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Home My WebLink AboutMONITORING CERT 1-24-11 r MONITORING SYSTEM CERTIFICATION IIIIIIIIIIIIIIIIIIII 17 For Use By All Jurisdictions Within the State of California IE 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 this date. A. General Information Facility Name: Mesa Marin Food Mart Bldg.No.: Site Address: 11101 Highway 178 City: Bakersfield Zip: 93306 Facility Contact Person: Moe Contact Phone No.: 661-3664886 Make/Model of Monitoring System: Veeder-Root TLS 350 Date of Testing/Servicing: 01/24/2011 B. Inventory of Equipment Tested/Certified Check the appropriate bows to in ate specific equipment inspectedherviced: Tank ID: 10000 gal.Regular Tank ID: 10000 gal.Plus [X] In-Tank Gauging Probe. Model:847390-107 U In-Tank Gauging Probe. Model:847390-107 ❑ Annular Space or Vault Probe. Model: ❑ Annular Space or Vault Sensor. Model: ❑ Piping Sump/Trench Sensor(s). Model: ❑ Piping Sump/Trench Sensor(s). Model: ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s). Model: ❑ Mechanical Line Leak Detector. Model: ❑ Mechanical Line Leak Detector. Model: [X] Electronic Line Leak Detector. Model:WPLLD U Electronic Line Leak Detector. Model: wPLLD U Tank Overfill/High Level Sensor. Model:847390-107 [x] Tank Overfill/High Leval Sensor. Model: 847390-107 ❑ Other(specify equip.type and model in Sec. E on Pg.2) ❑ Other(specify equip.type and model in Sec. E on Pg.2) Tank iD: 10000 gal.Super Tank ID: 10000 gal. Diesel [x] in-Tank Gauging Probe. Model:847390-107 [x] In-Tank Gauging Probe. Model:847390-107 ❑ Annular Space or Vault Sensor. Model: ❑ Annular Space or Vault Sensor. Model: ❑ Piping Sump/Trench Sensor(s). Model: ❑ Piping Sump/Trench Sensor(s). Model: ❑ Fill Sump Sensors(s). Model: ❑ Fill Sump Sensor(s). Model: [] Mechanical Line Leak Decector. Model: ❑ Mechanical Line Leak Detector. Model: U Electronic Line Leak Detector. Model:WPLLD U Electronic Line Leak Detector. Model: wPLLD [x] Tank Overfill/High Level Sensor. Model:847390-107 U Tank Overfill/High Level Sensor.Model:847390-107 ❑ Other(specify equip.type and model in Sec. E on Pg.2) ❑ Other(specify equip.typs and model in Sec. E on Pg.2) Dispenser ID: 1 &2 Dispenser ID: 3&4 ❑ Dispenser Containment Sensor(s). Model: ❑ Dispenser Containment Sensor(s). Model: [x] Shear Valve(s). [x] Shear Valve(s). U Dispenser Containment Float(s)and Chain(s). U 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 Chains(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/services in accordance with the manufacturers'guidlines.Attached to this Certification is information(e.g.manufacturers'checklist)necessary to varify that this information is correct and a plot plan showing the layout of monitoring equipment.For equipment capable of generating such reports,I have attached a copy of the report; (check all that apply) Q System Set-qp [x]Alarm history report Technician Name(print): Kristopher Kerns Signature: Certification No: 834108 License No:804904 Testing Company Name: Confidence UST Services,Inc. Phone No: 800-339-9930 Site Address: 11101 Highway 178,Bakersfield,CA 93308 1 1111111 IIIII 1111111 18 —Date of Testing/Servicing: 01/24/2011 IE D. Results of Testing/Servicing Software Version Installed: 14.00 Complete the following checklist: Lx] Yes ❑ No* Is the audible alarm operational? x 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 the 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) Hx N/A operational? x Yes ❑ No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary ❑N/A containment monitoring system detects a leak,fails to operate, or is electrically disconnected? If yes: which sensors initate positive shut-down? ❑Sump/Trench Sensors❑Dispenser Containment Sensors Did you confirm positive shut-down due to leaks and sensor failure/disconnected? U Yes; ❑ No; U Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e. no L]N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visual and audible at the tank fill