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Home My WebLink AboutFMC 2011 MONITORING SYSTEM CERTIFICATION 73 For Use By All Jurisdictions Within the State of California IE 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 nrenared 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 Facility Name: Lucky 7#3 Bldg.No.: Site Address: 726 South Union Avenue City: Bakersfield Zip: 93307 Facility Contact Person: Mohammed Contact Phone No.: 661-324-8516 Make/Model of Monitoring System: Gilbarco TLS 350 Date of Testing/Servicing: 04/25/2011 B. Inventorytof Equipment Tested/Certified Cbeek the appropriate ses to Indicate specific equipment Inspected/serviced: Tank ID: 4,000 gal Diesel Tank ID:4,000 gal Diesel n In-Tank Gauging Probe. Model:847390-107 [x] In-Tank Gauging Probe. Model: 847390-107 ❑ Annular Space or Vault Probe. Model: ❑ Annular Space or Vault Sensor. Model: [x] Piping Sump/Trench Sensor(s). Model:794380-208 Lx] Piping Sump/Trench Sensor(s). Model: 794380-208 ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s). Model: [I Mechanical Line Leak Detector. Model:FXIDV ❑ Mechanical Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: [x] Tank Overfill/High Level Sensor. Model:OPW-6I-SO [J 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: 8,000 gal.Super Tank ID: 10,000 gal Regular [z] In-Tank Gauging Probe. Model:847390-107 [x] In-Tank Gauging Probe. Model: 847390-107 ❑ Annular Space or Vault Sensor. Model: ❑ Annular Space or Vault Sensor. Model: [x] Piping Sump/Trench Sensor(s). Model:794380-208 [X] Piping Sump/Trench Sensor(s). Model: 794380-208 ❑ Fill Sump Sensors(s). Model: ❑ Fill Sump Sensor(s). Model: [x-1 Mechanical Line Leak Decector. Model:FXIV [x] Mechanical Line Leak Detector. Model:_FXIV ❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: [x1 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 ❑c Dispenser Containment Sensor(s). Model: 794380-208 [x] Dispenser Containment Sensor(s).Model: 794380-208 [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: 794380-208 [X] Dispenser Containment Sensor(s).Model: 794380-208 [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) Qx S tem Set-up [x]Alar�-�ist 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: 726 South Union Avenue,Bakersfield,COL 93307, 'late of Testing/Servicing: 0412512011 IIIIIII 111111111 74 IE D. Results of Testing/Servicing Software Version Installed: 7.03 Complete the following checklist: • Yes ❑ No* Is the audible alarm operational? g x x 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 