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HomeMy WebLinkAbout4647 WILSON RD (3) MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of Califomia Authority Cited.Chapter 6.7,Health and Safety Code;Chapter 16,Division 3 Title 23,Califomia 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 ownerloperator 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#16549,MKT 2368 City: BAKERSFIELD CA Zip:93309 Site Address: 4647 WILSON ROAD Contact Phone No: 833-0732 Date of Testing/Service: 12109/2010 Facility Contact Person: Manager Make/Model of Monitoring System:TLS-350 Work Order Number: 3179461 IIIIIIII IIIIIIII IIII 03 B.Inventory of Equipment Tested/Certified IE Check the appropriate boxes to indicate specific equipment inspected/serviced Tank ID: T-1 RUL Tank ID: T-2 PUL X In-Tank Gauging Probe. Model: VR MAG X In-Tank Gauging Probe. Model: VR MAG X Annular Space or Vault Sensor. Model: VR 420 21 Annular Space or Vault Sensor. Model: VR 420 X Piping Sump/Trench Sensor(s). Model: VR 208 VR 208 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: PLLD X Electronic Line Leak Detector. Model: PLLD X Tank Overfill/High-Level Sensor. Model: FLAPPER Tank Overfill/High-Level Sensor. Model: FLAPPER Other(specify equipment type and model in Section E on page 2). Other(specify equipment type and model in Section E on page 2). TanklD: TanklD: 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 Sumplfrench 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 OverfilUHigh-Level Sensor. Model: Tank Overfill/High-Level Sensor. Model: Other(specify equipment type and model in Section E on page 2). Other(specify equipment type and model in Section E on page 2). Dispenser I D: 1 -4 Dispenser ID: ®Dispenser Containment Sensor(s) Model:VR 208 Dispenser Containment Sensor(s) Model: RI Shear Valve(s). Shear Valve(s) ElDispenser 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 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 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/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): PATRICK M PFRANG Signature: Certification No.: A29052 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: 12/09/2010 Monitoring System Certification Page 1 of 3 I IIIIIII VIII III IIII 04 Based on CA form dated 03/08 IE Monitoring System Certification Site Address 4647 WILSON ROAD Date of Testing/Service: 12/09/2010 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? 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 �X Yes E]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) ❑ Sump/Trench Sensors; ❑X Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ❑X Yes Ej No Yes ❑No• ❑X NIA 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? Yes* MX 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. QX Yes [:]No• Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports,if applicable. MX Yes ❑No• Is all monitoring equipment operational per manufacturers'specifications? 