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HomeMy WebLinkAbout989 Resulsts 1-27-2009 11111111111111111111 67 Ou IE S W RCB,January 2002 Page_1 of 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(if opplicable),should be provided to the facility owner/operator for submittal to the local regulatory agency, 1. FACILITY INFORMATION Facility Name: CnR 1 Date of Testing:/ -3,q Facility Address: 3 J N C Facility Contact: Phone: Date Local Agency Was Notified of Testing: CD Name of Local Agency Inspector(ifpresent during resting): 2. TESTING CONTRACTOR INFORMATION Company Name:RICH ENVIRONMENTAL Technician Conducting Test: Credentials: 3 CSLB Licensed Contractor 0 SWRCB Licensed Tank Tester License Type. C611D40 License Number: 809850 Manufacturer Training Manufacturer Component(s) Date Training Ex ires INCON INCON TS—STS 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Repairs Component Pass Fail Not Repairs Tested Made Tested Made 0 D ❑ - ❑ ❑ r, ❑ o 9 ❑ �/1 ❑ ❑ '�Q D NN O D k 1 Q 1 F111 ❑ D D S RO N 1 ❑ ❑ ❑ ❑ ❑ X D 8�Z S ❑ ❑ ❑ ❑ ❑ D 1 ! Q D ❑ 9/ ,� �i D C ❑ tZ ❑ o ❑ �C ❑ ❑ D U D D f STID o ❑ o Q Q ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ S V o D ❑ D D r., - 1 O D 1 D ❑ ❑ ❑ Q If hydrostatic testing was perfprmed,describe what was done with the water after completion of tests: RECYCLE AND REUSFD_ CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the hest of my knowledge,lie facts stated in this document are accurate and In full compliance with legal requirements Technician's Signatur Date:2-j 1111111 VIII!II IIII 68 IE \C� b c") SWRCB,January 2002 Page Z of S. 4. TANK ANNULAR TESTING Test Method Developed By: ❑Tank Manufacturer :W Industry Standard 0 Profassional Engineer 0 Other(Spec6) Test Method Used. 0 Pressure 9 Vacuum ❑Hydrostatic 0 Other(Spec) Test Equipment Used: 41n. DIAL GAUGE Equipment Resolution: .5% r ft` Tank# Tank4 Tank# Tank# Is Tank Exempt From Testing?' 0 Yes 0 No 0 Yes ONO 0 Yes ONO 0 Yes C No Tank Capacity: Tank Material: Tank Manufacturer: Product Stored: Wait time between applying pressure/vacuum/water and starting test: /\/OT r Test Start Time: Initial Reading(Rj): Test End Time: Final Reading(111): Test Duration: Change in Reading(RF-FQ: Pass/Fail Threshold or Criteria: Test Result, 0 Pass ❑Fail 0 Pass 0 Fail 0 Pass 0 Fail 0 Pass n Fail Was sensor removed for testing? 0 Yes ❑No DNA , 0 Yes ❑No ❑NA 0 Yes 0 No 0 NA 0 Yes 0 No 1'NA Was sensor properly replaced and 0 Yes 0 No 0 NA D Yes ❑No 0 N 0 Yes ❑No ONA 0 Yes 0 No 0 NA verified functional after testing? Comments—(inciude it ormation on repairs made prior to testing, and recommended follow-u or jailed tests) NOT !:ES D t I i(''lp A)ha �tfE 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)1 SWRCB,January 2002 Page)of 5. SECONDARY PIPE TESTING Test Method Developed By: 0 Piping Manufacturer ftl Industry Standard 0 Professional Engineer 0 Other(Spec) Test Method Used: 91 Pressure 0 Vacuum ❑Hydrostatic 0 Other(Specify) Test Equipment Used: 4 i n. DIAL GAUGE Equipment Resolution: .5% Piping Run#g?