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Home My WebLink About2022 Cold StartAppendix VI Underground Storage Tank Monitoring System Certification Form CERS = California Environmental Reporting System, GPH = Gallons Per Hour, ID = Identification, ICC = International Code Council, LLD = Line Leak Detector, NA = Not Applicable, SW = Single- Walled, UDC = Under-Dispenser Containment, UST = Underground Storage Tank, VPH = Vacuum/Pressure/Hydrostatic Page 1 of 6 TYPE OF ACTION ܆܆ Installation ܆ Repair ܆ 12 Month 1. FACILITY INFORMATION CERS ID Certification Date Facility Name Facility Address City ZIP Code 2. SERVICE TECHNICIAN INFORMATION Company Performing the Certification Phone Mailing Address Service Technician Performing Test Contractor/Tank Tester License Number ICC Number ICC Expiration Date 3. TRAINING AND CERTIFICATIONS Manufacturer and Test Equipment Training Certifications Expiration Date 4. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST I hereby certify that the monitoring system is operational in accordance with California Code of Regulations, title 23, division 3, chapter 16, section 2638; that required supporting documentation is attached; and all information contained herein is accurate. Service Technician Signature Date 10134202 03/03/2022 Farrell's Fastrip 3360 6401 White Ln Bakersfield 93309 Confidence UST Services, Inc.(800) 339-9930 2209 Zeus Court, Bakersfield, CA 93308 Erick Cooley 1073967 8344109 Oct 3, 2022 Veeder Root A22265 July 28, 2022 03/03/2022 Total # of Pages 5Erick Cooley Underground Storage Tank Monitoring System Certification Form Page 2 of 6 5. MONITORING SYSTEM AND PROGRAMMING A separate Monitoring System Certification Form must be prepared for each control panel. Make of Monitoring System Control Panel Model of Monitoring System Control Panel Software Version Installed Attach the post-certification reports if the monitoring system is capable of generating either; ܆܆Monitoring System Set-up ܆܆ Alarm History Report Yes No NA All monitoring equipment is operational per manufacturer’s specifications? ܆܆܆܆ Secondary containment systems are free of damage, debris, or liquid? ܆܆܆܆ Are the audible and visual alarms operational? ܆܆܆܆ All sensors have been: 1) visually inspected for wiring kinks, breaks and residual buildup on floats; and 2) tested for functionality and confirmed operational? ܆܆܆܆܆܆ Are all sensors installed to detect a release at the earliest opportunity in the secondary containment? ܆܆܆܆܆܆ The monitoring system set-up was reviewed, and proper settings confirmed? ܆܆܆܆܆܆ Was the monitoring control panel’s backup battery visually inspected, functionally tested, and confirmed operational? ܆܆܆܆܆܆ Does the flow of fuel stop at the dispenser if a release is detected in the under- dispenser containment? ܆܆܆܆܆܆ Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is electrically disconnected? ܆܆܆܆܆܆ Does the turbine automatically shut down if the piping secondary containment monitoring system detects a release? Which sensors initiate positive shut down? (Check all that apply) ܆ Sump ܆ UDC ܆܆܆܆܆܆ If monitoring system alarms are relayed to a remote monitoring center, is all communication equipment operational? ܆܆܆܆܆܆ Describe all answers marked “No” or “Fail” and proposed remedy in Section 9. List all monitoring equipment either replaced or repaired in Section 9 Veeder-Root TLS-350 336.02 Underground Storage Tank Monitoring System Certification Form Page 3 of 6 6. SENSOR TESTING RESULTS List only sensors tested on date of this certification. List “Sensor ID” as labeled in system programming. Additional copies of this page may be attached to accommodate all sensors tested. Sensor ID Sensor Model Component(s) Monitored Pass Fail ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ Describe all answers marked “No” or “Fail” and proposed remedy in Section 9. List all monitoring equipment either replaced or repaired in Section 9 L1 794380-208 UNL 1 STP L3 794380-208 UNL FILL L4 794380-208 PNL STP L5 794380-208 PNL FILL L7 794380-208 DIESEL STP L10 794380-208 DIS 1 - 2 L11 794380-208 DIS 3 - 4 L12 794380-208 DIS 5 - 6 L13 794380-208 DIS 7 - 8 L15 794380-208 DIESEL FILL Underground Storage Tank Monitoring System Certification Form Page 