. ' " SLOW FINISH 0 _/_ . T - _,,n.; :3. -v-1-.~ A, TOTALIZER Z [Q2 7v Z v<..,- READINGS START MONEY _ GALLONS _ TOTALIZER SEALED METER SEALED ' __ 7/DWIDX DYEs Duo Elves". Club” yum PUMP# TOTAL Z . . <sAu_o~sRE_=rynuEoTosTonAcE ,._, _ . _ _____|J__ _ ' _\ -5-1-fg‘;, {Q1 I/-\ L? / » ‘ 7 /0 ~- ' PUMP MAK_E_AND MODEL SERIAL NUMBER CAUBRAHON i 1 ‘ _ -* ’"* ' CHECKED ADJUSTEDTQ ’' ,. {$5-,=;, FINISH ”'°“E' ‘rx _;. GALLONS ;’ E, ‘ j:;\<Zé..;7’g FAST SLOW FAST . SLOW ... ? __,§/ - _ F- REARDTNGS START MONEY 1,, 'TG_Al_LONS . 1-* >’A7:'.,z. 57 TOTALIZER SEALED _ , METER SEALED PRODUCT -\ .» ‘UC ‘-‘U \Q§ \ % PUMP MAKE AND MODEL ‘\.**~ {E9 I“ LONS RETURNED TO STORAGE 7-"Z-'4 /9'50 ‘_._$_-, SERIAL NUMBER 11,‘;_ ‘~ ‘CALIBRATION E) YES C) NO Cl YES D ~o I A, . \ I1 . J , I '‘ '\-“. I P4“-“",_‘( '§,"' “ADU USTED TO FINISH MM“ ' .GALLONS / )7 FAsT_ _, / ‘sww |FA§T »= ‘ 1-_‘ ., SLOW $3 ‘K <1 ‘\'_- T” “ "T. 'l\‘~§'V 5. ‘. /'.>-Io’ 2- READINGS MONEY I7 GALLONS Y - _ / TOTALIZER SEALED - METER . C1vEs Duo- SEALED I ‘.-' U vEs D no PRODUCT PUMP ¢ TOTAL @- GALLONS RETURNED KTORAGE‘ - ' ‘I /,2 ;' .. /~ PUMP MAKE A~?_MooE|.‘ ' SERIAL NUMBER _ CAL|B|qA‘|'|QN ,,, .-.91’ §§T~T~§?¢* T CHECKED "'ii"‘-,\"~.> 13' {T .11 * ‘ , ADJUSTED TO> ~ </H2. MONEY GALLONS - FAST sL0w‘ , - FAST Y‘ TOTAL2I2‘ER FINISH 7). 7 7/ A T‘ It _,~'.a:-+%=. 1-‘;':w I » 0. READINGS MONEY GALLONS, ’ > ~ TOTALIZER SEALED METERs < * START ' .;/ 7 El YES U no 5"‘-553.3%», 11- T, -i PPODUCT PUMP a TOTAL ' GALLONS RETURNED To sronass ’-Q’ *~“1*j;',,»g~;" ~ '_ . 1 ‘ 1 n 2 1 E ’ ‘J "11. E kiyr I . . E 6, .2 » . A .. . T . ,.~=~\<- '-Ta-§§>"-\=.~@z. ‘DEALERSSIGNATURE . .5‘ ‘> MAINTENANCE MA ' lam “’ T T‘ ' T 4 7" T '*".'*‘~-'” _.~ . - ‘~_‘;._._-_ _‘ ,,, no v; ‘- '@1*':§Z CI‘?»;E'§’=‘;»s*.* El ‘IVOTJ-7 1. .‘ f ‘A ;~. . E. - R fig” $- Z‘ Yr; ts ’ } , é ..,»~_-;:‘,_._./_ 1 1,, _' _ ; > H ' , 'j;' -" 1.’ z r . »--__‘ . .'{+ . fqf ,-"UM .,y's*.§§,1 1L I _ _ ‘Q ~- 1 13' <¢4>\_.;‘vH. >_» , - . \ 4 » - .. \ »' I- »-.‘*> - ‘* ' ' - .- . . -lr.4&'T‘r I 1 ' ‘ 1 ' - L 1. -./"r;1‘. I _\~,\ '~ - ., WEI "}"!“"- -_'k ~"4T,!L"H\( ‘K-49’ 4 -pi‘ _ " < ~._~., ..J . ‘ ,. - 1 ~ '_ ."' , . ';.q~ In‘. 1'...-.1 1 - ‘ Eff» .5: ‘H7 _ ,-.".;4!.‘.T ; .1 _. ,‘.;-."*. * . * /~_ 51"! .4: ~ . %~/-N £1 1-T51 :x'¢.fF§.>K :3)? t~h ,,¢¢:~. -.4 1' E,-aw... A ,-K L I~L K~ ~u 6-1 ;_: 5"-K. J‘ um. ’TI 2- *' I“ ‘Hg, .{‘ .1 K .,'_=_‘ ‘ __V - 1| ll“ ll \\ ' I II _ _ P . __ \ Q _ , Ll ‘ _ _q _/ ‘_ ‘ _r_Q _ W‘ _ Q _ __ _ _ ‘ ‘_ I _" ‘ __ _ ~ Q _ _ 4 _\\ \__ , \ _ _ A I \\“”_> A T‘ \__ ' _ ___ I V K x \__ X _ \ ' H“ _ . ___ ’ I \ L ' \ _ ‘ _ “_ ‘ ' , _~’_ \‘ __\ _ _ __ ‘ I ‘_ _* ‘ ‘ ‘ \ \_ _\ ‘ _ ‘ ‘ _ _ \ l " \‘_ ' ‘M __‘ _ ‘ _ _ _ _ __‘ _ ‘ d_‘_ * _ _ _ _ _ \ _ \ ‘_ I _ \__ _ \ _ fig: Wm \ a _\ \ _ ‘\_ _\_ \ ‘ \ _ J \ \\ VA§‘ } _-‘¥ \ _ \___ ‘ __ _ ‘ \ ‘ \ _ \ V\_ \ H _ ’ \ _ >3 ‘_ _ \ __ { _ _ \ 3 _ M \\ ‘ \ ~_ I)‘ k _ \ _ J _ J \ \ ‘ ‘ ‘ ‘ _ \ \ ‘ ‘ ‘ . ‘ \ __\\ _ _ \ ‘ 1 _ _ I ‘ \_\ O \ _ ‘ I _ _ ' _ _ _ \ ___ _ I _ \ x \ ‘ _ _ \ \ ‘ _ \_, -_ ' * TANK # ._.__/-Q ~ ’ TIME. PsRi_o0= Q-L/A-93 ' to 3'/3-‘)5 * ' 1 .A ’I I 2’ i)? r ;' , _.. . . -- ,- ‘Q ._- § ., sol’ kg 3 :,,._ > ANN1QL_ -TREND ANALYS IQ _sUMMARY -_'1*1}€%‘i£?‘i-4._.§'T-as ~ ‘¢_-‘.. w\>~1iJor1_-‘~:.¢<=ssne -~- -Y» )~jv.'8, " ' -. P \ .. ;l, .' ,-.t ~_' rs-_ -*. - I W, -- " _.~,~}‘<.<T_- \~ 1 QUARTER1 PERIOD PERIOD PERIOD QUARTERZ “PERIOD PERIOD 0 -PERIOD QUARTER3 PERIOD . .> PERIOD ‘- ' PERIOD r QUARTER4 PERIOD PERIOD _ PERIOD TIME*PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Totaluflinuses Action Number Total‘Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses sv Action Number 4 ' 0. Total Minuses Action Number . ,5 .d - Ia ‘_\ ' v.. ‘\0 ' 5»)/re: to‘ /2-as-a3 This Period (Line 3) 11;’- for this‘ Period (Line 4) d II This Period (Line 3)‘. [ff for this Period (Line 4) 3 2, This ‘Period (Line, 3) ' [.5 for this Period (Lino 4) f4‘ /2-:aé'—‘23 r to 31 :13-Q4 This Period (1.i'ho's')“ "I41A for this Period (Line A) 6%' This Period (Line 3): .L§~ for) this Period (Line 4) 3:5- This Period (Line 3) 11;’ for this Period (Line 4) l¢9/ :é:{2»94 . /0-is-)4 This Period (Line 3) . [£§" for this Period (Line 4) //-7 This Period (Line s) _'__g__ for this Period (Line 4)» [:?E?4 This Period (Line 3) I T3 for this Period (Line 4) P /‘*5 . " v' ]d-‘Q6-‘H ¢.,_ tz>L3-9; This Period (Line 3)"A for this Period (Line 4)‘ Z55,‘ This P-eriod (Line s) '- _ /3 for this Period (Line 4) [Z0 This Period (Line 3) for this Period (Line 4) P /96 \ I hereby certify this is a true and accurate F8DOPtu ‘. ,) v l 4;. |\ 0 I 4 ., t ».‘ o.- QP >\{‘ IP . ‘ .1: ~J I X I Q; B - ~~' ‘ 1 . . 1- ‘, ‘1_'--:_. D 1.51,‘-_.. I. >1 1. 1' ' 1,3‘, x-‘.\'*'_~»-I' . 35}?' I . 5. - ' "5 .2' Signature ‘ Date 3'/‘/-'7J’ 1 »; -C ' .- 5 ‘ 4.0J A 1 _5.‘.v./- 319$ .. ._37 ! I I I I E 5 1 -< -~ I ~".- _ . 1-- 4:‘ \ 0 4 TANK #“ ,3 TIME IPERIOD: u 3'//-93. to 3%? QUARTER 1' PERIOD . PERIOD PERIOD QUARTER2 'PERIOD PERIOD PERIOD QUARTER3 PERIOD I PERIOD PERIOD QUARTER4 ' Psfiron PERIOD I PERIOD TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME,PERIOD: Total Minuses Action Number Total~Minuses Action Number Total Minuses Action Number | TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number ’F TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number L -Y. if *5?. A\bJDUlg!!&L>-HFIZEZDJIJ A\DJA\Is\(E5I[q!!I E5IJDdDd1\Fl\( 3'“!/-93 .'I'to /.2-9.2-"Z3 This Period (Line 3) l3 for this Period (Line 4) QZC7 This Period_'(Line é.) [1 for this Period (Line 4) 3 I ' I This Period (Line 3) I for this Period (Line 4) :7¢/ I2-2‘)-Q3 to‘~5'Q1-H This Period (Line 3’) ‘ I? A ;"' for this.Period (Line 4) This Period (Line‘3) A » [Z' for this Period (Line.4) jV This Period (Line 3). 7 [3 for this Period (Line 4) lC?[ ‘to' This Period (Line 3) P /Q I for this Period (Line 4) /l_7 This Period (Line'3) /'3‘- for this Period (Line 4). /?3I This Period (Line s) ~ /ff for_this Period (Line 4) [915 (0 -Q4-‘)4 to This'Period (Line s) 7 ” [3 ,~ for this Period (Line 4)" ../1265’ This Period (Line 43) /ff for’thi‘s Period (Line 4) [Z0 This Period (Line 3) A /ff for this Period (Line 4) [Té. I hereby certify this is a true and accurate report. si8‘_‘acure~ -' I note -1’/"V7/" ~. 1 -1),/A . * )7 I Q,’ P 1 (" ' e1 \ 1.? I _ d ' _ !___ _ ‘ F‘ _ H. ‘ ‘ v _ _“. I _ V _ HA ._ ( _“ ,_ W _ I \_ _ U __ _ 0 ‘ >> _ I _ I I 1_ _ _ _' I ‘ r ‘ _\_ _ \\ J _ '__ ' _ I _ _ _ _ x _ __' ' , Q _ ‘ . _ _ ‘ _ _ _ ' ‘ U _ Q ' ' ‘ _ v J‘ _ _ _ _ _ . _ 3’ _ _ r ‘ ‘ _ _ . ‘ > _ . h__ " ‘ _ ‘J’ I . I‘ k “ _ _ _ ' _ 1 ‘ _ _~ B _ :4 _ __ |_ _ " _ >. _ _ ‘ _ ( _ _ __ .__ ' _ _ _ ‘ _ I . ' ' _ _ M _ _ _M ‘ 3 _ ' "U \ TANK #1 i TIME Psniooe 2?)-//-113 . to 3;’/3"?$/= xx N- QUARTER1 ‘H PERIOD K.) PERIOD ‘PERIOD QUARTER E* ‘PERIOD PERIOD PERIOD QUARTER 3) PERIOD PERIOD PERIOD QUARTER4 PERIOD PERIOD . PERIOD ,,,,, ,......'r W. s.-.~ ow - -new i .1 r..,-.~;_:o-e~\=..i-..-....io- -1--.-.-»__~ -e,_--_—_¢ ——7_ — ——— <7-_.-+_7_._. __ .i mi Ting; PERIOD: ~ ‘I v | $‘ .'' \0 . E‘ ‘L V0\ ‘ ‘ XANNUQ. -TREND ANALYSI !suMMARY- ) ' ' '' \ 3-//-93 to /2-29-23 Ah Total Minuses Action§Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses ActioneNumber Total Minuses Action Number This Period (Line 3) [:2 for this_Period (Line 4) ZICT This Period (:.ihe_*a) [[ -- ior this Period (Line 4)' This Period (Line s)- '-[ff for this Period (Line 4) =§ L;' )/2-is)-42 to 5-a1—Qy This Period ‘(Line a)~ /2 for this Period (Line 4) é‘! This Period (Line 3) for this Period (Line 4) ' 3.5’" This Period‘(Line a) I3 for this Period (Line 4) [01 ,. fs-:z2»)y" 4., ‘/a.~a$'~q¢s This Period (Line s) Ifl ' - for this Period (Line.4) [I77 This Period (Line 3) v‘ for this Period (Line 4) / 2'2' This Period (Line 3) [44 for this Period (Line 4) [V2 II /0- :2.<é4~/ to I 3-/72-9:’ This Period (Line 3) [sf for this Period (Line 4) [éf This'Period (Line a)‘ ‘ '/5' for this Period (Line 4) ['80 This Period (Line 3) I5 for this Period (Line 4) /Q4 I hereby certify this is_a true and accurate report. Signature A -< w Date 7*/“/’ I R. .4 '<r 0 \ i o \ .- 1 I . ' * ....i.._.... v 3 I 3 A I P §\ _N & _ Q w \ __ ‘ ob ’\ [U _ Q A\$ \‘ ‘_ _ __ _’__ _ _ 3 i \ K m ‘ G _ I_ ' 3 _._ NJ‘ __ _ \ ' \ - _\ ‘\ _ ‘E ( _ _\ W ‘K _ \ _ i‘ S il_|\|\|‘|‘|l 7‘ \’_ _ I \\__ _ \‘ _H__1__ Q _ I _ -.1 1»; 4 1 . .. .. . :11’ '' “'5 . . _'< ~ V VV 1 '1 -_ 1- ~~ ..V ' .. 4; VV ~ » -V ,1 ; . * “ > < V ‘V. 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' Specialist reviewing the tightness test report: V /Z Date tightness test reports were submitted: //@/ Date tightness tests were completed: //3/ ' Facility Permit Number: Ki 7? 72,5’ Number of Tanks Tested at the site: jf (list the tanks by their tank numbers if provided) Z QD Was the method a test of the entire tank system, piping alone, or just the facility tanks? (describe) 1i'}Qj‘i'Q@ , §_»\_(§juv\. - - Did the facility pass all tests: >2 Yes (if no, provide the leak rate and a description of the tank(s)'that failed the test) (failure is > 0.1 gal per hour) The facility will do the following to investigate the failed test: The test method certification that is submitted to the state specifies -that each test method be completed in a certain manner. Is there anything within the results which would suggest that the tank test was improperly "completed? Yes No (describe) . D Information has been reviewed and placed within the database: 1/ YES NO Date entered withinithe database: 1%)‘ HM” Entered by (name) CON F'ihDENCE- SERVlCES,3lNC. Qmy Green, R.E.H.S. A '“ Hazardous Materials Management Program 1 E: Y‘.‘\‘.~V Eel KERN“-COUNTY ENVIRQNMENTRL HEALTH DEPQRTMENT i 3 - 2732: -m~ Street,- Suite 3210' ~ __ 4. \ ~JAN"""'6\995 \ Bakersfield, California 933@1 - \ i Dear Ms. Green: » ~ Enclosed please find original of Tank Integrity Testing iand a copy of "QES —-5SYSTEM II Precision Tank& Line Test-Results-Summaryfwregardiné testing conducted January 3, 1995, iati Mikulfs“ Pumpkin. Center 'Truck- Ierminal, 2201 Taft Inspection Form Q . I ‘ ‘‘ \. Q _ z H. ' “C/omplianice VVAi~theConfidence" _ '1 3 January 5, 1995 3 _.4. W" as T“ _,_-._--v I r’.';:/\\.-- - _1 '. E/r’?'\J/ - 1 JJM _ -.-.-- _____ ___, ..-. Highway,,Pumpkin Center, Californiaf ‘ b" -I _.u .. ,. " " V.,.1 ‘ V _ 1‘ '_~ ‘:- _~ V ' X!‘ K \ ‘1 ‘ \. “#2 .. _ . rh_ y ‘Yours-truly;§_ , _' ‘Q \ . I. . CONFIDENCE UST_SERVICES, INC$ fr l= i, . v, ;; .1 .1_\,_‘_ Enclosures ,. . ‘ 3 . 3/ ~ ‘ ~-» ' ‘ " . ' -_ ._ _ ‘I H /~ ~ /1 < 7. ,1.» I , , ’ 3. ‘\ B,Y_;'.- ‘ . » “\ - , . ‘ .' $11 _ _ ¢_4» j H "»Q.,Y ng, Vice esiden __,_ _,,_.,,,,',_ . _ V -~< ,.u 1 1 --#3-:~~r cc (w/o enclosure):' MIKUL’S PUMPKIN CENTER-TRUCK TERMINQLE P. O; Box 78197 Pumpkin Center, CR 93383 Qttn:. Alan Mikuls- 417 Montclair srqée: . Bakersfield, CA 93309 3 (305) 4331-3370 or (aoo) 339-9930. . FAX (305) 331-3312 ~.n , 4v ' » 'g'~. .: 1‘/1‘-4:! I , .. _I ._,. -¢- _,m - . \-'*'>\ mi.-_‘ .¢¢ v»* iv» ~ ::»‘"*»v': @;=;1 uccu= urvu mznflffl uflnbuxu c6vcfl~* cu $2192 *§;:0' now >e1a; _ » _ __ w1unr.a-bnwnuxm CEHLEB LBHCH LEBMIMUF _ cu ;m\o suc]oan»u)= P >< '-Eucyoanuae '3?' A = ‘ Qus~$; u' Aunufl' @106-b»ae;qau¢ a>~- .- _ . -. - I - ‘ . .-_ -.__.\ CUWEIDKMCE H81 BEBAICEB‘ INC‘ ‘ an-_ _~'~'_I };Ofll»E €Lfl]'?\' ~ . _ ,\ fl§flpMUh"bflBbflZU 5sups»° ¢913;o»u;e*, I662‘ 9% wzv~z»v bfimbfiiv C§H$5%A ihflflfl i@%fi!U93° SS8! 19£¢ rgue Lac; guanypc gnnuauku asfiexqzufi ¢6e¢ru6 couqncyoq wwunqhk 3* 1uab8c¢!nu honn QUQ Q cobh 0; "559 - \3;315m 11 b»ocqa;ou JauyQ » Fuc1acnq byeoee gruq o»16zue1 05 Lqufl 1U¢G5»l;A Leapgufi -‘D6e»;wa?fp»bbur " " ‘’ guys»eg:e1q' Qéyrguuuyo 91991 axes ~w- P¢~6@r‘ aflzcfi Qwm KEHM CODMLA EMAIUGMMEMAHF HEUFiH DFbHH1NEML Hvsunqonn us¢e»1e3a uwusflcusug b»o0»au gua @»o0u' 5'E‘H’Q‘' '\‘.JUfl€7L,F\ Q‘ ]'3a;_> »-~-...:.'-».,--em; J1.\\.. “- ' ' '.‘1'\.";-»r41g~(~ ,1 ¢l""'|."’-t,| J‘ .. -. ‘J Z. '1IU (11 /__' 1' |4\ as Q7 .‘_¢ I» ‘I _ -__. .L‘ » \__ -J‘..J' ‘.. ' 1» __ .- 2 \.,-‘ 1 I L1 r =9’ c. STEVE~MI:CALLEY, R.E.H.S. onaecron ‘ , r-.w . g I ‘_ . , 'I " IIYENVIRONMENITA HEALTH SERVICES-F&PARTMENT'T - I I -- <\':..<.2P- 'I _ - - _ T Bakersfield, CA 93301 . ~(ao5)as1-seas" ;:-*i:¢@r,-;'I~‘- A-._\ ,<<;._,;.~,.%-=,@_.-;§§ . I ,(_sos) 861-3f%29 ffx 4%» ¢ sf &-<~ . V3 ‘.9; -.-'Q_ Q ' I ‘ -. "J S‘ = ' ‘ .-,_;___.._?‘_.::~___,..° 0' g '- a D ‘D -I I‘ N. :1-'_ g ' Oi‘.CA\,\ , g _ K _> _ ‘V .-- , TANK INTEGRITY TESTING INSPECTION FORM“ ” ' L ' -q :~r I THIS‘-FORM MUST BE COMPLETEDAT TIME OF INTEGRITY TEST BY TI-IE _TECHNICIAN ON SITE ANDISUBMITTED WITH THE ‘TANK INTEGRITY TEST - RESULTS TO THE KERN COUNTY ENVIRONMENTAL HEALTH. SERVICES DEPARTMENT Facility Permit to Tightness Test Number 77;) ’7’Z9 1:’-5,; Facility Name Facility Address- , _ . ' I '_. _» ,. _ - ~ \ »4 » . _ _ , * v Facility/_Permit_t’o Operate‘ Number I ' e5Q?@O/@ - I , E,T~=a*-?2 3;>c>gr"/'~Z\4 fiéoy _" '°*Y Facility Telephone Number Z352 553 963 -- i . ‘ Z" Have you complied ‘with the_following safety requirements stated in U_T-2Q, Section 259» YESMO' .._ 51 . ‘/55 ‘ .. L ” Z55 Z25“ I»\_)__ \(/'_,/"fit"-'>. ‘K’, fl,/[ -4 (- _ - - .l\ ws ,I 1; I‘ 5; 3. .17’. 12:41‘ ;‘I>";IL,-1.’ , , '11»-»-I4 7" 3 (‘I -H-5*-I 7 - I I1? :\‘--I-\ The area within 25 feet of anyg,underground's‘torage’ _tank opening is free of smoking, open flames, and any othersource. of ignition. . _ ' , I Legible signs with the words "NO SMOKING" are posted in conspicuous locations around the testing area. . _ .. The general public is restricted from the testing area by rope, flags, cones, and "if ‘dark" a fluorescent barrier. ' I " ' ’ - ' "' _ , '‘ Fir_e.protection in the form 0f.a 2A/ZOBC fire.-extinguisher is located within the restricted area. " ~< Vehicles utilizedduring the testing period, or within 25 feet of the underground storage tank opening, have adequate ventilation, and the tester has equipment which can be utilized to monitor the concentration of flammable vapors within the vehicle. I I ' Person'al=protective equipment, an eye wash and gloves, and a site safety plan are within the testing area. _ ‘ ' ' - ‘ _ - - - ' . Eqlllpllnrfilll/H13fCl’I3IS is available tp absorb and contain any= small release of t’e‘stii1g‘-lliqiiid-which is discharged as a result. of the test. (Examples include DOT-acceptable containers for storage of . the absorbent and an adequate supply of absorbent): A I' ., ¢ - e- \. If the answer to any of _theI~aboveI-_qugstions;‘is§NO, stop the testing procedure IMMEDIATEEY ~ until compliance is obtained. '\~ 0 r ' ‘. ,1-if ms ~\-coMp|;;T\E__n’EvEnsE SIDE 1 F I " . ' Q~ r A4, ' 2700 M Street Suite 300 1' -' Q TANK INTEGRITY TESTING INSPECTION FORM continued Is the following data consistent with theinformation submitted on the application for Permit To Perform Integrity Testing (PTT)? YESLNO E 5' ' . The number of tanks being tested lg; Testing company .22}? Test method used I‘ y€S State Licensed Technician on site %"§ State Licensed Technician’s # ' ’' /\/1 Is the site layout consistent with the application plot plan? ‘c State exceptions forany NO answers to the above questions: . '- t\\_) . ( _\ ? ‘M’ PW?‘A _ 4' ‘ _ .__>A -».'.:-~. _ I». t .: ' 1 _‘:\*. I CERTIFY THAT THE AFOREMENTIONEDFACTS ARE TRUE AND CORRECT UNDERPENALTY OF_ PERJURY. (Not valid if not signed and dated.) -\ 4 / <-; Signed this 3 ' day of .' date~ I-HVI54 I , 19 , I K SI: <:\C month a B/A cigagsmle Lr (‘Q7 6 ‘ I / _. .. 1,‘ ‘- (SIGNA RE ice 161 cian on Site Jlouee/5'5 §%>Q41¢I-’-1:‘ (PRINT) - State Licensed Technician on Site ,. l \. = f_ K I '- HES — SYSTEM II " ‘1 ' .. CONFIDENCE UST SERVICES, INC._ MONTCLQIR STREET - BQKERSFIELD, C9 933@9 ' (B05) 631¢387@T ' PRECISION TQNK & LINE TEST RESULTS SUMMQRY. A ' B / ., Invoice Qddressi ':" Tank Location: ~. ’_ ‘ _W.Dgfl|T1796 MIKULS TRUCK TERMINAL I A MIKULS TRUCK TERMINBL ,I;D. Number: N/Q ‘ 1 0.0. eox 7e1e7 2201 TQFT HIGHNQY L TechniciannD.YOUNG. pumnxxm CENTER, ca _ _ pumnxxu CENTER, ca - Tech.0186116 van#|01A Datel @1—@3—95 Time Start: @6§@@ End: 10:3@~ Countyn-KEy Facility Phonefi: (865) 83E—539® Groundwater Depth: 1449+: Blue Prints: N/Q Contact: ALLEN - E _ Date\TimeMsy0tem_was filled; sf HOURS .». . .“,..¢ A“ A , 4, E- - . *' . T . ,. ‘I‘ I - Tank ' ‘ - _Fill/Uent Product Type Of vapor Inches of lpuop Tank Tank Capacity' Producti Tank Vapor Lines Line ‘Recovery -Y ywater/Tank‘eType Material DIESEL DIESEL DIESEL DIESEL BQQG 1@@@@ 1@@@@ " 10802 ofloumw PQSS~ PQSS PQSS PQSS. 4 PQSS PQSS PQSS PQSS PQSS ' Poss PQSS PQSS N/A 0.00" ' TURB. sus N/A - 0.00" ‘June. sue N/Q 0.00" _TURB. sws N/Q S 0.00" _TURB. sws Additional Information: TEST TECHNICIQN: DOUG YOUNG O;T.T.L. (9@—l@76)I QLL MECHQNICQL LINE LEQK DETECTORS WERE TESTED QND'QRE ODERQTIDNQL.I ~ SITE LOG Set Up_Equipu_».- Bled Product Linea: Bled Vapor Lines:" Bled Qent lines: Bled Bled Risers Installed: [Turbine|‘ "_ _.».,-. Suction Pumpu' _ TIME @6:30 vgs N/Q YES YES N/Q vzs a) This system and method meets or exceeds the criteria in USEPQ 40CFR part 28¢, NFPQ 389587 and all applicable state and local codes. b) Any failure listed above may require further action, check with all regulatory agencies., Copyright (c) 1989 by QE8, Inc. _ Certified Technician Signaturen Y» \\ //_ , ._ I ' ' Date >=/-3-9,7 ‘ — vi ‘ ‘I W ,4-.-nun " "I ;" 1‘ ‘ . » ‘l 1 5‘,. . .Il-"41—l$."J'- . )5 ""‘ ___ ‘_ _*. ,-,-_-_..--.w ._.~-.. _ ---—‘ s C». \ 1 V W, , ,,_ ,_ _, , Hi, _,,,,,,,,,, ,, i I ‘ I _ V ___ _ L \> F_ > ~_ §HTi?_l tZ3tX%Z _Ziii _mii%1£?V h U ' , _ _ U > cg‘ S filo“? __g§m __ 3 “ass S 3 H __Hg wh In mg; EH? ' I ‘I > mwfi@ _lc§€fl “¢% _ i==1xHz nmz_mx_ fiD_ A V ‘ ‘ _ _ > _ > _ _ ‘_ ~N“Q N‘_ I E H ‘ _ _ _ V _! I ' '_ 9 , ‘_ __ _ T! i i ....._ _‘_..._..___ i,.__ __,.__P__ I T I 4 "1_ CONFIDENCE UBT_SERUICES,INC. 4-1'7 MONTCLQIR EBTREET BQKERBPIELD. CQ QEEQQ (EDS) 631-3870 A AQES/System II Precieion leak Test Graph (0venF11I) _ Invoice No.| 1796 ' Date: Q1/03/95 Technician: DMY Tank:1 Vo1ume(ga1): 1@@@@= Grade Leve1(in)| 147 Hater Level On Tenk(in):G ' " ' T1me 1eo7=23=11' Tank Diameter(in): 95 Product Leve1(1n)a 119 Specific Grav1ty:~.87 A < Coefficient Of Expenaiona 0.@@@4435 Calibration Ue1ue(m1)a 4@@ Channel: 1_ . \ .- ‘Level Segment From: 1 To 275 Temp Segment Front» 1»Toe3@@ T55 rmcmr , _ . . _ V 1 —%**E§£I TJZZTW-4 ‘Ix’ 0|": z _V ‘nu’ 0' ul II? '1uU§f'{ = F" Tim@mHhur§* _Change In Calibration Zone w 41 Starting Temperature (F): 62.556 Surface firea(sq. in): 51.3 Level vo1ume(gph): »—@.01 _Temp. vo1ume(gph)| 10.03 Net change(gph) a -0.04 Result-——)PQBS Copyright (c) 1989 by QES, Inc. ** Notes iiI MIKUL’S PUMPKIN CENTER TRUCK TERMINAL , a2@i'inFi‘H1GHwnY., PUMPKIN CENTER, on Wrmmmmr u Calibration Unitlgal/unit) = @.@@E58 Head Pressurefipsi (Btm)71 3.74 _ ' Temp. Change(F/n)‘ | 0;@08' _A Product Lino(gph)| -@.@18' F5/'L_ -—-) FFFQEBEB THIS IS Q HIGH LEVEL TEST WITH Q #@@ ML; CQLIBRQTIDN. ' rv. Q - \. l I. 0 -- ¢ =. . .I ‘ " . . 4' ' ‘I 1. .\ <. - . . l. v ,- ¢_ 3 -' :1 >. . "- .-.. . _ I ~ _ _, :4 _ _,‘| _ .~ . . _ I ~l . ‘' l l I: \ I ’01§<~..Q ~ 8 F'FWIFWT' $&—%**3ECI TJIIFW-4 Ramult ——>PQBB _C:CJFJF7]:I)EZPJCiiiT LJE31_ E3EZFQ\W]:C:EEEil>]:FJC:- ~11 MONTCLQIR er anxmnawxaco, ca 93309 5: ea:-mavm _ QES/System II Precision leak Test Graph (OverFii1) Invoice No.: 1796 Date: 01/oz/95 . Time |.07:az=11 Technician: DMY Tank: 2 4- Tank Diametertinia 95 Vo1ume(g§1)a 10000 Grade Leve1(in)a 148 Product Love1(in>a 118 water Level On Tank(in): 0 J - Specific Gravity: .87 _ Coefficient Cf Expansion: 0.0004435’ Calibration Va1ue(m1)a 400 v Channel: 2 _. Level Segment Fromm 1 To E75 Temp_8egment From: 41‘To 300 m m | n4 on ‘Ill. m' l“.‘| ran Inn‘ ‘nil I ‘Inn Ir l I - " ~ u". F’U m nu m nu 0 nu I 0 un 'm nu mo nun. J Jl ' ’ »1 I \ *“¢y@wM1-¢-~¢~-- ..._ .» ,1 H __M“, _-1 III z - .- 5’-!»»~-1~‘.'-1. -I, 55 Z —I2 .- : 0 Tim@wHmuvfi. Change In Calibration Zone w 41 Btarting Temperature (F): 61.698 Surface Area(eq. in): 51.3 Calibration Unit(gaI/unit) = 0.00258 Head Pressureipai (Btm))| 3.71 Temp. Change(F/h) | -0.001 9 -. Product Line(gph)| —0.018_ vo1ume(gph): -0.044 Temp. voIume(gph): 0.00 Not change(gph) n -0.04 F#4'L; --) F5¢§E3E3 Copyright (c) 1989 by QES, Inc.’ ** Notes ** . ~ ’ .' . ' MIKUL'S PUMPKIN CENTER TRUCK TERMINQL , E201 TQFT HIGHWQY , PUMPKIN CENTER, CG. THIS IS Q HIGH LEVEL TEST WITH Q 40$ ML._CQLIBRQTION. _ _ _.@. , , _ . ‘‘ ' “ V '-v’-;"'-"’“~ .',:7',_"\?~‘ ' » 4 '1‘ - ' . < ~ 1am ml Ii»; _7_ ‘ 3 \":“4__!_~_._I >_,'___“_’_‘_ l, ' ___x__ Ll . _ ___\ _ M _ 1 r _ \ hfé_ r ‘ ‘l ‘ 5 ‘ _’ ‘ _ ___ _ ii _ ‘ _ ’ \_ ' ‘ _ _ _ _ __\T '_ J _ _ _ ' l - . .. _ . 1 _ _ - .. Nr='11:>s-zmcg. us-:1" BE:-=zu,I cs‘:-zzgg xwc.' MCJNTCLRIR BTREET BF"-(E-IR8F'_I€L..D. CR 93309 (_ 05> 631.-CBB7O , -~ AE8/Systam II Precision leak Tout Graph (OverF111) 1' .0 30 1fivo1ce;No.| 1796 Dates 01/03/95 -‘ 'T1fia'a 07:23:11 > _* Technician: nmv _ Tank: 3 . Y ' Tank D1ameter(1n)g 95 T Vo1ume(ga1): 10000‘ Grade Leve1(1n)|'148* Product Lqve1(1n)| 143 Water Levél On Tank(1n): 0 ’ _’ ' ' » .1 Specific Brav1tyu_.B7 Coefficient Of Expans1bn| 0.0004455 Calibration Ua1ua(m1)u 400 Chaflnela 3 A ' Level Segment From: 1 To E75 _Tomp Segment From; 1.T0 300 ul ' In -I rid luv‘ nu. ‘ ‘ml run Ila‘ ‘nu I “Inn Ill I -‘ u M‘ '- vn nu an cu: I an II» uu'uo out ul 1| |;' _ ' i. . ..l , - ; ,1 I," ~1 ‘ aH:: qzmj rmcmr I '.I 15$ I ‘ __ '|' ' ‘ _ ' .— I I ' .' ' I 1 . -. ‘. 1 ’ 3 . » .. ' ' '--\-__ 11, 1TLUT LH 555 .... .__,: ._..:_': H ' T 1' ‘ In i ‘nu. mu |mI"ulu Ira ‘Ill! lll ' Ill ' " 0 | m uv uu nu. Change In Calibraiion Zone I 9E _ Calibration Un1t(ga1/unit) w 0.00115‘ Qtarting Temperature (F)| 64.420 Head Pres9uro(ps1 (Btm))| 3.55 ,8urface fireatsq. tn): 26.5 _ Temp. Chango(F/h) 1 -0.018‘. Levo1~vo1Uma<§ph)I V -0.12 T1» _" $1 I . “:_ Temp. vo1uma(gph)| --0.11 ' Product L1no(gph>| -0.007 Net changetgph) : -0.01 Result ——>mnss 1 P/L 4—>-pass ‘Copyright (c) 1989 by HES, Inc» ** Notes nu %_ ' ' . H .= Y.