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) x 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; Fx] 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? E9p % ❑ Yes* L^J 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? ❑ Product; ❑ Water. If yes,describe causes in Section E,below. x No* Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports,if applicable. x Yes 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: F. In-Tank Guaging/SIR Equipment: [X] 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: [] Yes No* Has all input wiring been inspected for proper enter and term ination,including testing for ground faults? x 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? x Yes No* Were all probes reinstalled properly? U 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. Com lete 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: [!J3 g.p.h.: ❑0.1 g.p.h.; ❑0.2 g.p.h.; x Yes No* Were all LLD's confirmed operational and accurate within regulatory requirments? x Yes No Was the testing apparatus properly calibrated? L] Yes No For mac anwa LLD's,does the LLD restrict product flow i it detects a leak? N/A ❑ Yes I No* For electronic LLD's,does the turbine automatically shut off if the LLD detects a leak? E 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 [x] N/A malfunction or fails a test? ❑ Yes No* For electronic LLD's,have all accessible wiring connections been visually inspected? [x] N/A x Yes No 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: LN-TANK,. SETUP SYSTEM' SETUP - - - - - -1' - :1 0 49 AM 7 1.:GIT CO 2 APR 25: 201 _ PRODUCT COGS 1 .THERMAL COEFF : .000450 TA14K D1AIIETER 72..00 TANK PROFILE 1 PT 110.%, 7.-NO.3. SYSTEM UNITS FULL VOL 4001 726 SO-UNION U.S. BAYERSFIELD ?A.93307 :SYSTEM LANGUAGE SUN VALLE%' OIL CO. ENGLISH FLOAT SIZE: 4..0 INCHES APR 25. ;'201 1 1'0,:48 -,Ah1 166 CLUCK;` 7 NO;.3 W�TER WARN]NG. : 2.p 7.26 SO,.UNION. HIGH WATER LIMIT: 3:0 BAKERSFIELD .CA..9.3307 "SUN 'VALLEY 01L CO. Ilk( OR LABS VOL: 4001 SYSTEM STATUS REPORT OVERFILL L1 IT 90% -'• ' - - _ SHIFT TIME i : 10'00 PM 3600 T I DELIVERY NEEDED 'SHIFT TIME : DISABLED HIGH PRODUCT 95% SHIFT T1 ME, 3 : D.ISABLED 38,00 T 2:.DELi.VERY' 14EEDED DELIVER' LIMIT i9% T 3:'DELiVERY NEEDED PERIODIC TEST WARNIAGS 760 DISABLED,TEST WARNINGS LOW PRODUCT 300 INVENTOR'! REPORT- DISABLED LEAK ALARM L.1 M I-T: 99 1 SUDDEN LOSS LIMIT: 50 S%SSTE,H SECURITY. TANK TILT 0...00 T 1 O I ESEL 2 CODE_' 000000 ' VOLUME a 37x7 GALS MAN 1 FOLDED. TANKS ULLAGE = 3624 GALS To': NONE 90A ULI.AGEa -3223 GALS PERIODIC TEST TYPE TC VOLUME