HomeMy WebLinkAboutNOT. VIOL 6/13/2012Ad .
Cal - Valley Equipment
3500 Gilmore Avenue Bakersfield, CA 93308
661) 327 -9341 (661) 888 - 327 -9341
FAX: (661) 325 -2529
Cont. Lic. #921733 A HAZ
08/02/12
RE: Notice of violation for Bakersfield Police Department, 1601 Truxtun Avenue dated 06/13/12
The following items were addressed and resolved by Jerry Rangel of Cal - Valley Equipment:
Item 4, Failure to perform product line integrity test:
Product line testing was performed on 11/18/11 along with the annual monitor
certification. A copy ofthe test results have been placed in the UST binder on -site. CVE
Ticket #83909
Item 5, Failure to perform secondary containment testing:
The secondary containment testing was performed on 11/18/11. A copy of the test results
were placed in the UST binder on site. CVE ticket #83909.
Item 6, Failure to maintain monitoring plan on -site:
The monitoring plan was filled out on 08/01 /12 and placed in the UST binder on -site.
CVE Ticket # 84629.
Item 7, Failure to maintain response plan ort-site:
The response plan was filled out on 08/01/12 and placed in the UST binder on site. CVE
ticket # 84629.
Item 8, Failure to maintain site plan on -site:
The site plan was filled out on 08/01/12 and placed in the UST binder on site. CVE ticket
84629.
Item 9, Failure to maintain monitoring or testing records on -site:
The 2009 and 2011 monitor certification and spill bucket test results have been placed in
the UST binder on -site along with the secondary containment test results from 11/18/11.
CVE ticket # 83909
Item 10
The designated operator training was conducted on 05/22/12. A copy of the training
record was placed in the UST binder on site. CVE ticket 4 83909
t
Cal - Valley Equipment
3500 Gilmore Avenue Bakersfield, CA 93308
661)327- 9341(661)888- 327 -9341
FAX: (661) 325 -2529
Cont. Lic. #921733 A HAZ
Item 11, Failure to monitor product piping:
The sump sensors in UDC 1/2 and 3/4 have been placed in the correct vertical position
and the test boots were pulled back from the secondary piping on all ofthe lines under
the dispensers and inside the turbine sumps to allow the detection of a leak at the earliest
opportunity. CVE ticket # 84629. Photos have been included with this letter.
Jerry Range]
California UST System Operator ID: 8160834
California UST Service Technician ID: 5309489
Date
UPCF UST -D (12/2007) 1/4
UNIFIED PROGRAM CONSOLIDATED FORM
UNDERGROUND STORAGE TANK
MONITORING PLAN - (Page 1 of 2)
TYPE OF ACTION 1. NEW PLAN ® 2. CHANGE OF INFORMATION 490-1
PLAN TYPE ® I. MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. 490-2
Check one item only) 2. THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S)-
1.. FACILITY INFORMATION
FACILITY ID # (Agency Use Only) I I I _ I I I I ---I I I I I 1
BUSINESS NAME (Same as FACILITY NAME) Bakersfield City Police Department 3.
BUSINESS SITE ADDRESS 1601 Truxtun Avenue 103 CITY Bakersfield 104.
fI: EQUIPMENT INTING AND PR WEN ME MAINTENANCE
Testing, preventive maintenance, and calibration of monitoring equipment (e.g., sensors, probes, line leak detectors, etc.) must be performed at the frequency
specified by the equipment manufacturers' instructions, or annually, whichever is more frequent, and that such work must be performed by qualified personnel.
23 CCRU2632,2634, 2638. 2641 )- ____--_ ___ ___ _______- -_____ -------------------
MONITORING EQUIPMENT IS SERVICED ® L ANNUALLY El 99. OTHER (Specify): 4990 -3b
III. MONITORING LOCATIONS
1. NEW SITE PLOT PLAN/MAP SUBMITTED WITH THIS PLAN. El 2. SITE PLOT PLAN /MAP PREVIOUSLY SUBMITTED. (23 CCR §2632,
2634)490-4
IV, TANK MONITORING'IS PERFORMED USING THE FOLLOWING ML- THOD(S)
I . CONTINUOUS ELECTRONIC TANK MONITORING OF ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT 490 -5
VAULT(S) WITH AUDIBLE AND VISUAL ALARMS. (23 CCR §2632,2634)
SECONDARY CONTAINMENT IS: ® a. DRY b. LIQUID FILLED c. PRESSURIZED d. UNDER VACUUM 490 -6
PANEL MANUFACTURER: Veeder Root 490-7. MODEL #: TLS -350 490-8
LEAK SENSOR MANUFACTURER: Veeder Root 490-9. MODEL #(S): 847390 -409 490 -10
2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALL TANK(S). (23 CCR §2643) 490-11
PANEL MANUFACTURER: 490-12. MODEL #: 490 -13
IN -TANK PROBE MANUFACTURER: 490-14. MODEL #(S): 490 -15
LEAK TEST FREQUENCY: a. CONTINUOUS b. DAILY/NIGHTLY c. WEEKLY 490-16
d. MONTHLY e. OTHER (Specify): 490 -17
PROGRAMMED TESTS: a. 0.1 g.p.h. b. 0.2 g.p.h. c. OTHER (Specify):
490 -I8
490-19
3. MONTHLY STATISTICAL INVENTORY RECONCILIATION (23 CCR §2646.1): 490 -20
4. WEEKLY MANUAL TANK GAUGING (MTG) (23 CCR §2645). TESTING PERIOD: El a.36HOURS F1 b. 60 HOURS 40-22
5. TANK INTEGRITY TESTING (23 CCR §2643.1): 490 -23
TEST FRE UENCY: a. ANNUALLY b. BIENNIALLY c. OTHERS eciQ (Specify): 490 -24
490-25
El 99. OTHER (Specify): 490-26
a90-z7
V. PIPE MONITORING I$ PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply)
I. CONTINUOUS MONITORING OF PIPE/ PIPING SUMP(S) AND OTHER SECONDARY CONTAINMENT WITH AUDIBLE AND 490-28
VISUAL ALARMS. (23 CCR §2636)
SECONDARY CONTAINMENT IS: ®a. DRY b. LIQUID FILLED c. PRESSURIZED d. UNDER VACUUM 490 -29
PANEL MANUFACTURER: Veeder Root 490 -30 MODEL #: TLS -350 490.31
LEAK SENSOR MANUFACTURER: Veeder Root 49oaz MODEL #(S): 847390 -208 490.33
PIPING LEAK ALARM TRIGGERS AUTOMATIC PUMP (i.e., TURBINE) SHUTDOWN. a. YES ® b. NO 490-34
FAILURE /DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. a. YES ®b. NO 490-35
2. MECHANICAL LINE LEAK DETECTOR (MLLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF
PRODUCT FLOW WHEN A LEAK IS DETECTED 23 CCR - 2636 490 -36
MLLD MANUFACTURER(S): Red Jacket 490 -37 MODEL #(S): RJFXI V, RJFXI DV 490 -38
3. ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS (23 CCR §2636) 490-39
ELLD MANUFACTURERS 49° 4 °. MODEL # S : 49041
PROGRAMMED IN LINE LEAK TEST: I. MINIMUM MONTHLY 0.2 g.p.h. 2. MINIMUM ANNUAL 0.1 g.p.h. 490-42
ELLD DETECTION OF A PIPING LEAK TRIGGERS AUTOMATIC PUMP SHUTDOWN. a. YES b. NO 49043
ELLD FAILURE /DISCONNECTION TRIGGERS AUTOMATIC PUMP SHUTDOWN. a. YES b. NO 49044
4. PIPE INTEGRITY TESTING 490-45
TEST FRE UENCY ® a. ANNUALLY b. EVERY 3 YEARS c. OTHER (Specify) 490- 46490 47
5. VISUAL PIPE MONITORING. 490-48
FREQUENCY a. DAILY ® b. WEEKLY C. MIN. MONTHLY & EACH TIME SYSTEM OPERATED* 490.49
Allowed for monitoring of unburied emergency enerator fuel pipingonly perHSC §25281.5(b)(3
6. SUCTION PIPING MEETS EXEMPTION CRITERIA 123 CCR §2636(a)(3)1. 490-50
7. NO REGULATED PIPING PER HEALTH AND SAFETY CODE, DIVISION 20, CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM
490 -51
El 99. OTHER (Specify) 490 -52
490 -53
UPCF UST -D (12/2007) 1/4
UST Monitoring Plan - Page I Instructions
Complete a separate UST Monitoring Plan for each UST monitoring system at the facility. This form must be submitted with your initial UST Operating Permit
Application and within 30 days of changes in the information it contains. Please note that your local agency may require you to obtain approval prior to installing or
modifying monitoring equipment. (Note: Numbering of these instructions follows the data element numbers on the form.)
490 -I. TYPE OF ACTION - Check the appropriate box to indicate why this plan is being submitted.
490 -2. PLAN TYPE - Check the appropriate box to indicate whether this plan covers all, or merely some, of the USTs at the facility. If the plan covers only some of the tanks,
identify those tanks in the space provided [e.g., by using the Tank ID #(s) in item 432 of the UST Operating Permit Application - Tank Information Form(s)].
I . FACILITY ID NUMBER - This space is for agency use only.
3. BUSINESS NAME - Enter the complete Facility Name.
103. BUSINESS SITE ADDRESS - Enter the street address where the facility is located, including building number, if applicable. Post office box numbers are not acceptable
This information must provide a means to locate the facility geographically.
104. CITY - Enter the city or unincorporated area in which the facility is located.
490 -3a MONITORING EQUIPMENT IS SERVICED - Check the appropriate box to specify the frequency of monitoring equipment testing/certification.
490 -3b Specify Other frequency for monitoring equipment servicing.
4904 SITE PLAN - Indicate ifa site plan /map is submitted with this monitoring plan or if it was submitted previously and is current for the facility. Monitoring plans must include
a Site Plot Plan/Map showing the tank and piping layouts and the locations where monitoring is performed (i.e., location of sensors, probes, line leak detectors, monitoring system
control panel, etc.).
490 -5 IV -1 CONTINUOUS ELECTRONIC MONITORING- Indicate ifthis monitoring method is being used to monitor the tanks.
490 -6 SECONDARY CONTAINMENT- If IV-] is checked, check the appropriate box to describe the environment inside the tank secondary containment.
490 -7 PANEL MANUFACTURER— If IV -1 is checked, enter the name ofthe manufacturer ofthe monitoring system control panel (console).
490 -8 MODEL # - If IV -I is checked, enter the model number for the monitoring system control panel.
490 -9 LEAK SENSOR MANUFACTURER- If IV -1 is checked, enter the name of the manufacturer of the sensor(s). Ifadditional space is needed, use Section X.
490 -10 MODEL #(S) -- If IV -1 is checked, enter the model number for each type of sensor installed. If additional space is needed, use Section X.
490-11 IV -2 AUTOMATIC TANK GAUGING - Indicate if this method is used for monitoring the UST's.
490 -12 PANEL MANUFACTURER -IfIV-2 is checked, enter the name ofthe manufacturer of the monitoring system control panel (console).
490 -13 MODEL # - If IV -2 is checked, enter the model number for the monitoring system control panel.
490 -14 IN -TANK PROBE MANUFACTURER -If IV -2 is checked, enter the name ofthe manufacturer ofthe probe(s).
490 -15 MODEL #(S) -IfIV -2 is checked, enter the model number for each type of in -tank probe installed. Ifadditional space is needed, use Section X.
490 -16. LEAK TEST FREQUENCY - If IV -2 is checked, check the appropriate box to describe the in -tank leak test frequency.
490 -17. SPECIFY - If490 -16e is checked, enter the frequency of programmed leak tests.
490 -18. PROGRAMMED TESTS - If IV -2 is checked, check the appropriate box to describe the tests programmed into the ATG system.
490 -19. SPECIFY - If 490 -18c is checked, enter the frequency of in -tank leak testing.
490 -20. IV -3 INVENTORY RECONCILIATION - Check the box if statistical inventory reconciliation is performed
490 -21. IV4 WEEKLY MANUAL TANK GAUGING. Indicate ifthis method is used to monitor the tanks.
490 -22. TESTING PERIOD - If IV4 is checked, check the appropriate box to describe the MTG testing period.
490 -23. IV -5 TANK INTEGRITY TESTING: Indicate if this method is used to monitor the tanks.
490 -24. TEST FREQUENCY - If IV -5 is checked, check the appropriate box to describe the frequency oftank integrity testing.
490 -25. OTHER: If490 -24c is checked, specify other test frequency.
490 -26. IV -99 OTHER: Indicate if monitoring ofthe tanks occurs that is not indicated in any other category.
490 -27. If IV -99 is checked, enter a briefdescription of the other tank monitoring method(s) used (e.g., vadose zone monitoring per 23 CCR §2647, groundwater monitoring per
23CCR §2648). Include the monitoring frequency (e.g., Continuous, Weekly). Ifadditional space is needed, use Section X.
490 -28. V -1 CONTINUOUS MONITORING OF PIPE/PIPING SUMP(S) AND OTHER SECONDARY CONTAINMENT WITH AUDIB LE AND VISUAL ALARMS:
Indicate if this is the monitoring method used for the piping.
490 -29. SECONDARY CONTAINMENT: If V -1 is checked, Check the appropriate box to describe the environment inside piping secondary containment.
490 -30. PANEL MANUFACTURER- IfV -I is checked, enter the name ofthe manufacturer ofthe monitoring system control panel (console).
490 -31. MODEL # - If V -1 is checked, enter the model number for the monitoring system control panel.
490 -32. LEAK SENSOR MANUFACTURER- If V -1 is checked, enter the name of the manufacturer of the sensor(s).
490 -33. MODEL #(S) - IfV -1 is checked, enter the model number for each type of sensor installed. If additional space is needed, use Section X.
490 -34. PIPING LEAK ALARM T RIGGERS AUTOMATIC PUMP SHUTDOWN - If V -1 is checked, check Yes or No.
490 -35. FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN - If V -I is checked, check Yes or No.
490 -36. V -2 PIPE MECHANICAL LINE LEAK DETECTORS PERFORM 3 GPH LEAK TESTS: Indicate ifthis monitoring method is used to monitor the pipelines.
490 -37. MLLD MANUFACTURER(S) - IfV -2 is checked, enter the name(s) ofthe manufacturer(s) ofthe mechanical line leak detector(s). Ifadditional space is needed, use
Section X.
490 -38. MODEL #(s) - If V -2 is checked, Enter the model number for each type ofmechanical line leak detector installed. If additional space is needed, use Section X.
490 -39, V -3 PIPE ELECTRONIC LINE LEAK DETECTORS: Indicate ifthis monitoring method is used to monitor the pipelines.
490 -40. ELLD MANUFACTURER - If V -3 is checked, Enter the name ofthe manufacturer ofthe electronic line leak detector(s).
49041. MODEL #(S)n - If V -3 is checked, enter the model number for each type ofelectronic line leak detector installed. If additional space is needed, use Section X.
49042. PROGRAMMED LINE INTEGRITY TESTS -If V -3 is checked, check the appropriate box to describe the type oftests programmed into the monitoring system.
49043. ELLD DETECTION OF A PIPING LEAK ALARM TRIGGERS PUMP SHUTDOWN - If V -I is checked, check Yes or No.
490 -44. ELLD DETECTION OF A PIPING LEAK FAILURE /DISCONNECTION TRIGGERS PUMP SHUTDOWN. - IfV -I is checked, check Yes or No.
49045. V4 PIPE INTEGRITY TESTING - Indicate if this monitoring method is used to monitor the pipelines.
49046. TEST FREQUENCY - If V4 is checked, check the appropriate box to describe the frequency of pipe integrity testing.
49047. SPECIFY - if490-46 -99 is checked, enter the frequency of pipe integrity testing.
490 -48. V -5 VISUAL PIPE MONITORING - Indicate if this monitoring method is used to monitor the pipelines.
49049. If V -5 is checked, check the appropriate box to describe the frequency of visual monitoring.
490 -50. SUCTION PIPING MEETS EXEMPTION CRITERIA - Indicate if this monitoring method is used to monitor the pipelines.
490 -51. NO REGULATED PIPING PER HEALTH AND SAFETY CODE, DIVISION 20, CHAPTER 6.7 IS CONNECTED TO THE TANK SYSTEM - Check this box ifno
piping in the tank system is regulated under the UST law, or there is no piping.
490 -52. V -99 OTHER - Indicate ifanother method is used for pipeline monitoring.
490 -53. SPECIFY - Enter a brief description of the other line monitoring method(s) used. If additional space is needed, see Section X. Be sure to clearly describe
monitoring method(s) and frequency.
This monitoring plan must include a Site Plan showing the general tank and piping layouts and the locations where monitoring is performed (i.e., location of each sensor, line leak
detector, monitoring system control panel, etc.). If you already have a diagram (e.g., current UST Monitoring Site Plan from a Monitoring System Certification form, Hazardous
Materials Business Plan map, etc.) that shows all required information, include it with this plan.
UPCF UST -D (12/2007) 2/4
UPCF UST -D (12/2007) 3/4
UNIFIED PROGRAM CONSOLIDATED FORM
UNDERGROUND STORAGE TANK
MONITORING PLAN (Page 2 of 2)
VI. UNDER DISPENSER CONTAINMENT (UDC) MONITORING
1. UDC MONITORING IS PERFORMED USING THE FOLLOWING METHOD 490 -54a
490 -546
I. CONTINUOUS ELECTRONIC MONITORING 2. FLOAT AND CHAIN ASSEMBLY ® 3. ELECTRONIC STAND -ALONE
4. NO DISPENSERS [199. OTHER (Specify):
PANEL MANUFACTURER: 490 ss MODEL #: 490 -56.
LEAK SENSOR MANUFACTURER:Veeder Root 490 -57 1 MODEL #(S): 330212 -001 490 -58
DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS a. YES ® b. NO 490 -59
UDC LEAK ALARM TRIGGERS AUTOMATIC PUMP SHUTDOWN ® a. YES b. NO 490 -60.
FAILURE / DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN. ® a. YES b. NO 490.61
UDC MONITORING STOPS THF. FLOW OF PRODUCT AT THE DISPENSER. ® a. YES b. NO 490-62
2. UDC CONSTRUCTION IS O L SINGLE - WALLED 2. DOUBLE - WALLED 490-63
IF DOUBLE WALLED: 490-64a
UDC INTERSTITIAL SPACE IS MONITORED BY: I. LIQUID F1 2. PRESSURE 3. VACUUM
A LEAK WITHIN THE SECONDARY CONTAINMENT OF THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS a. YES b. NO 490 -64b
VII. PERIODIC SYSTEM TESTING
I. ELD TESTING: THIS FACILITY HAS BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT ENHANCED 490-65.
LEAK DETECTION (ELD) MUST BE PERFORMED. PERIODIC ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED. X23 CCR §2644_I
2. SECONDARY CONTAINMENT COMPONENTS ARE TESTED EVERY 36 MONTHS. 490 -66
3. SPILL BUCKETS ARE TESTED ANNUALLY. 490 -67
VIII. RECORDKEEPING
The following monitoring/maintenance records are kept for this facility:
Alarm logs 490.68a ® Visual Inspection Records 490.686 Tank integrity testing results 490 -68c
SIR testing results (and supporting documentation records). 490 -68d Tank gauging results (and supporting documentation records). 49M8e
ATG Testing results (and supporting documentation records). 490.68f Corrosion Protection 60-day logs 490 -688
Equipment maintenance and calibration records. 49M8h
IX. TRAINING
Personnel with UST monitoring responsibilities are familiar with all of the following documents relevant to their job duties. 490-69a
REFERENCE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply)
THIS UNDERGROUND STORAGE TANK MONITORING PLAN (Required) 490 -69b
OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT (Required) 490 -69e
CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 490 -69d
CALIFORNIA UNDERGROUND STORAGE TANK LAW 490 -69e
STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS - MANUAL AND
STATISTICAL INVENTORY RECONCILIATION" 490 -69f
SWRCB PUBLICATION: "UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS" 490 -69g
OTHER (Specify): M69h, M69i
This facility has a "Designated UST Operator" who has passed the California UST System Operator Exam administered by the International Code Council ICC).
The "Designated UST Operator" will train facility employees in the proper operation and maintenance of the UST systems annually, and within 30 days of hire. This
training will include, but is not limited to, the following:
Operation ofthe UST systems in a manner consistent with the facility's best management practices
The facility employee's role with regard to the monitoring equipment as specified in this UST Monitoring Plan
The facility employee's role with regard to spills and overfills as specified in the UST Response Plan
Names of contact person(s) for emergencies and monitoring alarms. 490-70
X. COMMENTS /ADDITIONAL INFORMATION
Provide additional comments here or indicate how many pages with additional information on specific monitoring procedures are attached to this plan. 490 -71
XI. PERSONNEL RESPONSIBILITIES
The UST Owner /Operator is responsible for ensuring that: 1) the daily /routine UST monitoring activities and maintenance of UST leak detection equipment covered by
this plan occurs, 2) all conditions that indicate a possible release are investigated, and 3) all monitoring records are maintained properly.
The following person(s) are responsible for performing the monitoring and equipment maintenance:
NAME L alt V& 490-72 TITLE U (Sa /L 490.73
NAME 490-74 TITLE Q 490-75
The Designated Operdior shall perform a monthly visual inspection of the facility, provide a report to the owner /operator, and inform the owner /operator of any
conditions that need follow -up action.
XII. OWNER/OPERATOR SIGNATURE
CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge.
