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HomeMy WebLinkAboutUST-MONITORING SYSTEM PG 2 4/10/201314 Pass SWRCB, January 2002 Page -L— of IC Secondary Containment Testing Report Form Thisform is intendedfor use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages ofthisform to report resultsfor all components tested The completedform, written test procedures, and printouts from tests (tfapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: C &M SHELL I Date of Testing: 5/8/12 Facility Address: 3605 ROSEDALE HWY, BAKERSFIELD Facility Contact: I Phone: Date Local Agency Was Notified ofTesting: 3/28/12 Name of Local Agency Inspector (ifpresent during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: RICH ENVIRONMENTAL Pass Technician Conducting Test: RICH PHILLIPS Not Tested Credentials: X CSLB Licensed Contractor SWRCB Licensed Tank Tester License Type: C61/1340 A HAZ License Number: 809850 Manufacturer Training Manufacturer Component(s) ) Date Training Expires INCON TS -STS 6/11/2012 X V/R SEC PIPE X I 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass I Fail Not Tested Repairs Made L NL87 ANNULAR X V/R SEC PIPE X I PREM91 ANNULAR X TANK MANIFOLD SEC PIPE X DIESEL ANNULAR X UNL87 STP X 1 UNL87 SEC PIPE 41 X PREM91 STP X UNL87 SEC PIPE #2 X DIESEL STP X PREM91 SEC PIPE #1 X UDC #1/2 X PREM 91 SEC PIPE #2 X UDC #3/4 X 0 0 DIESEL SEC PIPE #1 X UDC #5/6 xi 1 DIESEL SEC PIPE #2 X UDC #7/8 X 1 UNL87 VENT SEC PIPE X UDC #9/10 X 0 PREM91 VENT SEC PIPE X1 UDC #11/12 X 0 DIESEL VENT SEC PIPE X 1 Ifhydrostatic testing was performed, describe what was done with the water after completion of tests: CERTIFICATION OF TEC ICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best ofmy knowledge, thefacts d in this document are accurate and infull compliance with legal requirements Technician's Signature: Date: 05/08/12 G 4o3 Alk 5WRCB, January 2002 Page z of Secondary Containment Testing Report Form Thisform is intendedfor use by contractors performing periodic testing ofUST secondary containment systems. Use the appropriatepages ofthisform to report resultsfor all components tested The completedform, written test procedures, and printoutsfrom tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: C&M SHELL I Date of Testing: 5/8/12 Fail Facility Address: 3605 ROSEDALE HWY, BAKERSFIELD Repairs Made Facility Contact: I Phone: Fail Date Local Agency Was Notified of Testing: 3/28/.12 Repairs Made Name of Local Agency Inspector (ifpresent during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: Rich Environmental Technician Conducting Test: RICH PHILLIPS Credentials: X CSLB Licensed Contractor SWRCB Licensed Tank Tester License Type: C61/D40 A HAZ License Number: 809850 Manufacturer Training Manufacturer Component(s) Date Training Expires INCON TS -STS 6/11/2012 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Repairs Made UNL87 FILL SUMP X PREM91 FILL SUMP X 0 0 DIESEL FILL SUMP X UNL87 VAPOR BUCKET X 0 PREM91 VAPOR BKT X VENT BOX X 0 0 0 0 01 0 Ifhydrostatic testing was performed, describe what was