HomeMy WebLinkAbout2612 BUCK OWENS BOULEVARD (3)SWRCB, January 2002 Page of
Secondary Containment Testing Report Form
Thisform is intendedfor use by contractors performing periodic testing of UST secondary containment systems. Use the
appropriatepages ofthisform to report resultsfor all components tested The completedform, written testprocedures, and
printoutsfrom tests ffapplicable), should beprovided to thefacility owner /operatorfor submittal to the local regulatory agency.
1. FACILITY INFORMATION
Facility Name: JOHNNY'S ARCO Date of Testing: 11 -30 -11
Facility Address: 2612 BUCK OWENS BLVD
Facility Contact: BAKERSFIELD, CA Phone:
Date Local Agency Was Notified of Testing:
Name of Local Agency Inspector (fpresent during testing): ERNIE MEDINA
2. TESTING CONTRACTOR INFORMATION
Company Name: RICH ENVIRONMENTAL
Technician Conducting Test: STEVEN OBERT
Credentials: X CSLB Licensed Contractor SWRCB Licensed Tank Tester
License Type: C61 / D40 License Number: 809850
Manufacturer Training
Manufacturer Component(s) Date Training Expires
INCON INCON TS- STS
3. SUMMARY OF TEST RESULTS
Component Pass Fail Not
Tested
Repairs
Made Component Pass Fail Not
Tested
Repairs
Made
UNL 87 ANNULAR X UDC 7 -8 X
LNL87 SYPH ANNULAR X UNL 87 FILL SUMP X
PREM 91 ANNULAR X UNL87 SYPH FILL SUMP X
UNL 87 SEC PIPE X PREM 91 FILL SUMP X
UNL87 SYPH SEC PIPE X 0 UNL 87 VAPOR BOX X
PREM 91 SEC PIPE X UNL87 SYPH VPR BOX X
UNL 87 STP X1
UNL87 SYPH STP X 1
PREM 91 STP X D 1 0 0 0 0
UDC 1 -2 X 0 0 Cl 0 0
UDC 3 -4 X 0 0 0 0 0 0
UDC 5 -6 1 X 0 0 0 D 0 0
Ifhydrostatic testing was performed, describe what was done with the water after completion oftests:
CERTIFICATION OF TECHNIC !ON RESPONSIBLE FOR CONDUCTING THIS TESTING
To the best ofmy knowledge, thefacts state is document are accurate and infull compliance with legal requirements
Technician's Signature: Date: 11 -30 -11
SWRCB, January 2002
4. TANK ANNULAR TESTING
qqjoc U
Page J of
Test Method Developed By: Tank Manufacturer X Industry Standard Professional Engineer
Other (Spec)
Test Method Used: Pressure X Vacuum Hydrostatic
Other (Spec)
Test Equipment Used: 41N DIAL GAUGE Equipment Resolution: .5%
Tank 487 Tank # 87 SYPHON Tank # 91 Tank #
Is Tank Exempt From Testing ? Yes X No Yes X No Yes X No Yes No
Tank Capacity: 12000 12000 12000
Tank Material: FIBERGLASS FIBERGLASS FIBERGLASS
Tank Manufacturer: UNKNOWN UNKNOWN UNKNOWN
Product Stored: UNL 87 UNL 87 PREM 91
Wait time between applying
pressure/vacuum/water and
starting test
30 MIN 30 MIN 30 MIN
Test Start Time: 12:00 12:00 12:00
Initial Reading (R): 10HG IOHG l OHG
Test End Time: 1:00 1:00 1:00
Final Reading (RF): IOHG IOHG l0HG
