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Home My WebLink AboutSB989 2014SWRCB, January 2002 Page __ of __ Secondary Containment Testing Report Form This form is intended for use by contractors performing periodic testing of UST second01y containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, wrillen test procedures, and printouts from tests (if applicable), should be provided to the facility owner/operator for submillal to the local regulatory agency. l. FACILITY INFORMATION Facility Name: #3351 Howard's I Date of Testing: 3/31/2014 Facility Address: 32000 Panama Lane Facility Contact: Omero Garcia I Phone: 661-393-7000 Date Local Agency Was Notified of Testing: 3/20/2014 Name of Local Agency Inspector (if present during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: Confidence UST Services Technician Conducting Test: Credentials: x CSLB Licensed Contractor X SWRCB Licensed Tank Tester License Type: CSLB J License Number:804904 ICC# 8022804 TT# I 1-1756 ·- Manufacturer Training Manufacturer Component(s) Date Training Expires UST 10/21/2015 lnstallaton!Retrofi t UST Service ICC 1-28-2015 technician Star. Smith. Fibercast Fiber Glass Systems N.A. 3. SUMMARYOFTESTRESULTS Not Repairs Component Pass Fail Not Repairs Component Pass Fail Tested Made Tested Made UDC 1-2 South X 0 0 0 91 Fill Spill Bucket X [J 0 [l UDC 1-2 North X 0 [l 0 91 Vapor Spill Bucket X n 0 0 UDC 3-4 South X L 0 ;] Diesel Fill Spill Bucket X c J UDC 3-4 North X 0 0 0 :J 0 ,-. ..... UDC 5-6 South X 0 0 0 0 n 0 0 UDC 5-6 North X 0 0 0 0 0 0 0 UDC 7-8 South X 0 [] 0 [_] 0 0 0 UDC 7-8 North X 0 0 0 0 r ~ 0 '--' 87 Fill Spill Bucket X 0 0 0 (] 0 J 87 Vapor Spill Bucket X 0 0 0 0 [] 0 0 87-2 Fill Spill Bucket X 0 0 0 n 0 0 0 87-2 Vapor Spill Bucket X [_] 0 0 0 0 0 0 If hydrostatic testing was performed, describe what was done with the water after completion of tests: Water was .e_ut back into test trailer and waste drum CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my kllow/etlg~etlr_·, __ '_this_tlocumttfil'prdJccurate anti i11 full compliallce with legal requirements Technician's Signature: ~ ri-/'l_,t_,t// Date: 3/28/2014 SWRCB, January 2002 Page __ of __ .. _,. ~--.-.-__ _._...._ __ .. ~----··--.-.-. ._._ -.-' -. Test Method Developed By: D UDC Manufacturer x Industry Standard D Professional Engineer 0 Other (Specify) Test Method Used: 0 Pressure D Vacuum x Hydrostatic D Other (Specify) Test Equipment Used: Ts-sts Equipment Resolution: UDC # 1-2 South UDC # 1-2 North UDC #3-4 South UDC # 3-4 North UDC Manufacturer: Western Western Western Western UDC Material: FRP FRP FRP FRP UDC Depth: 15.00" 15.00" 15.00" 15.00" Height from UDC Bottom to Top 0.00" 0.00" 0.00" 0.00" of Highest Piping Penetration: Height from UDC Bottom to 0.00" 0.00" 0.00" 0.00" Lowest Electrical Penetration: Condition ofUDC prior to Clean & Dry Clean & Dry Clean & Dry Clean & Dry testing: Portion ofUDC Tested Pipe Penetration Pipe Penetration Pipe Penetration Pipe Penetration Does turbine shut down when UDC sensor detects liquid (both DYes ONo XNA DYes ONoXNA DYes ONo X NA 0 Yes DNo XNA product and water)?