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HomeMy WebLinkAboutUST-MONT. REP. 1/29/2007/~~ TEXACO STATION - - - -- - r ;`~ ' 3698 MING AVE. - --~°=- _--. ~~~ ~ ~~ ~~ I (~ ~.~ l ~O`~.-J '~ ,r~J' ~~ '° ~~ ,.~d z ~, ~~~. -, ~,~ ~~,.~, , ,`. ,~ ~~~ ~~ u ` ~ (N\ o /~ MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California ~Iuthority Cite& Chapter 6 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code oJRegulations This fonn must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepare 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 ownerloperafor. The ownerloperator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: ,~;!-ELC.- Bldg. No.: Site Address: ~~ /"''~ ~~r~ ~`1/~ City: (~i¢,Y~{,~Sf~~ Zip: Facility Contact Person: Contact Phone No.: (!J Make/Model of Monitoring System: ~l ~-' ~~~.. Date ofTesting/Servicing: _~l~/~ B. Inventory of Ilquipment Tested/Certified INSPECTOR ON-SIT ;YES NO NAME: CI /~ Check the a ro riatc bogies to indicate s ecific a ui ment ins ected/serviced: Tank ID: U/(JC-~~ Tank lD: LU ,~, In=Tank Gauging Probe. Model: )$ In-Tank Gauging Probe. Model: AnnLdur Space or Vault Sensor. Model: Ud ~+ Annular Space or Vault Sensor. Model: O j ,~ Piping Sump /Trench Sensa•(s). Model: ~~ ,~ Piping Sump /Trench Sensor(s). Model: ,® Fill Sump Sensor(s). Model: 80~ .6a',Fill Sump Sensor(s). Model: ^ Mechanical Line Leak Detector. Model: ~~. ($ Electronic Line Leak Detector. Model: VTR! O;FQ - (L~XJ'ir ! Mechanical Line Leak Detector. Model: _ ~+Electronic Line Leak Detector. Model: ~- ) ^ Tank Overfill /High-Level Sensor. Model: ^ Tank Overfill /High-Level Sensor. Model: ^ Other (s ecifv a ui anent t e and model in Section E on Pa e 2). ^ Other (s ecif a ui ment a and model in Section E on Pa e 2 . Tank lD: ~"'7 ~ Tank ID: .L' ,® In-Tank Gauging Probe. Model: ~ In-Tank Gauging Probe. Model: / ~] Annular Space or Vault Sensor. Model: Od- ~ Annular Space or Vault Sensor. Model: O Piping Sump / "french Sensor(s). Model: 'd0~ .~ Piping Sump /Trench Sensor(s). Model: J~ Fill Sump Sensor(s). Model: a{J~ ~ Fill Sump Sensor{s). Model: ')dam ^ Mechanical Line Leak Detector. Model: ^ Mechanical Line Leak Detector. Model: Electronic Line Le~Jc Detector. Model : t? I;Q. - ¢.~T ~ Electronic Line Leak Detector. Model: D a ^ 1'anl< Overfil l /High-Level Sensor. Model: ^ Tank Ove~l l /High-Level Sensor. Model: ^ Other (specify equipment type and model in Section E on Page 2). ^ Other (specify equipment type and model in Section E on Pagc 2). dispenser lD: ) ~~ Dispenser TD: ~ ``~ ~, Dispenser Containment Sensor(s). Model: ~~~(2~yI-~,, ~ Dispenser Contaimnent Sensor{s}. Model; Shear Valve(s). ,lam Shear Valve(s). ^ Dis enser Containment Floats and Chains . O Dis enser Containment Floats and Chains . Dispenser Ill: Dispenser ID: ~- ~ Dispenser Containment Sensor(s}. Model: ~ Dispenser Containment Sensor(s). Model: ~~tlQ~~f"t~ ~ Shear Valve(s). ~ Shear Valve{s). ^ Dispenser Containment Float(s) and Chain(s). ^Dis enser Containment Floats and Chain(s). Dispensc,• ID: Dispenser 1D: Q Dispenser Containment Sensor(s). Model: ^ Dispenser Containment Sensor(s). Model: ^ Shear Valve(s). ^ Shear Valve(s). ^DIS enser Contaimnent Float(s) and Chain(s). ^Dis enser Containment Floats and Chain(s). ~It the lacUity contains more tanks or dispensers, copy this fonn. include information for every tank and dispenser at the facility. C. CertifiCatioIl - I certify that the equipment identified in tftls document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this informatlon 1s correct and a Plot Plan showi,tg the layout of monitoring equipment. For any equipment capable of generating such reports, 1 have also attached a copy of the re ort; (check all rhnl apply): System set-up .~ arm histo r ort Technician Name (print): ~.Y~,J y--~-r,~~J Signature: CertificationNo.: ~~~ 1LL~ ~{9,( 13'~ License. No.: Testing Company Name: RICH ENVIRONMENTAL Phone No.: { 61 ~ 392-8687 Site Address: ~~~~ /'~ 1~1,.'l,->' .