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HomeMy WebLinkAboutABOVEGROUND STORAGE TANK #1 12/9/2005(ABOVEGROUND STORAGE TANK) FIT,E #1 cos SOLID WASTE FACILITY 4101 TRUXTUN AVENUE r~ // 12/19!2005 10:27 6613252529 CAL VALLEY PAGE 07 VA.PORLESS M.A-NUFACTI.TRING, ANC, ~.A~'~H90 Leak Detectox'~'est Record Contractor ~m r Cal-!/~I~e u~1P~eaet ~.~e~s~':~,r~ C'~' C~I~ ~w.~ct! ~-r~s y/or,,.Tr~.xt~~ ,~~~. z3~,~err~~e%'c~,~, ~'7 ve. sec 'ciao r.~.ce ~ ~hr SuTamertible 1'ttmp Identification Manufacturer M el ~~~ Leak Detector Identi#cation Manttfachaer Description Other Srile Leak bt:tector ~~~ fi Diaphragnrtype_._ . Piston-type~_4..-~ 'l"atnper--proof seal itnstalled? Yes No Leak betector lm Sttbmers,'ble Pomp Test at Dispenser 1 _ Qperating Pump Pressure 2 ~ psi {para. 15) 2. Crallons per !tour rate ~ (para. 22) 3. Line pressure with pump shut ot#-- ~~ Psi (para. 23) 4. Bleedback Tcst with pump off ~a ml (para. 26) S. Step-though tittae to :Full flow ~ secvz~ds {para. 3p) 6_ Leak detector stays in leak search position. (para. 42) Yes G~ Nq LEAK AETECTQI~ TEST Nvtc: Pass = xcak rkteotor fits test protocol Fad = lxak detecoor faits test promcni Pass ~! Fail FotTxt 890C (9-1-96) 'Complete thermal expansion test before railing leap detector_ 1996 Vaporlt;ss ManwFactutYng, loc., Prescott Valley, ,A,Z 12!19/2005 10:27 6613252529 CAL VALLEY PAGE 06 `TAP()~.ESS MA~UFACTUR~ZITG, INC. LDT-890 Leak 1Detectox~ ~'es# Record Contractor tp Location C, r2-9 os ylvJ_ T>f'~xa~~ .4r ~e b~_rs~'~/A:~a-__ D:es~l_. 'cian ~ °- ccce l.Ii ~e9'~, .,,_ Submersible Purltl~ IdentiPlcatio~n Maoaifacturer ode No. a ia~ umUer _- ~efiYd _ Leek Detector Identi~catwon 1~Eannfachrrer 'lion r S , Ie Leak etect+or ~s~.L ~~ fi Diapbragtn-type piston-type a~ Tamper-provt'sea] installed? Yes No Leak Detector in Submersible 1Purtep Test st Dispeltser 1. Operating 1'Urnp Pressure. 27 nsi (para. l5) 2. Ga.llans psr hoezr rate 3 (para. 22) 3. Lane pressure with Pump shut off~_y p~ (para. 23) 4. BIeedbat:k Test with>~ off _~ (para. 2ti) 5. Step-tlarough rims m full flow- ~ __seconds (para. 30) G. Leak detector stays ;in Ieak search position. (para. 42) Yes. e/ No LEAD DETEC'T'OR '7'ES~' Note: Pass ° Lmk dcegttor fits test protocol Fall - Leak dctertor fat Is t~vc protoeoi Pass ~ ~~ Fgu Fazui 8900 (9-1-4b) "Complete thermal expan.5ion test before failing Teak detector. 1996 Vaporless .iV,[antzfacturing, Inc_, Prescott Valley, A7 UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD I LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION H r, ~ ~~ ~z D F1RI ARTM + T BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661)326-3979 Fax: (661) 852-2171 Page 1 of 1 PERMIT NO. ~ ~ """ D "`~~ ^ ENHANCED LEAK DETECTION I~ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST ~ TO PERFORM FUEL MONITORING CERTIFICATION - SITE INFORMATION FACILITY BakerSfleld Clty COrp Yard NAME & PHONE NUMBER OF CONTACT PERSON ADDRESS 4101 Truxtun Ave. OWNERS NAME City Of Bakersfield OPERATORS NAME Same PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO TANK# VOLUME CONTENTS 1 87 UL 2 Diesel i - NK TEST,ING COMPANY.'