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Home My WebLink AboutFMC 5-18-12HOODS ALA -RMS SPRINKLER SYSTEMS SPRAY BOOTH Permit No. Permit No. Permit No. Permit No. AST UST Permit No. Permit No. 1.2- l6 ZZ. File Number: Address: 1-2 Z0 S . r fiBakerseld, CA 933 n o3 Date Received: _ — Z Business Name: JSA, L c, - C SYSTEM: BUILDING SQUARE FEET: MPECTION LOG New Mod. Commercial Hood System Building Sq. Feet: Fire Alarrn System Calculation Bldg. Sq. Ft: Fire Sprinkler System Spray Finish System Aboveground Storage Tank Underground Storage Tank minor modification Underground Storage Tank removal Underground Storage Tank Other: 7Z-7n-'-7 C Comments: 1. 2. 3. 4. IL9. 0 Times Signature Signature BAKERSFIELD CITY FIRE DEPARTMENT -- INSPECTION RECORD Post this Card at the Job Site and DO NOT Remove for Duration of Work Inspection Request Phone No. (661) 326 -3979 UST NEW INSTALL DESCRIPTION DATE SIGNATURE BACKFILL PRIMARY PIPE SECONDARY PIPE SECONDARY CONTAINMENT SENSORS AUTHORIZATION FOR FUEL ELECTRICAL SEAK -OFF TANK TESTING UST REMOVAL DESCRIPTION DATE SIGNATURE AST NEW INSTALL DESCRIPTION DATE SIGNATURE MODIFICATIONS MINOR / MAJOR AST REMOVAL DESCRIPTION DATE SIGNATURE EVR UPGRADE PRIOR TO OPERATION OF ANY SYSTEM, ALL UST AND /OR AST SYSTEMS SHALL BE INSTALL, COMPLETE AND ACCEPTED BY MISC. ACTIVITY THE BAKERSFIELD CITY FIRE DEPARTMENT. FIRE DEPARTMENT (FINAL) REMARKS: BUILDING ADDRESS: 1,2pn S , JOB DESCRIPTION: OCCUPANCY TYPE: OWNER: L)-SA- L-lCeLic PERMIT NO. CONTRACTOR: Cd,v QKJ PHONE # FD 1743 BILLING & PERMIT STATEMENT BAKERSFIELD FIRE DEPARTMENT B Ni;e_x s N n Prevention Services PERMIT # I'` RE 2101 H StreetdjpaRrk,00'r Bakersfield, CA 93301 Phone: 661 -326 -3979 • Fax: 661 -852 -2171 Please make checks payable to CITY OF BAKERSFIELD. Thank you. CONFIDENCE UST SERVICES, INC. CMBANK, N.A. 10571 16250 MEACHAM RD. BAKERSFIELD- STOCKDALE /CALIFORNIA OFFICE BAKERSFIELD, CA 93314 BAKERSFIELD, CA 93309 72/3290-71 22 661) 631 -3870 5/18/2012 " 4> PAY TO THE ORDER OF City of Bakersfield " $* *192.00 One Hundred Ninety -Two and 001100**************'***********"******** * **** *** **" *" *** * *` * *** * * *** * *" ` * * *" * * * * *`* * * * * * * ** DOLLARS City of Bakersfield USA Liquor (MC) II'OL057LII' 1:322271724X 009534L4898711' U unaergrouno Storage IanK (Minor Moclitication) MTM 167 /site SITE INFORMATION Underground Storage Tank (Removal) TR Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. NOTE: $96 /hr for each type of test /per site /per UST system even if scheduled at the same time Oil well (Installation, Inspection, or re- inspection) X Tent # After -hours inspection fee 573 /tank 96 /hr (2 hrs minimum) = $192 H -t q_ 1-4 C%k I I, q -2 c 96 /hr 96 /tent 121 /hr (2 hrs minimum) = $242 LOCATION OFOF PROJECT , ljs-S ill .o . PROPERTY OWNER T.ht STARTING DATE -ee 1pre rm O'oft" T1' NAME PROJECT NAME ADDRESS CS PHONE# j ll- PROJECT ADDRESSV` l 33 96 /hr 1 CITY ,i>TZSFIELD STATE CA ZIP ODE 1 V CONTRACTOR INFORMATION. 