HomeMy WebLinkAboutSB989 2023
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
10120492
Test Date
6/27/2023
Facility Name
Sullivans Ming Chevron
Facility Address
6601 Ming Ave
City
Bakersfield Ca
ZIP Code
93309
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
6/27/2023
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 Diesel 87 91
Tank Manufacturer Unknown Unknown Unknown
Tank Capacity 11,849 11,849 11,849
Test Start Time 08:20 08:30 10:20
Initial Reading -10.00 InHg -10.00 InHg -10.00 InHg
Test End Time 09:20 09:30 11:20
Final Reading -10.00 InHg -10.00 InHg -10.00 InHg
Change in Reading 0.0 InHg 0.0 InHg 0.0 InHg
Pass/Fail Criteria +/- 0.0 InHg +/- 0.0 InHg +/- 0.0 InHg
Tightness Test Results X Pass ☐ Fail X Pass ☐ Fail X 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 Prod 91 Prod Diesel Prod
Pipe Manufacturer Unknown Unknown Unknown
Test Start Time 07:45 07:45 07:45
Initial Reading 5.0 PSI 5.0 PSI 5.0 PSI
Test End Time 08:45 08:45 08:45
Final Reading 5.0 PSI 5.0 PSI 5.0 PSI
Change in Reading 0.0 PSI 0.0 PSI 0.0 PSI
Pass/Fail Criteria +/- 0.0 PSI +/- 0.0 PSI +/- 0.0 PSI
Tightness Test Results X Pass ☐ Fail X Pass ☐ Fail X Pass ☐ Fail ☐ Pass ☐ Fail
Pipe Run ID
Pipe Manufacturer
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.
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 Fill Sump 91 Fill Sump Diesel FS 87 STP
Sump Manufacturer Unknown Unknown Unknown Unknown
Sump Depth (inches) 50 50 50 50
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
15 15 15 20
Test Start Time 08:20 08:46 08:46 09:19
Initial Reading 2.9891 2.3428 3.8132 3.2737
Test End Time 08:35 09:01 09:01 09:34
Final Reading 2.9882 2.3428 3.8126 3.2735
Change in Reading 0.0009 0.0000 0.0006 0.0002
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 91 STP Diesel STP UDC 1/2 UDC 3/4
Sump Manufacturer Unknown Unknown Unknown Unknown
Sump Depth (inches) 50 50 30 30
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
20 20 10 10
Test Start Time 09:19 09:53 13:47 13:26
Initial Reading 4.2675 3.8265 4.5590 5.6399
Test End Time 09:34 10:08 14:02 13:41
Final Reading 4.2655 3.8248 4.5590 5.6404
Change in Reading 0.0020 0.0017 0.0000 0.0005
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 5/6 UDC 7/8
Sump Manufacturer Unknown Unknown
Sump Depth (inches) 30 30
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
10 10
Test Start Time 10:57 11:17
Initial Reading 6.0566 5.1856
Test End Time 11:12 11:32
Final Reading 6.0573 5.1857
Change in Reading 0.0007 0.0001
Pass/Fail Criteria +/- 0.0020 +/- 0.0020
Tightness Test Results X Pass ☐ Fail X 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
All Passed
9. COMMENTS