The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLAN 9/19/2006I ~~ M„ .. FLYING B-#9_.._ '..,,,, ii 3699 WILSON ROAD ~ _. .. .~ ~ ~ - 1 ;~,~,, ~V, ~i '\. JI i~ 41 1 l.~ I ` ~ ~ ~~ ~. ~,. UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING ?= / SB989 SECONDARY CONTAINMENT TESTING ~- /TANKTIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. L ~-- _ __~~ BAKERSFIEI,D FII2E DEPT. B B R s F I D Prevention Services FsRr ARTIY l 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 FUEL MONITORING CERTIFICATION _ __ SITE INFORMATION FACILITY ~ ~ NAME & PHONE NUMBER OF CONTACT PERSON o ~- `~3d ~t- ~ - Po'~~ DDRESS 3t0-1-1 ~QI. l~f~, a33oq-a5S$ j WNERS NAME i PERATORS NAME 'PERMIT TO OPERATE NO. UMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO ~ TANK# VOLUME CONTENTS J I L ---- i ~ i ~ i I I i i I --- - - - -- - TANK TESTING COMPANY :> j - -- AME F TESTING COMPANY ~ NAME 8y PHONE NUM ER OF CONTACT PERSON "T~/ ~l~I -83 - (~ R R3 AILING ADDRESS NAME & PHONE NUMBER OF TESTER OR SP IAL INS ECTOR (~ ~ I- 3~3 - (. ~~(~ ERTIFICATION #: oai~ oS aSb~ I :DATE & TIME TEST TO BE CONDUCTED YI'I ~3 0200 I'aoPin CC #: 5a~go2~- UT ,EST METHOD (SIGNATURE O APPLICAN ATE ~/-a_D~ i APPROVED BY DATE •7 ~ FD2106 . ~. BASERSFIELD FIRE DEPT `- a Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST ~,~, soo Truxtun Ave., suite 210 ~~ _.:-- .q,~:.~~- .... , :. :: . _:_ -- - _- ._ _ . ; _ ,_......... .- ~Rrr Bakersfield, CA 93301 SECTION 1: Business Pla a d Inv~ rrt ~I~I~~Og11111 ~ Tel.: (661) 326-3979 t2pG~ -ll~ ~ ~~ ~,bQa~Cfi'Co(~o ~~D Fax: (661) 872-2171 FACILITY NAME NSPECT N D E NSPECTION TIME r fr (/ ~~ a/.~) 1 ` V ADDRESS /~. HONE NO. O OFYEES ~((' ~ ~ ~ FACILITY CONTACT (NESS ID NUMBE ~ ~~ .S~OZ ~ - Section 1: Business Plan and Inventory Program _ C~5 ~! ~~_ ^ ROUTINE OMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C ^ V ^ C=Compliance ( ) OPERATION V=Violation APPROPRIATE PERMIT ON HAND COMMENTS ^ ^ BUSInt3SS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ VERIFICATION OF INVENTORY MATERIALS ^ ^ VERIFICATION OF QUANTITIES ^ ^ VERIFICATION OF LOCATION ^ ^ ^ ^ PROPER SEGREGATION OF MATERIAL -- ----------------------___--- VERIFICATION OF MSDS AVAILABILITY ----------~----------------'_-_-- -- j ~~~ ~~ip ~ ® 9 L ^ ^ VERIFICATION OF HAZ MAT TRAINING ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS PROPERLY LABELED ^ ^ HOUSEKEEPING ^. ^ FIRE PROTECTION ^ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES L`t~NU FaCPLAIN: - - _ OUEST109(~jREGARI~ING THIS INSPECTION? PLEASE CALL US AT (861) 328-3979 Inspector (Please Print) Fire ~toGention / 1" In / Shift of Si1e/Station Ik White -Prevention Services Yellow -Station Copy Pink - 6uainese Copy FD2048 (Rev.02/OS) c ~0~~'`~ ~~~ e CITE' OF BAI{ERSFIELD FIRE DEPARTMENT ~°~~~ OFFICE OF ENVIRON~~IENTA[. SERVICES ~ y~` Uiv'IFIED PROC>;RA16'1 INSPECTION CHECKLIST ~~ Aw ~gti,,!' 