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HomeMy WebLinkAboutUNDERGROUND TANK (2ND FILE) Hazardous Materials/Hazardous Waste Unified Permit' ~ CONDITIONS OF: PEFIMIT ON Rl::¥1::R$1:: $1Dl:: This oermit is issued for the followin_~: ;l Hazardous Materials Plan El Underground Storage of Hazardous Materials Permit ID #:: 015-000-001121 El Risk Management Program BAKERSFIELD MEMORIAL H; El Hazardous Waste On-Site Treatment LOCATION: 420 34TH ST ]ELD TANK HAZARDOU~'S0'~ANG~ .,a.~.,.. CAP~C~}~,. DISPEN N ONITORING OFFICE OF ENWR ONMENTAL SER WCES ' ~~~ 1715 Chester Ave., 3rd Floor Approved by: ~C~~m~' Issue ~te Bakersfield, CA 93301 O~eeofEvi~S~ic~ Voice (661) 326-3979 F~ (661) 326-0576 Expiation Date: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CItECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME ~\o~m_c,a/ 14tO,.6~dto~ INSPECTION DATE Section 2: Underground Storage Tanks Program [] Routine [] Combined [] Joint Agency [~l Multi-Agency [] Complaint I~ Re-inspection Type of Tank {3ttlt~ Nmnber of Tanks '7. Type of Monitoring d_6~ Type of Piping D~,~ OPERATION C V COMMENTS tank data on file ~./r Proper Proper owner/operator data on file L.~ Permit tees current ~ Certification of Financial Responsibility ~ / / Monitoring record adequate and current .~ / Maintenance records adequate and current O' Failure to correct prior UST violations / Has there been an unauthorized release? Yes No L/" Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector: ~ (~ Bus~ine~~ Office of Environmental Services (661) 326-3979 ' ss Site Responsible Party White - Env. Svcs. Pink - Business Copy For Use By All .[uri}'dictionx Within the State of California ..4'~t[horio, Cited: Chapter 6. 7, Health and Safely Code; Chapter 16, Divixion 3, Title 23, California Code of Regulations This £orm must be used to document testing and servicing of monitoring equipment. A separate certification or report mqs[ be prepared ibr each monitorina system control panel by the teclmician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator mttst submit a copy of this form to the local agency regulating UST systems w/thin 30 days of test date. A. General Information _ '.'" zip: co, ac Person: Contact ?hone 3:L'n lvlake/ModelofiVlonimringSys[em: -- mt r - FLY-- t Dateofresting/Servicing: /L-}/ B. inventory of Equipment Tested/Certified · C_JI3xc.!;~.!Lr appropriate boxes to indicale spec fie equipraeat iaspected/se!-viced: Tank ID:_ ~,~[N-l;::~tr~.~¥"~C~, ~--~_ ~--~[_.,.-- Tank ID: ffl In-Tank Gauging Probe. Model: 121 In-Tank Gauging Probe. Model: ~Annutar Space or Vault Sensor. Model: L,,.)'~_~T- ~ 121 Annular Space or Vault Sensor. Model: [] Piping Sump /Trench Sensor(s). Model: ~ Piping Sump / Trench Sensor(s). Model: [] Fill Sump Sensor(s). Model: ~ Fill Sump Sensor(s). Model: [] Mechanical Line Leak Detector. Model: ID Mechanical Line Leak Detector. Model: [] Elecn'onic Line Leak Detector. Model: 121 Electronic Line Leak Detector. Model: [] Tank Overfill / High-Level Sensor. Model: ID Tank Overfill / High-Level Sensor. Model: [] Oth~er tspeci6' equipment type and model in Section E oa Page 2). 121 Other (specit}, equipment type and model in Section £ on Pa~e 2). Tauk ID: ~r~_l I. ~1~. ~"~_ 5L Tank ID: , [] ln--fm~k Gauging Probe. Model: D In-Tank Gauging Probe. Model:' ,,~.4~mular Space or Vault Sensor. Model: I~11~ ~W-- ~ ~ Annular Space'or Vault Sensor. lvIodel: [] Piping Sump / Trench Sensor(s). Model: ID Piping Sump / Trench Sensor(s). Model: FI Fill Stunp Sensorks). Model: 121 Fill Sump Sensor(s). Model: [] Mechmfical Line Leak Detector. Model: ID Mechanical Line Leak Detector. Model: lq £1ecn'onic Line Leak Detector. Model: ~ Electronic Line Leak Detector. Model: [] 'l'mak Overfill / High-Level Sensor. Model: ~ Tank Oveffill / High-Level Sensor. Model: [] Qrher (speciS, equipment type and model in Section E on Page 21. UI Other (specify equipment type and model in Section E on Pa~e 2). Dispenser ID: __ ~Jl ~o~ Dispenser ID: [] Dispenser Containment Sensor(s). Model: ID Dispenser Containment Sensor(s). Model: [] Shear Valve(s). Cl Shear Valve(s). [] l)ispenser Containment Float(s) and Chain(s). ID Dispenser Containment Float(s) mid Chain(s). Dispenser ID: /?