HomeMy WebLinkAboutFMC 2011 I 37 .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 rt wort must beprspared for each i
monitoring system control paaet by the technician who performs the work. N.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: CHEVRON Bldg No::
Site Address: 5609 STINE ROAD City:'BAKERSFIELD Zip::
Facility Contact Person: LOUNG CHAO Contact Phone No.: (661) 3464208
Make/Model of Monitoring System: TLS450: Date of Testing/Servicing:3/7/2011
B. Inventory of Equipment Tested/Certifted,
Check the awwopriate boxes to indicate s eiilc sqwpw ent the ted/servioed:
Tank ID: UNL87 Tank ID: UNL91101ESEL
®]n-Tank Gauging.Probe. Model: 1AAG-1 ®W-Tank Gauging Probe. Model• 1AAG-1
Annular Space or Vault Sensor: Model: 420 ®-Annular Space or Vault Sensor. Model: 420.
®Piping Sump I Trench Sensor(s). Model: 208 ®'Piping Sump/Trench Sensor(s). Model` 208,
❑Fill Sump Sensor(s). Model:- ❑`Filf Sump Setsor(s). Model:
0 Mechanical Line Leak Detector. Model[.RED.JACi(ET
®:Mechanical'Line,Leak Detector. Model: RED JACKET.
❑Elecui mic Line Leak Detector. Model: ❑Electronic1ine Leak Detector. Model:
®Tank Overfill/High-Level Sensor. ModeL MAG-1 ®Tank Overfill I High-Level Sensor. Model: IIAAG-1
❑Other(specify equipment type and model in Section,E-on Page 2). ❑Other(specify equipment type and model in.Section E on Page 2).
Tank ID: DIESEU91 Tank ID: .
®In-Tank Gauging Probe: Model- MAGA ❑b-Tank'Gauging Probe. Model:
0 Annular Space or Vault Sensor._ Model: 420 ❑Annular$p8ce or Vauk Sensor. Model: .
UPiping Sump/Trench Sensor(s). Model: 2011 ❑Piping Sump/TreriwSensor(s). Model:
❑Fill Sump Sensor(s). Model: ❑Fill Sum p Sensor(s). Model
®Mechanical Line Leak Detector: Model: RED JACKET ❑Meohaiilcal Line Leak Detector. Modd:
❑Eleetronic'Line Leak Detector: Model: [I Eleetranic Line Leak Detector. Modek.
®Tank Ovcr611/High-Level Sensor. Model: MAG-1 ❑Tank Overfill F.Frgh-l:evel Sensor. Model:
ui t
C]Oter h (specify eq pmea type and modet in Sochon Bon Page.2}. 13 Other(specify.equipment rype:and model.in Section E:on Page 2).
Dispenser ID: U2 Dispenser ED: 314
®Dispenser Containment Sensor(s). Model: 406 ®Dispenser Containment Sensor(s): Modal: 406
®Shear Valve(s). ®Sheaf Valve(s).
❑Dispenser ConWament Float(s)and Chain(s). ❑Dispenser Containment Float(s)and:Chain(o.
,Dispenmr,Im: 516 Dispenser ID: 718
®'pispensefCOniBimrrent:Settsa(s).
Model;-_4061 ®Disparser:Containment Sensor(s). Model: 001
t Shear Valve(s). ®Shear Valve(s).
1"D Dispenset Contament Float(s)and Chain(s). (]Dispasser.Contairmeni Float(s)and Chain(s).
1Ditpeaser ID:, 9110 Ditpenser-ID:
50ispepser Containment Sensor(s). Model:'.001
❑D'upmser Contaimmrit Seasor(s). Model:
Shear:Velve(s). ❑Shear Valye(s).
(]Dispenser Containment Floags)and Chain(s). ❑Dispenser Containment Float(s)and Chi o).
•Ifthe facility contains more tanks or dispensers,copy.this form.. Include information for every tank and dispenser at the faciiiiy.
