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Home My WebLink AboutSEC-TEST REPORT 5/21/2015SWRCB, January 2002 Page 1 of 1 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 farm, 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: 7- ELEVEN # 16329, MKT 2368 jDate of Testing: 5/21/2015 Facility Address: 1701 PACHECO ROAD , BAKERSFIELD, CA 93307 Facility Contact: Preet Phone: 661 -549 -1711 Date Local Agency Was Notified of Testing: 5/12/2015 Name of Local Agency Inspector (if present during testing): Shane Gardner 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY INC. Technician Conducting Test: Jeffrey Crisostomo Credentials: CSLB Licensed Contractor r- SWRCB Licensed Tank Tester License Type: A -UT ILicense Number: 743160 - 8199847 Manufacturer Training Manufacturer Component(s) Date Training Expires volt /secondary contaiment Sump tester 4/7/2016 3- SUMMARY OF TF,ST RF.SIILTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Repairs Made Tank Annular# I X STP Containment for Tank T1 RUL SIPHON rul 2 -1 X Tank Annular# 2 X UDC # 1/2 X Tank Annular# 3 X UDC # 3/4 X Secondary Pipe Test (Tank T2 RUL MAIN - rul) X UDC # 1/2 X Secondary Pipe Test (Tank T2 RUL MAIN - rul) X UDC # 3/4 X STP Containment for Tank T3 PUL pul - 1 X STP Containment for Tank T2 RUL MAIN rul - 1 X STP Containment for Tank T2 RUL MAIN rul - 2 X STP Containment for Tank T1 RUL SIPHON rul 2 -1 X STP Containment for Tank T3 PUL pul - 1 X STP Containment for Tank T2 RUL MAIN rul - 1 X STP Containment for Tank T2 RUL MAIN rul - 2 X If hydrostatic testing was performed, describe what was done with the water after completion of tests: Replaced 87 Main secondary Product line, re -test pass. H2O removed from site by Nieto and Sons.All test pass. 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: 5/21/2015 WO: 3424792 SWRCB, January 2002 Page 1 of 1 4. TANK ANNULAR TESTING Test Method Developed By: r Tank Manufacturer i* Industry Standard r Professional Engineer r Other (Specify) Test Method Used By: r Pressure r+ Vacuum r Hydrostatic r Other (Specify) Test Equipment Used: Vacuum Equipment Resolution: O loss Tank# 1 RUL 2 Tank# 2 RUL Tank# 3 PUL" Tank# Is Tank Exempt From Testing?' r Yes t* No r Yes r+ No r Yes ro No r Yes r No Tank Capacity: 9600 9600 9600 Tank Material: Steel Steel Steel Tank Manufacturer: unknown unknown unknown Product Stored: RUL 2 RUL PUL Wait time between applying pressure /vacuum /water and starting test: 15 min 15 min 15 min min Test Start Time: 10:00:00 10:00:00 10:00:00 Initial Reading (RI): - 10.00000 in. HG - 10.00000 in. HG - 10.00000 in. HG Test End Time: 11:00:00 11:00:00 11:00:00 Final Reading (RF): - 10.00000 in. HG - 10.00000 in. HG - 10.00000 in. HG Test Duration: 1 hr 1 hr 1 hr Change in Reading (RF -RI) : 0.00000 in. HG 0.00000 in. HG 0.00000 in. HG Pass/Fail Threshold or Criteria: +/-0.00000 +/-0.00000 +/-0.00000 +/- Test Result: Pass' Pass Pass Was sensor removed for testing? r+ Yes r Nor NA 4+ Yes r No r NA i* Yes r Nor NA r Yes r Nor NA Was sensor properly replaced and verified functional after testing? r` Yes r Nor NA t+ Yes r No r NA i+ Yes r Nor NA r Yes r Nor NA Comments ? (include information on repairs made prior to testing, and recommended ollow -u or ailed tests All annular pass. I 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. SWRCB, January 2002 Page 1 of 1 5. SECONDARY PIPE TESTING Test Method Developed By: Piping Manufacturer Industry Standard r Professional Engineer Other (Specify) Test Method Used