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Home My WebLink AboutBUSINESS PLAN (2)-- (V^1/ I ~mA J 1~ IVY 1I_` ` ~,ti Y ~~ ,~ ....r.~. ~/~ w ~ r g l~ ~ ~~ i ~ _ ~_ r ~~ ',', FASTRIP FOOD STORE '° 6401 SO H STREET l-- ~ ~ - - --~ -- psi ~ 7~~~~ 1 ~(,_ j ~~ J ~_ I r B E R S F I D FARE February 28, 2007 ~ R rM r Mr. Roy Saunders Fastrip #362 P.O. Box 1807 Bakersfield, CA 93380 RE: No Further Action Required for Fastrip #362 6401 South H Street, Bakersfield, California Ronald J. Froze Fire Chief Dear Mr. Saunders, Gary Hutton This is to inform you that this department has reviewed the Site Kirk Blair Investigation and Evaluation Report, dated July 2006, prepared by RAM Dean Clason Environmental. Based upon the information provided, this department Deputy Chlefs has determined that the assessment is complete, and that at this time, no further investigation, remedial or removal action is required in this instance at the above referenced site. Nothing in this determination shall constitute or be construed as a satisfaction or release from liability for any conditions or claims arising HOWARD H. WINES, III as a result of past, current, or future operations at this location. Nothing DIRECTOR in this determination is intended or shall be construed to limit the rights PREVENTION SERVICES of any parties with respect to claims arising out of or relating to deposit or disposal at any other location of substances removed from the site. 1600 Truxtun Ave. Suite 401 Nothing in this determination is intended or shall be construed to limit or , Bakersfield, CA 93301 preclude the Regional Water Quality Control Board or any other agency VOICE: (661) 326-3979 from taking any further enforcement actions. FAX: (661) 852-2171 This letter does not relieve the parties involved of any responsibilities mandated under the California Health and Safety Code and California Water Code if existing, additional, or previously unidentified contamination at the site causes or threatens to cause pollution or nuisance or is found to pose a threat to public health or water quality. If you have any questions regarding this matter, please contact me at (661) 326-3659. ~' Sincerely, Howard H. Wines, III Prevention Services Director Professional Geologist No. 7239 i Prevention Services Division cc: J. Ellis-McNaboe, RAM V~ V/~/ l/~~ ~ l.I~~'(I.i .'v V ifTiY V ~.i~C/G~'~~D' Wv~ N _~~ ~ a ~,`- '~ - Prevention Services UNIFIED PROGRAIVI INSPECTION CHECKLIST.. A ~ R. s r , . ,, 900Truxtun Ave., suite 210 _..c .~s~ ___ ~...~_,.. ~, _r_ ~_w~~.. _ - - FiR~ Bakersfield, CA 93301 ' SECTION 1: Business Plan Wand-Inventory Program ° '°RT"' .Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~ r INSPE rTI N DATE INSPECTION TIME "~ 1 1 ADDRESS- ~ ~ tl PH~N? i O. ~~ NO OF EMPL/ ~ES ~ ~ ~ FACILITY CONTACT BUSINESS ID NUMBER 15-021- ,. - Section:1: Business Plan and Inventory Program ^ ROUTINE m~'bMBINED ^ JOINT AGEPJCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS LAY ^ APPROPRIATE PERMIT ON HAND ^ BUSIr1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS / ^ CORRECT OCCUPANCY C ~ ~ / LJ~ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES L Y - / L~ ^ VERIFICATION OF LOCATION P . ~/ L~l ^ PROPER SEGREGATION OF MATERIAL ~ g ^ VERIFICATION OF MSDS AVAILABILITY l~ ^ VERIFICATION OF HAZ MAT TRAINING / ( X ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ / L~' ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ,~ / L~ ^ FIRE PROTECTION ^ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES '~ NO QUESTIO~~ REGARDIaYG THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Pre~ion / 1~` In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy /~ / a !~ Bus' es Sit /Responsible arty ( ase Print) Pink -Business Copy FD 2155 (Rev. 09/05 r INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST B E R S F I L D F/RE ARTM T INSPECTION DATE: ~ ~ 0 Page 1 of 1 FACILITY NAME: rG,~rc n Section 2: Underground Storage Tanks Program ^ Routine I~Combined ^ Joint Agency ^ Multi-Agency Type of Tank it~tts ~~S Number of Tanks Type of Monitoring (.` Lf11 Type of Piping ^ Complaint ^ Re-Inspection BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 OPERATION C V COMMENTS Proper tank data on file Proper owner /operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current / N ~ ~ Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? ^ Yes ~ No Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank Aggregate Capacity Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overfill /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services ~. ~~ Bus! ess Site Responsible Party Pink -Business Copy KBF-7335 FD 2156 (Rev. 09/05) .a <. FASTRIP 362 SiteID: 015-021-000626 Manager ROGER HAWATMEH Location: 6401 S H ST City BAKERSFIELD BusPhone: (661) 831-4709 Map 123 CommHaz Moderate Grid: 24D FacUnits: 1 AOV: CommCode: BFD STA 05 EPA Numb: SIC Code:5411 DunnBrad: Emergency Contact / Title Emergency Contact / Title ROGER HAWATMEH / MANAGER R CRAIG LINCOLN / DIR/MAINTENANCE Business Phone: (661) 831-4709x Business Phone: (661) 393-7000x 24-Hour Phone (661) 831-4709x 24-Hour Phone (661) 834-4503x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact R CRAIG LINCOLN Phone: (661) 393-7000x MailAddr: PO BOX 82515 State: CA City BAKERSF IELD Zip 93380-2515 Owner JACO HILL Phone: (661) 393-7000x Address PO BOX 82515 State: CA City BAKERSF IELD Zip 93380-2515 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG U - UST -- Based on my inquiry of those individuals responsible for obtai i n ng the information, I certify under penalty of iaev that t have personally examined and am familiar vrith the information submitted and beli eve the information is true, accurate, and complete. Signature " "'°""'° ~~~~ D~ e -1- 07/11/2007 F FASTRIP 362 SitelD: 015-021-000626 ~ STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: FASTRIP 362 Cross Street Business Type: Org Type: Total Tanks 4 IndnRes/Trust: No PA Contact: Dsg Own/Oper DOUGLAS M YOUNG III ICC Nbr: 0878646-UC PROPERTY OWNER INFORMATION Name R CRAIG LINCOLN Phone: Address: City State: Zip: Type CORPORATION (661) 393-7000x TANK OWNER INFORMATION Name R CRAIG LINCOLN Address: City Type CORPORATION Phone: (661) 393-7000x State: Zip: BOE UST Fee# 019753 Financ'1 Resp: SELF INSURED Legal Notif Date:04/26/2000 Name:R CRAIG LINCOLN State UST # Phone: (313) 2 - Ttl:DIR/MAINTENANCE 1998 Upg Cert#: 00764 x -2- 07/11/2007 r F FASTRIP 362 SiteID: 015-021-000626 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod PREMIUM UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod DIESEL #2 F IH DH L 12000.00 GAL Low -3- 07/11/2007 -4- 07/11/2007 F FASTRIP 362 SiteID: 015-021-000626 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: UST CAS# 8006-61-9 Liquid TMixtur~ AmbRent~E ~ AmbientT~E ~UNDEROGROIUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 8000.00 GAL t1L~GL-1KLVUJ ~Vinrulv~ivl5 %Wt. RS CAS# 100.00 Gasoline No 8006619 ru~~titcL H55~551~i~iv1 a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED GASOLINE Location within this Facility Unit UST STATE - TYPE PRESSURE Liquid Mixture I Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 TEMPERATURE CONTAINER TYPE Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 8000.00 GAL ru~c~xttl~vua ~.V1~1rVlvrJly t ~ %Wt. RS CAS# 100.00 Gasoline No 8006619 L1HGtiKL H.7 .7.C~.7.71"1L~1V 1 .7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -5- 07/11/2007 F FASTRIP 362 ~ Inventory Item 0004 COMMON NAME / CHEMICAL NAME DIESEL #2 Location within this Facility Unit UST SiteID: 015-021-000626 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 68476-34-6 Liquid TMixture ~mbient~E ~ AmbientT~E ~ UNDEROGROIUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 6000.00 GAL t~~~ttuvu5 ~ui~irvlv~;iv~t~5 %Wt. RS CAS# 100.00 Diesel Fuel No. 2 No 68476302 t11~L,t1tCL E35 Ji55a1~11";1v~1~J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -6- 07/11/2007 F FASTRIP 362 SiteID: 015-021-000626 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/01/2000 ~ CALL 911. Employee Notif./Evacuation 03/28/2007 ALL EMPLOYEES ARE TRAINED AND AWARE THAT IN THE EVENT OF AN EMERGENCY SITUATION THEY ARE TO FOLLOW THESE PROCEDURES: SHUT OFF, IF POSSIBLE, MAIN POWER BREAKER; EVACUATE THEMSELVES AND ANYONE IN OR AROUND THE PREMISES; CALL 911; AND NOTIFY CLOSE NEIGHBORS TO EVACUATE, IF NECESSARY. Public Notif./Evacuation 03/28/2007 EVACUATE ANYONE IN OR AROUND THE PREMISES AND NOTIFY CLOSE NEIGHBORS TO EVACUATE, IF NECESSARY. Emergency Medical Plan 07j18/2006 EMERGENCY 911 OR MEMORIAL URGENT CARE, 6501 MING AVE, 397-4004, MEMORIAL HOSPITAL, 420 34TH ST, 327-1792. -7- 07/11/2007 F FASTRIP 362 SiteID: 015-021-000626 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 03/28/2007 ~ ALL EMPLOYEES SHOULD BE AWARE OF LOCATION OF EMERGENCY SHUT-DOWN CONTROLS FOR GASOLINE EQUIPMENT. PROCEDURES TO FOLLOW IN THE EVENT OF AN EMERGENCY ON THE GAS ISLAND ARE AS FOLLOWS: IF A CUSTOMER OVERFILLS A VEHICLE TANK RESULTING IN A SMALL SPILL - HOSE DOWN THE AREA WITH WATER; IF A CUSTOMER DRIVES OFF WITH GAS NOZZLE IN CAR FILL TANK, RESULTING IN A SUBSTANTIAL FLOW OF GASOLINE - SHUT DOWN ENTIRE SYSTEM, CALL FIRE DEPT, CALL DISTRICT MGR, CLEAR THE GAS ISLAND; IF VEHICLE DAMAGE TO ONE PUMP RESULTS IN A LEAK, SHUT DOWN POWER TO THIS PUMP ONLY, HOSE DOWN AREA AND CALL YOUR DISTRICT MGR; AND IF AN ADJACENT BUSINESS/BLDG IS ON FIRE, SHUT DOWN THE ENTIRE GAS ISLAND. Release Containment 03/28/2007 GAS PUMPS HAVE EMERGENCY SHUT-OFFS. ABSORBANT MATERIAL IS STORED NEAR IN CASE OF SMALL SPILLS. Clean Up 03/28/2007 ABSORBANT MATERIAL USED TO SOAK UP SPILLS AND STORED IN AN APPROVED CONTAINER TO BE DISPOSED OF BY A HAZARDOUS WASTE HAULER. v~,iici .ccc~vui~.c tal~l.lV0.l.1V11 -8- 07/11/2007 F FASTRIP 362 SiteID: 015-021-000626 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ aNC~:iai na~.uiua Utility Shut-Offs 03/28/2007 GAS - NE CRNR EXT OF BLDG ELECTRICAL - SW CRNR INT OF STORE BEH STORAGE DOOR WATER - SW EXT OF BLDG Fire Protec./Avail. Water 03/28/2007 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS: ONE S INT DOORS AND ONE NW INT STOCKROOM. FIRE HYDRANT - SE CRNR OF SITE S H & PANAMA LN AND 100FT W OF SITE ON N SIDE OF PANAMA. Building Occupancy Level 03/31/2006 12 EMPLOYEES -9- 07/11/2007 ,: ,~ F FASTRIP 362 SiteID: 015-021-000626 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 03/28/2007 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUNII~lARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE TRAINED