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HomeMy WebLinkAboutUST-MONITORING SYS. 10/11/2010 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 98109 City: BAKERSFIELD CA Zip:93304 Site Address: 1131 OAK ST.X/ST CALIFORIA AVE Contact Phone No: 324-7621 Date of Testing/Service: 10/11/2010 Facility Contact Person: MANAGER-JALED Make/Model of Monitoring System:TLS-350 Work Order Number: 3178155 IIIIII�IIIIIIIIIIII 01 B.Inventory of Equipment Tested/Certified IE J Check the appropriate boxes to indicate specific equipment inspected/serviced Tank ID: T-1 Tank ID: T-2 PLUS 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: 208 Piping Sump/Trench Sensor(s). Model: 208 X Fill Sump Sensor(s). Model: 208 208 Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: X Electronic Line Leak Detector. Model: PLLD X Electronic Line Leak Detector. Model: PLLD X Tank Overfill/High-Level Sensor. Model: EXT ALARM Tank Overfill/High-Level Sensor. Model: EXT ALARM 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: Tank ID: 1-4 U11=6h In-Tank Gauging Probe. Model: MAG PROBE in-Tank Gauging Probe. Model: MAG PROBE X Annular Space or Vault Sensor. Model: 409 71 Annular Space or Vault Sensor. Model: 409 X Piping Sump/Trench Sensor(s). Model: 208 X Piping Sump/Trench Sensor(s). Model: 208 X Fill Sump Sensor(s). Model: 208 X Fill Sump Sensor(s). Model: 208 Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: X Electronic Line Leak Detector. Model: PLLD X Electronic Line Leak Detector. Model: PLLD Tank Overfill/High-Level Sensor. Model: EXT ALARM EXT ALARM 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 IL): 1-10 Dispenser ID: ®Dispenser Containment Sensor(s) Model:208 Dispenser Containment Sensor(s) Model: XO Shear Valve(s). Shear Valve(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). Dispenser ID: Dispenser ID: ❑ Dispenser Containment Sensor(s) Model: 7 Dispenser Containment Sensor(s). Model: Shear Valve(s). 7 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): ❑X System set-up XO Alarm history report Technician Name(print): FRANCISCO CASTRO Signature: -W44 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: 10/1112010 Monitoring System Certification Page 1 of 3 IIIIIIIIIIIII III IIII 02 Based on CA form dated 03/08 IE Monitoring System Certification Site Address 1131 OAK ST.X/ST CALIFORIA AVE Date of Testing/Service: 10/11/2010 D. Results of Testing/Servicing Software Version Installed: 327.04 Complete the following checklist: X 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? ❑X 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? FRI Yes No' NIA 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' ❑NIA 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; ❑x Dispenser Containment Sensors. Did you confirm positive shutdown due to leaks and sensor failure/disconnection? ❑X Yes No ❑ Yes ❑No• ❑N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device(Le.: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? so ❑ 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: 1131 OAK ST.X/ST CALIFORIA AVE Date of Testing/Service: 10/11/2010 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: Ifl 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? ❑x Yes ❑No• Was accuracy of system product level readings tested? EYes ❑No• Was accuracy of system water level readings tested? EYes ❑No• Were all probes reinstalled properly? Eyes 1:1 No•I 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? ❑Yes ❑No ❑NIA (Check all that apply)Simulated leak rate: Q 3 g.p.h❑0.1 g.p.h ❑0.2 g.p.h FX_j Yes ❑No' Were all LLDs confirmed operational and accurate within regulatory requirements? x Yes ❑No• Was the testing apparatus properly calibrated? ❑Yes ❑No' ©N/A For mechanical LLDs,does the LLD restrict product flow if it detects a leak? 0 Yes ❑No• ❑N/A For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? ❑x Yes ❑No• ❑N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? ❑x Yes ❑No• ❑N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ❑x Yes ❑No• ❑N/A For electronic LLDs,have all accessible wiring connections been visually inspected? Yes ❑No•I I 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 SWI,CB,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 98109 Date of Testing: 10/11/2010 Facility Address: 1131 OAK ST. X/ST CALIFORIA AVE , BAKERSFIELD, CA, 93304 Facility Contact: MANAGER - JALED Phone: (6 61) 324-7621 Date Local Agency Was Notified of Testing: 10/11/2010 Name of Local Agency Inspector(if present during testing): ERNIE MEDINA 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: FRANCISCO CASTRO Credentials: El CSLB Licensed Contractor SWRCB Licensed Tank Tester License Type: A / UT License Number: 743160 / 8026747 Manufacturer Training Manufacturer Component(s) Date Training Expires PHIL-TITE SPILL BUCKETS 08/02/2012 3. SUMMARY OF TEST RESULTS Not Repairs Not Repair Component Pass Fail Tested Made Component Pass Fail Tested Made Spill Box 1 SUP FILL E ❑ ❑ ❑ ❑ ❑ ❑ ❑ Spill Box 2 PLU FILL X ❑ ❑ ❑ ❑ ❑ ❑ Spill Box 3 REG FILL ❑ ❑ ❑ ❑ ❑ ❑ ❑ Spill Box 4 DIE FILL E ❑ ❑ ❑ ❑ ❑ ❑ ❑ Spill Box 3 REG VAPOR X ❑ ❑ ❑ El ❑ ❑ ❑ Spill Box 2 PLU VAPOR F-1 I ❑ ❑ ❑ ❑ ❑ ❑ ❑ Spill Box 1 SUP VAPOR El ❑ ❑ ❑ ❑ ❑ ❑ ❑ El I El I El El El El El El E Eli 0 1 E] El El E El El El El El El I Ell 1:11 0 0 If hydrostatic testing was performed,describe what was done with the water after completion of tests: SPILL BUCKET TEST WATER WAS LEFT ON SITE 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: , '4 % // Date: 10/11/2010 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 98109 Date of Testing: 10/11/2010 Facility Address: 1131 OAK ST. X/ST CALIFORIA AVE , BAKERSFIELD, CA, 93304 Facility Contact: MANAGER - JALED Phone: (6 61) 324-7621 Date Local Agency Was Notified of Testing: 10/11/2010 Name of Local Agency Inspector(if present during testing): ERNIE MEDINA 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: FRANCISCO CASTRO Credentials I: ❑CSLB Contractor ❑ICC Service Tech. ❑SWRCB Tank Tester ❑Other(Specify)A / UT License Number: 743160 / 8026747 3. SPILL BUCKET TESTING INFORMATION Test Method Used: El Hydrostatic El Vacuum El Other Test Equipment Used:MEASURING TAPE Equipment Resolution:VISUAL Identify Spill Bucket(By Tank 1 1 SUP FILL Z 2 PLU FILL 3 3 REG FILL 4 4 DIE FILL Number, Stored Product, etc.) Bucket Installation Type: Direct Bury Direct Bury E Direct Bury Ej Direct Bury XQ Contained in Sump X Contained in Sump Contained in Sump ❑X Contained in Sump Bucket Diameter: Bucket Depth: 1211 1211 1211 121, Wait time between applying 5MIN 5MIN 5MIN 5MIN vacuum/water and starting test: Test Start Time(TI ): 12 :3 0 0 9:15 09:15 0 9:15 Initial Reading(R I ): 9" 9.5" 9" 9" Test End Time(TF ): 1:3 0 10 :15 10:15 10:15 Final Reading(R F ): 91, 9.511 911 911 Test Duration: 1HOUR 1HOUR 1HOUR 1HOUR Change in Reading(R F-R1 ): 0 0 0 0 Pass/Fail Threshold or 0 0 0 0 Criteria: esui Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) REPLACED DRAIN VALVE AND 0-RING ON 87 SPILL BUCKET. 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: ,,4 % A"v Date: 10/11/2010 1 State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements 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 98109 Date of Testing: 10/11/2010 Facility Address: 1131 OAK ST. X/ST CALIFORIA AVE , BAKERSFIELD, CA, 93304 Facility Contact: MANAGER - JALED Phone: (6 61) 324-7621 Date Local Agency Was Notified of Testing: 10/11/2010 Name of Local Agency Inspector(if present during testing): ERNIE MEDINA 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: FRANCISCO CASTRO Credentials I: ❑X CSLB Contractor ❑ICC Service Tech. ❑SWRCB Tank Tester ❑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 3 REG VAPOR 2 2 PLU VAPOR 3 1 SUP VAPOR 4 Number, Stored Product, etc.) Bucket Installation Type: E]Direct Bury ❑Direct Bury ❑Direct Bury ❑Direct Bury X❑Contained in Sump X❑Contained in Sump X❑Contained in Sump ❑Contained in Sump Bucket Diameter: 11" 1111 Ill, Bucket Depth: 1211 12 It 1211 Wait time between applying 5MIN 5MIN 5MIN vacuum/water and starting test: Test Start Time(TI ): 10:3 0 10:3 0 10:3 0 Initial Reading(RI ): 10" 10" 10" Test End Time(TF ): 11:30 11:30 11:3 0 Final Reading(RF ): 10" 10" 10" Test Duration: 1HOUR 1HOUR 1HOUR Change in Reading(R F-RI ): 0 0 0 Pass/Fail Threshold or 0 0 0 Criteria: Tes ul . ® ass ® ail ® ass ail �® a 0 ail Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) REPLACED DRAIN VALVE AND O-RING ON 87 SPILL BUCKET. 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: 4,e A Date: 10/11/2010 I State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements ►larnly wiogy 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759 (512)451-6334 FAX(512)459-1459 TEST DATE:10/11/10 WORK ORDER NUMBER3178155 CLIENT:CHEVRON PRODUCTS COMPANY SITE:CHEVRON 98109 COMMENTS Conduct Witness Annual Monitor Certification with Bakersfield Fire Department. Site contacted 10/6/10, confirmed with "HASU". PARTS REPLACED •u�wnTY DESCRIPTIO 1 REPLACEMENT DRAIN VALVE ASSY; HANDLE-5 GAL CAPACTIY 1 SHUT OFF O RING HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) M TE TED HEUUAA PI DINT L TEST RESULTS Printed 10/25/2010 08:42 ACRAMER SITE DIAGRAM p,Tanknoibgy 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759 (512)451-6334 FAX(512)459-1459 TEST DATE: 10/11/10 WORK ORDER NUMBER3178155 CLIENT:CHEVRON PRODUCTS COMPANY SITE: CHEVRON 98109 Chevron#98109 DSL LO 1131 Oak St. Lt #1 9 Bakersfield, CA 1 10K L 93304 ct SUP 10K L 1 UL #1 STP A n 99 # 7 # #5 #4 3 10K L8 L STP PSU � I O 10K L5 E N cas VENT O Printed 10/25/2010 08:42 ACRAMER Work Order: 3176155 (ESO)&(ESV)Testing Form-Vas ion I-62SM07 Emergency Shut Off (ESO) & Dispenser Emergency Shutoff Valve (ESV) ANNUAL TEST RECORD LOCATI DNS AND TEST DATA Testing � G Et��,Company: Date: A n Location Name: Store #: State ID#: Address: 113I . cam S� G�;�r�►hD�� City: State: 64 Eme enc_y Shut Off SO Testin Resu s On t C N (/0 in accoidane with"ESO Vendor Letter 3-21-05).doc", from Valero's Retail Compliance Department, as a part of annual compliance t i ting,this representative tested the Emergency Shut Off SO switches indicated on this sketch. Findings listed below: Emergency Shut Off(ESO) if No,Provide Operational? N Maintenance Log ii Date Called: Disjoenser Emerggney Shutoff Valve ES Testing Results On (010LIO in accordance with NFPA 30A this represi ntative tested the automatic-closing feature of the Dispenser Emergency Shutoff VAI,VE(S)(ESV)located in the supply lines at the base of each individual island type dispenser indicated on the diagram b4ow.Each device(4)1_—in all, would automatically close. Finjjjngs listed below: Disp.Emergency Shut Off �-- If No,Provide Valve(ESV)Operational? / /N F Maintenance Log# Date Called: Site htap Of Location and Placcrnentk f Devices Tested: i 4 ' �' t r ^ (C`'� 5 Tp 9 St ; ? FDA $ - I Si nature Of Representative: T Tanknology Inc. 11000 N.MoPac Expressway, Suite 500,Austin,Texas 78759 Work Order: 3178155 Fa REP6RT ADARf, ALARI r1 18TOW; REPuK HLARI"I ---- IN-TAi-jr _ __ IN-TA-14K ALARvi T I MORIBIE T 2:PLLD- T j:REGULAF�, HIC411 I.-VATER i4.HRf"I HIGH QTER &AP-1 tI I GH I,Ji ATEP. HL_P.rl OCT I I . ^01 Ci I 1 :4 1 Ar! GC:T I I • 2010 ,1 :41 i;[,! OCT 11- 2010 11 :41 PW*1 60T 2 K 2109 k4:52 ,A f1 :,CT 21 :-,00-1 4:54 i4r-1 XT I I, 2010 10:5E PPf ivil 3. 2008 J001 Al h*V V 200e 111:24 AN JCT 21. 21009 @:5:3 AN 1,L HI LmSt"I 01,,'EPFILI.. qLr,R;-•i OvERFILL ALARM 11, 2010 Pv.l OCT I 1 '201 0 i I :C14 191 SEP 26, 2010 10:35 N,I :2010 110:�55 OCT 21 200-3 '3:Q,4 •Hr,j OUL 20 10 1 ;ti Ari .2 ri I 0 1 f1: '01 NCO 'j 200; pIq OUL 29, 2010 1 -.4? rdl LOW P'P0D-X:T �Lr;Rt,l LOW PEMUM MAR.! i.014 PP-• DUCT ALHF-1-1 NOV 3• 21-IG& 11.):314 110,/ 3. 2008 P41 AU? 25, 2WO CE31 P11 21IDDEN LOgli r;LHRI SUDDEN L•LS2 "LfvFj-1 �Ei: • 2009 5;23 PMI ^ E13 Lb, 2CIC19 5*13 I"I OCT I " 2olo 11 :38 vi 07 1 1 2,Cj I C1 I I Ot"T 21.- :=,009 8:48 Al. OCT 21 2009 .9;5C, f�[.j 8UDDEN L-D."J"S kLHRI NOV 2-006 1 l'i­34 �41 H('V '-�, 200i: I CX�T I i , 2010 11 :30 F41 Hli�H PRODUCT r+LHRt':l INOV 31 2001P, i Cl::3a 141 1`11'�­Pl PRODLK.-T F�Lm�Pr­i hK;V 3.. 