Bldg. 5, LB4 - LB7 - Monitoring Cert & Spill Container Test.pdf

PDF 2 MB Posted Jun 11, 2025

Attached to: PMI Underground Fuel Storage Tanks Long Beach VA Healthcare System
Solicitation number: 36C26225Q0989
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 22

About this file

Written by GovTribe AI · Jun 11, 2025

This document contains Underground Storage Tank (UST) Monitoring System Certification and Spill Container Testing Report Forms for the VA Hospital Long Beach Health Care System. The certification, performed by Tait Environmental Services, Inc. on 01/08/2025, covers multiple underground storage tanks (LB-4, LB-5, LB-6, LB-7) located at 5901 E 7th St, Long Beach, CA 90822. The comprehensive testing included monitoring system certification, sensor testing, line leak detector testing, and spill container testing, with all components passing the required examinations.

Key technical details include the use of a Veeder-Root TLS-350 Plus control panel with software version 127.04, Red Jacket mechanical leak detectors (models FX1DV and FX1V), and testing performed in accordance with PEI/RP-1200-19 standards. The testing verified the integrity of various tank components including annular spaces, piping, fill sumps, monitoring wells, and dispensers, with all sensors and leak detection systems found to be operational and meeting California Code of Regulations requirements for underground storage tank monitoring.

View the file

Other files

File	Type	Posted
Bldg. 150, LB22 - Monitoring Certification & Spill Container Test.pdf	PDF	Jun 11, 2025
Bldg. 133, LB14 - Monitoring Certification & Spill Container Test.pdf	PDF	Jun 11, 2025
Bldg. 5, LB5 - Secondary Containment Retest (5.9.24).pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 1 550G UST DG700.pdf	PDF	Jun 11, 2025
Bldg. 5B, LB9A - LB9D - Monitoring Certification & Spill Container Test.pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 15 1500G UST DG700.pdf	PDF	Jun 11, 2025
Bldg. 138, LB3 - Monitoring Certification & Spill Container Test.pdf	PDF	Jun 11, 2025
Bldg. 126, LB12 - Secondary Containment Test (7.22.23).pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 3 4K UST DG700.pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 9B 30K UST DG700.pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 9A 30K UST DG700.pdf	PDF	Jun 11, 2025
Bldg. 5A, LB9D - Secondary Containment Retest (5.10.24).pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 7 2K UST DG700.pdf	PDF	Jun 11, 2025
Bldg. 5A, LB9B - Secondary Containment Test (7.20.23).pdf	PDF	Jun 11, 2025
Bldg. 125, LB1 - Monitoring Certification & Spill Container Test.pdf	PDF	Jun 11, 2025
Bldg. 5A, LB9A - Secondary Containment Test (7.19.23).pdf	PDF	Jun 11, 2025
Bldg. 138, LB 3 - Secondary Containment Retest (9.16.24).pdf	PDF	Jun 11, 2025
Bldg. 5, LB6 - Secondary Containment Retest (5.9.24).pdf	PDF	Jun 11, 2025
Bldg. 133, LB14 - Secondary Containment Test (7.26.23).pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 12 6600G UST DG700.pdf	PDF	Jun 11, 2025
Bldg. 5, LB7 - Secondary Containment Retest (5.9.24).pdf	PDF	Jun 11, 2025
Amendment 36C26225Q0989 0001.docx	DOCX document	Jun 11, 2025
Bldg. 128, LB15 - Secondary Containment Test (7.27.23).pdf	PDF	Jun 11, 2025
Bldg. 5, LB4 - Secondary Containment Test (7.12.23).pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 2 10K UST DG700.pdf	PDF	Jun 11, 2025
Bldg. 138, LB3 - Secondary Containment Retest (5.9.24).pdf	PDF	Jun 11, 2025
Bldg. 5A, LB9C - Secondary Containment Retest (5.10.24).pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 22 5800G DG700.pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 6 10K UST DG700.pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 4 6K UST DG700.pdf	PDF	Jun 11, 2025
Bldg. 125, LB1 - Secondary Containment Retest (6.21.24).pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 5 6K UST DG700.pdf	PDF	Jun 11, 2025
Bldg. 126, LB12 - Monitoring Certification & Spill Container Test.pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 14 2K UST DG700.pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 9D 30K UST DG700.pdf	PDF	Jun 11, 2025
Lab Results 2785 LB 9C 30K UST DG700.pdf	PDF	Jun 11, 2025
Bldg. 126OP, LB2 - Monitoring Certification & Spill Container Test.pdf	PDF	Jun 11, 2025
Bldg. 128, LB15 - Monitoring Certification & Spill Container Test Form.pdf	PDF	Jun 11, 2025
Attachment 3 - VAAR 852.219-73 Notice of Total SetAside for Certified SDVOSB.docx	DOCX document	Jun 6, 2025
Attachment 4 - VAAR 852.219-75 Limits on Subcontracting.docx	DOCX document	Jun 6, 2025
Attachment 1 - 52.212-1 ADDENDUM Instructions to Offerors.docx	DOCX document	Jun 6, 2025
36C26225Q0989 Long Beach VA PMI Underground Fuel Storage Tanks.docx	DOCX document	Jun 6, 2025
Attachment 2 - 52.212-2 Evaluation.docx	DOCX document	Jun 6, 2025

