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HomeMy WebLinkAbout3624 CALIFORNIA AVENUE (3)F2411 qLv, 1'o SWRCB, January 2002 Page —L oft` Secondary Containment Testing Report Form Thisform is intendedfor use by contractors performingperiodic testing of USTsecondary containment systems. Use the appropriate pages ofthis form to report results for all components tested The completedform, written test procedures, and printouts from tests (ifapplicable), should be provided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name, DEL TACO MOBIL I Date ofTesting: 12/19/11 Facility Address: 3624 CALIFORNIA AVENUE, BAKERSFIELD Facility Contact: I Phone: Date Local Agency Was Notified of Testing: 10/31/11 Name of Local Agency Inspector (ifpresent during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: Rich Environmental Pass Technician Conducting Test: RICH PHILLIPS Not Tested Credentials: X CSLB Licensed Contractor SWRCB Licensed Tank Tester License Type: C6I /D40 A HAZ License Number: 809850 Manufacturer Manufacturer Trainine Component(s) Date Training Expires INCON TS -STS 6/11/2012 UDC #5/6 x 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Repairs Made 91PREM/DSL ANNULAR X UDC #5/6 x 87REG ANNULAR X UDC #7/8 X 87REG (DISP 41/2) SEC PIPE I X I UDC #9/10 X 1 1 87REG (DISP #7/8) SEC PIPE X 87REG FILL SUMP X 91PREM (DISP #1/2) SEC PIPE X 91PREM FILL SUMP X 91 PREM (DISP #7/8) SEC PIPE X DIESEL FILL SUMP X DIESEL SEC PIPE X p 87 VAPOR BUCKET X 87REG STP X 91 VAPOR BUCKET X 91 PREM STP X DIESEL STP X UDC #1/2 X UDC #3/4 X 1 Ifhydrostatic testing was performed, describe what was done with the water after completion oftests: CERTIFICATION OF TECHNI AN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best ofmy knowledge, thefacts state this document are accurate and infull compliance with legal requirements Technician's Signature: Date: 12/19/11 SWRCB, January 2002 4. TANK ANNULAR TESTING Page Z of Test Method Developed By: 0 Tank Manufacturer X Industry Standard Professional Engineer Other (Spec) Test Method Used: Pressure X Vacuum 0 Hydrostatic 0 Other (Spec) Test Equipment Used: 4" DIAL GAUGE Equipment Resolution: Tank # 91/DSL Tank # 87 Tank # Tank # Is Tank Exempt From Testing ?' Yes X No 0 Yes X No Yes C No 0 Yes No Tank Capacity: 12K 12K Tank Material: STEEL STEEL Tank Manufacturer: UNKNOWN UNKNOWN Product Stored: 911DIESEL 87 Wait time between applying pressure/vacuum/water and test: 30MIN 30MIN starting Test Start Time: 9:30 9:45 Initial Reading (RO: 11.0 10.5 Test End Time: 10:30 10:45 Final Reading (RF): 11.0 10.5 Test Duration: 60 MIN 60 MM Change in Reading (RF -R,): 0 0 Pass/Fail Threshold or Criteria: 0 0 Test Result: X Pass C Fail X Pass 0 Fail Pass Fail 0 Pass 0 Fail Was sensor removed for testing? X Yes 0 No NA X Yes No NA 0 Yes 0 No 0 NA 0 Yes 0No 0 NA Was sensor properly replaced and verified functional after testing? X Yes No 0 NA X Yes No 0 NA 0 Yes 0No 0 NA 0 Yes No [I 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 qt-616 Page —L of Test Method Developed By: Piping Manufacturer X Industry Standard Professional