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. If more than one monitoring system control panel is installed at the facility,a separate
certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank
system owner/operator. The 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: 7-ELEVEN#32376,MKT 2368 City: BAKERSFIELD CA Zip:93312
Site Address: 9600 BRIMHALL RD. Contact Phone No: 588-4059
Date of Testing/Service: 05/27/2010
Facility Contact Person: MANAGER IIIIIIIIIIIII III IIII 61
Make/Model of Monitoring System:VR TLS-350 Work Order Number. 3175015
B.Inventory of Equipment Tested/Certified IE
Check the appropriate boxes to indicate specific equipment inspected/serviced
Tank ID: 87 Tank ID: 91
71 In-Tank Gauging Probe. Model: VR ATG X In-Tank Gauging Probe. Model: VR ATG"
X Annular Space or Vault Sensor. Model: VR420 El Annular Space or Vault Sensor. Model: VR420
71 Piping Sump/Trench Sensor(s). Model: VR208 Piping Sumpr7rench Sensor(s).... Model: VR208
Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model:
X Mechanical Line Leak Detector. Model: LD2000 RX Mechanical Line Leak Detector. Model: LD2000
Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model:
X Tank Overfill./High-Level Sensor. Model: FLAPPER Tank Overfill/High-Level Sensor. Model: FLAPPER
Other(specify equipment type and model in Section E on page 2). Other(specify equipment type and model in Section E on page 2).
TanklD: TanklD:
In-Tank Gauging Probe. Model: In-Tank Gauging Probe. Model:
Annular Space or Vault Sensor. Model: Annular Space or Vault Sensor. Model:
Piping Sump/Trench Sensor(s). Model: Piping Sump/Trench Seensor(s): Model'.
Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model:
Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model:
Electronic Line Leak Detector. Model:
Electronic Line Leak Detector. Model:
Tank Overrill/High-Level Sensor. Model: Tank Overfill/High-Level Sensor. Model:
Other(specify equipment type and model in Section E on page 2). Other(specify equipment type and model in Section E on page 2).
Dispenser : 1-2 Dispenser ID: 3-4
®Dispenser Containment Sensor(s) Model:VR352 X Dispenser Containment Sensor(s) ModeV.VR352•-
X Shear Valve(s). FX_1 Shear Valve(s)
Dispenser Containment Float(s)and Chain(s). Dispenser Containment�RDat(s)and Chain(s):
Dispenser ID: 5-6 Dispenser ID: 7-8
0 Dispenser Containment Sensor(s) Model:VR352 _FX-1 Dispenser Containment Sensor(s). Model:VR352
❑ Shear Valve(s). Shear Valve(s).
Dispenser Containment Float(s)and Chain(s). Dispenser Containment Float(s)and Chain(s).
Dispenser ID: 9-10 Dispenser ID: 11-12
X❑ Dispenser Containment Sensor(s) Model:VR352 X Dispenser Containment Sensor(s). ModeL VR352
[X Shear Valve(s). Shear Valve(s).
X
Dispenser Containment Float(s)and Chain(s). Dispenser Containment Float(s)and Chain(s).
'If the facility contains more tanks or dispensers,copy this form.Include information for every tank and dispenser at the facility.
C. Certification
I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers'guidelines.
Attached to this certification is information(e.g manufacturers'checklists)necessary to verify that thisiiiformation is-correct:
and a Site Plan showing the layout of monitoring equipment.For any equipment capable of generating such reports,I have also attached
a copy of the(Check all that apply): System set-up X Alarm history report
Technician Name(print): DANIEL VISSER Signature: �u
Certification NO.: A31963 License. No.: 743160(Class'A'General Enginering Contractor License)
Testing Company Name:Tanknology Phone No.: (800)800-4633
Site Address: 11000 N.MoPac Expressway,suite 500,Austin,TX 78759 Date of Testing/Servicing: 05/27/2010
Monitoring System Certification Page1--of•3• IIIIIIIIIIIII III IIII 62 Based on-CA-fof m-dated 03/08
IE
Monitoring System Certification
Site Address 9600 BRIMHALL RD. Date of Testing/Service: 05/27/2010
D. Results of Testing/Servicing
Software Version Installed: 329.02
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?
Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not
❑X Yes ❑No
interfere with their proper operation?
X Yes No-f N/A If alarms are relayed to a remote monitoring station,is all communications.equipment(e.g...modem)operational?. .. ..
For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment
EX Yes E]No• ❑N/A monitoring system detects a leak,fails to operate,or is electrically disconnected?If yes:which sensors initiate positive
shut-down?(check all that apply) ❑X Sumprrrench Sensors; ❑X Dispenser Containment Sensors.
Did you confirm positive shutdown due to leaks and sensor failure/disconnection? ❑X Yes No
R Yes ❑No• N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device"(i.e.'no mechanical-
overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank fill points(s)and operating
properly? If so,at what percent of tank capacity does the alarm trigger?
MX 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* EX No Was liquid found inside any secondary containment systems designed as dry'systams?(check-aft thatapply)- DProduct,-
❑ Water. If yes,describe causes in Section E,below.
EX Yes ❑No• Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports,if applicable.
EX Yes ❑No• Is all monitoring equipment operational per manufacturers'specifications?
*In Section E below,describe how and when these deficiences were or will be corrected.
E. Comments:
REPLACED 7 ANNULAR SPACE SENSOR LIKE FOR LIKE VR 420 TESTED OK...
Page 2 of 3 Based on CA form dated 03/08
Monitoring System Certification
Site Address: 9600 BRIMHALL RD. Date of Testng/Service:. 05127/2010
F. In-Tank Gauging / SIR Equipment
0 Check this box if tank gauging is used only for inventory control.
❑ Check this box if no tank gauging or SIR equipment is installed.
Check this box if no tank gauging or SIR equipment is installed.
This section must be completed if In-tank gauging equipment is used to perform leak detection monitoring.
Complete the following checklist:
❑Yes ❑No• Has all input wiring been inspected for proper entry and termination,including testing for ground faults?
❑Yes ❑No' Were all tank gauging probes visually inspected for damage and residue buildup?
❑Yes ❑No' Was accuracy of system product level readings tested?
1:1 Yes ❑No' Was accuracy of system water level readings tested?
ElYes ❑No' Were all probes reinstalled properly?
❑Yes ❑No• Were all items on the equipment manufacturers'maintenance checklist completed?
'In the Section H,below,describe how and when these deficiencies were or will be corrected.
G. Line Leak Detectors (LLD) : ❑ Check this box if LLDs are not installed.
Complete the following checklist:
For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance?
Yes ❑No ❑N/A (Check all that apply)Simulated leak rate: x❑ 3 g.p.h❑0.1 g.p.h ❑0.2 g.p.h
x Yes ❑No Were all LLDs confirmed operational and accurate within regulatory requirements?
X Yes No Was the testing apparatus properly calibrated?
❑X Yes No ❑N/A For mechanical LLDs,does the LLD restrict product flow if it detects a leak?
❑Yes ❑No' ❑x N/A For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak?
❑Yes ❑No' ❑X N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system.is disabled or.disconnected?._.
❑Yes ❑No' 0 N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test?
❑Yes ❑No' ❑X N/A For electronic LLDs,have all accessible wiring connections been visually inspected?
LJ Yes ❑No' Were all items on the equipment manufacturers'maintenance checklist completed?
'In the Section H,below,describe how and when these deficiencies were or will be corrected.
H. Comments:
Page 3 of 3 Based on CA form dated 03108
SWRCB,January 2002 Page 1.
Secondary Containment Testing Report Form
This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the
appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and
printouts from tests(if applicable),should be provided to the facility owner/operator for submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: 7-ELEVEN #32376, MKT 2368 Date of Testing: 05/27/2010
Facility Address: 9600 BRIMHALL RD. , BAKERSFIELD, CA, 93312
Facility Contact: MANAGER Phone: (6 61) 588-4059
Date Local Agency Was Notified of Testing : 05/17/2010
Name of Local Agency Inspector(if present during testing): ERNIE MEDINA
2. TESTING CONTRACTOR INFORMATION
Company Name: TANKNOLOGY, INC.