AND AWARE THAT IN THE EVENT OF AN EMERGENCY SITUATION THEY ARE TO FOLLOW THESE PROCEDURES: SHUT OFF, IF POSSIBLE, MAIN POWER BREAKER; EVACUATE THEMSELVES AND ANYONE IN OR AROUND THE PREMISES; DIAL 911; AND NOTIFY CLOSE NEIGHBORS TO EVACUATE, IF NECESSARY. rciyC G Held for Future Use Held for Future Use -10- 07/11/2007 `~ ~~t1 7 -! -- GS`c~~ ~_~ +: ~ MONITORING SYSTEM CERTIFICATION 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 seuarate certification or report must be prepared for each monitoring 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 this date. A. General Information Facility Name: #362 Fastrip # #633 Bldg. No.: Site Address: 6401 South H Street City: Bakersfield Zip: 93304 Facility Contact Person: Omero Garcia Contact Phone No.: 661-393-7000 Make/Model of Monitoring System: Veeder-Root TLS 350 Date of Testing/Servicing: 08/2/2007 B. Inventory of E uipment Tested/CertiSed Cock the approgiale 6o=m N giasfie egmpment impatedlaecviced: Tank ID: 12000 gal. Regular Tank ID: 12000 gal. Super (X] In-Tank Gauging Probe. Model:~7390-7oT U In-Tank Gauging Probe. Model: ~~390-107 [x] Annular Space or Vault Probe. Model:7~~~3 [~ Annular Space or Vault Sensor. Model: 794390303 [x] Piping Sump /Trench Sensor(s). ModeL•~~-208 U Piping Sump /Trench Sensor(s). Model: 794380-208 U Fill Sump Sensor(s). Model:7~o-~ U Fill Sump Sensor(s). Model: 794380-208 [J Mechanical Line Leak Detector: Model: FX1v U Mechanical Line Leak Detector. Model: Fx1v ^ Electronic Line Leak Detector. Model: ^ Electmnic Line Leak Detector. Model: LU Tank Overfill /High Level Sensor. Model: 794390-707 U Tank Overfill /High Leval Sensor. Model: 794390-107 ^ Other (specify equip. type and model in Sec. E on Pg. 2) ^ Other (specify equip. type and model in Sec. E on Pg. 2) Tank ID: 12000 gal. Diesel Tank ID: [x] In-Tank Gauging Probe. Mode1:847390-107 ^ In-Tank Gauging Probe. Model: [x~ Annular Space or Vault Sensor. MOde1:847380-303 ^ Annular Space or Vault Sensor. Model: [x] Piping Sump !Trench Sensor(s). Model:~~o-~ ^ Piping Sump f Trench Sensor(s). Model: [x] Fill Sump Sensors(s). Mode1:794380-208 ^ Fill Sump Sensor(s). Model: [x1 Mechanical Line Leak Decector. Model:FX1DV ^ Mechanical Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model: (X] Tank Overfill /High Level Sensor. Mode1:847390-107 ^ Tank Overfill /High Level Sensor. Model: ^ Other (specify equip. type and model in Sec. E on Pg. 2) ^ Other (specify equip. typs and model in Sec. E on Pg. 2) Dispenser ID: 1 ~ 2 Dispenser ID: 3 & 4 [7 Dispenser Containment Sensor(s). Model: 794380-208 [X] Dispenser Containment Sensor(s). Model: 794380-208 [X] Shear Valve(s). [X] Shear Valve(s). ^ Dispenser Containment Float(s) and Chain(s). ^ Dispenser Containment Float(s) and Chain(s) Dispenser ID: 5 ~ 6 Dispenser ID: 7 ~ 8 (X] Dispenser Containment Sensor(s). Model: 794380.208 (x] Dispenser Containment Sensor(s). Model: 794380-208 U Shear Valve(s). [X] Shear Valve(s). ^ Dispenser Containment Float(s) and Chains(s). ^ Dispenser Containment Float(s) and Chain(s). Dispenser ID: Dispenser ID: ^ Dispenser Containment Sensor(s). Model: ^ Dispenser Containment Sensor(s). Model: ^ Shear Valve(s). ^ Shear Valve(s). ^ Dispenser Containment Float(s) and Chain(s) ^ Dispenser Containment Float(s) and Chain(s). *If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. CertifieaNoII - I certify that the equipment identified in this document was inspected/services in accordance with the manufacturers' guidlines. Attached to this Certification is information (eg manufacturers' checklist) necessary to varify that this information is correct and a plot plan showing the layout of monitories equipment For m t gable of generating such reports, I have attached a copy of the report; (check all that apply) ~ System report Technician Name (print): Matthew Jennings Signature: Certification No: 835445 License No: s049oa Testing Company Name: Confidence US7 Services, inc. Phone No: 80033 930 Site Address: saol south H street , Bakersfletd, CA 93304 Date of Testing/Servicing: 08!2/2007 ~~ D. Results of Testing/Servicing Software Version Installed: 327.04 Complete the following checklist: [x] Yes ^ No* Is the audible alarm operational? x Yes No* Is the Visual alarm operational? x Yes No* Were all sensors visually inspected, functionally tested, and confirmed operational? x Yes ^ No* Were all sensors installed at the lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? x Yes No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) N/A operational? x Yes ^ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary ^ N/A containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initate positive shut-down? ^ Sump/Trench Sensors[X]Dispenser Containment Sensors Did you confirm positive shut-down due to leaks and sensor failure/disconnected? [~ Yes; ^ No; ^ Yes ^ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no L] N/A mechanical overfill prevention valve is installed), is the overfill wanting alarm visual and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capasity does the alarm trigger? 90 ^ Yes* ^ No Was any monitoring equipment replaced? If Yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. ^ Yes* [] No Was liquid found inside any secondary containment systems designed as dry systems? ^ Product; ^ Water. If yes, describe causes in Section E, below. x No* Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. x yeS No* Is all monitoring equipment operational per manufacturer's specifications? * In Section E below, describe bow and when these deficiencies were or will be corrected. E. Comments: F. In-Tank Guaging /SIR Equipment: U Check this box if tank guaging is used only for inventory control. ^ Check this box if tank guaging or SIR equipment is installed. This section must be completed if in-tank guaging equipment is used to perform leak detection monitoring. Complete the following checklist: L] Yes ^ No* Has all input wiring been inspected for proper enter and termination,including testing for ground faults? x Yes No* Were all tank guaging probes visually inspected for damage and residue buildup? x Yes No* Was accuracy of system product level readings tested? x Yes No* Was accuracy of system water level readings tested? x Yes No* Were all probes reinstalled properly? ^ Yes ^ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section II, below, describe how and when these defciencies were or will be corrected. G. Line Leak Detectors (LLD): ^ Check this box if LLD's are not installed. Complete the following checklist: [x] Yes ^ No* For equip. start-up or annual equipment certification, was a leak simulated to varify LLD performance? (Check all that apply) Simulated leak rate: [x]3 g.p.h.: ^0.1 g.p.h.; ^0.2 g.p.h.; x Yes No* Were all LLD's confirmed operational and accurate within regulatory requinnents? x Yes No* Was the testing apparatus properly calibrated? Yes No* For machanical LLD's, does the LLD restrict product flow if it detects a leak? N/A ^ Yes No* For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak? [~ N/A ^ Yes No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is [x] N/A disabled or disconnected? ^ Yes No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system (~ N/A malfunction or fails a test? ^ Yes ^ No* For electronic LLD's, have all accessible wiring connections been visually inspected? U N/A ^ Yes No Were all items on the equipment manufacturer's maintenance checklist completed? * In the section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: FA:;TF,' I P 3'~t~ 641]1 S.H ST BAI;ERSFIELD C:A.8;s3Da 6t t -831 -~9D9 AUG. '?. ~'DIJ? 8:58 AI~I SY TEh9 S7'ATLI;~ REI='GRT ALL FUhJt:;TI~.:.+I+JS fVC~Rt°lAL I hJ'uENTUR"! REPt;RT T' l : urVL VGLUi°1E _ 8I 61 Gi;LS ULLAGE = 3839 GALS 9U3~ UL.LA~:,E= '.:.'639 C~AL.S TC 1?GLUt°IE = ? 56U GALS HEIGHT = 61:7? INCHEF.; .. 6+.Ir;TER. tIUL = 0 C,ALS WATER = D . iJD I fNCHE:~ TE(~1P - 95.1 DE~:a F T '~ :PNL 1.?s,LUP~IE = 66D5 GALS ULLAGE = 5:395 t. ALS 9U% ULLAC;E= 4195 GALS TC: VULUh1E = 6455 GALS HEIGHT = 51.81 IPJGHES WATER VUL = D GALS WATER = D , UU I INCHES TEf°1P = 92.4 DEG F T 3 : D I EE:EL VULUI°1E = 4?22 GALS ULLAGE _ ?278 GALS 50~'o ULLAGE= 60?8 GALS T~.~ VirLUh9E = 4653 G%LS HE I ~:~HT = 313.68 I PJCHES bJATER VUL = D GALS WATER = i7 , DD T NC:HE;3 TEt°1P = 5'2.4 DEC; F x * '~ ~ x EIVD * ~ x S'lSTEt"1 SETUP AUG 2. 2UU? 8:58 AI°t 5~'~~TEI°t UtV I TS 11.5 S'7STEI°1 LAPJGUAi ~E ENGLISH ~'fSTEN1 DATE,~T I h9E FURNIAT MUN DU ~ Y'Y'! HH : t°Ilvl : SS xtvl FASTRIF' 326 6401 S.H ST BA};ER ~F I ELD C'A. 933D4 661-831-4?09 SH I F'P T I t~iE 1 5: uD Aih SHIFT TII°lE '~ DISABLED SHIFT TIN1E 3 D[.SABLEG SHIFT TIh1E 4 DISABLED TAN}: PER TST PJEEDED UJRhJ DISABLEDt TAIV}: ANN T:~T hIEEDED 6JRN DISABLED LINE RE-ENABLE METHUI7 PASS L I tVE TEST L.I NE PER TST (NEEDED 6,IRN DISABLEDi LINE ANN T'ST tVEEDED J:JRhJ DISABLED PRINT TC' VuLUI°tES E tNABLED TEMP CUtWPEIVSAT 1 UN VALUE CDEG F is 6D.u ST I Gb`. HE I GNT UFFSE'L D[SABLED ULLAi~E : 9D:~. H-PRGTUCUL RATA FC>RI°1AT HEIGHT DA;'LIGHT SAI,+i Nu TIh9E EhJABLED START DATE APR WEE}' 1 SUhJ START T I h1E 2 : DD AI°1 EIVD DATE GCT WEE}; 6 SUhJ EIVU T 1 h1E 'i : DO At~l RE-DIRECT LGCAL PR1tdTGUT DISABLEDt EURU PRUTC>C.GL PREF I i; S CUt°iN1UN I CAT I UN;_ ;SETUP PURT SETT I IVi. S C'.GN1Ni BGARLi 1 (RS-232) ' BAUD RATE 1'2UD PAR I T`! : UUD STGP BIT 1 STGP DATA LEIVGTH : 7 DATA RS-232 SEC'URIT'Y C'UDE DISABLED t~UMNI BEARD ? ': RS-2'325 BAUD RATE : 96D0 PAR I T'! NUPJE STG+P HIT 1 STUF DATA LENGTH : J3 DATA RS-232 :RECUR I T"! CEDE DISABLED CGGt°tt°1 BUARD 3 s: EU I f°I i RS-232 SECURIT'! CUUE DISABLED AUTU TRAPJSP~II T SETTINGS AUTU LEA};: ALARh9 L I t'1 I T DISABLED AUTU HIGH I~JFiTER LIMIT DISABLED AUTU GL'ERF 1 LL L I t°I I T DISABLED AUTU LU4J PRUGUCT' D I SASLED ~~---~- AUTG THEFT L I t°1I T DISABLED AUTG DEL 1'~.?ER`f :=~T'F;R'1' DISABLED AUTG DELIVER'! EPJLi D I ;ABLED AUTG E~STERINAL INPUT UIV D I SABL.ED AUTG E~TERIVAL ] I+JPLIT UFF DI ABLED AUTG SEhJSUR FUEL ALARI°1 L? I BAWLED AUTG SENSUR G,IATER ALARM DISABLELt AUTU SENSUR UUT ALARI°1 DISABLED e I (V-TA1d}: SETUP T 1 : U(VL PRciDUGT GODS 1 THERP'lAL U.C,;EFF :. 000700 T 2 : FPIL TAN}:: D I AP'IETER 9G 00 PROLiU~ T C;UDE 2 .TAN}: FRf?FILE . 1 PT THERh1AL ~: G+EFF :. OOC1700 FULL t?CsL J '000 TANK LiIA1°IETER 96.Oia TANk: FR~1F I LE 1 PT FULL 'vCSi_ 1'000 FLi r;;T :3 I ZE : a . 0 I 1+J . Wt=1TER bJARN I fVG .