HomeMy WebLinkAbout2900 UNION AVENUE (5)P--sS
From: Franzen -Hill Inc. To: 16618522171 Page: 1/9 Date: 11/17/2011 10:50:54 AM
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Message:
Tiffany Sena
Compliance Coordinator
Franzen -Hill
Ph: (559) 688 -2977 Ext 3001
Fax: (559) 688 -1467
Cell: (559) 731 -0271
tsena@franzenhill.com
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Franzen-Hill Inc.
1100 N. J St, Tulare, CA 93274
Tel: 559 -688 -2977 Fax: 559 - 688 -1467
Website: http: //www.franzenhill.com
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From: Franzen -Hill Inc. To: 1 661 85221 71 Page: 2/8 Date: 11/17/2011 10:50:54 AM
Letter of Transmittal
Franzen -Hill Corporation
1100 N. J Street
Tulare, CA 93274
559)688 -2977 Fact. 3001
Fax (559)688 -1467
Email: tsena ®franzenhill.com
Organization: City of Bakersfield Fire Department
Name. Ernie Medina
Fax: 661- 852 -2171
Phone:
From: Tiffany Sena
Date: 11/17/11
Subject: Test Results
Pages: 8- Including Cover
Comments:
Please find the attached test results for the following site:
Minut Stop Texaco
2900 Union Ave
Bakersfield, CA
If you should have any questions or comments please let me know.
Respectfully,
7">ffany Sena
Compliance Coordinator
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From: Franzen -Hill Inc. To: 1 661 85221 71 Page: 3/9 Date: 11/17/2011 10:50:54 AM
MONITORING SYSTEM CERTIFICATION
For Use ByAll Jurisdictions Within the State of California
Authority Cited.- Chapter 6.7, Health and Safety Code, Chapter 16, Division 3, Y11le 23, California Code afRegulatlons
This form trust be used to doctuneut testing and servicing ofmonitoring equipment.
et- the - futility -p -A , paste certi8csiion or repo t must be tmeuxred for each mtttiitorinu sv tem ootitrol ganef by the technicisu who performs dtc
work. A copy of this form must be provided to the tank system owner /operator. The owner /operator must submit a copy of this form to the local
agency regulating UST systems within 30 days of test date, a-page,
A. General Information
Facility Name: Minit Stop Bldg, No.:
Site Address: 2900 Union Ave City: Bakersfield Zip: 83305
Facility Contact Person: Thomas Yoon Contact Phone No.: (661) 319 -1121
Ma kcfflodel of Monitoring System; Gilbarco EMC _ _ _ Date of Testing/Serviciag: 11/16/2011
B. Inventory ofEquipment Tested /Certified
Check the approprlale boxes to radtcate speeifte equtptaent inspWed /aenv)cedr
Tank ID: 87 Tank ID: 91
In -Tank Gauging Probe. Model: maul In -Tank Ganging Probe. Model: maid
Annular Space or Vault Semor. Model: 420 (spliQ Annular Space or Vault Sensor. Model: 420 isplt)
Piping Sump / Trench Sensor(s). Model: 208 Piping Sunup / TteachScnaor(s). Model: 208
Fill Sump Sursor(s). Mudcl: Q Fm Sunup Sensus(s). Model:
Mechanical Lire Leak Detector. Model: red jacket FXW Mechanical Line Leak Detector. Mdde1: REDJACKET FXIV
Q Electronio Line LeakDdeewr. Model: Elodronio Line Leak Detector. Model:
10 Tank Overfill / High - Level Sensor, Model: OPINGISOEVR 19 TackOverfill / High -Lavct Sensor. Model: OPVAISOEVR
Other (spcc4equipment type and modelin Section E on Page 2} 0 Od w (specifyequipment typoand model in ScetioaE on Page 2}
Tank ID: Tank ID:
In -Tank Gauging Prole. Model: In -Tank Gauging Probe. Model:
Annular Space or Vault Sensor. Model: Annular Space or Vault Sensor. Model:
Q Piping Sump / Trench Seusor(s). Model: Q Piping Sump / Trench Scwor(a). Model:
Pill Sump Sensor(s). Model: 3 rill Sump Sensor(s). Model:
Mechanical line leak Detwer. Model: Mechanical line Leak Ddcdor. Model:
Q Electronic Line Leak Detector. Model: Electronic Uuc Txzk Detector. Model:
TankOverfill / tfigh -Level Sensor. Model: TankOverfill / tligh -lavel Sensor. Model:
Other (specify equiptnen t typo and model in SectionE an Page2). Other (specifyoquiprnent type and mold in Scction E on Page 2).
Dispenser ID: 14 Dispenser ID: 3-4
Dispenser Contairmtem Sensor(s). Model: SEAUDREAU Dispenser Coatainnicat Sensors) Model: REAUDREAU"
Shear Valves} Shear valve(s).