By: F47 Pressure r' Vacuum r Hydrostatic Other (Specify) Test Equipment Used: gauge 1 -15psi Equipment Resolution: 0 loss (Tank T2 RUL MAIN- (Tank T2 RUL MAIN - RUL) STP RUL) STP Containment 1 to STP Containment 2 Containment 1 to STP Containment 2 Piping Material: Piping Manufacturer: frg frg Piping Diameter: frg frg in in Length of Piping Run: 2.5 in. 2.5 in. ft Product Stored: 100 ft. 100 ft. Method and location of RUL RUL boot boot piping-run isolation: Wait time between applying pressure /vacuum /water and min min starting test: 15 min 15 min Test Start Time: Initial Reading (RI): 09:30:00 10:45:00 Test End Time: 5.00000 PSI 5.00000 PSI Final Reading (RF): 10:30:00 10:45:00 Test Duration: 0.00000 PSI 5.00000 PSI Change in Reading (RF -RI): 1 hr 1 hr Pass/Fail Threshold or - 5.00000 PSI 0.00000 PSI +/-0.00000 +/-0.00000 Criteria: Test. Result: Fail Pass Comments - (include information on repairs made prior to testing, and recommended follow -up for failed tests) 87 Syphon and 91 product line are single wall pipe. Replaced 87 main secondary product line due to damaged boot, re -test pass. WO: 3424792 SWRCB, January 2002 Page 1 of 2 6. PIPING SUMP TESTING Test Method Developed By: F Tank Manufacturer Industry Standard F Professional Engineer Other (Specify) Test Method Used By: Pressure F Vacuum P Hydrostatic Other (Specify) Test Equipment Used: VPLT Equipment Resolution: 0.00001 in. STP Containment for Tank T3 PUL PUL - 1 STP Containment for Tank T2 RUL MAIN RUL - 1 STP Containment for Tank T2 RUL MAIN RUL - 2 STP Containment for Tank TI RUL SIPHON RUL 2 -1 Sump Diameter/Dimensions: 46 in. 46 in. 46 in. 46 in. Sump Depth: 37.00 in. 37.00 in. 37.00 in. 37.00 in. Sump Material: Polyethylene Polyethylene Polyethylene Polyethylene Height from Tank Top to Top of Highest Piping Penetration: 800 8.00 8.00 8.00 Height from Tank Top to Lowest Electrical Penetration: 5.00 5.00 5.00 5.00 Condition of sump prior to testing: good good good good Portion of Sump Tested' T ABOVE HIGHEST PIPING T ABOVE HIGHEST PIPING Z ABOVE HIGHEST PIPING T ABOVE HIGHEST PIPING Does turbine shut down when sump sensor detects liquid (both product and water) ?* r Yes r Nor` NA r Yes r Nor. NA r Yes " No C: NA r Yes r Nor NA Turbine shutdown response time 00:00:00 sec 00:00:00 sec 00:00:00 sec 00:00:00 sec Is system programmed for fail -safe shutdown ?* r Yes r No t- NA r Yes r No % NA r Yes r Nor. NA r Yes r Nor. NA Was fail -safe verified to be operational?* r Yes r Nor* NA r Yes r No Go NA r Yes r Nor- NA r Yes r No t* NA Wait time between applying pressure /vacuum /water and starting test 15 min 15 min 15 min 15 min Test Start Time: 09:11:00 09:11:00 09:11:00 09:11:00 Initial Reading (RI): 0.20830 in. H2O 0.67200 in. H2O 0.57250 in. H2O 0.26380 in. H2O Test End Time: 09:26:00 09:26:00 09:26:00 09:26:00 Final Reading (RF): 0.20950 in. H2O 0.67150 in. H2O 0.57220 in. H2O 0.26380 in. H2O Test Duration: 15 min 15 min 15 min 15 min Change in Reading (RF -RI) : 0.00120 in. H2O - 0.00050 in. H2O - 0.00030 in. H2O 0.00000 in. H2O Pass/Fail Threshold or Criteria: +/-0.00200 +/-0.00200 +/-0.00200 +/-0.00200 Test Resul . Pass Pass Pass ,Pass,. Was sensor removed for testing? 