` 0 FLirAT S T ZE : 4 : G I N. HIGH WATER L It°I I T : 3.0 WATER 4JAk. N l hlu 2 . G MA,~; . UR LABEL t~rUL : 1200p HIGH In1ATER L I NI I T : 3.0 OVERFILL LIMIT 9D3,' f'1AX UR LABEL '+IGt .; 12000 ' HIGH FRODU+~T • '10800 95iN . OVERFILL LIMIT' 90' • 1 1 ~IOD 10800 DELCb+Ek'c' LIMIT 15 HIGH Pk.UDUC;T 95` ' 1900 1140u DEL I tiERY L I h11 T 1 5"5 LCs1,J PR.ODUt_;T 500 1800 LEAK ALAR1°I L I t°111' : SUDDEN LOSS L I NI I T : 99 99 LUW PRUDU~ T 500 TAPJK TILT' 00 8 LEA}: ALARI+9 L I P9I T : S9 PROBE OFFSET : 0 00 SUDDEN LOSS LIMIT: 99 . TAN}; TILT 8.00 PROBE t.>FFBET 0 . DO 5 f FHOPJ JNAN I FOLDED TAIV},:S T#: NOtVE L I PlE f°IAN I FOLDED TAIVKS T#: NONE LEAK M I P1 .PER 1 CsD I C:: l r • 120 LEA}•'. MI tV A1VI+JUAL i ra • 120 F'ERIUDIC TEST TYPE STANDARD r'il'JPJUAL TEST FAIL ALARP1 DISABLED PERIGDIC: TEST FAJI_ .ALARM DISABLED `~RC'SS TEST FA I L ALARP9 DISABLED ANN TEST' AVERA~., I PJC~ : OFF PER "fES'T At/ERAG I IUG : i?FF TAN}: TEST NUT I Fj` : UFF T1V}': TST S I PHOPJ BREAM; :UFF DELIVERY' VELA ;` 1 }°i I N PUJ°iP THRESHOL.D 1 0.00 n SIPHON P'1AIV 1 Ft?LL?ED TAN}:S T#: tdO1VE L 1 NE MAN I FOLDED TAIV}'.S T# : 1VOPJE LEA}: hiIPJ PERICsDIG: 1%b 12D LEAK f°1I N A1V1'•IUAL. I °.< 120 PER 1 CsD I G TEST T ~`PE STA fJDARD ANNUAL TEST FAIL ALARP9 DISABLED PER I ULi l ~~ TEST FA 1 L ALARJ°1 D 1 BAWLED GROSS TE:9T FA 1 L ALARM DISABLED AhJIV TEST AVERAGING : OFF F'Ek: TEST AVERAC; I fJG : UFF TAN}: TEST 1VOT I F1` : OFF 1'Nh T:~T S I PHUIV SREA}.:UFF UEL I VERY DELAY` i t°t I N PUf°iP THRESHOLD 1 D . OCJ~S T 3:DIESEL ,~. F'kODUC;T CODE THERP9AL C-UEFF :.000:150 TANK DIA1°lE'LER 93.00 TAhdK PRC>F I LE 1 PT F1,JLL ~.?CsL : 12000 FLOAT SIZE: 'I.0 J:JATEI~ WARPJ I PJG '°' . U 3 0 HIGH WATER LIMIT: . MH;~C Uk L~B1L~,?tisL : 1 20Q0 LsiIEF.F I LG L I M lT 90r 10800 NIGH PRODUCT =~5~° I 1 X100 DELLVER'Y LINILT 8 1 00 LOW F'RODUi;T 500 9y LEA}; ALARM L I I°t I T: SUDDEN LOSS LIMIT: TANK TILT .,.0•UO FRUBE OFFSET • 0.00 S}FHUN P9ANIFOLDED TAPJ};S T # : PJOIVE L I IVE MAPJ I FclLUED TANKS T# : IVOhJE LEA}: NiIIV F'ERIUDIG: 1 1'?0 LEA}; MIN ANNUAL : 1 1?0 F'ER I UD I4.= TEST T`l~~AWDARD AhdfJUAL TESALARf1LDISABLED PER 1 UDI ~~ TAI_AR~~D I SABLELi i:,F.OSS TEST FA I L ALARM UI~A~LED ANhJ TE:.:T AVERT=tGIfJG: S+FF F'ER TEST A'JERAG I PJG : UFF 'TANK TEST iVUT I F`i : UFF TPJ}; TST SIFHON BREAK :OFF DELI 1?ER'! LiELA`; I t°1 I P PUNJF' THRESHOLD 10 . DO° LIuUID SEPJSOR SETUP L 1 : UhJL STF' 1'R I -STATE f S I tV~..LE FLOAT i CATEGORY STF SUNiP LEA}; TEST P9ETHOL`i TEST ON DATE lLI_ 'I'AtV}=: - FEB E. 'LOU9 STATT T I t~1E U I BAWLED TEST' RATE : u .~ 0 GAL, HR UURATION 2 ..HOURS TST EriRLY STOP : D ! SA}3LED LEAk; TEST REPORT FORMAT PJORtHAL L '~:UNL FILL TR I -STr=iTE { S I NiaLE FLGAT i CATEt;OR': P I P I 1VG 'SUl°iP L 3 : UfVL AtVPJ TR 1 -STATE f S 1 Ivc_aLE FI_t1HT 1 ~-ATEGORY AIVldULAR SPA~:E L 4 : PlVL STP TR l -STATE ! S I PJGLE FLOAT CATEGORY STP SUh1P L S:PNL FTLL TRI-STATE !SINGLE FLOATi CATEGORY P I P I IVG SUMP L 6:PNL ANrv TR I -STATE (;; I NGLE FLf}AT ) i:ATEt30RY : HNNULAR SPACE L 7:DIESEL STP TR 1-STATE { S I IVGLE FLsiAT 3 CATEGOR`1 STP SUMP L B:UIESEL FILL TRI-STATE fSttdGLE FLOATI CATEGORY F' I P I hJG SUt°1P L 9:UfESEL ANid TRI-STATE {:=IIIV~~LE FLGAT+ CATEGORY AhiPJULAR SPACE CSUTFUT-RELA'X' SETI.iP _ - - R I:SHUT DOIn1PJ T'', PE STAtVDARU PJORt°IALLY CLOSED TAN},' # : 1 LI~~UIU SENSOR ALI°JS L 1 :FUEL HLARI°i L a :FUEL ALARI°I L 7 : FUEL ALARM L.10 : FUEL ALARt~i L11:FUEL ALARM 1.1~ :FUEL. ALARI'^I L 13 : FUEL ALARNi L 1 : SENSOR O U'1` ALARI°i L 4 : SEIVSOR OUT ALARh1 L 7:SENSOR OUT ALARI°l L 1 U : SEIVSOR OUT ALARM L1 } :SENSOR OUT ALARJ°i L12:SENSOk UUT ALARI°I L13:SENSOR OUT ALARhI L 1 :SHORT ALARI°1 L 4 : SHORT ALARI°1 L ?:SHORT ALARM L 1 l7 : SHORT ALARI°1 L 1 1 : SHORT ALARf°1 L 12 : SHORT ALARI°I L 13 : SHORT ALAR.NI ISD SITE ALAkNiS . ISU GROSS FRES FAIL ISD UEGRD PRES FAIL ISU VAPOR LEA}`. FAIL. ISU ~1P PR,ES FAIL ISD VP STATUS FAIL L10:UISP 1-'~ TRI-STATE fSlPk:3LE FLOAT; CATEGORY U I SPEN:ER PAIN Lt I :DISP ;~-a TR I -STATE f S 1 !NGLE FLGAT'r CATEGOR'! DISPEPJSER F'AN L1':UISP 5-b TR I -STATE f S I PJGLE FLt~AT ~ i:ATEGORY DI:~F'EIVSER F'r=+t'•J L1.3:UISP r-E TRI-STATE {SINGLE FLr~AT) CATEGORY UISPEtVSEk PHPJ I SU HOSE ALARI°IS AL.L : GRO:;S. COLLECT FAIL ~ ~ -~- _ ALL : UEi_,kP GdLLECT FAIL I tV--TAPJ}ti ALAkt°IS - _- - {-~ 1 : FLOW COLLECT FA [ L ALL : O'~EkF I LL ALARP•1 h '~:FLOb.I COLLEiT- FAIL _ ALL:HIt^,H F I-. 3 : FLOW C:OLLEC:T FA I L I-~ 4:FLOW COLLECT FAIL h 5:-FLOW COLLECT FAIL 1-. 6 : FLOW COLLECT FA I L I-i 7 + FLOW i~OLt.Ei=,T FA I L h 8 : FLOW COLLECT FA I L I-. 9 : FLOW COLLECT FA I L I-~ 10 : FLO6~J COLLECT F'A I L hl1:FLOW COLLECT FAIL 1-~ 1 E :FLOW f,'OLLECT FA I L h1:~:FLOW COLLECT FAIL. 1-.1 ~1: FLOW COLLECT FA I L h 15~: FLOtrJ COLLECT FA I L I-~ 1 b : FLO6J COLLECT FA I L h17:FLOW COLLECT FAIL 1-~ 1 B :FLOW COLLECT FA1 L h19:FLOW COLLECT FAIL t-~~?0 : FLOI~,I COLLECT FA I L h'' 1 : FLOW COLLECT FA I L h'?2:FLOW COLLECT FAIL h'am' 3 : FLOW ~ :OLLEC.T FA 1 L t-i2~I :FLOW COLLECT FA I L I-~'~5 : FLOW COLLECT FA I L I-~'~b :FLOW COLLECT FA I L I-~27:FLOW COLLECT FAIL I-~28:FLOW COLLECT FAIL h29 : FLOW CCrLLECT F'A I L 1-~30:FLOW COLLECT FAIL 1;31 : FLOIJ COLLECT FA I L 1-~3E:FLOW COLLECT FAIL h33 : FLOW COLLECT FA I L I-~3y:FLOW COLLECT FAIL 1-35 : FLOW COLLECT FA I L h~6 : FLOW %OLLECT Fr"i I L 1-.3^:FLUW COLLECT FAIL h38 : FLUW i~.OLLECT FA I L I-~39 : FLOW COLLECT FA I L h~0:FLOW COLLECT FAIL 1-~y i : FLOLJ COLLECT FA I L ha'~ :FLOW i~OLLECT FA I L h43 : FLOW COLLECT Fia I L R '~ : tsVERF 1 LL ALARI°i TYPE: :~Tf=iPJrir"ikU fJORNIALL+' OF'EIV ALL :MAX PRODUiuT ~LARkrvt SI`1ARTSENSO'k SETUF s 1:P.S 1_.~ Cf=;TEiatsray L+r";Pc=sR PREtiSUI2E ~~'~F.th } _.a C~HTEia(~tk~• H jk FLOW f~'IETEk i~'ATEGOR ;' n I R FLGbJ f'IETE'R y.:F.M 5-6 ~~ATEi"aORI' AIk FLObJ thETEk s S:F.t'1 7_g CATEuOk~ A1k FLt3(.J f°IETER E~IF,r'ISD SETUP E11R TYPE : 11ACUUI°t ASSIST vAC: UUh1 ASSIST TYPE HEALY S.1fiii: fdOZvLE AtL RAPIGE htA:~ : l. l ~ t°i I N: 0.95 VHPOk PROCESSC}R T`c'F'E hI0 VAPOR PROCESSOR AIVALYS I S T I t°lES T I f°lE : 10:00 AN1 UELAY MINUTES: 1 ACCEPT HIi;H GRUB: DISABLED ISD HONE TABLE IU FP FL HL AA RR 01 33 01 u2 O1 UU 0'2 3~I 03 02 01 UU 03 35 03 02 02 UU U4 u0 04 02 02 UU 05 O1 05 U'~ 03 UU ob u'~ o~ a~ 03 uu 0'7 03 0? 02 Oa UU 08 04 08 02 04 UU 1 SCi AIRFLO W METER NIAF' I U SERIAL IVUI°i LABEL ! 8759 F.M 1-~ 3 8?52 F.Ni 5 -6 4 8757 F.I°I 7-a TANf: # : IVONE ~~ I SD FUEL UR;=yCiE H~JNE ht~F 1 r 3 FF~ t°iHH h1HH 1"iHH h1HH A 00 20~ 8U4-901 O 1 ?05 305 5 U ~ ---- - I PJ-'I'r~hlI°: HLNRI°i - -"_ F~,S1'R I P 326 905 U2 <O6 306 906 03 U U U U 3 3 1' I:UNL PRGUII~IT HLr~+RM 6401 :~ . H ST $HIiER;3FIELD ~'ri.G~i30~1 90? 207 307 04 908 5 U ~ HIi=N AUU ._.. 200? i : 3? F'P9 661 -831 -4?09 33 201 301 918 c ~ ~ j RUC; '2. '200? 9:'2'~ r~hi ~~ '20? 302 902 U U 1 3.~ 203 303 y03 b U 2 LHBELT~BLE ' S'i'STEhI E'Tr~1'U~ REPORT ------ ------ ------- 1 ~ UIV~~E 1 GNED ------ ---- L 2:FIJEL r~L~Rt°i 2: BLENDS _ 3 ~ REGULgR _ - -- I t'J-Thl'J1; HLr~RP't --- • ~: t"1ID i;Rr~DE T '2:FNL 5 : PREhI I UP9 H I f;M PRi iGUi :T ~Lr~Rt°1 6: 04LL1 r~Uu ~ '200'? 1 :38 FP9 7: EtkON?E 8 : SILL+ER 9: BLEND2 ! 0: BLEJdD~ L I : UPJL STF' :~1'P ~l1MF' ---_ I id-'THN}C r~L~RI°i ----- FUEL hL~RNI T 3:L~ [E ~EL HUG ?. 2'00? 9 :3l fif^'t H I ~ ~H PRODU~fT ALARI"1 HUG =. '200'i 1 :39 Ft'i Pt"1C SETUp FRUG'ESStyR t1ONTR0L LEVEL NOfJE ----- EEPlSOR .=iC.r`tRP1 ----- L 4 : FfJL 5TP ;~"fP SUI"1P FUEL r~LF~RhI huG 2, 2ort~ 9:31 ~M ---- GEIV:~t~~R ~LhRh9 ------ L ?:Ct{E~EL ~T'F' STP 5Ut"ti/ FIIEI_r',Li=1Rl"1 r~uG ~~. ~20Ct? 9:3'2 ~,r"t ----- 5Et'dSOR F7L~Rhi ----- L 5 : F'PJL F' I I..C. F T F I PJG :~UhiF FUEL HL~iRt^1 hUG 2, '20C? 9:32 rthl __ _ - -, • ----- SEPJEiJR h'Lr~Rt°1 -____ . ___-- SEt•J':~;~R hL~Rt^9 ----- L B:DIESELrFILL L 6:PIVL HPJPJ 1/IF I tVG JUh1F HldNUL~R Pi;~E FUEL HLr"iR(h FLIEL riLnRNI HUl_, ?: ?00? 9:;.i_i Ht°i HUB: 2, 20197 9:~l0 r-if"1 --_-- 6;E}V~~iR HLrkl°1 -~_____ ----- EEt'J~c>R ~LriRhJ __.___ i_IU:DISFr 1--2 L 9:DIE~:EL r;tVPd DISF'EPJSER F'F;tV rhJPdUL~R~~:fi•AC:E FUEL r~LNR(°I FUEL fiLi;RNI FiU~:a 2.00? 5: a3ri("1r"~Ui3 2. '?00? 9:40 HNJ ----° :~EPJ:.;t~k ~LrRP't _____ F~r5TRi1=~ ;926 Li'_:DLEI~ 5-6 6401 E~.li :3T D I SPE(VEER F'tat~l BH}:ERSF I ELD ~.r~ r 9:.i30~J FUEL HL~R(°1 661-831-4709 HUt9 2. 2007 9:34 HI°I riUi~ 2. 2U07 9:41 ~I°I ~`,'S7'Et'•I S1'~T'lJ ~ REF'GRT hLL FUtVGT I GIVS J•~1~RN}HL :UF.hlElk". ELF=iR(°I L1:9:DI ~F 7-8 D I:~FE(VSER F'i~PJ FUEL HLHR!°! NUi; 2. w'U07 9:36 HNI }-. 1 : FF' 1 : BLE('JD3 I:aEi:~k,U C:;:;LLE(:"[' 4~JNRP•! iiUi_d 2, 2007 1 U : 0 i ~(°J ~EN:30R ~Lr~RM L11:riISF 3-4 17I~F'EN~ER Fr;PJ FUEL ~LrR(°1 F~^.,Tk I F~ 32t; i;aDl ~.H ~T Bh}~ER;~FIELD i';fi.933G4 661-831-x709 HUi=; 2 . '?007 1 L"1:10 nhl L 3 : U(VL ~;tVtV 5y`5TE('9 ST~TLI ~ REF•URT hi'JIJLILF~R :~F'~ivE _ _ _ _ _ _ _ _ _ _ _ _ FUEL faLF`iR("1 (-i ! :DEGRD C<>LLF..i>1" 6Ji=iklV FtUia '?,x'00? 9:4U r'1f°l i, ~ 7 SWRCB, January 2006 Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and printouts from tests (japplicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: #362 Fastrip #633 Date of Testing: 8/2/2007 Facility Address: 6401 South H Street ,Bakersfield, CA 93304 Facility Contact: Omero Garcia Phone: 661-393-7000 Date Local Agency Was Notified of Testing : 7!23/2007 Name of Local Agency Inspector (if present during testing: None 2. TESTING CONTRACTOR INFORMATION Company Name: Confidence UST Services, Inc. Technician Conducting Test: Matthew Jennings Credentials!: X CSLB Contractor X ICC Service Tech. ^ SWRCB Tank Tester ^ Other (Specify) License Number(s): CSLB #804904 ICC #5302760-UT 3. SPILL BUCKET TESTING INFORMATION Test Method Used: x Hydrostatic ^ Vacuum ^ Other Test Equipment Used: Lake Test Equipment Resolution: 0.0625" Identify Spill Bucket (By Tank Number, Stored Product, etc.) 1 Regular 2 Super 3 Diesel 4 Bucket Installation Type: ^ Direct Bury x Contained in Sump ^ Direct Bury x Contained in Sump ^ Direct Bury x Contained in Sump ^ Direct Bury ^ Contained in Sum Bucket Diameter: 12.00" 12.00" 12.00" Bucket Depth: 10.75" 11.75" 10.75" Wait time between applying vacuum/water and start of test: 5 min. 5 min. 5 min. Test Start Time (TI): 9:30am 9:30am 9:30am Initial Reading (RI): 10.50" 11.50" 10.50" Test End Time (TF): 10:30am 10:030am 10:30am Final Reading (RF): 10.50" 11.50" 10.50" Test Duration (TF - T~): 1 hour 1 hour 1 hour Change in Reading (RF - RI): 0.00" 0.00" 0.00" Pass/Fail Threshold or Criteria: 0.0625" 0.0625" 0.0625" Test Result: X Pass ^ Fail X Pass ^ Fail X Pass ^ Fail ^ Pass ^ Fail CommeIIts - (include information on repairs made prior to testing, and recommended follow-up for failed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that aU the informatio containe in this report is true, accurate, and in full compliance with legal requirements. Technician's Signature: Date: 8/2/2007 ' State laws and regulations do not currently requir ing to be performed by a qualified contractor. However, local requirements may be more stringent. f~ ~ ~ ~~, ~ L/ Owner Statements of Designated Underground Storage Tank (UST) Operator and Understanding of and Compliance with UST Requirements Facility Name: Fastrip #633 (Exxon) Facility ID #: 3024 Facility Address: 6401 South -H- Street, Bakersfield, CA 93304 (City) Reason for Submitting this Form (Check One) X Addition of Designated Operator Facility Phone #: 661-831-4709 ^ Update Certificate Expiration Date Designated UST Operator(s) for this Facility ALTERNATE 3 (Optional) Designated Operator's Name: Jessica L. Meyers Relation to UST Facility (Check One) Business Name (If different from above): Confidence UST Services, Inc. ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 800-339-9930 ^ Service Technician x Third-Party International Code Council Certification #: 5313857-UC Expiration Date: June 30, 2009 ALTERNATE 4 tional Designated Operator's Name: Relation to UST Facility (Check One) Business Name (If different from above): ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: ^ Service Technician ^ Third-Party International Code Council Certification #: Expiration Date: ALTERNATE 5 (Optional) Designated Operator's Name: Relation to UST Facility (Check One) Business Name (If di, fJ`erent from above): ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: ^ Service Technician ^ Third-Party International Code Council Certification #: Expiration Date: I certify that, for the facility indicated at the top of this page, the individual(s) listed above will serve as Designated UST Operator(s). The individual(s) will conduct and document monthly facility inspections and annual facility employee training, in accordance with California Code of Regulations, title 23, section 2715(c) - (f). Furthermore, I understand and am in compliance with the requirements (statutes, regulations, and local ordinances) applicable to underground storage tanks. NAME OF TANK OWNER (Please Print): Jaco Hill Co. SIGNATURE OF TANK OWNER: DATE: August 9, 2007 OWNER'S PHONE #: 661-393-7000 NOTE: I) SUBMIT THIS COMPLETED FORM TO THE LOCAL AGENCY (NOT THE STATE WATER RESOURCES CONTROL BOARD) BY JANUARY 1, 2005. THE' LOCAL AGENCY LIST IS AVAILABLE AT: www.waterboards.ca.gov/ust/contacts/cupa agys.html. ' ' 2) NOTIFY THE LOCAL AGENCY OF ANY CHANGES TO THIS INFORMATION WITHIN 30 DAYS OF THE CHANGE. November 2004 .~~ 3G .2. Owner Statements of Designated Underground Storage Tank (UST) Operator and Understanding of and Compliance with UST Requirements Facility Name: Fastrip #633 (Exxon) Facility ID #: 3024 Facility Address: 6401 South H- Street, Bakersfield, CA 93304 (City) Reason for Submitting this Form (Check One) ^ Change of Designated Operator Facility Phone #: 661-831-4709 X Update Certificate Expiration Date Desiunated UST Oaerator(s1 for this Facility PRIMARY Designated Operator's Name: Douglas M. Young III Relation to UST Facility (Check One) Business Name (If d~erent from above): Con, fidence UST Services, Inc. ^ Qw,ner ^ Operator ^ Employee Designated Operator's Phone #: 800-339-9930 ^ Service Technician x Third-Party International Code Council Certification #: 0878646-UC Expiuation Date: September 22, 2008 ALTERNATE 1(Ot~tionall Designated Operator's Name: Jennifer Davis Relation to UST Facility (Check One) Business Name (If d~erent from above): Confidence UST Services, Inc. ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 800-339-9930 ^ Service Technician x Third-Party International Code Council Certification #: 5258845-UC Expiration Date: March 15, 2009 Designated Operator's Name: Edward Mitchell Relation to UST Facility (Check One) Business Name (If di,,~'erent from above): Confidence UST Services, Inc. ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 800-339-9930 ^ Service Technician x Third-Party International Code Council Certification #: 5258845-UC Expiration Date: May 15, 2008 ALTERNATE 2 (Optional) l certify that, for the facility indicated at the top of this page, the individual(s) listed above will serve as Designated UST Operator(s). The individual(s) will conduct and document monthly facility inspections and annual facility employee training, in accordance with California Code of Regulations, title 23, section 2715(c) - (f). Furthermore, I understand and am in compliance with the requirements (statutes, regulations, and local ordinances) applicable to underground storage tanks. NAME OF TANK OWNER (Please Prlnt): daC Hill CO. SIGNATURE OF TANK OWNER: C~ Q DATE: March 23, 2007 v OWNER'S PHONE #: 661-393-7000 NOTE: 1) SUBMIT THIS COMPLETED FORM TO THE LOCAL AGENCY (NOT THE STATE WATER RESOURCES CONTROL BOARD) BY JANUARY 1, 2005. THE LOCAL AGENCY LIST IS AVAILABLE AT: www.waterboards.ca.gov/ust/contacts/cues agys html. 2) NOTIFY THE LOCAL AGENCY OF ANY CHANGES TO THIS INFORMATION WITHIl~I 30 DAYS OF THE CHANGE. November 2004 t UNIFIED PROGRAM INSPECTION CHECKLIST ~1;, ~... .. ..: .w....~.. _ ..,.. _:,.:... ~Rrr r SECTION 1: Business Plan and Inventory Program ~ BAHERSFIEILD FIRE DEPT Prevention Services 900 Tnixtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAM, ~ ~~ /)„ (/y NSP CTIO DATE INSPECTION TIME ADDRESS ( (~ ~ H E `~ O OF E OYEES r J 7 ~~ FACILITY CONTACT USINESS ID NUM R 15-021- Section 1: Business Plan and Inventory Program ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ ^ COMPLAINT ^ RE-INSPECTION i C V (C=compliance` OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSInt?SS PLAN CONTACT INFORMATION ACCURATE '- ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION 9 e nnnc ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ~~ 1 0 LUUO-- ^ VERIFICATION OF HAZ MAT TRAINING I!Y ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION E~ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES [~O EXPLAIN: - _ QUESTIONS R~ARDINC~ ~jI1S~ISPECTION? PLEASE CALL US AT (681) 328-3979 Inspector (Please Print) Fire Prevention / 1" In / Shitt of Site/Station ii' White -Prevention Services Yellow - Station Copy Pink -Business Copy FD2049 (Rw. 02/05) ,;~ ~~ 4~w~~' T~;~\ CITY OF BAKERSFIEI,D FIRE DEPARTMENT t`~ ~ ~ ~~ OFFICE OF >i:NV1RONNIEN'1'AL SERVICES y++` UNIFIED PROGRAM INSPECTION CI~F.CKLIST =,:w ~g~,~~'+ 1715 Chester Ave., 3r`' Floor, Bakersfield, CA 93301 FACILITY NAME ~I1,,~Ti'i/~ INSPECTION DATE Section 2: Underground Storage 'Tanks Program ^ Routine ~(~cTmbined _ ~ Joint Agency ^Minti-Agency ^ Complaint ^ Re-inspection Type of Tank ~~~ Number of Tanks ~ _ Type of Monitoring _ P~+ Type of Piping _ OPERATION C V COMMENTS Proper tank data on the Proper ownerioperator data on the Permit tees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? YeS NO ~-~ Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OF,S Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overtill/overspill protection'? C=Compliance V=Violati m Y-Yes N=NO Inspector: Office oFEnvironmental Services (661) 326-3979 white - [nv. Svcs. Pin ~... r+ + FASTRIP 362 _________________________________________ SiteID: 015-021-000626 + Manager Location: 6401 S H ST City BAKERSFIELD BusPhone: (661) 831-4709 Map 124 CommHaz Moderate Grid: 19C FacUnits: 1 AOV: CommCode: BFD STA 13 SIC Code:5411 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title DYNDA FRAME / JOHN KERLEY / Business Phone: (661) 831-4709x Business Phone: (661) 393-7000x 24-Hour Phone (661) 397-692Ox 24-Hour Phone (661) 834-4503x Pager Phone (661) 831-7885x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact Phone: (661) 393-7000x MailAddr: PO BOX 82515 State: CA City BAKERSFIELD Zip 93380 Owner JACO HILL Phone: (661) 393-7000x Address PO BOX 82515 State: CA City BAKERSFIELD Zip 93380 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG U - UST Based on m inquiry respo ibie f obtaining urid pen ty of law 1 exa fined nd am fa~ su mitte and believ a urat and complet ividuals f certify rsonally ~fr~o6 ~~~~~ ~5~ ~~ ~ ~p~~ ~~~® ~ ~~ ~' 8 ?oQs ------------ ----------- ----------- -1-~ 03/31/2006 w °~JNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 -- FACILITY NAM , INSP CTI DATE INSPECTION TIME ~ag~~~ ~ e~_ . ADDRESS P O N No. of Employees ---~`~~ ~ -~----~--------. -------------- --------- X31_=-~~~_ t 3 FACILITYCONTACT ~ -_.....--------..._....---......__ Business ID umber 15-021- Section 1: Business Plan and Inventory Program ^ Routine ombined ^ Joint Agency OMulti-Agency ^ Complaint ^ Re-inspection C V \V=Voatonncel OPERATION COMMENTS l~^ APPROPRIATE JPERMIT ON HAND ~^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ~^ VISIBLE ADDRESS LV' ^ CORRECT OCCUPANCY I ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ---------- ------------------ ~,, ~ -- L1Y L^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITYE ^ VERIFICATION OF HAT MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES C3 ^ EMERGENCY PROCEDURES ADEQUATE ~^ CONTAINERS PROPERLY LABELED LJ' ^ HOUSEKEEPING ^ FIRE PROTECTION LY ^ SITE DIAGRAM ADEQUATE St ON HAND i ANY HAZARDOUS WASTE ON SITE: ^ YES ~NO EXPLAIN: QUESTIONS CARDING IS PECTION~ PLEASE CALL US AT ~6C'I ~ 326-3979 - ~ Inspector Badge No., Business esponsible Party White -Environmental Services Vetlow -Station Copy Pink -Business Copy i~~ P~~w~~' T~~ CITY OF BAKERSFIELD FIRE DEPARTMENT ;d ~ ~ ~; OFFICE OF ENVIRONMENTAL SERVICES ~`~ y+` UNIFIED PROGRAM INSPECTION CHECKLIST \\°,W ~gti,,~'++ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 ..~~~~ FACILITY NAME ~ c c ~ INSPECTION DATE ~' Section 2:,. Underground Storage Tanks Program ^ Routine ~mbined ^ Joint Agency ^MultrAgency ^ Complaint ^ Re-inspection Type of Tank .~t~l ~= Number of Tanks 3 Type of Monitoring ~_C-G/1- Type of Piping ~c.U~ OPERATION C V COMMENTS Proper tank data on the Proper owner/operator data on file Permit tees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY. Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector: Office of Environmental Services (805) 326-3979 White - F.nv. Svcs. Business e Responsible Party Pink -Business Copy ~~ _ , FASTRIP 362 Manager TI,TT,-,T TTTIIRT Location: 6401 S H ST City BAKERSFIELD CommCode: BFD STA 05 EPA Numb: 30~`~ BusPhone: Map 123 Grid: 24D SiteID: 015-021-000626 (661) 831-4709 CommHaz Moderate FacUnits: 1 AOV: SIC Code:5411 DunnBrad: Emergency Co t~jjact / Title ~ ~r Emergency Contact / Title.