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HomeMy WebLinkAbout13004 STOCKDALE HWY (2) (I�I������IIIIIIIIII 21 MONITORING SYSTEM CERTIFICATION IE For Use By All Jurlsdictions.Within the State of CalVorma P2,65 Authority Cited: Chapter 6.7, Health unit Safety Code; t:hapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring cquipment. &sen rate ecrtification or report must be prepared for each !l monituri.Og:5vgrm control paml.bv the technician who perfnrms:the'work: :A copy:of this fonn must,be"provided.to the truck system owner/operator. The ownct/6p6rat4.ttiust submit a copy ofthis.fmiti to the local<agency reguliting I:JST systems within 30 days of test date. A. General Information Facility Name:. CHEVRON Bldg.No.: Site Address: 13004 STOCKDALE HWY City: BAKERSFIELD: Zip: ><acilit)r'Contact?('Xsou: KHENG'C'HOA Contact,Phone No.: ( ) Make/model:of monitoring.Syswm: TL5?350" Date of T'esting/Servicing: 3/3012010 R. Inventory of Equipment Tested/Celrtiti`ed (:heck the ap2ropridie hoses to iiidicwtes " trk"e of meatatis "tixllsertiiced: Tank 1D: UNL87 Tank-16:' PLUS.891 ®ln-Tank.Gauging.Probe. Model AM ®ln-tank:Oftuging.Probc: Model: MAG a ®Annular 5pacc'or Vault Sensor. Model 410. 0 Annular Space or Vault Sensor, Model: 420 ©Piping Sump r Trench ticnscx{s}: Model 1G8:­. ®Piping Sump l Trench Senwr(s}:. Model: 208 ❑Pill Sump Sensor(s), Model' Aj.Sump;Scnsor(s): Model: E klechanical Line Leak Detector, Model: FX1V ®Mechanical Linc l.cak'Detector. Model: FX1V ❑Llectronic Lire,'Leak Detector: Mcgdel_. ❑Electronte Line.Beak Detecton Model: ❑Tank Overfill!Ftigh4,er'el Sensor. Model FLAPPER,, ®,Tank Ovar►111/,High-Level Sensor: Model: FLAPPER ❑Other(specify"equipment type and model in:Section F on page:Z} ❑of 1'(spco equipment type and nr6dcl in Section L'on Page 2}, Tank iD: PREM 911SPLIT. Tank'ID: DIESEL/SPLIT ®In-Tank Gauging'Protie. Modc1; MAG f rlri=J'ait...auging'1?ro C. Model: MAG . •Annular Space or Vault,Sensor:. Model: 4201SPLIT 0-Annular Spke or`Vault,Sensor., Model: 4201SPLIT •Pipinc Sump/Trench Scnsor(s). Model.` 208'' Piping Suinp/Trcitch Scnsar(s). Model: 208 ❑ Fill Sump Sensor(s): Model: ❑,FiII:Stuiip Seusor(`s); Model: ®Mechanical Line'Leak Detector: Model' FX1V ®`Mechanics L1he C Ak Ntedor, Model: FX1DV ❑J-:lectronic Line Leak Delector, Moth L ❑Electronic Line Leak h tector, Model: ® 1'ank Overfill!High-Level Sensor. modcL ®Tank Ovcafill%High-Level:Sensor: Model: ❑Other(specify equipment type and!nod&in Sccti6n F;o 'J'nge 2). ❑Cifhcr(specify equipment typr and model in Section E on Pagc 2)_ Dispenser 1D: 1.2 Dispenser ID:. 3-4 N,Dispenser Containment Se»sor(s). Model: 406 ®Di.kpenser C'ontainment,Sensor(s) Model: 406 . ❑Sheaf Valve(s). ®Shear Valve(s). ❑Dispenser Containment Float(s)and Chain(s). ❑Dispensor CContainmenfflo'ai(s)and Cfiain(s)_ Dispenser 1w. 5=6 Dispenser 10-. 