HomeMy WebLinkAboutBUSINESS PLAN (3)
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- _8""· ES· .... . -¡.....BELSH1RE ..
... .··ENVIRONMENTAL
· ... .........; SERVICES,INC.
PM8 269
25422 Ti;¡oucoRoad #105
Lake Forest, CA92630:2797
.. (949)450,1()1O ...
fOdl( 1949,1450:1/77
Transmittal
'\
Date:
November 16, 2004
TO:
Steve Underwood
City of Bakersfield Fire Dept.
715 Chester Avenue 3rd Floor
Bakersfield, CA 93301
FROM:
Jim Brown
Sent Via:
Ref#:
Fed Ex Ground
1Z E68 941 0390443528
RE:
Secondary Containment Testing
ARCO FAC# 05420
4203 Ming Ave.
Bakersfield, CA
D As Requested D For Review D Sign & Return
D For Your Use ~ ForYourFiles
Quantity
1
Description
Monitoring System Certification performed on 10/27.
Comments:
Please do not hesitate to call me at (949) 460-5200 if you have any questions or concerns
regarding this work.
MONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the State a/California
Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations
This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared
for each monitoring svstem cöt'itrol panel by the technician who performs the work:. A copy of this fonn must be provided to the tank
system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30
days aftest date.
A. . ~eneral Inform!tion~+i 1_ ^
FacIlity Name; ~kç..C) _ . ~ ~ "Z 1 t:)
Site Address: ~z. ~1:is \1~.
Facility Contact Person: k\~,,- ~
Make!Modet of Monitoring System: ~ -rc.s ~SO
B. Inventory of Equipment Tested/Certified
Cheek tbe a ro riate boxes to indicate s fie e ui ment ins ted/serviced:
Bldg. No.:
City: ~~~~~ Zip:
Contact Phone No.: ( J \"\ ) to,o 5"3'l. \
Date of Testing/Servicing: lQJ Ri 4
Certification No.: ()C)(o. 0$. O'ð?.l
Testing Company Name: ~E'U"'L«'C E..... V'L QøbME'~T~ ~".
Site Address: ~ZO~ ML~ ~,,~ ~ ~"mF-'IS-~
TankID: B7 MA$·Us.""'. TankID: ~~
a In-Tank Gauging Probe. Model a In-Tank Gauging Probe. Model:
[I( Annular Space or Vault Sensor. MOdel:¡. Œ -IF rJf Annular Space or Vault Sensor. Model:
¡¡(Piping Sump I Trench Sensor(s). MM0oddeell~. c.f 0.- ¡t'Piping Sump / Trench Sensor(s). Model:
Iiil Fill Sump Sensor(s). __ _ _ ~iIl Sump Sensor(s). Model:
a Mechanical Line Leak: Detector. Model: 0 Mechanical Line Leak Detector. Model:
IiiiJ"Electronic Line Leak Detector. Model: 094~~.c.) ·00 I 0 Electtonic Line Leak Detector. Model:
a Tank Overtill / High-Level Sensor. Model: a Tank Overfill / High-Level Sensor. Model:
o Other ui ment e and model in Section E on Pa e 2 . a Other i ui ment and model in Section E on P e 2 .
Tank ID: V Tank ID: SoT
a In-Tank Gauging Probe. Model: OJn-Tank Gauging Probe. Model:
ür' Annular Space or Vault Sensor. Model: mm . 4oC¡---. ct' Annular Space or Vault Sensor. Model: i~ ~ "'I
[ilfPiping Sump 1 Trench Sensor(s). Model: ~.. ~ ti't>iping Sump / Trench Sensor(s). Model: '58c ~
WFiII Sump Sensor(s). Model: ~FiIl Sump Sensor(s). Model: ~.~
o Mechanical Line Leak Detector. Model: [J Mechanical Line Leak Detector. Model:
o Electronic Line Leak Detector. Model: œ"'Electronic Line Leak Detector. Model: O~~~~'ðO ·001
o Tank o.vertill / High-Level Sensor. Model: 0 Tank Overfill 1 High-Level Sensor. Model:
a Other eci e ui ment and model in Section E on P e 2 . [J Other s eci e ui ment and model in Section E on P e 2 .
Dispenser ID: . EM' \ .. '2,.. Dispenser ill: '1 . e
5it""Dispenser Containment Sensor(s). Model: "Z.D8 9"Dispenser Containment Sensor(s). Model: "2.08
!! Shear Valve(s). I:YShear Valve(s).
a Dis enser Containment Float s and Chain(s . 0 Di enser Containment Float(s) and Chain s .
DiSjJenscr ID:... Dispenser ID: <\ - \0
O"bispenser Containment Sensor(s). Model: ISl'Dispenser Containment Sensor(s). Model: "ZO~
r!J'ShearValve(s). cY'Shear Valve(s).
o Dis nser Containment Float s) and Chain s . 0 Dis enser Containment Float(s) and Chain s .
Dispenser ID:. Dispenser ID: \ \ .. \ "
gDispenserContainment Sensor(s). Model: "20 St'DispenserContainment Sensor(s). Model: 'ZO~
~ Shear Valve(s). Ii"'Shear Valve(s).
aDis nser Containment Float(s) and Chain s . [J Dis ser Containment Float s and Chain s .
*Ifthe facility contains more tanks or dispensers, copy this form. Include infonnation for every tank and dispenser at the facility.
C. Certification - I certify that the equipment identified in this document was inspected/serviced in accordance with tbe manufacturers'
guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that tbis information is
eorrect and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating sucll reports, I have also
attached a copy of the report; (check all ,høJ øePIY): 0 System set-up 0 AI~ history report
Technician Name (print): ~¥J:.. Eu...,~ Signature: \.. ~<3J.....
~8'3\b
PhaneNo.:(~) ~..SUX>
Date of Testing/Servicing: II) / 1(1,) ~
~~3<tð ..~~
~1eo ..
1<\1.\,~90 -toS
License. No.:
Monitoring System Certification
Page 1 00
03/01
D. Results of Testing/Servicing
Software Version Installed: Ztf
Com tete the foUowin checklist:
~Yes CJ No'" Is the audible alarm 0 rational?
Yes (J No'" Is the visual alann 0 rational?
Gl'Yes CJ No'" Were all sensors visuall ins cted, functionall tested, and conftmled 0 rational?
~ Yes I:] No'" Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will
not interfere with their ro er 0 tion?
If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem)
operational?
For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment
monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate
positive shut-down? (Check all that apply) CJ SumpfTrench Sensors; 0 Dispenser Containment Sensors.
Did ou confirm sitive shut-down due to leaks and sensor failure/disconnection? CJ Yes; I:] No.
(J No'" For tank: systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no
üi' N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank
fill int(s) and 0 ratin ro rl. If so, at what rcent of tank ca aci does the alarm tri er? %
Was any monitoring equipment replaced? If yes, identitY specific sensors, probes, or other equipment replaced
and list the manufacturer name and model for an r lacement in Section E, below.
Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) 0
Product; Q Water. If es, describe causes in Section E, below.
o No'" Was monitorin s stem set-u reviewed to ensure r r settin s? Attach set
Yes 0 No'" Is all monitorin ui ment 0 tional r manufacturer's s ifications?
* In Section E below, describe how and when these deficiencies were or will be corrected.
CJ Yes
I:] No'"
g N/A
(J No'"
CJ N/ A
Yes
Q Yes
o No
E. Comments:
SðFTWAItE
No
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Va.. . 21
Page 2 of3
0311)]
..
F. In-Tank Gauging I SIR Equipment:
o Check this box if tank gauging is used only for inventory control.
o Check this box if no tank gauging or SIR equipment is installed.
This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring.
Comolete the 0 OWi02 c ec 1St:
DYes o No· Has all input wiring been inspected for proper entry and termination, including testing for ground faults?
o Yes o No· Were all tank gauging probes visually inspected for damage and residue buildup?
o Yes o No· Was accuracy of system product level readings tested?
o Yes 1:1 No· Was accuracy of system water level readings tested?
1:1 Yes o No· Were all probes reinstalled properly?
DYes o No· Were all items on the equipment manufacturer's maintenance checklist completed?
f, II h IdO
· In tbe Section H, below, describe how and when these defk:iencies were or will be corrected.
G. Line Leak Detectors (LLD):
o Check this box ifLLDs are not installed.
C
h HI
kl'
omplete t e 0 OWI02 cbec 1St:
Ø" Yes 1:1 No· For equipment start-up ~r annual eqUipme~ertifi.cation, was a leak simulated to verify LLD perfonnance?
1:1 N/A (Check all that apply) Sunulated leak rate: 3 g.p.h.; (J 0.1 g.p.h; 00.2 g.p.h.
6l Yes (J No· Were all LLDs confinned operational and accurate within regulatory requirements?
Iiiil Yes (J No· Was the testing apparatus properly calibrated?
1:1 Yes (J No· For mechanical LLDs, does the LLD restrict product flow if it detects a leak?
Ii' N/ A
Iil Yes o No'" For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak?
(J N/ A
Iïl Yes (J No· For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled
(J N/ A or disconnected?
!!I Yes D No· For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions
(J N/A or fails a test?
\if Yes (J No· For electronic LLDs, have all accessible wiring connections been visually inspected?
(J N/ A
[]fYes (J No* Were all items on the equipment manufacturer's'maintenance checklist completed?
", In the Section H, below, describe bow and when these deficiencies were or will be corrected.
H. Comments:
Page 3 of3
0310 1
'i.:
Monitoring System Certification
Site Address: ~ 200 b
UST Monitoring Site llan
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Date map was drawn: \0 / t. ë / ~.
Instructions
If you already have a diagram that shows all required infonnation, you may include it, rather than this page, with your
Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify
locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular
spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak
detectors; and in-tank liquid level probes (if used for leak detection). In the space provided., note the date this Site Plan
was prepared.
Page ~ of--L-
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