~J " ~ ~ ' T TTTT T. LSD TTRT y~/ -s~r.m: fr~~:~ ~~~~/ MANAGER R ~~/ {~ ~ ~ "-" CRAIG LINCOLN / - ~ Business P one: (661) 831-4709x Business Phone: (661) 393-7000x 24-Hour Phone (661) ail=~/7~- 24-Hour Phone (661) 834-4503x Pager Phone (661).. Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact R CRAIG LINCOLN Phone: (661) 393-7000x MailAddr: PO BOX 82515 State: CA City BAKERSFIELD Zip 93380 Owner JACO HILL Phone: (661) 393-7000x Address PO BOX 82515 State: CA City BAKERSFIELD Zip 93380 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG U - UST I~ I 1~(~ C` Based on my inquiry of those individuals responsible for obtaining the information, I certify under en lt ~N~o~ ~~~ ~ ~ ~p07 p a y of law that I have personally examined and am familiar with the information submitted and believe the information is true , accurate, and complete. Signature `3 2 ~~ Date -1- 01/31/2007 -. F FASTRIP 362 SiteID: 015-021-000626 ~ - STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: FASTRIP 362 Cross Street Business Type: Org Type: Total Tanks 4 IndnRes/Trust: No PA Contact: Dsg Own/Oper DOUGLAS M YOUNG III ICC Nbr: 0878646-UC PROPERTY OWNER INFORMATION Name R CRAIG LINCOLN Phone: (661) 393-7000x Address: City State: Zip: Type CORPORATION TANK ER INF RMATI N Name R CRAIG LINCOLN Address: City Type CORPORATION BOE UST Fee# 019753 Financ'1 Resp: SELF INSURED Legal Notif Date:04j26/2000 Name:R CRAIG LINCOLN State UST # - OWN O O Phone: (661) 393-7000x State: Zip: Phone: (132) 6 - x Ttl:VP 1998 Upg Cert#: 00764 -2- 01/31/2007 F FASTRIP 362 SiteID: 015-021-000626 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ - -_ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP UNLEADED GASOLINE P~irn-~~ UNLEADED GASOLINE ., ~' ~~I ~I~ ~ ~ ~~~° Av -8~- ~ . F IH - DH - L - 12000.00 GAL Mod F IH DH L 12000.00 GAL Mod F IH DH L 12000.00 GAL Mod -3- 01/31/2007 -4- 01/31/2007 F FASTRIP 362 ~ Inventory It 0001 COMMON NAME / HEMICAL NAME Location within thi acility Unit UST STATE TYPE PRESS Liquid TMixture Ambient A Largest Container Sit ID: 015-021-000626 ~ Facility Unit: Fix,~Containers on Site ~ Days On Site 365 Ma Grid: CAS# T ERATURE ~~ CONTAINER TYPE Tent I UNDER GROUND TANK A THIS LOCATION ily ximum Daily Average nt~ ~u~ ~~i~ir~iv~ivla oWt. RS CAS# 100.00 Gasoline No 8006619 nt~~tucL r~5 5~~ai~i~ivla TSecret RS Bio z Radioactive/Amount EPA Hazards FPA USDOT# MCP No No No/ Curies F IH DH / / Mod ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE Location within this Facility Unit UST Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~ Ambient ~ Ambient -~ER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 8000.00 GAL ruyc~rucLV V ~ ~.vi~irvt~r~iv t a %Wt. RS CAS# 100.00 Gasoline No 8006619 I12'~Gt1RL t~ J.7 Pia J1~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -5- 01/31/2007 F FASTRIP 362 ~ Inventory Item _0003 COMMON NAME / CHEMICAL NAME ~j~~~~6!/!~ UNLEADED GASOLINE Location within this Facility Unit UST '. STATE TYPE PRESSURE Liquid Mixture Ambient SiteID: 015-021-000626 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 TEMPERATURE CONTAINER TYPE Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00-GAL 12000.00 GAL ~ 8000.00 GAL rlti~t~tcl~vu5 ~vlnruiv~iv 15 °sWt . RS CAS# 100.00 Gasoline No 8006619 riAGH.ttL A~7~~~1~1J;1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0004 COMMON_NAME / CHEMICAL NAME Location within this Facility Unit UST STATE TYPE PRESSURE Liquid TMixture ~mbient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# TEMPERATURE CONTAINER TYPE Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL E~000.00 GAL 17.L-]LHKLVU.7 ~u1Y1rv1VJi,lv15 oWt. 100.00 ~~~~'~~~~~ ~-~ RS No CAS# 8006619 nc~,~~-~rcl~ r~a al,~~l~i~lyl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / .G,4i~d -6- 01/31/2007 F FASTRIP 362 SiteID: 015-021-000626 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/01/2000 ~ CALL 911. ~~ Ldll~JlVyCC 1VV 1.11. / P~VQl. UG1L1Vi1 ~l'~/~'irr~p~ji~~c ~'~ r~r-~,:rJ/~~'~o~,~a/ cPt~/~ ~e~-~');;ri ~~ ~~~ir/~ e-.~ ck,~ y-~'~~Gy ~' d~,~dG~~,=~,.~.'r~' ~~as~tS~~~3 ~,c~' ~cc~r~~~'cY~~ .~,~J C.,r~'' .a~-.lr.~1~ ~~'~r~.rS~ CG'~~ fir/ Public Notif . /Ev/acuation ~b/CI~G1'GCt~y~ ~,/,hl~U'~j frJ c3y irx-r~IG4~ ~~- ~,~~~ ~~1' ~9~0~ (.~~~ Emergency Medical Plan 07/18/2006 EMERGENCY 911 OR MEMORIAL URGENT CARE, 6501 MING AVE, 397-4004, MEMORIAL HOSPITAL, 420 34TH ST, 327-1792. -7- 01/31/2007 ._ I F FASTRIP 362 SiteID: 015-021-000626 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 07/18/2006 ALL EMPLOYEES SHOULD BE AWARE OF LOCATION OF EMERGENCY SHUT-DOWN CONTROLS FOR GASOLINE EQUIPMENT. PROCEDURES TO FOLLOW IN THE EVENT OF AN EMERGENCY ON THE GAS ISLAND ARE AS FOLLOWS: A) IF A CUSTOMER OVERFILLS A VEHICLE TANK RESULTING IN A SMALL SPILL - HOSE DOWN THIS AREA WITH WATER. B) IF A,CUSTOMER DRIVES OFF WITH GAS NOZZLE IN CAR FILL TANK, RESULTING IN A SUBSTANTIAL FLOW OF GASOLINE - SHUT DOWN ENTIRE SYSTEM, CALL FIRE DEPT, CALL DISTRICT MGR, CLEAR THE GAS ISLAND. C) IF VEHICLE DAMAGE TO ONE PUMP RESULTS IN A LEAK, SHUT DOWN POWER TO THIS PUMP ',ONLY. HOSE DOWN AREA AND CALL YOUR DISTRICT MGR. D) IF AN ADJACENT BUSINESS/BLDG IS ON FIRE, SHUT DOWN THE ENTIRE GAS ISLAND. Release Containment I.lCQll ll~J t7G i'6~GG- ~ r~rtY <r e,~~ tcrl~~C G'~~.G"~~,~' -8- 01/31/2007 s F FASTRIP 362 SiteID: 015-021-000626 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Other Resource Activation -9- 01/31/2007 .. ~ /~ F FASTRIP 362 SiteID: 015-021-000626 ~ Fast Format ~ ~~Site Emergency Factors Overall Site ~ ~rc~.l.ai na,~.aLUa Utility Shut-Offs 01/31/2007 A) GAS - NE CRNR EXT OF BLDG B) ELECTRICAL - SW CRNR INT OF STORE BEH STORAGE DOOR C) WATER - SW EXT OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 01/31/2007 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS: ONE S INT DOORS AND ONE NW INT STOCKROOM. FIRE HYDRANT - SE CRNR OF PROP S H & PANAMA LN AND 100FT W OF PROP ON N SIDE OF PANAMA. Building Occupancy Level 03/31/2006 12 EMPLOYEES -10- 01/31/2007 F~FASTRIP 362 SiteID: 015-021-000626 ~ ' Fast Format ~ -Training Overall Site ~ ~~ Employee Training 07/18/2006 MATERIAL SAFETY DATA ~S-HEETS ON FILE. r ~_y.1 ~~ ~~~"-~i~G.Yn~ cs~ / ~r.~i'.v~i~3 I~"s~~''GK'"9 ,~G~(~.,.~f~'~G3 G~"C ~''j"~'%`1~U'C ct~~ t~'-+A/c~!-~ ;:rJ ~~ ~-,~,P./~/,1 ~~. c~ c~a.~~vfQ,~z>-• :~r~r.,~ui~try-zi ~j.~ o,,~ ,~e s~~/~i~/-/ 7,~3~ ~~O~'G~n/[~ :~C~ c&~ j•~~n.~i';fJ/ ,~s~-'`yrJ~`'~v~-4.' ~-~z-~ c~"6~-~G~ uG~ !% ~/~lJ" °/% rays ~ Held for Future Use raciu ivt i• u~.uic vcc -11- 01/31/2007 ~./ ~• ~~~ r FASTRIP 362 _________________________________________ SiteID: 015-021-000626 + Manager BusPhone: (661) 831-4709 Location: 6401 S H ST Map 124 CommHaz Moderate City BAKERSFIELD Grid: 19C FacUnits: 1 AOV: CommCode: BFD STA ~ SIC Code:5411 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Co t pct / Title ~ ~ ~ DYNDA FRAME / ' ~' ~/ hon ~ ~ Business Phone: (661) 831-4709x ~661) 393-7000x Business P : e 24-Hour Phone (661) 397=6920x 24-Hour Phone (661) 834-4503x Pager Phone (661) 831-7885x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth +- --------------- Contact ~1 • ~-YC.c,4~G ~(~ ~-~~~ Phone: (661) 393-7000x MailAddr: PO BOX 82515 State: CA City BAKERSFIELD Zip 93380 Owner JACO HILL Phone: (661) 393-7000x Address PO BOX 82515 State: CA City BAKERSFIELD Zip 93380 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~~~.~'~ ENT J(f PROG A - HAZMAT ~ ~~ /' L 2 6 2006 PROG U - UST h ~0~'~ Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ~,S'~ v G Signature Date E~ ~~,~ 5s~~ p~~ v~ -1- 03/31/2006 MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited.• Chapter 6. ~ 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 monitoringwstem 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 this date. - A. General Information Facility Name: #362 Fastrip # #633 Bldg. No.: Site Address: 6401 South H Street Facility Contact Person: Omero Garcia Make/Model of Monitoring System: Veeder-Root TLS 350 B. Inventory of E~uipment Tested/Certified Check the aPP~'aPCiate hazes to is sate sperific equipaxat iaspected/serviad: Date of Testing/Servicing: 08/3/2006 Tank ID: 12000 gal. Regular _ r [, In-Tank Gauging Probe. Mode1:847390-107 [x] Annular Space or Vault Probe. Mode1:794390-303 [x] Piping Sump /Trench Sensor(s). Mode1:794380-208 [X] Fill Sump Sensor(s) Mode1:7s438o-208 [J Mechanical Line Leak Detector. Model: Fx1v ^ Electronic Line Leak Detector. Model: U Tank Overfill /High Level Sensor. Model: 794390-107 ^ Other (specify equip. type -and model in Sec. E on Pg. 2) Tank ID: 12000 gal. Diesel [x] In-Tank Gauging Probe. Model:847390-107 [x] Annular Space or Vault Sensor. Mode1:847380303 ' U Piping•Sump / Trench Sensor(s). Mode1:794380-208 [x] Fill Sump Sensors(s):- Mode1:Z9438o-208 . [~ Mechanical Line Leak Decector. Model: Fxi vv ^ Electronic Line Leak Detector. . Model: U Tank Overfill /High Level Sensor. Mode1:847390-107 ^ Other (specify equip. type and mod el in Sec. E on Pg. 2) Tank ID: 12000 gal. Super ~x] In-Tank Gauging Probe. Model: 847390-107 [X] Annular Space or Vault Sensor. Model: 794390-303 [X] Piping Sump /Trench Sensor(s). Model: 794380-208 U Fill Sump Sensor(s). Model: 794380-208 [X] Mechanical Line Leak Detector. . Model: Fxiv ^ Electronic Line Leak Detector. Model: U Tank Overfill /High Leval Sensor. Model: 794390-107 ^ Other (saecifv eauin. tvue and model in Sec. E on Pe. 21 Tank ID: ^ In-Tank Gauging Probe. Model: ^ Annular Space or Vault Sensor. Model: ^ Piping Sump /Trench Sensor(s). Model: ^:` Fill Sump Sensor(s). Model: ^ Mechanical Line Leak Detector. Model: - ^ Electronic Line Leak Detector. Model: ^ Tank Overfill /High Level Sensor. Model: ^ Other (specify equip. typs and model in Sec. E on Pg. 2) Dispenser ID: 1 ~ 2 Dispenser ID: 3 & 4 n Dispenser Containment Sensor(s). Model: 794380-208 [X] Dispenser Containment Sensor(s). Model: 794380-208 [X] Shear Valve(s). L] Shear Valve(s). ^ Dispenser Containment Float(s) and Chain(s).. ^ Dispenser Containment Float(s) and Chain(s) Dispenser ID: 5 8t 6 [x] Dispenser Containment Sensor(s). Model: 794380-208 U Shear Valve(s). ^ Dispenser Containment Float(s) and Chains(s). Dispenser ID: _7 & 8 U Dispenser Containment Sensor(s). Model: 794380-208 [X] Shear Valve(s). ^ Dispenser Containment Float(s) and Chain(s). Dispenser ID: Dispenser ID: ^ Dispenser Containment Sensor(s). Model: ^ Dispenser Containment Sensor(s). Model: ^ Shear Valve(s). ^ Shear Valve(s). ^ Dispenser Containment Float(s) and Chain(s) ^ Dispenser Containment Float(s) and Chain(s). more tanks or dispensers, copy this every tank and dispenser at the facility. C. Certification - I certify that the equipment identified in this document was inspected/services in accordance with the manufacturers' guidlines. Attached to this Certification is information (e.g. manufacturers' checklist) necessary to varify that this information is correct and a plot plan showing the layout of monitoring equipment. F ,equip eat capable of generating such reports, I have attached a copy of the report; (check all that apply) ^x Syst m t- ~ Alarm history report Technician Name (print): ~ougias M. Young iu Signature: Certification No: A32755 License No: 804904 Testlrig Company Name: Confidence UST Services, Inc. Pho No: 800-339-9930 Site Address: 8401 South H Street ,Bakersfield, CA 93304 Date of Testmg/Servicing: 08/3/2008 City: Bakersfield Zip: 93304 Contact Phone No.: 661-393-7000 D. Results of Testing/Servicing Software Version Installed: 14.01 Complete the following checklist: [x] Yes ^ No* Is the audible alarm operational? x Yes No* Is the Visual alarm operational? x yes No* Were all sensors visually inspected, functionally tested, and confirmed operational? x Yes ~ No* Were all sensors installed at the lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? Yes No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) x N/A operational? x yes ^ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary ^ N/A containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors irritate positive shut-down? [~ Sump/Trench Sensors[x] Dispenser Containment Sensors Did you confirm positive shut-down due to leaks and sensor failure/disconnected? ^Yes; ^ No; ^ Yes ^ No* 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 visual and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capasity does the alarm trigger? 90 ^ Yes* ^ No Was any monitoring equipment replaced? If Yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. ^ Yes* ^ No Was liquid found inside any secondary containment systems designed as dry systems? ^ Product; ^ Water. If yes, describe causes in Section E, below. x No* Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. x yeS No* Is all monitoring equipment operational per manufacturer's specifications? * In Section E below, discribe how and when these deficiencies were or will be corrected. E. Comments: F. In-Tank Guaging /SIR Equipment: U Check this box if tank guaging is used only for inventory control. ^ Check this box if tank guaging or SIR equipment is installed. This section must be completed if in-tank guaging equipment is used to perform leak detection monitoring. c:ompiete [ne iouowmg cnecx~~si: L] Yes ^ No* Has all input wiring been inspected for proper enter and termination,including testing for ground faults? x Yes No* Were all tank guaging probes visually inspected for damage and residue buildup? x Yes No* Was accuracy of system product level readings tested? x Yes No* Was accuracy of system water level readings tested? x Yes No* Were all probes reinstalled properly? ^ Yes ^ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section ~ below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ^ Check this box if LLD's are not installed. Complete the following checklist: [x~ Yes ^ No* For equip. start-up or annual equipment certification, was a leak simulated to varify LLD performance? (Check all that apply) Simulated leak rate: U3 g.p.h.: ^o.l g.p.h.; ^0.2 g.p.h.; ^ Yes ^ No* Were all LLD's confirmed operational and accurate within regulatory requirments? x Yes No* Was the testing apparatus properly calibrated? [~ Yes No* For machanical LLD's, does the LLD restrict product flow if it detects a leak? N/A ^ Yes ' No* For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak? x N/A ^ Yes No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is [x] N/A disabled or disconnected? ^ Yes No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system U N/A malfunction or fails a test? ^ Yes ^ No* For electronic LLD's, have all accessible wiring connections been visually inspected? ^ N/A [~ Yes No Were all items on the equipment manufacturer's maintenance checklist completed? * In the section ~ below, describe how and when these deficiencies were or will be corrected. H. Comments: FASTRIP 362 6401 SO, H BAKERSFIELD CA, 661 831 4709 AUG 3~ 2006 5:00 AM INVENTORY REPORT T I:UNLEADEU VOLUME _ = 8627 GALS ULLAGE = 3373 GALS 90j ULLAGE= 2173 GALS TG VOLUME = 8435 GALS HEIGHT = 64.86 INGHES WATER VOL = 0 GALS WATER = 0.00 INGHES TEMP = 91.7 UEG F T 2:FRE VOLUME = 8764 GALS ULLAGE = 3236 GALS 90o ULLAGE= 2036 GALS TC VOLUhiE = 8545 GALS HEIGHT = 65.78 INGHES WATER VOL = 0 GALS WRIER = 0,00 INGHES TEMP = 95,7 DEG F T 3:UIESEL VOLUME = 4437 GALS ULLAGE _ ?563 GALS 90%~ ULLAGE= 6363 GALS TC VOLUME = 4372 GALS HEIGHT = 38.11 INCHES WATER VOL = 0 GALS WATER = 0,00 INCHES TEMP = 92.4 PEG F ~ * ~ ~ ~ END * ~ ~ SYSTEM SETUP AUG -3, 2006 11:47 AM S~'STEM UNITS U,S. S`~STEM LANGUAGE ENGLISH S'1STEM UATErTIME FORMAT MON DD YYYY HH:MM:SS xM FASTRIP 362 6401 SO, H BAKERSFIELD GA, 661 $31 4?09 SHIFT TIME 1 5:00 AM SHIFT TIME 2 DISABLED SHIFT TIhiE 3 : DISABLED SHIFT TIME 4 DISABLED PERIODIC TEST WARNINGS DISABLED ANNUAL TEST WARNINGS DISABLED PRINT TG VOLUt iES ENABLED TEMP Gph1pENSATION VALUE fUEG F ): 60,0 H-PROTOCOL DATA FORMAT HEIGHT RE-DIRECT LOCAL PRINTOUT DISABLED SYSTEM SECURITY CODE : 000000 COMMUNICATIONS SETUF PORT SETTINGS: GOMM BOARD i fRS-232} BAUD RATE 9600 PARITY NONE STOF HIT 1 STOP DATA LENGTH: 8 DATA AUTO TRANSMIT SETTINGS: AUTO LEAK ALARhI LIMIT DISABLED AUTO HIGH WATER LIMIT DISABLED AUTO OVERFILL LIMIT DISABLED AUTO LOW PRODUCT DISABLED AUTO THEFT LIMIT DISABLED AUTO DELIVERY START DISABLED AUTO DELIVERY END DISABLED AUTO EXTERNAL INPUT OtV DISABLED AUTO EXTERNAL INPUT OFF DISABLED AUTO SENSOR FUEL ALARM DISABLED AUTO SENSOR WATER ALARM DISABLED AUTO SENSOR OUT ALARM DISABLED RS-232 SEGURITI' GLIDE 000000 RS-232 END OF MESSAGE DISABLED IN_TANK SETUP_ T 1:UNLEHDED PRODUCT CODE 1 THERMAL COEFF :.000700 TANK DIAMETER 96.00 TANK PROFILE 1 FT FULL VOL 12000 FLOAT SIZE: 4.0 IN. 8496 WATER WARNING 2.5 HIGH WATER LIMIT: 3.0 t°lAX OR LABEL VOL : 12000 OVERFILL LINiIT 90i 10800 HIGH PRODUCT 95d 11400 DELIVERY L I Ni I T 15%~ 1800 LO6J PRODUCT 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT 8.00 MANIFOLUED TANKS Tft : fVONE LEAK MIN PERIODIC: 10% 1200 LEAK MIN ANNUAL 10% 1200 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM D I SABLED GROSS TEST FAIL ALARM DISABLED ANIV TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON HREAK:OFF DELIVERY DELAY 1 MIN T 2:FRE T 3:UIESEL PRODUCT CODE `2 pRODUCT CUDE 3 THERMAL COEFF :.000700 THERMAL GOEFF :.000450 TAN}: DIAMETER 96.00 TANK DIAMETER 96.00 TANK PROFILE i PT TANK PROFILE 1 PT FULL VOL 12000 FULL VOL 12000 FLOAT SIZE: 4.0 IN. 8496 WATER WARNING 2.5 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 12000 OVERFILL LIMIT 90°0 . 10800 HIGH PRODUCT 95% 11400 DELIVERY LIMIT 10% . 1200 LOW PRODUCT 1000 LEAK. ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT 8.00 MANIFOLDED TANKS Tix : NONE FLOAT SIZE: 4.0 IN. 8496 WATER WARNING 2.5 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 12000 OVERFILL LIMIT 90% 10800 HIGH PRODUCT 95% 11400 DELIVERY LIMIT 100 1200 LOW PRODUCT 1000 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT 0.00 MANIFOLDED TANKS Tti: NONE LEAP. MIN PERIODIC: 10% • 1200 LEAK MIN ANNUAL l0a • 1200 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANY, TEST NOTIFY: OFF TNK TST SIPH©N BREAK:OFF DELIVERY DELAY 1 MIN LEAK N1IN PERIODIC: 100 1200 LEAK MIN ANNUAL 10°~ 1200 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARhI DISABLED GROSS TEST FAIL ALARM DISABLED AIVN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY 1 MIN LIQUID SENSOR SETUP L 1:UNL STP- TRI-STATE {SIfVGLE FLOAT) CATEGORY STP SUMP L 2:UNL FILL TRI-STATE {SINGLE FLOAT) CATEGORY PIPING SUMF L 3:UNL ANN DUAL FLOAT HYDROSTAT I C CATEGORY ANNULAR SPACE L 4:PREM STP TR1-STATE (SINGLE FLOAT) CATEGORY STP SUMP L 5:FREM FILL TRI-STATE (SINGLE FLOAT) CATEGORY FIPING SUMP L 6:FREM ANN DUAL FLOAT HYDROSTATIC CATEGORY ANNULAR SPACE L 7:DIESEL STP TRI-STATE (SINGLE FLOAT) CATEGORY STF SUMP L B:DIESEL FILL TRI-STATE (SINGLE FLOAT) CATEGORY PIPING SUMP L :DIESEL ANN DUAL FLOAT HYDROSTATIC CATEGORY ANNULAR SPAi;E L10:DIS 1 TRI-STATE {SINGLE FLORT) CATEGORY DISPENSER PAN L11:DIS 2 TRI-STATE {SINGLE FLOAT) CATEGORY DISPENSER PAN L12:DIS 3 , TRI-STATE (SINGLE FLOAT) CATEGORY D I SPEtVSER PAIV L13:DI8 d TRI-STATE {SINGLE FLOAT) CATEGORY DISPENSER PAN OUTPUT RELAY SETUP k 1:SHUT DOWN TYPE: STANDARD NORMALLY OFEfV IN-TANK ALARMS ALL:LOW FRODUCT ALARM LIQUID SENSOR ALMS ALL:FUEL ALARM ALL:LOW LIQUID ALARM R 2 : OL+ERF I LL ALARM TYPE: STANDARD NORMALLY OPEN ALARM HISTORY REPORT ----- SENSOR ALARM --~ L 1:UNL STP STP SUMP FUEL ALARM JUL 30. 2006 3:50 PM FUEL ALARM JUL 24. 2006 11:37 AM FUEL ALARM JUL 2~1. 2006 11 :12 AM ALARM HISTORY kEPORT ALARM HISTORY REPORT ----- SENSOR ALARM ----- L 4:FREM STP STP SUMP FUEL ALARM JUL 29. 2006 7:10 AM FUEL ALARM JUL 24. 2006 11:12 AM FUEL ALARM AUG 11. 2005 9:35 AM ALARM HISTORY REPORT ~~I N-TANK ALARMS ALL:OVERFILL ALARM ALL:HIGH PRODUCT ALARM ALL:MAX PRODUCT ALARM ----- SENSOR ALARM ----- L 2:UNL FILL PIPING SUMP FUEL ALARM JUL 24. 2006 11:38 AN1 FUEL ALARM JUL 24. 2006 11 :08 Af°1 FUEL ALARM DEC 2. 2005 7:26 ANl ALARM HISTORY REPORT ----- SENSOR ALARM ----- L 3:UNL ANN ANNULAR SPACE HIGH LIQUID ALARM JUL 24. 2006 11:15 AM LOW LIQUID ALARM JUL 24. 2006 11:1A AM HIGH LIQUID ALARM AUG 11. 2005 9:3a AM ----- SENSOR ALARM ----- L 5:PREM FILL PIPING SUMP FUEL ALARM JUL 24. 2006 11:08 AM FUEL ALARM JUL 24. 2006 11:07 AM FUEL ALARM AUG 11. 2005 9:30 AI°1 ALARM HISTORY REPORT ----- SENSOR ALARM ----- L 6:PREM ANN ANNULAR SPACE LOW LIQUID ALARM AUG 1. 2006 11:28 AN1 LOW LIQUID ALARM ~ AUG 1. 2006 11:27 AM HIGH LIQUID ALARM AUG 1. 2006 I:08 AM FILARM HISTORY REPORT ----- SENSOR ALARM ----- L 7:DIESEL STP STP SUMP FUEL ALARM JUL 24. 2006 11:13 AM FUEL ALARM AUG 11. 2005 9:35 ANl FUEL ALARM AUG 3. 2005 11:42 AM ALARM HISTORY REPORT ----- SENSOR ALARM ----- L B:DIESEL FILL PIPING SUMP FUEL ALARM JUL 24. 2006 11:07 AM FUEL ALARM JUL 24. 2006 11:06 AM FUEL ALARM DEC 16. 2005 6:4fi AM ALARM HISTORY REPORT SENSOR ALARM L 9:DIESEL ANN ANNULAR SPACE HIGH LIQUID ALARM JUL 24. 2006 11:15 AM LOW LIQUID ALARM JUL 24. 2006 11:13 AM HIGH LIQUID ALARM AUG 11. 