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Home My WebLink AboutFMC 2022 COLD STARTAppendix M U nderground Storage Tank Monitoring System Certification Form CERS = California Environmental Reporting $ystem, GPH = Gallons Per Hour, lD = ldentification, ICC = lntemational Code Council, LLD = Line Leak Detector, NA = Not Applicable, SW = Single- Walled, UDC = Under-Dispenser Containment, UST = Underground Storage Tank, VPH = Vacuum/PressurelHydrostatic Page 1 of6 TYPE OF ACTION ffi lnstallation ffi Repair ffi tZ Month 1. FACILITY INFORMATION CERS ID Certification Date 1Angt22 Facility Name WIBLE 76 Facility Address 3301 WIBLE RD City BAKERSFIELD ZIP Code 93309 2. SERVICE TECHNICIAN INFORMATION Company Performing the Certification BSSR ING Phone 661-588-2777 Mailing Address 6630 ROSEDALE HWY Service Technician Performing Test NATHAN HOLMAN Contractorffank Tester License Number 4728',r2 IGC Number 8111067 ICC Expiration Date 8122t24 3, TRAINING AND CERTIFICATIONS Manufacturer and Test Equipment Training Certifications Expiratian Date VEEDER ROOT LEVEL 4 4t2st23 4. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST I hereby certify thatthe monitoring systern is opentional 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 10t19t22 Total # of Pages U nderg rou nd Storage Tan k Monitoring System Certification Form A separate Monitoring Sysfem Certification Form must be prepared for each control panel. Make of Monitoring $ystem Control Panel VEEDER ROOT Model of Monitoring $ystem Control Panel TLS 350 Softrare Version lnstalled 336.02 Attach the post-ceftifrcation repods if the monitoring system is capable of generating either; ffi Monitoring System Set-up ffi Aarm History Report All monitoring equipment is operational per manufacturer's specifications?m ffi Secondary containment systems are free of damage, debris, or liquid?m m Are the audible and visual alarms operational?m m All sensors have been: 1) visually inspected for wiring kinks, breaks and residual buildup on floats; and 2) tested for functionality and confirmed operational?m m m Are all sensors installed to detect a release at the earliest opportunity in the secondary containment?m l?GlliJ ffi The monitoring system set-up was reviewed, and proper settings confirmed?m m m \l/as the monitoring control panel's backup battery visually inspected, functionally tested, and confirmed operational?m m m Does the flow of fuel stop at the dispenser if a release is detected in the under- dispenser containment?m m ffi Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is electrically disconnected?ffi m ffi Does the turbine automatically shut down if the piping secondary containment monitoring system detects a release? Which sensors initiate positive shut down? (Check allthat apply) fflSump M UOC Ital m m lf monitoring system alarms are relayed to a remote monitoring center, is all communication equipment operational?ffi E:ffi Descnbe all answers marked nNa" or *Fail" and proposed remedy rn Secfion 9. List all monitoring equipment either replaced ar repaired rn Secfion 9 Page 2 of 6 Yes No NA Underground Storage Tank Monitoring System Certification Fomr A!r hY r rrrY r thyvi List only sensors fesfed on date of ttris certificatian lisf "Sensor lD" as labeled in system pragramming. Additianalcoprbs of fhn page may be attached to accommodate a/l sensors fesfed. Sensor /D Sensor Model Component(s) Monitored Pass Fail L1 208 uDc 1-2 M,i ffi L2 208 UDC 34 m m L3 208 87 STP ffi m L4 208 91 STP m ffi L5 208 DSL STP m m m m m m m m ffi tFtLr l il ffi m m ffi m m FItJt m m m m ffi m m m ffi IFtl I ffi ffi m m m E] ffi ffi ffi ffi ffi ffi Describe all answers marked *No" ar.Fail" and proposed remedy in Section g. List all monitaring equipment either replaced or repaired in Secfion 9 Page 3 of 6 Underground Storage Tank Monitoring System Certification Form Describe all answers marked "No' or "Fail" and proposed remedy in Section g. List all monitoring equipment either replaced or repaired rn Secfion g ffi Check this box if line leak detectors ARE NOT installed. (Do nat complete this section.) Simulated release rate verified: (Check allthat apply.) Iff s cprl m 0.1 GPH fff o.z cpH ,ff4 Has the testing apparatus been properly calibrated?ffi m m For emergency generator tank systems, does the LLD create an audible and visual alarm when a leak is detected?ffi m m For mechanical LLDs, does the LLD restrict the flow through the pipe when a release is detected?il ffi m For electronic LLDs, does the turbine automatically shut off when a release is detected?m m m For electronic LLDs, does the turbine automatically shut off if any portion of the monitorins system is disabled or disconnected?m m m For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a tightness test?m ffi m For electronic LLDs, have allaccessible wiring connections been visually inspected for kinks and breaks?m ffi m Were all items on the equipment manufacturer's maintenance checklist completed?m m m Were all LLDs confirmed operationalwithin regulatory requirements?m m m LLD ID LLD Model Lrnes Monitored Pass Fail E]m ffi ffi ffi m m m m m m m m ffi m m m m m m m m ffi ffi Page 4 of 6 7. LINE LEAK DETECTOR TESTING Yes No Underground Storage Tank Monitoring System Certifi cation Form il Check this box if tank gauging is used only for inventory control. ffi Check this box if NO tank gauging equipment is installed. {Do not complete fhrs secfibn if either box is checked.) Yes No Allwiring has been: 1) visually inspected for kinks, breaks and proper entry and termination: and 2) tested for oround faults?m ffi m Were all in-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freely, functionally tested, and confirmed operational?m m m Was accuracy of system's product level readings tested?r m m Was accuracv of svstem's water level readinqs tested?m ffi E] Were all probes reinstalled properly?r il ffi Were all items on the equipment manufacturer's maintenance checklist completed?m m m Probe lD Probe Model Tanks Monitored Pass Fail m m m m m m ffi ffiilm ffi m Descnbe all ansvvers marked "Na" or *Faili' and proposed remedy. List all monitoring equipment either replaced or repaired. COLD START SENSOR TEST AFTER 336.02 SOFTWARE UPGRADE Page 5 of 6 NA 9. COMMENTS Underground Storage Tank Monitoring System Certifi cation Form Date site plan was prepared: /f a slfe plan has been prepared that shows all required information, you may include it, rather than this page, with your Manitoring System Certificatiorr Form. Ihe sr'fe plan must show the generallayout of tanks and identify locations af the monitaring panel, and all leak detection equipment and monitoring locatians. lnclude Page 6 of 6 M^AO OCT 19, 2022 8:48 Attl Sensor / Airfl.ow Meter I Hose Table / 6rade Table Relationship 55 AA Fl FL IYI1H1L1 I42H2L2 M3H3L3 M4H4L4 F2 L2 M1H1Ll I42H2L2 M3H3L3 I'44H414 01 61 02 A7 A3CI702 LAOLa? A20tA2 040069 A3 A? 03A202 LQA202 A24202 04AOOS a2 02 04 01 0ta3s2 tog3az azq302 040aCIa a5 CI4 a304a2 tag4az 0eo4a2 a4aoao r11100 OCT 19, 2022 8:48 AM WIBLE 75 33A1 h'IBLE RD BAKERSFIELD CA PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION I 1 INPUTI 1 INPUTI 1 INPUTI 1 INPUTI 1 INPUT I T INPUTI 1 INPUTI 1 INPUTI 1 INPUTI 1. INPUTI 1 INPUTI 1 INPUTI 1 INPUT I 1 INPUTI 1 INPUTI 1 INPUTI ]. INPUTI 1 INPUTI 1 INPUTI 1. INPUTI T INPUTI 1 INPUTI 1 INPUTI 1 INPUTI 1 INPUTI 1 INPUTI 1 INPUTI 1'INPUTI T INPUTI 1 INPUT HIRT HlRT HIRT HIRT HlRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT H]RT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT ALARM TYPE EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARH EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARIVI EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARIVI EXTERN INPUT ALARM EXTERN INPUT ALARM EXTERN INPUT ALARM STATE DATE TIME CLEAR Lg-!7 -22 L1: 54Alvl ALARII LO-17-22 11:35A1"1 CLEAR LO.L4-22 2:OOPM ALARM tA-14-22 1:40PM CLEAR t0-1E-22 11.:38PM ALAR|4 1.O-13-ZZ 11:64PM CLEAR tA-09-22 4z?7Pt4 ALARM 10-49-22 4:27Pt4 CLEAR 9-74-22 12:36PM ALARM 9-24-22 9:].3Alvl CLEAR 9-23-22 9:42AM ALARM 9-23-22 9:30Alv1 CLEAR 9-23-22 8:31AM ALARM 9-23-22 8:27AM CLEAR 9-23-22 8:17A1'l ALARM 9-23-22 7 |49A14 CLEAR 9-22-22 3:37PM ALARM 9-?2-22 3:35PM CLEAR 9-2L-22 2:32A1"1 ALARr,l 9-21-22 12:29AI"1 CLEAR 9-20-22 3r21Alt4 ALARM 9-ZO-22 3:06AM CLEAR 9-t8-ZZ 2:36Ai4 ALARM 9-18-22 2:18Avl CLEAR 9-t7-22 5:06AM ALARM 9-77-22 5:09Avl CLEAR 9-L7 -22 2:57AP1 ALARM 9-17-22 2:42AF1 CLEAR 9-77-22 1:15AM ALARM 9-17-ZZ 1:00AI'1 I1I1I1I1 I1I1I1I1I1I1I1I1I1I1I1ITI1I1I1I1 INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT INPUT NON-PRIORITYID CATEGORY SYSTEM SYSTEM SYSTEM SYSTEM T 1 TANK T 1 TANK OTHER SYSTEM SYSTEM SYSTEM SYSTEM 5Y5TEM SYSTEM 5Y5TEM '5Y5TEM OTHER SYSTEM HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT HIRT ALARM HISTORY DESCRIPTION UNLEADED UNLEADED INPUT ALARIVI INPUT ALARM INPUT ALARM INPUT ALARTI INPUT ALARM INPUT ALARM INPUT ALARM INPUT ALARM INPUT ALAR}4 INPUT ALARI4 INPUT ALARM INPUT ALARM INPUT ALARM INPUT ALARM INPUT ALARM INPUT ALARM INPUT ALARI'I INPUT ALARM INPUT ALARM INPUT ALARM CLEAR 9-!4-22 ALARM 9.T4.22 CLEAR 9-T4.22 ALARM 9-T4-22 CLEAR 9-L4-22 ALARm 9-14-?2 CLEAR 9-L4-22 ALARM 9-T4.22 CLEAR 9-t4-22 ALARM 9-T4.2? CLEAR 9^14-22 ALARM 9.T4-22 CLEAR 9-13-22 ALARM 9-!3.22 CLEAR 9-12-22 ALARM 9-L2.22 CLEAR 9-72-22 ALARM 9.12-22 CLEAR 9-t2-22 ALARM 9-L2-22 EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN EXTERN 16:3lAlvl 16:31AM 10:12AM 10: CI7Alvl LA:O4AM 16:01AM 9:47At4 8:S9Alvl 8:48Al"1 4: 55All 3:41A1'1 2:13AM 4:41All L2:15AM 11: CI8PM 1O:54PM 7:O4Att4 5:54AM 5:14A14 1:19AM TIME 6:2AF*1 6:2OAt4 12:O0Alvl L2zAAA!4 11:01PM 5:48PM L0:37AM 9: t2AM 9:12AM 9: L1AM 9:11AM 9:10AM 9:10401 2:00AM 2:O0Nn 1O:37AI'1 9:50All r.LlzCIA QC'f 19, 2022 8:49 AM WIBLE 76 3301 !dIBLE RD BAKERSFIELD CA ALARM TYPE PRINTER ERROR PAPER OUT PRINTER ERROR PAPER OUT DELIVERY NEEDED DELIVERY NEEDED ISD VP STATUS WARN PRINTER ERROR PAPER OUT PAPER OUT PRINTER ERROR PRINTER ERROR PAPER OUT PRINTER ERROR PAPER OUT ISD VP STATUS WARN PRINTER ERROR STATE DATE cLEAR tA-72-2? CLEAR 74.L2.22 ALARM TA-L2.22 ALARM tO-12-22 cLEAR LO-O4-22 ALARM tO-O4-22 CLEAR 9-25-22 CLEAR 9-25-22 CLEAR 9-25-22 ALARM 9.25-22 ALARM 9.25.22 CLEAR 9-25-22 cLEAR 9-25-22 ALARM 9-25.22 ALARM 9.25-22, ALARm 9-24-22 cLEAR 9-A8-22 h1 h1 T1 T1 PREMIUI4 PREMIUM h4 h4 r11X.A0 ACT L9, 2022 9:14 AM h,IBLE 76 3301 l,,lIBLE RD BAKERSFIELD CA PRIORITY ALARM HISTORYID CATEGORY DESCRIPTION L 2 DISP PAN DISP 3.4 L 2'DISP PAN DISP 3-4 L 1 DISP PAN DISP 1-2 L 1 DISP PAN DISP 1-2 PAPER OUT PRINTER ERROR PAPER OUT FLOt'l C0LLECT I^JARN FLOhI COLLECT K'IARN DELIVERY NEEDED DELIVERY NEEDED PRINTER ERROR PAPER OUT PRINTER ERROR PAPER OUT DELIVERY NEEDED DELIVERY NEEDED PRINTER ERROR PAPER OUT PAPER OUT PRINTER ERROR PRINTER ERROR PRINTER ERROR PRINTER ERROR PAPER OUT PAPER OUT PRINTER ERROR PRINTER ERROR PAPER OUT PRINTER ERROR PAPER OUT PRINTER ERROR PAPER OUT PAPER OUT PRINTER ERROR FLOhJ COLLECT hIARN FL0W COLLECT I^IARN CLEAR 9-08-22 ALARM 9-08-22 ALARM 9-48-22 CLEAR 9-06-22 ALARM 9.A2-22 CLEAR 8-3L-22 ALARM 8-3A.22 CLEAR 8-26-22 cLEAR 8-26-22 ALARM 8.26-22 ALARM 8-25.22 CLEAR 8-22-22 ALARM 8.22.22 CLEAR 8-LA-22 CLEAR 8-10-22 ALARM 8-L9.22 ALARM 8-TA.22 CLEAR 8-tO-22 ALARM 8.LA-22 cLEAR 8-70-72 CLEAR 8.IO-22 ALARI4 8-LA-22 ALARM 8-LO-22 CLEAR 7-25-22 CLEAR 7-25-22 ALARM 7.25.22 ALARH 7-25.22 CLEAR 7-97-22 CLEAR 7-A7-22 ALARM 7-O7-22 ALARM 7-O7.22 CLEAR 7-Ot-22 ALARM 6.28.22 STATE DATE cLEAR tO-Le-22 ALARM LO.Lg-22 cLEAR L0-!9-22 ALARI4 LO-19-22 SYSTEM SYSTEM SYSTEM OTHER OTHER TANK TANK SYSTEM SYSTEM SYSTEM SYSTEM TANK TANK SYSTEM SYSTEM SYSTEM SYSTEM SYSTEM SYSTEM SYSTEM SYSTEII SYSTEM SYSTEM SYSTEM SYSTEM SYSTEM sYsTEtvl SYSTEM SYSTEM SYSTEM SYSTEM OTHER OTHER FPl: BLEND3 FP].: BLEND3 UNLEAOED UNLEADED F?4: BLEND3 TP4: BLEND3 9: 50All 9:50AM 9:50AI{ 2:35PM 16:37AM 3:3LAM 6:39PM 7:42P14 7 z42Pl4 7:4@PM 7 t4OPl4 1:03PM 10:53A1,1 12:4LPt4 12:41PM L2:ATPM L2: LPM L2:4L?t4 t2:41PM !2:37PM L2:37P14 L2:37P14 12:35PM 5:36A14 6:36AM 6:34AM 5:34APl 6:35AM 6:35Alvl 6:33AM 6:33AM 3 r 13PM 19:374M T2 T2 ALARM TYPE FUEL ALARM FUEL ATARM FUEL ALARM FUEL ALARM TIME 9 r 12AM 9:12AM 9:12Alvl 9:12AM L5 L5L4L4 L3 L3 STP SUMP STP SUMP STP SUMP STP SUMP sTP SUMP STP SUMP SYSTEM SYSTEM DsL STP DSL STP PREMIUM STP PREMIUM sTP UNLEAOED STP UNLEADED STP FUEL ALARM FUEL ALARM FUEL ALARM FUEL ALARM FUEL ALARM FUEL ALARM BATTERY IS BATTERY I5 cLEAR !0-]'9-22 ALARM TO-Lg.22 cLEAR tO-79-22 ALARFI L0.T9.22 CLEAR LO-L9.22 ALARM tA-19-22 CLEAR 2-T3-2L ALARH 2.73.2L STATE DATE OFF OFF 9:11AM 9:11AM 9:1LAM 9:10AM 9;10Alvl 9:10AM 8:06Alvl 8:00Avl tttzaa OCT 19, 2022 9:15 At4 WIBLE 76 33OT WIBLE RD BAKERSFIELD CA NON-PRIORITY ALARIV1 HISTORY ID CATEGORY DESCRIPTION ALARM TYPE TIME I ll*l'irirJI:i aii:lTtji: T_ : ;F llEr,l l ilt1 F,.ltilLr1J[-'T i_]{}[rH I HEHI'1*-] i :' ',l--t rr*rlu lr"rr;ritlh,IH|,i}i I,E/.IFILE T I : i_tilLE*,,f,'F.l F kijlrl_tr-'T' r.,Jl,L I llF-Fl'lrrr, i rflFF'frilJ). l r I *ltl.l-Ei; T'rrl',1]. 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