HomeMy WebLinkAboutUST 5/2003 UNDERGROUND STORAGE TANK
I REMOVAL REPORT '
SBC FACILITY
' 5650 ALDRIN COURT
I BAKERSFIELD, CALIFORNIA
I Prepared for: '
I SBC
2600 Camino Ramon; Rm. 3E400GG
· San Ramon, CA 94583 . -
I Prepa'r~ed by:
I . Shaw Environmental, Inc.
' 4005 Port Chicago Highway '
i Concord, California 94520
I
Task Manager /
Project Manager/Quality Assurance
.Shaw Project ~o~ 8388'19.44
'l ,' ' May 2003 '. '.
I CNCD\5-14-03\O:SHARE\USTx03-0037.doc ' ,..
Table of Contents
List of Tables ............. ~ ........ :. ..... : .... ~ ....................... i ............ ,...'.'..,....~...'..:.. ....................................... ii
'List of Figures ..... i', ........................................... : ..... : .................. ~2 .................. 2.: .......... '..~..,...:~ ....... ii
!
List of Appendices ................. : .................................................................. : .................... : .............. ii
I 1.0 Introduction ................................ 2 ........................................... 2 ........................... ~.~ .................. 1
i 1.1 Site Description .......................................................... ~ ...................................... . .... : ..... . .... 1
1.2 Permits ................. : .......................................................................................................... 1
I 2.0 UST Removal Field Activities .......i ............................................... ~ ........................................ 1
2.1 Tank Removal ...................................................... ' .......... ] ................................................ 1
I 2.2 Sampling Activities ..... ~ ..................................................................... ' .......... ': ................... 3
2.3 Sample Analyses .................................... ' ...... k ........................................ ~..~ ...................... 3
.I 2.4 SamPle Analytical Results. .............. : ......... ~. ............................. · ..................... · .... :%. .... i ...... 3
3.0 Site Restoration .......................................................................... ' ................. : ....... ' .... : ............... 4
!
4.0 ConclUsions ................................................................ , ......... ~...: ....................... : ...................... 4
I4.1 Reporting Requirements. ......................... ' ........................................ ~ ..... ~ ......................... 5
I
I ' CNCD\O:S HARE\UST~03-0037.doc i
List of Tables.
Table Title
' 1 Soil Sample Analytical Results
List of Figures
Figure · Title ·
1 Site Vicinity Map
2 Site Plan
3 ' Site Map with Soil Sample Analytical Results (March 26, 2003)
List of Appendices,
Appendix Title
A Tank Removal Permit and State Forms
B Hazardous Waste Mani~'est for Rinsate Disposal
C Hazardous Waste Tank Closure Certification
D Hazardous Waste Manifests and Certificate of Destruction for the USTs
E Laboratory Reports and Chain of Custody Forms
CNCD\5-14-03\O:SHARE\USTX03 -0037.do~ ii
1.O Introduction.
On behalf of sBc (formerly Pacific Bell), Shaw Environmental, Inc. (Shaw) was contracted'to
provide environmental consulting services during the removal of a
6,000-gallon diesel undergrOund storage tank (USTs) at the SBC facili!y, located at 5650'Aldrin
Court in Bakersfield, California (Figure 1). SBC's construction management contractor,
Kleeman Roebbelen, subcontracted MJK Construction (MJK) to provide and operate equipment.
to perform the UST removal.' R.H.L. Design GrOup, Inc. (R.H.L.) Was subcontracted by SBC's
alliance architect, to provide engineering and permitting services. UST removal work discussed
in this report' was completed in compliance with local and state regulatory requirements in March
2003.
I. ~ Site Description
The SBC property is located in a predominantly commercial and undeveloped pa/t of Bakersfield
California. A one-story building housing offices and storage occupies the southern portion of the
site. To the north of the office building is a SBC maintenance garage. The remainder of the site
is paved and used for parking of SBC fleet and personal vehicles (Figure 2).
To the east of the maintenance garage was a 12,000-gallon UST containing gasoline and a 6,000-
gallon diesel UST, both used to fuel SBC fleet vehicles. As SBC has decided to remove a
majority of their USTs that are Used for fueling of motor vehicles, the USTs were scheduled for
removal. In preparation for planned removal activities, the USTs were taken out of service by
Shaw in December 2002. ·
~.2 Permits ' '
Prior to initiation of excavation activities, R.H.L. obtained a permit for the tank removal from the
Bakersfield Fire Department (BFD). A copy of the BFD permit is included in Appendix A.
Prior to removal of the tanks, a representative of the BFD was scheduled to observe the tank
removal activities.
2.0 'UST Removal Field Activities
2. ~ Tank RemoVal
On December 18, 2002, as part of the temporary closure activities, the USTs were triple rinsed by
Phillips Servi~e Co .rporation personnel using a fresh'water/detergent mixture and a hot water
CNCD\5-14-03\O:SHARE\USTx03-0037!doc 1 ' '
pressure washer. The tanks contents (gasoline and diesel fuel) had been removed prior to rinsing
activities. FolloWing rinsing, visual inspection'of the tanks did not indicate any residual sludge
or liquid on the visible portions of the interior of the tanks.. Approximately 559 gallons of rinsate
was removed from the tanks 'using a vacuum truck. The rinsate was then transported for-
disposal, under manifest number22095559 to Burlingt0ri Environmental, Inc: in Kent, '
Washington. A copy ofthemanifest for the rinsate is included in Appendix B.
"
On March 25, 2003, at the request of SBC, the' USTs were triple rinsed, again by Asbury '
Environmental Services personnel using a fresh water/detergent mixture and a hot water pressure
washer. FolloWing rinsing, visual inspection of the tanks did' not indicate any residual-sludge or
liquid on the visible portions of the interior of the tank. Approximately. 300 gallons ofrinsate
was remOved from the tanks using a vacuum truck. The rinsate was then transported for disposal
under manifest number 21197826to Romic Chemical corpOration in East Palo'Alto, California.
A copy of the manifest for the rinsate is included in Appendix B. ' ·
Following rinsing activities, MJK personnel began excavation activities with the removal of the
pea gravel fill material around the tanks. The excavated fill was placed on plastic adjacent to the
excavation. Dry ice was then placed into the tanks (325 pounds into the gasoline US~ and 175
pounds into the diesel UST) in preparation for removal.
On March 26, 2003, the lower explosive limit (LEL) and oxygen concentrations were measured
to ensure the tanks were safe to remove. The 'LEL and oxygen concentration of the' gasoline UST
were measured at 3% each. The LEL and oxygen c°ncentr_atiOns in the diesel UST were
measured at 2% and 0.3%, respectively. Upon authorization from Mr. Steve Underwood of the
BFD, the tanks were removed from the excavation. Following removal, the tanks were inspected
for signs of deterioration, holes, or leakage. The tanks were observed to be in good Condition,
without any holes or cracks. The tanks and associated piPing were then transported by Ecology
Control Industry to their facility in Richmond, California for disposal under manifest numbers
22095863 and 22095897. A copy of the hazardous waste tank closure certification is included in
Appendix C. Copies of the manifests and certificates of destruction for the transport and
disposal of the tanks are presented in Appendix D.
CNCD\5-14-03\o:sHARE~USTx03-0037.doc 2 " ' '
Soils encountered within the exchvation consisted of dark brown "silty clay. . No soil discoioration
or petroleum hydrocarbon~ odors were observed during eXcavation activities. GroundWater was
not encountered within the excavation.
2,2 Sampling Activities ..
On March 26, 2003, Shaw collected soil samples from the tank excavation under the direction
and supervision of Mr. Steve Underwood of the BFD. Five soil 'samples, labeled TP-01 ~2,
TP-02-2, TP-03-2, TP-04-2, and TP-05-2, were collected from two feet below the base of the
excavation at a depth ofapproximateiy 15 feet below surface grade (bsg). Five other soil
samples, labeled TP-01-6, TP-02-6, TP-03-6, TP-0476, and TP-05-6, were collected
approximately 6 feet below the base of the excavation at a depth of approximately. 19 feet bsg.
The soil samples were collected by pushing a sample tube into the soil, cOllected using the bucket
of the backhoe, until full.
In order to evaluate soil re-use or disposal options, 8 discrete Soil samples, labeled CS-1 through
CS,8, were collected from the soil stockpile of the former tank excavations. The soil samples
were collected by pushing sample tubes into the stockpile atrandom locations until full.
'
After each soil sample was collected, the ends of the sample tubes were covered with Teresa tape
and capped. The soil samples were then appropriately iabel~d, placed in a cooler with ice; and
transported under chain-of-custody protocol to the analytical: laboratory...: · COpies of the chain of
'custody forms are included in Appendix E.
2.3 Sample Analyses ..
The soil samples were transported and submitted to McCampbell Analytical, Inc., an ELAPo
certified laboratory in Pacheco, California. The soil samples were analyzed for total.petroleum-
hydrocarbons as diesel (TPH-D) and TPH-gasoline under EPA.method 8015 (modified), and for
benzene, toluene, ethylbenzene, and xYlenes (BTEX) constituents) under EPA method 8020. The
samples were further analyzed for the fuel oxygenate methyl tertiary butyl ether (MTBE) using
EPA method 8260.
2.4 Sample Analytical Results~
TPH-D was detected in tank excavation sample TP-05,2 at a concentration of 1.8 parts per
million (ppm). Stockpile samples CS-l, CS-4, and CS-6 contained TpH-D at concentrations of
· CNCD\5-14-03\O:SHARESUSTx03-0037.doc 3
2.-2 ppm, 1.8 ppm, and 2.5 ppm} respectively. Benzene and tOlUene were detected in sample
TP-03-2 at concentrations of 0.011 ppm and 0~023 ppm,.respeCtively. .SamPle TP-04-2 contained
MTBE at a cOncentration of 0.23 ppm. No other analytes were encountered in any of the
remaining samples collecte& The analytical reSults are summarized in Table 1 and dePicted in
I Figure of the included in APpendix E.
3.
Copies
analytical
reports
are
I' 3.0 Site RestoratiOn .. "'
Following completion of the UST removal activities, MJK ba~kfilled the ~ank excavation using-
~' stockpiled soils and clean imported fill material. The backfill, material was then compacted. Site
restoration activities were conducted by MJK personnel independent Of Shaw oversight.
4.0 Conclusions
I Based On the field observations and laboratory analytical data present'ed in this report, Shaw
concludes the following:
II. ~ On December 18, 2002, the USTs were emptied and rinsed as of temporary
part
· closure activities.
. · On March 25, 2003, at the request of SBC, the USTs were rinsed .again as part of
I preparation for removal.
· On March 26, 2003, the 12,000-gallon gasoline and 6,000-gallon diesel USTs were
removed and transported off-site for disposal..'
· No soil staining or petroleum hydrocarbon odors were observed Within the tank
" excavation or fill material during tank' removal activities.
· TPH-D was detected in one of the tank excavation samPles at aconcentration of 1.8
ppm. Benzene and toluene were detected in a~nother excavation sample at'
concentrations of0.011 ppm and 0.23 ppm, and MTBE encountered in a third
sample at 0.23 ppm.
·Three stockpile samples contained TPH-D at concentrations up to 2.5 ppm. No
other analytes were detecte&
II soils and clean backfill material used to backfill the
Stockpiled
imPorted
were
excavation.
· No further action is warranted for this site.
CNCD\5-14-03\O:SHARE\UST~0343037.doc 4
4.1 Reporting Requirements
A copy of this report should be forwarded to the' following regulatory.agencY:
Mr. Steve Underwood ~..
', Bakersfield Fire Department ~ '
2101 H Street . .
Bakersfield, California 93301
! ' CNCD~5:14-03\O:SHARE\USTx03 -0037.doc 5
TA'B'IcES-
Table
CNCDX5- i 4~03\O:SHAREXUSTx03 -0037.doc
TABLE 1
Soil Sample Analytical Results
SBC Facility
5650 Aldrin Court
Bakersfield, California
· Sample SamPle Sample Date TPH-D TPH-G Benzene Toluene Ethyl Xylenes MTBE
I.D. Location Depth Collected, Benzene
* (bsg) (all results reported in parts per million) :
Tp-01-2 tank excavation 15 feet 03/26/03 NDl,o ND~.o NDo~oo5 NDo.oo5 'NDo.oo5 NDo.oo5 NDo.o5
TP-01-6 tank excavation 19 feet 03/26/03 ND~.o NDi.o NDo.oo~ NDo.oo~ NDo.oo5 NDo.oo~ NDo.o~
TP-02-2 -tank excavation 15 feet 03/26/03 NDi.o NDi.o NDo.oos NDo.oos NDo,oo5 NDo.oos NDo.os
TP-02-6 tank excavation 19 feet 03/26/03 ND~.o ND~.o NDo.oo5 NDo.oo~ NDo.oo~ NDo.oo5 NDo.o5
TP-03-2 tank excavation 15 feet 03/2U03 ND~.o ND~.o 0,011 0,023 NDo.oo5 NDo.oo5 NDo.o5
TP-03-6 tank. excavation 19 feet 03/26/03 ND~.o ND t.o NDo.oos NDo,oo5 NDo,oo~ ',, ~ NDo.o~s NDo'.o~
TP-04-2 tank excavation 15 feet 03/26/03 ND~.o NDe.0 NDo.oo5 NDo.oo5 'NDo.oo~ NDo.oo~ 0,23
TP-04-6 tank excavation 19. feet 03/26/03 NDi.o NDi.o NDo.oos NDo.oo~ NDo.oos ND0.oo5 ND0.o5
· TP_05.2 tank excavation 15 feet 03/26/03 1,8 ~. ND~.o NDo.oo~ NDo.oo~ NDo.oo~ NDo.~o5 NDo.o5
TP-0526 tank excavation 19 feet 03/26/03 NDi.o NDI.o NDo.oo5 NDo.oos NDo.o05 ~ NDo.oos NDo.os
~S-1 soil stockpile --- 03/26/03 2,2 NDI.o NDo.oos ~ NDo.oo5 NDo.o05 NDo.oo5 NDo.os
CS-2 soil stockpile --- 03/26/03 ND~.o 'ND~.o NDo.oo5 NDo.oo5 NDo.oo~ ND0.0o~ ' ND0.o~ '
CS-3 soil stockpile --- 03/26/03 ND~ o ND~.o NDo.oo5 NDo.oo5 NDo.oo5 NDo.oo5 NDo.os
CNCD\5-14-03\O:SHARE\US~03-0037.doc ..
TABLE 1 - Continued
Soil Sample Analytical' Results
SBC Facility
5650 Aldrin Court
Bakersfield, California
. Sample Sample Sample Date TPH-D TPH-G Benzene Toiuene Ethyl 'Xylenes MTBE
I.D. Location Depth Collected Benzene
(bsg) (all results reported in pans per million)
CS-4 soil stockpile --- 03/26/03 1.8 ND~.o NDo.oos NDo.oo5 'NDo.oos NDo.oos NDo.o~
CS-5 soil stockpile --- 03/26/03 NDI,o NDi.o NDo.oos NDo.oo5 NDo.oos NDo.oo5 NDo.os
CS-6 soil stockpile --- '03/26/03 2.5 ND~.o NDo.oo5 NDo.oo5 NDo.oo5 NDo.oo5 NDo.os
CS-7 soil stockpile --- 03/26/03 ND~.o NDi,o NDo.oo5 NDo,oo5 NDo.oo5 NDo.oo5 NDo.o5
CS-8 soil stockpile --- 03/26/03 ND~.o NDi.o NDo.oos NDo.oo5 NDo,oos NDo.oo5 . :NDo.os
". Note~: . ': '.
bsg-.below surface grade ....
TPH-D -'total petroleum hydrocarbons as diesel
· TPH-G :- total petroleum hydrocarbons as gasoline
MTBE - methyl tertiary butyl ether
NDx - not detected above "x" laboratoi'y detection limits :.
,. C,NCD\5-14-03\O:S HARE\UST~03-0037,doc
Figures
I
CNC D\5~ 14-03\O:S HARE\USTx03 -0037'd°c
I
~,',
SCALE
o ~ooo ~ooo~
SBC
~' SAN RAMON, CALIFORNIA
'~ Shaw E & I, Inc.
FIGURE 1
SITE VlClNI~ MAP
REFERENCE:
USGS 7.5' QUADRANGLE: GOSFORD, CA SBC FAClLI~
DATE: 1973 5650 ALDRIN COURT
, BAKERSFIELD, CALIFORNIA
WHITE' LANE '
~/ TEMPORARY SOIL STOCKPILE
FORMER 6,000-GALLON
~. ,, GARAGE , ~/(REM0VED MARCH 26,
r-~ 2oo3)
~ ~~ APPROXI~TE EXTENT OF ~VATION~~~ORMERis~NDS DISPENSER
FORMER 12,000-GALLON GASOMNE UST .
~ (~OV[~ M~C~ 2~, 2003)
/
/
SBC BUILDING. ASPHALT-PAVED ~
~ PARKING LOT
GATE ~ ~ , x x x x x x ~ x ~ GATE ~ ,,. x ~ x ~ GATE
ALDRIN COURT
. SAN ~MON, CALIFORNIA
FIGURE 2
": SITE P~N.
SCALE SBC FACILI~
I I 5650 'ALDR~ COURT
0 8~0 160 FEET BAKERSFIELD, C~LIFORNIA
'AS P HALT- PAVED 1"
.~ PARKING LOT
0S-4 - '
' TPH,D
TPH-G ' ND J
B ND ..I
T' ND' I
X ND I CS-6
IMTB~ TPH-D 2.5
CS-2 CS-3 : . . - . TPH-G ND
B ND
CS-1 I.... T ND
TPH-D 2.2 E. ND
TPH-G ND MTBE ND
r ND L . j (ND) .
GARAGE E .D~L~ ' TEMPORARY SOIL
X ND ~' cs-8 ·STOCKPILE
MTBE ND %-5 (ND)
FORMER 6,000-GALLON D ESEL UST I '- ' ND TP-03 (1' 5 F.E,~b-'T
(REMOVED MARCH 26, 2003) ~' . .'-~.' (ND)_~../ I'PH-Dmu ese).
