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HomeMy WebLinkAbout2010 FMC RESULTS 43 MONITORING SYSTEM CERTIFICATIONt 1E For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6.7,Health and Safety Code;Chapter 1.6,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 pr yarcd for each monitoring system control panel by the technician,whd:perfornis the woilc: A copy of this form must,be provided to the taiik;system owner/operator. The owner/operator.must submit s copy of this form to the local agency.regulatingUST"systems within 30 days of test date. A. General.information Facility Name: HARRY'S MARKET#2 Bldg.No.: Site Address: 260:1 WHITE LN City:,BAKERSFIELD Zip: Facility Contact Person YOGI Contact Phone N:o.: Make/Model.of Monitofing System: TLS 350 Date of Teong/Servicing: 10/29/2010 B. Inventory of Equipment Tested/Certfied Check the a ro riate boxes to indicate m1fic Squipmint ine ted/servlced: [Z'Piping.Sump ank ID: UNL871SPLIT Tank: D: PREMS11SPLIT ®In-Tank Gauging Probe. Model: MAO 0 M-Tank Gauging Probe. Model:,MAG ®Annular Space or Vault Sensor. Model: 4201SPLIT B{Annular Space or Vault Sensor. Model:•42015PUT /Trench Sensor(s). Model:408 ®Piping Sump/Trench:Sensar(s).. Model­208 ®Fill.Sump Seesor(s): Model: 208 ®Fill sump Sensor(s). Model::208 1 Mechanical Line Leak Detector. Model::RED JACKET ®Mechanical Line Leak Detector. Modes: RED JACKET O'Electronic Line Leak Detector: Model: Cl•Electronic TLineleak•Ddector. Model ❑Tank Overfill/High-Level Sensor. Model: ❑Tank Overfill/High-Level Sensor. Model: O Other(specify equipment type and model in Section E on.Page 2) (]Other(specify equipment type and model:in.Secfioii E on Page 2}: Tank ID:. Tank ID: ❑In-Tank Gauging Probe. Model: [31n-Tank Ga gong Probe. Model: O Annular Space.or Vault Sensor. Model: 0:Annular Space or Vault Sensor.: Model: •Pipnsg Sump./'Trench Sensor(s). .Model: . O Piping Sump:/Trench Sensor(s)_ Model: •Fill Sump Sensor(s), Model: DRI1.Sump:Sensor(s). Model: C Mechanical:I.ine Leak Detector.. Model: O:Mechanical Lineleak Detector. Model: O Electronic Line Leak Detector. Model: 0 Electrnnic L ine L.tak'Detedor. Model: ❑Tank Overfill/Idig64 evel Sensor. Model: O Tank.Overfill/High-level Sensor. Model: ❑Other(specify eq.pmatt type andmodel in Section Epn:Page 2). Other(specifgequipmenttype and model un'Section E on Pagt2). Dispenser ID: 1-2 Dispenaer;ID: 3-4 .0 Dispenser Containment Sensor(s). Model.'208 ®Mpenser:ContainmcniSens*s). Model• 208 N Shear Valve(s). ®Shear Valve(s). O Dispeaser Containment Floats),and Chains}. O.Dispenser Containment Flost(s)and Chain(s). Dispenser ID: 5-6 Dispenser:ID: 7$' ®Dispenser ContarnmenfSensor(s). Model:'208: ®Dispenser Containment Sensor(s): Model: 208 .. .