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HomeMy WebLinkAbout#775 FMC Results 7-11-13MONITORING 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 2 3, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certilieation or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this torm 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: #7775 Chevron (North) Bldg. No.: ____ _ Site Address: 4901 South Union Avenue City: Bakersfield, CA Zip: .=.93.::..;3:..::0:...:..7 __ _ Facility Contact Person: Omero Garcia Contact Phone No.: (661) 393-7000 Make/Model ofMonitoring System: Veeder-Root TLS 350 Date ofTesting/Servicing: 7/11/2013 B. Inventory of Equipment Tested/Certified -··~·-•••~ .IIJIJI..IIJI ·-·~ ----ov •••----·~ o , ...... -. ••• _. .. ~ ... •••• ,. .. ,v••~• • --~-· Tank 10: 12,000 gal. Regular 1 Tank ID: 12,000 gal. Regular 2 181In-Tank Gauging Probe. Model: 847390-107 181In-Tank Gauging Probe. Model: 847390-107 181 Annular Space or Vault Sensor. Model: 794390-420 181 Annular Space or Vault Sensor. Model: 794390-420 181 Piping Sump I Trench Sensor(s). Model: 794380-208 181 Piping Sump I Trench Sensor(s). Model: 794380-208 0 Fill Sump Sensor(s). Model: 0 Fill Sump Sensor(s). Model: 181 Mechanical Line Leak Detector. Model: FX-1V 181 Mechanical Line Leak Detector. Model: FX-1V 0 Electronic Line Leak Detector. Model: 0 Electronic Line Leak Detector. Model: 181 Tank Overfill/ High-Level Sensor. Model: 847390-107 181 Tank Overfill/lligh-Level Sensor. Model: 847390-107 0 Other (specifY equipment type and model in Section Eon Page 2). 0 Other (specifY equipment type and model in Section Eon Page 2). Tank ID: 12,000 gal. Su~er Tank ID: 12,000 gal. Diesel 181In-Tank Gauging Probe. Model: 847390-107 181In-Tank Gauging Probe. Model: 847390-107 181 Annular Space or Vault Sensor. Model: 794390-420 181 Annular Space or Vault Sensor. Model: 794390-420 181 Piping Sump I Trench Sensor(s). Model: 794380-208 181 Piping Sump I Trench Sensor(s). Model· 794380-208 0 Fill Sump Sensor(s). Model: 0 Fill Sump Sensor(s). Model· 181 Mechanical Line Leak Detector. Model: FX-1V 181 Mechanical Line Leak Detector. Model: FX-1DV 0 Electronic Line Leak Detector. Model: D Electronic Line Leak Detector. \.1odci· 181 Tank Overfill/ High-Level Sensor. Model: 847390-107 181 Tank Overfill/ High-Lcl'cl Sensor. Model: 847390-107 0 Other (specifY equipment type and model in Section 1.: on Page 2). D Other (specify equipment type and modelm Scctton Eon Page 2). Dispenser ID: 1&2 Dispenser ID: 3&4 181 Dispenser Containment Sensor(s). Model: 794380-208 181 Dispenser Containment Sensor(s). Model: 794380-208 181 Shear Valve(s). 