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Home My WebLink About2011 FMC RESULTS (2) r , MONITORING SYSTEM CERTIFICATION 11111111111111111111 25 For Use By All Jurisdictions Within the State of California lE Authority Cited.- Chapter 6 7,Health and Safety Code; Chapter 16,Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring Ustem control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of this date. A. General Information Facility Name: #1001 Wholesale Fuels, Inc. Bldg.No.: Site Address: 2200 East Brundage Lane City: Bakersfield Zip: 93307 Facility Contact Person: Omero Garcia Contact Phone No.: 661-393-7000 Make/Model of Monitoring System: Veeder-Root TLS-350 Date of Testing/Servicing: 2/25/2011 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment Inspected/serviced: Tank ID: T-1 L-S Clear 10000 gallons Tank ID:T-2 L-S Dyed 10000 gallons [z] In-Tank Gauging Probe. Model:847390-107 L] In-Tank Gauging Probe. Model: 847390-107 ❑ Annular Space or Vault Probe. Model: ❑ Annular Space or Vault Sensor. Model: ❑ Piping Sump/Trench Sensor(s). Model: ❑ Piping Sump/Trench Sensor(s). Model: ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s). Model: ❑ Mechanical Line Leak Detector. Model: ❑ Mechanical Line Leak Detector. Model: [x] Electronic Line Leak Detector. Model.Veeder-Root U Electronic Line Leak Detector. Model: Veeder-Root [x] Tank Overfill/High Level Sensor. Model:847390-107 U Tank Overfill/High Leval Sensor. Model: 847390-107 ❑ Other(specify equip.type and model in Sec.E on Pg.2) ❑ Other(specify equip.type and model in Sec.E on Pg.2) Tank ID: T-3 Clear Diesel 20000 gallons Tank ID: T4 Unleaded 20000 gallons [x-] In-Tank Gauging Probe. Model:847390-107 [xj In-Tank Gauging Probe. Model: 847390-107 ❑ Annular Space or Vault Sensor. Model: ❑ Annular Space or Vault Sensor. Model: ❑ Piping Sump/Trench Sensor(s). Model: ❑ Piping Sump/Trench Sensor(s). Model: ❑ Fill Sump Sensors(s). Model: ❑ Fill Sump Sensor(s). Model: ❑ Mechanical Line Leak Decector. Model: ❑ Mechanical Line Leak Detector. Model: [x] Electronic Line Leak Detector. Model:Veeder-Root U Electronic Line Leak Detector. Model: Veeder-Root [x] Tank Overfill/High Level Sensor. Model:847390-107 U Tank Overfill/High Level Sensor. Model: 847390-107 E] Other(specify equip.type and model in Sec.E on Pg.2) ❑ Other(specify equip.typs and model in Sec.E on Pg.2) Dispenser ID: T-1 Clear Dispenser ID: T-2 L-S Dyed xn Dispenser Containment Sensor(s). Model: 794380-208 [X] Dispenser Containment Sensor(s).Model: 794380-208 [x] Shear Valve(s). U Shear Valve(s). ❑ Dispenser Containment Float(s)and Chain(s). ❑ Dispenser Containment Float(s)and Chain(s) Dispenser ID: T-3 Clear Diesel Dispenser ID: T4 Unleaded [x] Dispenser Containment Sensor(s).Model: 794380-208 U Dispenser Containment Sensor(s).Model: 794380-208 L] Shear Valve(s). U Shear Valve(s). ❑ Dispenser Containment Float(s)and Chains(s). ❑ Dispenser Containment Float(s)and Chain(s). Dispenser ID: T-5 Dyed Dispenser ID: T-6 Dyed [X] Dispenser Containment Sensor(s).Model: 794380-208 [x] Dispenser Containment Sensor(s).Model: 794380-208 [X] Shear Valve(s). fix] Shear Valve(s). ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Floats)and Chain(s). *If the facility contains more tanks or dispensers,copy this form.Include information for every tank and dispenser at the facility. C. Certification-I certify that the equipment identified in this document was inspected/services in accordance with the manufacturers'guidlines.Attached to this Certification is information(e.g.manufacturers'checklist)necessary to varify that this information is correct and a plot plan showing the layout of monitoring equipment.For equipment capable of generating such reports,I have attached a copy of the report;(check all that apply) ❑x Syste t-up [x]Alarm histo