HomeMy WebLinkAbout2023 SB989
Appendix VII
Underground Storage Tank
Secondary Containment Testing Report Form
CERS = California Environmental Reporting System, ICC = International Code Council,
ID = Identification, NA = Not Applicable, UDC = Under-Dispenser Containment,
Page 1 of 5
TYPE OF ACTION ☐ Installation ☐ Repair ☐ 6 Month X 36 Month
CERS ID
10121548
Test Date
4/17/2023
Facility Name
ARCO Brundage & H
Facility Address
1701 Brundage Ln
City
Bakersfield
ZIP Code
93304
Company Performing the Test
Advanced Compliance
Phone
6617064321
Mailing Address
4007 Brae Burn Dr Bakersfield Ca 93306
Service Technician Performing Test
Bradley Hinsley
Contractor/Tank Tester License Number
971259 ICC Number
8373948
ICC Expiration Date
8/9/2023
Manufacturer and Test Equipment Training Certifications Expiration Date
ICC Service Techican 8/9/2023
INCON STS 10/5/2023
Test Procedures Used Components Tested
PEI/RP1200-19 Sect. 4. Tank Annular
PEI/RP1200-19 Sect. 5. Line Secondary
PEI/RP1200-19 Sect. 6. Containment Sump
I hereby certify that the secondary containment was tested in accordance with California
Code of Regulations, title 23, division 3, chapter 16, section 2637; that required supporting
documentation is attached; and all information contained herein is accurate. I understand
that test procedures shall be made available upon request by the governing authority.
Service Technician Signature Date
4/17/2023
Total # of Pages
1. FACILITY INFORMATION
2. SERVICE TECHNICIAN INFORMATION
3. TRAINING AND CERTIFICATIONS
4. TEST PROCEDURE INFORMATION
5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST
Underground Storage Tank
Secondary Containment Testing Report Form
All tests marked “Fail” and any repairs made before or during the tightness test must be described in
the COMMENTS section.
Page 2 of 5
Test Method Developed by ☐ Manufacturer ☐ Industry Standard X Professional Engineer
Test Type ☐ Pressure X Vacuum ☐ Hydrostatic
Test Equipment Used: Tank Annular Testing Setup
Tank ID 87S 87M 87N 91
Tank Manufacturer Unknown Unknown Unknown Unknown
Tank Capacity 9,684 9,684 9,684 9,684
Test Start Time 09:00 09:15 10:40 11:05
Initial Reading -10.00 InHg -10.00 InHg -10.00 InHg -10.00 InHg
Test End Time 10:00 10:15 11:40 12:05
Final Reading -10.00 InHg -10.00 InHg -10.00 InHg -10.00 InHg
Change in Reading 0.0 InHg 0.0 InHg 0.0 InHg 0.0 InHg
Pass/Fail Criteria +/- 0.0 InHg +/- 0.0 InHg +/- 0.0 InHg +/- 0.0 InHg
Tightness Test Results X Pass ☐ Fail X Pass ☐ Fail X Pass ☐ Fail X Pass ☐ Fail
Test Method Developed by ☐ Manufacturer ☐ Industry Standard X Professional Engineer
Test Type X Pressure ☐ Vacuum ☐ Hydrostatic
Test Equipment Used: Piping Secondary Testing Setup
Pipe Run ID 87S Product 87S-87M Tran 87M Product 87M-87N Tran
Pipe Manufacturer Unknown Unknown Unknown Unknown
Test Start Time 12:20 09:05 09:10 14:10
Initial Reading 5.0 PSI 5.0 PSI 5.0 PSI 5.0 PSI
Test End Time 13:20 10:05 10:10 15:10
Final Reading 5.0 PSI 5.0 PSI 5.0 PSI 5.0 PSI
Change in Reading 0.0 PSI 0.0 PSI 0.0 PSI 0.0 PSI
Pass/Fail Criteria +/- 0.0 PSI +/- 0.0 PSI +/- 0.0 PSI +/- 0.0 PSI
Tightness Test Results X Pass ☐ Fail X Pass ☐ Fail X Pass ☐ Fail X Pass ☐ Fail
Pipe Run ID 87N Product 91 Product
Pipe Manufacturer Unknown Unknown
Test Start Time 09:15 09:45
Initial Reading 5.0 PSI 5.0 PSI
Test End Time 10:15 10:45
Final Reading 5.0 PSI 5.0 PSI
Change in Reading 0.0 PSI 0.0 PSI
Pass/Fail Criteria +/- 0.0 PSI +/- 0.0 PSI
Tightness Test Results X Pass ☐ Fail X Pass ☐ Fail ☐ Pass ☐ Fail ☐ Pass ☐ Fail
Additional copies of this page may be attached.
6. TANK SECONDARY CONTAINMENT TEST
7. PIPE SECONDARY CONTAINMENT TEST
Underground Storage Tank
Secondary Containment Testing Report Form
All tests marked “Fail” and any repairs made before or during the tightness test must be described in
the COMMENTS section.
Page 3 of 5
Test Method Developed by ☐ Manufacturer ☐ Industry Standard X Professional Engineer
Test Type ☐ Pressure ☐ Vacuum X Hydrostatic
Test Equipment Used: Incon STS
Sump/UDC ID 87S STP 87M STP 87N STP 91 STP
Sump Manufacturer Unknown Unknown Unknown Unknown
Sump Depth (inches) 68 68 68 68
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
41 43 41 41
Test Start Time 10:18 13:55 11:51 13:10
Initial Reading 3.9788 5.5310 5.9131 6.3899
Test End Time 10:33 14:11 12:06 13:25
Final Reading 3.9600 5.5295 5.9148 6.3898
Change in Reading 0.0188 0.0015 0.0017 0.0001
Pass/Fail Criteria +/- 0.0020 +/- 0.0020 +/- 0.0020 +/- 0.0020
Tightness Test Results ☐ Pass X Fail X Pass ☐ Fail X Pass ☐ Fail X Pass ☐ Fail
Sump/UDC ID 87S Fill 87M Fill 87N Fill 91 Fill
Sump Manufacturer Unknown Unknown Unknown Unknown
Sump Depth (inches) 68 68 68 68
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
12 12 12 12
Test Start Time 14:59 14:32 14:32 14:59
Initial Reading 3.4571 1.7850 1.8659 3.7758
Test End Time 15:14 14:47 14:47 15:14
Final Reading 3.4584 1.7858 1.8678 3.7767
Change in Reading 0.0013 0.0008 0.0019 0.0009
Pass/Fail Criteria +/- 0.0020 +/- 0.0020 +/- 0.0020 +/- 0.0020
Tightness Test Results X Pass ☐ Fail X Pass ☐ Fail X Pass ☐ Fail X Pass ☐ Fail
Additional copies of this page may be attached.
8. SUMP/UDC TEST
Underground Storage Tank
Secondary Containment Testing Report Form
All tests marked “Fail” and any repairs made before or during the tightness test must be described in
the COMMENTS section.
Page 4 of 5
Test Method Developed by ☐ Manufacturer ☐ Industry Standard X Professional Engineer
Test Type ☐ Pressure ☐ Vacuum X Hydrostatic
Test Equipment Used: Incon STS
Sump/UDC ID UDC 1/2 UDC 3/4 UDC 5/6 UDC 7/8
Sump Manufacturer Unknown Unknown Unknown Unknown
Sump Depth (inches) 32 32 32 32
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
16 16 16 16
Test Start Time 12:33 12:53 12:53 13:19
Initial Reading 4.3852 6.8054 3.9095 3.3621
Test End Time 12:48 13:08 13:08 13:34
Final Reading 4.3835 6.8063 3.9084 3.3621
Change in Reading 0.0017 0.0009 0.0011 0.0000
Pass/Fail Criteria +/- 0.0020 +/- 0.0020 +/- 0.0020 +/- 0.0020
Tightness Test Results X Pass ☐ Fail X Pass ☐ Fail X Pass ☐ Fail X Pass ☐ Fail
Sump/UDC ID UDC 9/10 UDC 11/12
Sump Manufacturer Unknown Unknown
Sump Depth (inches) 32 32
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
16 16
Test Start Time 15:29 14:59
Initial Reading 4.5872 5.9259
Test End Time 15:44 15:14
Final Reading 4.5866 5.9266
Change in Reading 0.0006 0.0007
Pass/Fail Criteria +/- 0.0020 +/- 0.0020
Tightness Test Results X Pass ☐ Fail X Pass ☐ Fail ☐ Pass ☐ Fail ☐ Pass ☐ Fail
Additional copies of this page may be attached.
8. SUMP/UDC TEST (continued)
Underground Storage Tank
Secondary Containment Testing Report Form
All tests marked “Fail” and any repairs made before or during the tightness test must be described in
the COMMENTS section.
Page 5 of 5
87S STP Failed, must be repaired and retested.
4/17/2023 tested all Annulars, Lines, STPs and Fill Sumps; and UDC 9/10-11/12. 4/18/2023 tested
UDC 1/2-7/8.
9. COMMENTS