MONITORING SYSTEM CERTIFICATION - Bakersfielddocs.bakersfieldcity.us/WebLink/0/edoc/1267652/2015 FMC...
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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 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: Bldg. No.: Site Address: City: Zip: Facility Contact Person: Contact Phone No.: Make/Model of Monitoring System: Date of Testing/Servicing: B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced: Tank ID: Tank ID: 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 Sensor(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 Overfill / 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). Tank ID: Tank ID: 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 Sensor(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 Overfill / 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 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). 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). 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/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 generating such reports, I have also attached a copy of the report; (check all that apply): System set-up Alarm history report Technician Name (print): Signature: Certification No.: License. No.: 804904 Testing Company Name: Confidence UST Services, Inc. Phone No.: (800) 339-9930 Site Address: Date of Testing/Servicing: Page 1 of 3 Flower Street Mini Mart 928 Flower Street Bakersfield 93305 Sam Mansour (661) 322-1521 Veeder-Root TLS-350 12/03/2015 10,000 gal. Regular 847390-107 794390-420 794390-420 794380-208 794380-208 794380-208 794380-208 FX1V 847390-107 8,000 gal. Super 847390-107 FX1V 847390-107 794380-208 1-2 794380-208 794380-208 794380-208 794380-208 3-4 5-6 7-8 9-10 794380-208 11-12 Dustin Reese B43426 928 Flower Street Bakersfield, CA 93305 12/03/2015
Transcript of MONITORING SYSTEM CERTIFICATION - Bakersfielddocs.bakersfieldcity.us/WebLink/0/edoc/1267652/2015 FMC...
MONITORING SYSTEM CERTIFICATIONFor 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 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: Bldg. No.:Site Address: City: Zip:Facility Contact Person: Contact Phone No.:Make/Model of Monitoring System: Date of Testing/Servicing:
B. Inventory of Equipment Tested/CertifiedCheck the appropriate boxes to indicate specific equipment inspected/serviced:
Tank ID: Tank ID: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 Sensor(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 Overfill / 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).
Tank ID: Tank ID: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 Sensor(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 Overfill / 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 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).
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).
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/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 generating such reports, I have also attached a copy of the report; (check all that apply): System set-up Alarm history report
Technician Name (print): Signature:Certification No.: License. No.: 804904Testing Company Name: Confidence UST Services, Inc. Phone No.: (800) 339-9930Site Address: Date of Testing/Servicing:
Page 1 of 3
Flower Street Mini Mart
928 Flower Street Bakersfield 93305
Sam Mansour (661) 322-1521
Veeder-Root TLS-350 12/03/2015
10,000 gal. Regular847390-107
794390-420 794390-420
794380-208 794380-208
794380-208 794380-208
FX1V
847390-107
8,000 gal. Super847390-107
FX1V
847390-107
794380-208
1-2794380-208 794380-208
794380-208
794380-208
3-4
5-6 7-8
9-10794380-208
11-12
Dustin Reese
B43426
928 Flower Street Bakersfield, CA 93305 12/03/2015
Monitoring System Certification
D. Results of Testing/Servicing
Software Version Installed:
Complete the following checklist:Yes No* Is the audible alarm operational?Yes No* Is the visual alarm operational?Yes No* Were all sensors visually inspected, functionally tested, and confirmed operational?Yes No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will
not interfere with their proper operation?Yes No*
N/AIf alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) operational?
Yes No*N/A
For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) Sump/Trench Sensors; Dispenser Containment Sensors.Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Yes; No.
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 point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? %
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* No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply)Product; Water. If yes, describe causes in Section E, below.
Yes No* Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicableYes 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
323.03
90
I had to change th 87 fill swivel adaptor and change the nozzle on pump #3 due to defects.
Monitoring System Certification
F. In-Tank Gauging / SIR Equipment: Check this box if tank gauging is used only for inventory control. Check this box if no tank gauging or SIR equipment is installed.
This section must be completed if in-tank gauging equipment is used to perform leak 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?
Yes No* Was accuracy of system water level readings tested?
Yes No* Were all probes reinstalled properly?
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.
G. Line Leak Detectors (LLD): Check this box if LLDs are not installed.
Complete the following checklist:Yes No*
N/AFor equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) Simulated leak rate: 3 g.p.h.; 0.1 g.p.h ; 0.2 g.p.h.
Yes No* Were all LLDs confirmed operational and accurate within regulatory requirements?
Yes No* Was the testing apparatus properly calibrated?
Yes No*N/A
For mechanical LLDs, does the LLD restrict product flow if it detects a leak?
Yes No*N/A
For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak?
Yes No*N/A
For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected?
Yes No*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*N/A
For electronic LLDs, have all accessible wiring connections been visually inspected?
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:
Page 3 of 3
Leak Detector Test Results Sheet
Customer Address: Work Order: Site Address: Test Date:
Site Contact: Phone: Technician: Phone: 800-339-9930 ICC No.:
Product Type LLD Type Model Serial No. Check Valve Holding Pressure
Bleed Off ML.
Leak Rate Tested:
Pass/Fail
3 gph @ 10 psi
3 gph @ 10 psi
3 gph @ 10 psi
3 gph @ 10 psi
3 gph @ 10 psi
3 gph @ 10 psi
3 gph @ 10 psi
3 gph @ 10 psi
Technician Name: Technician No.: Signature: Date:
Flower Street Mini Mart
928 Flower Street
Bakersfield, CA 93305
35528
12/03/2015
8216722-UT
Regular Mechanical FX1V
Dustin Reese
(661) 322-1521Sam Mansour
Bakersfield, CA 93305
928 Flower Street
Flower Street Mini Mart
13psi 300ml Pass
FX1VMechanicalPremium 12psi 225ml Pass
Dustin Reese 8216722-UT
12/03/2015
Flower St Mini Mart
System Setup: Responses Received: 200 FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 DEC 3, 2015 9:15 AM TANK PRODUCT GALLONS INCHES WATER DEG F ULLAGE 1 REGULAR UNL 9196 76.30 0.0 59.6 2831 2 SUPER UNL 2538 36.74 0.0 68.6 5651 I90500 DEC 3, 2015 9:15 AM SOFTWARE REVISION LEVEL VERSION 333.06 SOFTWARE# 346333-100-G CREATED - 14.10.01.16.35 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM I50500 DEC 3, 2015 9:15 AM SYSTEM TYPE AND LANGUAGE FLAG SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH SYSTEM DATE/TIME FORMAT MON DD YYYY HH:MM:SS xM I50201 DEC 3, 2015 9:15 AM SHIFT TIME 1 : 2:00 AM I50202 DEC 3, 2015 9:15 AM SHIFT TIME 2 : DISABLED
I50203 DEC 3, 2015 9:15 AM SHIFT TIME 3 : DISABLED I50204 DEC 3, 2015 9:15 AM SHIFT TIME 4 : DISABLED I54600 DEC 3, 2015 9:15 AM TANK PER TST NEEDED WRN: DISABLED I54900 DEC 3, 2015 9:15 AM TANK ANN TST NEEDED WRN: DISABLED I55300 DEC 3, 2015 9:15 AM LINE RE-ENABLE METHOD PASS LINE TEST I55600 DEC 3, 2015 9:15 AM LINE PER TST NEEDED WRN: DISABLED I55900 DEC 3, 2015 9:15 AM LINE ANN TST NEEDED WRN: DISABLED I50D00 DEC 3, 2015 9:15 AM PRINT TC VOLUMES ENABLED I50E00 DEC 3, 2015 9:15 AM TEMP COMPENSATION VALUE (DEG F ): 60.0
I60B00 DEC 3, 2015 9:15 AM STICK HEIGHT OFFSET ENABLE STATUS DISABLED I51400 DEC 3, 2015 9:15 AM H-PROTOCOL DATA FORMAT HEIGHT I51A01 DEC 3, 2015 9:15 AM DAYLIGHT SAVING TIME DISABLED I51B00 DEC 3, 2015 9:15 AM I51600 DEC 3, 2015 9:15 AM RE-DIRECT LOCAL PRINTOUT DISABLED I50400 DEC 3, 2015 9:15 AM 232 SECURITY CODE PORT SECURITY CODE STATUS 1 000000 DISABLED 2 000000 DISABLED 3 000000 DISABLED 4 000000 DISABLED 5 000000 DISABLED 6 000000 DISABLED I21900 DEC 3, 2015 9:15 AM TANK CHART SECURITY DISABLED
I5BD00 DEC 3, 2015 9:15 AM CUSTOM ALARM LABELS DISABLED I56000 DEC 3, 2015 9:15 AM MASS/DENSITY DISABLED I88101 DEC 3, 2015 9:15 AM PORT SETTINGS: COMM BOARD : 1 (EDIM ) RS-232 SECURITY CODE : DISABLED I88102 DEC 3, 2015 9:15 AM PORT SETTINGS: COMM BOARD : 2 (RS-232) BAUD RATE : 9600 PARITY : NONE STOP BIT : 1 STOP DATA LENGTH: 8 DATA RS-232 SECURITY CODE : DISABLED I88103 DEC 3, 2015 9:15 AM PORT SETTINGS: COMM BOARD : 3 (S-SAT ) BAUD RATE : 9600 PARITY : NONE STOP BIT : 1 STOP DATA LENGTH: 8 DATA RS-232 SECURITY CODE : DISABLED DTR NORMAL STATE: HIGH I88104 DEC 3, 2015 9:15 AM
I88105 DEC 3, 2015 9:15 AM I88106 DEC 3, 2015 9:15 AM I52000 DEC 3, 2015 9:15 AM RECEIVER AUTO DIAL TYPE & START TIME RCVR LOCATION LABEL DIAL TYPE START TIME 1 ON DATE JUN 26, 2015 DISABLED 2 ON DATE JUN 26, 2015 DISABLED 3 ON DATE JUN 26, 2015 DISABLED 4 ON DATE JUN 26, 2015 DISABLED 5 ON DATE JUN 26, 2015 DISABLED 6 ON DATE JUN 26, 2015 DISABLED 7 ON DATE JUN 26, 2015 DISABLED 8 ON DATE JUN 26, 2015 DISABLED I60100 DEC 3, 2015 9:15 AM TANK CONFIGURATION DEVICE LABEL CONFIGURED 1 REGULAR UNL ON 2 SUPER UNL ON 3 OFF 4 OFF I60200 DEC 3, 2015 9:15 AM TANK PRODUCT LABEL TANK PRODUCT LABEL 1 REGULAR UNL 2 SUPER UNL 3 4 I60300 DEC 3, 2015 9:15 AM TANK PRODUCT CODE TANK PRODUCT LABEL 1 REGULAR UNL 1 2 SUPER UNL 2 3 3 4 4
I60900 DEC 3, 2015 9:15 AM TANK THERMAL COEFFICIENT TANK PRODUCT LABEL 1 REGULAR UNL 0.000700 2 SUPER UNL 0.000700 3 0.000000 4 0.000000 I60700 DEC 3, 2015 9:15 AM TANK DIAMETER TANK PRODUCT LABEL INCHES 1 REGULAR UNL 109.00 2 SUPER UNL 109.00 3 0.00 4 0.00 I60A00 DEC 3, 2015 9:15 AM TANK FULL VOLUME TANK PRODUCT LABEL TANK PROFILE GALLONS 1 REGULAR UNL 20 PTS 12027 2 SUPER UNL 20 PTS 8189 3 1 PT 0 4 1 PT 0 I60400 DEC 3, 2015 9:15 AM TANK FULL VOLUME TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 12027 2 SUPER UNL 8189 3 0 4 0 I60500 DEC 3, 2015 9:15 AM TANK 4 POINT VOLUMES TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 12027 9879 6220 2503 2 SUPER UNL 8189 6711 4229 1698 3 0 0 0 0 4 0 0 0 0 I60600 DEC 3, 2015 9:15 AM
TANK 20 POINT VOLUMES TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 12027 11916 11547 11066 10511 9879 9196 8493 7745 6979 6220 5441 4648 3920 3204 2503 1850 1245 722 290 2 SUPER UNL 8189 8089 7850 7520 7141 6711 6259 5770 5269 4751 4229 3699 3180 2667 2175 1698 1258 847 490 198 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 I61500 DEC 3, 2015 9:15 AM TANK PRODUCT LABEL METER DATA 1 REGULAR UNL NO 2 SUPER UNL NO 3 NO 4 NO I62F00 DEC 3, 2015 9:15 AM MAG PROBE FLOAT SIZE TANK PRODUCT LABEL FLOAT SIZE: 1 REGULAR UNL 4.0 IN. 2 SUPER UNL 4.0 IN. I62700 DEC 3, 2015 9:15 AM TANK HIGH WATER WARNING LIMIT TANK PRODUCT LABEL INCHES 1 REGULAR UNL 3.0 2 SUPER UNL 3.0 I64200 DEC 3, 2015 9:15 AM WATER ALARM FILTER
TANK PRODUCT LABEL 1 REGULAR UNL LOW 2 SUPER UNL LOW I62400 DEC 3, 2015 9:15 AM TANK HIGH WATER LEVEL LIMIT TANK PRODUCT LABEL INCHES 1 REGULAR UNL 2.0 2 SUPER UNL 2.0 I62800 DEC 3, 2015 9:15 AM TANK MAXIMUM VOLUME LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 12027 2 SUPER UNL 8189 3 0 4 0 I62300 DEC 3, 2015 9:15 AM TANK OVERFILL LEVEL LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 10824 2 SUPER UNL 7370 3 0 4 0 I62200 DEC 3, 2015 9:15 AM TANK HIGH PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 11426 2 SUPER UNL 7780 3 0 4 0 I62900 DEC 3, 2015 9:15 AM TANK DELIVERY REQUIRED LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 1203 2 SUPER UNL 819 3 0 4 0
I62100 DEC 3, 2015 9:15 AM TANK LOW PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 350 2 SUPER UNL 400 3 0 4 0 I62600 DEC 3, 2015 9:15 AM TANK LEAK ALARM LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 99 2 SUPER UNL 99 3 99 4 99 I62500 DEC 3, 2015 9:15 AM TANK SUDDEN LOSS LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 99 2 SUPER UNL 99 3 99 4 99 I60800 DEC 3, 2015 9:15 AM TANK TILT TANK PRODUCT LABEL INCHES 1 REGULAR UNL 0.00 2 SUPER UNL 0.00 3 0.00 4 0.00 I60B00 DEC 3, 2015 9:15 AM STICK HEIGHT OFFSET ENABLE STATUS DISABLED I60C00 DEC 3, 2015 9:15 AM TANK STICK HEIGHT OFFSET TANK PRODUCT LABEL INCHES
1 REGULAR UNL 0.00 2 SUPER UNL 0.00 3 0.00 4 0.00 I61200 DEC 3, 2015 9:15 AM TANK MANIFOLDED PARTNERS TANK PRODUCT LABEL SIPHON MANIFOLDED TANKS LINE MANIFOLDED TANKS 1 REGULAR UNL NONE NONE 2 SUPER UNL NONE NONE 3 NONE NONE 4 NONE NONE I63600 DEC 3, 2015 9:15 AM PERIODIC LEAK TEST MIN VOLUME TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 1202 2 SUPER UNL 818 3 0 4 0 I62A00 DEC 3, 2015 9:15 AM ANNUAL LEAK TEST MIN VOLUME TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 1202 2 SUPER UNL 818 3 0 4 0 I62C00 DEC 3, 2015 9:15 AM TANK PERIODIC TEST TYPE TANK PRODUCT LABEL PERIODIC TEST TYPE 1 REGULAR UNL STANDARD 2 SUPER UNL STANDARD 3 STANDARD 4 STANDARD I62D00 DEC 3, 2015 9:15 AM TANK LEAK TEST FAIL ALARMS TANK PRODUCT LABEL 1 REGULAR UNL GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED
ANNUAL TEST FAIL ALARM DISABLED 2 SUPER UNL GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 3 GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED 4 GROSS TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ANNUAL TEST FAIL ALARM DISABLED I63100 DEC 3, 2015 9:15 AM TANK LEAK TEST AVERAGING TANK PRODUCT LABEL ANNUAL PERIODIC 1 REGULAR UNL OFF OFF 2 SUPER UNL OFF OFF 3 OFF OFF 4 OFF OFF I63000 DEC 3, 2015 9:15 AM IN-TANK LEAK TEST NOTIFY TANK PRODUCT LABEL TANK TEST NOTIFY: 1 REGULAR UNL OFF 2 SUPER UNL OFF 3 OFF 4 OFF I63200 DEC 3, 2015 9:15 AM TANK TEST SIPHON BREAK TANK PRODUCT LABEL SIPHON BREAK 1 REGULAR UNL OFF 2 SUPER UNL OFF 3 OFF 4 OFF I61000 DEC 3, 2015 9:15 AM TANK DELIVERY DELAY TANK PRODUCT LABEL 1 REGULAR UNL 1
2 SUPER UNL 1 3 1 4 1 I63A00 DEC 3, 2015 9:15 AM LOW LEVEL PUMP THRESHOLD FOR SEQUENTIAL LINE MANIFOLD TANK PRODUCT LABEL PUMP THRESHOLD 1 REGULAR UNL 10.00% 2 SUPER UNL 10.00% 3 10.00% 4 10.00% I61100 DEC 3, 2015 9:15 AM LEAK TEST METHOD - - - - - - - - - - - - TEST ON DATE : ALL TANK OCT 1, 2014 START TIME : DISABLED TEST RATE :0.20 GAL/HR DURATION : 2 HOURS TST EARLY STOP:DISABLED I61300 DEC 3, 2015 9:15 AM CSLD PROBABLITY OF DETECTION I61400 DEC 3, 2015 9:15 AM CSLD CLIMATE FACTOR I61600 DEC 3, 2015 9:15 AM TANK PRODUCT LABEL CAL UPDATE 1 REGULAR UNL IMMEDIATE 2 SUPER UNL IMMEDIATE 3 IMMEDIATE 4 IMMEDIATE I61A00 DEC 3, 2015 9:15 AM IN-TANK LEAK TEST EARLY STOP
TANK PRODUCT LABEL TST EARLY STOP: 1 REGULAR UNL DISABLED 2 SUPER UNL DISABLED 3 DISABLED 4 DISABLED I61B00 DEC 3, 2015 9:16 AM IN-TANK LEAK GROSS TEST AUTO-CONFIRM I61C00 DEC 3, 2015 9:16 AM CSLD REPORT ONLY I62B00 DEC 3, 2015 9:16 AM TANK LAST ANNUAL TEST TANK PRODUCT LABEL DATE 1 REGULAR UNL ??? 0, 0 2 SUPER UNL ??? 0, 0 3 ??? 0, 0 4 ??? 0, 0 I63300 DEC 3, 2015 9:16 AM LEAK TEST REPORT FORMAT: NORMAL I63400 DEC 3, 2015 9:16 AM RECONCILIATION WARNING LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 0 2 SUPER UNL 0 3 0 4 0 I63500 DEC 3, 2015 9:16 AM RECONCILIATION ALARM LIMIT TANK PRODUCT LABEL GALLONS 1 REGULAR UNL 1 2 SUPER UNL 1
