HomeMy WebLinkAbout989 RESULTS 2011SWRCB, Jar, uary 2002 Page / of
Secondary Containment 'Testing Report Form
This form is intendedfor use by contractors performing periodic testing of UST secondary containment systems. Use the
appropriate pages of thisform to report resultsfor all components tested The completedform, written testprocedures, and
printoutsfr m tests (fapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Ni e: MARKET EXPRESS I Date ofTesting: 10 /3 /11
Facility Address: 2500 WIBLE ROAD, BAKERSFIELD
Facility Contact:
Repairs
Made
Phone:
Date Loca Agency Was Notified of Testing: 9/9/11
Name of 1 Agency Inspector {ifpresent during testing):
2. TESTING CONTRACTOR INFORMATION
Company ame: Rich Environmental
Pass
Techniciai Conducting Test: RICH PHILLIPS
Repairs
Made
Credential;: X CSLB Licensed Contractor G SWRCB Licensed Tank Tester
License Type:
Manufacturer
C61ID40 A HAZ License Number: 809850
Manufacturer Traininp.
Component(s) Date Training Expires
CON TS -STS 6/11/2012
DISP 1/2 X
91/DSLANNULAR
3. SUMMARY OF TEST RESULTS
If hydrostatic testing was performed, describe what was done with the water after completion of tests:
CERTIFICATION OF q
To the best Of my knowledge, the facts
V RESPONSIBLE FOR CONDUCTING THIS TESTING
document are accurate and in full compliance with legal requirements
Technician' Signature: - Date: 10/3/11
Component Pass Fail Not
Tested
Repairs
Made Component Pass Fail Not
Tested
Repairs
Made
87 ANNULAR X DISP 1/2 X
91/DSLANNULAR X DISP 3/4 X
87 SECC NDARY X DISP 5/6 X Cl
91 SECONDARY X 87 FILL SUMP X
DSL SECONDARY X 91 FILL SUMP X
87 VEN SECONDARY X DSL FILL SUMP X
91 VEN SECONDARY X 71. VENT BOX X
DSL VENT SECONDARY X 7. 87 VAPOR BUCKET X
VAPOR SECONDARY X 91 VAPOR BUCKET X
87 STP X
91 STP X
DSL STP
If hydrostatic testing was performed, describe what was done with the water after completion of tests:
CERTIFICATION OF q
To the best Of my knowledge, the facts
V RESPONSIBLE FOR CONDUCTING THIS TESTING
document are accurate and in full compliance with legal requirements
Technician' Signature: - Date: 10/3/11
SWRCB, January 2002
4. TANK ANNULAR TESTING
Page 2--of$
Test Method Developed By: D Tank Manufacturer X Industry Standard 0 Professional Engineer
Other (Spec)
Test Method Used: Pressure X Vacuum Hydrostatic
IJ Other (Speci)j
Test Equip nt Used: 4" DIAL GAUGE Equipment Resolution:
Is Tank Exe
Nl IBM
Tank # 87
pt From Testing ?' Yes X No
Tank # 91/DSL Tank # Tank #
Yes X No C Yes No Yes No
Tank Capaci
Tank Material: STEEL STEEL
Tank Manuf cturer: JOOR JOOR
Product Stor d: 87 91/DSL
Wait time
pressure /vac
starting test:
een applying
um/water and 30MIN 30MIN
I
Test Start T' e: 9:30 9.35
Initial Reading R: l OHG l OHG
Test End Time: 10:30 10:35
Final Reading RF): 1 OHG 10171G
Test Duratio 60 MIN 60 MIN
Change in R ading (RF -Rt): 0 0
Pass/Fail Th vshold or Criteria: 0 0
Was sensor removed for testing?
W
X Yes D No NA C Yes No NA Yes No DNAXYes No D NA
Was sensor
verified functional
properly replaced and
after testing'?
