HomeMy WebLinkAbout2010 RESULTS IIIIIIIIIIIIIIIIIIII 23 MONITORING SYSTEM CERTIFICATION ��yv
IES
For lise By,All Jurisdiclions Within the Slate of Californiu
,lulhority Cited: Chapler 6.7, 11callh and Safety Code; Chapter 16, Oivision.3, Title 23, Cali16rnia Coda of Regulations
This form must be used to document testing.and servicing,of monitoring equipment. A scnarule certification or retort must he prepared for each
monitoring system control Panel by the technician who performs the work.-A copy o,l'this form must be provided to the tank systcrn otvnert'operutor_
The mxnerioperator must submit a copy cif this form to the local 4cncy regulating UST systerris within 30 days of icsi dirk.
A. General Information
Facility Name: STOCKDALE MOBIL _ " Bldg. No.:
Site Address: 13001 STOCKDALE HWY City: BAKERSFIEL_D _ _ Zip: 93314
Facility Contact Person: Contact.Phone No.:
MakelModel of Monitoring System: TLS-350. Date of Test.ing,'Servicing: 9!812010,_
B. Inventory of.Equipment Tested/Certified
Cheek the appropriate boxes to indicates eeific U ui mcnt inspected/serviced:
Tank 1D: UNL87 Tank ID' UNL87 SYPHON
®hi-Tank Cadging Probe. Model: MAGi. El In-Tank Gauging_Probc. Model: MAG1
®Annular Space or Vault Sensor. Model: 409 ®Annular Spacc;or Vault Sensor. Model:,409
®Piping Sump,' French Sensor(s). Model: 208 ®Piping Sump./Trench Sensor(s). Model: 208
® Fill Sump Scnsor(s). Model: NO SENSOR ®:Fill Sump ScT**%), Model: 'NO SENSOR
®Mechanical Line Lcak Detector. Model: FX1V ®..Mccltanicat Line Leak Detector. Model: FXiV
❑Hectronic Zinc Leak Detector. Model: ❑Electronic Line l.eak'fmccior. Model:
❑'tank Overfill/I Iigh-l.cvel Sensor. Model: 0 Tank Overii)I t High-Level Sensor.- Model:
❑(Other( pccil'-quipmew type and model in Section t:on page:2). ❑Other(specify equipment type and model in Section Iz on Pa
Tank ID: PREM91 Tank iD: DIESEL
®'ln=Tank Gaining I?rohc. ' Model: MAG1 ®In-lank Gauging Probe: Model: MAGI
®Annular Space or Vault Scnsor. Model: 409 0 Annular.Space.or Vault Sensor. Model: 409
®Pipin&Sump/Trench Sensor(s). Model: 208 ®1,iping Sump I'French Sensor(s): Model: 208
0.Fill Sump Senso4s). Model: NO SENSOR . ®Fill Sump.Scnsor(s). Model: NO SENSOR
®Mechanical Line F.cA Detector. Model: FXIV ®Mechanical Line Leak Detector. Rlodel: FXiDV
❑Electronic Line I cak Detector. Moolcl: ❑1-JeclronicTinc.l.eak Detwor. Model:
❑3 ank overfill/!{igh-Level Scnsor. Model [] tank{Overfill/I ligh-Level.Sensor, Model
E]Other(specify equipment type and model in Scctioml:on Page 2). El Other(specify ciluipntcrtt.typc and model in Section f:on Page 2)_
DispenseraD: 1-2 Dispenser ID: 3-4
23 I)ispcnser Containment Sensor(s). Model: 406 Dispenser Containment Scnsor(s). Model: 406
®Shear Valvc(s). ®Shear Valve(s).
El Dispenser Containment P1oal(s)and Chain(s). ❑Dispenser Containment Float(s)and,Ghain(s).
Dispenser iD: 5-6 Dispenser.ID: 7-8
®Dispenser Containment Scns.or(s). Model: 406 0'1)ispcnscrContainment Sensor(s). Model- 406
Shear Valve(s)- ®Shear Valvc(s).
❑Dispenser Containment Fioat(s)and Chain(,). ❑Dispenser Coniainmcnt FWf(s)and Chain(s)_
'Dispenser ID: Dispenser ID:
❑Dispenser Containment Sensor(s), Model; ❑INspenscrC,onta'tntnent Scnsor(s). Model:
Q Shear Valve(s). ❑Shear Valve(s)_
C Dispenser Containment JFloat(O and Chain(s). []Dispenser Containment Float(s)and Chain(s).