Engineer Other (Spec) Test Method Used: X Pressure Vacuum Hydrostatic Other (Spec) Test Equipment Used: 4" DIAL GAUGE Equipment Resolution: .5% Piping Run # 87 1/2 Piping Run # 87 7/8 Piping Run # 91 1/2 Piping Run # 917/8 Piping Material: PLASTIC PLASTIC PLASTIC PLASTIC Piping Manufacturer: TCI TCI TCI TCI Piping Diameter: 2" 2" 2" 2" Length of Piping Run: 75' 75' 75' 75' Product Stored: 87 87 91 91 Method and location of piping-run isolation: BOOT IN SUMP 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 30 MIN Test Start Time: VISUAL VISUAL 11:15 11:15 Initial Reading (Rj): LEAK LEAK 5.0 6.0 Test End Time: 12:15 12:15 Final Reading (RF): 3.0 6.0 Test Duration: 60 MIN 60 MIN Change in Reading (RF -Rj): 2.0 0 Pass/Fail Threshold or Criteria: 0 PSI 0 PSI Test Result: Pass X Fail Pass X Fail Pass X Fail X Pass Fail Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests) 87 1/2 (DISP) LEADING FROM A PEN HOLE IN TCI SINGLE WALL PRODUCT LINE / LEAKING 911/2 (DISP) LEAKING FROM BLUE LINE PENETRATION SECONDARY FROM SIP TO DISP 7/8. 91 PASSED SECONDARY FROM STP TO DISP 7/8, 87 FAILED L- 00 SWRCB, January 2002 Page L of S. SECONDARY PIPE TESTING Test Method Developed By: Piping Manufacturer X Industry Standard Professional Engineer Other (Spec) Test Method Used: X Pressure Vacuum Hydrostatic Other (Spec) Test Equipment Used: 4" DIAL GAUGE Equipment Resolution: .5% Piping Run #DSL Piping Material: PLASTIC Piping Run # Piping Run # Piping Run # Piping Manufacturer. APT Piping Diameter. 2" Length ofPiping Run: 50' Product Stored: DIESEL Method and location of piping-run isolation: Wait time between applying pressure /vacuum/water and starting test: 30 MIN Test Start Time: 10:00 Initial Reading (R,): 5.5 Test End Time: 11:00 Final Reading (RF): 5.5 Test Duration: 60 MIN Change in Reading (RF-RO: 0 Pass/Fail Threshold or Criteria: 0 Test Result: X Pass Fail Pass Fail Pass Fail Pass Fail Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests) SWRCB, January 2002 6. PIPING SUMP TESTING fit-.)/ Page , _of Test Method Developed By: Sump Manufacturer X Industry Standard 0 Professional Engineer 0 Other (Spec) Test Method Used: 0 Pressure 0 Vacuum X Hydrostatic Other (Spec) Test Equipment Used INCON TS -STS Equipment Resolution: Sump Diameter: Sump # 87 Sump # 91 Sump # DIESEL Sump # 39" 39" 39" Sump Depth: 57" 57" 57" Sump Material: FIBERGLASS FIBERGLASS FIBERGLASS Height from Tank Top to Top of Highest Piping Penetration: 21" 21" 21" Height from Tank Top to Lowest Electrical Penetration: 12" 12" 12" Condition ofsump prior to testing: GOOD GOOD GOOD Portion ofSump Tested' 23" 23" 23" Does turbine shut down when sump sensor detects liquid (both roduct and water)?* 0 Yes 0 No X NA Yes 0 No XNA Yes No X NA 0 Yes 0 No NA Turbine shutdown response time Is system programmed for fail -safe shutdown ?* 0 Yes 0 No X NA Yes No XNA 0 Yes No X NA Yes No NA Was fail -safe verified to be o erational ?