HomeMy WebLinkAbout2010 SPILL BUCKET IIIIIIIIIIIIIIIIIIII 53
IE SWRCB,January 2006
Spill Bucket Testing Report Form
This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form 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: #360 Farrell's Fastrip Date of Testing: 09/24/2010
Facility 6401 White Lane,Bakersfield,CA 93309
Facility Contact: Omero Garcia I Phone: 661-393-7000
Date Local Agency Was Notified of Testing: 8/27/2010
Name of Local Agency Inspector(fpresent during testing): Ernie Medina
2. TESTING CONTRACTOR INFORMATION
Company Name: Confidence UST Services, Inc.
Technician Conducting Test: Bryan A Self
Credentials: N CSLB Contractor 0 ICC Service Tech. ❑SWRCB Tank Tester ❑Other(Spec)
License Number(s): CSLB# 804904 ICC# 8022804-UT
3. SPILL BUCKET TESTING INFORMATION
Test Method Used: El Hydrostatic ❑Vacuum ❑Other
Test Equipment Used: Lake Test Equipment Resolution: 0.0625"
Identify Spill Bucket(By Tank 1 Diesel Fill 2 3 4
Number, Stored Product, etc.)
Bucket Installation Type: ❑Direct Bury ❑Direct Bury ❑Direct Bury ❑Direct Bury
❑x Contained in Sump ❑Contained in Sump ❑Contained in Sump ❑Contained in Sum
Bucket Diameter: 13.00"
Bucket Depth: 11.00"
Wait time between applying 5 Min.
vacuum/water and start of test:
Test Start Time(Tj): 10:45 am
Initial Reading(Ri): 10.00"
Test End Time(TF): 11:45 am
Final Reading(RF): 10.00"
Test Duration (TF—Tj): 1 Hour
Change in Reading(RF-Ri): 0.00"
Pass/Fail Threshold or 0.0625"
Criteria:
Test Result i
_ 7' '� C'= t t nr
® }Pass '❑Fail ❑.Pass ❑�Fa z : ❑ Pass ❑Fa�lw �❑ Pass ❑=Fal.
Comments— (include information on repairs made prior to testing, and recommended follow-up for failed tests)
CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING
I hereby certify that all the information contained in this report is true, ccurate,and in full compliance with legal requirements.
Technician's Signature: Date: 9/24/2010
' State laws and regulations do not currently require testing to be performed by a qualified contractor.However, local requirements
may be more stringent.
IIIIIIIIIIIIIIIIIIII 54
IE
r
0O
4 Owe*
uS t
Invoice No: 24440B
xr
While retesting the diesel spill bucket we also had to change the diesel swivel.
�7 Ada " Re uiredRe airs:
,Comments
�.
Updated 04/19/06 TATT Team
i
Us
!,
•CQVhJAMLE MTO COMilocu". Invoice No.: 24440
Site: #360 Farrell's Fastrip
6401 White Lane
Bakersfield, CA 93309
Repairs completed: I first opened up the diesel fill sump and changed the
fill S.B. While I was changed the S.B. I realized that there was no gasket on the
swivel adaptor and that it was not turning so I replaced the swivel adaptor.
Required Repairs, Still Pending:
Technician Name: Bryan A Self
Signature: �
-� �
Date: 8/27/10