•11'ihe facility contains more tanks or dispcnscrs,copy this.l'orrtt. Include information for every tank and dispenser at Lhc facility-
C. Certification -1 certify that the equipment'identified in this.document was,inspected/serviced in accordanee with the manufacturers'
guidelines. Attached to this Certification is information (e g. manufacturers' checklists)'necessary to verify that this information is
correct and a Plot Plan showing the layout?of monitoring equipment. For any.equipment capable of generating such reports,i have also
attached a copy of the report;(check all that apply): E.System set-up Alarm history report
Technician Name(print): STEVEN OBERT Signature:
Certification No.: A28531 ICC#8029980-UT . License.No.: C61/D40 809850
Testing Company Name: Rich Environmental Phone No.: :392.8687
Testing Company.Address: 5643 BROOKS CT.:BAKERSFIELD,.CA 93368 Date of Testing/Servicing:;9!812010
Page 1 of 5
UN-936- 1/4 24 Rev.01/17/08
IE
Monitoring System Certification ��`
D. Results of Testing/Servicing
Software Version Installed: .329.01
Com lete.the following checklist:
® Yes ❑ No* is the audible alarm operational?
® Yes ❑ No* is the visual alarm operational?
® Yes ❑ No* Were all sensors visually inspected;functionally tested,and confirmed operational?
® Yes ❑ No* Were all sensors installed at lowest point.of secondary containment and positioned so that other equipment will
not interfere with theirproper operation?
❑ Yes ❑ No* If alarms are relayed to a remote monitoring station, is all communications equipment (c.g:, modem)
El N%'A operational?
® Yes ❑ No* For pressurized piping systems, does the turbine automatically shutdown if the piping secondary containment
❑ N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? of yes: which sensors initiate
positive shut-down? (Check all,that apply) 0'Sump,/Trench Sensors; ❑ Dispenser Containment.Sensors.
Did you confirm positive shut=down due.to leaks and sensor failureldisconnectiob? 1gl Yes; ❑No.
C] .Yes ❑ No* For tank systems that utilize -the :monitoring system as the. primary tank overfill warming device (i.e., no
® NIA mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank
fill.point(s)and operating.properly? if so,at what percent of tank capacity does the alarm.trifler? %
❑ Yes* ® No Was any monitoring;equipment replaced? If yes, identify,specific sensors,probes, or other equipment replaced
and list the.manufacturer name and model for all replacement parts in Section.E,below.
❑ Yes* ® No Was liquid found inside any secondary containment systems designed.as dry systems? (Check all.thal.uppli>)
❑ Product;, ❑Water. if yes,describe causes in Section E, below.
® Yes ❑ No* Was monitoring system set-up reviewed to ensure proper settings?Attach set up'reporis, inapplicable
® Yes ❑ No* Is all monitoring equipment operational per manufacturer's specifications?
*.In Section E below,describe how and when tbese deficiencies were or will be:correeted.
E. Comments:
Page 2 of 5
"N-03b—214 W ww:unidocs.Org Rcv.01:/17/08
Monitt►ring System Certification
F. In-Tank Gauging/SIR Equipment: 0 Check this box if tank gauging is used only for inventory control.
❑ Check this box if no tank gauging or 5111 equipm:ent,is installed.
This section must he completed if in'-tank gauging equipment is usedfo perform leak detection:monitoring.
Complete the following checklist:
❑ Yes ❑ No* Has all input w firing been inspected for proper entry and termination, including testing for ground faults?
• Yes ❑ No* Were all tank gauging;probes visually inspected far damage and residue buildup?
• Yes ❑ No* Was accuracy of system product level readings tested?
❑ Yes ❑ No* Was accuracy ofsystem water level readings tested?
0 Yes ❑ No* Were all probes reinstalled properly?
❑ Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed?
*In Section H,below,describe how and when these deficiencies were or will be corrected.
G. Line Leak Detectors,(LLD): ❑ Check this box if LLDs are not'instalied.
Complete the following checklist:
® Yes ❑ No* For equipment start-up or annual equipment certification,.was,a leak simulated.to verify LLD.performance?
