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Home My WebLink AboutUST-REPORT 7/1/1988 Hazardous Materials/Hazardous Waste Unified Permit ,. CONDITIONS OF PERMIT ON REVERSE SIDE p~erm This Dermit is is$,_,_-,d_ for the follov,li~ I~ Hazardous Materials Plan ~t Per ' :: 15-000-000345 [] Underground Storage of Hazardous Materials E] Risk Management Program STUARTS MOBILE []Hazardous Waste On-Site Treatment LOCATION: 800 34TH ST IELD ----~TANK ~ HAZARDOU~ [ 015-000-000345-000 ~ GASOL-~-~ ? ~IGS DISP lNG 015-000-000345-0002 J GASOLI N E i~': "~'~ '~'~ ,'~ 015-000-000345-0003J. GASOLiNE ~" · :':~'.":,5: - - Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES' 1715 Chester Ave., 3rd Floor Approvexlby: Bakersfield, CA 93301 . Voice '(661) 326-3979 FAX (661) 326-0576 Expiration Date: Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ~-....:.""-:~ ';,,:: IN~~''' .~E~'~IAL..~IT~R;~:~:~-ONI~OR TYPE TYPE METHOD ONITOR 0001 GASOLINE 10,000[00::~GAL ""~".,. ~ ....... '~';', :D~:':¥~:F CLM":~~;~' ~G'~F LPT F PRESSURE ALD 0002 GASOLINE lO,000.0~:::~gL '?~,. DW;'" F C[M' ~IG' LPT F PRESSURE ALD Is~ by: O~CE OF~RO~L S~ ~CES ph Hu~,~~ I 1715 Chewer Ave., 3rd Floor ce of~~ B~e~el~ CA Voice (805) ~2~979 F~ (805)~6-0STb Expiration Date: dUn~ ~O~ ~OOO City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (805) 326-3979 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 2nd day of November, 1998 to: MANSOURS CHEVRON Permit #015-021-000345 800 34th St Bakersfield, California 93301 BUSINESSfDEAPRTMENT NAME: ~.~,~ rt,,,. ADDRESS: ~ % a~ ~+ , PROJECT DESCRIPTION: PROJECT NUMBER: -~ DATE: NAME: CHGD.;. COMMENTS: ¢~ c~ n= C"T ~'(~M'PT .F.TIC)N: DATE: I -. ... FINAL INSPECTION CHECKLIST C. . · ,.~.,... ~ ~'~ ,. Plot Diagram Plot plan notes i. 21 . .,'. i Yes '~o "~..... ....i 2. Does tank product correspond to product labels on ":'~ plot plan? 3 Was there no modifications Identified which were .'-. not depicted on the plot plans? · ~!: If "No" described .'.' ~'! 4. Are monitoring wells secure and free of water and I'~ l~l '' i.: product in sump? · .'i 5. Is piping system pressure, suction or gravity? CONTINUED (See 2na File) 12/11/00 16:02 'l~651 326 0576 BFD I~Z ~.T DI¥ ~]005 WRITTEN ROUTINE MONITORING PROCEDURE FOIl CARDLOC~SUPERVISED DISPENSING SAMPLE FORM Facility Name: Fa~ Address: Facili~ Telephone No.- Tank ~ N~e: Ta~ 0~ Address; T~ 0~ Phone No.: IA) Identify all ~uipment used to monitor the underground storage tanks on site. Include make and model of leak detection system. IB) Identify all equipment used to monitor the underground spill containment on site. Include leak detection system, type and placement of liquid sensors, type of leak detectors and, docs system have dispenser comainment. 2) Identify the name(s) and title(s) of the person(s) responsible for performing thc monitoring and/or maintenance of equipment. ~ 12/11/00 16:03 9661 326 0576 BFD HAZ MAT DIV ~007 3) Identify the location of the monitoring equipment. Include where remote monitoring wi]] be conducted and name of company assigned to monitor and report name of company and phone number if other than operator. Identify how frequently the monitoring equipment is tested/checked for operational status. Indicate each piece of equipment separately. 4) Identify how often the tank(s) are monitored on site (i.e. daily, continuously). Describe the training need~ to provide to the operator(s) of the underground storage tank for the proper operation of both the tank system and the monitoring equipment. 5) All equipment used in implementing thc monitoring program shall be installed, calibrated, operated and maintained in accordance with manufacturers instructions, including routine maintenance and service checks. 8) You must develop a reporting format/log that incorporates the following information: f) Verification of Equipment Testing g) Reporting/Recording when Alarm is Indicated h) Maintenance Performed -Fhcse repo~,~tlogs must be submitted to the Bakersfield Fire Department on a annual basis. Written records of equipment calibration/maintenance shall be kept on site for at least 3 years. 9) In thc event of a release, emergency equipment is limited to fire extinguishers and absorbent material maintained on site. Please discuss contingency plans for additional cleanup personnel and or contractor/clean up consultants. M~qLD~31~KJI~ELb~F..5 FOR Ck~I~.I)C~ OPERATOR GUI L ES EMERGENCY RESPONSE PROCEDURES CARDLOCK OR UNSUPERVISED DISPENSING Daily l~spection: 1. Check for sm~ll spills 2, Place absorbent on the spill immediately 3. Clean up absorbent within one hour 4. Check for hoses lying on the ground 5. Look for other ~pp/ng hazards and remove 6. Ensure fire cxtin~ishers arc in place and inspect daily 7, Check quantity of absorbent material daily Spill: 1, Determine thc source of spill or release 2. Stop thc flow of product 3, Hit emer§¢ncy shut-offvalve 4, Stabiliz~ the ama 5, Extinguish any smoking material 6. Locate nearest fire exfinEuisher 7. Use absorbent or spill pack to keep any product out of water source or 8. Isola~ the hazard area-deny ~ to non-emergency personnel. 1. Convaln the spill totally with a spill pack and/or absorbent 2. Never use wat~. 3. If larger tknn can be immediately coutamed, go tO stcp 4. Contact th~ local tim departmmt, 9-1-1. 5. Notify company management personnel Fire: !, Gasoline fire extln~ouJshers located on dispenser islands 2, Remow Pin 3. Point to th~ bottom o4: thc flame and squeeze handle 4. Call fire dcpartment ~won if fire is put out. (9-1-1) 5. Isolate and deny entry, except for emergency pcrsormci 6. Notify company ~ent pcrsonnci Earthquak~ Response: 1. Make sure gasoline inventories axe secure 2. If~crc am any signs of structuxal damage to thc control room or island canopy~ kccp cvcryonc away from thc dan~er area. If danger is inunin~nt, shut down facility opexations until it h~ bc~ dccmod safe to continue. CARDLOCK/UNSUPERV~D DISPENSING EMPLOYEE TRA~UIDELINES Employee Tr~ning: 3. General The Maintenance Supervisor/Health & Safety Director or designated person will train all new employees on the safe handling of hazardous materials, proper emergency response eoordlnation, and the use of emergency response equipment and supplies, Additionally, the manager will coordinate refresher training programs for all employees on an annual basis. Procedures for Safe Handling of Hazardous Materials a. Employees will be informed of the health and safety hazards involved with the handling of gasoline and diesel. b. Employees will be careful not to spill gasoline or diesel onto themselves or on the ground. c. Employees will not smoke, light matches, cause sparks, or take action which could ignite flammable liquids or vapors. 5. Procedures for Emergency Response Coordinator a. Employees will be familiar with the emergency response pmceclure outlined in company emergency response plnn. b. Employees will know the location and operation of electrical shut-off switches dispenser shut-offvalves. c. Employees will know the location of how and when to use dry chemical fire extinguishers that are located on the premises. d. Employees will know the location &the nearest Storm drain(s) and the location of absorbent materials to be used to prevent spills reaching the storm drain(s). e. Employees will be familiar with the kinds o£ emergency situations, which will warrant immediate evacuation of the premises. 1. Any gasoline, diesel or other type of fire.. 2. Any spill, leak or vapor leak that has the potential for igniting or oxploding. 3. Any spill or leak when employees or customers notice gasoline vapors or spills. C4J)RRECTION N O'JiikC E BAKERSFIELD FIRE DEPARTMENT N° 6 9 8 Sub Div. ~00 _r~ q ~-(X . Blk. Lot YOU are hereby required to make the following corrections at the above location: Cot. No Completion Date fo,' Date (~//~Lg) (~3 ~/ ~/L~ /t~I .... w,,iI~pector 326-3979 '-' 6ERTIFICATIO~N._OF FINANCIAL RESPONSIBILIIY' I FOR UND..~....OUND ~FORAGE TANK~ CONTAINING PETR~M I rm,-.,..d~..,,.,---- """ rm~-.. B. ~,~7'~/~,~'. ~ / P~ ~"',~"~ ~ ~'' / J~q'~' hereby certiSes that it is in compliance with the requirement~ of ,~-'Yion 2807, Article 3, Chapter 18, Division 3, 7'/tie 23, Cal~ornia Code of Regulations. The n-~chanisrr~ L~__ to dernorJ~a'ate Ena .r~_-~i. res/;onsibii~/ as required by Section 2807are as follows: ~ ~ ~,~7 Note: ff you ale using the 8tare Fund as any part of your demonstration of flnar, clal [~p~,r~i~,ility, your ~~ of &~ ceK~__.~_,_¥on also ceEEk-s that you are in compliance with all conditions for pa _t~_j~n~tion in E~e Fund. D. Fn~s'li~'Nsme ~ZI~J~Z~Z~ OF IPZ]I]IJICZAL PJSIIONSZB3~dZ2T PLease typo or print clam*If ell ~lf°fllltJafl on Certification of Flnsflclot Rmlbltlty fo~.' ALL UST facilities end/or oJtma cmfwd or operated my be Listed on one form; therefore · separate certificate Je not required for each site. C'OCJ_.I4ENT A. Amm~ bquJred ,-,. :Check the appropriate boxes.. 8. Name of Terd~ Owmf" - FuLL flame of either the tank old'tar or the operator. C. Iledmfljim Type - Indicate uhich State approved mechanism(e) are being used to shou financial respmaiblLity either as contained iff the federal regulations, 40 CFR, Part Subpart Il, Sections 280.90 through 280.103 (See Financial RparmibJLlty Guide, for more iflforamtion), or Section 2802.1, Chapter 18, 0JvJeJon 3, Title 23, CCJI. Name of~ Issuer o. list al'( ~ ltd eddrasses of ccxnpaflies arid/or JhcJJYJchJiLS issuing coverage. HeclmnJim limber * List JdefltJ~nb flunber for each mechanism used. ExemPt6': insurance% pol'Jcy'ruJnber or file tinier as JndJcatecf oll bond or doclJ11eflt. (If .using .$tate..CL .e.~flup,F~r~l (State Fu~cl) Leave blank. ) Caverugo ~t - Indicate amount of coverage for each type of mechanism(s). If more than one ,, .' . r mechanism ~s'-JndJcated, total must equal 1002.of financiaL, reeFxmsibJLJty,for each facility ' .... ' ' ' ......." Co~q~ge Period - Indicate the effective date(s) of aLL financial mochanismCs).' "(St~te~F~id c°Verage wo~td be continuous as Long as you maintain compliance end remain eLigibLe to continue participation in the Fund.) Corrective Action - Indicate yes or nc. Does the specified financial mechanism provide coverage for corrective action? (If using State Fund, indicate "yes".) Third Party - Indicate yes or no. Does the specified financial mechanism provide coverage for Compenmatjon third party canponsatJon? (If using State Fund, indicate "yes".) D. Facility - Provide eLL facility and/or site names and addresses. E. Sjgm~oture B&ock- Provide signature and date signed by tank ouner or operator; printed or typed and title of tank o~ner or operator; signature of uJtnese or notary and date signed; end printed or typed name of witness or notary (Jr notary signs es witness, please place notary seal next to notary's sJgr~tura). IJpere to Nil L Certification: PLease send orJgirmL to your Local agency Cogency ubs issues your UST penuJts). Keep e copy of the certification at aKA facJ(Jty or site Listed on the form. if you have q~eet~ons ~n fir~ncieL responsibility requirements or on the Certification of. Financial . .. Respon~ibi.iity Fonu, please contact the State UST CLearco F~d at (916) 739-2475. NO~O: Pan. tries 'for Failure to _r~iy uith Financial Re~sibility R~luir~e~: FaiLure to comply ma~'recuit'Jn: (.1) jeopardizing claimant eLigibiLity for the State UST CLeart42 Flmd, 8nd (2) liability for civiL'. MLtteo of up to $10,000 doLLars par day, per i~lergro~ storage toni(, for each .day of violation es stated in Article 7, Section ZSZ99.?6(a) of the CaLifornia HeaLth end'safel~y Code; ', . " . CONTINUOU,,,,S MONIT,,O, RING DEVICE CERTIFICATION ,,, TYPE OF CONTINUOUS MON TOR SYSTEM (WPPLD / SENSORS} MAKEAND MODEL ~. L: TANK ~ 1 TANK ~ 2 TANK ~ 3 ...... TANK ~ 4 ..... TANK g'~ ...... TANK $ 6 ~,~ ...................................... DiSP~NSOR CONTAINMENT SENSOR MECH~JC~L LINE LEAK DETECTOR m~ T'~K ~,GUAGING DEVICE · .: · :.;.:-~; ;~: , ............... ;. :~. . . I~ES THE ~U~BINE AUTO~TICALLY SHUT IS' ~j[:~6hI:I~0RING SYSTEM I NSTAL~O TO - ' I~ ~E:~M~.IJ'bRING SYSTEM OPE~LE AS PER m ...... : . :~?~...:" , ................. ~ICH f~)~'r NUOUS MONITORING D~CES DATE DE ~! .T~K CERTiFI~TION CERT}~: !~ 7ES~ERS I~ : l~ ~ ~ DATE ~' 1 '0 ~ TIME ON SiTE mTeST S¢ commnr,s TELEPHONE BSSR, INC. 661-588.2777 .' .~: '.. . CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME~ INSPECTION DATEe, holoo ADDRESS ~Otr) ~q~t/x .'g~. PHONE NO. ~{oq' I q'7~ FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [] Routine [~ombined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V! COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address J Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: [] Yes [] No Explain: Questions regarding this inspection? Please call us at (661) 326-3979 Business Site Responsible Party White- Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector:_ _~/~, CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~lk]0tX'~e~ .fl/lto[3~[t;., INSPECTION DATE Section 2: Underground Storage Tanks Program [] Routine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank 0~F Number of Tanks ,.~ Type of Monitoring Cg--~ Type of Piping l)0J ~' OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit fees current k// 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: ~ .~_~_~ Office of Environmental Services (805) 326-3979 Business Site Responsible Party White - Env. Svcs. Pink - Business Copy ( ICE OF ENVIRONMENTA' RVICES , 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANK:S - UST FACILITY ' TYPE OF ACTION r-] l. NEW SITE PERMIT [~] 3. RENEWAL PERMIT [] $. CHANGE OF INFORMATION (,~/~ change - [] 7. PERMANENTLY CLOSED SITE (Check one ~tem only) /ocU u~e On/Y). [~ 8. TANK REMOVED 400. [] 4. AMENOEO PERMIT C~] e. TEIvlPORARY SITE CLOSURE I. FACILITY I SITE INFORMATION NEAREST CROSS STREET I 401, FACILITY OWNER TYPE [] 4. LOCAL AGENCY/DISTRICT* BUSINESS ~. GAS STATION [] 3. FARM [] q. COMMERCIAL [] 6. STATE AGENCY* TYPE r-~ 3. PARTNERSHIP [] 2. OISTRIBUTOR [] 4. PROCESSOR I-] 6. OTHER 403. [] ?, FEDERAL AGENCY* 402, TOTAL NUMBER OF TANKS la f~y m ImPlant R#ar*,~r,G,~ Or I ~ ~ UST a pulse ~,,-~y~ name ~ lu~ ~ REMAINING AT S~TE b'u~tam~? I1. PROPERTY OWNER INFORMATION PROPERTY OWNER NAME 40T. ~ PHONE MAILING OR STREET ADDRESS CITY 410. I STATE 411. ZlPCODE 412. PROP~:HIY OWNER TYPE ~ CORPORATION i-] 2. INDIVIDUAL [] 4. LOCAL A(~NCYI DISTRICT f-I 8. STATE AGENCY 413. [] 3. PARTNERSHIP I-1 $. COUNI'YAOENCY [] ?. FEDERAL AC, ENCY I11. TANK OWNER INFORMATION TANK O%%~;~RNAME 414. f PHONE 415. MAILING OR STREET ADDRESS 416. CITY 417. STATE 418. ZiP CODE 419. TANK OWNER TYPE [] 2. INDMDUAL [] 4. LOCAL AGENCY I DISTRICT [] fl. STATE AGENCY 420. ~ CORPORATION [] 3. PAJ~T3J~R~HIP [] 5. COUNTY AI3~NCY [] 7. FEDERAL AGENCY IV. BOARD OF EQUALIZATION UBT STORAGE FEE AccoUNT NUMBER TY('TK)HQ 414 I' Call(g16)322-g~glfques~lSal~ae 421. V. PETROLEUM U~T FINANCIAL REs~)~mmn.nY · INDICATE MI='T14OO(S) [] 1. SELF-IN~URED [] 4. SURETY BONO ~ STAT~ FUND [] 10. LOCAL OOV'T MECHANISM [] 2. GUARANTEE [] S. LE'I'r~R OF CREDIT [] 8. STATEFUNO&CFOLEIiER [] gg. OTHER: [] 3. INSURANCE [] ~. EXEMPTION 1'-I 9. STATE FUND & CO 422. VL LEGAL NOTIFICATION AND MAILING ADDRE~,~ L~ ~ ~m~ ~ to~ ~ ~ 1~ 2~. ~ ~1. ~PMC~ 8IGNA~RE J ~JT~.TE U~T J:ACILIT"I( NUJ~R (~Cor to~#, u.i/4 o,t¥) 428. ,q~.~ UI:N31~ L;JljI~!iF~kTE NUIvlI~ER (Fo¢ k~,J, u.l. on/y) 42'J.. J UPCF (7/99) S:\CI. IP 6, FORMS\,swrcb-a.wpd ~ III I I II III I IIII I III IIIIII IIIIIII I I I I II III I I III I ~.c~n~,~c°~sr~uc~'~'z. ~u~w~ 0~. ~ ~ '~~ ~. o~ ~P ..--.,,~,~~~F~~ ' '0 g ~~~~~F~~~; 0 0 se. ~~~.t ~) 0 18. ~~~.t~ I .__ CITY OF BAKERSFIELD ._ ~. OFF~E OF ENVIRONMENTAL S'ICES ~ 17t5 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS-INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank p~. ./_. 0, ~ - I. FACILITY IDENTIFICATION BUSINESS NAME (Same as FACILITY NAME ot C~A - ~ ~ A~) ',/C::~o /t-/'~x~ .._ ................... II. INSTALLATION Cl~ck ~ll ~at al~ly * [] The Installer has been certtfled by the tank and piping manufacturers. [] The installation has been inspec*~l and certified by a registered professional engineer. I~/ The installation has been inspected and approved by the City of Bakemfleld Office of Environmental Services. [] All work listed on the manufacturer's installation checklist has been completed. ~ The installation contractor has been certified or licensed by the Contractors State License Board. [] Another method was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: III. TANK OWNER/AGENT SIGNATURE 17t5 Chester Ave., Bake~$i'~: ~A 93301 _~~~ (66t) 326~979 UNDERGROUND STOOGE TANKS-INSTAL~ON CERTIFICATE OF COMPLIATCE~ , One fo~ per tank P~ I. FACILI~ IDENTIFICATION ~ (~ II FAC~ ~ ~ ~ - ~ ~ ~) II. INSTAL~ON " ~ ~at~ ~e Installer has been ~ by ~e ~nk and piping The ins~lla~on has been ins~ and ~fl~ by a ~lste~ professional engineer. ~e ins~lla~on has ~en ins~ a~ appmv~ by ~e Ci~ of Bak~fleld ~ of Envlmnmen~l Se~s. ~1 ~ IIs~ on ~e man~m~s i~l~n ~ec~ist has ~en ~mple~. ~e lns~lla~on ~n~r ~s ~n ~ or Ii~ns~ by ~e ~n~o~ S~ Li~nse ~a~. Ano~er me~ ~s us~ as allow~ by ~e Ci~ of B;ke~fleld ~ of En~mnmen~l Sewi~s. Iden~ meth~: III. TANK OWNER/AGENT SIGNATURE ,... CITY OF BAKERSFIE,~D::~. ~ '~.i,. :~ii~ii~i~ 1715 Chester(661)Ave" 326.3979Bakersfield; ~A 93301 "~ UNDERGROUND STORAGE TANKS-INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank I, FACILITY IDENTIFICATION BUSINESS N,~ (~l~me a~ F ACII. ITY ~ o~ (3~A, · ~ ~ A~) ................................... II, INSTAL~ON ~e Installer has been ~ by ~e ~nk and piping The ins~lla~on has been ins~ and ~ by a ~iste~ professional engineer. ~e ins~llaflon has ~en ins~ a~ appmv~ by ~e Ci~ of Bake~fleld ~ of Envlmnmen~l Sewi~s. ~e lns~l~0on ~n~r has ~n ~ or II~ns~ by ~e ~n~om S~te Ll~nse Boa~. Ano~er me~ ~s us~ as allo~ by ~e Ci~ of Bake~fleld ~ of En~mnmen~l Se~ces. Iden~ meth~: III. TANK OWNER/AGENT :SIGNATURE D April 4, 2000 Stewarts Petroleum FIRE CHIEF Mr. Don Dozah RON FRAZE 11 East 4th Street ADMINISTRATIVE 8ERVICF.8 Bakersfield, CA 93307 2101 'H" Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 Dcar ~". Dozah: SUPPRESSION SERVICE8 2101 'H' Street You have been identified as the compliance coordinator for the Bakersfield, CA 93301 facility/facilities referenced in the attachment. VOICE (805) 326-3941 FAX (805) 395-1349 The permits to operate this facility/facilities will expire on June 30, 2000. PREVENTION SERVICE~ 1715 Chester Ave. However, in order for this office to renew your permit, updated forms A, Bakersfield, CA 93301 VOICE (805) 326-3951 B, & C must be filled out and returned prior to the issuance of a new FAX (805) 326-0578 permit. ENVIRONMENTAL SERVlCF.8 1715 Chestor Ave. Please make sure that you are sending the updated forms which are Bakersfield, CA 93301 VOICE (805) 326-3979 indicated by the date 7/99 in the lower left hand comer. Please complete FAX (8O5) 326-O576 and return to this office by May 15, 2000. Failure to comply, will result in Tmun~no o~ns~on a delay of issuance of your new permit to operate. 5642 Victor Ave. ' - '~ Bakersfield, CA 93308 VOICE (805) 399-4697 Should you have any questions, please feel free to call me at FAX (805) 399-8763 661-326-3979. Sincerely, Steve Underwood, Inspector Office of Environmental Services SU/dam attachment Facility Name Address BP Oil 2 Oak Street, Bakersfield, Ca 93304 Del Taco/Mobil 3622 California Ave, Bakersfield, Ca 93309 Fastbreak 4800 White Lane, Bakersfield, Ca 93309 Stuart's Mobil I01 19~ Street, Bakersfield, Ca 93301 Jim's Mobil 3200 "F" Street, Bakersfield, Ca 93301 Smarts Mobil 800 34t~ Street, Bakersfield, Ca 93301 D Febmaryl4,2000 Mr. John Stuart Jr. a.E C.~EF Stuart's Petroleum RON FRAZE 11 E. 4th Street ADMINISTRATIVE SERVICES Bakersfield CA 93307 2101 'H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE FAX (661) a96-~349 STORAGE TANK(S) LOCATED AT 800 34th Street Bakersfield, CA. SUPPRESSION SERVICES 93301 PERMIT # BR-0260 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Dear Mr. Stuart: PReVENTiON SERVICES This is tO inform you that this department has reviewed the results for 1715 Chester Ave. Bakersfield, CA 93301 the preliminary assessment associated with the closure of the tanks located VOICE (661) 326-3951 FAX (661) 326-0576 at the above stated address. ENVIRONMENTAL SERVICES Based upon laboratory data submitted, this office is satisfied with the 1715 Chester Ave. Bakersfield, CA93301 assessment performed and requires no further action at this time. VOICE {601) 326-3979 FAX (661) 326-0576 Accordingly, no unauthorized release reporting is necessary for this closure. TRAINING DIVISION If you have any questions regarding this matter, please contact me at 5642 Victor Ave. Bakersfield, CA 93308 (661) 326-3979. VOICE (661) 399-4697 FAX (661) 399-5763 Sincerely, Ralph E. Huey, Director Office of Environmental Services Steve Underwood Inspector REH/mv cc: Y.Pan, RWQCB M. Magaree H.F.A HO , FAHAN & ASS-- ,CIATES, INC. ENVIRONMENTAL MANAGEMENT CONSULTANTS November 29, 1999 Mr, Steve Underwood ";~';""'; ~$' [! ~3~ " City of Bakersfield Fire Department Environmental Services Division . . 