181 Shear Valve(s). D Dispenser Containment Float(s) and Chain(s). 0 Dispenser Containment Float(s) and Chain(s). Dispenser 10: 5 & 6 Dispenser 10: 7&8 181 Dispenser Containment Sensor(s). Model: 794380-208 181 Dispenser Containment Scnsor(s). Model: 794380-208 181 Shear Valvc(s). 181 Shear Valvc(s). 0 Dispenser Containment Float(s) and Chain(s). 0 Dispenser Containment Float(s) and Chain(s). Dispenser 10: Transition Sum~ 1 Dispenser 10: Transition Sum~ 2 181 Dispenser Containment Sensor(s). Model: 794380-208 181 Dispenser Containment Sensor(s). Model: 794380-208 0 Shear Valvc(s). 0 Shear Valvc(s). 0 Dispenser Containment Float(s) and Chain(s). 0 Dispenser Containment Flolll(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 this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of gener'\ting such reports, I have also attached a copy of the report; (check all that apply): ~ System set-up ~ Alarm history report Technician Name (print): Bradley Seykora Signature: ~~ Certification No.: B40738 ----~--------------License. No.: _.:::.80::.:4:!.:9::..:0~4~------------- Testing Company Name: Confidence UST Services Phone No.: (800) 339-9930 Site Address: 4901 South Union Avenue, Bakersfield, CA 93307 Date of Testing/Servicing: 7/11/2013 Page 1 of 3 Monitoring System Certification D. Results of Testing/Servicing Software Version installed: 327.04 ~~~--------------------------- c -he foil heckr . ..,_. 181 Yes 0 No* Is the audible alam1 operational? 181 Yes 0 No* Is the visual alarm operational? l8l Yes 0 No* Were all sensors visually inspected, functionally tested, and confirmed operational? l8l Yes 0 No* Were all sensors installed at lowest point of secondaty containment and positioned so that other equipment will not interfere with their proper operation? 0 Yes 0 No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) l8l N/A operational? l8l Yes 0 No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment 0 N/A monitoring system detects a leak, !ails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) l8l Sump/Trench Sensors; 181 Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? l8l Yes; 0 No. l8l Yes 0 No* For tank systems that utilize the monitoring system as the primaty tank overfill warning device (i.e., no 0 N/A mechanical overfill prevention valve is installed), 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? 90% 0 Yes* l8l No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufucturer name and model for all replacement parts in Section E, below. 