APPLICANT SIGNATURE PG 490-76
Re s3
DATE: 490-77
4t T
p -elf0- 0-i'``" 3
REP IN I. T nk w Fa ili wn r/ 3 ApIhQlizvd ftlorlitAdyr of Owner
APPLICANT NAME (print): 490 -70- APPLICANT TITLE: 490 -79
N(GVt L all-Y soPEI ggISO L- IV
UPCF UST -D (12/2007) 3/4
Agency Use Only) This plan has been reviewed and: Approved Approved With Conditions '
Local Agency Signature: Date:
Comments or Special Conditions:
UST Monitoring Plan - Page 2 Instructions
Complete a separate UST Monitoring Plan for each UST monitoring system at the facility. This form must be submitted with your initial UST
Operating Permit Application and within 30 days of changes in the information it contains. Please note that your local agency may require you to
obtain approval prior to installing or modifying monitoring equipment. (Note: Numbering of these instructions follows the data element numbers on
the form.)
490 -54a. MONITORING OF THE UNDER DISPENSER CONTAINMENT- Indicate the method used for UDC monitoring.
490 -54b. SPECIFY -If99 "Other" is checked, describe other method used.
If VI -I -1, VI -I -2 or VI -I -3 or VI -1 -99 is checked, complete 490 -55 to 490 -64b.
490 -55. PANEL MANUFACTURER -Enter the name of the manufacturer of the monitoring system control panel (console). If there is no control panel (e.g., only an electrical
relay box is installed) leave this space blank.
490 -56. MODEL # - Enter the model number for the monitoring system control panel (console). If there is no control panel (e.g., only an electrical relay box is installed) leave
this
space blank.
490 -57. LEAK SENSOR MANUFACTURER - Enter the name ofthe manufacturer ofthe sensor(s).
490 -58. MODEL #(S) - Enter the model number of the sensor(s) installed. If additional space is needed, use Section X.
490 -59. DETECTION OF A LEAK INTO THE UDC TRIGGERS AUDIBLE AND VISUAL ALARMS. Indicate Yes or No
490-60. UDC LEAK ALARM TRIGGERS PUMP SHUTDOWN - Indicate Yes or No
490 -61. FAILURE /DISCONNECTION OF UDC MONITORING SYSTEM TRIGGERS AUTOMATIC PUMP SHUTDOWN - Indicate Yes or No
490 -62. UDC MONITORING STOPS THE FLOW OF PRODUCT AT ]'HE DISPENSER - Indicate Yes or No.
490 -63. UDC CONSTRUCTION - Indicate ifthe construction of the UDC is single - walled, or double - walled.
490 -64a. DOUBLE- WALLED INTERSTITIAL SPACE MONITORING - Indicate what is used to monitor the interstitial space.
490 -64b. LEAK WITHIN THE SECONDARY CONTAIMENT OF UDC TRIGGERS AUDIBLE AND VISUAL ALARMS - Indicate Yes or No
490 -65. VII -I ELD TESTING - Check the box ifyou have been notified by the State Water Resources Control Board (SWRCB) that the UST(s) covered by this plan is/are
subject to Enhanced Leak Detection Requirements (i.e., UST has any single -wall component and is located within 1,000 feet ofa public drinking water well).
490 -66. TESTING OF SECONDARY CONTAINMENT COMPONENTS EVERY 36 MONTHS - Check the box ifyou have secondary containment that requires testing.
490 -67. SPILL BUCKET TESTING - Check the box ifyou have spill buckets.
490- 68a -h. VIII RECORDKEEPFNG - Indicate which monitoring and equipment maintenance records are maintained for this facility.
490 -69a IX TRAINING STATEMENT - Check the box to verify that the statement is true.
REFERENCE DOCUMENTS MAINTAINED AT FACILITY - Check the appropriate boxes to describe reference documents maintained at the facility. Note that the
first two items on the list must he kept at the facility.
490 -69b. MONITORING PLAN: Indicate that this plan is kept as a reference document.
490 -69c. OPERATING MANUALS FOR ELECTRONIC EQUIPMENT: Indicate that this plan is kept as a reference document.
490 -69d. CA UST REGULATIONS - Indicate that this is kept as a reference document.
490 -69e. CA UST LAW - Indicate that this is kept as a reference document.
490 -69f. STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION - "HANDBOOK FOR TANK OWNERS - MANUAL AND
STATISTICAL INVENTORY RECONCILIATION - Indicate that this is kept as a reference document.
490 -69g. SWRCB PUBLICATION: "UNDERSTANDING AUTOMATIC TANK GAUGING SYSTEMS ": Indicate that this is kept as a reference document.
490 -69h. OTHER - Indicate that other reference documents are kept.
490 -69i. SPECIFY -If "OTHER" is checked, enter a brief description of the other document(s) maintained at the facility. If additional space is needed, see Section X.
490 -70. DESIGNATED OPERATOR TRAINING - Check this box to verify that this statement is true.
490 -71. COMMENTS /ADDITIONAL INFORMATION - Make additional comments or you may attach and identify the number of additional pages of information to describe
any additional UST system monitoring - related information (e.g., additional information required by your local agency). Attach any monitoring logs that you will be using
for the monitoring ofyour tank system.
490 -72. NAME - Enter the name of the person who routinely conducts the monitoring and equipment maintenance under this plan.
490 -73. TITLE - Enter the title of the person.
490 -74. NAME - Enter the name of the second person, if applicable, who routinely conducts the monitoring and equipment maintenance under this plan.
490 -75. TITLE - Enter the title ofthe second person.
OWNER/OPERATOR SIGNATURE - The tank owner /operator, facility owner /operator, or an authorized representative of the owner shall sign in the space provided.
This signature certifies that the signer believes that all information submitted is true, accurate, and complete, and that the training program specified in Section IX has
been implemented.
490 -76. REPRESENTING -- Check the appropriate box to indicate whether the signer is the UST owner /operator, the UST facility owner /operator, oran
authorized representative ofthe owner.
490 -77. DATE - Enter the date the plan was signed.
490 -78. APPLICANT NAME - Print or type the name of the person signing the plan.
490 -79. APPLICANT TITLE - Enter the title of the person signing the plan.
UPCF UST -D (12/2007) 4/4
UNDERGROUND STORAGE TANK
RESPONSE PLAN - PAGE I (One form per facility)
TYPE OF ACTION I. NEW PLAN ® 2. CHANGE OF INFORMATION R01.
I. FACILITY INFORMATION
FACILITY ID # (Agency Use Only)
BUSINESS NAME (Same as FACILITY NAME) R02.
Bakersfield City Police Department
BUSINESS SITE ADDRESS R03. CITY R04.
1601 Truxtun Avenue Bakersfield
H. SPILL CONTROL AND CLEANUP METHODS
This plan addresses unauthorized releases from UST systems and supplements the emergency response plans and procedures in the facility's Hazardous Materials
Business Plan.
If safe to do so, facility personnel will take immediate measures to control or stop any release (e.g., activate pump shut -off, etc.) and, if necessary, safely remove
remaining hazardous material from the UST system.
Any release to secondary containment will be pumped or otherwise removed within a time consistent with the ability of the secondary containment system to
contain the hazardous material, but not greater than 30 calendar days, or sooner if required by the local agency. Recovered hazardous materials, unless still suitable
for their intended use, will be managed as hazardous waste.
Absorbent material will be used to contain and clean up manageable spills of hazardous materials. Absorbent material which has become too saturated to be
effective or which is no longer intended for use will be managed as hazardous waste unless a waste determination in accordance with 22 CCR §66262.11 finds that
it is non - hazardous. Used absorbent material, reusable or waste, will be stored in a properly labeled and sealed container. Waste material shall be disposed
appropriately.
Facility personnel will determine whether any water removed from secondary containment systems, or from clean-up activity, has been in contact with any
hazardous material. If the water is contaminated, it will be managed as hazardous waste unless a waste determination in accordance with 22 CCR §66262.11 finds
that it is non - hazardous. If the water has a petroleum sheen (i.e., rainbow colors), it is contaminated. A thick floating petroleum layer may not necessarily display
rainbow colors. Water (hazardous or non - hazardous) from sumps, spill containers, etc. will not he disposed to storm water systems.
We will review secondary containment systems for possible deterioration ifany ofthe following conditions occur:
I. Hazardous material in contact with secondary containment is not compatible with the material used for secondary containment;
2. Secondary containment is prone to damage from any equipment used to remove or clean up hazardous material collected in secondary containment;
3. Hazardous material, other than the product/waste stored in the primary containment system, is placed inside secondary containment to treat or neutralize
released product/waste, and the added material or resulting material from such a combination is not compatible with secondary containment.
III. SPILL CONTROL AND CLEAN -UP EQUIPMENT
PERIODIC MAINTENANCE: Spill control and clean-up equipment kept permanently on -site is listed in the facility's Hazardous Materials Business Plan. This
equipment is inspected at least monthly, and after each use, supplies are replenished as needed. Defective equipment is repaired or replaced as necessary.
EQUIPMENT NOT PERMANENTLY ON -SITE, BUT AVAILABLE FOR USE IF NEEDED: (Complete nly if applicable)
EQUIPMENT LOCATION AVAILABILITY
N tai EQ-
RIO.
1
p
Or TA 0TJN y{11
0. 2 q tf
R30.
RI 1. R21. R31.
R12. R22, R32.
R13. R23. R33.
R14. R24. R34.
RI S. R25, R35.
IV. RESPONSIBLE PERSONS
THE FOLLOWING PERSON(S) IS /ARE RESPONSIBLE FOR AUTHORIZING ANY WORK NECESSARY UNDER THIS RESPONSE PLAN:
NAME R40. TITLE R50.
NAME R41. TITLE R51.
NAME R42. TITLE R52.
NAME R43. TITLE R53.
V. MONITORING °INDICATORS
IF MONITORING INDICATES A POSSIBLE UNAUTHORIZED RELEASE, STEPS TO VERIFY THE RELEASE WILL BE MADE AS FOLLOWS:
Additional system testing or data collection ® Inspection by qualified persons ® Recalibration ofequipment
Other:
R60.
UST Response Plan (12/2010) - 1/3
I
UST Response Plan — Instructions
Complete one UST Response Plan for each UST facility. This form must be submitted with your initial UST Operating Permit
Application and within 30 days of changes in the information it contains. It supplements the Emergency Response Plans and
Procedures in the facility's Hazardous Materials Business Plan. (Note: Numbering of these instructions follows the data element numbers on
the form.)
RO1. TYPE OF ACTION — Check the appropriate box to indicate why this plan is being submitted.
FACILITY ID NUMBER — This space is for agency-use only.
R02. BUSINESS NAME — Enter the complete Facility Name.
R03. BUSINESS SITE ADDRESS — Enter the street address where the facility is located, including building number, if applicable.
Post office box numbers are not acceptable. This information must provide a means to locate the facility geographically.
R04. CITY — Enter the city or unincorporated area in which the facility is located.
RIO. EQUIPMENT — If you have spill control or clean -up equipment kept off -site, list that equipment in sections RIO through R15.
If no equipment is kept off -site, leave this section blank.
