HomeMy WebLinkAbout2010 FMC RESULTS MONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the State of California
Authority Cited:Chapter 6.7, Health and Safety Code;Chapter 16, Division 3 Title 23, California Code of Regulations
This form must be used to document testing and servicing of monitoring equipment. If more than one monitoring system control panel is installed at the facility,a separate
certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank
system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date.
A.General Information
Facility Name: CHEVRON#355920 City: BAKERSFIELD CA Zip:93307
Site Address: JITB#7723 Contact Phone No: 861-0543
10 UNION AVENUE Date of Testing/Service: 05/28/2010
Facility Contact Person: MANAGER
Make/Model of Monitoring System:VR TLS-350 Work Order Number: 3175009 IIIIIJIJII�II III III
II I I ( fill II 65
B.Inventory of Equipment Tested/Certified IE
Check the appropriate boxes to indicate specific equipment inspected/serviced
TanklD: 87 TanklD: 91
X In-Tank Gauging Probe. Model: VR ATG X In-Tank Gauging Probe. Model: VR ATG
X Annular Space or Vault Sensor. Model: VR409 Annular Space or Vault Sensor. Model: VR409
X Piping Sump/Trench Sensor(s). Model: VR208 Piping Sump/Trench Sensor(s). Model: VR208
X Fill Sump Sensor(s). Model: VR208 VR208
Fill Sump Sensor(s). Model:
X Mechanical Line Leak Detector. Model: LD2000 X Mechanical Line Leak Detector. Model: LD2000
Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model:
X Tank Overfill/High-Level Sensor. Model: VR ATG Tank Overfill/High-Level Sensor. Model: VR ATG
Other(specify equipment type and model in Section E on page 2). Other(specify equipment type and model in Section E on page 2).
Tank ID: DlE5EL Tank ID:
In-Tank Gauging Probe. Model: VR ATG In-Tank Gauging Probe. Model:
X Annular Space or Vault Sensor. Model: SPLIT TANK WHT 91 Annular Space or Vault Sensor. Model:
X Piping Sump/Trench Sensor(s). Model: VR208 Piping Sump/Trench Sensor(s). Model:
X Fill Sump Sensor(s). Model: VR208
Fill Sump Sensor(s). Model:
X Mechanical Line Leak Detector. Model: FX1 DV Mechanical Line Leak Detector. Model:
Electronic Line Leak Detector. Model:
Electronic Line Leak Detector. Model:
Tank Overfill/High-Level Sensor. Model: FLAPPER
Tank Overfill/High-Level Sensor. Model:
Other(specify equipment type and model in Section E on page 2). Other(specify equipment type and model in Section E on page 2).
rspenser : 1-2 Dispenser ID: 3-4
®Dispenser Containment Sensor(s) Model:VR208 �( Dispenser Containment Sensor(s) Model:VR208
RI Shear Valve(s). X Shear Valve(s)
F-1 Dispenser Containment Float(s)and Chain(s). 7 Dispenser Containment Float(s)and Chain(s).
Dispenser ID: 5-6 Dispenser ID: 7-8
Fx—1 Dispenser Containment Sensor(s) Model:VR208 X Dispenser Containment Sensor(s). Model:VR208
X❑ Shear Valve(s). M Shear Valve(s).
Dispenser Containment Float(s)and Chain(s). Dispenser Containment Float(s)and Chain(s).
Dispenser ID: 9-10 Dispenser ID: 11-12
XAI Dispenser Containment Sensor(s) Model:VR208 X Dispenser Containment Sensor(s). Model:VR208
FRI Shear Valve(s). X Shear Valve(s).
Dispenser Containment Float(s)and Chain(s). Dispenser Containment Float(s)and Chain(s).
"If the facility contains more tanks or dispensers,copy this form. Include information for every tank and dispenser at the facility.
C. Certification
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 Site Plan showing the layout of monitoring equipment.For any equipment capable of generating such reports, I have also attached
a copy of the(Check all that apply): System set-up XD Alarm history report
Technician Name(print): DANIEL VISSER Signature:
Certification No.: A31963 License.No.: 743160(Class'A'General Enginering Contractor License)
Testing Company Name:Tanknology Phone No.: (800)800-4633
Site Address: 11000 N.MoPac Expressway,suite 500,Austin,TX 78759 Date of Testing/Servicing: 05/28/2010
Monitoring System Certification Page 1 of 3 IIIIIIIIIIIIIIIIIIII 66 Based on CA form dated 03108
IE
Monitoring System Certification
Site Address JITB#7723 Date of Testing/Service: 05/28/2010
10 UNION AVENUE
D. Results of Testing/Servicing
Software Version Installed: 328.03
Complete the following checklist:
x Yes No' Is the audible alarm operational?
0 Yes No' Is the visual alarm operational?
❑x Yes No Were all sensors visually inspected,functionally tested,and confirmed operational?
0 Yes ❑No Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not
interfere with their proper operation?
x Yes No' n N/A If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational?
For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment
❑x Yes ❑No ❑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) ❑x Sump/Trench Sensors; [E] Dispenser Containment Sensors.
Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ❑x Yes ❑No
❑
X Yes E]No' ❑N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.:no mechanical
overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank fill points(s)and operating
properly? If so,at what percent of tank capacity does the alarm trigger? 90
❑ Yes' ❑X No Was any monitoring equipment replaced?If yes,identify specific sensors,probes,or other equipment replaced and list the
manufacturer name and model for all replacement parts in Section E,below.
❑ Yes' ❑x No Was liquid found inside any secondary containment systems designed as dry systems?(check all that apply) ❑Product;
❑ Water. If yes,describe causes in Section E,below.
❑x Yes ❑No Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports,if applicable.
❑x Yes ❑No Is all monitoring equipment operational per manufacturers'specifications?
'In Section E below,describe how and when these deficiences were or will be corrected.
E. Comments:
Page 2 of 3 Based on CA form dated 03/08
Monitoring System Certification
Site Address: JITB#7723 Date of Testing/Service: 05/28/2010
10 UNION AVENUE
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.
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 following checklist:
0 Yes ❑No• Has all input wiring been inspected for proper entry and termination,including testing for ground faults?
❑X Yes ❑No• Were all tank gauging probes visually inspected for damage and residue buildup?
0 Yes ❑No' Was accuracy of system product level readings tested?
❑Yes ❑No• Was accuracy of system water level readings tested?
X Yes ❑No• Were all probes reinstalled properly?
❑Yes ❑No• Were all items on the equipment manufacturers'maintenance checklist completed?
'In the Section H,below,describe how and when these deficiencies were or will be corrected.
G. Line Leak Detectors (LLD) ❑ Check this box if LLDs are not installed.
Complete the following checklist: .
For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance?
Q Yes ❑No• ❑N/A (Check all that apply)Simulated leak rate: X❑ 3 g.p.h❑0.1 g.p.h ❑0.2 g.p.h
FX-1 Yes [—]No' Were all LLDs confirmed operational and accurate within regulatory requirements?
X Yes []No• Was the testing apparatus properly calibrated?
❑X Yes ❑No• ❑N/A For mechanical LLDs,does the LLD restrict product flow if it detects a leak?
Yes ❑No• ❑X N/A For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak?
❑Yes ❑No• Q N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected?
❑Yes ❑No• 0 N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test?
❑Yes ❑No• ❑X N/A For electronic LLDs,have all accessible wiring connections been visually inspected?
rull
Yes ❑No• Were all items on the equipment manufacturers'maintenance checklist completed?
'In the Section H,below,describe how and when these deficiencies were or will be corrected.
H. Comments:
Page 3 of 3 Based on CA form dated 03108
SWRCB,January 2002 Page 1.
Secondary Containment Testing Report Form
This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the
appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and
printouts from tests(if applicable),should be provided to the facility owner/operator for submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: CHEVRON # 355920 Date of Testing: 05/28/2010
Facility Address: JITB # 7723 10 UNION AVENUE, BAKERSFIELD, CA, 93307
Facility Contact: MANAGER Phone: (6 61) 861-0543
Date Local Agency Was Notified of Testing: 05/17/2010
Name of Local Agency Inspector(if present during testing): Ernie Medina
2. TESTING CONTRACTOR INFORMATION
Company Name: TANKNOLOGY, INC.
Technician Conducting Test: DANIEL VISSER
Credentials: x❑ CSLB Licensed Contractor SWRCB Licensed Tank Tester
License Type: A License Number: 743160
Manufacturer Training
Manufacturer Component(s) Date Training Expires
OPW 5018 05/12/2011
3. SUMMARY OF TEST RESULTS
Not Repairs Not Repair
Component Pass Fail Tested Made Component Pass Fail Tested Made
Spill Box 1 UNL FILL P-71 0 0 0 ❑ 0 0 ❑
Spill Box 2 PRE FILL X ❑ ❑ ❑ ❑ ❑ ❑ ❑
Spill Box 3 DIE FILL El ❑ ❑ ❑ ❑ ❑ ❑ ❑
0 0 0 0
0 0 0 0 0 0 0
❑ I 0 0 0 0 0 0 ❑
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 El-
El 0 0 0 0 ❑ 0
0 0 0
If hydrostatic testing was performed,describe what was done with the water after completion of tests:
WATER WAS REUSED. . .
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
To the best of my knowledge, the facts'stated in this document are accurate and in full compliance with legal requirements
Technician's Signature: �,, , r f' Lw �'`�� Date: 05/28/2010
SWRCB,January 2006
9. 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.
1. FACILITY INFORMATION
Facility Name: CHEVRON # 355920 Date of Testing: 05/28/2010
Facility Address: JITB # 7723 10 UNION AVENUE, BAKERSFIELD, CA, 93307
Facility Contact: MANAGER Phone: (6 61) 861-0543
Date Local Agency Was Notified of Testing: 05/17/2010
Name of Local Agency Inspector(if present during testing): Ernie Medina
2. TESTING CONTRACTOR INFORMATION
Company Name: TANKNOLOGY, INC.
Technician Conducting Test: DANIEL VISSER
Credentials 1: CSLB Contractor ❑ICC Service Tech. 0 SWRCB Tank Tester E Other(Specify)A
License Number: 743160
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: ❑ Hydrostatic ❑ Vacuum [K] Other 1HR VISUAL
Test Equipment Used:TAPE Equipment Resolution:V I SUAL
Identify Spill Bucket(By Tank 1 1 UNL FILL 2 2 PRE FILL 3 3 DIE FILL 4
Number, Stored Product, etc)
❑Direct Bury ❑Direct Bury ❑Direct Bury E]Direct Bury
Bucket Installation Type: X Contained in Sump Contained in S Contained in❑ ump ❑ um X p ❑ Sump ❑ Contained in Sump
Bucket Diameter: 1111 1111 1111
Bucket Depth: 121, 1211 1211
Wait time between applying 15MIN 15MIN 15MIN
vacuum/water and starting test:
Test Start Time(TI ): 900 900 900
Initial Reading(RI ):
11" 11" 11"
Test End Time(TF ): 1000 1000 1000
Final Readin g(R 11" 1111 11"
F )�
Test Duration: 1HR 1HR 1HR
Change in Reading(R F-RI ): 0 0 0
Pass/Fail Threshold or .0020 .0 0 2 0 .0020
Criteria:
es esult: Pass ® ail M WIN Ala ass s ® Fail
Comments- (include information on repairs made prior to testing, and recommended follow-up for failed tests)
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
I hereby certify that all the informatio.n contained in this report is true,accurate,and in full compliance with legal requirements.,r.F'
Technician's Signature: � , �, �4,j-- Date: 05/28/2010
State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements
Work Order: 3175009
Emergency Shut Off (ESO) &
Dispenser Emergency Shutoff Valve (ESV)
ANNUAL TEST RECORD LOCATIONS AND TEST DATA
Company: �f7`�—tj �i2C� Date: =/ter Cc`s
Location Name: Store#: Stat►:ID#:
Address: l O U IV.t city.' State:
C,
_Emergency Shut Off(ESO) Testing Results
On in accordance with"ESO Vendor Letter(3-21-05).doc", from tail
Compliance Department, as a part of annual compliance testing, this representative tested the
Emergency Shut Off(ESO) switches indicated on this sketch. Findin s listed below:
Emergency Shut Off(ESO) if No,Provide
Operational? N Maintenance Log# Date Called
Dispenser Emergency Shutoff Valve (ESV) Testing Results
On Zf�--to in accordance with NFPA 30A this representative tested the automatic-closing featur
of the Dispenser Emergency Shutoff VALVE(S) (ESV) located in the supply lines at the base of each
individual island type dispenser indicated on the diagram below. Each device (#) `_ in all,
would automatically close. Findings listed below:
Disp. Emergency Shut Off If No, Provide
Y' N
Valve(ESV)Operational? Maintenance Log# Date Called :
Site Map Of Location and Placement of Devices Tested:
Tanknology Inc. 11000N.MoPac Expressway,Suite 500,Austin,Texas 78759
.,fin
8501 N MOPAC EXPRESSWAY,SUITE 400
AUSTIN,TEXAS 78759
(512)451-6334
FAX(512)459-1459
TEST DATE:05/28/10 WORK ORDER NUMBER3175009
CLIENT:CHEVRON PRODUCTS COMPANY SITE:CHEVRON # 355920
COMMENTS
Conduct LD, Impact Valve, ATG, SB, E-Stop. All tests passed.
PARTS REPLACED
QUANTITY DESCRIPTION
HELIUM PINPOINT TEST RESULTS (IF APPLICABLE)
�e
ITE S TESTED
HELI M PINPOINT LEAK TES RESULTS
Printed 06/21/2010 07:57 KOHLMEYER
SITE DIAGRAM
T�nly ak)gy
8501 N MOPAC EXPRESSWAY,SUITE 400
AUSTIN,TEXAS 78759
(512)451-6334
FAX(512)459-1459
TEST DATE: 05/28/10 WORK ORDER NUMBER3 3.7 5 0 0 9
CLIENT:CHEVRON PRODUCTS COMPANY SITE: CHEVRON # 355920
v/r
JITB
C-STORE
#5 #1
410 #9#9 46 L11 42 L9
q� #11 dsl #7 #3 dsl 8
#12 L14 #8 L12 dsl #4 L10 m
dsl z
L3 UL L2 STP 01 L1
0
L8 L7 L6 jL5 CAS
STP P I L4
ESO DSL S
Printed 06/21/2010 07:57 KOHLMEYER
Work Order: 3175009
ALARM HISTORY REPORT ALARM HISTORY REPORT
ALARM HISTORY REPORT
----- SENSOR ALARM ----- ----- SENSOR ALARM -----
ALARM HISTORY REPORT 7:D SENSOR ALARM -----
L I'UNLEADED ANNULAR L 4:SPLIT TANK ANNULAR
ANNULAR SPACE ANNULAR SPACE L :DIESEL STP SUMP---- IN-TANK ALARM -- SENSOR OUT ALARM STP SUMP
SENSOR OUT ALARM
T i:UNLEADEU MAY 28, 2010 9:56 AM MAY 28, 2010 9:56 AM SENSOR OUT ALARM
MAY 28. 2010 9:56 AM
OVERFILL ALARM FUEL ALARM FUEL ALARM
010 9:41 AM FUEL ALARM
MAY 28, 2010 10:04 AI' MAY 28, 2010 9:38 Af°I MAY 28. 2010 9:46 AM
HIGH PRODUCT ALARM
MAY 28, 2010 10:04 AN
PROBE OUT
MAY 2B, 2010 10:53 A('
MAY 28. 2010 10:05 AN
MAY 28, 2010 8:52 At,
DELIVERY NEEDED * * * END * * * )` * END * * x * * * * END x x x
MAY 27, 2010 9:07 AN
MAR 28. 2010 11 :34 AN
FEB 16, 2010 5:03 PN
MAX PRODUCT ALARM
MAY 28, 2010 10:04 Ar
ALARM HISTORY REPORT ALARM HISTORY REPORT ALARM HISTORY REPORT
----- SEI4SOR ALARM ----- ----- SENSOR ALARM -----
L 5:PREMIUM S*TP SUMP ----- SENSOR ALARM -----
L 2:UNLEADED STP SUMP L B:D[ESEL FILL
STP SUMP STP SUMP
SENSOR OUT ALARM SENSOR OUT ALARM PIPING SUMP
MAY 28, 2010 9:56 AM MAY 28, 2010 9:56 AM SENSOR OUT ALARM
iE [ x X X END * A * > MAY 28, 2010 9:56 AM
FUEL ALARM FUEL ALARM
MAY 28, 2010 9:36 AM MAY 28, 2010 9:43 AM FUEL ALARM
MAY 26, 2010 9:47 AM
FUEL ALARM
MAR 1, 2010 8:10 AM FUEL ALARM
APR 21. 2010 ' 5:32 PM
ALARM HISTORY REPORT
---- IN-TANK ALARM - * * END
T 2:PREMIUI°I END
X * -* END x * x
OVERFILL ALARM
MAY 28, 2010 10:01 Af
HIGH PRODUCT ALARM
MAY 28. 2010 10:,01 Af
PROBE OUT
MAY 28, 2010 10:52 Af ALARM HISTORY REPORT
MAY 28, 2010 10:02 Af
MAY 28, 2010 8:53 Af -- SENSOR ALARM -----
HIGH WATER WARNING L 3:UNLEADED FILL ALARM HISTORY REPORT ALARM HISTORY REPORT
MAY 28, 2010 10:08 AP PIPING SUMP SENSOR SENSOR ALARM -----
S:
SENSOR OUT ALA ----- SENSOR ALARM -----
MAY 28. 2010 9:56 AM L 6:PREMIUM FILL
PIPING SUMP L 9:DISP. 1-2
DELIVERY NEEDED SENSOR OUT ALARM DISPENSER PAN
MAY 19, 2010 9:56 PP FUEL ALARM MAY 28, 2010 9:56 AM SENSOR OUT ALARM
MAY 9, 2010 4:08 PI MAY 28, 2010 9:34 HM MAY 28, 2010 9:56 AM
MAY 7, 2010 4:34 PI' FUEL ALARM
FUEL ALARM FUEL ALARM
FEB 9, 2010 2:23 PM MAY 28, 2010 9:45 AM
MAX PRODUCT ALARM \ �AY`�8R2010 9__19 AM
MAY 28, 2010 10:01 Ahl�--�._- �uFL ALARM
__J,OW TEMP WARNING
X2010 10:53 AM
Tank nology Inc. 11000 N.MoPac Expressway,Suite 500,Austin,Texas 78759
Work Order: 3175009
ALARM,HISTORY REPORT ALARM HISTORY REPORT
----- SENSOR ALARM ----- ----- SENSOR ALARM -----
L10:DISP. 3-4 L13:DISP. 9-10
DISPENSER PAN DISPENSER PAN
SENSOR OUT ALARM SENSOR OUT ALARM
MAY 28, 2010 9:56 AM MAY 28, 2010 9:56 AM
FUEL ALARM FUEL ALARM
MAY 28, 2010 9:48 AM MAY 28, 2010 9:54 AM
FUEL ALARM
DEC 4, 2009 11 :55 AM
* END * X x * X
x . * END XA * x
ALARM HISTORY REPORT
-- SENSOR ALARM --
LII :DISP. 5-6 ALARM HISTORY REPORT
DISPENSER PAN -- SENSOR, ALARM -----
SENSOR OUT.ALARM -
MAY 28, 2010 9:56 AM L14:DISP. 11-12
DISPENSER PAN
FUEL ALARM SENSOR OUT ALARM
MAY 28, 2010 9:50 AM MAY 28, 2010 9:56 AM
FUEL ALARM
MAY 28, 2010 9:51 AM
FUEL ALARM AM..
MAY 28,
2010 9:05_,
X X X x END * n X * A
ALARM HISTORY REPORT
----- SENSOR ALARM -----
L12:D1SP. 7-8
DISPENSER PAN
SENSOR OUT ALARM
MAY 28. 2010 9:56 AM
FUEL ALARM
---MAy--2Q 2010 9:51 AM
Tanknology Inc. 11000N.MoPac Expressway,Suite 500,Austin,Texas 78759
P855
JLW-Tanknology
11000 N. MoPac Expressway,Suite 500
Austin,Texas 78759
Phone: (512)451-6334
Fax: (512)459-1459 Date Printed and Mailed: 06/21/2010
BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
INSPECTOR CRAIG PERKINS
1501 TRUXTUN AVE.
BAKERSFIELD, CA. 93301
Test Date: 05/28/2010
Order Number: 3175009
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
CHEVRON # 355920
J ITB # 7723
10 UNION AVENUE
BAKERSFIELD, CA. 93307
Testing performed:
Impact Valve
Leak detector tests
Monitor Certification
Secondary Containment-Spill Container
Sincerely,
Dawn Kohlmeyer
Manager, Field Reporting
FPURPOSE: TANKNOLOGY CERTIFICATE OF TESTING
8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759
TELEPHONE(512)451-6334 FAX(512)459-1459
COMPLIANCE TEST RESULT SUMMARY REPORT
TEST DATE: 05/28/10 WORK ORDER NUMBER: 3175009
CUSTOMER PO: 15055724
CLIENT; CHEVRON PRODUCTS COMPANY SITE:CHEVRON#355920
145 S.STATE COLLEGE BLVD JITB#7723
SUITE 400 10 UNION AVENUE
BREA,CA 92821 BAKERSFIELD,CA 93307
TINA SCOLARO MANAGER
(714)671-3356 (661)861-0543
TEST TYPE: TLD-1
Product Pipe Ti htness Test Results
LIN LINE E L!N DELIVERY IMPACT
1 PROD TERIAL pE TE5 RESULT FINAL EAK RATE (gph) VALVE
A B C D A B C U FUNC7TIO
1 UNLEADED DW FIBERG PRESSURE Y
2 PREMIUM DW FIBERG PRESSURE Y
3 DIESEL DW FIBERG PRESSURE Y
Existing Line Leak Detector Test
EXISjTING1L_E pE�TECTLOR{#I EXISTtNGiLEAKIL EtTIE,,
LINE MANUFACTURER MODEL# SERIAL# RESULT MANU ACTURER MODEL# SERIAL# RESULT
ID
1 VAPORLESS LD2000 UNKNOWN P
2 VAPORLESS LD2000 07121111 P
3 RED JACKET FX1-DV P
New Replacement Line Leak Detector Test
'ILI T hto - - 'W1 ` 4 is '1m t
L'pE MANUFACTURER MMODEL# ZE MSERALMM RESUL
For owner detailed report information,visit www.tanknology.com and select On-Line Reports-WRAP,or contact your local Tanknology office.
Tester Name:DANIEL VISSER Technician Certification Number:006-05-0311
Printed 06/21/2010 07:57 KOHLMEYER
INDIVIDUAL TANK INFORMATION AND TEST RESULTS
Mr Tenkmology
TEST DATE:05/28/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER317 5 0 0 9
CLIENT:CHEVRON PRODUCTS AUSTIN,TEXAS 78759(512)451-6334 SITE:CHEVRON # 355920
TARN�INF 'RM'A� ON
Tank ID: 1 Tank manifolded: Bottom to top fill in inches:
Product: UNLEADED Vent manifolded: Bottom to grade in inches:
Capacity in gallons: 19,703 Vapor recovery manifolded: Fill pipe length in inches: 7
Diameter in inches: 117.00 Overfill protection: Fill pipe diameter in inches:
Length in inches: 225 Overspill protection: Stage I vapor recovery:
Material: Dw FIBERG Installed: Stage II vapor recovery:
CP installed on:
COMMENTS
T,AN TES RESULTS Tes MeMM' N 1111 EAN DETECTOR TEST RESULTS est method: FTA
Start(in) End(in)
Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced
Dipped Product Level: L.D.#1 L.D.#1 L.D.#2 L.D.#2
Probe Water Level: Make: VAPORLESS
Ingress Detected: Water Bubble Ullage Model: LD2000
Test time: S/N: UNKMW N
Inclinometer reading: Open time in sec: 4.00
VacuTect Test Type: NOT Holding psi: 28 NOT
VacuTect Probe Entry Point: TESTED Resiliency cc: 200
Test leak rate ml/m: 189.0 TESTED
Pressure Set Point: Metering psi: 20
Tank water level in inches: Calib. leak in gph: 3.00
Water table depth in inches: Results: PASS
Determined by(method):
Result:
COMMENTS
COMMENTS
LINE TEST RESU TS Test type: xLD
LINE A "C
Material: Dw FIBERG
Diameter(in):
Length (ft):
Test psi:
Bleedback cc:
Test time(min): NOT NOT NOT NOT
Start time: TESTED TESTED TESTED TESTED
End time:
Final gph:
Result:
Pump type: PRESSURE
Pump make: FE PETRO
COMMENTS Impact Valves Operational: YES
Printed 06/21/2010 07:57
INDIVIDUAL TANK INFORMATION AND TEST RESULTS
Tankw1ogy
TEST DATE:05/28/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3175009
CLIENT:CHEVRON PRODUCTS AUSTIN,TEXAS 78759(512)451-6334 SITE:CHEVRON # 355920
THAN I,(�INFORMi4Tl'O
Tank ID: 2 Tank manifolded: Bottom to top fill in inches:
Product: PREMIUM Vent manifolded: Bottom to grade in inches:
Capacity in gallons: 10,369 Vapor recovery manifolded: Fill pipe length in inches:
Diameter in inches: 117.00 Overfill protection: Fill pipe diameter in inches:
Length in inches: 225 Overspill protection: Stage I vapor recovery:
Material: Dw FIBERG Installed: Stage It vapor recovery:
CP installed on:
COMMENTS
TAN EST RESULTS Tes Metho .Va... • LEAK UETECTO TEST RES LTS est method: FTA
Start(in) End(in)
Dipped Water Level: New/passed Failedireplaced New/passed Failed/replaced
Dipped Product Level: L.D.#1 L.D.#1 L.D.#2 L.D.#2
Probe Water Level: Make: VAPORLESS
Ingress Detected: Water Bubble Ullage Model: LD2000
Test time: S/N: 07121111
Inclinometer reading: Open time in sec: 3.00
Holding psi: 29
VacuTect Test Type: NOT Resiliency psi:
259 NOT
VacuTect Probe Entry Point: TESTED
Test leak rate ml/m: 189.0 TESTED
Pressure Set Point: Metering psi: 20
Tank water level in inches: Calib. leak in gph: 3.00
Water table depth in inches: Results: PASS
Determined by(method):
Result:
COMMENTS
COMMENTS
L_INETEST k9§Q L till
S es type: -i
LIN A B C D
Material: Dw FIBERG
Diameter(in):
Length (ft):
Test psi:
Bleedback cc:
Test time(min): NOT NOT NOT NOT
Start time: TESTED TESTED TESTED TESTED
End time:
Final gph:
Result:
Pump type: PRESSURE
Pump make: FE PETRO
COMMENTS Impact Valves Operational: YES
Printed 06/21/2010 07:57
INDIVIDUAL TANK INFORMATION AND TEST RESULTS
Tanknology
TEST DATE:05/28/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3175009
CLIENT:CHEVRON PRODUCTS AUSTIN,TEXAS 78759(512)451-6334 SITE:CHEVRON # 355920
WTNK INFO 'M'AATION
Tank ID: 3 Tank manifolded: Bottom to top fill in inches:
Product: DIESEL Vent manifolded: Bottom to grade in inches:
Capacity in gallons: 7,029 Vapor recovery manifolded: Fill pipe length in inches:
Diameter in inches: 118.00 Overfill protection: Fill pipe diameter in inches:
Length in-inches: 150 Overspill protection: Stage I vapor recovery:
Material: Dw FIBERG Installed: Stage II vapor recovery:
CP installed on:
COMMENTS
TANK ST RESULTS Test Method:VacuTect LEAK DETECTO TEST ESULT Test method: FTA
Start(in) End(in)
Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced
Dipped Product Level: L.D.#1 L.D.#1 L.D.#2 L.D.#2
Probe Water Level: Make: RED JACKET
Ingress Detected: Water Bubble Ullage Model: Fx1-DV
Test time: S/N: 301086138
Inclinometer reading: Open time in sec: 2.00
Holding psi: 29
VacuTect Test Type: NOT Resiliency cc: 1so NOT
VacuTect Probe Entry Point: TESTED
Test leak rate ml/m: 189.0 TESTED
Pressure Set Point: Metering psi: 15
Tank water level in inches: Calib. leak in gph: 3.00
Water table depth in inches: Results: PASS
Determined by(method):
Result:
COMMENTS
COMMENTS
LI E TEST RESULTS est type: TLD-1
LINE A B C D
Material: Dw FIBERG
Diameter(in):
Length(ft):
Test psi:
Bleedback cc:
Test time(min): NOT NOT NOT NOT
Start time: TESTED TESTED TESTED TESTED
End time:
Final gph:
Result:
Pump type: PRESSURE
Pump make: FE PETRO
COMMENTS Impact Valves Operational: YES
Printed 06/21/2010 07:57