__ - " .4? _ ,. V Y . .,! . ,1 MIKUL'S PUMPKIN CENTER TRUCK TERMTNQL f9€€@1*TQFT HIGHNQY , PUMPKIN CENTER, CQ. THIS IS Q HIGH LEVEL TEST WITH Q 40$ ML. CQLIBRQTION.0. ‘ ~ ‘_v If “\_1__‘__ t l___‘_ ; ' _ W ’ ‘ I 5' w _ _ __ _ ’ __ \ _ _ I __1 2 2_ ‘ ‘W _ ___‘_ ' J ' __ , _ Vt I ' i k C:CJPJF7]:I)E§bJCA!! LJE31F E3EEFQ\’]:C:EZé!! ]:FJC:- 411 MONTCLOIR aTnaaT anxanawxapo, ca ease» sacs: ea1—aava - QE8/System II Precision leek Test Graph (OverFii1) Ineoice No.| 1796 Date: e1/es/95 ' Time | @7:23:1i Technician: DMY Y Tank: 4 T Tank Diameter(in)a 95 Vo1ume(ge1)u Bmmm Grade Leve1(in)| 146 ‘Product Leve1(in)| 176 Hater Level On Tenk(in)| Q~ Specific Gravity: .87 . Coefficient O? Expeneionn 0.@@04435 Calibration Ue1ue(m1): 4ee , Channel:1 Level Segment From: 1 To 25@- - Temp Segment From; 1 To 3@@ .1-,». ’I rmcmr 4' -9 'x A —%**EZ£I TJIITW-4 1' -. i . m -.0 ‘nae ‘cu. 3‘ \ U Change In Calibration Zone w 33 Btarting Temperature (F): 68.479 Burface Qrea(sq. in)| 63.7 Level vo1ume(gph): —0.@4 Temp. vo1ume(gph): -8.06 TNet chengeigph) 1 @.@2 ' I ll lllll Iii I! Ell lil Ill HI! Result ~—>PQSSe Copyright (c) 1989 by QES, Inc. 4* Notes ee . 4 tW MIKUL'S PUMPKIN CENTER TRUCK TERMINQL ,$3a@¥;fiQFT HIGHWQY , PUMPKIN CENTER, CR _ nu ' 1” hmmflumt EWEEEL lnodlhw 1 1 1 H T ‘“|| 4 f ., | ll 0| |l u ll »1imm~Hmur£ Calibration Unitfgel/unit) w 0 @@32@ Heed Presaureipsi ¢Btm>>| 4. Temp. Change(F/h) 2|--0.018 4. Product Line(gph)| -0.021 F34'L_ »-—-) FPFQEBEB THIS IS Q HIGH LEVEL TEST WITH Q 49$ ML. CQLIBRQTION. ' _ . _v \ 1 I fill av, . .._,‘,,| imm , gffli. ,_é|»,|,l,‘.\‘,:}-.§ H _ |1:‘__'_, ‘:1 _ “I " 1' ‘ K ' ‘ " ‘A A" v “I I 3 . -hf" ' A I ‘T '1 ‘I Ki i E - ,i In}: ; -__ I" 5|.“ QT: ’ 3' -3 _ ‘ ‘ : 1 . ; - ~ ~ . ' - -. . r .: _ <;' ,1< , - ~ :¢ . "- * 1 ‘ . -,1 . . » ;; M gf - Y -; 3 Q 3 -- | I . ; I » T ;gl H I‘ ';y€“ . 1; Br-1' I‘ . ' - _ ii _ _ v_ __ ' '1 .' “I1 ‘I; F‘. 27 4 \'- : 4‘ - _.,_.‘ .'-»- I, Eu. » .¢ , ,_. _ .~ . ,_ ¢~ 2 .‘.,, R‘ ' » 0. 0 " .- 3» . 4- _ ., 0.. -1.. ~<._. . ,:fi \,,~‘|~_—- ~ - -.--1»--.v ,.»s- .~.-4»,,-'_\..y-p-\-.--~M-1.4.-1.-4, ,. *e -<- -._ -- ..3 - ‘-._ , lv\ P-Ta‘ ' . __ - . -. 1 . -.E l.- I -. . 4 >.-,-. _ 4.,. > K 4 CONFIDENCE us’-i'ERvT1cEs',e “mo._ ,5®1 NORKMQN #8 _, ‘ V " Bakersfield, CR 93327. A‘! ‘ H ¢ cams)-est-3a7o; 1ifl_ IR‘ _'; A V Dete__Z"‘3" _ R R InvoiceANuni.l:‘>er‘£ . ' mes PLT—1@@R - " ‘v,A HYDROSTQTIC PRODUCT LINE TEST wonm SHEET - 4 - ‘ I V ‘ ‘I ' ' ;_:="!.=. _ _ ' , - ~,._'_.“.> ‘~ TEST PRODUCT ‘STQRT_ STQRTH NO. " TIME VOL.(ML) END TIME ENDA ~ UOL.(ML) TEST“UOL. DIFF.(ML)A 21$” (‘Hp ‘:fi»w</ To Z‘ :j7’44/i<_-/ 7'2o_iio2_--55‘! HtsL _6__ KT; =' 70/0” T Us 1- 1-. / inlets 4_ /\s:i;02=s<>i 1‘-H R170 U 6- E! 3; 2 :f'4Lk3 's__0§07.'e/sj /90 J /33 i-he ~. -Q. "Lj- ¢¢>7 ;§_ V“ ‘Z541/< 5/ T» _QUz1</O,:07f$§:L Z ( "1 /Q 7'E Eb- =I I- 77 2 111»//<</iWoU7t;'ssi<>5»/<>. 197‘ 17¢ I II -._ .- .--— -- _-1 1.-. 1-_ 'f.~: DiOide the volume differential by the test time ( 15 minutes) and multiply by @.@158311, which will convert the volume differential from milliliters per minute to gallons per hour. ' » 4V The conversion constant is found by :~ (6% min/hr)/(3790 ml/gal) = 0.@1583l1'(min/hr) (gal/ml) The conversion constant causes the milliliters and minutes to cancel out. I ". . 'Ex,’ If the level dropped 3m1 in 15 minutes then: . 3/15 ml./min. x o.@15é31i"Ymin/h+$~%Qa$zh1? = 0;om3 Qai/hr. RESULTS OF THIS WORK SHEET TD BE COMPILED ON RESULTS SHEET. -¢—-1-__—-_---_-—-_-_._.-—-i-.-.--_--.-_._._-._--_- -. \ \ ‘,1' J '‘ > 0 \. / » QG '.w . 4 -., . ‘- ' | F . _,;~ jlc0"NF|DENCEg t P ' | 2 “Compliance With Confidence”~ SERVlCES,|NC. - "V ‘ ' . ‘ , ,,_.. 3.\ . ~;:.~..~4.¢~ . _. -- = ,.-:.,,, _ ,. 5 rz_ *-".;'~u<’- =' ¢ . if)‘. v___‘. ... \ , ~ : >‘ J -'\ -' ,-1 " \~ ' P‘: '“-"":'L'=f=¢‘ ‘\."-T";1r.;if‘;.».- December 1' 1994 '», v-. A s- '. _ . .~. <» .n_.\v,»,'~..., ‘-», '~ 5;-_ a| “,3 ‘KL '31),‘ ' if.“ ‘,~,_>:?|-_‘ ‘ 7; 9 0’ ‘Q __ 31,: id)‘ “L, __ 1" ,1, , . M, .\ . I A217 F 1 01$‘. "It -. .» ~ -1 \wp—~~ 1- '.1*;,§.,-A "‘ :-,-he * ..z. =. . . .. " ~ _ - X‘ 1!. - ‘ P > ' V- ~ ' _‘§‘**—§~_ '5-';:\C_-7) an-‘_____ V ‘ , iii] E?» Lf‘_f_J ‘ 3'5 9 Q , . ' 2700 H Street Suite 300 L——-_i__ %Lfl To Whom It Hay Concern: Enclosed for approval, please find original of Application for Permit to Test Underground Hazardous _Substances. Storage Tank, along with our check in the amount of $320.00, as and for your permit fee herein. _ ’ . The facility to he tested is Hikul’s Pumpkin Center Truck Terminal, 2201 Taft Highway, Pumpkin Center, California, on December 29, 1994. - ‘ _ _ ?. Please return the approved permit and receipt for fees _ to our office.' » Thank you for our attention herein. Yours_truly, ICGHFIDENCE us? SERVICES, INC. 3)’ - . . Cheryl A. oung, V€;z%€::2Z;ent Enclosures 417 Momclairt Street . Qakersfield, cA 93309 (aos) 631-as"/0 or'(800)'3391993O FAX(805)63r3872 \ '~ " i. ENVIRONMENTAL HEALTH SERVICES.DEPARTHENT _ ‘ *";H;q County of Kern, State-of California I]EC.~.7l994 1“; /I " Hazardous Materials Hana ement Pro ram T "' " '0 Bakersfield, California 93301 _ A .\\J J Q".YCMH!DL cpc=$? y' xoru1* qvrw-&!~;JvvrQ .-,fi r\ . ~3-=-Q-.~:.¢,-|uu~.. =-Q-.. '1-vv~<-am -¢>.. ¢ >.-._. »'- #-- ‘ COFBIDEH r'| {*1 I3 Q3 {.- EBSAICSQ‘ IRE‘ “unit, 4.141 IA‘ _'_]_*-u; Ann 3n_ .(,.m r-41;" L‘, .{v~. ;_ *-U ?r=|~ gm onn oxrncmi §~u€.~ <;;@LM ¢p~ abbxmnaq ~nx. 5 ~fiq LP€"“I 4'. rup- nwpnswfil fp* "-34- ., ... .1 ._ ]'1£H 3n;-fury‘ f“g? 10$; H”FPEPA‘ k1:%:*u fie":;rF.r**rxa:'"- \ 9| am‘ .'7"*C’:"'?fA {H tit-I» 4.6-L’ 2'4 Ia 1'.-Y‘; ' .1 1.1"--'-*.‘.'\.| '-' :4w Wt"-'1‘ "W". .*.u~|~ tn‘ '31" ‘T 2*.-'~.'-. n»,--_,-__T._,- lrstuzr :nwv' n?r"w nT;p cut fiurrt *0 mwe 1 Liv’ 7“ 1-" Qfiff1LW;Tnn rm »¢:»;$ go jpv; r ~»~{1ru;: ~".= 3-‘ . "= ~ \"LI| r .-‘ ' " \' ~ rvcrvunw znx abt'o@u1' t",rtv :.»v n;:\*"" in ¢-wry; 11¢ -1'1‘, (*1--v,.':.;:,u: " ~r._- .___> v“:fi ~v_—'_—;» ;;_ ,= -‘ h1f\LT7i4F7‘ ~;Tr13. ‘J ' ~_ ._k.\~_ .‘ __"h .4‘. I», 1",‘... - .\ - V- r‘ . 5 H.L'- ran‘ "*;1." V: ' 7' " 1; *- 53; ' . \‘.'- .» |"l'}.1U;,\ 4" , " -U' '1" -1’ I" ' Tf J ?V'i'f l',‘.;,\-Y.:d|‘7;k‘.-;.:-;r ‘_!». “J!-»l|.| V_,;‘.-...¢-\-'.r_‘v: ;H_-I :".,:: -Hf] .. _. ‘ -.>.: ~‘ - - < ‘J _ ~ _ .1. P‘ , . . q ., _‘ _' ‘. _"_'f 0 Kem County- ' W 15 ' " .4 Internal egpy /. ' .,_.._ T3_ . Environmental Health Services Dept‘1 ' ' _ "I PTI‘ No 5322’; # Tanks to Test/ Bakersfield, CA 93301 -' » (805) 861-3636 “ L'I"ank/Piping p 0' *~—h/Pi'1"o NQQ Q4242 Appl. Date 4;.-£1/1 r;____. F7132 Ya: rn <.-> 270_0 M Street, Suite 300 i 4 4 iggd to include: Tank onlyV - APPIJICKTION FOR PERMIT TOTESTI 1 UNDERGROUND HAZARDOUS SUBSTANCES STORAGE TANK \ \. I POST on PREMISES?-" .0-\\ }\ \\ A. Faciligg Information 6 . _ W \\ ~\\ _ __\ Kem County Environmental Health Services Dept. Pennit to Operate # 3200 1 0§C (If there is no permit number, an application for a permit_to operate must be submitted and - approved before the permit to test can be processed). Proposed~.~Test--Date: - December »29 , 1-994 -~ . 4 _- Facility Name AMIKUL'S PUMPKIN CENTER TRUCKKTERMINAL Address- A 2201 Taft Highway, Pumpkifi?Cénter, CA TANK # SIZE 1 , . _3i_ l_QK_' 4 8K 10K 10K Contact Person Day PRODUCT AGE OF TANK COMMENTS ‘Unleaded . &_1p.r_emeJlLL Diesel~ ‘s- phone( 805) 832-5390 @§I}:'2'§§M;i'kuiS Night Same Phone () B. Tank Owner Information OwnerName Alan Mikuls 'Phone(s'05 )s32-5390 Mai1i!1gAddress Q P. O. Box 78197, i“i;~.=j:1'ii1 Pumpkin Center, CA »Zip‘C0de 93383 1 C. Testing Company InformationV Company Name Confidence UST Services, -Iner: Addfcss 417 Montclair Street} Bakersfield, CA 93309231796 Contact Pérson Day Cheryl A. Young phone (805 ) 631-3870 NightDouqlas or Cheryl Yogrw Phone (§Q5 ) 535-25511 Worker’s Compensation Insurance # 1 3 O 8 3 7 13 Liability Insurance # POL? 0 2 9 61 Test Method Used AES_ System II (Overfill) State Licensed Tester Douglas M. Young State Licensed Tester # ' 90- 1 057-5' .5- ~ -_ THIS APPLICATION BECOMES A PERMIT WHEN APPROVED I/ P'IT# I//5775f ~ PTO # 7/fin/4 . . . . . . . . . . . . . . . . . . . . . . . . ..PO$TON PREMl$ES.......................... CONDITIONS AS FOLLOWS: l. It is the responsibility of the Pennittee to obtain permits which may be required by other regulatory agencies prior to beginning work (i.e., City Fire and Building Departments). 2. Permittee must the Hazardous Materials Management Program at (805) 861-3636 twenty-four hours pg to tank integrity test to allow the Hazardous Material Specialist the option of performing an inspection. 3. Tank integrity test must be per Kem County Environmental Health and Fire Department approved methods as described in Handbook UT-20.- 4. It is the state-licensed tester’s responsibility to know and adhere to all applicable laws regarding the handling of hazardous materials. 5. The tank integrity testing company must have the state-licensed tester listed on the pemmit on site performing the test. 6. If any tester other than the one listed on the permit and permit application is to be utilized, prior consent must be granted by the approving specialist on the permit. Deviation from the submitted application is not allowed. 7. A modification permit must be obtained from the department prior to exposing the tank to retest or investigating a release or failed integrity test. 8. . The following timetable lists pre- and post~tank integrity test requirements: ACIIEEX DEADLINE Complete permit application submitted to At least one week prior to tank the Hazardous Material Management Program integrity test Notify the approving specialist At least 24 hours before test of date and time of the tank integrity test, Send written results of a test to the No later than 30 days after testing approving specialist is completed Notify the approving specialist No later than 24 hours after of the results of a failed/inconclusive test completion of analysis RECOMMENDATIONS/GUIDELINES FOR THE PERFORMANCE OF A TANK INTEGRITY TEST ON UNDERGROUND STORAGE TANKS I This department is responsible for enforcing the state laws pertaining to underground storage tanks. Representatives from this department perfom inspections to ensure that the job performance is consistent with permit requirements, applicable laws, and safety standards. The following guidelines are offered to clarify the interests and expectations of this department. 1. Job site safety is one of our primary concems. Tank integrity tests are inherently dangerous. It is the tester's responsibility to know and abide by CAL-OSHA regulations. The state-licensed tester is responsible for any other testing company employees on the job site. Tools and equipment are to be used only for their designed function. 2. Properly state-licensed testers are assumed to understand the requirements of the permit issued. The tester is responsible for knowing and abiding by the conditions of the permit. Deviation from the permit conditions may result in a stop-work order. 3. The testing company will be held responsible for the post-test paperwork. Analyses documentation is necessary for each site in order to close a case file or move it into mitigation. When testers do not follow through on necessary paperwork, an unmanageable backlog of incomplete cases results. If this continues, processing time for completing new tank integrity tests will increase. ' THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ABOVE CONDITIONS OF THIS PERMIT AND ANY OTHER STATE, LOCAL AND FEDERAL REGULATIONS. THIS FORM was BEEN COMPLETED UNDER PENALTY OF PERIURY AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT. I Owner’s Authorized /2»?! te Signature Date Representativ7 INTERNAL USE ONLY Total Fee / Paid On 2,6? Permit Approved [Z04/1/Lg Receipt # . Check# Date /A "/6? - / Fee Received By Permit Expiration Date t5 ’/>3 55/ THIS APPLICATION BECOMES A PERMIT WHEN APPROVED HM44 . Ttenmssstrssnuo Qsponts 'EVALUATlON FORM Specialist the tightness test report: ' A_iQ¢4?;/ Wk __ Date tightness test reports were submitted: D g M’ 91 __ Date tightness tests were completed: _' Y‘ 556752’ Facility Penna Number: D QQQQIQ _. Number of Tanks Tested at the site: ___L._-(list the tanks by their tank numbers ifprovided) /V, ,;,>__ <*b/ __ Was the method a test of the entire tank systflm. piping alone, or just the facility tanks (describe) E‘/(_7f/rg tag §7]4§tg_m ? Did the facility pass all tests: ____,)_Q___“Yes _____ N9 ' ' ' that failed the test) (failure is (if no, provide the leak rate and a description of the tank(s) > 0.1 gal per hour) ‘ ' _ The facility will do the following to investigate the failed test:~ — I Ii 1l A '1 'I'he test method certification that is submitted to the state specifies that each test method ' ' ' ' hich uld suggest ' be completed in a certain manner. Is there anything wtthm the results w wo that the tank test was improperly completed? Yes ' No _ (describe)_ \ if i I_ Information has been reviewed and placed the database: / YES NO Date entered within the database: I 0 -4 --a -c G ~'-> t A." \ B. C. I0 Kern County “' Environmental‘!-Iealth Services Dept. 2700~M~Street, Suite 300 ; ' Bakersfield, CA 93301‘ ' - ~~ (sos) 851-3636 ~ ' V ' Internal UseO PTI‘ No.75 213myl# Tanks to Test fiz’ Test to include: Tank only Tank/Piping PTO No.3 zoo (C-)l)AppL Date '7-zfirfl1 ' . .’ ~ ~. APPucA1ji_gig FOR PERMIT TO TEST _y P .A ? - PUNDERQROUND H4Z.4§PQ}!§..5VBSTANCEs=r$!°RAGE‘TANK ,. i . O- =,Ji ivg. E? ii .' L ~ a i. in .. ; Ii $3’ ci o a o --t I . .. A“ p .1’ .;';'§Z!1T* .~»;. '" :< Y - ".¢f» - ~ *-*=+"~ ,;.~:. ~ P _ + M‘ >_Q.! "1? LL! Lu.‘ ta 1. 1 1 "SC ' L: o _’ ' m_ “ ~ Qfimle # 3Q Oj0."|:ib C/ __i,._(_I_f-_ll'1Cl:¢ is_no'.permit number, an application for a permitito operate-must be.subini_tted and' {approved before the permit to test can be processed). _y ._ _ Proposed Test.Date: 3‘ 5 r °'iQ_,* " $I00 gm _ '- ' ~' Facility Name _ H1 Kuté 'TP\\itc,L §ToP b I 'A<1<1ressZl0I TAFT Hl61umA\/ 84»~?_ls.i'~> 64-34§T§J€ EL _ "AGE 0F TANK COMEENTS .___...__ __ 41: Q-;.© |Z)E§EL» “EEL, D|E§E.L_. 5-] Q ‘I -___ I _Ai£§>_E; - L is . EI5 f Contact Person Day ,Q_|,.L€t~i) PM Ii \»\\-5 r. I Night »~. aim _ €'r\'Ei£F- Phone ( $05") j§?:55‘WZ) Phone (_6_0<,_Z) 359' Q § 3'0 é ‘Q |T SEU J1 % Scg L.- ' Tank Owner Information' I. 3 Owner Name Phone (8Q§) 832 ~5<?7U_ y Mailing Address - E0 X Z3] Q”! ‘Put A/\,'UL_L!\_) CEUTELQ, a C/A A. u Zip Code *6~\ 53 83 ,. Testing Company Information 7 ' ‘’ Company Name _)Q€D(,u /416' 7ZT§Z'//"/6 53‘/?U/68" //I/(L. Address _P-0- 60% ./$4 7 5/=1/was/=/e*¢.o 4/4, ?i30g - 5:; Contact Person Day D‘/éfi/Q 75/€/U£’K I Phone (<9@5'§ _,’Q;Z§/L Night 0446/4/U 77//6/z/E71. Phone (got:-) 3;, — ggg, w k "c V "t" ‘Ins # 5_ZZ;~/"E flu/U0 79.47. — ",2 ‘or. ers ompensa ion urance I 1 I . Z?/C_%?2_%z/S_ Liability Insurance /9fl)[;"7?/6/6’>~/ //U Tl ,§(/»€/’L(/_( .4.//u 1;/U‘ ,--~Test Method Used f '27 6 [fF[( I‘~ ‘State Licensed Tester Zf/‘MEAL - . I/)7 I 77$‘ '/ State Licensed Tester # Q] ~ /U / ,2 ' 2/" 7? ‘*0 9o THIS‘ APPLICATION BECOMES A ‘PERMIT WHEN APPROVED a I ‘ . P'IT#» ZZZ5/ ' ' PTO#,flOQ/O . . . . . . . . . . . ..............._PQ$TQ_N CONDITIONS AS FOLLOWS: 1. It is the responsibility of the Permittee to obtain permits which may be required by other regulatory agencies prim to beginning wort- (i.e., City Ftreand Building Departments)._ _, . . .. -W t 2. Permittee must ggtfithe Hazardous Materiab Management Program at (805) 861-3636 twenty-four hours pig to tank integrity test _ - to allowtheHamrdousMaterial»Specialist-the‘option.ofperforming an-inspection. - -- -- - - ~ -- 3. Tank integrity test must be per Kern County-Environmental Health and Fire Department approved methods as described in Handbook UT-20. 4. It is the state-licensed.tester's respomibility to know and adhere to all applicable laws reprding the handling of hamrdous materials. 5. The tank integrity testing company must have the state-licensed tester listed on the permit on site performing the test. 6.. If any tester other one: listed on the permit and permit application is to.be..utilized,_prior consent must be granted by the approving specialist on the permit. Deviation from the submitted application is not allowed.‘ 7. A modifiattionpermit must be obtained from the department prior to eirposing the tank to retest or investigating a release or failed integrity test. ' - - - '- 8. Tbe following timetable lists pre- and -post-tank integrity test requirements: .-~ ACIIYIIX _ I2E.ADI..INB Complete permit application submitted to At least one week prior to tank the Hazardous Material Management Program ; integrity test Notify the approving specialist At least 24 hours before test of date and time of the tank integrity test Send written results of a test to the No later than 30 days after testing approving specialist _ is completed- Notify the approving specialist No later than 24 hours after or the results of a failed/inconclusive test completion of RECOMMENDATIONS/GUIDELINES FOR THE PERFORMANCE OF A TANK INTEGRITY TEST ON UNDERGROUND STORAGE TANKS This department is responsible for enforcing the state laws pertaining to underground storage tanks Representatives from this department perform inspections to ensure that the job performance is consistent with permit requirements, applible laws, and safety standards. The following guidelines are offered to clarify the interests and expectations of this department. 1. Job site safety is one of our primary concems. Tank integrity tests are inherently dangerous. It is the tester’s responsibility to know and abide by CAL-OSHA regulations. The state-licensed tester is responsible for any other testing company employees on the job site. Tools and equipment are to be used only for their designed function. 2. Properly state-licensed testers are assumed to understand the requirements of the permit issued. The tester is responsible for knowing and abiding by the conditions of the permit. Deviation from the permit conditions may result in a stop-work order. 3. The testing company will be held responsible for the post-test paperwork. Analyses documentation is necessary for each site in order to close a case file or move it into mitigation. When testers do not follow through on necessary paperwork, an unmanageable backlog of incomplete cases results. If this continues, processing time for completing new tank integrity tests will increase. THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ABOVE CONDITIONS OF THIS PERMIT AND ANY OTHER STATE, LOCAL AND FEDERAL REGUIATIONS.. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERIURY AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT. ' ‘' Owner's Authorized Signature Date Representative W Z£O74-44 Date 772 7" INTERNAL USE ONLY , ' /— ’_A Z Total Fee j Z73 Paid on 7 27 G! 2* Permit Approved Receipt2 Date Q/§L ‘ ' Fee Received By Re / /é//77 1% K5 TH|S APPUCATIQN BECOMES A PERMIT WHEN APPROVED HM44~ r I ‘i'_,‘1 1 HM44 .7 1 ip~ ‘L _. If plot plan information is available before the test, provide a plot plan of the facility showing. all important points (including but not limited to):V i" tank location and number/designation, pump location; all buildings and roads, vapor, vent and product lines, fill boxes, etc. ' *i ‘ » ‘Proposed tanks to be tested designated by this symbol " 0 ". ‘ 4 Nearest streetior intersection i ', ' Any water wells or surface waters within 100’ radius of facility * NOl1h Arrow " . » i If plot plan information is not available before the test, it must be submitted with the ‘test results. » ‘ ' ~ A i _ /,'7rF;(.L.S ;~ ' W / Q 5 ikl ‘Ti I * 1 _ *7 51%//i>r1>~»—+’{‘—l _ l i ;- y "69" “ wt: I .. i / /"""".‘;_"J,_?_V.f_»:~'-f-.T—’.4-'f—\;L" »’ l..._t~--_->?-e-O‘ U til U Q? U ' 7u»2§5}»vts i ! A D5?"“§g’//I if / /00a9'§4z.wu iD/émc aw it Isl/\WT§ i ' 4/ 2 /0000 60:40” Pfi?5"5i 474 3 /OOQQ 32* 04 ‘ 5 ,// 2: <"’ fly goat: Gfiwvv Dgflfl. . .*i s’éocv@/w~' /‘M-séi‘ F‘ ~11" l s" .c ~43 H *1 “ l ' ~ 4 ’ av /1’ W§ , v : l l I 3 v i. |. » l -~ r -J */ 1,5 MUG?-DI! 44 43 42 42 41 41 40 35 30 3? 35 34 33 32 31 30 20 2? 20 25 THHK THNK THNK TEST THHH TEST C:HQ HHNI C€UEE"CEUEC_'L_E§ffi'I' srner PROJECT H0.: T0231 "TN OLD EHO LOSS- 43 42 42 41 41 40 39 30 3? 35 34 33 32 31 30 28 2? 26 25 24 HhiPiflNliHl#h*HTUPFlHP*QJ#Qt*# BOT TO GRHDE:- TOP TO GRHOE:, 0IRHETER' LEVEL 000v: 00000: XXXXXXXXXXXJCXXXXXXXX CLIENT: HIKULS TRUCK STOP LUCHTIUN: .2201 HHV 19 CITP, STHTE: ‘YPUHPKIN CENTER CH . ._"_ DEPTH OF HHTER IN THNK xCHJ x(H) O-O1 0.01 0.01 '0.01 0.01 0.01 O-01 0.01 0.01 0.01 0.01 0.01 O-O1 0.01 0.01 0.01 0.01 0.01 O-01 0-01 10.5 45.5 05.0 0.00 0.00 1 REOHINE TESTIHG'SUES., INC. TEST LEVEL: SIZE H:-I SIZE B: PRODUCT TEHP: 85 COEFFICIENT H: 0-00044 COEFFICIENT B: O-00044 PRODUCT TEHF: _ _ 85 10000 10000 H H _ PO BOX 155? BHKERSFIELO, Cfi.' 93302 10000 10000 I AA II A11 §Ah£A4\ QfiN5E.TLb9 AAéA . <0 N0.01811 . .Ex.piras:é-30"‘? 5 _ 05? " 04 . :c005> 320—0440 _ A >i%fC§g§< > 04 ,§§vm mnawav vr K? 9 A ¥ QQ4 > ' $95 "’v§$gvW"'< '9 5 b gP\fl CHLIBRHTIOH BHR OR LIOUIO:v BHR CHHRT CHLC (H): V 0-O25 / 3I TEHP CHLC CB1): O-00044H 0-0003 130 " (SVSTEH3 TEHP CHLC CB): 0.00044 H 10000 10000 PRODUCT- DIESEL. :9 € TOTHL LINE CHHNQE LEVEL reap. RESULT srnnr ‘= ‘-0.01 0.012 = -0.01 0;000 =“ 0.00 5 0.000 = -0.01 0.005 = ,0.00 0.003 -= I -0.01 I 0.002 = . -0.01 0.000 = - -0.01 0.500 = 0 -0.01 0.596 = 7 -0.02 = —0.01 =- -0.01 = .—0.01» =‘ _ -0.01 = I -0.01 = --0.02 " = 0 -0.010 = 2 -0.01 =* = -0.01 =_ A "0.01 0.500 0.505 0.502 0.520 0.5?0 0.523 0.500 0.505 0.502 0.550 0.593 TEHP-. 001"1 EHO ' LOSS.- -0-609 0.606 0.605 0-603 0.602 0.600 0.590 0-596 0.593 0.588 _ 0-585 0.582 0.570 ‘0-5?6 0.5?3 - 0.560 - 0.565 -. 0.562 0.559 0-555 -0.003 -0.003 -0.001 -0.002 -0.001 -0.002 -0.002 -0.002 -0.003 -0.005 -0.003 -0-003 -0.003 -0-003 -0.003 -0.005 -0.003 -0.003 -0-003 -0-003 “ DEPTH FOR THHK SRHPLE: ~ 93-O Qfl 0.0 " TEHPERHTURE PROBE 0EPTH:_ I 49.5 ” TEST LEVEL TO THNK BOTTOH 130-O " GROUHO'HRTER HBOVE THNK BOTTOH 0-000 " PRODUCT PRESSURE PER 1" HEIGHT 0.031 LHI I 1 1. »<0> < TEHP xEBD RESULT XXXJCXXXJCXXXXXIIXIIXI -A‘.L..h:h.h.b.b-L.h.L.h-A.l\.h.L.h.b-h-h.b IIIIIIIIIIIIIIIIIIII .5-is-B.A.L.h.h.I1.hi\.h.h.L.h-!