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Home My WebLink AboutUST 1/7/1991 · .. ) 2,000 Gasoline Asphalt Concrete (1) i0,000 Gallon Diesel Tank'~-~ I · (1) 2,,000 Gallon Gasoline Tank--~-~-'].. I Rock -- ~ Concrete" 'Aspha~ ~ ~ro~sod sa~lo I~tion (~ 2' and ~') ~ Vont ~ CAL PLY, PLA~E groundwater resources, inc. 5601 Aldrin Ct. ~ Bakersfield, California ~, _ ,0, ~ ~ ~ ~:~ .; Ooncmi~ . ~ .' O-Ri~ ~ ,' Concrete 2,000 Gallon ~spha~ Gasolinolank ~mposo~ sa~lo I~tlon (~ 2' an~ ~') ~ · Diesel ~11 for vent 10,000 Gallon Diesel Tank N~e: Distance of piping from tan~ to dls~nse~ is estim~t~ to ~ le~ than 15 feet. ~ CAL PLY PLATE groundwater resources; inc. $601 Aldrin Ct. ~ Bakersfield, California PLOT PLAN KERN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT INVESTIGATION RECORD ~DBA Oh~IER ADDRESS ADDRESS ASSESSORS' .PARCEL I CT ? CHRONOLOGICAn RECORD OF- INVESTIGATION =ADMNMa£n SelectiOns = Hazmat Handler Search (Add/Modify) --Hazmat Handler (Add) SlteID: next in sequence Comm. Code~ Location No.:6%0~ Dir: Street: ~D~'~ C0u~T unit: Mailing No.:* Dlr: Street: Unit: City: State: Zip: - Billing No.:* Dir: Street: Unit: City: State: Zip: - Business Owner: Phone:( ) - No.:* Dir: Street: Unit: City: State: zip: - <Fl0> Continue * 'SAME' as above <Esc> Exit ADMN Main Selections = ADMN Report Types ----Ad Hoc Report -- Previous Reports -- Site ID Parameters Site Data Parameters Regulatory Programs Site Milestone Parameters II] Include if mlstn's date is between · / / and / / date is between~]~ Mlstn [E] Exclude if mlstn's Setup [A] Include if mlstn has ANY date [X] Exclude if mlstn has ANY date Current Billing UST Permits UST Corrective Actions UST Surcharge Refund Req. l%/9~l~0Tank(s)Removed Billing Date Refund Sent ' -- Site Asmt Reqd Revised Date PTO Expires On Addl Char Reqd 2nd Notice Ins/Mod Tanks Remediatn Reqd Final Notice , ~ Ins/Mod Piping RWQCB Referral Payment Recv'd (If~/~0Removal Permit Last Qtry Rept Financial Reap ;/7/~ Closure Letter Referred <PgUp/PgDn> Scroll Milestones <Fl0> Continue <F3> Output eps <Esc> Exit .- BAKERSFIELD FIRE'DEPARTME .- ,~- BUREAU OF FIRE PREVENTION ~' ~"' Date APPLICATION Appl.ication. No. In conformity With provisions of pertinent ordinances~ codes and/or regulatiOns, apPliCation.jS.made by: Name of Company Address to display, store, install, use, operate, sell or handle materials or processes involving or Creating con- dJtions deemed hazardous to life or property as follows: ~al. ~ dfmnl tmtk. (!,1~ Ia-~m·mmmr of .~/~~...?~5~ .................................. Authorized Representative ~,~ ~,~ .... ~.~..~.~._~.~..~.x~...~ ,, ~~. ~ .....~, ~, ~~ ~, ~,o,-~-~-----~-~:;-~---~ .......... ~. ................... ~ BAKERSFIELD FIRE DEPAI~I-MENT ~/~"~' FIRE PREVI.U"~TIC)N BUREAU NOTE: A~:ce~lar (:e ;~pplie!; lo plans as submitteo ~ I' and for c{:rlst~uc~ior~ a~d/'or ii,stall'riehl thereon, ~ubject to final inspection arid acr:eptnn~e. Oate~_: ..... ~lre Marshal + ~;m ~' ~ m';BL~ , ' m m ' 'FIRE PREVENTION 'BUREAU- '' .:' L,~ . :~:t~ :~ .?,,-.',~:i' .... NOTE: Acceptance applies to pla'hs as subrfiittee' ':L '":''::" ; '' ' end for construction and/or installation thereon, ~' ,', /'ALDRIN COURT FILE CONTE.~ITS SUMMARY PERMIT #: ENV SENSITIVITY: ~/~ . Activity Date # Of' Tanks Comments ' ' ' · ' Environmental H~lth Sen,,ic~ Department "~DALL L. ABBO~ s~ McCa, R~S, DmECTOR DIRECTOR A~ Poi~ C~I D~ DAVID PRICE Bi ~. J. RODDY, ~O ~IST~ DI~CTOR ~nning & D~t ~ De~ent ~D J~, ~CP, DI~CTOR ENVIRONMENTAL HEALTH SERVICES DEPARTMENT Ju!y 12, 1991 James Deming Stockdale Materials Co., Inc. 5601Aldrin Court Bakersfield, California 93313 Dear Mr. Deming: / The Kern'County Environmental Health Services Department received a returned invoice from you for the' fee associated with the permit to operate two underground storage tanks located/at 5601 Aldrin Court in Bakersfield, California. A note at the tdp of the invoice states that the underground storage tanks were removed. According to our records, the amount owing is'for the 1990 annual fee that was billed to you'in August of 1990 prior to the submittal of an application for removal of these tanks, therefore, this fee is still due. I am returning this invo$ce for prompt payment upon ~eceipt. '~ Please be aware that this is our final attempt to collect this fee prior to being sent to a collection agency. Sincerely, Jane Warren Hazardous Materials Inspector 2700 "M" STREET, SUITE 300 BAKERSFIELD, CALIFORNIA 93301 (805) 861:3636 FAX: (805) 861-3429 'RESOURCE MANAGEMENT AGENCY · ~' .~ EnvironmentaJ Health Sewices [~nt RANDALL I_ ABBOTT ~ ~ McC^,, m,,, ~-~S; om~croR DIRECTOR ~' ~r PoU..o. Co..ol Di,~ DAVID PRICE !I! ~ .