C. CerM eatlon-.I certify that.the ecinipment.identifiedfl.n.this document was:iespected/serviced'in accordance with the manufacturers'
guidelines. Attached to this Certification is information(e.g. manufacturers' checklists)nec, to verify that this information is
correct and a Plot Plan showhi the*outof'monitoring,equipmetit. For,any eq meat Apa generating each reports,I have also
attached a,copy of the report;(check dl!`t6at'apply): ®System set-up Ala. ry:report
Technician'Name(print): RICH PHILLIPS Signature:
CertificationNo.: A29M4,1035169-UT License.-14 C611'D40 809850
Testing Company Name: RICH ENVIRONMENTAL Phone.No.:.(661):392 4687
Testing Company Address:,5843 BROOKS CT.BAKERSFIELD,6A:93308 Date of Testing(Servi6ing,3171M 1
Page 1 of 5
UN-.M-va www:onidoes org Rev.01/I71o8
I III III N�I�III IIII 38
IE
Monitoring System Certification
D: Results of Testing/Servicing
Software Version Installed: 329.01
Complete the f%ollo ag checklist:
Yes ❑ No* Is the.audible alarm operational?
® Yes ;❑ No* Is:the.visual alarm operational?
® 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 properoperation?
❑ Yes ❑ No* If alarms are relayed- to a remote monitoring station, is all communications ;equipment (e.g., modem)
® N/A operational?
® Yes ❑ No* For pressurized piping,systerns,does:the turbine automatically shut down if the piping secondary containment
❑ N/A monitoring system„detects a leak,fails to operate,or is electrically disconnected? If yes:which sensors initiate
positive shut-dawn? (Check all that apply) ❑Sumpl`I'rench Senwrs; ❑Dispenser Containment:Sensors.
Did you confirm positive shut-down due to leaks and.sensor failure/disconimctioo? ❑Yes;. ❑,No..
® Yes El No* For,tank systems°that_utilize.the monitoring system as the
prunary;tank overfill warning:device (i:e., no
❑ N/A
mechanical overfill.prevention valve is installeo), is the overfill warning alarm visible and audible at the tank
fill point(s)and _operating properly? If so,at what percent of tank,capacity does the alarm trigger? %
® Yes* ❑ No Was airy 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 Waslquid found inside any secondary containment systemms designed as dry systems? (Check rill that apply)
❑Product; ,[J Water: If yes,describe causes in Section E,below.
® Yes ❑ No*' Was monitoring system set-up reviewed to ensure proper settings?Attach setup reports,i.applicable
® Yes Cl No* Is all monitoring equipment operational per manufacturer's specifications?
*:In Section E below,;describe how"and when these deficiencies were or will be corrected.
lE.- Comments: REPLACE TIMER IN OVERFILL ALARM
Page 2 of 5
UN-036—214 www.umdomora Rev.01/17/08
Monitoring System.CerMcation
F. In-Tank Gauging!'SIR Equipment; R Check this box if tank gauging is used only for inventory control.
❑ 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.detec#ion monitoring:
Complete the following checklist:
Q Yes ❑ No* Has all input wiring been inspected for proper entry and temiinat on,including testing for ground faults?
❑ Yes Q .No* Were all tank gauging probes visually•inspected.for damage and residue buildup?
accuracy of system p. readings tested?
❑ Yes. ❑ No* Was: product level
❑ Yes ❑ No* Was accuracy of system water leyel.readings tested?
❑ Yes ❑ No* Were all probes;reinstalled properly?
.p Yes. ❑ No* Were all items on:the,eguipmentmanufacturer's maintenance.checklist completed?
*In Section.H,below,;.d.eseribe how and*hen these deficiencies were=or will be corrected.
G. LineLeak Detectors,(LLD); p Check this:box if LLDs are not installed:
' J
Com lets.the foil o checklist:
® Yes ❑ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance?
❑ N/A (Check all that apply) Simulated.leak rate: ®3 g p.h.; p 0.1 g.p h; [10.2 g.p b.
® Yes p No* Were.all LLDs confirmed operational and accurate•within.regulatmy requirements?
® Yes ❑ No* Was the testing•apparatus properly,calibrated?
® Yes E01"No* For mechanical.LLDs,:does the LLD restrict product flow if it detects;a leak?
❑ N/A
❑ Yes ❑ No* For electronic LLDs,does the turbine automatically shutoff if the LLD detects a leak?
® N/A
❑:Yes D No* Fouelectronic LLDs,does the:turbine automatically shut off if any portion of the monitoring.system is disabled.
® N/A or disconnected?
❑ Yes ❑ No* For electronic LLDs;does the turbine automatically.shut off if any,portion of the monitoring system malfunetions
® ;N/A or fails a.test?
in Yes ;,Q`No* For electronic LLDs have all'"acts Bible winng.connections been visually inspected?
19 Yes' ;❑
No, Were all items on the:equipment.manufacturer's maintenance checklist:completed?
*In Section H,below,describe how.and*hen.these deficiencies were or will be corrected.
