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HomeMy WebLinkAboutUNDERGROUND TANK-C-11/23/88PROVIDE DRAWING OF PHYS LAYOUT OF FACILITY USING SP IDED BELOW. ~T,T, OF THE FOLI/DWING INFORMATION MUST BE INCLUDED IN ORDER FOR APPLICATION TO BE PROCESSF~: %/ '' TANK(S), PIPING & DISPENSER(S), INCLUDING f.~THS AND DIMENSIONS ----~-- PROPOSED SAMPLING LOCATIONS DESIGNATED BY THIS SYMBOL "(~." J NEAREST STREET OR INTERSECTION  ~Y WATER WR"T.T.q OR SURFACE WATERS WITHIN 100' RADIUS OF FACILITY ~ NORTH ARROW FILE CONTENTS SUMMARY ADDRESS ~_ ~i) ~ -- ~ ~ PE~IT ~: ENV. SENSITIVITY:_ '1' Activity Date ~ # Of Tanks Comments KERN COUNTY HEALTH DEPARTMENT 2700 M Street HEALTH OFFICER Bakersfield, California ENVIRONMENTAL HEALTH DIVISION Leon M Hebertson, M.D. Mailing Address: 1415 Truxtun Avenue DIRECTOR OF ENVIRONMENTAL HEALTH Bakersfield, California 93301 Vernon S. Reichard (805) 861-3636 November 23, 1988 Jim & Blanche Sterner 3860 Nord Road Bakersfield, California 93312 RE: Tank Closure, Kern Valley Trucking Permit #A785-16 Dear Mr. & Mrs. Sterner: This department has received all the required submittals for the tank closure at the above address. The laboratory anaiyses for the soil samples taken beneath the two fuel tanks and the dispenser island indicate no significant soil contamination. Based on this information, the department considers this preliminary assessment complete and no further =an~ site assessment is required. Sincerely, Bill Scheide Hazardous Materials Management Program BS:cas cc: Bryan McNabb LABORATORIES, InC. J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Petrole,~m Hydrocar~-~ns (SOIL) McNabb Construction Date of 7808 Olcot% Ave. Report: O1-Nov-88 Bakersfield, CA 93.308 Attention: Bryan McNabb S~le Desc.: Kern Valley Packing 1025 26th Street 10,000 Gallon Tank east end 2' DATE SAMPLE DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED: RECEIVED @ LAB: EXTRACTED: COMPLETED: 20-0ct-88 20-0ct-88 25-0ct-88 27-0ct-88 Minimtm~ Reporting Analysis Reporting ~, · ~onst~tuent Units R~sults Level Benzene ug/g None Detected 0.10 Toluene ug/g None Detected 0.10 Ethyl ~enzene ug/g None Detected 0.10 p-Xylene ug/g None Detected O. 10 m-X¥1ene ug/g None Detecte~d O. 10 o-Xylene ug/g None Detected O. 10 Isopropyl benzene ug/g None Detected 0.10 Petroleum Hydrocarbons ug/g None Detected 10.00 Total Pet. Hydrocarbons ug/g None Detected 0.10 TEST METHOD: California State D.O.H.S. T.P.H. for Diesel (Car~on Disulfide Extraction) Dry Matter Basis C~r~r~nts: PETROLEX~ HYDROCARBONS: ~tan~tification of petroleu~ ?~vdr~car?~ons utilizing a diesel standard. As outlined bM the C~lifornia D.O.H.S. These petroleum hydl'ocark~ons are in addition to the constituents specifically defined on t~ais re~:~rt. TOTAL PETROLE[~ HYDROCAS~PNo:~ ' '~ The s,:~r~ total of all constib~ents on this report. Chemist ENVIRONMENTAL HE. ALIt- ,,,,,,,,,.,,, ,,,,,,,,',,, LABORATORIES, Inr-:. PEI'ROL£UAf J' J' EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 F'etrole,m~ Hydrcmar~ns ($)IL) McNabb Construction Date of 7808 Olcott Ave. Report: O1-Nov-88 Bakersfield, CA 93308 Attention: Bryan McNabb Lab No.: 7912-2 Sample Desc.: Kern Valley Packing 1025 26th Street 10,000 Gallon Tar~ east end 6' DATE SAMPLE DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED: RECEIVED @ LAB: EXTRACTED: COMPLETED: 