R20. LOCATION — If you have spill control or clean -up equipment kept off -site, list the equipment location(s) sections R20 through
R25. If no equipment is kept off -site, leave this section blank.
R30. AVAILABILITY — If you have spill control or clean -up equipment kept off -site, list the equipment availability in sections R30
through R35. If no equipment is kept off -site, leave this section blank.
R40. NAME — At least one person responsible for authorizing any work necessary under this UST Response Plan must be identified.
Use sections R40 through R43 to list the name(s) ofthe responsible person(s).
R50. TITLE — At least one person responsible for authorizing any work necessary under this UST Response Plan must be identified.
Use sections R50 through R53 to list the job title(s) of the responsible person(s).
R60. MONITORING INDICATORS Briefly describe the steps that will be taken to verify the presence or absence of a release if the
tank monitoring system indicates the possibility of a release.
OWNER/OPERATOR SIGNATURE — The owner /operator shall sign in the space provided. This signature certifies that the
signer believes that all information submitted is true, accurate, and complete.
R70. DATE — Enter the date the plan was signed.
R71. OWNER/OPERATOR NAME — Print or type the name of the person signing the plan.
R72. OWNER/OPERATOR TITLE — Enter the title of the person signing the plan.
UST Response Plan (12/2010) - 2/3
UNDERGROUND STORAGE TANK
RESPONSE PLAN - PAGE 2
VI. REPORTING AND RECORD KEEPING
We will report/record any overfill, spill, or unauthorized release from a UST system as indicated in this plan.
Recordable Releases: Any unauthorized release from primary containment which the UST operator is able to clean up within eight (8) hours after the release was
detected or should reasonably have been detected, and which does not escape from secondary containment, does not increase the hazard of fire or explosion, and does
not cause any deterioration ofsecondary containment, must be recorded in the facility's monitoring records. Monitoring records must include:
The UST operator's name and telephone number;
A list ofthe types, quantities, and concentrations of hazardous substances released;
A description of the actions taken to control and clean up the release;
The method and location of disposal of the released hazardous substances, and whether a hazardous waste manifest was or will be used;
A description of actions taken to repair the UST and to prevent future releases;
A description of the method used to reactivate interstitial monitoring after replacement or repair ofprimary containment.
Reportable Releases: Any overfill, spill, or unauthorized release which escapes from secondary containment (or primary containment if no secondary containment
exists), increases the hazard of fire or explosion, or causes any deterioration of secondary containment, is a reportable release. Reportable releases are also recordable.
Within 24 hours after a reportable release has been detected, or should have been detected, we will notify the local agency administering the UST program of the
release, investigate the release, and take immediate measures to stop the release. If necessary, or ifrequired by the local agency, remaining stored product/waste will
be removed from the UST to prevent further releases or facilitate corrective action. If an emergency exists, we will notify the California Emergency Management
Agency at (800) 852 -7550.
Within five (5) working days of a reportable release, we will subrnit to the local agency a full written report containing all of the following information to the extent
that the information is known at the time offiling the report:
The UST owner's or operator's name and telephone number;
A list ofthe types, quantities, and concentrations of hazardous materials released;
The approximate date of the release,
The date on which the release was discovered;
The date on which the release was stopped;
A description of actions taken to control and/or stop the release;
A description of corrective and remedial actions, including investigations which were undertaken and will be conducted to determine the nature and extent of
soil, ground water or surface water contamination due to the release;
The method(s) ofcleanup implemented to date, proposed cleanup actions, and a schedule for implementing the proposed actions;
The method(s) and location(s) ofdisposal of released hazardous materials and any contaminated soils, groundwater, or surface water.
Copies of any hazardous waste manifests used for off -site transport of hazardous wastes associated with clean-up activity;
A description of proposed methods for any repair or replacement of UST system primary/secondary containment systems;
A description of additional actions taken to prevent future releases.
We will follow the reporting procedures described above if any of the following conditions occur:
A recordable unauthorized release can not be cleaned up or is still under investigation within eight (8) hours ofdetection;
Released hazardous substances are discovered at the UST site or in the surrounding area,
Unusual operating conditions are observed, including erratic behavior ofproduct dispensing equipment, sudden loss of product, or the unexplained presence of
water in the tank, unless system equipment is found to be defective and is immediately repaired or replaced, and no leak has occurred;
Monitoring results from UST system monitoring equipment/methods indicate that a release may have occurred, unless the monitoring equipment is found to be
defective and is immediately repaired, recalibrated, or replaced, and additional monitoring does not confirm the initial results.
Record Retention: Monitoring records and written reports of unauthorized releases must be maintained on -site (or off -site at a readily available location, if approved
by the local agency) for at least 3 years. Hazardous waste shipping/disposal records (e.g., manifests) must be maintained for at least 3 years from the date ofshipment.
VII. OWNER/OPERATOR SIGNATURE
CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge.
OWNER/OPERATOR SIGNATURE r PC1Ie42,f J 3 Ir
DATE R70.
i "1eZ ®t
OWNER/OPERATOR NAME (print) Rai. OWNER/OPERATOR TITLE R72.
tc- a4yA- Su e ,soa
Agency Use Only) This plan has been reviewed and: Approved Approved With Conditions Disapproved
Local Agency Signature: Date:
UST Response Plan (12/2010) - 3/3
I
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Appendix VI
Lopies ofMonitoring System Certification form and UST Monitoring Plot Plan available at http: / /www.waterboards.ca.gov.)
Lt '
MONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the State of Callfomle
Authority Cited. Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, CaMmia 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: Bakersfield City Police Dept, Bldg. No.:
Site Address: 1801 Truxtun Ave. City: Bakersfield Zip:
FacWty ContactPerson: Contact Phone No.: t_
Make/Model of Monitoring System Veeder -Root TL67350 Date of Testing/Servicing: 11/18/2011
B. Inventory of Equipment Tested/Certified
Check the appromiate boxes to indicate specillic ecluftWmmient M ted/serviced:
Tank ID: 87 LIL Tank ID:
X In -Tank Gauging Probe. Model: Mag_ In -Tank Gauging Probe. Model:
X Annular Space orVault Sensor. Model: FRP Annular Space orVault Sensor. Model:
X Ptpk% Sump ( Trench Sensor(s). Madet: 208 PWN Sump ( TrenchServsor(%). uortet:
Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model:
X Mechanical Line Leak Detector. Model: PLD Mechanical Una Leak Detector. Model:
Electronic Line Leak Detector. Model: Electronic Una Leak Detector. Model:
Tank Overfill / High -Level Sensor. Model: Tank Overfill / High -Level Sensor. Model:
Other (sperclfV a of ment a and model in Sectfon E on Pa e 2 . Other (spec a of ment and model fn Section E on Pa e Z .
TanklD: TanklD:
In -Tank Gauging Probe. Model: In -Tank Gauging Probe. Model:
Annular Space or Vault Sensor. Model: Annular Space or Vault Sensor. Model:
P49% Sump ( Trench Sensor(%). OAodsk: Ptpk % Sump f Trench Sensor(%). U "..
Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model:
Mechanical Line Leak Detector. Model: Mechanical Una Leak Detector. Model:
Electronic Line Leak Detector. Model: Electronic Una Leak Detector. Model:
Tank Overfill / High -Level Sensor. Model: Tank Overfill / High -Level Sensor. Model:
Other s ecl a ul ment a and model in Sectfon E on Page Z . Other cf a of ment a and model In Sectfon E on Page 2).
Dispenser ID: 1 -2 Dispenser ID:
X Dispenser Containment Sensor(s). Model: VR Stand alone Dispenser Containment Sensor(s). Model:
X Sheer Valve(s). Shear Valve(s).
enser Contamrnarrt Fto s) and Chem s . enser Cortiatnmerrt Flo and Chatn s .
Dispenser ID: 3-4 Dispenser ID:
X Dispenser Containment Sensor(s). Model: VR Stand alone Dispenser Containment Sensor(s). Model:
X Shear Valve(s). Shear Valve(s).
DJ enser Containment Floats and Chains . Dl enser Containment Flogs) and Chaln s .
DlspenserID: Dispenser ID
Dispenser Containment Sensor(s). Model: Dispenser Containment Sensor(s). Model:
Shear Valve(s). Shear Valve(s).
Dispenser Containment Floats and Chaln s Dispenser Containment Flost s and Chaln 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 Inspectediserviced 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 thatapply): X System set-up X AI history re2ort
Technician Name (print): Rafael Martinez Signature:
Certification No.: B33309 License. .: 921733 A Haz,
Testing Company Name: Cal - Valley Eaulpment Phone No.:(881) 327 -9341
Testing Company Address: 3500 Gilmore Ave. Bakersfield. Co. 93308 Date of Testing/Servicing: 11/18/2011
Monitoring System Certification Pagel of 4 12107
2/21/07
D. Results of TestinglServicing
Software Version Installed: 324.01
Gom fete the Touowlna cneCKllst:
x Yes No' Is the audible alarm operational?
X Yes No' Is the visual alarm operational?
X Yes No* Were all sensors visually hrspecW, functionally tested, and confirmed operational?
X 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` If alarms are relayed to a remote monitoring station, Is all communications equipment (e.g. modem) operational?
X N/A
Yes X No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system
N/A detects a leek, fella to operate, or Is electrically disconnected? Ifyes: which sensors Initiate positive shut -down? (Check all that apply)
X Sump/Trench Sensors; Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks adId sensor
failure/dlsconnecdon? X Yes; No.
Yes No' For tank systems that utfffze the monitoring system as the primary tank overflff warning device (f.e. no mechanicaf overffff prevention
X N/A 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
oftank capacity does the alarm td er? %
Yes* X 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' X No Was liquid found Inside any secondary containment systems designed as dry systems? (Check all that appl)) Product; Water. If
es, describe causes in Section E, below.
X Yes No' Was monitoring system set -up reviewed to ensure proper settings? Attach set up reports, if applicable
X Yes No* Is all monitoring equipment operational per manufacturer's specifications?
In Section E below, describe now and when these deficiencies were or will be corrected.
E. Comments:
CYE Performed Product line testing.
Monitoring System Certification Page 2 of 4 12/07
2/21/07
F. in -Tank Gauging / SIR Equipment: X Check this box if tank gauging is used onlyfor inventory control.
Check this box If no tank gauging or SIR equipment is Installed.
This section must be completed ifin -tank gauging equipment is used to perform leak detection monitoring.
Cmmnlete the fnlinwinn rherkiict-
Yes No* Has all Input wiring been Inspected for proper entry and termination, Including testing for ground faults?
0 Yes No' Were all tank gauging probes visually inspected for damage and residue buildup?
0 Yes a tao• Was accuracy of system product level readings bested?
Yes 0 No' Was accuracy ofsystem water level readings tested?
0 Yes 0 No` Were all probes reinstalled properly?
Yes o 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 vrill be corrected.
G. Line Leak Detectors (LLD): J Check this box if LLDs are not installed.
Cmmnlete the Mllnwlnn rharkilat-
X Yes No' For equipment start -up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all
N/A that apply) Simulated leak rate: X 3 g.p.h.; 0.1 g.p.h ; 0.2 g.p.h.