20oG 10:',1 1 W'I 20 10 1 - I ID• 35 �,l OCT I 1, 201 0 1 OCT 1 " 2010 11:1 5;` (4-11 OCT 21, 200-9 9:J4 At•-I HIGH -,.)C;T 21, 2009 9:<:] Hl' 1`10V 3, 2005 j Cj:4f, F4,1 CICT 11, 210 113 1 Cl:52 t4i OCT _l, 2009 1;r1 I NVAL I f FUEL LEVEL IWAL2 FUEL :M-EL IALi" 27, 2009 13:13 HM 0(::T I l, ---Dtfj lima is OCT II 20D3 1 1 :3,y Arq ,_-i'T '2l , 3 0 o q P:4:_;i At-I CW1 21 2W9 a:so Hpj I NW L I b FUEL LEX,'EL NOV 2, 2008 1G:34 AN NOV 3, 200e 10:34 mr,j IOCT I I, 2010 I1 :38 Al,) 'OCT 2t, 2,009 8:49 PiH ow PR(,,9E OUT NOV :3, 21100 10:34 HI,l COT IL. 2uv..i I Cj:57 A•i 6CT I I . 201 Hj°j i I _,Fj I C, 1 o;55 A(.I Oo'r 21, 200c; '1.1:1,-1 rgq.l PROBE OUT il ^ 1a I U 1 o:54 Art 150T 21 - 2QCj-; a:=,j-j Al., OCT 11 . 2010 10;54 AN HIGH INTER WARMNG HIGH IJ&TER 69kNIN-,, OCT 11.- 2010 10:50 A,] OCT Ih 2WO H :41 AN COT I ;()CIT 211, 2009 9:27 A-m ocl' :21, .2009 !;:5? wl OCT 21 • 2009 8:54 Ati NOV '00S I ID:,31 �Af'l NOV 3.. 21-109 j j-): HIGH WATER WARN14,4 Pint OC-T 11� 2-Cpil-i 11 ;41 14,1 OCT 11, 20i-D 10:5IS L#-I DELIVE:P�.; tiHErIEL- DEL I VEK, NEEDQ (:K::T 21 - 2ul, a:t53 �tm OCT 11, 0 11 4,1 ''0,u I I .e 4- 201 o pr., LXT 5. �.f ::),'-'T 1 . 1,01fj - jII3 DEL 1:03 ;rl OCT 4, 201 C. OCT I 1 1 :38 A,,, fiLmpri 1`�.`P I'R`.')1JLK:T f�UG '25. 2C...cl 1 :47 Pf'I 11 . 2C,I,D lo:55 '-')CT it rVVY 27. 2CiO 7:13 T,.M CCT a'1 OCT 21 , 20oq 9:22 --c OCT I I - 20 1 Q 10'52 rtrt OCT 21, 200=1 9:26 IHrt HLARN hov 3, 2008 10:q1 Am 13 231.1-G PLLD HIST(-Fvi !•,'T 1 L ll 1 1 2- H[1 f.4LARN P `IjbAR LIHE F;i1[. PLU t'HUTE'lo•&l HLHRI-1 "6 OCT ':CT i I • 21j 10 2010 11 :22 Xi L i mF FH I I.. PLLD SHJTFA.A,Jf4 AiL,R11 GPQS�i LINE FF11_ PLLE. ")("T 1 1 201 CI I I.,: jLl A•l 00T 11 , 20113 ] 1 :,"2 "'I'l Ll c+.3 HI.-I P111) PLI-D SHUTDOkIrl ALAPP,j PLLD :;HUTDOIJN iiLAF-m -.01 ri 10 HP'l OCT 1. 201 L 10:56 hi•l PLLD 511UTL;CiL,IIJ r.L ,1:r1 FLI.11 SHUTDOwN ALAPli PLLD 53HUTDi��,,J'J HLAM­1 111 21010 1 L::46 rim 0r-'T I I , %010 1U:413 t41 10:41 Hrl PLLD BHUTf1(-:+;l-j ,LNRrl i PLLD SHUTjjc--w[.4 ALtipl,j OCT 1 l • 201 Q I L ::35 H'I C)•'-'T 11 . 20J0 10:40 Afl Tanknology Inc. 11000 N.MoPac Expressway,Suite 500,Austin,Texas 78759 Work Order: 3178155 .,LAR-1 REPORT HI3T(.':-P-z RFP-:)RT ----- - P. HD T 4.G[1: EL L I :c3UF,RE"E r;NlAJLP:iR L 6:PLUS TIJRB]rqE SUMP WINUI-HR RPA,"-' ST? Sl-iflP U 11:, 1 1 :4 1 r;f.1 FUEL HL�ik'm FUEL. Al-HRm (-.)CT 0-'T 11, 21010 llj:43 �41 CICT I I - 2010 10:36 AM c 3E S(P OLT I-ENSR OUT HL4RI,1 0vERFILL f-;LHRll OCT It.. 2010 10:24 N1 0C,'T 11, 2)CA0 10:":4 ;Lill 11 2 Ci 10 11 .02 i-;,kj OCT 11 • 2 C 10 1 1 0. Hrl S'ENSGR* Cii-IT HL.T'IRVI SEP813.' OUT AD�RM OCT 2009 9:i OCT 21, 10:16 MM (-J(*:T 211 - 210C.'; , ::33 P-1 ./.: ALARM HISTOk" REP"-Rl' T 2 1 • 20109 5 HIGH SEN'S."'R Al-HP'll OCT I I 10 1 D:59 w 1 1. SUPREME F;1-1- 2U11P L r?:RE,:',ULr'iP. HNNUDr R T 2'1 9-'004 9: 1 rif-I P I F.I r6 S 1-1111 Iql-IuLAR SPACE Fl--EL i;D)Rtl FLIEL HLARM I N'V;iL I D Ft If,'- tl% EL OCT I 1 201 Ci I J:4'_ �Vl JCT I 1 201 0 10:3D IA" -' T , '-- 't-' I! - 0 i C) I I -47 '2 1 � 2 0 0,9 8:F: SENS1UP OUT ALARM "t' uT ALHI�',m )'-T 11 , 27"13 i Fj I I.t:-'a i4l 2010 10:24 t;M PRC:fJE ;BUT OCT 11 0 1 Ci 11 r-iri S7 E I I I St R OUT 0 R OUT riL;)Plll V.; I rJ 16 i4 J 2 l ` CT 1, OCT 11 ''2010 I :I-I rit' OCT 21 C. 0("T i�LJ�Rrl HISTORY RFP--R-(- -j - HI;H I,I!ml--;-'R i-.ir;-lRr4l kEPORT I .:-.),.':T I 1, 20 10 1G:52 F4 I SENS-"Ai ALARM 201",'� CT 21 56 L 8:RbAJD;R FILL Sui-ip L PIPINC. SL*,Ip 'IE FM' 21VP •IJEL HLARM DELP,"FR;' NEEDED CICT I i I I"j:q0 it,j ll ::j•l HI 1 11 20 F G:-i, F-,1 CtT 1 1" 1J:41 rll . SE1,2CR OUT F��LAPM Z-3 12., 20 1 ::F OCT'JI, 2010 Ili:--.4 �)I°j - C3()F.' OUT J-1 Cu"T C-1 L 1 20 111 11.1; FUEL i4� pNj 3 t:T I I.• 10 10 JAN 21, 2010 61: 10.5q r �0CCIR 00T H-LARM 21 , 2009 9: 1^ Fill OCT 2 1 SENSGR AD4RII 9: Ul.,:;R TURBINE SUMP ,,Er-"'-)PT L 'STP 21UMP ;;NNUL*%R FUEL ""'LAPI'l - SENZv-'.)P HLr+Rl• FUEL. "Al-r-i?ll OCT 11, 2011D 10:413 N1 1:1 -l*iE'z'EL FLI.L) SH6TrXAJN HLf;R'l SEN8ij"R OUT PiD;Rll 1 24 P�fl 13.13 1 1 '1�% HI-1 HSOP CUT G"T I I ICI:- T 1 k CJ*Ll" 2 - SEf-L31"R OUT CJR i L1 4 E Fr I L OC7T 21 - '2009 11 :15 41 Q 1 U 1 1 ;ifl -E 00T j: j6 H"t H REPOR-T PI-1.1) �HUTDC)i.,Jfil GC'T P-1 I 1 . :'FI HIS REP,. LlCI:EelE'.-`-FL L -':PLUS FILL c:UHP FUEL Hh:iRVj l'*P.Q'-2S LINE FhlL P IT.,1 lv� St-11-IF; - FIIEL i4lARII ,-:T 111 -10115 11 05 vill. 21010 113-�,115 DLIT rl OUT Hb-�R'.i OCT 1 2 CI I G ci:-_i 4 Wl 01.T 1, 2010, 10:46 Hl` 0"T It . 217110 lc:*24 i IPt I k5EW-,'C?F,. OUT HLJ`;Rfi i�EHSCIR OuT ril-riR;l I (%T 21 , 10: 15 rill P'LLD '2l'HlJ7ll\'-.IJr4 ;-iLH,;;Tl I .,C:T 21, 2[10'-� 10: 16 i4l .DC T I _i�IFJ 10:45 -H c- "T 1l 0 10:45 r-0` JL Tanknology Inc. 11000 N.MoPac Expressway, Suite 500,Austin,Texas 78759 Work Order: 3178155 L.' I :DIESEL FILL F.UllF- P j P I PW sm FUM. MAM PrATWER Pm OCT I I 2010 113:-t rill FI:EL t4ARll OCT I 1 26 10 10:94 HP-1 REMOR 00' mU*f,l (1(1, 11 201 I_-] I o,l '-'.EVrS0R OUT Al-.;R11 2EN8OR (-,'-LJT Dl Rll 1 21309 1 Fj: I it SENSOR CUT rjf-;ipj.j OCT 21, 2005 10:15 q.1 HLA'Rr SMIP FUEL ADFIRH "010 Pr*Ill FUEL RAW u 2u13 I j" �.5:' fill IJT AL.HRH OCT IL, 2DO-I 10:24 SEMOR M mmKi OCT LI . ML) jl): A f0l 113, 2010 :1 r�ENSOR OUT �Lr4lli 6i"T '21 . 2009 law Al'.1 EENScF, )LHPH L1:3:DISPENSEP 1-2 NS�-Elt,ER FUEL ALARIl OCT [ 1 . 2010 1!f::.11 ri EDBOR -*,,LIT AL�iRll 11, 2010 10:2-4 Al SEP�0P OUT ALrlRll DC-T 21 . -2009 If-1: 15 i4i'1 j,Lj�p.m I-14:DlJF'fiIiSP.R •3-4 SEN�: FUE1. OCT It- 20LO M:32 fY 3ENSC-R COUT OCT 11 . '2DICI I OUT AlLhlkll OCT DISPERSER OCT I" 2WQ I Cl:3.3 OUT r,LFHRm IF 'T 11 -3.2ck I J:24 HI'l -jEN, C'UT ALHR!-1 OCT 21 2 JL Tanknology Inc. 11000N.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: 10/25/2010 KERN CTY- ENVIROMENTAL HEALTH 2700 M STREET SUITE 300 BAKERSFIELD, CA. 93301 NOV 2010 Test Date: 10/11/2010 MERN COUNTY Etivi Order Number: 3178155 SIRMCES Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CHEVRON 98109 1131 OAK ST. X/ST CALIFORIA AVE BAKERSFIELD, CA. 93304 Testing performed: Impact Valve Leak detector tests Monitor Certification Secondary Containment-Spill Container Sincerely, KAWrA- Dawn KohImeyer Manager, Field Reporting � njQ10�0 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: 10/11/10 WORK ORDER NUMBER: 3178155 CUSTOMER PO: 15055724 CLIENT: CHEVRON PRODUCTS COMPANY SITE:CHEVRON 98109 145 S.STATE COLLEGE BLVD 1131 OAK ST.X/ST CALIFORIA AVE SUITE 400 BAKERSFIELD,CA 93304 BREA,CA 92821 TINA SCOLARO MANAGER-JALED (714)671-3356 (661)324-7621 Product Pipe Ti htness Test Results TEST TYPE: TLD-1 IMPACT LIN INE U DEL R ST ESULT INAL L I. PRODU T MATERUiL TYPE C D A B C D FUNCTIO 1 1 SUPREME DW FIBERG PRESSURE Y 2 2 PLUS DW FIBERG PRESSURE Y 3 3 REGULAR DW FIBERG PRESSURE Y 4 4 DIESEL DW FIBERG PRESSURE Y Existinq Line Leak Detector Test FJ(IS1�NG 1!lEAK�DEtTECT R# EXisn GIBE-- ET1E_C_TOR#2 01 EIIIIIIIIIIIIIIIIIIIII MANUFACTURER MODEL# SERI, IMANU T ID 1 1 VEEDERROOT ELECTRONI 255795 P 2 2 VEEDERROOT ELECTRONI 296578 P 3 3 VEEDERROOT ELECTRONI 001095 P 4 4 VEEDERROOT ELECTRONI 153413 P New Replacement Line Leak Detector Test . M 17 '7 i' r �' I l '1 1• _ LI E MANUFACTURER MODEL# SERIAL# RESUL UFACTUR R F MODEL NS ER # RESUL I' 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 Printed 10/25/2010 08:42 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS OP TenlvWicogy TEST DATE:10/11/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3178155 CLIENT:CHEVRON PRODUCTS AUSTIN,TEXAS 78759(512)451-6334 SITE:CHEVRON 98109 T` K INFO ''ATI(�N Tank ID: 1 1 Tank manifolded: NO Bottom to top fill in inches: 156.0 Product: SUPREME Vent manifolded: YES Bottom to grade in inches: 161.0 Capacity in gallons: 9,842 Vapor recovery manifolded: YES Fill pipe length in inches: 56.0 Diameter in inches: 91.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 354 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW FIBERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TANK Tj E-$—jrj R ESULTS T Method va uTect ETECTOR TEST RES T Test method. FrA Start(in) End(in) Dipped Water Level: New/passed Failedfreplaced New/passed Failed/replaced Dipped Product Level: L.D.#1 L.D.#1 L.D.#2 L.D.#2 Probe Water Level: Make: VEEDERROOT Ingress Detected: Water Bubble Ullage Model: ELECTRONIC Test time: S/N: 755795 Inclinometer reading: Open time in sec: VacuTect Test Type: NOT Holding psi:Resiliency cc: NOT VacuTect Probe Entry Point: TESTED Test leak rate ml/m: 189.0 TESTED Pressure Set Point: Metering psi: 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 e'�S,t ty T -1 LINE A B C D Material: Dw FIBERG Diameter(in): 3.0 Length(ft): 250.0 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 10125/2010 08:42 INDIVIDUAL TANK INFORMATION AND TEST RESULTS r 7brJd7cW ogy TEST DATE:10/11/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3178155 CLIENT:CHEVRON PRODUCTS AUSTIN,TEXAS 78759(512)451-6334 SITE:CHEVRON 98109 AN INFORM'AT10 Tank ID: 2 2 Tank manifolded: xo Bottom to top fill in inches: 155.0 Product: PLUS Vent manifolded: YES Bottom to grade in inches: 160.0 Capacity in gallons: 9,842 Vapor recovery manifolded: YES Fill pipe length in inches: 55.5 Diameter in inches: 91.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 354 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:VacuTect LEAK DETECTOR ST RESULTS es meth� A 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: VEEDERROOT Ingress Detected: Water Bubble Ullage Model: ELECTRONIC Test time: S/N: 296578 Inclinometer reading: Open time in sec: Holding psi: VacuTect Test Type: NOT Resiliency psi: NOT VacuTect Probe Entry Point: TESTED Test leak rate ml/m: 189.0 TESTED Pressure Set Point: Metering psi: 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 E TEST RE UL+ Test typ TLn LINE A B D Material: Dw FIBERG Diameter(in): 3.0 Length(ft): 250.0 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 10/25/2010 08:42 INDIVIDUAL TANK INFORMATION AND TEST RESULTS V Ta TEST DATE:10/11/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3178155 CLIENT:CHEVRON PRODUCTS AUSTIN,TEXAS 78759(512)451-6334 SITE:CHEVRON 98109 TANK INFOR'M'ATION Tank ID: 3 3 Tank manifolded: NO Bottom to top fill in inches: 155.0 Product: REGULAR Vent manifolded: YES Bottom to grade in inches: 160.0 Capacity in gallons: 9,842 Vapor recovery manifolded: YES Fill pipe length in inches: 55.5 Diameter in inches: 91.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 354 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW FIBERG Installed: ATG Stage 11 vapor recovery: ASSIST CP installed on: COMMENTS SAN TE RESU st d: cu- ct LEAKDE C O STRESUL s ethod. TA 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: VEEDERROOT Ingress Detected: Water Bubble Ullage Model: ELECTRONIC Test time: S/N: 003.095 Inclinometer reading: Open time in sec: Holding psi: VacuTect Test Type: NOT Resiliency s3.: NOT VacuTect Probe Entry Point: TESTED Test leak rate ml/m: 189.0 TESTED Pressure Set Point: Metering psi: 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 ST RESULTS Test e' •LD- LItJ EA V11111111110 B C Material: DW FIBERG Diameter(in): 3.0 Length (ft): 250.0 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 10/25/2010 08:42 INDIVIDUAL TANK INFORMATION AND TEST RESULTS i Tar*rW ►ogy TEST DATE:10/11/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3178155 CLIENT:CHEVRON PRODUCTS AUSTIN,TEXAS 78759(512)451-6334 SITE:CHEVRON 98109 TANWINEORM ATION Tank ID: 4 4 Tank manifolded: NO Bottom to top fill in inches: 155.5 Product: DIESEL Vent manifolded: NO Bottom to grade in inches: 160.5 Capacity in gallons: 9,842 Vapor recovery manifolded: NO Fill pipe length in inches: 57.0 Diameter in inches: 91.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 354 Overspill protection: YES Stage I vapor recovery: NONE Material: DW FIBERG Installed: ATG Stage II vapor recovery: NONE GP installed on: COMMENTS AN TEST R SUL S st M 8th •:V• Mec L D CTOR ST RE UL est method: A 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: VEEDERROOT Ingress Detected: Water Bubble Ullage Model: ELECTRONIC Test time: S/N: 153413 Inclinometer reading: Open time in sec: VacuTect Test Type: NOT Holding psi:Resiliency cc: NOT VacuTect Probe Entry Point: TESTED Test leak rate ml/m: 189.0 TESTED Pressure Set Point: Metering psi: 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 est e: TLD IN B C Material: DW FIBERG Diameter(in): 3.0 Length (ft): 250.0 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 10/25/2010 08:42 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 98109 City: BAKERSFIELD CA Zip:93304 Site Address: 1131 OAK ST.X/ST CALIFORIA AVE Contact Phone No: 324-7621 Date of Testing/Service: 10/11/2010 Facility Contact Person: MANAGER-JALED I III III VIII II II Make/Model of Monitoring System:TLS-350 Work Order Number: 3178155 35 B.Inventory of Equipment Tested/Certified IE Check the appropriate boxes to indicate specific equipment inspected/serviced Tank ID: T-1 Tank ID: T-2 PLUS 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 Sumprrrench Sensor(s). Model: 208 Piping Sump/Trench Sensor(s). Model: 208 X Fill Sump Sensor(s). Model: 208 208 Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: 3( Electronic Line Leak Detector. Model: PLLD X Electronic Line Leak Detector. Model: PLLD X Tank Overfill/High-Level Sensor. Model: EXT ALARM Tank Overfill/High-Level Sensor. Model: EXT ALARM 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: Tank ID: In-Tank Gauging Probe. Model: MAG PROBE In-Tank Gauging Probe. Model: MAG PROBE _X] Annular Space or Vault Sensor. Model: 409 Annular Space or Vault Sensor. Model: 409 X Piping Sumprrrench Sensor(s). Model: 208 X Piping Sump/Trench Sensor(s). Model: 208 _X1 Fill Sump Sensor(s). Model: 208 X Fill Sump Sensor(s). Model: 208 Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: X Electronic Line Leak Detector. Model: PLLD X Electronic Line Leak Detector. Model: PLLD Tank Overfill/High-Level Sensor. Model: EXT ALARM Tank Overfill/High-Level Sensor. Model: EXT ALARM 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: 1-10 Dispenser ID: ®Dispenser Containment Sensor(s) Model: 208 Dispenser Containment Sensor(s) Model: X❑Shear Valve(s). Shear Valve(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). Dispenser ID: Dispenser lD: 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): �X System set-up XD Alarm history report Technician Name(print): FRANCISCO CASTRO Signature: 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: 10/11/2010 Monitoring System Certification Page 1 of 3 1113111111 ill 1111 36 Based on CA form dated 03/08 IE Monitoring System Certification Site Address 1131 OAK ST.X/ST CALIFORIA AVE Date of Testing/Service: 10/11/2010 D. Results of Testing/Servicing Software Version Installed: 327.04 Complete the following checklist: x Yes No' Is the audible alarm operational? Q Yes No Is the visual alarm operational? ❑x Yes No Were all sensors visually inspected,functionally tested,and confirmed operational? ❑x 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 nx Yes D No' NIA 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; ❑x Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ❑X Yes No �x Yes O 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? so % Yes* nx 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 1:1 No Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports,if applicable. ❑x Yes n 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: 1131 OAK ST.X/ST CALIFORIA AVE Date of Testing/Service: 10/1112010 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? MYes ❑No' Was accuracy of system product level readings tested? OYes ❑No• Was accuracy of system water level readings tested? El Yes ❑No• Were all probes reinstalled properly? QYes ❑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 00.2 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? ❑Yes ❑No• ❑NIA For mechanical LLDs,does the LLD restrict product flow if it detects a leak? ❑ X Yes ❑No' ❑N/A For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? MYes ❑No' ❑N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? ❑x Yes ❑No' ❑N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? M Yes ❑No• ❑NIA For electronic LLDs,have all accessible wiring connections been visually inspected? MYes ❑No' I 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 98109 Date of Testing: 10/11/2010 Facility Address: 1131 OAK ST. X/ST CALIFORIA AVE , BAKERSFIELD, CA, 93304 Facility Contact: MANAGER - JALED Phone: (6 61) 324-7621 Date Local Agency Was Notified of Testing : 10/11/2010 Name of Local Agency Inspector(if present during testing): ERNIE MEDINA 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 PHIL-TITE SPILL BUCKETS 08/02/2012 3. SUMMARY OF TEST RESULTS Not Repairs Not Repair Component Pass Fail Tested Made Component Pass Fail Tested Spill Box 1 SUP FILL ❑ ❑ ❑ 1-1 ❑ ❑ ❑ Spill Box 2 PLU FILL El ❑ ❑ ❑ ❑ ❑ ❑ ❑ Spill Box 3 REG FILL E ❑ ❑ ❑ ❑ ❑ ❑ ❑ Spill BOX 4 DIE FILL E ❑ ❑ ❑ ❑ ❑ ❑ ❑ Spill Box 3 REG VAPOR El ❑ ❑ ❑ ❑ ❑ ❑ ❑ Spill Box 2 PLU VAPOR x ❑ ❑ ❑ ❑ ❑ ❑ ❑ Spill Box 1 SUP VAPOR X ❑ ❑ ❑ ❑ ❑ ❑ ❑ D El D 0 1:1 Eli I EJ El D El 0 1:111:11 E F 1:1 El F El El El F-1 El If hydrostatic testing was performed,describe what was done with the water after completion of tests: SPILL BUCKET TEST WATER WAS LEFT ON SITE 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: _,,,,,4 1 A Date: 10/11/2010 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 6vner 1operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: CHEVRON 98109 Date of Testing: 10/11/2010 Facility Address: 1131 OAK ST. X/ST CALIFORIA AVE , BAKERSFIELD, CA, 93304 Facility Contact: MANAGER - JALED Phone: (6 61) 324-7621 Date Local Agency Was Notified of Testing : 10/11/2010 Name of Local Agency Inspector(if present during testing): ERNIE MEDINA 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: FRANCISCO CASTRO Credentials 1: E CSLB Contractor El ICC Service Tech. 0 SWRCB Tank Tester E Other(Spec)A / UT License Number: 743160 / 8026747 3. SPILL BUCKET TESTING INFORMATION Test Method Used: ❑ Hydrostatic El Vacuum ❑ Other Test Equipment Used:MEASURING TAPE Equipment Resolution:VISUAL Identify Spill Bucket(By Tank 1 1 SUP FILL 2 2 PLU FILL 3 3 REG FILL 4 4 DIE FILL Number, Stored Product, etc.) Bucket Installation Type: Direct Bury ❑Direct Bury Direct Bury Direct Bury X❑ Contained in Sump X❑ Contained in Sump OX Contained in Sump ❑ Contained in Sump Bucket Diameter: 1111 1111 1111 1111 Bucket Depth: 1211 1211 1211 1211 Wait time between applying 5MIN 5MIN 5MIN 5MIN vacuum/water and starting test: Test Start Time(TI ): 12 :3 0 0 9:15 0 9:15 09:15 Initial Reading(RI ): 91, 9.5" 911 91, Test End Time(TF ): 1:30 10:15 10:15 10:15 Final Reading(R F ): 91. 9.5" 91, 9" Test Duration: 1HOUR 1HOUR 1HOUR 1HOUR Change in Reading(R F-RI ): 0 0 0 0 Pass/Fail Threshold or 0 0 0 0 Criteria: es R lt: I ass ® ail ail ®® a ail ass © ai CommeiltS - (include information on repairs made prior to testing, and recommended follow-up for failed tests) REPLACED DRAIN VALVE AND O-RING ON 87 SPILL BUCKET. 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: do.,Z-e- % Date: 10/11/2010 I State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements 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 fdcility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: CHEVRON 98109 Date of Testing: 10/11/2010 Facility Address: 1131 OAK ST. X/ST CALIFORIA AVE , BAKERSFIELD, CA, 93304 Facility Contact: MANAGER - JALED Phone: (661) 324-7621 Date Local Agency Was Notified of Testing: 10/11/2010 Name of Local Agency Inspector(if present during testing): ERNIE MEDINA 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: FRANCISCO CASTRO Credentials 1: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 1 3 REG VAPOR 2 2 PLU VAPOR 3 1 SUP VAPOR 4 Number, Stored Product, etc) Bucket Installation Type: ❑Direct Bury F-1 Direct Bury E]Direct Bury ❑Direct Bury X❑ Contained in Sump X❑ Contained in Sump 0 Contained in Sump ❑ Contained in Sump Bucket Diameter: 1111 1111 ill, Bucket Depth: 1211 1211 1211 Wait time between applying 5MIN 5MIN 5MIN vacuum/water and starting test: Test Start Time(TI ): 10 :3 0 10:3 0 10:3 0 Initial Reading(R1 ): 10" 10" 10" Test End Time(TF ): 11:30 11:30 11:3 0 Final Reading(RF ): 10" 10" 10" Test Duration: 1HOUR 1HOUR 1HOUR Change in Reading(R F-Rt 0 0 0 Pass/Fail Threshold or 0 0 0 Criteria: T st esult: l IS ail © ss n Pass � a' ,U ass -1M Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) REPLACED DRAIN VALVE AND O-RING ON 87 SPILL BUCKET. 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: ,,,,4 % ,� Date: 10/11/2010 1 State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759 (512)451-6334 FAX(512)459-1459 TEST DATE:10/11/10 WORK ORDER NUMBER3178155 CLIENT:CHEVRON PRODUCTS COMPANY SITE:CHEVRON 98109 COMMENTS Conduct Witness Annual Monitor Certification with Bakersfield Fire Department. Site contacted 10/6/10, confirmed with "HASU". PARTS REPLACED QUANTITY DESCRIPTION 1 REPLACEMENT DRAIN VALVE ASSY; HANDLE-5 GAL CAPACTIY 1 SHUT OFF O RING HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) ITE S 3 0 HELIUM PINPOINT LEAK TEST RESULTS —M Printed 10/25/2010 08:16 ACRAMER SITE DIAGRAM Ap Tank w logy 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759 (512)451-6334 FAX(512)459-1459 TEST DATE: 10/11/10 WORK ORDER NUMBER3 17 8 15 5 CLIENT:CHSVRON PRODUCTS COMPANY SITE: CHEVRON 98109 Chevron#98109 DSL LO 1131 Oak St. 1 L TP 10K LTA I � #1 9 Bakersfield, CA 93304 STP SUP A Oj D 10K L� L1 UL #1 STP A n 99 # 7 # #5 #4 3 10K L8 L P t SU �'`,I� ) I 10K L5 L4 S E ►W N cas VENT O Printed 10/25/2010 08:16 ACRAMER Work Order: 3178155 (ESO)&(ESV)Testing Form-Version t-6/258007 Emergency Shut 0 ff (ESO) & Dispenser Emergency Shutoff Valve (ESV) ANNUAL TEST RECORD LOCA NS AND TEST DATA Corn /�an : t 1LHC 1. Y Date: l a Location Name: L 'r(�f�r1 " 3%�� Store#: State ID#: Address: 3 r ♦� T' [.�t�t ht��Ax U/ City: K State: Eme enc Shut Off ESO Testing Resu s On 1r (/0 in accordance with"ESO Vendor Letter 3-2 1-05).doc",from Valero's Retail Compliance Department, as a part of annual compliance t ing,this representative tested the Emergency Shut Off ESO switches indicated on this ske h. Findings listed below: Emergency Shut Off(ESO) Provide Operational? I N FlfNo, aintenance Log is Date Called: DisiDenaer Emer ncy Shutoff Valve ES Testing Results On � in actor ante with NFPA 30A this repre i ntative tested the automatic-closing feature of the Dispenser Emergency Shutoff VAI,VE(S)(ESV)l ed in the supply lines at the base of each individual island type dispenser indicated on the diagram Wow.Each device(#) t_7 ^in all, would automatically close. Finjjjngs listed below: Disp.Emergency Shut Off I if No,Provide Valve(ESV)Operational? / N Maintenance Log# Date Called: Site hLV Of I Axation and Placement Devices Tested: i I �I I 'S91 r- R Fly $� Signature Of Representative: I Tanknology Inc. 11000N.MoPac Expressway,Suite 500,Austin,Texas 78759 Work Order: 3178155 04 T 2:PLLIS T Hl-"'H t•f;TER r`1LHR'('1 H1,3H b •f'ER- HIGH 1,;JiiTEP fiI_Hkrl 'T I I 21 01-7 1 1, 201 u ] :41 (41 �CT I • 2009 �f:5` -1-1 0 C! 54 ;rl V " - %'ICT I I 20J0 t0:56 (AM H­ J 3'.. 20013 NQV cl 0 1 o:'4 Am -X'T 2! 2009 8:53 AH -_,VEKT1 L-L ALHRI-1 01,-'E?F'f L I.. OVERFILL '010 i 1 :114 t'il'l B I.P 26, 2010 10:',45 N1 'T 1 1 - '01C, I OCT 21, 2cio9 0 UL 47. _�010 1 ;56 al"I NOV 0 F, ,ID:L;Fj A,', 1 U L '21 9.. _H�10 1 -.47 i4l DDIJ PROD,ji".T LC,L,) ;'RoDUf.:T i�IAF-I­i j.01d F)Pt--DUCT qLHRH Nc,v 3. ZOOEI 11,-J::3W iiUG 25. 2010 7j:7j1 P11 EC� ;?• 2009 5:23 PH SUDDEH SUDDEN L,��;S EB l6, 2110L) 5:19 PI") ,"iCT I I . 2010"1 1 :38 -il" 61-7 1 1 • --Ci I P 1 S Am T 21 . 1 i 0 1;r 8:48 "'-f f2CT 21. 200,; ci 5 c' hm 'Pi U D L)E N 1_-,)S` kLHF.fi rltiJSi 2"DUG 10 Wl hc�'o .3, -2�1: uit I r): Ar•j Cx'T I i . 201 C, I I :'Jcj AH HIGH S, "CIC10 11 CI 01 H-63 10:21 1 PPI f�L,�iFvl 1,40V 1. F I I . 2C I I Fj I ID:55 "1"'1 `OCT 11 - 2111 U I i4n 9:104 Al'I H11',H PP-'_Dk.h.'T A _'T I I, RCI 10 10:S": f-4P1 0CT 21, 2 2009 9:.'1 AV-' K%' 3.. 2005 u:4E• W,j (Y�T I 1 20 113 IID:5 21 t4l 01.j �_'I _1009 '�4:2 f*1 I El FUEL LE�!EL 111 FUEL 1009 1 1 iLA111 201 0 1 1 :39 !41-! 01:7 1 1 2 C,Io, 1 1 !-j-� IALK� 21 7 �4'T 21, 2 0 0 ci P-:4 ",II-I C"f 21 2 0 0 1 NVLiL I D FLIEL LEVEL i4 •V *3' 2003 t G:_A-1 h+I NOV 91 200e, 1 i OCT 1 1 2010 11 .36 N,1 F'R';bE UT )UT '00T :I :'005 a:49 W1 0.:34 HN I fi'.S", Al-i 61"T I i . 201 is 1 H• ri t I--, 1 0:55 Hr 1 WT 21. Q-:T I 1 011; 1 Cj:54 1- t I T 21 - '?009 a 51�-) -tX;T L 1 2010 1 C1:64 AM PROBE OUT HIGH Lli�TER HP';H W�iTER QQJ I 1 20 10 10:50 AM I 1 . 201 0 1 1 :41 r-f! 0,-'.T 11 - _l71 C, ► ;-OCT 21 1 �009 9:27 AN 01::T 21. .2009 A:5 WT 21 - 2001'-_1 HPI 8:;::14 ,;['l H I GH WATER 6)A)RN I Pp a 200e L13:'31 Hfl Icv 3. 2nCie I Z'.; 0:_'r -1 1 2 G I U 11 :41 W OCT I 1 20 i u 10:5 r;m DEL I NEEDED CK:T 21 a:5U F4,1 0l'T I I iD I o I I 3z; 4,1 __'T I I ' 20 1 Ci I I 2010 T 5. 3 Pm (X: -7 1 'z ri I D ­3 0 -rj-j b"T 4. 2ci j Ci j I I.j8 OCT It. 2(! 3I3 r;I,I NIV* FRC_1DLk'T (;LAPI-I �;LfiRrj PU17 25, '2c 0 1 :47 F-fl cl-.-,- -j s:•cl' 11 , "ij I C, rvY 27. 0 7. 13 T"M .4 11 - 2 cl I I- 10T 11 , �D(-t 1 t3 1� - >CT 0 C, 2 0 09 MAX PFA�)IJLIC r HLj:'P -.'('T 21, 3 Ff cj P, "t'j OCT I I 2c,1 ci I'j.5.-, OCT 21 ZO(j•g 9: NOV 3, R ';jL"R[ 'k:t-LL) AD*v H1'8Tc-R',: 3 L Ct I I G' H11 PLL11 SHUTDoWN _'Fl 1 0 3:PF.cmjLAR 1..I HE V'�; 1. PLLD `4UTT'Gi•,N HLHRm (1 21-1 If) OCT 11 LI N L E FHI '1'_I n I I j PLLD LRt• GK-ISS LINE Fr;ff_ PLLf! 'S-HJT[c_-1IJJ4 rt1.HRf I I - 'xcll cl I Ij: 18 OUT 11, 2010 12 213107 1 i i c4 PLLD SHUTDOI,IN C1:r 11 1110 10:1 a:T 11 2 ij I C 10:50 hif} PI_L D H I_JT 1 I 1, 2ji ID I'D:42' PL1.11 X_'T I I '�'0 10 10 PLLD SHUTE);'.•I,Xj �ALARI­; . 201 u 1 L:�46 i4i Oi.7'T 1 -2,3 i(-I 10:41 Hri PLLD SHUTb-"t-.I,j r,Lt•f;pj PLLD SHUTDOWN r;L_AF.,t-j 0110 1t ::35 I�rl IOC'T It,. 2010 10:40 AN Tanknology Inc. 11000N.MoPac Expressway, Suite 500,Austin,Texas 78759 Work Order: 3178155 ALARM Hl-.3D-:-R'Z RFP•:%R • 208•)R T dKIESEL L. 1 :230PRE"E rirjl•;ljLr-,R L 6:PLL'S TIJPDlrqE SUMP ,qW&LviR EP {C:= STP �,DHP k H,,H iJATEF,. FUEL. ALHRM 0(,T 1 1 . 2 u 1 o I 1 1 j� FLIEL �il-ARN WT 2" 2009 8:56 n 0-:7 11. '-ZOIU 11-1:4 3 r41 IxT 11. 210111 10:36 All ()'v'ERFILL ALmRl 'SENSOR OUT HL�)Rll :SENSOR 01-IT 20 10 11 02 W-1 LN::T 1" 2003 10:24 i;l,l OCT I 1 2010 10:'24 i�il-i 21---'l D 11 :CI; H111 SDISOR, CWT SEN�;QR OUT ADAPPII COT 11 2009 Vu W 11 OCT 21- 2064 _ ..J3 Pl•l -')(7 2 1 0 0 9 10: 16 N'l OCT 2 1 . 2009 v 52 to RLARI HISTOR; MORT ALAW 111STOW1 REPART OCT 11 . 20 10 101:59 w i L 2:SUPPE11P. V;1-1- 2UHP 1- 7:REGUD�. ri1-41-41JLr;R ),:'T 21 ?009 PIPING SUl"Ir WCUAR SPWE FUEL (M-ART-1 FLIEL 4ARM F I I F.4. LE'+-'El- OC,T I I . 101 1-i I-J:4_ All OCT 1 1 - 'zO 10 10:3) 141 ---0 i 171 1 1 CCT A. 200, 0:°.3 t-� '2ENSOP OLT ALHkr'l Anal It , 2010 10----4 f4l PWTE WT CCT 11 - 2010 I I :0 ril'i OUT rAL.Ai4l F,,E[,JSCR OUT ALr)Rll 0i:*T I I - 201 ID 1 t :1-1 ril' ot-,T 21 . 2005 1,l:I All CT 21 , 009 10' 16 All OCT 11 . :1-0 H[i PiL.HRM HIWG+P4•- RDOWf Hll-iH 14111P bir4,P,I fli-, .::),--:T 1l, 2010 L 15:5-" Aft I f -.1 Fjj XT 2 5 2009 8•56 m ,-, L G:Rb�UD�R FILL sui-jr- PIP[NG suplp STP SmP FUEL ALARm MAVEN NEEDE) FUS. mLARI OCT I I Cj 10 1 1,j:L4 0 ;,f•j -'.);-:T 11 . -1010 ll ::",j I SEP '26, 2-1010 t:-4', it, 2011- P SElC7i,`,R CWT Fm;L, Rr-j AUG 12. 2M 0 1 :Cid 11' 12010 113:24 All ,�EjjS,)F., OUT OCT 11AX PPODUCT r�LAFJI 1)1-':T I I - '2131 Ll 10; FUEL HLAF1.1 O,-';T I I.- ,-Ci I ij I iD:Fig Fj[ -EICOR GUT id-ARII 2FjlC1 e:IF ':T OCT '_1 I - 2-U"H 1'.-: 16 14-1 --cjDq 9:17 Hf L '.;.REGUI-r;R l'uRSINE SLWIP ALAW HISTWO eEFORT L 4-.p1-05 STP SUMP ;•gNUD:iR �'P,,('E FUEL ALAW FUEL O 11 , 2010 10:413 f4l Q WDIESEL 0 16 10:3-�- FLLLi SHUTD.,;;-1N FkDN Ri SEWOR OUT AUTH -'ID:13 1 j t H['11 20113 10'-'24 hf-I 6kiT OCT I I - - S0,6P GUT ALHRM 6RCj2,13 LINE FRlL ---wT OCT 21 . 2009 10-:15 41 XT 11 . ni OCT H REPORT PLLD �HUTDO,JN OCT 11 . 20113 11 :03PO KARN HIM& EEPORT SEWOR r NNULiiR' GRv JS FILL �:Ur-]P FUEL ��LAR�j CT LI N �i E FlL 11 . '2 0 115 11 :0' ,P. FUEL MARI ?010 115:+15 -,Il ACT H. 2U") L&J? AM SEMOR OUT AJAY'j PLLD SENSGR OUT HLHR,-i OCT 11, 2016 ii)-j4 oCT 11. 201C! 10:4r, i4t C)"T 11 . 2010 il::L--;4 Hrt. i SEN7-,Op. OUT �ll ARr i — r<*T 21 1u:15 A,,, PLLD SHIZE, Il.-N ;-iLHRll OUT HLiR;l COT 11.- '010 10:45 4! (:!•(::T 21 , 2100,9 10: 1b r�!Wl 2 Pl.LD D' '7T l- I I • _111 0 10:45 Hl' Tanknologylnc. 11000N.MoPac Expressway, Suite 500,Austin,Texas 78759 Work Order: 3178155 HLrIFJ,l ISOR L,lI :[jlUTL FILL Elll•F' SEN&%R' FUEL ,,iL�RH OCT I1 2,0 1 Ci 10 FUEL A4ARI­i OC'T I 1 2610 10:`14 iirj �'ENSOR' OUT HLiiFr• OCT I I _-'CI I Ij I G-:24 1 il'l "')UT �;L"'-Rl I SEN2nC_)R C'UT nD;Rll 10: 1 5 r1l 2Ef4PC)R OUT I:,f_j4rj..j OCT 21, PL (.P'� FiLAR•I 'j'1jPF,,I(-4E -FiJEL ALOR• 1.1 '7:DISPENSFER Pf;.Il FIJEL t-4.ARM :AJT 141.0-19H t F, 1 C15 HI FAL 0 i;J 113 r4"1 P, �ENSOF. OUT -iLr'-iRfl I 'T _Oily 1 D;15 HI'l LS r�LHRH 2l.'PE 1%23ER I- PHN FUEL HUHRlll DCT I 1 2`01 fj AL'',RH c'.'f'.:T 11. 201 U I Cl'.2A i11 OUT C:T '31 . '0139 113:1S i4;'l M" R P +-T E 1.14-,DISPENSER .3-4 j,­.-F,Em;EP FUEL f-,Lr4F'll IDEI]SC-R OUT OCT 11 ".'010 IFJ:'-4 Q UT . 20 D I,-pFt.jSXP j'jr:.T'FT'is:F_P FUEL N'LAFM r"cT ll . 2.611-1 I 0:;-Q P,:•l i;Lf-iRll j 1 6C,'T ,jElmOR OUT OCT 21 . 2009 10*1' Tanknologylnc. 11000N.MoPac Expressway, Suite 500,Austin,Texas 78759 pates J'PP Tanknology 11000 N. MoPac Expressway,Suite 500 Austin,Texas 78759 Phone: (512)451-6334 Fax: (512)459-1459 Date Printed and Mailed: 10125/2010 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR CRAIG PERKINS 1501 TRUXTUN AVE. BAKERSFIELD, CA. 93301 Test Date: 10/11/2010 Order Number: 3178155 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CHEVRON 98109 1131 OAK ST. X/ST CALIFORIA AVE BAKERSFIELD, CA. 93304 Testing performed: Impact Valve Leak detector tests Monitor Certification Secondary Containment-Spill Container Sincerely, ,/ Oa+sr 1�A - Dawn Kohlmeyer Manager, Field Reporting TANKNOLOGY CERTIFICATE OF TESTING FESTDATE: gy 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759 TELEPHONE(512)451-6334 FAX(512)459-1459 COMPLIANCE TEST RESULT SUMMARY REPORT 10/11/10 WORK ORD ER NUMBER: 3178155 CUSTOMER PO: 15055724 CLIENT: CHEVRON PRODUCTS COMPANY SITE:CHEVRON 