HomeMy WebLinkAbout2011 SB989 RESULTSSWRCB, January 2002 Page _ of
Secondary Containment Testing Report Form
Thisform is intendedjor use by contractors performing periodic testing ofUST secondary containment systems. Use the
appropriate pages of this form to report resultsfor all components tested The completedform, written test procedures, and
printoutsfrom lests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulaion, agency.
1. FACILITY INFORMATION
Facility Name: CHEVRON Date ofTestima: 9/12/11
Facility Address: 5609 STING ROAD, BAKERSFIELD
Facility Contact: Phone:
Date Local Agency Was Notified of Testing: 8/18/1 t
Name of Local Agency Inspector (fpresent during testing):
2. TESTING CONTRACTOR INFORMATION
Company Name: Rich Environmental
Pass
Technician Conducting Test: RICH PHILLIPS
Not
Tested
Credentials: X CSLB Licensed Contractor i] SWRC13 Licensed Tank Tester
License Type: C61/1340 A HAL License Number: 809850 t
Manufacturer
INCON
Manufacturer Training
Component(s) Date Training Expires
TS -STS 6/11 /2012
UNL87 ANNULAR X UDC 95/6
3. SUMMARY OF TEST RESULTS
Component Pass Fail Not
Tested
Repairs
Made Component Pass Fail Not
Tested
Repairs
Made
UNL87 ANNULAR X UDC 95/6 17 X
PREM91 /DSL ANNULAR X LI Ci UDC #7/8 1] X
UNL87 SEC PIPE 1 -6 X UDC #9/10 X f_i
LINL87 SEC PIPE 7 -10 X L] L-" i UNL87 FILI, SUMP I o f. i
PREM91 SEC PIPE 1 -6 X PREM91 FILL SUMP 71
PRE-M91 SEC PIPE 7 -10 X 0 DIESEL FILL SUMP C
DIESEL SEC PIPE X p UNL87 VAPOR BUCKET X I1 h
STP 0 PREM91 VAPOR BKT XUNL87
STP X L li i i C'; PREM91
DIESEL STP X I C
UDC 91/2 X U 01 1 r-1 F1
UDC #3/4 X L1 LI i:;
Ifhydrostatic testing was performed, describe what was done with the water after completion of tests:
CERTIFICATION OFTECHVeTAN RESPONSIBLE FOR CONDUCTING THIS TESTING
To the best ofmy knowledge, thefacts stat this document are accurate and infull compliance with legal requirements
Technician's Signature:_ — 4__ _. W_.
Date: 9/12/11
S WRC B, January 2002
4. TANK ANNULAR TESTING
t7 to
Page ' Z' of
Q\ . I
Test Method Developed By: 0 Tank Manufacturer X Industry Standard 0 Professional Engineer
n Other (Spec)
Test Method Used: 0 Pressure X Vacuum Cl Hydrostatic
0 Other (Sped)
Test Equipment Used: 4" DIAL. GAUGE Equipment Resolution:
Tank # 87 Tani: # 91 /DSL Tank # Tank #
Is Tank Exempt From Testing?' 11 Yes X No FJ Yes X No 0 Yes n No C Yes D No
Tank Capacity:
Tank Material: STEEL STEEL
Tank Manufacturer: UNKNOWN UNKNOWN
Product Stored: UNL87 PREM91 /DSL
Wait time between applying
pressure /vacuum /water and
startin test:
30MIN 30MIN
Test Start Time: 9:00 9:00
Initial Reading (R,): IOHG l0HG
Test End Time: 10:00 10:00
Final Reading (RF): I OHG IOHG
Test Duration: 60 MIN 60 MIN
Change in Reading (R, -R,): 0 0
Pass/Fail Threshold or Criteria: O 0
Test ResWt X Pass::_, G £aih X Pass ' O,Eail f] (Pass` Q: Fail 0 Pass. C1.1Eaii
Was sensor removed for testing? X Yes L1 No DNA X Yes ONO U NA 0 Yes n No DNA O Yes FI No FI NA
Was sensor properly replaced and
verified functional after testin ? X Yes No Cl NA X Yes No t. NA Cl Yes U No NA f_l Yes U No DNA I
Comments — (include information on repairs made prior to testing, and recommended.Jollow -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 PLPE TESTING
Page 3 of 1
Test Method Developed By: Piping Manufacturer X Industry Standard U Professional Engineer
U Other (Spec)
Test Method Used: X Pressure U Vacuum Hydrostatic
Other (,Specify)
Test Equipment Used: 4" DIAL GAUGE Equipment Resolution: _5%
Piping Run #87 1-6 Piping Run 487 7 -10 Piping Run #91 1 -6 Piping Run #91 7 -10
Piping Material: FIBERGLASS PLASTIC FIBERGLASS PLASTIC
Piping Manufacturer: SMITH TCI SMITH TCl
Piping Diameter: 3" 2" 3" 2"
Length of Piping Run: 150' 1.00' 150' 100'
Product Stored: UNL87 IJNL87 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: VISUAL FAIL 10:00 10:00 VISUAL FAIL
Initial Reading (Rj): 5.5 5.0
rest End Time: 11:00 11:00
Final Reading (RF): 5.5 5.0
Test Duration: 60 MIN 60 MIN 60 MIN 60 MIN
Change in Reading (RF -R {): 0 0
Pass /Fail Threshold or
Criteria: 0 PSI 0 PSI 0 PSI 0 PSI
Test Result::" D Pass . Xat! X':Pass ::[1 Fatl -_ X'Pass . :O Fail. n Pass:;_:: X 1Fa(t
Comments — (include in/ormalion on repairs made prior to testing, and recommendedfollow -up for, failed tests)
TEST BOOTS BAD
SWRCB, January 2002
5. SECONDARY PIPE TESTING
C) lD" //
Page 4 -of _
Q r
l
Test Method Developed By: 1-1 Piping Manufacturer X Industry Standard 0 Professional Engineer
U Other (Spec)
Test Method Used: X Pressure 0 Vacuum Hydrostatic
n Other (Sped)
Test Equipment Used: 4" DIAL GAUGE Equipment Resolution: .5%
Piping Run #DSL
Piping Material: FIBERGLASS
Piping Run # Piping Run # Piping Run #
Piping Manufacturer: SMITH
Piping Diameter: 3"
Length of Piping Run: 75'
Product Stored: DIESEL
Method and location of
piping-run isolation:
BOOT IN SUMP
Wait time between applying
pressure/vacuum /water and
startin test:
30 MIN
Test Start Time: 10:00
Initial Reading (R,): 5PS1
1'est End Time: 11:00
Final Reading (RF): 5PSl
Test Duration: 60 MIN
Change in Reading (RrR,): 0
Pass /Fail Threshold or
Criteria: 0 PSI
Test Result X Pass O;;Fail O; .Pass 0 Fail " _ Q .= P ss ; b* : fl Pass'..: 0 Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
SWRCB, January 2002
6_ PIrPiNG Si1MP TESTING
I'D o
Page of
Test Method Developed By: Sump Manufacturer X Industry Standard Professional Engineer
0 Other (Specify)
Test Method Used: 0 Pressure Vacuum X Hydrostatic
0 Other (Specify)
Test Equipment Used: INCON TS -STS Equipment Resolution:
Sump #87
Sump Diameter: 37"
Sump #91 Sump #DSL Sump #
37" 37"
Sump Depth: 52" 52" 52"
Sump Material: FIBERGLASS FIBERGLASS FIBERGLASS
Height from Tank Top to Top of
Piping Penetration: 32" 32" 18" Highest
Height from Tank Top to Lowest
Electrical Penetration: 21" 21" 21"
Condition of sump prior to testing: CLEAN CLEAN CLEAN
Portion of Sump Tested' 34" 34" 20"
Does turbine shut down when
sump sensor detects liquid (both
product and water)?*
0 Yes No DNA 0 Yes 0 No DNA 0 Yes No NA 0 Yes 0 No 0 NA
Turbine shutdown response time
is system programmed for fail -safe
shutdown ?* 0 Yes 0 No NA 0 Yes 0 No DNA Yes No DNA Yes No DNA
Was fail -safe verified to be
operational?*
Yes No NA Yes No NA Yes No 0 NA Yes 0 No 0 NA
Wait time between applying
pressure/vacuum /water and starting
test:
30 MIN 30 MIN 30 MIN 30 MIN
Test Start Time: 12:00 12:17 12:00 12:15 10:27 10:49
Initial Reading (Rj): 2.494 2.495 2.540 2.544 2.201 2.218
Test End Time: 12:15 12:32 12:15 12:32 10:42 11:04
Final Reading (RF): 2.495 2.496 2.541 2.541 2.201 2.217
Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN
Change in Reading (RF -Ri): 001 001 001 001 001 001
Pass/Fail Threshold or Criteria: 002 002 002 002 002 002
Test Result:..; X Pass. Fell X. Pass , Fail X! 'Pass:.. 0 Fail .:. Pass- .. :Fail
Was sensor removed for testing? X Yes 0 No NA X Yes 0No NA X Yes 0 No NA Yes No DNA
Was sensor properly replaced and
verified functional after testing? X Yes 0 No NA X Yes No 0NA X Yes 0 No DNA Yes No 0 NA
Comments — (include information on repairs madeprior to testing, andrecommendedfollow -upforfailed tests)