®Shen Valve(s). ®Shear Valve(s): O`Dispenser Containment Float(s)and Chain(s): []:Dispenser Eontaiomentfloat(s)and Chain(s). .Dispenser ID: Dispenser ID: []Dispenser Containment Sensor(s).: Model; ❑`Dispenser Containment Sensor(s). Model: O Shear Valve(s). O Shear Valve(s). O Dispenser Containment Floags)and:Chain(s). O.f)ispenser Containment and Chain(s). *If the facility contains more"tanks:ordispensem copy this form, Include:ifi%nt ation for'every`tank and.dispenser at the facility. C. Certification-L certify that.the equipment identified in this document was inspected/serviced:in accordance with the manufacturers' guidelines. Attached to this Certiftcation is`information (e g 'manufacturers' cheeklists) 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;(chide:atlr/iarapply): System set=up ®'Alarm history report. Technician Name.(print): BRANDON MASON. Signature: CertificationNo.. 834335 13284980-UT License.No.: C611 D40 .809850 i Testing Company Name- RICH ENVIRONMENTAL Phone,No.:(661)4824687 Testing Company Address: 5643 BROOKS CT.BAKERSFIELD,CA 93308 Date of Testing/SeMcing: '10/2912010 Page 1 of 5 UN-036—114 rvww:ien[docs org. I IIIIIII I,II!III IIII 44 Rev.OL37/08 IE Monitoring System Certification D. Results of Testing/Servicing Software Version Installed: Complete the followinx checklist: K Yes ❑ No* Is the audible alarm operational? • Yes ❑ No* Is the visual.alarin operational? • Yes ❑ No* Were alt sensors visually'inspected,functionally tested,and confirmed operational? ® Yes ❑ No* Were all sensors installed at lowest point of secondary containment and positioned so:thatother.equipment will not interfere with theirproper operation?' ❑ Yes ❑ No* If alarms are relayed. to a remote monitoring: station, is all communications equipment (e.g., modem) 0 .N/A operational? 19 Yes ❑ No* For pressurized piping systems, does the°turbirie automatically shut down if the'piping secondary,containment ❑ N/A monitoring;system detects a leak,fails to:operate,;or,is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) ®Sump/Trench Sensors; M Dispenser Containment.Sensors. Did you confirm positive shut-down,due to leaks,mbd'sensor failure/disconnection? '®Yes; ❑No. 0 Yes ❑ ;No* For tank systems`that utilize the mm itoridg:system as the primary'tank`overfill warning device {i.e., no ® N/A mechanical overfill prevention valve is'installed), is tfie 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 trigger? % ❑ Yes* ® No Was any monitoring equipment replaced?, If yes,:identify,specific-sensors,probes,or odmr-,equipment replaced and list the:mamiftetureroame and model.;for affreplacement parts in Section E,below: ❑ Yes' ® No Was liquid found,inside any secondary�containment systems designed as dry-systems? (Check all 4t apply) p Product; ❑Water. If yes,describe causes M' Section E,below. ❑_No* . Vas monitoring system set-ug reviewed to ensure proper settings?Attach.set up reports,if applicable ® Yes ❑ No* Is:all monitoring equipment operational per:manufacturer's specifications? . *In Section E below,.describe'how, and When these'deficiencies were or will be corrected. E. Comments: Page 2 of 5 M-036—V4 www.uWdo&org Rev.01/17/08 Monitoring System Certification F. In-Tank Ganging SIR Equipment: ® Check1his box iftank'gauging is used onlyfor inventory.control. ❑, Check