HomeMy WebLinkAboutFMC 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. A separate certification or report must be
prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided
to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems
within 30 days of this date.
A. General Information IIIIIIIIIIIIIIIIIIII 11
Facility Name: Shell IE Bldg.No.:
Site Address: 4700 Coffee Road City: Bakersfield Zip: 93308
Facility Contact Person: Matt Jeffries Contact Phone No.: 661-496-7006
Make/Model of Monitoring System: Gilbarco EMC Date of Testing/Servicing: 8/19/2010
B. Inventory of Equipment Tested/Certified
Check the appropriate oxesto Indicate specl0c equipment inspected/serviced:
Tank ID: 10000 gal.Regular(North) Tank ID: 10000 gal. Regular(South)
Ex-] In-Tank Gauging Probe. Model:847390-107 [x] 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 [x] Piping Sump/Trench Sensor(s). Model: 794380-208
Ex] Fill Sump Sensor(s) Model:794380-208 U Fill Sump Sensor(s). Model: 794380-208
Q
x Mechanical Line Leak Detector. Model:FX1 V [x] Mechanical Line Leak Detector. Model: FX1 V
❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model:
[x] Tank Overfill/High Level Sensor. Model:OPW-61-SO [x] Tank Overfill/High Leval Sensor. Model: OPW-6I-SO
❑ 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: 10000 gal.Super Tank ID: 10000 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 [] Annular Space or Vault Sensor. Model: 794390-420
[x] Piping Sump/Trench Sensor(s). Model:794380-208 [x] Piping Sump/Trench Sensor(s). Model: 794380-208
[x1 Fill Sump Sensors(s). Model:794308-208 [x] Fill Sump Sensor(s). Model: 794380-208
n Mechanical Line Leak Decector. Model:FX1 V U Mechanical Line Leak Detector. Model: FX1 DV
❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model:
[x] Tank Overfill/High Level Sensor. Model:OPW-6I-SO [x] Tank Overfill/High Level Sensor. Model: OPW-6I-SO
❑ Other(specify equip.type and model in Sec.E on Pg.2) ❑ Other(specify equip.typs and model in Sec.E on Pg.2)
Dispenser ID: 1 &2 Dispenser ID: 3&4
P P _
xn Dispenser Containment Sensor(s). Model: 794390-420 [x] Dispenser Containment Sensor(s).Model: 794390-420
[x] Shear Valve(s). [x] Shear Valve(s).
❑ Dispenser Containment Float(s)and Chain(s). ❑ Dispenser Containment Float(s)and Chain(s)
Dispenser ID: 5&6 Dispenser ID: 7&8
[x] Dispenser Containment Sensor(s).Model: 794390-420 U Dispenser Containment Sensor(s).Model: 794390-420
[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 varify 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 S m Set-up Lx]Alarm st r report
Technician Name(print): Bryan A Self Signature:
Certification No: B37501 License No: 804904
Testing Company Name: Confidence UST Services,Inc. Phone No: 800-339-9930
Site Address: 4700 Coffee Road,Bakersfield,CA 93308 12 _Date of Testing/Servicing: 8/1912010
IIIIIIIIIIIIIIIIIIII
IE
A Results of Testing/Servicing
Software Version Installed: 329.00
Complete the following checklist:
[x1 Yes ❑ No* Is the audible alarm operational?
x Yes No* Is t e Visua a arm operationa?
x Yes ENo* Were all sensors visually inspected, functionally tested,and confirmed operational?
.Lj Yes ❑ No* Were all sensors installed at the lowest point of secondary containment and positioned so that other
equipment will not interfere with their proper operation?
Yes No* If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)
Hx 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❑Dispenser Containment Sensors
Did you confirm positive shut-down due to leaks and sensor failure/disconnected? [X] Yes; ❑ No;
UYes ❑ 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? 90 %
❑ Yes* [X] No Was any monitoring equipment replaced?If Yes, identify specific sensors,probes,or other equipment
replaced and list the manufacturer name and model for all replacement parts in Section E,below.
❑ Yes* E No Was liquid found inside any secondary containment systems designed as dry systems?
F] Product; ❑ Water. If yes,describe causes in Section E,below.
x No* I Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports, if applicable.
LxJ Yes 10 No* I Is all monitoring equipment operational per manufacturer's specifications?
*In Section E below,describe how and when these deficiencies were or will be corrected.
E. Comments' The 91 (Super)Relay kept sticking and needs to be replaced
F. In-Tank Guaging/SIR Equipment: ❑ 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:
U Yes ❑ No* Has all input wiring been inspected for proper enter and term ination,including testing for ground faults?
• 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?
_jxj Yes No* Were all probes reinstalled properly?
E Yes ❑ No*I Were all items on the equipment manufacturer's maintenance checklist completed?
* In the Section H,below,describe how and when these deficiencies were or will be corrected.
G. Line Leak Detectors (LLD): ❑ Check this box if LLD's are not installed.
Complete the following checklist:
Lx] 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.; 00.2 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?
U Yes For mac anical LLD's, does the LLD restrict product flow if it detects a leak?
F-1Yes #LN/A
No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a leak?
Lx] 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
U N/A malfunction or fails a test?
❑ Yes ❑ No* For electronic LLD's,have all accessible wiring connections been visually inspected?
U N/A
x Yes No I Were all items on the equipment manufacturer's maintenance checklist completed?
* In the section H,below,describe how and when these deficiencies were or will be corrected.
