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UNDERGROUND TANK (1ST FILE)
Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: · ?i?i ~! Materials Plan ?~' ~iiii'~'%ii~i~!iii!' iiii~'iii round Storage of Hazardous Materials Program BAKERSFIELD · ... '~ '~.::"" 4 .,., , ..... ~.. ~. . P~G O~CE OFE~RO~AL 1715 Chewer Ave., ~rd Floor B~e~el~ CA 9~301 Voice {805) ~2~979 ~ ~*** ~ CA Cert. No. 0 0 $ ! 3 City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (805) 3~-6-3979 -. An upgrade compliance certificate has been issued in connection with the operating permit for the facility indicated below. The certificate number on this facsimile matches the number on the certificate displayed at the facility. Instructions to the issuing agency: Use the space below to enter the following information in the format of your choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility; facility identification number (from Form A); name of issuing agency; and date of issue. Other identifying information may be added as deemed necessary by the local agency. This permit is issued on this 2na day of November, 1998 to: BAKERSFIELD MEMORIAL HOSPITAL Permit #015-021-001121 420 34th St Bakersfield, California 93301 -- KER - HOSPITAL, IN'C: 3600 San Dimas St., Bakersfield, CA 93301, (805) 327-7621 F 53-A W Facilities and Offices I Clinical Office 53-A Crafts Studio F Pool 2 Group Room 54 Living Center G Adult Inpatient Nursing Station 3-6 Clinical Offices 55 Activities Offices H Consultation Room 23 Kitchen 60 Clinical Office I Patient Lounge 24-30 Adult Inpatient Rooms 61 Group Room J Consultation/Exam Room 31 Nursing Report Room 62-63 Clinical Offices K Meeting Room 32 Nurses' Utility Room 70 Phoenix Learning Center Classroom L Meeting Room 33 Telephone Equipment 71-72 Phoenix Staff Offices M Storage 34 Beauty Shop and Laundry 101-108 Adult Inpatient Rooms N Nurse Utility Room 35 Housekeeping 201-208 Adolescent Inpatient Rooms O Storage 36-46 Adult Inpatient Rooms 209 Consultation Room P Adolescent Inpatient Nursing Station 47 Consultation Room 210 Director of Inpatient Services Q Kitchen 48 Medical Records 211 Consultation Room R Maintenance Office 49 Soiled Linen Storage A Entry Coordinator S Tennis Courts 50 Adolescent Classroom B Admissions T Print Shop 50-A Cafeteria/Dining Room C Psychiatrist Office '~.~_~U ,.Storage 51 & 52 Activities Offices D Psychiatrist Office 53 Recreation E Admissions/Appointments ADMINISTR;ATION MOBILE UNITS KERN VIEW HOSPITAL, INC. 3600 San Dimas Bakersfield, CA WHEN FIRE IS DISCOVERED: 1. Remove any patients or visitors from danger. 2. Press "1" and "7" on the security control panel (by the southwest exit). Press numbers until alarm sounds. 3. Notify receptionist (or nurse in charge) as to location and type of fire. 4. Unlock and close all doors. 5. Use fire extinguisher,if appropriate. Evacuation Route Location of Fire Extinguisher Security Control Panel -29- APPENDIX-FALSE ALARM i 1. Turnin~ Off Alarm, Sprinkler System and Resettin~ Air Handler a. If the fire alarm is set off, the air handler system in the inpatient unit is automatically turned off and must be reset by hand. The fire alarm must also be reset (turned off). The Plant Manager will do this. b. In the event of a false alarm and in the absence of main- tenance staff, reset the alarm system as follows: (1) Notify alarm company of false alarm. (2) Locate the alarm station that was pulled. Reset the pull station by - turning the screw at the top of the station (clock- wise) - the cover plate will drop down - flip the interior toggle switch - close cover plate (3) The main control panel is in the air handler room (basement under south hall's consultation room). Flip switch marked "RESET". (4) To reset air handler system: (a) Go to air handler room at the bottom of the steps located on the outside of. the building and to the left of the covered sidewalk between the main building and Building A. (b) The air handler room is unlocked by a 200 series key. (c) Push black reset button on box marked "Air Handler". (5) Advise maintenance as soon as possible of the false alarm. Call alarm company to verify that the system~ is operating. c. Turning off sprinkler system due to malfunction not related to fire: (1) The Fire Department will respond if the sprinkler system is activated. Notify alarm company and Fire Department of the malfunction. (2) North end of the main building: close the valve marked "Main Control". Fire Department will assist. (3) Notify the Chief Executive Officer and Plant Manager of the malfunction. ~ e. in case of actual fire: (1) The Fire Department will turn off sprinkler system. 2. Trouble Alarm - Annunciator' Pan'el at Nurses' Station a. When the trouble alarm goes off, alert Maintenance staff. If not available, call Cincinatti Time (833-1300) or ADT/ Crime Control (322-1961) to investigate and correct the the problem. " 3600 San Dimas Street ::;::;: ................ "" Bakersfield, California '.'.'.'.'.'.'.'. KERN VIEW :.:.;.:.:.:.;.:.:.. · .'.-.'.'.'.:.:.;.:.:.:.:.; HOS~, INC. (805)~J27-7621 :;:;:::::;.' .... :::':::;:::::;:. :.:.:,:.:.:.; ;::;. · ..... ~~"'"' .r,.~\ , x .................. ~, .~, .G · - ,--~ , , ~ ..... ' '.:.'.'.'.'-'-'.'"., , ~-"' ~",. 2 ~-' , ::::::::::::::\ · ... ~,,~, ~ ," ~~"~....'..'_.;.'.'.'.'.'.'%~,., ',,~.............~, '"'"":! ~,..._~~i!::iiiiii!! i!iI''' - ~ ~ ,, ,..,,.. ,.. ...... :.~ · ........ ~-~ ~ _..,. .~-.~ ~-.:.-...-.- · .-.-.-..........., ,. ......... ,...,, ,.,,.--:..--, ,: ............. 'c'..'.:-:.:.'/ ~ ~ · .'.'-'.-.'.-.--'.'"'""'""""''' ' ' ' ' ' ' ' '" ¢' ' ' "':0 '"'"'"'"'"-'-' Facilities and Offices X = GAS/WATER SHUTOFF -28- (3) Notify Chief Executive Officer (if not available, notify the Assistant Administrator). 6. Ail other staff members: a. Ail personnel on duty at the sign of a disturbance should make themselves available for special assignments until the situation is under control. b. If law enforcement personnel are called, the ranking officer shall be in charge upon his/her arrival. All orders are to be followed. c. Staff members will leave their group or activity immediately in any emergency situation if requested to respond. Instruct those in the groups to remain in the room D. Instructions 1. Attempt to keep disturbance in an enclosed area and centralized. This may require locking of interior or exterior doors. 2. Since the news media monitor all calls made to police and fire departments, it is extremely important that confidentiality laws are not violated if any reporter appears on the scene. 3. Incidents of emergency situations are to be recorded in the patient's record by staff members involved. 4. Ail injuries are to be reported on proper forms and submitted to administration. 5. Incident report forms are available at the NurSing Station I 686-03Q~ CIgNTRAL ]'LANT TANK J ~ 11 G F E D C B A'o B-2 ~'{~- SERVICE TUNNEL - ] B-4 B-3 5 6 EXISTING BUILDING 7 -, 8 NORTH' 9 ,$ GAL ~ , ,....~.. Hame: Memorial Hospital PLOT PLAN (2ity: Bakersfield, CA ' Location: 701 34th St. Work OriJer ~o. 1342 UST for "Old" Kern Vier/Bldg No Sc~e j_Ho,th Stairway × Drivewa~u Hospital Plant Building IMRI Bu"~g Dm~ By: Rob~ Bmc~ Dat~: ~.~_~ B~~d, Ca. BF~.OCKWAY~ S 'r'ANK TESTING Bakersfield ~ CA. USA (805) 834-1146 Performed for: Memorial Hnspital Test Location: 701 34th Street Bakersfield~ Test Identification : 1342--1 Test Date : 08-.(]3-. . !'-~. Start Data Collection : 08:29:04 Ending: Tes~ Period : 10:41:42 Time Filled f'-,r Test : + 24 Hrs. TANK ID. :Ke'~sf View- Gen. - CONTENTS :DIESEl_ V~,] ume : 300 Diameter : 48" Depth Bury :50" Product level :76.5" Groundwater : > 15 FT Pump Type :8uction Tank Type :1 Wall Steel Water in Tank :0 Test Fluid :DIESEL Vapor Recc, very :Nc, ne Average Rate of Change is based c,n 244 Data Pc, ints S t a n d a r d D e 'v i a t i c, n .............. 0001 G a i ]. o n s - Volume change of Tank Cc, ntents - Net Volume ~ ( 60 rain/Test Time) --.0018 Gal. ~' ( 60/ 61.32 min.) = -..0017 Gph. - Vc, lume change d.~e tc, Temperature Avg. Temp. ~- Volume ~ Cc, ef. c,f Expn. ¢& (60 min./ Test Time) · -.~]439. .. Deg. F * ..3 ,') ("). _ Gal. *~ 0.~")~'~(]4'7... . ~ 60/ 61.32 = -.0060 Gph. Net change = Level Vc, lume - Temperature Vz:,lume b,l X{~l 'T' {3 ~.t A N ~3 El{ ...... ~1~ Based c,n the Information provided and the Da~Z, l l This T~NK & SYSTEM LINES Test I~'- ~~~~S~]~~ Tester : Robert Brockman ~ 92-1251 '~~-- Certified This Test cc, replies with U.S.EP~ and NFP~ req~reme~s. P~oauct ~IESEL Te~ hte ................................................. · ......., LenYth (Hi~,) 61,32 Leto! P~eoision ,8~I Te~, P~eci~on Liquia Lovel 76,5 KERN VIEW HOSPITAL, INC. . ...... ::::::::::::::::::::::::::::::: 3600 San Dimas St., Bakersfield, CA 93301, (805) 327-7621 F 53-A W Facilities and Offices 1 Clinical Office 53-A Crafts Studio F Pool 2 Group Room 54 Living Center G Adult Inp~atient Nursing Station 3-6 Clinical Offices 55 Activities Offices H Consultation Room 23 Kitchen 60 Clinical Office I Patient Lounge 24-30 Adult Inpatient Rooms 61 Group Room J Consultation/Exam Room 31 Nursing Report Room 62-63 Clinical Offices K Meeting Room 32 Nurses' Utility Room 70 Phoenix Learning Center Classroom L Meeting Room 33 Telephone Equipment 71-72 Phoenix Staff Offices M Storage 34 Beauty Shop and Laundry 101-108 Adult Inpatient Rooms N Nurse Utility Room 35 Housekeeping 201-208 Adolescent Inpatient Rooms O Storage 36-46 Adult Inpatient Rooms 209 Consultation Room P Adolescent Inpatient Nursing Station 47 Consultation Room 210 Director of Inpatient Services Q Kitchen 48 Medical Records 211 Consultation Room R Maintenance Office 49 Soiled Linen Storage A Entry Coordinator S Tennis Courts 50 Adolescent Classroom B Admissions T Print Shop 50-A Cafeteria/Dining Room C Psychiatrist Office U Storage '~-./'[E'~ 51 & 52 Activities Offices D Psychiatrist Office '~---' ' 53 Recreation E Admissions/Appointments :.-.-...-..:-:.:.:.:-:.:.:.;.:.:.:-:.:.:.:.:.:-:.:.:.:-:.:.:.:.:.:.:.:.:.x ..... i: " .' 3800 San Dimas Street ....... '.'.'.'-'-'.'.'.'.'-'.'.'-'.'. · Bakersfield, California. ' ....... ' .... . KERN VIEW ;;:::';:;;;::;;:;:.- ·..'.'.'.'.:-;.;.:.;.:.:.. HOSPITAL, INC. (805) 327-7621 · :.;. :. ;. ;. ;. :.:. ;. ;::;:;; ' .......... 53 A ....... 53 \60 ' '.','.'.'- :. :. :. :. :. :. :' :0:.'.' .... __ ~ ~,~, o ,-~L' · :.:-:.:-:.:. ~' ~ :e:-'." . ........ ::::::::::::::. .... · .... . .... ......... . ........ \~ ~ "':'!:i:i: :.:-:-:.:.:.:-:.:." 5 ':':':':" ' :':':':" , ," ~'%~--'_~ ~-~. ~3~ '~:'" -s- ..........:.:.:.:.:.:.:.:.:.:.:.:.:.: ~. 2.~-..., ?,- ,.,_,7;-4i;~'~ ~ , , .......... ,' ' ' '.'.'.'.'. ......... _:.. 'S <' ' ~, .... --~ '~'¢ \~'~-. ¢----~', ~ ..... ......... '.'.'.'.'.'.L.,~,,~' / ~-" ~o ~ "~,~'~..'.'~;~: [ 6 ' ~-- ....... '. '.' .'.'.'. '. '.' .'. '.~., '~ _. /~ ~ . ~,""~%..'.' .'. '.' .~f~ I_:~-' , ~ ....... · .'.'.'.'.' · · ~~44 \-' " ¢.'~ -,.~,,,~'"T,'.".'.'.'.'.'.'.'.'.'.'% 4 ~ ~'~" ..... · %,\ 4~..~ --~ ..¢~ _~ ~-'--~¢~ ............. · ~ ; ~ ...... .'.'.' ' '~ ¢75_,-- "~'-' ~.~--- ?,, ~ %\ ~-'"~\ k'.'.'.'.'.'.' ..... ~'~-" .......... ...... r ¢~' 4' '-'- ~' -~ ~ ¢'~-~\ %\. k.'.'.'.'.'.'.'.'.'.'.'.'% 2 ~ ~-~ . ..... :':':':': ''. "'i-',~2~,,,,,~__~ ¢~,~., '~..'.:.:.:.::;..'.:.:.:.:.:..~ ? ....~ . .'.'.'.-.-.'.' .:.:.:.:~ ~ ~:::I, '~'~~L':::.'.'::::::':':¥ ,',, '-~,~ ':':':':':':':':': .... ¥ ~ ~ ....... -.-.~.~.-~ . ~ ~ ~,~.-.-.-.........-............~.-~ ~ ................... · .-..... ========================= ~ .-'.'.'.':':':':' .v"-~.:.:.:.:-:.:.:¥~.' '~-~'~ x ",,.:.:.:.:-:.:.:.:-:.:.:.:..~ ~ ,-'- i !::::::" ~ ~'~, ......... :~.::' ::::::::: ~¢~2¢0 Facilities and Offices 1 Admissions/Entry Coordinator 32 Nurses' Utility 59A Assistant Administrator 2 Clinical Director 33 Telephone Equipment 60 Accounting 3 Administrative Secretary 34 Beauty Shop and Laundry 61 Data Processing 4-6 Clinical Offices 35 Housekeeping 62 Accounts Payable 7 Conference RoomiProle~sionai Library 36-46 Psychiatric inpatient Rooms 63 F~nance 8 Clinical Office 47 Consultation Room 64 Alta' Vista Outpatient Unit 9 Group Room 48 Medical Records 70 Phoenix Learning Center Classroom 10-14 Clinical Offices 49 Soiled Linen Storage 71&72 Phoenix Staff Offices 15 Alta Vista Lounge 50 Community Room A Appointment Desk 16 Clinical Office 50A Cafeteria/Dining Room B Receptionist 17 Alta Vista Group Room 51&52 Activities Offices C Patio 18&19 Clinical Offices 53 Recreation D Kitchen 20 Patient Accounts 53A Crafts Studio E Maintenance Office 22 Director of Nursing 54 Living Center F Print Shop 23 Patient Kitchen 55 Activities Offices G Storage 24-27 Alta Vista Inpatient Rooms 56&56A Administration H Psychiatric Nursing Station 28 Alta Vista Nursing Station 57 Public Information I Ten~is Court · 29&30 Alta V{sta Inpatient Rooms 58 Kern View Foundation 31 Nursing Report Room 59 Personnel/Foundation/ Public Information Secretaries /¥ SITE/FACILITY DIAGRAM FORM NORTH SCALE: BUSINESS N~%[E: FLOOR: OF Bakersfield Memorial HOspital DATE: / / FACILITY N~E: UNIT ~: OF Enclosure for Oxygen Tanks at Rear of hospital I-I ~ ......... (CHECK ONE) SITE DIAGR.~! X FACILITY DIAGR.~ from 4A-1 (Page. 3 Of 12) (Inspector's Comments): -OFFICIAL USE ONLY- ~'~ '-%.0'. i , .¢ ,c . . Itl / '= ' ,- ~"~' ' +~ I~ ~' ~ r ~ i X~ ~ ~ ~; e:~" ,_~ ~ ',,,' ~ / ~~,," L~~ ~'l-~..~ ~ . ~X~~ ~;F I.~l L ~ ,'.z~ /F , ~ · -. ' ~ ~. ' ~/ ' ' ' -'--... , ' , '~ / '/,'- -~ "-" '1 _ ... I ., ~A'~' / ~ ............. sITE/FACILITY DIAGRAM FORM NORTH SCALE: BUSINESS NA%[E: FLOOR: OF Bakersfield Memorial Hospital DATE: / / FACILITY NAME: UNIT ~: OF Bakersfield Memorial Buildings _._~ ........ (CHECK ONE) SITE DIAGR.~! FACILITY DIAGR.~ XX I(Inspector's Comments): -OFFICIAL USE ONLY- SITE/FACILITY DIAGRAM FORM NORTH SCALE: BUSINESS N~ME: FLOOR: OF ~ Bakersfield Memorial Hospital DATE: / / FACILITY N~ME: UNIT ~: OF Engineering Shop Area and Boiler Room ~- I~ ! ......... (CHECK ONE) SITE DIAGR.~M X FACILITY DIAGR.~M from 4A-1 (Page 1 & 2 of 1~) (Inspector's Comments): -OFFICIAL USE ONLY- c~ ENGINEERI ,- ....... ~ ~ m ~ t CAFETERIA MEDICAL ~ L' L-~ ~f PRIMARY CA~ SITE/FACILITY DIAGR~2~I FORM NORTH SCALE: BUSINESS NAME: FLOOR: OF ~ Bakersfield Memroial Hospital DATE: / / FACILITY NAME: UNIT #: OF_ ~.I Kitchen and Kitchen Storage area ~ ~ ........ (CHECK ONE) SITE DIAGR.~M ~ FACILITY DIAGR.~M From 4A-1 (Page3~4&5~of 12) I(Inspector's Comments): -OFFICIAL USE ONLY- - SA - / 0 I ~ '~ ENGINEERI,~G ! .... SURGERY ABOVE I )]' - ICS ~ ...... EMERGENCY ' -- 2 i' · ' PR~MA~ L . ~. SITE/FACILITY DIAGRAM FORM 5 NORTH SCALE: BUSINESS NAME: FLOOR: OF Bakersfield Memorial H6spital DATE: / / FACILITY NAME: · UNIT ~:,~_0~ Labor & Delivery, Nursery, Post Partum & Pediatrics._ l u _._~ .... (CHECK ONE) SITE DIAGR.~M ×× FACILITY DIAGR.~M · From 4A-1 iPage 11 of 12) (Inspector's Comments): -OFFICIAL USE ONLY- - SA - sITE/FACILITY DIAGRAM FORM 5 NORTH SCALE: BUSINESS NAME: FLOOR: OF Bakersfield Memorial Hospital DATE: / / FACILITY NAME: UNIT ~: OF Housekeeping Storage areas. /e -'~ ~ _~ ....... (CHECK ONE) SITE DIAGRAM X FACILITY DIAGRAM From 4A-1 (Page 4&~5 of 12) I(Inspector's Comments): -OFFICIAL USE ONLY- - SA - sITE/FACILITY DIAGRAM FORM NORTH SCALE: BUS INESS NBaME: FLOOR: OF Bakersfield Memorial Hospital DATE: / / FACILITY NA~ME: UNIT Laboratory and Storage Area ......... (CHECK ONE) SITE DIAGR.~M X FACILITY DIAGR.~M From 4A-1 (Page. 7 & 8 of 12) I(Inspector's Comments): -OFFICIAL USE ONLY- - 5A - sITE/FACILITY D I AGR~lvl FORM $ NORTH SCALE: BUS INESS NAME: FLOOR: OF Bakersfield Memorial Hospital DATE: / / FACILITY NAME: UNIT ~: OF Respiratory Therapy ~'-I ~ _~_~ ...... (CHECK ONE) SITE DIAGR.~M ~ FACILITY DIAGR.a~M From 4A-1 (Page 11 ~of 12) i(Inspector's Comments): -OFFICIAL USE ONLY- - SA - sITE/FACILITY DIAGRAM FORM NORTH SCALE: BUSINESS N~uME: FLOOR: OF ~ Bakersfield Memorial Hospital DATE: / / FACILITY N~uME: UNIT ~: First Floor and First East ~OF_ I~ I __.__~ ........ (CHECK ONE) SITE DIAGR.~M X~ FACILITY DIAGR.~M From 4A-1 "(Page ll"of 12) l(Inspector's Comments): -OFFICIAL USE ONLY- - 5A - SIT'E/FACILITY DIAGRAM F O mlv~ 5 NORTH SCALE: BUS INESS NAME: FLOOR: OF Bakersfield Memorial Hospital DATE: / / FACILITY NAME: UNIT ~: OF Purchasing Warehouse & Print Shop J~ ._/~ .__.__. ....... (CHECK ONE) SITE DIAGRAM 7{ FACILITY DIAGRAM From 4A-1 (Page '21 .of 12) I (Inspector's Comments): -OFFICIAL USE ONLY- - SA - SITE/FACILITY DIAGRAM FORM NORTH SCALE: BUSINESS NAME: FLOOR: OF Bakersfield Memorial Hospital DATE: / / FACILITY NAME: UNIT Laundry and Storage Area .......... (CHECK ONE) SITE DIAGR.~M X FACILITY DIAGR.~M From 4A-1 (Page~ of 12)- I(Inspector's Comments): -OFFICIAL USE ONLY- - SA - sITE/FACILITY DIAGRAM FORM NORTH SCALE: BUSINESS NAME: FLOOR: OF Bakersfield Memorial Hospital DATE: / / FACILITY NAME: UNIT Nuclear Medicine ......... (CHECK ONE) SITE DIAGR.~M X FACILITY DIAGR.~M From 4A-1 (Page'10 of 12) I(Inspector's Comments): -OFFICIAL USE ONLY- - SA - SITE/FACILITY DIAGRAM FORM 5 NORTH SCALE: BUS INESS NA~[E: FLOOR: OF Bakersfield Memorial Hospital DATE: / / FACILITY NAME: UNIT ~: OF Magnetic Resonance Imaging I'~ "~ f ......... (CHECK ONE) SITE DIAGRD! XX FACILITY DIAGRAM From 4A-1 (Page 11 of'12) I(Inspector's Comments): -OFFICIAL USE ONLY- - SA - , ·- -...'. . . IL_I.I ,- sITE/FACILITY DIAGRAM FORM NORTH SCALE: BUSINESS NAME: FLOOR: Bakersfield Memorial Hospital Emergency Room ........ (CHECK ONE) SITE DIAGR.~M ~ FACILITY DIAGR.~M From 4A-1 (Page 11 of 12) (Inspector's Comments): -OFFICIAL USE ONLY- - SA - !' SITE/FACILITY DIAGRAM FORM NORTH SCALE: BUSINESS N~ME: FLOOR: OF .~ Bakersfield Memorial Hospital Diagnostic Services ! _._. ---- (CHECK ONE) SITE DIAGR.~M X FACILITY DIAGR.~M ] I From 4A-1 (Page l'of 12) i(Inspector's Comments): -OFFICIAL USE ONLY- SITE/FACILITY DIAGRAM F OR/Vf 5 NORTH SCALE: BUSINESS NAME: FLOOR: OF - Bakersfield Memorial Hospital DATE: / / FACILITY N~ME: UNIT ~: ,~OF.. ~ Second East/ Second West (Outpatient Surg.) ........... (CHECK ONE) SITE DIAGR.~M XX FACILITY DIAGR.~M From 4A-1 (Page 11 df 12) Also sho~s Surgery and Central I(Inspector's Comments): -OFFICIAL USE ONLY- - SA - sITE/FACILITY DIAGRAM FORM NORTH SCALE: BUS INESS NAME: FLOOR: OF Bakersfield Memorial Hospital DATE: / / FACILITY NAME: UNIT #: OF ~/ Surgery I~ "~ ......... (CHECK ONE) SITE DIAGR.~M X FACILITY DIAGR.~M From 4A-1 (Page'9 of 12) (Inspector's Comments): -OFFICIAL USE ONLY- - SA - second flOor '~ ~ SIT'E/FACILITY DIAGRAM NORTH SCALE: BUS INESS NAME: FLOOR: OF Bakersfield Memorial Hospital 2 DATE: / / FACILITY NAME: UNIT Central Services __~..~ ....... {CHECK ONE} SITE DIAGRAM X FACILITY DIAGR.~M From 4A-1 (Page ~ of 12) I(Inspector's Comments): -OFFICIAL USE ONLY- - 5A - .~ ~ .'-':-i; ...... ~'~ LJ..~ ~' .... '~' .I . ',,., : ,'.. '~.: '~, ~. ,': ' - ~ · ~, ' . .' . . ' ' . .','[ .:.,'~,. ",~ '." ' t~" - ~ ' ti ~ ,~'1~ X ~ ~' .. '~: . '~. ':,~,, - :'.' .;.. , . ... <...: · ' O~.;,':t..~ -~':2~, l.,~:~.l~,. ~' :., 'b :, ':~,."' -.' . i'... : " I" CONTINUED (See 2nd File) December 2, 2002 Ralph Huey Director of Prevention Services Bakersfield Fire Prevention Services FIRE CHIEF RON FRAZE 1715 Chester Avenue, Suite 300 Bakersfield, CA. 93301 ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 David A. Weirather VOICE (661) 326-3941 FAX (661)395-1349 Bakersfield Fire Prevention Services 1715 Chester Avenue, Suite 300 SUPPRESSION SERVICES Bakersfield, CA. 93301 2101 "H" Street Bakersfield, CA 93301 ~ --- VOICE (661) 326-3941 erM.erM.erM.erM.erM~al ospita, m FAX (661) 395-1349 RE: y Rm. Violation PREVENTION SERVICES Director Huey, FIRE SAFE'D' SERVICES · ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661)326-3979 On December 2, 2002 at 12:30 pm I received a telephone call complaining FAX (661) 326-0576 about the over crowding and the blocking of egress paths within the PUBLIC EDUCATION emergency room facility. Upon my arrival at Memorial Hospital I 1715 ChesterAvb. contacted the Hospital administrator's office and explained the complaint Bakersfield, CA 93301 VOICE (661)326-3696 we received to Terri, a representative of that office. I asked to inspect the FAX (661)326-0576 area of concern and she escorted me to that area of the Hospital FIRE INVESTIGATION immediately. I walked through the area with the department supervisors 1715 Chester Ave. and took four photographs (included) of the conditions I found. I asked Bakersfield, CA 93301 VOICE (661) 326-3951 how long the patients were being left in the aisles. They said all the FAX (661) 326-0570 patients had been in the aisles over an hour. They also stated that this was not an unusual situation for patients to be left in the aisles and that TRAINING DIVISION 5642 VictorAve. sometimes it was even worst. I advised them that they were in violation Bakersfield, CA 93308 the fire code and need to clear the aisles as soon as possible. I also advised VOICE (661) 3994097 FAX (661) 399-5763 them that I would be making a report to you City Fire Marshal and that a copy would go to EMS~ L D This is a violation of Article 12 section 1203 of the 2001 California Fire Code (see copy). A notice of violation should be issued and follow-up inspections made to insure compliance at this facility. Please advise me of the actions you wish to take on this matter. FIRE CHIEF RON FRAZE Sincerely, 2101 "H" Street Bakersfield, CA 93301 ' VOICE (661) 326-3941 FAX (661) 395-1349 David A. Weirather Fire Plans Examiner SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 CC: Kirt Blair VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVK~ES · ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Avb. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 L D FIRE CHII RON ADMINISTRATIVE -'RVICES 2101 et VOICE FAX SUPPRESSION 2101 Bakersfield VOICE FAX PREVENTION, Bakersfield, CA .c VOICE (661) PUBLIC Bakersfield VOICE (661) 5s42 Wctor Ave. Bakersfield VOICE (661) FAX (661) D · FIRE CHIEF ~ ~' RON FRAZE ADMINISTJiATIVE SERVICES 2101 "H" Street Bakersfield, CA VOIC~ (661) 326-39~1 SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3~1 PREVENTION SERVICES FIRE SAFE~ SE~ES, EN~RONME~ SE~E~ 1715 Chester Ave. Bakemfield, CA 93~1 VOICE(661) 326.3979 FAX (~61) 326~6 PUBLIC ED~CA~ON 1715 Che~te~ Av~, Bake~field, CA. 93301 FIRE VOICE F~ TRAINING 5642 VictOr/ VOICE FAX (66 2001 CALIFORNIA FIRE CODE 1201 ARTICLE 12 -- MAINTENANCE OF MEANS OF EGRESS AND EMERGENCY ESCAPES SECTION 1201 -- GENERAL 1. In areas serving employees only, the minimum aisle width aa shall be 24 inches (610 mm) but not tess than thc width required by aa 1201.1 Scope. Maintenance of means of egress and emergency thc number of employees served, a escapes in buildings and structures used or intended to be used for aa human occupancy shall be in accordance with Article 12. 2. In public areas of Groups 13 and M Occupancies, the mini- a mum clear aisle width shall be 36 inches (914 mm) where seats, aa See Articles 24, 25, 32, 77 and 81 for additional means of egress tables, counters, furnishings, displays and similar fixtures or aa requirements, equipment are placed on one side of the aisle only and 44 inches aa AIl references to the Building Code are to the code edition under (1118 mm) when such fixtures or equipment are placed on both aa which the building was constructed, sides of the aisle. 1201.2 Definitions. For definitions, see Article 2 and the Build- SECTION 1205 -- FIRE ESCAPE lng Code. t((.;}}:i~ When fire escapes are used as an approved means of egress, they '~. shall be maintained in accordance with this code. Fire escapes and SECTION 1202 -- ADEQUACY OF MEANS OF related balconies, ladders, landings and operating devices shall EGRESS IN EXISTING OCCUPANCIES not be obstructed in any manner. 1202.1 General. Means of egress conforming to the require- SECTION 1206 -- EMERGENCY ESCAPES mcnts of thc Building Code under which they were constructed may be considered as complying means of egress if, in the opinion Emergency escape or rescue windows, doors or window wells, [For SFM] or any exit door required by the California Building of the chief, they do not constitute a distinct h,7*rd tO life. The re. quired fire-resistive rating of walls, ceilings and openings that are Code for sleeping rooms of Group R Occupancies shall be main- part of a means of egress shall be maintained, tained free of any obstruction, including bars, grates or similar de- Buildings or structures that were not constructed under the re- vices which would inhibit egress. B quirements of a building code shall meet the minimum require- F_,XClgPTION 1: Bats, grilles, grates or similar devices are al- merits of Article 12. Sec also Appendices I-A and I-B. lowed provided that such devices are equipped with approved release B mechanisms which are openable from the inside without the use of a aa 1202.2 Abatement of Buildings and Strucmre~ with Innde. key or special knowledge or effort, the release mechanisms am mni,~. tained operable, and the building is equipped with smoke de.t~ctors B quate Means of Egress. Buildings or structures that are not pro- installed in accordance with the Buildinit Code. a vided with adequate means of egress or emergency escapes are [For the SFM] Such bars. grilles, grates or similar devices shall be C k unsafe and shall be subject to the abatement procedures specified equipped with an approved release device for use by the fire depart. CL in Section 103.4.5. When abatement is by repair or rehabilitation, ment only, on the eoaerior side for the purpose of fire department emer. CL means of egress and emergency escapes shall be provided and gency access, when required by the authority having jurisdiction. A4. maintained in accordance with the Building Code. 2. Where security bars (burglar bars) are installed on emergency egress and rescue windows or doors, such devices shall comply with C L the California Building Code and the California Referenced Standar~ C L SECTION 1203 -- MEANS OF EGRESS Code, Chapter 12-3. CL A.L OBSTRUCTIONS $. [For SFM] For those Group R, DivLrion I hotel occupoacies pro- CL vided with a monitored automatic sprinkler system in accordance with Obstructions, including storage, shall not be placed in the required Section 1003.2.9, designed in accordance with NFPA 13, operabte windows may be permanently restricted to a maximum 4--inch (102 width of a means of egress, except projections as allowed by the mm) open position, c k Building Code. Means of egress shall not be obstructed in any manner and shall remain free of any material or matter where its SECTION 1207 -- DOORS (...,~ presence would obstruct or render thc means of egress hazardous. ,,. 1207.1 General. Exit doors shall be maintained in accordance with Section 1207. Exit doors shall be maintained in an operable SECTION 1204 ~ AISLES condition. Doors installed as part of required fire assemblies shall I 1204.1 General. Aisles shall be provided from all occupied Ix)r- be maintained in accordance with Section 1111. tions of the exit access which contain seats, tables, furnishings, 1207.2 Swing and Opening Force. When required by the displays and similar fixtures or equipment. Aisles located within Building Code, exit doors shall be of the pivoted or side-hinged an accessible route of travel shall also comply with the Building swinging type. Exit doors shall swing in the direction of the path of Code requirements for accessibility, exit travel when serving any hazardous area or when the area served has an occupant load of 50 or more. The door shah swing to 1204.2 Aisle Width. full-open position when an opening force not to exceed 30 pounds (133.45 N) is applied to the latch side. 1204.2.1 General. Aisle width shall be in accordance with Sec- tion 1204.2 for occupancies, other than assembly occupancies, 1207.3 Locking Devices. Exit doors shall be openable from the without fixed seats. Aisle width in assembly occupancies shall be inside without the use of a key or any special knowledge or effort. in accordance with Section 2501.9. Exit doors shall not be locked, chained, bolted, barred, latched or otherwise rendered unusable. All locking devices shall be of an 1204.2.2 Width in occupancies without fixed seats. The width approved type. of aisles in occupancies without fixed seats shall be provided in EXCEPTIONS: 1. In Groups A, Division 3; B; F; M and S Occu- accordance with the following: pancies and in all churches, key-locking hardware may he used on the B 1-61 E:I Postage $ i-1 123 Certified Fee r-a .Return Receipt Fee Postmark ,.IJ (Enaoreement Required) Here ~ Restricted Delivery Fee 1:3 (Endorsement Required) Tot~" ~[g~ BAKERSFIELD MEMORIAL HOSPITAL t~i;~i[ 420 3nTH STREET ............. [.o.t.