HomeMy WebLinkAboutstorage tanks 2007APPLICATION FOR PERMIT
To Maintain an Existing/l'lew Storage Tank Facility Regulated under 527 CMR 9.00
To: Head ol Fire Departmenl City, town or district:YARMOUTH Date: 10/24 / o'7
Application is hereby nade lor a permit to maintain an existing/new slorage tank lacility as required by S27 CMR 9.00:
Location of property : 475 ROLITE 5A YA.RMO(I?HPORT
Owner oJ property:GETTY PETROLEIIM MARKETING, INC
Ful n8/nc ol @rcon, fi,,n u cot@Glioo
Number ol storage tanks: _ aboveground. 2 underg
Signature ol own€r or authorized iepresentative:
Fee paid: $(M.G.L. Chqpter 148, section 1OA)
(Fire Oepatlment's iopy - To be liled with FP-290)
20.00
q.
. Make application to local Fire Oepartment,
DO NOT make applicatlon to Department o, Flre Services or Stato Flre Marshal.gf "V".-rr"^-""/d"/ezl/a,tAa"a@"/*,a,*rt 4&* e7-r,;*" @tr"* "/il. o7an &i,* o/{r.l-l
@
@
tUKOIt Getty
GETTY PETROTEUM TnARKETING lNC., o subsidiory ol LUKOIL Oil Cohpony
Oclober 29, 200'7
Yarmouthport Fire Department
F'ire Prevention Officer
96 Old Main Street
So. Yarmouth, MA 02664
Doar Firc Prcvcntion Ofilccr,
RE: Getty Station #30635, 476Main Street, Yarmouthport
Please find enclosed renewal application for Permit to Maintain Storage Tanks along with
a check for $20.00 for the above referenced location in your district. Upon your review
and subsequent signing ofsaid form, please forward to me in the self-addressed, postage
paid envelope, which I have provided. Upon receipt I will promptly forward a copy to
the location for posting, a copy to the State Fire Marshall's office and retain the original
in our files
Thank you for your assistance. Ifyou should have any question please give me a call at
(800) 289-4388, ext. 10.
Sincerely,
Terry fr
Engineering Department
Enclosure
PO. Box I 590 r Portlond, ME 04104 r Tel: (207) 799-85I I
d\
W Notification for Storage Tanks Regulated Under 527 CMR 9.OO
Forward comdeted torm, slgned by local flre d€partrnent, to: lVtas s" IJST Proqdm, Dept.
ol Flre Serulces, P.O. Box 1025 - S-tate Boad, S,'oW MA 01775
Use Form FP-2908 to notify ol tank removals or closures in placo.
Telephone (978) 567-3710
(Fl16 Department retains one copy ot FP-290)
Dat6 Recelved:
I A. New Facility (soo instructions, +1) ! B. Amended E C. Renewal
accaptable, end wltr cal,8e a ,€gl8tratlon to b€ roturned. tl leogrsphtc tocatton ol tactlity t. not Fovldrd, pl€ase lndlcaladlllance end dll6ctlon lrom.closelt lnlorso6{on, s.!., (tac{ity ar 1S€ Nofi 6ts€t L locit6O ali! y!rd. ;;urherlr orcllI0m.0!-Bg$t (nh6.cton).
B. Dat€ Entsrod
C. Clelk's lnitials
O, Comments
A. Facility Number
EXCAdhni (!) ! lsrm or rBsHentlrl lenk ol 1,1m Aaions or l€ls cspadtv usod lor slorlm mobrfuBllornoncommorchlpoeos€3,or(b).t nk usrd lor rrorln! h.!tl;E o tor con.u;D v.ll.. on tha pr.ml!.a lvhon rtorod am not rrqulrcd to bc rcglat!.!d und€r E2z cM R 9.oO,
E!0gliqs'fury own€r who lclowlrEly lelb to muly or submls latse tntormauoo sha[ b€ subl€ctto a dvll penelly mt lo €xco€d $25,000 lor €edl lank ,or wtrch rbtltlcatlon ts mt otusn d tor
whlch hl!€ tnlormatton ls rlbrniBod. (MGL Chaptor 148, s€cion 3OH, 827 CMR-8,00)
Abovclbund Stotaga Trnkt
527 CMR 9.0O r€qulr$ the rsghlrallor o, arry abov€ground storago tenk whhh m€ots lholollolt,log d6llnlion: a hodzontal or vsnhat tantq e$al to or t66s then IO,OOO gaj ons
capaclty, lhet b Inlerdod lor fx6d hstallatloo wlthout b6ck ntt abovo or betow orsdo. and istisod lor lh€ stoEgo o, Hezedol,s Substenc€g, Hazardous Waslos, or Ftam;abb;rCombustlbh Lhul&.