. ,. ~; TA~.., . NAME OF TESTING COMPANY Cal-Valley Equipment Bruce W. Hinsley 661-327-9341 MAILING ADDRESS 3500 Gilmore Ave. Bakersfield, Ca. 93308 Bruce W. Hinsley 661-327-9341 CERTIFICATION #: 563545579 DATE & TIME TEST TO BE CONDUCTED December 9, 2005 13:00 ICC #: TEST METHOD AES PLT-100-R SIGNATURE OF APPLI ANT ~~~ ,~ DATE NOV. 18, 2005 FPLICATI .N B;ECC?MES A E MlT E ~l'ROVE APPROVED BY DATE ( ( d FD 2095 (Rev. 09!05) UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. ~ l - O Of ~~ ~ ~ ,? ~ r ~ 9 P ~ Ts ti' D ~ F~IA~ ,5._-. c~~a R lrer 'r -- 1~,. BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 ^ ENHANCED LEAK DETECTION ^ LINE TESTING ~ SB-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST ^ TO PERFORM Fl1Fl MONITORING CERTIFICATION ~'SITE'INFORMATION~`' "~ FACILITY Bakersfleid Clty Corp Yard NAME & PHONE NUMBER OF CONTACT PERSON ADDRESS 4101 Truxtun Ave. OWNERS NAME City Of Bakersfield OP;~RA'1~ORS NAME Same PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO TANK# VOLUME CONTENTS 1 87 UL 2 Diesel TANK TESTING COMPANY "~`£' NAME OF TESTING COMPANY Cal-Valley Equipment Bruce W. Hinsley 661-327-9341 MAILING ADDRESS 3500 Gilmore Ave. Bakersfield, Ca. 93308 Bruce W. Hinsley 661-327-9341 CERTIFICATION #: DATE & TIME TEST TO BE CONDUCTED December 27, 2005 09:00 ICC #: SIGNATURE OF APPLICANT-~r? - ~ DATE Dec. 7, 2005 S P'PLIC:ATI;U BECOMES. A RERMIT ..H ~ APPRQVED APPROVED BY DATE ~ FD 2095 (Rev. 09/05) UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD I L1NE TESTING / S6989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM . FUEL MONITORING CERTIFICATION PERMIT NO. `~ ~ ~ ~YJ ,~° ~J~ ~'~ BAKERSFIELD FIRE DEPT. , j~ ~ `, ~ P'~~G ~ p Prevention Services FJR~ tl&~PARTMIT 900 Truxtun Ave., Ste. 210 ~ ~ ,--~~ Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 ^ ENHANCED LEAK DETECTION ^ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING n TANK TIGHTNESS TEST ~ T(7 PFRFt~RM FUFI M(~NITnRING CFRTIFICATInN `SIT6INFORMATION' FACILITY Fed EX NAME & PHONE NUMBER OF CONTACT PERSON it ADDRESS 4101 Truxtun Ave. OWNERS NAME 6100 District Blvd. OPERATORS NAfJtE Samf: PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO TANK# VOLUME CONTENTS 1 Diesel TANK TESTING COMPANY.~~`` NAME OF TESTING COMPANY Cal-Valley Equipment Bruce W. Hinsley 661-327-9341 MAILING ADDRESS 3500 Gilmore Ave. Bakersfield, Ca. 93308 Bruce W. Hinsley 661-327-9341 CERTIFICATION #: 006-05-1178 DATE & TIME TEST TO BE CONDUCTED January 2S, 2006 13:00 ICC #: SIGNATURE OF APPLICANT ,-~" ~ DATE Jan. 17, 2006 T APRL ;AT,I; EC.QMES A PERM T WHEN AFPRQ-VEQ APPROVEDB ~ DATE FD 2095 (Rev. 09/05) 12/1912005 10:27 6613252529 CAL VALLEY PAGE 02 MONITC)~tING SYSTEM CE~'~'X~'ICA~`~ON For Use Sy Alt Jurtsdietio-rs wirftin the Smle of California Ar~thuri{y Cidrd: Chanter 6,7. ,ycctlrh and Safety Code; Chapter 16, f?ivisinn .?, Titlt~ 2a• C.'crfifornia Code ofResulnrr'urs This form must be used to document testing and servicing of monitoring equiptent• A, seoat;ate certi~ictti;,on or retort must be Preonred I'or each manito=irt>±system control. oanei by the technician who performs the woCk- A copy of this Form must 6c provided to the tank hystem owner/operator. The ownerloperatvr must submit a Copy of this form to the local agoncy regulating UST systems within 30 ci7y tartest date, A. Gellelral YnfQrxat_ati~n ~/ Facility Namc: ~~~~t..' ~Ot~P r~~ .. Bldg. No.: __ Site Address: ~~. ~1'7~)Cft~Ll~~~• _ City: cr~.~~_...- Zip: _.. Facility Contact Person: ~ - Contact Ph+mc No.: ( ) Make/Model of Monitoring System: ~~~~"^~~~ ~~`.3.r0 Date of TCSting/Servicing: ~l~l~a.? R. InvegtOry t)f Equipmient'T•estedlCartified _a t,nl 'K Tn! i ro r181C UPx*F m ~u,ucfnea oc.•.~ - 'I'ank ID; -•r Tank ID: ----. ~ In-Tank Gauging Probe. Model: ^ in-Tank Gauging Probe. Model: 1~ Annular Space or Vault Sensor. Model: 6tbt7rr~'~I~,f ?aMrS•trJ ^ Anna{nr Space or vault Sensor. Model: _, , '~i Piping Sump l Trench Senwr(s). Model: SlarttD S_C_~@~ ^ Pipins Sump r'C'rcnch Sersor(s). Model: __„~ O Fill Sutnp 5cnsar(s). Modei: _ ^ Pill Sump Sensor(s), Model: _.-_„ _. '$ Mechanical Line leek Detector. Model: _ , .~ ^ Mechanical Line Leak Detector, Model: ._. ^ Electronic Line Leak Detector. Model: ^ Electronic Linc Leak [7ctccter. Model; _ ,,,.•,,,_ ^ Tank Overfill /High-Level Sensor. Modal: O Tank Overfill /High-Level Sensor. Made1: ^ dthcr (s •if ui ment l and model in Section E on Pa C Z), ^ Qther s ci Ui mCnt e e and model in $cctien E on Pay+e 2 . Tank ID: ~~ Tank ID: _,__~_ ., ~ fn-Tank Gauging Probe. Medal: c • ^ In-Tank Gauging Pro!>e. Modei: __.. 1'~ Annular Space or vault $cnser. Model: ~ ~ _..h.+S.S~etta• ^ Annular Space or Vat+it Scnsor. Model: Piping Sump! Trench Scnso+4s), Mvdcl: r~S•B1aSmr ^ Piping Sump /Trench Senior(s). Model; •_,,,,_ ^ Fill Sump Sensor(s}, 1$ Mccltttttir:gt Line Lettk Detector, Model: 1+4edel: ^ Fill Sump Sensor(s). Modei: ^ Mechanics) Line Lcak Detector. Model: ,_~_ ^ Clectronic Line Lcak Detector. Modetc ^ E)ectronic Line Leak bctcctor. Model: i] Tnnk [)vcrfill !High-Level Scnsor. Model: ^ Tank Overfill /High-l.,evel Sensor, Modd; - ---. O Other (s oclf a ui mcnt t and model in Section E on Page 2). ^ Other (s coif a ui ment t e and mode) in Section E on Pa^e L). Dispenser 1¢: ~~ Diipenstar ID: f / ~ DiipenserContainmcm Sensar(s)_ Modei; -•__~R~tLtL c~ ,@y~ 1~ pispcnsorCantaintttenl Sensors}, Model: ~S,at ~ Shear Vnlvcfs). QF Sltear Valve(s). ^ Di. c+tser Containment Fluat(x) and Chain(s), ^ Ibis cnser Containment Float(s) god f'hain{s). Dispenser IIy: Dispet~er ID: ., .,~._ Di.pcttzer Containment $cnsora). Model: Ij r1i- ^ DispcnscrContainment SCnsraY(s). Modei: >Td' Shear Valvc(C). ^ Shear Valve(s). U Dis nicr Containment Fioat(s and Chain s). ^Dis enserContainment Floats and Chaltt s . • Dispenser ID: Disperser ID: l$ Dispcnur Containment 5cnsoKs). Model: a ^ DispcnserCon[ainment Sensor(s). Model: _- _ _.~_.. ~ Shear Va.lve(s)- Q Shear valvc(s)• ^t~is cnser Comainment Raat(s) and Chain(5 . ^Dis nser COntalnmerd Float(s) and Chain(s). ^tf the txility contains more tanks or dispensers, copy this form, lnchtdc inFatrrtatien far cvtr'y tank and dispenser gr the Facility. C. CePtlflCat:lon - 1 certify that the equipment identified in this document wa< inspected/serriced in accordance with the manufxcturetx' guiclelirres. Attached to this Certificntian is information (e.g. manufacturers' checkiiSt&) neeesaatw to verify that this infm•matirut is correct and a Plot P[an showing the layout of monitoring equipment. For any equipment capable of generetirtg such reports. I hove also atlrtched a cagy of the repo • (cLtcck alt chat ply)• C] 5ysbem get-up ^ Alarm history report , Technician Namc (prin[): rr~rp ZtJ. ~~~LP,~- Signature; ~•~-~-- _• .__ CertiFicacion No_: ~~~~]~ .License. No.: ,~t~'~l/7D"/1~ _ Testing Company Name: ~-t/~.d1~~~~~~~ Phone Nr,.:~ ~L+L~ 327 ~.~''SrI Site Addncs+: ~_~~~1C~eoi? ~[p_ ,[3 ~KP~•~,~~°- _-- Date of Tasting/Servicing: ~~~~~ Pale i of 3 ti3rni Monitoring System CertiCcation 12/19/2005 10:27 6613252529 CAL VALLEY PAGE 03 b. Results of Testing/Servicing 5oftwarr. Version InsraliFrl• ~,3 . C`nrnnlarn rho Fnllnarterb nharleliet~ Yes d Na* - -- __ Is the audible alarm a rational? ~ Yts ^ No• Is the visual alarm a stational? 1~• Yes ^ Na'r _ Wtrc al! scissors visuail ins ected, Furtctionall tested, and confitmt:d q rational? f~ Yes ^ No" Wtrc all sensors installed at lowest point oC secondary containment and posltinned ao that pthtr equipment will nqt interforc with their ro ern eratian? a Yes ^ Np* IC atarmS are rGlaytd to a remote monitoring station, is all communications equipment (e.g. rTtodcm) ~ N!A operational? Qd Yes ^ No* For pressurized piping systems, clges tht tufbinc automatically shut down if the piping secondary containment ^ N1A monitoring system detects a leak, Foils to optratc, or is electrically disconncctect? If yes: which sensors initiate positivt shut-down? fCheck aft rltut apply) ]l3(SumpfI'rcnch Sensors; ^ Dispenser Cnnt,ainment Sensors. Did ou confirm ositive shot down duo to Icaks And sensor failure/disconnection? ds~Yes; 4 No. ^ Yes ^ Np't FUr tank systems that utilize the monitoring, system as the primary ~•tisk gverflE warning device (i.e. no (~ NIA mechatticAt pvtr~Il prevention valve is installed), is the Overfill warning alarm visible and audible at the tank fill oint(s and o 1'8ttin ro rl ? If so, at what rCCnt of tank ca tacit does the alantt tri cr? 9b ^ Ycs'r No Was any monitoring equipment replaced? 1;f yes, identify specific sensors, probes, or other oquipmcnt replaced and list the manufacturer name and model For all re 1aCement arts in Section E, below. ^ Yes" ~ No Was liquid found inside any secondary containment systems designed as dry systems? (Check a1! thcrr apply! ^ product; ^ Water If es dcccgibe causes in Section 1r, below. ~ Yts Q No'" Was monitorin s stem set-u reviewed to ensure rp er settin s? Atatch set u re orte, if a livable Yoe ^ No° Is all monitorin a vi ment o ational cr manufacturer's s etifiC&tions? [n 5eetiort E below, describe It!ow and when these tieiwclencies were or will he COt'rettt2d. E. Com.metnts: Pale 2 of 1 t~'Utll 12119/2005 10:27 6613252529 F. In~ Tank Gouging l SIR Equipment: CAL VALLEY PAGE 04 !~ Check this box if tank gauging is used only for inventory contral. t] Check this bax IF no tank gauging or SIR equipment is installed. 'T'his section must be compieted if in-tank gauging equipment is used to perform leak detection monitoring. f`mm~lotP thr fntlnwtne cheekliAle ^ Y¢s U No" Has all input wiring hCen inspected Far proper entry anti tcrnnination, including testing CUr ground faults? © Yes ^ No" Were all tank gauging probes visually inspected for damage anti residue buildup? ^ Yes ^ No" Was accuracy of system product level readings tested? ^ Yes ^ No* Was accuracy of system water tevel reacings tested? ^ Yes D No'' Were all probes tninstalled properly? ^ Yes ^ No't WerC all itCm3 on the equipment manufaClurtr's maintenance checklist completed? g in the S ection H. below, descrihe how sod when these deficicncias were er will be corrected. C, Line Leatc Detectors (LLD): ^ Check this box if LLDs are not installed, /'`mm~lata H~a Fnllnwino rhuntrlref• J$ Yes ^ No'" For equipment start-up or annual equipment. cctYiFcation, was a lt:ak simulated to verify l.l: f.] pCrformance? ^ N1A (Check all nc~cr apply) Simtilatcd leak rate: 1~3 g.p,h.; ^ 0.1 g.p.h ; ^ 0,2 g.p.h. ~• Ycc ^ Na'~ WCrC all LLDs confirmed operational and accurate within regulatory requirements? ~, Ycs ^ No* Waa the testing apparatus properly calibrated? •~. Yec ^ No" For rnechanica] Lt.1JJs, dots the LLD restrict product flow if it detects a leak? ^ N!A ^ Yes ^ Noy For electronic LLDs. does the turbine automatically shut off if the LLp detects a leak? F~ NIA ^ Ycs O No" For electronic LLDs, dues the tttrbinc automatically shut off if any portion of the monitoring system is disabled ~, N/A or disconneCtCd? L] Yes ^ Nom For electronic LLT~s, dots the turbine automatically shut off if any portion of the monitoring system malfunctions ~4, NIA or fails a test? D Ycs ^ No* For electronic LLDs, hevc ail accessible wiring cannectians been visually inspected? N/A ,'~ Ycs ^ No" WCrc all items on r.he equipment manufacturer's maintenance checklist completed? - an u+e; ~ecuu+t n, ur+uw, ueySnpe aow ana wncn tne5e aencreneteS were or wlit ne CorreCled. ~-Y. Camrrtelnts: Page 3 of 3 u3/at 12/19/2005 10:27 6613252529 CAL VALLEY PAGE 05 ~ ~•~ i1'looitoring System Certification Site Address: UST Mor~itorin~ Site Plan . .~J/ . Date map was drawn: ~r~/~~': Instlritctions if you already have a diagram that shows alt required information, you may include it, rather than this page, with your Monitoring System Certification. Oit your site plan, show the general Iayout of tanks and piping- Clearly identify locations of the followin6 equipment, if insta[Ied: monitoring system control panels; sensors monitoring tank annular spaces, sutrtps, dispenser pans, spilt containers, or other secondary containment areas; mechanical or electronic line leak detectors: and in-tank liquid Level probes (if used for leak ctctcction)- I.rt the space provided, note the date Utiti Site Ptah was prepared. Page ~ of~ 05+00 CAL-VALLEY EQUIPMENT 3500 GILMORE AVENUE RAKERSFIELD, CA 33308 (661) 327'-934'! FAX: (661} 325-2529 CONTRACTdFZ'S L1C.#784170 A HAZ !~ t=ax: ~`Ij ~" c~I r~ ~ tpages= ~ tMCWDIhtG COVI=R Re: 4`"C: ^ Urgen# ^ For Rreview ^ Ptease t;.omtWlen# ^ Please Reply ^ Please Recycle Commen#s: S W RCE;, J:+nuary 2(lf12 i~a~C . ( OI~ / Se~andary Containnn~e~t Testing Report Fo~rxn This form is inrendtdfor use b}~ cOnlrrclarr pt~rfnrmin~ perrodiC lesding of UST sgeondary cnsturntxerrr sysre+r+s. Use nc~ upprv~riule pad?s of ~hrs f nrm to report resulls,jor c .'! canpori~ttls tested. The cor~leted form, wrrrte~a test procerlcr,•rv, c~,r~! prinrr,uts frr)m tests (if upplicnble), shotrld be provided to the fdt'tlityowner/opern-nr forsub+-ulto- !o the l~cnt rr~uralar~ti~ n~e~~rcv. 1 T; A!`ii.iTV INFL'"112MAT1[11V Faciiit Name~~r~~~ Carte ~~ ^DatcofTesting~~ ~ 5i~~~, c: ~.. Facility Address: ray ~ .