84 CONTRACTOR NAM= C I E' # ll TYPE OF LICEN` r\ EXPIRATION V DATE PHONE # CONT rPANY NAME L k 1 t 1 r 1 C c .._ _— Y LLC `>,- - - - -- FAX # l "lc 1 ADDRESS " " 1, IISL CITY ( ZIP CODE Please make checks payable to CITY OF BAKERSFIELD. Thank you. CONFIDENCE UST SERVICES, INC. CMBANK, N.A. 10571 16250 MEACHAM RD. BAKERSFIELD- STOCKDALE /CALIFORNIA OFFICE BAKERSFIELD, CA 93314 BAKERSFIELD, CA 93309 72/3290-71 22 661) 631 -3870 5/18/2012 " 4> PAY TO THE ORDER OF City of Bakersfield " $* *192.00 One Hundred Ninety -Two and 001100**************'***********"******** * **** *** **" *" *** * *` * *** * * *** * *" ` * * *" * * * * *`* * * * * * * ** DOLLARS City of Bakersfield USA Liquor (MC) II'OL057LII' 1:322271724X 009534L4898711' U unaergrouno Storage IanK (Minor Moclitication) MTM 167 /site 82 Underground Storage Tank (Removal) TR Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. NOTE: $96 /hr for each type of test /per site /per UST system even if scheduled at the same time Oil well (Installation, Inspection, or re- inspection) X Tent # After -hours inspection fee 573 /tank 96 /hr (2 hrs minimum) = $192 H -t q_ 1-4 C%k I I, q -2 c 96 /hr 96 /tent 121 /hr (2 hrs minimum) = $242 84 82 82 84 Pyrotechnic (1 permit per event, plus an inspection fee of 96 /hr during business hours) . Py NOTE: After hours Pyrotechnic event inspection is @ $121 /hr 96 /hr + (5 hrs min standby fee /insp) _ $576 5 hrs min standby fee/ ins 605 84 Re- inspection /Follow -up Inspection 96 /hr 84 Portable LPG (Propane): # of Cages? — 96 /hr 84 Explosive Storage 266 84 Copying & File Research (File Research fee $50 /hr) 0.25 /page 84 Miscellaneous 84 BILLING & PERMXT STATEMENT PERMIT # 4ni llimiiwn nr. Nmt,R,' E R S A I''nly Diu.,. F//E 11T BAKERSFIELD FIRE DEPARTMENT Prevention Services 2101 H Street Bakersfield, CA 93301 Phnna• F,F,1 - '47f, -3979 • Fax- 661 -R52 -2171 INFORMATION LOCATION OF PROJECT S •, 1 PRO ERTY OWNER STARTING DATE `Ae 5/Wo_ NAME uE& S PROJECT NAME r ADDRESS Q , PHONE # c - PROJECT ADDRESSU CITY NTR • CONTRACTOR NAME CA LICENSE # Wo g.4K,ET2 5 1>LD STATE C/4 TYPE OF LICENSE EXPIRATION DATE U ZIP CODE I I PHONE # C l 3- 37 CONTRA OR COMPANY NAME SK FAX # 0 106511-S_151 ADDRESS CITY ZIP CODE Please make checks payabie to CITY OF BAKERSFIELD. Thank you. I • • DUE Alarm - New & Modification (minimum charge) $280 ACCT Over 10,000 sq ft 0 .028 x sq ft Sprinkler - New & Modification (minimum charge) 280 Over 10,000 sq ft 0 .028 x sq ft Sprinkler - Minor Modification ( <10 heads) 96 (inspection only) 84 Commercial Hood (New & UL 300 Upgrade Modification) Additional Hood 470 58 hood Commercial Hood - Minor Modification add move nozzle 96 (inspection only) 84 Spray Booth (New & Modification) 470 98 Aboveground Storage Tank (1 inspection per installation) AST 180 /tank 82 Additional Tank ATI 96 /tank 82 Aboveground Storage Tank (Removal, Mod,or Inspect'n) ATR 109 /tank 82 Underground Storage Tank (Installation /Inspection) NI 878 /tank 82 Underground Storage Tank (Modification) MOD 878 /site 82 Underground Storage Tank (Minor Modification) MTM 