Technician Conducting Test: DANIEL VISSER
Credentials: CSLB Licensed Contractor SWRCB Licensed Tank-Tester.. . .
License Type: A I License Number: 743160
Manufacturer Training
Manufacturer Component(s) Date Training Expires
INCON TS-STS 06/01/2010
/
3. SUMMARY OF TEST RESULTS:,
Not Repairs Not Repair
Component Pass Fail Tested Made Component Pass Fail Tested
Halle-
Spill Box 2 REG FILL [xl ❑ ❑ ❑ ❑ ❑ F-1 ❑
Spill Box 2 REG FILL M El ❑ ❑ El F-1 1:1 ❑
Spill Box 2 REG VAPOR Fx1 ❑ ❑ ❑ ❑ ❑ ❑
Spill Box 2 REG VAPOR x ❑ ❑ ❑ ❑ ❑ ❑ ❑
Spill Box 3 PRE FILL El ❑ ❑ ❑ ❑ ❑ ❑
Spill Box 3 PRE FILL ❑ ❑ ❑ ❑ ❑ ❑
Spill Box 3 PRE VAPOR ❑ ❑ ❑ ❑ ❑ ❑
Spill Box 3 PRE VAPOR ❑ ❑ ❑ �.._. _... E.... ...
El El El El El
El El F nl EJ nl
I Ell Ell El El
If hydrostatic testing was performed,describe what was done with the water after completion of tests:
WATER REUSED. . .
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements
Technician s Signature:
n / VN��' Date:
� 05/27/2010
�, , f (w
SWRCB,January 2006
9. Spill Bucket Testing Report Form
This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and
printouts from tests(if applicable),should be provided to the facility owner/operator for submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: 7-ELEVEN #32376, MKT 2368 DateofTesting: 05/27/2010
Facility Address: 9600 BRIMHALL RD. , BAKERSFIELD, CA, 93312
Facility Contact: MANAGER Phone:. .._ (66 1) 5 88-40 52-.
Date Local Agency Was Notified of Testing: 05/17/2010
Name of Local Agency Inspector(if present during testing): ERNIE MEDINA
2. TESTING CONTRACTOR INFORMATION
Company Name: TANKNOLOGY, INC.
Technician Conducting Test: DANIEL VISSER
Credentials I: ❑X CSLB Contractor ❑ICC Service Tech. ❑SWRCB Tank Tester E Other(Specify)A
License Number: 743160
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: Hydrostatic ❑ Vacuum ❑-Other
Test Equipment Used: INCON Equipment Resolution:+-.0 0 2 0
Identify Spill Bucket(By Tank 1 2 REG FILL 2 2 REG FILL 3 2 REG VAPOR 4 2 REG VAPOR
Number, Stored Product, etc.)
❑X
Bucket Installation Type: Direct Bury ❑Direct Bury X❑Direct Bury ❑X Direct Bury
.•
❑Contained in Sump ❑ Contained in Sump El Contained in Sump ❑Contained in Sump
Bucket Diameter:
Bucket Depth: 1211 1211 1211 - 1211
Wait time between applying 15MIN 15MIN 15MIN.. 15MIN-
vacuum/water and starting test:
Test Start Time(TI ): 1207 1243 1207 1243
Initial Reading(RI ): 3 .3334 3 .3339 6.6910 6.6912
Test End Time(TF ): 1222 1259 1222 1259
Final Reading(R F ): 3 .3332 3.3332 6.6907 6.6911
Test Duration: 15MIN 15MIN 15MIN 15MIN
Change in Reading(R F-RI ): -.0011 - .0 0 0 7 - .0003 - .0 0 01
Pass/Fail Threshold or 0020 .0020 .0020 .0020
Criteria:
es Result: In ass ® ail ® ass Fail ® ass ail Pass ail
Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests)
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
I hereby certify that all the information contained in this report is true,accurate,and in full compliance with legal requirements.
