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Home My WebLink About2018 FMC RESULTS1 Danielle Blackburn Subject:SA002, AT&T Annual Monitor Certification & Spill Bucket Testing Notification w/Overfill Test (BKFDCA01), Bakersfield Location:1520 20TH ST, BAKERSFIELD, CA 93301-4406 Start:Fri 11/2/2018 9:00 AM End:Fri 11/2/2018 11:00 AM Recurrence:(none) Meeting Status:Meeting organizer Organizer:Simplex Communication Required Attendees:RENUK, ALLEN L; 'SANDERS, SEAN T'; kc9892@att.com; 'ATTCATesting@taitenv.onmicrosoft.com'; 'HAYN, CINDY H (ATTSI)' (ch1921@att.com) ; Brian Harmon; Carlos Cardenas; Jennifer Pruitt; ATT @ Calhaz (ATT@calhaz.com); Maria Figueroa; Adolfo Aguilar Categories:Annual Monitoring Certification & Spill Bucket Testing, Legacy T Site There is an AT&T Annual Monitoring Certification & Spill Bucket Test scheduled for this location on the date and time indicated. NOTE: -Testing will include the Overfill Test of the Overfill alarm SA002 1520 20TH ST BAKERSFIELD 93301-4406 Current Notification: Old Notification: TEST DUE DATE 11/7/2018 PERMIT REQUIRED for Testing Please contact the Compliance Manager with any questions and/or comments at: simplexcommunication@tait.com 2 714.560.8200 Environmental Health/CUPA Contact Information: Bakersfield City Fire Department 2101 H Street Bakersfield, CA 93301 Method of Notification: Email Contact: Kristopher Karns KKarns@bakersfieldfire.us 1 Danielle Blackburn From:Kristopher Karns <kkarns@bakersfieldfire.us> Sent:Monday, October 22, 2018 10:40 AM To:Carlos Cardenas Cc:Jennifer Pruitt Subject:RE: ***RE-Scheduling Request***SA002, AT&T Annual Monitor Certification & Spill Bucket Testing Notification (BKFDCA01), Bakersfield I’ve put you guys down tentatively for Friday November 2nd at 9:00am pending permit approval. Once the permit his been approved you will be notified, but for now we’ll just stick with the 2nd. Best regards, Kris Karns Fire Prevention/Environmental Officer Bakersfield FIRE Department (661) 326‐3706 office (661) 852‐2171 fax KKarns@BakersfieldFire.us From: Carlos Cardenas [mailto:ccardenas@TAIT.COM] Sent: Monday, October 22, 2018 10:22 AM To: Kristopher Karns Cc: Jennifer Pruitt Subject: ***RE-Scheduling Request***SA002, AT&T Annual Monitor Certification & Spill Bucket Testing Notification (BKFDCA01), Bakersfield Importance: High Hello Inspector Karns, Thanks for the response. I show that the permit package has been delivered today. Please let me know when the permit is approved and we can schedule the next available date. We would like to change our requested date to 11/2/2018 9:00 AM. Attached is the revised permit application. Carlos E. Cardenas Tait Environmental Services, Inc. (714) 567-6418 From: Kristopher Karns [mailto:kkarns@bakersfieldfire.us] Sent: Monday, October 22, 2018 8:34 AM To: Carlos Cardenas <ccardenas@TAIT.COM> Cc: Jennifer Pruitt <jpruitt@TAIT.COM> Subject: RE: ***Scheduling Request***SA002, AT&T Annual Monitor Certification & Spill Bucket Testing Notification (BKFDCA01), Bakersfield 2 I’m sorry Carlos, we will have to reschedule, as we are not allowed to complete jobs prior to permit approval… Best regards, Kris Karns Fire Prevention/Environmental Officer Bakersfield FIRE Department (661) 326‐3706 office (661) 852‐2171 fax KKarns@BakersfieldFire.us From: Carlos Cardenas [mailto:ccardenas@TAIT.COM] Sent: Friday, October 19, 2018 11:44 AM To: Kristopher Karns Cc: Jennifer Pruitt Subject: RE: ***Scheduling Request***SA002, AT&T Annual Monitor Certification & Spill Bucket Testing Notification (BKFDCA01), Bakersfield Importance: High Hello Kris, There was a delay with Accounting and I just got the permit check. Attached is the packet that is being shipped priority overnight and it should be arriving on Monday Morning. The date we were hoping for was 10/24/2018 9:00 AM, so please let me know if that won’t work, so that I can start working on a later date to schedule. Carlos E. Cardenas Tait Environmental Services, Inc. (714) 567-6418 From: Kristopher Karns [mailto:kkarns@bakersfieldfire.us] Sent: Thursday, October 11, 2018 4:12 PM To: Carlos Cardenas <ccardenas@TAIT.COM> Subject: RE: ***Scheduling Request***SA002, AT&T Annual Monitor Certification & Spill Bucket Testing Notification (BKFDCA01), Bakersfield Sounds good From: Carlos Cardenas [mailto:ccardenas@TAIT.COM] Sent: Thursday, October 11, 2018 3:41 PM To: Kristopher Karns Subject: RE: ***Scheduling Request***SA002, AT&T Annual Monitor Certification & Spill Bucket Testing Notification (BKFDCA01), Bakersfield No problem. I’ll send that in and you should be receiving it on Monday. I’ll follow up with you on Tuesday. Carlos E. Cardenas 3 Tait Environmental Services, Inc. (714) 567-6418 From: Kristopher Karns [mailto:kkarns@bakersfieldfire.us] Sent: Thursday, October 11, 2018 3:18 PM To: Carlos Cardenas <ccardenas@TAIT.COM> Cc: Jennifer Pruitt <jpruitt@TAIT.COM> Subject: RE: ***Scheduling Request***SA002, AT&T Annual Monitor Certification & Spill Bucket Testing Notification (BKFDCA01), Bakersfield I’m sorry Carlos, but I can’t schedule the testing until the permit has been approved. Best regards, Kris Karns Fire Prevention/Environmental Officer Bakersfield FIRE Department (661) 326‐3706 office (661) 852‐2171 fax KKarns@BakersfieldFire.us From: Carlos Cardenas [mailto:ccardenas@TAIT.COM] Sent: Thursday, October 11, 2018 1:22 PM To: Kristopher Karns Cc: Jennifer Pruitt Subject: ***Scheduling Request***SA002, AT&T Annual Monitor Certification & Spill Bucket Testing Notification (BKFDCA01), Bakersfield Importance: High Hello Kris, We were hoping to schedule the annual testing for 10/24/2018 9:00 AM. Once we can confirm a date I will send over the permit application with the check. Thank you for your time sir! Carlos E. Cardenas Tait Environmental Services, Inc. (714) 567-6418 There is an AT&T Annual Monitoring Certification & Spill Bucket Test scheduled for this location on the date and time