~. ~ODD¥, ~,CO ASSISTANT DIRECTOR ' Planm~ & Development Se,~ices Deparm~ent TED JAMES, AICP, DIR~CTOR ENVIRONMENTAL HEALTH SERVICES DEPARTMENT January 7, 1991 Joe Zucchero 7330 S. Cider Pico Rivera, California 90660 CLOSURE OF 2 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANKS LOCATED AT 5601 ALDRIN ROAD IN BAKERSFIELD, CALIFORNIA. PERMIT # A1354'-31/310054 ; This is to advise you that this Department has reviewed the project r6sults for the preliminary assessment associated with the closure of the tanks noted above. Based upon the sample results submitted, this Department is satisfied that the assessment is complete. Based on current requirements and policies, no further action is indicated at this time. It is important to note that this letter does 'not relieve you of further responsibilities mandated under the California Health and Safety Code and California Water Code if additional or previously unidentified contamination at the subject site caUses or threatens to cause pollution or nuisance or is found to pose a significant threat to public health. , Changes in the present-or proposed'land use may ,require further assessment and mitigation of potential public health impacts. Thank you for'your cooperation in this matter. WES ~Y NICKS, HAZARDOUS MATERIALS SPECIALIST cc: Groundwater Resources, Inc. 5400 Aldrin Ct. Bakersfield, CA 93313 RESNA/GROUN DWATER RESOURCES,. INC. ,5oo so. UN,O, Working to Restore 'Nature BAKERSFIELD, CALIFORNIA 93307 General Engineering Contractor Class A/Haz License No. 520768 December 12, 1990 Mr..Wesley Nicks · · Kern County Department of Environmental Health 2700 M Street Bakersfield, CA 93301 RE: Cai Ply . 5601 Aldrin Court - Bakersfield, California Permit #1354- Dear Mr. Nicks, On Noyember 29, 1990, Groundwater Resources Inc. (GRI), a RESNA company removed two-underground storage tanks with cap~cities of 2,000 and 10,000 gallons containing gasoline and diesel, respectively, from 5601 Aldrin Court. '-The tanks were decontaminated on site using a high pressure steam cleaner and inerted with dry ice. Rinsate was disposed of at Gibson Oil in Bakersfield, California under hazardous waste manifest #88524559. The tanks were removed to American Metal Recycling. · Soil was sampled under the direction., of Kern County. The samples were analyzed at SMC Laboratories of Bakersfield, California for BTEX, TPHG, and TPHD. A complete chemical analysis is enclosed.. In addition to the lab results, copies of the manifest, chain of custodY, tank disposition tracking record, and plot plan, are enclosed. Please contact our office if you should have questions or require any further information. Sincerely, GROUNDWATER RESOURCES INC. ?~J~oe~,,A;~unwoody ~ ' Project Geologist ' JAD:tdc cc: Terry Patterson, Cal Ply O tnk 1 '- Gasoline Dispenser ) ~ooooooooooooooomo~fiNSTO~AGEA~£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~ SAMPLE LOCATION I tnkl '[' 10,000 ~allonDiesel Tank SCALE sAMPLE INDENTIFICATION and DEPTH ~ 2,000 Gallon G~line Tank 1' = 20' NORTH State et C~,iilomia----Health ,~ncl Welfare ^genc~ -- $86 InstrUctions on Rack, ~age 6 DeFerment of Heallh Se~icea oved OMB No. 20~39 (Exp~es aRd ~fOR' )ag5 Toxic Subalince~ Co~lrol Division Please print-or type.' (Fo~ de~ned Sacramento. C~lllornia UNIFORM HA~ ~. G.,.,.,o,'~ us EP~ ~O No. ~ · 2. Page ~ ~ ' Document No. ~lo~tt~ ~ the ~aded ~ , T,a~apo~e¢.l Company N.me ~. US EPA ID Number C. Sllle Tr.na~er'l ID /~ ~ ~ 5. 7~Tranepo~er 2 Compsny Name 8. US EPA ID Number E. Stale T/lnepo~er'l ID ~. Oesignaled Facility Name aha SAc Addresa ~ 10. US EPA ID Number G. ~1111 ~iclll~'l ~ 12. Containers 13. Total 14. 11. US DOT Deacriplion (~cluding Proper Shipping Name, Hazard Class, and ID Number) Qu&ntity Unit Waltl No. Type Wt / Vol a. '* E b. 8tale A ' - ~Al~m . I d. St~te EPA/~er ... J: Additional Oea~ipliona for ~al~ais Liated ~ve K. ~al~g ~el I~ Watle~ ~at~ ~ove GENERATOR'S CERT~ICATI~: I hereby declare that the contents of l~is consignment are fully and accuralely described above ~y propel ~hipping name and are cla~ailied, packed, ma~ed, and labeled, and are in all respects in proper condition lot Iran~po~ by ~igAway according lo applicable inlarn~lion~l national gove~nmenl regulations. if I am a large quantity gene~alot, I ce~i~ Ihal I have a program in place Io reduce Ihe volume and toxicity of wa~le generated to the degr~ I have delerm~ .... "to be'economically practicaDle and lhal I have selectea the praclicsDle method of treatmenl, slorage, Ot disposal cu~enlly available Io me w~ic~ mJnimizel , presell an~ luture Ihte~l Io h~an healt~ and the'environment; OR. il I am a small quanlily generator, I have made a good failh elto~ to minimize my waale generation and select I~e ~esl wa~le management melhod l~al i~ available to me aha 1~81 I ca~ alford. Prinle~Typed Name ~~, Month Day Year A Printed/Typed Name Month Day Year ~ PrinledlTyped Name - I S'i'gnatu~e "Mont~ Dly' Year E 19. Diecrepancy Indication Sp~ce F A C OHS 8022 A (tt~) Do Not Writ~ ~low This Line EPA 87~22 (Rev. 9-88) Previoua editio,e are obsolete. Wh;te= TSDF SENDS THIS COPY TO DOHS'WITHIN 30 DAYS To: P.O. ~x 3~, Sacramento, CA 95812 SMC La oratory