HomeMy WebLinkAboutFMC RESULTS 9-3-08 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 monitoriniz 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. I IIIIIII VIII III IIII 61
A. General Information
Facility Name: Big Country Texaco IE Bldg.No.:
Site Address: 6009 Coffee Road City: Bakersfield zip:
Facility Contact Person: James Young Contact Phone No.: 661-327-5008
Make/Model of Monitoring System: Veeder-Root TLS-350 Date of Testing/Servicing: 9/3/2008 S
B. Inventory of Equipment Tested/Certified -A
Check the appropriate boxes to indicate specific equipment inspected/serviced:
Tank ID: 12000 gal.Regular Tank ID: 12000 gal.Super
[X] In-Tank Gauging Probe. Model:847390-107 [x] In-Tank Gauging Probe. Model:847390-107
[x] Annular Space or Vault Probe. Model:794390-409 [x] Annular Space or Vault Sensor. Model: 794390-409
[x] Piping Sump/Trench Sensor(s). Model:794380-208 [x] Piping Sump/Trench Sensor(s). Model: 794380-208
[x] Fill Sump Sensor(s) Model:794380-208 (x] Fill Sump Sensor(s). Model:794380-208
U Mechanical Line Leak Detector. Model:FX1y [x] Mechanical Line Leak Detector. Model: FX1y
❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model:
[X] Tank Overfill/High Level Sensor. Model:847390-107 Lx] Tank Overfill/High Leval Sensor. Model: 847390-107
❑ Other(specify equip.type and model in Sec. E on Pg.2) ❑ Other(specify equip.type and model in Sec. E on Pg.2)
Tank ID: 12000 gal.Diesel Tank ID:
[x] In-Tank Gauging Probe. Model:.847390-107 ❑ In-Tank Gauging Probe. Model:
[x] Annular Space or Vault Sensor. Mode 1:794390.409 ❑ Annular Space or Vault Sensor. Model:
[x] Piping Sump/Trench Sensor(s). Model:794380-208 ❑ Piping Sump/Trench Sensor(s). Model:
[x] Fill Sump Sensors(s). Model:794380-208 ❑ Fill Sump Sensor(s). Model:
[x] Mechanical Line Leak Detector. Model:FX1DV ❑ Mechanical Line Leak Detector. Model:
❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model:
[x] Tank Overfill/High Level Sensor. Model:847390-107 ❑ Tank Overfill/High Level Sensor.Model:
❑ Other(specify equip.type and model in Sec. E on Pg.2) ❑ Other(specify equip.typs and model in Sec. E on Pg. 2)
Dispenser ID: 1 &2 Dispenser ID: 3&4
n Dispenser Containment Sensor(s). Model: 4201208 [X] Dispenser Containment Sensor(s). Model: 4201208
E] Shear Valve(s). U Shear Valve(s).
❑ Dispenser Containment Float(s)and Chain(s). ❑ Dispenser Containment Float(s)and Chain(s)
Dispenser ID: 5&6 Dispenser ID: 7&8
[x] Dispenser Containment Sensor(s). Model: 420/208 (� Dispenser Containment Sensor(s). Model: 4201208
[x] Shear Valve(s). U Shear Valve(s).
❑ Dispenser Containment Float(s)and Chains(s). ❑ Dispenser Containment Float(s)and Chain(s).
Dispenser ID: 9&10 Dispenser ID: 11 &12
[x] Dispenser Containment Sensor(s). Model: 420/208 [x] Dispenser Containment Sensor(s). Model: 4201208
[X] Shear Valve(s). L] 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 eq ipment c of generating
such reports,1 have attached a copy of the report; (check all that apply) ❑System S t- p Alarm history report
Technician Name(print): Matthew Jennings Signature:
Certification No: 835445 License No:804904
Testing Company Name: Confidence UST Services,Inc. Phone No: 80Y-339-9930
Site Address: 6009 Coffee Road,Bakersfield,CA IIIIIIIIIIIIIIIIIIII _Date of Testing/Servicing: 9/3/2008
62
IE
D. Results of Testing/Servicing
Software Version Installed: 325.02
Complete the following checklist:
[x] Yes ❑ No* Is the audible alarm operational?
x Yes No* Is the Visual alarm operational?
x Yes No* Were all sensors visually inspected,functionally tested,and confirmed operational?
x 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;
I_I Yes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e. no
❑N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visual and audible at
the tank fill point(s)and operating properly?If so,at what percent of tank capasity does the alarm
trigger? 90 %
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* u No Was liquid found inside any secondary containment systems designed as dry systems?
❑ Product; ❑ Water. If yes, describe causes in Section E,below.
DI No* I Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports, if applicable.
Lxj Yes 1 0 No* I Is all monitoring equipment operational per manufacturer's specifications?
* In Section E below,discribe how and when these deficiencies were or will be corrected.
E. Comments: The 208 sensor in the Regular STP was replaced and retested.
The vent box located @ the vent line has two sensors.A 420 and a 208. Both were accurately tested and passed
F. In-Tank Guaging/SIR Equipment: M Check this box if tank guaging is used only for inventory control.
❑ Check this box if tank guaging or SIR equipment is installed.
This section must be completed if in-tank guaging equipment is used to perform leak detection monitoring.
Complete the following checklist:
U Yes ❑ No* Has all input wiring been inspected for proper enter and termination,including testing for ground faults?
_Tx3 Yes No* Were all tank guaging probes visually inspected for damage and residue buildup?
x Yes D No* Was accuracy of system product level readings tested?
x Yes No* Was accuracy of system water level readings tested?
_[xl Yes No* Were all probes reinstalled properly?
Lx] 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:
[x� 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: ❑3 g.p.h.: 00.1 g.p.h.; ❑0.2 g.p.h.;
x Yes No* Were all LLD's confirmed operational and accurate within regulatory requirments?
x Yes 7 No Was the testing apparatus properly calibrated?
r] Yes No* For machanical LLD's, does the LLD restrict product flow if it detects a leak?
N/A
F-1 Yes 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
Lx] N/A malfunction or fails a test?