H. Comments:
.Page 3 of 5
MOM www.unfdoce.urg Rev.01/17/48
Monitoring System Certification Form:Addendum for Vacuum/Pressure.Interstitial Sensors
L 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
systtmaovmer/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: Model: System Type:❑Pressure;❑vacuum
Sensor ID
Component(s)Monitored;bythis Sensor:
Sensor Functionality Test Result:,❑Pass; ❑ Fail Communication Test Result:❑Pass; ❑ Fail,
Component(s)Monitoredbythis Sensor.:
Sensor Functionality Test Result:❑Pass; ❑ Fail Interstitial Communication Test.Resuh;❑'Pass; ❑ Fail
Components)Monitored by.this Sensor:
Sensor Functionality'Test Result;.❑Pass;; ❑ Fail . Interstitial'Communication Test�itaiiit:El Pass;. ❑ Fail.
Componeat(s)Moniitored.by.'thls'Sensor:
Sensor Functionality ❑Test Result: Pass;. ❑ Fail Interstitial.Communication Test Resultv;:❑Pass;. ❑ Fail
Components)Monitored by this Sensor:.
Sensor Functionality Test Result:❑Pass; ❑ Fad Interstitial Communication Test.Resatt:❑Pass;. ❑ Fail
Component(s)'Monitored by this Sensor:
Sensor Functionality Test;Result:--C]Pass; [❑ Fail Interstitial Communication Test Result: ❑Pass; ❑ Fail
Componeat(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
Components)>Monitored'bythis Sensor:
Sensor Functionality:TeOt lkesult:El Pass; ❑ Fail Interstitial'Conimuriication Test Result ❑Pass; .❑ Fail
Component(s)Monitored by this Sensor:
Sensor Functionality Test Result:❑Pass; ❑ Fail Interstitial.Communication Test Result: ]Pass ❑ Fail,
,How was interstitial _
communicatlo&ver1hed4'
❑ Leak Introduced at Far End of lntelstitial . ace;' ❑ ;Gauge; ❑. Visual Inspection;,
f] Other(Describe to Seq J,'Below)
Was vacuum/pressure restored to operating1evels.br all interstitial spaces? ❑Yes ❑No:(lf no, describe 3n Sec.J,below)
J Comments: NONE OF THESE SENSORS ARE PRESENT AT THIS SITE.
Page 4 of 5
If the sensor success
fully detects.a simulated vv��ccuumfpressure leak introduced in the.interstitial space at tbe;furthest.pomt.from the
sensor,vacuum/pressure,has been demonstrated to be communicating throughout the interstice.
UN-036A-1/1 www.unidomorg Rev.0126106.
_ r
torir}$
Site tlddiess
. : . . . : : : . : I'�C
. . . . . . . . . . . . . . . ,tf� ,
. . . . . . . . .
. . . . . . . . . . . . . . . . . . . .. 1?r�o►d rs se/�rg�r
. „� �.
. . . . . . . . . . . . . .. . . . . '� „ wadi f ro't< .
Ca - blwnd CPt• 7�v.r,b fi'1f
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . '.Q'�y.1�:LtI;w e*
. . . . r : 1
a'
. . . .
�4 J11
. . . . . . . . . . . . . . , . _ . . . . . . ... _ . . . ra
ijgf
>it�ttt�ilot►g
4f.you alreacl�!have.a.di ram•-list shows.all'-e0tedanfannatiau,.:you:ma d+include:it,,rattier.thwT this page,ynth,�.your Monitoring
System t eEti pn.your site plan,sfiow:fhr. ::layout of'tapks.anrl pipin�_ Clearly Iilentlfy lacai_Iohs a the;follovvi g
equipment; if installed monitoring system`contml panels; sensors inatxitoiing taals:..ennulat agates; sumps,di:; nse{ Pans, spill
containess,.bs othersecb dory cofi#a9nm pt atnsu,tur uv�i t�reteGtma litie Eet�lc det ,;;arse:entl in-tank liquld'leyel probes(if used
OW
for leak,detocUoq). In th-soao provii�;na`t'd t�e,da its S.ire'l�l t ,..PrePat�d,.