a 374-GALS STANDARD HEIGHT ICJ,62.INCHES WATER VOL e 0'GALS . PER POD IC TEST FAIL WATER 0.00 INCHES ALARM DISABLED TEMP 78.1 DEG F T 2-DIESEL 2 GROSS TEST FAIL VOLUME a 442 GALS ALARM DISABLED ULLAGE a 3559 GALS COMMUNICATI.ONS SETUP PER TEST AVERAGING:. OFF 90l ULLAGE- 31,58 GALS' TC: VOLUME a 438 GALS TANK .TEST NOTIFY: ON HEIGHT 12.07 1NCHES WATER VOL a t7 GALS . -PORT SETT IN6�: TNK TST 'SIPHON BREAK:OFF WATER - d.00 i NCHF.S TEMP 76•.1 DEG F` NONE FOUND OF-LIVERY DELAY 15 MIN T. 3:SUPER RS-2'32,SECUR-ITY VOLUME a '787 GALS -CODE -: 001000 ULLAGE a 6'71.4 GALS 90% ULLAGEF 5963 GALS TC VOLUME = 786 GALS HEIGHT 15.53 1NOKH,; WATER VOL 9 GALS WATER 0.75 IN!`1406. RS-232 END OF MESSIiOE TEMP m 74.:2 Cry: 1< DISABLED T 4..REraULAR VOLUME 1965 GALS ULLAGE 8036 GALS 90%..ULLACE- 7035 GALS TC VOLUME a 1963 GALS HE 1,GHT = 24,0$ INCHES' WATER'VOL = 0 'GALS WATER = 0.00 INCHES TEMP = 73.0 .DEG F * x. ENDx .k t T a:SUPER T 2:DIESEL 2 PRODUCT CODE 3 T 4:RGT CODE. 4 PRODUCT CODE 2 .THERMAL. COEFF :.00U07U THERMAL COEFF :.000450 TANK DIAMETER. 96.00 THERMAL COEFF : .000070 TANK DIAMETER '72.00 TANK PROFILE I PT TANK DIAMETER 96.00 TANK PROFILE I PT FULL VOL 7501 TANK PROFILE I 'PT FULL VOL 4001 FULL VOL 10001 FLOAT SIZE:. 4,.0 INCHES FLOAT SIZE: 4.0 1WHE9 WATER WARNING 2:A FLOAT SIZE: 4.0 1NCHES � WATER WARNING, 2.0 HIGH WATER L;I M I T: 3.0 HWH WATER LIMIT: 3.0 WATER WARNING 2..0 x.MAX OR LABEL VOL.: 7501 HIGH WATER LIMIT: .3.0 MAX OR LABEL VOL: 4001 OVERFILL 'LI'MIT 90% OVERFILL LIMIT 90Y. 6750 MF+X OR,LABEL VOL: 10001 3600 HIGH PROb1�CT '954 OVERFILL LIMIT 90% HIGH PRODUCE 9,5Y. 7126. 9000 ,3800 DELIVERY LIMIT 19% HIGH PRODUCT 95/ DELIVERY LIMIT 19X 14.25 1-99 01 19% DELIVERY LIMIT l9 LOW PRODUCT 500 1900 LOW PRODUCT 300' LEAK.ALARM LIMIT.: 99 LOW •PRODUG7 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS: LIMIT: 50 LEAK ALARM LIMIT: 99 SUDDEN LO. LIMIT.: 5O TANK TILT 0,.00, SUDDEN LOSS LIMIT: 50 TANK T'I'LT 0.00 TANY T I,LT 0.00 MAN FOLDED 'I'AN}•'.S MAN!F"OLDED TANKS TA: NONE MANIFOLDEb TANKS TG' NONE TYPE TO: NONE PERIODIC 'LEST TYPE TES :ftANDARD STANDARD 'PERIODIC TEST TYPE, PERIODIC TEST FAIL, STHNDARD PERIODIC TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ALARM DISABLED GROSS TES"T' FAIL GROSS TEST' FA'IL ALARM D1;SABLED (;ROSS TEST FAIL ALARM DISABLED ALARM DISABLED i3 PER TEST AVERA1,NG': OFF PER TESL AVERAGING: OFF TANK.TEST NOTIFY: ON PER TFT.r',VERAG I PIG OFF TANK TEST .oOTI;FY: ON TANK TEST NOTIFY: ON TIC T5T SLPHON BREAK:OFF TNK TST SIPHON BREAK:OFF TNK ThT SIPHON BREAK:OFF DEL 1 VFItY DELAY 15 