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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 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 submillal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: #2233 D & G I Date of Testing: 3/28/2014 Facility Address: 2732 Brundage Lane Bakersfield, CA93304 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 I License Number:804904 ICC# 8022804 TT# 11-1756 p·•·r-• ···-· ·····' ···--·· Manufacturer Training Manufacturer Component( s) Date Training Expires UST 10/21/2015 Installaton/Retrofit UST Service ICC 1-28-2015 technician Star. Smith. Fibercast Fiber Glass Systems N.A. 3. SUMMARY OF TEST RESULTS Not Repairs Component Pass Fail Not Repairs Component Pass Fail Tested Made Tested Made UDC 1-2 X 0 0 0 0 0 0 0 87 Fill Spill Bucket X 0 0 0 0 0 0 0 87 Vapor Spill Bucket X 0 0 0 0 0 0 0 91 Fill Spill Bucket X 0 0 0 0 0 0 0 91 Vapor Spill Bucket X 0 0 0 0 0 0 0 Diesel Fill Spill Bucket X 0 0 0 0 0 0 0 Diesel Vapor Spill Bucket X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 If hydrostatic testing was performed, describe what was done with the water after completion of tests: Water was rut back into test trailer and waste drum To the best of my knowledge, t 1rate and in full compliance with legal requirements Technician's Signature: Date: 3/28/2014 SWRCB, January 2002 Page __ of __ - Test Method Developed By: D UDC Manufacturer x Industry Standard D Professional Engineer D Other (SpecifY) Test Method Used: D Pressure D Vacuum x Hydrostatic D Other (SpecifY) Test Equipment Used: Ts-sts Equipment Resolution: UDC # 1-2 UDC# UDC# UDC# UDC Manufacturer: Western UDC Material: FRP UDCDepth: 9.00" Height from UDC Bottom to Top 0.00" of Highest Piping Penetration: Height from UDC Bottom to 0.00" Lowest Electrical Penetration: Condition of UDC prior to Clean & Dry testing: Portion ofUDC Tested Pipe Penetration Does turbine shut down when UDC sensor detects liquid (both product and water)?* DYes DNo XNA DYes DNoDNA DYes DNoDNA DYes DNoDNA Turbine shutdown response time NA Is system programmed for fail- safe shutdown?• DYes DNo XNA DYes DNoDNA DYes DNoDNA 0 Yes ONoDNA Was fail-safe verified to be DYes DNo XNA DYes operational?* DNoDNA DYes DNoDNA DYes DNoDNA Wait time between applying 5 Min pressure/vacuum/water and starting test Test Start Time: Initial Reading (R1): ~--... •~"" ... Test End Time: ~GG II ~'-''-'I'W Final Reading (RF): Res lJits Test Duration: Change in Reading (RF-R1): Pass/Fail Threshold or Criteria: Test Result: X Pass DFail D Pass DFail D Pass 0 Fail D Pass D Fail Was sensor removed for testing? DYes DNoDNA DYes DNo DNA DYes DNo DNA DYes DNo DNA Was sensor properly replaced and DYes DNo DNA DYes DNo DNA DYes DNo DNA DYes ONo DNA verified functional after testing? Comments -(include information on repairs made prior to testing, and recommended.follow-up for .failed test:.) 1 If the entire depth of the UDC is not tested, specify how much was tested. If the answer to ill1Y 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_ 9. SPILL/OVERFILL CONTAINMENT BOXES Facility is Not Equipped With Spill/Overfill Containment Boxes 0 Spill/Overfill Containment Boxes are Present, but were Not Tested D Test Method Developed By: D Spill Bucket Manufacturer x Industry Standard 0 Professional Engineer D Other (Specify) Test Method Used: OPressure 0 Vacuum x Hydrostatic 0 Other (Specify) Test Equipment Used: Ts-sts Equipment Resolution: Spill Box # 87 Spill Box # 87 Spill Box # 91 Spill Box # 91 Fill Vapor Fill Vapor 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 starting test: I Test Start Time: I Initial Reading (R1): ·-_ ... Test End Time: See IN ICON ~ee tNv• ~·~ Final Reading CRF): ~A~ I Lit~ Result $ Test Duration: - Change in Reading (Rr-R1): Pass/Fail Threshold or Criteria: Test Result: X Pass 0 Fail X Pass 0 Fail X Pass D Fail X Pass OFail Comments -(include in[(Jrmation on repairs made prior to testing, and recommended follow-up forfailed tests) SWRCB, January 2002 Page __ of __ 9 SPILUOVERFILL 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 0 Other (Specify) Test Method Used: 0 Pressure r Vacuum x Hydrostatic :=: Other (Specify) Test Equipment Used: Ts-sts Equipment Resolution: Spill Box # Diesel Spill Box # Diesel Spill Box# Spill Box# Fill Vapor Bucket Diameter: 12.00" 12.00" Bucket Depth: 12.00" 12.00" Wait time between applying pressure/vacuum/water and 5 Min 5 Min starting test: Test Start Time: Initial Reading (R1): -••• -..