HomeMy WebLinkAboutSB989 2017I
environmental services, inc.
25971 Towne Centre Drive, Foothill Ranch, CA 92610
Tel: (949) 460-5200 Fax: (949) 460-5210
Date:
To:
From:
Sent Via:
Re:
2/28/2017
Ernie Medina
Bakersfield City CUPA
1500 Truxtun Ave
Bakersfield, CA 93301
Bill Moothart
Email
TRANSMITTAL
Secondary Containment Test
Circle K Store #2708605
5600 AUBURN ST
BAKERSFIELD, CA 93306
The following test report(s) are included:
SCT-3 yr
Comments:
Please do not hesitate to call me at (949) 460-5200 if you have any questions or concerns regarding this work.
1451583
SWRCB, Januaty 2002 Page __ of __
Secondary Containment Testing Report Form
This .form is intended.for use by contractors pe!forming periodic testing o.fUSt secondary containment systems. Use the appropriate
pages ofthis.form to report resultsjor all components tested The completedfoi·m, written test procedures, and phntoutsji·pm tests
(if applicable), should be provided to the faci !ity o11'nerloperqtorfor subiJiiftal to the !ocalregulatory agency.
1. FACILITY INFORMATION
Facility Name: Circle K Store #2708605 I Date of Testing: 2/9/2017
Facility Address: 5600 AUBURN ST, BAKERSFIELD, CA 93306
Facility Contact: Circle K Stores Inc. j Phone: (661) 871-6273
Date Local Agency Was Notified of Testing: 1/23/2017
Name of Local Agency Inspector (if present dui'ing testing): Shane Gardner '
2. TESTING CONTRACTOR INFORMATION
Company Name: Belshite Envitonmental Setvices, Inc.
Teclmician Conducting Test: Jeff Badders
Credentials: ~ CSLB Licensed Contractor D SWRCB Licensed Tank Tester
License Type: A -General Engineering Conttactor J License Number: 808313
" ' ' Manufacturer Tt:aining
Manufacturer Component( s) Date Training Expires
See Attached
3. SUMMARY OF TEST RESULTS
Component Pass Fail Not Repairs Component Pass Fail Not Repairs
Tested Made Tested Made
' Tank Annulars 3 ~ D D D 0 0 0 0 I
Secondary Pige 3 D ~ D D Q1 _EailNI 0 0 D 0
Piping Sump 3 D ~ D D 87 Failed 0 D 0 0
UDC 2 ~ D D D 0 D 0 0
Fill Sump D D D D Site Direct Bury 0 D 0 0
Spill Bucket 3 ~ D D D Only Fills Tested 0 D D 0
If hydrostatic testing was performed, describe what >vas done with the water after completion of tests:
0 Pla.ced in drums left on site for proper disposition.
0 Transported to next site for use in additional testing,
CERTIFlCATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
To the best of my knmVledge, the facts stated in this document are accurate aitd in full ciJmplic(iJCeWit!t legalrequirenleJJ.ts
Teclmician's Signature: (? ./.:S .. ···;::/l:$(~~ ,,~.o. .. -------------+-------------------------Date: ___ ""'2/,_,9.u/2"-'0~1_,_7 ___ _
Test Method Developed By:
Test Method Used:
4. TANK ANNULAR TESTING
D Tank Manufacturer
D Other PP•~CIJVJ
D Pressure
D Other (Spec([V)
!2l Industry Standard
!2l Vacumn
D ProfessionalEngineer
0 Hydrostatic
Test Equipment Used: Test plugs, venturi pump and gauges Equipment Resolution: 0.5% of st•an .................. ~._ .... ,
Is Tank Exempt From Testing?'
Tank Capacity:
Tank Material:
Tank Manufacturer:
Product Stored:
Wait time between applying
pressure/vacuum/water and
test:
Test Start Time:
Initial Reading (Rr):
Test End Time:
Final Reading (RF ):
Test Duration:
Pass/Fail Threshold or Criteria:
Test Result:
Was sensor removed for testing?