MIN DELIVERY DELAY 15 MIN DELIVERY DELAY : 15 MIN LEAK TEST METHOD TEST WEEKIN ALL TANK MON START TIME : 1:2,:00 AM TEST RATE :0.2U GALiHR DURATION 2 HOURS LIQUID SEM1SjOR SETUP OUTPUT RELAY SETUP SOFTWARE REVISION LEVEL - - - - - - - - - - - - - - - - - - - - .VERSION 7.03 L 1 :D 1 FSEL SUMP TANK 1 SOFTWARE✓ 349500-007-D CREATED - 94.08.24.10.26 TRI-STATE (SINGLE-FLOAT) CATEGORY : STP SUMP R I :DIESEL NO •SOFTWARE-MODULE TYPE' SYSTEM FEATURES: L 2:DIESEL STP TANK 2 STANDARD PERIODIC 1N-TANK TESTS TRI-STATE (SINGLE FLOATS NORMALLY'CLOSED ANNUAL IN-TANK' TESTS CATEGORY STP: SU11P LIQUID SENSOR ALMS L�3:S UPER STP :TANK 3 L I,:FUEL. ALARM :FUEL •ALARM TR1.-STATE ( L SINGLE FLOAT) +L 2 CATEGORY : STP SUMP ` L V:FUEL ALARM 1:SENSOR OUT ALARM L 2:SENS6R OUT' At.ARM L 4:REGULAR ST TANK 4 L ,8:SENSOR OUT A RM T.RI-STATE tSINGLE FLOAT) L [ :SHORT ALARM �1TECORY : STP SUMP L e �k OR'' ALARM ALARM HISTORY REPORT ----~ SYSTEM ALARM PAPER OUT L 5:MF.0 1-2 APR.25 2011 •10:47 Am CATEGOR3 E:(D I SPENSE'R' PAN PRINTER 5. ERROR k. 2:SUPER• APR 25. 2011 10:48 AM TYPE BATTERY IS .OFF STANDARD JAN 1, 1994 8,:00 Am L 6:INFD, 3-4 NORMALLY CLOSED TRI--9TA1'E (SINGLE FLOAT) CATEGORY : DISPENSER. PAN LIQUID SM4R'AUIS L 3:FUEL ALARM L 5:FUEL. ALARM L 7:MPTi 5-6 L 6:FUEL'ALHRM TR I-STATE (S 1 NGL'E FLOAT) L 7:FUEL AI ARM CATEGORY : .DISPENSER PAN L :SENSOR OUT ALARM L 5:SENSOR OUT ALARM. L 6-:SENSOR OUT ALARM L 7:SENSOR OUT ALARM L .t3:DiESEL 7-8 L 3:SHORT ALARM L 5:SHORT. ALARM TRI-STATE (SINGLE .FLOAT> CATEGORY DISPENSER PAN L 6:SHORT ALARM L 7:9HORT ALARM 3 R 3:REGULAR TYPE: STANDARD. , NORMALLY CLOSED LIQUID SENSOR ALMS L 4:FUEL ALARM L 5:FUEL ALARM L 6;FUEL.ALARM L 7:FUEL ALARM L 4:SENSOR OUT ALARM L 5:SENSOR OUT ALARM L 6:SENSOR OUT ALARM i 7,SENSOR_ OUT ALARM L 4:SHORT ALARM L 5:SHORT ALARM L '6:SHORT ALARM L 7:SHORT ALARM ALARM HISTORY REPORT ALARM .NISTORV PEPORT ALARM HISTORY REPORT ---- IN—TANX ALARM ----- ---- 114—TANK ALARM ----- ---- IN—TANK ALARM ----- T I :D.IESEL 2 T 2:DIESEL 2 T 3:8UPER LEAK ALARM LEAK ALARM HIGH WATER ALARM FEB 18. 3863 3:30 AM APR 30. 2007 1•:.00 AM APR 21 . '2010 9:38 AM HIGH WATER ALARM HIGH WATER ALARM OVERFILL ALARM APR 21 , 2010 9:54 AM APR 21. 2010 .954 AM' APR 21: 2010 9:38 AM AVERF1LL ALARM 'S.OVERFILL ALARM MAR'18. 2008 5:13 PM AR 13. 2009 1 1'1 PM LOW PRODUCT ' 6:JL .rl'1 APR 5. .2011 6:17 P1�1 SEP 2. 2004 ,10:41 AM MAR 27. 2008 5:06 PI°I MAR 8. 2011 11 :48 AM 'AUG. 22, 2004 3:35. PPI JUN 13. 2006 10:39 PM JAN 25 2011-. 