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Home My WebLink About2301 PANAMA LANE FMC 2013HOODS ALARMS SPRINKLER SYSTEMS SPRAY BOOTH AST UST Permit No. Permit No. Permit No. Permit No. Permit No. Permit No. File Number: a S Date Received: - e"- /3 Address: Bakersfield, CA 933 Business Name: rkae v-o Y.i SYSTEM: E BUILDING SQUARE FEET: New Mod. Commercial Hood System Fire Alarm System Fire Sprinkler System Spray FWsh System Aboveground Storage Tank Underground Storage Tank minor modification Underground Storage Tank removal Underground Storage Tank Ea/ Other. r- VA Q— Comments: Building Sq. Feet: Q' Calculation Bldg. Sq. Ft: A INSPECTION lOG Date Time 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 I UST REMOVAL DESCRIPTION DATE SIGNATURE AST NEW INSTALL DESCRIPTION DATE SIGNATURE 0 MODIFICATIONS MINOR / MAJOR AST REMOVAL DESCRIPTION DATE SIGNATURE EVR UPGRADE PRIOR TO!O.FERATIO:N -O.F- ANY- SYSTEM,_ ALL - UST:AND /OR:ASTSYBTEMS..SHALL -BE INSTALL,_COMPLETE_AND_ACCEPTED BY, MISC. ACTIVITY THE< BAKERSFIELD -CITY- FIRE'DEPARTMENT.i A-(FINAL) -- - -- —ti REMARKS: BUILDING ADDRESS: 36 A)4 wl A, JOB DESCRIPTION: Yr/I C__ I OCCUPANCY TYPE: OWNER: I ,sl , V-n c3 PERMIT NO. - 6606 3-f Z CONTRACTOR: PHONE # ,3 2 - G Sr% FD 1743 lb`1b MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State ofCalifornia Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, rifle 23, California Code ofRegulations This form must be used to document testing and servicing of monitoring equipment. A separate certifica 'on or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy ofthis form must be provided to the tank system owner /operator. The owner /operator must submit a copy ofthis form to the local agency regulating UST systems within 30 days oftest date. A. General Information Facility Name: BASHAAR'S CHEVRON Bldg. No.: Site Address: 2301 PANAMA LANE City: BAKERFIELD Zip: 93307 Facility Contact Person: Contact Phone No.: ( ) Make/Model ofMonitoring System: TLS-350 Date of Testing/Servicing: 8/2612013 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to Indicatespecific equipment inspected /serviced: Tank 1D: UNL87 Tank ID: PLUS89 In -Tank Gauging Probe. Model: MAG1 In -Tank Gauging Probe. Model: MAGI Annular Space or Vault Sensor. Model: Annular Space or Vault Sensor. Model: Piping Sump / Trench Sensor(s). Model: 208 Piping Sump / Trench Sensor(s). Model: 208 Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: RED JACKET Mechanical Line Leak Detector. Model: RED JACKET Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill / High -Level Sensor. Model: Tank Overfill / High -Level Sensor. Model: Other (specify equipment type and model in Section E on Page 2). Other (specify equipment type and model in Section E on Page 2). Tank ID: PREM91 Tank ID: TRANSITION SUMP in -Tank Gauging Probe. Model: MAGI In -Tank Gauging Probe. Model: MAG1 Annular Space or Vault Sensor. Model: AnnularSpace or Vault Sensor. Model: Piping Sump / Trench Sensor(s). Model: 208 Piping Sump / Trench Sensor(s). Model: RONAN SENSOR Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: RED JACKET Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill / High -Level Sensor. Model: Tank Overfill / High -Level Sensor. Model: Other (specify equipment type and model in Section E on Page 2). Other (specify equipment type and model in Section E on Page 2). Dispenser ID: 112 Dispenser ID: 3/4 Dispenser Containment Sensor(s). Model: DIS-M Dispenser Containment Sensor(s), Model: 406 Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: 516 Dispenser ID: 718 Dispenser Containment Sensor(s). Model: DIS -01 Dispenser Containment Sensor(s). Model: DIS-01 Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(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 Floats) and Chain(s). Dispenser Containment Float(s) and Chain(s). Ifthe 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 /serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equi ment capable ofgenerating such reports, I have also attached a copy of the report; (check all that apply): ® System set -up Alarm history report Technician Name (print): RICHARD MASON Signature: r v-,__ Certification No.: B3688015297857 -UT License. No.: C t D40 809850 Testing Company Name: RICH ENVIRONMENTAL Phone No.: (661) 392 -8687 Testing Company Address: 5643 BROOKS CT. BAKERSFIELD, CA 93308 Date of Testing/Servicing: 812812013 Page 1 of 5 UN -036 —1/4 www.unidocs.org Rev. 01/17/08 5Mb Monitoring System Certification D. Results of Testing/Servicing Software Version Installed: 8.05 Complete the foilowine checklist: Yes No* is the audible alarm operational? Yes No* Is the visual alarm operational? Yes No* Were all sensors visually inspected, functionally tested, and confirmed operational? Yes No* Were all sensors installed at lowest point ofsecondary 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) N/A operational? Yes No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? if yes: which sensors initiate positive shut -down? (Check all that apply) ® Sump/Trench Sensors; Dispenser Containment Sensors. Did you confirm positive shut -down due to leaks and sensor failure/disconnection? ® Yes; No. Yes 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 visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? % Yes* 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? (Check all that apply) Product; Water. Ifyes, describe causes in Section E, below. Yes No* Was monitoring system set -up reviewed to ensure proper settings? Attach set up reports, ifapplicable Yes I 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: Page 2 of 5 UN -036 — 2/4 www.unidocs.org Rev. 01117/08 Monitoring System Certification F. In -Tank Gauging / SIR Equipment: ct)W to Check this box iftank gauging is used only for inventory control. Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in -tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: Yes No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Yes No* Were all tank gauging probes visually inspected for damage and residue buildup? Yes No* Was accuracy of system product level readings tested? Yes No* Was accuracy of system water level readings tested? Yes No* Were all probes reinstalled properly? Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? In Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): Comnlete the following checklist: Check this box ifLLDs are not installed. Yes No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? N/A Check all that apply) Simulated leak rate: ® 3 g.p.h.; 0.1 g.p.h ; 0.2 g.p.h. Yes No* Were all LLDs confirmed operational and accurate within regulatory requirements? Yes No* Was the testing apparatus properly calibrated? Yes No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? N/A Yes No* For electronic LLDs, does the turbine automatically shut off ifthe LLD detects a leak? N/A Yes No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled N/A or disconnected? Yes No* For electronic LLDs, does the turbine automatically shut offifany portion ofthe monitoring system malfunctions N/A or fails a test? Yes No* For electronic LLDs, have all accessible wiring connections been visually inspected? N/A Yes No* Were all items on the equipment manufacturer's maintenance checklist completed? In Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: UN -036 - 3/4 Page 3 of 5 www.unidomorg Rev. 01117/08 V r r i system Certification UST Site Plan S Id,lo n Y . . . . . • . . . • ... • . . . . r . • • D . . . . . . - . - - • _ + • - r r Jr . . . . . . . . . . . r • 1-- .rr - -- -- -'---- - - -... ..----..........- r r • T w . . . . • • . - r r r . . . . . . ... . . • - • - r . • • • r . r _ • + i - - r - - - .. • r r - . . . . . r . . . • - • _ + - • - r • r . r w _ . . . • r • . . .. . w • • . . _ _- n•( jR/ .. • . r r • - r _ - - - • w • _ _ • r -- r . r . - + _ • . - • - - . . + • - - . • • • - r . • w • _ - +. - - - - - - - - - - - - - • - r • - • r • _ - • • . . r r • - r + . . - r r . . - _ • r . _ - - - - - - - - - r - - r - - r - - _ - . • w naremapa: a // ne3ctions Ifyou already iav8 a diagram that shows all required information, you may include A. rather than this page, with yourlvdonitnringRmtemCertification. On your site plan, show the general layout oftanks andpiping. Clearly identifylocationsoft>;e following equipment, if installed: monitoring system coatzoi panels; sensors monitoring tank aanularsp=4 sumps,diapenser pans, spilt containers, or other secondary contaii nieni areas; mechanical or electronic Iine leak detectors; and w -tank liquid Level probes (ifused for Ieak detectionj. IB the space provided, note the date this Site Planwasprepared. Page - 6f CD ioo 1 RICH ENVIRONMENTAL 5643 BROOKS CT. BAKERSFIELD, CA. 93308 OFFICE (661)392 -8687 FAX (661)392 -0621 PRODUCT LINE LEAK DETECTOR TEST WORK SHEET WIO#: FACILITY NAME: BASHAAR'S CHEVRON FACILITY ADDRESS: 2301 PANAMA LANE, BAKERSFIELD PRODUCT LINE TYPE: PRESSURE PRODUCT LEAK DETECTOR TYPE TEST TRIP PASS BELOW P.S.I. OR SERIAL NUMBER 3 G.P.H. FAIL UNL87 LID TYPE: MECHANICAL YES 10 PASS SERIAL # RED JACKET PLUS 89 L/D TYPE: MECHANICAL YES 10 PASS SERIAL # RED JACKET PREM91 L/D TYPE: MECHANICAL YES 10 PASS SERIAL # RED JACKET L/D TYPE: YES PASS SERIAL # NO FAIL I CERTIFY THE ABOVE TESTS WERE CONDUCTED ON THIS DATE ACCORDING TO RED JACKET PUMPS FIELD TEST APPARATUS TESTING PROCEDURE AND LIMITATIONS. THE MECHANICAL LEAK DETECTOR TEST PASS/ FAIL IS DETERMINED BY USING A LOW FLOW THRESHOLD TRIP RATE OF 3 GALLONS PER HOUR OR LESS AT 10 P.S.I. I ACKNOWLEDGE THAT ALL DATA COLLECTED IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. TECHNICIAN RICHARD MASON SIGNATURE: ? J DATE: 8/28/13 4 tb`Vo SWRCB, January 2006 Spill Bucket Testing Report Form Thisform is intendedfor use by contractors performing annual testing of UST spill containment structures. The completedform and printoutsfrom tests (ifapplicable), should beprovided to thefacility owner /operatorfor submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: BASHAAR'S CHEVRON Date of Testing: 8/28/13 Facility Address: 2301 PANAMA LANE, BAKERSFIELD Facility Contact: Phone: Date Local Agency Was Notified ofTesting: Name ofLocal Agency Inspector (ifpresent during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: RICH ENVIRONMENTAL Technician Conducting Test: RICHARD MASON Credentials`: CSLB Contractor X ICC Service Tech. SWRCB Tank Tester Other (S ecify) License Number(s): 5297857 -UT 3. SPII.L BUCKET TESTING INFORMATION Test Method Used: X Hydrostatic Vacuum Other Test Equipment Used: VISUAL Equipment Resolution: 0 Identify Spill Bucket (By Tank Number, Stored Product, etc. t UNL87 z PLUS89 3 PREM91 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" 12" 12" Bucket Depth: 16" 16" 16" Wait time between applying vacuum/water and start oftest: 30MIN 30MIN 30MIN Test Start Time (Ti): 1:00 1:00 1:00 Initial Reading (Rj): 10" 10" 10" Test End Time (Tr): 2:00 2:00 2:00 Final Reading (RF): 10" 10" 10" Test Duration (TF — T,): 60MIN 60MIN 60MIN Change in Reading (RF -Rj): 0 0 0 Pass /Fail Threshold or 0 0 0Criteria: Test Result: X Pass Fail X Pass Fail X Pass Fail Pass Fail Comments — (include information on repairs made prior to testing, andrecommendedfollow -upforfailed 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 fullcompliance with legal requirements. Technician's Signature: ( ^ Date: 8/28/13 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements may be more stringent. SOFTWARE REVISION LEVEL VERSION 329.01 SOFTWARE# 346329 -100 -B CREATED - 09.01.29.15.44 NO SOFTWARE MODULE SYSTEM FEATURES: PERIODIC IN -TANK TESTS ANNUAL 1N -TANK TESTS IN -TANK SETUP T I: SUPER PRODUCT CODE 1 THERMAL COEFF :.000700 TANK DIAMETER 95.00 TANK PROFILE 1 PT FULL VOL 9980 FLOAT SIZE: 4.0 IN. WATER WARNING 210 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 9980 OVERFILL LIMIT 95% 9481 HIGH PRODUCT 99% 9880 DELIVERY LIMIT 4% 399 LOW PRODUCT 0 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT 3.50 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS T#: NONE LINE MANIFOLDED TANKS T #: NONE LEAK MIN PERIODIC: 1% 99 LEAK MIN ANNUAL 99% 9680 PERIODIC TEST TYPE QUICK ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST IVOT I FY : OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY 15 MIN PUMP THRESHOLD 10.00% COMMUNICATIONS SETUP - - PORT SETTINGS: COMM BOARD : 5 (RS -485) BAUD RATE : 2400 STOPTBIT : I STOP DATA LENGTH: 7 DATA RS -232 SECURITY CODE : DISABLED COMM BOARD 6 (RS -232) BAUD RATE 1200 PARITY ODD STOP BIT 1 STOP DATA LENGTH: 7 DATA RS -232 SECURITY CODE : DISABLED AUTO TRANSMIT SETTINGS: AUTO LEAK ALARM LIMIT DISABLED AUTO HIGH WATER LIMIT DISABLED AUTO OVERFILL LIMIT DISABLED AUTO LOW PRODUCT DISABLED AUTO THEFT LIMIT DISABLED AUTO DELIVER:` START DISABLED AUTO DELIVERY END DISABLED AUTO EXTERNAL INPUT ON DISABLED AUTO EXTERNAL INPUT OFF DISABLED AUTO SENSOR FUEL ALARM DISABLED AUTO SENSOR WATER ALARM DISABLED AUTO SENSOR OUT ALARM DISABLED RS -232 END OF MESSAGE DISABLED LOF %10 SYSTEM SETUP AUG 28, 2013 9:08 AM _ SYSTEM UNITSU.S. SYSTEM LANGUAGEENGLISH SYSTEM DATE.;TIME FORMATMONDDYYYYHH:MM:SS xM BASHAARS SHIFT TIME 1 11:00 pMTIME27:00 AMSHIFTTIME3DISABLEDSHIFTTIME4DISABLED TANK PER TST NEEDED WRNDISABLED TANK ANN TST NEEDED WRNDISABLED LINE RE-ENABLENE"T T METHOD LINE PER TST NEEDED WRNDISABLED LINE ANN TST NEEDED WRNDISABLED PRINT TO VOLUMESENABLED TEMP COMPENSATION STICK HEIGHT OFFSET0'0DISABLED ULLAGE: 90% H-PROTOCOL DATA FORMATHEIGHT DAYLIGHT SAVING TIMEDISABLED RE- DIRECT LOCAL PRINTOUTDISABLED SURO PROTOCOL PREFIX SYSTEM SECURITYCODE : 000000 MAINTENANCE HISTORYDISABLED TANK CHART SECURITYDISABLED USTOM ALARMSDISABLED SERVICE NOTICEDISABLED ISO 3166 COUNTRYCODE: MASS/DENSITYDISABLED LEAK TEST METHOD TEST WEEKLY : ALL TANK MON START TIME : 12:00 AM TEST RATE :0.20 GAL /HR DURATION : 2 HOURS TST EARLY STOP:DISABLED LEAK TEST REPORT FORMAT NORMAL LIQUID - SENSOR SETUP_ L I:SUPER TRI-STATE (SINGLE FLOAT) CATEGORY :-STP SUMP L 2:PLUS TRI -STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 3:REG . TRI -STATE (SINGLE FLOAT) CATEGORY 1 STP SUMP L 4:PIPING NORMALLY CLOSED CATEGORY : PIPING SUMP OUTPUT RELAY SETUP R 1:SHUTDOWN TYPE: STANDARD NORMALLY CLOSED LIQUID SENSOR ALMS ALL:FUEL ALARM T 3:UNLEADED 3PRODUCTCODE THERMAL COEFF :.000700 TANK DIAMETER 95.00 TANK PR FULLEVOL 9980 FLOAT SIZE: 4.0 IN. WATER WARNING 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 9980 OVERFILL LIMIT : 9961 HIGH PRODUCT 99% 9880 DELIVERY LIMIT 399 LOW PRODUCT : 300 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 2. 90 TANK TILT 0 00PROBEOFFSET SIPHON I.4AN I FOLDED TANKS TO: NONE LINE MANIFOLDED TANKS TO: NONE LEAK MIN PERIODIC: 999% LEAK MIN ANNUAL : I% PERIODIC TEST TYPE QUICK ANNUAL TEST FAILALARMDISABLED PERIODIC FRMAIL GROSS TEST RM DISABLED ANN PER TEST T VERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF PUMPVTHRESHOLD 10.00% T 2: PLUS PRODUCT CODE 2 THERMAL COEFF 000700 TANK DIAMETER 75.80 TANK PROFILE 1 PT FULL VOL 3987 FLOAT SIZE: 4.0 IN. WATER WARNING 4.5 HIGH WATER LIMIT: 5.0 MAX OR LABEL VOL. 3987 OVERFILL LIMIT 95% 3787 HIGH PRODUCT 99% 3947 DELIVERY LIMIT 8% 318 LOW PRODUCT : 300 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT 2.60 PROBE OFFSET 0.00 SIPHON MANIFOLDED TANKS TO: NONE LINE MANIFOLDED TANKS TO: NONE LEAK MIN PERIODIC: le 39 LEAK MIN ANNUAL 0% 0 PERIODIC TEST TYPE QUICK ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIT. ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAI;:OFF DELIVERY DELAY 15 MIN PUMP THRESHOLD 10.00% 11410A ALARM HISTORY REPORT SENSOR ALARM - - -- L 4:PIPING PIPING SUMP FUEL ALARM AUG 28. 2013 9:36 AM FUEL ALARM SEP 19, 2012 4:07 PM FUEL ALARM SEP 19. 2012 4:06 PM ALARM HISTORY REPORT SENSOR ALARM -- L 1:SUPER STP SUMP SENSOR OUT ALARM AUG 28, 2013 9:36 AM FUEL ALARM AUG 28. 2013 9:33 AM SENSOR OUT ALARM SEP 19. 2012 4:07 PM x**** END ***cx ALARM HISTORY REPORT SE14SOR ALARM - - - -- L 2:PLUS STP SUMP SENSOR OUT ALARM AUG 28. 2013 936 AM FUFI. ALARM AUG 28. 2013 9:34 AM SENL,'OR OUT ALARM SEP 19, 2012 4:07 PM x END ALARM HISTORY REPORT SENSOR ALARM - - - -- L 3:REG STP SUMP SENSOR OUT ALARM AUG 28. 2013 9:36 W FUEL mLARM AUG 28, 2013 9:34 AM SENSOR OUT (ALARM SEP 19, 2012 4:07 PM wo WLJ riRTSENSOR SETUP s 1:PRESSURE SENSOR CATEGORY VAPOR PRESSURE s 3:VAPOR POLISHER CATEGORY VAPOR VALVE s 8: ATM CATEGORY ATM P SENSOR PMC SETUP PMC VERSION: 01.02 VAPOR PROCESSOR TYPE VEEDER -ROOT POLISHER ANALYSIS TIMES TIME: 10:00 AM DELAY MINUTES: 1 D kk5-* 11A MONITOR CERT. FAILURE REPORT SITE NAME: BASHAAR'S CHEVRON DATE : 8/28/13 ADDRESS: 2301 PANAMA LANE TECHNICIAN: RICHARD MASON THE FOLLOWING COMPONENTS WERE REPLACED/REPAMED TO COMPLETE TESTING. REPAIRS; LABOR: PARTS INSTALLED : NAM: TITLE: SIGNATURE : THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON - COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN LEFT ON -SITE FOR YOUR CONVIENENCE. UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING/ SB989 SECONDARY CONTAINMENT TESTING/TANK TIGHTNESS TEST AND FUEL MONITORING CERTIFICATION Please note that these are separate Individual tests and will be charged per separate type test accordingly.) PERMIT # ENHANCED LEAK DETECTION TANK TIGHTNESS JURN ARTr r BAKERSFIELD FIRE DEPARTMENT Prevention Services a10l 1-k 5-meE7- Bakerstield, CA 93301 Phone: 661 - 326 -3979 • Fax: 661- 852 -2171 Page I of 1 LINE TESTING SB -989 SECONDARY CONTAINMENT FUEL MONITORING CERTIFICATION SITE INFORMATION FACILITY NAME & PHONE OF CONTACT PERSON ADDRESS ` \ OWNER NAME t ^ 1 OPERATOR NAME PERMIT TO OPERATE # OF TANKS TO BE TESTED: IS PIPING GOING TO BE TESTED? YES NO TANK # VOLUME CONTENTS TANK :TESTING;C0 PANY... ` TESTING COMPANY NAME & PHONE # OF CONTACT PERSON MAILING ADDRESS jln -13 13 ookS C_T. - F3A K RSF 1'E. -O . CA °I33o8 NAME & PHONE # OFTRY SPECIAL IN PECTO CERTIFICATION #. S 0 eSv DATE & TIME TEST IrO BE CONDUCTED Jzz) 1GLV 1 ICC # TEST METHOD APPLICANT SIGNA DATE HIS APPLICATION BECOMES A PERMIT WHEN APPROVED AP7 BY Zt) DATE F02095 (Rev 03/08) BILLING & PERMIT STATEMENT PERMIT NO.: OW BAKERSFIELD FIRE DEPT. a B R 3 F I D Prevention Services FIRE TARTw 1600 Truxtun Ave Ste 401 Bakersfield CA 93301 Tel.: (661) 326 -3979 • Fax: (661) 852 -2171 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT Alarms - New & Modifications - (Minimum Charge) $280.00 SITE INFORMATION LOCATION OFPROJECT t PROPERTY OWNER STARTING DATE ry v I COMPLETION D NAME PROJECT NAME ADDRESS l`7)` PHONE NO. PROJECT ADDRESS CITY STATE ZIP CODE CONTRACTOR INFORMATION CONTRACTOR NAME CA LICENSE NO. TYPE OF LICENSE. IEXPIRATION DATE PHONE NO CONTRACTOR COMPANY NAME tC 'i-v FAX NO. 90 ADDRESS CITY f^ C ZIP wuc All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT Alarms - New & Modifications - (Minimum Charge) $280.00 M09 Over 10,000 Sq. Ft. Sq. Ft. x.028 = Permit fee 84 98 Sprinklers - New & Modifications - (Minimum Charge) 280.00 84 98 Over 10,000 Sq. Ft. Sq. Ft x.028 = Permit fee 84 98 Minor Sprinkler Modifications (< 10 heads) 96.00 [Inspection Only] 98 Commercial Hoods — New & Modifications 470.00 84 98 Additional Hoods 58.00 84 98 Spray Booths - New & Modifications 470.00 F 84 98 Aboveground Storage Tanks (InstallaliordInsp. -1m Time) 180.00 82 Additional Tanks 96.00 82 Aboveground Storage Tanks (RemovaUlnspection) 109.00 82 Underground Storage Tanks (Installation. /Inspection) 878.00 (per tank) 82 Underground Storage Tanks (Modification) 878.00 (per site) 82 Underground Storage Tanks (Minor Modification) 167.00 82 Underground Storage Tanks (Removal) 573.00 (per tank) 84 Oilwell (Installation) 96.00 ' 84 Mandated Leak Detection (Testing) / Fu Monit.0 SB989. Note: $96.00 for each type of test / per site ( heduled at the same time) 8 6e (per site! f 9 ,o n 1 'S- M 82 Tents 96.00 (per tent) 84 Pyrotechnic - (Per event, Plus Insp. Fee @ $96 per hour) 96.00 + (5 hrs. min. standby fee nnspection)=$576..00 84 After hours inspection fee 121.00 84 0 RE4NSPECTION(S) /FOLLOW-UP /NSPECT70N(S) 96.00 (per hour) 84 Portable LPG (Propane): NO. OF CAGES? _ 96.00 84 Explosive Storage 266.00 84 Copying & File Research (Flee Research Fee $50.00 per hr) 250 per page Miscellaneous 8a FD 2021 (Rev. 06/07) 1 - ORIGINAL WHITE (to Treasury) 1- YELLOW (to File) 1 -PINK (to Customer) o FIRE DEPT. BAKERSFIELD" Prevention Services U.NIRED PROGRAM :INSPECTION. CHECKLIST a " D "'2101'H- Street RTM r Bakersfield; CA. 93301' SECTION J: Business Plan and Inventory Program. Tel.: (66.1)326-3,979* Fax: (661) 852 -2171 FACILITY NAME INSPECTION DATE INSPECTION TI E i COMMENTS n ADDRESS PHONE NO. NO OF EM EES v 2 41V- D " FACILITY CONTACT BUSINESS ID NUMBER 02 Consent to Inspect Name/Title CFC: 505.1;.BMC: 15.52.020) Section 1: Business Planand -Inventory :Program ROUTINE COMBINED JOINT AGENCY 'MULTI-AGENCY COMPLAINT RE- INSPECTION C V C= Compliance OPERATION V= Violation i COMMENTS n APPROPRIATE PERMIT ON HAND BMC: 15.65.080) ce-- - ` I C j D " Business PLANCONTACT INFORMATION ACCURATE (CCR: 2729.1) L O / J VISIBLE ADDRESS CFC: 505.1;.BMC: 15.52.020) CORRECT OCCUPANCY CBC: 401) VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3) . VERIFICATION OF QUANTITIES CCR: 2729.4) VERIFICATION OF LOCATION CCR °2729.2) PROPER SEGREGATION OF MATERIAL CFC: 2704.1) VERIFICATION OF MSDS AVAILABILITY . " CCR: 272912(3)(b)) El, VERIFICATION OF HAZ MAT TRAINING CCR: 2732) elk VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) 1A' EMERGENCY PROCEDURES ADEQUATE CCR: 2731) CONTAINERS PROPERLY LABELED CCR: 66262.34(17, CFC: 2703:5) HOUSEKEEPING CFC: 304.1) FIRE PROTECTION CFC: 903 & 906) SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) NY HAZARDOUS WASTE ON SITE? YES NO Signature of Receipt - E x d•N n POST INSPECTION INSTRUC77ONS: J nom—. Correct the violation(s) noted above by Within 5 days of correcting all of the violations, sign and return a.copy of this page to: Bakersfield Fire Dept., Prevention. Services, 2101 H Street, California" 93301 White —Business Copy Yellow — Business Copy to be Sent in after return to Compliance Signature (that all violations have been corrected as noted) Date Pink— Prevention Services Copy - FD2155 (Rev 600) i KERN BUSINESS FORMS— (661)325.5818 #6013 ) c=am -- . — o cf UNIFIED PROGRAM. INSPECTION CHECKLIST' SECTION 1: Business Plan and Inventory Program FACILITY NAME BAKERSFIELD FIRE DEPT. INSPECTION TIME Prevention Services B a R S N L o P /RB 2101 H Street - AA RTM r " Bakersfield, CA 93301 Tel.: (661) 326 -3979 Consent to Inspect Name/Title Fax: (661) 852 -2171 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS PHONE NO. NO OF EMP OYEES FACILITY CONTACTj( BUSINESS ID NUMBBER2 9 / yam/ Consent to Inspect Name/Title 71 Section 1: Business Plan and Inventory Program ROUTINE ACCOMBINED JOINT AGENCY MULTI - AGENCY COMPLAINT RE- INSPECTION C v C= Compliance OPERATION V= Violation COMMENTS r, " x, —777 { APPROPRIATE PERMIT ON HAND BMC: 15.65.080) I Business PLAN CONTACT INFORMATION ACCURATE (CCR: 2729.1) VISIBLE ADDRESS CFC: 505.1, BMC: 15.52.020) j CORRECT OCCUPANCY CBC:401) VERIFICATION OF INVENTORY MATERIALS CCR: 2729.3) VERIFICATION OF QUANTITIES CCR: 2729.4) VERIFICATION OF LOCATION CCR: 2729.2) LfJ' NJ • PROPER SEGREGATION OF MATERIAL CFC: 2704.1) VERIFICATION OF MSDS AVAILABILITY CCR: 2729.2(3)(b)) VERIFICATION OF HAZ MAT TRAINING CCR: 2732) VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES (CCR: 2731(c)) It , ' EMERGENCY PROCEDURES ADEQUATE CCR: 2731) CONTAINERS. PROPERLY LABELED CCR: 66262.34(0, CFC: 2703.5) 0 HOUSEKEEPING CFC: 304.1) w FIRE PROTECTION CFC: 903 & 906) SITE DIAGRAM ADEQUATE & ON HAND CCR: 2729.2) ANY HAZARDOUS WASTE ON SITE? YES NO Signature of Receipt Explain: - POST INSPECTION INSTRUCTIONS: Correct the violation(s) noted above by Within 5 days of correcting all of the violations, sign and return a copy ofthis page to: Bakersfield Fire Dept., Prevention Services, 2101 H Street, California 93301 Signature (that all violations have been corrected as noted) Date White -Business Copy Yellow- Business Copy to be Sent in after return to Compliance Pink - Prevention Services Copy FD2155 (Rev 600) 5 T" BAKERSFIELD FIRE DEPARTMENT UNIFIED PROGRAM INSPECTION CHECKLIST Prevention Services Division314131RSFID Rid 2101 H StreetFIRE A ! Bakersfield, CA 93301 Underground Storage Tank Program # Phone: 661- 326 -3979 Fax: 661-852-2171 Facility Name: Bashaars Chevron Date of Inspection: Time In: Time Out: 0 Address: 2301 Panama Ln. Bakersfield, CA. 93307 Inspected by: Esther Duran ICC# 5296325 -Ul Contact: Bashaar Najdawi Type of Inspection: Annual Compliance Re- inspection Complaint Phone: 661)832-4551 Permission for Inspection Granted by: A fA A NQ C7 Tank ID 1 2 3 Size 4,000 10,000 10,000 Contents MID REG PREM Construction SW CP SW CP SW CP Tank Monitoring: DW: Continuous Interstitial Monitoring 0 Dry Brine/Hydrostatic Vacuum/Pressure. SW: SIR and Line Test every 2 years. SW: ATG 0.1 annual. SW: ATG 0.2 monthly. SW: Continuous In -Tank Leak Dete tion (CITLD). SW: Tank Gauging. SW: Vadose /GW Monitoring. Other Description. Piping Monitoring: DW Suction: Continuous Interstitial at UDC and Tank Sump. DW Pressurized: Interstitial at UDC and Turbine Sump and 3.0 gph LLD, Annual Line Test or Auto - shutdown and Failsafe. DW VPH Monitoring: Includes lines, sumps, fill pipe, vapor lines, etc. SW Conventional Suction: Triennial 0.1 gph line test., and daily monitoring. SW Pressurized: Line 0.1 gph annual or 0.2 gph monthly line test andsLLDwithAuto - Shutdown. SW or DW Safe Suction. SW: Vadose Zone or GW Monitoring. DW or SW: Gravity Flow Pipe. Other Description: References to the Health and Safety Code, the California Code of Regulations and the Code of Federal Regulations throughout this Appendix are intended to be useful but are not necessarily exhaustive of all legal references that might apply or be relevant to a specific compliance determination. Laws and regulations are subject to change, so the references contained herein may not be up to date. It is the responsibility of the owner and operator to know and comply with all applicable legal requirements. UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT Flacility Name: Date: Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 If in compliance, check the box. Check NA If not applicable. If a violation, determine If Minor, Class II, or Class I, or To ViolationsBeDetermined (TBD) If uncertain and will be determined later. Requirements: S1gnlflcant operatTonaLCompIlance C RDsRelease Detedtlon. R0 Release Prevention 1- COMMENT$, Q File Review 1 UST Permit to Operate is current. HSC 25284(x), 25299(a)(1) 25299 (b)(1) S 2 Transfer of permit and /or change of information provided within 30 days of ownership /information changes. HSC 25284(b) (c); T23 CCR 2712(d) UST form information current/correct for facility, including BOE number. Hsc25286(a) Fees are paid up-to date. HSC 25285(c), 25287 Monitoring Plan approved for current owner with appropriate content and level of detail. T23 CCR 2632(d), 2634 (d), 2641(h) 6 Current Emergency Response Plan submitted with appropriate content and level of detail. T23 CCR 2632(d), 2634 (d), 2641(h) 7 Plot Plan /Site Map submitted with appropriate content and level of detail. T23 CCR 2632(d), 2634(d), 2641(h), 2711(a)(8) 8 Owner/Operator agreement submitted, if required. HSC 25284(8)(3) 9 Certification of Compliance and Designated Operator Certification submitted by current tank owner. T23 CCR 2715 74 C 10 Certificate of Financial Responsibility submitted and is current for the permit period. Hsc 25292.2, 25299.30 - 25299.34; T23 CCR 2711; 2808.1; L 2809 - 2809.2 11 Monitoring system certification (most recent) conducted within allowable timeframe (sensors and console). Results submitted and show all required components with passing results. Hsc 25284.1 a 4 c ; T23 CCR 2638 2 Spill- bucket test results (most recent) conducted within allowable time frame. Results submitted and indicate a passing test. HSC 25284.2 13 Leak Detector testing conducted within allowable time frame. The most recent annual certification submitted and shows RD RD RD RD passing results. 40 CFR 280.40(6)(2), 280.43(9)(1) &(2), 280.44(x); HSC 25292(e); 7-23 CCR 2638, 2641 ' 14 Secondary containment testing conducted within allowable time frame. Most recent testing results submitted and indicate a passing test. HSC 25264.1(a)(4)(B); T23 CCR 2637(a) 015 Pipe and /or tank integrity testing conducted within allowable time frame. Most recent testing results submitted and indicate Y passing results. 40 CFR 280.33, 280.40, 280.41, 280.44; T23 CCR 26360, 2643(b)(3), (c)(3), d e 016 Repaired tanks /piping are tightness tested within 30 days of RD RD RD RD the repair. 40 CFR 280.33; T23 CCR 2661 017 ELD test conducted within allowable time frame. Most recent 6W M-4 a test results submitted and passing results achieved. T23 CCR X2644.1 018 The corrosion protection system is checked by a corrosion specialist within six months of installation /repair and at least every three years thereafter; results show protection to be RP RP RP RP adequate. Impressed current inspected every 60- calendar days. 40 CFR 280.31, 280.70; T23 CCR 2635(a)(2) 019 Tank Lining recertification is current (within 10 years of lining and every 5 years thereafter) and compliant. 40 CFR280.21(b)(1)pf,); RP RP RP ElCCR2663(h) RP Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT Flacility Name: Date: Bakersfield Fire Department— Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 W. 3 OF tonal Comp la ce Cgnlflcan RN elease Detectlon P =Re ease Prevention 1tl m CO M NTVV Q On -Site Review This Inspection is being conducted during the annual monitoring certification. OYES ONO The service technician has provided ICC Certification and manufacturers training documentation, and possesses a tank tester's license or works under a CSLB contractor's license. O YES O NO Tank/Piping Components, Monitoring and Monitoring Equipment General 020 Tank systems meet current construction standards as required for type of system. HSC 25288 21- -- Hazardous substance tanks have secondary containment. 40 RP RP RP RP CFR 280.42 6 ; T23 CCR 2631 022 Electronic monitoring system has audible and visual alarm in operating condition. T23 CCR 2632, 2634, 2636 023 Monitor console programmed appropriately for monitoring option used. T23 CCR 2638, 2643, 2643.1 024 Tank systems in temporary closure meet requirements. 40CFR RD RD RD RD280.70; T23 CCR 2670 & 2671 025 Overfill Prevention mechanism present and operational according to type: Flapper valve Audible- visual alarm RP RP RP RP ball float. AN alarm and Ball Float 40 CFR 280.20(c)(1)(Y), 280.21(d); T23 CCR 2635(b)(2), 2631 d 4 026 Spill prevention device is present and functional (in good condition and drain mechanism operational if applicable). 40CFR RP RP RP RP 280.20 c 1 I , 280.21(d); T23 CCR 2635(b)(1);2665 027 Piping and piping penetration boots within sumps /UDC are in good condition. HSC 25288(a), 25292.1 028 All sumps, spill buckets, and UDC's free from debris and liquid. HSC 25291(e), 25290.1, 25290.2; T23 CCR 2635(b)(1)(C) 029 Areas around vents appear to be free from signs of liquid releases. HSC 25288(a), 25290.1, 25290. 2, 25295.5 030 Release Detection methods are present and meet performance RD RD RD RDstandards. See LG -113. 40 CFR 280.40(x)(3) 031 All sensors are correct for the type of system and operational. RD RD RD RD 40 CFR 280.40 a 2 , 280.43(g)(1)&(2); HSC 25290.1 e , 25290.2, 25291; T23 CCR 2638 032 All sensors are located in the proper position /location. 40 CFR 280.40(a)(2), 280.43(g)(1) &(2); HSC 25290.1, 25290.2, 25291; T23 CCR 2630(d); RD RD RD RD 2632(c);2641(a) 033 All secondary containment, including UDC shall be equipped with a continuous monitoring system that either activates an A/V alarm or stops the flow of product at the dispenser when it detects a leak. T23 CCR 2636 (0(1) Tank Monitoring O DIN 034 Interstitial monitoring conducted properly. 40CFR280.40(a)(2), RD RD RD RD280.43 1& 2 T23 CCR 2632 (c)(2); 2634 d 1 035 VPH monitoring conducted properly. HSC 25290.1 RD RD RD RD O SW O SIR 036 SIR and Biennial 0.1 gph tank test performed properly. 40CFR 280.41, 280.43; T23 CCR 2643, 2646.1 RD RD RD RD 037 Non - passing SIR monitoring report results are reported and RD RD RD RDinvestigatedproperly. 40 CFR 280.41(a), 280.43(h)(1),(2); T23 CCR 2646.1 Bakersfield Fire Department— Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT Facility Name: Date: Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 R quit ®m ®nts: Slgnifl n Opera onal C C" t_AA gpliant r• JRD= elease De ctlon RPmRelease Proven Ion V O Automatic Tank Gauging (ATG) / Continuous In -Tank Leak Detection CITLD 038 ATG or CITLD 0.2 gph monthly test performed properly. 40 CFR RD RD RD RD280.43; T23 CCR 2643(b)(1), 2643 b 5 039 ATG generates a hard copy printout of all data reported including time and date, tank I. D., fuel depth, water depth, temperature, liquid volume and duration of test. If installed after 1/1/95 printout includes calculated leak rate and leak threshold. T23 CCR 2643 6 1 O Manual Tank Gauging SW tanks </ =1000 gal. ONLY 040 Weekly manual tank gauging performed properly. 40 CFR 280.43; RD RD RD RD T23 CCR 2645 041 Tank Integrity test performed, if necessary. 40 CFR 280.43; T23 CCR RD RD RD RD 2645 O Vadose Zone and /or Groundwater Monitoring 042 Monitoring system is installed and monitored properly. 40CFR RD RD RD RD 280.43; T23 CCR 2647 -48 OTank Exemption 043 Tanks /piping meet tank exemption criteria, and weekly visual monitoring records are kept up-do-date. HsC25283.5 Pipe Monitoring O DW O Continuous Monitoring System 044 DW piping (gravity, suction, pressure) in the turbine sump has continuous monitoring system that activates an audible and RD RD RD RD visual alarm or restricts or stops flow at dispenser. T23 CCR 2636 (0(1) 045 DW piping in the UDC is continuously monitored and method either shuts down the flow of product to the dispenser or activates an AN alarm. T23 CCR 2636(0(1) O Line Integrity Testing for Pressurized Piping 046 An annual 0.1 gph line integrity test is performed properly. Either third party or by Enhanced Line Leak Detection) T23 CCR RD RD RD RD 2636 (0(4) 47 In lieu of the annual tightness test for DW pressurized piping, the monitoring system for all product piping outside the dispenser is fail -safe and shuts down the pump when a leak is RD RD RD RD detected and the monitoring system shuts down the pump or flow restriction occurs when a leak is detected in the UDC. T23 CCR 2636(0(5) O Line Leak Detectors (LLD) 048 LLD's installed, annually tested, and operational on DW pressurized piping that detects a 3.0 -gph leak, and restricts or RD RD RD RD shuts off flow of product. T23 CCR 2636(0(2) O DW Emergency Generator Tank 049 LLD activates AN alarm and monitoring system is checked RD RD RD RD l daily. T23 CCR 2636(0(2) 050 In lieu of LLD, continuous monitoring system of DW emergency generator tank activates AN alarm, system is checked daily, and logs are kept. T23 CCR 2636 (0(6) O SW O Line Integrity Testing 051 SW pressurized piping: annual 0.1 gph line integrity test or a monthly 0.2.gph line integrity test is performed properly. 40 CFR RD RD RD RD 280.41, 280.44; T23 CCR 2643(c)(2),(3) 052 SW conventional suction system: 0.1 gph line integrity test is RD RD RD I RDperformedeverythreeyears. 40 CFR 280.40, 280.41; T23 CCR 2643(4) Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT Facility Name: Date: Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 Re i e e is c p a a . o p lance D e s. ctlo e e a re e I n C1 053 SW conventional suction system: inspections conducted for presence of air in the pipeline. Daily monitoring records are kept. T23 CCR 2643(d) 054 SW gravity flow piping: biennial 0.1 gph integrity test or overfill tank integrity test is conducted within allowable time frames. T23 CCR 2643(e) O Safe Suction (SS) System 055 Piping meets the SS requirements. 40 CFR 280.41; T23 CCR 2636(a)(3) RD RD RD RDA -D O LLD for Pressurized Piping 056 LLD's installed, annually tested and operational on SW pressurized piping. Pump shuts down when a leak occurs and RD RD RD RD when the LLD fails or is disconnected. T23 CCR 2666 57 LLD's installed, annually tested, and operational on SW emergency generator systems; LLD is connected to an AN alarm. 40 CFR 280.40(x)(2), 280.43(g)(1),(2), 280.44(a); T23 CCR 2666 Corrosion Protection 058 Metal Tanks and piping components have corrosion protection, RP RP RP RPorareisolatedfromthebackfill. 40 CFR 280.20, 280.21 059 Corrosion protection equipment turned on, functioning properly and provides continuous protection. 40 CFR 280.31(a),(b)(1); T23 CCR RP RP RP RP 2635 060 Cathodic protection system is tested within 6 months of installation and then every 3 years. 40 CFR 280.31(a) & (b)(1); T23 CCR RP RP RP RP 2635 a 2 061 Impressed current systems checked every 60- calendar days RP RP RP RP and records are up-to-date. 40 CFR 280.31(c); T23 CCR 2635(x)(2) On -site Paperwork 062 Permit and conditions available on -site. Facility is operated iv according t0 permit and conditions. HsC25293; 25299; T23 CCR 2712(i) 3 Monitoring and response plans are on -site and are the approved version. T23 CCR 2712(1); 2632 ;2634; 2641 Site plan depicts current site conditions and has all required elements. T23 CCR 2632(d) All release detection records for monitoring method are available, up -to -date, and appropriate for leak detection RD RD RD RD method. 40 CFR 280.41, 280.45 66 All monitoring /testing records /documents are available for the required timeframe. (3 years, 6' /I years, five years, life of tank) T23 CCR 2712 67 Equipment maintenance records/logs available. T23 CCR 2712(b) Alarm logs /tapes available and appropriate follow -up actions occurred. T23 CCR 2712(b); 2632; 2634 69 Visual observation logs available, up -to -date, and appropriate follow-up actions t0 problems occurred. T23 CCR 2712(b); 2642 0 Designated UST Operator monthly reports available and DOUA ram complete. T23 CCR 2716 1 Employee training records available and training appropriate V_ and up-to-date. T23 CCR 2715 072 Suspected or actual unauthorized releases are recorded and /or reported within allowed timeframes, including non- RD RD RD RD passing test results. Leak and Spill Logs available. 40 CFR 280.50; T23 CCR, 2650, 2652 3 Financial Responsibility Certificate and mechanisms (CFO p Q_ Letter, etc.) on -site and up -to -date. HSC 25292.2, 25299.30- 25299.34; T23 CCR 2711; T23 2808.1; 2809- 2809.2 Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 UNDERGROUND STORAGE TANK COMPLIANCE INSPECTION REPORT Facility Name: Date: SOC AND RED TAG S.O e Yes_ a. This facility is in compliance with Release Detection (RD) requirements only. (No violations in boxes marked RD, but one or more in boxes marked RP. b. This facility is in compliance with Release Prevention (RP) requirements only. (No violations in boxes marked RP, but one or more in boxes marked RD. c. This facility is in compliance with BOTH Release Detection (RD) and Release Prevention RP requirements. No violations in boxes marked RD or RP. oil ReclTa" eo,rti;n"fin, %_rrmation forRe or_-% 00-1 A Red Tag was issued to this facility based on the results of this inspection. Red Tag # Reason for Red Tag Choose one): On -Site Observation of Periodic Testing 2. Violation that impairs the ability of an UST system to detect a leak. CCR 2717(8)(2) 3. Chronic violation or committed by a recalcitrant violator. CCR 2717(x)(3) 4 Spill- bucket testing conducted appropriately and a passing test El achieved. 075 Secondary Containment testing conducted appropriately and a passing test achieved. SOC AND RED TAG S.O Re o,rtln InomratronforReort6Chooseone `;, Track in;.datab`as % "'F'h Yes_ a. This facility is in compliance with Release Detection (RD) requirements only. (No violations in boxes marked RD, but one or more in boxes marked RP. b. This facility is in compliance with Release Prevention (RP) requirements only. (No violations in boxes marked RP, but one or more in boxes marked RD. c. This facility is in compliance with BOTH Release Detection (RD) and Release Prevention RP requirements. No violations in boxes marked RD or RP. d. This facility is NOT in compliance with both Release Detection (RD) and Release Prevention (RP) requirements. (One or more violations marked in (both) boxes RD and RP. ReclTa" eo,rti;n"fin, %_r rmation forRe or_-% A Red Tag was issued to this facility based on the results of this inspection. Red Tag # Reason for Red Tag Choose one): 1. Violation that causes or threatens to cause a liquid release. CCR 2717(e)(1) 2. Violation that impairs the ability of an UST system to detect a leak. CCR 2717(8)(2) 3. Chronic violation or committed by a recalcitrant violator. CCR 2717(x)(3) Item Inspection Comments: Bakersfield Fire Department — Prevention Services Division, 2101 H Street, Bakersfield, CA 93301 (661) 326 -3979 4 To: Sessions SPECIAL INSPECTION REPORT Site: Bashar Chevron Date: March 11, 2005 Address: 2301 Panama Lane Bakersfield, CA 93307 The following results for the above location represent the conclusions of the Special Inspection which are to be presented to the regulatory agency, Tank No. 1 Capacity 10,000 gallon Dimensions T11 ° x 27' Product Fuel CCR Title 23 -2663 pass EM b) Tank shell will provide structural support if the tank is lined. 4 2) (A) Blasted free of scale, rust and foreign matter. 4 B) Witness ultrasound test - average of 75% or greater of original thickness. d 1. No open seam or split longer than 3 fnches. J 2. No perforation larger than 1 -112 inch. 4 3. Does not have five or more perforations in a one square foot area. 4 4. No multiple perforations in which any single perforation is larger than IC in diameter. 4 c) A serious corrosion problem does not exist. J Coating Inspector Dan Lawhom STAMP Professional Engineer Robert Paul P.E. Address 2243 Aspen Mirror Way Suite 204 Laughlin, NV 89029 Phone Number (702) 460 -8300 c QSOFESSro, Signature: 4 LST Registered Professional Engineer No. Corrosion 111 ` itExpirationDate: 3/3112006 ls. 111 is r r To: Sessions SPECIAL INSPECTION REPORT Site: Bashar Chevron Date: March 11, 2005 Address: 2301 Panama Lane Bakersfield, CA 93307 The following results for the above location represent the conclusions of the Special inspection which are to be presented to the regulatory agency. Tank No. 2 . Capacity 10,000 gallons Dimensions 7'11° x 27' Product Fuel CCR True 23 -2663 Pass Fall b) Tank shell will provide structural support if the tank is lined. 4 2) (A) Blasted free of scale, rust and foreign matter. 4 B) Witness ultrasound test - average of 75% or greater of original thickness. 4 1. No open seam or split longer than 3 inches. 4 2 No perforation larger than 1 -112 inch. 4 3. Does not have five or more perforations in a one square foot area. 4. No multiple perforations in which any single perforation Is larger than 1W in diameter. c) A serious corrosion problem does not exist. Coating Inspector Dan Lawhom §LAMP Professional Engineer Robert Paul P.E. Address 2243 Aspen Mirror Way Suite 204 Laughlin, NV 89029 Phone Number (702) 460 -8300 QgOFES& I Signature: w , atiRT p 'e% Registered Professional Engineer No. Corrosion 111 a Ido. illExpirationDate: 3/31/2006 J• RkOS G ' To: Sessions SPECIAL INSPECTION REPORT Site: Bashar Chevron Date: March 11, 2005 Address: 2301 Panama Lane Bakersfield, CA 93307 The following results for the above location represent the conclusions of the Special Inspection which are to be presented to the regulatory agency. Tank No. 3 Capacity 4,000 gallons Dimensions 67 x 1T2° Product Fuel CCR Title 23 -2663 pass Fa b) Tank shell will provide structural support if the tank is lined. N/ 2) (A) Blasted free of scale, rust and foreign matter. 4 B) Witness ultrasound test - average of 75% or greater of original thickness. J 1. No open seam or split longer than 3 inches. 4 2. No perforation larger than 1 -112 inch. d 3. Does not have five or more perforations in a one square foot area. 4 4. No multiple perforations in which any single perforation is larger then %" in diameter. 4 c) A serious corrosion problem does not exist q Coating Inspector Dan Lawhom STAMP Professional Engineer Robert Paul P.E. Address 2243 Aspen Mirror Way Suite 204 Laughlin, NV 89029 Phone Number (702) 4604300 tOfESSI Signature: oe aT P Registered Professional Engineer No. Corrosion 111 Expiration Date: 3/3112006 1: