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HomeMy WebLinkAboutFMC 2016IMPACT VALVE LEAK DETECTOR MONITOR CERTIFICATION SPILL BUCKET TEST 11000 N. MoPac Expressway, Suite 500 Austin, Texas 78759 Phone: (512) 451-6334 Fax: (512) 459-1459 Date Printed and Mailed: 3/28/2016 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR ERNIE MEDINA 1501 TRUXTUN AVE. BAKERSFIELD, CA 93301 Test Date: 3/24/2016 Order Number: 3429174 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: 7-ELEVEN #32376, MKT 2368 9600 BRIMHALL RD. BAKERSFIELD, CA 93312 In an effort to keep all our record keeping and reporting requirements as current as possible, Tanknology kindly requests you notify Dawn Kohlmeyer in writing at dkohlmeyer@tanknology.com when your CUPA requires all records to be submitted electronically via the CERS database. Your assistance in this endeavor is greatly appreciated. Testing performed: Sincerely, Dawn Kohlmeyer Manager, Field Reporting LDT 5000 Field Test Apparatus Line Leak Detector Test Page 1 of 1 Work Order:3429174 Date:3/24/2016 Site Name / ID:7-ELEVEN #32376, MKT 2368 / 32376 Address:9600 BRIMHALL RD. City:BAKERSFIELD State:CA Zip:93312 Tank ID Product Product Line Tested From Existing/New Mechanical/Electronic Manufacturer/Model Serial No. Pump Operating Pressure (psi) Calibrated Leak (ml/min) Calibrated Leak (gph) Holding PSI *N/A for Electronic LD's Resiliency (ml) *N/A for Electronic LD's Metering PSI *N/A for Electronic LD's Opening Time (sec) *N/A for Electronic LD's Test Results T2 RUL RUL 1 3 Existing Mechanical Vaporless LD-2000 02164 30.00 189.0 3.00 30.00 215.00 23 6.32 Pass T3 PUL PUL 1 3 Existing Mechanical Vaporless LD-2000 08041485 30.00 189.0 3.00 30.00 225.00 20 11.63 Pass Technician Comments: Technician Name:Jorge Hernandez Certification #:114337 Technician Signature:Expire Date:12/21/2018 Environmental Compliance for Petroleum Systems © 2016 Tanknology Inc., Austin, TX.    All rights reserved.    tanknology.com Impact Valve Inspection Impact Valve Operational Inspection Work Order:3429174 Date:3/24/2016 Site Name/ID:7-ELEVEN #32376, MKT 2368 Address:9600 BRIMHALL RD. City:BAKERSFIELD State:CA Zip:93312 Dispenser Number Grade Secure Mount? Valve Lock?Pass/ Fail Comments 1/2 87 Pass Fail Not Tested 1/2 91 Pass Fail Not Tested 3/4 87 Pass Fail Not Tested 3/4 91 Pass Fail Not Tested 5/6 87 Pass Fail Not Tested 5/6 91 Pass Fail Not Tested 7/8 87 Pass Fail Not Tested 7/8 91 Pass Fail Not Tested 9/10 87 Pass Fail Not Tested 9/10 91 Pass Fail Not Tested 11/12 87 Pass Fail Not Tested 11/12 91 Pass Fail Not Tested Technician Comments: Technician Name:Jorge Hernandez Signature: Environmental Compliance for Petroleum Systems ©2016 Tanknology Inc., Austin, TX. All rights reserved. tanknology.com Appendix VI (Copies of Monitoring System Certification form and UST Monitoring Plot Plan available at http://www.swrcb.ca.gov.) MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, California 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:7-ELEVEN #32376, MKT 2368 Bldg. No.: Site Address:9600 BRIMHALL RD.City:BAKERSFIELD Zip:93312 Facility Contact Person:Joseph or Kuldip 3/26/15 Contact Phone No.:661-588-4059 Make/Model of Monitoring System:Veeder Root TLS-350 Date of Testing/Servicing:3/24/2016 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced: Tank ID:T2 RUL - RUL In-Tank Gauging Probe.Model:847390-107 Annular Space or Vault Sensor.Model:794380-420 Piping Sump / Trench Sensor(s).Model:794380-352 Fill Sump Sensor(s).Model:794380-208 Mechanical Line Leak Detector.Model:Vaporless LD-2000 Electronic Line Leak Detector.Model: Tank Overfill / High-Level Sensor.Model:Flapper Other (specify equipment type and model in Section E on Page 2). Tank ID:T3 PUL - PUL In-Tank Gauging Probe.Model:847390-107 Annular Space or Vault Sensor.Model:794380-420 Piping Sump / Trench Sensor(s).Model:794380-352 Fill Sump Sensor(s).Model:794380-208 Mechanical Line Leak Detector.Model:Vaporless LD-2000 Electronic Line Leak Detector.Model: Tank Overfill / High-Level Sensor.Model:Flapper Other (specify equipment type and model in Section E on Page 2). Tank ID: In-Tank Gauging Probe.Model: Annular Space or Vault Sensor.Model: Piping Sump / Trench Sensor(s).Model: Fill Sump Sensor(s).Model: Mechanical Line Leak Detector.Model: Electronic Line Leak Detector.Model: Tank Overfill / High-Level Sensor.Model: Other (specify equipment type and model in Section E on Page 2). Tank ID: In-Tank Gauging Probe.Model: Annular Space or Vault Sensor.Model: Piping Sump / Trench Sensor(s).Model: Fill Sump Sensor(s).Model: Mechanical Line Leak Detector.Model: Electronic Line Leak Detector.Model: Tank Overfill / High-Level Sensor.Model: Other (specify equipment type and model in Section E on Page 2). Dispenser ID:1/2 Dispenser Containment Sensor(s).Model:794380-352 Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID:3/4 Dispenser Containment Sensor(s).Model:794380-352 Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID:5/6 Dispenser Containment Sensor(s).Model:794380-352 Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID:7/8 Dispenser Containment Sensor(s).Model:794380-352 Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID:9/10 Dispenser Containment Sensor(s).Model:794380-352 Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID:11/12 Dispenser Containment Sensor(s).Model:794380-352 Shear Valve(s). Dispenser Containment Float(s) and Chain(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 inspected/serviced 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 that apply): System set- up Alarm history report Technician Name (print):Jorge Hernandez Signature: Certification No.: B45883 License. No.:743160 Class 'A' Testing Company Name:Tanknology Phone No.:(800) 800-4633 Testing Company Address:11000 N. MoPac Expressway Suite 500 Date of Testing/Servicing:3/24/2016 Monitoring System Certification Page 1 of 3 12/07 D. Results of Testing/Servicing Software Version Installed:329.02 Complete the following checklist: Yes No*Is the audible alarm operational? Yes No*Is the visual alarm operational? Yes No*Were all sensors visually inspected, functionally tested, and confirmed operational? 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* N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? Yes No* N/A For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) Sump/Trench Sensors; Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Yes; No Yes No* N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no mechanical overfill prevention 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 of tank capacity does the alarm trigger? 90% 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) Product; Water. If yes, 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 deficiencies were or will be corrected. E. Comments: Replaced a 353 discriminating sump sensor under dispenser 3 & 4 Monitoring System Certification Page 2 of 3 12/07 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? Yes No*Were all tank gauging probes visually inspected for damage and residue buildup? Yes No*Was accuracy of system product level readings tested? Yes No*Was accuracy of system water level readings tested? Yes No*Were all probes reinstalled properly? 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 (LLD): Check this box if LLDs are not installed. Complete the following checklist: Yes No* N/A For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all 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? Yes No*Was the testing apparatus properly calibrated? Yes No* N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? Yes No* N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? Yes No* N/A For electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? Yes No* N/A For electronic LLDs that are programmed for positive shut down, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? Yes No* N/A For electronic LLDs, have all accessible wiring connections been visually inspected? 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. H.Comments: Page 3 of 3 12/07 SWRCB, January 2006 Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: 7-ELEVEN #32376, MKT 2368 Date of Testing: 3/24/2016 Facility Address: 9600 BRIMHALL RD. , BAKERSFIELD, CA 93312 Facility Contact: Joseph or Kuldip 3/26/15 Phone: 661-588-4059 Date Local Agency Was Notified of Testing: Name of Local Agency Inspector (if present during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY INC. Technician Conducting Test: Jorge Hernandez Credentials1: CSLB Contractor ICC Service Tech. SWRCB Tank Tester Other (Specify) License Number(s): 743160 3. SPILL BUCKET TESTING INFORMATION Test Method Used By: Hydrostatic Vacuum Other Test Equipment Used: LAKE TEST Equipment Resolution: 0.0625 in. Identify Spill Bucket (By Tank Number, Stored Product, etc.) Bucket Installation Type: Bucket Diameter: Bucket Depth: Wait time between applying vacuum/water and start of test Test Start Time (TI): Initial Reading (RI): Test End Time(TF): Final Reading (RF): Test Duration(TF–TI): Change in Reading (RF–RI) : Pass/Fail Threshold or Criteria: Test Result: Spill Box # Tank T2 RUL RUL - Fill 1 - Direct - Below Grade in containment sump Direct Bury Contained in Sump 11.00 16.00 15 min 01:30:00 15.00 in. 02:30:00 15.00 in. 1 hr 0.00 in. +/- 0.00 Pass Spill Box # Tank T2 RUL RUL - Vapor 1 - Direct - Below Grade in containment sump Direct Bury Contained in Sump 11.00 16.00 15 min 01:30:00 15.00 in. 02:30:00 15.00 in. 1 hr 0.00 in. +/- 0.00 Pass Spill Box # Tank T3 PUL PUL - Fill 1 - Direct - Below Grade in containment sump Direct Bury Contained in Sump 11.00 16.00 15 min 01:30:00 15.00 in. 02:30:00 15.00 in. 1 hr 0.00 in. +/- 0.00 Pass Spill Box # Tank T3 PUL PUL - Vapor 1 - Direct - Below Grade in containment sump Direct Bury Contained in Sump 11.00 16.00 15 min 01:30:00 15.00 in. 02:30:00 15.00 in. 1 hr 0.00 in. +/- 0.00 Pass Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true, accurate, and in full compliance with legal requirements. Technician's Signature:Date:3/24/2016 1State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. WO: 3429174 7-Eleven Test Water Log Work Order: Site Name/ID: Address: City: 3429174 7-ELEVEN #32376, MKT 2368 9600 BRIMHALL RD. BAKERSFIELD Date: 3/24/2016 State: CA Zip: 93312 Work Performed:ATG, E-Stop, Impv, LDs, SB's Was Test Water left on site? Yes Test Fluid Transported Off Site by Tanknology Transported off Site by Other Company No Water used If Yes describe how much water and how contained?NA If Yes who and when did you contact from site to report the water?NA If Transported Off Site by Tanknology how much was hauled?15 gallons If Transported Off Site by Other Company what company and how much water?NA Technician Signature: Date: 3/24/2016 WO: 3429174 Site Diagram (This site diagram is for reference only and is not drawn to scale) Work Order:3429174 Site ID / Name:32376 / 7-ELEVEN #32376, MKT 2368 Address:9600 BRIMHALL RD. City:BAKERSFIELD State:CA Zip:93312 W.O.# SC1-3429174 atg download W.O.# SC1-3429174 atg download W.O.# SC1-3429174 atg download W.O.# SC1-3429174 atg download W.O.# SC1-3429174 atg download W.O.# SC1-3429174 atg download W.O.# SC1-3429174 atg download W.O.# SC1-3429174 atg download