X Yes NW Were all LLDs confirmed operational and accurate within regulatory requirements?
X Yes No* Was the testing apparatus properly calibrated?
X Yes 0 Ne For mechanical LLDs, does the LLD restrict product flow If it detects a leak?
N/A
Yes 0 No` For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak?
X N/A
Yes 0 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system Is disabled or
X N/A disconnected?
0 Yes No' For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or
X N/A fails a test?
0 Yes No' For electronic LLDs, have all accessible wiring connections been visually Inspected?
X N/A
X Yes No` Were all items on the equipment manufacturer's maintenance checklist completed?
In the Secfion M, below, describe how and when these deficiencies were or will be corrected.
H. Comments:
87 line teak detector was replaced.
Monitoring System Certification Page 3 of 4 12/07
3 2/21/07
SWRCB, January 2006
Spill Bucket Testing Report Form
1 `7rtsfonn is intendedfor use by contractorsperforming annual testing ofUST spill containment structures The completedfonn and
printoutsfrom tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: Bakersfield City Police Dept. Date of Testing: 11/18/2011
Facility Address: 1601 Truxtun ave. Bakersfield ca.
Facility Contact: Phone:
Date Local Agency Was Notified ofTesting:
Name ofLocal Agency Inspector rifpresent during testing): Ernie M
2. TESTING CONTRACTOR INFORMATION
Company Name: Cal -Valley Equipment
Technician Conducting Test: Rafael Martinez
Credentials': X CSLB Contractor ICC Service Tech. SWRCB Tank Tester Other (Specify)
License Number(s): 921733 A Haz.
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: X Hydrostatic Vacuum Other
Test Equipment Used: Incon TS -STS Equipment Resolution: 0.0002
Identify Spill Bucket (By Tank
Number, Stored Product, etc.
1 87 UL Fill 2 87 ul vapor 3 4
Bucket Installation Type: X Direct Bury
Contained in Sump
X Direct Bury
Contained in Sump
Direct Bury
Contained in Sump
Direct Bury
Contained in Sum
Bucket Diameter: I 11" 11"
Bucket Depth: 13.5" 13"
Wait time between applying
vacuum/water and startof test: 10 min. 10 min.
Test Start Time (T): 9:4.9 am 10 :05 a.m.
Initial Reading (R): 5.9871" 5.9805"
Test End Time (TF): 10:04 am 10:20 a.m.
Final Reading (RF): 1 5.9871" 5.9768"
Test Duration (TF — T): 30 min. 30 min.
Change in Reading (RF - R): 0.0" 0.00371"
Pass/Fail Threshold or
Criteria: 0.002" 0.002"
Test Result: X Pass Fail Pass X Fail Pass Fail Pass 0 Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -up forfailed tests)
87 vapor bucket needs to be replaced.
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
I hereby certify that all the information contained in this report is true, accurate, andinfull compliance wide legal requirements.
Technician's Date: 11/18/2011
State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may hP mnrP ctrinaant
a
CI li
Cal- Valley Equipment
3500 Gilmore Ave.
Bakersfield CA 93308
661 - 327 -9341 FAX# 661 -325 -2529
VAPORLESS MANUFACTURING, INC.
LDT -890 Leak Detector Test Record
auDmersiwe rum p wentnncation
Manufacturer: F.E. Petro Model No.:
Serial No.: Notes:
Leak Detector Identification
Manufacturer: Red'acket
Customer: Bakersfield City Police dept.
Contractor: Cal - Valley Equipment
Piston-type: X
Date: 11/18/2011 Location: 1601 Truxtun ave. Bakersfield
Notes:
Ca.
Product: 87 ul Technician: Rafael Martinez
auDmersiwe rum p wentnncation
Manufacturer: F.E. Petro Model No.:
Serial No.: Notes:
Leak Detector Identification
Manufacturer: Red'acket Description:
Diaphragm-type: Piston-type: X
Tamper -proof sea] installed: Other Style Leak Detector:
Notes:
Leak Detector in Suhmerxihle Pumn Text at Dixnenxer
Operating Pump Pressure (psi): 24 para. 15
Gallons per hour rate: 3 para. 22
Line pressure with pump shut off (psi): 23 para. 23
Bleed -back Test with pump off (ml): 250 para. 26
Step-through time to full flow (secs): 3 para. 30
Leak detector stays in leak search position e o : para. 42
Leak Detector Test
larasl/ Fail Notes:
Complete thermal expansion test beforefaffing leak detector
1
CAL - VALLEY EQUIPMENT
3500 Gilmore Avenue
AES PLT —100R Bakersfield, CA 93308
Ph#661- 327 -9341
Fax#661- 325 -2529
NAME: Bakersfield Police Dept. LINE #1: 87 UL TECHNICIAN: Bruce W. Hinsle
ADDRESS: 1601 Truxtun Ave. LINE #2:
87 UL
LICENSE #: 90 -1069
CITY/ ST.: Bakersfield, Ca. LINE #3:
0.035
TEST DATE: 11/18/2011
THE CONVERSION CONSTANT IS FOUND BY: (60 MIN/HR) / (37901MIL/GAL) = 0.0158311 (MIN/HOUR (GAL/MIN)
Divide the volume differential by the test time (15 minutes) and multiply by 0.0158311, which will convert the volume differential from milliliters per
minute to gallons per hour. The conversion constant causes the millimeters and minutes to cancel out
PRODUCT TIME PSI START VOL
ml
END VOL
MI)DIFF.
TEST VOL
m
GPH GAIN/LOSS (ml) PASS FAIL
87 UL 09:25 50 183 148 35 0.035 X
09:55 50 148 115 33 0.033 X
COMMENTS:
PRODUCT TIME PSI START VOL
ml
END VOL
ml
TEST VOL
DIFF. ml
GPH GAIN/LOSS (ml) PASS FAIL
COMMENTS:
PRODUCT TIME PSI START VOL
ml
END VOL
ml
TEST VOL
DIFF. ml
GPH GAINILOSS (ml) PASS FAIL
COMMENTS:
I declare under penalty of perjury that I am a licensed tank tester in the State of California. and Xthattheinformationinthisreportistrueandcorrecttothebestofmyknowledge.
Appendix.Vl
Copies of Monitoring System Certification form and UST Monitoring Plot Plan available at http: //www.waterboards.ca.aov.)
MONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the State ofCalifornia
Authority Cited. Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, Califomla 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: Bakersfield City Police Dept. Bldg. No.:
Site Address: 1801 Tnodun Ave. City: Bakersfield Zip:
Facility Contact Person: Contact Phone No.: (
Make/ModeI of Monitoring System: Vseder -Root TLS -350 Date of Testing/Servicing: _L/_IL/ 2009
B. Inventory of Equipment Tested/Certified
Check the anaronriate boxes to indicate specific eauloment Insaected/servlced:
Tank ID: 87 UL Tank ID:
In -Tank Gauging Probe. Model: Maa. In -Tank Gauging Probe. Model:
Annular Space or Vault Sensor. Model: Annular Space or Vault Sensor. Model:
Piping Sump / Trench Sensor(s). Model: 208 o Piping Sump / Trench Sensor(s). Model:
FlII Sump Sensor(s). Model: FlII Sump Sensor(s). Model:
Mechanical Line Leak Detector. Model: PLD Mechanical Una Leak Detector. Model:
Electronic Una Leak Detector. Model: Electronic Una Leak Detector. Model:
Tank Overfill / High-Level Sensor. Model: Tank Overfill / High -Level Sensor. Model:
Other u ment a and model in Section E on Page 2). Other s e u ant and model In Section
Tank ID: Tank 10:
In -Tank Gauging Probe. Model: In -Tank Gauging Probe. Model:
Annular Space orVault Sensor. Model: Annular Space or Vault Sensor. Model:
Piping Sump / Trench Sensor(s). Model: Piping Sump / Trench Sensor(s). Model:
FlII Sump Sensor(s). Model: Fill Sump Sensor(s). Model:
Mechanical Una Leak Detector. Model: Mechanical Una Leak Detector. Model:
Electronic Una Leak Detector. Model: Electronic Una Leak Detector. Model:
Tank Overfill / High -Level Sensor. Model: Tank Overfill / High -Level Sensor. Model:
Other Lspgft e u ment M2 and model in Section E on Page 2). Other s a ul ent bTe and model In Section E on Page 2).
Dispenser, ID: 1 Dispenser ID:
Dispenser Containment Sensor(s). Model: Stand Alone Dispenser Containment Sensor(s). Model:
Shear Valve(s). Shear Valve(s).
f7 Dis rmer Containment Floats and Chains . Dis nser Containment Floats and Chain(s).
Dispenser ID: 2 Dispenser 10:
Dispenser Containment Sensor(s). Model: Stand Alone Dispenser Containment Sensor(s). Model:
Shear Valve(s). Shear Valve(s).
Dispenser Containment Floats and Chaln s . Dispqnser Containment FlostW and Chain(s).
Dispenser ID: Dispenser ID:
Dispenser Containment Sensor(s). Model: Dispenser Containment Sensor(s). Model:
ShearValve(s). Shear Valve(s).
Dispenser Containment Floats and Chains Dispenser Containment Floats and Chains .
If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser atthe facility.
C. Certification - I certify that the equipment Identified In this document was inspected/servlced In accordance with the manufacturers,
guidelines. Attached to this CerWication 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 thatapplyd: ILSystem set -up i5FAlarrn history report
Technidan Name (print): Bruce W. Hinslev Signature: 4
Certification No.: A25212 License. No.: 921733 A HAZ
Testing Company Name: Cal - Valley Eaulament Phone No.101) 327 -9341
Testing Company Address: 3500 GilmoreAve. Bakersfield, Ca, 93308 1 Date of Testing/Servidng: 8 / 19 / 2009
Monitoring System Certification Page 1 of4 12/07
2/21/07
D. Results of Testing/Servicing
Software Version Installed: 346234 -100 -B
COmblete the following checklist:
Yes 0 No* Is the audible alarm operational?
Yes No* Is the visual alarm operational?
Yes 0 No' Were all sensors visually Inspected, functionally tested, and confirmed operational?
0 Yes No` Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their
proper o ratan?
Yes No' If alarms are relayed to a remote monitoring station, Is all communications equipment (e.g. modem) operational?
WA
0 Yes 0 No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system
0 WA detects a leak, falls to operate, or Iselectrically disconnected? If yes: which sensors initiate positive shut -down? (Check all that apply)
0 Sump/Trench Sensors; Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks A!14 sensor
failure/disconnection? Yes; No.
Yes 0 No' For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no mechanical overfill prevention
N/A valve Is installed), is the overfill warning alarm visible and audible at the tank fill polnt(s) and operating properly? If so, at what percent
of tank capacity does the alarm bigger? %
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) 0 Product; Water. If
s describe causes In Section E below.
