HomeMy WebLinkAboutSB989 2024 REPAIR 3,&pBendix Vll
Underground Storage Tamk
$econdaryr Sontainmer:t Testing Report Fsrm
f] lnstallation x Repair I6 Month E SA Month
Test Date
fit4t2424
CERS = California Environmental Reporting System, ICC = lnternationalCode Council,
lD = ldentification, NA = Not Applicable, UDC = Under-Dispenser Containment,
UN-054 www.unidocs-org Rev. l0o1/20 Page 1 Of 5
CERS ID
Facility Name
ARCO AM/PM
1 588-2777
FhoneCompany Performing the Test
BSSR IN
Facili$ Address
3125 CALIFORNIA AVE
ZIP ecde
93304
City
BAKERSFIELD
Mailing Address
6630 ROSEDALE HWY #B
S*rvi*e Techni*ian Ferforn:!ng Test
FIDEL CARRILLO
eontractrrffank Tester l-icense Number
BSSR tNC, / #672812
ICC ffxpiration Date
14t24t2025
ii,il liui;i**r
5257282
Manufacturer and Test Equipment Training Certifications Expiration Date
CALIFORNIA UST SERVICE TECHNICIAN #5257282 10t24t2025
INCON TS.STS TESTER #1011253708 12t26t2025
Componenls IesfedTest Procedures Used
4-
PE!/RP 1200-19 SECT.5 LINE SECONDARY
PE|/RP 1200-19 SECT. 6.CONTAINMENT SUMP
f fiere$y cerfffy that tfue seromdary cerfainme*f was fesfed in aecordante wtth California
Code *f ffegrutrafibns, fffle *S, dfvisron & cftapfer f 6, seefion 2637; tha* required supBorffng
doerunremfafron rs affacJred; and aif rnfonnatlom confalned laerern gs accari"a*e. d ryndersfand
fflaf fesf proeedures shall&e fftade ayaifa$ie $pan requesf Sy ffte governing awtharity.
Service Technician Signature-{"^dJ- C c'.J"4".-'t"us
Date
11t4t2024
Total # of Pages
TYPf; *F ACTXSN
.{. F&CI&-ITY IruFORffiAYI*N
fr. str&vt*tr Ttr0*{rdl&rAF4 rslF*ffi$Jr&T{*N
3. TmAiNlrd* Arq* *ffiKT {FtSATt0h'S
s. *ffiffiTtF**&T{SfS ffiY $ffiRvi#& THfrh{r$tetA$ S$fti${-ffrTtedffi Ttr$T
Test Method Developed by H Manufacturer [] lndustry Standard I Professional Engineer
Test Type E Pressure I Vacuum ffi Hydrostatic
Test Equipment Used:
Tank IB
Tank Manufacturer
Tank Capacity
Test Start Time
lnitial Reading
Test End Time
Final Reading
Change in Reading
Pass/Fail Criteria
htness Test Results Fass Fai{Fail Fait
Test Method E Manufacturer ffi lno Standard E Professional noFr
Pass Faii Fass Fass
Test Type M Pressure E Vacuum ffi Hydrostatic
Test Equipment Used: NlrRocEN, PRESSURE GAUGE
Fipe Run !B 87 TO UDC'S I
Pipe Manufacturer AIO SIUITH
Test Start Time 10:00 Alrtl
lnitial Reading 5 P.S.t.
Test End Time 11;00 AM
Final Reading 5 P.S.I.
Change in Reading 0
Pass/Fail Criteria 0
Tightness Test Results
FIBe Run lB
ffi nass ffi rait F*il FailPassFass -LJ iex lfi tgl_,
Pipe Manufacturer
Test Start Time
lnitial Reading
Test End Time
Final Reading
Change in Reading
Pass/Fail Criteria
Tightness Test Results iil Pass it Fail E Pass E Fail I E Pass E rait [t Pass ffi rall
Undergreur*d $torage Tank
Se**erdary fisntaimment Testlng RepCIrt Foffi?"t
Additionalcopies of this page may be attached.
A// fesfs marked *Fail" and any repairs made before or during the tightness fesf must be described in
the CAMMENIS secfrbn.