I II ~ ' rPH-G ND
0.023
TP-02 (19 FEET BSG) I~ITSE ND
(ND) / / / I %k ~TP-04 (15 FEET as(2)
TP-01 (19 FED B$G)' / / / - ~ ' TPH-G ND
__p s'09 FEET BS (15 BS NDND
TBE. B NO ~' 0.23
'T ND TP-04 (19 FEET BSG)
E NB
X ND (ND)'
¢ITBE ND
FORMER 12,000=GALLON 'GASOLINE UST
(REMOVED MARCH 26, 2003)
SBC BUILDING
SCALE
LEGEND 0 ~'0 ' 60 FEET
T - TOLUENE
E - ETHYLBENZENE ~E&I,
X - XYLENES FIGURE 3
MTBE - METHYL TERTIARY BUTYL-ETHER SITE MAP- WITH SOIL SAMPLE
ND - NOT DETECTED ABOVE METHOD LIMITS ,
BSG- BELOW SURFACE GRADE ANALYTICAL RESULTS (MARCH 26, 2003
ALL SAMPLES ANALYZED FOR TPH--D, TPH-G, BTEX, AND MTBE .' SBC FACILITY
': 5650 ALDRIN COURT
ALL RESULTS REPORTED IN PARTS PER MILLION , BAKERSFIELD, 'CALIFORNIA
:!
ApP ·
Tank Removal Permit and State FOrms
CNCD\O:SHARE\USTX03 -0037.doc · '
MRY 06 2003 11:21 BKSFLD FIRE PREVEMTIOM (661)852-217,2 p.2
11 2003 2:35PH RHI_ DE$£GN GROUP ., .707'7~5 $$08 p.~
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171~ Che~t~ Ave., Bske~fle~ CA (~1)32~3979 *' *
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BUS,ESS ~ l. GAS STA~ON ~ 3. FA~ ~ S. COMMERC~L ~o~ ~'2. ~D~lDU~ ~ 5. STATE AGENCY*
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TOT~ ~BER OF TAN~ 4~, Is faciliW on ~di~ ~s~ation ~o~ * g o~r of U~ is a pubic agency: ~ of s~or o~ ~ion.
0 ~ Yes ~ No
PRoPER~ ~ERN~E . . . aa~. PHONE . ·
SBC ~vko~ml M~g~ment
' M~G OR S~ET ~D~SS
C~Y . 4~o. STATE ~1~ ~ CODE
:San ~mon Ca ~ 94583
PROPER~ O~ER ~E ~ I. CO.OPTION ~ 2. ~WIDUAL ~ 4. ~CAL AGENCY / DIS~ICT ~ 6. STA~ AG~CY
~ 3' PAR~E~ ~ 5. CO~TY AGENCY' ; ~ 7. ~D~L AGENCY
'['~K O~ER NAME '"' I PHONE
SBC Envgo~enml M~agement ] 925-~1-71 ~
MA~G OR ST~ET
2600 C~no K~o~ ~. 3~00K
C~ ~t*.[ STA~ sra. }Z[P CODE
S~ Ra~nn I Ca [ 94583
~ l. CO~O~ON ~ 2. '~DWIDU~ ~ 4. ~CAL AG~CY~ISTmCT ~ 6. STATE AO~CY
~ 3. PAR~E~H~ ~ 5. CO~ AGENCY ~ 7. FEDE~ A~CY
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SIGNATU~ OF APPLICANT DATE nzn. PHONE
N~ OF ~PLICANT ~fint) T~ OF ~FLICANT
.
UST FACIL~ ~BER (~v ua~ only} ~& l~8 ~G~DE CERT~ICA~ N~B~ (~
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~JPCF Hwfwrc-a (1/~)) -. ld2 lattp://www.unidoes.org "' '. . Rev, O1/16/00
" 05/06/03 TUE 10:28 [T~/RX NO 9810] ~]003
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UNIFI'ED PROGR~uM CO~O~A~D ~
ERGRO .STORAGE T KS - FACILITY
(~ pag~ p~ ~itc) Page ~1 of I
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Check one ~m only) ~ 4. ~ED PE~[T (~ec~ c~ge) . ~ 8. T~ ~OV~
~ST CROSS S~ET ao~ FACILITY O~fiR IYPE ~ 4. ~UAL AOENCY/DIST~CT' ~-
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BUS,ESS ~ 1. G~S STATION ~ 3. FA~ ~ 5. COMMERC~L ~o] ~ 2. ~DIV~H~ ~ 6_ STATE AGENCY*
TOT~ NUMBER OF TAN~ ~. Is facility on Indj~ Re~rvation a05. * If' ow~er uf U~ i~ a public agency: m~ of s~s~,r of div~iun, ~c~m or ~06.
~MA~G AT SITE or trot lands? office which ~s ~e ~T. (This is ~e ~ pe~n ~r ~e ~ ~o~)
0 ~ Y~s ~ No
PROPER'~ O~R N~ ~7. [ PHONE 4~.
SBC Env~o~enml M~gement ] 925-901-7104
MA~G OR ST~ET ~D~SS
2600 Ca~no ~on, ~. 3E000K
C~Y 4~0. STATE 411. .Z~CODE
S~ ~mon Ca 94583
P~OPE~O~VE ~ 1 CO.OPTION DZ~Dm~U~ DA.mCA~AG~CY/DIS~CT D 6. SZA~AG~CY ~.
~ 3. P~E~HW ~ S. CO~ AGENCY D ~. VgDE~ AGENCY
MA[L~G OR ST~ ADD~S a~.
2600 C~o Ramo~ ~. 3E00GK
CI~"S~ ~mon ~7. [ caSTA~ ~.] ZIP CODE94583
T.~ O~R ~PE ~ 1. CO.OPTION ~ 2. ~DIVIDUA C ~ 4. LOCAL AGENCY/Dm~CT ~ 6. STA~ AGENCY
~ 3. P~E~H~ ~ 5. CO~TY AGENCY ~ 7. ~DE~L AG~CY
': "v:B6~ OF EQU~A~ON USX STORAGE':F~ AeCO~'~3:
HQ ~- Call (916) 322-9669 if q~sfions ~ise
INDICAIE METHOD(s) ~ l. SEL.F-~SU~D ~ 4. SU~ BOND ~ 7. ~A~ F~ ~ 10. ~C.~ GOVW MEC~I~ 122
~ 2 GU~EE ~ 5. LETT~ OF C~DIT ~ fl. STA~ F~ & CFO LETT~ ~ 99. O~R:
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SIGNATU~ OF ~PLIC~T DA~ 4~. I PHO~
N~E OF APPLIC~T ~nt) ~6 ~E OF ~PLICA~ ' 427.
'STATE US T ]~ACILITY NUMBER_ (^gea~' me only) 428. 1998 UPGRADE CERTIFICATE NIJMBER (."qt~acy a~ only) 42~.
(See Data Element 1, above. ·
I}TCF Hwfwrc-ni (1/99) - I/2 http://www.unidocs.org .. Rev. {~2)16/00
!, -05/06/63 .TUE 10:28 [TX/RX NO 98101 ~006
lAY OG 2003 11:24 BKSFLD FIRE PREVEHTIOH {-G$1]852-2172
~UNIFIED PROGRAM CONSOLIDATED I~RM
· TANKS
UNDERGROUND STORAGE TANKS - TANK PAGE 1
. (Tv0o pages per tank)
· Pagers_' l of 2
TYPE OF ACT}ON [] I. NEW PERMIT [] ,~. AM_ENDED PER-MIT [] 5. CIZ~ANGE OF INI:ORMATION 1'-] 6. TEMPOIL~R,Y TANK CLOSLH~
~eckonehcmoa~y} Fl 3. RE'CgWAL PER. MqT [] 7. PEP,.MANENTLY CLOSED ON SITE
' · ' {Sl~:aify rr.~oa) (Spec/fy tva.mn) [~ 8. TANK REMOVED
*~. TANK MANUFACTURER ~. COMPARTMENTAL~ED TANK ~
2052 Modern Wgld~ ~ ~
DATE ~STALLED *3s. TANK CAPACI~ ~ GAL~NS ~6. N~BER OF ~MPAR~TS
437.
12,0o0 1
(~fchec~ c~ ~u~l~) ~ Ih. P~M~ ~E~ED ~ 3. D~S~ ~ 6. AVIATION O~ '
~ 2. NON-~EL~TROL~ ~ lc. M~G~DE~LE~ED ~4: G~OHOL ~ 99.'O~:
~ 3. C~ICAL PRODUCT COMMON N~ (~om ~rm~ ln~too ~e) 441, C~g (~om H~o~ ~a ]nv~ ~)
~ 4 ~ZARDOUS WAS~
95. ~O~
~E OF T~ ~ 1. S~GLE W~L ~ 3. S~GLE WALL ~TH ~OR ~ 5. S~GLE WALL ~TH ~AL BL~DER SYST~
~2. DO~LEWA~ ~a. S~GLEWALL~AVA~T ~99. ~
TA~ MAT~AL-~ ~ l. B~ S~EL ~ 3. ~GLASS/PL~S~C ~ 5. CONC~ ~ 95, ~O~
C~ one it~ou~x) ~ 2. ST~LESS ~EEL ~ 4. ~EL CL,~ Wff~ERGLASS ~ 8. F~ COMPAT~ ~ 99. O~R:
~FORCED PLASTIC (F~) W/l 0~A ME~OL
T~MAT~-~o~ ~ 1. BA~STEEL ~3. ~ERG~SS/PLASTIC ~8. F~COMP~LEW/IOO%MET~NOL ~ 95. L~O~
y) ~ 2. STAINLESS STEEL ~ 4. S~EL CL~ W~IBERGLASS ~ 9, ~ NON-CO~OD~ JACY~T ~ 99. O~R
~FORCED PLASTIC (~) ~ t0. ~ATED
~ 5. CONC~TE
T~ ~T~IOR L~G ~ 1. R~BE~ ~NED ~ 3, ~O~ L~G ~ 5 GLASS ~G ~ 95, ~O~ 446 DA~ ~ST~LED
OR CO~T~G ~ 2. ~KYD L~G ~ 4. P~NOLIC ~G" ~ 6. ~L~ED ~ 99. O~R nas. 1996
~R CO~OSION ~ 1. M.~ACTU~ CATHODIC ~ 3. ~ERG~S5 ~ORCED PLAS~C ~ 95, ~O~ DATE ~T~LED ~g.
PKOT~'TION PROTE~ION ~ 4, ~D C~ ~ 99. O~ 1996,
~ 2. SAC~CIAL ANODE
SPILL AND OX~I~ YEAR ~STALLED 45O TYPE aSL O~ILL PROTECTION ~ME~: YE~ ~S~ALLED 452.
(C~all~t~ly) ~ I. $PlLLCO~A~T 1996 ~ I. AL~ 1996 ~ LFILLT~ES~TOFFvA~VE I~6
~ 2. DROP ~E 1996 ~ 2. B~L ~OAT 1996 ~ 4. EXERT
~ 3. ST~R PLATE 1996
IF SINGLE W~L TANK 4~t. ~ DO~ WALL TANK OR TA~ ~TH B~BER
(C~k ail ~t ~ly) (Ch~k oay i~ o~)
~ 1, VlSUAL(E~SEDPORTION O~Y) ~ S.M~.T~OAUO~G (MTG) ~ 1..VISU~(S~o~W~L ~VAULTO~~
~ 2. AUTOMATIC T~K GAUG~G (ATG) ~ 6. V~OSE ~NE ~ 2. CO~OUS ~~
~ 3. CON~UOUS ATG ~ 7. GRO~WA~R ~ 3. M~AL MO~TO~O
~ 4. S'FA~IC~ ~ORY ~CONCILIATION ~ & T~
UPCF hwfwrc~ (1~) ~. 1/4 hUp://m.unidot~o~ ' R~. 0~/16~
05/06/03 TUE I0:28 [TX/RX.N0 9810] ~00~.
/
'hAY 05 ,~'003 11:~'5 'BKSFL[I FI~E P~EVENTION ('661)85~'-21?~'
i UNDERGROUND STORAGE TANKS - TANK PAGE 2
· ~]: . . ?ala: 2 of. 2
?1~. ~ .... --:,.~4~1~(; :CO~S:rR~ .~lONii~:~l~'~,i~l~' ",. ::: ,:.' '-',:,':~i. ' "-."-:i:.x~x 'i. ":'"':;'::::~:~=-..:=.!-'>'-:~ :"'-- .:i.. Z ?." ??~.:":'!5~:
I I1: UNDERGROUND PIPING ABOVEGROUIqD PIPING
'iCOP4STRUCTION/r.. [] 1. SINGLE wALL [] 3_ LINED TRENCH ' [] 99. OTHER 460. f-I I..gINOL~ WALL [] 95. UlqY, NOWN 462.
_ _lrnANLrFAC'FUR~R [] 2. DOUBLE WALL [] 9.5. LFNKHO~ ' [] 2. DOUBLE WALL .. [] ~9. OTH~R
II o ,. X'~ ~L [] 6. I:rRP COMPATIBLE W/,00% ME'THANOL [] I. BAR~ STEEL [-1 fi.
~-I 2. STAINLESS SI'EEL [] 7. GALVANIZED STEEL [] 2, STAINLESS STEEL ' [] 7. OALVA-'NIZED STEEL
[] 3. PLASTIC COMPATIBLE WITH CONTENTS ' [~ 95. UNKNOWN [] 3. PLASTIC COMPATIBLE W/CONTENTS I'-1 8. PLEXIBLE (HI~B) [] ~9. OTHER
II [] 4. F~BER~L.~gS I--I ,. FLEXIi~LE (HDPE, [] 99. OTFIER [] 4. FIBERGLASS ["'19. CATHODIC PROTECTION
[] 5. STEEL W/coATING [] 9. CATHODIC PROTECTION 464. [] 5. STEEL W/COATI]qG [] 95. ~OWN 465.
"~';!~',"~::'7i!'"'T.7:" '. ".~i'.ii".~';;~:':~'~{~!;~ii~!'.i~H~?~PINGLEA I{,~DET,.E~i.O~_~(g~' ..... · =-"=:~ ::~1~ ~}~ia:~.~l.~.~ ~[~!~LI~ ~.l~;L. iit.:.~i:~:i?.i~:ai;a:,i;:.:~:;~;i~i~ i~ii~i~!:~ii< ~;:',~,::~::,.' ..... ~., ~ :,:: z~ .:~ ,~-.-: · .......... :::--~, ::.: '::-:;:.:':~' :;. ':~., .-?'.':~:x'~x~ ..= =:x:;=:_:~:;r-.?- :::::~: ~; -~"~::~":~::: :t:!? -.::::'
UNDERGROUND PIPING ABOVEGRO~
1 5INGLE WALL PIPING ~. SINGLE WALL PIPING
PRF~SUR1ZED PIP[I~G (Check. all that apply): PRE..~Z~'D PIPING (Che~k all tirol apply):
"] 1. ELECTRONIC LINE LEAK DETECTOR. 3.0 GPI-f TEar ~FITH AUTO PUM[P [] I'. ELF~CTRON1CLINI~LEAKDI~TECTOR].OOPNTE~TW,ITI'[AUTO~
SHUT=OFF FOR LEAK. SYSTEIV[ FAIL~, AND SYSTEiM DISCOI',JNECTION ~ Ola'F leer LE.~(, SYST~ FA[LI..IRtl, AI'TD SY,.%'TliM
1 + AUDIBLE Al-ID VISUAL. ALA3LMS. + AUDIBLE AND VISUAL ALARI~IS.
"l 2. MOIWI'HLY 0.90PH ~ [] 2. MONTHLY 0.2 GPI-1TH~'T
~l 3. ANNUALINTE~R~TY TEs'rf0A ~PI-I) [] 3.. ANNUA~ n¢i'EaR~TY TF-~r (o.t ~e~'0 ' '
[] 4. DAILY VISUAL C[-I~C'K
I I, :ONV~TION~L SUCTION ,YSTEi~iS CON VENTIONAL SUCTION S~STEM5 (C'aeck al1 ttmt apply)
[ [] $. DAILY VISUAL MONITORING OF PUMPING S¥ST~ + TRIENI~IAL PIPING
II~I'EGRITY TEST (0. I OPH) [] $' DAILY VI.$UAL MoNrrORING OF PIPING AND PUMPIHG SYSTEM
8AF~ SUCTION 8¥~?EMS (NO VALVES IN BELOW GROUND PIPING): [] 6. TRIENNIALilqTEORITY TF~T (0.10PH)
11~[] 7. SELFMONITOR[NG SAFRSUCTION SYSTEMSCNOVALVES[NBELOWGROUNDPIP[NG):
]~RAVITY lq.,OW [] 7. SELF MONITORING
[] 9. BIENNIAL INTEGRITY TEEI' (0. I GPH) GRAVITY FLOW (Chgck all that apply):
[] $. DALLY VISUAL MONITOR.lNG
[] 9. BIENNIAL INTEGRITY TEST (0.1 OPH)
RCONDARIL¥ C NTAINED P [PING 51e. CONDARIL¥ CONTAINED PIPING
PRRSSURIZ~D PIPING (Check all that apply): PR~SSUR[ZEi) PIPING (Check. all that apply):
'',,'0. CONTINUOUS TURBINE SUMP SENSOR Wr. Tt~ AUDIBLE AND VISUAL I0. CONTINUOUS TURBINE SUMP SENSOR wry}{ AUDIBLE AND VIS~IAL
l[
ALARMfl AND (Check one) ALARMS AND (Check one)
i [] a. ALrrO FLIMP SHUT OFF WHeN A LEAK OCCURS [] s. AUTO PUMP SHUT OFF WHEN A LEAK OCCLIR~q
[] b. AD'TO PUMP 5HUT OFF FOR LEAKS, SYSTEM FA[LURE AND h-~(STEM [] b. AUTO PUMP.SHIJ'I' OFF ~OR LEAVe5. SYSTFAVI FAII~URE AND SYSTE,,M
II DISCONNECTION .DISCONNECTION
' l-lc. NO AUTO PUMP SHUT OFF i-'lc. NO ALITO PUMp sHUT oFF
[] 1 I. AUTOMATIC LINE LEA]{ DETECTOR (B.0 GPH TEST) WITH FLOW gl{UT [] 11. AUTOMATIC LEAK DETECTOR
OFF OR. R.~STR.1CT~ON
[] 12. ANNUAL INTEGRITY TES~ (0. l GPi-I) [] 12. ANNUAL I~'4TEORrIY TEST (o. 1
[ I ~UCTION/GRAVrfY SYSTEM SUCTIONtGRAV ITY sYST. M
[,~ t3. CONTINUOUS SOMP SENSOR + AUDIBLE ,~,ID VISUAL ALARMS [] 13. CONTINUOU~ SUMP ~BN~OI~. ? AUD[BLI~ AHD V]~0~L
IlMERGF.~NCY G~TOR~ ONLY (Check all that apply) EMERGENCY GKNERATOR8 ONLY (Check all that apply) '
[] 16. ANI'TL/.~~ T~ (0.1GPH) [] 16. ANNUAL INTF~3RITY TEST (0.1
] 1,~ 17. DALLY VISUAL CHECK. [] 17. DALLY VISUAL CHHCIC
DISPENSER CONT~ 4~g. [] 1. FLO/~T MECHANISM THAT SHUTS O'fflz SHEAR VALVE ['-I 4. DAILY VISUAL CHE~K.
DATE INSTA,LLED [~ 2. CONTINUOUS DISPENSER PAN SHNSOR-t- AUDIBLE'AND VISUAL ALARMS [] $. TP~NCH/LINER MON[TORrNG
111996 [-] 3. CONTINUOUS DL.gPENSER PAN SENSOR W1TH AUTO SHUT OFF FORD[SPENSER 4- AUDIBLE ~ VISUAL ALARMS ' f-] 6. NONE
'"-C/:::.:~!i:ii:/~ii~ii? !~_i,~i:;i;!i:ii!!!:.i~;!;{iiiiiiiii!i.::.!'i:i!:;-:!ii:?i? .- ' ' ::>.;i',i::iil;;i~-:.~o~o~si~~..~ :S~:':.%~:..,.';~:!.-~:. '....: :?;:.,:? :'. --..-! '" ::.' .':'. :..:7 '~::i~!~.:.:~ .':
[ certify that ll~ information provided bm-em is true and aocurate to li~ best of my knowledge.
I1 ~IONATURE OF O~OPERATOR DATE: 470,
/
NAME OF OWr]x~OP~RATOR ~rint): TITLE OF OWNER/OFER.AToR:
/ I 1 '""'1
UPCFhwfwrc-b(llg~)-314 . ht~p://www.unidocs.~rg -
' ~ -' · ' 05/06/03[ TUE'.10:28 '[TX/RXN0
.t~Ry 06 .2003 11: 21 BKSFLD .FIRE PREVEHTIO['t, .(661 ] 852-2172 -.p. 4
'. -' ' ""2UNIFIED PROGRAM coNsoLIDATED
'" ~ERGRO~ STOOGE TA~ - TA~ PAGE 1
. Pa~ __1 of 2
~PE OF A~[ON ~ 1. NEW PERMIT ~ 4. ~ED PE~ ~ 5. CH.~OE OF ~O~ATION ~ 6. ~O~Y T~ CLO5~
IChe~k one hcmonly)~ 3. ~N~AL PEKMI'[' ~ 7. PE~E~LY C~SED ON SITE
SBC Envkomen~ Ma~gement ~ ::::~
LOCATION W~ S[TE (~1 ~31.
T~N~ ID ~ 43~ T~K MA~ACT~R ' ' 4~. ~MP~ENTAL~D TANK ~ Yes ~ No
DATE ~SiA~ED nj=- T~ C~ACI~ ~ GALLONS naa. ~BER OF COMPAR~:
137.
1996 5,000
'1'~ USE 439. PE~OLEUM ~E
~ 2, NON-~LPETRO~ ~ lc. MI~DE ~LE~ED ~ 4. GASOHOL ~ 99. O~R:
~ 3. C~MIC~ PRODUCT COMMON N~ E (~m ~do~ M~al~ I,,v~,t~ ~) 441 CAS~ (~m ~m ~als ln~mc~e )
~ 4. ~OUSWASTE
({ml~ Used Off)
~ 95. u~No~
~E OF T~ ~ /. S~LB W ALL ~ 3. S~GLE W~L WITH EXTE~OR ~ ~. S~GLE WALL ~TH ~T~AL ~L~DER ~ST~I
(C~k one ~m only) M~B~ L~ER ~ 95. ~O~
~ 2. DOL~LE WALL ~ 4. S~GkE W~L ~ A vAULT ~ 99. OT~
(Ch~k ~e it~ only] ~ 2'. ST~SS STEEL ~ 4. STEEL CLAD W~IBERGLASS ~ g. F~ CORACLE. ~ 99.
~ORC~ P~STIC (F~) W/100% HEXOL
T~MA~RI~-Scco~ ~ 1. BA~STEEL ~3, ~GLASS/P~ST[C ~8. ~~WI100%~NOL ~95.~O~ 445
(C~kone~mon[y) ~2. STA~LESSSTEEL ~4. ~EELCL~W~ERGLASS ~9. ~NON-CO~ODABLEJAC~T ~.O~~
~ORC~ PLAS~C ~) ~ IO. COA/~ STOL
~ 5. CONC~
T~ m~EmOR ~G ~ 1. R~BER LYNED ~ 3. ~ L~G ~ 5. GLA~ ~G ~ 95. ~O~ ~6. DATE ~STAL~
OR ~AT~G . D 2. ALKYD LIN~G ~ 4. P~NOUC L~O ~ 6. ~. ~ ~. OT~ 1996
O~R ~O~ON ~ 1. M~A~ CATHODIC ~ 3. FIB~OLASS ~ORC~ P~S~[C ~ 95. ~O~ ~8. DATE ~ST~L~
PRO~TIDN PRO~E~ION . ~ 4. ~P~ss~ c~ B 99. o~R 1996
~ 2. SAC~V~C~L
SPILL,~DO~L YEAR~SI~L~ ;50. [ T~E ~L [ OVE~LPRO~TIONEQ~I~T: YES,STALLED
~ 2. DROP T~E 1996 · ~ 2. BA~ ~OAT 1~6 ~ 4. ~
~ ~. S~ P~TE 1996
W S~GLE W~L IANK qs3. IF.~ WALL T~K OR T~ ~ B~DER
~ck all tMt a~]y) (Ch~k ~e i~m only)
~ 1. VI~U~ (E~OS~ PORTION ONLY) ~ 5. M~AL T~ GAUG~G ~TG) ~ 1. VI~ {S~GLE WALL ~ VAST ONLY}
~ 2. AUTOMA~C T~ GAUG~G (ATG) ~ 6. VALSE ZONE ~ 2. CO~OUS ~TERSTmAL. MO~O~G
~ ~. CO~I~OU$ AIl ~ 7. GRO~DWATER ~ 3. M~AL MO~TO~G
~ q. ~A~SIICAL ~V~ORY ~CONC~IATION ~ 8. T~K IES~NG
(SIR) * BIE~ I~K TEST~G ~ 99. OT~R
'UPCF hw~rc-b (1~9)- 1)4 hRp;//m.unidocs, org .
' .' * 05/06Z03 TUE 10:28 [TX/RX NO ~810]. ~0'04
~D PROGRAM CONSOLIDA~D
~DERGROUND STOOGE TA~S - T~K PAGE~2.
· ~ P~ 2 o~ 2
CONSTRUCT[ON/ ~ 1. S~GLE WALL ~ 3. ~ED ~CH ~ 99. O~R ~0. 0 I, S~OLE W~L ~ 95. ~O~
O~R
~ I B~ ~EEL ~ 6. ~ COMPAT~LE W/I~ ~T~OL ~ 1. ~ ST~L D 6. ~ COMPAT~LE.W~10~ ME~NOL
P~S~C CO~AT~LE W~H CONTENTS ~ 95. ~O~ ~ 3. PLASTIC COMPA~LE W/~O~ D 8: ~BLE ~PE) ~ ~. OT~R
FIBERG~SS ~ 8. ~LE (HDPE) ~ 99. OT~R ~ 4. ~BERGLASS '~ 9. CA~OD1C PRO~ON
STEEL W.'COAT~G ~ 9. CATHODIC PROTEC~ON n64. ~ 5. S~L W./COAT~G ~ 95. ~O~
~ERGRO~D PiP~'G ABO~GRO~ P~G
S~GLE W~LL PIP~G ~- 8~GLE WALL P~ING ~-
'P~URiZR~ PIPING (C~R ~ ~t apply): PR~gfi~ ~IP~G (~eck all ~t
~ I. B~TRO~C ~ ~ DET~TOR 3.0 GPH ~S~.W~ A~O P~P ~ 1. EL~RONICL~LE~D~E~OR3.OGP~~AUTO~P
S~T-OFF FOR ~A~ ~S~M FAIL~. AND SY~ DI~O~TION S~ OFF FOR L~K, SY~EM FAIL~, ~D
~ 2. MO~Y O.2 GPH ~ST ~ 2. ~O~Y 0.2 GPH TEST
~,3. ~NNU~T~TYTEST(O.I GPH) ~3. ~UAL~EO~TEST(O.1 GP~
~ 4. D~Y VISU~ C~CK
CO~VENTIO~ SUCTION S~TEblS CONVE~ION~ SUC~ON SYSTE~ (Ch~k all ~t a~ly)
~ 5 DAILY V[SU~ MON~O~NG OF PUMPtNG ~YSTEM + T~E~AL P~G ~ 5. D~Y VI~ MO~G OF P~G ~ P~P~G
~ TE~ (O.I GPH)
~FE SUC~ON SYSTEMS ~O V~VES IN BELOW GRO~ ~G): ~ 6. T~E~ ~ TEST (O.I
~ 7 SELF MO~TO~G ~FE SUCTION SYS~MS ~O VALV~ ~ BELOW GRO~ ~P~):
G~VITY FLOW ~ 7. SELF MO~TO~G'
~ 9' B~IAL~EG~Y~SI'(0 ~ GPH) G~Vl~FLoW(~eckall~ata~}:
~ 8. D~LY VISUALMO~TO~O
SECON~Y'CONT~ED PIP~G SECONDAR~Y CONT~NED
PRESSURI~ PIPING (C~ck all that apply): P~S~O~ED pIPING (~ck all t~t apply):
10. CON~O~ ~ S~P SENSOR WITH A~ AND V~UAL 10. CO~OUS ~ S~ S~SOR ~ A~LE
~A~S ~ (Ch~k one) A~S ~ (Ch~k one)'
~ a. AUtO p~P S~T OFF W~N A LEAK OC~S ~ m A~O P~P S~ OFF W~ A LE~ ~C~S
~ b. A~ P~ S~ O~ FOR LE~S. SY~EM FA[~ ~ SYST~ ~ b.. A~ P~P S~ OFF FOR LE~ SYST~ F~ ~ SYSTEM
D1S~C~ON DISCO~CTION
~c. NO A~O P~ S~ OFF ~c. NO AUTO PLOP S~T OFF
I i. AU~MATIC L~ ~ DET~TOR (3.0 GPH T~) WIT~ FLOW S~T ~ 1 I. A~MATIC LEA~ ~ET~TOR · '
OFF OR ~ST~CTION
8U~ION/G~VITY 8Y~EM SUCYIO~/G~VITV SYSTEM
~ 13. CO~OUS S~ SENSOR + AUDIBLE ~D VI~AL AL~S ~ 13. CO~OUS S~P ~g + A~ ~'~$~ AL~S
~ERGEN~ GE~TO~ O~LY (C~ck all that app.) EMERG~CY GENE~ O~Y (Check ali ~l ~[y}
~ ln. CO~OUS S~ S~SOR ~OUT AUTO P~P ~T OFF ~ 14. C~OUS ~P S~SOR ~O~ A~ ~ ~ OFF
AU~ ~D ~U~ A~S AUDIBL~ ~D ~AL
~ 15. AU~MA~C ~ ~ DE~E~OR (3.0 GPH ~T) W[TH~ FLOW ~ 15. A~MATIC L~ L~ DETECTOR (3.0
S~'T O~ OR ~ION
~ 1% DALLY ~SUAL ~K ~ 17. DAVY VISU~ C~
DISPENS~RCONT~T n~. ' ~ 1. FLOATM~[~T~TS~SO~S~V~ ~ 4. DAILYV~ALC~
i996 ~3' CO~OUS DISP~SB~ P~ SENSOR WI~ A~O S~T O~ ,FOR ~6.
DIS~S~ + A~LE ,~D V~U~L
[I c~ify ~a ~e ~fo~fion ~o~dcd h~ein is true and accurate to ~ b~t of my ~o~cd~.
SIGNATURE OF O~OP~A~R ] DATE: 4~.
} w~ Or O~OPS~R (~t~: ~TLB OF O~OPE~TOR~ '
P~t N~r (Ag~y ~e ~ly) 473. [ P~t ~pm~d By (Agency ~e only) . ~74. P~t E~i~li~ ~ (Agcmy ~¢ o~y} a75.
uPcF h~wee-b (IDg)'- 374 hltp://~,unidoo.org . ~- ~v. O~6/00
~ ' 05/06/03 TUE 10:28' [TX/RX N0-9810] ~005
APpENDix
~::.. ;'....Appendix. B '- ~" ':
Hazardous Waste Manifests:for Rinsate Disposal. .
CNCD\O:S HARE\USTC03 -0037.doc
lifornio--Environmenl~l Protection Agency
I :~':~I"~M~'~'_-~'6~-~'~ I~oire, ~-30'-~) =ee Instructions on back at paganin195 Depm~ment of Toxic S ..... ~Contro['
~t o~ type.: F~rr~ ~ig~t~ for Ose ~h elite ~ 12-pitchf/yFmWrlter- Sacramento, (_ ! "~
1. Generator's US EPA ID No. Man[[e~f Documenl No.2. Page 1 In[ormation in ~e shadea
~ UNI[ORM HAZARDOUS ~ ,o~ ,~q,i,ed by ~e~ol
I WASTE MANIFEST CI/%'1 DI el 81Zl el 31 °l 41Zl zl 8 I 2 I 0 9 I ~' o~ z '
~ .~~~~ON & 6_ US EPA ID Number ~~~~RJ
':~ :'%':~='~':m'~'~'-~"~=~~ ~'~.~ ~ ' --: ' '::
ClalOjOi6131~ '~';'~-='"~=~"~""'~ .... :~ ::...~.., ~-,~..
7. Trans~ 2 Company Nome 8. U~ E~* ~0 a~b~ ?~ ;*-.!~!:~:: ~.~;~:'? =:~: ·
. , ~ ~ ~ . . '4~E~~,,~:;~:' :? :.-:_ . .. ~:.:(~:~:.:
I De,ri t on linc uding Proper Shipping No~, Haza~ Class, and lO Numar} ' ' . '. . :'
.I I. US ~ p . No. Type Quonh~ WI/Vol L
.............. ,
..
1 &. GENE~OR'S CERTIFI~TION: I ~ereby declare ~ot ~e conlenls or ~is consignmenl ore ~1~ on~ oc~mlely de~ ~ve by pro~r s~ipplng name and ore clossi~,
lB .......m?.,~Land labeled, a~d ore in all resp~s in pf~ condili~ [or kons~dby highway .... ding lo applicable iht .... gona[ and national g ....... I reouloti ....
If I am a large quanti~ generate, I c~i~ Sat I have a pr~ram in pl~ ~ r~uce ~e volume and Ioxici~ al wasle generated to ~e degr~ I h~e determinM ~ ~ economically
' pr6cgc0~e a~ ~af Ihove sel~t~ ~e procgcable me--'of keatmen[~ s~e, or aispoaa/currenlly ~ail~ble lo me ~ich minimizes ~e ~enl and ~e thr~
and ~ envlronment; ~, if I om a small quanti~ generate, I h~e made a go~ [ai~ effofl ~ minimize my waste generation and salad ~e ~st ~ste ma~ge~t meth~ th~ is
~ ~ai,oble~ d~atl ~rd. .... ....
Prin~ed/Typ~ Name [ ~gnoJure M~th ~y ,
~~ ~~¢-~ I ~-. ~~ .... ~l~l~l~l~
I I I 7. Tr~spd~ I Ac~nowl~emenl or R~ei~l or Mote~ols
O 18. Transp~ 2 Acknowledgement of R~eipt of Materials
j Printed/T~ N~me [ Signa~re ] Mon~
" ~~L ~~d DO NOT WRITE BELOW IHI; L~ .... ~ Z
~[ : ' · Wk; .... 'T~RF SFNDS THIS COPY TO DiSC WfHIN 30 DAYS:
J1/99) To: P_O. 'Box 3000, Socram~lo,-~'-{9581~ '
; ~4o~ 2050-003e (Eq,i,.s 9-30-99L, : See InstruCtion's on bock'of.' page 6. Deportment of T0x~c Substa .... Control
lype. Foe?n designed for use on elite ( I :Z-pitch) l~oewriler. :"~ '~:- i ' .~- Socromenla. Californlo
UNIFORM HAZARDOUS' ]. Generate"t.US EPA ID NO. Manifest DOCument NO.' 2. Pa~e ! InJ:0rnl~tion in.the shaded areas
- ~ is flat required by Federal law.