Ex.aprlon 41 : Abov6!rourd tanks ol mor€ han I O,O0O oalons capedV r€oularad bv 52O CM R1200 (B€quksmEntr lor h6 lnslathdon ol Tanks C6nlatntna FIuE! Oih6r'mair WatBr tnExc$5 ot 10,000 Gallons) ar€ not laquked tobo rcgtstorcd und€rS27 CMR 9.00.
Fxc6prlon *2: (a) a tem or aeBtdonttal lank ol 1 ,1 OO lallons or tsss cegactty r.rsgd tor stortmmolor fu€l tol non@mm€rclal purposes, or (b) a tank us6d tor sto ^i hgeIno o[,oiclnsuinplfuo u6e on th€ prcml6es wh6rs sto6d,ls hotrsquk€d to bo regtilered unlder 527cMR S.00.
PeDgllbri Any perEon who krclvhgly v{olal€s any ru16 or rsguhtton nadg by th6 Board ol F k€Pr6v6ntlon Flegulallom shall, €rc€pt as oth€rrvlss provtdEd, b6 puntEh€d bv e nns ot not tesslhan on€ hundred ddhrr nor morc ihqn on6 thousand dotlars, (MGL, Ctuipt6r 1r{}, seciton
10g, End g)27 CMn Lm)
Wh.r. lo Noiim Tvrc comg{stsd nolificaLbn torms shoLld b6 stanEd bv both the lank own.r.M the bcalllre d6paim6nt. On6 copy win b€ retatnsd bylh6l[6 d6p;dm6nl, and the tankownEr lhall 66nd e E€pal"alo copy to ll)€ Eddr6ss at he top ol hls pag6.
Wh.n to l{otlfy? 1. Owners of storage tanks In use or $at have b€€n laken out o, op€rauonmust notJfy 'rfihln lhlrty days.
Own.rt .nd Op.ntor. ot R.gullt d Sro6g€ T.nk Sysrem. must mrlntatn rgcodsc.dlfylng thai r,ll€rk d.loctlon,lnv!ntory cohhol 6nd1ig hh€s! tciIng 169ut16monr!tor lh. R.guhbd Storog. Tlnk Syltsmir! cunonL I;s. r.cordi ;ust'bc roadlty.v!il. blc lor ln.p.cilon
t{otflc.tlon Bcqulr.d
Fh€ Prev€ntlon.Form FP-290 l5 lo be us€d as Noltltcelloll R€glstralton, and p6onh lo.
aboveground and undoEround slorsoe tanks and t6nk lacllltl€s rsguletsd urde SZI
Code ol MB6.achus6tE Regulatlons e.oo. No rEgdatod sbovaOrornd or unc,€ryround
$olalE tank hdnty 6hrll b€ lNtallsd. mahtalnod, rsphced, rubshn atly modtfsd or
romoved wltlbul a p6nnh (FP- 290) b$6d by th€ h.ad of rlro tocat tk6 doDarlm.nt
TI}3 own€r o, eny ltorela laclllty shall withln 3€ven worLhg days noify lh6 h€sd ol th.
local flr6 dspart.llont.nd th€ O€pL ol Ftrc Sorylc€! ol eny dEi1g6 h ihe mm€,
eddr€Et, or lal6phon6 nuIlbor ol th6 oyyn€r or ot€rEtor ota stodge hd ty 3ubJoct to
rogulallon by Cheple, I {8, Mas!. Gen.lal LBw ;nd by saZ CUn E.OO.
llnd..Ero{nd Ston!. hnk.