/ Piping Run# -Z Piping Run# / / Piping Run#9/a Piping Material: PIASTIC EJASTIC PIAS11C I Piping Manufacturer: T C- 1 Piping Diameter: Z 2 Length of Piping Run: T` FT Product Stored: E A Qgft:llum If-164 Method and location of piping-run isolation: t Wait time between applying pressure/vacuum/water and starting test: Test Start Time: Q80 Initial Reading(Rr): Test End Time: Final Reading(Rr): 512si `J I Test Duration: f j / Change in Reading(RF-R,): D Pass/Fail Threshold or O O 1 Criteria: Test Result: PaA 0 Fall ,§ Pass 0 Fall X PasJ 0 Fail ,&Pass 0 Fail Comments—(include information on repairs madeprior to testing, and recommendedfollow-up orfalled tests) SWRCB,January 2002 Page +of 5. SECONDARY PIPE TESTING Test Method Developed By: 0 Piping Manufacturer :l industry Standard 0 Professional Engineer 0 Other(Specify) Test Method Used: Jd Pressure 0 Vacuum 0 Hydrostatic 0 Other(Specify) Test Equipment Used: 4 in. DIAL GAUGE Equipment Resolution: .5% x Piping Run# Piping Run fri Piping Run# Piping Run H Piping Material: 1 C Piping Manufacturer: =1 Piping Diameter: Z Length of Piping Run: Product Stored: Method and location of piping-run isolation: } Wait time between applying pressure/vacuum/water and 2 startin test: J Test Start Time: Initial Reading(Rj): j Test End Time: Final Reading(RF): as I Test Duration: Change in Reading(RF-R): Pass/Fall Threshold or Criteria: Test Result: Pass O Fail ❑ Pass 0 Fail 0 Pass 0 Fail 0 Pass D Fail Comments—(include Information on repairs made prior to testing, and recommended follow-up for failed tests) SWRCB,January 2002 Page of 6. PIPING SUMP TESTING Test Method Developed By: 0 Sump Manufacturer 15 Industry Standard ❑Professional Engineer ❑Other(Specify) Test Method Used: ❑Pressure 0 Vacuum %Hydrostatic D Other(Spec) Test Equipment Used: INCON TS—STS Equipment Resolution- .000fn. Im N�� Sump# - Sump#9 f Sump# Sump# Sump Diameter: 37 ov 33 //J Sump Depth: Sump Material: Fi t Height from Tank Top to Top of Highest Piping Penetration: r IN Height from Tank Top to Lowest Electrical Penetration: Condition of sump prior to testing: 0.5qkj CGF CLEA IV Portion of Sump Tested` f /b Does turbine shut down when sump sensor detects liquid(both [)Yes V No ❑NA 0 Yes .rNo 0 NA D Yes M No ❑NA D Yes ❑No 0 NA product and water)?' Turbine shutdown response time Is system programmed for fail-safe 0 Yes D No )6 NA ❑Yes 0 No X NA ❑Yes D No ,ANA D Yes 0 No DNA shutdown?* Was fail-safe verified to be ❑Yes 0 No k NA ❑Yes 0 No *9NA 0 Yes 0 No IYNA D Yes D No DNA o erationalf Wait time between applying press ure/vacuum/water and starting z,, test: .�Ul-'11 301-11/ ) e30 M/ Tcst Start Time: (pl I p / AM ( i I },q H %SRHI 931 Initial Reading(RO: s.0jq1p4 jy.0?j III &I .344 Lu Test End Time; 102 110 I Z Final Reading(RF): 6,0113,t4 9. IN 5fiftm I 5.9001 4.313, qlf PAJ Test Duration; K 115 15 Ml l N If Change in Reading(RF-R,); t1no/ I IN Pass/Fail Threshold or Criteria. g 2 t . ,002-114 Test Result: R Pass 0 Fail Pass 0 Fail 19 Pass ©Fail ❑ Pass D Fail Was sensor removed for testing? VYes 0 No 6 NA )O Yes ❑No ❑NA IM Yes 0 No ❑NA D Yes D No DNA Was sensor properly replaced and Jk Yes 0 No 0 NA �!Yes 0 No DNA kYes 0 No D NA 0 Yes 0 No DNA verified functional after testis ? COMMC1ttS—(include in ormalion on repairs mode prior to testing and recommended follow-up for ailed tests) If the entire depth of the sump is not tested,specify how much was tested. If the answer to an of the questions indicated with an asterisk(0) is"NO" or"NA",the entire sump must be tested. (See SWRCB LG-160) SWRCB,January 2002 Page 0__of 7. UNDER-DISPENSER CONTAINMENT C TESTING Test Method Developed By: 0 UDC Manufacturer 5a industry Standard 0 Professional Engineer 0 Other(Specty) Test Method Used: 0 Pressure D Vacuum 5 Hydrostatic 0 Other(S ecify) Test Equipment Used: INCON TS—STS Equipment Resolution: .000i n. UDC# UDC# — UDC# UDC# UDC Manufacturer: UDC Material: UDC Depth-. Height from UDC Bottom to Top of Highest Piping Penetration: Height from UDC Bottom to Lowest Electrical Penetration: Condition of UDC prior to testing: Portion of UDC Tested Does turbine shut down when UDC sensor detects liquid(both 0 Yes XNo ❑NA 0 Yes)l No DNA ❑Yes D No O NA 0 Yes 0 No ❑NA product and ter)?