7$. ®Dispenser C:ontainmentSensor(s): Model: 406 ®DispertscrConfaitiment Sensor(s). Wdel: 406 Shear Valie(s). ®.shear Velve(s):; ❑Dispenser CentaiamentFloat(s)and Chain(s). ❑D,ispenser'Co:n11"rimcnt Floats)and Chain(s). Dispenser ID: "9.-10 J)ispensetID:.. ' E Dispenser Containment Sensor(s): Model: 406. ❑.17ispenser Containment Setisc�r(s): Mndef: Z Shear Valve(s): Shear valve(s)... ❑.DispeasetContainn"tFloat(s)and Chain(s), ❑Dispenser.(ontamment Float(s)and Chain(s). ""lf the facility contains more.mnks or.dispetisers;.copy this;fortii: IncludC information for:cvc7:tank,mid:di�ienserat the facility. C. CertiFiCatii()n -1-certify Mat`OWegoipment identified.in this document wasJnspected/serviced.in accordance with the manufacturers' guidelines. "Attached ao:.this Certifkition is infOntatiou (e.g. manufacturers''checklists),necessary to verify that this information is correct and a Plot.Plan showing.the:layoutof monitoring.equipment.• For"any;'equipment"capable of generating such reports, 1 have also attached a copy of the report;(chrck'atl that Rpply): M System set-up ®Alarm history report Technician Name(print): BRANDON MASON Sign ature: Certification No.; B34335 16284980-UT License.No.: C611 D40 809850 Testing Company Name: RICH ENVIRONMENTAL Phone No.:(661) 392-8687 —_ Testing Company Address: 5643 BROOKS CT. BAKERSFIELD CA 93308 Tate of Testing/Servicing- 313012010 Page 1 of 5 1:V-1136_1/4 :.-WNV.inidoes.org IIIIIIIIIIIIIIIIIIII 22 Rev.4)1117108 IE Monitoring System Certification ��u D. Results of Testing/Servicing software.Version Installed: 329.t)l Complete the foilovrin :checklist: ® Yes ❑ Noy is:the;audible:alarm.operational? ® Yes ❑ No* Is the visual alarm,operational?: ® Yes No* Were all sensors visually inspected;:fiibctiorially Tested;and confirmed operational? ® Yes p No* Werc:all sensors installed at 1owest point ofsecondary, containment and positioned so that other equipment will not'interfere,with their.proper operation? 0 Yes ❑ No* Jf.alarms are.reltiyed to a remote monitoring: station;. is all communications equipment (e.g., modem) N N/A operational? N'Yes ❑ No* For pressurized piping systems, does.the ttrlime automatically shut down if.the piping secondary containment ❑ N/A monitoring system detect,a,lcak, tails to operate,.or is electrically disconnected? If yes: which sensors initiate positive.shut-down? (E>heck:all that apply) ® Somp/Trench;Sensors; [] Dispenser Containment Sensors. Did you confiim,posi6veshat-down due to.leaks aan sensor'#allure/dtsconnecEion? N Yes; ❑No. ❑ Yes ❑ Noy' For 'tank systems 'tliat utilize the monitoring system as the primary .tank overfill warning device (i.e., net ® `N!A mechanical overFI prc,vention.valve is installed)', is the overfill warning alarm visible and audible at.the tank lfiillpoint(s)and.operating properly? If`so;,at what percent off ankcapacity does;the.alarm trigger? % ❑ Y. N No Was any monitoring equipme' treplaced? Ifyes,.identify,`specifc sensors,probes, or other equipment replaced and,list the manufacturer name and,-model for all Yeplaeement pates in Section,E below. ❑ Yes* 0 'No Was liquid found inside any'seOhdaiy,conta.ininentsystems designed as dry'systems? (Cheek all that app4) ❑ Product;; El Winter. tfycs,,descrihe causes,in Section!