1715 Chester _1ve., 3~`' Floor, Bakersfield, CA 93301 FACILITY NAME ~1~ ~,o fao ''~ R3 ~ INSPECTION DATE ~ ~ ~ ~__ Section 2: Underground Storage Tanks Program ^ Routine ^-eombined ^ Joint Agency Type of Tank fQ W F~ S Type of Monitoring CtGi11 Multi-Agency 3 ^ Complaint ^ Re-inspection Number of "Tanks Type of Piping ~E_ OPERATION C: V COMMENTS Proper tank data on the Proper owner,'operator data un tilc Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes _ No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) _ Tvne of Tank AGGREGATE CAPACITY' Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placardin~%labeling Is tank used to dispense MVF? If yes, Does tank have overtillioverspill protection'? C=Compliance V=Violation Y=Yes N=NO ~ r Inspector: Office of Environmental Services (661) 326-3979 \~'hitc - 1'nv. Svcs. Pink - Bu _ Y; _- ~. _ MONITORING SYSTEM CERTIFICATION t ,J~~,..~- For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6. %, 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 system control pane( by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner;operator must submit a cop. of this form to the local agency regulating liST systems within 30 da~•s of test date. A. General Information Facility Name: HP Go Go # 930 Bldg. No.: Site Address: 3699 Wilson Road Citti-: Bakersfield, CA Zip: 93309 Facility Contact Person: Maxine Contact Phone No.: (661) 835-8044 . Make.!Model of Monitoring System: Veeder-Root TLS-350 S/N 40931584908001 Date of Testing/Servicing: 11/13/2006 B. Inventory of Equipment Tested/Certified Chrck the annrnnriatr hnxrs to indiratr cnrririr rnninmrnt incnrMrd/crrairrd~ Tank ID: 1 SUper ~~ I Tank ID: 2 PIUS I `~ ,I ®In-Tank Gauging Probe. Model: Mag ®In-Tank Gauging Probe. Model: Mag I ®At,nular Space or-Vault Sensor ~4odel:-409 -- - '- __ - ®Annular Space_or Vault Sensor. Model: 409 I ®Piping Sump !Trench Sensor(s). Model: 205 - ®Piping Sump /Trench Sensor(s). ' Model: 208 ® Fill Sump Sensor(s). tilodel: 205 ®Fill Sump Sensor(s). 1•lodel: 205 I~~ I' ^ Mechanical Line Leak Detector. Model: ! ^ Mechanical Line Leak Detector. Model: ®Electronic Line Leak Detector. Model: V/R 847590-001 i ®Electronic Line Leak Detector. Iv9odel: 847590-001 ;. ®Tank Overfill /High-Level Sensor. Model: 847390-109 ®Tank Overfill % High-Level Sensor. Model: 847 3 9 0-1 0 9 Ii ^ Other (specify equipment type and model in Section E on Page 2). I ^ Other (specih equipment type and model in Section E on Page 2). '!I i Tank ID: 3 Regular Tank ID: 4 Waste Oil ® In-Tank Gauging Probe. Model: Mag ®In-Tank Gauging Probe. Model: N/A ® Annular Space or Vault Sensor. Model: 409 ®Annular Space or Vault Sensor. Model: 420 I! ii ® Piping Sump i Trench Sensor(s). Model: 205 ®Piping Sump Trench Sensor(s). Model: 205 Fill Sum Sensors Model: 205 ~, ® p (). ! I ^ Fill Sump Sensor(s). Model: "il ^ Mechanical Line Leak Detector. Model: ~ ~ ^ Mechanical Line Leak Detector. ~4odel: ~ ~I ®Electronic Line Leak Detector. Model: V/R 847390-001 ^Electronic Line Leak Detector. N1ode1: ®Tank Overfill !High-Level Sensor. Model: 847390-109 ^Tank Overfill !High-Level Sensor. Model: ~; ^ Other (specih equipment type and model in Section E on Page 21. ^ Other (specifi• equipment type and model in Section E on Page 2). '~ Dispenser 1D: 1 8~ 2 Dispenser ID: 7 8 8 .i !~ ~~ ~I ^ Dispenser Contaimnent Sensor(s). Iv~todel: 205 ^ Dispenser Containment Sensor(s). Model: 205 ii i~l ^ Shear Valve(s). ^ Shear Valve(s). ^ Dispenser Containment Float(s) and Chain(s). ~ ^ Dispenser Containment Float(s) and Chain(s). I~ i Dispenser ID: 3 8c 4 Dispenser ID: ! ^ Dispenser Containment Sensor(s). Model: 205 ^ Dispenser Containment Sensor(s). Model: ^ Shear Valve(sl. I ^ Shear Valve(s). ':~ II ^ Dispenser Containment Float(s) and Chain(s). _ _ ^ Dispenser Containment Float(s) and Chain(s) I Dispenser ID: 5 8~ 6 ~ Dispenser ID: !