‘..h.l‘..l‘-.i'..P. = -0.0132 = —0.0132 = -0-0044 = I —0.00BB = -0.0044' = -0-0089' = —0.008B = -0.0088 = ‘—0.0132 = -0-022 : . —0-0132 = -0.0132 ‘ = —0.0132 = -0.0132 =,- -0.0132 = ’~0.022 : —0.0132 = 40.0132» = -0-0132 -0-0132.- " RESULTS PER HOUR: 7“ < TIGHT:\ “ , ' NET TEST PRESSURE: “ STHNDHRD DEUIHTIOH PSI_ ’ TECHNICIHN: CHLIF. LIC. NO.' "S4-1051- "?EfiFY_ srngr "'0T0§3 0.035 0-030 .0-036 0:036 '0.036 ' 0-035 ‘0.035 0.035 . 0.035 .0.03? ‘ 0-038 0,033 0.040 0-040 0.040 _ 0.041 " 0-041 0.042 ' 0.043 0.01033 ves- 4-03 .0072" TEST DHTE: ~8-5-92 HCCHRTHV 47 4, 0.025 1.1 I I 1.1 _FEfi5 EHO 0.035 0.036 0-036 0.030 0-036 0.035 0.035 0.035 0.036 0.03? 0.038 0.039 0-040 0.040 40 41 0.041 0-042 0.043 0.044 I ‘ l GRIN L055 0.001 0.001 .0 0 0 -0.001 0 A0 0.001 0.001 0.001 0-001 0.001 U0 . 0-001 ~0 0.001 0.001 0.001 THNK eor r0 GRHDE: , “ 139. : 45_ 6 __ __, __‘,,___ ___,__ .___,___,.__..._,, _,,,__ , 1 - .,........, ~» ,,..,.,=.._~.;.......=.:. W1.» ..:'-.:-.»-- _...~.....-...-- \ ""'§E§15_"7_*?EHF ______ “E _______ '“"5"'FffifiC """"""" _'Efi5' H .x<s1n- 1 .RESULT ’ I 1 ‘ rsnp ' - RESULT A TIHE XX XX XI XX XX XX IX XX XI XI A.AA.hA.hA.AA.hA.bA.hA.AA.AA.h I I I I I I l.l I I I I I I I I I I I I A.hA;hA.hJ.hA.h£.AA.AA.hA.hA.A THNK TOP T0 GRHDE THHK DIHHETER:1 TEST LEVEL HBOUE GRHDE: DEPTH 0F HRTER IN THNK: 0.0044 _ —0.0080 0.0044 -0.0080 0.0000 —0.0044 0.00440 0.0000 —0.0080 0.0000 -0.0044 —0.0044 “ 40.0132- 0.0000 —0_00B0 0.0000 * -0.0080 0.0044 —0.0080‘ 0.0044 <0.01?5 0.0044 , » —0-0000 0.0044 —0.0080 0.0054 ‘ ‘ —0.0080 0.0000 —0-0132 0.0000 #0.0132 0.0044 —0-01?B 0.0000 —0.0132 0.0044 ' —0.0080 U.0044 0."lIl04'-1 WMIM 0.00 0.00 J0 0 0 L**I I —0.000B —0.0080' UEPTHIFOR THNK SHHPLE: TEHPERHTURE.PROBE 0EPTH:‘ TEST LEVEL T0 THNK eorron GROUND unrER»HBOuE'rnnKB PRODUCT PRESSURE PER 1"H ".05 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 ‘.00 .00 .00 .00 .00 .00 91-3 4?.S 130.0 0.000 '0-031 PSI §5§ 914 920 926. $32 938 944 950 ‘Q56 1002 1008 1014 1020 1026 1032 1030 1044 1050 1056 1102 \ ¢ l 1%gW W_ *_ MWM WW5 A» __ :4 _ MW% W___ * _\E _, 5 _ __ _ _>_ _ i _ W &_1> 1 A__ ‘ _\_ 4_ ‘E i ‘ W gfl “ _ kw ‘I ___ mv >' 4_ _~HV_ ‘_ w_;W Lg“3‘1T_ ~_ _; _, __ n MM ‘__ ‘W_ __ I ,7 _ _ _v__ §W_ M_ Q M My ___ Y‘ _M__P \_V __ K _‘_“‘ h FQ M w _ h%_“_ % Wywfl H %““\ X __ _ I 4 My l$____§w_m___ W 7” mm “W \ __ __H_k_pm_wm_"¥§ 1. ‘_ ” _ _£__ H__ _~fl_‘_‘_m_ __ |_ Ev! 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'%?’If $% %%”mMmm"_mmm ““%£§_%\ N‘ Q\ \ Z'__J_*MMWM_‘mufl _V é/fly ‘ax lm mm ‘w *“ ® Q ® I. \\ I _ ‘_ /¢/WM,%% Mfilmmmmm _w\\®\MAWw_\ W ‘M11’ ' f Wk / 6% Q6! /0%” I HM‘ \ w Q X \ ' Am‘, ‘ an _r $ / if ‘ll MfMmm“%“\\\ “\ \ \ ‘X \ \ I ‘Q W_% Mmmwwfwwg WW1 //%% %// ¢% mMm'_H__Wmmfi“““ \\“v\\ $ % _/U V “WV. _WW_‘__P__ _A __ \ % _\ _ __J_h_’__' _ 4 MW W I ‘I ““ \\ _M__H____mwWmW_f___“M _ _ __‘_ ____ )_I _ __ _I K____I __ 1 > _ I h v ___V __ __'_>_ J“; ___‘ ";‘_h__ _‘ _ _ 2“ M” _?M___ _g_q_ _' _ ®___$ _ bl W_%~_n an _,__ ‘Wt ‘Q ‘Q ’ __‘_ _ / M \“ tr L‘ at Q. _A __ _ #_%_‘_ fig“ ‘_$___f§$é__l$L_l flfi Mfiwwmnhwwg N___‘_/_H$W’_M*_ _ _ 0”,’ Hi \_“‘w‘“““\\_\“\\A $3 ‘ km_”§_U%,h_“4§,_”_‘_mwH__W%N 1 __ '____ ___, _ _>_.1h_‘ q _ __v L . .0 N __pJ:’q__I "€_ 5 ____ T fin?“ M‘) _ _ _ , ‘ I _’ _ '7 _;_ Wu’ 2“; ___i ',__ _‘__ _ _,1___>_ ___’___“__U ‘_‘ '__________ “W _ ‘_ L _ _ |__ 341% Fl Jmv ‘MW flip \‘_§m__;_ >_ _ _ ‘F _ __ '7 A _ 5: ‘ _ __ . 7' hudgvflm __ *3 _”__W_“_M"_w""_ML“w__ ___ E ‘_ __M__,__“___h____' x V’ __‘__ _‘_/_;____"nv:)__”_ Li ‘_M'Iv'_‘t *QN\_‘§ _ a _' _%“,____ _“‘__'___:%1H_‘___’“_> _:'_fl_ 4_1_,"__"__g _ I I I r‘, _’_ '1‘ ‘I ‘__~_ _ _ “Q ( _ yr !_ ) ‘__ _ _ 5‘: I}, _ __ __k GM,‘ ‘ _m_’_‘ V ‘ __v_ _ _'_ _ V ‘uh ff __l’_“3JU“___n_w“”fi_m\_A‘_ J1 "!$€__ "_J(J‘_' _(__"_ ___ _ ___J_ _ ‘ __m__m”__%_fi“${:‘__Jp w _T Q’? \__H__“ ?_% Mwflfl . t H’ N A‘ __ L $3 V _ w__A_m U__M___“___W_~__,H “\€_ Kg h ya Mk 3 e 2 _ _ _ _ __ > _ W’ ' _ _ ‘ _ 5, J ‘ 8|‘ _ ‘C §_ _ I ‘ _ ___ tn" N‘ _ ‘J _'___‘ _ “V ___‘ 3 ___‘_ _4 _ _r _ ‘__ O _‘____‘_ _ ‘F _ _‘ 55” __;__ V _ _ AF J“, )__ _ -> ___“_: _ _" AA" ____ ,1, _"__ ~_ V h_&__‘___ _“__ A1 __ h __ ‘A B _ )6 *rU%‘_ _" _ ‘fa’ I _J__3___ ____ 67 Jf_%i_ __f‘__ _ I _ ‘_ ll _____' _“_“_‘\‘ {Q _ __ Q? _ ___ 7 __ __ ‘M? v“m%__>_ __ __5H_e_“___£___ bihfié 4 .6V 6* \<5E TU/9 Aéflulq §:fi>REGL£r _ N0. 01 11 Q. >$vw0~u5gg Enwncjtggijgg 4 5%: Q8 4' ‘$254 ¥ , 9$ 4 ”v$$§3“ (ha manumz rzsrms sucs., INC. Ag?’ .94 rssr HETH00: HORNER E2V—CHEK 1 P0 80H 158? >§PQFC%L§0§4 ‘ . ' EIFIKERSFIELD, cn. 93802 ">vvvqq‘1,» ’ (805) 328-0448 - ” CLIEM“ LOCHTION: CITY, ST PRDJECT TRHK TES LEVEL LEVEL STRRT 55- S?- 59- S2— 55— 69- ?1- 35- 3?- 39- 41- 44— 46- 48- 50- 52- 55— 58- 61- S4r MDDUJII I I III THNK TRWI THQK TEST RTE H0. T‘3 END 55' 58 82 as 88 71 ?4 3? 38 41 44 48 48 so 52 55 58 61 64 6? HIKULS TRUCK STOP ' CRLIBRRTIDN ERR 0R LIOUID: BRR ‘ 0.025 CHHRT CHLC CH): 0.025 / 9 = 8-0028 2201 HHV 19I PUHPKIN CENTER CH TEST LEVEL: 135.00 SIZE: 10000 PRO0UCT TEHP: 85 CDEFFICIENT: 0.00044 T0231 THREE BLUE 'Efiffi L055 -,- '_LL.‘.|.|L|..L Nf\.f‘~.'I QTUHJNFQA U ".100. BDT T0 GRHUE: TDP T0 GRHDE: DIRHETER: LEVEL HBDUE GRHDE: 0E='TH DF HHTER II’-I TFINK XIXIIIXXIXXXXXXIIXIX + """ xEHJ xfifil 0-0028 0.0028 0.0028 0.0028 0.0028 0.0028 0-0028 0.0028 0.0028 0.0028 0.0028 0.0028 0.0028 0.0028 0.0028 0.0028 0.0028 0.0028 0.0028 0.0028 143.0 48.0 95.0 0.00 0.00 E€U€[ """" '?Efi5T' RESULT srnnr €..""‘IG)'T1 1 1 0.0058 0.0058 0.0003 0.0083 0.0083 0.0003 0.0083 0.0056 0.0058 0.0055 0.0083 0.0058 0.0056 0.0055 0.0058 0.0083 0.0083 0.0083 0.0083 0.0083 1?5 .1?6 1?? 179 180 181 182 183 184 .185 185 183 190 191 192 194 196 198 0.200 0.201 DCDQ(DO(DOCDQCDOCDOCDOCDQCD .1.-I-1-.1.-1. H 10000 TEHP END DDDDODDDDQDOOODDD I I I I I I I I I I I I 175 .1?? 179 .100 .181 182 .183 184 185 185 183 190 191 194 195 - 198 0.200 0-201 0.203 DEPTH FDR THNK SHHPLE: TEHPERHTURE PROBE DEPTH: TEST LEVEL T0 THHK BDTTDH 192. PRUDUCT: TDTHL LINE CHHNBE: 4.4 2 ~ GRIN 4 x(B) TEHP L055 - x(B) .RESULT 8.001 = 0.0044 0.001 - = 0.0044 0.002 = 0.0088 0-001 = 0.0044 0.001 = 0.0044 0.001 = 0-0044 0.001 ; 0.0044 8-001 = 0.00448 0.001 = 0.0044 0.801 = 8.0844 0-002 = 0.0088 0.002 = 8.0088 0.001 = 0.0044 0.001 = 0.0044 0.002 = 0.0088 8.002 = 0.0088 0.002 = 0.0088 0.002 = 0.0088 0.001 =. 0.0044 0.002 = 0.0088 XXXXXXXXXXIIIXXXXXXI .L.h.B.h.b.\.h.h.b.h.A.L.h.b.L.b.A.A.b.h IIIIIIIIIIIIIIIIIIII .A.h.b.hL.I1.A.h.&.h.b.L.b.h.1‘..h.h.h.h.b " RESULTS PER HOUR: TIGHT: NET TEST PRESSURE 95.5 52.0“ 135.00'" . GROUND.HHTER RBOVE THNK BOTTOH 0.000 “ STHHDRRD DEVIHTIDH PRODUCT PRESSURE PER 1“ HEIGHT 0.031 PSI TEST DHTE' 8 r£cun1c1n§= CHLIF. LIC. no. ‘CSVSTEHD TEHP CRLC (B): 0.00044 H * 10000 = 4.4 DIESEL » 2? I. FffifiE'_"' RESULT .TIHE 0.001155 1153 0.001155 1150 —0.00046 120$ 0.003933 1211 0.003933 121? 0.003933 1223 0.003933 1228 0.001155 1235 0.001155 1241 0.001155 124? —0.0004B 1253 —D.00324 1258 0.001155 1305 20.001155 1311 -0.00324 131? -0.00045 1323 —0.00046 1329 -0.00048 0.003933 .341 134? —0.00045 —0-00258 was_ 4.1850 0.0020 8-s-92 nccnnruv 84-1081 -v ~ 0' "_ k____m__‘ '|_4_“__“'__h_“__M_____“‘__‘__ __’;‘_L"“>¥rmw_t_H_!HmJ1__._ __ }_ V _ _ ___ ‘ ’_____ w______\_" \ "-l’_. _ _ _ _ 7 _“_ ‘W _, {$4 _$”‘H~&%$%__mfi_w_dW_gi _ Y’ _%~_‘_ _ _ ___‘_______M_ __ L’; _ q I _ _ fix fix F, _§_ M_'_u_€ wt ‘ A ‘L5 ‘_|_’% !__V_ _ _ ‘ ____ _ __ J _> __H__“_ "!v___ __ _ _ an ‘TL A0’ _ __ _ ____P ’_U_ H“ I 5% ~_ 3 ‘_ '_'r“'__ _ P __ JP‘ K _>‘____H__ (U _\ __ _ ___H”“v_'_m‘___“_ v _ _{__ _ _ _ , _ Q W: A X)‘ _‘ W _ I’; -'7 _ _ W: L: ' _:_, "R I ‘nu __ _ _ __ ' _ A _;_::;},___)___ __ _ _ I! _§ __ _v_H _ x ‘W X Y ._‘_____m ‘U Q _ H‘ __ __“_ > ___ _4_ \ _fl,_“ _ _ __:_ ‘_ )_ _hw__H(_’__n_‘_J_W}“1“__\“.__\_ __ \“_l__ ‘ _ 1 _ _ W A. . __1_L A_ _ F g ‘_1_»__fI’_h__ _'__“_WML_ _ (Z _ M I _ ‘_ ‘_ _ ‘_A\|A_‘ 3:9 M ‘mp __V_ fit _‘ Mb" __ W ‘»___fi WK _ _ _,M___h_"rM__ _~ ‘J Hg? __ ' “_ _ ___ ‘ ‘ ‘J _ ‘_ I} _ _ _ _r__ ‘__ > __>%__"’t‘”’___:i_‘ in _ "P ‘ __"_;_"“1_"‘ A__ 3 \ \ \ __ , l _ yfl i’m____ Z i‘__H__H H ‘ \_ W \ /I _ _ / / fi W Hi 5 w§_$§W%WMfi%§W%%%/ Qgflg v *4 * _1 § € ‘ \ P \ ‘ N__\ \ h I lm H AV $ \\_ §‘ @$W’/fifig & ‘k ~\ 5% \§\§§%§§%@%_fl%®%%%%WW’gé . 2 H "_ W __’r ____ “ 3 A J5 R ' “J, W 4 ________ ___ QT M‘ é QM __ 1 ; _¢ W MWm_____g§____¢_;€_E__ _________” ’k_%__§m___Ew@%m Q WW) Efigamgggm ‘ M7 % _ \ E _____2% 5 §___% /' _ Q; 5 3 __ WW Mm _ WW“ W ____ ______:__§_ ___?§?%%§%%_M_WA_M%%$ M_|m__h_°H_§ $ _§_ wt ma > M é $ 2 ‘ Ma $ fig’ \ ¢__:____\\‘\_\“ ( E 2; 252; €%_%%§ § _@_§@ $ § \ & 22% % 9 t §_/5; % 5 s \~1 gé 5 §____\_§§§ &%Q%’@ _______ §_ __ 2 M/V/(7% é /W I mwmmmm ®®% _/Md‘ _ ‘ _ é %¢_ fig” \% W ~ F _ ®&% 6 F" ‘ \ /‘ ‘\ u_'__£H“ ’ I Q \\\ \\ E My gfig % 2% 1 _ b ~ “FL /7 /J V \ AW \ f \& F __H W xi g L _% %fi%m_ \§\Q~i x , g an X_ *3 E “ _ 3 m fir 3W my Afii $ _ "_~ FA ___ __ ___W»_‘_‘ __ _ h in wW3_ _~ _ _ $0 _ A __ __ _ ‘F “ ’ _€ >_ _h_ _ _ t AW “NV ’ A q Wm H _‘ ‘ “$ ‘ \ _ ' _ _ W‘ ¥ f 3 P Q‘ _ ’ V N _ _ >‘ ._ I > _ _ H \_ ‘ . _ l ‘___ _ _ I >__ I __ an V‘ ‘H’ _ E A h _ __|__ “Mn ‘H “I V f__‘d__1_ |_d_ II k W’, __ I ‘ ‘ ~_ _ _ __ _ __ _ V _, x ‘P '_ ____ : *5‘ __k_‘__ ' ‘_ Iv ‘> __ T bl p ’ _ ’__"_|_ __ “Y3? _ _ ___ _ _ _ ___ v 3 > __ ___ __( _ \___ 7‘ "J ‘__ _ __'_ _ I é W’ ‘ Y ,__,__M _ I _ _ _ _ _ _ V ‘ _ _ x I vi _ ___‘_'_.__fl_‘ 4:’, _> i V". y‘ *\\ ~‘ _ _ f _ 6 I i__ 3 __“ ‘ _ \\_ “_ _ ___~ _ ,5. ‘Q _ E _._ _ 7 L I H __ ‘ J‘ ~v _ v ___ ‘ 1 ‘ fly“ L _ F _'__;_‘> V fr __ __ g_V__’_____, _>__ _ _ \ ‘ \J V _ _ _‘_ _v nu" _ ‘ I ,_“_,_ __:_r__ _ dU_“Hh_‘_m__‘__ I ‘_ __ I _ _ ‘ \ \ _ _ W MW; A _g_ J Q M,“ Q ‘ % 0 __ Ow ; _ _______~__ \__;_n uh 1, _ ~ _ __ _ ‘Q’ J’ __w__ _K_\ _ _ __ k_ (“__'___f_____"_‘I_mvV___‘ _V >H L“ ‘ '\ ‘ ‘ l_ 3 by J _ at ‘ _ __ at fin __ 4 __"_&v I Emma“ \ Q ’ P ) "V? !J__ _ ‘_ J’ " .\v‘_’ __Ah“_\“’_-__ FT. H _ _____‘~_ _: ___ , LI‘ I”?! m X _ _fl___ _ I \ _ I I a \ » REDHIHE TESTING SVCS-, INC- 2 5@‘44 v*vm0n1Q§:§', €$5E'TLh9 6?2;§ ._§ . N0.0i811'- Expires:@2 ‘Q0 rssr HETHOD: HURNER E2P—CHEK 1 P0 502 155? 50> 0* LDCHTIUN: 2201 HHV 119 5544 ,>“g£cu§§< t . ¢5q .<%i2: ‘Z 4- }-¥ .59 P 805$? 4 ’Pvvv*‘ 55r<Erz5F1E1.0_. c5.~ 55502 A B1230 n,0\‘~q4' _ . _ 5505:’ 525-0445 . ~ >,.§‘C§L Q4 |:|.1£ur= ‘ n11<u|_s n7<u|::|< STOP’ » c5|._15m=|r10r+ 552 OR 1.10010": V 55512 cunnr CHLC <52: "0.025 /11 = 1 0.0025 zsvsrena TEHP cnL0.c5>: 0.00044 x ' 5000 CITY, STHTE: PUHPKIH CENTER CH TEST LEVEL: ‘ 135.00 SIZE: 0000 PROJECT N0.: T02311 ' PRUQUET TEHP: ' 85 THHK rE5r 5: FOUR ce6E£"ic§05c"-"*55i5 EHO LOSS STHRT .35_ 21- 25- 35- 44- 524 50- . 5- 124 15— 24— 30- 35- 42— 45- 54— 50- 5?- 73~ 1?- ‘3mI MD I I 21 29 36 44 52 E0 69 12 18 24 30 36 02 48 54 B0 B? ?3 ?9 22 @COE'fl@U EFL Targ (T1 J-pf Tfl IF '. THHK BOT T0 GRHDE: THNK TOP T0 GRHDE: Q. THNK DIHHETER: TEST LEUEL HBOUE GRHDE: DEPTH 0F HHTER IN THNK IIIUEFFIIIIIENT: 0.000‘1~‘1 + '§Efi5"'“’"EE6EE """" '?EiFT‘ — Hun: . - RESULT srner x ix xx xx xx xx I IX XX XX IE 0.0023 0.0023 0.0023 0.0023 0.0023 0.0023 0-0023 0.0023 0.0023 0.0023 0.0023 0.0023 0.0023 0.0023 0-0023 0.0023 0-0023 0.0023 0-0023 0.0023 142.0 -4?.0 95.0 0.00 0.00 L**IG1W I 0.0136 0-0102 0.0159 0.0182 0.0102 0.0102 0.0205 0.0135 0-0136 0.0135 0-0136 0-0136 0-0136 0.0136 0.0136 0.0135 0-0159 0.0136 0.0135 0.0114 03553 '0.509 0-513 0-510 0.523 0.520 0.533 0.539 0.543 0-545 0.550 0.553 0.55? 0-550 0.563 0.56? 0.571 0.575 0.579 0-583 ‘ B000 I‘ 3.52 TEHP END 0-500 0.513 0.510 20.523 0.520 0.533 0-539 0.543 0.545 0-550 0.555 0.55? -0-550 0.555 0.55? 0.551 0.5?5 1 0.5?5 0.555 0.555 DEPTH FOR THHK SHHPLE: TEHPERHTURE PROBE'0EPTH: TEST LEVEL T0 THNK BUTTON GROUND HHTER HBOVE THNK BOTTOM 0.000 PRODUCT PRESSURE PER 1" HEIBHT- 0.031 PRODUCT: ' . DIESEL TOTflL LINE CHHNGE: " 32 Efiffi'I """ "QEEF ____ '3"?Efi5'* """ "Effifi[-'- LOSS — "~<s> :RESULT RE$ULT 0.004 0-005 0-005 0.005 0-005 0-005 0-006 0.004 0-003 0-004 0.003 0-004 0-003 0.003 0-004 0-004 0.004 0-004 0-004 0.003 94-5 51.0 135.00 XX XX XX XX XX XX XX XX XX XX PSI 3.52 3.52 3.52 3.52 3.52 3.52 3.52 3.52 3.52 3.52 3552 3.52 3.52 3.52 3-52 3.52 3-52 3.52 3.52 3.52 =_"5f5I305 """ "36T055€€ = 0.01?5 - 0.000551 .: 0-01?5 1 ¢0.00155 :, 0.01?B' 0.000581 = 0.01?5 0.000551 = 0.01?5 ‘ 0.000551 = A 0.02112 1 j—0-00055 = ~ 0.01405 -0.00044 = 0.01055 0.005055 = 0.01405 1.—0.00044 = 0.01055 {0.0050?5 = . 0.01405 - -0.00044 = 0.01055 0.005055 = 0.01055 0.005055 = 0.01405 —0.00044 = 0.01405 4 -0.00044 = 0.01405 V 0.001525 = 0.01405 —0.00044 =_ 0-01405 , » —0-000fi4 = 0.01055 0.000503 RESULTS PER HOUR: 0.00554 TIGHT: _», VES‘ usr rssr PRESSURE: 4-1550 STHNDHRD.0EUIHTION 0-0015 rssr 05rs= V 5-5-52 TECHNICIHN: nccnnrnv CHLIF. LIC. N0. 94-1061 0-02$ 3.52 TIHE .1155 1155 1205 1211 121? 1225 1225 ~. 1235 1241 .124? 1253 V 1255 1505 * 1511 ' 131? »1525 1320 “l!535 541 .134? _u“_M_M_W_“_____‘N__w 1 _|_$__" _ _ _ kit T ') Z” ‘W M__m_w_ _ x"_____V_R L‘d_'_ _ ‘_hw____,T\_‘v_h _ _:_h_“_L __ _ _ “T _ t __ __O_ _ wfl_W'“'(‘___,_'_"__fi_ J v _ V __ M ‘ * i V 9 a _uWN_M_EW"M% Vflhflnm ___ _“M’$W’mmh >1‘.-‘!_~_-:-1. I _\_ J aw _ ____ ‘_ _____' Y‘ L _ _ __l_ ‘ _:“’,£ my _ "_ ‘ _a_(__‘uLw¢M%rI. __‘ > _ _ ___ _ ‘wk? _d“# _ ~€VmA‘_“_____%_'nN___“C_‘fl““%H____ ‘W in _ B). _L___Lv____n__‘ ’ I “N: _nmwH_3_fi__ __\____ 3 _w__J___ ____ _) __ ___;?__W _ _ _‘_:~_\___r__M__W __ ‘"__u__vmvv> '{___ qt?‘ :‘_> 'H___“_ W ____"_ __§ “L H5 _ ‘ ‘ ___£_“___t__§§)' hr __‘__ k;_x“ _ ‘ I '3 .'___v'_k___‘"__‘ __ _ _ ___“_4__*¥K’_“ _ wk”/____’vMNl_>u'_>v_ _ F I Til ‘p“MM_'__‘“_' ;__ f_l“___,___ _n‘_‘ _“‘__mJ ___‘___JmJh_'_fl. I r___ _‘h_\_“__ ‘_0w_‘]_ I __ ___ V”. ____“__° ‘_”>__‘v‘,_ _v ‘V g ,_ ,_ _ _ U, _ __ R} W_W__ "_§___‘uh _ 6'__>_4'_r _ __m__*____"I'w_ __ _7_¢__v~N__a__$_g_Y__:" _q’__'~4___'”__$_%_ N“ _ __ yéfiv; __ ’ ~ _ _ W _ M__‘_ W A I Q V __ ___mhW_W _ H“ _ M_M_’h__v” gfi _\ W mt Q F M H>__m_%“‘ M1 fl___mM"v__"M4_ ‘_ _ _h%____bH_’___h, _ Q ‘I V __ W i_L ______%_ f __ ‘E V“ n ‘ ‘ gflmflmgx A_ ‘M l I ‘ II I M I_ ®&“\\‘m“m“mmmmmml/ U _ L____“_ Q _; _ _ '_ __ ’ u \\ km“mu- W //wk M_ ¢ \ Q \% _l _ ‘U___“_§__V4 & L? __\ \ \_\‘ \“\@“_ \ Wlgxfill _‘ n ‘Q F; is _ _: % \ \ \\ mm A’ // WWW MW km _ \\ % Q‘ % \ \‘®®“§“mm m 0”/0% @/Hg A/AA? ///2///M,‘ :_ _ §\ ®&&§€“m_um__mnmm #%%$\ @%%/%%_¢ 5Z H _ __ \\ §\ \%%M®$“§mmmmmm %@%/&/”%’@__4W)///MW’ / §\\g§ % w V \§ §\ \§ // /% _aV_&“§LW_: _ _ \ S \\\§ g \§_\§%%§M§§“§&y%Mmmm§%£%V%%%§/g%%%%% _ §§§§ g §_~§_$ / _ _ §______ Q5 ___§§_:_=___ ~§___\_m_§““_'“““_““““““_“§__Mm_w’_' fH_mW§%w_§%_$M_j ”_ ; E ___ ___ ____________ __ mi if __ UM $ ______M___ \_____E a__mE__§ __ K i _ 3 ___ ____ “___? ,_”____:____m=____§fi____“____"_ M}; wm____h_______ __M___m_ _ __&_____£ 1% £2 %i§__§§ A £3” W __ ‘D _ _H' €_ vwH_‘"___H%“’?\____ Z I fi a "_A"__fi_ _“,h_)‘W¢ ‘~Q°__ ~§ Mrmm _ F 2/?’ 6%, /6%’ “#9,/4 F§__%m"“m‘mflU‘ &~§°_X$: _ 3 \ C v A % 5%?”//;’% ?””/2; I? 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W H W mm \ xx §01\\§ W‘ A fie _ _ ;////// /4% fiiwwlflmmwmmmw _ _ //Q fM_/if/%””””"_,_%%m_mmh_mmwmmm m_W~“N®\ _§ __\\\ _;/_ \_\_U _H W‘_J___ “’_ H_r__W_»_‘__> _‘__w_‘_ _ ~' gmmmm \ 9 _\ V; _b ,0;/%@%w%Mmmmmm“W%m \ A L /7 /%fi/w %W%%”__m__mmmm“m%m\““_\ \ \ 7 __ ~fl _ _ ___J‘MH_W__ HMHWHWH Hxwfl / 4”‘ / Q”/Q /WI/# flmmmufi \““ _ “W h_ // flimm VN_$_M___WQ__fi \__ _ & /”’%#%W ’!'_wm_mmmm‘;__fl“““\ d __ _ bW%/WwmMMmm%mm%“W“““& Q *%_ A 7 , aw __;_‘ fiwfifiy /’ R W‘ I kw 5%’ r ‘Al “Y if 0%“ H “flu ‘_ ‘U? __~“_|_ _ L’: _~ _ _ _ “ ‘ h_'__:_ H“ T _ J __ “_ _r_= ‘__ g__“__i ‘ _ _ ‘GK’/_ U_\d__V%,‘>_W H ‘vi Mfi ) _v/__4 _‘u_ fly M u __ _1 _ _ _>__~m___”___>_ “Wm V » ___ _ ___‘ _ _m"W__H_k_' _ _“__H_ ‘uh?! my QI I _ _ Q "WNW 'A_“&_____‘ M V _ _ fiwwwmmm _ &Q WW? _ __fl"M_M_um‘l__, _ '*__fi>_ _H‘___%/_Vmw_N___w_ _‘ _~ _ W it _ In __ _’P_ _’_'v__H_m _ 1“ N _“_§%il W _ __‘_,“~'_{__‘ _‘_h“%_‘\___ _ ; G 3: “A __fi“( $35 aw 5 _; %_fl?_‘ ' MEQMHV;®yW%\_V__%'”|""~w§ ‘u _ ‘F’ __ __ _ in ___ _ __ __P_ h_ _ ‘”h_‘_w“_V" K ___L_”" _r____h”__T_a M%‘ _;' _._E__%_~_'__$v~__ if W M_&_ ___ Gpykv J W _v_H_‘H “F ________‘_‘!_ _ ~_V_r_,' ___m_w_~ U_ _fl__\ __ §q_"__‘_A _ V; 4_‘M“fi_ _¥__~‘_K '_\ ‘Hwy _ _ _ _ _ 5 _ , "1 , __ _M___¥_ _ _L ‘_ an __m_fl‘m___ _ 3 _ z _ MW U _ I “$F____ _ I’ ‘A\_fl$_u__“%" __§’w%__vm_N£M§K“:_4 &_%K_D_ ht £__’__v I: WA__'%$Kw’___.flH§"_ Y-Q ‘ N__ _l ‘A2 _ _ ‘V __~__ 57 4‘ _ 7H_‘_ _“ _> _ _V) _ _w ‘:7 U H __ _ __ 2 Br __“_ “ ‘A fly J jg /‘ * ‘ Mg‘ > _‘ __4___:_ _ __ _ __ _ _ ___ Nv___~<M_‘ 1 '_ C I ( J; _ " _’ _ _ _r_\ 1 fl_Tv__d\, ’ !"f‘( '__‘_i\ _ _ _ ~_ ‘”_ _ K__W“~_| ,‘ CLIENT: HIKULS TRUCK STOP LDCHTIUN: 2201 HHV 119 V A nsouxuz resrxns svcs.. INC. @q> rssr ncru00= HURHER E2V—CHEH 1 , ~ P0 e0x.1ss? uggp. 0% BHKERSFIELD, cn. 33302 _ 1 >§Q§CAg§q4. QEMQA > 4'4 v>,4v|no1v.u,,~4$.,, 1;? Q fix‘ %.,....-W _ ‘M N0 01811 VEuwea@€%P7f 44 G4Q?§gq k (305) 325-0440 4 V‘ CITP, STHTE: PUMPKIN CENTER CH TEST LEVEL: _ 135.00 SIZE: ‘ B000 PROJECT N0.: T0231 TRNK TEST 8: FIVE C€DEE_'CEEE[""'Efiffi EHO L053 STH 72 ?4 75 79 B2 B5 B? 90 50 51 S3 55 S? S9 50 S2 54 S5 S? 59 MUFJQIJ I I I ll RT THNK THHK THNK TEST P4 ?6 ?9 02 $5 3? 90 93 51 S3 55 S? 59 B0 62 64 65 6? B9 ?0 3 Ei 3 LL-'- .\\~ N»4K .Nr~ H- BOT TO GRHDE TOP T0 GRHDE DIHHETER: LEVEL HBDUE GRHDE: DEPTH 0F HHTER IN THNK PRUUUET TEHP: COEFFICIENT: + mfiflh _____ "CEOEE__“_ — MCRD 1 RESULT IIXIIIXIIIMIIIXZIXIX 0.0023 0-0023 0.0023 0-0023 0-0023 0.0023 0-0023 0-0023 0-0023 0-0023 0.0023 0.0023 0.0023 0.0023 0.0023 0-0023 0.0023 0.0023 0.0023 0.0023 142.0 4?.0 95.0 0.00 0.00 n :- -1 -0 -- LHIQ11 0-0045 0-0045 0-0068 0-0068 0.0068 0-0045 0.0050 0-0000 0-0023 0-0045 DOG I I I ‘DD D .1’. U1 045 0045 0-0023 0.0045 0.0045 0.0023 0-0045 0.0045 0-0023 B5 0.00044 TEHP. STHRT 0.313 0.313 0-314 0.315 0.310 0.320 0.321 0.323 0.325 0.325 0.325 0.32? .329 330 331 .333 0.334 0.335 0.33? 0.338 GOOD I I H B000 TEHP END 0.313 0.314 0.316 0-310 0.320 10.321 0-323 0.323 0.323 0-320 0.32? 0.324 0-330 0.331 0.333 0-334 0.333 0.33? 0.330 0.333 DEPTH FUR THHK SHHPLE: TEHPERHTURE PROBE DEPTH: TEST LEVEL T0 THNK BOTTOH GROUND HHTER HBOVE THNK BUTTON 0.000 PRUDUCT PRESSURE PER 1“ HEIGHT 0.031 2.64 "“'Efiffi'+ """"" ';E§5 """"" '?Ei5 ______" CHLIBRHTIOH BHR OR LIQUID: CHHRT CHLC (H): 0.025-/11= CS?STEH) TEHP CHLC (B3: 0.00044H PRODUCT TOTHL LINE CHHNGE: LOSS — 2(8) RESULT 0 0.001 0.002 0.002 0.002 0.001 0.002 0.002 0 0-001 0.001 0.002 0-001 0.001 10-002 0.001 0.001 0-002 0.001 0-001 94-5 51.0 135.00 2.34 2.s4 2-54 2.64 2.34 2.54 2.s4 2.54 2.54 2.54 2-04 2.34 2-54 2.54 2.54 2.04 1 2.34 2.04 2-s4 2.34 XXXXXXXXXXXXIXXXXXXX PSI = 0-00264 = 0-00528 = 0-00520 = 0-00520 = .002B4 = .00528 = 00528» =0 = 0.00254 = 0.00264 = 0.00520» = 0-00264 = 0.00264 = 0-00520 = 0-00254 = 0-00264 = 0.00528 = 0.00264 =‘ 0-00264 DOD I RESULTS PER HOUR:- TIGHT: NET TEST PRESSURE: STHNDRRD DEUIHTION TEST DHTE: TECHNIEIHN: CHLIF. LIE. N0. : """" "'5 """"" T“ V, ;AAA *9. “E. 1; “>1. > a/‘ass’ TVVVVY BHR 0.0023 6000 DIESEL 33 FIHHL' RESULT 0.004545 0-001905 0.001530 0.001530 0-001530 0-001905 0.001538 0-001530 0.0022?2 0.001005 0.001905 —0.000?3 0-001905 —0-00035 -0-000?3 0.001905 -0-00035 —0.000?3 0.001905 —0.00035 0.00432 VES 4.1050 0.0012 0-5-92 HcCHRTHV 94-1061 4 - 0.025 I 2-54 TIHE 7 "I43? 1443 1443 1453 150]. 150? 1313 1513 1525 1531 153? 1343 1343 A 1355 1001 100? 1013 E10 "“B25 1531 .¢§1~4‘* ~g*>§;1;-11.“ ,1:.,_3 1.1- 1, -ggfizr-.1 *-~,;'»r‘Y11.,?.*&.‘ ' ‘h-',; ?“§.-$5?‘ ;¢-19*-‘?‘ -<\'.~='A; 4:3---‘ _:.-.,- .-, -. . ‘ ._ _. -3,=1=>1.;.§. %~:;~-1- :11: -f-' ¢.=s—»§.~;,-my ,. ":-'~-‘:;-.-1{-=-- ~"-T" “"‘\'Y.*?'-.1“.-f->.’=?; '?~.s"> .‘*l'~'"<‘.P*: -i" -mm , ‘-‘ 4‘5‘{"“i§‘“ ' ”‘"“ *5‘-fix-‘""Yi \,*§?,s'»1‘?,5%%""*”‘:2§1'»’ ’*§§ *i~ $9? :1 $1. ,“' T5? in ,2‘ .-Q. ~-"1: ‘-‘3> . 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Note: All major modifications require a Permit to Construct from the Permitting Authority.- I have done major modifications for which I obtained Permit(s) to Construct from Permitting Authority~m_-_-M~-~»~——-—~~~'"*1"" “"‘ ”” "” ‘Y » ~ Signature i .'‘ Permit to Construct # ' y 'Date Repair and Maintenancelsummary Attach-a summary of all: I * _. Routine and required maintenance done to this facility's tank, piping, and monitoring equipment.t Repair of submerged pumps or suction pumps.‘ ‘ . Replacement of flow—restricting leak detectors with same.t Repair/replacement of dispensers. meters, or nozzles.- Repair of electronic leak detection components. or replacement with same. * p ' Installation of ball float valves.- Installation or repair of vapor recovery/vent lines.. Include the date of each repair or maintenance activity. NOTE: All repairs or replacements in response to a leak requirea Permit to Construct from the Permitting.Authority as do all other modifications to tanks. piping or monitoring equipment not listed here.' Fuel Changes — Allowed for Motor Vehicle Fuel tanks Only.“ List all fuel storage changes in tanks. noting: Date(s), tank number(s), new fuel(s) stored. . 1 '' Inventory control monitoring is required for this facility on the Permit to Operate and I have not exceeded any reportable limits as listed in the appropriate inventory control monitoring handbook during the last twelve months (if not applicable. disregard). E L" Signature- Trend Analysis Summary~“'' Please attach Annual Trend Analysis Summary for the last 12 periods. G K - .> Meter Calibration Check Form _- I’ Please attach current. completed Meter Calibration Check Form l/VI 0 ‘. .1 ~ xi I \ -.1 4'» 2 E . -4 \\\ 2"‘ —. \\ ‘. ._/\ I ‘K \ '\\ <'»\ \¢ , -\v 1 .. \ as § H 1..,...._..,.._._4 S 0 13¢» 1 Q. ! _ -..._..-,- J L4 -A Véwvtlsumwu-.\¢~ _';,‘is.’I- I I 1 I OF WEIGHTS AND MEA§URES' ' ~s DEPARTMENT , ; ,_,_ ;~, COUNTY OF KERN _ ' STATE OF CALIFORNIA. I I I6 East California Avenue Bakersfield-93307 Telephone (805) 861-2418 Certificate of Inspection K O 9 9 Q3 This is to certify that, in accordance with the law, I have tested the scales, weights, and measures said to be the property of or used by: . DATE //5;, / 19/ / -__ /K "75 .h\‘ NAME /I///%'_.-Z; //‘l’ e\ /-6 /.7~,..