HomeMy WebLinkAboutFMC RESULTS 2010 Pass
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 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 this date.
A. General Information IIIIIIIIIIIIIIIIIIII 07
Facility Name: #233 D &G Liquor IE Bldg.No.:
Site Address: 2732 Brundage Lane City: Bakersfield Zip: 93304
Facility Contact Person: Omero Garcia Contact Phone No.: 661-393-7000
Make/Model of Monitoring System: Veeder-Root TLS 350 Date of Testing/Servicing: 8/16/2010
B. Inventory of Equipment Tested/Certified
es
Check the appropriate box to Indicate specific equipment inspected/servind:
Tank ID: 12000 gal.Regular Tank ID: 12000 gal.Diesel
[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:WPLLD U Electronic Line Leak Detector. Model: WPLLD
U 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: 12000 gal.Super Tank iD:
[x] in-Tank Gauging Probe. Model:847390-107 ❑ in-Tank Gauging Probe. Model:
❑ 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. Modei:WPLLD ❑ Electronic Line Leak Detector. Model:
Lx] Tank Overfill/High Level Sensor. Model:847390-107 E] Tank Overfill/High Level Sensor.Model:
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: 1 &2 Dispenser ID:
[x] Dispenser Containment Sensor(s). Model: 794390-208 ❑ 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 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 -1 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,1 have attached a copy of the report; (check all that apply) x❑System Set-up x Al hi ory report
Technician Name(print): Bryan A Self Signature:
Certification No: 837501 License N. 804904
Testing Company Name: Confldence UST Services,Inc. Phone No: 800-339-9930
Site Address: 2732 Brundage Lane,Bakersfield,CA 93304 11111111111111111 O8 Date of Testing/Servicing: 8/16/2010
A Results of Testing/Servicing
Software Version Installed: 14.04
Complete the following checklist:
❑ Yes [x-1 No* Is the audible alarm operational?
gx Yes x e No* Is t Visua alarm operational?
x Yes No* Were all sensors visually inspected,functionally tested,and confirmed operational?
Yes ❑ No* Were all sensors installed at the lowest point of secondary containment and positioned so that other
equipment will not interfere with their proper operation?
Yes No* If alarms are relayed to a remote monitoring station, is all communications equipment(e.g.modem)
x N/A operational?
x Yes ❑ No* For pressurized piping systems,does the turbine automatically shut down if the piping secondary
❑N/A containment monitoring system detects a leak,fails to operate,or is electrically disconnected? If yes:
which sensors initate positive shut-down? ❑Sump/Trench Sensors U Dispenser Containment Sensors
Did you confirm positive shut-down due to leaks and sensor failure/disconnected? U Yes; ❑ No;
U Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no
N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visual and audible at
the tank fill point(s)and operating properly?If so,at what percent of tank capasity does the alarm
trigger? 9p %
❑ Yes* U 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* E No Was liquid found inside any secondary containment systems designed as dry systems?
❑ Product; ❑ Water. If yes,describe causes in Section E,below.
TX N * Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports, if applicable.
E Yes I D No* I Is all monitoring equipment operational per manufacturer's specifications?
*In Section E below,discribe how and when these deficiencies were or will be corrected.
E. Comments:
F. In-Tank Guaging/SIR Equipment: M 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:
[.1] Yes ❑ No* Has all input wiring been inspected for proper enter and termination,including testing for ground faults?
x Yes No* Were all tank guaging probes visually inspected for damage and residue buildup?
Ix Yes No* Was accuracy of system product level readings tested?
x Yes No* Was accuracy of system water level readings tested?
_[xl Yes No* Were all probes reinstalled properly?
U 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 leik rate: [�]3 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?
x Yes No Was the testing apparatus properly calibrated?
❑ Yes No* For mac amca LLD's,does the LLD restrict product flow if it detects a leak?
x N/A
[x] Yes No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a leak?
❑ N/A
L] 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?
[x 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?
❑ Yes No* For electronic LLD's,have all accessible wiring connections been visually inspected?
❑ N/A
x Yes No 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.