/IO~ Dispenser ID: ~ Dispenser Containment S~or(s). Model: [] Dispenser Containment Sensor(s). Model: [] Shear V,flve(s). D Shear Valve(s). [] Dispenser Containment Float(s) and Chainqs). ID Dispenser Containment Float(s} and Chain(s). Dispenser ID: Dispenser ID: ID Dispenser Containment Sensor(s). Model: [] Dispenser Containment Sensor(s). Model: [] Shc~u' V~lve(s). ID Shear Valve(s). E]Dispenser Conta/nment Floatqs} and Chain(s). ID Dispenser Containment Float(s) and Chain(s). qfrhe facility contains more tan'ks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C, Certification - I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guiddines~ Attached to this Certification is information (e.g. manutheturers' checklists) necessary to verify that thi~ information is coffee[ and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also a~ached a copy of the report; (check all that apply): Fl, System set-up Fl AI~ history r~rt ..~ ~ Certification No.: ~'~4~'/a ~ tt~5~- O~~' ~S/'l'J~.~ License. N~./?O6 i/r~n~z'- # 9,00850 -' T'" ~ -' ' ~ - " ~' ' TesdngCompm~yName: RICH ENVIRONMENTAL PhoneNo.:(661 ). 392-868'7 . _ _ , tr ~ Date of Testing/Servi¢ing: Page I of 3 03101 Monigoring System Certilication t,~esctl~s of Testing/Servicing So£~:~re Version Installed: [~ 1 ~ Cocnple[e ~he folIowin checklist: _q.~¥es I ~ No~ ~'s the audible alarm operational? ~;~[.Yes [Cl No* Is the visual alarm operational? '~¥es [ ~ No* Were all sensors visually h~spected, fm~.ctionally tested, and confirmed operational? U~Ycs I I-I No* Were all sensors installed at lowest point 6fseconclary containment and positioned so that other equipment will not interfere with their proper operation.? Yes ~ NO* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) ~ N/A operational? Yes 121 N'o* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment ~I(N/A monitoring system detects a leak, fails ,to operate, or is elecn-ically disconnected? If yes: which sensors initiate positive shut-down? (ChecR all that a~ot~lyj ~ Sump/Trench Sensors; ~ Dispenser Contai~maent Sensors. Did you confirm positive shur-do, wn due to leaks m..~..d sensor failure/disconnection? Fl Yes; ~ No. Yes ~ No* For tank systems that utilize the monitoring system as the prhnary tank overfill warning device (i.e. no ~ N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s.) and operating proper, ly? If so, at what percent of tank capacity does the alarm trigger? Yes* ~ No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manuthcturer name and model for all replacement parts in Section E, below. Yes* /-1 No Was liquid faired inside any secondary containment systems designed as dry systems? (Check all thai i'~..~~t/fl Product; ~ Water. If yes, describe causes in Section E, below. Yes No* Was monitoring system set-up reviewed, to ensm'e proper settings? Attach se~ up reports, if applicable ~Yes [ ~ No* Is a.l! monitoring equipment operationa! per,manuf.a..c[urer's specifications? In Section £ below, describe how and when these deficiencies were or will be corrected. l>ago 2 of 3 03/01 iS. ia-Tank Gauging / SIR Equipment: U..I Check this box if tank gauging is used only for inventory control. .,Check this box if no tank gauging or SIR is installed. equipment This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complet-e the follo~,ving checklist: [3 Yes I El No* Has"'a[l input wiring been inspected fbr proper entry and termination, includh~g testh~g for ground faults? El Y cs ~ No* Were all tardc gauging probes visually inSpected for damage mhd residue buildup? [q Yes Q No* Was accuracy of system product 'level readings tested? Et Yes ~ No* Was accuracy of system water level renal{rigs tested9 ~ Yes El No* Were allprobes reinstalled properly? CI Yes El No* Were all items on the equipment manufacturer's mahatenance checklist