~1/‘:32 ,>~M.u:/ /' ’</ ,3“ I I I ADDRE55 220/ ‘/4-I 9/ ~/ ‘/1K OWNER FORMER NAME Tag Na _. "Ea NO; ' DESCRIPTION AND REMARKS Sea ed Correct J 74' E,-/4/I Z‘ /Z/I” W Q‘/’7//S Ia?‘ _:‘/F‘/'/if -/ 7‘/,/r/' * /I4’ 40-” /—’f4/J \ I \ ' )__, -;-- ,;..- Iv {if /Z/'.;./"*'<-»/BL /IE2’/4’/"‘TZ_'[ //V / 1: /_ / Zelfle, /at/t’/c%;e.»t>. ; -- (OWNER OR AGENT OF OWNER OF PROPERTY INSPECTED) . §, Mont); H. Hopper, Director "s " 4 ) / ' ‘/ ,."> .. TOTAL /I L4 /\§ //I p L/)?.__(// /_ PROMMENT PLACE DEPUTY/INSPECTOR .. ’M 45Q ~\ Q‘\ .40 TIME IN A _ .X '_t T|ME'~ ._ __ OUT ® Q . , _1 .H i 6 . x ' r- , -- >. > . . . _. | J . \V .¢ 1| ..~ 1' '|\. UUUQO m _I l 1?’ Totalizer E V‘ g,l<,.£_ .;\,V\ . O, M, ma, all cs ;;, ‘_ t-V, ,, __ §~>gk “.‘,_ & L _ F 6' X;\J_L> ',rQ/ 1,-. t 1». ’_1‘.;~ ~~~v :2,“ §,.»~4s“ 4:. ». > , _ ' * ' E (E "Q 5 _ ‘' Y ’ OUIPMENT COIVQANY o . 21 ity st. - Bakersfield, Calif. 93307 Record of Computer (805) 861-9510 or Meter Chane Location ‘,uL ii, 576;)’, ' (t,V" I -‘ IQ mDe' Dam Meter Change Job Numb“ €( ‘” B Computer Change at \ .\ \ ' lj W/M Notified Make and Model 5‘ Pump Serial Number Tagged Tag8 Bfled BGreen_ BBlue Finish (HIVQQEV) Totalizet if 1/‘! // Finish (gallons) %’5‘7»‘1Q <+ Readings Start (money) 0 s=—- /" 5 t. Start (gallons) __ 458$’ (S Calibration: Fail Slow Checked 7L 3 7L3 Adiufled Fast Slow To Product\ W 1/Q Return to Storage (gallons) Totalizer Sealed Meter Sealed ,/Yes‘ BNO Yes BN0 Make and Model _ '7 Pump J, ,, Serial Number Tagged Tag 8t BF ‘d BGreen BBlue Finish (money) s 12."/’% Finish (gallons) ‘V 954/‘/3~ $6 Ream“; Start(money) g ‘Pee: Start (gallons) 3/ 3 (/1 3 Y i§6 Caiturationz F35‘ , §|°W Checked UT _7 “fag Adiuned Fast Slow To Y‘ *3l Product C, \. l\ Return to Storage (gallons) 3.0 Totalizer Sealed Meter Sealed ‘/Yei BNO ‘(Yes BNO Make and Model 4‘ Pump Serial Number Tagged Tag8 Bfied BGreen BBlue Finish (money) /f ._' 5', V, Totalizer f " :2’I Finish (gallons) 8 7 3" ‘ll Readings Startlmoneyl é X I Start (gallons) 5;‘ 3 4 9 4 -‘1 Calibration: Fa" $'°W= Checked Adjusted Fa“ __) s'°‘” To 7L‘ K3 -/ Product Fleturn to Storage (gallons) Q1O Totalizer Sealed Meter Sealed “ Yes BNO Yes BNO Make and Model V/V Pump _Serial Number Tagged Tag 8' BRed BGreen BBlue Finish (mt;/ney) . Z ‘1 Totalizer ; //' /I Finish (gallons) S’ (‘l ‘9 / e/ Readings Start (money) +5?‘ Start (gallons) i2 /‘M />/ Calibration: F35! Slow Checked "Q/7;)“ 2*- Adiusted Fa“ slow TO Product ‘ 1,) Ls Return to Storage (gallons) Totalizer Sealed Meter Sealed ‘V Yes C) N0 “/Yes B No1 Make and Model Pump Serial Number Tagged Tag8 BRed BGreen B8lue Finish (money) v/7 Totalizor //” <4" Readings Start (money) __;_;_,;.4 g2./)5“/2 // Finishigallons) - Camnaiionz Fast stow /,, . t C") ;L=/-/ ,L/ necked C" 1"! Start (gallons) Adiuned Fast Slow To Product L _J\' Return to Storage (gallons) Totalizer Sealed Meter Sealed /0 e 1:1 0 el ‘ Yes N 'Yes BNO Make nd Model1 I ’"'"" 832 1353 Serial Number Tagged Tag8 BRed BGreen BBlue Finish (money) Totalizar W '»\ B‘ \ ' =~. F ‘i\.; “i Readings Start (money) ef ~/> i?/((6? 2’ 9”‘7 Fl11lSh‘ (gallons) Cagbraqion; Fast stow $5‘ ~ M? Checked if ii» '/'‘ Z ,_ Start (gallons) . Fast Slow Adtusted To l Product tt _/ ")( B Return to Storage (gallons) Totalizer Sealed Meter Sealed / O “(Yes BNO [§Q’Yes BN0/ Dealer's Signature / i "K “,1;/V /~ I /, ,1 Y /' 7'4./i‘*Z £1» 5’ 11 7' 4/‘I »2 Maintenance Man's Signature, i ~ w" it ,f7/t 4» Distribution: Original (white) Invoice Copy Duplicate (canary) File Copy Triplicate (pink) Dealer Copy / . .u5.|,,‘\,\~,;;¢‘\=.|¢¢;~¢g';-.q¢-.»1¢;:\-5<-,:,:;;.,»,~_:; ?:\Y;¢§$yv1_<_<_—;q~I§w<>|vY‘{v(\y:v\\~f'\at;y<.{é/Z‘1g\1\v1‘!»;vv\;.;‘v41'\\"I\f\|~ ]'\|“R"7'X7'2VV)|“~§'I7'<I‘v?:\—(;\g- , q_ L .‘ ‘~11 ' ,_ Y V3-1 -, ";‘)hI‘}"‘:I""I':I‘T]Y\~}J"I“ \pv7'I" -.-~,.v -Y-». _-r,~s-W-M-=-—-W---—~—-1---w-7~-.--v ~ ». ~-.-._ . ——= - ,~~ "- “<1= {$"‘ 5'-‘Q16 East California Avenue DEPARTMENT OF WEIGHTS AND MEASURES‘ Bakersfield-93307 CQUNTY Op KERN l NOTICE OF VIOLATION l .. Telephone (gas) 861-2418 l A STATE OF; CAUFORNIA Q U 0 6,56 Name I Ax./ZS TV ~/ f/L ~ Phone C l‘ , , --~ Date Z 21 , WZL Address 110/ /~44 vi»/4*-/‘7 City TIA/Q C ’ I" Time Q)/V1 Hrs: You Are Hereby Notified that you are in violation of the Business and Professions Code of the State of California, section(s): JV)-'l°Z1» ("Q/I-L1(~nJl0.1-\ “LI (°l»"\S\JlA-\Zv-£‘4,\/q\/ ’ '}/p/)q~';r~ ll/Ytl/‘vi €,.~l|¢JL1.‘l - __v \ C 1- .7 ‘gwaii P’@?\/I4/4}. 0|,-\ /av/(4, Si;-7h". ' _/2 (LU) “' Z7!/8&4/xl ;az;).l~/L;/'/qua/¢(q__ fzsvui-/12¢? ¢»1*72¢M/1 £‘///0;/imp /, ldiraglp /opal/-e.¢l 0». ‘ ‘ ‘ M 2. ~ J, ll AV;a\/l">’1P,j75 , Bra»/\¢l /6/1/6(z»V*\12I\j' Mae i-lzsl, 0 ‘<§fi,i_yg\e__C<4|=ai=EorPr/-ll*:@=Admi=nistrat+ve-God‘e lJ_/VJ V '\5"Y /Q ‘F79 - ' - complylvi/ithin E1/l/I V\a"2,<l,47lx'days from the above date. Failure to corhply with this notice will subject you to the penalties as rovided for in Division 5 of the Business and Profe o s Code of the State of CGlbfOfnl0 ' /V) /'l'ofl/‘Ea V VERNQN-L""'l:®WE Director ‘ V‘ , I'll" »l - ‘/4,’ . -~ . By D és /{Z/41,1//o .. '/ ' Sfinature of Owner“€r ployee in ChE'r'ge ‘ l _ _ . / Deputy/inspector wrs. a MEASJIZI (REV. a-73) ®M _ Date of Compliance .i ' . Inspector ‘ii H‘ ___ _ _, ‘H _ _ __ _ ‘I ’ mmkrr m I _ __ _ ' I ‘ I‘ _ v ’ i ‘ _ __ . _ _ ___ ~ I _ ‘_.‘_‘_\‘_'_'\‘ ‘W m ,_r __ ‘ ) _ _ _ I _ ’ _ _ D I H _ _/ ‘ ‘ _ £ ii *§"?I“5:‘,‘.‘~‘T‘E\*?'F<\Y'"-i?~T?‘5'*t'?‘T§5Ti??f~‘. '9'-9%‘ 4?‘ a1>~:<»1w>Y-a»»:r'#*er*?1. '2‘ ,y:-s;§w_*;'<»- :=v:éw"‘,'§‘."f1‘£"'.- v;-_, '3? is E \ a-” . *5 T"ir'=‘Z<*rW4“* I\ ,. _.'£. 1‘,» ,. ;.~.+ \i gi "IQ 5,. 5% 1? NC. DESCRIPTION AND REMARKS‘ S.A 5I .T______.__. .._ 4'-;1¢_' c_ W... ‘iv _ _._.. _'_-_-_—;;_r¢_;,:_i,.:;€__7.____V 3 _; I __ 1 r\ DEPART T OF WEIGHTS AND MEASTJRES COUNTY OF KERN STATE OF CALIFORNIA 'l ‘I ‘I6 East California Avenue Bakersfield-93307 Telephone (805) 861 -2418 ~ Certificate of Inspection K 1 44 19 This is to certify that. in accordance with the law, I have tested the scales, weights, and measures said to be the property of or used by: DATEA /1/9 _c__ .‘_ _. _. - Z»,K 19 7/ ‘iii NAME_M/.kJ/ 5 via»; j £1“ ADDRESS 3 2 0/ \\ “t/L/»</~¢/ £Ma’@<»/;J/,,*L/ OWNER FORMER NAME - ' - "CC §m '58 Sea ed Co Tag Na ‘"6 ' /nvl/v1_}0_$‘ '- 1’ flu:/“,4? l/'“ .I +4 °\°' KV Effie, _ g Sfakaqg, Tmi; T;¢s71a.l ‘I W £0“ (A/;»Tr,~ ~ V10),—u_ Ilncfllr-a/f_.éQl- 3&0 0/¢>J 2’ /,/7? {WK Z09: Ucesd é/‘ /-Q5“? C/:;.l"_7‘ t"I1T"./'/4/1 n,” H-M <‘77)\r /, An 4I """* ><9,.Z4M/ »§<§ TTOTAL '§. go-_I~ ,x_ . /1f?;-;-/ '.';1'|M_E _ _ _» - . (OWNER on AGENT OF QWNER-oF*P§oP'ER'rY INSPECTED) _»,@ ~“9‘" Monty H. Hopper, Director ~~ @' ’ / V’L , A PROMMENT PLACE DEPUTY/INSPECTOR v/.¢t_, 5 ah , 4 1 ,, 26§°Z""1.oQ0»‘: - .\¢'4~'=n; -.2;-> -~ "/eel /1370"‘ he~ . _ v ‘ _ r 4 ,7 ‘M’-.‘ ‘ 'f ';¢§f~7*‘." 3* ~’ .-3273'. “*Y<>f~3f 3‘-'' - .\, I _. J -1 1""_ » 1... nfi‘ ' \4 r '‘ I4 — » .. I ' "4 - ~ —- -- - -+ 1 1 \- ¢_ 4 1 4‘' | n n0 | \ . ‘z - . '1"? ‘ **- -.?w¢C@ ‘ , -. n. k ’ ‘ ri 1,- (aw/107 safflfi? Q » -<‘»V@'§7 5'65 V '$*?2{v(7,@r;g;_ 7w 927v,/‘*7 //Wu ~ (§<f/$949}-fig /;’!¢l}3‘7Vjv_‘('f/E-=9/fig’) i 1 2?, 29/Q +@77?7Cwy,yda;7 §,w#~1M/V» a'fl7vn/wjwr. N? @@~/ww/-8 "” 1 EH »v/“$.44 Wu“ ’@"W'Q . ' ~ __ 5.; pflaw /vr» ,$»h~E-8;} »,w,;~/my W» efvfiwwfi an/W??‘wvw@?@W Fe-1'-L '~ v#?#f»w»% -71/:2/fig " 8?? gm/=7 . 33 0°wr»Z/ fin/7 . , - . ; ’ _:§i94r.7~/j '6-$2?-19 W17 7%»: a M’?//*'%#~w;~ M W77 >Y@#¢¢> //W FQ/"W/9 "WM-‘~ W1:-7 v»,w¢*W”$~9?»*§s*¥4-°@’1*’/'di»?<>¥**/9WOFIE5 _ _ ' rim»;/77/wsavvg-Maw H???-'Z7~ 2/Q80 7w»~¥ ' 7H¢1'°7V "W/W""/'d ‘W-K ma;-7?} WW5/7F #97 re-I-c Q7737 792$ 3&3, 5-dw/Q sdwpdfnfiggi/?'§7b-£_t, ‘_ “ \ 5,, 93~fi"*w7Ifi*§z*¢/./.*a*§/val-;‘9L;7,;,;,;,(' ta wand 7 $45.51‘ QYW7 %~I/90 O4-L-I1‘ .. . 4 , f:_,yl?27,vg7 9' Mwnfiqoaqg 0é+§r-0/ _ »»W/wag/Li FWW/9 W?‘?1»~'/ 1/ @é~»@-4 ~@‘f'*°?%°?T‘€’ 1 /'0" 0-9-6 . _ . _ ’_ ‘_ ~:j€; * " * 04:1é * 1 * ~»>w7 #3 7744 w £33.‘ ' , ‘ m.,:7./3*- 61,-t'3 ) if . ‘ ‘ " I" ‘\|\" 2 " --_ F‘ ,» _'“‘€§¢ fund ‘.3/“(*7 xzfl "25 6?»QF\ K. ‘ 9 ? 47*”? WW\ "TD P»4Q /Zvxj Cry’; Q Qrfifflfififij 90¢/7333 6? V? ms ‘31 7.§d,7w¢; /27$ Wfaw =§;.u§?7/pg 5?W T" "1 ~\. *3:/~V%.S ~ ‘WW WP?/7119 Q? 5*» i 5; fimfi §?;-j§@¢/ %&}J@;y ‘*3’ Qi ~ "-"WW ?°j“’§/"'7 # -<W7@W W W?‘/9 .._1 @-u PM 9"»§ “-Q F5I2 , 9%:/q»!/Q “?W78fa"$% vfifiay $5 ah/v7'*J*37W-7a?#302>><:¢ <?' 21é ‘ - . ‘ _ . -Y 3, - ‘. 09 x{:{ - Eg a‘wnJ 59%;” Q3/,;w27 ><_/;; ~_ 5*‘Q "§iFQ\ H , - 54$ g’8b'7'§ .ryz.;.»am/ ‘Byway//¢/Q "x fix\ Qr~6 <5‘ ‘w d’ #3 Iwv/7 @3530; $9 fig '=- 6*»9 %v$ 6* . 9 L” *. V 5/J ?'¢\j- :%.uM4-fin; 90"”:/If//y‘g0<;~;/9 W-4, ~&>Cm9® - - fy %¢@§/fly’ ¢/14¢/y ¥2 Q2. *1 b @ - __;_’ ANNUAL TREND ANALYSIS SUMMARY TANK'# Z-,Q ‘TIME PE“RIOD:i ;'7'Q0"9OA to /'/K412 I QUARTER1 PERIOD » P|l:’R~1ob - PERIOD QUARTER2 PERIOD PERIOD PERIOD QUARTER3 I '-PERIOD PERIOD PERIOD QUARTER4 PERIOD PERIOD PERIOD TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action'Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses- ActioniNumber Total‘Minuses Action Number TIME PERIOD:/ Total Minuses Action Number Total Minuses Action Number Total Minuses ActionsNumber T l . 74-20-90 to‘ //-2440 This Period (Line 3) V‘ ‘for this Period (Line 4) This;Period (Line s) 21-} .A for this Period (Line 4) i‘3—I ' ~ This Period (Line 3) .37 for this Period iLine 4) 575$’ '- U-:11-?0 ts 4¢;23»q_; This Period (Line 3) Jjffli "' for this Period (Line 4/) . ,, .1 This Period (Line 3) é [ _ ,V for this Period (Line 4) 81;‘ This Period (Line 3) i i. '_7 /. for this Period (Line 4) [£7 I", » 4-23-9! to 9Tq'9/V This Period (Line 3)‘ .' 2 3L for this Period (Line 4) [I 1,. ii This Period (Line 3) 9.6. for this Period (Line 4) [33 This Period (Line s) 1 - /O7 for this Period (Line 4). ' /Ff‘?. 9'$'*'9/ . to [F l{*.qQ This Period (Line 3) ll 2A for this Period (Line 4)» 161;’. -7‘ This Period (Line 3). for this Period (Line 4)Q This Period (Line s) ~ I4?. ssh this Period (Line 4) IQ é- \ I hereby certify this is a true and accurate report. Si.3'!‘8'tiure A ‘I. I Date -~-~—— ~'*"-' ‘I »' =—-—r'—-—~“ n-an-anus-or‘ " ~ v *v— ~— ~— ‘—~ _= ' I -—~>— ,_ \~ ‘ I x _\_ ) ‘ ‘ ‘ Q‘ M _ x N _‘_ _ v . _ ‘Q ~ ' A \ _ _ 6 l I‘ _ . ' _ > H I ‘ _ _ v ‘ ‘ _ _ K‘ _ ‘ __‘ _ _ , _ U ¥ _ I _‘ _ _ V -‘__ _ '__ K’ O‘ ‘X E“ _ _ _|\ _ _ ‘ ‘ _ ‘ _I_ _ D _ _ _!_ _ __ Y I‘ R 7’ W‘ L _ ' _ _ ~ _ ‘ U ' _ Q ‘_ M __ xi‘ ‘ \ __. _ _ I W , _ _ _ V __ _ 1 _ _ _ &‘ _ _ H v _ _\\ _ ' ‘ v _ __ _‘ \ _‘\ _ ' 0 % _ ‘ ‘ _ _ _ __ _ _ __ _ _‘_ _ _ _ I ' § _ _ ‘ _ _ _ _ ‘ “ J ‘ __ \ _ . r ' I “‘ I ‘ _ _ _ )‘ ‘ __ ' ‘ f I ' . Q ‘ I ‘ Nb ‘ _¥ v_‘ _w _ _ . ‘, I _ _ I 3 V _ _ _ ‘F é __ _ fig _ ‘ ' _ 4* " J . an ‘H . U _ ‘ _ I‘ _ _ _ ‘ ANNUAL TREND ANALYSIS SUMMARY TANK'# ,3. . - TIME PERIOD: 7"Q0"90' to’. /‘L5-'99s QUARTER1 PERIOD PERIOD PERIOD ' 1‘ QUARTER2 PERIOD PERIOD -PERIOD QUARTER3 '.PERIOD Pfihioo PERIOD QUARTER4 '. PERIOD PERIOD PERIOD -. I.hereby certify ‘ s a rue and accurate report. Signature‘ (f:2g@k»o~/ /K77Q4£fii~4&” Date //"/(5<'}2;Z TIME PERIOD: Tota1:Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total‘Minuses Action Number Total Minuses -Action Number TIME PERIOD: Total Minuses Action’Number Total Minuses Action’Number Total Minuses Action Number this it .-i—- ii.-u-A---'1‘ -~3 r A" m -r -'4 —* ~ } — ——- - ‘;z'5zO7"€?C7 to L/}’;2é;"<i<7,' This Period (Line 3) 1:; for this Period (Line 4) é2C7 This Period (Line 3) for this Period (Line 4)I This P i d (Li 3 “ 2 23,1; $3 (4 LA>(M 0‘ er o _ ne) for this Period (Line 4) L/’Q7“%0 to Q». This Period (Line 3) . 5731 ~“ for this Period (Line 4) 6 QT This Period (Line 3) 6 Z A for this Period (Line 4) 8ST This Period (Line 3) Z9z for this Period (Line 4) ll)I H-in-q_) to 9»/-91 This Period (Line 3) for this Period (Line 4) // 2'4X This Period (Line 3) ' /0'4 A _ for this Period (Line 4) /3,3. This Period (Line 3) //"1 for this Period (Line 4) ZQIQ. 9-slm to o/4/J-.92. This Period (Line 3) [2 ZR" for this Period (Line 4)‘ I 4 This Period (Line 3) I /4fC7. for this Period '(Line 4). This Period (Line 3) ' ‘Z§;E§fi .‘ for this Period (Line 4) / i£;.Rn: 1 » . /r‘ .5 *. A. »\ >=l .~‘ M‘ »' \~ ‘‘ in ,4 ‘ '' ° \ . 1" ,. .4 1 \' ,. _-__,-..,...4 w. .~ 1 ‘' 11.‘ . '' ‘. ‘ :-\ A ‘ _ 1v ‘. m \ \\ .B _ ‘.> ‘ . _ . L A“_ \ e. \ :11" T’ ‘' .-4:~‘ W. -- \. I! l . \. \‘ e ._~,-> = . r/-' ..» ,. aw ‘ -~*. ' . -11-: H ANNUAL TREND ANALYSIS SUMMARY TANK 2' . Arms PERIOD: 7_',70"90 to /f/§—99\ QUARTER1 I PERIOD PERIOD " PERIOD QUARTER2 PERIOD . PERIOD PERIOD QUARTER3 '.PERIOD PERIOD PERIOD 17. QUARTER-4 PERIOD PERIOD PERIOD TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME.PERIOD: ,__ ___ IN‘ H. __-._<__~ 1 | - -,.,_.j-_.:,_'_ .‘.-_- .., s...uar._l_~i_ !_._.;’—— --+-- A----~ ~ 7 — _ -— --— *- 1 '7-20-90 to A/-2é—90H This Period (Line 3) litA for this Period (Line 4) ;Z<J This Period ‘(Line 3) A . Q5?‘ for this Period (Line 4) This Period (Line 3) for this Period (Line 4) 51!" //- 27~9o to 9- :13»)! This Period_(Line 3) §é for this Period (Line 4) .£;f2 I This Period (Line 3) ’ '70 for this Period (Line 4)) Q5’ This Period ‘(Line 3) for this Period (Line 4) )0] 5*-»:z~+-4)/" - to 9—~!»‘L/A Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total'Minuses Action Number 11: Total Minuses Action Number Total Minuses Action Number This Period (Line 3)" 9‘-I A> for this Period (Line 4) [[7‘_ This Period (Line 3) A ‘ for this Period (Line 4) .[:IE§. This Period (Line 3) 1.1.9‘ for this>Period (Line -4) 4-5-97 .to t/“LY-'91. This Period (Line 3) [3’§_/- for this Period (Line 4) Z6f;I This Period (Line 3) 4 1 iii; for this Period (Line 4) [30 This Period (Line 3) 1 for this Period (Line 4) ’/ii; I hereby certify this is a true and accurate reportj '. Signature Date I1 "/J?’ 91 »,. >~ "‘ \ 1, ~ E? 4.2! ‘,- It r 0' lg . wk \ .v $7.. r \ Q‘ 1 ‘ . \'> \~. .°~\~ » '- v\ » I," <._..- e LIB-"‘“‘4*:;".'.' I :1 1* ~ v44’ 1~--—-=1~~~- v e i —», T "'_““"‘" I I ) r > > ANNUAL TREND ANALYSIS SUMMARY“ TANK i: Q TIME PERIOD: _7"a?0"90 to /—/5d’-‘Z51.' QUARTER1 PERIOD . PERIOD PERIOD QUARTER2 PERIOD PERIOD Pfihion ,. 1 QUARTER3 '.PERIOD P PERIOD PERIOD QUARTER4 PERIOD :‘.,'F PERIOD PERIOD I H ‘l,’ ' ‘I’ i I TIME PERIOD: 740-90 to L/-ac-90 Tota1'Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD; Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME,PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number This Period (Line 3) '\im for this Period (Line 4) .;2C) This Period (Line 3) Elf) for this Period (Linee4) 3Z This Period (Line 3) " ‘H for this Period (Line 4) $rL* //- 3740 to ‘I-J.3l“1_/I °\ 0\ ~Q"\ This Period (Lines) ' QV for this Period (Line 4) This Period (Line 3) g» for this Period (Line 4) 8,5- This Period (Line 8)‘ 8 C7" for this Period (Line 4) [(71 4-1q~qJ ~m 9'q'9/ This Period (Line s) ?3 for this Period (Line 4) I )’_I‘*I This Period (Line 3) for this Periods (Line 4) This Period (Line 3) 172 for this Period (Line 4) /‘ii “?'S'f?/ @ Q /'/S?9i_. This Period (Line 3) . [Q22 for this Period (Line 4) 4/43 _’I o7°" This Period (Line 3)‘ for this Period (Line 4) This Period (Line 3) I. /J§§{ for this-Period (Line 4) [ 2%; I hereby certify this is a true and accurate report. $i.gnat:ure Date ‘(I "/J/7' or X‘ ‘ Q _ _ \ 5 *_ ‘ ‘ C? ‘_ 9 _ X 0 “ht _‘ A‘ __$ _\ 7 W \ a _ v _ _ AV_ “ ‘ ‘\ _ Q‘ \‘~ __J _ . J‘ _ V; ' ' _ \ , ‘ I Q I _ w § &"V_Q__~ _ Y \ m‘ L‘“‘ _ \\N\ 3 3: &_ _ “NV _ ‘_ ‘ _ ag ‘ _ ‘ ‘L “_ \_ ‘ _ '\ \ _*_\ \ v“ ' W_A 2 Aw \h _ i 1‘ > _ \ _ ' __ “N _‘ 31%’: _ ' ¢ 1_'1\»}:_~-:;~_%-:7:-F-.'-"w$;$-3=¢r*;2>w~':w-=§*p;v-::;»t' _ ~==' ‘1~~.;>.“’:“; ¢';' ;"'~ . ';--ff‘ _‘ ) *'' . »~_ »' ~ S‘ ..1”‘.3‘7%l§v?"\'f€17¥"$'7'};"F-"l'3*‘3§>?‘/ ,"§""."I'1'95-It 2'-'7' ‘I 1,,’ ;$‘1‘.:.‘-.7. _e__'.3:};-‘_,:~_;5,\-32-~;_x'.‘_:-*. W_.<_‘,»:v_j>__;,<\?3- ,_‘- _I‘1_:1 /121;» " 2? vdfl? ‘,‘\ .‘_,_.=..> sou: rwullm afr 0% \ w -MVP v. n,‘ -’_ -h.- ':.»;»>;=;\'e~"~'-:2-:.%r:=:~.-<.~":~<"=» ‘I \’v _. . .~ .1 .,~>;;v-. h.L _."-;.' .- - -' ‘ _ M‘ 1 _ _. 5; r. \.; ,='\: /:7. PUMPKINC amen micx renmm 1; -I $_, AL - PH: asz-savo 9'0 I-. . aoxfiw - PUMPKINc M. amen, CALIF. 63301 ‘. < , _ ...~,<‘§-q;;:"\ Q:-§F? _ — »:_ . , =. -- - <‘fl‘?f-i~:*=~4~,§.'~_§§§ ' ‘ ’ ;:,»~P /4’ U- ., ; 1 .\, \“'>fi4 1.1,: /7000-' _ _ /£14,: ?‘?70J" -.¢1..‘»_._. -.-. _'* t < ..-...- A J .~ .- ._. :.~.—' .,.»_...~_.!. e.“».,_._ .» _ Q --. ;§r:.~fl—>..= 1' . _,-.»\r=¢- ._A.._\.; D. » up ~.'r~='. . ‘W, If <3’ > .,; _A._.,,»._». . .' ., .._...,.@¢.,-.3--.:£_i@&.;?:1x' ' .» Q‘, i.--“Q ‘-Q’ DEPARTMENT OF WE|GHTS’AI\l;E)f;M\E/§§SURES, ; _ COUNTY or KE|_ZN 1-1 \ _. ATE OF CALIFORNIA _ V ‘I I ‘I6 East California Avenue Baker(§.fiel"d-93307 1 V Telephone (aos) 861-241;aA‘~ ; ' - “ Certificate of Inspection K _ 0 5504 1 ~ This is to certify that, in accordance with the law, I have tested the scales, f weights, and measures said to be the prpperty Qf Q used by: - ~ J_/. .g?_]', [ Q? - DATE..~ __ s A19 /.3 NAME l\/I wrucg (M/C;/Q gm; Aooiiess Z76 I-_ '.’\@.¢n 'H"Q~»@/37'~ OWNER A/L</WU _Y(\/('('<U‘~\' 1» roman~ NAME ’ - .¢n.-S-_ ; - _ .. _._ 1 - ‘*5 ;“- NO, t A DESCRIPTION AND REMARKS £1"? ‘\’-—@—P c _ euwisidexflq M" _ <\2~’;2.!QQ0 ,i ;I v 51/<»>/GU-=~1 *1‘ 1 _,u Sea ed Correct Out Ord Tug Na ’ “ Y . _ _ '*-—--“#15: ~¢_ ..,,,,,__Iw _ 2;" 23$ i vi. > W . E . l‘ £00-D all/2 #3 'z,(/LQ-Q12 _ '' t H/-°9. ~'\_ p.Z"¢'-"ii ‘I-N}, .. A /g.’ _ ‘ ' _, 5 "i”,?"‘(‘/Q ‘</V"”dC-°"yn’F‘*/I-€= www; U:'~Cu\CCc9-&/, ~,~_-.——v- s '2. " i’ Pi,’ 5 -.. ~A._..._\~.,-‘ Fe. 1It, A -a ; -- 5~ ' \ ' I 1? _ fl. fa ‘1 Us i 34%/M/ihéi '5‘ 5/‘ > TIME _ _ ~ (OWNER‘@R AGENT OF OWNER'0F PROPERTY/INSPECTED) v g -°u' . - Monty H. Hoppei, DirecForQ rouu _ t 4 ' ,K :5‘ -~pR°M|NEN-[PLACE DEPUTY/INSPECTORRi ' , , x I .- ‘\ T .. . . » \ . -I»- * E‘) ‘ K ? \ ‘| 1*, . ' ~- \| J \ ‘~1\\ ~. ~ ( , |~ ~‘~ ~1 /-* '1 .,. \,\ \\. \ - _ (“\) \--_ \ 07 1- | '1 . \‘ . ‘v §_/1‘ . _d_A v \_ . _ .‘ > \ v~ _ - ' -‘ ‘\‘ , L \-' ,‘\ -- __ 1 .\ 1-"\ 1 V 1 ,_\__ -.\; F; I .‘.. hf. ' \/‘-:‘.\._h\ ‘ ' \\ ' " -. ' \. __ ‘rim I ' "~ i.‘\‘} _- . \ _. \ I /s ¢ ( \z'. -»"\‘ _,,\‘ 4 1:’\ ‘ I‘ > V‘ ~_ ~_ ._|_,\ I f9I xv1 ,--. I ~ ) Ii‘! -.- I. I JK 1- v. | __ ..I 'I L _ _ ‘ \~ K .\ x F _? ~ \ s‘ >\. CL- F-.- J u I __ - xI r-2- "( _: _ _ - 1| 1, ‘<3 ‘ ' C i ‘ \_ _ . \, -; u \' \7 H\ a ~ \ - ‘ J' L_~J\: .§“—%~\ f““ “' . ‘ti,-14'-P‘,, » _DlE3TPE§I§ ‘(3!\IJ]II3IZ!k1F]I()Di (ZEIIZ(3I§ _I?()I{Dfll . Facilityyu D l I A ' l’ermi»t_#_D t ‘ , _ _ .<..- '' Notei '_ .7”; iv ' if ~, ' 4 D " ~ _ . ,' ., »'} ' _- '- \ ’ , 1. =AlI meters must haVe4calibration.checks a minimum of twice Q year, which may include checks done by the Department of Weights and Measures. ’"* 2. Before starting; calibration‘ runs, wet “the calibration can with product and‘ ‘return product to storage= _I’ ;’ _3\ VRUH 5 gallons with nozzle wide open-into the cane Note gallons and cubic D "iflfihes dPaWfl. and return product to-storage§ ‘_ '>A . 4- =Rufl_5~8al10nS with the nozzle one—half open into the cant Note gallons and Cubic iflfihes drawn, and return product to storage, L ' _ ' \< 5. ;After all product fofijone calibration check is returned to storage, remember 7Recording Sheet.“ _ LD » “ A ' ’ . i‘ ~' - V6, ilf the volume measuied in a 5—gallon calibration can is more than 6 cubic “ A»-to record the volume returned to storage in column'9 of the “Inventory_ V 1 ~- inches above or.below the 5—gallon mark, the meter requires calibration bya . ~registered device repairman, R _ A 1- 4 V. _ Date/Time Hose or Tank #/_ Fast Flow ~_@ Slow Flow '_Volume Returned Calibration ‘DeVice_Repairman Date of 3 A PUWD # Prflfiflfit 5>Gallon Draft §5—Gallon Draft‘ to Storage Required? Used for CalibrationV Gals Cu. Inches Gals Cu. Inches Gallons D Yes No Calibration" 7¢:v@2 er??? 3@57¢lt?@‘0¢i-i <9/~/97%» T"%*9” . , __ 4 ‘ ' "U -?:'=- I ' A 4 ' e1l' ‘ts /5 - 9*’; ’§~fi~[;"°’ ~36 _Z_//ZQTL X ' .2 ll ' L) ‘mm K </R "’ e~l~ — Q1 R r _ , . .,~. 4 3 otidMQf§§+kJe3§' R Y “ t”> WM " < ' ' ‘- A ' . . ' . ‘ . v;:-- . ’ _ ‘ ‘ V, i "f',>Zc}' m/15 X ~"e ‘lei" " ' . - _ z_ -D ,v gs, _' - V - "1 M H ts" 63¢) /<> X ~1 »>A 1.: -»~ :1 R 0rlner'or' Opera.torAS'i.gna-i5iPu1ig7 $1 e . D ~ D“Calibrat0rls;Signature;£2;Z£,4eaz7,;§€€;{Z2Zg%¢4?2Z”'____” Registration #<D/~—[§?§;‘E§- - " ~ ~ \-‘/ “Z ,-41-,_':, r _ , I K t ~ suqr4_rT,DA-- C{0l_°DY(QF-‘THIS; F@)R__M W ANNUAL R};-_;,:;a'ZRTl*.D ; ' ' ' _-4 §;.l§;If- ‘ ' ' - -, ' " _ . .. _ ._ . . _. .1 _ -Y-r—;-1.":=-::"::'::;:r.-~; .3, _.' ,_ __ ‘ .: __‘_‘ ‘_ - -- ';__-. Flt T77’ F - art- _ _ . _“;_r_:a _ ‘ _________ _ . ,,. .,.~. -r I. --..=. QUALITY @ saw.“ 211 Trinity st. - Bakersfield, Calif. 93307 Record of Computer CLARKTS EQUIPMENT COMPANY (805) 861-9510 or Meter Change Location _ Station number Date D Memr change Job Numbe, m , B Computer Change 7-Q/2+ h(H4_&L '7 _ W/M Notified //pék Finish (money) a 924 TotalizerQ Ffiisn (gallons) Q 7 3 012' ~/ Readings Start (money) Start (gallons) '3’? 2 5'1 -(7 (‘Make and vfidel Serial Number Tagged Tag# Pump f ' ’ '1' /if ‘Q '1 $~ Bfied BGreen BE-lue Calibration: F851 Slow Checked 'f Q C( Adiusmd Fast ' Slow ’ T° 4' Q.\ gQ,l Product'_\' i )\ e SQ.’ Return to Storage (gallons) ‘/ 0~0 Totalizer Sealed Meter Sealed BYes BNO Yes BNO 715"“ “Fr £911 Serial Number 1% O?¢ Tagged Tag8 BF ~d BGreen BBlue —\J ‘Ffnish (money) " 9 Totalizer 99 i=ariish(ga?>rZ)‘g O 2- Readings 5"" (),'%@V) Start (gallons)_ 5' 17 Q 'Z-Q Ca oration: Fa“ 5|°W Y Checked (X\ Adjusted Fa“ 5'°"" To Product s Return to Storage (gallons) Totalizer Sealed Meter Sealed/ BYes BNO Yes BNO Make and Model Pump K‘ / 0O Serial Number Tagged Tag# BRed BGreen Balue 7‘!/ e $94! /Q: :1-f:C“;:i:?@v'7 0 5’ §/D60 »i Totalizer _ ‘ Readings Start (money) [Start (gallons)’ r7< 29 /.7 Calibration: F35‘ 5|0W= Checked e- ’ ._/ Q‘ Adiuned Fast Slow' To‘ Product 0’ Return to"Storage (gallons)' Totalizer Sealed Meter SealedI N YN yyei C) 0 /Q es Bo ’“'Make and Model‘ Serial Number/-5‘ _Z ;/ 9/ 7'7 Tagged Tag# BRed BGreen BBlue Pump 3 Finish (money) ~ 252 §§ Finishlgptallons) ' Q' se? 7 7 .7 Totalizer iB Readings Start (money) .9 Calibration: Fa" 5l0W Checked **- I -mq Adjusted Fa“ 5'°"" \J T° "1 Q t “)4”/0 Product-w .y \‘ Mak'e'a?fc“t§/I-t>‘"ae;” \r Return to Storage (gallons) 3 S .O Serial Number I Totalizer Sealed Meter Sealed /Kfvés B No /me; U No Tagged Tag8 BFled BGreen BBlue Pump Q, - fiishfin o'r%)<-‘£11I Totalizer ~14» -'72 52603 .o3 /4 . 