HomeMy WebLinkAboutSB989 RESULTS 2016SWRCB, 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: Date of Testing:
Facility Address:
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:
Technician Conducting Test:
Credentials: CSLB Licensed Contractor SWRCB Licensed Tank Tester
License Type: License Number:
Manufacturer Training
Manufacturer Component(s)Date TrainingExpires
3.SUMMARY OF TEST RESULTS
Component PassFail Not
Tested
Repairs
Made Component PassFail Not
Tested
Repairs
Made
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:_________________________
$POGJEFODF6454FSWJDFT
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1 7
#7705/Fastrip#641 12/20/2016
1200CoffeeRoad Bakersfield,CA93308
OmeroGarcia (661)393-7000
11/15/2016
CameronMason
✔
ICC CAUSTServiceTechnician 10/07/2018
INCON TS-STS 10/14/2018
87-STP ✔Diesel-Vapor Secondary
87-Product Secondary ✔
87-Fll Bucket ✔
87-Vapor Bucket ✔
87-Vapor Secondary ✔
91-STP ✔
91-Product Secondary ✔
91-Fill Bucket ✔
91-Vapor Bucket ✔
Diesel-STP ✔
Diesel-Product Seconday ✔
91-Vapor Secondary ✔
✔
Diesel-Fll Bucket ✔
Diesel-Vapor Bucket ✔
UDC 1-2 ✔
UDC 3-4 ✔
UDC 5-6 ✔
UDC 7-8 ✔
12/20/2016
Test water was hauled off by CONFIDENCE UST SERVICES
SWRCB, January 2002 Page ____ of ____
4.TANK ANNULAR TESTING
Test Method Developed By: Tank Manufacturer Industry Standard Professional Engineer
Other (Specify)
Test Method Used: Pressure Vacuum Hydrostatic
Other (Specify)
Test Equipment Used: Equipment Resolution:
Tank # Tank # Tank # Tank #
Is Tank Exempt From Testing?1 Yes No Yes No Yes No Yes No
Tank Capacity:
Tank Material:
Tank Manufacturer:
ProductStored:
Wait time between applying
pressure/vacuum/water and
starting test:
Test Start Time:
Initial Reading (RI):
Test End Time:
Final Reading (RF):
TestDuration:
Change in Reading (RF-RI):
Pass/Fail Threshold or Criteria:
Test Result: Pass Fail Pass Fail Pass Fail Pass Fail
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)
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)}
27
✔
✔
CalibratedGauges 0.00"
87-1
✔
12,000
Steel
Joor
Gasoline
5min
0.000"
1 hour
-10.00hg
11:00 am
-10.00hg
10:00 am
0.000"
✔
✔
✔
91-2
✔
12,000
Steel
Joor
Gasoline
5min
10:00 am
-10.00hg
11:00 am
-10.00hg
1hour
0.000"
0.000"
✔
✔
✔
DIESEL
✔
12,000
Steel
Joor
Gasoline
5min
10:00 am
-10.00hg
11:00 am
-10.00hg
1hour
0.000"
0.000"
✔
✔
✔
SWRCB, January 2002 Page ____ of ____
5.SECONDARY PIPE TESTING
Test Method Developed By: Piping Manufacturer Industry Standard Professional Engineer
Other (Specify)
Test Method Used: Pressure Vacuum Hydrostatic
Other (Specify)
Test Equipment Used: Equipment Resolution:
Piping Run # Piping Run # Piping Run # Piping Run #
PipingMaterial:
Piping Manufacturer:
PipingDiameter:
Length of Piping Run:
ProductStored:
Method and location of
piping-run isolation:
Wait time between applying
pressure/vacuum/water and
starting test:
Test Start Time:
Initial Reading (RI):
Test End Time:
Final Reading (RF):
TestDuration:
Change in Reading (RF-RI):
Pass/Fail Threshold or
Criteria:
Test Result: Pass Fail Pass Fail Pass Fail Pass Fail
Comments – (include information on repairs made prior to testing, and recommended follow-up for failed tests)
37
✔
✔
CalibratedGauges 0.00"
87-product
Fiberglass
Smith
3.00"
100.00'
Gasoline
Test boot
5min
10:30am
5.00 psi
11:30am
5.00psi
1 hour
0.00psi
0.00psi
✔
87-vapor
Fiberglass
Smith
4.00"
130.00'
Gasoline
Test boot
5min
10:30am
5.00psi
11:30am
5.00psi
1 hour
0.00psi
0.00psi
✔
91-produc
Fiberglass
Smith
3.00"
110.00'
Gasoline
Test boot
5min
10:30am
5.00psi
11:30am
5.00psi
1 hour
0.00psi
0.00psi
✔
91-vapor
Fiberglass
Smith
4.00"
150.00'
Gasoline
Test boot
5min
10:30am
5.00psi
11:30am
5.00psi
1 hour
0.00psi
0.00psi
✔
SWRCB, January 2002 Page ____ of ____
5.SECONDARY PIPE TESTING
Test Method Developed By: Piping Manufacturer Industry Standard Professional Engineer
Other (Specify)
Test Method Used: Pressure Vacuum Hydrostatic
Other (Specify)
Test Equipment Used: Equipment Resolution:
Piping Run # Piping Run # Piping Run # Piping Run #
PipingMaterial:
Piping Manufacturer:
PipingDiameter:
Length of Piping Run:
ProductStored:
Method and location of
piping-run isolation:
Wait time between applying
pressure/vacuum/water and
starting test:
Test Start Time:
Initial Reading (RI):
Test End Time:
Final Reading (RF):
TestDuration:
Change in Reading (RF-RI):
Pass/Fail Threshold or
Criteria:
Test Result: Pass Fail Pass Fail Pass Fail Pass Fail
Comments – (include information on repairs made prior to testing, and recommended follow-up for failed tests)
47
✔
✔
CalibratedGauges 0.00"
DIESEL-pro
Fiberglass
Smith
3.00"
150.00'
DIESEL
Test boot
5min
10:30am
5.00psi
11:30am
5.00psi
1hour
0.00psi
0.00psi
✔
DIESEL-va
Fiberglass
Smith
3.00"
150.00'
DIESEL
Test boot
5min
10:30am
5.00psi
11:30am
0.00psi
1 hour
5.00psi
0.00psi
✔
DIESEL vapor return line is cracked where test boot was installed pictures at end of work order .
