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HomeMy WebLinkAbout#781 FMC Results 10-19-10 33 MONITORING SYSTEM CERTIFICATION IE 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 Facility Name: #781 Fastrip#22 (South) Bldg.No.: Site Address: 4013 South "H" Street 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/Sery icing: 10/19/2010 B. Inventory of Equipment Tested/Certified Check the appropelate boxes to to Cate specific equipment inspectedlw""d: Tank ID: 12000 gal.Regular 1 Tank ID: 12000 gal.Regular 2 U In-Tank Gauging Probe. Model:847390-107 U In-Tank Gauging Probe. Model:847390-107 [x] Annular Space or Vault Probe. Model:794390-420 [x] Annular Space or Vault Sensor. Model:794390-420 [x] Piping Sump/Trench Sensor(s). Model 794380-208 U Piping Sump/Trench Sensor(s). Model: 794380-208 ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s). Model: Lx] Mechanical Line Leak Detector. Model:FX1V ❑ Mechanical Line Leak Detector. Model: N/A ❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: 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: 12000 gal.Diesel [x] In-Tank Gauging Probe. Model:847390-107 [x] In-Tank Gauging Probe. Model:847390-107 [x] Annular Space or Vault Sensor. Model:794390.420 [x] Annular Space or Vault Sensor. Model:794390-420 LX] Piping Sump/Trench Sensor(s). Model:794380-208 U Piping Sump/Trench Sensor(s). Model: 794380-208 ❑ Fill Sump Sensors(s). Model: ❑ Fill Sump Sensor(s). Model: n Mechanical Line Leak Decector. Model:FX1V [x] Mechanical Line Leak Detector. Model: FX1DV ❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: U 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: 1 812 Dispenser ID: 3 814 [x7 Dispenser Containment Sensor(s). Model: 794380-208 U Dispenser Containment Sensor(s). Model: 794380-208 Ex Shear Valve(s). U Shear Valve(s). ❑ Dispenser Containment Float(s)and Chain(s). ❑ Dispenser Containment Float(s)and Chain(s) Dispenser ID: 5&6 Dispenser ID: 7 818 [x] 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 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'guidlines.Attached to this Certification is information(e.g.manufacturers'checklist)necessary to verify that this information is correct and a plot plan showing the layout of monitoring equipment.For equipment capable of generating such reports,l have attached a copy of the report; (check all that apply) Q Sy Se up C]Alarm history report Technician Name(print): Douglas M.Young III Signature: Certification No: A32766 License No:804904 Testing Company Name: Confidence UST Services,Inc. Phone No: 800-339-9930 Site Address: 4013 South"H"Street,Bakersfield,CA 93304 IIIIII�IIIIII III IIII 34 Date of Testing/Servicing: 10119/2010 IE D. Results of Testing/Servicing Software Version Installed: 326.01 Complete the following checklist: Lx] Yes ❑ No* Is the audible alarm operational? x Yes No* Is t e Visual alarm operational? • 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 I 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? E Sump/Trench Sensors[x]Dispenser Containment Sensors Did you confirm positive shut-down due to leaks and sensor failure/disconnected? L] Yes; ❑ No; [X] 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? L90 % xL] 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? ❑ Product; ❑ Water. If yes,describe causes in Section E,below. MNo* Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports, if applicable. eS I Ej 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: Replaced the Veeder-Root 420 sensor in the Diesel Annular,original is stuck in riser. Replaced the Regular#1 Red Jacket FX IV Leak Detector as the original one would not recognize a 3 gph leak when tested. 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: [x] 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? x Yes No* Was accuracy of system product level readings tested? x Yes No* Was accuracy of system water level readings tested? x Yes No* Were all probes reinstalled properly? IE 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. G. Line Leak Detectors (LLD): ❑Check this box if LLD's are not installed. Complete the following checklist: [j 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: E3 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 machamca LLD's, does the LLD restrict product flow if it detects a leak? N/A ❑ Yes No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a leak? ❑ N/A ❑ Yes El No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system is [x N/A disabled or disconnected? ❑ Yes Lj 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 D No* For electronic LLD's,have all accessible wiring connections been visually inspected? U 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: The above LLD results reflect the replacement LLD which was installed in the Regular 91 product line. SYSTEM SETUP OCT 19, 2010 11 : 11 AM FASTRIP 781 4013 S.H ST SYSTEM UNITS ISD DAILY REPORT BAKERSFIELD CA,93304 U.S. SYSTEM LANGUAGE FASTRIP 781 OCT 19, 2010 11 : 11 AM ENGLISH 4013 S.H ST SYSTEM DATE/TIME FORMAT BAKERSFIELD CA,93304 MON DD YYYY HH:Mrl:SS Al FASTRIP 781 SYSTEM STATUS REPORT 4013 S.H ST OCT 19, 2010 11 :11 AM - - - - - - - - - - - - BAKERSFIELD CA,93304 ALL FUNCTIONS NORMAL EVR TYPE: VACUUM ASSIST INVENTORY REPORT SHIFT TIME 1 ' : DISABLED ISD VERSION 01 .02 SHIFT TIME 2 DISABLED REPORT DATE: OCT 19 T I :UNL 1 SHIFT TIME 3 DISABLED ISD VERSION 01 .02 VOLUME = 7707 GALS SHIFT TIME 4 DISABLED ULLAGE = 4355 GALS TANK PER TST NEEDED WRN OVERALL STATUS PASS 90% ULLAGE= 3148 GALS DISABLED EVR CONTAINMENT PASS TC VOLUME - 7645 GALS TANK ANN TST NEEDED WRN EVR COLLECTION PASS HEIGHT = 68.02 INCHES DISABLED STAGEI I of 1 PASS