~J~ ~~{-~/~(,~ a-~-=!-- Date of TestiriglServicing: ~/ `1~J/ (}~ Page I of 3 OlIUI Monitoring System Certification .~s~ a a. D. Results of Testing/Servicing Software Version lnstalled: /,~ f . OQ Com lets the foilowin checklist: Yes O o Is the audible alarrn o erational? Yes ^ o Is the visual alarm o erational? ~ Yes D o Were all sensors visual) inspected, functional) tested, and confin-ned o erational? Yes ^ o Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper o eration? O Yes O o If alarms are relayed to a remote monitoring station, is all cot~nmunications equipment (e.g. modem) N!A operational? Yes ^ o For pressurized piping systems, does the turbine automatically shut down ifthe piping secondary containment ^ N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) Sump/Trench Sensors; .^ Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failureldisconneetion? Yes; D No. ^ Yes O o 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 point(s) and operatin roperly? If so, at what rcent of tank ca aci does the alarm trigger? ^ es ~, 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 re lacement arts in Section E, below. ^ es No Was liquid found inside any secondary containment systems designed as dry systems? (Check al! that apply) D Product; D Water. If es describe causes in Section E below. Yes D o Was monitarin s stem set-u reviewed to ensure ro er settin s? Attach set u re orts, if a licable ~ Yes 0 o Is all monitoring equipment operational per manufacturers specifications? * In Section E below, describe how and when these deficiencies were or will be corrected. E. Comments: Page 2 of 3 03101 Z 5~~~ F. In-Tank Gauging /SIR Equipment: Check this box if tank gauging is used only for inventory control. ^ 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 perform leak detection monitoring. f mm~frtP thr fnllnwina charkiisf~ ^ Yes ^ o Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ^ Yes O o Were aEl tank gauging probes visually inspected for damage and residue buildup? ^ Yes ^ o Was accuracy of system product level readings tested? ^ Yes ^ o Was accuracy of system water level readings tested? D Yes ^ o Were all probes reinstalled properly? ^ Yes ^ o Were afl items on the equipment manufacturer's maintenance checklist completed? * I:n the Section H, below, describe low and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD) Comnlete the followine checklist: O Check this box if LLDs are not installed. ~) Yes ^ Noy For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ^ N/A (Check all that apply) Simulated leak rate: ~; g.p.h., ^ 0. I g.p.h , !] 0.2 g.p.h. ^ Yes ~ o Were all LLDs confirmed operational and accurate within regulatory requirements? Yes ^ o Was the testing apparatus properly calibrated? ^ Yes ^ o For mechanical LLDs, does the LLD restrict product flaw if it detects a leak? ~.N/A ^ Yes ~, o For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ^ NIA ^ Yes ~ o .For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ^ N/A or disconnected? 0 Yes ~. o For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system maffunetions ^ N/A or fails a test? O Yes ~ o For electronic LLDs, have all accessible wiring connections been visually inspected? O N/A ~' Yes O o Were all items on the equipment manufacturer's maintenance checklist completed? In the Section H, below, describe how and when these deficiencies were or wil[ be corrected. H. Comments: t ~U ~2yD~~c,~ ~ ~ -iJ~ ~ n .vcr- 1~~t~ UHF F~ i ~~-~n~ Ll21~~. L yo ~~ r yir~`~' P c~~ZG~~1 ~ 2vti .A~~ ~-~.c.vQ,a-ate "" r'JJiLJL ~7 pL c.rO ~~ ,. (L~?~~ y~~ O ~LJ ~- `-Jti5 -O 7 ~9v !"'~'S ] i,~_~- Page 3 of 3 03!01 s~c~~- Monitoring System Certification Site Address: ~~ ~ ~ ~ s '~ UST Monitoring Site Plan ~6-tJ ~ ~~~~~ - - --------------------------- --------------------------- ---------- ---------- ------------- ------------- - :::::: -: _~ti~~~ _~_ -=== ------ - ---- =-==== ---~3------- ======: --- --------- .