~ . facility Contact: Rhone: Date l.oeal Agency Was Notifie oFTesting Natnc o F Loca I Agency [nspectpr (,f prece~rl durFng testen~;J: 1. TRRTlNf_ C'(lhiT17A~'I~If'l12 iNlif)12MATif)M1F Company Name: •• Tcrhnician Goaducting 'test: ~Z, „_~~ Crcderat~afti: ~CSLB Licensed Contractor , SWRCB Licensed Tank Tester LiccnscTvpe: ~~ I:it:enseNumber: '~~~1 ~~ Manufacturer Mantefattltrer T'reinine Con1 Clnent s Date Trainint; flx irt:s 3. SUMMARY if]w T1k::~T RFSIILTS Cnmporlent Pass Fail Not Tcstrd Rep~lt~s Mad! Component 1':~ss Fail 'Vlal TCStrd Rrp~irs \Tadc C ^ ~ ... 1 G L ~~ ~ ~ U U ~ ~ .. • ~ ~_ ~c~ ~ ^ fl ~ -~ ^ .:: '~~ dd W r' ^ ~ r-. - l11 ~S .r ~ ~ ~ . t,cl~ST~ ~ irr ~ . ~ ^ ^ ~ J . . . . __~ L7 U ~ .7 ~-~ !_~ 3~ L~ !- ~ J . i !: ~ .. f ~ ~ ^ ^ J G ^ i'~ ;' ^ ~ .... .1 - _ ,._ • ._ tf hydrostr~liG (esting was performed, describe what was done with the water after completion oftests: c CLRTIFICATION UP' TECM~NICIAN ItESPOi'Yf$ifi1.E FpR CUNbt1C?1tNG THIS TESTWG Tn the hest o, f'nrv knun•fed,~e, dfve fo~cis strtte~! in phis rlocu~ns•nr ~w~ ccrrrreve rrxrt in frr// cnrnpliRr:ce ~vilh /egnl -•er{rrirrnrPlnc Technirixn'c Signature:_~~~f,~, f ,x~ _ • f7afc:~~~~_l~ swRCt?<. ~;tnuary znoz rape '~ _ t,r ~_ 4. TANK A,NNULAy~t TESTING Test ;vlethod I?evelaped By: ~ Tank Manufacturer ~ Industry Standard :Professional Fm~inecr Other (3petfy) ' Vsftuurn :. 1-lydrnstatic Tc::l Method Used: Pressure ?L• ' Other (Speclfj~) ............... Test Gqui meat Usetl; Equipment Resolution: Tank # T'grtk tJ 'j ~; ~ Tank # Tank # to Tank Exempt 1=rorn Tcstirrst?' Yes )(' No :;? Yes ~'No _: YeS ~ No Ycs Nu Tank Capaeity: ............ Tank Material: r~ ~~ ______.,.__. Tan[€ Manufacturer: Product Stored; `• , • ~ "j ~~ .. Vb'ait time between dppiyin~ ~1'L'Stit,rciv.74P4,„,/tt•+iwr and startinv test: ' ..__ .... Tl~t Start Time: ~ • +Sa , initial Rcadin~ (R,1: _ ., Test F.:ncl7imc: tp~ ~• Final Reading (Rf}: ~ ;. Test I~uratinn. ~ Change in Reading (RF-R,). ~ Pass,'Fail ThreshoRi or Criteria: .~ Z ,~ Test Resul#: - _O~ P.ass !_1FAIh ~~. • ~1..~~'ags 'a"7+'aI•:~y .. .. s :iCJ~~Y1iss,:...~~'F:aiF .. .. -Pass :Fail vdas scnsorrcmoued fnr testing? ~'cs No NA ~`~t-s ':No -_:N~1 ~iYes i::No NA Yes Np NA w`as sensor prol+erly relalaccd and xYcs NO NA ~,~ NO ~ NA :3 Ycs '_1 No ~ J NA Ycs Np Nr~ ,~criliud functional aficr tcstinu~? CommElli:S - (inclr~llp informolian ox repairs mode prior la rt?slrrg, and recorrt-rtended follow-trpfdrfctiled assts) ' Secondary containment systems when: the eotltinUOUS monitoring auto,natically rnoniiors Hoch the prime,y and secondary containment, finch as systems that ere hydrostatically monitored oi` itndcr constant vacuum, 8rC exempt fro„+ periodic cunt+zin„tant truing. ;California Code of Regulations, Yule 23, Section 2537(ti)(b)J swlzr..~, tanuary Zi)a2 5. SIECONDAFt'k' PIPE T~STI11iG I~K~e . ~_. of __/. Test iWlcthad Developed liy: Piping Manufacturer ~Inducfry Standard _' Professional tngincrr C]ther (spec+fy! Test Method USed: XPressure •. Vacuum ~'. Hydrastatie Dthet• (Spec~J ~~ Toss frquipment Used: - tr F~uipment Resolution: piping Run ? Pipirt~ Run Piping iiun # Fipin~ l2un # --•_- Pip;nv, Material: F Pip;n~>: Manufacturer: ~ Piping ni~mctcr: . ~ _._ Lcngthol-Piping R~In: ~` ' ~rOdUCI $tOrCCl: Mcthud and location bf ~ L ~ ~ i ing,;run ir'olel;bn: o T~• __ " Wail lime between Applying pressure/vacuumlwatcr ai,;d tilarlln tu9t: .. ~ 1~ Te,t Stan Tinie: ( ~ ~..