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ARCOd Petroleum Productr 'ompDivision of A a y ;; Tan end Piping Leakage Report <br /> Address County <br /> Region Fades num r WLD <br /> CA ❑ CD <br /> Ok <br /> 1. On the diagram, mark an "X" i`: I I r ' �• Indicate <br /> at the exact location of leak point(s).If <br /> :k <br /> the tank was leaking and the fill was approximate <br /> ground water <br /> not at the center of tank,sketch its �l I line <br /> location on the dagrarn. <br /> 2. Report of spillage(A.R.CO:960-1)submitted? 3. Disposition of leaking equipment <br /> F l K�� ��`i <br /> ❑ Yes O No It"yes,"date ❑ Replaced ❑ Abandoned ❑ Interior-coated Other(specify) �lFt�uC� rZ� 12 <br /> 4. Type of backfill <br /> ❑ Sand ❑ Soil )R(Peagravel ❑ Crushed stone ❑ Other(specify) <br /> 5. Product grade 6. Was leak iq a weld? <br /> ❑ ARCO ❑ ARCOsupreme ARCOclear C3 Other(specify) ❑ Yes No <br /> 7. Cause of leak FA t�{Z� � � P 2 t�I Z <br /> ❑ Corrosion hole ❑ Loose fittinglplug C3 Flex connector failure C1 Physical breakage Other(specify) <br /> 8. Was foreign material(clay,cinders,wood,etc.)in contact with leak point? <br /> Q Yes (aescribe) No(describe) ❑ Unknown <br /> 9. How was leak detected ❑ Water in tank ❑ Tank/fine test ❑ Product or vapors in buildings,wells,sewers,etc. Date detected/time <br /> ❑ Inventory shortage I?`,��Leak detector ❑ Other(specify) <br /> A. If tank was leaking,complete the following <br /> 4Vnk age 11. Tank capacity 12. Tank diameter <br /> year(s) gallons <br /> 13. Type of tank Steell Steel/impressed <br /> ❑ Steel ❑ Fiberglass(FRP) ❑ sacrificial anodes ❑ current cathodic protection ❑ SteeWnterior coated ❑ Steel-exterior coated <br /> 14. Was tank equipped with fill(drop)tube? <br /> ❑ Yes ❑ No If'"yes,"was leak beneath tube? ❑ Yes © No <br /> 15. If tank failure was due to corrosion,what type of oorrosion had occurred? <br /> ❑ External ❑ Internal ❑ Both ❑ Unknown Note: Mark"Internal"or"both"only if tank was entered or opened following excavation <br /> B. If pipe was leaking,complete the following <br /> 16. Pipe age 17.Type of pipe Steellimpressed current 18. Type of pumping system <br /> ,4_1S year(s) ❑ Steel Fiberglass(FRP) ❑ cathodic protection ❑ Suction Submerged(remote) <br /> 19. Was the system equipped with a leak detector <br /> XYes ❑ No If"yes,"did it activate JYes ❑ No If"no,"was new leak detector installed? ❑ Yes ❑ No <br /> Briefly describe work done correcting leak and cost,including disposition of other tanks and piping, (l.e.,replaced three steel 4,000-gation tanks with <br /> three FRP 10,000-gallon tanks,installed leak detectors). <br /> 4#- ,�e� 1 <br /> C41� - - <br /> l Product Contractor Material Mechanic's time Total <br /> cost $ $ $ $ $ <br /> Signature C&M Engineer-date Date problem secured <br /> Distribution:(1)--Retail Facilities Manager,(2)—Environmentai Engineer—Los Angeles,(3)—C&M Engineer <br /> A.R.CO.960-C (6-64) <br />