HomeMy WebLinkAboutFMC 2023Appendix 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 Total # of Pages
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
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
Underground Storage Tank
Monitoring System Certification Form
Page 4 of 6
7. LINE LEAK DETECTOR TESTING
Check this box if line leak detectors ARE NOT installed. (Do not complete this section.)
Simulated release rate verified: (Check all that apply.)
3 GPH 0.1 GPH 0.2 GPH Yes No NA
Has the testing apparatus been properly calibrated?
For emergency generator tank systems, does the LLD create an audible and visual
alarm when a leak is detected?
For mechanical LLDs, does the LLD restrict the flow through the pipe when a
release is detected?
For electronic LLDs, does the turbine automatically shut off when a release is
detected?
For electronic LLDs, does the turbine automatically shut off if any portion of the
monitoring system is disabled or disconnected?
For electronic LLDs, does the turbine automatically shut off if any portion of the
monitoring system malfunctions or fails a tightness test?
For electronic LLDs, have all accessible wiring connections been visually inspected
for kinks and breaks?
Were all items on the equipment manufacturer’s maintenance checklist completed?
Were all LLDs confirmed operational within regulatory requirements?
LLD ID LLD Model Lines 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
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.
CVE
Cal- Valley Equipment
3500 Gilmore Ave.
Bakersfield CA 93308
661 -327-9341 FAX# 661 -325-2529
VAPORLESS MANUFACTURING, INC.
LDT-890 Leak Detector Test Record
Technician Date
Pass / Fail
Product
Manufacturer
Leak rate
Operating pressure
Line pressure (pump off)
Facility Address
Bleed back (pump off)
Step through time to full flow
Stays in leak search position
SHEAR VALVE OPERATION INSPECTION
Facility Name: Owner
Address: Address
City, State, Zip Code: City, State, Zip Code:
Facility I.D. #:Owner Phone #:
Testing Company: Phone #:
This data sheet is for inspecting shear valves located inside dispensers. See PEI/RP1200 Section 10 for the inspection procedure.
Product Grade
Dispenser ID#
Shear ValveType (Product/Vapor)
1. Is the shear valve rigidly
anchored to the dispenser box
frame or dispenser island?
Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
2. Is the shear section posi-
tioned between ½ inch above
or below the top surface of the
dispenser island?
Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
3. Is the lever arm free to move?Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
4.Does the lever arm snap the
the poppet valve shut?
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
5. Can any product be dispensed
when the product shear valve is
closed?
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
Yes No
NA
A “No” to Lines 1-4 or a “Yes” for Line 5 indicates a test failure.
Test Results Pass
Fail
Pass
Fail
Pass
Fail
Pass
Fail
Pass
Fail
Pass
Fail
Pass
Fail
Pass
Fail
Pass
Fail
Comments:
Tester’s Name (print) Tester’s Signature
Reference PEI/RP1200-19 Appendix C-10
Date:
Latest Version 3/14/2022
<I20100JAN 9, 2023 11:37 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
IN-TANK INVENTORY
TANK PRODUCT VOLUME TC VOLUME ULLAGE HEIGHT WATER TEMP 1 UNLEADED 8393 8379 11689 55.51 0.81 62.35 2 PREMIUM 3878 3866 8163 45.69 0.00 64.15 3 DIESEL 5580 5568 2447 83.62 0.00 64.39
><I90500JAN 9, 2023 11:37 AMSOFTWARE REVISION LEVELVERSION 336.02SOFTWARE# 346336-100-C CREATED - 21.02.13.11.53
S-MODULE# 330160-004-aSYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM
><I50500JAN 9, 2023 11:38 AM
SYSTEM TYPE AND LANGUAGE FLAG
SYSTEM UNITS U.S.SYSTEM LANGUAGE ENGLISHSYSTEM DATE/TIME FORMATMON DD YYYY HH:MM:SS xM
><I50201JAN 9, 2023 11:38 AM
SHIFT TIME 1 : 11:00 PM
>
<I50202JAN 9, 2023 11:38 AM
SHIFT TIME 2 : DISABLED
><I50203JAN 9, 2023 11:38 AM
SHIFT TIME 3 : DISABLED
><I50204JAN 9, 2023 11:38 AM
SHIFT TIME 4 : DISABLED
><I54600JAN 9, 2023 11:38 AM
TANK PER TST NEEDED WRN: DISABLED
><I54900JAN 9, 2023 11:38 AM
TANK ANN TST NEEDED WRN: DISABLED
><I55300JAN 9, 2023 11:38 AM
LINE RE-ENABLE METHODALARM ACKNOWLEDGE
><I55600JAN 9, 2023 11:38 AM
LINE PER TST NEEDED WRN: DISABLED
><I55900JAN 9, 2023 11:38 AM
LINE ANN TST NEEDED WRN: DISABLED
>
<I50D00
JAN 9, 2023 11:38 AM
PRINT TC VOLUMESENABLED
>
<I50E00
JAN 9, 2023 11:38 AM
TEMP COMPENSATIONVALUE (DEG F ): 60.0
>
<I60B00
JAN 9, 2023 11:38 AM
STICK HEIGHT OFFSET ENABLE STATUSDISABLED
>
<I51400
JAN 9, 2023 11:38 AM
H-PROTOCOL DATA FORMATHEIGHT
>
<I51A01
JAN 9, 2023 11:38 AM
DAYLIGHT SAVING TIMEENABLED OFF
>
<I51B00
JAN 9, 2023 11:38 AM