UN-036-414 w"111plii morg Rev:01117M
SWRCB,January 2006
Spill Bucket.Testing Report,Form
This.form is intendedj`or 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: CHEVRON 7 Date of Testing: '3t7/1.1
Facility Address: 5609 STiNE ROAD,BAKERSFIELD,
Facility Contact: LOUNG,CHAO Phone:
Date Local Agency Was Notified of Testing: 2/4111
Name of Locat Agency Inspector(ifpresent during.testing):
2. TESTING CONTRACTOR INFORMATION
Company Name: RICH ENVIRONMENTAL
Technician Conducting Test: RICH PHILLIPS
Credentials: J CSLB Contractor X>1CC Service Tech. ❑SWRCB Tank,Tester ❑Other(S );
License Number(s): 103M:69,UT
3. SPIEL BUCKET TESTING INFORMATION
Test Method Used: X Hydrostatic 'Vacuum ❑Other,
Test Equipment Used:VISUAL Filuipmeut.Resolution:'0
Identify Spill Bucket(By Tank t 2 3 4
Nwnber,Stored Product, etc. UNL81 7 tPVI 9i DIESEL Rt TEST DIESEL.
BuckeOnstaliation Type: X Direct Bury X Direct Bury X Direct Bury X Direct Bury
❑Contained in,Surhp ❑Contained in Sum ❑Contained in Sump ❑Contained in Sum
Bucket Diameter: .12 12 12 12
Bucket�Depth: .14 14 14 14
Wait time between applying
vacuum/water and start of test: 30 MIN 30 MIN 30:MIN. 301MIN
Test Starr Time(Tj): 9:30 9:30 9:30. 2:00.
:Initial Reading(R;): l4- 14 14
'Test End'Time(TF): I0:30 10:30 10:30 3:00
Final Reading(RF): 2 10 14
Test Duration(TF-Tr): ; -HOUR 1-HOUR 1-HOUR 1-HOUR
Change in.Readmg,(Rf-Ri): 000 12. 4 .000.
Pass/Fail Threshold or
4-/70.00 4-0.00 +/-0.00 +/-Om
Criteria:
70 nl!; F ,J n o v c n.1 I
Comments-(include informatton o?:`repairs madeprior to testing:and recommended follow-up for failed"tests)
DIESEL'-'REMOVED FILL ADAPTER AND NIPPLE=CLEANED AND RE-DOPED—PASSED
SECOND TEST UNL91 -"REMOVED DRAIN VALVE(PHIL-TIT'E);CLEANED-UP—STILL FAILING.
REPLACED PHIL-TITE DRAIN VALVE.ASSEMBLY
CERTIFICATION OF TECHNIC SPONSIBLE FOR CONDUCTING THIS TESTING
I hereby certify that''all the infortnado>s;contafn this report 1s true,accurate,.and in f ell conspHance-wlth legal requirements.
Technician's Signature: 'Date 3/7/11
State laws and regulations do not currently require testing-'to be performed.by a qualified contractor,Howeveri local requirements
may be more stringent.
SWRCB,January 2006
Spilt 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 rif applicable) should:be:piovided,to.the facility owner/operator for submittal to The local,Tegulatory agency.
L FACELITY INFORMATION.
Facility Name: CHEVRON Date of Testing 3/9/11
Facility.Address: 5609"STINE ROAD
Facility.Contact: . LOUNG CHAD Phone:
Date Local Agency Was.Notified of Testing
Name.of Local Agency Inspector(if present during testing):
2. TESTING CONTRACTOR;INFORMATION
Company Name: RICH ENV'IR0NM8NTAL
Technician Conducting Test: RICH:P.HILLIPS
Credentials': DCSLBCbntractdr X,ICC Service Tech. G SWRCB:Tank"Test& ❑`Other(Specify)
License Number(s): 1035:169=UT
3 SPIEL BUCKET TESTING INFORMATION
Test Method Used: X Hydrostatic 0 Vacuum L'Other
Test Equipment Used:VISUAL );yuipment Resolution:U
Identify.Spill Bucket(By Tank ,t 2 3 4'
Number,Stored Product; etc.' RF_TESG:9I:nLL
X:DhW Bury G.Direct Bury. 0 Direct Bury q DirectBury
Becket Installation Type: 0 Contained in Sumpf. ❑Contained in Sum d7 Contained in Sum .O Contained in Sump
Bucket Diameter: 12
Bucket,Depth: 14.
Wait tame Between applying. 30,MIN
s`vacuum/water and start of test: .
Test Start Time(Tj) 4;30
;.Initial Reading(RO: 14
Test End,Time(TF): 5:30
Final Reading(RF): 14.