WATER VOL = 0 GALS SELF TEST PASS WATER = 0.00 INCHES LINE RE-ENABLE METHOD ISD MONITOR UP-TIME 100% TEMP = 71 .6 DEG F PASS LINE TEST ---------------- LINE PER TST NEEDED WRN CONTAINMENT TESTS T 2:UNL 2 DISABLED VOLUME = 7746 GALS LINE ANN TST NEEDED WRN GROSS 95% -0.5 "WC ULLAGE = 4316 GALS DISABLED DGRD 75%s -1 .9 "WC 90 ULLAGE= 3109 GALS VAPOR LEAK 2 CFH TC VOLUME = 7684 GALS PRINT Ti. VOLUMES MAX 0.4 "WC HEIGHT = 68.31 INCHES ENABLED MIN -5.0 "WC WATER VOL = 0 GALS WATER 0.00 INCHES TEMP COMPENSATION ---------------- 71 .5 DEG F ---------------- VALUE (DEG F ) : 60.0 COLLECTION TESTS STICK HEIGHT OFFSET GROSS DGRD T 3:PNL DISABLED A/L(#) A,/L(#) VOLUME = 4578 GALS ULLAGE: 50 ULLAGE = 7484 GALS H-PROTOCOL DATA FORMAT FP 1 : BLENDS 90% ULLAGE= 6277 GALS HEIGHT 0.95( 84) 0.95(527) TC VOLUME = 4504 GALS DAYLIGHT SAVING TIME FP 2: BLENDS HEIGHT = 45. 14 INCHES ENABLED 0.87( 33) 0.87(176) WATER VOL = 0 GALS FP 3: BLEND3 WATER = 0.00 INCHES START DATE 1 .03( 82) 1 .01 (521) TEMP = 82.8 DEG F MAR WEEK 2 SUN FP 4: BLEND'S START TIME 0.97( 32) 1 .04(218) 2:00 AM FP 5: BLEND3 T 4:DIESEL NOV D DATE WEEK 1 SUN FP 64) 0.98(532) VOLUME = 1838 GALS END TIME FP 6: BLEND'S , ULLAGE = 10224 GALS 2:00 AM 1 .01( 24) 1 .02( 166) 90% ULLAGE= 9017 GALS FP 7: BLEND3 TC VOLUME = 1818 GALS RE-DIRECT LOCAL PRINTOUT 0.93( 50) 0.94(266) HEIGHT 23.38 INCHES DISABLED FP 8: BLEND3 WATER VOL = 0 GALS 0.82( 36) 0.99(225) WATER 0.00 INCHES EURO PROTOCOL PREFIX TEMP = 82.9 DEG F ---------------- SELF TEST A X x x *'END * A x x SETUP TEST PASS SENSOR OUT TEST PASS COMMUNICATIONS SETUP IN—TANK SETUP — — — — — — — — — — — SYSTEM SECURITY _ _ _ _ _ _ _ _ _ _ _ _ CODE : 000000 PORT SETTINGS: MAINTENANCE HISTORY T 1 :UNL 1 DISABLED PRODUCT CODE 1 COMM BOARD 1 (RS-232) THERMAL COEFF : .000700 BAUD RATE 9600 TANK. DIAMETER 1 1 1 .50 PARITY IJONE TANK CHART SECURITY TANK PROFILE 1 PT STOP BIT 1 STOP DISABLED FULL VOL 12062 DATA LENGTH: 8 DATA RS-232 SECURITY FLOAT SIZE: 4.0 I N. CODE : DISABLED CUSTOM ALARMS COMM BOARD 2 (RS-232) DISABLED WATER WARNING 2.0 BAUD RATE 9600 HIGH WATER LIMIT: 3.0 PARITY NONE SERVICE NOTICE STOP BIT 1 STOP DISABLED MAX OR LABEL VOL: 12062 DATA LENGTH: 8 DATA OVERFILL LIMIT 90i RS-232 SECURITY 10855 CODE : DISABLED ISO 3166 COUNTRY HIGH PRODUCT 95% CODE: 11459 COMM BOARD : 3 (EDIM ) DELIVER`! LIMIT 15% RS-232 SECURITY 1809 CODE : DISABLED MASS/DENSITY LOW PRODUCT 500 DISABLED LEAK ALARM LIMIT: 99 AUTO TRANSMIT SETTINGS: "SUDDEN LOSS LIMIT: 99 TANK TILT 2.00 AUTO LEAK ALARM LIMIT PROBE OFFSET 0.00 DISABLED AUTO HIGH WATER LIMIT DISABLED SIPHON MANIFOLDED TANKS AUTO OVERFILL LIMIT T#: NONE DISABLED LINE MANIFOLDED TANKS AUTO LOW PRODUCT T#: NONE DISABLED AUTO THEFT LIMIT DISABLED LEAK MIN PERIODIC: 1%S AUTO DELIVERY START 120 DISABLED AUTO DELIVERY END LEAK MIN ANNUAL lb DISABLED 120 AUTO EXTERNAL INPUT Oil DISABLED AUTO EXTERNAL INPUT OFF PERIODIC TEST TYPE DISABLED STANDARD AUTO SENSOR FUEL ALARM DISABLED ANNUAL TEST FAIL AUTO SENSOR WATER ALARM ALARM DISABLED DISABLED AUTO SENSOR OUT ALARM PERIODIC TEST FAIL DISABLED ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING^: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF RS-232 END OF MESSAGE DISABLED TNK TST SIPHON BREAK:OFF DELIVERY DELAY 1 MIN PUMP THRESHOLD 10.00% T 4:D I ESEL T 3:P 1VL PRODUCT GODS 4 PRODUCT CODE 3 T 2:UNL 2 THERMAL COEFF : .000450 THERMAL CGEFF : .000700 PRODUCT CODE 2 TANK DIAMETER 111 .50 TANK DIAMETER 111 .50 THERMAL CGEFF : .000700 TANK PROFILE 1 PT TANK PROFILE 1 PT TANK DIAMETER : 111 .50 FULL VOL 12062 FULL VOL 12062 TANK PROFILE 1 PT FULL VOL 12062 FLOAT SIZE: 4.0 IN. FLOAT SIZE: 4.0 IN. WATER WARNING 2.0 WATER WARNING 2.0 FLOAT SIZE: 4.0 IN. HIGH WATER LIMIT: 3.0 HIGH WATER LIMIT: 3.0 WATER WARNING 2.0 MAX OR LABEL VOL: 12062 MAX OR LABEL VOL: 12062 HIGH WATER LIMIT: 3.0 OVERFILL LIMIT 90% OVERFILL LIMIT 90% MAX OR LABEL VOL: 12062 HIGH PRODUCT 10855 10855 OVERFILL LIMIT 90% 95% HIGH PRODUCT 95% 10855 DELIVERY LIMIT 11459 11459 HIGH PRODUCT 95% 10% DELIVERY LIMIT 15% 11459 1206 1809 DELIVERY LIMIT 15% LOW PRODUCT 500 LOW PRODUCT 500 1809 LEAK ALARM LIMIT: 99 LEAK. ALARM LIMIT: 99 LOW PRODUCT 500 SUDDEN LOSS LIMIT: 99 SUDDEN LOSS LIMIT: 99 LEAK. ALARM LIMIT: 99 TANK TILT 0.00 TANK TILT 0.00 SUDDEN LOSS LIMIT: 99 PROBE OFFSET 0.00 PROBE OFFSET 0.00 TANK TILT 2.00 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS SIPHON MANIFOLDED TANKS NONE T#: NONE SIPHON MANIFOLDED TANKS LINE MANIFOLDED TA LINE I°iHN I FOLDED TANKS TO: NONE T#: NONE T#: NONE LINE MANIFOLDED TANKS T#: NONE LEAK. MIN PERIODIC: 1% LEAK MIN PERIODIC: 1% 120 120 LEAK MIN PERIODIC: i% LEAK MIN ANNUAL 1% LEAK MIN ANNUAL : i% 120 120 120 LEAK MIN ANNUAL 1% 120 PERIODIC TEST TYPE PERIODIC TEST TYPE STANDARD STANDARD PERIODIC TEST TYPE ANNUAL TEST FAIL ANNUAL TEST FAIL STANDARD ALARM DISABLED ALARM DISABLED ANNUAL TEST -FAIL DISABLED PERIODIC TEST FAIL PERIODIC TEST FAIL ALARM ALARM DISABLED ALARM DISABLED PERIODIC TEST FAIL GROSS TEST FAIL GROSS TEST FAIL ALARM DISABLED ALARM DISABLED ALARM DISABLED GROSS TEST FAIL ANN TEST AVERAGING: OFF ANN TEST AVERAGING: OFF ALARM DISABLED PER TEST AVERAGING: OFF PER TEST AVERAGING: OFF ANN TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TANK TEST NOTIFY: OFF PER TEST AVERAGING: OFF TNK TST SIPHON BREAK:OFF TNK TST SIPHON BREAK:OFF TANK TEST NOTIFY: OFF DELIVERY DELAY 1 MIN DELIVERY DELAY MIN TNK TST SIPHON BREAK:OFF PUMP THRESHOLD 10.00% PUMP THRESHOLD : 10.00% DELIVERY DELAY 1 MIN PUMP THRESHOLD : 10.00% PUMP SENSOR SETUP LIQUID SENSOR SETUP L 1 :UNL 1 STP S 1 :UNL 1 LEAK TEST METHOD TRI-STATE (SINGLE FLOAT) TANK 1 CATEGORY STP SUMP DISPENSE MODE: CATEGORY OIV DATE ALL TANK STANDARD JAN 16. 