done with the water after completion oftests: CERTIFICATION OF TECH CIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best ofmy knowledge, thefacts sta in this document are accurate and infull compliance with legal requirements Technician's Signature: Date: 5/8/12 SWRCB, January 2002 4. TANK ANNULAR TESTING qG sqo Page 3 of Test Method Developed By: Tank Manufacturer X Industry Standard Professional Engineer 0 Other (Spec) Test Method Used: Pressure X Vacuum 0 Hydrostatic Other (Specify) Test Equipment Used: 4" DIAL GAUGE Equipment Resolution. Tank #87 Tank #91 Tank #DSL Tank # Is Tank Exempt From Testing ?' X Yes No X Yes No X Yes No 0 Yes No Tank Capacity: Tank Material: Tank Manufacturer: Product Stored: Wait time between applying pressure/vacuum/water and starting test: 30MIN 30MIN 30MIN 30MIN Test Start Time: Initial Reading (Rj): Test End Time: Final Reading (RF): Test Duration: 60 MIN 60 MIN 60 MIN 60MIN Change in Reading (RF -IQ: Pass/Fail Threshold or Criteria: Test Result: Pass Fait 0 Pass 0 Fail Pass Fail Pass Fail Was sensor removed for testing? Yes No NA Yes No NA Yes No NA Yes No NA Was sensor properly replaced and verified functional after testing? Yes No NA Yes No NA Yes No NA Yes No NA Comment's — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests) TANKS HAVE WET ANNULARS 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 ofRegulations, Title 2' ), Section 2637(a)(6)) 11-1 SWRCB, January 2002 5. SECONDARY PIPE TESTING 7 0 5yo Page q of Test Method Developed By: 0 Piping Manufacturer X Industry Standard Professional Engineer Other (Specify) Test Method Used: X Pressure Vacuum Hydrostatic Other (Spec) Test Equipment Used: 4" DIAL GAUGE Equipment Resolution: .5% Piping Run #87 #1 Piping Material: FIBERGLASS Piping Run #87 #2 Piping Run #91 #1 Piping Run 491 #2 FIBERGLASS FIBERGLASS FIBERGLASS Piping Manufacturer. SMITH SMITH SMITH SMITH Piping Diameter: 3" 3" 3" 3" Length of Piping Run: 200' 100' 200' 100' Product Stored: UNL87 UNL87 PREM91 PREM91 Method and location of piping-run isolation: BOOT IN SUMP BOOT IN SUMP BOOT IN SUMP BOOT IN SUMP Wait time between applying pressure/vacuum/water and starting test: 30 MIN 30 MIN 30 MIN 30 MIN Test Start Time: 7:45 7:45 7:45 8:30 Initial Reading (Rj): 6.0 6.5 6.0 5.5 Test End Time: 8:45 8:45 8:45 9:30 Final Reading (RF): 6.0 6.5 6.0 5.5 Test Duration: 60 MIN 60 MIN 60 MIN 60 MIN Change in Reading (RF -Ri): 0 0 0 0 Pass/Fail Threshold or Criteria: 0 0 0 0 Test Result: X Pass Fail X Pass Fail X Pass Fail X Pass Fail Comments — (include information on repairs made prior to testing, andrecommendedfollow -upfarfailed tests) SWRCB, January 2002 S. SECONDARY PIPE TESTING 1 6 3V Page Z ofIL Test Method Developed By: Piping Manufacturer X Industry Standard Professional Engineer Other (Spec) Test Method Used: X Pressure Vacuum Hydrostatic Other (Spec) Test Equipment Used: 4" DIAL GAUGE Equipment Resolution: .5% Piping Material: Piping Run #DSL #1 Piping Run #DSL #2 Piping Run #87 VENT Piping Run #91 VENT FIBERGLASS FIBERGLASS FIBERGLASS FIBERGLASS Piping