[] NIA (Check all that apply) Simulated leak rate: 0 3 g p.h.; ❑ 0.1 g;p.h ; ❑0.2.:g.p.h.
® Yes ❑ No* Were all LLDs confirmed operational and accurate within regulatory requirements?
® Yes ❑ No* 'Was the testing apparatus properly,calibrated?
® Yes ❑ No* For mechanical LLDs, does the LLD restrict product flow if it.detects a leak?
❑ N/A
0 Yes ❑ No* For electronic LLDs;does:the turbine automatically shutoff if the LLD detects a<leak?
® N 1
❑ Yes ❑ No* For electronic LLDs, does the turbine,automatically shut off if any portion of the monitoring system is disabled
® N/A or disconnected?
[] Yes ❑ No* For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring;system malfunctions:
® N%A or fails a test?
❑ Yes ❑ No* For electronic LLDs,have all accessible.wiring connections been visually inspected?
® NIA
® Yes ❑ No's Were all items on the.equipment manufacturer's maintenance,checklist completed?
' to Section,H,below,describe how and when these deficiencies were or will be corrected.
H. Comments: _
Page 3 of 5
tiv,036-314 wwwmnidoes oeg Rev.01/17708.
Monitoring System Certification Form:Addendum for Vacuum/Pressure interstitial Sensors
1. Results of Vacuum/Pressure Monitoring Equipment Testing �l
This page should be used.to document testing and servicing of vacuum and pressure..interstitial sensors.. A copy of
this form must be included with the Monitoring System Certification Form, which,must,,he provided to the tank.
system owner/operator. The o\0e6operator must submit a copy of the Monitoring System Certification Form to the
local agency regulating UST systems within 30 clays of test date.
Manufacturer: NIA Model: System Type: Q Pressure;Q Vacuum
Sensor,ID
Component(s)Monitored by this Sensor:
Sensor Functionality Test Result: ❑ Pass; ❑ Fail. Interstitial Communication Test Result: ❑Pass; ❑ Fail
Component(s) Monitored'by this Sensor: _
Sensor Functionality Test Result:❑Pass; ❑ Fail , Interstitial Communication'test Result: ❑ Pass; ❑ Fail
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result:,El Pass; ❑ Fail Interstitial::Communication Test Result: [] Pass; ❑ Fail
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result:❑ Pass; ❑ Fail Interstitial'Communication Test Result:❑Pass; ❑ Fail
Component(s) Monitored by'this Sensor:
Sensor Functionality.Test Result: ❑ Pass; ❑ Fail Interstitial Communication'Test Result:.❑ Pass; ❑ Fail
Component(s)Monitored by this Sensor:
Sensor Functionality Test:Result: ❑ Pass; ❑ Fail Interstitial Communication"test Result: ❑ Pass; ❑ Fail
Component(s)Monitored:by this Sensor:
Sensor Functionality Test Result; ❑ Pass; ❑ Fail Interstitial Communication`1'est.Result.:❑ Pass; ❑ Fail
Component(s) Monitored by this.Sensor;
Sensor Functionality Test Result: ❑Pass; ❑ Fail 'Interstitial Communication Test Result-: Q Pass; ❑ Fail
Component(s) Monitored by this:.Sensor:
Sensor Functionality Test Result-;E] Pass; ❑ Fail interstitial Communication Test Result:❑ Pass:, ❑ Fail
Component(s) Monitored by this Sensor:
Sensor Functionality Test Result;❑ Pass; ❑ Fail Interstitial Communication Test.Result:❑ Pass; ❑ Fail
How was interstitial communication verified?
0 Leak Introduced at.Far End of interstitial Space:! ❑: Gauge; ❑ Visual;Inspection; ❑ father(Describe in:Sec. d, below)
Was vacuum/pressure restored to operating levels in 911 interstitial.spaces? ❑Yes ❑No ff no, describe in Sec. J. below):
J. Comments: NONE OF THESE SENSORS ARE PRESENT AT THIS SiTE.
Page' 4 of 5
If the sensor successfully detects a simulated vacuum/pressure leak-introduced in the interstitial space at the furthest point from the
sensor,vacuum/pressure has been demonstrated to be communicatingahroughout the interstice.