Yes No* Was monitoring system set -up reviewed to ensure proper settings? Attach set up reports, If applicable
Yes No* Is all monitoring equipment operational per manufacturer's specifications?
In section E below, describe how and when these deficlencles were or will be corrected.
E. Comments:
Performed product line testing.
Monitoring System Certificatlon Page 2 of 4 12107
2/21/07
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?
0 Yes 0 No* Were all tank gauging probes visually inspected for damage and residue buildup?
Yes No` Was accuracy of system product level readings tested?
0 Yes 0 No' Was accuracy of system water level readings tested?
Yes NW Were all probes reinstalled properly?
0 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 (1-1-13): Check this box if LLDs are not installed.
Complete the following checklist:
Yes No• For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all
WA 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?
0 Yes 0 No` Was the testing apparatus properly calibrated?
0 Yes No' For mechanical LLDs, does the LLD restrict product flow If it detects a leak?
WA
Yes 0 No' For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak?
WA
Yes 0 No' For electronic LLDs, does the turbine automatically shut o if any portion of the monitoring system Is disabled or
N/A disconnected?
Yes No' For electronic LLDs, does the turbine automatically shut off If any portion of the monitoring system malfunctions or
WA fails a test?
Yes 0 No* For electronic LLDs, have all accessible wiring connections been visually Inspected?
WA
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 orwill be corrected.
H. Comments:
Monitoring System Cord ication Page 3 of 4 12107
3 2/21/07
CVE
Cal- Valley Equipment
3500 Gilmore Ave.
Bakersfield CA 93308
661 - 327 -9341 FAX# 661 - 325 -2529
VAPORLESS MANUFACTURING, INC.
LDT -890 Leak Detector Test'Record
Contractor: Cal-Valley Equipment Customer: Bakersfield Police Dept.
Date: 8/19/2009 Location: 1601 Tru dim Ave.
Bakersfield, Ca.
Product: 87 UL Technician: Bruce W. Hinsle
Submersible Pump Identification
Manufacturer: RedJacket Model No.:
Serial No.: Notes:
Leak Detector Identification
Manufacturer: Red'acket Description:
Diaphragm-type: Piston-type: PLD
Tamper -proof seal installed: Other Style Leak Detector:
Notes:
Leak Detector in Submersible Pump Test at Dispenser
Operating Pum Pressure (psi): 25 para. 15
Gallons per hour rate: 3.0 para. 22
Line pressure with pump shut off (psi): 18 para. 23
Bleed -back Test with pump off (ml): 55 para. 26
Step-through time to full flow (secs): 3 para. 30
Leak detector stays in leak search position (Yes/No): Yes ara. 42
Leak Detector Test
Pass / Fail Notes:
Pass
Complete thermal a ansion test beforefailing leak detector
SWRCB, January 2006
Spill Bucket Testing Report Form
Thisform is intendedfor use by contractorsperforming annual testing ofUSTspill containment structures. The completedform and
printoutsfrom tests (ifapplicable), should beprovidedto thefacility owner /operatorforsubmittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: Bakersfield City Police Dept. Date of Testing: 8/18/2009
Facility Address: 1601 Truxtun Ave.
Facility Contact: Phone:
Date Local Agency Was Notified of Testing:
Name of Local Agency Inspector (rfpresent during testing):
2. TESTING CONTRACTOR INFORMATION
Company Name: Cal -Valley Equipment
Technician Conducting Test: Bruce W. Hinsley
Credentials': CSLB Contractor ICC Service Tech. SWRCB Tank Tester Other (Spec)
License Number(s): 921733A
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: Hydrostatic Vacuum Other
Test Equipment Used: Visual Equipment Resolution:
Identify Spill Bucket (By Tank
Number, Stored Product, etc.
1 87 UL 2 3 4
Bucket Installation Type: Direct Bury
Contained in Sump
Direct Bury
Contained in Sump
Direct Bury
Contained in Sump
0 Direct Bury
Contained in Sum
Bucket Diameter: 11"
Bucket Depth: 11"
Wait time between applying
vacuum/water and start oftest: 10 min.
Test Start Time (T): 08:25
Initial Reading (R): 9.25"
Test End Time (TF): 09:25
Final Reading (RF): 9.25"
Test Duration (TF — TO: 1 Hr.
Change in Reading (RF - RO: 0.0"
Pass/Fail Threshold or
Criteria: 0.25"
f
rS. • +.nv. w-n, !_YCfJ 3. "44.;ey._v`.li. lass yl`f jVk.,.n AiuL.Y.:.nn.. seY.71fn 0
yd•
Pt -0Llil. i .d2a ,Sw... isr'rLlt'alsv Pa ail z3v;K.... -an eirwa ..k.i
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
CERTIFICATION OF TECBMCIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
Ihereby certify that all the information contained In this report Is true, accurate, and infull compliance with legal requirements.
Technician's Signature: -Z— AWMI:,4r ! Date: 8/19/200
State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may N- mnrr etrinaPnt
CAL - VALLEY EQUIPMENT
3500 Gilmore Avenue
AES PLT —100R Bakersfield, CA 93308
Ph#661- 327 -9341
Fax#661- 325 -2529
NAME: Bakersfield Police Dept. LINE #1: 87 UL TECHNICIAN: I Bruce W. Hinsle
ADDRESS: 1601 Truxtun Ave. LINE #2:
87 UL
LICENSE #: 90 -1069
CITY/ ST.: Bakersfield, Ca. LINE #3:
0.005
TEST DATE: 8/19/2009
THE CONVERSION CONSTANT IS FOUND BY: (60 MIN /HR) / (3790/MIUGAL) = 0.0158311 (MIN/HOUR (GAL/MIN)
Divide the volume differential by the test time (15. minutes) and multiply by 0.0158311, which will convert the volume differential from milliliters per
minute to gallons per hour. The conversion constant causes the millimeters and minutes to cancel out
PRODUCT TIME PSI START VOL
ml
END VOL
ml
TEST VOL
DIFF. ml
GPH GAIN/LOSS (ml) PASS FAIL
87 UL 08:55 50 202 205 5 0.005 X
09:10 50 205 210 5 0.005 X
COMMENTS:
PRODUCT TIME PSI START VOL
ml
END VOL
ml
TEST VOL
DIFF. ml
GPH GAINILOSS (ml) PASS FAIL
COMMENTS:
PRODUCT TIME PSI START VOL
ml
END VOL
ml
TEST VOL
DIFF. ml
GPH GAIN/LOSS (ml) PASS FAIL
COMMENTS:
I declare under penalty ofperjury that I am a licensed tank tester in the State of California and
that the information in this report is true and correct to the best of my knowledge. X '-
LEAK TEST METHOD
TEST ON DATE : ALL TANKNOV10. 2003
START TIME : DISABLEDTESTRATE :0.20 GALiHRDURATION : 2 HOURS
TST EARLY STOP:DISABLED
LEAK TEST REPORT FORMAT
NORMAL
LIQUID SENSOR SETUP
L I :PIPING SUMP SENSOR
TRI -STATE (SINGLE FLOAT) CATEGORY : OTHER SENSORS
L 2 :ANNULAR SPACE SENSOR
TRI -STATE (SINGLE FLOAT) CATEGORY : OTHER SENSORS
OUTPUT RELAY SETUP
R 1:REMOT£ ALARM GARAGETYPE:
STANDARD
NORMALLY OPEN
IN -TANK ALARMS
T I:LEAK ALARM
T I:HIGH WATER ALARM
T 1 :OVERFILL ALARM
T I:LOW PRODUCT ALARM
T J:SUDDEN LOSS ALARMT1:HIGH PRODUCT ALARMTI:PROBE OUT
T J :HIGH WATER WARNING
T I :DELIVERY NEEDED
T I:MAX PRODUCT ALARM
T 1:GROSS TEST FAIL
LIQUID SENSOR ALMS
ALL:FUEL ALARM
ALL:SENSOR OUT ALARM
ALL:SHORT ALARM
ALL:WATER ALARM
ALL:WATER OUT ALARM
ALL:HIGH LIQUID ALARM
i ALL:LOW LIQUID ALARM
ALL:LIQUID WARNING
R 3 :FUEL LEAK
TYPE:
STANDARD
NORMALLY CLOSED
LIQUID SENSOR ALMS
ALL:FUEL ALARM
ALL:SENSOR:OUT ALARM
ALL:SHORT ALARM
R 4 :OUTSIDE ALARM
TYPE:
STANDARD
NORMALLY OPEN
IN -TANK ALARMS
ALL:LEAK ALARM
ALL:HIGH WATER ALARM
ALL:OVERFILL ALARM
I ALL:LOW PRODUCT ALARM
ALL:SUDDEN LOSS ALARM
T 1:HIGH PRODUCT ALARM
ALL:PROBE OUT
i ALL:HIGH WATER WARNING
ALL:DELIVLRY NEEDED
T 1:MAX PRODUCT ALARM
T 1:GROSS TEST FAIL
j LIQUID SENSOR ALMS
ALL:FUEL ALARM
ALL:SENSOR OUT ALARM
ALL :SHORT ALARM
ALL :WATER :ALARM
ALL:WATER OUT ALARM
ALL:HIGH L;IGUID ALARM
ALL:LOW LIQUID ALARM
ALL:LIQUID WARNING
SOFTWARE REVISION LEVEL
VERSION 324.01
SOFTWARE# 346324- 1.00 -B
CREATED - 03.11.10.17.15
NO SOFTWARE MODULE
SYSTEM FEATURES:
PERIODIC IN -TANK TESTS
ANNUAL IN -TANK TESTS
ALARM HISTORY REPORT
SENSOR ALARM
L 1:PIPI.NG SUMP SENSOR
OTHER SENSORS
FUEL ALARM
AUG 19. 2009 9:08 AM
FUEL ALARM
AUG 19, 2008 9:10 AM
FUEL ALARM
AUG 17, 2007 9:21 AM
x x x x X END x x x x
ALARM HISTORY REPORT
SENSOR ALARM - - - --
L 2:ANNULAR SPACE SENSOR
OTHER SENSORS
FUEL ALARM
AUG 19. 2009 9:06 AM
SENSOR OUT ALARM
DEC 29. 2008 12:08 PM
SETUP DATA WARNING
DEC 29. 2008 12:04 PM
I
END
i
3 qc. 3
SYSTEM SETUP
AUG 19, 2009 10:37 Allro
SYSTEM UNITS
U.S.