5 of 6 8. IN-TANK GAUGING TESTING ܆܆ Check this box if tank gauging is used only for inventory control. ܆܆ Check this box if NO tank gauging equipment is installed. (Do not complete this section if either box is checked.) Yes No NA All wiring has been: 1) visually inspected for kinks, breaks and proper entry and termination; and 2) tested for ground faults? ܆܆ ܆܆ ܆܆ Were all in-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely, functionally tested, and confirmed operational? ܆܆ ܆܆ Was accuracy of system’s product level readings tested? ܆܆ ܆܆ ܆܆ Was accuracy of system’s water level readings tested? ܆܆ ܆܆ ܆܆ Were all probes reinstalled properly? ܆܆ ܆܆ ܆܆ Were all items on the equipment manufacturer’s maintenance checklist completed? ܆܆ ܆܆ ܆܆ Probe ID Probe Model Tanks Monitored Pass Fail ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ ܆܆ 9. COMMENTS Describe all answers marked “No” or “Fail” and proposed remedy. List all monitoring equipment either replaced or repaired. ܆܆ Preformed Electronic Monitoring Cert The Veeder-Root ISD software has expired and site is getting a bunch of ghost alarms. I have been working with Veeder-Root Tech support on how to fix the issues. They have suggested that we upgradeing software and cold start system and reprogrm from scratch. On 3-3-2022 UST upgrade software and reprogrammed Veeder Root. Test all liquid sensor IN SUMPS AND UDCS for positive shut down and they all stop fuel flow and alarm on Veeder Root Underground Storage Tank Monitoring System Certification Form Page 6 of 6 10. MONITORING SITE PLAN Date site plan was prepared: If a site plan has been prepared that shows all required information, you may include it, rather than this page, with your Monitoring System Certification Form. The site plan must show the general layout of tanks and identify locations of the monitoring panel, and all leak detection equipment and monitoring locations. Include a legend for all symbols depicted. EXISTING BUILDING 78L13 12,000 GALLON87 UNLEADED 34L11 56L1212L10 STPL1 AL2 12,000 GALLONPREMIUM 12,000 GALLONDIESEL FV FV F AL5 AL16 STPL4 STPL7 L3 L6 L8 NOPARKING NOPARKING DUM P S T E R DRAINAGE WAYDRAINAGE WAY DRAINAGE WAYDRAINAGE WAY DRAINAGE WAY DRA I N A G E W A Y DUMPSTER H W W G WHITE LN. PROPERTY LINE AS H E R D . PR I C E S I G N PLA Z A S I G N PRICE SIGN N PROPERTY LINE LEGEND L1 87 STP L2 87 ANNULAR L3 87 FILL L4 91 STP L5 91 ANNULAR L6 91 FILL L7 DSL STP L8 DSL FILL L10 UDC 1 - 2 L11 UDC 3 - 4 L12 UDC 5 - 6 L13 UDC 7 - 8 L16 DSL ANNULAR 87 GAS 3/2 INCH DBL WALLED PIPE 91 GAS 3/2 INCH DBL WALLED PIPE DIESEL 3/2 INCH DBL WALLED PIPE VAPOR RETURN 3 AND 2 INCH SINGLE WALL PIPE VAPOR VENT 2 INCH SINGLE WALLED PIPE PRODUCT SPILL CONTAINER VAPOR SPILL CONTAINER ANNULAR EMERGENCY SHUT-OFF OVERFILL ALARM FIRE EXTINGUISHER GAS METER SHUT-OFF WATER SHUT OFF HEALY CAS EVACUATION MEETING POINT AUTOMATIC TANK GAUGE UST ELECTRICAL PANEL CIRCUIT BREAKER AIR AND WATER DISPENSER FIRE PREVENTION SYSTEM G A H P V W SCALE: SITE MAP C1 VICINITY MAP PROJECT DATA 1"=20'-0" INCHES012 SHEET SIZE 22 X 34 6401 WHITE LN. BAKERSFIELD, CA 93309 PROJECT OWNER: JACO HILL PO. BOX 82515 BAKERSFIELD, CA 93380 CONTACT: SITE PLOT PLAN FOR: FACITILY ID 15-021-003021 CERS ID 10134202 FASTRIP #3360 6401 WHITE LN. BAKERSFIELD, CA 93309 01/16/17 REV. A S H E R D . WHITE LN. IV4200 MAR 3, 2022 10:31 AM Sensor / Airflow Meter / Hose Table / Grade Table Relationship SS AA F1 FL M1H1L1 M2H2L2 M3H3L3 M4H4L4 F2 L2 M1H1L1 M2H2L2 M3H3L3 M4H4L4 02 01 02 01 030102 040102 100102 060000 03 02 030202 040202 100202 060000 03 02 04 03 030302 040302 100302 000000 05 04 030402 040402 100402 000000 04 03 06 05 030502 040502 100502 060000 07 06 030602 040602 100602 060000 05 04 08 07 030702 040702 100702 000000 09 08 030802 040802 100802 000000 IV4200 MAR 3, 2022 10:31 AM Sensor / Airflow Meter / Hose Table / Grade Table Relationship SS AA F1 FL M1H1L1 M2H2L2 M3H3L3 M4H4L4 F2 L2 M1H1L1 M2H2L2 M3H3L3 M4H4L4 02 01 02 01 030102 040102 100102 060000 03 02 030202 040202 100202 060000 03 02 04 03 030302 040302 100302 000000 05 04 030402 040402 100402 000000 04 03 06 05 030502 040502 100502 060000 07 06 030602 040602 100602 060000 05 04 08 07 030702 040702 100702 000000 09 08 030802 040802 100802 000000