✓,.below. ®. Yes ❑:No* Was.moiiitoring system setup reyiewed to,ens ,proper.sggirilrs';Attach set up reports,if applicable ® Yes ❑. NO* 1§all tnomtoring equipment operational pef.manufacturer's-specifications?. In Sectign.0 below,describe'how and whenAhe' dakieneies were or will.be`,corrected. F. Comments: Page 2 of $ 1:1-036 Z/4 www.auiduce.urg Rev.01/17M Monitoring System Certification �rJt F. 1n-Tank Gauging/ SIR Equipment: ® Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or.SIR equipment is installed. This section inusf.be completed tf`in-fank: auging eq.,ipmdAt:is'used:to perform.leak detection.monitoring. Complete the.fnllowing chec[tiisi:: ` ❑ Yes ❑ NO Has all:input-wiring been inspected forproper:entry.an'd,termination;including testing for ground faults? El Yes [I" No* Were'all tank gaugmg probes visually inspected fpr:.damage.and-residue buildup? ❑ Yes [I too* Was accuracy:'of,syste.product level readings,tested? ❑ Yes. ❑ NV Was accuracy ofsystem wales.-level readings tested? ❑ Yes. ❑ Nod' Were:all probes reinstalled.properl'y?` p Yes ❑ .No* Were all tterits on the.egn►pment,inauiufaeturees riairitenanee&6cklist completed? In Section H,below,describe'how and whenaNese deficienews'Were;or.will tie:corrected. G. 'Line:Leak Detectors(,LLO): [l Check hi"'box f�LLos:.are not.installed., 1 Com iete the following checklist:; ® `Yes [p No* ,For egiiipirient 'start''=up orr aan a equipment:certification,.was--a, leak simulated to verify LLD performance? p,N/A, (Check'A.that appfyJ -S►muiated leak rate: 3 gp h:, ❑0":1 g.p h'; 4:2 g:p.h. ! Yes. ❑ No* Were all LLI)s confirmed operational and accurate`within,regulatory.,requireinerits? .N Yes ❑ 'No* Was thc:tcsting apparatus propeily calibrated?. ® Yes ❑`Nod` rot rriechanieal.LLDs;does'ahe.ULP:fee trictproduct fl ow i.f.it detects,a:.leak?_` ❑ N/A ❑Yes. ❑ No* ` For,electronic LLDs,,:does1he turbine automatically`shut off ifthi.1LL)'detects a leak? ® N/A ❑ Yes. Cl No* For electronic'.CLDs,.does.the;turbine automatically s..hut.off if any;portion of the monitoring system is disabled ® N/A or disconnected? ❑ 'Yes ❑ No* For electronic,LLDs,does;the'turbine;automatically:Oli ',Off if any:portion gf'the monitoring system malfunctions ® N:'A. or fans a test? ❑ Yes n No's For electronic LLUs,.have all accessible wiring connections been:visually inspected? ®. N/A ID.Yes 0 Nil* Were all items on the equipmenr,manufacturer's maintenance checklist completed? In Section N,below,describe how and when:tb'ese;defcieneies,werc or will be corrected. 