167 /site 82 Underground Storage Tank (Removal) TR 573 /tank 84 Mandated UST Testing: Fuel Mont Cert/SB989 /Cath. Prot. NOTE: $96 /hr for each type of test /per site /per UST system even if scheduled at the same time 96 /hr (2 hrs minimum) _ $192 I Z Gk j, p 57 J 1 "Z 82 Oil well (Installation, Inspection, or re- inspection) x 96 /hr 82 Tent # 96 /tent 84 After -hours inspection fee 121 /hr (2 hrs minimum) = $242 Pyrotechnic (1 permit per event, plus an inspection fee of 96 /hr during business hours) Py NOTE: After hours Pyrotechnic event inspection is @ $121 /hr 96 /hr + (5 hrs min standby fee /insp) _ $576 5 hrs min standby fee ins = 605 84 Re- inspection /Follow -up Inspection 96 /hr 84 Portable LPG (Propane): # of Cages? _ 96 /hr 84 Explosive Storage 266 84 Copying & File Research (File Research fee $50 /hr) 0.25 /page 84 Miscellaneous 84 UNDERGROUND SYORAGE TANg(S A P Vh- 1C I% TV () i\i Cl ! BAKERSFIELD FIRE DEPARTMENT Pvellelltioll seovice.s 1-600 Ave., '-,uito /10 I. 0 EPA& FINIHNT Baker.shelcl, CA 9',1*,;().1, Fax: f ()I. I 171 NIONITHRII,)(:; Sffl: INFORMATION 1 -1At-If.' 1, IIHONI: /1 (,1 CON I'A I 1 *1 4v" U-,L- 011fill"WI: NiWil plAti. III 'I() I I Vt-f &a-v 0 OF TANK± 'I lif• I I D TA N K v 1- 1.) m I- C0 1\1 TI: N TS11 COMPANY I)IJOI-11: ll 01: CONTACT USA... sey Vic ets,- ty' S6 1-111,1101) IC:C 11 TI-115 APPLICATION BECOMES A PERIAXT 11f HEN APPROVED i MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner /operator. The owner /operator must submit a copy of this form to the local agency regulating UST systems within 30 days of this date. A. General Information Facility Name: USA Liquor Bldg. No.: _ Site Address: 1720 South Union Avenue City: Bakersfield Zip: 93307 Facility Contact Person: Refaat Make /Model of Monitoring System: Veeder Root TLS 300 B. Inventory of Equipment Tested /Certified Check the appropriate boxes to indicate specific equipment inspected /serviced: Contact Phone No.: 661 - 917 -1790 Date of Testing/Servicing: 5/21/2012 Tank ID: 10000 gal. Regular Tank ID: 10000 gal. Super [X] In -Tank Gauging Probe. Model: 847390-107 [x] In -Tank Gauging Probe. Model: 847390 -107 [x] Annular Space or Vault Probe. Model: 794390-420 [x] Annular Space or Vault Sensor. Model: 794390 -420 [x] Piping Sump / Trench Sensor(s). Model :794380 - 208 [x] Piping Sump / Trench Sensor(s). Model: 784380 -208 ❑ Fill Sump Sensor(s) Model: ❑ Fill Sump Sensor(s). Model: [X] Mechanical Line Leak Detector. Model:FX1V [x] Mechanical Line Leak Detector. Model: FX1V ❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: [x] Tank Overfill / High Level Sensor. Model:OPW -61 -SO L11 Tank Overfill / High Leval Sensor. Model: OPW -61 -SO ❑ Other (specify equip. type and model in Sec. E on Pg. 2) ❑ Other (specify equip. type and model in Sec. E on Pg. 2) Tank ID: 10000 gal. Diesel Tank ID: [x] In -Tank Gauging Probe. Model:847390 -107 ❑ In -Tank Gauging Probe. Model: 847390 -107 [x] Annular Space or Vault Sensor. Mode 1:794390 -420 ❑ Annular Space or Vault Sensor. Model: U Piping Sump / Trench Sensor(s). Model: 794380-208 ❑ Piping Sump / Trench Sensor(s). Model: ❑ Fill Sump Sensors(s). Model: ❑ Fill Sump Sensor(s). Model: [x] Mechanical Line Leak Detector. Model:FX1DV ❑ Mechanical Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: ❑ Electronic Line Leak Detector. Model: [x] Tank Overfill / High Level Sensor. Model:OPW -61-SO ❑ Tank Overfill / High Level Sensor. Model: ❑ Other (specify equip. type and model in Sec. E on Pg. 2) ❑ Other (specify equip. typs and model in Sec. E on Pg. 2) Dispenser ID: 1 & 2 Dispenser ID: 3&4 ❑ Dispenser Containment Sensor(s). Model: ❑ Dispenser Containment Sensor(s). Model: [X] Shear Valve(s), Lx] Shear Valve(s). [x] Dispenser Containment Float(s) and Chain(s). [x] Dispenser Containment Float(s) and Chain(s) Dispenser 1 D: Dispenser 1 D: ❑ Dispenser Containment Sensor(s). Model: ❑ Dispenser Containment Sensor(s). Model: ❑ Shear Valve(s). ❑ Shear Valve(s). ❑ Dispenser Containment Float(s) and Chains(s). ❑ Dispenser Containment Float(s) and Chain(s). Dispenser ID: Dispenser ID: ❑ Dispenser Containment Sensor(s). Model: ❑ Dispenser Containment Sensor(s). Model: ❑ Shear Valve(s). ❑ Shear Valve(s). ❑ Dispenser Containment Float(s) and Chain(s) ❑ Dispenser Containment Float(s) and Chain(s). *If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification - I certify that the equipment identified in this document was inspected /sery ices in accordance with the manufacturers' guidlines. Attached to this Certification is information (e.g. manufacturers' checklist) necessary to varify that this information is correct and a plot plan showing the layout of monitoring equipment. For equipment capable of generating such reports, l have attached a copy of the report; (check all that apply) x❑ Syste et -up [x]Alar sto y report Technician Name (print): Bryan A Self Signature: Certification No: 837501 License No: 804904 Testing Company Name: Confidence UST Services, Inc. Phone No: 800- 339 -9930 Site Address: 1720 South Union Avenue, Bakersfield C.A. 93307 Date of Testing/Servicing: 5/21/2012 D. Results of Testing /Servicing Software Version Installed: 424.00 Complete the following checklist: Lx] Yes ❑ No* Is the audible alarm operational? x Yes I No* Is the Visual alarm operational? -.x'-Yes F1 No* Were all sensors visually inspected, functionally tested, and confirmed operational? Yes ❑ No* Were all sensors installed at the lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? Yes No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) Hx N/A operational? x Yes ❑ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary ❑ N/A containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initate positive shut -down? E Sump /Trench Sensors❑ Dispenser Containment Sensors Did you confirm positive shut -down due to leaks and sensor failure /disconnected? [x] Yes; ❑ No; UYes ❑ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no ❑ N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visual and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capasity does the alarm trigger? 