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.
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<I20100DEC 18, 2023 8:35 AM
BROOKSIDE MARKET 4700 COFFEE RD BAKERSFIELD CA 93308661-588-1338
IN-TANK INVENTORY
TANK PRODUCT VOLUME TC VOLUME ULLAGE HEIGHT WATER TEMP 1 87 UNLEADED 13180 13184 8387 69.88 0.65 59.45 2 91 PREMIUM 7025 7012 1506 91.77 0.00 62.48 3 DIESEL 8508 8502 11443 53.01 0.00 76.02
><I90500DEC 18, 2023 8:35 AMSOFTWARE REVISION LEVELVERSION 335.00SOFTWARE# 346335-100-A CREATED - 18.08.27.10.22
S-MODULE# 330160-004-aSYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM
><I50201DEC 18, 2023 8:35 AM
SHIFT TIME 1 : 1:00 AM
><I50202DEC 18, 2023 8:35 AM
SHIFT TIME 2 : DISABLED
><I50203DEC 18, 2023 8:35 AM
SHIFT TIME 3 : DISABLED
>
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<I50204DEC 18, 2023 8:35 AM
SHIFT TIME 4 : DISABLED
><I54600DEC 18, 2023 8:35 AM
TANK PER TST NEEDED WRN: DISABLED
><I54900DEC 18, 2023 8:35 AM
TANK ANN TST NEEDED WRN: DISABLED
><I55300DEC 18, 2023 8:35 AM
LINE RE-ENABLE METHODALARM ACKNOWLEDGE
><I55600DEC 18, 2023 8:35 AM
LINE PER TST NEEDED WRN: DISABLED
><I55900DEC 18, 2023 8:35 AM
LINE ANN TST NEEDED WRN: DISABLED
><I51400DEC 18, 2023 8:35 AM
H-PROTOCOL DATA FORMATHEIGHT
><I51A01DEC 18, 2023 8:35 AM
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DAYLIGHT SAVING TIMEENABLED OFF
>
<I51B00
DEC 18, 2023 8:35 AM
DAYLIGHT SAVING TIME
START DATE MAR WEEK 2 SUN 2:00 AM
END DATE NOV WEEK 1 SUN 2:00 AM
><
I51600DEC 18, 2023 8:35 AM
RE-DIRECT LOCAL PRINTOUT
DISABLED
><
I50400DEC 18, 2023 8:35 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
><
I21900DEC 18, 2023 8:35 AM
TANK CHART SECURITY
DISABLED
><
I5BD00DEC 18, 2023 8:35 AM
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CUSTOM ALARM LABELS
DISABLED
><I56000DEC 18, 2023 8:35 AM
MASS/DENSITY
DISABLED
><I88101DEC 18, 2023 8:36 AMPORT SETTINGS:
COMM BOARD : 1 (RS-232) BAUD RATE : 9600 PARITY : ODD STOP BIT : 2 STOP DATA LENGTH: 7 DATARS-232 SECURITYCODE : DISABLED
><I88102DEC 18, 2023 8:36 AMPORT SETTINGS:
COMM BOARD : 2 (S-SAT ) BAUD RATE : 9600 PARITY : NONE STOP BIT : 1 STOP DATA LENGTH: 8 DATARS-232 SECURITYCODE : DISABLED DTR NORMAL STATE: HIGH
><I88103DEC 18, 2023 8:36 AMPORT SETTINGS:
COMM BOARD : 3 (EDIM )RS-232 SECURITYCODE : DISABLED
><
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I60100
DEC 18, 2023 8:36 AM
TANK CONFIGURATION
DEVICE LABEL CONFIGURED 1 87 UNLEADED ON
2 91 PREMIUM ON 3 DIESEL ON
4 OFF
><
I60200DEC 18, 2023 8:36 AM
TANK PRODUCT LABEL
TANK PRODUCT LABEL
1 87 UNLEADED 2 91 PREMIUM
3 DIESEL 4
><
I60300DEC 18, 2023 8:36 AM
TANK PRODUCT CODE
TANK PRODUCT LABEL
1 87 UNLEADED 1 2 91 PREMIUM 2
3 DIESEL 3 4 4
><
I60900DEC 18, 2023 8:36 AM
TANK THERMAL COEFFICIENT
TANK PRODUCT LABEL
1 87 UNLEADED 0.000700 2 91 PREMIUM 0.000700
3 DIESEL 0.000045 4 0.000000
><
I60700DEC 18, 2023 8:36 AM
TANK DIAMETER
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TANK PRODUCT LABEL INCHES 1 87 UNLEADED 120.00 2 91 PREMIUM 120.00 3 DIESEL 120.00 4 0.00><I60A00DEC 18, 2023 8:36 AM
TANK FULL VOLUME
TANK PRODUCT LABEL TANK PROFILE GALLONS
1 87 UNLEADED 4 PTS 21567
2 91 PREMIUM 4 PTS 8531
3 DIESEL 4 PTS 19951
4 1 PT 0
><I60400DEC 18, 2023 8:36 AM
TANK FULL VOLUME
TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 21567 2 91 PREMIUM 8531 3 DIESEL 19951 4 0><I60500DEC 18, 2023 8:36 AM
TANK 4 POINT VOLUMES
TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 21567 17567 10858 4125 2 91 PREMIUM 8531 6888 4294 1692 3 DIESEL 19951 16262 10044 3804 4 0 0 0 0
><I60600DEC 18, 2023 8:36 AM
TANK 20 POINT VOLUMES
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TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 21567 0 0 0
0 17567 0 0 0 0 10858 0
0 0 0 4125 0 0 0 0
2 91 PREMIUM 8531 0 0 0 0 6888 0 0
0 0 4294 0 0 0 0 1692
0 0 0 0 3 DIESEL 19951 0 0 0
0 16262 0 0 0 0 10044 0
0 0 0 3804 0 0 0 0
4 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0
><
I61500DEC 18, 2023 8:36 AM
TANK PRODUCT LABEL METER DATA
1 87 UNLEADED NO 2 91 PREMIUM NO
3 DIESEL NO 4 NO
>
<I62F00
DEC 18, 2023 8:36 AM
MAG PROBE FLOAT SIZE
TANK PRODUCT LABEL FLOAT SIZE: 1 87 UNLEADED 4.0 IN.
2 91 PREMIUM 2.0 IN. 3 DIESEL 4.0 IN.