Test'Duration(TF—T�: `i-HOUR
Change in Reading(RF-Rr): 000
Pass/Fail Threshold or +/-0.00
Criteria
i'@ is u
6
Comments—(include information onerepairs made:prior to testing, and recommended follow-up for failed tests)
CERTIFICATION OF TE ICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
I hereby,certify that all thchosfornebtion` rained in this report is true,accurate,and in fuff co►npliant<e with regal requberitents.
Technician's:Signature: Date: 3nii 1
We laws,aiid regulations do not currently require testing to be performed by a qualified contractor.However,local requiremeots
may be more stringent.
RICHENNIRONM'EVTAL
56433ROOKS CT-BAKERSFIELD,CA. 93308
OFFICE(661)392-8687 FAX(661)392-0621
PRODUCT LINE LEAK DETECTOR TEST
WORK SHEET
W/0#:
FACILITY NAME: .CHEVRON
FACILITY ADDRESS: .5609 STINE ROAD,BAKERSFIELD
PRODUCT LINE;TYPE: PRESSURE
PRODUCT LEAK DETECTOR TYPE TEST TRIP PASS
BELOW P.S.I. OR
SERIAL NUMBER 3 G.P.H. FAIL
lJD TYPE ;ZtED JACKET YES:UNL87 I1 PASS
SERIA1 ,
PREM91 U/D TYPE;:RED JACKET YES 12 PASS
SERIAL#
DIESEL L(D TYPE':'RED JACKET YES 10 PASS
SERIAL.#
IM TYPE:. YES PASS
SERIAL# NO FAIL
I CERTIFY THE ABOVE TESTS WERE CONDUCTED.ON THIS DATE ACCORDING TO RED
JACKET PUMPS FIELD TEST APPARATUS TESTING PROCEDURE AND LIMITATION&
THE MECHANICAL LEAK DETECTOR TEST PASS.?FAIL:IS DETERMINED BY USING A
LOW FLOW THRESHOLD,TRIP RATE OF 3 GALLONS PER HOUR OR LESS AT 10 P.S.I.I
ACKNOWLEDGE THAT ALL.DATA COLLECTED IS TRUE AND CORRECT TO THE REST,
OF MY KNOWLEDGE:
TECBMCIAN RI
SIGNATURE: DATE. .3/7/11
ALARM HISTORY REPORT
----- SENSOR ALARM ----- ALARM HISTORY REPORT
L 1 :87 ANNULAR
ANNULAR SPACE - --- SENSOR ALARM -----
SENSOR OUT ALARM L 4:91 STP
MAR 7, 2011` 9:39 AM STP SUMP
SENSOR OUT ALARM
FUEL ALARM MAR 7. 2011 9:39 AM
MAR 7. 201 1
'FUEL ALARM
MAR 7._2011 9:24 AM
* * * x END * xx �t *
* END X * X
ALARM HISTORY REPORT
-- SENSOR ALARM ----- ALARM HISTORY REPORT
L 2--191-DIESEL ANNULAR
ANNULAR SPACE ----- SENSOR.ALARM -----
SENSOR OUT ALARM L 5:DSL.STP
MAR 7 2011 9:39 AM STP SUMP
SENSOR. OUP ALARM
FUEL ALARM MAR 7 .2011 9::39 AM
MAR' 7. 2011 9:26 AM
FUEL ALARM
FUEL ALARM MAR 7. 2014 9:25 AM
MAR 7. 2011 9:25 AM
FUEL ALARM
PEC 20. 2010 6:24 AM
x x END x x x..x
ALARM HISTORY REPORT
- SENSOR ALARM -----
L 3:87 STP
STP, SUMP .
SENSOR:OUT AALARM
MAR 7. 201.1 9:39 AM
FUEL ALARM
MAR 71 '2011 9:24 AM
ACCEPT :NIGH{ ORVR:
OUTPUT .RELAY SETUP 5MARTSENSOR SETUP : ENABLED 'i
R 1 :87 ' s. I:CARIBON CANISTOR ISD HOSE-TABLE
TYPE: - CATEGO VAPOR VALVE ID FP--FL- HL AA- RR
RYr-
STANDARD Olt 01 01 ^02-l01 02
NORMALLY CLOSED s 2VAPOR PRESSURE 02 02 02 02 . 01 02
CATEGORY VAPOR PRESSURE 03 03 03 02 02 02
TANK W: 1 04 04 04 02 02 02
� 3::DdSP 1-2 05 05 05 02 03 02
CATEGORY AIR FLOW METER 06 06 06 02 00 02
LIQUID SENSOR ALMS 07 07 07 02 64 02
L 1 :FUEL ALARM 4:DISP 3-4 .D6 08 08 .02 04 02
L 3-FUEL ALARM CATEGORY- AIR FLOW METER 09 09 Og 02 . 05 . 02
L 1 :SENSOR OUT ALARM 1"0 16 10 02. 05 02
L 3:SENSOR OUT ALARM s 5,:DISP 5-6
CATEGORY AIR FLOW METER
ISD SITE. ALARMS ISD AIRFLOW METER MAP
I.SD GROSS PRES FAIL s 6:DISP 7-8 I.D SERIAL NUM LABEL
ISD DEGRD PRES FAIL CATEGORY AIR FLOW METER, ----------------- ---°
ISD VAPOR LEAK FAIL 1 42051 DI;IP 1.-2
ISD VP PRES FAIL s '7:DISP 9-,I0 2 36945 D.ISP 3-4
I.SD `VP STATUS FAIL CATEGORY AIR FLOW METER 3 40079 DISP 5-6
ISD HOSE ALARMS 3 B:ATM 4 40343 DISP 7-6
ALL:FLOW COLLECT FAIL CATEGORY ATM P SENSOR 5 4205? DI 9-10
R 21.191 ISD FUEL GRADE HOSE 'MAP
TYPE 1 2 3 4
STANDARD Fp MHH MHH MHH MHH AA
NoRMALLY ,CLOSED ---`---- ------------
is: 2 01 2011101 901 U U. 1
TANK
02 202 1.02 902 U U I
03 203 103 903 U U 2
LIQUID SENSOR ALMS 04 204 104 904 U U 2
L 2:FUEL ALARM 05 205 105 905 3 U 3.
L .4`:FUEL ALARM 06 206 10.6 906 3`U 3
07 207 107 90"7 U U
L 2:SENSOR 4
L 4:SENSOR OUT ALARM'OUT ALARM 4
08 208 108 908 U U
EVR/I9D SETUP 09 209 109 909 U U:
ISD SITE ALARMS 16 210 110 910 U. U 6
5
ISD GROSS PRES FAIL
ISD DEGRD PRES FAIL LABEL TABLE
IBID VAPOR LEAK,FAIL EVR TYPE: BALANCE _ -
ISD VP PRES FAIL j : UNASSIGNED
ISD VP STATUS FAIL BALANCE NOZZLE TYPE 2; 13LEHD3
V$T" 3: REGULAR
ISD HOSE ALARMS 4: MID GRADE
ALL:FLOW COLLECT FAIL VAPOR PROCESSOR' TYPE 5; PREMIUM
VEER ROOT -POLISHER
R 3. D IE SEL, 6: GOLD
TYRE:' 2: BRONZE
8: SILVER
STANDARD' ANALYSIS TIMES
NORMALLY 'CLOSED TIME:. .10:00 AM 9 BLEND2
TANK'4: ,3 ,.
DELAY`MINUTES: 1 1,4:'BLIrND4
LIAUI'D`SENSOR ALMS
L 2'FUEL ALARM
L 'SFUEL ALARM
L 2`SENSOR OUT ALARM
L '5:SMOR'BUT ALARM
R 4:OVERFILL pMC SETUP
TYPE
STANDARD . . PMC VERSION: 01.03.
NORMALLY OPEN
TANK 4:. NONE VAPOR PRBCESSt1R TYPE
VEEDER-ROOT. POLISHER_
IN-TANX ALARMS
ALL:OVERFILL ALARM
ALL:HIGH PRODUCT ALARM
ALL-MAX PRODUCT ALARM
T 2 .91 .IE8EL LEAK, TEST METHOD
T
PRODUCT CODE 2 3 D - - - - - - - - _ -
THERMAL COEFF ::000700 PRODUCT CODE , 3 TEST ON. DATE ALL TANK
TANK DIAMETER 95.00 THERMAL COEFF : :000450 MAR 3. 2010
TANK PROFILE I PT TANK :DIAMETER 95.Q0 'START TIME : 2:30 AM..
FULL VOL 8016 TANK PROFILE 1 :PT TEST RATE :0..20 GAL/HR
FULL, VOL 4008 DURATION: : 2 HOB
FLOAT SIZE: 4.•0 I:N. TST VARLY. STOP:DISAHLED
FLOAT, SIZE: 4.0 IN.