~q ~,. tniti:~l R~adinP, (Rt): _ ~* _ „T. -- _ Tc:tr Fnd Time: t Final Ru+ding iRt•)~ $ __ Test Dumtioh: Change in Rcadini; (Rv-R.J: _. --. _~ Pass~i~aii Threshold or Criteria: Z ' TestResttlt; ~ Foss ~7Fai1 _ ;;hm~s ;I3~~il''~'e` 'i~'Pase 'f~~Et':iil~' ~ Pass Fail SWRC,'13, January ?t)02 I'agc - y_ ctf 6. PIPING SCiI'~iP'Z'ESTING Test VJtxttotl Developed By: Sump Manufacturer 1~' Industry 5lar+ dard ~ ProfCSSional t;ngmcer Other (Spec JY} 'l'est Mcthnd Ustx3: Pressure -Vacuum ](Flydrostatic Other (spec y) Test irquiptttcnt Used: '~ ~. ~ Equipment Reso{utian: Sump I~ ~j Sttlttla I# Sump ~ 5uutt~ k Sutnp Diannler: ~'R . ..... 2" . =• Sump Depth; _ y y ~ ~1 S" _. Sump MatctiaL ,_Q~~„ .. .-.~ ...._ Hcittht F'ram Tank Tvp to Tqp of Hi ~hcst Pi inq Penetration; * 1qN Height Frptn Tank Top to Lowest ~ Clcrtrical I'cntaralian, ~ 2~ 1 ~ _... -- C'ondilion ol'suntp prior to testing: ..~ Pt~rtitm <tl 5ump Testcdt ~~ .~_ Does tur~ii,ie, shut down when sump sensor detects liquid (both (Yes No NA 'l,E'`Y'es 'iNo INA 1Ye5 i:No NA Ycs No NA roduct and water ?• .. ..-. . Turbine shutdown response time _ .•- [ssystcmprogratnmadl'nrfail•safc ~ lrYes Na NA X~rs No ":NA ;'Yes !No _~NA Yus Nu NA shuttlowtti? .... _ t~'as tail-safe verilied to lte • 7iYcs Nn NA ~YGS t~INo I•.1NA CYaa :.:No '•NA Ycc Nu NA o e;ralion.tl? 1~v'.tit time hettveen applying pressurelvacuunt/writer and starling test: ..... ~~.~ Tc,SI Su~n't'ime: ~ ~ ,. Initial Reading (R,): ' ,. Ttsl Fnd T'imc: ~1: S2 / wt Final Readin; flit:): _ r~ - ~"~:`~ ~7w •_-- 'I csl tilt ration; - Change in Reading (RF R,): .~.: _ PasslFail Threshold or Criteria: o Z 'n Z Test Resultt: Pass Ll FAiU w.~;war ~: Passx~r~ ~axl,. ~ ;.: i'E3?~ii!~ss:"~ GI k'sil ~~ • :"'; lyass I ~ f all Was st:nwr r(:,ttgvetl I'or testing? 1a'es No NA ~, Yess No '' NA ~:~ YCS ~_ No ' . NA Yea No NA V6'as srttsur prapcrly replaced and ' xYes Nv NA ~'YCS Na NA , NA :'Yes ' ; No Y~x Ntti N!1 un~tipnal after tesdn ? ya•ifted I Cornnnet7tS - (A+r/t~de in ormotion an repairs mudeprior lu t~tslrrrg and reeammendedfolFow-op fr,1r ailed tests} ' 1f the entire depth of the sump is not tested, specify haw much id~~~s tested, -f the answer tt) anx of the questirnta indicatctl with an asterisk (*} is "NO" yr "NA", the entire sump must ha tested. (SCe SwRCB LG-160) S W RC:'L#, lanuttry ?UQZ 7. UNDER-DISPENSER CON`?",e11NMENT (i1DC}TI ,__. rest ~lcthna I7evclo!>cd #3y: lJC7C Manufacsurcr >f Industry SianClard -- - - - 1"cst 1Rcthod Uscd: Pressurn Vacuum Otl,cr f5,t~ecijy) Test E.quipn,ent Used: ~„ ~.~,,,, '* Q ~ °G`!~S 6qui1 DC # 'r,,-- 4 I UDC # UDC hlanufactu~Y:r; ~1,~ tm„~,~, ~.i~s _. •C+~-~~~~~- UDC Material: ~' .... lJ UC Denth: - ? aQ ~~ Z~~, Fici~ltt from UDC Bottom to Top ' °~ °° ' u! Hi ~hcyt Pi in ~ Pcnetn~tion: l~ ~ ° -~~ Height. from UDC Bottom to Lowed Flectrict~l Penetration: ~~A ~y _ / ~y,J/j¢ _ C;onditiun ul'UDC Prior to I - - .. , ~. tcstirig: G Cen ~ _ 'l.~t~~ ".. t'orti~.~n pf l1DC Trsted ~~ d' a~a _~ _ g~~_. Doc, turbine shut down when ' ~1'es No NA - UDC strnsor detects liquid (bath ~ ~~ . NQ _ ~ NA . No Nn 'x~ Yes ~ Yes Nu NA )I'Od UCI a19i1 watCr ?' ~tIr1~InC 51,tiItIQ1Nn I'CS QriSI: hn1C Is syslc~u plvctranvt~cd for fail- stile shutdown?- -. 1(Yes No NA ~~~ No ' NA ...,, 'SiYea ;.'. Nt7 . ~ NA _ ~ Yes Nu NA ~. . Was tbll-safe vt~rilied to be c.~perationa!'?' XY'ec No NA ~'e~ No .. NA ~ ., 1 Yes .. Na ; , NA X ....-- k Ycs Na NA - Wxit lime between applying -- pressurcl~~acuumlwatCr and ,rani„ ~ test ~ Trtit Start Time: Initial Reading(R~}: _ ,~~ ! s ••/'~ ~~q~'a _ ~~~ e,~~~ _~~ Tc:~i ti.nd 1"inTC: ~` -- d ~'+f ~'~ , l~insl Rcatlin li.): t ~# ~~~~ 7csll3uration: ~~.,, - f~` j -. ,~ ;A Change in R_Cadint; (RF RI): " ~• ' --~ -.S~ca-~.. , _ ---~ . -. __ ~~~ Pass;bail threshold pr Criteria: Test Result: t?t-ss tl Fail Pass C];,1?ail?j..:• ~ ~ ~, Pass r'! Fail X Psss fail V4',iw ~vnsnr r4moved for lc~ting~ ~Ye, No NA t1',Ye_e No 'NA ~ Yes ~ Na .l NA fCYes No NA W+~s sansor prttperfy replaCCd and ticrificd Ii~nctivnalaRcrtestin~? ~4,Yes No NA ~Y~ No ~~NA ~.. Yes :Nn NA 1(Yes Nn Nr1 CUxn tl't+elttS -• (i+u:ftrdt~ +rrforn~vrivn on repar,s made prier Jo lC'aJir,~, and r~ccamme„ded joflow-up jorJr~iled !cars Pa~c •_.~ of ~.. NG • PmfB54ic~nal Enpincrr (Hydrostatic Resolution: If the entire dopth QPthe UDC ix not testC+i, specify how rnuc~i iMas tested. if the answer to arty Qf the qucsrions inclicatcd with ,m flSFCf1AIS (*~ Ic "NO" or "NA", the entire UDC must bC lCSted. ~5+o SWRCS LG-160) SVVRC'ti. lanaury 2UOa Page .. b_ ul' ._. $. F[LL RTSEt7 COI~tTA...f'~MIENT SUMP Tt~ST[Nt: 1=acirty i~ Nut r•~uipnca With Fill Riser Canllinment Sumps ~ _ , Fill Ricer Cc~ntainrncnt Sul^s~s are Present, bul were Nvt Tesk~rl Text Method De~elvpccf 13y: Samp Mynutacwrcr Industry Standard !'rvfesaiona[ t~nginCer Otttetr (SpecrJy) Trsl AAC(IIUtI USCd: t'reS5llrC Va4uurn :Hydrostatic QCI,Cr (,~7@fl~,1f ............... Test £quipn,ent Uscti: E.quipmcnt itesolution: Fill Sum ft f"III Sump # Fill Sum # Fil! Suttlp # $Lin1 alafLlClcr: Su:n Dr the ....... Hci;~ht Irvin Trnk Top la Top of Hi>;hcst Pi ins; PCOCtration: Her~ht from Tank Top to Lowest ~IeL:trical Penclration: ............ C:onditivn of sump prior to tcsl i rnt: _ I'orlion c~f'Sum Tc,tc;d ., Sum Material: Wllil time t,etwecn i+pplying pressure/vxcuwn/water and Startin 1CAt: Teat Start Tin1C: .. Trs~ I nd Time: ............ . . Final Rcadiriu_ (ItF•): „__, Test Qul•atiun: Chlmr:e in Rcadin {Rr-RI): _. Pass/Fail Thrcxhold orCriteris: .__......... Test )R gult• e. ~ s; Pass r! Fail ...~..,. I~;:.1t'I~ss':,;CkF,:>,tt-~ " ... r,~, :;. _aKS.; II Faiil f.: Pass : rsti! . is Mere a sensor in the sump? , yes No 'Yes ;., No f: Yes _ No Yes Nn, _ _. _ Does tf+~ tensor alarm when eitlter liroduct or w~atcr is YC'S No NA Yes No NA , ,Yes ~ No . '.Nn Yes No NA dctectrd~' _ 1,Vax ~enstrr rctnvved for tcslinG? Yes No NA Yes . No `NA Yc;e .. Nv NA Yea Nn N~1 Wa, aensur properly replartd ~tnd Yes . No NA Yes ' ' No ! • NA C Yes ~" No NF1 _. .. Yes Na NA vcrilied tluicuunal after tCStin~? . C.: urnments - (itrc~lcrde infarrrvlion on r~.pairs made priar~o i~s~ing; and recommend ed fallow-up•%rjnik:rl ~e:+vsi Com mentS - (irrclrrde irr~nrmnlioM w~ repab-a• ,Wade prior rc> l~srrn , anri reea'+tmendedfOllaw-vp for~QilNCl JesrcJ Page __(_,. of .-~ SWRC'B..lunu~iry 2UU2