09 Readings Start (monev,l’ Start (gallons) Calibration: F35‘ 5|°W -wed "'f‘ 3, 0/ -1‘/a? C.1 < Fast Slow’ Adgusted To ProdggM .<-E19 V @! / 53' LP Totalizer Sealed Meter Sealed BYes BNO BYes BNO Make arT—3 Model‘ Serial Number Tagged Tag8 BRed BGreen BBlue C) '3 <7 Pump Totalizer 'B<i°z¢QQ Readings Start (money) Finish (gallons) Start'(gaBc>ns)' Calibration: Fast 5|0W~ Checked B.) Adlusled Fast Slow To l Pro-Jucl_ D/Q < Q _/ Re4rn to Storage igallonsl Totalizer Sealed Meter Sealed /a . CD /\ BYes BNO BYes BNO Maingénance Man's Signature f_ /3 I K ; .-l 4-‘ if I ~ K I‘. 0‘ . ,V Dealer's Signature RuI 5A r t _Q/1I€¢1/ Ckitributionz Original (white) Invoice Copy T Duplicate (canary) File Copy ‘~ Triplicate (pink) Dealer Copy ‘G 1 - \._,4' '1 ¢ -, TANK FACILiTY ANNUAL-REPbhi ~ Facility /77//H/L5 , Permit #43gao/as Month/Yr._.i Z- ?0 ~_- I have not done any major modifications to this facility during the 1 tn ‘m. ~ -- as mon s i .A _. - Signature (i;221»»/4fi71ZA4Z:/41/’gg' Note: All major modifications require a Permit to _Construct from A the Permitting Authority. _ , A< ~ l I have done major modifications for which I obtained Permit(s).to Construct from Permitting Authority ' A ' _. » Signature‘\ % .. - - - l» ,1 A 7' Y - Permit to Construct # . ~ Date *‘ i' Repair and Maintenance Summary ' ,' Attach a summary of all: - _' ' * ' _p IL t ;& .~" Routine and required maintenance done to this facility's tank; piping, and monitoring equipment._ "t- Repair of submerged pumps or suction pumps; - ‘i _ -' Replacement of flow—restricting leak detectors with same; Repair/replacement of dispensers, meters, or noziles. I Repair of electronic leak“ detection components, or replacement with same. ' g ‘ . _ - e H _ _ ' Installation of ball float valves. 3 ,§_A 4“ ‘a _ '‘ Installation or repair of vapor recovery/vent lines. Include the date of each repair or maintenance activity._ NOTE: All repairs or replacements in response to a leak requirea Permit to Construct from the Permitting.Authority as do all ' other modifications to tanks. piping or monitoring equipment not listed here. . I i -f ,, F"elt¢hah8¢9rIA<11°".°d 1°01‘.‘W91’»-V@hi¢is.'..13,9¢i_otank? I List all fuel storage changes in tanks} haciaéé ”' 3, i"‘“ Date(s), tank number(s),’nefi fuel(s) stored.‘ ,* Y/~*. Inventory control monitoring is required_for this facility_on the Permit to Operate, and I have not exceéded_any reportable limits as listed .in -appropriate "inventory control monitoring -handbook during the last twelve months (if not applicable .disrégard). ' i it “Signature _[§:22é4i¢tQ;é?ZZ4éZ¢aé;?)H' Trend Analysis Summary ' _ ':» _ _ Please attach Annual Trend Analysis Summary for the last lé periods: Meter Calibration Check Form P u » A ,‘' '-Please attach current, completed Meter Calibration Check Form I _,.._.. _...-.._,,¢:,-‘--, 1 ~ 1 \\ \\ \. Q‘\ v l.¢’i'\.,. 1.; "r It AbAfiNUAL TREND ANALYSIS SUMMARY QUARTER1 . PERIOD PERIOD PERIOD QUARTER2 j PERIOD PERIOD r ’PERIOD QUARTER.3 .PERIOD -» PERIOD .PERIOD QUARTER4 Q PERIOD ' PERIOD . -PERIOD 1 Y, V .i TIME PERIOD: TANK # . /"" l . ‘TIME-PERIODE 52-II-8‘) to 7’./9’? 9v"L| °§Q‘ l to Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number : ‘Total Minuses Action Number Total'Minuses Action Number TIME PERIOD: This Period (Line 3) 1 /62 .v for this Period (Line 4) Q0. This Period (Line 3)‘ '~ Ii’_ for this Period (Lihe 4) no Z Z 1% This Period (Line 3) " [Q A» for this Period (Line 4) _$'Ei ’ to A, A This Period (Line 3) . 51;; ’ T for this Period (Line 4). /éfl -~ This Period (Line 3i [£2' for this Period (Eine 4) 2QY' This 3) o L [5" for this Period (Line 4)‘ ~[()I /.0-l8'3°] ~ to 3-'I'f?O'.» Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIMEAPERIOD: Total_Minuses Action Number Total Minuses Action Number Total Minuses -Action Number This Period (Line 3) _. /4+ ~. for this Period (Line 4) -[I IA This Period (Line 3} "_ [ff‘ Dfor this 4) [33 This Period ‘_(Line 5) '. [4 _ '1 for this Period (Line 4) /filfl LL 3'1-90 I to "7" |q’iQ This Period (Line _ii)_ l [5’= for this Period (Line 4)_ _ ~ This Perio“d (Line 3) A /3 ' forwthis‘ Period (Line 14) . [$0» "V 'I‘his ‘Period (Line 3) TH tor-this Period (Line 4) ilhZ§§ i I hereby certify this is a true and accurate report.~ Signature V A A u Date \ _ H ‘ J J _‘ ‘ a _ F Q I /_ ' ' x _’ ‘ ‘ _ Q_ __ xv‘ _ I _ _ V“ ' H 4 \_V é 1 - 1 _ _ __ \ ‘\_ ' L I ‘ *‘_ _ 0 _ ‘ ‘ \ _ Q _ “vv 3* _'_ _‘_ _\ u\\ ‘ 0 _ s I _‘\ ‘ ‘ __ __ _ M° t _‘ ‘ _v‘__ I \ § W_g 0 1 ‘b 5 AXDJDJIJIXIL UFIZESDJIJ" A\DJl\I;\(E§]IE3 EBIJDIDJIXPQXI 7I TANK # TIME PERIOD: Q.-4//.,.'"§9 t to _ 7'lq'qZ7 QUARTER1 PERIOD PERIOD PERIOD QUARTER2 PERIOD PERIOD PERIOD QUARTER3 '.PERIOD PERIOD PERIOD QUARTER4 PERIOD PERIOD PERIOD J TIME PERIOD: ‘Q’//"Q? - to 1: Total'Minu_ses This Period (Line 3) A A V. Action Number _for this‘ Period‘ (Line 4) 3: Total Minuses This Period (Line 3)f _Action Number for this Period (Line 4) a= Total Minuses This Period_(Line_ 3) > P IQ4 Action Number for this Period (Line 4)» I I TIME PERIOD: 6'/6'83. to__/O’/7’%q4 4: Total Minuses This Period (Line_~3) I - ‘Action Number for this Period (Line 4) Total Minuses This Period (Line 3) ' I 3A Action Number for this Period (Line 4) -. 6): Total Minuses This Period (Line_3) A '_ Action Number for this Period (Line 4) 10I TIME PERIOD: /0'13-89 to, 3-’ - V I Q0. 7: Total Minuses This Period (Line 3)’ ~..-Q, * Action Number for this Period (Line 4)1 8: Total Minuses»This Period (Line 3) ‘ Action.Number ‘for’ this Period (Line 4) 5 . l 9: Total Minuses This Period (Line 3) . [3 {Action Number for this Period (Line 4). TIME PERIOD: 3-—'3.'fi0 , to 7-I9-‘i0 10: Total Minuses This Period (Line 3) . I Action Number for this Period (Line 4)_ 11: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) 12: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) I hereby certify this is a true and accurate report. I Signature Date 7"a7o7"90 ; ____ __.- ,._.___, ;._.__-. __'\'__ _ :4 A - 1 . r -— 1- _ Hr ._~__._i--._i.__, H1 I -> .2‘ _.._ ___. __... 1 ‘ ANNUAL TREND ANALYSIS SUMMARY TANK? - I VTIME PERIOD: 3"/l'QI to,-7"/__9'q0 QUARTER1 PERIOD PERIOD PERIOD QUARTER2 PERIOD PERIOD PERIOD QUARTER3 ‘.PERIOD PERIOD ' PERIOD QUARTER4 PERIOD PERIOD PERIOD TIME PERIOD;‘ ~a-/1-we to Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: This Period (Line 3) I/J1 IE»I for this Period (Line 4)‘ =16? L}. This Period (Line 3) ./ff -3@L@ for this Period’(Line 4)‘ This Period (Line 3) [£2 “I for this Period (Line 4) 1:31 A ' 5-/A-<2) tot /04¢?/g7-8°) This Period (Line 3) <12;V for this Period (Line 4) ‘Ia, This Period (Line 3) 1 {f§' ». for this Period (Line 4) I g£§’R This Period (Line 3) [ii ‘~3 for this Period (Line 4)i 1C)I /0'18-8? ui 3'I~90e. Total Minuses Action Number Total Minuses Action.Number Total Minuses Action Number TIME PERIOD: Total‘Minuses Action Number Total Minuses Action Number Total Minuses Action Number This Period (Line 3)’ >7 ,..- . . ' =-'- for this Period (Line 4) [I lhf 5. This Period (Line 3) I . /1;’. . V} for this Period "(Line 4) This Period (Line 3) '.[jf 3- . for this Period (Line 4) [F13* 3'2-Q0) ,to 7-I")-90 This Period (Line 3) . [ff I.‘. for this Period (Line 4) [6i§', This Period (Line 3). A 13$? F.)- for this Period (Line 4) l This Period (Line 3) . I Zég for this Period (Line 4) A I hereby certify this is a true and accurate report. __ _ _ _ __ Signa_ture- I Date A:7'o?<>?"90 I . . "~ *5 > . ’~ 1 ¢ | S . 3 ' I‘ V. -‘ixM '.~ /?§ 1 1 . ,. xv '*Q ‘j ; 2 -. .»“ M9 q ‘ '.- r." R... \ v ~ -' , if. ,. - s_ ' In A .~ . ‘.v _» 1 I F -. 1\I~an_,~r-V-i4J|Ap'i‘?,_’i1Q-4>l1'*L' ~ 1——— P ' ' ‘_§ > I V ‘X ANNUAL TREND ANALYSIS SUMMARY TANK # 5 TIME PERIOD: Q~_"//fgq ‘to _ 7'i']‘i~'?0 QUARTER1 PERIOD PERIOD ~ PERIOD QUARTER2 PERIOD PERIOD ~PéP1on QUARTER3 ZPERIOD l PERIOD PERIOD QUARTER4 ~PERIOD .-‘z I 1.J PERIOD PERIOD ~‘— r1'~~—11a~——~-"— "i-dun-7"-10441 —~ — ~ -~ ~ 1...»;--~' ' — ' ' -—-—--- ' I' TIME PERIOD: ' 9~."[/—8Q to is Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME'PERIOD: This Period (Line 3)- T I3 for this Period (Line 4) Q26)' This Period (Line 3) [3 for this Period (Line 4) 2Z This Period (Line 3) II for this Period (Line 4) 1512i 3 6-/é-83 so /0-ii/T‘!-"1‘) Total Minuses Action Number Total Minuses Action Number Total Minuses Action.Number TIME PERIOD: This Period (Line 3) QJr for this Period (Line 4) I: . This Period (Line 3) ’ ,[§iw“ V) .) for this Period (Line 4) 215' This Period (Line a) [ii 'e _ for this Period (Line\4) _ ll)! .i /0-4?-'8'j to Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number This Period (Line 3)’ [,5 I ; for this Period (Line 4) ll IR '_ This Period (Line 3) 45;“ .. for this Period (Line 4)_ [3;:;. This Period (Line 3) [Q2. for this Period (Line 4) V, [#3. T 3"_Q~+q@’ _ to 7'l_q"?TO. This Period (Line 3) ‘ / 3 I _ for this Period (Line 4) This Period (Line 3) A l‘4. for this Period (Line 4) Z 3d?A This Period (Line 3) ,'l:;’ , 'u for this Period (Line 4) I Z§§ I hereby certify this is a true and accurate report. Signature Date 7'¢22'90 1. - . zi "E1 ~ -\~. - ,4 . ~ Q;w '¢ > .\ =, 4 » Y. 2! Q $;-G - -. .*~:' -5¢ 0 \‘_ '~ ‘ ‘ .:. \\p ‘Q. \ :_.. _‘e C . \, Q __ .- ~ \ ; """' . ,3’ “\ .-‘K ‘V’. ¢ <3‘: _<. _ , - W‘-" ‘_§\‘.{1/W, ,“\. §:»f », 31I I 4‘ ;i L -v 4. I . \ ‘ | " -- 0 € Zwywfl-"*“”’3'sé 06-/>-s ' Mwfi5 ‘°6'?§’*/7 .‘ . 1 .947. . »J% .-o 9 oi,/a 7’ /"W ¢>e»s/-/I A ‘ A l Q ’7€W¢7Q Qé-C/_/ WW7 *7/’£"¢»;-r3 ' ve=z-;/-t/ *\\ és cl 1/ F58 or 0/ ~ _ . 4 .LL¢, £ W -[fir-xr‘" /-"1 a W ¢M¢ /7 ' 'I '"'=*" 1-" Y“ 0 é . 5E /W WM /2% Q10 ’a ' ~ / $1 1 ‘. / "*1" '"w",v/ »~_ ,, 0»vN (>0 9/"fl-/Y’§@F%{,/M#“?’.”?’d xv ~' " -,4w~»a¢»»*%/>¢:;@-r%@;7 821% 00 5° U3 ‘Q < O0 ,9 - fffzQ 0- O9Q Go . 6“ 0°00 § @°%\ \ § 00 Q \D ' D_"V $3 F 75 T 0°W\ \0 % 7*-,-.5“; , /rt»/nflv \\\ < Z‘ . *,fl>s»/»/»5 . 1 "P'*_*/7 / yl>?>,z.r-—/7 M4’ 55.5/__/7 q" £3? gr . -2”??? '~ 1 I ~ QQ . ‘O~-I . :7p4._/Z” l \ _/ ' ‘ _‘ Y MPH‘ a _ i , Ti v‘ \i| ‘L? .!\“\“ L ‘\ M ‘ __ r \ \ ' \ ‘ . » , . _ ‘ M 'W‘~WWw¢%1y 0-6-8/-+L V ;'%#.’2<*%a>y \‘ 1 ~ _ .. ' - ’ . , obnli.-L.‘ , £$,. - . .v ~0_'cf_7. ./ H / , -» ‘ 0é’S:$" ‘ ‘ v . ._ ., .' u ,'' Y ;-"~> ~\ --i vi _.~_ _.. ; ...r-... ’ — arc, ;'; - DK , 5'"-*'“ 0 .\\ "1 J. 1 -\_ n. .,. IU=a....~»» A . IQ TANK FACILITY ANNUAL REPORT 32 .» ¢ Facility 07/A/I/L5 Permit .# 00/06 onth/Yr. ‘A 1. I have not done any major modificatio ~ '- his facility during the last 12 months. ' ' » A Signature ' _ the Permitting Authority. j , ~ 2. I have done major modifications for which I obtained Permit(s) to Construct from Permitting Authority P ~ _ 5, 1 A ' ‘ m ~ Signature ' '- ~' Note: All major modifications require a Permit to Construct from ‘Permit to Construct # . A Date~ 3. Repair and Maintenance Summary Attach a summary of all; ' l ‘ P‘ —~ Routine and required maintenance done to this facility's ,tank; - . piping, and monitoring equipment. ' » "—— Repair of submerged pumps or suction pumps.* —- Replacement of flow—restricting leak detectors with same. __ -- Repair/replacement of dispensers, meters, or nozzles —— Repair of electronic leak detection components, or_ replacement M »with same. v " _ -- A " m . VH ,s v 1'. 1-. E \- 1 1 I\ J. . '#— Installation of ball-float valves. :»’ ., , ; J ' ' r —< Installation or_repair of vapor recovery/vent lines. . - Include the date of each repair or maintenance activity. _ - _ n A. A) _' not listed here. a ,‘_. ’_ ~ _ ' < '.NOTE: All repairs or replacements in response to a leak requirea l_Permit to Construct from the Permitting Authority as do all *~ _other modifications to tanks. piping or monitoring equipment 4;fwFuel¢§hanges‘j Allowed for_Motor ighmwqflm Date(s), tank number(s), nefi fuel(s) stored.'_, "‘ 1. '1 5. Inventory control monitoring is required for this facility on the ‘ 4'Permit_to Operate, and I have not exceeded any reportable limits as I listed~ in the -appropriate inventory 'control monitoring jhandbook during the last tmelve months (if not app1icable'-disregard).m fp_k, , ,C P‘ Sienature 1 s 1 Q -> L1: 1 1 I . . 1 . g , - , ,. < ‘ . - .,.. “H. _ ,,. ,. ._; _ ,“‘.__,_ ,_. ._ _;;_j-'33; -Y-jg; ‘,»_->- .-.‘*"-‘_‘_- ~-§¢,*.>..kf;I§_\'3 ,._\.x ' List.all fuel storage changes in tanks, notingi ‘SJ, V A?‘ , A 1 “f‘,i~=j y»‘“3 ~ g ‘.3 \" . yX I i 1( v ;r x >2. i 6. Trend Analysis Summary ' _ 1 _ __ "* . Please attach Annual Trend Analysis Summary for the last 12 periods;7» 1. Meter Calibration Check Form " i4 r ~Please attach current, completed Meter Calibration Check Form LF%§W§ @313 fl'Q7[§_[i ..-u ‘J \ r T. u / >|‘ I i J1; y 1 A,’ 11 ,_.» ~.., ‘FEB 15 1989; ,.. 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'_ ‘ F .1. ._. _ n . . ) P .v‘ ‘ _’ . - .-l ._ : re \_ - ‘ - - . 1» , A -. > .. ‘ ¢ 1 . * ' .- I ~ 1 1|; I ' u >;' ' . ' g 0 1‘- - _\. 1 ‘ ' 4» .'\ _ ’- '. I ‘ J 7' ' \. . Q 1 " r‘ *" V V _ . V Q ‘V, V‘ \ . _ : U | | A H 5 . - . . 1 -. -IS __ _ I ' ‘ W _ _ _ __ _ ___ L‘ _ _ _ _ ‘ ‘ _“ |‘__;|‘};_ Mi“ ‘ k "_‘___||' ‘I "‘\H'l| _]{‘ “)‘ _“‘ _ 1 I _ _ 1 ' _ _ __ I ‘n ‘ __ \l‘ _ . _ l _ _ ‘ _ _ _ I vr U I _ ‘I _ ‘ # ‘_ _ __ _ _ _ *U _ _ _ _ __ 1_ _ ' ' __“ _ _ ‘ l ll "_.*hH‘_. _‘_ _ ‘ _ 7 W ‘_ ‘ _ b ’ F _' __ . _ _ I V‘— _\ _ _ _ _ _ ‘ __ _ _ V V v y . _ > ‘ , . t ~ H ~_ _ _ _ _¢ 11!‘! ‘J. ‘ll _ ‘ I ' _'4 _} H__ V“ _ _.x _ _ __ " Y‘ xl _ _ J’ v_ 1 H _ _ _ ' _V‘ __ . __ _ ‘ __ _ ‘ _ _ _ ‘ _‘ _ ‘ I _ . ‘ _"_‘_l> ii ' _ _ .'I|.“'|l"_'_i _I‘!-"‘|‘ 1 l ‘ kw _ 0 _ _ _ f ____ r ANNUAL TREND ANALYsis SUMMARY TANK # ., [P Q .4 TIME PERIODE _ “Q7 co Q",/0'QQ QUARTER1 ' PERIOD PERIOD PERIOD QUARTERIZ PERIOD PERIOD PERIOD QUARTERs :PERIOD y .. PERIOD ' PERIOD QUARTER4 'PERIOD PERIOD PERIOD TIME PERIOD Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number- Total Minuses- Action Number Total=Minuses Action Number TIME PERIOD: Total Minuses Action Number Total‘Minuses Action Number Total Minuses ‘Action Number TIME PERIOD Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number \ . ‘t \t Kr‘ ,. ~ R 1} ~ u-447 to ;z-23-32‘ This Period (Line 3) £7 Y .» for this Period (Line 4) ;2<9 -' This Period (Line 3)’ [é§es'. for this Period (Line 4) 3,7 :'= This Period (Line 3) /‘J V.I for this Period (Line 4) ~S:§L ~. Q-.14.-88 ‘to h,i‘i‘="é<‘@-‘~/Wit-g5_ ThisPeriod' (Line 3)‘ as I, for this Period (Line 4) =-f§€i 4. This Period (Line 3) ' [fi ,. for this Period (Line 4) ~g\S’ This Period (Line 3) 'l55'. for this Period (Line 4) Z>‘~v 6’r/3'82 - to. I0"I'2'% This Period (Line 3)” l;3 I4 for this Period (Line 4) [I 1' ,. This Period (Line 3) . J3. for this Period (Line 4) :l.3 3_ This Period (Line s) ._ ' IE5' for this Period (Line 4)v’ I £iEl E10-:2-»<z2 ,t.,' .2-/0-Q3 This Period (Line 3) /I4 for this Period (Line 4) [6§;_ This Period (Line 3) I3 for this Period (Line 4) [$0 This Period (Line 3) A ' r [(9 for this Period (Line A4) ' 7 I hereby certify this is a true and accurate report. Signature Daté -. '‘ I ,| ‘\- ;I \»;~ \”. ~ . “J \ ' 1 . ~. ~. 2 | v I1 \ ~»,..\ ~. || ‘ ;1:@ M;E_§3*§;¢_.,14»_,~:;,5’G x , ". -_ ‘.> \ » » -.; ;- ~ - . *I ‘ .‘ 1 -' 4. -i .»,-_ ‘ W ~ ANNUAL TRE ’ ~ - . I -.1 - 1» 1‘ ~~ .L i ‘ y. - H ‘ ' _ -w ‘ ‘I :_ 4, .‘ 4 I . I‘ ' . -,. . _ _' - -‘ 5‘ . . ‘ > ,_ 4 . _ , L‘ __ --_ r f - 1 .~* ‘ ‘ \ _ ,' ;--..: ‘ » : - > .._ ~ - v_ . - , ' , . ,- - I‘. -" ' '_:V;._-"'QIvlARTER.“1V 1 was P:-:R1‘o'n= ” i\:rD' :ANALYSI s. .".S_"UMMARY" . .- 1., ~,. TANK_#‘ ‘- “TIME; PERIOD: I/_/‘"6 f‘57 Itoti "1fI0-A-‘Zfl i~//#e1s1¢0m;va3>sse ’ ‘ I“ PERIOD 1; Total Minuses >'?, u‘* ‘ “"l ." " Action Number . . » , - . ,, ' R P?§i*¥i9¢F5:;?_u'?‘O";:TI5@@1: Min'.1.s¢? * I-I - 1:; ,. “Action Number ._ . _‘i- . '~ ' . y .., w . . , ., . “ 1‘ ' PERIOD 3: Iota1‘Minuses I »O I" 1 ‘ ‘I Action 'Numbe¥‘f I r » I . V’ r ‘ . '. .v _; _ _ _ ‘ I‘ 4‘ . _ ‘. . ’ . __ QUARTER 2 ¢57‘VTIME PERIOD: This Period (Line ts) » i/Q. __ _ . . -\ ror;rn1s P9§10d (Lin? 4>__£3§2i;;__i_r This Period (Line 3)‘ ’b' [/ III for_this{Periou (Lime 4)” '3_1I This Period (Line 3) 3 III!" I I . _for‘thi,sJPeriod <L1;.¢f4;' 7/ , .~ ,» '_', A)~ "2>:4~98 ¢ ‘"1 .- %L%.X 1*1 .“PER10Df4; -To¢ai§Minq§es: jlifgz‘? _§$ ‘..-'¢.~l:- *1“ ‘QTV4 ;,=;£;_,,%_»<I’.‘1;\»2~;:- ~. ,, This Perioo (Line 3)I‘ 'IjIg:Z;iIt- ;. for-‘this-iPeriQdv (b-;1fi¢"'4-)£§-§'3éQ~ ‘ Y ’ *;~ -" ' H PERIOD 5: Total Ninuses This Period (Line 3). ' 1&1 - U » - ‘ vAotion Number A 6: Total Minuses mg Period3'(LineI » Action Number _,_\_. 1_v'l~ _ ’ , -, ' TIME PERIOD:I f" » 'VQUARTER a. for this 'Period (Line 4) I - for this Period (Line 4) ' [C)l'‘ ' : Total Minuses I PERIOD7 l I ' » -'- Action Number. ' PERIOD A , Toral Minuses I .- _ Action Number .» PERIOD9 : Total Minuses » . I - Action Number QUARTER 4. 6-;zi+g8J to ~/0_-~:-Szsj This Period i(Line 3) ll ‘ for_this Period (Line 4) ;_ll:1______ This_“Period (Lin'e3)v [3 ~ I~ for this Period (Line 4)' I 3 3:‘ I’ This Period (Line‘3)‘ I3‘ 4‘ ' _ for this Period (Lime 4}‘ l‘* 1 ~// i/0-9~"@%4 to Q"'_I0*'Z<?' ,_ TIME PERIOD:_ PERIOD 1o= Tom Miruises. ' Action Number . ' ‘' ' PERIOD_ 11: Total Mihuses - Action Number 12: Tothl Minuses' ' PIERIOAI) “K .' This Reriod'(Line 3) _____Zé2;_______ for this Period (Line 4) I/é:5i' This Period (Line 3)“ I [.3 ' for this Period (L1m=.-.4) This Period (Line 3) A ' ' l / % IQ A I Action Number_for this Period (Line 4) _____f2é£___ I hereby certify this 1s a true and aocurate reoort I I “Date ‘ .- K I ‘ _~_V__ U __ _§ '_ ~ _ k I I l_\_‘ ‘ _ _ _‘ ‘ u __ A‘: _ \ A’ _. l\ _ pl I.‘ ‘ ‘ ‘ _ ‘ _‘ _ \ _ _ I _ x _ _ Y ' I . _\ '_ _ \ _i ‘ _ __\_\N ‘I V \ \ I‘ _ l /~~ -" ,r'.'~~.- 1.1- f ANNUAL TREND ANALYSIS SUMMARY QUARTER_1 ‘- PERIOD ' PERIOD PERIOD QUARTER2 PERIOD’ PERIOD 'PERIOD QUARTER3 i PERIOD PERIOD PERIOD QUARTER4 PERIOD PERIOD PERIOD TIME PERIOD: Total Minuses ActionfNumber Total Minuses‘ Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Tota1IMinuses Action-Number Total'Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Tota1~Minuses Action Number I TTME PER1dbe_ T87» Q2";/0-‘TH A //>5-s) 2-4242 This Period (Line 3) - § [I ' for this Period (Line 4)_ é2<’ This Period (Line's). "] [3>’. for this Period (Line 4)tUb3.2"A This Period (Line 3) “' I 3" -A for this Period (Line 4)T :2-.;w-/-22 to 4'41 <35 This Period (Line 8)F for this Period (Line 4).) '* 1 This Period (Line 3) Q I- for this Period (Line 4) @E§’ This Period (Line s)"4 forthis ‘Period (Line 4) 4-12 -ssh to A/0»)/-88 This Period (Line 3) _ 11f’ .< for this Period (Line 4) ».ll 2 I .~ This Period (Line-3) . I51A for this Period ‘(Line 4). L This Period (Line 3)~ R -/4; for_this“Period (Line 4) [fijfi /0'Q~'%8 to .3-"."I0.F'Q‘] This Period (Line 3) ' A114}» fer. this Period (Line 4) Z55’ This Period (Line 3) ' . [$1 for this Period (Line.4i I This Period (Lihe s) ZéieiP for 'this‘P_eriod (Line 4) ' /qé I hereby certify this is a true and accurate report.~ Stgnature / ‘E Dated Q1’ . ' I.>_ ‘ d_. |\‘ \‘ \ “ .- I ~ . '\ ‘ _ -> ‘z ' -'-.» v .\ 1 ‘ \. s I Rx \ 4|:" _~.n Xv '\ \_I e -! \ .4>s' / .1. P?“ *4 IXDUDJIJAXIQ UTFZIEDQID IXDJZXILXZESJIES E5IJD1LI!\f§\{ QUARTER1 -APERIOD ‘PERIOD ~PERIOD \ QUARTER2 PERIOD PERIOD . PERIOD QUARTER3 PERIOD ‘ PERIOD ~ ‘PERIOD QUARTER4 PERIOD I. PERIOD ' ,‘PERIOD TIME PERIOD: Total Minuses Action_Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses ActioniNumber Total Minuses Action Number Total Minuses Action Number TIME PERIOD§. Total Minusés Action Number Total Minuses Action Number Total Minuses Action Number K -, TANK # ; TIME PERIO_D:’ _ "ts ;Z‘."'[0:Q I //—;é.s+ 87 1 I to Ta-23-22 This Period (Line 3) ' /¢9 ~" for this Period (Line 4) "5lC) 4 ,5 This Period (Line 3):.‘ /<9, ,~» for this Period (Line 4)_ ii?Z This Period (Line 3) * /ifA for this Period (Line 4) ‘T l;1i£. ‘:1’ ;1~r‘-sax ts‘ '4»/7'88 This Period (Line 33 ‘ ' tléz ‘i‘\ . for this.Period (nine 4)-1' ]*<~,, This Period (Line 3) "T _, ' for this Period (Line 4)I This Period (Line 33' vi slfi- for this Period (Line 4) [0V 6'/8'88 to /0*/”%8<~ This Period_(Line 3) ,1 t'~ _i for this Period (Line 4)»».[[ 1 Y‘ This Period (Line 3) I I I V , ‘M forw-"this Period (Line 4)" [33 -A This Period (Line a) ~. F§;_* rob this Period (Lise 4) I¢%f1 '. IO-"';l?~‘Z3l to ~52 O-/0-89. This Period (Line 3) ‘A Z I ,7I for this Period (Line_4) [£;I;r This Period (Line 3) o' I Z / ., for this Period (Line.4) . 1 8(7i. This Period (Line.3) . ~ » 3H for this'PeEiod (Line 4) u» 17%;A I hereby certify this is a;true,and accurate flepprt. Signature I ' Date ¢ ,_ \/‘ ‘ -\\ ¢ _\‘n ‘ IN. ‘. " \.?:f§) 3,. -\ ¢ \. I "1 ' -K‘ - s (\¥ k‘, ., ~, 1,. '1 ‘. \_\ "Q5- ., *2 ‘ xi‘ H: \A.-. ¢~ Q*\\“g.£§ l“~‘=*;*, 1 U! \-—~ ..3 u\ \‘.~ 1 | 4 ' ..: L ; _ ~1> ~_—7 . A -- ' ' _ - ssnvuce RE|>0'A‘ INVOICE W‘ F‘ _\V,//,r\° A ,7» ,» ‘ JOB NO. INVOICE NO. ¢u5T/////7 /'¢&C) »_//" RX; ADDR P.O. NO. STATION NO. CITY AUTHORIZED DATE WORK PERFORMED AT \.~, 3 “~ 5°""""=""' 9'5""'¢=° FPU CAL. ADJ. na|.. ma. .nacav. ,P- ouucr P.s. ms. <i.r.m c.w.u " LBS/MIN nan rum: MODEL senuuuo. DESCR|PT|ON QF WORK PERFQRMED /31¢’/7 /R Q/7% 7/ (3 74/I 6*“ (er. ['9 tn K/5) /// 0' /a q €' /- T, _ _ ” , l" ¢>,:.w / @:.//<.; ////3 1/v .r 5 5 /fan /I A» 5., /T» K/ E»/ .</ ‘“ 4%‘ \€\ ‘i “Y ? / , ,, \/V V» In 4/ A;/T» 6/ /wfl /<~R ./ 64¢» /in »~. K“/‘/ , 1 ,/:4 . .4 “J S , ' /I ,_:j ‘iv ,/ / fi‘*<?,/~/25:./.1 v <»'> /2? W §;§'<\ fl\;4 ,/F2) <r*<. I/4 1; M’?. ~ / u '' CO FY OF -r|cKz~r warn USEALED ‘:1 NOT COMPLETE CIHTOMER D NOTIFIED wan OMPLETE u [:1 no NAME u-n-1. "M! U“ zcrfis .r°_ '15:-:;v TOTAL A _ ARRIVAL asvawrun 5°; v¢|_ 1-AL , » , F 1g fl5417% W 51‘ //-W212“ ?’> ”/§>5 PM §§@ AM AM PM PM AM AM PM MILEAGE A TOTAL LABOR INCLUDES SERVICE CALL 8: MILEAGE QTY MATERIALS PRICE AMOUNT ;/ K”/¥/I‘? K? If c-‘<2 T: ~ ,~ . *:, / Kr /< ~ 3 _/m» 2%? 5.’/*6»/ A/“ /~/.1; 4.. .< /v/ VI SERVICE STATION MAINTENANCE OF KERN COUNTY, INC. 1000 Mt. Vernon Ave. Bakersfield, California 93307 D Phqne: 32p5-0708 I (4) TAXT WORK COMFl;Ef|fB_fiv sA1'|/’lE‘1‘Ac'roR|,Lv~m INDICATED nus. /,» W /0;: .0 TOTAL $ ‘) (Z) MATERIAL" (3)* \\ ./t \\ d K\/” ' anuux no. "TEMs"‘ PRESS HARD - YOU ARE MAKING 5 COPIES I _ Q _ _ ‘ ‘ _‘ § _ _\ R _ I_ _ _§ ‘I I '—\* Q‘) 4; t;.q ,: -.;"-0 ._,_ "METEl?__7';CALIBRATIlON~ c'HEcK FORM‘ L Facillvity; ' Permit"§_ 3 lo OO Note: 1- All meters must hflvégcalibration checks a minimum of twice Q year, which may iHC1ude checks-done by the Department of Weights and Measures. Y' 2. 'Bef0re~ starting calibration runs, wet‘ the ‘calibration can with product and 3. 4. Run 5 gallons with the nozzle one—half open into the can. gallons and Cubic iflfihes drawn, and return product to storage. return product to storage Run 5 gallons WithQnozz1e wide open into the can. Note gallons and cubic A inches drawn, and return product to storage. - ' 5- After all PP0dUCt far one calibration check is returned to storage, remember to record» the Avolume returned to storage in column 9 of the Inventory ' Recording Sheet. ‘A _ ,_ If the volume measured in a 5—ga1lon calibration can is more than 6 cubic 6. inches above or below the 5—gallon mark, the meter requires calibration bya .',. _» registered device repairman.r - Y Date/Time Hose or Tank #/_ h_ East Flow Pump _#,Product 5—Ga1lon Draft '7‘-' -1-‘: 5 —G Slow Flow" allon Draft Volume Returned Calibration tDevice Repairman- Date of to Storage "Required? Used for Calibration 3 . iGals.Cu. Inches Gals Cu. Inches Gallons Yes No Calibration -#~e9#/-rwer * »-1'-/v~6’9 11:1, 49"<$~/' V ]¢/d~89“ 3C3 §#‘1 ‘ ' I-/¢,)"C?>'9 1]-_w.-~e_<; es 1': i.{~ /.<~1 Mai“? ' '¢- .6- -. 3 "*' |\ 1-.- I4 Ow 's¢=.r >- ‘ /)>‘f5>w(? "/ p wwwrmw Dot! {IV D4‘? y .~ um. -.—- ?~>\l N Wx o\w\ u-- 37:5‘- L/,‘\ U‘ Y"; ,:. "~11- ,. v 2 _ _ --' ._'vz , '$ .-49» 4:2~ -6 ). go ><~ r :12/-/M as /-/ma’? a,@e- g K r . K .- 1%.. '\.\\' *°@@ .,U< X r . A A Owner or Operator ‘Si A 0 q 1 _,zn@ we _ W < ‘ - " J.. ‘ -Cali‘brator'ls=Signaturei " A - ‘ ' - Registration‘ # -fa?‘ GYGO SUBMIT A1 COPY; OF’ THIS Froi{M~Vwl1Tn ANNUAL‘ R§"1"i_i2:§'.RT. “ - _r t. ‘:1; ~ ~,. ~-.‘L~. ,__,__ _ -- '(:~ ». -* . . 4 .. ~ ~ -':--, ~__ - ,\ _' , - ‘ - -,5 _., " \_;g.r= ._ .- ' :1 1!~ ._ ; .= ,_ .. <, ., ¢,___ . _ .' V _ - - . .. .~-_~;-=—.-;.-.~"-: :=r",r-'*--:~::_*-J_,.__ ~ __ p <_ ,4‘. ,. -r ' - .,_ _‘ .- ',_.,__ ~. --_-_. * n_.-,_: __ _- . ,-, . _.:;___-4 N- , __ -. » ‘ .!,£,v 4 _ J.‘ _ __ _ ' . .1). _. _ _. . V ~_. -.'~"- ,'- , I‘' \ <_ ,,-r J» ._w- ‘1 I 2 Adog) a|g,| (Meueo) 8]BO!|dI'\Q Adog aago/\u| (auum) |Bu!5!JQ <>swq~m0 %? -’ ‘ Zr anneufigss;-ue \ A‘ <‘§ §3\ ugew BJFIIE figs s,1a|2aQ ON 53AE] o~[} sufi 0 /lfwa pa|ea5 aaaaw paueag |az||910]_ (suo||e6)a5e.|o15 on umxag 7 ,¢/ lnflpoad 01 N\O|S ‘ Z57»? ~\o|5 xsed p°nsn'pV _ A (suo||eB) 11915 (Aauoua) 1:215 _0-‘ / 0» oaxvauoZ _1se5 IU0I)l?1q!l93 (suo||eB) \JS!Ulj (Aauow) qsluu5 sflugpeag I wzqenol an|g[:] uamgc] paag Q Bel pafifiel __ _ 1Gqu.JnN muag IQPOW PU? 9>l?W du.| n,_| saAD 99l9°S ONE] saAD nznaw pawag ‘ammo; (suo||eB)a6e:01$ 01 uaruag / I )~//W >fi \Dl‘\pOAd MO|S OL “ed pa1Sn!pv Mo|$ I595 3"°!l9"l!l9D' pvnvaua 63560 ,, _ 4(suo||e6) 11215 (Aauol-u) 14215 {'3 /7/7 6O (suo||e6) L|$[U!j (Aauow) MSIUQ5 $5"!P°°U 1e1g|e;o1 an|g[:| uamgc] peat] g 621 pa65e1_ dum¢| °N E] $12,; [3 0N C] sang C] pa|ea5 AQIBW . oa|ea_<; A;\ZI|E\O_|_ Aaqu-I"N |@!19S (suo||e6)a6e4o15 on unuaa wpvw puv anvw M"-'0 hzw 1:>npo4¢ MOIS 152:] O1 r>mr\!s>v S .~ Y D6>138\.|:) ;v\0|s 3595 Z\.l0!)81q!|E:) ,9 /564 (suo||e5) U915 (Aauow) uaxg .>6§6¢ (wouvfl) wvu (Aauom) qsgugg '5‘-WP"! 10152301 an|gU uamgc] paut] g 62; pafiflel JQQLLIHN |8!lBS dung 0N U saA [3 0N [3 sa;\U pmeag Jaxaw pa|e:->5 mzuexoi (:uo||e6) 8521015 on umxag wrww we new /“’§"¢’.’a , 3 #1 nnpmd . oi P81sn!9V Mo|$ )S€j /1 ____ / _# oaxvauo ~\o|g 1525 7"°!191q!l\?O 46:6? _(w.°||vQ) “=15 (Aauom) nus (_ y'_§ /'1U (WOIIRB) useuas (AQUOLU) \-Bgunjl sflugpeog 19zg|2|01 an|9O uaa15)[] pagg ¢ Bel pa66e;_ JBQUJHN |E§J9S |3D°W Pu? 319W dum4 N saA U 0N U sa; C] paws; mxaw pa|ea5 JBIl|l?lOJ_ (suo||e6) a6e10\$ on uJn)9g /11,410 ffl xanpow MO|S 1595 °.L Dalsnlpy - C _, oanvaufi M;-,|S “ed zuonmqggeg 9/9/A (suo||e6) 1:215 (Aauom) u9l$ yavva (5U°ll95) wuaa (Aauow) \.|5lUVl".j sbugpeag mzqenol amgc] uaa;QD paum Q 62; ;.|a65v1_ ABQUJHN |eu3§ |apoyq pue anew‘ dungd ON C] saA E] ON D saA pe|eag nuaw pa|eag )B1!|PlO1_ (SuO||E_5) a6e.|oa$ O1 uarnag / .»r/‘ /0 /# 13np0J4 1 '0‘ '0‘ °* oawflwv Mo|5 use, ,... 4 .._ paxveua MOIS 152:, ZUOIIEJQHBQ L</é/ (suo||g5) 11215 (Aauowu urns Lb/6/ rwouvfiy u§s§_!a (Aauow) u5§ug3 sbuqpeag |azg|e;o1 an|g[:] UFJBJQU pogo 3 Be_|_ pa6fie_|_ _ 1aqu.mN geuag , |apow pue anew dumd 48"" - 'Q. do/5 W“> 1 5 fl 5 X O O "I CI LUHN QOI‘ afiueua ‘mew D auzg J8Q\Lll’\U uogxexg = l: V%%V HVO 5;; [2 §F. Ir "-»=¥’r' '=* "~.= E5 IF. £1. 1, 3 Yi"" "'-1 ii? :> A 7: '.»; if it r» r. |. L.F f;.: -r- E4- F is '; i-3 if ii- E-"i? -5' P» -'= ,./ I. “,1 u‘ | . :I_ ,~ H L. ii”- 5‘ nit n~ r,, :-I I E -F‘ mX F DEPARTMENT OF WEIGHTS ANDA '1‘ ,.,r_».~.=. COUNTY OF KERN ‘ wz;==i=-[STATE OF CALIFORNIA I ‘I 16 East California Avenue Bakersfield-93307 if ‘ .. Te|e'phone(805)861:2418d 5;; Certzfzcate of Inspectzon This is to certify vhor in occordonce with the low, I hove.resled the scales, weights and measures, said to be the property of, or used by W DATE 5‘-ll 193% K ,- NAME W\\\Cu. 5 \n>.c\<_ 1E0 ADDRESS 210' \ ¢»‘v\ Hwy E1v\Zwz,4i€~1§(§Z OWNER FORMER NAME NO. <OE§CRlPTlON mo nsmzuzxs Sea ed Cor ec 7._ Ad'u ed & Sec ed Ou 0 Orde Tag No §<w\€>§ U’ (Auk 2%, v\\r;~;k § —-* (go C'f"\l»(-*a~'v\=~'3\B1\Q.i’>9/[_ mu LkI¥%g>;j@-VT TIME . ' TIME (OWNER on AGENTQF OWNER or; PROPERTY INSPECTED) om Vernon Eh)/e, D' -ecfor roux POST m A ilM PROMINENT PLACE DEPUTY/ INSPECTOR i 5,»®~ D __\5 \_ ‘ IQ U 6 W _ ‘ _ ‘G _ '_ _ J _ _ _ T __\ ‘ _ __ I. _ _ L: Mr 1” __ ’ h ii- _ T M r I v’__ \ _‘v _‘ . __J _ _ _ M“ V _ _ _.J_ I ‘I ‘W Q ~ l 9 i _ A _ _ I 6 \ _ _\_ ‘ _ _ _ ‘ _ \~_v L d WV 8 _ M _ _ i _ _ ___ _ _ I _ ‘ _ __ ’ _ _ 1:‘ \ % _ _ ‘ _ ‘ y J SERVICE Rem‘/‘ u\|vo|ce. ADDR /)4 _~ ,.- --"" JOB NO. INVOICE NO. ~, //4 I/Z» /la <4 A ya» r-.0. NO. STATION NO. CITY AUTHORIZED. DATE ""°‘“‘ "ER"°R"'E° AT ’/,-7?-if Z'<,;»2- Hwy- FPU cAL. ADJ. DEL. ms. HP .RECOV coua F.S. F.s. G.P.M G.P.M ' ' LBS/MIN EQUIPMENT SERVICED ITEM I MRKE I MODEL SERIAL NO I I I I I II . DESCRIPTION OF WORK PERFORMED 4‘ 6/vaaugg ’4,¢4/A>,(>,\v—//,4 fli .6/,:Jw1»1e.@<’..." fax </£»Px=re¢1 4* A/-P”. - '.€'/»*-‘/“ad wa mare! Q2,¢4.r 04/ ~*’-1/+"‘=‘$¢ \.?'//.)’,1Zi»<1.I“.4~=»~fi'.,.(‘ __ L...»-Q" I , I :\ '. _\ ‘cc_:fv' 0'5‘ '- I:IsEALEu I:I nor COMPLETE ‘;':;_‘gl.""“‘ COMPLETE “Kb vEs Una "rm: nouns 'H°um_v NAME NI-H-L L“_ _|_RA_ Y°_ RA-(E TOTAL A AnmvAL DEPARTUR eon VEL 1-AL 1-)]./ ,~ - , I AM 3 M ___. 94 Yylglil./\,- ”'V 'q.?0m ~' ‘QM *7 -.,, ,~ T I AM AM PM rm Am AM PM wm W’\ / MILEAGE / O@ TOTAL LABOR INCLUDES SERVICE cALL s< MILEAGE QTY l MATERIALS PRICE AMOUNT 1"’ 9' I av »-(fig ..» ¢.4 <:..:‘, SERVICE STATION MAINTENANCE OF KERN COUNTY, INC. 1000 Mt. Vernon Ave. (3,+ Bakersfield, California 93307 Phone: 325-0708 (4)1-Ax+ WORK COMPLETED, SATISFACTORILY/‘IN INDICATED TIME ",~~‘R X 3- TOTAL$ 7'; BANK N°_ II1'EMSl—4) (2) MATERIAL* PRESS HARD - YOU ARE MAKING 5 COPIES ‘METER _".CALI BRATI ON CHECK FORM’ q Facility: ‘ Permit_ Notezc. - ' - ' - 1» All mfitfirs must have -calibration checks a minimum of tw-iceia year, which may '-include checks done by} the Department of Weights and Measures.. 2. Before starting calibration runs, wet the calibration can with product and r‘eturn product to storage. " D ~ ‘3- R1"! 5 88110118 with nozzle_ wide open into the can. Note gallons and cubic é 1. ' inches drawn. and? return product to storage. , * A . l 4- RU" 5 ga.110I1S with the nozzle one—half open into the can. Note gallons and " .*-,;;.. _ _ cubic inches drawn. and return productto storage. AI ‘ " v ,5‘. .. . 7 £4» = ' A »;-;~p',1¢;_t;-;-;» 5- After all product for; one calibration check is returfizd to storage. remember 2 » tot record the vo‘lume_ returned to stor-age in column 9 of the Inventory : ' . - Recording Sheet. I :'_ ‘ ‘ _.- -_ 6- If the V01'\1m8‘ measured in a 5—gal1on calibration can is morethan 6 cubic >> inches above or be1ow-- the 5—ga1‘lon mark, the meter requires calibration bya \ registered device repairman.’R _ Date/Time Hose or Tank Fest Flow pf Slow Flow Volume Returned Calibration Device Repairman Date of_ " R Pump # Product 54Gal1on Draft 5—Gallon Draft to Storage Required? Used for pCalibration l ' G618 Cu- In¢h8S Gals Cu. Inches Gallons Yes No Ca1ibration< ' A"- (%‘-y\'7..5/‘gm #5 w/%e§1-cos" coy. ;,,;~ ,,~ /yin j-L»>_s"M +»-2r~~iA><§; Qt R7 $494 Q4sO ' />._ l //' 1» . A Y H’ A5 yfl/_ ,afl _/IQ_ 1 ’ _ f .. t . , R <~~~--—=—=~'¢ "%'jf*-""f=*"*i "' “ ‘ ‘R 7 7* 7)“ ',' R ~ 7i_fl'a3 ~ if l-2 ~/-/_ /Q» »g¢/ 1 15.. *3 t. .;/_ ____ L _, -_ _‘~_" ‘__.. -- 0- R-4 - ‘D5:-J ..(‘ ;;, L /1'~ pg: yaD inQ \» _¢_>Wp _ ' ,¢ .. , ~ ;0wner_,vor-'Ope'ri;§t‘or.'_vslignatgnije- l ' p ' _ " ' . ,_ ‘Calibratorjls§"T§ignature;;e'-‘Q4)ffi?- i ' i ‘ Registration # _Z "9620 - p 4, ~ bU.BM.IT;A1 QOPY; 0'B_.TH-_IS -FORM‘ wnru ANNUAL Rf_f1;_=j.RT , » Y i . _ .. > Q V ' ‘ ., - _ - _<|>.-;_\~>_~-~5<_o’§'\"\'¢g. .. _, A __ _, _-._~,.~.- '> »\ .- “ ~ ** ,4 s. .4 '.'.I"'-T-I" K‘ _ ‘ _ ‘I I A 4 _| I z 4|“ |1l_fl|‘| 1 I _ I ‘I- \‘| ‘I V ‘_’ ._ \‘ ‘ _ i >_ v’ ‘r ‘J _ I L _ _'“b;Vb H; _ _?_4_ _‘_k__f__ _ 5 ql ii’ ___ “ll ‘ _U II ‘ ‘L I _ ( _ 1 _ 1 JV» ‘W6 /____ ) ‘Q I /7 IN W, / 7 I _ :3 V V /_ UL’ C __' , hd V‘ 9 C ’ I _ ’ L? _'_l1_ ~ _ _ "L ‘P 7 " It‘ _ 1 _ ‘I ' Q ‘lb / f I’ _' /7 9/ /'_’ It _ f _ ' _ _ ,' If‘ _ Q I ' I __ _ l I'll ‘V I ‘ ‘W w m _ _ _ fl_ '_ ’ _ ' fly ' ' Q “ml, _ ‘ ___\\m‘m,' I flu‘ O _ HW H%”,“vfl‘,.W% __ A V _ “'_ ‘Y,’ Q 9 7) V O /_ [I 77 Ff I ‘L I. J“_V“_ _‘ F6 U _ 6I Q’0 to\ _\_G __ /\/ A‘, 0 AU‘ M | . R _ \ \ ‘g > ! M‘ L"v“_I_7J _ __ _ _ ‘_ . ‘ _ _ ,1‘ '_ __ ‘_ 4 ‘ _.'M__h_r'_Jv _ _ _. _“_ Y3 ;w‘ ‘_ ‘_ _ 4 ‘ _ ‘ _' ‘yn ‘ I _‘ __J_?\“ ._ ‘V _| ___’__4 _ ’_ .__| T __ _ ’ .7 __I_*3_ _ ' ‘_A'__ 1‘ ‘ _ ‘ ___’__ _ ‘ _ N 4_ _ ‘I _ ‘ _ J‘, H it an '_ ‘ _ _t N I _ _ _ I _ _ _ ‘ __ "-4 AV " { r ‘ P ‘ If _ Cy f xg/£3 ‘ Ir _ r__ ‘ 1 | _ \_ x H R. ‘I ‘ \ Z v___ _W% _\ ‘\ ' ‘ x: I _ M y ’ N ‘ll “ “M __ ~ /_ l E ‘ ‘I kw Q fl\|_r“___ yr ‘- ‘VF % ,\”_r_l‘ ‘ K I”, ,_ fl ;\|l Y K “ __ ‘ AI.‘ a __'___ “KN Wfi _ I ( ‘ll, A?’ [Vt /K? _A _MVVfiVL AWN ___ _'_,_ V W ,_ _ ‘ ['1' 1 I’ _¥ ‘L _ f _ I Z _ _u'< V K! an ‘“a_W__§_ I P __ )_ /Din” ff _\ M‘ I ‘J I A‘ __‘f _ _“ ’ ‘ 1 _ T L_ . t y’ Ink“ _ {‘_ V I __ I _ v J( n I r I §‘ ’ r I _ ‘_ ‘I ‘ ‘r ‘ ____ fig _ _ ‘ _ \ i V ___ \‘ _ _ ‘ _ \ Pump ‘V ' _ ‘N ._ ,i_, r~ “W -#5. .. 5:. _.~~,qa-;~e-.-;- 1-.w~Iar‘\j.rqopIr_;;-r_.,v -~-..‘_. -t-\,—,'__. ,,:_i:5.:v,,,_’_'$:!,,_:"-.._.__ 4-'~' -3: N: gr? M /\.g V A." ti @giwii3e$5(')'i'lCompai1'y "" ” "B B \ \\; ‘figimmsoflfih Record of Computer A ( V -~»Ba'l<e'r%fi‘éltl ‘ 80-. or Meter Chane :__ L; ,‘_\->“._».- 7 r.-_;;$-7-‘t___~;.7-1'...‘-v~_,- ml w '_ ‘ k ._w _,r1_\dW Qi \i <=iI§IliIE>IuI@ri>T-iiT!!.i=lBl5'= Station number Date E] Mew, change a‘ 7J(V7b Number U Computer Change '~ Q W/M Nomiea ‘; Make and Model "”’5 <.<=>*é _ E_]Red []Green [jflliie Serial Number Tagged Tag0 Finish (money) Totalizer FFIISYY igallons) cahbmuon‘; Fast Y0 5 0 g‘ C9 Checked Slow 1.’) Readings Start (money) Start (gallons) ' Adiuswd Fa“ §@7vXY3 *~ Slow /7/were Totalizer Sealed Meta Return to Storage (gallons) 1/ O {:]Yes (:]No r Sealed []Ves UNo l Make and Model Serial Number Taggeri Tag Ufied (:]Cireen Dfllue 3 \-a _F_l-f\l§h (money) Totalizer Finish (gallons) Calibration: Fa" ' Checked ‘k Slow J1 R5 Raging; Start (money) Start (gallons) “‘ Fast //0 ¢/J '7 Y /a SlOw \../ Sealed /7/»5»2.¢.. Return to St6?’age (gallolis) J 0 [3 Yes C] No I Totalizer Sealed " Mater [:]Vas ONO bf ‘Make and Model ~/ Pump Serial Number ' Tagged Tag DRGG (:]Green Dfllue 8 l l Finish (money) Totalizar Finish (gallons) 7 9 ‘ Calibration: 3" ,7 Slow Checked 7 LU). Fastl Readings Start (money) Star't (gallons) I ‘-7 Q ‘ Z Adiusted To -.-/ fr? 74/ Product L’ Totalizer Sealed ' Mate Retifirn t6Storage"@allons)7 P G U Yes E] No r SealedI BY“ ONO - Make and Model ,3/:‘jPump Serial Number C]Red [:]Green UBlue Tagged ‘ Tag0 Finish (money) Totalizer Finish (gallons) .242 "-75<?5' Calibration: F3"7 Checked ‘xy0 Slow Reading: Start (money) s§K?&5?5M Adjusted T0 Slow' 6//15,46~ Return to Storage (gallons) / 0 O Yes U No i Totalizer Sealed Meter Sealed UYGS ONO H: 7 Make and Model .::;'$K'/ Pvmv Serial Number ' ‘Tagged Tag Ufled [:)Green Dfllue 3 Finish (money) Totalizar Finish (gallons) 03? / é Calibration: Fa“ _7 Checked Slow ea Reading; Start (m0f\8Y) Start (gallons) zsyvz “%“Fw*/ Slow __7 xv; /Y Product ./)/at-/Q==l» Return to Storage (gall‘o'ns) (9 0 DYes ONO Totalizer Sealed Meter Sealed E)Yes []No V4 a Make and Model ///- Pump Tagged Tag DRed UGreen Ufllue Serial Number8 Finish (money) Totalizer Calibration: F-=15!“ Finish (gallons) (S Checked ; -5‘ Z7/néa Slow 7-5K Rqaginqg Start (money) Start (gallons)" fix?/a “W°m ToW Slovym 7/) Product /’\ .' /' _.//¢S" +1); 4_ 7 Return to Storage (gallons) Totalizer Sealed i Mete - (-\;.. (J , :1‘/es BNO r Sealed [;]Yes ONO Dealer's Signal-u're , Maintenance Man's Signature “ -'.-r~"-- I‘ (¥\ ¢*%....4~‘/,f-.§*z¢1.>/7,-rr’ " ~ (_'{;,{j/M9 I\)\...,_______ Distribution: Original (while) Invoice Copy Duplicate (canary) File Copy A I s+A_.__._l ‘~ L J‘ J- — —.———_— i— _=.,.,. z \ . ‘N r ' .11 ' . ~ ‘r-,""“' " --—.S.‘ \ . =_ ._, 3 ; .‘“_=,f;§, ; ‘-. '_'.,;~"F.'\ £1; Y 1. pl“.-1 ~24. .-v zv.. 1 1_ . 1,;\ . 1,\ u ._ I \ =>s\ .‘__ _r-\ ‘F- . f \ I ~‘ ‘ \-~~ ,, '--"7 tic) -| \ . \ lg ‘ .r‘\L; r - .K "_*C \\ F\ \ . ‘I 1 \_ _ \ \\ \ u b "-~I \Q §_'\J_\& P:r\'\//%?)>@@/s '-\‘:r f\\. 0 .. /*5‘ [kg. _ ‘ 8t 3/ /VI/4904, 5 /959 . 4¢5/V72] » Q .- H ‘n ("Q14 ’ * " 4"‘ ‘-"“*' »"‘ *'~i-"-'-*v- -» ' ‘>1 11» -:1 mu a n .-¢ A, | » ‘,_l"'- 1.4» -. L ‘ _ . »- /~\ 5L ¥ f '_v '' _\ ' ——|:.'.-Z$ - O \ ’ ~ '__ - ._., .. ~ \ ~< .__ I I \ \ \ 1 1 1Q 1 I ~ 1 gr, ~( 5.1-;' M p . .. .:*~.:v-¢;'$”.*"- O -’“ ., ‘ TP1\DiI(1 I?l\(3]IIJ]I1P$?“Aklibililklb PZE5I>C)IQ1T. Facility FUCK Swermit # 7200/0CMonth/Yr. 1. .I have not done any major modifications to this facility during the A last I2 months. A - ‘ » p Signature. Note: All. major ,modifications require 'a Permit to Construct from- ' the Permitting Authority. p A“ 2. I have done major modifications for which I obtained Permit(s) to ‘Construct from Permitting Authority. C-', '_ ‘ _ Signature .* ' i" Permit to Construct # ‘ Date 3. eRepair and Maintenance Summary’ Attach a summary of all: ~ _‘ " _ " _ -&_Routipe andi required maintenance dene to this facilityfs tank;. piping, and monitoring equipment. ” i__ —— Repair of submerged pumps or suction pumps. i——'Replacement of flow—restricting leak detectors with same. - '—— Repair/replacement of dispensers, meters, or nozzles. .‘P —— Repair of electronic leak detection components, or replacement* with same. . —- Installation of ball float valves. V’ ——~Installation.or repair of vapor recovery/vent lines. Include the date of each repair or maintenance activity.0 P .NOTE: All repairs or replacements in response to a leak require a; ' Permit to Construct from the Permitting_Authority as do all other modifications to tanks, piping or monitoring equipment not listed here. ' ' 4,».Fuel Changes +'Allowed for Motor Vehicle Fuel tanks Only. vList all fuel storagegchanges in tanks. noting:-» » Date(s), tank number(s), new fuel(s) stored-. /- /~87 7'Zmk**4 0/9/»~3;.d FROM Fqflulns Gm; ' . 7'6 O/'EsEL* 5. Inventory control monitoring is required for this facility on the Permit to Operate, and I have Egg exceeded any reportable limits as listed in the appropriate inventory ,control monitoring handbook during the last twelve months (if not applicable, disregard). V P M Signature flaw 6. Trend Analysis Summary ' . A ' , Please attach Annual Trend Analysis Summary for the last 12 periods. 1 . 7; Meter Calibration Check Form i " Please attach current, completed Meter Calibration Check Form ,1 \» f Ll , V '. ‘I. $ V. 1 v. .Y‘ R" \ . 1 . ‘. \ .¢ ‘ . _ ‘. . _ _. ,, 5 7 V_ _. ‘ ~‘ , € ‘ . ‘. V _ 1 .1 " = | u- /1 #}8-/r<@/ WWW” ”’2’7”'”’“7fl/“’¥”"?° r+Mw/ 9 'L8-s Y J’ /W Wéw W‘? _¢ _ I ?7<?/7""/kg jLL5'5/'5 1" " j “_~~ 71 f * ' ” H ‘[3,;/_.,7l7 _~ /‘7"’f‘?' tug . W 32””? J‘§l58*L‘/-ZTV __ ;_.~ ‘ fifty éga - - T7 @.y%L8’S/ég K; 5? g”*’;”?””””“?””JiL*'//'5 ” ‘§L8¢/~61 . Y T 1; MW’/7% IW/I/* | ; /77 ' "”*'W»/ f””‘”””’/<f”Z.’7”77“‘Y§”'/?‘*/@'7*;'” -I \ J r" - Q r _ -._-.-._ _-,--_---. ----. ---_-_..-------. - 7.... .-_.- _.. __-.______._.--___._-Zvq----.-_--L -- -~-- » _ . .._-_-..__.__.-.-._-__._.. __ ..__ --_-_-Q-_.. -_-._--__ 44- - ,_____ ...__-i.__-_._.—74_——~-__¥__ . _.. —~ _____ _7 7 - ._ - —-_ ._.__ __ .-_-,,._..._.__.i7 _..-__-_.-___.-_._.-.- 7- _.- _-...-_ ._.,_._ _- ..- _—_—_—..777j —_. 74,77 —,T _. __-'A~~ ' 'A—l _ _ ______.__l_ ‘_...-- _ _ __ _ _ ___ _ _ .-A7 7_A7- __.._ : _ : ¢~7- A_ _ 7 if 1,, — _-...- _____....._ 7~7 ___77 _ ____ __ --.--> _ _-»~_.+__.____-_.- --__ _- ,-__-,_’~_.._4.-___-.-_. _ -_.- ._ _...-io -._-.-—_:_—_—-_—_; --..--;___—__<- Q. ——.— - ———— _ --T-..__.-.___..___._ q.._.__.. _._.-..-Z- .. _ _...’ _._.-.-. -__ ----._.--<- -.___-_..‘.- -__-- -. - - _-__———_ ____;-._.-_ ¢<_._ _~—.—< —::_<_%<—7T_i—_—.—77777...77 7,... -.-~—— q._. ..____ __._.-.____-_- __..-A_ _ —_—‘-_T<-_._- ?_ _-.-__._7—-¢--_____-_.;__ —;.._— - — —— —— ___ ____ _ '-.-___ _ ___.— —:;_—_ —___.--.__: _ —— — ————— ——— __ ._ " ___ 7.77 7. 7 _+ 7-, ..__- __7..- 17 ,. __ ___ ___-_ 1» :—_ _ _ AA ..._.7 , ~ _ ~ . -__ ,7 7 _ __ _~77_-..7, , .._..-_ .. _._-.__._._-._\~ _.....-s.--Q-____-- _..- ~_A----—_ _ _A-*_._ —— ——— -—7 _ __ .. _ _ -7 —<—— ——+T— __,— ,A+7 -. ____ 7, 7 _ - I---_ ...___._--+~..._-_._.._.-.._ _--_-_-_.. _ . _ ___--i-___ __......._.._.._- _.-._-._._. --_ .,._r.. __--T-__ -.- - ¢._.- --.1 Q--.‘ ---._._ __- _ _ .< --_.-_ 4--. -7 7.. 777 _l...<_ ._______ _- ..__. _. _ --.__- -__-.- .,_--....,,.__...__.. ._-.-_..-_.__.i__.-.-____ _ _-- _ .---.-___ ....-.__.v__ ._......__ _.--_._r _- -- .-__ _ __.i_._._._._. ..__,.----_.-__- --_-¢_~_..__.__._..-_-__. _____..- ....._;_- _ __ _ _ _..-—————.77— -»~_-7, —T€—7.. I _ _ _ ..__..“ . _~___._, .q...i...__- ...___ \ .__.__----- ___.- --_..-_..- -- -¢-.._.7___ __7 —~_. _- ——— _____ - .7. .-T__77_7~_.__ _.. - -_-».-»-_-_..- u _ .. ..__. ___ ___.._--- --.. ___-.__._ .__ . _..._i _. ---_i._ ‘L.-_-_. .- __ _...__._,_~,... -_.._-.____,__¢ ____._._. ..- _ _ _ —_-7 777..-___. _.<._.. -i..__~._.._._i..i._.__€_.~ ¢ .. __ ._..__+‘_.- @..-__-_ - . ..__..._.____-_----__.-_. .-.-_.,___...- _.._...~‘_..____-_.. — — ——— ——~ _-- __.-._._____--> _____ _.___.- _. ____ ..._..77 _ _ _ _ __ _ _ __»-.- f ———_;——; , . -_..-__..._.1-___-._ -0-.;..>___a_.__ .-.--_..-___.-.-_-. - - _ —— "T ~—— T ——~ Q v-7 _ __ .....- _—— _ : ' ' ._ — —A~ 7— _ ____ _ __ _ ————;— _————_—_ _—~——— — — — ——— — — —— ..._ _..-. 77 ~7—__;_— — — '———~ ' —— l”‘\c [ I ~: \ v' I n¢ >‘-- -:- "° I ' Ia‘: ' ‘- AXDQDJIJIXIL 1TPZI5DJI)~ AXDUAXIJXZESIIES ESIJDIDJAXEZSZ »r TANK 1; i[~Q - TIME PERIOD: R /O-_I-QL to QUARTER-1 PERIOD rfPERIOD ‘ EPERIOD QUARTER2 PERIOD .PERIOD PERIOD QUARTER. s_.. *‘.PERIOD PERIOD PERIOD QUARTER4 ‘ PERIOD ' PERIOD PERIOD TIMERPERIOD: A -' . I. /-0» 1- <34, to /-947 1: Total Minuses AAction Number 2:‘ Total Minuses Action Number 3: 'Total Minuses i 'Action Number TIME PERIOD: ». 4: Total_Minuses _ Action Number 5: Total Minuses _ Action Number 6: Total Minuses _Action*Number » . TIME PERIOD: 7: Total Minuses ¢; 4 Action Number 8: Total Minuses ‘Actioh.Number 9: ‘Total Minuses »1 Action Number TIME PERIOD: 10: Total Minuses Action Number 11: Total Minuses Action Number 12; Total Minuses Action Number This Period (Line 3) 1 /5- for this Period (Line 4) ERG) A O This Perivode(Line 3) 31‘ for this Period (Line 4) fl3_7 _ This Period _'(r.ihe, 3) I ~ [I 4‘!-3/‘ for-this Period (Line 4) »S;£f»~ /'a'%7 . m *4-Q0'@7 This Period (Line. 3) /é I -I Q5“ it‘ for this Period (Line 4) 'é;i _ ‘ This Period (Line 3)‘ ’ II1Irj1Q for this Period (Line 4)i This Period (Line a) A [Ll 8% _ 6 for this Period.(Line'4)' '[C)[~ ’-I-T21)-‘$11 ‘ to I )'l'9~"'%"L This Period (Line 3) _ . ii; Q5 for this Period (Line 4) I "7' This Period (Line 3) ' . for this Period (Line 4) /33 , ~ This Period (Line 3) P [Q1 .l'l@ for this Period (Lihe 4) __lJELfi_____ -‘ L .. ..ri 1 7-12-2+) to. PL/»s~27 This Period (Line d)» '[fi;’_ [QQ for this Period (Line 4)" ' ;This Period (Line 3) [:§" F{5’. for this Period (Line 4) I I This Period. (Line 3) ' for"this‘Period (Line 4) I hereby certify this is a true and accurate report. Signature (_ ‘ , Date ' 1 AXDJDUIJIXIL UPPZESDJID‘ A\DJA\I,\(E5]IE5 E5IJFdDd1\P2\{ TANK xi h TIME PERIOD: -/0‘-'/I-'3§=‘ I to //'5-'87 QUARTER1 PERIOD PERIOD PERIOD QUARTER2 PERIOD PERIOD PERIOD QUARTER3 '.PERIOD PERIOD PERIOD QUARTER4 PERIOD PERIOD PERIOD TIME PERIOD Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD Total Minuses Action Number 11- Total Minuses Action Number. Total Minuses Action Number ~/0-/-is to /- 8‘-87‘ This Period (Line 3) [:7'i for this Period (Line 4) QC? This Period (Line 3) A QB. for this Period (Line 4) ,3 I ,. This Period (Line 3) . 1 3%; for this Period (Line 4) r.§;ft. I If-£3 "S?