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HomeMy WebLinkAbout1030 OAK ST 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: CIRCLE K#2708606 City: BAKERSFIELD CA Zip:93304 Site Address: 1030 OAK ST. Contact Phone No: 861-8048 Date of Testing/Service: 12/21/2010 Facility Contact Person: MANAGER-DONNA Make/Model of Monitoring System:TLS-350 Work Order Number: 3179837 IIIIIIIIIIIIIIIIIIII 29 B.Inventory of Equipment Tested/Certified IE Check the appropriate boxes to indicate specific equipment inspected/serviced Tank ID: T-1 UNL REG Tank ID: T-2 UNL X In-Tank Gauging Probe. Model: MAG PROBE X In-Tank Gauging Probe. Model: MAG PROBE X Annular Space or Vault Sensor. Model: 409 Annular Space or Vault Sensor. Model: 409 X Piping Sump/Trench Sensor(s). Model: SMART SENSOR 102 SMART SENSOR 102 Piping SumplTrench Sensor(s). Model: X Fill Sump Sensor(s), Model: 208 208 Fill Sump Sensor(s). Model: �( 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 OverfilllHigh-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). Tank ID: - TanklD: In-Tank Gauging Probe. Model: MAG PROBE In-Tank Gauging Probe. Model: _X1 Annular Space or Vault Sensor. Model: 409 Annular Space or Vault Sensor. Model: X Piping Sump/Trench Sensor(s). Model: SMART SENSOR 112 Piping Sump/Trench Sensor(s). Model: _X1 Fill Sump Sensor(s). Model: 208 Fill Sump Sensor(s). Model: X Mechanical Line Leak Detector. Model: LD2000 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). Dispenser : 1-4 Dispenser ID: ®Dispenser Containment Sensor(s) Model: BRAVO FLOATS Dispenser Containment Sensor(s) Model: X❑Shear Valve(s). Shear Valve(s) QX Dispenser Containment Float(s)and Chain(s). Dispenser Containment Float(s)and Chain(s). Dispenser ID: Dispenser ID: F]Dispenser Containment Sensor(s) Model: Dispenser Containment Sensor(s). Model: ❑ ShearValve(s). Shearvalve(s). 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. 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): MX System set-up X❑Alarm history report Technician Name(print): FRANCISCO CASTRO Signature: A�vafis- 3 102- Certification No.: B37663 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: 12/21/2010 Monitoring System Certification Page 1 of 3 IIIIIIIIIIIIIIIIIIII 30 Based on CA form dated 03/08 IE Monitoring System Certification Site Address , 1030 OAK ST. Date of Testing/Service: 12/21/2010 D. Results of Testing/Servicing Software Version Installed: 329.01 Complete the following checklist: El Yes No• Is the audible alarm operational? 0 Yes No* Is the visual alarm operational? Q Yes F1 No• Were all sensors visually inspected,functionally tested,and confirmed operational? DX 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/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 1:1 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) ❑ Sump/Trench Sensors; ❑x Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ❑X Yes El No El 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? Fx Yes' R 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' Q 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. EX Yes F—I No• Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports,if applicable. Q 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: REPLACED ANNULAR SENSOR ON 89 PRODUCT(MODEL 409) Page 2 of 3 Based on CA form dated 03/08 Monitoring System Certification Site Address: 1030 OAK ST. Date of Testing/Service: 12/21/2010 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? Ifl