point(s)and operating properly?If so,at what percent of tank capasity does the alarm trigger? E9p % [x] 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? E]Product; ❑ Water. If yes,describe causes in Section E,below. x N * Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports, if applicable. [x_1 Yes No* I Is all monitoring equipment operational per manufacturer's specifications? *In Section E below,describe how and when these deficiencies were or will be corrected. E. Comments: I replaced the Overfill Light Bulb,the original bulb was no longer working. I also replaced a blown out fuse on the Out Put Relay module,which controls the overfill alarm. After the repairs were made they were retested and confirmed operational. F. In-Tank Guaging/SIR Equipment: M Check this box if tank guaging is used only for inventory control. ❑ Check this box if tank guaging or SIR equipment is installed. This section must be completed if in-tank guaging equipment is used to perform leak detection monitoring. Complete the following checklist: E Yes ❑ No* Has all input wiring been inspected for proper enter and term ination,including testing for ground faults? x J Yes No* Were all tank guaging probes visually inspected for damage and residue buildup? __x j Yes No* Was accuracy of system product level readings tested? x Yes No* Was accuracy of system water level readings tested? x Yes No* Were all probes reinstalled properly? 1�j Yes ❑ No* 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): ❑Check this box if LLD's are not installed. Com lete the following checklist: Lx] Yes ❑ No* For equip. start-up or annual equipment certification,was a leak simulated to varify LLD performance? (Check all that apply) Simulated leak rate: E3 g.p.h.: ❑0.1 g.p.h.; 00.2 g.p.h.; x Yes No* Were all LLD's confirmed operational and accurate within regulatory requirments? x Yes No Was the testing apparatus properly calibrated? ❑ Yes No* For mac amca LLD's,does the LLD restrict product ow i rt etects a ea ? x N/A [x] Yes No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a leak? ❑ N/A ❑ Yes No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system is ❑ N/A disabled or disconnected? [x] Yes No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system ❑ N/A malfunction or fails a test? [x] Yes No* For electronic LLD's,have all accessible wiring connections been visually inspected? ❑ N/A X Yes No 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. H. Comments: MESA MARIN PIT STOP MARKET SYSTEM SETUP` I COMMUNICATIONS SETUP 11101 HWY 178 ' - - - - - - - - - BAKERSFIELD,CA 93306 JAN 24,2011 8:34.AM JAN 24, 2011 8:34 AM PORT SETTINGS: 1 (RS-232) SYSTEM.U.S. UNITS COMM BOARD 9600 SYSTEM STATUS REPORT SYSTEM LANGUAGE STOP BIT 1 STOP. - - - - - - - - - - - - ENGLISH DATA LENGTH: 7 DATA ALL FUNCTIONS. NORMAL SYSTEM DATE/TIME FORMAT INVENTORY REPORT MON DD YYYY HH:MM:SS xM MESA MARIN AUTO TRANSMIT SETTINGS: PIT STOP MARKET AUTO LEAK ALARM LIMIT T ! :UNLEADED 11101 HWY 178 DISABLED VOLUME 8043 GALS BAKERSFIELD.CA 53306 ULLAGE - 1942 GALS AUTO NIGH WATER LIMIT j 90% ULLAGE- 943 GALS SHIFT TIME 1 : 4:30 AM DISABLED TC VOLUME - 8023 GALS SHIFT TIME 2 DISABLED AUTO OVERFILL LIMIT HEIGHT - 71 .21 INCHES SHIFT TIME 3 DISABLED DISABLED WATER VOL - 0 GALS SHIFT TIME 4 DISABLED 1)1 DISABLED* -PRODUCT ` WATER - 0.00 INCHES AUTO THEFT LIMIT TEMP - 63.4 DEG F j PERIODIC TEST WARNINGS DISABLED t DISABLED AUTO DELIVERY START � j ANi,IUAL PEST WARNINGS DISABLED T 2:DIESEL DISABLED VOLUME = 2305 GALS r AUTO DELIVERY END ! ULLAGE m 7680 GALS PRINT TC VOLUMES AUTOBEXTERNAL INPUT ON 90. ULLAGE- 6661 GALS ENABLED DISABLED TC VOLUME - 2294 GALS AUTO EXTERNAL INPUT OFF HEIGHT - 26.70 INCHES TEMP C0111PENSiATION DISABLED WATER VOL - 0 GALS VALUE (DE(3 F ) : 60.0 WATER = 0.00 INCHES AUTO SENSOR FUEL ALARM i TEMP - 69.6 DEG F H-PROTOCOL DATA FORMAT DISABLED SENSOR WATER ALARM HEIGHT DISABLED RE-DIRECT LOCAL PRINTOUT AUTO SENSOR OUT.ALARM, T 3:SUPER UNLEADED DISABLED