2006 L 2:UNL 1 ANN START TIME : DISABLED S 3:PNL TRI-STATE (SINGLE FLOAT) TEST RATE :0.20 GAL/HR TANK tt: 3 CATEGOR`! OTHER SENSORS DURATION 2 HOURS DISPENSE MODE: STANDARD TST EARLY STOP:DISABLED L 3:DIESEL STP LEAK TEST REPORT FORMAT TRI-STATE (SINGLE FLOAT) NORMAL CATEGORY : STP SUMP L 4:DIESEL ANN TRI-STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE SET UP L 5:REG2 STP TRI-STATE (SINGLE FLOAT) CATEGORY STP SUMP L 6:REG 2 ANN TRI-STATE (SINGLE FLOAT) CATEGORY ANNULAR SPACE L 7:SUPER STP TRI-STATE (SINGLE FLOAT) CATEGORY STP SUMP L 8:SUPER ANN TRI-STATE (SINGLE FLOAT) CATEGORY ANNULAR SPACE L 9:DISP 1-2 TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L10:DISP 7-8 TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L1I :DISP 5-6 TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L12:DISP 3-4 TRI-STATE (SINGL•E FLOAT) CATEGORY : DISPENSER PAN R 3:DIESEL OUTPUT RELAY TYPE: — — — — — — — STANDARD EVR/ISD SETUP NORMALLY CLOSED R 1 :UNL 1 TANK : q TYPE: st PUMP CONTROL OUTPUT TANK EVR TYPE: VACUUM ASSIST LIQUID SENSOR ALMS VACUUM ASSIST TYPE L 7:FUEL ALARM LIQUID SENSOR ALMS HEALY VAC L10:FUEL ALARM L 1 :FUEL ALARM NOZZLE AiL RANGE L12:FUEL ALARM L4;FUEL ALARM L 7:SENSOR OUT ALARM L 9:FUEL ALARM MAX: 1 .15 MIN: 0.95 LIO:SENSOR OUT ALARM L10:FUEL ALARM VAPOR PROCESSOR TYPE L12:SENSOR OUT ALARM L11 :FUEL ALARM NONE L 7:SHORT ALARM L12:FUEL ALARM LIO:SHORT ALARM L 1 :SENSOR OUT ALARM L12:SHORT ALARM L 3:SENSOR OUT ALARM ANALYSIS TIMES L 9:SENSOR OUT ALARM R 4:OVERFILL ALARM LIO:SENSOR OUT ALARM TIME: 10:00 AM TYPE: L11 :SENSOR OUT ALARM DELAY MINUTES: 1 STANDARD L12:SENSOR OUT ALARM NORMALLY OPEN L 1 :SHORT ALARM ACCEPT HIGH OR.VR: L 3:SHORT ALARM ENABLED TANK NONE L 9:SHORT ALARM LIO:SHORT ALARM ISD HOSE TABLE LII :SHORT ALARM ID FP FL HL AA RR IN—TANK ALARMS L12:SHORT ALARM ALL:OVERFILL ALARM 01 01 01 02 01 UU ALL:HIGH PRODUCT ALARM ISD SITE ALARMS 02 02 02 02 01 UU ALL:MAX PRODUCT ALARM ISD GROSS PRES FAIL 03 03 03 02 02 UU ISD DEGRD PRES FAIL 04 04 04 02 02 UU 1SD VAPOR LEAK FAIL 05 05 05 02 03 UU ISD VP PRES FAIL 06 06 06 02 03 UU ISD VP STATUS FAIL 07 07 07 02 04 UU ISD HOSE ALARMS 08 08 08 02 04 UU ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL ISD AIRFLOW METER MAP ALL:FLOW COLLECT FAIL ID SERIAL NUM LABEL — --------------- R 2:PNL 1 25188 F.M DISP 1 SMARTSENSOR SETUP— — — TYPE: 2 8456 F.M DISP PUMP CONTROL OUTPUT 3 8280 F.M DISP 5 1 :V.P1SENSOR DISP i-2 TANK 4: 3 4 8449 F.M DISP 7 s CATEGORY VAPOR PRESSURE s 2:F.M DISP 1-2 LIQUID SENSOR ALMS ISD FUEL GRADE HOSE MAP CATEGORY AIR FLOW METER L 5:FUEL ALARM 1 2 3 4 L 9:FUEL ALARM FP MHH MHH MHH MHH AA--- ALARM LIO:FUEL ALARM _ _ _ _ __ ___ s 3:F.M DISP 3-4 O1 201 301-901 U U 1 CATEGORY AIR FLOW METER L12:FUEL ALARM 02 202 302 902 U U 1 L 5:SENSOR OUT ALARM 4:F.M DISP 5-6 L 9:SENSOR OUT ALARM 03 203 303 903 5 U 2 CATEGORY AIR FLOW METER L10:SENSOR OUT ALARM- 04 204 304 904 5 U 2 05 205 305 905 U U 3 LII :SENSOR OUT ALARM 06 206 306 906 U U 3 s 5:F.MDISP 7-8 L12:SENSOR OUT ALARM 07 207 307 907 5 U 4 CATEGORY AIR FLOW METER L 5:SHORT ALARM 08 208 308 908 5 U 4 LIO:SHORT ALARM 09 9 U 2 U 3 U 5 U 0 10 2 U 3 U 9 U 5 U 0 LII :SHORT ALARM 11 2 U 3 U 9 U U U 0 L12:SHORT ALARM 12 2 U 3 U 9 0 0 0 0 ISD SITE ALARMS ISD GROSS PRES FAIL LABEL TABLE ISD DEGRD PRES FAIL ------------------------ ISD VAPOR LEAK FAIL is UNASSIGNED ISD VP PRES FAIL 2: BLEND3 ISD VP STATUS FAIL 3: REGULAR ISD HOSE ALARMS 4: MID GRADE ALL:GROSS COLLECT FAIL 5: PREMIUM ALL:DEGRD COLLECT FAIL 6: GOLD 7: BRONZE ALL:FLOW COLLECT FAIL 8: SILVER 9: BLEND2 10: BLEND4 ALARM HISTORY REPORT ALARM HISTORY REPORT ----- SENSOR ALARM ----- ----- SENSOR ALARM ----- L 6:REG 2 ANN L 3:DIESEL STP ANNULAR SPACE STP SUMP PMC SETUP PMC VERSION: 01 .02 VAPOR PROCESSOR TYPE NONE END END PROCESSOR CONTROL LEVEL: NONE ALARM HISTORY REPORT ALARM HISTORY REPORT ALARM HISTORY REPORT ----- SENSOR ALARM ----- ----- SENSOR ALARM ----- ----- SENSOR ALARM ----- L I :UNL 1 STP L 7:SUPER STP L 4:DIESEL ANN STP SUMP STP SUMP ANNULAR SPACE FUEL ALARM JUN 28, 2010 11 :08 AM i x n * n END x END END ALARM HISTORY REPORT ALARM HISTORY REPORT ----- SENSOR ALARM ----- ----- SENSOR ALARM ----- L 2:UNL I ANN ALARM HISTORY REPORT L 5:REG2 STP OTHER SENSORS STP SUMP - -- SENSOR ALARM ----- FUEL ALARM LB:SUPER ANN AUG 8, 2010 9:47 PM ANNULAR SPACE FUEL ALARM FUEL ALARM AUG 5, 2010 9:56 AM JUN 27, 2010 2:07 PM FUEL ALARM AUG 5, 2010 5:55 AM END END * x n i x END * x * x FASTRIP 781 4013 S.H ST BAKERSFIELD CA.93304 ALARM HISTORY REPORT OCT 19, 2010 11 :41 AM — SENSOR ALARM ----- ALARM HISTORY REPORT IS:DIS 5 DISPENSER PAN ----- SENSOR ALARM ----- D L 9:DISP 1-2 SYSTEM STATUS REPORT DISPENSER PAN ALL FUNCTIONS NORMAL x * * END x * x n x * END . ----- SENSOR ALARM ----- L12:DISP 3-4 DISPENSER PAN FUEL ALARM — OCT 19, 2010 11 :43 AM ALARM HISTORY REPORT ----- SENSOR ALARM ----- ALARM HISTORY REPORT L12:DISP 3-4 DISPENSER PAN ----- SENSOR ALARM ----- LIO:DISP 7-8 ----- SENSOR ALARM ----- DISPENSER PAN LIO:DISP 7-8 DISPENSER PAN FUEL ALARM OCT 19, 2010 11 :44 AM END € END x x ----- SENSOR ALARM ----- LI1 :DISP 5-6 DISPENSER PAN FUEL ALARM OCT 19, 2010 11 :45 AM ALARM HISTORY REPORT ----- SENSOR ALARM ----- L11 :DISP 5-6 DISPENSER PAN ----- SENSOR ALARM ----- L 2:UNL I ANN OTHER SENSORS FUEL ALARM OCT 19, 2010 11 :46 AM END c ----- SE14SOR ALARM ----- L 4:DIESEL ANN ANNULAR SPACE FASTRIP 781 FUEL ALARM 4013 S.H ST OCT 19. 