Analytical Chemistry ~Client Name: Groundwater Resources, Inc. Address : 1500 So. Union 'Avenue Bakersfield, CA 93307 Attention : Joe'Dunwoody Date samples received : 12-04-90 Date' analysis completed: 12-07-90 Date of report : 12-07-90 Project Site: Kern County Project ~ : 1590-2- P.O. '~ : 5277 G RESULTS OF ANALYSIS: ~ 4405 ID: A-1 .'ugm/gm MDL,ugm/gm Benzene ,ND '0.005' Toluene ND 0.005 EthylbenZene ND 0.005. p-Xylene ND 0.005 m-Xylene ND 0.005 '- o-Xylene ND 0.005 Isopropylbenzene ND '0.005 TPH (Dieseli· ~ ND 10. % 4406 ID: A-2 ugm/gm MDL,ugm/gm Benzene ND 0.005 Toluene ND 0.005 Ethylbenzene ND 0.005 p-Xylene ND 0.005 m-Xylene ND 0.005 o-Xylen,~ ND 0.005 ' Isopropylbenzene ND 0.005 TPH (Diesel) ND i0. Method of Analysis for BTX/TPH (Gasoline): 3810/8020(FID) Method of Analysis for TPH (Diesel): 3540/8020(FID) MDL = MinimUm Detection Level TPH = Total Petroleum Hydrocarbons ugm/gm = micrograms per gram (ppm) ND = None Detected Stan Comer Analytical Chemist JAN-02-'Bi 10:21 ~ R I BAK TEL NO:O~ ~$~19 R02 ./ .,~ / RESULTS OF ANALYSIS 4407 ID: A-3 ugm/gm MDL,ugm/gm Benzene ND 0.005 Toluene ND 0.005 Ethylbenzene ND 0,005 p-Xylene ND' 0.005 m-Xylene' ND 0.005 o-Xylene ND 0,005 Isopropylbenzene ND 0.005 TPH (Diesel) 17 10. %'4408 ID: A~4 ugm/gm MDL,ugm/gm Benzene ND 0.005 Toluene ND 0.005 ~thylbenzene ND 0.005 p-Xylene~ ND 0.005 m-Xylene ND 0.005 o-Xylene ND 0.005 Isopropylbenzene ND 0.005 TPH (Diesel) ND 10. · 4409 ID: BJ1 ugm/gm MDL,ugm/gm Benzene ND 0.005 Toluene ND 0.005 Ethylbenzene ND 0.005 p-Xylene ND .' 0.005 m-Xylene ND 0.005 o-Xylene ND 0.005 Isopropylbenzene ND 0.005 TPH (Gasoline) ND ._ 1.0 Stan Comer ! .... Analytical.Chemist RESULTS OF ANALYSIS: % 4410 ID: B-2 ugm/gm MDL,ugm/gm Benzene ND 0. 005 Toluene ND 0. 005 Ethylbenzene ND 0. 005 p-Xylene ND 0. 005 m-Xylene ND 0. 005 o-Xylene ND 0. 005 Isopropylbenzene ND ~ 0. 005 ,. .TPH (Gasoline) ND 1.0 $ 4411 ID: C-1 ugm/gm MDL,ugm/gm Benzene 0. 015 0. 005 Toluene 0. 010 0. 005 - Ethylbenzene 0. 073 0. 005 p-.Xylene 0.14 0. 005 m-Xylene 0.15 0. 005 o-Xylene 0.041 0.005 Isopropylbenzene ND 0. 005/' TPH (Diesel) 2400 10 ' ~. 4412 ID: C-2 ugm/gm MDL,ugm/gm Benzene ND 0. 005 Toluene ND 0. 005 Ethylbenzene 0. 006 0. 005 p-Xylene 0.012 0. 005 m-Xylene 0.011 0. 005 o-Xylene 0. 005 0. 005 Isopropylbenzene ND 0. 005 TPH (Diesel) 87 10 Stan Comer Analytical Chemist RESULTS OF ANALYSIS: 4413 ID: D-1 ugm/gm MDL,ugm/gm Benzene 25 0~005 Toluene 77 0.005 Ethylbenzene 29 0.005 p~Xylene 41 0.005 m-Xylene 90 0.005 o-Xylene 59 0.005 .Isopropylbenzene 7.7 0.005 TPH (Gasoline) 1400 ~ 1.0 4414 ID~ D-2 ugm/gm MDL,ugm/gm Benzene 0.021 0.005 Toluene 0.070 0.005 Ethylbenzene 0.085 0.005 p-Xylene 0.11 0.005 m-Xylene 0.47 0.0.05, 'o-Xylene 0.36 0.005 Isopropylbenzene ND 0.065 TPH (Gasoline) 12 1.'~ Stan Comer Analytical Chemist GROUNDWATER RESOURCES INC. P.O'Box 93~"~ Bakersfle d, California, l.~- Telephone: (805) 835-7700 A'RESNA Company CHAIN,,, OF c, USTODy, RECORD Tele-Fax: (805) 835-7717 LAB DESTINATION: PROJECT NUMBER: / J'. ~2 6) - 'P-.-- . - SAMPLER(S): (Signature) Z.~ A I ] zri.- LAB sAMp"'L'~ (_~J oO z ANALYSIS SAMPLE CONTAINER NUMBER NUMBER DATE TIME SAM PLELOCATION O REQUESTED TYPE TYPE '-t~toL- J/"-~- :~ 3'~6 - - L SPECIAL INSTRUCTIONS: ' 1. Relinqu,shed by::.' ~×-~--~ ~'~/~c~.~'~-~.~.l~ Date/'13me:./Z~,.//~ ,?/.'~.~Received by:~ 1. Rehnqu,shed~~~?..~'~-~~ Date/Time?-..~/".~//~'/~5~.~'~ved b/~ ~-~_..~ Date/'13me:/~//~,~o I ~-..~ 7--- 1. Relinquished~.' J ' Date/Time: ~' .-' ' Date/Time: Received by: CCR (Rev 7/90) ~ WHITE: LABORATORY PINK: JOB FILE YFI I OW: SAMPLE TRIP l?,i~OFIower Slreel KERN COUNTY HEAl.IH Dt. PARTMENT HE^L'm0FFC~R ~l~ersfJeld, Cai Io~n a 93305 Leon M Ilobo~lsoo, M.D. Telephone (805)861-3636 .' ENVIRONMENIAL HEAL'Ill DIV,SION .,~,~~~~ DIRECTOR 0F ENVIRONMENTAL HEALTH ~~ VemonS. Re,cha~d . Facility Nam~ ,~~, Kern County Pe~mlt * * UNDERGROUND TANK DISPOSITION TRACKINO RECORD * * This .fo~m Is to be ~eturned to the Kern County Health Department ~lthin -' days of acceptance of tank(s) by disposal or recycling facility. The . holde~ of the permI~ ~Ith numbe~ noted above Is responsible fo~.lnsurlng. tlmt this form Js completed and returned. .-. 3ec'tJon 1 - T~ be~ filled out ~ tank removal contractor: ,..: Tank Removal Contractor: o~ ~~ b~,>~ ~: ~ , .. - Address ~ ~/~g/~. Phone ~ ~- Date Tanks Removed // /~ ~/¢~ No. of Tanks '/ . /.' , .., · ,. · , ,_ · .., ~ ~ · ~ .... .__. ................ · .... Sectioa 2 - To be filled out ~"-~o~tbackor "~ecoiitamlnatlnK tank(s)/ Tank "Decontamination" Contractor ,' .... Add~ess Phone ~ Zip Authorized repcesenta~lve of contractor certifies by signing below that tank(s) have been decontaminated Jn accordauce with Rem County Department requirements. ~ · Sectlon ~ - To be filled out and ~e~ ~ a~2 authorized representative o~ .,the treatment, stora~, or dlspo,sal faclllt~ 3cceptlnff ,tank{s): Date Tanks Recetved~ //- ~ --~O No. of Tanks {~uthorlzed Representative ) * * * M~IhI~O IRSTR~CTIO~S: Fold In half and staple. (Form DISTRICT OFFICES 5400.ALDRIN CT. groundwater resources inc. BAKERSFIELD, CALIFORNIA 93313 General Engineering Contractor Class A/Haz License No. $20768 Hr. ~esley Nicks Resource Nanagemen~ Agency Depar~men~ of Environmental Heal ~h Servi ces 2700 "H" S[ree~, Suite 300 Bakersfie]d, CA 93301 Re: Cai-Ply Removal Permi~ Dear Hr. Nicks, Please find enclosed a correc[ed "P]o[ Plan" ¢9~ ~he Ca]-P]y removal permit. / I¢ you should have any additiona~ questions, p~ea~e do n~t hesitate te ca~ our o¢¢ice at 835-7700. ie Irwin Encl. MAILING ADDRESS: P.O. BOX 9383, BAKERSFIELD CA 93389 (805) 835-7700 LOS ANGELES (213) 724-3147 ,700~lowe, S,,ee, KERN COUNTY HEALTH Di. PARTMENT HEALTH OFFICER Bakersfield, Cell,ornle 93305 · ' , Leon M Hebettson, M.D. . Telephone (80~) 861-3636 . ENVIRONMENIAL HEALTH DIRECTOR OF ENVIRONMENTAL HEALTH · ~ Vernon S. Relchard Facility Nam~ Kern County Per~tt ~ '* * UNDERGROUND~TANK DISPOSITION TRACKING R~CORD * * -- This form ts to be returned to the Kern county lieaith Department ~lthln'14 days of acceptance of tank(s) bY disposal or recycling ,.factllty..~mTh~ · ' bolder of the permit with number noted above Is responsible Secklon 2 - T~ b~ filled ou~ ~ contractor "deconEamlnattng tank(s~: Tgn~ "~econta~inatlon" Contractor _ Zip Authorized repPesen~a~lve of con~rac~or .certifies by signing belo~v tiler tank(s) have been decontaminated tn accordance with gem County Ilealth Oepart~en[ requirements. _ .... Section ~ -T~ ~ ~llled out and ~ ~ ~.a~ authorized representative o~ the treatment, storage, or dlsposal faClllt~ nccepttn~ tank(s]: Oa~e .Tanks Eecelved~ ~ -- ~ --~ No. oE Tonka (Authorized Representative) (Form #11t, lMP- 150 ) DISTRICT OFFICES RESOURCE MANAGEMENT AGENCY Environmental, Health Services Department RANDALL L. ABBOTT STEVE McC^~_~ ~:V, REHS, Dm£CTOR DIRECTOR Ai~ Pollution Co"trol Distdct DAVID PRICE III WmLU~ J. ~ODD¥, AP¢O ASSISTANT DIRECTOR Planning & Development Services Department TED JAMES, AJCP, DIRECTOR ENVIRONMENTAL HEALTH SERVICES DEPARTMENT PERMIT FOR PERMANENT CLOSURE PERMIT NUMBER A 1354-31 OF UNDERGROUND .HAZARDOUS SUBSTANCES STORAGE FACILITY .~ FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: CAL PLY .Joe Zucchcro Groundwater Resources Inc. 5601 Aldrin Ct. 7330 S. Cider 5400 Aldrin Ct. Bakersfield, CA Pico Rivera, CA 90660 Bakersfield, CA 93313 License,'~520768 Phone: (213) 949-5421 ~ Phone:"(805) 835-7700 PERMIT FOR CLOSURE OF' PERMIT EXPIRES February 19, 1991 2 TANK(S) AT ABOVE APPROVAL DATE November 19, 1990 "i LOCATION APPROVED BY Hazarti6fis Materials Specialist- ............................................................................. '..POST ON PREMISES ........................................................ , ........... ;....· ....... CONDITIONS AS FOLi~OWS: 1. It is the responsibility of the Permittee to obtain permits which may be required by other regulatory agencies prior to beginning work (i.e., City Fire and Building Departments). 2. Permittee must notify the Hazardous Materials Management Program at (805) 861-3636 two working days prior to tank removal or abandonment in place to arrange for required inspections(s). 3. Tank closure activities must be per Kern County Environmental Health and Fire Department approved meth6ds as described in Handbook UT-30. i 4. It is the contractor's responsibility to know and adhere to all a'pplicable laws regarding the handling, transportation or treatment of hazardous materials. ' 5. Theexperiencetank remoValprior toC°ntract°rworking unsupervised.must have a qualified company employee on site supervising the tank removal. Thc employee, must have tank removal 6. If any contractors other ·than those listed on permit and permit application are to be utilized, prior approval must be granted by the specialist listed on the permit~ Deviation from the submitted application is not allowed. 7. Soil Sampling: a. Tank size less than or equal to 1,000 gallons -a minimum o! two samples must bc retrieved from beneath the center of the tank at depths of approximately two feet and six feet. b. Tank size greater than 1,000 to I0,000 gallons - a minimum of four samples must be retrieved one-third of the way in from thc ends of each tank at depths of approximately two feet and six feet. c. Tank size greater than I0,000 galldns - a minimum of six samples must be retrieved one-fourth of the way in from the ends of each tank and beneath the center of each tank at depths of approximately two feet and six feet. 8. Soil Sampling (piping area): A minimum of two samples must be retrieved at depths Of approximately two feet and six feet for every 15 linear feet of pipe run and under the dispenser area. 2700 "M" STREET, SUITE 300 BAKERSFIELD, .CAL'iFORNIA 93301 (805) 861-3636 · FAX: (805) 861-3429 PERMIT FOR PERMANENT CLOSURE PERMIT NUMBER A 1354-31 OF UNDERGROUND HAZARDOUS ADDENDUM SUBSTANCES