Show all 43

On GovTribe

Work with this file

Download the original file
Contacts named in this file
Similar government files
Ask GovTribe AI about this file

Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

�� ! �"#$%&'($" �()$'&(*+(,"# �+-&',$(. �/0,+*1 234 ! 2"##&(0 3+' 4&5'1 67 ! 68+(,$%$9",$&(1 6�� ! 6(,+'(",$&("# �&8+ �&5(9$#1 ::7 ! :$(+ :+"; 7+,+9,&'1 <= ! <&, =--#$9">#+1 �? ! �$(.#+@ ?"##+81 A7� ! A(8+'@7$0-+(0+' �&(,"$(*+(,1 A�B ! A(8+'.'&5(8 �,&'".+ B"(;1 C34 ! C"955*D3'+005'+D4/8'&0,",$9

3".+ E &% F

GHIJKLMKNOGPLQ 6(0,"##",$&( �+-"$' ER S&(,T

UVMNOPWPGHKPQMLXYNGPLQ

�� 67 �+',$%$9",$&( 7",+

Z"9$#$,/ <"*+

Z"9$#$,/ =88'+00 �$,/ [63 �&8+

\V]JX̂ POJKGJO_QPOPNQKPQMLXYNGPLQ

�&*-"(/ 3+'%&'*$(. ,T+ �+',$%$9",$&( 3T&(+

S"$#$(. =88'+00

�+')$9+ B+9T($9$"( 3+'%&'*$(. B+0, �&(,'"9,&'DB"(; B+0,+' :$9+(0+ <5*>+'

6�� <5*>+' 6�� ̀-$'",$&( 7",+ aVGXNPQPQbKNQcKOJXGPMPONGPLQ] defgheijgklkmefnmolpjmqrgstulfjmokesfsfvmwlkjshsiejsxfp qytskejsxfmzejl

{VOJXGPMPONGPLQK|HK]JX̂ POJKGJO_QPOPNQKOLQc}OGPQbKGJ]G

�+')$9+ B+9T($9$"( �$.(",5'+ 7",+ B&,"# &% 3".+0

¢£¤¥¦§̈¤ £¢©£¥©ª£ª¦

«¬®̄ °±²³́µ¶̄ ·̧¹º́»¼®º́µ³¼½́ ¾º¿À°³ºÁÂ¹µÃ̧¦Ä¶¹Â¤Å¶¹Â¦Å¶ÆÂ§Å¶¹ÂÇÈ

¦É£¢ÊÇ³¼¿³ ¶̄ ·̧¹º́»¼ É£¥ªª

Ë́²³Ê·Ì²¾̄·Áº·³́µ¿º¾Ì²»º°ÅÍ·» Ç¢¤Â¤̈¤ÂÉÉÉ¦

¢¤̈¢Ê¿³¬·Ã¾ºÎÏµÅ¿́·³́¬·́Å½¬ÉªÇ£¦

½́ ¾µ̄°Ïº¾́Ð́

¦¥¥£É¥

¥¥¥¥§¥§ £¦©£Ç©ª£ª§

«ººÃº¾Ñ̄ ³̄Ò¹¤§Ç§ª £§©̈£©ª£ª¦

£¢©£¥©ª£ª¦ ª¢

0123456573189:;796;:<1=>273?1@367;A;B57;9:1C96?1?D271E314634563F1A96135BG1B9:769H145:3HI

J�K��J�LMN�OML��PQRN�S�

T�LNO�U��L�U�

J�V�U��J�LMN�OML��PQRN�S�

T�LNO�U��L�U�

P��NW�O��X�ORM�L�YLRN�UU�V�

Z[[\]̂_[̂̀ _abc[d]̀e[fgf]\[fbh_èabe[c_fg_[̂̀ _ibhf[befhj_ckc[̀i_fc_]\a\lm̀_bg_j̀h̀e\[fhj_ f̀[̂̀ en�� J�LMN�OML��PQRN�S�P�Nopq�� rU�OS�sMRN�OQ�t�q�ON u�R v� vr rUU�S�LMN�OML��wpMqS�LN�MR��q�O�NM�L�U�q�O�S�Lp��xNpO�OyR�Rq�xM�Mx�NM�LRz

P�x�LV�OQ�x�LN�MLS�LN�RQRN�SR��O��O��V�S��{�V�|OMR{��O�UMwpMVz rO��N}��pVM|U��LV�~MRp�U��U�OSR��q�O�NM�L�Uz rUU�R�LR�OR�}�~��|��L��~MRp�UUQ�MLRq�xN�V��O�WMOML��KMLKR{�|O��KR��LV�O�RMVp�U� |pMUVpq��L��U��NR��LV��N�RN�V��O��pLxNM�L�UMNQ��LV�x�L�MOS�V��q�O�NM�L�Uz rO��UU�R�LR�OR�MLRN�UU�V�N��V�N�xN��O�U��R��N�N}��OUM�RN��qq�ONpLMNQ�ML�N}�� R�x�LV�OQ�x�LN�MLS�LNz

�}��S�LMN�OML��RQRN�S�R�Nopq�W�R�O�~M�W�V{��LV�qO�q�O�R�NNML�R�x�L�MOS�Vz

��R�N}��S�LMN�OML��x�LNO�U�q�L�UyR�|�xKpq�|�NN�OQ�~MRp�UUQ�MLRq�xN�V{��pLxNM�L�UUQ� N�RN�V{��LV�x�L�MOS�V��q�O�NM�L�Uz

��R�N}��U�W��p�U�RN�q��N�N}��VMRq�LR�O�M��O�U��R��MR�V�N�xN�V�ML�N}��pLV�Oo VMRq�LR�O�x�LN�MLS�LNz

��R�N}��NpO|ML��pN�S�NMx�UUQ�R}pN�V�WL�M��N}��qMqML��R�x�LV�OQ�x�LN�MLS�LN� S�LMN�OML��RQRN�S��MUR�N��q�O�N��O�MR��U�xNOMx�UUQ�VMRx�LL�xN�Vz

��R�N}��NpO|ML��pN�S�NMx�UUQ�R}pN�V�WL�M��N}��qMqML��R�x�LV�OQ�x�LN�MLS�LN� S�LMN�OML��RQRN�S�V�N�xNR��O�U��R�z��}Mx}�R�LR�OR�MLMNM�N��q�RMNM~��R}pN�V�WLz� �T}�xK��UU�N}�N��qqUQ�� PpSq�� T

Y��S�LMN�OML��RQRN�S��U�OSR��O��O�U�Q�V�N��O�S�N��S�LMN�OML��x�LN�O{�MR��UU� x�SSpLMx�NM�L��wpMqS�LN��q�O�NM�L�Uz

�̀ c]efl̀_\mm_\hc�̀ ec_i\e�̀�_��b�_be_��\fm�_\h�_aebabc̀�_èì �k_fh_=3B7;9:1��

�fc[_\mm_ibhf[befhj_̀��faì h[_̀f[̂̀ e_èam\]̀�_be_èa\fè�_fh_=3B7;9:1�

�� ¡¢£¤¥¦§̈ ©ª«¬£

-./0123451/63/27/106/0681231890612:10;./1<670.:.<90.23=11-./01>?@ABCDEFGH19/149I64681.31/5/06J1

K72L79JJ.3L=111M88.0.23941<2K.6/12:10;./1K9L61J951I619009<;6810219<<2JJ2890619441/63/27/106/068=

N63/271OP N63/271Q2864 R2JK23630S/T1Q23.02768 U9// V9.4

P6/<7.I61944193/W67/1J97X681>Y2H1271>V9.4H19381K72K2/68176J6851.31?@Z[\CAE]=

-./019441J23.027.3L16̂_.KJ63016.0;67176K49<68127176K9.7681.31?@Z[\CAE]

àb cdefdgaehg ijklkmnopqrǹsacntqqumpvn w àh cdefxgahgy ijklkmnopqrǹsacnzj{jq|n}u~{n w àf cdefxgahgy ijklkmnopqrǹsacn�jmmn}u~{n w

�abn cdefxgacgg ijklkmnopqrǹsacn��qj��vjq|n�kmmn w àen cdefxgahgy �qmkp�k�ǹsa�nzj{jq|n}u~{ w ày cdefxgahgx �qmkp�k�ǹsa�n�pq�p�n}u~{n w à�n cdefxgahgx �qmkp�k�ǹsa�n�jmmn}u~{n w àc cdefdgaehg �qmkp�k�ǹsa�ntqqumpvn w àxn cdefxgahgy �qmkp�k�ǹsaynzj{jq|n}u~{n w àd cdefxgahgx �qmkp�k�ǹsayn�pq�p�n}u~{n w àbg cdefxgahgy �qmkp�k�ǹsayn�jmmn}u~{n w àbb cdefdgaehg �qmkp�k�ǹsayntqqumpvn w àbh cdefxgahgy ijklkmǹsaenzj{jq|n}u~{n w àbf cdefxgahgx ijklkmǹsaen�pq�p�n}u~{n w àbe cdefxgahgx ijklkmǹsaen�jmmn}u~{n w àbyn cdefdgahgx ijklkmǹsaentqqumpvn w àb�n cdefxgahgx �qmkp�k�nijl{kqlkvn�i�n w àbc cdefxgahgx ijklkmnijl{kqlkvn�i� w àbxn cdefdgaehg s̀aeǹsayǹsa�n�kl�n��qj��vjq|n�kmmn w àbd cdefdgaehg s̀aeǹsayǹsa�n�j�n��qj��vjq|n�kmmn w àhg cdefdgaehg s̀aeǹsayǹsa�n�pl�n��qj��vjq|n�kmm w

01�23�4156�7�8�5��95:��9��3�;�4�24�<6&'-%&$,*&5:64�99�;=�>?@AB@CAD@EFGHCHACIJKAKHDCJ@BLMA

N5OP9�4�;�<�9��6��<�4��Q�<5�5�;R�S01�23��99�41�4��TT9U=V

W�X�Y�� Z=[�X�Y�� Z=\�X�Y�

]�6 �̂ _̂

Y�6�41��4�645:��TT�<�4P6�7��:�T<�T�<9U�2�957<�4�;̀

a�<��O�<��:2U��:�<�4�<�4�:3�6U64�O6b�;��6�41��ccd�2<��4��:��P;579��:;�Q56P�9� �9�<O�e1�:��9��3�56�;�4�24�;̀ a�<�O�21�:52�9�ccd6b�;��6�41��ccd�<�64<524�41��9�e�41<�P�1�41��T5T��e1�:�� <�9��6��56�;�4�24�;̀ a�<��9�24<�:52�ccd6b�;��6�41��4P<75:��P4�O�452�99U�61P4��e1�:��<�9��6��56� ;�4�24�;̀ a�<��9�24<�:52�ccd6b�;��6�41��4P<75:��P4�O�452�99U�61P4��5��:U�T�<45�:��41�� O�:54�<5:��6U64�O�56�;56�79�;��<�;562�::�24�;̀ a�<��9�24<�:52�ccd6b�;��6�41��4P<75:��P4�O�452�99U�61P4��5��:U�T�<45�:��41�� O�:54�<5:��6U64�O�O�9�P:245�:6��<��596��45�14:�66�4�64̀ a�<��9�24<�:52�ccd6b�1�Q��99��22�66579��e5<5:��2�::�245�:6�7��:�Q56P�99U�5:6T�24�;� ��<�35:36��:;�7<��36̀ f�<��99�54�O6��:�41��gP5TO�:4�O�:P��24P<�<h6�O�5:4�:�:2��21�239564�2�OT9�4�;̀ f�<��99�ccd6�2�:�5<O�;��T�<�45�:�9�e5415:�<��P9�4�<U�<�gP5<�O�:46̀ ii?Aj? ii?Ak@lHG iJBHKAk@BJC@mHl noKK poJG

?HKDmJqHAoGGAoBKrHmKAEomsHlAtu@vA@mAtpoJGvAoBlAFm@F@KHlAmHEHlwAJBAxyz{|}~��L iJKCAoGGAE@BJC@mJB�AH��JFEHBCAHJCIHmAmHFGoDHlA@mAmHFoJmHlAJBAxyz{|}~��

-.�/0�1.23�4�5�2��1�60��7�26��23�73�8��69:��;�26<�61�;:�/�61;�9=� -.�/0�1.23�4�5�2��#>�1�60��7�26��?72@A�61�23�2631�99�8=B

BCDEBFEGBHEIJKLGLBGMNOBOLHGNEFBNPBLNGMLQBRESBNOBHMLHTLUVW

X�3 Y� YZ

Z99�[2;26��.�3�4��6\�]̂�<237�99:�263@�/1�8��;�02603_�4;��03��68�@;�@�;��61;:��68� 1�;A26�12�6̀��68�â�1�31�8��;��;�768��7913b c�;��99�26d1�60��7�26��@;�4�3�<237�99:�263@�/1�8��;�8�A��68�;�3287��472987@� 1��637;��1.�1��9��13�A�<��;��9:_��76/12�6�99:�1�31�8_��68�/�6�2;A�8��@�;�12�6�9b c�3��//7;�/:��3:31�Ae3�@;�87/1�9�<�9�;��826�3�1�31�8b c�3��//7;�/:��3:31�Ae3�[�1�;�9�<�9�;��826�3�1�31�8b c�;��99�@;�4�3�;�2631�99�8�@;�@�;9:b c�;��99�21�A3��6�1.��?72@A�61�A�67��/17;�;e3�A�261�6�6/��/.�/09231�/�A@9�1�8b fQERLBgD fQERLBhEULK ijFTOBhEFNGEQLU fjOO kjNK l!m>nn+#%, DLOHQNRLBjKKBjFOoLQOBIjQTLUBpqErBEQBpkjNKrBjFUBJQEJEOLUBQLILUsV tNOGBjKKBIEFNGEQNFuBLvwNJILFGBLNGMLQBQLJKjHLUBEQBQLJjNQLUVB x

�� !"#$%&" ��&'"%$&()&* !��)+$%*"&,��-.*)(/�01��02)&*"#"3 *"$&/�0��0&*)%& *"$& !��$2)� �$4&3"!

5 ,)�6�$#�7

89:;<=><?@8A=B 0&.* !! *"$&� �)+ "% 67�C$&*D

EF>?@AGA89<AB>=HI?8A=B

��01� J).*�1 *)�

K 3"!"*-�L ()�

K 3"!"*-�M22%)..� �"*-� N05��$2)�

OFP;HQA@;<8;@RBA@A?B<AB>=HI?8A=B

�$(+ &-�5)%#$%("&,�*D)�J).*� 5D$&)�

C "!"&,�M22%)..�

�)%'"3)�J)3D&"3" &�5)%#$%("&,�J).*�

�$&*% 3*$%SJ &T�J).*)%�U"3)&.)�L4(V)%�

0��L4(V)%� 0��W+"% *"$&�1 *)�

XF8H?ABABY<?BZ<@;H8A>A@?8A=BP

[\]̂_\̀âbcbd\]edfcgadhîjklc]adfb\j]j]mdncbaj_j̀\ajo]g hpkjb\ajo]dq\ac rF8;P8<:H=@;ZsH;<AB>=HI?8A=B fcgadtbòcêbcgdugce nolko]c]agdfcgace vF@;H8A>A@?8A=B<w9<P;HQA@;<8;@RBA@A?B<@=BZs@8ABY<8;P8 xyz{|{}~y�{|��~y�z��y{��zy��y��{|y��y�{��{�y��y��|��{y��zy��|��y��{y��y

�{��y��{y��y��y��y�z��{|y��y�{��y��y�z��y|{��|{�y��|��y

��{��y��y��z{��y��y��y��|��y��{�yz{|{��y��y��|��{�yyxy��{|��y

�z��y�{��y�|��{��|{�y�z��y}{y��{y��}�{y��y|{��{��y}~y�z{y��{|��y��z�|��~�

�)%'"3)�J)3D&"3" &��",& *4%) 1 *)� J$* !��$#�5 ,).�

¥¦§̈©ª«¬®̄§°©±²§³́ ®µ¶§̈ ®́̄¶§·®̧ §́¹ºª́»§¼§³̄½²§ §¾°³¼�¿§°³¼ ¿§°³¼¡¿§°³¼ÀÁ

Â��§Ã§À¶§¹§ °©±²§³́ ®µ¶ Â��¤¤

Ä®¬§Ã±Å¬̧©±» ±́®̄§¹́ Å̧¬µ́ª¿§Æ±µ À��¼�¢�¼ÂÂÂ

��¢�§Ã§¹§¦±½̧ Ḉ§È̄¿§¹®±®§¦±®¿§·¦§Â¤À�

·®̧ ©̄ª§È́ ®̧É®

��Â�

��¡�¡ � £�À£¤�¤¡

·ÊÆ§Ë �¡� ��£� £¤�¤¡

ÌÈÍ§Ë��Â¢Â�À ��£�À£¤�¤¡

ÈÃÆ§�¤�� ¹«¬̄̄§³ÎµḮ§

*+,-./.01./

234567789:;<=6;>?8@><=674

A-BC.D-CE0F.G-H-I0J-F.KL. D+MN1+OCNP-P. QMFNBCPL.RC+MF+PF. *P01-BBS0M+I.TM,SM--P

A-BC.ALJ-. *P-BBNP-. U+ONNV. WLFP0BC+CSO

<XYZ86@

RJSII.[0MC+SM-P.D+MN1+OCNP-P\

D-CE0F.01.[+CE0FSO.*P0C-OCS0M

]0MV-C+IISO

ĈE-P

]0MV-C+IISO

ĈE-P

]0MV-C+IISO

ĈE-P

]0MV-C+IISO

ĈE-P

QB.CE-.BJSII.O0MC+SM-P.VSMSVNV.

O+J+OSCL.1SH-.,+II0MB.-_OINFSM,.

PSB-P.H0INV-̀

a-B ]0b a-B ]0b a-B ]0b a-B ]0b

D-CE0F.C0.c--J.BJSII.O0MC+SM-P.

-VJCL

GP+SM

*NVJ

ĈE-P

GP+SM

*NVJ

ĈE-P

GP+SM

*NVJ

ĈE-P

GP+SM

*NVJ

ĈE-P

RJSII.[0MC+SM-P.A-BC.d-BNICB

*+BB

e+SI

*+BB

e+SI

*+BB

e+SI

*+BB

e+SI

<XYZ86@

RJSII.[0MC+SM-P.D+MN1+OCNP-P\

D-CE0F.01.[+CE0FSO.*P0C-OCS0M

]0MV-C+IISO

ĈE-P

]0MV-C+IISO

ĈE-P

]0MV-C+IISO

ĈE-P

]0MV-C+IISO

ĈE-P

QB.CE-.BJSII.O0MC+SM-P.VSMSVNV.

O+J+OSCL.1SH-.,+II0MB.-_OINFSM,.

PSB-P.H0INV-̀.

a-B ]0b a-B ]0b a-B ]0b a-B ]0b

D-CE0F.C0.c--J.BJSII.O0MC+SM-P.

-VJCL

GP+SM

*NVJ

ĈE-P

GP+SM

*NVJ

ĈE-P

GP+SM

*NVJ

ĈE-P

GP+SM

*NVJ

ĈE-P

RJSII.[0MC+SM-P.A-BC.d-BNICB

*+BB

e+SI

*+BB

e+SI

*+BB

e+SI

*+BB

e+SI f g39:hh>;<4 i!"�j�(!��"k!j"�&�jl!��mn�$!jop�mq�op��j�mr��p��!��$� j� �"!��j!&!�')� bD+Pc.E-P-.S1\

RJSII.O0MC+SM-PB.F0.M0C.E+H-.+.VSMSVNV.O+J+OSCL.01.1SH-.,+II0MB.+MF.P-sNSP-.P-JI+O-V-MCt u u vwxyz{xxy|}~� ��xyz{xxy|}~� ��xy��y|}~� ��xyz{xxy|}~� u u u u u u u u u u u u u u u u

��xy��y|}~� vwxyz{xxy|}~� u u u u u u u u

Mechanical Leak Detector Test Data Sheet

Site: VA Hospital Long Beach Date: 01/08/2025

Address: 5901 E 7th St, Long Beach, CA 90822

Test Information

1 2 3 4 5

Product Diesel LB-4 87 LB-6 87 LB-5

Manufacturer Red Jacket Red Jacket Red Jacket

Model Number FX1DV FX1V FX1V

Serial Number No# No# No#

Full Operating Pressure (psi) 26 27 35

Line Bleed Back (ml) 58 57 50

Trip Time (sec) 2 2 2

Metering Pressure (psi) 15 15 16

F/E Holding Pressure (psi) 30 30 30

Test Leak Rate (ml/min) (gph) 3.0 gph 3.0 gph 3.0 gph

PASS or FAIL Pass Pass Pass

Comments:

This letter certifies that the annual leak detector tests were performed at the above referenced facility according to the equipment manufacturers procedures and limitations and the results as listed are to my knowledge true and correct. The mechanical leak detector test pass/fail is determined using a low flow threshold flow rate of 3 gph at 10 PSI.

Inspected By: Contractor: Tait Environmental Services, Inc

Technician: Carlos Peraza Lic# 588098

Signature:

Test Procedures Utilized for UST Testing

To Whom it may concern:

In cases where manufacturer instructions are not available, Tait Environmental Services, Inc. will utilize industry standard procedures for testing Underground Storage Tanks. The sump manufacturer, Bravo Inc, has test instructions available, however, they also refer to PEI/RP-1200. Test procedures are listed below:

1. Secondary Containment Testing

a. Tank Secondary Containment Integrity (Annular Space) – performed per

PEI/RP 1200-19, Section 4.2

b. Piping Secondary Containment Integrity – performed per PEI/RP 1200-19, Section 5.3

c. Containment Sump & UDC Testing– performed per PEP/RP 1200-19, Section 6.6 (NOTE: Tait Environmental Services utilizes the Incon hydrostatic test equipment)

2. Overfill Prevention Inspections

a. Overfill Valve (Flapper) – performed per PEI/RP 1200-19, Section 7.1

b. Vent Flow Restrictor (Ball Float) – performed per PEI/RP 1200-19, Section

7.2

c. Overfill Alarm (A/V) – performed per PEI/RP 1200-19, Section 7.3

3. Other Testing

a. Spill Bucket

i. Contained in Sump – performed per PEI/RP 1200-19, Section 6.2

ii. Direct Bury – performed per PEI/RP 1200-19, Section 6.6

b. Line Leak Detection

i. MLLD – performed per PEI/RP 1200-19, Section 9.1

ii. ELDD – performed per PEI/RP 1200-19, Section 9.2

c. Electronic Monitoring System

i. ATG Functionality Test – performed per PEI/RP 1200-19, Section

8.2

ii. Sensor Functionality Test – performed per PEI/RP 1200-19, Section

8.3

Please contact our office with any questions regarding these procedures.

File details come from the government source that posted it. Updated Jun 11, 2025.