WASTE MANIFEST I oF I "' ·
3- Ge~leralor°$ I~l ..... d/'Roain0 kddre~ss~; :' ' ~
5. Transporter ] Company Name 6. US EPA ID Number '~.T~°°rt~'s ~/__
7. Transporter 2 Company Name '~, 8. US EPA ID Number J~ Slate Tran~'s I . ..... ~
9. ~sigeated Facility Name and Sitka Address. 10. L~ EPA ID Number '
.1 i. US DOT Description lindudin9 Proper. Shipping Name, Hazard Class, and ID Number} .. 12. Containers 13. Total .· ~ :' :':' '
:'j'$. :.~l~eclal le~ndllng Ins.udio .... d Additional In_~ormation
! 6. ~ENE~T~'S CE~TlflCA~ON: I bereG~ d~l~re ~ ~e con. Is at ~is con~ignmenl ~e ~l~ ond ~curo~l~ descH~ agave G~ proper s~lppi'ng florae
~rk~, and Iobel~, Qnd ore in oil res~ in ~ro~r Condition Ear ~ons~db~ ~gGwQ~ occording ~ oppIkoble in~rn~fionol Qnd notional goverAmenl
ff I om o ~rge quonfi~ gener~or, I .c~i~ ~ot I ~ove ~ ~rom' in ploce fo r~uEe ~e volume ond.~x~c~ o[ waste generQl~ ~ ~e d~ree I
~r~co~le ond ~af Ifiove selec~d ~e practicable mef~ o~ Ir~enf, sloroge, or di5~l currenl~ ~oflQble lo me ~ic~ minimizes l~e preseni
! 9. ~s~n~ Indication S~ce
" DO .NOT WRITE BELOW THIS LINE. ' .... '
~DTSC 802~ {I/99) · .. ' > whhe: TSDF SENDS 1HI5 coPY TO DTSC W!fHiN 30 DAYS.
. To: P.O. Box 3000. Sacramebto, CA 95812
APPENDIX
C
· Appendix C.
- . HazardoUs Waste Tank. Closure Certification ·
.
·
CNCD\O:SHARE\UST~03-O037.cloc
UNIFIED PROGRAM CONsoLIDATED FORM -" '
..... HAZARDOUS WASTE
" HAZARDOUS WASTE TANK CLOSURE CERTIFICATION
' ' I. FACILITY IDENTIFICATION
BUSINESS NAME (s ..... FACILITY NAME or DBA- Doing Business As) 3 FACILITY ID# ' 1~1
TANK OWNER N~IE .
TANK OWNER ADDRESS '741
TANK OWNER CITY 742I ST~tTE ~ ~r 743 I ZIP coDE q q ~-~ % 744
Va~ ~ 9--l'~/a'aD/l II. TANK CLOSURE INFORMATION ,'
· Tank ID # Concentration of Flammable Vapor Concedtration of Oxygen
(Attach additional copies
of this page for more than
TANK three tanks) Top Center Bottom Top . Center Bottom'
1NTERIOR ]1[ ~ 5 746a 746bI 746¢ 747a 74.71o 747c
READINGS 1231 '~ . ~}t~i 749a ~ offO 749b 749c 750a O. ~ 9~ 750b 750c
751 752a 752b 752e 753a 753b 753c
III. CERTIFICATION
On examination of the tank, I certify the tank is visually free from product, sludge, scale (thin, flaky residual oftank contents), rinseate agd debris. I further certify that
the information provided herein is true and accurate to the best of my knowledge.
m' .1 SIGNATURE OF CERTIFIER STxTUS OR AFFILIATION OF CERTIFYING PERSON
" ' Certifier is a representative of the CUPA, authorized agency, or LIA:
~1~.I ~.. ~) ~.~ "-~ ~(_../L.d ~r ~..~/'~ (_.) . Name of CUPA, authorized agengy, or LIA: 761
~: TITLE OF CE~'-TIFIER 755 ' :
756
ADDRESS [] a. Certi~¢d Industrial Hygienist (CIH)
fl{~)l~ ~'~ 9t~f '~ d~/~ \C ~--'~t ~ r'l b. Certified Safety Professional(CSP)
7s? [] c..Certified Marine Chemist (CMC)
CITY
· CO tXC O'/~ ~ I-I. d. Registered Environmefital Health Specialist (REHS)
758
PHONE [] e. Professional Engineer (PC)
~ Z ~ 2 8 ~ ~ I ~ ~ I--If. Class II Registered Environmental Assessor
7~9 I ~ql. iContractors' Siate License Board licensed contractor (with hazardous
DATE CERTIFICATION TIME
~ 2'(9 -O '~I substance removal certification)
TANK PREVIOUSLY HELD FLAMMABLE OR COMBUSTIBLE MATERIALS . · 763
i (If yes, the tank in~efixor atmosphere shall be re-checked with a combustible gas indicator prior to work being conducted on the tank.) ~Yes ' [] No
CERTIFIER'S TANK MANAGEMENT INSTRUCTIONS FOR SCRAP DEALER, DISPOSAL FACILITY, ETC: 764
A copy of this certificate shall accompany the tank to the recycling / disposal facility and be provided to the CUP^. If there is ao CUPA. copies-shall be ~nbmitted to the LI^ and authorized-
.aganc¥~ owner / operator of the tank system~ removal contractor; and the recycling / disposal.facility. ' ' ·
; UPCF (12/99) ' .. . 391.. . '. - . ' '. 'Formerly DTSC. 1249 (6~98)'
APPENDIX
,.Appendix D
HazardOus Waste Manifests and
Certificate*°f D~structi.on~ for the USTs
I CNCD\O:S HARE\USTx03 -0037.d0c ' ~ * .
' "::"~: DO NO~/WRITE BELOW THIS LINE.
.-~ · ~.:,: ~.~: :-.::::: %.:~!:j~'~.~' :~::::E~: ~:<, ~U:: :~:: :~:~i ~.:~ . :: ·
I
I'
I
I
I
I
I 91B-2-99
".,, Appendix E .
LaboratOry Reports and
chain"of CUstodyForms '~ i,'
!
CNCD\O:SHARE\UST~03-0037.doc
I
~ ,10 2nd Avenue Sour #D7, Pacheco, CA 94553-5560
~ McCampb¢ll Analytical Inc. Telephone:925-798-1620 Fax: 925-798-1622
http://www, mccampbell.com E-mail: main~mccampbell.com
Shaw Enviromental Client Project ID: #838819 Date Sampled: 03/26/03
400'5 Port Chicago Hwy Date Received: 03/26/03
Client Contact: Rob Delnagro Date Reported: 03/27/03
Concord, CA 94520 Client P.O.: Date Completed: 03/27/03
WorkOrder: 0303471
March 27, 2003
Dear Rob:
Enclosed are:
1).' the results of 10 analyzed samples from your #838819 project,
2). a QC report for the above samples
3). a copy of the chain of custody, and
4). a bill for analytical services.
Ali analyses were completed satisfactorily and all QC samples were found to be within our control limits.~
If you have any questions please contact me. McCampbell Analytical Laboratories strives for excellence
in quality, service and cost. Thank you for your business and I look forward to working with you again.
I Angela Rydelius, Lab Manager
!
!
110 2nd Avenue South, #D7, Pacl~eco, CA 94553-5560
McCampbell Analytical Inc. Xe~epho~e:925-798-1620 Fax: 925-798-1622
http://www.mccampbell, com E-mail: main~mccampbell.com
Shaw Environmental Client Project ID: #838819 Date Sampled: 03/26/03
4005 Port Chicago Hwy Date Received: 03/26/03 ·
Client Contact: Rob Delnagro Date Extracted: 03/26/03
Concord, CA 94520
Client P.O.: Date Analyzed: 03/27/03
Gasoline Range (C6-C12) Volatile Hydrocarbons as Gasoline with BTEX and MTBE*
Extraction method: SWS030B Analytical methods! SWS021B/8015Cm Work Order: 0303471
Lab ID Client ID 'Matrix TPH(g) MTBE I Benzene Toluene Ethylbenzene Xylenes DF % SS
00lA TP-01-2 S ND ND ND ND ~ ND I 101
002A TP-01-6 S ND ND ND ND ND I 100
003A TP-02-2 S ND ND ND ND ND ! 98.8
004A TP-02-6 S ND ND ND ND ND I 101
00SA TP-03-2 S ND 0.0ll 0.023 ND ND I 96.1
006A TP-03-6 S ND ND ND ND ND ! 103
007A TP-04-2 S ND ND ND ND ND I 103
008A TP-04-6 S ND ND ND ND ND I 100
009A TP-05-2 S ND ND ND ND ND I l 01
010A TP-05 -6 S ND ND ND ND ND l 105
Reporting Limit for DF =1; W I NA NA NA NA NA NA 1 ug/L
ND means not detected at or
above the reporting limit S 1.0 0.05 0.005 0.005 0.005 0.005 I mg/Kg
· water and vapor samples are reported in/ag/L, soil and sludge samples in mg/kg, wipe samples in gg/wipe, and TCLP extracts in lag/L.
# cluttered chromatogram; sample peak coelutes with surrogate peak.
+The following descriptions of the TPH chromatogram are cursory in nature and McCampbell Analytical is not responsible for their interpretation: a)
unmodified or weakly modified gasoline is significant; b) heavier gasoline range compounds are significant(aged gasoline?); c) lighter gasoline range
compounds (the most mobile fraction) are significant; d) gasoline range compounds having broad chromatographic peaks are significant; biological~ly
altered gasoline?; e) TPH pattem that does not appear to be derived from gasoline (stoddard solvent / mineral spirit?); f) one to a few isolated non-target
peaks present; g) strongly aged gasoline or diesel range compounds are significant; h) lighter than water immiscible sheen/product is present; i) liquid
sample that contains greater than -2 vol. % sediment; j) reporting limit raised due to high MTBE content; k) TPH pattern that does not appear to be
derived from gasoline (aviation gas). m) no recognizable pattern.
DHS Certification No. 1644 , _ Angela Rydelius, Lab Manager
110 2nd Avenue South, #D7, Pacheco, CA 94553-5560
McCampbell Analytical Inc. Telephone:925-798-1620 Fax: 925-798-1622
ht~p://www.meeampbell.c0m E-mail: main~mccampbell, com
I Shaw Environmental Client Project ID: #838819 Date Sampled: 03/26/03
I 4005 Port Chicago Hwy Date Received: 03/26/03
Client Contact: Rob Dehiagro Date Extractedi 03/26/03
Concord, CA 94520
i Client P.O.: Date Analyzed: 03/26/03-03/27/03
Diesel Range (C10-C23) Extractable Hydrocarbons as Diesel*
~xtraction method: SW3550C Analytical methods:. SW8015C Work Order: 0303471
I Lab ID Client ID Matrix TPH(d) DF % SS
0303471-001A TP-01-2 S ND I 97.5
I 0303471-002A TP-01-6 S ND I 95.2
0303471-003A TP-02-2 S ND I 97.0
i 0303471-004A TP-02-6 S ND 1 95.7
0303471-005A TP-03-2 S ND I 87.4
I 0303471-006A TP-03-6 S ND 1 88.1
0303471-007A TP-04=2 S ND 1 89.2
I 030347 1-00SA TP-04-6 S ND I 88.4
0303471-009A TP-05-2 S 1.8,c 1 88.0
'l 0303471-010A TP-05-6 S ND I 88.8
Reporting Limit for DF =1; W NA ~ NA
I ND means not detected at or .
above the reporting limit S 1.0 mg/Kg
* water and vapor samples are reported in gg/L, wipe samples in ug/wipe, soil/solid/sludge samples in mg/kg, product/oil/non-aqueous liquid samples in
i mg/L, and all TCLP / STLC / SPLP extracts in !ag/L
# cluttered chromatogram resulting in coeluted surrogate and sample peaks, or; surrogate peak is on elevated baseline, or; surrogate has been diminished
by dilution of oi:iginal extract.
I +The following descriptions of the TPH chromatogram are cursory in nature and McCampbeil Analytical is not responsible for their interpretation: a)
unmodified or weakly modified diesel is significant; b) diesel range compounds are significant; no recognizable pattern; c) aged diesel? is significant); d)
gasoline range compounds are significant; e) unknown medium boiling point pattern that does not appear to be derived from diesel; f) one to a few
isolated peaks present; g) oil range compounds are significant; h) lighter than water immiscible sheen/product is present; i) liquid sample that contains
I [greater than -2 vol. % sediment; k) kerosene/kerosene ran[ge; 1) bunker oil; m) fuel oil; n) stoddard solvent / mineral spirit.
DHS Certification No. 1644 ~ Angela Rydelius, Lab Manager
110 2nd Avenue South, #D7, Pacheco, CA 94553-5560
~ McCampbell Analytical Inc. Telephone: 925-798-1620 Fax: 925-798-1622
http://www.mccampbell.com E-mail: main~mccampbell.com
Shaw Environmental Client Project ID: #838819 Date Sampled: 03/26/03
4005 Port Chicago Hwy Date Received: 03/26/03
Client Contact: Rob Delnagro Date Extracted: 03/26/03
Concord, CA 94520
Client P.O.: Date Analyzed: 03/27/03
Methyl tert-Butyl Ether*
Extraction method: SWS030B Analytical methods: SW8260B Work Order: 0303471
001A TP-01-2 S ND 1 108
__ 002A TP-01-6 S ND I 72.9
003A TP-02-2 S ND I : 71.6
004A TP-02-6 S ND 1 71.2
005A TP-03-2 S ND I ---it
006A TP-03-6 S ND ! ---it
007A TP~04-2 S 0.23 20 103
00aA TP-04-6 S ND I 78.6
009A TP-05-2 S ND I 80.5
010A TP-05-6 S ND · 1 87.2
Reporting Limit for DF =1; W NA NA
ND means not detected at or
above the reporting limit s 0.005 mg/Kg
* water and vapor samples and all TCLP & SPLP extracts are reported in ~tg/L, soil/sludge/solid samples in mg/kg, wipe samples in p_g/wipe,
~roducffoil/non-aqueous liquid samples in mg/L.
ND means not detected above the reporting limit; N/A means analyte not applicable to this analysis.
h) lighter than water immiscible sheen/product is present; i) liquid sample that contains greater than -2 vol. % sediment; j) sample diluted due to high
organic content.
DHS Certification No. 1644 ~ ~-
~./~~ngela Rydelius, Lab Manager
110 2nd Avenue South, #D7, Pacheco, CA 94553-5560
~ McCampbell Analytical Inc. Telephone:925-798-1620 Fax:925-798-1622
· http://www.mccampbell.com E-mail: main~mceampbell.com
QC SUMMARY REPORT FOR SW8021B/8015Cm
Matrix: S WorkOrder: 0303471
EPA Method: SW8021B/8015Cm Extraction: SW5030B BatchlD: 6343 Spiked Sample ID: 0303471-001A
Sample Spiked MS* MSD* VIS~MSD* LCS LCSD LCS-LCSD Acceptance Criteria (%)
· Compound
mg/Kg mg/Kg % Rec. % Rec. % RPD % ReC. % Rec. % RPD Low High
TPH(gas) ND 0.60 115 114 0.397 11 ! 112 0.363 80 120
MTBE ND 0.10 94.2 90.7 3.83 96.6 93.5 3.32 ' 80 120
Benzene ND 0.10 101 104 2.80 93.6 98.3 4.88 80 120
Toluene ND 0.10 90.9 .92.6 1.78 88.5 88.2 0.441 80 120
Ethylbenzene ND 0.10 102 103 1.03 94.7' 97.6 3.00 80 120
Xylenes ND 0.30 96.7 96.7 0 88.3 88 0.378 80 '120
%SS: 101 100 98 99.5 1.50 97.5 99.3 1.88 80 120
All target compounds in the Method Blank of this extraction batch were ND less than the method RLwith the following exceptions:
NONE
!
!
VIS = Matrix Spike; MSD = Matrix Spike Duplicate; LCS = Laboratory Control Sample; LCSD = Laboratory Control Sample Duplicate; RPD = Relative Percent
Deviation,
N/A = not enough sample to perform matrix spike and matrix spike duplicate.
~IR = analyte concentration in sample exceeds spike amount for soil matrix or exceeds 2x spike amount for water matrix or sample diluted due to high matrix or
analyte content.
% Recovery = 100 * (MS-Sample) / (Amount Spiked); RPD = 100 * (MS - MSD) / (MS + MSD) * 2.
o o
· MS and / or MSO spike recoveries may not be near 100 Y~ or the RPDs near 0 '/~ if: a) the sample is inhomogenous AND contains significant concentrations of
analyte relative to the amount spiked, or b) if that specific sample matrix interferes with spike recovery.
110 2nd Avenue South, #D7, Pach¢co, CA 94553-5560
~ McCamPb¢ll Analytical Inc. . Telephone:925-798-1620 Fax :925-798-1622
· http://www.mccarapbell, com E-mail: main t~rnccampbell, com
~_ QC SUMMARY REPORT FOR SW8015C
I
Matrix: S WorkOrder: 0303411
EPA Method: SW80i5C Extraction: SW3550C BatchlD:6344 Spiked Sample ID: N/A
Sample Spiked MS* MSD* MS-MSD* LCS LCSD LCS-LCSD Acceptance Criteria (%)
Compound
I mg/Kg mg/Kg % Rec. % Rec. % RPD % Rec. % Rec. % RPD Low High
TPH(d) N/A 150 N/A N/A N/A 101 101 0.0393 70 130
· l %SS: N/A 100 N/A N/A N/A 93~9 92.7 1.26 70 130
All target compounds in the Method Blank of this extraction batch were ND less than the method RL with the following exceptions:
NONE
I
I
MS = Matrix Spike; MSb'= Matrix Spike Duplicate; LC'S = Laboratory Control Sample; L6SD = La~orator~ Control Sample Du~licate;'~PD =' Relativ~ Percent
Deviation. .
N/A = not enough sample to perform matrix spike and matrix spike duplicate.
NR = analyte concentration in sample exceeds spike amount for soil matdx or exceeds 2x spike amount for water matrix or SamPle diluted due to high matrix or
analyte content.
% Recovery = 100 * (MS-Sample) / (Amount Spiked); RPD = 100 * (MS - MSD) / (MS + MSD) * 2.