61-SO % ❑ Yes* U No Was any monitoring equipment replaced? If Yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. ❑ Yes* ❑ No Was liquid found inside any secondary containment systems designed as dry systems? ❑ Product; ❑ Water. If yes, describe causes in Section E, below. x o* Was monitoring system set -up reviewed to ensure proper settings? Attach set -up reports, if applicable. x YeS No* Is all monitoring equipment operational per manufacturer's specifications? * In Section E below, describe how and when these deficiencies were or will be corrected. E. Comments' I Removed APPX 22 gallons of water from the Super STP. F. In -Tank Guaging / SIR Equipment: [x] Check this box if tank guaging is used only for inventory control. ❑ Check this box if tank guaging or SIR equipment is installed. This section must be completed if in -tank guaging equipment is used to perform leak detection monitoring. Complete the following checklist: U Yes ❑ No* Has all input wiring been inspected for proper enter and term ination,including testing for ground faults? x Yes No* Were all tank guaging probes visually inspected for damage and residue buildup? x Yes No* Was accuracy of system product level readings tested? x Yes No* Was accuracy of system water level readings tested? Fxj Yes 7 No* Were all probes reinstalled properly? U Yes ❑ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ❑ Check this box if LLD's are not installed. Complete the following checklist: Lx] Yes ❑ No* For equip. start-up or annual equipment certification, was a leak simulated to varify LLD performance? (Check all that apply) Simulated leak rate: Lx]3 g.p.h.: 00.1 g.p.h.; ❑0.2 g.p.h.; x Yes No* Were all LLD's confirmed operational and accurate within regulatory requirments? x Yes No* Was the testing apparatus properly calibrated? L] Yes No* For machanical LLD's, does the LLD restrict product flow if it detects a leak? N/A ❑ Yes No* For electronic LLD's, does the turbine automatically shut off if the LLD detects a leak? Lx] N/A ❑ Yes No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system is [x] N/A disabled or disconnected? ❑ Yes No* For electronic LLD's, does the turbine automatically shut off if any portion of the monitoring system [xj N/A malfunction or fails a test? ❑ Yes No* For electronic LLD's, have all accessible wiring connections been visually inspected? Cx] N/A x Yes No Were all items on the equipment manufacturer's maintenance checklist completed? * In the section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: iLj( lk Ulii,,,I,l WE UHU'RI-FIEU) ,'til.. q `j *3 1 ] '.7 ALL, I WLMT R,l 1,TPOKN I I 'UNIXAD 0 iL2 VA-1.111E 7r:21, LI1AJ-11.'F -, . I fJ 4 9CI:, 1JL.U.;GE- 141..3 1'4" 1itk".1111- :t i I HE I 1 :11,17 - r, 11 , ft;, WITER V..101. - rl I WATER 0.00 14,Hr. 11,11P 7,-,. t IIEC, F 1 2;SljpFN VOLUME 0 iL2 50 Hl'.* f 6HT y Til J, i I f 41 ' H wwm. ., .17 (�AUj WATER I I FF. HE" ,.', TENP 71 .,-4 C'Et.; F -113% IJLL6:F 01a:- Tr, i'i I,' ,it_:; HE. I i',Frr I m TFre H � N ' 44, ID j:;OLA.s folii%k I ri• •111::5 Do; F Ail.'l PIP I t; orj I • '•,ITI. 1 RI'HTEI.- i, I 1.). -.1 . flu. 5b 1•0 Usm Llko�161` 17,, 1410 - -r-J 171, '1.11 FT TIHE I D �:HIFT Til-T. 2 SHIFT TIME j b t SHIFT TIME •i 11t,431X1, T11 SASL.EE+ 1APIK ANH UP11 [1) SABLED LINE PCR TST NI-111111i lAVJ DIStirlI.ED LINE: ANN 'P.;T NE1.111-1) WHIII V, I SANXI I PR I MT Ti' vcI-•UmE:j ENABLED TEMP VALUE il'D.: V 61,1. 0 ST I Cl; , i-IF Is' 3 Fi I' 5FF::FY D I SABl. I: I+ IE I uHT DAYLI+'JHT Tltlf" D I Sr ;lbl.Ul k-E-111RE-1 1.0041. PRINTOUT D I Pjf iDLED EURO PROT"31'ol-• FiNNLJ1x,R Llul_Jlb :::I1`N!J()R olJ,B.: :3E14c1'*k, I'lopl-Itm. EXTERN INI'll't, SIP SE142.OR D'TERI4 INPUT OIJ11%it I LIE tiDiki-I �IOORII 7 U;1 P'uvo jjI - t-ro D I Sf*A.EIJ (-,H UT(,) H 1 � It-j. j.IMIT AUTO 1_-1w F-Rc, Lit 11"• wiTo [.IHIT [j I SABLED . , .—V I Nv:,r fjUT , J)FL1VEIKi r; I. sAbl-E I I . ID AnTo DELAV ERe AUTO D 1 EXTEWO 1. 1 s, A n. I. E L) ILALITO ,-�EVISOF: 1) 1 i4lyfn "o'c.ok AUT, D I SPNEII-FE' RS Star, _140 f, I .r3A j3 1. E L, I N- TANK THEP11CL (X)F.FF I I I I V 111.111 TANK i) 1 9,1 .110 THNK. P$)• I LE 1 I-r FULL V--d. I D FU i1' Sl*.:E: -1.0 IN. Aquyly 1110-1 WATEP LANIT: j. 5 MAX UR LHI;EL I (I',; 10 OVERFILL 1. 1 I'l I I* I FIT SIPHON HIGH PROJILi,:•j, I H . WATER vdFiPIC 1219 11ELIVE*P'i, 1.11-11T pi fW( 0P I.HF.&J, I fy'l I I) LOW 500 LEN: 99 1�101.0p.11 U,&6 1;9 TANK TiLT, : 2. Iii) PRI,&E OF'F:;E'r f 1. CIO 21PHON 0 TO: 14011E LINE M,'iHIj-VIjCI1 fF %Nl:t7; TO PUMP T WSUPER Aquyly THERNAL. 0 Two: c, 1 0 i-1 PRoFiI.I: I FIT SIPHON FLOAT I H . WATER vdFiPIC 0 HIGH •HTER L".1"11T: pi fW( 0P I.HF.&J, I fy'l I I) PIIf,IP- THR2.,,I•(0L.f1 : 1 0.00% ��UDDEH LIMIT: �q H I U-1 PP01 -1 R-7 j P ROBE 0: 6ci I LjELV-A.R' I.ImIT 0 j PPODUCT 'I'l-ILKINAL I *oLFF : . I'l I 11, W '* TANK 131Ht11."'TrR 1,11.1 TANK PROM LE I V1, FULL V-*,*-I. 1-1-Oh'IF Sf—'E: 4.0 119. LE+Ar. ALA J-1 L.II'IiT: I� .31JLjLJEI,4 CAPHT: 99 TAP,11-'. T I Ul' J. 2 7 00 SIPHON TO : NONE LINE MAN IFoll-Ell 0 To: NOME OELIVE'P`t' : I rI I m PIIf,IP- THR2.,,I•(0L.f1 : 1 0.00% j PPODUCT 'I'l-ILKINAL I *oLFF : . I'l I 11, W '* TANK 131Ht11."'TrR 1,11.1 TANK PROM LE I V1, FULL V-*,*-I. 1-1-Oh'IF Sf—'E: 4.0 119. SIPHON T14: 1141,1F I INH' TO: NONE DELIVERN U.'IA-I : I H! III PUMP THRE Iiu;H-j : 1 L 1, of r:;, 1.1wUlD !:;EItY4.* L I IN '21, it., 1- 3: L) I FS H, TRO 11-1 L 4:LINL-EW)L:1'j 11'41 'k:.,TI Al.. FLOAT) L 5:PRF1111-111 '.1HTFJJOPY SPACE L 6: L, I EiaEl. I VIA ER',niT 101. OUTPUT RFL.1,'.' R I : F �; rol-, TYPE: "'TA11T."PIKI S L OUT' - ... p?•T.P NPR 30 2,il 1 '-1 2 F R I HTER FPPOP CATTE.P.,11 IL: 0(-T 24, A0:1 1,1(iX LHIBEL %,IQL: I 1-1:,i 10 IAHIT q sk. )?94 1.11-11T 0 LOIJ PROPI-11"T 1500 I.F'f�W Pikkrl .,i,j ��UDDEH LIMIT: �q TANK TILT 1 6 5 P ROBE 0: 6ci I SIPHON T14: 1141,1F I INH' TO: NONE DELIVERN U.'IA-I : I H! III PUMP THRE Iiu;H-j : 1 L 1, of r:;, 1.1wUlD !:;EItY4.* L I IN '21, it., 1- 3: L) I FS H, TRO 11-1 L 4:LINL-EW)L:1'j 11'41 'k:.,TI Al.. FLOAT) L 5:PRF1111-111 '.1HTFJJOPY SPACE L 6: L, I EiaEl. I VIA ER',niT 101. OUTPUT RFL.1,'.' R I : F �; rol-, TYPE: "'TA11T."PIKI S L OUT' - ... p?•T.P NPR 30 2,il 1 '-1 2 F R I HTER FPPOP CATTE.P.,11 IL: 0(-T 24, A0:1 SEP ::01 LI ':4: 31) AM •e f-I I) i T 3: f+1 E: SETUP F'HT6 14,1RI'M1'.; NOV 24. A I'l 140V 4 17 1111,J1 WiTER JUL. I'D. 21'Ju3 t,:.I[; Pill UL 111, EiU.3 `.1:. _i FT'l T I WNLE61) *201.w 'r 2:8UPER Low PR(�Fjlvl' JUN 25 2FRIP DF TA 1,14:111 I'll.; C1 r, PH 0 11-1 Ov "4. fii'i:i 1:14 l't.1 MA".1 21-11. :.UnS 2 27 PH 4:14 Ph VERIF I LL JUL I 2oD *: s 0: 1 fi f rl N`v'HL. I r., f1'9 Hlk> Wfl'Ek AIN 25. t01 NOV '242 4 1 h 1.1-1 IT I Fc.: 2 P41 JUL 13. 21iliEl 1 1:1: .11z Pill 1•'ROBL 01.1'1 Hl ;II f-Rol•j-,T Fkl.fiRpi LOW 1+11'.17-ul 'T oLrill-I NOV 24 '201X*j 4: IF) Pill S E F - 27 L i I L 'I: " I'l 61.1 1 JUL 8. -"o 1u 2 pm 1 N%jti L I 1 11 ll':I_ LEVEL H I CAA PIP•"ID1.11-1 1AL.1 IR11 JAN JUL. I C1. (4,R 2a. 21,:11:? 4:;1:1 tJ-1 JLI[q 4 1-hl ' "..4. 2(.111 JUL 1 15 0 1) & 2:41 P111 filU: PRO13F. ()Ifr I NOAL I b FUEL l:V EL 11AY •,008 2 �j i Ill JUN C1 :j 4 i W-1 1 APR ?. 2001; rti I'lov 24 20rij 4 :<11 PI.-I PRODE, Ou'r HA" 22. I"m NOV 24 • 200u :3 -. 4 4 PH SEP ::01 LI ':4: 31) AM •e f-I I) i T 3: f+1 E: SETUP F'HT6 14,1RI'M1'.; NOV 24. A I'l 140V 4 17 1111,J1 WiTER JUL. I'D. 21'Ju3 t,:.I[; Pill UL 111, EiU.3 `.1:. _i FT'l J 1.11. 1111. *201.w 9 16 Low PR(�Fjlvl' JUN 25 ul),-, C1 r, PH JUL `4 110E1 9 ou Hr I MA".1 21-11. :.UnS 2 27 PH HIGH PP0110.7 JUL I 2oD *: s 0: 1 fi f rl N`v'HL. I r., FUL!, LEVI-''L AIN 25. '2 1,.'/ Pill 11 IL 24. IT I Fc.: 2 P41 JUL 13. 21iliEl 1 1:1: .11z Pill 1•'ROBL 01.1'1 JUL 24. *HiCiii H:57 JUL 9 - ;31.11711; V:'48 r-fl JUL 8. -"o 1u 2 pm JUL 19. :.111.1LI 6: .10 PH JUL. I C1. �!0 u ri 4:;1:1 tJ-1 J1.11- I Cj . ^01-18 :4: 16, j,'jr-I i LOW TEMf, 144:111 NC�' J1.11- e. :"i:, - .6 11-1 SAT n ojvs, AUC N. ENI. ---- -- "LIT&DR At,v,Rll - ---- I L -3: D i D-1-1 TPO, 114 `-3-WIP �--Tp SUP'll" STP ;UNP JUL 14. '., 0 1 1 .1:4!j Pri ST• .;Uf•llrl APR 15 2011 9: 10 fil-I c t-%Ll', 24. .,fju,:j 10:01 h(l SETUP f)HTA WMPNIN13 FEB I Ll - '20 1 1 10: 1.14 r4'1 SLIAl - -, Pi: FEB 14. :ol-lll 5o tAl i 4 011 TIJIV cl L I J01 I,p 61', OUT "2011 AV? 20 - 9 l. I : �-' t-, SEE '3 • a'ul. 1pf-, I (q C sump 1"4 N"I I j �jrj Auc; 24" x-t I SAT n ojvs, AUC N. ENI. ---- -- "LIT&DR At,v,Rll - ---- I L -3: D i D-1-1 TPO, 114 `-3-WIP �--Tp SUP'll" STP ;UNP JUL 14. '., 0 1 1 .1:4!j Pri ST• .;Uf•llrl APR 15 2011 9: 10 fil-I c t-%Ll', 24. .,fju,:j 10:01 h(l SETUP f)HTA WMPNIN13 FEB I Ll - '20 1 1 10: 1.14 r4'1 SLIAl - -, Pi: FEB 14. :ol-lll 5o tAl i 4 011 TIJIV cl L I J01 I,p 61', OUT "2011 AV? 20 - 9 l. I : �-' t-, SEE '3 • a'ul. :jTP OUT HLIAr-J"I . ; HAY 21. 11111-! %0:0o ;'M it 1. 61 til-:1 1 Allt-11.11-hR HH", 4 13 km 0011 21. 2WN 9:45 mm I WAS our milwy Hiili 2E L I W1111-I.-Jili '114.1011-41 I. 5:g,pr'1 t6i-i I am. Halil" (4,114ULHP, EMWk Our L 4:1.111I.Eiii1l.11 I NTJ '2,1 MAY '1 .,4:46 N1 fil,1111.1LAN, ;,hirT L 4:1JIMMI, 2:PPRf,liijI-I hNNU1,4P :jj,,jt-t, 01'k,01 "JET' *R QIJI fiUARM Ill 'I I 'I. I lAY 21 • 9 •ANNULAR ',;PiiI"L rA'P S1114. I,JAY 2 1. 2u I L 5: F k! L - .;TP W LIUM, SIVIOR J7::,,I.i jj 111,11:)[A 11VE Hi T. 9'. 4b 1-41 PrI RCPOR'l ALI. Ail SWRCB, January 2006 Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and printouts from tests (if applicable), should be provided to the facility owner /operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: USA Liquor Date of Testing: 5/21/2012 Facility Address: 1720 South Union Avenue, Bakersfield, C.A. 93307 Facility Contact: Refaat I Phone: 661 -917 -1790 Date Local Agency Was Notified of Testing : 4/30/2012 Name of Local Agency Inspector (f present during testing): Ernie Medina 2. TESTING CONTRACTOR INFORMATION Company Name: Confidence UST Services, Inc. Technician Conducting Test: Bryan A Self Credentials: X CSLB Contractor X ICC Service Tech. X SWRCB Tank Tester ❑ Other (Specify) License Number(s): CSLB #804904 ICC #8022804 -UT SWRCB #11 -1756 3. SPILL BUCKET TESTING INFORMATION Test Method Used: x Hydrostatic ❑ Vacuum ❑ Other Test Equipment Used: Lake Test Equipment Resolution: 0.0625" Identify Spill Bucket (By Tank Number, Stored Product, etc. 1 Regular 2 Super 3 Diesel 4 Bucket Installation Type: x Direct Bury ❑ Contained in Sump x Direct Bury ❑ Contained in Sump x Direct Bury ❑ Contained in Sump ❑ Direct Bury ❑ Contained in Sum Bucket Diameter: 12.00" 12.00" 12.00" Bucket Depth: 14.00" 14.50" 14.50" Wait time between applying vacuum /water and start of test: 5 min. 5 min. 5 min. Test Start Time (TI): 9:15 am 9:15 am 9:15 am Initial Reading (Rj): 10.00" 10.00" 10.25" Test End Time (TF): 10:15 am 10:15 am 10:15 am Final Reading (RF): 10.00" 10.00" 10.25" Test Duration (TF — Ti): 1 hour I hour I hour Change in Reading (RF- R,): 0.00" 0.00" 0.00" Pass /Fail Threshold or Criteria: 0.0625" 0.0625" 0.0625" Test Result: X Pass ❑ Fail X Pass ❑ Fail X Pass []Fail ❑ Pass ❑ Fail Comments — (include information on repairs made prior to testing, and recommended follow -up for failed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true, accurate, and in full compliance with legal requirements. r Technician's Signature: Date: 5/21/2012 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. Q ❑ J O 3 SOUTH UNION AVE. SITE PLOT PLAN for: 4 USA LIQUORS 1720 SO. UNION AVE. BAKERSFIELD, CA 93307 ^2 015- 021 - 013910 1 - 10,000 GALLON USTS - (4Tti ATN3 ATc A (A` CA T• L5 L6 H )I PN r.'A V/R CIRCUIT BREAKER CLOSET m N LEGEND L1 87 STP L2 91 STP L3 DSL STP L4 87 ANNULAR L5 91 ANNULAR L6 DSL ANNULAR ESO EMERGENCY SHUT -OFF ® PRODUCT SPILL CONTAINER t� VAPOR SPILL CONTAINER !4? ANNULAR FIRE EXTINGUISHER 4i GAS METER SHUT -OFF WATER METER SHUT-OFF O HEALY CAS EVACUATION MEETING POINT L1 L L2 L L3 STP STP S STP O8 3 O A (A` CA T• L5 L6 H )I PN r.'A V/R CIRCUIT BREAKER CLOSET m N LEGEND L1 87 STP L2 91 STP L3 DSL STP L4 87 ANNULAR L5 91 ANNULAR L6 DSL ANNULAR ESO EMERGENCY SHUT -OFF ® PRODUCT SPILL CONTAINER t� VAPOR SPILL CONTAINER !4? ANNULAR FIRE EXTINGUISHER 4i GAS METER SHUT -OFF WATER METER SHUT-OFF O HEALY CAS EVACUATION MEETING POINT