Each ownsr ol ar urdorground tank llral Frt lnto @er.tofl on or elt€r Jan. I , I gg I ,6na , wllhln hllty days r,tu lhe tank ls lllst put lnto oD€radon. notEv lhe D€oarlm€nt ot
FL6 S6 lce. (he d€perlhont) ol ths snsbncs ol 6Gh t6nk sp€d&hg, to ihe extent
l(nown, lhe own€r ol lhe tank, dal6 ol lnslallatloo, capeclty, Iypa, loi:a[on, and usB! ol
6uch bnk. By no hler hen J Bn, 3l , I 99 I , sach owner o{ an und€rcround sloaegs tank
lhat wa! h opsrallon al 6hy lme all6r Jsn. I , 1 974, r6gardt6ss o, th6tl6r or ndi such
lank was rcrnovod fiom bgneEth lh€ sudac6 or the grotnd at any fins, 6hall notfy th€
d6p3 tnsnt ol th€ exlstence ol such tank, 6psclfylng. lo the exl6;t knotyr, $€ o$m€r olli.lenk, dat6 ollnstallaton, caEclty, typ€, and tocaton ol tie tantq and th6 typo andqua4llly o, 6ubslancs3 llored ln 6udr lank o( whlci wer. stored tn such tankiisfort
lh€ lanl c€esed belng ln opsratlon Il th€ hnk was romoyod lrom b€n6ah lll€ surlaca
ol lhe grourd prlor lo th€ srrbmtlal o, such nolic€ lo lha d€partrnsnL Sud ooice shell
elso sp€dt, lo th€ €xt€nt known, lhs dat€ th€ lank was remov€d lrom b€neath tle
sudaco ol lhe orcund pdor to tho submtttnl ol such no{ce lo th€ depsrtm.nt Th6op€Glo, ol 3ny lank hel has no ownd or shoso olxoor cannot b€ dsflnll€ly
Escsrtah6d, shal no ly tho departm€nt ol lh€ €{stsnce ot stjch tal1t. sD€;ti!t4!, to 1116686nl known, ary lnlomatlon rehllng lo own6rshtp o, the tenlq ard daie ot' -
hstellatlon, capaclly, type, and locadon ol the tanh and lh€ tws ard quan ty ol
substancot slorod ln such lanl! or whldl w€re Elorod h ludi lank b€6.6 m; l6nk
cias€d balng ln opelatoo I tlb lank was Gnrovod trom bensalh lh€ surlac€ ol lh6g&und 9 o. to $e sobmlttal ol such ,rctics to tll€ depBrt n€ot ll lha tsnk wa6atarldonod b6naath fl6 turlace ol tE oround pdor tb lhe submtnal ol sudt no c€ toths d6pairn6nl, such nolice shall alro 6p6c[y, to lh€ €xl€nl kbwn lo li6 own6l orop€ralor, lh6 dele the lank was abandon€d tn th€ ffound and all h€lhDd6 us6d tollaullzs th6 rank Brl6r lh€ tankc€sssdb€hg lo ofr€rBton.
l. Owxrnsxlp oF TANK(s)ll. Locarrox or TaHx(s)
RI 42974
02675
11-3339235
Orilir Emdoy.r F€d.l.I lo tPhone Nurnb.r (ndud. Ar.rrrod.)
GETTY STATION *30635 (FACILITY S2O6O9
Dexter Road & Mas6asoit Ave.
irorn.ros€st hter8€ction
Ea6t Providence
Latitude Longitude
Owller Nam6 (Corporatlon, lMlvldual, Pubtlc Ag6ncy, or Oth6r Enuty)
1Getty Pet.loleum MatkeEing, Inc.
Fr.W Nrm. or Coop.ry Sll. ld.dfi.r, rt rpp{..bb
476 MAIN STRBET
Slt..llddo.r (PO. 8o,( not r.c.drue - $o hrtudh.! ,2)YARMoU"THPoRT IiA
lf known, gtv6 tho geographic locauon of tanks by d6gr66s, mlnutes, and
66conds. Exampl€: Lat. 42,36, 12 N Long. BS, 24, .17W
ca,
Plovidence County
1401-) 434-1322
ctv
BARNSTABLE
1OO YDS. WEST OF OLD CHURCI{ ST.