· MS and / or MSD spike recoveries may not be near 100% Or the RPDs near 0% if: a) the sample is inhomogenous AND contains signifiCant concentrations of
anal)/te relative to the amount spiked, or b) if that specific sample matrix interferes with spike recover,/,
110 2nd Avenue South, #D7, Pacheco, CA 94553-5560
~ McCampbell Analytical Inc. Te!ephone:925-798-1620 Fax :925-798-1622
' http://www.mccampbell.com E-mail: main@mccampbell.com
QC SUMMARY REPORT FOR SW8260B
Matrix: S - WorkOrder: 0303471
EPA Method: SW8260B ExtractiOn: sW5030B ' BatchlD: 6284 ID: N/A
Spiked
Sample
sample Spiked MS* MSD* MS-MSD* LCs LCSD LCS-LCSD Acceptance Criteria (%)
Compound
lag/Kg pg/Kg % Rec. % Rec. % RPD % Rec. % Rec. % RPD Low High
Methyl-t-butyl ether (MTBE) N/A 50 N/A N/A N/A 97.4 100 2.89 70 130
%SSI: N/A 100 N/A N/A N/A' 92.4 94.9 2.66 70 130
All target compounds in the Method Blank of this extraction batch were ND less than the method EL with the following exceptions:
NONE
!
MS = Matrix Spike; MSD = Matdx Spike Duplicate; LCS = Laboratory Control Sample; LCSD = Laboratory Control Sample Duplicate; RPD = Relative Percent
Deviation.
N/A = not enough sample to perform matrix spike and matrix spike duplicate.
NR = analyte concentration in sample exceeds spike amount for soil matrix or exceeds 2x spike amount for water matrix or sample diluted due to high matrix or
analyte content.
% Recovery = 100 * (MS-Sample) / (Amount Spiked); RPD = 100 * (MS - MSD) / (MS + MSD) * 2.
· MS and / or MSD spike recoveries may not be near 100% or the RPDs near 0% if:. a) the sample is inhomogenous AND contains significant concentrations of
analyte relative to the amount spiked, or b) if that specific sample matrix interferes with spike recovery.
' McCalnpbell AnalyticalInc. CHAIN-OF-CUSTODY RECORD
Seco id Ave ~ue SoL t ~ #D7
'
Pacheco, CA 94553-5560
¢925) 798-1620 XVol'kOrder: 0303471
Client':
Shaw Environmental TEL:
4005 Port Chicago Hwy FAX:
Concord, CA 94520 ProjectNo: #838819 Date Received' 3/26/03
PO: Date Printed: 3/26/03
Sample ID ClientSamplD Matrix Collection Date Hold - SW8015C ~--~021~/80i~
~03'6'~'f-~':~'E{ ....... i .................. YP:6~:~ ~i .............. ~Y~'76~'~ ~'0'5~ ~-"j" "?:~j A- .......... [ A ' ' l ....... -~ ......... : ...................... i ..... ~ .................. l .............
~-0303471-002 ~ TP-01:~ I' ......................... ...... ~oi, .... ~ ~/~103 11~:='10'0~ ....... A~ '~-7(:_:~_
~03471-004: '-] .... TP-~ .......... ~ ..... ~5i 3~26~03 11:25:00 AM ~--~ .......... ~ ...............~ .................. A' ' .........
030-~71~-]00~-'' '-~ ............ T~-~5]5 ............ [ ......... Soi~ ....... ['5/~05~2:0~:~5 P'~ - - I:z~ ..... A
~303471-007 .....-~[- TP-04-2 Soil ................ [ 3/26/03 12:25:00 PM .... [-~ [ A ........ I A A , ,, ~ [ I
0303471-010 TP-05-6 ~ ssii ' ]' 3/26)0~"1~00 P~ ~ ' ..... ' ' ,
Prepared by: Melissa Valles
Comments:
NOTE: Samples are discarded 60 days after results are reported unless other arrangements are made. Hazardous samples will be returned to client or disposed of at client expense.
'" McCAN-~BELL.~NALYTIC^'"' ':' "~ I~C.' ~ ~~ ~ ~HAIN OF CUSTODY RECORD '
! 10 2''a AVENUE SOU'IH, ~i)7 ........
v~xomco, ca 9d~-~o TURN AROUNI) TIME ~ ~
Teleplione: (925) 798-1620 Fax: (925) 798-1622 RUSH 24 HR 48 HR 72 tlr S DAV
EDF Required?,,, Yes No
~ro Iq . Project Name: ~ '~" ;
Sampler Signature: ff ]~~ ~~ ~..~ ~.~ ~ ¢.," ~ ~< ~,.q~
SAMPLING ~ MATRIX PRESERVED ~ ~ ~ = ~ ~' ~ 8 { --
SAMPLEID .~ ~ z 8 .g --- ~ ....... ~ ~ ~'
(Field PointName) LA)CATION ~ ~ ~: ~ 5 ~ ~, ~ ~ '~ . ~
Date ,Ti,ne = ~ ~ ~ ~ ~ ~ ~ x ~ ~ ~ ~'
............ ~.................................... ;
~-~}~-~ -- ~ .......... i---;-i- ' [-~ ...... r ........................................ !
.............. 4 ...................................................................................................
m~- ~-~ _~.~. ' ~ ..... ~ ...... , ~ .........................................
~-,p.~_ ,~ .................. ;~ .. .........................
~p~ o~- ~ ~ .... ~ i-~. ..~/_. ._~ _,;__ :__, ....... ,.j~.; _~ ~., '............................................................ ~..~ .......
I
.................... ~ .................................... ~.]~- ........................... .....................
· ' VOAS O&G METAL OTHE~
Rei~qulshed By: .... Date: Time: Rec~ivefi By: ~' GOOD CONDITION~ APPROPRIATE/
~mAn SeAC~ AaS~'r CONTMNeRS ~
Reil~'~ulshed By:- time: Time: ~e~iv~t~ ~: ......... DECHLOR1NATED IN LAB ' PERSERVED IN LAB~
~ 110 2nd Avenue South, #D7, Pacheco, CA 94553-5560
McCampbell Analytical Inc. Telephone: 925-798-1620 Fax:925-798-1622
http://www, mccampbell.com E-mail: main~mccampbell.eom
Shaw Environmental Client Project ID: #838819; PB- Date Sampled: 03/26/03
Bakersfield
4005 Port Chicago Hwy Date Received: 03/26/03
Client Contact: Rob Delnagro Date Reported: 03/27/03
Concord, CA 94520 Client P.O.i Date Completed: 03/27/03
WorkOrder: 0303472
March 27, 2003
Dear Rob:
Enclosed are:
1). the results of 8 analyzed samples from your #838819; PB-Bakersfield project,
2). a QC report for the above samples
3). a copy of the chain of custody, and
4). a bill for analytical services.
All analyses were completed satisfactorily and all QC samples were found to be within our control limits.
If yoU have any questions please contact me. McCampbell Analytical Laboratories strives for excellence
in quality, service and cost. Thank you for your business.and I look forward to working with you again.
' Angela Rydelius, Manager
110 2nd Avenue South, #D7, Pacheco, CA 94553-5560
McCampbell Analytical Inc. X~elep~one: 925-798-1620 Fax: 925-798-1622
http://www, mccam~bell.com E-mail: main a~nccan~bell.com
~ Shaw Environmental Client Project ID: #838819; PB- Date Sampled: 03/26/03
Bakersfield
' 4005 Port Chicago Hwy Date Received: 03/26/03
I Client Contact: Rob Delnagro. Date Extracted: 03/26/03
Concord, CA 94520
Client P.O.: Date Analyzed: 03/27/03
Gasoline Range (C6-C12) Volatile Hydrocarbons as Gasoline with BTEX and MTBE*
Extraction method: SWS030B Analytical methods: SW8021B/8015Cm Work Order: 0303472
'l Lab ID Client ID Matrix TPH(g) MTBE Benzene Toluene Ethylbenzene Xylenes DF % SS
00lA CS-1 S ND ND ND ND ND I 95.8
I 002A CS-2 S ND ND ND ND ND I 96.8
003 A CS-3 S ND ND ND ND ND I 104
'l 004A CS-4 S ND ND ND ND ND I 104
005A CS-5 S ND ND ND ND ND l 97.5
I 006A CS-6 S ND ND ND ND ND 1 101
007A CS-7 S ND ND ND ND ND 1 102
I' 008A CS-8 S ND ND ND ND ND 1 102
I
i
I
Reporting Limit for DF =~; W NA NA NA NA NA NA 1 ug/L
ND means not detected at or
I above the reporting limit S 1.0 ' 0.05 0.005 0.005 0.005 0.005 I mg/Kg
*water and vapor samples are reported in gg/L, soil and sludge samples in mg/kg, wipe samples in gg/wipe, and TCLP extracts in Ixg/L.
I, t cluttered chromatogram; sample peak coelutes with surrogate peak.
+The following descriptions 0fthe TPH chromatogram are cursory in nature and McCampbell Analytical is not responsible for their interpretation: a)
unmodified or weakly modified gasoline is significant; b) heavier gasoline range compounds are significant(aged gasoline?); c) lighter gasoline range
I compounds (the most mObile fraction) are significant; d) gasoline range compounds having broad chromatographic peaks are significant; biologically
altered gasoline?; e) TPH pattern that does not appear to be derived from gasoline (stoddard solvent / mineral spirit?); f) one to a few isolated non-target
. peaks present; g) strongly aged gasoline or diesel range compounds are significant; h) lighter than water immiscible sheen/product is present; i)liquid
sample that contains greater than -2 vol. % sediment; j) reporting limit raised due to high MTBE content; k) TPH pattern that does not appear to be
derived from gasoline (aviation gas). m) no recognizable pattern.
DHS Certification No. 1644 Angela Rydeljus, Lab Manager
!
'~ 110 2nd Avenue South, #D7, Pacheco, CA 94553-5560
McCampbell Analytical Inc. Telephone:925-798-1620 Fax:925-798-1622
http://www.mCCampbell, com E-mail: main~mecampbell, com
'l ' Shaw Environmental Client Project ID: #838819; PB- Date Sampled: 03/26/03
Bakersfield
4005 Port Chicago Hwy Date Received: 03326/03
I Client Contact: Rob Delnagro Date Exlxacted: 03/26/03
Concord, CA 94520
Client P.O.: Date Analyzed: 03/26/03-03/27/03 .
i ·
Diesel Range (C10-C23) Extractable HydrocarbOns as Diesel*
Extraction method: SW3550C Analytical methods: SW8015C Work Order:' 0303472
il Lab ID Client ID - Matrix TPH(d) DF % SS'
0303472-001A CS-1 S 2.2~b I 98.4
il _ 0303472-002A CS-2 S ND. l 10l
0303472-003A CS-3 S ND I 100
Ii 0303472-004A CS-4 S 1.8,b I 102
' 0303472-005A CS-5 S ND I 99.2
I
03034722006A CS-6 S 2.~,b I 101
0303472-007A CS-7 S ND I 100
I 0303472-008A CS-8 S ND 1 102
I
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Reporting Limit for DF =1; W / NA NA
I ND means not detected at or
above the reporting limit S 1.0 mg/Kg
* water and vapor samples are reported in gg/L, wipe samples in ug/wipe, soil/solid/sludge samples in mg/kg, product/oil/non-aqueous liquid samples in
rog/L, and all TCLP / STLC [ SPLP extracts in gg/L
I' # cluttered chromatogram resulting in coeluted surrogate and sample peaks, or; surrogate peak is on elevated baseline, or; surrogate has been diminished
--~ by dilution of original extract.
I I +The following descriptions of the TPH chromatogram are cursory in nature and McCampbell Analytical is not responsible fo~ their interpretation: a)
, unmodified or weakly modified diesel is significant; b) diesel range compounds are significant; no recognizable pattem; c) aged diesel? is significant); d)
' gasoline range compounds are significant; e) unknown medium boiling point pattern that does not appear to be derived from diesel; f) one to a few
isolated peaks present; g) oil range compounds are significant; h) lighter than water immiscible sheen/product is present; i) liquid sample that contains
'l l~reater than -2 v01. % sediment; k) kerosene/kerosene ranl~e; 1) bunker oil; m) fuel oil; n) stoddard solvent~/mineral spirit.
DHS Certification No. 1644 ~~Angela Rydelius, Lab Manager
I
'l
110 2nd Avenue South, #D7, Pacheco, CA 94553-5560
~ McCampbell Analytical Inc. r~ephone: 925-798-1620 Fax:925-798-1622
http://www, mccampbell.com E-mail: main~mccampbell.com
Shaw Environmental Client Project ID: #838819; PB- Date Sampled: 03/26/03
Bakersfield
4005 Port Chicago Hwy Date Received: 03/26/03
Client Contact: Rob Delnagro Date Extracted: 03/26/03
Concord, CA 94520
Client P.O.: Date AnalYZed: 03/27/03
Methyl tert-Butyl Ether*
E~traction method: SW5030B Analytical methods: SW8260B Work Order: 0303472
LabID ] ClientID [ Matrix ] Methyl-t-butylether(MTBE) ] DF [ %SS ]
00lA CS-1 S ND . I 94.5
002A CS-2 S ND l 94.9
003A CS-3 S ,ND I 94.3
004A ~ CS-4 S ND I 91.5
005A CS-5 S ND 1. 92.7
006A CS-6 S ND 1 93.6
007A ~- CS-7 S ND ' I 83.4
00SA CS-8 S ND I 84.4
Reporting Limit for DF =l; W NA NA
ND means not detected at or
abo.ve the reporting limit S 5.0 pg/Kg
* water and vapor samples and all TCLP & SPLP extracts are reported in g,g/L, soil/sludge/solid samples in gg/kg, wipe samples in ~tg/wipe,
~roduct/oil/non-aqueous liquid samples in mg/L.
ND means not detected above the reporting limit; N/A means analyte not applicable to this analysis.
h) lighter than Water immiscible sheen/product is present; i) liquid sample that contains greater than -2 vol. % sediment; j) sample diltited due to high
Organic content.
DHS Certification No. 1644 ~/~ Angela Rydelius, Lab Manager
~ 110 2nd Avenue South, #D7, Pacheco, CA 94553-5560 ['
McCampbell Analytical Inc. . Telephon~:925-798-1620 Fax: 925-798-1622
· http://www.mccampbell.com E-mail: main~mccampbell.com
QC SUMMARY REPORT FOR SWS021B/8015Cm
Matrix: S WorkOrder: 0303472
EPA Method: SW8021B/8015Cm Extraction: SW5030B BatchlD: 6343 Spiked Sample ID: 0303471-001A
Sample Spiked MS* MSD* MS-MSD* LCS LCSD LCS-LCSD Acceptance Criteria (%)
Compound
" mg/Kg rog/Kg %Rec, %Rec, %RPD %Rec. %Rec. ~ %RPD Low High
TPH(gas) ND 0.60 115 114 0;397 ' 111 112 0.363 80 120
MTBE ND 0.10 94.2 90.7 3.83' 96.6 93.5 3.32 80 120
Benzene ND 0A0 101 104 2.80 93.6 98.3 4.88 80 120
Toluene ND 0.10 90.9 92.6 1.78 88.5 88.2 0.441 . 80 120
Ethylbenzene ND 0.10 102 103 1.03 94.7 97.6 3.00 80 120
Xylenes ND 0.30 96.7 96.7 0' 88.3 88 0.378 80 120
%SS: 101 100 98 99.5 1.50 1;88
97.5
99.3
80
120
All target compounds in the Method Blank of this extraction batch were ND less than the method RL with the followifig exceptions:
I
MS = Matrix Spike; MSD = Matrix Spike Duplicate; LCS = Laboratory Control Sample; LCSD = Laboratory Control Sample Duplicate; RPD = Relative Percent
l Deviation.
N/A = not enough sample to perform matrix spike and matrix spike duplicate.
NR = analyte concentration in sample exceeds spike amount for soil matrix or exceeds 2~ spike amount for water matdx or sample diluted due to high matrix or
'1 analyta content.
! % Recovery = 100 * (MS-Sample) / (Amount Spiked); RPD = 100 * (MS - MSD) / (MS + MSD) * 2,
' MS and / or MSD spike recoveries may not be near 100% or the RPDs near 0% if: a) the sample is inhomOgenous AND contains significant concentrations of
Ianalyte relative to the amount spiked, or b) if that specific sample matrix interferes with spike recovery. ,
!
110 2nd Avenue South, #D7, Pacheco, CA 94553-5560
McCampbell Analytical Inc. Telephone:925-798-1620 Fax: 925-798-1622
I http://www.mccampbell.com E-mail: main~xtccampbell, com
! QC SUMMARY REPORT FOR SWS015C
Matrix: S WorkOrder: 0303472
I '
' EPA Method: SW8015C Extraction: 8W3550C BatchlD:6344 Spiked Sample ID: N/A
Sample Spiked MS* MSD* MS-MSD* LCS LCSD LCS-LCSD Acceptance Criteria (%)
Compound
I
mg/Kg mg/Kg % Rec. % Rec. % RPD % Rec. % Rec. % RPD Low High
~ ! TPH(d) N/A 150 N/A N/A N/A 101 101 0.0393 70 130
'l %SS: N/A 100 N/A N/A N/A 93.9 92.7 1.26 70 130
All target compounds in the Method Blank of this extraction batch were ND less than the method RL with the following exceptions:
NONE
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MS = Matrix Spike; MSD = Matrix Spike Duplicate; LCS = Laboratory Control Sample; LCSD = Laborato~ Control S;mple Duplicate; RPD = Relative Percent
IDeviation.
N/A = not enough sample to perform matrix spike and matdx spike duplicate.
NR = analyte concentration in sample exceeds spike amount for soil matrix or exceeds 2x spike amount for water matdx or sample diluted due to high matrix or
analyte content.
% Recovery= 100 * (MS-Sample) / (Amount Spiked); RPD = 100 * (MS - MSD) / (MS + MSD) * 2.
~ MS and / or MSD spike recoveries may not be near 100% or the RPDs near 0% if: a) the sample is inhomogenous AND contains significant concentrations of
analyte relative to the amount spiked, or b) if that specific sample matdx interferes with spike recever)t.
