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HomeMy WebLinkAboutUNDERGROUND STORAGE TANKI', (UNDERGROUND STORAGE TANKS) 7-11 (#18655) - -_ _ - -_ ~' 300 N. CHESTER AVENUE ~ ~ ~ 1 _„ , .;, Owner Statements of Designated Underground Storage Tank (UST) Operator and Understanding of and Compliance with UST Requirements Facility Name: 7-ELEVEN #18655 Facility ID #: 235070 Facility Address: 300 NORTH CHESTER AVE. BAKERSFIELD, CA 93308 Reason for Submitting this Form (Check One) ~ Change of Designated Operator Facility Phone #: 661-393-5700 ^ Update ICC # and/or Expiration Date Designated UST Operator(s) for this Facility Designated Operator's Name: John Ablakat Relation to UST Facility (Check One) Business Name (If d~erent from above): ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 818-992-8981 ^ Service Technician ^O Third-Party International Code Council Certification #: 5279288-UC Expiration Date: 03/09/2008 Prima O tional Designated Operator's Name: Tony Mansour Relation to UST Facility (Check One) Business Name (If different from above): ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 818-992-8981 ^ Service Technician ®Third-Party International Code Council Certification #: 5269136-UC Expiration Date: 11/17/2007 ALTERNATE 1 (Optionag ALTERNATE 2 (Optional) Designated Operator's Name: Sarkiss Zoumalan Relation to UST Facility (Check One). Business Name (Ifd~erent from above): ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 818-992-8981 ^ Service Technician ®Third-Party International Code Council Certification #: 5238439-UG Expiration Date: 07/09/2008 I certify that, for the facility indicated at the top of this page, the individual(s) listed above will serve as Designated UST Operator(s). The individual(s) will conduct and document monthly facility inspections and annual facility employee training, in accordance with California Code of Regulations, title 23, section 2715(c) - (f). F~.Irthermore, I understand and am in complia cj. v th th ~'quirements (statutes, regulations, and local ordinances) applicab to~under oun torage tanks. NAME OF TANK OWNER (Please Print): 7- Y MARTIN SIGNATURE OF TANK OWNER: DATE: 2/15/2007 oWNER's PHONE #: (253) 796-7170 November 2004 Ownar Statements of Designated Underground Storage Tank (UST) Operator and Understanding of and Compliance with UST Requirements -continued ,;e ' ALTERNATE 3 (Optional) Designated Operator's Name: Kevin Watermolen Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 916-212-7973 ^ Service Technician ^O Third-Party International Code Council Certification #: 5250470-UC Expiration Date: 12-21-2008 Ai,TF.RNATF. 4 (nntinnall Designated Operator's Name: Jessica Tuttle Relation to UST Facility (Check One) Business Name (lf different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 831-537-7663 ^ Service Technician ~ Third-Party International Code Council Certification #: 5286530-UC Expiration Date: 07-03-2008 ALTERNATE 5 (Optional) Designated Operator's Name: Jim Palmer Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 831-840-5235 ^ Service Technician ^D Third-Party International Code Council Certification #: 5254109-UC Expiration Date: 2-21-2007 ALTERNATE 6 (Optional) Designated Operator's Name: Brian Ellsworth Relation to UST Facility (Check One) Business Name (If different froth above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 707-815-2511 ^ Service Technician ~ Third-Party International Code Council Certification #: 5263224-UC Expiration Date: 7-7-2007 ALTERNATE 7 (Optional) Designated Operator's Natne: Aaron Celaya Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 510-364-0385 ^ Service Technician ^D Third-Party International Code Council Certification #: 5246905-UC Expiration Date: 01-20-2007 ALTERNATE 8 (Optional) . Designated Operator's Name: Darrell Riley Relation to UST Facility (Check One) Business Name (lf different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 619-206-8379 ^ Service Technician x^ Third-Party International Code Council Certification #: 5248975-UC Expiration Date: 11-29-2008 ALTERNATE 9 (Optional) Designated Operator's Name: Darren Austin Relation to UST Facility (Check One) Business Name (!f different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Opetator's Phone #: 858-699-2751 ^ Service Technician ~ Third-Party International Code Council Certification #: 5250436-UC Expiration Date: 11-11-2008 ALTERNATE 10 (Optional) Designated Operator's Name: Eric Banghart Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 310-467-2529 ^ Service Technician ^O Third-Party International Code Council Certification #: 5250118-UC Expiration Date: 11-9-2008 ALTERNATE 11 (Optional) Designated Operator's Name: Blake Herness Relation to UST Facility (Check One) Business Name (If different from above): Gilbarco Veeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 951-288-1519 ^ Service Technician ^D Third-Party International Code Council Certification #: 5249180-UC Expiration Date: 12-12-2008 4~ < February 15, 2007 BAKERSFIELD FIRE DEPARTMENT 900 TRUXTUN AVENUE, SUITE 210 BAKERSFIELD, CA 93301 RE: Statement of Compliance and Designated Operator ~- Dear Sir or Madam: Gilbarco/Veeder-Root, acting as the authorized agent of Safeway/Vons is submitting on behalf of the company, the attached Owner Statements of Designated Underground Storage Tank (UST) Operator and Understanding of Compliance with UST Regulations for the subject fuel facility to register this site and Designated Operators with the county. The owner understands that with the submission of this document, Gilbarco/Veeder-Root is stating, on behalf of Safeway/Vons that each location is in compliance with all applicable UST regulations. Further, as specified in regulations Title 23, Section 2715 (c)-(f), the individuals listed as designated operators for the location will complete and document a monthly inspection to be maintained in accordance with the applicable requirements. Each statement of compliance being submitted herein is based on: (1) Gilbarco/Veeder- Root reasonable and good faith review of facility operations to evaluate compliance with applicable UST regulations, as well as information provided by facility operations as of the date the statement of compliance is made, and (2) Gilbarco/Veeder-Root's understanding of the applicable UST regulations and requirements as of the date the statement of compliance is made. Should you have any questions or require further information please do not hesitate to contact me at (303) 986-8011. Sincerel Sherry Peczka Designated Operator Program Manager Gilbarco/Veeder-Root Enclosures . ;~ Bakersfield Fire Department Office of Environmental Services Inspector Steve Underwood 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Test Date: 07/12/06 Order Number: 3147506 Dear Regulator: Enclosed are the results of recent testing performed at the following facility: 7-11 18655 300 N. Chester Ave. Bakersfield, CA 93308 Services performed: Interstitial Line testing Interstitial Tank testing Spill Bucket testing Dispenser pan testing Sump testing Sincerely, ~~ Dawn Kohlmeyer Manager, Field Reporting SWRCB, January 2002. Page 1. ~. Secondary Containment Testing Report Form This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (tf applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: 7-ELEVEN #18655 Date of Testing: 07/12/2006 Facility Address: MARKET 2133 300 N. CHESTER AVENUE, BAKERSFIELD, CA, 93308 Facility Contact: MANAGER Phone: (661) 393-5700 Date Local Agency Was Notified of Testing : / / Name of Local Agency Inspector (if present during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: DANIEL VISSER Credentials: a CSLB Licensed Contractor ~ SWRCB Licensed Tank Tester License Type: A License Number: 7 4 3160 Manufacturer Manufacturer Training Component(s) Date Training Expires INCON TS-STS 06/01/2008 / / / / / / 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Repair