HomeMy WebLinkAboutSB-989 RESULTS 2014SWRCB, January 2002 Page ____ of ____
Secondary Containment Testing Report Form
This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the
appropriate pages of this form to report results for all components tested. The completed form, written test procedures, 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: Jim Burke Ford Date of Testing: 8/29/2014
Facility Address: 2001 Oak Street Bakersfield, Ca.
Facility Contact: Phone:
Date Local Agency Was Notified of Testing :
Name of Local Agency Inspector (if present during testing):
2. TESTING CONTRACTOR INFORMATION
Company Name: Advanced Compliance
Technician Conducting Test: Bruce W. Hinsley
Credentials: X CSLB Licensed Contractor SWRCB Licensed Tank Tester
License Type: C61/D40 License Number: 971259
Manufacturer Training
Manufacturer Component(s) Date Training Expires
Incon TS-STS 9/17/2014
3. SUMMARY OF TEST RESULTS
Component Pass Fail Not
Tested
Repairs
Made Component Pass Fail Not
Tested
Repairs
Made
87 UL STP Sump X
87 UL Annular X
87 UL Fill Bucket X
87 UL Product Line X
UDC X
If hydrostatic testing was performed, describe what was done with the water after completion of tests:
Water was removed from site and will be reused.
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: 8/29/2014
SWRCB, January 2002 Page ____ of ____
4. TANK ANNULAR TESTING
Test Method Developed By: Tank Manufacturer X Industry Standard Professional Engineer
Other (Specify)
Test Method Used: Pressure X Vacuum Hydrostatic
Other (Specify)
Test Equipment Used: Vacuum pump/Vacuum gauge. Equipment Resolution:
Tank # 1-87 Tank # Tank # Tank #
Is Tank Exempt From Testing?1 Yes X No Yes No Yes No Yes No
Tank Capacity: 11,430 Gal.
Tank Material: Steel
Tank Manufacturer: Unknown
Product Stored: 87 UL
Wait time between applying
pressure/vacuum/water and
starting test:
10 Min.
Test Start Time: 11:30
Initial Reading (RI): -10.0” Hg.
Test End Time: 12:30
Final Reading (RF): -10.0” Hg.
Test Duration: 1 Hr.
Change in Reading (RF-RI): 0. Hg.
Pass/Fail Threshold or Criteria: -2.0” Hg.
Test Result: X Pass Fail Pass Fail Pass Fail Pass Fail
Was sensor removed for testing? X Yes No NA Yes No NA Yes No NA Yes No NA
Was sensor properly replaced and
verified functional after testing? X Yes No NA Yes No NA Yes No NA Yes No NA
Comments – (include information on repairs made prior to testing, and recommended follow-up for failed tests)
1 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 Page ____ of ____
5. SECONDARY PIPE TESTING
Test Method Developed By: Piping Manufacturer X Industry Standard Professional Engineer
Other (Specify)
Test Method Used: X Pressure Vacuum Hydrostatic
Other (Specify)
Test Equipment Used: Nitrogen / Pressure Gauge Equipment Resolution:
Piping Run # 87 UL Piping Run # Piping Run # Piping Run #
Piping Material: FRP
Piping Manufacturer: Smith
Piping Diameter: 3”
Length of Piping Run: 25’
Product Stored: 87 UL
Method and location of
piping-run isolation: Test Boot
Wait time between applying
pressure/vacuum/water and
starting test:
10 Min.
Test Start Time: 11:00
Initial Reading (RI): 5.0 Psi.
Test End Time: 12:00
Final Reading (RF): 5.0 Psi.
Test Duration: 1 Hr.
Change in Reading (RF-RI): 0.0 Psi.
Pass/Fail Threshold or
Criteria: -0.02 Psi.
Test Result: X Pass Fail Pass Fail Pass Fail Pass Fail
Comments – (include information on repairs made prior to testing, and recommended follow-up for failed tests)
SWRCB, January 2002 Page ____ of ____
6. PIPING SUMP TESTING
Test Method Developed By: Sump Manufacturer X Industry Standard Professional Engineer
Other (Specify)
Test Method Used: Pressure Vacuum X Hydrostatic
Other (Specify)
Test Equipment Used: Incon TS-STS Equipment Resolution: 0.002
Sump # 87 STP Sump # Sump # Sump #
Sump Diameter: 42”
Sump Depth: 55”
Sump Material: Plastic
Height from Tank Top to Top of
Highest Piping Penetration: 16”
Height from Tank Top to Lowest
Electrical Penetration: 18”
Condition of sump prior to testing: Clean
Portion of Sump Tested1 50%
Does turbine shut down when
sump sensor detects liquid (both
product and water)?*
X Yes X No NA Yes No NA Yes No NA Yes No NA
Turbine shutdown response time 3 Sec.
Is system programmed for fail-safe
shutdown?* X Yes No NA Yes No NA Yes No NA Yes No NA
Was fail-safe verified to be
operational?* X Yes No NA Yes No NA Yes No NA Yes No NA
Wait time between applying
pressure/vacuum/water and starting
test:
10 Min.
Test Start Time: 11:17/11:34
Initial Reading (RI): 5.6151”/5.6150”
Test End Time: 11:32/11:49
Final Reading (RF): 5.6150”/5.6149”
Test Duration: 30 Min.