- - ------------7~1- - ----~~r"'- ---------- ------------ Date map was drawn: ~ / 'a-`sr/O 7 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 Ieak 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_~ os~oo ~~ yq~ 563 SROD~S C~' ~C~~t3F~EI~D,CA.93308 OFFTC~ f bbl) 392-6687 & ~',A:C {661.) 392^C1b21 MECIi~:LFrCAZ 'L•~s5A7a 2Y,~}h',,,~j"_T~R 'rE9T wQ ~w.~ .m w/o#: Fae:l.ii+ty' Nau~e;~~-L- Proc;lueC ~,3.rxe Type (Pressure, 8uctiam, fdravi.by) Y I~SSU~-~`~ PRc;IDVeT LEAK DETECTOP T3tPE TEST TRxP PASB ' s~z.~. ~~as~ BET~QW PSI QR ~fA ~"7fP~ ~ft~CTR.c+~~ C. ' ~3 P s~~tz~s. #S~E~ g-~ ~T ~x~ L~'7 _ S~xtT.A,T~ # V.~OE.1Z- (ibv~- N O ~'ATL 67~EtxAL # 1~~1-~ ~'~-T" ~+tO O RAIL ~~ _. z.1n ~xP~~~c.~nvzc. s nss ~~~~ ~~~~, ~a o ~~ ~~ X ::ertify the above teats were corxducCerl on this date aeeox@ing fo ~2ed ,:~aQl~et trumps Field teat appaxatus testing pxo.eeduxe an limitat~.ona, Th,s, Mer_hanir..al. Leak DeL-ector. :Cast pass / fail is detex~nined. by using a lcr.t flow threshold trip rate of 3 gallom per houx or leas at 10 BSI. I •acknowledgn tb.at s. ).l data r_ollacted ie true an@ aoxreet to the best o£ rr4~ knoarledge . xech : Q`~-~9~~J O't' Sigiz.~tuxe ; pate : ~`~~~ ~ a•. a ism ~. ,, ,~ I CIS' ENV T ~ ONNlE~TA~ ~~ ~ 5643 BROOKS CT BAKERSFIELD,CA.93308 ' O$FICE(661)392-8687 & FAX (661)392-0621 MSC ATTT[±LT. T.RAK I]STECT04 TEST wa$IC ,_,4~ET w/o#: Facility Name:/'f~LC- _ Facility Address • ~~ ~~ w11'c~C~_,~9+... (3~~~£/uFi~~rO. !'~ Product Line Type (Pressure, Suction, Gravity) P(r~SSy2~ PRODUCT LEAK DETECTOR TYPE TEST TRIP PASS SERIAL NL7M$ER BELOW PSI OR n L/D TYPL 1SL.aG~1 L ES ASS `~ SERIAL # (~~~~ QOOi NO ~ FAIL ~~~ L/D TXPEt YSS PA33 SERIAL # NO FAIL L/D TYPB YES PASS SRRIAL # NO FAIL L/D TYPE YSS PASS SERIAL # NO FAIL I certify the above tests were conducted on this date according to Red Jacket Pumps field test apparatus testing procedure an limitations. The Mechanical Leak Detector Test pass / fail_is determined by using a low flow threshold trip rate of 3 gallon per hour or less at 10 PSI. I acknowledge that all data collected is true and correct to the best of my knowledge., Tech : /~..~/~¢'!J .i~1~SG'c~ Signature : ,~ pate ; 1 ~ ~~-!~ _, l~~~ SWRCB, January 2006 Spill Bucket Testing Report Form Thrs form is inte~rded for use by contractors performing annual testing of UST spill containment structures. The completed form and. printouts from.tests {ijapplicable), should be provided to the facility.owner/operator for submittal to the local regulatory agency. t 'Gti 1 l+TT TT~7 T7lTLV~DILT A TTr11V . FacilityName• 5/~LC~ - - --- - --- Date of Testing: J - -D7 Facility Address: ,,~ `f r:.~+ t ~zJG ~.~' ~~ ~~~ ~ Facility Contact: Phone: Date Local Agency W as Notified of Testing : , Name ofLocal Agency Inspector (ifpresent during testing: ) n mtaa~iYAT/"~ I~AT-Tn`D A!'~T`AD TATC!\DMA'ITff11V . Company Name: Llf' F•'V lJl ~tJr'L ~'t/ ~ . .Technician Conducting Test: •z..~ . Credentials: CSLB Contractor CC Service Tech SWRCB Tank Tester Other {Specie) License Number(s): ) ~ - tJ`' ~ evrr r. urTr-~uF.'r'r*~c~rrrtr_ nvxnurure'rrrnv Test Method Used: drostatic Vacuum Other Test Frquipmegt Used: (J1 V Equipment Resolution: Identify Spill Bucket (By Tank Number, Stored Product, etc. I UtiL ~ ~ 2 e..VS ~ 3 ~~ `~~ 4 I'~ Bucket Installation Type: Direct Bury ontained in S Direct Bury tamed in Direct Bury ~ ntained in Sum Direct Bury tamed in um Bucket Diameter: I a~~ I I a" 1 Bucket Depth: ! ! ~ ~ / , ~ J ~ Wait time between applying ~~watGr and start oft: 30 ~„-~ 3D 3~ ~„ 3D ~t Test Start Time (T~: I ' (' r„~ ) % ,,.,~ ,,~,~ Initial Reading {R~: f t-I ~ 1 ~ '~ / I 'ti.7 ~ a ! '~ Test End Tinoe (TF): ~ ~, ~ ,,,,.i a„' ,,,,,~ Final Reading (RF): ~ y J ~ i ~'I - 'il 1 ' `I I '~ I c~- t -`J Test Duration (Tp - T~: ~,,~ ~ 1J , ~ t .y t Change in Reading (RF-Ril: /-U ~ Q.