completed9 * Iix the Section 14, below, describe how and when these deficiencies were or will be corrected. ~. Line Leal{ Detectors (LLD): ' ~Check tiffs box ifLLDs are not installed. Complete the following checklist: ~ Yes [] No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performm~ce? ~ N/A (Check all that apply) Simulated leak rate: rq 3 g.p.h.; f-I 0.1 g.p.h; Fl 0.2 g.p.h. ~ Yes [3 No* Were all LLDs con£nm~ed operational and accurate within regulatory requirements? U Yes [] No* Was the testing apparatus properly cali6ratefl? ~1 Yes gl No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? [] Yes [] No* For electronic LLDs, does the turbine a~tomafically shut off if the LLD detects a leak? [] Yes gl No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled 2~ N/A or disconnected? [] Yes [] No* For electronic LLDs, does the turbine aiaomatically shut off{f any portion of the monitoring system malthnctions .~N/A or fails a test? [] Yes [] No* For electronic LLDs, have alt accessible wirh~g connections been visually inspected? [] Yes [] No* Were all items on the equipment manufacturer's maintenance checklist completed9 ~' In the Section 1t, below, describe how and when these d~ficieneies were or will be corrected. }if. Comments: Page 3 of 3 Monitoring System Certification _ UST Monitoring Site Plgn _ _... ...................... ::"' .... ..... D~ m~p w~ a~w~: ~//3 / 03. Instructions If you ah-eady have a diagm ~at shows all required information, you may include it, rather than this page, with your Monitoring System Ce~ification. On your site pimp, show the general layout of tanks and piping. Clearly identil~' locations of fl~e following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser p~s, spill containers, or other secondly containment areas; mechanical or electronic line teak detectors; ~d in-tank liquid level probes (if used fbr le~c detection). In fl~e space provided, note the date this Site Plan was prepared. Page ¢ of y 0s/00 *COPY REQUESTED PLEASE FAX( 66~ ) 392-0~2 ~ CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 FAX (661) 326-0576 APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION FACILITY /~_.'.~fi/! 0 .~ta:lX~ OPERATORS NA~ OW~RS NA~ NA~ OF MON~OR ~ACT~ DOES FAC~Y ~ DISPENSER P~S? ~S~ NO TANK # VOLUME CONTENTS NAME OF TESTING COMPANY RICH ENVIRONMENTAL. CONiRACTORS UCENSE # _~OO?~3, _ NAME & PHONE N{JMBER OF CONTACT PERSON_JAMES RICH 1 66,1 ) 392-8687 DATE & TIME TEST IS TO BE CONDUCTED APPROVED BY DATE ~G-N-~TU~ 0; AppLICANT ~ ii/i3/2003 14:59 661392 PAGE 02/05 MONITORING SYSTEM CERTIFICATION For U.~e By WII Jur~dictians Within the State of California A~trhori~ C#~d: Chapter 6. 7, ~aalth and $afe~ Cod~; Chapter 16, Dlvl,[on ~, Title 2~, Cal~ornla Co~ of R,~laaon, Thi~ tBrm muir ba u~ed to doc~nt tast~g ~ ~r~cing ofmoni~r~g equ~p~nt, A aep~ate ae~i~cadon._9~.reumX mua[ be ~r ~ac~n~j'ing sys~m consol p~[ by th~ t~clmician ~ petfort~ the work, A copy oith[a form must ~ provided to system owner/operator. The o~'/opemtor musl sub,it a copy ~f []~s ~m~ to ~a ~ca] agency regulating UST systems wJr~ 30 day~ of ~es~ A. G~aeral ~nforma~ion B. lnveato~ of Equipment Teste~Ce~ed Chc~l: thc approprl, r~ Doses ~o imdjcalc apcei~c ~aulnm~at nSl)~et~e~i~d: ~ ,,, , ........... ' Model: O In-Tank Gauging Probe. Modal: ~ In-T~k Gauging Probe. ~Annut~ Sp~ce or VauR Sensor. ModH: ~T~~ D ~ul~ Sp~e or Vault Sensor. Model: ~ P~p[~g Sump / T~ch Se~or(s), Model: ~ Piping Sump / Tren~ Sm~s). Mode[: ~ Fill Smnp Se~or(s), Model: ~ Fill Sump S~so[(s), ~ D M~cha~ical Line Le~ De[etlon Mo~el: Q Mech~l~ Line Le~ Damc~ar. Medal: ~ EJecn'onk Line Lo~( Detector. Model: ~ El~c~nic Line ~ De~cwlt, Mode[: ~ O~er.tSgeci~' equfpmem ~)?. md model in S~ctioa E o~ ~gg~ ~__. ~ O~her [~eci~ equipmen[ typ~ and model in Section ~ on Pa~ 2), ., , ~ ln-]'~k ~aa~m~ Probt~ ...... Model: ~ ln-T~k Gauging Probe. Mode[: ~.~mulm' ~pac~ ot V~mlt Sensor. Model: [~. ~ ..... ~ ~nular Spa'or Vault Sensor, Model: ~ Piping Sump I Trench Seasons), Model: ~ Piping S~mp / Trench S~naor(s). Model: ~ Fill Stlmp Se~sot[s), Mo~l: ~ Fill Sump Sensor(s), Model; Q Mechanical Lin~ Lc~ De. cron Model: ~ Mech~lc~ Line Le~ D~mor. Model: ~ Electronic L~¢ L~ak Detec[or, Mode]: ~ E[ec~aic Line L~ Dot.or, Mo~e[: ~ l'~k Ove~lt / ~gh-Level S~sor. Mode]: ~ T~k Ow~tl / ~Jgh-Lew[ Sensor. ~ Otl)cr (~pcci~' cqu]pmen~ Wpe ~d mod~l in Section E on ~a~9 2[~., ._ ~O~cr~.~i~_~uipmcnt. W.p~ ~d modal in Section E on Pa~ 2~, , ~ Disp~a~ Coat~amenf ~e~o~). M~eI: ~ Di~ea~r Contai~eat SCa~s). ~ Disp~s~r Co,t~nmcm Flo~(s) ~d Ch~in~) ............ ~ Dispenser ~omonm~ot Float(~) ~d Chain(a~, 0 Dispenser Coatfinmem S&sor(s). Model: 0 Disp~ Conminm~ S~nsor(s). Mod~l: ...... O S~e~u' Valves), O S~*ar Valv,(s). ~ Dispenser Coo,.ainmcn~ Fl~ar(s) ~d Chain(s). . ...... 0 Disposer Containm~t Fl~al~} ~d Chain,s). _ ..... ~ Diapon~r Conmiam~r S~sor(s), Mod*l: ~ Dbpa~r Contala~m Sea~s). Model: 0 Shem' Valve(s). 0 Sh~ VarY*is), DDispen~er C~,,~;-ment Flour(s) ~0 Cl?~n~s}. , ...... ~ Dispense,' Cont~inm~t Plo~s) ~ Chain(~) .......... ,lfm&lheili;y'eodt~ins mo~ ~ or disp~aa~m ~opy mis tbna. Izclud~ informa~on for ~ t~k ~d disposer a~ the familia. C. Certification - I certify that the equipment ideotifled in the document wu inspagt~/se~iced in accordance wieh the manufacturers' gaidrliats. ~tached ta thi~ Certification is information (e.~ manu'/hcture~~ chec~ists) ne~sary to wri~ ~ha~ ~is ia~rmario~ eot'r~cr and a Pior Plan showing the ~youl of monRorini equlpmem. For any ~quipm~t capable of generating such r~po~s, [ have also at~acheda~opyof~herepon;(cbee~ailth~ap~)~ ~ System set-up 0 A~ hk~tory ~rt ~ ~ Date Page 1 ot'3 O310t lVlOairoring Sysl,m Certffica~on 11/13/2003 14:59 6613921 PAGE 03/05 D. I~¢sults of Testing/Servicing Sof~va,'¢ Version In, tailed:, ~ ] ~ Coin fle'c~ rite fottowin cl~ec~i~t: ~.k~ ~ ~* Is ~e viaaai a~m op~,~onat~ ........ ;" ' 0 No' Wm alt sen'sov~ ~ua}l~ ~Sp~c~,, ~mcdon~[y t~s~'~=~d ~onfi~d operational9 ,,, 'cs 0 No* Ware al[ se~o~ ~stalJed at towed point Ofseconda~ conta~en; ~d positio~d so thai: other equipment wttl not interfere with th~ pr0pet' Wve tf mrms ~ reNyed to a remote momlor~g 'i~tion, i~ ail communications equipmmt (e.g. moden;) ~ N/A operational9 ~ Ye; ~ No* Fox, Preasu.ri~d pip~g'i31tem~, do~s ~tu~h~e automatically shin a°~ i~ the pi~mg s~cona~y contMnment ~N/A mo'nJ;ofing symm detecto a leak, thila to op~-a't¢, or is ~lacwi~ally diaeo~cted9 If y~: which 8~sors ~kiate positive ~at-down? (Cheok all that apply) Did you qpnfim~ positive ahu~-do~ d~ m le~s ~ $~sor ~tur~diaeo~ectJon? ~ Yea; ~ No. ~ Yes O' No* for t~; systems th:at utili~ ct'~¢' &o~to~g system ~ me p'r~ m~' owrfi~ w~ning d,~ie~" (i.~. ao ~ NIA mechanical ov~ll prevention valve ia ~atal[~d), i~ tl~a overfill waruing al~ visible aM audible at ~a mak fill poin~) ~fl qpera6ng proDerly? 1~ ~o, at what peycent o~ capaci~ does ~e flan~ =igger~ ~ .... ~ Ye~* ~ No Was ~y moait0rNg eauipmen; replae~8? If y~s, ~iO specific se~o~, probes, or o~ eqttipmen~ replaced ~a list the mufaetm:er name and mod{l lb[ ~t mplacment p~ in Section E, below. ~ Yes*'" ~ No Was liquid fo~d ~sid* any aeoondm'y eonmimem lfl Pro4uct; ~ Water. If. zt~, describe ca~e, in Section E, below. ~'es ~ Nb* W~a..modmring *y~ set-uP review~ m e=ure prop~ ae=in~a9 Aaach ,et up }gpoas, if applicable ~YesI ~ rio, .}~ ~ monitor~g ~9~{Dmalt opet3fional ~er manufamrer's ~pecifications9 * In geefion ~ balow d~erlbe how and when thane flefieieue~ ware or will be eorreetad. Comments; 11/13/2003 14:59 661392 PAGE 84/05 ]~. ln-¥av.k Gauging J SIR Equipment: r~ Check this box if tar~ ~augin~ ia used only for inventory control. "~Chcck thi~ box if no ~ gauging or SIR eqnipm~m is ~tall~.. This section x~xust be completed if in.-t~c ganging equipment i$ used to pedorm le~ de~ation mo~rMg. Corn )lex'e the t~liowin ~ ~;~,a ~ N~'* We~ all ~c gau~ng probes vi~uatlr i~pcc~d for dat~e ~'d re$id'ue buildup? Q Y~s ~ N~* W~ acc~acy ofsyst~ produ~ revel ~s tested? ~ Ye~ ~ ~o* Was accuracy o~ys[em water leve("read~s ~ Yes D No* W~ a~ probes reinstalled properly? Q Yes ~ No'; Were all items on ~e equipn~¢~.