H. Comments:
D AND G 233 SYSTEM SETUP
2732 BRUNDAGE LN - - - - - - - - - - - -
SAKERSFFiLD CA 9330 AUG 16, 2010 1'2:23 PM
661-326-1083
D AND G 233
2732 BRUNDAGE LN AUG 16. 2010 12:23 PM SYSTEM UNITS
BAKERSFFILD CA 9330 U S
661-326-1083 SYSTEM LANGUAGE
AUG 16, 2010 12:23 PM ,SYSTEM STATUS REPORT ENGLISH
- - - - - - - - - - - - SYSTEM DATE:TIME FORMAT
T 3:DELIVERY NEEDED MON DD YYYY HH:MM:SS xM
SYSTEM,STATUS REPORT D AND G 233
- - - INVENTORY REPORT 2732 BRUNDAGE LN
T 3:D)IVERY NEEDED BAKERSFFILD CA 9330
661-326-1083
T ! :UNLEADED
INVENTORY REPORT VOLUME m 7070 GALS SHIFT TIME I : DISABLED
ULLAGE - 4930 GALS SHIFT TIME 2 DISABLED
90% ULLAGE- 3730 GALS SHIFT TIME 3 DISABLED
T ) :UNLEADED TC VOLUME - 6929 GALS SHIFT TIME 4 DISABLED
VOLUME = 7070 GALS HEIGHT - 54.75 INCHES
ULLAGE - 4930 GALS WATER VOL - 0 GALS TANK PER TST NEEDED WRN WRN
90% ULLAGE= 3730 GALS WATER = 0.00 INCHES DISABLED
TST NEEDED DISABLED TC VOLUME - 6929 GALS TEMP . 88.4 DEG F DISABLED
HEIGHT = 54.75 1NCHE5
WATER VOL 0 GALS
- T 2:PREMIUM LINE RE-ENABLE METHOD
WATER 0.00 INCHES VOLUME = 1963 GALS PASS LINE TEST
TEMP 88,4 DEG F ULLAGE - 10037 GALS
90% ULLAGE= 8837 GALS LINE PER TST NEEDED WRN
T 2:PREMIUM TC VOLUME - 1927 GALS DISABLED
VOLUME = 1963 GALS HEIGHT - 21 .16 INCHES LINE ANN TST NEEDED WRN
ULLAGE - 10037 GALS WATER VOL - 15 GALS DISABLED
90Y. ULLAGE= 8837 GALS WATER - 0.79 INCHES
TC VOLUME - 1927 GALS TEMP - 85.6 DEG F PRINT TO VOLUMES
HEIGHT = 1 . 16 INCHES ENABLED
WATER VOL = 15 GALS T 3:DIESEL TEMP COMPENSATION
TEMP 8 B ,..6
WATER = 5 INCHES VOLUME = 1199 GALS VALUE (DEG F > : 60.0
6 DEG F ULLAGE = 10801 GALS STICK HEIGHT OFFSET
90% ULLAGE- 9601 GALS DISABLED
T 3:DIESEL v TC VOLUME = 1047 GALS ULLAGE: 9(r6
VOLUME = 1199`GALS HEIGHT = 15.01 INCHES
ULLAGE , - 10801 GALS WATER VOL - 0 GALS H-PROTOCOL DATA FORMAT
90 ULLAGE= 9601 GALS WATER = 0.00 INCHES HEIGHT
TC VOLUME - 1047 GALS TEMP = 88.0 DEG F PRECISION TEST DURATION
HEIGHT = 15.01 INCHES HOURS: 12
WATER VOL - 0 GALS DAYLIGHT SAVING TIME
WATER a 0.00 INCHES x X " R ENE) x h DISABLED
TEMP a 88.0 DEG F RE-DIRECT LOCAL PRINTOUT
DISABLED
R END EURO PROTOCOL PREFIX
S
SYSTEM SECURITY
CODE : 000000
MAINTENANCE HISTORY
DISABLED
TANK CHART SECURITY
DISABLED
CUSTOM ALARMS
DISABLED
MASS/DENSITY
DISABLED
1 T 2:PREMIUM
IN-TANK SETUP PRODUCT CODE 2
- - - - - - - - - - - - THERMAL COEFF : .000700
T ( :UNLEADED TANK DIAMETER 96.00
COMMUNICATIONS SETUP_ _ _ PRODUCT CODE I TANK PROFILE I PT
- - - - - - - - - THERMAL COEFF : .000700 FULL VOL (2000
TANK DIAMETER 96.00
PORT 3ETT11Vt;°: TANK PROFILE t PT FLOAT SIZE: 4.0 IN.
FULL VOL 12000
C-OMI-i BOARD : I (R5-232) WATER WARNING 2.0
BAUD RATE : 9600 FLOAT SIZE: 4.0 IN. HIGH WATER LIMIT: 3.0
PARITY NONE
STOP BIT t STOP MAX OR LABEL VOL: 12000
DATA LENGTH: 8 DATA WATER WARNING 2.0 OVERFILL LIMIT 90.
RS-232 SECURITY HIGH WATER LIMIT: 3.0 10800
CODE DISABLED MAX OR LABEL VOL: 12000 HIGH PRODUCT 11400
OVERFILL LIMIT 90% DELIVERY LIMIT 15%
AUTO TRANSMIT SETTINGS. 10800 1800
HIGH PRODUCT 956
AUTO LEAK ALARM LIMIT 11400 LOW PRODUCT : 600
DISABLED DELIVERY LIMIT 15%6 LEAK ALARM LIMIT: 99
AUTO HIGH WATER LIMIT 1600 SUDDEN LOSS LIMIT: 99
DISABLED TANK TILT 0.00
AUTO OVERFILL LIMIT LOW PRODUCT 600 PROBE OFFSET 0.00
DISABLED LEAK ALARM L1111T: 99
AUTO LOW PRODUCT SUDDEN LOSS LIMIT: 99
DISABLED TANK TILT 0.00 SIPHON MANIFOLDED TANKS
AUTO THEFT L1M17 PROBE OFFSET 0.00 TO: NONE
DISABLED LINE MANtFOLDED TANKS
AUTO DELIVERY START SIPHON MANIFOLDED TANKS To: NONE
DISABLED Td: NONE
AUTO DELIVERY END LINE MANIFOLDED TANKS LEAK MIN PERIODIC: In
DISABLED Td: NONE
AUTO EXTERNAL INPUT ON 120
AUTSO EXTERNAL. INPUT OFF LEAK MIN ANNUAL IV.
LEAK MIN PERIODIC: lry
DISABLED 120 t20
AUTO SENSOR FUEL ALARM
DISABLED LEAK MIN ANNUAL 1%L
AUTO SENSOR WATER ALARM 120 PERIODIC TEST TYPE
DISABLED STANDARD
AUTO SENSOR OUT ALARM
ANNUAL TEST FAIL
DISABLED
PERIODIC TEST TYPE ALARM DISABLED
STANDARD
PERIODIC TESTS FAIL
ANNUAL TEST FAIL ALARM DISABLED
ALARM DISABLED
GROSS TEST FAIL
PERIODIC TEST FAIL ALARM DISABLED
ALARM DISABLED
RS-232 END 6F MESSAGE GROSS TEST FAIL ANN TEST AVERAGING: OFF
DISABLED ALARM GISABLED PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
ANN TEST AVERAGING: OFF
PER TEST AVERAGING: OFF TNK TST SIPHON SREAK:OFF
TANK TEST NOTIFY: OFF DELIVERY DELAY 1 MIN
PUMP THRESHOLD : 10.00%s
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY 1 MIN
PUMP THRESHOLD : 10.004
LIINE LEAK,LOCKOUT ;SETUP
T 3:DIESEL LEAK 'TEST METHOD' LOCKOUT SCHEDULE -
PRODUCT CODE 3 - - - _ DAILY:
THERMAL COEFF .004500 TEST WEEKLY #iLL TANK START 'CIME-:, DISABLED
TANK DIAMETER 96.00 SUN STOP TIME DISABLED
TANK PROFILE I PT START TIME 2:00 A10
FULL VOL. : 12000 TEST RATE :u•.20 GAL'HR
DURATION 2 HOURS
FLOAT SIZE: 4.0 1N. TST EARLY STOP:DISABL:ED
WATER WARNING 2.0 LEAK TEST REPORT FORMAT
HIGH WATER LIMIT.: 3.0 NORMAL
MAX OR LABEL VOL: 12000
OVERFILL LIMIT 90X.
