HomeMy WebLinkAboutUNDERGROUND TANK (2) 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 . '.. · -
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~.~ .... ta,'s~ho~U;~:~'...~.:,','~-~+/~,.-~, .',.'-_.~,::~.'~.~.- .~. ......
6 5. Transporter 1 Company Nome " 6. US EPA ID Number · C." Sic~e
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~ .¢ ' , ... .... '; I. US EPA I~ Number: '. E;..Sfdi-T'.r'_~.~::.~~~:~,~ '
'~: 7. Transporter 2 Company Name' . ·
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-- 9. ~s;gnmed Foc;l~ N~m~ and S~ Address ....... · ..... ~'~ "' 10. US ~A ID NUmber..' ~:"'- · ~: St~.~l~:~~~~-
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'~ 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~ ~~~ '
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--O 1~... Sp~iol Handling In,fru~ons end Add~onol. lnJorm¢io~'.. · '." '.':.:'.'::~':.::' :~'." .'." '.'..'.d.'.- '" "' ' '': '" .... ""*?~;~ fJ",['2 ¢':'~}'~'~'~'-~.'~'~':
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~ 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