Manufacturer: SMITH SMITH SMTH SMITH Piping Diameter: 3" 3" 3" 3" Length ofPiping Run: 75' 50' 25' 25' Product Stored: DIESEL DIESEL UNL87 PREM91 Method and location of piping-run isolation: BOOT IN SUMP BOOT IN SUMP BOOT IN SUMP BOOT IN SUMP Wait time between applying pressure /vacuum/water and starting test: 30 MIN 30 MIN 30 MIN 30 MIN Test Start Time: 8:30 8:30 9:45 9:45 Initial Reading (Ri): 6.0 6.0 6.5 6.0 Test End Time: 9:30 9:30 1 0:45 10:45 Final Reading (RF): 6.0 6.0 6.5 6.0 Test Duration: 60 MIN 60 MIN 60 MIN 60 MIN Change in Reading (RF -Rj): 0 0 0 0 Pass/Fail Threshold or Criteria: 0 0 0 0 Test Result: X Pass Fail X Pass Fail X Pass []Fail X Pass Fail Comments — (include information on repairs made prior to testing, andrecommendedfollow -upforfailedtests) SWRCB, January 2002 5_ SECONDARY PIPE TESTING YG 34o IPage4ofit Test Method Developed By: 0 Piping Manufacturer X Industry Standard 0 Professional Engineer 0 Other (Spec) Test Method Used: X Pressure 0 Vacuum Hydrostatic 0 Other (Spec) Test Equipment Used: 4" DIAL GAUGE Equipment Resolution: .5% Piping Run #DSL VENT Piping Run #VR #1 Piping Run #TANK MANIFOLD Piping Run # Piping Material: FIBERGLASS FIBERGLASS FIBERGLASS Piping Manufacturer. SMITH SMITH SMITH Piping Diameter. 3" 4" 3" Length ofPiping Run: 25' 300' 50' Product Stored: DIESEL GASOLINE GASOLINE Method and location of piping-run isolation: BOOT IN SUMP BOOT IN SUMP BOOT IN SUMP Wait time between applying pressure /vacuum/water and test: 30 MIN 30 MIN 30 MIN starting Test Start Time: 9:45 11:00 7:45 Initial Reading (R): 5.0 5.0 6.0 Test End Time: 10:45 12:00 8:45 Final Reading (RF): 5.0 5.0 6.0 Test Duration: 60 MIN 60 MIN 60 MIN Change in Reading (RF -Rt): 0 0 0 Pass/Fail Threshold or Criteria: 0 0 0 Test Result: X Pass 0 Fail. i X Pass 0 Fail X Pass 0 Fail 1 Pass 0 Fail Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests) Y(9 Mo SWRCB, January 2002 Page 7 of 2 6. PIPING SUMP TESTING Test Method Developed By: D Sump Manufacturer X Industry Standard D Professional Engineer Other (Spec) Test Method Used: Pressure Vacuum X Hydrostatic Other (Specify) Test Equipment Used: INCON TS-STS Equipment Resolution: Sump #87 Sump #91 Sump #DSL Sump #VENT BOX7S7ump!Diaw!neter: 42" 42" 42" 48" 51" 49" 49" 27" p Material: FIBERGLASS FIBERGLASS FIBERGLASS FIBERGLASS Height from Tank Top to Top of Highest Piping Penetration: 22" 18" 18" 8" Height from Tank Top to Lowest Electrical Penetration: 22" 19" 19" 15" Condition of sump prior to testing: GOOD GOOD GOOD GOOD Portion of Sump Tested' 24" 20" 20" 20" Does turbine shut down when sump sensor detects liquid (both product and water)?* D Yes No X NA Yes No X NA Yes No X NA Yes No X NA Turbine shutdown response time Is system programmed for fail -safe shutdown ?* Dyes D No X NA Yes No X NA D Yes O No X NA Yes No XNA Was fail -safe verified to be operational?