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u <br />• <br />OCT 2 0 2004 <br />LAKE TEST PROTOCOL <br />PIPINGS SUNDER DISPENSER CONTAINMENT SUMPS <br />BUSINESS NAME: Mad -e '�J f}/y 1 ((w6m ) <br />LOCATION/ADDRESS: <br />PHONE/FAX: 0209-0 - <br />OWNER/OPERATOR NAME: <br />SCHEDULED TEST DATE: <br />PERMITTINC <br />INSPECTOR: <br />3(11:2 <br />PHONE: FAX: OW- W-999 �16 - 3% .� <br />Wright Environmenal Services, Inc. <br />General Contractor, Lie. No. 651501 A, B, Haz Mat <br />Ph 209-833-0758 Fax 209-832-5152 <br />1. Clean sump of all loose debris and other material <br />® Separate "initial wash water" from "test water" in labled and separate 55 -gal. <br />drums <br />2. Inspect all penetrations into sump for damage, repair and reseal as required <br />I Raise and anchor sump leak detection sensor to top of highest penetration fitting such <br />that leak detection system will continue to operate while 24-hour lake test is underway. <br />If sensor cannot be raised and there is inadequate freeboard within the sump above the <br />highest penetration to contain potential leaks while dispensing systems continue to <br />operate then the station must: 1). discontinue operation during testing, 2). discontinue <br />operating those dispenser sumps that are being tested (partial shutdown) <br />4. Fill sump with tap water to above the highest product penetration <br />5. Allow water to stabilize for only a few minutes <br />6. Record date and time on sump wall, cover or dispenser cover with permanent marker <br />7. Mark water level using upside down marking paint (one location 6" long) <br />8. Cover sump with sump cover or close dispenser access panels <br />9. Uncover sump 24-hrs later and remark using upside down marking paint cover one half <br />of previous mark to contrast any change in water elevation <br />10. Remove all water from sump (see No. 1 above) <br />11. Record any change in water elevation in inches or fraction thereof <br />Any change of water depth that allows greater than !4 inch of water loss indicates a failure in <br />the test. RECORD ALL TEST INFORMATION AND NOTES ON REVERSE OF THIS <br />FORM. <br />.NOTE <br />Vert& that conduit penetrations are not lower than highest product line penetration(s) tconduits do not seal). If <br />such a condition exists, seal conduit fittings and penetrations with jitel compatihie sealant iBOSTIC; prior to <br />the test! NEVER DISABLE THE LEAK DETECTION SYSTEM! <br />Rev 11-26-02 LAKE TEST PROTOCHOL <br />