H. Comments:
C'01`11`IUNICiil'10112, RETUP
S :pl '.;rTup - - - - - - - - - - - -
"Lr, 19. 2010 7:42' FAM
PORT 8071 PICS:
HKOUK-111E MiiRKET (1101111.1 1301ARD : "I (EDII-I
- RE, .16-
a7f
I ELT? ('A 932CIO
t;I ENt-,L I SH (7101"Im BOARD 5
AUC, 19. '20 10 7 42, All S"STEP11 rjA*j*F,-.-rn"q- rm,wr RAUD RATE ;1600
11614 DD PAR['I'll NONE
t;POOES I DE M4RI:E,r !;TOP �f IT I S-TOP
4700 COFFIE RD WrA LENO'I'li: El DATA
PAKE'P2FIF1.1) CA 9ZI'2138 SECURITY'
'ODE ".- VISA81-6
ALL I'l.111K-l"JONS NORMAL
2H)F*r Timr- I I :i3o Am 170mm BOARD 6
1 NVENTORY REF')RT riALILO RATE 9600
SHIFT T INE 2 T)I SABLED
.3HIFT TIME 3 11 1 SABLED PARIPI NONE
SHIFT TIME 4 11 1 SABLED TOP B I T I STOP
VATA LE(X-1'H: 8 DATA
C-AL.` 'r�Am,, Pi�R T1 6T NEEDED IAIRN
D
UI-LtAC�C 5902 GALS D I B L E D i,*000 : D IS'ABLE'
901. ULLAGE- 48B6 CAL:
'17, VOLUME d2a;3 GALS T�)N), A 1111 TS*r NLEXIED WRN
HE:I CIFfl, 11 .74 1 NCHES DISABLED i-%UT0 TkHNSII IT 2ETT I P4('.,i;:
WwTEA' %)OL e Ci GALS LINE RE-ENAN.E METHOD
WATER 0.CIO I NCHE.'i PASS) L I NE TEST AUTO LEAK ALARM LINIT
TEMP 93.5 DEC F r'I -.✓PLED
L I NE PER TST NEEDED WRN AUTO HIC.H WATER LIMIT
DISABLED DISABLED
T 2:11NI.5-iDEC, SOUTH AUTO OVERFILL LIMIT
voLuc . 6r,91 GALS LINE ANN TST NEEDED LIPN I)ISABLED
LILLt-iGE . 2461 GALS 1)1 SABLED AUTO I-Ow PRODUCT
2.145 GAL.° PRINT T1' VOLUMES DISABLED
Tt7' VOLUME - 6554 C4mL.;' ENABLED- AUTO THEFT LIMIT
11CAGHT - 1 I,C�IES 1)ISABLED
WATER VOL - 0 CIALP, TEMP i,'• l-lP•ENr,ATION AUTO DELIVERY START
WATER . C).CIO I[It',HES VALUE t DE,:: F I : 60.0 Cr I SAIIII-ED
Trj,IP . 69.0 DEC; F STICX HEIGHT OFFSET AUTO DELIVER".' END
2ABLED
DISABLED D1
E-2
T 2:01,11.&N EL, NORTH ULI-mCE: 90% D AUTO I.%)BI-ED cTERNAL INPUT ON
VOLUML . 6788 0".1 Ls H-PROTOA OL DATA Foou-)'r AUTO WrEMAL I NPUT OFF
ULLAC;E . q364 .ALPi HEIGHT DISABLED
6 GALS 15AYLIGKF SAVING TINE AUTO SV12OR FUEL ALAFI-I
TC vot.LwE ,17 ci4i-s D I SABLED DISABLED
HCI CHT 60.71 1 N1'HES C ALITO SENSDR WATER Ab-APPI
PE-DIRET LOCAL PP
WATER VOL 0 CAl-S DISABLED DISABLED
WATER 1 .00 I NC H I-'-' AUTO SENSOR OUT HLAF.11
TrJ1F' C0.4 DEC F EUP0 PROT017'OL PREFIX DISABLED
VOLMIE r-i' 0 Ci-%LS;
-M t'!'Et7'IJP ITY
LILLA%'E- '."17 1 C. GALS ;ODE OurIGLIIJ
Tf� VOLUME = 5229 CALS
HE I CHT - 50.43 1 fqt'HES MAINTENANCE HISTORY
111;irER VOL - 12 (;ALS PS-232 END OF 1`0`,& CE
DISABLED
WATER . 0.77 1 NCHES 1',1 S;IBLE D
TRIP - 11U.4 05 F
TANK CHART ..,E(,IJRir/
END b I SABLED
CUIS,TOM tiLmR1,13-
D I SABLED
SERVI,"E NOTICE
DISABLED
1130 '116b i.N)UNTPY
COPE:
Mi SS LiEltilTY
DISABLED
T r:I,INLG6iDED :SOUTH T 2•UICEADED NORTH
C'p,L}C�;U4:I` l:f)DE Ci
THERM LiL GOEFE :.,OCIFJ?00. THERHAL...UORFF 0190 700
T 1 :C l E:�EL TANK D I POETFR 95.75 TAN! D 1riliETER 95.•'75
PPOD0,7 Ct,LI: 1 TANK PFc7FIL) t PT s 1�aiVK .F--KOFiLE. 1 PT
THISP.f A;L. COEFF : .000045 F11L1 •'VOL I CJ.!'S FULL VOL i 018
TAN1; L I mMETER 95.75
TANJI. PROP I LE' 1 PT FLUAT• Sd-zE: 4.U: IN.
FULL VOL 1015c 1?iUAi .�r2E: d.0 IIV.
'.WATER WARNING . : 0 1..
HATER WARN 1'Nu 2:0
F:.0FAT SIZE: 4.L-1 IN. HI H 'WATER LMit: 3..0 Hlta}I• WATER.LIMIT:: 3.0
i,t,i'CEk
WARN ARN I NG 2.0 MA:t •Gk LABEL, VOL, 1 Ll!5 1IArt'.pR. LABEL. VOL:, 1'01'6;6'
HIGH WATER LIMIT: 3.G GVEl?FILL. Ld�I1T'. y5�: MPFAL.L. LIMIT 9574
9.0A�i1, 9b4��
MAX, OR LABEL. VOL: 1015 H I i�H F�R�t}UC7 35 c HIGH PROM. T' 95'
OVERFILL. LIMIT qs;i 9 ''1`'1
.96,11
9644 DELIVEPY L],Pi:l riFL fVERY LLMIT 5X
H l H PROEM 71' 507.