McCampbe]l AnalyticalInc. CHAIN-OF-CUSTODY RECORD
110 Second Avenue South, #67
15acheco, CA 94553-5560
(925) 798-1620 WorkOrder: 0303472
Client:
Shaw Environmental TEL:
4005 Port Chicago Hwy FAX:
Concord, CA 94520 ProjectNo: #838819; PB-Bakersfield Date Received: 3/26/03
PO: Date Printed: 3/26/03
' Requested Tests
Sample ID ClientSamplD Matrix Collection Date Hold i SW_8_0_15C_ _ 8_0_21B/80_1.5_ ..... $_ _W_ ~ 2_ .6 0 _B
'03(~,~ :~'2:'6~:1 ".' '~S.~1 ..... SSil ......... 3~'~'0:~ .........i' ':.::i: ........... A ...................... ~, .......... ' ........... ~, .... ' .......... i ........... ] .....................
0303472-002 CS-2 Sod 3~26~03 10:14:00 AM
0303472-0~ ...... i ................. ~"-'~ ............................. ~S-'o~ ....... ["5')~U0'~45i16:o5 A~ i
3~26~03 10:17:00 AM i
0303472-004 [ CS-4 So~l [ A A A
~-~;~-~'~:5~; ..... i .............. ~'~"~ ........................... ~'~i ......... I '-:~/26/03 10'22'00 AM
5~5~-~fZ507 CS-7 So 3~26~03 10:27:00 AM
6~65~5~-65-~ ~ OS-8 ' Soil [3126103 10:29:00 AM
Prepared by: Melissa Valles
Comments:
NOTE: Samples are discarded 60 days after results are reported unless other arrangements are made. Hazardous samples will be returned to client or.disposed of at client expense.
I I0 2"4 AVI,[NtJI~ SO JTII. ~1)7
Telc,~,hon~,: (925),,77,8-1620 -Fax: (,92,5) 798-1622 RUSII 2~ fIR 48 HR 72 lilt
'~Repor,:i'o: L~g O~j.~,~3 Bil['{'o:~~
~~ ........
Tele: ~e_.%io% ' 'Fax: q~.-O~
a .'- ~ ~ .........
'. SAMPLING ~ MATRIX ~ ~ ~ ~ ~ <-
. ' ~ ,
Dale lmm ~
c~6 t~'~ ~, X' __ ~> ....... , ..... ~ .............. ,
,cs-~ ..... t'%q ', 'X -
............ ,. -, .
'~iih,qui41,~d By: --- iJate: Ti,,,e: Received Uy:
Shaw Environmental & Infrastructure, Inc.
I 4005 Port Chicago Highway
Concord, CA 94520-1120
S~a~w 925.288.9898
I Fax 925.288.0888
The Shaw Group Inc."'
I- February 4, 2003
!
Mr. Andrew Taylor
SBC
I 2600 Camino Ramon; Room #3E000
San Ramon, California 94583
I Subject: Report Temporary Closures, Facilities,
Letter
for
UST
Various
SBC
California
I Dear Mr. Taylor:
~ Shaw Environmental Inc. (Shaw) is pleased to present this letter report outlining temporary
I underground storage tank (UST) closure activities completed at 26 SBC facilities located
throughout California. The temporary tank closure activities were performed in preparation for
i future re-use or potential removal in 2003. Field activities were completed in accordance with
. the State of California Code of Regulations Title 23, Division 3, Chapter 16, Section 2671 UST
temporary closure regulations and specific local oversight agency requirements. A list of the
i various SBC sites is included in Table 1.
Field Activities
i Prior to performing any field activities, Shaw submitted permit appliCations to the appropriate
· local oversight agencies. Copies of the permits that were issued to Shaw are included in
Attachment 1. SBC had previously arranged for removal of remaining fuel from the USTs or for
Ithe USTs to be used until empty. In addition, Shaw personnel and their subcontractors reviewed
a site-specific health and safety plan outlining any potential hazards and outline appropriate
responses prior to conducting closure activities.
I The electrical power to the fuel dispensers was disconnected and locked out/tagged out by
Performance Electrical, Inc. of Modesto, California, with the tank monitoring system remaining
I operational. The check valves for the piping were then opened, with the USTs and associated
piping rinsed by hazardous waste-certified subcontractors using a hot-pressure washer and
detergent. Following rinsing, the tanks were then visually inspected to ensure all liquids, solids,
or sludge have been removed.
In order to inert the atmosphere of the tanks, dry ice was then placed in the tanks at a rate of at
I least 20 pounds per 1,000-gallons capacity, with additional dry ice added as needed. Time was
· ' then allowed for the dry ice to displace residual vapors from the tank before measuring the lower
explosive limit (LEL) and percent oxygen within the tanks. Once the oxygen and LEL
,I concentrations were below 10% or permission was given from the regulator to proceed, the
i: CNCD:\SHARE\US'I~03~0004.Ooc
Mr. Andrew Taylor
February 4, 2003
Page 2
tanks' access ports were either locked out or sealed off with concrete. The vent pipes remained
unsealed per UST temporary closure requirements. Copies of regulatory inspection forms
submitted to Shaw are includedin Attachment 2.
Waste Disposal
The rinsate was transported off-site under hazardous waste manifests to Romic Environmental
Technologies Corporation in East Palo Alto, California for recycling. Due to elevated
concentrations of PCBs encountered in the contents of one of the tanker trucks, rinsate from
select sites (Bakersfield, Paso Robles, both San Jose sites, San Mateo, and Sonora) was
transported to Burlington Environmental, Inc. in Kent, Washington for recycling. Copies of the
rinsate manifests included in Attachment 3. are
Shaw appreciates the opportunity to be of continued service to SBC. If you have any questions
or comments, please do not hesitate to contact me at (925) 288-2119.
Sincerely,
Shaw Environmental, Inc.
Program Manager
cc: Mr. Steve Underwood, Bakersfield Fire Department; Ms. Leslie Roberts, Butte County Environmental Health
Department; Mr. Mort Meyers, Chico Fire Department; Mr. Ken Williams, County of Lake Health Department;
Mr. Norm Crawford, Humboldt County Environmental Health Department; Mr. Paul Ferrara, City of Fremont Fire
Department; Mr. Harpreet Dillon, Fresno County Health Department; Mr. David Block, Merced County
Environmental Health Department; Mr. Mike Stephenson, City of Merced; Mr. Tony Moniz, Stanislaus County
Environmental Health Department; Mr. Mike Vaiz, Modesto Fire Department; Mr. Doug Calhoun, Napa County
Environmental Health Department; Ms. Lynnea Grossman, San Luis Obispo County Environmental Health Agency;
~. Paul Smith, Livermore-Pleasanton Fire Department; Mr. Robert Fernandez, Monterey County Health
Department; Mr. Larry Steiber, Salinas Fire Department; Mr. Mike Lepisto, San Jose Fire Department; Ms. Sandra
Estrin, San Mateo County Health Services Agency; Mr. Michael Leong, San Mateo Fire Department; Mr. Steven
Riggs, San Rafael Fire Department; Mr. Mike McGee, County of Tuolumne Health Department; Mr. Dennis
Catanyag, San Joaquin County Environmental Health Department; Mr. Ray Towell, San Joaquin County Fire
Prevention Bureau; Mr. Rick Miller, City of Sunnyvale; Mr. George Hynek, County of Mendocino Department of
Public Health; Mr. Tim Epperson, County of Santa Cruz Health Services Agency; Ms. Cindy Okusaku, Yolo County~
Environmental Health; Mr. Bill Summers, West Sacramento Fire Department
Attachments:
Table 1 - Temporary UST Closures
Attachment 1 - Permits
Attachment 2 - Inspection Forms
Attachment 3 - Rinsate Manifests
CNCD:\SHARE\UST~03-0004.doc
TA.B,EE,S,--
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~ TABLE
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I CNCD:\SHARE\UST~03-0004,doc
Table 1
Temporary UST Closures
26 SBC Facilities
Amount of UST
Manifest Amount of Oxygen LEL
Address Temporary UST Size UST Contents Rinsate/Contents
Number Dry Ice Added Percentage Percentage
Closure Date Generated
12,000 gal. Gasoline 300 lbs <3% <3%
5650 Aldrin Court, 12/17/02 559 gal. 22095559'
Bakersfield 5,000 gal. Diesel 100 lbs <3% <3%
8,000 gal. Gasoline >160 lbs <10% <10%
3720 Morrow Lane, 12/18/02 1,500 gal. 21394859
Chico 4,000 gal. Diesel >80 lbs < 10% < 10%
10,000 gal. Gasoline >200 lbs 9.3% 0.6%
2510 Old Highway 12/30/02 600 gal. 22095582
53, Clearlake
2,000 gal. Diesel >100 lbs 4.2% 0.1%
5749 Humboldt Hill 4,000 gal. Gasoline 250 lbs < 10% < 10%
12/30/02 385 gal. Pending
Road, Eureka
6,000 gal. Diesel 250 lbs <10% <10%
44900 Industrial
12/13/02 10,000 gal. Gasoline 1,300 gal. 22095553 >150 lbs 9% 3%
Drive, Fremont
5555 East Olive
12/27/02 8,000 gal. Gasoline 200 gal. 22232198 160 lbs 1.3% 1%
Street, Fresno
10,000 gal. Gasoline >200 lbs 0% 3%
2515 South Orange 12/27/02 200 gal. 22232202
Avenue, Fresno
8,000 gal. Diesel >160 lbs 0% 2%
1420 Tuolumne
Street, Fresno 12/27/02 8,000 gal. Gasoline : _800. ,., ga!.~ , .~ ~. 22095584 200 lbs 0.1% 4%
1860 Wardrobe 6,000 gal. Gasoline ~' ('; ~ ':~? c'; ~ i ~ r. ;~ > 120 lbs < 10% < 10%
12/19/02 1,120 gal. 21996787
Avenue, Merced
4,000 gal. Diesel >80 lbs <10% <10%
CNCD:\SHARE\UST~03-0004.doc
Table 1
Temporary UST Closures '~
26 SBC Facilities
Amount of UST Manifest Amount of Oxygen LEL
Address Temporary UST Size UST Contents Rinsate/Contents
Closure Date Generated Number Dry Ice Added Percentage Percentage
8,000 gal. Gasoline 160 lbs 20.9% 0%
1548 Carpenter
Road, Modesto 12/20/02 400 gal. 21996789
4~000 gal Diesel 100 lbs 20.9% 0%
1412 Granite Lane, 12/20/02 8,000 gal. Gasoline 350 gal. 21996788 160 lbs 18% 0% '
Modesto
10,000 gal. Gasoline >200 lbs <10% <10%
230 Camino Oruga 12/23/02 1,500 gal. 22232197
Court, Napa 2,000 gal. Diesel >200 lbs <10% <10%
908 28z Street, 4,000 gal. Gasoline 80 lbs 0% 2%
12/19/02 1,100 gal. 22095560'
Paso Robles 6,000 gal. Gasoline 150 lbs 7.5% 8%
8,000 gal. Gasoline 250 lbs 9.5% 0%
7240 Johnson Drive,
Pleasanton 12/27/02 ...... 850 gal. 21996790
4,000 gal. Diesel 150 lbs 9.4% 0%
6,000 gal. Gasoline >120 lbs <10% <10%
1060 Terven Street, 12/26/02 500 gal. 22095564
Salinas 4,000 gal. Diesel >80 lbs <10% <10%
5285 Doyle Road, 12/17/02 10,000 gal. Gasoline 1,iO8 ~ai.i~ 22095558' >200 lbs 18.8% 9%
San Jose
3598 Hillcap 12/17/02 10,000 gal. Gasoline 100 gal. 22095557' >200 lbs 20.9% 1%
Avenue, San Jose
262 East 19th 22095566/
Avenue, San Mateo 12/20/02 10,000 gal. Gasoline 1,400 gal. 22095561' >200 lbs <10% <10%
96 Louise Street, 12/23/02 10,000 gal. Gasoline 1,000 gal. 22095583 >200 lbs < 10% < 10%
San Rafael
CNCD:\SHARE\UST~03-0004.doc
Table 1
Temporary UST Closures
26 SBC Facilities
Amount of UST
Address Temporary UST Size UST Contents Rinsate/Contents Manifest Amount of Oxygen LEL
Closure Date Generated Number Dry Ice Added Percentage Percentage
142 West Ponderosa 4,000 gal. Gasoline 260 lbs 2.3% 10%
12/16/02 1,333 gal. 22095555'
Drive, Sonora
4,000 gal. Diesel 150 lbs 8.5% 2%
10,000 gal. Gasoline 150 lbs 19.7% 0%
2300 East Eight 12/31/02 1,500 gal. 21394856
Mile Road, Stockton
5,000 gal. Diesel 150 lbs 12.3% 0%
4051 Newton Road, 12/26/02 10,000 gal. Gasoline 1,200 gal. 21771071 500 lbs 4.1% 5%
Stockton
1188 West Evelyn 12/30/02 10,000 gal. Gasoline 200 gal. 22095567 500 lbs 2% 10%
Avenue, Sunnyvale
8,000 gal. Gasoline > 160 lbs 0.1% 0%
300 Kuki Road, 12/30/02 200 gal. 22095581
Ukiah 4,000 gal. Diesel >80 lbs 7.7% 8.1%
515 Chappell Road, 6,000 gal. Gasoline >120 lbs < 10% < 10%
12/26/02 1,000 gal. 22232205
Watsonville 4,000 gal. Diesel >80 lbs <10% <10%
1777 West Cebrian 8,000 gal. Gasoline >160 lbs 8.5% 2%
12/23/02 600 gal. 22095585
Street, Sacramento
2,000 gal. Diesel >40 lbs 8.4% 6%
Notes:
LEL - lower explosive limit
* - rinsate was disposed of at Burlington Environmental, Inc. in Kent, Washington
CNCD:\SHARE\UST~03-0004.doc
A-T--TAGHMEN~!' .
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I ATTACHMENT 1
I Permits
i CNCD:\SHARE\UST~03-0004.doc
it. By: BUTTE CO ENVIRONMENTALHEALTH; 530 895 6512; .ov-25-02 4:34PM;
P.o, Box ~4 (4xx NiX~ ~:lt~) ~hLco, ~ 9s~27-5364Chico, Caf[~omi~
APPL[CA~ZON FOR PE~;~ ~OE TENEO~R~ CLOSURE ""-
UNDERGROUND ~Z~US ~TERI~S STOOGE T~K(S)
J~ed DXm~oXt~on of T~Im): -
. sure ~Cractor: ~n,u~ ~A~t~m~ ' Telephone: ~ 9~ ~ '- -~---
Hip{ I~P~s~'~ ~ ~c~,C~ Lac. ~=. -~o
' . III ... JlIILI I. I I I II II1[.1111 I .. _ I
~ker~' ~n~aelon ~ldxae~o.: X be~ ~ffi~
~llow~ng ~l~r~tioflm~
~ff~.
~rr~r~ .... ~i ~m~r~n (~S~_(_~~9 ~Jl~
Z ~ mc ~ ~ ~ ~ ~ ~ ~om M~ ~ ~c la imm~, Z m~lZ ~e ~Zoy any
__- ~ · .11 ~ ~ ~ ~ IIII I I I I II Ill I I II L
, -~-t).~ ~ .... ~ ~~-o= '
Ic~s TO BE XNCLUDED~ Closure Work Plan - Da~e Reed /~-~ ~0~ ......
MYT _F~l-q; Closure Fee:
I 11/25/02 MON 16:18 [TX/RX NO 8597] ~002
1'2/12/ -102 TRU 09:32 FA~ 530 895 4931 CITY OF CtlIC0-FS 1 [~]002
I
]~ ~e~t REMOVAL I CLOSURE
Pe~R No: MISC~2-03 Facile: PACIFIC BELL.
Applicant: THE SHAW GROUP, INC. Bus Phone. (925) 288-2~03
, S~: 3720 MORROW ~NE, CHICO
Description: Pete for o~sional, specific a~iv~ to temporarily ~ose underground h~a~ous
materials storage ~nk(s). which must be pu~ed ~ d~ i~ (16 lbs per 1.000
gallon capad~). Pu~in~removal must be w~s~ by authorized Chico Fire
Depa~ment pemonn~. A 24 hour nofi~ is required (895~930). Soil samples to
. ~ provided, as r~uir~. Insumn~ and Ii,rising of contractor to ~ in o~er~
~S ~IT ~ I~ED ~D ~ ~ =u ~N ~D~S ~T~ ~ON$ N~
~IS PE~IT DOES NOT T~E ~E D~of~ue:
P~CE OF ~Y UCENSE REQUIRE[:) BY
~W ~D iS NOT ~NS~ 1=11102
THIS PERMIT MUST AT ALL TIMES BE POSTED ON THE PREMISES MENTIONED ABOVE
I
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)IVISION OF ENVIRONMENTAL HEALTH (OEH) Repair/modification (includes leak detection & product lines)· ~Roceipt
WREKA, CA 95501
Identify tank(s) involved: 1~) '" ~¢'~
^pptication is hereby made to the Humboldt Coun~ Health Officer for a permit to construct, repair, or alter an underground storage tank. or for closure.
temporary or permanent. This permit application must be signed on all three signature lines by the sam. e person, Le., contractor or owner/operator.
I ER~TOR'S ADDRESS:
II TA* P: P.ONE: DEC 0 4
,;ONTRACTOR'S NAME :_ "~
. .. uuMS OF PERMIT - Applicant Agrees That
mboldt County DEH will be ~otitied a minimum of 48 hours pdor to starting work.
mbeldt County DEH inspection will be obtained pdor to backfilling and/or covedng the work (where applicable).
i AN.y DEVlATIO.N. from the,approved permit without pdor approval [rom the Humboldt County DEH may be cause for stopping work until the changes are fully justified and
approved. ;- · .
is permit is subject to revocation if ~ou~id to be in nonconformance with Humboldt County Code, City Codes, or standards of the Humboldt County DEH or State Underground
Storage Tank Regulations. ~ . ~ _
[~. the undersigned ownerloperator/applicant of the subject facility, hereby authorize ,.~ICNIN~ ZCNO*t~Dt~O,~ /~-~.~'1 ,o release any and all analytical
I, results, geotechnical data and site assessment information to the Humboldt' County DEH as soon as it is available and is provided to me or any representative.