1 N4MA-1/1 www.unidocs.org Rev.01/26/06
Monitoring System Certification
UST Monitoring SiteTlan-
Site Address:
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Date map was drawn;; q /
Ing'-uctions
If you already have a diagram,that shows all required information,you may include it; rafher,than this page,with your
Monitoring System Certification. On your site plan,show the generaf`layout,oftanks and piping.Clearly identify
locations of the following equipment,"if-iuistalled:tnonitoring.systern control panels; sensors,inonatoring tank annular
spaces, sumps,dispenser pans, spill containers,or other secondary containment areas;mechanical or electronic line leak
detectors;and in-tank liquid level probes(if used for leak detection) In the space provided,note the date this Site Plan
was prepared.
Page of _ 05100
1'All k
RICH ENVIRONMENTAL
5643 BROOKS CT. BAKERSFIELD,CA. 93308
OFFICE(661)392-8687:FAX (661)--)92-0621
PRODUCT LINE-LEAK DETECTOR TEST
WORK SHEET
W/0#:
FACILITY NAME: STOCKDALE MOBIL,
FACILITY ADDRESS: 13001 STOCKDALE HWY BAKERSFIELD, CA
PRODUCT LINE TYPE: PRESSURE
PRODUCT LEAK DETECTOR TYPE TEST TRIP PASS
BELOW P.S.I. OR
SERIAL NUMBER 3 G.P.H. FAIL
UNL87 L/D TYPE: FXIV
YES 13 PASS
SERIAL# 9152
PREM91 L/D TYPE.: FXIV
YES 13 PASS
SERIAL# 9151
DIESEL /D TYPE : FXI DV
-L
YES 10 PASS
SERIAL# 6579
L/D TYPE YES. PASS
SERIAI.# NO FAIL
I CERTIFY THE ABOVE TESTS WERE CONDUCTED ON.THIS DATE ACCORDING TO RED
JACKET PUMPS FIELD TEST APPARATUS.TESTING PROCEDURE AND LIMITATIONS.
THE MECHANICAL LEAK DETECTOR TEST PASS/FAIL IS DETERMINED BY USING A
LOW FLOW THRESHOLD TRIP:RATE OF 3 GALLONS PER HOUR OR,LESS AT l0 P.S.I. I
ACKNOWLEDGE THAT ALL DATA COLLECTED`IS TRUE AND CORRECT.TO THE BEST
OF MY KNOWLEDGE.
TECHNICIAN: STEVEN OBERT
SIGNATURE: DATE...9-8-10 .
SWRCB,January 2006-
Spill Bucket-Testing Report Form
This Jbrm is intended fir use by contractors perfc)rming annual testing of UST spill-containment structures. The completeclfi)rtn and
printouts from tests(if'applicahle), should he provided to the facility olvnerloperator for submittal to the local regulatory agency"
1. FACILITY INFORMATION
Facility Name: STOCKDALE MOBIL Date of Tes(ing: 9-8-10
Facility Address: 13001 STOCKDALE HWY BAKERSFIELD,CA 93314
Facility Contact: Phone:
Date Local Agency Was Notified of Testing
Name of Local Agency Inspector(if present during testing): ERNIE MEDINA
2. TESTING CONTRACTOR INFORMATION
Company Name.- RICH ENVIRONMENTAL
Technician Conducting"Pest: STEVEN OBERT
Credentials': I CSLB Contractor X.ICE Service"Tech. 1. 'SWRCB Tank Tester 1 Other(.SheciA)
License Number(s): 8029980-UT
3., SPILL BUCKET TESTING INFORMATION
Test Method Used: X Hydrostatic i I Vacuum ! Other
Test Equipment Used:VISUAL Equipment Resolution:0:0.0
Identify Spill Bucket (ay Tank 1 2 3 4
Number, Stored Product; etc, t'N�7 11Nt$7SYPti()N 1'Kl;a19t. DIESEL
Bucket Installation Type: I l Direct.Bury ! j Direct Bury 1.1 Direct Bury I ! Direct Bury
X Contained in Sump X Contained in Sump X Contained in Sump X Contained in Summa
Bucket Diameter: 12" 12 12" - " 12'
Bucket Depth: 16" 16" 16 16"
Wait time between applying
m water and start of test: 30 MIN N 30 MIN 3Q.-MIN 30 MIN
vacuu
Test Start Time(Ti): 9.00AM 0:00AM 9:QOAM 9:00AM
Initial Reading(R,): 13 13" 13" 13"
Test End Time(TO.- ]0:04AM 10;00AM 10:00AM l O:00AM
Final Reading.(RE): 13" 13" 13" — 131"
Test Duration (Ty-T,): 17HOUR. 1-HOUR 1.-HOUR 1-I IOU R
Change in Reading(Ri:-Ri): 0" 011 01, --_...- --- 0: —
Pass/Fail Threshold or
+/-0.00 ' +/-0.00 +/-0.00 r 0.00
Criteria:
Test Result .1L'a s }Fettl XE Ft s : [l F$il Pass_ :I:I Fjktl K Pass ti;1 Fail
Comments- (include information on repairs made prior to testing;and"recommended folloiv-up fi r failed tests)
CFRTIFICAT.ION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS.TESTINC
1 herefiy certify that all the informs ioit contained in this report h true,accurate,and in full compliance with legal requirements.
