HomeMy WebLinkAboutSB989 RESULTS 20114410A
SWRCB, January 2002 Page __ of
Secondary Containment Testing Report Form
Thu form is intendedfor use by contractors performingperiodic testing ofUST secondary containment systems. Use the
appropriatepages ofthisform to report results for all components tested. The completedform, written test procedures, and
printouts from tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: FREEWAY LIQUORS Date ofTesting: 11/8/11
Facility Address: 2140 E. BRUNDAGE LANE, BAKERSFIELD
Facility Contact: Phone:
Date Local Agency Was Notified ofTesting: 9/23/11
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 0 SWRCB Licensed Tank Tester
License Type: C61/D40 A HAZ License Number: 809850
Manufacturer
Manufacturer Training
Component(s) Date Training Expires
UNL87 SEC PIPE #1 X UNL91 VAPOR X
3. SUMMARY OF TEST RESULTS
Component Pass Fail Not
Tested
Repairs
Made Component Pass Fail Not
Tested
Repairs
Made
UNL87 SEC PIPE #1 X UNL91 VAPOR X
UNL87 SEC PIPE #2 X ANNULAR SPACE 87 X
PREM91 SEC PIPE #1 X p ANNULAR SPACE 91 X 1
PREM91 SEC PIPE #2 X 0 0
UNL87 STP X 0 0
PREM91 STP 0 X 0
UDC #1/2 X D
UDC #3/4 X1 0 0
UDC #5/6 X 1 0 0
UNL87 FILL SUMP X 0 0 0
UNL91 FILL SUMP X 0 0 0
UNL87 VAPOR X 0 1 1
If hydrostatic testing was performed, describe what was done with the water after completion oftests:
CERTIFICATION OF TECRN191AN RESPONSIBLE FOR CONDUCTING THIS TESTING
To the best ofmy knowledge, thefacts slat this document are accurate and infull compliance with legal requirements
Technician's Signature: Date: 11/8/11
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SWRCB, January 2002
d_ TANK ANNTTLAR TFCTTN(:
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Test Method Developed By: Tank Manufacturer X Industry Standard 0 Professional Engineer
Other (Spec)
Test Method Used: 0 Pressure X Vacuum Hydrostatic
0 Other (Spec)
Test Equipment Used: 4" DIAL GAUGE Equipment Resolution:
Tank #87 Tank #91 Tank # Tank #
Is Tank Exempt From Testing ?' 0 Yes X No Yes X No 0 Yes No Yes No
Tank Capacity: 12K 12K
Tank Material: STEEL STEEL
Tank Manufacturer. UNKNOWN UNKNOWN
Product Stored: UNL87 UNL91
Wait time between applying
pressure/vacuum /water and
starting test:
30MIN 30MIN
Test Start Time: 11:00 11:00
Initial Reading (R1): 10.5HG 1 OHG
Test End Time: 60MIN 60MIN
Final Reading (RF): 10.5HG 10HG
Test Duration: 60 MIN 60 MIN
Change in Reading (RF -RO: 0 0
Pass(Fail Threshold or Criteria: 0 0
Test Result: X Pass Fail X Pass Fail Pass 0 Fail 0 Pass Fail
Was sensor removed for testing? X Yes No 0 NA X Yes 0 No NA Yes No 0NA Yes ONO NA
Was sensor properly replaced and
verified functional after testin . X Yes 0 No NA X Yes 0 No NA Yes No 0 NA 0 Yes 0 No 0 NA
Comments — (include information on repairs made prior 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 ofRegulations, Title 23, Section 2637(a)(6))
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SWRCB, January 2002
5. SECONDARY PIPE TESTING
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Test Method Developed By: 0 Piping Manufacturer X Industry Standard 0 Professional Engineer
0 Other (Spec)
Test Method Used: X Pressure Vacuum Hydrostatic
Other (Spec)
Test Equipment Used: 4" DIAL GAUGE Equipment Resolution: .5%
Piping Run #87 #1 Piping Run #87 #2 Piping Run #91 #1 Piping Run #91 #2
Piping Material: PLASTIC PLASTIC PLASTIC PLASTIC
Piping Manufacturer: TCI TCI TCI TCI
Piping Diameter: 2" 2" 2" 2"
Length ofPiping Run: 50' 50' 50' 50'
Product Stored: UNL87 UNL87 PREM91 PREM91
Method and location of
piping-run isolation: BOOT IN SUMP BOOT M SUMP BOOT IN SUMP BOOT IN SUPM
Wait time between applying
pressure /vacuum/water and
starting test:
30 MIN 30 MIN 30 MIN 30 MIN
Test Start Time: 9:30 9:30 11:00 11:00
Initial Reading (Rr): 5PSI 5PSI 5PSI 5PSI
Test End Time: 10:30 10:30 12:00 12:00
Final Reading (RF): 5PSI 5PSI 5PSI 5PSI
Test Duration: 60 MIN 60 MIN 60 MIN 60 MIN
Change in Reading (RF -R,): 0 0 0 0
Pass/Fail Threshold or
Criteria: 0 0 0 0
rTest_Result: X Pass Fail X Pass 0 Fail X Pass []Fail X Pass 0 Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -up forfailed tests)
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SWRCB, January 2002
6. PIPING SUMP TESTING
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Page 4 of
Test Method Developed By: 0 Sump Manufacturer X Industry Standard Professional Engineer
Other (Spec)
Test Method Used: 0 Pressure Vacuum X Hydrostatic
Other (Spec)
Test Equipment Used: INCON TS -STS Equipment Resolution:
Sump #87 91 Sump # Sump #91 7sump
Sump Diameter: 3T' 37"
Sump Depth: 60" 60"
Sump Material: FIBERGLASS FIBERGLASS
Height from Tank Top to Top of
Highest Piping Penetration: 32" 32"
Height from Tank Top to Lowest
Electrical Penetration: 20" 20"
Condition of sump prior to testing: GOOD GOOD
Portion of Sump Tested' 34" 34"
Does turbine shut down when
sump sensor detects liquid (both
product and water) ?*
Yes No XNA Yes No XNA Yes No NA Yes 0 No 0 NA
Turbine shutdown response time 30MIN 30MIN
Is system programmed for fail -safe
shutdown ?* 0 Yes No XNA Yes No XNA Yes No NA Yes No NA
Was fail -safe verified to be
operational?*
Yes No XNA 0 Yes No XNA Yes No NA Yes No DNA
Wait time between applying
pressure/vacuum /water and starting
test
30 MIN 30 MIN 30 MIN 30 MIN
Test Start Time: 2:35 3:00 2:35 3:29 5:14
Initial Reading (Ri): 2.311 2.310 911 4.521 2.806
Test End Time: 2:51 3:15 2:51 3:45 5:29
Final Reading (RF): 2.311 2.310 647 4.291 2.806
Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN
Change in Reading (RF -Ri): 000 000 264 230 000
Pass/Fail Threshold or Criteria: 002 002 002 002 002
Test Result: X Pass 0 Fail Pass X Fail X Pass Fail 0 Pass 0 Fail
Was sensor removed for testing? X Yes 0 No NA X Yes No NA X Yes No NA Yes No 0NA
Was sensor properly replaced and
Lerified functional after testing? X Yes No NA X Yes No NA X Yes No DNA 0 Yes 0 No NA
Comments — (include information on repairs made prior to testing, andrecommendedfollow -upforfailed tests)
91 TEST AT 3:29PM RAN UNDER PRODUCT LINES
91 TEST AT 5:14PM RAN AT TANK COLLAR
Ifthe entire depth of the sump is not tested, specify how much was tested. If the answer to a_y ofthe questions indicated with an
asterisk ( *) is "NO" or "NA ", the entire sump must be tested. (See SWRCB LG -160)
SWRC13, January 2002
7. UNDER- DISPENSER CONTAINMENT (UDC) TESTING
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Page S of
Test Method Developed By: 0 UDC Manufacturer X Industry Standard 0 Professional Engineer
Other (Spec)
Test Method Used: Pressure Vacuum X Hydrostatic
Other (Specify)
Test Equipment Used: INCON TS -STS Equipment Resolution:
UDC #1/2 UDC #5/6 UDC #7/8UDC #3/47UDCanufacturer: ENRON ENRON ENRON ENRON
aterial: PLASTIC PLASTIC PLASTIC PLASTIC
the 30" 30" 30" 30"
egt from UDC Bottom to Top
of Hi est Piping Penetration:
8" 8" 8" 8"
Height from UDC Bottom to
Lowest Electrical Penetration:
9" 9" 9" 9"
Condition ofUDC prior to
testing;
GOOD GOOD GOOD GOOD
Portion ofUDC Tested 10" 10" 10" l0"
Does turbine shut down when
UDC sensor detects liquid (both
product and water) ?'
0 Yes 0 No X NA 0 Yes 0 No X NA 0 Yes No X NA 0 Yes 0 No X NA
Turbine shutdown response time
IS system programmed for fail-
safe shutdown ?'
0 Yes No X NA Yes No X NA 0 Yes No X NA Yes 0 No XNA
Was fail -safe verified to be
operational?*
0 Yes No X NA 0 Yes No X NA 0 Yes 0 No X NA 0 Yes 0No X NA
Wait.time between applying
pressure/vacuum /water and
starting test
30MIN 30MIN 30MIN 30MIN
Test Start Time: 3:00 3:29 4:13 4:28 4:13 4:28 4:13 4:28
Tiiitial Readin (RI): 933 763 1.973 1.974 3.923 3.923 3.682 3.682
Test End Time: 3:15 3:45 4:28 4:44 4:28 4:44 4:28 4:44
Final Reading (RF): 932 763 1.974 1.973 3.923 3.923 3.682 3.682
Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN
Chan a in Reading (RF-R,): 001 000 001 001 000 000 000 000
Pass/Fail Threshold or Criteria: 002 002 002 002 002 002 002 1 -.002
Test Result: X Pass Fail X Pass D Fail X Pass 0 Fail X Pass 0 Fail
Was sensor removed for testing? X Yes D No D NA X Yes No 0 NA X Yes No NA X Yes 0 No 0 NA
Was sensor properly replaced and
verified functional after testing? X Yes 0 No D NA X Yes 0 No 0 NA X Yes 0 No 0 NA X Yes 0 No D NA
CoMinentS - (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
Ifthe entire depth of the UDC is not tested, specify how much was tested. ifthe answer to any of the questions indicated with an
asterisk (") is "NO" or "NA ", the entire UDC must be tested. (See SWRCB LG -160)
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SWRCB, January 2002
S_ FILL RISER CONTAINMENT SUMP TESTING
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Page 10 of
Facility is Not Equipped With Fill Riser Containment Sums
Fill Riser Containment Sumps are Present, but were Not Tested 0
Test Method Developed By: Sump Manufacturer X Industry Standard Professional Engineer
Other (Specify)
Test Method Used 0 Pressure 0 Vacuum X Hydrostatic
0 Other (Spec)
Test Equipment Used: INCON TS -STS Equipment Resolution:
Fill Sump 487 Fill Sump #91 Fill Sump # Fill Sump #
Sump Diameter: 37" 37"
Sump Depth: 60" 60"
Height from Tank Top to Top of
Highest P!ping Penetration:
0 0
Height from Tank Top to Lowest
Electrical Penetration:
16" 16"
Condition of sump prior to
testing:
GOOD GOOD
Portion of Sump Tested 10" 10"
Sump Material: FIBERGLASS FIBERGLASS
Wait time between applying
pressure /vacuum/water and
starting test:
30MIN 30MIN
Test Start Time: 1:01 1:36 12:44 1:01
Initial Reading (Rr): 1.685 2.352 1.832 1.831
Test End Time: 1:16 1:51 1:00 1:16
Final Reading (RF): 1.684 2.356 1.831 1.831
Test Duration: 15MIN 15MIN 15MIN 15MIN
Change in Reading (RF -R,): 001 000 001 000
Pass/Fail Threshold or Criteria: 002 502 002 002
Test Result: X Pass 0 Fail X Pass Fail Pass Fail 0 Pass 0 Fail
Is there a sensor in the sump? X Yes No X Yes No 0 Yes No 0 Yes No
Does the sensor alarm when
either product or water is
detected?
Yes No X NA Yes No X NA Yes 0 No Q NA 0 Yes 0 No 0 NA
Was sensor removed for testing? X Yes No NA X Yes No DNA Yes No DNA 0 Yes No NA
Was sensor properly replaced and
verified functional after testing? X Yes No DNA X Yes No NA Yes No NA 0 Yes 0 No 0 NA
Comments — (include information on repairs made prior to testing; andrecommendedfollow -upforfailed tests)
SWRCB, January 2002
9. SPYLL/OVERFILL CONTAINMENT BOXES
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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 X Industry Standard Professional Engineer
Other (Specify)
Test Method Used: D Pressure Vacuum X Hydrostatic
Other (Specify)
Test Equipment Used: WCON TS -STS Equipment Resolution:
Spill Box #87 VPR Spill Box #91 VPR Spill Box # Spill Box #
Bucket Diameter: 12" 12"
Bucket Depth: 14" 14"
Wait time between applying
pressure/vacuum /water and
starting test:
30MIN 30MYN
Test Start Time: 12:44 1:01 12:44 1:01
Initial Reading 1.111 1.111 3.734 3.733
Test End Time: 1:00 1:16 1:00 1:16
Final Reading (RF): 1.111 I.111 3.734 3.733
Test Duration: 15MIN 15MIN 15MIN 15MIN
Change in Reading (RF -RD: 000 000 000 000
PasVFail Threshold or
Criteria: 002 002 002 002
Test Result: X Pass Fail X Pass Fail Pass Fail Pass Fail
S ..
include information on repairs made prior to testing, and recommended,
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FREEWAY LIQUORS
2140 E BRUNDAGE LN
BAKERSFIELD CA
11/08/2011 i:00 PM
SUMP LEAK TEST REPORT
G7UPR
TEST STARTED 12:44 Ptl
TEST STARTED 11/08/2011
BEGIN LEVEL 1.1117 IN
END TIME 1:00 PM
END DATE 11/68/2011
END LEVEL 1.1112 IN i
k.EAK THRESHOLD' 0.002 IN
TEST RESULT PASSED
FREEIlfjY LIQUORS
2140 E LN
CA
41UPk
1133 Pt1
LEAK TEST REPORTSUMP
BEGIN LEVEL
67VPR
END TIME
END DATE
TEST STARTED.
TEST STARTED
1117 Pig
11i0
3011
8EGIN LEVEL IN
1;33 PMTIME
END DATE 11/08/2011
1ENDLEVEL ,1113 IN
0. LEAK THRE%ie02 IN
TEST
RESULLTULD
PASSED
41UPk
12:44 PM
TEST, STARTED
TEST STARTED
1:17 PM
11/08/2011
3.7333 INBEGINLEVEL1;33 PMENDTIME
END DATE 11/08/2011
3.7333 INENDLEVEL0.002 IN
SU
OLD PASSED
TES .R
END LEVEL
31VFH
TEST STARTED 12144 PM
TEST STARTED 11/08/2011
BEGIN LEVEL 3.7341
3 PMENDTIME
END DATE 11/08/2011
END LEVEL 3.7332 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
91FILSS
TEST STARTED 12:44 PM
TEST STARTED 11/08/2011
BEGIN LEVEL 1.8322
END TIME 00 PM
END DATE 11/08/2011
END LEVEL 1.8319 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
FREEWMY LIQUORS
2140 E BRUNDAGE LN
BAKERSFIELD CA
11/66/2011 1:17 PM
SUMP LEAK TEST REPORT
87LIPR
TEST STARTED 1:01 PM
TEST STARTED 11/08/2011
BEGIN LEVEL 1.1113
MENDTIME
END DATE 11/08/2011
END LEVEL 1.111 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
87FILS
TEST STARTED 1101 PM
TEST STARTED 11/08/2011
BEGIN LEVEL 1.6856 IN
END TIME 1116 PM
END DATE 11/08/2011
END LEVEL 1.6840 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
91UPR
TEST STARTED 1:01 PM
TEST STARTED 11/08/2011
BEGIN LEVEL 3.7331 IN
END TIME 1:16 PM
END DATE 11/08/2011
END LEVEL 3.7333 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
91FILS
TEST STARTED 1:01 PM
TEST STARTED 11/08/2011
BEGIN LEVEL 1.8319 IN
END TIME 1:16 PM
END DATE 11/08/2011
END LEVEL 1.8317 IN
LEAK THRESHOLD 0.002 IN
FREEWAY- LIQUORS
2140 E BRUNDAGE LN
BAKERSFIELD CA
11/0812011 1:52 PM
SUMP LEAK TEST REPORT
87VPR
TEST STARTED 1136 PM
TEST STARTED 11/08/2011
BEGIN LEVEL 1.1248 IN
END TIME 1:51 PM
END DATE 11/08/2011
END LEVEL 1.1249 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
87FILS
TEST STARTED 1:36 Pm
TEST STARTED 11/08/2011
BEGIN LEVEL 2.3567 IN
END TIME 1151 PM
END DATE 11/08/2011
END LEVEL 2.3569 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
FREEWAY LIQUORS
2140 E BRUNDAGE LN
BAKERSFIELD CA
11/08/2011 2:51 PM
SUMP LEAK TEST REPORT
87STP
TEST STARTED 2 :35 PM
TEST STARTED 11/08/2011
BEGIN LEVEL 2.3116 IN
END TIME 2:51 PM
END DATE 11/08/2011
END LEVEL 2.3112 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
DI5P1"2
3:
DLSP1 -2
TEST STARTED 3:24 PVI
TEST STARTED 11/06/2011
BEGIN LEVEL 0.7639 INPM
El.D 71iiE 11/081201'1ENDDATE (2.7637 IN
aa 9
TEST STARTED 11/68
00 Ptq
x011
0.933TEST
BEGIN LEVEL
END TIME
3 15,011
10/y -4
IN
END DEQF -L IN
THRESHOLD
0' pRg ,EDARK
TEST RESV --
DLSP1 -2
TEST STARTED 3:24 PVI
TEST STARTED 11/06/2011
BEGIN LEVEL 0.7639 INPM
El.D 71iiE 11/081201'1ENDDATE (2.7637 IN
aa 9
C-EgRUNflH y
2140. IE p
4:44 PM
11/fW iESY
REP091
pISP S
I.pa 4' 1
BEN 1 TIP16 11/x/20
IN
EHp,ppTE -9.21Z IN
Etdt7 gr1p1 0• PH$5 p
r
a
LILAul tPR.EEWMY LIQUORS
wrnrtir-p 4:28 Ff9TESTSTARTED1.1/08/2011BEGIN2140EBRUNDAGELN
BAK.ERSFIELD CA
LEVEL 1.9TIME740 IN
11/08/2011
END 4:44 PMNDDATE11/08/2011ENDLEVEL4:28 FM 1.9739 INLEAKTHRESHOLD
SUMP LEAK TEST REPORT TEST RESULT 0.002 IN
PASSED -
DISP5 -6
DISP ? -8TESTSTARTED4:13 PMTESTSTARTED11/08,2011 TEST S
T STARTED 4 :28 PP1ESTBEGINLEVEL '3.9,233 INENDTIME
STARTED 11/8,8/2011VELEN[i4:28 PM
END LEVEL 13.923
011 3.6825 INTIME
END DATE 4'44 PM3.923 INLEAKTHRESHO'D END LEVEL 11/03/20110.002 INTESTRESULTPASSED LEAK THRESHOLD 3.6826 INTESTRESULT .0.002 IN
PASSED
DISP3 -4
TEST STARTED, 4:13 PM
TEST STARTED 11/08/2011
BEGIN LEVEL 1.9738 IN
END TIME 4:28 PM FREEt*Y 'LIQUORS
END DATE 11/08/2011 49 E BRWtP GE LN
END LEVEL 1.9741 IN 8' ERSFIELP, CAAK
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED ll/08/201i ; -'.: `;;5:29 PM
SUMP LEAK TEST`kEPORTDISP ? -8.
91STP
TEST' STARTED, 4:13 PM
TEST. STARTED 11/08/2011 TEST STARTED 5:14 PM
BEGIN LEVEL' 33.6827 IN TEST STARTED 11/08/2011
END TIME 4 :28 PM BEGIN LEVEL .8069 IN
5:29 P19ENDDATE11/08/2011
END LEVEL 3.6826 IN END TIME
END 'DATE 11/08/2011
LEAK THRESHOLD 0.002 IN END LEVEL_ 2.8067 IN
INTESTRESULTPASSEDLEAKTHRE:4OLD 0.00213 ; i
TEST RESULT PASSED
C-EgRUNflHy
2140. IE p
4:44 PM
11/fW iESY
REP091
pISP S
I.pa 4' 1
BEN1 TIP16 11/x/20
IN
EHp,ppTE -9.21Z IN
Etdt7 gr1p1 0• PH$5 p
r
a
LILAul t
ii
FRMJAY LIQUORS
2140 E BRUNDAGE LN
BAKERSFIELD CA DISP3 -4
11/08/2x11 4:28 Fhi TEST STARTED 4:28 PhiTESTSTARTED11/08/20!1BENINSUMPLEAKTESTREPORTLEVEL1.9740 INEND
DISP5 -6
TIME 4:44 P9ENDDATE11/08/2011
TEST STARTED 4;13 PM
END LEVEL 1.9735 INLEAKTHRESHOLD0.002 INTESTSTARTED1110812 -011
LEVEL
TEST RESULT PASSEDBEGIN3.923 IN
END TIME 4:26 PM
END DATE 11/08/2011 DISP7 -8
END LEVEL 3.5233'Ih1
LEAK THRESHOLD 0.002 IN TEST STARTED 4:28 PmTESTRESULTPASSEDTESTSTARTED11/08/2011
3.6826ENDTIME PMENDDATE08,1 20ENDLEVEL3.6826 NLEAKTHRESHOLDJ0.006 INTESTRESULTGISP.3 -4 PASSED
TEST STARTED 4:13 PM
TEST STARTED 11/08/2011
u: BEGIN LEVEL 1.9738 IN
END TIME 4:28 PM
END PATE 11/08/2011
END LEVEL 1.9741 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
DISP7 -8
TEST STARTED 4:13 PPi
TEST STARTED 11/08/2011
BEGIN LEVEL 3.6827 IN r t,•t m m m -1 -+ m z z rq m PI WENDTIME4:28 PM rn z
U7 S7G gG' co U)
END DATE 11/08/2011
9- nf3i 2 sENDLEVEL3.6826 INI
A m
rn c-sr. -,-i r- s x mLEAKTHRESHOLD0.002 IN v, 70 m r t m m x x' _, m
TEST RESULT PASSED y} - w
6 w
FREEWHY LIQUORS t,.c.-:', ' j ", .
2140 E BRUNDAGE LN
BAKER'SFIELD CA @pa rJt },mom c. emu,
mT w6Q, _ a - i r
11 /0fs /2+ 11 4:44 Pht
D ty -P' —{
SUMP I.E.AK, TEST REPORT
DISP5 -6
y.
TEST STARTED 428 Ph1
TEST.STARTED 11/08/2011
BEGIN LEVEL 3.4233 IN
END TIME 4:44 PM
END DATE 11/08/2011
END LEVEL 3.9233 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
SB989 TESTING FAILURE REPORT
SITE NAME: 15;ol-z- L kL A z Z-! 9 L--0 /-J DATE: %mot
TECHNI
13 -AJ4 "Z,
Lh V7,o9 /
THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE
TESTING.
REPAIRS: TZ2
LABOR:
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
Q CONVIENENCE.
F-117,