2010 11 :59 All FASTRIP 781 BAKERSFIELD CA,93304 4013 S.H ST BAKERSFIELD CA.93304 OCT 19, 2010 12:07 PM OCT 19, 2010 11 :47 AM SYSTEM STATUS REPORT - - - - - - _ - - - - - SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL ----- SENSOR ALARM ----- - - - - - - L 4:DIESEL ANN ALL FUNCTIONS NORMAL ANNULAR SPACE SENSOR OUT ALARM OCT 19, 2010 12:00 PM ----- SENSOR ALARM ----- L 4:DIESEL ANN ----- SENSOR ALARM ----- ANNULAR SPACE L 6:REG 2 AIVfV FUEL ALARM ANNULAR SPACE OCT 19, 2010 12: 15 PM ----- SENSOR ALARM ----- FUEL ALARM L 4:DIESEL ANN OCT 19, 2010 11 :47 AM ANNULAR SPACE FUEL ALARM OCT 19, 2010 12:02 PM FASTRIP 781 4013 S.H ST SENSOR ALARM ----- BAKERSFIELD CA.93304 L B:SUPER ANN ANNULAR SPACE ----- SENSOR ALARM ----- FUEL ALARM OCT 19, 2010 12:54 F'M L 4:DIESEL ANN OCT 19, 2010 11 :48 AM ANNULAR SPACE SENSOR OUT ALARM OCT 19, 2010 12:02 PM SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL ----- SENSOR ALARM ----- L 4:DIESEL ANN ANNULAR SPACE -- SENSOR ALARM ----- FUEL ALARM L 4:DIESEL ANN OCT 19, 2010 11 :53 AM ANNULAR SPACE ---- IN-TANK ALARM ----- FUEL ALARM T 1 :UNL 1 OCT 19, 2010 12:04 PM HIGH PRODUCT ALARM OCT 19, 2010 12:54 P11 --_-- SENSOR ALARM ----- L 4:DIESEL ANN ANNULAR SPACE -- SENSOR ALARM ----- - SENSOR OUT ALARM L 4:DIESEL ANN OCT 19, 2010 11 :58 AM ---- IN-TANK ALARM ----- ANNULAR SPACE T 2:UNL 2 FUEL ALARM HIGH PRODUCT ALARM OCT 19, 2010 12:06 PM OCT 19, 2010 12:55 .PM i 1 ----- SENSOR ALARM ----- ---- IN-TANK ALARM ----- L 7:SUPER STP T 3:PNL STP SUMP ----- SENSOR ALARM ----- HIGH PRODUCT ALARM FUEL ALARM L 1 :UNL I STP OCT 19, 2010 12:55 PM OCT 19, 2010 11 :35 AM STP SUMP FUEL ALARM OCT 19, 2010 11 :25 AM ---- IN-TANK ALARM ----- -- SENSOR ALARM ----- T 4:DIESEL L 3:DIESEL STP HIGH PRODUCT ALARM STP SUMP FASTRIP 781 OCT 19, 2010 12:56 PtM FUEL ALARM 4013 S.H ST OCT 19, 2010 11 :36 AM BAKERSFIELD CA.93304 OCT 19. 2010 11 :31 AM SYSTEM STATUS REPORT - FASTRIP 781 ALL FUNCTIONS NORMAL 4013 S.H ST FASTRIP 781 BAKERSFIELD CA.93304 4013 S.H ST BAKERSFIELD CA.93304 OCT 19, 2010 12:56 PI°1 OCT 19. 2010 11 :37 AM SYSTEM STATUS REPORT SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL ----- SENSOR ALARM ----- ALL FUNCTIONS NORMAL L 7:SUPER STP ALL STP SUMP FUEL ALARM OCT 19, 2010 11 :32 AM ----- SENSOR ALARM L 4:DIESEL ANN ----- SENSOR ALARM ----- ANNULAR SPACE L 3:DIESEL STP SENSOR OUT ALARM STP SUMP OCT 19. 2010 1 :03 P11 FUEL ALARM OCT 19, 2010 11 :38 AM 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(if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: #781 Fastrip#22 (South) I Date of Testing: 10/19/2010 Facility Address: 4013 South H Street,Bakersfield,CA 93304 Facility Contact: Omero Garcia Phone: 661-393-7000 Date Local Agency Was Notified of Testing : 1015110 Name of Local Agency Inspector(if present during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: Confidence UST Services, Inc. Technician Conducting Test: Douglas M.Young III Credentials: ❑x CSLB Contractor Nx ICC Service Tech. 0 SWRCB Tank Tester ❑Other(Spec) License Number(s): CSLB#804904 ICC#878646-UT Tank Tester# 901076 3. SPILL BUCKET TESTING INFORMATION Test Method Used: Nx Hydrostatic ❑Vacuum ❑Other Test Equipment Used: Lake Test Equipment Resolution: 0.0625" Identify Spill Bucket(By Tank 1 Regular 1 2 Regular 2 3 Super 4 Diesel Number, Stored Product, etc.) Bucket Installation Type: ❑Direct Bury ❑Direct Bury ❑Direct Bury ❑Direct Bury Nx Contained in Sump Nx Contained in Sump ZContained in Sump Nx Contained in Sum Bucket Diameter: 12.00" 12.00" 12.00" 12.00" Bucket Depth: 14.00" 13.75" 14.00" 14.50" Wait time between applying 5 min. 5 min. 5 min. 5 min. vacuum/water and start of test: Test Start Time(T[): 11:30am 11:30am 11:30am 11:30am Initial Reading(R,): 7.75" 7.50" 7.75" 7.25" Test End Time(TF): 12:30pm 12:30pm 12:30pm 12:30pm Final Reading(RF): 7.75" 7.50" 7.75" 7.25" Test Duration(TF—Ti): 1 hour 1 hour 1 hour I hour Change in Reading(RF-Rj): 0.00" 0.00" 0.00" 0.00" Pass/Fail Threshold or 0.0625" 0.0625" 0.0625" 0.0625" Criteria: Test Result . _ Pass O Fail � ® Pass l]hFil aw; O Pass Fail 'x © Pass ,j Oil Comments— (include information on repairs made prior to testing, and recommended follow-up for failed tests) 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: Date: 10/19/2010 State laws and regulations do n t current y require testing to be performed by a qualified contractor.However,local requirements may be more stringent. 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 Facility Name: #721 Fastrip#22 (North) Bldg.No.: Site Address: 4013 South "H" Street City: Bakersfield zip: 93304 Facility Contact Person: Orrmero Garcia Contact Phone No.: 661-393-7000 Make/Model of Monitoring System: Veeder-Root TLS 350 Date of Testing/Servicing: 10/19/2010 B. Inventory of Equipment Tested/Certified Check the App"priAte boxes to in[kate specific equipment Inspected/serviced: Tank ID: 12000 gal. Regular Tank iD: 12000 gal.Super [x] In-Tank Gauging Probe. Model:847390-107 Lx] In-Tank Gauging Probe. Model:847390-107 Lx] Annular Space or Vault Probe. Model:794390-420 [x]. Annular Space or Vault Sensor. Model: 794390-420 Lx] Piping Sump/Trench Sensor(s). Model:794380-208 Lx] Piping Sump/Trench Sensor(s). Model: 794380-208 ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s). Model: [x] Mechanical Line Leak Detector. Model:FX1V [x] Mechanical Line Leak Detector. Model: FX1V ❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: U Tank Overfill/High Level Sensor. Model:847390-107 Lx] 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.Diesel Tank ID: [x] In-Tank Gauging Probe. Mode 1:847390-107 ❑ In-Tank Gauging Probe. Model: L] Annular Space or Vault Sensor. Mode1:794390-420 ❑ Annular Space or Vault Sensor. Model: U Piping Sump/Trench Sensor(s). Model:794380-208 ❑ Piping Sump/Trench Sensor(s). Model: ❑ Fill Sump Sensors(s). Model: ❑ Fill Sump Sensor(s). Model: [x1 Mechanical Line Leak Decector. Model:FX1DV ❑ Mechanical Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: Lx] Tank Overfill/High Level Sensor. Model:847390-107 ❑ Tank Overfill/High Level Sensor.Model: ❑ 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: 9 &10 Dispenser iD: 11 &12 F] Dispenser Containment Sensor(s). Model: 794380-208 [!] Dispenser Containment Sensor(s). Model: 794380-208 [X] Shear Valve(s). [x] Shear Valve(s). ❑ Dispenser Containment Float(s)and Chain(s). ❑ Dispenser Containment Float(s)and Chain(s) Dispenser ID: 13&14 Dispenser iD: 15&16 Lx] Dispenser Containment Sensor(s). Model: 794380-208 [x] Dispenser Containment Sensor(s). Model: 794380-208 [!] Shear Valve(s). Shear Valve(s). ❑ Dispenser Containment Float(s)and Chains(s). ❑ Dispenser Containment Float(s)and Chain(s). Dispenser ID: 17&18 Dispenser iD: 19&20 Lx] Dispenser Containment Sensor(s). Model: 794380-208 [x] Dispenser Containment Sensor(s). Model: 794380-208 U Shear Valve(s). U 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'guidlines.Attached to this Certification is information(e.g.manufacturers'checklist)necessary to verify 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 Sy t-up rx]Alarm history report Technician Name(print): Douglas M.Young III Signature: Certification No: A32755 License No:804904 Testing Company Name: Confidence UST Services,Inc. Phone No: 800-339-9930 Site Address: 4013 South"H"Street,Bakersfield,CA 93304 Date of Testing/Servicing: 10/1912010 D. Results of Testing/Servicing Software Version Installed: 327.04 Complete the following checklist: L] Yes ❑ No* Is the audible alarm operational? x Yes No* Is the Visual alarm operational? x Yes No* Were all sensors visually inspected,functionally tested,and confirmed operational? x I 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? Lj Yes No* If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem) Hx N/A operational? x I 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? E Sump/Trench Sensors Lx]Dispenser Containment Sensors Did you confirm positive shut-down due to leaks and sensor failure/disconnected? [X] Yes; ❑ No; U Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.no L]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? F 90 % ❑ Yes* ❑ No Was any monitoring equipment replaced?If Yes, i enti specs is sensors,probes,or of er 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? ❑ Product; ❑ Water. If yes,describe causes in Section E,below. x No* Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports, if applicable. x Yes No* 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: The Regular U/L Red Jacket LLD was replaced due to a failure of the original LLD. F. In-Tank Guaging/SIR Equipment: U 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: L] Yes ❑ No*I Has all input wiring been inspected for proper enter and termination,including testing for ground faults? _1x1 Yes D 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 No* Was accuracy of system water level readings tested? x Yes No* Were all probes reinstalled properly? L] Yes I ❑ 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. G. Line Leak Detectors (LLD): ❑ Check this box if LLD's are not installed. Complete the followin checklist: L] 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: L]3 g.p.h.: ❑0.1 g.p.h.; ❑0.2 g.p.h.; x Yes 71 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? N/A ❑ Yes No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a leak? L] N/A ❑ Yes No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system is [x] N/A disabled or disconnected? ❑ Yes No* For electronic LLD's,does the turbine automatically shut off if any portion of the monitoring system L] N/A malfunction or fails a test? ❑ Yes No* For electronic LLD's,have all accessible wiring connections been visually inspected? L] 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: Replaced the Regular U/L Red Jacket Leak Detector as the original LLD would not recognize a 3 gph leak when tested. C_Ot'IIMUI'JI CAT IONS SETUP - SYSTEM SETUP - OCT 19, 2010 9:00 AM PORT SETTINGS: FASTRIP 721 COMM BOARD : I (ED I M > StiISTEi°M UtV UNITS 4013 SO. H ST. RS-232 SECURITY BAKERSFIELD.CA 93304 CODE : DISABLED U•S• 661-832-61224 SYSTEM LANGUAGE COMM BOARD 2 (RS-232) ENGLISH OCT 19, 2010 8:59 AM BAUD RATE : 9600 SYSTEM DATE.%TIME FORMAT PARITY NONE MON DD YYYY HH:MM:SS Al STOP BIT I STOP FASTRIP 721 uc c DATA LENGTH: 8 DATA SYSTEM STATUS REPORT RS-232 SECURITY 4013 SO. H ST. - - CODE : DISABLED BAKERSFIELD.CA 93304 ALL FUNCTIONS NORMAL 661-832-6124 COMM BOARD 3 (RS-232) INVENTORY REPORT BAUD RATE 9600 SHIFT TIME 1 6:00 HM PARITY NONE SHIFT TIME 2 DISABLED STOP BIT 1 STOP SHIFT TIME 3 DISABLED T 1 :UNL DATA LENGTH: 8 DATA SHIFT TIME 4 DISABLED VOLUME = 4428 GALS RS-232 SECURIT`! ULLAGE4 = 7572 GALS CODE DISABLED TANK PER TST NEEDED WRN 90% ULLAGE= 6372 GALS DISABLED TC VOLUME = 4370 GALS TANK ANN TST NEEDED WRN HEIGHT = 38.05 INCHES AUTO TRANSMIT SETTINGS: DISABLED WATER VOL = 0 GALS WATER = 0.00 INCHES ~AUO LEAK: ALARM LIMIT LINE kE-EIVtiPASS LINE TEST METHOD TEMP = 76.4 DEG F DISABLED AUTO HIGH WATER LIMIT LINE PER TST NEEDED WRN DISABLED DISABLED T 2:PNL - F AUTO OVERFILL LIMIT VOLUME 592J 6 GALS DISABLED LINE ANN TST NEEDED WRN ULLAGE = 6074 GALS AUTO LOW PRODUCT DISABLED 90% ULLAGE= 4874 GALS DISABLED PRINT TC VOLUMES TC VOLUME = 5850 GALS AUTO THEFT LIMIT ENABLED HEIGHT = 47.53 INCHES DISABLED WATER VOL = 0 GALS AUTO DELIVERY START WATER = 0.00 INCHES DISABLED TEMP COMPENSATION TEMP = 78.2 DEG F AUTO DELIVERY END VALUE (DEG F ) : 60.0 DISABLED STICK HEIGHT OFFSET AUTO EXTERNAL INPUT ON DISABLED T 3:DSL DISABLED ULLAGE: 90% VOLUME = 4701 GALS AUTO EXTERNAL INPUT OFF ULLAGE = 7299 GALS DISABLED