HomeMy WebLinkAboutSECONDARY CONTAINMENT TESTING REP. FROM 5/29/2015SWRCB, January 2002
Secondary Containment Testing Report Form
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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: USA LIQUOR
I Date of Testing: 5/29/15
Facility Address: 1720 S. UNION AVE BAKERSFIELD CA.
Facility Contact:
Phone: (661) 832 -0457
Date Local Agency Was Notified of Testing:
Name of Local Agency Inspector (fpresent during testing):
2. TESTING CONTRACTOR INFORMATION
Company Name: LC SERVICES
Pass
Technician Conducting Test: EIVIND BYE
Not
Tested
Credentials: ❑ CSLB Licensed Contractor
❑ SWRCB Licensed Tank Tester
License Type:
ucc :� •nx.. �.� .•a:?�:x
Manufacturer
License Number:706992
xaa. xxe.�.: • �;xs� <.as:' >;.:.'. , • ^apt: a`.,. • x • •`+
Manufacturer Training
Component(s) Date Training Expires
INCON
SUMP TESTER 9 -24 -16
87 STP
X
❑
❑
❑
UDC 3 -4
3. SUMMARY OF TEST RESULTS
Component
Pass
Fail
Not
Tested
Repairs
Made
Component
Pass
Fail
Not
Tested
Repairs
Made
87 STP
X
❑
❑
❑
UDC 3 -4
❑
X
❑
❑
87 SEC. PRODUCT
X
❑
❑
❑
❑
❑
❑
87 ANNULAR
X
❑
❑
❑
❑
❑
❑
❑
87 VAPOR BUCKET
X
❑
❑
❑
❑
❑
❑
❑
91STP
X
❑
❑
❑
❑
❑
❑
❑
91 SEC. PRODUCT
X
❑
❑
❑
❑
❑
❑
91 ANNULAR
X
❑
❑
❑
1
❑
❑
❑
❑
91 VAPOR BUCKET
X
❑
❑
❑
❑
❑
❑
❑
DSL STP
X
❑
❑
❑
❑
❑
❑
❑
DSL SEC. PRODUCT
X
❑
❑
❑
❑
❑
❑
❑
DSL ANNULAR
X
❑
❑
❑
❑
❑
El
El
UDC 1 -2
I Xf
❑
❑
❑
❑
❑
❑
If hydrostatic testing was performed, describe what was done with the water after completion of tests:
RETURNED TO HOLDING TANK.
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
To the best of my knowledge, the facts stated in this meat are accurate and in full compliance with legal requirements
% ,
Technician's Signature: ` _ Date:5 /29/15
SWRCB, January 2002
4. TANK ANNULAR TESTING
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Test Method Developed By: ❑ Tank Manufacturer ❑ Industry Standard ❑ Professional Engineer
❑ Other (Spec)
Test Method Used: ❑ Pressure X Vacuum ❑ Hydrostatic
❑ Other (Sped)
Test Equipment Used:
Equipment Resolution:
Tank # 87
Tank # 91 TTank
# DSL 17Tank
#
Is Tank Exempt From Testing ?'
❑ Yes X No
❑ Yes X No
❑ Yes X No
❑ Yes ❑ No
Tank Capacity:
103000
10,000
10,000
Tank Material:
FIBERGLASS
FIBERGLASS
FIBERGLASS
Tank Manufacturer:
UNKNOWN
UNKNOWN
UNKNOWN
Product Stored:
87
91
DSL
Wait time between applying
pressure /vacuum /water and
starting test:
15 MINUTES
15 MINUTES
15 MINUTES
Test Start Time:
1:OOPM
2:OOPM
3:OOPM
Initial Reading (RI):
-10
-10
-10
Test End Time:
2:OOPM
3:OOPM
4:OOPM
Final Reading (RF):
-10
-10
-10
Test Duration:
1 HR
1 HR
1 HR
Change in Reading (RF -Ri):
0
0
0
Pass /Fail Threshold or Criteria:
0
0
1 0
Was sensor removed for testing? X Yes ❑ No ❑ NA X Yes ❑ No ❑ NA X Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA
Was sensor properly replaced and X Yes ❑ No ❑ NA X Yes ❑ No ❑ NA X Yes ❑ No ❑ NA ❑ Yes ❑ No ❑ NA
verified functional after testing?