20-0ct-88 20-0ct-88 25-0ct-88 27-0ct-88 Miraimum Reporting Analysis Reporting Cons ti tuent Uni ts Resul ts Level Benzene ug/g None Detected O. 10 Toluene ug/g None Detected O. 10 Ethyl Benzene ug/g None Detected O. 10 p-Xylene ug/g None Detected O. 10 m-Xylene ug/g None Detected O. 10 o-Xylene ug/g None Detected O. 10 Isopropyl benzene ug/g None Detected O. 10 Petrole,~m Hydrocarbons ug/g None Detected 10.00 Total Pet. Hydrocarbons ug/g None [~tected 0.10 TEST METHOD: California State D.O.H.S. T.P.H. for Diesel (Car~.n Disulfide Extraction) Dry Matter Basis C~r~ents: PETROLEUM HYDROCARBONS: Q.~antification of ~etrole~ ?vdr~carbons utilizing a diesel standard. As outlined by the California D.O.H.S. These petroleum hydr¢~arbons are in addition to the constituents specifically defined on this report. TOTAL PETROLE[~ HYDROCARBONS: The s,m~ t~otal of all constituents on this report. ~fJ./~. E~in Robert Plaisance ~ (~emist LABORATORIES, Inc. J. J. EGLIN, REG. CHEM. ENGR. PETflOIELI¥ 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Petroleum. Rvdrcf~'ar~ns (SOIL) McNabb Construction Date of 7808 Olcott Ave. Report: 01-Nov-88 Bakersfield, CA 93308 Attention: Bryan McNabb Lab' No.: 7912-3 S~r~le Desc.: Kern Valley PacP, 4ng 1025 26th Street 10,000 Gallon Tar~ west tank, 2' DATE SAMPLE DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED: RECEIVED (% LAB: EXTgACTED: COMPLETED: 20-Oct-88 20-Oct-88 25-Oct-88 27-Oct-88 Reporting Analysis Reporting Constituent Units Results Level Benzene ug/g None Detected 0.10 Toluene ug/g None Detected 0.10 Ethyl Penzene ug/g None Detected 0.10 p-Xylene ,~/g None Detected 0.10 m-Xylene ~/~ None Detected O. 10 o-Xylene u~/g None Detected O. 10 Isopropyl benzene u~/~ ,None Detected O. 10 Petrole~o Hydrc~car~xms u4~/g None [~tected 10. O0 Total Pet. Hydrocarbons ug/g None Detected O. 10 TEST METHOD: California State D.O.H.S. T.P.H. for Diesel ( Cartym Disulfide Extraction) Dry Matter Basis Cotri~ents: PETROLEUM HYDROCAgBONS: ~antification of petrole~mi hydrocarhgns utilizin~ a diesel st~Mard. As outlined by the C~lifornia D.O.H.S. These petrole~ma hydrocartfms are in addition to the constituents specifically defined on this rer~.,rt. . TOTAL PETROLE[~{ HYDROCAgBONS: The s,mri t~.,tal of all constif~ents on this rel~.~rt. ~[. ~. 9o?~rt Plaisance A~RI£U~ TUR£ ,,,,,,,, LABORATORIES. IrqC. J. J. EGLIN, REG. CHEM. ENGR. PETROLEUM 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Petrolet~n Hyrlrocar~,ns (SOIL) McNabb Construction Date of 7808 Olcott Ave. Report: 01-Nov-88 Bakersfield, CA 93308 Attention: Bryan McNabb Lab No.: 7912-4 Sample Desc.: Kern Valley Packing 1025 26th Street 10,000 Gallon Tar~ west ~tank 6' DATE SAMPLE DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED: RECEIVED @ LAB: EXTRACTED: COMPS: 20-0ct-88 20~0ct-88 25-0ct-88 27-0ct-88 Minim~n Reporting Analysis Reporting Constituent Units Results be~vel Benzene ug/g None Detected 0.10 Toluene ug/g None Detected O. 10 Ethyl Benzene ug/g None Detected O. 10 p-Xylene ug/g None Detected O. 10 m-Xylene ug/g None Detected O. 10 o-Xylene ug/g None Detected O. 10 Isopropyl benzene ug/g None Detected O. 10 Petroleum Hydrocarbons ug/g None [~tected 10. O0 Total Pet. Hydrocar~,ns ,~g/g None Detected O. 10 TEST METHOD: California State D.O.H.S. T.P.H. for Diesel (Carbon Disulfide Extraction) Dry Matter Basis Corr~ents: PETROLEfTM HYDROCARBONS: Q~antification of ~trole,~ ?~vdroearbons utilizing a diesel standard. As outlined ~ the California D.O.H.S. These petroleum ~drocar?~Jns are in addition to the constituents st~cifically define] on this report. TOTAL PETROLEO]~ HYDROCARI~}NS: The s,.~, total of all constituents on this report. ~ J'.. ,~ · Ro~-~rt Plaisance Chemist RATORIES, Ir-lc. J. J. EGLIH, REG. CHEM, ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Petroleum, Hydrocarbons (SOIL) McNabb Construction Date of ' 7808 Olcott Ave. Report: 012Nov-88 Bakersfield, CA 93308 Attention: Bryan McNabb Lab.No.: 7912-5 S~ple Desc.: Kern Valley PackZtr~ 1025 26th Street 2,000 Gallon tar~ center of tank 2' DATE SAMPLE DATE ~SAMPLE DATE SAMPLE DATE ANALY~I~ COLLECTED: RECEIVED @ LAB: EXTRACTED: COMPLETED: 20-Oct-88 20-Oct-88 25-Oct-88 27-Oct-88 Minimum Reporting Analysis Reporting Constituent Units Results Level Benzene ug/g None Detected 0.10 Toluene ug/g None Detected 0.10 Ethyl Benzene ug/g None Detected O. 10 p-Xylene ug/g None Detected O. l0 m-Xylene ug/g None Detected 0.10 o-Xylene ug/g None Detected 0.10 Isopropyl benzene ug/g None Detected 0.10 Petroleum Hydrocarbons ug/g None Detecta~l 10. O0 Total Pet. Hydrocarbons ug/g None [~tected 0.10 TEST METHOD: California State D.O.H.S. T.P.H. for Diesel (Carbon Disulfide Extraction) Dry Matter Basis Comments: PETROLEI~M HYDROCARBONS: QJantification of petrole,.~n hydrocarbons utilizir~ a diesel standard. As outlined ~; the California D.O.H.S. These petroleum ?~drocarbons are in addition to the constituents specifically defined on this reDz, rt. TOTAL PETROLEUM HYDROCARBONS: The sum t~,tal of all constib~ents on this report. Chemist LABORATORIES, Inc. PET,9OLEU~ __ J' J' EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327~4911 Petrole,.~n Hydr¢~ar?~:~ns (SOIL) McNabb Construction Date. of 7808 Olcott Ave. Report: 01-Nov-88 Bakersfield, CA 93308 Attention: Bryan McNabb Lab No.: 7912-6 Sample Desc.: Kern Valley PacP.~ng 1025 26th Street 2,000 Gallon tar~ center of tsx~ 6' DATE SAMPLE DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED: RECEIVED (_~ LAB: EXTRACTED: CJIMPLETED: 20-Oct-88 20-Oct-88 25-Oct-88 27-Oct-88 Minimum Reporting Analysis' Reporting Constituent Units Results Level Benzene ug/g None Detected 0.10 Toluene ug/g None Detected 0.10 Ethyl Benzene ug/g None Betected 0.10 p-Xylene ug/g None Detected 0.10 m-Xylene ug/g None ~tected O. 10 o-X¥1ene ug/g None Detected 0.10 Isopropyl benzene ug/g None Detected 0.10 Petroleum Hydrocarbons ug/g None Detected 10.00 Total Pet. Hydrocar~ons ug/g None Detecte~] 0. l0 TEST METHOD: California ~ - ... .otate D.O.H..q T.P.H. for Diesel (Car~xm Disulfide Extraction) Dry Mati~er Basis C~rrn~nts: PETROLEUM HYDROCARBONS: f~antification of petrole,~r~ ~vdr¢~carbons utilizing a diesel standard. As outlined by the California D.O.H.S. These petroleum ~drocar~ns are in addition to the constituents specifically defined on this re~rt. TOTAL PETROLEUM HYDROCARBONS: The st~ ~tal of all c~,nstituents on this re~rt. .4GR/£17~ TUA£ ,,,,,,,, LABORATORIES, Inn. PET~OL£LIAf J. J. EGLIN, REG. CHEM. ENG,. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Petrole,.~n ~[vdrc~arp~{,ns (SOIL) McNabb Construction Date of 7808 Olcott Ave. Report: 01-Nov-88 Bakersfield, CA 93308 Attention: Bryan McNabb Lab No.: 7912-7 Sample Desc.: Kern Valley Packing 1025 26th Street Dispenser 2' DATE SAMPLE DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED: RECEIVED @ LAB: EXTRACTED: ~LETED: · 20-0ct-88 20-0ct-88 25-0ct-88 27-0ct-88 Min~fJ Reporting AnalYsis Reporting C~onstituent Units Results Level Benzene ug/g None Detected O. 10 Toluene ug/g None Detected O. 10 Ethyl Benzene ug/g None Detected O. 10 p-Xylene ug/g None Detected O. 10 m-Xylene ug/g None Detected O. 10 o-Xylene ug/g None Detected O. 10 IsopropF1 benzene ug/g None Detected O. lO Petroleum Hydr~car~ons ug/g None Det~:ted 10. O0 Total Pet. Hydrocarbons ug/g None Detected O. 10 TEST METHOD: California State D.O.H.S. T.P.H. for Diesel (Carbon Disulfide F~xtraction) Dry Matter Basis C~nts:.~ple does not exhibit gasoline c?~om_~t~,graphic fingerprint. PETROLE~M HYDROCARBONS: Q~antification of petrole,z~ ?~dr~arbons utilizir~ a diesel standard. As outlined ?~ the Califorr~ia ~D.O.H.S. These petroleun~ hydr¢~ar~ns are in addition tr~ the constit3~ents specifically defined on this rep~rt. TOTAL PETROLD1M HYDRf~ARBONS: The s,~ tr~tal of all constituents on tkis reinhart. (~Lemi.st LABORATORIES. IrqC. J. J. EGLIN, REG. CHEM. ENGR. PETROLEZ/M 4100 PIERCE RD,, BAKERSFIELD, CALIFORNIA 93308 PHONE 317-4911 Pe%roletun Hydrc.uarbons (~)IL) McNabb O3nstruetion Date of T808 Oleott Ave. Re~: ~ers~ieid, CA 98808 Attrition: B~ McRabb ~b ~o.: T91218 S~le ~se.: · Ke~ Vaiie~ Pae~ 102~ 26th Street Dis~nser 6 DATE S~LE DATE S~LE DATE S~LE DA~ ~YSIS COLLE~: ~CEI~ e ~: ~~l: ~L~: 20-~t-88 20-~t-88 25-~t-88 27-~t-88 ~ni~ Re~i~ ~alysis Re~i~ Consti~ent Uni~ Resul~ Level ~nzene ug/g None ~~ 0.10 Toluene ~/g None ~~ 0.10 Et~l ~nzene ~/g None ~~d 0. l0 p-Xylene ~/g None ~t~d 0.10 m-Xylene ug/g None ~c~ O. 10 o-Xylene ug/g None ~~ 0. l0 Isop~l ~nzene ~/g None ~~ 0.10 Petrole~ ~ar~ns ug/g None [~c~d 10.00 To~l Pet. ~ar~ns ~/g None ~~] 0.10 TEST ~OD: California S~ D.O.H.S. T.P.H. for Diesel (C~n Disulfide ~traction D~ Mater ~sis C~nts: ~le does not exl~bit gasoline c~o[~m~,grap~c finge~rint. PETROLE~ ~R~NS: Q~tification of ~trole~n l~~ns utilizing a diesel s~dard. As outlined ~ese ~t~le~ ~ar~ns ~e in addition ~ the consti~en~ s~cifically defined on t~s re~. T~ P~ROLE[~ ~R~AR~JNS: ~e s,~ ~1 of all consti~Jent~ on t~s re~J~. (~emist ,;0or~w~ St,o., -' KERN COUNTY HEALTH DEPARTMENT I~.ALTHOFFICER S&k®r~d, C&llfornle 93~ ~n M ~, M.D. T~ (~S) ~ 1-3638 EN~RONMEN~L H~ ~1~ ~RE~R OF EN~RONMENT~ H~L~ ~ ~m~ & R~hlrd Facility ~a~e , ~ Kern County Per=It ~ * * UNDERGROUND T~ DIs~OsIII~ T~C~IN6 RgCO~ * * This form is to be returned to the Kern County Health' Department ~lthin 14 days of acceptance of tank(s) by }tispos'al or recycling facility. The holder or' the permit~ with number noted above ts responsible for insuring that this form is completed and returned. ........... ii ;; ................................. Section 1 - To be f 1 e u b_~ tank renoval contractor: ~ate Tanks Removed ~ctlon ~ - To be tilled out ~ contractor 'deconta~ln~tln~ tank(s): '-'" / C zip q Authorized representative of contractor certifies b~ .stinln¢ belo~ that ta~(,) have been decont~lnated In accordance ,tth E~--~,~v Oepar t~ent require=ents. Slgnat~e~ Title Section 3 -T~ b~ filled out and signed ~ a~ authorized epresentatlve of the treatment, storage, o~ disposal faclllti acceptln~ gank(s): Faci I I ty N~e /~/~" ~~ Address . ~ ~ ~ ~ ~. ~.~/~~.( Phone ~ ~ Date Tanks Received /~-,~- ~-' No. of Tanks Signature kix , ~ Title (Authorized Representative) · a · ~ILING INSTRUCTIONS: Fold In halff and staple. PostaEe and mailing label have already been affixed to outside for ~our convenience. fForm ,',ease 3nnT of ~/pe. (~-orm ,~esl~neo tot u/e 2~ typew~ter). ' ........................... ~', "! .................. Sacramento. Califomi~ i1. Genef'ator's US ;:PA ID No ........ Manifest 3. Generator's Name and Mailing' Address 5. Transporter t Company Nam~ . · ? .- US EPA ID Number · C. State~Tra~eCa IO -~:4~"',~? ............ 7. T~ansporter 2 Company Name 8. US EPA ID Numi~er E. Stere ?raa~l~a. ID :.~:~.~.~-._ .~: .... 9. Designated FacilitY Name and Site Addres~ __ tO. US EPA ID Number . Q.. State Facil~a ID:'~.:.~.~.:~_~:: ._:.:: '.. I 12. Containers 13. Total 14 ......I. t t. U~ DOT Description (Including Proper Shipping Name. Hazard Class, and ID Number) ..... Quantity Unit .": .'_Waste No..'/ No. Ty~e EPA/Other E b. ~tate 0 " I I I I I I I """ R c. ......... State ~. · . ., - , . - ....... ;-::.-. ? . _ ...' .............. ' '- · EPA/Other I I I' I I I I d. State .~ ................ I I I IIII ......... J. Additional Descdptions for Idateriala Listed Above K. Ha~ C~ for Waatea Listed Above · 1,5. Special Handling instructions and Additional information GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packed, marked,, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that I have selected the practicable method of treatment· storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment: OR, if I am a small quantity generator, I have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford. Printed/Typed Name Signature .._..__..:.__...::..:~_. Month Day Year T 17. Transp°rtsr I Acknowledgement of Rscel~lt~'' of Materials " (~ 18. Transporter 2 Acknowledgement of Receipt of Materials " 7 ,---' j '" TR Printed/Typed Name I Signature ~ Month Day Year E I t~. ~iscrspancy Indication c I L I 20. Facility Owner or Operator Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. ~ Printed/Typed Name ~ ///// ] Signature ~' /'-~.,..' Month Day Year EPA .700--22 ~ (;~EEN: HAULER RETAii~ ~NSTRUCT~ONS O/N 'file BACK (Rev, g-86) Previous sdilions ars obsolele, IN CASE OF AN EMERGENCY OR SPILL. CALL THE NATIONAL RESPONSE CENTER 1-800-424-8802; WITHIN CALIFORNIA CALL 1-800-852-7550 .,E,.., COUNTY HEALTH DEPAR 2700 M Street HEALTH OFFICER Bakersfield, California ENVIRONMENTAL HEALTH DIVISION Leon M Hebertson, M.D. Mailing Address: ' DIRECTOR OF ENVIRONMENTAL HEALTH 1415 Truxtun Avenue' Vernon S. Reichard Bakersfield, California 93301 (805) 861-3636 PERMIT FOR PERMANENT CLOSURE PERMIT NUMBER A785-16 OF UNDERGROUND HAZARDOus SUBSTANCES STORAGE FACILITY FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: Kern Valley Trucking Jim & Blanche Sterner McNabb Construction 1025 - 26th St. 3860 Nord Rd. ·7808 Olcott Ave. Bakersfield, CA 93301 Bakersfield, CA 93312 Bakersfield, CA 93308 License # 474331 Phone: (805) 589-3355 Phone: 805-399-4742 PERMIT FOR CLOSURE OF PERMIT EXPIRES December 18, 1988 ~ TANK(S) AT ABOVE APPROVAL DATE October 18r 1988 Bill Scheide ................................ POST ON PREMISES ........................... CONDITIONS AS FOLLOW: i. It is the responsibility of the Permittee to obtain permits which may be required by other regulatory agencies prior to beginning work. 2. Permittee must obtain a City Fire Department permit prior to initiating closure action. 3. Tank closure activities must be per Kern County Health andFire Department approved methods as described in Handbook UT-30. 4. If any contractors other than those listed on permit and permit application are to be utilized, prior approval must be granted by the specialist listed on the permit. 5. Tank removal contractor must have a qualified company employee on-site supervising the actual tank removal. 6. Any deviation from sample locations and numbers or constituents to be sampled for which are described below and in Handbook #UT-30 must receive prior approval by the Health Department. a. A minimum of four samples must be retrieved one'third of the way in from the ends of each tank at depths of approximately two feet and six feet. b. A minimum of two samples must be retrieved at depths of approximately two feet and six feet for every 15 linear feet of pipe rum and alsc near the dispenser area(s). DISTRICT OFFICES Delano · Larnont · Lake Isabella · Moiave · Ridqecrest · Shafter · Taft PERMIT FOR PERMANENT CLOSURE PERMIT NUMBER A785-16 OF UNDERGROUND~HAZARDOUS ADDENDUM SUBSTANCES STORAGE FACILITY ?. Ail (leaded/unleaded) gasoline samples must be analyzed for benzene, toluene, xylene, and total petroleum hydrocarbons. All diesel samples must be analyzed for benzene and total petroleum hydrocarbons - diesel. 8. Copies of transportation manifests must be submitted to the Health Department within five days of waste disposal. g. All'applicable state laws for hazardous waste disposal, transportation, or treatment must be adhered to. The Kern Gounty Health Department must be notified before moving and/or disposing of any contaminated soil. 10. Permittee is responsible for making sure that "tank disposition tracking record" issued with this permit is properly filled out and returned within 14 days of tank removal. 11. Advise this office of the time and date of the proposed sampling with 24 hours advance notice. 12. Results must be submitted to this office within three days of analysis completion. ACCE rED nA rS BS:cd .- ~ NI~RI';A [- USE; KERN COUNTY HF..,ALTH DEPAR.TM£NT )TO PTA ~?00 ~,co.ee STREET. H^KeHSPIeLO. CA. '9330S 80P TANKS TO SE ABANOONEO API~T-I CATI ON FOR PERMIT FO.R PERMANENT CLOSURE/ABANDONMENT OF ~DBROROUND HAZ~DOUS SUBST~CES STORAOE FACILITY THiS PR~E~ONTA~ JPHONE ~ JSEC/T/R (R~ ~TIONS ONLY) F~K R~OVAL CO~OR . [~DRESS. PROPOS~ PROJB~ARTING ~ ~LIPORNIA LXC~SE · ~RK~*~ COMP~SATION · [INS P~NIN~Y SITE ~S~SN~ CO~OR DDR~S ~ ,. ~ ~RKER*S COMPENSATION 8 INS~ER PHONE =H~ICA~ COHPOSITION 0P ~T~[~ STOR~ 'A~K s VOL~E ~I~R~.~NON-CO~CIAL g~g) DA~ ~R~ . ~I~L PR~IOUSLY ~D INAT~R ~ ~G~LI~ PROVID~ BY ~ , I DK~H tN~T ~ATER WELL - GI~ DIST~CE ~D DESCRIBE ~J IF WITHIN 8OO FE~ ISOIL ~l AT ~ACILI~ Im[S ~.so[[ ~e ~D4GROU~NA~E~.De~H DSTE~;NATZON . . .. / / ~OTAL NUMBER OF ~PLES ~ BE ~ IS~ WILL BE ~YZ~ ~OR: ~ , ~ ; . ~E H~ RESIDUE I~ T~K(S) ~D PIPING IS ~ BE R~O~ ~ DISPOSED 0F ~(INCLUDE ~NS~ATION ~D DISPOSA~CO~ANIES): · · PLEASE PROVIDE TN~R~TTON REQUESTED ON RE~RSK SIO~ O~ TRT$ S~ BBPORE SUBMI~TNG APPLICATION POR REVTEW ~IS ~ORM ~ PLEAD ~ER PENAL~ O~ P~J~Y ~D ~ ~E B~T O~ ~ ~LEDGE IS ~U~ ~ CORRE~. - (Porm