X Yes No NA X Wes No NA Yes DNo NA Yes D No DNA
COMMCR6 - on repairs made prior to testing, and recommended
Secondary a ntainment systems where the continuous monitoring automatically monitors both the primary and secondary
containment, uch as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment
testing. (Ca fornia Code of Regulations, Title 23, Section 2637(a)(6))
SWRCB, .lanu ry 2002
5. SECONDARY PIPE TESTING
43-) ,bS
Page
Test Method Developed By: D Piping Manufacturer X Industry Standard n Professional Engineer
30 MIN
Other (Specifi )
Test Method Used: X Pressure Vacuum Hvdrostatic
C Other (Sped)
Test Equipme rt Used: 4" DIAL GAUGE Equipment Resolution: .5%
Pipinp1:
Piping Run #19l VENT Piping Run #DSL Piping Run #VPR piping Run #
5.5
VENT SECONDARY
12:00
FBERGLASS FIBERGLASS
Final Readin
FBERGLASS
Piping Manus tnrer: SMITI4 SMITH SMITH d
Piping Diame er: 3" 3" 3"
L, ength of Pip ng Run: 15' 15' 125'
Product Store LNL91 DIESEL UNL87/9I
Method and 1 anon of
1 ninin -ivn is latinn: TEST BOOTb TEST BOOS' TEST BOOT Kt
Wait time be
pressureivacu
startup test:
meen applying
m"water and 30 MIN 30 MIN 30 MIN
Test Start Time: 1 1:00 11:00 12:15
lnitial Reading RI): 5.0 5.0 5.5
Test End Tim 12:00 12:00 1:15
Final Readin Rr.): 5.0 5.0 5.5
SWRCB, Janu• ry 2002
5. SECONDARY PIPE TESTING
43, :Tp 1Page __ of D _
Test Method Developed By Piping Manufacturer X Industry Standard Li Professional Fngineer
0 Other (Sped)
Test Method Used: X Pressure C Vacuum r Hydrostatic i
1 Other (Specify)
Test Equipme t Used: 4' DIAL GAUGE Equipment Resolution: .5%
Piping Run # 87 Piping Run # 91 Piping Run # DSL Piping Run 987 VENT
PLASTIC PLASTIC I FIBERGLASS0ipingMateri7ctwer- PLASTIC
P, Manuf TCI TCl TCI SMITH
Piping Uiame 2" 2" 2" 3"
Length of Pipi tg Run: 125' 125' 125 36'
l Product Store 87 91 DSL I 87
Method and location of IBOOTINSUMPBOOTINSUMPBOOTINSUMP VENT BOXiin -run iso ation:
Wait time between applying
pressure/vacu
starting test:
miwater and 30 MIN 30 MIN 30 MIN 30 lvti
Test Start Time: 9:45 9:45 9:45 11:00
Initial Reading R,): 5.5 6.0 5.5 5,0 i
test End Time: 10:45 10:45 10:45 I 12:00
Final Readin Rr): 5.5 — 6.0 5.5 5.0
Test Duration 60 MIN 60 MIN 60 MIN 60 MIN^
Change in Reading RF -Ri): 0 0 0 0
Pass /Fail Threshold or 0 PSI 0 PSI 0 PSI 0 Pst ICriteria:
t n r - it r.;.•,b -:r i L.tr1. - e
yrna,,t {la r t s 7 r pr tY` ,! y. t :91 2,.
SWRCB, Jar u Eiry 2002
6. PIPING SUMP TESTING
Page S of
Test Method Developed By: F Sump Manufacturer X Industry Standard. Q Professional Engineer
El Other (Speck)
Test. Method Used: C! Pressure Vacuum X Hydrostatic 4
Other (Speci&
Test Equipme t Used: INCON TS -STS Equipment Resolution:
Sump Diameter:
Sump Depth:
Sump # 87
39"
49"
Sump # 91 Sump # DSL Sump # VENT BOX
39"
49"
39"
49" 1
26"
23"
Sump Material: FIBERGLASS FIBERGLASS FIBERGLASS FIBERGLASS
Height from I
Highest Pipin
ank Top to Top of
Penetration: 18" 18" 17" 4"
Height from Tank
Electrical Pen
Top to Lowest
tration:
1519 15" ! 16" _ N/A
Condition of ump prior to testing: GOOD GOOD GOOD GOOD
Portion of Sut rip Tested' 20"
V
20" 19" 6"
Does turbine!
sump sensor
roduct and
but down when
etects liquid (both
ater' ?•
Yes 0 No X NA F7 Yes E No X NA
I
0 Yes 'D No XNA I Yes No X NA r
Turbine shutdown response time
Is system prolVammed
shutdown?*
for fail -safe
Yes J No X NA Yes ` No X NA CI Yes ..J No X NA Yes ;__ No X NA
Was fail -safe
operational?