'In Section E below,describe how and when these deficiences were or will be corrected. E. Comments: Page 2 of 3 Based on CA form dated 03/08 Monitoring System Certification Site Address: 4647 WILSON ROAD Date of Testing/Service: 12/09/2010 F. In-Tank Gauging /SIR Equipment ❑x 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: 0 Yes ❑No• Has all input wiring been inspected for proper entry and termination,including testing for ground faults? ❑x Yes ❑No• Were all tank gauging probes visually inspected for damage and residue buildup? ❑x Yes ❑No' Was accuracy of system product level readings tested? El Yes ❑No• Was accuracy of system water level readings tested? M Yes ❑No' Were all probes reinstalled properly? QYes ❑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? ❑X Yes ❑No ❑N/A (Check all that apply)Simulated leak rate: x❑ 3 g.p.h❑0.1 g.p.h E]0.2 g.p.h X Yes ❑No Were all LLDs confirmed operational and accurate within regulatory requirements? X Yes ❑No• Was the testing apparatus properly calibrated? ❑Yes ❑No• ©NIA For mechanical LLDs,does the LLD restrict product flow if it detects a leak? M Yes ❑No' ❑N/A For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? ❑x Yes ❑No• ❑N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? 0 Yes ❑No' ❑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• ❑N/A For electronic LLDs,have all accessible wiring connections been visually inspected? MYes ❑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 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 farm to report results for all components tested. The completed form, written test procedures, 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 #16549, MKT 2368 DateofTesting: 12/09/2010 Facility Address: 4647 WILSON ROAD , BAKERSFIELD, CA, 93309 Facility Contact: Manager I Phone: (661) 833-0732 Date Local Agency Was Notified of Testing : 11/30/2010 Name of Local Agency Inspector(if present during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: PATRICK M PFRANG Credentials: CSLB Licensed Contractor SWRCB Licensed Tank Tester License Type: tank tester License Number: 051590 Manufacturer Training Manufacturer Component(s) Date Training Expires OPW Fill bucket 06/10/2012 3. SUMMARY OF TEST RESULTS Not Repairs Not Repair Component Pass Fail Tested Made Component Pass Fail Tested Made— Spill Box 1 REG FILL ❑ ❑ ❑ ❑ ❑ ❑ ❑ Spill Box 2 PRE FILL X ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ El El El 1:1 El El E ❑ I ❑ I ❑ ❑ 0 0 0 ❑ ❑ ❑ I ❑ ❑ ❑ ❑ ❑ El- El El El El El El E El I El I F El El El El E El I El I El El El El ED E El El El El F-1 El El El El El El F1 If hydrostatic testing was performed,describe what was done with the water after completion of tests: Left buckets on site for 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: � �/ � Date: 12/09/2010 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(if applicable),should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: 7-ELEVEN #16549, MKT 2368 DateofTesting: 12/09/2010 Facility Address: 4647 WILSON ROAD , BAKERSFIELD, CA, 93309 Facility Contact: Manager I Phone: (6 61) 833-0732 Date Local Agency Was Notified of Testing: 11/30/2010 Name of Local Agency Inspector(if present during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: PATRICK M PFRANG Credentials): ❑CSLB Contractor E ICC Service Tech. E SWRCB Tank Tester ❑Other(Specify) tank tester License Number: 051590 3. SPILL BUCKET TESTING INFORMATION Test Method Used: [K] Hydrostatic ❑ Vacuum ❑ Other Test Equipment Used: Tape measure Equipment Resolution:Visual Identify Spill Bucket(By Tank 1 REG FILL 2 2 PRE FILL 3 4 Number,Stored Product, etc) Bucket Installation Type: ❑Direct Bury ❑Direct Bury ❑Direct Bury ❑Direct Bury ❑Contained