� 0?)
9644 LC•W;.PRODUCT 500 r, SUG,
1'CL I VERY LIMIT 5% LOCI ,PROL.UCT
50i L:Ekl ALARM- L.INfT: '9s LEA ALARM' LIMIT: 99
SUPI)EN L0GS'Li M J T;: '99 SUDDEN,.LG;`3 L I P911 : 99
101AJ }rkGDll�i' 500 CANY Tt--LT O.,SD "IRi�11:; 'CELT 0.,70
LEAK HI..ARM LIMIT': 94 ill O}iE OFFSET 0.00' t,Rr k .OFFSET 0.00
SUDDEN LIMIT: 9y
TmNK TILT 0-.90 ."JPHON MAN1F'tLDED THNKS.
PROrIE OFFSET 0.00 SIPHON MAN I FOLDF..D TANKS
Tti.: NONE T,U: NONE
L NE MAN IFOLDED .TANVS L.I I r hiFihlL)0LDE1? "I`khJp
I PHON m/.-N I FOLDED TAN};!; T,11:: NONE T.g.:. NONE
Tit:. NONE
LINE h'AN I FOLDED 1'r1(yl: " I..EHK: M I N F'ER'I DD G: OY
TO: NOME 0 LEAP MIN PFRIGDIC•: 04s
0
LEAK Ci l N PCR I OD I!.: Cc:, d..EAi: 1.1 I IV ANNUAL ;. IN LEAK MI-N ANNUAL 140
0 Vol 1.01
101 ;PER 1 OD 1 C.,TES'T. T'VPE•6 PPERAj*D 1 t:
11 1,CK� �TUI•i�};
JE:RJ001C: 'PEST TYPE i;fdlVUr L TE,�;r. FA`IL.- ,ANNU44b 'TE.ST. FA11
ODIC 1-; ALARM D;1266L.Er� ALAtyhl 1ASAELED.
AfVfVUr�I.. TEST. FA 1 L. PER I.'+L I u 'H`y;T .F+',I'I N.I'12:i4: 1).: T h�1.I.G
riLt+R'I`I L I ti�F_!LGL, ALARM D 1-:,i, l ALARM DT5.'jAFI FD
PER I on I TTfiT FAIL t�Kt;�:_L5 'fT 1'T' FAIL G.RCK," TE-T FAIL
ALAR11 D 19ABLED ALARM D 1 :ABLCID rIL:AR9 DISABLED
ED
3Rt:; TE ;T FAIL_ ANNV TEST' AVERAG''143: OFF ANN;:TI:2T (iVERAGI'NG: OFF
ALARM 012AULED PER TEST AVEPAuI-NG: OFF PER TE:3'I' AvEPAGLNG:. OFF
r"HN TEST AVEh'AL31 f*3 =F'F TANK TEST NOT'1FY. OFF TANK, IEST hIOTIPY bFF
PEFK TES r AVERAG I NC: OFF TNX- TS`I' S I PHOil 13PEAK:OP
TIVt: T1331' SIPHON BREhK-:G>FF
TANK TEST OVF DEL I VERY 1;)EL.AV 15 H I N
PUMP THRF2HOLD 10.00!; [3GL'1 VEC�'! DELAY 15 MIN 1�l
TNI: Tar :f FKom v-PEAK:0FF PUMP THRESHOLE, 1 Cr.L)a
DEL 1 VERY DELIAV 15 .N I N
PLIMP f HRESHGLU 10.13i i
LJQUI.U-wE1f$0R SETUP
FhUL)UC1' t~t)C+E - - - GUFF+U7` RELAY SL"CUF _ -
THERMAL COEFF : .0007.00 - - - -
7'l,hth I1114I1k FER 95.75 L 1 :REGULAR SOUTH
TANK PROFILE 1 PT TR t-STATE (S I IQLi: FLOAT I. R I.:REc ULAP SOUTH
FULL VOL : I0152 CATEMPV ANNULWSPAC.Ea TYPE:
STANDARD
1*RM4i;0' CLOSED,
171-0RT SIZE. 4.0 1N.
L 2:REGULAR, S0UTk1 TIANK ;tt: 2.
WATEk WMP.NING 2 0 TYd.-STATE (SdNGLE FLOAT)
H 1 C:H WTER LIMIT: 3.Q cArm(31a`t : P'i A Ne sil 1p
l td-T�}NK AL,FiRh1:s
!tilt_X OR LABEL VOL: 10152 T 2-.COW P.RMUCT .ALARM
OVERFiLL LIMIT 95% L 3'!REGULAR SOUTH
9644 TRI-:STATE '(SINGLE FLQAT> LIQUID SENSOR AL11S
1111:1( PF+.i71�UCT 95`.0 rrr1TEGC}RY :' 1'R` tJ11i� ALI;:° I+L"idK .OUT. ALARM
g6<1 I
DELIVERY LIMIT 5�: ISD c1TE ,ALIIF'tf1$
507 L 4:REGULAR NORTH T_$I) +1R0� PRA .FmI L
TR 1-S'T'ATE l 2.I IJt'il E �FLst?r�i), i SD DEGRD {�RLS FAIL'
1_31 J f Nt?F,Ui T 5vu CATF.WP: : ANNUL. R -SPADE i sti, VAPQk; LFf FA I'L
I_1i7t: tiLllRif I.1ttIT ?y 1S(Z VP PRE a- FAIL
:=I1i'jkld I,US:; LIMIT: 99 1 SD VP 6TKTUS' EA I L
TANIr T I LT 2.110 I SI). HOSE ALARI•IS
Nh0B OFFS ' 7.00 L 5:Rrc:U.?R NORTH .
