HomeMy WebLinkAbout12727 003964 101 12-22-2020 LDLTTEST SLA LINE AND LEAK DETECTOR TEST 53446.51 LDLTTEST
DRAFT ADEM
AUTOMATIC LINE LEAK DETECTOR (ALLD)and LINE TIGHTNESS TEST REPORT
Facility Name 11 Owner:
Address: Address:
City.
it Count ,Zi : tr d C' State Zip:
Facili I.D.#: — ,9 — Phone#:
Tester Name:Christopher Hod Dempsey Tester Phone#:205-339-3536
Tester Certification: Estabrooks Ezy Chek Certification Ex iration: 03/ 31 12MI
Tester Company:oualiry rank Testing Test Date: - 22- ZO
Instructions
1. Submit this form,attach all test data for every last performed and submit a completed copy of this form to: Groundwater Branch,PO
Box 301463,Montgomery,AL 36130-1463,or fax to: (334)270-5631.at email to: USTcomoliancetaadern alae ma.aov. This form
must be completed and Included with the test data or the submittal will not be accepted.
2. This form allows up to 6 ADEM Unique Tank Numbers,assuming that the Facility ID Number and last equipment remain the same.
3. Testing must be performed in accordance with a nationally recognized code of practice(such as PEI RP-1200 or equivalent)or the
manufacturer's instructions.
4. Line tightness test equipment used must be approved by ADEM. Visit the NVVGLDE websae at www.mwclde.om to view a list of
release/leak detection squipmentimethods that ADEM approves for use in Alabama.
5. Automatic Line Leak Detectors are designed to be tested in-place. Do not remove and test outside of the tank system.
6. Keep a copy of this testing for 3 years. Questions on how to complete this form should be directed to the Groundwater Branch,UST
Compliance Unit at(334)270-5655.
Type of Test Performed-check all that apply: aromatic Line Leak Detector(ALLD) ne Tightness Test
Reason for Test-check all that apply: nnual Test ONew Installation ORequired by ADEM Enforcement Action
Manufacturer of ALLD Test Equipment VMI I Model or Version:LDT890
Manufacturer of Line Tightness Test Equipment Estabrooks Ezy Chalk Malec or Version:Manuel Test
ADEM Unl ue Tank#
Product Stored
,iihiberglasts berglass rglass Dfiberglass Dfibergiass Ofiberglass
Piping material Ofiexible Elfie>able Oflexible Ofiexiloe 011emble Ofiebble
Osteel Osteel Osteel Osteel Osteel Osteel
Approx. length of piping /
nun tested ineseselt foot
Piping capacity
(gallons) `Zdd 74D
Automatic Line Leak Detector Test
Type of ALLD echanical echanical mechanical Omechanical Omechenical Omechanical
Oelecbonic Deledronic Oelectronic Oelectronie Oelectronic Oelectronic
Line pressure
during ALLD test i
Measured ALLD leak rate
(gp h J rZ 3 3
Results of ALLD test f7011 Ofail s O s fail Dpa [fall Opals Ofail Doses [fail
Opals Effie" Oinconelusive Oincoalushe Dineonelusive [inwnelsive Oinwnelusive
Line Tightness Test
Line pressure ✓,1 Tl.
during Tine Lest i
Measured line leak rate 6 A
(gph) (/
Results of lino Drell Ofail pas Ofall Opens; Ofail [pass Died Opals Ofail
ti htness test "On.-inclusive Dinconclusive I Oinconclusive Oinconclusive I Oincatclusive OinconGusive
Repairs Needed Dsteof Repair Description of any Relative
Tester's Signature:
ADEM Form xaa(new torn)
Quality
Cathodic,Tank&Line Testing
PO Box 1457
Northport,AL 35476
Ph: (205)339-3535
DATE: I/ -22
ESTABROOK'S EZY CHEK TEST SITE: { fivd
1 ruz r- q
PRODUCT LINE TESTER ADDRESS: 9Z G t 3G/O�
TEST RESULTS TESTER NAME: Christopher(Hody)Dempsey
CERTIFICATION#: AL 69-0691
APPUED PRESSURE: SO PSI
PRODUCETYPEORTANKIF. (FJ PRODUCT TYPE OR TANK K:
TIME D T /+ GPL RES GPH TIME i D' ^A,TA /+ GPL RES GPH
D �f .0037 ^ 6 /OAS 0 .0037 O o
.0037 _Q Q /, D YD .0037 -5
.0037 _� //�/� ,70 O .0037 0 _p_
_ .0037 .0037 _
.0037 .0037
.0037 .0037 -
Final ResukArf5 Final Result: Cl S.S
PRODUCTTYPE ORTANK C: PRODUCT TYPE OR TANK a:
TIME DATA -/+ GPL --REERSS- GPH TIME DATA -/+ GPL RES GPH
ArOy�lA-xS .0037 _(L .0037 -
I 2101) .0037 Q .0037 -
_ .0037 .0037 -
_ .0037 .0037 -_
.0037 .0037
Final Result: Final Result:
PRODUCTTYPE OR TANK n: PRODUCT TYPE OR TANK R:
TIME DATA -/+ GPL RES GPH TIME DATA -/+ GPL RES GPH
_ .0037 .0037
_ .0037 .0037 _
_ .0037 .0037
_ .0037 .0037
_ .0037 .0037
.0037 .0037
Final Result: Final Result:
Quality
Cathodic, Tank& Line Testing
PO Box 1457
Northpon,AL 35476
Ph: (205)339-3535
DATE: /12 —` Zr ZO
VMI LDT 890 TEST SITE:
LEAK DETECTOR ADDRESS:
TEST RESULTS
TESTER NAME: Christopher De sev
CERTIFICATION#:
TEST REPORT INDICATES
TYPE OF LEAK DETECTOR TESTED
PUMP# IVAKE MODEL SERIAL
SERIAL#
2
3
4
5
6
7
8
FUNCTIONAL TEST LEAK
ME
TERING ETERING ELEMENT DATE OPENING PASS
PUW ft TYPE PRESSURE HOLDING PSI RESILIENCY M IN TIME FAIL
1 PA 2G �40 189m1 J Q.S.5 2 (/J G�
�Gry cQ 189.1 3
3 ese Zg g zoo 1119.1 3
4 189.1
$ 189.1
6 189 1111
7 189.1
8 199.1