H-PROTOCOL DATA FORMAT 90% ULLAGE= 6099 GALS AUTO SENSOR FUEL ALARM HEIGHT TC VOLUME = 4655 GALS DISABLED DAYLIGHT SAVING TIME HEIGHT = 39.80 INCHES AUTO SENSOR WATER ALARM DISABLED WATER VOL = 0 GALS DISABLED RE-DIRECT LOCAL PRINTOUT WATER = 0.00 INCHES AUTO SENSOR OUT ALARM DISABLED TEMP = 81 .7 DEG F DISABLED EURO PROTOCOL PREFIX S x x h x n END x A SYSTEM SECURITY CODE : 000000 RS-232 END OF MESSAGE MAINTENANi.E HISTORY DISABLED DISABLED TANK: CHART SECURITY DISABLED CUSTOM ALARMS DISABLED SERVICE NOTICE DISABLED ISO 3166 COUNTRY CODE: MASS;DENS 17/ DISABLED T 2:PNL IN—TANK SETUP PRODUCT CODE 2 — — — — — — — — — — — — THERMAL COEFF : .000700 TANK DIAMETER 96.00 T I :UNL T 3:DSL TANK PROFILE 1 PT PRODUCT CODE 1 PRODUCT CODE 3 FULL VOL 12000 THERMAL COEFF : .000700 THERMAL COEFF : .000450 TANK DIAMETER 96.00 TANK DIAMETER 96.00 TANK PROFILE I PT TANK PROFILE I PT FLOAT SIZE: 4.0 IN. FULL VOL 12000 FULL VOL 12000 WATER WARNING 2.0 FLOAT SIZE: 4.0 IN. HIGH WATER LIMIT: 3.0 FLOAT SIZE: 4.0 IN. MAX OR LABEL VOL: 12000 WATER WARNING 2.0 WATER WARNING 2.0 OVERFILL LIMIT 901 HIGH WATER LIMIT: 3.0 HIGH WATER LIMIT: 3.0 10800 HIGH PRODUCT 95% MAX OR LABEL VOL: 12000 MAX OR LABEL VOL: 12000 11400 OVERFILL LIMIT 90%, OVERFILL LIMIT 90%o DELIVERY LIMIT 15% 10800 10800 1800 HIGH PRODUCT 95% HIGH PRODUi;T 95". 11400 11400 LOW PRODUCT 1200 DELIVERY LIMIT 15% DELIVERY LIMIT 15 LEAK ALARM LIMIT: 99 1800 1800 SUDDEN LOSS LIMIT: 99 TANK TILT 0.00 LOW PRODUCT : 1200 LOW PRODUCT : 1200 PROBE OFFSET' 0.00 LEAK ALARM LIMIT: 99 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT 0.00 TANK TILT 0.00 SIPHON MANIFOLDED TANKS PROBE OFFSET 0,00 PROBE OFFSET 0.00 TO: NONE LINE MANIFOLDED TANKS TO: NONE SIPHON MANIFOLDED TANKS SIPHON HAN I FOLDED TANKS TO: NONE TO: NONE LINE MANIFOLDED TANKS LINE MANIFOLDED TANKS LEAK MIN PERIODIC: 110 T#: NONE TO: NONE 120 LEAK MIN ANNUAL 1% LEAK MIN PERIODIC: 1 LEAK MIN PERIODIC: 1% 120 120 120 LEAK MIN ANNUAL 1% PERIODIC TEST TYPE LEAk: t°I I N ANNUAL 1 120 120 STANDARD ANNUAL TEST FAIL PERIODIC TEST TYPE PERIODIC TEST TYPE ALARM DISABLED STANDARD STANDARD PERIODIC TEST FAIL ANNUAL TEST FAIL ANNUAL TEST FAIL ALARM DISABLED ALARM DISABLED ALARM DISABLED GROSS TEST FAIL PERIODIC: TEST FAIL PERIODIC TEST FAIL ALARM DISABLED ALARM DISABLED ALARM DISABLED ANN TEST AVERAGING: OFF GROSS TEST FAIL GROSS TEST FAIL PER TEST AVERAGING: OFF ALARM DISABLED ALARM DISABLED TANK TEST NOTIFY: OFF ANN TEST AVERAGING: OFF ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF PER TEST AVERAGING: OFF TNK TST SIPHON BREAK:OFF TEST NOTIFY: OFF TANK. TEST tVOT I FY: OFF DELIVERY DELAY 1 N1 IN TANK. PUMP THRESHOLD 10.00% TNK TST SIPHON BREAK:OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY 1 MIN DELIVERY DELAY i MIN PUMP THRESHOLD : 10.00° PUMP THRESHOLD 10.00% PUMP SENSOR SETUP— — — — LIGUID SENSOR SETUP S 1 :UNL L 1 :UNL STP LEAK TENT METHOD TANK 1 TRI—STATE 4SINGLE FLOAT) — — — — DISPENSE MODE: TEST ON DATE : ALL TANK STANDARD CATEGORY STP SUMP TEST 29, 2009 START TIME : DISABLED S 2:PNL TEST kATE :0.20 GAL/HR TANK #:' 2 L 2:UNL ANN DURATION '? HOURS DISPENSE MODE: NORMALLY CLOSED STANDARD CATEGORY : ANNULAR SPACE TST EARL`: STOP:DISABLED LEAK TEST REPORT FORMAT L 3:PNL STP NORMAL TRI—STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 4:PNL ANN TRI—STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 5:DSL STP TRI—STATE (SIIV(;LE FLOAT) CATEGORY : STP SUMP L 6:DSL ANN TRI—STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 9:DISP I TRI—STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L10:DISP 2 TRI—STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L11 :DISP 3 TRI—STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L12:DISP 4 TRI—STATE (SINGLE FLOAT) CATEGORY DISPENSER PAN L13:DISP 5 TRI—STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L14:DISP 6 NORMALLY CLOSED CATEGORY : DISPENSER PAN a R 3:DSL ^^—w TYPE: STANDARD OUTPUT RELAY SETUP 1ORMALLY CLOSED - - - - - - - - - - - - TANY it: NONE R I :UNL TYPE: EVR,r'ISD SETUP PUMP CONTROL OUTPUT L I GU I D SENSOR ALMS TANK t1: 1 L I :FUEL ALARM L 5:FUEL ALARM EVR TYPE: VACUUM ASSIST L `:FUEL ALARM LIQUID SENSOR ALMS VACUUM ASSIST TYPE L10:FUEL ALARM L 1 -FUEL ALARM HEALY VAC LII :FUEL ALARM L 9:FUEL ALARM L12:FUEL ALARM L10:FUEL ALARM NOZZLE A/L RANGE L13:FUEL ALARM LII :FUEL ALARM MAX: 1 . 15 MIN: 0.95 L14:FUEL ALARM L12:FUEL ALARM L 5:SENSOR OUT ALARM L13:FUEL ALARM VAPOR PROCESSOR TYPE L 9:SENSOR OUT ALARM L14:FUEL ALARM NONE L10:SENSOR OUT ALARM L 1 :SENSOR OUT ALARM L11 :SENSOR OUT ALARM L 9:SENSOR OUT ALARM L12:SENSOR OUT ALARM L10:SENSOR OUT ALARM ANALYSIS TIMES L13:SENSOR OUT ALARM LII :SENSOR OUT ALARM TIME: 10:00 AM L14:SENSOR OUT ALARM L12:SENSOR OUT ALARM DELAY MINUTES: 1 L 5:SHORT ALARM L13:SENSOR OUT ALARM L 9:SHORT ALARM L14:SENSOR OUT ALARM L10:SHORT ALARM L 1 :SHORT ALARM ACCEPT HIGH ORVR: LII :SHORT ALARM L 9:SHORT ALARM DISABLED L12:SHORT ALARM LIO:SHORT ALARM L13:SHORT ALARM LII :SHORT ALARM ISD HOSE TABLE L14:SHORT ALARM L12:SHORT ALARM ID FP FL HL AA RR L13:SHORT ALARM ` - -- -- - R 4: L14:SHORT ALARM 01 2509 02 01 UU TYPE: 02 26 10 02 01 UU STANDARD ISD SITE ALARMS 03 27 11 02 02 UU NORMALLY OPEN ISD GROSS PRES FAIL 04 28 12 02 02 UU ISD DEGRD PRES FAIL 05 01 13 02 03 UU TANK NONE ISD VAPOR LEAK FAIL 06 02 14 02 03 UU ISD VP PRES FAIL 07 03 15 02 04 UU - NO ALARM ASSIGNMENTS - ISD VP STATUS FAIL 08 04 16 02 04 UU 09 05 17 02 05 UU ISD HOSE ALARMS 10 06 18 . 