2005 9:32 AM ALARM fiISTORY REPORT SENSOR ALARM L10:DIS 1 DISPENSER FAN FUEL ALARM JUL 24. 2006 11:09 AM FUEL ALARM AUG 11. 2005 9:25 ANl FUEL ALARM AUG 3. 2005 11:39 AM ALARM HISTORY' REPORT SEfVSOR ALARf°1 L11:DIS 2 DISPENSER PAN FUEL ALARM JUL 24. 2006 11:10 AM FUEL ALARM AUG 11. 2005 9:26 Ahl FUEL ALARM AUG 3. 2005 11:38 AM ALARM HISTORY REPORT ----- SENSOR ALARM ----- L12:DIS 3 DISPENSER PAN FUEL ALARM JUL 24. 2006 11:11 AM FUEL ALARM AUG 11, 2005 9:28 AM FUEL ALARM AUG 3. 2005 11:39 AM ALARM HISTORY REPORT ----- SENSOR ALARM ----- L13:DIS 4 DISPENSER PAN FUEL ALARM JUL 24. 2006 11:10 AM FUEL ALARM AUG 11, 2005 9:27 AM FUEL ALARM AUG 3. 2005 11:36 AM ALAkf°i H I STORY REPORT ----- SENSOR ALARM ----- L14: OTHER SENSORS ALARNI HISTORY REPORT ----- SENSOR ALARPI ----- L15: OTHER SENSORS SETUP DATA WARNING JUN 23. 2004 3:05 PM SETUP DATA WARNING JUN 23. 2004 3:05 PM SETUP DATA WARNING JUN 23. 2004 3:04 PM :~ ~, ~` ^ ~ y ~s SEIVS0R ALARM ----- SENSOR ALARM ----- - L B:DIESEL FILL PIPING SUMP FUEL ALARM AUG 3. 2006 12:19 FM ----- SENSOR ALARM ----- L 3:UNL ANN ANNULAR SPACE LOW LIQUID ALARM AUG 3. 2006 12:21 PN1 L 1:UNL STP STP SUMP FUEL ALARM AUu^ 3. 2006 12:1I3 PM SEIVS0R ALARM L 4:PREM STP STF SUMF FUEL ALARM AUG ~3• 2006 12:19 PN1 ----- SEtVSOR ALARNI ----- L 7:DIESEL STP STF SU(°1P FUEL ALARM AUG 3. 2006 12:19 PN1 SENSOR ALARNI L 5:PREM FILL PIPING SUMP FUEL ALARM AUG 3. 2006 12:20 PM ----- SENSOR ALARM ----- L 2:UtVL FILL P I P I tVG SUMP FUEL ALARM AUG 3. 2006 12:20 FM SENSOk ALARM L 6:PREM ANN ANNULAR SFACE LOW LIQUID ALARM AUG 3. 2006 12:22 Phl SENSOR ALARM L 9:DIESEL ANN ANNULAR SPACE LOW LIQUID ALARM AUG 3. 2006 12:22 PM • ~ ~~~''~• 4 "x«4.4..-..r".,a.~ _ '. ^ ~ ~ ~ r _ . FASTR I P 362 ~ ' -`-" 6401 SO. H - - BAKERSFIELD CA. ~ '- - ----- SENSOR ALARM ----- 661 831 4709 L10:DIS 1 DISPENSER PAN AUG 3. 2006 12:29 PM FUEL ALARM AUG 3. 2006 12:23 PM FASTRIp 362 SYSTEt°i STATUS REPt]RT ~ 6401 S{~. H BAKERSFIELD CA. _ _ _ 661 831 4709 ALL FUNCTIONS NORMAL ~ AUG 3. 2006 12:52 PM SYSTEM STATUS REPORT -- SEtVSOR ALARM -- - - L11:DIS 2 ALL FUNCTIONS NORMAL DISPENSER PAN FUEL ALARM INVENTORY REPORT AUG 3. 2006 12:24 PM -- IN-TANK ALARM ----- T 2:PRE ' HIGH PRODUCT ALARM T 1:UiVLEADED AUG 3. 2006 12:30 PM VOLUME = 6885 GALS ' ULLAGE 5115 GHLS 90o ULLAGE= 3915 GALS TC VOLUME 6727 GALS HEIGHT = 53.58 INCHES WATER VOL 0 GALS WATER = 0.00 I tVCHES ', ~ ----- SEtVSOR ALARM ----- TEMP 92.7 DEG F L12:DIS 3 DISPENSER PAN FUEL ALARM FASTRIP 362 -~ T ~:FRE ~ AUG 3. G006 12:25 PM 6401 SO. H VOLUME = 8488 GALS BAKERSFIELD CA• ULLAGE = 3512 GALS 661 B31 4709 9014 ULLAGE= 2312 GALS TC VOLUME = 8273 GALS AUG 3. 2006 12:30 pM HEIGHT = 63.93 INCHES WATER VOL = 0 GALS WATER = 0.00 INCHES TEMP = 96.0 DEG F SYSTEM STATUS REPORT -- SENSOR ALARM --__ - ALL FUNCTIONS N0RNIAL T 3:DIESEL L13:DIS 4 VOLUME = 4352 U'ALS DISPENSER PAN ULLAGE = 7648 GALS FUEL ALARM 90o ULLAGE= 6448 GALS AUG 3. 2006 12:26 PM TC VOLUME = 4287 GALS HEIGHT = 37.56 INCHES WATER VOL = 0 GALS WATER = 0.00 INCHES TEMP = 92.7 DEG F ---- IN-TANK ALARM ----- T 3:DIESEL ~ ~ * ~ * END ~ ~ * ~ HIGH PRODUCT ALARM AUG 3. 2006 12:30 PM ---- I N-TAtVK ALARM ----- T 1 : UtVLEADED HIGH PRODUCT ALARM AUG 3. 2006 12:29 PM FASTRIP 362 6401 SO. H BAKERSFIELD CA. 661 831 4709 AUG 3. 2006 12:32 PM SYSTEM STATUS REPORT ALL FUNCTIONS NQRMAL ., _~ . SWRCB, January 2006 Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and printouts from tests (f applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: #362 Fastrip #633 Date of Testing: 8/3/2006 Facility Address: 6401 South H Street ,Bakersfield, CA 93304 Facility Contact: Omero Garcia Phone: 661-393-7000 Date Local Agency Was Notified of Testing : 7/10/2006 Name of Local Agency Inspector (f present during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: Confidence UST Services, Inc. Technician Conducting Test: Douglas M. Young III Credentials': X CSLB Contractor X ICC Service Tech. X SWRCB Tank Tester ^ Other (Sped) License Number(s): CSLB #804904 ICC #878646-UT Tester # 901076 3. SPILL BUCKET TESTING INFORMATION Test Method Used: x Hydrostatic ^ Vacuum ^ Other Test Equipment Used: Lake Test Equipment Resolution: 0.0625" Identify Spill Bucket (By Tank Number, Stored Product, etc.) 1 Regular 2 Super 3 Diesel 4 Bucket Installation Type: ^ Direct Bury x Contained in Sump ^ Direct Bury x Contained in Sump ^ Direct Bury x Contained in Sump ^ Direct Bury ^ Contained in Sum Bucket Diameter: 12.00" 12.00" 12.00" Bucket Depth: 12.50" 12.75" 11.60" Wait time between applying vacuum/water and start of test: 30 min.' 30 min. 30 min. Test Start Time (TI): 11:SOam 11:SOam 11:SOam Initial Reading (R~): 12.25" 12.55" 11.40" Test End Time (TF): 12:SOpm 12:SOpm 12:SOpm Final Reading (RF): 12.25" 12.55" 11.40" Test Duration (TF - Ti): 1 hour 1 hour 1 hour Change in Reading (RF - RI): 0.00" 0.00" 0.00" Pass/Fail Threshold or Criteria: 0.0625" 0.0625" 0.0625" Test Result: X Pass ^ Fail X Pass ^ Fail X Pass ^ Fail ^ Pass ^ Fail Colrlments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) CERTIFICATION OF I hereby certify that all the info~ti Technician's ' State laws and regulations do not may be more stringent. ~N RESPONSIBLE FOR CONDUCTING THIS TESTING in this report is true, accurate, and in full compliance with legal requirements. Date: 8/3/2006 to be performed by a qualified contractor. However, local requirements 3G ~ Owner Statements of Designated Underground Storage Tank (UST) Operator and Understanding of and Compliance with UST Requirements Facility Name: Fastrip #633 (Exxon) Facility ID #: 3024 Facility Address: 6401 South -H- Street, Bakersfield, CA 93304 (City) Reason for Submitting this Form (Check One) ^ Change of Designated Operator Facility Phone #: 661-831-4709 X Update Certificate Expiration Date Designated UST Operator(s) for this Facility PRIMARY Designated Operator's Name: Douglas M. Young III Relation to UST Facility (Check One) Business Name (If different from above): Confidence UST Services, Inc. ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 800-339-9930 ^ Service Technician x Third-Party International Code Council Certification #: 0878646-UC Expiration Date: September 22, 2008 ALTERNATE 1 (Optional) Designated Operator's Name: Jennifer Davis Relation to UST Facility (Check One) Business Name (If different from above): Confidence UST Services, Inc. ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 800-339-9930 ^ Service Technician x Third-Party International Code Council Certification #: 5258845-UC Expiration Date: March 15, 2009 ALTERNATE 2 (Optional) Designated Operator's Name: Edward Mitchell Relation to UST Facility (Check One) Business Name (If different from above): Confidence UST Services, Inc. ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 800-339-9930 ^ Service Technician x Third-Party International Code Council Certification #: 5258845-UC Expiration Date: May 15, 2008 I certify that, for the facility indicated at the top of this page, the individual(s) listed above will serve as Designated UST Operator(s). The individual(s) will conduct and document monthly facility inspections and annual facility employee training, in accordance with California Code of Regulations, title 23, section 2715(c) - (f). Furthermore, I understand and am in compliance with the requirements (statutes, regulations, and local ordinances) applicable to underground storage tanks. NAME OF TANK OWNER (Please Print.-- deco Hill Co. SIGNATURE OF TANK OWNER:: C~ /~ p DATE: March 23, 2007 v OWNER'S PHONE #: 661-393-7000 NOTE: I) SUBMIT THIS COMPLETED FORM TO THE LOCAL AGENCY (NOT THE STATE WATER RESOURCES CONTROL BOARD) BY JANUARY t, 2005. THE LOCAL AGENCY LIST IS AVAILABLE AT: www.waterboards.ca.Pov/ust/contacts/cupa a~ys.html. 2) NOTIFY THE LOCAL AGENCY OF ANY CHANGES TO THIS INFORMATION WITHIN 30 DAYS OF THE CHANGE. November 2004 UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING / S6989 SECONDARY CONTAINMENT TESTING RANK TIGHTNESS TEST AND TO PERFORI1fJ FUEL MONITORING CERTIFICATION PERMR NO. ~ 7 ~ l v .'` .' '' ~' ~ BAKERSFIELD FIRE DEPT. B E_ R_9 P 7 L D PI@V@II'tlOa w~'rV1C@S F~Re ARTAI~tT 900 Truxtun Ave., Ste. 210 ~~~a~ Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 _ ENHANCED LEAK DEFECTION LWE TESTING ,TANK TIRMNFCS TF4'F F'C Tn PFRFCIRM Fi IFI MnNffnRINA CFRT7FICATInN $8-989 SECONDARY CONTAINMENT TESTING SITE INFORMATION FACILffY 0. ~ R1ANlE 8 PHOWE WU(~BER OF COWTACT PERSON 0. -7 ~ ADDRESS ~~ ~ ~ S -1t- r C a3 d OWNERS NAME 1 OPERATORS NAP7E PERMIT TO OPERATE WO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? eS YES es NO TANK ~ VOLUME CONTENTS ' TANK TESTING COMPANY NAME OF TESTING COMPANY .e. ('. WAGE & PHOWE WUL~BER OF COWTA T PERSOW O 1 In B MAILING ADDRESS NAME 8 PHONE NUMBER OF TESTER ORS CU1L 1 PECTOR 2 - CERTIFICATION #: DATE 8~ TI E TEST TO BE C NDUCTED ' 2 ICC #: 52' Fs~4~4- L TEST METHOD SIGNATUR OF APPUC DATE , _ R i BECOM -S A H RR OY APPROVED BY DATE "~ FD 2095 (Rev. 09/05) \ , SWRCB, January 2002 Page t of~_ Secondary Containment Testing Report Form This fcrm is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (zf applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: Fastrip #362 Date of Testing: °3 _ ~:i' _. ,~r~ Facility Address: 6401 South H Street, Bakersfield, Ca. 93304 Facility Contact: Jaco Oil Phone: y .., F~~y i ~ ~~ ~ ~ y7 Date Local Agency Was Notified of Testing : - _ r_ Name of Local Agency Inspector (fpresent dzzring testing): 2. TESTING CONTRACTOR INFORMATION Company Name: Sunset Mechanical Technician Conducting Test: Ken Brus Credentials: JH CSLB Licensed Contractor ^ SWRCB Licensed Tank Tester License Type: Manufacturer C-36 C-10 License Number: 589517 Manufacturer Trainins Com onent(s) ~ Date Trainin Ex fires Incon TS-STS Ins ection E ui ment 1/12108 Veeder Root Monitoring System 6/12/06 AO Smith Secondary Pi ing 6/19/06 ICC Cal. UST Service Tech 12/21/06 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Repairs Made ^ ^ ^ ^ ^ ^ ^ ^ -, •, ~~ ~„~ ~: w- i C~ ^ ^ ^ be ~ i ® ^ ^ ^ _ ^ ^ ^ ^ ^ ^ ^ ^ ~~~s• Y 4 ^ ^ ^ ^ ^ ^ ^ v~ _.~~ ® ^ ^ ~ ^ ^ ^ ^ If hydrostatic testing was performed, describe what was done with the water after completion of tests: i~~N~~.A~".;fC ~g~'£~ 5~-!~'~"~. T'~ `iC 6 t~ ~y.~ 9.yA `~ ~_~tl1~t ~ ~ ~1 :L fs? L'S ~?J `~f ;CS ~id, ~1C1 AI ~• !.' t.9 et;. :'Cll+". ~~9.Ar°.