0 Yes r Nor NA ro Yes r Nor NA d' Yes r Nor NA r+ Yes r Nor NA Was sensor properly replaced and verified functional after testing? r. Yes r Nor NA is Yes r No r NA t"+ Yes r Nor NA 0 Yes r No r NA Comments - (include information on repairs made prior to testing, and recommended follow -up for failed tests) i 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. WO: 3424792 S WRCB, January 2002 6. PIPING SUMP TESTING Page 2 of 2 Test Method Developed By: F Tank Manufacturer FF Industry Standard Professional Engineer F. Other (Specify) Test Method Used By: Pressure Vacuum Hydrostatic Other (Specify) Test Equipment Used: VPLT Equipment Resolution: 0.00001 in. STP Containment for STP Containment for STP Containment for STP Containment for Tank T3 PUL PUL -1 Tank T2 RUL MAIN Tank T2 RUL MAIN Tank TI RUL SIPHON RUL -1 RUL -2 RUL2 -1 Sump Diameter/Dimensions: 46 in. 46 in. 46 in. 46 in. Sump Depth: 37.00 in. 37.00 in. 37.00 in. 37.00 in. Sump Material: Polyethylene Polyethylene Polyethylene Polyethylene Height from Tank Top to Top of 8.00 8.00 8.00 8.00 Highest Piping Penetration: Height from Tank Top to Lowest Electrical Penetration: 5.00 5.00 5.00 5.00 Condition of sump prior to testing: good good good good Portion of Sump Tested' 2 inch above T above 2' above 2' above highest piping Does turbine shut down when sump sensor detects liquid (both r Yes r No d* NA r Yes r No d* NA r Yes r No dw NA r Yes r No 1✓ NA product and water)?* Turbine shutdown response time 00:00:00 sec 00:00:00 sec 00:00:00 sec 00:00:00 sec Is system programmed for fail -safe r yes r No d NA r Yes r No d': NA r Yes r No d* NA d"? Yes r Nor. NA shutdown ?* Was fail -safe verified to be r yes r No r* NA r Yes d"` Nod* NA r Yes r Nod NA r Yes d"' Nor* NA operational?* Wait time between applying pressure /vacuum /water and starting 15 min 15 min 15 min 15 min test Test Start Time: 09:28:00 09:28:00 09:28:00 09:28:00 Initial Reading (RI): 0.20960 in. H2O 0.67150 in. H2O 0.57220 in. H2O 0.26380 in. H2O Test End Time: 09:43:00 09:43:00 09:43:00 09:43:00 Final Reading (RF): 0.20970 in. H2O 0.67130 in. H2O 0.57210 in. H2O 0.26380 in. H2O Test Duration: 15 min 15 min 15 min 15 min Change in Reading (RF -RI) : 0.00010 in. H2O - 0.00020 in. H2O - 0.00010 in. H2O 0.00000 in. H2O Pass/Fail Threshold or Criteria: +/-0.00200 +/-0.00200 +/-0.00200 +/-0.00200 Test R6sWt: Pass Pass Pass Pass . Was sensor removed for testing? d+ Yes r No d"' NA lt' Yes r Nor NA d+ Yes r Nor NA dt Yes r No r NA Was sensor properly replaced and r; yes r No d"` NA + Yes r Nod"" NA d* Yes d"' No r NA Yes ` No d" NA verified functional after testin ? 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. WO: 3424792 SWRCB, January 2002 Page 1 of 1 7. UNDER - DISPENSER CONTAINMENT (UDC) TESTING Test Method Developed By: UDC Manufacturer Industry Standard Professional Engineer Other (Specify Test Method Used By: 17 Pressure r7 Vacuum P7 Hydrostatic Other (Specify Test Equipment Used: VPLT Equipment Resolution: 0.00001 in. UDC #1/2 UDC #3/4 UDC #1/2 UDC #3/4 UDC Manufacturer: Polly Polly Polly Polly UDC Material: Fiberglass Fiberglass Fiberglass Fiberglass UDC Depth: 30.00 30.00 30.00 30.00 Height from UDC Bottom to Top of Highest Piping Penetration: 12.00 12.00 12.00 12.00 Height from UDC Bottom to Lowest Electrical Penetration: 8.00 8.00 8.00 8.00 Condition of UDC prior to testing: good good good good Portion of UDC Tested' X ABOVE HIGHEST PIPING T ABOVE HIGHEST PIPING Z ABOVE HIGHEST PIPING T ABOVE HIGHEST PIPING Does turbine shut down when UDC sensor detects liquid (both product and water)?* r Yes f No i* NA r Yes r Nor* NA r Yes r No d* NA r Yes r Nor NA Turbine shutdown response time 00:00:00 sec 00:00:00 sec 00:00:00 sec 00:00:00 sec Is system programmed for fail - safe shutdown ?