~ ^ Dispenser Containment Sensor(s). Model: 205 ' ^ Dispenser Containment Sensor(s). tilodel: ^ Shear Valve(s). ^ Shear Valve(s). ~~ ^ Dispenser Containment Float(s) and Chain(s). ^ Dispenser Containment Floats} and Chain(s). ~ ^It the tacihty contains more tanks or dispensers, copy this form. Include information for even tank and dispenser at the facility. C. CertlfiCatlon - I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the report; (check alt that apply): ®System set-up ®Alarm history r~ep~o~rpt~,p Technician Name (print): Michael Moore Signature: "~'~a~'. ~.~~(,,~,~ Certification No.: 5249074-UT License. No.: V/R 006050508 Testing Company Name: Redwine Testing Servicecs, Inc. Site .Address: 3699 Wilson Road, Bakersfield, CA 93309 Phone No.: (661) 834-6993 Date of Testing/Servicing: 11/13/2006 Page 1 of 3 Monitoring System Certification D. Results of Testing/Servicing Software Version Installed: V/R TLS-350 # 4093158490800] Complete the fnllnwina rherklict~ ® Yes ^ No* Is the audible alarm operational? ® Yes ^ No* Is the visual alarm operational? ® Yes ^ No* Were all sensors visually inspected; functionally tested, and confirmed operational? ® Yes ^ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? ^ Yes ^ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g., modem) y ® ;~]/q operational? ®Yes ^ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment ^ 1.liq monitoring system detects a leak, fails to operate. or is electrically disconnected`' If yes: which sensors initiate positive shut-down? (Check all that apply] ^' Sump;Trench Sensors: ®Dispenser Containment Sensors. " - ~ -` Did' you confirm positive shut-do~~m due to leaks and sensor failure/disconnection? ®Yes; ^ No. ® Yes ^ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.; no ^ N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? 90% ^ Yes* ®No Was any monitoring equipment replaced? If yes, identif;- specific sensors, probes. or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, belov<~. ^ Yes* ®No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that applij ^ Product; ^ Water. If yes, describe causes in Section E; below. ® Yes ^ No* Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable ® Yes ^ No* Is all monitoring equipment operational per manufacturer's specifications? r In Section E below, describe how and when these deficiencies were or will be corrected. E. Comments: Category Form S/N T-1 Super Tri State Piping Sump 0794390-205 339050 Tri State Fill Sump 0794390-205 117813 Tri State Annular 0794390-409 N/A Tank Gauge Mag Probe 847390-109 068332 T-2 Plus Tri State Piping Sump 0794390-205 N/A Tri State Fill Sump 0794390-205 117408 Tri State Annular 0794390-409 469709 Tank Gauge Mag Probe 847390-109 868311 T-3 Regular Tri State Piping Sump 0794390-205 119099 Tri State Fill Sump 0794390-205 N/A Tri State Annular 0794390-409 N/A Dispensers 1 & 2 Tri State Dispensers 3 & 4 Tri State Dispensers 5 & 6 Tri State (continued to page 3) Page 2 of 3 Monitoring System Certification F. In-Tank Gauging /SIR Equipment: ®Check this box if tank gauging is used only for inventory control. ^ 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. Complete