-J Pass/Fail Threshold or Criteria: +'U /-V I'L) Comments - (include in ormation o irs made rior to t ,and recommended u or ailed ~ t -V tests CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the snformatton contained in this report is troy accurate; and in full compliance with legal requirements. Technician's Date• f `- ~~-O7 i State laws and rcguladons do ~currrntly re~u' a testiug to be performed by a qusli5ed contractor. However, local requirements maybe more stringent. -~ SOFTWHRE REVISIGN LEVEL VERSION 121.00 SOFTWARE# 346121-100-A CREATED - 00.11.15.13.2::1 S-MODULE# 330160-162-fl SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS CSLD HIR PLLD 0.10 AUTO 0,2^ REPETITIV WPLLD o,lo AUTO 0.20 REPETITIV _ . _ _----.- ~'s~a SYSTEM SETUP JAN 30. 20U? 10:45 AM COMMUNiGHTIONS SETUP SYSTEM UNITS U.S. S'lSTEM LAtJG UAGE PORT SETT 1 NGS ENGLISH SYSTEM DATEiTIME FORMAT GOMM HOARD 1 <RS-232? MON DD YYYY HH:MM:SS xM BAUD RATE 960q PARITY : ODD 12?824 TEXACO 121176 STOP BIT 2 STOP 3698 MING.AVE. DATA LENGTH: 7 DATA BAK£RSFIELD. GA. RS-232 SECURITY CODE : 000000 SHIFT TIME 1 5:00 AM SHIFT TIME 2 DISABLED AUTO TRANSMIT SETTINGS: SHIFT TIME 3 DISABLED . SHIFT TIME 4 DISABLED AUTO LEAK ALARM LIMIT DISABLED SHIFT BIR PRINTOUTS HUTO HIGH WATER LIMIT DISABLED DISABLED pA1LY BIR PRINTOUTS AUTO OVERFILL LIMIT DISABLED DISABLED TICKETED DELIVERY AUTO LOW PRODUCT DISABLED DISABLED TANK PER TST NEEDED WRN AUTO THEFT LIMIT DISABLED DISABLED TANK ANN TST NEEDED WRN AUTO DELIVERY START 'DISABLED DISABLED AUTO DELIVERY END LINE RE-ENABLE METHOD DISABLED PASS LINE TEST AUTO EXTERNAL INPUT ON DISABLED LINE PER TST NEEDED WRN AUTO EXTERNAL INPUT OFF DISABLED DISABLED LINE ANN TST NEEDED WRN AUTO SENSOR FUEL ALARM DISABLED DISABLED AUTO SENSOR WATER ALARM PRINT TC VOLUMES DISABLED DISABLED AUTO SENSOR OUT ALARM DISABLED TEMP COMPENSATION VALUE (AEG F ): 60.0 STICK HEIGHT OFFSET DISABLED H-PROT000L DATA FORMAT HEIGHT PRECISION TEST DURATION HOURS: 12 RS-232 END OF MESSAGE 0,20 GPH LINE TEST DISABLEA AUTO-CONFIRIh: DISABLED 0.10 GPH LINE TEST AUTO-CONFIRM: DISABLED DAYLIGHT SAVING TIME ENABLED START DATE APR WEEK 1 SUtd - START TIME 2:00 AM END DATE OCT WEEK 6 SUN END TIME - 2:00 AM- RE-DIRECT LOCAL PRINTOUT DISABLED EURO PROTOCOL PREFIX S SYST>iM S~GUR I TY GbDE ObbbOb ..~~ IN-TANK SETUP T 1:REGULAR 87 PRODUCT CODE 4 THERMAL COEFF :.000700 TANK DIAMETER 89.75 TANK PROFILE I PT FULL VOL 11527 METER DATA NO FLOAT SIZE: WATER WARNING HIGH WATER LIMIT: MAX OR LABEL VOL: OVERFILL L1 MIT HIGH PRODUCT DELIVERY LIMIT 4.0 IN. 2.0 3.0 11527 95~"~ 10950 98i 11296 15% 1729 LOW FRODUCT LEAK ALARM LIMIT: SUDDEN LOSS LIMI TANK TILT . MANIFOLDED TANKS Tst: NONE 500 3 T: 50 a.oo LEAK MIN PERIODIC: Oi 0 LEAK MIN ANNUAL Oi 0 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 TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY 1 MIN T 2:PLUS 89 PRODUCT CODE 6 • THERMAL COEFF :.000700 TANK DIAMETER 89.75 TANK PROFILE 1 PT FULL VOL : 11527 METER DATA NO FLOAT SIZE: A.0 IN. WATER WARNING 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 11527 OVERFILL LIMIT 95i 10950 HIGH PRODUCT 11296 DELIVERY LIMIT 1729 LOW PRODUCT 500 LEAK ALARM L[MiT: 3 SUDDEN LOSS LIMIT; 50 TANK TILT 4.03 MANIFOLDED TANKS T p : NONE t~s~l~ T 3:PREMIUM 91 PRODUCT CODE 2 THERMAL COEFF :.DD0700 THNK DIAMETER 89.75 TANK PROFILE 1 PT FULL VOL : 11527 METER DATA : NO FLOAT SIZE: a.0 IN. WATER WARNING 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 11527 OVERFILL LIMIT 95°r. ta95o HIGH PRODUCT ~ 98i 11296 DELIVERY LIMIT 15i • 1725 LOW PRODUCT 50C LEAK ALARM LIMIT: c SUDDEN LOSS LIMIT: 5C TANK TILT 2.61 MANIFOLDED TANKS Tri: NONE LEAK MIN PERIODIC: U%+ LEAK MIN PERIODIC: 0% LEAK M]N ANNUAL Op LEAK N1I N ANNUAL 0% f PERIODIC TEST TY~TANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TAI~ARMADISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY 1 MIN PERIODIC TEST TYPE STANDARI ANNUAL TEST FAIL ALARhI D I SABLE] PERIODIC TEST FAIL ALARM DISABLE! GROSS TEST FAIL ALARM DISABLE] ANN TEST AVERAGING: OF1 PER TEST AVERAGING: OF1 TANK TEST NOTIFY: OF: TNK TST SIPHON BREAK:OF: DELIVERY DELAY 1 MI _... ~. ' 4:DIESEL 'RODUCT CODE 1 'HERMAL COEFF :.000450 'ANK. D I AMETER 89.75 'ANK PROFILE I PT FULL VOL 9684 9ETER DATA : NO =COAT SIZE: 4.0 IfV. ~JATER WARNING 2.0 -l1GH WATER _LIMIT_? 3.0 hAX OR LABEL VOL: 9684 3VERFILL LIMIT 94% 9103 HIGH PRODUCT 98% 9490 DELIVERY LIMIT 14% 1452 LOW PRODUCT 500 LEAK ALARM LIMIT: 3 SUDDEN LOSS LIMIT: 5A TANK TILT 2.77 I"IAN I FOLDED TANKS Tq: NONE LEAK M[N PERlODIG: 0% 0 LEAK. MIN ANNUAL 0% 0 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAiL ALARM DISABLED FERIODIC TEST FAIL ALARIN DISABLED GROSS TEST FAFL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY l MIN -~-- ......_. -- --- - ,~SK_goC LEAK TEST METHOD TEST CSLD ALL TANK Pd 99%: CLIMATE FACTOR:MODERATE GROSS TEST AUTO-CONFIRM: DISABLED REPORT ONLY: END OF MONTH TST EARLY STOP:DISABL£D LEAK TEST REPORT FORMAT NORMAL PRESSURE LINE LEAK SETUP Q 3:PREMIUM UL PLLD TYP:2.Oi3.0IN FIBERGLASS ?.GIN DIA LEN:199 FEET 3.0JN DIA LEN: 0 FEET 0.20 GPH TEST: DISABLED 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE 0 PSI T 3:PREMIUM 9! DISPENSE MODE: STANDARD SENSOR: NON-VENTED PRESSURE OFFSET: O,OPSI G 1:REGULHR UL PLLD TYP:2.0,~3.O1N FIBERGLASS 2.OIN DIA LEN:160 FEET 3.OIN DIA LEN: 0 FEET 0.20 GPH TEST: DISABLED 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE 0 PSI T (:REGULAR 87 DISPENSE MODE: STANDARD SENSOR: NON-VENTED PRESSURE OFFSET: O OPS[ Q 2:PLUS UL PLLD TYP:2.Oi3.01N FIBERGLASS 2.O1N DIA LEN:l60 FEET 3.OIN D[A LEN: 0 FEET 0.20 GPH TEST: DISABLED 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE 0 PSI T 2:PLUS B9 DISFENSE MODE: STANDARD SENSOR: NON-VENTED PRESSURE OFFSET: O.OPS1 Q 5:DIESEL TYP:2.Oi3.O1N FIBERGLASS 2.OIN DIA LEN:160 FEET 3.OIN DIA LEN: 0 FEET 0.20 GPH TEST: DISABLED 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH LOW PRESSURE SHUTOFF:NO LOW PRESSURE 0 PSI T 4:DIESEL DISFENSE MODE: STANDARD SENSOR: NON-VENTED PRESSURE OFFSET: O.OPS1 LINE LEAK LOCKOUT SETUP LOCKOUT SCHEDULE DAILY START TIME: DISABLED STOP TIME :DISABLED ls~~~ LI~dU1D SENSOR SETUP L 1:87 ANNULAR DUAL FLOAT HYDROSTATIC GATEGORY ANNULAR SPACE L L :REGULAR UI. FILL SUMP TRI-STATE (SINGLE FLOAT} CATEGORY FIPING SUMP L 3:REGULAR UL STP SUMP TRI-STATE (SINGLE FLOAT> CATEGOR'! STP SUMP L 4:PLUS UL ANNULAR TRI-STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 5:PLUS UL FILL SUMP TRI-STATE (SINGLE FLOAT} CATEGORY PIPING SUMP L 6:PLUS UL STP SUMP TRI-STATE (SINGLE FLOAT) CATEGORY STP SUMP L 7:PREMIUM UL ANNULAR DUAL FLOAT HYDROSTATIC CATEGORY : ANNULAR SPACE L B:PREMIUM UL FILL SUMP TR!-STATE (SINGLE FLOAT} CATEGORY PIPING SUMF L 9:91 STP TRI-STATE (SINGLE FLOAT} CATEGORY STP SUMP L10:DIESEL ANN DUAL FLOAT HYDROSTATIC CATEGORY : ANNULAR SFACE L11:DIESEL FILL TRI-STATE (SINGLE FLOAT> CATEGORY PIPING SUMP L12:DSL STP TRI-STATE (SINGLE FLOAT} CATEGORY STP SUMP PLLD LINE DISABLE SETUP G f:REGULAk UL PLLD LIt~U1D SENSOR ALMS L 3:FUEL ALARM L 3:SENSOR OUT ALARM 0 2:PLUS UL PLLD L19UID SENSOR ALMS L 6:FUEL ALARM L 6:SENSOR OUT ALARM C~ 3:PREMIUM UL PLLD LI~2UID SENSOR ALMS L 9:FUEL ALARM L 9:SENSOR OUT ALARM ~d S:DIESEL LI9UID SENSOR ALMS L]2:FUEL ALARM L12:SENSOR OUT ALARNI RECONCILIATION SETUP AUTOMATIC DAILY CLOSING TIME: 2:00 AM AUTO SHIFT ttl CLOSING TIME: DISABLED AUTO SHIFT q2 CLOSING TIME: DISABLED AUTO SHIFT it3 CLOSING TIME: DISABLED AUTO SHIFT it4 CLOSING TIME: 5:00 AM PERIODIC RECONCILIATION MODE: MONTHLY ALARM: DISABLED TEMP COMPENSATION STANDARD METER CALIBRATION OFFSET: 0.000: BUS SLOT FUEL METER TANK TANK MAP EMPTY ALARM HISTORY REPORT ----- SYSTEM ALARM ----- HATTER`! IS OFF JAN 1. 1996 8:00 AM * ~ * * x END * * ~ ~ ~ ALARM HISTORY REPORT ---- IN-TANK ALARM ----- T 1:REGULAR 87 _ -INVALID ~FUEL'LEtiEL---~- - _ JAN 1. 1996 8:05 AM DELIVERY NEEDED JAN 1. 1996 8:05 AM x ~ k x ~ END ALARM HISTORY REFORT ---- IN-TANK,ALHRM ----- T 2:PLUS 89 INVALID FUEL LEVEL JAN 1. 1996 8:05 ANI DELIVERY NEEDED JAN 1. 199b 8:05 ANI ~- ~ _ lsc1~'~ ALARI°I HI~aTORY REPORT ALARM HISTORY REPORT ALARNI HISTORY kEPORT -- SENSOR ALARM ----- ___-- SENSOR ALARM ---"- SUMP ---- IN-TANK ALARM ----- L 1:$7 ANNULAR L 3:REGULA~Z UL STP T 3:PREMIUM 91 ANNULAR SPACE SENSOR OUT ALARM STP SUMP SENSOR OUT ALARM 2:20 PM JAN 29, 2007 2:20 PM JAN 29. 2007 SETUP DATA WARNING JAN 1. 19'36 10:00 AM SENSOR OUT ALARM SENSOR OUT ALARM 2:i3 PM JAN 29, 2007 2:13 PM JAN 29, 2007 INVALID FUEL LEVEL JAN 1, 1996 10:01 AM HIGH LIQUID ALARM FUEL ALARM 1:33 PM JAN 29, 2007 1:50 PM JAN 29. 2407 PRONE OUT JAN 1. 1996 8:59 AM DELIVERY NEEDED JAN 1, 1996 10:01 AM ~ * ~: ~ * END ~ ~ * * * x * ~ ~ ~ EIVD * ~ * ~ ~ ~ END ALARM HISTORY kEPORT ALARM HISTORY R1;FORT ----- SENSOR ALARM ----- ----- SENSOR ALARM ~---- ANNULAR L 2:REGULAR UL FILL SUMP L 4:PLUS UL PIPING SUMP ANNULAR SPACE SENSOR OUT ALARM FUEL ALARM 007 3:15 PM JAN 29, 2007 2:2D PM JAN 29, 2 ALARM HISTORY REPORT SENSOR OUT ALARM NIGH LIQUID ALARM ~ ---- IN-TANK ALARM ----- JAN 29, 2007 2:13 PM 1 JAN 29. 2007 3:15 PI T 4:DIESEL FUEL ALARM FUEL ALARM 07 3:08 PM JAN 29, 2007 1:q9 PM JAN 29. 20 SETUP DHTA WARNING JAN i, 1996 9:57 AM INVALID FUEL LEVEL JAN 1. 1996 9:55 AM PROBE OUT JAiV ! . 1996 8:59 AM DELIVERY NEEDED ~ * * ~. * -END ~ * * * *. * * * * ~ END * ~ ~ JAN 1. 1996 9:55 AM ;< * ~ ~ ~ END ~ * * ~ ~ ,, _ ALARM HISTORY REPORT ALARM HISTORY REPORT -- SENSOR ALARM -- -- -- SENSOR ALARM ----- L 7:PREMIUM UL ANNULAR L 5:PLUS UL FILL SUMP ANNULAR SPAGE PIPING SUMP SENSOR OUT ALARM SENSOR OUT ALARM JAN 29. 2007 2:20 PM JAN 25, 2007 2:20 PM SENSOR OUT ALARM SENSOR OUT ALARM JAN 29. 2007 2:13 PM JAN 29, 2007 2:13 PM HIGH LIQUID ALARM FUEL ALARM JAN 29. 2007 1:45 PM JAN 29. 2007 1:46 PM ~ x ~ ~ x END ~ x ~ * ~ ~ ~ ~ ~ ~ END * ~ x * ~ ALARM HISTORY REPORT ALARM HISTOR`! REPORT ----- SENSOR ALARM ----- -- SENSOR ALARM -- L 6:PLUS UL STP SUMP L B:PREMIUM UL FILL SUMP STP SUMP P I P I tVG SUMP SENSOR OUT ALARM SENSOR OUT ALARM JAN 29. 2007 2:20 PM JAN 29. 2007 2:20 PM SENSOF. OUT ALARM SENSOR OUT ALARM JAN 29. 2007 2:13 PM JAN 29. 2007 2:13 PM FUEL ALARM FUEL ALARM JAN 29. 2007 1:36 PM JAN 29. 2007 1:44 PM ~ ~ ~ x * END * ~ x ~ * ~e * ~ ~ ~ END ~ s yea ALARM HISTORY REPORT -- SENSOR ALARM ----- L 9:91 STP STP SUMP SENSOR OUT ALARM JAN 29. 2007 2:20 FM SENSOR OUT ALARM JAN 29. 2007 2:13 PM FUEL ALARM JAN 29. 2007 1:37 PM * ~ ~ * ~ END x ~ ALARM HISTORY REPORT -- SENSOR ALARM ----- LlO:DIESEL ANN ANNULAR SPACE SENSOR OUT ALARM JAN 29. 2007 2:20 PM SENSOR OUT ALARM JAN 29. 2007 2:13 PM HIGH LIQUID ALARM JAN 29. 2007 1:43 PM x * * * ~ END * * x * ~ •~ ALARM HISTORY REPORT -- SENSOR ALARM ----- LII:DIESEL FILL PIPING SUMP SENSOR OUT RLARM JAIV 29. 2007 2:20 PM SENSOR OUT HLARNI JAN 29, 2007 2:13 PM FUEL ALARM JAN 29. 2007 1:34 PM ~ x ~ ~ * END ALARM HISTORY REPORT ----- SENSOR ALARM ----- L12:DSL STP STP SUMP SENSOR OUT ALARM JAN 29. 2007 2:20 PM SENSOR OUT RLARM JAN 29. 2007 2:13 PM FUEL ALARM JAN 29. 2007 1:38 PM ALARM HISTORY kEPORT ----- SEtVSOR ALARM ----- 9 1:REGULAR UL PLLD PLLD SHUTDOWN ALARM JAN 29. 2007 2:20 PM PLLD SHUTDOWN ALHRM JAN 29, 2007 2:19 PM PLLD SHUTDOWN ALARM JAN 29, 200? 1:33 PM PLLD SHUTDOWN ALARM JAN 29, 2007 1:31 PM CONT HANDLE ALM JAN 18. 2007 8:32 AM PLLD SHUTDOWN ALARM JAN 11, 2007 9:27 HM GROSS LINE FAiL JAN I1, 2007 9:27 AM FUEL OUT JAN !. 1996 10:09 AM ~ ~ * * ~ END ~ * ~ ~ ~ ~s~~a ALARM HISTORY kEPORT ----- SENSOR ALARM ----- Gt 2 : PLUS UL PLLD PLLD SHUTDOWN ALA3k6MPN1 JAN 29, 2007 GROSS LINE FAIL JAN 29. 2007 2:36 PI~I PLLD SHUTDOWN ALARM JAN 29, 2007 2:20 PM PLLD SHUTDOWN ALARM JAN 29. 2007 2:19 PM PLLD SHUTDOWN ALARM JAN 29. 2007 1:36 PM CONT HAIVDLE ALM JAN 18. 2007 8:32 AM FUEL OUT JAN 1. 1996 9:19 AM ****~cENDx~*~?~ ~ ~ i~ * * END ~ ~ ~ * ~ 5 V L ~ ALARM H1`TOk1' kEPURT --'-- SENSOR ALARM ----- 9 3:pREMIUI~I UL PLLD ALARM HISTORY REPORT PLLD SHUTDOWN ALARM JAN 29. 2007 2:32 PM ----- SENSOR HLARM ----- 6t 5:DIES£L PLLD SHUTDOWN ALARM GROSS LINE FAIL JAN 29. 2007 2:25 PM JAfV 29. 2pp7 2:32 PM GROSS LINE FAIL PLLD SHUTDOWN ALARM JAN 29. 2D07 2:25 PM JAN 29. 2D07 2:20 PM PLLD SHUTDOWN ALARM PLLD SHUTDOWN ALARM JAN 29. 2007 2:2U PM JAN 29. 2007 1:37 PM PLLD SHUTDOWN ALARNI ~.ONT HANDLE ALM JAN 29. 2007 2:19 PM JAN 18. 2007 8:32 AM PLLD SHUTDOWN ALARM FUEL OUT JAN 29. 2007 i:3B PM JAN 1. 1996 9:20 AM FUEL OUT JAN 1. 1996 9:21 AM x x ~ END ~ ~ ~ rt ~ * ~ ~ ~ * END b~ ALARM HISTORY REPORT ALARFi HISTORY REPORT ~ti:~'.`§~~~$'~k£:~~~....--' _____ SENSOR ALARM ----- 0 2:PLUS UL PLLD ic~S'°'r®':'' idl~lo+r^ `ie • o• n-+ PLLD SHUTDOWN ALARM 2:36 PM JAN 29. 2007 PLLD SHUTDOWN ALARM JAN 29. 2007 2:20 PM GROSS LINE FAIL JAN 29. 2007 2:36 PM PLLD SHUTDOWN ALARM JAN 29. 2007 2:19 PM PLLD SHUTDOWN ALARM JAN 29. 2D07 2:20 PM PLLD SHUTDOWN ALARM JAN 29. 2007 1:33 PM D SHUTDOWN ALARM PLI • JAN 29. 2007 2:19 ~ PLLD SHUTDOWN ALARM .. JAN 29. 200? 1:31 PM PLLD SHUTDOWN ALARM JAN 29. 200? 1:36 PM CONT HANDLE ALM JAN l8. 2407 6:32 AM CONT HANDLE ALM JAN 16. 2007 6:32 AM f3~~iA.Z~uv~l b~C^' ~ S';"'^Iw JANp11L12~J0~7~j9:27 AM FUEL OUT l99b 9:19 AM JAN 1. FUEL OUT JAN 1. 199b 10:09 AM x ~ x * x END ~ * ~ x .. ~ /sy~~ ALARM HISTORY REPORT ----- SENSOR ALARM ----- G 3:PR£MJUM UL PLLD PLLD SHUTDOWN ALARM FEB 15. 2007 2:05 PM GRD9S LINE FAIL FEe l5. 200? 2:05 PM PLLD SHUTDOWN ALARM 3RN 29. 2007 2:32 PM- - GROSS LINE FAIL 3AN 29. 2007 2:32 PM PLLD SHUTDOWN ALARM JAN 29. 2007 2:20 PM PLLD SHUTDOWN ALARM JAN 29. 2007 1:37 PM CONT HANDLE ALM JAN 16. 2007 8:32 AM FUEL OUT JAN 1. 1996 9:20 AM e~ck~xEND*~xxx ~***~£ND*~x~:x ~. ~sY9~? MONI'T'OR CERT: FAILURI; REPORT SITE NAME• S (~ L, ~._. DATE: ~ ~ yl `Q 7 ADDxESS• .~l ~ ~ ~r_ r~11 ~.,~1, .A-v~ TECHIVICIAN: 2 `~-4-v v~.4-s c-~ THE FOLLOWING COMPONENTS TESTING. REPAIItS: v~v ~ ~ 7 ~ ~ ~ ~~ n .S coo ~~' ~~ 1~~~ ,~-t1~D LABOR: ~~ ~~ PARTS INTALLED: ~~U ~~ NAME: TTY; SIGNATURE: _ t 'T'HE ABOVE NAMED PERSON TAKES FULL RESPON$IBII,ITY OF NOT1F'YII~TG THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYII~TG RICH ENVIItOrfMAN•I'AL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON-COMPLLANCE. A COPY OF T$IS DOCUMENT HAS BEEN LEFT ON-SITE FOR YOUR CONVIENENCE. JOB CARD POST CARD AT JOB SITE INSPECTION RECORD-USTs _ $ E R 8 F 1 D ~~,~s aAr~ r BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 FACILfTY NAME OWNER ~~ AA VL ADDRESS ADDRESS ,,^^ V1 ,, MM V~ CITY STATE ZIP 7 CITY STATE ZIP BAKERSFIELD CA 3v PHONE NO. PERMR i',~ ('~ C TW l._ ®-L J INSTRUCTIONS: PLEASE CALL FOR AN INSPECTOR ONLY WHEN EACH GROUP OF INSPECTIONS WITH THE SAME NUMBER ARE READY. THEY W{LL RUN IN CONSECUTIVE ORDER BEGINNING WITH NUMBER 1. D N T COVER WORK FOR ANY NUMBERED GROUP UNTIL ALL ITEMS IN THAT GROUP ARE SIGNED OFF BY THE PERMITTING AUTHORITY. FOLLOWING THESE INSTRUCTIONS WILL REDUCE THE NUMBER OF REQUIRED INSPECTION VISITS AND THEREFORE PREVENT ASSESSMENT OF ADDITIONAL FEES. INSPECTION DATE INSPECTOR -TANKS AND BACKFILL BACKFILL OF TANK(S) SPARK TEST CERTIFICATION OR MANUFACTURES METHOD CATHODIC PROTECTION OF TANK(S) PIPING SYSTEM PIPING & RACEWAY W/COLLECTION SUMP CORROSION PROTECTION OF PIPING, JOINTS, FILL PIPE ELECTRICAL ISOLATION OF PIPING FROM TANK(S) CATHODIC PROTECTION SYSTEM-PIPING DISPENSER PAN SECONDAR CONTAINMENT, OVERF LPROTECTION, LEAK DETECTION LINER INSTALLATION -TANK(S) I In ~ r LINER INSTALLATION -PIPING ~ (j VAULT WITH PRODUCT COMPATIBLE SEALER LEVEL GAUGES OR SENSORS, FLOAT VENT VALVES PRODUCT COMPATIBLE FILL BOX(ES) PRODUCT LINE LEAK DETECTOR(S) LEAK DETECTOR(S) FOR ANNUAL SPACE-D.W. TANK(S) MONITORING WELL(S)/SUMP(S) - H2O TEST LEAK DETECTION DEVICE(S) FOR VADOSEiGROUNDWATER SPILL PREVENTION BOXES FINAL MONITORING WELLS, CAPS & LOCKS FILL BOX LOCK MONITORING REQUIREMENTS TYPE AUTHORIZATION FOR FUEL DROP QrL CONTRACTOR CONTACT e~ LICENSE NO. ~r p ~/ PHONE NO. ; ;oL~ l~- a r O 7 FD 2097 (Rev. 09/05) J~~ ~0~-~7~~ F/RE AItTM RONALD J. FRAZE FIRE CHIEF Gary Hutton, Senior Deputy Chief Administration 326-3650 Deputy Chief Dean Clason Operations/Training 326-3652 December 1, 2005 Texaco 3698 Ming Avenue Bakersfield, CA 93309 FINAt_ REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirements by December 31, 2005 of Underground Storage Tank (s) Located at the Above Stated Address Dear Valued Customer, Deputy Chief Kirk Blair Over the last six months this office has continued to send reminder notices regarding Fire Safery/Prevention Services secondary containment testing. 326-3653 Code requires that all secondary containment systems must be tested 6 months post construction and every 36 months there after. 2101 "H" Street ~ Senate Bi11989 became effective January 1, 2002, section 25284.1 (California Bakersfield, CA 93301 ! Health & Safety Code) of the new law mandates testing of secondary containment OFFICE: (661) 326-3941 ~ components upon installation and every 36 months, thereafter, to insure that the FAX: (661) 852-2170 ': systems are capable of containing releases from the primary containment until they are detected and removed. Our records indicate that your facility is due prior to December 31, 2005. RALPH E. HLTEY, DIRECTOR PREVENTION SERVICES Those sites that have not been tested and have not pulled a permit prior to December 31, 2005, will have their permit to operate revoked. FlRE SAFETYSERVICE3•ENVIRONMENr/LL SERVICES ~ 900 Truxtun Avenue, Suite 210 ' This office does not wish to take such action, which is why we will continue to send monthly Bakersfield, CA 93301 ~ reminders. OFFICE: (661) 326-3979 FAX: (661) 852-2171 Contractors are already booked several weeks in advance. I urge you to schedule your testing date as soon as possible to avoid possible revocation of your permit to operate. David Weirather Fire Plans Examiner ~ Should you have any questions, please feel free to call me at (661) 326-3190. 326-3706 Sincerely, Howard H. Wir1eS, III RALPH . HUEY, Director of Prevention Services Hazardous Materials Specialist '~ -- 326-3649 j Steve Underwood i Fire Prevention Officer SU:db ~J~isa~ f,1lse Z~c~~ ~ ..~J~ ~J1~s~ ~S~af~ .. L ~ ARCHITECTURE • E N G I N E E R I N G • ENVIRONMENTAL SERVICE S ~ GROUP INC. 1137 North McDowell Boulevard, Petaluma, CA 94954-1 1 1 0 Telephone: (707) 765-1660 Facsimile: (707) 765-9908 June 6, 2006 John W. Johnson Prevention Services Co-President Bakersfield Fire Department Architect ~ 900 Truxtun Avenue, Suite 210 Bakersfield, CA 93301 Brian F. Zita Co-President RE: Shell Station Closure/Sale Architect Dear Prevention Services: John B. Hicks This letter is to inform you that the Shell Station located at 3698 Ming Avenue in Yice President Bakersfield (Customer #3330) has been sold to the operator effective 03/23/2005. Shell Oil Products no longer operates this business. All future correspondences regarding this facility, Regional Managers the hazardous materials permit and the underground storage tanks should be directed to: Brad A. Gubser Steve Yang -Yang's Oil Corporation Jesse E. Macias Ming Texaco 121176 Roy W. Pedro 3698 Ming Avenue Alan K. Shimabukuro Bakersfield, CA 93309-5148 805 831-5151 John W. Strobel If you have any questions, please feel to contact me at the number above. Respectfully, RHL DESIGN GROUP, INC. Steve Skanderson Project Manager Off ces Cc: Shell Oil Products US ANAHEIM, CA BELLEVUE, WA CAMAS, WA DENVER, CO MARTINEZ, CA PETALUMA, CA ROSEVILLE, CA SCOTTSDALE, AZ \\rhl-haz\hazma[\HAZMA71She11\zFORMS\Agency SOLD HMMP Le[ter Merge.doc www.rhldesign.com