IOB00
HIGH PRODUCT 95 LIQUID. SENSOR SETUP
1.1400 - - - - - - - -
DELIVERY LIMIT 1.5%
1800 L. 1 :D'ISP 1
- TRI-STATE•: (SINGLE FLOAT)
LOW PRODUCT -600 CATEGORY ;. DISPENSER AN
LEAK ALARM LIMIT: 99 lJPLLD LINE LEAK SETUP
SUDDEN.LOSS LIMIT: 99
TANK TILT 0.00 -
PROBE OFFSET 0.o0
W i :,DIESEL
SIPHON MANIFOLDED TANKS
LINE NONE LINE2LENGTH , 00. FEET
LINE MANIFOLDED 'TANKS SHUTDOWN RATE.! 3:O GPH
To' NONE
T 3:DIESEL:
DISPENSE, MODE.:
LEAK. M I.N PERIODIC: !s: STANDARD
120 OUTPUT RELAY•SETUP
PRESSURE OFFSET: 0.0P3i - - - - - - -
LEAK M1N ANNUAL 11X
120 �°R .1,:'OVERF I,LL ALARM.
TYPE;:
STANDARD
PERIODIC TEST TYPE NOR ALLY .OPEN
STANDARD
ANNUAL TEST FALL IN-TANK ALARMS
ALARM DISABLED ALL.:'OVERF I LL ALARM
.ALL:'kIGH PRODUCT;ALARM
PERIODIC TEST FAIL -ALL:MAk PRODUCT ALARM
ALARM DISABLED
W 2:-UNLEADED
GROSS TEST FAIL
ALARM DISABLED TYP:2,0 .IN SCEEL
LINE LENGTH,: '100-FEET
ANN TEST AVERAGING: OFF SHUTDOWN RATE,: 3.0, GPH
PER TEST AvERAOLNG: OFF T i :UNLEADED
DISPENSE'MODE:
TANK TEST NOTIFY: OFF STANDARD. '
TNK TST SIPHON BREAK:OFF PRESSURE' OF;FSET: O'.OPSt
WPLLD L I NE. D'I SABLE .SETUP
DELIVERY DELAY I MIN
PUMP THRESHOLD 10.01
W 1 :DIESEL
LIQUID SENSOR ALMS
ALL:FUEL ALARM
ALL:SENSOR •OUT.ALARM
ALL':,SHORT .ALARM
W 2:UNLEADED
W 3:PREMI Lim. LIQUID SENSOR, ALMS
NILL:FbEL ALARM
TY,P:�2..0 IN, S'F_EEL ALL::SENSOR:OOT ALARM
L I NE";LEiVGTH: 1:00','FEET, ALL-.SHORT ALARM
SHUTDOWN'<RATE: .3.;0 GPm
T 2:PREMI.UM W. 3:PREM I UII1
DISPENSE;
"MODE'
STANDARD- L l'dU I D',SEIS'Ei6R ALMS
ALL,IFUEL ALARM
PRESSURE- OFFSET'. O':OPS'l ALL::SENSOR' OUT`ALARM
ALL;SHORT`AL:ARM
---- IN-TANK. ALARM -----
T 2:PREMIUM
ALARM HISTORY REPORT INVALID FUEL LEVEL
AUG 16. 2010 12:50 PM
ALARM HISTORv REPORT
---- Iht-TANK ALARM -----
---- IN-TANK ALARM -----
T 3:DlESEL
T I :UNLEADED
OVERFILL ALARM DELIVERY NEEDED
JUL 31, 2010 6:56 PM AUG 4, 2010 3:42 PM
---- IN-TANK ALARM -----
T 2:PREM I UIM
PROBE OUT
AUG 16, 2010 12:50 PM
hxxxEND END xrix
i
- IN-TANK ALARM -----
T 3:DIESEL
PROBE OUT
AUG 16, 2010 12:50 PM
ALARM HISTORY REPORT ALARM HISTORY REPORT
---- 11,1-TANK ALARM ----- ----- SENSOR ALARM -'
L I :DISP I
T 2:PREMIUM DISPENSER PA14 D AND G 233
2732 BRUNDAGE LN
LOW PRODUCT ALARM BAKERSFFILD CA 9330
AUG 7. 2010 5:25 PM 661-326-1063
INVALID FUEL LEVEL AUG 16. 2010 12:51 PM
AUG 8, 2010 1 :58 PM
DELIVERY NEEDED SYSTEM STATUS REPORT
JUL 26, 2010 11 :42 AM x h END r R - - - - - - - - - - -
T 2:LOW PRODUCT?ALARM
T 2:SUDDEN LOSS ALARM
T 2:INVALID FUEL LEVEL
T 2:PROBE OUT
T 2:DELIVERY NEEDED
x END x h x x T 3:LOW PRODUCT ALARM
T 3:SUDDEN LOSS ALARM
T 3:lNVALID FUEL LEVEL
T 3:PROBE OUT
T 3:DELIVER'Y NEEDED
D AND G 233
IN-TANK ALARM ----- 2732 BRUNDAGE LN D AND G 233
T ! :UNLEADED BAKERSFFILD CA 9330 2732 BRUNDAGE LN
DELIVERY NEEDED 661-326-1083 BAKERSFFILD CA 9330
AUG 16, 2010 12:52 PM 661-326-1083
AUG 16. 2010 1 :03 PM
AUG Ib, 2010 1:06 PM
SYSTEIN STATUS REPORT
- - - - - - - - - - - - SYSTEM STATUS REPORT
T 2:SUDDEN LOSS ALARM - - - - - - - - - - - -
ALL FUNCTIONS NORMAL.