-. .. Test End Time: "ee1~ ~v~ Final Reading (RF): Kesu [Its Test Duration: Change in Reading (RF-R1): Pass/Fail Threshold or Criteria: Test Result: X Pass 0 Fail X Pass 0 Fail 0 Pass 0 Fail 0 Pass DFail -------·----------- Comments-(include information on repairs made prior to testing. and recommended follow-up .for.failed tests) 2233 D-G 2732 BRt.WllAGE L.AII: BAKERSFIElD CA 93304 03/28/2014 10:011 AH Sl.t:P LEA~ TEST REPI:flT 87 FSB TEST STARTED 9:119 1111 TEST STARTED 03/28/2014 BEG Ill LEVEL 2. 3690 ltl Elll TillE 10:04 ill1 EJID DATE 03/28/2014 av LEva 2. 3686 m LEAK THRESHOLD 0. 002 ltl TEST RES\lT PASSED 87 VSB TEST STARTED 9:~9 AH TEST STARTED 03/28/2014 BEG ltl LEVEL 6. 5668 Ill Elll Tit£ 1o:o4 AH Elll DATE 03/28/2014 EIIO LEVEL 6, 5563 Ill lEAK THRES!lllD 0, 002 Ill TEST RESUI..T PASSED 91 FSB TEST STARTED 9:119 AH TEST STARTED_ 03/2~/2014 BE'GIIII.EVEL 6. 3758 Ill E/[) liiiE 10:04 AH EIC DATE 03/28/2014 Elll LEVEl 6. 3757 Ill LEA'< TlflESlla.D 0. 002 ltl TEST RESll T PASSED 2233 D-G 2732 BR\Wn\GE L.AIE BAXERSF I ElO CA 93304 03/28/2014 10:20 AH SU11P LEAK TEST REPORT -- 87 FSS TEST STARTED 10:05 1111 TEST STARTED 03/28/2014 BEG Ill LEVEL 2. 3686 Ill El!l TillE 10:20 1111 EIO DATE 03/28/2014 EID lEVEl 2.3681 ltl lEAK THRESHOLD 0, 002 ltl TEST RESllT PASSED 87 VSB TEST STARTED 10:05 1111 TEST STARTED 03/28/2014 BEG I II lEVEl 6. 5662 ltl EIO liiiE 10:20 A/1 E/[) DATE 03/28/2014 EJ[) lEVEL 6, 5656 Ill lEAK TlflESHtx.O 0, 002 ltl TEST RESULT PASSED 91 FSB TEST STARTED 10:05 AH TEST STARTED 03/28/2014 BEG Ill lEVEl. 6. 3757 Ill Elll TII1E 10:20 AH EIIO DATE 03/28/2014 EIIO lEVEl. 6, 3755 ltl lEAK THRESHOLD 0.002 Ill TEST RESIJL T PASSED 2233 1>-G 2732 BRIJAIIlAiiE l.ftJlE BAKERSFIELD CA 93304 03/28/2014 10:113 AH SUI1P LEAK TEST REPC.~T we 1-2 TEST STARTED 10:28 AH TEST STARTED 03/28/2014 BEGIIILEVEL. .0,2813JIL. _ em TilE 10:43 All EI:O DATE 03/28/2014 EIIO LEVEL 0, 2871 HI LEAK THRESHOLD 0, 002 Ill TEST RESULT PASSED 2233 0-G 2732 BRUAIIOAGE LAIIE BAKERSFIELD CA 93304 03/28/20111 ll:OOAH SUIIP lEAK TEST REPOOT uoc 1-2 TEST STARTED 10:45 A/1 TEST STARTED 03/28/2014 BEG HI lEVEl 0. 2877 Ill E/10 TillE 11:00 All EIIO DATE 03/28/2014 EIIO lEVEL 0, 2877 Ill LEAK THRESlD.O 0, 002 HI TEST RESil. T PASSED 2233 D-G 2732 BRl!!IJAGE LNiE BAKERSFIElD CA 93304 03/28/2014 · 10:U4 AH Slt1P LEAK TEST REPORT 91 VSB TEST STARTED 9:119 AH TEST STARTED 03/28/2014 BEG Jt1 LEVa 7.02111 Ill am TillE 1o:o4 AH EIIO DI\TE 03/28/2014 EIIO LEVa 7, 0238 Ill lEAl( THRESHOLD 0.002 Ill TEST RfStJL T PASSED OS FSB TEST STARTED 9:119 All TEST STARTED 03/28/2014 BEGIIILEVEl 3,1155 Ill EIO TilE 10:04 All EIO DATE 03/28/2010 EIO LEVEl 3. 1147 Ill lEAl( TIRES!Dll 0, 002 Ill TEST RES1l. T PASSED OS VSB TEST STARTED 9:119 AH TEST STARTED 03/28/2014 BEGJtl lEVa 7, 6565 Ill EJIO lli\E 10:04 All EIIO 01\TE 03/28/2014 EIIO LEVa 7, 6560 Ill LEAl( TI!RESHOLO 0, 002 Ill TEST RESULT PASSED 2233 0-G 2732 BRltiDAGE LA!.£ BAKERSFIB.O CA 93304 03/28/2010 10:20 All SUltP lEAK TEST REPORT 91 VSB TEST STARTED 10:05 All TEST STARTED 03/28/2014 BEGIII lEVa 7, 0238 Ill EJIO TI11E 10:20 All EJIO DATE 03/28/2014 EJIO LEVEL 7, 0234 Ill LEM THRESiltO 0, 002 Ill TEST RESa.T PASSED OS FSB TEST STARTED 10:05 All TEST STARTED 03/28/2014 BEGIII LEVEL 3, 1145 Ill 810 TillE 10:20 All EJIO DATE 03/28/2014 810 LEVEl 3, 1139 Ill LEAK THR€SHOlO 0, 002 Ill TEST RESULT PASSED OS VSB TEST STARTED 10:05 All TEST STARTED 03/28/2010 BEG Ill lEVEl 7, 6555 Ill Elll T111E 10:20 All Elll DATE 03/28/2014 EllllEVa 7. 6553 Ill LEAK Tft!<ESW.O 0, 002 Ill TEST RESil.T PASS£0