Wait time between
pressure /vacu
test:
verified to be
applying
m /water and starting
L- Yes E] No X NA
30 MIN
Yes J No X NA
f
30 MIN
Yes L' No XNA
30 MIN
I Yes ,2 No XN,4
30 MIN
Test Start T' e: 11:37 11:57 11:37 ! 11:57 11:37 11:57 10:21 10:45
Initial Reading Rj): 4.286 4.286 4.372 4.372 2.105 2.105 2.278 i 2.278
Test End Time: 11:52 12:12 11:52 12:12 11:52 12:12 10 :36 11:00
Final Readin RF): 4.286 4.286 4.372 4.372 2.106 2.105 2.278 2.278
Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15M[N
Change in Reading RF R ): 001 000 000 000 001 000 000 000
Pass /Fail Threshold or Criteria: 002 002 002 002 002 002 002 -.002
1 l
r31 -' ji w < ,. e i -- ' S,'!= t;rr,}';
Was sensor removed for testing? X Yes D No Ii NA i X Yes No NA X Yes D No NA F_! Yes C No X NA
Was sensor p
verified functional
operly replaced and X Yes :] No NA
after testing?
X Yes No ' NA X Yes Ci No Cl NA Yes i= o X NA.
Comment include informarion on repairs made prior to testing, and recommendedfollow -upforfailed tests)
If the entire epth of the sump is not tested, specify how much was tested. Vthe answer to an of the questions indicated with an
asterisk (1) is' NO" or "NA ", the entire sump must be tested. (See SWRCB LG -160)
GI
SWRCB, January 2002
7. UNDER- DISPENSER CONTAINMENT WDCI TESTING
Lj -;l 36
Page 6 of Q yy
Test Method Developed By: ;7 UDC Manufacturer X Industry Standard Professional Engineer
Other (Spec)
Test Method Used: Pressure C Vacuum X Hydrostatic
Other (Spec)
Test Equipm nt Used: fNCON TS -STS Equipment Resolution:
UDC #1/2 UDC #3/4 UDC #5/6 UDC #
UDC Manu cturer: UNKNOWN UNKNOWN UNKNOWN
UDC Materi l: FIBERGLASS FIBERGLASS FIBERGLASS
UDC Depth: 24" 30" 30"
Height from
of Highest P
UDC Bottom to Top
iping Penetration:
8" 8" 8"
Height from
Lowest Electrical
UDC Bottom to
Penetration:
3" 3" 3"
Condition of
testing:
UDC prior to GOOD GOOD GOOD
Portion of U DC Tested 10" 10" 10"
Does turbine
UDC sensor
product and
shut down when
detects liquid (both
water)?*
Yes :]No X NA D Yes G No X NA C Yes No X NA Yes No NA
Turbine shut own response time
Is system programmed
safe shutdown?*
for fail- Yes No X NA Yes CI No X NA Yes C No X NA Yes No NA
Was fail-safe
operational?'
verified to be
Yes No X NA D Yes 0 No XNA Yes No X NA 0 Yes No D NA
Wait time Ix
pressure /vac
starting test
tween applying
um /water and 30MFN 30MIN 30MIN
Test Start Tine: 1:25 1:41. 1 :41 1 1:57 1:41 1:25
Initial Read' ig (R,): 3.025 3.026 1.803 1.801 3.458_ 3.457
Test End Time- 1:40 1:56 1:58 2:12 1:56 1:40
Final Read' RF): 3.026 1026 1.802 1.799 3.458 3.458
Test Duratio 15MIN 15MIN 15MIN 15MIN 1 SMIN 15MIN
Change in R adin (RF -13q): 001 000 001 002 000 001
Pass/Fail Th eshold or Criteria: 002 002 002 002 002 002
rsernsor emoved for testing? X Yes No NA X Yes D No NA X Yes No DNA Yes 0 No NA
roperly replaced and
ional after testin ? X Yes D No NA X Yes No NA X Yes No DNA Yes D No 0 NA
on repairs made prior io testimz and recommended
Ifthe entir depth ofthe UDC is not tested, specify how much was tested. If the answer to My of the questions indicated with an
asterisk (•) i "NO" or "NA ", the entire UDC must be tested. (Sec: SWRCB LG -160)
SWRCB, J uary 2002 Page -of i}
8. FILL RISER CONTAIIVMF.NT SI1MP TF.ST]NG
Facility is Not Equipped With Fill Riser Containment Sumps Q
Fill Riser Containment Sumps are Present, but were Not Tested
Test Method Developed By: Sump Manufacturer X Industry Standard Professional Engineer
El Other (Specify)