DISABLED VOLUME - 3336 GALS ULLAGE - 6649 GALS ; SYSTEM SECURITY 901% ULLAGE- 5650 GALS CODE 000000 TC VOLUME - .3319 GALS HEIGHT - 34.93 INCHES WATER VOL - 0 GALS RS-232 SECURITY WATER 0.00 INCHES 1 ! TEMP - 66.9 DEG F CODE : 000000 i T 4:PLUS >.d VOLUME - 3599 GALS ULLAGE - 6386 GALS RS-232 END OF MESSAGE 90% ULLAGE- 5387 GALS I DISABLED TC VOLUME - 3582 GALS HEIGHT a 36.95 INCHES WATER VOL - 0 GALS WATER - O.00. INCHES „ TEMP - 66.7 DEG F * x x END t i 1 , IN-TANK SETUP - - - -- - - - - - - t T 2:DIESEL T 3:SUPER UNLEADED PRODUCT.CODE 2 PRODUCT CODE 3 T 1 :UNLEADED THERMAL COEFF : .000470 THERMAL COEFF ::000700 PRODUCT CODE 1 TANK DIAMETER 95.00 TANK DIAMETER 95.00 THERMAL COEFF : .000700 TANK PROFIT..£ 1 PT TANK PROFILE I PT TANK DIAMETER 95.00 .-FULL : 10003 FULL VOL 10003 TANK PROFILE 1 PT �� .t... FULL VOL 10003 AT S/IZ E: 4.0 IN. 6496 FLOAT SIZE: 4.0 IN. 8496 FLOAT SIZE: 4.0 IN. 8496 WATER WARNING 2.0 WATER WARNING : 2.0 HIGH WATER LIMIT: 310 HIGH WATER LIMIT: 3.0 WATER WARNING 2.0 HIGH INTER LIMIT: 3.0 I MAX OR LABEL VOL: 9995 MAX OR LABEL VOL: 9985 ' i OVERFILL LIMIT 890% OVERFILL LIMIT 8986 MAX OR LABEL VOL: 9985 HIGH PRODUCT 95� HIGH PRODUCT `�5y OVERFILL LIMIT 90% 9465 9485 8986 I DELIVERY LIMIT 6b DELIVERY LIMIT 10% HIGH PRODUCT 95:0 9485 600 lOQO f DELIVERY LIMIT 15% 1500 LOW PRODUCT : 500 LOW PRODUCT 500 LEAK ALARM LIMIT: 99 LEAK ALARM LIMIT: 99 LOW PRODUCT 500 SUDDEN LOSS LIMIT: 99 SUDDEN LOSS .LIMIT: 99 LEAK ALARM LIMIT: 99 TANK TILT 0.20 TANK TILT 1 .04 SUDDEN LOSS LIMIT: 99 I TANK TILT 0.30 MANIFOLDED TANKS MANIFOLDED TANKS MANIFOLDED TANK8. 1 Ttt� NONE T#: NONE LEAK MIN PERIODIC: 1500 LEAK MIN PERIODIC: 1500 LEAK MIN PERIODIC: 15% : • 1500 LEAK MIN ANNUAL 159 LEAK MIN ANNUAL 15% 1500 1500 LEAK MIN- ANNUAL 15y • 1500 f PERIODIC TEST TYPE PERIODIC TEST TYPE STANDARD STANDARD PERIODIC TEST TYPE ` STANDARD ANNUAL TEST FAIL ANNUAL TEST FAIL pIrAR11. D I SABLED, ALARM DISABLED ANNUAL TEST FAIL PERIODIC TEST FAIL PERIODIC TEST FAIL ALARM DISABLED PERIODIC DISABLED ALARM DISABLED' PERIODIC TEST FAIL GROSS TEST FAIL GROSS TEST FAIL ALARM DISABLED ALARM ENABLED ALARM ENABLED GROSS TEST FAIL ;.� ALARM ENABLED 'ANN TEST AVERAGING: OFF ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF PER TEST AVERAGING: OFF ANN TEST AVERAGING: OFF PER TEST AVERAGING': OFF TANK TEST NOTIFY: ON TANK TEST NOTIFY: ON � TANK TEST NOTIFY: ON j TNK TST SIPHON BREAK:OFF TNK TST SIPHON BREAK;OFF TNK TST SIPHON BREAK:OFF ' DELIVERY DELAY 10 MIN DELIVERY DELAY 10 MIN DELIVERY DELAY : 10 MIN T 4:PLUS - PRODUCT CODE 4 t PRESSURE LINE LEAK SETUP THERMAL COEFF : .000700 - ` - - - - - - -- - - TANK DIAMETER 95.00 OUTPUT RELAY SETUP TANK PROFILE 1 PT FULL VOL 10003 Q 1 :UNLEADED PIPE TYPE: STEEL R 1 :OVERFILL ALARM FLOAT SIZE: 4.0 IN. 8496 LINE LENGTH: 250 FEET TYPE: 0.20 GPH TEST: ENABLED STANDARD WATER WARNING 2.0 0.10 GPH TEST: DISABLED NORMALLY OPEN HIGH WATER LIMIT: 3.0 SHUTDOWN RATE:. 3.0 GPH T 1 :UNLEADED MAX OR LABEL VOL: 9985 DISPENSE MODE: IN-TANK ALARMS OVERFILL LIMIT 900; STANDARD ALL:OVERFILL ALARM 8.986 SENSOR: NON-VENTED ALL:HIGH PRODUCT ALARM HIGH PRODUCT 959, 9485 DELIVERY LIMIT 10% 1000 LOW PRODUCT 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT 0.74 MANIFOLDED TANKS T#: NONE Q 2:D I ESEL PIPE TYPE: STEEL LEAK MIN PERIODIC: 15% LINE LENGTH: 30 FEET • 1500 0.20 GPH TEST: ENABLED 0.10 GPH TEST: DISABLED LEAK MIN ANNUAL 159 SHUTDOWN RATE: 3.0 GPH 1500 DISPENSE MODE: STANDARD PERIODIC TEST TYPE SENSOR: NON-VENTED STANDARD I ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL PLLD LINE DISABLE SETUP ALARM DISABLED AL � _ - - _ - - - - - GROSS TEST FAIL Q I :UNLEADED ALARM ENABLED - NO ALARM ASSIGNMENTS - ANN TEST AVERAGI : OFF Q 3:SUPER UNLEADED PER TEST AVERAGING: OFF PIPE TYPE: STEEL TANK TEST NOTIFY: ON LINE LENGTH: 50 FEET 0 2:DIESEL 0.20 GPH TEST: ENABLED ` NO ALARM ASSIGNMENTS - TNK TST SIPHON BREAK:OFF 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH DELIVERY DELAY 10 MIN T 3:SUPER UNLEADED DISPENSE