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HomeMy WebLinkAbout2010 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. 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 IIIIIIIIIIIIIIIIIIII 17 Facility Name: OSWELL LIQUOR IE Bldg.No.: Site Address: 100 S. OSWELL ST City: BAKERSFIELD Zip: r Facility Contact Person: BOBBY Contact Phone No.: (661) 861-9769 Make.Model of Monitoring System: TLS-350 ESTHER DURAN ON-SITE Date of Testing/Servicing: 1212/2010 B. Inventory of Equipment Tested/Certif ed Check the apffopriate boxes to indicates fic equipment inspected/serviced: Tank ID: UNL87 MASTER Tank ID: UNL87 SLAVE SPLIT PREM91 0 In-Tank Gauging Probe. Model: MAGI ®In-Tank Gauging Probe. Model: MAGI 0 Annular Space or Vault Sensor. Model: 420 ®Annular Space or Vault Sensor_ Model: 420 ®Piping Sump/Trench Sensor(s). Model: 208 ®Piping Sump/Trench Sensor(s). Model: 208 ❑Fill Sump Sensor(s). Model: ❑Fill Sump Sensor(s). Model: ®Mechanical Line Leak Detector. Model: FXIV ❑Mechanical Line Leak Detector. Model: ❑Electronic Line Leak Detector. Model: ❑Electronic Line Leak Detector. Model: ®Tank Overfill/Higb-Level Sensor. Model: FLAPPER 0 Tank Overfill/High-Level Sensor. Model: FLAPPER (]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: PREM91 SPLIT UNL87 SLAVE Tank ID: DIESEL ®In-Tank Gauging Probe. Model: MAGI ®In-Tank Gauging Probe. Model: MAGI ®Annular Space or Vault Sensor. Model: 420 ®Annular Space or Vault Sensor. Model: 420 r ®Piping Sump/Trench Sensor(s). Model: 208 0 Piping Sump/Trench Sensor(s). Model: 208 ❑Fill Sump Sensor(s). Model: ❑Fill Sump.Sensor(s). Model: ®Mechanical Line Leak Detector. Model: FX1V ®Mechanical Line Leak Detector. Model FXIDV. 0 Electronic Line Leak Detector. Model: ❑Electronic Line Leak Detector. Model: ®Tank Overfill/High-Level Sensor. Model: FLAPPER ®.Tank.Overfill/High-Level Sensor. Model:. FLAPPER ❑Other(specify equipment type and model in Section E on Page 2). ❑Other(specify equipment type and model in Section E on Page 2). Dispenser ID: 1-2 Dispenser ID: 3-4 0 Dispenser Containment Sensor(s). Model: 208 M Dispenser Containment Sensor(s). Model: 208 ®Shear Valve(s)_ ®Shear Valve(s). 0 Dispenser Containment Float(s)and Chain(s). ❑Dispenser Containment Float(s)and Chain(s). Dispenser ID: 54 Dispenser ID: 7-8 0 Dispenser Containment Sensor(s). Model: 208 ®Dispenser Containment Sensor(s). Model: 208 ®Shear Valve(s). ®Shear Valve(s). 0 Dispenser Containment Float(s)and Chain(s). ❑Dispenser Containment Float(s)and Chain(s)_ Dispenser ID: Dispenser ID: ❑Dispenser Containment Sensor(s). Model: ❑Dispenser Containment Sensor(s). Model: ❑Shear Valve(s). ❑Shear Valve(s). ❑Dispenser Containment Float(s)and Chain(s). ❑Dispenser Containment Float(s)and Chain(s). 