SWRCB, January 2002 Page ____ of ____
6.PIPING SUMP TESTING
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:
Sump # Sump # Sump #Sump #
Sump Diameter:
Sump Depth:
Sump Material:
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 Tested1
Does turbine shut down when
sump sensor detects liquid (both
product and water)?* Yes No NA Yes No NA Yes No NA Yes No NA
Turbine shutdown response time
Is system programmed for fail-safe
shutdown?* Yes No NA Yes No NA Yes No NA Yes No NA
Was fail-safe verified to be
operational?* Yes No NA Yes No NA Yes No NA Yes No NA
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
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)
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)
Please see Incon results:
5 7
✔
✔
TS-STS 0.002"
87 stp
48.00"
51.00"
Fiberglass
18.00"
19.00"
Clean/dry
Highest penetration
✔
Automatic
✔
✔
5min
✔
✔
✔
91 stp
48.00"
50.00"
Fiberglass
19.00"
16.00"
Clean/dry
Highest penetration
✔✔
Automatic
✔
✔
5min
✔
✔
✔
DIESEL stp
48.00"
Highest penetration
Automatic
5min
✔
✔
✔
✔
✔
✔
Clean/dry
17.00"
19.00"
Fiberglass
50.00"
Automatic
✔
✔
✔
DIESEL STP was a visual fail per vapor return secondary line being cracked could not install test boot
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 Hydrostatic
Other (Specify)
Test Equipment Used: Equipment Resolution:
UDC # UDC # UDC # UDC #
UDC Manufacturer:
UDC Material:
UDC Depth:
Height from UDC Bottom to Top
of Highest Piping Penetration:
Height from UDC Bottom to
Lowest Electrical Penetration:
Condition of UDC prior to
testing:
Portion of UDC Tested1
Does turbine shut down when
UDC sensor detects liquid (both
product and water)?* Yes No NA Yes No NA Yes No NA Yes No NA
Turbine shutdown response time
Is system programmed for fail-
safe shutdown?* Yes No NA Yes No NA Yes No NA Yes No NA
Was fail-safe verified to be
operational?* Yes No NA Yes No NA Yes No NA Yes No NA
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
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)
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)
Please see Incon results:
67
✔
✔
TS-STS 0.00"
1-2
Highest penetration
Clean/dry
12.00"
13.00"
33.00"
Fiberglass
Unknown
Automatic
5min
✔
✔
✔
✔
✔
✔
3-4
Automatic
✔
5min
✔
✔
✔✔
Highest penetration
Clean/dry
12.00"
13.00"
33.00"
Fiberglass
Unknown
✔
✔
5-6 7-8
Unknown Unknown
Fiberglass Fiberglass
33.00"33.00"
13.00"13.00"
12.00"12.00"
Clean/dry Clean/dry
Highest penetration Highest penetration
✔✔
✔✔
✔✔✔
Automatic Automatic
✔✔
✔✔
5min 5min
✔✔
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 Industry Standard Professional Engineer
Other (Specify)
Test Method Used: Pressure Vacuum Hydrostatic
Other (Specify)
Test Equipment Used: Equipment Resolution:
Spill Box # Spill Box # Spill Box # Spill Box #
BucketDiameter:
BucketDepth:
Wait time between applying
pressure/vacuum/water and
starting test:
Test Start Time:
Initial Reading (RI):
Test End Time:
Final Reading (RF):
TestDuration:
Change in Reading (RF-RI):
Pass/Fail Threshold or
Criteria:
Test Result: Pass Fail Pass Fail Pass Fail Pass Fail
Comments – (include information on repairs made prior to testing, and recommended follow-up for failed tests)
77
✔
✔
TS-STS 0.00"
87 fill 87vapo 91 fill 91vap
12.00"12.00"12.00"12.00"
14.00"14.00"14.00"14.00"
5min 5min 5min 5min
9.20"
10:00am 10:00am 10:00am
9.00"9.50"
0.00"1.00"
11:00am 11:00am 11:00am 11:00am
9.00"9.50"8.00"
1 hour 1hour 1 hour 1 hour
10:00am
9.00"9.20"
0.00"0.00"
0.00"0.00"0.00"0.00"
✔✔✔✔
91 fill bucket would not hold 5 gallons even included the sleeve above bucket leaks around top of Bucket.