❑ Yes D No* For electronic LLD's,have all accessible wiring connections been visually inspected?
Lx] N/A
FUx 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:
Monitoring Systen Certification Form:Addendum for Vacuum/Pressure Interstitial Sensors LG 163-1,Enc.11
I. 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 owner/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 the test date.
Manufacturer: Model: F— System type: ❑ Pressure; ❑Vacuum;
Sensor ID
Component(s)Monitored by this Sensor:�UN PRODU CT s-1 Sensor Funtionali Test Results X Pass Interstitial Communication Test Results: X Pass Fail
Component(s)Monitored by this Sensor: [�Fail
VAPOR LINE
S-2 Sensor Funtionality Test Results:X Pass Fail Interstitial Communication Test Results: X ass; I I Fail
Component(s)Monitored by this Sensor: UNL VENT LINE
s-3 Sensor Funtionality Test Results: X Pass Fail Interstitial Communication Test Results: X ass; I IFail
Component(s)Monitored by this Sensor: PRM PRODUCT
s-4 Sensor Funtionality Test Results: Pass X Fail Interstitial Communication Test Results: ass; X Fail
Component(s)Monitored by this sensor: PRM VENT
s-5 Sensor Funtionality Test Results ix]Pass I Fail Interstitial Communication Test Results: ass; I Vail
Component(s)Monitored by this Sensor: DIESEL PRODUCT
s-6 Sensor Funtionality Test Results: X Pass Fail Interstitial Communication Test Results: X ass; I IFail
Component(s)Monitored by this Sensor: DIESEL VENT
s-7 Sensor Funtionality Test Results• X Pass Fail Interstitial Communication Test Results: IxFas s; Fail
Component(s)Monitored by this Sensor:
Sensor Funtionality Test Results Pass Fail Interstitial Communication Test Results: ass;I Vail
Component(s)Monitored by this Sensor:
Sensor Funtionality Test Resultsn Pass Fail Interstitial Communication Test Results: I ass; Fail
Component(s)Monitored by this Sensor:
Sensor Funtionality Test Results: Pass Fail Interstitial Communication Test Results: ass; ail
Component(s)Monitored by this Sensor:
Sensor Funtionality Test Results: Pass Fail Interstitial Communication Test Results: ass; Fail
How was interstitial communication varifyed?
[X—j Leak Introduced at Far End of Interstitial Space; Gauge; X Visual Inspection; Othe Discribe in Sec.J, below
Vacuum was restored to operating levels in all interstitial spaces: ❑ Yes X❑ No(1f no, discribe in Sec.J Below)
Comments:
S-4 was in alarm upon arrival . The sensor was tested, but was unable to hold a
vaccum.
Page 4 of 4
If the sensor successfully detected a simulated vacuum/pressure leak introduced in the interstitial space at the furthest point from the
sensor,vacuum/pressure has been demonstrated to be communicating throughout the interstice.
SYSTEM SETUP - COMMUNICATIONS SETUP
BIG C:OUl'JTR'Y TEXACO - - - - - - - - - - - - - - - - - - - - - - - - '
6009 COFFEE RD. SEP 3, 2008 6:50 AM
BAKERSFIELD,CA 93308
PORT SETT I NGS:
SEP 3. 2008 8:50 Ahi SYSTEM UNITS COMM BOARD 2 t FX.MOD)
U.S. BAUD RATE 2400
SYSTEM LANGUAGE PARITY : ODD
ENGLISH STOP BIT : I STOP
S`Y'STEM STHTU a REPORT S,S
TEM CITE: T 1 P9E FvkMAT DATA LENGTH: 7 DATA
PION LSD YY'.Y HH:Nll°l:SS : l-1 RS-232 SECURITY
s 4:140 VACUUM ALARM CODE : DISABLED
BIG COUNTRY TEXACO DIAL TYPE : TONE
6009 COFFEE RD. ANSWER ON i RING
INVENTORY REPORT BAKERSFIELD.CA 93306 MODEM SETUP STRING
DIAL TONE INTERVAL: 3'2
T 1 :UNLEADED SHIFT TIME 1 DISABLED
VOLUME = 9105 GALS SHIFT TIME 2 : DISABLED
ULLAGE = _2895 GALS SHIFT TIME 3 DISABLED RECEIVER SETUP:
904. ULLAGE= 1695 GALS SHIFT TIME 4 DISABLED
TC VOLUME = 8970 GALS NONE
HEIGHT = 68.12 INCHES TANK PER TST NEEDED WR1V
WATER VOL = 0 GALS DISABLED
WATER = 0.00 INCHES TANK ANN TST NEEDED WRhI
TEMP = 81 .1 DEC F DISABLED
LINE RE-ENABLE METHOD
T 2:PREMIUPI PASS LINE TEST
VOLUME = 2932 GALS
ULLAGE 9068 GALS
LINE PER TST NEEDED NEEDED l 1RhJ
90% ULLAGE= 7866 GALS DISABLED
TC VOLUME = 2677 GALS LINE ANN TST NEEDED WRN
HEIGHT = 28.14 INCHES DISABLED AUTO DIAL TIME SETUP:
WATER VOL = 0 GALS PRINT TC VOLUMES NONE
WATER = 0.00 I NCFIES � ENABLED
= 86.3 DEC F
TEMP i�OMPENSAT ION
T 3:DIESEL VALUE (DEC F ) : 60.0
VOLUME = 3631 GALS STICK HEIGHT OFFSET
ULLAGE = 8369 GALS' DISABLED
90% ULLAGE= 7169 GALS
TC VOLUME = 3576 GALS H-PROTOCOL DATA FORMAT
HEIGHT = 32.66 INCHES HEIGHT-
WATER VOL = 0 GALS DAYLIGHT SAVING TIME
WATER = 0.00 INCHES ENABLED
TEMP = 93.2 DEG F START DATE
MAR WEEK 1 SUN
START TIME
* = END 2:00 All DISABLED
OF MESSAGE
END DATE
OCT WEEK 6 SUN
END TIME AUTO DIAL ALARM SETUP
2:00 AM - - - - - - - - - - - -
RE-DIRECT LOCAL PRINTOUT
DISABLED
EURO PROTOCOL PREFIX
S
SYSTEM SECURITY
CODE : 000000
CUSTOM ALARM LABELS
DISABLED
IN—TANK SETUP T 2:PRElllIUM T 3:D}ESEL
— — — — — — — — — — — — PRODUCT CODE 2 PRODUCT CODE 3
THERMAL COEFF : .000700 THERMAL COEFF : .000450
T 1 :UNLEADED TANK DIAMETER 96.00 TANK DIAMETER 98.00
PRODUCT CODE I TANK PROFILE I PT TANK PROFILE 1 PT
THERMAL COEFF : .000700 FULL VOL 12000 FULL VOL 12000
TANK DIAMETER 98.00
TAPdK; PROFILE 1 PT
FULL VOL 12000 FLOAT SIZE: 4.0 IN. FLOAT SIZE: 4.0 IN.