this.box'if no tank;gauging,or 9.1k equ pment is installed, This section must be completed if in-tank gauging equipment is used to perform leak detection_monitoring. Complete:the following checklist: ® Yes ❑ No* Has all input wiring been inspected for proper.entry:and.termination,including testing for ground faults? ® Yes Q, No* Were all tank gauging probes visually inspected`for damage and residue buildup? ® Yes ❑ .NO* Was accuracy of system product level..readings tested? ® Yes .0 No* Was-accuracy of.system water level readings tested? 0 Yes ❑ No* Were all probes reinstalled properly? ® Yes ❑ No* Were all items on,the equipment manutacturer's,mainteriance checklist:completed? *In Section.H,below,describe Low and when these deficiencies were or will be. corrected.. G. Line Leak Detectors(LLD) ❑ Check this box if tL aremot installed. Complete the-foil owia :Obecklist: ® Yes ❑ No* .For equipment start-up or,annual equipment certification, was a leak simulated to verify.LLD performance? ❑ N/A. (Check all that apply): Simulated leak;rate: :($3 g:p.h:; p 0.1 g.p:h; [10.2 g.pai. ®Yes ❑ No* Were all LLDs confirmed operational,and accurate within regulatory requirements? ® Yes ❑ No* Was the testing.apparatus properly calibrated? ® Yes ❑ No* 'For;mechanical LLDs,does the LLD.restrict productflow if.it detects a leak? ❑ N/A ❑ Yes ❑ No* For electronie LLDs,does the turbin6zigomatid.AUY shut off.ifthe LLD detects a leak? N/A ❑ Yes ❑ No' Far.electronic:LLDs,does the turbine automatically shut off if any portion of the monitojring.system is disabled ® NIA or.disconnected? ❑ Yes ❑ No* For electronic LLDs;does.the:turbine automatically shut off.if any portion of the monitoring system malfunctions ® N/A or fails a test? ❑ Yes ❑ No* For electronic.LLN,,have:all accessible'wiring,connectionabeenvisually*spectM? ® N/A ® Yes p No* Were all items ontheiequipmeitt.inanufada.rei's;maintenance checklist completed? *In Section K below,:describe Low aridwhen.ihese`deficiencies.were or wiltibe corrected. H. Comments: Page: 3 of, 5. UN-036—314 www:anldomorg Rev.013708 Monitoring System Certification Form: Addendum for Vacuum/Pressure Interstitial Sensors /(�( I. Results of Vacuum/Pressure Monitoring Equipment Testing This page should be used to document testing.and.servicing.of vacuum..and.pressure,interstitial sensors. A copy,of this form must be included with the Monitoring System Certification Form, which must$e provided. to the tank system owner/operator:.The owner/operator must submit a.copy of the Monitoring System.Certification Form.to the local agency.regulating UST.systems.:within 30 days of test date. Manufacturer::NONE Model: System Type::❑Pressure;®Vacuum Sensor ID Component(s).Monitored by this Sensor. Sensor Functionality Test Result:❑Pass;. [] Fail Interstitial Communication'Pest 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 Commumcatioli TestResult ❑`Pass; ❑ Fail. Component(s)Monitored bythig.Sensor. Sensor:Functionality Test Result [l 