Page 2 of 5
S" YEh*K $H*#r1IMAKY E*ruTA8NAfiHhiT Tffi$T
?" pipH $gC*rumARY **NT&lr,{MHruT TffiST
Test Method Developed by E lvlanufacturer ffi lndustry Standard ffi Professional Engineer
Test Type E Pressure E Vacuum ffi Hydrostatic
.l-*si *:qi.iipi'::*i:t ij:l*ri: lNcoN TS-STS TESTER
$urnplUDe iS uDc 7/8 uDc 9/10
Sump Manufacturer
Sump Depth (inches)
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
Test Start Time 10:50 AM 10:50 AM
lnitial Reading 5.2979 rN 4.2135lN
Test End Time 1'1:05 AM 11:50 Alt/
4.2140 tNFinal Reading 5.2973 rN
Change in Reading 0.0006 rN 0.0005 rN
Pass/Fail Criteria 0.002 rN 0.002 rN
Tightness Test Results ffi Pass ffi Faii ffi Pass ffi Fail IE Pass E Fail lE Pass E rait
Underground Storage Tank
Ss*cmdary #sr,ltainment Testing Report Forrx
Additionalcopies of this page may be attached
A// fesfs marked "Fail" and any repairs made before or during the tightness fesf must be described in
the COMMENIS secfibn.
$umpfUDe trD
Sump Manufacturer
Sump Depth (inches)
Sump Bottom to Top of
Highest Pipe Penetration
(inches)
Test Start Time
lnitial Reading
Test End Time
Final Reading
Change in Reading
PasslFail Criteria
Tightness Test Results ffi Pass ffi Fail ffi Pass ffi ratt E Pass E rait ffi Pass E rait
Page 3 of 5
*. s{.iffipfL}#f; TffisT
Underground $torage Tank
$ecpmdary Somta$alrment Testing Report Formr
TIGHTENED ALL CLAMPS IN UDC #718 & 9I1O AND APPLIED SEALANT TO ELECTRIGAL
CONDUITS ENTRY BOOTS
A/l fesfs marked'Fail" and any repairs made befare or during the tightness fesf must be described in
the COMMENIS secfibn.
Page 5 of 5
*" ##s#ffiffiruTs
AftC* AI4_PN
3i:5 enl.ir A\lE
nr!/rllcTifl nlllll\fnJr tLLU
B$Sfi I|lC
1,\lti4l2*24 1l:2i <
${JI'1P LEAI{ TLST ftiF{]Ri
l,t1/1 ] --u
itsi SIAHl'[ii 1].:*E Al{
IISi SIARTF.D 111il4i?Oz4
Blf;iN LIVIL B.?9i_3 It!
$,10 TiHt 11:?i Al1
Et-{il ilATi i1/04/?*?4
INU L[V[L 5,29$8 Il'{
LIAH THRESHilLX u,UOZ il'i
i[sI R[5i]1-T PASSID
uuc 7-8
1r ,ni AMlf5 I ) l,\ll tLU 1 i; U! 4rl
TIST STARTEI 11i{]4i20?4
gtiilr.r L[vtL 5.4573 llt
tNU llHt li:Zi AH
Lirn fioTf \l/ft4/?fi?lI tlll unlL
rNil L[iiil 1.45$8 1t'{
LIAH IHRISHOLI] il,OO? il\l
rr.T nrc!rr T iirn5lnt:nlr.)t nHlul i rrriJ[Ln.rLU
UilCq-10
TtSi STARTEil i1:t8 Afi
trST SIARTi0 1i/*4/?*?4
fl[filt{ LEVTL 4.2i3$ 1l{
tHD TiFlt 11:Zl &11
tl,lil fiAi[ ]i/c4/?0?4
Ell0 LrdUtL 4, ?137 IN
LIAI{ iHftT5HilLi] O"IS? Il'l
IISI RTSULT PASSTD
uDCv-l{.1
TIST $i*RTiD l::0E AYI
rr.r r.TailTrn 11 l{\Al}n'r,4
; fJ I J I a!l-r I [U I li ual LUtl
B[Glr] LEVrL 5"3961 il',i
fHil illl[ 11:?1 Af4
FNn r [VFr 1.3gE0 iti
L[Ai{ Tt-lRiSHSLil *.110? II'i
"I[ST RISULi FASSTT
AREO il}t-FFl
3i21 (jALIT Al,i
BAtffi{ilF1TLfi
BSsft INC
llitr4llfr?| ii:01 Al'1
rr.r iannnT:uflt' Ltfln lt)i fttrurr
u0c 7-8
;' cr crtroli-ir lll'5i) aHILJI JINIlILU
IIST :lARTiE iil'e4li0z4
stclr'{ LIVEL 1.2979 lll
ti,lD ilHf L1:05 Al{
iH0 D*IE 11/04,/2024
IND LEVIL 5.?973 III
LIAH THRESHiJLil O,ilC: I}i
iF!'I ilFllI! T PASSED
IJfi[ 7-B
i[ST STAI{TE'LJ 1$:5{} *l'l
TEST SiAfiTI* 11./fl4,rZSU4
Brclr1 Lr\/tl 1.4147 lN
tl{S iifll 11;05 A}t
[]is s*Tt !ii14/?*?4
Llilj Lt.YLt t. c+l I { I n
L[AI( iHRISHOL} 0,0il7 I|{
T[Si ftTSULT Ir{CflEASf;*
UUil! ],;
Trn: L.rinrril 1/1.f,n nMlLiI )lfinIEU llr'-iU nr'l
TISI $TAR{ED 1],/i4,i2OT4
$[G]N LrVrL 4.?135 If{
tND Til4F 11:05 AH
[tt* DA"i[ l1/il4,'.?0r4
Erit Lt\lEL {.fi4c il.l
LlAli iHRfSLiilL[ ,1'{j0i IN
i[ST IIISULT Pf,SSI*
ii[Lq- is
ir.T lTAftI[i] i0:50 Al1
i[$T STARTI* ii/*4r'2*?4
B[Gt]l LtvEL _t.i!61 iS
EtiU 1 I l'lE 11 ; 05 r{H
iND ilAT; II/OU?AZ{
IliS i-irrii- a"3g$f IN
r r rr, 'r ,na( rral n fl frna i lli Lnn I ilnl Jl ruLU L, . uut I r!
TISi RIS{JLI PESSEO
Appendix Vll
Undergreumd Storage Tank
Sec*rt#ery **ffi tai * em*nt Yest* r: g R*petr& F*nm
T\/nr Ar &FTt^ltE r f"*, lJr" P4t/ N t\-rill
T " F'ACILITY INtrSRII4ATISN
I lnstallation I Repair il 6 tulonth ffi:A hi}onth
-trpq in Test Date
10t31t2024
Facility Name
ARCO AMIPM
Facility Address
3125 GALIFORNIA AVE
City
BAKERSFIELD
ZIP Code
93304
fl nri: na t:'r, J-)fr'-{r) f n-t. r.r- 1 r'.L: -I 65q l-,,.,:,r!i r.i(- :\-)t
BSSR INC,
I
I
i
Phone
(66{} 588-2777
Mailing Address
6630 ROSEDALE HWY #B
Service Techrriciar: Perf*rmrng "I-*st
FIDEL CARRILLO
^-.-i---!-.-,?- -l T,--..-.-,t: ir- --t-,-1. UIlild'-i{.J;,':Jl!F, iri5[*i L. li-dl!sti l.lUf l![Jel
BSSR tNC, / #672812
ICC Number
5257282
iCi. F rp:,a1.,:r: l-irie
1012412025
3, TRAITq]ING AN* CffiR?IF'ICATiON$
Manufacturer and lesl Squipment Training Ce#fficaficns ffxprrafion #afe
CALIFORNIA UST SERVICE TEGHNICIAN #5257282 1A12412925
INCON TS-STS TESTER #1011253708 12t2612025
4. Tf;$? PffiO*ESL}ffiH
'NFOffiMATI*NI*sf Prcrsdures #sed Componenfs Iesfed
PE|/RP 1200-19 SECT.5.91 LINE SECONDARY
RED THRIEAD IIA PIPING 91 LINE PRIMARY
SYSTEM MANUAL
NO.B2160 PAGE 13
5. C*RT*t;teATi*ru ffiY SfifrVifr* TrCF{$\itCI&N e*r*#{-}CrtrqG TH$T
f &ere&gr e*rtify ffi*f ffse se**nd*ry *orfasnrmerrf was fe$fcd l.ry aseordarese wfffe Csf*'fcrmsa
esde of fiiegufafrcns, ffffe ?3, efivrslon 3. efiapfer f $, seeffon ?S37; ffl*f'r*ryarined supp*rtrxg
d*eg"rrv;*fff.aff*n is *ffacf-r*d," agld aJf elef*rrcafsor; e*nf*rrred &*re;rl rs ##*#,**f*" f a"lndersfe*d
f&af fesf Fr"*c*dc.rr'*s sfraff, &s n:ede avarda&de #p#r? reqa;esf *y ffi* Sl#y#,rff$Flgr *uffu*rify.
$erviee Teehni*ian Signature Date
10t31t2024
Tatal# ef Fages
4 FFml !tnr YF4t lf,l!Ar 4 Ar ttrr^ft*i ^ YrALad,, $f,ilVlrrC I trLri-liIlL,lAl1l ,l\lrUr(lYlA I lLJl{
CER$ = California finvironrnental Reporting $ystem, ICC = lnternatianai Code Council,
lD = ldsntlfication, l{A = Not ApplicabXe, UilC = Under-Dispen*er e*ntainment,
UN-054 www.unidocs.org Rov.10/0'1r20 Fage 'l Of 5
S. TAhIK SfeOhCnAftY C0NllTAift.trlffiEr,lT T
Test Method Developed by ffi Manufacturer ffi lndustry $tandard f,j Pr*fessianal finEineer
Test Type ll_l Hressure Ll Vaeuum ffi Hydrastatic
Test Equipment Used
Tank i*
Ta nk tr\r,la r ri ifaCiU r+'i
I
Tank Capacity
Tesf Start -i'irne
lnitiai Reading
l-*st [nC Tin'le
Final R*adir:g
Change in Reading
F*sslFai! ilriterta
Tightness Test Relsults n*,^,.t* ci55 r-;l n---^l- d-ll
7" mpr SEC*N rr'\5i-f fr tf,la/ir$.t?u\JrY t #\tr'atvtf,[Y I
Test ir,4*thod Deve ffi ildanufacturer ffi lndustry Standard ffi Professional E
Test Typ*ffi Pressur* ffi Vacuum ffi.,u flyqrosiaitc
Test Equipment Used: NlrRoGEN, PRESSURE GAUGE
Fipe ftur: lD 91 TO UDC',S NOTE:91 PRIMARY i
Pia* F;la*ufa*turer AJO SMITH A/O SMITH
"l-e*t Sta;'t Time 10:00 AM 10:00 AM
{nitial Reading 5 P.S.r.50 P.S.r.
Test fnd Time 11:00 AM 11:00 AM
Finai Reading 5 P.S.l 50 P.S.l
Change in Reading 0 0
Fas*1ilail Cr!t*c'i*0 0
Tightnes* T*st f,{esuit*
Fip* Run iS
ffi Fass ffi ralt F*qq Fail Pass f:aii ff Pass ffi rail
rfl,-", ild-^,,€a..+,,#.ri lLrg lYlq! !UlAqrtUt Gt
Test Start Time
ti illidt r\Edtl!l tu
Ta*t [nci Timr:
Finai Reading
r- h=nnc in E?a:,-irnn
Pas*/Fail Cirieria
Tightness Test Results ffi Fass ffi ra;t ffi Passffi rait 1 ffi r,ass ffi ra;l il:Efi ,1 !"Fq -il I HaSS ll i i.-all
Undergr*und Stsrage Tanlt
Seeondary Conta i r"l nqent Testi n g Repmnt Forrm
Additi*nalcoples af this pase may be attached.
All fesfs marked "Fail" and any repairs made before or during the tightness fesf rrusf be deserbed in
f&e CGMf#ETVIS seefi+c.
Page 2 af 5
l1_.1 rass [l Fati ffi Fass ffi Fai[
Underground Storage Yamk
$eeorld a ry C *nta I n m-'l ent Yesti n g Repnrt Fnrun
PRESSURIZED 91 PRIMARY TO 50 PSI FOR 1 HOUR I PASS
PRESSURIZED 91 SECONDARY TO 5 PSI FOR 1 HOUR / PASS
A// fesfs marked *Fail' and any repairs made before or durinE the tightness fesf must he descrlhed l*
ths CCIMMENIS secfibn.
Page 5 *t 5
g. COMMENT$