Was sensor properly rer:,lac:ed
verified functional
87 Maste1· 89 91
Owens Corning Owens Corning Owens Corning
89 91
10 minutes 10 minutes 10 minutes
08:
10 In. Vac 10 In. Vac 10 In. Vac
10 In. Vac 10 In. Vac 10 In. Vac
0 0
No Detectable Loss No Detectable Loss No Detectable Loss
Pass Pass Pass
N/A N/A N/A
N/A N/A N/A
Comments-(include information on repairs made prior to testing, and recommended follow-up for failed tests)
1 Secondary containment systems where the contin~10us monitoring autoll1atically inonitors both the primary and secondary
containll1ent, such as systems that are hydrostatically monitored or under constantvacuum, are exempt from periodic containment
testing. {California Code ofRegulations, Title23, Section 2637(a)(6)}
5. SECONDARY PIPE TESTING
Test Method Developed By: D Piping Manufacturer ~ Industry Standard D Professional Engineer
0 Other (Spec(fy)
Test Method Used: ~ Pressure D Vacuum D Hydrostatic
0 Other (Spec(fy)
Test Equipment Used: Test reducer boots, air compressor and gauges Equipment Resolution: 0.5% of span
91 87M 89
Piping Material: Fiberglass Fiberglass Fiberglass
Piping Manufacturer: AO Smith AO Smith AO Smith
Piping Diameter: 3" 3" 3"
Length of Piping Run: 45' 45' 45'
Product Stored: 91 87 89
MP.thorl and location of
piping-run isolation: Reducer Boots/Fittings Reducer Boots/Fittings lo. ,J. Boots/Fitting~
Wait time between applying
pressure/vacutJm/water and 10 minutes 10 minutes 10 minutes
starting test:
Test Start Time: 08:15AM 08:30AM 08:30AM
Initial Reading (RI): 5 5 5
Test End Time: 09:15AM 09:30AM 09:30AM
Final Reading (RF): 2 5 5
Test Duration: 60Min 60Min 60Min
Change in Reading (RF-RI): -3 0 0
Pass/Fail Threshold or
Criteria: No Detectable Loss No Detectable Loss No Detectable Loss
Test Result: Fail Pass Pass
Comments -(include informafion on repairs made prior to testing, and recommended.follow-up for failed tests)
91 secondary is failing underground.
No visual failure at sump or UDC.
6 PIPING SUMP TESTING
Test Method Developed By: 0 Sump Manufach1rer 18.1 Industry Standard 0 Professional Engineer
0 Other (,'>pec!M
Test Method Used: 0 Pressure 0 Vacuum 18.1 Hydrostatic
0 Other (Specifj')
inmP.nt I neon Sump Test System Equimi1ent Resolution +/-0.002" -r
91 89 87 Master
Sump Diameter: 42" 42" 42"
Sump Depth: 45' 45' 45'
Sump Material: Fiberglass Fiberglass Fiberglass
Height from Tank Top to Top of
Higl1est Piping Penetration: 22" 22" 22"
-Height from Tank Top to Lowest
Electrical Penetration: 10" 10" 10"
Condition of sump prior to testing: Good Good Good
Portion of Sump Tested1 4' Above Pen. 4 Above Pen. 4' Above Pen
Does rnrbine shut down when
sump sensor :,:~~~~~·liquid (both 0 Yes 0 No 18JNA DYes ONo ~NA 0 Yes 0 No ~NA D YesO No 18JNA
product and
Turbine shutdown response time N/A N/A N/A
Is system progranuned for fail-safe
shutdown?" OYesONo~NA 0 Yes 0 No 18.1 NA DYes 0 No ~NA 0 Yes 0 No 18.1 NA
Was f~il-"~fp verified to be
operational?. 0 Yes 0 No 18.1 NA 0 Yes 0 No 18.1 NA 0 Yes 0 No0NA OYesONo 0NA
Wait time between applying
pressure/vacuum/water and starting 30 minutes 30 minutes 30 minutes
test:
Test Start Time: 09:45AM 10:19 AM 08:56AM
Initial Reading (R1): 4.3315 5.7628 5.2858
Test End Time: lO:OOAM 10:34AM 09:11AM
Final Reading (RF): 4.3312 5.7623 5.2026
Test Duration: 15 min. 15 min. 15 min.
Change in Reading (RF-RI): -0.0003 -0.0005 -0.0832
Pass/Fail Threshold or Criteria: +!-0.002" +/-0.002 +!-0.002
Test Result: Pass Pass Fail
Was sensor removed for testing? Yes Yes Yes
W: sensor properly 110pwvw and
wriflt:u functional after testing? Yes Yes Yes
Comments -(include.information on repairs made prior to testing, and recommendedfollow-up for failed tests)
Sensor functionality was not confirmed. This nrocedure is not nm1 of the Secondarv Containment Testin!! scone of work
87 turbine failed at penetration of secondary line.