Test Duration: 60 MIN 60 MIN 60 MIN
Change in Reading (RF -RO: OHG OHG OHG
Pass/Fail Threshold or Criteria: OHG OHG OHG
Test Result: X Pass Fail X Pass Fail X Pass Fail Pass Fail
Was sensor removed for testing? X Yes No NA X Yes No NA X Yes No NA Yes No NA
Was sensor properly replaced and
verified functional after testing? X Yes No NA X Yes No NA X Yes No NA Yes 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 of Regulations, Title 23, Section 2637(a)(6))
SWRCB, January 2002
5. SECONDARY PIPE TESTING
Lkt-tb W
l' Page 3 of I
Test Method Developed By: Piping Manufacturer X Industry Standard Professional Engineer
Other (Sped)
Test Method Used: X Pressure Vacuum 0 Hydrostatic
Other (Spec)
Test Equipment Used: 41N DIAL GAUGE Equipment Resolution: .5%
Piping Run # 87
Piping Material: FIBERGLASS
Piping Run#87SYPH Piping Run # 91 Piping Run #
FIBERGLASS FIBERGLASS
Piping Manufacturer: SMITH SMITH SMITH
SUMP
Piping Diameter. 31N 31N 31N
Length ofPiping Run: 100FT 100FT 100FT
Product Stored: UNL 87 UNL 87 PREM 91
Method and location of
piping-run isolation: BOOT IN SUMP BOOT IN SUMP BOOT IN SUMP
Wait time between applying
pressure /vacuum/water and
starting test:
30 MIN 30 MIN 30 MIN
Test Start Time: 3:OOPM 3:OOPM
Initial Reading (RO: 5PSI 5PSI UNABLE
Test End Time: 4:OOPM 4:OOPM TO
Final Reading (RF): 5PSI 5PSI PRESSURE
Test Duration: 60 MIN 60 MIN
Change in Reading (RF -Ri): OPSI OPSI
Pass/Fail Threshold or
Criteria: OPSI OPSI
Test Result: Pass X Fail Pass X Fail Pass X Fail Pass Fail
Comments — (include in on repairs made prior to testing, and recommendedfollow -upforfailed tests)
PREM 91_ SEC PIPE FAILS DUE TO BAD PENETRATION ON DISP 5 -6
WILL NEED TO PERFORM A HELIUM TEST TO LOCATE SOURCE OF
LEAK
87 FALLED DUE TO BAD PENETRATION ON DISP 1 -2
NO TEST BOOT ON 87 SYPHON LINE TO MASTER SUMP
SWRCB, January 2002
6. PIPING SUMP TESTING
KVY1,
Page of` l
Test Method Developed By: Sump Manufacturer X Industry Standard 0 Professional Engineer
Other (Specify)
Test Method Used: 0 Pressure Vacuum X Hydrostatic
Other (Spec)
Test Equipment Used: INCON TS -STS Equipment Resolution:
Sump # 87 Sump # 87SYPH Sump # 91 Sump #
Sump Diameter: 42" 42" 42"
Sump Depth: 60" 60" 60"
Sump Material: FIBEERGLASS FIBERGLASS FIBERGLASS
Height from Tank Top to Top of
Highest Piping Penetration: 32" 32" 32"
Height from Tank Top to Lowest
Electrical Penetration: 20" 20" 20"
Condition of sump prior to testing: GOOD GOOD GOOD
Portion of Sump Tested' 34" 34" 34"
Does turbine shut down when
sump sensor detects liquid (both
product and water)?*
Yes No X NA 0 Yes No X NA 0 Yes No X NA Yes 0 No NA
Turbine shutdown response time
Is system programmed for fail -safe
shutdown ?'