Technician's Signature: !_`__ Date:" 918/10
' State laws and regulations do not currently require testing to be-performed by a qualified contractor. However, local requirements
may be more stringent:
S.WRCB,January 2006
Spill Bucket Testing Report.Form
This form is intended for use by conlraelors performing annual testing bf UST spill containment struclures. The completed furrn and
printouts from tests (if applicable), shoidd be.provided to'thc facilityownerloperalor for submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: STOCKDALE MOBIL Date of Testing: 9-8-10
Facility Address. 13001 STOCKDALE HWY BAKERSFIELD,CA 93314
Facility Contact: Phone:
Date Local Agency Was Notified of Testing
Name of Local Agency Inspector(ifprecent during te tiny: ERNIE.MEDINA
2. TESTING.CONTRACTOR INFORMATION
Company Name: RICH ENVIRONMENTAL. _
Technician Conducting Test: STEVEN OBERT
Credentials': CSLB Contractor X 1CC Setvice Tech. t SWRCB Tank.Tester. I Other(Specify)
License Number(s): 8020980-UT
3. SPILL BUCKET:TESTING INFORMATION
Test Method Used: X Hydrostatic I.I Vacuum 1.l Other
"Test Equipment Used:VISUAL Equipment Resolution:0.00
Identify Spill.Bucket(By Tank 1 2 3 4
Number, Slored Produce, etc.) I1N.IS7-VAPOR 87-SYPII VAPOR PREN191 VAPOR
Bucket Installation Type: ' I Direct Bury I l Direct Bury I:Direct Bury.
X Contained in.Sum X Contained in Sum X Contained in Sum
Bucket Diameter: 12" 12" 12"
Bucket Depth: 16" 14'° 16". _
Wait time between applying 30 MIN iO MIN 30 MIN
vacuum/water and start of test:
Test Start Time(T,): 9:OOAM 9:00AM 9:00AM
initial Reading(R,): 13" 13„
'Pest.End Time M--): 10:00AM 10:00AM - IO:OOAM `
Final Reading(Rt): 13" 13" 13"
Test Duration(Tr--Ti): 1-1-10 UR 1 1-HOUR
Change in Reading(Ry-R,): 0" 0 0"
Pass,`F'ail Threshold or +/-0.00 +/-0.00 r/-0.00
Criteria:
Comments—(include information on repairs made prior,to`tsting'and recommended follow-up_for.luiled tests)
CERTIFICATION'OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
I hereby certt that all the information contained in this report is true,accurate,and in full compliance with legal requirements.
Technician's Signature: Date: 9/8110
State laws and regulations do not currently require testing to be'performed'by a.qualified contractor. However,local requirements
may be more stringent.
