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Home My WebLink AboutUST-TESTING REP. 1/27/2009 SVjV CB,January 2002 1111011 27 Page of � IE 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 (f applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION - Facility Name: Chevron#98109 Date of Testing: —Q Facility Address: 1131 Oak St. Bakersfield, CA 93304 Facility Contact: Phone: Date Local Agency Was Notified of Testing: Name of Local Agency Inspector(rf present during testing): Repair/Retest 2. TESTING CONTRACTOR INFORMATION Company Name: Belshire Environmental Services, Inc. Technician Conducting Test: u ( Cc Credentials: ® CSLB Licensed Contractor ❑SWRCB Licensed Tank Tester License Type: A-General Engineering Contractor License Number: 808313 Manufacturer Training Manufacturer Component(s) Date Training Expires Available upon request 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Repairs Component Pass Fail Not Repairs Tested Made Tested Made Tank Annulars ❑ ❑ 0 ❑ ❑ ❑ 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ 0 ❑ Secondary Pipe ❑ ❑ 0 ❑ 0 ❑ 1 ❑ Turbine Sump J4 ❑ 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ UDC ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Fill Sump ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Spill Bucket ❑ ❑ ❑ 0 0 ❑ 0 ❑ El ❑ ❑ ❑ El El If hydrostatic testing was performed,describe what was done with the water after completion of tests: T ' 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 Technician's Signature: q�,0_Aj Date: z — o 1 1111111 IIIII III IIII 28 IE SWRCB,January 2002 Page of 1' 5. SECONDARY PIPE TESTING Test Method Developed By: ❑ Piping Manufacturer ID Industry Standard ❑ Professional Engineer ❑ Other(Spec) Test Method Used: ® Pressure ❑ Vacuum ❑ Hydrostatic ❑ Other(Spec) Test Equipment Used: Test reducer boots,air compressor and gauges Equipment Resolution: 0.5%of span Piping Run# Piping Run# Piping Run# Piping Run# Piping Material: banit rss Piping Manufacturer: /*- Sf4i Piping Diameter: `3 Length of Piping Run: 4/p Product Stored: 89 91 D Other 87 89 91 D Other 87 89 91 D Other 87 89 91 D Other Method and location of Reducer i in -run isolation: Reducer Boots/Fittings Reducer Boots/Fittings Boots/Fittings Reducer Boots/Fittings. Wait time between applying pressure/vacuum/water and 10 minutes 10 minutes 10 minutes 10 minutes starting test: Test Start Time: Initial Reading(Ri): .�- Test End Time: d UO ` ~ Final Reading(RF): .� Test Duration: Change in Reading(RF-Rj): Pass/Fail Threshold or No detectable Loss No detectable Loss No detectable Loss No detectable Loss Criteria: 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 Page of v , 6. PIPING SUMP TESTING Test Method Developed By: ❑ Sump Manufacturer ® Industry Standard ❑ Professional Engineer ❑Other(Specify) Test Method Used: ❑ Pressure ❑ Vacuum ® Hydrostatic ❑ Other(Spec) Test Equipment Used: Incon Sump Tester Equipment Resolution: +/-0.002" Hnow- Sump# 2ie3d Sump# Sump# Sump# Sump Diameter: " Sump Depth: 20 " Sump Material: p f A tass, Height from Tank Top to Top of - , Highest Piping Penetration: Height from Tank Top to Lowest O Electrical Penetration: Condition of sump prior to testing: 0 v Portion of Sump Tested' Does turbine shut down when sump sensor detects liquid(both ❑ Yes❑No ®NA ❑ Yes❑No ®NA ❑Yes❑No®NA ❑ Yes❑No ®NA product and water)?* Turbine shutdown response time N/A N/A N/A N/A Is system programmed for fail-safe ❑ Yes❑No ®NA ❑ Yes ❑No ®NA ❑ Yes❑No N NA ❑ Yes❑No ®NA shutdown?" Was fail-safe verified to be ❑ Yes ❑No ®NA ❑Yes ❑No ®NA ❑ Yes❑No®NA ❑ Yes❑No ®NA o erational?` Wait time between applying pressure/vacuum/water and starting 30 minutes 30 minutes 30 minutes 30 minutes test: Test Start Time: y A4 Initial Reading(Rj): `3. acj 3, Q Test End Time: e?l� ' Final Reading(RF): 3 b 3, ) Test Duration: 15 min. 15 min. 15 min. 15 min. 15 min. 15 min. 15 min. 15 min. Change in Reading(RF-Rj): oo , Q00 " Pass/Fail Threshold or Criteria: +/-0.002" +/-0.002" +/-0.002" +/-0.002" Test Result: Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail Was sensor removed for testing? 