---- 1N-TANV ALARM -----
T ) :UNLEADED
PROBE OUT
AUG 16, 2010 12:52 PM
---- IN-TANK ALARM -----
WPLLD LINE LEAK ALARM T 2:PREMIUM
W I :DIESEL HIGH PRODUCT ALARM
WPLLD SHUTDOWN ALM AUG 16. 2010 1 :07 PM
---- IN-TANK ALARM
AUG 16. 2010 1 :05 PM
-----
T ) :UNLEADED
LOW TEMP WARNING
AUG 16, 2010 12:153 PM
---- IN-TANK. ALARM -----
WPLLD LINE LEAK ALARM T 2:PREMIUM
W 2:UNLEADED PROBE OUT
WPLLD SHUTDOWN ALM AUG 16, 2010 1 :07 PM
AUG 16. 2010 1 :05 PM
T 3:DIESEL
INVENTORY INCREASE
INCREASE START
AUG 16. 2010 12:50 PM
T 3: 1NVALID FUEL LEVEL
VOLUME 427 GALS
HEIGHT n 7.41 INCHES
WATER - 0.00 INCHES WPLLD LINE LEAK ALARM
TEMP - 88.0 DEG F W 3;PREMIUM
WPLLD SHUTDOWN AL11
AUG 16. 2010 1 :05 PM
INCREASE END
AUG 16. 2010 12:54 PM
VOLUME a 5274 GALS
HEIGHT - 43.43 INCHES
WATER = 0.83 INCHES
TEMP = 90.3 DEG F
GROSS IIdC;REASE- 4847 ----- SENSOR ALARM -----
TC NET INCREASE- 4182 L I :DISP 1
DISPENSER PAN
FUEL ALARM
AUG 16, 2010 1 :05 PM
D AND G 233
2732 BRUNDAt;E LN
BAKERSFFILD GA 9330
661-326-1083
T 2:PREM I Ul,l
AUC 16. 2010 1 :07 PM INVENTORY INCREASE
INCREASE START
---- 1N-TANK ALARM ----- AUG 16, 2010 1 :08 Pfl
SYSTEM STATUS REPORT T I :UNLEADED
- - - - - - - - - - - - LOW TEMP WARNING 7 2:1NVALID FUEL LEVEL
T 2:H1GH PRODUCT' ALARM AUG 16, 2010 1 :09 PM VOLUME = 679 GALS
HEIGHT = 10.16 INCHES
T 2:PROBE OUT WATER - 0.00 INCHES
TEMP - 105.1 DEG F
INCREASE END
AUG 16, 2010 1:11 PM
VOLUME = 1942 GALS
---- IN-TANK ALARM ----- HEIGHT - 21 .00 INCHES
T 3:DIESEL WATER - 0.81 INCHES
HIGH PRODUCT ALARM TEMP = 105.1 DEG F
AUG 16. 2010 1 :10 PM
-- 114-TANK ALARM ----- GROSS INCREASE 1263
INVALID FUEL LEVEL 2: UM TO NET INCREASE- 1223
I
AUG 16. 2010 1 :00 F'M
---- IN-TANY ALARM -----
T 3:DIESEL
PROBE OUT
AUG 16. 2010 1 :10 PM
---- IN-TANK ALARM -----
T 2:PREMIUM -- 1N-TANK ALARM
PRODUCT ALARM T -:DIESEL
AUG lo. 2010 1 :06 Phl INVALID FUEL LEVEL
AUG 16. 2010 1 :11 PM
T I :UNLEADED
INVENTORY INCREASE
INCREASE START
---- IN-TANK ALARM ----- AUG 16. 2010 1 :08 PM
T LIVERYI VOLUME - 5461 GALS ---- 1N-TANK ALARM --
DELIVERY NEEDED 10 1 HEIGHT - 44,61 INCHES T 3:DIESEL
AUG 16. 2010 t :uti PM WATER ¢ 0.00 INCHES DELIVERY NEEDED
TEMP - 104.9 DEG F AUG 16. 2010 1 :11 PM
INCREASE END
AUG 16. 2010 1 :l1 PP1
VOLUME - 11327 GALS
HEIGHT - 85.90 INCHES
---- IN-TANK ALAFb%l ----- WATER - 0.00 INCHES
T I :UNLEADED TEMP - 105.4 DEG F
OVERFILL AUaRM
AUG lb. 2010 1 :08 PM GROSS INCREASE- 5866