* Yes No X NA Yes No X NA Yes DNo X NA D Yes No XNA Wait time between applying pressure /vacuum/water and starting test: 30 MIN 30 MIN 30 MIN 30 MIN Test Start Time: 11:38 11:59 9:25 9:44 10 :18 10:38 9:25 10:01 Initial Reading (R,): 2.730 2.730 4.117 4.117 3.060 3.061 5.757 5.788 Test End Time: 11:53 12:14 9:40 9:59 10:34 10:53 9:40 10:16 Final Reading (RF): 2.730 2.730 4.117 4.117 3.061 3.060 5.758 5.788 Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN Change in Reading (RF -R,): 000 000 000 000 001 001 001 000 Pass/Fail Threshold or Criteria: 002 002 002 002 002 002 002 002 Test Result: X Pass Fail X Pass Fail X Pass Fail X Pass Fail Was sensor removed for testing? X Yes No NA X Yes No DNA X Yes No NA X Yes No NA Was sensor properly replaced an verified functional after testin ? XYes No NA X Yes No NA X Yes D No NA X Yes No NA Comments -(include information on repairs madeprior to testing', and recommendedfollow -upforfailed tests) Ifthe entire depth ofthe sump is not tested, specify how much was tested. If the answer to Any of the questions indicated with an asterisk(*) is "NO" or "NA ", the entire sump must be tested. (See SWRCB LG -160) SWRCB, January 2002 7. UNDER- DISPENSER CONTAINMENT (UDCI TESTING q(3Y0 Page - of lif Test Method Developed By: UDC Manufacturer X Industry Standard Professional Engineer 0 Other (Spec) Test Method Used: Pressure 0 Vacuum X Hydrostatic Other (Specify) Test Equipment Used: INCON TS -STS Equipment Resolution: UDC #3/4 UNKNOWN UDC #5/6 UDC #7/8UDC #1/2 UDC Manufacturer: UNKNOWN UNKNOWN UNKNOWN UDC Material: FIBERGLASS FIBERGLASS FIBERGLASS FIBERGLASS UDC De th: 27 27 27" 27" Height from UDC Bottom to Top of Highest Piping Penetration: 8" 8" 8" 8" Height from UDC Bottom to Lowest Electrical Penetration: 4" 4" 4" 4" Condition of UDC prior to testing: GOOD GOOD GOOD GOOD Portion of UDC Tested 10" 10" 10" 10" Does turbine shut down when UDC sensor detects liquid (both and water)?* 0 Yes 0 No X NA Yes No X NA Yes No X NA Yes No X NA product Turbine shutdown response time Is system programmed for fail- safe shutdown ?* Yes No X NA Yes No X NA Yes No X NA Yes No XNA Was fail -safe verified to be operational?* Yes No X NA Yes No XNA Yes No X NA 0 Yes No XNA Wait time between applying pressure/vacuum/water and starting test 30MIN 30MIN 30MIN 30MIN Test Start Time: 2:05 2:22 1:10 1:28 2:05 2:22 1:10 1:28 Initial Reading (R,): 3.067 3.067 1.244 1.243 3.785 3.785 5.338 5.338 Test End Time: 2:20 2:37 1:25 1:43 2:20 2:37 1:25 1:43 Final Reading (RF): 3.067 3.067 1.243 1.242 3.785 3.785 1 5.338 5.338 Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN Change in Reading F-R,): 000 000 001 001 000 000 000 000 Pass/Fail Threshold or Criteria: 002 002 002 1 -.002 002 002 002 Test Result: X Pass Fail X Pass Fail X Pass Fail X Pass Fail Was sensor removed for testing? X Yes No NA X Yes No NA X Yes No 0 NA X Yes No NA Was sensor properly replaced and verified functional after testing? X Yes No DNA X Yes No NA X Yes No NA X Yes 0 No NA Comments - (include information on repairs made prior to testing, andrecommended ollow -upforfailed tests) 1 Ifthe entire depth of the UDC is not tested, specify how much was tested. Ifthe answer to M of the questions indicated with an asterisk(*) is "NO" or "NA ", the entire UDC must be tested. (See SWRCB LG -160) SWRCB, January 2002 7. UNDER- DISPENSER CONTAINMENT (UDO TESTING Page q of Test Method Developed By: UDC Manufacturer X Industry Standard Professional Engineer 0 Other (Spec) Test Method Used: C Pressure 0 Vacuum X Hydrostatic 0 Other (Specify) Test Equipment Used: INCON TS -STS Equipment Resolution: UDC #9/10 anapsyme UDC #11/12 UDC # UDC # UDC Manufacturer. UNKNOWN UNKNOWN UDC Material: FIBERGLASS FIBERGLASS UDC Depth: 27" 27" Height from UDC Bottom to Top ofHighest Piping Penetration: 8" 8" Height from UDC Bottom to Lowest Electrical Penetration: 4" 4" Condition ofUDC prior to testing-. GOOD GOOD Portion ofUDC Tested 10" 10" Does turbine shut down when UDC sensor detects liquid (both roduct and water)?* Yes 0 No X NA Yes No X NA Yes 0No NA 0 Yes 0 No 0NA Turbine shutdown response time Is system programmed for fail- safe shutdown ?* 0 Yes No X NA Yes No XNA 0 Yes 0 No NA 0 Yes 0 No 0 NA Was fail -safe verified to be o final ?' Yes 0 No X NA 0 Yes No XNA Yes D No NA 0 Yes No NA Waittime between applying pressute/vacuum/water and starting test 30MIN 30MIN Test Start Time: 3:21 3:50 3:21 3:50 Initial Reading (Ri): 4.315 4.315 5.377 5.378 Test End Time: 3:36 4:05 3:36 4:05 Final Reading (RF): 4.315 4.315 5.378 5.378 Test Duration: 15MIN 15MIN 15MIN 15MIN Change in Reading (RF-R,): 000 000 001 000 Pass/Fail Threshold or Criteria: 002 002 002 002 Test Result: X Pass Fail X Pass Fail 0 Pass Fail 0 Pass Fail Was sensor removed for testing? X Yes No 0 NA X Yes No NA 0 Yes D No 0 NA Yes No NA Was sensor properly replaced and verified functional after testing? X Yes 0 No DNA X Yes 0 No DNA Yes No 0 NA 0 Yes No 0 NA Comnnents — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests) If the ,-ntire depth ofthe UDC is not tested, specify how much was tested. Ifthe answer to My ofthe questions indicated with an asterisk ( *) is "NO" or "NA ", the entire UDC must be tested. (See SWRCB LG -160) SWRCB, January 2002 R_ 1PH,i, RTSF,R CONTAiNIVIENT SUMP TESTING V Page-?p of l Facifity is Not Equipped With Fill Riser Containment Sums Fill Riser Containment Sumps are Present, but were Not Tested 0 Test Method Developed By: 0 Sump Manufacturer X Industry Standard Professional Engineer Other (Spec) Test Method Used: Pressure Vacuum X Hydrostatic Other (Spec) Test Equipment Used: INCON TS -STS Equipment Resolution: Fil! Sump # Fill Sump # Fill Sump Fill Sump # Sump Diameter. Sump Depth: 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 of Sump Tested Sump Material: Wait time between applying pressure /vacuum/water and starting test: NOT TESTED Test Start Time: Initial Reading (R, Test End Time: Final Reading Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN Change in Reading (RF -R,): Pass/Fail Threshold or Criteria: Test Result: Pass Fail Pass Fail Pass Fail Pass Fail Is there a sensor in the sump? Yes No Yes No Yes No Yes No Does the sensor alarm when either product or water is detected? Yes No NA Yes No NA Yes No NA Yes No 0 NA Was sensor removed for testing? Yes No NA Yes