DAYLIGHT SAVING TIME
START DATE APR WEEK 1 SUN 2:00 AM
END DATE OCT WEEK 6 SUN 2:00 AM
>
<I51600JAN 9, 2023 11:39 AM
RE-DIRECT LOCAL PRINTOUTDISABLED
><I50400JAN 9, 2023 11:39 AM
232 SECURITY CODE
PORT SECURITY CODE STATUS
1 000000 DISABLED 2 000000 DISABLED 3 000000 DISABLED 4 000000 DISABLED 5 000000 DISABLED 6 000000 DISABLED
><I21900JAN 9, 2023 11:39 AM
TANK CHART SECURITYENABLED
><I5BD00JAN 9, 2023 11:39 AM
CUSTOM ALARM LABELS
DISABLED
><I56000JAN 9, 2023 11:39 AM
MASS/DENSITY
DISABLED
><I88101
JAN 9, 2023 11:39 AM
PORT SETTINGS:
COMM BOARD : 1 (EDIM )RS-232 SECURITY
CODE : ******
><
I88102JAN 9, 2023 11:40 AM
PORT SETTINGS:
COMM BOARD : 2 (S-SAT ) BAUD RATE : 9600
PARITY : NONE STOP BIT : 1 STOP
DATA LENGTH: 8 DATARS-232 SECURITY
CODE : ****** DTR NORMAL STATE: HIGH
>
<I88103
JAN 9, 2023 11:40 AMPORT SETTINGS:
COMM BOARD : 3 (RS-232)
BAUD RATE : 9600 PARITY : NONE
STOP BIT : 1 STOP DATA LENGTH: 8 DATA
RS-232 SECURITYCODE : ******
>
<I88104
JAN 9, 2023 11:40 AM
><
I88105JAN 9, 2023 11:40 AM
>
<I88106
JAN 9, 2023 11:40 AM
><
I52000
JAN 9, 2023 11:40 AM
RECEIVER AUTO DIAL TYPE & START TIME
RCVR LOCATION LABEL DIAL TYPE START TIME 1 ON DATE JUN 11, 2008 DISABLED 2 ON DATE JUN 11, 2008 DISABLED 3 ON DATE JUN 11, 2008 DISABLED 4 ON DATE JUN 11, 2008 DISABLED 5 ON DATE JUN 11, 2008 DISABLED 6 ON DATE JUN 11, 2008 DISABLED 7 ON DATE JUN 11, 2008 DISABLED 8 ON DATE JUN 11, 2008 DISABLED><I60100JAN 9, 2023 11:41 AM
TANK CONFIGURATION
DEVICE LABEL CONFIGURED 1 UNLEADED ON 2 PREMIUM ON 3 DIESEL ON 4 HACKED OFF
><I60200JAN 9, 2023 11:41 AM
TANK PRODUCT LABEL
TANK PRODUCT LABEL 1 UNLEADED 2 PREMIUM 3 DIESEL 4 HACKED ><I60300JAN 9, 2023 11:41 AM
TANK PRODUCT CODE
TANK PRODUCT LABEL 1 UNLEADED 1 2 PREMIUM 2 3 DIESEL 3 4 HACKED 4><I60900JAN 9, 2023 11:41 AM
TANK THERMAL COEFFICIENT
TANK PRODUCT LABEL 1 UNLEADED 0.000700
2 PREMIUM 0.000700 3 DIESEL 0.000450
4 HACKED 0.000000>
<I60700
JAN 9, 2023 11:41 AM
TANK DIAMETER
TANK PRODUCT LABEL INCHES 1 UNLEADED 127.50
2 PREMIUM 127.50 3 DIESEL 127.50
4 HACKED 0.00>
<I60A00
JAN 9, 2023 11:41 AM
TANK FULL VOLUME
TANK PRODUCT LABEL TANK PROFILE GALLONS
1 UNLEADED 1 PT 20082
2 PREMIUM 1 PT 12041
3 DIESEL 1 PT 8027
4 HACKED 1 PT 111111
>
<I60400
JAN 9, 2023 11:41 AM
TANK FULL VOLUME
TANK PRODUCT LABEL GALLONS 1 UNLEADED 20082
2 PREMIUM 12041 3 DIESEL 8027
4 HACKED 111111>
<I60500
JAN 9, 2023 11:41 AM
TANK 4 POINT VOLUMES
TANK PRODUCT LABEL GALLONS 1 UNLEADED 20082 0 0 0 2 PREMIUM 12041 0 0 0 3 DIESEL 8027 0 0 0 4 HACKED 111111 0 0 0
><I60600JAN 9, 2023 11:41 AM
TANK 20 POINT VOLUMES
TANK PRODUCT LABEL GALLONS 1 UNLEADED 20082 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 PREMIUM 12041 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 DIESEL 8027 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 HACKED 111111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
><I61500JAN 9, 2023 11:41 AM
TANK PRODUCT LABEL METER DATA 1 UNLEADED NO 2 PREMIUM NO 3 DIESEL NO 4 HACKED NO
><I62F00JAN 9, 2023 11:41 AM
MAG PROBE FLOAT SIZE
TANK PRODUCT LABEL FLOAT SIZE: 1 UNLEADED 4.0 IN. 2 PREMIUM 4.0 IN. 3 DIESEL 4.0 IN.
><I62700JAN 9, 2023 11:41 AM
TANK HIGH WATER WARNING LIMIT
TANK PRODUCT LABEL INCHES 1 UNLEADED 2.0 2 PREMIUM 2.0 3 DIESEL 2.0><I64200JAN 9, 2023 11:41 AM
WATER ALARM FILTER
TANK PRODUCT LABEL 1 UNLEADED LOW 2 PREMIUM LOW 3 DIESEL LOW
><I62400JAN 9, 2023 11:41 AM
TANK HIGH WATER LEVEL LIMIT
TANK PRODUCT LABEL INCHES 1 UNLEADED 3.0 2 PREMIUM 3.0 3 DIESEL 3.0><I62800JAN 9, 2023 11:41 AM
TANK MAXIMUM VOLUME LIMIT
TANK PRODUCT LABEL GALLONS 1 UNLEADED 20082 2 PREMIUM 12041 3 DIESEL 8027 4 HACKED 111111>
<
I62300JAN 9, 2023 11:41 AM
TANK OVERFILL LEVEL LIMIT
TANK PRODUCT LABEL GALLONS
1 UNLEADED 18074 2 PREMIUM 10837
3 DIESEL 7224 4 HACKED 0
><
I62200JAN 9, 2023 11:42 AM
TANK HIGH PRODUCT LIMIT
TANK PRODUCT LABEL GALLONS
1 UNLEADED 19078 2 PREMIUM 11439
3 DIESEL 7626 4 HACKED 0
><
I62900JAN 9, 2023 11:42 AM
TANK DELIVERY REQUIRED LIMIT
TANK PRODUCT LABEL GALLONS
1 UNLEADED 2008 2 PREMIUM 1204
3 DIESEL 803 4 HACKED 0
><
I62100JAN 9, 2023 11:42 AM
TANK LOW PRODUCT LIMIT
TANK PRODUCT LABEL GALLONS
1 UNLEADED 500 2 PREMIUM 500
3 DIESEL 500 4 HACKED 0
><
I62600JAN 9, 2023 11:42 AM
TANK LEAK ALARM LIMIT
TANK PRODUCT LABEL GALLONS 1 UNLEADED 99 2 PREMIUM 99 3 DIESEL 99 4 HACKED 99><I62500JAN 9, 2023 11:42 AM
TANK SUDDEN LOSS LIMIT
TANK PRODUCT LABEL GALLONS 1 UNLEADED 50 2 PREMIUM 50 3 DIESEL 50 4 HACKED 99><I60800JAN 9, 2023 11:42 AM
TANK TILT
TANK PRODUCT LABEL INCHES 1 UNLEADED 0.00 2 PREMIUM 0.00 3 DIESEL 0.00 4 HACKED 0.00><I60B00JAN 9, 2023 11:42 AM
STICK HEIGHT OFFSET ENABLE STATUSDISABLED
><I60C00JAN 9, 2023 11:42 AM