Change in Reading (RF-RI): 0.0001”/0.0001”
Pass/Fail Threshold or Criteria: 0.002”
Test Result: X Pass Fail Pass Fail Pass Fail Pass Fail
Was sensor removed for testing? X Yes No NA Yes No NA Yes No NA Yes No NA
Was sensor properly replaced and
verified functional after testing? X Yes No NA Yes No NA Yes No NA Yes No NA
Comments – (include information on repairs made prior to testing, and recommended follow-up for failed tests)
1 If the entire depth of the sump 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 sump must be tested. (See SWRCB LG-160)
SWRCB, January 2002 Page ____ of ____
7. UNDER-DISPENSER CONTAINMENT (UDC) TESTING
Test Method Developed By: UDC Manufacturer X Industry Standard Professional Engineer
Other (Specify)
Test Method Used: Pressure Vacuum X Hydrostatic
Other (Specify)
Test Equipment Used: Incon TS-STS Equipment Resolution: 0.002
UDC # 1-2 UDC # UDC # UDC #
UDC Manufacturer: Unknown
UDC Material: Plastic
UDC Depth: 36”
Height from UDC Bottom to Top
of Highest Piping Penetration:
10”
Height from UDC Bottom to
Lowest Electrical Penetration:
8”
Condition of UDC prior to
testing:
Clean
Portion of UDC Tested1 50%
Does turbine shut down when
UDC sensor detects liquid (both
product and water)?*
X Yes No NA Yes No NA Yes No NA Yes No NA
Turbine shutdown response time 3 Sec.
Is system programmed for fail-
safe shutdown?* X Yes No NA Yes No NA Yes No NA Yes No NA
Was fail-safe verified to be
operational?* X Yes No NA Yes No NA Yes No NA Yes No NA
Wait time between applying
pressure/vacuum/water and
starting test
10 Min.
Test Start Time: 11:17/11:34
Initial Reading (RI): 6.1706”/6.1706”
Test End Time: 11:32/11:49
Final Reading (RF): 6.1706”/6.1706”
Test Duration: 30 Min.
Change in Reading (RF-RI): 0.0000”/0.0000”
Pass/Fail Threshold or Criteria: 0.002”
Test Result: X Pass Fail Pass Fail X Pass Fail X Pass Fail
Was sensor removed for testing? X Yes No NA Yes No NA Yes No NA Yes No NA
Was sensor properly replaced and
verified functional after testing? X Yes No NA Yes No NA Yes No NA Yes No NA
Comments – (include information on repairs made prior to testing, and recommended follow-up for failed tests)
1 If the entire depth of the 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 Page ____ of ____
8. FILL RISER CONTAINMENT SUMP TESTING
Facility is Not Equipped With Fill Riser Containment Sumps X
Fill Riser Containment Sumps are Present, but were Not Tested
Test Method Developed By: Sump Manufacturer Industry Standard Professional Engineer
Other (Specify)
Test Method Used: Pressure Vacuum Hydrostatic
Other (Specify)
Test Equipment Used: Equipment Resolution:
Fill Sump # Fill Sump # Fill Sump # Fill Sump #
Sump Diameter:
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 of Sump Tested
Sump Material:
Wait time between applying
pressure/vacuum/water and
starting test:
Test Start Time:
Initial Reading (RI):
Test End Time:
Final Reading (RF):
Test Duration:
Change in Reading (RF-RI):
Pass/Fail Threshold or Criteria:
Test Result: Pass Fail Pass Fail Pass Fail Pass Fail
Is there a sensor in the sump? Yes No Yes No Yes No Yes No
Does the sensor alarm when
either product or water is
detected?
Yes No NA Yes No NA Yes No NA Yes No NA
Was sensor removed for testing? Yes No NA Yes No NA Yes No NA Yes No NA
Was sensor properly replaced and
verified functional after testing? Yes No NA Yes No NA Yes No NA Yes No NA
Comments – (include information on repairs made prior to testing, and recommended follow-up for failed tests)
SWRCB, January 2002 Page ____ of ____
9. SPILL/OVERFILL CONTAINMENT BOXES
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: Pressure Vacuum X Hydrostatic
Other (Specify)
Test Equipment Used: Incon TS-STS Equipment Resolution: 0.002”
Spill Box # 87 UL Spill Box # 91 UL Spill Box # Spill Box #
Bucket Diameter: 12”
Bucket Depth: 12”
Wait time between applying
pressure/vacuum/water and
starting test:
10 Min.
Test Start Time: 11:17/11:34
Initial Reading (RI): 5.2078”/5.2078”
Test End Time: 11:32/11:49
Final Reading (RF): 5.2078”/5.2078”
Test Duration: 30 Min.
Change in Reading (RF-RI): 0.0000”/0.0000”
Pass/Fail Threshold or
Criteria: 0.002”
Test Result: X Pass Fail Pass Fail Pass Fail Pass Fail
Comments – (include information on repairs made prior to testing, and recommended follow-up for failed tests)