indicated. SA002 1520 20TH ST BAKERSFIELD 93301-4406 4 Please contact the Compliance Manager with any questions and/or comments at: simplexcommunication@tait.com 714.560.8200 Environmental Health/CUPA Contact Information: Bakersfield City Fire Department 2101 H Street Bakersfield, CA 93301 Method of Notification: Email Contact: Kristopher Karns KKarns@bakersfieldfire.us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ame as Facility Name or DBA-Doing Business As) %XVLQHVV6LWH$GGUHVV &LW\ =,3&RGH ,, 81'(5*5281'6725$*(7$1.6(59,&(7(&+1,&,$1,1)250$7,21 1DPHRI&RPSDQ\3HUIRUPLQJWKH&HUWLILFDWLRQ 3KRQH 0DLOLQJ$GGUHVV 1DPHRI8676HUYLFH7HFKQLFLDQ3HUIRUPLQJWKH&HUWLILFDWLRQ(Print as shown on the ICC Certification) &RQWUDFWRU7DQN7HVWHU/LFHQVH ,&&&HUWLILFDWLRQ ,&&&HUWLILFDWLRQ([SLUDWLRQ'DWH 0RQLWRULQJ6\VWHP7UDLQLQJDQG&HUWLILFDWLRQV(List all applicable certifications.) ([SLUDWLRQ'DWH ,,, 5(68/762)7(67,1*6(59,&,1* Indicate and attach the following reports if the monitoring equipment is capable of generating either.<11$0RQLWRULQJ6\VWHP6HWXS$ODUP+LVWRU\5HSRUW :DVDQ\PRQLWRULQJHTXLSPHQWUHSODFHG" (If “Yes,” identify the specific devices replaced and list the manufacturer and model for all replacement parts in section IV below.) :DVGDPDJHGHEULVRUOLTXLGIRXQGLQVLGHDQ\VHFRQGDU\FRQWDLQPHQWV\VWHPV" (If “Yes,” describe what was found in section IV below.) ,VDOOPRQLWRULQJHTXLSPHQWRSHUDWLRQDOSHUPDQXIDFWXUHU¶VVSHFLILFDWLRQV" (If “No,” describe why in section IV below.) ,9 &200(176 If directed to use this section, describe how and when the issues were or will be corrected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acific Bell Telephone Co. dba AT&T California 1520 20th St.Bakersfield 93301 TAIT Environmental Services, Inc.(714) 560-8222 701 N. Parkcenter Dr., Santa Ana, CA 92705 Adolfo Aguilar 588098 5238610 5238610 Veeder-Root TLS-350 / #A20066 12/19/2018 Adolfo Aguilar ,' ,GHQWLILFDWLRQ6: 6LQJOH:DOOHG93+ 9DFXXP3UHVVXUH+\GURVWDWLF//' /LQH/HDN'HWHFWRU 81'(5*5281'6725$*(7$1. 021,725,1*6<67(0&(57,),&$7,21)2503DJHRI 9, ,19(1725<2)(48,30(17&(57,),(' A separate Monitoring System Certification Form must be prepared for each monitoring system control panel. 0DNHRI0RQLWRULQJ6\VWHP&RQWURO3DQHO 0RGHORI0RQLWRULQJ6\VWHP&RQWURO3DQHO 6RIWZDUH9HUVLRQ,QVWDOOHG Check the appropriate boxes to indicate specific equipment inspected/serviced. 0RQLWRULQJ'HYLFH8VHG'HYLFH0RGHO0RQLWRULQJ'HYLFH8VHG'HYLFH0RGHO 7$1.,' (By tank number, stored product, etc.) 7$1.,' (By tank number, stored product, etc.) ,Q7DQN*DXJLQJ(SW Tank),Q7DQN*DXJLQJ(SW Tank) $QQXODU6SDFHRU9DXOW6HQVRU$QQXODU6SDFHRU9DXOW6HQVRU 93+6HQVRU93+6HQVRU 3URGXFW3LSLQJ 3URGXFW3LSLQJ 0HFKDQLFDO//'0HFKDQLFDO//' (OHFWURQLF//'(OHFWURQLF//' 93+6HQVRU3LSLQJ93+6HQVRU3LSLQJ 6XPS6HQVRU6XPS6HQVRU 93+6HQVRU6XPS93+6HQVRU6XPS )LOO3LSLQJ )LOO3LSLQJ 93+6HQVRU3LSLQJ93+6HQVRU3LSLQJ 6XPS6HQVRU6XPS6HQVRU 93+6HQVRU6XPS93+6HQVRU6XPS 9HQW3LSLQJ 9HQW3LSLQJ 93+6HQVRU3LSLQJ93+6HQVRU3LSLQJ 6XPS6HQVRU6XPS6HQVRU 93+6HQVRU6XPS93+6HQVRU6XPS 