TANK STICK HEIGHT OFFSETTANK PRODUCT LABEL INCHES 1 UNLEADED 0.00 2 PREMIUM 0.00 3 DIESEL 0.00 4 HACKED 0.00><I61200JAN 9, 2023 11:42 AM
TANK MANIFOLDED PARTNERS
TANK PRODUCT LABEL SIPHON MANIFOLDED TANKS LINE MANIFOLDED TANKS 1 UNLEADED NONE NONE
2 PREMIUM NONE NONE 3 DIESEL NONE NONE
4 HACKED NONE NONE >
<I63600
JAN 9, 2023 11:42 AM
PERIODIC LEAK TEST MIN VOLUME
TANK PRODUCT LABEL GALLONS 1 UNLEADED 2008
2 PREMIUM 1204 3 DIESEL 802
4 HACKED 0>
<I62A00
JAN 9, 2023 11:42 AM
ANNUAL LEAK TEST MIN VOLUME
TANK PRODUCT LABEL GALLONS 1 UNLEADED 2008
2 PREMIUM 1204 3 DIESEL 802
4 HACKED 0>
<I62C00
JAN 9, 2023 11:42 AM
TANK PERIODIC TEST TYPE
TANK PRODUCT LABEL PERIODIC TEST TYPE 1 UNLEADED STANDARD
2 PREMIUM STANDARD 3 DIESEL STANDARD
4 HACKED STANDARD
><
I62D00JAN 9, 2023 11:42 AM
TANK LEAK TEST FAIL ALARMS
TANK PRODUCT LABEL
1 UNLEADED GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED
ANNUAL TEST FAIL ALARM DISABLED
2 PREMIUM GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED
3 DIESEL GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED
4 HACKED GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED
><I63100JAN 9, 2023 11:42 AM
TANK LEAK TEST AVERAGING
TANK PRODUCT LABEL ANNUAL PERIODIC 1 UNLEADED OFF OFF 2 PREMIUM OFF OFF 3 DIESEL OFF OFF 4 HACKED OFF OFF
><I63000JAN 9, 2023 11:42 AM
IN-TANK LEAK TEST NOTIFY
TANK PRODUCT LABEL TANK TEST NOTIFY: 1 UNLEADED OFF 2 PREMIUM OFF 3 DIESEL OFF 4 HACKED OFF
><I63200JAN 9, 2023 11:42 AM
TANK TEST SIPHON BREAK
TANK PRODUCT LABEL SIPHON BREAK 1 UNLEADED OFF 2 PREMIUM OFF 3 DIESEL OFF 4 HACKED OFF
>
<I61000JAN 9, 2023 11:42 AM
TANK DELIVERY DELAY
TANK PRODUCT LABEL 1 UNLEADED 15 2 PREMIUM 15 3 DIESEL 15 4 HACKED 1><I63A00JAN 9, 2023 11:42 AM
LOW LEVEL PUMP THRESHOLD FOR SEQUENTIAL LINE MANIFOLD
TANK PRODUCT LABEL PUMP THRESHOLD 1 UNLEADED 10.00% 2 PREMIUM 10.00% 3 DIESEL 10.00% 4 HACKED 10.00%
><I61100JAN 9, 2023 11:42 AM
LEAK TEST METHOD- - - - - - - - - - - -TEST ANNUALLY: ALL TANKDEC WEEK 2 WEDSTART TIME : 2:30 AMTEST RATE :0.20 GAL/HRDURATION : 2 HOURS
TST EARLY STOP:DISABLED
><I61300JAN 9, 2023 11:42 AMCSLD PROBABLITY OF DETECTION
><I61400JAN 9, 2023 11:42 AMCSLD CLIMATE FACTOR
>
<
I61600JAN 9, 2023 11:42 AM
TANK PRODUCT LABEL CAL UPDATE
1 UNLEADED IMMEDIATE 2 PREMIUM IMMEDIATE
3 DIESEL IMMEDIATE 4 HACKED IMMEDIATE
>
<I61A00
JAN 9, 2023 11:43 AM
IN-TANK LEAK TEST EARLY STOP
TANK PRODUCT LABEL TST EARLY STOP: 1 UNLEADED DISABLED
2 PREMIUM DISABLED 3 DIESEL DISABLED
4 HACKED DISABLED>
<I61B00
JAN 9, 2023 11:43 AM
IN-TANK LEAK GROSS TEST AUTO-CONFIRM
>
<I61C00
JAN 9, 2023 11:43 AM
CSLD REPORT ONLY
>
<I62B00
JAN 9, 2023 11:43 AM
TANK LAST ANNUAL TEST
TANK PRODUCT LABEL DATE 1 UNLEADED ??? 0, 0
2 PREMIUM ??? 0, 0 3 DIESEL ??? 0, 0
4 HACKED ??? 0, 0
><
I63300
JAN 9, 2023 11:43 AM
LEAK TEST REPORT FORMAT: ENHANCED
><I63400JAN 9, 2023 11:43 AM
RECONCILIATION WARNING LIMIT
TANK PRODUCT LABEL GALLONS 1 UNLEADED 0 2 PREMIUM 0 3 DIESEL 0 4 HACKED 0><I63500JAN 9, 2023 11:44 AM
RECONCILIATION ALARM LIMIT
TANK PRODUCT LABEL GALLONS 1 UNLEADED 1 2 PREMIUM 1 3 DIESEL 1 4 HACKED 1><I63900JAN 9, 2023 11:44 AM
ACCU CHART END SHAPE FACTOR
TANK PRODUCT LABEL 1 UNLEADED END FACTOR: NONE
2 PREMIUM END FACTOR: NONE
3 DIESEL END FACTOR: NONE
4 HACKED END FACTOR: NONE
<I70200
JAN 9, 2023 11:45 AM
LIQUID LABEL
DEVICE LABEL
1 87 ANNULAR 2 87 STP
3 87 FILL 4 91-DIESEL ANNULAR
5 91 STP 6 91 FILL
7 DIESEL STP 8 DIESEL FILL
9 DISP 1-2 10 DISP 3-4
11 DISP 5-6 12 DISP 7-8
13 14
15 16
>
<I70300
JAN 9, 2023 11:45 AM
LIQUID TYPE
SENSOR LOCATION TYPE 1 87 ANNULAR TRI-STATE (SINGLE FLOAT)
2 87 STP TRI-STATE (SINGLE FLOAT) 3 87 FILL TRI-STATE (SINGLE FLOAT)
4 91-DIESEL ANNULAR TRI-STATE (SINGLE FLOAT) 5 91 STP TRI-STATE (SINGLE FLOAT)
6 91 FILL TRI-STATE (SINGLE FLOAT) 7 DIESEL STP TRI-STATE (SINGLE FLOAT)
8 DIESEL FILL TRI-STATE (SINGLE FLOAT) 9 DISP 1-2 TRI-STATE (SINGLE FLOAT)
10 DISP 3-4 TRI-STATE (SINGLE FLOAT) 11 DISP 5-6 TRI-STATE (SINGLE FLOAT)
12 DISP 7-8 TRI-STATE (SINGLE FLOAT) 13 TRI-STATE (SINGLE FLOAT)
14 TRI-STATE (SINGLE FLOAT) 15 TRI-STATE (SINGLE FLOAT)
16 TRI-STATE (SINGLE FLOAT)
><
I70400JAN 9, 2023 11:45 AM
LIQUID CATEGORY
SENSOR LOCATION CATEGORY 1 87 ANNULAR ANNULAR SPACE 2 87 STP STP SUMP 3 87 FILL OTHER SENSORS 4 91-DIESEL ANNULAR ANNULAR SPACE 5 91 STP STP SUMP 6 91 FILL OTHER SENSORS 7 DIESEL STP STP SUMP 8 DIESEL FILL OTHER SENSORS 9 DISP 1-2 DISPENSER PAN 10 DISP 3-4 DISPENSER PAN 11 DISP 5-6 DISPENSER PAN 12 DISP 7-8 DISPENSER PAN 13 OTHER SENSORS 14 OTHER SENSORS 15 OTHER SENSORS 16 OTHER SENSORS
><I74200JAN 9, 2023 11:45 AM
><I74300JAN 9, 2023 11:45 AM
><I74400JAN 9, 2023 11:45 AM
><I80700JAN 9, 2023 11:46 AM
RELAY LABEL
DEVICE LABEL 1 87 STP 2 91 STP 3 DIESEL STP 4