1-1. Comments: Page 3 of 5 Lv-036—3/4 www.nnidoeg.org Rev.007M8 117108 WonAoring System Certification UST II oixitoring Sitcrisn i'i d t . ran w !: . . . . . . . �. . . .. . . . . . . . . . . . . . . N. . . . . . . � � l -bore . . • ' ; - . - : . . .V . . _ . .. . . . . . � .,rfc . . . . . . . . Dat6,mep was draryn;;�f�/ a��.. If you already have a diagram that q&,pis all rey.wed': tr. ay [;rclnde it radzer:tharr this:page,with your Monitoring Svstem.Certificetron. '.On your site pien, show#}te g4t►Pr layout O rafting: (;leanly identify locations of the-following, equipment if installed: nnoAitnt.n� ay em coil;�ql p �a ..unso� T,ionriorii�,g.tali annular.:spaces;.snips, dispenser pans, spill, containers,or other scoondan.'ooetta:� . 0. �ceS,mh. it►f electronic i' Jcakdet�+;brs;and itt-! .k'liquid level probes(if used fa leak detieciiun), :In the�rnr . ,+�� re rr^ j{c Plnn;ivgs " Pas 4 of. 4 UN436-alt Monitoring System Certification Form: Addendum for Vacuurn[Pr•essure Interstitial Sensors t;-�)V-6 I I. Results of Vacuum/Pressure Monitoring Equipment Testing 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 I~orrn;,which must he }provided to the tank system fawner/'operator: The:ow.ner/ perator:mus(;S!j mtt a:copy:of"the Monill ing Sys iem.Certification Form to the local ageney'fegulatitig UST``s�steths,within 3O day's oftest.date Manufacturer: NONE Model: $ptem.Type: ❑ Pressure; ® Vacuum .Sensor ID Component(s) Monitored,by this S�nsdr. Sensor Functionalrty',`l'est;l7esult:❑Pass,, .[],Fail lnterstitial CornniunicWon:Test Result: ❑Pass; E] Fail Component(s)`Monliored':by thi9 Sensor: Sensor Kinctionality Test:Result: ❑;Pass ❑ r'ail Interstitial C'omru'n'jeation-Test Result: ❑ Pass; ❑ Fail Component(s)Monitored'.by.thisSensor: Sensor Functionality"fest Result,.❑;Pass; ❑ Fail 'interstitial Communication Test Result: ❑ Pass; ❑ Fail Component(s)]Monitored by this:Seng0e: _ Sensor Ftibi tioilalk,Test Result:,❑Pass; ❑ Fail Interstitial.Coiumuhieation Test Result: ❑ Pass; ❑ Fail Components)Monitored by this:Sensor: Sensor Functionality Test:Kesult; ❑'Pass; ❑ Fail Interstitial,Communication'Test Result: ❑Pass; ❑ Fail -- - Component(s)Monitored,by this'Sensor: Sen_sor,Functionality.TCst:Result: r-1 Pass; ,❑ 1:4H Interstitial Communication"!'est Result: ❑Pass; ❑ Fail Component(s) .onitored;.by this Sensor Sensor Functionality Test'Result: ❑Pass; `❑ Fail Interstitial.Conununication Test Result: ❑ Pass; ❑ Fail Component(s)Monitored by thisSensor: Sensor Functionality Test,ResulE ❑.Pass; ❑ Fail jnlerstitial Communication Test Result: ❑ Pass; ❑ Fail + T Component(s).Monitored by this Sensor: SensorTunctionality Test.Result: ❑,foss; ❑ Fail Inferstitial"Communication'Test Result: ❑ Pass; ❑ Fail Component(s),Monitored by this I Sensor: Sensor Functional ity`Test:Result: ❑Pass; ❑ Fail' Interst.itiatCommunication Test Result: ❑ Pass; ❑ Fail How was interstitial t.61ninunicatlon,verit3ed? ❑ Leak Introduced auFar End of interstitial Space; ❑ Gauge; ❑ Visual.lnspection; ❑ Other(Describe in Sec. J• beloa�% Was vacuum/Uressure.restureil to:operating levels`in ah interstitial space's? ❑Yes ❑No(if no, describe in Sec:.J, below) J. Comments: NONE OF':THESE SENSORS ARE