8:13 PM LOW PRODUCT ALARM LOW PRODUCT ALARM HIGH :PRODUCT ALARM MAR 24, 2011 2:20 PM MAY —4, 2010 12:32 PM APR 2.1 , 2010 9:38 AM MAR '1I : 2011 8:57 AM JUN 24'. 2006 12:03 PM FES 28. 2011 2:30 PM MAY 13: 2005 5:51 AM INVALID FUEL LEVEL SUDDEN LOSS ALARM SUDDEN LOSS ALARM DEC 18� 20,10 1 :52 All APR 30. 2b07 12:39' AM APR '30- 2007 12::34 AM NOV, 2V, 20.10 9:31 All APk. �t 2010- 9:38 AM HI�GH .PRODUCT ALARM HIGH PRODUCT ALARM PROBE OUT APR 21 . 2010. 9:54 All APR 21- 2010 -9;:54 Alai APR 21 . 2010 9:39 AM JAN 10_, 2004 T:07 AM SEP 6. 2004 10;.37 ,APi APR 21 2010 9.:37, AM FEB 1.1, 21)04 12:29: Ph FEB 21, :2004' 4::49 AM MAR. -18. 2008 12:37 PM INVALID FUEL LEVEL INVALID FUEL. LEVEC HIGH WATER WARNING JAN. 5, 2011 6:46 PM APR .21;. 201.0. :9:54 AM' APR 21, 2010 9:38 AM MAY 41 201'0 1:08 PM APR 13i,. 2004 6•:10 AM APR. 2f. 2010 9:53'All PROBE .OUT DELIVER! NEEDED PROBE OUT APR -21 o 2010 '9:56 AM: FEB 16. 2011 4:11 PM APR 21. 201.0 9:58 AM MAR 2•, 2007 2:09 PM NOV Z2.. 2010 6:36 .PM MAR 2, 2007 2:10 PM JUN 10. 2004 2.:19 PM' OCT '21, 2010 5:,08 PM JUN 1.0: 2004, 2:19 PM HIGH WATER WARNING, HIGH 1, 2010 9':5G APR 21 . 2010' 9:54 AM APR 21, 2010 9':54 AM TANK. TEST ACTIVE APR ,25, .2011 1.2:00 AM DELIVER�'. NEEDED, ;APR 1'8: .20 1.1 1 2:.00 HM DELIVERY NEEDED APR. 1.4.. '201 1' 1;,0;:03 AN APR 1':1 . .201 1 1.2:00 AM APR' 11-, X011 ' :56 PM MAR 28;• '201,1 9:10 AM' JAN 31 201 1. -11':16 AM MAR 14• 201 I 1 :05 'PM DEC 23. _2010 8:57 AM MAX .PRODUCT ALF W MAX PRODUCT ALARM APR 21 : .2010 `9,54 AM FEB 11, 2004 1'2:30 PM 'SEP 6' 2003 3 24 PM NOV 27, 2003 335' AM APR 8.• 2003` 17 :31 .PIh OG"t 25-, 2003 3:03 AM TANK TEST ACTIVE TANK TEST AI:T I VE APR 25: .2011 42_'1'00 AM APR' 25, 201-1 12:00 AM APR 18:. 2011 12:00 APP APR •18, 2011 .12:00 AM APR 11 . '2011 1.2:00 AM APR 11. 2011 12;00 AM ALARM HISTORY REPORT ALARM HISTORY REPORT i ALARM HISTORY REPORT ---- IN-TANK ALARM ----- -- SENSOR ALARM ---_ ----- SENSOR.ALARM ----- t 1 DIESEL'.SUMP TANK I L 5:MPD .l-2 T 4:REGULAR STP SUMP DISPENSER PAN SENSOR OUT ALARM FUEL ALARM HIGH WATER ALARM APR 2.1. 2010 10:07 AM APR 21. 2010 9:15 AM APR 21. 2010 9:33 AM FUEL-ALARM SENSOR OUT ALARM OVERFILL ALARM APR 21., 2010 3:24 Alit MAR 91 2009 8:38 AM APR 21, 2010 9:34 AM SEP 22. 2009 10:41 AM SENSOR OUT ALARM FUEL ALARM AUCL 13. 2008 6:34 AM `MAR 9. .2009 8:37 AM MAR 9, 2009 8:29 AM LOW PRODUCT ALARM DEC 31. 2010 1'1 :06 AM DEC 11. 2010 4:•314 PM JUL 24, 2010 6:12 Phi HIGH PRODUCT ALARM APR 21. 2010 9:33 AM FEB 4. 2007 3:39 Pht JUL S. 2006 10:07 AM ALARM H1$'CORY REPORT ALARM HISTORY REPORT INVALID FUEL LEVEL DEC 31 . 2010 .1 :12 PM ----- SENSOR ALARM --- - ----- SENSOR ALARM -DEC. II . 