~.~ufac~er's m~ntena~ce ~ea~iat campleted? ....... 'r la [~e Section H, below, describe how and when these deficiencies were or will be corrected. G. LMe Leak Detectors (~LD): ~Checl~ this box d~Ds are not ia~led. Comt~je~e the followinh eheegl~t: ...... .. ~ Yes ~ Ho* For ~quipmeat $t~.u~ ~r atmua] cqui~em certification, was a leak s~zed to vcri~ LLD p~ocma~ce'? ~N/A (Check all tha~ apply) Simu[ated]~km~: ~3g.p.h.; Q0.lg.p.h; Q0.2g.p.h. O Yes Q No* ~e ~l L~s COhEred op~io~l ~cumte wi~Ja re~]ato~ requ~ments? '~' Yes ~ "N~* Was the ~e~g apparatus properly c~ibratcd? ~-y¢~ ~ No* Forme~calLLDs, doestheLLDres~ctpmductflowJfitd~cc~alc~<? Q Yes Q Ho* For eJec~'c LLDa, do~ the ~bi~e"'[utomadcally ~ut o~if~ dL~ dezcm a leak? ~ Yes ~ '~* For eteeeo~i~'LLDs, do~s t~ tu~6i~'e auto~tically shut off if any potion of fl~e monito;i~'~ystem ~ disabled ~ N/A or disco=creed? ~'es ~ No*' For elecuoMc LLD], does the tt{rbin~ a&o~ically ~u, offifany po~ioa"~?~o monitoring system ~H/A or~i~a "D Yes ~ No* For elacuon]g~LDs, ~¢ ~t accea's'ifilu w~i~ c°~ec~ons been visu~ty inspected? ~ Yes D NO'* Were all items o~' ~e equipment manuf~er's mMtenanc¢ ch~klimt completed? · ~ the Section ~, below, de$cribe how ~d when these defiaianeies were or will ~ corrected. Comments: Page 3 ol'3 oa/ot ~ ' 11/13/2003 14:59 66139 PAGE 05/05 Monitoring Site Plan _ ~stmctigns If ~ou already have a dia~m ~at show~ gl required in. marion, you t~y include it, rather than this page, with your Monitoring Sy~em C~ificadon. On your ~ite ~1~, ~ow the g~.eml layout of t~ ~d. piping. Cl~rly idcnri~' [ocario~ of fl~e ~owing .qui~mem, if in~.ll~d: mon~orlag ~7~tom control pan.ts; ,~n~or~ monitoring rank annular spaces, sum.ps, dispenser pans, spill co'a~ner,, or other secondly eontainm~t are~; mechanical or electronic llne leak ~e~ectors; ~nd it~-ta~ liquid level probes (if used ~r 1,~ detection), In ~o space provided, note the date th~ Site Ptan wa~ prepm'e~. Pa~e ¢ of~ o~00 11/13/2003 15:01 PAGE 01/01 *COPY REQUESTED PLEASE FAX(§61)392-0621 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION OP~TORS NA~ OW~S N,A~ N~ OF MOTOR ~N~AC~ ~~-- ~~ % DOES FA~Y HA~ D~P~S~ PANS7 ~ NO ~/~ TANK # VOLUME CO1VI'ENTS / ...... /~ooO. P~¢",<.._. ! NAME OF TESTING COMPANY RICl-I, E.I~¥~RONME_NT~AL coNTRACTORS LICENSE _~ .?O~~ . NAME & PHONE NUMBER OF CONTACT PER$ ON=eAME S R x ¢~ _( 6 6 _~..)..3_9 DATE & TIME TEST IS TO BE CONDUCTED ~u'~ =(3 D' Postage l$ ~ Ceded Fee / ;-1 V ' P~ ~ R~m R~le~ F~ / Here ~ (E~o~ment Requt~) ~ ~ Re~ Del~e~.~/ ~ ~do~m~ ~ M~ WOOD ~ To~ Pc ~ ~ ~RCY So~EST ~ ~_ 400 OLD RI~R · Complete items 1,2, and 3. Also complete item 4 if Restricted Delive~j is desired. · Print your name and address on the reverse [] Addressee so that we can return the card to you. Date of Delivery · Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: MIKE WOOD BAKERSFIELD MEMORIAL HOSPITAL 420 34"m STREET [ i Semice Type BAKERSFIELD, CA 93301 [] Certified Mail [] Expres,' [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. · Restricted Delivery? (Extra Fee) [] Yes 7002 3150 0004 9985 3868 PS Form 3811, August 2001 Domestic Return Receipt 2ACPRI-03-Z-0985 D May 8, 2003 Mike Wood Mercy Southwest 400 Old River Rd Bakersfield, CA 933 CERTIFIED MAIL RE: Failure to Complete SB 989 Secondary Containment Repairs & Retest FIRE CHIEF RON FRAZE A,..,.,ST.AT,VE SE.VIOES FINAL REMINDER NOTICE 2101 "H' Street Bakersfield, CA 93301 VOICE (661)326-3941 Dear Underground Storage Tank Owner & Operator: FAX (661) 395-1349 SUPPRESSION SERVICES Since January 1, 2003, this office has sent you monthly reminders 2101 'H' Street advising you of a failed SB 989 test. In that letter, this office also Bakersfield, CA 93301 VOICE (661) 326-3941 requested an update with regard to repairs of your system. FAX (661) 395-1349 PREVENTION SERVICES This office further explained that repairs of your system are a s,~.s~.,~s.~.,,.o..~..,~s~, condition of your permit to operate. Please be advised that you must 1715 Chester Ave. Bakersfield, CA 93301 have your system repaired and retested by June 15, 2003. Failure to VOICE (661) 326-3979 comply may result in further enforcement action up to, and including FAX (661) 326-0576 revocation of your permit to operate. PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 This office has extended every courtesy with regard to sending VOICE (061) 326-3696 contractor information as well as one on one visit's FAX (661) 326-0576 FIRE INVESTIGATION Should you have any questions, please feel free to call me at 661-326- 1715 Chestor Ave. Bakersfield, CA 93301 3 1 90. VOICE (661) 326-3951 FAX (661) 326-0576 Sincerely, TRAINING DIVISION 5642 VlctorAvo. Ralph E. Huey Bakersfield, CA 93308 VOICE (661) 399-4697 Director of Prevention Services FAX (661) 399-5763 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc ©FFIC A USE Po~e $ ~) Cer~ed Fee ~ Ream R~;e~ F~ P~ ~ (E~o~me~ Requl~ Hem ~ Re~ed DeI~w F~ ~ (~dome~nt Requi~ ~ T~ PO~~ m ,s~tro B A~RSF~LD ~MORIAL ~ [~-~-~: 420 34TH ST~ET ~ [o,~no.' BA~RS~LD CA 93301 .... ; ..... ;; ...... ~ . · Complete items 1, 2, and 3. Also complete [] Agent item 4 if Restricted Delivery is desired. [] Addressee ' · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery; 1. Article Addressed to: if YES, enter delivery 'BAKERSFIELD lv~MORIAL 42,0 34TH STREET BAKERSFIELD CA 93301 ,. Service Type [] Gertified Mail [] Express [] Registered [] Return Receipt for Merchandise  [] Insured Mail [] C.O.D. ~ 4. Restricted Delivery? (Extra Fee) [] Yes 2'Artic~'~-'~ 7002 3150 0004 9985 2946__ (Tral ZACPRI-03-Z-0985 PS Form 3811, August 2001 Domestic Return Receipt March 5, 2003 Bakersfield Memorial 420 34th Street Bakersfield CA 93301 mE C.~EV CERTIFIED MAIL RON FRAZE RE: Recent SB 989 Secondary Containment Testing ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 vo,cE 166,)326-3 n, THIRD REMINDER NOTICE FAX (661) 395-1349 SUPPRESSION SERVICES Dear Owner/Operator: 2101 "H' Street Bakersfield, CA 93301 VOICE (661)326-3941 Our records indicate that you completed your secondary containment FAX (661) 395-1349 testing on October l I, 2002. Our records further show a failed test. PREVENTION SERVICES Therefore you are required to have your system repaired and re-tested FIRE SAFETY SERVICES* ENViRONMeNTAL SERVtCE$ as soon as possible. 1715 Chester Ave.' Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 This office requests an update with regard to repairs of your system. Please be advised that repairs involving the replacing of components PUBLIC EDUCATION 1715 ChesterAVb. must be under permit from this office. The repairs of your system are Bakersfield, CA 93301 a condition of your permit to operate. Failure to repair and re-test will VOICE (661) 326-3696 FAX (661) 326-0576 result in the revocation of your permit to operate. FIRE1711NVESTIGATION5 Chester Ave. Should you have any questions, please feel free to contact me at 661- Bakersfield, CA 93301 326-3190. vO,CE (66~) 3~6-3961 FAX (661)326-0576 TRAINING DIVISION 5642 Vlctor Ave. /'" Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc ~ eJ"~ BAKERSFIELD MEMORIAL r"l ........ 420 34TH STREET -------, l~!i~! BAKERSFIELD CA 93301 ............ Il · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, C. Date of Delivery or on the front if space permits. 1. Article Addressed to: D. ~ if YES, enter 3 below: [] No BAKERSFIELD MEMORIAL 420 34TH STREET BAKERSFIELD CA 93301 .. iO- Service Type FI Certified Mail [] Express Mail [] Registered l"l Return Receipt for Merchandise - "' [] Insure~d Mail Fl C.O.D. 2~ [41 Restricted Delivery? (Extra Fee) F'I Yes 7002 0860 0000 1641 6162 PS Form 3811, August 2001 Domestic Return Receipt 2ACPRI-03-Z-0985 February 13, 2003 Bakersfield Memorial 420 34th Street Bakersfield CA 93301 FIRE CHIEF RON ~R~ZE Certified Mail ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield. CA 93301 VOICE (661) 326-3941 ~ RE: Recent SB 989 Secondary Containment Testing FAX (661) 395-1349 suPPRESS,O. SE.VICES SECOND REMINDER NOTICE 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 Dear FAX (661) 395-1349 uwner/uperator: PREVENTION SERVICES Our records indicate that you completed your secondary containment FIRE SAFETY SERVICES. ENVIRONMENTAL SERY~E$ 1715 Chester^ye. testing on October 11, 2002. Our records further show a failed test. Bakersfield. CA 93301 VOICE (r~l) 326-3979 Therefore you are required to have your system repaired and re-tested FAX (661)326-0576 as soon as possible. PUBLIC EDUCATION 1715 ChesterAv~. " This office requests an update with regard to repairs of your system. Bakersfield, CA 93301 VOICE (661) 326-3696 Please be advised that repairs involving the replacing of components FAX (661) 326-0576 must. be under permit from this office. The repairs of your system are FIRE INVESTIGATION a condition of your permit to operate. Failure to repair and re-test will 1715 ChosterAve. result in the revocation of your permit to operate. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 Should you 'have any questions, please feel free to contact me at 661- 326-3190. TRAINING DIVISION 5642 Victor Ave. VOICE (661) 399-4697 FAX (661) 399-5763 : Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc January 22, 2003 Memorial Hospital F,RE CHIEF 420 34th Street RON FR~E Bakersfield CA 93301 ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 RE: Upgrade Certificate & Fill Tags VOICE (661) 326-3941 FAX (661) 396-1349 Dear Owner/Operator: SUPPRESSION SERVICES 2101 'H' Street Bakersfield, CA 93301 Effective January 1, 2003 Assembly Bill 2481 went into effect. This vOiCE (661)326-3941 Bill deletes the requirement for an upgrade certificate of compliance FAX (661) 395-1349 (thc blue sticker in your window) and the blue fill tag on your fill. PREVENTION SERVICES FIRE SAFETY SER~ICES · ENVIRONI~.NTAL SERVICES 1715 Chester Ave. You may, if you wish, have them posted or remove them. Fuel Bakersfield, CA 93301 vendors have been notified of this change and will not deny fuel VOICE (661)326-3979 FAX (661) 3260576 delivery for missing tags or certificates. PUBLIC EDUCATION 1715 ChesterAv~. ,. Should you have any questions, please feel free to call me at 661- Bakersfield, CA 93301 326-3190. VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION o, ,y~, e:ncere'- /' 1715 Chester Ave, VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION Steve Underwood 5642 Victor Ave. Bakersfield, CA 93300 Fire Inspector/Environmental Code Enforcement Officer VOICE (661) 399-4697 FAX (661) 399-5763 Office of Environmental Services SBU/dc 1:::3 Postage $ 1::3 r-1 E:::3 Certified Fee r-'l Return Receipt Fee Postmark ,_13 (Endorsement Require~ Here =[3 Restricted Delivery Fee [::3 (Endorsement Required) [~i;g;~"~ BAKERSFIELD MEMORIAL [.o.~.~.o..~, 420 34TH STREET .BAKERSFIELD CA 93301 January 13, 2003 Bakersfield Memorial 420 34th Street Bakersfield CA 93301 FIRE CHIEF RON FRAZE Certified Mail ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 RE: Recent SB 989 Secondary Containment Testing FAX (661) 395-1349 SUPPRESSION SERVICES REMINDER NO TI CE 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Dear Owner/Operator: PREVENTION SERVICES F,.Es,~,.s~Es.~.o.,~'~,.~.~E. Our records indicate that you completed your secondary containment 1715 Chester Ave. Bakersfield, CA 93301 testing on October 11, 2002. Our records further show a failed test. VOICE {661) 326-3979 Therefore you are required to have your system repaired and re-tested FAX (661) 326-0576 as soon as possible. PUBLIC EDUCATION 1715 ChesterAv~. " This office requests an update with regard to repairs of your system. Bakersfield, CA 93301 VOICE (661) 326-3696 Please be advised that repairs involving the replacing of components FAX (661) 326-0576 must be under permit from this office. The repairs of your system are FIRE INVESTIGATION a condition of your permit to operate. 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661)326-3951 Should you have any questions, please feel free to contact me at 661- FAX (661) 326-0576 326-3 190. TRAINING DIVISION 5642 Victor Ave. Sincerel~ Bakersfield, CA 93308 VOICE (661) 399-4697 ~ ~ FAX (661) 399-5763 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc 12/04/2002 08:02 66132?5806 BMH ENGINEERING PAGE 01/11 KFRN NA~I. ~ HOS~A[. .. ~0 ~th Street lhake~fie~ Ca. 933O] Phor~ (661) 0274r~7 ~ ,LOroO l::uc (~1) 327-58O6 ~ 12/04/2002 08:02 6613275806 BMH ENGINEERING PAGE 02/11 Secondary Containment Testing Report Form - DBJiFT 1. FACILITY ~O~A~IOH LN~ of LO~ A,g~Cy 7~ector Pt~ent:, ~  ' . - ~tat~in~ ~y ~an~fa~tur~ 12/84/2002 88:82 GG1327580G BMH ENGINEERING PAGE 83/11 Ta~ M~I: ,-~ci~cto.~';o,-'*': ~--- '~- -' ....... ~- ......... ~rmit ci~ b~eo applyi~ pr~u~/~un~'at~ mid s~ Te~ ~ T, me: ,, -'Chou in ........... '-" ................... ~;n~ ~): T~t Result: 12/0412002 08:02 6613275806 BMH ENGINEERING PAGE 04/11 Wait d~ b~.~ Commeuts - (include ?formation on repair, made prfi)r 12/84t2882 88:82 6613275886 BMH ENGINEERING PAGE 85111 ~nufao~uror: .... ..~:,en~t~ ofeipin8 ~un: .......... ~nd location Of · ~ol~tiOn; Wait ,~me b~w~ T~ Sto~ T.i~ Test Duration: T~ t R~ult; 12104/2002 08:02 6613275806 BHH ENGINEERING PAGE ~ ping [)iametem / ~~ ......... 'Ih oduct Storcd', ~lethud ~nd Ioe~tio, of ~Va~ tit~e betw~ pt~sur~vacu~weter aad T~ut Scan Time: . ,,.. Lai. tial ~ding '¥C~t ~,nd T~me: Final Re,di~ (.Rr): ' Te~t Ch~ge in Co,,oments - (incl~e m[o~,n~ation on ~a~r~_mqff~rior to resting) ....... . 12/04/2002 08:02 6613275806 BNH ENGINEERING PAGE 07/11 ~ Other ~p, ...... -- .... ~.~_ - ._~ . .... Change in K--d~,~ ~.~): Pas~ail Tbr~hold: ........... Te~t R~uIc ' ~ , _ ~ , ,. ------- Comment~ -(tr~clude ~n~on ? repa~r~ made~,'ior to te,~t~ngJ . 12/84/2882 88:82 6613275886 BMH ENGINEERING PAGE 88/11 a on.~ ~.~) ~ . ......... l,~i~ht ~om T~k Top ~o Cofl(~ll~ to t~t~ ..... Poerion of ~ump To~ed~ ,~ ~rbil~ ~h~ d~ ~h~ ~mp sen~r det~ oi~ product ~utdown? ' W~s ~l-saf~ ~66ed to W~it time betw~. D Te~ End 7i~e: ,,, Test Du~: 'T~t R~ult; t ffthe ~e~ing meth~ do~ aot test th, e~ro de~h oftbe sump, ~ped.~ h~ much oft~ ~p w~ t~. ~hod, oct t~F enth~ ~mp shmdd only ~ ~ ~Um monitofio8 lp~em pro~de~ t~i}-sa~e tu~ine ShUT~. contaJnme.t (~ting m~hod us~ do~ not :est tht onti~ volume of;he s:}mp, 12/84/2882 88:62 6613275806 BMH ENGINEERING PAGE 09/11 T~t Mettlod D~lop~ ~; 0 ~ ~urer , To~ ~.~od Uses: O P~m-e D V~cuum at~t~ I UDC ~32 ~t: · 14J~~ ~e~etr~t~on: ~ ~ , ~igb~ ~m ~C ~ottom to Co~{~on etUDC p~or to - ~ ...... D~ l~rbi~e ~hut do~ w~ ~C ~mt d~.ec~ ~o~ gi~do~n ~s~n~' : ....... ~s ~s~ pro~ed for ~ ~bu~dawn? ~i~s~ ve~O~ to be - - Wait ~me ~twe~. app~ pres~a~us~at~ a~ ~,,8tan .~ test'. . -~ .... . .................... ~ ~ti~ ~j~)~ .............. Test Dot.ion: Cha~e ~ Pas~l Test R~ult: ~as ~n~ remo~ for ........................ ' ~'the t~dng m~h~ d~ sot test ~e e,]Ii~ depth of the ~C, mpecify how much ogthe ~C w~ t~mt~. Metl~s ~ t~mg endre UDC ~hould o~y be used ~the monkm~ng ~yz:~ pro~de{ ta.H.~e turbine ehutdow~ a ~3~ ~ mubme~ble ~mp ~n~ pl~c t~ ~ensor in pmOuct (~t~ri,~unati~ ~r~ should ~so L~e p{a~ ia wmm~). ~c be/wc.e~ pieing the ~sor jn pr~u~ and tho u,~ine sl~tlJ~g down j~ lhe re~p~e time, This ~h~Jd be done ~ cont~t~t t~ng m~od u~ do~m not ~ tho c~re volu~e o~the ~C 12/84/2882 08:02 661327§806 BMH ENGINEERING PAGE 18/11 ~g~ fi'om T~nk Top tO ~o~ion o~ 3um~ T~t~ lnhi~ ~i~_ . ',r~ End Time: ....... ' Pas~l T~eshold; ~ ~~ '-- 9~ ~.,or m. ih~ ,~'w ............. .. ~ - --~- Does the s~' ~a~ when ei~ product or wat~ WeS s~sO~ mmov~~_ror - :- - --=- -'---- ............ ........... ~'-'- ..... ~ =- ......... ~tmg? W&l senior pm~rly ~r-O~ .......... .... ~~~ ........ , ..... 12/84/2882 88:82 6613275806 BMH ENGINEERING PAGE 11/11 9. CONTA/NI~ENT BO~ , ' - Te~ ~thod D~o~ ~y: 0 Spill .Bu~ T~t ~i~ ~s~: O Pr~e~ 0 V~um ~ydro~flc 0 Other ~uck~ time be~ ln~6el ~e~ding Te~t .End ~i,mc: Test Duration: ~a~aii T~hold: , Commeu,~ ~ (inalude ~farmatton an r~air~ made ~r~,ar W SW~ ~ST PrO~s'~, ~,. ~Cntt ~con l OOt I" 8~c~ ~ox 944212 ~bon~; (916) ~41-5873, E~; (916) c-malh b~n~:~b,~