PRESENT.AT THIS'SIT.E ~^ Page 4 of 5 If the sensor successfully detects a simulated vacu�rm/pressure leak introduced in the interstitial space at the furthest point from the sensor, vacuumlpressurc.has been demonstrated to be communicating throughout the interstice, UN-036A-r/t www.unidomorg Rev.01f26/06 RICH ENVIRONMENTAL 5643 3RWKS CT. BAKERSFTELI) LA: 9330.8 OFFICE (661)35 2 8687 FAX(667 .. —(?621 ,PRODUCT-LINE�LEAK DETECTOR,,TEST. WORK SHEET W/O#: FACILITY NAME-:CHEVRON FACTI.ITY ADDRESS. 130,04 STOCKDAtiE HWY,BAKERSFIELD, CA 93314 PRODUCT`LINETYPEc' PRESSURE' PRODUCT LEAK;DETECTOR TYPE. TEST TRIP PASS BLOW P.S.I. OR SERIAL NUMBER E3 G.P:H. FAIL. LTNL87 I_JD TYPE :RED JACKET. 1Z PASS SERIAL'##MECHANICAL YES PLUS89 LID TYPE : RED J_ CA KETT iZ PASS YES SERIAL,#t MECHANICAL PRE M91 L/D TYPE ::RED JACKET PASS YES: t2' SERIAL#MECHANICAL /DTP :RJACKET DIESEL 12 PASS Y:ES SERIAL#'MECHANICAL. I CERTIFY THE A.BOVE:T,EStS WERE COND.VCTED,ON THIS DATE ACCORDING TO RED JACKET PUMPS'-FIELD TES T'Ap1'ARATUS:7TSTING PROCEDURE AND.LIMITATIONS. THE MECHANICAL:LEAK DETECTOR.TEST.PASS/FAIL IS,DETERMINED.`BY USING A LOW.FLOW TH,RESHnLD:TRIP RATE OF 3 GALLONS I'Eli`NQUR OR LESS;AT I U P.S.I. 1. ACKNOWL.EDGE.T,HAT,.ALL DATA£OLLECTFD.IS TRUErAND-CORRECT TO THE BEST OF,MY.KNOWLEDGE. TECHNICIAN: BRANDON MASON SIGNATURE: . DATE: VG I SWRCS,January 2006 Spill Bucket Testng;.Report Farm 7 his form is intended for use by contractors performing annual testing,of UST spill containment structures. The completed farm and printouts from tests(if applicable), should:be prbvidecd,to:th?focility oivner/operator for submittal:lo the local regulatory agency-. L., T kCILITY.INFORMATION Facility:'Nalne: CHEVRON Date of Testing: 3/30./2010 Facility Address: °13004 STOCKDALE;HWY,-.13'AKERSFIELD;CA 9..3314' Facilily.Gontacts` KHBNG CHUA Phone: Datel:.ocal Agency WasNotified'of Tking; 010,112010. Name of Local'Agency inspecttir(rfpreseiit durfng,testirig)_. ESTER w 2:., TESTING CnNTRACTQR INFORIVIATWN Company Name. RICH ENVIRONMENTAL 'Technician Conductin"g:Test: BRANDON MASON Credentials': _CSLB Contractor X ICC Service,.Tech_ $WRCB.Tank.Tester P Q#)cr(�pecrfj),. License Nu nber(s) 5284990.-UT 3. .SPILL BUCKET TESTING;INFORMAhON' Test Method Used: X Hydrostatic l I Vacuum 0 Qther 'Test Equipnae.nt Used: VISUAL Bquiprnent Resolution: 0 Identify Spill F3ucket h3'Tank 1 2 RLUS89 FILL 3,PREM9l-FILL 4 DIESEL-FILL Numher, StoredPrpduct; etc. :., 'REG'U4AR$7-FILL Bucket,lnstaltation,Type X Direct Bury X.Qire&Bury X Direc(Bury X Direct Bury _ Contained1h sit u Gontained;in Sum -Contained_in:Sum Contained in Sum Bucket,Dian)eter. I2" 1'2" 12" 12" Buckewepth: 14" i4" 1:4" 14" Wait time between applying MAIN 3..0 MIN, 30,MIN 30MIN vacuumiwatcr and start:of.testt Test Start Time(`f,): 9'OOAIv1 9`00AN1 9:00AIV1 9:OOAM Initial Reading(R1}: 9" 9'' 9" 9" Test End Time(1'1:): l0 00AM 10:00AMN 10:00AM 10:OOAM Final Reading(R' 9„ V 9": 9" Test Duration(TI.,—''I i): A-HOUR 1-140UR 1410UR 1-HOUR _ Change in Reading, 0 0" V V. Pass.:`f:ai l'I'hre0fold or 0:00'. +I-0.00 Criteria: Tkst Itit: ..