the following checklist: ® Yes ^ No* Has all input wiring been inspected for proper entry and termination; including testing for ground faults? ® Yes ^ No* Were all tank gauging probes visually inspected for damage and residue buildup? ® Yes ^ No* Was accuracy of system product level readings tested? ® Yes ^ No* Was accuracy of system water level readings tested? ® Yes ^ No* Were all probes reinstalled properly? ® Yes ^ No* Vl-'ere all items on the equipment manufacturer's maintenance checklist completed? r In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): Complete the fnllnwin4 cherklicte ^ Cheek this box if LLDs are not installed. ® Yes ^ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ^ N;A (Check al! that apply] Simulated leak rate: ®3 g.p.h.; ^ 0.1 g.p.h ; ^ 0.2 g.p.h. ® Yes ^ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ® Yes ^ No* Was the testing apparatus properly calibrated? ^ Yes ^ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ® N; A ® Yes ^ No* For electronic LLDs, does the turbine automaticall}~ shut off if the LLD detects a leak? ^ N/A ® Yes ^ No* For electronic LLDs; does the turbine automatically shut off if any portion of the monitoring system is disabled v ^ N%q or disconnected? ® Yes ^ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions ^ NSA or fails a test? ® Yes ^ No* For electronic LLDs; have all accessible wiring connections been visually inspected? ^ NiA ® Yes ^ No* Vb'ere all items on the equipment manufacturer's maintenance checklist completed? - in ine ~ecnon ti, ne~ow, clescr~be how and when these deficiencies were or will be corrected. II. Comments: Cate~ar~~ Ferm S/N nis~exi~exs ~ Rr ~ 'Lri~~tate TafLCaug~ag PrnhP R47'i9(1 1f1Q ~8$~~1 T-4 Waste (ail Annular Tri States [)7d4'i9~-SOS 6 18 5 Pi ~i~n~ Sumg Tri State 0794390-420 11 123 Page 3 of 3 6~te ~~°vss: ~i.~ic1 ~,,.~~n cl D ,~.~ ~33~~- - ~ ~ - ~ ~ ;~ . a. Q: ~; ~ ~~ $ i _ _ - ~ - . _ ~ ~ ~ ~~ ~ ~ ; . ... ~ ... .. f. . ~~~e ~~ ~.~~ ~ ;~~ Wit: ~' 7 _ ~ a° s.~'*- ^„~i `~~w ~2??~~-!-~?~.'sEtSI=, 'vi:'s.2 ~~t.`d ~std_'.~~~ €z, ~2tz_2~T ~SJ:c~? ~s"€€~ €:f~~m9 `vi,~°ti€ p''~ S ~:?V ~dG.~(o~. f~a. 6~..1v`^r.`3.~~ =~xCi.t 3±SV k~~ 'ia'~~J,: x11s J .. '- i p~Q's.~ ~E~~. J _ "~ .. ~'Q'li ~S'~6~iLiE}?7"y 3r ~~u.~ ~~-Q~f~ ~i,~L~. ~c~"_ri,~6s ~~Yf3ui. Qi ~c`t~°~~ ~rt~„ . - =m, ~~ } r ~ '~! ~+_4:`~~' ~.; s,; P~ it~? Q ~3~'1°.4~~ Sdt"SQ=u ~zi=1?,vi; .` 3~'iti~ij~ ~{~.'de`.~,Y:~"~'_~ LF ~I° i.~i€Q`v'«li~~; °v' ' _~! ? =s. ~3~`s .~ ~i~+~€,..- ~_~ ~.e_t. Liu' .rte '~ k +r,~- s:nr~: ~i ii t.:~~'~'~a t'~eF'j;.= C.t~~~~~ teiS~. v_~*_G''~_'_i~- "r L~.t L~ eF.T~13 E1..S4~f' S~: a'~.v'i5~,~..{{3'wi~s~~~ t'cl `.r~9~~L'za4~?' ~%~43~ `3'~'-~?5~~ a:£.,°i."-! t, ~ -- ~~v~~i Qr~~ F'1~ ~v~~ td ~b~~~_~~ L<s-~ 7?1-~~33~ li°~',4 (,1._-Gj. 3~~~E ~diii~.. Ji..~9 r`_3'~~u~vb~ 1Q ibwit ~F«~r~~F /~?- :T~ E.~~°. 4=. .t.i°L ~'~'i~~vSi. F?Qia ~a~"ti +.Sa ~`~, ~f"t~ ~}5-~. ~E.x~? ~'4 ~~ ~ ~~7~,5 e.Sl. SWRCB, January 2006 Spill Bucket Testing Report Form This form is intended for use by contractors perfor{Wing annual testing of UST spilt containment su•zrctz{res. The completed form and pi'Int0lftS fYOin tests(f applicable), shoztld be provided to the facility owner/operator for sztbmittal to the local regulatory agent}%. 