HomeMy WebLinkAbout13004 STOCKDALE HWY (7)4 (0 Z.1,
SWRCB, January 2002 Page ` of
Secondary Containment Testing Report Form
Thisform is intendedfor use by contractors performing periodic testing ofUSTsecondary containment systems. Use the
appropriate pages ofthisform to report resultsfor all components tested. The completedform, written test procedures, and
printoutsfrom tests (fapplicable), should be provided to thefacility ownerloperatorfor submittal to the local regulatory agency.
1. FACT LTTY INFORMATION
Facility Name: CHEVRON Date ofTesting: 12/1/11
Facility Address: 13004 STOCKDALE HWY
Facility Contact•. KHENG Phone:
Date Local Agency Was Notified of Testing: 10/31/11
Name of Local Agency Inspector (tfpresent during testing):
2. TESTING CONTRACTOR INFORMATION
Company Name: Rich Environmental
Pass
Technician Conducting Test: RICH PHILLIPS
Not
Tested
Credentials: X CSLB Licensed Contractor 0 SWRCB Licensed Tank Tester
License Type: C61/1340 A HAZ
Fail
License Number: 809850
Manufacturer
Manufacturer Trainine
Component(s) Date Training E ires
INCON TS -STS 6/11/12
DISP #3/4 X
3. SUMMARY OF TEST RESULTS
Component Pass Fail Not
Tested
Repairs
Made Component Pass Fail Not
Tested
Repairs
Made
REG87 ANNULAR X DISP #3/4 X
MID89 ANNULAR X DISP #5/6 X
PREM91/DSL ANNULAR X 1 DISP #7/8 X
REG87 SECONDARY PIPE X DISP #9/10 X
MID89 SECONDARY PIPE X RE087 VAPOR BUCKET X
PREM91 SEC PIPE 0 X MID89 VAPOR BUCKET X
DSL SECONDARY PIPE X PREM91 VAPOR BKT X
REG87 STP X Cl
MID89 STP x
PREM91 STP x
DSL STP X
DISP #1/2 1 X 0-1
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, thefacts stat ds document are accurate and infull compliance with legal requirements
Technician's Signature: Date: 12 /1 /I 1
SWRCB January g2002Page ?/ of
4. TANK ANNULAR TESTING
Test Method Developed By: 0 Tank Manufacturer X Industry Standard 0 Professional Engineer
D Other (Spec)
Test Method Used: 0 Pressure X Vacuum Hydrostatic
Other (Spec)
Test Equipment Used: 4" DIAL GAUGE Equipment Resolution: .5%
Tank #PREM91 Tank # Tank #REG87 Tank #MID89
Is Tank Exempt From Testing?' 0 Yes X No 0 Yes X No 0 Yes X No 0 Yes 0 No
Tank Capacity: 12000 12000 12000
Tank Material: STEEL STEEL STEEL
Tank Manufacturer: UNKNOWN UNKNOWN UNKNOWN
Product Stored: REG87 MID89 PREM91
Wait time between applying
pressure /vacuum/water and
starting test:
30MIN 30MIN 30MIN
Test Start Time: 9:30 9:30 10:15
Initial Reading (R): 1 OHG IOHG IOHG
Test End Time: 10:30 10:30 11:15
Final Reading (RF): IOHG I OHG IOHG
Test Duration: 60 MIN 60 MIN 60 MIN
Change in Reading (RF -Rj): 0 0 0
Pass/Fail Threshold or Criteria: 0 0 0
Test Result- X Pass 0 Fail X Pass 0 Fail X Pass Fail Pass Fail
Was sensor removed fortesting? X Yes 0 No 0 NA X Yes 0 No 0 NA X Yes DNo DNA Yes 0No DNA
Was sensor property replaced and
verified functional after testin ? X Yes No D NA X Yes No NA X Yes 0No NA Yes 0 No NA
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed 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 ofRegulations, Title 23, Section 2637(ax6)1
SWRCB, January 2002
5. SECONDARY PIPE TESTING
4049 ?JA-7
Page ,1) of8
Test Method Developed By: Piping Manufacturer X Industry Standard Professional Engineer
0 Other (Specify)
Test Method Used: X Pressure Vacuum Hydrostatic
Other (Specify)
Test Equipment Used: 4" DIAL GAUGE Equipment Resolution: .5%
Piping Run #87 Piping Run #89 Piping Run #91 Piping Run #DSL
Piping Material: PLASTIC PLASTIC PLASTIC PLASTIC
Piping Manufacturer: TCI /APT TCI /APT TCI /APT TCI /APT
Piping Diameter: 2" 2:" 2" 2"
Length of Piping Run: 150" 150" 150" 150"
Product Stored: 87 89 91 DSL
Method and location of
piping-run isolation: BOOT W SUMP BOOT M SUMP BOOT M SUMP BOOT IN SUMP
Wait time between applying
pressure/vacuum/water and
starting test:
30 MIN 30 MIN 30 MIN 30 MIN
Test Start Time: 9:15 9:15 9:15 10:30