>Pass P t X P.. /Fail. . CammentS—(incluctc;,mformafion on'xepdirs.maiieprior toa esttn��:andrecommenderl,fnllgw-up for failed tests] CERTIFICATION OF TECtINICIAN-RESPONSIBLE FOR'.CONDUCTIM;THIS TESTING I hereby certify that.all the information contained in this report Is true, accurate,and in fall compliance with legal requirements. "fcchnician's Signature: — Date, ^ ' State laws and regulations do not currently require testing to be performed.by a qualified contractor. However,local requirements may be more stringent. SOFTWARE REVISION LEVEL, __.. ._..__..-_. _--. .---.. I�_T'ANK ,E 1 ur VERSION 329.01 r11'luN I CAT 11t+1S\SETUP _ '_ SOFTWARE# 3463'2'9-100-13 CREATED - 09.01 .29. 15.44 _ - _ _ _ - - - - - - T 1 :UNLEADED 1 NO SOFTWARE MODULE PRODUCT t;4n1~ : ,000760 S12STEM FEATURES: PORT, ,SETT I NGS THERMAL COF.FF 96.00 PERIODIC IN-TANY-. TESTS TANK DIAMETER 1 PT ANNUAL IN-TANK TESTS COMM ;BOARD : 1 (RS-,232) TA, PROFILE 1?Up0 13FiU1�1 .RATE 1200 FULL VOL .PAR I TYt DDT? STOP 131 T I S.T.OR 4.0 I N 'DAT•A I��iGTH 7 DATA F1.pRT S12E R8 .232_ 2ECUR:I.'TY 2.0 CO[iE D I AHLF.T} WATER. LdARN I NG 3 Q HIGHIGH WATER I Ii9IT: AUTO TRANS JT" SETTINGS;' t"4AX OR LABEL VOL 1200% 90/ LEAK c�VERF ILL LIMIT 10800 SYSTEh1 SETUP AUTO `LEAK ALARM LIMIT DISABLED HIGH PRODUCT 11400 MAR 30. 20.10 11 :37 AH y ,AUTO,. HIGH WATER` I IM T' DELIVEF'1 LIMIT 10% T)TS ABU Z, 1?DO AOTO-'OVERF fLl_ L IJI111 DISABLED 500 SYSTEM AUTO ;I:.OW PRODUCT LOW .ppoDUCT 95 .�1�TEFt UN1T3 ALARM LIMIT: U•;; TidSABLED LEAD 50 SYSTEMI LANGUAGE AUTO THEFT.L IM:IT If N LOS 1,I hIIT= 0.00 ENGLISH DISABLED TArIK TILT . _ 0,00 SYSTEM DATE/TIME. FORMAT AUTO"DELIVERY START PROBE OFFSET MO N DD YYY Y HH"MH'SS :tl D 19ABLED 'AUTO D£L I.VER`. Ems: STOCYDALE ,CH> VRON DISABLED -SIPHON MANIFOLUED THiJI�S 1:30p4 'STGi:.hDALE 'AUTO. EXTERNAL 1,14PUT CAN T�:. 'NONE BA}:ERSF.I1 I:D t;A D.TSABL1vD LINE .MANIFOLDECD TANKS :AUTO EXTEkNHL INPUT OFF Ti1:``NONE D-I,SABLED SHIFT 'TIME I DISABLED AUTO, SENSOR FUEL '6L,411 , . PR I OI i C: DI SHIFT TI ME 2. DI SABLED' DI SABL ED 0 SHIFT TIME 3 DISAHL81) AOTb.SENSOR WATER ALARM: SHIFT TIME 4. :: DISABLED D SAiBLED 0%0 -AUTO SEWOR :CUT ALARM =LEAK FI I N ANNUAL 0 TANK.PER TS•i' NEEDED WRN DISABLED: DISABLED . TANK ANN TST 'NEEDED I R.N .P'B'RIODIC TEST TYPE DISABLED STANDARD LINE RE-ENABLE. METHOD ANNUAL TEST FAIL PASS LINE LEST ALARM DISABLED LINE PER TST NEEDED WON IL DISABLED RS, 232` END; OF MES GE. PER16DIC TEST AIDISABLED LINE ANN �TST NEEDI D :WRN ��DJ0§ABL=ED; DISABLED GRt?SS TESTCiLARM DISABLED PRINT TC VOLUMES. ENABLED OFF fi�Nl�l TEST AVERF�U I t G' OFF TEMP COMPENSATION PER TEST AVERAG VALUE (DEG F .> : 66','0 T TEST NOT I F`,: OFF ST.Ii.Y HEIGHT .+�F'FFT D 1 SABLED ULLArE.: 90% TNh TST SIPHON k�REHK:oi=-is MIN H-PROTOCOL DATA FORMAT pII�NIP�lTHREUHOLD 10.00: HEIGHT DAYLIGHT SAVING T F IE DISABLED . RE-DIRECT LOCAL. PR I P(rOUT :DISABLED EURO PROTOCOL PREFIX S SYSTEM SECURITY CODE : 000000 MAINTENANCE HISTORY D12ABLED TANK CHART SECURITY DISABLED CUSTOM ALARMS DISABLED THERMAL CtSEFF 9450 T 2:PLUS PRODUCT CODE 0 TANK DIAMETER 29.Op PRODUCT CODE 2 THERMAL.COEFF. : :000700 TANK PROFILE 1 PT THERMAL COEFF : .000700 TANK DIAMETER : 1e_ , , FULL VOL 10000 TANK DIAMETER 95.00 TANK PROFILE I PT TANK PROFILE I PT FULL VOL 101000 FULL VOL 12000 FLOAT SI?E: 4.0 IN. FLOAT S IZEI 4.p ,I_N:< WATER WARNING 2.0 FLOAT SIZE: 01 IN. HIGH WATER LIMIT: 310 WATER WARNING MATER WARNING. HICFi:. WAC>~k LIMIT 3.0 MASS OR LABEL VOL: I0000 H Y GH WATER C I I1 I T: 3;,;p; OVERF I Ll. L I M I T 90% .MAX 'OR LABEL; VOL 0000 900Q mm OR LABEL VOL,: 12000: OVERFILL LIMIT 30 HIGH PRODUCT 95h OVERFILL LIMIT 90%¢ 900G 9500 10800 HIGH PRODUCT 95i DELIVERY LIMIT 10% .HIGH. PkOD(JC.T y5 9500 t oori I`14Q0. BEI IVERY LIM1 .. 1,0%+ fcw, 1000 LOW PRODUCT 500 DELIVERY LIMIT �QO LEAK ALARM LIMIT: 99 LOW PkiDUCT. , 1.. 5017 SUDDEN LOSS LIMIT: 50 LOW. PROD'UCT tbo LEAK ALARM IMI,.Tv 99 TANK. TILT 0.00 LEAK ALARM L I p1i T:` 99 SUDDEN LOSS L 1 MI T: . 5Q PROBE OFFSET 6.00 SUDDEN LOSS LIMIT.' 50. TANK TILT . 0,00 TANK T.11 LT, � E}:.0>�. PROBE OF1=SET C1.OQ PROBE OFFSET. 0. .00 SIPHON MANIFOLDI=D TANKS T#: NONE SIPHON MARIFOLt) I? ;'I`ANK LINE 11ANIFflLDED Tf�NKS SI'PHON MANTFOLDED TANKS T;tt:� .NONE. TO: NONE TO: NONE LIf4E'MANIFOLDED T+`4NkS LINE ME P'IAN I Fi?L PED TAiKs Ti: NONE: LI NONE LEAK MIN PERIODIC: 0114 0 LEAK Ml N PER I OD I:C: TO, LEAK MIN PER I OD I'C: 0% R LEAK MIN ANNUAL 0% p 0 LEAK `MIN ANNUAL 0°Q: LEAK hl i N ANNUAL f1! PERIODIC TEST TYPE 0 STANDARD PER IDD I c ;TE8.I tYPE;, PER J OD IG tEST TYKE STANZWiRP ANNUAL TEST FA I L .. STANDARD ALARM DISABLED ANNUAL TEST FAIL, ANNUAL TEST FAI.I.. . . :ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ALARM DISABLED PERIOn'IC .TJFST' FAIL PERIODIC TEST ,FAIL ALARM :D:I SABLED GROSS TEST FAIL 'ALARM DISABLED ALARM DISABLED FE ST'faT FAIL (396M TEST,FA I L, . . ALARM D!8044ED ANN TEST AVERAG I NG: OFF ALARM DISABLED PER TEST AVERAGING: OFF ANN T'8ST .AVERAGING OFF ANN TEST' AVERAGING: OFF IER TEST :AVEpAGIW',- OFF TA14K TEST NOTIFY: OFF PER TEST AVERA61 NO: OFF TAW"TEST, NOT IF..Y: qF TfdK T5T SIPHON BREAK:OFF TANK TEST NOT I F`}': OFF T.NKi J'ST SI P:HON SREAK:OFF DEI:.I VM,/ DELAY 15 MIN TNK TST SIPHON BREAK:OFF PUMP THRESHOLD 10.00% I7EL.I VERY DELA`! : 15 111:14 DEL I VERY DELAY : 45 MIN PUhIP THRESHOLD 1'.0.Q0 PUMP THRESHOLD TO.am. LEAK TEST METHOD TEST ON DATE ALL TANK JAN 29, 2009 START TIME D I SABLED TEST RATE :0:20 GAL/HR DURATION 2 HOURS TST EARLY STOP:DISABLED LEAK TEST REPORT FORMAT NORMAL LIQUID SENSOR SETUP OUTPUT-RELAY SIrTuP `�`� ` ALAPil HISTORY REPORT !/ . . .1 :87 ---- IN-TANK ALARM ----- L 1 :87 STP TYPE: TRI-STATE (SINGLE FLOAT) STA14DARD T 1 :UNLEADED CATEGORY STP SUMP NORMALLY CLOSETS OVERFILL ALARM MAR 26. 2010 6:03 AM 1. 2:89 S'I'P" L 1 GU I U SENSOR' ALMS. MAR 21 . 