02 05 UU ALL:GROSS COLLECT FAIL 11 07 19 02 06 UU ALL:DEGRD COLLECT FAIL 12 08 20 02 06 UU ALL:FLOW COLLECT FAIL R 2:PNL ISD AIRFLOW METER MAP TYPE: ID SERIAL NUM LABEL PUMP CONTROL OUTPUT ------------------------ TANI' 0: 2 1 8203 FM-1 2 8256 FM-2 3 8446 FM-3 SMARTSENSOR SETUP LIQUID SENSOR ALMS 4 8271 FM-4 - - - - - - - - - - - L 1 :FUEL ALARM 5 7983 FM-5 L 3:FUEL ALARM 6 8495 FM-6 s I :PS-2 i L 9:FUEL ALARM CATEGORY VAPOR PRESSURE L10:FUEL ALARM LII :FUEL ALARM s 2:FM-1 LI2:FUEL ALARM CATEGORY AIR FLOW METER L13:FUEL ALARM L14:FUEL ALARM s 3:FM-2 L I :SENSOR OUT ALARM CATEGORY AIR FLOW METER L 3:SENSOR OUT ALARM L 9:SENSOR OUT ALARM s 4:FM-3 L10:SENSOR OUT ALARM CATEGORY AIR FLOW METER L11 :SENSOR OUT ALARM L12:SENSOR OUT ALARM s 5:FM-4 L13:SENSOR OUT ALARM CATEGORY AIR FLOW METER L14:SENSOR OUT ALARM L I :SHORT ALARM s 6:F1'i-5 L 3:SNORT ALARM CATEGORY AIR FLOW METER L 9:SHORT ALARM L10:SHORT ALARM 7:FM-6 LII :SHORT ALARM CATEGORY AIR FLOW METER L12:SHORT ALARM L13:SHORT ALARM L14:SHORT ALARM ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL ' ISD VP PRES FAIL ISD VP STATUS FAIL a ISD HOSE ALARMS ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL COLLECT FAIL ISD FUEL GRADE HOSE MAP 1 2 3 4 FP MHH MHH MHH MHH AA ALARM HISTORY REPORT ALARM HISTORY REPORT ------------------ 01 205 305 905 5 U 3 ----- SENSOR ALARM ----- 02 206 306 906 5 U 3 L 1 :UNL STP - -- SE(VSOk ALARM ----- 03 207 307 907 5 U 4 STP SUMP L NULAR ANN 04 208 308 908 5 U 4 ANNULAR SPACE 05 209 309 909 U U 5 06 210 310 910 U U 5 07 311 911 211 5 U 6 08 212 312 912 5 U 6 17 2 U 9 U 3 0 0 0 0 18 3 U 2 U 9 0 0 0 0 19 2 U 9 U 3 U 5 U 0 20 2 U 9 U 5 U 3 U 0 21 2 U 9 U 3 0 0 0 0 iE * END n * x * # n * END n 22 9 U 2 U 3 U U U 0 23 5 U 2 U 9 U 3 U 0 24 2 U 5 U 3 U 9 U 0 25 201 301 901 5 U 1 26 202 302 902 5 U 1 27 203 303 903 U U 2 26 204 304 904 U U 2 LABEL TABLE ------------------------ 1 : UNASSIGNED ALARM HISTORY REPORT ALARM HISTORY REPORT : BLEND'S ' 3: REGULAR ----- SENSOR ALARM ----- 4: MID GRADE L 2:UNL ANN _ - SENSOR ALARM ----- 5: PREMIUM ANNULAR SPACE L 3:PNL STP 6: GOLD STP SUMP 7: BRONZE 8: SILVER 9: BLEND2 10: BLEND4 R K x ri END * * ri END PMC SETUP PMC: VERSION: 01 .02 VAPOR PROCESSOR TYPE NOIVIr ALARM HISTORY REPORT ALARM HISTORY REPORT PROCESSOR CONTROL LEVEL: NONE _____ SENSOR ALARM ----- SENSOR ALARM ----- L 2:UNL ANN ANNULAR SPACE L 4:PNL ANN ANNULAR SPACE SENSOR OUT ALARM AUG 12. 2010 4:09 PM SENSOR OUT ALARM AUG 12 2010 4:06 PM SENSOR OUT ALARM AUG 12. 2010 3:59 Pil n x x r END x * n n ri END fi x z ALARM HISTORY REPORT ALARM HISTORY REPORT ALARM HISTORY REPORT ----- SENSOR. ALARM ----- ----- SENSOR ALARM ----- ----- SENSOR ALARM ----- L 5:DSL STP L 8: L11 :DISP 3 STP SUMP OTHER SENSORS DISPENSER PAN END END . ALARM HISTORY REPORT ALARM HISTORY REPORT ALARM HISTORY REPORT ----- SENSOR ALARM ----- ----- SENSOR ALARM ----- ----- SENSOR ALARM ----- L 6:DSL ANN L 9:DISP I L12:DISP 4, ANNULAR SPACE DISPENSER PAN DISPENSER PAN SENSOR OUT ALARM AUG 5, 2010 12:49 Pil SENSOR OUT ALARM AUG 5, 2010 12:39 PM SENSOR OUT ALARM AUG 5, 2010 12:39 PM iE 3i 'fi * n END * * r * fi ri ii # END END x x x ALARM HISTORY REPORT ALARM HISTORY REPORT ----- SENSOR ALARM ----- ----- SENSOR ALARM ----- LIO:,DISP 2 L14:DISP 6 DISPENSER PAN DISPENSER PAN ALARM HISTORY REPORT ----- SENSOR ALARM ----- L 7: OTHER SENSORS iE iE 3t x ri END EIVD x ri END h FASTRIP 721 ----- SENSOR ALARM ----- 4013 SO. H ST. L13:DISP 5 _ ---- BAKERSFIELD.CA 93304 ----- SENSOR ALARM - DISPENSER PAN 661-832-6124 FUEL ALARM L 1 :UNL STP OCT 19, 2010 9:28 AM STP SUMP OCT 19, 2010 9:36 AM FUEL ALARM OCT 19, 2010 9:24 AM SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL ----- SENSOR ALARM ----- L 2:UNL ANN -- SENSOR ALARM ----- ANNULAR SPACE L 3:PNL STP FUEL ALARM STP SUMP OCT 19, 2010 9:29 AM FUEL ALARM OCT 19, 2010 9:24 All ----- SENSOR ALARM ----- L 6:DSL ANN ANNULAR SPACE FUEL ALARM OCT 19, 2010 9:37 AM ----- SENSOR ALARM ----- L11 :DISP 3 ----- SENSOR ALARM ----- DISPENSER PAN L 3:PNL STP FUEL ALARM STP SUMP OCT 19, 2010 9:31 AM FUEL ALARM OCT 19, 2010 9:25 AM ----- SENSOR ALARM ----- L 5:DSL STP STP SUMP , SENSOR OUT ALARM OCT 19, 2010 9:38 AM ----- SENSOR ALARM ----- L14:DISP 6 ----- SENSOR ALARM ----- DISPENSER PAN L 5:DSL STP FUEL ALARM STP SUMP OCT 19, 2010 9:32 AM FUEL ALARM OCT 19, 2010 9:25 AM ----- SENSOR ALARM ----- L 3:PNL STP STP SUMP SENSOR OUT ALARM OCT 19, 2010 9:38 AM ----- SENSOR ALARM ----- L12:DISP 4 ----- SENSOR ALARM ----- DISPENSER PAN L 9:DISP 1 FUEL ALARM DISPENSER PAN OCT 19, 2010 9:32 All FUEL ALARM OCT 19, 2010 9:26 AM ----- SENSOR ALARM ----- L 4:PNL ANN ANNULAR SPACE SENSOR OUT ALARM OCT 19, 2010 9:38 AM ----- SENSOR ALARM ----- L 4:PNL ANN ----- SENSOR ALARM ----- AIVNULAR SPACE L10:DISP 2 FUEL ALARM DISPENSER PAN OCT 19, 2010 9:34 AM FUEL ALARM OCT 19, 2010 9:27 AM ----- SENSOR ALARM ------ L i :UNL STP STP SUMP SENSOR OUT ALARM OCT 19, 2010 9:38 All T 2:PNL FASTRIP 721 1NVENTORY INCREASE 4013 SO, H ST. SAKERSFIELD,CA 53304 ---- IN-TANK ALARM ----- INCREASE START 661-632-6124 T 1 :UNL OCT 19, 2010 5:45 AM HIGH PRODUCT ALARM OCT 15, 2010 9:56 Am OCT 15, 2010 9::48 48 AM T 2: INVALID FUEL LEVEL VOLUME - 458 GALS HEIGHT = 7.78 INCHES WATER = 0.84 INCHES SYSTEM STATUS REPORT TEMP = 75. 1 DEG F T I :HIGH-PRODUCT ALARM INCREASE END T I :MAX PRODUCT ALARM OCT 19. 2010 9:48 AM MISSING RELAY SETUP ---- IN-TANK ALARM ----- VOLUME = 4591 GALS T 1 :UNL HEIGHT = 39.09 INCHES MAX PRODUCT ALARM WATER = 0.95 INCHES OCT 15. 2010 9:50 AM TEMP = 73.7 DEG F GROSS INCREASE= 4133 TC NET INCREASE= 4093 I N-TANX ALARM ----- T-2:PNL T 1 :UNL " HIGH PRODUCT ALARM INVENTORY INCREASE OCT 15. 2010 9:58 AM INCREASE START OCT 19, 2010 9:45 AM T 1 : INVALID FUEL LEVEL VOLUME - 400 GALS T 3:DSL HEIGHT = 7.09 INCHES INVENTOR.' INCREASE WATER = 0.00 INCHES TEMP = 77.6 DEG F INCREASE START _ OCT 19. 2010 9:45 AM - IN-TANK ALARM ----- T 3:DSL INCREASE END T 3: INVALID FUEL LEVEL HIGH PRODUCT ALARM OCT 19, 2010 5:52 AM VOLUME 425 GALS OCT 19, 2010 9:59 AM HEIGHT = 7.43 INCHES VOLUME = 12000 GALS WATER = 0.76 INCHES HEIGHT = 95.98 INCHES TEMP = 76.9 DF.G F WATER = 0.00 INCHES TEMP = 70.5 DEG F INCREASE END OCT 19, 2010 5:48 AM GROSS INCREASE= 11600 TC NET INCREASE= 11516 VOLUME = 5348 GALS HEIGHT = 43.90 INCHES IN-TANK ALARM ----- WATER = 0.00 INCHES T I :UNL TEMP = ?5.2 DEG F HIGH WATER WARNING OCT 19. 2010 5:55 AM GROSS INCREASE= 4915 TC NET INCREASE= 4886 ---- ISD SITE ALARM ---- MISSING RELAY SETUP _ IN-TANK ALARM ----- OCT 19, 2010 9:56 AM T 1 :UNL HIGH WATER ALARM OCT 19, 2010 9:59 Al°1 ---- IN-TANK ALARM ----- T 3:DSL ----- SENSOR ALARM ----- - IN-TANK ALARM ----- LOW PRODUCT ALARM L 6:DSL ANN T 1 :UNL OCT 19, 2010 9:41 AM ANNULAR SPACE PROBE OUT SENSOR OUT ALARM OCT 19, 2010 9:43 All OCT 19, 2010 93F1 All ---- IN-TANK ALARM ----- T 2:PNL - IN-TANK ALARM ----- DELIVERY NEEDED ----- SENSOR ALARM ----- T I :UNL OCT 19. 2010 9:42 AM L, :UNL ANN LOW PRODUCT ALARM ANNULAR SPACE OCT 19. 2010 9:44 AM FUEL ALARM OCT 19, 2010 9:38 AM ----" IN-TANK ALARM ----- T 2:P'NL ---- IN-TANK ALARM ----- LOW PRODUCT ALARM T i :UNL OCT 19. 2010 9:42 AM FASTRIF 721 INVALID FUEL LEVEL 4013 SO. H ST. OCT 19, 2010 9:44 All BAKERSF I ELD,CA 9304 661-832-6124 OCT 19, 2010 9:39 AM ---- IN-TANK ALARM ----- SYSTEM STATUS REPORT T 2:PNL ALL FUNCTIONS NORMAL IN-TANK ALARM ----- PROBE OUT T 1 :UNL OCT 19, 2010 9:42 AM OVERF I LL ALARM OCT 19. 2010 9:46 AM ---- IN-TANK ALARM ----- IN-TANK ALARM - T 3:DSL - PROBE OUT --- IN-TANK ALARM ----- LOW PRODUCT ALARM OCT 19. 2010 9:40 ALARM AM T I :UNL. OCT 19, 2010 9:43 AM HIGH PRODUCT ALARM OCT 19, 2010 9:46 AM ---- IN-TANK ALARM ----- ---- IN-TANK ALARM ----- T VALID `; INVALID FUEL LEVEL INVALID FUEL LEVEL OCT 19, 2010 9:41 AM OCT 19, 2010 9:43 AM ---- IN-TANK ALARM ----- IN-TANK ALARM ----- T 3:DSL DELIVERY NEEDED T I :UNL OCT 19,'2010 9:41 AM DELIVERY NEEDED OCT 19, 2010 9:43 AM T 1 :UNL INVENTORY INCREASE - INCREASE START ---- IN-TANK' ALARM ----- OCT 19, 2010 10:01 AM T } :UNL LOW TEMP WARNING FASTRIP 721 VOLUME = 3087 GALS OCT 19. 2010 10:01 AM 4013 SO. H ST. HEIGHT = 29.21 INCHES BAKERSFIELD,CA 93304 WATER = 0.00 INCHES 661-832-6124 TEMP = -99.0 DEG F OCT 19, 2010 9:59 All I NCREASE ENE) OCT 19, 2010 10:04 AM SYSTEM STATUS REPORT VOLUME = 4408 INCH T---P�N-TANI' ALARM -- T 1 :HIGH WATER ALARM HEIGHT = 37.92 INCHES �,: --- WATER 0.00 INCHES PROBE OUT T 1 :H1GH WATER WARNING TEMP = -99,0 DEG F OCT 19, 2010 10:02 Ah1 MISSING RELAY SETUP GROSS IIVC'REASE= 1321 TC NET INCREASE= 1468 1 ISD SITE ALARM ---- ISD SETUP WARN OCT 19: 2010 10:02 AM T 2:PfVL INVENTORY INCREASE IN-TANK ALARM ----- INCREASE START T 3:DSL OCT 19, 2010 9:Be AM INVALID FUEL LEVEL VOLUME = 4590 GALS OCT 19, 2010 10:04 AM VOLUME = 39.09 INCHES WATER = 0.94 INCHES ---- ISD SITE ALARM ---- TEMP = 65.7 DEG F ISD SENSOR OUT WARN OCT 19, 2010 10:02 All INCREASE END OCT 19, 2010 10:00 All VOLUME = 9929 GALS _ HEIGHT = 74.03 INCHES -- S PJ-TAIVk: ALARM ----- WATER = 1 .00 INCHES LOW TEMP WARNING T 3:DSL TEMP = 65.8 DEG F OCT 19, 2010 10:04 AM ---- IN-TANK ALARM ----- GROSS INCREASE= 5339 T 3:DSL TC NET INCREASE= 5317 PROBE OUT OCT 19. 2010 10:03 All T 2:PNL INVENTORY INCREASE INCREASE START OCT 19, 2010 10:03 AM VOLUME = 3526 GALS ---- 1N-TANK, ALARM ----- HEIGHT = 32.16 INCHES T 1 :UNL WATER = 0.00 INC PROBE OUT TEMP = 66.2 DEG F OCT 19, 2010 10:01 All INCREASE END OCT 19, 2010 10:05 AM VOLUME = 5924 GALS HEIGHT = 47.52 INCHES WATER = 0.00 INCHES TEMP = 66.3 DEG F GROSS INCREASE= 2398 TC NET INCREASE= 2387 T 3:DSL INVENTORY 'INCREASE INCREASE START OCT 19, 2010 10:04 AM VOLUME = 3783 GALS HEIGHT = 33.86 INCHES WATER = 0.00 INCHES TEMP = -99.0 DEG F INCREASE END OCT 19, 2010 10:06 AM VOLUME = 4700 GALS HEIGHT = 39.79 INCHES WATER = 0.00 INCHES TEMP = -99.0 DEG F GROSS INCREASE= 917 TC NET INCREASE= 982 i z 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 (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: #721 Fastrip 422 1 Date of Testing: 10/19/2010 Facility Address: 4013 South H Street,Bakersfield,CA 93304 Facility Contact: Omero Garcia I Phone: 661-393-7000 Date Local Agency Was Notified of Testing: 1015110 Name of Local Agency Inspector(rf present during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: Confidence UST Services, Inc. Technician Conducting Test: Douglas M.Young III Credentials': ❑x CSLB Contractor ❑x ICC Service Tech. ❑x SWRCB Tank Tester ❑Other(Spec) License Number(s): CSLB#804904 ICC#878646-UT Tank Tester# 901076 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 Fill 2 Super Fill 3 Diesel Fill 4 Number, Stored Product, etc. Bucket Installation Type: ❑Direct Bury ❑Direct Bury ❑ Direct Bury ❑Direct Bury ❑x Contained in Sum ❑2 Contained in Sump ❑x Contained in Sump ❑ Contained in Sum Bucket Diameter: 12.00" 12.00" 12.00" Bucket Depth: 14.25" 14.00" 14.50" Wait time between applying 5 min. 5 min. 5 min. vacuum/water and start of test: Test Start Time(Ti): 9:15am 9:15am 9:15am Initial Reading(Ri): 11.25" 10.50" 10.25" Test End Time(TF): 10:15am 10:15am 10:15am Final Reading(RF): 11.25" 10.50" 10.25" Test Duration(TF—Tj): 1 hour 1 hour I 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: El Pass ❑Fail ® Pass ❑Fail © Pass ❑Fail ❑ Pass ❑Fail Comments— (include information on repairs made prior to testing, and recommended follow-up for failed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certto that all the information contained in this report is true,accurate,and in full compliance with legal requirements. Technician's Signature: Date: 10/19/2010 ' State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent.