HomeMy WebLinkAboutDiesel Spill Bucket Results 3-17-161. FACILITYINFORMATION
Facility Name: ROSEDALE PLAZA GROUP Date of Testing: 3-17-16
Facility Address:7851 ROSEDALE HWY
Facility Contact NOLLIE Phone: 661-588-0557
Date Local Agency Was Notified of Testing :
Name of Local Agency Inspector (if present during testing): KHRIS
Dt€6et SWRCB, January 2006
Spilt Bucket Testing Report Form
This form is intendedfor use by contractors performing anmtal testing of UST spill containment structures. The completedform and
printoutsfrom tests (dapplicable), should be prwided to thefacility owner/operatorfor submittal to the local regulatory qgency.
2. TESTING CONTRACTOR INFOR]VIATION
3. SPILL BUCKET TESTING INT'ORMATION
CERTIFICATION OF TECHMCIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
I hereby certify that all the information contained in this report is fiue, accutale, and in full complionce wilh legal requirements.
Technician's Signature:Date; 7-\n- l6
' State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements
may be more stringent.
Company Name:BSSRINC,
Technician Conducting Test:SALVADORSANCHEZ
Credentialsr: BCSLB Contractor EICC Service Tech. tr SWRCB Tank Tester n Other (specfy)
License Number(s):csLB#672812 / lCC TECH#5309490
Test Method Used: EHydrostatic n Vacuum n Other
Test Equipment Used:VISUAL Equipment Resolution:
Identiff Spill Bucket (By Tank
Number. Stored Product. etc.)
DTfiSEL 2 3 4
Bucket Installation Type:D Direct Bury
ff Contained in Sump
tr DirectBury
tr Contained in Sump
tr Direct Bury
fl Contained in Sumo
tr Direct Bury
fl Contained in Sumo
Bucket Diameter:12"
Bucket Depth:170'
Wait time between applying
vacuum./water and start of test:15 MIN,
Test Start Time (T1);ll:00 AM
Initial Reading (ft):12"
Test End Time (Tr):12:00 PM
Final Reading (Rr):12"
Test Duration (Tp - T):I HOUR
Change in Reading (Rp-R):0
Pass/Iail Threshold or
Criteria:0.002"
Test Re*ult:Xfl'P,ass E::FsiI::,:::il ill*ss ',EI'aiI B,Pass nF il I Pass "':ilF'aiI
Comm&nts - (inclade information on repairs made prior to test@, qnd recommendedfollow-apforfqiled tests)