J-1502000-21-05 Leak Detection (LD) Field Reporting Form.pdf
PDF 407 KB Posted
- Solicitation number
- N62470-19-R-2004
About this file
This document contains a leak detection field reporting form and details of a related federal contract opportunity for base operations support services. The leak detection form collects information on tank and piping systems at an installation, including tank capacities and contents, leak detection methods used, results of inspections, and notes. The related solicitation is for base operations support services at the Naval Support Activity Northwest Annex in Chesapeake, Virginia, to be provided through an indefinite-delivery indefinite-quantity contract with firm-fixed prices issued by the Naval Facilities Engineering Command. Services will include facility management, utilities, environmental services, and transportation. The response deadline is not specified.
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Text version
Leak Detection (LD) Field Reporting Form
Inspector: _____________________ Date: ____________________ Installation: ____________________ Building Name: ______________
Tank Information
T1 T2 T3 T4 Tank ID
Capacity
Usage
Contents
Tank LD Method
Piping LD Method
Tank System Information
Electronic Pressurized Line LD (PLLD): Remote Monitoring: Vapor Recovery:
Accu/Chart/Inventory Reconciliation Software: Continuous Statistical LD (CSLD): Suction Piping:
Automatic Tank Gauge Alarm Status
System: _________________ Model: _________________ Serial #: __________________
T1 T2 T3 T4 Comments All Functions Normal
Low Product Invalid Fuel Level
Delivery Needed Fuel Out
Fuel Alarm Leak Alarm
NO MONITORING
* this document does not act as a regulatory document, and should only be used in conjunction with monthly ATG leak detection receipts
Leak Detection Results* Date: Notes:
Date: Notes:
Additional Site Inspections
Date: Notes:
Tank LD Method Results Primary Secondary LD Method Pass Fail Other Pass Fail Other
U S
T Secondary Containment Interstitial Monitoring
0.2 gph UST Internal Product LD Monitoring
NONE
A S
T Secondary Containment Interstitial Monitoring
Visual Inspection Product Detection
0.2 gph AST Internal Product LD Monitoring
NONE
Line LD Method Results Primary Secondary LD Method Pass Fail Other Pass Fail Other
U S
T
Fuel Piping Interstitial Containment Liquid Detection Monitoring
3 gph Mechanical Product Line LD Electronic PLLD
Annual Tightness Testing
NONE
A S
T
Fuel Piping Interstitial Containment Liquid Detection Monitoring
Visual Inspection Product Detection Electronic PLLD
3 gph Mechanical PLLD
NONE
Pass Fail N/A
UST Fill Port Spill Containment Visual Inspection Dispenser Pans Visual Inspections
ATG Electronic Remote Tank Overfill Alarm Test AST Fill Station Spill Containment Visual Inspection
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