WATER WARNING : 2.0 WATER WARNING 2.0
FLOAT ;SIZE: 4.0 IN. HIGH WATER LIMIT: 3.0 HIGH WATER LIMIT: 3.0
WATER 1AARNING 2.0 MAX OR LABEL VOL: 12000 MAX OR LABEL 'VOL: 12000
HIGH WATER LIMIT: 3.0 OVERFILL LIMIT 90% OVERFILL LIMIT 90%
10800 10800
MAX OR LABEL VOL: 12000 HIGH PRODUCT 95% HIGH PRODUCT 95%
OVERFILL LIMIT 90% 11400 11400
10800 DELIVERY LIMIT 15% DELIVERY LIMIT 15%
HIGH PRODUCT 95% 1800 1800
11400
DEL I VER`! L I I°1 I T 15% LOW PROIiUCT 1000 LOW PRODUCT 1000
1800 LEAK ALARM LIMIT: 99 LEAK; ALARM LIMIT: 99
SUDDEN LOSS LIMIT: 99 SUDDEN LOSS LIMIT: 99
LOW PRODUCT 1000 TA14K TILT 0.00 TANK TILT 0.00
LEAK: ALARM LIMIT: 99 PROBE OFFSET 0.00 PROBE OFFSET 0.00
SUDDEN LOSS LIMIT: 99
TANK TILT 0.00
PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS SIPHON PIANIFOLDED TANKS
TO: NONE T#: NONE
LINE NIANIFOLDED TANKS LINE MANIFOLDED TANKS
SIPHON MANIFOLDED TANKS T#: NONE TO' NONE
TO: NONE
LINE MANIFOLDED TANKS
TO: NONE LEAK MIN PERIODIC: 1% LEAK MIN PERIODIC: 1
120 120
LEAK 1111--1 PERIODIC: 1% LEAK MIN ANNUAL I LEAV. MIN ANNUAL 1%
120 120 120
LEAK: M111 ANNUAL 1%
120 PERIODIC: TEST TYPE PERIODIC TEST TYPE
STANDARD _ STANDARD
PERIODIC TEST TYPE ANNUAL TEST FAIL ANNUAL TEST FAIL
STANDARD ALARM DISABLED ALARM DISABLED
ANNUAL TEST FAIL PERIODIC TEST FAIL PERIODIC: TEST FAIL
ALARM DISABLED ALARM DISABLED ALARM DISABLED
PERIODIC TEST FAIL GROSS TEST FAIL GROSS.; TEST FAIL
ALARM DISABLED ALARM DISABLED ALARM DISABLED
GROSS TEST FAIL ANN TEST AVERAGING: OFF ANN TEST AVERAGING: OFF
ALARM DISABLED PER TEST AVERAGING: OFF PER TEST AVERAGING: OFF
ANN TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TANK TEST NOTIFY: OFF
PER TEST AVERAGING: OFF
TAP}}t TEST NOTIFY: OFF TNY•. TST SIPHON BREAK:OFF TNK TST SIPHON BREAK:OFF
DELIVERY DELAY I MIN DELIVERY DELAY 1 MIN
TNK TST SIPHON BREAK:OFF PUMP THRESHOLD 10.00% PUMP THRESHOLD 10.00
DELIVERY DELAY 1 MIN
PUMP THRESHOLD 10.00"
LEAK TEST METHOD
- - - - - L11 :DIESEL STP SUMP L25DISP 7-6 2
TEST ON DATE : ALL TANK : 2ND TRI-STATE (SINGLE FLOAT) LORI CLOSED
ALLY CLO
JAN 15, 2007 CATEGORY : STP SUMP CATEGORY OTHER SENSORS
START TIME : 2:00 Art
TEST RATE :0.20 GAL/HR
DURATION 2 HOURS L12:DIESEL FILL SUMP 2ND
NOWIALLY CLOSED L26:D I SP 9-10
TST EARLY STOP:DISABLED CATEGORY : OTHER SENSORS TRI-STATE (SINGLE FLOAT)
LEAK TEST REPORT FORMAT CATEGORY : DISPENSER PAN
NORMAL
L13:DIESEL FILL SUMP
TRI-STATE (SINGLE FLOAT) L27:DISP 9-10 2ND
CATEGORY : OTHER SENSORS NdR11ALLY CLO,yED
CATEGORY : OTHER SENSORS
L14:DIESEL FILL SUMP 219D
NORMALLY CLOSED L28:DISP 11-12
CATEGORY OTHER SENSORS TRI-STATE (SINGLE FLOAT)
CATEGORY : DISPENSER P'A14
LIQUID SENSOR SETUP
- - - - - - - - - - - - L15:DIESEL ANNULAR
DUAL POINT HYDROSTATIC L29:DISP 11-12 2ND
L 1 :U�IL STP SUMP, CATEGORY : ANNULAR SPACE IVdkt1ALL1' CLOSED
CATEGORY STP SUMP STATE (SINGLE FLOAT; CATEGORY : OTHER SENSORS
G'A
LI6'- ENT BOX,
L 2:UNL STP SUMP 2ND TRI-STATE tS1NGLE FLOAT)
NORMALLY CLOSED CATEGORY : OTHER SENSORS