1715 Chester Avenue Bakersfield, California 9330] Subject: TANK CLOSURE REPORT FOR THE $4TH STREET MOBIL SERVICE STATION 800 34TH STREET, BAKERSFIELD, CALIFORNIA (BFDESD PERMIT #BR-0260) Dear Mr. Underwood: This report presents the results of soil sampling performed by Holguin, Fahan & Associates, Inc. (HFA) in association with the, removal of one 1,000-gallon waste-oil UST from the above-referenced site (see Figure ] - Site Location Map). The tank removal activities were performed under Permit #BR-0260 with the City of Bakersfield Fire Department Environmental Services Division (BFDESD). BACKGROUND Stuarts' Petroleum Company (Stuarts' Petroleum) contracted with ELC Construction (ELC) to remove one 1,000-gallon, single-walled, steel, waste-oil UST (see Figure 2- Plot Plan). On September 23, 1999, the waste-oil UST was removed from the site. HFA was contracted to provide an environmental geologist under the direct supervision of the undersigned state of California registered geologist to collect soil samples at the direction of Mr. Steve Underwood, with the BFDESD. TANK CLOSURE SOIL SAMPLING On September 23, 1999, soil samples TK-I-10 and TK-1-14 were collected from 2 and 6 feet beneath the invert at the center of the 1,000-gallon waste-oil UST (designated Tank #1) (see Figure 2 for the tank removal soil sample locations). All sampling equipment was washed with a non-phosphate cleanser, pre-rinsed with tap water, and finally rinsed with delonlzed water prior to sampling. The soil samples were collected from the backhoe bucket immediately following excavation, The soil samples were stored in 2-inch-diameter brass ENVIRONMENTAL: SCIENTISTS · GEOLOGISTS · ENGINEERS Contaminated Site Assessments · Phase I Audits * Site Remediation ° Hazardous waste Management 143 South Figueroa Street 16570 Aston Street 2820 Pegasus Drive. Suite I 3001 South 35th Street, Suite C-I l Ventura, California 93001 Irvine. California 92606 Bakersfield, California 93308 Phoenix, Arizona 85034 (805) 652-0219 (949) 442-6665 (805) 391-0517 (800) 789-0219 · (602) 426-1000 (805) 652-0793 FAX (949) 724-0446 FAX (805) 391-0826 FAX (602) 426-0113 FAX lnternet: first_last@hfa.com Internet: first_la$1@hfa.com lnternet: first_last@hfa.com lllternet: first_last@ph.hfa.coFn HOL©UIN, Mr. Steve Underwood BFDESD FAHAN ~ November 29, 1999 - Page 2 & IATES, INC. ENVIRONMENTAL MANAGEMENT CONSULTANTS tubes, sealed with TeflonTM liners and end caps, labeled, placed in on ice chest at a temperature of less than 4oC, and transported to a California state-certified laboratory for analysis. Sample identification and chain-of-custody procedures were followed for the samples to ensure sample integrity and to document sample possession from the time of collection to the ultimate destination. The sample labels identified the job number, sampler, date and time of collection, and a sample number unique to each sample. ANALYTICAL METHODS AND RESULTS The soil samples were analyzed for TRPH as oil and grease using EPA Method 418.1, TPH as diesel and TPH as gasoline using EPA Method 8015 (M), and total lead using EPA Method 7421. An adsorbed-phase TPH as diesel concentration was detected in the soil sample collected from a depth of 10 fbg beneath the former waste-oil UST. However, TPH as gasoline and TRPH as oil and grease concentrations were not detected in the soil samples collected from beneath the former 1,000-gallon UST. Total lead was detected at concentrations consistent with the naturally occurring concentrations of lead in the near-surface soils in the Bakersfield area (see Figure 2 for the soil sample locations, Table 1 -Summary of Soil Sample Analytical Results, and Attachment 1 for the laboratory reports). RINSATE AND STORAGE TANK DISPOSAL Prior to tank removal, the UST was triple rinsed. The rinsate was transported to Demenno/Kerdoon's disposal facility in Compton, California, under Non-RCRA Hazardous Waste Manifest (see Attachment 2 for the Non-RCRA Hazardous Waste Manifest). An LEL meter was utilized to verify that the hydrocarbon vapor concentrations were less than 5 percent of the LEL. Subsequently, 20 pounds of dry ice per 1,000 gallons of tank capacity was introduced into the UST, and oxygen metering was conducted to verify that the level of oxygen within the UST was less than 12 percent. With the approval of the BFDESD, the storage tank was removed, placed on a flatbed truck, and transported to Mr. Ernie Lancaster's ranch property in the unincorporated area of Kern County, west of the city of Bakersfield for reuse as a water storage tank (see Attachment 3 for the tank tracking form). HOLC, UIN, Mr. Steve Underwood BFDESD ~ FAH N November 29, 1999 - Page 3 & ASSOC T , INC. ENVIRONMENTAL MANAGEMENT CONSULTANTS CONCLUSIONS Based on the soil sampling and laboratory analytical results, hydrocarbon concentrations were not detected in the soil samples collected from 2 and 6 feet beneath the waste-oil UST, and total lead was detected at concentrations consistent with the naturally occurring concentrations of lead in the near-surface soils in the Bakersfield area. The BFDESD will likely not require additional site investigation activities and may consider the site for closure. This report has been prepared for the exclusive use of Stuarts' Petroleum and its representative, Ernie Lancaster Construction, as it pertains to the referenced property in the city of Bakersfield, Kern County, California. The services performed by Holguin, Fahan & Associates, Inc., were conducted in a manner consistent with the level of care and skill ordinarily exercised by . members of its profession currently practicing under similar conditions in the state of California. No other warranty is expressed or implied. Thank you for this opportunity to have been of service. If you have any questions regarding this report or the information contained herein, please contact me at (661) 391-0517 or at e-mail address Mark_Magargee@bk.hfa.com. Respectfully submitted, Mark R. Magargee, CHG, RG Senior Hydrogeologist Holguin, Fahan & Associates, Inc. MRM:rrl Enclosures: Figure 1 Site Location Map Figure 2 PIct Plan Table 1 Summary of Soil Sample Analytical Results Attachment 1 Laboratory Reports Attachment 2 Non-RCRA Hazardous Waste Manifest Attachment 3 Tank Tracking Form cc: Mr. John Stuart, Jr., Stuarts" Petroleum Mr. Ernle Lancaster, ELC I-IULUUII'N' '~--~' "' ', Mr. Steve Underwood BFDESD ~ FAHAN November 29, 1999 - Page 4 ~ & ASS(X2IATES, INC. ENVIRONMENTAL MANAGEMENT CONSULTANTS ,, / i -~--,,~i '~..~.~ o ~ ~' :,,.. ~ '% '¥M'ile .'V ' '" ' ' ..~.-" ~""* 18 ',, DoD %01,1i ' : ,. ..?' ' SITE LOCATION"] LEGEND STUARTS' PETROLEUM COMPANY oI 5 MiLE ~ 34TH STREET MOBIL SERVICE STATION b I__ - I t I I -F-~--:F~'' I / :.000 2,000 3.000 4,000 5,000 FEET jj'xJ] 800 34TH STREET ~_-hd h-~__ r i __ r- ..... --~ BAKERSFIELD, CALIFORNIA [~-~---b t~ 0.5~ ~----I--.%--J! KILOMETER I~ FIGURE 1 - SITE LOCATION MAP USGS OIL CENTER/OILDALE 7 5 MINUIE SERIES QUADRANGLES I I"IOI.,GUIIq', FAI'I_J~ &: ASSOCI~TI~S, INC. ~ HOL©UIN, Mr. Steve Underwood BFDESD ~ FAHAN November 29, 1999 - Page 5 ~ &ASSOCIATES. lNG. ENVIRONMENTAL MANAGEMENT CONSULTANTS PROPERTY LINE PLANTER ~ ~ ~,~ FORMER "-.-'TK-1 1,000-GALLON UNDERGROUND WASTE-OIL UST ELECTRICAL SERVICE _ _ _EX_~T~ _ _ PROPOSED CAR WASH - E-N~'F~A~I(~ uo~ VENT RISERS 0 'i PRODUCT PIPING ; DISPENSERS i DISPENSERS 10,000-GALLON GASOLINE USTs L CANOPY APPROACH ~k~ SIDEWALK J APPROACH 34TH STREET SCALE IN FEET 0 15 30 LEGEND STUARTS' PETROLEUM COMPANY · SOIL SAMPLE LOCATION 34TH STREET MOBIL SERVICE STATION 800 34TH STREET BAKERSFIELD, CALIFORNIA FIGURE 2 - PLOT PLAN HOIA~UIN, FAI-IAN & ASSOCIATES, INC. :{EVISION DATE: NOVEMBER 29, 1999: RRI ~ ~,._~L.,,_..~,~ .~ ~,~,~_~ m,,~, Mr. Steve Underwood BFDESD ~~ F/~ November 29, 1999 - Page 6 & ASSOC T , INC. ENVIRONMENTAL MANAGEMENT CONSULTANTS TABLE 1. SUMMARY OF SOIL SAMPLE ANALYTICAL RESULTS 34TH STREET MOBIL SERVICE STATION, BAKERSFIELD, CALIFORNIA SAMPLE DATE SAMPLE TPH AS TPH AS TRPH AS OIL TOTAL SOURCE SAMPLED DEPTH ID GASOLINE DIESEL AND GREASE LEAD REF (fbg) (mg/kg) (mg/kg) (mg/kg) (mg/kg) EPA ANALYTICAL METHOD 8015 (M) 418.1 7421 N/A REPORTING LIMIT 10 10 10 0.6 N/A Waste-Oil UST 9-23-99 10 TK-I-10 ND 191 ND 2.8 A 9-23-99 14 TK-1-14 ND ND ND 2.0 A REF = Report reference. N/A = Not applicable. ND = Not detected. A = Holguin, Fahan & Associates, Inc.'s, current report. --~~ HOLGUIN, ~ FAHAN & ASSOCIATF~, INC. ENVIRONMENTAL MANAGEMENT CONSULTANTS ATTACHMENT 1. LABORATORY REPORTS HOLGUIN, FAHAN & ASSOCIATES, INC. ENVIRONMENTAL LABORATORIES ~43 South Figueroa Street · Ventura, California 95001 · (805) 652-0219 · FAX: (805) 652-0793 REPORT OF ANALYTICAL RESULTS (')c~:ober 14, 1999 Page l CLIENT: ~alyzed By: T. Karageorge ELC Construction Sampled By: M. Magargee Units: mg/kg Matrix: Soil PROJECT: 34th Street Mobil Analyses Methods: BTEX: TPH: 8015-M CONCENTRATION OF TOTAL PETROLEUM HYDROCARBONS (TPH) WITH BTEX DISTINCTION CONSTITUENT TPH- TPH- Ethyl Total Percent Lab Sample Dates Sampled, Gasoline Diesel Benzene Toluene Benzene Xylenes MTBE Surrogate NO. No. Received and Tested RL RL RL RL RL RL RL Recovery 991656 TK - 1-10 9/23/99 9/24/99 10/7/99 ND 19 10 10 991657 TK - 1-14 9/23/99 9/24/99 10/7/99 ND ND 10 10 ND = NOC De~ec~ed at o~ above RL /~./~ HOLGUIN, FAHAN & ASSOCIATES, INC. ENVIFIONMENTAL LABOFIATOHIES 143 South Figueroa Street · Ventura, Colifornia 93001 · (805) 652-02t9 · FAX: (805) 652-0793 REPORT OF ANALYTICAL RESULTS October 14, 1999 Page 2 CLIENT: ELC Construction Analyzed By: T. Karageorge Sampled By: M. Magargee Units: mg/kg Matrix: Soil PROJECT: 34th Street Mobil Analysis Method: TRPH: EPA 418.1 CONCENTRATION OF TOTAL RECOVERABLE PETROLEUM HYDROCARBONS (TRPH) CONSTITUENT Lab Sample Dates Sampled, TRPH NO. NO. Received and Tested RL 991656 TK - 1-10 9/23/99 9/24/99 10/7/99 ND 10 991657 TK- 1-14 9/23/99 9/24/99 10/7/99 ND 10 RL = Reportin9 Limit ND = NOt Detected at or above MRL Lab Certification: CAELAP #1878; 1/31/00 Laboratory Manager: Holguin, Fahan & Associates, Inc. Environmental Laboratories 22S5 N. Ventura Ave. Unite B Ventura, CA 93001 (80S}/,52-2876 METHOD BLANK REPORT REPORT OF ANALYTICAl RESULTS Dale Analyzed: 29-$ep-99 QC Batch ID: 9/29/99 Analyzed By: TDK Instrumenl ID: HP 5890 GC-I Analysis Method: 8015-m/8020 CONCENTRATION OF TOTAL PETROLEUM HYDROCARBONS (TPH) WITH BTEX DISTINCTION in rog/Kg (soil) TPH- Ethyl Total Client Gasoline Benzene Toluene Benzene Xylenes Lab No. Sample No. Matrix RL RL RL RL RL 36 t 40 Method Blank Soil ND ND ND ND ND I0 0.005 0.005 0.015 0.015 Volatile fuel hydrocarbons are quantitated against a gasoline standard. Hydrocarbons detected by this method range from C4 to CI2. Analytes reported as ND were not present above the stated limit of detection. RL: Method Reporling Limit ND = Not Detected at or above RL LAB CERTIFICATION: CAELAP # 1878:1/31/2000 HOLGUIN, FAHAN & ASSOCIATES, INC. ENVIRONMENTAL LABORATORIES 2550 Eastman Ave., Unit 1, Ventura, CA 93003¥(805) 650-?750¥FAX (805) 650-6810 METHOD BLANK REPORI REPORT OF ANAI¥IICAL RESULTS QC Batch ID ' 9/29/99 Date Extracted: 23-Sep-99 Instrurnenl IE) · HP 6890 GC-3 Date Analyzed: 29-5ep-99 Analysis Melhod: 8015M Analyzed By · TDK CONCENTRAIION OF IOIAL PETROLEUM HYDROCARBONS (tph) AS DIESEL In mg/Kg (soil) TPH- Client Diesel Lab No. Sample No. Matrix RL 36432 Method Blank Soil ND I0.0 Extractable fuel hydrocarbons are quanfitated against a diesel standard. Hydocarbons detected by this method ~ange from CiO loC24. Analytes reported as ND were not present above the stated limit of detection. RL = Method Efeporting Limit ND = Nol Detected at or above RL LABCERIIFICAIION: CAELAP #1878; 1/31/2000 ]HOLGUIN, FAHAN & ASSOCIATES, INC ~ . ~ ENVIRONMENTAL LABORATORIES 2550 Eastman Ave., Unit 1, Ventura, CA 93003¥(805) 550-7750¥FAX ($05) 550-6810 METHOD BLANK REPORI REPORT OF ANALYTICAL RESULTS QC Batch ID ' 9/29/99 Date Extracted: 23-Sep-99 Inslrumenl I© · HP 6890 GC-3 Date Analyzed ' 29-Sep-99 Analysis Method: 8015M Analyzed By · TDK CONCENTRATION OF TOTAL PETROLEUM HYDROCARBONS (tph) AS DIESEL in mD/Kg (soil) TPH- Client Diesel Lab No. Sample No. Matrix RL 36432 Method Blank Soil ND I0.0 Extractable fuel hydrocarbons are quantitated against a diesel standard. Hydocarbons detected by lhis method range from CiO toC24. Analytes reported as ND were not present above the stated limit of detection. I~L = Method Reporting Limit ND = Not Detected at or above I~L LABCERTIFICAilON: CAELAP #1878; 1/31/2000 Holguin, Fahan & Associates Environmental laboratories 2255 N. Ventura Ave. unit B Ventura, CA 93001 (805)652-2876 f (805)652-2878 Sample ID:. MS &MSD Date Extracted: 23-Sep~99 Lab No: 991421 Date Analyzed: 29-Sep-99 Instrument ID: HP 6890 GC-3 Matrix: Soil Standard: STL - 142 Matrix Spike Worksheet EPA Method 8015-M Matrix Spike Results Compound Sample Matrix Spk. Spike Sol. Recovery Control Conc.(Ug) Conc.(UG) Conc.(UG) (%) Limits TPH as 0.000 14.1 10 141 35-165 Diesel Matrix Spike Duplicate Results Compound Sample Matrix Spk. Dup. Spike Sol. Recovery Control Conc.(UO) Conc.(UO) Conc.(UO) (%) Limits TPH as 0.000 14.1 10 141 35-165 Diesel Average Recovery & RPD Data Compound Spike Matrix Spk. Dup Average %RPD Control Recovery Recovery Recovery Limits TPH as 141 141 141 0.0 <31 Diesel Holguin, Fahan & Associates Environmental Laboratories 2255 N. Ventura Ave. unit B Ventura, CA 93001 (805)652-2876 f (805)652-2878 Sample ID: MS &MSD Date Extracted: 23-Sep-99 Lab No: 991421 Date Analyzed: 29-Sep-99 Instrument ID: HP 6890 GC-3 Matrix: Soil Standard: STL - 142 Matrix Spike Worksheet EPA Method 8015-M Matrix Spike Results Compound Sample Matrix Spk. Spike Sol. Recovery Control Conc.(UG) Conc.(UG) Conc.(UG) (%) .Limits TPH as 0.000 13.0 10 130 35-165 Diesel Matrix Spike Duplicate Results Compound Sample Matrix Spk. Dup. Spike Sol. Recovery Control Conc.(UG) Conc.(UG) Conc.(UG} (%) Limits TPH as 0.000 14.3 10 t 43 35-165 Diesel Average Recovery & RPD Data Compound Spike Matrix Spk. Dup Average %RPD Control Recovery Recovery Recovery Limits TPH as 130 143 137 9.3 <31 Diesel Holguin, Fahan & Associates Environmentc~t Laboratories 2255 N. Verflura Ave. Unit B Venluro, C,A 93001 1805)652-2876 METHOD BLANK REPORT REPORT OF ANALYTICAL RESULTS QC Batch II) : 10/7/99 Dale Extracted: 7-Oct-99 Instrument ID ~ Foxboro iR Date Analyzed : 7-Ocl-99 Analysis Melhod: 418. I Analyzed By : T. Karageorge CONCENTRATION OF TOTAL RECOVERABLE PETROLEUM HYDROCARBONS (h'ph) in mg/Kg (soil), mg/I (water) TRPH Lab Id. Matrix IdRL METHOD Soil ND BLANK 0.0 Analyles ~eported as ND were not present above the stated limit of detection. MRL = Melhod Reporting Limil ND = Nol Detected al or above MRL LAB CERTIFICATION: CAELAP #1878; 1/31/98 Holguin, Fahan & Associates Environmental Laboratories 2255 N. Ventrua Ave. Unit B Ventura, CA 93001 (805)652-2876 fax (805)652-2878 Sample ID: ms / msd Date Extracted: ?-Oct-99 Lab No: 991 657 Date Analyzed: 7-Oct-99 Instrument ID: Foxboro IR Matrix: Soil Matrix Spike Worksheet TRPH by 418.1 Matrix Spike Results Compound Sample Matrix Spk. Spike Sol. Recovery Control Conc.(mg/Kg) Conc.(mg/Kg) Conc.(mg/Kg) (%) Limits TRPH 0.00 410.0 400 103 44-150 Matrix Spike Duplicate Results Compound Sample Matrix Spk. Dup. Spike Sol. Recovery Control Conc.(mg/Kg) Conc.(mg/Kg) Conc.(mg/Kg) (oM0 Limits TRPH 0.00 392.0 400 98 44-150 Average Recovery & RPD Data Compound Spike Matrix Spk. Dup Average %RPD Control Recovery Recovery Recovery Limits TRPH 103 98 100 4.49 <26 CHAIN-OF-CUSTODY RECORD Page I of / ' Client Name ~'~ ~ ~, ~ Project N,ar~e . Client Contact/Phone No. Send report to: CONTRACT CODE 4~/~._.~;~4/t :~'~'"/'~.' ~.j,13.4:r2t.~/ / ~O~,~4v~~}~ll,.~r~;~ Holguin, Fahan&Associates, lnc. 2820 Pegasus Drive. Suite 1 Sample ~ ' Samp~d Sampled air. wat~) ~ boring (x MW #, e~c.) Containers ~ ~ REQUIRED Dk-I'E~N LIMrrs [] L~/~,~ Co~W ' ~ ~ LUrr [] ~~ []~ [] ~~ O~ see reverse for re~n~ detection limits SAMPLE RECEIPT Yes No i P~ESERVATIVE ADDED? Al sam~ stood o~ at HFA am refuted at 4~C. Samples are trattsp<xled to the laborato~ in ~ filled wfth BIt~e IceTM. Derrvered to HFA's refrigerator for temporary storage on ~ (Initials) P~-.r.x~'.,d ~. (S,~a~) / - O..,m.~ I" ~qeoel,,ede,/-./(S~',atu~,~:)roan~)n) i O~e/'nme{" (kx'm uo¢~.~ 1/94) ~ B~: (Sagnatum,~::h~gan~z~t~on) Oat~./T~'~e Received ~ a3~. (SIg~teture/O~anlzalto~) Date/Time Include Sp~<=Ial ~ Hef'e: Return sample(s)/cooler to: Holguin. Fahan & Associates, Inc. ,. 3157 Pegasus Drive. Bakersfield, California, 93308 · (805) 391-0517 o FAX # (805) 391-0826 Capco AnalYtical Services Incorporated (CAS) 1536 Eastman Avenue, Suite B Ventura, CA. 93003 (805) 644-1095 Prepared For: Holguin,Fahan & Assoc., Inc. October 14, 1999 2820 Pegasus Drive, Suite 1 Bakersfield, CA 93308 ATTENTIONs Mark Margargee Laboratory No: 991735 Job No: B00745 · Date Received: 11-OCT-99 Sampled By: Client Project: 34th Street Mobil (BK 364) I..D: See Below RESULTS On October 11, 1999, two (2) samples were received for analysis by Capco Analytical Services Inc. The samples were identified and assigned the lab numbers listed below. This report consists of 1 page excluding the cover letter, and the Chain of Custody. SAMPLE DESCRiPTiON CAS LAB NUMBER TK-i-10 99173501 TK-i-14 99173502 Dan A. Farah, Ph.D. Director - Analytical Operations This report shall not be reproduced except in full without the written approval of Capco Analytical Services Inc.The test results reported represent only the items being tested and may not represent the entire material from which the sample was taken. GPCO Analytical Services, Inc. tapco Analytical Services INC (CAS) 1536 Eastman Avenue, Suite B Ventura, CA 93003 (805) 644-1095 Client: Holguin, Fahan & Assoc. sample Matrix: Soil Lab ID: 991735 Date Sampled: 9/23/99 Date Received: 10/11/99 Analyst: ENN LEAD ANALYSIS Results Date CAS Lab # Client ID Pb (mg/kg) Analyzed 99173501 TK-i-10 2.8 10/12/99 99173502 TK-1-14 2.0 10/12/99 991735-MB Method Blank BQL 10/12/99 PQL:· Practical Quantitation Limit BQL: Below Practical Quantitation Limit Lead. PQL: 0.6 mg/kg EPA Method on Lead Analysis: 7421 Principal GPCO., 3~nal~'ical Services, Inc. ., u 0 1 7 3 5 ~age CHAIN-OF-CUSTODY RECORD Client Name ~ ~ ~,~ Pmj~ ~e Client Conta~hone No. Send re~ to: ~A~OE ~~ ~y~4 ~~~.'/ ~O~~]~.~~ Holguin, Fahan &~ates, I~. 2820 P~asus D~, Suffe 1 Samplers Name · ---- ~. ~ Anal~es R~ Jest~ >kem~%M~_ ~. ~ ~ (~, ~r Inf~a~on ~. and HFA Da. .~ g~ ~.r, (e.g., .m~ ~t~, *p., T~of. ~,~< O.e., ~ma~ ,~. etc.) ~m~ · ~m~ ~ ail ~t~) ~1 ~d~ or ~ ~, ~c.) ~inem _ REQUIRED D~C~N LIM~S ~ L~ ~ ~ ~ ~ LU~ see mveme for ~ui~ det~on lim~ SAMPLE RECEI~ Y~ ~ESERVA~VE ADDED? ~ ~ sto~ ~t at HFA am r~mt~ at 4'0. ~ a~ ~n¢ ~ ~ In~mt~ in ~m fi~ ~ BI~ I~TM. Deliver~ to HFA's refrigerator for tem~w storage on ~ (In~ials) lY o .... . . Ream ~mple(s)/~ler to: Holguin, Inc. · 3157 Pegasus Ddve, Ba~ , California, 93308 · (805) 391-0517 · F~ ¢ (805) 391~826 1 H OL©UIN, FAHAN & ASSOC~T~, INC. ENVIRONMENTAL MANAGEMENT CONSULTANTS ATTACHMENT 2. NON-RCRA HAZARDOUS WASTE MANIFEST · 'I,'~" i Cummings Vacuum Service,~ Inc. NH # .... 4 8 8 5 ~kersfield, CA 9~8 ~i~:-(8~) 387-1842 . *.~' ~ON I ~ BE' FI~ED OUT BY GENERATOR :W~OFW~: [,',,~ ff~g{,'.. QUmTITY OF WASTE ~. Gals. .~F~A~ T~ ~ste de~rib~ a~ve w~ ~nsigned ~ar~ I ~y ~at ~ foregoing is tree a~ ~ffe~ to ~e ~ of my k~w~. . .~INEO ~E OF ~~TOR '- .... SIG~TURE OF GE~TOR DATE ~1~ ~DRE88: 1~ ~O~ ~ne, Bake~eld, CA ~8 Pho~ ~ (8~) 387-1~2 CE~A~: I ~i~ that Ihe waste in lhe qua~ ~ve ~s acmp~ by me for ~ipm~l Io.I~ ~e ~s~ion. ~~~E O[T~SPORTER ~~B~ ~NSP~TER ~ A~CEPT~ SEC~ON IU TO BE RLLED ~ BY DISPOSER ~,~S I: C. 6' . OF DISPOSER I · ~ ~. ~W~T · ~~ cA ~ '--~ . ' I ~EE: ~ PD 0 ~0 S, -. ...... : . .. .. .:-.:..:... .:..:.:...... ...: · ,,.,.. . . , · .... ; ...'.....~' .~'.. · - ?~?-,-:....: :.; . . ... ~].?.".. . . :: ~-... .. .. ~:~ .'... ':., 'v. .'" - ; .7. ' ... .....,: .. '....~- ·. ~ .; ·. :.. ~ ..'.~. · ..: :.....~'. .. - .. :.~:. '] '. ,-. ,:.. . .. . y' ' ..'., ,. :.. ... . ~,~- :' . · 'L " ' "' : ~ "~ ... . ~ HOLGUIN, ~ FAHAN ~ & ASS(XZIATES, INC. ENVIRONMENTAL MANAGEMENT CONSULTANTS ATTACHMENT 3. TANK TRACKING FORM 1715 Chel~e: Ave., Bike=afield, CA 93301 (g0S) 32S-3g79 CERTXFZCATZON STATEM~ OF TANK DECONTAMXHATZOR C°n~a~Lng being r~ov~ under pe~tt ~ '~ , , has ~ =~o~/decon~naC~ proper~F and a ~ (IM~ o~los~ve ~t) reading of no g~eater than 5t was measu=~ ~~a~o~y rolls,ag the c~8an~nq/decon~na~on p~ocess, .... ~ ~ o~ Bakerntleld I~ENvRSFIELD FIRE DEPAR~ IRONMENTAL SERVICES w_ 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 TANK REMOVAL INSPECTION FORM FACILITY,~,~4~ ~Sh,~ ADDRESS ~0 OWNER .~Ja~%4 ~~,~ PERMIT TO OPE~ ~-~O CO~CTOR ~ ~,~4~. CO.ACT PERSON ~O~RY ~ ~ OF S~LES ~ST ~ODOLOGY ~(~ J~O ~, ~ ' P~LI~Y ASSESS~ CO. H~ CO.ACT PERSON PLOT P~ CONDITION OF PIPING ¢'~,,,(! ~Z t_/)~F CONDITION OF SOIL 6r~/.r/~, ~/~, ~o ~oz~,,, ~,o~¢ ~ COMMENTS DATE ;I~IPECTOR8 NAME CITY OF BAKERSfiELD C.g.. -~ 1~ ' OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-:}979 PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK SITE INFORMATION S[TE:.{~O~OI~ ADDRESS ~00 31"~4'k ~' ZIPCODE APN FACILITY NAME ~ff~,o~,otl _ CROSS STREET TANK OWNER/OPERATOR~O ~ rO~~ PHONE NO. MAILING ADDRESS ,~ ~ ~, ~k ~ CIW ~%~ ZIP CONI'RACTOR INFORMATION COMP~NV~m'~ ~?~ ~ ~ONENO. 5~gM~ UCENSE~O a0~ iNSURANCE CARR~ER~c~ ~. WO~NS COM~ NO. ,R~U~,~AeV ~ssrss~r~t ,~O~At,O~ COMPANY ~_ P~O~NO.~O~kq _ . L~CENSENO. ~SVRA~CE CARmER WO~S CO~, ~O. T*~ C~r,~,~a ,~OR~,T~O~ WASTE T~ANSPORTER ~OENT~CATION ~E8 ~ ~l q M ~ NAME OF RINSA~ DIS~OSAL FACILITY ~C~ ~ ~ ~ ~ , ADDRESS ~55 ~~ We$~ CITY ~clCt~.~ FACILITY [DENTIFICATION'NU~ER ~ ~ ~O~~ TA~ TRA~S~Omr~ ~OR~At~O~ COMPANY~b~~ 6~T P~O~NO. 3q~J~qz UC~NSENO. ADDRESS ~ D~ ~¢ ~ Cl~ ~i& SC! TANK DESTINATION <~m~ &,~ ~~ ZIP TANK INFORMATION CHEMICAL DATES CHEMICAL · ~N~ NO. ~ VO~UM~ S~ STO~ For Official Usc (.hdy l'l I1! ^PI'I,ICANT i lAS RECEIVI):I). UNDERSTANDS, AND W[LI, COMPI,Y WH'H TI-IE AI-I'ACHEI) CONI)ITIONS O1: l'[ lIS I'I':RMIT AND ANY ()Ti II.:R STATI!, I,OCAL AND I.'EDI;,RAL REGULATIONS. TI IlS I:(1RM I IAS IJI.:I!N COMP[,I.711',:I) UNI)ER PENALTY OF PERJURY, AND TO 'FH17, BEST O1.' MY KJ~)W~IS TRUI.: AI'PRI.