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HomeMy WebLinkAboutFMC 2024Appemdix Vlll Underground Storage Tank $pill Gontainer -fbsting Report Fonm TYPE OF "AeTlON [f installatiein t Repair Wil 12 Month 1, FAEItffY INFSRMAT.!*T'I r'E:DC l11-uLl \\J lu Tesi Date 2{15124 Facility Name CHESTER FUEL Facility Address 402 S. CHESTER AVE eity j ZIP Code BAKER$FEELS ISA3O+ 2. SERVICE TECHNICIAN INFORMATION Company Perforrning the Test BSSR INC Phone 661-588-2777 l/lailing Address 6S30 RCISEDALE HWY i:j*i'vi*e Teehn icia n Ferf*r"ming Test ilIATHS\ru H*LMAN Contractor/Tank Tester l-icense hiumber 672813 ICC Nurnber 81 1 1067 ICC Fxpiratiori Date &123!24 3.' TR II\llNG ANB.€ERTIFICI\TIO,NS {rfi a n ufa ctu re r a n d T e st Eq u i p m e nt T ra i n i n g Ce;rlficafrons Expiratian Date CIPW 10120124 CERS = California Environrnentai Repariing Systenr, lD = ldentificatlcn, ICC * lnternational eode Cq:uncil Page 1 of 2 4. TEST PROCE$U.RE INFORMATIGN Test Proeedures Used Conip*nenfs Issfed HYDROSTATIC T HR 87,91 FILL BUCKETS I hereby certify that each spill eontainer was fesfed in aceardance with California Code of Regulations, title 23, divisian 3, e hapter 16, secffon 2637.1; that required swpporting docurnentatian fs affached; and all infarmation contained herein fs aecurate. I understand that test procedures stral/ be made available upon request by the governing awthority. Service Technician Signature it'.+,'t i13ffi;Li-1, fY e#na;r" Date Totai # r;f Pages 5. CERTIFICAT!CIN BY SERVICE TECHNICIAN CONDUCTING TEST Underground $tsrage Tank $piXI Container T:esting Repoft Form 6. SPILL CONTAINER tsETAILS Test Method Developed hy il Manufacturer ffi lndustry Standard il Prcfessional Engineer Test Type ifl Pr*ssure ffi Vacuum ffi Hydrostatie Tank lD 87 q{ Spill Container Manufacturer:CIPW CIPW Method of Cathodic Protection ffi Nonnretallic lfi Cther El Nonmetailic ffi Othet ffi Nonrnetallic Kl *ther ffi Nonmetallic Ifi Other ls the spill ccntainer minimum capacity five gallons exciuding riser volume? I.-_j { * L' !, I t\rl' ffi Yes ffi No* m E] YCS Nou ffi Yes ffi No* !\4ethod to keep sprll ccntainer er-npty Itt iL: -l r'at__.1 ii-t ilrain Pump Other ttr' I t -.1tt ti Drain Fump Cther I:1 r-'l[__.i ti r Drain Purnp Other fl tlrain ffi Pump F-l f)thprfl Spiil ilcntainer Test Results n Fass tr:ril t!) UJ Fass Fai! tiv17ti; i__ i Pass F=il til li_-.1 Iitv.) Pass Faii Tank lD Spill Container Manufacturer: Method of Cathodic Protection ffi Nonmetailic l7l 0ther t Nonmetaliic ilJ Othei' ffi Nonmeialiic ffi Cther ffi Nonrnetallic ffi Other ls the spill c*ntainer ri:inimurn capacity five gallons excluding riser volume? it-1. ,! m Yes hJcr* [I Yes ffi N*" ffi Yes ill Nc. il vojp-) Yes No* Method to keep spiil container empty ffi Drain ffi Pump ffi Cltirer r-"1[--.1 tit tl Irit Drain Pump Oihter tztld t? l r"1tit Drain Fump Sther FI l?t Drain Purnp Cther $piil Contairier Test Resuits E-1L__l r7rr i Fass Fail m I;i Pass Fail I; Irt Yi Pass E-itI flti FI;! 11LL Pass Faii $(r. Descritse a/l aitsmrer*s iriarked "Ath*r," "Na," a{ "Fail" antl each prcp:r:sed remerly" o Vlark here if. ffi Spill containers do not have a minimum capacity of five eallans and re:quire repiacemeni. Additiona! copies of fhis ,sage may be attached. Page ? af ?. Appendix Vl Underground Storage Tank Monitoring System Certifi cation Form TYPE OF ACTION E lnstallation E Repair E tZ Month 1. FACILITY INFORMATION CERS ID Certification Date 2t15124 Facility Name CHESTER FUEL Facility Address 402 S.CHESTER AVE City BAKERSFIELD ZIP Code 93304 2. SERVIGE TECHNICIAN INFORMATION Company Performing the Certification BSSR INC Phone 661-588-2777 Mailing Address 6630 ROSEDALE HWY SUITE B Service Technician Performing Test NATHAN HOLMAN Contractorffank Tester License Number 672812 ICC Number 81 1 1067 ICC Expiration Date 8t23124 3. TRAINING AND GERTIFICATIONS Manufacturer and Test Equipment Training Certificatians Expiration Date VEEDER ROOT LEVEL 4 3t30t24 4. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING TEST I hereby certify that the monitoring system is operational in accordance with California Code of Regulations, title 23, division 3, chapter 16, section 2638; that required supporting documentation is attached; and all information contained herein is accurate. Service Technician Signature Date Total# of Pages CERS = California Environmental Reporting System, GPH = Gallons Per Hour, lD = ldentification, ICC = lnternational Code Council, LLD = Line Leak Detector, NA = Not Applicable, SW = Single- Walled, UDC = Under-Dispenser Containment, UST = Underground Storage Tank, VPH = Vacuum/Pressure/Hydrostatic Page 1 of6 Underground Storage Tank Monitoring System Certification Form Describe all answers marked "No" or "Fail" and proposed remedy in Section 9. List all monitoring equipment either replaced or repaired in Section 9 5. MONITORING SYSTEM AND PROGRAMMING A separate Monitoring System Certification Form must be prepared far each control panel, Make of Monitoring System Control Panel VEEDER ROOT Model of Monitoring System Control Panel TLS 350 PLUS Softrrare Version I nstalled 333.m Attach the post-certification repofts if the monitaring system is capable of generating either; El Monitoring System Set-up ffi Atarm History Report Yes No NA All monitoring equipment is operational per manufacturer's specifications?m E Secondary containment systems are free of damage, debris, or liquid?m m Are the audible and visual alarms operational?m tr All sensors have been: 1) visually inspected for wiring kinks, breaks and residual buildup on floats, and 2) tested for functionality and confirmed operational?E m E Are all sensors installed to detect a release at the earliest opportunity in the secondary containment?m fl ffi The monitoring system set-up was reviewed, and proper settings confirmed?m m m Was the monitoring control panel's backup battery visually inspected, functionally tested, and conflrmed operational?m E m Does the flow of fuel stop at the dispenser if a release is detected in the under- d ispenser containment?m m m Does the turbine automatically shut down if the piping secondary containment monitoring system fails to operate or is electrically disconnected?m tr ltt Does the turbine automatically shut down if the piping secondary containment monitoring system detects a release? Which sensors initiate positive shut down? (Check all that apply) ElSump ffi uoC m m m lf monitoring system alarms are relayed to a remote monitoring center, is all communication equipment operational?m n m Page 2 of 6 Underground Storage Tank Monitoring System Certification Fomt 6. SENSOR TESTING RESULTS List only sensors fesfed on date of this certification Lrsf 'Sensor lD" as labeled in system programming. Additionalcopies of this page may be attached to accammodate a/l sensors fesfed Sensor/D Sensor Model Component(s) Monitared Pass Fail L1 208 87 STP SUMP m a L2 420 87 ANNULAR m E L3 420 91 ANNULAR m m 1-2 OO1 STANDALONE uDc 1-2 m m 34 OO1 STANDALONE UDC 34 m E n E m m ffi m fl E n m m m a m il tr m m m m m m m m n tr m n m m il m m E n E n m Describe all answers marked oNo" or*Fail" and proposed remedy in Secfi'on 9- List all.monitoring equipment either replaced or repaired rn Secfibn 9 Page 3 of 6 Underground Storage Tank Monitoring System Gertification Form Describe a/lanswers marked nNo" or"Fail'and proposed remedy in Secfion 9. List all.monitoring equipment either replaced or repaired rn Secfi'on I 7. LINE LEAK DETECTOR TESTING EJCnecf this box if line leak detectors ARE NOT installed. (Do not complete this section.) Simulated release rate verified: (Check allthat apply,) lil e cpH fl 0.1 GPH ffi o.z ePH Yes No NA Has the testing apparatus been properly calibrated?m a m For emergency generator tank systems, does the LLD create an audible and visual alarm when a leak is detected?E m ffi For mechanical LLDs, does the LLD restrict the flow through the pipe when a release is detected?m a m For electronic LLDs, does the turbine automatically shut off when a release is detected?ffi m m For electronic LLDs, does the turbine automatically shut off if any portion of the monitorinq system is disabled or disconnected?ffi il m For electronic LLDs, does the turbine automatically shut off if any portion of the monitorinq svstem malfunctions or fails a tiqhtness test?m ffi m For electronic LLDs, have all accessible wiring connections been visually inspected for kinks and breaks?tr ffi m Were all items on the equipment manufacturer's maintenance checklist completed?m m m Were all LLDs confirmed operationalwithin regulatory requirements?E m m LLD ID I LLD MOdEI Lines Manitored Pass Fail 87 LD2000 87 m fl 91 LD2000 91 ffi m il a ffi m m m fl m ffi fl m tr m m n m fl atm Page 4 of 6 Underg round Storage Tank Monitoring System Certification Form 8. IN.TANK GAUGING TESTING ffi Cnecf this box if tank gauging is used only for inventory control. t Checf this box if NO tank gauging equipment is installed. (Do not complete this section if either box t's checked.) Yes No NA All wiring has been: 1) visually inspected for kinks, breaks and proper entry and termination; and 2) tested for qround faults?m ffi a Were all in-tank gauging probes visually inspected for damage and residue buildup to ensure that floats move freelv, functionally tested, and confirmed operational?n m t Was accuracy of system's product level readings tested?r E a Was accuracy of system's water level readings tested?r il m Were all probes reinstalled properly?m il m Were all items on the equipment manufacturer's maintenance checklist completed?E n E Probe lD I Probe Model TanKs Monitored Pass Fail m fl a m n n n m a m m E 9. COMMENTS Describe all answers marked "No" or "Fail" and proposed remedy. List all monitoring equipment either replaced or repaired. 91 LEAK DETECTOR FAILED 1 MINUTE HOLDING REQUIREMENT. PULL PERMIT, REPLAGE, AND RETEST. J Page 5 of 6 Underg round Storage Tank Monitoring System Certification Fomt 10, MONITORING SITE PLAN Date site plan was prepared: lf a site plan has been prepared that shows all required information, you may include it, rather than this page, with your Monitoring Sysfem Cefiification Form. The site plan must show the general layout of tanks and identtfy locations of the monitoring panel, and all leak detection equipment and monitoring locations. lnclude a legend for all symbols depicted. 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