* Turbine shutdown resp2nse time Is system programmed for fail- C yes ' O No )d NA D Yes 0 No ANA ❑Yes O No DNA O Yes ❑No ❑NA safe shutdown?' Was fail-safe verified to be 0 Yes 0 No KNA O Yes D No )4 NA 0 Yes ONO ❑NA D Yes 0 No 0 NA operational?* Wait time between applying pressure/vacuum!water and starting test r-1 I ti Mf lU Test Start Time: 121 om 1139 Pm f 2 Initial Reading R, Test End Time: ilapm 1154- / Final Reading RF): J• IN Test Duration; I -Change in Readin F-Rt : f IN OD 1114 D. Pj Pass/Fail Threshold or Criteria: t Test Result: V Pass 0 Fail K Pass Q Fail 0 Pass D Fail 0 Pass D Fail Was sensor removed for testing? Yes 0 No 0 NA I XYes 0 No DNA 0 Yes ❑No 0 NA 0 Yes 0 No 0 NA Was sensor properly replaced and �9 Yes ❑No ❑NA )<Yes Q No O NA 0 Yes ❑No D NA U Yes ❑No ❑NA verified functional after testing? Comments—(include information on repairs made prior to testing, and recommended follow-up forfailed rests) If the entire depth of the UDC is not tested,specify how much was tested. If the answer to a�of the questions indicated with an asterisk M is"NO"or"NA",the entire UDC must be tested. (See SWRCB LG-160) SWRC8,January 2002 Page a of 8. FILL RISER CONTAINMENT SUMP TESTING Facility is Not Equipped With Fill Riser Containment SumE 0 Fill Riser Containment Sumps are Present,but were Not Tested ❑ Test Method Developed$y: 0 Sump Manufacturer 3 Industry Standard 0 Professional Engineer D Other(Spec) Test Method Used: 0 Pressure ❑Vacuum 9 Hydrostatic 0 Other(Spec) Test Equipment Used: INCON TS—STS Equipment Resolution: .000 i n. Fill Sump# Fill Sump# FIII Sump Fill Sump# Sump Diameter: Sump Depth: Height from Tank Top to Top of Highest Pi in Penetration: Height from Tank Top to Lowest Electrical Penetration: Condition of sump prior to testing: Portion of Surnp Tested Sump Material: Wait time between applying pressure/vacuum/water and starting test: Test Start Time: Initial Reading (R,): Test End Time: Final Reading(R F): Test Duration: Change in Reading R R): Pass/Fail Threshold or Criteria: Test Result: 0 Pass 0 Fail 0 Pass 0 Fail ❑ Pass ❑Fail 0 Pass ❑Fail 1s there a sensor in the sump? 0 Yes ❑No 0 Yes ❑No 0 Yes 0 No 0 Yes 0 No Does the sensor alarm when either product or water is 0 Yes 0 No 0 NA D Yes 0 No 0 NA 0 Yes ❑No DNA D Yes []No RNA detected? Was sensor removed for testing? D Yes D No ❑NA 0 Yes 0 No DNA ❑Yes ONO, 0 NA C Yes D No DNA Was sensor properly replaced and 0 yes ONO DNA ❑Yes ONO DNA ❑Yes D No 0 NA 0 Yes 0 No i?NA verified functional after testing? Comments—(include in ormation on repairs made rior to testing, and recommended fbtlow-upf or ailed rests) l SWRCB,January 2002 Page of_ 9. SPILUOVERFILL CONTAINMENT BOXES Facility is Not Equipped With S iwoverfill Containment Boxes D SpilUOverfill Containment Boxes are Present,but were Not Tested 0 Test Method Developed By: 0 Spill Bucket Manufacturer lid Industry Standard 0 Professional Engineer 0 Other(Spec6) Test Method Used: 0 Pressure 0 Vacuum 9 Hydrostatic D Other(Spec) Test Equipment Used: INCON TS-STS Equipment Resolution: .000 . Spill Box#V12R Spill Bo:#1 J77 R Spill Box# Spill Box# Bucket Diameter: 12- 1 t l rZ JAI Bucket Depth: Wait time between applying pressure/vacuum/water and 1 starting test: Test Stan Time: 9( Initial Reading(Ri): 5 Test End Time: /4 Final Reading(RF): 14 5- Test Duration: / t4 Change In Reading(RF-Rj): i rtj -O Pass/Fail Threshold or Criteria. 