~,I, ff~ APPI,ICANT NAME (PRINT) AI'PI,~N'~ SI(;NXTURE THIS APPLICATION BECOME A PERMIT WHEN APPROVED D FII E February 9, 1999 FIRE CHIEF Mansours Mobile RON FRAZE 800 34th Street ADMINISTRATIVE SERVICES Bakersfield, CA 93301 2101 'H' Street Bakersfield, CA 93301 vOiCE (so5) 328-8941 FAX (805) 395-1349 RE.' Compliance Inspection SUPPRESSION SERVICES Dear Underground Storage Tank Owner: 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 The city will start compliance inspections on all fueling stations within the city limits. This inspection will include business plans, Pa~E~O, SEaVICE$ underground storage tanks and monitoring systems, and hazardous 1715 Chester Ave. Bakersfield, CA 93301 materials inspection. VOICE (805) 326-3951 FAX (805) 326-0576 To assist you in preparing for this inspection, this office is ENVIRONMENTAL SERVICES enclosing a checklist for your convenience. Please take time to read this 1715 Chester Ave. Bakersfield, CA 93301 list, and verify that your facility has met all the necessary requirements to VOICE (805) 326-3979 be in FAX (805) 326-0576 compuance. TRAINING DIVISION Should you have any questions, please feel free to contact me at 5642 Victor Ave. Bakersfield, CA 93308 805-326-3979. VOICE (805) 399-4697 FAX (805) 399-5763 Sincerqly, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure BAKERSFIELD FIRE DEPARTMENT May 8, 1998 Mahamed Mansour Mansours Mobile 800 34th Street nl~ CHIEF Bakersfield, CA 93301 MICHAEL R. KELLY RE: 'Failure to Update Business Plan ADMINISTRAi'NE SERVICES 2101 'H" Street NOTICE OF vIOLATION 26- 9 1 AND FAX (805) 395-1349 SCHEDULE FOR COMPLIANCE SUPPrr. S~ON SEI~VICE$ 2101 'H" Street Bakersfield, CA 93,~1 Dear Mr. Mansour: (805) 326-3941 FAX (805) 395-1349 You have failed to notify this office of a change in your business name within n~VENnON sE~nc~s thirty (30) days, and are in violation of Section 25505(a)(b) and Section 25510(4)(5) of 1715Chester Ave. the Health and Safety Code. Bakersfield, CA 93,301 (805) 326-3951 FAX (805)326-0576 Section 25505(a)(b) and Sections 25510(4)(5) 1997 Edition ENVIEONMENTALSERVICES "Whenever a substantial change in 1715 Chester Ave. handlers operation occurs which Bakersfield, CA 93301 (805) 326-3979 requires modification (change in FAX (805)326-0576 business name, change in ownership) of its business plan, handler shall submit a TRAINING DIVISION 5642 Victor Street copy of the plan revision to the Bakersfield, CA 93,308 administering agency within 30 days of (805) 399-4697 FAX (805) 399-5763 operational change". You must update, and submit copies to our office the following documents per Title 23 CCR: 1. Forms A&B The above mentioned documents must be submitted within thirty (30) days, (June 8, 1998). Failure to comply with result in further enforcement action. Should you have any questions, please feel free to call me at 326-3979. Sincerely, Steve Underwood Office of Environmental Services SBU/dm T 3:PREMIUM INVENTORY I I',I(:F:EF~SE ~ . lc_, I I'.ICF:Ea'3E ~'I'~RT T tz :I:LI .... I'.'I~4Ft 27. 1998 2 :':27 RM I N'~'ENTOR'7' I r.iC'.RE&SE -. - "C~E STAR'[ ",/C'LUME ; 77:5 ,g~LS I N...,RE~-' 9: 2'3 ~I"'1 HEIGHT = 12.:33 INCHES I'.'IAR 27, 19:38 - r'"'N UNLE/4DED I..I~fl'EF: = O. O0 INCHES; - -~-~'~' ~.~:,q (;aLS ENT©RY I HCRE~;SE T£MP = 67.9 DEG F' {/OLUNE = _,' - -- HEIGHT --, '-CE STAR"[' t4aTER = 13. 130 INCHES IN._..REa,~ :3 = 67 ~' DEG F '-'~, 1999 2: 1 al'"l .- ~ ,~SE END TEI"IP ' ' lde4R ~,.. '?. 1998 '2:56 aM ~ ~OLUI'IE = 21 ?:3 GaLS _~ ~' ' = .t.R.I~-~ 1NCHES 3806 C'"' e ._ - HEIGHT .... = ~ML I Nc:RE&SE END ,a'I'ER = -}.I~I1 iNC;HES ~.. = :YT.G1 IN,'2HES l'.'laR 27. 1999 2.~,'? TEMP = E, 9 .:5DEG F [....m~,Thk = 0. O0 1NCHES 2450 GALS TEMP = 61.'2 DEG F 'v'OLUME = -- HEIGHT 27.:3u INONES t4RTER iI"IGREaSE Elf.il'., _,R~ .... INCREaSE= :3028 TEMP 63,6 DEG F l'.taR 27 · 1 ':)'93 '2: 41 al"l t-',-.,:-o TO NET [NC;RERSE= 3030 VOLUME = 61'70 HEIGHT = 5,1.62 [ fICHES GROSS I NC'REe~SE= 1 69 HATER = 0 .'76 II"ICHES TC NET I NCREa~E= 1 690 'rEMF' = 65.S DEG F .CRC, SE; t Iq,'?RE~SE= :3997 ; NET [ I"l':l;FtEaSE= ......... SEN'30R e:~LARM L. 5:8'7 ?,TF' SUMI:' ......... SEl'.lSO~ ~::I_~RI'.'I ,il:t: ,c_:l. Jl'"ll::~ L 4 :TRENCH LI bIER FUEL ~L~RM OTHER ,-a_E MaR '27. 1'9'30 7:'2E, AM FUEL rli.~N;3,::.~UR MC'B ! L i"I~R '-..-"7 · 199cd 7 ~00 ._'34Tt:i- - BaKERSF I ELD ,?A, 9 3:3- 1 - - ~ ,-~ ,0 '-~ - Q '- ,:ii WLI.~-,~ ~ _.b_. 4 MAR '-'"" 1 q':~::-: 6 :CIO P,I":I ' I N",. Et. IT':) ~." REI:~C'RT ..... ~EI'4;3,2'R nL~RM L 6:co9 STP SLII'-II: .......... ;3EI'I;3,L.q:t ~LAIKT'I ........ T 1: UNLEnDED ;3'I'P $1.JMI:' L 4 :TRENCH LIbIER ~,'OLLI"IE = 6,164 C;~::fl._S FUEL AI..F~F.'M (;,THER ;3ENSiSR;3 ULLAGE '3577 GRLB MAR :,. l q'98 7:27 AM F'LIEL ALARM L90% ULLaC;.E= '2E, 02 GAI_.t:_; MaR 27, 1'_4"9;E: 7:4n AM TC ',',St. dP1E = 6 ! :38 GALS HEIGHT = 54.58 INCHE;3 bJF~TEP. VC, L = 11 GaLS I.....I~TER = O. 76 1 NC;RES TEMF.' : 65.9 DEG F ~ T" ~,L'LIS :,,.'t,,~,P1E = 24.1d _,-~L .... . ........;3ENS,:)R aL~F-tM ........ ,,,_,nJLLAC-;E = 7'?.3.~ ,_;~-~L;3 L 4 :TREI'.ICH L I NER ......... SENSOR "gL."~.'Z.'o tILI-,~4(;E= 6,:]1~: GaL,c_; (:,THEF'~ ;3ENSORS L 6:89 STP ?,LiMI:' Ti]; 'v".;)LUME : 2442: L4aLcD FUEL aL~:iRI"I STI:' SLIMt::' HE / OHT ::, . ;Y2' I I'.ICHES MtAR 27 · 1998 ,,: '27 al'"l FUEL ~I.~-:~F.T'I I...,IATER VOL = 0 GAL;3 i~:MR ??. !99',3 ,?:.l,-I e4['t ,JYTER = 0. O0 I NC;HES TEMP = 62.? DEG F 7' :3: t::'REM I LIM ',,/i)L UME = 37'3,9 GALS ULLAGE = 594:3 GaLS 90.'.'.;!; ULLAC4E= 496,8 ,:]ALS TC ',J,[.)LUME = '.37'94 ,:]ALS ........ F3ENSC, R aLARM ..... ..... e., 11'4CHE$ L ?: 9:2 ;3TP' SI iMl:' HE 1C;HT = 3? a .- - - - SE['.I;3,:)I:;f e::d_Pd.7tM ...... b,IATER ',./OL = 0 GALS STP SUMt::' I...ATER = 13.1_-10 INCHES FUEL ALARM L ,1;'['F.'EN,.['H I..INER TEPIt::' 61 5 DE'-; F MaR '?"? 199:~ 7:2,°3 apl ,:':,THEk i.'TII,-~':.'P;:: = · - ~ ' ' t?ltt:'!. -~-! ,' ' i, , .,:3 '?': 4':_' ',._.~ ........ SE I'.I;:5i) R aLaRM ........... L 5:9? ;'-3Tl:' ;30['"1t::' ',-::F_NG;OFt al._e:Rl'.'l ........ ,C_;TP ':'.UMI:" 1. ',' :'-:.'.--' .'a_;'l~:' F'uk l'-'lAR"-ff',.". 1990 7:::113 AM ;::'f'b' ;::;UI"I:' F. UEL aLa F::M i"I~R 27. lq'3t: 7:42 afl ~ CITY OF BAKERSF~LD OFFICE OF ENVIRONMKNTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 INSPECTION RECORD POST CARD AT JOB SITE T~ ~ ~~ DA~ SECONDLY CO~NME~. O~L PROTE~ION. L~ ~ ~s) For ~ Sp~D.W. T~s) FIN~ CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 PERMIT APPLICATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK TYPE OF APPLICATION (CHECK) [ ]NEW FACILITY [ ]MODIFICATION OF FACILITY [ ]NEW TANK INSTALLATION AT EXISTING FACILITY STARTING DATE ~'~- ~ ^ C~ ~ PROPOSED COMPLETION DATE '-~ - Z 5 - FACILITY NAME IYl tK~ 5Or,L(' ~r~ m~o t i .. EXISTING FACILITY PERMIT NO. FAcmrrvADmREss ~ .-~,,~-, .~- crrv ~-z,t~13, ZmCOD£~ TYPE OF BUSINESS ~'Y~\ ~ u ~YI n, ~- '~, - APN # TANK OWNER (~SP. ~t~rx ~$ t~ (~- 4- PHONE NO. ADDRESS ctn~ ZIP CODE. CONTRACTOR~"z~e. L~fa~'~'.~,' fo~'l-~ CA LICENSE NO. '?O~ ADDRESS ,4 ~'oo l'~:rrr:- Av~ crrY ~g,~.q~o~ zn'CODE - BAKER~ CITY Busn~E_ SS ,LIC ,I~NpE NO. WORKMAN COMP NO. O I '7 % t~ ~, WATER TO FACILITY PROVIDED BY ~[ t '~. co DEPTH TO GROUND WATER ? SOIL TYPE EXPECTED AT SITE_ ~ ¢ d c~ INSTALLED ' ARE THEY FOR MOTOR FUEL - ~ES NO NO. OF TANKS TO BE C~ ' YES NO SPILL PREVENTION CONTROL AND COUNTER MEASURES PLAN ON FILE .. SECTION FOIl MOTOR FUEL TANK NO. VOLUME UNLEADED ~ ?R~a'u'~ DmSEL AV~nON I ~o~00o 2. I 0. OOO SECT~O~ FOR ~O~ MOTOR Ft~L STORAGE TANK NO. VOLUME CHEMICAL STORED CAS NO. CHEMICAL PREVIOUSLY STORED (NO BRAND N~ME) (n~ KNOWN) FOR OFFICIAL USE ONLY T~ Am'UCA~r ~S RECEIV£D, USD~aSTASDS, ~ ~ CO~Y ~ ~ A~AC~D CO.mOSS OS ~S ~S~ ~ ~ O~ STAre ~ ~ S~D~ ~UOSS. -- - - ~PLIC~ N~ (P~) ~p~ SIGNA~ ~PRO~D BY: ~r ~[~ ~lS APPLICATION BECOMES A PE~IT WHEN APPRO~D BAKERSFIELD FIRE DEPARTMENT February 13, 1998 FiI~ CHIEF MICHAEL r~. KELLY Mansours Chevron 800 34th Street ADMINISI~.AI1VE SEI~flC~ Bakersfield, CA 93301 2101 "H' Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 ~PPI~.$t~N $r:i1~$~ RE: "Hold Open Devices" on Fuel Dispensers 2101 "H' Street Bakersfield, CA 93301 (805) 326-3941 Dear Underground Storage Tank Owner: FAX (805) 395-1349 The Bakersfield City Fire Department will commence with our annual PREVEffilON SERVICES 1715 Cheste~ Ave. Underground Storage Tank Inspection Program within the next 2 weeks. Bake~field, CA 93301 (805) 326-3951 FAX (805)326-0576 The Bakersfield City Fire Department recently changed its City Ordinance concerning "hold open devices" on fuel dispensers. The Bakersfield City Fire ENVIRONMENTAL SERVICES 1715 Chester Ave. Department now requires that "hold open devices" be installed on all fuel Bokersfield. CA 93301 dispensers. The new ordinance conforms to the State of California guidelines. (805) 326-3979 FAX (805) 326-0576 The Bakersfield Fire Department apologies for any inconvenience this TRAINING DIVL~ION may cause you. 5642 Victor Street Bakersfield, CA 93308 (805) 399-4697 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 6, 1998 FI~ CHIEF MICHAEL R. KELLY Mr. Eric Roehl Chevron Products Co. g)MIN~Sm, aVE SE~CES P.O. Box 2833 2101 'H" Street Bakersfield, CA93301 La Habra, CA 90632-2833 (805) 326-3941 FAX (805) 395-1349 su~,~aSlONSmaCU RE: Baseline Soil Sampling Report, Chevron Facility No. 9-4025 2101 'W Street Located at: 800 34~h Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 Dear Mr. Roehl: ~N~ON SE~ICES 1715 Chester Ave. This is to inform you that this department has reviewed the results for the Bakersfield, CA 93301 (805) 326-3951 preliminary assessment associated with the underground tanks located at the above FAX (805) 326-0576 stated address. ENVIRONMENTAL SEIIVICES 1715 Chester Ave. Based upon laboratory data submitted, this office is satisfied with the Bokersfield, CA 93301 C805) 3264979 assessment performed and requires no further action at this time. Accordingly, no FAX (805)326-0576 unauthorized release reporting is necessary for this assessment. .. mINING DIVISION 5642 Victor Street If yOU have any questions regarding this matter~ please contact me at ........ (805) - Bakersfield, CA 93308 "- C805) 399-4697 3'26-3979. FAX (805) 399-5763 Sincerely, Howard H. Wines, III Hazardous Materials Technician HHW/ed cc: Kevin Hamilton, Fluor Daniel GTI FLUOR DANIEL GTI December 8, 1997 Mr. Eric Roehl Chevron Products Company Post Office Box 2833 La Habra, California 90632-2833 RE: Transmittal, Phase II Baseline Soil Sampling Report, Chevron Facility No. 9-4025, 800 34th Street, Bakersfield, California Dear Mr. Roehl: Enclosed is a Phase II baseline soil sampling report for the above referenced Chevron site. Four bodngs were drilled and sampled to determine soil conditions beneath the dispensers and USTs prior to property transfer. Six soil samples from the gasoline USTs and dispenser borings (B1 through B3) were analyzed for BTEX, TPHG, and MTBE. Two soil samples from the used-oil UST boring (B4) were analyzed for halogenated volatile organics, total lead, and TRPH. BTEX, TPHG, MTBE, and halogenated volatile organics were not detected. TRPH and total lead were detected at Iow concentrations beneath the used-oil UST. A copy of the report will be forwarded to Mr. Brett Shaves of Chevron Property Management and the Kern County Environmental Health Services Department for their files. Additionally, one copy will be forwarded to Mr. Ramzi Mansour the prospective buyer/operator. Thank you for this opportunity to provide Chevron with our services. Should you have any questions or comments please call me at (805) 328-3083. Sincerely, Fluor Daniel GTI, Inc. Kevin L. Hamilton, RF_~ Lead Geologist enclosure: Baseline Soil Sampling Report-Chevron Facility 9-4025 cc: Mr. Brett Shaves (Chevron) KCEHSD Mr. Ramzi Mansour (prospective buyer/operator) 5080 California Avenue / Suite 300 / Bakersfield, CA 93309 USA (805) 328-3083 FAX (805) 328-3081 ~%~>,1t~ 1715 CNESTER AVE., BAKERSFIELD, ~A 93304 ~PLICATION TO P~RFO~ A ~I~NESS TES~ ~-~ OPE~TORS N~ ~~0~ O~ERS N~ ~E~ 0F T~S TO BE TESTED iS PIPING GOING TO T~ VOL~fE '. CONTE~S TEST '~THOD ~/ N~ OP TESTER ~ f~¢/~'~ ~ERTIFIC~TION ~ ~V STATE REGIST~TION DATE & TIME TEST IS TO BE CONDUCTED ///1~ BY: DATE - P glGNATUR~ OF A~*~~ HAZARDOUS MATERIALS INSP '-~ ON akersfield l~Jze Dept. OF ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 Date Completed Location: ~ Stf ~/,, Business Identification No. 215-000 (Top of Business Plan) Station No. Shift __ Inspector 5~,t~ Arrival Time: Departure Time: Inspection Time: Adel~e Inadequate Adel~te Inadequate Address Visable r'l Emergency Procedures Posted r"l Correct Occupancy 0~ [] Containers Propedy Labled ~' [] Verification of Inventory Materials I~ [] Comments: Verification of Quantities [] Verification of Location I~ i'1 Verification of Facility Diagram d I'1 Proper Segregation of Material I~ [] Housekeeping Fire Protection I~ [] Comments: Electrical [] Comments: Verification of MSDS Availablity~ [] Number of Employees: ~ UST Monitoring Program Comments: Verification of Haz Mat Training ~]//' [] Permits I~ [] Comments: Spill Control I~ [] Hold Open Device [] Verification of Hazardous Waste EPA No. Abbatement Supplies and Procedures ~ [] Proper Waste Disposal [] [] Comments: Secondary Containment ~ [] Secudty [] Special Hazards Associated with this Facility: Violations: Busi~ess'O~er/Manag~ PRI~¢NAME /~NATURE All Items O.K Correc~on Needed ~H~ Mat Div. Yello~S~on L)NDERGROUND STORAGE TAI~INSPECTION Bakersfield Fire Dept. Office of Environmental Services Bakersfield, C^ 93302 FACILITY NAME tll~utq,~,,r'q ~j,, ,.,ct),', BUSINESS I.D. No. 215-000 FACILITY ADDRESS ~J~_~0o .lq'~ _et" CITY gt~¢,,d ZIP CODE FACILITY PHONE No. ~D~ ~D~ ~D~ INSPECTION DATE _~[J'T[?? [ -~ .t. :j , - · Produol Product Producl TIME IN - TIME OUT 0~. I~ld5 ~. 0 i~ Inst Date Inst Date Insl Date INSPECTION TYPE: I'P35 i?$~ ROUTINE L// FOLLOW-UP Size Size Size REQUIREMENTS yes no n/a yes no rVa yes no Wa 1 a. Forms A & B Submitted V/ 1 b. Form C Submitted V,/ 1 c. Operating Fees Paid ld. State Surcharge Paid le. Statement of Financial Responsibility Submitted lf. Written Contract Exists between Owner & Operator to Operate UST t,,/ 2a. Valid Operating Permit 2b. Approved Written Routine Monitoring Procedure 2c. Unauthorized Release Response Plan 3a. Tank Integrity Test in Last 12 Months 3b. Pressurized Piping Integrity Test in Last 12 Months 3c. Suction Piping Tightness Test in Last 3 Years ,/ ~'~ 3d. Gravity Flow Piping Tightness Test in Last 2 Years ,V/ ~ 3e. Test Results Submitted Within 30 Days v/ "" 3f. Daily Visual Monitoring of Suction Product Piping ~/ 4a. Manual Inventory Reconciliation Each Month ~/ ~ 4b. Annual Inventory Reconciliation Statement Submitted V/ ~ 4c. Meters Calibrated Annually / ~ 5. Weekly Manual Tank Gauging Records for Small Tanks 6. Monthly Statistical Inventory Reconciliation Results 7. Monthly Automatic Tank Gauging Results V 8. Ground Water Monitoring 9. Vapor Monitoring 10. Continuous Interstitial Monitoring for Double-Walled Tanks 11. Mechanical Line Leak Detectors ,V/ 12. Electronic Line Leak Detectors ,V/ 13. Continuous Piping Monitoring in Sumps ~V/ 14. Automatic Pump Shut-off Capability ,v/ 15. Annual Maintenance/Calibration of Leak Detection Equipment 16. Leak Detection Equipment and Test Methods Listed in LC-113 Series 17. Written Records Maintained on Site V,/ 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 23. Drop Tube /1/' /,' RE-INSPECTION_~AI'E ,/ // RECEIVED BY: ~ INSPECTOR: ~l~u ~Z~_/z~'.) OFFICE 9. FD 1669 (rev. 9/95) '- Chevron April 30, 1996 Chevron Products Company 6001 Boilinger Canyon Road ,~¢.x,~,.--, ~ ~ San Ramon, CA 94583 P.O. Box 5004 Bakersfield Fire Department .: .,: -4 :-~ !i, San Ramon, CA 94583-0804 UST Division Marketing - Northwest Region ~r~.L.. , Phone 510 842 9500 Bakersfield, CA 93301 Dear Sirs, RE: Financial Responsibility For Underground Tanks Chevron SS// STREET CITY 90705 ' 9700 Rosedale Hwy. Bakersfield 91536 .2700 Oswell St. Bakersfield 91554 ' 10 Union Ave. Bakersfield 92718 .5101 Stockdale Hwy. Bakersfield 93978 3100 Niles St. Bakersfield 94025 ~~-¢~:_St. ~' Bakersfield 94416 3699 Wilson Rd. Bakersfield 95325 2525 White Lane Bakersfield 98109 1131 Oak St. Bakersfield 99615 3624 California Ave. Bakersfield 99702 5201 Olive Dr. Bakersfield 60201238 8100 E. Brundage Lane Bakersfield 60201527 -6601 Ming Ave. Bakersfield 60205673 SWC Rosedale Hwy. & Bakersfield 1) Proof of financial Responsibility 2) "Certificate of Financial Responsibility" These documents meet the financial responsibility requirements for all USTs owned by Chevron. These documents have previously been submitted directly to the State. If you have any questions feel free to contact Cheryle R. Canfield at (510) 842-9002. Sincerely, Chevron Chevron Corporation 575 Market Street San Francisco, CA 94105-2856 Martin R. Klitten Vice President, Finance April 30, 1996 UST FINANCIAL ASSURANCE To Whom It May Concern: I am the chief financial officer of Chevron Corporation, 575 Market Street, San Francisco, CA. This letter is in support of the use of the financial test of self-insurance and guarantee to demomtrate f'mancial respomibility for taking corrective action and compensating third parties for bodily injury and property damage caused by sudden accidental releases and/or nonsudden accidental releases in the amoum of at least $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate arising from operating underground storage tanks. Underground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized State program by this guarantor -- all underground storage tanks owned by Chevron U.S.A. Inc. in the United States are assured by this financial test. A financial test and guarantee are also used by this guarantor to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: EPA REGULATIONS AMOUNT Closure (§§264.143 and 265.143) $ 151.180.720.00 Post--Closure Care (§§264.145 and 265.145) $_ 46.894.203.00 Liability Coverage (§§264.147 and 265.147) $ 8.000.000,00 Corrective Action (§264.101 (b)) $. 4)- Plugging and Abandonment (§144.63) $ 3.379,327.00 California State Program Closure $ 194.808.00 Post-Closure Care $ 686.933.09 Liability Coverage $ 56.000.000.00 Corrective Action $ 4)_ Plugging and Abandonment $ 4)- Louisiana State Program Closure $ 4.455.472.00 Post-Closure Care $ 765.810.0Q Liability Coverage $ 1.000.000.00 Corrective Action $ 4)_ Plugging and Abandonment $ 4)_ Total $ 272.557.273.00 This guaramor has not received an adverse opinion, a disclaimer of opinion, or a "going concern" qualification from an independent auditor on his financial statements for the latest completed fiscal year. Page 2 of 4 ALTERNATIVE Il' 1. Amount of annual UST aggregate coverage being assured $. 2.000.000.00 by a test and guarantee 2. Amount of corrective action, closure and post-closure care $ 272.557.273.00 costs, liability coverage, and plugging and abandonment costs covered by a financial test and guarantee 3. Sum of lines 1 and 2 $. 274.557.273,00 4. Total tangible assets $ 34.253.000.000.00 5. Total liabilities $ 19.975.000.000.00 6. Tangible net worth $ 14.278.000.000.00 7. Total assets in the U.S. $ 19.183.000.000.00 Yes No 8. Is line 6 at least $10 million? X 9. Is line 6 at least 6 times line 3? X 10. Are least 90% of assets located in the U.S.? X (If "No", complete line 11.) 11. Is line 7 at least 6 times line 3? X 12. Current assets $.. N/A 13. Current liabilities $. N/A 14. Net working capital (subtract line 13 from line 12). $ N/A 15. Is line 14 at least 6 times line 3? $ N/A 16. Current bond rating of most recent bond issue AA 17. Name of rating service Standard & Poors 18. Date ofmaturi .ty of bond August 15, 2004 Page 3 of 4 Yes No 19. Have financial statements for the latest fiscal year been X filed with the SEC, the Energy Information Administration, or the Rural Electrification Administration? I hereby certify that the wording of this letter is identical to the wording specified in 40 CFR part 280.95(d) as such regulations were constituted on the date shown immediately below, except that information concerning California and Louisiana were added to make disclosure more complete. M. R. Klitten Vice President, Finance April 30, 1996 Page 4 of 4 Guarantee made this April 30, 1996, by CHEVRON CORPORATION, a business entity organized under the laws of the State of Delaware, herein referred to as guarantor, to EPA Regional Administrators and/or state agencies implementing underground storage tank regulation for the states listed in Paragraph 2 (hereinafter collectively referred to as the 'implementing agencies"), and to any and all third parties, and obligees, on behalf of CHEVRON U.S.A. INC. ("CUSA"), of 575 Market Street, San Francisco, CA. RECITA[~ 1. Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d) and agrees to comply with the requirements for guarantors as specified in 40 CFR 280.96(b). 2. CUSA owns or operates the following underground storage tanks covered by this guarantee m underground storage tanks at various facilities in the states of.' Alabama Mississippi Alaska Nevada Arizona New Mexico California Ohio Florida Oregon Georgia Tennessee Hawaii Texas Idaho Utah Kentucky Virginia Louisiana Washington This guarantee satisfies 40 CFR part 280, subpart H requirements for assuring funding for taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases arising from operating the above-identified underground storage tanks in the amount of $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate. 3. On behalf of our subsidiary, CUSA, guaramor guaramees to implementing agencies and to any and all third parties that: In the event that CUSA fails to provide alternative coverage within 60 days after receipt of a notice of cancellation of this guarantee and the Director of the implementing agency has determined or suspects that a release has occurred at an underground storage tank covered by this guarantee, the guarantor, upon instructions from the Director, shall fund a standby trust fund in Page 1 of 3 accordance with the provisions of 40 CFR 280.108, in an mount not to exceed the coverage limits specified above. In the event that the Director determines that CUSA has failed to perform corrective action for releases arising out of the operation of the above-identified tanks in accordance with 40 CFR 280, subpart F, the guarantor upon written instructions from the Director shall fund a standby trust in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. If CUSA fails to satisfy a judgement or award based on a determination of liability for bodily injury or property damage to third parties caused by sudden and/or nonsudden accidental releases arising from the operation of the above-identified tanks, or fails to pay an amount agreed to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor, upon written instructions from the Director, shall fund a standby trust in accordance with the provisions of 40 CFR 280.108 to satisfy such judgement(s), award(s), or settlement agreement(s) up to the limits of coverage specified above. 4. Guarantor agrees that if, at the end of any fiscal year before cancellation of this guarantee, the guarantor fails to meet the financial test criteria of 40 CFR 280.95(b) or (c) and (d), guarantor shall send within 120 days of such failure, by certified mail, notice to CUSA. The guarantee will terminate 120 days from the date of receipt of the notice by CUSA, as evidenced by the return receipt. 5. Guarantor agrees to notify CUSA by certified mail of a voluntary or involuntary proceeding under Title 11 (Bankruptcy), U.S. Code naming guarantor as debtor, within 10 days after commencement of the proceeding. 6. Guarantor agrees to remain bound under this guarantee notwithstanding any modification or alteration of any obligation of CUSA pursuant to 40 CFR part 280. 7. Guarantor agrees to remain bound under this guarantee for so long as CUSA must comply with the applicable f'mancial responsibility requirements of 40 CFR part 280, subpart H for the above-identified tanks, except that guarantor may cancel this guarantee by sending notice by certified mail to CUSA, such cancellation to become effective no earlier than 120 days after receipt of such notice by CUSA, as evidenced by the return receipt. 8. The guarantor's obligation does not apply to any of the following: (a) Any obligation of CUSA under workers' compensation, disability benefits, or unemployment compensation law or other similar law; (b) Bodily injury to an employee of CUSA arising from, and in the course of, employment by CUSA; Page 2 of 3 (c) Bodily injury or property damage arising from the ownership, maintenance, use, or entrustment to others of any aircraft, motor vehicle, or watercraft; (d) Property damage to any property owned, rented, loaned to, in the care, custody, or control of, or occupied by CUSA that is not the direct result of a release from a petroleum underground storage tank; (e) Bodily damage or property damage for which CUSA is obligated to pay damages by reason of the assumption of liability in a contract or agreemem other than a contract or agreement emered into to meet the requirements of 40 CFR 280.93. 9. Guarantor expressly waives notice of acceptance of this guaramee by the implementing agency, by any or all third parties, or by CUSA. I hereby certify that the wording of this guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. Effective date: April 30, 1996 CHEVRON CORPORATION M. R. Klitten Vice President, Finance Assistant Secretary Page 3 of 3 CERTIFICATION OF FINANCIAL RESPONSIBILITY CHEVRON U.S.A. INC. hereby certifies that it is in compliance with the requirements of subpart H of 40 CFR part 280. The financial assurance mechanism used to demonstrate financial responsibility under subpart H of 40 CFR part 280 is as follows: Corporate guarantee of Chevron Corporation in the amoum of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 30, 1996, and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 1997. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. CHEVRON U.S.A. INC. J, effr Mojcher, Seniof~fCounsel April 30, 1996 Jfidith L. Martin April 30, 1996 · "~ Yes No ',.i 6. Are Red Jacket subpumps and all line leak detector ~-_/ Type of line leak detector if any ¢~0~.~ 7. Overfill containment box as specified on app~-i~ation? : If "No", what type and mod~l number: ".: a) Is 'fill box' tightly sealed around fill tube? i' '~ ' b) Is access over water tight? [ [_] ' ::i b) Is the fluid level in Owens-Corning liquid level · .., monitoring reservoir and alarm panel in proper .. :; operating condition? · ' : · : c) Does the annular Space or secondary containment : liner leak detection system have self diagnostic If "Yes", is it functional , If "No", how is it tested for proper operating condition? · i 9. Notes on any abnormal conditions: - . ..-. - .~. - . ..' ;.. ' ~.;-/.:.. I.:i·' .! C110 ',{49 11/38/1995 11:48 3105425627 NDE ENVIRONMENT~ PA6E 82 · J~3~FXF, AJ; FIiI~ DEPAR~ OFFICE OF ENVI~NTAL SERVICES 1715 Chester Ave., . ~kersfie~d, CA 93301 (805) 326-3979 APPLZCATIONTO PERFORM A TIGHTNESS TEST PE~XT ~ OPE~T~ ' I O.~O ~ ue_ I ~ )0'00(~ ~ ~ ~ocl '" ~ //.~'..'/.~ 1~13olq.~ CITY of BAKERSFIELD FIRE DEPARTMENT ~ 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, . Ralph E. Huey Hazardous Materials Coordinator Enclosure erate Underground Hazardous Materials Storage Facility CONDITIONS O~ p~!!~'~ ON REVERSE SIDE - ===============================================================. ','.::::::~:::~ ..::. . HAZARDOUS MATERIALS DIVISION MAHAMED MANSOUR 1715 Chester Ave., 3rd Floor MANSOUR'S CHEVRON Bakersfield, CA 93301 ~00 34TH STREET (805) 326-3979 BAKERSFIELD, GA 93~01 Approved by: ~alph ~o~, Coordinator Valid from: 07-01-04 to: FIRE SAFETY SERVICES & OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVE. · BAKERSFIELD, CA ° 93301 R.E. HUEY R.B. TOBIAS, HAZ-MAT COORDINATOR FIRE MARSHAL (805) 326-3979 (805) 326-3951 October 25, 1995 Dear Underground Storage Tank 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, H~ardous Materials Coordinator Enclosure erate Underground Hazardous Materials Storage Facility CONDITIONS ~ P~~i~ ~ "EVERSE SIDE Tank Hazardous G~ii~??:i::i~?:ii~::-?'~" ~..~.~ii?;i.!!??~:: ::~?.[.:~T ank .... ::i;~i!~.~iii:~::.iiii!i:.::!:~i:!!~!::;~: Piping Piping Piping Number Substance C a~i~a~i~%.:~? i ns t ~ll~:i!i:i....:, .. :!~.:? y p e M o ~:~:.~i ~:.~:::::;~:?::::?~. Type Method Monitoring O1 PREMIUM U/L ~.~O~'O~:~:'? ;':;; ~:;:':'-:~':~:~ :::;:~:::?~ ~ ?'~WF :?'?~?~;~'~:~ ........... ~::~?:::':'~'~ .... ... ..... :::::::::::::::::::::::" :' :::~;:: SWF PRESSURE ALD O2 GASOLINE ;;.10, OOO ;~::~ ....... ::]:];;;'..?;'~'~8~?:~ :?;~?' :'D~F ?~:':~(::?.:~ ...... CL~::?;? ~. ?'::~::;~::SWF PRESSURE ALD O3 GASOLINE ::~:~6;oeo ~:;;:'~. ~?:.:.?::: ~.9B8..:..~:~.~;~:~;~:D~E~:~;~:~;~:.;~:..;.~...:~:;~.~;~::: cUM :~[::?~SWF PRESSURE ALD 04 WASTE OIL :~?~:0~O~© ?::.: ~;~;;;;;;;;;;;~;~?~;~;:?~;~?~;~;~;~:~:~:~:~;~?~?~:~.~?.~ c:~M?... ~?:::::?SWF GRAVI~ ALD Bakersfield Fire Dept. HAZARDOUS MATERIALS DIVISION ............. ::::::::::::::::::::::::::::::::::::::::::::::::::::::: ............ MAHAMED MANSOUR 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 MANSOUR'S CHEVRON (805) 326-3979 800 34TH STREET BAKERSFIELD, CA 93301 Approved by: R~p~ ~Huey, H~ls Coordinator Valid from: 07-0!-94 to: 07-01-99 CCR, TITLE '/-3, LIMSION ~), ~.HAFI'I~R ZO, U~lVl:l~tKuu~v o~vm~t~- am~ a~u~ (b) ~ers or operato~ of t~ which ~e cons~cted pu~u~nt to sec~on 2633 ~d which con~n motor vehicle ~el shaR implement a monitoring pro.am approved by ~e loc~ agen~ and specked in ~e ~k operating pe~it. (c) New ~ ~ich con~n motor vehicle ~el ~d whi~ ~e cons~ed in accor~ce ~ se~on 26~3 sh~ be monitored ~ foRo~: (1) ~e le~ intercep~on ~d dem~on ~mm sh~ be mortared in accor~ce ~ subse~on (d) of ~is se~on; (2) ~e motor vehicle ~el invenm~ sh~ ~ reconc~ed according to ~e peffo~ce requ~emen~ in sec~on 2~6; ~d, (3)~ unde~ound pip~g sh~ ~ msmd ~d mo~tored ~ ~cord~ce ~ se~on 2636. (d) Before implemen~ng a monitoring pro~, ~e o~er or ope~tor sh~ demons~ate to ~e sa~s~c~on of ~e lo~ agen~ ~at ~e pro~ is effective in detecting an unau~or~ed rele~e from ~e prim~ container before it c~ escape from ~e le~ intercep~on ~d dete~on system. A monito~ng pro.am for le~ intercep~on ~d detec~on s~tem sh~ meet ~e foRo~ng requirement: (1) The s~tem sh~ detect any unau~or~ed rele~e of the motor vehicle ~el using eider: (A) One or more of ~e con~nuous monitoring me~odg prodded in T~le 3.2. The s~tem sh~ ~ connected to ~ audible and ~su~ ~m s~tem approved by ~e loc~ agent; or, (B) M~u~ monitoring. ~ ~is me.od is used, it sh~ be perfo~ed d~ly, except on weekends ~d recogn~ed state ~or feder~ holidays, but no less ~ once in ~y 72 hour period. Manu~ monitoring may be required on a more frequent b~is ~ specked by ~e loc~ agent. (2) The o~er or operator sh~ prep~e a ~itten procedure for rouane monitoring which es~HsheS: (A) The ~equen~ of pe~o~ing ~e monito~ng; (B) ~e me.ods ~d equipment to ~ used for perfo~g ~e mo~toring;' (C) ~e l~aflon(s) ~ere ~e mo~to~g ~ ~ peffo~ed; (D) ~e nme(s) ~d title(s) of ~e pe~on(s) responsible for peffo~mg ~e monitoflng ~or m~n~ning ~e e~ipment; (E) ~e repo~ng lo.at; (~ The preventive m~nten~ce schedule for ~e monitoring equipment. The m~nten~ce s~edule sh~ be in accor~ce 3-10 C CR, T~~d~T£R 16' U NDERGRO~ TAN~;REGULATtONS with the manufacturer's instructions; and (G) A description of the training necessary t0r the operation of both the tank system and the monitoring equipment. (3) For methods of monitoring where the presence of the hazardous substance is not determined directly, for example, Where liquid level measurements are used as the basis for determination (i.e., liquid level measurements), the monitoring program shall specify the proposed method(s) for determining the presence or absence of the hazardous substance if the indirect method indicates a possible u~.nauthorized release of motor vehicle fuel. (e) A response plan for an unauthorized release shall be developed before the underground storage tank system is put into service. If the leak interception and detection system meets the volumetric requirement of section 2631(d), the local agency shall require the owner to develop a response plan pursuant to the requirements of section 2632(d)(2). If the leak interception and detection system does not meet the volumetric requirements of section 2631(d)(1) through (5), the response plan shall consider the following: (1) The volume of the leak interception and detection system in relation to the volume of the primary container; (2) The amount of time the leak interception and detection system shall provide containment in relation to the period of time between detection of an unauthorized release and cleanup of the leaked substance; (3) The depth from the bottom of the leak interception and detection system to the highest anticipated level of ground water; (4) The nature of the unsaturated soils under the leak interception and detection system and their ability to absorb contaminants or to allow movement of contaminants; and (5) The methods and scheduling for removal of all of the hazardous substances which may have been discharged from the primary container and are located in the unsaturated soils between the primary container and ground water, including the leak interception and detection system sump. Authority: Health and Safety Code 25299.3, 25299.7 Reference: Health and Safety Code 25281, 25291, 25292 40 CFR 280.41 3-11 COI i ECTION NOTIC BAKERSFIELD FIRE DEPARTMENT ~ Location /'l'~-~ ~50L~-~ sub ~)ivc ~..q~) ~i'~ ~ . ~]~. . You are hereby required to make the following cor~ctions at the above location: Cor. No ~ 7 ', / - I' U ....... Completion Date for Corrections Date ] (}/~7 ,/:]~ Inspector HAZARDOUS MATERIALS IN~I~I~CTION Bakersfield Fire Dept. ........ · , ~: ~ ~.:~ ............................................. .......... ~ .................... · ............. · ........................... :~: ......... ,~ '. ......... HAZARDOUS MATERIALS DIV/SION ~ 1715 Chester Ave. Bakersfield, CA 93301 Date Completed ]0/~./~- Business Name: Location: ~ ,~/+~_5._ Business Identification No. 215-000 ,~.z/~~'- (Top of Business Plan) StationNo. ~]~z/)34'~ Shift2..~L Inspector ~-~-~'P-. Arrival Time: Departure Time: Inspection Time: /-/'~..% /'~ //g/ Adel~ Ina~uate Adequate Inadequate Address Visable Emergency Procedures Posted ~ [] Correct Occupancy [~ {-I Containers Propedy Labled ~ [] Verification of Inventory Materials ~ [] Comments: Verification of Quantities ~ [] Verification of Location ~ [] Verification of Facility Diagram r [] Proper segregation of Matedal ~ [] Housekeeping ~ [] Fire Protection ~ [] Comments: Electrical ~l~ [] Comments: Verification of MSDS Availablity i~r [] Number of Employees: Comments: Verification of Haz Mat Training i3;!."" [] Permits ~ [] Comments: Spill Control ~ [] Hold Open Device ~ [] Verification of Hazardous Waste EPA No. Abbatement Supplies and Procedures ~ [] Proper Waste Disposal ~ [] Comments: Secondary Containment ~ r"l Security ~ [] Special Hazards Associated with this Facility: / )~"~'~/',,q-~_~Y'~%',~/ ,,~; % e.,% ~ "/'e~ '~ Violations: ' /~oe.. /4('~o o,q" / ,~_~ All Items O.K [] ~ Business Owner/Manager PRINT NAME SIGNATURE Correction Needed ~ ~ VVhite-Haz Mat Div. Yellow-Station Copy Pink-Business Copy u_ UNDERGROUND STORAGE TANK~II~PECTION *-.~- ....~lii~'.~,'-,*B.akersfield Fire Dept. Bakersfield, CA 9330 l FACILITY NAME /~~ ~__~ ~/3 ~O V,~r~ BUSINESS I.D. NO. 215-000 FAClLI~ PHONE NO. · INSPECTION DATE ~O/~o/~ ~ - Pr~' TIME IN TIME OUT , ,.. ~ ~ I { ~ ~ ~ ~C ~_~ i~ ~te I~ ~l~ I~st'~te INSPECTION ~PE: ~( ~((~ ~; ~'~- ROUTINE ~' FOLLOW-UP /~, REQUIREMENTS ~ no ~a y~ ~ ~a y~ no ~a la. F~s A & B Su~a~ lb, F~ C Su~ lc. O~mti~ F~ Pa~ ld. State Surcharge Paid le. State~nt of Fina~ial R~si~l~ Su~a~ lf. W~en Contm~ ~sts ~n ~r & O~ to O~e UST ~. ~lid O~mting Pe~ 2b. Ap~ov~ Wr~en Ro~i~ Monitoring Pr~ure 2c. Una~ Relea~ Res~n~ P~n ~. Tank Int~r~ Tes~. in Last 12 Months 3b. Pre~u~ Piping Int~ri~ T~t in Last 12 M~ths ~. Suction Piping ~ghtn~s T~t in ~st 3 Yearn ~. Gmv~ FI~ Piping ~ghtn~ T~ in ~M 2 Y~m ~. T~t R~uEs Subm~ Within ~ Da~ 3f. DaiN ~sual Mon~oHng of S~ Pr~ Piping ~. Manual Invento~ R~ncil~tion Each M~th ~. Annual Invento~ R~iliati~ Statement Su~ ~. Metem Calibmt~ Annually 5. W~ Manual Tank Gauging R~rds f~ Small Tan~ 6. MonthN Statisfi~l Invento~ R~nciliati~ R~uEs 7. Month~ A~atic Tank Gauging Resu~s 8. Ground Water ~ing/ ~0. C~tinuou~ Int~titi~l Monlodn~ f~ ~oubl~W~ll~ Pr~ures of UST S~tem Within ~ Da~ 19. Re~R~;'Una~ho~ Relea~ W~hin 24 Houm ~. Ap~ov~ U~T S~tem Re.irs a~ U~md~ .2~. ,~s S~ng C~th~ic Prot~ ~ ns~ ~. Dr~Tu~~// . ~ RE-INSPECTION DATE ~~' RECEI~D BY: FD l~g HAZARDOUS MATERIALS INSPE~ON Bakersfield Fire Dept. ........... ......... .................. :~:'":' ........ ............. ":~ ~'~ ~¥~ ~'~ :'~ ........... ' '" ....... ........ '~ ~ .......... " .........." HAZARDOUS MATERIALS DIVISION 171 $ Chester Ave. Bakersfield, CA 93301 Date Completed Business Name: /~~.~ Location: .,cy*~ ~z/*~ .5+ Business Iden~fica~on No ~_215~000~ ,~ ~, o Business :~:~,~.~ ;~ v, ~.'., ~.~; ~ ~ p of Plan) a~on No. ~)z/~ Sh~ff *~y -' 'Inspector Arrival Time: Depadure Time: Inspec~on Time: Adel~~ Inadequate Adequate Inadequate Address Visable [] Emerge.ncy Procedures Posted Correct Occupancy ~ []'1 ~?J~taiffers Proped~ Labled Er' [] Verification of Inventory Materials~ [] Comments:~ ' Verification of Quantities ~ [] ~" ~ Verification of Location 13t"" [] Verification of Facility Diagram ~ [] Proper Segregation of Material ~ [] Housekeeping ~ [] Comments: Fire Protection El"- [] Electrical ~ [] Comments: Verification of MSDS Availablity ~ [] Number of Employees: ~ UST Monitoring Program [] Comments: Verification of Haz Mat Training ~ [] Permits ~ [] Comments: - Spill Control ~ [] Hold Open Device ~ [] Verification of Hazardous Waste EPA No. Abbatement Supplies and Procedures ~ [] Proper Waste Disposal ~ I-I Comments: Secondary Containment Secudty ~ [] Viola~ons: Business O~er/Manag~ PRINT NAME SIGNATURE Correc~on Needed ~ite-H~ Mat Div. Yello~Station C~y Pink-Business C~y ~ ~evran Chevron Chevron U.S.A. Products Company ?~ay 2 4 19 9 5 Marketing Department ' 1300 South Beach Boulevard Building 4516 La Habra, California P.O. Box 2833 La Habra, CA 90632-2833 Bakersfield Fire Department Phone 310 694 7300 UST Division 1715 Chester Avenue . ~,A~/~k,,. Bakersfield, CA 93301 ..,?,~. Attention: Ralph Hwey /'~.4~, ~': Re: Underground Storage Tank '"'~,,~'. Financial Responsibility "~/~ Dear Ralph Hwey: The enclosed letter is provided to comply with the requirement to demonstrate financial responsibility for underground storage tanks owned by Chevron U.S.A. Products Company. Financial responsibility applies to the enclosed list of service stations located in the City of Bakersfield. If you have any questions, please contact Jean Chavira-Flores at 310-694-7452. Very truly yours, K. F. Wiseman Manager-Environmental, Safety and Health Enclosure 057.jac PAGE 5 CHEVRON U.S.A. PRODUCTS CO. - SOUTHWEST REGION SW REGION STATION LIST - APSI & 3 PTY OUTLETS 05/22/95 TgSWPOR -SW_OULET FACILITY STREET CITY COUNTY ...... ST/ZN ZiP CROSS ST DEALER NAME/PHONE 91835 1011 IMPERIAL STREET CALEXICO IMPERIAL CA 92231 qTH STREET ARTURO U ANTUNEZ 8E 619-357-2336 90130 905 N MAIN ST BISHOP INYO CA 93514 HAINE RICK CASSEL, II DBA 61 619-873-4430 90086 460 S MAIN ST LONE PINE INYO CA 93545 DARRELL C CATHERMAN '~/90 61 619-876-5971 705 9700 ROSEDALE HWY BAKERSFIELD KERN CA 93308 CALLOWAY RAY SUTTON INC 61 805-589-9011 v'/91536 2700 OSWELL STREET BAKERSFIELD KERN CA 93306 AUBURN STEVE R THORNE, INC. 61 805-871-1200 V'/91554 10 UNION AVENUE BAKERSFIELD KERN CA 93307 NOLAN W BERST DBA \/~92 61 805-322-2445 718 5101 STOCKDALE HWY BAKERSFIELD KERN CA 93309 VILLAGE LANE PHILIP A WELCH DBA 61 805-832-1818 ~.~-,~ 93978 3300 NILES ST BAKERSFIELD KERN CA 93306 OSWELL KENNETH MC COY 61 805-871-1865 94025 800 34TH ST BAKERSFIELD KERN CA 93301 Q ST MOHAMED MANSOUR 61 805-323-9694 94416 3699 WILSON ROAD BAKERSFIELD KERN CA 93309 REAL RD SONNY SWAFFAR 6 805-831-6075 95325 2525 WHITE LANE BAKERSFIELD KERN CA 93304 EL PORTERO BOB HALEY SERVICE, INC 6 805-832-9781 98109 1131 OAK STREET BAKERSFIELD KERN CA 93304 CALIF ST PHILIP A WELCH DBA 9 6 805-324-7621 9615 3624 CALIFORNIA AVE BAKERSFIELD KERN CA 93309 REAL RD CHARLES SUTTON INC 6 805-325-1642 CA 93308 HWY 99 KEESTER INC 99702 5201 OLIVE DR BAKERSFIELD KERN 6 805-399-9056 C/ 201238 8100 E. BRUNDAGE LANE BAKERSFIELD KERN CA 93307 WEEDPATCH HWY THOMAS W SCOTT 6 805-366-5542 201527 KERN CA 93307 A.P.S.I. # 1830 6601 MING AVENUE BAKERSF ELD 6 805-831-1270 ./ 93249 KERN CA 93206 PERRY C SCOTT DBA 26056 TRACY AVENUE BUTTONW 1 LLOW 6 805-764-5419 · Chevron Corporation 225 Bush Street, San Francisco, California 94104-4289 M. R. Klitten Vice President, Finance April 28, 1~5 UST FINANCIAL ASSURANCE To Whom It May Concern: I am the chief financial officer of Chevron Corporation, 225 Bush Street, San Francisco, CA. This letter is in support of the use of the financial test of self-insurance and guarantee to demonstrate financial responsibility for taking corrective action and compensating third parties for bodily injury and property damage mused by sudden accidental releases and/or nonsudden accidental releases in the amount of at least $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate arising from operating underground storage tanks. Underground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized State program by this guarantor: all underground storage tanks owned by Chevron U.S.A. Inc. in the United States are assured by this financial test. A financial test and guarantee are also used by this guarantor to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: EPA REGULATIONS AMOUNT Closure (§§264.143 and 265.143) $ 158,409,500.00 Post-Closure Care (§§264.145 and 265.145) $ 59,726.500.00 Liability Coverage (§§264.147 and 265.147) $ 8,000,000.00 Corrective Action (§264.101(b)) $ -0- Plugging and Abandonment (§144.63) $ 3,096.000.00 ALTERNATIVE II 1. Amount of annual UST aggregate coverage being assured $ 2.000.000.00 by a test, and/or guarantee 2. Amount of corrective action, closure and post-closure care $ 292.320.000.00 costs, liability coverage, and plugging and abandonment costs covered by a financial test, and/or guarantee 3. Sum of lines 1 and 2 $ 294,920.000.00 4. Total tangible assets $ 34,315.000.000.00 5. Total liabilities $19,811.000.000.00 6. Tangible net worth $14,504,000.000.00 7. Total assets in the U.S. in excess of $ 20,175,000,000.00 Yes No 8. Is line 6 at least $10 million? X 9. Is line 6 at least 6 times line 3? X 10. Are least 9095 of assets located in the U.S.? (If "No", X complete line 11.) 11. Is line 7 at least 6 times line 3? X 12. Current assets $ N/A 13. Current liabilities $ N/A 14. Net working capital. (subtract line 13 from line 12). $ N/A 15. Is line 14 at least 6 times line 3? $ N/A 16. Current bond rating of most recent bond issues. AA 17. Name of rating service Standard & Poors 18. Dates of maturity of bond August 15, 2004 Page 3 of 4 GUARANTEE Guarantee made this April 28, 1995, by CHEVRON CORPORATION, a business entity organized under the laws of the State of Delaware, herein referred to as guarantor, to EPA Regional Administrators and/or state agencies implementing underground storage tank regulation for the states listed in Paragraph 2 (hereinafter collectively referred to as the "implementing agencies"), and to any and all third parties, and obligees, on behalf of CHEVRON U.S.A. INC. (~CUSA"), of 575 Market Street, San Francisco, CA. RECITALS 1. Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d) and agrees to comply with the requirements for guarantors as specified in 40 CFR 280.96(h). 2. CUSA owns or operates the following underground storage tanks covered by this guarantee -- underground storage tanks at various facilities in the states of: Alabama Mississippi Alaska Nevada Arizona New Mexico California Ohio Florida Oregon Georgia Tennessee Hawaii Texas Idaho Utah Kentucky Virginia Louisiana Washington This guarantee satisfies 40 CFR part 280, subpart H requirements for assuring funding for taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases arising from operating the above-identified underground storage tanks in the amount of $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate. 3. On behalf of our subsidiary, CUSA, guarantor guarantees to implementing agencies and to any and all third parties that: In the event that CUSA fails to provide alternative coverage within 60 days after receipt of a notice of cancellation of this guarantee and the Director of the implementing agency Page 1 of 3 (c) Bodily injury or property damage arising from the ownership, maintenance, use, or entrustment to others of any aircraft, motor vehicle, or watercraft; (d) Property damage to any property owned, rented, loaned to, in the care, custody, .or control of, or occupied by CUSA that is not the direct result of a release from a petroleum underground storage tank; (e) Bodily damage or property damage for which CUSA is obligated to pay damages by reason of the assumption of liability in a contract or agreement other than a contract or agreement entered into to meet the requirements of 40 CFR 280.93. 9. Guarantor expressly waives notice of'acceptance of this guarantee by the implementing agency, by any or all third parties, or by CUSA. I hereby certify that the wording of this guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. Effective date: April 28, 1995 CHEVRON cORPORATION M. R. Klitten Vice President, Finance Assistant Secretary Page 3 of 3 CERTIFICATION OF FINANCIAL RESPONSIBILITY CHEVRON U.S.A. INC. hereby certifies that it is in compliance with the requirements of subpart H of 40 CFR part 280. The financial assurance mechanism used to demonstrate financial responsibility under subpart H of 40 CFR part 280 is as follows: Corporate guarantee of Chevron Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 28, 1995, and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 1996. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. CHEVRON U.S.A. INC. ' . l'i / ~..__.- '( J. J6ffrey~'Mojcher, S~nior Counsel ENV8114 Underground Hazardous Materials !torage Facility I . · : ~o..:.'.: ............. '.~ ...................... - ..............· ........ '..-.. · :~:... :. .:::::..::::::" ~.'j: ...:.:~:::... . '. :.:.~.::~::.:.*.~ ~:'' ~ ~ ~ *?:*:~:.:-.:.... · ~:~:::.:.:...:..~ :~... ~:. . ~.~ e .~ ................ I~ .................. . ................................. · ....... : .... --.. '~.~'.'"".:~:. '::::5. } '-.:?'::? '~:.':~ .... ':?' ::~. '...'":: :.:::::' ~x ~- ' HAZaaDOU8 MA~EalAL$ DIVISION 1715 Chester Ave., 3rd Floor ~q ~ 5o~ ~ ~,~ v~ Bakersfield, CA 93301 ~ ~ ~ ~ (805) 326-3979 / Ralph E. Huey, Hazardous Materials Coordinator Valid lrom> y Ir (q~r~ lo: CONDITIONS OF SYSTt~4 AT 17~SPECTION: /~// / ~ o~, . ~NI~R D~: ~I~ITION OF EQUIP~ AT ~SP~ION. 17~SPECTION TEc}~ICI~: .~J CO'mANY PERFORMING INSPECTION: COiJRECTION N OTI ~JIE BAKERSFIELD FIRE DEPARTMENT N° 574 Location .~./1~ I~ ~J r ] ff~O ~'e ~% . Sub Div. ~ .]ql~ ~ ,. Blk. ~t You are hereby required to ~nake the following cor~ctions at the above l~ation: Cot. No Inspector 325-39?9 LO0)~' VacuTectT" TEST REPORT '~?:- Date Owner CI-1FJdRON USA PRODLIC t'S CO. Site # 94025 ,~C Phone <3,,~ O> 694--7349 BOX 283~'~ [.A HABRA, CA Invoice Name/Address CHEVRON USA PRODUCTS CO. P.O. ' ..... ' TA 4K TEST lNG DESK Site Name/Address, CHEVRON U~A PRODUCTS CO. 800 34TH ST. BAKENSFIELD, CA 93301 Attn: TANK~ LINES Leak Der ~ Ullage~NKS and LINES Tested to CFR-40 Pads ~e Tank Dipped Dipped Probe Water Bubble Air Line Final ~ Exist ~ 80-281 & NFPA 329 Spec's. Diag. For Dia. & Water Product Water Ingress Ingress Ingress TANK Line Delivery LINE LINE Leak LINE LD(s) NEW Material Level Level Level Detected Detected Detected ~ Material Syst. Type TEST TEST Rate · ~ss/ LD(s) k Tank Tank FPP/ START START START or ST/ START END or or & ~ther: Lined END END END Yes/No Yes/No Yes/No Fail Line~ FPP PS/SS/CS TIME TIME GPH Fail NONE PASS ~ Product Capacity UNL New/2nd LD SN/MDL/MFG: Tank ~ Probe Inclinometer Dispenser Shear Valves y End Time: Test PSI: J Enid: D~r~s: Operate UNL~ ~ ~.w/~nU LD SN/MDL/MFG: Percent of Fill at Pump ,~ ,~j ~LINE TEST PSI Material Sta. Time: Timeof Test: Mfg.: :: ~,~:: :, :~¢;; ~': ;c?, Tank Probe Inclinometer ~Dispenser Shear Valves y End Time: Test PSI: Ent~: DeDrees: ?O~erate ~es/no~ LiN[I I New/2nd LD SN/MDL/MFG: ~rcent of Fill at Pump ; ~o ~ , ~ .INE TEST PSI Material Sta~ime: TimeofTest: Mfg.: . ~. : '.,~ J~: ~?~'' C, : Tank Probe Inclinometer 3ispenser Shear Valves End Time: T~ P~I: Ent~: D~Dr~: operate ~'~ist LD SN~DL/MFG: ew/2nd LD SN/MDL/MFG: Tank Inclinometer ~ispenser Shear Valves T~ ~?: ]Probe ~perate ~.s/no~ End Time: I Ent~: Deqr~s: Diameter ~ I ~ J' ~ I I ~rcentof Fillat Pump 't ~ :~ ' End Tim~: Test ~1: Ent~: De~r~: D~erate ~es/no~ I I ~rcent of Fill at Pump ~ ~ ' ~: ' Material Sta~ Time: Time of T~t: Mfg.: ' (} , ~t~, ~ ~ ~ ~~ ~ ~ LINE TEST PSI: End Time: T~st PSI: Ent~: D~r~: Operate ~es/no~ Tankn =logy Corporation International KNOLOGY Region: Unit ~ State Lic. ~ State: 5225 Hollister St., Houston, TX 77040 ~: Original VacuTect Data recordings are reviewed by Tanknology's Audit Control Depa~ment and maintained on file. (80~) 888-8563 · FAX (7i 3) 690'2255 1Q07 H iii' ~ ~Y ~ Chewon Produc~ ~mpany, Inc. April 30, 1997 ~ .............. ~ ~ ........................ P.0. Box 6~4 San Ramon, Ca 94583~904 Che~e Canfield Pe~it Desk B~cFs~ie]d ~iFc Dep~men~ Phone No. 510-842-9002 UST Division F~ No. 51~842-9591 17~5 Chester Ave. B~crsficld, CA 9330~ ~: ~C~ ~SPONS~~ FOR ~ERGRO~ T~ Dc~ Sirs: Plebe find enclosed thc following document: ~) Proof of Financial Rcspo~ibili~ 2) "Cc~ificatc of Financial Rcspomibility" These documcn~ mcc[ thc financial responsibility rcquircmcn~ for all USTs owned by Chevron and have previously been submi~d directly to thc State. If you have any questions feel free to contact me. Chevron is responsible for {he following facilities in your jurisdiction: C~ON ~Sff ~T ~D~ CITY 90705 9700 Roscda]c Hwy. B~crsficld 9~536 2700 Oswcll S~cct B~crsficld 9~554 10 Union Avenue B~crsfic]d 93978 3100 Niles St. B~crsficld 94025 8~ 34th St. B~crsficld 94416 3699 Wilson Road B~crsficld 95325 2525 White ~nc B~crsficld 98109 ~ 13 ~ O~ S~cct B~crsficld 996~5 3624 California Ave. B~ersficld 99702 5201 Olive Dr. B~crsficld 201238 8100 E. Brundagc ~nc B~crsficld 201527 660~ Ming Avenue B~crsficld 201921 6601 Ming Avenue B~crsficld 203576 1125 Coffee Road B~crsficld Sincerely, ' Marketing Assistant Environmental Compliance Enclosure Chevron Chevron Chewon Corporation 575 Market Street San Francisco, CA 94105-2856 Martin R. Klitten Vice President, Finance April 28, 1997 UST FINANCIAL ASSURANCE To Whom It May Concern: I am the chief financial officer of Chevron Corporation, 575 Market Street, San Francisco, CA. This letter is in support of the use of the financial test of self-insurance and guarantee to demonstrate financial responsibility for taking corrective action and compensating third parties for bodily injury and property damage mused by sudden accidental releases and/or nonsudden accidental releases in the amount of at least $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate arising from operating Underground storage, tanks. Underground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized State program by this. guarantor -- all underground, storage tanks owned by Chevron U.S.A. Inc. in the United States are assured by this f'mancial test. A financial test and guarantee are also used by this guarantor to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: EPA REGULATIONS AMOUNT Closure (§§264.143 and 265.143) $ 182.211.758.00 Post-Closure Care (§§264.145 and 265.145) $ 52.567.819.00 Liability Coverage (§§264.147 and 265.147) $ 8.000.000.00 Corrective Action (§264.101(b)) $ 4)- Plugging and Abandonment (§144.63) $ 2.430.000.00 California State Program Closure $ 196.731.00 Post-Closure Care $ 694.620.00 Liability Coverage $ 66.000.000.00 Corrective Action $ 4)- Plugging and Abandonment $ 4)- Louisiana State Proeram Closure $ 4.504.037.00 Post-Closure Care $ 774.158.00 Liability Coverage $ 1.000.000.00 Corrective Action $ 4)- Plugging and Abandonmem $ 4)- Total $ 318.379.123.00 This guarantor has not received an adverse opinion, a disclaimer of opinion, or a "going concern" qualification from an independent auditor on his financial statements for the latest completed fiscal year. Page 2 of 4 ALTERNATIVE II 1. Amount of annual UST aggregate coverage being assured · $ 2~000.000.00 by a test and guarantee 2. Amount of corrective action, closure and post-closure care $ 318.379.123.00 costs, liability coverage, and plugging and abandonment , costs covered by a financial test and guarantee 3. Sum of lines 1 and 2 $ 320.379.123.00 4. Total tangible assets $ 34.785.000.000.00 5. Total liabilities $ 19.231.000.000.00 6. Tangible net worth $ 15.554.000.000.00 7. Total assets in the U.S. $ 18.855.000.000.00 Yes No 8. Is line 6 at least $10 million? X 9. Is line 6 at least 6 times line 3?' X 10. Are least 90% of assets located in the U.S.? X (If "No", complete line 11.) 11. Is line 7 at least 6 times line 3? X 12. Current assets $ N/A 13. Current liabilities $ N/A 14. Net working capital (subtract line 13 from line 12). $ N/A 15. Is line 14 at least 6 times line 3? $ N/A 16. Current bond rating of most recent bond issue AA 17. Name of rating service Standard & Poors 18. Date of maturity of bond August 15. 2004 Page 3 of 4 Yes No 19. Have financial statements for the latest fiscal year been X flied with the SEC, the Energy Information Administration, or the Rural Electrification Administration? I hereby certify that the wording of this letter is idemical to the wording specified in 40 CFR part 280.95(d) as such regulations were constituted on the date shown immediately below, except that information concerning California and Louisiana were added to make disclosure more complete. M. R. Klitten Vice President, Finance April 28, 1997 Page 4 of 4 GUARANTEE Guarantee made this April 28, 1997, by CHEVRON CORPORATION,, a business entity organized under the laws of the State of Delaware, herein referred to as guarantor, to EPA Regional Administrators and/or state agencies implementing underground storage tank regulation for the states listed in Paragraph 2 (hereinafter collectively referred to as the "implementing agencies"), and to any and all third parties, and obligees, on behalf of CHEVI~ON U.S.A. INC. CCUSA"), of 575 Market Street, San Francisco, CA. RECITALS 1. Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d) and agrees to comply with the requirements for guarantors as specified in 40 CFR 280.96(b). 2. CUSA owns or operates the following underground storage tanks covered by this guarantee -- underground storage tanks at various facilities in the states of: Alaska Mississippi Arizona Nevada California 'New Mexico Florida Oregon Georgia Texas Hawaii Utah Idaho Virginia Louisiana Washingtgn This guarantee satisfies 40 CFR part 280, subpart H requirements for assuring funding for taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases arising from operating the above-identified underground storage tanks in the amount of $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate. 3. On behalf of our subsidiary, CUSA, guarantor guarantees to implementing agencies and to any and all third parties that: In the event that CUSA fails to provide alternative coverage within 60 days after receipt of a notice of cancellation of this guarantee and the Director of the implementing agency has determined or suspects that a release has occurred at an underground storage tank covered by this guarantee, the guarantor, upon instructions from the Director, shall fund a standby trust fund in accordance with the provisions of 40 CFR 280.108, in an amoum not to exceed the coverage limits specified above. In the event that the Director determines that CUSA has failed to perform corrective action for releases arising out of the operation of the above-identified tanks in accordance with 40 CFR 280, subpart F, the guarantor upon written instructions from the Director shall fund a standby trust in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. If CUSA fails to satisfy a judgement or award based on a determination of liability for bodily injury or property damage to third parties caused by sudden and/or nonsudden accidental releases arising from the operation of the above-identified tanks, or fails to pay an amount agreed to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor, upon written instructions from the Director, shall fund a standby trust in accordance with the provisions of 40 CFR 280.108 to satisfy such judgement(s), award(s), or settlement agreement(s) up to the limits of coverage specified above. 4. Guarantor agrees that if, at the end of any fiscal year before cancellation of this guarantee, the guarantor fails to meet the financial test criteria of 40 CFR 280.95(b) or (c) and (d), guarantor shall send within 120 days of such failure, by certified mail, notice to CUSA. The guarantee will terminate 120 days from the date of receipt of the notice by CUSA, as evidenced by the return receipt. 5. Guarantor agrees to notify CUSA by certified mail of a voluntary or involuntary proceeding under Title 11 (Bankruptcy), U.S. Code naming guarantor as debtor, within 10 days after commencement of the proceeding. 6. Guarantor agrees to remain bound under this guarantee notwithstanding any modification or alteration of any obligation of CUSA pursuant to 40 CFR part 280. 7. Guarantor agrees to remain bound under this guarantee for so long as CUSA must comply with the applicable financial responsibility requirements of 40 CFR part 280, subpart H for the above-identified tanks, except that guarantor may cancel this guarantee by sending notice by certified mail to CUSA, such cancellation to become effective no earlier than 120 days after receipt of such notice by CUSA, as evidenced by the return receipt. 8. The guarantor's obligation does not apply to any of the following: (a) Any obligation of CUSA under workers' compensation, disability benefits, or unemployment compensation law or other similar law; (b) Bodily injury to an employee of CUSA arising from, and in the course of, employment by CUSA; (c) Bodily injury or property damage arising from the ownership, maintenance, use, or entmstment to others of any aircraft, motor vehicle, or watercraft; Page 2 of 3 (d) Property damage to any property owned, rented, loaned to, in the care, custody, or control of, or occupied by CUSA that is not the direct result of a release from a petroleum underground storage tank; (e) Bodily damage or property damage for which CUSA is obligated to pay damages by reason of the assumption of liability in a contract or agreement other than a contract or agreement entered into to meet the requirements of 40 CFR 280.93. 9. Guarantor expressly waives notice of acceptance of this guarantee by ~he implementing agency, by any or all third parties, or by CUSA. I hereby certify that the wording of this guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. Effective date: April 28, 1997 CHEVRON CORPORATION M. R. Klitten Vice Presidem, Finance Assistant Secretary Page 3 of 3 CERTIFICATION OF FINANCIAL RESPONSIBILITY CHEVRON U.S.A. INC. hereby certifies that it is in compliance with the requirements of subpart H of 40 CFR part 280. The financial assurance mechanism used to demonstrate financial responsibility under subpart H of 40 CFR part 280 is as follows: Corporate guarantee of Chevron Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for-the period commencing April 22, 1997, and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 1998. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. April 28, 1997 CHEVRON U.S.A. INC. ,JUdith L. Martin Legal Analyst CUSA UST FINANCIAL ASSURANCE April 28, 1997 bcc: D.V. Barksdale L. T. Brown C. R. Canfield $. P. Casey E. V. Cottrell ' H. P. Davis Jr. W. H. Ford A. G. Fredeluces E. Gonzalez M. Leong P.T. Liang D. E. Ludlam R. W. McCranie S. E. Merritt R. B. Miller, Honolulu A. R. Mora D. A. Newell I. O. Ng K. L. Norris B. C. Randle D. T. Sherman R. J. Shewchuk S. C. Stoner S. W. Strader G. L. Sweinhart .. E. A. Thompson C. P. Woodland 72413 ~famon, San Rarnon California Mail P.D. Box 5004, San Ramon 'CA 04585-0804 ~ " .... " West Central Division '" , .. ...... ,..' . :, .'... ~'.-': . ... .. -. . '...,:~:,....,' .; "~., ..'~.,:.~.:.'".'.,,..'..:."?..:'".:. ~':/,:,.:' :':,.~.:~, ~:'.. ':-"-:. ,. ~ER OF T~S TO BE TESTED iS PIPING ~ING TO BE T .;,..~.'. ' ...DATE... & TI~.,~ST iS TO BE CONDUCTED -~) .~ , -~ SIGNATU~ OF APPLiC~ ~--" Chevron U.S.A. Products Company Marketing Department 1300 South Beach Boulevard June 1, 1994 Building4516 La Habra, California R0. Box 2833 La Habra, CA 90632-2833 Phone 310 694 7300 Underground Storage Tank Financial Responsibility Bakersfield Fire Department 2101 H Street Bakersfield, CA 93301 To Whom It May Concern: The attached letter is being provided in order to comply with the requirement to demonstrate financial responsibility for under- ground storage tanks owned by Chevron U.S.A. Products Company. Financial responsibility applies to the attached list of service stations located in the city of Bakersfield. If you have any questions, please contact Suzanne Sissung at (310) 694-7452. Very truly yours, K. F. Wiseman Environmental, Safety, Fire & Health Manager SMS Enclosure d PAGE 2 REPORT: DLRCITY SOUTHWEST DIVISION STATION LIST (DELIVERY CITY ORDER) 06/08/94 DELIVERY ADDRESS CROSS STREET CITY ACCT PRE ZONE (GULF - 1ST BEL, ADDRESS) (GULF - 2ND DEL. ADDRESS) DEALER NAME TELEPHONE ALTADENA 93267 C19 1002223 907 E ALTADENA DR LAKE AVE ANWAR E FAKHOURI 818-797-9221 ANAHEIM 92069 819 1002239 10972 KATELLA AVE KAHRAN NAEIM DBA 714-638-0664 93558 834 1002239 2175 W LA PALNA ST BROOKHURST ST EBWARB O'SON 714-956-3209 94927 C33 5183816 1221 AUTO CENTER DRIVE QUALITY LINCOLN MERCURY 95321 819 1002239 1801 S HARBOR BLVD KATELLA MICHAEL M. FLYNN DBA 714-533-8741 96477 C33 5183816 953 SOUTH ANAHEIM BLVD STEFFY BUICK CO INC 714-776-7360 97779 819 1002.239 2501 E LINCOLN JRANS PETROSIAN 714-533-7181 98449 C33 4241754 1200 S ANAHEIM BLVD MCPEEK CHRY-PLY, INC 99545 819 1002239 590 N MAGNOLIA PHONG CHIEU TANG 734-827-2220 99795 821 1002239 3490 W LINCOLN KNOTT AVE ZAFAR AHMED DBA 714-527-4391 99950 A94 5583556 1801 S HARBOR BLVD CHEVRON USA INC METHONAL 714-533-8741 201029 A35 1002239 8000 E. SANTA AMA CANYON A,P.S.I, # 1494 714-998-2637 202326 C15 1002239 1200 SOUTH HARBOR G & M OIL 714-999-9075 202586 C19 1002239 1198 S, STATE COLLEGE BALL VASKIN KOSHKERIAN 714-535-6500 202756 C17 1002239 9225 BROOKHURST AT BROADWAY G AND M OIL #31 714-535-9364 ANAHEIM HILLS 95264 C33 5183816 5395 E.~A PALMA CALIBER MOTORS 714-777-1900 APACHE JUNCTION 99943 842 1002216 140 OLD WEST HIGHWAY IDAHO HARBERT D JORDAN 602-982-8106 APPLE VALLEY 90575 819 1002251 17937 HWY 18 APPLE VALLEY RD LOYE W WILLHITE 619-242-4114 201467 A35 1002251 19180 BEAR VALLEY RD, REATA A,P,S.I. # 1488 619-247-2937 ARCADIA 91293 819 1002223 102 E HUNTINGTON DR 1 ST MOHAMMAD SATERI 818-446-7423 92407 819 1002223 500 N SANTA ANITA COLORADO BLVD FAISAL SALEH SHARI DBA 818-445-0261 93583 819 1002223 11 E LIVE OAK AVE SANTA ANITA FAWAZ ELMASRI DBA 818-446-5659 98913 814 1001483 1421 SO.2ND AVE RALPH W HAUPT ARROYO GRANDE 91156 819 1002219 251 GRAND AVE US 101 ROBERT BEWLEY DBA 805-489-5048 ARTESIA 90207 C16 1002235 17509 PIONEER BLVD, RONALD R, WORKMAN DBA 310-860-5616 95619 826 1002234 16725 PIONEER BLVD 168TH ROBERT W STINSON 310-860-5718 ATASCADERO 93181 826 1002219 6280 HORRO RD U S 101 MICHAEL W HEILMAN 805-466-1853 AZUSA 92190 C19 1002238 1195 WEST FOOTHILL YASSER KABAB 838-334-2477 92313 C19 1002238 901 E GLADSTONE CITRUS SHAMSADDIN KARIMI DBA 818-915-6485 98633 819 1002238 101 N AZUSA FIRST ST MILAD FARAH DBA 818-334-8515 BAKER 99879 B19 1002251 I 15 AT KELBAKER RD 1-15 CLARK A BRYNER 619-733-4334 BAKERSFIELD ~ 90705 834 1002188 9700 ROSEDALE HWY CALLOWAY RAY SUTTON INC 805-589-9011 91152 C16 1002188 920 34TH STREET 0 STREET CHARLES FENLEY 805-323-9071 91536 B3h 1002188 2700 OSWELL STREET AUBURN STEVE R THORNE, INC. 805-873-1200 ~z~91554 819 1002188 10 UNION AVENUE BRUNDAGE GLENN HOOVER 805-322-2445 92718 816 1002188 5101 STOCKDALE HWY VILLAGE LANE PHILIP A WELCH DBA 805-832-1818 &C,93978 819 1002188 3100 NILES ST OSWELL KENNETH MC COY 805-871-1865 94025 819 1002188 800 34TH ST Q ST MOHAMED MANSOUR 805-323-9694 REPORT: DLRCITY ~ SOUTHWEST DIVISION STATION LIST (DELIVERY CITY ORDER) 06/08/94 · DELIVERY ADDRESS CROSS STREET CITY ACCT PRE ZONE (GULF - 1ST DEL, ADDRESS) (GULF - 2ND DEL, ADDRESS) DEALER NAME TELEPHONE BAKERSFIELD 94416 B19 1002188 3699 WILSON ROAD REAL RD SONNY SWAFFAR 805-831-6075 95325 B34 1002188 2525 WHITE.LANE EL PORTERO BOB HALEY SERVICE, INC 805-832-9781 98109 B21 1002188 1131 OAK S~REET CALIF ST PHILIP A WELCH DBA 805-324-7621 99615 B19 1002188 3624 CALIFORNIA AVE REAL RD CHARLES SUTTON INC 805-325-1642 ~C'99702 B34 1002188 5201 OLIVE DR HWY 99 KEESTER INC 805-399-9056 .~.C201238 B34 1002188 8100 E, BRUNDAGE LANE WEEDPATCH HWY THOMAS W SCOTT 805-366-5542 201527 A34 1002188 6601 MING AVENUE A.P.S.I. #' 1830 805-831-1270 201921 BSO 1002224 660~MING AVENUE LUBE MANAGEMENT CORP BALDWIN PARK 91196 B35 1002236 14477 MERCED AVE PUENTE AVE DAVID KOHANTEB DBA 818-960-9927 91846 B21 1002236 13905 FRANCISQUITO AVE DALEWOOD NELSON W. QUAN #2 818-337-1255 BANNING 90255 B19 1002250 3251 WEST RAMSEY ST. SUNSET AVE TUAN KHONG 909-849-1456 94886 B34 1002250 290 S, HIGHLAND SPRINGS FIFTH JAMES J. PFEIL DBA 909-769-1866 BARSTOW 92325 B17 1002251 913 BARSTOW RD HWY 15 RONALD D. BARRETT DBA 619-256-9679 93933 A15 1002251 1451 EAST MAIN STREET A.P.S.I, # 1415 619-256-7415 99752 A17 1002251 2890 LENWOOD RB 1-15 A.P.S,I, # 1490 619-253-4076 BEATTY 95854 B19 1002253 HWY 95 AND MCDONALD U S 95 DONALD F DAWSON DBA 702-553-2736 BELL 91686 B34 1002234 5001 E FLORENCE AVE AZAR DOKHT RITA 213-773-8043 BELL GARDENS 202423 C1'5 1002234 5703 E, GAGE AVE GARY WEBB & SON, INC. 213-773-2673 BELLFLOWER 94031 B26 1002234 10340 E ROSECRANS MCNAB ZABIHULLAH ABDULLAH 310-920-1419 201934 C15 1002234 17106 BELLFLOWER BLVD. O AND M OIL CO, 714-373-0833 BERNALILLO. 75777 B19 1290512 HWY 44 AND US HWY 85 US HWY 85 ROBERT F ATLER DBA 505-867-6260 BEVERLY HILLS 93532 B19 1002225 9378 WILSHIRE BLVD CANON HAROLD W BUTLER DBA 310-275-1153 202286 C15 1002225 391 SOUTH ROBERTSON OLYMPIC BLVD WORLD OIL MARKETING COMP 310-855-9588 BIG BEAR CITY 95464 C15 1002250 101 W BIG BEAR BLVD HWY 18 MICHAEL GIESLER DBA 909-585-8848 BIG BEAR LAKE 93111 B19 1002250 41895 BIG BEAR BL SUMMIT BLVD JAMES RYAN GESSNER 909-866-3246 BISHOP 90130 B19 1002229 905 N MAIN ST MAINE RICK CASSEL, II DBA '619-873-4430 BLOOMINGTON 98646 B19 1002238 18745 VALLEY BLVD CHURCH CHARLES W. O'NEAL, JR DBA 909-877-3492 BLYTHE 91045 B34 1002250 321 S LOVEKIN LOVEKIN WAYNE C CUSICK DBA 619-922-7710 202361 C19 1002250 761 EAST HOBSONWAY W. C. CUSICK CORP DBA 619-922-2366 BORREGO SPRINGS 90153 C15 1236353 590 PALM CANYON DR BRITISH MOTOR CAR DIST. 619-767-5513 BOULDER CITY 94912 C17 1002253 1004 NEVADA HWY HWY 93/BUCHANAN JOHN SAMUEL SLEDGE 702-293-0819 BRAWLEY 97790 C33 2328876 811 BRAWLEY AVE P 0 BOX 79 DEL NORTE CHEVROLET CO .i ',l'),!x/ r'/l) Chevron Corporation 225 Bush Street San Francisco, CA 94104-4289 M. R. Klitten Apl'il 29, 1~:~4 Vice President. Finance UST FINANCIAL ASSURANCE To Whom It May Concern: I am the chief financial officer of Chevron Corporation, 225 Bush Street, San Francisco, CA. This letter is in support of the use of the financial test of self-insurance and guarantee tO demonstrate financial responsibility for taking corrective action and compensating third parties for bodily injury and property damage caused by sudden accidental releases and/or nonsudden accidental releases in the amount of at least $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate arising from operating underground storage tanks. Underground stOrage tanks at the following facilities are assured by this financial test or a financial test under an authorized State program by this guarantOr: all underground stOrage tanks owned by Chevron U.S.A. Inc. in the United States are assured by this financial test. A financial test and guarantee are also used by this guarantor tO demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: EPA RE(31,1LATION$ AMOUNT Closure (§§264.143 and 265.143) $ 155.744.232.00 Post-Closure Care (§§264.145 and 265.145) $ 58.800.406.00 Liability Coverage (§§264.147 and 265.147) $ 8.000.000.00 Corrective Action (§264.101Co)) $ -0- Plugging and Abandonment (§144.63) $ 3.097.310.00 California State Program Closure $ 819.000.0Q Post-Closure Care $ 1.196.915.00 Liability Coverage $ 56.000:000.00 Corrective Action $ -0- Plugging and Abandonment $ -0o Page 1 of 4 Louisiana State Program Closure $ 1.250.096.00 Post-Closure Care $ 604.521.00 Liability Coverage $ 1.000.000.00 Corrective Action $ -0- Plugging and Abandonment $ -0- Total $ 286.512.480.00 This guarantor has not received an adverse opinion, a disclaimer of opinion, or a "going concern" qualification from an independent auditor on his financial statements for the latest completed fiscal year. Page 2 of 4 ALTERNATIVE ri 1. Amount of annual UST aggregate coverage being assured $ 2.000.000,00 by a test, and/or guarantee 2. Amount of corrective action, closure and post-closure care $ 286.:512.480.00 costs, liability coverage, and plugging and abandonment costs covered by a financial test, and/or guarantee 3. Sum of lines 1 and 2 $ 288.:512.480.00 4. Total tangible assets $ 34.636.000.000.00 5. Total liabilities $ 20.739.000.000.00 6. Tangible net worth $13.897.000.000.00 7. Total assets in the U.S. in excess of $ 20.816.000.000.00 Yes N0 8. Is line 6 at least $10 million? X 9. Is line 6 at least 6 times' line 3? X 10. Are least 90% of assets located in the U.S.? If ~No~, X complete line 11. 11. Is line 7 at least 6 times line 3? X 12. Current assets $ N/A 13. Current liabilities $ N/A 14. Net working capital (subtract line 13 from line 12). $ N/A 15. Is line 14 at least 6 times line 3? $ N/A 16. Current bond rating of most recent bond issues. AA 17. Name of rating service Standard & Poors 18. Dates of maturity of bond April 1, 1998 Page 3 of 4 Yes N0 19. Have financial statements for the latest fiscal year been X filed with the SEC, the Energy Information Administration, or the Rural Electrification Administration? I hereby certify that the wording of this letter is identical to the wording specified in 40 CFR part 280.95(d) as such regulations were constituted on the date shown immediately below. April 29, 1994 M. R. Klitten Vice President, F~mance Page 4 of 4 Guarantee made this April 29, 1994, by CHEVRON CORPORATION, a business entity organized under the laws of the 'State of Delaware, herein referred to as guarantor, to EPA Regional Administrators and/or state agencies implementing underground storage tank regulation for the states listed in Paragraph 2 (hereinafter collectively referred to as the "implementing agencies"), and to any and all third parties, and obligees, on behalf of CHEVRON U.S.A. INC. ('CUSA"), of 575 Market Street, San Francisco, CA. 1. Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d) and agrees to comply with the requirements for guarantors as specified.in 40 CFR 280.96(b). 2. CUSA owns or operates the following underground storage tanks covered by this guarantee -- underground storage tanks at various facilities in the states of: Alabama Nevada Alaska New Jersey Arizona New Mexico California Ohio Florida Oregon Georgia Pennsylvania Hawaii South Carolina Idaho Tennessee Kentucky Texas Louisiana Utah Maryland Virginia Mississippi Washington This guarantee satisfies 40 CFR part 280, subpart H requirements for assuring funding for taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases arising from operating the above-identified underground storage tanks in the amount of $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate. 3. On behalf of our subsidiary, CUSA, guarantor guarantees to implementing agencies and to any and all third parties that: In the event that CUSA fails to provide alternative coverage within 60 days after receipt of a notice of cancellation of this guarantee and the Director of the implementing agency Page 1 of 3 has determined or suspects that a release has occurred at an underground storage tank covered by this guarantee, the guarantor, upon instructions from the Director, shall fund a standby trust fund in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. In the event that the Director determines that CUSA has failed to perform corrective action for releases arising out of the operation of the above-identified tanks in accordance with 40 CFR 280, subpart F, the guarantor upon written instructions from the Director shall fund a standby trust in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. If CUSA fails to satisfy a judgement or award based on a determination of liability for bodily injury or property damage to third parties caused by sudden and/or nonsudden accidental releases arising from the operation of the above-identified tanks, or fails to pay an amount agreed to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor, upon written instructions from the Director,- shall fund a standby trust in accordance with the provisions of 40 CFR 280.108 to satisfy such judgement(s), award(s), or settlement agreement(s) up to the limits of coverage specified above. 4. Guarantor agrees that if, at the end of any fiscal year before cancellation of this guarantee, the guarantor fails to meet the financial test criteria of 40 CFR 280.95(b) or (c) and (d), guarantor shall send within 120 days of such failure, by certified mail, notice to CUSA. The guarantee will terminate 120 days from the date of rex. eipt of the notice by CUSA, as evidenced by the return receipt. 5. Guarantor agrees to notify CUSA by certified mail of a voluntary or involuntary proceeding under Title 11 (Bankruptcy), U.S. Code naming guarantor as debtor, within 10 days after commencement of the proceeding. 6. Guarantor agrees to remain bound under this guarantee notwithstanding any modification or alteration of any obligation of CUSA pursuant to 40 CFR part 280. 7. Guarantor agrees to remain bound under this guarantee for so long as CUSA must comply with the applicable financial responsibility requirements of 40 CFR part 280, subpart H for the above-identified tanks, except that guarantor may cancel this guarantee by sending notice by certified mail to CUSA, such cancellation to become effective no earlier than 120 days after receipt of such notice by CUSA, as evidenced by the retum receipt. 8. The guarantor's obligation does not apply to any of the following: (a) Any obligation of CUSA under workers' compensation, disability benefits, or unemployment compensation law or other similar law; (b) Bodily injury to an employee of CUSA arising from, and in the course of, employment by CUSA; Page 2 of 3 (c) Bodily injury or property damage arising from the ownership, maintenance, use, or entrustment to others of any aircraft, motor vehicle, or watercraft; (d) Property damage to any property owned, rented, loaned to, in the care, custody, or control of, or occupied by CUSA that is not the direct result of a release from a petroleum underground storage tank; (e) Bodily damage or property damage for which CUSA is obligated to pay damages by reason of the assumption of liability in a contract or agreement other than a contract or agreement entered into to meet the requirements of 40 CFR 280.93. 9. Guarantor expressly waives notice of acceptance of this guarantee by the implementing agency, by any or all third parties, or by CUSA. I hereby certify that the wording of this guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. Effective date: April 29, 1994 CHEVRON CORPORATION M. R. Klitten Vice President, Finance Assistant Secretary Page 3 of 3 'CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of ~_c~ ! ,'-1~o v. ,~,',~ County of .5",~ ~ F~-,,,,~-.0'~ On ,q?,~';! ~'7.~ tqg,.~ before me, /v',~,,~,~,, :7. /~1.,~,~ ~o~,~/~,',, /vo.~,..y DATE NAME, TTI'LE OF OFFICER - E.G., 'JANE DOE, NOTARY PUBLIC' personally appeared 3-¢-F~,~. ~". /~f o~ NAME(S) OF SIGNER(S) [~ personally known to me - OR - [] proved to me on the basis of satisfactory evidence to be the person(~ whose name(~ is/a-re subscribed to the within instrument and ac- knowledged to me that he/she/they-executed the same in his./,h~*'~ authorized capacity(ie~--~, and that by his~r signature(s) on the instrument the person(j~), or the entity upon behalf of which the person(s) acted, executed the instrument. ~ WITNESS my hand and official seal. ~'SIGNATURE OF NOTARY OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT [] INDIVIDUAL [] CORPORATE OFFICER Tm.E(S) TITLE OR TYPE OF DOCUMENT [] PARTNER(S) [] LIMITED [] GENERAL [] A'FrORNEY-IN-FACT NUMBER OF PAGES [] TRUSTEE(S) [] GUARDIAN/CONSERVATOR [] OTHER: DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(lES) SIGNER(S) OTHER THAN NAMED ABOVE ©1993 NATIONAL NOTARY ASSOCIATION · 8236 Remmet Ave., P.O. Box 7184 · Canoga Park, CA 91309-7184 CERTIFICATION OF FINANCIAL R1;~$PONSIBILITY CHEVRON U.S.A. INC. hereby certifies that it is in compliance with the r~uirements of subpart H of 40 CFR part 280. The financial assurance mechanism used to demonstrate financial responsibility under subpart H of 40 CFR part 280 is as follows: Corporate guarantee of Chevron Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 29, 1994, and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 1995. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases and nonsudden accidental releases or accidental releases. _ CHEVRON U.S.A. INC. Date: Semor C nsel ~NV~ 17 9 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM A COMPLETE THIS FORM FOR EACH FACILITY/SITE I MARK ONLY ~ 1 NEW PERMIT ~ 3 RENEWAL PERMIT ~ 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED SITE ONE ITEM ~ 2 INTERIM PERMIT E~ 4 AMENDED PERMIT [] 6 TEMPORARY SiTE CLOSURE ~. r~v,LITY/SITE INFORMATION & ADDRESS' (MUST BE COMPLETED) NAME OF OPERATOR . DBA OR FACILITY NAME m-ADDRESS NEAREST CROSS STREET PARCEL # (OPTIONAL) C AME --- I STATE [ ZiP CODE SiTE PHONE # WITH AREA CODE ,/ BOX ~ CORPORATION ~ INDIVIDUAL E~ PARTNERSHIP [---] LOCAL-AGENCY [~ COUNTY-AGENCY ~ STATE-AGENCY E~ FEDERAL-AGENCY TO INDICATE DISTRICTS EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY)- optional OAYS: NAME (LAST, FtRS~ PHONE ~ WITH AREA CODE DAYS: NAME (LAST, FIRS~ NIGHTS: NAME (LAST, FtRS~ PHONE ~ WITH AREA CODE NIGHTS: NAME (LAST, FIRS~ II. PROPERTY OWNER INFORMATION - (MUST BE COMPLETED) NAME ~ CARE OF ADDRESS INFOR~ION MAILING OR STREET ADDRESS [ ~ ~x ~i~ate ~ iNDIVIDUAL ~ L~AL-AGENCY ~ STA~-AG~CY [ STATE [ ZiP CODE I PHONE ~ WIT" AREA COe6 [ CI~ NAME Iff. TANK OWNER INFORMATION-(MUST BE COMPLETED) NAME OF OWNER CARE OF ADDRESS INFORMATION MAILING OR STREET ADDRESS ¢ ~x uindic~le ~ INDIVIDUAL ~ L~AL-AG~OY ~ STATE-AGE~OY %& ~, ,¢,~ ~CO,~RATION ~ PARTNERSHIP ~ COU~Y-AGE~Y ~ FEDERAL-AGENCY E STATE ZIP CODE PHONE I WITH AREA CODE IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER - Call (916) 323-9555 if questions arise. r . . . V. PETROLEUM UST FINANCIAL RESPONSIBILITY - (MUST BE COMPLETED) - IDENTIFY THE METHOD(S) USED ~ t SELF-INSURED ~ 2 GUARA~EE ~ 3 INSURANCE [ ~ 5 LE~ER OF CREDIT ~ 6 ~EUPTION ~x OTHER vm. LEGAL NOTIFICATION A~D BILLING ADDRESS Legal notifi~tion and billing will be sent to the tank owner unless box I or II is check~. I ' CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD ~E USED FOR LEGAL NOTIFICATIONS AND BILLING: I. ~ II, ~ ill. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY. AND TO THE BEST OF MY KNOWLEDGE. IS TRUE AND CORRECT , APPLICANT'S NAME (PRINTED & S,GNATUR~~. _ . ~.~ ~ APPUCAN~S TITLE~.. ~ ']'~ ~ DATE MONTH/DAY~EAR/¢ ~/~ LOCAL AGENCY USE ONLY ~ COUNTY ~ ' JURISDICTION ~ FACILITY ~ LO~'A~¢~N CODE ."OPTIONAL ~CENSUS TRACT = - OPTIONAL ~ SUPVISOR - DISTRIC~ CODE - OPTIONAL ! THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION - FORM B, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. FORM A (12-91) FILE THIS FORM WEH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FOR0~3A-R6 '" STAT£ OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UND£RGROUND STORAGE TANK PERMIT APPLICATION- FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM, ONE ITEM [] 2 iNTERIM PERMIT [~ 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE 8 TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: ~/-Y&~:df',~/~ ~'7"~,-,~A/ 9- ~"~0~"' . I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I.D., / B. MANUFACTURED BY: c. DATE INSTALLED(MO,DAY"EAR) 0. TANK CAPAC,', IN GALLONS: lq II. TANK CONTENTS IF A-1 IS MARKED. COMPLETE ITEM C. A. ~', MOTOR VEH,CLE FUEL [] ~ O~L B. C. [] ~.REGULAR ~ 3 D,ESEL [] 6 AV,AT,ONGAS UNLADED~ ~ ~SAHOL UNLEADED [] 5 JET FUEL [] 3 CHEMICAL PRODUCT [] 95 UNKNOWN [] 2 WASTE [] 2 LEADED [~ 99 OTHER (DESCRIBE IN ITEM D. BELOW) III. TANK CONSTRUCTION MARKONE{TEMONLYINBOXESA,~,ANDC, ANDALLTHATAPPLIESINBOXDANDE A. TYPEOF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] g5 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULYEDTANK) [] 99 OTHER B. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLEW/FRP (PrimaryTartk) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER [] 1 RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY LINING [] 4 PHENOLIC LINING C. INTERIOR LINING [] 5 GLASS LINING [] 6 UNLINED [] 95 UNKNOWN [] 99 OTHER iS UNING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES__ NO__ D. CORROSION [] 1 POLYETHYLENE wRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER E, SPILL AND OVERFILL SPtLL CONTAINMENT INSTALLED (YEAR) ~ ~.¢~,z OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) IV. PIPING INFORMATION C~RCLE A IFABOVEGROUNDOR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTEMTYPE A U 1 SUCTION A~ PRESSURE A U 3 GRAVITY A U ~ OTHER B. CONSTRUCTION A U I SINGLE WALL A~..~ DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 RARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC) U~_~ FIBERGLASS PfPE CORROSION A U '5 ALUMINUM A U 6 CONCRETE ,~ U ~ STEEL W/ COATiNG A U 8 100% METHANOL COMPATISLEW/FRP PROTECTION A U g GALVANIZED STEEL A U 10 .CATHODIC PROTECTION A U 95 UNKNOWN A U. 99 OTHER D. LEAK DETECTION F~ 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTITIAL MONITORING [] 99 OTHER V. TANK LEAK DETECTION F-~ 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VADOZE MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUND WATER MONITORING' ~"'6 TANK TESTING [~ 7 INTERSTIT)ALMONITORING [~ 9! NONE [] 95 UNKNOWN [] 99 OTHER VI. TANK cLoSuRE INFORMATION 1. ESTIMATED DATE LAST USED (MO/DAWYR) 2. ESTIMATED QUANTITY OFsuBSTANCE REMAINING GALLONS 3. WAS TANK FILLED WITHiNERT MATERIAL ? YES [] NO [] THIS FORM/'/AS BEEN COMPLETED UNDER PENAL.TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT IAPPLICANI~S NAME ~_~ IDATE LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSE NUMBERS BELOW COUNTY # JURIS__DI_CTIO. N # _FACILITY_ # _ TANK # PERMIT NUMBER PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION · FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATION5 FORM B (12-91) FOBO~,4B-R$ STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY. [~j 1 NEW PERMIT [] 3 RENEWAL PERMIT ~ 5 CHANGE OF iNFORMATION [] 7 PERMANENTLY CLOSED ON SITE ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: (~/~'~___i~/,~N/ ~'7~,.4.7~ o,'J '~- I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF ~NKNO~ A, OWNER'S TANK I. D. ~ ~ a, MANUFAC~REO aY: ~ I II.TANK CONTRAS IF A-1 IS MARKED. COMPLETE ITEM C. UNLADED ~ 5 JET FUEL ~ 3 CHEMICAL PROOUCT ~ 95 UNKNOWN ~ 2 WASTE ~ 2 LEADED ~ 99 O~ER (DESCRIBE IN I~M O. BELO~ III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B. ANDC,~DALLTHATAPPLIESlNBOXDANOE A. ~PEOF ~ 1 ~UBLE WALL ~ 3 S~NGLE WA~ Wm~ E~ER~OR LINER ~ 95 UNKNOWN SYSTEM ~ 2 SINGLE WALL ~ 4 SECONDARY CONTAINMENT (VAULTED TAN~ ~ ~ O~ER B. TANK ~ 1 BARE STEEL ~ 2 STAINLESS STEEL ~ 3 FIBERG~S ~ 4 STEELCLAD W/FIBERGLA~.EtNFO.CEOPLASTmC MATERIAL ~ 5 CONCRETE ~ S mLWINYL CHLORIDE ~ 7'~UMINUM ~ a 1~, UE~ANOL ~aPAT)BLEW/FRp (Prima~Tank) ~ 9 BRONZE ~ 10 ~LVAN,~O S~EL ~ 95 UNKNOWN ~ ~ O~ER ' ~ 1 RUBBER LINED ~ 2 AL~D LINING ~ 3 EPO~ LINING ~ 4 PHENOL~ LINING C. INTERIOR LINING ~ 5 GLASS UNmNG ~ 6 UNLINED ~ g5 UNKNOWN ~ gg O~ER IS LiNiNG UATERIAL COUPATIBLE WITH 1~% UE~ANOL ? YES__ NO__ D. CORROSION ~ 1 POLYETHYLENE WnAP ~ 2 COATING ~ 3 VINYL WR~ ~ 4 FIBERGLASS REINFORCED P~STIC PROTECTION ~ 5 OATHODiC PROTEOT~ON ~ 91 NONE ~ g5 UNKNOWN ~ gg O~ER E. SPILL AND OVERFILL SPILL CONTA)NUENT iNSTALLED (YEAR) /~ OVERFILL PR~ENTION EOUIPUENT INSTALLED ~EAR) IV. PIPING INFORMATION CIRCLE A IFABOVEGROUNDOR U mFUNOERGROUND, BO~ IF APPLICABLE A. SYSTEMTYPE A U 1 SUCTION ~2 PRESSURE A U 3 GRAVI~ A U 99 B. CONSTRUCTION A U 1 SINGLE WALL A~2 ~UBLE WALL A U 9 LINED TRENCH A U g5 UNKNOWN A U ~ OTHER C. ~ATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 9 ~L~INYL CHLORIDE (PVC)~4 FISERG~SS PIPE CORROSION A U 5 ALUUiNUU A U 6 CONCRE~ A U 7 STEEL Wl COATING A U 8 I~ UE~ANOL COUPATIBLEW/FRP PROTE~ION A u g GALVANIZED STEEL A U lO CATHODIC PROTECTION A U g5 UNKNOWN A U ~ O~ER D. LEAK DETECTION ~ 1 AUTOMATIC LINE LEAK DETECTOR ~ 2 LINE T~HTNESS TESTING ~ 3 INTERSTITIAL ~NffORING ~ ~ O~ER V. TANK LEAK DETECTION ~ ~ VISUAL CHECK ~ 2 INVENTORY RECONCILIATION ~ 3 VA~ZE ~ONmTORmNG ~ 4 AUTOMATIC TANK ~UGmNG ~ 5 GROUND WATER UONITORiNGm ~ 6 TANK TESTING ~ 7 'NTERSTITIALMONITORING ~ 91 NONE ~ ~5 UNKNOWN ~ ~ OmER m VI. TANK CLOSURE INFORMATION 1. ESTIMATED DATE LAST USED (MO/DAY. R) 2. ESTIUATED OUANTI~ OF 3. WAS TANK FILLED WITH SUBSTANCE REUAINING GALLONS INERT MATERIAL ? YES THIS FORM HAS BEEN COMPLETED UNSER PENAL~ OF PERJURY, AND TO THE 8EST OF UY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPO NUMBERS BELOW COUN~ ~ JURISDICTION ~ FAClL~ ~ ~ TANK ~ PER~IT NUMBER ~ER~IT APPROVED BY.ATE PER~IT EXPIRATION DATE THIS FORM MU~T 8E ACCOMPANIED BY A PER~IT APPLICATIO~ - FOR~ ~, UNLESS A CURRENT FORM ~ HAS aEE~ FILED. FILE THIS FORM WffH TNE LOCAL ~ENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGU~T~ ~ORM ~ ~RO~R6 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM, MARK ONLY [] I NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED ON SITE ONEITEM [] 2 INTERIM PERMIT [] 4 AMENOED PERMIT [] 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED DBAOR FACILITY NAME WHERE TANK IS INSTALLED: ~,~/..~,~_~_~/~ ~/,.~.~ -T',x+ 7; ~, ~ 1. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNO~ A. OWNER'S TANK I.D., ~ B. MANUFAC~RED BY: ~~ II. TANK CONTRAS ~ A-1 is MARKED, COMPLETE ITEM C. ~ 3 CHEMtCAL PRODUCT ~ 95 UNKNOWN ~ 2 WASTE ~ 2 LEADED ~ 99 OmER (DESCRIBE IN ITEM D. BELOW) III. TANK CONSTRUCTION MARKONEITEMONLYINBOXESA, B, ANDC,~DALLTHATAPPLIESlNBOXDANDE A. ~PEOF ~ ~ ~UaLE WALL ~ 3 SINGLE WALL WI~ E~ERIOR LINER ~ 95 UNKNOWN SYSTEM ~ 2 SINGLE WALL ~ 4 SECONDARY CONTAINMENT (VAULTED TAN~ ~ ~ OTHER B. TANK ~ 1 BARE STEEL ~ 2 STAINLESS STEEL ~ 3 FIBERGLAS ~ 4 STEEL CLAD W/FlaERG~ REINFORCED PLASTIC MATERIAL ~ 5 CONCRETE ~ 6 POLWlNYL CHLORIDE ~ 7 ~UMINUM ~ 8 1~ METHANOL COMPATIBLEW/FRP (Prima~Tank) ~ 9 BRONZE ~ 10 ~LVANIZED S~EL ~ 95 UNKNOWN ~ ~ OTHER c. mNTERIOR ~ 5 GLASS LINING ~ 6 UNLINED ~ 95 UNKNOWN ~ gg O~ER LINING IS LINING MATERIAL COMPATIBLE WiTH 1~% UE~ANOL ? YES__ NO__ D. OORROSION ~ 1 POLYE~YLENE WRAP ~ 2 COATING ~ 3 VINYL WRAP ~ 4 FIBERGLAS ~EiNFO~CED P~STmC PROTE~ION ~ 5 CATHODIC PROTECT)ON ~ gl NONE ~ g5 UNKNOWN ~ gg O~ER E. SPILL AND OVERFILL SPILL CONTAINMENT iNSTALLED (YEAR) /~[ OVERFILL PR~ENTION EOUIPUENT INSTALLED ~EAR) ~'~ IV. PIPING iNFOR~ATION C~.CLE A IFABOVEG~OUNDOR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTE~TYPE A U 1 SUCTION A~2 PRESSURE A U 3 GRAVI~ A U 9g O~ER B. CONSTRUCTION A U 1 SINGLE WALL A~2 ~UBLE WALL A U 3 LINED TRENCH A U g5 UNKNOWN A U gg O~ER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL' A 'U 3 POLW)NYL CHLORmDE(PVC)A~4 FIBERO~S PIPE CORROSION A U 5 ~UUmNU~ A U 6 CONCRE~ A U 7 STEEL W/ COATING ~ U 8 1~. UE~ANOL ~UPATIBLEW/FRP PROTE~mON A u g GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U g5 UNKNOWN A U ~ O~ER D..LEAK DETECTION ~ 1 AUTOUATiCLINELEAKDETECTO~ ~ 2 LINE T~HTNESS TESTING ~ 3 INTERSTmAL ~N~ORING ~ ~ O~ER V. TANK LEAK DETECTION ~ 1 VISUAL ~.ECK ~ 2 ~NVENTORY RECONCmLmATION ~ 3 VA~ZEVONITORING ~ 4 AUTOVATiCTAN[~UGiNG ~ 5 GnOUNOWATEnUONmTOR)NO ) ~ 6 TANK TESTING ~ 7 INTERSTITIAL MONITORING ~ 91 NONE ~ 95 UNKNOWN ~ ~ OTHER / VI. TANK CLOSURE INFORMATION ~ 1. ESTIMATED DATE LAST USED (MO/DAY. R) . 2. ESTIMATED QUANTI~ OFsuBSTANCE REMAINING GALLONS I3' WAS TANK FtLLED WITHINERT MATERIAL ? YES ~ NO~ TH/S FORM HAS BEEN COMPLETED UNDER PENAL ~ OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OFTHE FOUR ~RS BELOW STATE I.D.~ _ I I I I PERBIT NUMBE~ PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FI~D ........ FILE THIS FORM W~H THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND ~TORAGE TANK REGU~TIO~ FORM B (12-91) ~RO~R6 ~TATE OI= CAUFORNIA STATE WATER REBOURCE5 CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORM COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] S CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED ON SITE ONEITEM [] 2 ~NTERIM PERMIT [] 4 AMENDED PERMIT[] 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: ~----~,/~,~:::f~__~ I. TANK DESCRIPTION COMPLETE ALL ITEMS -- SPECIFY IF UNKNOWN A. OWNER'S TANK L D. # ~ B. MANUFACTURED BY: C. DATE,NSTALLED<MO,DAY EAR, D. TANKCAPAC,TY,NG LONS:- ' II. TANK CONTRAS ~ A-1 is MARKED, COMPLETE ITEM A. ~ 1 ~OlO, VEHICLE FUE~ ~ ~ cml ~. O. ~ 1.,E~U~*R ~ ~ DmESE~ ~ ~*V,ATmONGAS ~ 2 PETROLEUM ~ ~ E~P~ ~ 1 PRODUCT ~ lb PRE,iUM '~ 7 METHANOL UNLEADED ~ 5 JET FUEL ~ 3 CHEUiCAL PRODUCT ~ 95 UNKNOWN ~ 2 WAST~ ~ 2 LEADED ~ 9g O~ER (DESCRIBE mN mTEU D. BELOW) O. IF (A.1) iS NOT MARKED, ENTER NAME OF SUBSTANCE' STORED ~~ O/ ~ C.A.S. ~: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, 8, ANDC,~DALLTHATAPPLIESINBOXDANDE A. ~PEOF ~ 1 ~UBLE WALL ~ 3 SINGLE WA~ WI~ E~ERIOR LINER ~ 95 UNKNOWN SYSTEM ~ 2 SINGLE WALL ~ 4 SECONDARY CONTAINMENT (VAULTED TAN~ ~ ~ OTHER B. TANK ~ 1 BARE STEEL ~ 2 STAINLESS S~EL ~ 3 FIBERGLAS ~ 4 STEELC~O W/FIBERG~SS REINFORCED PL~TIC MATERI~ ~ 5 CONCRETE ~ 6 POLWlNYL CHLORIDE ~ 7 ~UMINUM ~ 8 1~ ME~ANOL ~MPATIBLEW/FRP (Prima~Tank) ~ 9 BRONZE ~ 10 ~LVANIZED STEEL ~ 95 UNKNOWN ~ ~ OTHER C. INTERIOR ~ 5 CLASS L)N)N~ ~ ~ UN~mNED ~ 95 UNKNOWN ~ gg OTHER LiNiNG )S LmNING UATERIAL COUPAT)BLE WITH 1~/. UE~ANOL ? YES__ NO__ D. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REmNFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER E. SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) ,/~---~ ,1(~L~' OVERFILL PREVENTION EOUIPMENT INSTALLED {YEAR) IV. PIPING INFORMATION CIRCLE A IFABOVEGROUNDOR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTEMTYPE A U 1 SUCTION A U 2 PRESSURE A~ GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A02 DOUBLE WALL A ti 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL'AND A U 1 BARESTEEL A ti 2 STAINLESS STEEL A ti 3 POLYVINYL CHLORIDE(PVC)A(~4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC'PROTECTION A U 95 UNKNOWN A U 99 OTHER D, LEAK DETECTION [] 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTITIAL MONr'rORING [~ 99 OTHER V, TANK LEAK DETECTION [] I VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VADOZEMONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUNO WATER MONITORING [] 6 TANK TESTING [] 7 INTERSTiTIAL MONITORING [] gl NONE [] 05 UNKNOWN [] 9g OTHER VI. TANK CLOSURE INFORMATION I 1. ESTIMATED DATE LAST USED (MO/DAYYY'R) 2. ESTIMATED QUANTITY OFsuBSTANCE REMAINING GALLONS 3. WAS TANK FILLED WlTHiNERT MATERIAL ? YES[] NO[] THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE.STATEI.D. NUMBER iSCOMPOSEDOFTHEFO~,,i~JFBERS BELOw` it [I S/¢)5 STATE I.D.~ ~ '~ IOID I¢ t-- PERMIT NUMBER PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FI~D. FILE THIS FORM WEH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGU~TIO~ FORM B (12-91) ~RO~R6 BAKERSFIELD FIRE DEPT HAZARDOUS MATERIALS DIVISION Operating Permit: ~(~ ~o(g,F~ Date ComPleted Business Name: /YT/~^~,~u~ Location: ~ ~~ Business Identification No. 215-000 ~Y~ ~op of Business Plan) Number of Tanks: ~ Type: Containment: ~1~ ~_~/~ (~~ Lines: ~ Contact Information Owner: ~'~~ Emergency Contacts: ~~ ~5~ Adequate Inadequate Monitoring Program ' Records Maintenance . .~ ~ Testing ~/~// _ Inventory Reconciliation m Response Plan Emergency Plan BL,, All Items OK J Correction Needed uslness uwner ...... ? .... ;~ ~ HAZARDOUS MATERIALS DIVISION. 2130 G Street, Bakersfield, CA 93301 "~ (805) 326-3970 " ~W~Z[.~z UNDERGROUND TANK QUESTIONNAIRI~ RECEIVED JAN ;5 0 !992 I, FACILITY/SITE No, OF TANKS ~ H~: ~AT- BIV. D~ OR FAClLIW NAME ~ JNAME ~ OPE~TOR C.I~ NAME~ / ..... STATE =PCODE . ~ BOX TO INDICATE ~COEPO~ON ~ INDIVIDUAL ~ PA~ERSHIP ~ L~AL AGENCY D~IC~ ~ COUN~ AGENCY ~ STATE AGENCY ~ FEDE~L AGENCY ~PE OF ~USlNE~ ~GAS $TA~ON ~ 2 DISTRIBUTOR ~ KERN COU~ PERMff EMERGENCY CONTACT PERSON (PRIMAR~ EMERGENCY CONTACT PERSON (SECONDAR~ optlonol DAYS: NAME (~ST, ~,~, PHONE ~. wm. AR~ CODE ~AYS: NAME (~ST. FI~ PHONE NIGHTS: NAME (~ST. FIRS~ PHONE ~. W~ AR~ CODE ~ N~H~: NAME (~ST. FI~ PHONE II. PROPE~ OWNER INFOEMATION (MUST BE COMPLETED) NAME CA~E OF ADORE~ IN~EMA~ON ~O. ~ ~ TO INDICATE Q PA~ERSHIP Q COUNW AGENCY Q FEOE~L AGENCY CIW NAME ~E ZIP CODE PHONE ~. WITH AR~ CODE III.TANKOWNER INFORMATION (MUST BE COMPLETED) NAME CARE OF AODRE~ IN~RMATION MAILING OR STREET ADDRESS ~ BOX ~ INDIVIDUAL ~ LOCAL AGENCY ~ STATE AGENCY ~.~, ~O ~ TOINDICATE ~PARTNERSH,P ~COUNWAGENCY ~FEDE~LAGENCY CIW NAME PHONE No. WITH AREA CODE OWNER'S DATE VOLUME PRODUCT IN TANK No. INSTALLED STORED SERVICE I G ( / o Y/N Y/N DOYOU HAVE FINANClALEESPONSIBILI~? Y/N ~PE t, TANK DESCRIPTION sPEcIFY IF UNKNOWN t B. MANUFACTURED BY: C. DA~ INSTALLED {M~DAY~EAR) ~ -- ~ ~ r D. TANK C~ACIW tN G~LONS: IlL TANK CONSTRUCTION MARK ONE i~M ONLY iN GOXES ~ B, ANDC,~DALLTHATAP~IESINGOXD A. ~PE OF ~ ~ ~UBLE WALL ~ 3 SINGLE W~ WI~ E~ERIOR LINER ~ 95 UN~OWN SYSTEM 2 SINGLE WALL ~ 4 SECONDARY ~NTAINMENT (VAUL~DTAN~ ~ ~ O~ER .B, TANK 7 ~UMINUM ~ 8 1~= MEdrOL ~MPATIBLEW/FRP MATERIAL ~ 5 CONCRE~ ~ 6 ~L~INYL CHLORIDE (PrimaryTank) ~ 9 BRON~ ~ 10 ~LVANI~D S~ ~ ~ UN~OWN ~ ~ o~ER b, INTERIOR ~ 5 ~ L~N~NG ~ e UNUN~ ~ ~ UN~WN ~ ~ O~ER UNING "YES__ D. CORROSION ~ I ~LY~LENE W~ ~ 2 ~A~NG ~ 3 VI~L ~ ~ 4 FIBERG~S REINFORCED ~S~C PROTEC~ON, ~ 5 CA~OO~C PROTECTION ~ a~ ~NE ~ ~ UN~WN ~ ~ O~ER IV, PIPING INFORMATION c~Rc~ A IFABOVEGROUNOOR U IFUNOERGROUND, BO~IF~UCA~ A, SYSTEM ~PE A~ I SUC~ON A ~ 2 PRESSURE A ~ 3 G~VI~ A U ~ O~ER B. CONSTRU~ION A ~ 1 SINGLE WALL A ~2 ~UBLE WA~ A ~ 3 LINED TR~CH A ~ g5 UN~OWN A ~ ~ O~ER C. MA~RIAL AND A U 1 ~RE STOL A ~ 2 STNNLESS S~EL A U 3 ~LWI~L CHLORIDE(PVC)A~4 FIBERG~S PIPE CORROSION A ~ 5 ~UMINUM A U 6 ~NCRE~ A ~ 7 ST~LWI~A~ A ~ 8 1~ MEdrOL ~MPA~B~W/FRP PROTE~ION ' A ~ 9 ~LVANI~D S~ A ~ 10 CA~OOIC P~TECTION A ~ g5 UN~O~ A ~ ~ O~ER D, LEAK D~ECTION ~ ~TOMA~CLINELEAKDE~CTOR ~ 2 LINE T~H~ESS TESTING V, TANK LEAK DETECTION I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN · O. TANK CAPACITY IN GALL(~NS: C. DATE INSTALLED (MO/DAY~ III. TANK CONSTRUCTION MARK ONE iTEM ONLY IN BOXES A, B. ANDC, ANDALLTHATAPPLIESINBOXD A. TYPE OF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT {VAULTED'TANK) [] 99 OTHER [] 1 BARE STEEL [] 2 STAINLESS STEEL ~ 3 FIBERGLASS [] 4 STEEL CLAD W/FISERGLASS REINFORCED PLASTIC B, TANK MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE F'~ 7 ALUMINUM [] 8 l(D~'/o METHANOL COMPATiBLEW/FRP Ipri~.ar~Ta.kl [] 9 BRONZE [] lo GALVA.,ZEO STEEL [] 95 UNKNOWN [] 99 OTHER [] ~ RUBBER LINED [] 2 MO LIN,NG [] 3 EPOX~ L,N,NG[] ~ PHENOL~ L~N,NG C. INTERIOR [~ 5 GLASS LINING [] S UNUNEO [] 95 UNKNOWN [] 9~ OTHER lINING YES ~ NO~ IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? O, CORROSION [] ~ POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [~4 F~BERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 9~ NONE [] 95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION C~RCLS A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH tF APPUCABLE A. SYSTEM TYPE A...~ 1 SUCTION A ti 2 PRESSURE A U 3 GRAVITY A tJ 99 OTHER B. CONSTRUCTION A t.J 1 SINGLE WALL A~" 2 DOUBLE WALL A IJ 3 LINED TRENCH C. MATERIAL AND ' A U 1 BARE STEEL A ~ 2 STAINLESS sTEEL A U 3 POLY~/INYL CHLORIOE(PVC)A ~' 4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A tJ 6 CONCRETE A tJ 7 STEELWlCOATING A [.I 8 100% METHANOL CO/,APATIBLEWlFRP PROTECTION A [J 9 GALVANIZED STEEL A ~ 10 CATHOOIC PROTECTION A [J 95 UNKNOWN A I~ 99 OTHER 99 OTHER ..~ MONITORING ~ LEAK DETECTION AUTOMATIC LiNE LEAK DETECTOR [] 2 LINETIGHTNESS TESTING [] V, TANK LEAK DETECTION I ~-~. 1 VISUAL CHECK ~ 2 INVENTORY RECONCILIATION [~3 VAPOR MONITORING F---~4 AUTOMATIC TANK GAUGING [~ 5 GRouNDWATER MONITORING ~ ~AN~ ~ INTERSTITIAL MO.,TORING [] 9' NONE [] 95 U.KNOW" [] ~ OTHER ~. I. TANK DESCRIPTION COMPLETE I SPECIFY IF UNK,O~I B. MANUFACTURED A. OWNER'S TANK,.O.# 3 , % C. DATE INSTALLED (M~AY~EAR) III, TANK CONSTRUCTION MARK ONE I~M ONLY IN BOXES ~ B. ANOC.~DALL~ATAP~IESlNBOXD A. ~PE OF ~ ~ ~UaLE WALL ~ 3 SINGLE W~ WI~ E~ERIOR LINER ~ 95 UN~OWN SYSTEM ~'2 SINGLE WALL ~ 4 SECONDARY ~NTAINME~ ~AUL~DTAN~ ~ ~ O~ER .B.. TANK ~ 1 ~RE STEEL ~ 2 STAINLESS S~EL - ~ 3 FIBERG~S ~ 4 STEEL C~D W/FIBER~ REINFORCED P~C MATERIAL ~ 5 CONCRE~ ~ 6 ~LWlNYL CHLORIDE ~ 7 ~UMINUa ~ 8 1~ ME~ANOL ~MPATIBLEW/FRP (PrimaryTank) ~ 9 ~RON~ ~ 10 ~V~I~D S~ ~ ~ UN~OWN ~ ~ O~ER ~ 1 RUBBER LINED ~ 2 ~D L~G ~ 3 ~O~ LINI~ ~ 4 PHENOL~ LINING C, INTERIOR ~S UNING MATERIAL ~MPATlaLE W~ 1~ M~A~L ? YES_ ~__ D. CORROSION ~ 1 ~LY~LENE W~P ~ 2 ~A~ ~ 3 ~L ~ ~ 4 FIBERG~S REINFORCED ~C PROTEC~ON. ~ 5 CA~ODIC PROTECTION ~ 91 ~NE ~ ~ UN~WN ~ ~ O~ER IV, PIPING INFORMATION c~,c~ A IFABOVEGROUNDOR U IFUNOERG~UNO. aO~IF~LICA~ A. SYSTEM~PE A~ I SUCTION A ~ 2 PRESSURE A ~ 3 G~V~ A U ~ O~ER B, CONSTRUCTION A U 1 SINGLE WA~ A ~ ~ ~UaLE WA~ A ~ 3 LIN~ TR~H A ~ 95 UN~OWN A ~ ~ O~ER ~ C, MATERIAL AND A ~ 1 ~RE STEEL A ~ 2 STNNLESS S~ A U 3 ~LWI~L ~LQRIDE(PVC)A~4 FIBERG~S PIPE CORROSION A ~ 5 ~UMINUM A ~ 8 ~NCRE~ A ~ 7 ST~LWI~A~ A ~ 8 1~ M~OL ~MPA~a~W/FRP PROTE~ION A u 9 ~LVANI~D S~ A ~ 10 CA~ODICPRO~CTION A ~ 95 UN~O~ A ~ ~ O~ER D. LEAK D~ECTION ~TOMATIC LINE LEAK DE~CTOR ~ 2 LINE T~H~ESS TESTING ~ ~NffORING ~ ~ O~ER V, TANK LEAK D~ECTION I I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN . III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. B. ANDC. ANOALLTHATAPPLIESINBOXD A. TYPE OF [~ 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SECONDARY CONTAINMEN~ (VAULTED TANK) [] 99 OTHER B. ' TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL [~ 3' FIBERGLASS [] 4 STEELCLAD WI FIBERGLASS REINFORCED PLASTIC MATERIAL ~ 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLEW/FRP (PrimaryTallk) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN .[~ 99 OTHER [] 1 RUBBER L,N D [] 2 AL O LI.I.G [] 3 EPOXY L,.ING [] 4 PHENOL": LIN,NG C. INTERIOR [] 5 GLASS LINING ~6 UNLINED [] 95 UNKNOWN [] 99 OTHER LINING IS LINING MATERIAL COMPATIBLE wITH 100% METHANOL ? YES__ NO__ D. CORROSION [] I POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [~ 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] g9 OTHER IV. PIPING INFORMATION C~RCLE A IFASOVEGROUNDOR U IF UNDERGROUND. 8OTH IF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION A I,I 2 PRESSURE A{~3 GRAVITY ~, IJ 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A~'~ 2 DOUBLE WALL Jt U 3 LINED TRENCH A U 95 UNKNOWN A t.J 99 OTHER C. MATERIAL AND ' A U 1 BARE STEEL A U 2 STAINI..~SS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A (~4 FIBERGLASS PiPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COATING A U 8 100°/o METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A IJ 99 OTHER D. LEAK DETECTION ~--"] ~ AUTOMATIC LINE LEAK DETECTOR [] 2 LiNE TIGHTNESS TESTING [~3 MONITORING [] 99 OTHER V. TANK LEAK DETECTION 6 TANK TESTING 7 INTERSTITIAL MONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER PE IT UMSER TYPE OF INSTALLATION ( ) 1. In-Tank Level Se_ns0.r ~} 2. Leak Detector ( ) 3. Fill Box FACILITY ADDRESS ~ CONTACT PERSON ":': ................... I:"-INTANK LEVEL ~ENSORS '~' Number of Tanks List By Tank ID Name of System Manufacturer & Model Number Contractor/Installer 2. LEAK DETECTORS Manufacturer h Mode~ N~m,~er Contractor/Installer ~-~'~'~/~ N~ber of Tanks List By Tank ID Name of System Manufacturer & Model Number Contractor/Installer OWNER/OPERATOR -~ ..... I __D_ATE .,PERDJ'I T ;~ ........ _~,.......~.....~..,0,..! ................ F AC I L I TY : ......................................................................... i.__ ~.[~V. $[~SI~IVI~¥ ......... NUMBER OF TANKS AT THE SITE: ..................... EMERGENCY CONTACT PERSON( PRIMARY): NAME: PHONE NUMBER: EMERGENCY CONTACT PERSON(SECONDARY): ....... ='::~ ..... -' ..... NAME: ............................... ~ -- 'PHONE NUMBER: TANK OWNER INFORMATION: - NAME:. PHONE NO.: TANK CONTENTS: TANK ~ MANUFACTURER YEAR INSTALLED CAPACITY CONTENTS TANK CONSTRUCTION: .cont ) MATERIAL INT LINING CORROSION PROT. ~ · LEAK DETECTION: TANKS: VISUAL GROUNDWATER MONITORING WELLS VADOSE ZONE MONITOR-~ING WELL~'-'- U-TUBES WITH ~INERS U-TUBES WITHOUT LINERS VAPOR DETECTOR LIQUID SENSORS CONDUCTIVITY SENSORS PRESSURE SENSORS I---'~ ANNULAR SPACE LIOUID RETRIEVAL SYSTEMS IN U-TUBES, MONITORING WELLS, OR ANNULAR NON E UN KNOWN OTH ER PING INFORMATION= LEAK DETECTION: PIPING: .~ ...... FLOW RESTRICTING LEAK DETECTORS FOR PRESSURIZE£ PIPING MONITORING SUMP WITH RACEWAY S~'~'~'~"'-~'~'~CRETE RACEWAY HALFCUT COMPATIBLE PIPE RACEWAY , -,,c~ ~^n~W~v NONE UNKNOWN " TANK FACILITY ~NUAL REPORT .. ,. ..... 1. I have not done any ~ajor ~odlfications to this facility during the ~' - .... Sl~ature ' Note: Ail m~jor modifica~ions require a Permit to Construct from the[Permittinz Authority .... '.:. 2. I> h~ve done major modifications for which I obtained Permit(s) to '" '~ons~ruc~ from Permittlnz Authori~y ......... ' ......... :: ............. ........ Permit-to 'Construct ~ ................... --'zDate-- .~: ' _). ~ 8. Repai~ and ~ainten~nce S~a y '?-', .~ .:.......:~-:, '" ~ttach ~ ~a~y of ~11~ ':'~:.'::" '.' -.~'" -- Routine and ~equl~ed ~aintenance done to thi~ faclllty'~ t~nk, plpiag, ~ad ~oaito~lag equlp~eat. -- Repal~ of ~ub~e~ged pu~p~ o~ ~uction p~p~. -- ~eplace~ent of flo~-~e~t~icting leak detecto~ ~ith ~e. . -- Repai~/~eplaee~ent of dl~pen~e~, ~ete~, e~ nozzle~. · r'. -- Repai~ of ~leet~onlc leak detection ~o~ponent~, ~ ~place~ent. ,',(' ' ~ith a~e. j -- In~t~llatlon of ball float v~lv~. -- Installation o~ ~pai~ of vapo~ ~ecove~y/vent ltne~. Include the date of each tepal~ o~ ~alntenance ~cttvity. NoTE; All ~epal~ o~ teplace~ent~ in ~e~pon~e to ~ le~ ~equl~e ~ Pe~lt to Construct f~o~ the Pe~ittlng ~utho~lty aa do all othe~ ~odlficatien~ to ta~, plping o~ ~onito~lng equip~en{ aot ll~ted here. 4. Fuel Change~ - Allo~ed ~or ~otor Vehicle Fuel ta~k~ Only. Ll~t all fuel ~to~ge changes in tank~, noting: .. ~ate(s), tank nu~be~(~), ne~ fuel,(~) ~to~ed. - 5. Inventory control monitoring is ~equi~ed fo~ this facility on the ~' Permit to 0De,ate, and I have not ~xceeded any ~e~o~table limits as listed in the appropriate lnvento~y control monitoring handbook during the last twelve months 5f~appliVle, disregard). ' ~ 6. Trend ~alysts S~ary :' Please attach ~nual Trend Analysis Summary for the last 12 periods. ~ 7. Meter Calibration Check Form Please attach current, completed ~eter Calibration Check Form ANNUAL TREND ANALYS I $ $UI~II~L~,RY TANK # ~ TIME PERIOD: to QUARTER 1 TIME PERIOD: to PERIOD 1: Total Minuses This Period (Line 3) ~:=,~ .... - ....... ~Action Number~forth~-Period.(Ltne~..4 .... ' -'~ PERIOD 2: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) · '~: PERIOD 3: Total Minuses This Period (Line 3) ..~ Action Number for this Period (Line 4) · : qUARTER 2 TIME PERIOD: ' PERIOD 4i Total MinUses This Period (Line 3) ~ · · Action Number for this Period (Line 4) PERIOD 5: Total Minuses This Period (Line 3) Action Number for this PeriOd (Line 4) PERIOD 6: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) qUARTER 3 TIME PERIOD: /~f~ ' to PERIOD ?: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) PERIOD 8: Total Mlnuses This Period (Line 3) ~" · Action Number for this Period (Line 4) PERIOD 9: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) qUARTER4 TIME PERIOD: ~/~/~ to 'PERIOD 10: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) PERIOD 11: Total Minuses This Period (Line 3) /, /F~ Action Number for this Period (Line 4) PERIOD 12: Total MinUses This Period (Line 3) Action Number for this Period (Line 4) DEPARTMENT OF WEIGHTS AND MEASLIRES ...... COUNTY OF KERN STATE OF CALIFORNIA -1 J'16 East Callfomia Avenue Bakersfield-93307 "~' Telephone (805) 861-2418 Certificate of Inspection K 0 3 5 5 4 This is to cerl~'y that, in accordance with the law, I have tested the scales. weights, and measures mid to be t~ properS/of or used by:. OWNER FORMER NAME NO. DESCRIPTION AND REMARKS · rJJ~J[. ' '(OWINF'R OR ,~GEINT OF OWhl£l~ out ....... Mont¥ H. Hopper, Director/ PROMINENT p[_~rK !116 East California Avenue DEPARTMENT OF WEiGI~TS AND MEASURES.. --NOTICE OF VIOL TION ' . · Name" ~--.~ ~,~- . , .~ ~ Phone. : . 'You, ,are~in violat aa of the Busin--~ and Profe~ions Code-z~T~l~e~- ~ ~~rs. ;:~.??,; : : /~ /~/ ~ /1 ~ ~ ~'7~ or, ne ~a~o~ ~afirornia,~ section(s~:-; " and/or sec s : ' ': .. . · - ~ ": ~ ...... . ~of th~ California'Administrative Cod,z ' "' ' · ~ ~ ;~omply within_ . ."_days from the a~ove date.' - -~ · ' Failure to comply with this notice will subject you to the ~engJtJe~s pro~ided for In Division · .5 of the Business and · ' ~ * Professions~de of the State of~Califorgi~ ~] ~ . . t . ' '~ ~s. ~ ~.,~ ~,~. e-~> ~ · Date of Compliance . :~ '~. ' ' ~ .~ .:.:.- . · . '~ ' Inspector ~ .: -. · METER CALI BRATI ON CHECK FORJVl Facility: ' Permit # Note: -- 1. Ail' meters must have calibration checks a minimum of {wlce a ~ear, which may include checks done by the Department of Weights and Measures. 2. Before starting calibration runs, wet the calibration can with product and return prdduct to storage. 3. Run 5 gallons with nozzle wide open into the can. Note gallons and cubic inches drawn, and return product to storage. 4. Run 5 gallons with the nozzle one-half open into the car. Note gallons and cubic inches drawn, and return product to storage. 5. After all .product for one calibration check is returned to storage, remember to record the volume returned to storage in column 9 of the Inventory Recording Sheet. 6. If the volume measured in a §-gallon calibration can is more than 6 cubic inches above or below the 5-gallon mark. the meter requires, calibration by a registered device repairman. Hose or Tank #/ Fast Flow Slow Flow Volume Returned Calibration Device Repairman Date of Date/Time Pump # Product 5-Gallon Draft 5-Gallon Draft to Storage [ Required? Used for Calibration Cu. Inches Gals Cu. Inches Gallons { Yes No Calibration , i Owner or Operator Signature Calibrator's Signature Registration # SUBMIT A COPY OF THIS FORM WITH ANNUAL REPORT. . , ,, ~(D~ip~o~ - ... . ., · . .' : '(L~e Bay-Pay Booth4~es Ar~a) :'~ : ..'.~::.. ~" Date Tested ,, _Tested OK Yes_ ' No . . . ..~..~. Chevron ( Chevron U.~S.A. Inc. 2 Annabel Lane, Suite 200, San Ramon CA 94583 · Phone (415) 838-5000 Markedng Operadons D. Moiler 3uly ~, 19gg Division Manager, Operations S. L. Patterson Area Manager, Operations .... I~-: G: Trimbach Manager, Engineering ......... ' ..... -== ~ - Ms. Amy Green Kern County Health Department Environmental Health Division lgl§ Truxton Bakersfield~ California 93301 Dear Ms. Green: Please see the enclosed report from Krazan & Associates on 55 #g02§, located at 3#th and Q Streets in Bakersfield. Based on this report and the fact that the Soil was removed from the area vze discussed by the inside pump island, vce plan to do no further investigation at this site. Very truly yours, D. MOLLER 3WS:vjs:QK 1-100 Enclosure 2700 M STREET KEhN COUNTY HEALTH DEPARTME'i~T HEALTH OFFICER MAILING ADDRESS t Leon M Hebertson, M.D. 1415 TRUXTUN AVENUE ENVIRONMENTAL HEALTH DIVISION BAKERSFIELD. CA 93301 " DIRECTOR OF ENVIRONMENTAL HEALTH (805) 861-3636 " Vernon S. Relchard PERMIT TO CONSTRUCT PERMIT NUMBER #060018B UNDERGROUND STORAGE FACILITY FACILITY ~AME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: Stal}ingChevron-#4025 -ChevronUSA Caltfornta-Petroteum.-~Equipmen~ 800 34th Street $2 Annabelle Lane P.O. Box 9364 Bakersfield, CA San Ramon, CA Fresno, CA 93792 License #432613 X_~.X[ NEW BUSINESS I 'PERMIT EXPIRES June 16~ 1989 I~1 CHANGE O~ERSHIP I }~{ RENEWAL { APPROVAL DATE J~ne 16, 1988 , , MODIFICATION { (/~~f~ ~.' I { OTHER t APPROVED BY ~ ~m~'~/ G~e~lr~_~ .. OST ON ...................... CONDITIONS AS FOLLOWS: 1. All construction to be as per facility plans approved.by this department .and verified by Inspection by permitting Authority. 2. All equipment and materials in this construction must be installed in accordance with all manufacturers~ spec/f/cations. 3. Backfill material .for piping and tanks to be as per manufacturers' specifications. 4. Float vent valves are required on vent/vapor lines of underground tanks to prevent overfllllngs. ~ 5. Construction inspection record card Is Included with permit given to Permlttee. This card must be posted at jobstte prior to initial inspection. Permittee must oontaot Permitting Authority and arrange for each group of required inspections numbered as per instructions on oard. Generally, inspections, will be made of: a. Tank backfill b. Piping system with secondary containment c. Overfill protection and leak detection/monitoring d. Any other inspection deemed necessary by Permitting Authority -- 6 ...... Al.l..underground metal_ -connec~l_ons_..(..e_,g .... p~R~g,_~t~.ngs ..... ~.tll ~pipes)_.~o tank(s) must be' electrically isolated, and wrapped to minimum 20 mil thickness with corrosion-preventive, gasoline-resistant tape or otherwise protected from corrosion. DISTRICT OFFICES n~,f=nn · I Rmnnt · I.Rkel~Rhella · Mniave · Ridqecrest · Shafter · Taft PERMIT TO CONSTRUCT UNDERGROUND'. PERMIT NUMBER 060018B STORAGE F'ACILITY ADDENDUM Permitting Authority. 8. Contractor must be certified by tank manufactur.er for lnst~llatton of fiberglass tank(s), or tank manufacturer's representative must be present at slte.~urtng installation. 9. Liner s&all be installed by a trained experienced liner contractor and Installation at site approved by the Permitting AuthoritY. 10. Permtttee must contact Permitting Authority for on-site Inspection(s) 11. Monitoring requirements for this facility, will be described on final "Permit to Operate." ,~. "~700 M STREET KERN COUNTY HEALTH DEPARTIv, cNT HEALTH OFFICER MAILING ADDRESS ' ' Leon M Hebertson, M.D. 1415 TRUXTUN AVENUE ENVIRONMENTAL HEALTH DIVISION BAKERSFIELD, CA 93301 DIRECTOR OF ENVIRONMENTAL HEALTH (805) 861-3636 Vernon S. Reichard PERMIT TO CONSTRUCT - ~-- ~ ~PERMIT-NUMBER' #080018B UNDERGROUND STORAGE FACILITY FACILITY NA~E/ADDRESS: ,0, ,I~NER (S) NA~IE/ADDRESS: CONTRACTOR: Stalling Chevron t4025 Chevron USA California Petroleum Equipmen 800 34th Street #2 Annabelle Lane P.O. Box 9364 Bakersfield, CA San Ramon, CA Fresno, CA 93792 License t432613 XX[ NEW BUSINESS I PERMIT EXPIRES June 16~ 1989 I_1 CHANG OWNERSHIP I [~[ RENEIgAL [ APPROVAL DATE JAne 16r 1988 ') . ~ J I OTHER I APPRO~D BY .................... POST 0N PREmiSES ....... - .... ' ........... CONDITIONS AS FOLL0~: 1. All construction to be as pe~ facility plans approved by tht~ department .and verified by Inspection by permitting Authority. 2. All equipment and materials in this construction must be Installed in accordance ~lth all manufacturers' specifications. ~. Backfill material fo~ piping and tanks to be as pe~ ~anufactu~e~s _ ~peclflcatlon~. 4. Float vent valves a~e ~equl~ed on vent/vapo~ lines of underground tanks to p~event ove~fllllngs. 5. Construction. inspection ~eco~d card ts Included ~lth permit given to Permlttee. This card must be posted at Jobstte'" prior to initial inspection. Permlttee ~ust contact Permitting Authority and arranse for each group of required Inspections numbered as per Instructions on card. Generally, inspections, .111 be made of: a. Tank backfill b. Piping system with secondary containment c. Overfill protection and leak detection/monitoring .......... d.-"Any"other-i-n~pe'ctlon'deemed-~necessary- by Permitting Authority 6. All underground ~etal connections (e.g. piping, fittings, fill pipes) to tank(s) must be electrically Isolated, and wrapped to minimum 20 mil thickness with corrosion-preventive, gasoline-resistant tape o'r otherwise protected from corrosion. DISTRICT OFFICES PERMIT TO CONSTRUCT UNDERGROUND PERMIT NUMBER 060018B STORAGE FACILITY ADDENDUM 7.- No product shall be stored In tank(s) until approval Is granted' by the Permitting Authority. 8. Contractor must be certified by tank manufacturer for Installation of fiberglass tank(s), or tank manufacturer's representative must be present at site~ during Installation. 9. Liner shall be Installed by a trained ekperienced liner contractor and tns~.allation_at..site.~pprov.ed by the Permitting AuthoritY. 10. Permtttee must contaCt Perm~'i~-i~g"-~-~h~t~' for-'o~Lsii~e "~nspectlon(S) with 48 hour advance notice. 11. Monitoring requirements for this facility, will be described on final nPermit to Operate." ACCEPTED BY ~/' , ! ~s DATE ~ /- ~ t. NEW CONSTRUCTION/MObIFICATION STATUS SHEET Application Check : Date Comment: ' ..... Application Resubmitted: Date By ..' ,. Additional 8ubmtttals/Chan~es Requested Date By Comment: Submittals Received Rechecked Plan: Date By ~ Passed ~ Failed Comment: Permit to Construct/Mod/fy Tanks Issued: Date By Denied: Date By ' First Inspection: Date By ~ Passed ~ Failed Comment: ReinspecttOn: Date By ~ Passed ~ Failed Comment: Notes: Permit Application Checklist Facility Name CD+ llina % CAcao Facility Address ~CfD ~qJ~% ~ , )~ Standard Design Motor Vehicle Fuel.~Exemption. Design ; (Seconda.ry.Conttainment) ~t.',~-- '~."(Non-Secondary Containment) " Approved .-~ Permit Application Form Properly,-Completed Deficiencies: ~.~r~~. e~ .~_~ 7W~-~ ......... ' .................. ~"['.n~. ~2~---~' "~m:~,o o~ .~,t~ ~t ~, ~r~-~o ~" "t-~-~' ............ i ..... 't c'r ,, - ..7.-- v , - ' - ~-- .~ ~ , , -.. , ~ .... , ,. , 3 Copies of Plot Plan Depicting: ~ Property lines :' ,.:- · ..~...' < .... ':"-' ~ Area encompassed by minimum 100 foot radius around tank(s) and piping lCUt/,~ IO~ ~ a,~ao,~,, ,~ ~;~-0,~_~ ~L~ ': ~.. :-~.~" Alit:tank(s) identifi.?d by a number and product to be stored Adequate scale .(minimum 1"=16'0" in detail) North -arrow .- -. ........... : ,~-. All stru'ct.ures within 50 foot radius of tank(s) 'and pxp~ng Location and labeling of all product piping and dispenser islands Environmental sensitivity data including: · Depth to first groundwater at site · Any domestic .or agricultural water well within 100 feet 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, leach lines,' seepage pits, drainage systems) - · 'Asterisked items: appropriate documentation if permittee seeks a motor vehicle fuel exemption 'from s'econdary containment - Comments: Approved 3 c6Pies of Construction Drawings Depicting: -- side Vi~-~ ~-~ T-~ ~n-~allation with B~¢~filI, Raceway(s), Secondary Containment and/or Leak Monitoring System in Place Top View of Tank Installation with Raceway(s), Secondary ..... Containment and~or Leak__~onitoring System in Place Materials List (indicating those used in the construction): Backfill ~ ~ Tank(s) ~..~ Product Piping Secondary containment Leak Detector(s) ~ Overfill Protection Gas or Vapo~ Detector(s) Sump(s) ~ ~'~ -Ju Monitoring ~s) Additional: --- Documentation of Product Performance' Additional Comments Reviewed By. Date SITE INSPECTION: Approved Disapproved Comments: InspectOr Date $ ~_'.a_!ul_'_d_r.?.l._.C 0 re.i_) L J a n c e C h e c k . of USuction ~Pressurized P~oof 'of Contractor's ~Jcense - ~jcense Proc[ of Cont~,ctor's ~orke~', Co,,pe,s,tJo, .tberglass (FRP) Make & Model iberglass-clad steel ~ake & ~odel ~Uncoated steel Nake & Nodel ~Other: Nake & Nodel Comment: Additional: Inspect i on: DsOUble-walled tank(s) Make & Model · ynthetlc liner Make & Model [-]Lined concrete vault(s) Sealer used ~Other Type Make & Model Comment: Addi tional: Inspect ion: ~& Secondary Contaiument Volume at Least .100% of Primary Tank~ I Comment: ~ Additional: '" Inspect i on: Secondary Containment Volume for More Than One Tank Contains 1504 of Volume of Largest Primary Containment or 10~ of Aggregate Primary Volume, Wltici~ever is Greater Comment: Additional ................... [n-specti-o-n-; ............................................... _Req' d ~/,~JlF_oved .. ' ' Secondary Containment Open to Rainfall Must. Accommodate 24 Hour Raitlfall Total Volume Comment: Additional: Inspect 1 on: ry Contalnment ts Product-Compatible Pvoduc E Docl~mei~ Ea E i on Comment: Additional :. '.* Inspection: ~z~ ~ . ~pn. ulaF Space Llquid is Compat~.l~.,,,~i,~.h Pvodu~..t pvo~-~c-t ............ Annular liquid Comment: Additional: Inspection: . ~ P rimag Co n tainment of Piping ' z~Fiberglassc pip.ing Size ~ Make ' oated steel piping Size ~ Make ~Uncoated steel pipinff Size ~Other Comment: Additional: Inspection: ~ Secondary Containment of Piping Double-walled p~pe Size & Make Synthet~llner in trench Size & Make C o1~11~ e n t: Additional: Inspection: ' Corrosion Protection ~ ~ ~Tank { s ) ~Pipi~g & fittit~gs ~E] (~ct~ical lsolatJon Addit:io]'~al: Reqfd . AppPoved ., Additional: · - Inspection: Tank(s) Locate~ n~ C~tos.~r ~tJ~n/~0~ F,~e_ t (eotBuil~il}g(s ~Ltqutd level indicato~(s) ~Liqutd used ................................................ ~THe-~ Ail---~o. ndU c t j v i t y sensor(s) ~P~essure sensor(s) ~Vacuum gauge su p s) Gas or vapo~ detector(s) ~lanual inspection & sampling ~Visual inspection Additional: ~ Othei- ~loni. ~PerJo~lic tightness testing ~ethod Pr~:s~;.~'e--~'educing line leak detector(s) COIlIltleI'I [. : Additional: Overfill Protection []Tape float gauge(s) · ~ ~Float ve,~t valve(s) ff_JCapacitance sensor(s) [--]ffigh level alarm(s) ~Automa.tic shut-off control(s) . , ~Fill box(es) ~lth 1 ft. 3 volume ......... , ~Operat:o~· controls wiLh visual ]ev~l monitorlng Othel' ................................................. C o.mme.n~t-~ Req ' d Approved ~ :~ .' Additional: Inspection: 14onitorlng Requirements Additional Con, ments -, Ext'~a Inspections/Reinspect i OhS/Cons.1 tati OhS Date: Comment: _.,.~ · :.- Time Utilized · ' '----Date-: - ......................... Purpose: Comment: Time Utilized Date: Pllrpose: Comment: Time Utilized Date: Purpo s.e: Comment: Time Utilized Invoice Date: Total Time: Inspector Date: KERN COUNTY HEALTIt DEPARTI~ W' 1700 FLOWER STREET ENVIRONMENTAL HEALTH DI-VISkoN ~ ~ BAKERSFIELD, CA 93305 HAZARDOUS SUBSTANCES SECTION I PHONE (805) $61-3636 .~ INSPECTION RECORD POST CARD AT JOBSITE FACILITY INSTRUCTIONS: Please call for an inspector only when each group of inspections with the same number are ready. They ~J. 11 run in consecutive order beginning ~i. th number 1. DO NOT cover work for a~y numbered group until all items in that group are signed off by th-~ Permitting Authority.~ Follo~ring these instructions ~i. ll reduce the number of required inspection visits and therefore prevent assessment of additional fees. - TANKS & BACKFILL - INSPECTION DATE ~ ~ INSPECTOR i "[' ! ~Backfill of Tank(s) ,_/~ "' I~ Igpark Test Certification ~ , ICathodic Protection of Tank(s) I I ..... - PIPING SYSTEM - l~[Piping & Raceway w/Collection Sump , [~Corrosion Protection of Piping, Joints, Fill Pi' ~ [Electrical Isolation of Pipin~ From Tank(s) I , ', 1 Cathodic Protection System-P ipin$ ", ,' I I I I I I I I I I l - SECONDARY CONTAINMENT, OVERFILL PROTECTION, LEAK DETECTION - ' [Liner Installation Tank(s) I /lLiner Installation - Pipin~ ' [' [Vault With Product Compatible Sealer , Level Gauges or Sensors, Float Vent Valves Product Compatible Fill Box(es) Product Line Leak Detector(s) i Leak Detector(s) for Annular Space-D.W. Tank(s) __ ~:~ Monitorin~ Well(s)/Sump(s) , Leak Detection Device(s) For Vadose/Groundwater ! , PVC Sleeve Pipin$ ' L'eak Detector(s) , ! ! - FINAL - ? ' [~[Monitorin$ Wells, Caps & Locks j~!Fill Box Lock !,Z! Monitoring Requirements. !' ~, ~,"-(m'"~,,',~q ! I -- ' -- ~ %.. I I I I I I I I Kern County Health D(. rim --' (. Permit No. Division of Environm~ .... al tle~. ,~ ' A ation Date 1700 Flower Street, Bakersfield, CA 93305 (805) 861-3636 APPLICATION FOR PERMIT TO OPERATE UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY Type Of Application (check): ' [~ew Facility ~]Modification ~f Fac. ility Ogxisting Facility ~]Transfer Of Ownership A. Emergency 24-Hour Contact (name, area'code, phone): Days ~os-ff23-?~c~ Type Of Business (check~: ~-~Oasoline Station r-]other (describe) Is Tank(s) Located On An Agricultural Farm? r~Yes r~No Is Tank(s) Used Primarily For Agricultural Purposes? rlYes ~-']No Facility Address ~o':' ./? Z~,Z~ -~' Nearest Cross St. T ~ R SEC (Rural Locations Only) ~ -- B. ater To Facility Provided By DePth to r°undwater -tV / 6[Soil Characteristics At Facility ~,~/~. ~/,/---rT t'.L~t4 :~.~Basis For Soil Type and Groundwater 'Depth~Deter~lnatlons ~'~ d4~d3-~ L~)/r~ C. Contractor C~/oE/~o/i~ ~,,,~,~r_~/~/d~ CA Contractor ~ s License No. Address ~,~ c~y~/ ~/ ~ Zip ~??z Telephone Proposed Starting Date z/-~2~-~V Proposed Completion Date 5--~<[ Worker's Compensation Certification No. /~'~ol Insurer ~ff D. If This Permit Is For Modification Of An Existing Facility, Briefly Describe · j E. Tank(s) Store (check all that apply): Tank # #aste Product Motor Vehicle Unleaded Re~ular ~reaium Diesel Waste Fuel" Oil F. Chemical Composition Of Materials Stored (not necessary fo~ motor vehicle fuels) Tank # Chemical Stored (non-commercial name) CAS # (if known) Chemical Previousl2 Stored (if different) O. Transfer Og Ownership Date Of Transfer Previous Owner Previous Facility Name I, accept fully all obligations of Permit No. issued to I understand that the Permitting Authority may review and 'modify or terminate the transfer of the Permit to Operate' this underground storage facility upb-~-~bGtV-fh~th-i~compI~'t~-d-T~rm. ~ This form has been completed under penalty of perjury and to the best of my knowledge is true and correct. Facility Name 3~f~ ,.~~l~ ~p2Z PesmiL No. ~ TANK ~ /~lOoo;~ (FILL OUT SEPARATE _ORS FO~,'~ACH TANK) EOR EACH SECTION, CtlECK ALL APPROPRIATE BOXES H. 1. Tank is: ~ Vault'~d [] Non-Vaulted [~ Double-Wall. [-I Single-Wall 2. ~ank MateriaI [~I Carbon Steel [] Stainless. Steel [] Polyvinyl Chloride [] Fiberglass-Clad Steel ~I Fiberglass-Reinforced Plastic [] Concrete ~ Aluminum ~] Bronze []Unknown [ [] Other (describe): 3. Primary Containment ,Date Installed Thickness (Inches) Capacity (Gallons) Manufacturer 4. Tank Secondar¥Cohtainment [] ' Double-~all [] Synthetic Liner [] Lined Vault [~] None [] Unknown [], Other (describe): Manufacturer: ~a~Pf · Material YX~e~l~ig Thickness (Inches) ~//~u Capacity (Gals.) 5.?ank Interior Lining ~] Rubber ~] Alkyd []Epoxy ~ Phenolic [] Glass [-[ Clay [] Unlined [] Unknown [] Other (describe): -. ...... 6. Tank Corrosion Protection I, .' [] 'Oa'lv~n'i~ed .... [] Fibergia~ZC'l'~--[]''-~d~-fh~I'ene-'Wrap~-[-[ -Vinyl-wrapping [] Tar or Asphalt ~] Unknown [~] None ~ Other' (describe): i.. Cathodic Protection:.[l~ None [] Impressed Current System [] 'Sacrificial Anode System [] Describe System & Equipment: : ?. Leak Detection, Monitoring, ~nd Interception · a. Tank: [] ViSual (vaulted ta~ks only) [] Groundwater Monitoring ~ell(s) [] Vadose Zone Monitoring ~ell(s) ~] U-Tube ~lthout Liner [] U-Tube with Compatible Liner Directing Flo~ To Monit~ring ~ell(s)* [] Vapor Detector'*~ Liquid Level Sensor* [] COnductivity Sensor* .. ~ Pressure Sensor In Annular Space Of Double ~all Tank*" [] Liquid Retrieval & Inspection From U-Tube, Monitoring ~ell Or Annular Space [] Oatly Gauging & Inventory Reconciliation f'! Periodic Tightness Testing [] None [] Unknown [] Other /~f/-~/~ /V~/,/~/z 227~ b. Piping: [~ Flo~-Restricting Leak Detector(s) For Pressurized Piping* · []Monitoring Sump ~tth Raceway [] Sealed Concrete Raceway [] Half-Cut Compatible Pipe Raceway []Synthetic Liner Raceway [] None [] Unknown [] Other ~'T&e'~ ~r-~ff~/o~ · 'Describe Make & Model:~ ~.~c/C~M /~/~/~' Has This Tank Been Ttghtness-Tes~e~¥ [~ Yes [~ No ['] Unknown Date Of Last Tightness Test Results Of Test Test Name Testing ComPanY '' 9. Tank Repair · , Tank Repaired? U]¥es [~ No []Unknown Cate(s) Of ~epalr{s) Describe Repairs 10'. Overfill Protection [] Operator Fills, Controls, &.Visually Moultora Level [] Tape Float Gauge [] Float Vent Valves [] Auto Shut-Off Controls [] Capacitance Sensor [] Sealed Fill Box [] None []:Unknown [] Other: /r~/~ga~ ///FF List Make ~ Model For Above Devices 11. Piping ~ Material a. Underground Piping: ~ Yes [] No [] Unknown Thickness (inches) Diameter Manufacturer ~] Pressure [] Suction [] Gravity Approximate Length Of Pipe Run /~ . b. Underground Piping Corrosion Protection: .... []__G..!ly_~Di~e~]_Ei.he~g.lass~C!ad [] Impressed Current [] Sacrificial Anode [] ~oiy~t~Ylene W~ap [] Bl~C~i~SO~-~t-i~i--~¥VlnyrWrap .... [~Tar-~or ~A~ph'art~ : [] Unknown [] None [] Other (describe): c. Underground Piping, Secondary Containment: [] Double-Wall [] Synthetic Liner,System [[]None ['] Unknown [] Other (describe): ~7,~~zc~ · TANK # I~,0oo. ~ (FILL OUT SEPARATE ~ORM FO,, dACg TANK) AC" S CTION, A--FFRO-- YA 1. Tank is: C].Vaul~gd [] Non-Vaulted ~ Oouble-Wall ~ Slngle-~all 2. Tank Material Carbon Steel ~ Stainless Steel D Polyvtnyl Chloride ~ Fiberglass-Clad Steel Fiberglass-Reinforced Plastic ~ Concrete ~ Aluminum ~ Bronze ~Unkno~n Other (describe): 3. Primary Coutalnment ,Date Installed, Thickness (Inches) Capacity (Gallon~) Manufacturer ......... ........... .... . ........ .... ~. ~ank ~eaondar~ Containment ~ Double-~all ~ S~nthetic Liner ~ Lined Vault ~ None ~ ~no~n ~, Other (describe): Manufacturer: ~~ - Material ~e~<l Thickness (Inches) ~. Capaoit~ (Gals.) 5.'Tank Interior LlninR ~ Rubber ~ Alkyd ~Epox~ ~Phenolio ~ ~lass ~ Cla~ ~ Unlined ~ Unknown ~ Other (describe): ' 6. Tank Corrosion Protection " . ' .. ~ Galvanized ~ Fiber~-i'a~f~'i-~d--~--~Of~th~i~-~rd~'~'~in~l Wrapping · ..... ' ~ Tar or Asphalt ~ Unknown ~ None ~ Other' (describe): " Cathodic Protection: ~ None ~ Impressed Current Sy~teI ~ ~Saoriftctal Anode ~ Describe System ~ Equipment: ~. Leak Detectioo, Monitoring, .and Interception ' , a. Tank: ~ Visual (vaulted tanks only} ~ Groundwater Monitoring Well(s) ~ Vadose Zone Monitoring Well(s) ~ U-Tube Without Liner I '. ~ U-Tube with Compatible Liner Directing Flow To Monitdring Well(s)~ : ~ Vapor Detector'~ Liquid Level Sensor* ~ COnductivity Sensor* ~ Pressure Sensor In Annular Space Of Double ~all Tank* ' ~ Liquid Retrieval & Inspection From U-Tube, Monitoring ~ell Or Annular Space ~ ~ Daily Gauging & Inventory Reconciliation ~ Periodic Tightness Testing ~ None ~ Unknown ~ Uther /~-~/f~ ~/~ ~ ~~/ b. Piping: ~ Flo~-Restricting Leak Detector(s) For Pressurized Piping* , ~Monitoring Sump With Race.ay ~ Sealed Concrete Race.ay ~ Half-Cut Compatible Pipe Race.ay ~S~nthetlc Liner Race.ay ~ None ~ Unknown ~ Other '~ ~~ ~ *'Describe Make a Model:~ ~ f~o~M ~ 8. Tank Tightness ~ /~f~_~t ' .. ~ ~his Tank Been TIMhtne~s~zt~? O Yes O NO . O Unknown Da~e O~ Las~ Tigh~ness Tes~ Resuits O~ Tes~ { Tes~ Name Testing Company 9. Tank Repair ; Tank Repaired9 ~ yes ~ No ~ Unknown Da~e(s) O~ Repaiu(s) Descuibe Repairs _ 20. Over~ill Protec~ion -~ Operator Fills, Coutruls, &.Visually Monitors Level - ~ Tape Float Gauge ~ Float Vent Valves ~ Auto Shut-Off Controls ~ ~ Capacitance Sensor ~ Sealed.Fill Box ~ Nons ~:~nkno~n ~ Other: ~/~d ///f~ List ~ake ~, Model For Above Devices 11. Piping , a. Underground Piping: ~ Yes ~ No ~ Unknown.' Material Thickness (inches) Diameter Manufacturer ~ Pressure ~ Suction ~ Gravity Approximate Length Of Pipe Run / b. Underground Piping Corrosion ProtectiOn: ~---Ga.l. van./zed .... ~-.F4ber~lass~Clad~ Impressed_Current .... ~_~aortftot~l A~ode ~ Polyethylene Wrap ~ Electrical Isolation ~ Vinyl Wrap ' ~Tar or Asphmlt .' ~ Unknown ~ None ~ Other (describe): c. Underground Piping, Secondary Containment: ~ Double-Wall ~ S~nthetlc Liner,System ~ None ~ Unknown ~ Other (describe): TANK' ~ I~Oo~'~/Z (Fill OUT SEPARAT'~ · =ORH dACH TANK) FOR EACII SECTION, CIlECK ALL APPROPRIATE BOXES H. 1. Tank is: []-vaulted [] Non-Vaulted ~ Double-Wall r~ Single-Wall 2. Tank Material Carbon Steel [] Stainless Steel [] Polyvtnyl Chloride [] Fiberglass-Clad Steel []Fiberglass-Reinforced Plastic r'] concrete r-] Aluminum [-] Bronze []Unknown []Other (describe): 3. Primary Containment ,Date Installed Thickness (Inches) Capacity (Gallons) Manufacturer 4. Tank Secondary Containment ~ Double-Wall ~ Synthetic Liner ~ Lined Vault ~ None ~ Unknown ' ~ Other (describe):- Manufacturer: Material ~e4~<l Thickness (inches) ~. Capacity (Gals.) 5.'Tank Interior Llnin~ ~ Rubber ~ Alkyd ~Epoxy ~Phenolic ~ Oluas..O Clay ~ Unlined ~ Unknown ~ ~ther (describe): Corrdi/On-P~'~:t'e'd~Zon ......... ~ ..............~ ............................. ~-.~~_~L_. . ~ Galvanized ~ Fiberglass-Clad ~ Polyethylene Wrap ~ Vinyl WrappinK ..... .~ ,. ~ Tar or Asphalt ~ Unknown ~ None ~ Other' (describe): Cathodic Protection:-~ None ~ impressed Current System ~ ~Sacrificial Anode System ~ Describe System & Equipment: 7. Lea~ Detectio~, Monitorin~, .and'_Interception : a. Tank: ~ Visual (vaulted tanks only) ~ Groundwater Monitorin~ Well(s) ~ Vadose Zone MonJtor/n~ Well(s) ~ U-Tube Without Liner ~ U-Tube wi~h Compatible Liner Oirectin~ Flow To Monit~rin~ ~ Vapor Detector'*~ Liquid Level Sensor * ~ COnductivity Sensor* ~ Pressure Sensor In Annular Space Of Double Wall Tank *" ~ Liquid Retrieval & Inspection From U-Tube, Monitoring Well Or Annular Space ~ Daily Oau~in~ & Inventory Reconciliation ~ Periodic Tightness Testing ~ None ~ Unknown ~ Other /~-~/f~ ~//~ ~ ~~/ b. Piping: ~ Flow-Restricting Leak Detectou(s) ~or P~essurized Piping* ~Monitorin8 Sump With Raceway ~ Sealed Concrete Raceway ~ Half-Cut Compatible Pipe Raceway ~Synthetic Liner Raceway ~ None ~Unknown ~ Other ~~F~c.~ · 'Describe Make & Model:', ~~Y ~ 8. Tank TiRhtness ~. /~z -..t ' ~ Has This Tank Been Tightness 'res~eo'¢ ~ Yes ~ No ~ Unknown Date Of Last Tightness Test Resuits Of Test Test Name Testing Company 9. Tank Repai~ 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 FiZZ Box ~ None ~Unkno~n ~ Other: ~/~d ///i~ List Make &~ Model For Above Devices 11. Piping , a. Underground Piping: ~ Yes ~ No ~ Unknown.' Materiai Thickness (inches) Diamete~ Manufacturer ~ Pressure ~ Suction ~ Gravity Approximate Length Of Pipe Run I .b .... UndqcgFo~n~.9~g.C~crosion Protection: ~ Polyethylene W~ap .~ Electrical Isolation ~ Vinyl Wrap ~Tar or Asphait ~ Unknown ~ None ~ Other (describe): c. Underground Piping, Secondary Containment: i ~ Double-Wall ~ Synthetic Liner.System ~ None .~ Unknown ~ Other (describe): ~~c.~ * {