><I80900JAN 9, 2023 11:46 AM
RELAY ORIENTATION
RELAY DESIGNATION ORIENTATION
1 87 STP NORMALLY CLOSED
2 91 STP NORMALLY CLOSED 3 DIESEL STP NORMALLY CLOSED
4 NORMALLY OPEN
><
I80B00JAN 9, 2023 11:46 AM
RELAY TANK ASSIGNMENT
RELAY DESIGNATION TANK
1 87 STP 1 2 91 STP 2
3 DIESEL STP 3 4 NONE
>
<I80A00
JAN 9, 2023 11:46 AM
RELAY TYPE
RELAY DESIGNATION TYPE 1 87 STP STANDARD
2 91 STP STANDARD 3 DIESEL STP STANDARD
4 STANDARD
><
I80C00JAN 9, 2023 11:46 AM
>
<I80800
JAN 9, 2023 11:46 AM
RELAY SETUP REPORT
R 1:87 STP TYPE:
STANDARDNORMALLY CLOSED
TANK #: 1
LIQUID SENSOR ALMS L 1:FUEL ALARM
L 2:FUEL ALARM
L 9:FUEL ALARM L10:FUEL ALARM L11:FUEL ALARM L12:FUEL ALARM L 1:SENSOR OUT ALARM L 2:SENSOR OUT ALARM L 9:SENSOR OUT ALARM L10:SENSOR OUT ALARM L11:SENSOR OUT ALARM L12:SENSOR OUT ALARM
ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL
ISD HOSE ALARMS ALL:FLOW COLLECT FAIL
R 2:91 STP TYPE: STANDARDNORMALLY CLOSED
TANK #: 2
LIQUID SENSOR ALMS L 4:FUEL ALARM L 5:FUEL ALARM L 9:FUEL ALARM L10:FUEL ALARM L11:FUEL ALARM L12:FUEL ALARM L 4:SENSOR OUT ALARM L 5:SENSOR OUT ALARM L 9:SENSOR OUT ALARM L10:SENSOR OUT ALARM L11:SENSOR OUT ALARM L12:SENSOR OUT ALARM
ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL
ISD HOSE ALARMS ALL:FLOW COLLECT FAIL
R 3:DIESEL STP TYPE: STANDARD
NORMALLY CLOSED
TANK #: 3
LIQUID SENSOR ALMS L 4:FUEL ALARM
L 7:FUEL ALARM L12:FUEL ALARM
L 4:SENSOR OUT ALARM L 7:SENSOR OUT ALARM
L12:SENSOR OUT ALARM
R 4:
TYPE: STANDARD
NORMALLY OPEN
TANK #: NONE
- NO ALARM ASSIGNMENTS -
>
<I79000
JAN 9, 2023 11:46 AM
EDIM:1 VR:349643-001-B TD:97.10.27.11.25
><
I79100JAN 9, 2023 11:46 AM
>
<I72300
JAN 9, 2023 11:46 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA
BAKERSFIELD CA 93311
SMARTSENSOR ASSIGNMENT
DEVICE LABEL CATEGORY01 DISP 1-2 FM AIR FLOW METER
02 DISP 3-4 FM AIR FLOW METER03 DISP 5-6 FM AIR FLOW METER
04 DISP 7-8 FM AIR FLOW METER
05 PRESS SENSOR VAPOR PRESSURE06 UNKNOWN
<IV4E00JAN 9, 2023 11:46 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
EVR/ISD SETUPTYPE: BALANCE
><IV4F00JAN 9, 2023 11:46 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
NOZZLE A/L RANGEA/L RATIO: 0.95 - 1.15
><IV4000JAN 9, 2023 11:47 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
VAPOR PROCESSOR TYPENONE
><IV4700JAN 9, 2023 11:47 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
ASSESSMENT TIMESTART TIME: 9:00 AMTIME DELAY MINUTES: 1
><
IV5200JAN 9, 2023 11:47 AM
BROOKSIDE MARKET
8803 CAMINO MEDIA BAKERSFIELD CA 93311
ACCEPT HIGH ORVR: NO >
<IV4A00
JAN 9, 2023 11:47 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA
BAKERSFIELD CA 93311
ISD HOSE TABLE
HOSE FP FP AFM REL HOSE
ID ID LABEL ID ID LABEL 01 01 01 01 UU BLEND3
02 02 02 01 UU BLEND3 03 03 03 02 UU BLEND3
04 04 04 02 UU BLEND3 05 05 05 03 UU BLEND3
06 06 06 03 UU BLEND3 07 07 07 04 UU BLEND3
08 08 08 04 UU BLEND3
><
IV4B00JAN 9, 2023 11:47 AM
BROOKSIDE MARKET
8803 CAMINO MEDIA BAKERSFIELD CA 93311
PRODUCT/HOSE MAP TABLE
FP AFID M1/H1 M2/H2 M3/H3 M4/H401 01 02/01 09/01 01/01 xx/xx
02 01 02/02 09/02 01/02 xx/xx03 02 02/03 09/03 01/03 xx/xx
04 02 02/04 09/04 01/04 xx/xx05 03 02/05 09/05 01/05 xx/xx
06 03 02/06 09/06 01/06 xx/xx
07 04 02/07 09/07 01/07 xx/xx08 04 02/08 09/08 01/08 xx/xx
><IV4900JAN 9, 2023 11:47 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
LABEL TABLEID LABEL01 UNASSIGNED02 BLEND3 03 REGULAR 04 MID GRADE 05 PREMIUM 06 GOLD 07 BRONZE 08 SILVER 09 BLEND2 10 BLEND4
><IV1000JAN 9, 2023 11:47 AM
ISD VERSION: 01.06
><I10200JAN 9, 2023 11:47 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
SYSTEM CONFIGURATION
SLOT BOARD TYPE POWER ON RESET CURRENT 1 UNUSED 10340846 10134265 2 UNUSED 10264550 10107036 3 UNUSED 10253776 10103994 4 UNUSED 10256495 10104057 5 4 PROBE / G.T. 164181 163759 6 INTERSTITIAL BD 202863 202079 7 INTERSTITIAL BD 203964 203454 8 8SMARTSENSOR BD 39611 39523
9 UNUSED 10274437 10114393
10 RELAY BOARD 14980 14958 11 UNUSED 10267565 10113848
12 UNUSED 10251061 10102645 13 UNUSED 10247075 10100191
14 UNUSED 10248507 10105624 15 UNUSED 10252618 10101513
16 UNUSED 10257164 10100548 COMM 1 ELEC DISP INT. 101655 101429
COMM 2 SERIAL SAT BD 487411 485560 COMM 3 RS232 SERIAL BD 15042 15042
COMM 4 UNUSED 10258784 10116701 COMM 5 UNUSED 10246203 10103506
COMM 6 UNUSED 10240265 10093016
><
I90200JAN 9, 2023 11:47 AM
SOFTWARE REVISION LEVELVERSION 336.02
SOFTWARE# 346336-100-C CREATED - 21.02.13.11.53
S-MODULE# 330160-004-a
SYSTEM FEATURES: PERIODIC IN-TANK TESTS
ANNUAL IN-TANK TESTS ISD/APM
>
<I11100
JAN 9, 2023 11:47 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA
BAKERSFIELD CA 93311
PRIORITY ALARM HISTORY
ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIMEL12 DISP PAN DISP 7-8 SENSOR OUT ALARM CLEAR 1-09-23 9:33AM
