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(610) 278-7203 Fax - VA Vendor Portal

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2/21/2019 St BVA WO 585899, Feb 19th, 2019 http://portal.crompco.com/workorderpop.php?workorderid=585899&stationnumber=BVA&cview=1&rview=1&photos=1 1/59 CERTIFICATE OF STORAGE TANK SYSTEM TESTING Crompco, LLC 1815 Gallagher Road Plymouth Meeting, PA 19462 Phone: (610) 278-7203 Fax: (610) 278-7621 Work Order #585899 Client Information Location #BVA Date:Tue Feb 19th, 2019 Reason:Compliance Bath VA Medical Center(Danelle Wassink) Invoice #737080 Permit# P.O.# 36C24219P0556 - OBL#526- C90072 Bath VA Medical Center Bronx VA 130 W Kingsbridge Bronx, NY 14810 County: Bronx State ID: 2-602985 Testing was conducted in accordance with all applicable portions of Federal, NFPA, and local regulations. Tanks Equip # Grade Test Result 05 Diesel/Fuel Oil EZY-3 Locator Plus Fail 06 Diesel/Fuel Oil EZY-3 Locator Plus Fail 07 Diesel/Fuel Oil EZY-3 Locator Plus Fail Additional Costs LABOR: Labor: 2 Men (3 hours) EXPENSES: Fuel Surcharge, Miscellaneous Consumables, One-Way Mobilization, Test Results Storage Francis Dryslewski EZY-3 Locator Plus# 46-3772 (Exp: 11/15/2019) NYC Fire Department Certificate of Fitness# 63662746/63662753 David Sponburgh
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2/21/2019 St BVA WO 585899, Feb 19th, 2019

http://portal.crompco.com/workorderpop.php?workorderid=585899&stationnumber=BVA&cview=1&rview=1&photos=1 1/59

CERTIFICATE OF STORAGE TANK SYSTEM TESTING Crompco, LLC

1815 Gallagher Road Plymouth Meeting, PA 19462

Phone: (610) 278-7203 Fax: (610) 278-7621

Work Order #585899 Client Information Location #BVADate:Tue Feb 19th, 2019

Reason:ComplianceBath VA Medical Center(DanelleWassink)Invoice #737080

Permit#

P.O.#36C24219P0556 - OBL#526-C90072

Bath VA Medical Center Bronx VA

130 W Kingsbridge Bronx, NY 14810

County: Bronx State ID: 2-602985

Testing was conducted in accordance with all applicable portions of Federal, NFPA, and local regulations.

TanksEquip # Grade Test Result05 Diesel/Fuel Oil EZY-3 Locator Plus Fail 06 Diesel/Fuel Oil EZY-3 Locator Plus Fail 07 Diesel/Fuel Oil EZY-3 Locator Plus Fail

Additional CostsLABOR: Labor: 2 Men (3 hours)

EXPENSES: Fuel Surcharge, Miscellaneous Consumables, One-Way Mobilization, Test Results Storage

Francis Dryslewski

EZY-3 Locator Plus# 46-3772 (Exp: 11/15/2019) NYC Fire Department Certificate of Fitness#

63662746/63662753

David Sponburgh

2/21/2019 St BVA WO 585899, Feb 19th, 2019

http://portal.crompco.com/workorderpop.php?workorderid=585899&stationnumber=BVA&cview=1&rview=1&photos=1 2/59