in Sump ❑ Contained in Sump ❑ Contained in Sump ❑ Contained in Sump Bucket Diameter: 12 12 Bucket Depth: 13 .5 13.5 Wait time between applying 10 min 10 min vacuum/water and starting test: Test Start Time(TI ): 091 0 916 Initial Reading(RI ): 7.75 7.75 Test End Time(TF ): 1016 1016 Final Reading F ): 7.75 7.75 Test Duration: 1 hr 1 hr Change in Reading(R F-RI ): 0 0 Pass/Fail Threshold or 0 Loss 0 Loss Criteria: es lt. s ail ®Pass - ail ��Pass � ail 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: 12/09/2010 I State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements Work Order: 3179461 (ESO)dr.(ESV)Tcsting FoQm-Varsion I-6725!2007 Emergency Shut Off (ESO) & Dispenser Emergency Shutoff Valve (ESV) ANNUAL TEST RECORD LOCATIONS AND TEST DATA Testing Company, TXA1A"'t/O Date: /O Location Name: store stat:ID#: Address: Vo&g7 k/!e-.S©�t/ City: cAc te: Emergency Shut Off(ESO) Testing Results On 0-9-W 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: iEmergency Shut Off(ESO) If No,Provide 6 Operational? Y Maintenance Log# Date Called Dispenser Emergency Shutoff Valve (ESV) Testing Results On 19-—9—/O in accordance with NFPA 30A this representative tested the automatic-closing feature of the Dispenser Emergency Shutoff VALVE(S)(ESV)located in the supply lines at a base of each individual island type dispenser indicated on the diagram below.Each device{#) _in all, would automatically close.Findings listed below: Disp.Emergency Shut Ofd' If No,Provide Valve(ESV)Operational? �JNN Maintenance Log# Date Called: Site Map Of Location and Placemm ni or Devi=Tested: SEE �i.46ltr9s-� Sianature Of Representative: " Tanknology Inc. 11000 N.MoPac Expressway,Suite 500,Austin,Texas 78759 SITE DIAGRAM i Ten/ar> bogy 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759 (512)451-6334 FAX(512)459-1459 TEST DATE: 12/09/10 WORK ORDER NUMBER3 17 94 6 1 CLIENT:7-ELEVEN, INC. SITE: 7-ELEVEN #16549, MKT 2368 Breakers DROPTUBE TLS FLAPPER #1 ESO VALVES L3 z L4 #2 L5 SUP I OA OV F STP i REG #3 �` I OA OF STP • 1 #4 L6 L1 L2 Mid grade tank still underground. All tank components have been VENT removed. Tank and tank W sumps filled with dirt and S N CAS gravel. Printed 12/20/2010 08:38 ACRAMER ATG Information Work Order# 3179461 150301 DEC 9,2010 11:59 AM #1:235053 7-11 16549 150302 DEC 9,2010 11:59 AM #2:4647 WILSON RD 0 150303 DEC 9,2010 11:59 AM #3:BAKERSFIELD,CA93309 0 0 150304 DEC 9,2010 11:59 AM #4AO369053005001 0 151700 DEC 9,2010 11:59 AM SYSTEM TYPE AND LANGUAGE FLAG SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH SYSTEM DATE/TIME FORMAT MON DO YYYY HH:MM:SS xM 0 150F00 DEC 9,2010 11:59 AM MON DO YYYY HH:MM:SS xM 0 ❑ 110200 DEC 9,2010 11:59 AM 235053 7-1116549 4647 WILSON RD BAKERSFIELD,CA93309 A0369053005001 SYSTEM CONFIGURATION SLOT BOARD TYPE POWER ON RESET CURRENT 1 4 PROBE/G.T. 163939 163604 2 INTERSTITIAL BD 202264 201942 3 PLLD SENSOR BD 3920 3923 4 UNUSED 9888531 9871253 5 UNUSED 9873953 9852473 6 UNUSED 9866404 9853699 7 UNUSED 9860919 9853128 8 UNUSED 9860731 9845228 9 RELAY BOARD 15014 15000 10 PLLD POWER BD 101105 101030 11 UNUSED 9869199 9857636 12 UNUSED 9861086 9849630 13 UNUSED 9867051 9849123 14 UNUSED 9856206 9649693 15 UNUSED 9865111 9848911 16 UNUSED 9864444 9849186 3179461 ATG Information Work Order# 3179461 COMM 1 ELEC DISP INT. 101382 101375 COMM 2 ELEC DISP INT. 101212 101095 COMM 3 SERIAL SAT BD 487578 486460 COMM 4 UNUSED 9870825 9859643 COMM 5 RS485 SERIAL BD 68773 68752 GOMM 6 MT COMM BOARD 413426 412442 160100 DEC 9,2010 11:59 AM TANK CONFIGURATION DEVICE LABEL CONFIGURED 1 RUL ON 2 PUL ON 3 OFF 4 OFF 160200 DEC 9,2010 11:59 AM TANK PRODUCT LABEL TANK PRODUCT LABEL 1 RUL 2 PUL 3 4 160300 DEC 9,2010 11:59 AM TANK PRODUCT CODE TANK PRODUCT LABEL 1 RUL 1 2 PUL 3 3 3 4 4 ❑ 160400 DEC 9,2010 11:59 AM TANK FULL VOLUME TANK PRODUCT LABEL GALLONS 1 RUL 10018 2 PUL 10018 3 0 4 0 160700 DEC 9,2010 11:59 AM TANK DIAMETER TANK PRODUCT LABEL INCHES 1 RUL 109.00 2 PUL 109.00 3 0.00 4 0.00 160900 DEC 9,2010 11:59 AM TANK THERMAL COEFFICIENT TANK PRODUCT LABEL 1 RUL 0.000700 2 PUL 0.000700 3179461 ATG Information Work Order# 3179461 3 0.000000 4 0.000000 0 161200 DEC 9,2010 11:59 AM TANK MANIFOLDED PARTNERS TANK PRODUCT LABEL SIPHON MANIFOLDED TANKS LINEMAN IFOLDED TANKS 1 RUL NONE NONE 2 PUL NONE NONE 3 NONE NONE 4 NONE NONE 0 162100 DEC 9,2010 11:59 AM TANK LOW PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 RUL 900 2 PUL 900 3 0 4 0 162200 DEC 9,2010 11:59 AM TANK HIGH PRODUCT LIMIT TANK PRODUCT LABEL GALLONS . 1 RUL 9517 2 PUL 9517 3 0 4 0 162300 DEC 9,2010 11:59 AM TANK OVERFILL LEVEL LIMIT TANK PRODUCT LABEL GALLONS 1 RUL 9016 2 PUL 9016 3 0 4 0 162400 DEC 9,2010 12:00 PM TANK HIGH WATER LEVEL LIMIT TANK PRODUCT LABEL INCHES 1 RUL 1.5 2 PUL 1.5 162800 DEC 9,2010 12:00 PM TANK MAXIMUM VOLUME LIMIT TANK PRODUCT LABEL GALLONS 1 RUL 10018 2 PUL 10018 3 0 4 0 ❑ 162900 DEC 9,2010 12:00 PM 3179461 ATG Information , Work Order# 3179461 TANK DELIVERY REQUIRED LIMIT TANK PRODUCT LABEL GALLONS 1 RUL 1001 2 PUL 1001 3 0 4 0 ❑ 170300 DEC 9,2010 12:00 PM LIQUID TYPE SENSOR LOCATION TYPE 1 RUL ANNULAR TRI-STATE(SINGLE FLOAT) 2 RUL STP SUMP TRI-STATE(SINGLE FLOAT) 3 SUL ANNULAR TRI-STATE(SINGLE FLOAT) 4 SUL STP SUMP TRI-STATE(SINGLE FLOAT) 5 DISPENSER 1-2 TRI-STATE(SINGLE FLOAT) 6 DISPENSER 3-4 TRI-STATE(SINGLE FLOAT) 7 TRI-STATE(SINGLE FLOAT) 8 TRI-STATE(SINGLE FLOAT) 178500 DEC 9,2010 12:00 PM PRESSURE LINE LEAK TANK NUMBER LINE TANK NUMBER Q 1:RUL 1 Q 2:SUL 2 Q 3: NONE 172900 DEC 9,2010 12:00 PM 172A00 DEC 9,2010 12:00 PM 172B00 DEC 9,2010 12:00 PM 172C00 DEC 9,2010 12:00 PM 161500 DEC 9,2010 12:00 PM TANK PRODUCT LABEL METER DATA 1 RUL YES 2 PUL YES 3 NO 4 NO 190200 DEC 9,2010 12:00 PM SOFTWARE REVISION LEVEL VERSION 329.02 SOFTWARE#346329-100-C CREATED-09.07.01.16.29 S-MODULE#330160-162-A SYSTEM FEATURES: 3179461 ATG Information Work Order# 3179461 PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS CSLD BIR PLLD 0.10 AUTO 020 REPETITIV W PLLD 0.10 AUTO 0.20 REPETITIV 120600 DEC 9,2010 12:00 PM 235053 7-11 16549 4647 WILSON RD BAKERSFIELD,CA93309 A0369053005001 TANK ALARM HISTORY TANK 1 RUL HIGH WATER ALARM DEC 9,2010 9:52 AM OVERFILL ALARM DEC 9,2010 11:02 AM DEC 2,2010 12:07 AM NOV 8,2010 8:41 PM LOW PRODUCT ALARM DEC 9,2010 9:49 AM SUDDEN LOSS ALARM DEC 9,2010 9:47 AM NOV 3,2010 12:56 PM HIGH PRODUCT ALARM DEC 9,2010 11:04 AM INVALID FUEL LEVEL DEC 9,2010 9:49 AM PROBE OUT DEC 9,2010 11:07 AM DEC 9,2010 9:48 AM HIGH WATER WARNING DEC 9,2010 9:52 AM DELIVERY NEEDED DEC 9,2010 9:49 AM TANK 2 PUL HIGH WATER ALARM DEC 9,2010 9:50 AM OVERFILL ALARM DEC 9,2010 10:58 AM LOW PRODUCT ALARM DEC 9,2010 9:46 AM SUDDEN LOSS ALARM DEC 9,2010 9:47 AM HIGH PRODUCT ALARM DEC 9,2010 10:59 AM INVALID FUEL LEVEL DEC 9,2010 9:47 AM PROBE OUT DEC 9,2010 11:01 AM DEC 9,2010 9:45 AM HIGH WATER WARNING DEC 9,2010 9:49 AM DELIVERY NEEDED DEC 9,2010 9:46 AM MAX PRODUCT ALARM DEC 9,2010 10:59 AM GROSS TEST FAIL SEP 23,2010 223 AM 130200 DEC 9,201012:01 PM 235053 7-11 16549 4647 WILSON RD BAKERSFIELD,CA93309 A0369053005001 LIQUID ALARM HISTORY REPORT 3179461 ATG Information . Work Order# 3179461 SENSOR LOCATION 1 RUL ANNULAR DEC 9,2010 9:29 AM SENSOR OUT ALARM DEC 9,2010 9:23 AM FUEL ALARM JUL 1,2009 8:03 AM SETUP DATA WARNING 2 RUL STP SUMP DEC 9,2010 9:29 AM SENSOR OUT ALARM DEC 9,2010 9:22 AM FUEL ALARM AUG 3,2010 9:24 AM FUEL ALARM 3 SUL ANNULAR DEC 9,2010 9:29 AM SENSOR OUT ALARM DEC 9,2010 9:24 AM FUEL ALARM JUL 1,2009 8:03 AM SETUP DATA WARNING 4 SUL STP SUMP DEC 9,2010 9:29 AM SENSOR OUT ALARM DEC 9,2010 9:24 AM FUEL ALARM AUG 3,2010 9:10 AM FUEL ALARM 5 DISPENSER 1-2 DEC 9,2010 9:29 AM SENSOR OUT ALARM DEC 9,2010 925 AM FUEL ALARM AUG 3,2010 9:09 AM FUEL ALARM 6 DISPENSER 3-4 DEC 9,2010 9:29 AM SENSOR OUT ALARM DEC 9,2010 9:26 AM FUEL ALARM AUG 3,2010 9:10 AM FUEL ALARM 138200 DEC 9,2010 12:01 PM 235053 7-11 16549 4647 WILSON RD BAKERSFIELD,CA93309 A0369053005001 PRESSURE LINE LEAK ALARM HISTORY REPORT 0 1:RUL DEC 9,2010 9:36 AM PLLD SHUTDOWN ALARM DEC 9,2010 9:36 AM GROSS LINE FAIL DEC 9,2010 9:29 AM PLLD SHUTDOWN ALARM DEC 9,2010 9:26 AM PLLD SHUTDOWN ALARM DEC 9,2010 9:25 AM PLLD SHUTDOWN ALARM DEC 9,2010 9:23 AM PLLD SHUTDOWN ALARM DEC 9,2010 9:22 AM PLLD SHUTDOWN ALARM AUG 3,2010 924 AM PLLD SHUTDOWN ALARM AUG 3,2010 9:10 AM PLLD SHUTDOWN ALARM AUG 3,2010 9:09 AM PLLD SHUTDOWN ALARM 0 2:SUL DEC 9,2010 9:42 AM PLLD SHUTDOWN ALARM DEC 9,2010 9:42 AM GROSS LINE FAIL DEC 9,2010 9:29 AM PLLD SHUTDOWN ALARM DEC 9,2010 9:26 AM PLLD SHUTDOWN ALARM DEC 9,2010 9:25 AM PLLD SHUTDOWN ALARM DEC 9,2010 9:24 AM PLLD SHUTDOWN ALARM DEC 9,2010 9:24 AM PLLD SHUTDOWN ALARM SEP 23,2010 2:23 AM PLLD SHUTDOWN ALARM AUG 3,2010 9:10 AM PLLD SHUTDOWN ALARM . AUG 3,2010 9:10 AM PLLD SHUTDOWN ALARM 3179461 fr Manknology 11000 N. MoPac Expressway,Suite 500 Austin,Texas 78759 Phone: (512)451-6334 Fax: (512)459-1459 Date Printed and Mailed: 12/20/2010 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR CRAIG PERKINS 1501 TRUXTUN AVE. BAKERSFIELD, CA. 93301 Test Date: 12/09/2010 Order Number: 3179461 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: 7-ELEVEN #16549, MKT 2368 4647 WILSON ROAD BAKERSFIELD, CA. 93309 Testing performed: Leak detector tests Line tests Monitor Certification Secondary Containment-Spill Container Sincerely, -b oprv, KAY Dawn Kohlmeyer Manager, Field Reporting �� TANKNOLOGY.CERTIFICATE OF TESTING 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759 TELEPHONE(512)451-6334 FAX(512)459-1459 PURPOSE: COMPLIANCE TEST RESULT SUMMARY REPORT TEST DATE: 12/09/10 WORK ORDER NUMBER: 3179461 CUSTOMER PO: CLIENT: 7-ELEVEN,INC. SITE:7-ELEVEN#16549,MKT 2368 P.O.BOX 711 4647 WILSON ROAD DALLAS,TX 75221 BAKERSFIELD,CA 93309 Manager (972)828-7908 (661)833-0732 TEST TYPE: TLD-1 Product Pipe Ti htness Test Results UN I BIN DEL R FACT RESU L RA Ph E ID PRODUCT MATE TYP g C A D F NC110 1 1 REG DNLEAD FIBERGLASS PRESSURE P 0.000 Y 2 2 PREMIUM FIBERGLASS PRESSURE P 0.000 Y Existina Line Leak Detector Test ISTINGjL s DETECTOR#'I MEX TIN L EAKtDIN RESU MA