// 05/27/2010
Technician's Signature: `��,,, � C� . Date: _ .
I State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements
SWRCB,January 2006
9. Spill Bucket Testing Report Form
This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and
printouts from tests(f applicable),should be provided to the facility owner/operator f&r sub'mittal-to the"local regulatory agency.
1. FACILITY INFORMATION
Facility Name: 7-ELEVEN #32376, MKT 2368 DateofTesting: 05/27/2010
Facility Address: 9600 BRIMHALL RD. BAKERSFIELD, CA, 93312
Facility Contact: MANAGER Phnnew"_ (661.1—5B.8,7 405.9 —
Date Local Agency Was Notified of Testing: 05/17/2010
Name of Local Agency Inspector(if present during testing): ERNIE MEDINA
2. TESTING CONTRACTOR INFORMATION
Company Name: TANKNOLOGY, INC.
Technician Conducting Test: DANIEL VISSER
Credentials I: a CSLB Contractor ❑ICC Service Tech. ❑SWRCB Tank Tester E Other(Specify)A
License Number: 743160
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: X❑ Hydrostatic ❑ Vacuum ❑ Other --
Test Equipment Used: INCON Equipment Resolution:+- .0 0 2 0
Identify Spill Bucket(By Tank 3 PRE FILL 2 3 PRE FILL 3 3 PRE VAPOR 4 3 PRE VAPOR
Number, Stored Product, etc)
Bucket Installation Type: X❑Direct Bury XO Direct Bury ❑X Direct Bury X❑ Direct Bury
❑Contained in Sump ❑Contained in Sump ❑Contained in Sump Dcontained in Sump
Bucket Diameter: 1111 11T, 1111 111,
Bucket Depth: 1211 1211 1211 1211
Wait time between applying 15MIN 15MIN 15MIN. 15MIN
vacuum/water and starting test:
Test Start Time(TI ): 1207 1243 1207 1243
Initial Reading(RI ): 6.2738 6.2729 7.3521 7.3509
Test End Time(TF ): 1222 1259 1222 1259
Final Reading(R F ): 6.2725 6.2727 7.3509 7.3503
Test Duration: 15MIN 15MIN 15MIN 15MIN
Change in Reading(R F-RI ): - .0013 - .0002 -.0012 - .0006
Pass/Fail Threshold or 0020 .0020 .0020 .0020
Criteria:
es esulb Mal ail 0 ass ■ ail 16; ass Fail
Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests)
CERTIFICATION OF TECHNICLAN 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: C4, j Date: 05/27/2010
I State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements
SITE DIAGRAM
i Tankrmlogy
8501 N MOPAC EXPRESSWAY,SUITE 400
AUSTIN,TEXAS 78759
(512)451-6334
FAX(512)459-1459
TEST DATE: 05/27/10 WORK ORDER NUMBER3175015
CLIENT:7-ELEVEN, INC. SITE: 7-ELEVEN #32376, MKT 2368
• � -
FAIR/ VENTS 00
'CAS
#12 H2O #10
#11 #9 O O ICE
#8 #6 REG PREM
10K 10K
#7 #5 ^'
L1 L3
#4 #2 W
t4;� i�) S N
#3 #1
Printed 06/08/2010 10:05 ACRAMER
Work Order: 3175015
Emergency Shut Off (ESO} &
Dispenser Emergency Shutoff Valve (ESV)
ANNUAL TEST RECORD LOCATIONS AND TEST DATA
Testing
Company: _Date:._.. �— ?.- co
Location Name: 7-1 ( Store#: State ID#:
Address: q 6 j0 j t t City: s State:
Emergency Shut (off(ESO) Testing Results
On C--2-7-as in accordance with"ESO Vendor Letter(3-21-05).doc", from Valero's Retail
Compliance Department, as a part of annual compliance testing, this Tepresentative"tested the
Emergency Shut Off SO switches indicated on this sketch. Findings listed below:
Emergency Shut Off(ESO) If No,Provide
Operational? YO N FM aintenance Log# Date Called :
Dispenser Emergency Shutoff Valve (ESV) Testine Results
On 5-27-to in.accordance with NFPA 30A this representative tested-the-autornatie-closing,feature
of the Dispenser Emergency Shutoff VALVE(S) (ESV) located in the supply lines at the base of each
individual island type dispenser indicated on the diagram below. Each device (#)'" 1-2--- in all,
would automatically close. Findings listed below:
Disp. Emergency Shut Off I If No, Provide
Valve(ESV)Operational? y Maintenance Log# Date Called :
Site Map Of Location and Placement of Devices Tested:
a
-7— t
---- �---
Signature Of Representative:
Tanknology Inc. 11000 N.MoPac Expressway;Suite-500;Austin,Texas,-78-7-59-
Work Order: 3175015
ALARM H I STOF.Y REPORT ALARM HISTORY RREPORT 7-11 '23x6
3175015
,.
