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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 10132186 Test Date 7/24/2023 Facility Name WIBLE 76 Facility Address 3301 Wible Rd City Bakersfield 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 7/24/2023 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 ID Tank Manufacturer Tank Capacity 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 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 Product 91 Product Diesel Prod Pipe Manufacturer Unknown Unknown Unknown Test Start Time 08:10 08:15 08:20 Initial Reading 5.0 PSI 5.0 PSI 5.0 PSI Test End Time 09:10 09:15 09:20 Final Reading 0.0 PSI 0.0 PSI 5.0 PSI Change in Reading 5.0 PSI 5.0 PSI 0.0 PSI Pass/Fail Criteria +/- 0.0 PSI +/- 0.0 PSI +/- 0.0 PSI Tightness Test Results ☐ Pass X Fail ☐ Pass X 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 Fill 87 STP Sump Manufacturer Unknown Unknown Unknown Unknown Sump Depth (inches) 35 35 35 35 Sump Bottom to Top of Highest Pipe Penetration (inches) 14 14 14 15 Test Start Time 08:27 09:01 09:01 Visual Initial Reading 1.3878 2.9550 2.6919 Failure Test End Time 08:42 09:16 09:16 Bad Final Reading 1.3124 2.9559 2.2175 Penetration Change in Reading 0.0754 0.0009 0.4744 Boot Pass/Fail Criteria +/- 0.0020 +/- 0.0020 +/- 0.0020 +/- 0.0020 Tightness Test Results ☐ Pass X Fail X Pass ☐ Fail ☐ Pass X Fail ☐ Pass X Fail Sump/UDC ID 91 STP Diesel STP UDC 1/2 UDC 3/4 Sump Manufacturer Unknown Unknown Unknown Unknown Sump Depth (inches) 35 35 28 28 Sump Bottom to Top of Highest Pipe Penetration (inches) 15 15 13 13 Test Start Time 11:13 10:26 11:44 12:10 Initial Reading 5.9194 4.9500 5.8449 2.8551 Test End Time 11:29 10:41 11:59 12:25 Final Reading 5.9117 4.9436 4.2796 2.8169 Change in Reading 0.0077 0.0064 1.5653 0.0382 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: 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 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 87 Product line failed due to crack in line in Disp 3/4. 91 Product line failed due to bad boot in STP Sump. 87 STP Sump was a visual failure due to bad penetration boot. 87 and Diesel Fill Sumps, 91 and Diesel STP Sumps and both UDCs and all other failures listed above must be repaired and retested. System is single walled, no annulars on tanks. 9. COMMENTS