1. FACILITY INFORMATION Facility Name: HP Go Go # 930 Date of Testing: 11;13,'06 Facility Address: 3699 Wilson Road, Bakersfield, CA 93309 ~~ i~ Facility Contact: ,~ Date Local Agency Maxine Was Notified of Testing : 11!7/06 Phone: 661-83~-8044 ~I Inspector Steve Underwood City of Bakersfield Fire Dept ;~ ~ Name of Local Agency Inspector (if present during testing): N.%A I~ 2. TESTING CONTRACTOR INFORivIATION ~ Company Name: Red«-ine Testing Services, Inc. ~I ;Technician Conducting Test: Michael Moore is j Credentials': L CSLB Contractor X ICC Service Tech. ~~ SWRCB Tank Tester ^ Other /Spec fi~j ~I ~ License Number(s): 5249074-UT ViR 0060~0~08 3. SPILL BUCKET TESTING INFORMATION Test Method Used: ~ Hydrostatic ^ Vacuum X Other Test Equipment Used: Measuring Tape Equipment Resolution: Mark Height ~~ I Identify Spill Bucket (By Tank Number, Stored Product, etc.) ; 1 T-1 Fill Super i ~ 2 T-1 Vapor Super 3 T-2 Fill Plus 4 T-2 Vapor Plus ii ~ Bucket Installation Type: ~ ~' Direct Bury X Contained in Sum ~ Direct Bury X Contained in Sum ~ Direct Bury ~ X Contained in Sum ~~ Direct Bury X Contained in Sum i Bucket Diameter: 12 12 12 12 Bucket Depth: 16 16 16 16 'Wait time between applying vacuum,!water and start of test: ~ 5 Min 5 Min j 5 Min ' 5 Min . Test Start Time (T~): 1:00 PM 1:00 PM 1:00 PM I 1:00 PM ~ Initial Reading.(R~): 3" 3" j 3" 3" Test End Time (TF): 2:00 PM 2:00 PM ~ 2:00 PM 2:00 PM Final Reading (RF): 3" 3" 3" 3" Test Duration (TF - T,): 1 Hr 1 Hr I Hr 1 Hr Change in Reading (RF - R~): No No No i No Pass/Fail Threshold or ~ Criteria: ~l Test Result:. Pass X Pass ^ Fail ~ Pass ~ X Pass ~ Fail :.:. Pass X Pass; ^ Fail Pass _ i X Pass' : ^ Fail j COmmeritS - (inclz{de information on repairs made prior to testing, and recommended follow-up for failed tests] CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING 1 /:ereby certify t/:at all the information coiztained i~z~~t,hppi~~s,,~~report is true, accurate, and in full con:pliance wit/:legal requirements. "~YI~~ Technician's Signature: Date: ; /- / 3 = ~ ~_ ' State lay+~s and regulations do not currently require testing to be performed by a qualified contractor. Ho«-ever, local requirements may be more stringent. y SWRCB, January 2006 Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of UST spill containrnent structures. The completed form and printouts f •om tests (applicable), should be provided to the facility oiwner/operator for subrnitta! to the local regulatory agency. 1 F e (`TT .TTV TNF(lR M A TT(1N Facility Name: HP Go Go ~ 930 Date of Testing: 1 li 13%06 ~ Facility Address: 3699 Wilson Road, Bakersfield; CA 93309 Facility Contact: Maxine Phone: 661-83~-8044 Date Local Agency V6'as Notified of Testing : 1 1; 7i06 Inspector Steve Underwood City of Bakersfield Fire Dept Name of Local Agency Inspector (f present during testing]: i~l!A ~I 2. TESTING CONTRACTOR INFORMATION Test Method Used: _~ Hydrostatic ^ Vacuum X Other ~i Test Equipment Used: Measuring Tape ~ Equipment Resolution: Mark Height _„ Identify Spill Bucket rBy Tank ,~'utnber, Stored Product. etc.) j' 1 T-3 Pameco Fill Re ular 2 T-3 Pameco Vapor ~ Re ular 3 T-4 CNI Waste ~ Oil 4 ~~ Bucket Installation Type: '~ Direct Bury X Contained in Sum ,Direct Bury X Contained in Sum ^ Direct Bury X Contained in Sum ^ Direct Bury ~~ X Contained in Sump ~' Bucket Diameter: ~ 12 12 12 Bucket Depth: 16 16 16 Wait time bet~~~een applying vacuum,•'water and start of test: ~ Min ~ Min ~ Nlin ~ Test Start Time (TI): ~ 1:00 PM 1:00 PM 1:00 PM i I~ Initial Reading (Ri): 3" ~ 3" 3" li Test End Time (TF): ! i~ Final Reading (RF): ~ 2:00 PM 3" 2:00 PM 3" 2:00 PM 3" I I~ Test Duration (Tr - TI): ~ 1 Hr 1 Hr I Hr ~ II Chance in Reading (RF - R~): No I No No Pass!Fail Threshold or ' Criteria: Pass ~ Pass Pass ~ i ' ~~ Test Result _~ X ;Pass ; ~ Fail ;: _• : X Pass p-Fail X::Pass:: p Fail ^ Pass ^ Fail Ili Comments - (inclz~de if formation on repairs made prior to testing, and recommended follotiv-zip for failed tests] CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I Hereby certify that all flee information contained iee t/:is report is true, accurate, and in full compliance with legal requirements. ~` Technician's Signature: ~ Date: t / - t 3 - ~ U 'State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. 3_ CPTT,T. RTIC'KF.T TFfiTTNG TNFnRMATTnN ;. , REDWIIVETESTIIVG SERVICES, INC. P.O. BOX 1567 ~ BAKERSFIELD, CA 93302-1567 PH (661) 834-6993 Fax (661) 836-3177 Email: redwinetest@prodigy.net MECHANICAL LEAK DETECTOR TEST WORK SHEET W/O#: Facility Name: HP Go Go #-930 Facility Address: 3699 Wilson_ Road, Bakersfield, CA 93309 Product Line Type QPre~_ssur~~ Suction, Gravity) Pressure PRODUCT LEAK DETECTOR TYPE TEST TRIP PASS SERIAL # BELOW PSI OR 3 M T-1 UD TYPE V/R PASS Super SERIAL # 14407 NO YES FAIL T-2 UD TYPE V/R E Plus SERIAL # 11804 NO YES FAIL T-3 UD TYPE V/R YES PASS Regular SERIAL # 16013 NO YES FAIL L/D TYPE YES PASS SERIAL # ~ ._ _ _NO FAIL- - I certify the above tests were conducted on this date according to Red Jacket Pumps field test apparatus testing procedure an limitations The Mechanical Leak Detector Test pass /fail is determined by using a low flow threshold trip rate of 3 gallon per hour or les at 10 PSI I acknowledge that all data collected is true and correct to the best of my knowledge. Tech: Michael Moore 5249074-UT License No. A-532878HAZ HG No. 415 RG No. 5761 , Tank and Pipeline Compliance Experts Testing • Installation • Removal • Closure Monitor and Cathodic Protection Testing Signature: ~ ~~,~~~~, Date:11-13-06 I~ND~RG~_®l3i~aD ST®~ACaE TFliti!€i~ ~ PERFGf?M ELG (f_f~fE TESTING ~i3989 SEGGi~DAt~Y GONTAINNlE~.1tT TESTING "ANKTiGf~TNESS TEST ANG TG PERfcGRI!~ FFfEL fGNfTGP.`i'iG ;/=I_RTfFiGATfGN P~R~.~!I T NO see E~si<1._ ~9~~ , ~ ~ ~ a B~ersfieln, C-~ 933Q' F~~: ,66I) ~~2.-21 ~ ~ ~a~_ , J' I ,~\,~~\ I T .. T I^t i SB-3R9 JG~O.dCARY COti ~ ~ ~ . ~- ~ c r.--fcCTiO~! ~' _~NF -cST'!~iC z. u- i~ c TANK TAG. i P. S TcS i iNrORPv1ATtJl ! ji ~ t -.. Tv ~ ": X3 .. iE 3 C13 itl Aa~._ ... .. [: 'f •l LL~l~T.-f`i(: _. ~~Z~: ti:ti . . ~~ ~ x~ ~~ . _ _. ~ ~ a ~ 0 ~ ~ y ~,~,; , CV~R~ERS 'vAMe iPEa=. ~:" ::?:°_~ ~xT JYS ~ ; yiE _ .,-. ~n ------ ~;iSER Or TRtiKS TO BE f ---- C C N T E N T~ _.-----------= ;I -- - .- - - --- --- - -- - - 7?.NK Ti=S t ING .,O~r~r^ ~l~'Y ---- i~AlSiE i= TESTING CG~'?PAidY - ~ ~! ~~ ~ _ ~ 3 ~ - ! ~ `~ `? S JIAiLiNG ADDPESS ~ ~~ fiIAPJIE & PHONE Nilh7BER OF TESTER GR SP~iAL IidSPECTOR ~d~ ~~ J~ ~~ r ,_ . ~, ~ i - 343 - ~ ~b~~ ` _ .TEST METHGD 'DATE & TIME TEST TO SE CONDUCTED ~~ j~~ ~ J`~_ ~~ SfGNP.TUREG APPLICANT ~ -_ .-~~ATE ~~ ~_,~~ ---------- DAT= ?,P?ROVtD 3Y ~~;~~jF