IF Technician Name(print): Bryan A Self Signature: Certification No: 837501 License No: 804904 Testing Company Name: Confidence UST Services,Inc. Phone No: 800-339-9930 Site Address: 2200 East Brundage Lane,Bakersfield,CA 93307 Tate of Testing/Servicing: 212512011 IIIIIIIIIIIIIIIIIIII 26 IE f , 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. A separate certification or report must be prepared for each monitoring U tern control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of this date. A. General Information Facility Name: #1001 Wholesale Fuels, Inc. Bldg.No.: Site Address: 2200 East Brundage Lane City: Bakersfield Zip: 93307 Facility Contact Person: Omero Garcia Contact Phone No.: 661-393-7000 Make/Model of Monitoring System: Veeder-Root TLS-350 Date of Testing/Servicing: 2/25/2011 B.Inventory of Equipment Tested/Certified Check the appropriate ones to indicate specific equipment inspectedherdced: Tank ID: T-5 L-S Dyed 20000 gallons Tank ID-T-6 L-S Dyed 20000 gallons [x] In-Tank Gauging Probe. Model:847390-107 [x] In-Tank Gauging Probe. Model: 847390-107 ❑ Annular Space or Vault Probe. Model: ❑ Annular Space or Vault Sensor. Model: ❑ Piping Sump/Trench Sensor(s). Model: ❑ Piping Sump/Trench Sensor(s). Model: ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s). Model: ❑ Mechanical Line Leak Detector. Model: ❑ Mechanical Line Leak Detector. Model: [X] Electronic Line Leak Detector. Model.Veeder-Root U Electronic Line Leak Detector. Model: Veeder-Root 1x] Tank Overfill/High Level Sensor. Model:847390-107 L] Tank Overfill/High Leval Sensor. Model: 847390-107 ❑ Other(specify equip.type and model in Sec.E on Pg.2) ❑ Other(specify equip.type and model in Sec.E on Pg.2) Tank ID: T-7 L-S Dyed 20000 gallons Tank ID: T-8 Clear Diesel 12000 gallons [x] In-Tank Gauging Probe. 'Model:847390-107 [x] In-Tank Gauging Probe. Model: 847390-1.07 ❑ Annular Space or Vault Sensor. Model: ❑ Annular Space or Vault Sensor. Model: ❑ Piping Sump/Trench Sensor(s). Model: ❑ Piping Sump/Trench Sensor(s). Model: ❑ Fill Sump Sensors(s). Model: ❑ Fill Sump Sensor(s). Model: ❑ Mechanical Line Leak Detector. Model: ❑ Mechanical Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: [x] Tank Overfill/High Level Sensor. Model:847390-107 [x] Tank Overfill/High Level Sensor. Model: 847390-107 ❑ Other(specify equip.type and model in Sec.E on Pg.2) ❑ Other(specify equip.typs and model in Sec.E on Pg.2) Dispenser ID: T-1 Clear Dispenser ID: T-2 L-S Clear ❑ Dispenser Containment Sensor(s). Model: 794380-208 [x] Dispenser Containment Sensor(s).Model: 794380-208 [x7 Shear Valve(s). [x] 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 Chains(s). ❑ Dispenser Containment Float(s)and Chain(s). Dispenser ID: Dispenser ID: ❑ Dispenser Containment Sensor(s).Model: ❑ Dispenser Containment Sensor(s).Model: ❑ Shear Valve(s). ❑ Shear Valve(s). ❑ Dispenser Containment Float(s)and Chain(s) ❑ Dispenser Containment Float(s)and Chain(s). *If the facility contains more tanks or dispensers,copy this form.Include information for every tank and dispenser at the facility. C. Certification-I certify that the equipment identified in this document was inspected/services in accordance with the manufacturers'guidtines.Attached to this Certification is information(e.g.manufacturers'checklist)necessary to varify that this information is correct and a plot plan showing the layout of monitoring equipment.For equipment capable of generating such reports,I have attached a copy of the report;(check all that apply) ❑x System Set-up [x]Alarm his re ort Technician Name(print): Bryan A Self Signature: Certification No: B37501 License No: 804904 Testing Company Name: Confidence UST Services,Inc. Phone No: 800-339-9930 Site Address: 2200 East Brundage Lane,Bakersfield,CA 93307 Date of Testing/Servicing: 2/25/2011 