No NA Yes No NA Yes No NA Was sensor properly replaced and verified functional after testing. Yes No NA Yes No NA Yes No NA Yes No NA Comments — (include information on repairs made prior to testing and recommendedfollow -up forfailedtests) NO FILL SUMPS SWRCB, January 2002 9_ SPTT,iJOVF.RFTi.T, CONTAINMENT BOXES cl 30 Page It of Facility is Not Equipped With S ilUOverfill Containment Boxes Spill /Overfill Containment Boxes are Present, but were Not Tested Test Method Developed By: Spill Bucket Manufacturer X Industry Standard 0 Professional Engineer Other (Specie) Test Method Used: Pressure Vacuum X Hydrostatic Other (Spec) Test Equipment Used: INCON TS -STS Equipment Resolution: Spill Box #87 VPR Spill Box 491 VPR Spill Box # Spill Box # Bucket Diameter: 12" 12" Bucket Depth: 16" 16" Wait time between applying pressure/vacuum /water and starting test: 30MIN 30MIN Test Start Time: 9:25 9:44 9:25 9:44 Initial Reading (R): 3.737 3.736 3.394 3.393 Test End Time: 9:40 9:59 9:40 9:59 Final Reading (RF): 3.736 3.736 3.393 3.393 Test Duration: 15MIN 15MIN 15MIN 15MIN Change in Reading (RF -R,): 001 000 001 000 Pass/Fail Threshold or Criteria: 002 002 002 002 Test Result: X Pass Fail X Pass Fail Pass Fail Pass Fail Comments — (include information on repairs made prior to testing, andrecommendedfollow -upfor failed tests) SHELL 3605 RGSEDALE HWY 8AKE.RSF I ELD CA 05/08!2012 9:40 AN SUMP LEAK TEST REPORT 87VPR TEST STARTED 9,25 M TEST STARTED 05/08/2012 aEGIN LEVEL 3.7371 iN END TIME 9:46 AM END DATE 05/08/2612 END L.EUEL , 3.7366 IN LEAK THRESHOLD 0.002 IN TE,T RESULT PASSED 91VPR TEST STARTED 9:25 AM TEST STARTED 05/08/2012 BEGIN LEVEL 3.3945 IN END TIME 9'40 AM END DATE 05/08/2012 END LEVEL 3.3936 IN t -EAR THRESHOLD 0.4302 IN TEST RESULT PASSED VENTGX TEST STARTED 9 :25 AM TEST STARTED 05/08/2012 P,EGIN LEVEL 5.7575 IN END TIME 9:40 AM END DATE 05/08/2012 END LEUEL 5.7585 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED 91S'TP TEST STARTED 9:25 AM TEST STARTED 05/08/2012 BEGIN LEVEL 4.1170 IN END TIME 9:40 AM END DATE 05/08 {2012 END LEVEL 4.1175 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED uSL T? TEST STARTED 9600 2012 tt.ST STAEDRT 05/08 % D BEGIN LEVEL 3. KI4 END TI.ME 9,x,/08/2012 EtiD DATE 4 0617 IN E- E LFQEL -,"COLD 0, PA LEAK THRE ' I TESZ RESULT HELL 3605 RGSEDALE ?IWY RGSEDALE HWY 6'AKERSFiELD CA05 YAKEkSFIELD LA 4 1175 IN5:59 At4aADTIME. 0;:08/2012 ] 1::J3• Art 05/08/ 201'2 9:59 Att 4.1174 IN END LEVEL . b.Oat,IN LEAK THRESHOLD PASSED Ot9P L;--'AK TEST REPORT SUMP LEAK TEST REPORT 87STP 87UPR TEST STARTED 11:38 AM TEST STARTED 9:44 AM TEST STARTED 05/08/2012 TEST STARTED 05/08/'[0 + {12 BEGIN LEVEL 2.7302 IN BEGIN LEUEL 3.7366 IN END TIME 11:53 AM END TIME 9:59 AM END DATE 05/08/2012 END VATE 05/08/2012 ENO LEUEL 2.7303 IN END LEVEL 3.7362 IN LE.X THRESHOLD 0.002 IN LEAK THRESHOLD `-002 N TEST RESULT PASSED TEST RESULT PASSED 9i,JPR TEST STARTED 9:44 AM HkLL 3605 RGSEDALE HWY TEST STARTED 05/x/20123.3935 IN BAKERSFI.ELD CA BEGIN LEVEL END TIME 9:59 AM 05/08/2012 05,r0B/20] 12:14 Pt', END DATE END LEVEL 3.1932 IN SUMP LEAK 'TEST REPORT LEAK THRESHOLD 0.005EDTESTRESULT 87 ^;TP VENT5k; TEST STARTED 10:01 AM TEST STARTED 05/08/2012 BEGIN LEVEL 5.7885 IN END TIME 10'16 AM END DATE 05/082 INENDLEVELLEAKTHRESHOLD0.002 N TEST RESULT PASSED 91ST? TES-r STARTED 9;44 At9 O 08/2012TESTSTAREED41175IN5:59 At4aADTIME. 