WATER WARNING 2.0 LEA{ TEST ,REPORT FORMAT
HIGH WATER LIMIT 3.0 WATER.WARNING 2.0 ENHANCED
HIGH WATER LIMIT: 3.0
MAX OR LABEL VOL: 8.01.6
OVERFILL LIMIT 90% MAX OR .LABEL, VOL: 4008
7214 ovERFiLL LIMIT 90X
HIGH PRODUCT 95* 3607,
7615 HIGH PRODUCT 95%
DELIVERY LIMIT 1Q% 3807
SQ1 DELIVERY LIMIT 10%,
400
LOW PRODUCT 500.
LEAK ALARM LIMIT: 99 LOW? PRODUCT 300
BUDDEN LOSS LIMIT: 50 LEAK ALARM LIMIT.:. 99 LIQUID,SENSOR SETUP
TANK TILT 0.00 SUDDEN LOSS LIMIT: 50
PROBE- OFFSET 0.:00 TANK TILT 0.00 T.
PROBE OFFSET 0.00 L 1 :82 ANNULAR
1`R I-STATE ($1 NGLE FLOAT)
SIPHON MANIFOLDED TANKS CATEGORY ANNULAR SPACE
T#- NONE S 101401 MAN I FOLDED TANKS`
INE MANIFOLDED TANKS Ta.:; NONE
p#; NONE LINE. MANIFOLVED 'TANKS
T#: ;NONE L .2:91-DIESEL, ANNULAR
TRY.=STATE (S;INGLE. FLOAT.)
.EAK HI'.N PERLODIC: Iok CATEGORY ANNULAR SPACE
BO1 LEAK MIN PERIODIC: 10%
400.
_PAX: MIN ANNUAL : 1ox
S0i LEAK MIN ANNUAL 10% L 3:87 STP
4.0.0 TRI-STATE (SINGLE FLOAT)
CATEGORY : STP SUMP
>EAIODIC TEST TYPE
QUICK PERIODIC TEST TYPE
QUICK L 4;91 STP'
iNNUAL TEST,FAIL TRI-STATE. (SINGLE..FLOAT.)
ALARM. DISABLED, 'ANNUAL, FAIL CATEGORY : STP SUMP
ALARM DISABLED
)ERIODIC TEST FAIL
ALARM DISABLED PERIODIC ZEST FAIL L 5:DSL STP
ALARM DISABLED TRI-�STATE (SI.NGLE. FLOAT)
ROSS TEST FAIL CATEGORY STP SUMP
ALARM DISABLED GROPS' 4T FAIL
ALARM DISABLED
tNN ,TES'T AVERAGING: OFF
'ER TEST AVERAGING: OFF ANN TEST AVERAGING,: OFF
PER TEST -AVERAGING:. OFF
'ANK TEST NOTIFY: OFF
TANK TEST NOTIFY: OFF
'NK TST SIPHON BREAK:OFF
TNK TST SIPHON 'BREAK:OFF
IELIVERY DELAY 15,MIN
,UMP THRESHOLD 10.00% DELIVERY DELAY .15 MIN
:PUMP THRESHOLD 10.00%
;YSTEM SETUP IN-TANK SETUP - f� C�
- COMMUNICATIONS SETUP - - - - - - - - - - - `[V✓.��
1AR 7.- 2011 -9:12 AM _ _ _ _ _. �j
T 1 :67
PRODUCT CODE 1
PORT SETTINGS: THERMAL .
OQEFF : .Q00700
SYSTEM UNITS TANK DIAMETER 95.00
U'S' COMhI BOARD ' 1 (EDIM ) TANK PRomLE 1 PT
SYSTEM LANGUAGE RS=232 :SECURITY FULL VOL 1:2048
-ENGLISH CODE D`I SABL:ED
;YSTEM DATE/TIME FORMAT .
ION. DD YYYY HH:MM:SS xM COMM""'BOARD 3, (RS-232) FLOAT SIZE: 4.0 IN.