9DSRU5HFRYHU\3LSLQJ 9DSRU5HFRYHU\3LSLQJ 93+6HQVRU3LSLQJ93+6HQVRU3LSLQJ 6XPS6HQVRU6XPS6HQVRU 93+6HQVRU6XPS93+6HQVRU6XPS 0RQLWRULQJ'HYLFH8VHG 'HYLFH0RGHO0RQLWRULQJ'HYLFH8VHG 'HYLFH0RGHO 7$1.,' (By tank number, stored product, etc.) 7$1.,' (By tank number, stored product, etc.) ,Q7DQN*DXJLQJ(SW Tank),Q7DQN*DXJLQJ(SW Tank) $QQXODU6SDFHRU9DXOW6HQVRU$QQXODU6SDFHRU9DXOW6HQVRU 93+6HQVRU93+6HQVRU 3URGXFW3LSLQJ 3URGXFW3LSLQJ 0HFKDQLFDO//'0HFKDQLFDO//' (OHFWURQLF//'(OHFWURQLF//' 93+6HQVRU3LSLQJ93+6HQVRU3LSLQJ 6XPS6HQVRU6XPS6HQVRU 93+6HQVRU6XPS93+6HQVRU6XPS )LOO3LSLQJ )LOO3LSLQJ 93+6HQVRU3LSLQJ93+6HQVRU3LSLQJ 6XPS6HQVRU6XPS6HQVRU 93+6HQVRU6XPS93+6HQVRU6XPS 9HQW3LSLQJ 9HQW3LSLQJ 93+6HQVRU3LSLQJ93+6HQVRU3LSLQJ 6XPS6HQVRU6XPS6HQVRU 93+6HQVRU6XPS93+6HQVRU6XPS 9DSRU5HFRYHU\3LSLQJ 9DSRU5HFRYHU\3LSLQJ 93+6HQVRU3LSLQJ93+6HQVRU3LSLQJ 6XPS6HQVRU6XPS6HQVRU 93+6HQVRU6XPS93+6HQVRU6XPS Veeder-Root TLS-350 Plus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pecify in section VII.)2WKHU(Specify in section VII.) 2WKHU0RQLWRUHG&RPSRQHQW,' 2WKHU0RQLWRUHG&RPSRQHQW,' 2WKHU(Specify in section VII.)2WKHU(Specify in section VII.) 2WKHU0RQLWRUHG&RPSRQHQW,' 2WKHU0RQLWRUHG&RPSRQHQW,' 2WKHU(Specify in section VII.)2WKHU(Specify in section VII.) Include information for every underground storage tank component monitored by this monitoring system control panel. If the monitoring system control panel monitors more components than this form accommodates, additional copies of these pages may be attached. 9,, &200(176 Use this section to provide additional comments about the inventory of the equipment certified. (L6) Transition Piping Sump 794380-208 / 877657 (L3) Day Tank Rupture Basin (L7) Remote Pump Cabinet Overfill Alarm 794380-208 / 454053 794380-208 / NA 790091-001 Certified All Of Following Components: (L1) Fill Sump Sensor 794380-208 (L2) Piping Sump Sensor 794380-208 (L3) Day Tank Rupture Basin Sensor 794380-208 (L4) AST Day Tank Annular Sensor 794380-208 (L5) UST Annular Sensor 794390-420 (L6) Transition Sump Sensor 794380-208 (L7) Remote Pump Cabinet Sensor 794380-208 SA002U001 T1 ATG Probe 846390-105 SA002A002 T2 ATG Probe 847390-301 Overfill Alarm 790091-001 (Main Overfill Prevention). < <HV1 1R1$ 1RW$SSOLFDEOH 81'(5*5281'6725$*(7$1. 021,725,1*6<67(0&(57,),&$7,21)2503DJHRI 9,,, 021,725,1*6<67(0$1'352*5$00,1* This section must be completed if a monitoring panel is used to perform leak detection monitoring.<11$ $UHWKHYLVXDODQGDXGLEOHDODUPVRSHUDWLRQDO" :HUHDOOVHQVRUVYLVXDOO\LQVSHFWHGIRUNLQNVDQGEUHDNVLQWKHFDEOHVDQGIRUUHVLGXDOEXLOGXSWRHQVXUHWKDWIORDWVPRYHIUHHO\ IXQFWLRQDOO\WHVWHGDQGFRQILUPHGRSHUDWLRQDO" :HUHDOOVHQVRUVLQVWDOOHGDWORZHVWSRLQWRIVHFRQGDU\FRQWDLQPHQWDQGSRVLWLRQHGVRWKDWRWKHUHTXLSPHQWZLOOQRWLQWHUIHUHZLWK WKHLUSURSHURSHUDWLRQ" :DVPRQLWRULQJV\VWHPVHWXSUHYLHZHGWRHQVXUHSURSHUVHWWLQJV" :DVWKHPRQLWRULQJSDQHO¶VEDFNXSEDWWHU\YLVXDOO\LQVSHFWHGIXQFWLRQDOO\WHVWHGDQGFRQILUPHGRSHUDWLRQDO" 'RHVWKHIORZRIIXHOVWRSDWWKHGLVSHQVHULIDOHDNLVGHWHFWHGLQWKHXQGHUGLVSHQVHUFRQWDLQPHQW" 