Gtngnal lnronnaartoH
State Use Only
Fire Dept. Use Only
Vr.*-^rr"lZ /a/h..J"ra - @"*-*"-,t r/&A* E*,,,**
6*"*;,*@tr"*{@,"t1*a7"/.tyElpWW.f ,/./",,y@-al-,,,-%*t
Fire Dept. lD#
Fire Dept. Sig.
lll, Tvpe or Owxsn
U Federal Government
D Slate Governmenl
! Local Government
E Commercial
(storage and sale)
tr Private
(slonge and use)
D Tanks ara located on land within an lndlan ReseNation or on
other trust lands.
E Tanks are owned by native Amerlcan natlon, tribe, or Individual
V. Tvp: oF Facrllry
Select the Appropriate Facility Description: (check all that apply)
-L Gas Station
-
Madna
-
Petroleum Dlstrlbutor
-
Rall;oad
Airport Federal- Mllhsrv
-
Aircraft Owner
-
lndustrlal
-
Vehlcle D€al€rship
-
Contractol
Utllltlas
Rasld6ntlal
Farm
Other (explaln)
Trucklng/Transport
Vl. GoHracr P:nsox lr.Gxanoe oF TANKS
OpeTaToT;NICK AND JAY ENTERPRISES
Job Title:Group Enqioeer
Name:James E. Stewalt Addr6ss:cetty Petroleum Marketing, fnc
y uexcer _(oactE. Provlclence,RI 02 914
Phon6 Number (includa arsa code):
Home:
Buslnossl
(800) 289-4388
Vll. Frxlxcral REspoNslBtl.rrv508-362-4594
E I have met the financial r€sponslbility requiroments in accordance with S27 CMR 9.00.
Check all that apply:
' tr Setl lnsurance
! Commercial lnsurance
. ! Flisk Retention Group
-I r
VllI. ExvrnoNMENrAL Srrr lnronuarlox
This inlormatlon should be avallable from iocal health agent, conservallon commlsslon, or plannlng deparrment.
1. Tank sltg located in wellhead protectlon area tryos oNo d Unknown
2. Tank site located in surface drlnklng wator supply protoctlon area tr yss D No d unkno,rn
. 3. Tank slte locatbd withln l00 feet ot a wetland o yes D No d Unk rown
4. Tarnk sito located withln 3OO feet of a stream or water body tr yes tr No d ,n*no*rn .
)t
D AST SUST O AST dUST AST tr USTE tr AST O UST tr AST B UST
4/tB/e6
10000
lX. DescntprloN oF SToRAGE TaNKs AND PtprNc (couelere FoR EACH rANK Ar rH s LocAroN
Tank ldentification Number Tank No.a- Tank No.f_ Tank No._Tqnk No._ Tank No._
Tank status
a. Tank mfr's serial # (if known)
b. Currently in USe
c, Temporarily Out of Use (Start Date)
d. Permanently Out of Use
e. Aboveground storage tank (AST) or
Underground storage tank (UST)
2. Dale of lnstallation (mo.idaylyr.)
3. Estlmated Total Capaclty (gallons)
lV. lxoran Laxos
E Guaranlee
f] Surety Bond
E Stats Fund
O Letter of Credit
C Trust Fund
D Other lvlethod Allowed - Specify
t
E_l
4/ts/96
6000/4000
4. Substance Curr€ntly or Last Stored
a. Gasolino
Motor vehicle or other use
b. Diesel
Motor vehlcle or othar use
c. Kerosene
d. Fuel Oll.
' 'Consumplivo Use' tanks nesd not ba reglstered,
'Consumptlve Use' luel used excluslvely lor area' hea ng ad/ot hot waler,
e. Waste Oil
,. Oth€r, Please speclry
Tank No. 1 TankNo.2 Tank No.- Tank No.- Tank No.-
Hazardous Substanc€
(olher than 4a thru 46 above)
. CEBCLA name and/or
. CAsnumbor
x
6 w o uartira
O othsr
0 MV tr Marlna
D other
I
I
x
6 uv o uaan6
C olher
O MV O Marlna
tr other
I
-
D MV D Madna
E olher
U MV O Madna
O glh€r
D MV El Maina
D olhor
D MV tr Marlna
tr oth6r
I
tr MV O Madna
O other
tr MV tr Marlnafl other
Bars steel (lncludes asphalt, galvanized
and epoxy coated)
Calhodlcally protected steol
Composit€.(steel wlth flb6rglass)
Fib6rglass reinforied plastic (FRP)
Concrete
Unknown
Other
. Please specily
E f-r I f::I
6. Type ol Construction-Tank
(mark only one)
Slng16 walled
. Double walled
' Unknown
Other
Please specify
ls tank llned?
Oo6s tank hav6 excavation liner?
trYes dNo
o Yes JNo
x
o Yes d tto
o Yes dNo
X
D YEs O No
trY€s ONo
O Yes O No
O YEs tr No
O Yes C No
trYes ONo
Mlxture oJ Substances
' Please specify
FP-29r0 kevlsod 1 l/96)Pag6 3
Tank ldentilication Number (cont.)
f--I
rl
5. Material of Construction - Tank (mark only on(
_-.]
L --___l
f
E-l
l
tt
L_
E___.l
-__l f----l
f-
__l
x
I
-
Tank No. 1 TankNo. 2 Tank No,- TankNo.- Tank No.-Tank Identlflcatlon Number (conl.)
7, Materialof Construclion - Plping (markonly one
Bare stsel (lncludes asphalt, galvanlzed
nd epoxy coated)
Cathodically protectod steel
Fiberglass reintorced plaslic (FBP)
Fl€xible
8. Type ol Comtruction - Piplng (malk only on6)
Single walled
Double walled
Unknown
,,""r".ooiliJ
Has piplng been repalred?
ls piping gravlty leed?
Date
Copper
Unknown
Other
Please specify
.1
E Y€s dNo
El Ye8 6 No
x
o Yes dNo
o Yes bNq
trYss DNo
O YEs tr No
I
OYer trNo
O Yss f] No
I
D YBs D.No
DY€s ONo
X, CenrrncarroN oF CoMpLtaNcE
x x
x
Iank
x
Tank Tank
1. lnstallatlon
.A. lnstaller c6rtified by tank and plplng
mantjfaclurers
B. Installer certilied or licensed by the
implementing agency
C. tnstallation inspected by a reglstergd
englneer
D. lnstallatlon ihspected and approved by
the implementing agency
E. Manufaclurers' installation checklists
have been completed
F. Another method allowed by 527 CMR
9.00..Please specify
2. Tank Leak Dotection
(mark only one)
A. Double-walltank - IntBrslitial monltoring
B. Approved in-tank monitor
C. Soil vapor monitoring (check one below)
tr Monthly tr Continuous
E. lnventory record-kdeping and tank testing
F. Other mothod allowed by 527 CMR 9.00.
Pleaso spscify
:P-2€O lr6vie6d'l 1/S8l
r-- tr-l
l
I___]
l
r-I tl
r
t I
E-__l
l
I-
f-=
tr
Tank
tr
Ttr trtr
tr
TT
T
Tank
ntrtr
xx
Plplng Plping Piping
I /2 / 0'l 8/2/01
x
x
x
Tank
Tank
x
x
x
Tank
Tank PIping Tank Plplng Tank Plplng
and that based on rnylhls and all attachod documonts,
ls lruo, accuGle, aM
Slgnalu16:r Oal6:
to /24/ o'1
Tank ldentillcation Number (conl.)Tank No.-_L Tank No._L Tank No._ Tank No._Tank No._
3. Plping Leak Dotection (mark only one)
A. Pressuriz6d
a. lnterstltial spacs monitor
b. Product llne leak detector
(mark all thal apply below) .
El Automatlc tlow restrlctorr
tr Automatic shut-otf devicoi
o Continuous alarm* ..' Also requires annual test of dsvlco and
piping tlghtness t€st or monthly vapor .
monltorlng ol soil.
B. Suctlon: Check valve at tank only
(R6qukes lnterstltlal space monllor or
line tightnass test every three ysars)
D lnterstitial space monitor
tr Llne tlghtness test
C. Sucllon: Check valve at dlspenser only
(No monitor r6quired)
D. Other method allowed by 527 CMB
9,00. Please specily
4. Date ol last tightness iest (tank & plping)
5. Gravity feed piping
6. Spill contalnment and overlill protection
A. Spill contalnment devlce installed
. B. Overlill prevention devics installed
7. Dally lnventory Control (mark only one)
A. Manual gauging by stick and rscords
roconcillatlon
B. Mechanicaltank gauge and records
reconciliation
C. Automatlc gauglng system
L Cathodlc Protection (if applicabte)
.A. Sacrilicial Ano(e Type
B. lmpressed Current Type
Cortification ot Compliance No,:20509
XI. Ggnf lf tClf lON (Road and srgn affor compteting a soc on6)
NOTE: Bolh lh6 copy b€hg smi lo th6 D6,t. ol
rcc6pt6d on 6llhor dodlmgnl Flr6 Scrvlc6 and th6 copy retalnej by th6 tocal ltr6 separately. A photocopied slgnature wflt not be
I declaro und6rpomltyol per,ury lhat I havo psrsonaly exsrnlnsd and am lamllar wljh thaol thos€ lndMduab lmrnedlatdy res lbl6lor lhe lnlormatlon, l beilove lhe h6 s
'{am€ and otfbld n6 of own6r or owno/s authgrhod r6prosentawa (prlnl)
JA},IES E. STEWART, GROUP TNGINEER
P-290 (r6vlsed 11/66)
dspartmeot must b6 signod
C. Date o, Last Test
tr f
Plplng
trT
Plping
T
T
n
T
tr tr
tr
Tank
trtr
T
trtr
tr T
tr Ttr
fank
trtr
trtrT
Tank
I
f,tr
Plplng
trtr
Piping
Ttr
Tank
Ttr
Tyree Maintenance Co., Inc.
I Oris Srreer, Weslborough, MA OlSat-33 I I . Fax: 508-871-a3l I . Phone: 508-871-83OO
Octobcr 23.2007
EDo'l \Site # l06i 5
476 Main Street
Fire Marshall
Yarmoutlrport Fire Dcparlnrent
96 OId Main Srreet
South Yarrnouth. MA 02664 &Yalmorrthport, MA
[,isted are thc passing results perfbrrned on Aullust ]-:007 at the abovc nanrcd
location.
o Line and [.cak Detector Testing
o Pressurc Decaya Wet/Dry
o Pressure Rclicf Valvet Vapor Space'fie-in
Please feel frce to contact me at (508) 871-8300 crl. 264 if yol havc any qucstions
conceming the enclosed test results.
Sincerclr'.
/-
?il4
C.,
Lynn M. Taglieri
Regulatory Testing Coord inator
LTlKh
'tyree
Environmental
Technologies
h
\t\
t
rt4u--^-
TYREE SERVICES
9 OIIS ST WESTBORO MA015B1
TC,044
J t .., .. .'..
/tunt:tilitptrl, //,fr
Date(s):2:a ai' I
ID/PBS#
Violation f
TANK TESTS
Test Performed N OTES
trtr
tr
trtf
Du
tr.L_l
tr
LINE TESTS
Test#erformed PASS FAIL NOTES
,/
it
tr
Eil
tr
Regular
Premium
Plus
LEAK TESTS
Test ASS FAIL NOTES
tr
Du
tr
-
wRegular
Premium
Plus
VAPOR TESTS
est Pedormed NOTES
lvl.'
tl
L]rl
Pressure Dec€y
Vapor Space Tie in
P/y
wet / Dry
MraV-
MISC INFO CERT #S
HASSTECH
ACCURITE
HASSTECH
ACCURITE
BRENDAN TOOHIL #1662.1TN
#314,STN
#1661.1TN
#313.STN
CHRIS DESULNIERS
Technician '.>r-",,',,n ij.....r).,., -f;-\. \
s snature ij-i--Signature
Station #:
Address:
I FAIL
SITE DIAGRAM
Getty #
Address
30h
0rt llr+
DIAGRAITI
Plaar. tralrr qr tnc dbryfl lha loaatgt oa t,I haqrno trr*.. Olrprn$rs vtrtr c'rE dt{.r crcis
trca d tct t
/
I L ,t/
K,ui \
\
/it*f ,).