TO NET INCREASE= 5676
---- IN-TA14Y. ALARM -----
T I :UNLEADED
PROBE OUT
AUG 16. 2010 1 :09 PM
D AND C 233
2732 BRUNDAGE LN
BAKERSFFILD CA 9330 D AND G 233
661-326-1083 2732 BRUNDAGE LN
BAKERSFFILD CA 9330
AUG 16, 2D10 1 : 11 Phi 661-326-1083
WPLLD LINE LEAK ALARM AUG 16, 2010 1 :31 P1M
W 3:PREIM I UM
SYSTEM STATUS REPORT WPLLD SHUTDOWN ALM
- - - _ _ _ - _ AUG 16. 2010 1:13 PM
T 3:DELIVERY NEEDED SYSTEM STATUS REPORT
T 3:DELIVERY 14EEDED
----- SENSOR ALARM -----
L I :DISP I
DISPENSER PAN
T 3:DIESEL SENSOR OUT ALARM "
INVENTORY INCREASE AUG 16, 2010 1 : 13 PiM
WPLLD LINE LEAK ALARM
INCREASE START W 2:UNLEADED
AUG 16, 2010 1 :09 PM GROSS LINE FAIL
hl
VOLUME . 5275 GALS AUG 16, 2010 2:02 P
HEIGHT - 43.44 INCHES
WATER a 0.84 114CHES
TEMP o 105.4 DEC F
D AND C 233
INCREASE END 2732 BRUNDAGE LN
AUG 16, 2010 1 :12 PM BAKERSFFILD CA 9330
661-326-1083
VOLUME - 11289 GALS WPLLD LINE LEAK ALARM
HEIGHT - 85.51 INCHES AUG 16, 2010 1 :13 PM W 2:UNLEADED
WATER 1 .60 INCHES WPLLD SHUTDOWN ALM
TEMP a 105.4 DEC F AUG 16. 2010 2:02 Ph
SYSTEM STATUS REPORT
GROSS INCREASE- 6014 T 3:DELIVERY NEEDED
TC NET 1NCREASEa 4784
L I :SENSOR OUT ALARM
W I :WPLLD SHUTDOWN ALM
W 2:WPLLD SHUTDOWN ALM D A14D G 233
W 3:WPLLD SHUTDOWN ALM 2732 BRUNDAGE LN
BAKERSFFILD CA 9330
661-326-1083
AUG 16. 2010 2:03 PM
WPLLD LINE LEA}: ALARM
W 1 :D1£SEL
WPLLD SHUTDOWN ALM SYSTEM STATUS REPORT
AUG 16. 2010 m3 PM - - - - - - - - - - - -
T 3:DELIVERY NEEDED
D AND G 233 W 2:GROSS L114E FAIL
2732 BRUNDAGE LN W 2:WPLLD SHUTDOWN ALM
BAKERSFFILD CA 9330
661-326-1083
AUG 16, 2010 I :31 Ph{
WPLLD LINE LEAK ALARM
W 2:UNLEADED
WPLLD SHUTDOWN ALM SYSTEM STATUS REPORT
AUG 16. 2010 1 :13 PM
T 3:DELIVERY NEEDED -
D AND G 233
D AND G 233 2732 BRUNDAGE LN
2732 BRUNDAGE LN BAKERSFFILD CA 9330
BAKERSFFILD CA 9330 661-326-1083
661-326-1083
AUG 16, 2010 2:14 PM
AUG 16, 201 2:05 PM
SYSTEM STATUS REPORT
SYSTEM STATUS REPORT - - - - - - - - - - - -
- - - - - - - - - - - - T 3:DELIVERY NEEDED
T 3:DELIVERY NEEDED
W 3:GROSS LINE FAIL
W 2:GROSS LINE FAIL
W 3:WPLLD SHUTDOWN ALM
W 2:WPLLD SHUTDOWN ALM
D AND G 233
WPLLD LIME LEAK ALARM 2732 BRUNDAGE LN
W 3:PREMIUM BAKERSFFILD CA 9330
GROSS LINE FAIL 661-326-1083
AUG 16. 2010 2:13 PM
AUG 16. 2010 2:22 PM
SYSTEM STATUS REPORT
-
T 3:DELIVERY NEEDED
WPLLD LINE LEAK ALARM
W 3:PREMIUM
WPLLD SHUTDOWN ALM
AUG 16, 2010 2: 13 PM
WPLLD LINE LEAK ALARM
W I :DIESEL
GROSS LINE FAIL
AUG 16, 2010 2:26 PM
D AND C 233
2732 BRUNDAGE LN
BAKERSFFILD CA 9330
661-326-1083
AUG 16. 2010 2:14 PM
SYSTEM STATUS REPORT WPLLD LINE LEAK ALARM
- - - - - _ - - - - - - W [ :DIESEL
T 3:DELIVERY NEEDED WPLLD SHUTDOWN ALM
AUG 16. 2010 2:26 PM
W 3:GROSS LINE FAIL
W 3:WPLLD SHUTDOWN ALM
D A14D G 233
2732 BRU14DAGE LN
BAKERSFFILD CA 9330
661-326-1083
AUG 16. 2010 2:30 PM
SYSTEM STATUS REPORT .
-
T 3:DELIVERY NEEDED
SWRCB,January 2006
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 (f applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: #233 D and G I Date of Testing: 8/16/2010
Facility Address: 2732 Brundage Lane , Bakersfield,CA 93304
Facility Contact: Omero Garcia I Phone: 661-393-7000
Date Local Agency Was Notified of Testing : 7/23/10
Name of Local Agency Inspector(f present during testing): Erina Medina
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Bryan A Self
Credentials: X CSLB Contractor X ICC Service Tech. ❑ SWRCB Tank Tester ❑Other(Spec)
License Number(s): CSLB#804904 ICC 98022804-UT
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: x Hydrostatic ❑Vacuum ❑Other
Test Equipment Used: Lake Test Equipment Resolution: 0.0625"
Identify Spill Bucket(By Tank 1 Regular 2 Diesel 3 Super 4
Number, Stored Product, etc.
Bucket Installation Type: ❑Direct Bury ❑Direct Bury ❑ Direct Bury ❑ Direct Bury
x Contained in Sump x Contained in Sump x Contained in Sump ❑Contained in Sum
Bucket Diameter: 12.00" 12.00" 12.00"
Bucket Depth: 13.50" 14.25" 14.25"
Wait time between applying 5 min. 5 min. 5 min.
vacuum/water and start of test:
Test Start Time(Ti): 1:00pm 1:00pm 1:00pm
Initial Reading(Rj): 11.00" 11.50" 11.001,
Test End Time(TF): 2:00pm 2:00pm 2:00pm
Final Reading(RF): 11.00" 11.50" 11.00"
Test Duration(TF—T,): 1 hour I hour 1 hour
Change in Reading(RF-Ri): 0.00" 0.00" 0.00"
Pass/Fail Threshold or 0.0625" 0.0625" 0.0625"
Criteria:
Test Result: X Pass ❑Fail X Pass ❑Fail X Pass ❑Fail ❑ Pass ❑Fail
Comments— (include information on repairs made prior to testing, and recommended follow-up for failed tests)
The repaular SB was pasing- but would not allow aas to drain back into tank and
Needs to be replaced.
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:'&AA Date: 8/16/2010
State laws and regulations do not c require testing to be performed by a qualified contractor. However,local requirements
may be more stringent.