'RHVWKHWXUELQHDXWRPDWLFDOO\VKXWGRZQLIWKHSLSLQJVHFRQGDU\FRQWDLQPHQWPRQLWRULQJV\VWHPIDLOVWRRSHUDWHRULVHOHFWULFDOO\ GLVFRQQHFWHG" 'RHVWKHWXUELQHDXWRPDWLFDOO\VKXWGRZQLIWKHSLSLQJVHFRQGDU\FRQWDLQPHQWPRQLWRULQJV\VWHPGHWHFWVDOHDN" :KLFKVHQVRUVLQLWLDWHSRVLWLYHVKXWGRZQ"(Check all that apply.)6XPS8QGHU'LVSHQVHU&RQWDLQPHQW ,IDODUPVDUHUHOD\HGWRDUHPRWHPRQLWRULQJVWDWLRQLVDOOFRPPXQLFDWLRQVHTXLSPHQWHJPRGHPRSHUDWLRQDO" For any answer of “N” above, describe in Section IX how and when these deficiencies were or will be corrected. ,; &200(176 ; ,17$1.*$8*,1*7(67,1* &KHFNWKLVER[LIWDQNJDXJLQJLVXVHGRQO\IRULQYHQWRU\FRQWURO(Do not complete this section.) <11$&KHFNWKLVER[LI12WDQNJDXJLQJHTXLSPHQWLVLQVWDOOHG (Do not complete this section.) This section must be completed if in-tank gauging is used to perform leak detection monitoring. +DVDOOLQSXWZLULQJEHHQLQVSHFWHGIRUNLQNVDQGEUHDNVLQWKHFDEOHVDQGIRUSURSHUHQWU\DQGWHUPLQDWLRQLQFOXGLQJWHVWLQJIRU JURXQGIDXOWV" :HUHDOOLQWDQNJDXJLQJSUREHVYLVXDOO\LQVSHFWHGIRUGDPDJHDQGUHVLGXHEXLOGXSWRHQVXUHWKDWIORDWVPRYHIUHHO\IXQFWLRQDOO\ WHVWHGDQGFRQILUPHGRSHUDWLRQDO" :DVDFFXUDF\RIV\VWHP¶VSURGXFWOHYHOUHDGLQJVWHVWHG" :DVDFFXUDF\RIV\VWHP¶VZDWHUOHYHOUHDGLQJVWHVWHG" :HUHDOOSUREHVUHLQVWDOOHGSURSHUO\" :HUHDOOLWHPVRQWKHHTXLSPHQWPDQXIDFWXUHU¶VPDLQWHQDQFHFKHFNOLVWFRPSOHWHG" For any answer of “N” above, describe in Section XI how and when these deficiencies were or will be corrected. ;, &200(176 Veeder-Root w/ All Functions Normal, Therefore No Ground Faults Present At Time Of Test. *3+ *DOORQV3HU+RXU< <HV1 1R1$ 1RW$SSOLFDEOH93+ 9DFXXP3UHVVXUH+\GURVWDWLF,' ,GHQWLILFDWLRQ 81'(5*5281'6725$*(7$1. 021,725,1*6<67(0&(57,),&$7,21)2503DJHRI ;,, /,1(/($.'(7(&7257(67,1* &KHFNWKLVER[LIOLQHOHDNGHWHFWRUV//'DUH127LQVWDOOHG(Do not complete this section.)<11$This section must be completed if LLDs are installed. :DVDOHDNVLPXODWHGWRYHULI\//'SHUIRUPDQFH" (Check all that apply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¶VPDLQWHQDQFHFKHFNOLVWFRPSOHWHG" :HUHDOO//'VFRQILUPHGRSHUDWLRQDOZLWKLQUHJXODWRU\UHTXLUHPHQWV" For any answer of “N” above, describe in Section XIII how and when these issues were or will be corrected. ;,,, &200(176 ;,9 9$&88035(6685(+<'5267$7,&021,725,1*(48,30(177(67,1* &KHFNWKLVER[LI93+PRQLWRULQJLV127XVHG(Do not complete this section.) This section must be completed if VPH monitoring is used to perform leak detection monitoring. 6\VWHP7\SH0DUNDOOWKDWDSSO\9DFXXP3UHVVXUH+\GURVWDWLF 6HQVRU,'&RPSRQHQW60RQLWRUHG%\7KLV6HQVRU 6HQVRU)XQFWLRQDOLW\ 7HVW ,QWHUVWLWLDO&RPPXQLFDWLRQ 7HVW 3DVV )DLO 3DVV )DLO 3DVV)DLO3DVV)DLO 3DVV)DLO3DVV)DLO 3DVV)DLO3DVV)DLO 3DVV)DLO3DVV)DLO 3DVV)DLO3DVV)DLO 3DVV)DLO3DVV)DLO 3DVV)DLO3DVV)DLO 3DVV)DLO3DVV)DLO 3DVV)DLO3DVV)DLO 3DVV)DLO3DVV)DLO 3DVV)DLO3DVV)DLO +RZZDVLQWHUVWLWLDOFRPPXQLFDWLRQYHULILHG"6LPXODWHG/HDNDW)DU(QGVRIWKH,QWHUVWLWLDO6SDFH9LVXDO,QVSHFWLRQ 2WKHU(Describe the method in section XV below.)*DXJH :DVWKHYDFXXPRUSUHVVXUHUHVWRUHGWRRSHUDWLQJOHYHOVLQDOOLQWHUVWLWLDOVSDFHV"<HV1R(Describe the reason in section XV below.) For any answer of “Fail” above, describe in Section XV how and when these issues were or will be corrected. ;9 &200(176 Suction System. 81'(5*5281'6725$*(7$1. 021,725,1*6<67(0&(57,),&$7,21)2503DJHRI ;9, 021,725,1*6,7(3/$1 'DWHVLWHPDSZDVSUHSDUHG If you already have a site plan that shows all required information, you may include it, rather than this page, with your Monitoring System Certification Form. The site plan must show the general layout of tanks and piping and clearly identify locations of the following equipment, if installed: 1) monitoring system control panels; 2) in-tank liquid level probes (if used for leak detection); 3) devices monitoring tank annular spaces or vault; 4) devices monitoring product piping; 5) devices monitoring fill piping; 6) devices monitoring vent piping; 7) devices monitoring vapor recovery piping; 8) devices monitoring vent/transition sumps; 9) devices monitoring under-dispenser containment; 10) line leak detectors; and 11) devices monitoring any other secondary containment areas. /(*(1' 11/2/2018 &(56 &DOLIRUQLD(QYLURQPHQWDO5HSRUWLQJ6\VWHP,' ,GHQWLILFDWLRQ867 8QGHUJURXQG6WRUDJH7DQN,&& ,QWHUQDWLRQDO&RGH&RXQFLO$9 $XGLEOHDQG9LVXDO 81'(5*5281'6725$*(7$1. 29(5),//35(9(17,21(48,30(17,163(&7,215(3257)2503DJHRI 7\SHRI$FWLRQ,QVWDOODWLRQ,QVSHFWLRQ5HSDLU,QVSHFWLRQ0RQWK,QVSHFWLRQ , )$&,/,7<,1)250$7,21 &(56,''DWHRI2YHUILOO3UHYHQWLRQ(TXLSPHQW,QVSHFWLRQ %XVLQHVV1DPH(Same as Facility Name or DBA-Doing Business As) %XVLQHVV6LWH$GGUHVV &LW\ =,3&RGH ,, 81'(5*5281'6725$*(7$1.6(59,&(7(&+1,&,$1,1)250$7,21 1DPHRI8676HUYLFH7HFKQLFLDQ3HUIRUPLQJWKH,QVSHFWLRQ(Print as shown on the ICC Certification.) 3KRQH &RQWUDFWRU7DQN7HVWHU/LFHQVH ,&&&HUWLILFDWLRQ ,&&&HUWLILFDWLRQ([SLUDWLRQ'DWH 2YHUILOO3UHYHQWLRQ(TXLSPHQW,QVSHFWLRQ7UDLQLQJDQG&HUWLILFDWLRQV(List applicable certifications.) ,,, 29(5),//35(9(17,21(48,30(17,163(&7,21,1)250$7,21 ,QVSHFWLRQ0HWKRG 8VHG0DQXIDFWXUHU*XLGHOLQHV(Specify) ,QGXVWU\&RGHRU(QJLQHHULQJ6WDQGDUG (Specify) (QJLQHHUHG0HWKRG(Specify) Attach the inspection procedures and all documentation required to determine the results.RI$WWDFKHG3DJHV 7$1.,'(By tank number, stored product, etc.) :KDWLVWKHWDQNLQVLGHGLDPHWHU" (Inches) ,VWKHILOOSLSLQJVHFRQGDULO\FRQWDLQHG"<HV1R<HV1R<HV1R<HV1R ,VWKHYHQWSLSLQJVHFRQGDULO\FRQWDLQHG"<HV1R<HV1R<HV1R<HV1R 2YHUILOO3UHYHQWLRQ(TXLSPHQW0DQXIDFWXUHUV :KDWLVWKHRYHUILOOSUHYHQWLRQHTXLSPHQWUHVSRQVH ZKHQDFWLYDWHG" (Check all that apply.) 6KXWV2II)ORZ6KXWV2II)ORZ 6KXWV2II)ORZ 6KXWV2II)ORZ 5HVWULFWV)ORZ5HVWULFWV)ORZ 5HVWULFWV)ORZ 5HVWULFWV)ORZ $9$ODUP$9$ODUP $9$ODUP $9$ODUP $UHIORZUHVWULFWRUVLQVWDOOHGRQYHQWSLSLQJ"<HV1R<HV1R<HV1R<HV1R $WZKDWOHYHOLQWKHWDQNLVWKHRYHUILOOSUHYHQWLRQVHW WRDFWLYDWH"(Inches from bottom of tank.) :KDWLVWKHSHUFHQWFDSDFLW\RIWKHWDQNDWZKLFKWKH RYHUILOOSUHYHQWLRQHTXLSPHQWDFWLYDWHV" ,VWKHRYHUILOOSUHYHQWLRQLQSURSHURSHUDWLQJFRQGLWLRQ WR UHVSRQG ZKHQ WKH VXEVWDQFH UHDFKHV WKH DSSURSULDWHOHYHO" <HV<HV<HV<HV 1R (Specify in V.)1R(Specify in V.)1R(Specify in V.)1R (Specify in V.) ,9 6800$5<2),163(&7,215(68/76 2YHUILOO3UHYHQWLRQ,QVSHFWLRQ5HVXOWV3DVV)DLO3DVV)DLO3DVV)DLO3DVV)DLO 9 &200(176 Any items marked “Fail” must be explained in this section. Any additional comments may also be provided here. 9, &(57,),&$7,21%<8676(59,&(7(&+1,&,$1&21'8&7,1*7+,6,163(&7,21 ,KHUHE\FHUWLI\WKDWWKHRYHUILOOSUHYHQWLRQHTXLSPHQWZDVLQVSHFWHGLQDFFRUGDQFHZLWK&DOLIRUQLD&RGHRI5HJXODWLRQV7LWOH 'LYLVLRQ&KDSWHU6HFWLRQDQGDOOWKHLQIRUPDWLRQFRQWDLQHGKHUHLQLVDFFXUDWH 8676HUYLFH7HFKQLFLDQ6LJQDWXUH If the facility has more components than this form accommodates, additional copies of this page may be attached. SA002 10029370 11/2/2018 Pacific Bell Telephone Co. dba AT&T California 1520 20th St. Bakersfield 93301 Adolfo Aguilar 714560-8200 588098 5238610 5/26/2020 Veeder-Root PEI RP 1200 SA002U001 82" Veeder-Root 790091-001 69.25" 90% MRP does not have ball floats listed for overfill prevention. Vent piping not inspected if flow restrictor preset since it does not affect overfill alarm from operating properly. Concurrently certified overfill alarm day of the annual monitor certification. Adolfo Aguilar 81'(5*5281'6725$*(7$1. 63,//&217$,1(57(67,1*5(3257)2503DJHRI 7\SHRI$FWLRQ,QVWDOODWLRQ7HVW5HSDLU7HVW0RQWK7HVW , )$&,/,7<,1)250$7,21 &(56,''DWHRI6SLOO&RQWDLQHU7HVW %XVLQHVV1DPH(Same as Facility Name or DBA-Doing Business As) %XVLQHVV6LWH$GGUHVV &LW\ =,3&RGH ,, 81'(5*5281'6725$*(7$1.6(59,&(7(&+1,&,$1,1)250$7,21 1DPHRI8676HUYLFH7HFKQLFLDQ3HUIRUPLQJWKH7HVW(Print as shown on the ICC Certification.) 3KRQH &RQWUDFWRU7DQN7HVWHU/LFHQVH ,&&&HUWLILFDWLRQ ,&&&HUWLILFDWLRQ([SLUDWLRQ'DWH 6SLOO&RQWDLQHU7HVWLQJ7UDLQLQJDQG&HUWLILFDWLRQV(List applicable certifications.) ,,, 63,//&217$,1(57(67,1*,1)250$7,21 7HVW0HWKRG8VHG0DQXIDFWXUHU*XLGHOLQHV(Specify) ,QGXVWU\&RGHRU(QJLQHHULQJ6WDQGDUG (Specify) (QJLQHHUHG0HWKRG(Specify) Attach the testing procedures and all documentation required to determine the results.RI$WWDFKHG3DJHV 7$1.,'(By tank number, stored product, etc.) 6SLOO&RQWDLQHU0DQXIDFWXUHU 0HWKRGRI&DWKRGLF3URWHFWLRQ1RQ0HWDOOLF1RQ0HWDOOLF1RQ0HWDOOLF1RQ0HWDOOLF ,VRODWLRQ,VRODWLRQ,VRODWLRQ,VRODWLRQ 2WKHU(Specify in V.)2WKHU(Specify in V.)2WKHU(Specify in V.)2WKHU(Specify in V.) ,QVLGH'LDPHWHURI6SLOO&RQWDLQHU(Inches) 'HSWKRI6SLOO&RQWDLQHU(Inches) 'RHVWKHVSLOOFRQWDLQHUKDYHDJDOORQFDSDFLW\"<HV1R<HV1R<HV1R<HV1R 0HWKRGWR.HHS6SLOO&RQWDLQHU(PSW\'UDLQ9DOYH'UDLQ9DOYH'UDLQ9DOYH'UDLQ9DOYH 2QVLWH3XPS2QVLWH3XPS2QVLWH3XPS2QVLWH3XPS 2WKHU(Specify in V.)2WKHU(Specify in V.)2WKHU(Specify in V.)2WKHU(Specify in V.) ,9 6800$5<2)7(67,1*5(68/76 6SLOO&RQWDLQHU7HVW5HVXOWV3DVV)DLO3DVV)DLO3DVV)DLO3DVV)DLO 9 &200(176 Any items marked “Fail” above must be explained in this section. Any additional comments may also be provided here. 9, &(57,),&$7,21%<8676(59,&(7(&+1,&,$1&21'8&7,1*7+,67(67,1* ,KHUHE\FHUWLI\WKDWWKHVSLOOFRQWDLQHUVZHUHWHVWHGLQDFFRUGDQFHZLWK&DOLIRUQLD&RGHRI5HJXODWLRQV7LWOH'LYLVLRQ &KDSWHU6HFWLRQDQGDOOWKHLQIRUPDWLRQFRQWDLQHGKHUHLQLVDFFXUDWH 8676HUYLFH7HFKQLFLDQ6LJQDWXUH If the facility has more components than this form accommodates, additional copies of this page may be attached. &(56 &DOLIRUQLD(QYLURQPHQWDO5HSRUWLQJ6\VWHP,' ,GHQWLILFDWLRQ867 8QGHUJURXQG6WRUDJH7DQN,&& ,QWHUQDWLRQDO&RGH&RXQFLO SA002 10029370 11/02/2018 Pacific Bell Telephone Co. dba AT&T California 1520 20th St. Bakersfield 93301 Adolfo Aguilar 7145608200 588098 5238610 5/26/2020 OPW / 100804 PEI RP 1200 SA002U001 OPW 14" 16" Took Non-Haz. Test Water To TAIT Shop. Adolfo Aguilar Identification of Inspection Procedures for Overfill Prevention Equipment To Whom It May Concern: Tait Environmental Services, Inc., utilizes the following procedures when conducting Overfill Prevention Equipment Inspections: 1) Drop Tubes with Overfill Prevention Valves a) Verify information based upon Manufacturer installation instructions and follow their inspection procedures. b) If manufacturer information is not available, we conduct the inspection per PEI-RP1200-17, Section 7.1 2) Audible/Visual Alarms a) Verify programming or installation per manufacturer guidelines and test the system per manufacturer specifications. b) If manufacturer information is not available, we conduct the inspection per PEI-1200-17, Section 7.3. 3) Ballfloat Inspections are conducted following the procedures in PEI-RP1200-17, Section 7.2 Identification of Test Procedures for Secondary Containment Testing To Whom It May Concern: Tait Environmental Services, Inc., utilizes the following procedures when conducting Secondary Containment Testing: 1) Containment Sumps, Transition Sumps, UDCs – Tait follows PEI‐RP1200‐17 Section 6.6 for the accelerated test method. Tait uses the Incon TS‐1000 hydrostatic test equipment following the attached procedures. 2) Spill Buckets; Direct Bury & Contained in Sumps – Spill buckets contained in sumps are tested per PEI‐1200‐17, Section 6.2, however Tait Pass/Fail threshold is 0” drop in one hour. Direct Bury Spill Buckets are test the same as containment sumps per PEI‐1200‐17, Section 6.6. 3) Tank Annular Space – testing is conducted per PEI‐1200‐17, Section 4.2 4) Piping Secondary Containment – Testing is conducted per PEI‐RP1200‐17, Section 5.3 Please consider this letter as our Test Procedure utilized when conducting Secondary Containment Testing in lieu of either parts or the whole RP1200 document due to copyright infringement. California Environmental Reporting System: Business Jennifer Pruitt's Account Sign Out Tools Reports Help Submittal Finished: Submittal Finished: AT&T Corp. - SA002/CAK010 (USID92203)AT&T Corp. - SA002/CAK010 (USID92203) Home »Draft Submittal »Submittal Finished (10029370) Print Submittal You have submitted the following elements on 11/27/2018 to Bakersfield City Fire Department • Underground Storage Tanks • Facility Information What's Next? • Return to the Draft Submittal page. • Return to Facility Home. 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