TR 1-STATE 1S I NGLF' FLOAT) 'ALL`-FLOW OW'G(1Ll ECT FA 1'L
CATEGORY : 'P UYI NG. SUM?
-1 PHON h)N I FOLUEii TANJG vp l; A1_AR11:3
C1
T rt: NONE V P Ft�i I SS i NS. Fr31 t.
LINE I.1AN I FAL LED TANK: L G:REOULAR NORTH VP PREMME FAIL
TO: WO NE -TRI-STATE (S 1'NGLE FLOm I)
CATEGORY S'I'P :3UM!' R :J�EOULAP. NORTH
TiPE:
L.Fii): MIN PERIODIC: r1'r STAN tRD
0 L 7:SUPJ2EME, NORmRL:L:l CLOSED
TR1 STATE. (SI,t LE FLOAT).
LE W, 1-11 Pl ANNUAL i CATEGORY' :, ANNULAR 'SPAIGF TANK 0* a
101
LN tAM' AIAP.MS
PEI;I QD I U ' EIST TVPE L 8:SUPREME. T 3`:1..GW PRODUCT AI,NRM
(i01 CJ; TR I-81 ATE' '(S,I WLE FLOHT)
C••ATEORY, : PI P]NO Sl IP L l Lill) SENSOR' AL►'Ii'
HNI-Will_ TEST FAIL ALLL:SENSOR OUT ALARM
Ai-ARm III-SABLED L 9:SLIPPEJC I$D $1Tt ALARMS
PERIODIC. TEST FAIL. TRi.-STATE (SINt,Li~ 1=LOAT) ISD :GROSS PRES .FAtL
ALARM DISABLED CATEGORY : 'STI SUMP )SO UErRb PRF-S FiA l{..
1 SD=VAPO L.FAAI:,S 1,I L
19D VP PR)±'� Fr�'I L,
LA ISU•V}� STATUS FAIL
r:tLF;I>.Ih G 1�ABLE:L'� 1.10:C,�1 ESk:L
TR J-STATE (S 1 NGI E FLOAT)
F;Ni) TCaT AVERAC iNC:: OFF C,'lTEC*PY : .ANNULAR .SPA E I D ,HOSE'ALARMS
PER TC'.ST AVERAG i idC: OFF ALL:FLOW cOL'I ECT FAIL
TO NI: TEST 140T I FY: or-F lkfO,ALARMS
1.1 J :DIESEL Up "MjI$SJoNS FAIL
'fill; 1:317 �;I.PHON DREmV:CJFF TRI-STATE ,(SItiGLE FLOAT) VP PRESSURE FAIL
CA7'Ec:ORY : P I P.I NG SUMP
DELI VEW DELAY 15 1'11 PI R .�:?liPkCr"lE
T
PLUIP THRE SHULI+ : J 0.110% YPE
L 12:C+t�:FI. STpNBAAi]
'CR 1 NGLE FLOAT'i NOF WLLY`CL.05EL/
CATF-c30RY : STP 'SUMP'
I:I:3:ff 15�E1'iiiEk '1.-2
1'R I—STAT7 (:SINGLE ,FL.OIJT.)
cwrEGQRY :. A I SFsENSER PAN
I
JXAI'. TES'!- MFTi it7F+ f J-STATE- (;'3I Nt±l E t-L4AT)
CATEWR v, ': Ti1 SN1rNy1~Tt 'PAN
Tan, ON DrATE ALL 1•E•ri+l1!
O T 9. 2009
START TJME : Dlj�;A IXP {_I :iti1LPEbi`1 R .a-n
TEST RATE :Q.,C! C,/AL�Ht Tkt "s'lfiTE"iti°IN��LE rLUf�T"l:
f:Uk:�'f J 4tH I�QUidS" 0ATEGt?k.' .: ffI SPI=NS-8R PAN
Tti T El,;PLV E'T0P:D 1.5NhLRD
FORVIAT
NOPMHL L t 6:�t 1 SPIN ;ER ?-J
'fRI-wT(,TE (SIW.LE' FLOW)
CATEG0PY : .D]$PENSER PAN
TAN'll 13: 4 TAW a: NONE
EVF 1 SD SE 1'UP
1 N-Tmic mi-ARitk L I OU I D �:kN:30R Au1S
T 4:LOW PRODUCT ALHk1-9 L15:FUEL ALARM
EVR TYPE: £it-il.Allt E
L 1 OU I U ;FhJ.�:CSR ALf"c' R 8:111!3p '7-8
1. I :SENSOR Our ALmRt1 FYPE: BALANCE Nr,'7:�LE TWE
L 2:SEIt30 P OUT ALARM !TANDARD VST
L 3:SENSOR OUT ALARM NORMALLY CIA)SED
L 4:8EN6SOR OUT ALARM VAPOP. PROCEE;SOR 'r PE
L S:SENSOR OUT FlLARM TANK 13: NONE V&I' Vr-�PGR PRVi I SOR
L t+:SEICOR OUT ALARM
L 7:5ENSOF. OUT ►iLr-)RI
I. 3:SENSOR OUT ALARM L I Of I 1 D yENROP: ALMS ANALYSIS TIMES
L 9:SENE:OR GI•I'C ALARM 1.16:FUF-L. ALARM TIME: 1 U:00 AM
L10:SENSOR OUT ALARIl DELAY MINUTES: I
Ll1 ::SENSOR OUT ALARM R `':
L 12:SEN OR OUT ALARM TS/PE:
L13:SE14SOR OUT ALARM STANDAF.'L, ACCEPT HIGH ORVR
L W SENSOR OUT ALARM N0P.MHLLY CLOSED DISABLED
L l 6:SENSOR OUT ALARM TANK It: N,::SNE I SE) HOI:E TABLE
ISO SITE ALARMS 1D FP FL HL AiA RR
I SD GROSS PRE.S FAIL --
I SD DEC:RD PRES FA I i_ SE*Jl : SR ALVIS' 01 01 01 0*:� -01 UU
1:30 VAPOR LEAK FAIL AJ.l.:FUEL ALARM 0_ 02 02 02 01 UU
1SD VP PRES FAIL 03 0:3 03 02 0^- UU
I SD VP STATUS FA 11. R 1 D:V'. T t°ONTPOL OPEN 04 04 04 02 05- OU
TYPE: 05 OF 05 0? 03 UU
1:-;D 1131-,E AL ARI°IS VAPOR FFth:'GSSCSF 06 06 CIE. 0? 03 UU
ALL:FLOW r:OLLEt::T Frill. NORMALLY CLOSED 07 07 07 02 04 OU
OS OE OB 02 04 UU
PMT: hILAPHS NO ALAk1°1 1-`Fa`�1 GNh1El+IT: -
VF' E~MISS1()NS FAIL
VP PRESSURE FAIL 1 :D A I RFLOW METER MAP
R 1 1 :Vi'I' CONTPOL. GL OED 10 SERIAL NUM LABEL
R 4:D I CBEL TYPE: ----- - ---TYPE: : TFiIVDHhO 1 DISP 1-2 F
>"r+ IUL`iAkl'� NORMALLY CL.03E0 2 14945 DISP 3-4 F
NORMALLY U1.022C, ,r 25313 DISP 5-6 F
TANK d: NONE 4 24957 DISP 7-8 F
TAI'Jh p: I
I N-•TANK ALAR.ME; I':*.T) FUEL (;;R.ALIE HOSE MAP
!it-TriNh ALr-Ihl'1�; ALL:OVERFILL ALARM 1 3 4
'1' I :L.OLJ PROI!I.lCT AL,HRI-I ALL:H l GH PRC)D(J,::T ALARM FP 11HH MHH MHH MHH AA
1.1641.11 r, '8E=N:=0y mL!°I: U1 104 301 201 9 U 1
I, 1 :S1rNSOR OUT riLARM 02 102 30'2 20'2 `-+ U I
I. :SENE;i)R OUT ALARM i13 103 303 11011 U U
L,l G:SFIVSOR OUT Al-mRIM 04 l C14 304 204 U U 2
1-15 1 U5 305 205 U U 3
I SI71 S'I TE ALARMS 06 106 s06 "06 U Ll ;l
I SCE GROSS PRF:� FA I L 07 109 30? 21 07 4 LI a
I!;D DE6RD PPES FA t L 0B 1 013 3061 208 a U 4
121) VAPOR LEAF FAIL
ISD VP PRES FAIL
I ST, VP STATUS FA 1 L ;HART: 11116 ;R SETUP LABEL. TABLE
F.' S:iSI ;p 1 -2 1 : UNAS:SIGNED
T`,'F,E: = I :D I SF 1 '? FLOW r•M'ER ': BLENDzi
:,TANDAF.L1 i F�'CEt�i>R`;' m R FLOW HETEk 3: REGULAR
NORi'v"L1-V CLOSED 4: 1-11D GRADE
=':Dl SP -•1 FLOW IML-`rER Pi: PREMIUM
Tmill; it: NONE l:.ATEG'0R1' AIR FL01,:1 1.9ETER 6: GOLD
7: BRONZE.
t:D I�F• 5 t FLOW ME'ru: 8: SILVER
L1OUID SENSOR, r',LM.S C-HTEGt:RV r41R FLOW METER 9: BLEND2
1-13:FUEL ALARM 10: BLEND4
L. I :SENc*R Our ALAR11 s 4:DI:..P 7-i:: FLLW NIETEF
L 2:2ENSOR OUT ALAPH CATEGORV AIA FLOW METER
P. 6:0I SP 3-4 s 7:PREFiS IRE SENSOR
TYPE: GHTEGORV VAPOR PRESSURE
�:7'siNDARI-�
NOPHALL'C CLOSED
TANK o: I *JE
LIQUID SENSOR ALMS
L.1 u:FLIEL ALARM
ALL:SEIJSOR OUT AJ-ARIM
li 7:WSP 5-6
TYPE:
ST:ANDmPTs
NORMALLY GLOSEC'
1410 vL-'pS l om: 01 .02
---- IN-TANK ALARM - -- SENSOR ALARM
VAPOR PROC I:_' OR TYPE L t 'REGULAR SOUTH
W5'C 1iAPbk P'90 ES�01 C i:UNLFAGE> NORTH ANNU*LAR SPACE
SENSOR OUT ALARM
PR)CESSOR CONTROL LEVEL: OVERFILL ALARM AU0 18. 0-009 11 :32 Ali
FULL AUG &. 2010 2:80 AM
AUG 6, 2010 12:21. PM :FUEL ALARM
HA" RUNTIME M I NUTFS: 30 JUL 26, 201'0 8:.0'6 AM AUG .J k7. 2009 10:55 All-
ow
. 0.20Cr I NCHFS
OFF: -O.200 1 NGHES HIGH PROIDLCT ALARM
AUG 8. '2010 ?:,30 1111
AUG 6:: 2010 'i 2:,21 PM
JUL. 26. 2010 .8:06 AM
I KIALI'D FUEL LEVEL
AUG 18. 2009 9:X38 .AM'
PROBE OUT
F-iLAR1.1 HISTORY REPORT AUG IB. 2009 1;1 :.1.1 AI`1 E1VC?.'.m t .y ;t
AUG 18. 2409 9":'17 AM
_..---
T I :DleSEL LOW TEMP WARNING.
riUC 18. 2009 11 :k2 HM
C1�'t:k2f IL.I. h1.HRh1
AU 18. 21JI39 11 :00 ✓•11•I
1i t ;f l PPODUI::T ALARM
r4tnr; I6. 21005 I0:59 AM
I NVAL i L, FUEL LEVEL AlI APM H[STORY REPORT
ALN1 112. 2009 9:42 Ahl
PROBE OU'C L 2:IREGuLAR S7U'PH
AUG: I$, 20Q+ 1 1 :0 x' END r x }: PI P:1 Nu sUMP
S'02OR 0UT'.A1.ARPl
AUC I'S. 7009 11':33 HM
LOW T:7'IP 11AiRNI P6
Aw Is, '2t71i9 I I :113 -.m FUFL ARM
AUG Ib. z009 10: 3 HM
ALARM Ill ;TO t It 'POPT
____ lhl.--THINK f�L�iRi•1 -_,._..
END m
T 4:SUPRENE A +i END. *. K X + �.
OVERFILL ALARM
Atji3 It), faiag 11 :14 All,
HIGH PROLkLICT 'ALARM
AUU 18. 2009 11 :13 .AIM
l I'b,AL I h FUEL LEVEL
AUG 18. 2009 9:.49 AM
ALARM HISTORV REPOPT PROBE OUT
AUG 18: 2009 1 1 :1 6 HM i:t1 ARM AISTORY REPORT
---- 1 P1-TtANE ALARM --- - 14W IS. 2009 1:,1 :13 AM
AU{.:. 10. 2009 '.3.49 PJII SW30R. ALARM --- -
T `'_:UP1! ElitJ!?D.SOUTH L 3r:1'ECULAR SOUT-A
S;TP SU1)>
O' EPF,k LL ALARM SENE*R-OUT.ALARM
AL143 I I . 2010 P-55 AM AUG 03'. '20Lk9 1,1 :32:AM
JLJI.. 3Q. -"010 g:16,All
JI.IL 27.. 2010 8:27 AM FUEL ALARM
'fAff
H k i;H PP.c DW,1' ALAR11
AUx; J I . 2016 6:55 1.41
JUL 30. 2OI0 9:16 AM
JUL 27. -;Ol G 6:27 AM
F 1?c+EE OUT
AIX. IS. 009 11 ;07 AM
END. K x X jai ?i
END
141-4.1°1 H I sTCIT<v h 1;I'G p.T ALARM H is l'ORY PEPOR7
SERSOR ALARM
� - ALARM,. HIatt
PY -9EPvR T
ENSOR
L 4:RG ULAi 1110?TH L P _ gENSOk ALARM
ANNULAR SPACE ANNULAR SPA I Li T 16SEL
5EN-gOR: OUT ALARM 2Ea,130R OUT, AL ARM >t13ING --
-
�:UMF
AUCG 18, 2009 1 1:1;2 All AtL; 16.. x'1109 1 1 :32 AM FUEL ALARM
P ER 27.' ''201.0 2.:'15 Al°t
FUEL ALARM FULL ALAMI
AUG 1@. 2009 10:53 AM AIIG 1b. 2Q�1� 1,G:,51 �M FtIE1. ALARM
'1':1. 2010 4:45 PIM
,,_14S 3R 0Lrr r�C:fiR M
AUu 18. 2009 12':03 Pig
h 3r E14D x Y r
ALARM 111:"fvk`: REPORT tALt-PM H I:'TC}Wa" kEPOR"!
::Err�'t;;r hHLF;Tdhi --•--- _-°-_ ciEiVSi,77 liLiiklM -----
I 5:1;EGUI-AR NORTH L Et-:2UPRiEflE �,
1,I€,I Nc surly-' �1 F�l Plt ::::Ul1F AL'AP1 Ht�'1TCtR, REPORT
:=EtV�I R: OLIT ALARhI S,i IJCCSR �J-ur 'ALARM
003 18 210 9' la :3? Hhl Aui- 1.Ft., 2609 11 :•`_12 All, - rt�PiSOR AL ARM -.
FUEL, ALARM FLIEL 'AL,)RM _ 8TP SUMP
AIJ." 18- 2clocl 10 16 Atli ALIT I'S 2009 I'D.:07 All 8 N.-�GR OUT ALFIR,M
r1ii�; 15, 2009 12:03 Ff1:
�s>rIV'•tJF: £BUT ALARM
AUG 18,. •2009 i 1.`:3t1 rt�l
0J EL- ALARM
'1'10:?:7 AM
A. END
r ti :E � ,,. L'fVC� 'r. .t � � � :. ., .� .• EIIx� +�. ;: � r
AL.aRM H i STOP ` R1:I3.PT ALARM HISTORY REPORT
SENSOR al APH ._ ._ _ _-._-- SEM6R ALARM -----
L L-:PEC'ULAR NORTH L 9:SUPKk 112:'
1•P):' SLNMP "TO' SLIMP
:SENwvR t?Il1'-ALAPr•i `,ENSOI?•UUT ALARM
AUG 15: 2009 11 :32 AM AUt3 18. • '0,09 12:.03 PH
FUEL "LARrt SGhk'-fVR OUT ALtikk
AUG is. n00y W:'2113 AI-I AU(; 113. 2005 I1 ;3-0 AIM,
'FUEL ALARM .
1UG t 0,. ^_009 1 Ci:'30 mm
r .END ..
K .. n END
ALARI-1 IA I STORY REPORT' MARKET
MS-l'OF"I PEPORT 4700 (.Qf-FJE Rb
-- �-*,ENSOR ALARM CA 93:308
' ALApt'l lJf-:rjlSPEW*,EP
L 1�3:V I DISPENSER PtAN
!�PENSJ;.'R 1-2
F)12PEN,'ER PAN '�EWWR OUT ALARM ALIG 19, 2u 10 III -,f
SEI,r-*.(','R OUT .141.iAl• AUG 18. 2009 12:03 P11
AW 18. 2009 )2.:03 F*li SENSOR OUT RLARtl
ALA; 18. 2009 1 1 :Z30 ki 2','�;TFM ':lA'kTLlS- klhi•�*.*l
3-EW
SOR OUT ml-APM - - - - - - -
AW 18• 21 009 1 1 '3U Am
FUEL ALAFT-1 PILI- FUNCTIONS PIQF-tlml-
FUFL ALAR1,1 ALK. la. 21009 10:36 Pil
A10' 18. 2004 10:'<i mm
BROOKSIDE MARKET
END 4700 COME RD --3
CA 9aJij
END
HUG 19. .2-1)10 9:41.1 AM
Sysaoi ;,r,,Tu,3 REP,40'
L16:FUEL ALARM
i4APM HISTORY REPOR,r
tiLAPH HISTORY REPOPT SEr�•OR ALAKII -----
ml-AFM L.1 F�:1)1'SPENSER 7-8
111SPFNE'FF., PAN
L 14:Dl�,Pl-142ER J-4 FUEL ALAF.11
DISPENSER PAN JfAN 18. 2010 3.36 PM
OUT o4j-0,1
AW 18. 2009 12:W Pil FUEL AL-MR11
OUT ml-ARM Is. 21010 3:36 ptli --iENsOR 1LARN
j,j6:tlj!"PEljSER 7-8
muo 1*, '2009 1 1 ::40 w
FUEL ALARH DisrIENSER PAN
FUEL AU-00-1 JAN 1 . 2010 3:41 PM FUEL AILAFtl
19�A uC. 2,0 10
AUG IE:. 20oq 10::44 Am
END MAREET
X EjqD t:;01*,I-,I1: RD
.A 93308
-SGO-1330
19. -010 9:41 AM
SysTpi-i
-)PT
I-I
D 15'1'LrJ:?G:P, PAN
FULL HLmPri f'•ki,Ui.S i C1r ,1raR1:Er
- - '-ENc:�fr �1LI Rh1 ----- FL lE
AUG 19, e'01 Cl +::1^ r=U1 i.. 9:: UPREIIL" d 761) Ca; = RD
E:TP SLUIP GAI k cSF 1 ELP CA 9:3304
FURL MY)
HUG 19• 2010 10:00 HM AUG 19. 20113 10:C15 i;H
:."I:3TEM s,rHTUS REPOPT
- r�Ch✓<;t'sJ? LHRr1• --- 1s6 V WART+! - -
L.1.1:111 PENISFY 3-•1 11F' Elhl:: l JN3 WARN
DENEWER PAN FUEL, ALMRrt SENE;C)R ALARM -----
ti1.10
19. 201 fa 3:a5 AP1 L.i:; :t�!>~Pl IVER I
DISPENSER PAN
FUEL. ALARM
AUG 1 9. 2010 10:01 Htl
!�J:NSOF' iiLARH . .__ _ 4700 COFF I E RU
L 12:D I SPENSEP 1-2 B:;J<Ef�:P I EL.0 �1F; 9�:30>a
f'r-1N V 1-5r1E- I LL)
FUEL A1_AFt t i-o.AF.'M ----
HUia
19. 2010 9:41'. HP1 L]4:r,1 SPENSER 7-4
D I SC'EN:riGR PAN AUG 19. 2010 10:06 Art
FUEL_ ALAPI"I
HUi; 19. 2010 10:02 Af-I
:JY.JTI::hI �:TATL�� F.'Er•s:Il:r
y -
11,r) VP STATf.f: kh4RN
VP EP1I SS I GN5 IAIARPI
J.•J E�:L-I.
STP suM>•
FUEL ALAR-i --- 2'LvISOR ALARM ---
r3L�1a
19. 201 LI `+:50 Fill 1.1 :►a l PEP[:lai' 5-6
C11: F'ENSER PAN
Al fr; 1 9. :'01 U 10:02 k1l
1.1 l :1-+I ESEL
P l 1:l Nt: SKIP
�:Erh2;QR ALr-in' i -- -- • FIJEL ALAP.M
L kECULAf.' SGU'rN AIJG 19. •1310 10:0? Hr1
STP Su Ir•
FIJEI. HI_:;F.'ri -- - 1,;r1 SITE AL.ARN
AUG UG 1•3. 2010 9:5,j mm I SG VP E imi ,� W RI'l
AU, 19. 2010 10:02 AM
L 2:REGLIL 4F* Z01-ITH
PIPING SUMP
FUEL AbARhI
:.�l:l',:;Ul•, Tl::11 19. 2;010 10:09 All
L. r".:F-.'}-'�':11>_AF.' rr,;T:'1'I i ------•- PP•ti; A1sA121°I ------ AUG,'
r 1'I Slil°Il' VF' 0111,313,10112: L,It3RP!