Q•EL# RU1L S T I 1 1 VAPORLESS ELECTRONI 108123 P 2 2 VEEDERROOT ELECTRONI 200875 P New Replacement Line Leak Detector Test Ir T hip UNE MAN= ER FMODEL SERIAL# RESUL MANUFA- RER MODE # SERU\L RESUL ID For owner detailed report information,visit www.tanknology.com and select On-Line Reports-WRAP,or contact your local Tanlmology office. Tester Name:PATRICK M PFRANG Technician Certification Number:1590 Printed 12/20/2010 08:38 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS i Tanknobgy TEST DATE:12/09/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3179461 CLIENT:7-ELEVEN, INC. AUSTIN,TEXAS 78759(512)451-6334 SITE:7-ELEVEN #16549, MKT 2368 i4NK INFO Mq ON Tank ID: 1 1 Tank manifolded: No Bottom to top fill in inches: 109.0 Product: REG UNLEAD Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 10,018 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 109.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 251 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW STEEL Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS ANKTESTRESULTS es Meth d:vacuTee O ST SU es method LDT-5000 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: ELECTRONIC Test time: S/N: 109123 Inclinometer reading: Open time in sec: VacuTect Test Type: NOT Holding psi: Resiliency Cc: NOT VacuTect Probe Entry Point: TESTED Test leak rate ml/m: 189.0 TESTED Pressure Set Point: Metering psi: 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 TEST RESULTS eS typ2' TLD-1 LINE A C D Material: FIBERGLASS Diameter(in): 2.0 Length (ft): 40.0 Test psi: 50 Bleedback cc: 0 Test time(min): 30 NOT NOT NOT Start time: 10:01 TESTED TESTED TESTED End time: 10:31 Final gph: 0.000 Result: PASS Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: YES Printed 12/20/2010 08:38 INDIVIDUAL TANK INFORMATION AND TEST RESULTS Mi Tan1vnobqy TEST DATE:12/09/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3179461 CLIENT:7-ELEVEN, INC. AUSTIN,TEXAS 78759(512)451-6334 SITE:7-ELEVEN #16549, MKT 2368 TAN INFORM'ARION Tank ID: 2 2 Tank manifolded: No Bottom to top fill in inches: Product: PREMIUM Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 10,018 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 109.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 251 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW STEEL Installed: ATE Stage II vapor recovery: ASSIST CP installed on: COMMENTS TAN TEST RESULTS est Meth d:Va u• ee L DE CTOR ST RES LTS Tes ethed' - 0 Dipped Water Level: Start(in) End(In) New/passed Failed/replaced New/passed Failedireplaced Dipped Product Level: L.D.#1 L.D.#1 L.D.#2 L.D.#2 Probe Water Level: Make: VEEDERROOT Ingress Detected: Water Bubble Ullage Model: ELECTRONIC Test time: S/N: 700875 Inclinometer reading: Open time in sec: VacuTect Test Type: NOT Holding psi:Resiliency cc: NOT VacuTect Probe Entry Point: TESTED Test leak rate ml/m: 189.0 TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: 3.00 Water table depth in inches: Results: PASS Determined by(method): Result: COMMENTS COMMENTS u TES RES T IN A B D Material: FIBERGLASS Diameter(in): 2.0 Length (ft): 40.0 Test psi: 50 Bleedback cc: 0 Test time(min): 30 NOT NOT NOT Start time: 10:01 TESTED TESTED TESTED End time: 10:31 Final gph: 0.000 Result: PASS Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: YES Printed 12/20/2010 08:38