CATEGORY : OTHER SENSORS
L17:VENT BOX 2ND
L 3:UNL FILL SUMP TRI-STATE (SINGLE FLOAT)
TRI-STATE (SINGLE FLOAT) CATEGORY : OTHER SENSORS
CATEGORY : OTHER SENSORS
PUMP SENSOR SETUP
L1S:DISP 1-2 _
L 4:UNL FILL SUMP 214D TRI-STATE (SINGLE FLOAT) - - - - - - - - - -
NORMALLY CLOSED CATEGORY : DISPENSER PAN S I :UNLEADED
CATEGORY OTHER SENSORS TANK #: I
DISPENSE MODE:
L19:DISF' 1-2 211U
STANDARD
L S:UNL ANNULAR NORMALLY CLOSED S 2:PREMIUM
DUAL POINT HYDROSTATIC CATEGORY : OTHER SE14SORS TALK U: 2
CATEGORY : ANNULAR SPACE DISPENSE MODE:
STANDARD
L20:DISP 3-4 S 3:DIESEL
L 6:PREM STP SUMP TRI-STATE (SINGLE FLOAT) TANK it: 3
TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN DISPENSE MODE:
CATEGORY : STP SUMP STANDARD ,
L 7:PREM STP SUMP 2ND L21 :DISP 3-4 2ND
NORMALLY CLOSED NORMALLY CLOSED
CATEGORY : OTHER SENSOR' CATEGORY : OTHER SENSORS
L 8:PREM FILL SUMP L22:DISP 5-6
TRI-STATE (SINGLE FLOAT) TRI-STATE (SINGLE FLOAT)
CATEGORY : OTHER SENSORS CATEGORY : DISPENSER PAN
L 9:PREM FILL SUMP 2ND L23:DISP 5-6 2ND
NORMALLY CLOSED NORMALLY CLOSED
CATEGORY : OTHER SENSORS CATEGORY : OTHER SENSORS
L10:PREM ANNULAR L24:DISP 7-8
DUAL POINT HYDROSTATIC TRI-STATE (SINGLE FLOAT')
CATEGORY : ANNULAR SPACE CATEGORY DISPENSER PAN
R 3:DIESEL SMARTSENSOR SETUP
TYPE: OUTPUT RELAY SETUP _ - _ - - - - _ _ _ - -
PUMP CONTROL OUTPUT - - - - - - - - - - - -
TANK #: 3 s 1 :UNL PRODUCT
R 1 :UNLEADED CATEGORY VAC SENSOR
TYPE: PUMP #:
IN-TANY ALARM: PUMP CONTROL OUTPUT R 1 :UNLEADED
T 3:LEAK ALARM TANK #: 1 VOLUME: 200.0 GALLONS
RELIEF VALVE: : NO
LIQUID SENSOR ALMS
L11 :FUEL ALARM IN-TANK ALARMS 5 2:VAPOR LINE
L18:FUEL ALARM T '. :LEAK ALARM CATEGORY VA+_: SENSOR
L20:FUEL ALARM PUMP #:
L22:FUEL ALARM LIQUID SENSOR ALMS R 1 :UNLEADED
L24:FUEL ALARM L 1 :FUEL ALARM VOLUME: 175.0 GALLONS
L26:FUEL ALARM L 6:FUEL ALARM RELIEF VALVE: : NO
L28:FUEL ALARM LIB:FUEL ALARM
L1l :SENSOR OUT ALARM L20:FUEL ALARM s 3:UNL VENT
L18:SENSOR OUT ALARM L22:FUEL ALARM CATEGORY VAC: SENSOR
L20:SENSOR OUT ALARM L24:FUEL ALARM PU11P #:
L22:SENSOR OUT ALARM L26:FUEL ALARM R 1 :UNLEADED
L24:SENSOR OUT ALARM L28:FUEL ALARM VOLUME: 20.0 GALLONS
L26:SENSOR OUT ALARM L I :SENSOR OUT ALARM RELIEF VALVE: : NO
L28:SENSOR OUT ALARM L 6:SENSOR OUT ALARM
L11 :SHORT ALARM LIB:SENSOR OUT ALARM s 4:PREMIUM PRODUCT
L18:SHORT ALARM L20 2ENSOR OUT ALARM CATEGORY VAC SENSOR
L20:SHORT ALARM L22:SENSOR OUT ALARM PUMP #:
L22:SHORT ALARM L242ENSOR OUT ALARM R 2:PREMIUM
L24:SHORT ALARM L26:SENSOR OUT ALARM VOLUME: 200.0 GALLONS
L26:SHORT ALARM L28:SENSOR OUT ALARM RELIEF VALVE: : NO
L26:SHORT ALARM L 1 :SHORT ALARM
L 6:SHORT ALARM s 5:PREMIUM VENT
R 4:OUERFILL L18:SHORT ALARM CATEGORY VAC SENSOR
TYPE: L20:SHORT ALARM PUMP #:
STANDARD L22:SHORT ALARM R 2:PREJMIUM
NORMALLY OPEN L24:SHORT ALARM VOLUME: 20.0 GALLONS
L26:SHORT ALARM RELIEF VALVE: : NO
L28:SHORT ALARM
IN-TANK ALARMS s 6:DIES:EL PRODUCT
ALL:OVERFILL ALARM R 2:PREIMIUIM CATEGORY VAC SENSOR