Yes 0 No X NA Yes No X NA Yes 0 No X NA Yes 0 No NA
Was fail -safe verified to be Yes No X NA Yes 0 No X NA 0 Yes No X NA 0 Yes No NA
operational?*
Wait time between applying
pressure /vacuum/water and starting
test:
30 MIN 30 MIN 30 MIN
Test Start Time: 1:04 1:25 1:58 2:25 1:58 2:25
Initial Reading (RO: 3.109 3.109 2.517 2.276 4.601 4.573
Test End Time: 1:20 1:40 2:13 2:40 2:13 2:40
Final Reading (RF): 3.109 3.109 2390 2.156 4.587 4.561
Test Duration: 15 MIN 15 MIN 15 MIN 15 MIN 15 MIN 15 MIN
Change in Reading (RF -R,): 000 000 127 120 141 012
Pass/Fail Threshold or Criteria: 1002 002 002 002 002 002
Test Result: X Pass Fail Pass X Fail Pass X Fail Pass Fail
Was sensor removed for testing? X Yes No NA X Yes 0 No 0 NA X Yes 0 No NA Yes No 0 NA
Was sensor properly replaced and
verified functional after testing? X Yes No NA X Yes No DNA X Yes No NA 0 Yes No NA
Comments — (include information on repairs made prior to testing, andrecommendedfollow -upforfailed tests)
Ifthe entire depth of the sump is not tested, specify how much was tested. If the answer to any ofthe 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 (UDC) TESTING
LK W
Page e" of11
el
Test Method Developed By: 0 UDC Manufacturer X Industry Standard Professional Engineer
0 Other (Specify)
Test Method Used: 0 Pressure Vacuum X
Other (Specify)
Test Equipment Used: Equipment Resolution:
UDC Manufacturer:
UDC # 1 -2 UDC #34 UDC # 5 -6 UDC #7 -8
TCI TCI
UDC Material: PLASTIC PLASTIC
UDC Depth: 20" 20"
Height from UDC Bottom to Top
ofHighest Piping Penetration:
12" 12"
Height from UDC Bottom to
Lowest Electrical Penetration:
VISUAL FAIL 4" VISUAL FAIL 4"
Condition ofUDC prior to
testing:
GOOD GOOD
Portion ofUDC Tested
Does turbine shut down when
UDC sensor detects liquid (both
and water)?*
Yes No NA Yes No X NA Yes 0 No 0NA Yes 0 No X NA
product
Turbine shutdown response time
Is system programmed for fail-
safe shutdown ?*
Dyes No DNA Yes D No X NA Yes No NA 0 Yes No X NA
Was fail -safe verified to be
operational?'
Yes 0 No NA Yes No X NA Yes 0 No 0 NA 0 Yes 0 No X NA
Wait time between applying
pressure/vacuum /water and
starting test
30 MIN 30 MIN
Test Start Time: 2:25 6:02 6:18
Initial Reading (R): 3.530 8.260 8.259
Test End Time: 2:40 6:17 6:33
Final Reading (RF): 3.350 8.259 8.258
Test Duration: 15MIN 15 MIN 15 MIN
Change in Reading (RF- 000 001 -001
Pass/Fail Threshold or Criteria: 002 002 002
Test Result: Pass X Fail X Pass Fail 0 Pass X Fail X Pass Fail
Was sensor removed for testing? 0 Yes No 0 NA Yes No NA 0 Yes 0 No 0 NA X Yes No NA
Was sensor properly replaced and
verified functional after testing? 0 Yes 0 No NA Yes 0 No NA Yes 0 No NA X Yes d No NA
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests)
DISP 3 -4 PASSED UNDER PIPE PENETRATION (ELECTRICAL GOOD)
DISP 1 -2 BAD PENETRATION ON 87 VISUAL FAIL
DISP 5 -6 LEAK DOWN PASSED PIPEPENETRATIONS. ONLY
ELECTRICAL PENETRATION STILL UNDER WATER STILL DROPING
If the entire depth ofthe UDC is not tested, specify how much was tested. Ifthe answer to My of the 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
OMb?.L)
Page Co of ._!_ft
Facility is Not EquipELA With Fill Riser Containment Sums 0
Fill Riser Containment Sumps are Present, but were Not Tested
Test Method Developed By: Sump Manufacturer 0 Industry Standard 0 Professional Engineer
Other (Spec)
Test Method Used: 0 Pressure 0 Vacuum 0 Hydrostatic
Other (Spec)
Test Equipment Used:
Fill Sump # Fill Sump#
Equipment Resolution:
Fill Sump # Fill sume #
Sump Diameter:
Sump Depth:
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 ofSump Tested
Sump Material:
Wait time between applying
pressure/vacuum /water and
starting test:
Test Start Time:
Initial Reading (R,):
Test End Time:
Final Reading
Test Duration:
Chan a in Reading (RF -&):
Pass/Fai1 Threshold or Criteria:
Test Result: 0 Pass Fail Pass 0 Fail Pass 0 Fail D Pass 0 Fail
Is there a sensor in the sump? Yes D No Yes No 0 Yes No Yes No
Does the sensor alarm when
either product or water is
detected?
