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• SWRCB,January 2002 Page of 1--
Secondary Containment Testing Report Form
This form is intended for use by eomractorsperformingperiodic testing of USTseeondry containment systems. Use the
appropriate pages of this form to report:results for.all'components tested The completed form,writtenlestprocedures,and
printouts from tests(if applicahle),;should be provided:to the facility ownerloperator for submittal tothe local regulatory agency:
1.. ,FACILITY INFORMATION.
I.Facility Name: STOCKDALE;MOBIL#2 Date of Testing: 11-.18-10
Facility Address: 5401 STOCKDALE HWY—BAKERSFIELD CA 93312
Facility Contact: FONG..CHAO Phone: 661-832-9928
Date Local Agency Was.Notified of Testing:ERNIE MADINA
Name of Local Agency
Inspector(t`present during testing):
1. TESTING CONTRACTOR INFORMATION
Company Name: Rich Environmental
Technician Conducting Test: RICH,PHILLEPS
Credentials: X CSLB Licensed.Coniractor Q SWRCB Licensed Tank Tester
License Type: C61/D40 A HAZ License Number:; 809850
Magyfactumi Training
Manufacturer Component(s) bate Tmining Expires
INCON 6-11-12
3. SUMMARY OF TEST RESULTS
Component Pass Fail Not. Repairs Component Pass 'Fsil Not Repairs
T Made : Tested .Made
DIESEL PILL BUCKET' X ❑ J X ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ❑ ❑ o
❑ ❑ o ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ' ❑ [1 ❑
❑ ❑ ❑ ❑. ❑ 0 ❑
If hydrostatic testing was performed,describe what was done with the water after completion of tests.
TESTED AFTER REPAIRS
CERTIFICATION OF TECHNICIAN RESPONSEBLE FOR'CONDUCTING TMS,TESTING
To tke:bW of my knowledge,tkefaets,stated document,are accurate and In full cdmpAdnce;wilh.legal requirements
Technician's Signature: Date: l 1-18-10
Illlillllllll►IIIIII 04
1E
~ SWRCB,January 2002 Pagel,a Z
9. SPH.UOVERFILL CONTAINMENT BOXES
Facili is Not With S ill/Overf ll Containment;Boxes Q
SpilllOverfll ON"imnent:Boxes are.Prese%but wereNof Tested :U
Test Method Developed:By: D:Spi111 Bucket Manufacturer X Industry Standard 0 Professional Engineer
U Othe''(Spe#y)
Test Method Used: pPressure q Vacuum X Hydrostatic
J.0ther(Specify) .
Test Equipment Used: INCON Equipment Resolution:. 0.002
Spill Box#DIESEL Spin Box# Spill Boz# Spill Box#
Bucket Diameter. 14"
Bucket Depth: 12
Wait time between applying
pressurelvacuum/water:and 30MINS 30MINS 30MINS 30MINS
test:
Test Start Time: 1:07 PM 1:23'PM
Initial Reading-(Rt) 4.5741 4.5741
Test End.Time: .1:22 PM 1:38 PM
Final Reading.(R£): 4.5741 4.5741
Test Duration: 15MINS 15M MS 15IvIINS 15MINS 15KWS 15MINS. 15MINS 15MINS
Change in Reading
Pass/Fait Threshold or .002IN: .0021N .0021N .002IN .(WIN .002IN .002IN .0021N
Criteria:
COMMOAs (include in ormatioh:on repairs made prior to testing, and recommended_follow-up for.failed tests)
TESTED AFTER INSTALLATION OF NEW BUCKEL
1
C
MOBIL
5402 STOCKDALE HWY
BAKERSFIELD CA
i]11.8i201b 1:22 PM
Si BHP L;ERK TEST REPORT
USL FIL
'T,EST;STARTED i;;g7 P!9
TEST STARTED ili18s2010
BE031N LEVEL 4.5747 IN
END TIME X1::22 Pht.
END DATE ] .]8
END 'LEVEL 4;;5741 IN
LEAK THRESHOLD 0.:092' IN.
TEST RESULT pAD
MOBIL
5401 'STOCKDALE :HW..y
BAKERSFIELD CA
1`1iI$f2016 1:38 PH
SUMP LEAK TEST'REPORT
DSL .F-IL
TEST STARTED ItZ PH
TEST STARTED 1.4x/2918
BEGIN LEVEL. 4.5741 IN
END TIME i:38 PM
END DATE. �1I�1291A
EN
D'LEVEL 4.5741, IN'
LEAK THRESHOLD 0'.002. IN
TEST RESULT' PASSED.
SB989, TESTING .FAILURE REPORT
SITE NAME: STOCKDALE MOBIL#2 DATE: 11-1&10
ARLRE.
5401 ST KDALE:HWY TECEM IAN: RICH P96ms
CITY: BAKERSFIELD,CA 93312 SIGNATURE:
THE FOLLOWING COMPONENTS WERE REPLACED/RFPAIRED TO COMPLETE
TESTING.
REPAIRS: '�'' �
LABOR: 1`'L'
PARTS INSTALLED•
NAME: TIT LE:
SIGNATURE•
THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING
THE APPROPRIATE PARTY TO HAVE CORRECTrVE ACTION TAKEN TO REPAIR
THE ABOVE LISTED-PROBLEMS AND NOTIFYING RICH:ENVIRON AANTAL FOR
ANY NEEDED RETESTING::THIS ALSO RELEASESRICH ENVIRONMENTAL OF
ANY FINES OR PENALTIES OCCURING FROM NON=COMPLIANCE.
A COPY OF THIS DOCUMENT HAS BEEN LEFT,ON.SITE FOR YOUR
CONVIENENCE.