STORAGE FACILITY 9. Soil Sample analysis: a. Ali soil samples retrieved from beneath gasolin~ (leaded/unleaded) tanks and appurtenances must be analyzed [or benzene, toluene, Xylene, and total petroleum hydrocarbons (for gasoline). b. Ali soil samples retrieved from beneath diesel tanks and appurtenances must be analyzed for total petroleum hydrocarbons (for diesel) and benzene. c. All soil samples retrieved from beneath waste oil tanks and appurtenances must be analyzed for total organic halides, lead, oil and grease. d. All soil samples retrieved from beneath crude oil tanks and appurtenances must be analyzed for oil and grease. e. .All soil samples retrieved from beneath tanks and appurtenances that contain unknown substances must be analyzed' for a full range 'of substances that may have been stored within the tank. 10. The followin~ timetable lists pre- and post-tank removal requirements: ACTIVITY DEADLINE Complet~ permit application submitted At least two weeks prior to closure to Hazardous Materials Management Program Notification lo inspectOr listed on permit o~ date Two, working days and time of closure and soil sampling Transportation and tracking forms sent to Hazardous No later Ihan 5 working days for t~ansportation and 14 working Materials Management Program. All hazardous waste days for the tracking form after tank removal manifests must be signed by tile receiver of the · hazardous waste Sample analysis to Hazardous Materials Management No later than 3 working days after completion of analysis Program 11. Purging/lnerting Conditions: a. Liquid shall be pumped from tank prior to purging such that less than 8 gallons of liquid re~ain in tank. (CSH&SC b. T~ank shall be purged through vent pipe discharging at least 10 feet above ground level. (CSH&SC 41700) c. No emission shall result in odors detectable at or beyond property line. (Rule 419) d. No emission shall endanger the health, safety, comfort or repose of any person. (CSH&SC 41700) e. Vent lines shall remain attached to tank until the inspector arrives to authorize removal. RECOMMENDATIONS/GUIDELINES FOR REMOVAL OF UNDERGROUND STORAGE TANKS This department is responsible for enforcing tile Kern Couhty Ordinance Code, Division 8 and state regulations pertaining to underground storage tanks. Representatives from this department respond to job sites during tank removal~ to ensure that the tanks are safe to remove/close and that the overall job performance is consistent with permit requirements, applicable laws and safety standards. The following guidelines are offered to clarify the interesls and expectations for this department. 1. Job site safety is one of our primary concerns. Excavations are inherently dangerous. It is the contractor's responsibility to know and abide by CAL-OSHA regulations. The job foreman is responsible [or the crew and any subcontractors on the job. As a general rule, workers are not permitted in improperly sloped excavations or when unsafe conditions exist in the hole. Tools and equipment are tO be~sed only for their designed function. For example, backhoe buckets are never substituted for ladders. 2. · Properly licensed contractors are assumed to understand the requirements of the permit issued. Tile job foreman is responsible for knowing and abiding by the conditions of the permit. Deviation from the permit conditions may result in a stop-work order. 3. Individual contractors will be held responsible for their post-removal paperwork. Tracking forms, hazardous waste manifests and analyses 'documentation are necessary for each site in order to close a case file or move it into mitigation. When contractors do not follow through on necessary paperwork, an unmanagea~ble backlog of incomplete casa results. 1[ this continues, processing time for complet'ing new closures will increase. f ' - OWNE~ OR AGENT -/' I~AT~ WGN:cas KE~N COUNTY RESOURCE MANAGEMENT ACENCY INTERNAL USE CNLY: ENVIRCNFENTAL HEALTH SERVICES DEPARTMENT APPLICATION DATE:./'.i/-/..?_-~:~ PTA:.~./_~__~"_~/__-_~. 2?00 "M' STREET, SUITE 300 BAKERSFIELD, CA 93301 1~ OF TANKS TO ABANCX]N:~__ (8os)861-3636 (FILL OUT..C~.E APPL]CATICN PER FACILITY) APPLICATICN FOR PERMIT FOR PERMANENT CLOSURE/ABANDONMENT OF UNDERGROUND HAZARDOUS SUBSTANCE STORAGE FACILITY THIs :APPLICATICN IS FOR ~[~J REMOVAL, 'OR [] A~3ANDCNMENT IN PLACE A: FAC]LIlY INFI3~ATICN ~EfiTga~IACT: Ter,ry Patterson [RDiEI: 398-0571 IT/I~SB~(E~LL~TlCt6): N/A ~ 8: 398-0571 ¢llY: Bakersfield 'lIP: CA ......... ' · ~ 8: 213/9~9-5421 ClI~: Pico Rivera lIP: 90660 T~ ~ C~T~CT~: GROUNDWATER RESOURCES I'NC. I/~: 5400 Aldrin Ct. I ~TIT~: CA F~I: 805/835-7700 iCIlY: Bakersfield 1/I~: 93313 ST~T R'I~I: SMC LABORATORIES Cl]~: Baker.