HomeMy WebLinkAbout13004 STOCKDALE HWY (6)SWRCB, January 2002 Page I of
Secondary Containment Testing Report Form
Thisform is intendedfor use by contractors performing periodic testing of UST secondary containment systems. Use the
appropriatepages ofthis form to report resultsfor all components tested. The completedform, written test procedures, and
printoutsfrom tests (tfapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: CHEVRON Date of Testing: 45 -12
Facility Address: 13004 STOCKDALE HWY, BAKERSFIELD
Facility Contact: Phone:
Date Local Agency Was Notified ofTesting:
Name ofLocal Agency Inspector (rfpresent during testing):
2. TESTING CONTRACTOR INFORMATION
Company Name: Rich Environmental
Pass
Technician Conducting Test: RYAN MASON
Not
Tested
Credcndals: X CSLB Licensed Contractor SWRCB Licensed Tank Tester
License Type: C61/1340 A HAZ License Number: 809850
Manufacturer
Manufacturer Training
Component(s) Date Trainin , Expires
INCON TS -STS 10 -5 -13
11 i i
3. SUMMARY OF TEST RESULTS
Component Pass Fail Not
Tested
Repairs
Made
Component Pass Fail Not
Tested
Repairs
Made
DIESEL SEC. PIPE X 11 i i
UDC 1 -2 X C:I
UDC 9 -10 X Ll 1.1
L E U CI l
L
Li r1
n n CI 11 rl
n CI LI I r
1-i o r -I r 1 1-1 I
Ll n i:j r:1 L I 1
Ll i_1 I
111 f 1.
If hydrostatic testing was performed, describe what was done with the water after completion oftests:
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
To the best ofmy knowledge, thefacis stated in this document are accurate and in full compliance with legal requirentents
Technician's SiOnature: Date: ____
SWRCB, January 2002
5. SECONDARY PIPE TESTING
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Page Z of 3
Test Method Developed By: Piping Manufacturer X Industry Standard Professional Engineer
Other (Specify)
Test Method Used: X Pressure Vacuum Hydrostatic
Other (Spec)
Test Equipment Used: Equipment Resolution:
Piping Run # DSL
Piping Material: PLASTIC
Piping Run # Piping Run #
Oo
Piping Run #
Test Result:
Piping Manufacturer: TCI
0 Pass Fail Pass Fail
Piping Diameter: 2"
Length of Piping Run: 200'
Product Stored: DIESEL
Method and location of
piping-run isolation:
TEST BOOT IN DSL
STP
Wait time between applying
pressure/vacuum/water and
starting test:
60MIN
Test Start Time: 1:00
Initial Reading (RJ: 5PSI
Test End Time: 2 :00
Final Reading (RF): 5PSI
Test Duration: 60MIN
Change in Reading (Rf Rl): 0
Pass/Fail Threshold or
Criteria: 0
Test Result: X Pass Fail Pass Fail 0 Pass Fail Pass Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailedtests)
SWRCB. January 2002
7. UNDER- DISPENSER CONTAINMENT (UDQ TESTING
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Page _ 3 _ of ,3
Pest Method Developed By: D UDC Manufacturer D Industry Standard Ll Professional Engineer
Other (Specify)
Test Method Used: Pressure 1:1 Vacuum n Hydrostatic
D Other (Specify)
Test Equipment Used: Equipment Resolution:
UDC #1 -2 UDC 9-10 UDC# UDC#
UDC Manufacturer: TCI TCI
L)DC Material: PLASTIC PLASTIC
UDC Depth: 24" 40"
Hei-lit from UDC Bottom to Top 14" 14"
Of Highest Piping Penetration:
Height from UDC Bottom to 6" 6" Lowest Electrical Penetration:
Condition of UDC prior to CLEAN CLEAN
testing:
Portion of UDC Tested 16" 16"
Does turbine shut down when
UDC sensor detects liquid (both X Yes No D NA X Yes n No DNA D Yes 1.7 No I-I NA f) Yes ['No !. NA
and water) ?* product
Turbine shutdown response time N/A N/A
Is system programmed for fail - X Yes L] No NA X Yes 11 No 0 NA Yes DNo l] NA I_l Yes f ! No ;I NA
safe shutdown ?*
Was fail -safe verified to be
X Yes No DNA X Yes D No DNA D Yes L l No NA C1 Yes No i ! NA
operational?*
1
Wait time between applying
pressure /vacuum /water and 30MIN 30MIN 30MIN 30MIN
starting lest
Test Start Time: 3:54PM 4: l 1 PM 7:11 PM 7:26PM
Initial Reading (R,): 3.7441N 3.7451N 5.9541N 5.954IN
Test End Time: 4:09PM 4:26PM 7:26PM 7:41 PM
final Reading (RI-): 3.7441N 3.7451N 5.954IN 5.5941N
Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN
Change in Reading (RI.R,): OOOIN OOOIN 000IN 0001N
Pass /Fail Threshold or Criteria: 0021N 0021N 0021N I .0021N 0021N 0021N OQ21N 0021N
Test Result: X Pass Fail X Pass Fail D Pass Fail Pass Fail
Was sensor removed for testing? X Yes No DNA X Yes No i'I NA D Yes No DNA I l Yes 1 No NA
Was sensor properly replaced and
verified functional after testing? X Yes 17J No DNA X Yes No U NA Yes No [I NA L i Yes I iNo :NA
Comments — (include information on repairs made prior to testing, andrecommended fbllow -up for.failed t(,-sts)
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)
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04/a3i2011INLEVEL3.7446
ND DATk 4:09 pm
YU cVt y4/03/20;2
3.7447 int-EAK TH ES_HSLD 6.002 1r: ES, RESU L I PASSED
QDCl -2
TEc- STARTED 4:_1 ?n•
EST KjV M 04ie3/2012
BEGIN LEVEL 3.7451 :r
ND TIME 4:26 A4
END DATE 0a 03 20ai
ND LEUFL 3.7452 Ery
rEflK THP- "%lQLD 0.002 -,,N
TEST RESU -T PASSEL)
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26 N„
gl!Ma '_` AK T .ST R EaORT
UDC9-1 6
T'aT S7MRTED 7:1 P,
TEST STARTED 04/05/201HH-
T EL 5.9534 PC
END TIME 7:26
1
1.40 DATE 5 9542 I END LEUELOAKT}{RESHO D
TEST RESULT
BUMP _EAK TEST REPORT
UDC9 -10
S' cTARTED
TEST STARTED
26 PTT,
04/05/20"
6EGIN • EUEL 5.5-55447;41 P.`: END TIME
ND DATE 95518. I
END LEUELrLEAKTHREaHOLD PAbS
TEST RESULT