L11 DISP PAN DISP 5-6 SENSOR OUT ALARM CLEAR 1-09-23 9:33AML10 DISP PAN DISP 3-4 SENSOR OUT ALARM CLEAR 1-09-23 9:33AM
L 9 DISP PAN DISP 1-2 SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 8 OTHER DIESEL FILL SENSOR OUT ALARM CLEAR 1-09-23 9:33AM
L 7 STP SUMP DIESEL STP SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 4 ANNULAR 91-DIESEL ANNULAR SENSOR OUT ALARM CLEAR 1-09-23 9:33AM
L 6 OTHER 91 FILL SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 3 OTHER 87 FILL SENSOR OUT ALARM CLEAR 1-09-23 9:33AM
L 5 STP SUMP 91 STP SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 2 STP SUMP 87 STP SENSOR OUT ALARM CLEAR 1-09-23 9:33AM
L 1 ANNULAR 87 ANNULAR SENSOR OUT ALARM CLEAR 1-09-23 9:33AM
L 6 OTHER 91 FILL SENSOR OUT ALARM ALARM 1-09-23 9:32AML 5 STP SUMP 91 STP SENSOR OUT ALARM ALARM 1-09-23 9:32AML 4 ANNULAR 91-DIESEL ANNULAR SENSOR OUT ALARM ALARM 1-09-23 9:32AML 3 OTHER 87 FILL SENSOR OUT ALARM ALARM 1-09-23 9:32AML10 DISP PAN DISP 3-4 SENSOR OUT ALARM ALARM 1-09-23 9:32AML 2 STP SUMP 87 STP SENSOR OUT ALARM ALARM 1-09-23 9:32AML 9 DISP PAN DISP 1-2 SENSOR OUT ALARM ALARM 1-09-23 9:32AML 8 OTHER DIESEL FILL SENSOR OUT ALARM ALARM 1-09-23 9:32AML 1 ANNULAR 87 ANNULAR SENSOR OUT ALARM ALARM 1-09-23 9:32AML12 DISP PAN DISP 7-8 SENSOR OUT ALARM ALARM 1-09-23 9:32AML 7 STP SUMP DIESEL STP SENSOR OUT ALARM ALARM 1-09-23 9:32AML11 DISP PAN DISP 5-6 SENSOR OUT ALARM ALARM 1-09-23 9:32AML 1 ANNULAR 87 ANNULAR FUEL ALARM CLEAR 1-09-23 9:31AML 1 ANNULAR 87 ANNULAR FUEL ALARM ALARM 1-09-23 9:31AML 3 OTHER 87 FILL FUEL ALARM CLEAR 1-09-23 9:31AML 3 OTHER 87 FILL FUEL ALARM ALARM 1-09-23 9:31AML 8 OTHER DIESEL FILL FUEL ALARM CLEAR 1-09-23 9:29AML 8 OTHER DIESEL FILL FUEL ALARM ALARM 1-09-23 9:29AML 6 OTHER 91 FILL FUEL ALARM CLEAR 1-09-23 9:29AML 6 OTHER 91 FILL FUEL ALARM ALARM 1-09-23 9:29AML 4 ANNULAR 91-DIESEL ANNULAR FUEL ALARM CLEAR 1-09-23 9:28AML 4 ANNULAR 91-DIESEL ANNULAR FUEL ALARM ALARM 1-09-23 9:28AML12 DISP PAN DISP 7-8 FUEL ALARM CLEAR 1-09-23 9:25AML12 DISP PAN DISP 7-8 FUEL ALARM ALARM 1-09-23 9:25AML11 DISP PAN DISP 5-6 FUEL ALARM CLEAR 1-09-23 9:24AML11 DISP PAN DISP 5-6 FUEL ALARM ALARM 1-09-23 9:24AML10 DISP PAN DISP 3-4 FUEL ALARM CLEAR 1-09-23 9:23AML10 DISP PAN DISP 3-4 FUEL ALARM ALARM 1-09-23 9:23AML 9 DISP PAN DISP 1-2 FUEL ALARM CLEAR 1-09-23 9:22AML 9 DISP PAN DISP 1-2 FUEL ALARM ALARM 1-09-23 9:22AML 5 STP SUMP 91 STP FUEL ALARM CLEAR 1-09-23 9:21AML 5 STP SUMP 91 STP FUEL ALARM ALARM 1-09-23 9:20AML 7 STP SUMP DIESEL STP FUEL ALARM CLEAR 1-09-23 9:19AML 7 STP SUMP DIESEL STP FUEL ALARM ALARM 1-09-23 9:19AML 2 STP SUMP 87 STP FUEL ALARM CLEAR 1-09-23 9:18AML 2 STP SUMP 87 STP FUEL ALARM ALARM 1-09-23 9:17AML 8 OTHER DIESEL FILL FUEL ALARM CLEAR 1-03-23 9:34AML11 DISP PAN DISP 5-6 FUEL ALARM CLEAR 1-02-23 8:50PM
><I11200JAN 9, 2023 11:47 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
NON-PRIORITY ALARM HISTORYID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIMEh 4 OTHER FP4: BLEND3 FLOW COLLECT WARN CLEAR 10-21-22 12:40PMh 4 OTHER FP4: BLEND3 FLOW COLLECT WARN ALARM 10-21-22 9:03AM OTHER ISD GROSS PRES WARN CLEAR 10-11-22 9:17AM
OTHER ISD GROSS PRES WARN ALARM 10-11-22 9:04AM
SYSTEM PRINTER ERROR CLEAR 9-07-22 5:42PM SYSTEM PAPER OUT CLEAR 9-07-22 5:42PM
SYSTEM PAPER OUT ALARM 9-07-22 5:42PM SYSTEM PRINTER ERROR ALARM 9-07-22 5:42PM
SYSTEM PRINTER ERROR CLEAR 9-07-22 5:22PM SYSTEM PRINTER ERROR ALARM 9-07-22 5:22PM
SYSTEM PRINTER ERROR CLEAR 9-07-22 4:40PM SYSTEM PRINTER ERROR ALARM 9-07-22 4:40PM
SYSTEM PRINTER ERROR CLEAR 8-13-22 3:01PM SYSTEM PRINTER ERROR ALARM 8-13-22 3:01PM
SYSTEM PRINTER ERROR CLEAR 8-13-22 12:11AM SYSTEM PRINTER ERROR ALARM 8-13-22 12:11AM
SYSTEM PRINTER ERROR CLEAR 8-13-22 12:11AM SYSTEM PRINTER ERROR ALARM 8-13-22 12:11AM
OTHER ISD VAPOR LEAK WARN CLEAR 7-28-22 5:00PM OTHER ISD VAPOR LEAK WARN ALARM 7-27-22 9:03AM
OTHER ISD VAPOR LEAK WARN CLEAR 7-12-22 4:19PM OTHER ISD VAPOR LEAK WARN ALARM 7-12-22 9:05AM
OTHER ISD VAPOR LEAK WARN CLEAR 7-05-22 5:18PM OTHER ISD VAPOR LEAK WARN ALARM 7-01-22 9:04AM
h 1 OTHER FP1: BLEND3 FLOW COLLECT WARN CLEAR 5-31-22 6:53PMh 1 OTHER FP1: BLEND3 FLOW COLLECT WARN ALARM 5-31-22 9:04AM
SYSTEM PRINTER ERROR CLEAR 3-14-22 9:29AM SYSTEM PAPER OUT CLEAR 3-14-22 9:29AM
SYSTEM PRINTER ERROR ALARM 3-14-22 9:29AM SYSTEM PAPER OUT ALARM 3-14-22 9:29AM
>
<I20600
JAN 9, 2023 11:47 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA
BAKERSFIELD CA 93311
TANK ALARM HISTORY
TANK 1 UNLEADED
OVERFILL ALARM AUG 5, 2022 5:27 AM JUL 29, 2022 6:31 AM
JUN 16, 2022 7:18 AM
TANK 2 PREMIUM
TANK 3 DIESEL
<I38200
JAN 9, 2023 11:48 AM