~field IZIP: 93308 C: 013(IC~ IIFC~TlC# cHEMICAL (N]M;:CGTICN OF MATERIALS STORED: TANK 1, VOLUME CHEMICAL STORED DATES STORED CHEMICAL FO[;~4ERLY STORED 1 lo.ooo DTESEL UNK TO ' [ 10I~L }t/4]ER 0~ SAq~S l0 8E myZE~: 6' [ fi~S l0 I~'~YI~ ~[ BTX&E, TPU (DIESEL) ~]~]~ ~U~: TRIPLE RINSE ~]~[]~: 805/835-7700C~R~C[~: GROUNDWATER RESOURCES INC.I O]5°~L L~I~ ~ ~]NS~[: GIBSON REFINERY D]S~L ~ ~ [~(S): TRANSPORT TO AMR!IDI~ L~[]~ ~ [~($): AMR ONTARIO ~[~L ~ ~ ~]PI~: TRANSPORT TO AMR ~ D].5~6~L L0~[]~ ~ PIPIt: AMR ONTARIO THIS FORM HA~ BEEN CON~LEIED UNDER RENALTY OF PERJURY AND ~O THE BEST OF MY KNONLEDGE [$ TRU£ AND ~C~ECT. ' .:..... '..,. :-~.: '. : ~' :"."I · . - i' lc::~.~ ~.::~ ~.. ...... · ~, - KERN COUNTY ENVIRONMENTAL HEALTH Env. Health 580 4113 06~ (3/89) "~> 170OFIower Street KEHN COUNTY HEALTH DEPARTME . . Bakersfield, California 93305 I NTERI M PERMI 'r,.~ pER.Mx T~310054C TO OPERATE : ::: ~) I S SUED : NOVEMBER 1, 1986 E Xp I RE S : NOVEMBER 1, 1989 UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY NUMBER OF TANKS=, 2 NOTE: ALL INTERIM REQUIREMENTS 'ESTABLISHED BY THE PER~ilTTING ..... AUTHORITY MUST BE MET DURING THE .TERM OF THIS PERMIT ' NON--TRANSFERABLE * * * POST ON PREMISES DATE. pEPaXlIT MAII_~: DATE P~IT ~K BisT Division[-~g:~ Environmental }te~l'tJ~ Appl icat te ' ' 1700~F.!o~r Street, Bakersfiehl.'-- CA 93]{15 ~- ~~US SUBST~CES S~E FAC!LI~ T~ of Application (check): / . ~New Facility ~dification of Facility~isti~ FaCility· ~ansfer of ~ershtp a. ~ergency 24m~ur Contact (n~e, area c~e, ~one): ~ys ~j~d~ Facility Na~ cJ'~ckE~i/F ,. ~ of Business (check)~ ~line S~-tion ~o~er ('d%~ri~) Is Tank(s) ~cat~ on ~ Agricultural Fa~? ~Y~ ~ ' ' Is Tank(s) Us~ Primarily fo~ ~ricu!tural ~r~ses? ~Yes Facility Addrea ~G/ ~/~r/~ ~' Nearest Cro~ St. T R SEC (RUral ~attons ~ly) ~dress ~A~i '~ /~ [~ (/~ ~ Zip ~,~3 7.~ ~le~one ~.~,~/ . , O~rator ~ ~ .~ ~. Con.ct ~r~n ~dress ~ ~ ~ Zip Tele~one ~il ~aracterisCics' at Facili[y ~ '. ~sis for Soil ~ i~ Gro~ter ~p~ ~temi'na[ions -' C. Contractor ~ Contractor's Lice~e ~dr e~ Zip Te le~0~ Pro~s~ S~r[t~ ~te pro~s~ C~ple'tion Worker's C~~Ci~ C~[ti[tcation t Insurer D. If ~is ~mit Is. For ~ification 0f ~ ~isti~ ~cility, Briefly ~ri~ ~ifi~ti~ Pro~ , E. Tank(s) Store (~eck all t~C a~ly): .' Tank [ ~ste 9r~uct ~tor Vehicle Unleaded R~ular' Pr~ Diesel ~ste ' O O 'D F. Ch~i~l ~sition of ~terials Stor~ (~t ~ces~ry for ~tor vehicle f~ls') Tank % Chemi~l Stor~ (n~c~rcial ~e) ~ ~ (if kn~) Ch~ical. Pr~i~sl.. (if different) G2- Transfer of ~ershi~ ~te of ~fer Previous ~er Previous Facility N~ I, accept ~6ilY all ~blt%ations of ~mit . . I ~dersta~ that the ~itti~ ~ority may ~i~ a~ ~ify or temi~te ~e transfer of the ~it to ~rate ~is ~dergro~d stor~e facility u~n receivi~ ~ls c~pleted fo'~. ~is fora ~s ~en c~plet~ ~der ~lty of ~r'~ury a~ ~ ~e ~st of my ~owl~ge is true and cor'r~t. ' ~ : ./ .J .... . . ' .~acility Name ,~,f~~{ Permit No. ~.,'~' - TANK ~ ( (FILL OUT SEPARATE FO~ FOR ~'~ ~T~K) ~ ~CH ~E~ION, CHE~K ~ APPROPRIATE BOXES {. 1. Tank is: ~ vaulted ~n-Va~l t~ ~uble-Wal 1 ~le~al 1 2. ~ ~terial ar~n Steel ~S~inless Steel ~l~inyl C~o~ide ~Fi~rglass<l~ Steel i~rglass-Reinforc~ Plastic ~Concrete ~~in~ ~Bronze ther (de~ri~) 3. Priory .Contai~nt ~te Install~ ~ic~ess (Inches) Ca.city (Gallons) ~nuf~c~re~ 4. Tank SecOndary cont~i~ent " ~l~Wall ~thetic Liner ~Lin~ Vault ~ne ~Other (descri~): Manufacturer: ~terial Thic~es~ (Inc~s) Ca,city (Gals.} 5. Tank .Interior Llni~ ~Other (de~ri~): 6. 'Tank Corrosion Protect~'~h ' ~ ~ass-Cl~ ~l~yl.~ ~ap ~Vinyl ~a~i~ ~r or ~lt ~k~ ~No~ ~Other (de~ri~)._..' Cath~ic Protection: ~nm ~pres~ ~rrent S~t~ :~criflclai'~ ~t~ ~ri~ System ~ Egui~ent: 7. Leak Detection, ~nitorf~, .an~ IntercePtion - a. Ta~: ~Vis~l (vault~ tanks only) ~Gro~ter ~nitori~' ~ll(s) ~Vadose Zone ~nitori~ ~ll(s) ~U~ Wi~ut ~ner U-~ wi~ C~tible Liner Directt~ Flow ~ Monitori~ ~%l(s)* Va~r ~t~tor= ~Li id ~vel ~n~r' ~Cond~tivit~ ~ Pressure Sen~r ~n ~ular S~ce of ~ubie Wall Tank ~ Liquid ~tri~al & Ins~ction Fr~ U-T~-, Monitori~ ~11 or ~ar lly ~i~ & I~entory Reconciliation ~Perl~ic Tigh~e~ Testi~ ne~o~ ~her ' b. Pipit: ~Fl~Restricti~ ~ak ~tector(s) for eressuriz~ Pipit' ~nitori~ S~p with ~ce~y ~al~ ~crete ~ce~y '~lf~t C~tible .Pi~ ~ce~y ~S~t~tic Liar ~y ~ U~no~ ~ ~er ~ *~ri~ ~ & ~el: 8. ~en Tigh~ess ~st~? '~s '~ S~kno~ ~ '~ , ~te of ~st Tightne~ Test ~ . Result~ of Test Test ~e ~ - ~s:~ C.~ny ~L'~ ~~ 9. Tank ~; .... / $ Ta~ Re~ir~? "~Yes ~ ~kno~ ' ~te(s) of ~ir(s) ~ri~ Re, irs 10. ~erfill Protection ~rator Fills, Controls, & Visually Monitors ~vel "' ~Ta~ Fl~t Ga~e ~Fl~t Vent Valves ~o Shut- Off Controls citance ~r ~al~ Fill ~x ~o~ Other: '. List ~ & ~el For ~e ~ices / b. Unde~g~o~ ~tpt~ Corrosion ~ot~tt~ : , ~lvanized ~Fi~rglass~l~ ~ess~ ~rrent ~crificial ~e ~Polye~ylg~rap ~E.lectrical Isolati~ ~Vinyl Wrap ~Tar or ~lt ~Unkno~ ~one ~her (de~ri~): c. Undergrou~ P ipi~, Seco~ary .Conta ~ ~ent: ~l~Wall ~S~thetic Liner b~st ~m ~ne ~kn°~ ~Other (descri[~): TANK ~ (FILL OUT .qEPARATE FORM .,~H TANK) ~ ~.,~4~ FO--R EA---~'S'ECTION, CHECK ALL APPROPRIATE ~OXES 4. 