Tank Annular 87 a ~ ~ ~ Piping Sump 91 Tank Annular 87 aX ~ ~ ~ UDC 1-2 Tank Annular 91 ^X ~ ~ ~ UDC 1-2 Secondary Pipe 87 X^ Secondary Pipe 91 ^X ~ ~ ~ Spill Box 87 M Piping Sump 87 ~ ~ ~ ~ Spill Box 87 M Piping Sump 87 a ~ ~ ~ Spill Box 87 M Piping Sump 87 ~ a ~ ~ Spill Box 87 M a Piping Sump 87 ~ a ~ ~ Spill Box 87 S Piping Sump 87 ~ ~ ~ ~ Spill Box 87 S Piping Sump 87 a ~ ~ ~ Spill Box 87 Piping Sump 91 ~ 0 ~ ~ Spill Box 87 ~ ~ ~ a If hydrostatic testing was performed, describe what was done with the water after completion of tests: WATER WAS PUMPED OUT BY PUMP TRUCK. CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements °' 07/12/2006 Technician's Signature: '~r~~,~ ~ '`~ Date: -~ SWRCB, January 2002 Page 2 . Secondary Containment Testing Report Form This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (tf applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: 7-ELEVEN #18655 Date of Testing: 07/12/2006 Facility Address: MARKET 2133 300 N. CHESTER AVENUE, BAKERSFIELD, CA, 93308 Facility Contact: MANAGER Phone: (6 61) 3 9 3- 5 7 0 0 Date Local Agency Was Notified of Testing : / / Name of Local Agency Inspector (if present during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC . Technician Conducting Test: DANIEL VISSER Credentials: a CSLB Licensed Contractor ~ SWRCB Licensed Tank Tester License Type: A License Number: 7 4 316 0 Manufacturer Manufacturer Training Component(s) Date Training Expires INCON TS-STS 06/01/2008 / / / / / / 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Repair Spill Box 91 ~ ^X ^ ^ Spill Box 91 ^ ^X ^ ^ ^ ^ ^ ^ Spill Box 91 ~ ^ ^ ^ ^ ^ ^ ^ Spill Box 91 ~ ~ ~ ~ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ If hydrostatic testing was performed, describe what was done with the water after completion of tests: WATER WAS PUMPED OUT BY PUMP TRUCK. CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my knowledge, the facts state/d in this document are accurate and in full compliance with legal requirements Technician's Signature:_~_i~,,..~ (~. ~'`~~' Date: 0 7 / 12 / 2 0 0 6 SWRCB, January 2002 4. TANK ANNULAR TESTING Page 3 . Test Method Developed By: ~ Tank Manufacturer ~X Industry Standard ~ Professional Engineer Other (Specify) Test Method Used: ~ Pressure ~ Vacuum ~ Hydrostatic Other (Specify) Test Equipment Used: _ ~ Equipment Resolution: ., _ _.~ '' -: 87 1 Tank # Tank # 87 SLAVE Tank # 91 Tank # Is Tank Exempt From Testing? t ~ Yes X No ~ Yes ~ No ~ Yes ~ No ~ Yes ~ No Tank Capacity: lOK lOK lOK .Tank Material: DW STEEL DW STEEL DW STEEL Tank Manufacturer: OWEN OWEN OWEN Product Stored: 8 7 8 7 91 Wait time between applying pressure/vacuum/water and starting test: 15 MIN 15 MIN 15 MIN Test Start Time: 9: 3 0 9: 3 0 11:3 0 Initial Reading (RI ): lOHG lOHG l OHG Test End Time: 10:30 10:30 12:30 Final Reading (Rp ): lOHG lOHG lOHG Test Duration: 1 HR 1 HR 1 HR Change in Reading (Rp - I~ ): 0 0 0 Pass/Fail Threshold or Criteria: 0 0 0 Test Result: ~~Pass ~ Fail "~ ~ Pass ~ Fail `Pass ~ Fail ~ Pass ~ Fail Was sensor removed for testing? aYes~No~NA Yes No~NA Yes^N NA Yes^No^NA W l d as sensor proper y replace and verified functional after testing? ^ X Ye ~ N ~ NA a x Ye ~ N ~ NA ^ X Ye ~ ~ N NA a Ye N NA Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) t Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment testing. {California Code of Regulations, Title 23, Section 2637(a)(6)} SWRCB, January 2002 Page 4 . 5. SECONDARY PIPE TESTING Test Method Developed By: ~ Tank Manufacturer ^X Industry•Standard ~ Professional Engineer Other (Sped) Test Method Used: ~ ^X pressure ~ Vacuum ~ Hydrostatic Other (Sped) Test Equipment Used: Equipment Resolution: _ _ .7 _ .