Test Meth d Used: Pressure a Vacuum X Hydrostatic
Other (Spec)
Test Equi
Sum Di
ment Used: INCON TS -STS
Fill Sump # 87 Fill Sump # 91
eter: 37" 37"
Equipment Resolution:
Fill Sump # DSL Fill Sump #
37"
Sump De h: 49" 49" 49"
Height fro
Hi est Pi
Tank Top to Top of
in Penetration:
14" 14" 13"
Height fro
Electrical
n Tank Top to Lowest
enetration:
16" 16" 15"
Condition
testing:
of sump prior to GOOD GOOD GOOD
Portion of ump Tested 16" 16" 15"
F-Sump Ma rial: FIBERGLASS FIBERGLASS FIBERGLASS
Wait time
pressure/v:
starting to
etween applying
cuum/water and
t:
30MIN 30MIN 30MIN
Test Start ime: 10:45 11:19 11:57 12:13 10:21 10:45
Initial Reading R,): 1.567 1.567 2.708 2.709 2.563 2.564
Test End ime: 11:00 11:34 12 :12 12:28 10:36 11:00
Final Rea ing (RF): 1.567 1.570 2.709 2.710 2.564 2.564
Test Dura ion: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN
Change in Reading (R,-Rj): 00 002 001 001 001 001
Pass/Fail eshold or Critcria: 002 002 002 002 002 002
Is there a ensor in the sump? X Yes No X Yes L No X Yes No Yes No
Does the s
either pro
detected?
nsor alarm when
uct or water is Yes No X NA Yes []No X NA Yes No X NA Yes No NA
Was sen removed for testing? X Yes C No NA X Yes No NA X Yes No NA Yes No NA
Was Sens
verified ft
r properly replaced and
nctional after testing') X Yes No NA X Yes :1 No NA X Yes No El NA Yes No NA
SWRCB, January 2002
9. SPILL/OVERFILL CONTAINMENT BOXES,
Page of
Facility is oof Equipped With S ill/Overfiill Containment Boxes Q
Spill./Overfill CContainment Boxes are Present, but were Not Tested C
Test Metho I DDeveloped By: Spill Bucket Manufacturer X Industry Standard E. Professional Engineer
D Other (Spec)
Test Method UUsed: 0 Pressure C Vacuum X Hydrostatic
D Other (Spec)
rest Equip eent Used: INCON TTS -STS EEquipment Resolution:
Buc"Dia eer: 1
Spill Box #87 VPR Spill Box 491 VPR SSpill Box # SSpill Box #
12" 112" 1
Bucket Dep hh: 116"
Wait time b ttween applying
VISUAL FALL 330M N
Test Start 'I' mme: 110:2 l 110:45
Initial Read nng (R,): 22.687 22.687
Test End Time: 11036 111:00
Final Readi gg (RF): 22.688 22.687
Test Duration: 115MIN 115MLN
Change in Reading ( Rr -R,): - 001 - 000
Pass,/Fail T eeshold or - 002 - 002
t s r rr' F
TEST S "FARTED 12:13 Phi
TEST STARTED 10/03/2011
BEGIN LEVEL 2.7092 IN
END TIME 12:28 PIS
END WITE 10/03/2011
END LEVEL 2.7107 IN
LEAK THRESHOLD 0.0x2 IN
TEST RESULT PASSED
TEST STAR-1-ED 12:13 Pit
TEST STARTED 10/03/2011
BEGIN LEVEL 9.0000 IN
END TIME 12:28 PM
END DATE 10/03/2011
END LEVEL 0.0000 iN
LEAK THRESHOL 0.002 IN
TEST RESULT PASSED
rIARKJ 7' EkFkESS2500WBLERDEAWRs'F`ELD CA
10/03/2011 1:40 PP)
SUMP LEAK TEST REPORT
DISP -2
TEST STARTED
TEST STARTED 1325 Pm
BEGIN LEW-L 1 -
0257
x NENDTIME3•b257 IN
END DATE 1:4G Fri
END LEVEL le/03/201f
LEAK i HRESHOL 3.6265 IND0.002 INTESTRESULTPASSED
DISP5 -6
TEST STARTED
TEST STARTED
BEGIN LEVEL
END TIME
END DATE
END LEVEL
LEAK THRES;H0i
TEST RESULT
1:25 PM
10/03'261 i
3.4578 IN
1:40 PM
10/03/2011
3.4582 IN
D 0.002 IN
PASSED
MARKET EXPRESS
2580 WIBLE RD
EAKEF6FIELD CA
10/03/2011 1:57 PM
SUMP LEAr•; TEST REPORT
DISPI -2
TEST STARTED 1:41 PM
TEST STARTED 10/03/2011
BEGIN LEVEL 3.0264 IN
END TIME 1:56 Ph
END DATE 10/03/2011
END LEVEL 3.0266 IN
LEAK THREEHOLD 0.062 IN
TEST RESULT PASSED
DISP3 -4
TEST STARTED 1:41 PM
TEST STARTED 10/03/2011
BEGIN LEVEL i.8W4 IN
END TIME 1:56 PM
END DATE 16/03/2011
END LEVEL 1.8023 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
DISP5 -6
TEST STARTED
TEST STARTED
BEGIN LEVEL
END TIME .