>
<I62700
DEC 18, 2023 8:36 AM
TANK HIGH WATER WARNING LIMIT
TANK PRODUCT LABEL INCHES
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1 87 UNLEADED 1.5 2 91 PREMIUM 1.5 3 DIESEL 1.5><I64200DEC 18, 2023 8:36 AM
WATER ALARM FILTER
TANK PRODUCT LABEL 1 87 UNLEADED LOW 2 91 PREMIUM LOW 3 DIESEL LOW
><I62400DEC 18, 2023 8:36 AM
TANK HIGH WATER LEVEL LIMIT
TANK PRODUCT LABEL INCHES 1 87 UNLEADED 2.0 2 91 PREMIUM 2.0 3 DIESEL 2.0><I62800DEC 18, 2023 8:36 AM
TANK MAXIMUM VOLUME LIMIT
TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 21567 2 91 PREMIUM 8531 3 DIESEL 19951 4 0><I62300DEC 18, 2023 8:36 AM
TANK OVERFILL LEVEL LIMIT
TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 19410 2 91 PREMIUM 7678 3 DIESEL 17956 4 0><I62200DEC 18, 2023 8:36 AM
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TANK HIGH PRODUCT LIMIT
TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 20489
2 91 PREMIUM 8104 3 DIESEL 18953
4 0>
<I62900
DEC 18, 2023 8:36 AM
TANK DELIVERY REQUIRED LIMIT
TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 2157
2 91 PREMIUM 853 3 DIESEL 1995
4 0>
<I62100
DEC 18, 2023 8:36 AM
TANK LOW PRODUCT LIMIT
TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 1000
2 91 PREMIUM 500 3 DIESEL 1000
4 0>
<I62600
DEC 18, 2023 8:37 AM
TANK LEAK ALARM LIMIT
TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 99
2 91 PREMIUM 99 3 DIESEL 99
4 99>
<I62500
DEC 18, 2023 8:37 AM
TANK SUDDEN LOSS LIMIT
TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 99
2 91 PREMIUM 99
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3 DIESEL 99 4 99><I60800DEC 18, 2023 8:37 AM
TANK TILT
TANK PRODUCT LABEL INCHES 1 87 UNLEADED 0.00 2 91 PREMIUM 0.00 3 DIESEL 0.00 4 0.00><I60B00DEC 18, 2023 8:37 AM
STICK HEIGHT OFFSET ENABLE STATUSDISABLED
><I60C00DEC 18, 2023 8:37 AM
TANK STICK HEIGHT OFFSETTANK PRODUCT LABEL INCHES 1 87 UNLEADED 0.00 2 91 PREMIUM 0.00 3 DIESEL 0.00 4 0.00><I61200DEC 18, 2023 8:37 AM
TANK MANIFOLDED PARTNERS
TANK PRODUCT LABEL SIPHON MANIFOLDED TANKS LINE MANIFOLDED TANKS 1 87 UNLEADED NONE NONE 2 91 PREMIUM NONE NONE 3 DIESEL NONE NONE 4 NONE NONE ><I63600DEC 18, 2023 8:37 AM
PERIODIC LEAK TEST MIN VOLUME
TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 0
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2 91 PREMIUM 0
3 DIESEL 0 4 0
><
I62A00DEC 18, 2023 8:37 AM
ANNUAL LEAK TEST MIN VOLUME
TANK PRODUCT LABEL GALLONS
1 87 UNLEADED 0 2 91 PREMIUM 0
3 DIESEL 0 4 0
><
I62C00DEC 18, 2023 8:37 AM
TANK PERIODIC TEST TYPE
TANK PRODUCT LABEL PERIODIC TEST TYPE
1 87 UNLEADED STANDARD 2 91 PREMIUM STANDARD
3 DIESEL STANDARD 4 STANDARD
>
<I62D00
DEC 18, 2023 8:37 AM
TANK LEAK TEST FAIL ALARMS
TANK PRODUCT LABEL 1 87 UNLEADED GROSS TEST FAIL ALARM DISABLED
PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED
2 91 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 GROSS TEST FAIL ALARM DISABLED
PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED
>
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<I63100DEC 18, 2023 8:37 AM
TANK LEAK TEST AVERAGING
TANK PRODUCT LABEL ANNUAL PERIODIC 1 87 UNLEADED OFF OFF 2 91 PREMIUM OFF OFF 3 DIESEL OFF OFF 4 OFF OFF
><I63000DEC 18, 2023 8:37 AM
IN-TANK LEAK TEST NOTIFY
TANK PRODUCT LABEL TANK TEST NOTIFY: 1 87 UNLEADED OFF 2 91 PREMIUM OFF 3 DIESEL OFF 4 OFF
><I63200DEC 18, 2023 8:37 AM
TANK TEST SIPHON BREAK
TANK PRODUCT LABEL SIPHON BREAK 1 87 UNLEADED OFF 2 91 PREMIUM OFF 3 DIESEL OFF 4 OFF
><I61000DEC 18, 2023 8:37 AM
TANK DELIVERY DELAY
TANK PRODUCT LABEL 1 87 UNLEADED 5 2 91 PREMIUM 5 3 DIESEL 5 4 1><I63A00DEC 18, 2023 8:37 AM
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LOW LEVEL PUMP THRESHOLD FOR SEQUENTIAL LINE MANIFOLD
TANK PRODUCT LABEL PUMP THRESHOLD 1 87 UNLEADED 10.00%
2 91 PREMIUM 10.00% 3 DIESEL 10.00%
4 10.00%
><
I61100DEC 18, 2023 8:37 AM
LEAK TEST METHOD
- - - - - - - - - - - -TEST ON DATE : ALL TANK
AUG 27, 2018START TIME : DISABLED
TEST RATE :0.20 GAL/HRDURATION : 2 HOURS
TST EARLY STOP:DISABLED
>
<I61300
DEC 18, 2023 8:37 AMCSLD PROBABLITY OF DETECTION
><
I61400DEC 18, 2023 8:37 AM
CSLD CLIMATE FACTOR
>
<I61600
DEC 18, 2023 8:37 AM
TANK PRODUCT LABEL CAL UPDATE 1 87 UNLEADED IMMEDIATE
2 91 PREMIUM IMMEDIATE 3 DIESEL IMMEDIATE
4 IMMEDIATE
><
I61A00DEC 18, 2023 8:37 AM
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IN-TANK LEAK TEST EARLY STOP
TANK PRODUCT LABEL TST EARLY STOP: 1 87 UNLEADED DISABLED 2 91 PREMIUM DISABLED 3 DIESEL DISABLED 4 DISABLED><I61B00DEC 18, 2023 8:37 AM
IN-TANK LEAK GROSS TEST AUTO-CONFIRM
><I61C00DEC 18, 2023 8:37 AM
CSLD REPORT ONLY
><I63400DEC 18, 2023 8:38 AM
RECONCILIATION WARNING LIMIT
TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 0 2 91 PREMIUM 0 3 DIESEL 0 4 0><I63500DEC 18, 2023 8:38 AM
RECONCILIATION ALARM LIMIT
TANK PRODUCT LABEL GALLONS 1 87 UNLEADED 1 2 91 PREMIUM 1 3 DIESEL 1 4 1><I78700DEC 18, 2023 8:38 AM
><
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I70200
DEC 18, 2023 8:38 AM
LIQUID LABEL
DEVICE LABEL 1 87 STP
2 87 FILL 3 91 STP
4 91 FILL 5 DIESEL STP
6 DIESEL FILL 7 UNLEADED ANNULAR
8 DIESEL ANNULAR 9 1-2 UDC
10 3-4 UDC 11 5-6 UDC
12 7-8 UDC 13 VENT BOX
14 15
16
><
I70300DEC 18, 2023 8:38 AM
LIQUID TYPE
SENSOR LOCATION TYPE
1 87 STP DW SUMP 2-1 2 87 FILL DW SUMP 2-1
3 91 STP DW SUMP 2-1 4 91 FILL DW SUMP 2-1
5 DIESEL STP DW SUMP 2-1 6 DIESEL FILL DW SUMP 2-1
7 UNLEADED ANNULAR DUAL POINT HYDROSTATIC 8 DIESEL ANNULAR DUAL POINT HYDROSTATIC
9 1-2 UDC DW SUMP 2-1 10 3-4 UDC DW SUMP 2-1
11 5-6 UDC DW SUMP 2-1 12 7-8 UDC DW SUMP 2-1
13 VENT BOX DW SUMP 2-1 14 TRI-STATE (SINGLE FLOAT)
15 TRI-STATE (SINGLE FLOAT) 16 TRI-STATE (SINGLE FLOAT)
>
<I70400
DEC 18, 2023 8:38 AM
LIQUID CATEGORY
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SENSOR LOCATION CATEGORY 1 87 STP STP SUMP 2 87 FILL PIPING SUMP 3 91 STP STP SUMP 4 91 FILL PIPING SUMP 5 DIESEL STP STP SUMP 6 DIESEL FILL PIPING SUMP 7 UNLEADED ANNULAR ANNULAR SPACE 8 DIESEL ANNULAR ANNULAR SPACE 9 1-2 UDC DISPENSER PAN 10 3-4 UDC DISPENSER PAN 11 5-6 UDC DISPENSER PAN 12 7-8 UDC DISPENSER PAN 13 VENT BOX OTHER SENSORS 14 OTHER SENSORS 15 OTHER SENSORS 16 OTHER SENSORS
><I80700DEC 18, 2023 8:38 AM
RELAY LABEL
DEVICE LABEL 1 87 STP 2 91 STP 3 DIESEL STP 4 TEST 5 DISP 1-2 6 DISP 3-4 7 DISP 5-6 8 DISP 7-8 9 10 11 12 OVERFILL
><I80900DEC 18, 2023 8:38 AM
RELAY ORIENTATION
RELAY DESIGNATION ORIENTATION 1 87 STP NORMALLY OPEN 2 91 STP NORMALLY OPEN 3 DIESEL STP NORMALLY OPEN 4 TEST NORMALLY OPEN 5 DISP 1-2 NORMALLY OPEN 6 DISP 3-4 NORMALLY OPEN
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7 DISP 5-6 NORMALLY OPEN 8 DISP 7-8 NORMALLY OPEN 9 NORMALLY OPEN 10 NORMALLY OPEN 11 NORMALLY OPEN 12 OVERFILL NORMALLY OPEN
><I80B00DEC 18, 2023 8:38 AM
RELAY TANK ASSIGNMENT
RELAY DESIGNATION TANK 1 87 STP 1 2 91 STP 2 3 DIESEL STP 3 4 TEST NONE 5 DISP 1-2 NONE 6 DISP 3-4 NONE 7 DISP 5-6 NONE 8 DISP 7-8 NONE 9 NONE 10 NONE 11 NONE 12 OVERFILL NONE
><I80A00DEC 18, 2023 8:38 AM
RELAY TYPE
RELAY DESIGNATION TYPE 1 87 STP PUMP CONTROL OUTPUT 2 91 STP PUMP CONTROL OUTPUT 3 DIESEL STP PUMP CONTROL OUTPUT 4 TEST STANDARD 5 DISP 1-2 STANDARD 6 DISP 3-4 STANDARD 7 DISP 5-6 STANDARD 8 DISP 7-8 STANDARD 9 STANDARD 10 STANDARD 11 STANDARD 12 OVERFILL STANDARD
><I80800DEC 18, 2023 8:38 AM
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RELAY SETUP REPORT
R 1:87 STP
TYPE: PUMP CONTROL OUTPUT
TANK #: 1
IN-TANK ALARMS
T 1:LOW PRODUCT ALARM
LIQUID SENSOR ALMS L 1:FUEL ALARM
L 9:FUEL ALARM L10:FUEL ALARM
L11:FUEL ALARM L12:FUEL ALARM
L 1:SENSOR OUT ALARM L 9:SENSOR OUT ALARM
L10:SENSOR OUT ALARM L11:SENSOR OUT ALARM
L12:SENSOR OUT ALARM L 1:SHORT ALARM
L 9:SHORT ALARM L10:SHORT ALARM
L11:SHORT ALARM L12:SHORT 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:
PUMP CONTROL OUTPUTTANK #: 2
IN-TANK ALARMS T 2:LOW PRODUCT ALARM
LIQUID SENSOR ALMS
L 3:FUEL ALARM L 9:FUEL ALARM
L10:FUEL ALARM L11:FUEL ALARM
L12:FUEL ALARM L 3:SENSOR OUT ALARM
L 9:SENSOR OUT ALARM
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L10:SENSOR OUT ALARM L11:SENSOR OUT ALARM L12:SENSOR OUT ALARM L 3:SHORT ALARM L 9:SHORT ALARM L10:SHORT ALARM L11:SHORT ALARM L12:SHORT 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: PUMP CONTROL OUTPUTTANK #: 3
IN-TANK ALARMS T 3:LOW PRODUCT ALARM
LIQUID SENSOR ALMS L 5:FUEL ALARM L 9:FUEL ALARM L10:FUEL ALARM L11:FUEL ALARM L12:FUEL ALARM L 5:SENSOR OUT ALARM L 9:SENSOR OUT ALARM L10:SENSOR OUT ALARM L11:SENSOR OUT ALARM L12:SENSOR OUT ALARM L 5:SHORT ALARM L 9:SHORT ALARM L10:SHORT ALARM L11:SHORT ALARM L12:SHORT ALARM
R 4:TEST TYPE: STANDARDNORMALLY OPEN
TANK #: NONE
- NO ALARM ASSIGNMENTS -
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R 5:DISP 1-2
TYPE: STANDARD
NORMALLY OPEN
TANK #: NONE
- NO ALARM ASSIGNMENTS -
R 6:DISP 3-4 TYPE:
STANDARDNORMALLY OPEN
TANK #: NONE
- NO ALARM ASSIGNMENTS -
R 7:DISP 5-6
TYPE: STANDARD
NORMALLY OPEN
TANK #: NONE
- NO ALARM ASSIGNMENTS -
R 8:DISP 7-8 TYPE:
STANDARDNORMALLY OPEN
TANK #: NONE
- NO ALARM ASSIGNMENTS -
R 9:
TYPE: STANDARD
NORMALLY OPEN
TANK #: NONE
- NO ALARM ASSIGNMENTS -
R10: TYPE:
STANDARDNORMALLY OPEN
TANK #: NONE
- NO ALARM ASSIGNMENTS -
file:///C/Users/jerryr.JEFFRIESBROS/Desktop/12-18-23%20Riverlakes%20-%20Monitor/Riverlakes%20setup.txt[12/22/2023 10:12:53 AM]
R11: TYPE: STANDARDNORMALLY OPEN
TANK #: NONE
- NO ALARM ASSIGNMENTS -
R12:OVERFILL TYPE: STANDARDNORMALLY OPEN
TANK #: NONE
IN-TANK ALARMS ALL:OVERFILL ALARM ALL:HIGH PRODUCT ALARM
><I79000DEC 18, 2023 8:39 AM
EDIM:1 VR:349643-001-B TD:97.10.27.11.25
><IV4F00DEC 18, 2023 8:39 AM
BROOKSIDE MARKET 4700 COFFEE RD BAKERSFIELD CA 93308661-588-1338
NOZZLE A/L RANGEA/L RATIO: 0.95 - 1.15
><IV4000DEC 18, 2023 8:39 AM
BROOKSIDE MARKET 4700 COFFEE RD BAKERSFIELD CA 93308661-588-1338
VAPOR PROCESSOR TYPE
file:///C/Users/jerryr.JEFFRIESBROS/Desktop/12-18-23%20Riverlakes%20-%20Monitor/Riverlakes%20setup.txt[12/22/2023 10:12:53 AM]
NONE
>
<IV4700
DEC 18, 2023 8:39 AM
BROOKSIDE MARKET 4700 COFFEE RD
BAKERSFIELD CA 93308661-588-1338
ASSESSMENT TIME
START TIME: 9:00 AMTIME DELAY MINUTES: 1
>
<IV5200
DEC 18, 2023 8:39 AM
BROOKSIDE MARKET 4700 COFFEE RD
BAKERSFIELD CA 93308661-588-1338
ACCEPT HIGH ORVR: YES
><
IV4A00DEC 18, 2023 8:39 AM
BROOKSIDE MARKET
4700 COFFEE RD BAKERSFIELD CA 93308
661-588-1338
ISD HOSE TABLE
HOSE FP FP AFM REL HOSE ID ID LABEL ID ID LABEL
01 01 01 01 02 BLEND3 02 02 02 01 02 BLEND3
03 03 03 02 02 BLEND3 04 04 04 02 02 BLEND3
05 05 05 03 02 BLEND3 06 06 06 03 02 BLEND3
07 07 07 04 02 BLEND3 08 08 08 04 02 BLEND3
>
<IV4B00
DEC 18, 2023 8:39 AM
file:///C/Users/jerryr.JEFFRIESBROS/Desktop/12-18-23%20Riverlakes%20-%20Monitor/Riverlakes%20setup.txt[12/22/2023 10:12:53 AM]
BROOKSIDE MARKET 4700 COFFEE RD BAKERSFIELD CA 93308661-588-1338
PRODUCT/HOSE MAP TABLE
FP AFID M1/H1 M2/H2 M3/H3 M4/H401 01 xx/xx 02/01 01/01 xx/xx02 01 02/02 xx/xx 09/02 01/0203 02 02/03 09/03 01/03 xx/xx04 02 02/04 01/04 09/04 xx/xx05 03 02/05 01/05 09/05 xx/xx06 03 02/06 09/06 01/06 xx/xx07 04 02/07 01/07 09/07 xx/xx08 04 02/08 01/08 xx/xx 09/08
><IV4900DEC 18, 2023 8:39 AM
BROOKSIDE MARKET 4700 COFFEE RD BAKERSFIELD CA 93308661-588-1338
LABEL TABLEID LABEL01 UNASSIGNED02 BLEND3 03 REGULAR 04 MID GRADE 05 PREMIUM 06 GOLD 07 BRONZE 08 SILVER 09 BLEND2 10 BLEND4
><IV1000DEC 18, 2023 8:39 AM
ISD VERSION: 01.05
><I90200DEC 18, 2023 8:39 AMSOFTWARE REVISION LEVELVERSION 335.00
file:///C/Users/jerryr.JEFFRIESBROS/Desktop/12-18-23%20Riverlakes%20-%20Monitor/Riverlakes%20setup.txt[12/22/2023 10:12:53 AM]
SOFTWARE# 346335-100-A CREATED - 18.08.27.10.22
S-MODULE# 330160-004-aSYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM
><I11100DEC 18, 2023 8:40 AM
BROOKSIDE MARKET 4700 COFFEE RD BAKERSFIELD CA 93308661-588-1338
PRIORITY ALARM HISTORYID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIMEE 1 OTHER COMMUNICATION ALARM CLEAR 12-18-23 2:11AME 1 OTHER COMMUNICATION ALARM ALARM 12-18-23 2:10AMs 6 OTHER DIESEL PRODUCT NO VACUUM ALARM CLEAR 12-12-23 8:19AMs 6 OTHER DIESEL PRODUCT NO VACUUM ALARM ALARM 12-12-23 8:19AMs 6 OTHER DIESEL PRODUCT NO VACUUM ALARM CLEAR 12-12-23 8:19AMs 6 OTHER DIESEL PRODUCT NO VACUUM ALARM ALARM 12-12-23 8:18AMs 6 OTHER DIESEL PRODUCT HIGH LIQUID ALARM CLEAR 12-12-23 8:18AMs 6 OTHER DIESEL PRODUCT HIGH LIQUID ALARM ALARM 12-11-23 5:49AME 1 OTHER COMMUNICATION ALARM CLEAR 12-11-23 2:11AME 1 OTHER COMMUNICATION ALARM ALARM 12-11-23 2:10AME 1 OTHER COMMUNICATION ALARM CLEAR 12-04-23 2:12AME 1 OTHER COMMUNICATION ALARM ALARM 12-04-23 2:11AML 5 STP SUMP DIESEL STP SENSOR OUT ALARM CLEAR 12-01-23 3:00PML 5 STP SUMP DIESEL STP LOW LIQUID ALARM CLEAR 12-01-23 2:55PML 5 STP SUMP DIESEL STP SENSOR OUT ALARM ALARM 12-01-23 2:55PML 5 STP SUMP DIESEL STP LOW LIQUID ALARM ALARM 12-01-23 2:36PMs 6 OTHER DIESEL PRODUCT NO VACUUM ALARM CLEAR 11-30-23 3:17PML 5 STP SUMP DIESEL STP LOW LIQUID ALARM CLEAR 11-30-23 1:07PML 5 STP SUMP DIESEL STP LOW LIQUID ALARM ALARM 11-30-23 1:07PML 5 STP SUMP DIESEL STP LOW LIQUID ALARM CLEAR 11-30-23 1:06PML 5 STP SUMP DIESEL STP LOW LIQUID ALARM ALARM 11-30-23 1:06PML 5 STP SUMP DIESEL STP LOW LIQUID ALARM CLEAR 11-30-23 1:06PML 5 STP SUMP DIESEL STP LOW LIQUID ALARM ALARM 11-30-23 1:06PML 5 STP SUMP DIESEL STP SENSOR OUT ALARM CLEAR 11-30-23 1:00PML 5 STP SUMP DIESEL STP SENSOR OUT ALARM ALARM 11-30-23 12:47PMs 6 OTHER DIESEL PRODUCT NO VACUUM ALARM ALARM 11-30-23 10:54AMs 6 OTHER DIESEL PRODUCT HIGH LIQUID ALARM CLEAR 11-30-23 10:49AMs 6 OTHER DIESEL PRODUCT HIGH LIQUID ALARM ALARM 11-30-23 10:48AML 5 STP SUMP DIESEL STP LOW LIQUID ALARM CLEAR 11-30-23 10:18AML 5 STP SUMP DIESEL STP LOW LIQUID ALARM ALARM 11-30-23 10:17AMs 6 OTHER DIESEL PRODUCT HIGH LIQUID ALARM CLEAR 11-30-23 9:34AML 5 STP SUMP DIESEL STP FUEL ALARM CLEAR 11-30-23 9:34AML 5 STP SUMP DIESEL STP FUEL ALARM ALARM 11-30-23 9:33AM
file:///C/Users/jerryr.JEFFRIESBROS/Desktop/12-18-23%20Riverlakes%20-%20Monitor/Riverlakes%20setup.txt[12/22/2023 10:12:53 AM]
s 6 OTHER DIESEL PRODUCT HIGH LIQUID ALARM ALARM 11-30-23 9:33AM
s 6 OTHER DIESEL PRODUCT NO VACUUM ALARM CLEAR 11-30-23 9:33AML11 DISP PAN 5-6 UDC LOW LIQUID ALARM CLEAR 11-28-23 3:31PM
L11 DISP PAN 5-6 UDC LOW LIQUID ALARM ALARM 11-27-23 10:26PML11 DISP PAN 5-6 UDC LOW LIQUID ALARM CLEAR 11-27-23 3:40PM
E 1 OTHER COMMUNICATION ALARM CLEAR 11-27-23 2:12AME 1 OTHER COMMUNICATION ALARM ALARM 11-27-23 2:11AM
L11 DISP PAN 5-6 UDC LOW LIQUID ALARM ALARM 11-26-23 11:54PML11 DISP PAN 5-6 UDC LOW LIQUID ALARM CLEAR 11-26-23 2:13PM
L11 DISP PAN 5-6 UDC LOW LIQUID ALARM ALARM 11-26-23 3:59AML11 DISP PAN 5-6 UDC LOW LIQUID ALARM CLEAR 11-25-23 11:48AM
L11 DISP PAN 5-6 UDC LOW LIQUID ALARM ALARM 11-25-23 6:18AME 1 OTHER COMMUNICATION ALARM CLEAR 11-20-23 2:12AM
E 1 OTHER COMMUNICATION ALARM ALARM 11-20-23 2:10AMs 6 OTHER DIESEL PRODUCT HIGH LIQUID ALARM CLEAR 11-14-23 9:17AM
s 6 OTHER DIESEL PRODUCT NO VACUUM ALARM ALARM 11-14-23 9:17AMs 6 OTHER DIESEL PRODUCT HIGH LIQUID ALARM ALARM 11-13-23 3:45PM
>
<I11200
DEC 18, 2023 8:40 AM
BROOKSIDE MARKET 4700 COFFEE RD
BAKERSFIELD CA 93308661-588-1338
NON-PRIORITY ALARM HISTORY
ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME SYSTEM PRINTER ERROR CLEAR 12-01-23 8:29AM
SYSTEM PRINTER ERROR ALARM 12-01-23 8:29AM SYSTEM PRINTER ERROR CLEAR 11-22-23 8:37AM
SYSTEM PAPER OUT CLEAR 11-22-23 8:37AM SYSTEM PAPER OUT ALARM 11-22-23 4:52AM
SYSTEM PRINTER ERROR ALARM 11-22-23 4:51AM SYSTEM PRINTER ERROR CLEAR 11-22-23 4:51AM
SYSTEM PRINTER ERROR ALARM 11-22-23 4:51AMh 1 OTHER FP1: BLEND3 FLOW COLLECT WARN CLEAR 10-28-23 9:00AM
h 1 OTHER FP1: BLEND3 FLOW COLLECT WARN ALARM 10-27-23 9:02AM OTHER ISD GROSS PRES WARN CLEAR 10-26-23 9:00AM
OTHER ISD GROSS PRES WARN ALARM 10-24-23 9:02AM OTHER ISD GROSS PRES WARN CLEAR 10-17-23 1:58PM
OTHER ISD GROSS PRES WARN ALARM 10-17-23 9:01AM SYSTEM PRINTER ERROR CLEAR 10-11-23 9:16AM
SYSTEM PRINTER ERROR ALARM 10-11-23 9:16AM OTHER ISD GROSS PRES WARN CLEAR 10-09-23 11:39AM
SYSTEM PRINTER ERROR CLEAR 10-09-23 9:04AM SYSTEM PRINTER ERROR ALARM 10-09-23 9:04AM
OTHER ISD GROSS PRES WARN ALARM 10-09-23 9:01AMh 1 OTHER FP1: BLEND3 FLOW COLLECT WARN CLEAR 10-06-23 4:00PM
h 1 OTHER FP1: BLEND3 FLOW COLLECT WARN ALARM 10-06-23 9:01AM SYSTEM PRINTER ERROR CLEAR 9-27-23 11:23AM
SYSTEM PAPER OUT CLEAR 9-27-23 11:23AM
file:///C/Users/jerryr.JEFFRIESBROS/Desktop/12-18-23%20Riverlakes%20-%20Monitor/Riverlakes%20setup.txt[12/22/2023 10:12:53 AM]
SYSTEM PAPER OUT ALARM 9-27-23 11:23AM SYSTEM PRINTER ERROR ALARM 9-27-23 11:22AM SYSTEM PRINTER ERROR CLEAR 9-27-23 11:22AM SYSTEM PAPER OUT CLEAR 9-27-23 11:22AM SYSTEM PRINTER ERROR ALARM 9-27-23 11:06AM SYSTEM PAPER OUT ALARM 9-27-23 11:06AMT 3 TANK DIESEL DELIVERY NEEDED CLEAR 9-05-23 9:21PMT 3 TANK DIESEL DELIVERY NEEDED ALARM 9-05-23 1:10PMT 3 TANK DIESEL DELIVERY NEEDED CLEAR 7-26-23 5:29PMT 3 TANK DIESEL DELIVERY NEEDED ALARM 7-26-23 4:35AMh 4 OTHER FP4: BLEND3 FLOW COLLECT WARN CLEAR 7-24-23 9:00AMh 4 OTHER FP4: BLEND3 FLOW COLLECT WARN ALARM 7-23-23 9:04AMh 4 OTHER FP4: BLEND3 FLOW COLLECT WARN CLEAR 6-15-23 9:27AMh 4 OTHER FP4: BLEND3 FLOW COLLECT WARN ALARM 6-15-23 9:04AM SYSTEM PRINTER ERROR CLEAR 5-23-23 12:39PM SYSTEM PAPER OUT CLEAR 5-23-23 12:39PM SYSTEM PAPER OUT ALARM 5-23-23 12:38PM SYSTEM PRINTER ERROR ALARM 5-23-23 12:38PMh 4 OTHER FP4: BLEND3 FLOW COLLECT WARN CLEAR 5-01-23 8:59AMh 4 OTHER FP4: BLEND3 FLOW COLLECT WARN ALARM 4-30-23 9:05AMT 3 TANK DIESEL DELIVERY NEEDED CLEAR 4-04-23 1:04PMh 4 OTHER FP4: BLEND3 FLOW COLLECT WARN CLEAR 4-03-23 8:36AMT 3 TANK DIESEL DELIVERY NEEDED ALARM 4-03-23 7:39AMh 4 OTHER FP4: BLEND3 FLOW COLLECT WARN ALARM 4-02-23 9:02AM SYSTEM PRINTER ERROR CLEAR 12-27-22 8:21AM SYSTEM PRINTER ERROR ALARM 12-27-22 8:21AM
><I20600DEC 18, 2023 8:40 AM
BROOKSIDE MARKET 4700 COFFEE RD BAKERSFIELD CA 93308661-588-1338
TANK ALARM HISTORY
TANK 1 87 UNLEADED
SETUP DATA WARNING OCT 9, 2019 2:20 PM
HIGH WATER ALARM OCT 10, 2019 7:39 AM
OVERFILL ALARM NOV 17, 2020 11:29 AM OCT 10, 2019 11:45 AM
LOW PRODUCT ALARM DEC 6, 2021 10:40 AM OCT 10, 2019 7:35 AM OCT 9, 2019 2:18 PM
HIGH PRODUCT ALARM NOV 17, 2022 11:42 AM
file:///C/Users/jerryr.JEFFRIESBROS/Desktop/12-18-23%20Riverlakes%20-%20Monitor/Riverlakes%20setup.txt[12/22/2023 10:12:53 AM]
DEC 6, 2021 10:47 AM
NOV 17, 2020 11:29 AM
PROBE OUT NOV 17, 2022 11:48 AM NOV 17, 2022 11:25 AM
DEC 6, 2021 10:49 AM
HIGH WATER WARNING OCT 10, 2019 7:39 AM
DELIVERY NEEDED DEC 6, 2021 10:40 AM OCT 10, 2019 7:35 AM
OCT 9, 2019 2:18 PM
MAX PRODUCT ALARM DEC 6, 2021 10:47 AM NOV 17, 2020 11:30 AM
LOW TEMP WARNING NOV 17, 2022 11:49 AM
DEC 6, 2021 10:50 AM NOV 17, 2020 11:58 AM
TANK 2 91 PREMIUM
SETUP DATA WARNING OCT 9, 2019 2:20 PM
HIGH WATER ALARM NOV 17, 2020 11:52 AM
OCT 9, 2019 3:09 PM OCT 9, 2019 2:24 PM
OVERFILL ALARM SEP 3, 2023 12:16 PM
NOV 17, 2022 11:29 AM AUG 18, 2021 9:23 AM
LOW PRODUCT ALARM NOV 17, 2020 11:22 AM
OCT 9, 2019 2:40 PM
SUDDEN LOSS ALARM NOV 17, 2020 11:23 AM
HIGH PRODUCT ALARM DEC 6, 2021 10:45 AM NOV 17, 2020 11:49 AM
OCT 9, 2019 2:18 PM
PROBE OUT NOV 17, 2022 11:46 AM NOV 17, 2022 11:24 AM
DEC 6, 2021 10:50 AM
HIGH WATER WARNING NOV 17, 2020 11:52 AM OCT 9, 2019 3:09 PM
OCT 9, 2019 2:24 PM
DELIVERY NEEDED NOV 17, 2020 11:22 AM OCT 9, 2019 2:40 PM
MAX PRODUCT ALARM NOV 17, 2020 11:49 AM
OCT 9, 2019 2:18 PM
file:///C/Users/jerryr.JEFFRIESBROS/Desktop/12-18-23%20Riverlakes%20-%20Monitor/Riverlakes%20setup.txt[12/22/2023 10:12:53 AM]
LOW TEMP WARNING NOV 17, 2020 12:12 PM
TANK 3 DIESEL
SETUP DATA WARNING AUG 27, 2018 8:19 AM
HIGH WATER ALARM OCT 10, 2019 8:36 AM OCT 10, 2019 7:37 AM
OVERFILL ALARM NOV 17, 2020 11:27 AM OCT 10, 2019 11:41 AM OCT 10, 2019 8:33 AM
LOW PRODUCT ALARM APR 4, 2023 10:01 AM APR 3, 2023 11:47 PM NOV 17, 2022 11:25 AM
HIGH PRODUCT ALARM NOV 17, 2022 11:46 AM DEC 6, 2021 10:48 AM OCT 10, 2019 11:41 AM
INVALID FUEL LEVEL NOV 17, 2022 11:25 AM AUG 27, 2018 8:05 AM
PROBE OUT NOV 17, 2022 11:49 AM NOV 17, 2022 11:26 AM DEC 6, 2021 10:49 AM
HIGH WATER WARNING NOV 17, 2022 11:49 AM OCT 10, 2019 7:56 AM OCT 10, 2019 7:37 AM
DELIVERY NEEDED SEP 5, 2023 1:10 PM JUL 26, 2023 4:35 AM APR 3, 2023 7:39 AM
LOW TEMP WARNING OCT 10, 2019 12:21 PM
TANK 5
TANK 6
TANK 7
TANK 8
TANK 9
TANK 10
TANK 11
TANK 12
file:///C/Users/jerryr.JEFFRIESBROS/Desktop/12-18-23%20Riverlakes%20-%20Monitor/Riverlakes%20setup.txt[12/22/2023 10:12:53 AM]
TANK 13
TANK 14
TANK 15
TANK 16
><
I38200DEC 18, 2023 8:40 AM
>
<I30200
DEC 18, 2023 8:40 AM
BROOKSIDE MARKET 4700 COFFEE RD
BAKERSFIELD CA 93308661-588-1338
LIQUID ALARM HISTORY REPORT
SENSOR LOCATION
1 87 STP NOV 17, 2022 11:58 AM SENSOR OUT ALARM
NOV 17, 2022 10:48 AM FUEL ALARM NOV 17, 2022 10:38 AM LOW LIQUID ALARM
2 87 FILL MAR 15, 2023 4:55 AM FUEL ALARM
MAR 1, 2023 5:26 AM FUEL ALARM JAN 15, 2023 6:55 PM FUEL ALARM
3 91 STP NOV 17, 2022 11:58 AM SENSOR OUT ALARM
NOV 17, 2022 10:50 AM FUEL ALARM NOV 17, 2022 10:39 AM LOW LIQUID ALARM
4 91 FILL NOV 17, 2022 11:58 AM SENSOR OUT ALARM
NOV 17, 2022 10:51 AM FUEL ALARM NOV 17, 2022 10:40 AM LOW LIQUID ALARM
5 DIESEL STP DEC 1, 2023 2:55 PM SENSOR OUT ALARM
DEC 1, 2023 2:36 PM LOW LIQUID ALARM NOV 30, 2023 1:07 PM LOW LIQUID ALARM
6 DIESEL FILL NOV 17, 2022 11:58 AM SENSOR OUT ALARM
NOV 17, 2022 10:53 AM FUEL ALARM NOV 17, 2022 10:41 AM LOW LIQUID ALARM
7 UNLEADED ANNULAR NOV 17, 2022 11:58 AM SENSOR OUT ALARM
file:///C/Users/jerryr.JEFFRIESBROS/Desktop/12-18-23%20Riverlakes%20-%20Monitor/Riverlakes%20setup.txt[12/22/2023 10:12:53 AM]
NOV 17, 2022 10:42 AM HIGH LIQUID ALARM NOV 17, 2022 10:41 AM LOW LIQUID ALARM 8 DIESEL ANNULAR NOV 17, 2022 11:58 AM SENSOR OUT ALARM NOV 17, 2022 10:43 AM LOW LIQUID ALARM NOV 17, 2022 10:42 AM HIGH LIQUID ALARM 9 1-2 UDC NOV 17, 2022 11:58 AM SENSOR OUT ALARM NOV 17, 2022 10:55 AM FUEL ALARM NOV 17, 2022 10:43 AM LOW LIQUID ALARM 10 3-4 UDC NOV 17, 2022 11:58 AM SENSOR OUT ALARM NOV 17, 2022 10:57 AM FUEL ALARM NOV 17, 2022 10:44 AM LOW LIQUID ALARM 11 5-6 UDC NOV 27, 2023 10:26 PM LOW LIQUID ALARM NOV 26, 2023 11:54 PM LOW LIQUID ALARM NOV 26, 2023 3:59 AM LOW LIQUID ALARM 12 7-8 UDC OCT 18, 2023 2:08 PM FUEL ALARM OCT 18, 2023 2:08 PM LOW LIQUID ALARM OCT 18, 2023 2:07 PM FUEL ALARM 13 VENT BOX NOV 17, 2022 11:58 AM SENSOR OUT ALARM NOV 17, 2022 11:01 AM FUEL ALARM NOV 17, 2022 10:45 AM LOW LIQUID ALARM
><I31600DEC 18, 2023 8:40 AM
BROOKSIDE MARKET 4700 COFFEE RD BAKERSFIELD CA 93308661-588-1338
SMART SENSOR ALARM HISTORY REPORT
SENSOR LOCATION 1 87 PRODUCT NOV 17, 2022 11:13 AM HIGH LIQUID ALARM NOV 17, 2022 11:13 AM NO VACUUM ALARM DEC 6, 2021 10:08 AM HIGH LIQUID ALARM 3 VAPOR RETURN NOV 17, 2022 11:15 AM HIGH LIQUID ALARM NOV 17, 2022 11:15 AM NO VACUUM ALARM DEC 6, 2021 10:08 AM HIGH LIQUID ALARM 4 91 PRODUCT APR 11, 2023 3:37 PM NO VACUUM ALARM APR 11, 2023 3:25 PM COMMUNICATION ALARM MAR 22, 2023 9:46 PM NO VACUUM ALARM 5 ALL VENTS JUL 27, 2023 1:07 AM SENSOR FAULT ALARM
file:///C/Users/jerryr.JEFFRIESBROS/Desktop/12-18-23%20Riverlakes%20-%20Monitor/Riverlakes%20setup.txt[12/22/2023 10:12:53 AM]
APR 25, 2023 12:02 AM NO VACUUM ALARM
APR 24, 2023 1:33 PM SENSOR FAULT ALARM 6 DIESEL PRODUCT
DEC 12, 2023 8:19 AM NO VACUUM ALARM DEC 12, 2023 8:18 AM NO VACUUM ALARM
DEC 11, 2023 5:49 AM HIGH LIQUID ALARM 8 ATM
9 1-2 FLOWMETER AUG 27, 2018 9:34 AM COMMUNICATION ALARM
10 3-4 FLOWMETER AUG 27, 2018 9:34 AM COMMUNICATION ALARM
11 5-6 FLOWMETER AUG 27, 2018 9:34 AM COMMUNICATION ALARM
12 7-8 FLOWMETER OCT 18, 2023 2:13 PM COMMUNICATION ALARM
AUG 27, 2018 9:34 AM COMMUNICATION ALARM 16 PRESSURE SENSOR
AUG 27, 2018 9:34 AM COMMUNICATION ALARM
><
I10200DEC 18, 2023 8:40 AM
BROOKSIDE MARKET
4700 COFFEE RD BAKERSFIELD CA 93308
661-588-1338
SYSTEM CONFIGURATION
SLOT BOARD TYPE POWER ON RESET CURRENT 1 UNUSED 4952047 4946610
2 UNUSED 4939418 4934295 3 4 PROBE / G.T. 165562 165562
4 INTERSTITIAL BD 204254 204137 5 INTERSTITIAL BD 204109 203967
6 7SMARTSENSOR BD 516304 515813 7 8SMARTSENSOR BD 39981 39952
8 UNUSED 4932980 4942221 9 RELAY BOARD 15141 15135
10 RELAY BOARD 15141 15135 11 RELAY BOARD 15163 15157
12 STP SENSE BOARD 33612 33609 13 UNUSED 4942637 4942908
14 UNUSED 4938220 4939750 15 UNUSED 4936444 4940243
16 UNUSED 4938753 4936235 COMM 1 RS232 SERIAL BD 15186 15157
COMM 2 SERIAL SAT BD 488306 488157 COMM 3 ELEC DISP INT. 102294 102249
COMM 4 UNUSED 4940528 4939818 COMM 5 UNUSED 84872 4939124
COMM 6 RS232 SERIAL BD 15208 15202
file:///C/Users/jerryr.JEFFRIESBROS/Desktop/12-18-23%20Riverlakes%20-%20Monitor/Riverlakes%20setup.txt[12/22/2023 10:12:53 AM]
><I90200DEC 18, 2023 8:41 AMSOFTWARE REVISION LEVELVERSION 335.00SOFTWARE# 346335-100-A CREATED - 18.08.27.10.22
S-MODULE# 330160-004-aSYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM
>
UDC-1UDC-2
UDC-3UDC-4123456
78Diesel91 Premium87 Unleaded22,000 GALLONSUST-18,000 GALLONSUST-220,000 GALLONSUST-3TS-3TS-1TS-2FS-1FS-2FS-3AAVVVVDISPENSER UDC 1-2536 SENSORDISPENSER UDC 3-4536 SENSORDISPENSER UDC 5-6536 SENSORDISPENSER UDC 7-8536 SENSOR87 TURBINE SUMP536 SENSOR480 SENSOR99LD LINE LEAK DETECTORVACUUM SENSOR KIT #11-2-3-4-5-6-7-8 PRODUCT LINEDIESEL TURBINE SUMP536 SENSOR480 SENSOR99LD LINE LEAK DETECTORVACUUM SENSOR KIT #31-2-7-8 PRODUCT LINE91 TURBINE SUMP536 SENSOR480 SENSOR99LD LINE LEAK DETECTORVACUUM SENSOR KIT #21-2-3-4-5-6-7-8 PRODUCT LINE87 FILL SUMP536 SENSORDIESEL FILL SUMP536 SENSORPREMIUM FILL SUMP536 SENSORDIESEL ANNULAR303 SENSOR8791 ANNULAR303 SENSORHEALY CLEAN AIR SEPERATORVENTSUMPTRANSITION SUMP536 SENSORZONE # 1-87 REGULARZONE#4- 91 PREMIUMZONE #2- 87 VAPOR LINEZONE #3- 87 VENT LINEZONE #7- DIESEL VENT LINEZONE #5-91 VENT LINESLOPE 18" PER FOOT MIN. TO TANKSSTOREELECTRICAL TIE INFIRE HYDRANTE STOPTLSHAGEMAN RDCOFFEE RD30K SPLIT TANKLEGENDVACUUM SENSOR KIT # 1- 87 TURBINEZONE 187BRUGGPRODUCTZONE 287VAPOR LINEZONE 387VENT LINEVACUUM SENSOR KIT # 2- 91 TURBINEZONE 491BRUGGPRODUCTZONE 591VENT LINEVACUUM SENSOR KIT # 3- DIESEL TURBINEZONE 6DIESELBRUGGPRODUCTZONE 7DIESELVENT LINEVEEDER ROOT SENSOR,PROBES,LEAK DETECTORS4 DISPENSER +UDCUDC 1,2,3,4330020-536HYDROSTATICDISPENSER PANSENSOR2 ANNULARS30K SPLIT + 20K330020-536HYDROSTATICDISPENSER PANSENSOR794380-303BRINE SENSOR3 TURBINESUMPS87 , 91, DIESELPRODUCTS330020-536HYDROSTATICDISPENSER PANSENSOR330020-480VACUUMSENSOR116-057-5 LINELEAK DETECTOR3 FILL SUMPS87,91,DIESEL330020-536HYDROSTATICDISPENSER PANSENSOR1 VENT SUMPHEALY TANK330020-536HYDROSTATICDISPENSER PANSENSOR3 TANK PROBES87,91,DIESEL846390-110 MAGPROBE 3 LEAKDETECTORS87,91,DIESEL99LD-2000 VMILINE LEAKDETECTOR6" X 7 FOOT BOLLARDSHB PROPANETANKSITE MAP= Penetrations BRAVO F-75-PE-BRG-D (65) FOR PRODUCT= Penetrations BRAVO F-32-TS-D BRAVO FB (51) FOR VAPOR/VENTNORTHZONE# 6- DIESELPRICE SIGNAIR /WATERSITE HAZMAT INVENTORYCARBON DIOXIDE LIQUIDABSORBANT PADSCIM-TEK FILTERSLIQUEFIED PETROLEUM GAS (LPG)GASOLINE ALL GRADESDIESEL FUEL NO. 2CO2CO2FIRE SUPRESSIONCIRCUIT BREAKERWATER METER SHUTOFFOVER FILL ALARMCIM-TEKFILTERSOUTSIDEABSORBANT PADSOUTSIDE
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.
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