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 lhis'Sensor: Sensor Functionality Test Result:❑Eass;; C❑ 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'Re'cult::❑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 TestResult:Z]Pass; ❑ Fail How was interstitial cammuitication.verified? ❑ Leak IAtro&ced of Far End,of Interstitial Space;' ❑ •Gauge;: ❑ Visual.Inspeetion; ❑ Other(Describe in Sec..J below) Was vacuum/p9 nodescribe in-Sec.J,:below; ressute restored:to operating levels in all interstitial spaces,: ❑Yes ❑No(If J. Comments*., NONE OF THESEISENSORSARE 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 poini from the sensor,vacuum/pressure'h'as been denibAstrated.to be communicating throughout the interstice: UN436A-1/1 www.nnSdocs org Rev.01/16/06 -- - - - - - - - - - - - - - 1Vliwitoring system Cerdhcation us'T Monatp Site PI an Site Aress: a19O 4.1�2E 1.�t.) SF�E`e, G-� = - - - F m I -x :3 - = - - -- - - - - - - - - -- - - - - - - - � - - • - - - - - - _ - -' - - - - - - - - - - - - . . - _ - - - - n - - - - - - - - - - - - - - - - - -' = - - . . . . . . . . .. . . . _ . .- _ . . _ . . r -. . _ _ _ _ • _ - �.• . _ r _ r _ -A- _ r - . . r - . .- - _ - _ Y - - r - _ - - - - • - _ r r - ` _. - - - - - - - - - - - 1 .. . . . . . . . . . . . . . . . . . . . . . .. • _ ._ _ • - _. • _ . _ r . _ - - - r - . . r . .. . . . . . . . .... . . . • - - - - - - - - - - _ . r . _ _ . . r . _. _ _ ♦ - _. r . _ . _ . r ♦ _ . . _ r . r . . _ . . r _ - ! . . . . . . . . ... . .r r . w _ r . _ _. - r r .. • r . . .. . . . . . . .r r ! _ . . . . . . . .. . .. ► _. . . . . . r . r . . . • _ - - 4 - - - - - - - - - _ _ -' .�.�. . _ r . r. -. - - .- - _ - . r _ Date:msp wss drawn. Imo'-n o If you already have.a diagram<that shows all required information,you may i�lnde it;rather than this Monitoring.%weni r y pag with our . p �erai.layovt of and piping,_Clearly identify Cemficaiian.on your site ,lan,show rhea locations of the'following equipmwt,ifiustalled:monitoring system cpWol panels,•'sensors monitoring tank annular spaces,sumps,dispenser pans,z ii coata�ners or other s-eohdary roman mt areas:mfbWCW:or tlocbvnir-line leak detemrs,•and in-tame liquid*d probes(if used for leak detection):In the gm=,prruAdod,uote'the data this Site Plan was pmparod, Pap of 07100 RICHENVIRONMENTAL 5643 BROOKS.CT. BAKERSFIELD,CA. 93308. OFFICE(661)392-8687 FAX;(661)392-0621 PRODUCT LINE LEAK DETECTOR TEST WORKSHEET W/0#: FACILITY NAME: HARRY'S MARKET:#2 FACILITY ADDRESS: 2601 WHITE`LN.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 1M TYPE:.RED JACKET 12 PASS YES SERIAL,#'MECHANICAL PREM91 LID TYPE:RED JACKET 12 PASS. YES SERIAL# MECHANICAL LID TYPE: PASS YES SERIAL# FAIL L/D TYPE. PASS YES SERIAL.