0 Yes* l8l No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) 0 Product; 0 Water. If yes, describe causes in Section E, below. l8l Yes 0 No* Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable 181 Yes 0 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. E. Comments: Page 2 of 3 Monitoring System Certification F. In-Tank Gauging I SIR Equipment: 18:1 Check this box if tank gauging is used only for inventory control. 0 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: 18:1 Yes 0 No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? 18:1 Yes 0 No* Were all tank gauging probes visually inspected for damage and residue buildup? 18:1 Yes 0 No* Was accuracy of system product level readings tested? 18:1 Yes 0 No* Was accuracy of system water level readings tested? 18:1 Yes 0 No* Were all probes reinstalled properly? 18:1 Yes 0 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. G. Line Leak Detectors (LLD): 0 Check this box if LLDs are not installed. c he foil heck!' 18:1 Yes 0 No* For equipment start-up or annual equipment certification, was a leak simulated to verity LLD performance? 0 N/A (Check all that apply) Simulated leak rate: 18:1 3 g.p.h.; 0 0.1 g.p.h ; 0 0.2 g.p.h. 18:1 Yes 0 No* Were all LLDs confirmed operational and accurate within regulatory requirements? 18:1 Yes 0 No* Was the testing apparatus properly calibrated? 18:1 Yes 0 No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? 0 N/A 0 Yes 0 No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? 18:1 N/A 0 Yes 0 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled 18:1 N/A or disconnected? 0 Yes 0 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions 18:1 N/A or fails a test? 0 Yes 0 No* For electronic LLDs, have all accessible wiring connections been visually inspected? 18:1 N/A 18:1 Yes 0 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: Page 3 of 3 L'HL:\IkON 775 .:.1901 S.UNIOI~ AAKEkS~IELD Ch93307 bld -391 -9387 ,1Ul. II. ~013 8: <13 1'11'1 :::Y!:i'I EM STA I'U3 REPORT I-ILL FUNCT I 01vS NORMAL I N\/!::NTOi\'o' ~EPOF.T T I : tiNLF.A[•ED '••OLU~IE UllAGE ':<C.', ULLf-IGE = TC \JOLLII·Il~ HrlGHI' WHTER VOL WATJ:R TCl•IF T ;,· : UNLEI-IDED VOLUI1E IJi.!.llt';[. 90~; UL!A(:Ea TC 1/0l 1.11 IE • HEI-.>HT WATER VOl. -I.JATER TEMP T J : Pl<f.l'll Ul"l I 2597 (;At.S 9335 Gi4LS 8131 GALS 2640 •:;1-\LS 2G . .:I C. li•ICHES 0 GALS 0. 00 I Nl'IU:::c:: 90.0 [JEG F 2 3080 •:;HLS 8952 GALS 7748 r';AL.S 3022 (:HLS 29. I 0 I NC:HI:S !G G1-1LS 0, 82 I Nt::HES 87.0 DEG F 't0Ll~'IE = 2882 GALS U.I\(;E • 91 4 9 GALS ~~J~. ULLA•:;J:-:= 7945 ·~;~LS TC VOLUflE " L8<::3 GALS HEI•::HT c 27.'/4 INCHES I~ATER VOl. ~ 2'2 GI-lLS l,JATF:R "' I . U2 I NC:HE:'3 TEMP D 88.8 DEG f T .J:DIESEL \IOLUI'IE ULLHt:;E 1919 GALS 10\l::.l GALS 8'309 GALS I 093 GI\LS ·~(!' •. ULLAGF.e T(' V~)JUi1E HE l•.