201.0 LQ:.02 AI°1 TR I-STATE (S IXf LE FLOAT) L 1 .F,U£L 'ALARM' MAR 4 4. 2010 11 :16 AM CATEGORY : .STF SUMP L S FUEL.ALARH L. 1 : ALARM H)STORY REPORT ---- 'IN-TANK ALARM ---- ALARM HISTORY REPORT -� ALARM HISTORY REPORT SENSOR ALARM -- T 1 :UNLEfiUED __ IN—TANK ALARM - is 1 :87 STP STP SLHP OVERFILL ALARM T 3:PREMIUM FUEL ALARM MAR 2G, 2Q1O 40:0,21 6 03 AM MAR 30, 2010 11 : 10 AM :MAR 2.1, 201.0 AM MAR 14, 2010 11 :1.B I-vi SETUP DATA WORN]NO , MAR 28 40G9' .3.29;FAG'! 'SENSOR OUT .ALARM h6AR 30, 201 G 9:37 Am LOW PRODUCT ALARM, K GH PRO.DUCT ALARM t}CT 20.' 2005' 9.:56 AM }R Vie. 2Q09 3 29 Ph1 FUEL ALARM APR 4, 2G[19 ,:;24 Phl' MAR, 30 2010 9:31 AM H1 GH PRODUCT ALARM MAX :PRODUCT .ALARM MAR 6, 2010` 4:4"1 AM .20 2609 3:2y F MAR 1::: 201U 3.5� AM: SEP 16, 2009 1:04 T14 I NVAI 1_D FUEL. LEVEL OCT 20 2009 ;9'550 -AM. APR 4, 2009. A L8 PM' DELIVER; NEEDED END OCT 20, 2009 7.:5 ' AM AUG 14, 2009' 1 Z�36 ?M APR 4_, 2[109 I :27 PM � :* :� wx ENO, MAC: 00c)r)LrT :t4LARM, SEP 16 ''2005 1 :29 Phi SEP 16.. 2009 1:20 PM ALAY41 HISTORY REPORT �- SElg2 iR ALARM `t::�2.:89 STP ;FLATW 4 li 1:s TORY REPORT STP. SUMP SENSOR OUT ALARM MAR 30. 2010 9:37 Al-1 * END * * 1=UEL ALARM T A':D'I EsI~L MAR. 30, 2010 9:30 AM OVERFILL ALARM` FUEL ALARM MAY"24 2009 1 :09.: PI.1 MAR 30, 2010 9:1q AM bEL I.VERY :.NEEDE R . . SEP 2,> 2009 ALARM H'11-STQRY REF'.ORT' - - I'N-TAiVK ALAR M -- - _ T 2:F'L US DELIVERY NEEDED x. .0 .* ,k -)o: END.: �, ?�° �. x � APR 1.7: "20Q9 4:08 PM ALARM 1ii.STORY REPORT SENSOR ALARM L.G:91 STP STP SUMP SENSOR OUT ALARM MAR 30, 2010 9::37 Aid FUEL ALARM MAR 30, 2010 9:29 AM FUEL ALARM JAN 19. 2010 .1 : 10 PM ALARM HISTORY REPORT - SEIIC*R ALARM ALARM HISTORY REPORT L-4:DIESEL STP STP SUMP. - _- `SENSOR AL ARM - SENSOR OUT ALARM L-751-DIES. ANN MAR 30, 2010 9;:37 .AM ANNULAR SPACE FUEL r LARP1 SEh1SOR OUT ALARM MAR °;30 ,2010 .9;:29. Ai�t MAR 30. 2010 9 37 AII SEIu80R; OUT ALARM... FUEL AI AR3 �t�R so' : U 9:32' Ai'1 APR 13:, 2009' .21 36 Fhl SEf soR OIJT "ALARM APR 8: 2009 2:.35 PM E P1U . 'ALARM' HISTORY` i?EPOR, T S8NBbR ALARM ' -- -- FiI AI;i '1 H1SToRY REPORT L. 5:B7 ANN ANNULAR SPACE. ... --- SEW O ALARM SENSOR' OUT ALARM .. 1 MAR 30. :201.& 9:3,71 OTHER SENSO1RS, FUEL AI.,ARNI,,... MAR 30. 2010 '3:34' HIS! SENSOR?OUT :ALARM, APR 8: 2Q09 2':35 Ptl' END � � � x � Al ARM .H FSf ORY .REF Op -- SENSOR`: L 6 r139 ANN ANNUL R, SPA(t 'ENSOR OUT: ALARM MAR 30.. 2010 94,.37 ki FUEL ALARM MFR 30, 2010 9.:3 4 AM SENSOR .OUT ALARM APR S. 2009 2:35 PM MONITOR:CERT..FAI-LURE .REPORT -SITE .NAME.: cHf-y,xo?4 DATE.: ,ADDRESS : TECHNICIAN CITY: H�4 SIGNATURES THE FOLLOWING t,.(iMPONENTS WFRE;REPLACED/REPAIRED TO`COMPLETE TESTING. REPAIRS`; AJo p`-�.. LABOR N0:4oj : PARTS INTALLED :., NAME :` TITLF SIGNATURE TIIE ABOVE'NAMED"PERSON TAKES FULL-RFSPONSI:BnXr'V 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 0CCURING FROM NON=COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN—LEFT ON-SITE FOR YOUR CONVIENENCE.