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Home My WebLink AboutUNDERGROUND TANK FI LE CON'rl~N'rS INVENTORY Permit to ^bandon f of Tanks Da~e Permit to Construct ~ Date Permit to Operate ~ Date Application ~o Abandon Tank(s) Date -- ~ .... Application to Construct_ . . Appl~atf0~{'~0'0perate -- /,~~ Tank Sheets./ ............ Plot Plans'- Amended Per.it Conditions , Annual Report Forms .~- ........... , ............. ~Copy at Written Contract Det~een Owner & Operator Inspection Reports Correspondence - Received Date Date Date Date Da te Correspondence - Mai led Date Date Date Date Date Unauthorized Release Reports Abandonment/Closure Reports Sampling/Lab Reports ~VF CompJla.ce Check (New Construction Checklist) STD Compliance Check (New Construction Checklist) MVF Plan Check (New Construction) STD Plan Check (Ne. Construction) MVF Plan Check (Existing Facility) STD Plan Check (Existing Facility) "Incomplete Application" Form Permit Application Checklist Permit Instructions , Discarded Tightness Test Results Date Date Date Monitoring Well Construction Data/Permits Environmental Sensitivity Data: Groundwater Drilling. Boring bogs Location of Water Wells Plot /'lan Featuring All Env'.onmentally Sensitive Data Photos Constructlou Oi-a~v: ,gs Lucatluq: Miscellaneous BAKE RS Fi I,.'LD, CA 933U1 AI'I'LICATION FOR PERMIT TO OPERATE UNDERGROUND llAZARDOUS SUBSTANCES STORAGE FACiLiTY Type Of AppllcuLIon (check): E]New Facility [~]Modiflcatlon Of Facility ~Existtng Facility ~]Transfer Of Ownerslllp A. -Emergellcy 24-}lour Contact..iname,. area code phone): Days ~/~g'-.~Z~- Facility Name .~F~ /e~-~ No. Ot Tacks Type Of Business {check): ~Gusollne Stutiou ~ti~er (descrlbe)~ Is Tankis) Located On An Agrlcuiturai Farm? ~Yes ~o Is Tank{s) Used Primarily For Agrtcu~ural Purposes? ~Yes Facility Address ~/~ /~~e/ Nearest Cross St. T R SEC (Rural Locations Only) Tank O~ner ~u c ~~ Contact Person " .Telephone .--~D .... : ........... Address ~'~ ~~ ~ City/State ~ .. Operator Contact Person Address Zip Telephone B. 'Water To Facl1Xty Provided BN ~ d~ ~F~/~,-~ Depth to Groundwatev Soil Characteristics At ~acllit~ Basis For Soil T~pe aud Uroundwater Depth Determinations C. Contractor CA Contractor's License No. Address - · Zip Teiephone P~oposed Startln~ D~te Proposed Completion Date Worker's Compeusotlon Certification No. lnsure~ ~,~~ D. If Tills Permit Is For Modification Of An Existing Facility, Briefly Descrlb Modifications Proposed E. Tank(s) Store (check all that apply): Tank ~ Waste Product Motor Vehicle Unleaded Rezular Premium Diesel Waste ' Oil 0 F. Chemical Composition Of Materials Stared (not necessary for motor vehicle fuels) Tank g Chemical Stored {non-commercial name) CAS t {If known) Uhemlcul Previously Stvred (If different) .. O. Transfer Of Ownersh/l! "' ~'"' ........... ' ' Date Of Transfer Previous Owner Previous Facility Name ." I, accept fully all obl/ga~-lons of Permit N?.. ~ :~' issued t. I t, ndersLand that tile {P,-ermi. ttlnK/=Authority---may review au modify or terminate the transfer of the Permit to"Operate this underground stora~, ........... fac 11'1 ty 'uPoh' Fete lvlhg Tills form has been~pleted uuder pew, ity of perjury and to the best of my knowledge is true and correc t.~.~~ f_AN__K_ _~ / (FILL UUT ~;J.;i'ARA'rE FORN FOR ~ACII 'I'AHK) 2. '/'auk NuLerlul ~ Cai'bolt Steel ~ StuJnless Steel ~ I'ulyvlayl Chloride ~ Fiberglass-Clad Steel ~ Flberglass-Relaforced I'lustlc ~ Concrete ~ Uther (descr/be): 3. Pr/marz Colitainment ....... ,DaLe liLs'~ulled Thlckileas"(-inches} - _ CupaciLy 4. '~'unk 8ecqnduL'~ ~unLulmnent ~ Double-Wu1/ ~ Synthetic Liner ~ L/ned Vnulk ~None ~. .Other (describe): Manufackurer: ~ Nater/nl Thickuess (Lnches) 5. ?mdc [akerior Llaiag ~ Rubber ~ Alkyd ~ gpuxy ~ Phenu11c ~ Glu~s ~ Clay ~ Unlhled ~nknol~n .......... - ..... ~ ' Other--(deacr-l. be): ........ 6. Tank Corro9iou ]'roLectlon ................................................ ' .... ~ On/van/zed ~ FlbeL'~.iuss-Clad ~ I'ulyetlwlene ~rap ~ Vlnyl tVrapping -. ~ Tnt or Asphalt ~ Unknown ~ None ~ Uther (describe): 7. beuk DeLecLiun, Munitorln~{, hud lnLercupLiuu 'ruuk: ~ Visual (vualted Luuk9 uulyJ ~ {;t'ound{vater Nouitorlng Well(s) ~ Vudose Zul~e MullJtul'lllu IVellis) ~ U-Tube WlthuuL Lilier ~ U-Tube wll:h gompatible Liner Dli'eutllq{ ~ Vapur I}eLectur *~ Liquid Level 8enaor* ~ guuductlvlty Sensor* [~ Pressure SellaOf Iii Annular Space Of Double Wall Tank * ~ I,Jqtlid ReLi'ieval & luspecL.lou FL'om U-TaLe, ~ionitoi'tllg iVell Ur Annulal' Space ally GaugluA & inveutory Reconciliation ~Pe'riudic TighLness 'resLing b. Piping: ~ Flotv-l{estrictinR Leak Detector(s) For Pressttt'lzed Piping* ~ MouJLol'Jilg Sumi) WJLh Race,ray ~ Sealed CuncreLe Race~uy ~ Ilalr-CLIL Compatible Pipe Race,ray ~ SynCheLlc Liner Raceivuy ~one · Describe Make & Model:. B. 'l'anl( Tlghtuess Has T/Ils Tank Been T/g/it:ness Tested7 ~ Yes ~ No ~ Unknown Date Of Last TlghLness Tes~ ResulLs Of Tes~ Test Name 'resting Company 9. Tank. Repair Ua~e(s) Of Relmir(s} Describe RepaJ J'~ 10. Over'fiji I-'roLecLJou ~ Opez'aLor FI.lis, Conl:ro.ls, &VlsualJy NouJtors Level ~ Tape Float Gauge ~ FIoaL VenL Valves 0 AuLD Shun-Off Controls O -Cal,acitauce Sensor ~ Sealed Fill Box ~Nolie ~ Uiiknown ~ OtlieL': blst,~ake: & ~lodel..For Above Devices 'rhlckl,ess {inches) ~~iu,,,eLer /~ ~ Pressure ~SklC lJOII ~ Gravity ~ Polyethylene {Vi'a{} ~ lecLrical Isolation ~ Vinyl {¢rap ~ Tau or Asphalt ~ Unkliu~vn ~ Nuue ~ Iher (describe): c. Ul~del-gl-OUhd Piping. Seuon,{;, '.' ~ DuubJe--iYaJ] 0 SyuLh,.' ;(: LJliel' SysLem g Othcr (describe}: ~ FLOOR: OF NORTH SCALE: BUSINESS NAME: ~r/~ x/2~"f'"~.~c-< ~ OATE: / / FACILITY N~E: ~NIT ~: OF , (c.gcg oNE} SlTg UIAOaAM ~ ~d .......... ~ ~' ' -.._~- .... ._ ~ ............. ~.:-..-..._..:.. __ ...... . .......... , '. ..... ~ ..... ..... , ': ~:~ : -- [ ~ ,.' : ~ . .':; ~.. . ~ '~.',..:. .... · . -... :. ::f .~, . ( inspector's Comments): ~j:?OFFtCIAL USg .ONLY-'-'".~ iIMCU-13 ............... COUNTY OF k ERNW .. Environmental Health Servie,-s Department 2700 "M" Slree~,-$ulle 300 Bakersfield, CA 93301 (805) 861-3636 (805) 861.3429 Fax Number~ ~\ Star Petroleum P,O, Box 387 Bakersfield, CA 93302 Attn: Jessie Gilbert RE: Underground Storage Tank(s) 'Dear Mr. Gilbert: It has come to the attention of the Kern County Environmental Health Services Depa~u~tent that one ¢1) underground storage tank is located at 619 16th Street, Bakersfield, California and is not permitted. You are therefore in violation of: 1) Division 20, Chaptei 6.7 Section 25284(a) of the California Health and Safety Code which states "... no person shall own or operate an underground storage tank unless a permit for its operation has been issued by the local agency to the owner." 2) Division 8, Section 8.48.030(a) of the' Kern County Ordinance Code which states, "No person shall operate a facility for the underground storage of any. hazardous substance..., unless by authority of a valid, unexpired and unrevoked Permit to Operate is issued to owner..." Enclosed you will find an application for the Permit to Operate. The completed form must be returned to this office w/thin 14 days of the date of this letter. In lieu of the application for a Permit to Operate, a completed permit for permanent closure of your tanks may be submitted within 14 days. Failure to obtain a permit may result in fines of five hundred dollars ($500.00) to five thousand dollars ($5,000.00) per day per Division 8 Section 8.48.480 of the Kern County Ordinance Code. Star Petroleum May 16, 1989 Page 2 .._ . ...... After we receive the application, an invoice will be sent to you for the annual fee for a ... Permit to Operate of one hundred dollars ($100.00) for the first tank and twenty dollars '($20.00) for each additional tank. A state surcharge of fifty-six dollars ($56.00) per tank for each facility permitted will also be included. This is per Chapter 6.7 Section 25287(b) of the California Health and Safety Code. If you have any questions, please do not hesitate to contact me at (805) 861-3636. Your ........... Cooperation is much appreciated. Sincerely, Turonda R. Crumpler, REHS Hazardous Materials Specialist Hazardous Materials Management Program TO:dr \permit.no COUNTY OF kERNO Environmental Health Servic, s Department Bakersfield. CA 93301 (80~) 861-3636 ,S05) ,61-3429 Fax Numb.r ~f/~ May 16, 1989 Star Petroleum P,O, I~o.~ llakersti~Id, ff_..& 9:t302 I(~~.~ Arm: Jessie Gflbe~ RE: Underground Storage Tank(s) Dear Mr. Gilbert: It has' come to the attention of the Kern County Environmental Health Sen, ices Depamnent that one (1) underground storage tank is located at 619 16th Street. Bakersfield. California and is not permitted. You are therefore in violation of: 1) Division 20, Chapter 6.7 Section 25284(a) of the California Health and Safety Code which states "... no person shall own or operate an underground storage tank unless a permit for its operation has been issued by the local agency to the owner." 2) Division 8, Section 8.48.030(a) of the Kern County Ordinance Code which states, "No person shall operate a facility for the underground storage of any hazardous substance..., unless by authority of a valid, unexpired and unrevoked Permit'to Operate is issued to owner..." Enclosed you will find an application for the Permit to Operate. The completed form must be returned to this office within 14 days of the date of this letter. In lieu of the application for a Permit to Operate,' a completed permit for permanent closure of your tanks may be submitted within 14 days. Failure to obtain a permit may result in fines of five hundred dollars ($500.00) to five thousand dollars ($5,000.00) per day per Division 8 Section 8.48.480 of the Kern County Ordinance Code. Star Petroleum May 16, 1989 Page 2 After we receive the application, an invoice will be sent to you for the annual fee for a Permit to Operate of one hundred' dollars ($100.00) for the first tank and twenty dollars. ($20.00) for each additional tank. A state surcharge of fifty-six dollars ($56.00) per tank for each facility permitted will also be included. This is per Chapter 6.7 Section 25287Co) of the California Health and Safety Code. ~ If you have any questions, please do not hesitate to contact me at (805) 861-36'36. Your cooperation is much appreciated. ........................ Sincerely,. ........... Turonda R. Crumpler, REH$ Hazardous Materials Specialist Hazardous Materials Management Program TC:dr \permit.no COUNTY OF KERN Environmental Health Services Department 2700 "1~!" Streel, Su/le .300 Bnkerslleld, CA 93301 (805') 86t.3636 ~ (801;) 861,-3429 Fax Number , Hay 9, 1989 Star Petroleum ATTN: Jessie Gilbert 619 lgth Street Bakersfield, California 93301 RE: Underground Storage Tank(s) Dear Mr. Boyance: It has come to the attention of the Kern County Environmehtal Health Services Department that one (1) underground storage tank is located at 619 19th Street, Bakersfield, California and is not permitted. You are therefore in violation of : 1) Division 20, 'Chapter 6.7 Section 25284(a) of the California Health and Safety Code which s~at~s ",,. no person shall own or operate an underground storage tank unless a permit for its operation has been issued by the local agency to the owner." 2) Division 8, Section 8.48.030(a) of the Kern County Ordinance Code which states, "No person shall operate a facility for the underground storage of any hazardous substance .... unless by authority of a valid, unexpired and unrevoked Permit to Operate is issued to owner..." Star Petroleum May 9, 1989 Page 2 Enclosed you will find an application for the Permit to Operate, The completed form must be returned to this office within 14.days of the date of this letter. In lieu of the application for a Permit to Operate, a completed permit for permanent closure of your tank may be submitted within 14 days. Failure to obtain a permit-may result _in_fines of five hundred dollars _.($500.00) ..... five thousand dollars ($5,000.00) per day per Division 8 Section 8.48.480 of the Kern County Ordinance Code. After we receive the application, an invoice will be sent to you for the annual fee for a Permit to Operate of one hundred dollars ($100.00) for the first tank and twenty dollars ($20.00) for each additional tank. A state surcharge of fifty-six dollars ($56.00) per tank for each facility permitted will also be included. This is per Chapter 6.? Section 2§287(b) of the California Health and Safety Code. If you have any questions, please do not hesitate to contact me at (805) 861-3636. Your cooperation is much appreciated. Sincerely, Turonda R. Crumpler, R.E.H.S. Environmental Health Spe¢£al~st I Hazardous Materials Management Program TC:cas Enclosures \starpetr.np 5-9-4 ,.. HAZARDOUS MATERIALS DIVISI~ -' UNDERGROUND STORAGE TANK PROGRAM PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK SITE INFORMATION ~' SITE· Star Petroleum ADDRESS 619 - 16th St. ZIP CODE 93301 APN FACILITY NAME Star Petroleum Texaco CROSS STREET "P" Street TANK OWNER/OPERATOR BWS - Jan Meyer PHONE No. (805)589-5510 MAILING ADDRESS P.O. Box 2243 CITY Bakersfield ZIP CODE 93303 CONTRACTOR INFORMATION COMPANY Kern Environmental Service PHONE No. (805) 589-5220 LICENSE No. 432372 ADDRESS P.O. Box 5337 CITY Bakersfield ZIP CODE 93388 INSURANCE CARRIER Tolman & Wiker WORKMENS COMP No. WC5822461 PRELIMANARY ASSEMENT INFORMATION COMPANY Kern Environmental Service PHONE No. (805)589-5220 LICENSE No. 432372 ADDRESS P.O. Box 5337 CITY Bakersfield ZIP CODE 93388 INgURANCECARRIER Tolman & Wiker WORKMENS COMP No. WC5822461 TANK CLEANING INFORMATION COMPANY Kern Environmental Service PHONE No.(805~589-5220 ADDRESS P.O. Box 5337 CITY Bakersfield ZIP CODE 93388 WASTE TRANSPORTER IDENTIFICATION NUMBER CAD 982, 495 608 NAME OF RINSTATE DISPOSAL FACILITY Gibson gnvirbnmental ADDRESS End of Commercial Drive CITY Bakersfield ZIP CODE 93308 FACILITY INDENTIFICATION NUMBER CAD 980 883 177 TANK TRANSPORTER INFORMATION COMPANY KVS Transportation Inc. PHONE No. (805)589-5220 LICENSE No. 432372 ADDRESS P.O. Box 5295 CITY Bakersfield ZIP CODE 93388 TANK DESTINATION Golden State Metals, Inc. TANK INFORMATION TANK No. AGE VOLUME CHEMICAL DATES CHEMICAL STORED STORED PREVIOUSLY STORED 1 30 years '1,000 Gallons Gasoline 1963 to Present Gasoline THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE A'PI'ACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE. LOCAL AND FEDERAL REGULATIONS. THIS FORM HAS BEEN C~)MPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE. IS TRUE AND CORRECT. · CraSg Cornett ' *' TH'l' ICATION BECOMES A PERMIT ~HEN APPRO;'VED :'' .?. HAZARDOUS MATERIALS DIVISIO1Y ~' ~1~~ . U NDERGROUNDSTO RAGE TANK PROGRAM PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK SITE INFORMATION SITE Star Petroleum ADDRESS 619 - 16th St. ZIP CODE 93301 APN FACILITY NAME Star Petroleum Texaco CROSS STREET "P" Street TANK OWNER/OPERATOR BWS - Jan Meyer PHONE No. (805)589-5510 MAILING ADDRESS P.O. Box 2243 CiTY Bakersfield ZIP CODE 93303 CONTRACTOR INFORMATION COMPANY Kern Environmental Service PHONE NO. (805)589-5220 LICENSE No. 432372 ADDRESS P.O. Box 5337 CITY Bakersfield ZIP CODE 93388 INSURANCE CARRIER Tolman & Wiker WORKMENS COMP No. WC5822461 PRELIMANARY ASSEMENT INFORMATION COMPANY Kern Environmental Service PHONE No, (805)589-5220 LICENSE No. 432372 ADDRESS P.O. Box 5337 CITY Bakersfield ZIP CODE 93388 INSURANCE CARRIER Tolman & Wiker WORKMENS COMP NO. WC5822461 TANK CLEANING INFORMATION COMPANY Kern Environmental Service PHONE No. (805~589-5220 ADDRESS P.O. Box 5337 CiTY Bakersfield ZIP CODE 93388 WASTE TRANSPORTER IDENTIFICATION NUMBER CAD 982 495 608 NAME OF RINSTATE DISPOSAL FACILITY Gibson Environmental ADDRESS End of Commercial Drive CITY Bakersfield 7tP CODE 93308 FACILITY INDENTIFICATION NUMBER CAD 980 883 177 TANK TRANSPORTER INFORMATION COMPANY KVS Transportation Inc. PHONE No. (805)589-5220 LICENSE No. 432372 ADDRESS P.O. Box 5295 CITY Bakersfield ZIP CODE 93388 TANK DESIINATION Golden State Metals, Inc. TANK INFORMATION TANK No. AGE VOLUME CHEMICAL DATES CHEMICAL STORED .STORED PREVIOUSLY STORED 1 30 years 1,000 Gallons Gasoline 1963 to Present Gasoline THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE, LOCAL AND FEDERAL REGULATIONS. . '~ THIS FORM HAS BEEN C~MPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT. cra%g ' ~ ' ON BECOMESA PERMIT HEN APPROVED .'' .,.. .... ~ ................................................................ ,. ................................ :-F-~:i.-.. ~ ~ ' .... ................... ~ ....................................................... ~_--.'_ .~;____£_: .......... - ..1 ~ ~ ~~. ............................. .... ' :. ' . . . " ' ': GqTt~ .......... ' '. .. ' ':'. _. ': _5.:_: 7'..5-:_-_ _-": :'....' :B~!_L.~_I~V¢ .-. :._ "-..-. '.-:::.. .' 7 -- _ '...'" .-'- 7". .."-:. :'."- .: ' ..'~ '_' :.'.'"._.. ';-"::'".' ' :-':". ::.-_~'-.::_- :-'-': -..L'::"Z:'::_7':::':Z::7.:'~Z_:.' X 2130 G Street, Bakersfmeld, CA 93301 · (805) 326-3970 6'~b '~ UNDERGROUND TANK~Q~IRE R ,~Ug 0 9 ~99~ I. FACILI~/SITE No. OF TANKS / DBA OR FAClLI~ NAME NAME ~RATOR ADDR[~. N~R[SI, CRO~ SIR[~ PARC[L No.(OPHONAL) CI~ NAME .~~ SYATE ZlPCODE EMERGENCY CONTACT PERSON (PRIMAR~ EMERGENCY CONTACT PERSON (SECONDAR~ optional OAYS: NAME (~ST. FI~ PHONE ~. WITH AREA CODE DAYS: NAME (~ST. FI~ ~ PHONE No. WITH AR~ CODE NIGHTS: NAME (~ST~I~S~ PHONE ~. WITH AR~ CODE NIGHTS: N~ME (~ST~I~ PHONE No. WITH AR~ CODE II. P~OPEE~ OWNEE INFOEMATION (MU~T BE COMPLETED) NAME~ CA~E OF ADDEE~ INFORMATION MAILING O~ STR~ AODRESS ~ ~OX ~IVID~AL ~ LOCAL AGENCY ~ STME AGENCY ~ '~0~ ~d~ U ~ d ~y TO INDICATE ~ PARTNERSHIP ~COUN~ A~ENCY ~FE,ERA, ~ENCY CI~ NAME STATE ZIP CODE PHONE No. WiTH AREA CODE III, TANKOWNE~ INFORMATION (MUST BE COMPLETED) MAIUNG~R_ST~E~] ADD~ES~ ........ - ....... ~ BOX ~IVIOUAL ~ LOCAL AGENCY ~ STA~E AGENC~- CI~ NAME STATE ZiP CODE PHONE No. WITH AREA CODE OWNER'S . DATE VOLUME PRODUCT IN TANK No. INSTALLED STORED SERVICE Y/N Y/N Y/N Y/N .Y/N DO YOU HAVE FINANCIAL RESPONSIBILITY? Y/N TYPE I.'TANK DESCRIPTION COMPLETE Alarm, s -- SPECIFY IF UNKNOWN c. ATE ,,,STALLED,MO,DAY";EA ,.,, . D. TANK C,,,'ACITY ,N G LONS: ,,,, III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. S. ANDC. ANDALLTHATAPPLIESINE)OXD A, TYPE OF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM ~ SINGLE WALL [] 4 SECONDARY ~3NTAINMENT (VAULTED TANK) [] 9a OTHER 8. TANK ~ BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEELCLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLEWIFRP (PrimaryTank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER [] , RUBBE. L,NED [] 2 AL~D L.~,.G [] 3 EPOX~ L,NmNG [] , P.ENO.~ L'.,NG C. INTERIOR [] 5 GLASS LINING [] 0 UNLINED [] g5 UNKNOWN [] 9<30TNER LINING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES__ NO__ D. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE .; . [] 05 UNKNOWN [] 99 OTHER IV, PIPING INFORMATION C~RCL~ & IFABOVEGROUNDOR U IF UNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A_(~ 1 _SUCTION .......... A U .2 PRESSURE ._ A U 3 GRAVll:Y .... A-II -99~ OTHER B. CONSTRUCTION A{~7 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A IJ 99 OTHER · C, MATERIAL AND A u 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A U 4 FIBERGLASS PIPE CORROSION ALI 5 ALUMINUM A U 6 CONCRETE 'j~ 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION [~]1 AUTOMATIC LINE LEAK DETECTOR r--1 2 LINETIGHTNESS TESTING r'--1 3 'NTERST1TIALMoN[TOR[NG [] 99 OTHERi~v~iF~,~,~, V,~ LEAK D['rECTION VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VAPOR MONITORING [] 4 AUTOMATIC TANK GAUGiNG [] S GROUNDWATER MONITORING [] 6 TANK TESTING [] ' 'NTERST,T,ALMON'TO.,NG [] a. "O"E [] ~ UNKNOWN []" OTHER I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY 1F UNKNOWN A. OWNER'S TANK I. D. # B. MANUFACTURED BY: C. DATE INSTALLED (MO/DAY/YEAR) D. TANK CAPACITY IN GALLONS: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B. ANDC. AND ALL THAT APPLIES IN BOX D A. TYPEOF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULTED TANIO [] 99 OTHER B. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC .... MATERIAL .... [] 5 CONCRETE.. [] 6_P_OLYVINYL CHLO~RIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLE W/ERP (,rimaryTank)[] g BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER [] , RUBBER L,NED [] 2 AL~D LI.ING [] 3 EPOX~ L,.ING [] , PHENOL.C LIN,NG C. INTERIOR LINING [] 5 GLASS UN,Ne [] S UNLINED [] aS UNKNOWN [] aa OTHER IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES.__ NOs D. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION E~ 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION C~RCLE A IFABOVEGROUNDOR U IFUNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION A U 2 PRESSURE .~ U 3 GRAVITY A U ag OTHER B. CONSTRUCTION A U 1 SINGLE WALL A IJ 2 DOUBLE WALL A I.J 3 LINED TRENCH A U 95 UNKNOWN A [J 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC)A U 4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/COATING A U 8 100"/o METHANOL COMPATIBLE W/FRP PROTECTION A U 9 GALVANIZED STEEL A IJ 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION ~ 1 AUTOMATICLINELEAKDETECTOR [] 2 LINETIGHTNESSTESTING [] 3 INTERSTITIAL MONITORING [] 99 OTHER V. TANK LEAK DETECTION [] , v,SUAL CHEOK I~ 2 ,NVENTORY RECONC,L.AT,ON [] ~ VAPOR MON,TOR,NG []. AUTOMATIC TANK GAUG,NG [] ~ GROUND WATER MONiTOR,NO [] ~ TA"K TESTING [] . ,NT~RST,T,ALMON,TOR,NG [] al NONE [] a~ UNKNOWN [] ~ OTHER HM761801 Account Number ACCOUNTS RECEIVABLE ADJUSTMENT Mamh 10, 1994 Date New Acco,,nt New Addre88 Esther Dumn Close Account From Service Chanqe Other Adjustments X Fire Department- Hazardous Materials Division Department/Division STAR PETROLEUM Billing:.~me 619 '~H ST Billing Address Site Addre88 Parcel # (If Applicable) Landlord Name & Address (If Applicable) ADJUSTMENT Last Billed Correct Billing Adjustment to Effective Date of Billing Change 66.00 0 <7.93> 1-1-94 Remarks: THIS UST WAS REMOVED PRIOR TO THE BILLING PERIOD. Page: 1 Account Billing/Collection Activity Inquiry SUTL108 Acct : 761801 Cyc St: CL Bill St: NO Cyc: 6 Rt: 1 Seq: $SN : Parcel: .... Svc Cls :e Name : STAR PETROLEUM Svc. Add: 619 16TH ST Amt due: 73.93 Current Period Postings Lst Pmt: -50.00 Type Desc Date Amount Receipt # Pmt Dte: 02/03/93 B91 PENALTY 03/01/94 6.60 -- Prior Bills -- B92 FINANCE CHARGE 03/01/94 1.33 Date Balance 01/01/94 66.00 01/01/93 0.00 Enter '/' For Billing History, 'P' To Print Report, 'D' For Detail Page, or '/C' For Credit and Deposit History or 'XX' To Exit Please enter one of the requested commands. FIRE DEPARTMENT 2101 H STREET S. O. JOHNSON July 2, 1993 BAKERSFIELD, 93301 FIRE CHIEF 326-3911 B.W.S. c/o Jim Meyer P.O. Box 2243 Bakersfield, CA 93303 CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANKS LOCATED AT 619 16th Street, IN'BAKERSFIELD, CALIFORNIA. PERMIT ~ BR-0076 Dear Mr. Meyer: This is to inform you that this department has reviewed the results for the preliminary assessment associated with the closure of the tanks located at the above stated address. Based upon laboratory data submitted, .this office is satisfied with the assessment performed and requires no further action at this time. This letter does not relieve you of any liability for past, present, or future operations.-In addition, any future changes in · .site use may' require further assessment or mitigation. It is the property owners responsibility to notify this department of any changes in site usage. -- If- you -~v~ any questions regarding this matter, 'please :~ontact me at.:(.805)-326-3979. Sincerely, Hazardous Materials Coordinator Underground Tank Program REH/dlm CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT 2101 H STREET S. D. JOHNSON July 2, 1 9 9 3 BAKERSFIELD. 93301 FIRE CHIEF 326-3911 STAR PETROLEUM' 619 16TH STREET BAKERSFIELD, CA 93301 RE: Monitoring.requirements for underground storage tanks. Dear Business Owner: Our records reveal that no precision tank testing has been '~ performed on t'he underground storage tank located at 619 16Th Street. Section 2643 2(A) of Article 4; Title 23, Div. 3, Chapter 16, CCR., requires that all underground tanks that do not utilize automated leak detection shall have a precision tank test annually. Additionally, pressurized piping shall be tested annually and no'n- pressurized piping shall be tested every three years. Pipeline leak detectors and automated leak detection systems also have to be certified to be in working order on an annual basis. Please make arrangements to bring the tanks into compliance with state law. ' ' If you h-~ve any questions, please call me at (805) 326-3979. erely~ / Hazardous Materials Coordinator Underground Tank Program. KERN ENVIRONMENTIL SERVICE June 29, 1993 Ralph Huey CITY OF BAKERSFIELD HAZARDOUS MATERIALS DIVISION 2130 "G" Street Bakersfield, California 93301 REGARDING: Underground Tank Removal, Permit No BR-O076 (KES Project No. E-1035) Dear Mr. Huey: Regarding the above referenced underground tank removal for BWS at 619 16th Street, Bakersfield, California we are forwarding the following items for your records. 1. Soil sample analysis results Zalco Laboratory Nos. 35979-1 through 35979-3. 2. Sample cha#z of custody doct,nentation. 3. Uniform Hazardous Waste Manifest No. 92712235. 4. Receipt for Dry Ice from Brandco (Invoice No. 95295). 5. Non-Hazardous Waste Hauler Record No. 101602. 6. Certificate of Destruction (Golden State Metals No. 10488). Feel free to contact Mr. Frank Rosenlieb or the undersigned should you require additional #zformation regarding this project. Sincerely, CORNETZ, Lead Technician DCC:bd Enclosures Post Office Box 5337, Bakersfield, California 93388 · (805) 589-5220 In California · (800) 332-5376 StYe of Cgllfornla.~EnvlronmentaJ Protection Agency .Forr~ApprovedO/C. BNo. 2050-OO39(Explresg. 30-94).~ See Instructlons on back of.~ge 6. Deporlment at ToxlC Subst ..... Cont~'ol ,I Please print or type. Form design, ed for use on elite (1.%ioitch~rlter. . Sacramento, Callforn;a ' '" UNIFO. Rb64q~7.&RDOUS 1. Generator's UR EPA ID h~o. Manifest Document r, roT. 2. Page 1 Information in the shaded areas ' I is not required by Federal law. WASTE MANIFEST (ii I,".I?').I'L':t'{:>I:"I~ I":K 171..2I fl .: I Z .~' I£ o~ I . '.. · - . ... ^: ~:~. ~.~:~~ · -- ~.~.:..~g;~:.~;-~:.'.~-', °' 'LL~:¢ ~'~.~ T.~.'~.-~i · ' ·" " ' , ' iL::. .~.- .~ "', ,,:, ',/ ' ~ "','~* - ~' · . · . ...... . : -... .... . ....... . : .rj.~ '~.,, :¢.~-..~,,--_%p~ ~:, ~-' 1~ r.~.~'.'~'~'~' r~ ~.~ .- ~.~ .... ta,'s~ho~U;~:~'...~.:,','~-~+/~,.-~, .',.'-_.~,::~.'~.~.- .~. ...... 6 5. Transporter 1 Company Nome " 6. US EPA ID Number · C." Sic~e ' ' ..... "" ' "" ~ .¢ ' , ... .... '; I. US EPA I~ Number: '. E;..Sfdi-T'.r'_~.~::.~~~:~,~ ' '~: 7. Transporter 2 Company Name' . · _ ' '.': · - ..' -.- : '. '~" ::'"'_ 7 :~'. ' ." .... ': :-.:-':-~v.?. ~ ~.;. .,' .... .'- ; · -- 9. ~s;gnmed Foc;l~ N~m~ and S~ Address ....... · ..... ~'~ "' 10. US ~A ID NUmber..' ~:"'- · ~: St~.~l~:~~~~- ........... :.:e::- ~:,:j~;c~,:~. ~ u.. .~.... ·. · .~ ~ .5-: 'r~' · ~..' - · ". '. . - ...' '.:;': .~.j-. - ~.-;; -:..;.h.L~::;_..u:: -/'.- '.. :~. ::'; .... ~ ~ < ~ ~. .;, ~.~,'~,.~ ~: 0 .~-~:.~..'-..::..;.~;?:~..?::-..?...: .. : .. ....... -. U;?.~%v~,~;:,'"L~~~~'"...' ~'~ .~ . ... '. '~ Z 11. US DOT Description (~ncludin'g P,oper ~h~i;g ~e,'~0z~r~ Cl~;;~"~d I~ ~um~er).- :.. - 12. Comaine~ .: .: 13. Total?,- ~4: Un~ ~~~ ' 0 A '11 I ". ~~~" ~° t ~. ':";"..':." "h':-::::"'"': -(-:::':"':'.';:' ~:' '"" '; ........... " = ~ - ' . · ..... ..... ~~~. ~ ..... ..... ..:..-'... ' :.'.".'~.~?..';A;':./,::.:-...";.':':".. I I I"'1 I t I :'" Z d. '. . ...... '-. : .. ." .'.'. '-.:.-..'. . · - · . ~ · . ............:......-.. ..... : ...... :,;:...~ ..... . ....... . ......... :,... ...... . ~ ....:..., ~~.: . .... · ........ ,--. ........... ~A/ ~.~ ,, . .. . . . --O 1~... Sp~iol Handling In,fru~ons end Add~onol. lnJorm¢io~'.. · '." '.':.:'.'::~':.::' :~'." .'." '.'..'.d.'.- '" "' ' '': '" .... ""*?~;~ fJ",['2 ¢':'~}'~'~'~'-~.'~'~': ~ ~..¢,~ { ,,f · ... < ...... ~'(~'(~.~ ~, I;~/"..'. . "..':';~.';7:~:~::~"~ ':.' ::' ...:_':" "' "-: · ':.::'.'" >''' .:..:. :_....-.:, .'.:.:...: ...:. Z .... :. :: . . .. . · ..: .. . · .' ...... '=- . . .. ......= .......- · . ~ .. ,' .':_~'. .: ..-.-.. _ - . . :'.. . '.-. . .. .' :. ... . · :... ,:' ~ l& GENERATOR'5 CERTIFI~TION: I here5~ declare fh~e c~nfen~ of ~e consignment ore full~ and accurately ~e~crlbed a~ by proper ~hipping nome =n~ o~ clos~itle8, - U< packed, marked, =n~ labeled, en~ ore ....................... in oil re~ in proper cond~ion Jar tron~pod, b~ highwo~ occordlng .f° =ppllcobJe {e~ere[, date and intemmionol..., le~. ~ If I am o large qgonfi~ gener¢or, I cedi~ ~ I ha~ e pr~ro~ in place ~o re~uce ~e volume on~ toxici~ o~ waste generate8 fo f~e degree I hove ~efermln~8 fo be ~ economlco]~ pro,cable and tkm I he~ ~l~e¢ the pro¢coble me~o8 of ~e~menf, storage, or 81spo~ol currently available fo me wkich minimize~ ~e pre~nf and Ju~re ' ~:. ~ · ~ fhrem 1o human heol~ and ~e envlronment~ OR, iJ I am o small quon~ generator, ~ kove mo~e o goad Jai~ effod to minimize m~ wolfe ~ener~on on~ ~le¢ the ~ waste management me~o¢ ~¢ is ovoileble to me and ~ I con afford.. :'. ' '.': ' '"..'~:' · · ' ~ ' ; ".. · '. .' .. - ' ~ Printed~yped Name . / J . J .M°~h D~ Year I'" '~ ~ ~ 1~. Y[oAsDo.er 2 ~knowle~'eme~t of ",ceiDf of M~erloJs '' - ;~.: , e~:': ';~ ~ ~i Printed~yped Nome . . "J SignOre.r ·· ' ., ... . ~on.iI I I I'D~ .Year._ ~¢' ~""P""~'""~("t~O"sP°" ..- '~"""' '" ' ..... ;-~:..::'.~ '- ...:-' .'.:'u ...: ...: ........ · ..... ,.....,:::".: ' '.;~ :.' :~: z_ c, : .;.':: ::: ::.: · . : .':' · ." I 20. FocJliw ~e~ or O~ermor Ce~fica~on oJ receipt of hazardous' m~tefiol5 covered 5y this moniJe~J ex~pt o~ nofe~ Jn Item 1~. . · · · ' - .1 . Y Printed/Typed Nome .... . J S:gna~r. .... / · /~, J.J Month .. '.- ~ - Ye~, .- · - /~/ ~' · ~ .'....- .... .~> ............. Green HAULER RETAINS -. .~ . . . · . . . .... . .......... :.... ..,.. ~::..:.::..: ..... ZALCO BORATORIES, IN Analytical S C°nsulcincj Services Kern Environmental Services Laboratory No: 35979 P 0 Box 5337 Date Received: 5-25-93 Bakersfield, CA 93388 Date Reported: 6-1-93 Attention: Craig Cornett Sample: Soil Sample Description: Star Petroleum, BWS E-1035 35979-1 Soil at 2' Under Tank 35979-2 Soil at 6' Under Tank 35979-3 Soil at 2' Under Pump Sampled by Craig Cornett on 5-25-93 at 1110 hours -1 -2 -3 mq/kg njg/kq mq/kq Volatile Aromatic Hydrocarbons Benzene < 0.005 < 0.005 0.008 Toluene < 0.005 < 0.005 0.068 Ethyl Benzene < 0.005 < 0.005 0.014 Xylenes < 0.005 < 0.005 0.080 Method: EPA 8020 Date Analyzed: 5-28-93 Minimum Rep. orting Level = 0.005 m§/kg mq/kq mq/kq .,~/~- ",~i ·-~ Total Petroleum Hydrocarbons as 6asoline < 10 < 10 < 10 Method: DOHS Luft Manual Date Analyzed: 5-28-93 Minimum Reporting Level -- 10 mg/kg x L~b Operations Manager JE/ccw ~ 4309 Armour Avenue Bakersfield, California 93308 (805) 395-0538 FAX (805) 395-3069 CItAIN OF CUSTODY i;ECO/1D F KERN' ENWRONMENTAL SERVICE Post Office Box 5337 Bakersfield, (~alifomia 9330g (oos) sDg-5~o In California (~00)332-5376 ~Ch,/DRY ICE - :IRE EQUIPMENT 24 HR. PHONE: (805) 322-6001 SAFETY EQUIPMENT 101 TRUXTUN AVE. CAUF. WATTS (BO0) 272-6326 --{YDROSTATIC TESTING _ICENSES BAKERSFIELD, CA 93301 ORDER DESK FAX (805) 322-0127 5T.~.TE # 546 CA. CORP. FED. I.D. NO. 9~-2599411 OFFIC~ FAX (805) 322-6000 D O.T. A 105 · CONTRACTORS LIC. I~C-.36-52~'781 :.PcATg,, ' /, / 95295 ~DDRESS 31TY STATE ZIP Qty. Descript~gf~,~..~/~../ Price Amount DRY ICE PROCESS CHARGES L~e. CO~ BULK WEIGHT TICKET # Lbe. CO~ CYLINDERS HELIUM CYLINDERS c,,. NITROGEN CYLINDERS cu. Et CYLS. DELIVERED CYLS. RETURNED HYDROSTATIC TESTS I~ CASH [~CHARGE THANK YOU TAX · "o ror t , 7' 5- aATERIAL SAFETY DATA SHEET AVAILABLE ON REQUEST REMIT TO: P,O, BOX 1631 BAKERSFIELD, CA 93302-1631 TITLE TO ALL ABOVE ENUMERATED PERSONAL PROPERTY OR RENTALS SHALL REMAIN ~OLLY IN BRAND DRY ~CE UNTIL FULLY PAID FOR AND VENDEE SHALL BE RES~NSIBLE FOR SAME ~ILE IN H~S ~SSESSION AND WILL SURRENDER SAME UPON DEMAND IF IN DEFAULT. IT IS ALSO AGREED THAT, IF COLLECTION IS MADE BY SUIT OR OTHERWISE, I~E AGREE ~O PAY A FINANCE CHARGE OF 1.5% PER MONTH, WHICH IS 1~% PER ANNUM. A~ER ~ DAYS. ALSO COLLECTION COSTS AND INCLUDING ATTORNEY'S FEES. AND WAIVE ALL RIGHTS TO ANY CLAIMS EXEMPTED UNDER STATE LAWS· MINIMUM INTEREST CHARGE $1 50. BASIS ON WHICH CYLINDERS ARE LOANED: PROVIDED THAT IF ANY LOANED CYLINDER NOT RETURNED WITHIN 30 DAYS FROM DATE OF SHIPMENT THE DISTRIBUTOR RESERVES THE R~GHT TO MAKE A RENTAL CHARGE OF ~4.00 PER CYLINDER PER MONTH FOR ALL T~ME OVER 30 DAYS THAT SUCH CYLINDER IS AWAY FROM THE DISTRIBUTOR. WHICH DEMURRAGE CHARGE THE CUSTOMER AGREES TO PAY ON DEMAND THE CUSTOMER SHALL PAY ~OMPTLY ON DEMAND TO THE D~STRIBUTOR ESTABLISHED VALUATIONS AND RATES FOR LOSS OF OR DAMAGE TO ANY OF SAID CYLINDER5 OR FITTINGS RESULTING FROM .;.NY CAUSE AFTER DELIVE~ THEREOF TO THE CUSTOMER AND UNTIL RETURNED TO THE DISTR~BUTOR. REFILLING OF CYLINDERS Received ~y ~ TRANSPORTATION, IN~. Well, Tank No. P.O. BOX 5295 · BAKERSFIELD. CALIFORNIA 93388 Field or Area (805) 589-5220 NON-HAZARDOUS WASTE HAULER RECORD TO BE USED FOR NON-HAZARDOUS WASTES ONLY GENERATOR I (Generator Must Complete) WASTE TO BE DISPOSED j Type ~¢t'-~ ~o~,~ ~'R~ j Name ~l,J,,.~ Generating Location~l~~ 1 6~ ~ / ~ ~ Field Address ¢.O, ~ Z~1~ Special Handling Instructions: City, State, Zip ~~fEc~ ~ q'~3~3 ~ Gloves ~ Goggles ~ Other Phone ~-~10 _. Quantity O~ ~ Ioo~ ~e~ Bbls. Order Placed By ~ ¢EY~ ~ DESIGNATED FACILITY Signature of Authorized Agent ~ Name ~otJ~ ~ ~lj %~c._ ' ,~4~~~_/~ -~ ~ ~ Address ?_,co ¢. ~ ~o~e ~. TRANSPORTER I (Hauler Must Complete) Ticket ¢ Unit No. //0 / Name ~ r&,~; ~ AM Address p.O. ]~,~ ¢' ?3 ") ' Pick Up Date ...~'"',~ $-~ ~, Time //"~'O [] PM City, State, Zip ./~ q/C,,' ~r~L~ ~ ~ 3 5 ~ NOTE: This form to be used in lieu of the California Department of Health Services Hazardous Waste Manifest for NON-HAZARDOUS wastes only. Phone ~- ~-~ REMARKS: Signature of Authorized Agent or Driver Date c,~ -=~--¢-' ~ ? I¢'¢:.r J ~ ~ ~ - (~ Y J (Facility Operator Must Complete) J B bls. I DISPOSAL FAC/~1~ Quantity Received Date Name ~(~O.~ ~~, ~~ ~~- DAM Address (~~ ~.~¢J.~~ I ~ Time ~ PM City, State, Zip ~-~~ ¢~ i ~~ ~~ ' DISPOSAL METHOD: D Surface Impoundment ~ Injection Phon~'~%~O~ / Disp. Ticket ¢ J O LJs~ D Landfill ~ Other Relurn Copy To: f r ed Agent ~ Date FORM KVS-T-20~~ ~. ~ ~~/ GENERATOR'S/COP, ~ NOTE: It isNon°t HAZARDOUsneCessary to FEEsse nd c OpysHOULDtO Dept. OfBE LEVIEDHealIh Serv ices. 5/9o TANK DISPOSAL FORM GOLDEN STATE METALS, INC. ,__.~/'_~ _~ P. O. Box 70158 · 2000 E. Brundage Lane Date ,19 ' Bakersfield, California 93387 Phone (805) 327-3559 · Fax (805) 327-5749 Contractor'¢, Scrap Metals, Processing & Recycling License N~. Contractor st DESTINA~ON: G.S.M. · 2000 E. BRUNDAGE LANE B~ERSFIELD, CA 93387 o,.,..o: 'T ,¢ g;= q TOTAL EHSD PERMIT NO: QTY GALLONS SERIAL NO. NET TONS 250 .14 COUNTY: ......... · .................................................................... · ...................................... 550 .24 ' ~ 1000 - 6 ~ .61 ECTION 2000 .97 ~ RESIDUALS PRESENT (REdECT) 3ooo ~.32 ' LEL READING . 5000 2.42 OXYGEN CONTENT 7500 3.28 ~ DISPOSAL FEE 9000 3 ~2 SCRAP VALUE .......... ;';'. ............... . ...................................... ':' ......... ' ........... .................. ". ' ...... 12000 4.93 ~ OTHER ...... · .......................... : ....... .: ............... · ............ . .......... .-. ............. · TOTAL represents acceptance ol terms lot payment, and confirms that tank removal complies with State laws. :..-. ~:~::::::::.:'..'. :....:..:.~::::: .::-..: ............. ~ CERTIFICATE OF TANK DISPOSAL / DESTRUCTION T~S tS TO~ERTtFV THE RECEIPT ANU ACCEPTANCE OF T~E TANK(S) AS SPECiFiED ABOVE. ALL MATER~AL SPECiFiED W~LL ~E COMPLET~bY D~S~R~OY FCR~CRAP ~C~CLING PURPOSES ONLY. / / - WHITE ~ ~ctor Copy · YELLOW ~ ~le Copy · PINK -- Perma~nt Copy .AKERSFIELD FIRE DEPARTM] HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 TAXX REMOVAL I sPECTION FORM OWNER -~ .% - ~-~ ~4~/e~ PERMIT TO OPE~TE~ CONT~CTOR ~ ~ 5 ' CONTACT PERSON LABO~TORY ~-~.L c O, ~ OF S~PLES TEST METHODOLOGY ~- ~ . PRELI~NARY ASSESSMENT CO. ~3 CONTACT PERSON ~f~- · . PLOT P~N COMMENTS SIG~ -' . · - DATE INSPECTOP~ NAME