1. Tank is:' [-]Vaulted. [-]Non-vaulted I-]Double-Wall [~ngle-Wall 2. ~ Material Steel bh Steel [] [~Polyvinyl [~]Fiberglass-Clad Steel Stainless Chloride iberglass-Reinforced Plastic [] Concrete [] Al~inum [] Bronze []Unknown ther (describe) 3. Pr~ima ry.. Containment Date Installed Thickness (Inches) Capacity (Gallons). Manufacturer . .. ,/¢" 4. .'rahk Sec°ndary Conta~r~ent i-IDeuble-Wall i-lsyntheti¢ Liner []Lined Vault I~ne I-Iunknown i--IOther (describe): Manufacturer:. i-lMaterial ThiCkn'ess (Inches) Capacity (Gals.) 5. Tank Interior Lining --l~ubb. r I-IAlkyd I-lU~ox¥ Ulmenolic I-IGlass I-Jcla¥ I-Iunlined I'lOther (describe): 6. Tank Corrosion Protectfon --~G~ ~ass-Clad OPolyetbylene Wrap'r[]Vinyl Wrapptrg l~i~ar or A~nalt l-lunkm~n []Non.. []Other (describ.): CathOdic prote¢l~ion:[~one []Impressed Current System l'lsabr~flclal ~ S~stem Describe System & Equi~ment: 7. Leak Detection, Monitoring, .and Interception' a. Tank: ~Visual (vaulted tanks only) UIGroundw~ter Manitori~ Well(s) - []Vadose Zone Monitoring ~ll(s) ~-Tube Without Liner ~U-Tub~ with~C~9, patible Liner Dire~ti_n~ Flow to Monitoring We.ll(s)* [] Vapor D,t~ct°r* [] Liquid Level Sensor [] Conductivit~ S~nsor" [] Pressure Sensor in Annular Space of Double Wall .Tank [] Liquid Bstrieval & Inspection Fr~m U-Tube, Monitoring. Well or AnnUlar SPace ' ~. ily .~uging & Inventory Reconciliation []periodic ,Ti~htness Testln~ [.~[None Unkno~ [] Other ' ' · b. Piping: [-IFlow-Restricting Leak Detector(s) for. Pressurized Piping' [---I Monitoring S~np with Raceway []Sealed Concrete Race~y i-IHalf-Cut C~mpatible Pipe Raceway ~Synthetic Liner Race,ay [~f6ne [] Unknown [] Other ! *Describe Make & Model~ 8. Tank Tightness ]~-~ls Tan~ Been Tightness Tested? ~Yes []No DUnknown Date of Last Tightness Tgst ;9~'- Rasults of Test ---~-~,~ Test Name D~_~,i~}~ ~;~-~e~.~; ~esting C~pany ~L~ //~7~.~~ 9. Tank Re~air I - .. - ~ / Tank e ired? ' • es ' mnown Date(s) of .. Describe Repairs 10. Overfill Protection []Operator Fills, Controls, & VisUally Monitors Level []Tape Float' Gauge [2]Float vent Valves [].Auto Shut- Off Controls Capacitance Sensor []Sealed Fill Box ~l~°ne []Unknown Other: List Make & Model For Above Devices Thickness (inches) .L~b~.,,~ Diameter L~.'~b~_ Manufacturer ~ [-]Pressure []Suct'ion-' []Gravity Approximate Length of Pipe b. Underground Piping Corrosion Protect io~ -- [2]Galvanized []Fiberglass-Clad [~Impressed Current ~-lSacri~ficial Anode [-]Polyethylene~Wrap [-]El.ectrical Isolation. [~Vinyl Wrap []Tar or Asphalt .. []Unknown ~one [-]Other (describe): ' c. Underground Piping, Secondary ContaJr~ent: []Double-Wall []Synthetic Liner. Sysl~m ~ne '[]Unknown [~Other (describe): ~ ~ PERNIT CHECKLIST ' This checklist is provided to.ensure that all necessary packet enclosures were received' and that the Permittee has obtained all necessary-equiPment to implement the first phase of · · monitoring requirements. Please complet~ this form and return' to KCHD in the self-addressed envelope provided within 3O days of receipt. Check: 'Yes. No , .×' A. The packet I received contained: - 1)-Cover Letter['-Perm'lt Checklist, Interim Permit/ Phase I' Interim Permit HonitorinE/Requirements,~Information Sheet (A~reement Between Owner and . Operator),VCha~ter 15 (KCOC s0-3941), Explanation of Substance Codes,~' 'Equipment Llsts~and Return Envelope.. . ' ' '~/~ 2) Standard Inventory Control Honitorinz Handbook tUT-10._ __ 3) The FollowinE Forms: a) Inventory RecordinE Sheet b) Inventory Reconciliation Sheet with summary on reverse c) Trend Analysis Worksheet ~/ ¢) An Action Chart (to post at fac~lity) B. I have examined the information on my Interim Permit, Phase .! MonitorinE Requirements, and Information Sheet (A~reement. between ,,Oumer and Operator), and find owner's name and address, facility name and add,ess, operator's name and address, substance codes, and number of tanks to be,~ccurately listed {if 'no~ is checked, note appropriate corrections on the back side of this sheet). C.I have the following required equipment (as described on paze 6 of Handbook): 1) AcBeptable Eauginz instrument 'v/ 2) "Striker plate(s)' in tank(s) ,r// 3) Water-finding paste ~// O. ~ have read the .information on ~he enclosed ~Information Sheet' pertaining to Azreements between Owner and Operator and hereby state that the owner of this facility is the operator .(if 'no' is checked, attach a copy of aETeement between owner and operator). E. I have enclosed a copy of Calibration Charts for all tanks at this facility (~f tanks are identical,\one chart will suffice; label chart(s) with correspondinE tank numbers lis~ed on permit). F. As required on paEe 6 of Handbook tUT-10, all =e~ers at this .facility have had calibration, checks within' the last 30 days and were calibrated by a registered device repairnan if out of tolerance (all meter calibrations must be recorded on "Meter Calibration Check Form' found in the Appendix of Handbook). ~. Standard Inventory Control Monitorinz was started at this facility in accordance with Procedures described in Handbook tUT-10. $iffnaCure off Person Co~plettn~ ~heckltst: ~ ' This ch list is provided to ensure that ail, necessary packet enclosures were received .and that the P~raittee has obtained all necessary.equipment to Iapleaent the first, p~ase of aonltoringrequirements. · Please complet~ this form and return to KCHD in the self-addressed 'envelope provided within 30 days of receipt. Check: .. Yes No ./~ A. The packet I received contained: - ' -- ~i) Cover Letter~ Permit Checklist, Interia Permit'~ Phase I lnteri' Per,it, " Nonitoring .Requirements.