Yes ❑No• Were all tank gauging probes visually inspected for damage and residue buildup? El Yes ❑No Was accuracy of system product level readings tested? QYes ❑No• Was accuracy of system water level readings tested? LE Yes ❑No• Were all probes reinstalled properly? E]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? ❑x 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 X 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• ©N/A For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? ❑Yes ❑No• O N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? ❑Yes ❑No' ❑x 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• M N/A For electronic LLDs,have all accessible wiring connections been visually inspected? MYes ❑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 03/08 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: CIRCLE K#2708606 I DateofTesting: 12/21/2010 Facility Address: 1030 OAK ST. , BAKERSFIELD, CA, 93304 Facility Contact: MANAGER - DONNA Phone: (6 61) 861-8048 Date Local Agency Was Notified of Testing : 12/10/2010 Name of Local Agency Inspector(if present during testing): Ernie 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: FRANCISCO CASTRO Credentials: CSLB Licensed Contractor SWRCB Licensed Tank Tester License Type: A / UT I License Number: 743160 / 8026747 Manufacturer Training Manufacturer Component(s) Date Training Expires OPW SPILL BUCKET 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 REG FILL Efl ❑ ❑ ❑ ❑ ❑ ❑ ❑ Spill Box 2 PLU FILL El ❑ ❑ ❑ ❑ ❑ ❑ El- Spill Sox 3 SUP FILL X ❑ ❑ ❑ ❑ ❑ ❑ ❑ El El 0 El El El El F1 El El El El El E El El E El 10 1 El El El F1 El 0 E E El El El EJ El El El F-1 El El El El- F] El 0 D El El El El El El E E El j El El El El 1:1 1:1 El 0 If hydrostatic testing was performed,describe what was done with the water after completion of tests: SPILL BUCKETS TEST WATER WAS LEFT ON SITE WASTE DRUM. 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: ,� Date: 12/21/2010 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: CIRCLE K#2708606 DateofTesting: 12/21/2010 Facility Address: 1030 OAK ST. , BAKERSFIELD, CA, 93304 Facility Contact: MANAGER - DONNA Phone: (6 61) 861-8048 Date Local Agency Was Notified of Testing: 12/10/2010 Name of Local Agency Inspector(if present during testing): Ernie 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: FRANCISCO CASTRO Credentials I: E CSLB Contractor ❑ICC Service Tech. ❑SWRCB Tank Tester E Other(Specify)A / UT License Number: 743160 / 8026747 3. SPILL BUCKET TESTING INFORMATION Test Method Used: X❑ Hydrostatic ❑ Vacuum ❑ Other Test Equipment Used:MEASURING TAPE Equipment Resolution:VISUAL Identify Spill Bucket(By Tank I 1 REG FILL Z 2 PLU FILL 3 3 SUP FILL 4 Number, Stored Product, etc.) ❑ Bucket Installation Type: Direct Bury ❑Direct Bury ❑Direct Bury ❑Direct Bury X❑Contained in Sump ❑ Contained in Sump X❑Contained in Sump ❑Contained in Sump Bucket Diameter: 11" Bucket Depth: loll 10" loll Wait time between applying 5MIN 5MIN 5MIN vacuum/water and starting test: Test Start Time(TI ): 09:00 09:00 09:00 Initial Reading(RI ): 7.511 8" 811 Test End Time(TF ): 10:00 10:0 0 10:00 Final Reading R 7.511 8" 811 ( F ): Test Duration: 1HOUR 1HOUR 1HOUR Change in Reading(R F-RI ): 0 0 0 Pass/Fail Threshold or 0 0 0 Criteria: estResult - s „aEl ass ? ail Pass ait Comments- (include information on repairs made prior to testing, and recommended follow-up for failed tests) CERTIFICATION OF TECIIl"41CIAN 