* 0 Yes 0 No X NA 0 Yes No X NA 0 Yes No X NA Yes No 0 NA Wait time between applying pressure /vacuum/water and starting test: 30 MIN 30 MIN 30 MIN Test Start Time: 10:45 11 :06 12:24 12:42 10:45 11:06 Initial Reading (Ri): 4.447 4.449 3.180 3.180 4.165 4.165 Test End Time: 11:01 11:21 12:40 12:37 11:01 11:21 Final Reading (RF): 4.449 4.449 3.180 3.180 4.165 4.165 Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN Change in Reading (RF -&): 002 000 000 000 000 000 Pass/Fail Threshold or Criteria 002 002 002 002 002 002 Test Result: X Pass 0 Fail X Pass 0 Fail X Pass 0 Fail 0 Pass 0 Fail Was sensor removed for testing? X Yes 0 No DNA X Yes No DNA X Yes No NA Yes No NA Was sensor properly replaced and verified functional after testing? X Yes No DNA X Yes 0 No NA X Yes 0No DNA Yes No NA Comments — (include information on repairs madeprior to testing, and recommendedfollow -upforfailed tests) Ifthe entire depth ofthe sump is not tested, specify how much was tested. Ifthe answer to any ofthe questions indicated with an asterisk ( *) is "NO" or "NA ", the entire sump must be tested. (See SWRCB LG -160) e ofSWRCB, January 2002 Pag 7. UNDER- DISPENSER CONTAINMENT (UDC) TESTING Test Method Developed By: UDC Manufacturer X Industry Standard Professional Engineer Other (Spec) Test Method Used: 0 Pressure 0 Vacuum X Hydrostatic Other (Specify) Test Equipment Used: INCON TS -STS Equipment Resolution: UDC #1/2 TCI UTDC #3/4 TCI UDC #5/6 UDC #7/8 UDC Manufacturer: TCI TCI UDC Material: PLASTIC PLASTIC PLASTIC PLASTIC UDC Depth: 19" 19" 19" 19" Height from UDC Bottom to Top ofHighest Piping Penetration: 9" 9" 9" 9" Height from UDC Bottom to Lowest Electrical Penetration: 9" 9" 9" 9" Condition of UDC prior to testin : GOOD GOOD GOOD GOOD Portion of UDC Tested i l" 11" 11" 11" Does turbine shut down when UDC sensor detects liquid (both product and water)?' Yes D No X NA D Yes No X NA 0 Yes 0No X NA Yes 0 No XNA Turbine shutdown response time Is system programmed for fail- safe shutdown ?' Oyes D No X NA Yes No X NA 0 Yes No X NA Yes 0 No X NA Was fail -safe verified to be operational?* Dyes D No X NA D Yes D No X NA D Yes No X NA Yes 0 No X NA Wait time between applying pressure /vacuum /water and starting test 30MIN 30MIN 30MIN 30MIN Test Start Time: 12:24 12:42 12:24 12:42 1:48 2:16 12:08 12:24 Initial Reading (R,): 2.577 5.576 4.362 4.362 717 735 930 930 Test End Time: 12:40 12:57 12:40 12:57 2:03 2:31 12:23 12:40 Final Reading (RF): 2.578 2.578 4.362 4.361 717 735 930 930 Test Duration: 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN 15MIN Change in Reading (RF-Rj): 001 002 000 001 000 000 000 000 Pass/Fail Threshold or Criteria: 002 002 002 002 002 1 -.002 002 002 Test Resnilt: X Pass 0 Fail X Pass Fail X Pass 0 Fail X Pass 0 Fail Was sensor removed for testing? X Yes 0 No DNA X Yes DNo DNA X Yes DNo NA X Yes No 0NA Was sensor properly replaced and verified functional after testing? X Yes 0 No NA X Yes DNo NA X Yes 0No NA X Yes 0No DNA Comments - (include information on repairs made prior to testing andrecommendedfollow -upforfailed tests) Ifthe entire depth ofthe UDC is not tested, specify how much was tested. if the answer to M ofthe questions indicated with an asterisk ( *) is "NO" or "NA ", the entire UDC must be tested. (See SWRCB LG -160) SWRCB, January 2002 7- UNDER- DISPENSER CONTAINMENT ffMCI TESTING Ngb`t n Page _1_ of Test Method Developed By: UDC Manufacturer X Industry Standard Professional Engineer 0 Other (Specify) Test Method Used: Pressure Vacuum X Hydrostatic Other (Spec) Test Equipment Used: INCON TS -STS Equipment Resolution: UDC Manufacturer. UDC # 920 UDC # UDC # UDC # TCI UDC Material: PLASTIC UDC D the 19" Height from UDC Bottom to Top ofHighest Piping Penetration: 9" Height from UDC Bottom to Lowest Electrical Penetration: 9" Condition of UDC prior to testing: GOOD Portion of UDC Tested 11" Does turbine shut down when UDC sensor detects liquid (both induct and water)?* Yes D No X NA 0 Yes No DNA 0 Yes No DNA D Yes No DNA Turbine shutdown response time Is system programmed for fail- safe shutdown? yes No X NA Yes No DNA Yes No 0NA 0 Yes No NA Was fail -safe verified to be operational?' yes D No X NA 0 Yes C No NA D Yes No DNA Yes No NA Wait time between applying pressure/vacuum /water and starting test 30MIN Test Start Time: 1:21 1 :48 Initial Reading ): 4.013 4.012 Test End Time: 1:36 2:03 Final Reading F : 4.012 4.011 Test Duration: 15MIN 15MIN Change in Reading (Rp -Ro: 001 001 Pass/Fail Threshold or Criteria: 002 002 Test Result: X Pass 0 Fail Pass 0 Fail 0 Pass 0 Fail 0 Pass 0 Fail Was sensor removed for testing? X Yes No NA Yes No DNA Yes No 0NA 0 Yes No 0 NA Was sensor properly replaced and verified functional after testin ? X Yes No NA Yes No DNA 0 Yes :1 No 0 NA 0 Yes No 0N Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests) 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 qq/0 I Page I_ of Y Facility is Not Equipped With Fill Riser Containment Sums Fill Riser Containment Sumps are Present, but were Not Tested 0 Test Method Developed By: Sump Manufacturer X Industry Standard Professional Engineer 0 Other (Spec) Test Method Used: Pressure Vacuum X Hydrostatic Other (Specify) Test Equipment Used: INCON TS-STS If Sump # Fill Sump # Sump Diameter: Equipment Resolution: Fill Sump # Fill Sump # 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 of Sump Tested Sump Material: Wait time between applying pressure/vacuum/water and starting test: Test Start Time: Initial Reading j): Test End Time: Final Reading RF): Test Duration: Change in Reading RF -R,): Pass/Fail Threshold or Criteria: Test Result: Pass Fail 0 Pass 0 Fail 0 Pass 0 Fail Pass 0 Fail Is there a sensor in the sump? 0 Yes O No 0 Yes No Yes O No Yes 0 No Does the sensor alarm when either product or water is detected? Yes 0 No NA 0 Yes No 0 NA Yes 0 No NA 0 Yes No 0 NA Was sensor removed for testing? Yes 0 No 0 NA Yes 0 No NA Yes No 0 NA Yes 0 No NA Was sensor properly replaced and verified functional after testing? Yes 0 No 0 NA Yes ONo DNA 0 Yes No DNA Yes No DNA Comments — (include information on repairs made prior to testing, andrecommendedfollow -upforjailed tests) NO FILL SUMPS Page ofSWRCB, January 2002 Pag 9. SPILL/OVERFILL CONTAINMENT BOXES Facility is Not Equipped With Spill/Overfill Containment Boxes Spill/Overfill Containment Boxes are Present, but were Not Tested 0 Test Method Developed By: Spill Bucket Manufacturer X Industry Standard Professional Engineer 0 Other (Spec) Test Method Used: Pressure Vacuum X Hydrostatic 0 Other (Spec) Test Equipment Used: INCON TS -STS Equipment Resolution: Spill Box #87 VPR Spill Box #91 VPR Spill Box # Spill Box # Bucket Diameter. 12" 12" Bucket Depth: 14" 14" Wait time between applying pressure/vacuum/water and starting test: 30MIN 30MIN Test Start Time: 10:45 11:06 10:45 11:06 Initial Reading (R,): 4.805 4.805 4.934 4.934 Test End Time: 11:01 11:21 11:01 11:21 Final Reading (RF): 4.865 1 4.865 4.934 4.934 Test Duration: l5MIN 15MIN 15MIN 15MIN Change in Reading (RF -R,): 000 000 000 000 Pass/FaiI Threshold or Criteria: 002 002 002 002 Test Result: X Pass Fail X Pass 0 Fail 0 Pass 0 Fail Pass Fail Comments — (include information on repairs made prior to testing, and recommendedfollow -upforfailed tests) r_L-irn.0 PIUMIL 362,4 CALIFORNIA AUE BAKERSFIELD CA 12/19/201i i1:01 AM SUMP LEAK TEST REPORT 87VPR TFST STARTED 10:45 AM TEST STARTED 12/19/201i BEGIN LEVEL 4.8658 IN END TIME 11:01 AM END DATE 12/19/2011 END LEVEL 8657 IN LEAK THRESHOLD 0.802 IN TEST RESULT PASSED 87STP TEST STARTED 10:45 AM TEST STARTED 12/19/2011 BEGIN LEVEL 4.4474 IN END TIME 11:01 AM END DATE 12/19/201! END i-EUEL 4.4492 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED 91UPR TEST STARTED 10:45 AM TEST STARTED 12/19/2611 BEGIN LEVEL 4.9343 IN END TIME 11:01 AM END DATE 12/19/2011 END LEVEL 4.9342 IN LEAK THRESHOLD 8.002 IN TEST RESULT PASSED DSLSTP TEST STARTED 10:45 AM TEST STARTED 12/19/2011 BEGIN LEVEL 4.1658 IN END TIME 11:01 AM END DATE 12/19/2011 END LEVEL 4.1655 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED ELTACO MOBIL 362BAKERSFIIEDNCA sE 12/19/2011 ii-.21 Am SUMP LEAK TEST REPORT 87UPR iLST STARTED TEST STARTED 11:06 AM 12119/2011 BEGIN LEQ& 4.8657 IN 11:21 AMENDTIME END DATE 12/19/2011 END LEVEL 4.8656 IN xAK THRESHOLD 0.002 IN TEST RESULT PASSED 87STP TEST STARTED TEST STARTED 11;06 At 12/19/2911 BEGIN LEVEL 4.4499 1 11:21 AENDTIME END DATE 12/19/201 e.ND LEVEL 4.4516 , LEAK. THRESHOLD 0.002 TEST RESULT PA55 91VPR TEST STARTED TEST STARTED i1:06 AM la,c13420IN8EG11iLEVEL11:21 AMENDTIME END DATE 12/19/2011 END LEVEL 4.9341 IH LEAK THRE54{OLD 0.002 EDTESTRESULT TEST RESULT DSLSTP I MW MOBIL33624CALIFORNIAAUtaAKERSFIELDCA 12/19/2011 !2:23 PM SUMP LEAK TEST REPORT UDC! -2 TEST STARTED 12;08 PMTESTSTARTED12/19/201! BEGIN LEVEL 2.5741 INENDTIME12:23 PMENDDATE, 12/19/2011ENDLEVEL2.5763 INLEAKTHRESHOLD0.002 INTESTRESULTINCREASED UDC3 -4 TEST STARTEDTESTSTARTED 12:08 Pm BEGIN LEVEL 12/19/2011 4.3626 INENDTIME END DATE 12:23 PM 12/19/2011ENDLEVELLEAKTHRESHOLD4.3625 INTESTRESULT6.002 IN PASSED TEST STARTED 11:96 Am 12/19/2011ESTSTARTED BEGIN LEVEL 4.1654 IN END TIME 11:21 AM 12/19/2011ENDDATE END LEVEL 4.1652 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED UDC7 -8 TEST STARTED 12:08 PM TEST STARTED 12/19/2011 BEGIN LEVEL 0.9307 IN END TIME 12:23 PM END DATE 12 /19/2011 END LEVEL 0.9306 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED DELTACO MOBIL 3624 CALIFORNIA AUE BAKERSFIELD CA 12/19/2011 12:40 PIS SUMP LEAK TEST REPORT UDCi -2 TEST STARTED 12:24 PM TEST STARTED 12/19/2011 BEGIN LEVEL 2.5776 IN END TIME 12:40 PM END DATE 12/19/2011 END LEVEL 2.5780 IN LEAK THRESHOLD 6.602 IN TEST RESULT PASSED UDC3 -4 DELTACO MOBIL 1:48 PM UDC7-8 3624 CALIFORNIA HUETESTSTARTED12:42 PM r AKERSFIEL 7 uyTESTSTARTED12/19/2011 TEST STARTED 12:42 PM BEGIN LEVEL 4.3624 IN 12/19/2011 2:03 PM END TIME 12:57 PM BEGIN LEVEL 0.9303 IN END DATE 12/19/2011 SUMP LEAK TEST REPORTENDLEVEL4.3616 IN LEAK THRESHOLD 0.002 IN UDC9 -10TESTRESULTPASSED TEST RESULT FAILED TEST STARTED 1:48 PM TEST STARTED 12/19/201191STP TEST STARTED BEGIN LEVEL 4.0123 IN TEST STARTED 12:42 PM END TIME 2 :03 PM END DATE 0111. 011TESTSTARTED12/19/2011 4ENDLEVEL4. INBEGINLEVEL3.1804 IN LEAK THRESHOLD 0..002002 INENDTIME12:57 PM TEST RESULT PASSEDENDDATE12/19/2011 4.3623 IN END LEVEL 3.1802 IN 12/19/2011 1:36 PM LEAK THRESHOLD 0.002 IN UDC5 -6TESTRESULTPASSED UDC-5-6 TEST STARTED TEST STARTED 1:48 PM UDC7-8 TEST STARTED 12/19/2011 END TIME BEGIN LEVEL 0.7179 IN TEST STARTED 12:42 PM END TIME END DATE 2 :%13 °M TEST STARTED 12/19/2011 TEST RESULT o. INBEGINLEVEL0.9303 IN LEAK THRESHOLD b.002 INENDTIME12:57 PM TEST RESULT PASSEDENDDATE12/19/2011 END LEVEL 0.9282 IN LEAK THRESHOLD 0.002 IN TEST RESULT FAILED UDC3 -4 TEST STARTED 12:24 PM TEST STARTED 12/19/2011 BEGIN LEVEL 4.3627 IN DELTACO MOBIL END TIME 12:40 PM 3624 CALIFORNIA AVE END DATE 12/19/2011 BAKERSFIELD CA END LEVEL 4.3623 IN LEAK THRESHOLD 0.002 IN 12/19/2011 1:36 PM TEST RESULT PASSED SUMP LEAK TEST REPORT 91STP UDC9 -10 TEST STARTED 12:24 PM TEST STARTED 1:21 PM TEST STARTED 12/19/2011 TEST STARTED 12/19/2011 BEGIN LEVEL 3.1804 IN BEGIN LEVEL 4.0137 IN END TIME 12:40 PM END TIME 1:36 PM END DATE 12/19/2011 END DATE 12/19/2011 END LEVEL 3.1805 IN END LEVEL 4.0129 IN LEAK THRESHOLD 0.002 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED TEST RESULT PASSE UDC7 -8 TEST STARTED 12:24 PM TEST STARTED 12/19/2011 BEGIN LEVEL 0.9305 IN END TIME 12 :48 PM END DATE 12/19/2011 END LEVEL 0.9303 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED UDC-5-6 TEST STARTED 2:16 PM TEST STARTED 12/19/2011 BEGIN LEVEL 0.7354 IN END TIME 2 :31 PM END DATE 12/19/2011 END LEVEL 0.7358 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED qqicl-3 / SB989 TESTING FAILURE REPORT SITE NAME: DEL TACO MOBIL DATE: 12/19/11 THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE TESTING. REPAIRS: DISPENSER #5/6 PENETRATION ON 87 TORN. DISP #1/2 LEAKING THROUGH A PEN -HOLE ON WHITE TCI SINGLE WALL PIPE (USING ROCK GUARD AS SECONDARY). DISP #1/2 91 LEAKING AROUND PENETRATION LOOKS LIKE NEWER BLUE LINE. SECONDARY FROM STP TO DISP #7/8 87 FAILED. NO SIGNS IN TURBINE SUMP OR UDC. SECONDARY FROM STP TO DISP #7/8 91 PASSED. NO JUMPER HOSES ON GAS PRODUCTS FROM DISP 1/2 -#5/6. NO JUMPERS ON GAS PRODUCTS FROM DISP 0/849/10. DIESEL HAS JUMPERS EIGHT (8) JUMPER HOSES MISSING. 87 -91 STP SUMP SENSORS ON WRONG SIDE OF SUMP. NAM: 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 ENVIRONMENTAL 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.