----- SENSOR ALARM ----- 06/04/2010 12:59 PM
----- SENSOR ALARM -- L 1 :F.UL STP SUMP
L10:DISP. 7-8 STP SUMP SUMP LEAK TEST REPORT
DISPENSER PAN SENSOR OUT ALARM
SENSOR OUT ALARM MAY 27. 2010 10:33 AM 87FB 7-11 M2376
MAY 27. 2010 10:33 AM 3175015
FUEL ALARM TEST STARTED 12:43 PM
LIQUID WARNING MAY 27, 2010 9:36 AM TEST STARTED 06/04/2010 06/04/2010 12:22 PM
MAY 27. 2010 10:30 AN BEGIN LEVEL 3.3339 IN
SENSOR OUT ALARM END TIME 12:59"'PM'" SUMP .LEAK TEST REPORT
JUL 1, 2009 8:05 AM END DATE 0610412010
END LEVEL 3.3332 IN 87FB
LEAK THRESHOLD 0.002 IN TEST STARTED 12'•07 PM
TEST RESULT PASSED TEST STARTED 06/04/2010
BEGIN LEVEL 3:3343 IN
87VB END TIME 12:22 PM
END DATE 06/04/2010
* * * * X END * * * x TEST STARTED 12:43 PM LRK�TURREESHOLD . 332 303002 IN.
TEST STARTED TEST RESULT PASSED
* * * END x * * * X BEGIN LEVEL 6.6912 IN
END TIME 12:59 PM
END DATE 06/04/2010 87U6
- END LEVEL 6.6911-'IN,-
LEAK THRESHOLD 0.002 IN TEST STARTED 12:07 PM
TEST RESULT PASSED TEST STARTED 06/04/2010
BEGIN LEVEL 6.6910 IN
91FB END TIME 12:22 PM
END DATE 06/04/2010 '
ALARM HISTORY REPORT TEST STARTED 12:43 PM LEAK THRESH"THRESH" 0. °IN.
TEST STARTED 06/04/2010 EST RESULT PASSED
----- SE NOR ALARM --- ALARM HISTORY REPORT BEGIN LEVEL 6.2729 IN
LII :DISP. 9-10 END TIME 12:59`PM'
DISPENSER PAN ----- SENSOR ALARM ----- END DATE 06/84/2810 91FB
SENSOR OUT ALARM L 2:RUL ANNULAR END LEVEL 6.2727 IN
MAY 27, 2010 10:33 AM ANNULAR SPACE LEAK THRESHOLD 0:
Work Order: 3175015
ALARM HISTORY REPORT '
----- SENSOR ALARM -----
L 7:DISP. 1-2
DISPENSER PAN
SENSOR OUT ALARM
MAY 27, 2010 10:33 AM
LIQUID WARNING
MAY 27, 2010 10:29 AM
HIGH LIQUID ALARM
FED 12, 2010 1 :06--PNL—
* X * X END * X x * X
ALARM HISTORY REPORT
----- SENSOR ALARM -----
L B:DISP. 3-4
DISPENSER PAN
SENSOR OUT ALARM
MAY 27, 2010 10:33 AM
LIQUID WARNIIIG
MAY 27, 2010 10:30 AM
HIGH LIQUID ALARM
MAY 27, 2010 9:08 AM
ri * x * END
ALARM HISTORY REPORT
----- SENSOR ALARM -----
L 9:DISP. 5-6
DISPENSER PAN
SENSOR OUT ALARM
MAY 27, 2010 10:33 AM
'-�CLLlI U WARN I NG
Tanknology Inc. 11000 N.MoPac Expressway;Suite-500,Austin,Texas-7&7-59
Tanknology Fell� a ,
11000 N. MoPac Expressway,Suite 500
Austin,Texas 78759
Phone: (512)451-6334
Fax: (512)459-1459 Date Printed and Mailed: 06/08/2010
BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
INSPECTOR STEVE UNDERWOOD
1501 TRUXTUN AVE.
BAKERSFIELD, CA. 93301
Test Date: 05/27/2010
Order Number: 3175015
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
7-ELEVEN #32376, MKT 2368
9600 BRIMHALL RD.
BAKERSFIELD, CA. 93312
Testing performed:
Impact Valve
Leak detector tests
Monitor Certification
Secondary Containment-Spill Container
Sincerely,
Dawn Kohlmeyer v
Manager, Field Reporting
TANKNOLOGY CERTIFICATE OF TESTING
0p T'Al7km*:P9y 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759
TELEPHONE(512)451-6334 FAX(512)459-1459
PURPOSE: COMPLIANCE TEST RESULT SUMMARY REPORT
TEST DATE: 05/27/10 WORK ORDER NUMBER: 3175015
CUSTOMER PO:
CLIENT: 7-ELEVEN,INC. SITE:7-ELEVEN#32376,MKT 2368
P.O.BOX 711 9600 BRIMHALL RD.
DALLAS,TX 75221 BAKERSFIELD,CA 93312
MANAGER-'
(972)828-7908 (661)588-4059
Product Pipe Ti htness Test Results TEST TYPE: TLD-1
LINE L I N LINE DELIVERY IMP' CT
1 OD ER
T i" TYPE TEST RESU T FINAL L ATE Bph) VE
A B C D A B Tl
10k 2 REGULAR ENVIROFLEX PRESSURE Y
10k 3 PREMIUM ENVIROFLEX PRESSURE Y
Existina Line Leak Detector Test
AXISIT11NG[LE_'AK DE , EXISTINGjL.Ei4K 0 E+T,EC7TiORf#2
LIN
ID MANUFACTURER MODEL# SERIAL# RESULT MANUFACTURER MOD L# SERIAL
`
10k 2 VAPORLESS LD2000 02164 P
10k 3 VAPORLESS LD2000 08041486 P
New Replacement Line Leak Detector Test
LI E MANUFACTURER MODEL# SERIAL# RESULT MANUFACTURER MODEL# SERIAL# RESUL
ID
For owner detailed report information,visit www.tanknology.com and select On-Line Reports-WRAP,or contact your local Tanknology office.
Tester Name:DANIEL VISSER Technician Certification Number:006-05-0311
Printed 06/08/21110-10:05 ACRAMER-
INDIVIDUAL TANK INFORMATION AND TEST RESULTS
Mr 7brz
TEST DATE:05/27/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3175015
CLIENT:7-ELEVEN, INC. AUSTIN,TEXAS 78759(512)451-6334 SITE:7-ELEVEN #32376, MKT 2368
TANK INFORM,_SON
Tank ID: 10k 2 Tank manifolded: NO Bottom to top fill in inches: 144.0
Product: REGULAR Vent manifolded: YES Bottom to grade in inches: 147.0
Capacity in gallons: 10,028 Vapor recovery manifolded: YES Fill pipe length in inches: 48.0
Diameter in inches: 96.00 Overfill protection: YES Fill pipe diameter in inches: 4.0
Length in inches: 324 Overspill protection: YES Stage I vapor recovery: DUAL
Material: Dw JCTD ST Installed: ATG Stage II vapor recovery: ASSIST
CP installed on:
COMMENTS
TANK TEST RESULTS Test Metho•.'�aeuTec LEAK DETECTOR TEST RESU Start(in) End(in) es method: F -
Dipped Water Level: New/passed Failed/reptaced° New/passed- Failed/reptaced`
Dipped Product Level: L.D.#1 L.D.#1 L.D.#2 L.D.#2
Probe Water Level: Make:_ vAPOaL$ss.