~. ~: L' Piping Run # 8 7 Piping Run # 91 Piping Run # Piping Run # Piping Material: PLASTIC PLAS T I C Piping Manufacturer: ENVIRON ENVIRON Piping Diameter: 2" 2" Length of Piping Run: 7 5 ' 7 5 ' Product Stored: B 7 91 Method and location of piping-run isolation: 87 91 Wait time between applying pressure/vacuum/water and starting test: 15 min 15 MIN Test Start Time: 9:30 9:30 Initial Reading (Rt ): 5PSI 5 P S I Test End Time: 10:30 10:30 Final Reading (Rg ): 5PSI 5 P S I Test Duration: 1 HR 1 HR Change in Reading (Rp -1$ ): 0 0 Pass/Fail Threshold or Criteria: 0 0 Test Result: ~ Pass ~ Fail ~ Pass ~ Fail ~ Pass ~ Fail ~ Pass ~ Fail Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) SWRCB, January 2002 6. PIPING SUMP TESTING Page 5. Test Method Developed By: ~ Sump Manufacturer ~X Industry Standard ~ Professional Engineer Other (Sped) Test Method Used: ~ Pressure ~ Vacuum ~ Hydrostatic Other (Sped) Test Equipment Used: Equipment Resolution: _ - _ '' Sump # 87 Sump # 87 Sump # 87 Sump # 87 Sump Diameter: 4 3" 4 3" 4 3" 4 3" Sump Depth: 26" 26" 25" 25" Sump Material: FIBER GLASS FIBER GLASS FIBER GLASS FIBER GLASS Height from Tank Top to Top of Highest Piping Pentration: 10 " 10 " 12 " 12 " Height from Tank Top to Lowest Electrical Pentration: 8" 8" 12" 12" Condition of sump prior to testing: CLEAN CLEAN CLEAN CLEAN Portion of Sump Tested: 1 2" ABOVE 2" ABOVE 2" ABOVE 2" ABOVE Does turbine shut down when sump sensor detects liquid (both product and water)?* yes ~NoaN Yes ^NoaN Yes aNoaN ~ Yes ~NoaV Turbine shutdown response time: 0 0 0 0 Is system programmed for fail-safe shutdown?* ^ ^ ~ Yes N X N ~ ~ ~ Yes N X N ^ ~ ~ Yes N X N Yes No X ^ Was fail-safe verified to be operational?* yes aNoaN Yes ^NoaN Yes ~NoaN ~ Yes ^Noa~T Wait time between applying pressure/vacuum/water and starting test: 15 MIN 15 MIN 15 MIN 15 MIN Test Start Time: 11:5 6 13:2 5 9 : 5 2 11:11 Initial Reading (Rt ): 5.6561 5.6452 7 .0167 6.8562 Test End Time: 12 :11 13:4 0 10:0 8 11:2 6 Final Reading (Rg ): 5. 6 5 7 6 5. 6 4 4 6 6. 9 9 3 0 6. 8 3 8 6 Test Duration: 15 MIN 15 MIN 15 MIN 15 MIN Change in Reading (Rp - Rt ): + . 0 015 - . 0 0 0 6 - . 0 2 3 7 - .017 6 Pass/Fail Threshold or Criteria: .0020 .0020 .0020 .0020 "Test Result: ~ Pass ~ Fail a Pass ~ Fail ~ Yasst _. I Fail ~ Pass ~ Faij Was sensor removed for testing? aYesaNoaNA aYesaNoaNA ayesaNo^NA a Yes ~No^N W l d as sensor proper y replace and verified functional after testing? ^ X Ye ~ ~ N NA ^ X Ye ~ ~ N NA ^ X Ye ~ ~ N NA a X yes N Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) t If the entire depth of the sump is not tested, specify how much was tested. If the answer to anxof the questions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (See SWRCB LG-160) SWRCB, January 2002 6. PIPING SUMP TESTING Page 6. Test Method Developed By: ~ Sump Manufacturer ~X Industry Standard ~ Professional Engineer Other (Sped) Test Method Used: ~ Pressure ~ Vacuum ~ Hydrostatic Other (Sped) Test Equipment Used: ~~ ~~-x ~, +`' Sump # 87 Sump # 87 Equipment Resolution: Sump # 91 ~y Sump,# 91 Sump Diameter: 4 3" 4 3" 4 3" 4 3" Sump Depth: 2 6" 2 6" 2 4" 2 4" Sump Material: PLASTIC PLASTIC FIBERGLASS FIBERGLASS Height from Tank Top to Top of Highest Piping Pentration: 14" 14" 9" 9" Height from Tank Top to Lowest Electrical Pentration: 8 „ 8 " 4 " 4 " Condition of sump prior to testing: CLEAN CLEAN CLEAN CLEAN Portion of Sump Tested: t 2" ABOVE 2" ABOVE 2" ABOVE 2" ABOVE Does turbine shut down when sump sensor detects liquid (both product and water)?* yes^No~N ~Yes~NoaN ~YesaNoaN Yes ^No~N Turbine shutdown response time: 0 0 0 0 Is system programmed for fail-safe shutdown?* ~ ~ ~ Yes N X N a ^ _n Yes N N ^ ^ „r'~N Yes N ~ Yes ~NoQN Was fail-safe verified to be operational?* ~ ~ ~ Yes N X N ~ a ~ Yes N X N ~ ^ Yes N X N Yes No X Wait time between applying pressure/vacuum/water and starting test: 15 MIN 15 MIN 15 MIN 15 MIN Test Start Time: 13:0 3 13:2 5 9 : 5 2 11:11 Initial Reading (RI ): 5 .4 6 5 3 5. 4 8 0 9 5.9116 6. 8 5 6 2 Test End Time: 13:18 13:4 0 10:0 8 11:2 6 Final Reading (RF ): 5. 4 6 4 7 5. 4 817 5. 8 5 7 2 6. 8 3 8 6 Test Duration: 15 MIN 15 MIN 15 MIN 15 MIN Change in Reading(Rg-RI ): -.0006 +.0008 -.0544 -.0176 Pass/Fail Threshold or Criteria: . 0 0 2 0 .0 0 2 0 .0 0 2 0 .0 0 2 0 Test Result: ~ Yass ~ Fail ~ Pass ~ Fail ~ Pass ~ Fail ~ Pass a Faii Was sensor removed for testing? Yes^No~NA ~YesaNo^NA aYes~NoaNA Yes ^No~N W as sensor properly replaced and verified functional after testing? ~ X Ye ~ N ~ NA ^ X Ye ~ N ~ NA ~ X Ye ~ N ~ NA a X yes N COmmerits - (include information on repairs made prior to testing, and recommended follow-up for failed tests) t If the entire depth of the sump is not tested, specify how much was tested. If the answer to a~of the questions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (See SWRCB LG-160) SWRCB, January 2002 7. UNDER-DISPENSER CONTAINMENT (UDC) TESTING Page 7 . Test Method Developed By: ~ UDC Manufacturer UX Industry Standard ~ Professional Engineer Other (Sped) Test Method Used: ~ Pressure ~ Vacuum ~ Hydrostatic Other (Sped) Test Equipment Used: 1"~7"~'~+"'T~ -.nom.-^'T, .~^~n-T--°- ... ~# ~ ~~ ~ ~ UDC # ` ,~,, 1-2 UDC # y 1-2 ~ ~. Equipment Resolution: 7 - - UDC # " ..._. ~,. -UDC # _ .. UDC Manufacturer: ENVIRON ENVIRON UDC Material: PLASTIC PLASTIC UDC Depth: 29" 29' Height from UDC Top to Top of Highest Piping Pentration: 8 „ 8 „ Height from UDCTop to Lowest Electrical Pentration: 6" 6" Condition of UDC prior to testing: CLEAN CLEAN Portion of UDC Tested: t 2" ABOVE 2" ABOVE Does turbine shut down when sump sensor detects liquid (both product and water)?* yes^No~N Yes^No~N UYes^No~N ^Yes ^No^N Turbine shutdown response time: 0 0 Is system programmed for fail-safe shutdown?* ^ ^ ~ Yes N X N Yes N X N ^ ^ o^ Yes N N ^. ^ `~ Yes No ^ ^ U`~ Was fail-safe verified to be operational?* ^Yes^NoaN Yes^NoaN ~YesaNoUN ^Yes ^No^N Wait time between applying pressure/vacuum/water and starting test: 15 MIN 15 MIN Test Start Time: 13:0 3 13:2 5 Initial Reading (RI ): 3.3 3 0 3 3.2 3 0 2 Test End Time: 13 :18 13:4 0 Final Reading (RF ): 3.2 7 4 8 3.17 7 2 Test Duration: 15 MIN 15 MIN Change in Reading (Rg - RI ): - . 0 5 5 5 - . 0 5 3 0 Pass/Fail Threshold or Criteria: . 0 0 2 0 .0 0 2 0 Test Result: ~ Pass ^ Fail ~ Pass ~ Fail ~ Pass ~ Fail ~ Pass ~ Fail Was sensor removed for testing? aYesUNoUNA ~YesUNoUNA UYesUNoUNA ^Yes UNoUN Was sensor properly replaced and verified functional after testing? a ~ ~ Ye N NA ~ ~ ~ Ye N NA ^ ~ ~ Ye N NA ^ ^ Yes NOUN COmmerits - (include information on repairs made prior to testing, and recommended follow-up for failed tests) 1 If the entire depth of the UDC is not tested, specify how much was tested. If the answer t an of the questions indicated with an asterisk (*) is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG-160) SWRCB, January 2002 8. FILL RISER CONTAINMENT SUMP TESTING Page 8 Facility is Not Equipped With Fill Riser Containment Sumps Fill Riser Containment Sumps are Present, but were Not Tested Test Method Developed By: ~ Sump Manufacturer ~ Industry Standard ~ Professional Engineer Other (Spec) Test Method Used: ~ Pressure ~ Vacuum ~ Hydrostatic Other (Spec) Test Equipment Used: - --~~ Equipment Resolution: . ~ '- Fil{ Sump # Fill Sump # Fill Sump # Fi11 Sump # Sump Diameter: Sump Depth: Height from Tank Top to Top of Highest Piping Pentration: Height from Tank Top to Lowest Electrical Pentration: Condition of Sump prior to testing: Portion of Sump Tested: Sump Material: Wait time between applying pressure/vacuum/water and starting test: Test Start Time: Initial Reading (RI ): Test End Time: Final Reading (RF ): Test Duration: Change in Reading (RF - I~[ ): Pass/Fail Threshold or Criteria: Test Result: ~ Pass ~ Fail oPi-ss ~ ,Fail ~ Pass ~ Fail ~ Pass ~ Rail Is there a sensor in the sump? ~ Yes ~ No ~ Yes ~ No ~ Yes ~ No ~ Yes No Does the sensor alarm when either product or water is detected? ayes aNoaNA ayes aNoaN ayes aNoaNA ~ Yes aNoaN Was sensor removed for testing? ayes aNoaNA ayes aN N ayes aNoaNA ~ Yes aNo Was sensor properly replaced and verified functional after testing? a Yes ^ N ~ NA ^ Yes ^ N ~ N ^ Yes ^ N ~ NA ~ Yes ~ N "LJ I~ Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) SWRCB, January 2002 9. SPILL/OVERFILL CONTAINMENT BOXES Page 9 Facility is Not Equipped With Spill/Overfill Containment Boxes: SpilUOverfill Containment Boxes are Present, but were Not Tested: Test Method Developed By: ~ Spill Bucket Manufacturer ~ Industry Standard ~ Professional Engineer Other (Sped) Test Method Used: ~ Pressure ~ Vacuum ~ Hydrostatic Other (Sped) Test Equipment Used: Equipment Resolution: ' -~ ~~' Spill Box # 8 7 M Spill Box # 8 7 M Spill Box # 8 7 M Spill Box # 8 7 M Bucket Diameter: 11 " 11 " 11 " 11 " Bucket Depth: 12 " 12 " 12 " 12 " Wait time between applying pressure/vacuum/water and starting test: 15 MIN 15 MIN 15 MIN 15 MIN Test Start Time: 9:52 11:11 9:52 11:11 Initial Reading (RI ): 2.7 3 8 6 2.7 5 60 4 .3 3 5 6 4 .3 3 51 Test End Time: 10:0 8 11:2 6 10:0 8 11:2 6 Final Reading (Rg ): 2.7390 2.7570 4.3356 4 .3353 Test Duration: 15 MIN 15 MIN 15 MIN 15 MIN Change in Reading (RF - I~) +.0004 +.0010 +.0004 +.0002 Pass/Fail Threshold or Criteria: .0020 .0020 .0020 .0020 Test Resuk: .Pass ~ Fail ~ Pass ~ Fail ~ Pass ~ Fail ~ Pass ~ Fail COmmCrits - (include information on repairs made prior to testing, and recommended follow-up for failed tests) SWRCB, January 2002 9. SPILL/OVERFILL CONTAINMENT BOXES Page 10 Facility is Not Equipped With SpilUOverfill Containment Boxes: Spill/Overfill Containment Boxes are Present, but were Not Tested: a Test Method Developed By: ~ Spill Bucket Manufacturer a Industry Standard ~ Professional Engineer Other (Sped) Test Method Used: ~ Pressure ~ Vacuum ~ Hydrostatic Other (Sped) Test Equipment Used: ~ Equipment Resolution: .~ . ~ ~ ~ } ~ i ,` ~, .... Spill Box # 8 7 S Spill Box # 8 7 S Spill Box # 8 7 8 7 Spill Box # Bucket Diameter: 11 " 11 " 11 " 11 " Bucket Depth: 12 " 12 " 12 " 12 " Wait time between applying pressure/vacuum/water and starting test: 15 MIN 15 MIN 15 MIN 15 MIN Test Start Time: 8: 5 8 9:16 9: 5 2 11:11 .Initial Reading (RI ): 2.-5568 1.5886 4.3352 ,4.3351 Test End Time: 9:13 9:31 10:0 8 11:2 6 Final Reading (RF ): 1.9567 1.5295 4.3356 4 .3353 Test Duration: 15 MIN 15 MIN 15 MIN 15 MIN Change in Reading (RF - I~) -.6001 -.0591 +.0004 +.0002 Pass/Fail Threshold or Criteria: .0020 .0020 .0020 .0020 . Test Result: ~ Pass a Fail ~ Pass ~ Fail ~ Pass ~ Fail ~ Pass ~ Fail Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) SWRCB; January 2002 9. SPILL/OVERFILL CONTAINMENT BOXES Page 11 Facility is Not Equipped With SpilUOverfill Containment Boxes: ^ SpilUOverfill Containment Boxes are Present, but were Not Tested: Test Method Developed By: ~ Spill Bucket Manufacturer a Industry Standard ~ Professional Engineer Other (Specify) Test Method Used: ~ Pressure ~ Vacuum ~ Hydrostatic Other (Specify) Test Equipment Used: Eq uipment Resolution: ~ .,~ '' ' t ~'`~ ~~ ~ >-~ ~ "~~ t'..t ,. Spill Box # 91 .. Spill Box # 91 Spill Box # 91 Spill Box # ~ 91 Bucket Diameter: 11 " 11 " 11 " 11 " Bucket Depth: 12 " 12 " 12 " 12 " Wait time between applying pressure/vacuum/water and starting test: 15 MIN 15 MIN 15 MIN 15 MIN Test Start Time: '8 : 5 8 9:16 8 : 5 8 9:16 Initial Reading (RI ): 2.0 414 1. 8 7 8 4 4. 4 4 61 4 .3 2 5 4 Test End Time: 9:13 9:31 9:13 9:31 Final Reading (RF ): 1.9520 1.7831 4.4456 4.3254 Test Duration: 15 MIN 15 MIN 15 MIN 15 MIN Change in Reading (RF : ~ ) -.0894 -.0950 -.0005 0 Pass/Fail Threshold or Criteria: .0020 .0020 .0020 .0020 Test Result: Pass ~ Fail ~ Pass ~ Fail X '.Pass ~ Fail ~ Pass Fail Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) i Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE:07/12/06 WORK ORDER NUMBER3147506 CLIENT:7-ELEVEN, INC. SITE:7-ELEVEN #18655 COMMENTS 3 Year Tri-Annaul SB-989 Testing with Kern County. 87 syphon sump - failed at piping penetration 91 stp sump - failed at electrical penetration 87 syphon fill spill bucket - at seam, direct bury will require concrete work 91 fill spill bucket - at seam, direct bury will require concrete work Remaining components passed. PARTS REPLACED QUANTITY DESCRIPTION HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) ITEMS TESTED HELIUM PINPOINT LEAK TEST RESULTS Printed 08/07/2006 17:38 CLEACH ITE DIAGRAM Tankrtology o 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE: 07/12/06 CLfENT:7-ELEVEN, INC. WORK ORDER NUMBER9147506 SITE:7-ELEVEN #18655 W S ,., e N ~Q VENTS w Q ~ J ~ W i- ~ _ W - ~ ~ ~ ~ ~ ~ ~ 0~0 ~ U Y ~ Z m O O M - N. CHESTER AVE PUL I STP OF V RUL ~ PIPE O O SIPHON RUL I PIPE STP O O PRIMAR f. O 00 it7 D m Printed 08/07/2006 17:38 CLEACH Work Order: 3147506 f- 7~nla~Ology SITE SAFETY CHECKLIST, SERVICE AGREEMENT & OPEAATOA VERIFICATION FORAq Site Name: Adoress~ Wd. ~: _ Site t: ~G~j~;s /""' Ci4y/ST,~Zip: Data: Scoae ct w«k' Parts d f aerials °rovidud: AnivalimeatSte: ClepartureCametrpmSite' TcRalTravprTimr.: ./ PRE-TEST PROCEDURES J P0.ST--TEST PROCEDURES - t. ~-Discuss satefy procedures with silo personnel. :. emove all "Lodcoulrfagout` cevices. ?. ~ Prior to foul dz!iveriee. Ilte Cvrrtplele tank syetertt 2. ^ Run all pumps and verify there are rto leaks under disps~sa:s or must be paced bacK into wo•ki~g order. in STP 9ttmpa. Must be witnessed by Site representative. 3. 7 All pbr-lps. dispensers. and electrical breakers of r1 Impact Valve Test Port the product(s) to br: fc_,u:d must ttr. d;nolyd during U Leak Detec,•tvr T'Ireads the test{sl, l:l Functional Element 8 Re ief Screw 41 7"Secure entire work Anna with 28" cvtss, (laps, and 3. U Ins1aA a lead wire seat cn all test olugs & leak de:~.'o•s that caution tape wrm:,crviocd. Count L~ thread^,: S1~.I~Place tint: gxti~guisher5 and "NO Smoking' signs rn Li L'1 l.3 L4 L5 the work area. 4. Q Ensure that all lark system cempv~rdnL: are reslar5d Ic :,t8i' t3. J Turn off and Secure the circuit breakensl of the original state (in~ludi~g-- PrvduCl to bri fasted with lockout dsvicrfis arx! iagE. - AI C3 probes, sensors. 5, caps '. ~ Plate "(}ilt of SPrvicn"tkxt., nn the disnPnsr?r nrzzles Ball floats, dry breaks & caps Ot 1he produdts) to be tested. - Cathodic protection system iS operational 8. ] ~it:rify proper Lot:kuuLTayvul procedure i5 ::vnphae by trying Ia operate pumps - Containment sumps ors d~y - Disprnzrrs 8 PQS ^.yst, m 9. 7 Close ball naives er cneck valves on th= praducl - Dispenser pawls are replaced pipincd to be trstrrl. - Drvp tubes. till 3daNters 8 calr• 10..J Remove the electrical `bayonet" connector from - Leak detectors R Capper vent tunes ltte SIP(S). - Ma~hot9 covers and sump ids Monltorine systvm b: opcraticral - F,hear valves at the di,pensars - Siphon lines and nani-old -valves ~ - Spill r:nntainers S drain vnlvPa ~/ STP fittings and bayonet connectors 5. "9 uvve eunes, flags, and cauliCl• jape. rknoregY Pr ust Sig•ratur Pest T iyn , r ~ t~ Signerure below rnrAirms that the items listed in the POST-TEST Procedures have been visually verified by the location represerAalire. Site Representative Name I're~ lest Signature Pt:. -ast Sgna:~re TuiAnolog}'•yUlr, Inlerrcuirm~l Nrvi~rd .I;IRn'2 Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 0 O z d Cn 0 0 0 ~'. n 7C• >/ o.. ~~ tIG N 0 O ~. ~-•] k >v v v J '~'-.L1 eD~JTNI_ijND_ GAKE'?S['IF.LD ~_R y33 3117546 SL~Ms: LEAK 'EST REF3R~ ?iF:.LBK TEST iTRN'.tL' A: SS !1:51 STAR'CD A7/1 ?/ 7A06 DCGTN LFVF; 2.24:4 IN ~!~~ T~~}E v: 13 EhID ?RTl: 87/17/21=65 END __UEL 3.95?H !h LF9<. ~HiESHOLD 0.001 I~ TLST :iE5111_F FA1LrG 91UAP9K TCGT .`'.TARTED 8:5d T='ST STARTED q7/l;f?aat, Sf.GIN LEVEL 4.4461 CN EiD TCME 9:13 tNU JRIt ?%/12/2866 CND LEUCL 4.445b IN i FA!~ THRESHGLD 0.002 IN TEST PESULT PASSED yfSt-LaK TEST STARTED o:~~ TFST STARTED 87/f2r'>~06 SEGIH LEVEL 2,556$ [N END 'II"1L q: 13 END D!ITE O'l/12/1H86 i"ND I,FUEL i_JS67 IN LERY. THRESHOLD 8.08¢ IN TEST RESULT =RILED e7~neK -EST ~TRR7ED 8:58 TEST TRR.TED B7h2/700b 13f3~LN LEVEL 3.6506 iN END TIF1C 9:15 END DATE A7/12/2086 ENU LEVE_ 3.6595 IN l_EAY, TFRESr1pLD :].>::62 IN TLSI'PESU_T PASSED + i-i l 'oU11T-L_RNU JfiYrRSFIEL'! CA y:I38N 3147 SIMP LCRIC TEST R~FOR i' '31r-ILeK TEST 5TAkTED 9:16 TE°•i STf1RTED 97/:2/2865 y~GIN 1FUEL 1.8754 IN FND DATE. 8r/12/2r766 =ND LEVEL :7834 IN LEAK THRESHOLD 0.082 .N IESi RESIP_T fRI~tD 9 LURPiSK TES- S E RRT~D `_+: i fs T- ~Tr.TtIRTE.7 A7/?.t/2C+F36 IiEGTN I F..UEL 4.3254 IH 'Nf, TIME 9:3'. Qm DPTE 8'/i~/280G JJD 1_EIEL 3.3254 IN LtflK THRESHOLD A_0t32 I~ 87~~1_BK I TLST STRRTFfi 9:16 TCST STAR'[ED 87%12124441 • FEGIN LEVEL 1.5fieG IN EHD TIME ?:31 ~ EItD DATE 07/12/2886 ~ EY:? LLUEL 1. =295 I!i LEAK THR.FS~-kOL[> 8.60: 1N TFST 4EULT 'rRILCD D7SL1A6K TCST ATARTED `.+:16 TEST STRRTEC 0: /1? 28Rr. BEGIN LF_VEL 3.o5A3 IN END T1ME S:31 trip JATF: 97 '::?/3846 E!ID LFUFL 3.641?`_+ 1k LE9K ~1RESHDL D 0.81x1 SH TES RESLILT 1'R3SED 306 "I ChlESTER RUE I SFKERSrIELG CR y3i0E1 314"~}b6 ! Mr/12/2906 19:dE SUNG LEAK TEST REPORT SL:"ffl ~ TCST STARTf'G 9:52 TF57 STARTED !lr_i/2666 B~GIPI LEVEL 5.9116 1N Ehf~ TINE 1b: BB ENU DATE 07.'1~/2L1AF. FVD LEVEL 5.8572 IY LEAK TF:RE5-lpLD 0.682 IIJ I TEST RESULT FRILaD d7S.';il'la ?'EST CTR~TED 9:.X TE5T STARTED f7/12/26db BED CH f_FUEL '.4157 'N EHP. TI"lE 1A:8S END DATE x7!12/2066 ENa LFUF'T E•. 5936 IN Lf.AK THRESHOLD 8.603 IN TEST RESULT FAFLED f.R7FTl BK TF:iT STRS<TED °=}2 ~ TFST S'ARTE.D 87/S2/208G BEGIN LE4~EL 2.7386 IN E''1~ T:Mt 10:0r3 ! '_~ND DATE 07/12/2006 AND 1 FUEL :739@ IN I LEAF; THRESHOLD E.9k1Y iN ' TES'. RESULT PASSED I R7UWPBK TEST STARTED y: 52 TEST sTRR'ED 07%12/20AS RCT31N l_VEL 4.3152 IN ' END TI`IE 14:08 CND DRTF y7/12/2666 Eh'D LEVEL 4, 3,.'56 I N LEAK T~LRESNOLD d. 002 IN TEST RESULT PArSFD I • 7-Il 5DliTHLRNU ~9 F CHESTER PUt cAlCER^aFIEL~: t:A 7338k ?•1 J•lS[1L S1.MP LEAK TEST NcP[IRT yiST[' TCST .ryARTED il-/] TCST STARTED a7%12~28b6 R::.GIN LEVEL }.5364 IN E'!~ TIME 11:25 EHD DATE A7/12/2306 F„~ LF UEL 5.4£25 TN LEAK THRESHOLD E.0B2 1N TFST RESULT FRI.CD 87~'SUflF TEST '.TRRTED ii~tl TFST STARTED d7/12/288G FEGIN LEl1EL o.95G2 [N FND TIME 11:26 END DATE g7/12/2bb6 I FHD LEVEL 6.5386 IN LERIC 'IiRESHOLD 0.082 IH TES: RE5IJLT FRIED C7-il. IqC TEST STARTE:• 1::11 'EST STARTEii 6712/2806 BEGIN _EUEL 2_75FA li, EWD TS"IE 1_:26 LND Di1TE 07. 1'[/2855 Lf1D ;.EUF.:_ 2.7.ai0 IN LFAk THRESHOLD 0.ed'_+ IH TET RESULT flR~SED A7VAPBK TEST STARTED 11:11 TEST STARTED d~/ice/20Ar1 BEGIN LEVt_ 3.S:i°1 IN END fIM= 1:2: kND DPTE 67/1'''. ~0d6 ENO 1 FUEL 4.:353 If• 1 EPK THRESHOLD 6_4'42 IN TEST RESULT PASSED 6~ rv) c C O ~-t 7S' •t R. :-e W r v 0 01 O O d trl 0 0 ;~' O A~ f7 W C a ~• oc N O 0 a C ~• H X w y J 00 J J ;i09 N CHESTER AUE: ! 7-11 ~OIiThL9'7D E.RKtItSFiFI.D R 933ey ' SB0 N EirESTER At+E ~ ;tt75E~6 , CT.<FRSFIELD CR ~u-~©2 31475t~i g7/+L/°b$6 t 3:40 i 9?/!2/25bfi 1::13 ~ S!!Yp LcAK TEST kEPLYiT SUIT' LEAK SST RE''DF- FOrbF.PSM ~ $7PiP~Y: I 1'E~7 STPFTED LS:'25 i -•'Sr STPRTEV 07/12/2906 . TEAT ciARTCD 13~e3 I REC•IN LEV_-~ G.4R9`J 1N TFST S'ARTFD 97/;2/2~lBE ,MD TIME 1"'tA BEr;;N LFOEL 5-ifi5', IN END DArC d7/1'2/2AA6 ''=SID 'TME 1 ::16 I ENO tCUFL 5.4017 IN EM? DATE 57!12~G90c I LERk THRESHOLV 0.002 Ilt I FhJD LEUE_`-457 IN PAS&ED , TCST p,Eg11LT LEAK T%iRE'~i01 i. x.0002 lh -F..GT R :"111- PRS'.iED ' n7c-p B75TP t -CST STARTED 13 25 TFST STARTED B7i17-•2006 I ,:5b ST STAR'F_U ' ~ 7f ?EGI'i LEVEL 5.642 tN .. TEST C'ARIEO a7•'.2/2d0E Ey, T*~ ly:c0 , REGIii ! EIJCI. 5.65111 IN FyV LyyTE 9i/12/200F. END rIl"E 1^c 11 END LEVEL 5.6440, IPf E!~V ANTE 0Y/1?i~uE>fs i ~CA{C TF:RES}ii7W 5.002 IN tNe [fVE~ 5.6ry6 iN Tr•ST RESi1L' PRSSED ' Lt="AK TtiRESHU_D 0.002 IN TEST RE°itLT PASSED I ,_~;Dr ! 1-2UDC i TES'' STARTED t.3:~5 rrgT STA~TFD 13:03 ~ T-ST STARTED 07/l'!20R5 i BEGIN LEVEE 3,2:{02 =I'; "~T STI1RTCb 97/12/2006 END TIh1E I3:~ 0EG1N LEVEL 3.3.1E+3 IN ENr DI1T" 07/12, 2A06 '3: [y ENO TIME ~ 'NO LF!!fL 3.1772 il` r• Fl7/li/2906 ENR DATE _ LEAli" THREShOL4 A.tlO- IM Cob I..EUEL 3.2'4ti 1N TFST RE_UL'I KA[LEU ' LEAK THtitE`1F47LD 9.06? IN ' TEST :2C;~1LT 'Ai LED 0 ., x O -, a n W r iP v In 0 rn