* r Yes r No C+ NA r Yes r No G NA r Yes r Nor- NA r Yes r Nor* NA Was fail -safe verified to be operational?* r Yes r Nor NA r Yes r No C NA r Yes r Nor NA r Yes r Nor* NA Wait time between applying pressure /vacuum /water and starting test 15 min 15 min 15 min 15 min Test Start Time: 10:34:00 10:39:00 10:58:00 10:58:00 Initial Reading (Rj): 0.06210 in. H2O 0.28980 in. H2O 0.06100 in. H2O 0.28890 in. H2O Test End Time: 10:49:00 10:49:00 11:13:00 11:13:00 Final Reading (RF): 0.06100 in. H2O 0.28900 in. H2O 0.06100 in. H2O 0.28880 in. H2O Test Duration: 15 min 15 min 15 min 15 min Change in Reading (RF -RI) : - 0.00110 in. H2O - 0.00080 in. H2O 0.00000 in. H2O - 0.00010 in. H2O Pass/Fail Threshold or Criteria: +/-0,00200 +/-0.00200 +/-0.00200 +/-0.00200 Test Result: Pass Pass Pass Pass Was sensor removed for testing? 1 * Yes r Nor NA 0 Yes r Nor NA ro Yes r Nor NA fo Yes r Nor NA Was sensor properly replaced and verified functional after testing? ( Yes r Nor NA ro Yes r Nor NA C* Yes r Nor NA r Yes r Nor 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. WO: 3424792 S WRCB, 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 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY INC. Technician Conducting Test: Jeffrey Crisostomo Credentialsi: CSLB Contractor We, ICC Service Tech. SWRCB Tank Tester Other (Specify) License Number(s):743160- 8199847 3. SPILL BUCKET TESTING INFORMATION Test Method Used By: Hydrostatic 17 Vacuum Other Test Equipment Used: VPLT Equipment Resolution: 0.00001 in. Identify Spill Bucket (By Tank Number, Stored Product, etc.) Spill Box #Tank T2 RUL MAIN RUL - Vapor 1- Direct - Grade level Spill Box #Tank T2 RUL MAIN RUL - Fill 1 - Direct - Grade level Spill Box #Tank T1 RUL SIPHON RUL 2 - Vapor 1- Direct - Grade level Spill Box #Tank TI RUL SIPHON RUL 2 - Fill 1- Direct - Grade level Bucket Installation Type: "` Direct Bury r+ Contained in Sump r Direct Bury l* Contained in Sump r Direct Bury r Contained in Sump " Direct Bury r* Contained in Sump Bucket Diameter: 11.00 11.00 11.00 11.00 Bucket Depth: 14.00 13.50 14.00 13.50 Wait time between applying vacuum /water and start of test 15 min 15 min 15 min 15 min Test Start Time (TI): 09:50:00 09:50:00 09:50:00 09:50:00 Initial Reading (RI): 0.5231 in. H2O 0.7964 in. H2O 0.0075 in. H2O 0.7318 in. H2O Test End Time(TF): 10:05:00 10:05:00 10:05:00 10:05:00 Final Reading (RF): 0.5232 in. H2O 0.7961 in. H2O 0.0077 in. H2O 0.7315 in. H2O Test Duration(TF —TI): 15 min 15 min 15 min 15 min Change in Reading (RF —RI) : 0.00 in:. H2O 0.00 in. H2O 0.00 in. H2O 0.00 in. H2O Pass/Fail Threshold or Criteria: +/-0.0020 +/-0.0020 +/-0.0020 +/-0.0020 Test.Resi lt: Pass Pass Pass 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: 5/21/2015 1 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. W O: 3424792 S WRCB, 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 # 16329, MKT 2368 Date of Testing: 5/21/2015 Facility Address: 1701 PACHECO ROAD, BAKERSFIELD, CA 93307 Facility Contact: Preet Phone: 661 -549 -1711 Date Local Agency Was Notified of Testing: 5/12/2015 Name of Local Agency Inspector (if present during testing): Shane Gardner(Bakersfield fire) Test Method Used By: Hydrostatic r' Vacuum Other Test Equipment Used: VPLT Equipment Resolution: 0.00001 in. Identify Spill Bucket (By Tank Number, Stored Product, etc.) Spill Box #Tank T2 RUL MAIN RUL - Vapor 1- Direct - Grade level Spill Box #Tank T2 RUL MAIN RUL - Fill 1 - Direct - Grade level Spill Box #Tank T1 RUL SIPHON RUL 2 - Vapor 1- Direct - Grade level Spill Box #Tank TI