~ir' FT. 1^.S L'' /~~~t 1.J LS~'~c~ ~y~ ~ __ CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To t/re best of my knowledge, the facts stated in t/tis document are accurate and in full compliance witlt legal requirements Technician's Signature: s~ '~4a ~ ~• Date: ~ - "L t -~ e?!; _ SWRCB, January 2002 4. TANK ANNULAR TESTING Page ~ of 't Test Method Developed By: ^ Tank Manufacturer ^ Industry Standard ^ Professional Engineer ^ Other (Sped) Test Method Used: ^ Pressure ^ Vacuum ^ Hydrostatic ^ Other (Sped) Test Equipment Used: Equipment Resolution: ~ Tank # ' Tank # '2 Tank # ~ Tank # [s Tank Exempt From Testing?~ ~"Yes ^ No ~ Yes ^ No ~ Yes ^ No ^Yes ^ No Tank Capacity: Y Z ~~ j w ~~ ~ ? t ~er1~ Tank Material: ~~~ ~~ ~,. r ~~ ~• ~~ ~. Tank Manufacturer: JEEP X •' JCS ~~ ~E~ E~ Product Stored: Wait time between applying pressure/vacuum/water and startin test: ~/~ J~,j ~~ ~' }~/ ^~ ~' Test Start Time: Initial Reading (R,): Test End Time: Final Reading (RF): Test Duration: Change in Reading (RF-R~): Pass/Fail Threshold or Criteria: Test Result: ^ Pass ^ Fail ^ Pass ^ Fail ^ Pass ^ Fail ^ Pass ^ Fail Was sensor removed for testing? ^Yes ^ No ^ NA ^Yes ^ No ^ NA ^Yes ^ No ^ NA ^Yes ^ No ^ NA Was sensor properly replaced and verified functional after testing? ^Yes ^No ^NA ^Yes ^No ^NA ^Yes ^No ^NA ^Yes ^No ^NA Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) S"t.~ ~ ~ l1/~ ~-iYl~ ? :i.3+.~~C~c Y t`~1+!1~N'sT(1~~1~ ~c• Rt'^ 1 ~t LEVE t_ ~ Eg-- "Y Sat ~' ~-+ a, ~ Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment testing. {California Code of Regulations, Title 23, Section 2637(a)(6)} SWRCB, January 2002 5. SECONDARY PIPE TESTING Page ~ of_? Test Method Developed By: 9 Piping Manufacturer .~ Industry Standard ^ Professional Engineer ^ Other (Sped) Test Method Used: p9' Pressure ^ Vacuum ^ Hydrostatic ^ Other (Sped) Test Equipment Used: ~~_a-~~L:~~~,~D ~~tg ~ 4 i ~s ~ L':.t 4 ~_~~y.~ ~t' ~~S- Equipment Resolution: O -~ Piping Run # ~ Piping Run # '~ Piping Run # ~ Piping Run # Piping Material: ~.~, ~. d. Piping Manufacturer: ,~ ~. ~~ ;-. lam, ~. ~ Piping Diameter: ~ ~= -- Length of Piping Run: '+' ~~ -lr ~i r, •' -~- ~~ ' Product Stored: ~ Q ~ ~ Method and location of i in -run isolation: "fE~: _ ~~rsp- ~ ; ~~; -'~~,-~~ ~• ~ ~ n TEs':"-~G~~F" Wait time between applying pressure/vacuum/water and startin test: j ~a -Lt ~,~, I S ~,"~ ~ ~~ - ~ ~ ~ i w - Test Start Time: • C,~ n+ ~.. ~ :~ ^ r~ Initial Reading(Ri): z's.~ ~ ~-,^;~ c F^;`.S Test End Time: R ~'~ ~ .~~ ~ "^ . ~ a ~`^ Final Reading (RF): F~~i ~" z r3 c'*~'i Test Duration: 6,~ ~,,t a~ . ~ ~ Cy i'a, w Change in Reading (RF-R~}: Pass/Fail Threshold or Criteria: -"~~ " ~ "-~ Test Result: ~ Pass ^ Fail ~ Pass ^ Fail ~' Pass ^ Fail ^ Pass ^ Fail COmlllerit5 - (include information on repairs made prior to testing, and recommended follow-up for failed tests) SWRCB, January 2002 6. PIPING SUMP TESTING Page ~} of ~ Test Method Developed By: 1r1 Sump Manufacturer ~l Industry Standard ^ Professional Engineer ^ Other (Specify) Test Method Used: ^ Pressure ^ Vacuum ~ Hydrostatic ^ Other (Sped) Test Equipment Used: ~~~ '~``i _ S? ~ Equipment. Resolution:?`.- d p"~,_ -- - - - - - - - -- - - J~ Sump # ~ Sump # ~ Sump # ' Sump # Sump Diameter: ~.,{. - :.~± ~ •° <i.~1 Sump Depth: ,, - - r Sump Material: ~ ~~ 1~t • Height from Tank Top to Top of Hi hest Pi in Penetration: /'a "• 17 '• 1 ~ '• Height from Tank Top to Lowest Electrical Penetration: ~ ~ "' 1~ -' 1 ~ -' Condition of sump prior to testing: G~ ~ ~ . ~©~ Portion of Sump Tested .}. 4~ -. t - +` .- Does turbine shut down when sump sensor detects~liquid (both roduct and water)? ~ Yes ^ No ^ NA ~ Yes ^ No ^ NA .Yes ^ No ^ NA ^Yes ^ No ^ NA Turbine shutdown response time -F- ~~ ~~• { ~~~ ~~:.. '!', ~C3 `;e=~.- . [s system programmed for fail-safe shutdown?» ~ Yes ^ No ^ NA ~ Yes ^ No ^ NA f~ Yes ^ No ^ NA ^Yes ^ No ^ NA Was fail-safe verified to be o erational?~ ®Yes ^ No ^ NA ~ Yes ^ No ^ NA ~ Yes ^ No ^ NA ^Yes ^ No ^ NA Wait time between applying pressure/vacuum/water and starting test: ~~ ~„~ ~~ , c~ ~ .~ ~ w ~ ~ a~ i W Test Start Time: ~ ; ~.. A~"~ 7_~a:~ ~,. A ~-+ Initial Reading (R,): ~• - 7 -- -. ~ ~ 7 .. Test End Time: ~~ ~''~- ~ a-+ c rn Final Reading (RF): ~,,~ •7 ~ ate. -- "i, G>`~~i ~ •, Test Duration: j S ,~,~ ~ rv ., i s~ ~ ~~., . ~ 5' rti , w Change in Reading (RF-R,): _ . ~~p ~ • • - . ~ ~,C; • • _ , ~ ~ -~ Pass/Fail Threshold or Criteria: -~ , ~~, ~ '• •~• , ~,~•~ ~• -r~ . ~,~,~ '• Test Result: ~ Pass ^ Fail JRl Pass ^ Fail J~ Pass ^ Fail ^ Pass ^ Fail Was sensor removed for testing? ®Yes ^ No ^ NA ~ Yes ^ No ^ NA Yes ^ No ^ NA ^Yes ^ No ^ NA Was sensor properly replaced and verified functional after testin ? ~ Yes ^ No ^ NA Yes ^ No ^ NA Yes ^ No ^ NA ~ ^Yes ^ No ^ NA Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) ~ If the entire depth of the sump is not tested, specify how much was tested. If the answer to a~ of the questions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (See SWRCB LG-160) SWRCB, January 2002 7. UNDER-DISPENSER CONTAINMENT (UDC) TESTING Page~~ of ~_ Test Method Developed By: fcT UDC Manufacturer ~ Industry Standard ^ Professional Engineer ^ Other (Sped) Test Method Used: ^ Pressure ^ Vacuum ®, Hydrostatic ^ Other (Specie) Test Equipment Used: Z~ev_~ py ; ~ - ~ r ~ Equipment Resolution: ~" . ~Z - _ UDC Manufacturer: 'rp • - ~, ~ ,ter , ~~„ ~ ~~ •~• UDC Material: FI ~ ~ ,~ ~ ~ , ~ ~- ,Ct a UDC De the ~c • • ~f - ~ -- ~ Height from UDC Bottom to Top of Hi hest Pi in Penetration: _ 11 - !! ~' ti i y- -' Height from UDC Bottom to Lowest Electrical Penetration: ,?j '' ' " ' Condition of UDC prior to testin r,„c9p,~ ~, C3G~Y:~ ~c'r~'arG r ~o ~ Portion of UDC Tested f- t ;~ " -~ . - t ~ `s -• ••~ i ry •~ Does turbine shut down when UDC sensor detects liquid (both roduct and water)?` f~7 Yes ^ No ^ NA Yes ^ No ^ NA ~ Yes ^ No ^ NA ~-Yes ^ No ^ NA Turbine shutdown response time +_ ~~ c,~,~ , -+ ~~ ,:;may , i- C3 e~~ , .., :~~ :3 ~~, Is system programmed for fail- safe shutdown?` yes ^ No ^ NA ~ ~9 Yes ^ No ^ NA !~ Yes ^ No ^ NA Yes ^ No ^ NA ~ Was fail-safe verified to be o erational?` l~Yes ^ No ^ NA ~.'-Yes ^ No ^ NA ~ Yes ^ No ^ NA ~ Yes ^ No ^ NA Wait time between applying pressure/vacuum/water and starting test 9 ~ ~ ~ e+~- . (~ d~ , ,a. . (~ i~+ , W ) 5 ~ , w , Test Start Time: -:~ •3rw • •~ ~r.~ . ~ n.y • -~_c! ~:'~ Initial Reading (R,): _ •~ -~ r • • ~. • ~~ _ ~ ~ - Test End Time: ~ - • • E~ ~~ ; ~ ~ ~~ n a~., s` ~~ Final Reading (RF): ~ . i • • ~; ..,7 ~ r • Test Duration: 1 ° ~~, ~~ : 15 (tit,w . ~ ~ .fin, ~, ~ D .' :~n ew - Change in Reading (RF-R,): -• `• -t . p~ p •• - _ ~ 4G4 - ~ • - Pass/Fail Threshold or Criteria: ..... P~'t,. ~- '+- . ~-~„ • • -!' . Cad: •- '!' , ~0 ~ '° Test Result: .~ Pass ^ Fail !~. Pass ^ Fail Pass ^ Fail B, Pass ^ Fail Was sensor removed for testing? [~ Yes ^ No ^ NA ~ Yes ^ No ^ NA I~Yes ^ No ^ NA Yes ^ No ^ NA Was sensor properly replaced and verified functional after testing? •~-Yes ^No ^NA 'f~Yes ^No L1NA 1~'Yes ^No ^NA l~Yes ^No ^NA Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) ' If the entire depth of the UDC is not tested, specify how much was tested. If the answer to a~ of the questions indicated with an asterisk (*) is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG-160) SWRCB, January 2002 8. FILL RISER CONTAINMENT SUMP TESTING Page ~ of ~_ Facility is Not Equipped With Fill Riser Containment Sumps ^ Fill Riser Containment Sumps are Present, but were Not Tested ^ Test Method Developed By: f~ Sump Manufacturer D Industry Standard ^ Professional Engineer ^ Other (Spec) Test Method Used: ^ Pressure ^ Vacuum ID Hydrostatic ^ Other (Specify) Test Equipment Used: ],~,~~~ i ~y -: ~', i ~, Equipment Resolution: -~ . ~~~ r - _ _-- - -- - ` r _ ~ Fill Sump # I' Fill Sump # ~ Fill Sump # ? Fill Sump # Sump Diameter: y ~ -- - Sump Depth: ~ • Height from Tank Top to Top of Hi hest Pi in Penetration: ~~~~~ Nf~ ~~~' Height from Tank Top to Lowest Electrical Penetration: ~ ~ ~ . ~ ~ 2 `t Condition of sump prior to testin % ~~~ ~;c~~3^ G~G~ Portion of Sum Tested ~ - •- -t- ry .~- ~ - Sump Material: c' ~ ~,.~< ~q ~~_~~r ~~_ r~ Wait time between applying pressure/vacuum/water and starting test: Test Start Time: to ~"~ ~; y t? d:~ y+ r~~ Initial Reading (R,): r ~ -• ~„ ~ , -~ ~ • • ~ •~ c.• -~• Test End Time: ~: •^~ ; r' ~- < 4+~ ~ ; a .~ Final Reading (RF): ~~, g ., ~- "'a, ~-^ ~ - Test Duration: t S' ,~ ~ +~+ ~ 1 ' ~~ ~v ., rV . Change in Reading (RF-R,): =t' . ~~ • '• Pass/Fail Threshold or Criteria: °+° Oo~. •- -t- '? - - -~° . ~,,-, -- Test Result: .® Pass ^ Fail Sd Pass ^ Fail }~ Pass ^ Fail ^ Pass ^ Fail Is there a sensor in the sump? ®Yes ^ No {+~ Yes ^ No ~ Yes ^ No ^Yes ^ No Does the sensor alarm when either product or water is detected? ®Yes ^ No ^ NA i3iYes ^No DNA Yes ^No DNA ^Yes ^No ^NA Was sensor removed for testing? ~ Yes ^ No ^ NA ~ Yes ^ No ^ NA ~l Yes ^ No ^ NA ^Yes ^ No ^ NA Was sensor properly replaced and verified functional after testing? ~ Yes ^ No ^ NA ~ Yes ^ No ^ NA Yes ^ No ^ NA ~ ^Yes ^ No ^ NA Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) SWRCB, January 2002 9. SPILL/OVERFILL CONTAINMENT BOXES Page ~_ of ~_ Facility is Not Equipped With Spill/Overfill Containment Boxes ^ Spi1llOverfill Containment Boxes are Present, but were Not Tested ^ Test Method Developed By: 17 Spill Bucket Manufacturer ~ Industry Standard ^ Professional Engineer ^ Other (Sped) Test Method Used: ^ Pressure ^ Vacuum !~l Hydrostatic ^ Other (Specify) Test Equipment Used: •~ ~;,~ -r -~~' , v Equipment Resolution: T . ~xj p 2. ~- - - r Spill Box # 1 Spill Box # •~ Spill Box # 3 Spill Box # Bucket Diameter: ~ ~y ' • `Z °- 12 ~. Bucket Depth: _ I ~ • • 1 ~ ' Wait time between applying pressure/vacuum/water and starting test: ~~ 'M ' ~ ~ ~~ ~t ' w '~ ~ ,.,,~ , ,,~„ , Test Start Time: C~. ~ ~ ~'~ { R ~ ca ! a<I, ~'"~.+ Initial Reading (R,): ry, -~ ~. ~~~ •• ~~ _ ~ •, Test End Time; t J ~ ~ ~'~t l a: 1 t# '~ ~°'~ ~ : I ~ ,~+.~ Final Reading (RF)~ rh' . ,; r ~{ . `el• ~, ~ '• ~ ; ~ '~ ~ ' Test Duration: ~ ~; ~ ~ ~.,,~ , ,~, , I ~ ,,,~ , ~, , Change in Reading (RF-R,): - : ~ ~,~ •. - . ~ a~ ; -• - . d ~~ I -• Pass/Fail Threshold or Criteria: "~` . C~'O" '~` . C50? - > '~ • b~Q^`" Test Result: ~ Pass ^ Fail g Pass ^ Fail ~ Pass ^ Fail ^ Pass ^ Fail COmmeritS - (include information on repairs made prior to testing, and recommended follow-up for failed tests) ,~ ~ ,_ ~' ~ - _ l ....:, _ - 1~ I _ `-', : , . ,.;,~ : 4~ ~,[, ~ ~ i ~ , 1 ~ F ~141~'i` ~ 4 i~Y I x3 Y ~ I t f: { -.' '. : . ` t n , Il I 1 it -:: - _ ` 1 , lE1r r ~ t. 1 I'I `~y'k f r y~~ ' k . . ~ - - J ~ ~•. 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