Ingress Detected: Water Bubble Ullage Model: LD2000
Test time: S/N: oaacs�.
Inclinometer reading: Open time in sec: 4.00
Holding psi: 30
VacuTect Test Type: NOT Resiliency cc: 100 NOT
VacuTect Probe Entry Point: TESTED TESTED
Test leak rate ml/m: 189.0
Pressure Set Point: Metering psi: 20_.
Tank water level in inches: Calib. leak in gph: 3.00
Water table depth in inches: Results: PASS
Determined by(method):
Result:
COMMENTS
COMMENTS
LINE TES RESULTS es type: - -1
LINE A B C D
Material: ENVIROFLEX
Diameter(in): 1.5
Length (ft): 260.0
Test psi:
Bleedback cc:
Test time(min): NOT NOT NOT NOT
Start time: TESTED TESTED TESTED TESTED
End time:
Final gph:
Result:
Pump type: PRESSURE
Pump make: FE PETRO
COMMENTS Impact Valves Operational: YES
Printed 06/08/2010 10:05
INDIVIDUAL TANK INFORMATION AND TEST RESULTS
V Tbn
TEST DATE:05/27/10 8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER3175015
CLIENT:7-ELEVEN, INC. AUSTIN,TEXAS 78759(512)451-6334 SITE:7-ELEVEN #32376, MKT 2368
T/1NK INFORMATION
Tank ID: 10k 3 Tank manifolded: No.. Bottom.to top fill in inches: 146.0
Product: PREMIUM Vent manifolded: YES Bottom to grade in inches: 150.0
Capacity in gallons: 9,975 Vapor recovery manifolded: YES Fill pipe length in inches: 50.0
Diameter in inches: 96.00 Overfill protection: YES Fill pipe diameter in inches: 4.0
Length in inches: 324 Overspill protection: YES Stage I vapor recovery: DUAL
Material: Dw JCTD ST Installed: ATC Stage II vapor recovery: ASSIST
CP installed on:
COMMENTS
TANK TEST RESULTS Test Method: seuT t EAK DETECTOR TE RESULTS T method A
Dipped Water Level: Start(in) End(in) New/passed' Fairedheptaced- New/passecr Faited/repraced-
Dipped Product Level: L.D.#1 L.D.#1 L.D.#2 L.D.#2
Probe Water Level: Make: vApouA=.
Ingress Detected: Water Bubble Ullage Model: LD2000
Test time: S/N: 444414".— .
Inclinometer reading: Open time in sec: 5.00
Holding psi: 30
VacuTect Test Type: NOT Resiliency cc: 100 NOT
VacuTect Probe Entry Point: TESTED
Test leak rate ml/m: 189.0 TESTED
Pressure Set Point: Metering psi: 20..
Tank water level in inches: Calib. leak in gph: 3.00
Water table depth in inches: Results: PASS
Determined by(method):
Result:
COMMENTS
COMMENTS
LIN ME RE3fJ_LT est e:
INE A B C D
Material: ENVIROFLEX
Diameter(in): 1.5
Length(ft): 280.0
Test psi:
Bleedback cc:
Test time(min): NOT NOT NOT NOT
Start time: TESTED TESTED TESTED TESTED
End time:
Final gph:
Result:
Pump type: PRESSURE
Pump make: FE PETRO
COMMENTS Impact Valves Operational: YES
Printed 06/08/2010 10:05