Comments — (include information on repairs made prior to testing, and recommended follow -up for failed 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 Page of
5. SECONDARY PIPE TESTING
Test Method Developed By: ❑ Piping Manufacturer ❑ Industry Standard ❑ Professional Engineer
❑ Other (Specify)
Test Method Used: X Pressure ❑ Vacuum ❑ Hydrostatic
❑ Other (Specify)
Test Equipment Used:
Equipment Resolution:
Piping Run# 87
Piping Run# 91
Piping Run #DSL
Piping Run#
Piping Material:
FIBERGLASS
FIBERGLASS
FIBERGLASS
Piping Manufacturer:
AMARON
AMARON
AMARON
Piping Diameter:
T)
2"
2"
Length of Piping Run-
50'
50'
10,
Product Stored:
87
91
DSL
Method and location of
piping-run isolation:
AIR VALVE
AIR VALVE
AIR VALVE
Wait time between applying
pressure/vacuum/water and
starting test:
15 MINUTES
15 MINUTES
15 MINUTES
Test Start Time:
2:OOPM
2:OOPM
2:OOPM
Initial Reading (RI):
0
0
5 PSI
Test End Time:
3:OOPM
3:OOPM
3:OOPM
Final Reading (RF):
0
0
5 PSI
Test Duration:
I HR
I HR
I HR
Change in Reading
_5PSI
-5 PSI
0
Pass/Fail Threshold or
Criteria:
NO DROP IN PSI
NO DROP IN PSI
NO DROP IN PSI
Comments — (include information on repairs made prior to testing, and recommended follow -up for failed tests)
BOTH LINES ARE LEAKING UNDER PIPING IN DISPENSER PAN IN
-BETWEEN PIPING. DISP. 1-2 IS 91 AND DISP. 3-4 IS 87
SWRCB, January 2002 Page of
6. PIPING SUMP TESTING
Test Method Developed By: ❑ Sump Manufacturer ❑ Industry Standard ❑ Professional Engineer
❑ Other (Sped)
Test Method Used: ❑ Pressure ❑ Vacuum X Hydrostatic
❑ Other (Sped)
Test Equipment Used:
Equipment Resolution: .002
p
Sump # 87
Sump # 91
Sump # DSL
Sump #
Sump Diameter:
46"
46"
46"
Sump Depth:
55"
54"
53"
Sump Material:
FIBERGLASS
FIBER GLASS
FIBERGLASS
Height from Tank Top to Top of
Highest Piping Penetration:
24"
23"
23"
Height from Tank Top to Lowest
Electrical Penetration:
18"
16"
18"
Condition of sump prior to testing:
OK
OK
OK
Portion of Sump Tested'
HIGHEST
HIGHEST
HIGHEST
Does turbine shut down when
sump sensor detects liquid (both
product and water) ?*
X Yes ❑ No ❑ NA
X Yes ❑ No ❑ NA
X Yes ❑ No ❑ NA
❑ Yes ❑ No ❑ NA
Turbine shutdown response time
AUTOMATIC
AUTOMATIC
AUTOMATIC
Is system programmed for fail -safe
shutdown?*
X Yes ❑ No ❑ NA
X Yes ❑ No ❑ NA
X Yes ❑ No ❑ NA
❑ Yes ❑ No ❑ NA
Was fail -safe verified to be
operational ?*
X Yes ❑ No ❑ NA
X Yes ❑ No ❑ NA
X Yes ❑ No ❑ NA
0 Yes ❑ No ❑ NA
Wait time between applying
pressure /vacuum /water and starting
test:
15 MINUTES
15 MINUTES
15 MINUTES
Test Start Time:
4:37PM 4 :53PM
3:06PM 3:30PM
1:25PM 2:02PM
Initial Reading (RI):
6.0945 6.0794
5.6707 5.6708
6.0246 5.9778
Test End Time:
4:52PM 5:08PM
3:21PM 3:45PM
1:40PM 2:17PM
Final Reading (RF):
6.0949 6.0782
5.6708 5.6694
6.0252 5.9783
Test Duration:
15 MINUTES
15 MINUTES
15 MINUTES
Change in Reading (RF -Ri):
.0004 .0012
.0001 .0014
.0006 .0005
Pass /Fail Threshold or Criteria:
.002
.002
.002
Tt Result:
X P ass ❑Fail
X Pass ❑ Fair
Pass' D`aiI
Pass ❑'Fail
Was sensor removed for testing?
X Yes ❑ No ❑ NA
X Yes ❑ No ❑ NA
X Yes ❑ No ❑ NA
❑ Yes ❑ No ❑ NA
Was sensor properly replaced and
verified functional after testing?
X Yes ❑ No ❑ NA
X Yes ❑ No ❑ NA
X Yes ❑ No ❑ NA
❑ Yes ❑ No ❑ NA
Comments — (include information on repairs made prior to testing, and recommended fallow -up for failed tests)
' If the entire depth of the sump is not tested, specify how much was tested. If the answer to a—X 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 ❑ Industry Standard ❑ Professional Engineer
❑ Other (Specify)
Test Method Used: ❑ Pressure ❑ Vacuum X Hydrostatic
❑ Other (Spec)
Test Equipment Used: Equipment Resolution:
x.