RUL SIPHON RUL 2 - Fill 1- Direct - Grade level Bucket Installation Type: Direct Bury {* Contained in Sump r Direct Bury 0 Contained in Sump r Direct Bury t* Contained in Sump r Direct Bury t* Contained in Sump Bucket Diameter: 11.00 11.00 11.00 11.00 Bucket Depth: 14.00 13.50 14.00 13.50 Wait time between applying vacuum /water and start of test 15 min 15 min 15 min 15 min Test Start Time (TI): 10:10:00 10:10:00 10:10:00 10:10:00 Initial Reading (RI): 0.5232 in. H2O 0.7961 in. H2O 0.0077 in. H2O 0.7315 in. H2O Test End Time(TF): 10:25:00 10:25:00 10:25:00 10:25:00 Final Reading (RF): 0.5234 in. H2O 0.7951 in. H2O 0.0079 in. H2O 0.7315 in. H2O Test Duration(TF —Tl): 15 min 15 min 15 min 15 min Change in Reading (RF —RI) : 0.00 in. H2O 0.00 in. H2O 0.00 in. H2O 0.00 in. H2O Pass/Fail Threshold or Criteria: +/-0.0020 +/-0.0020 +/-0.0020 +/-0.0020 Test Result! Pass Pass Pass 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: 5/21/2015 'State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. WO: 3424792 S WRCB, 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 #16329, MKT 2368 Date of Testing: 5/21/2015 Facility Address: 1701 PACHECO ROAD, BAKERSFIELD, CA 93307 Facility Contact: Preet ==Phone: 661- 549 -1711 Date Local Agency Was Notified of Testing: 5/12/2015 Name of Local Agency Inspector (if present during testing): Shane Gardner(Bakersfield fire) Test Method Used By: Hydrostatic Vacuum Other Test Equipment Used: VPLT Equipment Resolution: 0.00001 in. Identify Spill Bucket (By Tank Number, Stored Product, etc.) Spill Box #Tank T3 PUL PUL - Fill 1 - Direct - Grade level Spill Box #Tank T3 PUL PUL - Vapor 1 - Direct - Grade level Spill Box #Tank T3 PUL PUL - Fill 1 - Direct - Grade level Spill Box #Tank T3 PUL PUL - Vapor 1 - Direct - Grade level Bucket Installation Type: d"" Direct Bury ro Contained in Sump r Direct Bury i* Contained in Sump r Direct Bury t* Contained in Sump " Direct Bury co Contained in Sump Bucket Diameter: 11.00 11.00 11.00 11.00 Bucket Depth: 13.50 14.00 13.50 14.00 Wait time between applying vacuum /water and start of test 15 min 15 min 15 min 15 min Test Start Time (TI): 09:30:00 09:30:00 09:52:00 09:52:00 Initial Reading (RI): 0.7368 in. H2O 0.57 in. H2O 0.7361 in. H2O 0.5691 in. H2O Test End Time(TF): 09:45:00 09:45:00 10:07:00 10:07:00 Final Reading (RF): 0.7361 in. H2O 0.5691 in. H2O 0.7362 in. H2O 0.5691 in. H2O Test Duration(TF —TI): 15 min 15 min 15 min 15 min Change in Reading (RF —RI) : 0.00 in. H2O 0.00 in. H2O 0.00 in. H2O 0.00 in. H2O Pass/Fail Threshold or Criteria: +/-0.0020 +/-0.0020 +/-0.0020 +/-0.0020 Test Results Pass Pass Pass 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: 5/21/2015 1State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. WO: 3424792 7- Eleven Test Water Log Work Order: 3424792 Date: 5/21/2015 Site Name /ID: 7- ELEVEN #16329, MKT 2368 Address: 1701 PACHECO ROAD City: BAKERSFIELD State: CA Zip: 93307 Work Performed: Disp Sump, Line Interstitials, SB's, STP Sump, Tank Interstitials Yes Was Test Water left on site? Test Fluid Transported Off Site by Tanknology FF Transported off Site by Other Company r— No Water used If Yes describe how much water and how contained? If Yes who and when did you contact from site to report the water? If Transported Off Site by Tanknology how much was hauled? If Transported Off Site by Other Company what company and how much water ?H20 pump out by Nieto and sons and its about 500 -700 gallons. Technician Signature: WO: 3424792 Date: 5/21/2015