3 1 4 1 I63900 DEC 3, 2015 9:16 AM ACCU CHART END SHAPE FACTOR TANK PRODUCT LABEL 1 REGULAR UNL END FACTOR: NONE 2 SUPER UNL END FACTOR: NONE 3 END FACTOR: NONE 4 END FACTOR: NONE I78000 DEC 3, 2015 9:16 AM I77700 DEC 3, 2015 9:16 AM I77800 DEC 3, 2015 9:16 AM I78C00 DEC 3, 2015 9:16 AM I78300 DEC 3, 2015 9:16 AM I78F00 DEC 3, 2015 9:16 AM I78700 DEC 3, 2015 9:16 AM
I70200 DEC 3, 2015 9:16 AM LIQUID LABEL DEVICE LABEL 1 87-91 ANNULAR 2 87 STP 3 87 FILL 4 91 STP 5 91 FILL 6 DISP 1-2 7 DISP 3-4 8 DISP 5-6 9 DISP 7-8 10 DISP 9-10 11 DISP 11-12 12 DISP 7-8 13 14 15 16 I70300 DEC 3, 2015 9:16 AM LIQUID TYPE SENSOR LOCATION TYPE 1 87-91 ANNULAR TRI-STATE (SINGLE FLOAT) 2 87 STP TRI-STATE (SINGLE FLOAT) 3 87 FILL TRI-STATE (SINGLE FLOAT) 4 91 STP TRI-STATE (SINGLE FLOAT) 5 91 FILL TRI-STATE (SINGLE FLOAT) 6 DISP 1-2 TRI-STATE (SINGLE FLOAT) 7 DISP 3-4 TRI-STATE (SINGLE FLOAT) 8 DISP 5-6 TRI-STATE (SINGLE FLOAT) 9 DISP 7-8 TRI-STATE (SINGLE FLOAT) 10 DISP 9-10 TRI-STATE (SINGLE FLOAT) 11 DISP 11-12 TRI-STATE (SINGLE FLOAT) 12 DISP 7-8 TRI-STATE (SINGLE FLOAT) 13 TRI-STATE (SINGLE FLOAT) 14 TRI-STATE (SINGLE FLOAT) 15 TRI-STATE (SINGLE FLOAT) 16 TRI-STATE (SINGLE FLOAT) I70400 DEC 3, 2015 9:16 AM LIQUID CATEGORY SENSOR LOCATION CATEGORY 1 87-91 ANNULAR ANNULAR SPACE 2 87 STP STP SUMP 3 87 FILL PIPING SUMP 4 91 STP STP SUMP 5 91 FILL PIPING SUMP 6 DISP 1-2 DISPENSER PAN
7 DISP 3-4 DISPENSER PAN 8 DISP 5-6 DISPENSER PAN 9 DISP 7-8 DISPENSER PAN 10 DISP 9-10 DISPENSER PAN 11 DISP 11-12 DISPENSER PAN 12 DISP 7-8 DISPENSER PAN 13 OTHER SENSORS 14 OTHER SENSORS 15 OTHER SENSORS 16 OTHER SENSORS I74200 DEC 3, 2015 9:16 AM I74300 DEC 3, 2015 9:16 AM I74400 DEC 3, 2015 9:16 AM I74700 DEC 3, 2015 9:16 AM I74800 DEC 3, 2015 9:16 AM I74900 DEC 3, 2015 9:16 AM I7BC00 DEC 3, 2015 9:16 AM I80200 DEC 3, 2015 9:16 AM I80300 DEC 3, 2015 9:16 AM I80400 DEC 3, 2015 9:16 AM
I80700 DEC 3, 2015 9:16 AM RELAY LABEL DEVICE LABEL 1 REGULAR UNL 2 SUPER UNL 3 OVERFILL 4 I80900 DEC 3, 2015 9:16 AM RELAY ORIENTATION RELAY DESIGNATION ORIENTATION 1 REGULAR UNL NORMALLY CLOSED 2 SUPER UNL NORMALLY CLOSED 3 OVERFILL NORMALLY OPEN 4 NORMALLY OPEN I80B00 DEC 3, 2015 9:16 AM RELAY TANK ASSIGNMENT RELAY DESIGNATION TANK 1 REGULAR UNL 1 2 SUPER UNL 2 3 OVERFILL NONE 4 NONE I80A00 DEC 3, 2015 9:16 AM RELAY TYPE RELAY DESIGNATION TYPE 1 REGULAR UNL STANDARD 2 SUPER UNL STANDARD 3 OVERFILL STANDARD 4 STANDARD I80C00 DEC 3, 2015 9:16 AM I80800 DEC 3, 2015 9:16 AM RELAY SETUP REPORT R 1:REGULAR UNL
TYPE: STANDARD NORMALLY CLOSED TANK #: 1 IN-TANK ALARMS T 1:LOW PRODUCT ALARM LIQUID SENSOR ALMS L 2:FUEL ALARM L 6:FUEL ALARM L 7:FUEL ALARM L 8:FUEL ALARM L 9:FUEL ALARM L10:FUEL ALARM L11:FUEL ALARM L12:FUEL ALARM L 2:SENSOR OUT ALARM L 6:SENSOR OUT ALARM L 7:SENSOR OUT ALARM L 8:SENSOR OUT ALARM L 9:SENSOR OUT ALARM L10:SENSOR OUT ALARM L11:SENSOR OUT ALARM L12:SENSOR OUT ALARM L 2:SHORT ALARM L 6:SHORT ALARM L 7:SHORT ALARM L 8:SHORT ALARM L 9:SHORT ALARM L10:SHORT ALARM L11:SHORT ALARM L11:SHORT ALARM ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL ISD VP PRES FAIL ISD HOSE ALARMS ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL ALL:FLOW COLLECT FAIL PMC ALARMS VP EMISSIONS FAIL VP PRESSURE FAIL VP DUTY CYCLE FAIL PMC SETUP FAIL R 2:SUPER UNL TYPE: STANDARD NORMALLY CLOSED TANK #: 2 IN-TANK ALARMS T 2:LOW PRODUCT ALARM
LIQUID SENSOR ALMS L 4:FUEL ALARM L 6:FUEL ALARM L 7:FUEL ALARM L 8:FUEL ALARM L 9:FUEL ALARM L10:FUEL ALARM L11:FUEL ALARM L 4:SENSOR OUT ALARM L 6:SENSOR OUT ALARM L 7:SENSOR OUT ALARM L 8:SENSOR OUT ALARM L 9:SENSOR OUT ALARM L10:SENSOR OUT ALARM L11:SENSOR OUT ALARM L 4:SHORT ALARM L 5:SHORT ALARM L 6:SHORT ALARM L 7:SHORT ALARM L 8:SHORT ALARM L 9:SHORT ALARM L10:SHORT ALARM L11:SHORT ALARM ISD SITE ALARMS ISD GROSS PRES FAIL ISD DEGRD PRES FAIL ISD VAPOR LEAK FAIL ISD VP PRES FAIL ISD VP STATUS FAIL ISD HOSE ALARMS ALL:GROSS COLLECT FAIL ALL:DEGRD COLLECT FAIL ALL:FLOW COLLECT FAIL PMC ALARMS VP EMISSIONS FAIL VP PRESSURE FAIL VP DUTY CYCLE FAIL R 3:OVERFILL TYPE: STANDARD NORMALLY OPEN TANK #: NONE IN-TANK ALARMS ALL:OVERFILL ALARM ALL:HIGH PRODUCT ALARM R 4: TYPE: STANDARD NORMALLY OPEN TANK #: NONE
- NO ALARM ASSIGNMENTS - I79000 DEC 3, 2015 9:16 AM EDIM:1 VR:349643-001-B TD:97.10.27.11.25 I79100 DEC 3, 2015 9:16 AM I72300 DEC 3, 2015 9:16 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 SMARTSENSOR ASSIGNMENT DEVICE LABEL CATEGORY 01 VAPOR PRESSUR VAPOR PRESSURE 02 FM 1-2 AIR FLOW METER 03 FM 3-4 AIR FLOW METER 04 FM 5-6 AIR FLOW METER 05 FM 7-8 AIR FLOW METER 06 FM 9-10 AIR FLOW METER 07 FM 11-12 AIR FLOW METER 08 UNKNOWN 09 UNKNOWN 10 UNKNOWN 11 UNKNOWN 12 UNKNOWN 13 UNKNOWN 14 UNKNOWN 15 UNKNOWN 16 UNKNOWN 17 UNKNOWN 18 UNKNOWN 19 UNKNOWN 20 UNKNOWN 21 UNKNOWN 22 UNKNOWN 23 UNKNOWN 24 UNKNOWN 25 UNKNOWN 26 UNKNOWN 27 UNKNOWN 28 UNKNOWN 29 UNKNOWN 30 UNKNOWN 31 UNKNOWN 32 UNKNOWN 33 UNKNOWN 34 UNKNOWN
