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HomeMy WebLinkAboutUNDERGROUND STORAGE TANK I .~r I i i ~~~ ,! ~,~~ _, ~, .~: ,~ / (UNDERGROUND STORAGE TANKS)TT* FILE # STOCI~ALE MOBIL -- - " 13001 STOCKDALE HWY. ~320049C _ _ _ _ __ -- ~ - ~ L i~ I y ~ "~ ~ ~t: > ~ 3 ,~. y M ~ ~` , 4- ~.. TY, ~ ~ • ~ I '`1 1: ~ - / .. i _ S"::, d ._ ~. .~_. .- - ~ ~~ .. ~ ~ _,. i - -- 1'~•1f)NITO:R~.NG SYSTElvi CERTIFICATION For Use By rill Jurisdictions Within the State of California 1 t;rhui•i .y Cited: Chapter 6.7, Nealrh rand Snfaty Code; Chapter 16, Division 3, 7Ytlt 23, Californtn Code vjRegulrrt ns J17~ :l~9dress:._,~3~t ~~ r~UC.~FtG„~ ~-li,~)~/ ~ Ciry:.~iC~,S~SF'z~L~ zip: ___._..._.... 1~~~lili Cotnact Person: F ~~~,~ C3-4~ L, ~ Contact Phone No.: (______,)~ _.---_ _-_-. 1 hi: tutu, must be used to document testing and servicing of monitoring equipment. seRarate certification or repa't must be ureuzu•r.a i~_r ~_:,ch nonitoring_systzn~ control panel by thz reclutician who performs the work. A copy of this form must be provided to the real. ;',.;t~,n owner/operator. Thz owner/operator must submit a copy of this form to the local agency regulating UST systems within ~Ct ~l:i~~~ i~I test d'at~. _-~. 'Lyra>ieral Ynform~tion tztti[iti N:une: ~~~i"CC~ Bldg. No.:_____.._....__.... ~~.{;;l..e: nludel oflvloniroring System: T{, ~ _,_._ Date of Testing/Servicing: ~/~'~ Yy. Y~t'~°r.,itor}' of Equipment Tested/Certified es to indicil[c bus i l,~cic il~~t:,ru riute - spectlie equipment inspected/sen'ice~ ac ~c o~ r~ a c ~ ~ ;j l~ ill. ill' Ult~ (~ ~~" ~ . ___,_ a; ~~1:~-!':utl.li:utgingProba. Model; f~,~ 'h ~.=~:nnilar Sparc or Vault Sznsor. Model: of m R °{ u~4`h,tin~_ Sump r'Trench Sensor(s). Model: ~~ i. ~1 i.l 5unlp Sznaor(s). Model: n £,E~.~14~ ~~~ 'J P.,~rh;uiical Line 1.zakDztector. Model: ~:1.1~~avni~LinrLeal:Dztecto!•. Nlodzl: i.l i:,:tl, O,,~erisll I High-Live! Sensor. Model: '~ i_J tither tspztity ayuipment q'pe and model in Section E on Page 2). t'., tli, ill: ~ Q 1 _ , ~ i~~„-1':ud:GaugingProbr. ~ tv]odel: MACS ; ~.., : r,;,ul~r Space or Vuulr Sznsor. ' S Modal: ^~[]~ ~, M ~ .y F t~.;n; Junto /Trench ensor(s). odel: t~~5 ,~ ilr~l i[! Jtunp Sensor(s). Modal; ~S~F~,)S~ CZ'L ;i lri Al, ~h:ti;ii;:tl Linz Luck Detector. Model; ti; ,J L• l:c_rn>uic Linz Leak Detector. Niodzt; ~~ it 1,u,6 ti~~rtilli Higlt-Level Sensor, Model: r; ~) t)tl,r {speuifi• c. ui menr ty e and modal in Section T on Page 2). ~ f ll i i t Se o C d l M gEA ~ ;p~tts~r onta nmen ns r(s). o ; e ~ c ~~~ ~ / , i.) L~;;p~nscr Caxainmen[ Floats) and Chains}. 1)i;j~,~llsu.r Conrainlnznr Sensor(s). .~~ Ivlodel: g~t~. ~/ "I J C?i~i~cnser Conrainmant filoat(s) and Chain(s). Tank ID:~' L~_R_~ 4~P~i_~ -'1 _ _._ .. Ell In-Tank Gauging Probe. Modal: >MA ~ __._.._ ®'' ular Space or Vault 5znsvr. 1vIodel: t'-t Ci'S9 Piping Sump /Trench Sensors}. _ Modal: ~~8 _______ .._ &f Fikl Sump Sensor(s), 1vlodal: tJ0 SEt,,?SQR__... ^ Mechanical Line Leak Detector, Model: _ ___ __ , ^ Elecuonic Line Leak Detector. lvlodel: ~ __._... _ ._ .. ^ Tank Overfill 1 High-Level Sensor. Model _ __ _.. ^ Other (specify eaui~m~nt type and model in 5ecrion E on Pc~e~_ t. Tanlr ID: ~~lri~~- ~n-Tank Gauging Probe. V S _ Model: _^ __ _ ,_. l M znsor. ault ~~~~~~r Spacz or : _ _ oda GT Piping Sump r' Trench Sensor(s). _ __ A4odel: _ _ t3~Fil1 Sump Sensors}. „ tv]odel: tJ~~~_5~2 ._ ... ^ Mechanical Linz Leak Detzcror. B9ode1: _ _ _ ^ Elecuonic Linz Leah Decoctor. Model: __'_. . D Tank OverIIU /High-Level Sensor. Model: _ „_. ^ Other s ecify equipment t)~pz and mods! in J'ection E on (aye _ ~. --- C D~is~eraser ID: 7„~ 'a y , ~Lf' "Dispenser Cuntainrnent Sensor(s). Modal: ;~'u~ ~_ ____ _ y[ hear Valve(s). ;~ O Dispenser Containment Float(s) and Chain(s). Dispenser ID: ~- 3 g ~._._.. `-~A ~~tspenser Containment Sensor(s). Model: Bi~A~__". l`~ Shear Valve(s). ^ Dispenser Containment Floattsl and Chainlsl. ,~ ' Ui.paaser Ill: ~ Dispenser tD: _ __ ;4 ~i .J ~:~sl:u,~ur Containment Sensor(s), tvfodzi: O Dispenser Containment Sensor(s). Model: s ' ::J ~rt;::t_ ~- eIi'ctsl. ^ Shear Valvt:(s). ~ J1);;>>, isl r C.antsinmznt Flour(s) and Chain(s). O Disnznszr Containment Float(s) and Chain(s). ^;1 tL; la~iJity contains more tanks or dispensers, copy this fnnn. Include information for every tank and dispenser at the fdcilit}'. ~h. tl.ei't1f1Ct1t10ri -1 certify that the equipment ideatitied in this document was inspected/serviced in accordance with the manut'acu,~~ra-s' ~idrli„es. Attached to this Certification is intormation (e.g. manufacturers' checklists) necessary to verify that this inform>trin,t i< correct and a Plot Plan showing the layout of monitoring eq ipment. For any equi meat capable of generating such reports, t ha~a wlst~ attauhrd a copy of the report; (check rail that r+pply): l~System set-up Alarm history report I ccut„ciau Nuzrtz (print): ~f-~.~f~F~_.__ Signature: ^____ _, _ ._.- ~rni_icationNu.: C13C7~(r.~- ~~-{ ~~ License.No.: C61/D40- _#809850 _ l~;tir,~ i'olnpanyNalne: RICH ENVIRONMENTAL ~ PhoneNo.:~661 ~ 392-8687 5il~' -1~i~ll~zss: t~~- l It fi£t 1`~ V~f-lI(J'r,2~~E.t~f C+A Date ofTestin Servicin ~ Page I of 3 :13: r~i ~laiitoriub system Certification , 'S w~. t~r5uli9 r-f resting/Servicing ~utr~::uc l'ersion lnsrtlled: ,d~•~ L ~~ ~-$"1 Co „ ;Lc~c rlir follotivi n~ checl:lis't: _ `~~ .~ li ^ Nu' Is [llz audible alarm o erational? •~'' --- ~:~ !e~`. ,~ Cl No* _..-__..__, is the visual alarm o erational? ~' _~ d`%.; , ^ No* _ Were all sensors visuall uu ected, fitnctional[ tested, and continued o erational? _ ~~ 1 :; ~ I~ Nat _ _ Were all sensors installed at lowest point pf secondary containment and positioned so that other egt!ipuleni tviil 1 _ not interfere with their ro per o oration? _ _ ~~ u Z c. _ ~ LU u* _ If alarms are relayed to a remote inonitoruig siation, is all COnllllltnlCflriORS equipment (e.g. mo~Jcnl) ~ IrY N/A operational? :~; ~, O ND* For pressurized piping systems, does the turbina automatically shut down if the piping secondary co,lrjinni~,nc ~j l.3 N'A monitoring system detects a leak, fails to opera +:, or is electrically discotulected? if yes: which sensors uiiciai~ positive shut-doavn? (Cheek nll !feat npFlli Sun~p/Trench Sensors; ^ Dispenser, Cpntaiiv~lent Sensors. ;; ~ Did ou confirm ositive shut-down due to leafs Zd sensor failureldisconnection? ~J Yes; O No. __ _ _ _ ii ~.1 ~ ; O Nu* Fur tank systems That utilize the monitoring system as the prunary tai>h overfill warning device (i.r:. nu ~d'N~A (' mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at dlo tank 'i till Dint(s) and o eratin~ pro erly? if so, at what ercent of tank ca aci does the alarm u•i~~~~er? ° ~, ~j ~ `, ~~-~'^ _ No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment re~~lacc~l ~i and list the manufacturer name and model for ail re lacemenr arts in Secripn E, below. _ _ .__. I~ :J `. ~-s" No Was liquid found inside any secondary containment systems designed as dr)~ syste.ms? (Check all rlnu ue?rr'i ~ tl ~, Product; C] Water. If es, describe causes in Section E, below. _ ` ~~ ~s l~ No* Was monitoring s stem set-u reviewed to ensure rp er settings? Attach sett re orts, if a licable I ~~. ~s i~-----~.__ ^ No* Is all monitoring a ui men! p erational er iuallufacnirer's specifications? -~- iu tiecriun )~ belotiv, describe bow and when these deficiencies were or will be corrected. i;. ~~>;illmenrs: page 3 of 3 '~.~ ~'? i, i f~. dn-'f'.ti~k Gauging /SIR ~qui:pme>at: ---- ..... t bg~s 1 Check this box if tank gauging is used only for inventory conn•ul. O Check this box if no tank gauging or SIR equipment is inst.illyd, i'hi~ s~~,ion must br completed if in-tanl; banging equipment is used to perform leak detection monitoring. ~'a~u~~l,~n; rl,e fullnwins~ checklist f p `., ; ~ ^ No* L Has ell input wiring been inspected for proper entry and termination, including testing for ground faults'' .' _ ..._.._.__ i ',_i `, 4~ ^ No* .__~ Were all racrlc gauging probes visually inspected for damage and residue buildup? I j i:i `, ~ ~ L] No* Was accuracy of system product level readings tested? ~i' ~ U 'i c~ I i ^ No* Was accuracy of system water Leval readings tasted? ~~ - ~'~ ---- --- ;I u '~ r~ ^ Nu'" ~-. Were all probes reinstalled properly? ~~ _ i ~:i `;',a ^ No* ---;~ Were all items on the equipment manufacturer's maintenance checklist completed? _ ~~ °~ iu ,tic ~acriun H, below, describe how andw,/hen theca deficiencies were or will be corrected. iv. 1_lYlt' Le;11:.17eteCtUrS (LLD): tC1 Check this box if LLDs are not installed. (',,,;~nlrtt~ rltr 1'ollnwina checittist: ~ff`~ :;1 1 , ~ ^ No* For equipment start-up or atumal equipment certification, was a leak simulated to verify LLD performance" I~~ ~ ^ N.~A (Check all that npply) Simulated lean rare: 0 3 g.p.h.; Cl 0,1 g.p.h ; O 0.2 g.p.h_ ~~ ~ ~ ^ 1'~ ~ CJ No* ii Were all LLDs confirmed operational and accurate within regulatory requirements? ~ ~ 1~ ~ O No* Was the testing apparatus properly calibrated? _ ~ ' ' ~:i ~~ ~, {I O No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? + ~l- _- ----~ O Nip ~ ---...., ,` U Ycs O No* ~ ~ For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak'? 1 ^ N/~ ------ r----- ~ J ` ~; O No* ortion of the monitoring system is disal?I~:~i ; does the turbine automaticall shut off if an For electronic LLDs . , y p y . j ` U N!A or discomiected? ' .~ _- 4 y._ __-, ` ~ i ~; .. 0 Na* _ For eli:etronic LLDs, does the turbine automatically shut aff if any portion of the monitoring system rnalli,nction~ I; ~ ~ ~ - D NiA or fails a test? - i ' u ~ c3 I ^ No* For electronic LLDs, have all accessible wiruig connections been visually inspected? " I - I ^ Nra -- I---- -- l U i zs <J No* Ware all items on the egt,ipmanr manufacturer's maintenance checklist completed? - -_ `~ l„ c1u Secriat H, below, describe how and when these deficiencies were or will be corrected: fit. t~'c;,npnents: n10 c.t.tn • S A2~ T--~,~P~a~ __`..__-.._ .- Page 3 of 3 u~,,, ~ t_ f oSFsl __.__- 1~?'1<i1L1i0rjI1~' J,}'SLe1n Certification US7C iVlonitoring Site Plan tic .-~~j~~, ~s~: _ i~~mC~ 1 5~~..~pP-_t...~.. k~~2`~t3~1-~ s2,5~=~-~~C A ____.___-- - . ~ . i ~. ..................... .......................... 4 ::::::::::::: :::~::::::::::::::~:::~:~ I { ~~~ . ' ~3 .ql.~~. i `. .~ . . ! n ' P'u'b P ti ~ ~ wad 4 ~ X57 pKt)+~ . fem. f •~ Date ntap was drawn: ~( /~~j Instructions If ) ru xla~eady have a diagram that shows all required information, you may inctu.de it, rather than this page. ~~ ir[t . ~un~ 1~lw~i~orin~~ System Certification. On your sire pla~~, show the general layout of flanks and piping. Clearl~~ id=.«.t+l~~ l~~c:niu,is of the following equipment, if installed: monitoring system control panels; sensors monitoring tanl: annol;u• ~pa4es, sumps, dispenser pans, spill containers,. or other secondary containment areas; mechanical or electronic line 14sk l~c;lN~C01'S; ~tnd in-tank liquid level probes (if used £or teak detection}. Tn the space provided, ^ote the date this 5it~ t'Eaii ~~:~. prepared. Page r.f u; ti~~ d~g~ M4N I T QR CE RT . FAI Lt3RE RE PART SITE NIiME : (~ Q ~` (.,.~ DATE : q ~ ~ ~ ~~~ zwnRrss : (3~) 5~s?G~e~ N ~,, y TECxNICIAN:~y.F~~lE,1~J Ob~7" CYTY: ~~titi~~5~~_L~yQ SIGNATURE:UL.-~~ ~~ SZTE CONTACT: THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE THE MONITOR CERTIFICATION TESTING. LIST OF PAEtTS REPLACED/REPAIRED: REPAIRS : lV(~tJ ~, N END TQ ~ ~! sT~c~. t~r..~E ~~rc.~~St~ LA80R: fVp(~~ PARTS INSTALLED:Np~~ r• 6`lSTEI°l `tET11F" REF' ! 9. '?i1Q5 l'~ : 1 U PI°1 aYSTEI"1 UfVITS U.S. SYSTEh'I LAIVC;Uri~_E EIVGLI,~H SYSTEI`1 I}tiTE.%f I l°l~; Fr?RP9r'T MGN DD Y4",'.' HH :I"t!°1 : S:; :~I'1 htOB I L 13001 STGCKDHI_E HW`; BAKERSF I TrLD CA SHIFT T 1 NiF 1 : fj I `.JABI.EE~ SHIFT '1' 119E '~~ E;1 SAFiLED SHIFT T I t°fE .a DISABLED SHIFT T 119E 4 I'~ I SAbLED TANY: PER TS1' INEEUED WRN D I B;AI~LEG TANk: AVIV TST fVEEDED WRN DISABLED LINE RE -FINABLE h1ETH~fD PASS L I IVE TEST LINE PER T;T NEEEiED WRN DISAbLEli LINE ANN TST NEEDED WRN DISABLED PR I IVT Tt_ +,ttiLUi°1£5 ENABLI~D TEMP COI°IF'EPJSHI' I vIV VHLUE (DE~3 F ) : 60.0 STICK HEIGHT OFFSET DISABLED DAYLIGHT .,HV I fuv TIME DISABLED SYSTEM SECJJR f T`i" CGDE : UUUQUU CUSTOhI ALAfiI`1 LABELS DISABLED ' l N=1 HIVK. ~t i ur T 1 :87 SYPHEIV THNk: PRODUCT CODE 1 THERMAL c;OEFF :.000700 TANK DIAMETER 3F,.U0 TANK PROFILE 1 F'T FULL VGL 0 FLOAT SI?E: WATER WARNIIVG HIGH WATER LIP'1IT: h1AX OR LABEL VOL OVERFILL LIhITT . HIGH F'RGDUCT DELIVER`.' L T I'l 1 T . 1 e: a r ht,uu~..n,. ~~.r-.., .~•.... PRODUCT CODE 2 THERP'IAL GOEFF :.000700 TANK DIAMETER 96.00 TANK PROFILE 1 PT FULL VOL 10000 100 0 FLOAT SIZE: 4.0 IN. WATER WARINT NG 2.0 4.0 IN. HIGH WATER LIh1IT: 3.0 i '~•0 MAX OR LABEL VOL: 10000 3.U OVERFILL LIMIT 95P•; ' 9500 I IOOOU; HIGH PRODUCT 90% 95%:: 9000 9500. DELIVERY LIMIT 15%~ 90% 1506 5000. 150; LOW PRODUCT 1000 1500, LEAK ALARM LIMIT: 95 SUDDEN LOSS LIMIT: S9 LOW PRODUCT 1000 LEAK ALHRI°i L I hi I T : 9g' SUDDEN LOSS LIMIT: 99 TAPJK TILT 0.00 PROBE OFFSET 0.00 SIPHON MHNIFOLDED TANKS Ti:: NONE LINE MANIFOLDECi TANKS Ttt: NONE TANK TILT 0.00 PROBE OFFSET 0.00 SIPHON MHIVIFOLDED THINKS Ttt : NONE LINE hWNIFOLDED TAfVKS Tit : NONE LEAK MIN PERIODIC: 0!d 0 LEAK h1I N ANNUAL a"•e o LEAK hl I N PEk I OD I C: 0%0 ul LEAK MIN HNIVUAL Or! 0 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL HLARI°i DISABLED' PERIODIC TEST FA I I. ALARhI DISABLED GROSS TEST FAIL HLARhI DISABLED HNN TEST A\IERAG 1 NG : OFF PER TEST AVERAG I INS : OFF TANK TEST NOTIFY': OFF TNK TST S I PHGN bREA}::OFF!, DELIVERY DELAY 5 MIN PUMP THRESHOLD 10.00% PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARJH DISABLED PERIODIC TEST FAIL ALARM DI:ABLED GRGw TEST FHIL ALARM U I SAbI.ED ANN TEST AVERAGING: OFF PEk TEST AVERAGING: OFF TANK TEST NOTIFY: UFF TNK TST SIPHON BREAK.:'OFF DELIVERY DELAY 5 MIN' PUMP THRESHOLD LO.OU%: 1 u.JJa4..+a.1..~ PRODUCT CODE THERMAL COEFF •.000450 TANK DIAMETER 96.00 TANK PROFILE 1 PT' .F:ULL- .Vt~f ;..,E,,. .:•1-0000 i I FLOAT SIZE: i4.0 IN. WATER WARNING ~ ~ 2.U HIGH WATER LIMIT: ~ 3.0 MAX Ok LABEL VOL~ 10000 OVERFILL LIMIT 95%; 3500 HIGH PRODUCT 90°~a 9000 DELIVERY LIMIT 115%s . ''1500 LOt~I PRODUCT : 1000 LEAK ALARM LIMIT: . 9y SUDDEN LOSS LIMIT: 9y TANK TILT 0.00 PROBE OFFSET 10.00 SIPHON MAPJIFOLDEC? T~NKS Tq: NONE LINE MANIFOLDED TANKS Ttt: NONE i LEAK MIN PERIODIC : I 0'~0 i L~ LEAK MIN HNNUAL : ? 0% I o PERIODIC TEST TYPE I bTA~VUARI? ANNUAL TEST FHIL ~ ALARM DIS~bLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM D 1 S}~BLED ANN TEST AVERAGIPG:' OFF PER TEST AV$RAGING:I OFF r TANK TEST NOTIFY: OFF TNK .TST SIPHON BREA~:OFF DELIVERY DELAY ~ MIrV PUMP THRESHOLA 1 .00% ~roo[-•° ooa.° a oo °~o,•o:.o oinoc~ou~o omm©o ommoo o0 0° ~ ° ~' u u : fz-• N w w w " . .. . ~ z ~ w m .,.. : . ° o . ~ Q , tu~ v t .. .. - • ~ F» .-, ........... .. ~ .... A [~-• U Cwi, i~Jl A ~ A A ~ ~ ... ` ~ O ~ i ~ E. F, ` w, i7 A A o .a H ~. ~ ¢ ta. ~ ~ ~ ~ ~•• ~ acwa.ww z...1 a~ F-. ~ a'~ F. w ^ ~ a ~ H w r. t.d [-.a ¢¢ u' ~ .F-. ~,, q.A~ a.4,aw~.a 0~, -1 w ~cx ~...~ ~ ..~ 1 ~;~ ~ a ~" w z H~ w~ ~ ~ `~• a;:: _ , ll ~0~ ~~ ~ w ¢ p caH~ oa Q a ¢ E-. w E-. ~ ~ ¢~ ~ ;~rao F ...I ~- tk • U1 E . 3 ~ r.. . .~.., o ..i tx OC Q .¢.l .a ~ O ~ ~ ~ Z ~ ~ ~ ~" v w F• ~ -» _ :'• oc ~ m~ ~ ' ~~`?~ = Sri ~`' 3 a¢ `E' o~~o g ~ A A H p ~ u~tG3 ~ F ~t G.F ' ~ 4 w w ~ w w QAx ~ ~ O [I] . F F ~ : : ~~s4 .a., eta x w ~ z'o °G ¢ w a..Z.. ~ ~ ~ w z ~ ~ o za . f Ft~F-F•H u. 3= ~o z A ° -.n ~taE . ar ~ r ° ~ ~ .. . . E .iE -.. -. ..i a a s a .ti c da ~ '~ ci. LEAK TEST P9ETHGD ........ TEST ON DHTE : ALL TANK OUTPUT-BEERY SETUP - _ - JAIV 1. 19 9ti START T I P'IE G I SAItLED R l: 87 STP RELAY TEST RATE :0..='0 UAL~HR TYPE: DURHT I OtV '? HOURS STANDARD TST EHRL`I STGP:DISAHLED NORfHALLY CLOSED LEHk: 'LEST REPORT FORMHT LIWUID SENSOR ALI.1B I•JORMAL L 1:FUEL ALARM LI~dUID SEPJ SOR SETUP L 2:FUEL HLARM _ _ _ _ _ _ .. _ _ _ _ _ L 3 : FUEL ALARM L 4:FUEL HLARM L 1 :87 STP SUI°IF TRI-STATE cSIN~LE FLGHTi R 2:91 STP kELHY CATEUORY STP SUMP TYPE: STANDHRTf tVORMALL4" CLGSED L ' : 87 tiNPJ ULAR TRI-STHTE tSIN~LE FLOAT? CATEC:ORY ANNULAR SPADE LI~dUID SENSOR ALMS L 7:FUEL ALARM L B:FUEL ALARM L 3: d7 STP SUMP R 3:DIESEL STP RELAY TRI-;STATE (SiNi;LE FLUHTi TYPE: CATEGORY STP SUMP ~ STAIVDHRD NORMALLY CLOSED L 4: ti7 ANI•J ULAR TRI-STATE (SIN~~LE FLGATi L I GNU I D SENSOR AU°IS CHTEC+ORY ANiVULAR SPACE L S:FUEL HLARM k 4 : REhiGTE ALARM TYPE: L 5:GIESEL STP SUf°IP R TRI -STHTE t N I IVGLE FLOFIT ) NORMHLLY GPEN CHTEGORY STP SUf°1P LI~dUID SENSOk ALMS L b:DIESEL AIVNULHR HLL:FUEL HLARM TR i -STATE (S I fVi3LE FLOAT i CHTEUGRY AIVNULHR SPACE REC:GNCILIHTIGN SETUP L 7:91 STP SUt°IP AUTOMAT I G GA 11_Y CLOSING TRI-STATE tS[NGLE FLOAT? ~ 'T'IME: ':00 AM CATEGORI' STP SUI~1P ~ - PERIGDIC RECONCILIHTION L 8':91 HNIVULHR MODE : MGNTHL'i TRI -STATE t S I NuLE FLGHT i TEI.1P CGMPEIJSAT I ON CATEi,GR1 ANNULAk SPACE STANDARD HUS SLOT FUEL METER TANK TANK MHP EMPTY SOFTWHRE REVISION LEVEL VERSION 123.01 SOFTWHREit 346123-100-H CREATED - 02.06.QI.13.00 NO SOFTWARE MODULE SYSTEM FEATURES: PERIODIC IfV-TANK TESTS ANNUAL I N-THN}~: TESTS l~ I ,, t,. ALARM HISTOR`! REPORT ---- I rv-TrJPJf: ALHRM - T 1 :87 SYPHEIV THIV}:: O+JERF [ LL Ai.Akhl SEP 7. '2005 3:21 PN1 HUG 11. 2005 9:28 PM JUL 18. '?005 2:18 PM LOW PRUDU~'T :;LHRN1 MAY 10. ::.'004 8:07 Alh AUG 2U. 'wOU:~ 4:39 Pf°1 HIGH PRCJDUI;T HLI=tRNI SEP 7. '2005 3:20 Pt°1 AUG 11. '2005 9:27 PM JUL 18. 2005 '3:1^r PN1 DEL I U'Ek ; I'JEEDED JUL ?8. 2005 12:42 F'I°I MAY 9. 004 9:07 PN1 SEP 17, •2003 301 PM .,ORY REPORT ---- 1 N- TAfJ}; ALARM ---- T 2:87 kE~sULHR UNLEADEL SETUP DHTH WHkIVI NG JAN 9. 2003 12:27 PM OVERFILL ALARM JUL 16, 2005 2:41 PNl JUN ?U. 2005 11:07 A!N MAY 30, 20r)5 i/:05 ANI LOW PRODUCT ALHRM JUL '~8. 2005 12.:41 PN1 MAY 10. 2004 5:25 AM HUG 20. ~OU3 4:57 PNi HIGH PRODUCT ALARM S£F' 7.. 2005 3:24 PM AUG 11. '2005 9:43 PM JUL 18. 2005 2:41 PM DELIVERY NEEDED SEP 17. 2005 6:58 PM SEP 15. 2005 11:59 ANI JUL 28. 2005 7:05 ANI HLARM HISTOR`! REPORT ---- I N-TANK HLr=ARM T 3:L~IES2rL HLAkhI H I STORY kEF~C,~kT ---- I PJ-TANK ALAkN'1 -- T 4:91 SUPER UNLEADED SETUP DATA WARNING JHN 9. 2003 12:27 PM HIGH F'RUDUi;T ALHRM JUN 20. '~'l104 8:17 PNI JAIV 9. 2003 t2:27 PM NWX PRODUCT ALARNI JAN 9. 2003 12:27 PM HLARt°i H I STORY REPORT ----- SENSOR HLAF.M ----- L 1:87 STP SUMP STP SUMP FUEL ALARNI SEP 19. 2005 12:3U PIH FUEL ALHRM AUG 2. 2004 il:al AM FUEL ALARM MAY 28. 2004 7:24 HM ALHRM HISTOR`! kEPORT SENSC1k F;LHRM L 2:87 HNtVULAR ANNULAR SPACE FUEL HLARM SEP 19. 2005 12:48 PI°I FUEL ALARM MAY 2. 2005 8:42 AM FUEL ALARM AUG 2. 2004 11:38 AM HLARM HISTORY REPORT -- SENSUR ALARM ----- L-3:87 STP SUMP STP SUMP FUEL ALARM SEP 19. 2U05 1'x:28 PNi FUEL ALARNI AUG 2. 2004 1,! :'~'9 AM FUEL ALHRM MAY 2B. 20U4 7:24 AM HLARM HISTORY REPORT -- S1;NSOR ALARNI ----- L-4:87 ANNULAR ANNULFiR SPACE FUEL ALHRM SEP 19. 2005 12:45 PM FUEL ALARM AUG 2.2004 12:U9 PM FUEL HLFYRM AUG 2, 2004 11:49 ANi ALARM HISTORY REPORT -- SENSOR ALARN ----- L 5:DIESEL STF SUMP STP SUMP FUEL ALARM SEp 19. 2005 12:29 PM FUEL ALARM AUG 2. 2004 11:42 ANl FUEL ALARNI MAY 28. 2004 7:2e AM ALARNI H I STORY REPORT ----- SENSUR ALARI'1 --•--- L 6:DIESEL ANNULAR ANNULAR SPACE FUEL ALARM SEP 19. 2005 12:34 FM SENSOR OUT tiLARM MAY 2. X005 8:55 AM FUEL ALARM MAY 2. 2005 8:49 AM ALARM HISTORY REPORT SEPJSOR ALARM L 7:9t STP SUINP STP SUMP FUEL ALARM SEP 19. 2005 12:29 PNl FUEL HLARM AUG 2. 2004 11:41 AM FUEL ALARM MAY 28. 2000 7:28 HNI ALARNI HISTOR`! REPORT -- SENSOR ALARM ----- L 8:91 ANNULAR ANNULAR SPACE FUEL ALARNI SEP 19. 2005 1_':36 PM FUEL ALARM AUG 2, 2004 12:16 PM FUEL ALARM AUG 2. 2004 12: ! I AP'i 08'8 loS~s UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION BAKERSFIELD FIRE DEPT. f~~~ Prevention Services ALTS 900 Truxtun Ave:, Ste. 210 Bakers$eld, CA 93301 Tel: (661) 326-3979 . Fax: (661) 852-2171 Page 1 of 1 .- -- S T INF.ORMAT O FACILITY j 1 DDRESS ~~5..>1 ~ } _ .._ ~ONEI~.4TOHS NAME WNERSNAME 'n i O~~ ` ( ~r ~' w~ TANK~f ~ VOLUME U C~00 CONTENTS - ~ ~ ~~ ~ ~V _ _ _ TE8i1NG:~QMPA~IY ,.. ! ', =__~ AME OF TESTI G COMPANY ,~ AILING ADDRESS ~~ ~ ~O ~ ~~ ~. • - ~ O AME ~ FitONff NUMBER OF CONTACT PERSON ,~• ~ ~C~),i~l. . ~ ATE & TIME TEST TO BE CO DUCTED CC ~ IGNATUREO LICANT_ ~C ATE ~ ~~ O THRS APPl.fCAT10Pi BECOOAES A PEROAIT N APPROVED PPROVED BY qTE Foa~os ta...~,~, ,x ;~ . SUZETTES CLEANERS SiteID: 015-021-002264 Manager KAREN ATRIANO Location: 13001 STOCKDALE HWY B City BAKERSFIELD BusPhone: (661) 589-4842 Map 101 CommHaz Moderate Grid: 35D FacUnits: 1 AOV: CommCode: BFD STA 15 EPA Numb: SIC Code:7212 DunnBrad: Emergency Contact / Title Emergency Contact / Title KAREN ATRIANO / OWNER RAFINO ATRIANO / OWNER Business Phone: (661) 589-4842x Business Phone: (661) 589-4842x 24-Hour Phone (661) 246-5060x 24-.Hour Phone (661) 246-5914x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire React ImmHlth DelHlth Contact KAREN ATRIANO Phone: (661) 589-4842x MailAddr: 13001 STOCKDALE HWY B State: CA City BAKERSFIELD Zip 93312 Owner KAREN ATRIANO Phone: (661) 589-4842x Address 13001 STOCKDALE HWY B State: CA City BAKERSFIELD Zip 93312 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ~ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN E3ased on my inquiry of those individuals rsspons:> !e for ohtainin~ the information, I certify under pvr.alty of iav„~ that I have personally oxamined and am familiar with the information submitte and ~ieiinve the information is true, accuratf aid complete. ENrD A u ~ 0 3 200 -1- 07/16/2007 '?- ::, ti~ F SUZETTES CLEANERS = ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-002264 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PERCHLOROETHYLENE F R IH DH L 75.00 GAL Low WASTE PERCHLOROETHYLENE R L 15.00 GAL Low -2- 07/16/2007 a -3- 07/16/2007 ~ !4 ~ ~, 1, F SUZETTES CLEANERS SiteID: 015-021-002264 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PERCHLOROETHYLENE Days On Site 365 Location within this Facility Unit Map: Grid: DRY CLEANING MACH REAR OF STORE CAS# Liquid TMixture~_Ambient~E ~AmbientT~E IN MACHINE/EQUIPPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 75.00 GAL 75.00 GAL 75.00 GAL t1AGE1KLV U~7 1.V1~lYV1VJ;1V7 ~ %Wt. RS CAS# 100.00 Perchloroethylene No 127184 t1HGHKIJ L'~aJL' JJ1~1~1V 1 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Low ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE PERCHLOROETHYLENE Days On Site 365 Location within this Facility Unit Map: Grid: BEH DRY CLEANING MACH CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste ~mbient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average _15.00 GAL 15.00 GAL 15.00 GAL nt~Gli.tCLVUJ L.V1~1rv1v~,1v1S %Wt. RS CAS# 100.00 Perchloroethylene No 127184 riEiGEitCL ta~7~7~A.71~1~1V 1.7 TSecret RS BioHaz _ Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / j / Low -4- 07/16/2007 ~. ~, F SUZETTES CLEANERS SiteID: 015-021-002264 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ rlyvllvy 1VV1.111Ud1.1V11 i~ ~LlL~J1V~/CC 1VV l.1l f LTV dC: l.Ld 1.1 Ull i ~-. t UiJ l.L l: 1VV loll f LiVdl.:Udl..l Vll Emergency Medical Plan -5- 07/16/2007 ~~- ~ F SUZETTES CLEANERS SiteID: 015-021-002264 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention Release Containment l.1 CC111 U~J i_ V ~.11Ct nG.7VU1 ~:C C'11~1.1 VCLL1V11 -6- 07/16/2007 s. , F SUZETTES CLEANERS SiteID: 015-021-002264 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ oNc~.lal nac~aiua Vl.llll.y J11U1.-Vila r 1LC rl_vI.CC:./1-~V d.11. wdl.~Z o U11u111y VI:L U~Jd11C: ~/ LE'VE.'1 c -7- 07/16/2007 F SUZETTES CLEANERS SiteID: 015-021-002264 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training rays ~ Held for Future Use n~iu ivi ru~uiC u5C °s -8- 07/16/2007 ~,;'. ~ F SUZETTES CLEANERS Manager KAREN ATRIANO Location: 13001 STOCKDALE HWY B City BAKERSFIELD CommCode: BFD STA 15 EPA Numb: SiteID: 015-021-002264 BusPhone: (661) 589-4842 Map 101 CommHaz Moderate Grid: 35D FacUnits: 1 AOV: SIC Code:7212 DunnBrad: Emergency Contact / Title Emergency Contact / Title KAREN ATRIANO / OWNER RAFINO ATRIANO / OWNER Business Phone: (661) 589-4842x Business Phone: (661) 589-4842x 24-Hour Phone (661) 246-5060x 24-Hour Phone (661) 246-5914x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire React ImmHlth DelHlth v~Contact :KAREN ATRIANO Phone: (661) 589-4842x MailAddr: 13001 STOCKDALE HWY B State: CA City BAKERSFIELD Zip 93312 Owner KAREN ATRIANO Phone: (661) 589-4842x Address 13001 STOCKDALE HWY B State: CA City BAKERSFIELD Zip 93312 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN Suzette's Cleaners ^p ~ 13001 Stor_~~a.te ~fwy, Ste. B ~,o Bakersfield, C~ 93312 _ _ _ _ , _ _ _ . -.(661) 5$9-4842 _ _.- - ~esed ©n my inquiry of those indivi~o~I~ r~~f~ott~tibla for obtaini ng the infc~rmi~tion, I t;ortify un~tor (a~anelty pf I~w that i have ~or~an e ll ~ y xamine{ and am ft~miliar with th~r ir~forfflt~tion submitted sn haligvp the Information is true accurate a , , omplete. ENT'D ~E~ ~ ~ ._' -- ~ ~- -.--- - d L'~ ... Si 20 ~, _ _ gna Date ~- ;. -1- 02/16/2007 ~`v UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTiFiCATION /-/R/ ARTr r '- BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 PERMIT NO. ~~~ ^ ENHANCED LEAK DETECTION ^ ^ SB-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST TO PERFORM FUEL MONITORING CERTIFICAT FACILITY ` O ~ ~`~C'~'l.b ~ NAME 8 PHONE NUMBER OF GONTACT PERSON ~J 01 - ~ ADDRESS -- -- - -- •- ---- -- --- - - -- ~ ---- 13ov ~ 5-~ -- ------ ~.~ Id ~- OWNERS NAME OPERATORS NAME PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO T # VOLUME CONTENTS . ~d G n o (~IL--$ ~ ~Q~- a ~ o ~ ~ L-~ ~s .}' ~ Ada o '~ V o C~ _~ -TANK.TESTING COMPANY ` NAME OFT STING OMPANY t~ NAME 8 PHONE NUMBER OF CONTACT PERSON MAILING ADDRESS S J ~~ ~~~ NAME 8 PHONE NUMBER OF TESTER OR SPECIAL INSPECTOR d CERTIFICATION #: DATE 8 TIME TEST TO BE C UCTED _ / D ~ ~ ^, ^,~ V ICC #: ~ ~ ~~ v TEST METHOD SIGNATURE OF APPLIC T f C i^ ~ (-,~-_ DATE _ APPROVED BY DATE FD 2095 (Rev. 09/05) ~~ - BIL-LING & PERMIT STATEMENT PERMIT NO.: _~ BAKERSFIELD FIRE DEPT. Prevention Services PtR! 900 Truxtun Avenue, Suite 210 ~Rrr r Bakersfield, CA 93301 LOCATION OF PROJECT , ^ ,~ ~~ Y Y) C I II ~ U ~ J'~~'~'"( • - ~ • PROPERTY OWNER n ~- STARTING DATE COMPLETION DATE NAME ' PROJECT NAME - ^ A (~ ~ A~DREOSSQ ~ ~ ~ ` PHONE N~Q ~ _ ~ ! - PROJECT ADDRESS 'J ~ O I ~~ / /'i V v 'may c%,~'-• CITY ~ STATE ~ ~ ZIP CODE •CONTRACTOR NAM a CA LICENSE NO. • - • - • TYPE OF LICENSE. EXPIRATION DATE PHONE NO. ` ~~ CONTRACTOR COMPANY U t r FAX NO.~~~ ~~ / ...Q ADDRESS CffY ~j~ I [vim ~ ZIP CODE p ~ 6 J ~ ~ ~ ^ Alarms -New & Modifications - (Minimum Charge) $262 50 • ~ • _ . 98 7 F>* Over 20 000 Sq Ft x 013125 =Permit fee Sq ~ l , . . . 98 ^ Sprinklers -New & Modifications - (Minimum Charge) $210 00 ~ . 98 ^ 000 Sq. Ft Over 5 Sq. Ft x 042 = Permif 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 00 $458 ~ . 98 ^ Aboveground Storage Tanks (lnstallation/Insp: 1~ Time) $165.00 82 ^ Additional Tanks $ 26.00 82 ^ Aboveground Storage Tanks (Removal/Inspection) $109.00 82 ^ Underground Storage Tanks (/nstatlation.llnspection) $878.00 (per tank) 82 ^ Underground Storage Tanks (Modfication) $878.00 (persite) 82 ^ Underground Storage Tanks (Minor Modification) $155.00 82 ^ Underground Storage Tanks (RemovaQ $675.00 (per tank) 84 ^ Oilwell (Installation) $ 72.00 ~ 84 Mandated Leak Detection (resti /Fuel Monit. Ce . $ 81.00 (persi 82 ^ Tents $ 93.00 (per tent) 84 ^ After hours inspection fee $122.00 84 ^ Pyrotechnic - (Per event, Plus Insp. Fee @ $90 per hour) $ 60.00 + (5 hrs. min. stand ~y tee /inspection) _ $510.00 84 ^ RE-INSPECTION(S) /FOLLOW-UP INSPECTION(S) $ 93.00 (per hour) 84 ^ Portable LPG (Propane): NO.OF CAGES? $66.00 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. 09105) 1 -ORIGINAL WHITE (to Treasury) 1-YELLOW (to Flle) 1-PINK (to Customer) 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 document testing and servicing of motutoring equipment. A seQarate 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 form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name; 1'''1(~b~ 1 t- Bldg. No.: Site Address: /.~UQ/ ITGCK.I~'4~-~ /~~t/ City; (J'~¢~2,s ~i,+~C,o~ Zip: ~~ Facility Contact Person: ~^G~~[7 Contact Phone No.: L~~ Make/Model of Monitoring System: 1 L S `,S' S`O Date of Testing/Servicing: ~ l ~ LI O,(~ B. Inventory of Equipment Tested/Certified Check the annrnnriate hoses to indicate. snecific eauinment insneC[ed/serviced: Tank tD: ~~ ~'7 Tank ID: ~ 1C. ~'~ 1'~ In-Tank Gauging Protx. Model: ~ In-Tank Gauging Probe. Model: /1 y ~ Annular Space or Vault Sensor, Model: C1 ~ Aruwlaz Sparc or Vault Sensor. Model: ~G Piping Sump /Trench Sensor(s}, Model:.~~ ~ ,~, Piping Sump /Trench Sensor(s). Model: ~7 ~' ~ Fil! Sump Sensor(s). Model: ~tJU S2~J _ ~_ ,I~ Fill Sump Sensor(s). Model: ~~ SIE Mechanical Line Leak Detector. Model: ~ ~ ,® Mechanical Line Leak Detector. Model: ^ 131ectronic 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 ment a and model in Section E on Pa e 2 . ^ Other s eel a ui men! a and model in Section E on Pa e 2 . Tank ID: P/Lr,Ei~") g~ Tank ID: ~ S.E[, f>iI In=Tank Gauging Probe. Model: ~ Annular Space or Vault Sensor. Model: d In-Tank Gauging Probe. Model: / Annular Space or Vault Sensor. Model: O ~ Piping Sump /Trench Sensor(s), Model: Piping Sump /Trench Sensor(s). Model: J~ Fill Sump Sensor(s). Model: 1~v1.S6 l~ Fill Sump Sensor(s). Model: ~' G l~ Mechanical Lino Leafs Detector. Model: Er1 .~ Mechanical Line Leak Detector. Model: J O Electronic Line Leak Detector Model: ^ Electronic Line Leak Detector. Model: ^ Tank Overfill /High-Level Sensor. Model: ^ Tank OverFll /High-Level Sensor. Model: ^ Other (specify equipment type and model in Section E on Page 2). ^ Other (specify uipment.type and mode! in Section E vn Page 2). Dispenser ID: / ~ of Dispenser [D: -~'"`~ ~[ Dispenser Containment Sensor(s). Model: ~-/Ul j~T Dispenser Containment Sensor(s). Model: ~I(,(~2 l~ Shear Valve{s). ~ Shear Valve(s). (] Dis nser Containment Floa s and Chains . ^Dis enser Containment Float s and Chains . Dispenser [D: ~~~ Dispenser ID: 7 Dispenser Containment Sensor(s). Model:. ~j~ ~ Dispenser Containment Sensor(s). Model: ' ~ Shear Valve(s). ~ Shear Valve(s). ^ Dispenser Containment Float(s) and Chain(s). ^Dis enser Containment Floats and Chains . Dispenser ID: Dispenser 1D: ^ Dispenser Containment Sensor(s). Model: ^ Dispenser Contairtrnent Sensor(s). Model: ^ Sheaz Valve(s). O 5heaz Valve(s). ^Dis enser Containment Float s) and Chain(s). O Dis enser Containment Floats and Chains . *Ii'tho facility Contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C.-.CertlfiCatlOri - I certify that the equipment identified in this 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 information is correct and a Piot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, l Gave also attached a copy of the report; (check all that apply): .System set-up ~ rm history re ort Technician Name (print): ~ ~.~ ~ I^'1~5O~J Signature: Certification No.: /f~ ~,~(p 7 / ~ /~~~ ~J`jT" License. No.: ~~Q~~ ,~y~~ ~D~~Q Testing Company Name: RICH ENVIRONMENTAL Phone No.: { 6(1 } 39~-86{~ Site Address:1r~~1 {~~U(,~/~,dL,~- /~y/y ~i¢,~,cl,(ySjt'j~L~ l-~ Date of Testing/Scrvicing: `1 /r~ / /_O~. ~~~/a Page I of 3 03101 Monitoring System Certification - - -- - ~ - - ~~--I~.oL) D. Results of Testing/Servicing Software Version Installed: f`n.....lota tha fnlln.Lina rhor4lict• Yes ^ o Is the audible alazrn o erational? Yes ^ o Is the visual alarm o erational? Yes ^ o Were ail sensors visuall ins ected, functionall 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 operation? ^ Yes 0 o If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) N/A operational? Yes ^ 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 o rate, 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 ositive shut-down due to Leaks and sensor failure/disconnection? J~'Yes; ^ No. ^ Yes ^ o For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no ~3( N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill rot(s) and operati ro rl ? If so, at what rcent of tank ca aci does the alarm tri get? ^ es No . Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and ]ist 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 O o Is all monitoring equipment operational per manufacturer's specifications? ~` la Section li below, describe how and wben these deficiencies were or will be corrected. E. Comments: Page 2 of 3 03101 1~ ~~~~ 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. Complete the foilowine checklist: ^ .Yes ^ o Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ^ Yes ^ o Were all 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? O Yes O ° Were all probes reinstalled properly? O Yes ^ 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 will be corrected. G. Line Leak Detectors (LLD}: Com lete the followin checklist: O Check this box if LLDs are not installed. J~ Yes ^ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? O N/A (Check all that apply) Simulated leak rate: ~, 3 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 o For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^ N/A ^ Yes ^ 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? O Yes O o For electronic LLDs, does the turbine automatically shut off'if any portion of the monitoring system malfunctions N/A or fails a test? D Yes O o For electronic LLDs, have all accessible wiring connections been visually inspected? N/A Yes ^ o Were all items on the equipment manufacture-'s maintenance checklist completed? to the section ti, below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 63101 Gy Monitoring System Certification UST Monitoring Site Plan Site Address; I. ?d01 ~~ C ~Dif2.~ /~ Y f~~'Xl` ~ iZS~ ~ « 5 -------------------------------------- -------------------------------------- ------------ ------------ -- -- ------------------------------------- ------------------------------------- -------------------------------------- ------------- ------------- ------------ -- -- -- -------------------------------------- ------------ -- -------------------------------------- -------------------------------------- ---- _---- a- --~,------- - ----------- 1o s ~ ~ -----~,~~-~L d-- ------ ------~-- ------- - ---Q~------ -- -------~-- ------------ ------------ -~------- -------~7 -- --------~~- -- -- -~ ~v -~ ----=i~~L.~7 ~--~ ------- ~- ---------- - ~ --=--=-- :~ - - - - - - - - - - - - - ~-~ L ~` ~- - - - ~ - - - - - - - - - - - - - - - - - - - - - - Date map was drawn: ~/~i~ Instructions If you already have a diagram that shows all required information, you may include it, rather than this page, with your Monitoring System Certifcation. On your site plan, show the general layout of tanks and piping. CIearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes {if used for leak detection}. In the space provided, note the date this Site Plan was prepared. Page ~of~ os~oo i~(a~ 5 6 3 BRaQ~CS G'~' k'~A,K~RSF:~~LD, CA . 93 3 0 B QF&`TCE (&6Z) 392-&687 & ~'AX (6fi2) 392-0621 2RECxt__.?~T.~AL LS.~~ 'DEm DR TE4 , W/0#II Fac:i,la,fi.y tame; ~fl~/L- z~ac:l.~.~.~y~ Acidare~s:) ~J ~71~y~,~ Icy t3i2s~i~e-D, C~ T Pr4c;lueC ,T.,2Ile Type {Pressure, Suctiomt Cdz~avfty?_ ~~~'SSUI~ QR(:tDUC~' LEAK DETECTOk2 TYk~E ~ xEBT TRxP PA98' s~~~.z. z~t~aa~:zz fi$LOW P,SZ QR 97ERI,A.L # ~~n ~-~ ~ /~ ,L_,~~> _ ~ L/A 2'itPEl"1 ~G '9'~ ~ AS9 _ S~~2I,A,L #~ J ~ ...~, tQ0 /~ FAIL ~~~ v't p1 ~ _ _ _ x./D TYPS,.~"} ` S ASS . S.RRx,AL #.~~~~_._..1 kto 1~ F L 1~5~~ . _ ... L,/T] TYPE X&S 8A8S S~E22A~ #..~_~. ~r1'O FAIL' z :;ertify tb.e above teats were conducCed on this dat:~ accozding t.o Red ~:rackat Pumas Field text appaxatus t:sst:S.ng procedure an limitations. Tli~_; Mechana.c~1. Leak DetecC.or. 'Cast. pass / tail is determined by using a lcr~r flow threshold trip rate of 3 gallon pax hour or leas at 10 PSI. I s~ckn,owledge. tklat aJ.1 da,r_a n_alleated 3.FJ true az]d oorrecc to the .best n£ rryr kzaowzedge. s igi~..~tuxe : Rata : / ~~'~_, ~,>. i f SWRCB, January 2046 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 (if applicable), should be provided to the facility.owner/operator for submittal to the local regulatory agency. ~ e l~Tf .i'f`V 71VTC1RMATi[1N Facility Name: vl~j L -- - - --- --- - Date oi`Testing': 9- ~ 1-4 Facility Address: p/ S~(jG K ~' / `~ rll~C~ C'~ 1 Facility Contact: Phone: Date Local Agency Was Notified of Testing Name of Local Agency Inspector (ijpresent during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: I L vl/! t7..G~tM. U 4` .Technician Conducting Test: ~ C1 Credentials : CSLB Contractor Service Tech. SWRCB Tank Tester Other (Specify) License Number(s): ~ 3. SPrr ,I .BUCKET TESTING INFORMATION Test Method Used: drostatic Vacuum Other Test Equipment Used: Equipment Resolution: Identify Spill Bucket (By Tank Number, Stored Product, etc. 1 7 ~ 2 U~.JL ~ S P ~ 3 ~ J 4 !~ B k t ll ti T t I Direct B Duect Bury Direct B I3irect Bury uc e on ype: ns a a Contained in Sum ntained in S on in Sum ontaine to um Bucket Diameter: ~ ~' ( ~ Bucket Depth: f ~'' J '' f J ~ " Wait time between applying vacuum/water and start of test: ~O ~ S ~ 3 o -~ t '~ ~~ /- t ~ ~ Q w, t Test Start Time (Td: 1 ~, "JC.J wt ' ~~~ ,,~.~ J ,,,..~ ~ ~ ~a Initial Reading CRJ: . '.' j) " ~ J ,. ~ J „ Test End Time (TF): J: Q ,.,,~ ~•~~ +,,~ /.' - ,'~~ r.- Final Reading (RF): J I" ,t ~~ , Test Duration (TF - Td: a, ,,~/ ~ ,~ ,,,t t ,~ Change in Reading (RF -R~: (' .. ~ 't Pass/Fail Threshold or a ~ ~ti ~ ~ ~ Criteria: COIILIrientS - (include information on repairs made prior to tesh'ng, and recommended fo ow-up for failed ~ •~ tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING Y hereby certify that all the information contained in this report is true, accurate; and in full compliance with legal requirements: ,--. Technician's Signature: State laws and regulations do maybe more stringent. D$te: g- ~ ~ - o testing to be performed by a qualified contractor. However, local requirements _-- _ 1~a©~._ iOFTWARE REVISION LEVEL VERSION 123.01 iOFTWAREtt 346123-100-B TREATED - 02,06,21.13.00 JO SOFTWARE MODULE iYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS SYSTEM SETUP >EP 21, 2006 -1:09 PM- - iYSTEhI UNITS u.S. SYSTEM LANGUAC,E ENGLISH SYSTEM DATEiTIME FURIhAT 10N DD YYYY HH:I~Ih1:SS xM 10HIL 3001 STOCKDALE H6JY IAKERSFIELD CA SHIFT TIME 1 DISABLED SHIFT TIh1E 2 DISABLEI} iHIFT TIME 3 DISABLED SHIFT TIME 4 DISABLED 'ANK PER TST NEEDED WRN ~ISAHLED 'ANK AVIV TST I~IEEDED WRN DISABLED .I NE RE-ENHBLE METHOD 'ASS LINE TEST .I NE PER TST NEEDED WRIJ DISABLED .I NE ANN TST NEEDED WRN DISABLED ~RINT TC VOLUMES :NABLE,p 'EMP COMPENSATION 'ALUE (DEG F ~: 60.0 TICK HEIGHT OFFSET . DISABLED ~AYL I GHT SHV I NG T I IWE ~1SABLED YSTEM SECURITY ODE : 000000 USTOM ALARlN LABELS I SAt~LED IN-TANK SETUP T 1:87 SYPHEN TANK T 2:87 REGULAR UNLEAUED2 PRODUCT CODE THERh1AL COEFF :. 1 ; 000700 PRODUCT CODE 0007D0 THERMAL COEFF 96 00 TANK DIAI~M1ETER 96.U0 TANK DIAMETER PROFILE . J PT TANK PROFILE 1 PT TANK FULL VOL : 10000 FULL VOL ~ IODOU FLOAT SIZE: 4 .0 IN. FLOAT SIZE: 4. 0 IN. WATER WARfy I NG : 2 .0 WATER WARN 1 t~G : H WATER LIMIT: 2 ' 0 3.0 NIGH WATER LIN1iT: 3.U HIG MAX OR LABEL VOLT 10000 MAX OR LABEL VUL: 10000 95° OVERFILL LIMIT 95i OVERFILL LIMIT 9500 HIGH PRODUCT 9500 90i HIGH PRODUCT 9Di 9000 DELIVERY LIMIT 905 I DELIVERY LIMIT 15~ ]500. . 1500. LOW PRODUC"C'••" -..'.'.K.,.1~"iOD.. LOW PRODUCT LIMIT: 1000 99 LEAK ALARM LIMIT: SUDDEN LOSS LIMIT: 99 99 LEAK ALARM SUDDEN LOSS LIh1IT: 99 00 0 TANK TILT PROBE OFFSET 0.00 0.00 TANK TILT PROBE OFFSET ' 0.00 SIPHON MANiFOLUED TANKS SIPHON MANIFOLDED TANKS T#: NONE T#: NONE LINE MANIFOLDED TANKS LINE MANIFOLDED TANKS T# : NONE T# : NONE LEAK MIN PERIODIC: Oi LEAK MIN PERIODIC: 0°~D° 0 LEAK MIN HNNUAL Oi LEAK M1N ANNUAL 0~ 0 0 PERIODIC TEST TYPE PERIODIC TEST T,~~STANDHRD STANDARD ANNUAL TEST FA 1 I. ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AIIERAG I NG : OFF PER TEST AVERAG I IVG : OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:UFF DELIVERY DELAY 5 MIN PUMP THRESHOLD : IO.OOi ANNUAL TESALARMLUISABLED PERIODIC T~LARMADISABLED GROSS TESTALARM DISABLED PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK. TST SIPHON BREAK:OFF DELIVERY DELAY 5 MIN PUMP THRESHOLD : 10.00% 1 ~-f ~O ~ T 3:DiESEL PRODUCT CODE 3 THERMAL COEFF :.000450 TANK DIAMETER 96.00 TANK PROFILE 1 PT FULL VOL 10000 FLOAT SIZE: 4,0 JN, WATER WARNING 2.p HIGH WATER L]1~1IT: 3.0 MAX OR LABEL VOL: 10000 OVERFILL LIA4Y'F"°'':`° _-_. 951 HIGH PRODUCT 990 9000 DELIVERY LIMIT 15% • 1500 LOW PRODUCT 1000 LEAK ALARPI L I M! T : 99 SUDDEN LOSS LIMIT: 99 TANK TILT 0.00 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS T#: NONE LINE MANIFOLDED TANKS T#: NONE LEAK M[N PERIODIC: 0% • 0 LEAK M1N ANNUAL 0% • 0 PERIODIC .TEST TYPE STANDARD ANNUAL TEST FAIL ALARIM DISABLED PERIODIC TEST FAIL HLARhI DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAG I (VG : OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY 5 MIN PUhIP THRESHOLD 10.001 T 4:91 SUPER UIJL.EADED PRODUCT CODE 4 THERMAL COEFF :.000700 TANK DIAMETER 96.00 TANK PROFILE 1 PT FULL VOL !0000 FLOAT SIZE: 4.0 IN. WATER WARNING 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 10000 ~ OVERFILL LIMIT 951 9500 HIGH PRODUCT 90% . 9000 DELIVERY LIMIT 15% . 1500 LOW PRODUCT 1000 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT 0.00 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS T#: NONE LINE MAIVIFOLUEU TANKS T#: NONE LEAK MIN PERIODIC: 0% 0 LEAK h1IN ANNUAL Oi 0 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FHIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY 5 MIN PUMP THRESHOLD 10.00% LEAK TEST METHOD TEST ON DATE ALL TANK JAN 1. 1996 START TIME DISABLED TEST RATE :0,20 GHL:~HR DURATION 2 HOURS TST EARLY STOP:DISABLED LEAK TEST REPORT FORMAT iVORMAL LI9U1D SEP4SOR SETUP L 1:87 STP SUMP TRl-STATE (SINGLE FLOAT} CATEGORY STP SUMP L 2:87 ANNULAR TRI-STATE +:SINGLE FLOAT> CATEGORY ANNULAR SPACE L 3:67 STP SUMF TRI-STATE (SINGLE FLOAT) CATEGORY : STP SUh1P L 4:87 ANNULAR TR1-STATE (SINGLE FLOAT) CATEGORY ANNULAR SPACE L S:DIESEL STP SUMP TRI-STATE (SINGLE FLOAT) CATEGORY STP SUMP L 6:DIESEL ANNULAR TRI-STATE (SINGLE FLOAT) CATEGORY ANNULAR SPACE L 7:91 STP SUMP TRI-STATE (SINGLE FLOAT} CATEGORY STP SU1HP L B:91 ANNULAR TRI-STATE .(SINGLE FLOAT) CATEGORY ANNULAR SPACE OUTPUT RELAY SETUP R 1:87 STP RELAY TYPE: STANDARD NORMALLY CLOSED L I QU I D SEfJSOR ALr1S L 1 :FUEL ALARIh L 2:FUEL HLARM L 3:FUEL HLARM L 4:FUEL ALARM R 2:91 STP RELAY TYPE: STAt+1DARD NORMALLY CLOSED LIQUID SENSOR ALMS L 7:FUEL ALARM L B:FUEL ALARM R 3:DIESEL STP kELAY TYPE= STANDARD IORMALLY CLOSED L I QU 1 D SEf1SOR ALMS L 5:FUEL HLARM R 4:REr10TE ALARM TYPE: STANDARD NORMALLY OPEN LIQUID SENSOR ALMS ALL:FUEL ALARM RECONCILIATION SETUP AUTOMATIC DAILY CLOSING T I r1E : 2: 0 0 Art PERIODIC RECONCILIATION MODE : I~IUNT HL'l TEMP GOMPEfJSAT101V STANDARD 'BUS SLOT FUEL METER THIVK TANK MAP EMPTY ALARM HISTORY REPORT ---- SYSTEhI ALARM ----_ PAPER OUT SEP 7, 2006 B:16 AM PRINTER ERROR SEP 7, 2006 8:16 Al°I BATTERY IS OFF JAIV 1 , l 996 B : UO AM * ~ ~ * ~ END ~ ~ ~ ~ ~ ALARM HISTORY REPORT ---- IN-TANK ALARM - T 1 :87 SYPHEIV TANK OVERFILL ALARM JUL 14. 2006 6:20 prl APR 13. 2006 1:25 AM JAN 1 1 , 2006 1 1:50 Al~I LOW PRODUCT ALARM MAY 10. 2004 8:G7 AN! AUG 2p. 2003 4:39 PM HIGH PRODUCT ALARNI AUG 28, 2006 12:31 PM JUL 21. 2006 5:56 PM JUL 17, 2006 6:38 PM DELIVERY NEEDED JUL 28, 2005 12:42 PM MAY 9, 2004 9:07 PM SEP 17, 2003 3:01 PM * * * ~ ~ END x x x * ;~ Ua c cl ----___ ALARM HISTORY REPORT ---- I N-THfJK. ALARIh ---- T 2:87 REGl1LHR UNLEADED SETUP DATA WARNING JAN 9, 2003 12:27 PI°1 OVERFILL ALHRM JUL 13, 2006 3:44 PM JUL 18, 2005 2:41 PM JUN 20, 2005 11 :07 AI°1 LOW PRODUCT ALARM JUL 28, 2005 12:41 PI•M1 IhAY 10, 2004 8:25 Ahl AUG 20. 2003 4:57 PM HIGH PRODUCT ALARM JUL 14. 2006 6:32 PM JUL 13, 2006 3:42 PM JUL 5, 2006 5:48 AM DELIVERY NEEDED SEP 20. 2006 7:03 F'M SEP t8. 2006 2:26 PNI DEC 7, 2005 4:13 PI.1 ALARM H]STORY REPORT ---- IN-TANK ALARM ----- T 3:DIESEL DELIVERY NEEDED AUG 17, 2006 1:13 Pr1 AUG 8, 2006 5:12 AP1 FEH 18, 2006 6:39 AI~1 * * * * * END x x ~ ~ x i z~ ALARM HISTORY REPORT ---- IN-THNK ALARhI -- T 4:91 SUPER UNLEADED SETUP DATA WARNING JAN 9. 2003 12:27 PM LOW PRODUCT ALARM SEP 12. 2006 1:10 PM SEP 1. 2006 6:31 AM AUG 24. 2006 4:3t AM HIGH PRODUCT ALARM JUN 20. 2004 8:17 PM JAN 9. 2003 12:27 PM I IVUAL I D FUEL LEVEL AUG 24. 2006 1:11 PM DELIUEk`f NEEDED SEP 18. 2006 1:27 Phl SEP 15. 2006 4:36 PM SEP 11. 2006 4:41 PM MAX PRODUCT ALARM JAN 9. 2003 12:27 Pht * ~ * * ~ END x * ~t ~ :+~ ALARM HISTORY REPORT ----- SENSOR ALARM ------ L 1 :87 STP SUPIp STP SUMP FUEIr_ ALARM' SEP 21. 2006 12:11 PM FUEL ALARM SEP 19. 2005 t2:30 ph1 FUEL ALARP7 AUG 2. 2004 (1:41 AM ALARM HISTORY REPORT ALARM HISTORY REPORT ---- - SENSOR ALAR1°t ----- ---- - SENSOR ALARM ------ L 2: 87 ANNULAR L 4: 87 ANNULAR ANNU LAR SPACE ANNU LAR SPACE FUEL ALARM FUEL ALARM SEP 21. 2006 12:17 Phl SEP 21. 2006 12:21 PM FUEL ALARM FUEL ALARM SEP 19. 2005 12:48 PM SEP 19. 2005 12:45 PM FUEL ALARM FUEL ALARM h1AY 2. 2005 8:42 AM AUG 2. 2004 12:09 P1~1 * ~ ~ ~ ~ ENU ~ * ~ ~ x x ~ * ~ ~ END ALARM HISTORY REPORT ALARM HISTORY REPORT -- SENSOR ALARM ----- ----- SENSOR ALARI°1 ----- L 3:87 STP SUMP L 5:DIESEL STP SUMP STP SUMP STP SUMP FUEL ALARM FUEL ALARM SEP 21. 2006 12:11 PM SEP 21. 2006 1.2:12 PM FUEL ALARM FUEL ALARM SEP 19. 2005 12:26 PM SEP 19, 2D05 12:29 Phl FUEL ALARM FUEL ALARM AUG 2. 2004 11:29 At°I AUG 2, 2004 11:42 AM * x * ~ x END ri ~i x x ~ ~ ENU ~ * ~ x ~ END x x ~ ~ x l~~~y ALARhI HISTORY REPORT ---- 5ENSOR ALAkf°1 ----- L 6:DIESEL ANNULAR ANNULAR SPACE FUEL ALARM SEP 21. 2006 12:24 PM FUEL ALAkhI SEP 19. 2005 12:34 Phl SENSOR OUT ALARM MAY 2. 2005 8:55 AM x 3E ~ ~ * END * ~ is ~E x ALARM HISTORY REPORT ----- SENSOR ALARM ----- L ? : 91 STP SUNIP STP SUMP FUEL ALARM SEP 21. 2006 12:10 Pht FUEL ALARM SEP 19. 2005 12:29 Phl FUEL ALARNI AUG 2. 2004 11:41 AM ALARM H[STURY kEPOkT ____- SENSOR ALARM ---`- ANNULARASPHCER FUEL ALARM • SEP 21. 2006 12:27 PM FUEL ALARP1 SEP !9. 2005 12:36 PM FUEL ALARM AUG 2. 200A 12:16 Pf°1 ****~END;R~~~~ x * * ~ ~ E1VD * * * x x ~i t. i _ __ _.__ ----- SENSOR ALARM ----- L 2:87 ANPJULAR ANNULAR SPACE FUEL ALARM SEP 21. 2006 1'2:17 PM ----- SENSUR ALARM ----- L 4:87 ANNULAR ANNULAR SPACE FUEL ALARM SEP 21. 2006 12:21 Phl SENSOR ALARNI L 6:4IESEL ANNULAR ANNULAR SPACE FUEL ALARM SEP 21. 2006 12:24 PNI ----- SENSUR ALARM ----- L 8:91 ANNULAR ANNULAR SPACE FUEL ALARM SEP 21 . 2006 ! 2:27 P1°i - - - - - ~ ~c~ ~ C~, SENSUR HLARM L 7:91 STP SUMF STP SUMP FUEL ALARM SEP 21. 2006 12:10 Phl ----- SENSOR ALARNI ----- L 3:87 STP SUMP STP SUMP FUEL ALARM SEP 21. 2006 12:11 Phl SENSOR ALARNI L 1 :87 STP SU1°IP STP suMP FUEL ALARM SEP 21. 2006 12:11 PM SEIUSOR ALARNI L 5:DIESEL STP SUMP STP SUMP FUEL HLAF.M SEP 21. 2006 12:12 PM I~j~o MONITOR CERT. FAILURE REPORT ______ I L- - DATE: " ~' ~ PA RT S INT LED: A I /, / ~~ k _ NAME: TI'T'LE: SIGNATURE: THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTII~'YIN THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO RE THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMENTAL ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL ANY FINES OR PENALTIES OCCURING FROM NON-COMPLIANCE. A COPY OF TffiS DOCUMENT HAS BEEN LEFT ON-SITE FOR YOUR CONVIENENCE. OR F CITY: ~ 1 ~~- SIGNATURE: THE FOLLOWING COMPONENTS WERE REPLACED/REP D OMPL TE TESTING. 08/31/2005 14;16 6613920621 UNDERGR4tlND $?ORAGI~ TANKS . .:w.e ~: ln.nu... •..n. .....~`~.h9iN7 l~n'-c.ua~ •i APPLfCATf~N TO PERFORM FUEL MONftQRINCi . CEATIPICATI~N ' ' PAGE 01101 srs~~tfi~t~ PEE DEPT. ~~ ~1'~YCx1~~II $~I~C~ ,!~!' sOU TY~uxtun A.v~e., ste. 21a Bakersfield, CA.93301 'Tel: {66'1) 326-3979 Fax: (661) 852-217]. page 1 of S rvc ~vo (xw.mw. y~•. F/RE ARTM December 1, 2005 RONALD J. FRAZE Stockdale Mobil FIRE CHIEF 13001 Stockdale Hwy. Bakersfield, CA 93312 Gary Hutton, ~ FINAL REMINDER NOTICE Senior Deputy Chief Administration ~ RE: Necessary Secondary Containment Testing Requirements by 326-3650 ~ December 31, 2005 of Underground Storage Tank (s) Located at Deputy Chief Dean Clason ~ the Above Stated Address Operations/Training 326-3652 Dear Valued Customer, Deputy Chief Kirk Blair Over the last six months this office has continued to send reminder notices regarding Fire Safety/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 Bill 989 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. HUEY, DIRECTOR i PREVENTION SERVICES Those sites that have not been tested and have not pulled a permit prior to December 31, flRESAPETYSERVICES•ENVIRONMENrALSERVICES j 2005, will have their permit to operate revoked. 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 i 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 i Should you have any questions, please feel free to call me at (661) 326-3190. 326-3706 Sincerely, Howard H. Wines, III 12ALPH .HUEY, Director of Prevention Services Hazardous Materials Specialist 326-3649 Steve Underwood i Fire Prevention Officer SU:db