BAUD RATE, 1200
!HEVRON STINE PARITY ODD WATER WARNING : 2.0
1609 ETINE RD STOP BIT : 1 STOP HIGH WATER LIMIT: 3.0
tAKERSFI£LD.CA 'DATA LENGTH: 7 DATA
RS,-232 $ECURIIY MAX OR 'LABEL VOL: 12048
SHIFT TIME 1 : DISABLED
CODE . DISABLED OVERFILL LIMIT 90x
tHIFT TIME 2 : DISABLED HIGH PRODUCT 1.0843
tHIFT TIME 3 : DISABLED AUTO TRANSMIT SETTINGS: 1:1445
:RIFT TIME 4 : DISABLED DELIVERY LIMIT 10%
AUTO LEAK ALARM LIMIT 1204
'ANK PER TST NEEDED WRN DISABLED
'ISABLED AUTO HIGH WATER LIMIT LOW PRODUCT 500
'ANK' ANN TST NEEDED WRN DISABLED LEAK ALARM LIMIT.: 49
+tSABLED AUTO OVERFILLLIMIT SUDDEN LOSS LIMIT:.'. 99
DISABLED TANK TILT Q,00
A NE RE-ENABLE METHOD. AUTO LOW PRODUCT PROBE OFFSET 0.00
'ASS IL I NE TEST D,I SABLED
AUTO THEFT,`LIMIT
INE PER TST NEEDED WRN DISABLED SIPHON MA TANKS
11SABLED AUTO DELI VERY START Tit: NONE
.JNE ANN TST NEEDED WRN DISABLED . ` LINE MANIFOLDED TANKS
'1 BABLED AUTO ,DEL IVERY END TO' NON
D'I WLED:
'RINT TO VOLUMES AUTO,,EXTERNAL INPUT ON
:NABLED D I SABLED LEAK ,MIN PERIODIC 1,0%
AUTO :�XTgRNAL iNPUT OFF 1204
'EMP :COMPENSATION DISABLED
'ALUE 0EG, P 1 : 60,0 AUTO SENSOR FUEL ALARM LEAK MIN ANNUAL IOy
TICK HEIGHT OFFSET DISABLED 1,204
'I SAELED .A'U'TO; SENSOR WATER ALARM
ILLAGE: 9.0% DISABLED
t-PROTOCOL DATA FORMAT AUTO SENSOR OUT"ALARM PERIODIC TEST TYPE
IEIGHI DISABLED QUICK
+AYLIGHT SAVING TIME
11SABLED ANNUAL TEST FAIL
'E-DIRECT LOCAL PRiMTO1.1T ALARM DISABLED
ISABLED PERIODIC TEST FAIL
:URO PROTOCOL PREFIX ,::; ALARM DISABLED.
GROSS TEST FAIL
RS=232= END OF MESSAGE
DISABLED: ALARM DISABLD
;YSTEM SECURITY ANN TEST" AVERAGING: OFF
'ODE 000000 PER TEST AVERAGING: OFF
'AINTENANCE; HISTORY TANK TEST NOTIFY: OFF
1SABLED TNK TST SIPHON BREAK-:OFF
ANK CHART SECURI'T'Y DELIVERY DELAY 15 MIN.
11SABLED PUMP THRESHOLD 10:.00%
i
USTOM ALARMS
11SABLED
;ERVICE NOTICE
DISABLED
SO 3166 COUNTRY
'ODE::.
ASS/DENSITY
124LEV
MONITOR CERT. FAILURE, REPORT
SITE NAME: CHEVRON DATE : .3/7/11
ADDRESS; 5609 STINE ROAD TECHNIC RI PHILLIPS'
CITY: BAKERSFIELD. SIGNATURE:
THE FOLLOWING CO IPONEIV°TS WERE REPLACED/REPAIRED:TO COMPLETE
TESTING.
REPAIRS: DIESEL-REMOVED FILL ADAPTER AND NIPPLE AND RE-DOPED.
REPAIRED-AND RE-TESTED-PASSED
91 SPILL BUCKED REPLACED DRAIN VALVE ASSEMBLY(PHILrTITE)
REPAIRED TIMER ON OVERFILL ALARM.AFTER INSPECTOR LEFT .
LABORi
PARTS INSTALLED,; rmTITE.DRAIN ASSEMBLY:I-TEVIER OVERFILL
ALARM VEEDER-ROOT
NAME f: TITLE .
SIGNATURE:
THE ABOVE NAMED PERSON'TA.KES FULL RESPONSIBILITY OF.NOTIFYING.
THE APPROPRIATE'.PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR,
THE ABOVE.LISTED.PROBLEMS AND.NOTIFYING RICH ENVIRONMANTAL.FOR
ANY NEEDED RETESTING.THIS ALSO RELEASES RICH ENVIRONMENTAL OF
ANY FINES OR PENALTIES OCCURING:FROM' NON-COMPLIANCE.
A COPY OF THIS DOCUMENT HAS BEEN LEFT ON-SITE FOR YOUR
CONVIENENCE.