Crompco, LLC

1815 Gallagher Road Plymouth Meeting, PA 19462

Bronx VA Phone: (610) 278-7203

FAX: 610-278-7621

130 W Kingsbridge Bronx, NY 14810

State ID: 2-602985

Facility/Agency Copy Site #BVA / WO #585899

Tue Feb 19th, 2019

EZY 3 Locator Plus

TOTAL TANK VOL (gal): 30982 TANK # / PRODUCT TYPE: 05 / Diesel/Fuel Oil DRONE

ULLAGE VOL (gal): 3718 WALL TYPE: DoublePRODUCT VOL (gal): 27264 MATERIAL: Steel

PRESSURE SENSOR CALCULATION

103.0000 X 0.031 psi = 3.1930 PSI(1)(INCHES OF PRODUCT) (WEIGHT OF PRODUCT) 0.0000 X .036 psi = 0.0000 PSI(2)(INCHES OF WATER IN TANK) (WEIGHT OF WATER) Line 1 + Line 2 = Total Positive Head Pressure in Tank = 3.1930 PSI(3)0.0000 X 0.036 (Water Table Outside Tank) = 0.0000 PSI(4)

(INCHES OF WATER OUTSIDE TANK)

0.049 (Brine Filled DW Tank) 0.000 (Double Wall Dry) 0.036 (Double Wall with Water in

Outerwall)

Total Head Pressure Minus Outside Water Pressure = 3.1930 +/-PSI(5)

Always add .5 PSI = 3.6930 PSI(6)NOTE: If Line 6 is less than .5 PSI, Line 7 shall be .5 PSI

TEST PRESSURE = 3.6930 PSI(7)

TIME

PRESSURE (psi of vacuum)

BLOWER STARTED: 12:00 0.0000TEST PRESSURE REACHED: 12:11 3.9800BLOWER TURNED OFF: 12:14 4.0000TEST BEGAN: 12:15 3.9900TEST ENDED: 12:20 2.0000

Depth of Groundwater Determined:By: Double-wall dry interstitialWhere: Outerwall riser

WATER SENSOR CALIBRATION TANK SYSTEM

Added (ml): 0.0000 0.0000 0.0000 Cal #1 Cal #2 Cal #3 Average: 0.0000 Water Intrusion Test Period: Began: Ended:Calculation for test period: 0.0000 / 3780 = 0.0000 / .05 X 60 = 0.0000 (min)Ave. Cal. "A" Factor Time of Test

Product in Tank (inches): 103.0000Water in Tank (inches): 0.0000Tank top to grade (inches): 48.0000Diameter (inches): 120Bottom to grade (inches): 168.0000Groundwater (inches): 0.0000

THE ACOUSTIC CHARACTERISTICS OF A LEAK REVEALS: WATER SENSOR INDICATES:

TIGHT TANK This underground storage tank PASSES the criteria set forth by the U.S. EPA

ULLAGE (DRY) PORTION LEAK This underground storage tank FAILS the criteria set forth by the U.S. EPA

BELOW PRODUCT LEVEL (WET) PORTION LEAK This underground storage tank FAILS the criteria set forth by the U.S. EPA

Inconclusive

NO WATER INTRUSION WATER INTRUSION NOT APPLICABLE INCONCLUSIVE

Serial: Calibration Expiration:Water Sensor Display:Water Sensor Probe:Acoustic Signal Processor: E1544021 2019-06-30In-Tank Microphone: M1701002 2019-06-30

2/21/2019 St BVA WO 585899, Feb 19th, 2019

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Digital Pressure Sensor: 40968717 2019-06-30Analog Vacuum Gauge: NG1704259 2019-06-30

2/21/2019 St BVA WO 585899, Feb 19th, 2019

http://portal.crompco.com/workorderpop.php?workorderid=585899&stationnumber=BVA&cview=1&rview=1&photos=1 4/59

Crompco, LLC

1815 Gallagher Road Plymouth Meeting, PA 19462

Bronx VA Phone: (610) 278-7203

FAX: 610-278-7621

130 W Kingsbridge Bronx, NY 14810

State ID: 2-602985

Facility/Agency Copy Site #BVA / WO #585899

Tue Feb 19th, 2019

EZY 3 Locator Plus

TOTAL TANK VOL (gal): 1018 TANK # / PRODUCT TYPE: 06 / Diesel/Fuel Oil DRONE

ULLAGE VOL (gal): 143 WALL TYPE: DoublePRODUCT VOL (gal): 875 MATERIAL: Steel

PRESSURE SENSOR CALCULATION

39.0000 X 0.031 psi = 1.2090 PSI(1)(INCHES OF PRODUCT) (WEIGHT OF PRODUCT) 1.7500 X .036 psi = 0.0630 PSI(2)(INCHES OF WATER IN TANK) (WEIGHT OF WATER) Line 1 + Line 2 = Total Positive Head Pressure in Tank = 1.2720 PSI(3)0.0000 X 0.036 (Water Table Outside Tank) = 0.0000 PSI(4)

(INCHES OF WATER OUTSIDE TANK)

0.049 (Brine Filled DW Tank) 0.000 (Double Wall Dry) 0.036 (Double Wall with Water in

Outerwall)

Total Head Pressure Minus Outside Water Pressure = 1.2720 +/-PSI(5)

Always add .5 PSI = 1.7720 PSI(6)NOTE: If Line 6 is less than .5 PSI, Line 7 shall be .5 PSI

TEST PRESSURE = 1.7720 PSI(7)

TIME

PRESSURE (psi of vacuum)

BLOWER STARTED: 13:05 0.0000TEST PRESSURE REACHED: 13:09 0.0000BLOWER TURNED OFF: 13:12 0.0000TEST BEGAN: 13:13 0.0000TEST ENDED: 13:15 0.0000

Depth of Groundwater Determined:By: Double-wall dry interstitialWhere: Outerwall riser

WATER SENSOR CALIBRATION TANK SYSTEM

Added (ml): 0.0000 0.0000 0.0000 Cal #1 Cal #2 Cal #3 Average: 0.0000 Water Intrusion Test Period: Began: Ended:Calculation for test period: 0.0000 / 3780 = 0.0000 / .05 X 60 = 0.0000 (min)Ave. Cal. "A" Factor Time of Test

Product in Tank (inches): 39.0000Water in Tank (inches): 1.7500Tank top to grade (inches): 54.0000Diameter (inches): 48Bottom to grade (inches): 102.0000Groundwater (inches): 0.0000

THE ACOUSTIC CHARACTERISTICS OF A LEAK REVEALS: WATER SENSOR INDICATES:

TIGHT TANK This underground storage tank PASSES the criteria set forth by the U.S. EPA

ULLAGE (DRY) PORTION LEAK This underground storage tank FAILS the criteria set forth by the U.S. EPA

BELOW PRODUCT LEVEL (WET) PORTION LEAK This underground storage tank FAILS the criteria set forth by the U.S. EPA

Inconclusive

NO WATER INTRUSION WATER INTRUSION NOT APPLICABLE INCONCLUSIVE

Serial: Calibration Expiration:Water Sensor Display:Water Sensor Probe:Acoustic Signal Processor: E1544021 2019-06-30In-Tank Microphone: M1701007 2019-06-30

2/21/2019 St BVA WO 585899, Feb 19th, 2019

http://portal.crompco.com/workorderpop.php?workorderid=585899&stationnumber=BVA&cview=1&rview=1&photos=1 5/59

Digital Pressure Sensor: 40968917 2019-06-30Analog Vacuum Gauge: NG1704264 2019-06-30

2/21/2019 St BVA WO 585899, Feb 19th, 2019

http://portal.crompco.com/workorderpop.php?workorderid=585899&stationnumber=BVA&cview=1&rview=1&photos=1 6/59

Crompco, LLC

1815 Gallagher Road Plymouth Meeting, PA 19462

Bronx VA Phone: (610) 278-7203

FAX: 610-278-7621

130 W Kingsbridge Bronx, NY 14810

State ID: 2-602985

Facility/Agency Copy Site #BVA / WO #585899

Tue Feb 19th, 2019

EZY 3 Locator Plus

TOTAL TANK VOL (gal): 1018 TANK # / PRODUCT TYPE: 07 / Diesel/Fuel Oil DRONE

ULLAGE VOL (gal): 230 WALL TYPE: DoublePRODUCT VOL (gal): 788 MATERIAL: Steel

PRESSURE SENSOR CALCULATION

36.0000 X 0.031 psi = 1.1160 PSI(1)(INCHES OF PRODUCT) (WEIGHT OF PRODUCT) 0.0000 X .036 psi = 0.0000 PSI(2)(INCHES OF WATER IN TANK) (WEIGHT OF WATER) Line 1 + Line 2 = Total Positive Head Pressure in Tank = 1.1160 PSI(3)0.0000 X 0.036 (Water Table Outside Tank) = 0.0000 PSI(4)

(INCHES OF WATER OUTSIDE TANK)

0.049 (Brine Filled DW Tank) 0.000 (Double Wall Dry) 0.036 (Double Wall with Water in

Outerwall)

Total Head Pressure Minus Outside Water Pressure = 1.1160 +/-PSI(5)

Always add .5 PSI = 1.6160 PSI(6)NOTE: If Line 6 is less than .5 PSI, Line 7 shall be .5 PSI

TEST PRESSURE = 1.6160 PSI(7)

TIME

PRESSURE (psi of vacuum)

BLOWER STARTED: 15:05 0.0000TEST PRESSURE REACHED: 15:08 1.9100BLOWER TURNED OFF: 15:11 1.9600TEST BEGAN: 15:12 1.9500TEST ENDED: 15:17 0.0000

Depth of Groundwater Determined:By: Double-wall dry interstitialWhere: Outerwall riser

WATER SENSOR CALIBRATION TANK SYSTEM

Added (ml): 0.0000 0.0000 0.0000 Cal #1 Cal #2 Cal #3 Average: 0.0000 Water Intrusion Test Period: Began: Ended:Calculation for test period: 0.0000 / 3780 = 0.0000 / .05 X 60 = 0.0000 (min)Ave. Cal. "A" Factor Time of Test

Product in Tank (inches): 36.0000Water in Tank (inches): 0.0000Tank top to grade (inches): 56.0000Diameter (inches): 48Bottom to grade (inches): 104.0000Groundwater (inches): 0.0000

THE ACOUSTIC CHARACTERISTICS OF A LEAK REVEALS: WATER SENSOR INDICATES:

TIGHT TANK This underground storage tank PASSES the criteria set forth by the U.S. EPA

ULLAGE (DRY) PORTION LEAK This underground storage tank FAILS the criteria set forth by the U.S. EPA

BELOW PRODUCT LEVEL (WET) PORTION LEAK This underground storage tank FAILS the criteria set forth by the U.S. EPA

Inconclusive

NO WATER INTRUSION WATER INTRUSION NOT APPLICABLE INCONCLUSIVE

Serial: Calibration Expiration:Water Sensor Display:Water Sensor Probe:Acoustic Signal Processor: E1544021 2019-06-30In-Tank Microphone: M1701007 2019-06-30

2/21/2019 St BVA WO 585899, Feb 19th, 2019

http://portal.crompco.com/workorderpop.php?workorderid=585899&stationnumber=BVA&cview=1&rview=1&photos=1 7/59

Digital Pressure Sensor: 40968917 2019-06-30Analog Vacuum Gauge: NG1704264 2019-06-30

2/21/2019 St BVA WO 585899, Feb 19th, 2019

http://portal.crompco.com/workorderpop.php?workorderid=585899&stationnumber=BVA&cview=1&rview=1&photos=1 8/59

Crompco, LLC

1815 Gallagher Road Plymouth Meeting, PA 19462

Bronx VA Phone: (610) 278-7203

FAX: 610-278-7621

130 W Kingsbridge Bronx, NY 14810

State ID: 2-602985

Facility/Agency Copy Site #BVA / WO #585899

Tue Feb 19th, 2019

2/21/2019 St BVA WO 585899, Feb 19th, 2019

http://portal.crompco.com/workorderpop.php?workorderid=585899&stationnumber=BVA&cview=1&rview=1&photos=1 9/59

Crompco, LLC

1815 Gallagher Road Plymouth Meeting, PA 19462

Bronx VA Phone: (610) 278-7203

FAX: 610-278-7621

130 W Kingsbridge Bronx, NY 14810

State ID: 2-602985

Facility/Agency Copy Site #BVA / WO #585899

Tue Feb 19th, 2019

Site Diagram Labels

1: Block - V A Main w/ Ambulance Entrance

2: Block - Building

3: Tank - 7 Diesel/Fuel Oil 1K

4: Block - Boiler Room

5: Tank - 4 Fuel Oil 30K

6: Tank - 6 Diesel/ Fuel Oil 1k

7: Tank - 5 Diesel/Fuel Oil 30k

8: Tank - 2 Fuel Oil 30k

9: Tank - 1 Fuel Oil 30k

10: Tank - 3 Fuel Oil 30k

11: Road - Webb

12: Road - KingBridge

13: Block - Day Tank

14: Block - Day tank

2/21/2019 St BVA WO 585899, Feb 19th, 2019

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IMPORTANT LEGAL DOCUMENTS

February 21st, 2019

Bronx VA #BVA 130 W Kingsbridge

Bronx, NY 14810

Re: 2019 Compliance Test Results

Crompco Work Order #585899 Test Performed on Tue Feb 19th, 2019

Dear Manager (Facility #BVA):

Enclosed are the 2019 Compliance Test Results for testing performed by Crompco for Bath VA Medical Center. These testresults are important legal documents that are required to be retained at your facility in the "Environmental ComplianceBinder" in case an inspection would occur by a state or local agency. Upon receipt, please put the results in the binder asrequested by Bath VA Medical Center.

The 2019 compliance tests performed at your facility are indicated below. For specific testing detail, please refer to theenclosed test report.

X Tank(s) Line(s) and/or Leak Detector(s) Cathodic Protection Monitor Inspection Vapor Recovery Other (See Report for Details)

If you should have any questions regarding the test results enclosed, please contact Crompco at 1-800-646-3161.

Sincerely,

Francyne Klein Compliance Administrator

2/21/2019 St BVA WO 585899, Feb 19th, 2019

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TEST RESULTS

February 21st, 2019

New York State DEC DEC Region 2

Hunters Point Plaza, 2nd Floor 47-40 21st Street

Long Island City, NY 11101-5407

Test Results - UST Testing

Dear Sir / Madam:

Enclosed are copies of the test results performed by Crompco at the location listed below. On behalf of our customer, theseresults are being submitted to you in accordance with local regulations. Copies of the test results were also sent to the facilityto be retained at the location in case an inspection would occur by a state or local agency.

ID Numbers Address Test DateCrompco

Work Order Test(s) Performed

Location: BVA UST: 2-602985

130 W Kingsbridge Bronx, NY 14810

Tue Feb 19th, 2019 585899 EZY-3 Locator Plus

If you should have any questions regarding the tests enclosed, please contact Crompco at 1-800-646-3161.

Sincerely,

Francyne Klein

Compliance Administrator

2/21/2019 St BVA WO 585899, Feb 19th, 2019

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Work Ticket #: 585899 PO #: 36C24219P0556 - OBL#526-C90072

Address: 130 W Kingsbridge Bronx, NY 14810 Station #: BVA

Service Date: 02/19/2019Parts Sold

Quantity Sold Part Name Manufacturer Part # Description

Service Details

Crompco was on site performing testing,repairs, calibration and/or inspections forthe following reason:ComplianceComments

Gallons Pumped:

Site Arrival Time: 08:00:00 Site Depart Time: 16:30:00

Confirmation

By signing this verification you are agreeing that Crompco LLC performed various compliance testing and/or repairs andreplaced parts as listed above.

Printed Name Email Signature

Mike [email protected]

Signature captured Refused to sign

No one available to sign

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