#: FAIL I CERTIFY THE ABOVE TESTS WERE CONDUCTED ON THIS_DAT,EACCQRDING TOAED JACKET PUMPS FIELD TEST APPARATUS TESTING PROCEDURE AND,LIIVIITATIONS:. THE MECHANICAL LEAK,DETECTOR TEST'PASS/FAIL,IS DETERMINED BY,USING A LOW FLOW THRESHOLD TRIP RATE:OF 3 GALLONS PEWHOUR OR LESS AT I OT.S.I.I, ACKNOWLEDGE THAT ALL DATA:COLLECTED IS TRUE'AND CORRECT TO THE BEST OF mY KNOWLEDGE. TECHNICIAN: BRANDON MASON ^ SIGNATURE: DATE-,10-29-10 °SWRCB,.January 2006 Spill.Bucket Testing.Report Form This form is.intended for use by.contractors,performing annual testing of LIST spill containment structures. The completed form and printouts from tests(rf applicable);should:be;provided to the facility-owner/operator for submittal to the local-regulatory agency. 1. FACILTI'Y INFORMATION Facility Name: HARRY'S;MARKET#2. . Date of Testing, 10-29-10 Facility Address: 2601 WHITE LANE,BAKERSFIELD;,:CA Facility Contact: YOGI Phone: .Date Local.Agency,Was Notified ofTesting: Name,of Local-Agency Inspector,ffpresentl during testingh: ERNIE MADENA 2. TESTING CONTRACTOR INFORMATION Company:Name;. RICH ENVIRONMENTAL Technician Conducting Test BRANDON:MASON Credentials!: ❑CSLB Contractor X ICC Service Tech. ❑SWRCB Tank.Tester ❑Other,(Sped) License Number(s): 5284980-UT 3. SPILL BUCKET TESTING INFORMATION Test Method Used: X Hydrostatic ❑Vacuum ❑;Other Test Equipment Used:VISUAL: Equipment Resolution:6 Identify Spill Bucket(By.'Tank ' A 2 PREN1HUM 91- 3 4 Number,Stored Product, etc REGULAR 87-FILL FILL DIESEL FILL ❑Direct Bury a Direct Bury ❑Direct Bury. ❑Diirect.Bury Bucket Installation Type: X Contained:in Sumv X Contained,in Sump o Contained`in Sump ❑Contained:in Sum Bucket Diameter. 12" 12" 12": Bucket Depth: 14" 14" 14" Wait time'between applying vacuum/water and start oftest 30 MIN 30 NUN 3O MIN Test Start Time(T�. 9:OOAM 9:OOAM InitialReading(R) 91N 91N Test End Time T 16:00AM 10:60AM Final Reading(RF): 9IN .9IN Test Duration(TI:—Til: 1'=HOUR: 11.-HOUR 1:-HOUR Change in-Reading(RI, 0IN OIN Pass/Fail.Threshold or +/-0:00 +/_0.00 +1-0.60 Criteria: Comments—(include information;on repairs made prior to testing, and recommended follow-up for failed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING X hereby certify.that all:the lnforneadon.contained.hi this report h true,.accurate,and in full compliance with legal requirements. Teclmician's.Signature: '''~-—�_ Date: 10-29-10' 1 State laws and regulations do not currently'require testing to be.performed by a qualified contractor.However;local.requirements .may be more stringent: laf1�-IV—liV t iv-truvt� iniur f`4-: J t'KVUUI t I:UUt t 260IWH:ITE LN - - - - - - - - THERMAL GOEFF ..,00070.0 BACKERSFIELD:.CA TANK DIAMETER 114.00 : 1-661-833-8553 T 1 :PREM TANK PROFILE 1 PT PRODUCT CODE ;' 2 . FULL VO.L 12000 OCT 29. 2DIO 6:21 PM THERMAL'COEFF : .0Q0700 TANK DIAMETER TANK PROFILE ., I PT FLOAT SIZEi 4,0 IN. FULL VOL 5000 SYSTEM STATUS REPORT WATER WARNING 2.0 - - - - - - - - - - - - HIGH WATER LIMIT: 2.5 ALL FUNCTIONS NORMAL FLOAT SIZE: 4.0' IN. MAX OR :LABEL VOL: 12009. '� WATER WARNING .. : 2.0 OVERFILL LIMIT 9M. Ft WATER LIMIT: 2.5 10800 a cox MAX OR LABEL VOL: 8000 HIGH PRODUCT 10680 OVERFILL LIMIT 90% •l DELIVERY LIMIT 10: 7200 1200 HIGH PRODUCT 89% 7.,120 ,. _ LOW PRODUCT 1200 k ' V *' >r I T , SYSTEM-SETUF D£L'I E 640 LEAK .ALARM LiM:IT: 99 - - - - SUDDEN LOSS LIMIT: 99 OCT 29, 2010 6:21' PM TANK TILT 0.00. LOW. PRODUCT 109.0 PROBE. OFFSET 0.00 '�F..: LEAK ALARM LIMIT: 99 ,� ... SUDDEN LOSS LIM.IT': 99 SYSTEM 60M- TANK TILT 0.00 SIPHON ,MANIFOLDED TANKS PROBE OFFSET O.00 Tit;: NONE: MTEM I:ANGUAGE.' LINE MANIFOLDED TANKS ENGLISH' Tp: NONE SYSTEM DATE/TIAS'FORMAT SIPHON MANI.FOLDEDJANKS MON DD YYYY Ht I mm-SS xM T#`:_ NONE LINE MAN I FOLDED TANKS LEAK 'MIN PER I ODJ C: 0•/6 GAS-N—GO T#: NONE 0 2601WHITE LN BACKERSFIELD.:CA LEAK: MLN ANNUAL 0:. 1-661--833-8553 LEAK MI'N PERIODIC 00 0 SHIFT TIME 1 : DISABLED SHIFT TIME 2 : DISABLED LEAK, MIN ANNUAL 0 PERIODIC TEST TYPPE� NDARD SHIFT TIME 3 : DISABLED ' SHIFT TIME 4 : DISABLED ANNUAL TEST FAIL ',TANK PER 'TST NEEDED WRN PERIODIC TEST TYPE ALARM DISABLED DISABLED STANDARD TANK ANN TST NEEDED WRN PERIODIC TEST FAIL DISABLED ANNUAL TEST FAIL. ALARM DISABLED ALARM DISABLED LINE RE-ENABLE METHOD wGROSS TEST FAIL PASS LINE TEST PERIODIC TEST FAIL ALARM DISABLED ALARM_ DIISABLED LI';NE.PER TST NEEDED AN ANN TEST AVERAGING:. OFF DISABLED G.ROSS WEST FAIL REP TEST AVERAGING. OFF LINE ANN TST NEEDED WRN. ALARM DISABLED DISABLED TANK TEST NOTIFY,: OFF ANN; TEST AVERAGING; OFF PRINT TC VOLUMES PM TEST AVERAGING::, OFF TNK 'TST SIPHON BREAK:OFF ENABLED TANK TEST NOTIFY: OFF DELIVERY DELAY 1 MIN TEfIP COMPENSATION ;z PUMP THRESHOLD 10.00% VALUE' �DEG; .:Y 60. .0. ? TNK, TST SIPHON BREAK:OFF TICK HEIGHT OFFSET "ISABLED DELIVERY DELAY 1 .MIN DAYLIGHT SAVING TIME PUMP THRESHOLD IG.00%, DISABLED SYSTEM SECURITY CODE' OQODDO CUSTOM ALARM LABELS DISABLED - - - - - ,�Z»v TEST WEEKLY ALL TANK - ---- IN-TANK ALARM --- SUN R 1 :UNLEADED .SHUT-DOWN START TIME 12:00. AM, TYPE: T I :PREM TEST RATE 0.20 .GALiHR. STANDARD LOW PRODUCT ALARM DURATION 2 HOURS NORMALLY CLOSED OCT 15: 2010 ALARM PM 'TT EARLY STOP D F SABL ED . JUL 31 , 20Q9 1 :55 PM LI;AUID .SENSOR ALMS: JUL 23, 2009 4-:14 PM LEAK TEST REPORT FORMAT ALL FUEL :ALARM NVALID FUEL LEVEL NORMAL ALL:SENSOR OUT ALARM � INNV 17,. FUEL LEVEL P1N R. 2:PREM SHUT-DOWN OCT 25: '2009 f0:25 AM TYPE: OCT II 2009 9:14 AM STANDARD PROBE OUT 1 NORMALLY CLOSER OCT OUT 2003 9:19 41 OCT 10: 2003 3:02 PM LIQUID' SENSOR AL14S ALL.:FUEL ALARM ALL:SENSOR OUT ALARM DELIVERY NEEDED SEP 70' 2009 5:36 'PM LIQUID SENSOR SETUP AUG 28, 2009 4:37 PM - - - - - - - - - - AUG 16, 2009 4:20 PM L 1 :91TRURINE TRI-STATE (S,I NGLE FLOAT) LOW TEMP'WARN I.NG CATEGORY : STP SUMP OCT 1:0, 2003 3.:22 PM L 2:91FILL TRI;-STATE' (SINGLE FLOAT) CATEGORY PIPING SUMP RECONCILIATION. SETUP L 3:87TRUBINE TRI'-STATE (SINGLE FLOAT) AUTOMATIC DAILY CLOSING CATEGORY :, STP SUMP TIME:. 2:00 AM * K . END PERIODIC. RECONCI,LIATION L 4:87 FILL MODE: MONTHLY TRI-STATE .(SINGLE FLOAT) CATEGORY PIPING SUMP TEMP COMPENSATION STANDARD L 5::DISP 1x2 BUS SLOT FUEL METER TANK TR I-STATE (SINGLE,NGLE, FLOAT) - - CATEGORY DISPENSER, PAN. TANK' MAP EMPTY L 6:D.ISP 3k4 TRI- STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L 7:DISP 5x6. TRI-STATE (SI.NG FLOAT). CATEGORY : DISPENSER. PAN ALARM HISTORY 'R£PORT ----- PYSTEMALARH _---- PAPER, ;OUT L 8:DI:SP 7x8 OCT .2§.., 2010 9:44 AM TRI-STATE (SINGLE .FLOAT) PRINTER ERROR CATEGORY : DISPENSER PAN OCT 29. 201Q 9:1.4 AM BATTERY IS OFF JAN 1, .1996 .'8;:00 AM SYS SECURITY WARNING L. 9:ANNULAR OCT 10. 2003 2:43 PP1 TRI-STATE (SINGLE FLOAT) CATEGORY ANNULAR SPACE x x x END. x x x x x. u ALARM HISTORY REPORT --- IN-TANK ALARM ---- ----- SENSOR ALARM =--- L 1,:91 TRU13I NE T 2:UNLEADED STP sue' FUEL ALARM OVERFILL ALARM' OCT 29 2010 12:56 PM SEP 12. 2006 41:48 PM JUL 19, 2006 5::26 PM FUEL.ALARM DEC.' 6, 2007. 10:19 AM LOW PRODUCT ALARM, OCT 17. `20'10 5:.11 PM FUEL ALARM ` NOV B. 2009 2`:.23 PM DEC 6., 2006. '2=05 PM NOV 2. 2009 4:19 AM HIGH PRODUCT ALARM SEP 12, 2006 4.:48 PM JUL 19, 2006 5:25 PM INVALID FUEL LEVEL NOV 28, 2069 3:56 PM NOV 22. 2009 e:Q9 PM NOV 21 , 2009 1"0:12 AM * * * ENDS * * PROSE OUT OCT 13, 2003 9:18 AM 66T 10, .2003 3:03 PM DELIVERY 10DED OCT t7.-'201'0 8,:-1,0 PM' NOV 8- .2004 2:10 PM NOV 2'. 2009 4:1B AM LOW TEMP WARNING ALARM HISTORY REPORT OCT 13, 2063 12:07 PM -- SENSOR ALARM - -- L '291FILL PIPING SUMP FUEL ALARM OCT 29, 20.1.0. 4:.26 PM FUEL ALARM OCT 29, 2010 12:57 ,PM FUEL ,ALARM * END * OCT 29. 2010 12:15 PM x ; k, )i END X x ,.ALARM HISTORY REPORT -- .-- SENSOR ALARM ----- L 3.:'97TRUBINE , STP 'SUMP FUEL. ALARM OCT. 2S, 2010. I2:57 .PM FUEL ALARM OCT 291 20.10 1.2,:17 PM FUEL ALARM DEC 6, 2007 10:16 AM ALARM HISTORY REPORT -- -- SENSOR ALARM -- __ SENSOR: ,ALARM -_ L.7:DISP 5*6 L 41.87 FILL DISPENSER PAN P:I P'I NG SUMP FUEL ALARM FUEL ALARM OC.T 29, 2010 1 :0.6 PM OCT 29. 2610 4:19 PM FUEL ALARM FUEL ALARM DEC 6, 2007 50:•26 AM OGT' 29.. 2010 12:5$! PM FUEL ALARM FUEL ALARM DEC 6, 2006 10:20 AM DEC 6, 2007 10:15 AM END . ALARM HISTORY REPORT ALARM HISTORY REPORT ----- SENSOR. ALARM ----- ---- SENSOR ALARM ----= L B:DISP. 7*8 L 5.:DISP 1*2 DISPENSER PAN DISPENSER ;PAN FUEL: ALARM FUEL ALARM OCT 29, 2010 4:-23 PM OCT 29, 2010 3:02' PM FUEL ALARM FUEL ALARM OCT 29. 2010 1 :05 PM OCT 29.''2010 1 :04 PM FUEL ALARM FUEL ALARM DEC 6. 2007 10:28 AM DEC S. 2-007 10:26 AM xxXXx. ENDX.. : , x9x * Xxk END xx .x ALARM HISTORY REPORT ALARM HISTORY REPORT' ----- SENSOR ALARM --- -- SENSOR ,ALARM ----- L 9:ANNUiAR L 6:DISP 3)(4 ANNULAR' SPACE DISPENSER •PAN FUEL ALARM FUEL .ALARM OCT 29, 2010` I = PM OCT 29. 20.10 5 35 PM FUEL ALARM .. FUEL .ALARM OCT 29, 2010 1 :.012 PM OCT 29. 2010 1 :04 PM FUEL. ALARM FUEL ALARM OCT 29. 2610 1 ;01 PM DEC: 6, 2007 10:24 AM MONITOR CERT. FAILURE REPORT SITE NAME : r7IL�'J S "ALE-% DATE: /0 ADDRESS ct�__A _.i;x� tky--m L_N TECHNICIAN Xg2 `i l o-j /mss r� CITY SIGNATURE : �I THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE TESTING'. REPAIRS• u a LABOR: lJo PARTS INTALLED CU IV'G NAME : TITLE SIGNATURE THE ABOVE NAMED PERSON. TAKES FULL RESPONSIBILITY OF NOTIFYING THE,APPROPRIATE PARTY TO HAV E ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND;NOTIFYING.RICH ENVIRONMANTALFOR 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 CONVIENENCE.