'~dditional items:
lunderstood that the issuance a permit in no way indicates that a guarantee perfect operation by County hereby acknowledge
and
inde§nite
is
made
the
Humboldt
DEH.
I
I have read this application and state that the above information is correct and agree to comply with all County and applicable dty ordinances, and state laws regulating
mderground storage tanks. This permit shall expire by limitation if work authorized is not commenced within 90 days.
, undersigned applicant certifies the following: ,a,~aN~u~E OF ~,rPLICANT
Yes '-~ Coastal Zone Permit Agency contacted, if project is in Coastal Zone.
'INTRAcToRS'~~ LICENSE LAW CERTIFICATE (Complete A or B) WORKERS' COMPENSATION CERTIFICATE (Complete A or B)
--'A. The applicant is licensed under the provisions of the ., A. A currently effective certificate of Workers'
Contractors' License Law under License # ~ I ~1 .~'~ ] Compensation Insurance coverage is on lile with the
'1 and said license is in full force and effect. Humboldt County DEH. Policy #
$ e,A i 6Cl °00
B. The applicant is exempt from the previsions of the B. I ceddfy that, in the performance of the work for
Contractors' License Law for the following reason: which this perrnit is issued, I shall not employ any
I 1) Owaer/Operator person in any manner so as to become subject to the
2) Other (explain) Workers' Compensation laws of California.
I AP P LIC,4~'4T -- "/ DATE: APPLICANT DATE: '
-=XPIRATION OATE:
N TRANSFERABLE WHEN APPROVED, THIS IS YOUR PERMIT . UST 4/2002 (Page 1 o~ 1)
page 1 of 2
I
INDICATE ~E OF TANK CLOSURE YOU ARE APPLYING FOR:
~ PERCENT CLOSURE O~ ~TEMPO~RY CLOSURE
I ~ REMOVAL
Q CLOSURE IN-P~CE
I) TE: 'TANK" INCLUDES ALL ASSOCIATED PIPING WHICH. CAN HOLD STANDING FLUID AND IS NOT PREVENTED FROM
LDING STANDING FLUID BY AN APPROVED DEVICE, FROM THE TIME OF INSTALLATION.
OVIDE THE FOLLOWING FOR EACH TANK:
TANK CAPACITY AGE OF TANK . TANK CONTENTS REMAINING PRODUCT DATE TANK
(GALLONS) (YEARS) (GALLONS) LAST OPERATED
q .COO q Go.t,t,,,,z i?--,' t'2-o2
ALL TANK(S) CONTENTS MUST BE REMOVED AND DESTINATION DOCUMENTED PRIOR TO CLOSURE.
~AH~RDOUSWASTE GENE~TORNUMBER FORTHIS FACILI~: ~0900 ~59q ~
I
OI~AIER S~PLING FOR PRODUCl CONI~INAIION ~OSl BE DONE FOR PER~ANENI I~K CLOSURE.
IME OF LABORATOR~ TO BE USED FOR ANALYSIS: pHONE:
I NOTE: SUBMIT A COPY OF ANALYTICAL TEST RESULTS TO THE HUMBOLDT COUNTY DIVISION OF ENVIRONMENTAL HEALTH
· - WITHIN 30 DAYS OF CLOSURE ACTIVITIES.
page 2 of 2
HUMBOLDT COUNTY' UNDERGROUND STORAGE TANK PROGRAM
SUPPLEMENTAL TANK CLOSURE PERMIT APPLICATION'
IOR ALL TYPES OF TANK CLOSURE, THE APPLICANT MUST PROVIDE A PLOT PLAN OF THE EXISTING FACILITY SHOWING PROPERTY
BOUNDARIES, LOCATION OF TANKS AND PIPING TO BE CLOSED OR REMOVED, UNDERGROUND UTILITIES, WELLS, AND ANY REMAINING
TANKS.
IECTION I - TANK REMOVAL
YEslLL THE TANK(S) AND PIPING BE CLEANED ON SITE? E] YES Q NO
: NAME OF COMPANY CLEANING TANK AND PIPING:
METHOD OF CLEANING TANK:
LHOD OF CLEANING PIPING:
E OF COMPANY HAULING RINSATE:
COMPAN~"S DHS HAZARDOUS WASTE HAULER'S LICENSE NO.:
lANK/PIPINGDESTINATION NAME AND ADDRESS):
(FACILITY
M Op: NAME OF COMPANY HAULING TANK AND PIPING:
ANY'S DHS HAZARDOUS WASTE HAULER'S LICENSE NO.:
TREATMENT, STORAGE AND DISPOSAL FACILITY NAME AND ADDRESS:
~VILL THE TANK(S) BE USED FOR SCRAP METAL? [~ YES I~ NO
E ESTH: SCRAP FACILITY NAME AND ADDRESS:
E REMOVED TANK(S) PROPOSED FOR A SPECIFIC REUSE? ' Q YES [3 NO
IF YES: NAME OF OWNER:
I O~TCATION OF REUSE:
URE OF REUSE:
E~CT~oFIR_[E JURISDICTION APPROVAL IS REQUIRED PRIOR TO REUSING TANK FOR ABOVEGROUND STORAGE.
N II - TANK CLOSURE IN-PLACE
l AME OF COMPANY CLEANING TANK:
METHOD OF CLEANING TANK:
o ME OF COMPANY HAULING RINSATE:
MPANY'S DHS HAZARDOUS WASTE HAULER'S LICENSE NUMBER:
WHAT INERT SOLID WILL BE USED TO FILL THE CLEANED IN-PLACE TANK?
I QUANTITY IN CUBIC YARDS:
i ECT~ON Itl - TANK TEMPORARY CLOSURE
NAME OF COMPANY CLEANING TANK:
MPANY'S DHS HAZARDOUS WASTE HAULER'S LICENSE NUMBER: ~ ~)~5 / {~ WOt ~ ! ~0~[~.~ ~)O'30! t/~.
UNDERGROUND STORAGE 'TANK CONSTRUCTION PERMIT .
~l ''~ POST ON SITE
~- FOr compliance with California Health & Safety Code, Division 20, Chapter 6.7 UNDERGROUND "
I STORAGEOF'HAZARDOUS SUBSTANCES and the California Code of Regulations, Title 23; ·
Chapter 3~ Subchapte~ .I~6 UNDERGROUND TANK REGULATIONS.
Datei i~:x~-c~..~-~ z_ PERMIT NO: 02-1-TC2
i ' ISSUED BY:
I Facility Pacific Bell Facility ID# 0002713-.
Addi'e~s' 1860 Wardrobe Ave, Merced, CA "'
I Contractor Universal Environmeatal"
Address .. - 4101 Industrial; Benicia, CA 94510 .
Ei~ens~ NO &':Class 730700 Class A/HAZ '
-1· :~dd~g~i!.::(i':': .i.i-' i:~:::'O'iB~ 5095; Rm 35000; San ramon, CA 94583 (925) 901-7401.
Za:ii~i~h~':X~¢a~e'NotieeReqniredF~r ~ InspeCtiOns (209) 385-7391:
I
"::" PERMIT VALID FOR SIX (6) MOI~I'ItS · .
CORSTRUCTION CLOSURE:
NEW'CONSTRUCTION Tank Removal · . ·
Tank Installati0m In Place Closure .' ' :. · ' ·
Tank:Test: .- . ~AFemporary Cio sure~ 'ct~/~.
Primary
'1 SecofidarY
PiPeline Test - '-
Primary PipeLines: _ STOP WORK ORDER
Secondary containment . -
I
Type,-.
OVerall Containment
Overfill. preVention By Date .Time
Monitor systems Test
'l Annular space Gauging Method '.
REPAIR- STOP WORK ORDER RELEASE '
-- Tank · :...
I Pipelines: ·
__ CONSTRUCTION FINAL
~' · · · By Date Time
: By . Date
I ' X:Ujb\!UST permit..wpd ' · . ·
!
ONTEREY COUNTY HEALTH DEPARTMENT
~VISION OF ENVIRONMENTAL HEALTH
CERTIFIED UNIFIED PROGRAM AGENCY
~-I 1270 Natividad Rd., Rm. 301, Satirms CA 93906 ? (831) 755-4505
I f-11200 Aguajito Rd., Monterey CA 93940 ? (831) 647-7654
[~] 1180 Broadway, King City CA 93930 ? (831) 385-8350
I TEMPORARY CLOSURE PERMIT - UNDERGROUND STORAGE TANK
Rob Delnagro DATE: December 16, 2002
I The Shaw~Group, Inc. ~: PERMIT #: 2341
14005 Port Chicago Hwy. # OF TANKS: 2
Concord, CA 94520-I 120 SITE NAME: Pacific Bell
SITE ADDRESS: 1060 Tcrven.
ISalinas, CA 93901
VThis permit is granted to the above named business for temporary closure of underground storage tanks in which storage
i has ceased but where the owner or operator proposes to close or upgrade or use the underground storage tank within one
ear.
The owner or operator shall comply will all the following requirements to complete and maintain temporary closure of an
iinderground storage tank:
· All residual liquid, solids, or sludge's shall be removed and handled in accordance with the applicable provisions of
Chapters 6.5 and 6.7 of Division 20 of the Health and Safety Code.
I. Except for required venting, all fill and locations and piping shall be sealed using locking or concrete
access
caps
plugs.
Power service shall be disconnected from all pumps associated with the use of the underground storage tank unless
the power services some other equipment which is not being closed, such as the impressed-current cathodic
protection system·
The monitoring required pursuant to this permit may be modified by this departme~nt during the temporary closure
period· In making a decision to modify monitoring requirements, this department shall consider the need to maintain
monitoring in order to detect unauthorized releases that may have occurred during the time the underground storage
tank was used but that have not yet been detected. In all cases, corrosion protection shall continue to be operated.
5. owner or operator inspect the underground storage tank at least once every three months to verify that the
The
shall
temporary measures are still in place. The inspection shall include but is not limited to the following:
I A. Visual inspection of all locked caps and' concrete plugs·
B. If locked caps are used, at least one shall be removed to determine if any liquids or other substances have
been added to the underground storage tank.
I . At the end ora temporary closure period over 12 months,' including any extension granted by this department, the
owner may reuse the underground storage tank(s) only if the tank(s) meet the requirements of Article 3 for new
underground storage tanl~ or is upgraded to meet the requirements of Article 6.
All new and existing underground storage tank systems which have been temporarily closed must continue to comply
with repair and record keeping requirements, release reporting and investigation requirements, and release response
and {5orrective action requirements as specified in Title 23, Division 3 and Chapter 16 of the California Code of
I R
egulations and Chapter 6.7 of the Health and Safety Code.
L The Monterey County Health Department Operating Permit conditions and fees shall be kept current during the
closure period.
I ERMIT EXPIRES
ix (6) months from
Allen J. Strph~ R.E.H.S, M.P.A,
~ o/~ntal Health
l ecember 16, 2002
IJ_~hn Ramirez, R. E. H. S.
~,gupervising Hazardous Materials Specialist
!
lev. 12/07/01)
...... ~'"~ HaZardoUs Materials s~. jo~ ~
S uqJOSE
$tora~o 8~stom Permit ~. ~ ~. s~.
San J~, ~ ~11~1~5
~ OF ~ v~Y ~e: (~8) 2~59
Busin~N~e: ?~,g~ ~[[ Date: [I / ~ /
Addr~s: ~ ~t~ ~O SanJ~e. CA,~p:
Busin~ Name:
~ili~Addre~: ~06~q$; gm 5ZO~ 0~: 5~0~ smm:~ . Zip:
'
Busings Name:
Phone: (~) ~- 1~1 or ( ) ~ail addre~:
~San J~O~Bu~ne~nseNum~r ~Ot~ Expim~onDate: /~ /~ ~ ~ ~ ~
~e~s~pen~a~Numbe~ ~t~Z ExpimgonDate: [~ / ~t /0~
*S~n~om~nseNum~randI~e: ~qO~ Expim~n Date: O 7 / ~ ~
*If ~empt. ~en ~fs in~a~on sh~t must ~ submiff~ ~ applim~on.
~ Oosum ~ Fadli~ Paffial Cl~ure ~ H~ffi Compress~ Ga~C~enic Sysmm ~ va~an~
Repair ~ Faoli~ Full Closu~ ~ Ine~ ~mpre~ed ~s S~ ~ Ba~e~ Syst~
New Ins~l~aon ~ ~temOon ~ O~er H~ous ~tefial System {NOS) ~ Meal Finishin~Plafing Hne
Remoml ~lem~m~ ~ ~ ~ ~veground T~Piping S~tem (liquid) ~ Fadli~ Closure
Note: UnO.round fan.Piping Swtem ~ Variant, mu~ ~Undergr~nd lan~iping System 0iquid) ~ LP.G. Tank Piping System
I~ve addia~a~ a~i~tions am~ m ~is ~o~.
3
4
5
Attention Contractor:
This pe~ is being issued pumuant to ~e r~uimmen~ specified on the a~ed San Jose Fire Depa~ent Plan Gh~k. It is your
r~nsibili~ to ~st this do.merit conspicuously at t~ job site prior to ~mmencing ~. You are to have an approved set of plans and
San Jose Fire Depa~e~ Plan Check available at ~e job site. You must mn~ our office to ~ule all required insp~ons at least
48 houm in advance. ~is pe~ is valid for 180 days from date issued. ~e pro~t must be ~mpleted by ~is date. unless prior wfiEen
approval for e~ension is given by the San Jose Fire Oepa~ent.
~P~s N~ (Please ~int}
{ ~ ~ ~ I~TLE (please Pdn~
~ A~CAN~S SIGNA~RE DA~
Pdma~ ~n~ment __ I /
Se~nda~n~inment I~1 . ~ ~ ~
Moni~ngSystem I~/ ~./ O~ ~~~
O~ec __ / ~ / ~ ~ '
F~ No, 2~-143 (Rev.)~2) Cop~s: WHITE-Pe~it Fi~ PINK-~p~nt HARD Copy-Job Site
I
I
Proiect: P-6722 Permit/Plan Check: 2002-060476-HZ File: 401461
SAN JOSE FIRE DEPARTMENT HAZARDOUS MA TERIALS PROGRAM
4 North Second SL, Suite 1100
San Jose,. CA 951f3-1305
HAZARDOUS MATERIAL PLAN CHECK
Date: December 11, 2002
Project Location: 5285 Doyle Rd.
Facility Name: Pacific Bell
Application. Date: December 9, 2002'
Project Contractor: Philip Service Corporation '
Type of Work/Construction: Underground tanktemporary closure
PLAN IS APPROVED WITH THE FOLLOWING REQUIREMENTS.
GENERAL REQUIREMENTS:
~ A copy of this Plan Check and Permit must be on site and available for review when
requested. (2001 CFC 105.5)
~ Personnel trained in accordance with 'applicable local, state and Federal regulations
shall perform all work.
/~. Equipment capable of producing static electricity shall be bonded and grounded.
~ The tank shall be temporary out of service for a period not to exceed one year. If
the tank is out of service for more than one year it shall be removed. (2001 CFC
7902.1.7.2.3)
~ Product shall be removed from the tank. The tank shall be inerted, as often as
necessary, to levels that will preclude an explosion. (2001 SJFC 7902.1.7.2.2; CCR
23167.2671 (a)(2))
,.6!. Power service shall be disconnected from all pumps associated with the
underground storage system. (23167.2671(a)(5))
7. All piping, including fill line, gauge opening, vapor return and pump connection shall
be capped or plugged and secured against tampering. (2001 SJFC 7902.1.7.2.2)
/~. Vent lines shall remain open propedy maintained. (2001 SJFC 7902.1.7.2.2)
and
/29T' The tank shall be inspected at least every three months to vedfy that temporary
closu re measu res are still in place (CCR 23167.2671 (b))
Page 1 of 2
Project: P-6722 Permit/Plan Check: 2002~360476-HZ File: 401461
SAN JOSE FIRE DEPARTMENT HAZARDOUS MA TERIALS PROGRAM
4 North Second St., Suite 1100
San Jose, CA 95113-1305
HAZARDOUS MATERIAL PLAN CHECK (cont.),,
~i. The monitoring system shall be maintained and operational at alt times during the
period of the temporary closure. (H&SC 25284.1(a)(4)(C))
Closure is subject to final inspection and approval. Contact the inspector identified at
least 48 hours in advance to schedule a final closure inspection.
NOTE: This plan check is for the requirements of the Fire Department
Hazardous Materials Division only. The Fire Department
Engineering Division or other City of San Jose Departments
may have additional requirements.
If you have any questions regarding this project, please contact Inspector Michael P~[.episto '
at (408) 277-8748.
Page 2 of 2
..... Lg~.r~ Hazardous Materials san Jo~e ~re ~.ent
: Storage System Permit ~.. s~ m..
S~J~.CA 9511~1305 '
~ ~ ~ v~ P~ne: (408) 2~59
Busin~ N~e:
'Address: 35qB
Phone:(.~Z~.) ~Z~ - ~ ~ (q~f) ¢O~ - oqol ~ailadd~:
B~in~s Name:
*If exemp~ ~en ~s in~afl~ s~et must be submiR~ ~ applique.
WORK PROPOSED (Sel~ One) ~ ~PE OF PROJECT/SYSTEM: (Sel~t One)
~ O~um ~ Fadl~ Pa~ Cl~ure~ ~ H~rd ~mpr~ ~ic S~tem ~ Vafian~
~ New Ins~l~fion D N~mflon ~ ~er Ha~rdous Material System (NOS) ~ Meal Finbhin~la~ng ~ne
~ Remoml ~ Tm~ ~ ~f ~ ~vegr~nd Tan~Piping S~t~ (liquid) ~ Fadli~ O~ure '
Note: Unde~mu~ Tan~ing S~em ~Vafian~. m~t ~nde~round Tan~iping S~tm (liquid) ~ L.P.G[ Tank Piping Syst~
ve a~ifional appli~ons a~
4
5
Attention Contractor:
~is pe~it is bei~ issued pumuant to ~e requirements sp~ified on the a~ched San Jose Fire Depament Plan ~k. It is your
res~nsibili~ to ~st ~ document mnspic~usly at ~e iob site pdor to mmmencing wo~. You are to have an approved set of plans and
San Jose Fire ~pament Plan Ch~ a~ailable at ~e job site. You must contact our off~ to ~hedule all r~uir~ impatiens at least
~ houm in advan~. ~is pe~it is valid for 180 days from date issued. ~e pmj~ must be ~mplet~ by ~is date, unless prior ~ffen
a~roval f0~ e~ens~n is given by the San Jose Fire Oepa~nt.