END DATE
END LEVEL
LEAK THRESH01
TEST RESULT
1:41 PM
16/6;3/201/
33.4560 IN
1:56 PM
10/03/2011
3.4580 IN
D 0.002 IN
PASSED
DZSP3_q.
TEiT rARTTESTSTAR7ED 1 °5r' Pp) BEGIN LEVEL 1074011ENDT
ME /.80 NENDDATE2:12 PriENDLEVELlb/13;3,,2011LEAKTHRESHOLD17999INTESTRESJLI0.002 IN
PASSED
nag
IK
91VPR
TEST STARTED 1'3:21 At"'
TEST _STARTED 0/03/2011
BEGIN LEVEL 12.6872 IN
END TIME 10:36 AM
END DATE 0/03/2011
END IE.UEL .6885 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
DSLrIL81
TEST 'TART `ED 10:21 AM
TEST STARTED 1 /03/2011
BEGIN LEVEL 5635 IN
END TIME 10:36 Am
END DATE 1' 03/2611
END LEVEL 5643 IN
LEAK THRESHOLD 002 IN
TEST RESULT PASSED
UENTBX
TEST STARTED 0:21 11111,
STARTED 10 03 /2011
BEGIN LEVEL 2 2782 IN
END TIME 0:36 AM
END DATE 10 03/2011
END LEVEL 2.2783 IN
LEAK THRESHOLD .002 IN
EST RESULT PASSED
RKE: E1crK
25x0 WIB'Li. R AaAKEFSFIELD
1 .34 Am
1F/03/2N11
o tN ! ErlK TEST R PORT
87r 1L$
MARKET EXPRESS
2500 W I BL £ RD
3AK£kSFIELD CA
10/03/2011 11:0Ei Art
SUMP LEAJ< TEST REPORT
87FILS
TEST STARTED 10:45 All
TEST STARTED 10/03/2011
BEGIN LEVEL 1.5675 IN
END TIME 11:00 AM
END DATE 10/03/2011
END LEVEL 1.5677 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
VPR
DSLSTP
TEST STARTED 11:37 AM
TEST STARTED 1
2.0054 1N01BEGINLEVEL
11:52ENDTIME
END DATE 10/03/2011
END LEVEL 2.1060 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
S1STP
TEST STARTED 11:37 AM
TEST STARTED 10/03/2011
BF_GIN LEVEL µl3 ?52 AMENDTIME
END DATE 16/03/2011
END LEVEL 4.3723 IN
LEAK THRESHOLD 0.0,02 I
TEST RESULT
q3n--,)%
TEST STARTED 18:45 API
rJARKef LypRESS
TEST STARTED 10/03/2011 MARKET EXPRESS
BEGIN LEVEL 2.6879 IN 25Hf WI>3± E RD
END TIME 11:00 AM 6'AKEl FIEL GA
END DATE 10/03/2011
LEAK THRESHOLD
TEST RESULT
END LEVEL 2.6876 IN 10/03/2e1i 12:12 Pm
LEAD THRESHOLD 0.002 IN
TEST STAR IED 11 :37 AM
1;.