SYSTEM LANGUAGE
ENGLISH
SYSTEM DATE /TIME FORMAT
MON DD YYYY HH:MM:SS xM
BKFD CITY POLICE DEP
1601 TRUXTUN AVE
BAKERSFIELD.CA93301
661 -326 -3888
SHIFT TIME 1 DISABLED
SHIFT TIME 2 DISABLED
SHIFT TIME 3 DISABLED
SHIFT TIME 4 DISABLED
TANK PER TST NEEDED WRN
DISABLED
TANK ANN TST NEEDED WRN
DISABLED
LINE RE— ENABLE METHOD
PASS LINE TEST
LINE PER TST NEEDED WRN
DISABLED
LINE ANN TST NEEDED WRN
DISABLED
PRINT TC VOLUMES
ENABLED
TEMP COMPENSATION
VALUE (DEG F ): 60.0
STICK HEIGHT OFFSET
DISABLED
H— PROTOCOL DATA FORMAT
HEIGHT
DAYLIGHT SAV'LNG TIME
ENABLED
START DATE
APR WEEK 1 SUN
START TIME
2:00 AM
END DATE
OCT WEEK 6 SUN
END TIME
2:00 AM
RE— DIRECT LOCAL PRINTOUT
DISABLED
EURO PROTOCOL PREFIX
S
SYSTEM SECURITY
CODE : 000000
CUSTOM ALARM LABELS
DISABLED
COMMUNICATIONS SETUP
PORT SETTINGS:
COMM BOARD 1 (FXMOD) BAUD RATE 2400
PARITY ODD
STOP BIT 1 STOP
DATA LENGTH: 7 DATARS -232 SECURITY
CODE : DISABLED
DIAL TYPE TONE
ANSWER ON : 1 RING
MODEM SETUP STRING
DIAL TONE INTERVAL: 32
RECEIVER SETUP:
NONE
AUTO DIAL TIME SETUP:
NONE
RS -232 END OF MESSAGE
DISABLED
AUTO DIAL ALARM SETUP
IN —TANK, SETUP
T 1:UNL -87
PRODUCT CODE 1
THERMAL COEFF 000670
TANK DIAMETER 112.13
TANK PROFILE 4 PTS
FULL VOL 14783
84.1 INCH VOL 11261
56.1 INCH VOL 6808
28.0 INCH VOL 2509
FLOAT SIZE: 4.0 IN.
WATER WARNING 3.0
HIGH WATER LIMIT: 5.0
MAX OR LABEL VOL: 14783
OVERFILL LIMIT 95%
14043
HIGH PRODUCT 90%
13304
DELIVERY LIMIT : 0%
0
LOW PRODUCT 12
LEAK ALARM LIMIT: 99
SUDDEN LOSS LIMIT: 99
TANK TILT 0.00
PROBE OFFSET 0.00
SIPHON MANIFOLDED TANKS
T#: NONE
LINE MANIFOLDED TANKS
T#: NONE
LEAK MIN PERIODIC: 0%
0
LEAK MIN ANNUAL 0%
0
PERIODIC TEST TYPE
STANDARD
ANNUAL TEST FAIL
ALARM DISABLED
PERIODIC TEST FAIL
ALARM DISABLED
GROSS TEST FAIL
ALARM DISABLED
ANN TEST AVERAGING: OFF
PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY 1 MIN
PUMP THRESHOLD 10.00%
SWRCB, January 2002 Page -L of
Secondary Containment Testing Report Form
Thisform is intendedfor use by contractors performing periodic testing ofUSTsecondary containment systems. Use the
appropriate pages ofthisform to report resultsforall components tested. The completedform, written testprocedures, and
printoutsfrom tests (ifapplicable), should beprovided to thefacility owner /operatorfor submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: QL ( ,F p Date of Testing:
Facility Address: p !' 7-ru
Facility Contact: Phone:
Date Local Agency Was Notified of Testing:
Name ofLocal Agency Inspector (fpresent during testing):
2. TESTING CONTRACTOR INFORMATION
Company Name: C — l l E
MM
Technician Conducting Test kolrian
Credentials: I.CSLB Licensed Contractor Q SWRCB Licensed Tank Tester
License Type: C A I License Number: A:,11 "1 S -3 •-
Manufacturer
Manufacturer Trainine
Component(s) Date Training Wires
i•YeLi1 1 CC Ji - ` .5 .. . ho A
nno nnnM
3. SUMMARY OF TEST RESULTS
If hydrostatic testing was performed, describe what was done with the water after completion of tests:
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements
Technician's Signature: Date:
k
MM M.
A nno nnnM
C n n0 nnn=
000 0000
00 IMI
n a oo
nnoin 0000
nnn 0000
noon noon
0000 nano
If hydrostatic testing was performed, describe what was done with the water after completion of tests:
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements
Technician's Signature: Date:
k
SWRCB, January 2002
4. TANK ANNULAR TESTING
Page q of--7
Test Method Developed By: Tank Manufacturer iftIndustry Standard Professional Engineer
Other (Specj&)
Test Method Used: Pressure Vacuum 0 Hydrostatic
Other (Spec)
Test Equipment Used: r Equipment Resolution:
Is Tank Exempt From Testing ?'
Tank # Tank # Tank # Tank #
Yes 9No Yes No Yes 0 No Yes 0 No
Tank Capacity: l 0p
Tank Material:
Tank Manufacturer: Oil VA 4
Product Stored: Gas o 1l ne
Wait time between applying
pressure/vacuum/water and
starting test: IC tl t ")
Test Start Time: 6 A
Initial Reading (1;4): o j.1
Test End Time: a ; W %l/vc
Final Reading (RF): jQ 0,--
Test Duration: 4
Change in Reading (RF-U: 1,0-
Pass/Fail Threshold or Criteria:
DD 7 aa ii
Was sensor removed for testing? Yes 0 No 0 NA 0 Yes 0No NA Yes ONO 0 NA Yes No NA
Was sensor properly replaced and
verified functional after testing?
11Q Yes 0 No NA 0 Yes 0 No NA 0 Yes No DNA Yes No NA
Comments —(include infonnation on repairs madeprior to testing, and recommendedfollow -upforfailed tests)
Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary
containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment
testing. (California Code of Regulations, Title 23, Section 2637(a)(6))
SWRCB, January 2002
5. SECONDARY PIPE TESTING
Page of
Test Method Developed By: 0 Piping Manufacturer 9( Industry Standard 0 Professional Engineer
0 Other (Spec)
Test Method Used: 51 Pressure 0 Vacuum 0 Hydrostatic
0 Other (Spec)
Test. Equipment Used: f- e, k pf, i 4 Equipment Resolution:
Piping Material:
Piping Ruq # g Piping Run # Piping Run # Piping Run #
Piping Manufacturer.
Piping Diameter:
Length of Piping Run:
Product Stored: aso nC-
Method and location of
i in -run isolation: vUV
Wait time between applying
pressure/vacuum/water and
starting test: I ,
Test Start Time:
Initial Reading (PQ: 5 psi
Test End Time: f •. —
Final Reading (RF): og i
Test Duration: O A4%0
Change in Reading (RF -RI):
Pass/Fail Threshold or
Criteria: v oZ 1
tt~st 1esult: a ti . l--I r :,
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
SWRCB, January 2002
6. PIPING SUMP TESTING
Page 0aof
Test Method Developed By: Sump Manufacturer XjIndustry Standard Professional Engineer
Other ()7ec)
Test Method Used: Pressure Vacuum kHydrostatic
Other (Specj&)
Test Equipment Used: Equipment Resolution: a ±
Sump Diameter
Sump # 7
t i
Sump # Sump # Sump #
Sump Depth: L "-,L + +
Sump Material:
Height from Tank Top to Top of
Highest Piping Penetration:
Height from Tank Top to Lowest
Electrical Penetration:
Condition of sump prior to testing: e Cti
Portion of Sump Tested' 6 v
Does turbine shut down when
sump sensor detects liquid (both
product and water)?*
Yes No NA Yes No NA Yes No NA 0 Yes No 0 NA
Turbine shutdown response time Geo
Is system programmed for fail -safe
shutdown ?*
K Yes No NA 0 Yes 0 No 0NA Yes No 0NA 0 Yes 0 No NA
Was fail -safe verified to be
operational?'
J Yes No NA 0 Yes No NA Yes 0 No NA 0 Yes No NA
Wait time between applying
pressure /vacuum/water and starting
test:
16 M k 1*
Test Start Time:
Initial Reading (Rj): y
Test End Time: I 1
Final Reading (RF): 77 `/
Test Duration: k vI
Change in Reading (RF -&):
Pass/Fail Tlaeshold or Criteria: v C)O,;L f
Test Result: d
w
Q ryP s h ..laC.
Was sensor removed for testing? Yes 0 No 0 NA 0 Yes No NA Yes No NA Yes No 0 NA
Was sensor properly replaced and
verified functional after testing?
Res 0 No NA 0 Yes No NA Yes No NA Yes No 0 NA
Comments —(include information on repairs made prior to testing, and recommended follow -up for failed tests)
1 If the entire depth of the sump is not tested, specify how much was tested. If the answer to Any ofthe questions indicated with an
asterisk ( *) is "NO" or "NA ", the entire sump must be tested. (See SWRCB LG -160)
SWRC13, January 2002
7_ UNDRR- DTgPF.NRF.R CONTAiNMF.NT Mnf'1 TR.RTTNf_
Page
Q`-%
of 7
Test Method Developed By: UDC Manufacturer Iindustry Standard 0 Professional Engineer
Other (Specify)
Test Method Used: 0 Pressure Vacuum 4Hydrostatic
0 Other (Spec)
Test Equipment Used: rricon Equipment Resolution: Uvaa jh
UDC Manufacturer.
UDC # I O 1,, UDC # 'S UDC # UDC #
In U n hKc; w b
UDC Material: F P
UDC De the loll
Height from UDC Bottom to Top
ofHighest Piping Penetration: I
Height from UDC Bottom to
Lowest Electrical Penetration:
Condition ofUDC prior to
testing: C leo, V) C Pm• d1
Portion of UDC Tested a p % y'e
Yes No NA Yes 0 No DNA 0 Yes 0No NA
Does turbine shut down when
UDC sensor detects liquid (both
product and water)?
P yes 11 11
Turbine shutdown response time 3 sec
Is system programmed for fail -
safe shutdown ?*
MYes No NA Yes No NA Yes 0No DNA 0 Yes No NA
Was fail -safe verified to be
operational ?*
0•Yes 0 No 0 NA Yes 0No NA Yes 0 No DNA 0Yes 0No NA
Wait time between applying
pressure./vacuum/water and
starting test 6,j
Test Start Time:
Initial Reading a
Test End Time: I i
Final Reading q
Test Duration: wi n r` = A•
Change in Reading R : 10 00 i
Pass/Fail Threshold or Criteria: 00a. p a,
Test Result:. r3
i W°. _; i, 1?.:i
Was sensor removed for testing? Yes 0 No NA W Yes 0 No NA 0 Yes No 0 NA 0Yes No NA
Was sensor properly replaced and
verified functional after testing?