Ifthe entire depth of the sump is not tested, specify how much was tested. Ifthe answer to any ofthe 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 (UDC) TESTING
R 'D LbV
Page (10 ofI_
Test Method Developed By: UDC Manufacturer X Industry Standard Professional Engineer
11 Other (Spec)
Test Method Used: L1 Pressure 0 Vacuum X Hydrostatic
J Other (Specify)
Test Equipment Used: INCON TS -STS Equipment Resolution:
UDC #1/2 UDC #3/4 UDC 45 /6 UDC #7/8
UDC Manufacturer: UNKNOWN UNKNOWN UNKNOWN TC1
UDC Material: FIBERGLASS FIBERGLASS FIBERGLASS PLASTIC
UDC Depth: 30" 30" 30" 30"
Height. from UDC Bottom to Top
of Ni hest Piping Penetration:
14" 14" 14" 10"
Height from UDC Bottom to
Lowest I ?.lectrical Penetration:
2" 2" 2" 2"
Condition ofUDC prior to
tcstin;:
CLEAN CLEAN CLEAN CLEAN
Portion of UDC Tested 16" 16" 16" 16"
Does turbine shut down when
UDC sensor detects liquid (both
product and water)?*
17 Yes []No XNA LI Yes No XNA Yes 0 N X NA CJ Yes 0 No X NA
Turbine shutdown response time
Is system programmed for fail-
safe shutdown? Yes No X NA Cl Yes U No XNA U Yes nNo XNA li Yes n No X NA
Was fail -safe verified to be
operational?*
Yes 1:7 No XNA 17 Yes LI No XNA 17 Yes F1 No X NA C; Yes +i No XNA
Wait time between applying
pressure /vacuum/water and
starting test
30MIN 30MIN 30MIN 30MIN
Test Start Time: 12:00 12:17 1 1:27 1:46 VISUAL FAIL VISUAL. FAIL
Initial Reading (R1): 4.1.08 4.110 3.398 3.400
Test End Time: 12:15 12:32 1:42 2:01
Final Kcading (RF): 4.110 4.111 3.400 3.400
Test Duration: 15MIN 15MIN 15MIN 15MIN
Chan a in Reading RF -R,): 002 001 002 0007
Pass/Fail Threshold or Criteria: 002 1 .002 002 002
TesrResult .: ,: X bass`'. C]:)Fauf X Pass::: [7 Faii1= Pass Pass::' X Fail:.:,;.
Was sensor removed for testing? X Yes U No CJ NA X Yes No DNA Yes No 1 NA Yes 17 No Cl NA
Was sensor properly replaced and
verified functional after testin ? X Yes No NA X Yes F3 No DNA Yes No NA Yes CJ No DNA
Comments — (include information on repairs made prior to testing, and recommended follow -ripforfailed tests)
DISP #5/6,x# 7/8 VISUAL FAILURE ON TEST BOOT ON LISP #718 AND
CRACKS IN FIBERGLASS SECONDARY DISP #516
Ifthe entire depth ofthe UDC 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 UDC must be tested. (See SWRCB LG -160)
SWRCB, January 2002
7. UNDER- DISPENSER CONTAINMENT (UDC) TESTING
t wt..,
Page i of I
rest Method Developed By: n UDC Manufacturer X Industry Standard Cl Professional Engineer
D Other (Spec)
Test Method Used: C Pressure Vacuum X Hydrostatic
Q Other (Spec)
Test Equipment Used: 1NCON TS -STS Equipment Resolution:
UDC #9/10 UDC # UDC # UDC #
UDC Manufacturer: TCI
UDC Material: PLASTIC
UDC Depth: 24"
Height from UDC Bottom to Top
of Highest Piping Penetration:
10"
Height from UDC Bottom to
Lowest Electrical Penetration:
2"
Condition of UDC prior to
testing:
CLEAN
Portion of UDC Tested 12"
Does turbine shut down when
UDC sensor detects liquid (both
product and water)?*
U Yes IJ No I7 NA U Yes l7 No 13NA Tn Yes Ll No DNANA f7Yes DNo fl NA
Turbine shutdown response time
Is system programmed for fail-
safe shutdown ?' L-] Yes 11JNo DNA D Yes DNo LI NA J Yes D No L NA U Yes D No ,j NA
Was fail -safe verified to be
operational?*
D Yes D No [.I NA f ]Yes DNo DNA D Yes O No fINA D Yes DNo DNA
Wait time between applying
pressure /vacuum /water and
starting test
30MIN
rest Start Time: 1:27 1:46
Initial Reading (RI): 2.656 2.658
Test End Time: 1:42 2:01
Final Readin (Ri:): 2.658 2.658
Test Duration: 15MIN I 15MIN
Change in Reading (RF -R,): 002 -.000
Pass/Fail Threshold or Criteria: 002 -.002
Test Result:.. X Pass: a Fail Pass -.. C1 Rail.:. 7: Pass :: C- Fsii: 8 Pass O Fail .
Was sensor removed for testing? X Yes DNo ON U Yes C No DNA 11 Yes D No C NA C1 Yes C No O NA
Was sensor properly replaced and
verified functional after testing? X Yes DNo DNA D Yes No DNA o Yes D No C NA 11 Yes [I No Ll NA
Comments — (include information on repairs made prior to testing, and recommendedfollow -up for. failed tests)
1 f the entire depth ofthe UDC 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 UDC must be tested. (See SWRCB LG -160)
SWRCB, January 2002
R_ FftJ,RISER ('ONTAINMENT SUMP TESTING
f:) l -bb
Page of
Facili is Not Equipped With Pill Riser Containment Sums
Fill Riser Containment Sumps are Present, but were Not Tested
Test Method Developed By: CI Sump Manufacturer X Industry Standard 11 Professional Engineer
G Other (Specify)
Test Method Used: Pressure D Vacuum X Hydrostatic
C1 Other (Sped)
Test Equipment Used: INCON TS -STS Equipment Resolution:
Sump Diameter:
Fill Sump #
Rem
Fill Sump # Fill Sump
um
Fill SUM2 #
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 ofSump Tested
Sump Material:
Wait time between applying
pressure /vacuum/water and
starting test:
30MIN
Pest Start Time:
Initial Reading (Rj):
Test End Time:
Final Reading RF):
Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN
Change in Reading-(RF -Rj :
Pass/FaiI Threshold or Criteria:
Test'Resialt:`; d Pass: O Fail D Pass. B$il D Pas§ Fail D Pass =' a. Fail . '
Is there a sensor in the sump? 11 Yes D No 13 Yes No Yes 13 No LI Yes 0 No
Does the sensor alarm when
either product or water is
detected?
Yes No NA Yes No NA Yes No Cl NA r Yes D No 17 NA
Was sensor removed for testing? Yes Ll No 11 NA C3 Yes No NA 1 Yes 13-No t7 NA I_Yes Li No _^ NA
Was sensor properly replaced and
verified functional after testin ? Q Yes No 11 NA 7 Yes No L1 NA Yes L No tl NA ID Yes IJ No Fl NA
CoMmentS — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests) _
NO FILL SUMPS
SWRCB, January 2002
9. SPILL/OVERFILL CONTA1NNMNT BOXES
1l
J t u
n
v
Page —1 of `\
Facility is Not Equipped With Spill/Overfill Containment Boxes DSpill /Overfill Containment Boxes are Present, but were Not Tested Ci
Test Method Developed By: U Spill Bucket Manufacturer X Industry Standard U Professional Engineer
0 Other (Specify)
rest Method Used: U Pressure U Vacuum X Hydrostatic
U Other (Specify)
Test Equipment Used: INCON TS -STS Equipment Resolution:
Spill Box #87 VPR Spill Box #91 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
rest Start Time: 10:27 10:49 10:27 10:49
Initial Reading (Ri): 2.524 2.524 2.482 2.481
test End Time: 10:42 11:04 10:42 11:04
Final Reading (Rr): 2.525 2.525 2.482 2.481
Test Duration: 15MIN 15MIN 15MIN 15MIN
Change in Reading (R,: Rl): 001 +.001 000 000
Pass /Fail Threshold or
Criteria: 002 -.002 002 002
A: Pass:: 0..2 l X; Bass - :D Fail D :)Pass ;.: D fail; D Pass. Fail:
Comments — (include inLrmation on repairs made prior to resting and recommendedfollow -upfor.failed tests)
CHEORON
560? S71mE RD
SAKERSPIELD CA
09/12/201 i 11:04 Are
6UMP wEHK TEST REPORT
041,
ST MW ED 10;49 Am
TEST STARTEM09/iWOn
WEGIN LWEL 2.5246 IN
END TIME 11:04 AM
iND GATE 09/12/2e11
END LEVEL 2.5254 IN
WK THRESHOLD 0.002 1H
TEST RESULT PASSED
91FILB
TEST STARTED 10:49 AM
TEST STARTED 09/12/201.1
BEGIN LEVEL 2.4817 IN
END TIME 11104 AM
END DATE 09/12/2011
END LEVEL 2.4818 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
DSLSTP
TEST STARTED 10:49 AM
TEST STARTED 09/12/201 "A
BEGIN LEVEL 2.2180 1
END TIME 11:04 A
END DATE 89112.2810
END LEVEL 2.2173,
tT-AK THRESHOLD 0.002 IN-:
TEST RESULT PA;Pgb
A , AQ
5609 STINE RD
SAKERSFIELD CA
09/12/20!1 10%42 AN
SUMP LEAK TEST REPORT
801W
TEST STAR"ilD 1012? AM
TEST STARTED 09112/2011
BEGIN LEVEL 2.5248 IN
END TIME 10:42 AM
END DATE 09/12/2011 -1
END,LEVEL 2.5252 IN .4
LA THREWOLD 0.002 IN QA
TEST RESULT PASSED Z
91FILS Z_10
OwTESTSTARTED10:27 AN
TEST STARTED 09/1'2/261,1
14, BEGIN LEVEL 2.4928 JA
END TIME 19:42 A
jt-" END DRTE. 0 1
END. 2.022 MIT111
L Fig D 6.002 I
Tf&
THRESHOLD
RESULT-,-, PASSED
DSLSTP
TEST STARTED 10270m
TEST STARTED K/1?/2011
BEGIN LEVEL 2.2011 IN
END TIME 10-42 AMENDDATE' 09/W20li
END LEVEL 2.2017 IN
LEAK THRESHOLD 0.002 IN 1
TEST RESULT PASSED
I.... I - --. - -- -1 . ---L-t 116b
5609 SINE Q
WKERSPE0 CA
04/12/20o A42 pp*
SW wEAK TEST REPORT
DISQ-4
T87 WARTED W? Pm
TEST STARTED 09/12/201:
BEGIN QUEL 3,3980 IN
E&D 71ME. !:42 Pri
imo 06TE 09/12/2011
END LEQEu 1.4000 ir,;
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
WSP910
TEST STARTED W? A
TEST STARTED 09/12/2011
BEGIN LEVEL 2.6562 IN
END TIME 1:42 Am
END DATE 09/12/200.
END LEVEL 2.6584 a
LEAK THRESHOLD 0.002 Its
TEST RESULT INCREASED
YAK THRESHOLD 6.002 IN
7EST .RESULT
Gf-;EijRON
5609 STINE P0
WERSFIELO CA
09/12/ 2011 am
SUMP LEW TEST REPORT
0103-a
TEST STARTED ', 1:46 09
TEST STARTED 09/12/2@1!
WIN 0VEL 3.4002 lN
END QmE 2:0 Pm
END OATE 09/12/2011
END LEVEL 3.4004 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
DISR910
TEST STARTED 1:46 W;
TEST STARTED 09/12/2011
BEGIN LEVEL 2.6586 hv.
AD TIME 2:01 PM
END DATE 09/i2/201!
END LEVEL 2.6589 W
YAK THRESHOLD 6.002 IN
7EST .RESULT PASSED
f
4EVRON
56E STINE RD8AKER' FIELD ch 5609 ST(NE RD
9 2. 6AKEi6PIELL) C;A
SUMP TEST REPORT 09/12/20)l 2 :32 PP*,
LEAK 'TtST REPORT
W'E -0 12:00 PMTEST
67STP
EGI r-VEL 2.4941 YEST. STARTED 12'17 Pil
END . f ImE IN
N") ..22:.,5 Pp.f TEST STARTED 09/12/20!i
H7E 09,,'12120ilEND
BEGIN LEVEL 2.4956 IN
LEVE, -
AK ,R z 2.495.5 1r4kSHOLD0-002
END TIME
END :,'PHTE
12:32 Pm
09/12/2011
EF: RESULT IN
PASSED ENE) LEVEL
HRr--6HOLO
2.4961 IN
LcAK 0.002 lN
TEST RE,,UL-l' PASSED
41 S
E .5ii R7EO !2:00 ppCl - :Z, f NRTEo
iSTP
R4iN LEVEL. 2.540 1 TEST STARTED 12:17 PM
ME
END I)A'IE 12, 15 pf, TEST STARTED 09/12/2011
ND 09/12/2011 BEGIN LEVEL 2.5414 IN
LEVELLEAKTHRESHOLD Z.5415 IN END TIME
END DATE
12:32 PM'
09/12/2011
tRESLLr 0.402 It,
PASSED END LEVEL 2.5413 IN',
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
OISPI-2
137f)R- 1" pED klo pmTES. T '
DISPI-2
S I TED 09 /12,'2011GINLEQEL4.laDq TEST STARTED 12,17 Pm
AND IME IN
12: i5 pp-, TEST STARTED 09/12/201'.
ND DATE 9/12/2011N0 BEGIN LEVEL 4.1109 IN
LEVEL 4.1107 IN1HRESHOLD0.002
END TIME
ENDND DATE
12:32 PM
2t:AK 09lZe-011INRESULTPASSEDENDLEVEL4.1112 IN
LEAK THREa4OLD 0.002 IN
TEST RESULT PASSED
43r4`6
SB989 TESTING FAILURE REPORT
SITE NAME: CHEVRON DATE: 9/12/11
THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE
TESTING.
REPAIRS: ioJ T fl
tD 0-61 i i CL"Lb1- ra /Z ( /-.,k J
G
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 ENVIRONMENTAL 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.
SWRCB, January 2002 Page t of
Secondary Containment Testing Report Form
This form is intendedfor use by contractors performingperiodic testing of UST secondary containment systems. Use the
appropriate pages ofthisform to report resultsfor all components tested The completedform, written testprocedures, and
printoutsfrom tests (rfapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: CHEVRON I Date of Testing: 9/12/11
Facility Address: 5609 STWE ROAD, BAKERSFIELD
Facility Contact: Phone:
Date Local Agency Was Notified ofTesting:
Name of Local Agency inspector (ifpresent during testing):
2. TESTING CONTRACTOR INFORMATION
Company Name: RICH ENVIRONMENTAL
Technician Conducting Test: JAMES RICH
Credentials: X CSLB Licensed Contractor SWRCB Licensed Tank Tester
License Type: C61 / D40 License Number: 809850
Manufacturer Training
Manufacturer Component(s) Date Training Expires
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: 9/12/11
Component
UNL87 SEC PIPE 1-6
PREM91 SEC PIPE 7-10 oo m o oo.
a000; or oo
niao ono:
0000 ono
omoo aano s
o00o anoo
ain o; oaoo
onoo noon
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: 9/12/11
SWRCB, January 2002
5. SECONDARY PIPE TESTING
aac,FJv
Page z of Z
Test Method Developed By: Piping Manufacturer Industry Standard Professional Engineer
Other (Spec)
Test Method Used: Pressure Vacuum Hydrostatic
Other (Specify)
Test Equipment Used: Equipment Resolution:
Piping Run #87 1 -6
Piping Material: FIBERGLASS
Piping Run #917-10 Piping Run # Piping Run #
PLASTIC
Piping Manufacturer. SMITH TCI
Piping Diameter 3" 2"
Length of Piping Run: 150' 100'
Product Stored: UNL87 PREM91
Method and location of
piping-run isolation: BOOT IN SUMP BOOT IN SUMP
Wait time between applying
pressure/vacuum/water and
test:
30 MIN 30 MIN
starting
Test Start Time: 6:00PM 5:30PM
Initial Reading (R): 5.0 PSI 5.1 PSI
Test End Time: 7:OOPM 6:30PM
Final Reading (RF): 5.0 PSI 5.1 PSI
Test Duration: I -HOUR 1 -HOUR
Change in Reading (RF -R): 0 0
Pass/Fail Threshold or
Criteria: 0.00 0.00
Test Result: X Pass Fail X Pass Fail Pass Fail Pass Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
REPLACED TEST BOOTS ON 87 AND 91
NAbS -4,-
SB989 TESTING FAILURE REPORT
SITE NAME: CM12caN DATE:
THE FOLLOWING COMPONENTS WERE REPLACENREPAIRED TO COMPLETE
TESTING.
LABOR: / &2 5'tl4fc FSl 4& i2y
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