_]i to I 4;";kQ"i%:7 This Period (Line 3) 14*‘ ‘IQ for this Period (Line 4) £5‘?U This Period (‘Line 3) _' [5 I Q1} for this Period (Line '4), This Period (Line 3) . ilfik ' fig for this Period (Line 4) iU2C?l V ‘f'Q.I-'%'7 . to _ 7"Q-7"%»7_ This Period (Line 3)“ for thio Period (Line 4) 11'7") This Period (Line 3) [ff [05, for this Period _(Line 4) [33I This Period (L_ine_3) for this Period (Line 4) 7-J3-3'7 to //45-27 This Period (Line 3) I rig; /36' for this Period (Line Q) __’é1§' This Period (Line 3) - '- for this Period (Line 4)’ -[80 This Period (Line 3) for this Period (Line 4)‘ I hereby certify this is a true and accurate report. Signature I Date //" g’ F7 ~5?1""' '". - TANK # ';'_/’ TIM); PERIOD: /0"/" 84 to _//“§'%7 QUARTER1 PERIOD PERIOD ‘ PERIOD QUARTER2 PERIOD PERIOD PERIOD QUARTER,3 '-PERIOD PERIOD PERIOD QUARTER4 PERIOD , PERIOD PERIOD TIME PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME'PERIOD: Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD Total Minuses Action Number Total Minuses Actioh)Number Total Minuses Action.Number TIME PERIOD: Total Minuses Action Number Total Minuseé Action Number Total Minuses Action Number ANNUAL TREND ANALYSIS SUMMARY ~/0»/-24 to /-84-87) This Period (Line 3). for this Period (Line 4) 21C?. This Period (Line 3) J»2§ ~26. for this Period (Line 4) .3—7 This Period (Line 3) [d2 22$) for this Period (Line 4) ,§;f£. /-9 4&7 ‘ to) lift-'Q0"Z'7 This Period (Line 3) Y £:;+\ EKZ for this Period (Line 4') 63 This Period (Line 3) . A' for this Period (Line 4)‘ A This Period (Line 3) I V for this Period (Line 4) A/29/A 44¢-4/-27) to 7-:17-27V This Period (Line 3) [ft ifZ/5-. for this Period (Line 4) , [12 This Period (Line 3) lfi [Q5 h for this Period (Line 4) _ [,3 This Period (Line 3) for this Period (Iiine 4) [FIQ 7)-=12-27 to P //'.§"37 This Period (‘Line a) [K Q [.39 for this Period (Line 4) [§§é§' This Period (Line s) _ '[ Q Z521’) for this Period (Line 4) Z80 This Period (Line 3) [L+‘ QEQ for this Period (Line 4) _, I hereby certify this is a true and accurate report. Signature @4»~/ I Date W1/"6"97 ‘ ‘|l'\_'_ I‘ AO ANNUAL TREND ANALYSIS sUMMARY TANK # T. TIME PERIOD: /9'.‘/'84 to //‘AS’ QUARTER1 PERIOD PERIOD PERIOD QUARTER2 PERIOD PERIOD PERIOD QUARTER3 '-PERIOD PERIOD PERIOD QUARTER4 PERIOD PERIOD PERIOD TIME PERIOD Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD! Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number TIME PERIOD Total Minuses Action Number Total Minuses Action Number Total Minuses Action Number 87 -/0-/-94. to /-8+2‘? -~ This Period (Line a) . [é ' for this Period (Line 4) QLCDP I . This Period (Line 3) ftgg ;Z5 for this Period (Line 4) o3 I: This Period (Line.3) lf§' éfi for this Period (Line 4) Si /"?"g‘} Ito ‘if-.-JO-"‘Z"] This Period (Line 3) - 51 for this’Period (Line 4) This Period (Line 3) ' 2&2 ‘ Qfi for this Period (Line 4)A This Period (Line 3) '*- 1;; 8! for this Period.(Line 4) [(9] PP-:1:-Q1 to 7~i7—27 This Period (Lihe 3)" [3 for this Period (Line 4)‘ [1 Z_'.- 7 This Period (Line 3) ,‘il' /05;’. for this Period (Line 4) I 1,3‘; This Period (Line 3) [:1 /1k for this Period (Line 4) ,[Ei9. A7-;z%-.~21.e, //-5-87\ This Period (Line 3) ' [3 /§Q'_ for this Period (Line 4) [é5J§' This Period (Line s) A 13 /15- for this Period (Line 4) li;C7‘ This Period (Line 3) l ./£2, [Efi§ I for this Period (Line 4) /Q5)4 I hereby certify this is a true and accurate report. si8‘_‘ature , I Date 41/"§"?7’ 3!! ‘ll E7 W % \\ Al fl_ 9 FF OW E N Em“ TLP CLD _nmMIiUU \b_ N_REK w _ _ 3“ I L‘, _ \ ‘I zfinq \’ F "'§“ \ \ ‘ J‘ .~ V .¢ "‘\ {J -"“i,;1‘; 1,.4 1' - I»q » .F\. _r F‘ \ »\_ I _§§§;3f DIIETTIEII (Zl\I,]II3I(£\1T]I()Dq (3III3(3I( I?()IlDJ '&;‘~“W-- -;j I M a K u Ls Facil ity: ' ?umpkln Center Tmck Terminas Permit jg 320 0 / 0 C p P£lB0x197 Note z Qumpkin fCe_a£:er, Caiif. 93313 1. All meter§ must have calibration checks a minimum of twice a year. which may; u fi/ include checks done by the Department of Weights and Measures. 2. Before starting calibration runs, wet the calibration can with product and I? return product to storage. 3. Run 5 gallons with-nozzle wide open into the can. Note gallons and cubic inches drawn, and return product to storage. 4. Run 5 gallons with the nozzle one—ha1f open into the can. Note gallons and cubic inches drawn, and return product to-storage.. 5. After all product for one calibration check is returned to storage, remember to record. the volume returned to storage in column 9 of the Inventory ~ Recording Sheet. 6. If the volume measured in a 5—gaIlon calibration can is more than 6 cubic inches above or below the 5—gaIlon mark, the meter requires calibration bya registered device repairman.' ~ .1’. 1% I R u . ~ ‘ ’ Date/Tlmelfiump i? Product 5-Gallon Draft 5—Gallon Draft to Storage Required? ~ ‘Used for_ Calibration . , -‘ iHoseQbr=Tank"#/ ' Fast Flow Slow Flow Volume Returned Calibration Device Repairman $ Date of‘: A. :3 ._. “ ' Gals Cu. Inches Gals Cu. Inches Gallons Yes No Calibration ,_ '4 JJA‘4 pg ;7{M2{;? {<2¢Q/ ' ‘47<v;z¢¢ £5‘ 7L Q’! 4; 7% €:!('// %§?§>§5 " .5-O“? Z77 ~1llI? ‘£gfi;7 R5?“ /2’ :20 \? 27 '5??? ér ~ .~, :7 . _ . ,- 7“ -/ -6 ~,> %/I “v11 D76 J" 1 @420 3:2a?? *7 +2 » 0 A J~;?<5??, -a . (7 . 4” “-3 /d ~L;? 5) _g? :9 A%w :’i’_?’4@ 3 ~-// ~ 8'7 \‘> , )1 e¥" /, geezer me; 5» 7,? »/ "-2 ‘\.-‘ ,-e . éy tr /5' / / “? , /- b ’ /-5” _j? /5" l? /1 §d»87 3'2 +/£7 /0 ~@? 79¢?7 /047457», wave-57 /<9-.2» 6> /a7>57 /Ow? 7- 87 #7 fil as h-¢/ er #6 wwwwwa [I It ‘n H H M #1i _flQ/ -2 _@~ + .2- +1 "\"\"\"\°'\ "\ -3i /6 ,a/_ >1, A. /0 .49 _ 1 /Q9 2“/---»>,. -- /4 u ¢l- 5” /0_ '/0"&a Am Owner or Operator =. 1 ’Calibrator's Signature é%g,Q29»(gf?Eg3§,___ 'flfi'*” ‘ Registration # Z"fi%9 OQT ,. ‘ Y‘ ‘>-'~ V,- SUBMIT A COPY OF THIS FORM WITH ANNUAL REPORT. ~ = V §§%¢Q§~. . 1 §§ ‘-1, _ ' '< ' * \ _ . : _ ‘ __Z__Z_'____ I _fj_,_,_”_ _ - _____ A ~ R ___ y ;_ _ ' _ __.._, \\\\\\ ;{=~,;‘ 444 z [.51-3;-_=‘;\:3‘.‘ v. It_ " 3%.‘;- 1_".~' 1 _ _ ' ‘r , Av V 4' ‘AW ‘ my H \ \ ‘_ ‘\kw¢“ 5m J __l V‘ _ _ _ I ‘ \_M_W\_ _ I 1;“ ‘ _ _ N; _ _ ‘_ _ '_M__ _ _ _ Ir‘ of 7 _ :3‘ _‘3__ \ _ _ _’ _' K _ ' &__ \ M ’ ___ 1 v_‘ _ N _ __ _ ‘ _ ‘- _ M ' _ b(__vH__‘r4_ _ _ 5 it x L ___" _ l ‘ V, _‘,’._ _____ “ __ I _ J in H: “ H 'fl$\"H___$‘ A ‘_‘_ _ V __ “/"P _ _ _ v tn __ _ _“ A_‘___C _ _ z‘ _‘ r_ I U1 5 n ‘ I _ ‘ ____)_’_~} '1 ' _ _ ‘_____J _ _ _ ‘ ‘ _)_:~__ }_ V _ __‘___w€__ ’ _i_£_ ‘ _14 1 I _ ___ x aw x ‘ J ‘L (F _ I _ ‘ JL__*_ 4___ I __ ‘L ‘_ __ ‘f _~ _ hf. I ‘ "_ __ _ _ ’ _ _ _ ’ L _r ’ _"_ _ _ ‘M _ _ J“ __ _ M _P;‘_ x _ U \ £4 A _ ,“‘_5___ __ _ a_r“*'__ ___ _ _ _ ‘ __ ’ _‘ U4’ ‘_ vi ~ M ‘“_“M“_‘_~'_> _ D u _ _ '_ $3 , _ ‘ _ _“__M L4‘__:___ 1"’ _ I ‘_ ___‘_h__J__“‘_ _ ‘ : ‘_'__J__ __ _ ‘ l_‘__'2 ‘ ____ ' ' _b _ _ _ _,_‘_ ___ F’ ha~h'km ‘ ‘ ’ I ' _ ___ _ ‘_\_ 7 _/ ) 3 __ * __ __ “kn” 12 __ J ‘ ‘t I“ \ ‘ m M€“_r_ _ I __ _' _ _ _ _ ' __ ‘ _ _ _ _ ) I / V U _ ' £0 _ _;“w__ I _ ‘M A _‘%§_:_h M_7__¢‘_'”____’_ _#‘w_%_”_§ _ I ~W_v‘ v_ uh’ I _ ’;®__w‘w _‘ ‘_,!‘5____ _ If V 39¢, V T \_g_h_H_ ' If n_ __ _ 3 fl a‘ Z N '7‘ I (~__‘_‘_ I " _: _ ‘W 0 ‘ _F “ _ ( __ _ __ ___I' ‘Z _ _ r ‘ X) _'_ _ I __ \ i _‘4_ N: J _W_;i‘v I _ Ind, W“ _:vyn‘\1~ A _\_ _ 4:’; ‘___ x __ J f fir _ 5 ‘ . __ ___'Hn J ‘P I _ _ ___‘___n_'_‘Hhv ~ _ : y‘ _ _ L“ I ‘ ' _ "’§_ _ > ‘_' ‘:7 ‘ 2: ‘ ‘> I ’_‘*'>_ _ _ __ " ‘ii t_‘|'__" _ \' q __ r f ‘ ‘ _ I I _ ,_‘“__ _“ _ > I _ v ’ J l ‘_‘_fii ‘_ ' /' _ Lw I _ '_ ¢ 1 I ‘ _ 4 " _ I _ A _ _ _ _ gr an ‘_ Hafllww '_ _____) Y ‘I _ I _’ ' _ ’ g '~ I '__ W S ‘ J H _ ’ _ ’ _ K nh _ ‘_ ‘ f _ _/' _ M’, N ' . __ _ 7 r _ W f _ 7 , ¢ 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US 06/02/2014 11:17AM 6616349233 -3 Dept Main KERN CONSTRUCTION @001/007 PAGE 01/07 Appendix VI (copies of Monitoring System Certification form and UST Monitoring Plot Pfan available at http://Www.waterboards.ca.qov.) MONITORING SYSTEM CERTIFICATION For Use ByAll Juiisdictions 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. 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: Mikuls Truck Stop Bldg. No.: site Address:2201 Taft Hwy.City:Bakenfield Zip: Facility Contact Person:Allen Miku] Contact Phone No.: () Make/Model of Monitoring System:lncon 2001 Date of Testing/Servicing:3 l 21 l 2014 B.inventory of Equipment Tested/Certified ChRe k rho mnnrnnrimta hrbvae tn inrlirmto <nonifir Am finmant inenonfad[ea~ieod' N XI M Tank ID:DSL Tank ID: X ln-Tank Gauging Probe.Model: TSP-LL2 [j In-Tank Gauging Probe.Model: _ X Annular Space or Vault Sensor.Model:TSP-U-S [j Annular Space or Vault Sensor.Model: X Piping Sump l Trench Sensor®-Model:"SP-ULS [j Piping Sump l Trench Sensor(s).Model: _ [j Fill Sump Sensor(s).Model:c] Fill Sump Sensor®.Model: _ X Mechanical Line Leak Detector.Model: VMl L3 2000 - a Mechanical Line Leak Detector.Model: _ [j Electronic Line Leak Detector.Model:[j Electronic Line Leak Detector.Model: X Tank Overfill l High-Level Sensor.Model:O"W 61 SO "[j Tank Overfill l High-Level Sensor.Model: [i Other (specify equipment type and model in Section E on Page 2).[j Other (specifY equipment type and moqpi in Section E on Page 2), Tank ID:Tank ID: [j ln-Tank Gauging Probe.Model:Cl In-Tank Gauging Probe.Model: (j Annular Space or Vault Sensor.Model: _[j Annular Space or Vault Sensor.Model: i] Piping Sump /Trench Sensor®.Model:o Piping Sump /Trench Sensor(s).Model: [j Fill Sump Sensor(s).Model:.O Fill Sump Sensor(s)-Model: c! Mechanical Line Leak Detector.Model: lj Mechanical Line Leak Detector.Model: q Electronic Line Leak Detector.Model:[j Electronic Line Leak Detector.Model: [j Tank Overfill l High-Level Sensor.Model:[j Tank Overfill l High-Level Sensor.Model: D Other (speciq equipment type and model in Section E on Eage 2). ·Cl OtPqr (specify equip,ment type and model in Spction Eon page 2)., , " Dispenser ID:l-2 Dispenser ID:3-4 X Dispenser Containment Sensor(s).Model:BE 406 X Dispenser Containment Sensor(s).Model: BE -06 X Shear Valve(s).X Shear Valve(s). [j Dispenser Containment Float(s) and Chain(s)·..{j Dispenser Containment Float(s) and Chain(s)·,,, Dispenser ID:5-6 Dispenser ID: Cl Dispenser Containment Sensor(s)-Model:3El 406 Cl Dispenser Containment Sensor(s).Model: {j Shear Valve(s)-'[j Shear Valve(s)- - Q Dispenser Containment Float(s),and Chain(s)-[j ,,fjispenser Containment FlS!at(s) and Chain(s)- Dispenser ID:Dispenser ID: [j Dispenser Containment Sensor(s).Model: _O Dispenser Containment Sensor(s).Model: [j Shear Valve(s).ll Shear Valve(s)- | q Dispenser, Containment Float(sj and Chain(s ,[j Dispenser Containment F|?,at(s) and chainlg" *lf the facility contains more tanks or dispensers, copy this form, Include information for every tank and dispenser at the facility. C.Certification - l certify that the equipment identified [n this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklisw) 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, l have also attached a copy of the report; (check all that apply):i} System set-up [j Alarm history report ^ Technician Name (print): josh Simmons Signature: a e m Certification No.:55200340-LIT License. No.?mT)53 Testing Company Name: Kern County Construction, Inc .Phone No.:(661 )634-9950 Testing Company Address:PO Box 6096, Bakersfield, CA 93386 Date of Testing/Servicing:3 l 21 l 2014 Monitoring System Certification Page1 of4 12/07 1 2/21/07 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US 06/02/2014 11:17AM 6616349233 a Dept Main KERN CONSTRUCTION @002/007 PAGE 02/07 D. Results of Testing/Serviging Software Version installed: g4^u¶mnw4w lb uw uyuuv""" 'Q? "' '""'""""" X Yes Cl No*Is the audible alarm operational? x Yes [j No*ls the visual alarm operational? X Yes {j No*Were all sensors visually inspected, functionally tested, and confirmed operational? X Yes n No*Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere wIth their proper operation? Cl Yes [j No*If alarms are relayed to a remote monitoring station, is ail communications equipment (e.g. modem) operational? X N/A X Yes Cl No*For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system Cl N/A detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) X Sump/Trench Sensors;[j Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor faiture/disconnection? X Yes; c] No. ll Yes [j No*For tank systems that utilize the monitoring system as the primary tank overfill warning device (Le. no mechanical overfill prevention X N/A 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 of tank capacity does the alarm trigger?, °/0 c] Yes*X No Was any monitoring equipment replaced?If yes, identify specific sensors, probes, or other equipment replaced and list themanufacturer name and model for all replacement parts in Section E, below. [j Yes*X No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) Cl Product; O Water. If yes, describe causes in Section E, below. X Yes Cl No*Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable X Yes Cl No*ls all monitoring equipment operational per manufadurets specificatiom .. r'^mmlafo fh^ fnllmminn r-hankli-ct" * In Section E below, describe how and when these deficiencies were or will be corrected. E.Comments:3/21/14 Sensors alarmed but did not shutdown. Corrected proqramminq on 3/28/14 and tested. Monitoring System Certification Page2of4 12/07 2 2/21/07 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US 06/02/2014 11:17AM 6616349233 -3 Dept Main KERN CONSTRUCTION @003/007 PAGE 03/07 F. ln-Tank Gauging l SIR Equipment:X Check this box if tank gauging is used only for inventory control. Cl 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. ^—¶~6~ &W^ €^n~n&u;^04 ^X^tLelief"uuqvwjulu u eu gEjU3Uvv 1¶ dy '^ 'UU^' '0"· [j Yes Cl No*Has all input wiring been inspected for proper entry and termination, including testing for ground faults? [j Yes Cl No*Were all tank gauging probes visually inspected for damage and residue buildup? [j Yes O No"Was accuracy of system product level readings tested? Cl Yes Cl No*Was accuracy of system water level readings tested? Cl Yes [j No*Were all probes reinstalled properly? Cl Yes [j No*Were all items on the equipment manufacturers maintenance checklist completed? * [n the Sec:ion H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD):Cl Check this box if LLDs are not installed. gompiere me Tollowgng cnegimsg X Yes I] No*For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all [j N/A that apply) Simulated leak rate: X 3 g.p.h.; [j 0.1 g.p.h ; Cl 0.2 g.p.h. X Yes [j No*Were all LLDs confirmed operational and accurate within regulatory requirementsU X Yes Cl No*Was the testing apparatus properly calibrated? X Yes [j No*For mechanical LLDs, does the LLD restrict product now if it detects a leak? Q N/A [j Yes [j No*For electronic LLDS, does the turbine automatically shut off if the LLD detects a leak? X N/A Cl Yes [j No*For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or X N/A disconnected? Cl Yes [j No*For electronic LLDS, does the turbine automatically shut off if any portion of the monitoring system malfunctions or X N/A fails a test? [j Yes a No*For electronic LLDs, have all accessible wiring connections been visually inspected7 X N/A X Yes [j No*Were all items on the equipment manufacturets maintenance checklist completed? * In the Sec"ion H. below, describe how and when these deficiencies were or will be corrected- " — — — L- ——H.H:—&.K E —4.L-F— W n —- - --~ H. Comments: Monitoring System Certification Page3of4 12/07 3 2/21/07 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US 06/02./2e114 ll: 17AM 6616349233 -> Dept Main KERN CONSTRUCTION @004/007 PAGE 04/07 'i~:;u asstPPSr43 fonitoring System CerUficaUon UST Monitoring Site Pl"", ,Sb a"m.- ^AA.-^^. '-7n-cji «"&1 LL ;=-Lk -A7t.jd L , O U """"""'""' """ " """ ' t '"""""" ""l(OG tjj q7jj' ,1:1'4 ::: :::: ""' ,:,:::: :€':dq::"::: ::::: ::: ·--,,---·-·.iii'iiii)iQi?iiiCii'"qp""""""""""4^::::::: P ··. : pc-'j"""""qA't':::"' " ' " 'y' ' " '" " '" "" " ' "° '"'"""'""''.......... ....:::: :::A,n.... : .J..-.....--.-..-... ¶r b · -f......uDLz:ji:: ::: :.."' "" ' ' " ' " "q · :::::ci"i!b ·· ·-- ··: .-.. ..... .-. ..- .. +-.. .. -.·b O .»P.0 .W 0 . o jSnn- - · · · - · - · · · · - · - - · - - · - · · - · · · · · - · · · · · - ··q 0 · e V © ·P ··0 .Uq . . . . . . -. . . .. . . dj"' " ' "' ' ' " '° " '" : ' ' " " ""¶0 P . O 0 B b O ·0. . . . . . . . . . . . . . . . . . . . . . . .. . . . 4L1± . . . P ·W 0 b P 0 0 ·. . . . . 2 i3' ' " " " ' " " "b O .0 ·.b ....* ..W ·0 . 0 W ·. .h 0 Pq. B V q ....P ·N 0 b ·' ' " ri,bA^6·=' . . W . .0 0 P P . . . . . . . . . . . . . . . . .. . . .lj. . .·0 ·0 ..P q ·...·0 P ·0 0 b ·.rW 4.+*0 .h...P ." P 0 0 PP" 0 ··O . Date map was drawn: 3—/ ' lrLc lnsbyctions 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 of tanks and piping. Clearly identiN Iomtions of the following equipment, "f installed: monitoring system control panels: sensors monitoring tank annular spaces, 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 dete«ion). In the spaoe provided, note the date this Site Plan was prepared. Monitoring System CeMfication page4of4 12107 4 2/21/07 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US 06/02/2014 11:17AM 6616349233 a Dept Main KERN CONSTRUCTION @005/007 PAGE 05/07 SWRCB, January 2006 Spill Bucket Testing Report Form This form is intendedfor use by contractors performing annual testing of USTspill containment structures. The completed form and printouts from tests (ifapplicable), should be providedto the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name:Mikuls Truck Stop Date of Testing:3-21-14 Facility Address:2201 Tan hwy. Facility Contact:Allan Mikul Phone: Date Local Agency Was Notified of Testing :3-14-14 Name of Local Agency Inspecto{, (ifpresent during testing): , 2. TESTING conTraCtor INIoRNWrIoN Company Name:Kern County ConsWuction, Inc. PO Box 6096, Bakersfield, CA 93386 Technician Conducting Test:josh Simmons Credentials':X CSLB Contractor X ICC Service Tech.[j SWRCB Tank Tester O Other (Specify) License Number(s):481053 5242369-UT 3. SPILL BUCKET TESTING INFORMATION Test Method Used:XHydrostatic Cl Vacuum [j Other Test Equipment Used: Visual Equipment Resolution: 0.0" «'^*=mm"«'»' ?=d'mLmce·¥ ».hq*?v=K=xmr%=.'w=mm-m*mw,"* gTr-«m. Ub7>>=r~ #bi'"" m4a~&4·%2.~' ;· .~.=-w—wmm~=s~e=w , ... .. .. - ... . ..... Identify Spill Bucket (By Tank I DSL 2 3 4 Number, Stored Product, etc) X Direct Bury 13 Direct Bury [j Direct Bury Cl Direct BuryBucket Installation Type:D Contained in Sump CI Contained in Sump Ci Contained in Sump [j Contained m Sump Bucket Diameter:ll" Bucket Depth:IS" Wait time between applying vacuum/water and start of test-15 Min. Test Start Time (Ti):9:30 Initial Reading (Ri):T' Test End Time (Tf):10:30 Final Reading (Rf):5"" Test Duration (Tf — Ti):1 Hr. Change m Reading (Rf- Rt):2.0" PassLFail Threshold or 0,0" Criteria: Test Result:O Pass X Fail lj Pass lj Fail -Ll Kass"" CI Fail· "Cl Pass Ii Fail Comments — (include information on repairs made prior to testing, and recommendedfollow-up for failed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING Ihereby certgty that allthe informakn contained in this repon is true, accurate, and in full compliance with legal requirements. Technician's Signature:&/ J'Date: 3" ZJ—i'jf i State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US 06/02/2014 11:17AM 6616349233 » Dept MainKERN CONSTRUCTION @006/007 PAGE 06/07 MIKULSTRUCK STOP 2201 TAFTkbiV BAKER"FIELCK CA 933!3 SITE # 00001 5f22/2014 !2:59 AM ' SYSTEM SETUP REPORT 'SOFTHARE UERSI0N U. 991! LOCATION i MKULS :lucation 2 truck snip STREET 1 2201 TAFT :STREET 2 HVY "CITY i BAKER"FIELD :CITY 2 STATE CH ZIP CUISE 93313 SITE #00001 E'0L'"0NFTS"8ALL0NS LEUEL UNITS II-ICHES TEMP UNITS FAHRENHEIT TIME STYLE 12 HOUR DATE STYLE PIM/DDfYY DAYLIGHT SAU ENABLED SET TIME i:0o M SET DATE 05."22i20i4 -- NU.TANKS i *"' LEAK LIMIT 2. OLa THEFT LIMIT 10.00 ·DELIIJ LIMIT 2Q0.00 sntNl NUDE " OFF .START SNTNL !2:00 RM 'end sntnl i2:0o Alq DELIU DELAY 15 . REPORT DELIU ENKBLED REPORT ALRMS ENABLED REPORT TESTS ENABLED "NU.OF ALARMS 50 PRINT INTERIJAL 1.00 MUDE CHAN 1 NATIUE BAUD CHAN !!200 DATA BITS. l 8 STOP BITS 1 I PARITY i NONE SECURITY I ACCESS 1 PHONE 1 REDIAL 1 DISABLED ACCESS 2 PHONE 2 REDIAL 2 .DISABLED ACCESS 3 PHONE 3 REDIAL 3 DISABLED ACCESS 4 PHONE 4 REDIAL 4 DISABLED 1!"4l DEL!'J " DIAL ALARM DIAL LEAK SCHD INUTRY TINEI IH'JTR TINE2 INUTR TIME3 INUTR SCHD IN'JRC TIMEL,.INURC 'TIAE'2"""iiqfjkc TIM£3 INURC SCHD DLHST TIME1 DLHST TIME2 DLHST TIME3 DLHST SCHD ALHST TIME1 91-FIST TIME2 9LHET TIME3 ALHST ECHO ACT AL TIP!E1 ACTAL TIME2 ACTAL TIME3 ACTAL SCHD HLST TIMEI ALST TIME2 ALST TINE3 ALGT CONFIDENCE LEAK TEST ".m¥:%%ES7T:'."- IW·4K i !TIWE· TEST i 'TAKK i ALARM TINEUL'" µ.U;H '. :.".'1 ':.ai ' :" R7GH l-if:?- i-ow L9h' HATER .."'· LEAK Liia SYSFCIIL ',¥. T.'!EFT RELAY TIHEUUT HIGH LIM" LOi.d LIM HIGH HIGH :cu LCldl i HATER LIN "-LEAK 'LIM SYSFAIL THEFT NCINE i2:00 AM 12:M M i2:0K AM NONE 12:00 AN :2:L30 AM i2:00 M NONE !2:@0 APl 12:00 AM i2:w0 AM NONE 12:00 AM !2:00 AM :.2:00 APl NONE i2:00 AM !2:00 AM 12:00 Ab1 NONE !2X30 AM !2:00 Al'l 12:00 AP1 99.02 0.10 NONE :2:00 AM 0 OFF OFF apF OFF OFF 9FF PFF OFF ;.5 UFF UFF OFF OFF Off OFF OFF IIFF , STD ALRRN ALARM I Oh' ALARM 2 Ukl ALARM 3 ctFF ALARM 4 OFF RLRRN 5 OFF ALARM E.QFF ALARM 7 OFF ALARjq 8 (jff STD RELAY ALARM :t UN ALARM 2 IJN ALARM 3 OFF 3LRRM 4 OFF ALARM 5 OFF AL¢!RM 6 UFF ALARH 7 OFF ALARM 8 OFF STD ALARM I DIESEL SUMP ALARH 2 "AMULAR ALARM 3 STD 3 ALARM 4 STD 4 ALARM 5 STD 5 M-ARM 6 STD 6 ALARM ?STD 7 ALARM 8 STD 8 SENSCIR TYPE 'SENSOR i STD SENSOR 2 ST!) SENMJR 3 STD SENAOR 4 STD SFNSQR 5 STD SENSOR 6 sTci .SENSUR 7 STnSENSUR 8 STD 'U'NTRCiL OUTPUT GRACE PERIOD 0 !LOW LCltd l NONE . LU19 LOlj 2 MNE LOki i " '"'"" '"""' '"""'"mm""' Li3i9 2 NONE HISH WTR !NONE HIGH HTR Z NONE HIGH i -NONE HIGH 2 HONE HIG'R FII&!A i NONE HIGIH HIGH 2 NONE S4STEF FAIL NONE STD i UUTPUT I sn 2 l-lCltQE STD 3 NONE STD 4 NONE STD 5 NONE CTR 4 ·NUKE ..— 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US .Y/02/2014 11:17AM 6616349233 ' ,12>, ."?" '' """-"-" '" '·.-. k . ;·.4 ".MIKULSTRUCK STOPZ2201 TAFTHblV q : BAKERSFIELD, CA 933!3 h, :C SITE # 00001 ·" b ..'SQ2i20i4 01:14 AN -ALARM REPORTi..Z'- ;:8l".Sf22/2014 01:14 M i 'Diesel SUMP " Dept MainKERN CONSTRUCTION @007/007 PAGE 07/07 MIKUL.qTRUcK STOP 2201 TAFTHI9\/ BAKERSFIELD. CA 93313 'SITE # 000Qi " 2 ·L ' ·'"':"7~9M '. ":5/22/2014 .0l:i5'M .ALRRPI REPORT . S'22i'2014 "Qi:i5 M ''Diesel SUMP .'