2010 8:44 PM L 2:DI.ESEL STP TANK 2 L 6:MPD 3-4 APR 21 , 2010. 9:33 AM STP SUMP DISPENSER PAN FUEL f,LARM FUEL ALARM PROBE OUT APR 21., 20.1-0 9:,26 AM APR 21 .2010 9:17 AM APR 21. 2010 9:34 AM APR 21, 2010 9:32 AM SENSOR OUT ALARM SENSOR OUT ALARM MAR 18, 2008 12:37 PM MAR 9: 2009 8:38 AM MAR 9. 2009 8:37 AM HIGH WATER WARNING FUEL .ALARM FUEL ALARM' APR 21, .2010 .9:33 AM MAR: '9,2009 8:25 AM MAR 9. 2009 8:31 AM DELIVERY NEEDED APR 18: 2011 7:38 AM 'APR 70 2011 6:15 PM MAR 31 . 2011 10:06 AM MAX 'PRODUCT (ALARM JUL 5.. 2006 10:09 AM FEB 25.. 2004 1 :23 AM JUL 31.. 2002 3:27 AM ALARM H I STORY REPORT "RM H I STORY' REPORT -- SENSOR, ALARM. ----- ----- SENSOR ALARM ----- TANK TEST ACTT I VE L 3:SUPER STP TANK:9 L 7::MPD.5-6 APR' 25- 2011 12:00 AM STP SUMP DISPENSER PAN APR 1H,. 20.11 12:00 AN FUEL ALARM APRLap�070 9'!9 AM APR Il , 2011 12:00 AM APR 21 . 2010. 10:11 AM FUEL ALARM SENSOR OUT ALARM APR 21. 2010 9:28 AM MAR 9 2009 8:37 AM SENSOR OUT. ALARM FUEL ALARM MAR. 9, 2009 8:38 AM MAR 9. 2009 8:33 4M ALARM HISTORY REPORT -----SENSOR ALARM ----- L 4:REGULAR STP TANK 4 STP SUMP FUEL ALARM APR 21 . 2010 10:1.1 AM FUEL ALARM, APR 21, 201`0' 9:30' AM SENSOR OUT ALARM MAR 9, 2009 8:38 AM - SENSOR. ALARM ----- ----- SENSOR ALARM L-2:DIESEL STP TANK 2 L. 8:DIESEL 7-8 STP SUMP DISPENSER PAN FUEL 'ALARM FUEL: ALARM APR 25, 2011' 11 :16 AM APR 25., 2011 11 :23 AM SENSOR ALARM LUCKY 7 N0,3 L 1 DIESEL "P4 ! 1. 726 SO.UNION , STP SUMP BAKERSFIELD CA.93307 FUEL ALARM SUN: VALLEY OIL CO. APR 95. 2011 11 :17 AM APR 25:: 2011 11 :24 AM SYSTEM STATUS REPORT T ( :DELIVERY NEEDED ---- SENSOR ALARM ----- T 2:DELIVERV NEEDED L 3:SUPER STF• TANK 3 T 3•DELIVERY NEEDED STP SUMP FUEL 'ALARM APR. 25. 2011. 1 l :18' rill -- .SENSOR.ALARM ------ SENSOR ALARM --- -- L 4:.RECUL:AR STP TANI, a L 2 DIESEL STP ?ANK 2 6?P SUMP STP SUMP SENSOR OUT ALARM fi UEL,ALARM .APR'25, 2011 1.1:25 AM APR 25�. 201,1 11 :19 All i ----- ----- -- SENSOR ALARM SENSOR ALARM L ----- 4:RECULAR STP TANK 4 L 5,:MPD 1-2 STP SUMP . DISPENSER.PAN SENSOR OUT ALARM FUEL 'ALARM: 'APR 25, 2011 11 :25 AM' APR 25. 20.11 11:21 HM -_--- 8ENSOR ALARM ----- -- SENSOR ALARM ----- L•5:MP0 .1-2 L 6:41) 3-4 DISPENSER FAN DISPENSER PAN SENSOR OUT ALARM FUEL ALARM 'APR 25, 20.11 11 :25 AM APR 25. 2011 •11 :21 AM ---- SENSOR ALARM --- L 6-` SENSOR ALARM :MPD 3-4. L 7:MPD 5-6 , DISPENSER PAN DISPENSER. PAN SENSOR OUT ALARM FUEL ALARM APR, 25, 2011. 1'i :25 AM AP R ?a• X011 11:22 AM P LUr;KY 7 NO.3 726 SO,IJN I ON BAKERSFIELD CA.53307 ----- ,SENSOR ALARM ----- SUN VALLEY OI.L CO.. L 7:MPD 5-6 DISPENSER PAN APR '25. '2011 11 :25 AM SENSOR OUT ALARM APR 25. 2011 11 :25 HM SYSTEM STATUS REPORT - - - T I :DELIVERY NEEDED y T 2:DELIVERY NEEDED T 3:DELIVERY NEEDED ---�- SENSOR ALARM ----- L I-:SENSOR OUT ALARM L B:DIESEL 7=8 DI$PENSER PAN, L .2:SENSOR OUT ALARM SENSOR OUT ALARM APR 28. -2011 11 :25 AM L 3:SEN$OR OUT ALARM .L 3:SENSOR. GUT ALARM L 5:SEN80R OUT ALARM L 7:SENSOR OUT ALARM L B:SENSOR OUT ALARM ----- SENSOR ALARM.- ---- L I :DIESEL SUMP TANK I STP SUMP' SENSOR OUT ALARM APR 25. 2011 11 :25 HM LUUKY 7 NO.3 726 SO.UNION BAKERSFIELD CA.93307 SUN VALLEY 011- CO. --- SENSOR ALARM ----- L 3:SUPER STP TANX 3 APR 25.. 2011 11 :2� AM STP SUMP SENSOR OUT ALARM APR 25.. 2011 11 :25 41-1 SYSTEM STATUS REPORT. T .1 :DEL.IVERY NEEDED T 2:DELIVERY NEEDED T 3:DELI,VERY NEEDED L :5:SENSOR OUT ALARM ----- SENSOR ALARM ----- L 3:SUPER STP TANK 3 STP SUMP FUEL ALARM APR 25, 2011 12:12 PfI 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(f applicable), should be provided to the facility owner/operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: Lucky 7#3 Date of Testing: 4/25/2011 Facility Address: 726 South Union Avenue, Bakersfield,CA 93307 Facility Contact: Mohammed Phone: 661-324-8516 Date Local Agency Was Notified of Testing: 3/30/2011 Name of Local Agency Inspector(af present during testing): Ester Duran 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 Diesel M. 2 Diesel S. 3 Super 4 Regular Number, Stored Product, etc.) Bucket Installation Type: ❑x Direct Bury ❑x Direct Bury ❑x Direct Bury ❑x Direct Bury ❑Contained in Sump ❑Contained in Sump ❑Contained in Sump ❑Contained in Sum Bucket Diameter: 12.00" 12.00" 12.00" 12.00" Bucket Depth: 14.00" 14.00" 14.00" 14.00" Wait time between applying 5 Min 5 Min 5 Min 5 Min vacuum/water and start of test: Test Start Time(Ti): 11:30 am 11:30 am 11:30 am 11:30 am Initial Reading(R,): 10.00" 10.00" 10.25" 9.75" Test End Time(TF): 12:30 pm 12:30 pm 12:30 pm 12:30 pm Final Reading(RF): 10.00" 10.00" 10.25" 9.75" Test Duration (TF—Tj): 1 Hour 1 Hour 1 Hour 1 Hour Change in Reading(RF-Rj): 0.00" 0.00" 0.00" 0.00" Pass/Fail Threshold or 0.0625" 0.0625" 0.0625" 0.0625" Criteria: Test Resew .:=X Pass DF X Pass ®Fail MEMO Pass < �sil X Pass ®Fad Comments—(include information on repairs made prior to testing, and recommended follow-up forfailed 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: 04/25/2011 State laws and regulations do not curr tly require testing to be performed by a qualified contractor.However,local requirements may be more stringent.