A Yes No 0 NA 19 Yes 0 No 0NA 0 Yes No 0NA Yes No NA
Comments — (include information on repairs made prior to testinz, and recommended follow -up for failed tests)
rrr,:zNIMMw cra r
1 If the entire depth of the UDC is not tested, specify how much was tested. Ifthe answer to a_y ofthe questions indicated with an
asterisk ( *) is "NO" or "NA ", the entire UDC must be tested. (See SWRCB LG -160)
SWRCB, January 2002
8. FILL RISER CONTAMENT SUMP TESTING
Page of 7
Facility is Not Equipped With Fill Riser Containment Sumps
Fill Riser Containment Sumps are Present, but were Not Tested
Test Method Developed By: Sump Manufacturer Industry Standard Professional Engineer
Other (Spec)
Test Method Used: Pressure Vacuum Hydrostatic
Other (Specj&)
Test Equipment Used: Equipment Resolution:
Diameter:
Fill Sum # Fill Sump # Fill Suinp # Fill Sum #
Sump
Depth: Sump
Height from Tank Top to Top of
Highest Piping Penetration:
Height from Tank Top to Lowest
Electrical Penetration:
Condition of sump prior to
testing:
Portion ofSump Tested
Sump Material:
Wait time between applying
pressure/vacuum/water and
starting test:
Test Start Time:
Initial Reading
Test End Time:
Final Reading
Test Duration:
Change in Reading R :
Pass/Fail Threshold or Criteria:
Test Result: 7 +;Pe : 0.1N ss
Is there a sensor in the sum2? Yes D No _ Yes ._ Y s _.... D Nn _
Yes No NA
Does the sensor alarm when
either product or water is
detected?
Yes No NA Yes No 0 NA Yes No NA
Was sensor removed for testing? Yes No NA Yes No NA Yes No NA Yes No NA
Was sensor prnperly replaced and
verified functional after testing?
Yes No DNA D Yes No NA D Yes No NA Yes No NA
Comments — (include information on repairs made prior to testing, andrecommendedfollow -upforfailed tests)
SWRCB, January 2002
9. SPILL /OVERFILL CONTAINMENT BOXES
Page-7 of
Facility is Not Equipped With Spill/Overfill Containment Boxes
Spill/Overfill Containment Boxes are Present, but were Not Tested 0
Test Method Developed By: Spill Bucket Manufacturer Kindustry Standard 0 Professional Engineer
0 Other (Spec)
Test Method Used: Pressure Vacuum Hydrostatic
0 Other (Spec)
Test Equipment Used: 111 C C-) Equipment Resolution: P,
Bucket Diameter:
Spill Boy Spill Box # . -Vpg
i
Spill Box # Spill Box #
I
Bucket Depth: j, 1 y9.1 I I i
Wait time between applying
pressure/vacuum/water and
starting test:
Test Start Time: a, tq loo8 101315 S
Initial Reading R): 5. ' 7 5 EQ
Test End Time: 16og 1 [pao 1010
Final Reading (RF): 54jif / CS . a -566 '
Test Duration: I Mlnz 15 min hi V1
Change in Reading (RF -RI):
Pass/Fail Threshold or
Criteria:_ o '
Fail
Comments —(include information on repairs madeprior to testing, and recommendedfollow -upfor ailed tests)
191"LD/"f06IM(1 r i yar 6cr rr
W.
BPD
1601 TRUXTUN AVE
BAKERSFIELD
93301.
58989
11/18/2011 10:41 AM
SUMP LEAK TEST REPORT
87 FILL
TEST STARTED 10:25 AM i
TEST STARTED 11/18/2011
BEGIN LEVEL 5.9871 IN
END TIME 10:40 AM
END DATE 11/18/2011
END LEVEL 5.9871 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
i
87 UPR
TEST STARTED 10:25 AM
TEST STARTED 11/18/2011
BEGIN LEVEL 5.9661 IN
END TIME 10 :40 AM
END DATE 11/18/2011
END LEVEL 5.9560 IN
LEAK THRESHOLD 0.00$ IN
TEST RESULT FAILED
BPD
1601 TRUXTUN AVE
BAKERSFIELD
93301 j
8989
gg
11/18/2011 10:04 AM i
SUMP LEAK TEST`REPORT
i 87 FILL
i
TEST STARTED 9:49 AM
TEST STARTED 11/18/2011
BEGIN LEVEL 5.9871 IN
END TIME 10:04 AM
END DATE 11/18/2011
j END LEVEL 5.9871 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
I
87 UPR
f
f TEST STARTED 9:49 AM
TEST STARTED 11/18/2011
BEGIN LEVEL 5.9808 IN
END TIME 10 :04 AM
END DATE 11/18/2011
END LEVEL 5.9806 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT , _ .... - Pte_._..
3
s SWRCB, January 2002
t 3T-
9. SPILL /OVERFELL CONTAINMENT BOXES
Page _ of
Facility is Not Equipped With Spill/Overfill Containment Boxes
Spill/Overfill Containment Boxes are Present, but were Not Tested
Test Method Developed By: Spill Bucket Manufacturer `glndustry Standard Professional Engineer
Other (Spec)
Test Method Used: Pressure Vacuum Hydrostatic
Other (Specify)
Test Equipment Used: I N Cott - — Equipment Resolution: p Dno,2
Bucket Diameter.
Spill Boa # j Spill Box # Spill Box # Spill Box #
l 2'
Bucket Depth: 2
Wait time between applying
pressure/vacuum /water and
starting test:
5r 4 ( IJ
Test Start Time: L 2 2 rrr ! : 3 Pr,
Initial Reading (RI): q85 %W8 qW 7 I-)
Test End Time: I ) S3 P rn
Final Reading (RF): S21,-) 82to
Test Duration: Tmt N i v" I Id
Change in Reading (RF-R4): j N -O, i N
Pass/Fail Threshold or
Criteria: D•002 Iw
Fail Ly N
Comments —(include information on repairs made prior to testing, and recommended
BKFD CITY POLICE DEP
1601 TRUXTUN AVE
BAKERSFIELD CA 93301
661- 326 -3888
TEST AFTER BACKFILL•
05/10/2012 1:38 PM `
SUMP LEAK TEST REPORT
87 VB
TEST STARTED 1:22 PM
TEST STARTED 05/10/2012
BEGIN LEVEL 4.4859 IN
END TIME 1:38 PM
END DATE 05/10/2012
END LEVEL 4.4852 IN'
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
BKFD CITY POLICE DEP
1601 TRUXTUN AVE
BAKERSFIELD CA 93301
661- 326 -3888
TEST AFTER BACKFILL
05/10/2012 1:53 PM
SUMP LEAK TEST REPORT
87 VE
TEST STARTED 1:38 PM
TEST STARTED 05/10/2012
BEGIN LEVEL 4,4852 IN
END TIME 1:53 PM
END DATE 05/10/2012
END LEVEL 4.4850 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
lltill i
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1
MEMBER CVE:84629
Cal- Valley Equipment
MPE 3500 Gilmore Avenue, Bakersfield, CA. 93308NUMEQUIPMENT !j Cont. # 921733 A HAZ Phone (661)327 -9341 Fax (661)325 -2529
Customer: ' SA3r;crSF.FI a .. Pnli t e Qgp- . Arrival Date:/-j-/-AL
1st Time:j9t!FAA. /P.M.
Job Location I(nc i ;, y by PA JK— end Time: A.M. /P.M. Customer PO#
City: E 1 Departure
1st Time: -L
Phone: Contact: LtANAX-, TO ye rV end Time: A.M. /P.M.
W/M Confirmation#
Make Model Serial#
Reported Problem
Date:
Primary Cause /Corrections Made
1 i A,.3 .. Q
QtY Parts Number and Description Unit Cost Total Cost
Date:
Additional Information Listed Below: 1) Parts
44,00n _Se_ /a,,,
rj n J 4<4 oo. 5 P il- MQ
2) Sales Tax
9) Freight
4) LaborTotal
5) Mileage Total IC-
s) Equip. Rental
7) Subcontract
Total Amount
It is understood and agreed that in the event this bill becomes overdue and the seller commences legal action for the collection ofsame, the buyer will pay all costs
of collection including attorney's fees. The title to the property described herein shall remain the property of the seller, and title shall not pass to the purchaser until
paid. A service charge of 2%, equal to 24;6 per year, charged on past due accounts.
Service Work Acc pted
By. S3 P Cal -V ey Equipment Representative
Title: V 0 Date:
MEMBER CVE: 83909
Cal - Valley Equipment
m P E kt--.z 3500 Gilmore Avenue, Bakersfield, CA. 93308
97EUM EQUIPMENT Cont. # 921733 A HAZ Phone (661)327 -9341 Fax (661)325 -2529
Customer. P)r k,ia I C,t k; Pcl c e OLV Y - Arrival Date:
1st Time: A.M. /P.M.
Job Location: fir 4nd Time: A.M. /P.M. Customer PO#
City: 'iJr LC r5 A e i J
Phone: Contact:
Departure
1st Time: A.M. /P.M.
2nd Time: A.M. /P.M.
W/M Confirmation#
Make Model Serial#
Reported Problem
Primary Cause/ Corrections Made
QtY• I Parts Number and Description Unit Cost Total Cost
Additional Information Listed Below: 1) Parts
2) Sales Tax
3) Freight
4) Labor Total
5) Mileage Total
G) Equip. Rental
71 Subcontract
Total Amount I
It is understood and agreed that in the event this bill becomes overdue and the seller commences legal action for the collection of same, the buyer will pay all costs
of collection including attorney's fees. The title to the property described herein shall remain the property of the seller, and title shall not pass to the purchaser until
oaid. A service charce of 2 %. eaual to 24% ner vear. charged on nast due accounts.
Service Work Accepted ° }
By' j
Cal -VOIcy Equipment Repr entative
c' n
Title: lgC, y, Date: 7) a t'
r
April 10, 2012
State of California
State Water Resources Control Board
P.O. Box 944212
Sacramento, Co. 942442121
To Whom It May Concern:
The City of Bakersfield is self- insured for General LiabTrty, Automobile liability and
Workers' compensation.
All exposures, including contractual liability, arising out of City operations are
coveeed by the Crfiy's.self- insurance,progirom undertaken pursuant to California
Government Code Section 990.
Under our self-insurance program, we will bear all risk of bodily injury. and
property dornage losses until we have satistled a6y obligations we may have.
TF+i= letter is In fug force and effect untq rescinded
Sincerely,
a Covey
Risk Manager
City of Bakersfield - Office of Risk !Management - 1600 Truxtun 4venue
Bakersfield - California - 93301
661) 326 -3738 - (6611852 -2030
X102-oz
B A K E R S F1 E L D
April 10, 2012
State of California
State Water Resources Control Board
P.O. Box 944212
Sacramento, Co. 942442121
To Whom It May Concern:
The City of Bakersfield is self- insured for General LiabTrty, Automobile liability and
Workers' compensation.
All exposures, including contractual liability, arising out of City operations are
coveeed by the Crfiy's.self- insurance,progirom undertaken pursuant to California
Government Code Section 990.
Under our self-insurance program, we will bear all risk of bodily injury. and
property dornage losses until we have satistled a6y obligations we may have.
TF+i= letter is In fug force and effect untq rescinded
Sincerely,
a Covey
Risk Manager
City of Bakersfield - Office of Risk !Management - 1600 Truxtun 4venue
Bakersfield - California - 93301
661) 326 -3738 - (6611852 -2030