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
10159413
Test Date
6/1/2023
Facility Name
Obie's Downtown Shell (South)
Facility Address
2317 L St. (South)
City
Bakersfield
ZIP Code
93301
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
6/1/2023
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 87/Diesel 91
Tank Manufacturer Unknown Unknown
Tank Capacity 20,153 10,145
Test Start Time 08:50 09:10
Initial Reading -10.00 InHg -10.00 InHg
Test End Time 10:50 10:10
Final Reading -10.00 InHg -10.00 InHg
Change in Reading 0.0 InHg 0.0 InHg
Pass/Fail Criteria +/- 0.0 InHg +/- 0.0 InHg
Tightness Test Results X Pass ☐ Fail X Pass ☐ Fail ☐ Pass ☐ Fail ☐ 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 87 1-10 87 3-12 91 1-10 91 3-12
Pipe Manufacturer Unknown Unknown Unknown Unknown
Test Start Time 08:30 08:35 08:45 08:50
Initial Reading 5.0 PSI 5.0 PSI 5.0 PSI 5.0 PSI
Test End Time 09:30 09:35 09:45 09:50
Final Reading 3.0 PSI 5.0 PSI 1.0 PSI 5.0 PSI
Change in Reading 2.0 PSI 0.0 PSI 4.0 PSI 0.0 PSI
Pass/Fail Criteria +/- 0.0 PSI +/- 0.0 PSI +/- 0.0 PSI +/- 0.0 PSI
Tightness Test Results ☐ Pass X Fail X Pass ☐ Fail ☐ Pass X Fail X Pass ☐ Fail
Pipe Run ID Diesel 1-10 Diesel 3-12
Pipe Manufacturer Unknown Unknown
Test Start Time 08:15 08:20
Initial Reading 5.0 PSI 5.0 PSI
Test End Time 09:15 09:20
Final Reading 1.0 PSI 0.0 PSI
Change in Reading 4.0 PSI 5.0 PSI
Pass/Fail Criteria +/- 0.0 PSI +/- 0.0 PSI
Tightness Test Results ☐ Pass X Fail ☐ Pass X 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 87 STP 91 STP Diesel STP UDC 1/2
Sump Manufacturer Unknown Unknown Unknown Unknown
Sump Depth (inches) 38 38 38 30
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
15 15 15 16
Test Start Time Visual 11:41 Visual 10:07
Initial Reading Failure 5.8942 Failure 2.9049
Test End Time Torn 11:56 Torn 10:22
Final Reading Sump 5.8488 Sump 2.7238
Change in Reading Penetration 0.0454 Penetration 0.1811
Pass/Fail Criteria +/- 0.0020 +/- 0.0020
Tightness Test Results ☐ Pass X Fail ☐ Pass X Fail ☐ Pass X Fail ☐ Pass X Fail
Sump/UDC ID UDC 3/4 UDC 5/6 UDC 7/8 UDC 9/10
Sump Manufacturer Unknown Unknown Unknown Unknown
Sump Depth (inches) 30 30 30 30
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
16 16 16 16
Test Start Time 10:07 12:32 12:32 13:13
Initial Reading 2.3031 3.9049 4.6414 2.7831
Test End Time 10:22 12:47 12:47 13:28
Final Reading 1.9553 3.5903 4.0007 1.7200
Change in Reading 0.3478 0.3146 0.6344 1.0631
Pass/Fail Criteria +/- 0.0020 +/- 0.0020 +/- 0.0020 +/- 0.0020
Tightness Test Results ☐ Pass X Fail ☐ Pass X Fail ☐ Pass X Fail ☐ Pass X 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 11/12
Sump Manufacturer Unknown
Sump Depth (inches) 30
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
16
Test Start Time 13:13
Initial Reading 5.8461
Test End Time 13:28
Final Reading 5.1255
Change in Reading 0.7206
Pass/Fail Criteria +/- 0.0020
Tightness Test Results ☐ Pass X Fail ☐ Pass ☐ Fail ☐ Pass ☐ Fail ☐ Pass ☐ Fail
Sump/UDC ID
Sump Manufacturer
Sump Depth (inches)
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
Test Start Time
Initial Reading
Test End Time
Final Reading
Change in Reading
Pass/Fail Criteria
Tightness Test Results ☐ Pass ☐ Fail ☐ 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
9. COMMENTS