D Yes No NA Yes No DNA 0 Yes 0 No DNA iOYes DNo DNA
Was sensor removed for testing? 0 Yes 0 No NA Yes No 0 NA Yes D No ONA1 Q Yes No NA
Was sensor properly replaced and
verified functional after testing? 0 Yes 0 No DNA Yes No 0 NA Yes 0 No 0 NA Yes 0 No DNA
Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailedtests)
NO FILL SUMP
SWRCB, January 2002
9_ SPILL /OVERFILL CONTAINMENT BOXES
gwojo
Page Lofj
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
Other (Spec)
Industry Standard Professional Engineer
Test Method Used: Pressure
Other (Specify)
Vacuum Hydrostatic
Test Equipment Used: Equipment Resolution:
Bucket Diameter:
87 Spill Box # VAPOR
12"
87 Spill Box # 2 91 Spill Box #VAPOR Spill Box #
12" 12"
Depth: 14" 14" 14" Bucket
Wait time between applying
pressure/vacuum/water and
starting test:
30 MIN 30MIN 30MIN
Test Start Time: 12:48 1:04 12:48 1:04 12:48 1:04
Initial Reading (R,): 3.724 3.724 4.224 4224 5.251 5.251
Test End Time: 1:04 1 :20 1:04 1:20 1:04 1:20
Final Reading (RF): 3.724 3.725 4.224 4.224 5.251 5.251
Test Duration: 15 MIN 15 MIN 15 MIN 15 MIN 15 MIN 15 MIN
Change in Reading (RF-R,): 000 000 000 000 000 000
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)
87STP1
TEST STARTED 1:04 PM
TEST STARTED 11/30/2011
BEGIN LEVEL 3.1092 IN
END TIME 1:20 PM
END DATE 11/30/2011
END LEVEL 3.1091 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
87UPR2
TEST STARTED 1:04 Fig
TEST STARTED 11/30/2011
BEGIN LEVEL 4.2245 IN
END TIME 1:20 PM
END DATE 11/30/2011
END LEVEL 4.2243 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
k fbBa7GHNNYSARCO
2612 BUCK w ARCHBUCKOWENSBAKEID LUD
TEST STARTED 12:48 PM 2612 BUCK OWENS BLVD
BAKEFtSFIELD GHTESTSTARTED11/30/2011
11/30/2011
BEGIN LEVEL
END TIME
4.2247 IN
1:04 PM 11/30/2011 2:13 PM
1:04 PM
SUMP LEAk TEST REpORT
END DATE
END LEVEL
11/30/2011
4.2245 IN- SUMP LEAK TEST REPORT
LEAK THRESHOLD 0.002 IN UDC3--4
87VPR1 TEST RESULT PASSED
TEST STARTED 12 :48 PM TEST 'STARTED 1:58 PM
TEST STARTED 11/30/2011TESTSTARTED11/30/2011BEGINLEVEL
G1UPR BEGIN LEVEL 4.5718 iN
3.7247 INENDTIME1:04 PM TEST STARTED 12:48 PM END TIME 2:13 PM
END DATE 11/30/2011ENDDATE . 11/3Qi2011END .LEVEL
TEST STARTED
BEGIN LEVEL
11/30/2011
5.2516 IN END LEVEL 4.4995 IN
LEAK, THRESHOLD 0 8`2 IN END TIME 1:04 PM LEAK THRESHOLD b'
RILEDTESTRESULTTESTRESULTPASSEDENDDATE11/30/2011
END LEVEL 5.2514 IN
LEAK THRESHOLD 0.002 IN 57STP2TESTRESULTPASSED
TEST STARTED 1:58 Phi
91VPR TEST STARTED 11/30/2011
BEGIN LEVEL 2.5176 IN
TEST STARTED 1:04 PM END TIME 2:13 PM
END DATE 11/30/2011TESTSTARTED11/30/2011
BEGIN LEVEL 5.2514 IN END LEVEL 2.3903 IN
END TIME 1:20 PM LEAK THRESHOLD 0.002 IN
FAILEDENDDATE11/30/2011 TEST RESULT
END LEVEL 5.2515 IN
LEAK THRESHOLD 0.002 IN JOHNNYS ARCO 91STFTESTRESULTPASSED2612BUCKOWENSBLVD