><I30200JAN 9, 2023 11:48 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
LIQUID ALARM HISTORY REPORT
SENSOR LOCATION 1 87 ANNULAR JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:31 AM FUEL ALARM MAR 17, 2022 10:13 AM SENSOR OUT ALARM 2 87 STP JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:17 AM FUEL ALARM MAR 17, 2022 10:13 AM SENSOR OUT ALARM 3 87 FILL JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:31 AM FUEL ALARM MAR 17, 2022 10:13 AM SENSOR OUT ALARM 4 91-DIESEL ANNULAR JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:28 AM FUEL ALARM MAR 17, 2022 10:13 AM SENSOR OUT ALARM 5 91 STP JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:20 AM FUEL ALARM MAR 17, 2022 10:13 AM SENSOR OUT ALARM 6 91 FILL JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:29 AM FUEL ALARM MAR 17, 2022 10:13 AM SENSOR OUT ALARM 7 DIESEL STP JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:19 AM FUEL ALARM MAR 17, 2022 10:13 AM SENSOR OUT ALARM 8 DIESEL FILL JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:29 AM FUEL ALARM DEC 31, 2022 10:59 PM FUEL ALARM 9 DISP 1-2 JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:22 AM FUEL ALARM MAR 17, 2022 10:13 AM SENSOR OUT ALARM 10 DISP 3-4 JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:23 AM FUEL ALARM MAR 17, 2022 10:13 AM SENSOR OUT ALARM
11 DISP 5-6 JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:24 AM FUEL ALARM JAN 2, 2023 5:19 PM FUEL ALARM 12 DISP 7-8 JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:25 AM FUEL ALARM MAR 17, 2022 10:13 AM SENSOR OUT ALARM
><I31600JAN 9, 2023 11:48 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
SMART SENSOR ALARM HISTORY REPORT
SENSOR LOCATION 1 DISP 1-2 FM 2 DISP 3-4 FM 3 DISP 5-6 FM 4 DISP 7-8 FM 5 PRESS SENSOR
<IV0100JAN 9, 2023 11:48 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
ISD ALARM STATUS REPORT
EVR TYPE: BALANCEISD TYPE: 01.06VAPOR PROCESSOR TYPE: NONE
OVERALL STATUS :PASS EVR VAPOR COLLECTION :PASS EVR VAPOR CONTAINMENT :PASS ISD MONITOR UP-TIME :100% EVR/ISD PASS TIME :100%
WARNING ALARMSDATE TIME DESCRIPTION READING VALUE22-10-21 09:03:04 FLOW PERFORMANCE HOSE BLOCKAGE FP 4 BLEND3 0.5422-10-11 09:04:48 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.4322-07-28 09:03:29 VAPOR CONTAINMENT LEAKAGE CFH@2 INCHES WC 13.8822-07-27 09:03:38 VAPOR CONTAINMENT LEAKAGE CFH@2 INCHES WC 13.35
22-07-12 09:05:05 VAPOR CONTAINMENT LEAKAGE CFH@2 INCHES WC 12.53
22-07-05 09:04:54 VAPOR CONTAINMENT LEAKAGE CFH@2 INCHES WC 15.8322-07-04 09:05:18 VAPOR CONTAINMENT LEAKAGE CFH@2 INCHES WC 14.76
22-07-03 09:05:18 VAPOR CONTAINMENT LEAKAGE CFH@2 INCHES WC 14.1922-07-02 09:05:10 VAPOR CONTAINMENT LEAKAGE CFH@2 INCHES WC 13.91
22-07-01 09:04:49 VAPOR CONTAINMENT LEAKAGE CFH@2 INCHES WC 13.53
FAILURE ALARMSDATE TIME DESCRIPTION READING VALUE
SHUTDOWN & MISCELLANEOUS EVENTS
DATE TIME DESCRIPTION ACTION/NAME23-01-09 09:33:42 READINESS ISD:PP EVR:NN EVR READINESS PENDING
23-01-09 09:33:42 ISD STARTUP 23-01-09 09:33:29 ISD SHUTDOWN
22-10-30 01:00:00 TIME CHANGE DETECTED AT: 22-10-30 02:00:1322-10-21 12:40:05 COLLECTION TEST HH04 GRADE TEST MANUALLY CLEARED
22-10-12 09:04:39 READINESS ISD:PP EVR:PP ISD & EVR READY22-10-11 11:04:12 READINESS ISD:PP EVR:NN EVR READINESS PENDING
22-10-11 11:04:12 ISD STARTUP 22-10-11 11:04:05 ISD SHUTDOWN
22-10-11 09:17:42 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED
>
<I10200
JAN 9, 2023 11:48 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA
BAKERSFIELD CA 93311
SYSTEM CONFIGURATION
SLOT BOARD TYPE POWER ON RESET CURRENT
1 UNUSED 10340846 10134265 2 UNUSED 10264550 10107036
3 UNUSED 10253776 10103994 4 UNUSED 10256495 10104057
5 4 PROBE / G.T. 164181 163759 6 INTERSTITIAL BD 202863 202079
7 INTERSTITIAL BD 203964 203454 8 8SMARTSENSOR BD 39611 39523
9 UNUSED 10274437 10114393 10 RELAY BOARD 14980 14958
11 UNUSED 10267565 10113848 12 UNUSED 10251061 10102645
13 UNUSED 10247075 10100191 14 UNUSED 10248507 10105624
15 UNUSED 10252618 10101513 16 UNUSED 10257164 10100548
COMM 1 ELEC DISP INT. 101655 101429
COMM 2 SERIAL SAT BD 487411 485560 COMM 3 RS232 SERIAL BD 15042 15042 COMM 4 UNUSED 10258784 10116701 COMM 5 UNUSED 10246203 10103506 COMM 6 UNUSED 10240265 10093016
><I90200JAN 9, 2023 11:48 AMSOFTWARE REVISION LEVELVERSION 336.02SOFTWARE# 346336-100-C CREATED - 21.02.13.11.53
S-MODULE# 330160-004-aSYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM
><I11100JAN 9, 2023 11:49 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