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: I� -,,,,,i � d Date: 12/21/2010 I State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements Work Order: 3179837 I (PSO)3t(FSV)Testing Form-Version 1-612512007 I Emergency Shut Off(ESO) & Dispenser Emergency Shu off Valve (ESV) ANNUAL TEST RECORD LOCATI S AND TEST DATA Testing __ I Company: �'tK! ate: Location Name: l C 3(5) tore#: Z70ffacC State ID#: Address: 10-�o <5qIL 5T ity: ":(r 0 state: Emereency Shut Off ESO Testing Resul On in accordance with"ESO Vendor Letter(3 21-05).doc",from Valero's Retail Compliance Department,as a part of annual compliance t g,this representative tested the Emergency Shut Off ESO switches indicated on this sketc Findings listed below: Emergency Shut Off(FSO) If No,Provide Operational' N Maintenance Log t Date Called: i Dispenser Emergency Shutoff Valve ES Testing Results On 12 Al&e in accordance with NFPA 30A this represen ative tested the automatic-closing feature of the Dispenser Emergency Shutoff VALVE(S)(ESV) located in the supply lines at ffie base of each individual island type dispenser indicated on the diagram bel�w. Each device{#} in all, would automaticall •close. Findings listed below: Disp.Emergency Shut Oft' If No,Provide Valve(ESV)Operational? ey)N Maintenancc Log* Date Called: i Site Map Of Location and Placement of Devices Tested: Aso G fcl(, VC 5 .89 3 � f Ffv fl FIV � z 5�P Si nature of Representative: Tanknology Inc. 11000N.MoPac Expressway,Suite 500,Austin,Texas 78759 i Tin kw1ogy 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759 (512)451-6334 FAX(512)459-1459 TEST DATE:12/21/10 WORK ORDER NUMBER3179837 CLIENT:CIRCLE R STORES SITE:CIRCLE R#2708606 COMMENTS Witness Annual Monitor Certification Testing with Inspector Ernie Medina Bakersfield Fire. Site contacted and emailed 12/15/10, Confirmed with °DYNDA" Replaced (1) VR-409 sensor, (1) Hour labor for parts replaced and toubleshooting. parts replaced to be billed on WO# 3179954. PARTS REPLACED TV- �4UANTITIf SPIR® N�k HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) 'HELIUM PINPOINT L EAWJEST Rr ES.fiU rTS . i Printed 12/27/2010 07:55 KOHLMEYER SITE DIAGRAM v Tank m*Vy 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759 (512)451-6334 FAX(512)459-1459 TEST DATE:12/21/10 WORK ORDER NUMBER3179837 CLIENT:CIRCLE K STORES SITE: CIRCLE K#2708606 PROPANE breaker ESO � TLS Circle K #2708606 S V 0 pv zero O #3 cas � �G C, sG-o x'001 -q i #2 #1 s s� AIR/ H2O s Printed 12/27/2010 07:55 KOHLMEYER Work Order: 3179837 ALARM HISTORY RPPOk; ALARM HISTORY REPORT ALARM HISTORY REPORT ---- IN-TANK ALARh1 ----- - I t4-TH141: ALARM ----- ----- IN-TANK ALARM ----- T 1 :UP1L-AEG T 2:1-1NL-PRE11 T 3:UNL-111D HIGH WATER ALARM H I CH WATER ALARt,1 HIGH WATER ALARM DEC 21, 2010 10:23 All DEC 2I, 2010 10:28 Am DEC 21, 2010 10:'_'6 ,1!1 OVERFILL ALARM OVERFILL ;LARNl OVERFILL ALARH DEC 21, 2010 10:56 AM DEC 21 , 2010 10:30 AM DEC 21. 2010 10:31 Al°1 NOV 16. 2010 9:3- HM LOW PRODUCT ALHRM L041 PRODUCT ALARM DEC 21, 2010 10: 11 AM DEG r '2010 10:45 AM LOW PRODUCT ALHRM DEC 7, 2010 10:32 AM DEC: 21 , 2010 10:1:3 Att INVALID FUEL LEVEL OCT 15. 2010 :3:17 PH DEC 21, 2010 10:12 AM INVALID FUEL LEVEL OCT 5. 2010 1 l :31 A'•1 DEC 21, 2010 10:32 AM PROBE OUT DEC 21, 2010 10:18 AM INVALID FUEL LEVEL DEC 21, 2010 10:57 AM DEC 7, 2010 10:45 AM DEC 21. 2010 10:13 0-01 DEC 21. 2010 10:44 AM PROBE OUT PROFlE QUIT DEC 1 , :'01 U 1 U:1 1 AM DEC ^_1 . 2010 10::3E HI'•i DEC 1 2010 10:32 fVM DEC '21, 2010 10:13 Fh: HIGH WATER UJARN I NC; DEC 21• 2010 10:15 AM DEC 7. 2010 9:5:3 Alt DEC 21, 9-010 10:23 HM DEC 7, 2010 10:45 AM HIGH WATER WARNIN HIGH WATER wHRN[ru �' DEC 2 G 1. 2010 I0:28 AM DEC 21, 2010 16:17 ALARM H]r Pi .�T�iRY REPORT DELIVERY NEEDED ----- SENSOR ALARM ----- ALARM HISTORY REPORT DEC 21, 2010 10:13 Ar, L 7:87 FILL --- SMARTSEPISOR ALARM FUEL ALHALARM MP -- PIPING ti s 1 :B7 TURBINE ALARM HISTORY kEF'JRT DEC '21, '2010 9:09 All INSTALL ALARM DEC 21. 2010 9:06 AM SENOR ALARM ----- SENSOR OUT ALARM DEC: 21, 2010 6:54 AM WATER ALARM L 1 .87 ArJNULAR DEC 21. 2010 5:07 HM ANNULAR SPACE FUEL ALARM ALARM HI' TuR'1 F.EPORL WATER ALARM DEC 21 , 2010 9:11 Al°I DEC 21.- 2010 9:05 AM :;EIJSOR OUT ALARM -` S-EtUSOR ALARM ----- ' DEC 21, 2010 6:5AM 4 A L 8:91 FILL F'I P I l'IG SUMP ALAR11 HISTORY REPORT FUEL ALr;Rm HLARh1 HIwTt R`i REP-DRT DEC 21. 2010 9:36 AM --- SMARI'SENSOR ALARM SENOR -- SENOR GUT ALARM s 2:91 TURBINE ---- SENSOR ALARM - -- DEC 21, 2010 B:54 Ni INSTALL ALARM L 2:91 ANNULAR DEC 21 , 2010 9:35 AM At4liuLAR SPACE FUEL ALARM WATER ALARM DEC 21 - 2010 '3:3a At, ALARM HISTORY REPORT I DEC 21. 2010 9:35 AM SENSOR OUT ALARM __ SEpl54-R ALARM -- INSTALL ALARM DEC 21. 2010 8:54 t41 L 9:89 FILL DEC 21. 2010 9::35 AM PIPING :LKI FUEL ALARM ALARM HISTORY REPORT DEC 21, 2010 9:31 AM ALARM HISTORY REPORT ----- SENSOR ALARM ----- SEt4✓OR OUT ALARM L 3:69 ANNULAR DEC 21, 2010 B:54 AM --- SMARTSE14SOR ALARM -- ANNULAR SPACE s 3:89 TURBINE FUEL ALARM INSTALL ALARM DEC 21 . 2010 4:30 Al°t DEC 21, 2010 9:34 AM FUEL ALARM WATER ALARM DEC 21, 2010 9:30 µl•1 DEC 21, 2010 9:33 AM FUEL ALARM INSTALL ALARM DEC 21 . 2010 9:2a AM DEC 21, 2010 9:33 AM i Tanknology Inc. 11000 N.MoPac Expressway,Suite 500,Austin,Texas 78759 Tanknology 11000 N. MoPac Expressway,Suite 500 Austin,Texas 78759 Phone: (512)451-6334 Fax: (512)459-1459 Date Printed and Mailed: 12/27/2010 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR CRAIG PERKINS 1501 TRUXTUN AVE. BAKERSFIELD, CA. 93301 Test Date: 12/21/2010 Order Number: 3179837 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CIRCLE K#2708606 1030 OAK ST. BAKERSFIELD, CA. 93304 Testing performed: Leak detector tests Monitor Certification Secondary Containment-Spill Container Sincerely, Dawn Kohlmeyer Manager, Field Reporting �,�� TANKNOLOGY CERTIFICATE OF TESTING 8501 N MOPAC EXPRESSWAY;SUITE 400 AUSTIN,TEXAS 78759 TELEPHONE(512)451-6334 FAX(512)459-1459 PURPOSE: COMPLIANCE TEST RESULT SUMMARY REPORT TEST DATE: 12121/10 WORK ORDER NUMBER: 3179837 CUSTOMER PO: Rex Abacan CLIENT: CIRCLE K STORES SITE:CIRCLE K#2708606 495 E.RINCON,STE.150 1030 OAK ST. CORONA,CA 92879 BAKERSFIELD,CA 93304 REX ABACAN MANAGER-DONNA (951)270-5193 (661)861-8048 TEST TYPE: TLD-1 Product Pipe Ti htness Test Results ID ? P ODUCTr M M TERIAL pDTLYryPER q BSTRES�ULT D AB r- F RATE (Dgph) FIVALVE'p LINE 4 F g` '4 kL.' UNCTIO T1-87 1 REG M-LEAD DW FIBERG PRESSURE Y T3-89 2 PLUS DW FIBERG PRESSURE Y T2-91 3 SUPER DW FIBERG PRESSURE Y Existing Line Leak Detector Test `EXISTINgpLE/�DETECTOR,#1 � �� �v� EXISifING�LEAK�DETEG�TOR;#2 LINE BAV ^w ID x ' MANUFACgTURER MODEL# SERIAL•# RESULT M ANUFATaURER MODE # SCR # RESULT _ . T1-87 1 VAPORLESS LD2000 16476 P T3-89 2 VAPORLESS LD2000 07111268 P T2-91 3 VAPORLESS LD2000 16478 P New Replacement Line Leak Detector Test Di LEAWDEE E t '_i r a .. "/ t D, ` 4�L - g , �. r ARNAM 4a LINE" MANUgCTUR R MOD EL# 'SERIAL# -RESULT MANUFACTURERS MODEL# S nRESUL ID° t ERI' # For owner detailed report information,visit www.tanknology.com and select On-Line Reports-WRAP,or contact your local Tanknology office. Tester Name:FRANCISCO CASTRO Technician Certification Number:6753 w Printed 12/27/2010 07:55 KOHLMEYER INDIVIDUAL TANK INFORMATION AND TEST RESULTS 7bnknofogy TEST DATE:12/21/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3179837 CLIENT:CIRCLE K STORES AUSTIN,TEXAS 78759(512)451-6334 SITE:CIRCLE K#2708606 s yFANK�11!IFORMATiON _ T .tA , WWAW Tank ID: T1-87 1 Tank manifolded: NO Bottom to top fill in inches: Product: REG UNLEAD Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 9,684 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 353 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TANK=`,TEST RESULTS Test_Method va uTec ? �,``li K DETECTOR TEST�RESIlL _ W T est'method FTA _ _ Dipped Water Level: Start(in) End(In) 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: 16476 Inclinometer reading: Open time in sec: 4.00 : 27 VacuTect Test Type: NOT Resiliency Holding psi: 27 NOT VacuTect Probe Entry Point: TESTED Test leak rate ml/m: 189.0 TESTED Pressure Set Point: Metering psi: 17 Tank water level in inches: Calib.leak in gph: 3.00 Water table depth in inches: Results: PASS Determined by(method): Result: COMMENTS COMMENTS type to � LINETE$ �RESULIT3 -D �- G, ` A .. Material: DW FIBERG Diameter(in): 2.0 Length(ft): 120.0 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 12/27/2010 07:55 INDIVIDUAL TANK INFORMATION AND TEST RESULTS i Tin TEST DATE:12/21/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3179837 CLIENT:CIRCLE K STORES AUSTIN,TEXAS 78759(512)451-6334 SITE:CIRCLE K#2708606 - ,.__ 1NF.OR ATJOPI Tank ID: T3-89 2 Tank manifolded: NO Bottom to top fill in inches: Product: PLUS Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 9,684 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG. Stage 11 vapor recovery: ASSIST CP installed on: COMMENTS TANK STRESU.TS TesfMethod:v' cuT z � ,.. _ e'dt L..EAKxDETECTaRtTESTRESULTS- TestratethOdz Dipped Water Level: Start(in) End(in) 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: 07111268 Inclinometer reading: Open time in sec: 4.00 VacuTect Test Type: NOT Holding psi`. 25 Resiliency cc: 70 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 t rw A B UNE TESLIRESUL�TS Test typ . @ TLD p Material: Dw FIBERG Diameter(in): 2.0 Length(ft): 120.0 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 12127/2010 07:55 INDIVIDUAL TANK INFORMATION AND TEST RESULTS 7br TEST DATE:12/21/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3179837 CLIENT:CIRCLE K STORES AUSTIN,TEXAS 78759(512)451-6334 SITE:CIRCLE K#2708606 " .-INFORMATION Tank ID: T2-91 3 Tank manifolded: No Bottom to top fill in inches: Product: SUPER Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 9,684 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TAN' 1EST RESULTS Test Meth �Tod aeuT ctEAKUET OR TEST RESULTS Tres method FTi► 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: 16476 Inclinometer reading: Open time in sec: 3.00 Holding psi: 22 VacuTect Test Type: NOT Resiliency cc: 70 NOT VaCUT@Ct Probe Entry Point: TESTED TESTED Test leak rate ml/m: 189.0 Pressure Set Point: Metering psi: 18 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 TESLINEStJLTSA B rest - C D Material: Dw FIBERG Diameter(in): 2.0 Length(ft): 120.0 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 12/27/2010 07:55