'If the facility contains more tanks or dispensers,copy this form_ Include information for every tank and dispenser at the facility: C. Certifica$Pon -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 Plot Plan showing the layout of monitoring a uipmenL For any equi meat capable of generating such reports,I have.aLso attached a copy of the report;(check all that apply): Dg System set-up rm history report Technician Name(print): RYAN MASON Signature: Certification No.: A27367 ICC#8029371-UT License.No.: 09911 D40: 809850 Testing Company Name: Rich Environmental hone (661) 392.8687 'Testing Company Address: 5643 BROOKS CT. BAKERSFIELD,CA 93308 Date of Testing/Servicing: 12/2/2010 Page 1 of 4 UN-036-1/4 www.unidocs org IIIIIIIIIIIIIIIIIIII 18 Rev.01/17/08 IE Monitoring System Certification A Results of Testing/Servicing Software Version Installed: 123.02 Complete the folio win checklist: • Yes ❑ No* Is the audible alarm operational? • Yes ❑ No* Is the visual alarm operational? • Yes ❑ No* Were all sensors visually inspected, functionally tested,and confirmed operational? ® 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? ❑ Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) ® N/A operational? ® Yes ❑ No* 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; ®Dispenser Containment Sensors. Did you confirm positive shut-down due.to leaks and sensor failure/disconnection? ®Yes; ❑No. 0 Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e., no ® N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger? % ❑ Yes* ® No Was any monitoring equipment replaced? If yes,.identify specific sensors,probes,or other.equipment replaced and list the manufacturer name and model for all replacement parts in Section E,below. ❑ Yes* ® No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ❑Product; ❑ Water. If yes,describe causes in Section E,below. ® Yes ❑ No* Was monitoring system set-up reviewed to ensure proper settings?Attach setup reports,if applicable ® Yes ❑ No' Is all monitoring equipment operational per manufacturer's specifications? In Section,F below,describe.how and when these deficiencies were or will be corrected. 'E. Comments: Page 2 of 4 UN-036—Z/4 www.unidomorg Rev.01/17/08' Monitoring System Certification _71U01 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 following checklist: ❑ Yes ❑ No"' Has all input wiring been inspected for proper entry and termination,including testing for ground faults? ❑ Yes ❑ No* Were all tank.gauging probes visually inspected for damage and residue buildup? ❑ Yes ❑ No* Was accuracy of system product level readings tested? ❑ Yes ❑ No* Was accuracy of system water level readings tested? ❑ Yes ❑ No* Were all probes reinstalled properly? ❑ Yes ❑ No* Were all items on the equipment manufacturer's.maintenance checklist completed? *In Section II,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: ® Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? [] N/A (Check all that apply) Simulated leak rate: ® 3 g.p.h.; [10.1 g.p.h; ❑0.2 g.p.h. I& Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements? 10 Yes ❑ No* . Was the testing apparatus properly calibrated?. (� Yes ❑ No* For mechanical LLDs,does the LLD restrict product flow if it detects a leak? NIA ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? ® N/A ❑ Yes p No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled N/A or disconnected? ❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions ® N/A or fails a test? Q Yes ❑ No* For electronic LLDs,have all accessible wiring connections been visually inspected? ® N/A Yes ❑ Noy` Were all items on the equipment manufacturer's maintenance checklist completed? *In Section H,below,describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 4 IN-436—3/4 www.unidocs.org Rev.01/17/06 Monitoring System Certification UST onitonng Site'Plan Site Address: - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - • - - - - - - - - - - - - - - - - - - - - - - - - - = - - - - - - - - - - - - - r - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -_ _ _ . - - - - - - • - - - - - - - - - - - - _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . - w - - - - - - - - - - - - - - - - - - r - - - _ - - - - - - - - - - r - - - - . -0 - - - - - - - - - - - - - - - - - - - - - - - - - - - .. .. w . _ - • . + r . _ . r _ _C4 - - - - - - - - - - - - - - - - - - - - - - - --- w . - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - • - - - - - - - - - - - - - . - - - - - - - - - - - - - - - - - » - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . . . _ . . . . . . . . . . . . . . .. - - _ - - _ . - - - - - . . .. . - • - - - - - - - - - - - - - - - - - - - - - - _ . - _ - r a r _ . _ . - - - - - • . . . . . . . - - - - - - - - - - - - - - - • _ - - - -'- - - - - -- - - - - - - - - - - - - - - - - - - - - -- - - . . . . . .. . . . . . . . . . . - - - - -®- . _ 2 . . - - - - - - - - - - - - - - - - - _ r r - - - - - - - - - - - _ . . . _ . . . Date map was dnawz If you,&eady have a diagram that shows all required information,you may include it,rather than thi -Me,with your Monitoring Systern Certifrcabon. On your site plan,show the general layout oftanks and piping.Clearly idea* locations of the following equipment,if installed:monitoring systeth.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 prep". Page of 05100 -'�1t01 T 2:87 UNLEADED IN—TANK SETUP PRODUCT CODE A— — - — — THERMAL COEFF : .000200 — — — — — — TANK DIAMETER 95.50 T 1 :87 UNLEADED TANK PROFILE, 1 PT SOFTWARE REVISION LEVEL PRODUCT CODE gOp70I FULL VOL 5064 VERSION 1 7'3.02 THERMAL COEFF 95.50 SOFTWAREU :346123-100—C TARK DIAMETER FLOAT SIZE' 4.0 IN. CREATED — 02.11 .'25. 15. 17 TANK PRO PT FULL VOL VOL 1I PT WATER WARNING 2.0 NO SOFTWARE MODULE HIGH WATER LIMIT: 3.0 SYSTEM FEATURES: 4 0 IN• PERIODIC IN—TANK TESTS FLOAT SIZE: MAX OR LABEL VOL: 5064 ANNUAL I N-TA14K TESTS WATER WARNI NG : 2.0 OVERFILL LIMIT 90%, HIGH WATER LIMIT: 3.0 455' HIGH PRODUCT 95 MAX OR LABEL VOL: 10152 4810 OVERFILL LIMIT 90% DELIVERY LIMIT 25 5136 1266 HIGH PRODUCT 95 9644 LOW PRODUCT 500` DELIVERY LIMIT 25% LEAK ALARM LIMIT: 99 253B SUDDEN.LOSS LIMIT: 99 TANK TILT 0.00 SYSTEM SETUP — — — — — _ LOW PRODUCT : 15 PROBE OFFSET O.QO DEC —2. 2010 12:00 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANX TILT 0.00 SIPHON MANIFOLDED TANKS PROBE OFFSET 0.00 To. NONE LINE MANIFOLDED TANKS SYSTEPI UNITS T#: NONE U " SIPHON MANIFOLDED TANKS SYSTEM LANGUAGE T NONE ENGL.I SH SYSTEM DATE;TINE FORMAT LINE MANIFOLD ED Tr�l'aKS LEAK MIN PERIODIC: 0 MON DD Y'YY'Y HH:MM:SS T#: NONE LEAK MIN ANNUAL (r/ OSWELL LIQUOR 0 100 S.OSWEL.L LEAK MIN PER I c}D I C: 0 BAKERSF I ELD,CA 661-8E 1-9769 LEAK 0°LEAK MIN ANNUAL : PERIODIC TEST TYPE 0 STANDARD SHIFT TIME 1 DISABLED SHIFT TIME 2 DISABLED ANNUAL TEST FAIL SHIFT TIME 3 : DISABLED PERIODIC TEST TYPE ALARM DISABLED SHIFT TIME � DISABLED STANDARD PERIODIC TEST FAIL TANK PER TST NEEDED WRN ALARM A DISABLED Lt�RM DISABLED TANK ANN TST NEEDED WRNLAI?f°i T3 E BAWLED GROSS TEST FAIL DISABLED PERIODIC TENT FAIL ALARM DISABLED LINE RE—ENABLE METHOD ALARM DISABLED ANN TEST AVEkAG I NG: OFF PASS LINE TEST oROSr,,. TEST FAIL PER TEST AVERAGING: OFF LINE PER TST NEEDED WRN ALARM DISABLED TANK TEST NOTIFY: OFF DISABLED LINE ANN TST NEEDED WRN ANN TEST AVERAGING: OF DISABLED P£R TEST AVERAGING' OFF T(VK TST SIPHON BRFAfC:OFF TANY, TEST NOTIFY: OFF DELIVERY DELAY 3 MIN PRINT Ti. VOLUMES PUMP THRESHOLD 10.00% ENABLED. TFiK TST SI PHOtd E,PEAK:OFF 'TEMP COMPENSATION 3 MIN VALUE <DEG F ) l 60.0 D LIVERY DELAY HOLD : 10.009 STICK HEIGHT OFFSET DISABLED DAYLIGHT SAVING TIME DISABLED 9I PREilI Lh-1 t PRODUCT CODE LEAK TEST .METHOD -THERMAL CI-DEFF : .000700 T 4:D I ESEL _ _ _ _ — — — — — — — TANK DIAMETER 95.50 PRODUCT CODE 4 — TEST ON DATE ALL TANK TANK PROFILE I PT THERMAL COEFF : .000450 FULL VOL 5064 TANK DIAMETER 95.50 .JAN 1., 1596 TANK PROFILE 1 PT START TIME DISABLED FULL VOL. 10152 TEST RATE :0.20 GAL/HR FLOAT SIZE: 4.0 IN. DURATION 2 HOURS WATER WAR.N114G 2.0 FLOAT SIZE: 4.0 IN. TST EARLY STOP:.DISABLED HIGH WATER LIMIT: 3.0 WATER WARrdI rWG 2.0 LEAK TEST REPORT FORMAT MAX OR LABEL VOL: 5064 HIGH WATER LIMIT: 3.0 NORMAL OVERFILL LIMIT 957 457 MAX OR LABEL VOL: 10152 HIGH PRODUCT 95 OVERFILL LIMIT 90% 4810 9136 DELIVERY LIMIT 25i HIGH PRODUCT 954 1266 9644 DELIVERY LIMIT 25 0 LOW PRODUCT 500 2538 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT' 99 LOW PRODUCT 500 TANK TILT 0.00 LEAK ALARM LIMIT: 99 PROBE OFFSET 0.00 SUDDEN LOSS LIMIT: 99 LI�IUIU—SENSOk—SETUP— — TANK TILT 0.00 — PROBE OFFSET 0.00 SI'PHt?N 1°IAN 1 FOLDED TANKS L 1 :87 ANNULAR TR1—STATE (SINGLE FLOAT) T#: NONE LINE MANIFOLDED TANKS SIPHON MANTFOLDED TANKS CATEGORY STP SUMP T#: NONE LINENMANIFOL.DED TANKS T#: NONE L 2:91-87ANNULAR LEAK MIN PEP I01)IC: 0% TRI—STATE (SINGLE FLOAT) 0 CATEGORY ANNULAR SPACE LEAK MIN PERIODIC: 00 LEAK IlIN ANNUAL 0% 0' 0 L 3:.DIESEL ANNULAR LEAK MI N ANNUAL 0 0 TRI—STATE (SINGLE FLOAT) PERIODIC TEST TYPE CATEGORY : ANNULAR SPACE STANDARD PERIODIC 'TEST TYPE ANNUAL TEST FAIL STANDARD L 4:87 STP SLWIP ALARM DISABLED ANNUAL TEST FALL TRI—STATE (SINGLE FLOAT) PERIODIC TEST FAIL ALARM DISABLED CATEGORY : STP SUMP nLAFM DI°ABLELZ PERIODIC TEST FAIL GROSS TEST FAIL ALARM DISABLED L 5:87 SYP.SUMP ALARM DISABLED TRI—STATE (SINGLE FLOAT) GROSS TEST FAIL CATEGORY : PIPING SUMP ANN TEST A)vERF-G I NG: OFF ALARM DISABLED PER TEST AVERAGING: OFF s L 6:91 STP SL"P ANN TEST AVERAGING. OFF TANK TEST NOTIFY: OFF PER TEST AVERAGING: OFF TRI—STATE' (SINGLE FLOAT) . CATEGORY : STP SUMP TNK TST SIPHO19 BREAK:OFF TANK TEST NOTIFI': OFF DELIVERY DELAY 3 MIN TNK TST SIPHON BREAK:OFF L 7:DIESEL STP DUMP THRESHOLD : 10.00% TRI—STATE (SINGLE FLOAT) DELIVERY DELAY 1 MIN CATEGORY STP SUMP PUMP THRESHOLD 10.00%s L 8:D1SP. 1-2 TRI=STATE (SINGLE FLOAT). CATEGORY DISPENSER PAN L 9:DISP.3-4 TRI—STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L10:DISP.5-6 TRI—STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L11 :DISP.7-8 TP I-crraTF e R I wrn C C1 naT S OUTPUT-RELAY SETUP - - _ ALARM H 1:STOR Y REPORT R 1 :97 SHi1T-DC;WN -- SYSTEM ALARM ----- ALARM HISTORY REPORT TYPE: PAPER OUT STANDARD OCT 31 . 2010 15:53 ---- IN-TA NK ALARM ----- NORIIIALLY CLOSED PRINTER ERROR OCT 31 . 2010 18:53 T 2:67 UNLEADED BA'I TERY IS CUFF LIQUID SENSOR ALMS JHt'-f 1 . 1996 8:OC�. OVERFILL ALARM L 1 :FUEL ALARM FEB 22, 2010 23:07 JAN L 4:FUEL ALARM FEB 2 2010 15:06 L 5:FUEL ALARM FEB 277,, 2009 1e:35 L S:FUEL ALARM LOW PRODUCT ALARM L 9:FUEL ALARPI L10:FUEL ALARM JUL 13, 2010 16:25 L11 :FUEL ALARM JUL 16. 20.10 14:35 L 1 :SENSOR OUT ALARM JUL 6, _D10 18:03 L 4:SENSOR OUT ALARM H"IGH PRODUCT ALARM L 5:S£NSOR OUT ALARM * .k END X FEB 22, 2010 23:07 L 6:9ENSOR OUT ALARM JAN' 24, 2010 15:08 L 9:SENSOt OUT ALARM MAY 7, 2008 7:20 LIO:SENSQR OUT ALARM L11 :SENSOR OUT ALARM INVALID FUEL LEVEL R NOV 14, 2010 14:24 -':91 BRUT-DAWN T'i'FE: JUL 17. _010 14:06 STANDARD MAR 18. 2010 22:26 NORMALLY CLOSED PROBE OUT MAY 20, 2005 8:58 LIQUID SENSOR ALMS ALARM 20, 2%3o5 7:20 L 2:F UEL ALARM ALARM HISTORY REPORT L 6:FUEL ALARM ---_ IN-TANK ALARM --- - DELIVERY NEEDED L S:FUEL ALARM L 9:FUEL ALARM NOV 29: 2010 x:04 L10:FUEL ALARM T 1 :d7 UNLEADED WV 20, 2010 11 :00 NOV 10, 2010 10:42 L11 :FUEL ALARM L 2:SENSOR OUT ALARM OVERFILL ALARM 2338 I. 6:SENSOR OUT ALARM JUN 2. 21110 NOV 25, 2009 12:01 L B:SEtJSvR OUT ALARM NOV 11 , 2006 22:38 L 9:SENSOR OUT ALARM LIO:SENSOR OUT ALARM HIGH PRODUCT !ALARM L11 :SENSOR OUT ALARM JUN 2, 2010 23:40 Nov R 3:DIESEL SHUT-DOWN SEP 2 2, 06 12:56 TYPE: EF 3. 20175 .1.3:54 _ STANDARD INVALID FUEL LEVEL NORMALLY CL02ED NOV 14, 2010 12:40 4 END JUL 17. 2010 1.0:38 LIQUID SENOR ALMS JUL 7, 2010 2i :23 L 3:FUEL ALARM PROBE OUT L 7:FUEL ALARM MAY 20, 2005 8:55 L 9:FUEL ALARM mAY 20. 2005 7:48 L11 :FUEL ALARM L 3:SENSOR OUT ALARM L ?:SENSOR OUT ALARM DELIVERY NEEDED L 9:SENSOR OUT ALARM NOV 28, 2010 18:38 LII :SENSOR OUT ALARM NOV 19, 2010 21 :06 NOV 9. 2010 19:06 MAX PRODUCT ALARM SEP 3. 2005 13:56 APR 21 , 2003 1301 RECOPh_'I L I AT I;:ld SETUP AUTOMATIC DAILY CLOSING TIME: 2:00 r'-m * ri END PERIODIC RECONCILIATION MODE: MONTHLY TEMP COMPENSATION STANDARD r,1 10 67 r_1 err •, ^-" ALARM HI STORY REPORT ALARM H i STORY REPORT ALARM HISTORY REPORT - SENSOR ALARM ----- SENSOR ALARM --- - -- IN-TANY ALARM ----- L 1 :87 ANNULAR L 4:87 STP SUMP STP SUMP STP SUMP T 3:91 PRFt°lI U3°t SENSOR OUT ALARM SENSOR OUT ALARM DEC 2, 2010 10:31 DEC 2, 2010 10:32 OVERFILL ALARM FUEL ALARM FUEL ALARM MAR 24, 2007 2:12 DEC 2, ?010 10:28 DEC 2. 2010 10:23 LOW PRODUCT ALi�RM FUEL (ALARM UP! 14. 2010 14:5b FUEL ALARM JJUN 6. 2010 17:10 APR 20. 21710 15:23 SEP 13, 201 G 12:46 qAy MAR 5, 2010 16:43 HIGH PRODUCT ALARM MAR 24. 2+307 2:13 INVALID FUEL LEVEL JAN 2, 2005 13:29 NOV 30, 2008 12:27 AUG 6, 200? 17:04 PROBE OUT ri END * ?� �: x ?� END MAY 20. 9'005 8:28 DELIVERY NEEDED NOV 26, 2010 21 :28 NOV 14. 2010 19:13 OCT 21 . 2010 12:52 ALARM HISTORY REPORT ALARM HISTORY REPORT ----- SENSOR ALARM ----- - --- SENSOR ALARM ----- L 2:91-67ANNULAR L 5:87 SYP.SUMP ANNULAR SPACE PIPING SUMP SENSOR OUT ALARM SENSOR OUT ALARM DEC 2. 2010 10:31 DEC 2. 2010 10:32 x * END * * FUEL ALARM FUEL REARM DEC 2. 2010 10:27 DEC 2, 2010 10:22 SENSOR OUT ALARM SENSOR OUT ALARM NOV 5, 2009 10:52 NOV 5, 2009 10:52 ALARM HISTORY REPORT ---- IN-TANK ALARM -- T 4:DIESEL x x * END ri .x * f END LOW PRODUCT ALARM AUG 23, 2010 10:45 NOV 15. 2009 13:32 NOV 21 2009 10:55 INVALID FUEL LEVEL AUG 24. 2010 7:46 NOV 15, 2009 21 :35 SEP 12, 2009 17:11 ALARM HISTORY REPOPT ALARM HISTORY REPORT DELIVERY NEEDED. -_--- SENSOR ALARI4 - _- ---- SENSOR ALARM DEC ----- DEC 19. 2009 6:23 L 3:DIESEL ANNULAR L 6:91 STP SUMP NOV 3, 2006 11 :48 ANNULAR SPACE. STF SUMP OCT 2?, 2006 11 : 11 SENSOR OUT ALARM SENSOR OUT ALARM DEC 2. 2010 10:32 DEC 2, 20t0 10:32 FUEL ALARM FUEL ALARM DEC 2, 2010 10:29 DEC 2, 2010 10:21 SENSOR OUT ALARM SENSOR OUT ALARM NOV 5, 2009 10:52 NOV 5. 2009 10:52 ALARM HISTORY REPORT r�� --- - SEVISOR ALARM -- -- -- L ?:DIESEL STF' STP SUMP ALARM HISTOR`,' REPORT SEPMSOR OUT ALARM DEC 2. 2010 10:32 ----- SENSOR ALARM L10:DISP.5-6 FUEL ALARM DISPENSER PAN DEC 2, 2010 10:23 SENSOR OUT ALARM DEC 2, 2010 10:32 FUEL ALARM NOV 23, 2010 2:.-J:51 FUEL ALARM DEC 2. 2010 10:26 SENSOR OUT ALARM NOV 5, 2005 10:51 END x END x ALARM HISTORY REPORT ----- SENSOR ALARM --- -- L 2:DISP. 1-2 DISPENSER PAN ALARM HISTORY REPORT SENSOR OUT ALARwI DEC 2, 2010 10:32 ----- SENSOR ALARM ----- L11 :DISP.7-8 FUEL ALAPJl DISPENSER PAN DEC 1. 2010 10:27 SENSOR OUT ALARM DEC 2, 2010 10:32 SENSOR OUT ALARH NOV 5, 2009 10:52 FUEL ALARM. DEC 2, 2010 10:25 SENSOR OUT ALARM NOV 5. 2009 10:52 X x x END * ri X w END ALARM HISTORY REPORT ----- SENSOR ALARM L 9:DISP.3-4 DI SPEI9SER PAN SENSOR OUT ALARM DEC 2, 2010 10:32 FUEL ALARM DEC 2, 2010 10:24 SENSOR OUT ALARM NOV 5, 2009 10:52 RICH ENYMONMENTA.L 5643 BROOKS CT. BAKERSFIELD, CA. 93308 OFFICE(661)392-8687 FAX(661)392-0621 PRODUCT LINE LEAK DETECTOR TEST WORK SKEET W/0#: FACILITY NAME: OSWELL LIOUORS FACILITY ADDRESS: 100 S. OSWELL ST BAKERSFIELD, CA PRODUCT LINE TYPE: PRESSURE PRODUCT LEAK DETECTOR TYPE TEST TRIP PASS BELOW P.S.I. OR SERIAL NUMBER 3 G.P.H. FAIL UNL87 I.JD TYPE: MECHANICAL 10 PASS YES SERIAL# RED JACKET PREM91 UD TYPE: MECHANCIAL PASS SERIAL# RED JACKET YES 10 DIESEL LID TYPE: MECHANICAL PASS YES 10 SERIAL# RED JACKET LID TYPE. YES PASS SERIAL# NO FAIL I CERTIFY THE ABOVE TESTS WERE CONDUCTED ON THIS DATE ACCORDING TO RED JACKET PUMPS FIELD TEST APPARATUS TESTING PROCEDURE AND LIMITATIONS. THE MECHANICAL LEAK DETECTOR TEST PASS/FAIL IS DETERMINED BY USING A LOW FLOW THRESHOLD TRIP RATE OF 3 GALLONS PER HOUR OR.LESS AT 10 P.S.I.I ACKNOWLEDGE THAT ALL DATA COLLECTED IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. TECHNICIAN: AN MASON SIGNATURE: DATE: 12-2-10 0 SWRCB,January 2006 Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and printouts from tests(if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: OSWELL LIQUOR I Date of Testing: 12-2-10 Facility Address: 100 S.OSWELL ST BAKERSFIELD,CA Facility Contact: Phone: Date Local Agency Was Notified of Testing: Name of Local Agency Inspector(tfpresent during testing): ESTHER DURAN 2. TESTING CONTRACTOR INFORMATION Company Name: RICH ENVIRONMENTAL Technician Conducting Test: RYAN MASON Credentials': 0 CSLB Contractor X ICC Service Tech. 0 SWRCB Tank Tester 0 Other(Spec) License Number(s): 8029371-UT 3. SPILL BUCKET VESTING INFORMATION Test Method Used: X Hydrostatic 0 Vacuum 0 Other Test Equipment Used:VISUAL Equipment Resolution:.0.00 Identify Spill Bucket(By Tank 1 -' 3 4 Number, Stored Product, etc.) U'Z87 NIASTER FILL UN"7 SLAVE FILL PREM91 FILL DIESEL Bucket Installation Type: X Direct Bury X Direct Bury X Direct Bury X Direct Bury 0 Contained in SuLmp 0 Contained in Sump 0 Contained in Sump 0 Contained in Sump Bucket Diameter: 12" 12" 12" 12" Bucket Depth:. 16" 16" 16" 16" Wait time between applying 30 MIN 30 MIN 30 MIN 30 MIN vacudm/water and start of test: Test Start Time(TO: 9:OOAM 9:00AM 9:OOAM 9:OOAM Initial Reading.(RF): 14" 14" 14" 14" Test End Time(TF): 10:OOAM 10:OOAM I O:OOAM 10:00AM Final Reading(RF): 14" 14" 14" 14" Test Duration(TF—TO: I-HOUR 1-HOUR 1-HOUR I-HOUR Change in Reading(RF-R�: W 0" 0" 0" Pass/Fail Threshold or +/-0.00 +/-0.00 +/-0.00 +/-0.00 Criteria: Comments—(include information on repairs made prior to testing, and recommended follow-up for failed tests) CIERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true,accurate,and in full compliance with legal requirements. Technician's Signature: Date: 12-2-10 State laws and regulations d not curWntly require testing to be performed by a qualified contractor.However,local requirements may be more stringent. MONITOR CERT. FAILURE "PORT SITE NAME: OSWELL LIQUOR DATE: 12-2-10 ADDRESS: 100 S. OSWELL ST TECHNICIAN: RYAN MASON CITY: BAKERSFIELD SIGNATURE: REPAIRS: NONE PARTS INSTALLED: NONE TIE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMENTAL FOR ANY NEEDED RETESTING.THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON-COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN LEFT ON-SITE FOR YOUR CONVIENENCE.