PRIORITY ALARM HISTORYID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIMEL12 DISP PAN DISP 7-8 SENSOR OUT ALARM CLEAR 1-09-23 9:33AML11 DISP PAN DISP 5-6 SENSOR OUT ALARM CLEAR 1-09-23 9:33AML10 DISP PAN DISP 3-4 SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 9 DISP PAN DISP 1-2 SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 8 OTHER DIESEL FILL SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 7 STP SUMP DIESEL STP SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 4 ANNULAR 91-DIESEL ANNULAR SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 6 OTHER 91 FILL SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 3 OTHER 87 FILL SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 5 STP SUMP 91 STP SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 2 STP SUMP 87 STP SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 1 ANNULAR 87 ANNULAR SENSOR OUT ALARM CLEAR 1-09-23 9:33AML 6 OTHER 91 FILL SENSOR OUT ALARM ALARM 1-09-23 9:32AML 5 STP SUMP 91 STP SENSOR OUT ALARM ALARM 1-09-23 9:32AML 4 ANNULAR 91-DIESEL ANNULAR SENSOR OUT ALARM ALARM 1-09-23 9:32AML 3 OTHER 87 FILL SENSOR OUT ALARM ALARM 1-09-23 9:32AML10 DISP PAN DISP 3-4 SENSOR OUT ALARM ALARM 1-09-23 9:32AML 2 STP SUMP 87 STP SENSOR OUT ALARM ALARM 1-09-23 9:32AML 9 DISP PAN DISP 1-2 SENSOR OUT ALARM ALARM 1-09-23 9:32AML 8 OTHER DIESEL FILL SENSOR OUT ALARM ALARM 1-09-23 9:32AML 1 ANNULAR 87 ANNULAR SENSOR OUT ALARM ALARM 1-09-23 9:32AM
L12 DISP PAN DISP 7-8 SENSOR OUT ALARM ALARM 1-09-23 9:32AM
L 7 STP SUMP DIESEL STP SENSOR OUT ALARM ALARM 1-09-23 9:32AML11 DISP PAN DISP 5-6 SENSOR OUT ALARM ALARM 1-09-23 9:32AM
L 1 ANNULAR 87 ANNULAR FUEL ALARM CLEAR 1-09-23 9:31AML 1 ANNULAR 87 ANNULAR FUEL ALARM ALARM 1-09-23 9:31AM
L 3 OTHER 87 FILL FUEL ALARM CLEAR 1-09-23 9:31AML 3 OTHER 87 FILL FUEL ALARM ALARM 1-09-23 9:31AM
L 8 OTHER DIESEL FILL FUEL ALARM CLEAR 1-09-23 9:29AML 8 OTHER DIESEL FILL FUEL ALARM ALARM 1-09-23 9:29AM
L 6 OTHER 91 FILL FUEL ALARM CLEAR 1-09-23 9:29AML 6 OTHER 91 FILL FUEL ALARM ALARM 1-09-23 9:29AM
L 4 ANNULAR 91-DIESEL ANNULAR FUEL ALARM CLEAR 1-09-23 9:28AML 4 ANNULAR 91-DIESEL ANNULAR FUEL ALARM ALARM 1-09-23 9:28AM
L12 DISP PAN DISP 7-8 FUEL ALARM CLEAR 1-09-23 9:25AML12 DISP PAN DISP 7-8 FUEL ALARM ALARM 1-09-23 9:25AM
L11 DISP PAN DISP 5-6 FUEL ALARM CLEAR 1-09-23 9:24AML11 DISP PAN DISP 5-6 FUEL ALARM ALARM 1-09-23 9:24AM
L10 DISP PAN DISP 3-4 FUEL ALARM CLEAR 1-09-23 9:23AML10 DISP PAN DISP 3-4 FUEL ALARM ALARM 1-09-23 9:23AM
L 9 DISP PAN DISP 1-2 FUEL ALARM CLEAR 1-09-23 9:22AML 9 DISP PAN DISP 1-2 FUEL ALARM ALARM 1-09-23 9:22AM
L 5 STP SUMP 91 STP FUEL ALARM CLEAR 1-09-23 9:21AML 5 STP SUMP 91 STP FUEL ALARM ALARM 1-09-23 9:20AM
L 7 STP SUMP DIESEL STP FUEL ALARM CLEAR 1-09-23 9:19AML 7 STP SUMP DIESEL STP FUEL ALARM ALARM 1-09-23 9:19AM
L 2 STP SUMP 87 STP FUEL ALARM CLEAR 1-09-23 9:18AML 2 STP SUMP 87 STP FUEL ALARM ALARM 1-09-23 9:17AM
L 8 OTHER DIESEL FILL FUEL ALARM CLEAR 1-03-23 9:34AML11 DISP PAN DISP 5-6 FUEL ALARM CLEAR 1-02-23 8:50PM
>
<I11200
JAN 9, 2023 11:49 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA
BAKERSFIELD CA 93311
NON-PRIORITY ALARM HISTORY
ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIMEh 4 OTHER FP4: BLEND3 FLOW COLLECT WARN CLEAR 10-21-22 12:40PM
h 4 OTHER FP4: BLEND3 FLOW COLLECT WARN ALARM 10-21-22 9:03AM OTHER ISD GROSS PRES WARN CLEAR 10-11-22 9:17AM
OTHER ISD GROSS PRES WARN ALARM 10-11-22 9:04AM SYSTEM PRINTER ERROR CLEAR 9-07-22 5:42PM
SYSTEM PAPER OUT CLEAR 9-07-22 5:42PM SYSTEM PAPER OUT ALARM 9-07-22 5:42PM
SYSTEM PRINTER ERROR ALARM 9-07-22 5:42PM SYSTEM PRINTER ERROR CLEAR 9-07-22 5:22PM
SYSTEM PRINTER ERROR ALARM 9-07-22 5:22PM SYSTEM PRINTER ERROR CLEAR 9-07-22 4:40PM
SYSTEM PRINTER ERROR ALARM 9-07-22 4:40PM
SYSTEM PRINTER ERROR CLEAR 8-13-22 3:01PM SYSTEM PRINTER ERROR ALARM 8-13-22 3:01PM SYSTEM PRINTER ERROR CLEAR 8-13-22 12:11AM SYSTEM PRINTER ERROR ALARM 8-13-22 12:11AM SYSTEM PRINTER ERROR CLEAR 8-13-22 12:11AM SYSTEM PRINTER ERROR ALARM 8-13-22 12:11AM OTHER ISD VAPOR LEAK WARN CLEAR 7-28-22 5:00PM OTHER ISD VAPOR LEAK WARN ALARM 7-27-22 9:03AM OTHER ISD VAPOR LEAK WARN CLEAR 7-12-22 4:19PM OTHER ISD VAPOR LEAK WARN ALARM 7-12-22 9:05AM OTHER ISD VAPOR LEAK WARN CLEAR 7-05-22 5:18PM OTHER ISD VAPOR LEAK WARN ALARM 7-01-22 9:04AMh 1 OTHER FP1: BLEND3 FLOW COLLECT WARN CLEAR 5-31-22 6:53PMh 1 OTHER FP1: BLEND3 FLOW COLLECT WARN ALARM 5-31-22 9:04AM SYSTEM PRINTER ERROR CLEAR 3-14-22 9:29AM SYSTEM PAPER OUT CLEAR 3-14-22 9:29AM SYSTEM PRINTER ERROR ALARM 3-14-22 9:29AM SYSTEM PAPER OUT ALARM 3-14-22 9:29AM
><I20600JAN 9, 2023 11:49 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
TANK ALARM HISTORY
TANK 1 UNLEADED
OVERFILL ALARM AUG 5, 2022 5:27 AM JUL 29, 2022 6:31 AM JUN 16, 2022 7:18 AM
TANK 2 PREMIUM
TANK 3 DIESEL
