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HomeMy WebLinkAboutFMC 2004 / \' I~ '>,../ " ''i 'i ¡:? OCT- 4-04 MaN 14:36 FROM B.S.S.R. INC. P.02 r BSSR, Inc. 6630 Roseda1e Hwy., # 8, Bakersfield. CA 93308 Phone (661) 588·2777 Fax (661) 588-2786 ,." MONITORING SYSTEM CER'I'IFICA TION ' ;: J'~j~ ,:I~~rJ:1Jnu$t be us.ed .to document te$tin~ '~nd servicing of monitol'ing equiplncnt. A 8e )aro~~Jis.!.n. Qr, r~Q2!t.m!!.tt...122 :'~¡i~'P~~ .~"'" , "',.... . e, ~ÜJW by the tec1u\icia,n who perfo~ the work. A copy orchis form mu~(bè p'rq'Vided tõ: ;,':~r.~; ~~~tem owner/operator. Th~ owner/o¡)el'atQr must subtnlt a copy or this form to the local agency regulating UST systems' . ',~~,?~!,,~,"¡I(,4~ys ?f~~~t da~, : :,i ...~ti.*;~;~~~:f~~ t~for. atio, ' . ~'{'~:~~1t.i~~1'ne: "72!.t!'~ ,,4Øð/L --.--.... .-...,..,.. '~.. 7..-- B]dg.No.:_ . ,~I:~f~\r~~'s: , '2£~Lc:.~....d(¿ ...._._ City:~¿'~~ ,~ziP~£?-!02 ,':'r.ift(q1r~~;9>J:\tac.1,Per~n: (?ðMi£...-,-w __._.___.. __.. Contact Phone No.: cMwLl.ï4.r? 70 I , :' ~¥~f'~~9,~~,1: of~on;ito.lin8, ~ystem: w4(ð...,~ /' Æ~, ___._.. Date ofT~ting/SctViçÎDg: I Z!J¡PI! : ,i. ~~;!~~¡~Yff"':(O.ry of Eqùip"m.ent Tesfed/Ç¢rtifled . ,.;,,¡t""·'k ,~~:'r.¡,:" ~ò "¡<¡ate bOx;:' tiI Jadlc~te' s '~Iiii: "~I ~~~t I~J o:dtdlse..vSud: ~ "~f:"" ~. ""'-4.", " ,'," ,:,"" " ' ,. '~'Z··7Æ/!. '>~ 'J?i;·~~:~·.h~t~~, j:t .' ~~~;~~t':.~·s,",,, .-J:~; . .::j J~1!; ~~,~~rT,r~çt\ Sor¡$O~Çs).~o4~1:' ~!plng Sump/Trench Sensol{st));Modl#l: '" [~': ,t.'!!d~!.;~~~p'se~~r(s), " . Model: P FIll Sump Scnsor(s). Model: , , .), ,~;: ~q~~~,IÇ,Ø Lu,!e Leak DctcCCor. Mod,cl: C) Mechanical Line [.e!lk Decc:çtor. Model: ;: ¡ DY. ;.¡:)./ ':o.#¡ç~i'ne,t.~*.Dc.~ec~o,r.,:. Model:. ,. Q Electronic. Lint Lt~ Detcotor. Modèl: . ,,' ',," : . Vi.':; ,'þ,!' '" r(j JJ Highw[.e-,:c1 Sensor, Mod<:l:_;, 0 Tank Overfill! HIgh-l.eve1 Sensor, Model: : l ' ;i ~:r~' ; ·¡I.'i;':; :~r1.· if' '. i.1i 'rñêlÎt I' , ar.dmodcl'in Sectiòh Eon Jln ~:2 . a OJ!1CI' ~s~ecify c~u¡m'l!J!~ and elln Section:)! åh Po' c 2 ;' ;';~ !:;:~:;, :'i!',t iI'i'(:',:" " T"øk JD: ' ' "'" " , ~ ~.~ ,.'..\., ,..,j',' r:~ '. . " , --:- -...-.-. . : ~¡: :, ~~g'f~T~!1~."..,~,u8Ing Probe. Odd: (J In-Tank Gaugmg "robe. ModeJ: : :'~'¡, ,'¡ "l.~9.\¡~~'IST.~' $p¡I~ or Vaull $cnsor~odcl: 0 ADnular Space or Vault Sensor. Model: !,kj'/ ;,~~[f:t~.~~~:~~~j).trrçnc;~ ,~c.~9.~Wl"¥.)c(cl: " CJ P!plng Sump! Tl'Qnch Sensor(9). Model: : :: ::'Ý:: ~t!~!W~UIPP $.c,I,)~r($). ':0';' -: ~,'_ ,Jv19dçE __.i~' , C FIll Sump Scnso!'(s), M~deh" r-;, "", , . :' J\ ..qt.:", ' ,,'~' Lì~~ ~eak ~9tect!>r, Mo«el: 0 Mechanical Line LcaI< Detector. ~~~~!,,: ._, ,:,:,:,~,,:,:,~.<r..'::,:_,:,~:~/~' ,! :;::<:i J~;:~~. . ,:~í.q..i~e ~ t)e¡~cç!ór.· . Mod,G1:,~.....:-.......--_ 0 Electronic Line L~ak DctcctQr. 'Y4VU"'" " .: , "f, " . : .i: ¡..; ,~1;iÞ!? ~:P.Y§,~filll Hlg~~~tvel S~nsor" Mo~e1: a Tank Overfill !I'l1gh.Level Sensor, MQdet: ..:, r, ~>!~ ,.!;'~ ,"I '¡'., I , :: l;:: ,~t:(.)1ïla'· $ "ci ci ui ment 'e and Inode] in Swtion Bon P e Z . [J Othl:r 59-ceil c ui mcnt t Dnd model in Section 'E on p. '02-;: ':,j fi~:. :~mt.l;:'~f"'I·Ð· .;,¡:: :;'·:"1 ...:..' .. DI \ (D' . - ", ",': ':":'.':~I',...."" , r,:!:;' :-",~s.¡)~t~%"l"'!:~' .' sp~ßscr . ---". - ~ ~ ..',.:~;.. : :;'H::t\I :,.Ct~;~ '\,I:!1,ln~ent, $.tnspr(s), MQdel: D fJ.i$þcnser Contaln/nel'! Sonaor(s). ~odol: .-_.:.:.:....-__ ..::'~:;;; " " vc(s}_ ':',.,:;:' : '. o\i'~ ~hcar Valve(s), . ' . : ' ~ HP::: ~~ 'Containment PIQat s and Chain s . .,J 0 is cOler c<¡:t:a:ZWlo~,U~..9"iO s . ¡:;,¡~;:: 'JiJ ~ Dispenser 1D: f';:tH J:!\ ",'"Çoritain1'l\cnr cnsor(s). Model: __ 0 ~enscr Cö'ntammt7;¡ SelISOr(S), Modol: ~ V:"" J~ ~!~~($). B1hëar Valve(5), : . ~ ':~?, ,~l),::~ er'~ontai~~ PlOSS) ~ Chal~($). _, :_. 0 ,~CI1SC~ ~o\' tainmenc Flo~.$=hl1ln s ' 'I:':' JJ~~¡! , " ~p., --:"7- ~?ã.. :.. ,~: _ _ DL~p~Dser 1'0, .._~._.._---_.. '. ; ~ :':µ} . ¡~í,¡I'J.I~,~Çon~,lnmont Slnsor(s). Mode\: tJ Dlspen~t.:r Contllnmcnt Sensor(s). Model; ; ¡ ,I' ., ,. ·lYc(s).' tJ Shear Vulvc(s). . , :,; ( ',Ô ~Conlainmcnt Flollt s tlnd Chain s . _ a E!!~cn.scr ContaiJl~1~nt Flowes) aJ'\~ Ch.!!ln~!ò~. , , ::¡: '.i:~5'f;,~ ., Wèòntalns'iriciic tel'\ks or'dispcl\:scrs, eopi thi$ form, Include:: In(ormation for every lank and di:llpetlscr III thø facillt)l. I" ';~ :':" . :. . ~ ~t~.~JI : : 'I . ':'!;;:¢~l;:(:':~r..:~:,:C~µOD. . I artily that *he cq~pJnC~t Ideut1ßèd ID tllts doouneo.t was IDspectecllscrvJccd In acc:or~~nÇG »,Ub the .', : f frH!n~~ra.,t~,i(i'ei1' &\ddtJlDCL Atta~c:4 ~ ,th~s ,~r$~nèftdon Is ~fol'mntlon (c.g. ~n u.r ¡Cturer8' c:heddlsts) lIecessnQ' CO: Yèr~ tliat th.ls . .,'i!:~h!W.1;~ Mlon Is correct and. Plot P~II h~w~g tl;l.o layout of mOllltorlng ì!qJlI~m~nt. 'r ;'1I1Y IIlpmcnt tal.able of eencrPo~,Q8 51&clI . ,': rf:~~~~.J.hAv~Alsoatts~dJlj¡P.Pf.A~Æ'~"lappJJ!,I: [J S)' ct~u""-=º_Á~ report' :,11~';ii~f¡\\i\~&.n~e(pr~t)I.Æ..l¡rv/U~~_ , Signature:, LL"e;r~. ~ -..- q¢r.~i~\~~iQnNo.: ';.() (/, '_ License. No.: . o~72£ /2 . " ~r':'i"';:>' N. :.£ PhoncNo'( LL/) .~7ff;¿/?? "~f,~,~$.I~mp~J1y' ~n\e...~._.. ,. "..,.... .. ./i2~- -~~ " - I' ,.jlA~!:~it' 'i 4*~¡ , .. , .'~~ ____. Date of Testing/Sc::rvicìng: ..!Z./ ?:X/Or ¿: ';,f··:¡r~"·'~" ~1~¡(~;, \',' - , ' " ~ -. ~ , 'f.i7~i~::WijJ~f.t~J1!1e SY$tom CcrtU1catlon rag~ 1 of 3 ",II ':«if.h~:!:r·' . ..f . l1l.I I" . ',:';'';., .~ 03101 :0 OCT- ....-0.... MaN 1....:37 FROM B.S.S.R. :INC. P.03 01;;, ~,~sµlts of Te$tJnglSeryicing sçi.rr.w,~CB Version Ins iii lied: \, /tJ "o1~ I,,(;,!.p~l~..the followJn checklist I '~__'" ",.=._..=__~___"":;:,.""=-""",,,,,~~:=......= ::: ,~jy'~!;~\ ','0, No·' I.s the audible alarm 0 erational? ______,_,_,_. ¡.. ' . ~$f::·; , No·' ts the YlsuaJ alarm' 0 crational? _______....._ :~ : ' ,'~Æ.~~: a No,· Were all sensors visuaU ins ectcd functionalJy tested, and c.2Eflnned o~crational? . ' ',' ;'~.Ù"(r;~~í':'" ,Q No· Were ¡¡II scn:sqrs ins'tålled at lowcn point ofsecondaty <:ontainrnent and positioned so that other equipment wjll '.:: ",~ "::,;.......--- not intel'(ere with their Proper oPcratlon? ".'___'_'... ~,~lW4.!, ': ¡ ÇJ No'" If ataims are relayed to a remote n10nitoring station, is all c;ommunications equipment (e.g. modem) (~'::' ,~": 'N/A operatio!)al? _ 'i~~~~i¡:¡ : CJ No· For presswized piping s)'stems, does the turbine autÖ~Ÿ-shut dôWiìlftiiePfpíng secondar)' oontalnmcl)t ;:J.~\ , ¡ 0 N/A monitorlng system detocts a leak, fails to operatol or is elcctricaJ/y disconnected? lfyes: which sensors initiate positive shut·down? (Cited a/I that (lpp/)1) a,Sumpll'rcnch SOIJ&ors¡ a Dispenscr Contalnmcnt S~n$or$. ' , Did ()u confirm ositive shut-down due to llaks sensor t'ai1uroldisconnection? .. Yes' 0 No. fOr tanIc systems niat urIUze the monitoring system as tbe prinuuy tank ovèifill wamin.g device (J.e, no . mechanical ovcrfill,prcvention valve is installed), is the overfill warning alflrrn visible and audible at the ta.lIe fill oin s and () råtin ro erl ? If so at what ercent ot rank ca.pacity does the ata.rm trig er? % Was anr ~nltori1)i equipl11ent replaced? Ifycs, identify specific sensors, probes, or other equipment replaced and list the 'manufacturer name and nlodd for all rc lacement arts in See . n B below, . W~ liquid found ùislde any secondlU}' containment systems designed as dry syslcms? (CÞeck at/that apply) ~ ',~' .,,""""...~' .. 0 Producr' Q Water If cs descn1>e causes In Secrion E. bclow,~_,... , ,\ lx~~$':¿f -:0 No'" Was monitor s stcrn sct-u rcviewed to Ci\.SUre proper $~ttinRS? Attaoh set up report$, If applicable . " )~~~~t~¡ -,fJ 'No· Is aU monitorin' uS: mc£nl 0 alional cr manu cturcr's $ ¡ficatio~l.........._,....".......____...... . ~:~å:;~~J~;~~' E below. describo how and wbëu tbese de£I<:lcn4:ics were or will be cOI'rccted. ~Ç~!!»!iÇDI8: (/&7' <f T/' ~~ Sf' M1'-"'_.{~_ .~~~~,:~~ -" íibllC4-,d)Jr /Jt:ð1!!L._,-"",..La:e.u:1i. :~~~4ta¡ø& ~ 7f27~ßJ, -~Otf': _'._......___...._.....,' ________~ ...........-..........' ..... ----.-.-..-.-..... ._. .... -............, ----- ,.--. ---.-..-. .. ..... _......"....___--- _.,..,_I....~..\jIoo.... -- ....-...-.---.. ......... -.--..- _.......... .-...... '" _..no _...._ _ ....._. .. .,........ -.-",..-,-.... - .. ... '............. .-.. _...~......,. ,'W'.___.. ..........- _. -. ....', . ..-......------- ._,,_._'M ......._... .......-.. . ,. ............-.....-.. .._w....,.... ..... ..,...-- ...._~..... . .... .. w_._...__ --......,..............-.. . ."",. ......- .-- ...._- --..----.........----.... ..-........... ··..·1····__ ,,,-,-""'.-..... ....-- . ...-.---.-.-....- -...-..........-..-.... . .....-..... ... . .. .........__.__1 ---- -............, ".,......... ----- -..-.......-.--.- .. ..._.- -.-.- ~---......."""",.. _.... ......,...--....-... ....----.-- ----................ w' . ..-.~~ ......-... ..---. ........--.....---- ,-,,,:,,,... .....,...... ...... .. .....-.. ... . ".-..-........ ___, Pace 2 of 3 0.)/0 I ¡, :j/ OCT- 4-04 MaN 14:38 FROM Ð.S.S.R. :INC. P.04 ~".., ~~~~Tauk G~ugjng I SU~.Eq....ipme,lIt: o Check this box if ta~ gauging is used only (or inventory control. . a Check this box if no tank gauging 01' SIR. equipment is Installed. ~FhÜf.5';Ctioñ must be compll:ted if in-hUlk g~ug.ing eq\dpmeIlt is used to porform leak detection monitoring, ,,' ,$iP~' £ltc the ~ U win oJaeekIisb '=-..,,'_~___ J ~..._....,r-"'-'--~~~ '_=~ . _ . ~"; :. 9, Nò~ a~ ,!t11 ipput w1r:in¡ bee~ inspe<:tcd ror propcr entry and tennmation. including tesÛDS for gtound fa,u.Its? ,:¡ :~Ä..~ /,' Q' No'" W~r~ ~11 tå,n\( gausing probes visually inspected for dax:nagc and residue buildup? :~ l~t ,\:¡: ',9 No'" Was accúracy of s)'$tcm product leyel readings œsted~_, .__..,.. .,_., ,,_. .___ .. "9'.. Nò'" " ,Was a~curåcy' bf system water level readins tested? "'q No~ 'Wore all,probes r!;~n$talled,ptopcr1y? " tJ No·' W$IO all, items 9,n ~e, equ.ipmcót manufacturc-;S maint~~~ëeé:bë·ë.kiTStcom.Pleted? a¡r;ø.r. ...,-...---- -mur----..,..........~......,..,,~ _._ Z""T-I~='~'":t"""\~~'a;L~ cictlon ~ below, describe boW and when tbest deflclendes were or wiD be corrected. 1',:._1\' ,,' ,:' . . ':¡'; ,:r'" ':, . ¡ ~,~:~\~~~:~~,~,k;"Detect~rs (LLJ:»: ¡tJ01eCk this box ifLLDs 1/,1'(1 D.ot inslßlled. . ,.,ir~~;!.&f¡¡¡w the fullowlnll checklist: ,~.."..._.,~...~~~ "~.........~___ ""'_w..,...q_ ,,~,_...~tt"_. ":, "~)':§ë,¡~: :,~ 1;1, No~ Pór equip~nt ~up ~ annual equipment oerütlcation. was a leak sitnutated to verity LL:D ~tfOJ'manc~? ;' ';: ~·t;:, ' ?:~¡!~:: :..~" N/A (Check all that apply) SunuIated leak rate: C 3 g.p,b.; CJ 0.1 g.p.b; 0 0,2 g.p.h. :;>:~"" 'i:"" ~:'.:': ~n:;;y~}-: :QNo. . . 2!~:.,.~f:li,~.r ...j..,. . ;,!: :f ·'~~~il,''' <:':(',0 ,No· ". :Fi~~~ ,; ',:ë)" No~ " :~~\ "'¡.&.\. ¡ :~., .;, ..... .N/A ) :,t;t~~,¡ ::¡: C , No· For electronic LLDs, does the turbine auto1U4ticaUy shütõffiTciiëï:''i.D detects a teak? " :,.,'::'.:,;,: m:-",~[j\t:~~' ':F ~H NN/~ n ~J;(, ~~,\; ;: "":I 0 "j:,;;(:,q,NIA :1 ~:ri~.~~;~~~,'o No. ':,::~"~'\ '1'" H . , :,~::~ :'Q: N!A , ,,¡Q;'&1jn: ,...9, . No·. ;:~;~H:tJ 'N/A " :~'0f~§ ;':t;I ,No"': w: e.r~ ~U, Items, Ç)D the equipment manufactu.rc.r' 8 maintéñãñëè-ë.!ÏcCkn8t QOmpleted? ' .' ' ~;¡~~~::'il~~~~Î~ Ii~ below; des~lbe b9w and ;b'cú thes~·¡;~';;;.;";': \;iïi be ;;;~tcd. u.......-.-. ., I" !,", :., -....__._..'~.,.. ....-.-...... . Were all LLDs confirmed operatio:naland accurate withúÎ';egulatórY requitcments~ Was the ~esting apparatus properly calibrated? Por f!1qc1pmical1;LDs; does tM LLD restrict product flow jf it detects a leak? For electronic LLD$þ does the turbine automQt1callÿ-áhut'õff"¡fänÿ"p~rÍiôñ~õfthe mQnitoring Gystem is d~blcd or diSç9~ected? Por el~ctxoniç ~Lps, does the tw:bine automaticnlly Siiut off ifany portion ot the monitorÞ.I:g:~systcm ~OnS ,Of faUs a test? ' , ~or ~l~trp~iic LLDs, have all accessible wiring connootiollS beèñviš~Ï1y inspected" II), Q~XÄW1cnts: ---...,. .,~ ......--.-.-........ -.-......-- .....-..."'..-..- . ,. ....._.. .. ..__......... '1.···_- ,....~..I/.~_~..I _... ~~..... .~_.........~ M' _..._.__. . "-A~_"t!~....... .---_.. - , .... .-..--.-..-..--......,.."..--. .-.......-.--- _",.".'_ ._. .._,. _,..__...~ ." n ...__.._..____.. ..-~....._. -.........-- .. .. . ..-... _..... -.-..-.-.-- .--.. '4·~~·~'· ..--.-...-. ....-_.... -.----- '-'~:"'-~.:"" .................. _..11. ............ ...... ._-~...:::"'" _..... .......... .-.---... .........- ........... _·....:.......0.11 .-.-.,...---..-............-...- .......... ..-. .-...-..." .. ................--...---... Pace 3 of 3 ,03101 .. " . -...J..'" OCT 4-04 MaN 14 <S'Si' FROM B.S.S.R. J:NC. P.0S ~~mtt.?{~I.J& System Certlf1çaUon !~¡~~ A~~~~,S$: ~~ ('")? L\ f~' f:~ :..¡. UST Monitoring Site Plan Ce I.- ) :fðR~ I A AV..E.... _. \'¡; . , . , :~TQ~~ .::: ~ .' }.:~. .,~' '~' . , , 5: I· · ~ 'Z .~.~. (I" " , " . ~ ~ , ';':~ . . " .:' ':~D' " , , . of .. .. .. ,. ,1 . .. i ..:'1 : ;.; '~ '0' ' , , ,d t': ..i04 . '... ~ ;i :' .';:~ j::f ;','þ; .... :, .' I, ::,~ (. ; , , 1, ~ ,;- ,!" ..,"; .' '. ' o . '. ., . ,.. ." ~. f< ~~ " " I,. " " '. ,. !:;~ ,'.,. . . . . : ·;'~~~4·~-r· .. " " . ~ <II , "~'.J.(t. 00' o :c® : :~p. : '. '0' ¡,,~~ 'G~: ðfl'. ',,~' :~~ , ~':",:'·~¡;'',..O·, f·., .... ", .'.'. ! ~I~:~~. I~' . "....;. . Q~' o ~.~ : .s.~~~ :~~: 000:' Date map was ch'awn: ft.:J .A2t/~, InstruçtiQn~ :l.1.'ý'~ì-i~~~~~Y have a diagram ~t, shows all requir~d il1fonnation, you may include it, rather than this page, with )lour ',!~ìß¡~~~fiiiij' 'System certifiç.tion. On yoÜr !lite plan, show the gentn\l layout of tanks and piping. Clearly identify !i~*~~Jr~;:~~' the following 'equipm~rit. if mstal1e:d: monitoring system control panels: sensors monitori~g tank annular :~ij3;' '~n~~~, d~ser~. spill øntaiJ,lers, or ot:btrsCC,onda~ containment areas; mechanical or eleCtronic tine leak ',;~r::~ff.~l ~,.:~r1,ú)·tank liqUld level ptQPes (if used for lea.k detection), In the space provided, note tho date this SUe Plan ;~¡UI ...-6"!t.T.. . . 1:'1' ~\I~ . '1'~' " PSI¡8 _ or_ 05/00 \