HomeMy WebLinkAbout3301 Wible Rd (76 Wible) 7-27-2020 SB989 ResultsCERS = California Environmental Reporting System, ID = Identification, UST = Underground storage tank, ICC = International Code Council,
NA = Not applicable, UDC = Under-dispenser containment
UNDERGROUND STORAGE TANK
SECONDARY CONTAINMENT TESTING REPORT FORM (Page 1 of 6)
Type of Action Installation Test Repair Test Six Month Test 36 Month Test
I. FACILITY INFORMATION
CERS ID
10132186
Date of Secondary Containment Test
7/27/2020
Business Name (Same as Facility Name or DBA-Doing Business As)
WIBLE 76
Business Site Address
3301 Wible Rd
City
Bakersfield
ZIP Code
93309
II. UNDERGROUND STORAGE TANK SERVICE TECHNICIAN INFORMATION
Name of UST Service Technician Performing the Test (Print as shown on the ICC Certification.)
Bradley Hinsley
Phone #
(661)706 - 4321 Ext.
Contractor/Tank Tester License #
971259
ICC Certification #
8373948
ICC Certification Expiration Date
8/10/2021
III. SUMMARY OF SECONDARY CONTAINMENT TESTING RESULTS
Tank ID: (By tank number, stored product, etc.) A 87 B 91 C Diesel D
Tank Containment
Tightness Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
Product Piping Containment
Tightness Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
Communication Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
Remote Fill Piping Containment
Tightness Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
Communication Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
Vent Piping Containment
Tightness Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
Communication Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
Vapor Recovery Piping Containment
Tightness Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
Communication Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
Turbine / Product Piping Sump
Tightness Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
Fill Riser Sump
Tightness Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
Vent / Transition Sump ID: a b c d
Tightness Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
UDC ID: 1 1/2 2 3/4 3 4
Tightness Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
UDC ID: 5 6 7 8
Tightness Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
UDC ID: 9 10 11 12
Tightness Test Result Pass Fail NA Pass Fail NA Pass Fail NA Pass Fail NA
All items marked “Fail” or “N/A” must be explained in their respective “COMMENTS” section.
IV. CERTIFICATION BY UST SERVICE TECHNICIAN CONDUCTING THIS TESTING
I hereby certify that the secondary containment was tested in accordance with California Code of Regulations, title 23,
division 3, chapter 16, section 2637 and all the information contained herein is accurate.
UST Service Technician Signature
ID = Identification
UNDERGROUND STORAGE TANK
SECONDARY CONTAINMENT TESTING REPORT FORM (Page 2 of 6)
V. TANK CONTAINMENT TESTING INFORMATION
Manufacturer Identify Tank ID from section III for each Manufacturer
A B C D
A B C D
Test Method Used: Manufacturer Guidelines: (Specify)
Industry Code or Engineering Standard: (Specify)
Engineered Method: (Specify)
Attach the testing procedures and all documentation required to determine the results. # of Attached Pages
Tank Containment Testing Training and Certifications (List applicable certifications.) Expiration Date
VI. COMMENTS
Provide any additional comments here.
VII. PRODUCT PIPING CONTAINMENT TESTING INFORMATION
Manufacturer Identify Tank ID from section III for each Manufacturer
Unknown A B C D
A B C D
Test Method Used:
Manufacturer Guidelines: (Specify)
Industry Code or Engineering Standard: (Specify) PEI/RP1200-19 Sect. 5.3
Engineered Method: (Specify)
Attach the testing procedures and all documentation required to determine the results. # of Attached Pages
Product Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date
ICC Service Techican 8/10/2021
INCON STS 10/9/2021
Interstitial Communication Verification Method Used:
VIII. COMMENTS
Provide any additional comments here.
ID = Identification
UNDERGROUND STORAGE TANK
SECONDARY CONTAINMENT TESTING REPORT FORM (Page 3 of 6)
IX. REMOTE FILL PIPING CONTAINMENT TESTING INFORMATION
Manufacturer Identify Tank ID from section III for each Manufacturer
A B C D
A B C D
Test Method Used:
Manufacturer Guidelines: (Specify)
Industry Code or Engineering Standard: (Specify)
Engineered Method: (Specify)
Attach the testing procedures and all documentation required to determine the results. # of Attached Pages
Remote Fill Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date
Interstitial Communication Verification Method Used:
X. COMMENTS
Provide any additional comments here.
XI. VENT PIPING CONTAINMENT TESTING INFORMATION
Manufacturer Identify Tank ID from section III for each Manufacturer
A B C D
A B C D
Test Method Used:
Manufacturer Guidelines: (Specify)
Industry Code or Engineering Standard: (Specify)
Engineered Method: (Specify)
Attach the testing procedures and all documentation required to determine the results. # of Attached Pages
Vent Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date
Interstitial Communication Verification Method Used:
XII. COMMENTS
Provide any additional comments here.
ID = Identification
UNDERGROUND STORAGE TANK
SECONDARY CONTAINMENT TESTING REPORT FORM (Page 4 of 6)
XIII. VAPOR RECOVERY PIPING CONTAINMENT TESTING INFORMATION
Manufacturer Identify Tank ID from section III for each Manufacturer
A B C D
A B C D
Test Method Used:
Manufacturer Guidelines: (Specify)
Industry Code or Engineering Standard: (Specify)
Engineered Method: (Specify)
Attach the testing procedures and all documentation required to determine the results. # of Attached Pages
Vapor Recovery Piping Containment Testing Training and Certifications (List applicable certifications.) Expiration Date
Interstitial Communication Verification Method Used:
XIV. COMMENTS
Provide any additional comments here.
XV. TURBINE / PRODUCT PIPING SUMP TESTING INFORMATION
Manufacturer Identify Tank ID from section III for each Manufacturer
Unknown A B C D
A B C D
Test Method Used:
Manufacturer Guidelines: (Specify)
Industry Code or Engineering Standard: (Specify) PEI/RP1200-19 Sect. 6.6
Engineered Method: (Specify)
Attach the testing procedures and all documentation required to determine the results. # of Attached Pages
Turbine / Product Piping Sump Testing Training and Certifications (List applicable certifications.) Expiration Date
ICC Service Techican 8/10/2021
INCON STS 10/9/2021
XVI. COMMENTS
Provide any additional comments here.
ID = Identification
UNDERGROUND STORAGE TANK
SECONDARY CONTAINMENT TESTING REPORT FORM (Page 5 of 6)
XVII. FILL RISER SUMP TESTING INFORMATION
Manufacturer Identify Tank ID from section III for each Manufacturer
A B C D
A B C D
Test Method Used:
Manufacturer Guidelines: (Specify)
Industry Code or Engineering Standard: (Specify)
Engineered Method: (Specify)
Attach the testing procedures and all documentation required to determine the results. # of Attached Pages
Fill Riser Sump Testing Training and Certifications (List applicable certifications.) Expiration Date
XVIII. COMMENTS
Provide any additional comments here.
XIX. VENT / TRANSITION PIPING SUMP TESTING INFORMATION
Manufacturer Identify Vent / Transition Sump ID from
section III for each Manufacturer
a b c d
a b c d
Test Method Used:
Manufacturer Guidelines: (Specify)
Industry Code or Engineering Standard: (Specify)
Engineered Method: (Specify)
Attach the testing procedures and all documentation required to determine the results. # of Attached Pages
Vent / Transition Piping Sump Testing Training and Certifications (List applicable certifications.) Expiration Date
XX. COMMENTS
Provide any additional comments here.
UDC = Under-dispenser containment, ID = Identification
UNDERGROUND STORAGE TANK
SECONDARY CONTAINMENT TESTING REPORT FORM (Page 6 of 6)
XXI. UNDER-DISPENSER CONTAINMENT TESTING INFORMATION
Manufacturer(s): Identify UDC ID from section III for each Manufacturer
Unknown 1 2 3 4 5 6
7 8 9 10 11 12
1 2 3 4 5 6
7 8 9 10 11 12
Test Method Used:
Manufacturer Guidelines: (Specify)
Industry Code or Engineering Standard: (Specify) PEI/RP1200-19 Sect. 6.6
Engineered Method: (Specify)
Attach the testing procedures and all documentation required to determine the results. # of Attached Pages
UDC Testing Training and Certifications (List applicable certifications.) Expiration Date
ICC Service Techican 8/10/2021
INCON STS 10/9/2021
XXII. COMMENTS
Provide any additional comments here.
Both UDCs visually failed due to torn rock guard boots. Must be repaired and retested.
If the facility has more components than this form accommodates, additional copies of these pages may be attached.