HLHfA"I 1-1 1�L UkY klrY4?k l` '»•,�... ...•...`•.• ....... _..- > t""ti`�'v -
----- SENSOR ALARM ----- ' ----- SENSOR ALARM -- SENSOR ALA -
L 1 :87 STP SIPHON L 41:8.7 ANNULAR SIPHON L 7:91 STP
STP SUMP ANNULAR SPACE STP SUMP
SENSOR OUT ALARM SENSOR OUT ALARM SENSOR OUT ALARM,
SEP 8, 2010 1 :26 PM SEP 8, 20.10 126 PM SEP S. 2010 1 :26 PI
FUEL ALARM FUEL. ALARM FUEL ALARM
SEP 8, 2010 1 :06 PM SEP G. 201:0 1 :12 PM, SEP 8, 2010 1 :09 P
* x * x
END xx * * X END X X X X END * *
ALARM HISTORY REPORT ALARM HISTORY REPORT ALARM HISTORY R£POR'
-- SENSOR ALARM ---- -- SENSOR ALARM ---- ----- SENSOR ALARM
L 2:87 ANNULAR L 5:DIESEL STP L ,8;91 ANNULAR
ANNULAR SPACE STP SUMP ANNULAR SPACE
SENSOR OUT ALARM SENSOR OUT ,ALAPM SENSOR OUT ALARM
SEP B. 2010 1 :26 PM SEP' 8. 2010 1 :26 PM SEP 8, 2010 1 :26 1
FUEL ALARM. FUEL. ALARM FUEL ALARM
SEP B. 2010 1 :12 PM SEP 8, 2010 1.:08 PM SEP 8, 2010 1 :13
x x x x A END x x x x �. x x � x x END X x END * x x
ALARM HISTORY REPORT ALARM HISTORY REPORT
----- SENSOR ALARM ----- ----- SENSOR ALARM -----
L 3:87 STP L 6:DIESEIL ANNULAR,
STP SUMP ANNULAR SPACE
SENSOR OUT ALARM SENSOR OUT,ALARM
SEP S. 2010 1 :26 PM SEP 8, 2010 1 :26 PM
FUEL ALARM FUEL. ALARM
SEP G. 2010 1 :07 PM SEP 8, 2010. 1 : 13 PM
i'ANK DIAMETER i �.+. ....�.. ✓ t �.�
1 5 J,V'13Q Ad3/1I73Q TANK PROFILE '` V96 PRODUCT CODE 3 - - - - - - - - -
t:5IV3d8 NOHdIS J.S.L AN.L FULL VOL I Ql TANK DI. METER : .1700450 SEP $. 2010 12 4/P
TANK DIAMETER y£.00
TANK PROFILE I PT
� :1.3IJ.OId 1.53:L }1NWJ. FLOAT SIZE: FULL. VOL 10000
4.0I SYSTEM UNITS
3 :ONIOVd3AV LS31 dad WATER, WARNING U.S.
Y :`7N_I OVdAAV IS31 NNW HIGH WATER I.,I M I T: 3 FLOAT SIZE: 4.0 I N. SYSTEM LANGUAGE
lays I G WdV'IV WATER,WARNING : 2.0 ENGLISH
ZIW3 ,LS3,L Mao OVERFILL OR LABEL VOL: 100 HIGH WATER LIMIT: 3.0 SYSTEM DATE/TIME, FOR
OVERFILL LIMIT 9i MO N DD YYYY HFI t F1M:S5
IHWSIG WdW1W HIGH PRODUCT 90( MAY( OR LABEL VOL: 10000 MOBIL
"IIV3 .133.E OIQ0Idad 9. OVERFILL. LIMIT 9wd
DELIVERY 95t 95F10 13001 STOCKDALE HWY
IHt�.I G WdV'IV LIMIT IC HIGH. PRODUCT 90% BAKERSF I ELD CA
I I V3 1931 'IVnNNV 100 9000'
LOW PRODUCT DELIVERY LIMIT 15% SHIFT. TIME 1 DISAf
iQNVLB LEAK igI-ARM LIMIT: X00 1500 SHIFT TIME 2 : DISAE
3d Al ZS91. 0IGOI83d LFDDEN LOSS LIIWIT: 9 SHIFT TIME 3 : DISAI
TANK TILT 4' LOW PRODUCT 1000
0.0( SHIFT TIME 4 : DISP3
PROBE OFFSET LEAK ALARM LIMIT: 99
'IWf1NNW NIWV3I 0 OF SUDDEN LOSS LIMIT 9.9
TANK TILT G 00 + TANK PER TST NEEDED
PROBE OFFSET 0,Q0 DISABLED
T;t:ON MANIFOLpED TANKS TANK ANN TST NEEDED
N I W ?Ro3'I T#: :O 1 DISABLED
LINE MA N I FOLDED TANKS T# NONE S-1 PH4 N 1 A N I FOLD~D TANKS
LINE RE ENABLE
METH(