<I30200JAN 9, 2023 11:49 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
LIQUID ALARM HISTORY REPORT
SENSOR LOCATION
1 87 ANNULAR
JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:31 AM FUEL ALARM
MAR 17, 2022 10:13 AM SENSOR OUT ALARM 2 87 STP
JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:17 AM FUEL ALARM
MAR 17, 2022 10:13 AM SENSOR OUT ALARM 3 87 FILL
JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:31 AM FUEL ALARM
MAR 17, 2022 10:13 AM SENSOR OUT ALARM 4 91-DIESEL ANNULAR
JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:28 AM FUEL ALARM
MAR 17, 2022 10:13 AM SENSOR OUT ALARM 5 91 STP
JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:20 AM FUEL ALARM
MAR 17, 2022 10:13 AM SENSOR OUT ALARM 6 91 FILL
JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:29 AM FUEL ALARM
MAR 17, 2022 10:13 AM SENSOR OUT ALARM 7 DIESEL STP
JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:19 AM FUEL ALARM
MAR 17, 2022 10:13 AM SENSOR OUT ALARM 8 DIESEL FILL
JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:29 AM FUEL ALARM
DEC 31, 2022 10:59 PM FUEL ALARM 9 DISP 1-2
JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:22 AM FUEL ALARM
MAR 17, 2022 10:13 AM SENSOR OUT ALARM 10 DISP 3-4
JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:23 AM FUEL ALARM
MAR 17, 2022 10:13 AM SENSOR OUT ALARM 11 DISP 5-6
JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:24 AM FUEL ALARM
JAN 2, 2023 5:19 PM FUEL ALARM 12 DISP 7-8
JAN 9, 2023 9:32 AM SENSOR OUT ALARM JAN 9, 2023 9:25 AM FUEL ALARM
MAR 17, 2022 10:13 AM SENSOR OUT ALARM
><
I31600JAN 9, 2023 11:49 AM
BROOKSIDE MARKET 8803 CAMINO MEDIA BAKERSFIELD CA 93311
SMART SENSOR ALARM HISTORY REPORT
SENSOR LOCATION 1 DISP 1-2 FM 2 DISP 3-4 FM 3 DISP 5-6 FM 4 DISP 7-8 FM 5 PRESS SENSOR
Appendix VIII Underground Storage Tank Spill Container Testing Report Form
CERS = California Environmental Reporting System, ID = Identification, ICC = International Code Council Page 1 of 2
TYPE OF ACTION ☐ Installation ☐ Repair ☐ 12 Month
1. FACILITY INFORMATION
CERS ID
Test Date
Facility Name
Facility Address
City
ZIP Code
2. SERVICE TECHNICIAN INFORMATION
Company Performing the Test
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. TEST PROCEDURE INFORMATION
Test Procedures Used Components Tested
5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST
I hereby certify that each spill container was tested in accordance with California Code of
Regulations, title 23, division 3, chapter 16, section 2637.1; that required supporting
documentation is attached; and all information contained herein is accurate. I understand
that test procedures shall be made available upon request by the governing authority.
Service Technician Signature Date
Total # of Pages
Underground Storage Tank Spill Container Testing Report Form
Additional copies of this page may be attached. Page 2 of 2
6. SPILL CONTAINER DETAILS
Test Method Developed by ☐ Manufacturer ☐ Industry Standard ☐ Professional Engineer
Test Type ☐ Pressure ☐ Vacuum ☐ Hydrostatic
Tank ID
Spill Container Manufacturer:
Method of Cathodic Protection ☐ Nonmetallic
☐ Other
☐ Nonmetallic
☐ Other
☐ Nonmetallic
☐ Other
☐ Nonmetallic
☐ Other
Is the spill container minimum capacity five gallons excluding
riser volume?
☐ Yes
☐ No*
☐ Yes
☐ No*
☐ Yes
☐ No*
☐ Yes
☐ No*
Method to keep spill container empty
☐ Drain
☐ Pump
☐ Other
☐ Drain
☐ Pump
☐ Other
☐ Drain
☐ Pump
☐ Other
☐ Drain
☐ Pump
☐ Other
Spill Container Test Results ☐ Pass
☐ Fail
☐ Pass
☐ Fail
☐ Pass
☐ Fail
☐ Pass
☐ Fail
Tank ID
Spill Container Manufacturer:
Method of Cathodic Protection ☐ Nonmetallic
☐ Other
☐ Nonmetallic
☐ Other
☐ Nonmetallic
☐ Other
☐ Nonmetallic
☐ Other
Is the spill container minimum
capacity five gallons excluding
riser volume?
☐ Yes
☐ No*
☐ Yes
☐ No*
☐ Yes
☐ No*
☐ Yes
☐ No*
Method to keep spill container empty
☐ Drain
☐ Pump
☐ Other
☐ Drain
☐ Pump
☐ Other
☐ Drain
☐ Pump
☐ Other
☐ Drain
☐ Pump
☐ Other
Spill Container Test Results ☐ Pass
☐ Fail
☐ Pass
☐ Fail
☐ Pass
☐ Fail
☐ Pass
☐ Fail
1 8. COMMENTS
Describe all answers marked “Other,” “No,” or “Fail” and each proposed remedy.
* Mark here if:
Spill containers do not have a minimum capacity of five gallons and require replacement.
SPILL BUCKET TESTING INFORMATION
Test Method Used:
Test Equipment Used: Equipment Resolution:
Identify Spill Bucket (By Tank Number, Stored Product, etc.) 1 2 3 4
Bucket Installation Type:
Bucket Diameter:
Bucket Depth:
Wait time between applying vacuum/water and start of test:
Test Start Time (TI):
Initial Reading (RI):
Test End Time (TF):
Final Reading (RF):
Test Duration (TF – TI):
Change in Reading (RF - RI):
Pass/Fail Threshold or
Criteria:
Test Result: