HomeMy WebLinkAbout2004 RESULTS
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MONITORING SYSTEM CERTD'ICATION
For Use By All Jurisdictions Within the State of California
Authority Cited: Chapter 6. 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations
This form must be used to document testing and servicing of monitoring equipment A separate certification or report must be prepared
for each monitorine: System control panel by the technician who performs the work. A copy of this form must be provided to the tank
system owner/operator, The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30
days of test date.
A. General Infol"!Di'tion,...-- ',Mo..
Facility Name: ~ b ~ f74c5/.Lh -r-r-f::>
Site Address: / ~ ¥O S~ /Ie5¡e¡e
Facility Contact Person: <:;;!. :Jò V OA-
MakeIModel of Monitoñng System: ~0l.. ~ 3.52:>
B. Inventory of Equipment Tested/Certified
Check the a ro 'te boxes to indicate 5 'c ' t '
TanUD:', E
eriÍI- Tank Gauging Probe. Model:
.e('" Annular Space or Vault Sensor. Model:
a'Pïping Sump I Trench Sensor(s). Model:
IJ Fill Sump Sensor(s). Model:
Q Mechanical Une Leak Detector, Model:
IJ Electronic Line Leak Detector. Model:
IJ Tank Overfill! High-Level Sensor. Model:
IJ Other s ui ment and model in Section E on P e 2 .
Tank ID: L.v
-a1n.. Tank Gauging Probe.
r:fAnnular Space or Vault Sensor.
~Piping Sump! Trench Sensor(s),
Q Fill Sump Sensor(s).
IJ Mechanical Une Leak Detector.
IJ Electronic Line Leak Detector.
IJ Tank Overfill! High-Level Sensor. Model:
IJ Other s ui ment t and model in Section E on P e 2).
Bldg. No,:
City: ~~~Fre.-bL- Zip: 933:::>'/
Contact Phone No.: (~/ ) 39 7 -- 8'=:>Ok
Date of Testing/Servicing: -fj/yð7
"'7 ~ 07
serviced:
Tq 10: u.AJ L..
--t:J1JJ- Tank Gauging Probe. Model:
e:('" ~nular Space or Vault Sensor. Model:
~Piping Sump I Trench Sensor(s). Model:
IJ Fill Sump Sensor(s). Model:
Q Mechanical Line Leak Detector. Model:
IJ Electronic Line Leak Detector. Model:
IJ Tank Overfill! High-Level Sensor. Model:
IJ Other s ui ment and model in Section E on Pa e 2).
Tank ID: ! e..Ç
-010- Tank Gauging Probe.
fJÂnnular Space or Vault Sensor.
rrPiping Sump! Trench Sensor(s),
IJ Fill Sump Sensor(s).
IJ Mechanical Une Leak Detector.
IJ Electronic Line Leak Detector.
IJ Tank Overfill! High-Level Sensor. Model:
IJ Other s ui ent and model in Section E on Pa e 2).
DIspeoser 10:
Ia1:S'ispenser Containment Sensor(s). Model:
~Shear Valve(s).
IJ Dis Containment Float(s) and Chain(s).
DIspenser ID: '/<7
ç;l-6ispenser Containment Sensor(s), Model:
Ia"Shear Valve(s).
IJ Di eoser Containment Float(s) and Chain s).
f4
Model:
L
JI1..
f¡
L
QDispenser
IJ Shear Valve(s).
C. Certification -I certify that the equipment 1denti6ed in this documeot was inspectedIserviced in accordance with the manufacturers'
guidelines. Attached to this Certification Is information (e.g. manufacturers' checldists) necessary to verify that this Infonnation Is
_............_..._............._ ...._ _~__ _I........
attad1ed a copy oCthe ~eck oil ~ply): Ia'Sf'stem set-up ~ report
Technician Name (pñnt): 0'" \ '€~ Signature: r...c....--'
Certification No,: ~7? .b License, No.: f? 1..3 b I f.e:::, A-
Testing Company Name: ~ j?t:7Jà:>¿§Uð1 £.~¡~ . PhoneNo,:(6~/) -:587-6$"2-7-.-
S;te Addreoo, /5 S'fp SïtJEi;1ov 4>--. ~~ Date 01 Tem.ISm';""",, 8" ') I ð Y
I ~ 93;)'1' if 7/ð ý'
Page 1 of 3 03101
Monitoring System Certification
":
D. Results of TestingIServicing
VI5
Software Version Installed:
checklist:
Is the audible alarm 0 tional?
Is the visual alarm 0 rational?
Were all sensors visuall ins ted. functionall tested. and confirmed 0 rational?
Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will
not interfere with their ro r ration?
If alarms are relayed to a remote monitoring station. is all communications equipment (e.g. modem)
operational?
For pressurized piping systems. does the turbine automatically shut down if the piping secondary containment
monitoring system detects a leak, fails to opera~ is electrically disconnected? If yes: which sensors initiate
positive shut-down? (Check all that apply) ErS"umpfl'rench Sensors; I3"DiSpenser Containment Sensors.
Did ou confirm itive shut-down due to leaks and sensor failure/disconnection? 13"Ta'; a No.
a Yes a~· For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no
~N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank
fill int s and 0 ratin ro rl? If so, at what rcent of tank ca acit does the alarm tri er? %
Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced
and list the manufacturer name and model for all re lacement arts in Section E, below.
Was liquid found inside any secondary containment systems designed as dry systems? (Check all thot apply) a
Product; a Water, If es, describe causes in Section E, below.
a No· Was monitorin s stem set- reviewed to ensure ro r settin s7 Attach set u
Yes a No· Is all monitorin ui ment 0 rational r manufacturer's s ecifications7
· In Section E below, describe how and when these deficiencies were or will be eorreeted.
a ~.
er'N1 A
a No·
a N/A
a Yes
Yes
a Yes·
a Yes·
E. Comments: c¡ -7-0'/ ;2e-p/'HIL/'€: () DJJ/l~~1L f~ ___
5 Cl\JcS~ - I~ .¡.p dt> Cô t..() ðí"Ã- r ðk.J /¥1 ~ ¡1Ð/U A
Page2of'3
03101
F. In-Tank Gauging I SIR Equipment:
l¥6eck this box if tank gauging is used only for inventory control.
a Check this box if no tank gauging or SIR equipment is installed.
This section must be completed if in-tank gauging equipment is used to perfonn leak detection monitoring,
Com ete the foRo checklist:
Yes a No· Has all input wiring been inspected for proper entry and termination. including testing for ground faults?
a No* Were all tank gauging probes visually inspected for damage and residue buildup?
a No· Was accuracy of system product level readings tested?
[J No* Was accuracy of system water level readings tested?
[J No* Were all probes reinstalled properly?
Yes a No· Were all items on the equipment manufacturer's maintenance checldist completed?
· In the Section H, below, describe how and when these deficiencies were or wDI be corrected.
G. Line Leak Detectors (LLD): ~eck this box if LLDs are not installed.
Complete the foRo rin2 checklist:
a Yes a No· For equipment start-up or annual equipment certification. was a leak simulated to verify LLD perfonnance?
[J N/A (Check all that apply) Simulated leak rate: [J 3 g.p.h.; [J 0.1 g.p.h; a 0,2 g,p.h,
o Yes o No· Were all LLDs confinned operational and accurate within regulatory requirements?
o Yes [J No· Was the testing apparatus properly calibrated?
a Yes o No· For mechanical LLDs, does the LLD restrict product flow if it detects a leak?
o N/A
a Yes a No· For electronic LLDs. does the turbine automatically shut off if the LLD detects a leak?
a N/A
[J Yes o No* For electronic LLDs. does the turbine automatically shut off if any portion of the monitoring system is disabled
a N/A or disconnected?
[J Yes a No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions
[J N/A or fails a test?
a Yes a No· For electronic LLDs. have all accessible wiring connections been visually inspected?
a N/A
a Yes a No* Were all items on the equipment manufacturer's maintenance checldist completed?
· In the Section H, below, descn1Je how and when these deficiencies were or wDI be corrected.
No
1'1,~
~/~
D .lZ..--J...<u-Io.v!::.. "
H. Comments:
Page30f3
03/01
-:
Monitoring System Certifieation
Site Address:
_ _ UST MonitOrtJ;t2 S~ PIa» r
562- ~~, j ¡rot¡€) -S CH£l:SlE~1 ~~n~, ~ 933ðY
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Date map was drawn:..t5 fa ð r
Instructions
If you already have a diagram that shows all required information, you may include it, rather than this page, with your
Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify
locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular
spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak
detectors; and in-tank liquid level probes (if used for leak detection), In the space provided, note the date this Site Plan
was prepared.
Page_of_
05/00
SYSTElv SETUP
8EP 7. 2004 11 :23 AM
RS-232 SECURITY
CODE : 000000
8Y8TEI-1 UN I T8
U,S.