35 UNKNOWN 36 UNKNOWN 37 UNKNOWN 38 UNKNOWN 39 UNKNOWN 40 UNKNOWN I72A00 DEC 3, 2015 9:16 AM VACUUM SENSOR VOLUME DEVICE LABEL VOLUME IV4E00 DEC 3, 2015 9:16 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 EVR/ISD SETUP TYPE: VACUUM ASSIST VACUUM ASSIST TYPE: HEALY VAC IV4F00 DEC 3, 2015 9:16 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 NOZZLE A/L RANGE A/L RATIO: 0.95 - 1.15 IV4000 DEC 3, 2015 9:16 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 VAPOR PROCESSOR TYPE NONE IV4700 DEC 3, 2015 9:16 AM FLOWER ST MINI MART 928 FLOWER ST
BAKERSFIELD CA 93305 661-328-0673 ASSESSMENT TIME START TIME: 10:00 AM TIME DELAY MINUTES: 1 IV5200 DEC 3, 2015 9:16 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 ACCEPT HIGH ORVR: NO IV4A00 DEC 3, 2015 9:16 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 ISD HOSE TABLE HOSE FP FP AFM REL HOSE ID ID LABEL ID ID LABEL 01 01 01 01 02 BLEND3 02 02 02 01 02 BLEND3 03 03 03 02 02 BLEND3 04 04 04 02 02 BLEND3 05 05 05 03 02 BLEND3 06 06 06 03 02 BLEND3 07 07 07 04 02 BLEND3 08 08 08 04 02 BLEND3 09 09 09 05 02 BLEND3 10 16 10 05 02 BLEND3 11 17 11 06 02 BLEND3 12 18 12 06 02 BLEND3 IV4B00 DEC 3, 2015 9:16 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 PRODUCT/HOSE MAP TABLE FP AFID M1/H1 M2/H2 M3/H3 M4/H4 01 01 02/01 09/01 01/01 xx/xx 02 01 02/02 09/02 01/02 xx/xx 03 02 02/03 09/03 01/03 xx/xx 04 02 02/04 09/04 01/04 xx/xx 05 03 02/05 09/05 01/05 xx/xx
06 03 02/06 09/06 01/06 xx/xx 07 04 02/07 09/07 01/07 xx/xx 08 04 09/08 02/08 01/08 xx/xx 09 05 02/09 09/09 01/09 xx/xx 16 05 02/10 09/10 01/10 xx/xx 17 06 02/11 09/11 01/11 xx/xx 18 06 02/12 09/12 01/12 xx/xx IV4900 DEC 3, 2015 9:16 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 LABEL TABLE ID LABEL 01 UNASSIGNED 02 BLEND3 03 REGULAR 04 MID GRADE 05 PREMIUM 06 GOLD 07 BRONZE 08 SILVER 09 BLEND2 10 BLEND4 IV1000 DEC 3, 2015 9:16 AM ISD VERSION: 01.05
Flower St Mini Mart
Alarm Hist: Responses Received: I10200 DEC 3, 2015 9:20 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 SYSTEM CONFIGURATION SLOT BOARD TYPE POWER ON RESET CURRENT 1 UNUSED 10457924 10457924 2 UNUSED 10331431 10331431 3 UNUSED 10312623 10312623 4 8SMARTSENSOR BD 39519 39519 5 4 PROBE / G.T. 163572 163572 6 INTERSTITIAL BD 201659 201659 7 INTERSTITIAL BD 201747 201747 8 UNUSED 10331048 10331048 9 UNUSED 10314410 10314410 10 RELAY BOARD 14965 14965 11 UNUSED 10317088 10317088 12 UNUSED 10306036 10306036 13 UNUSED 10308587 10308587 14 UNUSED 10311371 10311371 15 UNUSED 10310818 10310818 16 UNUSED 10307503 10307503 COMM 1 ELEC DISP INT. 100670 100670 COMM 2 RS232 SERIAL BD 14901 14901 COMM 3 SERIAL SAT BD 484996 484996 COMM 4 UNUSED 10316238 10316238 COMM 5 UNUSED 10299002 10299002 COMM 6 UNUSED 10303019 10303019 I90200 DEC 3, 2015 9:20 AM SOFTWARE REVISION LEVEL VERSION 333.06 SOFTWARE# 346333-100-G CREATED - 14.10.01.16.35 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM I11100 DEC 3, 2015 9:20 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673
PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME OTHER ISD GROSS PRES FAIL CLEAR 12-01-15 10:07AM OTHER ISD GROSS PRES FAIL ALARM 12-01-15 10:01AM OTHER MISSING HOSE SETUP CLEAR 10-02-14 10:00AM OTHER MISS VAPOR FLOW MTR CLEAR 10-01-14 12:32PM OTHER MISS VAPOR FLOW MTR ALARM 10-01-14 12:30PM OTHER MISSING HOSE SETUP ALARM 10-01-14 12:30PM OTHER MISS VAPOR PRES SEN CLEAR 10-01-14 8:05AM OTHER MISS VAPOR FLOW MTR CLEAR 10-01-14 8:05AM OTHER MISSING HOSE SETUP CLEAR 10-01-14 8:05AM OTHER MISSING TANK SETUP CLEAR 10-01-14 8:05AM OTHER MISS VAPOR PRES SEN ALARM 10-01-14 8:02AM OTHER MISS VAPOR FLOW MTR ALARM 10-01-14 8:02AM OTHER MISSING HOSE SETUP ALARM 10-01-14 8:02AM OTHER MISSING TANK SETUP ALARM 10-01-14 8:02AM SYSTEM BATTERY IS OFF CLEAR 10-01-14 8:00AM SYSTEM BATTERY IS OFF ALARM 10-01-14 8:00AM I11200 DEC 3, 2015 9:21 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 NON-PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME h 7 OTHER FP7: BLEND3 DEGRD COLLECT WARN CLEAR 12-02-15 10:00AM h 7 OTHER FP7: BLEND3 DEGRD COLLECT WARN ALARM 12-01-15 10:01AM OTHER ISD GROSS PRES WARN CLEAR 12-01-15 10:00AM T 1 TANK REGULAR UNL DELIVERY NEEDED CLEAR 12-01-15 12:01AM T 1 TANK REGULAR UNL DELIVERY NEEDED ALARM 11-30-15 6:53PM OTHER ISD GROSS PRES WARN ALARM 11-24-15 10:02AM h11 OTHER FP11: BLEND3 DEGRD COLLECT WARN CLEAR 11-23-15 1:39PM h 1 OTHER FP1: BLEND3 DEGRD COLLECT WARN CLEAR 11-23-15 1:38PM h11 OTHER FP11: BLEND3 DEGRD COLLECT WARN ALARM 11-21-15 10:01AM h 1 OTHER FP1: BLEND3 DEGRD COLLECT WARN ALARM 11-21-15 10:01AM SYSTEM PRINTER ERROR CLEAR 11-17-15 2:50PM SYSTEM PAPER OUT CLEAR 11-17-15 2:50PM SYSTEM PRINTER ERROR ALARM 11-17-15 2:48PM SYSTEM PAPER OUT ALARM 11-17-15 2:48PM T 2 TANK SUPER UNL DELIVERY NEEDED CLEAR 10-01-14 3:17PM T 2 TANK SUPER UNL DELIVERY NEEDED ALARM 10-01-14 8:05AM I20600 DEC 3, 2015 9:21 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 TANK ALARM HISTORY TANK 1 REGULAR UNL
DELIVERY NEEDED NOV 30, 2015 6:53 PM TANK 2 SUPER UNL DELIVERY NEEDED OCT 1, 2014 8:05 AM TANK 5 TANK 6 TANK 7 TANK 8 TANK 9 TANK 10 TANK 11 TANK 12 TANK 13 TANK 14 TANK 15 TANK 16 I38200 DEC 3, 2015 9:21 AM I30200 DEC 3, 2015 9:21 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 87-91 ANNULAR 2 87 STP 3 87 FILL 4 91 STP 5 91 FILL 6 DISP 1-2 7 DISP 3-4 8 DISP 5-6 10 DISP 9-10 11 DISP 11-12 12 DISP 7-8
I31600 DEC 3, 2015 9:21 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 SMART SENSOR ALARM HISTORY REPORT SENSOR LOCATION 1 VAPOR PRESSUR 2 FM 1-2 3 FM 3-4 4 FM 5-6 5 FM 7-8 6 FM 9-10 7 FM 11-12 I40200 DEC 3, 2015 9:21 AM I40300 DEC 3, 2015 9:21 AM I34200 DEC 3, 2015 9:21 AM I34700 DEC 3, 2015 9:21 AM IV0100 DEC 3, 2015 9:21 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 ISD ALARM STATUS REPORT EVR TYPE: VACUUM ASSIST ISD TYPE: 01.05 VAPOR PROCESSOR TYPE: NONE OVERALL STATUS :PASS EVR VAPOR COLLECTION :PASS EVR VAPOR CONTAINMENT :NOTEST ISD MONITOR UP-TIME :100% EVR/ISD PASS TIME :100% WARNING ALARMS DATE TIME DESCRIPTION READING VALUE
15-12-01 10:01:48 A/L RATIO DEGRADATION FP 7 BLEND3 0.80 15-11-30 10:01:59 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.61 15-11-29 10:02:00 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.61 15-11-28 10:02:11 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.61 15-11-27 10:01:32 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.62 15-11-26 10:02:10 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.55 15-11-25 10:02:25 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.48 15-11-24 10:02:19 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.48 15-11-23 10:02:01 A/L RATIO DEGRADATION FP11 BLEND3 0.79 15-11-23 10:02:01 A/L RATIO DEGRADATION FP 1 BLEND3 0.78 FAILURE ALARMS DATE TIME DESCRIPTION READING VALUE 15-12-01 10:01:48 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.62 15-10-07 10:03:08 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 2.40 15-09-03 10:01:50 A/L RATIO DEGRADATION FP 9 BLEND3 0.80 15-08-21 10:03:01 A/L RATIO DEGRADATION FP10 BLEND3 0.78 15-08-20 10:03:05 A/L RATIO DEGRADATION FP10 BLEND3 0.78 15-06-23 10:02:07 SENSOR OUT SELFTEST E 1 15-06-23 10:02:07 SETUP SELFTEST MISSING HOSE(S) 15-06-22 10:01:34 SENSOR OUT SELFTEST E 1 15-06-22 10:01:34 SETUP SELFTEST MISSING HOSE(S) 15-06-21 10:01:09 SENSOR OUT SELFTEST E 1 SHUTDOWN & MISCELLANEOUS EVENTS DATE TIME DESCRIPTION ACTION/NAME 15-12-02 10:03:21 READINESS ISD:PP EVR:PN EVR READINESS PENDING 15-12-01 10:07:46 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED 15-12-01 10:06:19 PUMPS MANUALLY RE-ENABLED 15-12-01 10:01:48 READINESS ISD:PP EVR:PF CHECK EVR SYSTEM 15-12-01 10:01:48 CONTAINMENT GROSS DISABLED DISPENSERS 15-11-30 10:01:59 READINESS ISD:PP EVR:PF CHECK EVR SYSTEM 15-11-29 10:02:00 READINESS ISD:PP EVR:PF CHECK EVR SYSTEM 15-11-28 10:02:12 READINESS ISD:PP EVR:PF CHECK EVR SYSTEM 15-11-27 10:01:32 READINESS ISD:PP EVR:PF CHECK EVR SYSTEM 15-11-26 10:02:10 READINESS ISD:PP EVR:PF CHECK EVR SYSTEM
Flower St Mini Mart
Alarm Hist After: Responses Received: I10200 DEC 3, 2015 10:59 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 SYSTEM CONFIGURATION SLOT BOARD TYPE POWER ON RESET CURRENT 1 UNUSED 10457924 10377637 2 UNUSED 10331431 10326663 3 UNUSED 10312623 10320154 4 8SMARTSENSOR BD 39519 39578 5 4 PROBE / G.T. 163572 163518 6 INTERSTITIAL BD 201659 201590 7 INTERSTITIAL BD 201747 201925 8 UNUSED 10331048 10333708 9 UNUSED 10314410 10319307 10 RELAY BOARD 14965 14964 11 UNUSED 10317088 10336062 12 UNUSED 10306036 10320703 13 UNUSED 10308587 10323281 14 UNUSED 10311371 10320080 15 UNUSED 10310818 10325429 16 UNUSED 10307503 10319930 COMM 1 ELEC DISP INT. 100670 100767 COMM 2 RS232 SERIAL BD 14901 14921 COMM 3 SERIAL SAT BD 484996 485104 COMM 4 UNUSED 10316238 10330327 COMM 5 UNUSED 10299002 10313314 COMM 6 UNUSED 10303019 10320939 I90200 DEC 3, 2015 10:59 AM SOFTWARE REVISION LEVEL VERSION 333.06 SOFTWARE# 346333-100-G CREATED - 14.10.01.16.35 S-MODULE# 330160-004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD/APM I11100 DEC 3, 2015 10:59 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673
PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME L11 DISP PAN DISP 11-12 FUEL ALARM CLEAR 12-03-15 10:50AM L11 DISP PAN DISP 11-12 FUEL ALARM ALARM 12-03-15 10:50AM L10 DISP PAN DISP 9-10 FUEL ALARM CLEAR 12-03-15 10:49AM L10 DISP PAN DISP 9-10 FUEL ALARM ALARM 12-03-15 10:49AM L12 DISP PAN DISP 7-8 FUEL ALARM CLEAR 12-03-15 10:47AM L12 DISP PAN DISP 7-8 FUEL ALARM ALARM 12-03-15 10:47AM E 1 OTHER G COMMUNICATION ALARM ALARM 12-03-15 10:46AM L11 DISP PAN DISP 11-12 FUEL ALARM CLEAR 12-03-15 10:40AM L11 DISP PAN DISP 11-12 FUEL ALARM ALARM 12-03-15 10:40AM L10 DISP PAN DISP 9-10 FUEL ALARM CLEAR 12-03-15 10:38AM L10 DISP PAN DISP 9-10 FUEL ALARM ALARM 12-03-15 10:38AM L 6 DISP PAN DISP 1-2 FUEL ALARM CLEAR 12-03-15 10:36AM L 6 DISP PAN DISP 1-2 FUEL ALARM ALARM 12-03-15 10:36AM L 7 DISP PAN DISP 3-4 FUEL ALARM CLEAR 12-03-15 10:36AM L 7 DISP PAN DISP 3-4 FUEL ALARM ALARM 12-03-15 10:35AM L12 DISP PAN DISP 7-8 FUEL ALARM CLEAR 12-03-15 10:35AM L12 DISP PAN DISP 7-8 FUEL ALARM ALARM 12-03-15 10:34AM L12 DISP PAN DISP 7-8 FUEL ALARM CLEAR 12-03-15 10:32AM L12 DISP PAN DISP 7-8 FUEL ALARM ALARM 12-03-15 10:30AM L12 DISP PAN DISP 7-8 FUEL ALARM CLEAR 12-03-15 10:29AM L12 DISP PAN DISP 7-8 FUEL ALARM ALARM 12-03-15 10:29AM L12 DISP PAN DISP 7-8 FUEL ALARM CLEAR 12-03-15 10:29AM L12 DISP PAN DISP 7-8 FUEL ALARM ALARM 12-03-15 10:28AM L 8 DISP PAN DISP 5-6 FUEL ALARM CLEAR 12-03-15 10:26AM L 8 DISP PAN DISP 5-6 FUEL ALARM ALARM 12-03-15 10:25AM L 3 PIPE 87 FILL FUEL ALARM CLEAR 12-03-15 10:23AM L 3 PIPE 87 FILL FUEL ALARM ALARM 12-03-15 10:23AM L 2 STP SUMP 87 STP FUEL ALARM CLEAR 12-03-15 10:22AM L 2 STP SUMP 87 STP FUEL ALARM ALARM 12-03-15 10:21AM L 2 STP SUMP 87 STP FUEL ALARM CLEAR 12-03-15 10:21AM L 2 STP SUMP 87 STP FUEL ALARM ALARM 12-03-15 10:21AM L 5 PIPE 91 FILL FUEL ALARM CLEAR 12-03-15 10:20AM L 5 PIPE 91 FILL FUEL ALARM ALARM 12-03-15 10:19AM L 4 STP SUMP 91 STP FUEL ALARM CLEAR 12-03-15 10:18AM L 4 STP SUMP 91 STP FUEL ALARM ALARM 12-03-15 10:18AM T 1 TANK REGULAR UNL PROBE OUT CLEAR 12-03-15 10:17AM T 1 TANK REGULAR UNL OVERFILL ALARM CLEAR 12-03-15 10:16AM T 1 TANK REGULAR UNL PROBE OUT ALARM 12-03-15 10:16AM T 1 TANK REGULAR UNL OVERFILL ALARM ALARM 12-03-15 10:14AM T 1 TANK REGULAR UNL PROBE OUT CLEAR 12-03-15 10:13AM T 1 TANK REGULAR UNL PROBE OUT ALARM 12-03-15 10:12AM T 2 TANK SUPER UNL PROBE OUT CLEAR 12-03-15 10:11AM T 2 TANK SUPER UNL PROBE OUT ALARM 12-03-15 10:10AM T 2 TANK SUPER UNL OVERFILL ALARM CLEAR 12-03-15 10:10AM T 2 TANK SUPER UNL OVERFILL ALARM ALARM 12-03-15 10:08AM T 1 TANK REGULAR UNL HIGH WATER ALARM CLEAR 12-03-15 10:07AM T 1 TANK REGULAR UNL PROBE OUT CLEAR 12-03-15 10:04AM T 1 TANK REGULAR UNL PROBE OUT ALARM 12-03-15 10:03AM T 1 TANK REGULAR UNL HIGH WATER ALARM ALARM 12-03-15 9:46AM T 1 TANK REGULAR UNL PROBE OUT CLEAR 12-03-15 9:43AM I11200 DEC 3, 2015 10:59 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673
NON-PRIORITY ALARM HISTORY ID CATEGORY DESCRIPTION ALARM TYPE STATE DATE TIME T 1 TANK REGULAR UNL LOW TEMP WARNING CLEAR 12-03-15 10:17AM T 1 TANK REGULAR UNL LOW TEMP WARNING ALARM 12-03-15 10:17AM T 1 TANK REGULAR UNL LOW TEMP WARNING CLEAR 12-03-15 10:14AM T 1 TANK REGULAR UNL LOW TEMP WARNING ALARM 12-03-15 10:13AM T 2 TANK SUPER UNL LOW TEMP WARNING CLEAR 12-03-15 10:13AM T 2 TANK SUPER UNL LOW TEMP WARNING ALARM 12-03-15 10:11AM T 2 TANK SUPER UNL HIGH PRODUCT ALARM CLEAR 12-03-15 10:10AM SYSTEM PRINTER ERROR CLEAR 12-03-15 10:10AM SYSTEM PAPER OUT CLEAR 12-03-15 10:10AM SYSTEM PAPER OUT ALARM 12-03-15 10:09AM SYSTEM PRINTER ERROR ALARM 12-03-15 10:09AM T 2 TANK SUPER UNL HIGH PRODUCT ALARM ALARM 12-03-15 10:08AM T 1 TANK REGULAR UNL HIGH WATER WARNING CLEAR 12-03-15 10:07AM T 1 TANK REGULAR UNL HIGH PRODUCT ALARM CLEAR 12-03-15 10:02AM T 1 TANK REGULAR UNL HIGH PRODUCT ALARM ALARM 12-03-15 10:02AM T 1 TANK REGULAR UNL HIGH WATER WARNING ALARM 12-03-15 9:46AM T 2 TANK SUPER UNL INVALID FUEL LEVEL CLEAR 12-03-15 9:41AM T 2 TANK SUPER UNL DELIVERY NEEDED CLEAR 12-03-15 9:41AM T 2 TANK SUPER UNL INVALID FUEL LEVEL ALARM 12-03-15 9:41AM T 2 TANK SUPER UNL DELIVERY NEEDED ALARM 12-03-15 9:39AM h 7 OTHER FP7: BLEND3 DEGRD COLLECT WARN CLEAR 12-02-15 10:00AM h 7 OTHER FP7: BLEND3 DEGRD COLLECT WARN ALARM 12-01-15 10:01AM OTHER ISD GROSS PRES WARN CLEAR 12-01-15 10:00AM T 1 TANK REGULAR UNL DELIVERY NEEDED CLEAR 12-01-15 12:01AM T 1 TANK REGULAR UNL DELIVERY NEEDED ALARM 11-30-15 6:53PM OTHER ISD GROSS PRES WARN ALARM 11-24-15 10:02AM h11 OTHER FP11: BLEND3 DEGRD COLLECT WARN CLEAR 11-23-15 1:39PM h 1 OTHER FP1: BLEND3 DEGRD COLLECT WARN CLEAR 11-23-15 1:38PM h11 OTHER FP11: BLEND3 DEGRD COLLECT WARN ALARM 11-21-15 10:01AM h 1 OTHER FP1: BLEND3 DEGRD COLLECT WARN ALARM 11-21-15 10:01AM SYSTEM PRINTER ERROR CLEAR 11-17-15 2:50PM SYSTEM PAPER OUT CLEAR 11-17-15 2:50PM SYSTEM PRINTER ERROR ALARM 11-17-15 2:48PM SYSTEM PAPER OUT ALARM 11-17-15 2:48PM T 2 TANK SUPER UNL DELIVERY NEEDED CLEAR 10-01-14 3:17PM T 2 TANK SUPER UNL DELIVERY NEEDED ALARM 10-01-14 8:05AM I20600 DEC 3, 2015 11:00 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 TANK ALARM HISTORY TANK 1 REGULAR UNL HIGH WATER ALARM DEC 3, 2015 9:46 AM OVERFILL ALARM DEC 3, 2015 10:14 AM HIGH PRODUCT ALARM DEC 3, 2015 10:02 AM PROBE OUT DEC 3, 2015 10:16 AM DEC 3, 2015 10:12 AM
DEC 3, 2015 10:03 AM HIGH WATER WARNING DEC 3, 2015 9:46 AM DELIVERY NEEDED NOV 30, 2015 6:53 PM LOW TEMP WARNING DEC 3, 2015 10:17 AM DEC 3, 2015 10:13 AM TANK 2 SUPER UNL OVERFILL ALARM DEC 3, 2015 10:08 AM HIGH PRODUCT ALARM DEC 3, 2015 10:08 AM INVALID FUEL LEVEL DEC 3, 2015 9:41 AM PROBE OUT DEC 3, 2015 10:10 AM DEC 3, 2015 9:39 AM DELIVERY NEEDED DEC 3, 2015 9:39 AM OCT 1, 2014 8:05 AM LOW TEMP WARNING DEC 3, 2015 10:11 AM TANK 5 TANK 6 TANK 7 TANK 8 TANK 9 TANK 10 TANK 11 TANK 12 TANK 13 TANK 14 TANK 15 TANK 16 I38200 DEC 3, 2015 11:00 AM I30200 DEC 3, 2015 11:00 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305
661-328-0673 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 87-91 ANNULAR DEC 3, 2015 9:35 AM SENSOR OUT ALARM 2 87 STP DEC 3, 2015 10:21 AM FUEL ALARM DEC 3, 2015 10:21 AM FUEL ALARM DEC 3, 2015 9:35 AM SENSOR OUT ALARM 3 87 FILL DEC 3, 2015 10:23 AM FUEL ALARM DEC 3, 2015 9:35 AM SENSOR OUT ALARM 4 91 STP DEC 3, 2015 10:18 AM FUEL ALARM DEC 3, 2015 9:35 AM SENSOR OUT ALARM 5 91 FILL DEC 3, 2015 10:19 AM FUEL ALARM DEC 3, 2015 9:35 AM SENSOR OUT ALARM 6 DISP 1-2 DEC 3, 2015 10:36 AM FUEL ALARM DEC 3, 2015 9:35 AM SENSOR OUT ALARM 7 DISP 3-4 DEC 3, 2015 10:35 AM FUEL ALARM DEC 3, 2015 9:35 AM SENSOR OUT ALARM 8 DISP 5-6 DEC 3, 2015 10:25 AM FUEL ALARM DEC 3, 2015 9:35 AM SENSOR OUT ALARM 10 DISP 9-10 DEC 3, 2015 10:49 AM FUEL ALARM DEC 3, 2015 10:38 AM FUEL ALARM DEC 3, 2015 9:35 AM SENSOR OUT ALARM 11 DISP 11-12 DEC 3, 2015 10:50 AM FUEL ALARM DEC 3, 2015 10:40 AM FUEL ALARM DEC 3, 2015 9:35 AM SENSOR OUT ALARM 12 DISP 7-8 DEC 3, 2015 10:47 AM FUEL ALARM DEC 3, 2015 10:34 AM FUEL ALARM DEC 3, 2015 10:30 AM FUEL ALARM I31600 DEC 3, 2015 11:00 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 SMART SENSOR ALARM HISTORY REPORT SENSOR LOCATION 1 VAPOR PRESSUR 2 FM 1-2 3 FM 3-4 4 FM 5-6 5 FM 7-8 6 FM 9-10 7 FM 11-12
I40200 DEC 3, 2015 11:00 AM I40300 DEC 3, 2015 11:00 AM I34200 DEC 3, 2015 11:00 AM I34700 DEC 3, 2015 11:00 AM IV0100 DEC 3, 2015 11:00 AM FLOWER ST MINI MART 928 FLOWER ST BAKERSFIELD CA 93305 661-328-0673 ISD ALARM STATUS REPORT EVR TYPE: VACUUM ASSIST ISD TYPE: 01.05 VAPOR PROCESSOR TYPE: NONE OVERALL STATUS :PASS EVR VAPOR COLLECTION :PASS EVR VAPOR CONTAINMENT :PASS ISD MONITOR UP-TIME : 99% EVR/ISD PASS TIME :100% WARNING ALARMS DATE TIME DESCRIPTION READING VALUE 15-12-01 10:01:48 A/L RATIO DEGRADATION FP 7 BLEND3 0.80 15-11-30 10:01:59 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.61 15-11-29 10:02:00 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.61 15-11-28 10:02:11 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.61 15-11-27 10:01:32 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.62 15-11-26 10:02:10 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.55 15-11-25 10:02:25 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.48 15-11-24 10:02:19 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.48 15-11-23 10:02:01 A/L RATIO DEGRADATION FP11 BLEND3 0.79 15-11-23 10:02:01 A/L RATIO DEGRADATION FP 1 BLEND3 0.78 FAILURE ALARMS DATE TIME DESCRIPTION READING VALUE 15-12-01 10:01:48 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 3.62 15-10-07 10:03:08 CONTAINMENT GROSS OVER PRESSURE WEEKLY 95% 2.40 15-09-03 10:01:50 A/L RATIO DEGRADATION FP 9 BLEND3 0.80 15-08-21 10:03:01 A/L RATIO DEGRADATION FP10 BLEND3 0.78 15-08-20 10:03:05 A/L RATIO DEGRADATION FP10 BLEND3 0.78 15-06-23 10:02:07 SENSOR OUT SELFTEST E 1 15-06-23 10:02:07 SETUP SELFTEST
MISSING HOSE(S) 15-06-22 10:01:34 SENSOR OUT SELFTEST E 1 15-06-22 10:01:34 SETUP SELFTEST MISSING HOSE(S) 15-06-21 10:01:09 SENSOR OUT SELFTEST E 1 SHUTDOWN & MISCELLANEOUS EVENTS DATE TIME DESCRIPTION ACTION/NAME 15-12-03 10:01:57 READINESS ISD:PP EVR:PP ISD & EVR READY 15-12-03 09:34:05 READINESS ISD:PP EVR:NN EVR READINESS PENDING 15-12-03 09:34:05 ISD STARTUP 15-12-03 09:33:13 ISD SHUTDOWN 15-12-02 10:03:21 READINESS ISD:PP EVR:PN EVR READINESS PENDING 15-12-01 10:07:46 CONTAINMENT GROSS & DEGRD TEST MANUALLY CLEARED 15-12-01 10:06:19 PUMPS MANUALLY RE-ENABLED 15-12-01 10:01:48 READINESS ISD:PP EVR:PF CHECK EVR SYSTEM 15-12-01 10:01:48 CONTAINMENT GROSS DISABLED DISPENSERS 15-11-30 10:01:59 READINESS ISD:PP EVR:PF CHECK EVR SYSTEM
SWRCB, January 2006
Spill Bucket Testing Report FormThis 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 INFORMATIONFacility Name: Date of Testing:Facility Address:Facility Contact: Phone:Date Local Agency Was Notified of Testing :Name of Local Agency Inspector (if present during testing):
2. TESTING CONTRACTOR INFORMATIONCompany Name: Confidence UST Services, Inc.Technician Conducting Test:Credentials1: CSLB Contractor � ICC Service Tech. � SWRCB Tank Tester � Other (Specify) License Number(s): CSLB# 804904 ICC#
3. SPILL BUCKET TESTING INFORMATIONTest Method Used: Hydrostatic � Vacuum � Other Test Equipment Used: Lake Test Equipment Resolution: 0.0625”
Identify Spill Bucket (By Tank Number, Stored Product, etc.)
1 2 3 4
Bucket Installation Type: � Direct Bury� Contained in Sump
� Direct Bury� Contained in Sump
� Direct Bury� Contained in Sump
� Direct Bury� Contained in Sump
Bucket Diameter:Bucket Depth:Wait time between applying vacuum/water and start of test:Test Start Time (TI):Initial Reading (RI):Test End Time (TF):Final Reading (RF):Test Duration (TF – TI):Change in Reading (RF - RI):Pass/Fail Threshold or Criteria:Test Result: �� Pass �� Fail � Pass �� Fail � Pass �� Fail �� Pass �� FailComments – (include information on repairs made prior to testing, and recommended follow-up for failed tests)
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTINGI hereby certify that all the information contained in this report is true, accurate, and in full compliance with legal requirements.
Technician’s Signature:________________________________________________ Date: _________
1 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent.
Flower Street Mini Mart 12/03/2015
928 Flower Street Bakersfield, CA 93305
Sam Mansour (661) 322-1521
11/12/2015
Kris Karns
Dustin Reese
8216722-UT
Regular
12.00"
12.00"
5 min.
9:29 am
11.25"
10:29 am
11.25"
1 hour
0.00"
0.0625"
Super
12.00"
12.00"
5 min.
9:29 am
11.75"
10:29 am
11.75"
1 hour
0.00"
0.0625"
12/03/2015