~HT I.'HTF.R '•I<'•I. 1~1-\TEF.' ~ ?0.79 INCHES 0 GI-\LS 0.00 INCHI:t> 89.0 DEG F TEtiP ~·II-IN I J'\'·IJ•FI THI'II:8 I Nlll::f~Tt>lo:\' l'iiTi-\LS T I : UNLEAl•Et, 1 T 2: UNLEHLJI':lJ ~! \/OLLil'lE = 5778 GALS TC I/OLU~1E "' 566~: GilLS ~ ~ ft • ~ END ~ ~ ~ ~ ~ ~0Fll.li-1RE REIII 8 I ON l.F.VF.l. \!Ek'3 I ON :·~'.:..'7 . Cl4 SOFTWHREII 3c.lt>:3:.''/-l 00-E •.:RE.-\TEn ll'/. 02. 0Lo. I 0. ~8 :,; -I·IODULE ll 3::-:0 I t.O-OU<l-a S'tSTEt-1 FE• I'! UF:F.S: l-'Ef<!ODJ(: II'J-THI•H: TESTS ANNUAL IN-n-INK TESTS IRP H1C !=-:\':7:TI:.Il SETUP -----·· -·--- ,] Lll. I I . ;.'U 1 3 8 : 4 3 At· I ::i\'ST 1::11 UN I TS u.s. SVSTEI'1 L1-1NGUIIGE Elk~:..tf;::H SYSTEI•I DATE /T 1 J•IE FOP.I'IAT !"ION DD \"i\'V HH: ~111: SS ;M CHEVRON 775 4901 S.UNION Bf\1\ERSF I ELD C.-193307 661-391-9387 SHIFT THIE I SHIFT TIHE 2 SHIF'I Tll"lE 3 ~3HI FT T I 1•1E 4 6:00 Al"l Olf-:ABLED DISABLED DISHBLED T?\NI: PER T::>T NEEDED WRN DISHBLED TANK 1-1NN TST NEEfJED ~IRN DlS14BLED L I I~E RE -ENh8LE I•IETHOD r·nSS Ll NE TEST L1 NE PER TST riEEIJED ~.JRI'I DISABf.E[l L I NE HNN TST NEEDt:rJ lJRN DISABLED PJ.: I NT TC VOLUMES ENABLED TEI"lF' CONPENSAT I ON Vf-\I.UE <DEG F >: 60.0 STICK HEWHT OFFSCT GISHBLED ULU~GE: 90\ H-f.'I<OTOC:OL DiHA FORt•IAT HEIGHT VA\'L I GHT S?\V! Nt3 T! J·1E ENi-1BLEf• START DATE 1-lPR WEEJ: I SUN STflf<T T I ~1E 2:00 Al"l END Dr1TE OCT WEEK 6 SUN END Tll"l[ ?:oo Ar1 RE-[ll RECT LCX:AL PRINTOUT lliSAOLED F.URO PROTu•:OL PREFIX s S'/8TEI·1 SECUR lTV r·oDE : 000000 I"'A I NTENr\NC'E HI STOR\' ft!SABLED T1-1NI~ ('HART SE('UR I TV DI::>ABLED CUSTOI·I ALARr·1S DISA6L£[J 11ASS, DENS I TV DISABLED COl lf•IUN I CATIONS SETUP PORT SETTINGS: l'OIIM BOARD : l <EDIM > RS-232 SECURITY C:ODE : DISABLED C0111'1 BOARD : :;: ~R!-';-23::·> BAUlt RATE : %00 PAR ! TV : NONE f>TI..lP I:JIT : I STO!=' DATA LENI;TH: 8 DATI-l RS-2;32 GECUR IT\' CI>DE : D 1 SABLCD (:()f"\11 801-\P.D : ;3 < RS-23L' > B~UD RATE : 9600 PAR I TV : NOI'IE STOP BIT : 1 STOP [II'ITA LF.I'~3TH: 8 DATI~ RS ·.::32 SEGUR I TV CO[IE : DISABLED 1-\UTO TRANSt1 IT SI.:TT JI{(;S: HUTO LEAY. 1-\LAR~·i L I 1·11 T D!SAP.LF.D AUTO HIGH LJATER L.II"!IT DISABLED AUTO 0\/ERF ILL Ll tilT DISABLED AUTO LOW PRODUCT DISABLED i-1UT0 THEFT LII11T D!SI-iBl.ED 1-\UTO DEL I VE'kY STfo~RT DISABLED AUTO DE::L.l \IERY EI~J:• [IISI-\BLED AUTO C'(TEI<NAL I NPUT ON f•l SABLE[• AUTO E~<TERNHL INPUT OFr DISABLED AUTO SENSOR FUEL 1-'\LARI•l PISABLED AUTO SENSOR l·J.t:\TEJ: HU-Il-11"1 [IIBABLED AUTO SENf30R OUT I-ILARI"I DISABLED ~:s-2:32 F.ND Of l·fESSnGC DISABLED l N-T riNI: :'-;ET uP f 1 : UNI.I:I"PCI, 1 Pl-X1PI ,('T ;oDE THERtt,.;L l'OErF TANI: [J! 1-11'1ETER TANI: PROf' I L[ FULL VOL FLOAT SIZE: l>IATEI\ l·l~RN I NG : HI(;H WHTER LIMIT: 1·11-1:< 01< LMBEL VOL: OIIERF ILl. i.ll"l IT H113H ~·RODliCT DEL.I VERY L!l'll T LOW J·RODUC1 LEI-\l~ ALARI1 L I 1'1 I T : 1 .000700 %.00 1 PT 120::32 4.0 Pl. :?.0 3.0 12032 90~0 10828 95~. 11<130 15}, 1804 SUDDEN LOSS 1.!1·1! T: 500 99 99 7.30 TI-\I··Jl: TILT : f'F:'}BE on ·~:ET 0.00 S I PH0N ~IAN I F{il.DF [1 Tr-~t•WS Til: 02 L li•JE tii-\N I FOLf>ED TAf·JI~~; Til: ~ONE LEn I~ 11 I N l'l:.R I OD 1 C: LEAi; ~~iN ANNUAL : 1% 1::?0 IY. 120 f'Ek'IODIC TEST TYfE ~:T,'\NDMRD r\NNUI-\L TEST Ff\ l L ALI~kl'l [1! !-';HI:JLED PJ:R 1 OD I(' '('[::)T rAJ L ALARI1 D I .?1-18LED ,;ROSS TEST FAIL ALAR~·! [ll ::;:.c,FJLED HNN TE::l'l .-1\IEk'A~ IN:;: OFF F'Ei\' TEST 1-'VER111-: l NG: OFF T.-INJ: TEST NOT l F'i: OFF TNK TST S J PHON BREr~J: :OFF Llt:L J VER\' fJELr-1'.' : I 11 I N F'U'1~ THF:ESIIOLD : I 0. flO'• T 2: UNI .tAD Ell 2 Pf<0[11Ji''T ''O['E TH[RI'IAL r·ot:H' T11NI>: [l I 1-111ETF.R 'I ..;Nl: f,.ROF I LE FULL \IOL FLOHT SI::E: Wi-\TI::R l~I-\RN I NG : Hf\.;H I.Jr'ITER LI11IT: ~·lA": OR l.f1BI:::L VOL: OVJ::RF I I.L LI t'l I T : H l GH PROl•UCT DEL I VERY Ll rl IT J Oh' F-P.O[•Ul:T LEI-\J; 1iLt4R~1 l I 1'1 J T : 2 .000'100 9b.OO IPT 12032 4.0 IN. 2.U :3.0 t2tl32 90~-'. 10828 95_.·· ll ~30 15~~ 1804 SIJ[lPEN LiXJ:J L I 1•11 T: 500 ~9 99 ~.88 THNK TILT : ~ RORL: UFF'SI:T 0.00 SIPHON r1AN I FOI .[•ED Ti-\NKS Til: 01 Ll NE PIAN I FOLDED TANKS Til: NONE LEAK !•II N FER!OD!1~: LE;-;K MIN 1-\NNIJAL 1 ~0 120 I,;, 1:?0 PEF< I Olll C TEST T'IPE STf.•NDr4P.D nNI•lUAL n:: iT FAIL ALAR11 l• I Sf\BLE[l f'CRIODIC: TC::;T F14IL ALAl<M D I S,lBLED l;f-~OS:"; TES'I FA I I. ALI~RI1 [)I SIIBLEL) ril'll J TEST f-1\/Ek'l=lG I NG : OFF PER TEST A\/!.:: RAG I Nt';: OFF TAN~: TEST NOTIFY: OFF TNt: TST S lf•HON BREi-\ I~: OFF DEL I \IER'.· I.JELAY : I 1'1 I N PUI'IF THRESHOL [) : I 0. 00~• r :J: r·r:EI'll ur1 PR~>fJUt.:T ,:;olJF. THEF!t'IAL l'vEI'F TANK fil AIIETER Ti-\Nl\ f.'R0F l Lf: FULL \!OL ;j .000700 96.00 I PT 120:"ll FLOAT 81Zt: 4.0 IN. l~I-\TEI< L•II-IRI~ I NG : HIGH 1·11-\TER Ll ~I !T: 111-\X OR LABEL \/OL.: OVERF I LL L I 1"1 IT : HIGH PRODUCT UEL IVERY L I I' liT LULJ J.·R\)[Jlh ·T : LEAl~ ALARf1 L.l ~liT : SllfollF.N LOG~: L I~ I! T : TAN~: TILT : FROBE C:•FFSF.'f 2.0 3.0 12031 90}. ll)828 95~ .. 1\<123 15% 1804 500 9'J 99 2.b7 U.ClO S I }·HON 1•\i-\N I FOLIJt:D TI"~J<:··: Til: N01~E L I i'IE M1-1tl I fi)L[l[D TANKS Til: NONE LE141: r·HN PERIODIC: LEr:-.K 1·\ 1 N ANNUi-\L : p, i20 1°1 120 FER l Of1 I(' n:ST TYPE STANtiARD ANNUI-\L TEST FAIL ALHR~1 D I SAElLE[• PERIODIC 'l'E::>T FAIL r.;LARt1 [1 I Sr~BLH• GROSS TCST FAIL t\Li-\RM D J S148LEi • 14Nl1J TEST 1-\VERAG l NG: \1FF i>l:l-1 TEST rWERAG l Nv : OFF TMNl: TEST NOT l F't: OFF TN!