TYREE SERVICES
Single Line Test Data Sheet
Date: August 2.2007
Location:
PRODIT('1'
( omnr.'n(s
Getty #30635 ,.
476 Main St.
YCrnqo.!!p94, l4A
T{'"citi
Brendon Toohil
RIiL PRE}I PLTIS
l'unrp Ilanufacturcr 37 92
lsolation Ntechanistlr (Pwnp )Ball Valve
1l t : Tinas vorking pressttre)
Tcst Pressure 50 PSI 5O PSI
lnitial Clliuder Level (1CL7 0.10 0.10
!-inal Cl linder Lsal (l'CL)0{0 0.10
l,cak Yolurrrc = I( L - FCl,0
'l inre Started 2:30 2:3 0
'l inre Conryleted 3:30 3:3 0
'I otal Tcst 'l inlc /-i/l ,li, DuDi tut )lhr Ihr
Conclusion (Pass or Fai Pass Pass
(lf ovailablc ...)
Tank Leak Rate at Start ofTest
1lf avikrhle....1
'I'ank Leak Rate at End of 'l'est
ACCL'Rl I E r\r
Test Number:
Operator:
Ball Valve
0
TYREE SERVICES
l cst Date: 08.02'07
Facilitl Name:
!'acilit-v Address:
Tcst Contractor:
Address:
l est 'I'echniciall:
Genv #30635
.176 N{ain St.
Yarmouthport. itlA
Facilitt Phone:
Twee Services
9 Otis Street
Westborough, MA 01581
Contractor Phone: ( 508 ) 871-8300
Tcst'l'cchnician:
Brendon Toohil Signature:
Siguature:
Tinre;
6r
Datc;ALrgust 2, 2007
87 STP.MLD 202057'7 25 36PH Pass2410
92 STP.MI,T)3070300 29 36PII Pass22n
( onlnrclls:
TSC 1000 Leak Detector Tester
DATA COLLECTION & REPORT T-OR.\4
I'roduct Leak Detector
lltodel
Line
PSISerial Number @
Pass
orFlorY Rate
@ lo PSr
Seating
PSI
Slorv Florv
PSI
f--I-_--
f-l tl
t-_l
_l
I_l
==
-
TYREE SERVICES
Summary of Source Test Data
GoF Name and address and Title
#106-1 5
.176 NIain St.
\1.\
Permit Conditions
E
D
D
D
D
D Max vac
Jacket
PHASE II SYSTEM TYPE
(CnecN o.e I
Balance
Hirt
Hasstech
Healy
Other
vE nE
Number of Nozzles Served Tank #1 4 4Number of Nodes Served Tank #3
Number of Nozzles Served Tank 4 Number of Nozles Served by Tank #4
1 2 3 4 Total
R R P
10K 4K 6K 20K
5730 221'l 4398 12339
3954 1496 1600 7050
10
9.97
9.96
9.94
9.42
9.89
1 Product Grade
2 Actual Tank Capacity, gallons
3 Gasoline Volume
4 Ullage, gallons (#2 - #3)
5 lnitial Pressure, inches H2O
6 Pressure After 1 Minute, inches H2O
7 Pressure Afler 2 Minutes, inches H2O
I Pressure After 3 Minutes, inches H2O
9 Pressure After 4 Minutes, inches H2O
10 Final Pressure Afler 5 Minutes. inches H2O
1 1 Allowable Final Pressure
Source Tesl Resulls and Commenls
Tank #:
9.32
Test Conducted by:Tesl Company:Test:Date
Brendon Toohil Tyree Services August 2,2007
SOURCE INFORMATION FACILITY PARAMETERS
Parameters
Applicable Requlations:VN
-T--+-
TYREE SERVICES
TESTING DIVISION
Faciiity Name Getty #3063!