2 � 2 /tJ Test Result: )v Pass 0 Fail AL Pass 0 Fall 1 0 Pass O Fail 0 Pass D Fail Comments-(include informaticn on repairs made prior to testing, and recommended follow-up for failed tests) 97STP�w DSLSTP 43�'kq TEST STARTED- 10111 AEI 'EST STARTED 9:13 AM TEST STARTED 27/01/2009 'EST STARTED 27/01/2009 BEGIN LEVEL 5.0192 IN EGIN LEVEL 4.3434 IN END TIME 10.27 AM :ND TIME 9:28 AM END DATE 27/01/2009 :ND DATE 27/01/2009 END LEVEL 5.0193 IN COLLEGE HEIGHTS .ND LEVEL 4.3431 IN LEAK THRESHOLD 0.002 IN 3711 MT VERNON EAK THRESHOLD 0.002 IN TEST RESULT PASSED BAKERSFIELD EST RESULT PASSED 27/01/2009 1:36 PP? _ 91STP 91VPR TEST STARTED 10:11 AM SUMP LEAK TEST REPORT TEST STARTED 27/01/2009 1_2 'EST STARTED 9:13 AM BEGIN LEVEL 5.9003 IN FEST STARTED 27/01/2009 END TIME 10:27 AM TEST STARTED 1:21 PM 3EGIN LEVEL 6.0186 IN END DATE 27/01/2009 TEST STARTED 27/01/2009 AND TIME 9:28 AM END LEVEL 5.9001 IN BEGIN LEVEL 1.6094 IN :ND DATE 27/01/2009 LEAK THRESHOLD 0.002 IN END TIME 1:36 PM =ND LEVEL 6.0190 IN TEST RESULT PASSED END DATE 27/01/2009 EAK THRESHOLD 0.002 IN END LEVEL 1.6088 IN TEST RESULT PASSED LEAK THRESHOLD 0.002 IN TEST RESULT PASSED 87VPR TEST STARTED 9:13 AM 91STP TEST STARTED 27/01/2009 TEST STARTED 10:34 AM BEGIN LEVEL 5.1001 IN TEST STARTED 27/01/2009 END TIME 9:28 AM BEGIN LEVEL 5.8999 IN END DATE 27/01/2009 END TIME 10:50 AM END LEVEL 5.0997 IN DATE 27/01/2009 LEAK THRESHOLD 0.002 IN END COLLEGE HEIGHTS TEST RESULT PASSED END LEVEL 5.9009 IN 3711 MT VERNON LEAK THRESHOLD 0.002 IN BAKERSFIELD TEST RESULT PASSED 27/01/2009 1:54 PM DSLS'TP -- _ -� _ ... SUMP LEAP; TEST REPORT 87' TP 1-2 TEST STARTED 9:31 AM TEST STARTED 27/01/2009 TEST STARTED 10:52 AM TEST STARTED 1:39 PM BEGIN LEVEL 4.3430 IN TEST STARTED 2710112009 TEST STARTED 27/01/2009 END TIME 9:46 AM BEGIN LEVEL 5.0295 IN BEGIN LEVEL 1.6085 IN END DATE 27/01/2009 END TIME 11:07 AM END TIME 1:54 PM END LEVEL 4.3441 IN END DATE 27/01/2009 END DATE 27/01/2009 LEAK. THRESHOLD 0.002 IN END LEVEL 5.0287 IN END LEVEL 1.6077 IN TEST RESULT PASSED LEAK THRESHOLD 0,002 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED TEST RESULT PASSED 91 VPR �- TEST STARTED 9:31 AM TEST STARTED 27/01/2009 BEGIN LEVEL 6.0184 IN TEST STARTED 12:27 PEI END TIME 9:46 AM TEST STARTED 27/01/2089 END DATE 27/01/2009 BEGIN LEVEL 3i2.^42 6887 IN END LEVEL 6.0190 IN END TIME PM LEAK THRESHOLD 0.002 IN END DATE 27/01/2009 TEST RESULT PASSED END LEVEL. 3.6877 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED 87VPR TEST STARTED 9:31 AM TEST STARTED 27/01/2009 BEGIN LEVEL 5.1003 IN END TIME 9:46 AM 3-4 END DATE 27/01/2009 END LEVEL 5.0994 IN TEST STARTED 1:04 PM LEAK THRESHOLD 0.002 IN TEST STARTED 27/01/2009 TEST RESULT PASSED BEGIN LEVEL 3.6822 IN END TIME 1:19 PM END DATE 27/01/2009 END LEVEL 3.6821 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED SB989 TESTING FAILURE REPORT SITE NAME: 101)1 IEC l DATE: 2-7-, R-QN-09 ADDRESS•s7 V MT V gLb N TECHNICIAN: SjPl4NL10N MASON CITY: SIGNATURE: ?�J� SITE CONTACT: THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE THE SB989 TESTING. LIST OF PARTSf REPLACED/REPAIRED: REPAIRS: LABOR PARTS INSTALLED: N��