1 If the entire depth of the sump is not tested, specify how much was tested. If the answer to ill!Y. of the questions indicated with an
asterisk(*) is "NO" or "NA", the entire sump must be tested. {See SWRCB LG-160) ·
7. UNDER-DISPENSER TESTING
Test Metl10d Developed By:
Test Metl10d Used:
D UDC Manufacturer
D Otl1er (Spec((y)
D Pressure
D Other (Specify)
15"
Fair
121 Industry Standard D onal Engineer
D Vacuum 121 Hydrostatic
15"
Fair
OYesONo 1:2lNA OYesONo 1:2lNA DYesONo 121NA DYesONo 121NA
DYes ONo 121 NA 0 Yes D No l:2l NA 0 Yes D No 121 NA DYes D No 121 NA
30 minutes
Yes Yes
Comments -(include information on repairs made prior to testing, w1d recommended.fol!ow-up for failed tests)
Sensor functionality was not confirmed. This J)rocedure is not J)ati of the Secondary Containment Testing scope of work
1 If the entire deptl1 of the UDC is not tested, specify how much was tested. If the answer to fillY. of the questions indicated witl1 an
asterisk(*) is "NO" or "NA", tl1e entire UDC must be tested. (See SWRCB LG-160)
8. FILL RISER CONTAINMENT SUMP TESTING
Facility is Not Eqwpp~;d With Fill Riser r~ lPnt Smnps D
Fill Riser ronl: Sumps are Present, but were Not Tested D
Test Method Developed By: D Sump Manufacturer f2l Industry Standard D Professional Engineer
0 Other (.S'pecijj')
Test Method Used: D Pressure 0 Vacuum f2l Hydrostatic
D Other (Spec(jjl}
Equipment Used: lncon TS-STS Sump Test System Equipment Resolution: +/-0. 002"
s~li)
Sump Depth:
~~i?ht from Tanlc Top to Top of
Highest Piping Penetration:
Height from Tanlc Top to Lowest
Electrical Penetration:
rMilition of sump prior to
testing:
Portion of Sump Tested
Sru_!lp M~ial:
Wait tinte between applying
pressure/vacuum/water and
starting test:
T~ Start Time:
Initial ReHdins:r (Rr):
Test End Time:
Final Readins:r (Rr)
Test Duration:
rhiltHTP in ReHdins:r (Rr-Rr):
Pass/Fail Threshold or Criteria:
test Result!
Is there a sensor in the sump?
Does the sensor alarm when
either product or water is DYes D No 12JNA DYes DNo 12JNA 0 Yes 0 No l2l NA D YesD No 12JNA
detected?
Was sensor uowuv~.-\,l for LtJMmg?
Was sensor properly repl;wPil and
verified functional after testing?
Comments-(include information on repairs made prior to testing, and recommended follow-up for failed tests)
Direct Bury
9 SPILL/OVERFILL CONTAINMENT BOXES
Facility is Not ~ With Spill/Overfill n •Boxes D
SpilVOverfill Containment Boxes are Present, but were Not Tested D
Test Method Developed By: D Spill Bucket Manufacturer ~ Industry Standard D Professional Engineer
D Other (Specify)
Test Method Used: D Pressure D Vacuum ~ Hydrostatic
D Other (Specify)
Test Equipment I neon TS-STS Sump Test System Equipment Resolution: +/-0.002"
Spill Box# 91 Fill S1>ill Box# 89 Fill Spill Box# 87 Fill Spill Box#
Bucket Diameter: 12" 12" 12"
Bucket Depth: 12" 12" 12"
Wait time between applying
pressure/vacuum/water and 30 minutes 30 minutes 30 minutes
;tarting test:
Test Strui Time: 08:56AM 10:19 AM 08:56AM
Initial Reading CRr): 6.7734 6.7244 5.7129
Test End Time: 09:11AM 10:34 AM 09:11AM
Final Reading (RF): 6.7733 6.7242 5.7121
Test Duration: 15 min. 15 min. 15 min.
Change in Reading (RF-Rr): -0.0001 -0.0002 -0.0008
Pass/Fail Threshold or
Criteria: +/-0.002" +!-0.002" +/-0.002"
Test Result: Pass Pass Pass
Comments -(include information on repairs made prior to testing, and recommendedfollow-up for failed tests)
Name
Badders, Jeff
Badders, Jeff
Badders, Jeff
Badders. Jeff
Badders, Jeff
Badders, Jeff
Manufacturer Training
Training
OPW EVR Phase I
Phil Tite Spill Collectors & Associated Hardware
FiberGlass Systems Piping (Formerly AO Smith)
Modern Welding Tank Installation
Xerxes UST Installation Training Seminar
INCON Level4-Franklin Sump Test System
Completed
9/15/2015
7/21/2015
7/11/2014
9/2/2015
9/16/2015
10/28/2016
Expires
9/15/2017
7/21/2017
7/11/2017
9/2/2018
9/16/2018
10/28/2018
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BUSINESS NAME:Circle K #2708605
SITE ADDRESS: 5600 Auburn Street I CITY: Bakersfield IZIP:93306
MAP DATE:2/15/17ISURVEY BY: I DRAWN BY:ZK I AGENCY FACILITY#:
A B c D E F G H K L M
I
1---+----+~----+---+~t--+---+------------+------t+--
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; I i .,.\ 87 ' i-...... c-~, .. _... ' l----------+-------+--------~-------+-------+--------~------1 __ ,.-·-·. \.·""'-',, -.. -''.-----._ --:-------+---------1
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' -,, --'~ ·-·Ol -... .,,, .... 1------r----r----~----~-----+---~----~-----~, 91 ~ ; o.~~--=------------1~---1 ·~ -,,, '.9._.0 I . ' ··o·'' -'f--,:,o : -~ l-------r-------r-----+--------r------~--~----~----+--~ ·-·o,J-+-----------;i-----------+------1
,.,..
-., I
vvo.y
~ Auburn St ~~ , I
**Nu tt:: ALL PIPING I nr.~TIONS ARE ESTIMATED & SCALING IS APPROXIMATE**
LEGEND
8 DISPENSER 0 [£h] FLAMMABLE LIQUID I MSDS ~~~~~G~NCY PlAN I BR I BATH ROOM SHUTOFF -CASHIER ABSORBENT
8 GAS PUMP ~ s EMERGENCY FIRE HYDRANT MONITORING [fg COMBUSTIBUE ~ ®SEWER/FLOOR DRAIN SHUT OFF WEUL LIQUID TRASH BIN
0 EUECTRICAL PANEL • ® WATER I MC I MOTOR COOlANT + TANK MONITOR FENCE FIRST AID 0 SOLID WASTE DRUM * EVACUATION t PPE I Mol MOTOR OIL t FIRE EXTINGUISHER ••• VENT RISERS 0 LIQUID WASTE DRUM AREA
IY.§] «O)) OVERFIUL ALARM c TEUEPHONE IE M I EMERGENCY EXIT I C:<>21 C02 CYLINDER 1?1 STORM DRAIN
-DISPENSER w [UJ VENT RISERS or CUEAN AIR c::::::::::::) UST
--·--
SENSOR TRANSFORMER with ~SEPARATOR ,,, ® NATURAL GAS SHUTOFF VENT SUMP/ s 0 NITROGEN VENT BOX
BELSHIRE ENVIROMENTAL
5600 AUBURN ST
BAKERSFIELD CA
CIRCLE K 2703605
1-949-453-0391
02/09/2017 10:00 Al1
SUMP LEAK TEST REPORT
91 TS
TEST STARTED 9:45 AM I
TEST STARTED 02/09/2017
BEGIN LEVEL 4,3315 IN
END TIME 10:00 AM
END DATE 02/09/2017
END LEVEL 4,3312 IN
LEAK THRESHOLD 0,002 IN
TEST RESULT PASSED
39 TS
TEST STARTED 10:19 AM
TEST STARTED 02/09/2017
BEGIN LEVEL 5, 7623 IN
END TIME 10:3a AM
END DATE 02/09/2017
END LEVEL 5, 7623 IN
LEAK THRESHOLD 0,002 IN
TEST RESULT PASSED
37M TS
I
I TEST STARTED 8:56 AM
TEST STARTED 02/09/2017
BEGIN LEVEL 5,2858 IN
END TIME 9:11AM
END DATE 02/09/2017
END LEVEL 5,2026 IN
LEAK THREShOLD 0, 002 IN
TEST RESULT FAILED
DP 1-2
TEST STARTED 10:19 AM
TEST STARTED 02/09/2017
BEGIN LEVEL 6,0648 IN
END TIME 10:3a AM
END DATE 02/09/2017
END LEVEL 6,06aa IN
LEAK THRESHOLD 0,002 IN
TEST RESULT PASSED
DP 3-4
TEST STARTED 10:19 AM
TEST STARTED 02/09/2017
BEGIN LEVEL 7,3043 IN
END TIME 10:3a AM
END DATE 02/09/2017
END LEVEL 7,3045 IN
LEAK THRESHOLD 0,002 IN
TEST RESULT PASSED
91 FB
TEST STARTED 8:56 AM /
TEST STARTED 02/09/2017
BEGIN LEVEL 6, 7734 IN
END TIME 9: 11 AM
END DATE 02/09/2017
END LEVEL 6, 7733 IN
LEAK THRESHOLD 0, 002 IN
TEST RESULT PASSED
89 FB
TEST STARTED 10:19 AM
TEST STARTED 02/09/2017
BEGIN LEVEL 6, 7244 IN
END TIME 10:34 AM
END DATE 02/09/2017
END LEVEL 6, 7242 IN
LEAK THRESHOLD 0,002 IN
TEST RESULT PASSED
37M FB
)
TEST STARTED 8:56 AM
TEST STARTED 02/09/2017
BEGIN LEVEL 5, 7129 IN
END TIME 9: 11 AM
END DATE 02/09/2017
END LEVEL 5, 7121 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
/
\ D~ \