--Inf°r~ation Sheet (A~reemen~ Between O~ner and · . Operator),~' Chapter 15 .(KCOC ~G-3941), Explanation of Substance Codes,' Equipment Llsts~and Return'~nvelope_ ~i' ' ~' "' ~: 2) Standard Inventory cOntrol Nonitorin~ a~book tilT-10. " 3) The Following For, s: . " :~: '.- ' a) Inventory Recording Sheet b) Inventory Reconciliation Sheet with sus~ary on reverse c) Trend Analysis ~orksheet ~/ 4) An Action Chart (to post at facility') B. I have examined the information on my Interim Perait, Phase I Nonltoring Require~ents, and Inforsatlon Sheet (A~ree~ent between ~0~ner and Operator), and find o~ner's na~e and address, facility na~e and ad~ress,, operator's nasa and address, substance codes, and number of tanks to be, accurately listed (if 'no' -~-~s checked, note appropriate correct~ons on ~he backside of. t~is sheet). ' _~/ : have the followtnK required eqUipment (as,described on paze 6 of Handbook): '1) Acceptable Zauging instrument ~--~ 2) "Striker plate(S)'.ln tank(s) 3) Mater~ftndlng paste -, D. I have read the .information on the enclosed 'Inforuation Sheet' pertaining to Azreements between Owner and Operator and hereby state that the owner of this facility Is the operator (if 'no'.i.s. checked, attach a copy of azreement between o~ner and operator), ~ have enclosed a copy of Calibration Charts fo~ all tanks at this facility (if ~~tanks are identical, one chart will suffice; label chart(s) with corresponding tank numbers listed on permit) Q_. As required on page $ of ~andbook #UT-10, all ~'eters at this facili.t¥ have had calibration Checks within the last 30 days and-were calibrated by a registered device repairsan [f out of tolerance (a11' seter calibrations aust be recorded on. 'Neter Calibration Check For,' found In the Appendix of Handbook). O. Standard Inventory Control Nonttoring was started at this facility in aCcordance with procedures described i~ Handbook sUT-IO. . $1Knature off Person Complettn~ Checklist: Oatg:' COMPUTER CHANGE .~"~A. LIBRATION Record of Comber Change, Meter Change, or Callbratior CALIBRATION ......... AOJUSTE~ TO ~ODuCT . CHECKED ADJU~ rED fO TOTALIZER .' . READINGS I l o rALIZ[R } START O Y~S O~O ~v~S [ - CHECKED * ADJUSTED TO TOTALIZER FI'NISH READINGS "' J~NEY GALLONS TOIALIZER S~LED METER ST~T J O'" O .o O '" O"° · CHECKE~ ~ ADJUSTED TO TALtZE~ ~ FINISH . [ ~O{}UCT ~ GALLONS RETURNED TO STORAGE ~ ~ -- I ' Pump ¢ TOTAL ~ X [ ' - ~"'~ :"~ ~, ' /. ~ Note: t. All meters must have calibration checks a minimum of twice a ey_g~_, 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 product 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 tff~ can. Note gallons and cubic, inches drawn, and return Product to storage. 5. After all product for one calibraEion 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 5-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. Date/Time Hose or Tank #/{ Fast Fl°w Slow Flow Volume Returned Calibration Device Repairman Date of Pump # Product{' 5-Gallon Draft 5-Gallon Draft to Storage Required7 Used for' Callbratic [Gals{Cu. Inches ~.s]Cu. Inches Gallons Yes I~ Calibration { Owner °r Operator Si natur SUBMIT A COPY OF THIS FORM WlTI! ANNUAL REPORT. ooo ,oo, ,ooo ooo.- ooo :" · ~ ' 8 10 9 11 13 ,15 : 21 5 ~[~ 34 ' 60 ' :=57 86 112 10~ 126 148 163 ~8i 237 6 .... ~-~ ~' 7~ ~:~ 112 ]47 136 165 194 214. ~-i 311 8 67 120 ~16 :. , 204 225 208'" 253 ~97 ~27~: 476 9 79 142 :~ ~S~:;'~ 238 267 248 301 354 389 10 92 165 ~i~3-?' 400 311 289 3~1 413 454~FS~ 664 11 104 '~9 ~i8-2~,:( 273 3~8 332 404 47~ ~22 ~ 760 12 119 213 ~)/~' 310 · 406 377 4~8 '- )39 593 13 134 239 ~'~ ~' 348 455 424 515 606 667 b70 14' 148 265 ~58< 387 507 472 574 675 742 . 1080 17 194 345 ~l.'::: 511 669 625 759 894 983: i 1430 18 209 373 ~'~)~0: .' 555 725 679 825 970 1067 1552~ 19 224 401 ~.:-599 783 734 891 1048 llS3i;~ ::~: ~:'"8':~"<:= 1677 - 644 '~,241 2~ 254 457 ~59-t 689 901 846 1028 1209 1330 : :~- 22 270 ,, 485 ~'~'~'"'7 735 962 904 1098 1292 1421 2067 23 28~ 514 ~2~' 782 1023 963 1169 1376 1513 ~6%~ 2201 24 301 542 ~:553 , 830 1085 1023 1242 1461 1607 ~'~'~5 :':: 2338 2S . 317 STO ~8~i 878 1148 1083 1315 1547 1702 26 . 332 598 ~ 926 1211 1144 . 1389 1635 1798 ~2~::'~. 2616 27 347 626 d'~b ' 9~S ~27~ ~206 ~46~ ~23 ~896 {~3:.:: 2~5~ 2~ 363 6~4 ...... 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