F. Iu-Tank Guaging/SIR Equipment: [x] Check this box if tank guaging is used only for inventory control. ❑ Check this box if tank guaging or SIR equipment is installed. This section must be completed if in-tank guaging equipment is used to perform leak detection monitoring. Complete the following checklist: Fxj Yes ❑ No* Has all input wiring been inspected for proper enter and termination,including testing for ground faults? -TxA Yes No* Were all tank guaging probes visually inspected for damage and residue buildup? x Yes No* Was accuracy of system product level readings tested? x Yes El No* Was accuracy of system water level readings tested? _[xj Yes No* Were all probes reinstalled properly? Lx] Yes ❑ No*I Were all items on the equipment manufacturer's maintenance checklist completed? *In the Section H,below,describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑Check this box if LLD's are not installed. Complete the following checklist: [x] Yes [] No* For equip.start-up or annual equipment certification,was a leak simulated to varify LLD performance? (Check all that apply) Simulated leak rate: U3 g.p.h.: ❑0.1 g.p.h.; ❑0.2 g.p.h.; x Yes No* Were all LLD's confirmed operational and accurate within regulatory requirments? Mx No* Was the testing apparatus properly calibrated? ,IN o or mac ca LLDs, oes tie D restrict pr uct ow i it etects a ? N/A[x] No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a leak? ❑ N/A [x] Yes No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system is N/A disabled or disconnected? [� Yes No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system ❑ N/A malfunction or fails a test? L Yes No* For electronic LLD's,have all accessible wiring connections been visually inspected? ❑ N/A x Yes No I Were all items on the equipment manufacturer's maintenance checklist completed? *In the section H,below,describe how and when these deficiencies were or will be corrected. II. Comments: PRESSURE LINE LEAK' ALARM 0 3:CLEAR DIESEL. PRESSURE LINE LEAK ALARM GROSS LINE FAIL 0 5:L-S DYED FEB 25, 2011 8:53 AM GROSS LINE FAIL FEB 25, 2011 10:01 AM V-PRESSURE LINE LEAF; ALARM ' A` 3:CLEAR DIESEL 0 PRESSURE LINE LEAK PLLD SHUTDOWN ALARM PLLD SHUTDOWN ALARM FEB 25, 2011 8:53 AM FEB 25, 2011 10:01 AM PRESSURE LINE LEAK ALAP.hf 0 6:L-S DYED PRESSURE LINE LEAK ALARM GROSS LIME FAIL 0 2:L-S DYED FEB 2� 2011 9:23 AM GROSS LINE FAIL FEB 25. 2011 10:13 AM PRESSURE LINE LEAK ALARM ALARM PRESSURE LINE LEAK ALARM PLLD Q D SHUTDOWN ALARM 0 .2:L-S DYED FEB 25. 2011 9:23 API PLLD SHUTDOWN ALARM FEB 2.5, 20341- X10:13 AM WHOLE SALE FUELS 2200 E BRUNDAGE WHOLE SALE FUELS BAKERSFIELD CA 2200 E BRUNDAGE 93304 13AYERSF.IELD CA 93304 FEB 25, 2011 9:24 Ahl FEB 25; 2011 10:13 AM SYSTEM STATUSREPORT - - - SYSTEM STATUS REPORT 0 6:GROSS L 1 I4E FAIL - -- - - - - - - - - - - 0 2:GROSS LINE FAIL 0 6:PL.LD SHUTDOWN ALARM A 2:PLLD SHUTDOWN ALARM PRESSURE LINE LEAK ALARM 0 2:L-S DYED PRESSURE LINE LEAK ALARM GROSS LINE FAIL 0 3:CLEAR DIESEL FEB 25. 2011 9:33 AM GROSS LINE FAIL FEB 25, 2011 10:15 AM PRESSURE LINE LEAK ALARM 0 2:L-S DYED PLLD SHUTDOWN ALARM PRESSURE LINE LEAK ALARM H 3:CLEAP. DIESEL PLLD SHUTDOWN ALARM PRESSURE LINE LEAK ALARM FEB 25. 2011 10:15 AM 0 ► :L-S CLEAR . GROSS LINE FAIL FEB 25, 2011 11 :02 AM PRESSURE LINE LEAK ALARM 0 4:UNLEADED GROSS LINE FAIL PRESSURE LINE LEAK ALARM FEB 25. 2011 10:29 AM 0 1 :L-S CLEAR PLLD SHUTDOWN ALARM FEB 25. 2011 11 :02 AM PRESSURE LINE LEAK ALARM 0 4:UNLEADED PLLD SHUTDOWN ALARM WHOLE SALE FUELS FEB 25. 2011 10:29 AM 2200 E BRUNDAGE BAKERSFIELD CA 93304 FEB 25, 2011 11 :09 AM SYSTEM STATUS REPORT - _ - PRESSURE LINE LEAK ALARM Q I :GROSS LINE FAIL 0 2:L-S DYED CROSS L 1 NE FAIL 0 ► :PLLD SHLR'DOWN ALARM FEB 25. 2011 10:40 AM PRESSURE LINE LEAK ALARM 0 2:L-S DYED PLLD SHUTDOWN ALARM FEB 25, 2011 10:40 AM