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UST-REPORT 8/8/2006
__ _ _ . ~ (UNDERGROUND STORAGE TANKS) FILE # ~ BASHAAR NAJDAWI CHEVRON _ 2301 PANAMA LANE ;' i / ~ - - ------ - - -_ _~ i -,.x. a• /,, L 'aii I :.r ~:.. ,A ~. +~~ ` ; ~( i ~ fly - - _ _ ~~ .- ~ 3~ . MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cite& Chapter 6 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code ofRegulations This form must be used to doctunent 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 owner/operator. The owner/operator must submit a copy of this fot~rrt to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: L~~ Bldg. No.: Site Address: a)C> I Qq'V~'"'1,9 Lit,> City: ~.tf-YC,£~L~~'1~C1~ Zip: `~ Jb7 Facility Contact Person: n Contact Phone No.: ~~ Make/Model of Monitoring System: 1 L-V~~ a~o Date of Testing/Servicing: ~/ ~ !~ B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific a uipment inspected/serviced• Tank ID: ~ L. ~ Tank ID: / l~ In-Tank Gauging Probe. Model: ~ ~ In-Tank Gauging Probe. Model: ^ Annular Space or Vault Sensor. Model: ^ Annular Space or Vault Sensor, Model: Piping Sump /Trench Sensor(s). Model- ~ Piping Sump /Trench Sensor(s). Model: ^ Fill Sump Sensor(s). Model: ~ Mechanical Line Lcak Detector. Model: _ '4 ^ Fill Sump Sensor(s). Model: -7~-~-~~ ~ Mechanical Line Leak Detector. Model: IC,Lit! ~ ~G~~" ^ Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: ^ Tank Overfill /High-Level Sensor. Model: ^ Tank Overfill / I-ligh-Level Sensor. Model: ^ Other s eci a ui ment a and model in Section E on Pa e 2 . ^ Other s ecif a ui ment a and model in Section E on Pa a 2). Tank ID:. tM Tank ID: ~ !! ~ ~Q In-Tank Gauging Probe. Model: 1 ^ In-Tart: Gauging Probe. Model: ^ Annular Space or Vault Sensor. Model: ^ Annular Space or. Vault Sensor, Model: Piping Sump/Trench Sensor(s). Model: ).Piping Sump /Trench Sensors}. Model: Fill Sump Sensor(s). Model: O Fill Sump 5ensor(s}. Model: Mechanical Line Leak Detector. Model: 1T ^ Mechanical Line Leak Detector. Model: O Electronic Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model: ^ Tank Overfill / HIgh-Level Sensor. Model: O Tank CNerfill /High-Level Sensor. Model: O Other (specify equipment type and model in Section E on Page 2). ^ Outer (specify equipment type and mode] in Section E onPage 2). Dispenser ID: }-~- Dispenser ID: "y Dispenser Containment Sensor(s). Model: - "(3~ ~ Dispenser Containment Sensor(s). Model: Shear Valve(s). ~ Shear Valve(s). O Dis enser Containment filoat s and Chains . Q Dis enser Containment Floats and Chains . Dispenser ID: _~~ D Dispenser ID: ,~ Dispenser Containment Sensor(s). Model: y~~ ~ Dispenser Containment Sensor(s). Model: ~$ Shear Valve(s). ~ Shear Valve(s), ^ Dispenser Containment Float(s) and Chain(s). ^Dis eriser Containment Floats and Chains . Dispenser ID: Dispenser ID; ^ Dispenser Containment Sensor(s). Model: ^ Dispenser Containment Sensor(s). Model: ^ Shear Valve(s). O Shear Valve(s). ODispenser Containment Float(s) and Chain(s). ^Dis enser Containment Floats and Chains . •lfthe facility contains more tanks or dispensers, copy this fonn. Include information for every tank and dispenser at the facility. C.:CLrrtlfiCdtlOn - I certify that the equipment ldentJfied in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verity that this information is correct and a Plot Ptan showing the layout of rnonitoring a uipment. For any a ui ment capable of generating such reports, J leave also attached a copy oC the repe}I-tJ(c~ all that apply): ~ System set-up ~ rm histo r port Technician Name (print}: f(~~77 ~ Signature: Certification No.: ~~'O~- l~7 `7 ILL'S` ~a~l~~~'yT License: No.: (~ Testing Company Name: RICH ENVIRONMENTAL Phone No.: { 661 ~ 392-8ti87 Site Address: ~Q / ~~y~~ ~,3 ,2._ .~~~ f /~'(1~1, f ~ Date of Testing/Servicing: ~/~/~ Page I of 3 03101 Monitoring System Certification D. Results of Testing/Servicing Software Version Installed: ~-d,~ !`mm~lata tha fnllnwino rhPr4licf• 13~~ ___----- Yes ^ o Is the audible alarrn o erational? Yes ^ o Is the visual alarm o erational? Yes ^ ~ Were all sensors visual! ins ected, functional) tested, and confin-ned o erational? ~ Yes O o Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their pro er operation? O Yes O o If alarms are relayed to a remote monitoring station, is ail communications equipment {e.g. modem) ~ N/A operational? 1~ Yes O o For pressurized piping systems, does the turbine automatically shut down if the 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; O Dispenser Containment Sensors. Did ou confirm ositive shut-down due to leaks and sensor failure/disconnection? Yes; ^ No. O 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 ove~ll warning alarm visible and audible at the tank fill point(s) and operating pro erly? If so, at what percent of tank capaci 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 all that apply) ^ Product; ~ Water. If es describe causes in Section E below. Yes ^ o Was monitorin s stem set-u reviewed to ensure ro er settin s? Attach set u re orts, if a licable Yes Q o Is all monitoring equipment operational per manufacturer's specifications? * In Section E below, describe how and when these deticiencies were or wil[ be corrected. E. Comments: Page 2 of 3 03!01 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. (`mm~lete the. follnwinv checklist: Yes ^ ° Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Yes ^ o Were alt tank gauging probes visually inspected for damage and residue buildup? Yes ^ ° Was accuracy of system product level readings tested? >~ Yes ^ ° Was accuracy of system water level readings tested? Yes ^ ° Were all probes reinstalled properly? ~ Yes ^ o Were all items on the equipment manufactwer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or wilt be corrected. G. Line Leak Detectors (LLD):. Com lete the followin checklist: ^ Check this box if LLDs are not installed. Yes ^ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ^ N/A (Check all Jhat apply} Simulated leak rate: ~ 3 g,p.h., ^ 0. I g,p.h , D 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 flow if it detects a leak? ^ N/A O Yes O o For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? N/A ^ Yes ^ o For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled [~ N/A or disconnected? ^ Yes 0 o For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions t~l N/A or fails a test? ^ Yes 0 o For electronic LLDs, have all accessible wiring connections been visually inspected? N/A Yes ^ o Were afl items on the equipment manufacturer's maintenance checklist completed? !n the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 03101 onitoring System Certification UST~onitoring Site P Site Address: ~~U ~ ~~V~-.~ ~ Z (5~~ ~ 1 ------------ --------------------------------------- ------------ --------------------------------------- ------------ -==-=-r.~ ~t~...................:..:.. """""""" p-'-'- - - "'- --"'- '- --------- - a:_-.:... ____________________~3=:=:__:_::__:::::E~:___:_: ---------~-•---------- 3 ••-•-----•----------j-----•-- ------------- ~J~.~1-----L-1t~---------------------- Date map was drawn: ~/ ~ /Q~ 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 teak 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~ 05100 t3~-~y Y 5643 F113QQ~i.S CT ,B,~ERSF:~EI,D, CA. 93308 QFF'TCE ($61) 392-8b$7 & F.A~c (&61,) 3920621 ' M~CB BbLlCA3~i;~'~RkG~B~'~4B~& ~ T ~o~x sN~~m w/o#: Fae:i.l3ty Name ~ ~.~i>~`L-~ ~'ac:l.~.~.~y' AddxQ,ss ; ~~O t Y'~'V'~•Vt,4 ~~ ~~~~~I~C.Q (rtT¢ Px'oc:ltldt T,~.ne Type? (Pressure, 6uakl,axz, draviry) 1 ~~~~ PR(:IDUCT S,EAK 17ETECTOk2 `PS~PE r ~~EFT TRT$ P.~sF3S s~zixa.~, ~~a~~ a~T~AW PSG AR 7L/A ~'YPR ~ ~ ~~ 8 As3i s~z~zks. # ~~ ~ L/D ~~'~~ L R a! t,vS ~ CJ LJL+ 7`Y'PF. ~~'~LS.-~.-- ~S AB lam' ' ~~ -- ~ z, /n T3tQ~__ Y~3 PABS t ;:ertify tb.e above Tests wexe conducteri on this data accraarding to Rad ..racket 7t•umps field teaY_ apparaL-us test.5.ng Pxocedux'e an limitat~.ons, Tkr~:~ Merhan.i.r.~zl. z~ea)c Uet.ectnr. Tact. pass / fa.i]. is determined by using a lc~vr flaw th.r.Pslzald trip rate of 3 gAllgzz per ksour or leas aL 10 PSI. i e~ckn.owledr~R t~~,a.c a]. 1. data eozlaeted 3.e txue arxd coxraot Co the best a£ rl•y kLlgwledge . Sigzks~ture: Date: ~~~ c,. ti3ga~ SWRCB, January 2 6 Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of LIST spill containment structures. The completed form and. printoutsfrom.tests (if applicable), should be provided to the facility,owner/operator for submittal to the local regulatory agency. ~ ~ s rrr .YTV rnri4 nttn,r a ~rrn~v Facility Name: v 17 Date ofTesting: -CI Facility Address: a'~p j ~ ~~ Z Facility Contact: Phone: Date Local Agency Was Notified of Testing : . Name ofLocal Agency Inspector (ifpresenl during testing: ~cTn~r_ rnNTU a rTn~r rnr~nrrwre TrnN Company Name: L ~'} -- If) ~ . .Technician Conducting Test: Credentials: CSLB Contractor CC Service Tec SWRCB Tank Tester Other (Spec~J License Number(s); _- (, 4;.iii7(`i~4'T TF.~TT11T[~ iNFinRMATinN Test Method Used: drostatic Vacuum Other Test Equipment Used: Equipment Resolution: Identify Spill Bucket (By Tank Number, Scored Product, etc. 1 (J 2 n Y ~ 3 ~~ 4 Bucket Installation Type: u-ect Bury Contatn to S Duect B o in Sum irect B Sum Dn•ect $ury Contained in Sum Bucket Diameter; Bucket Depth: ~ ~ ~ t Wait time between applying vacuum/water and start of test: ~ U y-I / -v 3-o h t -v / ~ 3~ >wl 1'~ Test Start Time {T~: ~~~U ~..~ ; ~ Initial Reading (Rt): ~Q '' Test End Time (Tp); ~ %~ 9 s~ g , Final Reading (RF): ~ ~ `~ /(J ~ JQ „ Test Duration (TF - Tl): „,t,,v ,,,t ' ,~ Change in Reading (RF - R~: d '' Q " PesslFail Threshold or w •, c Criteria: Comments -('include infrmation on repairs made prior to tesn'ng and recommended follow-up forfailed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true, accurate; and in full co.npliance with legal requirements. Technician's Dater~~ ~ State laws and regulations do ~o currently re~ue testing to be performed by a qualified contractor. However, local requirements may be more stringent. 4 ~~ ~ ----~.; 50FTUJHRE RE1/ [ S I QN LEVEL VERB I OJ'J B . 05 SGFTWAREp 349500-008-F ~REATL-'D - 95.07.06.D8,33 rVO SOFTWARE MODULE S'YSTEI°1 FEHTURES: PERIUDIC IN-TANK TESTS AIVI'JUAL I PJ-TAtVK TESTS SYSTENI SETUP AUi; 8, 2006 10:;36 AI°1 - S`,'STEP'I UNI'CS U.S, SYSTEI°1 LHNGUAGE ENGLISH 13ASHAAkS CHEVRON RT 2 2301 PANAMA LIV BA},'ERSFIEL.U CA..93307 661-8;32-4551 SHIFT TIME 1 9:57 Ah1 SHIFT 1' I hIE 2 D I SABLEU :3HlFT TIh1E 3 : Ul~A~LED SHIFT T1h1E 4 UISAHLEIi PER I OU I C TEST IJARN I PJGS DISABLED ANNUAL TEST WARNINGS DISABLED SYSTEM SEi:URIT`,' CODE DODDDD PRINT TC: VOLUMES ENABLED 7'EI'1P COIIPENSAT I ON VALUE (DEC F ): b0.0 CGI"11°IIJPJ I CAT I GINS SETUP PURT SETTINGS: IVGI'JE FC~IJND R.5-'~32 SECURITY CODE 000000 kS.-23's. ENU OF NIESSr3GE . . U'[~AbL)wD • .. IN-TANK SETUP T ?:PLUS PRODUCT CODE 2 THERMAL CGEFF :.000070 TAiVK. U I AMETER 75 , t30 'I'AIVK PROFILE I PT FULL UOL : 3987 FLOAT SIDE: q.0 INCHES I,JATEk WARNING 2.0 HIGH WATER LIIwIT: 3.0 MA.~: OR LABEL VUL : 3987 OVERFILL LIMIT 95!. _ 3787 HIGH FF:ODUCT 99i 3947 DELIVER`! LII'1IT e°r, • 316 LOW PRODUCT 300 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 5u TANK TILT 2.60 MAPJIFGLDEU TANKS Tit : IVO NE LEAK M11V AIdtVUAL 398 PERIODIC TEST TYFE c~UICK. T 1:SUFER PRODUCT CODE 1 THERhiHL COEFF :.000070 TANK DIAMETER 95.OD TANI: PROFILE 1 PT FULL VUL : 9980 FLOAT S 1 ~E : 4.0 I INCHES WATER WHRIJIIVG 2.0 HIGH WATER LIMIT: 3.0 h1A~C OR LABEL VOL : 9980 OVERFILL LII°t I T 95°a 9481 HIGH PRi7DUC'f 99°0 9880 UEL 1 VERY L.I I°1 I T 4%0 • 399 LOW PRODUCT 30U LEAK ALARNI LII°1 I T : 99 SUDDEN LGSS LIhIIT: 50 TAPJI; TILT 3.50 I°IAIVIFOL~DED TANKS T JJ : rJG IVE LEAK P9I N APJNUAL 998 PERIUDIC 'CEST TYPE QUICK HIVPJUAL TEST FAIL ALARI°1 D [ SASLED PERIUDIC TEST FAIL ALARI'1 D i SABLEU GROSS TEST FAIL ALARI°I DISABLED AIVN TEST AVERA~ 1 N~ ~ : OFF F'ER TEST' AVERAGING: GFF TANK TEST IV01' I FY : OFF TIVK TST SIF'HOIV BREAK.:GFF DELIVERY UEL.AY : J 5 IH I N ANNUAL TEST FAIL ALARI°I ENABLED PERIUDIC TEST FAIL ALARM EIVABLEU GROSS TEST FAIL ALARM ENABLED ANN TEST AVERA~~IIVG: ON P£R TEST AVERAGING: OFF TANK TEST NGTIFY: GFF TIVK TS'C ,IPHGN BREAK: ON DELIVERY DELAY 15 MIN ~`8~ T 3 : UIVLEHDED PkgUUi~:T CODE 3 THERMAL COEFF :.0000'70 TANK DIAMETER 95.OU TANK. FROF I LE i P1' FULL tiJOL 9980 FLOAT 5 I ~E : 4.0 I INCHES WHTER WARN 1 PJG 2 , 0 HIGH WHTER LiM]T: 3.U MAX OR LRBEL VOL: 9980 OVERFILL LIh1IT 95%' 9481 HIGH F'RODUC:T 99 a 9866 DEL. I vEkY L I I°I I T 4aa 399 LOW PkODUC'I' 300 LEAK ALARM LIh11T: 99 SUDDEN LOSS L I f°11'T : 50 THNK TILT 2.90 hIANIFOLDED TANKS Ttt: NONE LEH1•: IHIfV ANNUAL 998 PERIDUIG,TEST TYPE idUIGK F;NIVUr1L TEST FAIL ALHRhI DISABLED PER l OD I ~ ~ PEST FH I L ALARM D I SABI..ED GROSS TEST FAIL ALARM UISAFLEL~ AIVIV TEST AVERAG I IVG : OFF PER TEST AVERAG I tVia : UFF 1'A NK TEST IVOT I FY : OFF TPJI: TST S I PHOIV BREAP, :OFF L~EL I VERY DELAY 1 5 NI I N LEAK TEST I"IETHgD 'LEST f"IOrVTHLY : ALL TANK WEEK 1 MUIV START' T I f°1E 2:00 HI°i TEST RATE :0.20 GAL; HR DURATION 2 HOURS LICUID SENSOR SETUP L I:SUPER TRI-STATE (SINGLE FLOAT? CATEGORY STP SUh1P L 2:PL.US TRI --STATE (S ] Ni;LE FLOAT i CATEGDRY STA SUMP L 3 : UNLEADED TR[-STATE (SINGLE FLOAT) CATEGORY STP SUMP L 4:PIPING SUI"IP NORr"TALLY CLOSED C?ATEGOR'! : PIPING SUf"1P OUTPUT RELA`r' SETUP R 1:SHUTUOWrJ TYPE: STAfVDAF.D NC>RNIALLY CLDSED L I GU I D SENSOR ALr"1S L 1 :FUEL ALAP.hI L 2:FUEL ALARNI L 3:FUEL ALARM L 4:FUEL ALARI"1 ALARM HISTORY REPORT PAPER UUTTEM ALARWI ---_._ JUL 11. 2006 9:11 AI"1 PRINTER ERROR •JUL 11. 2006 9:11 Ahl SYSTEM EEPROM CFG ERROR UC:T 57, 852 4:17 Ar`1 BATTER'! I S OFF APR 44, 705 0:48 PM TOO hIANY 'I'AN}:S 27. 2 12:58 HJh S'!S SEi~UR l TY WARNING RONI REVIS ON WARIOVINGM JUIV 32, 1254 5:03 PM REhIUTE DISPLAY ERROk MAk 8. 433 12:02 Pf"1 AUTODIHL ERROR t"iH'! 32. 211 0:00 AM SOFTWARE MODULE WARN TANK 1 TEST SHUTDOWN PM SEP 60, 1394 13:34 Phl PROTECTIVE CGVER ALM UNKIVOWPJ SYSTEM~AIARhAjM MAY 39, 1411 13:63 Af"I UNKNOWN SYSTEM ALARh] UNKIVUWIV SYSTEhIaALARIH1M J1AY 36, 2781 3:03 PI"I SYSTEI'1 SELF TEST ALhI JUA1 7, 4034 ! 1:29 HIH Aga ALARM HISTORY REPORT ---- IN-TAP1K ALARr°I ----- T 1:suPER SETUP DATA WARNIIVG JAN 4, 0 0:37 AM OVERFILL ALARM JUN b. 2001 2:17 Phl JUN 2, 2001 5:23 PM SUDDEIV LOSS ALARNI SEP 5. 2005 3:21 AI°1 HIGH FkODUCT ALHRf°I JUIV S. 2001 2:37 PIN SEF 5. 1997 9:47 ArN IIVVHLID FUEL LEVEL JUL 11. '2006 10:58 ANI JUL 3, 2006 7:50 Phl JUIV 23. 2006 6:25 PIN PROBE GUT APR 1. 2005 8:31 AM rNAR 17, 2005 9:15 ANI hIAR 9. 2005 11:21 Ar°1 ALHR1'1 HISTORY REPORT ---- 1hV-TANK HLHRPI ---•-- 'T ~':Pi.US SETUP LATH WARNING SEP ! 0. 1997 1 1:14 Al°i UVERFILL ALARM ,TUL 11. 2006 8:34 HM NOV 28. 2002 6:32 PIN FEB 2. 2002 0:14 AM LOW PRODUCT ALARM NOV 25. 2005 10:02 Phl NOV 2. 2005 10:45 AM AUG 29. '2005 12:07 AM NIGH PRODUCT ALARM JUL 11. 200b 8:35 A1N 1VOV 28, 2002 6:33 PfN JUN 6. 2001 3:13 PNI iIVVALID FUEL LEVEL AUG 2. 2006 9:30 AA7 JUL 11. 2D06 10:35 AIN JUL 7. 2006 5:03 PNI PROBE OUT HUG 8. 2UOb 10:23 AN1 AUG E~, 200b 10:11 At.I AUG 8. 2006 9:08 Ar°i P,L,F;Rf 1 H I STOR~f kEPOkT _._-~- I N-TAN}'. ALARM - T 3;UNLEADED OVERF I I.L `ALARM6 ; 05 AP1 JUL 23. OO.i 8:56 AI"I NOV 30. 2002 1 :00 AI'1 OCT 26. 2001 OUDDEIV LUSS AL~R311 Art AUG 7. 2006 2;58 AM SEP 5. 2005 3:15 AI~I JUL 4. 2005 ~{IGH PRODUCT ALARI°I JUL 23, 2pp3 6.21 AM JUIV b. 2UD1 2:c`I A1M JUfV 1 . 2001 1~' -i3 IIVVALIP FUEL Lgvp FM AUG 6 . 2006 ~ , 29 Al°I AUG 4' ~p06 y:42 PP1 JUL 30, PRONE OUT 0:18 ANI flPR g. 2006 13.36 HNI OCT 16. 1999 f7A-; PRODUCT ALARNI JUIV 6. 2001 2:42 PI°I GEL I VERY rVEEDED AIJG 2. 2006 9:46 Hhl JUL 1 1. 2006 10:35 Hl°1 JUL 7, 2006 5:11 Ph1 GROSU' "!'EST FA I L MAY 1. 200b 3:30 AhI JHIV 2. 2006 3:30 AI°1 DEC 5. 2005 3:30 AM PERIO DIC: TEST FAIL P1AY 1 . 2006 4:3U AM JHN 2. 2006 4:30 AM SEP 5. 2005 4:30 AIN TAIVK SIPHON BREAK AUG 7. 200b 2:00 AM JUL 3, 200b 2:00 ArN JUIV 5. 200E 2:00 ar°l ti MAY, PRODUCT~AI.6RP7 AM JUL 23. 200~j 2.57 PM JUN 6. 2001 12 54 AM .7UN 1, 2001 t,=o~° ALARM HISTORY REPORT ---- - SENSOR ALAk{°4 ------ HLARM HISTORY REPORT L 1 : STP SUPER SUMP -~---- SENSOR ALARM - - FUEL ALARM L 3 : UIVLEADED STP SUMP AUG 8. 2G06 5:15 lihl FUEL HLARM FUEL ALARM wUG 8, 2066 5:13 AIM HUG 10, 2GG5 9:43 AM '~ FUEL HLAkf°I FUEL ALARM AUG 10, 2005 9:43 At°l AUG 4. 2005 9:4G Ahi FUEL HLARM HUG 4. 2005 5:41 AI°I ALARM HISTORY REPORT ---•-- SEPJSOR ALARM ----- HLARM HISTORY kEPCiRT L '?:PLUS STP SUMP -'--- SENSOR ALARM -----. FUEL ALARM L 4:PIF'ING SUMP AUG 8, 200b 9:12 AhS IV P FUEL ALHRh1 FUEL ALARM AUG t3. 2G06 9:16 Ht°i AUG 10. 2065 9:43 AIh FUEL ALARM FUEL ALHRhI 'HUG 10, 2005 9:44 AI°I ' AUG 4. 2005 5::32 AM FUEL ALAkfh AUG 4. 2005 5:43 Ht°1 ~~ MONITOR CERT. FAILURE REPORT SITE NAME• G ~~'~(f~-G "t-~ DATE: ~' 0 "C~ t0 AnnRESS: y~C~ l P~4~v~.~ 1~ TECIBVICIAN: ~~~9-t.> _ _ ~"~~~G'v THE FOLLOWING COMPONENTS WERE REPLACED/REP. TESTING. REPAIRS: ~~1~~ LAAB,O~RA lam' U~ PARTS INTALLF,D: NAME: TITLE: SIGNATURE: THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIN'YING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR TAE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIItONMANTAL FOR ANY NEEDED RETESTING. TffiS ALSO RELEASES RICH ENVII20NMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON-COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN LEFT ON-SITE FOR YOUR CONVIENENCE. ~ ~s~-~ ______ UNDERGROUND STORAGE TANKS ~° ~s I~gF1i1F1T~IN~`F9GLOYgiIItcbwFA~`YW,;.A^~.•4tMMa~Yf~iXti~4a'! }4siiR+RJAJ.Ab;u'aY/Yw'.Y'`,~~ APPLfCAT10N TO PERFORM ELD /LINE TESTING ! S6989 SECONDARY CONTAINMENT TESTING (TANK TIGHTNESS TESF AND TO PERFORM FUEL MONITORING CERTIFICATION ~~~ BAKERSFIELD FIRE DEPT. -~ Prevention Services ~RTTd~ • f 900 Tnixtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 PERMIT N0. ^ ENHANCED LEAK DETECTION ^ LINE TESTING ^ SB-969 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST _. -- " ~~ ~~ TO PERFORrvt FUEL MONITORING CERTIFICATION ~` ~- SITE INFORDrAT10N r ''` FACILITY. ,~ ~ -' - Na'ME-&•PHpNENUMBER OF CONTACT PERSON ADDRESS , / ,l~ OWNERS NAME ..~_ t ~~ OPERATORS NAtdE PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED I IPIN OlN E TE T 07 ^ Y S ^ N TAN ;!: L ME . TANK TESTING COfv1PANY ` NAME OF TES ~G COMPANY ~ ~ '-- (`` Ai:7driE E PHONE NUMBER OF CONTACT PERSON ~~ MAILING ADDRESS _/ j/~~ /^~ 1 i ~• ~ NAME HONE NUFdBER OF TESTER OR SPECIAL INSPECTOR Uf - ~ " CERTIFICATION #: DATE 8 TIME ES DUCTED ., ,. ~. ~~~. ,~ n. iCC n: S~CPr~~s-~ TEST METHOD SIGNATURE OF APPLICANT~~ ~ ?~G~-,~ DATE ~,_ a ~ v • T'i~iIS~PLSO~~'lOfd SEEO ES ~E~ r ~4PPROVED BY ! phTE FD 2095 (Rev. 09/05) - ~- - - - - -- - - - rl;~~,. ~~~ B1L:LtNG & PE~~'~8~' S1'~TE~11E~tlT' ~r~~~~`~-_._ BAKERSFIELD FIRE DEPT. °°~-R._s Prevention Services ~°'~~ 900 Truxtun Avenue, Suite 210 pERMtT NO.: ~'~'~~ r~r . r Bakersfield CA 93301 @'~ ,., a ., - LOCATpN OF PROJECT n PROPERTY OWNE ~ STARTING GATE CUh1PLETION DATE i NAME -~~ ~ ~ ~ D~,~'1 ' PHONE N0. PROJECT I ~!., CRESS PROJEGTAODRES ~ ~ D ~ ~/r /n ~ ^~~~ ~ (:~' ' ~ ~ ~ ~ STATE ~ ZPCOOFyi ~ ~ O CONTRACTOR NAME CA LICENSE NO. ll'PE OF LICENSE. EXPIRATION DATE PHONE N0. ,39a ~ CONTRACTOR.COMP YNAM FAX NO. _ ~' yu~ t try---~- ~LV~.,~ ~~.I,Y ~IP~DE3 9~ -c~ (~~ ADDRESS -- _~` j ~ `7 4' i 000 S Over 20 FL Ft x 013125 = Permif fee S ~ ~ q. , q. . 98 ^ rinklers -New & Modifications - Minimum Char S e) $210 00 ~ ( p g . 98 ^ Over 5 000 Sq Ft 042 =Permit fee Ft x i Sq ~ , . . _ . . . . _ - -- 98 ^ _ _ _ -- --- rinkler h4odi~cations (< 10 heads) Minor S .. -._ ... --- j IJO [Inspection Onl ) ' $ 9's ~ p ___ _ y , . _ __ 98 ^ _ Commercial Hoods - New ~ Nlodifications ~ _ 26 S 398 ~ . ^ Additiora! Hoods $ 36 00 ~ . 98 ^ Spray l8ooths -New & Modifications $458 00 ~ . 98 ^ Aboveground Storage Tanks (tnsta/lat;on/Insp.-1s Time ) $ 165.00 82 ^ - - -~ Addi£ior;al Tanks - I ~ 26.00 82 ^ Aboveground Storaye Tanl<s (Remova/,'Inspection) ~ $1U9.OC 82 ^ Underground Storage Tanks {/nstatlarron./lnspe~tion) - ~878.OC (per tank) ~ 82 O Underground Storage 1-anks (Modification) 5878.00 (persite) 82 ^ Underground Storage Tanks (Minor Modfication) $155.00 ~. ^ Underground Storage Tanks (Removal) $675.00 (perfank) 84 ^ Oilwell (Installation} $ 72.00 84 Mandated Leak Detection (festinc Fuei Mond. Cert. _ $ 81.00 (persite) 82 ^ Tents ~.s $ 93.00 (per tent) 84 ^ FVter hours inspection fee I $~i 22.U~a ~ 84 ^ PyfOteCtlniC - (Per event, Plus Insp, 1=ee ~ $9G pcr hour) i ;i 60.60 + (5 hr;. min. stand -4y fee rlnsl~on) _ $510.40 84 ^ RE-INSPECTION(S) / FOLLOhI/-UP INSP[C T10N(S) -j $ 93.C0 (per hour) 84 ^ _ Portable LPG (Propane): NO. OF CAGES? S 66.00 84 ^ Explosive Storage .~ $249.00 84 ^ Copying & File Research {File Research Fee $33.00 per hr} 25¢ per page 84 ^ Miscellaneous s ~ ~ FD 2021 (Rev. 08/05) t -ORIGINAL WtIITE (ln Treasury) 5-YEi:_6iN ito File) 1-PINK (to Customer ~ ~ UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD t LINE TESTING I SB989 SECONDARY CONTAINMENT TESTING. /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION BAKERSFIELD FIRE DEPT. ~ FiW~ Prevention Services Att 1'1M T 900 Truxtun Ave., Ste. 210 Bakersfield, CA 9330 L Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 7 of i PERMIT N0. ~~ ^ ENHANCED LEAK DETECTION ^ LINE TESTING ^ SB-9~89/ SE_CO~NDARY C~AINMENT~T.~E(STING ^ TANK TI(,HTNFSS TFST T ~ _n ~M.D'OC.,I C'_ 1 I l~~ I El . .. ,.,: FACILITY - ,:: '. SITE INFORMATION UMBER OF CONTACT PERSON irCJ ADDRESS Q -/ OWNERS NAME - OPERATORS NAME PERMIT TO OPERATE N0. NUMBER OF TANKS TO SE TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO TANK# VOLUME C NTENT d~~ a O0~ c ~~~! 3 ~ c, p~-~ ~ -R/ TANK,TESTING COMPANY NAME OF TES G COM ANY NAME & PHONE NUMBER OF CONTACT PERSON \~ MAILING ADDRESS O~, O NAME HONE NUMBER OF TESTER OR SPECIAL INSPECTOR CERTIFICATION #: DATE 8 TIME EST T0, BE CONDUCTED ~j ICC #: ~7 /~ p TEST METHOD SIGNATURE OF APPLIC T ~~_ DATE r a APPROVED BY DATE FD 2095 (Rev. 09/05) f j . r >~~ BILLING & PERMIT STATEiiAENI' PERMIT NO.: ''`~"` BAKERSFIELD FIRE DEPT. B s D Prevention Services F~~,t? 900 Truxtun Avenue, Suite 210 a ~ ri~v r Bakersfield, CA 93301 . LOCATION OF PROJECT ( Z - PROPERTY OWNE > STARTWG DATE _ _ COMPLETION DATE ~ NAME ~ . PROJECT E (/~ ~ - {~ ~ ~ ADDRESS PHONE NO. PROJECTADDRE ~ ~ O ~ ~ ~ ~ ,^ O CnY n ~ ~~ STATE ~ ZIP CODE ~ ~ Q CONTRACTOR NAME o e- e- o CA LICENSE NO. TYPE OF LICENSE. EXPIRATION DATE PHONE NO. 39a -fs!>? CONTRACTOR COMP Y NAM ~~--~,- FAX N0. 39~ -a (~~ ADDRESS CrrY /~ ~ ~ ~ I~KV ZIP CEDE c~' J • • ~ ^ Alarms -New & Modifications - (Minimum Charge) $262 50 . ~ • . 98 Over 20 000 Sq Ft Sq Ft x 013125 =Permit fee ~ ^ , . . . . 98 ^ Sprinklers -New & Modifications - (Minimum Charge) $210 00 ~ . 98 ^ Over 5 000 Sq Ft Ff Sq x 042 =Permit fee ~ , . . . . . 98 ^ Minor Sprinkler Modifications (< 10 heads) $ 93.00 [Inspection Only) ~ 98 ^ Commercial Hoods -New & Modifications $ 398 26 ~ . 98 ^ Additional Hoods ~ $ 36 00 ~ . 98 ^ Spray Booths -New & Modifications $458 00 ~ . 98 ^ Aboveground Storage Tanks (Installation/Insp.-1~' Time) $165.00 82 ^ Additional Tanks $ 26.00 82 ^ Aboveground Storage Tanks (Removal/Inspection) $109.00 82 ^ Underground Storage Tanks (Instal/ation./Inspection) $878.00 (per tank) 82 ^ Underground Storage Tanks (Modification) $878.00 (per site) 82 ^ Underground Storage Tanks (Minor Modification) $155.00 82 ^ Underground Storage Tanks (RemovaQ $675.00 (per tank) 84 ^ Oilwell (Installation) $ 72.00 ~ Mandated Leak Detection (Testi Fuel Monit. Cert. $ 81.00 (per site) 82 ^ Tents $ 93.00 (per tent) ~ ^ After hours inspection fee $122.00 ~ 84 ^ Pyrotechnic - (Per event, Plus Insp. Fee @ $90 per hour) $ 60.00 + (5 hrs. min. stand -by fee /Inspection) _ $510.00 ~ ^ RE-INSPECTION(S) /FOLLOW-UP INSPECTION(S) $ 93.00 (per hour) ~ ^ Portable LPG (Propane): NO. OF CAGES? $ 66.00 ~ ~ ^ Explosive Storage $249.00 ' ~ ^ Copying & File Research (File Research Fee $33.00 per hr) 25¢ per page ; ~ ^ Miscellaneous : ~ FD 2021 (Rev. 09/05) - 1 -ORIGINAL WHITE (to Treasury) 1-YELLOW (to File) 1-PINK (to Customer _ _ _ _ I. ~.... '~_ - ~-- -- - 'r-(-0~ 2 8 - ~~" MONI"YOKING SYSTEM CERTIFICATION t For Use By Al! Jurisdictions {1~tthin the State of Calrfornia ,4rrthorrty Ci(e& Chapter 6 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code ofReguiatiats rl his term must be used to document testing and servicing of monitoring equipment. A separate certification or report must be r~ enare fc~• each monitoring s, stem control pane! by the technician who performs the work. A copy of this form must be provided to the tar-rk system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 clays of test date. ~~. Gerlel•;1! Iltform~tion }=acility ?Jame: ,~.9-S //94~- ~ ~ l~ t/~ "t-~ Bldg. No.:____ _ Site Address: o?,~~JI ~~}?J~''"L¢' 1., ~ City ~'¢K~S~/fie.•~ Zip: ~,3~~17 _ i~acility (~ontact Person: Contact Phone No.: (T~)_ !vfake/1\4odcl of Monitoring System: % L 5 - 3SZ~ Date of Testing/Servicing: ~/ e`ll_/ I~, Inventory of ~quirJnicrtt Tested/Certified ~ ~ ~ `~ Check the tinnrooriate boxes to indicate speciUc equipment inspected/serviced' INSPECTOR ON-SITE, ''~NO_ AME: ~ "rank l0: ~~,L~-~ ~-Tank JD,: ~LV ~~ _ _ [n-Ta•rk Gauging Probe. Model: __-__( ~ J~ ]n-Tank Gauging Probe: Model: L~ __ 1 l~ ;lnnuls~.r Shacc err Vault Sensor. Model: _ _ ;~ t~ ~p'+ng Sump / "hrench Sc:nsar(s). Model: ~_~-~ ^ Annular Space or Vault Sensor. Model: „_ (~ Piping Sump /Trench Sersor(s)_ Model: _~ ^ Gill Sump Sensor(s). Model: ^ Fill Sump Sensor(s). Model: F~ ~~lechtu~ical Line Leak Detector. Model: (} c~''~'CK~' ~ Mechanica) Line Leak Detector. tvlodel: Y~17 ~~UK-~-t " U rilcctronic 1_ine Leak Detector. Model: ^ Electronic Line Leak Detector. Model: Q Tank Overtifl /High-Level Sensor. Model: ^ Tank Overfill /High-Level Sensor. Model: ~ ^ Other (J~ecif e ui ment t ~ e and model in Section E ort Pa e 2). ^ Other (s eci a ui ment pe and model in Se lion E on Pa e 2). "yank II): /L-~ ~ Tarik lll: ~'I.JS S ?"1C~'J SUr~ )~ In-'l'ank Gauging Probe. Model: /'"1/f~'7 / ^ Jn-Tank Gauging Probe. Model: CJ Annular Space or Vault Sensor. Model: ^ Annular Space or Vault Sensor. Model: ~q P.iping Sump /'trench Sensor(s). Model: O ~ Piping Sump /Trench Sensor(s). Model: e~-vv" C? Fill Sump Sensor(s). Model: ^ Fill Sump Sensor(s). Model: _._. ~ I`~icchanic~ll Line leak Detector. Model: RL~~Q tIG~T ^ Mechanical Line Leak Detector. Model: (] l~accu•onic Line Lcak Detector. Model: _____. D Electronic Line Leak Detector. Model: D Tank Overfill / 1-Iigh-Level Sensor. Model: ^ Tank Overfill /High-Level Sensor. Model: r] Other (specify equipment type and model in Section E on Page 2). O Other{specify equipment type and model in Section E on Page 2). Ml)ispcnser (U: 1 Dispenser 1D: ~_ ~ l:~ispcnscr Containment Sensor(s). Model: ~L~ '~ d -~ Dispenser Containment Sensor{s). Model: yU _ ~ Shear Valve(s). _ ~ Shear Valve(s). C1 Dispenser Containment Floats and Chain(s). ^ pis enser Containment Floats and Chains . i)ispunser I ll: ~~- ~Q Dispenser ID: Disi~enscr Containment Sensors}. NiocJel: (~ S -U 1 _ . ~ Dispenser Containment Sensors}. Model: ~ 1 S - CJ j _ S1-sear Valve(s). Shear Valve(s). r.. Cl !7ispcnscr C_onr7inmcnt f~loat(s} and Chain(s). O Dis enser Containment Float(s) and Chains J Dispenser ID: _ Dispenser 1D: Q Dispenser Cont~innrent Sensor(s). Model: _ ^ Dispenser Containment Sensor{s). Model: ' ^ 5iicar Valvc(s)• ~ ^ Shear Valve(s). C1Dispenscr Containment Float(s) and Chain(s). ^ pis enser Containment Floats and Chain{s). '; P the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility C. (..et'tItlCltiOri - 1 certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' gnidctines. Attached to this Certification is information (e.g. manufacturers' checklists} necessary to verify that this information is correct :rnci a Plot Plan shotiving the layout of monitoring equipment. For any equipment capable of generating such reports,.) have also attached a copy oi'the rep rt; (checkatt 1ha! appty~:System set-up ~ r history r port 'f'ccimici<1nT`'ame(print):l_ ~y~"L~ r.-y~}--C{,j-LJ Signature: / `-~^" C;er-ti(icationNo•: /-~a'?.~ L`~ I~C~#~~ltl~c?~tJl r License.No.: te.stirrg Cvn~panyT~'aJne: RICH ENV1ItONMENTAL Phony No.:.~ 61 ~ 3~2-8687 Site Address: _~a~,P~ti~~2 L..3~ ,~¢~,~/ ,t/Q C !~ Date ofTestin Servicin Page 1 of 3 03101 Monitoring Syste+n Cet'Citicati0n D. Resuit~s of Testing/Servi~cjing So(n-vare Version Installed; 0 ~ Us~ i C'nu,nlrfr~ the fnllnwina checklist: _. ..... ,-.. ___ Yes ~ .... .--•-- ^ o --a ----------- Is the audible alarm o erational'? Yes ^ o [s the visual alarm o erational? Y'es ^ ~ o Were aEl sensors visually ins ected, functional! tested, and confin-ned o erational? Yes ^ o Were a!! sensors installed at lowest point ofsecondary contairnnent and positioned so that other equipment will not interfere with their proper operation? ^ Ycs ^ o If alarms are relayed to a remote monitoring station, is al! communications equipment (e.g. modern} N/A operational? Ycs ^ o For pressurized -piping systems, does the turbine automatically shut down if the 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 al! rha~ apply) Sump/Trench Sensors; .^ Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Yes; ^ No. O 1'cs O ' o Far rank 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 operating properly? If so, at what percent of tank capacity does the alarm trigger? 'J 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) O Product; O Water. (f es, describe causes iii Section E below. Yes _ ^ o ~1~as monitoring s stem set-u ~ reviewed to ensure ra er settin s? Attach set u re orts, i F a liable Yes ^ No Is all monitoring equipment operational her manufacturer's specifications? In Section L below, describe how and when these deficiencies were or will be carreeted, 1~~. Cot~trnents: Page 2 of 3 03101 1=. In-~.[~Znk Gauging / SII2 Equiptllent: Q Check this box if tank gauging is used only for inventory control. d Check this box if no tank gauging or S1R equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. ~~ Yes d o Has all input wiring been inspected for proper entry and Germination, including testing for ground faults? -Yes Yes ^~o O ~ ° Were all tank gauging probes visuaii}~ inspected for damage and residue buildup? Was accuracy of system product level readings tested? +~ Ycs r] o Was accuracy of system Ovate+' level readings tested? ,J Ycs O '~ Were all probes reinstalled properly? Yes Q o Were all items on the equipment manufacturer's maintenance checklist completed? In it+e .section H, below, deSCrlbe t[OW anG 1VUen [neSC UCIICICnC1eS WCrC Oi' Wlll 4e COri-Cl'[eu. C:~. Line Leak Detectors {LLD) ~'mm~lefe the fnllmvinn checklist: O Check this boy if LLDs are not installed. Yes Q ~'°` For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ^ NIA (Check a!! char crpp/y) Simulated leak rate: ~ 3 g,p.h., 0 0. I g.p.h , 0 0.2 g.p.h. Yes ^ o Were all LLDs confirmed operational and accurate within regulatory requirements? 1'es ^ o Was the testing apparatus properly calibrated? ~ Ycs ^ ' o For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^ N/A ^ 5'es ^ o For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? {~ N/A ^ Yes O o For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring syste+n is disabled ~. N/A or disconnected? ^ Y`es ^ o For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system rnalfunetions ~? N/A or fails a test? C~ Yes O 'o For electronic LLDs, have all accessible wiring connections been visually inspected? ~ N/A _ 1'es ^ ~ o Were all items on the equil?ment manufactucet's rriaintenance checklist completed? in [nc ~ecuon n, uelort~, aescr+ne 1[oW anu wnen u[ese deuctenctes were or wilt be corrected. ET. Co-rtntents: Page 3 of 3 03101 ~MonJtorltig System Ger~caflon Form: Addendum far Vacuutn/Pressure Interstitia! Sensors LG 163-1~.Enc. II g. Results of Vacuum/Presswe Monitoring Equipment Testing ' This page should be used to document testing and 'servicing of vacuum and pressure interstitial sensors. A copy of this form must be included with the Monitoring System Certification Form, which must be'~providtd 'to the tank system owner/operator. The owner/operator must,submit a copy of the Monitoring System Certz-fication Foxin to the local agency regulating UST systems within 30 days of test ,date. Manufacturer: Model: Sensor ID Component(s) Monitored by this Sensor: Sensor Functionality Test 12csult; l~ Pass; .[] Fail Compozent(s) Monitored by this Sensor: Sensor Functionality Tort Result: ^ Pass;' ~ ~] Fail Component(s).Monitored by this Sensor: Sensor Functionality Test Result: ^ Pass; .Q Fail Component(s) Monitored by this Sensor; _ Sensor Fuuetionality Test Result: Q Pass; ^ Fail ' 'component(s) Monitored by this Sensor: Sensor Functionality TestResult:IIPass; ^ Fail ~~~ Component(s) Monitored by thlc.Sensor: Saasor Functionality Test Result: ^ Pass; ^ Fail Component(s) Monitored by~this Sensor: Sensor Functionality Test Resulf» Q Pass; ^ Fail Component(s) Monitored by this Sensor: Sensor Fun4tionality Test Result: II Pass; ^ .Fail .Component(c) Monitored by this Sensor: Sensor Functionality Test Result: ^ Pass; II Fail ' Cpmponent{s) Monitored by this Sensor: ScnsorFunctionalityTest Result: ^ Pass; ^ Fail low vas Interstitial communication verified? f,~ lr~;akTntroduced~atFarEndofInterstitialSpacc;~ [] Gauge; 'Vacuu,tt was restored to operatfuP levels lu all interrtitlsl spacer: System TyQe:~ Pressure; ^ Vacuum Interstitial Communication Test R.esu1C. ^ Pass; ^ Fail Intersdtial Communication Test Result: ^ Pass; ^ Fail Interstitial Conununication Tcst Rcsu.lt: [~ Pass; ^ Fail futerstitiei t;pmmuui,cation TostRcsult: [~ Pass; ^~ Fail 1'ntcrstitial Communication TestRrsult: [~ Pass; ~] Fail Intersdtial Communication TtstResult: ~ Pass; Q Fail .interstitial Communication Test Result: j] Pass; [~ Fail Intctstitian Copapaumication'Tcst Result: 4] Pass; ^ Fail Interstitial Communication Test Result: Q Pass; ^ Foil Interstitial Comul1urlication Test Result: ^ Pass; [~ Fail ^ Visual ~ action; ,^ Other (Describe ~ Sec. J, below) [] Yea. ^ No (.(f'no, describe to Sec. J, below) J. Con~lucnts: . paee ~ of~ ~ If the sensor successfully detects a simulated vacuum/pressurc leak introduced in the inteixtitial space at the furthest point trora the sensor, vacuum/pressure has boetl demonstrated to be eonuuunicating throughout tbo iutcredce. onitorinj System Certification Site Address: ~J©1 .~'~v UST Monitoring Site Plan ~ .~- ~~~~ == ===============--==-= - =s~~=~--===-==== =--------- Date map was drawn: ~ / a ~ 10 ~ Ins'~uctions if you already have a diabram 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, dispe~iser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; Ind 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 l~ 56#3 BROODS C',C £RS~~~I,U,CA, 9330$ aPk'xc_~~ (6s~,) 3928687 & ~',A.~ (661) 392~(~s21. MRf!HIt7JT~AT. T,~~ D~E~'T~T2 ~L'~"'S',C 1 W/4#: Fie:f;li~y Name ~N9'~~ ~/f~c/~ti i Fa~:l.~.i.~y Acldx~ss a~LL~~ug"-~'q- C ti _ ~~/~i.~C~ C. Pr4c'1ue~ Li,t~e ~Pe (Prsasuxe, SuCtigxt, l3x'av~,ty) .~~y~$y2~ ,' P~2(:-ALJC~ LEAK DETECTOR T~P:~ ~'ESx' T1Z,Tk' PASS,. sR.kx,~z, z~uz~a.~x B~T,OW PSG OR 8~~2x.A.L # ~~ J'}LI~"' gyp. ~` &`A I~ v~~ L/~A 2'XF~ "'t FGtY~2/7«'1 A3Sf S~sR~.A.~ #.,.~~~~ NO ~] F i ~~S~S _. ~./z~ ~rP~.~.~2~t~~ Ass:: S~RxAZ, ~...~~,Q,~ ~+T4 ~ FA X,/i~ ~''~'PS--- _ 7t'~S PASS! S~RxA~, ~_._., NO FA.ZI. z ;:ertify Che aba~rF teats were cdnducted on this date accoxding ~o Red ~:~acl~aC Pumps .£ie.l~3 test appaxatus testj.an~ ~pxaeedure an limita~.~ana. Thee Mechanir.al z,eak Detector. .Test, past / fail. is' determined by using a ].c~'~r flow thxesho7_d trip. rate of 3 gallom ,pex hour or less at 1p kSI. I .ac~cnaw2.edge L:kx~t aJ_1. data ao~lected ie .true axad Aox~.z•eaC to ~k~e beet of rry knowledge. Tech : ~ v ~`'~_~ . sigzk;ture 1 - - -- pate ~ ~) -off ~~ k~. SWRCB, J 201 Spiil•Bucket Testing Report Form . phis form is intended for use by contractors performing annual testing of UST spill containment structures. •The completed form ar printoutsfront.tests Cfapplicable), should be provided to thefacility:owner/operatorforsubmittal to the local regulatory agency. ' 1 _ FA C'IT.7TY l'NF(?RMAr1ZON ,~'. ' Facility Namo: ~ Qom Date ol~TGSting: -~1 ~ 7' -`~ Facility Address: p' ~(J/}-~~ L't, - • Facility Contact: Phone: llnte Local Agency Was Notified of Testing : '• • Name ofl.ocal Agency Inspectcsr (jpresent.during testinp~: • 2. TESTING CONTRACTOR INFORMATION. Company Nome: ,('.. )Ltf ~'gJtJj nd-v ~"-~2J i~¢2_ .Technician Conducting Test: (L,4' ~ d~ Credentials: CSLB Contractor CC Service Tee SWRCB Tank Tester. Other ( ec~) License Number(s); ..~',--/o I~-13 ~ cJ> 3. SP L BUCKET TESTING INFORMATION CERTIFICATION OF TECI~ICIAN R];SPONSIBLE FOR CONDUCTING THYS TE52IlYG thereby certify that all the i>{J~orn, lion contained in this report is true, aceuratc~ and in ju11 eompllanee with legal requirements. Technician's Sigpature;_.___1 • ~ Date: ~" ~ { -~7 ' Stace laws and regulations don t c ently rcQuir f~r' ling to 6e performed by a qualified contraeu)r. However, local rcc}uircmcnts ni~y be LAOCC 8tringont. IN-TANK SETUP T I:SUPER " PRODUCT CODE f T 2:PLUS ' ' THERMAL COEFF :.000070 PRODUCT CODE iOF I l~tA~;E REV I S I OPJ LEVEL TANK DIAhIETER 95.00 TH>"RMAL COEFF :.0 000?0 ,JEF„~TC:tfJ B 05 TANK PROFILE 1 PT TAN1`; DIAf°1ETER 75.b0 :aC:FTI~IFIRE# 349500-u08-F FULL VOL 9980 TAPJ}•: PROFILE 1 F'T CREATED - 95.07.Ob. 06.33 FULL VGL : :1987 PJO :~OF`fWF=iRE I°IODULE ' FLOAT SIZE : 4.0 INCHES S ~'STENf Ft=.ATURES : FLOA'C S 1 ?E : 4 . (J I NCHES PERIODIC Ii+!-TANK TESTS LJATER WARNING 2.0 AP1tdUAL 1N-TANK TESTS HIGH UJATER LIMIT: 3.0 WATER WARNIt'JG : ~'.0 HIGH ~JATER LIi°1IT': 3.0 MA:C +JR LABEL VOL : 9980 ' OVERFILL LIMIT 95°r; MAC OR LABEL VOL: 3987 9481 OVERFILL I_II°lIT 95%b HIGH PRODUCT 99% 3787 9880 HIGH PRODUCT 99%~ DELIVERY LIWIIT 4 a 3947 399 DELIVERY L. I I.1 I T tii :318 S'!S"T'EI°1 SETUP ~ LOW PRODUCT : LEAK ALARI°I L I hl t T : 300 99 ...:__.__~_____ _... .. LOW PRODUCT __ ;300 ` - - SUDDEN LOSS LIMIT: 50 LEAK ALARM LIMIT: 99 F;U~_ : 1 . ~U07 10' 12 AI~I TAN}, TILT 3.50 SUDDEN LOS'S L (N1 I "T : 50 TANK TIL"r 2.60 MANIFOLDED TANKS ` T~: NONE '~ IVI EEZ~ TA{VKS c 8'`rS fEl°1 Ut'JITS T ~ NON SYSTEf'1 LAtVGUAGE LEAK MIN AIVIVUAL 998 LEAK MIN ANNUAL 39d lLI`~H EtV`' ~' PER I OU I C TEST TYPE CVUICK PERIODIC TEST TYPE BASNAARS CHEVRON GUICK RT 2 'x'301 PANAI°lA LIV BAKERSFIELLi CA.93307 ANNUAL TEST FAfL ALARM DI SABLED ANNUAL TEST ~ RN 661-a32-A551 A E A NABLED 51 I I FT T I hIE 1 7:00 AM PERIODIC TEST FA ] L ALARM D T SABLI"D PERIODIC Tir ST FA I L SF; I FT T 1 hlE 2 1 1 : C10 Phi ALA}21"1 EI'dABLED SI-{ I F'r T I NiE 3 G 1 BAWLED ' GROSS TEST FAIL 51I 1 FT T i NlE 4 D I SAHLED ALAkI'1 D I aAHLED GRs~SS TEST T A I L ALA;*'t°I E I'IABLED PEI I Op I ~ TEST WARN I IVGS ppJN TEST AVERAG 1 NG : UFF D],SAbLEI~ PER TEST AVERAGING : OFF ANN TEST AVERAuiIVG : GfJ F,NfVUAL TEST WARNINGS PER TEST AVERAGING : OFF DISABLED TAIV}: TEST NOTIFY: OFF -SYSTEM SECURITY TNK TST SIPHON BREAY.:OFF TAN}: TEST iVOT I F`l ~ OFF C;C>DE 000000 TPJK TST SI PHOIV DREA}; : ON F ]<;' I N'f TC VOLUMES DEL l VERY DELAY 15 M I N DEL I VEk ~ GELA'Y 15 Iy I PJ ENABLED TF'NiF' COI°iPENSAT I ON UALUF. (DFG F ?: 60.0 COI`91°IUIV 1 CAT I OfV.S SETUP FORT ti'f'f T I NG5 PJOPIE . FUUPdD R'S ~ ~'3'~ SE~.UR I TY coG~ oooouo ~'5--~ ;~:' .1^IVI~ -~>~ ~r`I>~SSACF G I SABI_EL~ '1' ;3 : UhJLEALiEI1 PRC'~DUC1' COf~E D 1'HERt°IAC. COEFF : .000070 '1'APJ}; D I AI"IETER 95.00 'I'F~tPJK PROFILE 1 PT FL~Li, VOL 99190 FL~A'I' S I ~E : 4.0 I NGHES t.JrsTER WARPJ 1 Nu 2 , G FIIGN Wf"~1'ER LIMIT: 3.0 I°IA; ~'R LABEL VuL: y9d0 C)~iE}~F 11.1_ LIMIT 95%0 8481 1-! r eH PRODUCT 99 5880 L~~L-'L f VEF,'1' [. 11°1 I T 4% 399 LOW PF;~:~DU~: T 300 I..E/3Y F+LARI°1 L II°l I'I' : 99 ;aU1=;DJN LG'~Sl~ LI1°IIT: 50 TAlV}' TILT 2.90 h4F1iV t FOI~L+ED "CANk;S T q : IVOIVE LEE;}; 1°11 N APJtVUAL 998 PLR1t1DIC TEST TYPE QUICK AiJNUAI. ?'ES1' FAJL ALARI°1 D I SAFiLED I~ER I Ol:i I C TEST FA I L ALARI"1 D I F~AFILED GROS:3 "I'ES`1' F'A I L ' ALARM DISABLED Ardrd "TEST AVERAGING : dFF F'1:R TEST AVERAG I Nr, : OFF TAi'J1~. TE:3~' 15JOT I FY : OFF ~'Pv'}; 'fST ,] I PFIQN BREAK : dFF ` hEL 11lEF;Y DELAY ~ : 15 1°i I N LIi~UID SENSOR SETUP L 1:SUPEk TRI-STATE (SINGLE FLOAT? CATEGORY STP SUI°1P L 2 : PL US TRI-aTATE (SJNGI_E FLOAT) CATEGORY STP SUfhP L 3 : UrJLEADI~D TRI--STATE {SINGLE FLOAT) CATE+adRY STP SUriP L a:PIPING SUMP NORMALLY CLOSED CATEGORY P I P I !VG SUMP ,. OU'T'PUT RELAY SETUP R i:SHUTDOWN TYPE: STAPtDARD tVOR!°1ALLY CLOSED I_IAK TE;aT METHOD TEST f°1:31VTHLY : F;LL TANK WEEK 1 f°Is_J1V S7'F+R"1' T 1 h9E 2:00 A1~1 TEST RATIO :0.2G GAL: HR DUF.AT I ON 2 HOURS LIi~UID SENSOR ALP1S L 1:FUEL ALARM L 2:FUEL ALARM L 3:FUEL ALARI`? L 4:FUEL ALARM ALARr1 NISTOR'~' f~EPO>;'"I ----- S'i:3T1~i°1 ALARI°l --- -- PAPER OUT AUG 6. 2007 B:D4 AI°1 PR I IVTER ERROR AUG 6. 2007 8:04 AM S~'STEI`1 EEF'ROI~I i~FG GRRuR OCT 57. 852 4:17 AIM BATTERY IS OFF AF'R 44. '?05 U:48 P1°I Td0 h1ANY TAN};S 2? ; 2 1 '~' : 58 Ai~i SYS SEA • Uk I TY` WAR IV 1 IVG JAN ae. 319 1:02 PNi RCJt°1 REV I S I dN WARNING JUN 3'~. 1254 5:03 Phl REf°1t3TE DISPLAY ERRdR h1AR 8. 433 12:D2 P1~1 AUTODIAL ERROR_ h1AY 32. 1 1 1 U : OG Ahl StiFTWARE t°IdDULE WARN 11. 0 12:34 Pt°1 TANK TEST SHUTI?dWN SEP 60. 1.994 1;1:34 PM PROTi~CT I VE COVER AL1~9 a 3, U 1 2: l a At°I UfV};NOWfJ SYSTEM ALA}~hl h1AY 39 , 141 1 13:63 Ahl UNKIVO6JfV SYSTEM ALARI°I 47, 413 8:38 AI°1 UNKIVOWIV S`rSTEf~I ALARI°1 MA`f 36. ?781 3:03 P!°l SYSTEM SELF TEST ALM JUN 7. 403a 11:29 Ahl ALARf I H I ST+yRY REPGRT ---- I tV-TAtVK ALARM - T 1:SUPER .. W.F1RN I Nr SETUP.. DATA JAtV 4. . 4 0:37 Al~1 OVERFILL ALARM JUN 6.. 2001 2:17 Pt°I JUIV 2. 2001 5:23 PI`7 SUDUI;N L GSS ALARM SEP 5. 2005 3:'21 AI°1 H I C~H PRO DUi~T A(_ARM JUN 6. 2001 2:37 F'hl SEP 5. 1997 9:47 Ahl 11JUAL]D FUEL LI?.VEL JUL I0. 2U07 12:32 F'(°I JUL 2. 2007 9:42 PI°t JUL 1. 2007 3:06 At°i PkdBE OUT NOU 30. 2006 6:32 P1°i NOV 30. 2006 b::.'6 PN1 IVDV 30. 2006 ~ • 25 PM MH,~, PR~aDUC'1' ALARM JUtV b, 2Q01 2:42 P1°i A!_i;Rl°l I-{I:~'I'URY REPC:RT _._.__ IN-TAN}; ALARM - :~rTUP I~ATA WARNING ~~~F' l0. 1997 11 :14 AIH c?1/ERF 1 LI_ riC.ARI°1 J1JL 1I. 2006 8:34 AI'1 1VOV 28, 2002 6:32 P{°1 FEB 2. 2002 8:14 AI~I LULJ PRODUCT ALARNI DEC G7, 2006 2:46 PIH NOV 26, ''006 3:21 AM OCT ~'9. 2006 7:23 At°1 H 1 Gl~t PRtaGUCT ALARI°f JUL 1 1 . 2001 8:35 AI°1 Nt~V 2a . '002 6:33 PN1 JLJIV 6. 2001 3:13 Pf°t I IVVFaL I I:~ FUEL LEV&L AI_ir, I . 201x7 12:03 AM JUL 25. 2007 2:51 Af°! _ JUL 1 Ci . 2007 5:43 AM PROBE UUT NOV 30. 2006 6:33 PM NOV 30. 2006 6:19 PM hJQV 3G. 2006 6:17 PI°t [,r'L (',I~RY NEEUEU FiIJG 1 , 2007 5:06 AM . lUL '~5. 2007 5:54 AIH JUPI 30. 2007 4:28 PM GRCr:F, "I'FST' FA I L f°lA'1 7. '4007 3:30 ANl JAN 1. 2007 3:30 AP1 N1AY I . 2006 3:30 AM PER I CiL+ [ i:: Tl~aT FA I L I°1AY 7, 2'007 4:3G AIH J%Pd 1. 2G07 4:30 ANt !°1A`,' f . 2006 4:30 ANI T'F;I'dY: S i PHUN BREAK JUL ?, 2G0'1 2:OD AI`1 JIJhd 4, ~00`T 2:00 AI°1 ALARM HISTUR~' REPURT ----- I N-T'ANK ALARM - T 3:UNLEAUED UVERFILL ALARM JUL 23, 2003 6:05 AM NUL+ 30, 2002 8:56 AM UCT 26, 2001 1:U0 AM SUPUEIV LUGS ALARI°1 AUG 6, 2G07 3:43 AM JUL 2, 2007 3:a7 AM !°lAR 5. 2007 3:'~0 AM HIGH PRUUUCT ALARM JUL 23, 2003 6:21 AM JUIV 6. 2001 2:53 PM JUN 1, 2001 12:53 AM I IVL+AL I U FUEL LEVEL AUG 20, 2007 5:19 AM JUL 22, ?007 9:21 AM JUL ! . 2607 10:15 Af~1 PRUBE UUT NUL+ 30, 2006 6:19 PI°i NUV 30, 2006 6:17 PM AF'R 1. 2005 13:18 AM I°lA?; PRUUUCT ALARM JUL 23. 2003 6:27 AM JUIV 6. 2001 2:57 PM JUfJ 1, 2001 12:54 AM ALARM NINTURY REPURT SEfVSOR ALARI`1 L 1:SUPER STP SUN1P FUEL ALARf°I AUG 21. 2U07 9:33 AN1 FUEL ALARf°1 AUG 8, 2006 9:11 Arl FUEL ALARNI AUG 10. 2005 9:43 ANl ALARNI HISTUR`! REPURT _____ SEps;3UR ALARNI - L 2:PLUS SITP SUP1P F UEL ~ ALARrt y: G 2 A!°1 AUG 21, 2GU7 FUEL ALARI{ _ 9 : 1 '~ AM AUG 8, '~OUb FUEL ALARI°1 AUG 10, 2005 9: A3 AI°} ALARI°t >-II51'CiR`! R;vPURT -.---- SkCdSUR ALARNI ----° L '3 : UI'lLEAI?EL> STP F;UI°1P FUEL _ALARP1 AUG -' 1 , 2007 9:32 Af°! FUEL AUG ALARi'1 8,. 2006 y : 1 U AM , FUEL AUG ALARI~M1 10, '4U05 9:4'3 AI°t ALAR'l~l H 15TURY REPURT -- SEN50R ALAkf°t --- L 4:PIPING SUMP PIP 1 Pdu S UIhF' FUEL ALARNI 9 ; •,j5 At~t AUG 21, 2U07 SETUP UA'fA WARNING N1AR 1 1 , 2007 r . 44 AI~1 FUEL ALARI°1 MAR 11, '007 7:39 AM 1VIONI'I`C)12 BERT: FAILURE RESORT SITE NAME (~~1/~•~ll'S Gh~i%'~2~~ DATE• ~~"~ l '~ ADDRESS ~~l P-gy 9~~t- Z-'y TECHNICIAN: ~.Y-¢v `''4''°'`-~ r ~~ THE FOLI.O~VING COMPONENTS WERE REPLACED/REP TESTING. REPAIRS: ~d ~~ ' LABOR: ~~ ~~ ~ . ~, PARTS:INTALfLED: ~Jc~ ~% NAME:. T[TLEr SIGNATURE: 'I'FIE AI3,OVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING TITS APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR TI3E ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICII ENVIRONMENTAL OF ANY FINES OR PENAI:TIES OCCURING FROM NON-COMPLIANCE. A COPY!OF TffiS DOCUMENT HAS BEEN LEFT ON-SITE FOR YOUR CONVIENENC`E. Ut~~[)ERGROUND STORAGI= TANKS A~;f~L1CATION 70 PERFORM ELD /LINE TESTING / S898.9 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT N0. ^ EhIFiANCED LEAK DETECTION^`CINE TE B,AKERSFIELD FIRE DEPT ~I~~ Prevention Services ARTr1I T 900 Trtxxtun Ave., Ste. 2I0 Bakersfield, CA 93301 Tel.: (66I) 326-3979 Fax: {661) 852-2171 Pie 10(1 - ~~----~_. ^ SB-889 SECONDARY CONTAINMENT TESTWG ^ TANK T}GHTNES5 TEST ,~ TO PERFORM FUEL MONITORING CE FACILITY ~, I ^ NAME 8 PH E NUMB R OF CONTACT PERSON ` C !/ OWNERS NAME OPERAI~ORS NAME PERMIT TO OPERATE N0. NUMBER OF TANKS TO BE TESTED IP T N . ~y +! ` O ~ _ a /~ ~c-~ ~ vk~ .~r~-~/ ;',TANK~7ES71NGC,t)MPANY- __ NAME OF TESTlNG~iQPA Y l NAME ~ PHONE NUMBER OF CONTACT PERSON ~ ~~ MAILING ADDRESS ~ ~~ ~ -J~~ ~S ~~ ~ ` ~ ^ ~ `~ O NAME ~ P NE NUMBER OF TESTER OR SPECIAL INSPECTOR d t.Q ' ~~ CERTIFICATION iC: ' DATE 8 TIME ST TO HE CONDUCTED - a -- 0'1 ; o o~ m ICC #: 5 a C~ ~ a_r~ --~T-- .TEST METHOD SIGNATURE OF APPLICANT f/~ ~~ ~ DATE ~ I _ D --~ ~EPl~~L DATE FD 2095 (R©V. 09/05) ~31~.1,~1RlG v~ PERMlT STATEMENT BA.KERSFIELD FIRE DEPT. Prevention Services ' ~lR6 900 Truxtun Avenue, Suite 210 .~nrr r ~I'ERMIT NO.: Bakersfield, CA 93301 LOCATION OF PROJECT PROPERTY 51'ARTWG DATE COMPLETION DATE NAAAE ?ROJEC7 NfJ.1C ADDRESS n ' ll~_-- NE N0. PROJECTMDRESS ~~~' CfTY ,/T , /~{ STATE /'~ /1 ~1- 4` ~~../~-3\ lei b~(~.. ~ ~ ~~ i.J c ~~' " • • • • CONTRACTOR NAME CA LICENSE NO. - TYPE OF 41CENSE EXPIR47fON DATE PHONE NO. n CONTRM:TORCOMPANYNAMF • `~(.~.~I{ FAX NGL C~ `~ -~~~ A~or~ss ~ ~ `~4 ~ ~~~~ ~ ~~ . `` (~ /~ cm `~" C /'C z~' cooE ~ ~~J~ r. ~ :, ~ ^ ~, .a. Alarms -New & Modiftgiions - (Minimum Charge) $262.50 ~ 98 FL Over 20 000 S 013125 =Permit fee FL x S ~ p , q. . q. 98 ^ S rinklers- New 8 Modifications - (Minimum Ghar e) $210 00 ~ p g . 98 ^ Ovor 5,000 Sq. Ft. Sq. Ft x.042 =Permit tee ~ 98 _ T ^ ~ Min6r Sprinkler Modifications (< 10 heads) 00 jlnspection On/yJ S 93 ~ _ . _ 98 ^ Cornmeraal Hoods -New & Modifications $ 398 26 ~ . 98 ^ Additional Hoods a 36 00 ~ . s8 ^ Spray Booths -New & Modificaf'wns $458 00 ~ ~ . 98 ^ Abov rourxi Story e Tanks (lnstallatloNlnsp.-1~ Tme) $165:00 82 ~ Additional Tanks 3 26.00 82 ^ ^ Aboveground Storage Tanks (Remova//lnspaction) $109:00 82 ^ Underground Storage Tanks (tnstellationJlnspeciionj $878.00 {pertank) 82 ^ Underground Storage Tanks (Modification) $878.00 (persite): 62 ^ ^ ~ Underground Storage Tanks (Minor Modification) Underground Storage Tanks {Removap $155.00 $675.00 (per tank) 82 84 ^ Oifwell (Installation) $ .72.00 ~ 84 ~ Mandated teak Detection (Testing) / ueI Moni~ Cert. 81.00 {persite) 82 ^ ~ Tents 93.00 (percent) 84 ~~ ^ After hours inspection .fee x122.00 84 ^ ~ ~ Pyrotechnic - (Per event, Ptus tnsp. Fee ~ $90 per hour) $ 60.00 + (5 hrs. min. stand -by fee /Inspection} = $510.00 84 ^ _ f2F-INSPECTION(S)/FOLLOW-UPINSPECTiON(S) $93.00 {per hour) 84 ^ -- Portable LPG (Propane): NO. OF CAGES? $ 66.tx? 84 - ^ Explosive Storage $249.00. 84 ^ ~ Copying $ File Research (File Research Fee $33.00 per hr) 25¢ per page 84 ^ Miscellaneous ; 84 FD 2021 (Rev. OSU05)