ALL:HIGH PRODUCT ALARM TYPE: PUMP #:
ALL:MAX PRODUCT ALARM PUMP CONTROL OUTPUT R 3:DIESEL
TANK #: 2 VOLUME: 200.0 GALLONS
RELIEF VALVE: : NO
IN-THNK ALARMS s 7:DIESEL VENT
T 2:LEAK ALARM CATEGORY VAC SENSOR
PUMP #:
LIQUID SENSOR ALMS R 3:DIESEL
L I :FUEL ALARM VOLUME: 40.0 GALLONS
L 6:FUEL ALARM RELIEF VALVE: : NO
L18:FUEL ALARM
L20:FUEL ALARM s B:ATM
L2 2:FUEL ALARM CATEGORY ATM P SENSOR
L24:FUEL ALARM
L26:FUEL ALARM
L28:FUEL ALARM
L 1 :SENSOR OUT ALARM
L 6:SENSOR OUT ALARM
L18:SENSOR OUT ALARM
L20:SENSOR OUT ALARM
L22:SENSOR OUT ALARM
L24:SENSOR OUT ALARM
L26:SENSOR OUT ALARM
L28:SENS0R OUT ALARM
L 1 :SHORT ALARM SOFTWARE REVISION LEVEL
L 6:SHORT ALARM VERSION 325.02
L1B:SHORT ALARM SOFTWARE# 346325-100-C
L20:SHORT ALARM CREATED - 05.08.09. 12.51
L22:SHORT ALARM
L24:SHORT ALARM NO SOFTWARE (MODULE
L26:SHORT ALARM SYSTEM FEATURES:
L26:SHORT ALARM PERIODIC IN-TANK TESTS
ANNUAL IN-TANK TESTS
` ALARM HISTORY REPORT
ALARM HISTORY REPORT
ALARM HISTORY REPORT ----- SENSOR ALARM -----
----- SENSOR ALARM ----- L S:UNL ANNULAR
---- IN-TANK ALARM ----- L 2:UNL STP SUMP 2ND ANNULAR SPACE
OTHER SENSORS LOW LI(JU1D ALARM
T I :UNLEADED FUEL ALARM AUG 17, 2007 1 : 10 Phi
AUG 17. 2007 2:00 PM
OVERFILL ALARM LOW LIQUID ALARM
AUG 28, 2008 1'-2:54 AM FUEL ALARM MAR 6, 2006 1 :52 PM
MAY 31 , 2008 11 :05 PM SEP 29, 2006 8: 13 AM
MAY 24. 2008 2: 14 AM HIGH LIQUID ALARM
FUEL ALARM MAR 6. 2006 1 :38 Pill
LOW PRODUCT ALARM SEP 26, 2006 2:56 PM
AUG 5. 2008 6: 18 PM
JUL 12,, 2008 8:34 AM
DEC 24, 2007 2:29 Phi
HIGH PRODUCT ALARM
MAY 31 , 2008 11 :06 PM
.IAN 14. 2007 3:37 PM
DEC 17. 2006 11 :01 AM
INVALID FUEL LEVEL ri r M ri ri END AE dE
JUL 12. 2008 10: 10 AM * x END * n
DEC 24, 2007 3:27 Phi
AUG 27, 2007 8:31 PM
PROBE OUT
JAN 28, 2008 12:50 AM
JAN 28, 2008 12:45 AM
JAN 28, 2008 12:23 AM
DELIVERY NEEDED
SEP 1 , 2008 2:09 All ALARM HISTORY REPORT
AUG 29. 2008 5:46 PM ALARM HISTORY REPORT
AUG 25. 2008 8:18 Pill ----- SENSOR ALARM -----
-- SENSOR ALARM ----- L G:PREM STP SUMP
MAX PRODUCT ALARM L 3:UNL FILL SUMP STP SUMP
JAN 14. 2007 3:37 Pil OTHER SENSORS FUEL ALARM
JUN 17, 2006 4:49 AM FUEL ALARM AUG 17.. 2007 2:13 PM
JUN 12, 2006 6:14 All AUG 17, 2007 5:31 PM
SENSOR OUT ALARM FUEL ALARM
LOW TEMP WARNING AUG 17. 2007 5:22 PM MAR 6. 2006 1 :26 Pill
MAR 6, 2006 2:15 PM FUEL ALARM
FUEL ALARM MAR 4, 2006 11 :43 AM
AUG 17, 2007 4:56 Pi°1
ri * n n END x x ri ri x
h i i X END * * END ii ii if i
ALARM HISTORY REPORT
----- SENSOR ALARM ----- ALARM HISTORY REPORT ALARM HISTORY REPORT
L 1 :UNL STP SUMP ----- SENSOR ALARM -----
STP SUMP ----- SENSOR ,:ARhi ----- L 7:PREM STP SUMP 2ND
FUEL ALARM L 4:UNL FILL SUMP 2ND OTHER SENSORS
AUG 17. 2007 2:12 Phi OTHER SENSORS. SENSOR OUT ALARM
FUEL ALARM MAY 30, 2008 7:26 PM
FUEL ALARM AUG 17, 2007 1 :54 PM
AUG 17. 2007 2:08 PM SENSOR OUT ALARM
FUEL ALARM MAY 30. 2008 7:21 PM
FUEL ALARM MAR 6, 2006 1 :42 PM
MAR 6, 2006 1 :35 PM SENSOR OUT ALARM
MAY 30. 2008 4:30 PM
ALARM HISTORY REPORT
ALARM HISTOR':