Initial Reading (Rj): 6.0 5.5 5.5 6.0
Test End Time. 10:15 10:15 10.15 11:30
Final Reading (RF): 6.0 5.5 5.5 6.0
Test Duration: 60 MIN 60 MIN 60 MIN 60 MIN
Change in Reading (Rr -Rj): 0 0 0 0
Pass/Fail Threshold or
Criteria 0 PSI 0 PSI 0 PSI 0 PSI
Test Result: X Pass 0 Fail I X Pass 0 Fail 0 Pass X Fail X Pass 0 Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -upfarfailed tests)
THIS TEST IS FROM STP' S TO DISP #8. NEW APT PIPE FROM DISP #7
ON GAS 91 GRADES. TCI ALL DONUTS ARE OUT - NOT TESTED
91 TEST BOOT IN DISP #8 NEEDS TO BE REPLACED
DIESEL HAS TCI PIPE FROM DISP 99 TO DISP 91. DIESEL DOESN'T
RUN THROUGH DISP #3/4.5/6. OR 7/8 (GOES AROUND TO OUTSIDE
DISP.
SWRCB, January 2002
6. PIPING SUMP TESTING
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Page 'I of
Test Method Developed By: 0 Sump Manufacturer X Industry Standard 0 Professional Engineer
0 Other (Spec)
Test Method Used: 0 Pressure Vacuum X Hydrostatic
0 Other (Specify)
Test Equipment Used: INCON TS -STS Equipment Resolution:
Sump #87 Sump #89 Sump #91 Sump #DSL
Sump Diameter: 37" 37" 37" 37"
Sump Depth: 60" 60" 60" 60"
Sump Material: FIBERGLASS FIBERGLASS FIBERGLASS FIBERGLASS
Height from Tank Top to Top of
Highest Piping Penetration: 17" 17" 16" 16"
Height from Tank Top to Lowest
Electrical Penetration: 12" 19" 11" 10"
Condition of sump prior to testing: GOOD GOOD GOOD GOOD
Portion of Sump Tested' 19" 19" 18" 18"
Does turbine shut down when
sump sensor detects liquid (both
product and water)?*
0 Yes 0 No X NA Yes 0 No X NA 0 Yes No X NA Yes No X NA
Turbine shutdown response time
Is system programmed for fail -safe
shutdown ?*
0 Yes 0 No X NA 0 Yes 0 No XNA Yes 0No X NA 0 Yes No X NA
Was fail -safe verified to be
operational?*
Dyes 0 No X NA 0 Yes []No XNA 0 Yes 0No X NA 0 Yes 11 No XNA
Wait time between applying
pressure /vacuum/water and starting
test:
30 MIN 30 MIN 30 MIN 30 MIN
Test Start Time: 12:40 12 :57 12:40 12:57 12:57 1:13 1:36 2 :20
Initial Reading (Rj): 4.470 4.470 3.402 3.402 2.420 2.420 3.870 3.682
Test End Time: 12:55 1 :12 12:55 1:12 1:12 1:28 1:52 2:35
Final Reading (RF): 4.470 4.471 3.402 3.402 2.420 2.420 3.872 3.682
Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN
Change in Reading (RF -Rj): 000 000 000 000 000 000 002 000
Pass/Fail Threshold or Criteria: 002 002 002 1 -.002 002 002 002 002
Test Result: X Pass 0 Fail X Pass 0 Fail X Pass 0 Fail X Pass 0 Fail
Was sensor removed for testing? X Yes No DNA X Yes No DNA X Yes 0 No DNA X Yes 0 No 0 NA
Was sensor properly replaced and
verified functional after testin ? X Yes 0 No DNA X Yes No 0 NA X Yes No DNA X Yes No 0 NA
Comments - (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
Ifthe entire depth ofthe sump is not tested, specify how much was tested. Ifthe answer to any of the questions indicated with an
asterisk ( *) is "NO" or "NA ", the entire sump must be tested. (See SWRCB LG -160)
SWRCB, January 2002
7. UNDER- DISPENSER CONTAINMENT WDCI TESTING
Page J of
Test Method Developed By: 0 UDC Manufacturer X Industry Standard Professional Engineer
Other (Specify)
Test Method Used: Pressure Vacuum X Hydrostatic
Other (Spec)
Test Equipment Used: INCON TS -STS Equipment Resolution:
UDC #1/2 UDC #3/4 UDC #7/8UDC #5/6
UDC Manufacturer: UNKNOWN UNKNOWN UNKNOWN UNKNOWN
UDC Material: FIBERGLASS FIBERGLASS FIBERGLASS FIBERGLASS
UDC Depth: 28" 28" 28" 28"
Height from UDC Bottom to Top
of Hi est Piping Penetration:
9" 9" 9" 9"
Height from UDC Bottom to
Lowest Electrical Penetration:
10" 10" 10" 10"
Condition of UDC prior to
testing:
GOOD GOOD GOOD GOOD
Portion ofUDC Tested'
Does turbine shut down when
UDC sensor detects liquid (both
and water)?*
Yes No X NA Yes No X NA Yes No XNA Yes No X NA
product
Turbine shutdown response time
Is system programmed for fail-
safe shutdown ?'