MODE:. Q 3:SUFER UNLEADED i STANDARD - NO •ALARM ASSIGNMENTS - SENSOR: NON-VENTED Q 4:PLUS - NO ALARM ASSIGNMENTS - LEAK TEST METHOD TEST WEEKLY : ALL TANK- Q 4:PLUS MON START TIME : 12:30 AM PIPE TYPE: STEEL TEST RATE :0.20 -GAL/HR LINE LENGTH: 50 FEET DURATION 2 HOURS 0.20 GPH TEST: ENABLED 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH T 4:PLUS LEAK TEST REPORT FORMAT DISPENSE MODE: NORMAL STANDARD SENSOR: NON-VENTED SOFTWARE REVISION LEVEL TANK LEAK TEST HISTORY TANK LEAK TEST HISTORY VERSION 14.00 SOFTWARE# 346014-100-A T 2:DIESEL T 3:SUPER UNLEADED CREATED - 97.02.10.13.33 1 LAST GROSS TEST PASSED: LAST GROSS TEST PASSED: S-MODULE# 330160-010-A JAN 24, 2011 12:30 AM JAN 24. 2011 12:30 AM SYSTEM FEATURES: STARTING VOLUME- 2374 STARTING VOLUME- 3352 PERIODIC IN-TANK TESTS PERCENT VOLUME = 23.7 PERCENT VOLUME - 33,5 ANNUAL IN-TANK TESTS TEST TYPE = STANDARD PRECISION PLLD TEST TYPE m STANDARD ? LAST ANNUAL TEST PASSED: LAST ANNUAL TEST PASSED: f NO TEST PASSED NO TEST PASSED FULLEST ANNUAL TEST PASS f FULLEST ANNUAL TEST PASS NO TEST PASSED NO TEST PASSED LAST PERIODIC TEST PASS: JAN 10, 2011 12:30 AM LAST PERIODIC TEST PASS:TANK LEAK TEST HISTORY TEST LENGTH 2 HOURS JAN 24, 2011 12:30 AM TEST LENGTH 2 HOURS STARTING VOLUME- 3700 STARTING VOLUME= 3352 T 1 :UNLEADED PERCENT VOLUME - 37.0 PERCENT VOLUME - 33.5 ' TEST TYPE - STANDARD LAST GROSS TEST PASSED: TEST TYPE STANDARD JAN 24, 2011 12:30 AM STARTING VOLUME- 8275 PERCENT VOLUME - 82.7 FULLEST PERIODIC TEST FULLEST PERIODIC TEST TEST TYPE - STANDARD PASSED EACH MONTH: PASSED EACH MONTH: JAN 10, 2011 12.:30 AM JAN 24. 2011 12:30 AM LAST ANNUAL TEST PASSED: TEST LENGTH 2 HOURS TEST LENGTH 2 HOURS STARTING VOLUME 3700 STARTING VOLUME- 3352 NO TEST PASSED PERCENT VOLUME a 37.0 . PERCENT VOLUME - 33.5 FULLEST ANNUAL TEST PASS TEST TYPE - STANDARD TEST TYPE - STANDARD NO TEST PASSED MAR 29. 2010 12:30 AM TEST LENGTH 2 HOURS MAR 1. 2010 12:30 AM LAST PERIODIC TEST PASS: STARTING VOLUME 5491 TEST LENGTH 2 HOURS JAN 24, 2011 12:30 AM ± PERCENT VOLUME = 54.9 STARTING VOLUME= 3546 TEST LENGTH 2 HOURS TEST TYPE . STANDARD PERCENT VOLUME 35.5 STARTING VOLUME- 8275 TEST TYPE a STANDARD ' PERCENT VOLUME- - 82.7 TEST TYPE STANDARD FEB-15, 2010 12:30 AM TEST LENGTH 2 HOURS STARTING VOLUME- 4191 FULLEST PERIODIC TEST PERCENT VOLUME a 41 .9 PASSED EACH MONTH: TEST TYPE - STANDARD i JAN 24. 2011 12:30 AM ! TEST LENGTH 2 HOUR'S STARTING VOLUME- 8275 > APR 19, 2010 12:30 AM PERCENT VOLUME - 82.7 TEST LENGTH 2 HOURS TEST TYPE =1 STANDARD STARTING VOLUME- 7758 PERCENT VOLUME - 77.6 TEST TYPE STANDARD FEB 15, 2010 12:30 AM TEST LENGTH 2 HOURS STARTING VOLUME= 8185 PERCENT VOLUME a 81 .8 TEST TYPE STANDARD j TANK LEAK TEST HISTORY - --- ? JUN 14, 2010 12:30 AM MAR 1. 2010 12:30 AM i TEST LENGTH 2 HOURS T 4:PLUS TEST LENGTH 2 HOURS STARTING VOLUME- 3422 LAST GROSS TEST PASSED: STARTING VOLUME= 3389 PERCENT VOLUME = 34.2 JAN 24, 2011 12:30 AM PERCENT VOLUME = 33.9 TEST TYPE = STANDARD STARTING VOLUME= 3590 TEST TYPE = STANDARD PERCENT VOLUME = 35.9 OCT 11, 2010 12:30 AM TEST TYPE - STANDARD JUL 26, 2010 12:30 AM TEST LENGTH .2-,HOURS TEST LENGTH 2 HOURS STARTING VOLUME= 7356 LAST ANNUAL TEST PASSED: STARTING VOLUME= 7421 PERCENT VOLUME = 73.5 PERCENT VOLUME = 74.2 TEST TYPE - STANDARD I NO TEST PASSED TEST TYPE = STANDARD .JUL 26. 2010 12:30 AM FULLEST ANNUAL TEST PASS APR 14, 2008 12:30 AM TEST LENGTH 2 HOURS TEST LENGTH 2 HOURS STARTING VOLUME- 3254 NO TEST PASSED STARTING VOLUME- 4807 TEST RCENT VOLUME = 32.5 DA LAST PERIODIC TEST PASS: PERCENT VOLUME 48. 1 JAN 24. 2011 12:30 AM TEST TYPE STANDARD TEST LENGTH 2 HOURS SEP 13, 2010 12:30 AM STARTING VOLUME- 3590 JUN 22, 2009 12:30 AM TEST LENGTH 2 HOURS PERCENT VOLUME = 35.9 TEST LENGTH 2 HOURS STARTING VOLUME= 4018 TEST TYPE - STANDARD STARTING VOLUME= 3375 TEST ERCETNT VOLUME TAPJDA40 2 PERCENT VOLUME - 33.7 TEST TYPE - STANDARD FULLEST PERIODIC TEST JUL 27, 2009 12:30 AM PASSED EACH MONTH: APR 19, 2010 12:30 AM TEST LENGTH 2 HOURS TEST LENGTH 2 HOURS STARTING VOLUME= 3359 .JAN 24. 2011 12:30 AM STARTING VOLUME= 2850 PERCENT VOLUME = 33.6 TEST LENGTH 2 HOURS PERCENT VOLUME = 28.5 TEST TYPE - STANDARD STARTING VOLUME= 3590 TEST TYPE - STANDARD { TESTETYPE -VOLUME� g STANDARD IVOV 8, 2010 12:30 AM AUG 16, 2010 12:30 AM TEST LENGTH 2 HOURS TEST LENGTH 2 HOURS STARTING VOLUME= 5423 MAY 17, 2010 12:30 AM STARTING VOLUME= 7309 PERCENT VOLUME = 54.2 TEST LENGTH 2 HOURS PERCENT VOLUME = 73.1 TEST TYPE = STANDARD STARTING VOLUME= 6711 TEST TYPE = STANDARD PERCENT VOLUME - 67.1 TEST TYPE = STANDARD AUG 23, 2010 12:30 AM MAY 24, 2010 12:30 AM TEST LENGTH 2 HOURS TEST I..ENGTH 2 HOURS STARTING VOLUME= 2893 FEB 8, 2010 12:30 AM STARTING VOLUME= 3450 PERCENT VOLUME - 28.9 TEST LENGTH 2 HOURS PERCENT VOLUME = 34.5 TEST TYPE - STANDARD STARTING VOLUME= 3007 TEST TYPE = STANDARD PERCENT VOLUME = 30.1 TEST TYPE = STANDARD OCT 25. 2010 12:30 AM JUL 26, 2010 12:30 TEST LENGTH 2 HOURS APR 26, 2010 12:30 AM TEST LENGTH 2 HOURS.. ARTING 3699 TEST LENGTH 2 HOURS STARTING VOLUME= 34 TEST TYPE - STANDARD STARTING VOLUME- 3923 PERCENT VOLUME 34. ; PERCENT VOLUME - 39.2 TEST TYPE STANDARD TEST TYPE - STANDARD f AUG 3. 2009 12:30 AM MAY 24, 2010 12:30 AM TEST LENGTH 2 HOURS TEST LENGTH 2 HOURS STARTING VOLUME= 3106 FEB 15, 2010 12:30 AM STARTING VOLUME= 3144 ! PERCENT VOLUME - 31 .1 TEST LENGTH 2 HOURS PERCENT VOLUME - 31 .4 1 TEST TYPE - STANDARD STARTING VOLUME= 3216 TEST TYPE = STANDARD PERCENT VOLUME - 32.2 TEST TYPE - STANDARD ! DEC 20. 2010 12:30 AM SEP 6, 2010 12:30 AM TEST LENGTH 2 HOURS JUN 20, 2010 12:30 AM 1 TEST LENGTH 2 HOURS PERCENTG VOLUME- VOLUME - 83.0 TEST LENGTH 2 HOURS STARTING VOLUME= 7787 TEST TYPE STANDARD STARTING VOLUME- 6989 PERCENT VOLUME PERCENT VOLUME = 69.9 TEST TYPE STANDARD TEST TYPE - STANDARD JUN 7, 2010 12:30 AM MAR 8, 2010 12:30 AM TEST LENGTH •2 HOURS TEST LENGTH 2 HOURS STARTING VOLUME= 2981 STARTING VOLUME- 3571 j PERCENT VOLUME = 29.8 TEST TYPE = STANDARD PERCENT VOLUME = 35.7 TEST TYPE - STANDARD t AUG 2, 2010 12:30 AM MAY 17, 2010 12:30 AM TEST LENGTH 2 HOURS TEST LENGTH 1 HOURS STARTING VOLUME- 3472 STARTING VOLUME= 3767 PERCENT VOLUME 34.7 TEST TYPE STANDARD PERCENT VOLUME - 37.7 = TEST TYPE m. STANDARD SEP. 6, 201,0 12:30 AM . - - - - TEST LENGTH 2 HOURS ALARM HISTORY REPORT STARTING VOLUME= 3918 ---- IN-TANK ALARM PERCENT VOLUME 39.2 --- SENSOR ALARM --- - T 4:PLUS TEST TYPE - STANDARD G 1 :UNLEADED SUDDEN LOSS ALARM ANNUAL LINE FAIL JAN 24, 2011 8:49 AM NOV 16, 2009 12:30 AM JAN 5. 2011 12:57 AM TEST LENGTH 2 HOURS ANNUAL LINE FAIL STARTING VOLUME= 3191 NOV 16,2010 12.:02 AM PERCENT VOLUME = 31 .9 TEST TYPE = STANDARD PLLD SHUTDOWN ALARM i JAN 7, 2010 11 :47 AM SEP 6, 2010 12:30 AM TEST LENGTH 2 HOURS ---- IN-TANK ALARM --- STARTING VOLUME= 4205 T 4:PLUS PERCENT VOLUME - 42.0 PROBE OUT TEST TYPE - STANDARD JAN 24, 2011' 8:49 AM OCT 11, 2010 12:30 AM TEST LENGTH 2 HOURS STARTING VOLUME= 3431 ALARM HISTORY REPORT PERCENT VOLUME - 34.3 TEST TYPE - STANDARD ----- SENSOR ALARM ----- 0 2:DIESEL DEC 20, 2010 12:30 AM PLLD SHUTDOWN ALARM -- TEST LENGTH 2 HOURS MAR 3, 2010 11 :09 AM -- 1N-TANK ALARM ----- STARTING VOLUME= 3950 T 3:SUPER UNLEADED GROSS LINE FAIL SUDDEN LOSS ALARM PERCENT VOLUME = 39.5 TEST TYPE = STANDARD MAR 3, 2010 11 :09 AM 1 JAN 24, 2011 8:50 AM PLLD SHUTDOWN ALARM MAR 3, 2010 11 :04 AM ---- IN-TANK ALARM --~ - T 3:SUPER UNLEADED OU OCT 18, 2010 12:30 AM JAN B24, 2011 8:50 AM TEST LENGTH 2 HOURS ALARM HISTORY REPORT STARTING VOLUME- 2905 PERCENT VOLUME - 29.0 -- --- SENSOR ALARM ----- i TEST TYPE . STANDARD 0 3:SUPER UNLEADED I ANNUAL LINE FAIL FEB 3, 2010 10:24 PM NOV 1. 2010 12:3p.flM TEST LENGTH 2 HOURS ANNUAL LINE FAIL STARTING VOLUME= 2806 JAN 30. 2010. 1 :26 AM PERCENT VOLUME - 28.1 I ---- IN-TANK ALARM ----- TEST TYPE - STANDARD ANNUAL LINE FAIL T 2:DIESEL JAN 25, 2010 11 :08 PM SUDDEN LOS lALAR52 AM NOV 15.2010 12:30 AM JAN 24 TEST LENGTH '2 HOURS STARTING VOLUME= 3119 PERCENT VOLUME - 31 .2 ! TEST TYPE - STANDARD DEC 20. 