.MIKULSTRUCK STOP ..'"2201 TAFTHW/"·: BAKERSFIELD. CA 93313 SITE # 00001 r· 5/22/20!4 "0§:15 AM 'ALARM REPORT '5e'22i2014 0i:i5 AM bIEsEL Sump . .e -i:-·· ·-- · .:a- =- .': .—. '"":i. a :-i;MIKULSTRL'CK i"?p '220! TA7TF:/:Y "T ; BAKERSFIELD, ca 93SI3 . SITE" # 0q@rn. "5122120!4 0!:15 M '""ALARH REPORT 926'2014 0!:15 AM · 'Annular '""mikul3nuck sTCiP 220! TAFT!dtd\/ "bakersfield, ca 933!3 site # 00%1 :-922120!4 0!:16 ahka~~%wm^M: %E"'2rt '"'':---"m ..F...: ='"'J'""'""""'"C"" ^' H:--..... ','WI}(:jL@TR'jCK stjjp : lj'.220i trfthin ' i bakersftcld. ca '33313i "site # 00001 &2l'20!4 0!:16 am -' ' ; "'alarm report d"':;9,. f ="""' " 'm%"ITkm '..- P 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US 06/02/2014 11:17AM 6616349233 -3 Dept Main KERN CONSTRUCTION @001/007 PAGE 01/07 Appendix VI (copies of Monitoring System Certification form and UST Monitoring Plot Pfan available at http://Www.waterboards.ca.qov.) MONITORING SYSTEM CERTIFICATION For Use ByAll Juiisdictions 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. 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: Mikuls Truck Stop Bldg. No.: site Address:2201 Taft Hwy.City:Bakenfield Zip: Facility Contact Person:Allen Miku] Contact Phone No.: () Make/Model of Monitoring System:lncon 2001 Date of Testing/Servicing:3 l 21 l 2014 B.inventory of Equipment Tested/Certified ChRe k rho mnnrnnrimta hrbvae tn inrlirmto <nonifir Am finmant inenonfad[ea~ieod' N XI M Tank ID:DSL Tank ID: X ln-Tank Gauging Probe.Model: TSP-LL2 [j In-Tank Gauging Probe.Model: _ X Annular Space or Vault Sensor.Model:TSP-U-S [j Annular Space or Vault Sensor.Model: X Piping Sump l Trench Sensor®-Model:"SP-ULS [j Piping Sump l Trench Sensor(s).Model: _ [j Fill Sump Sensor(s).Model:c] Fill Sump Sensor®.Model: _ X Mechanical Line Leak Detector.Model: VMl L3 2000 - a Mechanical Line Leak Detector.Model: _ [j Electronic Line Leak Detector.Model:[j Electronic Line Leak Detector.Model: X Tank Overfill l High-Level Sensor.Model:O"W 61 SO "[j Tank Overfill l High-Level Sensor.Model: [i Other (specify equipment type and model in Section E on Page 2).[j Other (specifY equipment type and moqpi in Section E on Page 2), Tank ID:Tank ID: [j ln-Tank Gauging Probe.Model:Cl In-Tank Gauging Probe.Model: (j Annular Space or Vault Sensor.Model: _[j Annular Space or Vault Sensor.Model: i] Piping Sump /Trench Sensor®.Model:o Piping Sump /Trench Sensor(s).Model: [j Fill Sump Sensor(s).Model:.O Fill Sump Sensor(s)-Model: c! Mechanical Line Leak Detector.Model: lj Mechanical Line Leak Detector.Model: q Electronic Line Leak Detector.Model:[j Electronic Line Leak Detector.Model: [j Tank Overfill l High-Level Sensor.Model:[j Tank Overfill l High-Level Sensor.Model: D Other (speciq equipment type and model in Section E on Eage 2). ·Cl OtPqr (specify equip,ment type and model in Spction Eon page 2)., , " Dispenser ID:l-2 Dispenser ID:3-4 X Dispenser Containment Sensor(s).Model:BE 406 X Dispenser Containment Sensor(s).Model: BE -06 X Shear Valve(s).X Shear Valve(s). [j Dispenser Containment Float(s) and Chain(s)·..{j Dispenser Containment Float(s) and Chain(s)·,,, Dispenser ID:5-6 Dispenser ID: Cl Dispenser Containment Sensor(s)-Model:3El 406 Cl Dispenser Containment Sensor(s).Model: {j Shear Valve(s)-'[j Shear Valve(s)- - Q Dispenser Containment Float(s),and Chain(s)-[j ,,fjispenser Containment FlS!at(s) and Chain(s)- Dispenser ID:Dispenser ID: [j Dispenser Containment Sensor(s).Model: _O Dispenser Containment Sensor(s).Model: [j Shear Valve(s).ll Shear Valve(s)- | q Dispenser, Containment Float(sj and Chain(s ,[j Dispenser Containment F|?,at(s) and chainlg" *lf the facility contains more tanks or dispensers, copy this form, Include information for every tank and dispenser at the facility. C.Certification - l certify that the equipment identified [n this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklisw) 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, l have also attached a copy of the report; (check all that apply):i} System set-up [j Alarm history report ^ Technician Name (print): josh Simmons Signature: a e m Certification No.:55200340-LIT License. No.?mT)53 Testing Company Name: Kern County Construction, Inc .Phone No.:(661 )634-9950 Testing Company Address:PO Box 6096, Bakersfield, CA 93386 Date of Testing/Servicing:3 l 21 l 2014 Monitoring System Certification Page1 of4 12/07 1 2/21/07 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US 06/02/2014 11:17AM 6616349233 a Dept Main KERN CONSTRUCTION @002/007 PAGE 02/07 D. Results of Testing/Serviging Software Version installed: g4^u¶mnw4w lb uw uyuuv""" 'Q? "' '""'""""" X Yes Cl No*Is the audible alarm operational? x Yes [j No*ls the visual alarm operational? X Yes {j No*Were all sensors visually inspected, functionally tested, and confirmed operational? X Yes n No*Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere wIth their proper operation? Cl Yes [j No*If alarms are relayed to a remote monitoring station, is ail communications equipment (e.g. modem) operational? X N/A X Yes Cl No*For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system Cl N/A detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) X Sump/Trench Sensors;[j Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor faiture/disconnection? X Yes; c] No. ll Yes [j No*For tank systems that utilize the monitoring system as the primary tank overfill warning device (Le. no mechanical overfill prevention X N/A 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 of tank capacity does the alarm trigger?, °/0 c] Yes*X No Was any monitoring equipment replaced?If yes, identify specific sensors, probes, or other equipment replaced and list themanufacturer name and model for all replacement parts in Section E, below. [j Yes*X No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) Cl Product; O Water. If yes, describe causes in Section E, below. X Yes Cl No*Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable X Yes Cl No*ls all monitoring equipment operational per manufadurets specificatiom .. r'^mmlafo fh^ fnllmminn r-hankli-ct" * In Section E below, describe how and when these deficiencies were or will be corrected. E.Comments:3/21/14 Sensors alarmed but did not shutdown. Corrected proqramminq on 3/28/14 and tested. Monitoring System Certification Page2of4 12/07 2 2/21/07 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US 06/02/2014 11:17AM 6616349233 -3 Dept Main KERN CONSTRUCTION @003/007 PAGE 03/07 F. ln-Tank Gauging l SIR Equipment:X Check this box if tank gauging is used only for inventory control. Cl 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. ^—¶~6~ &W^ €^n~n&u;^04 ^X^tLelief"uuqvwjulu u eu gEjU3Uvv 1¶ dy '^ 'UU^' '0"· [j Yes Cl No*Has all input wiring been inspected for proper entry and termination, including testing for ground faults? [j Yes Cl No*Were all tank gauging probes visually inspected for damage and residue buildup? [j Yes O No"Was accuracy of system product level readings tested? Cl Yes Cl No*Was accuracy of system water level readings tested? Cl Yes [j No*Were all probes reinstalled properly? Cl Yes [j No*Were all items on the equipment manufacturers maintenance checklist completed? * [n the Sec:ion H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD):Cl Check this box if LLDs are not installed. gompiere me Tollowgng cnegimsg X Yes I] No*For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all [j N/A that apply) Simulated leak rate: X 3 g.p.h.; [j 0.1 g.p.h ; Cl 0.2 g.p.h. X Yes [j No*Were all LLDs confirmed operational and accurate within regulatory requirementsU X Yes Cl No*Was the testing apparatus properly calibrated? X Yes [j No*For mechanical LLDs, does the LLD restrict product now if it detects a leak? Q N/A [j Yes [j No*For electronic LLDS, does the turbine automatically shut off if the LLD detects a leak? X N/A Cl Yes [j No*For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or X N/A disconnected? Cl Yes [j No*For electronic LLDS, does the turbine automatically shut off if any portion of the monitoring system malfunctions or X N/A fails a test? [j Yes a No*For electronic LLDs, have all accessible wiring connections been visually inspected7 X N/A X Yes [j No*Were all items on the equipment manufacturets maintenance checklist completed? * In the Sec"ion H. below, describe how and when these deficiencies were or will be corrected- " — — — L- ——H.H:—&.K E —4.L-F— W n —- - --~ H. Comments: Monitoring System Certification Page3of4 12/07 3 2/21/07 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US 06/02./2e114 ll: 17AM 6616349233 -> Dept Main KERN CONSTRUCTION @004/007 PAGE 04/07 'i~:;u asstPPSr43 fonitoring System CerUficaUon UST Monitoring Site Pl"", ,Sb a"m.- ^AA.-^^. '-7n-cji «"&1 LL ;=-Lk -A7t.jd L , O U """"""'""' """ " """ ' t '"""""" ""l(OG tjj q7jj' ,1:1'4 ::: :::: ""' ,:,:::: :€':dq::"::: ::::: ::: ·--,,---·-·.iii'iiii)iQi?iiiCii'"qp""""""""""4^::::::: P ··. : pc-'j"""""qA't':::"' " ' " 'y' ' " '" " '" "" " ' "° '"'"""'""''.......... ....:::: :::A,n.... : .J..-.....--.-..-... ¶r b · -f......uDLz:ji:: ::: :.."' "" ' ' " ' " "q · :::::ci"i!b ·· ·-- ··: .-.. ..... .-. ..- .. +-.. .. -.·b O .»P.0 .W 0 . o jSnn- - · · · - · - · · · · - · - - · - - · - · · - · · · · · - · · · · · - ··q 0 · e V © ·P ··0 .Uq . . . . . . -. . . .. . . dj"' " ' "' ' ' " '° " '" : ' ' " " ""¶0 P . O 0 B b O ·0. . . . . . . . . . . . . . . . . . . . . . . .. . . . 4L1± . . . P ·W 0 b P 0 0 ·. . . . . 2 i3' ' " " " ' " " "b O .0 ·.b ....* ..W ·0 . 0 W ·. .h 0 Pq. B V q ....P ·N 0 b ·' ' " ri,bA^6·=' . . W . .0 0 P P . . . . . . . . . . . . . . . . .. . . .lj. . .·0 ·0 ..P q ·...·0 P ·0 0 b ·.rW 4.+*0 .h...P ." P 0 0 PP" 0 ··O . Date map was drawn: 2l1 ' lrLc lnsbyctions 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 of tanks and piping. Clearly identiN Iomtions of the following equipment, "f installed: monitoring system control panels: sensors monitoring tank annular spaces, 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 dete«ion). In the spaoe provided, note the date this Site Plan was prepared. Monitoring System CeMfication page4of4 12107 4 2/21/07 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US 06/02/2014 11:17AM 6616349233 a Dept Main KERN CONSTRUCTION @005/007 PAGE 05/07 SWRCB, January 2006 Spill Bucket Testing Report Form This form is intendedfor use by contractors performing annual testing of USTspill containment structures. The completed form and printouts from tests (ifapplicable), should be providedto the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name:Mikuls Truck Stop Date of Testing:3-21-14 Facility Address:2201 Tan hwy. Facility Contact:Allan Mikul Phone: Date Local Agency Was Notified of Testing :3-14-14 Name of Local Agency Inspecto{, (ifpresent during testing): , 2. TESTING conTraCtor INIoRNWrIoN Company Name:Kern County ConsWuction, Inc. PO Box 6096, Bakersfield, CA 93386 Technician Conducting Test:josh Simmons Credentials':X CSLB Contractor X ICC Service Tech.[j SWRCB Tank Tester O Other (Specify) License Number(s):481053 5242369-UT 3. SPILL BUCKET TESTING INFORMATION Test Method Used:XHydrostatic Cl Vacuum [j Other Test Equipment Used: Visual Equipment Resolution: 0.0" «'^*=mm"«'»' ?=d'mLmce·¥ ».hq*?v=K=xmr%=.'w=mm-m*mw,"* gTr-«m. Ub7>>=r~ #bi'"" m4a~&4·%2.~' ;· .~.=-w—wmm~=s~e=w , ... .. .. - ... . ..... Identify Spill Bucket (By Tank I DSL 2 3 4 Number, Stored Product, etc) X Direct Bury 13 Direct Bury [j Direct Bury Cl Direct BuryBucket Installation Type:D Contained in Sump CI Contained in Sump Ci Contained in Sump [j Contained m Sump Bucket Diameter:ll" Bucket Depth:IS" Wait time between applying vacuum/water and start of test-15 Min. Test Start Time (Ti):9:30 Initial Reading (Ri):T' Test End Time (Tf):10:30 Final Reading (Rf):5"" Test Duration (Tf — Ti):1 Hr. Change m Reading (Rf- Rt):2.0" PassLFail Threshold or 0,0" Criteria: Test Result:O Pass X Fail lj Pass lj Fail -Ll Kass"" CI Fail· "Cl Pass Ii Fail Comments — (include information on repairs made prior to testing, and recommendedfollow-up for failed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING Ihereby certgty that allthe informakn contained in this repon is true, accurate, and in full compliance with legal requirements. Technician's Signature:&/ J'Date: 3" ZJ—i'jf i State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US 06/02/2014 11:17AM 6616349233 » Dept MainKERN CONSTRUCTION @006/007 PAGE 06/07 MIKULSTRUCK STOP 2201 TAFTkbiV BAKER"FIELCK CA 933!3 SITE # 00001 5f22/2014 !2:59 AM ' SYSTEM SETUP REPORT 'SOFTHARE UERSI0N U. 991! LOCATION i MKULS :lucation 2 truck snip STREET 1 2201 TAFT :STREET 2 HVY "CITY i BAKER"FIELD :CITY 2 STATE CH ZIP CUISE 93313 SITE #00001 E'0L'"0NFTS"8ALL0NS LEUEL UNITS II-ICHES TEMP UNITS FAHRENHEIT TIME STYLE 12 HOUR DATE STYLE PIM/DDfYY DAYLIGHT SAU ENABLED SET TIME i:0o M SET DATE 05."22i20i4 -- NU.TANKS i *"' LEAK LIMIT 2. OLa THEFT LIMIT 10.00 ·DELIIJ LIMIT 2Q0.00 sntNl NUDE " OFF .START SNTNL !2:00 RM 'end sntnl i2:0o Alq DELIU DELAY 15 . REPORT DELIU ENKBLED REPORT ALRMS ENABLED REPORT TESTS ENABLED "NU.OF ALARMS 50 PRINT INTERIJAL 1.00 MUDE CHAN 1 NATIUE BAUD CHAN !!200 DATA BITS. l 8 STOP BITS 1 I PARITY i NONE SECURITY I ACCESS 1 PHONE 1 REDIAL 1 DISABLED ACCESS 2 PHONE 2 REDIAL 2 .DISABLED ACCESS 3 PHONE 3 REDIAL 3 DISABLED ACCESS 4 PHONE 4 REDIAL 4 DISABLED 1!"4l DEL!'J " DIAL ALARM DIAL LEAK SCHD INUTRY TINEI IH'JTR TINE2 INUTR TIME3 INUTR SCHD IN'JRC TIMEL,.INURC 'TIAE'2"""iiqfjkc TIM£3 INURC SCHD DLHST TIME1 DLHST TIME2 DLHST TIME3 DLHST SCHD ALHST TIME1 91-FIST TIME2 9LHET TIME3 ALHST ECHO ACT AL TIP!E1 ACTAL TIME2 ACTAL TIME3 ACTAL SCHD HLST TIMEI ALST TIME2 ALST TINE3 ALGT CONFIDENCE LEAK TEST ".m¥:%%ES7T:'."- IW·4K i !TIWE· TEST i 'TAKK i ALARM TINEUL'" µ.U;H '. :.".'1 ':.ai ' :" R7GH l-if:?- i-ow L9h' HATER .."'· LEAK Liia SYSFCIIL ',¥. T.'!EFT RELAY TIHEUUT HIGH LIM" LOi.d LIM HIGH HIGH :cu LCldl i HATER LIN "-LEAK 'LIM SYSFAIL THEFT NCINE i2:00 AM 12:M M i2:0K AM NONE 12:00 AN :2:L30 AM i2:00 M NONE !2:@0 APl 12:00 AM i2:w0 AM NONE 12:00 AM !2:00 AM :.2:00 APl NONE i2:00 AM !2:00 AM 12:00 Ab1 NONE !2X30 AM !2:00 Al'l 12:00 AP1 99.02 0.10 NONE :2:00 AM 0 OFF OFF apF OFF OFF 9FF PFF OFF ;.5 UFF UFF OFF OFF Off OFF OFF IIFF , STD ALRRN ALARM I Oh' ALARM 2 Ukl ALARM 3 ctFF ALARM 4 OFF RLRRN 5 OFF ALARM E.QFF ALARM 7 OFF ALARjq 8 (jff STD RELAY ALARM :t UN ALARM 2 IJN ALARM 3 OFF 3LRRM 4 OFF ALARM 5 OFF AL¢!RM 6 UFF ALARH 7 OFF ALARM 8 OFF STD ALARM I DIESEL SUMP ALARH 2 "AMULAR ALARM 3 STD 3 ALARM 4 STD 4 ALARM 5 STD 5 M-ARM 6 STD 6 ALARM ?STD 7 ALARM 8 STD 8 SENSCIR TYPE 'SENSOR i STD SENSOR 2 ST!) SENMJR 3 STD SENAOR 4 STD SFNSQR 5 STD SENSOR 6 sTci .SENSUR 7 STnSENSUR 8 STD 'U'NTRCiL OUTPUT GRACE PERIOD 0 !LOW LCltd l NONE . LU19 LOlj 2 MNE LOki i " '"'"" '"""' '"""'"mm""' Li3i9 2 NONE HISH WTR !NONE HIGH HTR Z NONE HIGH i -NONE HIGH 2 HONE HIG'R FII&!A i NONE HIGIH HIGH 2 NONE S4STEF FAIL NONE STD i UUTPUT I sn 2 l-lCltQE STD 3 NONE STD 4 NONE STD 5 NONE CTR 4 ·NUKE ..— 06/02/2014 12:20 IFAX EH@CO.KERN.CA.US .Y/02/2014 11:17AM 6616349233 ' ,12>, ."?" '' """-"-" '" '·.-. k . ;·.4 ".MIKULSTRUCK STOPZ2201 TAFTHblV q : BAKERSFIELD, CA 933!3 h, :C SITE # 00001 ·" b ..'SQ2i20i4 01:14 AN -ALARM REPORTi..Z'- ;:8l".Sf22/2014 01:14 M i 'Diesel SUMP " Dept MainKERN CONSTRUCTION @007/007 PAGE 07/07 MIKUL.qTRUcK STOP 2201 TAFTHI9\/ BAKERSFIELD. CA 93313 'SITE # 000Qi " 2 ·L ' ·'"':"7~9M '. ":5/22/2014 .0l:i5'M .ALRRPI REPORT . S'22i'2014 "Qi:i5 M ''Diesel SUMP .'.MIKULSTRUCK STOP ..'"2201 TAFTHW/"·: BAKERSFIELD. CA 93313 SITE # 00001 r· 5/22/20!4 "0§:15 AM 'ALARM REPORT '5e'22i2014 0i:i5 AM bIEsEL Sump . .e -i:-·· ·-- · .:a- =- .': .—. '"":i. a :-i;MIKULSTRL'CK i"?p '220! TA7TF:/:Y "T ; BAKERSFIELD, ca 93SI3 . SITE" # 0q@rn. "5122120!4 0!:15 M '""ALARH REPORT 926'2014 0!:15 AM · 'Annular '""mikul3nuck sTCiP 220! TAFT!dtd\/ "bakersfield, ca 933!3 site # 00%1 :-922120!4 0!:16 ahka~~%wm^M: %E"'2rt '"'':---"m ..F...: ='"'J'""'""""'"C"" ^' H:--..... ','WI}(:jL@TR'jCK stjjp : lj'.220i trfthin ' i bakersftcld. ca '33313i "site # 00001 &2l'20!4 0!:16 am -' ' ; "'alarm report d"':;9,. f ="""' " 'm%"ITkm '..- P SWRCB, January 2002 Page i ofq Secondary Containment Testing Report Form This form is intended for use by contractors performing periodic testing of USTsecondary containment systems. Use the appropriate pages ofthis form to report results for all components tested. The completedform, written test procedures, and printouts from tests (ifapplicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name:Mikuls Truck Stop Date of Testing:7-30-14 Facility Address:2201 Taft Hwy. Facility Contact:Phone: Date Local Agency Was Notified of Testing : 7-23-14 Name of Local Agency Inspector (ifpresent during testing): 2. TESTING CONTRACTOR INFORMATION Company Name:Kern County Construction, Inc. Technician Conducting Test:josh Simmons Credentials:x CSLB Licensed Contractor [j SWRCB Licensed Tank Tester License Type:A, B, Haz License Number:481053 Manufacturer Manufacturer Training Component(s) Incon TS-STS Date Training Expires 10/15/2015 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Repairs Component Pass Fail Not RepairsTestedMadeTestedMade UDC 1/2 X [j [j [j [j d [j q DSL Annular X [j [j [j [j [j [j [j DSL Spill Box X [j [j [j [j [j [j [j "B n [j [j 13 [j -[j q [j lj [j [j [j [j [j [j [j [j [j [j [j q [j q Cl [j [j d [j [j [j [j [j [j [j [j [j [j [j [j lj [j [j [j [j D Cl lj [j [j [j [j [j [j Cl lj Cl [j [j [j [j |j [j [j [j O If hydrostatic testing was performed, describe what was done with the water aRer completion of tests: Water returned to test tank for re-use. CERTIFICATION OF TECHNICIAW RESPONSIBLE FOR CONDUCTING THIS TESTING To the best ofmy knowledge, the facb statedin tjitfs d)'cument are accurate and in full compliance with legal requirements Technician's Signature:-—-==Date: 7-30-14 SWRCB, January 2002 Page 2- of L{ 4. TANK ANNULAR TESTING Test Method Developed By:[j Tank Manufacturer [j Industry Standard [j Professional Engineer [j Other (Spe@) Test Method Used:Cl Pressure [j Vacuum O Hydrostatic [j Other (Spe@) Llest E,q,ui,p,ment Used: E,q,ui,p,ment Resolution: Tank #DSL Tank #I Tank#I Tank# Is Tank Exempt From Testing?'Yes X No Yes X No Yes X No [j Yes [j No Tank Capacity:20000 Tank Material:Steel Tank Manufacturer:Unknown Product Stored:87 Wait time between applying pressure/vacuum/water and 30 min. starting test: Test Start Time:9:00 Initial Reading (Ri):lO " HG Test End Time:11:00 Final Reading (Rf):lO " HG Test Duration:2 HR Change in Reading (Rf-Ri):0.0 Pass/Fail Threshold or Criteria:0.0 Test Result:X Pass [j Fail [j Pass [j Fail [j ,Pass [j Fail [j Pass [j Fail Was sensor removed for testing?XYes IjNO IJNA 1jYes IjNO IINA CjYes IjNO IJNA 1jYes CjNO IJNA Was sensor properly replaced and verified functional after testine XYes ijno ijna CjYes ijno iina 1jYes ijno ijna 1jYes ijno ijna Comments — (include information on repairs made prior to testing, and recommended follow-up,for failed tests) ' Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt Hom periodic containment testing. {California Code of Regulations, Title 23, Section 2637(a)(6)} SWRCB, January 2002 Page"jj of"/ 5. b . Test Method Developed By:Cl UDC Manufacturer x Industry Standard [j Professional Engineer [j Other (Spe@) Test Method Used:Cl Pressure D Vacuum x Hydrostatic [j Other (specgj') Aest E,qui,p,ment Used:lncon tsgts E,q,uip,ment Resolution::0l" UDC #1/2 UDC #UDC #UDC # UDC Manufacturer:Unknown UDC Material:hp UDC Depth:32" Height from UDC Bottom to Top 12" of Highest Piping Penetration: Height from UDC Bottom to 24" Lowest Electrical Penetration: Condition of UDC prior to good testing: Portion of UDC Tested'1/2 Does turbine shut down when UDC sensor detects liquid (both xYes IjNo CINA Yes IINo IJNA Yes ONo IJNA Yes CINo IJNA product and water)?* Turbine shutdown response time 3 sec Is system programmed for fail- safe shutdown?*xYes IjNO CINA Yes IJNO IJNA Yes CINO CINA Yes IJNO IJNA Was fail-safe verified to be operational?*xYes IjNO IJNA Yes ONO CINA Yes IjNO CINA Yes IJNO IINA Wait time between applying 15 min. pressure/vacuum/water and starting test Test Start Time:9:34 Initial Reading (Ri):5.636 Test End Time:9:49 Final Reading (Rf):5.636 Test Duration:15 min Change in Reading (Rf-Ri):0 Pass/Fail Threshold or Criteria:-.002 Test Result:x Pass Cl Fail lj Pass " lj Fail O Pass [j Fail Pass Cl Fail Was sensor removed for testing?xYes ONO IJNA Yes IINO IINA Yes IjNO IJNA Yes IJNo DNA Was sensor properly replaced and verified functional after testing?xYes IjNO DNA Yes IjNO IINA Yes ONO IJNA Yes ONO DNA K-UNDER-DISPENSER CONTAINMENT (UDC) TESTING Comments — (include information on repairs made prior to testing, and recommendedfollow-up for failed tests) ' If the entire depth of the UDC is not tested, specify how much was tested. If the answer to anY of the questions indicated with an asterisk (*) is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG-160) SWRCB, January 2002 Page 97' ofSl 7. 8. SPILL/OVERFILL CONTAINMENT BOXES Facility is Not Equipped With Spill/Overfill Containment Boxes 2 Spill/Overfill Containment Boxes are Present, but were Not Tested G Test Method Developed By:[j Spill Bucket Manufacturer X Industry Standard [j Professional Engineer [j Other (Spe@) Test Method Used:[j Pressure [j Vacuum X Hydrostatic [j Other (Specify) Jest E,q,ui,pment Used: E,q,ui,p,ment Resolution: Spill Boxpill Boxpill Boxpill Box=T Bucket Diameter:12" Bucket Depth:ll" Wait time between applying pressure/vacuum/water and 15 Min starting test: Test Start Time:9:11 Initial Reading (Ri):6.109 Test End Time:9:26 Final Reading (Rf):6.108 Test Duration:15 min Change in Reading (Rf-Ri):0.001 Pass/Fail Threshold or 0.002 Criteria: Test Result:X Pass lj Fail lj Pass Cl Fail lj Pass lj Fail Cl Pass lj Fail Comments — (include information on repairs made prior to testing, and recommended follow-up for failed tests)