ALARM HISTORY REPORT ALARM HISTORY REPORT ALARM HISTORY REPORT
----- SENSOR ALARM ----- SENSOR ALARM -----
----- SENSOR ALARM -----
L23:D I SP 5-6 21VU
L17:VENT BOX 2ND L20:DISP 3-4 OTHER SENSORS
OTHER SENSORS DISPENSER PAN FUEL ALARM
FUEL ALARM FUEL ALARM
AUG 17, 2007 3:52 PM AUG 17, 2007 3:38 PM DEC 8, x'007 7:32 All
FUEL ALARM FUEL ALARM FUEL ALARM
SEF 5. 2007 4: 10 All
MAY 25, 2007 10:40 AM MAR 6, 2006 1 :33 PM
SENSOR OUT ALARM FUEL ALARM FUEL ALARM
AUG 17, 2007 2: 19 PI°i
MAY 25. 2007 10:31 All AUG 9, 2005 8:48 AM
?i END n 3F # E ri '* f x ri END x t 3E h * END n ri ri ri
ALARM HISTORY REPORT ALARM HISTORY REPORT ALARM HISTORY REPORT
----- SENSOR ALARM ----- ----- SENSOR ALARM ----- ----- SENSOR ALARM -----
LI8:DISP 1-2 L21 :DISP 3-4 2ND L25:DISP 7-8 2ND
DISPENSER PAN OTHER S OTHER SENSORS ENSORS FUEL ALARM
FUEL ALARM FUEL ALARM FUEL 12, 4:09 Pt°1
AUG 17, 2007 3:39 PM AUG,, 17. 2007 2:21 PN1 NOV
FUEL ALARM FUEL ALARih
FUEL ALARM
MAR 6. 2006 1 :32 PH JAN - 9,. 2007 8:28 AM NOV 1'-2, 2007 4:09 PM
FUEL ALARM FUEL ALARM FUEL ALARM
NOV 12. 2007 4:03 PM
AUG 9, 2005 8:48 AM JAN 9, 2007 8:06 AM
iE ii i x END E ie 3E iE if x iE i iE n END ii { rx iE i rE ii a ii END
ALARM HISTORY REPORT ALARM HISTOR`! REPORT ALARM HISTORY REPORT
-----
SENSOR ALARM ----- `---- S
SE ENSOR ALARM -----
- SENSOR ALARM L26:DISP 9-10
L19:DISP 1-2 2ND L22:DISP 5-6 DISPENSER PAN
OTHER SENSORS DISPENSER PAN FUEL ALARM
FUEL ALARM FUEL ALARM
JUN 3, 2008 1 :35 PM AUG, 17, 2007 3:35 PM AUG 17. 2007 3:29 PM
FUEL ALARM
FUEL- ALARM FUEL ALARM MAR 6, =006 1 '35 Ph1
MAY 15, 2008 5: 16 AM AUG 17, 2007 3:33 PM -
FUEL ALARM FUEL ALARM FUEL ALARM
MAY 8, 2008 11 :22 AM IlAR 6, 2006 1 :34 PM AUG 9, 2005 8:47 AM
ALARM HISTORY REPORT
ALARM HISTORY REPORT ALARM HISTORY REPORT
-- SMARTSENSOR ALARM -- --- SMARTSENSOR ALARM --
----- SENOR ALARM ----- I :UNL PRODUCT s 4:PREMIUM PRODUCT
L27:DISP 9-10 2ND NO VACUUM ALARM NO VACUUM ALARM
OTHER SENSORS DEC 12, 2007 11 :00 AM MAR 28, 2008 3:04 AM
FUEL ALARM
AUG 17, 2007 5:47 PM COMMUNICATION ALARM NO VACUUM ALARM
FUEL ALARM NOV 15, 2007 10:52 AM NOV 15, 2007. 11 :22 AM
AUG 17, 2007 5:39 PM NO VACUUM ALARM NO VACUUM ALARM
FUEL ALARM 110V 15, 2007 10:52 AM NOV 15, 2007 10:32 AM
AUG 17. 2007 4:52 PM
fi * r x END +F ie if 34 r r 4 * END n ri n
END * ri
ALARM HISORY REPORT ALARM HISTORY REPORT
ALARM HISTOR`! REPORT --- SMARTSENSOR ALARM -_ --- SMARTSENSOR ALARM --
- 2:VAPOR LINE s 5:PREM1UNl VENT
----- SENSOR ALARM ----- C:OMMUNIC'ATION ALARM NO VACUUM ALARM
L28:DISP 11-12 JAN 27. 2006 11 :33 PM OCT 19, 2007 11 : 15 AM
DISPENSER PAN
FUEL ALARM COMMUNICATION ALARM HIGH LIQUID ALARM
AUG 17. 2007 3:31 PI 11 JAN 27. 2008 11 :31 RM OCT 19, 2007 10:55 AM
FUEL ALARM COMMUNICATION ALARM 110 VACUUM ALARM
AUG 17. 2007 3:30 PM JAN 27. 2008 9:46 PM OCT 19, 2007 10:54 AM
FUEL ALARM
MAR 6, 200E 1 :34 PM
ti x * ri END ri n * 1: x END w � n r X
END x
ALARM HISTORY REPORT ALARM HISTORY REPORT
--- SMARTSENSOR ALARM -- --- SMARTSENSOR ALARM --
ALARM HISTOR`i REPORT s 3:UNL VENT s 6:DIESEL PRODUCT
NO VACUUM ALARM COMMUNICATION ALARM
----- SENSOR ALARM ----- FEB 13, 2008' 9:30 AM JAN 27, 2008 11 :52 PM
L29:DISP 11-12 2ND
OTHER SENSORS COMMUNICATION ALARM COMMUNI 'T�I. ON ALARM
FUEL ALARM .JAN 2-7, 2006 11 :37 PM JAN 27. 11 :49 PM
AUG 17. 2007 2: 18 PM
COMMUNICATION ALARM r_OMMUNI" ON ALARM
FUEL ALARM ' JAN 27, 2008 11 :35 PM JAN 27.'08 11 :37 PI°l
MAR 6, 2006 1 :40 PM
FUEL ALARM
MAR 6, 2006 1 :40 PM
- - ----- SENSOR ALARM -----
ALARM HISTORY REPORT ----- SENSOR ALARM ----- L 7:PREM STP SUMP 2ND
L 2:UNL STP SUMP 2ND OTHER SENSORS
--- Sh1ARTSENS0k ALARM - OTHER SENSORS FUEL ALARM
s -:DIESEL VENT FUEL ALARM SEP 3, 2008 9:23 AM
COMMUNICATION ALARM SEP 3. 008 9: IE All
JAN 27, 2008 11 :55 PM