98109 145 S.STATE COLLEGE BLVD 1131 OAK ST.X/ST CALIFORIA AVE SUITE 400 BAKERSFIELD,CA 93304 BREA,CA 92821 TINA SCOLARO MANAGER-JALED (714)671-3356 (661)324-7621 TEST TYPE: TLD-1 Product Pipe Tightness Test Results LINE LmFE MVERY IMPACT ID PE FINAL LEAs l RATE gph) VE A B FUNCTIO 1 1 SUPREME DW FIBERG PRESSURE Y 2 2 PLUS DW FIBERG PRESSURE Y 3 3 REGULAR DW FIBERG PRESSURE Y 4 4 DIESEL DW FIBERG PRESSURE Y Existing Line Leak Detector Test EXIStTiING1LE'AKiR TEC7TkO— #I ®EXISiTiING LE;41(iDE E TDRI#2_�® 11 ID MANUFACTURER MODEL# SERIAL# RESULT MANUFACTURER MODEL# SE # RESULT 1 1 VEEDERROOT ELECTRONI 255795 P 2 2 VEEDERROOT ELECTRONI 296578 P 3 3 VEEDERROOT ELECTRONI 001095 P 4 4 VEEDERROOT ELECTRONI 153413 P New Replacement Line Leak Detector Test (N MANUFACTURER 11111111~MODEL# SERI # RESU MAN FAGTUR O E R R SUL 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 Printed 10/25/2010 08:16 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS Tanknokpqy FTEST :10/11/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3178155 CLIENT:CHEVRON PRODUCTS AUSTIN,TEXAS 78759(512)451-6334 SITE:CHEVRON 98109 TA�t�K INFORM%kTION Tank ID: 1 1 Tank manifolded: NO Bottom to top fill in inches: 156.0 Product: SUPREME Vent manifolded: YES Bottom to grade in inches: 161.0 Capacity in gallons: 9,842 Vapor recovery manifolded: YES Fill pipe length in inches: 56.o Diameter in inches: 91.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 354 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW FISERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS WMKjTME8—NRESVM qstfMgt hOd:VaeuTee LEAK DETECTOR TES RESULTS mule" st m SET 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: VEEDERROOT Ingress Detected: Water Bubble Ullage Model: ELECTRONIC Test time: SAN: 255795 Inclinometer reading: Open time in sec: Holding ps VacuTect Test Type: NOT i: Resiliency cc: NOT VacuTect Probe Entry Point: TESTED Test leak rate ml/m: 189.o TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: 3.00 Water table depth in inches: Results: PASS Determined by(method): Result: COMMENTS COMMENTS IN TEST RESULTS es type TLD-1 LIN A B C Material: Dw FIBERG Diameter(in): 3.0 Length(ft): 250.0 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 10/25/2010 08:16 INDIVIDUAL TANK INFORMATION AND TEST RESULTS Ji Tanknobgy FTEST :10/11/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3178155 CLIENT:CHEVRON PRODUCTS AUSTIN,TEXAS 78759(512)451-6334 SITE:CHEVRON 98109 TAN INFdRMA�TION Tank ID: 2 2 Tank manifolded: No Bottom to top fill in inches: 155.0 Product: PLUS Vent manifolded: YES Bottom to grade in inches: 160.0 Capacity in gallons: 9,842 Vapor recovery manifolded: YES Fill pipe length in inches: 55.5 Diameter in inches: 91.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 354 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG Stage 11 vapor recovery: ASSIST CP installed on: COMMENTS TAN TEST RESULTS es Method:VacuTeet Start(in) End(in) LEAK DETECTOR TEST RESULTS Tes method: A 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: VEEDERROOT Ingress Detected: Water Bubble Ullage Model: ELECTRONIC Test time: S/N: 296578 Inclinometer reading: Open time in sec: Holding psi: VacuTect Test Type: NOT Resiliency cc: NOT VacuTect Probe Entry Point: TESTED Test leak rate ml/m: 189.0 TESTED Pressure Set Point: Metering psi: 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 RESULTS Test type: TLD- LINE A 8 D Material: Dw FIBERG Diameter(in): 3.0 Length (ft): 250.0 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 Emmmmum- Printed 10/25/2010 08:16 INDIVIDUAL TANK INFORMATION AND TEST RESULTS i TanlumWile gy TEST DATE:10/11/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3178155 CLIENT:CHEVRON PRODUCTS AUSTIN,TEXAS 78759(512)451-6334 SITE:CHEVRON 98109 TANK INFORMATION Tank ID: 3 3 Tank manifolded: NO Bottom to top fill in inches: 155.0 Product: REGULAR Vent manifolded: YES Bottom to grade in inches: 160.0 Capacity in gallons: 9,842 Vapor recovery manifolded: YES Fill pipe length in inches: 55.5 Diameter in inches: 91.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 354 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:VaeuTee LEAK DETECTOR TEST RESULTS 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: VEEDERROOT Ingress Detected: Water Bubble Ullage Model: ELECTRONIC Test time: S/N: 001095 Inclinometer reading: Open time in sec: VacuTect Test Type: NOT Holding psi:Resiliency cc: NOT VacuTect Probe Entry Point: TESTED Test leak rate ml/m: 189.0 TESTED Pressure Set Point: Metering psi: 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 RESULTS Test type: TLD-1 LINE B D Material: DW FIBERG Diameter(in): 3.0 Length (ft): 250.0 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 10/25/2010 08:16 INDIVIDUAL TANK INFORMATION AND TEST RESULTS i Tanknology TEST DATE:10/11/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBERS 178155 CLIENT:CHEVRON PRODUCTS AUSTIN,TEXAS 78759(512)451-6334 SITE:CHEVRON 98109 TANK INFORIN'ARtON Tank ID: 4 4 Tank manifolded: NO Bottom to top fill in inches: 155.5 Product: DIESEL Vent manifolded: NO Bottom to grade in inches: 160.5 Capacity in gallons: 9,842 Vapor recovery manifolded: No Fill pipe length in inches: 57.0 Diameter in inches: 91.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 354 Overspill protection: YES Stage I vapor recovery: NONE Material: Dw FIBERG Installed: ATG Stage II vapor recovery: NONE CP installed on: COMMENTS ES RTAN TEST RESULTS est Metho SULTS Tes 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: VESDERROOT Ingress Detected: Water Bubble Ullage Model: ELECTRONIC Test time: S/N: 153413 Inclinometer reading: Open time in sec: Holding psi: VacuTect Test Type: NOT Resiliency c s NOT VacuTect Probe Entry Point: TESTED Test leak rate ml/m: 189.0 TESTED Pressure Set Point: Metering psi: 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 RESULTS Tes TLD-1 LINE A B C D Material: Dw FIBERG Diameter(in): 3.0 Length (ft): 250.0 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 10/25/2010 08:16