NONE:01 LI NE MAI FOLDED TANKS PASS LINE TEST
SXNV.L G3GlOJINVW 3NIi LEAK MIN: PERIODIC: 0� T#: NONE LINE PER TST NEEDED
5fNVI 03QI03INVW NOHdIS 0 DISABLED
LEAK MIN PERIODIC: O LINE: ANN TST NEEDED
LEAK MIN AN LEAK: 0 DISABLED
•0 135340 3BOad 00
'0 1'II L ?WWJ LEAK MIN ANNUAL pp, PRINT TC VOLUMES
:.LFWIl SSO'I N3QQf1S .0. ENABLED
:1.IWIZ WdV'IV }[W3'I PERIODIC TEST TYPE
01 .L0f1GOdd MO'I STANDARD TEMP COMPENSATION
PERIODIC TEST TYPE VALUE (DEC F 1 : 6
ANNUAL TEST FAIL. STANDARD STICK HEIGHT OFFSET
D[ ALARM DISABLED DISABLED
I Z I W I'I h2i311 I t3Q'
9;
ANNUAL TEST
ULLAGE: 901 L
6 J OCGOdd HO I H PERIODIC TEST FAfL
ALARM DISABLED ALARM DI Sr HEED H. PROTOCOL DATA FOR
06 HEIGHT
6 .LIWIl llIdd3AO GROSS. TEST FAIL PERIODIC TEST FAIL DAYLIGHT SAVING TIM
OCT :'IOn T3S+dI i•[0 XWbE ALARM: DISABLED ALARM DISABLED i DISABLED
E :.L I W I'i d31b5"I HD I H GROSS TEST FA;I L RE-DIRECT LOCAL PR I
ANN TEST AVERAGIN,: ALARM DISABLED DISABLED
ONINdVM d3.LVM PER TEST AVERAGING': OFF
EURO PROTOCOL. PREFI
I 0,b :3Z I3 .LWO'Id TANK TEST :NOTIFY: ,ANN TEST AVERAGING: OFF S
OFF PER TEST AVERAGING: OFF
001 'IOA _l Ind TNK TST SIPHON .BREAK:OFF
TANK TEST NOTIFY: OFF
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LOW : 33300 110483H.L
3(100 J.OnClOdd DELIVERY DELAY : 5 MIN
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7RMAL COEFF : .000700
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FULL VOL 1,0000
s 2:CARBON: CANISTOR BALANCE NOZZLE TYPE
CATEGORY VAPOR VALVE _ -_ VST
)AT SIZE: 4.0 IN.
s 3:DIS... 5-6 OU- - RELAY SETUP_ _ - r VAPOR PROCESSOR TYPI
PER WARNING : 2.0 CATEGORY AIR FLOW METER VEEDER-ROOT POLISHEI
;H WATER LIMIT: 3.0 R 1 :87 SHUTDOWN
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X
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9500 NORMALLY CLOSED TIME: 10:00 AM GH PRODUCT 900 s 5:DIS. 7-8 DELAY MINUTES: I
9000 CATEGORY AIR FLOW METER TANK 4: 2
LIVERY LIMIT 15i s 6:DIS. 1-2 ACCEPT .HIGH ORVR:
1500 CATEGORY AIR FLOW METER LIQUID SENSOR ALMS DISABLED
W PRODUCT 1000 L 1 :FUEL ALARM
s B:ATM L 3:FUEL ALARM ISD H05£ TABLE
AK ALARM LIMIT: 99 CATEGORY ATM P SENSOR L 1 :S£NSOR OUT ALARM ID FP FL HL AA
�DDEN LOSS LIMIT: 99 -------- -----------L 3-.SENSOR OUT ALARM
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:OBE OFFSET 0:00 ~ SENSOR SETUP
LIQUID' _ - - - ISD SITE REARMS 02 02 02 .02 04
ISIX GROSS,PRES FAIL 03 03 03 02 02
L 1 ::87 STP.SIPHON
ISD DEGRD PRES FAIL 04 04 . 04 Q2 02
PHNO MANIFOLD TANKS I$D VAPOR LEAK FAIL 05 05 05 : 02 Al
c: NONE TRI SPATE ISINGLE, FLOAT) 06 06 :06. 02' .01
NE MANIFOLDED TANKS _.CATEGORY STP suM'P ISD VP PRES FAIL. 07 07 07 02 03
1: NONE ISD. HOSE-ALARMS 08 08 08 02 03.