Yes No X NA Yes No XNA Yes No X NA Yes 0 No X NA
Was fail -safe verified to be
operational?* 0 Yes 0 No X NA Yes No XNA Yes No X NA 0 Yes 0 No X NA
Wait time between applying
pressure/vacuum/water and
test
30MIN 30MIN 30MIN 30MIN
starting
Test Start Time:
Initial Reading (Rj):
Test End Time:
Final Reading (RF ):
Test Duration: 15MIN 15MIN 15M1N 15MTN 15MIN 15MIN 15MIN 15MIN
Change in Reading (RF-R,):
PassiFail Threshold or Criteria: 0021N 0021N 0021N 1 .0021N 0021N 0021N 0021N 0021N
Test Result: Pass 0 Fail Pass 0 Fail Pass 0 Fail Pass Fail
Was sensor removed for testing? Yes 0 No 0 NA Yes No NA 0 Yes No NA Yes No 0 NA
Was sensor properly replaced and
verified functional after testing? D Yes No NA Yes No NA Yes No NA Yes No NA
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
UNABLE TO TEST, ALL THE TO DONUTS IN PENETRATIONS ARE
REMOVED. PIPE AND /OR DISPENSER MAY NEED TO BE REMOVED
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)
SWRCB, January 2002
4YOZ/6:2
Page _if) of 0 r
7. UNDER- DISPENSER CONTAINMENT (UDC) TESTING
Test Method Developed By: UDC Manufacturer X Industry Standard Professional Engineer
Other (Specify)
Test Method Used: 0 Pressure Vacuum X Hydrostatic
0 Other (Spec)
Test Equipment Used: INCON TS -STS Equipment Resolution:
UDC #9/10 UDC # UDC # UDC #
UDC Manufacturer: UNKNOWN
UDC Material: FIBERGLASS
UDC De the 28"
Height from UDC Bottom to Top 9"
of Highest Piping Penetration:
Height from UDC Bottom to 10"
Lowest Electrical Penetration:
Condition of UDC prior to GOOD
testing:
Portion of UDC Tested'1 l"
Does turbine shut down when
UDC sensor detects liquid (both Yes No X NA 0 Yes No DNA D Yes No NA Yes 0 No NA
product and water)?*
Turbine shutdown response time
Is system programmed for fail- D Yes No X NA D Yes No DNA Yes 0 No NA 0 Yes No NAsafeshutdown ?'
Was fail -safe verified to be Dyes No X NA Yes 0No NA Yes No DNA D Yes No NA
operational ?`
Wait time between applying
pressure/vacuum/water and 30MIN 30MIN 30MIN 30MIN
starting test
t est Mart i une:
Initial Reading
Test End Time:
I Test Duration: I 15MIN 1 15MIN I 15MTN I 15MIN I 15MIN I 15MIN I 15MFN I 15M1N I
Change in Reading (RF -R,):
Pass/Fail Threshold or Criteria:
Test Result: Pass [)Fail Pass Fail Pass Fail D Pass Fail
Was sensor removed for testing? Yes No NA Yes 0 No DNA Yes 0 No DNA 0 Yes 0No 0 NA
Was sensor properly replaced and
verified functional after testing? D Yes No NA Yes 0N DNA Yes 0 N NA 0 Yes No 0N
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
UNABLE TO TEST, ALL TO DONUTS REMOVED.
Ifthe entire depth ofthe UDC is not tested, specify how much was tested. Ifthe answer to any ofthe 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
4gi, Vo
Page I of 0
Facility is Not Equipped With Fill Riser Containment Sums
Fill Riser Containment Sumps are Present, but were Not Tested
Test Method Developed By: Sump Manufacturer 0 Industry Standard Professional Engineer
0 Other (Spec)
Test Method Used: Pressure 0 Vacuum 0 Hydrostatic
Other (Spec)
Test Equipment Used: Equipment Resolution:
Fill Sump #
Sump Diameter:
Fill Sump # Fill Surne # Fill Sum #
Sump Depth:
Height from Tank Top to Top of
Highest Piping Penetration:
Height from Tank Top to Lowest
Electrical Penetration:
Condition ofsump prior to
testing:
Portion of Sump Tested
Swnp Material:
Wait time between applying
pressure/vacuum/water and
starting test:
30MIN 30MIN 30MIN 30MIN
Test Start Time:
Initial Reading (R):
Test End Time:
Final Reading (RF ):
Test Duration: ISMIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN
Changa in Reading (R. -Ri):
Pass/Fail Threshold or Criteria: 0021N 0021N 002IN 0021N 0021N 1 .0021N 0021N 002lN
Test Result: Pass Fail 0 Pass 0 Fail Pass Fail Pass 0 Fail
Is there a sensor in the sump? 0 Yes 0 No 0 Yes No 0 Yes 0 No Yes 0 No
Does the sensor alarm when
either product or water is
detected?
Yes No NA Yes 0 No NA Yes 0No 0NA 0 Yes No 0 NA
Was sensor removed for testing? Yes 0 No NA 0 Yes No 0 NA Yes 0 No NA 0 Yes No 0 NA
Was sensor properly replaced and
verified functional after teWn ? 0 Yes No NA Yes 0 No 0 NA 0 Yes 0No NA Yes 0 No DNA
Comments — (include information on repairs made prior to testing, andrecommendedfollow -upforfailed tests)
SITE HAS NO FILL SUMPS
SWRCB, January 2002
9. SPILL/OVERFILL CONTAIlV WNT BOXES
Page -L of &r
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 (Spec)
Test Method Used: Pressure C Vacuum X Hydrostatic
Other (Spec)
Test Equipment Used: INCON TS-STS Equipment Resolution:
Spill Box #87 VPR Spill Box #89 VPR Spill Box #01 VPR Spill Box #
Bucket Diameter: 12" 12" 12"
Bucket Depth: 16" 16" 16"
Wait time between applying
pressure /vacuum/water and
test:
30MIN 30MIN 30MIN
starting
Test Start Time: 12:16 12:40 11 :58 12:16 12 :16 1 12:40
initial Reading (1 ): 4.633 4.632 4.915 4.912 4.685 4.730
Test End Time: 12:31 12:55 12:13 12:31 12:31 12 :55
Final Reading (RF): 4.632 4.632 4.913 4,911 4.685 4.732
Test Duration: 15M1N 15MIN 15MIN 15MIN 15MIN 15MIN
Change in Reading (RF -RI): 001 000 002 001 000 002
Pass/Fail Threshold or
Criteria 002 002 002 002 002 002
Test Result: X Pass Fail X Pass Fail X Pass Fail Pass Fail
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
i`sWNli
CHEVRON
TEST STARTED 11:58 AM 13004 STOCKDALE HWYTESTSTARTED12/01/2011 BAKER - -FIELD CA
BEGIN LEVEL 4.9150 IN 12/01/2011ENDTIME12:13 PM 12:55 PMENDDATE12/01/2011
END LEVEL 4..991333 INN SUMP LEAK. TEST REPORTLEAKTHRESHOLD0.002 IN
TEST RESULT PASSED 87sTP CHEVRON
13004 STOCKDALE HWY
TEST STARTED 12 :40 PM BAKERSFIELD CA
TEST STARTED 12/01/2011BEGINLEVEL 12/01/2011 1:12 PM