476 Main St.
Yarmouth rt, MA
System Manifold: (choct 6.)Above{round ! Bebw{round E
Storage Ta6k(s) to which venl is connected of Manifolded (Circle one)Numbea
RU MU SU'RU MU SU'RU MU SU'RU MU SU'RU MU SU'
T.nk *1 3
RU1 RU SU
Noazle
Numt er
Product
Grade
Storage Tank(s) to which venl is connecled of i/anifolded (Circle one)
RU MU SU'RU MU SU'RU MU SU'RU MU SU'RU MU SU'
Tank #1 I 2 ,l i
1-2 878992 RU RU SU
878992 RU RU SU
Tank
#1
#4
#5
TP-201.3C
Vapor Piping Connections Test Report Form
Test Date:Auoust 2. 2007
3-4
Fail
T
Tr
T
I_
Pass-v
r'
F/'r
f
TYREE SERVICES
DYNAMIC BACK PRESSURE
Test Date:
Test Time
8t2t2007
Run A
Source lnformation Representatives
Station Name and Address
Getty #30635
476 Main St.
Yarmouthport, MA
Station Representative and Title:
Phone No. ( )
Source Test Engineers
l-\
Permit Conditions:Source: GDF Vapor Recovery
GOF#
r,/cfl
Permit Services Division/Enforcement
Division:
Test Requested By:
Getty
Operating Parameters:
Applicable Regulations:VN Recommended:
Riser #
Gas
Grade
Arlowanc( (.16)
40 CFH
Dynamic Back Pressure, lnches H20
(.3s) (.62)
60 CFH 80 CFH
12
Results Received byt4../t /
Date Results Reviewed by
tl
Date Results Approved/Disapproved
Approved
Calrfornia Air Resources Board July 3.2002
Sources Test Results and Comments:
0.20.15
o.n
--- .lo-
,,10Dry
Dry
Wet
TYREE SERVICES
Form 1
Pressure/ Vacuum (PA/) Vent Valve Data Sheet
Facllity Name
Addressi
City:
Getty #30635
476 Main St
Yarmouthport
Test Dale:
Test Company
Tester Name:
August 2, 2007
Tyree Services
Brendon Toohil
PN Valve Manufacture OPW Model #523 NIV lCheck one)
Manufacturers Specified
Positive Leak Rate (CFH)3
N.4anuf acturers Specif ied
Negative Leak Rate (CFH)8"
Measured Positive Leak Rate (CFH).15 l\.4easured Negative Leak Rate (CFH)17
Positive Cracking Pressure (in.H2O)2.75 Negative Cracking Pressure (in.H2O)-6.24
PA/ Valve Manufaclure [,,!odel#(Check one)
Manufacturers Specified
Positive Leak Rate (CFH)
l\4anufacturers Specified
Negative Leak Rate (CFH)
Measured Positive Leak Rate (CFH)l\.4easured Negative Leak Rate (CFH)
Negative Cracking Pressure (in.HrO)
PA/ Valve Manufaclure tdodel#(Check one)
PAS
Manufacturers Specified
Positive Leak Rate (CFH)
Manufacturers Specilied
Negative Leak Rate (CFH)
Measured Posative Leak Rate (CFH)i,Ieasured Negative Leak Rate (CFH)
Negative Cracking Pressure (in.H2O)
P,ry Valve Manufacture Nlodel#(Check one)
Pass ,u
Manuf acturers Specif ied
Positrve Leak Rate (CFH)
Manufaclurers Specified
Negative Leak Rate (CFH)
Positive Cracking Pressure (in. H2O)Negative Cracking Pressure (in.H20)
: i-
Pass -,' Frit
Positive Cracking Pressure (in.HrO):
I
iFa
Positive Cracking Pressure (in.H2O):
Measured Positive Leak Rate (CFH):Measured Negative Leak Rate (CFH):