0—Yes ❑No ❑NA ❑Yes❑No ❑NA ❑ Yes❑No ❑NA ❑ Yes❑No ❑NA Was sensor properly replaced and yes❑No El NA ❑ Yes ❑No El NATO Yes❑No ❑NA ED Yes❑No ❑NA verified functional after testing? Comments— (include information on repairs made prior to testing, and recommended follow-up for failed tests) Sensor functionality was not confirmed. This procedure is not part of the Secondary Containment Testing scope of work. If the entire depth of the sump is not tested, specify how much was tested. If the answer to aM of the questions indicated with a asterisk(*) is"NO"or"NA",the entire sump must be tested. (See SWRCB LG-160) SWR.CB, January 2002 Page of r' 7. UNDER-DISPENSER CONTAINMENT C TESTING Test Method Developed By: ❑ UDC Manufacturer ® Industry Standard ❑ Professional Engineer ❑ Other(Specify) Test Method Used: ❑ Pressure ❑ Vacuum ® Hydrostatic ❑ Other(Spec) Test Equipment Used: Incon Sump Tester Equipment Resolution: +/-0.002" UDC# UDC# UDC# UDC# UDC Manufacturer: orf UDC Material: - UDC Depth: '3 6 Height from UDC Bottom to Top of Highest Piping Penetration: /0 " Height from UDC Bottom to Lowest Electrical Penetration: Condition of UDC prior to Q �Q testing: J Portion of UDC Tested Does turbine shut down when UDC sensor detects liquid(both ❑ Yes❑No ®NA ❑ Yes ❑No E NA ❑ Yes.❑No M NA ❑ Yes ❑No ®NA product and water)?* Turbine shutdown response time N/A N/A N/A N/A Is system programmed for fail- ❑ Yes ❑No ❑NA ❑ Yes❑No ❑NA ❑Yes❑No ❑NA ❑ Yes❑No ❑NA safe shutdown?` Was fail-safe verified to be ❑ Yes❑No ❑NA ❑ Yes❑No ❑NA ❑ Yes❑No ❑NA ❑ Yes❑No ❑NA operational?* Wait time between applying pressure/vacuum/water and 30 minutes 30 minutes 30 minutes 30 minutes starting test Test Start Time: t Initial Reading(111): c(. 'LOI .2.515 Test End Time: Final Reading RF): y. 26/ 2io1 Test Duration: 15 min. 15 min. 15 min. 15 min. 15 min. 15 min. 15 min. 15 min. Change in Reading(RF-R,): —.bbo Pass/Fail Threshold or Criteria: +/-0.002" +/-0.002" +/-0.002" +/-0.002" Test Result: K-Pass ❑Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail ❑ Pass ❑ Fail Was sensor removed for testing? QLYes❑No ❑NA ❑Yes 0,No ❑NA ❑ Yes❑No ❑NA ❑ Yes❑No ❑NA Was sensor properly replaced and verified functional after testing? IYes❑No E]NA ❑ Yes ❑No E3 NA ❑ Yes [I No ❑NA ❑ Yes❑No ❑NA Comments— (include information on repairs made prior to testing, and recommended follow-up for failed tests) Sensor functionality was not confirmed. This procedure is not part of the Secondary Containment Testing scope of work. If the entire depth of the UDC is not tested,specify how much was tested. If the answer to aM of the questions indicated with an asterisk(*)is"NO"or"NA",the entire UDC must be tested. (See SWRCB LG-I60) SW,ZCB,January 2002 Page of 9. SPILL/OVERFILL CONTAINMENT BOXES Facility is Not Equipped With Spill/Overfill Containment Boxes ❑ Spill/Overfill Containment Boxes are Present,but were Not Tested ❑ Test Method Developed By: ❑ Spill Bucket Manufacturer ® Industry Standard ❑ Professional Engineer ❑Other(Spec) Test Method Used: ❑ Pressure ❑ Vacuum ® Hydrostatic ❑Other(Spec) Test Equipment Used: Incon Sump Tester Equipment Resolution: +/_0:002" Spill Box# F& Spill Box# Spill Box# Spill Box# Bucket Diameter: a '` Bucket Depth: Wait time between applying pressure/vacuum/water and 30 minutes 30 minutes 30 minutes 30 minutes starting test: Test Start Time: Initial Reading(R,): 3 , S t Test End Time: Y .3; Q7 Final Reading(RF): 3. < 1 , 3130- Test Duration: 15 min 15 min 15 min 15 min 15 min 15 min 15 min 15 min Change in Reading(RF-R[): _0.0 UOOZ Pass/Fail Threshold or +/-0.002" +/-0.002" +/-0.002" +/-0.002" Criteria: 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) BELSHIRE r NVIRONMFNTAr I SERVICES, INC. 2,1971 Towne Centre Dri e, Foothill Ranch, CA 92690 Tel. (949)460-5200 Fax. (949)460-5210 TRANSMITTAL Date: 2/5/2009 To: Steve Underwood Bakersfield Fire Dept. 1500 Truxtun Ave Bakersfield, CA 93301 From: Shawna Chambers Sent Via: UPS Ground Tracking#: 1ZF834R60398911280 Re: Secondary Containment Test CHEVRON#98109 1131 OAK ST BAKERSFIELD, CA 93304 The following test report(s)are included: Secondary Containment Test performed on 1/27/2009. Comments: Please do not hesitate to call me at(949)460-5200 if you have any questions or concerns regarding this work. Tiown nager