~ TST S 11-'HU''I RRf.,.,l: :OFF DELl VERY DLLI-\\' : I ~II N F·UI''lr' THRF.~HOLP : I 0. 00"• J' ·I: L1l!::!:·:LL f·f~\..f•U(:T (·e:r·E THfHtiHL C'OEFF 1111~1. II I !111LTf.P. r ·~1~1~ r•F:OF I LE F1.1LL V"ll 4 . ULlU41JU 96.00 1 l'T I.'L.12 FLO!=.T ::;I:.::E: ·1.0 IN. l'HTU: t.~t.oi-:NIIn : Hl1al J.l~TEf~ Llr'll J: t·ifli( i)k' LHI:IEL \/OJ.: O\fl:!-.'1' II.! L If• II T : H I• ;H Ff;O[tlf(;T LJl·ll vu.;v i.. JriiT Ulh f '1:\ 1lillt;1 : 1 E~-<r: l~l.HP.t1 1.1111 T: :-;II!JIFI~ LOf:;::; LllliT: THNI~ TILT : FRt8E OFFSET .:.o 3.0 1 :~U:J2 901(, lll82R 9~·· ! 1 ~~:o 1 "i1.; 180•1 "iOO =!';.! 'l'_l ,i. /5 o.uu SII'HC>I~ t11ll'llFOLr1ED TnNl:.:; Tli: IIOI>E I I ~:r. I'AN I l'OL.IJE£1 Tlll·ll:S Tli: NONE LEnl: 1·11 1'1 r·ER I \:'T•I (': t·~ 120 Ll·.flt: ;1( N I ;:JNI.!AL : l ~. 120 ~TP.lOl' l t • T[ST TYf-E STHNL•nP.IJ HNI·Illl-ll. TD :T fl-l I I. ALAF:.Il D 1 :::AC:LH• Ptk 1 OL•I1: TEST F1-1 I L 1-ILHRI i [If :;f.ll:ll.El• GF.CSS TEST F~IL ALARI•' I I I :'rlBI.l] I l-INN TEST .~VEI<HI., I tH: OFf F l:R TeST 1-\\IEF.1-11.; I N1.3: OFF JJ..\NI: TES:' NOT l F'.': \I!'F Tl'll~ r:.:T ~: lf·HON E;P.F'•\1: :(•f-F L•F.I 1 \:F.P.V f· f.U1\' : I 111 tl F'f.l;~ 1'11~£:·:;;-iOLD : :.u .I IIi'• LE1ll' ., E'':T '·lETfh ... -ll TC.;T ()N 01~·1 1:. : 1-\LL 1'111~1: n:v to. ::'007 STt4~'T TillE : DJ:::Aili.U• TEST F.1, n: : n. ;on <;f-'11 HP. DU~~\T 10N : 2 I t0Uk:3 TST EJ)F.:s :':TN': Lt! 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I 11'-1 -----IN-THNK AL14RM -··--- T 3 :PREI11\Ifl LOt.! TEl IP t<li-IRN I NG JUl. II. 2013 9:<:5 flfi .. ___ IN TANJ~ i-\LARM ----- T <l:LJIE.SEL LOvJ T£r1P t..lt~RN I N(; .JtJL. IL 201'1 S:<J7Ai": CHEVRON 7'/':J ..J9nl S.UNION Bl~l\ERSr I El.fl CA933Cl? 661-391-9387 JLIL I I . 2013 9: 4 'l ri'·l S'.'!::TH1 STr1TlJS REPOF.T --------- AU. fUNCT! OI{S tk>R1'1AL SWRCB, January 2006 Spill Bucket Testing Report Form This form is intended/or use by contractors pe1jorming annual testing ofUSTspi/1 containment structures. The completed form and printouts from tests (if applicable), should be provided to the facility owner/operator/or submillalto the local regulato1y agency. 1. FACILITY INFORMATION Facility Name: #7775 Chevron (No11h) I Date of Testing: 7/11/2013 Facility Address: 490 I South Union Avenue . Bakersfield, CA 93307 Facility Contact: Omero Garcia I Phone: 661-393-7000 Date Local Agency Was Notified ofTesting: 6/17/2013 Name of Local f\.~ency I ns~ctor (if prescmt during testing): Esther Duran 2. TESTING CONTRACTOR INFORMATION Company Name: Confidence UST Services, Inc. Technician Conducting Test: Bradley Seykora Credentials 1: X CSLB Contractor X ICC Service Tech. l SWRCB Tank Tester 0 Other (SpecifY) License Number(s): CSLB #804904 ICC #811 I 23 I -UT 3. SPILL BUCKET TESTING INFORMATION Test Method Used: x Hydrostatic 0 Vacuum f1 Other Test Equipment Used: Lake Test Equipment Resolution: 0.0625" IdentifY Spill Bucket (By Tank 1 Regular 1 2 Regular 2 3 Super 4 Diesel Number, Stored Product, etc.) Bucket Installation Type: 0 Direct Bury 0 Direct Bury 0 Direct Bury 0 Direct Bury x Contained in Sump x Contained in Sump x Contained in Sump x Contained in Sump Bucket Diameter: 12.00"' 12.00" 12.00" 12.00" Bucket Depth: 13.50" 14.00" 14.00" 14.50" Wait time between applying 5 min. 5 min. 5 min. 5 min. vacuum/water and start of test: Test Start Time (T1): 9:10am 9:10am 9:10am 9:10am Initial Reading (R1): 11.25'' 11.25" 11.25'' 11.50"' Test End Time (TF): 10:10 am 10:10 am 10:10 am !O:lOam Final Reading (RF): 11.25" 11.25" 11.25" 11.50" Test Duration (T F-T1): I hour I hour I hour I hour Change in Reading (RF-R1): 0.00" 0.00" 0.00" 0.00" Pass/Fail Threshold or 0.0625" 0.0625" 0.0625" 0.0625" Criteria: Test Result: 181 Pass OFail 181 Pass 0 Fail 181 Pass OFail 181 Pass 0 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 contained iu this report is true, accurate, all(/ in full compliance with legal requiremeuts. Techn;c;an's s;gnature: ~ Dale: 7/1112013 7 1 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. I I I ~ ~~~I~ I ...._ ; ~ : I I : I I !m! ~"~~ "Oo :z: ..r: ~Q~ !1~~8~ g~~ >-o~ :)>~ ..., "' e "' ~ 0 .., ~ .. !II c z -i : =· ~ ••n 1 ~~ F 0 n Ill ~ ~·· -< ~ zal.... I I 1 ... ~~ _-< 1!' 1 1 -lil-t· -,~r w .... : r-~ "0 ~-g:. :n -oi ! L .-r··-t&·-1'5----- f • • ' •• i L 1o--j:l []._L8 : . . . I I • ~ . .. -.. I I I I ! I : . . . . : . . : L • • • • 7 : I a a • • ) t-. .. :14.. 13. ·-----------10--&-.JJ ~ r-~~------------------... ,,,, I ' ' ' ' ' ! '' ... ""------------·----~-: I ~· r-+- 1 I c= #725 I I ESO OFA • @ ® If,: • • EMERGENCY SHUT-OFF OVERFILL ALARM PRODUCT SPILL CONTAINER VAPOR SPILL CONTAINER ANNULAR FIRE EXTINGUISHER GAS METER SHUT-OFF WATER METER SHUT -OFF @ HEALYCAS * EVACUATION MEETING POINT #725 "L" SENSOR SETUP: L1 8t :>II"' L2 87 ANNULAR L3 91 STP L4 91 ANNULAR L5 OSLSTP L6 DSL ANNULAR L7 UDC 9-10 L8 UOC 11-12 L9 UOC 13·14 L 10 UOC 15-16 #775 "L" SENSOR SETUP: L 1 87-1 STP L2 871-1 ANNULAR L3 87-2 STP L4 87-2 ANNULAR L5 91 STP L6 91 ANNULAR L7 OSL STP L8 DSL ANNULAR L9 UOC 1-2 L10 UDC 3-4 L 11 UDC 5-6 L12 UOC 7-8 L13 N TRANS SUMP "' : L 14 S TRANS SUMP I~ .. .. I; ______ .J