2010 12:30 AM TEST LENGTH 2 HOURS STARTING VOLUME- 3714 ALARM HISTORY REPORT ---- IN-TANK ALARM ---- PERCENT VOLUME - 37.1 T 2:DIESEL TEST TYPE - STANDARD ----- SENSOR ALARM ----- PROBE OUT G 4:PLUS JAN 24. 2011 8:52 AM I PLLD' SHUTDOWN ALARM JAN 7. 2010 11 :43 AM GROSS LINE FAIL JAN 7, 2010 11 :43 AM ANNUAL LINE FAIL MAR 13. 2009 10:19 PM ---- IN-TANK ALARM - --- DEC 13. 2010 12:30 AM T 1 :UNLEADED TEST LENGTH 2 HOURS SUDDEN LOSS ALARM STARTING VOLUME= 3902 I JAN 24, 2011 8:53 AM PERCENT VOLUME = 39.0 TEST TYPE - STANDARD 1 _ MESA MARIN. ` -- IN-TANK ALARM ----- PIT STOP MARKET _ T 2:DIESEL 11101 HWY 178 - - PROBE OUT BAKERSFIELD.CA 93306 MESA MARIN JAN 24, 2011 8;53 AM . P1`T STOP MARKET JAN 24. 2011 9:02 AM 1110-1 HWY 178 BAKERSFIELD,CA 93306 J SYSTEM STATUS REPORT AN 24, 2011 9:11 AM - PRESSURE LINE LEAK ALL FUNCTIONS NORMAL TEST RESULTS IN-TANK ALARM ----- INVENTORY REPORT T 1 :UNLEADED Q 1 :UNLEADFD PROBE OUT T I :UNLEADED JAN 24. 2011 8:53 AM VOLUME - 8457 GALS I ULLAGE - 1528 GALS 3.0 GAL/HR RESULTS: r TC ULLAG = 529 8480 GALS LAST TEST: HEIGHT - 74.88 INCHES JAN 24,2011 8:34AM PASS WATER VOL - 0 GALS WATER - 0.00 INCHES NUMBER OF TESTS PASSED TEMP - 56.0 DEG F PREY 24 HOURS : 73 SINCE MIDNIGHT : 18 -- IN-TANK ALARM ----- T 2:DIESEL T i :UNLEADED VOLUME 9160 GALS LOW TEMP WARNING ULLAGE 825 GALS 0.20 GAL/HR RESULTS: JAN 24.2011 8:54 AM 90% ULLAGE- 0 GALS TC VOLUME - 9178 GALS JAN 23,2011 9:11PM PASS HEIGHT - 81 .79 INCHES JAN 23,2011 8:16PM PASS WATER VOL - 21 GALS JAN 23.2011: 7:23PM PASS WATER - 1 .12 INCHES JAN 23,2011 3:13AM PASS TEMP - 55.6 DEG F JAN 23,2011 1 :16AM PASS JAN 22,2011 11 :30PM PASS JAN 22,2011 8:49PM PASS T 3:SUPER UNLEADED JAN 22.2011 1 :21AM PASS -- IN-TANK ALARM ----- VOLUME - 6361 GALS JAN 21 -2011 11 :28PM PASS T 2:DIESEL ULLAGE - 3624 GALS JAN 20.2011 11 :27PM PASS PROBE OUT 90% ULLAGE- 2625 GALS JAN 24, 2011 8:56 AM TG VOLUME - 6407 4 INC HEIGHT 5HES 0.10 GAL/HR RESULTS: ? x WATER VOL - 12 GALS WATER o 0.78 INCHES JAN 23.2011 11 :35PM PASS TEMP - 49.5 DEG F JAN 23,2011 6:40AM PASS JAN 22.2011 4:32AM PASS JAN 21,2011 2:06AM PASS ;r T 4:PLUS JAN 20.2011 3:03AM PASS VOLUME - 7678 GALS JAN 19,2011 12:41AM PASS ULLAGE - 2307 GALS JAN 17,2011 10:58PM PASS 90%I ULLAGEw 1308 GALS JAN 16,2011 10:51PM PASS TC VOLUME = 7743 GALS JAN 16,2011 3:13AM PASS HEIGHT = 68.13 INCHES JAN 15,2011 3:22AM PASS WATER VOL - 0 GALS WATER - 0.00 INCHES TEMP - 47.8 DEG F * * * END * )iXXA Q 2:DIESEL 9 3:SUPER UNLEADED 0 4:PLUS 3.0 GAL/HR RESULTS: LAST TEST: . 3.0 GAL/HR RESULTS: 3.0 GAL/HR RESULTS:. JAN 24.2011 6:4BAM PASS LAST TEST: LAST TEST: . JAN 242011 j NUMBER OF TESTS PASSED 8:39AM PASS JAN 24,2011 7:53AM PASS PREV 24 HOURS 6 NUMBER OF TESTS PASSED SINCE MIDNIGHT 3 PREY 24 HOURS 26 NUMBER OF TESTS PASSED PREV 24 HOURS 11 SINCE MIDNIGHT 6 SINCE MIDNIGHT 3 0.20 GAL/HR RESULTS: JAN 24.2011 7:19AM PASS + 0.20 GAL/HR RESULTS: 0.20 GAL/HR RESULTS: JAN 23.20.1t 3:04PM PASS JAN 23.2011 6:26PM PASS JAN 23.2011 1 :38PM PASS 303PM PASS I JAN 23.2011 6:16PM PASS JAN 23,2D11. : JAN 23.2011 11 :51AM PASS 1 JAN 22.2011 1 :03PM PASS JAN 23,2011 1 :39PM PASS JAN 22.2011 6:42AM PASS JAN 22,201 ! 5:58PM PASS JAN 23.2011 11 :08AM PASS JAN 21.011 12:34PM PASS JAN 22.2011 1 '03AM PASS JAN 22,2011 5:14PM PASS JAN 21,201.1 10:40AM PASS JAN 21:2011 1 :03AM PASS JAN 21.2011 10:18PM PASS JAN 21.2011 10:02AM PASS JAN 21.2011 2:12PM PASS JAN 21 .2011 9:09AM PASS E JAN 21 .2011 12:40AM PASS JAN 21.20]1 11 :39AM PASS JAN 21.2011 8:33AM PASS JAN 19.2011 9:32PM PASS JAN 20.2011 7:10PM PASS JAN 19.2011 12:51PM PASS JAN 20.2011 3:20PM PASS JAN 18.2011 3:37PM PASS JAN 19.2011 3:34PM PASS 0.10 GAL/HR RESULTS: JAN 24.2011 7:34AM PASS 0.10 GAL/HR RESULTS: 0.10 GAL/HR RESULTS: JAN 23.2011 5:51PM PASS ! JAN 23.2011 7:27PM PASS JAN 23.2011 B:49PM PASS JAN 22.2011 10:15AM PASS { JAN 21 ,2011 3:06PM PASS j JAM 22.2011 11 :03PM PASS JAN 22.2011 5:44PM PASS JAN 19.2011 . 