HomeMy WebLinkAboutFMC RESULTS 2010 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. If more than one monitoring system control panel is installed at the facility,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 test date.
A General Information
Facility Name: 7-ELEVEN#32241,MKT 2368 City: BAKERSFIELD CA Zip:93312
Site Address: 4101 CALLOWAY DRIVE Contact Phone No: 587-8826
Date of Testing/Service: 12/14/2010
Facility Contact Person: MANAGER
Make/Model of Monitoring System:TLS350 R Work Order Number: 3179607 IIIIIIIIIIIIIIIIIIII 01
B.Inventory of Equipment Tested/Certified IE
Check the appropriate boxes to indicate specific equipment inspected/serviced
Tank ID: T4 RUL Tank ID: T5 PUL
X In-Tank Gauging Probe. Model: MAGPLUS X In-Tank Gauging Probe. Model: MAGPLUS
X Annular Space or Vault Sensor. Model: 303 Annular Space or Vault Sensor. Model: 303
X Piping Sumprrrench Sensor(s). Model: 208 Piping Sumprrrench Sensor(s). Model: 208
X Fill Sump Sensor(s). Model: 208 208
Fill Sump Sensor(s). Model:
X Mechanical Line Leak Detector. Model: LD2000 X Mechanical Line Leak Detector. Model: LD2000
Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model:
X Tank Overfill/High-Level Sensor. Model: FLAPPER VALVE E Tank Overfill/High-Level Sensor. Model: FLAPPER VALVE
Other(specify equipment type and model in Section E on page 2). El Other(specify equipment type and model in Section E on page 2).
Tank ID: Tank ID:
In-Tank Gauging Probe. Model: 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 Sensor(s). Model: Fill Sump Sensor(s). Model:
Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model:
Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model:
Tank Overfill/High-Level Sensor. Model: Tank Overfill/High-Level Sensor. Model:
Other(specify equipment type and model in Section E on page 2). Others equipment(specify eq p ment
type and model in Section E on page 2).
ispenser : 1-2 Dispenser ID: 3-4
®Dispenser Containment Sensor(s) Model:208 X Dispenser Containment Sensor(s) Model:208
X❑Shear Valve(s). X Shear Valves)
EjDispenser Containment Float(s)and Chain(s). 7 Dispenser Containment Float(s)and Chain(s).
Dispenser ID: 5-6 Dispenser ID: 7-8
0 Dispenser Containment Sensor(s) Model:208 X Dispenser Containment Sensor(s). Model:208
OShear Valve(s). 71 Shear Valve(s).
Dispenser Containment Float(s)and Chain(s). 7 Dispenser Containment Float(s)and Chain(s).
Dispenser Dispenser lD:
P
❑ Dispenser Containment Sensor(s) Model: Dispenser Containment Sensor(s). Model:
Shear Valve(s). Shear Valve(s).
ElDispenser Containment Float(s)and Chain(s). Dispenser Containment Float(s)and Chain(s).
If the facility contains more tanks or dispensers,copy this form. InGude information for every tank and dispenser at the facility.
C. Certification
I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers'guidelines.
Attached to this certification is information(e.g manufacturers'checklists)necessary to verify that this information is correct.
and a Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached
a copy of the(Check all that apply): �X System set-up X❑Alarm history report
Technician Name(print): WILBERT CRISOSTOMO Signature: lr.
Certification No.: B33025 License.No.: 743160(Class'A'General Enginering Contractor License)
Testing Company Name:Tanknology Phone No.: (800)800-4633
Site Address: 11000 N.MoPac Expressway,suite 500,Austin,TX 78759 Date of Testing/Servicing: 12/14/2010
Monitoring System Certification Page 1 of 3 11111111111111111111 02 Based on CA form dated 03/08
IE
Monitoring System Certification
Site Address 4101 CALLOWAY DRIVE Date of Testing/Service: 12/14/2010
D. Results of Testing/Servicing
Software Version Installed: 329.02
Complete the following checklist:
X Yes No• Is the audible alarm operational?
0 Yes No• Is the visual alarm operational?
❑X Yes No• Were all sensors visually inspected,functionally tested,and confirmed operational?
0 Yes ❑No• Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not
interfere with their proper operation?
X Yes No' N/A If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational?
For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment
0 Yes ❑No• ❑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) 0 Sump/Trench Sensors; 0 Dispenser Containment Sensors.
Did you confirm positive shut-down due to leaks apd sensor failure/disconnection? 0 Yes No
❑ Yes ❑No• ❑X N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.:no mechanical
overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank fill points(s)and operating
properly? If so,at what percent of tank capacity does the alarm trigger? a�
❑X 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• ❑X No Was liquid found inside any secondary containment systems designed as dry systems?(check all that apply) ❑Product;
❑ Water. If yes,describe causes in Section E,below.
❑X Yes ❑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 manufacturers'specifications?
In Section E below,describe how and when these deficlences were or will be corrected.
E. Comments:
THEY HAVE VACUUM SENSOR MODEL 470 TESTED PASSED ALSO ALL VACUUM SENSOR PROGRAM FOR POSITIVE SHUTDOWN,
I NET HAVE VENI SUMP VVI I FI 208 SUMP SENSOR I Es 11=0 PASSED.
Page 2 of 3 Based on CA form dated 03/08
Monitoring System Certification
Site Address: 4101 CALLOWAY DRIVE Date of Testing/Service: 12/14/2010
F. In-Tank Gauging / SIR Equipment
Check this box if tank gauging is used only for inventory control.
❑ Check this box if no tank gauging or SIR equipment is installed.
Check this box if no tank gauging or SIR equipment 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 ❑No• Were all tank gauging probes visually inspected for damage and residue buildup?
❑Yes ❑No• Was accuracy of system product level readings tested?
OYes ❑No Was accuracy of system water level readings tested?
X Yes ❑No• Were all probes reinstalled properly?
MY. ❑No• Were all items on the equipment manufacturers'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 LLDs are not installed.
Complete the following checklist:
For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance?
0 Yes ❑No• F-1 N/A (Check all that apply)Simulated leak rate: Q 3 g.p.h❑0.1 g.p.h ❑0.2 g.p.h
X Yes ❑No Were all LLDs confirmed operational and accurate within regulatory requirements?
FX_j Yes ❑No' Was the testing apparatus properly calibrated?
❑X Yes ❑No' ❑N/A For mechanical LLDs,does the LLD restrict product flow if it detects a leak?
❑Yes ❑No' Q NIA For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak?
❑Yes ❑No' M N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected?
❑Yes ❑No• M N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test?
❑Yes ❑No• M N/A For electronic LLDs,have all accessible wiring connections been visually inspected?
Yes ❑No• Were all items on the equipment manufacturers'maintenance checklist completed?
'In the Section H,below,describe how and when these deficiencies were or will be corrected.
H. Comments:
Page 3 of 3 Based on CA form dated 03/08
Work Order: 3179607
Monitoring System Certification Form:Addendum for Vacuum/Pressure Interstitial Sensors LG 163-1,Enc.11
1. 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 be provided to the tank
system nwner/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. vi Model: System Type:❑Pressure;OVICUUM
Sensor iD
Component(s)Monitored by this Sensor:
Sensor Functionality Test Result: _ ass; ❑ Fail Interstitial Communication Test Result:.Erp—ass; ❑ Fail
00 Component(s)Monitored by this Sensor:40 P/e�G/Gr LI/vr G
Sensor Functionality Test Result:�ss; ❑ Fail Interstitial Communication Test Result: Pass; ❑ Fail
Component(s)Monitored by this Sensor:
�J Sensor Functionality Test Result: 'ass; ❑ Fail Interstitial Communication Test Result: Pass; ❑ Fail
(1- Components)Monitored by this Sensor: }r f� aW
12 Sensor Funetionalit)?Tcst Resuli.-epIss; ❑ Fail interstitial Communication Test Result: Pass; ❑ Fail
Component(s)Monitored by this Sensor:671 1#1WIMI A114C
a
Sensor Functionality Test Result: ass: ❑ Fail Interstitial Communication Test Result: Pass; ❑ Fail
Component(s)Monitored by this Se sor:
Sensor Functionality Tes? Result ass; ❑ Fail interstitial Communication Test Result: Pass; ❑ Fail
Component(s)Monitored by this Sensor
Sensor Functionality Tess Result: ❑_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 this Sensor:
Sensor Functionality Test Result: ❑Pass; ❑ Fail interstitial Communication Test Result:❑Pass; ❑ Fail
Component(s)Monitored by this Sensor:
Sensor Functionality Tcst Result:❑ Pass; ❑ Fail Interstitial Communication Test Result: ❑Pass; ❑ Fail
How was interstitial communication verified? �-
❑ Leak introduced at Far End of Interstitial Spacc;' [r Gauge. ❑ Visual inspection; ❑ Other(Describe in Sec.J,below)
Vacuum was restored to operating levels in all interstitial spaces: Ycs ❑No(if no.describe in Sec.J.below)
J. Comments:
Page--.--
if the sensor successfully detects a simulated vatuum/pressurc leak introduced in the interstitial space at the furthest point from the
sensor, vacuum pressure has been demonstrated to be communicating throughout the interstice.
Tanknology Inc. 11000N.MoPac Expressway,Suite 500,Austin,Texas 78759
SWRCB,,January 2002 Page 1.
Secondary Containment Testing Report Form
This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the
appropriate pages of this form to report results for all components tested. The completed form, written test procedures, 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: 7-ELEVEN #32241, MKT 2368 Date of Testing: 12/14/2010
Facility Address: 4101 CALLOWAY DRIVE , BAKERSFIELD, CA, 93312
Facility Contact: MANAGER I Phone: (6 61) 587-8826
Date Local Agency Was Notified of Testing: 12/06/2010
Name of Local Agency Inspector(if present during testing): ERNIE MEDINA/ESTHER
2. TESTING CONTRACTOR INFORMATION
Company Name: TANKNOLOGY, INC.
Technician Conducting Test: WILBERT CRISOSTOMO
Credentials: El CSLB Licensed Contractor ❑ SWRCB Licensed Tank Tester
License Type: A-UT License Number: 743160-5282036
Manufacturer Training
Manufacturer Component(s) Date Training Expires
OPW PHASE 1 EVR 06/24/2010
3. SUMMARY OF TEST RESULTS
Not Repairs Not Repair
Component Pass Fail Tested Made Component Pass Fail Tested Made
Spill Box 4 REG FILL M ❑ ❑ ❑ ❑ ❑ ❑ ❑
Spill Box 5 PRE FILL X ❑ ❑ ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ I ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ I ❑ ❑ ❑
❑ El- ❑ ❑ Ell ❑ ❑ ❑
If hydrostatic testing was performed,describe what was done with the water after completion of tests:
LEFT 2 5GALLONS BUCKETS ON SITE NEED TO BE PICK UP
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
To the best of my knowledge, the facts stated in this document;are accurate and in full compliance with legal requirements
Technician's Signature: I Date: 12/14/2010
SWRCB,January 2006
9. 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: 7-ELEVEN #3 2 2 41, MKT 2368 Date of Testing: 12/14/2010
Facility Address: 4101 CALLOWAY DRIVE , BAKERSFIELD, CA, 93312
Facility Contact: MANAGER Phone: (6 61) 587-8826
Date Local Agency Was Notified of Testing : 12/06/2010
Name of Local Agency Inspector(if present during testing): ERNIE MEDINA/ESTHER
2. TESTING CONTRACTOR INFORMATION
Company Name: TANKNOLOGY, INC.
Technician Conducting Test: WILBERT CRISOSTOMO
Credentials l: E CSLB Contractor ❑ICC Service Tech. ❑SWRCB Tank Tester x❑Other(Specify)A-UT
License Number: 743160-5282036
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: Fil Hydrostatic ❑ Vacuum ❑ Other
Test Equipment Used: TAPE MEASURE Equipment Resolution:VISUAL
Identify Spill Bucket(By Tank 1 4 REG FILL 2 5 PRE FILL 3 4
Number, Stored Product, etc)
❑
Bucket Installation Type: Direct Bury ❑Direct Bury ❑Direct Bury ❑Direct Bury
EE Contained in Sump x❑Contained in Sump ❑Contained in Sump ❑Contained in Sump
Bucket Diameter: 1411 1411
Bucket Depth: 1411 14
Wait time between applying 10MINS 10MINS
vacuum/water and starting test:
Test Start Time(TI ): 0 9:0 0 0 9:0 0
Initial Reading(RI ): 911 9 7/811
Test End Time(TF ): 10:0 0 10:0 0
Final Reading(R F ): go[ 9 7/811
Test Duration: 1HRS 1HRS
Change in Reading(R F-RI ): 0 0
Pass/Fail Threshold or 0 LOSS 0 LOSS
Criteria:
es Result: 116MWIMMM all 1 ass a as
Comments - (include information on repairs made prior to testing, and recommended follow-up for jailed tests)
CERTIFICATION OF TECIINICIAN 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: 12/14/2010
State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements
SITE DIAGRAM
p Tar*rwjogy
8501 N MOPAC EXPRESSWAY,SUITE 400
AUSTIN,TEXAS 78759
(512)451-6334
FAX(512)459-1459
TEST DATE:12/14/10 WORK ORDER NUMBER3179607
CLIENT:7-ELEVEN, INC. SITE: 7-ELEVEN #32241, MKT 2368
VPH site. - S S_
S� 1 , 3,14 F AIR/
A
V L-11 9S_ r 2O
0 �O,r
VENT
PAN L-3 L-6
CAS #2
#5 #8
ICE L-1 C"9�O�o L-4 Oj L 5
#1
#7
-2
7-11 #32241 #3
4101 Calloway Dr.
N Bakersfield, CA 93312
E 661.587.8826 ESO
TLS APCD#S-3256-1-2
Printed 12/21/2010 08:18 ACRAMER
Work Order: 3179607
("0)&(ESV)Testing Form-Version 1-&25/2007
Emergency Shut Off (ESO) &
Dispenser Emergency Shutoff Valve (ESV)
ANNUAL TEST RECORD LOCATIONS AND TEST DATA
Testing /►, / / _
Company: /T/v/���c�(_ �� Date: 1.2 -1/
Location Name: YG I Store#: 322 Y/ SUL ID#:
Address: 0/[�/LLQ(re�r4y ��. city: � State:
Emergency Shut Off ESO Testing Results
On in accordance with"ESO Vendor Letter(3-21-05).doc", from Valero's Retail
Compliance Department,as a part of annual compliance testing,this representative tested the
Emergency Shut Off(ESO) switches indicated on this sketch. Findings listed below:
Emergency Shut Off(ESO) If No,Provide
Operational? &I N I Maintenance Log N Date Called : /Z `/y-/U
Dispenser Emergency Shutoff Valve (ESV) Testing Results
On in accordance with NFPA 30A this representative tested the automatic-closing feature
of the Dispenser Emergency Shutoff VALVF(S) (FSV) located in the supply lines at the base of each
individual island type dispenser indicated on the diagram below. Each device IV in all,
would automatically close. Findings listed below_:
Disp. Emergency Shut Off , If No,Provide
Valve(ESV)Operational? N Maintenance Log# Date Called
S
aD! ; t10
1j W VPH site. L_7 s S
pin SJA �. �TA9'2,1.3,14 AIR/ l
L-11 9L 9,10 L-9 H2O I
PAN L-3
�j CAS #� #5
ICE L 1 .. L+5,.
L-4
#1 #4,
#7
L-2
7-11 #32241 #3
4101 Calloway Dr.
N Bakersfield,CA 93312
661.587.8826
*4*E TLS APCD#S-3256-1-2
Sig
�.
Tanknology Inc. 11000 N.MoPac Expressway, Suite 500,Austin,Texas 78759
ATG Information
Work Order# 3179607
110100
DEC 14,2010 2:07 PM
235421 7-11 32241
4101 CALLOWAY DR
BAKESFIELD,CA 93312
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
❑
150301
DEC 14,2010 2:07 PM
#1235421 7-11 32241
150302
DEC 14,2010 2:07 PM
#2:4101 CALLOWAY DR
150303
DEC 14,2010 2:07 PM
#3:BAKESFIELD,CA 93312
150304
DEC 14,2010 2:07 PM
#4:
151700
DEC 14,2010 2:07 PM
SYSTEM TYPE AND LANGUAGE FLAG
SYSTEM UNITS
U.S.
SYSTEM LANGUAGE
ENGLISH
SYSTEM DATE/TIME FORMAT
MON DO YYYY HH:MM:SS xM
150F00
DEC 14,2010 2:07 PM
MON DO YYYY HH:MM:SS xM
O
110200
DEC 14,2010 2:07 PM
235421 7-11 32241
4101 CALLOWAY DR
BAKESFIELD,CA 93312
SYSTEM CONFIGURATION
SLOT BOARD TYPE POWER ON RESET CURRENT
1 4 PROBE/G.T. 165615 164153
2 4 PROBE/G.T. 164130 163452
3 INTERSTITIAL BD 203079 201953
4 INTERSTITIAL BD 203014 202153
5 8SMARTSENSOR BD 39422 39342
6 7SMARTSENSOR BD 510047 507191
7 UNUSED 4968831 4845575
8 UNUSED 4958087 4642009
9 RELAY BOARD 14960 14952
10 RELAY BOARD 15040 15034
11 STP SENSE BOARD 33208 33144
12 UNUSED 4963002 4844691
13 UNUSED 4958990 4841351
14 UNUSED 4954959 4840900
15 UNUSED 4954045 4841945
16 UNUSED 4952198 4841372
COMM 1 ELEC DISP INT. 101451 101267
COMM 2 ELEC DISP INT. 101409 101203
COMM 3 SERIAL SAT BD 490127 487901
COMM 4 UNUSED 4958732 4842376
COMM 5 RS485 SERIAL BD 69047 68950
3179607
ATG Information
Work Order# 3179607
COMM 6 MT COMM BOARD 411943 410030
160100
DEC 14,2010 2:07 PM
TANK CONFIGURATION
DEVICE LABEL CONFIGURED
1 OFF
2 OFF
3 OFF
4 RUL ON
5 PUL ON
6 OFF
7 OFF
8 OFF
160200
DEC 14,2010 2:07 PM
TANK PRODUCT LABEL
TANK PRODUCT LABEL
1
2
3
4 RUL
5 PUL
6
7
8
160300
DEC 14,2010 2:07 PM
TANK PRODUCT CODE
TANK PRODUCT LABEL
1 1
2 2
3 3
4 RUL 4
5 PUL 5
6 6
7 7
8 8
160400
DEC 14,2010 2:07 PM
TANK FULL VOLUME
TANK PRODUCT LABEL GALLONS
1 0
2 0
3 0
4 RUL 14544
5 PUL 9695
6 0
7 0
8 0
160700
DEC 14,2010 2:07 PM
TANK DIAMETER
TANK PRODUCT LABEL INCHES
1 0.00
2 0.00
3 0.00
4 RUL 91.63
5 PUL 91.63
6 0.00
7 0.00
8 0.00
160900
DEC 14,2010 2:07 PM
TANK THERMAL COEFFICIENT
3179607
ATG Information
Work Order# 3179607
TANK PRODUCT LABEL
1 0.00000O
2 0.000000
3 0.000000
4 RUL 0.000700
5 PUL 0.000700
6 0.000000
7 0,000000
8 0,000000
161200
DEC 14,2010 2:07 PM
TANK MANIFOLDED PARTNERS
TANK PRODUCT LABEL SIPHON MANIFOLDED TANKS LINEMAN IFOLDED TANKS
1 NONE NONE
2 NONE NONE
3 NONE NONE
4 RUL NONE NONE
5 PUL NONE NONE
6 NONE NONE
7 NONE NONE
8 NONE NONE
162100
DEC 14,2010 2:07 PM
TANK LOW PRODUCT LIMIT
TANK PRODUCT LABEL GALLONS
1 0
2 0
3 0
4 RUL 800
5 PUL 800
6 0
7 0
8 0
162200
DEC 14,2010 2:07 PM
TANK HIGH PRODUCT LIMIT
TANK PRODUCT LABEL GALLONS
1 0
2 0
3 0
4 RUL 14250
5 PUL 9500
6 0
7 0
8 0
162300
DEC 14,2010 2:07 PM
TANK OVERFILL LEVEL LIMIT
TANK PRODUCT LABEL GALLONS
1 0
2 0
3 0
4 RUL 13500
5 PUL 9000
6 0
7 0
8 0
162400
DEC 14,2010 2:07 PM
4 RUL 1.5
5 PUL 1.5
❑
162800
DEC 14,2010 2:07 PM
TANK MAXIMUM VOLUME LIMIT
3179607
AtG Information
Work Order# 3179607
TANK PRODUCT LABEL GALLONS
1 0
2 0
3 0
4 RUL 15000
5 PUL 10000
6 0
7 0
8 0
162900
DEC 14,2010 2:07 PM
TANK DELIVERY REQUIRED LIMIT
TANK PRODUCT LABEL GALLONS
1 0
2 0
3 0
4 RUL 2250
5 PUL 1500
6 0
7 0
8 0
170300
DEC 14,2010 2:07 PM
LIQUID TYPE
SENSOR LOCATION TYPE
1 DISP 1-2 PAN TRI-STATE(SINGLE FLOAT)
2 DISP 3-4 PAN TRI-STATE(SINGLE FLOAT)
3 DISP PAN 5.6 TRI-STATE(SINGLE FLOAT)
4 DISP PAN 7-8 TRI-STATE(SINGLE FLOAT)
5 87 ANNULAR SPACE DUAL POINT HYDROSTATIC
6 87 FILL SUMP TRI-STATE(SINGLE FLOAT)
7 87 STP SUMP TRI-STATE(SINGLE FLOAT)
8 91 ANNULAR SPACE DUAL POINT HYDROSTATIC
9 91 FILL SUMP TRI-STATE(SINGLE FLOAT)
10 91 STP SUMP TRI-STATE(SINGLE FLOAT)
11 VAPOR PIPING PAN TRI-STATE(SINGLE FLOAT)
12 TRI-STATE(SINGLE FLOAT)
13 TRt-STATE(SINGLE FLOAT)
14 TRI-STATE(SINGLE FLOAT)
15 TRI-STATE(SINGLE FLOAT)
16 TRI-STATE(SINGLE FLOAT)
172100
DEC 14,2010 2:07 PM
SMART SENSOR CONFIGURATION
DEVICE LABEL CONFIGURED
1 1-2 FLOW METER ON
2 3-4 FLOW METER ON
3 5-6 FLOW METER ON
4 7.8 FLOW METER ON
5 OFF
6 OFF
7 OFF
8 ISO PRESSURIr SENSOR ON
9 87 FILL VRL UDC VAC ON
10 87 PRODUT LINE VAC ON
11 87 STPSUMP-FILLCNCT ON
12 91FILL-VENT'CONTSUMP ON
13 91 PRODUCT LINE VAC ON
14 91 STPSUMP-FILLCNCT ON
15 OFF
16 ATM P SENSOR 5-6 ON
172200
DEC 14,2010 2:07 PM
SMART SENSOR LABEL
DEVICE LABEL
1 1-2 FLOW METER
2 3-4 FLOW METER
3 5-6 FLOW METER
3179607
ATG Information
Work Order# 3179607
4 7-8 FLOW METER
5
6
7
8 ISD PRESSURE SENSOR
9 87 FILL VRL UDC VAC
10 87 PRODUT LINE VAC
11 87 STPSUMP-FILLCNCT
12 91FILL-VENT'CONTSUMP
13 91 PRODUCT LINE VAC
14 91 STPSUMP-FILLCNCT
15
16 ATM P SENSOR 5.6
172900
DEC 14,2010 2:07 PM
VACUUM SENSOR PUMP NUMBER
DEVICE LABEL PUMP NUMBER
9 87 FILL VRL UDC VAC R 5:87 REGULAR STP
10 87 PRODUT LINE VAC R 5:87 REGULAR STP
11 87 STPSUMP-FILLCNCT R 5:87 REGULAR STP
12 91 FILL-VENT'CONTSUMP R 6:91 PREMIUM STP
13 91 PRODUCT LINE VAC R 6:91 PREMIUM STP
14 91 STPSUMP-FILLCNCT R 6:91 PREMIUM STP
15 NONE
172AOO
DEC 14,2010 2:07 PM
VACUUM SENSOR VOLUME
DEVICE LABEL VOLUME
9 87 FILL VRL UDC VAC 36.0 GALLONS
10 87 PRODUT LINE VAC 36.0 GALLONS
11 87 STPSUMP-FILLCNCT 36.0 GALLONS
12 91FILL-VENT'CONTSUMP 36.OGALLONS
13 91 PRODUCT LINE VAC 36.0 GALLONS
14 91 STPSUMP-FILLCNCT 36.0 GALLONS
15 501.0 GALLONS
172600
DEC 14,2010 2:07 PM
VACUUM SENSOR RELIEF VALVE PRESENT
DEVICE LABEL RELIEF VALVE
9 87 FILL VRL UDC VAC NO
10 87 PRODUT LINE VAC NO
11 87 STPSUMP-FILLCNCT NO
12 91FILL-VENT'CONTSUMP NO
13 91 PRODUCT LINE VAC NO
14 91 STPSUMP-FILLCNCT NO
15 NO
❑
172COO
DEC 14,2010 2:07 PM
VACUUM SENSOR RELIEF VALVE PRESSURE
DEVICE LABEL RELIEF VALVE PRESSURE
9 87 FILL VRL UDC VAC -9.0 PSI
10 87 PRODUT LINE VAC -9.0 PSI
11 87 STPSUMP-FILLCNCT -9.0 PSI
12 91FILL-VENT'CONTSUMP -9.0 PSI
13 91 PRODUCT LINE VAC -9.0 PSI
14 91 STPSUMP-FILLCNCT -9.0 PSI
15 -9.0 PSI
190200
DEC 14,2010 2:07 PM
SOFTWARE REVISION LEVEL
VERSION 329.02
SOFTWARE#346329-100-C
CREATED-09.07.01.16.29
S-MODULE#330160-104-a
SYSTEM FEATURES:
PERIODIC IN-TANK TESTS
3179607
AfG Information
Work Order# 3179607
ANNUAL IN-TANK TESTS
BIR
ISO
120600
DEC 14,2010 2:07 PM
235421 7-11 32241
4101 CALLOWAY DR
BAKESFIELD,CA 93312
TANK ALARM HISTORY
TANK 4 RUL
HIGH WATER ALARM DEC 14,2010 9:33 AM
OVERFILL ALARM DEC 14,2010 9:38 AM
OCT 24,2010 5:38 AM
AUG 27,2010 7:05 AM
LOW PRODUCT ALARM DEC 14,2010 9:20 AM
NOV 29,2010 6:06 PM
MAY 21,2010 8:41 PM
SUDDEN LOSS ALARM DEC 14,2010 920 AM
HIGH PRODUCT ALARM DEC 14,2010 9:39 AM
INVALID FUEL LEVEL DEC 14,2010 921 AM
PROBE OUT DEC 14,2010 9:43 AM
DEC 14,2010 9:21 AM
HIGH WATER WARNING DEC 14,2010 9:33 AM
DELIVERY NEEDED DEC 14,2010 9:43 AM
DEC 14,2010 9:20 AM
NOV 29,2010 1220 PM
MAX PRODUCT ALARM DEC 14,2010 9:40 AM
TANK 5 PUL
HIGH WATER ALARM DEC 14,2010 9:29 AM
OVERFILL ALARM DEC 14,2010 9:35 AM
LOW PRODUCT ALARM DEC 14,2010 920 AM
SUDDEN LOSS ALARM DEC 14,2010 9:19 AM
HIGH PRODUCT ALARM DEC 14,2010 9:37 AM
INVALID FUEL LEVEL DEC 14,2010 920 AM
PROBE OUT DEC 14,2010 9:44 AM
DEC 14,2010 9:19 AM
OCT 8,2010 1:22 PM
HIGH WATER WARNING DEC 14,2010 9:29 AM
DELIVERY NEEDED DEC 14,2010 9:19 AM
AUG 28,2010 7:00 AM
APR 2,2010 4:26 PM
MAX PRODUCT ALARM DEC 14,2010 9:37 AM
130200
DEC 14,2010 2:07 PM
235421 7-11 32241
4101 CALLOWAY DR
BAKESFIELD,CA 93312
LIQUID ALARM HISTORY REPORT
SENSOR LOCATION
1 DISP 1-2 PAN
DEC 14,2010 10:06 AM SENSOR OUT ALARM
DEC 14,2010 9:58 AM FUEL ALARM
2 DISP 3-4 PAN
DEC 14,2010 10:06 AM SENSOR OUT ALARM
DEC 14,2010 9:59 AM FUEL ALARM
3 DISP PAN 5-6
DEC 14,2010 10:06 AM SENSOR OUT ALARM
DEC 14,2010 9:56 AM FUEL ALARM
4 DISP PAN 7-8
DEC 14,201010:06 AM SENSOR OUT ALARM
DEC 14,2010 9:57 AM FUEL ALARM
5 87 ANNULAR SPACE
DEC 14,2010 10:06 AM SENSOR OUT ALARM
DEC 14,2010 9:54 AM LOW LIQUID ALARM
DEC 14,2010 9:54 AM HIGH LIQUID ALARM
6 87 FILL SUMP
DEC 14,2010 10:06 AM SENSOR OUT ALARM
DEC 14,2010 9:54 AM FUEL ALARM
7 87 STP SUMP
3179607
ATG Information
Work Order# 3179607
DEC 14,2010 10:40 AM FUEL ALARM
DEC 14,2010 10:06 AM SENSOR OUT ALARM
DEC 14,2010 9:55 AM FUEL ALARM
8 91 ANNULAR SPACE
DEC 14,2010 10:06 AM SENSOR OUT ALARM
DEC 14,2010 9:52 AM HIGH LIQUID ALARM
DEC 14,2010 9:51 AM LOW LIQUID ALARM
9 91 FILL SUMP
DEC 14,2010 10:06 AM SENSOR OUT ALARM
DEC 14,2010 9:51 AM FUEL ALARM
DEC 14,2010 9:50 AM FUEL ALARM
10 91 STP SUMP
DEC 14,2010 10:06 AM SENSOR OUT ALARM
DEC 14,2010 9:49 AM FUEL ALARM
11 VAPOR PIPING PAN
DEC 14,2010 10:06 AM SENSOR OUT ALARM
DEC 14,2010 10:00 AM FUEL ALARM
131600
DEC 14,2010 2:07 PM
235421 7-11 32241
4101 CALLOWAY DR
BAKESFIELD,CA 93312
SMART SENSOR ALARM HISTORY REPORT
SENSOR LOCATION
1 1-2 FLOW METER
2 3-4 FLOW METER
3 5-6 FLOW METER
4 7-8 FLOW METER
8 ISO PRESSURE SENSOR
AUG 11,2010 1:46 PM COMMUNICATION ALARM
AUG 7,2010 11:06 AM COMMUNICATION ALARM
9 87 FILL VRL UDC VAC
DEC 14,2010 1:45 PM HIGH LIQUID ALARM
DEC 14,2010 1:45 PM NO VACUUM ALARM
10 87 PRODUT LINE VAC
DEC 14,2010 1:45 PM HIGH LIQUID ALARM
DEC 14,2010 1:41 PM NO VACUUM ALARM
11 87 STPSUMP-FILLCNCT
DEC 14,2010 1:45 PM HIGH LIQUID ALARM
DEC 14,2010 1:41 PM NO VACUUM ALARM
12 91FILL-VENT'CONTSUMP
DEC 14,2010 1:53 PM NO VACUUM ALARM
DEC 14,2010 1:49 PM HIGH LIQUID ALARM
OCT 30,2010 7:57 PM HIGH LIQUID ALARM
13 91 PRODUCT LINE VAC
DEC 14,2010 1:53 PM NO VACUUM ALARM
DEC 14,2010 1:50 PM HIGH LIQUID ALARM
OCT 30,2010 7:47 PM COMMUNICATION ALARM
14 91 STPSUMP-FILLCNCT
DEC 14,2010 1:50 PM NO VACUUM ALARM
DEC 14,2010 1:49 PM HIGH LIQUID ALARM
OCT 30,2010 8:01 PM HIGH LIQUID ALARM
16 ATM P SENSOR 5-6
3179607
► Tanknology
11000 N. MoPac Expressway,Suite 500
Austin,Texas 78759
Phone: (512)451-6334
Fax: (512)459-1459 Date Printed and Mailed: 12/21/2010
BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
INSPECTOR CRAIG PERKINS
1501 TRUXTUN AVE.
BAKERSFIELD, CA. 93301
Test Date: 12/14/2010
Order Number: 3179607
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
7-ELEVEN #32241, MKT 2368
4101 CALLOWAY DRIVE
BAKERSFIELD, CA. 93312
Testing performed:
Impact Valve
Leak detector tests
Monitor Certification
Secondary Containment-Spill Container
Sincerely, `,
Dawn Kohlmeyer
Manager, Field Reporting
FPURPOSE: TANKNOLOGY.CERTIFICATE OF TESTING
8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759
TELEPHONE(512)451-6334 FAX(512)459-1459
COMPLIANCE TEST RESULT SUMMARY REPORT
TEST DATE: 12/14/10 WORK ORDER NUMBER: 3179607
CUSTOMER P0:
CLIENT: 7-ELEVEN,INC. SITE:7-ELEVEN#32241,MKT 2368
P.O.BOX 711 4101 CALLOWAY DRIVE
DALLAS,TX 75221 BAKERSFIELD,CA 93312
MANAGER
(972)828-7908 (661)587-8826
TEST TYPE: TLD-1
Product Pipe Ti htness Test Results
LINE E INE D R IMPACT
ID PROD C MA< ERIAL SU 111=111111161 WAR) yq►_
A B C D A B C D FUNCTIO
T4 87 4 REG UNLEAD DW FIBERG PRESSURE Y
T5 91 5 PREMIUM DW FIBERG PRESSURE Y
EM
Existinq Line Leak Detector Test
EXIS1TiINGiLE' ED) iTiE"CTOR#1 EXISTING1LEA_KiDEiTiEC�TQR;#2�a
LINE M UFAC ODEL SE # S MANUF RER MOD # RIAL RES LT
ID
T4 87 4 VAPORLESS LD2000 07081385 F
T5 91 5 VAPORLESS LD2000 07081386 P
New Replacement Line Leak Detector Test
.M D10 ' tD �i G% i 1� 1� ��-_CT'G
LINE UFACTU E hMODEL# SERIAL RESULT MANUFA TURER MOD L SERIAL# RESUL
ID
T4 87 4 VAPORLESS LD2000 10061087 P
For owner detailed report information,visit www.tanknology.com and select On-Line Reports-WRAP,or contact your local Tanknology office.
Tester Name:WILBERT CRISOSTOMO Technician Certification Number:5282036-UT
T
Printed 12121/2010 08:18 ACRAMER
INDIVIDUAL TANK INFORMATION AND TEST RESULTS
Mr TardvWi0gy
FTEST :12/14/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3179607
CLIENT:7-ELEVEN, INC. AUSTIN,TEXAS 78759(512)451-6334 SITE:7-ELEVEN #32241, MKT 2368
MIN LOR
,jMXW
NOWN
Tank ID: T4 87 4 Tank manifolded: No Bottom to top fill in inches: 164.0
Product: REG UNLEAD Vent manifolded: YES Bottom to grade in inches: 168.0
Capacity in gallons: 15,000 Vapor recovery manifolded: YES Fill pipe length in inches: 68.0
Diameter in inches: 96.00 Overfill protection: YES Fill pipe diameter in inches: 4.0
Length in inches: 484 Overspill protection: YES Stage I vapor recovery: DUAL
Material: Dw FIBERG Installed: ATG Stage II vapor recovery: ASSIST
CP installed on:
COMMENTS
TANK TEST RESULTS e t MethU :VacuTect LEAK DETECTOR TEST RES--_ Tes method LT-
Start(in) End(in)
Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced
Dipped Product Level: L.D.#1 L.D.#1 L.D.#2 L.D.#2
Probe Water Level: Make: VAPORLESS VAPORLESS
Ingress Detected: Water Bubble Ullage Model: LD2000 LD2000
Test time: S/N: 10061087 07081385
Inclinometer reading: Open time in sec: 3.00
Holding psi: 30
VacuTect Test Type: NOT Resiliency psi:
230 xoT
VacuTect Probe Entry Point: TESTED
Test leak rate ml/m: 189.0 TESTED
Pressure Set Point: Metering psi: 20
Tank water level in inches: Calib. leak in gph: 3.00 3.00
Water table depth in inches: Results: PASS FAIL
Determined by(method):
Result:
COMMENTS
COMMENTS
LINE TE5 RESULTS es type. -1
' � r
Material: DW FIBERG
Diameter(in): 2.0
Length (ft): 125.0
Test psi:
Bleedback cc:
Test time (min): NOT NOT NOT NOT
Start time: TESTED TESTED TESTED TESTED
End time:
Final gph:
Result:
Pump type: PRESSURE
Pump make: FE PETRO
COMMENTS Impact Valves Operational: YES
Printed 12/21/2010 08:18
INDIVIDUAL TANK INFORMATION AND TEST RESULTS
lip TamfumbW
TEST DATE:12/14/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3179607
CLIENT:7-ELEVEN, INC. AUSTIN,TEXAS 78759(512)451-6334 SITE:7-ELEVEN #32241, MKT 2368
TANK IN R •.••-
Tank ID: T5 91 5 Tank manifolded: NO Bottom to top fill in inches: 164.0
Product: PREMIUM Vent manifolded: YES Bottom to grade in inches: 168.0
Capacity in gallons: 10,000 Vapor recovery manifolded: YES Fill pipe length in inches: 68.0
Diameter in inches: 96.00' Overfill protection: YES Fill pipe diameter in inches: 4.0
Length in inches: 323 Overspill protection: YES Stage I vapor recovery: DUAL
Material: Dw PIBERG Installed: ATG Stage II vapor recovery: ASSIST
CP installed on:
COMMENTS
TANK TEST RESUL Ties Method:VacuTee DETE O TEST RESULTS est method L• -
Start(In) End(in)
Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced
Dipped Product Level: L.D.#1 L.D.#1 L.D.#2 L.D.#2
Probe Water Level: Make: VAPORLESS
Ingress Detected: Water Bubble Ullage Model: LD2000
Test time: S/N: 07061386
Inclinometer reading: Open time in sec: 3.00
Holding psi: 30
VacuTect Test Type: NOT Resiliency cc: 120 NOT
VacuTect Probe Entry Point: TESTED
Test leak rate ml/m: 189.0 TESTED
Pressure Set Point: Metering psi: 20
Tank water level in inches: Calib.leak in gph: 3.00
Water table depth in inches: Results: PASS
Determined by(method):
Result: COMMENTS
COMMENTS
LINE EST RESULTS Tes type: TLn-
L INE B C
Material: Dw FIBERG
Diameter(in): 2.0
Length (ft): 175.0
Test psi:
Bleedback cc:
Test time(min): NOT NOT NOT NOT
Start time: TESTED TESTED TESTED TESTED
End time:
Final gph:
Result:
Pump type: PRESSURE
Pump make: FE PETRO
COMMENTS Impact Valves Operational: YES
Printed 12/21/2010 08:18