COMMUNICATION ALARM
JAN 27. 2008 11 :52 PM
COMMUNICATION ALARM
JAN 27, 2008 11 :37 PM
----- SENSOR ALNRt'9 ----- DID-' COUNTRY TEXACO
6009 COFFEE RD.
L ?:PREM STP SUMP '2ND
BAk:EkSFIELU.CA 93308
OTHER SENSORS
FUEL ALARM
SEP 3. 2008 9: 17 AM SEP 3, 2000 9:23 AM
SYSTEM STATUS REPORT
- - - - - - - - - - -
L 7:FUEL ALARM
s 4:NO VACUUM ALARM
--- SENSOR ALARM -----
L l :DIESEL FILL SUMP 21111)
OTHER SENSORS
FUEL ALARM
SEP 3. 2008 9: 17 AM
ALARM HISTORY REPORT
--- SMARTSENSOR ALARM --
B:AThI ----- SENSOR ALARM -----
L12:DIESEL FILL SUMP 2ND
OTHER SENSORS
FUEL ALARM
----- SENSOR ALARI-1 ----- SEP 3, 2008 9:26 All
L a:UNL FILL PUMP
OTHER SENSORS
FUEL ALARM
SEP 3, 2008 9:18 AM
END
----- SENSOR ALARM -----
Ll5:DIESEL ANNULAR
ANNULAR SPACE
LOW LIQUID ALARM
-- SENSOR ALARM ----- SEP 3, 2008 9:27 All
L13:DIESEL FILL SUMP
OTHER SENSORS
SENSOR ALARM ----- FUEL ALARM
LII :DIESEL STP SUMP SEP 3, 2008 9: 19 AM
STP S
S .BUMF
FUEL ALARM
SEP 3. 2008 9: 13 AM
----- SENSOR ALARhi -----
L15:DIESEL ANNULAR
ANNULAR SPACE
ALARM ----- HIGH LIQUID ALARM
SENSOR ALARM
SEP 3. _008 9:27 AM
L 14:D I ESEL FILL SUMP 21,11)
OTHER SENSORS
SENSOR ALARM ----- FUEL ALARM
L 6:PREM STP SUMP SEP 3, 2008 9:20 All
STP SUMP
FUEL ALARM
SEP 3, 2006 9: 14 All
----- SENSOR ALARM -----
----- SENSOR ALARM ----- L20:D1SP 3-4
----- fiENSOR ALARM ----- L28:DISP 11-12 DISPENSER PAN
LIO:PREII ANNULAR DISPENSER PAN FUEL ALARM
SPACE FUEL ALARM SEP 3, 2008 9:36 All
HIGH LIQUID ALARM SEP' 3, 2008 9:30 All
SEP 3. 2006 9:28 AM
----- SENSOR ALARM -----
B1G COUNTRY TEXACO LIB:DISP 1-2
--- - SENSOR ALARM ----- 6009 COFFEE RD. DISPENSER PAN
L 5:UNL ANNULAR BAYERSFIELD,CA 93308 FUEL ALARM
SPACE SEP 3, 2008; 9:37 AM
LOW LIQUID ALARM
SEP 3, 2008 9:28 AM SEP 3, 2008 9:30 AM
----- SENSOR ALARM ----- SYSTEM STATUS REPORT
L 5:UNL ANNULAR - - - - - - - - - _ -
ANNULAR SPACE L28:FUEL ALARM
HIGH LIQUID ALARM
SEP 3. 2008 9:28 AM s 4:NO VACUUM ALARIt
----- SENSOR ALARM -----
L29:DISP 11-12 2ND
OTHER SENSORS
FUEL ALARM
SEP 3, 2008 9:39 All
----- SENSOR ALARM -----
L S:UNL ANNULAR
ANNULAR SPACE ----- SENSOR ALARM -----
LObJ LIQUID ALARM L26:D I SP 9-1 0
SEP 3, 2008 9:28 AM DISPENSER PAN ----- ;SENSOR ALARM -----
FUEL ALARM L27:DISF' 9-10 2ND
SEP .3, 2008 9:31 AM OTHER SENSORS
FUEL ALARM
SEP 3. 2008 9:40 AM
----- SENSOR ALARM -----
L24:DISP 7-8
DISPENSER PAN ----- SENSOR ALARM -----
FUEL ALARM L25:Li I SP 7-8 211D
SEP 3, 2008 9:32 All OTHER SENSORS
FUEL ALARM
SEP 3, 2008 9:40 All
----- SENSOR ALARM -----
L'22:DISP 5-6
DISPENSER PAN ----- SENSOR ALARM -----
FUEL ALARM L23:DISP 5-6 2ND
SEP 3, 2008 9:35 AM OTHER SENSORS
FUEL ALARM
SEP 3, 2008 9:40 All
--- SMARTSENSOR ALARM --
--- SHARTSENSOR ALARM --
- SENSOR ALARM ----- s 5:PREMIUM VENT s 3:UNL VENT
L21 :DISP 3-4 211D IJU VACUUM ALARM NO VACUUM ALARM
OTHER SENSORS SEP 3, 008 10'07 All SEP 3, 2008 10:42 All
FUEL ALARM `
SEP 3, 2008 9:44 AM
--- SMARTSENSOR ALARM -- --- SMARTSE1,2OR ALARM --
s 5:PREMIUM VENT s 2:VAPOR LINE
----- SENSOR ALARM ----- 110 VACUUM ALARM NO VACUUM ALARM
L19:DISP 1-2 2ND SEP 3. 2008 10:10 AM SEP 3, 2008 10:43 All
OTHER SENSORS
FUEL ALARM
SEP 3, 2008 9:44 All
f
BIG CUUIJTk'i TEXACO --- SMARTSENSOR ALARM --
60U1J COFFEE RD. s -,:VAPOR LINE
BAKERS:FIELD.CA 93308 •:»IGH LIQUID ALARM
--- . ARTSEI,6'?,,)P ALARM -- SEP 3. 2008 10:46 All
s 7:DIESEL VENT
NO VACUUM ALARM SEP 3, 2008 10:10 AM
SEP 3, 2008 9:52 AM i
SYSTEM STATUS REPORT
- - - - - - - - - - - - :.
s 4:110 VACUUM ALARM
--- SMARTSENSOR ALARM --
s i :UNL PRODUCT
NO VACUUM ALARM
---
SMARTSENSOR ALARM -- SEE' 3, 2008 10:47 All
s 6:DIESEL PRODUCT
NO VACUUM ALARM
SEP 3, 2006 9:54 AM
--- SHARTSENSOR ALARM --
s 4:PREMIUM PRODUCT
HIGH LIQUID ALARM
SEP 3. 2008 10:13 AM BIG COUNTRY TEXACO
'6009 COFFEE RD.
'! BAKERSFIELD.CA 93308
--- SMARTSENSOR ALARM --
s 6:DIESEL PRODUCT
NO VACUUM ALARI°I SEP 3. 2008 10:48 AM
SEP 3, 2008 9:56 All
SYSTEM STATUS REPORT
--- SMARTSENSOR ALARM -- s 3:NU VACUUM ALARM
- -
s 4:PREMIUM PRODUCT °1
VACUUM WARNING 4:NO VACUUM ALARM
EP 3. 2008 -10:14 AM
--- SMARTSENSOR ALARM --
s 4:PREM I Ut°1 PRODUCT -2:VAPUR LINE
NO VACUUM ALARM SMARTSENSOR ALARM --
�
SEP 3, 2008 10:14 All `_•jjp VACUUM ALARM
:SEP 3. 2008 10:50 AM
- STP-SUMP
--- SENSOR ALARM ----- SENSOR OUT ALARM
6:D I SP .9-10 SEP 3. 2008 11 :53 AM
-- SENSOR ALARM ----- SPENSER PAN
L47:'VENT BOX 2ND EL ALARM
}THER SENS0RS P 3, 2008 11 :32 AM
,UEL ALARM
EP 3, 2008 11 : 12 All
BIG COUNTRY TEXACO
6009 COFFEE RD.
BAKERSFIELD-CA 93308
--- SENSOR ALARM ILIO:DISP 1-2
---- SENSOR ALARM ----- DISPENSER PAM SEP 3. 2008 11 :54 AM
16:VENT BOX FUEL ALARM
HER SENSORS SEP 3, 2008 11 :42 All
UEL ALARM TM STATUS REPORT
P 3.. 2008 1 l :13 All " SE_ T
s 4:N0 VACUUM ALARM
BIG COUNTRY TEXACO
6009 COFFEE RD.
-- IN-TANK ALARM ----- BAKERSFIELD.CA 93308
I :UNL,EADED
IGH PRODUCT ALARM
P 3. 2008 11 : 16 AM SEP 3, 2008 11 :51 AP1
----- SENSOR ALARM -----
L 1 :UNL STP SUMP
STP SUMP
SYSTEM STATUS REPORT FUEL ALARM
- - - - - - - - - - - - SEP 3. 2008 11 :55 AM
L 18:FUEL ALARI°i
s 4:NO VACUUM ALARM
-- IN-TANK ALARM -----
2:PREI°1 I Ull
IGH PRODUCT ALARM
P 3• 2008 1 1 : 1 6 All
----- SENSOR ALARM -----
L I :UNL STP SUMP
STP SUMP
FUEL ALARM
SEP 3, 2008--1-1 :57 AM
----- SENSOR ALARM -----
L 1 :UNL STP SUMP
STP SUMP
-- IN-TANK ALARM ----- SENSOR OUT ALARM
3:DIESEL SEP 3, 2008 11 :53 AM
IGH PRODUCT ALARM
P 3. 2008 11 : 17 All
BIG COUNTRY TEXACO
6009 COFFEE RD.
BAKERSFIELD,CA 93308
----- SENSOR ALARM ----- SEP 3. 2008 11 :59 AM
L I :UNL STP SUMP
--- SENSOR ALARM ----- STP SUMP
B:DISP 1-2 FUEL ALARM
SPENSER PAN SEP 3, 2008 11 :53 AM SYSTEM STATUS REPORT
EL ALARM s 4:NO VACUUM ALARM- - -
P 3. 2008 11 :20 All
----- SENSOR ALARM -----
L 4:UNL FILL SUMP 2ND
OTHER SENSORS
FUEL ALARM
SEP 3, 2008 12:06 PM
BIG COUNTRY TEXACO
6009 T=OFFEE RD.
BAKERSFIELD.CA 93308
SEP 3, 2008 12:07 PM
SY'S'TEM STATUS REPORT
s 4:N0 VACUUM ALARM
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: Big Country Texaco Date of Testing: 9/3/2008
Facility Address: 6009 Coffee Road, Bakersfield,CA
Facility Contact: James Young Phone: 661-327-5008
Date Local Agency Was Notified of Testing: 8/20/2008
Name of Local Agency Inspector(rf present during testing): Ernie Medina
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Service, Inc.
Technician Conducting Test: Matthew Jennings
Credentials: X CSLB Contractor X ICC Service Tech. ❑SWRCB Tank Tester ❑Other(Spec)
License Number(s): CSLB#804904 ICC#5302760-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(fay Tank 1 Regular 2 Super a 3 Diesel 4
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 ❑Contained in Sum
Bucket Diameter: 1 12.00" 12.00" 12.00"
Bucket Depth: 13.25" 13.25" 13.25"
Wait time between applying 5 Min. 5 Min. 5 Min.
vacuum/water and start of test:
Test Start Time(Ti): 9:30 am 9:30 am 9:30 am
Initial Reading(Rj): 1 8.75" 9.00" 9.00"
Test End Time(TF): 10:30 am 10:30 am 10:30 am
Final Reading(RF): 8.75" 9.00" 9.00"
Test Duration(TF—Ti): 1 hour 1 hour 1 hour
Change in Reading(RF-Ri): 0.0" 0.0" 0.0"
Pass/Fail Threshold or 0.0625" 0.0625" 0.0625"
Criteria:
Test Result: X Pass ❑Fail X Pass ❑Fail X Pass ❑Fail ❑ Pass ❑Fail
Comments— (include information on repairs made prior to testing, and recommended follow-up for failed tests)
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
I hereby certify that all the information con aimed in this report is true,accurate,and in full compliance with legal requirements.
Technician's Signature: "C--7:77
Date: 9/3/2008
State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.