8:03PM PASS 1 JAN 22,2011 1 :49AM PASS JAN 21,2011 10:48PM PASS JAN 18,201t: 8:34AM PASS JAN 21,201.1 1 :41AM PASS JAN 20,2011 7:41PM PASS JAN 17,2011 4:34PM PASS JAN 20,2014 12:51AM PASS JAN 19,2011 3:49PM PASS JAN 16,2011 2:10PM PASS 1 JAN 18,20 t'1 5:08PM PASS JAN 18,2011 .1 :41PM PASS JAN 15.2011 12:23PM PASS JAN 18:20J'1 1:10AM PASS JAN 17.2011 7:39PM PASS JAN 14,2011 1 :38PM PASS JAN 17,2011 12:46AM PASS 1 JAN 16.201.1 9:09PM PASS JAN 16.201„1 1 :19AM PASS. JAN 15,2011 3:OOPM PASS JAN 14,2011 2:11PM PASS JAN 14,2011 2:03PM PASS r' I L PRESSURE LINE LEAN, SFTLIP E ---- IN-TANK ALARM ----- T 4:PLUS T 1 :UNLEADED INVENTORY INCREASE y - - - - - - - - - MAX PRODUCT ALARM JAN 24, 2011 9:17 AM INCREASE START 0 1 :IafJLi �tCiEG JAN 24, 2011 9:25 AM PIPE TYPE:..STEEL VOLUME - 7678 GALS LINE LENGTH: 250 FEET WATER - 0.00 INCHES 0.20 GPH TEST: ENABLED TEMP - 45.9 DEG F 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH T 1 :UNLEAD£D E' INCREASE END DISPENSE MODE: JAN 24, 2011 9:28 AM STANDARD ----. 1N-TANK ALARM ----- SENSOR: NON-VENTED T 1 :UNLEADED VOLUME - 9535 GALS HIGH PRODUCT ALARM WATER - 0.00 INCHES JAN 24. 2011 9:17 AM TEMP - 46.3 DEG F GROSS INCREASE- 1857 TC NET INCREASE- 1872 Q 2:DIESEL ---- IN-TANK ALARM ----- T 1 :UNLEADED PIPE TYPE: STEEL HIGH WATER WARNING LINE LENGTH: 30 FEET ! JAN 24, 2011 9:20 AM 0.20 GPH TEST: ENABLED 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH T 2:DIESEL . DISPENSE MODE: STANDARD SENSOR: NON-VENTED ---- IN-TANK ALARM ----- T 1 :UNLEADED ----- HIGH PRODUCT ALARM -- IN-TANK ALARM T i :UNLEADED JAN 24. 2011 9:47 AM r HIGH PRODUCT ALARM JAN 24. 2011 9:21 AM 1 0 O:SUPtR UNLEADSD +� ---- IN-TANK ALARM ------ PIPE TYPE: STEEL T 4:PLUS LINE LENGTH: 50 FEET HIGH PRODUCT ALARM 0.20 GPH TEST: ENABLED ---- IN-TANK ALARM ----- JAN 24, 2011 9:50 AM 0.10 GPH TEST: DISABLED T i :UNLEADED SHUTDOWN RATE: 3.0 GPH HIGH WATER WARNING T 3:SUPER UNLEADED JAN 24. 2011 9:24 AM DISPENSE MODE: STANDARD SENSOR: NON-VENTED t ---- IN-TANK ALARM ----- T 4:PLUS --- IN-TANK ALARM ----- PROBE OUT T -:PLUS- JAN 24. 2011 9:50 AM HIGH PRODUCT ALARM JAN 24, 2011 9:26 AM 0 4:PLUS, PIPE TYPE: .STEEL LINE LENGTH: 50 FEET 0.20 GPH TEST: ENABLED 0.10 GPH-,TEST: DISABLED ---- IN-TANK ALARM -�--- SHUTDOWN RATE: 3.0 GPH T 4:PLUS T 4:PLUS LOW TEMP WARNING DISPENSE MODE: ---- 1N-TANK ALARM ----- JAN 24, 2011 9:51 AM STANDARD T 4:PLUS SENSOR: NON-VENTED OVERFILL ALARM JAN 24, 2011 9:26 AM T 4:PLUS ~T 3:SUPER UNLEADED INVENTORY INCREASE INVENTORY INCREASE _--- IN-TANK ALARM ----- INCREASE START I T 2:DIESEL ,IAN 24. 2 9:50 AM INCREASE START SUDDEN LOSS ALARM JAN 24, 2011 9:53 AM JAN 24. 2011 10:09 AM VOLUME - 6546 GALS VOLUME - 6361 GALS WATER - 0.00 INCHES WATER = 0.79 INCHES TEMP - 46.9 DEG F TEMP - 54.4 DEG F INCREASE END INCREASE END JAN 24. 2011 9:53 AM JAN 24, 2011 9:56 AM VOLUME = 9402 GALS VOLUME = 9252 GALS ---- IN-TANK ALARM ----- WATER - 0.00 INCHES WATER = 0.79 INCHES T 2:DIESEL TEMP = 49.0 DEG F + TEMP - 54.5 DEG F SUDDEN LOSS ALARM JAN 24, 2011 10:20 AM GROSS INCREASE- 2856 r GROSS INCREASE 2891 TC NET INCREASE- 2.868 TC NET INCREASE- 2901 MESA MARIN PIT STOP MARKET 11101 HWY 178 BAKERSFIELD,CA 93306 ---- IN-TANK ALARM ----- JAN 24.2011 10:22 AM T 3:SUPER UNLEADED -- IN-TANK ALARM ----- HIGH PRODUCT' ALARM T 2:DIESEL JAN 24, 2011 9:54 AM SUDDEN LOSS ALARM JAN 24, 2011 9:57 AM SYSTEM STATUS REPORT - - - - - - - - - - - - } T 2:SUDDEN LOSS ALARM INVENTORY REPORT -� T I :UNLEADED 1N-TANK ALA*+ --- VOLUME 8039 GALS __ T 3:SUPER UNLEADED -- IN-TANK ALARM -- ULLAGE - 1946 GALS PROBE OUT T I :UNLEADED 90% ULLAGE- 947 GALS JAN 24, 2011 9:,54 AM HIGH PRODUCT ALARM TC VOLUME - 8019 GALS JAN 24, 2011 10:01 AM HEIGHT - 71 .18 INCHES WATER VOL - 31 GALS r WATER = 1 .44 INCHES TEMP 63.5 DEG F T 2:DIESEL VOLUME - 2309 GALS ULLAGE - 7676 GALS -- IN-TANK ALARM ----- -- IN-TANK ALARM ----- 90% ULLAGE= 6677 GALS T 2:DIESEL TC VOLUME - 2298 GALS HIGH PRODUCT ALARM IN-TANK HEIGHT = 26.74 INCHES MAX PRODUCT ALARM WATER VOL - JAN 24. 2011 9:55 AM JAN 24. 2011 10:01 FPM ' WATER = 0.00 INNC$ HES TEMP = 69.6 DEG F I T 3:SUPER UNLEADED VOLUME - 3315 GALS GALS ULLAGE 90% ULLAGE= 56710 GALS TC VOLUME - 3299 GALS ---- IN-TANK ALARM ----- ---- IN-TANK ALARM ----- HEIGHT - 34.77 INCHES T 2:DIESEL T 1 :UNLEADED WATER VOL - 0 GALS MAX PRODUCT ALARM PROBE OUT WATER = 0.00 INCHES JAN 24, 2011 9:55 AM JAN 24, 2011 10:02 AM TEMP - 67.0 DEG F T 4:PLUS VOLUME = 3592 GALS ULLAGE = 6393 GALS 903. ULLAGE- 5394 GALS TC VOLUME - 3575 GALS HEIGHT = 36.90 INCHES WATER VOL = 0 GALS ---- 1N-TANK ALARM ----- WATER = 0.00 INCHES T 2:DIESEL TEMP = 66.8 DEG F PROBE OUT JAN 24, 2011 , 9:56 AM END PR£ URE 'L I NE LEAK ALARM ----- -- -__ Q 4:PLUS PRESSURE LINE LEAK ALARM GROSS LINE FAIL Q 2:DIESEL JAN 24: 2011 10:37 AM PIS SHUTDOWN ALARM JAN 24, 2011 11 :19 AM i ' PRESSURE LINE LEAK ALARM Q 4:PLUS MESA MARIN iPLLD SHUTDOWN ALARM PIT STOP MARKET JAN 24, 2011 10:37 AM 11101 HWY 178 E BAKERSFIELD,CA 93306 JAN 24, 2011 11 :26 AM f I SYSTEM STATUS REPORT - - - - - - - - - - - - -PRESSURE LINE LEAK ALARM Q I :GROSS LINE FAIL Q 3:SUPER UNLEADED Q 1 :PLLD SHUTDOWN ALARM GROSS LINE FAIL JAN 24. 2011 10:45 AM Q 2:GROSS LINE FAIL Q 2:PLLD SHUTDOWN ALARM r Q 3:GROSS LINE FAIL ' Q 3:PLLD SHUTDOWN ALARM iQ 4:GROSS LINE FAIL PRESSURE LINE LEAK ALARM Q 4:PLLD SHUTDOWN ALARM t Q 3:SUPER UNLEADED PLIED SHUTDOWN ALARM JAN 24: 2011 10:45 AM PRESSURE LINE LEAK ALARM MESA MARIN P Q I :UNLEADED 11101 HW MARKET Y1778 GROSS LINE FAIL BAKERSFIELD,CA 93306 JAN 24, 2011 10:48 AM JAN 24, 2011 11 :28 AM i • SYSTEM STATUS REPORT - ALL FUNCTIONS NORMAL PRESSURE LINE LEAK ALARM Q 1 :UNLEADED PLLD SHUTDOWN ALARM JAN 24. 2011 10:48 AM i PRESSURE LINE LEAK ALARM Q 2:DIESEL GROSS LINE FAIL JAN 24. 2011 11 :19 AM 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 (f applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: Mesa Marin Food Mart I Date of Testing: 1/24/2011 Facility Address: 11101 Highway 178,Bakersfield,CA 93306 Facility Contact: Moe I Phone: 661-3664886 Date Local Agency Was Notified of Testing: 1/3/2011 Name of Local Agency Inspector(f present during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: Confidence UST Services,Inc. Technician Conducting Test: Kristopher Karns Credentials': X CSLB Contractor X ICC Service Tech. X SWRCB Tank Tester ❑Other(Specify) License Number(s): CSLB#804904 ICC#5264406-UT SWRCB#09-1743 3. SPILL BUCKET TESTING INFORMATION Test Method Used: x Hydrostatic ❑Vacuum ❑Other Test Equipment Used: Lake Test Equipment Resolution: .0625" Identify Spill Bucket(By Tank 1 Regular 2 Plus 3 Super �4 Diesel Number, Stored Product, etc. x Direct Bury x Direct Bury x Direct Bury x❑Direct Bury Bucket Installation Type: ❑Contained in Sump ❑Contained in Sump ❑Contained in Sump ❑Contained in Sum Bucket Diameter: 1 12.00" 12.00" 12.00" 12.00" Bucket Depth: 15.00" 14.75" 14.00" 14.00" Wait time between applying 5 min. 5 min. 5 min. 5 min. vacuum/water and start of test: Test Start Time(Ti): 9:15am 9:15am 9:15am 9:15am Initial Reading(Ri): 12.50" 10.75" 10.25" 10.00" Test End Time(TF): 10:15am 10:15am 10:15am 10:15am Final Reading(RF): 12.50" 10.75" 10.25" 10.00" Test Duration(TF—Ti): 1 hour 1 hour 1 hour 1 hour Change in Reading(RF-R,): 0.00" 0.00" 0.00" 0.00" Pass/Fail Threshold or .0625" .0625" .0625" .0625" Criteria: Test Result: X Pass ❑Fail X Pass ❑Fail X Pass ❑Fail X Pass ❑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 information contained in this report is true,accurate,and in full compliance with legal requirements. Technician's Signature: / Date: 1/24/2011 ' State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. 1= Gilbarco EMC Mesa Marin CHevron & Food 2= Overfill Alarm Mart, 11101 Highway 178 3= ESO Switch Bakersfield, CA 93306 4=ATG 5= Regular Turbine 1 1/24/2011 6=Plus Turbind 7= Super Turbine 8= Diesel Turbine 9= Bravo Box O 3 10= PLLD 4 3 2 1 9 9 5,10 8,10 7,10 6,10 O 0 O 0 O 0 0 0 0 0 0 Regular Fill Diesel Fill Direct Burial Super Fill Plus Fill Direct Burial Direct Burial Direct Burial