BAKERSFIELD CA
TEST STARTED 1:58 PM
11/30/2011 1:20 PM TEST STARTED 11/30/2011
4.6012 INBEGINLEVEL
37STPi
SUMP LEAK .TEST REPORT END TIME 2:13 PM
END DATE 11/30/2011
TEST STARTED 87VPRi END LEVEL 4.5573 IN
LEAK THRESHOLD 0.002 IN
TEST STARTED 11/30 /2011/ TEST STARTED 1:04 PM TEST RESULT FAILED
BEGIN LEVEL 3.1091 INEND TEST STARTED i1 /3b/201i
TIME 1 :40 PMENDDATE BEGIN LEVEL 3.7246 IN
11/30/2011ENDLEVEL END TIME 1:20 PM
3.1091 INLEAKTHRESHOLD0.602 IN END DATE
END LEVEL
11/30/2011
3.7253 INTESTRESULTPASSELEAKTHRESHOLD0.002 IN
TEST RESULT PASSED
87STP1
TEST STARTED 1:04 PM
TEST STARTED 11/30/2011
BEGIN LEVEL 3.1092 IN
END TIME 1:20 PM
END DATE 11/30/2011
END LEVEL 3.1091 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
87UPR2
TEST STARTED 1:04 Fig
TEST STARTED 11/30/2011
BEGIN LEVEL 4.2245 IN
END TIME 1:20 PM
END DATE 11/30/2011
END LEVEL 4.2243 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED
k fbBa
JOHNNY$ ARCO
2612 BUCK OWENS BLVD
BAKERSFIELD CA lJDC7_8
11/30/2011 2:40 Phi TEST STARTED 6:02 Pri
TEST STARTED 1140/2011
SUMP LEAK TEST REPORT BEGIN LEVEL 8.2602 IN
END TIME 6:17 PM
UDC3 -4 END DATE 11/30/2011
END LEVEL 8.25% IN
TEST STARTED 2:25 PM LEAK THRESHOLD 0.002 IN
TEST STARTED 11/30/2011 TEST RESULT PASSED
BEGIN LEVEL 3.5300 IN
END TIME 2:40 PM
END DATE 11/30/2011
END LEVEL 3.5300 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT PASSED UDC7 -8
TEST STARTED 6:18 PM
87STP2 TEST STARTED 11/30/2811. BEGIN LEVEL 8.2592 IN
TEST STARTED 2:25 Phi END TIME 6:33 PMENDDATETESTSTARTED11/30/2011 11/30/2011
BEGIN LEVEL 2.2768 IN 8.2584 INLEAKTHRESHOLDTHRESHOLD6,002ENDTIME20/ END DATE 21/30/261111
INTESTRESULTPASSED
END LEVEL 2.1561 IN
LEAK THRESHOLD 0.002 IN
TEST RESULT FAILED
91STP
TEST STARTED 2:25 PM
TEST STARTED 11/30/2011
BEGIN LEVEL 4.5739 IN
END TIME 2:40 PM
E- 4D DATE 11/30/2011
END LEVEL 4.5612 IN.
LEAK THRESHOLD 0.002 IN
TEST RESULT FAILED
Ib8a
SB989 TESTING FAILURE REPORT
SITE NAME: JOHNNY'S ARCO DATE: 11 -30-11
ADDRESS: 2612 BUCK OWENS BLVD TECHNICIAN: RICH PHILLIPS
CITY: BAKERSFIELD, CA SIGNATURE:
THE FOLLOWING COMPONENTS WERE REPLACEDMEPAI RED TO COMPLETE
TESTING.
REPAIRS: PREM 91 SEC PIPE FAILS DUE TO BAD PENETRATRATION ON DISP 5-
6. WILL NEED TO PERFORM A HELIUM TEST TO DETERMINE WHERE LEAK IS
LOCATED. 87 FAILED DUE TO BAD PENETRATION ON DISP 1 -2. NO TEST BOOT
ON 87 SYPHON LINE TO MASTER SUMP. DISP 3-4 PASSED UNDER PIPE
PENETRATION (ELECTRICAL GOOD). DISP 1 -2 BAD PENETRATION ON 87
VISUAL FAIL. DISP 5-6 LEAK DOWN PASSED PIPE PENETRATIONS. ONLY
ELECTRICAL PENETRATION STILL UNDER WATER STILL DROPPING.
LABOR:
PARTS INSTALLED:
NAME: TITLE:
SIGNATURE:
THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY 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.