Q Dispenser Containment Floats) and Cbain(s). Dispemsa Contabintew Float(s) and Chains}
Dispenser ID: Dispenser ID:
Q Dispenmw Containment Sertsor(s). Model: Q Dispenser Containment Sensor(s). Model:
Shear Valve(s). Shear Valve(s).
DispenserContaimrent Floats) and Chains) 3 DispcuscrContaintimt Floats) and Chains).
Dispenser M: Dispenser ID:
Dispense• ConMi anent Sensor(s). Model: Disperser Cootaiunient Sam r(s). Model:
Shear valve(s) Shear Vatve(s).
El Disperser Containment Floats) and Chain(s). Dispe Containment 1•l9ats) andChains}
Ifthe facility contains more tanks or dispensers, copy this form. include infortnation for every tank and dispettser at the facility.
C. Certification - I certify that the equipment Identified In this document was InspectedAerviced in accordance with the
manufacturers' guidelines. Attached to this Certification Is Information (e g. manufacturers' checklists) necessary to verlty that this
Information is correct and a Site -Plot Plan showing the layout of monitoring equi tnent. For any equipment capable of generating
such reports, I have also attached a copy of the report; (check aU that apply): System Set -up ® Alarm history report
Technician Name ADAM TAYLOR Signature
Certification No.: B383831 5311678 License, No.: B- 304147
Testing Company Name: FRANZENHILL Phone No,: (669) 688 -2977
Testing Company Address: 1100 N J ST. TULARE CA. 93274 Date of Testing/Servicing: 11116/2011
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From: Franzen -Hill Inc. To: 1 661 85221 71 Page: 4/9 Date: 11/17/2011 10:50:55 AM
Monitoring System Certification
D. Results of Testing/Servicing
Software Version Installed:
f mnn1&P the fnllnwino obPeklict!
Yes No* Is the audible alarm operationai'l
Yes No* Is the visual alarm operational?
Yes No* Were all sensors visually inspected, functionally. tested, and confirmed operationid ?...
Yes No* Were all sensors installed at. lowest point of secondary containment and positioned so that other equipment
wilt not interfere with their proper operation?
Yes No* If alarms are relayed to a remote monitoring station, As -all. communications . equipment (e.g., modem)
NIA operational?
Yes No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment
N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? Tf yes: which sensors
initiate positive shut - down? (Check all that apply) IN Su npiTrench Sensors; ® Dispenser Containment
Sensors.
Did you confirm positive shut- ,down.due to.leaks and sensor.fallure/disconnection? . ® Yes; No.
Yes No* For tank systems that utilize the monitoring system- as•the•primmy tank overfill warning -device -(i.c.; no
N/A mechanical overfill.prevention valve is.installcd), is the averfill warning alarm visibie..andAudible at the L;;-_
fill point(s) and operating properly? Ifso, attivhat• percent of tank capacity-does•tix alarm trigger? %
Yes* 0 No Was any monitoring equipment replaced? ..If yes; identify. specific• sensors, probes, • or- -outer equipment
replaced and list the manafacturar name and model for all replacement parts in Section E, below.
Yes* No Was liquid found inside any secondary containment systems designed asdry systems? (C heck all- that apply)
Product; Water. Ifyes, describe causes in Seetion.E,. below. -
Yes No* Was monitoring system set -up reviewed to ensure proper settings? Attach set up.reports, if a licable..
Yes No* Is all monitoring equipment operational per mhnufacturO's spi;cificationS?
In Section E below, describe how and when these deficiencies were or will be corrected.
E. Comments: ALL FUNCTIONING PROPERLY.
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From: Franzen -Hill Inc. To: 1 661 85221 71 Page: 5/9 Date: 11/17/2011 10:50:55 AM
Monitoring System Certification
F. In -Tank Gauging / SIR Equipment: (R Check this box iffank gauging is used only for inventory control.
Check thisbox if no tank- gauging or SIR equipment is installed.
This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring.
Complete the following checklist:
Yes No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults?
Yes No* Were all tank'gauging probes visually inspected for•damage•and residue buildup?
Yes No* Was accuracy of system product level teadingg tested?
Yes No* Was accuracy of system water level readings tested?
Yes No* Were all pmbes reinstalled properly?
Yes No* Were all items on the equipment manufacturer's maintenance checklist completed?
In Section H, below, describe how and when these deficiencies were or will be corrected.
G. Line Leak Detectors (LLD): Check this box if11-Ds are not installed.
Cmmnl.-tP the fallnwlnsr rhrrklivt:
Yes No* For equipment start -up or annual equipment ceitifrcation, was a leak simulated to verify LLD performance?
N/A Check all that apply) Simulated leak rate: ® 3 g p.h.; 0 -0.1 g.p.h ;• 0.2 g.p.h.
Yes No* Were all LLDs confirmed operational and accurate -wid" regulatory-requirements?
Yes No* Was the testing apparatus properly calibrated?
Yes No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak?
N/A
Yee No" For electronic LLDs, does the turbine automatically shut offif the LLD detects a- leak?
0 N/A
Yes No* For electronic LLDs, does the turbine automatically shut off ifany portion of the monitoring system is disabled
N/A or disconnected?
Yes No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system
N/A malfunctions or fails a test?
Yes No* For electronic LLDs, have all accessible wiring connections been visually inspected?
N/A
Yes No* Were all items on the equipment manuf'acturer's maintenance checklist completed?
In Section b, below, describe how and when these deficiencies were or will becorrected.
H. Comments:
T _ w _• Is
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From: Franzen -Hill Inc. To: 1 661 85221 71 Page: 619 Date: 11/17/2011 10:50:55 AM
Monitoring System Certification
UST Monitoring.Site.i_'aaa
Site Address: 2900 UNION AVE BAKERSFIELD CA.
I ....... ....... .......
I.........
a:...: ........
I....: :
Date map was drawn: IV16 /jj.
Instructions
If you already have a diagram that shows all required information, you may include it, rather than this page, with your Monitoring
System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following
equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill
containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in -tank liquid level probes (if
used for leak detection). In the space provided, note the date this Site Plan-was prepared.
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From: Franzen -Hill Inc. To: 1 661 85221 71 Page: 7/9 Date: 11/17/2011 10:50:56 AM
Franzen -Hill
Construction, Mafnlerri noo & Tesftng forFueling Faci iti" & Lubricating 6Wema
California Ucenwit Cordractor No. 3041147
Obb -655 -3438
SOURCE TEST RESULTS
LEAK DETECTOR TEST
Site Name and Address: Testing Company:
MINIT STOP FRANZEN -HILL CORPORATION
2900 UNION AVE 1100 North J. Street
BAKERSFIELD CA, 93305 Tulare, CA 93274
County: KERN W.O # _133379
Service Order #41495
of Leak Detectors Tcsted check one
XLD P/N 116036 -5 XLP P/N 118035 -5 BFLD..()(L ModeJ) PIN .1160.39 -5
DLD P/N 116017 -5 PLO P/N 118030 -5 BFLD P/N 118012 -5
XOTHER—REDJACKET
TANK #
UNL.
PREM.
SERIAL # RESILIENCY TIME
OPEN
FX1V 100 2SEC
FX1 V 125 2SEC
TEST LEAK
RATE
3 GPH
3
3
Test Conducted By: Date:
ADAM TAYLOR_.
Coinments: ALL I'T'EMS PASS
METERING RESULTS
PSI
10 PASS
10 PASS
11 -16 -11
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Form 12/2004
From: Franzen -Hill Inc. To: 1 661 85221 71 Page: 8/9 Date: 11/17/2011 10:50:56 AM
Spill Bucket Testing Form
FACILITY INFORMATION
Page I of2
TESTING CONTRACTOR INFORMATION
SPILL BUCKET CONTAINMENT BOXES
Facility is Not Ectuipped, With Spill/Overfill Containment Boxes
Spill/Overfill Containment Boxes are Present, but were Not Tested 0
Test Method Developed By: 0 Spill Bucket Manufacturer 0 Industry Standard x Professional Engineer
0 Other (Specify)
Test Method Used: Pressure 0 Vacuum x Hydrostatic
0 Other (Specify)
Test Equipment Used: VISUAL
SEE= Bucket:UNL. Bucket :PREM.
Equipment Resolution:
Bucket: -Bucket:
Bucket Diameter: 12 12
Bucket Depth: 17 17
Wait time between applying
pressure/vacuum/water and
test:
1MIN IN"
starting
Test Start Time: 900 900
Inidal Reading (IRS: 17 17
Test End Time: 1000 1000
Final Reading (Rn): 17 17
Test Duration: I HR 1 HR
Change inReading (RrR: 0 0
Pass/Fad Threshold or
Criteria: NO CHANGE =PASS NO CHANGE-PASS
Test:Rgsult: X, Pass Fail 1 "Pass.:gF l;, O.."Pass UPail 0..Pa8s,;0.Faii.,:':
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From: Franzen -Hill Inc. To: 1661 85221 71 Page: 919 Date: 11/17/2011 10:50:56 AM
Form 1212004
Page 2 of 2
Bucket Diameter:
Bucket: Bucket: Bucket: Bucket:
Bucket Deptlr,
Wait time between applying
pressurefvacuunVwater and
test:
Test Start Time:
Initial Reading (Ril:
Test End Time:
Final Reading (Rr):
Test Duration:
Change inReading (Ri.-Rr)
Pass/Fail Threshold or
Criteria:
Test'Result. :: IJ =rasa ( Fail: Vass ,. Cl'FarC . CI <Aasa' .;al Fail :.. IJ; Paso; :.'Q Fail
Comments -(include information on repairs madeprior to testing, and recommendedfollow -upforfoiledtests)
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
To the best ofmy knowledge, thefacts stated in this document are accurate and in full compliance with legal requirements
Technician's Signature:
Technician's Printed Name: —ADAM TA OR/_._
Date:-11-16-11
Company: Franzen -Hill
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