CHEVRON END TIME 4.4707 IN
130;14 STOCKDALE HWY END DATE 12'55 FM
14. 911
SUMP LEW TEST REPORT
BAKERSFIELD CA END LEVELf• 470LEAKTHRESHOLD4.4704 INx•002 IN
87STP
12/01/2011 12:31 PM TEST RESULT PASSEDE TEST STARTED 12:57 PM
SUMP LEAK TEST REPORT TEST STARTED 12/01/2011
89STP BEGIN LEVEL 4.4707 IN
87UPR END TIME 1:12 PM
TEST STARTED 12:46 PM END DATE 12/01/2011TESTSTARTED12:16 PM TEST STARTED 12/01/2011 END LEVEL 4.4712 IN
TEST STARTED 12/01/2011 BEGIN LEVEL 3'4023 LEAK THRESHOLD 0.002 IN
BEGIN LEVEL 4.6338 IN END TIME IN
12:55 TEST RESULT PASSEDENDTIME12:31 PM END DATE PM
12/01/2011ENDDATE12/01/2011 END LEVEL 3.4022ENDLEVEL4.6323 IN INLEAKTHRESHOLD0.002 89STP
LEAK THRESHOLD 0.002 IN INTESTRESULTTESTRESULTPASSEDPASSED TEST STARTED 12:57 PM
TEST STARTED 12/01/2011
91VPR BEGIN LEVEL 3.4023 IN6'9VPR END TIME 1 :12 PM
TEST STARTED 12:16 PM TEST STARTED 12;40 PMTESTSTARTED
END DATE
END LEVEL
12/01/2011
3.4028 IN
TEST STARTED 12/01/2011 1'2-/01/2011BEGINLEVEL4.7306 IN LEAK THRESHOLD 9.002 INBEGINLEVEL4.9125 IN END TIME 12: SS TEST RESULT PASSED
END TIME 12:31 R4 PMENDDATE12/01/2011ENDDATE12/01/2011 END LEVEL 4.7323ENDLEVEL4.9116 IN INLEAKTHRESHOLD0,002 91STP
LEAK THRESHOLD 0.002 IN TEST RESULT IN
TEST RESULT PASSED PASSED TEST STARTED 12:57 PM
TEST STARTED 12/01/2011
BEGIN LEVEL 2.4205 IN
91VPR END TIME 1:12 PM
END DATE 12/01/2011
TEST STARTED 12:16 PM END LEVEL 2.4206 INTESTSTARTED12/01/2011 LEAK THRESHOLD 0.092 IN
BEGIN LEVEL 4.6851 IN TEST RESULT PASSED
END TIME 12:31 PM
END DATE 12/01/2011
END LEVEL 4.6854 IN 91STP
LEAK THRESHOLD 0.002 IN 1:13 PMTESTRESULTPASSEDTESTSTARTED12/01/201
DSLSTP
TEST STARTED
BEGIN LEVEL 2.4208 IN TEST STARTED 1:36 PM
END TIME 1:28 PM
01/2011
TEST STARTED 12/01/2011
END DATE 1'2/ 2.4207 IN BEGIN LEVEL 3.8707 IN
DSLSTP END LEVELLEAKTHRESHOLD 0.002 IN
END TIME
END DATE
1:52 PM
12/01/2011
TEST STARTED 2;20 PM
PASSED
TEST RESULT PA END LEVEL 3.8721 IN
TEST STARTED 12/01/2011 LEAK THRESHOLD
TEST RESULT
0.002 IN
PASSEDBEGINLEVEL0.9530 INENDTIME2 :35 PMENDDATE12/01/2011ENDLEVEL0.9529 INLEAKTHRESHOLD0.002 INTESTRESULTPASSED
DSLSTP
TEST STARTED 2:20 PMTESTSTARTED12/01/2011BEGINLEVEL3.6821 INENDTIME2:35 PMENDDATE12/01/2011ENDLEVEL3.6826 IN
LEAK THRESHOLD 0.002 INTESTRESULTPASSED
f+kbZh A
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SB989 TESTING FAILURE REPORT
SITE NAME: G%T I )g -- DATE:
ADDRESS: / i 01-ly f v w s )TkCIMCLAN: RICH PHILLIPS
CITY: 13 )' )el-1-2, Z-A SIGNATURE: A/ —
THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE
TESTING.
REPAIRS: a
l/n
00 13
r
LABOR: % f / n-vin l7L - % -0 !, 4
0 o AL-Tj I4Y),7 O tt
PARTS INSTALLED:
NAME: TITLE:
SIGNATURE:
THE ABOVE NAMED PERSON TAKES FULL RESPONSIBnXrY OF NOTIFYING
THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR
THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR
ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF
ANY FINES OR PENALTIES OCCURING FROM NON - COMPLIANCE.
A COPY OF THIS DOCUMENT HAS BEEN LEFT ON -SITE FOR YOUR
CONVIENENCE.