5-0-
UDC # 1/2
UDC # 3/4
UDC #
UDC #
UDC Manufacturer:
BRAVO
BRAVO
UDC Material:
METAL
METAL
UDC Depth:
10"
10"
Height from UDC Bottom to Top
of Highest Piping Penetration:
N/A
N/A
Height from UDC Bottom to
Lowest Electrical Penetration:
N/A
N/A
Condition of UDC prior to
testing:
OK
OK
Portion of UDC Tested'
HIGHEST
HIGHEST
Does turbine shut down when
UDC sensor detects liquid (both
product and water) ?*
❑ Yes ❑ No X NA
❑ Yes ❑ No X NA
❑ Yes ❑ No ❑ NA
❑ Yes ❑ No ❑ NA
Turbine shutdown response time
N/A
N/A
Is system programmed for fail-
safe shutdown ?*
X Yes ❑ No ❑ NA
X Yes ❑ No ❑ NA
❑ Yes ❑ No ❑ NA
❑ Yes ❑ No ❑ NA
Was fail -safe verified to be
operational ?*
X Yes ❑ No 0 NA
X Yes ❑ No ❑ NA
❑ Yes ❑ No ❑ NA
❑ Yes ❑ No ❑ NA
Wait time between applying
pressure /vacuum /water and
starting test
15 MINUTES
15 MINUTES
15 MINUTES
15 MINUTES
Test Start Time:
11:32AM
11:32AM
Initial Reading (RI):
3.7034
2.5935
Test End Time:
11:47AM
11:47AM
Final Reading (RF):
2.3769
2.3556
Test Duration:
15 MINUTES
15 MINUTES
15 MINUTES
15 MINUTES
Change in Reading (RF -Ri):
1.3265
0.2379
Pass /Fail Threshold or Criteria:
.002
.002
.002
.002
Test Result:
Pass Fail
❑Pass X Fail
❑Pass ❑Fail
0 Pass ❑;Fall
Was sensor removed for testing?
❑ Yes ❑ No X NA
❑ Yes ❑ No X NA
❑ Yes ❑ No ❑ NA
❑ Yes ❑ No ❑ NA
Was sensor properly replaced and
verified functional after testing?
❑ yes ❑ No X NA
❑ Yes ❑ No X NA
❑ Yes ❑ No ❑ NA
0 Yes ❑ No ❑ NA
Comments — (include information on repairs made prior to testing, and recommended follow -up for failed tests)
PANS ARE LEAKING FROM SECONDARY LINES UNDER PIPING GOING
DOWN THROUGH PAN NOT FROM PLUGS.
' If the entire depth of the UDC is not tested, specify how much was tested. If the answer to aM of the questions indicated with an
asterisk ( *) is "NO" or "NA ", the entire UDC must be tested. (See SWRCB LG -160)
SWRCB, January 2002
S. FILL RISER CONTAINMENT SUMP TESTING
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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 (Spec)
Test Equipment Used:
=WME
Equipment
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:
15 MINUTES
15 MINUTES
15 MINUTES
Test Start Time:
Initial Reading (Rj):
Test End Time:
Final Reading (RF):
Test Duration:
15 MINUTES
15 MINUTES
15 MINUTES
Change in Reading (RF -RI):
Pass /Fail Threshold or Criteria:
.002
.002
.002
Test Result:
D Pass ❑ Fail
0 Pass ❑Fail
Pass ❑ `Faii
Pass ❑ Fa: iY
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 0 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
9. SPILL/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: ❑ Pressure ❑ Vacuum X Hydrostatic
❑ Other (Specify)
Test Equipment Used: --�Equipment
Resolution:
Spill Box #87 VAPOR
Spill Box#91 VAPOR
Spill Box 4
T Spill Box #
Bucket Diameter:
1211
12"
Bucket Depth:
1451
1411
Wait time between applying
pressure/vacuum/water and
starting test:
15 MINUTES
15 MINUTES
Test Start Time:
9:OOAM
9:OOAM
Initial Reading (RI):
13"
13"
Test End Time:
10:OOAM
10:OOAM
Final Reading (RF):
13"
13"
Test Duration:
I HR
I HR
Change in Reading (RF-Ri)-.
0
0
Pass/Fail Threshold or
Criteria:
002
.002
Comments — (include information on repairs made prior to testing, and recommended follow -up for failed tests)