• Turbine shutdown response time NA NA NA NA Is system programmed for fail- safe shutdown?· DYes .-.No XNA DYes ONoXNA DYes ONo XNA Yes ~No X NA Was fail-safe verified to be DYes DNo X NA DYes DNoXNA rYes DNo XNA DYes DNo X NA operational?" Wait time between applying 5 Min 5 Min 5 Min 5 Min pressure/vacuum/water and starting test Test Start Time: ~--.... --.... ~"'"' 1~11 'n~• Initial Reading (R1): '-'Ct: II' \I UN ~~ .,...., ... Test End Time: R~~ tltc: -Kesu ItS Final Reading (RF): Test Duration: Change in Reading (RF-R1): Pass/Fail Threshold or Criteria: Test Result: X Pass D Fail X Pass DFail X Pass DFail X Pass DFail Was sensor removed for testing? DYes DNo ,...,NA 0 Yes DNo DNA w Yes DNo ONA C'Yes DNo DNA Was sensor properly replaced and DYes DNo DNA DYes ONo DNA DYes DNo DNA 0 Yes DNo DNA verified functional after testing? Comments-(include information on repairs made prior to testing, and recommended follow-up/or failed tests) 1 If the entire depth of the UDC is not tested, specify how much was tested. If the answer to~ of the questions indicated with an asterisk(*) is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG-160) SWRCB, January 2002 Page __ of __ ----. -----. ----~·-------·--·-------- Test Method Developed By: D UDC Manufacturer x Industry Standard D Professional Engineer D Other (Specify) Test Method Used: rPressure D Vacuum x Hydrostatic ._ Other (Specify) Test Equipment Used: Ts-sts Equipment Resolution: ~~zr:,,_,._,., ~i:: "' .~s.~m:s;:s:~; ."![ ;,: .·;~· '· '··· UDC # 5-6 South UOC # 5-6 North UOC # 7-8 South UDC # 7-8 North UDC Manufacturer: Western Western Western Western UDC Material: FRP FRP FRP FRP UDC Depth: 15.00" 15.00" 15.00" 15.00" !Ieight from UDC Bottom to Top 0.00" 0.00" 0.00" 0.00" of Highest Piping Penetration: Height from UDC Bottom to 0.00" 0.00" 0.00" 0.00" Lowest Electrical Penetration: Condition of UDC prior to Clean & Dry Clean & Dry Clean & Dry Clean & Dry testing: Portion of UDC Tested1 Pipe Penetration Pipe Penetration Pipe Penetration Pipe Penetration Does turbine shut down when UDC sensor detects liquid (both 0 Yes DNo XNA []Yes DNoXNA DYes DNo X NA DYes CJNo X NA product and water)?• Turbine shutdown response time NA NA NA NA Is system programmed for fail- safe shutdown?· 0 Yes DNo XNA Yes uNoXNA CYes UNo XNA C Yes CNo XNA Was fail-safe verified to be ~Yes :;No X NA DYes operational?• DNoXNA DYes ONo X NA DYes w No X NA Wait time between applying 5 Min 5 Min 5 Min 5 Min pressure/vacuum/water and starting test Test Start Time: Initial Reading (R!): ~--.. II"' 1"\ lU s~~•N :oN Test End Time: "'"" .. ·--· ... " u. Final Reading (RF): Kes LJitS nt::nJ U::» Test Duration: Change in Reading CRr-R1): Pass/Fail Threshold or Criteria: Test Result: X Pass DFail X Pass DFail X Pass D Fail X Pass 0 Fail Was sensor removed for testing? [1 Yes 0 No DNA 0 Yes rNo DNA DYes fJNo DNA DYes DNo DNA Was sensor properly replaced and DYes DNo DNA DYes CJNo DNA DYes ONo DNA DYes ONo DNA verified functional after testing? Comments-(include information on repairs made prior to testing, and recommendedfollow-upforfai/ed tests) 1 If the entire depth of the UDC is not tested, specifY how much was tested. If the answer to ill!Y of the questions indicated with an asterisk(*) is ''NO" or "NA", the entire UDC must be tested. (See SWRCB LG-160) ' SWRCB, January 2002 Page __ of __ 10. SPILUOVERFILL CONTAINMENT BOXES Facility is Not Equipped With S ill/Overfill Containment Boxes 0 SpilVOverfill Containment Boxes are Present, but were Not Tested Test Method Developed By: 0 Spill Bucket Manufacturer x Industry Standard 0 Professional Engineer 0 Other (Specify) Test Method Used: OPressure 0 Vacuum x Hydrostatic 0 Other (Specify) Test Equipment Used: Ts-sts Equipment Resolution: ~·-· "5: ~~.?::·~1;:-"<::l:~;~~~:· <';; ·~ Spill Box # 87 Spill Box # 87 Spill Box# 87-2 Spill Box # 87-2 Fill Va or Fill Va or Bucket Diameter: 12.00" 12.00" 12.00" 12.00" Bucket Depth: 12.00" 12.00" 12.00" 12.00" Wait time between applying pressure/vacuum/water and 5 Min 5 Min 5 Min 5 Min startin test: Test Start Time: Initial Reading (R1): Test End Time: Final Reading (RF): Test Duration: Change in Reading CRF-R1): Pass/Fail Threshold or Criteria: Test Result: X Pass 0 Fail X Pass 0 Fail X Pass 0 Fail X Pass OFail Comments-{include information on repairs made prior to testing, and recommended.follow-up[or failed tests) SWRCB, January 2002 Page __ of __ 9 SPILL/OVERFILL CONTAINMENT BOXES Facility is Not Equipped With SpiiVOverfill Containment Boxes 0 ! Spill/Overfill Containment Boxes are Present, but were Not Tested 0 Test Method Developed By: 0 Spill Bucket Manufacturer x Industry Standard 0 Professional Engineer [J Other (Specify) Test Method Used: Pressure 0 Vacuum x Hydrostatic 0 Other (Specify) Test Equipment Used: Ts-sts Equipment Resolution: ", .... l~;}iit.;.. Spill Box # 91 Spill Box# 91 Spill Box # Diesel Spill Box# Fill Vapor Fill Bucket Diameter: 12.00" 12.00" 12.00" Bucket Depth: 12.00" 12.00" 12.00" Wait time between applying pressure/vacuum/water and 5 Min 5 Min 5 Min starting test: Test Start Time: Initial Reading (R1): Test End Time: See INCU N Final Reading (RF): R~4E::IIIt~ Test Duration: Change in Reading (RF-R1): Pass/Fail Threshold or Criteria: Test Result: X Pass DFail X Pass DFail X Pass DFail D Pass 0 Fail Comments -(include information on repairs made prior to testing, and recommended.follow-up[or.failed tests) Name: Street: City: Tenns: ~fiDE'+. CJo <'~ \UST¥ " ~-,..,oc1\0 ~fiDE"+, CJo ~ ~UST(J. -,,CES•~ 'BUILD WITH CONFIDENCE" "COMPLIANCE WITH CONFIDENCE" Lic.970703 Lic.804904 Toll Free #: 1-800-339-9930 Confidence UST 16250 Meacham Road Bakersfield CA 93314 Description of work performed: .7./<J:;" A -~~ ~.,4/;A. 1A/..t£rs~ Job Order /Invoice#: ~'Z'$ t;.~.4 Date Called Time To Whom Site Name: S~.r/ Rc-AIAeLG Street: 3Zooc; -9JJ" .... ;.L ~ City: 1'5~ -· State: C.A Zip: '7'~/~ Store No: .'?3~/ -C>v..~Z/.ue.... <:7/J#J .7 JII!~_,./L e.Y.P" t'Y.A]f";. r;., At~-~-r ·",., ~17'. ~~-i'> ·?;~ q,A 7 _1-.;·/7 .If/{; ,.-?£-/, ALJ.e.-~ ~.e.-~/~///~ "' , nt£.& £:17 ; YCc-7' /.L~/. , TRAVEL and LABOR (0.5 Hour Minimum Labor Charge) OVERTIME (5:00 PM -7:00AM) Date Technician(s) Name Start End Total OT Start OTEnd OTTotal ~AIIHI Dvl/~ A-~,4' Travel '{ Labor Travel Date Technician(s) Name Start End Total OT Start OTEnd OTTotal Travel Labor Travel Date Technician(s) Name Start End Total OT Start OTEnd OTTotal Travel Labor Travel ' SUPPLIES -MATERIALS-RENTALS Check One i Qty. UST Parts Site Parts I $'~ brA./11/~ !fA?.-.HA .. ..,.. bl!tl!.rJ-..1 x~ IPS.- COMMENTS Store Employee Print Name: Technician Print Name: Store Employee Signature: I Date Technician Signature: 1 Date INVOICE -WL iiTt. SITF. CANARY 3351 HOVAROS 32000 PAUAHA LAtlE BAKERSFIELD CA 93313 03/31/2014 9:32 AH SUHP LEAK TEST REPORT 87 FSB -TEST STARTED 9:11 AH TEST STARTED 03/31/2014 BEG ttl lEVEL 5, 9538 W Eta> TII1E 9:32 AH EtiD DATE 03/31/2014 EtiO lEVa 5. 9546 w LEAK THRESHOLD O. 002 JU TEST RESULT PASSED 87 VSB TEST STARTED 9:11 AH TEST STARTED 03/31/2014 BEGIIl LEVa 6. 7327 Itl EtiO Tlt1E 9:32 AH EtlD DATE 03/31/2014 EtiO lEVa 6, 7328 Jtl LEAK THRESHOLD 0, 002 Ill TEST RESULT PASSED OS FSB TEST STARTED 9:17 AH TEST STARTED 03/31/2014 BEGJU LEVa a, 7125 Itl EtiO TII1E 9:32 AH EtiO DATE 03/31/201a am Leva 4, 7131 w LEAK THRESHOLD 0, 002 Ill TEST RESULT PASSED ·~ 3351 HO\IARDS 32000 PAtlAHA LAtlE BAKERSFiaD CA 93313 03/31/2014 9!48 AH SUHP LEAK TEST REPORT 87 FSB TEST STARTED 9:33 AH TEST STARTED 03/31/2014 BEGW lEVEL 5, 9546 Ill EtiO TII1E 9:48 AH EtiO DATE 03/31/2014 aro Leva 5. 9545 Ill LEAK THRESHOLD 0, 002 Itl TEST RESULT PASSED 87 VSB TEST STARTED 9:33 AH TEST STARTED 03/31/2014 BEGIIILEVEL 6, 7329 Ill EtlO TIME 9:a8 AH EtlD DATE 03/31/2014 am LEVEL 6, 7327 Ill LEAK THRESHOLD 0, 002 Ill TEST RESULT PASSED OS FSB TEST STARTED 9:33 AH TEST STARTED 03/31/2014 BEGIII lEVa 4, 7131 W am TII1E 9:a8 AH am DATE 03/31/2014 am LEVa a. 7119 Ill LEAK THRESHOlD 0, 002 Itl TEST RESULT PASSED 3351 HOVAROS 32000 PAIIAHA LAIIE BAKERSFIRD CA 93313 03/31/2014 9:32 AH sut'R lEAA TEST REPORT 872FSB --~ ............ TEST STAR TEO,. -9: l7 Al1 TEST STARTED 03/31/2014 BEG Ill LEVEL 6, 7639 Ill EJlO TillE 9:32 AH 810 DATE 03/31/2014 EJIO LEVEL 6. 7636 Ill LEAK THRESHOLD O. 002 Ill TEST RESl!T PASSED 872VS8 TEST STARTED 9:17 At1 TEST STARtED 03/31/2014 BEG Ill LEVEL 6. 9032 Itl EJl) TillE 9:32 At1 Ell) DATE 03/31/2014 Elll LEVEL 6. 9025 Ill LEAK THRESHil.D 0. 002 Ill TEST REStl.T PASS£0 91 FS!! TEST STARTED 9:17 AN TEST STARTED 03/31/2014 BEGIIl LEVEL 5. 7279 Ill EJIO TitlE 9:32 AN 810 DATE 03/31/2014 910 LEVa 5. 