286711
TEST RESULT PASSED SUMP LEf f TEST REPORT
87STP
USLFILS
END LEVEL INLEAKTHREOLDa. PASSED
TEST STARTED 11:57 AM
TEST STARTED 10:45 AM TEST STARTED 10/03/2011
TEST STARTED 10/03/2011 BEGIN LEVEL 4.2866.IN
BEGIN LEVEL 2.5647 IN END TIME 12:12 PM
END TTNE 11:00 AM END DATE 10/03/2011
END 08TE 1@/03/2011 END LEVEL 4.2863 IN
END LEVEL 2.5647 IN LEAK THRESHOLD 0.002 IN
LEAK THREE#HOLD 0.002 IN TEST RESULT PASSED
TEST RESULT PASSED
91FILS
kA:NTBX
TEST STARTED 10:45 AM
TEST STARRED 10/03/2011
BEGIN LEVEL 2.2782 IN
END TIME 11:06 AM
END DATE 10/03/2011
END LEVEL 2.2782 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
TEST STARTED 11 :57 All,
TEST STARTED 10/03/2011
BEGIN LEVEL 2.7088 IN
END TIME 12 :12 PM
END DATE 10/03/2011
END LEVEL 2.7045 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
DSLSTP
TEST STARTED 11 :57 AM
TEST STARTED 10/03/2011
BEGIN LEVEL 2.1058 IN
END TIME 12:12 PM
END DATE 19/03/2011
END LEVEL 2.1058 IN
LEAK THRE HOLD 0.002 IN
TEST RESULT PASSED
91STP
TEST STARTED
TEST STARRED
BEGIN LEVEL
END TIME
END DATE
END LEVEL
LEAK THRESHOI
TEST RESULT
11:57 .AM
10/03/2011
4.3723 IN
12:12 PM
10/03/2011
4.3722 IN
D 0.002 IN
PASSED
0
1 :19 AM rJARKef LypRESS
TEST ';TARTE:D
STARTED
201'1
11.
250@ WIBLE RDCATEST
3EGIN LEVEL
82 IN
1:34 AM
BAKERSFIELD
11:53 AEIENDTIME
DATE 147 03/2011IN
10/03/2011
i:ND 1 5701ENDLEVEL , X392 IN SUMP LEAP; 7tST REPORT
LEAK THRESHOLD
TEST RESULT
kASSED
8 ?STN
TEST STAR IED 11 :37 AM
1;.
286711TESTSTARTED
BEGIN LEUEL 11:52 AteENDTIMEi0/03/2011ENDDATE4.2966 INENDLEVELINLEAKTHREOLDa. PASSED
TEST RESULT
TEST STARTED 11 :57 All,
TEST STARTED 10/03/2011
BEGIN LEVEL 2.7088 IN
END TIME 12 :12 PM
END DATE 10/03/2011
END LEVEL 2.7045 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
DSLSTP
TEST STARTED 11 :57 AM
TEST STARTED 10/03/2011
BEGIN LEVEL 2.1058 IN
END TIME 12:12 PM
END DATE 19/03/2011
END LEVEL 2.1058 IN
LEAK THRE HOLD 0.002 IN
TEST RESULT PASSED
91STP
TEST STARTED
TEST STARRED
BEGIN LEVEL
END TIME
END DATE
END LEVEL
LEAK THRESHOI
TEST RESULT
11:57 .AM
10/03/2011
4.3723 IN
12:12 PM
10/03/2011
4.3722 IN
D 0.002 IN
PASSED
0
S
LA
SB989 TESTING FAILURE REPORT
E NAME: MARKET EXPRESS DATE: 10/3/11
DRESS: 2500 WIBLE ROAD TECHNICIAN: RICH ISP
CITY. BAKERSFIELD SIGNATURE:
THE FOLLOWING CONIPONENTS WERE REPLACED/REPAIRED TO COMPLETE
STING.
PAIRS: VPR BUCKET VISUAL FAIL. NEED NEW STYLE OPW. NEED
DOTE.
LABOR:
PARTS INSTALLED:
N TITLE:
Sl GNATURE:
THE
T
A
C
ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING
APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR
ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR
NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF
FINES OR PENALTIES OCCURING FROM NON - COMPLIANCE.
COPY OF THIS DOCUMENT HAS BEEN LEFT ON -SITE FOR YOUR
DNVIENENCE.
3l'93