05/0872012 END DATE 4.1174 IN END LEVEL . b.Oat,IN LEAK THRESHOLD PASSED TEST RESULT OE'LSTP TEST TARTED YQ. X012. 05108.16 IN I6.53LtJF-LgErITIME 05/05720/2ANDDATE8,0607 IINO'?ASSEDEGAD - * CvQLD LEcti. TEJZ RESUL t 7EST STARTED 11:59 Art TEST STARTED 05/08/2012 BEGIN LEVEL 2.7303 IN END TIME 12:14 PM tND DATE 05/08/2Oi2 END LEVEL 2.7303 IN LEMK THRESHOLD 0.002 IN TEST RESULT PASSED rJDC3 -4 TEST STARTED ]:28 PP) TEST STARTED 05/08/2012 BEGIN LEVEL 1.2436 IN END TIME 1:43 PM END DATE 05/08/2012 END LEVEL 1.2420 IN LEAK THRESHOLD 0.052 IN TEST RESULT PASSED C Cpr,3 -4 TEST STARTED 1:10 Pt! TEST STARTED 05/08/'2012 BEGIN LEVEL i.2442 IN tND TIME 1:25 PM ENC, DATE 05'087 -E 1L Ei4D LEVEL 1.X433 IN LEAK THRESHOLD 0.002 1ETESTRESULT 7'0 341 1 S L 36P R EDk.EHWY 3h 4.;'[LD CH 05/08/2012 2;20 Pn SunP LEAK TE$T /REPORT uDCl-2 ESr STHHTED 2`05 Pm TE-5T STARTED 05/08/20!2 yEGIN LEVEL 3.0678 IN END TIME 2;20 PM wD ')HT[ 05/08/2012 END LEVEL 3.0678 IN LEAK THRESHOLD 8) TES7 STARTED 2 :0b Pn BFC,j LEVEL 05/08/2012 BEGIN LEVEL 3.7855 IN PASSED 2:37 PM END N2.TE my 2:38 Pn SL P -EHK TEST REPORT UDC!-2 TEST STARTED 2'?2Pn 7EST STARTED 05/08/20!2 E:ESIN LEVEL 1'0677 IN END TlnE 2:37 PM WwV DATE 05/e8/2012 EwD LEVEL 3.0677 IN LEAK THRESHOLD 0.802 IN TEST RESULT PASSED TEST STARTED 2:22 PM TEST STARTED 05/08/2012 BEGIN LEVEL 3.7855 IN END TIME 2:37 PM END N2.TE 05/08/2012 N0 L-EVEL 3.7853 1 LEAK THRESHOLD 0.002 16 TEST RESULT PASSED uDC7-8 TEST STARTED 1'10 Pm TEST STARTED 05/08/2012 BEGIN iEUEL 5.3380 IN END TIME 1:25 PM END DATE 05/08/2012 END LEVEL 5.3386 lN LEAK THRESHOLD 0.002 Ir TEST RESULT PASSED EST _.~' UDC9, END -rjfjF LEA '- EQE1 ASSED u&Czzz2 T STARTED TEST STow/Eu 1: n28 05/08/2012 J:21 Pn D(iTE7 3. N0 DATE S6 202THp I-E87 RESULT IN 1402 LEAK-THRESHOLO 0.002 IN jr4 T STARTED TEST STow/Eu 1: n28 05/08/2012 9EGIw L.EuEL 5,3388 IN E#D TIME 1;43 pn N0 DATE 05/08/2012 F-N0 EVB- 5,33B4 IN LEAK-THRESHOLO 0.002 IN TEST RESULT i,HSSE0 SHELL 3 05 ROSE0ALE wWY 8AKER8FIEL0 CH 85/88/2012 4`15 Pn SUMP LEAK TEST REPORT UDC9-10 TEST STARTED 3:50 PM TEST STARTED 05/08/2012 8EGIN LEVEL +.3156 IN END TIME +'05 PM END DATE 05/88/2012 END LEVEL 4.3155 IN EHK THRESHOLD 0.002 IN TEST RESULT PASSED UDC z112 TEST STARTED 3^50 Pn TEST STARTED 05/08/2012 BEGIN LEVEL 5.3782 IN END TIME 4:05 PM END DATE 05/08/2012 END I-EVEL 5,3784 IN LEAK THRESHOLD 0.002 Ih TEST RESULT PASSED L11 yd 34a SB989 TESTING FAILURE REPORT SITE NAME: C &M SHELL DATE: 518/12 THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE TESTING. REPAIRS: ilie/% LABOR: /-0 /y<- PARTS INSTALLED: NAME: TITLE: SIGNATURE: THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON - COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN LEFT ON -SITE FOR YOUR CONVIENENCE.