7279 Ill lEAK THRESHOlD 0, 002 Ill TEST RESULT PASSED 91 VSB TEST STARTED 9:11 AH TEST STARTED 03/31/2014 BEG Ill lEVa 5. 9723 111 EJD TIHE 9:32 AH Elll DATE 03/31/2014 EJD lEVEL 5. 9720 Ill lEAK THRES!Wl 0, 002 Ill TEST REStlT PASSED 3351 HOV~.RDS 32000 PAIIAIIA lAIIE BAKERSFiaO CA 93313 03/31/2014 9:08 All stJtf LEA'< TEST REPORT 872FSB TEST STARTED 9:33 Ali TEST STARTED 03/31/2014 BEGIII LEVEL 6.7635 Ill ElKl TIHE 9:48 Al1 ElKl OATE 03/31/2014 EllO lEVEL 6, 7634 Ill LEAK THRESHOLD 0, 002 Ill TEST RESULT PASSED 872VSB TEST STARTED 9:33 Ali ---TEST STARTED 03/31/2014 BEG !II LEVEL 6, 9025 Ill EJIO TIHE 9:48 Al1 EJIO DATE 03/31/2014 EJ,'I) LEVEL 6, 9022 Ill lEAK T~SHOLO 0,002 Ill TEST RESULT PASSED 91 FSB TEST STARTED 9:33 AN TEST STARTED 03/31/2014 BEG Ill LEVEL 5. 7282 Ill EIIO TIHE 9:48 AH EllO DATE 03/31/2014 EJ/0 LEVEL 5. 7283 Ill LEAK 'MES!O..O 0, 002 Ill TEST RESLlT PASSED 91 VSB TEST STARTED 9:33 Al1 TEST STARTED 03/31/2014 BEG Ill lEVEL 5, 9719 Ill EJIO TIHE 9!118 AH Elll DATE 03/31/2014 81l lEVEL 5,9718 Ill LEAK THRESHOLD 0,002 Ill TEST RESll.T PASSED 335i'HOVAROS - 32000 PAtiAHA lAt!E BAKERSFIELD CA 93313 03/31/20111 10:51 Ali SUtiP lEAK TEST REPORT 1-2 s TEST STARTED 10:36 Ali TEST STARTED 03/31/20111 BEGIU LEVEL 2. 7850 Ill EliO TIME 10:51 Ali 810 DATE 03/31/2014 810 lEVEL 2. 7840 Ill lEAK THRESHOLD 0, 002 Jtl TEST RESULT PASSED 1-2 tl TEST STARTED 10:36 AH TEST STARTED 03/31/2014 BEGJU LEVEL 3, 4439 Ill 8D TitlE 10:51 Ali 8ID DATE 03/31/2014 810 LEVEL 3, 11437 Ill lEAK THRESHOLD 0, 002 Jtl TEST RESULT PASSED -..... .. . ., I 1 • 3351 HOVARDS 32000 PAtlAHA lAtiE BAKERSFIELD CA 93313 03/31/20111 11:09 Ali SUMP l£AK TEST REPORT 1-2 s TEST STARTED 10:54 AH TEST STARTED 03/31/2014 BEGJU lEVEL 2. 7847 Ill 810 TitlE 11:09 Ali 81D DATE 03/31/2014 810 lEVEL 2, 7849 Ill lEAK THRESHOLD 0,002 IU TEST RESULT PASSED 1-2 u TEST STARTED 10:5d AH TEST STARTED 03/31/20111 BEG HI lEVEL 3, 4436 Ill END TitlE 11!09 A/1 810 DATE 03/31/20111 810 LEVEL 3, 4437 Ill l£AK THRESHOLD 0,002 Ill TEST RESULT PASSED 3351 HOVAROS 32000 PAUAHA lAUE BAKERSFIELD CA 93313 03/31/201/l 12:02 Pl1 SUI1P LEAK TEST REPORT I • .3-t s TEST STARTED 11:47 AH TEST STARTED 03/31/2014 BEGIU LEVEL 0, 6736 IU EliO TIME 12:02 Pl1 -m)·OATE·--~03/31/2014 ·- EllO LEVEL 0, 6736 m lEAK THRESHOLD 0, 002 JU TEST RESULT PASSED l .. '! tl TEST STARTED 11:47 AH TEST STARTED 03/31/2014 BEGIU lEVEl 1, 6297 W EliO TIHE 12:02 PH EtlO DATE 03/31/201/l EllO LEVa 1, 6308 JU LEAK THRESHOLD 0, 002 JU TEST RESULT PASSED -. . ...__..,. .. __ . • 3351 HOVAROS 32000 PAtlAHA LAtlE BAKERSFIELD CA 93313 03/31/2014 12:18 Pl1 SUH? LEAK TEST REPORT 3"'\ s TEST STARTED 12:03 PH TEST STARTED 03/31/201/l BEGIU lEVEl 0, 6735 Ill EtiO TIME 12:18 Pl1 EtiD DATE 03/31/2014 em LEVEL o. 6737 m LEAK THRESHOLD 0,002 Jtl TEST RESULT PASSED j-'{ t~ TEST STARTED 12:03 Pl1 TEST STARTED 03/31/2014 BEGIU LEVEL l, 6306 Jtl EllO TIME 12:18 Pl1 EllO DATE 03/31/2014 EllO lEVEl 1. 6310 Itl LEAK THRESHOLD 0,002 W TEST RESULT PASSED \