~ BAKERSFIELD CA 93301 II ' · Complete items 1, 2, and 3. Also complete [] Agent item 4 if Restricted Delivery is desired. [] · Print your name and address on the reverse so that we can return the card to you. B. Received by (Printed ~ · Attach this card to the back of the mailpiece, or on the front if space permits. ? Is delivery address different from item 17 [] Yes 1. Article Addressed to: If YES, enter delivery address below: [] No BAKERSFIELD MEMORIAL HOSPITAL , 420 34TH STREET BAKERSFIELD CA 93301 13. Service Type [] Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise ~ ~ ~ [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes ~22~, 7002 0860 0000 1641 7480 "PS Form 381 1, August 2001 Domestic Return Receipt ' 102595-02-M-083u December 1, 2002 Bakersfield Memorial Hospital 420 34th Street Bakersfield CA 93301 FIRE CHIEF nON FRAZE CERTIFIED MAIL ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX ( 11 FINAL REMINDER NOTICE suPPRESS,O. SERVICES JANUARY 1, 2003 DEADLINE 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Dear Tank OWner/Operator: PREVENTION SERVICES ~'"~"~'~"~'~"""~""'""~'"~" You will be receiving this letter on or about December 1, 2002. One 1715 Chester Ave. Bakersfield, CA 93301 month from today, January 1, 2003, your current underground VOICE (661) 326-3979 FAX (661) 326-0576 storage tank(s) will become illegal to operate. Current law would require that your permit be revoked for failure to perform the pusuc EDUCATION necessary Secondary Containment testing. 1715 Chester Av~). Bakersfield, CA 93301 VOICE (661)326-3696 In reviewing your file, I see that you have received "Reminder FAX (661) 326-0576 Notices" since April of this year. This is your last chance to comply FInE INVESTIGATION with code requirements for Secondary Containment testing prior to 1715 Chester Ave. Bakersfield, CA 9.3.301 January 1, 2003. VOICE (661) 326-3951 FAX (661) 326-0576 Should you have any questions, please feel free to contact me at 661- TRAINING DIVISION 326-3190. 5642 VIctor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 Sincere[y, FAX (661) 399-.5763 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc ~ - DRAFT ¢,~/ Secoo. dary CoT inment Testing Report. F~l~im iht,reded for ~l~e b)' conmaclor,~ i)erfo~wtmg ~e~ ~ic testin~ of ~TST xecOnd~ontai~menl ,~'stems. ~nd printos/ts fi'Om t~St,~ [~ qpplicablO, sh~tld ~c prm,ided to ~h~ f~eili¢ ~neWOpe~'ator fo~ sub~$~ttol to the local regulatoo~ 1. FACILITY ~FO.~AT1ON Date Local ~4e~c)' Was No~ of T~n~: 'N~, of Loc~ Agmcy Inspector .Present:. ~¢redentiMs: g CSLB Lkc.en~ed Contt'actor g $~CB Licensed Tank Tester Manufacturer ComRoaem(9) Dmat~ Tr~n ExpirE~ 3. SUMM[ARY OF TEST RESULTS ,. , ..... Number et'Tanks Tested:" Number of Pipij~g_Rum Tested: __ 'Nurnber of Submersible .Pump Sumps Tested: Number of UDC Boxes Tested: Number o£FiU Sum Tested' Number of Overfiil Boxes Tes;eA: -- --__ Component Comments 'reeh~ician's Signature: ' 4. TANK ANNULAR TES-I.'].NG 're.~t M~d~d D~'etoped By: ~k M~nufacx S~a~da O Pro~.s~o~al E~nco~ D O~b~r Q Other 6g~ec~fi9 ..... Tank Cag~¢iLy: ~ . , Ta~ Material: Tank Mam~ot~rer'. --~- Product Stored: · , Wait time botw~e. ~p0tying pressu re/v~cuun~'ater ~ld T~t: .... Test gtm~ Time'. ,- ' ~ - 'rest E~d Time; , Change in ~eading ~-Ki): .... '-- ~. .......... · ~~~' ~ ~.~ ~.~ Test ~esult: Was seusor rumowd 'fo~ [~sti~? , -- ..... Was 9~so,' properly replaced a~er m~.iAg? _= -- , _- Commen~ - (include in/brmotion on repairs mad~ prior to testing) -.- ]~S ~',CO~DA.RY 't~s~ Me,od D~dopcd By: u r~pmg ~ U Other ~ec~ ...... Test Me. od lJses: D Pressure ~ctst, m O t-Iydrostati~ 13 Other 6S~e,c~d ,. '--- ~ Leogrh of Piping~un: , ~~. l'rodoct SWred: Method nad location of · Wai~ tJm~ between pressur~vacuum/water ~d Test Sta~ Time: hfiti~l Readins Test End Time: · Final Reading (R~): ~re~t ~ur~tio.: , Change in Reading (K~,-RO: P~s~I Threshold: Test R~ult: '~ ~ Comments - Onclude information on re~airs made prior to~ testing~ ~ ,~ ~u.t-~~_ ]?I..'PE TESTING' ['3 l~l~lg Manufac, mrer ~li~Indu~tw D ProfessionaJ Engineer t'I'est 'Method Dcv,loped .By: O Other (Spec~.') . 'rcs~ Method Un,s: 17] Pre.~l;urc ' '-~ac~Jum [I I-l. ydfo.~tati.~ c3 0the, r (;gpec~;5,) ..... ' Mea,urmg Equipment U,ed 'I'm' To.sting: P(ping Run # l"iping ~,tm ~, >lng R.u, .~_~ P}pin Lt. Material: ~ ~ing Manuhcturer'. Piping 'D i, meter: -~-..--,-J- .~ 1.,en_?._h.of'Piping Run: ...... iProduo'. S~ol cd. · ' isolation: - -~ ...... ~ '~' "°- pfesSu fe/vacuu m/wllt*r and ' st_2~E!.ns te~.: T¢,.st Sr,~rt Time: Initia[ R. eading (R0: 'JTcst End T)mc: Final Reading (R~): ' 're.qt D,.,'atio~: Change in Reading 'P..xss[F~.il Tlare.qhotd: '~- 'res t Result: Comments- (i~wlude informc2rion one. irs mode p,:y,.i_or__t..O .~t$'EC:O.NDAR'¥ PIPE TESTING. ,I, ....... , 'lest 't¥lcthod Developed By: fJ Piping M~)uf~turer d iii Profe,s~onal Engineer ~ Other (Spec~¢ ' ....... '1 · ' Q Pt'essuro ~acuom o ~),drostatlc Tc~t Mctho~ E s~..s. ................. , "~ ~~_ r~ .~.~:~ ~-. ~ ~.~., ..... ~' ' ~ , ~~t :~)',",~,',' ¢~;,.~ ...... ~~CC .~~ ....... - {':~',"o,~,.~,','¢5; . , ~ . ...... ~ ..... ,~ - ,. j ...~]?.~.~ents. T, ({~clude ig, fo~,marion oI~ re]~airs ma~rior to ~esti~,~) '-;i't.~t Method Us~: 0 ~eessur~ ~cuum -?;~.g:~:,~; "., 5.~0~~ .... 5. · . I-'ipin~ Diameter: . J '~'t ---' ' ...... Leng~'l~ oePiping Run: I~ .... ~ .... 'Product S~ored: .... Method and location of * Wait time betwe~ applyi.ng .~tarrig/: test: Tes~ Stn~ Time: ..... Tes~ End T~me: " Final A.eadi~$ ~): ..... Test Duro. tion: ...... Change in. Reading ~-~,}: Pass,q/all ThmsNold: " ~ ..... Test Result: Comments -, Orgclude i~..malion on reeaira made yrior to t,~stin:g) .. SUBMERSIBI~g 6 ...... e Other (S~eci~.~ ' ' Test M~hod Uses: O ~..I.easu,'ing l~quipmCn~ TJsed 'fof Ta~tin S~mp Diameter; Sumo Depth: Sump Mamdal: ....... .ti.eight ~'om Ta~lk Top to ~ghest ~$.pen.etrafion: l:{cight f~om Tank TOp to Lowest ~ n ~ . EtectMc~ pen~ratiom Co~didon o.f s~p phor to re, tin ~ Poe,ion of Sump Tested~ .Does turbine shu~ dowm sump sensor detects Dither product _ or water'? Torbine sbutdom response ts system progr~ed for f~t-,~o ~~ : ......... shutdown? · Was fail-saf~ vebfied to be pre~sur~vacuum/Wat~ and ~a~ing ~ 're~t St,.~ Time.: -- -- Ink/at Reading (K,): 'rest Duration: I Pas5.~aiI Tl~oshold: · 'Test Result; '~V~5 ~en.qor removed l~or testing? ................... '~'.9~ sensor properly repl, ced Comments- anctude /Or'motion on rc~aira mode ~t; tq,,m,~ti?W ~ 12[ the resting method does ,or test the enti. re depth o£the, sump, speci£5' how m.ucl~ of the sump w~ t~tcd. Mctkods not entb'e suing ,hould only be used ~the monitoring sy~em provides t~ai}-sa~e turbine shurdom, ~ With. the submersible pump m~.rJng, pls~e thc sensor in. product. (di~i.minating ~or~ ~txovld ~lso bo ptaoed ~ water) The tin hct~,,,een pfaoing the, ~cn~or in product and the turban* ~hutting do~* {* th, response time.. Tlq~ ~hould be do~ irth~ seconda~ containment testing motbod used does not test the entire volume o.Fthe sump. Merited D~,-velopcd By; El Other 6~eci.& ....... .'l.'esx M.~.hod U's¢$: E1 Pr~suro O Vacuum ,l~yd,'ostadc. ~,f.C~u~ng Eq, m~nt LT~d for Tcmtin ~IDC I]DC M~ufactt, rer __ Heioht ~om ~C Bottom to 't-leight eom ~C Bottom to Lowest Electrical Pen~r~tiotl: Condition ofUDC pilor to 'Po~.ion afdC ~e~tc~T Does turbine shut do~m when ~C ~ensor detec~ ei'th~ ~l-nduct or water? .... Turbine ~hutdown response . time~ .... . .. . Is ~,stom programmed for ~.il- Was t%il-~e ve6fi,d to be ~per~3ional7 Wait time betwee~ pressur~acum~tcr and ,ta~i~g 'test: "~ '~"Stm Time: ........ ..... Test E. nd Time: Test Duration: --.-- ,-~ Pas~Fail Tbre.,hotd: ~~~ '--- -- -- Test ~ult': -- '~ ~n~or r~mov~d for W~s ~nser property o~er tesu~ ~ommet~ts- [~'n:t'ude i,~rn.ic~lion on re~air.~ mode pr~or ~o te,~'~i~ ..... ' .~.'th¢ resting method does sot test the entire depth of the UDC, specifF bow much of the UDC was tested. Metkods not enLire UDC should onJy be used bf. thc monitodnB sy.qtcm provides fa.~l-sa.fe turbine shutdown. .1 ~'id'~ tlhe submersible pump cunning, place the sensor in producr-(di.~cri,uinaltirt$ sensors should aJto be placed, k, w~t,..w). Thc thr betwcc, plaoing the sensor in product and tho turbine sllutlmg down i~ I. he, respa'nsc time. This should be done i{' the .?,ec. ondary containment testing mc0tod used do¢,q not test the tnt/re volume of the UDC SUMP T E, ST1-N G ' ' 8, FILL 'RI. SF.,R CONTAINNIENT ~ --~- 'rest Mod,od Developed By: --~l M~u[acturer ~ndust~ Stand~ O Professiona. Eegi~ce.r Test ~e.rhod Uses: U Press~Jre D Vacuum . drost~tic M~amrlng ~t Used for Testing: ~ .Fitl Sum ~ ~Fil. I Sump ~ Fill }tA~pfl- ...... ~eight ~om T,nk TOp to Penetration: Hcqght ~'om Tank'rop to . .Lowest Eteotric~ ~enetro.tion: '~dition of,u.mp 9riot to Po~ion O~ Sum ~ Tested Matcri~: Wait 6 me between applying presm.~r~vacum~water and sD~rt_~p_g test: ........ Test Sta~ Time: Keadin.g ~Rt): .. --' .[ e.,t En Time: Test Dura6on: 'Pass~'~l T~eshold: Test .Resul.t: Is there a sensor in thc sum -~0es th~ sensor ala.m when eiO~er product or water is d~cct~d? W~s sensor removed for Was sensor properly Q Other CSpec¢O Measuring Equipment Used For Spill Box Buck~ Diametor: ~ Bucket DepOt: ~ ) ~ '- time be~een applying pr assure/vacuum/water and ~.~ · regm St~ Time: ln)~ial ~.eadtng Test End Time: Final ~eadi. ng Test Duration: Pas~ail T~eshold: Test Rest.t: Corem.cuts - (include. inJbrmation on repairs made tjrior ro testing.~).__ __ This is a draft document intended fat. public reviow and comment. ~'ot, r in.put i,~ apl)reeLs.ted. ]Please direct any comments regarding' tltis form to: SWKCB ~ST Pro.'am, &ttn: Scott Bacon 100l r' stre~, Box ~44212 Sacramento, CK 95~1.4 Pl~ono: (916) 34t-5873, Fax: (916) 341-5B08 c-mail: bacensOmvp, swrcb, ca. gov · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. [] Agent · Print your name and address on the reverse [] Addressee SO that we can return the card to you. · Attach this card to the back of the mailpiece, Delivery or on the front if space permits." 1. Article Addressed to: Yes If YES, enter ~ BAKERSFIELD MEMORIAL HOSPITAL ~.~0 Q 420 34TH STREET BAKERSFIELD CA 93301 3. Service Type [~ Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 7002 0860 0000 1641 6247 PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-0835 C::] Postage $ , 1::3 r--I ~3 Certified Fee Postmark Re{urn Receipt Fee Here 1:::3 (Endorsement Required) cO Restricted Delivery Fee ~:] (Endorsement Required) nj Total Postage & Fees c:31 Sent To ............ ............. I Street, Apt. No,; I .. ........... .............................. Il City, State, ZIP+ 4 BAKERSFIELD CA 93301 October 3 l, 2002 Bakersfield Memorial Hospital 420 34th Street Bakersfield CA 93301 CERTIFIED MAIL REMINDER NOTICE FIRE CHIEF RE: Necessary secondary containment testing requirements by December 31, ~ON CRAZE 2002 of underground storage tank (s) located at the above stated address. ADMINISTRATIVE SERVICES 2101 'H' Street Dear Tank Owner / Operator, Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 If you are receiving this letter, you have not yet completed the necessary SUPPRESSION SERVICES secondary containment testing required for all secondary containment 2101 'H' Street components for your underground storage tank (s). Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661)395-1349 Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary PREVENTION SERVICES containment components upon installation and periodically thereafter, to FIRE SN=E'W SERVICES * EIII/tI~NIIEHI'N. 8ERVlCES 1715 Chester Ave. insure that the systems are capable of containing releases from the primary Bakersfield, CA 93301 containment until they are detected and removed. VOICE (661) 326-3979 FAX (661) 326-0576 ! Of great concern is the current failure rate of these systems that have been PUBLIC EDUCATION I tested tO date. Currently the average failure rate is 84%. These have been 1715 Chester Ave. I. Bakersfield, Ca 93301 ' due to the penetration boots leaking in the turbine sump area. VOICE (661) 326-3696 FAX (661) 326-0576 For the last six months, this office has continued to send you monthly FIRE INVESTIGATION reminders of this necessary testing. This is a very specialized test and very 1715 ChosterAve. few contractors are licensed to perform this test. Contractors conducting this Bakersfield, CA 93301 VOICE (661) 326-3951 test are scheduling approximately 6-7 weeks out. FAX (661) 32643576 The purpose of this letter is to advise you that under code, failure to perform TRAINING DIVISION 5642 VictorAve. this test~ by the necessar7 dcadline~ December 31~ 2002~ will result in the Bakers~eld, CA 93308 revocation of ,~our permit to operate. VOICE (661) 399-4697 FAX (661) 399-5763 This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Sincerely, Steve Underwood Fire Inspector/Environmental Code Enfomement Officer Office of Environmental Services m r-~ Postage $ r~ r'-i Ce~tifleq Fee (~ Postmark Return Receipt Fee Hem r--1 (Endorsement Required) Restricted Delivery Fee (Endorsement Required) ru Total Postage & Fees S ! Street, Apt. No.; cu~ s.te, z~KERSFiELD CA 93301 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, or on the front if space permits, 1, Article Addressed to: BAKERSFIELD MEMORIAL 420 34TM STREET BAKERSFIELD CA 93301 Service~¥pe ~] Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes ~ 7002 0860 0000 1641 7213 102595-02'M'0835 PS Form 381 1, August 2001 Domestic Return Receipt October 21, 2002 Bakersfield Memorial Hospital 420 34* Street Bakersfield, CA 93301 CERTIFIED MAIL FIRE CHIEF ~oN F~AZ~ NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield. CA 93301 R~: Failure to Submit/Perform Annual Maintenance on Leak Detection System VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES Dear Underground Storage Tank Owner: 2101 "H' Street Bakersfield, CA 93301 VOICE (661)326-3941 Our records indicate that your annual maintenance certification on your leak detection FAX (661) 395-1349 system was past due on September 6, 2002. PREVENTION SERVICES FSaES~mSelWlCES.EIh'IROI~BIT~.$E~'I~£S YOU arc currently in violation of Section 2641(J) of the California Code of 1715 Chester Ave. -- ~,-. -- l~emdat;on S. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 "Equipment and devices used to monitor underground storage tanks shall be installed, calibrated, operated and maintained in accordance with manufacturer's instructions, PUBLIC EDUCATION 1715 ChesterAvb. including routine maintenance and service checks at least once per calendar year for Bakersfield, CA 93301 operability and running condition." VOICE (661) 326-3696 FAX (661) 3260576 You arc hereby notified that you have thirty (30) days, November 21, 2002, to either FIRE1711NVESTIGAT1ON5 Chester Ave. perform or submit your annual certification to this office. Failure to comply will result Bakersfield, CA 93301 in revocation of your permit to operate your underground storage system. vOiCE (68~) 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. Sincerely, Bakersfield, CA 93308 VOICE (681) 399-4697 FAX (661) 399-5763 Ralph Huey Director of Prevention Services Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services cc: Walter H. Port Jr., Assistant City Attorney 01/07/2003 10:48 GG1327580G BMH ENGiNEERIN PAGE 02/05 MONITORING SYSTEM CERTIFICATION For Use ~y All Jurisdictior~s Within the ~tata of Col~ornia . AuthOr[~ Cited: Chapt~ 6. L ~th and ~a~ Cod,; Cha~t~r 16, Div~'ion 3, Tit&23, Cul~ornia Code of R*~lation, 2~lis fo~ nest be used to do,meat t~t~ ~d se~ic~g of monitorhg equipment. & $cp~ate ce~ificafion or report mu~t be p~ed for each monitor,s system coati p~el by ~e tec~ici~ who peffoms ~e work. ~ copy of this foe m~t be provided to "~ t~ system owns/operate'. ~e omer/operator must submit a copy of ~is fomx to fl~e local agency r~gulat~ UST systems with~ 30 days ofte~ date. A. General Iafomafou Fu~fli~ God,mcr P~son: ~_~.~ COn, Ct Phone No.: (~! ) 3R~~ ~-~~ Mak~odei of Mouitm'~g System: 0~ -~&~t~ ~&~- ~l Date ofTest~S~wich~g: /~/O / 0 ~ B. Inveuto~ ol' ~quipmeut Tested/Certified Check thc appropriate boxta (o inBiOte ~pecific equipm~ut i~p~ct~/servlced: Q ~-T~k Gauges Probe. Model: ~ In-T~ Oaughg Frobe. ~dei: ~ Anuul~ Space or Vault Sensor. Modet: ~._~h ~ ~ ~u[~ Space 0r Vault Set, or. Mod~l: Q Piping Sump / Trenc~ Scmor(s). Mod~l: Q Piping Sump / TmnO S*nsor(s). Mod,l: ~ Fill Sump Sensors). Model: D Fill Sump ~ensor(s). Model: Q Mech~ic~ Line l~ Detector. Model: ~ M~ical ~, L~ D~mclor. Model: ~ Eiec~oaic L~e Lt~ Dete~or. Model: D Ele~onic Line Le~ D~emor. Mod~l: D T~k 0wtfill / Hi~-Levei $~sor. Mod~l: ~ ta~ 0veffill / Hi~-~y~ S~sor. Mod, l: D Other (~p~oi~'.~quipmenl ~p~ ~d m~¢l ~ Senior E oa Page 2). ~ O~r ~specl~ equip~em type and modal h~ S~fiol~ ~ uu Pag~ 2). Q In-T~ Oaughg Pro~, Model: Q [n-T~ Oaugmg Probe, Model: ~ ~mul= Spac~ or Vault Sensor. Model; ~ ~-- ~ ~ _ ~ ~nul= Spac~ or Vault ~unsor. Model: O Pipes S~lp / Trod{ S~lsor(s). Model: ~ Piping Sump / T~ch S~uso~m). ~ode[: ~ Fill Sump Se~o~$). Model: ~ Fitl Sump Sen~o~s). Mod*l: . Mmhauiml L~ Lc~ Detector. Model; ~ Mech~ic~ Lin~ L{ak Detector, Model: ~ El~onio Lin~ L~ D~tc~lot. Mod~l: ~ Elec~onl, Lin~ L~ D~tuc/or. Mod~l: ~ T~¢ 0veffill / Hi~-Lewl Sensor. Model: ~ T~k Overfill / ~gh-Level S~sor. Modcl: ~ 0~er (specify ~uipm~nt ~pc ~d mod~l in Section E on Pose 2). ~ O~er (spec~ equipmeut ~p~ ~d model in Senior B ou Page 2). D~pcn~er ID: ~ / ~ ;. Dispenser ~: ~ Disp~mor Containm~t S,nsor(s). Model: ~ Disp~r Oonta~mmt g~n~s). Model: a 8~e~ Valve(s), ~ Sh~ Vdw(s). ~ Disp~se[,Cont~ment Float(s) md ~h~(,). , ....... -. ~ Dispenser Gon~i~ent Flo~s) ~d Chaiu(s)., ' ~ D[~eaq~ Conla~t Sensors). Model: O Dispens~ Conta~eut Seuso~). Model: ~ Shl~ Valve(s), ~ Sh~ Valve(s). Dispenser ID: Dispenser ID: ~ Disp~sor Contai~mmt Senso~s). MOdel: ~ Diaper Cont~mmt S~nso~s). Modal: Q Shea' Valve(s). ~ Shear Valves). ~Dispe~ Conminm~nt Floats) md Ch*h(s). ~ Dispenser Contuinmunt FloaKs) md Cha~(s), *If tM h~tiB' ~nt~us mor~ ~ or ~spen~rs. ~py t~s lots. Include iMom~ation for ~c~ ~ md disp~s~ at th~ f~ili~. C. Ce~ifieatiou - I certify /t~at the ~uipment identified in th~ document was inspected/servic~ in accordance with the manuhctur,r~' guideline. Attached to ~is C,rtification is information (e,g. manufacturers' cb~ckU,~) ume~ma~ to verify that this information is correct a~ s Plot P~n showing the layout of monitoring ~uipmmnt. YOr ney equipment capabl, of g~u~rafing mu~ r~por~, I have also att~ch~ s copy of the repori; Check ali tha{ ~p&): ~ Sys~*t-up ~ ~ ~]ar~tory ~po~ '~ite Ad~s: ~O0 ~ q~ _~ ~~~4.0~ ~ Date of Teatin~ge~ic~g:~ Page 1 of 3 0~/01 ~onitoring System Certification 01/07/2003 10:40 GG13275BBG BMH EHGINEERIN( PAGE 83/05 D. Results of Testing/Se~icing So~v~e Version ~sta~ed: ~ / ~ ~omplete the tbllowln~ checklist: mm ; ...... Yes ~ No* I ~e ~dibl~ ~'m operational? ' .~ Yes '~ No* Is ~e visual ala~ operational? ' ~Yes Q No* We~ all senSjf~ visually iapeci~d, functionally tested, anJ conf~ed 0~oragonal? - -~ Yes ~ No* Were sll sensors installed at lowest peat'of secon~ ~ntainm~n{ and positioned so ~at o~ equipm~t will not httcr~cr¢ wj~ thuir proper ~¢mtio~? ~ Yes ~ No* If ala~s ~e relayed to a remote mo~itor~' s~tiou, is all commlmioaio~ equipment (~.g. ~ N/A opsrational? ~ Yes Q No* For'pres~ized pip~ 'systeas, do~s ~¢ arbi~o automatically Shut down ~ the pip~g se~ ¢oatai~ont ~ N/A moa[or~i system detoc~ a 1~, fails to opcrato, or is sl~ctrically disconnect? If yes: which sensora initiate posiUve shut-down? (C~e¢i all/~ apply) ~ S~lp/T~n~h S~som; ~ Disposer Conta~¢nt S~sol's. Did you conf~ positive ~ut-d~n duo to le~s ~d se~or failur~disco~ecd~? ~ Yes; ~ "Q 'Yei ...... ~' 'N~~- For t~ syst¢ms aa~ utili~ tho monitoring sysm~ ~ ~o p~ t~k overfill w~ag device {i.e. no ~ N/A mcchadcal owrall prevention valve is ~tallod), ~ ~e ove~ll w~g alum visible ~d audibk at the fib po~t{s) ~d opeating properly? If so, at what ~rcs~t of ~k capaci~ does ~o ~ ~i~r? a Yos* ~ No Was any monitoring equipment replaced? if~es, idenU~ specific sensors, pro~s, or o~¢r equipment ~plac~ ~d list ~e m~ufact~er n~e ~d model for ~ ~placement p~s j~ $~tion ~, below. ~ Yes* Q "~o' ' Was ~quid fo~d ~side ~y secondary"~ontaiauent systems ~si~ed as dry systems? (Ch¢~i ~J~ ~ Product; ~ Water. If yes, describe causes ~ Section ~, below, ~ Yes a No* Was monitoring s~siem s~Fj,p revi~d to e~u[~ Proper seaiQis? A~ach set up r,po~ts, if ap~l?abl¢ ~ YeS Q No* Is all monitor~g equipment ope~atio~l per m,~uf~ur~'s spscifca6o~i~{ ' * ~' ~*~' ~ ~ .... ~'~;~' ~"-; ~-~ '"~nthee deficienei~ were' ' or will be correct~d'. ...... '"" '. Comments: Page Z of 3 03/01 81/87/2883 10:48 GG1327580G BMH ENGINEERING PAGE 84/85 F, In-Tank Gauging / SIR Equipment: o Ch~ck ~hi: box ifta~ g~ug~ i~ used o~y for hwcato~ consol. Check ~s bo~ if no tank ~au~ing or S~ cq~pment ~s section must be completed if in-t~ gauging cq~pm~nt is used to p~rform lc~ detcc~on monitoring. Complete ~e following chea~ist: ~ Yes. ~ No* Has all ~put w~ing been inspected for pro,er ent~ and teau~afion, McludMg tea~ng for ~o~d ~ Yes ~ No* Were all t~ gaug~g probes V~ually ~aPe~ed for d~age ~d r~iduo buildup9 O Yes ~ No* Was a¢ouracy 6~ system product level read'ga tested~" ~ Yes ~ N°* W~e a~ probes ~eMa~ll~d properly9 ....... O Y~ O No* W=r~ ~i~'l't~'~ ~ ~ equipment manufacturer's mainte~ checklist c6mpleted? "' G. ~i~e Leak Detectors (LLD): '~ Cheek ~is box ifLLDs ~ not Mstalled. Corn )late the followiug checklist; O Yes O No* For equipment s~-up or a=~l ~aipmcnt cen/fica~on, w~ a le~ $~ul~t¢~ to vori~ LLD ~ Yes ~ No*. We~'aB'~b; ~$~f~ed opora~ional'aad acc~ate with~'~gula~o~ requ~ement$? ~ Ye: ~ Ho* W~ ~¢ ~$t~g appar~ properly ¢alibntod? '" ~ Yes ~ ~o* For mech~l~l LLD$, do~ tho ~D rea~ict'~todu~ flow i~t ~ete¢~ ~ 1~? -- ~ N/A ~ Ye~' O No* For elecwon~c LLD~, does the ~b~e a~t~matically shut o~if~c LLD dete~"a le~7 ~ Yc~ O ~o* For vl*v~onlc LLDz, dov~ ~v ~ au~omatlc~ly ~Ut'~ff ff ~ny po~o~ oi'~= mo~tormg ~ ~ N/A or &sco~ected? ~ Yes ~ No* For el~c LLDs, doe~ the' t~rbine automatically"shut off if any p~on of the moni:or~g syste~ ~ Yes ~ No* For elec~onic ~Ds, have ~1 aCCeSsible w~Eg co~cti0~ be~ v~ua~y ~p~cted? O Ye~' ~ ~o* Were ~ item~ on the cquipm~t ~'~fac~rer's mz~t~c~'~e~i~t completed? * In the Section H, bc]ow, d~cribe how and when the~e deficiencies were or wi~ be corrected. II. Comments: Page 3 0f3 o$/oi ~ 01/07/2003 10:48 GG13275806 BMH ENGINEERING PAGE 05/05 Monitoring System Certification UST Monitoring Site Pla Date map was drawn:/0 / D /~, Instructions If you ak~ady have a diagr~ ~t 0bows all required iafo~ation, you may include it, rather ~ ~i~ page, wi~ your Monitoring Sy,tem Ce~ifiea~ion. On your site plan, ~how ~, g~neral layout of mt~ ~d pip~g. Clearly identify locations of ~o follow~g equipment, if in,tailed: monitoring system consol panel~; sensor~ ~offitor~g t~ mmul~ spaces, s~ps, dispe~ser p~s, spill containers, or o~er secondly contaiment ~oas; m~ch~ical or elec~o~c line le~ detectors; and in-tank liq~fid level probes (if u~,d for loak detection). In ~ ~pa~ provided, note ~e dato ~ia 8[to Plaa ~ ~a~ prepared. Page ~ of~ 05/00 Y 01/07/2003 10:57 6613275806 BMH EHGINEERIN PAGE 02105 MONITORING SYSTEM CERTIFICATION For Use By All jurisdictions Within the 3'rate of California · Authority Cited: Chapter 6. 7, f-~alth and Safety Cod6; Chapter 16, Division 3, Title 23, Califbrnia Code of R~gulationz This tbl~a must be used to document testing and servic~g of monitoring equipment. A separate certification or report must be p~ed for each monitoring_system control paue! by the t~r. imiclan who perfonns thc wo~Yk. ,A. copy ofthb form must be providad to "m'~ tank system owner/operator. The owner/operator must submit a espy of this form to the local agency regulatL~g UST wfttlia 30 days of test date. A. General Information Fa¢iliryNam~: ta~'~.O!~',! ~ fi", J-I-O~Ot"'i'~l,,. _._ Site Address: d/t~a '~q"r]4- -~3_'~ City: ~~i~;g, e3 Zip: Facility Contact Person: ~ ~.,~ O '~-~_--~_ _~._ Contact Phone N0.: (~ I _)_~ll~ ~- 4/'G~'7-' Make/Model of Monitoring System: Ot70'ff. s3 -Oa.si/ol_.ot,, ""gK-f'~T :2. t -~-- Date of Testing/Servicing: /O .!/0 / O B. Inventory of Equipment Tested/Certified Check the ipproprhte boxes to indicate spe¢i§c equipment ?~pectedts~rvl'¢¢d: .r , , ... , ,,, -- ' ~ ' - ' Tank ID: El in-T~n~Using Pr~¢. Model:. [3 la-Tank Gauging Prob~. Model: ~ Annular Space or Vault Serisor. Mo(lo.l: I,ta'~~'-- /~ .'?- ~ A~nul~' Space or Yau~t SenSor. Model: ~ Piping Sump / Trench Sensor(s). Model: ....... UI Piping Sump / T~neh Sensoe(.~). Model: .. ~ Pill S~mp Sensor(s). Model: ~.. I~l Fill Sump Sensor(s). Modal: ~ Me~anical Line Leak Detector. Model: [3 Mechanical Line Leak Detector. Model: El ElectronS; Lin~ Leak Detector. Model: El 15lecteoni; Li~ Leak Detex~tor. Model: ~ Tank Overfill ! I-tigk-Lovel Sensor. Model: .... El Tank Overfill / High-L .evel Sensor. Model: ~ Other (specify equipment VPO a~d mo~} in Se~tion,, E on Page 2).~ ..~1.0~er (specify eq, u, ipm_~t ry~¢ and mode! in Section 15 on Pag~ 2). __ TaakD>: ~ I L"i~,~//- '"' ~r~$~.. TsnklD: El Ia.Ta~k'~aug~ng Prob~. . Modeh D In.Tan~ Qauging Probe. Model: ][[f Annular Space or Vault Sensor. Model~- __~._'~ .'~"' ~ '~ El Annular Spac~ or Vault Sensor. Model; ~ Pipi~ Sump / Trench Sensors). Model; [3 Piping S~mp / Trench $emsoNs). Model: ~1 Fill Sump Sensor(s). Model: ~" [3 Fill Sump Sensor(s). ' Model: Mechanical Line L~ak Detector. Model: ~ Mecl~anic~l Li~e Leak Detector. Model: -~ Biecironic Lin~ Leak Detector. Model: El Bleclronic Ling Lc~k D~tx;~tor, Model: El Tax~ Overfill / High-Level Scr~or. Model: [3 Tank O¥crl;,ll / lailgh-I.~v¢l Sensor. Model: [30thc~ (specify equipment ~¢ and modcl in Secti,on E on Page,2). .. [3~,,Other (sp, ecif¥, e~uiprneat wpe_and model in Section E on P__age 2). -Dispenser ID: ~ [ t~. Dispenser ID: ~1 Dispen~er Co~tainme~lt Sensor(s). Model: El Dispenser Contalnm~t Sensor(s). Model: El Shear Valve(s). IZI Shear Yalvc(s). [3 Dispenser Co~t~i'm~t Float,s) and C~in(s). ,, ~ Dispe4aser Containment Fl,oat(s) and ,Chain(s). -Disps~ser ID: ~d } i~ Dispenser ID: ~ Dispenser Contai~eaxt S'~nso,'(s). Modct: El Dispenser Contail~meut Sensor(s). Model: i~ She. st Valve(s). ~_Disp~enser Con~in,~lent Float(s) t~nd Chain(s). ~ . O Dispensar,,Containme,~t Ftoa~($) md Chah~(~). Dispenser ID: Dispeu~r ID: O Dispenser Coutainmen~ Sen~or($), Model: ~.. f'l Dispen~'t Containment Sensor(s), Model: El Shear rave(s). El Shtar Valve(s). [3Dispenser Cont.~inmeat Float(s) and Chitin(s). El Di~pen?er Containment Float,s) and Chain(s). ,, · If ~e facility cont~in~ more t~nks or diil~nserS, copy this form. Include infommtion for every tank and dispe~ser at the f.~lity. C. Certificadoll - I certif[ th'~f the equipment idcntified in this document wa~ inspectedlse~iced ia accordance with the m,,nuf~cturera' guidelines. Attached to th~ Czrl~catlon is informatio, (e.g. mauufacturers' checklists) necessary to verify thai this reformation is correct ned a Plot Plan sbowiul the layout of monitoring equipmeng For s~y eqe|pmznt capable or' ge~er~tln~ reportsl I have also attached a copy of the report; (check o2l ~1~ ~.vly); [] Syst~m~et-up . ~ A~h~rm~bisto'ry report Page 1 al3 ~3/01 . Monitoring System Cerlificatiou 01/87/2003 10:57 GG1327§88G BMH E~GINEERING' PAGE 83/85 Results of Testin~Servicing $of~ware Yer~ion Ia~H~d: ~ / ~ . ~;omplete ~he I~llowiag cheekier; Yes]~- ~o* Is ~e v~at a~ operational? ' ..... ~Ye, O ~o* Wet;' all senso~ visuall~ i~pecred, fimctio~al?.~iia. ~d co~fi~ed op~tio~al? Yez ~ No* Were aH s~sors iust~led at Lowest po~t of ~con~ contai~ent ~d posigoned so ~t o~ equipment will not interfere wi~ the~ prop~ opera,on? Ye~ ~ No* If al~sae relayed to a retool6 m0nitorins ~tation, is all oommunkaio~ ~uipment (e.~ modem) ~ ~/A operaional? Y~S ~ NO* For pressuri~d pip'~'systems, does ~he ~b~e automatically shut do~ ~ the pip~g ~nd~ cona~eut ~ N/A me,tong syszem detects ~ leak, fails to o~mte, or is elec~ic~ly discounted? If yes: which sensors iu~at~ positive ~hul-dowa? (C~ct ~li t~i ~pp]~) ~ Sump~nch Senso~; ~ Dispenser Conta~ment Sen~o~. Did you ?o~m positiv!..~ut-dow~ due to lea~ and sens~ fail~dh~tion? ~ Yes; ~ No. Yes ~ No* For t~k systems ~la util~ ~c monito~g sysmm as ~e pr~ ~ N/A mcch~i~l ow~[l prevention valve is ~utled), ~ ~e overfill w~ al~ visible ~d ~udible at the ta~ fill point(s) ~d opcraia$ prope~'ly? If so, at ~.~a~c~t of ~k capaci~ docs ~e fll~ ~itler? __. --._.:,.~. Yes* ~ No' Was ~y monitor'S equipment replace? If yes, id~nti~ sp~ific $enso~, p~s, or o~er equipm~t mp~d ~d Iht ~e m~u~c~e~r n~e ~d model for all?placement p~s E Sectio~ [, below. Ye~' ~ No Was'liquid fotmd'~ide ~y secon~~ contaimcnt systems desiin~ ~}~. o Product; O Water. I~?s, d~c~ib~ causc~ ~ Scctlon E, below. ~ ~? O No* W~ monitor~ system s?~}p reviewed to ens~ ~?~? Sa~s? A~h"s~ ~p ~po~, if ~pplicabl~ [~ Y~ a ~*' I~ al! ~}onitor~i ei~i~ment operational plr marcher's specification? In section E below describe how and when these deficiencies were or will be corrected. % Coraments: / .Page il of 3 03/01 81/87/2883 18:57 6613275866 BMH ENGINERINGO PAGE 84/85 IF. In-Tank Gauging / SIR Equipment: 12 Check this box if rank gauging is usod only for ~en~ ~ Ch~ck ~i~ box if no ~a~k gauging or SIR equipm~t ~s ~ecfion must be complied if ~-ta~ gauging equipment is used to p~fform leE( detection mo~tor~g. Com.flete the followiug check,t: O"Yes ~ No*" W~r~ all t~ gau~ prob~ visu~y hspe~d'f~ ~age md r~idue buildt~p?'" ~ Y~ ~ No* "~as aca~cy of sygem p'roduct level ~ad~ test~? 0 V~' ~ NO* Was a~uracy of system water level re~s t~ed? ' ' ~ 'Y% ~ '~o* Were ~ probes re'stalled p~operly? '~ Yes" ~ ~o~ Were a~ items o~ th~ equipm~t m~ufa~'s m~tcn~ce c~t ~ ~ the Sectio2 H, below~ d~ibe how and whe~ thee deficienci~ were or will be corrected, C', Linc 'Leak Defectors ~LD): ~ Check th~ ~ox ff LI,D~ are not ins~lled. Complete the following checMMt: Q Ycs O ~o* For eq~pmen~ s~-up or ~ua[ equipment' Ce~/fic~o~, w~ a le~ s~ulat~ to veri~ LLD '~ N/A [Chec~ ~]~ ~ cp~fy] S~uhted 1~ ~te: ~ 3 ~,p,h,; ~ 0.1 g.p.h; ~ 0.2 g.p.h. -~ Yes ~ No* ~e~ aB ~s coiffed ~rational a~d acc~te"~'ith~ re~lato~ ~- Yes ~ No' W~ ~e t~t~ app~a~s properly eahbrated~' O Ye~" O No* For mechanical LL~s, does ~e LLD ~s~ci pr~uct flow · it det~B ~'le~? O Y~s ~ ~o* For elec~o~c L~Ds, does ~e mrb~e ~tomai~ly ~hut offif ~e LLD demeB a le~' - ' O NOi For e]~o~{~ LLDs, does"~e mrb~e autom~{c~ly ~hut off if ~y potion of ~e moni~rh~g sys~m is disabled ~ Ye~ ~ No* For el~e~o~e LLDs. does the ~b~"~oma~cslly ~ut off if" any portion of ~e monitor~ sys~ ,~ N/A mal~tio~ or fa~s a test? ~ Ye~ ~ No* For elec~onicLLDs, ha~e'E1 ae~ss~le wir~'~ ~o~eefio~ been vhua~y'~pect~? ~ N/A ..... ~- Yes,,[ ~ No* We~ all items Sn'~e equipment m~u~etu~r'~ ma~te~e eheokl~l o~pl~{'~? · ~ the Section ~ below~ describe how and when ihese deficienci~ were or wiB be corrcctod. H. Comments; Page 3 of 3 o~/0J 01/07/2003 10:57 GG13275~86 BMH E~GINEERING PAGE 85/85 1YlOnitoring System Certification UST Monitoring Site Plan Date map was dra~:/0 //0 ] 0 ~. Ins~uctions If you already have a diagram &a~ skows ~11 reqvi~d iMo~tion, you may ~cludo it~ rather than ~is page, with your Mo~itor~g Syst,m Ce~ification, On your site plan, show fl~ g~lleral layout of tat~s and pip~g. Cl~ly lo,atioa, of ~ followi~ equipmeat, if ~tall,d: monitoring ~y~tem ~n~ol pan~l,; ,en~ors monitoring t~k spaces, s~ap~, dispea~or p~s, spill contaia~s, or other ~ondary coataiment area~; m~h~i~l or elec~o~c l~e 1o~ d,t~ctor~; ~d ia-m~ liquid level ~rob,s (if use~ for le~ ~e[ec~ioa). ~ ~he ,pa~ provide, not, th~ date ~is 8it~ Plan /~ prepped. User: RightFAXUser Host: FAX Class: Fax Job: !Q_FSC1 7 06/05/2003 0S:11 661392 PAGE 82/06 For Uza By.111.luriSdi~tiOn~ Wilhin fha $tae~ of Colfornia Authori~ Cited: C~pt~r 6. L Heaffh and,~a~ Cod~; C~pter 16, Division 3, Titl~ 23, Cal~b~ia Cod~ of .R~laeiona This fo~ must bo ~ed to do~ment test~g ~d s~ic~g of mo~r~g ~quipm~$. A sep~ate ce~ification or repo~ must be pr~o~ad for each monitors system con~ol g3~el by ~e t~ician who performs the work. & ~py of this fo~ must ~ provided to floe ta~ system ownorlop~tor. ~e ~/o~rator must submit a copy of ~is form to tl~o lo.al agency regulates UST systems within 30 days of tes~ date. A. General Inbrmaflon B. Invento~ of~quipment Tested/Cer~fied Check tho oppropriate box~ to iedlcste sgcclfle equipment i~pecr~dl~ccd: ~ ln-T~k Gaugi~ P~be. Modah ~ l~-Tink Gauging ~ob¢. Model: [ Annular Space or Vault $c~or, MMeI: ,~~ ~ ~nuI~ SOaoc or Vault 8~or, Model; ~ Piping Sump / ~ 8~sor(s). Modch ~ Piping Sump / Trono~ Saner(s}. Mod~l: ~ P~l Sump $enso~s). Mod~: ~ Fill Sump S~so~sL Model D El~c~nic Linc L~ D~or. Model: ~ El~oie Lioe Le~ D~cmr. Model: ~ Ta~ Ov~fil} t Hi~-L~el 86m~r. Mod~l: ~ T~k ~fill t High-Level $~n~r. Model: 00~r (~ci~ ~m~lWp~Fdmodcl~ 8~!9~ Eon Page 2)- GOacr (sp~i~ equlpment~cmd modclin S~fion Epp~g~). ~ lu-Ta~ Oau~g P~he. Mod~l: ~ Ia-T~k Oauging Probe. ~ ~nular Spa~ or Vault Semqor. Model: ~. ~ ~nnular Spa~ or Vault $~nso~. ~ode{: ~ Pipi~ Sump / Trcu~ 8~nsor{$). Modol; ~ .Piping Sump / T~nuh S~so~O. MOdel: ~ FiB S~p ~s~(s), Mod~{: ~ Fil{ ~mp Senso~s). Model: ~ Mco~ica{ LM¢ ~ Dmctor. Model; ~ Mech~i~t Line L~ Det~r, ~ Ta~ Oveffili / High-~vol Stoner. M~=I; ~ To~ Ove~ll / High-Level Sensor. ~ ~hcr (~i~y equipmcnt~po ~d ~odel.{9 So~i~,~ o~ ~a~ 2). O Othur(sp~ify ~uipm~t~p~and modol}~ ~tion EouPagc 2). ;Dispenmer ID: ~ I ~ . Dispenser ~: ~ Disp~ Contalum~nt Sonar(s). M~oI; ~ Dis~ns~ Cont~nm~[ S~r(s). ~ Sh~r V~w(a). ~ Sh~r Valve(s). U Dispe~r ~n~inm~t Float(s) ~d ~n(s). U Disp~ Containment FlunKs) ~, Ch~n(s? _ . Dbpeuser ~:,_. ~ I ~. Dispenser ~ Dispou$~ Coni~.nm~t S~s~s). Mndel'. ~ Dis~r Container Scnaor(a). U Dispenser CoUChant Flo~) sub Chain(0. ,,,, U DinG.er Con~nmot ~st(s) and ~ ~fi~ Continent 5en~s). Model: ~ Di~ Cont~nm~t S~so~s). Model: ~ S~ Valve(s). ~ Sh~ ~Dispen~r Con~inment Float(0 ~d ~aln(s). . ..... ~ Die. set ~n~nmcnt Float{s).~d ChaiB(a). .._ *if~h~ ~aci[i~ con~ ~o~ m~ or'~spe~fi~, ~py ~[s fo~. Include info~tlon for ~cw'~k ~d dispenser at ~c facility, C. Ce~ifics~on - Iceaify that the equipment idotified in thb document was tnspec~dlse~ked in accordance wi& manufacturers' guideline. AHached to this ~ificagon b informa~on (e.~ man~a~ureri' ~ecklb~) ~ssa~ to verify that information i$ correct and a Plot ~lsn sheens the layout of monitoring equipm~t ~or shy equipment ~p.ble of generating such rep0r~, I have also a~ehed s c~y of the reporq (~e~ all tknt n~p~): ~ Sys~et-up . ~ Al~r~to~ repo~ Page I of 3 05/01 Monitoring System Ce~ificafiou 06/05/2009 09:11 6613'92~! PAGE 03/06 D. Results of Testing/Servicing software Version Installed: .___, ,ffi~ ~ ~ Complete the followi.[~ checklist; es ~ ~o* ~s ~e ~dible al~ opera,anal? -- ~ Yes ~ No* Is the visual al~ opc~ali~'ai? ' ' ~Yes ' D No* W~ all ~so~ ~suall~,,~s~med, fimc~onalJy toned, a~d conf~ed operational? ~ Yes O No* ~m aU sensors inst~led at lowest point o~ieconda~ oon~ment flag Positi0~ed so that other ~ui~ent wi. lC sot inmrfere with their prope~ ~emdonV ~ Yes ~ Nos. If alarms ~ relayed to a r~aote monit~Hai station, is ail'communications 'equ~ment (e.g, m~em) ~ N/A operational? Q Y~s ~ No* Fo,~'p~ss~l~d piping syj~[~xts, does ~c t~ine a~tomaticaliy shut down if the pipins ~[coada~ eoa~i~en~ ~ N/A moifitor~g syit~ dete~ a leak, fai~ to operate, or is elcc~cally discovered? If yes: whl~ scasom initiate ~tJve shat-down? (Cae~t all rf~at apply) ~ Sump~nch Sensors; ~ Dispenser Con~f~e~t Sensom. Did you con~m positive shut~own du~ to I~s and sensor fai]urEdisco~ecfion? ~ Yes; ~ No, Q Y~ Q No* For t~k s~s~as tha utilize thc monitoHng syst~ ~ the pr~ t~k ove~ll w~g devi~ (i.e.' no ~ NIA mcch~ical overfill prevention valve is installed), is the ove~ll wamin~ ala~ visible and audible at the ~nk fi~ po~s) and ope~g partly? lfso, at wha p~t of~k ~acl~ d~s the al~ Wi~er? % ~ Y~* ~ No Was ~y monitoring equi~ent repl~[g? If yes, ident~ Specific ~nsors, ~obe~; or o~er cquipment repined ~d list ~e m~ufac~er n~e and m~e] for all r~placement para in S~tio~ E, ~low. '~ Yes* Q No W~ liquid '~dxind ~sidc any seconda~ ~tai~eut SYstems ~i~d ~ d~ s~tems? (Ch~i all that ~PPM ~J~ ~ P~oduc~ ~ Wa~r, If yes, dcs~be ca. es ~ S~don E, below. ~ Yes ~ No* Was moni~orin$ system ~t-~p revie~e~ ~o ~re proper seeings? A~ set up repo~, jf a~p!icable ~ Yes ~.__.~_..~No*" ~ ~.1 monitoring equipme~o~rat!on~ p~ m~u~ca~r's speci~ons? ' ' ...... and when ~ese deficiencies were or will be corrected. ~. Comments: Page 0~/05/200@ OB:ll 6613B2~1 PAC~E 04/0~ F: l.n-Tank Gauging / SIR Equipment: c~ Check this box if tank gauging is used only for hw~ntory control. ~ Check this box if no tank gauging or SIP. equipmvnt i.n inetalled. This sect[on must be completed if in-tank gauging equipment is used to p'~rform leak detection monitoring, Complete the following checklist: ~ yes' Ci lie* Has all input wiri~ been btspectod fo~'proper entry 'and termination, includit)g testing for groun~l'~auits? -- ~ Y~s [] No* Were all tank gauging probes visually inspected for damage and residue buildup? " ~ Yes Cl Ilo* Was accuracy of system product level r¢~ings tested? '" ~ Yes ~ Ilo* Was a~lir'dcy of system wate~ i'~vel readings test~ '" [] Yes Cl No* Were'all probe~ }einstalled proper]'~? L~ Yes ~ bio* Were all items on Ibc eqUiPment manufacturer's"~aintenanc¢ checklist completed? * In the Sectioa H, below, describe how and when thesc deliciencle.$ were or will be corrected. G. Line Leak DeteCtors (I.,LD): ~ Check this box ifLLDs are not installed. Complete the following checklist: ia Yes ~"~Io--i For equipment start-up or annual equipment ~crtification, was a lank simulat;d to vcril~ LLD p~'rformance{' '~ N/A (C3~ck ail that apply) Simulat~loakrat¢; ~3g.p.h.; ~10.1 g.p.h; ~ Yes ~ No* Were ell LLDa confirm~l operatiollal and accurnt~"within regulatory re~tirements? [] Yes ~ No* Was the testing apparatus p~operly oalibrated? ........ ~1 Y~ ~ No* For mechanical LLI~s~ 'd~ca the LLD rcatri~ prodti'~'~ flow if it detects a'16~? ........ ~ N/A ~] Yes ~ No* For electronic LLD-~, do~ the turbin~-~utomatically ~bot off if tl{'~ LLD d~t¢c~ a leak? .... ~ Yes ~ No* For cl~¢troaic LUDs, do~ th'~ lurb{n¢ automa~eaHy ~t off if atly porlion o£th~ ~nitorh~§ ~j~s~¢m i$ ~l'i~abled ~ N/A o~ di~onn~ct~? ~ ~f~s ~] No* For electronic LLD~, c~es ~h~'l~r~ne automa~ally ~hut off"if any port{on of th-~' monitoring ~ys~m ~ N/A malfunctions or fa~]s a ~ Yes ~ No· ]For ele~r~ie LLDs, haw all ac~sil~l~ wiring connections been vi-~ually i~p¢ctcd? ' ' ' ~N/A * In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 02/01 06/05/2003 09:11 66139 i PAGE 05/0B ~onitoring System CerUflcatton UST Monitoring Site. Plan :::::::::::: ::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ........... ~' ' ' ~'::::: :" ~" -0' '::' "0 =~ ..... ........... ~~ ....... u ......... --~ '~~s.~ · ::::::::::::::::::::::::::::::::::::::::::::::: Imtmcfions you almay have a diem ~at shows all required in~nuation, you may include i~ rgher than ~is page, wi~ your Moni~ring Sy~em Ceaification. On your site pl~ show thc general layout of tanks and piping. Clearly ide~i~ lomtions of th~ ~llowing oquipmenh if imtalled: monitoring ~,tem tonal pan,B; ~onsors monitoring t~k s~cos, sumps, disp~sor p~, spill conmiucm, or oth,r s=conda~ containment areas; mechanical or ele~onio linc det~tors; and in-tank liquid level pmb~ (if reed ~r le~ dete~ion). In ~he ,pace provide, note~e d~e ~s Sim w~ pmpamd~ Pa~e ~ of ~ o~oo 06/85/2083 89: ll 661~39 i PAGE CI~ OF BA~F~ O~ICE OF ~RON~NT~ SER~S APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION . .__~.~ ~,~.. /-~,~ ...................... . .... .]un 05 03 10:5;~a FI FIR/~JESTSTRR (5.= '7'7-0106 po 1 .]UN 05 2003 9~06 9KSFLI) FIRE PREVENTION (6G1)852-2]72 p.1 CITY OF BAKEKSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave~, Bakersfield, CA (661) 326-3979 ¢..., C0 [ - 3'Zo -o~-'-74.,. /:"~ ~ APPLICATION TO PERFORM C TnUC T OS ~D~SS /~,. ~_J,O/o,~. ~" OWNE~ NAME ~' DOES FACILITY HAVE DISPI~X~I~ PANS? Yp.~__ NO T~, voLv~ com~rs. APPROVED BY DATE SI(}NATUR]/OF APPLICANT MONIT NG SYSTEM CERTIFIC ION For Use By All Jurisdictions Within the State of California AuthoriO: Cited: Chapter 6. 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring 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 must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: .,,%4'~¢k,&O{O~l i/X ~ ~t'O'~p/"/"~, Bldg. No.: Site Address: ,g./' "~ o '~ q '7"/4- '~ "/- City: /~~/~'/., O Zip: Facilits' Contact Person: [::~ O ~ Contact Phone No.: (~(~l ) 3O, h'" MakeAVlodel of Monitoring System: 01./0'~'..O -C~AJ~XI& '""l~&~. - ~2. I Date of Testing/Servicing: /0 / B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced: ~ in-Tank Gauging Probe. Model: t-I In-Tank Gauging Probe. Model: ~8~ Annular Space or Vault Sensor. Model: bO..~'~"- /'~ .~ ~ Annular Space or Vault Sensor. Model: [] Piping Sump / Trench Sensor(s). Model: FI Piping Sump / Trench Sensor(s). Model: ~ Fill Sump Sensor(s). Model: Fl Fill Sump Sensor(s). Model: [] Mechanical Line Leak Detector. Model: [] Mechanical Line Leak Detector. Model: [] Electronic Line Leak Detector. Model: Fl Electronic Line Leak Detector. Model: [] Tank Overfill / High-Level Sensor. Model: F1 Tank Overfill / High-Level Sensor. Model: FI Other (specify equipment type and model in Section E on Page 2). [] Other (specify equipment type and model in Section E on Page 2). TankH): 1'~Oi k,'~l/'~ ~ ~'~$~., TanklD: Iq In-Tank Gauging Probe. Model: [] In-Tank Gauging Probe. Model: ~t' Annular Space or Vault Sensor. Model: Jj~'~;'f"-' t'~o ~ [] Annular Space or Vault Sensor. Model: [] Piping Sump / Trench Sensor(s). Model: [] Piping Sump / 'French Sensor(s). Model: [] Fill Sump Sensor(s). Model: [] Fill Sump Sensor(s). Model: lq Mechanical Line Leak Detector. Model: rn Mechanical Line Leak Detector. Model: Iq Electronic Line Leak Detector. Model: [] Electronic Line Leak Detector. Model: [] Tank Overfill / High-Level Sensor. Model: [] 'rank Overfill / High-Level Sensor. Model: ~ Other (specify equipment type and model in Section E on Page 2). [] Other (specify equipment type and model in Section E on Page 2). Dispenser ID: ~J/ Dispenser ID: [] Dispenser Containment Sensor(s). Model: [] Dispenser Containment Sensor(s). Model: [] Shear Valve(s). [] Shear Valve(s). [] Dispenser Containment Float(s) and Chain(s). [] Dispenser Containment Float(s) and Chain(s). Dispenser ID: ils _~ ./~ Dispenser ID: Iq Dispenser Containment Sensor(s). Model: Iq Dispenser Containment Sensor(s). Model: [] Shear Valve(s). [] Shear Valve(s). [] Dispenser Containment Float(s) and Chain(s). [] Dispenser Containment Float(s) and Chain(s). Dispenser ID: Dispenser ID: lq Dispenser Containment Sensor(s). Model: [] Dispenser Containment Sensor(s). Model: [] Shear Valve(s). [] Shear Valve(s). IZIDispenser Containment Float(s) and Chain(s). FI Dispenser Containment Float(s) and Chain(s). *if the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification - I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the report; (check all that apply): UI SystR4u~set-up ~ Ala, rm,Jlistory report Teclmician Ned-ne (print):._'~h0,/~ 'li~ ,"7~' : ~::~t,.¢,¢'td _ Signature:. ~//"/~ff_~ff~ Certification No.: C'"o,~p. zLo'-~ OoGT" 07~: i~qSt/l.~'~$8 License N .~'. ~C (,o[ / ~/-,lC) - ~ Oq Testing Company Name: ~lG/;4- '.~.x.YOIte~O.O'/I./!?,o~._ PhoneNo.:((a(~[ )~q,)-.-~>-(a,?q . Site Address: _,d/tOO '~ ~"t'~ _~'7'F-- ~'l~~"/~/~O-- Cd- Date of Testing/Servicing::/O--/O,"O~ Page 1 of 3 03/01 Monitoring System Certification D. Results of Testing/Servicing Software Version Installed: jkJ / Complete the following checklist: ~ Yes ' [] No* Is the audible alarm operational? ~ Yes [] No* Is the visual alarm operational? 'J/~Yes vi No* Were all sensors visually inspected, functionally tested, and confirmed operational? C~ Yes [] No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? [] Yes [] No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) ~ N/A operational? [] Yes [] No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary contai~m~ent ~' N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) [] Sump/Trench Sensors; [21 Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 121 Yes; VI No. [] Yes [] N'o* For tank systems that utilize the monitoring system as the primary tank overfill warmng device (i.e. no ~ N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? % IZl Yes* ~ No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. [] Yes* [] No Was liquid found inside any secondary contaimnent systems designed as dry systems? (Check all that apply) ~}I~A/]~ [] Product; VI Water. lfyes, describe causes in Section E, below. ~i~ Yes C21 No* Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable .~ Yes El No* Is all monitoring equipment operational per manufacturer's specifications? * In Section E below, describe how and when these deficiencies were or will be corrected. E. Conlmeuts: Page 2 of 3 03/0l F. In-Tank Gauging / SIR Equipment: Cl Check this box if tank gauging is used only for inventory control. ~ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: [] Yes [] No* Has all input wiring been inspected for proper entry and tenninatmn, including testing for ground faults? [-1 Yes [] No* Were all tank gauging probes visually inspected for damage and residue buildup? 121 Yes [] No* Was accuracy of system product level readings tested? VI Yes [] No* Was accuracy of system water level readings tested? [] Yes [] No* Were all probes reinstalled properly? ~ Yes [] No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H below, describe how and when these deficienmes were or will be corrected. G. Line Leak Detectors (LLD): ~i~ Check this box ifLLDs are not installed. Complete the following checklist: [] Yes [] No* For equipment start-up or mmual equipment certification, was a leak simulated to verify LLD performmxce? '~1 N/A (Check all that apply) Simulated leak rate: 121 3 g.p.h.; [] 0.1 g.p.h; Vi 0.2 g.p.h. [] Yes Vi No* Were all LLDs confirmed operational and accurate within regulatory requirements? ~ Yes ~ No* Was the testing apparatus properly calibrated? [] Yes [] No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak'? ~ N/A [] Yes [] No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ~i~ N/A [] Yes [] No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled q~ N/A or disconnected? [] Yes [] No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system ~1 N/A malfunctions or fails a test? [] Yes ~ No* For electronic LLDs, have all accessible wiring connections been visually inspected? ~ N/A [] Yes [] No* Were all items on the equipment manufacturer's maintenance checklist completed? ~ In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 03/o~ Monitoring System Certification UST Monitoring Site Plan ............ : .................~~~ ~0 .......~,L'" ....... ........... .......... , ........ ..... ....................-- ~ ..... ~- ~ ....... ~ sV~o.~ - ........... ~' s~ · Bo~_~ ..... ~.~~ '~ ......... ~t~ m~p w~ &~wx~:/0 //0 / 0 ~. Instructions If you already have a diagram that shows all required information, yon may include it, rather than this page, with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date fl~is Site Plan was prepared. Page ~ of q 0~/00 11/15/2002 12:40 66132?5806 BMH ENGINEERING PAGE 02/05 MONITO NG SYSTEM CERTIFICATION For Use By All Jurl~d~et~ons ~/th~n the ~tate of Cal~ornla .4~tthori~ Cite& Chapter 5. 7, Health and Saf¢~ Co~; Chapt~ 16, Division 3, Titl¢ 2~, Cal~ornia Cod¢ of R~latlo~ ~is rolm must be used to docum~t Iesthg ~d s~vic~g of monitor~g ~quipm~t. A s~parat~ ce~ificat[on or rcpo~ mt~t be ~mp~d fo: ~sch m~tor~ syst~ ~neol panel by ~c toc~ici~ who pcrfo~s ~e work. ~ oopy of~is fo~ mu~ be pmvid~ ~ the t~ system owner/operator, The owner/operator mus~ submit a copy of~is fo~ ~ ~o local ag~cy regulat~ UST systems wi01~ 30 days of test date. A. General Information Facili~ N~: ~ ~ 0~1 ~ ~ ..~ ~ ~ '~ldg, No.: SJ~Ad~ess:~..~ ~~ ~ CAW: ~~ Zip: FacHi~ Contact Person: ~_~.~ Contact ~ono No.: (~1 )3~' ~e~- M~odel of Monttor~g Systom: 0 ~ -~ ~ t ~ ~ ~A~- ~ t Date of Tes~$e~[c~g: /~./~0 / 0 ~ B. Invento~ of Equipment T~te~Ce~ied _ Check ~he ~ppl'opriat~ boxes to in~ka~e ~p~eific eq~pme.t [n~pee~ed/see~6etd~ ................. . ~ ~-T~k Giu~ Prob~. Mod~l: ~ Iu-T~ Glugmg P~Be. Modal: ~ ~ul~ Spa~ or V~ult S~sor. Model: ~- ~_~. ~ ~ul~ Space ar ~ault 8~or. Mod~l: ~ Piping ~ ~ Tl~na~ Sensor(s). Model: ~ Piping Su~ / Trench S~o~). Modal: ~ Fill Sump S~nsor(s). Mod~l: ~ Fill $~p g~s). Modoh ~ Elc~oak Lm~ L~ D~tor. Mod~[: ~ E~e~nic Lin~ Le~ D~e~or. Mod~: ~ T~ 0v~dl / Hi~-L~el Sensor. MOdel: ~ Ta~ 0v~l ~ High-L~v~ S~or. Mod~l: ~ Oth~ ($~ec~ ~u[pm~nl ~p~ ~d model.ia ~on Eoa Pag~ 2).._~ 0mit (s~ ~uipm~nt ~ ~d m~ ~ $~ E on F,~ 2). O In-Ta~C~u~ Prob~. . Mofl~l: ~ In-T~ G~ging Pwb~. Modeh ~ ~ul~ Space or Va~: S~sor, Modal:- ~-- ~ ~ ~ ~ui~ Sp~e or vault S~or. Model; A Pipint ~ump / ~nch Bensor(~). Modal: ~ Pipin~ gump / Tr~h Seaso~s). ~ ~E Sump Se~or(s). Modal: ~ O Fill Sump S~sot(s), Mod~l: Q Mech~ic~l Line L~ De~ctor. Model: O Mech~icg Lin~ L~ ~tor. Mod~: ~ Elecvo~lc Line L~ De,color, Modal: ~ E[ec~oni¢ L~e Le~ Delecwr, Model: O Ta~ Ove~ll / Hi~-Leve[ S~sor, Model: O T~ Ov~fi[l / ~-Leve[ S~r. Mod~l; D O~ (s~c[~' eq~pme~t ~ ~d n~odd in S~tioa ~ on Pag~ 2). O 0~ (sp~ify ~u/9me~t ~ ~d m~al l~ Section E on P~ 2), Dispenser ID: ~ I ~ ._ Dispenser ~; ~ Dlspcns~ Contaimn~nt ~), M~el: O D~s~ Cont~nmmt Sen~). Model: ~ She~ V~ve(s), O Sh~ V~ve(s). 0 D/~e~ Co~ment Sensors). Model: O Dis~ns~ Con~i~ SeroUs). Modol: O Shc~ Valw(s). O Sh~ V~ve(s). O Di~cnser Cont~nm~n~ Float(s) ~U C~(s), O Dispcl~r C~mi~ent Flo~s).~d Cha~(s). _ Dispenser ID: Di~penser O Disp~s~ Conmiment ~s). M~i; ~ Dispcns~ ~amlmn~t S~so~s). Me,el: ODisp~n~r Canminment Flo~(a) ~d C~n(s). 0 Dis~ser ~nminm~t Floa~,s) ~d ~(s). *If ~he f~ili~, con~ more t~ or d~pe~er~ copy ~ls form. Include i~o~ation for ~v~ ~ ~d dispenser ~ ~eYaoili~. C. Ce~fieation - x cea~y ~s~t the equipment identified in ~ document was insp~ted/~ice8 in accordance with mas~ufact~r~rs' ~ia~in~. At, eked to this Certification is i~fformstion (e.g. manufacture~~ che~is~) n~s~ to verff~ ~at informaeon h cerrect ~nd a Plot Plan Showing ~ layout 0t monitoring equipmen~ ~ar any equlpm~t e~pable or g~n~rafia~ r~por~, I haw abe ~aehed a cu~ of the repo~ (~h~ ~! that ~ply): ~ S~s~set-up _~ A~r~hto~ repo~ Tes~C~p~yNam~: RIC~ ff~O/~e~- PhoneNo.:(&~/ ) SiteAd~es~: 4~0 ~ ~~~~-- ~ ...... Da~ofT~stln~Se~lc~g:~ Page I of 3 03~01 Monitorhzg System Certification 11/15/2002 12:48 6G13275806 BHH ENGINEERING PAGE 03/05 D. ~esults Software V~rsionI~ted: ~ / ~ Complete lhe following check,t: ~ Yes ~ Ho* Is ~he'~t~at ~la~ op~a~io}.al? "' ~ Yes ~ Ho* Were all sensors visua~y i~!cte¢ l~ctiona~l~ ~eacd, ~d coflf~ o~ational? ~ Yes ~ No* Were all sensors ~stalled at lowes~ po~i of 5econd~ coflm~eat ~d ~sigoned so ~a ~er equipm~ will- not ~ere wl~ ~e~ proper o~ra~ion? ~ Yes ~ No* If al~s ~e relayed to a remote m~i~oriu~" ~tation, is all ~mmunicatlo~ e~uip~cnt (c.g'. m~em~ ~ N/A op~'atio~l? ~ Yes ~ No* ~or pressurized piping systems; d~'~ ~e m~iflc autoaa~i~lly shut down i~ ~e p~g se~nda~ con~en~ ~ N/A monkor~g ly~[em deiecls a le~, f~ to oporto, or is elec~ically disco~n~ted? I~y~: w~ch ~ensors positive shun-down? (CA~i M/that op~l~) ~ Sump/Trench Sensor; ~ Dispe~s~ Con~e~l Se~so~. Did you con~ posi~y~ ~ul-down due to le~s a~d ~ensor f~l~/~sco~eclion? ~ Yes; ~ ~ Yes ~ No* For t~ sys~ms ~a~ utilize the mo~ito~ system as ~e prim~ t~ ov~gl w~g ~ N/A mech~ical overfill pr~ven~on valve is ~stalled), is thc oveffi~ warner ~m v~ible ~d audible al lhe ta~ fill point(s) ~d operat~ properly~ If so, a~ what percen~ oft~ ~paciw do~ ~e al~ ~i~or? ~ Yes' ~ No Wa ~y mo~kori~g equipment replaced? 'If yes, ide~t~ specific se~r~ prob~, or o~er equipment rep~ed ~d list ~e m~ufac~r n~e and aodei for ~!l?p~acem~t p~s iff Se=ion E, below. ~ Ye~* ~ No Was liquid fo~d ~ide ~y seconda~ cofl~ent syst~ desired ~ ~ ~ystems? (C~ ~ ~ P~du~t~ ~ Water. Ilyes, ~sc;ibe ~uses i~ ~o~on E, below. ~ Yes ~ Nos W~ mo~W~g system se~-up revie~ to ~u~ pro~ se~n~? A~a~h set u~o~, ffapplicable ~ Yes '~ No* Is ali monitorifli equipmeflt operational ~r manu~c~r~s s~c~ca~ous? '" · In Sectiou E below, d~cribe how and when these deficie~ci~ were oF wffi be corroded. Comments: Pnge 2 of 3 / 03/Or 11/15/2002 12:40 GG1327580G BMH ENGINEERING PAGE 84/05 F. In-Tank (~auging / SIR Equipment: ~ Check thi~ box if~ ~su~g i~ used only for ~v~to~ consol. ~ Check this box if no ~nk ~u~ or ~IK equipment is ~stal[cd. ~is section must be conipl~ed ifin-ta~ gauging equipm~t i~ used to p~fform Ie~ detection monito~g. Corn ,lete the follow~g checklist: ~ Y% ~ No* H~s ail input wiring ~en ~speo~e~ for proper ~t~ and re. Marion, ~clud~g te~t~g for g%~8 fault~7 ~ ~e'~ ~ No* Were all t~ gaug~g~ro'bes visually i~p~oted tbr d~e ~d r~idue buiM~p? ~ ~s Q No* Was accwacy of sj~t product level rea~ugs tested? .... O Yes O No* Wa~ aco~cy of system water le~el read~g~ te~ted~ 0 Yes ~ ~*- ' -W~'~'~b~s-~e~s'~l~p~rly? ........ ~ Yes 0 'No* Were ~1 it--s on ~e equip~ie~t ~fac~er'$ m~te~c checklist completed? '" , ~ +~ e~.~. ~, below, ~ ~ ~--' and whe~ th~e deficienci~ were or ~[! be corrected. G. L~e Leak Detectors (LLD): ~ Che& ~ box ifLL~ are not Complete the following checklist: ~ Yv~ D No* For eq~pm~t a~-up or ~u~ equipm~al certifivation, was a ~ N/A (Chgck ~1I th~ app,) Simulated l~k rate: ~ 3 g.p,k; ~ 0,1 g.p~; ~ 0.2 g.p,h. ~--Y~ ~ No* Were all LLDs conf~ed operational and a~a{e w~ r~laW~ req~m~9 .......... ~Yes ~ No* W~ ~e mst~g app~ams properly caltbrated? ........... D Y~s D Ho* For mcch~ival LLD~, do~ ~v LLD rca~']~ P~'~c~ flow ff il dv~ a ~ N/A D Ye~ ~ No* For el~o~c LLDs, does the turb~e automatically shut offd~o LLD d~c~ a ~ Yea ~ No* For el~-ffo~v LLD~, aoos ~o ~arb~ auto~a~caly ~hut off ff ~y portion of ~e moaiWr~ Sy~em ~ d~abl~d [~ ~A or ~co~ected? Yes I ~ No* For el~Wonic LLDa, does ~ mrb~e 'automatic~y ~ug off If ~y poffion of ~hz monffOr~g sy~tvm '~ ~A mal~cao~ or f~ a test? D Y~'" "~' No* For etec~c LLDs, have afl accessible wk~g co~tiom b~n vis~i}' ~/A 0 Y~'- 0 No* W~r~ all ~t~ on ~e equ~pmmt mmuf~'~ ma~n~ ~2k~ ~o~pletefl~ * In the Seetio~ H, below, de~cribe how and when these deflcienci~ were or will be corrected. ' .... Page 3 of~ 03/ol 11/15/2882 12:48 6613275886 BMH ENGINEERING PAGE 05/0S Monitor~g System Certification UST Monitoring Site Plan Dae m~ was ~awn: Instructions If you akeady havo a dia~m ~at shows ~1 ~qu/~d intrusion, you may include it, rath~ ~ ~is page, ~ your Monitoring Sy~tom Ce~ificafion. On your ~it~ pl~, show ~e general l~out of t~ ~d piping. C!~17 id~nfi~ loe~ions of ~o ~llowing ~quipm,n~, if installed: monitoring sysmm consol panel,; ~n~or~ monitoring t~k ~ul~ specs, sumps, dispenser pmis, spill containers, or other secondly containment ~eas; mech~lcal or electronic line leak detectors; ~d ~-t~ liquid level pro~s (if used ~r le~ d~ection). ~ ~e space provide~ note ~o date ~ia Site Plan was prepped. Page User: RightFAXUser Host: FAX Class: Fax Job: !Q_HAZl 11-15-2002 14:~0 Fr0m-0ES HQ S^CRA~ENT0 W/C g16-$4Hg10 T-347 P.001/001 F-471 T~ 1319 [ OSPR-[ OES- ~u ~cnsen. [NRc-[OES' 024~l_ 1. ~: 2. AG~CY: 3. PHONE~: 4. Ali,a ~3ome W~o~Ic ~¢1 ~I-327-4~ l. NAME= 1. u~ g~liuc = I0 Oat(=) P~O~ ~ D~CR~I'ION= Ov~ffi of ~ ~er~ouad ~or~e ~nk c~s~ ~ spill ~ CONT~: g. WAT~ ~OLVED: ~ WATERWAY: Y~ No $, ~. ]NC]DENT LOCATION: ~915 N. Ch~4~r Aw b. CITY: e. COUNTYs d, ZIP: B aketsfw, ld Kern Coun~ 933~8 4. INCIDENT DESCRIPTION: a. DATE, II/15/2002 b. TI~'IE (~t~t~t~):04~O o. SITE: SetwiceS~ion d. INJURI~# ~. FATALS #: f. EVACS #: g. CLEANUP BY: 0 0 0 Contraztor Sa~e ae #1.'PER,~)N NOTIFYING S. SUSPECTED RESPONSIBLE PAR~ a. N~ b. AGENCY: e. PHO~: ~ ~.: ~s~ ~ome ~olesale ~el 661-327~9~ e. ~ ADD. S: f. C~: ~ STA~: ~ ~P: ~ Box 82277 B~sfield ~ 93380 6. N~I~TION ~~TION: ~. ON S~: b. O~ ON SCAR: c ~R NOT~: d. ADMIN. AGF, NCY: Balarsfiaid Fu~ D~partmtmt e. SEC, AGENCY: ~ Co. ~nviromm~al Dept f. NOTIFICATION LLS'['~ ~ O~itz RW~I~ Uuiu ~C: I , / 1~-08-202 11 :~SAM FROM RICH ENVIRONMENTAL ~1+39'2+0621 . CITY OF BAKERSFIELD OFFICE OF ENVIRONM~.NTAL SERVICF~ 1715 Chester Ave., Bakersfield, CA (661) 326.3979 APPLICATION TO pERFORM FUEL MONITO~G CERTIFICATION September 30, 2002 Bakersfield Memorial Hospital 420 34th Street Bakersfield CA 93301 REMINDER NOTICE FIRE CHIEF RON FRAZE RE: Necessary secondary containment testing requirements by December 31, 2002 of ADMINISTRATIVE SERVICES 2101 'H' Street underground storage tank (s) located at the above stated address. Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Deal' Tank Owner / Operator, SUPPRESSION SERVICES If you are receiving this letter, you have not yet completed thc necessary secondary 2101 "H' Street ~ Bakersfield, CA 93301 containment testing required for all secondary containment components for your underground VOICE (661)326-3941 storage tank (s). FAX (661) 395-1349 PREVENTION SERVICES Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Health & Safety ~,.~ s.~ms;.v,c~s.a,v.~.~,~s~.v=~ Code) of the new law mandates testing of secondary containment components upon installation 1715 Chester Ave. Bakersfield, CA 93301 and periodically thereafter, to insure that the systems are capable of containing releases from vOICE (661)326-3979 the primary containment until they are detected and removed. FAX (661) 326-0576 PUBLIC EDUCATION Of great concern is the current failure rate of these systems that have been tested to date. 1715 ChesterAv6. Currently the average failure rate is 84%. These have been due to the penetration boots leaking Bakersfield, CA 9.3.301 VOICE (661)326-3696 in the turbine sump area. FAX (661) 326-0576 For the last five months, this office has continued to send you monthly reminders of this FIRE INVESTIGATION 1716 Chester^ve. necessary testing. This is a very specialized test and very few contractors are licensed to Bakersfield, CA 93301 perforlB this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. VOICE (661) 326-3951 FAX (661) 326-0576 The purpose of this letter is to advise you that under code, failure to perform this test, by the TRAINING DlVlSlON necessary deadline, December 31, 2002, will result in the revocation of your permit to operate. 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661)399-4697 This office does not want to be forced to take such action, which is why we continue to send FAX (661) 399-5763 monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services m Postage $ .:l' ru I.rl Certified Fee ru Return Receipt Fee Postmark Here r-1 (Endorsement Required) I'-1 Restricted Delivery Fee r-I (Endorsement Required) I-'1 Total Postage & Fees I'¢1 I Sent To [ akersfield Memorial Hospital ,~ i ~i;~'~'E;,'EF.'~'~:f .......................................................................... ~[o, POaoxNo. 420 34th St r,- ;~i~'~'Gi:.ff~F.; ................... ': ........................................................ · Complete items 1, 2, and 3. Also complete item 4 Jf 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, or on the front if space permits. [] Agent 1. Article Addressed to: 17 r-lYes Bakersfield Memorial Hospital If YES, enter delivery address below: [] No 420 34th St Bakersfield CA 93301 s. ServiceZype -~ Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise []lnsu dMail []C.O.D. 4. Restricted Delivery? (Extra Fee) ""--'~-- ~'- ~-- -- [] Yes 7001 0360 0002 5244 7377 PS Form 381 1, July 199~----'~ Domestic Return ~-- 102595-00.M.0952 September 13, 2002 Bakersfield Memorial Hospital 420 34* Street Bakersfield, CA 93301 CERTIFIED MAIL FIRE CHIEF ,RON ,cRAZE NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 RE: Failure to Submit/Perform Annual Maintenance on Leak Detection System FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H' Street Dear Underground Storage Tank Owner: Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661)395-1349 Our records indicate that your annual maintenance certification on your leak detection system was past due on September 6, 2002. PREVENTION SERVICES FIRE SAFEI~ SERVICES · ENVlRONMENTh[ SERVICES 1715 ChosterAve. You are currently in violation of Section 2641(J) of the California Code of Bakersfield. CA 93301 VOICE (661) 326-3979 Regulations. FAX (661) 326-0576 PUBLIC EDUCATION "Equipment and devices used to monitor underground storage tanks shall be installed, 1715 ChesterAve. calibrated, operated and maintained in accordance with manufacturer's instructions, Bakersfield, CA 9,3.301 including routine maintenance and service checks at least once per calendar year for VOICE (661) 326-3696 FAX (661) 326-0576 operability and running condition." FIRE INVESTIGATION You are hereby notified that you have thirty (30) days, October 13, 2002, to either 1715 Chester Ave. Bakersfield, CA 93301 perform or submit your annual certification to this office. Failure to comply will result VOICE (661) 326-3951 in revocation of your permit to operate your underground storage system. FAX (661) 326-0576 TRAINING DIVISION Should you have any questions, please feel free to contact me at 661-326-3190. 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 oincere~y, FAX (661) 399-5763 Ralph Huey Director of Prevention Services Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services cc: Walter H. Pon' Jr., Assistant City Attorney August 30, 2002 Bakersfield Memorial Hospital 420 34th Street Bakersfield, CA 93301 REMINDER NOTICE RE: Necessary secondary containment testing requirements by December 31, 2002 of underground storage tank (s) located at the above stated address. FIRE CHIEF RON FRAZE Dear Tank Owner / Operator, ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 If you are receiving this letter, you have not yet completed the necessary secondary VOICE (661) 326-3941 FAX (661) 395-1349 containment testing required for all secondary containment components for your underground storage tank (s). SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 Senate Bill 989 became effective January 1, 2002, section 25284.1 (Califomia Health VOICE (661) 326-3941 FAX (661) 395-1349 & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to insure that the systems are PREVENTION SERVICES capable of containing releases from the primary containment until they are detected 1715 Chester Ave. Bakersfield, CA 93301 and removed. VOICE (661) 326-3951 FAX (661)326-0576 Of great concern is the current failure rate of these systems that have been tested to ENVIRONMENTAL SERVICES date. Currently the average failure rate is 84%. These have been due to the 1715 Chester Ave. Bakersfield, CA 93301 penetration boots leaking in the turbine sump area. VOICE (661) 326-3970 FAX (661) 326-0576 For the last four months, this office has continued to send you monthly reminders of TRAINING DIVISION this necessary testing. This is a very specialized test and very few contractors are 5642 Victor Ave. Bakersfield, CA 93308 licensed to perform this test. Contractors conducting this test are scheduling VOICE (661) 399-4697 FAX (661) 399-5763 approximately 6-7 weeks out. The purpose of this letter is to advise you that under code, failure to perform this test, by the necessary deadline, December 31, 2002, will result in the revocation of your permit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Since~., ~ Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services D FIi E July 30, 2002 Bakersfield Memorial Hospital 420 34th Street Bakersfield CA 93301 REMINDER NOTICE FIRE CHIEF RE: Necessary Secondary Containment Testing Requirements by December RON FRAZE 31, 2002 of Underground Storage Tank (s) Located at ADMINISTRATIVE SERVICES the Above Stated Address. 2101 "H' Street Bakersfield, CA 93301 VOICE (661)326-3941 Dear Tank Owner/ Operator: FAX (661) 396-1349 SUPPRESSION SERVICES If yOU are receiving this letter, you have not yet completed the necessary 2101 "H' Street secondary containment testing required for all secondary containment Bakersfield, CA 93301 components for your underground storage tank (s). VOICE (661) 326-3941 FAX (661) 395-1349 Senate Bill 989 became effective January l, 2002, section 25284. l (California PREVENTION SERVICES Health & Safety Code) of the new law mandates testing of secondary FIRE SaJ:E'Pf SERVICES- ENVIRONMENTAL SER~ICE$ 1715 ChesterAvo. containment components upon installation and periodically thereafter, to insure Bakersfield, CA 93301 that the systems are capable of containing releases from the primary VOICE (661) 326-3979 FAX (661) 326-0576 containment until they are detected and removed. PUBLIC EDUCATION Of great concern is the current failure rate of these systems that have been 1715 Chester Ave. Bakersfield, CA 93301 tested to date. Currently the average failure rate is 84%. These have been due VOICE (661) 326-3696 to the penetration boots leaking in the turbine sump area. FAX (661) 326-0576 FIRE INVESTIGATION For the last four months, this office has continued to send you monthly 1715 C~sler^ve. reminders of this necessary testing. This is a very specialized test and very few Bakersfield, CA 93301 contractors are licensed to perform this test. Contractors conducting this test VOICE (661) 326-3951 FAX (661) 326-0576 are scheduling approximately 6-7 weeks out. TRAINING5642 VlctorOlVlSlONAve. The purpose of this letter is to advise you that under code, failure to perform Bakersfield, CA 93308 this test, by the necessary deadline, December 31, 2002, will result in the VOICE (661) 399-4697 revocation of your permit to operate. FAX (661) 399-5763 This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Sincere , ~j~ Fire Inspector Environmental Code Enforcement Officer BAKERSFIELD FIRE DEPARTMENT July 7, 1998 FIRE CHIEF Peter M~CHAEt R. KELLY Armstrong Memorial Hospital ,,aM~NmU. nVES~:~WC~S 420 34th Street 2101 'H' Street Bokorsflold, CA 93301 Bakersfield, CA 9330 1 (805) 326.3941 FAX (805) 395-1349 CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE SI,IPPRESSIONSERVICES TANK LOCATED AT SKILLED NURSING CENTER, 420 34TM STREET. 2101 'H' Street Bakersfield, CA 93301 PERMIT #BR-0211. (805) 326.3941 FAX (805) 395-1349 Dear Mr. Armstrong: PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA93,301 This is to inform you that this department has reviewed the results for the c805) 326.3951 preliminary assessment associated with the closure of the tanks located at the above FAX (805) 326-0576 stated address. ENVIRONMENTAL SERVICES 1715 Chester Ave. Based upon laboratory data submitted, this office is satisfied with the Bakersfield, CA 93301 (805) 326.3979 assessment performed and requires no further action at this time. Accordingly, no FAX (805) 326-0576 unauthorized release reporting is necessary for ti/is closure. 11~AINING DIVISION 5642 Victor Street If you have any questions regarding this matter, please contact me at (805) Bakersfield, CA 93308 C805) 399-,4697 326-3979. FAX (805) 399-5763 Sincerely, Howard H. Wines, III Hazardous Materials Specialist HHW/dlm cc: Y.Pan, RWQCB M. Magargee, HFA D /~'1/~' June 30, 2002 Bakersfield Memorial Hospital 420 34th Street Bakersfield, CA 93301 REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 420 34th Street. FIRE CHIEF RON FRAZE Dear Tank Owner / Operator: ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 The purpose of this letter is to inform you about the new provisions in VOICE (661) 326-3941 FAX (661) 395-1349 California Law requiring periodic testing of the secondary containment of underground storage tank systems. SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93:301 Senate Bill 989 became effective January I, 2002, section 25284.1 (California VOICE (661) 326-3941 FAX (661) 395-1349 Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure PREVENTION SERVICES 1715 ChesterAve. that the systems are capable of containing releases from the primary Bakersfield, CA 93301 containment until they are detected and removed. VOICE (661) 326-3951 FAX (661) 326-0576 Secondary containment systems installed on or after January 1, 2001 will be tested ENVIRONMENTAL SERVICES 1715 Chester Ave. upon installation, six months after installation, and every 36 months thereafter. Bakersfield, CA 93301 Secondary containment systems installed prior to January 1, 2001 will be tested by VOICE (661) 326-3979 FAX (661) 326-0576 January 1, 2003 and every 36 months thereafter. REMEMBER! Any component that is "double-wall" in your tank system must be tested. TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 Secondary containment testing shall require a permit issued thru this office and VOICE (661) 399-4697 FAX (661) 399-5763 shall be performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (661)326-3190. Sinc¢~ Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Environmental Services SU/kr D May 29, 2002 Bakersfield Memorial Hospital 420 34th Street Bakersfield, CA,93301 RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 420 34th Street FIRE CHIEF REMINDER NOTICE RON FRAZE Dear Tank Owner/Operator: ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 The purpose of this letter is to inform you about the new provisions in California VOICE (661) 326-3941 FAX (661) 395-1349 Law requiring periodic testing of the secondary containment of underground storage tank systems. SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 Senate Bill 989 became effective January 1, 2002. section 25284.1 (California vOiCE (661)326-3941 Health & Safety Code) of the new law mandates testing of secondary containment FAX (661) 395-1349 components upon installation and periodically thereafter, to ensure that thc systems PREVENTION SERVICES are capable of containing releases from the primary containment until they are 1715 ChesterAvo. detected and removed. Bakers[ield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 Secondary containment systems installed on or after January 1, 2001 shall be tested upon installation, six months after installation, and every 36 months thereafter. ENVIRONMENTAL SERVICES Secondary containment systems installed prior to January 1, 2001 shall be tested by 1715 Chester Ave. Bakersfield, CA 93301 January 1, 2003 and every 36 months thereafter. REMEMBER! ! Any component VOICE (661) 326-3979 that is "double-wall" in your tank system must be tested. FAX (661) 326-0576 TRAINING DIVISION Secondary containment testing shall require a permit issued thru this office, and 5642 Victor Ave. shall be performed by either a licensed tank tester or licensed tank installer. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (661) 326-3190. SincereK,, Fire Inspector/Environmental Code Enforcement Officer SBU/kr enclosures D April 17, 2002 Bakersfield Memorial Hospital 420 34th Street FIRE CHIEF Bakersfield CA 93301 RON FR~E ADMINISTRATIVE SERVICES RE: Necessary Secondary Containment Testing Required by December 31, 2002 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 REMIND'~R NOTIC'I~ SUPPRESSION SERVICES Dear Tank Owner/Operator: 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 The purpose of this letter is to inform you about the new provisions in California law FAX (661) 395-1349 requiring periodic testing of the secondary containment of underground storage tank systems. PREVENTION SERVICES 1715 ChesterAve. Senate Bill 989 became effective January 1, 2002. Section 25284.1 (California Health & Bakersfield, CA 93301 VOICE (661) 326o3951 Safety Code) of the new law mandates testing of secondary containment components FAX (661) 326-0576 upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary containment until they are detected and removed. ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 Secondary containment systems installed on or after January 1, 2001 shall be tested upon VOICE (661) 326-3979 installation, six months after installation, and every 36 months thereafter. Secondary FAX (661) 326-0576 containment systems installed prior to January 1, 2001 shall be tested by January 1, 2003 and every 36 months thereafter. TRAINING DIVISION 5642 Victor Ave. Bakersfield. CA 93308 Secondary containment testing shall require a permit issued thru this office, and shall be VOICE (661) 399-4697 FAX (661) 399-5763 performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at 661-326-3190. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/dm enclosures CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 Section 2: Underground Storage Tanks Program [] Routine [] Combined [] Joint Agency [] Multi-Agency [21 Complaint [] Re-inspection Type of Tank 0IM i2 Number of Tanks ~ Type of Monitoring ~(...g,~ Type of Piping ~ot'" OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No 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: Omce of Environmental Services (805) 326-3979 Bus~ness Site R-'~e por~sible Party White - Env. Svcs. Pink - Business Copy RICH ENVIRONFIENTAL 5643 BROOKS CT B~E~FIE~,CA.93308 OFFICE(661)392-8687 & F~ (661)392-0621 KS MODEL PLT-100R HYDROSTATIC PRODUCT LINE TEST Precision Product Line Test PRODUCT PRODU~ ~C~IC~ MONITOR PRODUC~ LI.b~'TEST ~ DETECTOR LEAK DE~CTOR #i-DIESEL SUCTION LINE N/A HYDROSTATIC-~NU~R PASS #2-DIESEL SUCTION LINE N/A HYDROSTATIC-~NU~R PASS COMMENTS A precision test was performed on product lines at the above location using the AES MODEL PLT-100R HYDROSTATIC PRODUCT LINE TEST. I have reviewed the data produced in conjunction with this test for purpose of verifying the results and certifying the product line test systems. The testing was performed in acorrdance with AES protocol, and therefore satisfies all requirements for such testing as set forth by NFPA 329-92 and USEPA 40 CFR part 280. The results of testing are shown on the following page. Included with the report are reproduction of data .compiled during the test which formed the basis for these conclusion. This information is stored in a permanent file if future verification of test results is needed. AL\NC 040 Certi fied By: ~ames J. ~ch State cert~99-1072 5643 BROOKS CT BA~KERSFIELD,CA.93308 OFFICE (661) 392-8687 & FAX(661)392-0621 Monitor Certification Inspection California Code of Regulations, Chapter 16, requires that equipment which monitors tanks and/or piping systems containing hazardous materials be tested/serviced annually or on a schedule specified by the manufacturer, whichever is more frequent. This form, or a service report with equivalent information, must be used to document tesdng and servicing of monitoring equipment. If more than one monitoring system (e.g. Veeder-Root TLS-350,. Roman X76S. etc.) is installed at the facility, a separate certification or report must be prepared for each monitoring system. Facility Name: A/X .'~v% 0 r~ ! iA (' · ~/-O,i~ ,"T'~ t.,. Date of Testing/Servicing: <~-- ~, --0 i Facility Contact Person: Contact Phone No.: Make/Model of Monitoring System: C)(AJ ~'Ju- C..o (0, A,~tx)~., ~A,T-q,tLocation of Control Panel: $~tr~ t, cr~ tx_ Make/Model of Line Leak Detector (I,LD): _A J o ~t ~' LLD Leak Threshold g.p.h. Complete the following checklist: ~ Yes No* Monitoring system is operable per manufacturer's specifications? ~ Y~s No* Audible alarm is operational? ,~ ; Y~s No* Visual alarm is operational? X Yes No* Monitoring system is secured from the unauthorized tampering.* Yes No* For pressurized piping systems,.do the turbines automatically shut down if the monitoring system detects a leak, fails to operate, or is electrically disconnected? if yes, which monitoring dcvica$ initiate positive shut down? .... Sump SenSors? Pressum Line I~ak Detectors ? Yes No* For monitoring systems which serve as tank overfill warning devices, does the overfill warning function operate pwperly? If so, i' ~ al what percent of tank capacity does the alarm Irigger?. Check the appropriate boxe to indicate specific equipment ins.)ected/serviced: Annular Space Sensor ~ Annular Space Sensor Annular Space Sensor Annular Space Sensor Piping Sump S~nsor Piping Sump Sensor Piping Sump Sensor Piping Sump Sensor h-Tank Gauging Probe In-Tank Gauging Probe In-Tank Gauging Probe In-Tank Gauging Probe Dispenser Contalmnant Sensor(s) !Dispenser Containment Sensor(s) Dispenser Containment Sensor(s) Dispenser Containment Sensor(s) Mechanical Linc Leak Dcr~ctor Mechanical Line Leak Detector Mechanical Line Leak Detector Mec~ical Line Leak Detector Electronic Line Leak Detector Eleclmnic Line Leak Detector Electronic Line Leak Detector Electronic Line Leak Detector Il all P Valves Per spe cati°ns? I *In the comments section below, describe how and when these deficiencies were or will be corrected. Comments: I certify that the equipment identified above was inspected/serviced in accordance with manufacturer[Is guidelines. Name ofQualified Technician (print): ~ ~ ~£~ · ~/' - - ~' - H:~.COiVlMON~,WP,,DOCUMEN'r~FoRIV~S\HAZMA'~CUPAMSEC.DOC 14-Apr-00 r'-t 'Postage $ -- ~ 2.10 _n Certified Fee - postmark' Retum Receipt Fee 1 · 5 0 Hem r-~ (Endorsement Required) ~ r-'l {EndOrsement Requ~rea.~ 3 9 'ro~lpostage&~eos ~i I · (' ')lete items 1, 2, and 3. Also complete i~,¢'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, Agent or on the front if space permits. [] Addressee D. Is delivery address different from item 17 [] Yes 1. Article Addressed to: If yES, enter delivery address below: [] No Pete Armstrong Memorial Hospital 420 34tt~ Street Bakersfield Ca 93301 ~ 3. Service Type E~[Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (£xtra Fee) [] Yes 2. Article Number (C°py from service label) -7000 0520 0021 9610 7851 PS ~ 3811, July 1999 Domestic Return Receipt 102595-99-M-1789 August 27, 2001 Pete Armstrong Memorial Hospital CERTII~IED MAIL 420 34th Street Bakersfield Ca 93301 F~RE CHIEF NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE RON FRAZE RE: Failure to Submit/Perform Annual Maintenance on Leak Detection ADMINISTRATIVE SERVICES System 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Dear Mr. Armstrong SUPPRESSION SERVICES Our records indicate that your annual maintenance certification on your leak 2101 ~H" Street Bakersfield, CA 93301 detection system is past due. (July 3, 2001 .) VOICE (661) 326-3941 FAX (661)395-1349 YOU are currently in violation of Section 2641(J) of the California Code of PREVENTION SERVICES Regulations. 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 "Equipment and devices used to monitor underground storage tanks shall be FAX (661) 326-0576 installed, calibrated, operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks at least once per ENVIRONMENTAL SERVICES 1715 Chester Ave. calendar year for operability and nmning condition." Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 You are hereby notified that you have thirty (30) days, September 26, 2001, to either perform or submit your annual certification to this office. Failure to comply TRAINING DIVISION will result in revocation of your permit to operate your underground storage 5642 Victor Ave. Bakersfield, CA 93308 system. VOICE (661) 399-4697 FAX (661) 399-5763 Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph Huey Director of Prevention Services by: Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services cc: Walt Porr, Assistant City Attorney CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~r.~fq¢(d (~lem. Oc,~.t tq~a,'kzl INSPECTION DATE Section 2: Underground Storage Tanks Program [~l Routine [~1 Combined [] Joint Agency [] Multi-Agency [~ Complaint [] Re-inspection Type of Tank 06d{::: Number of Tanks Type of Monitoring ~St..a4 Type of Piping OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current / Failure to correct prior UST violations L/ Has there been an unauthorized release? Yes No 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 Office of Environmental Services (805) 326-3979 Business Site Responsibl~Party White - Env. Svcs. Pink - Business Copy RICH ENVIRO ENTAL 5643 BROOKS CT BAKERSFIELD,CA.93308 OFFICE(661)392-8687 & FAX (661)392-0621 AES MODEL PLT-100R HYDROSTATIC PRODUCT LINE TEST Precision Product Line Test TEST RESULTS JOB#: Test Date:07-03-2000 BILLING:MEMORIAL HOSPITAL SITE:MEMORIAL HOSPITAL 430 34TH STREET 430 34TH STREET BAKERSFIELD, CA 93303 BAKERSFIELD, CA. PRODUCT PRODUCT MECHANICAL MONITOR PRODUCT~ LINE TEST LEAK DETECTQR LEAK DETECTOR DIESEL SUCTION N/A HYDROSTATIC ANNULAR-PASS DIESEL SUCTION N/A HYDROSTATIC ANNLW_~R-PASS COMMENTS A precision test was performed on product lines at the above location using the AE~ MODEL PLT-100R HYDROSTATIC PRODUCT LINE TEST. I have reviewed the data produced in conjunction with this test for purpose of verifying the results and certifying the product line test systems. The testing was performed in acorrdance with AES protocol, and therefore satisfies all..requirements for such testing as set forth by NFPA 329-92 and USEPA 40 CFR part 280. The results of testing are shown on the following page. Included with the report are reproduction of data compiled during the test which formed the basis for these conclusion. This information is stored in a permanent file if future verification of test results is needed. AL~NC 040 Tes~ Certified By: ~×James J. Rich State cert#99-1072 5643 BROOKS CT BAKERSFIELD,CA. 93308 OFFICE(661)392-8687 & FAX(661)392-0621 Monitor Certification Inspection Facility Name: A,'l'~./~t ORv't,~%~, ~-,:, Facility Address: ~0 Monitorin~ system make and model: Tank & Monitor Description Tank I Tank 2 Tank 3 Tank 4 Tank Contents ~- Tank Capacity Product Line TvDe(Dressure,suc~iQn) Tank Annular SDace Sensor Sump Sensor A)~ /JO Dispenser Containment .Sens°r Electronic In-Line Leak Detector In-Tank Gau~in~ Device Mechaical Line Leak Detector /Pt/aZ ~//~ Does the monitoring system have audible and visual alarms? Does the turbine automatically Annu Annu Annu Annu shut down if the sensor is put Sump Sump Sump Sump into alarm DiSD DiSD DiSD DisD When signed by an authorized techician, this certifies that the monitor panel alarm and the sensors are in the correct position, and the system is operating according to manufacturer's specifications. CERTIFIED BY: 7, '- ._ CITY OF BAKERSFIELFL. rlCE OF ENVIRONMENTAL ERVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY TYPE OF ACTION [] I. NEW SITE PERMIT ~ 3. RENEWAL PERMIT [] 5. CHANGE OF INFORMATION (S~ecb'y cl~ange - [] 7. PERMANENTLY CLOSED SITE (C~ec~ one ,~m one,) [] 4. AMENDED PERMIT local use only). [] 8. TANK REMOVED 400. [] 8. TEMPORARY SITE CLOSURE I. FACILITY I SITE INFORMATION Bakersfield Memor±al Hospital 215-000-1121 NEAREST CROSS STREET 401. FACIUTY OWNER TYPE [] 4. LOCAL AGENCY/DISTRICT' 34 t h a n d U n i o n ~ 1. CORPO"ATION [] 5. COUNTY ^GENCW BUSINESS [] 1. GAS STATION [] 3. FARM E::] 5. COMMERCIAL ["1 2. INDNIDUAL [] 6. STATE AGENCY' TYPE [] 3. PARTNERSHIP [] 7. FEDERAL AGENCY* 402. [] 2" DI~'TRIBUTOR [] 4. PROCESSOR I~ 6. OTHER 403. Bakersfield MemoriaI Hospital I 66/_ 327-/_?92 42034th Street CITY 410. I STATE 411. ZIPCODE 412. Bakersf±e[d I CA 93301 PROPERTY OWNERTYPE [] 2. INDIVIDUAL [] 4. LOCALAGENCY/DISTRICF [-1 S. STATE AGENCY 413. Baker$£ield ~emorialHosp±tal ~0] 377-~7q? MAILING OR STREET ADORESS 416. 420 34th Street 417. I STATE 418. ZIPCODE ,-. 419. Bakersfi~ld TANK ~TYP~ [] 2. INDIVIDUAL [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY 420. ~ 1. coePo~'noN [] 3. pAm~Ees~P [] 5. COUNTY AGENCY [] 7. ~EDERAL ^C_~d~CY : .:' IV. BOARD OF EQUALIZATION LLST STORAGE FEE ACCOUNT NUMBER TY0'K)HQ -I 4 I 4 I Call(916)322-g6691fqussflonsarise 42~. INDICATEMETHOD(S) :~1. SELF-INSURED [] 4. SURETYBOND [] 7. STATE FUND [] 10. LOCALGOV'T MECHANISM [] 2. ~ . [] 5. ~:~,~O~C~-~IT [] 8. STATEFUND&C-FO L~:~ ~e.R [] 99. OTHER: [] 3. INSURANCE [] 6. ExEbl:rriON [] 9. STATE FUND & CD 422. VI. LEGAL NOTIFICATION AND MAILING ADDRES~ Chec~ one ~ox to ~ ~ ~/houid I~ ~ f~' legal noelltcaltem, ~ m~ltng. ~[ 1. FACILITY [] 2. PROPERTY OWNER [] 3. TANK OWNER 423. VII. APPLICANT SIGNATURE /~ 61327-4647 ext.4952 . 42~. TITLE OF APPLICANT 427. ~aci:].it ¥ Hana§er UPCF (7/99) S:\CUPAFORMS~swrcb-a.wpd OFF'~E OF ENVIRONMENTAL SERVICES 171~ Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - TANK PAGE 1 VYP~ OF ACTION ~ 1. ~ ~ ~ ~ 4. ~O ~R~ ~ 5. ~ ~ ~T~N) ~ 6. ~Y ~~) ~ Y. ~Y~O~D~ 420 34th Street O~e n C o r n ~ n ~ ~'. 1986 20~000 ~M JPC Diesel ~2 0 4. ~W~AV~T O~ ~ ~ ~~ 1992 ~PCF (7/99) S :~CUPAFORMS~'~VRCB-e.WPO OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bake.flel~ CA 9~301 (661) ~2~979 UNDERGROUND STOOGE TANKS - TANK PAGE 1 OF A~N ~ 1. ~ ~ ~ ~ 4. ~D ~ ~ S. ~ ~ I~O~N) ~ 5. ~Y ~E ~0~ Bakers fSeld ~emorSal HospS~l L~T~ ~ m~ ~ 420 34th Street Owen CornSng ~w~-.~~~ I. TANK ~ ~3.~~ ~M JPC Diesel~2 (~M~ 0 ~ ~~ (~~) (~MM~ ~ ~1. ~M!992 ~1.~ 1992 ~3.~~v~ . ~ ~~ 1992 - ,. .... ~.~r : ~ :.,.,'..?~..~-;~.. . e...:~.~,.;~:~h~..--:. ~.:~:..~.%~.:~f~.~.~:~i~,,i,~m: .~;.~,~,:.;.~.~........ · . .... :~e...i .::,~, ~ )'...~. ...... .~.,- ?.'...~..~i%,~.:cq~. ":,.~;:, ~..~:..:g~.:~:~:..:,~--~.~,~ ~..~,~... ~..: ..... . .... ..... ~...: ......... ' PCF (7/gg) $:~CUPAFORMS~%"WRCB-e.WPD I ' .~ CITY OF BAKERSFIELD 2~97 *' SERVICES t ~ ~. , _~ OFFICE OF ENVIRONMENTAL $ Che.ter Ave., Bakersfield, CA 93301 (661) 3 9 : U~T. TANK PAGE 2 1 Pa~e -- of VI. PlPlNO CONSTRUCTION (Check UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE Ir'-~ 1. PRESSURE ~i~ 2. SUCTION [] 3. GRAVITY 458 [] l. PRESSURE ~[ 2. SUCTION [~] 3. GRAVITY 455 CONSTRUCTION/ [] 1. SINGLE WALL [] 3. LINED TRENCH [] 99. OTHER 460 [] 1. SINGLE WALL [] 95. UNKNOWN 46.~ MANUFACTURER ~[ 2. 0OUBLE WALL [] 95. UNKNOWN J~ 2. DOUBLE WALL ~' [] 99. OTHER MANUFACTURER U n k l'*J. 0 ~v~ n 461 MANUFACTURER :~ ~ ~ ~ TJ O 'v~ TI_ 463 [] I. BARE STEEL [] 6. FRP COMPATIBLE W/100% METHANOL [] 1. ~ARESTEEL [] 6. FRP COMPATIBLE W/100% METHANOL MATERIALS AND [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL CORROSION PROTECTION [] 3. PLASTIC COMPATIBLE WITH CONTENTS [] 95. UNKNOWN [] 3. PLASTIC COMPATIBLE WITH CONTENTS [-1 0. FLEXIBLE (HOPE) [] 99. OTHER ~4. FIBERGLASS [] 8. FLEXIBLE (HOPE) [] 99. OTHER ~i~ 4. FIBERGLASS . [] 9. CATHODIC PROTECTION [] 5. STEEL WI COATING [] 9. CATHODIC PROTECTION 464 [] 5. STEEL W/COATING [] 95. UNKNOWN 465 · '.?.:::~.' VII. PIPING LEAK DETECTION (Cheek UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPfl TEST ~'H AUTO PUMP SHUT OFF FOR ~-] 1. ELECTRONIC LINE LEAK OETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK, LEAK, SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS ALARMS [] 2. MONTHLY 0.2 GPH TEST [] 2. MONTHLY 0.2 GPH TEST [] 3. ANNUAL INTEGRITY TEST (0.1GPH) [] 3. ANNUAL INTEGRITY TEST (0.1 C4:~) [] 4. OAJLY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS (Check all that apply): 1~ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY ~i~ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST(0.1 GPH) [] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): [] 7. SELF MONITORING [] 7. SELF MONITORING GRAVITY FLOW: GRAVITY FLOW (Check all that apply): [] 9. BIENNIAL INTEGRITY TEST (0.1 GPH) ~i~ 8. DAILY VISUAL MONITORING [] 9. BIENNIAL INTEGRITY TEST (O.1 Gl:q-f) SECONDARJLY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check ,11 that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WlTI'~ AUDIBLE AND VISUAL Al-ARMS AND (Chec~ one) 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (cttec~ one) [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] I~. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM [] b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION [] c. NO AUTO PUMP SHUT OFF F'] c. NO AUTO PUMP SHUT OFF [] 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR [] 11. AUTOMATIC LEAK DETECTOR RESTRICTION [] 12. ANNUAL INTEGRITY TEST (0.1 GPH) [] 12. ANNUAL INTEGRn'Y TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: SUCTION/GRAVITY SYSTEI~ [] 13. CONTINUOUS SUMP SENSOR * AUDIBLE AND VISUAL N. ARMS [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check a//ghat a/~) EMERGENCY GENERATOR~ ONLY (Check all Umt apply) [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF +AUOIBLE AND [] 14. CONTINUOUS SUMP SENSOR WTT'HOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL VISUAL ALARMS ALARMS [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 C~i TES'F) WITHOUT FLOW SHUT OFF OR [] 15. AUTOMATIC UNE LEAK DETECTOR (3.0 GPH TEST) RESTRICTION [] 16. ANNUAL INTEGRITY TEST (0.1 GPH) [] 16. ANNUAL INTEGRITY TEST (0.1 GPH) 17. DAILY VISUAL CHECK ~, 17. DAILY VISUAL CHECK DISPENSER CONTAINMENT ~[~ 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ~' 4. DAILY VISUAL CHECK DATE INSTALLED 468 [] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS [] 5. TRENCH LINER I MONITORING ~ C~ 8 ~) [] 3, CONTINUOUS DISPENSER PAN SENSOR ~ AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS r-] 6. NONE 469 IX. OWNER/OPERATOR SIGNATURE I ce~lify mat the informatlo911~' ~ I~eln il true and accurate to the I~eat of my knowlm:lge. __ · NAME OF OWNER~0~'~'RATOR ~0~'/.~t,,) 471 TITLE OF OWNERJOPERATOR 472 oO'C, FAc, ctT I IPeml,INumDer(Forlocaluseonly) 473 PemlltApproved(Forlocaluseonly) 474[PermitExplraUonOate(ForlocaluZeonly) 475.i UPCF (7/99) S:\CUPAFORMS\SWRCB-B.WPD CiTY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES ~ *~: .... ~ ~heater Ava., Bakarafield, CA 93301 (661) 326-1~j~9 U~l'. TANK PAGE 2 VI. PIPING CONSTRUC'TIO~ (Che~ aa ~ ~y) UNDER~ PIPING ABOVEGROUND PIPING SYSTEM TYPE !r'] 1. PRESSURE ~1~=2. SUCTION C] 3. GRAVITY 458 [] 1. PRESSURE ~[ 2. SUCTION [] 3. GRAVITY 45S [] 1. SINGLE WALL [] 3. UNEDTRENCH [] 99. OTHER 460 [] 1. SINGLE WALL [] 95. UNKNOWN 46: CONSTRUCTION/ MANUFACTURER ~1} 2. DOUBLE WALL ~[~ g~. UNKNOWN ~ 2. DOUBLE WALL [] 99, OTHER' Unknown MANUF^CTURER U n K n O w n 46~ MANU~^CTURER 463 [] 1. BARESTEEL C] 6. FRP COMPATIBLE W1100% METHANOL [] 1. BARESTEEL [] 6. FRP COMPATIBLE WI100% METHANOL MATERIALS AND I--] 2. STAINLESS STEEL ~J 7. GALVANIZED STEEL [] ?- STAINLESS STEEL [] 7. GALVANIZED STEEL CORROSION PROTECTION [] 3. Pt. ASTIC COMPATI~.EWITH CONTENTS [] g~. UNKNOWN [] 3. Pt. ASTIC COMPATIBLE WITH CONTENTS [] 8. FLEXlBLE(HDPE) [] 99. OTHER ST~r. EL WI COATING [] 9. CATHODIC PROTECTION 464 [] 5. STEEL W/COATING [] 95. UNKNOWN 465 U~ PIPING ABOVEGROUND PIPING ~NGLE WAU. PURNG 466 SINGLE WALL PIPING 467 PRESSURtZED PIPING (Ct, ack a~ that a~oty): PRESSURIZED PIPING (Check a~ U~at apply): O 1. E/.ECTRONIC MNE LEAK DETECTOR 3.0 GPH TESl' ~ITH AUTO PUMP SHUT OFF FOR [] 1. ELECTRONIC MNE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK, LEAK. SYSTEM FAILURF_ AND SY$~Jd DISCONNECTION * AUDIBLE AND VISUAL SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALAI~dS~ ALARMS [] 2. MONTHLY 0.2 ~ TEST n z ~trrHLY02G~TEST I-I ~ ANNU~rrEGmTYTEST(0.~ ~] 3. ANNUAL INTEGRJTY TEST (0.1GPH) I~ 4. DAJLYVlSUA~CHEC~ CONVENTIONAL SI~'TION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS (Check all Ihat apply): ~, S. DAILY VISUAL MONITORING OF PIJIA=ING SYS'TEM 'e TRIENNIAL PIPING INTEGRII'Y I~ S. DAILY VISUAL MONITORING OF PIPING ANDI=KJMPINGSYsTEM TEST(0.~ G~) [] 6. T~UENN~d.~NTEGRrrYTEST(04 G~) SAFE SUCTION SYS¥~.M$ (NO VALVES IN BELOW GROUNO PIPING~ SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): [] 7. SELF MONITORING [] 7. S~LF MONITORING GRAVrrY FLOW. C~A. vrzY FLOW (Check a~ mat a~oiy): [] S. mae;w. ~rrEc_,mTY TEST (0J G~q M 8. D~dLY WSU~ MONrTOKNG [] s. s~t~. ~ ~ (04 G~) SECONDARILY CO#TAINE~ PIFING SECONDARILY' CONTAJNED PIPING PRESSU~q=~ ~ (Che~ all that ~ PRESS~e~7~n PIPING (Check all that 10. CONTINUOUS TURBINE SUIdP SENSOR WITIt AtK)IBI.E AND V1SUAL ALARMS AND 10. CONTINUOUSTURBINESUMPSENSORWITHAUDIBLEANDVISUALALARMSAND(cttectcone) (CheeSe me) [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCtJRS [] b. AUTO PUMP SHUT OFF FOR ~ SYSTEM FAILURE ANO SYSTEM [] b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION D~uCONNECTION [] r, NO AUTO PUMP SHUT OFF r-J c~ NO AUTO PUMP SHUT OFF [] ~ ~. AUTOMA~C URE LEAK DETECTOR (3J) GPH TESl~ WITH FLOW SHUT OFF OR [] ~ ~. AUTOMATIC LEAK DETECTOR [] ,*~Z ANM4AL~rEGRr~YTEST(0.~ C,~H) [] ~2. ANNUALi~TEST(0.~ SuC'noNm-'RAV~Y SYSTE~ suc-no~vrrY sysl~t [~ 13. CONTINUOUS~UMPSENSOR+AU~BLEANE)VI~UALALARMS [] 13. CONTINUOUS SUN~ SENSOR + AUDIBLE AND VlSUAL ALARMS UPCF (7199) S:~CUPAFORMS\SWRCB'B.WPD CONTRACT ENVIRONbXENTAL SERVICE / FONTANA, CA 92336 (909) 822-6553 MONITOR CERTIFICATION CUSTOMER: BAKERSFIELD MEMORIAL HOSPITAL DATE 2-25-00 LOCATION: 420 34TM STREET BAKERSFIELD, CA 93301 MANUFACTURER WARWICK CONTROLS MODEL No. SB0011 SERIAL No. NONE No. OF TANKS 2 ALARMS: VISUAL OK AUDIBLE OK PRINTER NONE MODEM NONE PROBES: TANK 1 TANK 2 TANK 3 TANK 4 TYPE OF PRODUCT DIESEL DIESEL IN TANK (LIQUID LEVEL) YES YES IN TANK SENSING ANNULAR SPACE SENSOR PASS PASS SUMP SENSOR MONITORING WELL POSITIVE SHUT OFF Y/N N/A N/A SAFETY: INTRINSIC OK ELECTRICAL OK PROBE CONNECTIONS N/A OTHER -- REMARKS: EMERGENCY GENERATOR - SUCTION LINES. ONE CONTROL PANEL AND RESERVOIR FOR EACH TANK, TOSCO IN TANK GAUGES THIS IS TO CERTIFY THAT THE ABOVE MONITOR HAS BEEN TESTED BY AN AUTHORIZED REPRESENTATIVE OF CONTRACT ENVIRONMENTAL SERVICE, HAS BEEN ADJUSTED AND/OR CALIBRATED AS NECESSARY, AND IS OPERATING ACCORDING TO MANUFACTURER'S SPECIFICATIONS. TECHNICIAN: ~ ~ '-- ---- --~. DATE: 2-25-00 ANTONIO DOM~_~UEZ CONTRACT ENVIRONMENTAL SERVICE ¢759 MAINE STREET ,~'ONTANA. CA 92336 t{909) 822-6553 __.. .......... ..... .... ..... ......................' ~AKERSFIg~,D M~O~IAL HOSPITAL DATE 2-25-00 'I'~C~T,~ON: 4~ 34TM STREET BAKERM[IELD, CA 9~01 MANUFACT~E~ WARW!~ CONTROLS ~EL No. S~00].l SERTnT, No. ~NONE No. OF TANKS 2' a~s: v I S~L~-_~- o~-- __ AUDI BLE ............. .q~. ..... PRIN~R NONE MODEM NON E ,TYPE OF PROI,UCr .__", DIESEL DIESEL ..................... ]:N TAN~ S~,~ ............ j.J .................... ~NULm~ S~'ACZ S~,.;~SOR ~Ass PASS. f:UM'P SENSOR __ ~ONETOR[NG WEI,I POG~TJ. VE SHUT OFF Y/~ ' N{A N/A SAFETY: I NTRIN S I C OK ELE~RI CAL OK PRO~E CONN]iCTIONS ' N/A OTHER .............. KE,WA~K~;: f~ERGENCY G ',NESTOR - SUCTION LINES. ONE CONTROL PANEL AND RESERVOIR F( R EACH TANK, TOSCO IN TANK GAUGES :ALIBRATED AS NECESSARY, AND JS OPF, I~ATING AC(:OI~I)ING TO MANUFAC'I U] :~' S SPECIFICATIONS. CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~a~er~tc~ lllem~aa[ 14~,~'o.1 INSPECTION DATE i lt'4/, ?q Section 2: Underground Storage Tanks Program [~[ Routine [] Combined [~J'oint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank 01all~' Number of Tanks O. Type of Monitoring dr./vt Type of Piping ,rio fi" OPERATION C V COMMENTS tank data on file Proper Proper owner/operator data on file Permit tees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current / Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) ~OD qa( AGGREGATE CAPACITY Type of Tank O/uot~¢r Number of Tanks OPERATION Y N COMMENTS SPCC available t,,// 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 I.~,~N t- Inspector: ~ _~ ~2./Z/~ N~ ,,. Omce of Environmental Services (805) 326-3979 ~tJsiness Site Responsible Party White - Env. Svcs. Pink - Business Copy D 'r February 9, 1999 ~RE C.~EF Bakersfield Memorial Hospital RON FRAZE 420 34th Street ADMINISTRATIVE SERVICE8 Bakersfield, CA 93301 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 l~--,: Compliance Inspection SUPPRESSION SERVICES Dear Underground Storage Tank Owner: 2101 'H" Street Bakersfield, CA 93301 VOICE (805) 326-3941 The city will start compliance inspections on all fueling stations FAX (805) 395-1349 within the city limits. This inspection will include business plans, pREVENTION SERVICES underground storage tanks and monitoring systems, and hazardous 1715 Chester Ave. materials Bakersfield, CA 93301 tnspecuon. VOICE (805) 326-3951 FAX (805) 328-0578 To assist you in preparing for this inspection, this office is ENWaOn.EmAL SERWCES enclosing a checklist for your convenience. Please take time to read this 1715 Chester Ave. Bakorsfield, CA 93301 list, and verify that your facility has met all the necessary requirements to VOICE (805) 326-3979 FAX (805) 326-0576 be in com~,,,ance. 'r~.~.o oMs~o. Should you have any questions, please feel free to contact me at 5642 Victor Ave. Bakersfield, CA 93308 VOICE (805) 399-4697 FAX (805) 399-5763 Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure BAKERSFIELD FIRE DEPARTMENT February 13, 1998 RRE CHIEF Bakersfield Memorial MICHAEL R. KELLY etosp~tai 420 34th Street ~NmU~VE s~me~s Bakersfield, CA 93301 2101 'H' Street Bakersfield, CA 93801 (80~) 326-3941 FAX (805) 39~- 1349 ~m~ ~a~nc~ RE: "Hold Open Devices" on Fuel Dispensers 2101 'H" Street Bakersfield, CA 93801 (805) 326-3941 Dear Underground Storage Tank Owner: FAX (805) 395-1349 ~'vmnON S~V~:~S The Bakersfield City Fire Department will commence with our annual 1715 Chester Ave. Underground Storage Tank Inspection Program within the next 2 weeks. Bakersfield, CA 93801 (805) 326-3951 FAX (805)326-0576 The Bakersfield City Fire Department recently changed its City Ordinance mV~M~S~C~ conceming "hold open devices" on fuel dispensers. The Bakersfield City Fire 1715 Chester Ave. Department now requires that "hold open devices" be installed on all fuel Bakorsfiold, CA93301 dispensers. The new ordinance conforms to the State of California guidelines. (80,5) 326-3979 FAX (80~) 326-0~76 The Bakersfield Fire Department apologies for any inconvenience this 5642 Victor Street may cause you. Bakersfield, CA 93308 (805) 3994697 FAX (805)399-5763 Should you have any questions, please feel free to contact me at 326-3979. Sincerely, Steve Underwood Underground Storage Tank Inspector cc: Ralph Huey BAKERSFIELD FIRE DEPARTMENT January 27, 1998 Mr. Pete Armstrong Fi~ C,IEF Memorial Hospital MICHAEL R. KELLY 420 34th Street Bakersfield, CA 93304 ADMINISlI~A'nVE SEEVICES 2101 "H° Street Bakersfield, CA 93301 ( 326-3 41 UNDERGROUND STORAGE TANK UPDATE FAX (805) 395-1349 SUPPt~ON s~c~ Dear Mr. Armstrong: 2101 'H' Street Bake~fleld, CA 93301 (805) 326-3941 The City of Bakersfield wishes to congratulate those tank owners who FAX (805) 395-1349 have upgraded, removed or replaced their tanks in the month of January. During the month of January, our office had six sites (14 tanks) which are now in PREVENRON SEWICES 1715 Chester Ave. compliance. This is a very big "first step". Bakersfield, CA 93,301 (805) 326-3951 FAX (805) 326-0576 For those who have not yet upgraded, I would like to share some thoughts on why it is so important to act right away: ENVIRONMENTAl. SEEVlCES 1715 Cl~ester Ave. Bakersfield, CA93301 l. Licensed contractors are booking up fast, in some cases, up (805) 326-3979 FAX (805)326--0576 to three months in advance. 2. Supplies (pumps, dispensers, leak detection equipment) TRAINING DIVISION may be scarce. 5642 Victor Street Bakersfielcl, CA93308 3. The cost for upgrading or removing could go up as demand (805) 399-4697 increases. FAX (805) 399-5763 4. Assembly Bill 1491 will ban fuel deliveries after January 1999 to non-upgraded owners. The good news, is there is still time!!! If there is anything this office can do to assist you in your planning, do not hesitate to call. Sincerely, Ralph E. Huey Hazardous Materials Coordinator Office of Environmental Services cc: Kirk Blair, Assistant Chief BAKERSFIELD FIRE DEPARTMENT December 22, 1997 Memorial Hospital 420 34th St FIRE CHIEF M~C~EL~. Ka~¥ Bakersfield, CA 93304 ~MIN~mSnVE SErViCES Dear: Pete Armstrong 2101 'H' Street Bakersfield, CA 93301 (805) 326-3941 FAX (805)395-1:M9 Last summer, you answered a survey, conceming your underground storage tank(s) stating that you would be (~, replacing, upgrading) your tank(s). SuPPmS~ON SE~C~ However, you did not give us a target date! In November, we invited you to a free 2101 'H' Street Bakersfield, CA 93301 underground storage tank workshop, where State representatives discussed both the (805) 326-3941 FAX C~)39S-1~ regulations and alternatives that you as a tank owner will have. - ..... You did not attend! ...... We are concerned! PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 You will be receiving this letter on our about December 22, 1997. One year C805) 326-3951 from today, December 22, 1998, your current underground storage tank(s) will FAX (805) 326-0576 become illegal to operate. Current laws and code requirements would require that ENVIRONMENTAL SERVICE$ if your tanks are not (~PlaCed, upgraded) by that date, your permit to 1715 Chester Ave. Bakersfield, CA 93.301 operate would be revoked, - - it will be illegal for any fuel distributor to deliver C805) 326-3979 fuel to your tank(S), - - and your tank(s)would then be considered illegally FAX (805) 326-0576 abandoned and require that action be taken within ninety (90) days to remove the mINING DIVISION tank(s). 5642 Victor Street Bakersfield. CA 93308 (805) 3994697 Of course, we have no interest in pursuing this route. We would like to FAX (805) 399-5763 have your tanks properly handled prior to this December 22,1998 deadline. Please review your situation and reply within two weeks as to the current (realistic) plans for your existing tank(s): As we get closer to the December 22, 1998 deadline, I would expect construction costs, as well as lead times to increase considerably. If there is anything this office can do to assist you in your planning, do not hesithte to call. Sincerely, Ralph E. Huey Hazardous Materials Coordinator REH/dm -07-1998 12: 23PM FROM BMH I NTGRTD SERV ! CE 3278413 P. 2 · ¢. L~rr~ C~rr. Preeider,I Board M Dlrectom: Go~n K. Fo~mr. Oh~ir~n Edwa~ H. S~ler, Vice ~air~n 4~ 34th Street / Telepho~ (805) 327.1792 Bernard J. Her~n Mad~n Mu~hyay, M, D, Tho~W, Smith January 7, 1997. Ralph E. Huey Bakersfield Fire Dept. 1715 Chester Ave. Bakersfield, CA 93301 RE: Underground Storage Tank, Bakersfield Memorial Hospital Sub Acute Nursing Unit 430 34th' Street, Bakersfield, CA 93301 Dear. Mr. Huey, In answer to your letter.dated 12/18/97; we have been approved by OSHPD to install an above ground tank and remove the underground tank OSHPD #SS-9724743-15 at the location above. This' project has been contracted with Industrial Contamination Extraction Services, Inc., 2345 Fruitvale Ave., Bakersfield, CA, (805) 861-1884. Work on this project began with the' installation of the cement pad for the above ground tank. Expected completion date is approximately March 1, 1998. Sincerely, Pete Armstrong Engineering Supervisor Bakersfield '- Mem.oriai Hospital . Service Center 805;327~4647 ext 4647 Fax Number 805-327 8413 ADDITIONAL ; COMMENTS i I Integrated Service Department Bakersfield Memorial Hospital 420 34th Street ~:~ .o . EL?gL~E 30IA~3S QI~gLN! HH~ HO~J HdSL:EL L66L-SL-~[ CVE- 2 9 0 2 3500 Gilmore Ave. l~akersfiefa~ Calif. 93308.6299 Phone: (805) 327-934I Fax 1805) 325-2529 TOKHEIM OISTRIBUTOR ' L AUTHORIZED aY .... ORDER NO. / O '/ 7 3 6/.~ DATE / '~"' Cl~. NOTIFICATION TO W JOB ~ OFFICE CONF~RMATION ' ~KE ~DEL .... SERIAL NUMBER "' ~ .......... O~ ~RT NUMeER AND OESCRI~ION PRIMARY CAUS~ORRECTIONS ~OE '" .................... 1) Pa~s 2) Sales T~ 3) Freighl II is undemt~ ~d ~ ~at i~ event ~is bill ~mes ove~ue and ~e selter ~mmea~s I~al ~c~on for I~ ~11~ ~ 9~me. lhe b~er ~11 pay ~1 ~ of ~11~i~ in~udi~g a~mey's fees. The ~e to t~ pro~ 4) Lair T~I ~d~ herein sh~l rein ~e pr~e~ of ~he ~ller. and t~e shall ~1 p~s to pumhaser until ~id. A ~ce ~ge of ~, ~u~ ~ 24% ~r~r. cha~ on ~ d~ ~s. 5) Mileage To~l SER~CE WORK ACCE ~O C~ V~ R EPRESENTA~VE ' ' 6) Equipment Re~a~ sv X~ ~C ~ ~~ 7) Ouls,de Re.,rs C R, RECTION NOTICE BAKERSFIELD FIRE DEPAFITMENT N-° §32 Sub Div. 33 7- I ?qZ Blk. ~t You are hereby required to make the following cor~ctions at the above l~ation: . ~¢ ~ L~ Completion Dale fo~ Corrections ~ Date '4q,/4', -~ ~ ~ Inspector 326-3979 UNDERGROUND STORAGE TAN _iNSPECTION Bakersfield Fire Dept. Bakersfield, CA 93301 FACILITY NAME ~aJz'e~J-~eg ~tcttu~¢~J/ /'~5~,Jra.! BUSINESS I.D. No. 215-000 FACILITY ADDRESS q~ll~) ~ ~ E~I- CITY ~3~r6-~(~'( ZIPCODE ~'.~.~ff/' FACILITY PHONE No. .~- I??'z- ~D~ INSPECTION DATE I Product . Product Product TIME IN TIME OUT Inst Date Inst Date Inst Dat~ INSPECTION TYPE: Size Size Size ROUTINE V'" FOLLOW-UP REQUIREMENTS yes no n/a yes no n/a yes no n/a la. Forms A & B Submitted v"' V~' Vr 1 b. Form C Submitted V~ V' lc. Operating Fees Paid V/ ~" Id. State Surcharge Paid V' le. Statement of Financial Responsibility Submitted V lf. Written Contract Exists between Owner & Operator to Operate UST 2a. Valid Operating Permit V/ V 2b. Approved Written Routine Monitoring Procedure 2c. Unauthorized Release Response Plan V' V" V" 3a. Tank Integrity Test in Last 12 Months t~l[l~lq~, '~' 3b. Pressurized Piping Integrity Test in Last 12 Months t,/' ~/ ~/' 3c. Suction Piping Tightness Test in Last 3 Years 3d. Gravity Flow Piping Tightness Test in Last 2 Years 'v" ~/' V 3e. Test Results Submitted Within 30 Days t/ 3f. Daily Visual Monitoring of Suction Product Piping 4a. Manual Inventory Reconciliation Each Month ~// ~/ L/ 4b. Annual Inventory Reconciliation Statement Submitted ,4c. Meters Calibrated Annually 5. Weekly Manual Tank Gauging Records for Small Tanks U 6. Monthly Statistical Inventory Reconciliation Results 7. Monthly Automatic Tank Gauging Results L/ 8. Ground Water Monitoring 9. Vapor Monitoring 10. Continuous Interstitial Monitoring for Double-Walled Tanks v/ iv/ V" 11. Mechanical Line Leak Detectors 12. Electronic Line Leak Detectors V' 13. Continuous Piping Monitoring in Sumps ,.,/ 14. Automatic Pump Shut-off Capability ~ V/ 15. Annual Maintenance/Calibration of Leak Detection Equipment 16. Leak Detection Equipment and Test Methods Listed in LG-113 Series 17. Written Records Maintained on Site %/' t,/ 18. Reported Changes in Usage/Conditions to Operating/Monitoring Procedures of UST System Within 30 Days ~/' 19. Reported Unauthorized Release Within 24 Hours [/' ~/ ~" 20. Approved UST System Repairs and Upgrades 21. Records Showing Cathodic Protection Inspection 22. Secured Monitoring Wells F/ ~/ 1// 23. Drop Tube ~ RE-INSPECTION DF~I'E / //t/~[~/7 RECEIVED BY: INSPECTOR: ~ ~//~/~_/~'~/~/'~ OFFICE TELEPHONE No. FD 1669 (rev. 9/95) DOUBLE WALL UNDER GROIYND DIESEL TANKS POLICY: THE PURPOSE OF THE MONITORING PANEL IS TO DETECT A LEAK IN EITHER THE OUTER OR INNER WALL OF THE DOUBLE WALLED TANK. WATER HAS BEEN PLACED BETWEEN THE TWO WALLS Ai~-DSENSORS HAVE BEEN PLACED TO DETECT A HIGH LEVEL OR LOW LEVEL OF WATER IN THIS AREA. IF EITHER OCCUR THE MONITOR WILL BRING ON THE ALARM LIGHT ~ BELL. TEMPERATURE CHANGES CAN CAUSE A WARNING. PROCEDURE: NORMAL OPER31TION: A STABLE LIQUID RANGE IN THE RESERVOIR INDICATES THAT BOTH THE INNER AND OUTER WALL OF THE DOUBLE-WALL TANK ARE LEAK FREE. THE LIQUID LEVEL IN THE RESERVOIR WILL FLUCTUATE AS THE TEMPERATURE OF THE INCOMING STORED PRODUCT CHANGES. THE RESERVOIR IS DESIGNED TO PROVIDE ADEQUATE CAPACITY FOR NORMAL THERMAL EXPANSION AND CONTRACTION. AS LONG AS THE RESERVOIR LIQUID LEVEL IS IN THE NORMAL RANGE THE "NORF~AL" LIGHT IS ILLUMINATED CONTINUOUSLY. TESTING A_ND MAINTENANCE: THE CONTROL PANEL WARMING SYSTEM SHOULD BE CHECKED AT LEAST ONCE PER YEAR. DEPRESS THE "TEST BUTTON" SWITCH LOCATED ON THE SIDE OF THE CONTROL PANEL TO VERIFY THAT EACH CIRCUIT IS OPERATIONAL. THE "TEST BUTTON" VERIFIES THE OPERATION OF THE INTERNAL CIRCUITS OF THE CONTROL PANEL. HOWEVER, IT DOES NOT TEST THE OPERATION OF THE MONITORING SENSORS. THE TANKS WILL BE DIPPED WEEKLY AND LOGGED IN THE BOILER OPERATORS LOG. THE PIPES WILL VISUALLY CHECKED WEEKLY DURING THE GENERATOR TEST TO INSURE THERE IS NO LEAKAGE. THIS WILL ALSO BE LOGGED IN THE BOILER OPERATORS LOG. LEAK DETECTION: IN THE UNLIKELY EVENT THE RESERVOIR TOTALLY DRAINS, THE CONTROL PANEL ALARM WILL BE ACTIVATED- THE WARNING LIGHT WILL ILLUMINATE AND THE ALARM BELL WILL SOUND. TESTING OF SENSORS: THE FIBERGLAS UNDERGROUND STORAGE TANKS INSTALLATION INSTRUCTIONS DESCRIBES HOW TO TEST PROBES. UNDERGROUND STORAGE TANK 1. A. TANK: THE TANK IS MONITORED CONTINUOUSLY BY ELECTRONIC MONITOR. MONITOR TEST ONCE A YEAR WITH TEST SWITCH. THE TANKS ARE DIPPED ONCE A WEEK BEFORE THE GENERATOR TEST. THIS INFORMATION IS LOGGED IN THE BOILER OPERATORS LOG BOOK. PIPES: CHECKED ONCE A WEEK DURING GENERATOR TEST TO ENSURE THAT THERE IS NO LEAKAGE. LOG IN THE BOILER OPERATORS LOG BOOK. B. TANK: ELECTRONIC MONITOR MODEL SB0011B. PIPES: VISUAL AND SOUND DURING GENERATOR TEST. CHECKED BY TANK DIP. C. TANK MONITOR IS LOCATED IN THE MAINTENANCE SHOP ON THE BACK WALL. THE TANKS LOCATED OUTSIDE THE SHOP ON THE NORTH SIDE IN THE DRIVE WAY. SEE ATTACHED SHEET. D. MIKE WOOD FACILITIES MANAGER E. TANK: CONTINUOUSLY MONITORED BY ELECTRONIC MONITOR. TEST ONCE A YEAR WITH TEST SWITCH. TANKS DIPPED ONCE A WEEK BEFORE GENERATOR TEST. LOGGED IN BOILER OPERATOR LOG BOOK. PIPES: VISUAL Ai~D SOUND CHECKED DURING GENERATOR TEST. TANK DIP READING WELL CONFIRM FUEL RETURNING TO TANK AND PIPES ARE NOT LEAKING. F. MANUFACTURE RECOMMENDS THAT ELECTRONIC MONITOR BE TEST ONCE A YEAR WITH MONITOR TEST SWITCH. WE HAVE THE TA/~KS TEST FOR INTEGRITY ONCE A YEAR BY OUTSIDE CONTRACTOR. RESULTS ARE IN ENGINEERING OFFICE. G. ALL PERSONNEL ARE GIVEN TRAINING ON THE UNDERGROUND STORAGE SYSTEM. VERIFICATION IS ON COMPUTER TRAINING RECORDS. RICH ENVIRONMENTAL 5643 BROOKS CT BAKERSFIELD,CA. 93308 (805) 392-8687 ALERT 1000 UNDERFILL AND ALERT 1050 ULLAGE SYSTE~, Precision Underground Storage Tank System Leak Tes.'t~,./.-czf~ ~,~--<~ t~ "t_-"(~ i~...j ViF~~ TEST RESULTS z ~'~11 ii/ / JAN Job~: f ,~ ~,, Test Date: 12/17/96 BILLING:MEMORIAL HOSPIT~ S ITE:MEMORI~ HOSPITAL 4~ 34TH STREET ~ 34TH STREET B~ERSFIELD, CA 93303 B~ERSFIELD,~ CA 93303 PRODUCT VOL~E %FULL WETTED NON-WETTED PRODUCT LEAK WATER IN (GAL) pORTION PORTION LINE DETECTOR DIESEL 300 65% -0. 014 PASS PASS-SUCTION LINE 0" WATER BALANCE Measurements showed that water in the backfill area at the time of testing was below tank bottom, and therefore not a factor in test determination. A precision test was performed on tanks at the above location using the Alert 1000 underfill system and the Alert 1050 ullage system. I have reviewed the data produced in conjunction with this test for purpose of verifying the results and certifying the tank systems. The testing was performed in acorrdance with Alert protocol, and therefore satisfies all requirements for such testing as set forth by NFPA 329-92 and USEPA 40 CFR part 280. The results of testing are shown on the following page, and indicate whether the wetted and non-wetted portion passed or failed. Included with the report are reproduction of data compiled during the test which formed the basis for these conclusion. This information is stored in a permanent file if future verification of test results is needed. ~L\NC 040 Test Certified By: State cert#90-1072 ALERT TECHNOL OGLES PLOT OF ULLAGE TEST DA TA MEMORIAL HOSPITAL 430 34TH ST. BAKERSFIELD, CA 93303 300 GALLON DIESEL TANK 12KHz AMPLITUDE RATIO 25KHz AMPLITUDE RATIO 0 75 '1 5 750+ 0 75 ~. 5 750+ MuNI :' ' :ii :.':':! .... i MuNi :' E 3 E 3 ~2KHZ DETECTION RATIO = 1.00 25KHz DETECTION RATIO = .983 TEST RESULT = PASS DATE AND TIME OF TEST: &2/'17/96 ~' 45AM BEGINNING BOTTLE PRESSURE = 1500 ENDING BOTTLE PRESSURE = ~400 BEGINNING TANK PRESSURE = 1.5 PSZG ENDING TANK PRESSURE = ~.5 PSZG ~X~ TO OP~RA~'E # HUHBER OF TAHIqS TO BE TSSTED___[... XS PXPXHG C~OTIW '1'O BE TESTED DATE s '~xm~ 'FEs'r zs To Be c0mxJc2~D ,19.- lh.-?~ .p:o~,,~,~ .,, 10/24/95 09:34 ~80S 326 05T6 BFD Fd~Z MAT DI¥ i~1003 I T ] ,S CHESTER AVE · BAKER$RELD, CA · ~3301 TANK INTEGRrI'Y TESTING INSPECTION FORM THTS FORM MUST B_E_COMPLETF~____ AT TIME OF INTEGRITY ~ BY THE TI~CHNICIAN O__N_ _Slrl=E AND S .UBMrI"TED WITH THE TANK INTEGR~ TEKI~ FaciUw. Penmt to Operate Humber ..... _ Fac~ .w Pern~z m Tighmcss Test Number ........ Have you complied with the following safety, rcquircmems ~//r~ The asea with/n 25 ieet oi any underground storage tank opening is tree of smoldn~ open flames, and any other source of ignitiot~ hg~'~ Leg/hie signs with the ~r~ "NO SMOKING" are poszed in conspicuous locations arouud the tesUu_e area. %/-~ _ The general public is ~estric~cd/rom ~hc tc~tin~ area by. ropc. fla~, cones, and "if dark" a fluorescent brat/er. Fire Frotection in thc form of a ~_a~20BC f/re ex~ugu/shcr is located withm the testr/cted area. ~'~'S _ Vehicles util/zed during the testing pet/od, or within ~ feet of the underground * storage tank opening. ~ve aclenuate ventilation, and the tester has equipment which can be utiUze0 to monitor the concenu'at/on oi flammable vaoors with/n the vehicle. L//;'C Personal protective eqmpmcnt, an eve wash and gloves, and a site safety plan arc w/thin The testing area. L/~'$ Equipment/materiaLs i~ available ~o absorb and contain any. small rclcasc of ---~- t~ting liquid which is discharged as a result of the test. (~amples include DOT-acceptable containers for storage of the absorbent and an adequate supply of absorbent). If the ~r to atly of The above questions is NO. stop Thc test/nil procedure IMIVIT:DIATI~_LY ua~ campi~ is ~ COMPLETE REVERSE SIDE BAKERSFIELD FIRE DEPARTMENT December 4, 1996 RRE CHIEF Greater Bakersfield Memorial Hospital MICHAEL R. KELLY 420 34th Street ADMINISIRATIVI: SI:RVIC~:$ Bakersfield, CA 93301 2101 'H" Street Attn: Pete Armstrong Bakersfield, CA 93301 (805) 326-3941 FAX (805)395-1349 RE: Underground Storage Tanks located at 420 34th Street in Bakersfield. SUPPRESSION SERVICES 2101 'H" Street Dear Mr. Armstrong: Bakersfield, CA 93301 (805) 326-3941 FAX (80.5)395-1349 AS I am sure you are aware, all existing single walled steel tanks that do not meet the current code requirements must be removed, replaced or upgraded to PREVENTION SERVICES 1715 Chester Ave. meet the code by December 22, 1998. Your tanks do not currently meet the new Bakersfield, CA 93301 code requirements and therefore fall into the remove, replace or upgrade category. (805) 326-3951 FAX (805)326-0576 Your current operating permit expires on or before that date and of course will not be renewed until appropriate upgrade of your tank system is accomplished. ENVIRONMENTAL SERVICES 1715 Chester Ave, Bakersfield, CA 93301 In order to assist you and this office in meeting this fast approaching (805) 326-3979 FAX (805) 32643576 deadline, I have attached a brief questionnaire addressing your plans to upgrade these tanks. Please complete this questionnaire and return it to this office by TRAINING DIVISION Thursday, December 19, 1996. 5642 Victor Street Bakersfield, CA 93308 (B05) 399-4697 If yOU have any questions concerning your tanks or if we can be of any FAX (805) 399-5763 assistance, please do not hesitate to contact this office. Sincerely, Ralph E. Huey Hazardous Materials Coordinator Office of Environmental Services attachment BAKEILSII'XKt,D F3;RE · ].715 CheatoF A~e,,, BaJcozI£J. eZd, CA g33OX (805)' APi~LICATZGI TO PBRFOJOf A 'I'X~I'L'NKSS "g'KBT , HU~ER OF 'T'AltE:S TO BE TESTED___J.~ IS :FXPZIIG GOTIIG 'lC) BE TESt'ED TAXX# VOL~ C~ / '~on , · '"~ ~'- ' BAKERSFIELD FIRE DEPARTMENT.` ' -~ 10-2-75' BUREAU OF FIRE PREVENTION ~ 065 ,. Date APPLICATION Application No. · In:'conformity with provisions ~of pertinent ordinances, codes and/or regulations, application is...made - by: l~rtte! llo~ptt:a! 420 '-. 3Aeb Street,' ''* ,' Nome of Company Address to display, store, install, use, operate, sell or handle materials or p~-ocesses involving or creating con- ditions deemed hazardous to life or property as follows: Installattoa 0£ (1) 12,000 Gal. understouad~ steraSe tan/~. Technical Support l~ax Transmission ~FLuID' ' ,~,~':iCONIAINMENT i Technical Support Team '-i~ ~(~,"~ 1'~80 phone: 409-756-7732 'Conroe, Tx 77301 fax: 409-7S6-7766 / ~ ~ncluding this - · ' ': ' .... : ; Bob Upton - Nou 10 '95 10:05 FR FLUID CONTAINMENT TX 409 ?56 ?665 TO 180532605?6 P.02×09 ,.... ,s Results of U.S, EPA Standard Evaluation Volumetric Tank Tightness Testing Method This form tells whether the tank tighmess testing method described below complies with the perfnrmance requixcments of the federal underground storage tank regulation. The evaluation was conducted by an independent third parry evaluator according to an EPA evaluation procedure that is cquivalem to the U.S. EPA's "Standard Test Procedure for Evaluating Leak Detection Methods: Volumetric Tank Tighmess Testing Methods" published in March 1990. This evaluation was completed 15 May 1991. The evaluaxion rspon includes a description of the method, thc evaluation procedure, the test data, and thc performance calculations.. Tank owners using this leak detection system should keep this form on t'de to prove compliance with the federal regulations. Tank owners should check with state.and local agencies to make sure this form satisfies their requirements. Method Description Name O/C TANKS Hydrostatic Precision Tank Test for' Double-Wall Talg. kn Version I DWT-Tv!ge H Taoks with No Dispensing Vendor O/C TANKS COKPORATIQ~ Fiberglas Tower (street address) Toledo. Ohio 43699 (4191 248~5475 (city) (state) (zip) (Telephone) Evaluation Results This method, which declares a tank to be leaking when the measurexi leak rate exceeds the threshold of 0-05 gallon per hour, has a probability of false alarms (P~^) of, ,1.2 %. ,.. The corresponding probability of detection (Pa) of a 0.10 gallon per hour leak is 99.9 %. Therefore, this method ( x ) does ( ) does not meet the federal performance standards established by the U.S. Environmental Protection Agency (0.10 gallon per hour at Po of 95% and P~, of 5%). · Test Conditions During Evaluation The evaluation testing was conducted in a 20.000 gallon ( ) steel ( x ) double-wall fiberglass tank that was 120 inches in diameter and 442 inches long. The tests were conducted with the annular space in the tank .100 percent full. (The evaluation was conducted with the product height for half of the tests at 60 percent of capacity and the product height for the other half at 75 percent of capacity.) The temperature difference between product added to fill the tank and the liquid in the annular space ranged from -22.0~ to +21.6~]~, with a standard deviation of 17.0~. The liquid used in the annular space during the evaluation was water. Limitations of the Results The performance estimates above are only valid when: · The method has not been substantially changed. · The vendor's instructions for using the method ate followed. · The tank is no larger than 30~000 gallons. · The tank contains a product identified on the method description form. ., . * The height of the product in the tank is anywhere between 0 and I00 percent full. Volumetric TTT Method - Results Form Page I of 2 13 1991 (415) 966 -1171 (date) (phone number ) Volumetric TTT Method - Re.mits Form Pa~oe 2 of 2 NOU 10 '95 10:06 FR FLUID CONTAINMENT TX 409 ?56 ?665 TO 180532605?6 P.02×09 Results of U.S. EPA Standard Evaluation Volumetric Tank Tightness Testing Method This form tells whether the tank tighmess testing method described below complies with the performance requirements of the federal underground storage tank regulation. Thc evaluation was conducted by an independent third parry evaluator according to an EPA evaluation procedure that is equivalent to the U.S. EPA's "Standard Test Procedure for Evaluating Leak Detection Methods: Volumetric Tank Tightness Testing Methods" published in March 1990. This evaluation was completed 15 May 1991. The evaluation report includes a description of the method, the evaluation procedure, the test data, and the performance calculations.. Tank owners using this leak detection system should keep this form on file to prove compliance .. with the federal regulations. Tank owners should check with state .and local agencies to make sure this form satisfies their requirements. Method Description Name O/C TANKS Hydrostatic Precision Tank Te~t for' Double-Wall Tar~kn Version I DWT-Tvp_ e II Taoks with No D. ispensing Vendor O/C TANKS CORPORATION Fiber~las~Tower (street address) Toledo. Ohio 43699 (419~ 24I~,-.~4.7~ (city) (state) (zip) (Telephone) Evaluation Results This method, which declares a tank to be leaking when the measured leak rate exceeds the threshold of 0.05 gallon per hour, has a probability of false alarms (Ps~,) of 1.2 %. The corresponding probability of detection (Po) of a 0.10 gallon per hour leak is 99.9 %. Therefore, this mcthod( x ) does ( ) does not meet the federal performance standards established by the U.S. Environmental Protection Agency (0.10 g.allon per hour at Po of 95% and Ps^ of 5%). Test COnditions During Evaluation The evaluation testing was conducted in a 20.000 gallon ( ) steel ( x ) double-wall fiberglass tank that was 120 inches in diameter and dA~ inches long. The tests were conducted with the annular space in the tank 100 percent full. Crhe evaluation was conducted with the product height for half of the tests at 60 petcent of capacity and the product height for the other half at 75 percent of capacity.) The temperature difference between product added to fill the tank and the liquid in the annular space ranged from -22.0~ to +21,6~, with a standard deviation of 17.0~. The liquid used in the annular space during the evaluation was water. Limitations of the Results The performance estimates above are only valid when: · The method has not been substantially changed. · The vendor's instructions for using the method are followed. · The tank is no larger than ~0.000 gallons. · The tank contains a product identified on the method description form. · The height of the product in the tank is anywhere between 0 and 1,0O percent full. Volumetric TIT Method - Results Form Page I of 2 (city., state, (zip) 1~ 1991 (415) 966 -! 171 (date) (phone number) Volumetric TTT Method - Results Form Pa~ 2 of 2 OCT-B5 95 05:01 FROM:OWENS CORN N.B. 714-645-8~67 TO:I 385 05?6 PAGE:01 NOU 18 '95 10:07 FR FLUID CONTI~INMENT TX 409 ?56 ?665 TO 180532605?6 P.03×09 .~ ContinuoU~ecision ..... Tank Testing from Owens-Corning lllllD t NOU 10 '95 10:69 FR FLUID CONTAINMENT TX 469 ?56 ?665 TO 186532605?6 P.63/69 ,~ Continuo~recision " Tank Testing from Owens-Corning llllll C(~RRECTION N 0 T~iiCE BAKERSFIELD FIRE DEPARTMENT ~,',.~.;~ 020§ Sub Div. Zl,:,~0 ~-3'/~ ',~, Blk Lot You are hereby required to make the following correc{ions at the above l~ation: ~°,.~°I ~ , ~~ ~,.~ .... ~ _~, /.,, ,,, _,,,, ~. '-' = ' 't~'~'omI >/~ o,~li ~a Completion Date for Corrections ~~ , ~ Inspector 326-3979 UNDERGROUND STORAGE-T/lIE INSPECTION' ' ' ' .'" Bakersfield Fire Dept. Hazardous Materials Division ~c~' ~o,~,.s Bakersfield, CA 93301 FACILITY ADDRESS ~';~Z(') ~zl ~ .%"} ICITY FAOILI~ PHONE No. (.~ ~ - i 7~' ~ INSPECTION DATE /~/~(-~ ~c~ TIME IN TIME OUT [C ~ I ' ~ ;~c~ t INSPECTION~PE: ~ I;~u~;lL'4 ~l~4 In~t~ ROUTINE .' FOLLOW-UP ~[,~-~,.(~ °)C~ REQUIREMENTS~ 10. O~ting F~ Pa~ ~ ~ ld. S~te Sum~rge Pa~ ~ le. State,hr of Fi~ial R~si~l~ Su~ ~ lf. W~en Cont~ ~s ~n ~er & O~mt~ to O~te UST ~ ~ ~lid O~mting Pe~R ~ ~ / ~.. ~ 2b. Appmv~ Wr~en Ro~ine Mon~ng Pr~ure ~ ,/ 2c. Una~ho~ Relea, R,~n~ Plan ~ ~ ~. Tank Int~r~ T~t in ~st 12 Months ~~ 3b. ,Pr~ur~ Piping Int~r~ Test in Last 12 Months ~ .~ ~ ~,-~ ([~d ~:,,~W~ ~. Sucti~ Piping ~ghtn~ T~t in Last 3 Y~ ~ ~¢~, .... I ~e '~ ' ~. Gmv~ FI~ P~plng ~ghtn~ T~ ~n Last ~ am ~. T~t R~uRs Subm~ Within ~ Da~ ~ / 3f. Dai~ ~sual Monitodng of S~ Pr~kng / ~. Manual Invent.~R~cilati~c[~th~ ~. Annual Inve~t~R~hab~ ~tateme~Su~, ~. Meters Calib~t~ Annuall~"~ .~ 5. W~Hy Manual ~a~k Gauging R~ f~ Small Tan~ . . ~ ~.. . 6. Monthly Stabsb~l Invento~ R~d~abon R~u~s 7. MonthN A~atic Ta~'Gau~i~ff~uRs 8. Grou~ Water ~n~ng 9. ~r MonR~ing .... 10. Continuous IntemtRial Mon~oring f~ D~WalI~ Tan~ 11. M~hani~l Line Leak D~om 12. El~tmnic Line Leak Det~om 13. Continuous Piping Mon~oHng in Sum~ 14. A~omatic Pump Shrift Ca~bil~ { 15. Annual Maintenan~Calibmtion of Leak Det~i~ Equl~nt ' 16. Leak Det~tion Equipment and T~t Meth~s Llst~ in L~113 ~ 17. W~en R~ords Maintain~ on SEe 18. Re~ Chang~ in U~g~Cond~ions to O~ti~E~ng Pr~ures of UST S~tem Within ~ Da~ ' 19. Re~ Una~ho~ Relea~ WRhin 24 Houm ~. Appmv~ UST S~tem Re,irs a~ U~md~ 21. R~rds S~ng Cath~ Pmt~ti~ Ins~ ~. ' S~ur~ ~n~qg Wells ~. Drop Tu~ RE-INSPECTION DATE . II/2 ~/~ ~ RECEIVED / INSPEOTOR: ~, OFFIOE TELEPHONE No. CITY of BAKERSFIELD FIRE DEPA R TMENT FIRE SAFETY CONTROL & HAZARDOUS MATERIALS DIVISIONS 1715 CHESTER AVE. · BAKERSFIELD, CA · 99301 R.E. HUEY R.B. TOBIAS, HAZ-MAT COORDINATOR FIRE MARSHAL (805) 326-3979 (805) 326-3951 November 21, 1995 Dear Underground Storage Tank Owner: Enclosed is your updated Permit to Operate for the underground storage tank(s) located at the referenced place of business. Please take a moment to review the information printed on the permit to make sure everything is correct. If any corrections need to be made, please call the discrepancies to our attention immediately. Your Permit to Operate is a legal document and its accuracy determines whether you are in compliance with the law, If you are the tank owner and not necessarily the tank operator at the site, please make a copy of this permit for your own files. Forward the original permit to the tank location so that it may be conspicuously posted on site. If you have any questions regarding the Permit to Operate or your responsibilities as an underground storage tank owner, please call the Office of Environmental Services at (805) 326-3979, or write to us at the letterhead address. Sincerely, Hazardous Materials Coordinator Enclosure rate Underground Hazardous Materials Storage Facility C 0 N D I T I 0 N:S ~:~i~::;iO F; P:E. RMIT ;ii~.;O N iRE V E R S E S I D E Tank Hazardous Gi~iJ:iO~i?.iiiii::ii?.;.?.:?;:,' .... Ye:a~i~iiiii!iii!i.::~::.. ::il:: '~.~Tank "'::;::-;iT:.a:~:i~.;ii?;i?::. Piping Piping Piping Number '~" Substance C~ipa~!~:%.:-:::?' in'~'{~ii~::?i.'::.:., i:?..i~Type Moh'ii~i~:i~::~::':'.:'::':i:?~i~: Type Method Monitoring 01 DIESEL ~0ii~I ~:! ?:' .::: ]::~:~:~::::::L:1~:98~!~:::.:?:}::::?~ iiiiD~F ~'" .::!!;~::i'.i!: ii. SWF SUCTION LTT 02 DIESEL ii:?':i:~0~'" ?!i!: ::.;:];;:;:i:'].::':~9~???'~ SW-~:!':;:'-:~:.:~::.: ...... a~:.::;::;? :ii !: ::::ili: SWS SUCTION LTT 03 DIESEL !i?20;00ol;:.::!i .... ~::':':' i-'~8~":;.:'?'?.:?'i::D:WF':..::::.-.:::~..?i!I?:?~: CEa ..... ?:::':i!:;iii SWF SUCTION LTT '.:;~...-.- .......... ~:..:;;::..<?! ...... :..:. . · ..:....:. . ...'.: . ::::-. :...:::;:. .... .Condff[ons::subject to change: m...regulatmns~.' Issued By: .................. · ........ . .................................... · ........................... ...... ·: ..... .... %;i.i?!:.::':.::?;;::!::ii!;iii!~: .iii? '::!i!i!::'"::!iil;i iiii!-;:;ili!!!!...:::i!i?:~: ..:.!i!~.i;: ;::'::"i: ~ Bakersfield Fire ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ..... To: Dept. "%::::~:;:.:;.:;:::.i:,]..: ............-...-... :.: ::: .~:...:~?: ............. GREATER BAKERSFIELD MEMORIAL HOSPITi HAZARDOUS MATERIALS DIVISION .............. ::::::::::::::::::::::::::::::::::::::::::::::: ............. 420 34TH STREET 1715 Chester Ave., 3rd Floor BAKERSFIELD, CA 93301 Bakersfield, CA 93301 (805) 326-3979 Approved by' 12-22-93 12-22-98 Coordinator Valid from: to: ?q Underground Hazardous Materials Storage Facility State I.D. No. ~ i~; ....... ,??.~'i...!'.... ii ........................ . ................ :.:.........:?.?~,~:.~,~Permit Ni CONDITIONS ~ ~::p:~!~i~ ~ aEVERSE SIDE Number Substance cap:a:6:!~%?' in~'taii'6~a¥::..~:~::'.?Type aon'it:6]~ifi~?':~}~?~;:, Type Method Monitoring ~.. Issued By: ";<~;;Y..~::,.;/:~:~;;,::..:..;~:' ,::::;::":;L:~;*:::::*;;,;"~':'::::~;: ':::::;:::: ':; :.~::':;...:::-:'~ :~::~ .... . ...... ::::::::::::::::::::: .::~:::::": ;::::L ~::::: ~*:~::::~:.;;]...';:::::::.."::~;:: ..;-:::.:?': ~ .:::::~*:" Issued ;o; HAZARDOUS MATERIALS DIVISION .......... ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ............. (Q ~ -" 1715 Chester Ave., 3rd Floor ~ ~0 Bakersfield, CA 93301 (805) 326-3979 Approved by: Ralph E. Huey, Hazardous Materials Coordinator Valid from: ~¢~ FILE CONTE.~TS SUMMARY PERMIT #: ~OOC~ ENV. SENSITIVITY: Activity Date # Of Tanks Comments CERTIFICATION OF FINANCIAL RESPONSIBILITY ' FOR UNDERGROUND STOOGE TANK8 CONTAINING P~O~UM A. l am required to demons~a~ ~ncial Res~nsibai~ in ~e mq~red amounU as s~cified in bcfion ~7, ChapMr 18, ~. 3, Title 23. CCR: ~ 5~,~ dollars ~r ~nm [~J 1 m~ion dollars annul a~e~te or ~D or ~ 1 million dollars ~r ~u~nm ~ J 2 million dollars annul a~esate B. ~reby ce~s t~t ~ ~ /n comp/~e wSh t~ r~uire~n~ of ~t~n 2~ A~/e 3, C~pter ~, D~n 3, T~le 23, ~l~rnb ~e of ~gu~t~. ~ ~n&~ ~ ~ ~tmte ~1 ~s~i~l~ ~ ~uir~ by ~t~n 2~Tare ~ ~//o~: C. M~m'/? ' ~ a~ ~rmOf:~r~. · ' · , ~m, ~=.~p'= ~m~ ~rr~ ~ird Pa~ Note: If you are ~ing t~ ~ate Fu~ as any ~ of ~ur de~tmt~n of fl~l r~ibil~, ~ur exxon a~ su~s~n of th~ ce~at~n a~o ce~ t~t ~u are in com~e ~h afl co~ ~r ~i~t~n in t~ Fu~. F~ N~e TN~TRUCTTON~ ~ERTXFX~JtTZON OF FXIq~ICZ~I, I~BPOI~BXBXLXTY ~ ....... PLease t~ or print cLearLy att fnfo~tt~ ~ Certtficatt~ of Ff~fnt Re~tbitttyfom.~[t usT f~ltlties ~or ~ttes ~ or ~rnt~ ~y ~ tlst~ ~ ~ foe; therefore r~ir~ for e~ site. DO~EHT ~t R~i~ - Check the a~r~riate ~xes. B. N~ of T~ ~r -Futt ~ of either the tank o~er or the o~rator. or ~rator C. ~mim T~ - l~icate ~tch State ~rov~ ~ch~tm{s) are ~i~ res~fbit'ity either as c~tai~ tn the f~rat r~tati~, ~0 CFR, Part 2~, S~rt H, S~tt~ 2~.~0 throb 2~.10~ (S~ Fibular R~ibility Gui~, for ~re Info~ti~}, or Secti~ 28~.1, Chapter 18, Oivi~t~ ], TitLe ~, OCR. ~i~ x~r - List i~tifying ~r for each ~chani~ us~. Ex~Le: ~ura~e ~ttcy or file ~r as i~icat~ ~ ~ or d~t. (If using State Ctea~ (State F~) Leave blank.) C~ra~ ~t - ]~icate ~t of coverage for each t~ of ~chani~(s). If ~re than o~ ~chani~ is i~icat~, total ~st ~t 100~ of fi~iat res~ibiLity for each ·. f ac i t i ry. Cover~ Peri~ - ]~icate the effective ~te(s) of aLL fi~iaL ~chani~(s). (State F~ coverage ~td ~ c~ti~ as L~ ns y~ ~nta~n c~t~a~e a~ r~in eLigibLe to c~ti~ ~rt~ci~ti~ in the Corr~ti~ ~tim - ]~icate yes or ~. Does the s~cifi~ ft~iaL ~chani~ provide coverage for corrective action7 (If usin~ State F~, i~cate "yes".) Thi~ Party - l~icnte yes or ~. Does the s~cifi~ financial ~chani~ provide coverage for C~tJ~ third ~rty c~sation? (If ~Jng State F~, i~icate "yes".) O. F~JtJ~ - Provide att facility a~/or site ~s a~ a~resses. info--tim E. Si~ture Bt~k - Provide signature a~ date signed by tank ouner or o~rator; prJnt~ or t~ a~ title of tank o~ner or operator; signature of ~Jtness or notary a~ date sJg~; a~ print~ or t~d na~ of ~it~ss or ~tary (if notary signs as ~Jtness, please place notary seal next to notary~s signature). I~ere to Nail Certification: PLease send original to your Local ~gency (agency_who !sRues yo_ur. US.T permits). Keep a_copy_of.the ......... ~-ti~i-c~i~n-'a't-eac-h- fa~i~y-~ s~-t~-[i-~ted on the ~orm. - I~uest lens: if you have questions on financial responsibility requirements or on the Certification of Financial ResponsibiLity Form~ please contact the State UST CLeanup Fund at (916) Note: penalties for Failure to Comply lith Financial Ra%_rz~s_ibitit¥ FaiLure to comply may result in: (1) jeopardizing claimant eLigibiLity for the State UST CLeanup Fund, and (2) LiabiLity for civil penalties of up to $10,000 dot[ars per day, per underground storage tank, for each day of violation as stated in ArticLe ?, Section 25299.76(a) of the CaLifornia HeaLth and Safety Code. INSURANCE SUMMARY FOR BAKERSFIELD MEMORIAL HOSPITAL AS OF JUNE 30, 1994 COMPANY POLICY NO. TYPE OF COVERAGE & LIMITS EXPIRATION PREMIUM Farmers Insurance Group 4200540-0139 ltOSPITAL LIABILITY Continuous Reported (NO AGGREGATE) . Monthly $500,000 per occurrence* Underwriters at Lloyd's C30048-0139 Excess Hospital Liability 10-01-94 Reported London, et al $1,500,000 Excess of $500,000 Monthly Modified Occurrence Form with 7-Year Prepaid Discovery Underwriters at Lloyd's C30049-0139 Excess Hospital Liability 10-01-94 Reported London, et al $3,000,000 Excess of $2,000,000 Monthly Modified Occurrence Form with 7-Year Prepaid Discovery American International CLM 773-16-73 Excess Hospilal Liability {}1-2{}-95 $57,695.14 Specialty Lines Ins. Co. $5,000,000 Excess of $5,000,000 Modified Occurrence Form with 7-Year Prepaid Discovery Underwriters at Lloyd's 10X1093-0139 Excess Hospital Liability 05-01-95 $48,934.80 London, et al $10,000,000 Excess of $10,000,000 Modified Occurrence Form with 7-Year Prepaid Discovery American International CLM 770-89-23 Excess Hospital Liability ¢}5-01-95 $10,1X}O. 17 Specialty Lines Ins. Co. $10,000,000 part of $20,000,000 Excess of $20,000,000 Modified Occurrence Form with 7-Year Prepaid Discovery *Terms and Conditions subject to change on Non-Renewal or Cancellation. 7/21/94 SULLIVAN, KELLY & ASSOC., INC. INSURANCE I~ROKEI~ INSURANCE SUMMARY BAKERSFIELD MEMORIAL HOSPITAL Page 2... COMPANY POLICY NO. TYpE OF COVERAGE & LIMITS EXPIRATION PREMIUM Lexington Insurance Co. 865-7275-0139 Excess Hospital Liability 05-01-95 $10,000.01 $10,000,000 part of $20,000,000 Excess of $20,000,000 Modified Occurrence Form with 7-Year Prepaid Discovery Underwriters at Lloyd's 10X4092-0139 Excess Hospital Liability 08-30-94 $10,813.51 London, et al $10,000,000 Excess of $40,000,000 Modified Occurrence Form with 7-Year Prepaid Discovery Kern View Excluded Farmers Insurance Group N0042-02-63 MISCELLANEOUS LIABILITY 02-15-95 $12,031.90 For $500,000 Single Limit** Uninsured Motorist Coverage for $500,000 per person, $500,¢X)0 per accident; $5,000 Medical Payments Physical Damage for Autos: Comprehensive $100 Deductible Collision $100 Deductible Hired & Non-Owned Autos Employees & Volunteers Owners and Contractors Protective Royal Surplus Lines KEP 301807 DIRECTORS, OFFICERS & TRUSTEES 07-21-95 $50,239.47 $10,000,000 Limit of Liability (Annually) $100,000 Retention per occurrence Including Entity Coverage National Union Fire 649-6173 SPECIAL INSURANCE COVERAGE 11-20-96 $8,430.00 $10,000,000 Limit of Liability ** Excess Liability Coverage has been automatically extended to provide full limits of liability - $50,000,000. INSURANCE SUMMARY BAKERSFIELD MEMORIAL HOSPITAL Page 3... COMPANY POLICY NO. TYPE OF COVERAGE & LIMITS EXPIRATION PREMIUM National Union Fire 415-47-15 EXCESS WORKERS' COMI;ENSATION INSURANCE 01-15-95 '$26,656.00 Workers' Compensation - Limits- Statutory Employers' Liability - SI,tX)0,000 Self- Insured Retention - $300,000 "This Summary of Insurance does not take thc place or alter any of the conditions, exclusions, or other terms of the insurance policies herein summarized. This is merely a short descriptive guide to the policies in force. The policies themselves should be reviewed carefully and questions on coverage, claims and all other insurance matters should be referred to your Sullivan, Kelly & Associates representative." ,- . 7/21/94 SULLIVAN, KELLY & ASSOC., INC. 2130 G Street, Bakersfield, CA 93301 (805) 326-39?9 ~PLX~TXON ~ PE~O~ A TIGRESS TEST OPERATORS NAME . ~.~ ~- OWNERS NAME . - - -- NUMBER OF TANKS TO BE TESTED /' IS PIPING GOING TO'BE TESTED .Y~-_,~ TANK# VOLUME CONTENTS TEST ~THOD N~ OF TESTER~o¢~ DA~E BAKERSFIELD FIRE DEPT HAZARDOUS MATERIALS DIVISION Operating Permit:. ©GCb~C,- ~t Date Completed Business Name: C~:,~e~ ~. ~,~,'~l,-[ rr~,,.~,.,~;~l ~?,.~/ Location: ~ ,%~/~ Business Identification No. 215-000 /~ ~op of Business Plan) Number of Tanks: ~ Type: ~_,,~-~~ Containment: ~,~~ Lines: ~(~ ~ ~,~:~ Contact Information Owner: Emergency Contacts: ~. /~?,~k~l Adequate Inadequate 'Monitoring Program · _~' _ Records Maintenance Testing Inventory Reconciliation Response Plan Emergency Plan ._v/ _ Violations: All Items OK Correction Needed Business Owner CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT 2101 H STREET S. O. JOHNSON Jol¥ 2, 19 9 3 BAKERSFIELD. 93301 FIRE CHIEF 326-3911 MEMORIAL HOSPITAL 420 34TH 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 the underground storage tank located at the old Kern View Hospital site at 3600 San Dimas 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 non- 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 have_any questions, please call me at (805) 326-3979. Hazardous Materials Coordinator Underground Tank Program ENVIRONMENT',' _ HEALTH SERVICES OE~ART~ 2?00 "M"' ~TREET, SUITE ~00, BAKERSFIELO, ~'A.g~01 .. (805)881-363~ UNDERGROUND HAZARDOUS SU"STANOE STORAGE FACILITY * INSPECTION REPORT .FAC~LZTY ADDRESS: 420 34TH _STREET BAKERSFIELD, CA ONNERS NA~:BAKERSF~ELD NEHORZAL HOSPZTAL ......... C. ~d~fied Invsntory Oontrol ~~ c. ~ravity 6. NE, CONSTRUCTiON;MODIF~OATIONS ~0 ~~ ~. CLOSURE/ABANDON"ENT ~/~' 8. UNAU~ORIZED RELEASE ~ ~.- OPERATIN~ CONDITION OF FACILITY COMMENTS/;ECOMMEN OAT IONS INSPECTOR: . .~]]]]] ........ REPORT RECEIVED ~Y:..~.=~_~~ 1700 Flower Street r~:RN COUNTY HEALTH DEPARTMEh, .EALTH OFFICE. Bakersfield, California 93305 r Leon M Hebertson, M.D. Telephone (805) 86{-3636 , - ENVIRONMENTAL HEALTH DiViSION DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Reichard May 13. 1987 Jim Couglin American Air 4525 New Horizon Blvd., S~tte 1 Bakersfield, California 93309 Dear Mr. Cougltn: Thls is to advise you that this department has completed the new construction inspections for the underground tanks at Bakersfield Memorial Hospltal at 420 34th Street in Bakersfield, California. Based upon the findlngs durlng the facillty inspections, thls department is satisfied that all the new construction requirement have been met as per permit #060003B. Should you have any questions, please feel free to call me at (805) 861-3636. Sincerely, ~oe Canas , Environmental Health Specialist Hazardous Materials Management Program JC:sw DISTRICT OFFICES Delano . Lamon! ~ke Isabella . Mojave Rldgecrest . Shafter . Taft · E UNTY HEALTH DEPARTMENT ._RMIT TO CONSTRUCT V .rmi~ /~ 0~30003B ~UNDERGROUND STORAGE FACILIT! FACILITY NAME AND ADDRESS: OWNER(S) NAME 'AND MAILING ADDRESS: Memorial Hospital Great.~er Bakersfield Memorial Hospital .420 34th Street. 420 34th Street 'Bakersfield, CA Bakersfield, CA 93301 ~[x~[ NEW BUSINESS [ PERMIT EXPIRES January 17, 1987 ' CHANGE OWNERSH~ ~ i RENEWAL , APPROVAL DATE J'anuary 17, 1986 '~ ~ OTHER ~ APPROVED BY ,.,~.,,~ .... ., ~'1. All pe'rtin~nt ~q~lpment and materials Used in this oonstru~tion ...~'- Authority prior to ~onstruction. 'This p~rmit ~ ~ ,~ssu~d '', · , ~ontingent upon guarant~ed complianc~ ~ith th~ guidelin'~s ~termined by th~ Permitting Authority. d~part~ent and verified by inspection by P~rmitting Author~ty. ~ 3. P~r~ltt~ must 'montact Permitting A~thority for on-~ite ~nspection(s) ~ith 48 hours advance notice. "~'." 4 Secondary containment of underground product piping must be identified ~nd ~pprov~d by this depar tme,nt prior to " 5. Backfill' material for piping and tanks to b~ as p~r -. 6.' All underground metal product piping, fi'ttings, and connection~ · ,:';.must be wrapped to. a m~nimum 20-mil thickness with corrosion- preventive, gasoline~resistant tape or oth~rwise protected from corrosion. ,, 7. ,Construction ~nsp~ction record ~ard is included with permit ' ,~ g~ven to,.P~rmittee. This card .must b~ posted at jobsite prior to initial inspection. P~rmitt~ must contact Permitting Authority and arrange for ~ach g~oup of required inspections numbered as per instructions on card. Generally, inspections' a. tank~ and backfill b. piping System With secondary containment ~. overfill protection and leak detection/monitoring d. any other inspection deemed n~c~ssary by Permitting '~ Authority .8. All ~quipment and materials in this construction must be installed In accordance with all manufacturers' sp~cificati.on~. '.' 9. Contractor must be certifie.d by tank manufacturer for installation of fiberglass tanks or a manufacture, representative must be present at site during installation. ,,, by Permitting Authority. 11. Monitoring requirements for this facility will be described on final "Pe¢~ to operate./ 1700 FIower Street K .~ COUNTY HEALTH DEPART~IEN HEALTH OFFICER Bekm'alleid, California 93305 Leon M Hehertson, M.D. Telephone (805) 861-3636 EN¥1RONMENTAL HEALTH DIVISION ,, ~C~,:~,,,:-.~,. DIRECTOR OF ENVIRONMENTAL HEALTH ,., . ~. Vernon S. Re/chard January 14, 1986 .. Greater Bakersfield Memorial Hospital ' :'_~_._~420 34th.. Street. :'.: ' ;' ' ~ Bakersfield, California 93301 .......................... :..::;, S~¥'/Madam: ' ' '.::' ": This is to' advise you that this department has reviewed the project results for the fuel seepage :investigation you conducted at 420 34th St~-~t, Bakersfield, California. Based upon the findings described in the report, this department is "' .... s~tisfied that the assessmont is complete and no significant soil con~d.nation resulting from fuel tank leakage exists at the site. ' .. Thank you for your cooperation in this matter. -Sincerely, ..//;QI '"') ,. ~nn Boyce, R.S. Environmental Health Specialist III '~' Hazardous Substances l~:~nagor~nt Program' .. AB: aa cc: Bernard Brothers DISTRICT OFFICES Delano . Lamont . Lake I-abella . Mojave . Rldgecrest Shatter Taft Since 1898 Geotechnical and Environmental Consultants · Engineering anO Chemical Laboratories File: HL-830081-15 October t5, 198-6 ...... Examination #686-0306 For: Bernards Bros. Construction 3500 San Dimas Bakersfield, CA 93301 Attn: Mr. Robert K. Lindeman '" Project: 'GREATER BAKERSFIELD MEMORIAL HOSPITAL NEW TOWER AND CENTRAL PLANT PROJECT BAKERSFIELD, CALIFORNIA Architect: Millard Archuleta-Eddy-~aynter Contractor: Bernards Bros. Construction Subject: Soil Sampling and Analysis Dear Gentlemen, In accordance with your request and authorization, Ted Wright o'f our firm obtained soil samples from the above-referenced site. The soil samples were obtained at the loCations outlined on the attached site plan. The locations and sample depths were determined by Bernards Bros. Construction personnel. The.testing performed was determined from Kern County Health Department Permit No. Al04 for the 55'0 gallon tank. The soil samples were transported to our Fresno laboratory by Twining Laboratories, Inc. personnel. Strict chain-of-custody procedures were followed. Please find enclosed the 'results of the chemical analysis of the soil samples. Also included is a copy of the khain-of-custody form and a site map. Finally, we have attached our invoice which covers the services provided. [~ 2527 Fresno Street · P.O. Box 1472 E] 9401 West Gost~en Avenue Fresno, California 93716 · (209) 268-7021 Visalia, California 93291 · (209) 651-2190 r-i 1405 Granite Lane, Suite I i 5301 Office Park Drive, Suite 310 Modesto, California 95351 · (209) 523-0994 Bakersfield, Califorma 93309 -(805) 322-5216 Greater Bakersfield Memorial Hospital ~xamination #686-0306 Page 2 We appreciate the opportunity to be of service to you. If you ~_~hould have any questions_.regarding .the information provided,~ please~ _ contact our office. Sincerely, THE TWINING LABORATORIES, INC. Theodore D. Wright, RCE ~33710 (exp. 6-~0-90) Engineering Manager Bakersfield Office TDW/kl RD/TDW/kl 2c: Bernards Bros. Construction lc: Freeman Little Millard Archuleta-Eddy-Paynter Langdon-Wilson-Mumper Heery Program Management, Inc. . Wheeler and Gray Greater Bkfd. Memorial Hosp. Office of Statewide Health, Planning and Development OSA , Sacramento B Fresno Moclesto Visal~a BaV, etstietd Great%r Bakersfield Memorial Hospital Examination #686-0306 Page 3 Sample: ........... 6 Soils .. ................................ ~ ................ Received': 10-3-86 from R. Kurz of Twining Labs TEST RESULTS TEST .R .ESULT$ SAMPLE BENZENE TVOH mg /kg mg/kg Soil #1; B-i, 2.0-2.5 ND ND Soil 92; B-2, 6.0-6.5 ND ND Soil #3; B-3, 2.0-2.5 ND ND Soil #4; B-4, 6.0-6.5 ND ND Soil #5; B-5, 2.0-2.5 ND ND Soil ~6, B-6, 6.0-6.5 ND ND MDL 0.05 0.5 mk/kg: milligrams per kilogram (ppm) TVOH: Total Volatile Organic Hydrocarbons (standard reference: diesel #2) ND: None Detected above the MDL MDL: Method Detection Limit Fresno Mo~esto Visalia Bakersfield The Twining LaboratorieS, Inc. CHAIN OF CUSTODY RECORD Project No. ~/~- [-'~ ~~J\ ' Affiliation of Sampler/Snipper '- ~ ~ ~~.' ................... Number Street City ~ ~ State Zip Telephone Sig~ture Transported ay~+ ~--*~ Date Shipped Io-~-~G Sample Receiver I,~'~,~ ~ ~.'-.~,,,~ ~ Date/Time Received ~ - 3.. ~ ~ I. ~7 Comments ~ Collector's Sample No. Sample Description Analysis Requested Chain of Possession: ~.~~ Inclusive Dates 2. ' '7'~ ;~i,~/,~.~ ~ · 1o-2- · Affi~ation ' Inclusive Dates / Sign~ure ' / Affiliation Inctusive D~tes 1700 Flower Slreel KEHN COUI'~I] ¥' HF AL. l H I)I~P/\RTN .EA-Z. OFfiCeR BMMIIIIi~ California 93305 r Leol} M Heberlton, TM~hone (805) 861-3636 . ENv IRONMEN] AL HEAL IH DIVISION c?:: :' -. DIREC ] OR OF ENVIRONMENT~ HEALTH I .3~u~ 14, 1986 ~ '"'"' Gr~t~ ~ersfield ~rial .Hospital ~;:. ¥, ~ersfield, California 93301 rosults for ~e fuel s~o ~vos~ation 7m co~uct~ at 420 34~ ~sfield, ~lifo~ia. ..- ~s~ u~n ~e find~gs descr~ in ~e re~, ~is de~nt is -." . · ' 'satisfi~ ~t ~e assess~t is co~lete ~d no si~ific~t soil con--nation '-"..' result~g fr~ fuel ~ l~age ~ists at ~e site. ': ~ ~u for yo~ c~ration in ~is ~tter. S~cere ly, ~ ~ Boyce~ R.S.~ ~viro~l Heal~ S~ialist III ,. : Hazardous S~s~ces ~ag~t pr~r~ " cc: .Bernard Brothers DISTRICT OFFICES Deteno . Lament . Lakelaabell& , Mojeve Rldgecresf Shelter Taft CHEMISTS · ENGINEERS 1405 Granite Lane, Suite 1 Modesto, CA 95351 (20<3) 523-0gg4 g401 W. Goshen Vlsalla, CA 93277 (209) 651.2190 5301 Office Park Orive, Suite 310 Bakersfield, CA 93309 (805) 322-5216 File: B1.,_830081_15Please Address All Mail to P.O. Sox 1472, Fresno, California 93716 January 13, 1986 Examination 86-00212 For: '''~ Greater Bakersfield Memorial Hospital ~- c/o Heery Program Management, Inc. ............. ~ ............................... ~ ....... 16255-Ventura Boulevard,_ Suite. 503 Encino, CA. 91436 .. ,... Attn: Esther J. Cabanban Project: GREATER BAKERSFIELD MEMORIAL HOSPITAL NEW TOWER PROJECT BAKERSFIELD, CALIFORNIA Architect: Millard Archuleta-Eddy-Paynter Contractor: Bernards Bros. Construction Subject: Soil. Sampling and Analysis Sampled By: Ted Wright Gary Kiger, Twining Laboratories, Inc. - Date Sampled: 12-27-85 .Date Received: 12-30-85 ENGINEERING AND ANALYTICAL SERVICES FOR CONSTRUCTION. TESTING. CONTROL. AND RESEARCH Soil Foundation and Gcologica~ lnves~ C--m~ -.mxion .N4a~erials Jnspection and T~ Ch~micat and PhFsk~J Analyr~s ol' Concrtt~ Steel. AJloys. So~ls. Plant Tissue. Tt. MM,m~. As · mMtml proet~tion to client~, the public and twrs~lves, afl rt~x~s are s~hni(ted as lite conf'dem~d prol~rty od' db.nt% and auOn~.~om for Im~c~tiofl of Eeery Program Management, Inc. Examination %86700212 Page 2 .,-~ Sample Location ~TOE 0il and Grease Benzene , ug/g ug/g ug/g West End Excavation 2.0-2.5' ND ND NA West End Excavation 6.0-6.5' ND ND NA End Excavat ion 2.0-2.5 ' ND · · ND East, NA · Eas~ End Excavation 6.0-6.5' ND ND '-550 gal. Tank 2.0-2.5' ND NA 550 gal Tank 6 0-6.5' ND NA Pipeline 2.0-2.5' ' ND ND : 'NA Pipeline 6.0-6.5' ND ND NA MDL (Diesel) 10 0.2 0.05 MDL (Fuel Oil %4) 20 0.2 ANALYSIS DATES Benzene: 1-3-86 TOE (Diesel): 1-6-86 TOE (Fuel Oil %4): 1/10/86 Oil Grease: 1/7/86 MDL, - Method Detection Limit ND - Constituent not detected at or above method detection limit NA '--- Not Analyzed ug/g - Microgram per gram (part per million) TOE - Total Organic Eydrocarbon Reference Materials: Diesel %2 for 550 gal Tank samples : Fuel Oil %4 for all other samples TEST METHODS Benzene: EPA Method 5020 and 8020 TOH : Modified EPA Method 3540 and 8015 .' Oil Grease: Standard Methods for the Examination of Water and Wastewater, Method 503 C Fresno Modeslo Visalla Bakersfield TLO~ 2527 Freeno Streel Fresno, CA 93721 (209) 268.?021 CHEMISfS · ENGINEERS 1405 Granite Lane, Suite I Modesto, CA95351 (20~)523-0994 9401 W. Goshen Visalla. CA 93277 (209) 651-2190 5301 Office Park Drive, Suite 310 Bakersfield, CA 93309 (~05) 322-5216 8_ _____e :~L__30081_lsPlease Address All Mall to P.O. Box 1472, Fresno, California 93716 January 13, 1986 Examination 86-00212 For: Greater Bakersfield Memorial Hospital · . .... c/o Heer7 Program Management, Inc. '"'""-'~ ........... 16255 Ventura Boulevard,-.'Suite'503 Attn:, Esther J. Cabanban Project: GREATER BAKERSFIELD MEMORIAL HOSPITAL NEW TOWER PROJECT 'BAKERSFIELD, CALIFORNIA Architect: Millard Archuleta-Eddy-Paynter Contractor: Bernards Bros. Construction Subject: Soil Sampling and Analysis Sampled By: Ted Wright Gary Kiger', Twining Laboratories, Inc. Date Sampled: 12-27-85 Date Received: 12-30-85 ENGINEERING AND ANALYTICAL SERVICES FOR CONSTRUCTION, TESTING, CONTROL. AND RESEARCH Soil Foundation and GeoioSic~J lnve~H~ati~a~. ~ioa Male~aJs inspection and T~-~i~ Ch~nical and Physi~ai Aa~lyses of Concrete. SUxL Alloys, S~. PI~ul Tisme. %~ Heery Program Management, Inc. ..... Examination %86-00212 !.:':?' .' Page 2 ' Sample Location "TOH Oil and Grease Benzene :, ug/g ug/g Ug/g West End Excavation 2.0-2.5' ND ND NA West End Excavation 6.0-6.5' ND ND NA ~' East End Excavation 2.0-2.5' ND ND NA ':: "East End Excavation 6.0-6.5' ND ND NA "' .,- ,.,.5'50 gal. Tank 2.0-2.5' ND NA ND ~.:. . 550 gal. Tank 6.0-6.5' ND NA ND' ' Pipeline 2.0-2.5' ND ND NA Pipeline 6.0-6.5' ND ND NA MDL (Diesel) 10 0.2 0.05 MDL (Fuel Oil %4) 20 0.2 ANALYSIs DATES Benzene: 1-3-86 ' TOH (Diesel): 1-6-86 TOH (Fuel Oil %4): 1/10/86 Oil Grease: 1/7/86 MDL - Method Detection Limit ND r..Constituent not detected at or above method detection limit 'NA - Not Analyzed Ug/g - Microgram per gram (part per million) TOH - Total Organic Hydrocarbon · Reference Materials: Diesel %2 for 550 gal Tank samples ~ Fuel Oil %4 for all other samples' TEST METHODS Benzene: EPA Method 5020 and 8020 TOH : Modified EPA Method 3540 and 8015 Oil Grease: Standard Methods for the Examination of-Water and Wastewater, Method 503 C Fresno Mo(leslo VIsalla Ba~(e;sl~eld 17~Flower Street kERN COUNTY HEALTH DEPART ~ HEATH OFFICER Bakersfield, California 93305 r Leon M Hebertson, M.D. ~lephone (805) 861-3636 ENVlRONMEN~L HEALTH DIVISION DIRECTOR OF EN~RONMENTAL HEALTH · ~rnon S. Relchard .August 19, 1986 Doug Wittrock ............................. Project'Engi~e~ .................................. i America Air Company 616 E. Race Visalia, CA 93291 Dear Mr. Wittrock: This is in response to the drawings and equipment information received by this department regarding the piping at the Greater Bakersfield Memorial Hospital expansion project. Pursuant to Kern County Ordinance Code Section 3912.3.01, Chapter 3 all Underground storage tanks must be .designed and constructed to provide primary and secondary levels of containment. After reviewing the information submitted on the 20th of June, this department feels that the requirements of the Kern County Ordinance are being met. The use of A.O. Smith- Inland secondary containment system piping complies with the requirements of permit number 060003B, condition #Tb. The completion of the underground piping construction may continue as proposed. Should you have any questions, please "feel free to call me at (805) 861-3636. Sincerely, Environmental Health Specialist Hazardous Materials Management Program JC:aa DISTRICT OFFICES Delano . Lamont Lake Isabella . Mojave Ridgecrest . Shafler . Taft BAI RSFIELD MEMORIAL HOSPITAL "°" FULLY APPROVED BY THE JOINT COMMISSION ON ACCREDITATION OF HOSPITAI~ " MAlUNG ADDRESS: P.O. BOX 1888 · BAKERSFIELD, CALIFORNIA 93303-1888 420 34TH STREET ~, (80.5) 327-1792 ~ LARRY CAP, R, PRESIDENT August 26, 1986 'County of Kern Health Department ........................ ....... . ......... 1700 Flower Street Bakersfield, CA 93306 Gentlemen: RE: Local Air Pollution Control Authority Permit Requirement for Boiler Installation Local Requirement for Do~ble Walled Pip~n~ to Underground Fossil Fuel Storage Tanks The attached notice is sent by the State to local plan review agencies. This notice explains that the State has preempted from local plan review and inspection processes projects such as Memorial Hospital's six story tower addition. The notice further explains legislative intent when there are local require- ments that are more restrictive than the State requirements. It shallbe the responsibility of the local jurisdiction to keep the State advised of more restrictive requirements. Such requirements shall be enforced by the State. In two-instances the Health Department has attempted to apply more restric- tive requirements to Memorial Hospital's State permitted project. In our effort to maintain a cooperative relationship with the County of Kern', we have endeavored to accommodate the County's request; however, problems have resulted because of this. Memorial Hospital wishes to remain in conformance with all applicable lOcal requirements. However, we must also comply with State law which requires us to build in accordance with State approved plans and specifications. If the State is to approve the plans and specifications that are in compliance with local law, it appears to us that local requirements must be promulgated through the State process as outlined. BOARD OF DIRECI'ORS GORDON K. FOSTER, CHAIRMAN JOHN R. ALMKLOV, M.D., VICE CHAIRMAN EDWARD H. SHULF,]R, SECRETARY.TREASURER JOHN M. BROCK, ,IR. C. LARRY CARR WALTER H. CONDLEY JOEL D. MACK, M.D. ROBERT C. MARSHALL, M.D. THOMAS W. SMITI~ D. IANN WILEY County of Ke~n Heal th Department August 26, 1986 ~. Page two -I-~tould qn~l~t~--~e~re~ntatives-from-your-Health Department-toFmeet with-~ representatives from the State Health Planning and Development Agency during one of their regular visits to our job site here in Bakersfield. It is my desire that you could participate in such a meeting so that these issues could be discussed and hopefully resolved. I have taken the liberty of scheduling such a meeting for September 8, 1986, at 11:00 a.m. in the Memor- ial Hospital Conference Room. VH~rman Ruddelij ~~ i ~... ........................... . Vice President Support Services cc: Merle Carnegie/State Health Planning & Development Agency David Larson/Langdon, Wilson, Mumper Esther Cabanban/Heery Program Mgmt. 'AU~ 2 9 1~86 COUNTY H~.TH DEPT. Provisions of the Hospital Seismic Safety Act of T983 (Chapte~ lj commencing with Sectional5000 of Division 12.5 of the Health and Safety Code) health facility projects licensed under Section 1250 of the Health and. Safety Code are exempt ............ _~rgm local plan review and inspect~on~prpces~~ a~PrOceduresr ........... ~_~..-~_~ ................ ?wever~ Section 1500l of the Health and Safety Code states in Part:-.. .. '--' '' "It:is the intent of the legislature that where local jurisdictions have more restrictive requirements for the enforcement of building standards, other building regulations and construction supervisionj..suchlrequirements shall be enforced by the State. It shall be the responsibilf~y of each local jurisdiction to keep the Office of Statewide Health Planning and Development advised as to the existence of any more restrictive requi-rements. Where a reasonable doubt 'exists as to whether the requirements of the local jurisdiction are more restrictive, the effect of these requirements shall be determined by the Building Safety Board." Matters related to use permits, local zoning, environmental impact and architectural review committees, etc., remain the responsibility pf the .local building jurisdiction. If you have not previously informed this office of your more restrictive local standards, or if you have local zoning, environmental impact, etc., matters that must be considered, or if you wish to make input into the plan revie~ process, please advise this office at your earliest convenience. In order to facilitate an early plan review response to the applicant, we request your input within the next fifteen days. Lack of response will be construed to - mean that no more restrictive local standards exist. --' 0616D/gsw · - Standard Compliance gheck Equipment to be installed: ~_ Tank(s) , ~Oc3 ft. of [~]suction [3Pressurized piping ...... ;.~Req,~d ...... ~- - - ......... . ......... --- v"' ~_~-~6,Pr i ma r y Containment [~Fiberglass (FRP) Make & Model ~,~- DFiberglass-clad steel Make & Model ~ DUncoated steel Make & Model ~ [3Other: Make & Model Comment: ....................................... Additf onal: ,~ /~ Secondary Containment of Tank(s) ~Double-walled tank(s) Make & Model /~,~/'~_~ [3Synthetic liner Make & Model'-''-22D .... [3Lined concrete vault(s) Sealer used [3Othe'r Type Make & Model Comment-. Additional: ' Secondary containment volume at least 100% of'primar'y tank vol ume (s) Comment: Additional: Secoh'd'~ry containment v61ume for more than one tank contains 150% of volume of largest primary containemnt or 10% of aggregate primary volume, whichever is greater Comment: Additional: Secondary containment open to rainfall must accomodate 24 hour rainfall Total Volume Comment: Additional: Seco~{dary containment '~s productScompatible Product Documentation Comment: Additional: -~ ~%, -'~ Annular space liquid is comp,atible with productt ,, '- Product b;~_l ~2 -A~,~ar ~iqui~.: " Comment: "'-' ' '- ' .... ' "" Additional: Primary Containment of Piping [2]Fiberg!ass piping Size & Make [-]Coated steel piping Size & Make ~Uncoated steel piping Size Comment: Additional: Secondary Cor{tai'nment of Piping -~ [~]Double-walled pipe Size & Make []Synthetic liner in trench Size & Make [2]Other Comment.'. :" ............................................. / ~ I-~ CorrosionAdditi°hal~"~TankPr°tecti°n/'~w ~z~z~'~( s): ~, ~a~<~' --~ b~- ' ~" { ~J~ ' [2]Piping & fi'ttings~ []Electrical isolation Comment: ' ' ~ddit ional .' V~ .'~ ;~ Manufacturer-App. f6ve~r% BaCkfill for Tanks & Piping' Type ~, ~"J~ ~ Comment: Tank('s) Located No Closer ,Than 10 Feet to Buildin~(s)l .' · · Comments: 7~i /~.~ ~/-~' ~.~,~' · Additional: ~/~ ~_~ Complete Monitoring System Monitoring device within secondary contai/Iment: [~Liquid level iqd~cator(s) ~~ ~Liquid used ~'./~L.,,- o~,.~ ~]Thermal conductivity sensor(s) [-]Pressure sensor (s) -- [2]Vac uum gauge -- ~Sump (s) J-]Gas or vapor detector(s) J-]Manual inspection & sampling ~]Visual inspection Other ~3,'~; ~ ~ ' Additional: Other Monitoring Periodi~ tightness testing Method Pressure-reduci'ng line leak detector(s) Other Comment: ................... Additional: .... Overfill Protection ~' [']Tape float gauge(s) ~i~Float vent valve(s) /')/~'/.4.,1 .~"3 V~5 ~3/ []Capacitance sensor(s) [-]High level alarm(s) [']Automatic shut-off control(s) ill box(es) with 1 ft.3 volume ........................ perator controls' with Visual ie~'~~ing.. Other Comment - Additional: Monitoring ReqUirements · Additional Comments Inspector ~ ' Date · . Permit Application Checklist · u/Standard Design __ MOtor Vehicle Fuel Exemption Design (Secondary Containment) (Non-Secondary Containment) Approved~. ..-.. Permit Application Form Properly Completed Deficiencies: 3 Copie~ of Plot Plan Depicting: ~ -- Property. lines ~ Area encompassed by minimum 100 foot radius around tank(s) and 'piping All tank(s) identified by a number and product to be stored Adequate scale (minimum 1"=16'0" in detail) ~'= ~' North arrow All structures within 50 foot ~adius of tank(s) and piping _~0_. Location a~d !abel~ng o~ ~1~ p~d~ct piping and dispenser Environmental sensitivity datW~i~3~luding: *Depth to first groundwater at site *Any domestic or agricultural water well within 100 leer'of ..... tank(s) and piping *Any surface water in unlined conveyance within 100 feet of tank(s) and piping *Ail utility lines within 25 feet of tank(s) and piping (telephone, electrical, water, sewage, gas, lea~h lines, seepage pits, drainage systems) '*Asterisked items: appropriate documentation if permittee seeks a motor vehicle fuel exemption ~rom ~econdary containment Comments: · Approved " 3 Cio'Pies of Construction Drawings Depi, ctin9 ~ -- Side View bf Tank Installation with Backf'~li, Raceway(s), Secondar. y Contair~ment and/~r Leak Moni'toringSys~em in Place Top View of Tank Installation with RacewaY(s), Secondary ~ .. Containment ~nd/or Leak ~onitorinq Szstem ~in~Plac .. -~~~ ~~ ~~.~ · . A Materials List (indicating those used in the construction). . ~ -~ Tank(s) - ~,,~ - ~~ .. ~ Product Pi~ihg ~k ~[~~,~ / -- · '.. .... · Raceway (s) Sealer(s) Secondary Containment 'n~ak D~tec~or(s) .~ ~~ 'Gas or Vapor Detector(s) ' Sump(s) ,- Monitoring W~ll(s) Additional: Documentation of Product Performance SITE INSPECTION: Approved Disapproved COmments: Inspector Date ~! .... · Kern County H,ealth Department Permit Number A104 ~' 1700 Flower Street · .~: Baker-~fie~d, CA 93305 . CT 06 ,- ~,., ....~ {805) 861-3636 '~ r' PERMIT FOR TEHPORARY OR PERHANENT CLOSURE/ABANDONHENT OF UNDERGROUND HAZARDOUS SUBSTANCES STORAGE~.F_ACX ~ ~-.~,~:;.~.T~aq~.~Name and Address. .-. Owner'.. N~me and Addr'e~s'. ....~-~ ~'.~'~?, ;~;:'~,::;~'.~ ,~...~.~:~,,.~.~.~f~-~ ~:",.. ~'~.~h..~" 5 ~ .re:et .... ~...: .'.~:~:., .,':, .~:'. ,:?. '.:'--~- '.. ~: .~20 .. ~.~ ~ .:~t ~,p~ t ::~-' ::~..~.'?~. ?~::~ '~. ~.' ~,: ... ~;- -~ :: . ,~ ~ ..... ~.,.~ ...; .~ ...... . ........... ~ .......... ~ .... ......... ~ .., ~.,.~ ...... ~ .... . ...... ~.?".'~L ", ~:~/ .... : .... ':.~- ':~ ' ' '; :' '~'~' ':: -'~." ~ .. ' . ' ....... ~" ~' '~ ~ '.~ '.'~ ...... · · '~,' ' "~ ~,~:~-~:5'~.~; ~an~:a~. above ;:.,,~:-'~ ~'< '. :"~ppPova~ '~.a'~Peeember~"13, 1985 .:. ... .... .:..: ..... . ~ ,.:;,~ ~: ...... ~.' ~...' ..: . . -~ ..'.~.: : · -;:~ :~' . ~/ ~ ",.,'-~ .?.~?...-.,?-~.Oa~. · ..... : '.. .- ... ~ppPove.d b7 · ~..'?~ ~,~.//~~, ,. ~.... ,~: ....~.-.:,..~:~.~.~,: ....-. ..~...-;. ,. ~: ~.". . .... ..... ::~ ~: : .... ~.. ., ...... . . ~ . .... .~: ~ ~ ...... ~ ............................... ~-~-~--~._ · . . .. -~ ~ ' .~... :~ . . . -, ~.~.. . *.~,.'..:: : ;~:~' ':~ ':.' ~:. '- '1. ,: ' ~erm'tg~el':'m~3~ .ob~aZn pe~mi~ from.. Fl~e .Depa~tmenk .priOr '. ,-'. ~ .." Abando.nmen~/mua~'be per approved me~hod~ a~ .deScribed ~n '~:~": ~:/pe~.}~_'aPpll.~ag~on-and Fire ~epargme'n~ ~a~d°u['. ~..-;~:~.~:..-:': ,/.: " '" · l'~.,~pro,e~ure~ ~ed mu~ be ~n.'~ac~fdanOe,~,,~.h~. ~,.;~. ~:-~'.:' .. '~. ~:~Ime.n~:'a~.tow ~'. 'Kern cbun~:/Y 6~/~an'oS/:;:.~e''''. :l:~:~'.q,1.'.< A ...... ~ :O:P~'-'.;~ f - these ~equ lrementa~.'/lre, ~nC.l.o.sed.'~'w~.th.:..~h i$~.e rm~ t .. ~ ':"'~',',..,'. :.'~-. '" nd~':6:'?~dlree~ly ,~.:under t~:;~'~ngaF./o~- the.':~.~O.:.~Sal-~:o~:". ~ank' '':~ ~.~?.":' '. "::::'"" ? i'..,'.:::.?,:,..~.~nd~ every i5 .llne'a~ feet o~ .piPe, run.. must. ~-~ re~rtev.ed .,~'. ~ ~ ~' ~:/..?~'r.~.. ., '~':?a~aample'd~.. . . for t°.tal hyd.ro~arbona and 'b~'~Zehe, .:-':~:'..:. .. "~5~.~/;~-:A m'$nlmum of rour'~amples, a~. de.p~ha or app.~o~...1ma~e17 2/ "~'.~,-: :..5' ~:~:)?:..,and' 6:* :--one-third from the' end ~f ~,~e' 12,0::~0'.. gal;10n ..~ank ':' ::,:.; """~ ...... and":~very..15 Itnear. ree~ :~-pSpe run mUS~ be pe,~Zeved ..... ..... , . .~ :~'.. /.-~.-'...~.;~...' ... , :....~?:,~ ..,6..2:Adv~'=a ~h-i= or~-i~e o.r t~me' and da~e. o~"~o~'~d''~. _, __ 3am.pl~n~ ~(:.~tgh'"'2~ ho~r'~ adV.an~e nOt,o'S::;' ~ .... '. ::~::.::.'~:,~:' .. ',:'~.. . "".'~' .~. .:. ~ ~.." '..~' . .: ~. . ~ ; .. .~/, ... :.' .,..; ~'-~:,.ao~'e~a .~v · O~ · "~ "'Da~'~ /~ ,;. . . ..... , .... ~:. , ,,. .. .,. ...~._ ...... .: _'; ............. ~ ....... '~: . '. .. ..... ~ ........... : J: :_ .'_: ......... :. . .." __..~ ........ . ..... .~ '~. . ~i Kern County Health Department Permit Number A104 '?' 1700 Flower Street .... ~ ~. Bakersfield, CA 93305 . CT 06 · '''" (805) 861-3636 ': .'~ PERMIT FOR TEMPORARY OR PERMANENT .: , ~ CLOSURE/ABANDONMENT OF UND OUND '" -* .' HAZARDOUS SUBSTANCES STORAGE F_ACILITY'*'" '" ' '~ ~,*~:?: . ~" '.L. ~* .'.. , '.: ' .:' · ~.' . , .~ :.- '. ~?,* ' :~ ' ,;~k:~:'~,~:.~,~::~3~'~a=il~:~y::~Hame and Address. ~- Owner., N~me aad 'Addr'e~'a'.. .,. :- k...~'-~:-~.,~.~,~--'. '~.'~' .~c~ .~,~' '~[.% .', . .~<'~.' .:.~ ...,., ~ . -~, .~ , ~ · .;': . ~. , ~ ', ,~-.:~ ; .... ~ · ' '~. '~... - '" ;~z.~;~4~.'(z'~:~.;:~emo~t.,~:,.Ho~lt'a.~.'..~ '. ;.~/.'.'~ ::.jr,(.' .:Grea~er-::~ake~,f'~l~:'~:~emorial '8o3~ '~ ~'. ~.;:.,::aa ke.~,' f ~e:~d-,----~ ~ ::~::~----~-~-~--."--B~ k e r'm.t~i e~' ;~-:;~A :-~:~'~93:3 ~lt~:~-'~':i- ~,Y~';'~:i,.Z %an~t'-m~. above ;:.,'? ..... .t '- ."Approval '~.e'?~Deeember "13, 1985 :~'.;'i-.:' :."V': '~' :, ". "":' ~:'~;".: :'.;: .: ',-~ ' "~ ' . '~ ..?:~:" ' ' ~ ,' .',:~ :~.' ' ~'~ ~ "~-'-~. · -~.-~;.,~ .-.-~ --.. ~ ,~ ,~ ,'.~...',~' .-., .~:-. ~..-.... --~ ~ ~~ . -~ ~,...~ ; ~ ~ ~ , . - , ~;-,.. ~. . .~ ~. .~.- .,~ ~.~;~' : .- .,~ · ~ .. ?, -,. . . ~:,.. .,. ., ~..',, ,~, :~ ~ ~.. , ~'?:. ,~; ~ · . ~ '... . ~.:~. ,~.~-., ..-.f ~,. :...~:,~;~.~.,,, .... :. :...-:,:., . . ~ .... . ~.;-.. ~: . , .~ ,, ,. .... ~:...~',~...j~::.~?.:.~ ,.~. .. - .~... ,"~:' "~f .':),~["'!.,::" ~er'm'~gtel.:"m~=t' .Obtain perm~~. from..'Fi~e .De'~"a'~'~m~n% p'r't~r ' ,'% ?<.<-:~" · ;:<*;' : . :': "' .. : ' ', "'-'. : ..~/ ..: ' ' ' ' .* '. ~.~::¢,.:.¢~'~" iband'onm~¢t~mu~t'.be per approved method~, a~ ,de~cr~.bed :" '.:',?:~.. :::~':~t':pe~m~.,'aPpli.catl'on- and Fire"Departmen~ Hand°ut'. ~..'.;gl :.~:~ .:..' ""):~...:~ .??',~: .'~.' "::' A-l~.','~r6~edure= u~,d must 'be ~n.'~ac~o~d~n~e',:~tg, h ~:":'::-~:~,:~:'" '." '~'~i~-":%:~,:;:~ :':-~:' :~eq:~'~ement= o~. ~:.'"Standard= 'an~' G.u Id~ 1 ~u~.e~ve loped ~:~':~ ..~; ..'-.?~, -.,..:~7~.'~ -. :--.; ~. .. ~. . :: - .... . ", -:<: . ,.:;. :? .,' . .> '.., ..: ..,. . ~< ..... ':.. ~...:::. ....... <~. ~>;:?[:.~lme.n~at$on' ~f. · Kern Coua:~'y O~inanoe'::~e · j~l. ',~ ': :'"'.~":..:'~: ~; ,":/~[::? '? ...aO:p~::¢f. these ~e'qu i remen ta;:.':are an~.l.osid":'w{th :th ti~e rm '. :-. . .- ' ;~' ' '' :')". · ' '' : ~ - -' '.~' '; · ',?~:': · '-"' ':..~" ,' '::i'. · '~ .:..':~:~:-..- :::.. ~t,:.~:::,m~n$.mum 'of t~o sara'pies ~gt.:,~eptha of .Ipp~:~ximateI'~ ;' ..... ,~,: .... <:'".',: lind: every 1~ ll~ea~ fee~ o~ pipe Fun mu~t · ~a~leved ' :' '~:" 'd:::", ':': . :':.. · ' . . . ' ~ ' · ' ' '...'.:":'~ - .,:::.'.: ':'...:-:::-~?' :.:'.a~ sampled: for total hyd.roc.arbon8 and be'~zene, . :: ' "" :':::'',,: .':':5~,.,..,:-:i minimum, of four ~amples at depths off. app.~o~-ima~el7 ?.':::,.,and' ~:' ,-..one-third From the' end of ~:he 12,O.00,. ga:,lon ..tank -..:.... . ....:: ...... , .... . ,., , ~, and"'aver7 15 linear, feet '~f.-pipe run mUst~ be ret~ieved '::':':: .: ::': :~(~?,.'.'[-'. :' and:: :'-'~ampl'ed~. ~or .oil, Er'ease ex~racti~ "a~d" total ,,'~:~/ :: . . .'.:.., ....... ~:' . ' :.: , ., :~ .. · . : .. ~ : >.~. . ~' /.. ':',. ::.:.:')~, ,.6:"~.:l. dvl'~a th'i= office< of time' and dale 'oF"~'Po~d'~ampli.ng '~' ,~:~.' .:"'L'.~;.:-':, :...~.Wit~'""2~ ho~r~ adV.an~e not.l~'~' ~-~. :. il:'..'<:.~:'." .~. .. ,:::..,::... ~':.,~'... :.,; ...: . .~.-.~:: .-.. ,: · . , ,. . ',:~::- ~. ". ,. ~ "~: .!.:..~ :.. · ~ -. ~ . · .. ~'.. - .. . . . .Z. ,~ . . Provide Descripti i 'sical Layout of Facility pace Provided Below; I~clude All the F~ _owing Infomation: _,~., Location of~ Tank(s) , Piping & Dispenser(s) .Z'~ Proposed Sampling Locations Indicating Approximate Depth of Samples Nearest Street or Intersection J~/} Any Water Wells or Surface Waters Within 100' Radi,us of Facility Approved By Scale Provide Descripti~f Ph sical La out of Facilit ~l~{n~ S~ace {~,,. . Y Y. ~- y( ~ ~-- Provided Below; I~clude All the Ft~ ;lng Infomatlon: ~,~., Location of Tank(s), Piping & Dispenser (s) · ~ =~ Proposed Sampling Locations Indicating Approximate Depth of Samples Nearest Street or Intersection J~/] Dz~ Any Water Wells or Surface Waters Within 100' Radius of Facility Approved By Scale ~ -'~Division o~ Enviro~ental H~I~- .- A~licatio~-~ ~ , . - '~PLI~TION ~R PE~IT ~ OP~TE ~E~R~ ~ Facility ~dification of Facility ~isti~ Facility ~nsfer , Oohn Brewer o~ ~ Wetcn ' A. ~ergen~.24-~ur contact (n~e, area e~e, ~one): ~ 327~1792 Ex. 1891 Nigh~ 366-6855 or~22-8919 ~ Facility ~ Bakersfield Memorial ~o~pital. ~. . ,~ .i .~ , .' ~ of' 8~ineSs (c~ck): ~line S~t:on ~er {oe~rz~l Hospital '~ Zs ~nk(s) Us~ ~rily for ~ricultural ~r~ses? OYes ~ .' Facility ~dre~ ~20 34th Street ~eare~ Cro~ St. San Dimes . ~. T R SEC (R~al ~at~'o~ ~ly) ' ' ~r · G.B:M.~ ~n~ct ~r~. Paul Wel~h .,~ . ~. ~r~sS ~420'~th Street Zip ~le~ ~27-q792 Ex. q89~ ~rator Same ~n~ct ~r~ ,. .... B. ~r m ~aclli~ p~id~ by California Water Service ~ ~: ~ro~~r ~2' · '~il ~r~ristics' at ~cility ~andv and Rocky '. " C, ~tractor Ama*lean AiD Ca. :'~ ~ntractor's ~a'~. 292529 ~la~ 805-397-1776 ~dre~ 4525 New Horizon' Zip ~_ /"" Pro~ 'S~rti~' ~ ~-~}-8~ . ~o~s~ C~etl~ ~ta 12-31-85 ~rk~r's C~~ti~ C~r-tificatl~ [ R,C:S.' 097D84 Imur~ Royal Insurance v Pro~ Nh ' ~E. ~nk(s) Stor~ (~mck all ~t a~ly): . ' Ta~ { ~s~ Pr~uct ~tor V~hicl~ Unl~ R~Ular Pr~i~ Di~l o' m o ',o D Q. 'G. ~ansfer of ~er~ip ~te of ~fer NA Pr~io~ ~er '", Pr~io~ Facility N~ · :.. I, accept fully all obligatio~ of ~mit :~:' I ~dersta~ that ~e ~mitti~ ~ority ~ r~i~ a~ ~i'f~ or te~i~te ~e t~a~fer of ~e ~it ~ ~rate ~is ~dergro~d stor~e '.facility u~n r~eivi~ ~is c~plet~ fo~. ., tr~ a~ cor~'~t.l ~ ' ' 2. ~ ~teriai Fi~rglass-Reinforc~ Plastic ~Co~rete Other (de~ri~) 3. Priory Contai~nt ~te Ins~ll~ ' ~ic~ss (Inches)' ~city (~11~) ~ufac~rer 4. Tank ~co~ary C~tai~nt ~(s) of b~lr(s) OTap rl~t ~o ~rl~t Vent ~ic~ (i~s) ~~ter Varies ~ufmc~rer , c. U~ergro~ Pipit, ~co~ary Contai~nt: 2. ~ ~teriai Fi~rglass-Reinforc~ ~lastic ~Co~rete ~~tn~ ~Br~ ~~. Other (de~ri~) 3. Priory Contai~nt , ~te Ins~ll~ ~lc~ss (Inches) ~city (~11~) 4. Tank ~co~ary C~tai~nt 5. Ta~ Interior~~ ~(m) of ~ir(s) ~ic~ (i~s) ~~er Varies ~u~ac~rer c. O~ergro~ pipit, ~co~ary ConCai~nt: " Flat, lass-Re inforc~ Plastic 3. ~ri~ry Contai~nt ~te Ins~l~ ~ic~ss {~nches) ~city (~11~) ~u~ac~re~ 4. Tan~ ~co~ar~ C~tai~nt ' - 5. ...... 6. ~ Cozro=ion Prot~l~ ~Tar ~ ~lt ~~ ~~ ~r (~i~)z ". . . ~~ ~r ~at ~-. ~sti~ ~y , O~ens/Corninq , ,, ~rlb b~lrs ..... OTa~ Fl~t ~e ~Fl~t Vent Valv~ ~ ~ S~t- Off ~trols 11. Plpi~ ' a. ~ergro~ Pipl~ ~s ~ ~~ ~ri~ Schedule 80 S~eel ~lc~ (i~hes) Sch. 80 Dieter Varies ~ubct~er c. U~ergro~ Pipit, ~ary Contai~nt: Kern County ·Health Department Permit Number A104 1700 Flower. ~treet Bakersfield, CA 93305 CT ~ 06 (805). 861-3636 PERMIT F~OR TEMPORARY OR PERMANENT CLOSURE/ABAND6NMENT OF UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY , Facility Name and Address Owner .Name and Address Memorial ·Hospital . Greater Bakersfield Memorial Hosp, ~20. 34th'Street 420 34~h Stree~ Bakersfield, CA ' Bakersfield, CA R330!. Eermtt to Abandon Permit Expires'Deuember 13, 1986 2 ~anks .a~ above .Approval Date ' December 13, 1985 'focatl.on Approved by ,~ ~ ' Co~diBlons as Follows: .. .. =o ~ia~in~ abando~men~ sa~ion.. '~, · . and every 15 linear feet of pipe run must be retrieved - and sampled for total hydrocarbons and benzene. " 5. A minimum of four samples at depths of approximately 2' and 6' one-third from the end of the 12,000 gallon. ~ank and every 15 linear feet of pipe run must be retrieved ,. and sampled for oil, gr'ease extraction and total ' hydrocarbons. .'.,' 6. Advise this office of time and date of proposed sampling '' with 2~ hours advance notice .... Contractor's Ucense No. 2~.529 4~,25 New Horizon, Suite ~ Bakersfield, California 93313 · (805) 3~7-1776 September 30, 1986. KERN GOUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH DIVISION 1700 Flower' Street Bakersfield, CA 93303 ............ AT'IN: ....... aOE._CANAS ..................................................... RE: ...GREATER BAKERSFIELD MEMORIAL HOSPITAL SUBJECT: CONFIRMATION Of INFORMATION DISCUSSED DURING HEALTH DEPARTMENT SITE VISIT OF FRIDAY, SEPTEMBER 26, 1986. Dear Mr. Canas: AMERICAN AIR OO. 'understands that it is acceptable to the KERN COUNTY HEALTH DEPARTMENT for AMERICffqq AIR CO. to modify 2 inch A.O. Smith- Inland Thermosetting resin fittings for use as a substitute for an item which is not conTnercially available. These fittings will be modified as follows: Fittings will be longitudinally split and reassembled with epoxy and bands. These fittings are to be used only on the secondary containment piping of the 3/#" steel pipe'used for the existing emergency generator tem- porary fuel oil system. If the KERN COUNTY HEALTH DEPARTMENT understands differently, please respond within seven (7) days. ~ o, INCo ?roiect Engineer JC/rp cc: Ken Kemple - B.B.c. Kern County Health Departmen Permit ..... F%Oiv'zsion of Environmental. Healt' Application Bat /~700 Flower Street, Bakersfield, CA 93305 No. of Tanks to be Abandoned APPLICATIGN FOR PEI~MIT FOR TIg~POl%%R~ aR P~ CLOSURE/~ OF UND~ BAZA~DOUS SUBSTANCES STOR~SE ~ACI~ ........ Type of Application .-(Fill. Out One Application Per_Facility) .......................... [] T~porary Closure/Abandonmen--~ ~d/~{/~ ~ Permanent Clo~ure/~%b~n_donment A. Project Contact_ (name, area code, phone): ,Days ~DF-$~-$C&§ _ Nights Facility Name ~dd~F, ~z~?_,~/~ /~eiW~£;&/ /~r~;F_~/- /~ /_~, .~$_ _ . Facility Address ~/3J9 ,FNh~ _{~.z~-~te/~.~3~$~! Nearest Cross St. ~.~'~n 'T. -- ;' R ~ 'SEC -' - ~'(RUfaI Locations Only) O~erator. ~ ~z~/F~ ~_~,~beY~l~/J~,~/~///~27~/ Telephone ' S. ~ter to 'Facility ~ovid~ by ~X ~~ ~;.._ ~p~ ~. Gro~d~t~r ~. ~}~'"' 'Soil Characteristics at F~ility P~~ ' ~sis for ~i! ~ a~ Sro~ter ~p~ ~emi~tio~ /~f~ C. T~ Re,val ContractQr ~/~o ~ ~~~ ~ Lice-- ~. ~dress ~~D~~. ~ ~/~ ~, ~//~. Zip ~ Tele~ne ~ ~r-ker s C~n~tion Certification ~ ~ ~A~./~/ I~urer ~_n F.~.~/~a~m~ Enviro~ental Asses~ent Coatractor ~ Lice~ ~. ~dress Zip Tele~ne Pro~s~ Starti~ ~te .... Pro~s~ C~pletion ~ ~rker s C~a~ion CertifiCation ~ Insurer D. Ch~ical C~sition of Materials Stor~ Tank ~ Chemical Stored (non-co~rcial na~) Dates Stor~ Chemical Previousl~ Stor~ ( if different). to to E~ ~sc~i~ ~eth~ for Ret~i~v[~ S~ples $~~ ~D~.c ~ D~z~ ~s wilt ~ ~al~ f~. ' ' ~~ / ~?~ t~.win ~fo~ ~a~es of s~ie~ ~ ~z~,~ ~ ~. F. This application for: ~removal or ~a~ndo~ent in pla~ * * PL~SE ~IDE I~O~TION. REQUESTD ~ ~E SIDE OF ~IS ~ BE~RE SU~I~I~ ~PPLICATI~ ~R ~. This' fo~ has been completed ~nder penalty o~ perjury and to the best of my knowledg-~-is true and correct. Kern County Health Departm~ J- Permi~-~- ~.~i~Jision of Environmental F~ Application~I · ~700 Flower Street, Bakersfield, CA 93305 No. of Tanks to be Abandoned APPLICA~ON ~R PE/~MIT H3R ~ OR ~ CI~A~ OF UND~ ~hype of Application · (Fill Out One A~plication ~er Facility) .............. ' ..... FITe~porary- Closu~e/Abandonme~ ~_--~ ~?~ ~/~ ~ I~manent. Clo~sur~/J~ndonment- A. ~ro~ect Contact (name, area code, phone): Days ~L~Jj(~-$f~ 'Nights Soil Characteristics at Facility U~gu Enviro~ental Asses~ent Contractor ~ Lice~ ~. Address Zip Tele~one Pro~s~ Starti~ ~te Pro~s~ C~pletion ~te ~rker s C~nsation CertificatiOn ~ Insurer D. Ch~ical C~sition of Materials Stor~ Tank % Chemical Stored (non-co~rcial name) Dates Stor~ Chemical Previously Stor~ (if different). to to F. This application for: ~ removal or ~a~ndo~ent in pla~ -This-foL~ has--been completed.under, penalty of-perjury and to the .best. of my knowledge is true and corroct. '- FILE CONTENTS. INP3~TOH¥ [~]Permit to Ope~afe t O~'DDO3~_~ ' Date ~Const[uction Permit ~ ~~~ Date /~-/?-~ ~Permit to abandon~ ~/~ No. of Tanks ~ Date ~ended Permit Conditions ~Pe~mit Applicatio~ Form, .~ Tank Sheets, FlOw Chart ~Applicatio. to Abandon~ tanks(s) ...... Dat~___/~_-/~.~ ~Copy o{ Written Contract Be:ween Owner g Opera:or ~Inspection Reports ~Correapondence - 'Received ~C°rresaondence - Nailed Date ~Unauthott~e4 Relearns Reports ~Abandoneent/Closure Reports ' ' ~Sampltng/Lab Re~rts~}~,~ ~, ' ' ~MVF C~pllance Check (NeW ~OnstrUc"tio'n Chec'kli"~t) ' ~STO C~pltance Check (New Construction Chec~st~ ~MVF elan Check (New Construction) O STO Plan Check (New Construction) OMVF elan Check (Existing Facility) ~STD Plan Check (,Existing Facility) ~'lncomplete Application' Form ~Permit Application Checklist OPermit Instructions ODiscarded ~Tightnese Test Results -- Date Date Da te ~Monito[l~ Well Construction Data/Permits ~Enviro~ental Sensitivity Data: Groundwatec Drilling, Boring Logs Location of Water Wells ~Statement of Underground ConduCts ~Plot elan Featuring All Environmentally Sensitive Data ~Photos OConst ruction Drawings Location: ~Hal~ sheet showing date received and tally of inspection OMC scel laneous GREATER BAKERSFIELD MEMORIAL HOSPITAL FULL Y APPROVED BY THE JOINT COMMISSION ON ACCREDITATION OF HOSPITALS P.O. BOX 1805 * 420 $4TH STREET * BAKERSFIELD. CALIFORNIA 93303 * (805) J27-17~2 C. L~4RR¥ C~4RR. PRESIDENT April 5, 1985 Kern~County Health Dept. DiviSion of E viromental Health 1700 Flower St. ........... BakersfLeld, Ca~. 93305 Attn: UndergoUnd Storage Permits PERMIT NO. 060003C Gentlemen: Construction of our new tower will start as soon as final plans are approved by the state. We will replace these 2 tanks with 2 - 12~000 gal fuel tanks. In the interim I trust the attached information will be adequate. John J.-Brewer Chief Engineer JJB:pb BOARD OF DIRECTORS OORDON I~. FOSTER, CHAIRMAN JOHN I~. ALMKhOV, M.D., VICE CHAIRMAN WARD C. WATERMAN, SECRETARY-TREASURER THEODORE L BOSONETTO, M.D. C. LARRY CARR JOHN J. CAWLEY, M.D. WALTER H. CONDLEY JOEL D. NI~CK, M.D. RALPH K S~4]TH, Jl~. THOMAS W. SMITH Kern C~unty Health Department~ . Permit O~ (~(~O~ ' .D~vis~on of Enviro~en~l He~' A~lication - 1700 Flo~r Street, Bakersfield, _~ 93305 . ~PLI~TION ~R PE~IT ~ oPE~TE ~E~R~ ~~US SUBST~C~ S~E FACILI~ ~ of Application (ch~k): ~ Facility ~ificatton of Facility ~isti~ Facility ~a~fer of ~er~ip 3ohn Brewer Paul Welch 18 A. ~ergen~ 24-~ur Contact (~e, area c~e, ~one): ~ 327-1792 ex-1891 327-1792 ex Nigh~366- 6855 322-89 Facility ~ Bakersfield Memorial Hospital ~. Of T~ 2 .......... ~ of B~iness- (c~6k): .... ~'~line--S~tion ..... ~e~(de~ri~) .... Hos~p~t-a-1 .... ~ ..... Is Tank(s) ~cat~ on ~ ~ricultural Fa~? ~Y~ Is Tank(s) Us~ ~i~rily for ~ricultural ~r~ses? ~Yes Facility~dre~ 420 34th Street Bakersfield Nearest Cro~ St. San Dimas T R SEC (R~al ~atio~ ~ly) ~er Bakersfield Memorial Hospiatl Con.ct ~r~ Paul Welch ~ress 420 34th Street Bakersfield 'Zip 93301 ~le~one327-1792 ext. 1891 ~rator same Con.ct ........ ~dress ~. . Same ................................. Zip B. ~r ~ Facili~ Pr~id~ by California Water Servi~p~ ~: Gro~~N 22 Ft ~il ~racteristics'at ~cility Sandy and Rocky ~ ' ~sis for Soil ~ ~ Gro~ter ~p~ ~temi~tio~BSK Engineer's Report C. C~tractor N.A. ~ ~ntractor' S ~ce~e ~. ~rker' s C~~ti~ .Ce'rtificati~ ~ I~urer , ' ' ' Pro~ N.A. g. ~k(s) S~re (~eck all ~t a~ly): T~R ~ ~s~ Pr~uct ~tor Vehicle Unle~ R~ular Pr~i~ Die~l ~ste F. ~i~l ~sl~i~ of ~terials Stor~ (~t ~es~ry for ~tor v~icle ~ls) (if 'differmn[) ] # 2 Dfesel 2 [/ 4 Fuel Oil G. Transfer of Ownership Date of ~--ansfer N. A Previous Owner Previous Facility Name ' ' I, accept fully all obligations 'of permit N~. __ issued to · I understand that the permitting Authority may review and modify or terminate the transfer of the permit to Operate this t~dergrotmd storage facility upon receiving this completed form. ~h'is form has been completed under 'penalty of perjury and to the best of my knowledge is true and correct~-~ Signature~ ~~JY~ TitlePlant Manager Date 3-13-85 Facility Name Bakersfield ~morial Hospital Permit No. ~)~O'~ TANK ~ ' (FILL OUT SEPARATE FORM zH TANK) · ~OR' EACH SECTION, CHECK ALL APPROPRIATE BOXES H. 1. Tank is: [~Vaul~ed x~Non-Vaulted [~Double-Wall [~Single-Wall ' 2. ~ Material Carbon Steel [] Stainless Steel [-]Polyvinyl Chloride D Fiberglass-Clad Steel Fiberglass-Reinforced Plastic [] Concrete [] Alumin~u [] Bronze []']Unknown ['~ Other (describe) 3. Primary Containment Date Installed Thickness (Inches) ~ ~Capact~y (Gallons) Manufacturer 19 5 5 ~ __5_5..0 L..A.___B o i 1 e r 4. Tank Secondary contail~uent [~Double-Wall [] Synthetic Liner []Lined Vault [~None []Unkno~ [] Other (describe): Manufacturer []Material Thickness (Inches) Capacity (Gals.) 5. Tank Interior ~ ' ---~Rubber []Alkyd []Epoxy [~henolic []Glass []Clay []Unlined ~U~kno~ []Other (describe): .......... 6...Tank Corrosion Protection .................. . --]~GalvaniZed ~ass-Clad •Pol~thylene Wrap OVinyl Wra~ing []Tar or Asphalt x~Jnkn~m~ []None []Other (describe): Cathodic Protection: ~]None []Impressed Current System ~l~acrifi¢ial ~ System Descri'be System & Equi[:ment: 7. Leak Detection, Monitoring, and In.t~ ~. 'T~:.. ~-~is~al (vaUlted "tan~ only) [2]Groundwater Monitor~r~3' Wall (s) []Vadose Zone Monitoring Well(s) ['] U-Tube Without Liner ~[~U-Tube with C(mmpatible Liner Directing Flow to Monitoring Wall(s) Vapor Datector* [] Liquid Level Sensor' [] Conductivit~ Sensor' [] Pressure Sensor in Annular Space of Double Wall Tank [] Liquid Bstrie~al & Inspection Fr~m U-Tube, Monitoring Wall or A~ar Space [] DailyG~uging~ & Inventory Reconciliation [~ Periodic Tightness Tasting r'~ione Ii Unkno~,,n [] Other b. Piping: Flow-Restricting Leak Detector(s) for Pressurized Piping' [']Monitoring S~np wi~h Race~a¥ []Sealed Concrete Rece~a¥ []Hal~-Cu~ Compatible Pipe Raceway ~'~S~n~etic Liner Race~ay [] unknown [] (Ycher *Describe Make & ~del: 8. ~en Tiqhkness Tested? ~¥es ~']No []Unkno~m Date o~ La~c Tightness Test Resulks o~ Tes~ Test Name Testing Company 9. Tank Repair Tank Repaired? []Yes ~No []Unknown Date(s) of Repair(s) Describe Repairs 10. Overfill Protection []Operator Fills, Controls, & Visually Monitors Level []Tape Float Gauge []FlOat Vent Valves []Auto Shut- Off Controls Capacitance Sensor []Sealed Fill Box. ~None []Unknown Other: List Make & Model F~ A~ De~ices 11. Piping a. Underground Pipirg: ~]Yes []No ~Unknown Material Thickness (inches) Diameter Manufacturer []Pressure []Suc{'f6n ~Gravity Approximate Length o'f Pipe'l?ia~ ............... ~... ..... _Und. erground .Piping Corrosion Protection : []Galvanized [7Fiberglass-Clad ~Im[xessed Current []Sacrificial Anode []Polyethylene Wrap [qElectrica! Isolation []Vinyl Wrap []Tar or ,Asphalt []Unknown ~None []Other (describe): c. Underground Piping, Secondary Contair~ent: ~Double-Wall []Synthetic Liner System ~]None [-~Unkno~ []Other (describe): Facility Name ~r~.al Hospital Pemit No. TANK ~ 2 (FILL OUT SEPARATE FORM FOR ~C~] TANK) ~.FOR EACH SECTION, CHECK Af.T. APPROPRIATE BOXES H. 1. Tank is: []]Vaulted ~on-Vaulted []Double-Wall []Single-Wall 2. ~ Material Carbon Steel ~q Stainless Steel []polyvinyl Chloride []Fiberglass-Clad Steel Fiberglass-Reinforced Plastic []Concrete [2] Alumin~ [] Bronze []Unknown Other (describe) - Primary Containment Date Installed Thickness (Inches) Capacity (Gallons) Manufacturer · T~'? ~--='~-~ .....~ .... -Unknown- .... 1'-2-~-000 ...... ~ ..........Bue'hie ~. 4. Tank Secondary Containment DDouble-Wall []Synthetic Liner [~Lined Vault ~None ['~Unknown [-~Other (describe): Manufacturer: ~lMaterial Thickness (Inches) Capacity (Gals.) 5. Tang Interior Lining '-~Rubber FTAlkyd []Epoxy []Phenolic F3Glass FTClay WUnlined [l[~alo%m "[]Other (describe): I ............ 6~ .... Tank-Corrosion-Protection ---~Galvani'zed --~l~oer---~£ass-Clad []Polyethylene Wrap [2]Vinyl Wral~ir~ .' ~Tar or Asphalt []Unkno~m []None []Other (describe): ' ':' Cathodic Protection: ~None []Impressed Current System ~lgacrificisl ~ System ~e--s~ribe' System & Equit~ent: ~ 7. Leak Detection, Monitoring, and InterceptiOn a. Tank: UlVisual (vaulted tanks only) [2]Groundwater Monitorirg' [2]Vadose Zone Monitoring Well(s) []U-Tube Without Liner _[]U-Tube with Ccmpattble Liner Directing Flow to Monitorirg We_ll(s) Vapor Detector* [] Liquid Level sensors [] ¢onductivit~ Sensor' U1 Pressure Sensor in Annular Space of Double Wall Tank [] Liquid Retrieval & Inspection Pr~m U-Tube, Monitoring Well or ;~allar Space ~__Daily C~,uging & Inventory Reconciliation aPeriodic Tightness Tasting None[] Unknown ~Other 3 mo. gauging b. Piping: Flow-Restrictir~ Leak Detector(s) for Pressurized Pipir~j= []Monitoring St~p with Race~y O Sealed Concrete []Half-Cut Compatible Pipe Raceway []Synthetic Liner Race,my D Unknown [] Other *Describe Make & Model: 8 's zs Tank Tightness en ' Tightness Tested? []Yes ~ r]Unknown Date of Last Tightness Test Results of Test Test Name Testin~ Ccmpany 9. Tank ~ ~ ~epaired? . nyes ~[~o []Unknown Date(s) of Repair(s) Describe Repairs ._ .10. Overfill Protection [~Operator PillS, Controls, & Visually Monitors Level ' ['~Tape Float Gauge []Float Vent Valves []Auto Shut- Off Controls Capacitance Sensor rTSealed Fill Box ¥.' .-3_ ~one []Unknown Other: List Make i Model I~o~ Abort De, ices a. Underground Piping: II,Yet ._'.~No []Unknown Material Steel Thickness ( tnches);~·'/~.~o~4~iameter Manufacturer []Pressure []SuctS'on/U1Gravity Approximate Length of Pipe lama .......... b: -- Underground Piping Corrosion- Protection--: ........................ .- =- ' []Galvanized []Fiberglass-Clad []Impressed O~rent []Sacrificial Anode I-]Polyethylene Wrap [-]~.lectrical Isolation ~Vin¥1 Wrap ~ar or Asphalt ['lUnknown ~.:~one []Other (describe): c. Underground Pxpirg, Secondary Contai~uent: [-]Double-Wall []Synthetic Liner System ~t~one []Unknown []Other (describe): · ~ -- -~ ~ ,, ..... . '~[.:~;.' .:.,_:~, ~ , -'~?t~,~. ~ ~r~?~' ...... '?:~ . · .: .-:': .. ' t ,, . .':. ~:.(.... :- >".:" 2.03 FUEL OIL CONTROL P~EL: .. ....'.:::: ..;,.'L[ ' ~ . ~;~ '. ~....., .: : ~'.'.""::-:. ": A. The fuel' o~1 level ~ndicator, control and ~lar~ syste~ sh~ll be Tesco -- ;'?~" "" : Reattve Air. Control 'No. LA26789-3C as fur~ished by Ken Cramer C~pany of Los ~:., ¥..,: ..., ... .~. ~, '4,L ~'t :[ ."-e~ .'. :t,'.'~'L.:',..?. B. The fuel otl control shall be enclosed in a NEMA 1, wall mounted enClOsUre'"':':: ,,~..:',.::,',:'.~,. ?. .... .. approximately 36" wide, 54" high and 10" deep, for operation on 120 volt, single.;;/' '.,...',~,?~-.:: phase, 60 Hz po~er supply. ~ontrol sh~ll be c~plete ~h ~11 level co~rols~:;::;'f~'' ~ .'.>'-':?~;'F:~.'~. ~ ~. ,~.~: ....butl~-ln ~tr c~pres~or and receiver tank, indlca~lon ~nd ~l~m lt~h~, ~nk 'L-',..."v:'; '::: level ~nd~c~or ~a~e~ ~or ~round ~ora~e ~ank~', c~l~br~ed ~ ~llons for }~.~. L .. f~ 1~1 ~ltch {d~y-cont~ct~) tn ~ach of th~ day tank~. ~on~oll~r ~h~ll '-:~...'~ -: ~:-:~.: -~rov~d~ 8-O-g ~tehe~ for.'~ch 'of -tho t~nsfo~'~u~¢s'~th--d~lnd ~d '~ .. ~nd ~o~o~ control~ for each pu~. St~r~ ~nd ~op sen~n~ fr~ ~t~h~ {d~ .':- ~.~ , ...:.:,.. contacts in each day tank) · ~'. ~:~' '..,. :~ .. . ;:~:~'~:' ... .. i ~ ~;' Greater Bakersfi~ ,em. Hosp. Fuel Oil' System ~?~.i~ Bakersfield, California 15606 - 3 ZY- ... C. Remote alarm panels shall be provided to be mounted'at tank fill location. . to provi'de high alarm light and reset button to operate at high 1.evel of the ~ '"' ground storage tanks which will. energize the solenoid valve in the fill line to .-.~. .... '~" close. Pushing the reset button will open the valve to allow the draining of ..~,. .:.,"~:,~::~ ~ .... the tank truck fill hose., Remote alarm shall be Monel LA-26790 as furnished by .-:--- ..... ~. ~~'7~7.- _ -- . _ . ..... r~.-,~7:.-.~,.- : i~.:'?:7-? .:.. 1. Control panel shall provide an amber "power on" light, ground storage.i.~ "?-' tank indicator gages, 'high and low alarm indicator lights' for ground storage '"- ~':~, ~,:~'.... ',.-.: .:.. tanks and low alarm indicator lights for each day tank. A low air pressure i?'~.;. ';::.,-': .:-:..l'ight shall also be provided. , ~?:'.':".~?~.:" "' 2. Alarm and indicator lights shall be of the Dim-Glow type, normally ~ .~,-.---?.~,'? ..... burning at low brilliance but comin.g to_full brilliance when ind.ica~ing._an.._a.l_a~r.m,_..i. , .......... :~¥~-7'--T': ' Cond i t i on .' ........................ . ?.-,.,: .'. ..... , 3. Accurate measurement of the level of the underground storage tanks'. ~:.....:~_: .... .:i~-:.shall be by Tesco Self-Purging Reactive Air Control. Air shall flow through an ?: · ~""'~-~ .~':'-..." adjustable air flow regulator and air control lines to the ground storage tanks.'.',' "' .'~-.-.. · a. Level measurement for alarm levels shall be by individual pressure'''~ .~.~.~- .... switches, pressure range .! to 10", each adjustable and operating an enclosed -.'~'.":~-.-~... mercury switch. Air-flow regulator shall be calibrated 0 to ~.0 CFH to permit :, ' - . visual setting of the bubbling rate. -F-:, b. Shut-off and bleed valves shall be included in the tank line to .~. facilitate the adjustment and set-up of the control system. .. :' 4. The air supply .for this control system shall include an integrally · '.~ mounted 1/2 HP air compressor complete with 2 gallon storage tank, air filter, adjustable pressure switch and pressure reducing valve with pressure gages for tank, and .dj scharge pressure. ~. . ";' .. 5. Continuous level indication of the underground storage tanks shall be... '~'*' '~i>..:' by flush mounted 6" pressure gages calibrated i.n gallons of fuel oil. . .':.7,. ,' ."' 6. If the level in ground storage tanks No. 1 or No. 2' drops to 1000 ':: gallons, low level alarm shall be actuated. When the level during filling rises ....~.. to 9,500. gallons in No. 1 or No. 2, the high level alarm shall be actuated and .... ~'~-.... visual and audible alarm in the remote alarm panel at the fill location shall be ':" "" actuated, closing the solenoid fill valve to prevent street overflow. Silencing ii~"" the alarm in remote panel shall open the solenoid valve to allow for draining of ~. the fill hose. . .' ..~ 7. If the level in a day tank drops to 10 gallons as sensed by the float .... '-"-. -- sensor in the Simplex day tank it shall close a dry contact to send a signal to :711' :. the control panel for low level alarn~indication. ~.,. ,., 8. There shall be furnished integrally mounted in the control panel motor' starters with H-O-A switches and demand and run lights for each of the transfer pumps (one for each day tank), start and stop points for the control of these ..- ..... -~ ........... transfer pumpS'Shall be~by' dry"contacts-in- the 'day-tanl~§~ ..................... - .... g. There shall be a pressure switch in the air supply system. Should the air pressure fall to an emergency low level (15 psig), the pressure switch Shall ......~ ·. Greater Bakers ' tem. Hosp. Fuel Oil System .~:'-.~. '~Bakersfield, CalifOrnia 15600 - 4. ~i;.'~':i.:' c~lose energizing a time delay relay. If pressure remains low for a preset time, .. · ~j;',.:i~.:,~ij~:~,: .' a contact will close to energize the "low air pressure alarm". ...~-' .- ~.:..~.~.... 10. Provide flush mounted on the face of the panel in addition to the tank · ;: .F.-~ . .-.~ level indicators for Tanks No. 1 and 2, and the transfer p~p H-O-A switches and :L"~...:..': "demand and run lights, g alarm stations with a co~on 4" bell and auxiliar~ ..~...~¥ .'.'.:.. .'": light with adjustable Dim-Glow feature..and silencer button. · Alarm stations .~' '~.' .... full brilliance and sound the alarm bell, pressing the silencer button for the" alarm station shall silence the bell and the light will continue to glow at full' . '~;:;.. ':~'"~......' .~ brilliance until the condition is corrected. Operation of the silencer button '~'"'""~?~" ::'~' station will in.no way effect the full operation of other stations. '"~:~"~ .~': -~'-..:.. 11. provide, for s~arate mounting adjacent to the tank fill· locations," .' ~. " remote ala~ panels which' shall be actuated from .the main panel On "high level"--; storage tank alarm. The panel shall provide a single alarm station with red indicator light and a 2" bell and silencer button. On actuation of the high .. ~ 4%~'~'~ ~m alarm, the solenoid valve in the fill line shall be closed. Actuation of the' -. '... silencer button on the remote panel shall silence the alarm bell and open the .. -.-- solenoid valve to allow for drainage of the hose. The r~ote panel shall be ... provided in a NE~ 3 flush mounted, locked door enclosure requiring a 1~0 volt .. power supply. ~.~. 12. All control equipment shal,lJ. Oe guaranteed against defects in material ;:.,. and workmanship for a period of one year from the date of installation. After " ..... equipment has been installed and made ready for operation, the services of a ~'?~::' technical representative of the control manufacturer shall supervise the final ~.~: adjustment and.~instruct the operating and maintenance personnel in the syst~ ~..:.. operation and maintenance procedures. ,f~ S~F 2.05 FUEL OIL DAY T~KS: Tanks shall be fabricated of steel, welded throughout and conforming in all respects to the applicable provisions of the National Fire· 2~ Protection Association Standards and shall bear UL label -. ~:,."-~.-.~. A. Tanks shall be capacity as indicated on the Drawings. · .. B. T~ks shall be thoroughly cleaned, primed with red lead and finish painted ' with gray entel on the exterior. Inside of tank shall be thorobghly cleaned. C. Tappings shall be as required for connections of fuel oil piping as indi- :~ ...........cated on the Drawings and as required for'float operated switches to provide operation described under "Fuel Oil Control Panel" and as shown. Greater Bakersf ~ tem. Hosp. Fuel',Oil System Bakersfield., California ,'D. Tanks shall be installed where shown on welded structural steel supports." · ..;.and sec~ed to wall by steel strap spacer. -~-, -.,:,..., 'E. Float switches shall be McDonne11-Mille~ No. 80 with UL label fo~ use on. ,.~'~'.?~::,:.?~?.'~,..,3.0J- INSTALLATION: Install this Work in coordination with the other Work '~."~ti,.':??'::'~:3.02 PUMPS: P~p shall be installed on welded structural steel Supports 3.05 INSTRUCTIONS: ~hen'requJted approvals of ~hi~ ~otk have been obtained. ':'""' ~nd at a ~me designated 'by ~he Owne~. thoroughly demonstrate ~o the Owner's' ': -.maintenance personnel ~he operation and m~Jn~enance of ~hJs ~o~k ~nd d~onst~te the contents of the approved manu~l. ~condary :;!.; protection sheil!'f¢ '."product pipe lines;~ ' sizes for the2;'.3" and..4" UL ..:~ ....... RED THREAD][ DOUBLE-WALL S£¢ONDAR¥ CONTAINMENT PIPING Secondary Containment fittings available Two-piece Secondary Containment fittings from A. O. Smith-Inland include 90° elbows, are assembled with standard bolts, nuts 45° elbows, tees, couplings and termination and flat washers along with A. O. Smith- concentric roducers. Inland adhesive. INSTALLATION Secondary Containment fittings utilize Unlike liner systems, RED THREAD II plain-end pipe which has been thoroughly double-wall Secondary Containment- sanded to remove all surface gloss, systems can be pressuretested_ar]d _ continuously monitored. For installation, Secondary Containment pi.pc should be positioned over product pipe For additional information, request A. O. pnor to bonding the product piping. After Smith-Inland Manual No. 1190 for details testing the product pipe, the Containment on the installation of RED THREAD Tr fittings should be assembled; the Secondary Containment systems. Containment system may then be tested .... A. O. Smith-Inland Inc. 2700 W. 65th Street Little Rock, AR 72209 (501) 568-4010 'I'~VX 910-722-7377 Printed in U.S.A. '~Copyr~gh11985 A. O. Smith-Inland Inc. 7.5)4985 Manual 11 90 July 1, 1985 DOUBLE-WALL SECONDARY CONTAINMENT PIPING 'INSTALLATION INSTRUCTIONS A.O. SMITH-INLAND INC. · 2700 W. 65TH ST., LITI'LE ROCK, AR 72209 · 501/568-4010, TWX 910-722-7377 The A.O~ Smith-Inland double-wall secondary containment Useful sections of Manual 9474: eystem is designed for use with U.L Listed REDTHREAD® II - Tool and Equipment List pipe, manufactured by A.O. Smith-Inland. Secondary con- (NOTE: Two 7/16" wrenches are tainment systems consist of the next larger size of pipe and ....... ~lso required for installation.) special two-piece fittings. Refer to Manual 9474 or 1055 - Storage and Handling and Bulletin 1004 for installation instructions for the U.L - Layout and Preparation ' Listed pipe. - Cutting - Bonding/Adhesive Mixing SECTION I PREPARATION AND ASSEMBLY ,.~ A, Containment System The length of the containment system is determined A.O. Smith-Inland secondary containment sizes are: from: Containment For Product L---- (OAL of Product Piping) --(B) Pipe Size Pipe Size ' 3" RED THREAD II 2" RED THREAD II (See Figure 1 ) 4" RED THREAD II 3" RED THREAD II 6" RED THREAD Il 4" RED THREAD Il Containment Product All factory spigots and couplings must be cut off the containment piping prior to installation. Containment , fittings accept only plain-end pipe (thoroughly sanded). The ends of the containment pipe must be thoroughly Figure 1 sanded with 40-60 grit sandpaper to remove all sur- face gloss when the pipe is to be joined with fittings. Product Any heavy resin drips or surface irregularities must be Pipe Size B removed. Belt.sanders, disc sanders, drum sanders or 2" 3" a coarse cut flat file may be used. The sanded length 3" must exceed 3~". 3½" 4" 3½" The containment pipe must be positioned over the L = OAL-- B RED THREAD II product pipe prior to bonding of the product pipe. After testing of the product pipe, the Example: If 2" product pipe is 20 ft., 6 in. long, cut containment fittings should be installed and the con- tainment system tested, containment pipe 20 ft., 3 in. long. It is helpful to lay out the system, cut, taper and dry fit ..,,/ ............................... all product lines. Where possible, place containment fitting halves under the product fittings. {See Figure 2.) eRED THREAD is a registered trademark of A.O. Smith-Inland Inc. 1 Fittings are assembled with standarc] oc~,;s, nuts and flat washers, along with A.O. Smith-Inland adhesive. Lay out system ' with ell dry joints. (NOTE: Fittings are supplied by A.O. Smith-Inland without hardware.) The fitting I.D. and flat bonding surfaces are pre-sanded in the factory. Two-piece secondary containment fittings must be bonded with a Figure 2 greater amount of adhesive than is normally used with the ball and spigot joints. (See Figure 4) To prevent interference of containment fittings, do not locate two product fittings closer than shown in Figure Adhesive -- Apply to 3. both helves end to pipe 1/16" minimum thickne~ I Figure 4 . - Figure 3 ~M~i~c~~~~ii~~~ Product M Pipe Size (Min.) 2". 7%" 3" 7~" filled with adhesive. 4" 8½" B. Containment Fittings · Available containment fittings are 45° elbows, 90° elbows, tees, couplings, and termination concentric reducers (with or without %" NPT threaded outlet). All containment fittings consist of two halves. TABLE I Bolt Information (Number of Bolt Holes) Termination Size 90° 45° Concentric (In.) Elbow Tee Elbow · Reducer Coupling 3 10 11 9 6 10 4 10 11 9 6 10 6 10 11 9 8 10 All bolts are ~" - 20 NC x 1.0" long. All nuts are %" - 20 NC. All washers are %" standard flat (2 per hole). 2 C. Termination Fittings D.' Bonding and Assembly Termination at the.bulk tank connections is accom- (For Containment Piping) plished by using a termination concentric reducerwith Use only DS-7014, DS-7024 or DS-7069 adhesive ~" female NPT threaded outlet. (See Figure 5) manufactured by A.O. Smith-Inland for installation of ~ A.O. smith-Inland containment piping systems. The Fiber Glass '. number of 3" containment fittings which can be i//BThrasded Adapter bonded from one DS-7014, DS-7024, or DS-7069 ell x, Male) ~ adhesive kit is shownTABLEin Tablell II. f ............ ~ - /- Bonding -of-Containment-Fittings __ ,u~ . ~ DS-7014 ~ DS-7024 Kits DS-7069 Kit : , Type of Fitting Fittings Per Kit Fittings Per Kit ~ ~ 3~.. NPT 3" 90° Elbow 1¥2 2½ i 3" 45° Elbow 2 3 3" Tee 1½ 2 3" Coupling 2 3 ..... ........ ~ .... '_ O1___ 3" x 2" Termination Tank Concentric Reducer 2 3 Figure 6 NOTE Information for 4" and 6" diameter fittings not available at present time. Termination at the dispenser is at the end of the fiber glass containment piping and is accomplished using a Refer to bonding procedures in Manual 1055 for termination concentric reducer. (See Figure 6) adhesive mixing and surface cleaning. After cleaning all sanded surfaces, apply a thick Dispenser ~ Impact Valve coating (1/16" minimum) of adhesive to the socket! (bell) area of the fitting. The stir stick supplied with -~ the adhesive kit works well as an applicator. Liberally Fiber Glass coat the tabs (flat bonding surfaces) of both halves of -- / Threaded Adapter the fittings with adhesive (1/16" minimum thickness). (Bell x Male) Apply a thick coating (1/16" minimum) of adhesive to the sanded surfaces of the pipe ends. I . NOTE: Two-piece containment fittings require more adhesive than is normally used with A.O. Smith-Inland bell and spigot joints. Use the bolts, nuts and washers to assemble the ~---- Galvanized Steel fittings on the pipe. Two 7/16" wrenches are required for the bolts. Note that a flat washer is required on both ,~. Figure e halves of the fittings. (See Figure 4) Tighten the nuts and bolts completely. Termination on the shear valve (impact valve) may be accomplished with a flexible hose, clamped and Make sure that adhesive fills anygaps between pipe bonded in place. (NOTE Not supplied by A.O. Smith- endls and fitting sockets (bells). Inland.) (See Figure 7) Care should be taken not to disturb ~he containment Dispenser piping joint when assembling additional joints. The .~ ~- Impact Valve adhesive must be fully cured before applying stress to -'~ assembled joint. Use adhesive as thread sealant for NPT threads on termination fittings. Figure 7 Galvanized Steel 3 A'D H E SI V E C U R E Precautions: Cure time is dependent on ambient temperature. External 1. A.O. Smith-Inland Inc. does not recommend testing heat is recommended for cure when ambient temperature is of 3" through 6" containment pipe with air pressure .below 70° F. Cure time at 75° F is 4 to 5 hours. For cure cycle greater than 10 psig. Maximum hydrostatic test curves, refer to the instructions in the adhesive kits. pressure for containment pipe is 25 psig. (NOTE: ' Some city water pressures may exceed the ultimate ............. Use.of external heat_(s~uch as ._hot a!~_guns).will.shorten_the -_bondstreogth..of_thefittings.)_. ==--- . ........... cure times and is highly recommended for all installations where the temperature is below 70°F. External heat is 2. Avoid contact with the adhesive and hardener since essential for temperatures below 50° F. they are capable of causing skin and eye irritations. Gloves and eye protection are suggested. If contact is Direct flames should not be used to cure the adhesive. Hot made, flush with water a nd wash with soap and water. spots may cause overheating of the adhesive resulting in a Although the hardener is only mildly toxic, avoid in- bad bond~ haling fumes by working in well ventilated area. Pipe sections should not be handled or stressed until the 3. Solvent containers may be under pressure. Use cau- glue.line has returned to-ambient- temperature. .................... tionwhen removing the inner-seals. Eye protection is ......... recommended. Printed in USA 5M785 4 ,..lng Sump · - Short Form Specification: The contractor shall provide Fiberglase piping ~unJi with fittings as shown on the drawings. The piping shall be manufactured by Owens-Corning Fibergla~ Piping sumps sha~ be installed with pea gravel or approved alternate crushed stone backfill mate~al. according to the current installation instructions (Ow~ Corning Fiberglas Publication 5-PE-13606) provicle~ with the pip!..ng_su__mp ........... Model PS42-22 Model 8PS42-22 With Standard Fittings Shown With Standard Fittings Shown . 'B I' 4 Nl~Tflttlf~wl~l 4,10,11,A~ a 1' 4 Nlvl'flttlngewlplug~ 4,10,1&,,1~ ..~ E 4 ~ Top:l.13;lm,om:l.13 I~IEJ -- C..;.,_ t ~ & Method 'c~,~..v~ ..... 1~42.23 236 gal~, 1 '26 lbo. 1. Installation accessories not shown: ~ ._ (1) 22" Cork Manway gasket, (24) metal/ · neoprene washers, (1) tube of silicone " caulk. / 2. Filting positions are every 15 degrees as,~ ~' ~own in Figure A. 3; Standard fitting positions are at 1 and 7 ,