FUEL mt.;41tvi AIJ(3 19. 'aJl 11 i o:O' Hl"I
ALa:; 1eJ. ;;L,l1i Ju:ini HI°1
L. 5:PEI:LILA? NORTH
- =4 OR A+I_r-1RN - - F'I P i Nr_; SLa-1F
7-0 FUFJ-. ALAPI.1
G I SPF.P).$ER PAN ALIG 19, 15,010 10: 1 l AI°I
FUEL :41-ARM
6LIC, 19. 2010 10:03 r-thl
--- 2EP60P 13L(•1F!M -- --
I_1 1):1)1 ESEL
c:;EW,OR Abakl9 ----- wINLILAP. SPA O, _
::�!IPR1 hiE FUEL ALAF2010'I'I
I_
R t F f AUC 19. 10:18 t-N
FLIED. HL FiF f l
r4U+; 19. 2t_l I t3 I C1: 13 NI"1
FiF;WY,::-;I UE VV4RKET
4700 +_CtFF1E PO
F:P.Cv1atLG h1HPl•:1_!' bnl-5R$-103l3
17ACI rOFF I E RD
BAKEF:::F 1 k(.I+ OA C#3 60e At3(: 1 20 10 10:20 Ht f
661-5t1N-1.i,10
AL1+> I{+. '?U 10 t 0: 14 Ahl
S.YSTEII STH'I'LN; PE:1,O f
1:311 VP STHTUS WARN - ^
VP 0112S1ON5 WAPN
)::U VP STATUS WARN
VI" uaNPN
..-- :�EPISiSR r3LARl•i �-•--
1_ y: •urJ?Er•JF
4,;TP SUMP
OLIT ALARM
1. ?: 1:IF'PE:PII: AIJG l`+. 2010 10:20 W
I-iNIVLILP1R
FUEL ALi-iRM
AU'-' 19. 2111 U 10:15 W
*--El'ISJOR ALARM
i.t O: O E�'DEL
W-INULHP SPfACE
:::L i'1SL3P ml-HPH --- cEhISOP ouT ALRRM
1. .I:RE+:;LJl_AR NORTH ALL, 19. 2010 10:23 All
raNNULAP :3Pr:t+::1=
F LIF 1_ mLARm
AUG 19. 2010 10: 16 AM
�- -- SEIC'O: NL.PIRM -----
L l 1 :I:r 1 ES:EL
sCiv: tj(; HL;iRt^I -----
F.I P.I P,ha 5Ut°IF
SE NSc?F. OUT ALAPII
:REr:I)L ' SOUTH AUG 19, 2010 10: AM
HNNULAP'. SN-kC E
FUEL. ALt 4FTl
f f ffN 19. 2010 1 L*1:17 4.1
LIa:L+1SPL`NSEF! 1-2
SENSOR uLfl' ALARM
AUG 19. 2010 10:23 All
1.1":1:11 MEL
SENSOR OUT ALmkl-1
1AUC; 19, 201 CI 10!'-"3 riM
:'ENSCIR ALARM
b)2:PENSFKI PAN
OUT ALARM
HUG 19. 201 1 1 ri:LlLs W-1
4700 0DIFFIE RD
BAKERSFIELD CA 93202
ALAS 19. '2010 10:2f3 AM
11k,001's I DIE 11ARKE7
4701) COME RD
—STEM STM'Lt3 REPORT &-XEP$FlF-Lf) CA 5"308
66 1-506-1,338
L 9:SENSOR 01-rr ALHRII
AUG 19. 2010 10:24 "1
l.)0:c;ElqtOP. OUT ALARM
L) I :SENSOR OUT AIAPII STATUS REPORT
L)2:SEi,r.;oR OUT - - - - - - - - - - - -
L I :SFrt;oF.- OUT ALAFI-I
OUT ALARM OUT ALMRI•I
I.Srj VP STATUS wApi,i L I I:SEN20P ou'r ALAF.,m
VP Ft-IIIS'SIONP, WARN Llt,:SENSOR OUT PLAPPI)
Lit:.:SENSsOR OUT ALAPri
I':1) VP STATUS wi)wil
IFMISSJON.? WARN
SEN�X)R ALARf"I
L15:01SPI7112hR 5-6
PAN
�Em,IoR ou'r ALARII
AUG 14. 2010 1 CI:*-:'.'I All
----- -:;Ei,IS0R ALARI-I
L 14:P I SPENSEP 2-4
rdspEtBEP PA14
SEN20R OUT mLAM
AU.-I 19. 2010 10:23 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: Shell I Date of Testing: 8/19/2010
Facility Address: 4700 Coffee Road, Bakersfield,CA 93308
Facility Contact: Matt Jeffries Phone: 661-496-7006
Date Local Agency Was Notified of Testing:
Name of Local Agency Inspector(rf present during testing):
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Bryan A. Self
Credentials': X CSLB Contractor X ICC Service Tech. ❑ SWRCB Tank Tester ❑Other(Spec)
License Number(s): CSLB: 804904 ICC: 8022804-UT
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: X Hydrostatic ❑Vacuum ❑Other
Test Equipment Used: Lake Test Equipment Resolution: 0.0625"
Identify Spill Bucket (By Tank 1 Regular(North) 2 Regular(South) 3 Super 4 Diesel
Number, Stored Product, etc.
Bucket Installation Type: ❑Direct Bury ❑Direct Bury ❑ Direct Bury ❑ Direct Bury
X Contained in Sump X Contained in Sump X Contained in Sump X Contained in Sum
Bucket Diameter: 13.00" 14.00" 15.00" 15.00"
Bucket Depth: 12.50" 13.00" 13.50" 13.00"
Wait time between applying 5 min. 5 min. 5 min. 5 min.
vacuum/water and start of test:
Test Start Time(Tj): 9:30am 9:30am 9:30am 9:30am
Initial Reading(RI): 10.00" 10.75" 11.75" 10.50"
Test End Time(TF): 10:30am 10:00am 10:30am 10:30am
Final Reading(RF): 10.00" 8.75" 11.75" 10.50"
Test Duration(TF—Tj): 1 hour 1 hour 1 hour 1 hour
Change in Reading(RF-Rj): 0.00" 2.00" 0.00" 0.00"
Pass/Fail Threshold or 0.0625" 0.0625" 0.0625" 0.0625"
Criteria:
Test Result: X Pass ❑Fail P s X Fail X Pass ❑Fail X Pass ❑Fail
Comments— (include information on repairs made prior to test 6l and re mended 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: A Date: 8/19/2010
' State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.