8YSTEf'1 LANGUAGE
ENGLISH
FASTRIP
r'1 I NG-GHESTER
~~}ŒRSF I ELD CA, '33304
t:lU5-397-8606
SHIFT TIME 1 DISABLED
SHIFT TIME 2 DISAB E
SHIFT TIME 3 DISABtEE
SHIFT TIME 4 DISABLED
PERIODIC TEST WARNIN~S
DISABLED ~
ANNUAL TEST WARNINGS
DISABLED
RS-232 END OF MESSAGE
DISABLED
T 2:PLUS
PRODUCT CODE
THERMAL COEFF
TANK DIAI"1ETER
TANK PROFILE
FULL VOL
: 2
: . 000700
: 1 1 1 ,50
1 PT
12062
IN-TANK SETUP
T l:PREMIUM
PRODUCT CODE
THERMAL COEFF
TANK DIAMETER
TANK PROFILE
FULL VOL
: 1
: .000700
111 . 50
1 PT
12062
FLOAT SIZE: 4,0 INCHES
WATER WARNING : 2.0
HIGH WATER LlI"1IT: 3.0
MAX OR LABEL VOL: 12062
IT' 90%
OVERFILL LIM : 10855
95%
11459
10%
1206
HIGH PRODUCT
DELl VERY Ll M IT
------
PRINT TC VOLUMES
ENABLED
TEMP COMPENSATION
VALUE (DEG F >: 60.0
FLOAT SIZE: 4.0 INCHES
WATER WARNING : 2 0
HIGH WATER LIMIT: 3:0
MAX OR LABEL VOL: 12062
OVERFILL LIMIT: 90%
HIGH PRODUCT : 10~~~
DELIVERY LIMIT lli5~
1206
750
25
25
4.50
LOW PRODUCT :
LEAK ALARM LIMIT:
SUDDEN LOSS LIMIT:
TANK TILT :
MANIFOLDED TANKS
Tit: NONE
PERIODIC TEST TYPE
ØU I CI<
750
25
25
2,50
PORT SETTINGS:
COl"1I1 BOARD
BAUD RATE
PARITY
STOP BIT :
DATA LENGTH:
1 (RS-232)
9600
NONE
1 STOP
8 DATA
LOW PRODUCT :
LEAK ALARM LIMIT:
SUDDEN LOSS LIMIT:
TANK TILT :
MANIFOLDED TANKS
Tit: NONE
PERIODIC TEST TYPE
QU I CK
PERIODIC TEST FAIL
ALARM DISABLED
GROSS TEST FAIL
ALARM DISABLED
PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : 15 MIN
PERIODIC TEST FAIL
ALARI-' D I SABLEr
GROSS TEST FAIL
ALARM D I SABLE}
PER TEST AVERAG I NG : OF!
TANK TEST NOT I FY : OF
TNK TST SIPHON BREAK:OF
DELIVERY DELAY : 15 MI
COI"'I"IUN I CAT I ONS SETUP
- - - -
- - - -
AUTO TRANSMIT SETTINGS:
AUTO LEAK ALARM LIMIT
DISABLED
AUTO HIGH WATER LIMIT
DISABLED
AUTO OVERFILL LIMIT
DISABLED
AUTO LOW PRODUCT
DISABLED
AUTO THEFT L I ", IT
DISABLED
AUTO DELIVERY START
DISABLED
AUTO DELIVERY END
DISABLED
AUTO EXTERNAL INPUT ON
DISABLED
AUTO EXTERNAL INPUT OFF
DISABLED
AUTO SENSOR FUEL ALARM
DISABLED
AUTO SENSOR WATER ALARM
DISABLED
AUTO SENSOR OUT ALARM
DISABLED
'.
-:
T 3:UNLEADED
PRODUCT CODE
THERI"IAL COEFF
TANK DIAI1ETER
TANK PROFILE L
FULL VO
. 3
: .000700
: 1 11 . 50
1 PT
12062
4.0 INCHES
2.0
3,0
FLOAT SIZE:
WATER ~.JARN I NG :
HIGH WATER LIMIT.
I"IA>:' OR LABEL VOL:
OVERFILL LIMIT :
HIGH PRODUCT
DEll VERY Lll"ll T
LOW PRODUCT :
LEAK ALARM LIMIT:
SUDDEN LOSS LIMI~:
TANK TILT '
MANIFOLDED TANKS
Tit: NONE
LEAK MIN ANNUAL :
PERIODIC TEST TYPE
12062
90%
10855
95%
11459
10%
1206
750
25
25
4.30
o
QUICK
·NNUAL TEST FAIL
A ALARM DISABLED
PERIODIC T~t¡R~AÕYSABLED
GROSS TESTAr~k~ DISABLED
ANN TEST AVERAG I N~ : OFFF
PER TEST AVERAGIN\,j. OF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : 15 HIN
T 4:DIESEL
PRODUCT CODE
THERMAL COEFF
TANK DIAMETER
TANK PROFILE
FULL VOL
4
.000450
111 ,50
1 PT
12062
FLOAT SIZE: 4.0 INCHES
WATER WARNING : 2,0
HIGH WATER LIMIT: 3.0
MAX OR LABEL VOL: 12062
OVERFILL LIMIT: 90%
10855
95%
1 1 459
5%
603
50
25
100
4.44
HIGH PRODUCT
DELI VERY LI 1'1 I T
LOW PRODUCT :
LEAK ALARM LIMIT:
SUDDEN LOSS LIMIT:
TANK TILT :
MANIFOLDED TANKS
T#: NONE
PERIODIC TEST TYPE
QUICK
PERIODIC TEST FAIL
ALARM DISABLED
GROSS TEST FAIL
ALARM D I BABLED
PER TEST AVERAGING: OFF
TANK TEST NOT I FY : OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : 15 MIN
~~1:ß+~~E5(~INGLENS~~O~¡~
CATEGORY : DISPE
~kI:ß+~~E~(~DII~~~~S~~O~¡~
CATEGORY .
~~1:ß+~~E9(~?NGLE FLOAT}
CATEGORY : DISPENSER PAN
------
LEAK TEST METHOD
------
- - - -
TEST ANNUALLY: ALL TANK
JAN WEEK 1 SUN
START TIME : DISABLED
TEST RATE :0.20 GAL/HR
DURATION : 2 HOURS
-----
LIQUID SENSOR SETUP
------
- - - -
L 1:91 SH'
TRI-STATE (SINGLE FLOAT)
CATEGORY : STP SUMP
L 2:91 ANNULAR
TRI-STATE <SINGLE FLOAT)
CATEGORY : ANNULAR SPACE
L 3:89 SH'
TRI-STATE {SINGLE FLOAT}
CATEGORY : STP SUMP
L 4:89 ANNULAR
TR I -STATE (s I NGLE FLOAT>
CATEGORY : ANNULAR SPACE
L 5:87 STP
TRI-STATE (SINGLE FLOAT)
CATEGORY : STP SUMP
L 6:87 ANNULAR
TRI-STATE <SINGLE FLOAT)
CATEGORY : ANNULAR SPACE
L 7:DIESEL STP
TRI -STATE <81 NGLE FLOAT>
CATEGORY : STP SUMP
L 8:DIESEL ANNULAR
TRI-STATE (SINGLE FLOAT)
CATEGORY : ANNULAR SPACE
L 9:DISP 1-2
TRI-STATE <SINGLE FLOAT>
CATEGORY : DISPENSER PAN
L10:DISP 3-4
TRI-STATE <81 NGLE FLOAT}
CATEGORY : DISPENSER PAN
..
';
OUTPUT RELAY ~E:U~
- - - -
R 1:91 STP
TYPE:
STANDARD
NORMALLY CLOSED
Ll QUi D SENSOR ALMS
L 1: FUEL ALARM
L 2 : FUEL ALARM
L 9:FUEL ALARM
L 10: FUEL ALARM
L II : FUEL ALARM
LI2:FUEL ALARM
LI3:FUEL ALARM
ALARM H I STORY REPORT
----- SENSOR ALARM -----
L I :PREMIUM SUMP
STP SUMP
FÜEL ALARM
AUG 10. 2004 1:19 PM
FUEL ALARM
AUG 10. 2004 1:02 PM
FUEL ALARM
AUG 12. 2003 12:50 PM
ALARM HISTORY REPORT
----- SENSOR ALARM _____
L 5: UNLEADED SU/1P
STP SU/1P
FUEL ALARM
AUG 10. 2004 1:20 PM
FUEL ALARM
AUG 10. 2004 1: 1 BP/"I
FUEL ALARM
AUG 10.2004 1:05 PM
R 2:89 STP
TYPE:
STANDARD
NORMALLY CLOSED
LIQUID SENSOR ALMS
L 3:FUEL ALARM
L 4:FUEL ALARM
L 9:FUEL ALARM
LI0:FUEL ALARM
Lll : FUEL ALARM
L12:FUEL ALARM
L13 : FUEL ALARM
ALARM HISTORY REPORT
----- SENSOR ALARM -----
L 2:PREMIUM ANNULAR
ANNULAR SPACE
FUEL ALARM
AUG 10. 2004 1:19 PM
FUEL ALARM
AUG 10. 2004 1:17 PM
FUEL ALARM
AUG 10. 2004 12:58 PM
ALARM HISTORY REPORT
----- SENSOR ALARM -____
L 6:UNLEADED ANNULAR
ANNULAR SPACE
FUEL ALARM
AUG 10.2004 1:21 PM
FUEL ALARM
AUG 10. 2004 1:18 PM
FUEL ALARM
AUG 10. 2004 12:55 ~1
R 3:87 STP
TYPE:
STANDARD
NORMALLY CLOSED
LIQUID SENSOR ALMS
L 5: FUEL ALARM
L 6: FUEL ALARM
L 9: FUEL ALARM
Ll 0 : FUEL ALARM
Ll1 :FUEL ALARM
LI2:FUEL ALARM
L13:FUEL ALARM
ALARM HISTORY REPORT
----- SENSOR ALARM -----
L 3:PLUS SUMP
STP SUMP
FUEL ALARM PM
AUG 10. 2004 1:20
FUEL ALARM P~
AUG 10. 2004 1:04 I
FUEL ALARM PM
AUG 12. 2003 12:47
ALARM HISTORY REPORT
----- SENSOR ALARM
L 7:DIESEL SUMP
STP SUMP
FUEL ALARM
AUG 10. 2004 1:21 PM
FUEL ALARM
AUG 10. 2004 1:01 PM
FUEL ALARM
AUG 12. 2003 12:50 PM
R 4:DIESEL STP
TYPE:
NO~~~~BLOSED
LIQUID SENSOR ALMS
L 7:FUEL ALARM
L 8: FUEL ALARM
L 9: FUEL ALARM
L1 0 : FUEL ALARM
Lll : FUEL ALARM
LI2:FUEL ALARM
LI3:FUEL ALARM
ALARM H I STORY REPORT
----- SENSOR ALARM -----
L 4: PLUS ANNULAR
ANNULAR SPACE
Ä~L 1 ~~~04 1: 20 PM
FUEL ALARM PM
AUG 10. 2004 1:16
ALARM HISTORY REPORT
----- SENSOR ALARM -----
L 8:DIESEL ANNULAR
ANNULAR SPACE
FUEL ALARM
AUG 10. 2004 1:22 PM
t:'I It:'T ~,' ^n...
ALARM HISTORY REPORT
----- SENSOR ALARM -----
L 9:DISP 1-2
DISPENSER PAN
FUEL ALARM
SEP 7.2004 11:35 AM
SETUP DATA WARNING
AUG 10. 2004 1:15 PM
-.-----..
_.~
ALARM HISTORY REPORT
----- SENSOR ALARM -----
LtO:DISP 3-4
DISPENSER PAN
FUEL ALARM
SEP 7. 2004 11:36 AM
SETUP DATA WARNING
AUG 10. 2004 1:15 PM
ALARM HISTORY REPORT
----- SENSOR ALARM -----
LI3:DISP 9-10
DISPENSER PAN
FUEL ALARM
SEP 7. 2004 11:37 PWI
SETUP DATA WARNING
AUG 10. 2004 1:15 PM
ALARM HISTORY REPORT
----- SENSOR ALARM -----
Ltl :DISP 5-6
DISPENSER PAN
FUEL ALARM
SEP 7.2004 11:34 AM
SETUP DATA WARNING
AUG 10. 2004 1:15 PM
ALARM HISTORY REPORT
----- SENSOR ALARM -----
Lt2:DISP 7-8
DISPENSER PAN
FUEL ALARM
SEP 7. 2004 11:36 AM
SETUP DATA WARNING
AUG 10. 2004 1:15 PM
Au~ 08 04 07:35p
e
Ron Ro~ers
e
661-387-6522
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, CITY OF B~ ..-cR~...€' ~n
OFFICE OF JœrlVIRONMENTAL SERVICES
1715 Chester Ave., Baker.sßeId, CA <"I) 326-03979
APPLICATION TO PERFORM
FUEL MONITORING CER".l1FICATlON
FA.œ..trY 56, ¡?,-.J.~ .~
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