L 2:87 ANNULAR ALL:GROSS ,COLLECT FAIL
AK MIN PERIODIC: 0% TRI-STATE (S.I,NGLE, FLOAT) ALL:DEGRD. COLLECT FAIL ISD AIRFLOW METER P
Q CATEGORY : ANNULAR SPACE ALL:FLOW COLLECT FAIL FD SERIAL NUM LABE1
:AK MIN ANNUAL Oy R 2.:91 SHUTDOWN -1 38978 �_---DL8.
TYPE:.
0 STANDARD 2 36596 DIS.:
L 3:S7 STP' NORMALLY CLOSED 3 3,8982 D1S,
T$I=STATE. (SINGLE FLOAT) NORMALLY 38266 DIS
3RIODIC TEST TYPE CATEGORY : STP' SUMP
STANDARD TANK #: 4
ISD FUEL GRADE :HOB:
dNUAL TEST FAIL L 4:87 ANNULAR SIPHON LIQUID SENSOR ALMS 1 2 '3 4
IQD
ALARM DISABLED TRI—STATE (SINGLE FLOAT) FP MHH MHH MHH MHH
CATEGORY ANNULAR SPACE L. 7:FUEL ALARM ____________ _
ERIODIC TEST FAIL L 7:S£NSOR OUT ALARM 01 101 901 201 U—U
ALARM DISABLED ISD SITE ALARMS 02 102 902 202 'U U
03 103 903 203 .U. U
ROSS TEST FAIL L 5:DIESEL .STP ISD GROSS PRES FAIL. 04 104 904 204 U U
ALARM DISABLED TRI-STATE (SINGLE FLOAT) ISD DEGRD PRES FAIL 05 10590 L'
5 205 3
CATEGORY : STP SUMP ISD VAPOR' LEAKFAIL 05 106 905 206 3 L
NN TEST AVERAGING: OFF ISD VP ;PRES FAIL 07 107 907 207 3 L
ER TEST AVERAGING: OFF ISD VP STATUS FAIL 0
L 6:DIESEL ANNULAR 8 208 908 108 3 L
ANK TEST NOTIFY: OFF TRI-STATE" (SINGLE FLOAT) ISD HOSE ALARMS
CATEGORY ANNULAR SPACE ALL:GROSS COLLECT FAIL LABEL TABLE
NK TST SIPHON BREAK:OFF ALL:DEGRD COLLECT FAIL __________________
ALL.-FLOW COLLECT FA;I L
£LIVERY DELAY 5 MIN 1 % :UNASSIGNED
R 3:D.IESEL SHUTDOWN 2: HLEND3
UMP THRESHOLD : 10.00% L I-S STP 3: REGULAR
TRI—STATE (SINGLE FLOAT) TYPE':. GRADE
CATEGORY : STP SUMP i STANDARD 5 4:: MID MID DE
GRA
NORMALLY CLOSED 5: GOLD
L 8:91 ANNULAR
TANK 0: NONE 7:: EVER
TRI-STATE (SINGLE FLOAT) 9: BLEND2
CATEGORY :" ANNULAR SPACE LIQUID SENSOR ALMS 10: BLEND4
L 5:FUEL ALARM
L 5:$ENSOR OUT ALARM
SOFTWARE. Rev%s i ON LI
VERSION ,329.01
CREATED - p960i929.
8-MODULE# 330160-00
SYSTEM FEATURES:
PERIODIC IN-TANK
ANNUAL. IN-TAW TE
� 15D
MONITOR CERT. FAILURE REPORT
SITE NAME : STOCKDALE MOBIL DATE : 9/8/10
ADDRESS : 13001 STOCKDALE HWY TECHNICIAN : STEVEN OBERT
CITY : BAKERSFIELD SIGNATURE :,. :
THE FOLLOWING COMPONENTS WERE REPLACED/REPAI.RED:'TO C. MPLETE
TESTING.
REPAIRS : NONE:
LABOR : NONE
PARTSINTALLED : NONE
NAME : TITLE :
SIGNATURE
THE ABOVE NAMED PERSON TAKES FULL.RESPONSIBILITY OF NOTIFYING
THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR
THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR
ANY NEEDED RETESTING'-THIS ALSO RELEASES RICH ENVIRONMENTAL OF
ANY FINES OR PENALTIES OCCURING FROM NON-COMPLIANCE.
A COPY OF THIS DOCUMENT HAS BEEN LEFT ON-SITE FOR YOUR
CONVI.ENENCE.