~,MC~S ,~E (Ple,e Prin, ~ (PI .... Print) APPUCAN~S SIGNA ~RE DAm
I
: · ~} ~.. : ..
Plans Revie~ ~1 Il
Se~nda~ ~n~inment /. /
F~ NO. 24~ 43 (Rev. 1~2) Copies: WHITEbait ~te PINK~p~nt HA~ Copy-Job Site
I
!
Project: P-6723 Permit/Plan Check: 2002'060480:HZ File: 401471
SAN JOSE FIRE DEPARTMENT HAZARDOUS MA TERIALS PROGRAM
4 North Second SL, Suite 1100
San Jose, CA 95113-1305
HAZARDOUS MATERIAL PLAN CHECK
Date: December 11, 2002
Project Location: 3598 Hillcap Ave.
Facility Name: Pacific Bell
Application Date: December 9, 2002
Project Contractor: Philip Service Corporation
Type of Work/Construction: Underground tank temporary closure
PLAN IS APPROVED WITH THE FOLLOWING REQUIREMENTS.
GENERAL REQUIREMENTS:
1. A copy of this Plan Check and Permit must be on site and available for review when
requested. (2001 CFC 105.5)
2. Personnel trained in accordance with applicable local, state and Federal regulations
shall perform all work.
3. Equipment capable of producing static electricity shall be bonded and grounded.
4. The tank shall be temporary out of service for a period not to exceed one year. If
the tank is out of service for more than one year it shall be removed. (2001 CFC
7902.1.7.2.3)
5. Product shall be removed from the tank. The tank shall be inerted, as often as
necessary, to levels that will preclude ah explosion. (2001 SJFC 7902.1.7.2.2; CCR
23167.2671(a)(2))
6. Power service shall be disconnected from all pumps associated with the
underground storage system. (23167.2671(a)(5))
7. All piping, including fill line, gauge opening, vapor return and pump connection shall
be capped or plugged and secured against tampering. (2001 SJFC 7902.1.7:2.2)
8. Vent lines shall remain and properly maintained.-(2001 SJFC 7902.1.7.2.2)
open
9. The tank shall be inspected at least every three months to verify that temporary
closure measures are still in place (CCR 23167.2671(b))
Page 1 of 2
Project: P-6723 PermitJPlan Check: File: 401471
2002-060480.HZ'
SAN JOSE FIRE DEPARTMENT HAZARDOUS MATERIALS PROGRAM
' 4 North Second SL, Suite 1100
San Jose, CA 95113-1305
HAZARDOUS MATERIAL PLAN CHECK (cont.)
10.The monitoring system shall be maintained and operational at all times during the
period of the temporary closure. (H&SC 25284.1(a)(4)(C))
Closure is subject to final inspection and approval. Contact the inspector identified at
least 48 hours in advance to schedule a final closure inspection.
NOTE: This plan check is for the requirements of the Fire Department
Hazardous Materials Division only~ The Fire Department
Engineering Division or other City of San Jose Departments
may have additional requirements.
If you have any questions rega rd ing this project, please c on ts ct ln spe cto r
at (408) 277-8748.
!
!
Page 2 of 2 i
SAN RAFAEL FIRE DEPT PAGE 82
12/28/~80~
37
415-453-1627
Stooge T~k I~s~U~fion Fire Chief
Robe~ E. M~mucci
De~ Applicant:
Your pe~it application h~ been r~eived. ~e c~ent smms and conditions p~ining to ~is
appli~tion ~e norad below.
Pe~it Numar: 2002~023
Address of Project: 96 ~uise
Projec~usine~: Pacific Bell
~ner/Contractor: Shaw Envi~en~ & Infras~ucmre, Inc.
Mailing Address: 4005 Pon Chicago Highway
Ci~/State/Zip: Concord, CA 945201120
Phone:
CO~ITIONS: To comply wi~ Title 4, San Rafael, Municipal
Coae
Unde~round Storage T~iue Performsnc
Con~itions Inspections
A~cle 79, UFC On 8~e Setup
Pedo~ Tests In Pmsen~ of Fire Mamhall Da~ Oo~umen~tion
Additional Conditions ~lc~c Note; Tcmpora~ closure is valid for a 12 mon~ period, wi~ a
possible extension of 12 additional months. ~activation of the ta~k aRer
12 months r~uir=s that thc t~ be brou~t up to cu~ent m~lato~
s~d=ds for a new inst~lation. .
At lc~t one busings day prior notice is required to schedule ~ ins~ion ap~intmenL Contact the
San Rafael Fire Prevention Bureau at 485-3308.
I
I
I
fire Department Offices: 1039 C Street, $~n Rafael, CA 94901
I Administration (415) 485-3304 Fire Prevention: (415) 485-3308
Fax: (415) 453-1627
12/1~]/2~82 8~: 39 2094683433 FIFTH FLOOR PAGE 86
ENVIRONMENTAL HEALTH DEPARTMENT
SAN JOAQUIN COUNTY
Dir"2'!recto' .... 304 East Weber Avenue, Third Floor Carl Borgmau, R.E.H.$.
Al OI,~,~.V..I~.S. Stockton, California 95202L2708
D~uglaa W'. Wilson, R.E.H.S.
gr M~ ir Telephone: (209) 468-3420 Margaret Lagorlo, R.E.~t.S-
Laurie A- Cotulla. R.E.H-S.
Pragram Manager Fax: (209) 464-0138 Rob~ McClellon, ILE,H,S,
Mark Barc¢llos, R.E.H.S,
December 9, 2002
I Shaw Environmental and Infrastructure,
Inc.
4005 Port Chicago Highway
iConcord, CA 94520-1120
Re: Pacific Bell, 2300 E. Eight Mile Road, Stockton, CA
I' Thc permit application to remove the underground storage tank from the above referenced
.__ facility has been approved with the following conditions:
I 1. A copy of the fire departmer~t permit must be submitted at the time of removal.
2. Schedule removal appointment 48 hours in advaaco.
3. This tank is to be purged and rinsed prior to removal.
4. In addition, the following information must be submitted within 30 days of the removal
date:
I (a) Hazardous Waste Manifest for piping, rinsate, residual fuel, or waste oil recelpt if
applicable
5. All fill and access locati6ns and piping shall be sealed using locking caps or concrete plugs.
I 6. This permit expires on March 9, 2003.
7. All monitoring and record keoping requirements in accordance with Title 23 Section 2671
must be satisfied throughout the 12 month period in which the temporary closure is in place.
If you have any questions please contact me at (209) 468-3459.
Thank you,
Registered Environmexttal Health Specialist
1
12/10/02 TUE 09:43 [TX/RX NO 87091 ~006 ~
12/10/2BB2 89:39 28946B3433 FIFTH FLOOR PA6E B5
Des~ ~ ~o~ce ol
13. ~e ~ere ~y water we~ on ~ p~cel or ~ce~ ~es? ~ 11
~bHc WeH
1~ ~ ~e ~s) pen~g clos~ be rep~ced ~ ~ a~n~ or ~d~d storaga ~a}7 ~ i NO[ I
15. ~catu ~e tcspo~lble ~ ~ be b~ed ~or ~un~ ~S.~ s~[[ ~e e~en~ed he.nd 3 ho~ mlnlm~ ~t pa~ent
per ~ ff ~e pa~ d~a~d belo~ Is ~ff~ut ~ ~e pe~t ~pH~ e.g. p~pe~ o~r. ~e p~ must
~ ~spnnslbm~ lot ~e h~ by s~a~ ~ ~ln below.
EH 23 046 (Revised 0~/13/99) Page 6
"
12/t0/02 TUE 09:45 [TX/RX NO 8709] [~005
12111~1'~1~11~2 ~: ~ '~46B3433 FIFTH FLOOR P~6E 04
!
I 8. a. Describe tho.method that ~ be utilized to p~e u~or ~e~ ~e r~ ~.
~ Hair ~~ P Or ba~cd ~ ~d~s).
~A ~ p~ ~pofled ~ a pe~ed T~
9. h ~ s~p~g ~ ~ ~udent ~d p~ from ~e con~o~
~ 9L ~9~e, h ~ how ~e sob ~or water s~s) benea~ ~e ~ ~d pip~ ~ ~ ob~ed:
10. D~c~e how ~e ex~vt~an ~ be ba~sd ~ s~ble m~ upon remov~
S)~t m~ ~ ~ ~e(~ ~e ~e ~ pit nd cover ~e
I2/10/02 ~ 09:43 [TX/RX NO 8709] ~004
i2/18/2082 89:39 2894683433 FIFTH FLOOR PAGE 83
i 1. (a) Is r~ere ~iI~-EtlD CQntTIctAL~Z nnd ~b~u~s qu~o~t,e ou ~e or en~iose~ · ~ M NO [ J
(c) Does ~ ~fl~cmr p~e a '~~ ~m ~v~ ~~n'? ~S ~ ~o [ I
~ (~ ~ eye,ne on size. hclu~g cm~ec~oe o~Mr. been ce~fled
~ B~ a*~ H~ ~ ~e~ ~* for ~ Job ~1~ been sub~d~ ~ NOII
~ 4. H~ ~e ~n~ ob~ed approval ~m ~e l~c~ ~e
5. Is~ere~ow~d~eore~dence orle~e~m~e~s)~orpt~ ~fy~,ple~e e~)~[] N0[~
~' ~ ~ ,:-~j) andpfp~bc ~u~ate~ prior ~o remov~ ~S ~ NO [ ]
'~ ~ De~ me~o~ M be mod for de~n~lnndo~ .
~ · Describe how ~a~ ~ ~ b~ stood a~te p~or m m~ of~:
~ ~ 12/10/02 '~ 09:43 [TX/~ NO 8709] ~003
SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES
I ENVIRONMENTAL HEALTH DIVISION
-- APPLICATION FOR UNDERGROUND STORAGE TANK CLOSURE PERMIT
I ' THIS PERMIT FOR pERM~NE. NT/TEMPORA/~Y Ct.O~URE OR ABANDONMENT IN PLACE Ol:; UNDERGROUND HAZARDOUS SUBSTANCES
STORAGE TANK(S) EXPIRES 90 OA¥$ FROM THE APPROVAL. DAT'~, {:tO NOT WRfl'E It{ ANY SHADED AREAS. INDICATE PERMIT TYPE:
r-i REMOVAL I~. TEMPORARY CLOSURE [] CLOSURE'IN PLACE
FACILr~"iI~FbRMATION
I
CRO~S STREET
m
'/ {.ABORATOR¥ NAME ~1~ . . COUNTY ~ i~¥ I PHO,~d~ [~ ~ .~I~ .
I ' ~AN~ I(~ ~' _' TANK SIZE TANK CO~TENT$ (pRIn..RENT & PAST) ' 13ATE INS'~ALt~ED '
.39-
39- . ......
39-
,e,c~PLIC;ANT f4US¥ PERFORM ALI. wORK IN ACCOROANG'~ WFrH SAN $OAC3UEN COUNTY ORI3IN~{::E$, ~TAT~ LAWS, FEOEP. AL I,,AW'$, AND RML~$ AND
I REGULa. TIONS OF SAN JOAQUIN COUNTY FUaLK: HE. eJ..TH SEA'dICES. OWNER OR UCEFI$~-O AGGN'~$ SK3NATUla~ CE. RTIFtES THE r-GLI.OWING:.
CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR wHiCH THI~ PERMIT I$ I,.~'~L/EO, I S~..ALL NOT ENI~LOY ANY PERE~ON IN SLI~H A M,,.,~NNER
TO BEL~--.,OM~ SUBJECT TO V~"ORKER'S COMF"~:'N~AI'ION LAWS OF ~a,L.II='OR~IA.' GONTRa. CTOla,'S HIRING OR SUB~ONrI'~G SIGNATURE.
THE ;~LLOWING: 1 C~RTIF'Y THAT tN THE PERFORI~NCE OF T~E WORK FOR WH[C4-1 'n-lis PERk~" Is 1~.5UEO, I S,I-~.t.L Et.~LOY Pl;R~ON$ SUELIEC'T TO
I E] APPROVED ' ' ~'APPROVED WITH C(~i~DI-TI-oN(~)~ D- [~ISApPRov~:D
ANY DEVIATIONS FROM 'rill8 APPLICATION MUST BE SUBMITTED TO P.-.HD FOR APFROVA/. P_RIOR TO~ COMMEN~IN_G
CONDITIONS:
E~ :23 NS' {RE'I~ISED 08153fg91 ..... ~;~ag; 3 ....
I 1Z/10/02 TIJE 00:43 [TX/IIX NO 8700]
FIRE PERMIT
'SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
1810 E HAZELTON AVENUE, STOCKTON CA 95205
BUSINESS PHONE (209) 468-3380
SITE LOCATION INFORMATION pERMIT NUMBER
Job Site Address: 2320 E EIGHT MILE RD S/OC FP-0200568
Cross St: WEST LANE APN: 092-020-13
Scope of Work: CLOSURE OF UG TANK AT PAC BELL SITE
OWNER NAME AND ADDRESS APPLICANT NAME AND ADDREss
NAME: PACIFIC BELL CORP NAME: SHAW ENVIRONMENTAL, INc.
ADDRESS: 2600 CAMINO RAMON f~330 ADDRESS: 4005 PORT 'CHICAGO HIGHWAY
SAN RAMON CA CONCORD, CA 94520-1129
Zip: 94583 Phone: Zip: Phone: 925-288-2109
CONTRACTOR INFORMATION DESIGNER INFORMATION
NAME:
ADDRESS~ .
Lic. No.: Phone:
PERMIT DESCRIPTION
THIS PERMIT MUST, AT ALL TIMES, BE KEPT ON THE PREMISES
Rmove % TKS~NST~L~J~ Permit Expires: 12/06/2003
This permit does not take the place of any License required by law and is not transferable. Any changes in use or occupancy of
permit. This permit shall, in no way, relieve the party to whom it is issued from full responsibility for
incurred
FIRE pERMIT INFORMATION
Total Sq. It,: 0 Occupancy: ConsL Type: Fee: $95.00
Accepted By: T JR Approved: Applied Date: '12/11/2002 · Issue Date: 12/11/2002
ENVIRONMENTAL HEALTH DEPARTMENT
SAN JOAQUIN COUNTY v,-su ·
Donna I~ Heran, R-E.H.$. . ' Carl Bo a~ R.E H,$
DireCtor 30ge East Weber Avenue, Third Floor r~m , . .
Mike Huggins, P,.E.I-LS., P-~D.L
Al Ol~ea, l~g. itS. Stockton, California 95202-2708 ~o~4as w. wa~on, KE.H.S.
Program lffanag~r Telephone: (209) 4683420 Marsa'ec La,rio, R.E.~4.S.
Laurie A. CotuHs, R-EA:I-$. '
'1 Progr~.~,,n,,ger Fax: (209) 464-0138 ~rt McClellon, R.E.H.S.
December 9, 2002 Mark Bareelios, R.E.H..~.
1
Shaw Environmental and Infrastructure, Inc.
4005 Port Chicago Highway
i, Concord, CA 94520-1120
Re: Pacific Bell, 4051 Newton Road Stockton, CA
- The permit application to remove the nderground storage tm~k from the above referenced
facility has been approved with the fo] towing conditions:
· - 1. A copy of thc fire depmiincnt permit must be submitted at the time of removal.
2. Schedule removal appointment 48 l~ours/n advance.
'~ 3. Th/s tank is to be purged and r/nsc~ prior to removal.
'W,,~ z[. In addition, the following information must be submitted within 30 days of the removal
i, date: -
(a) Hazardous Waste Manifest fo~ piping, rinsate, residual fuel, or waste oil receipt if
applicable
5. All fill and access locations and pip,'ing shall be sealed using locking caps or concrete plugs.
ii: 6. This permit expires on March 9, 2~03.
...- 7. All monitoring and record keeping ~equ/rements in accordance with Title 23 Section 2671
must be satisfied throughout the 12 n/onth per/od in which the temporary closur~ is in place.
I
If you have any questions please cont act me at (209) 468-3459.
Dc',n~ H. Catanyag, R.E.H.S.
i Reg/stered Environmental Health S ~ialist
I 12/10/02 TUE 09:43 [TX/RX' NO 87091 ~001
i Des~flbe ~ so~ce of
,,~ l~. ~ ~re ~ w~te~ w~ o~ ~ ~cei or ~3eent ~rope~e~? ~s ! ]
O~er
~' l~ ~ ~e ~n~) pen~g clos~e be replaced ~
m
per ~nk~ If ~e p~ de~a~d below~ ~ffe~nt
~ r~ponstb2~ f~r ~e ~ by.~a~ ~d date bot~.
12/18/2882 89:39 2894683433 FIFTH FLOOR PAGE 8.9
!
!
I~ 8. a- Di~%'Tlbc th,, method that will he utttlzc~i to purge alldlor I~ct't tlXe tazfl~s):. . .
Aiidress Glty. Zip
i Phone No~ . ]
..... BaUler lbgtsi:~ ti(If hauled as hazardous)
em,,
~7
l"hone No.(
RPAID~ (Ir transported to a permitted TSD facfll~]
9. h the sa~2zpll.fl.~ firm ~n tml~pcndent third party from the contractor?
ilt 9a. Describe. Iff det2~l, how the soft alld/ox' wa~r SeA,pie(s) beneath ghe r~tnk and p~ ~ bo obtained:
10. Deacrtbe how the excavation ffi he backfllle'~l wttb suitable zna~crlal upon remova~
~it 11. i~a~dllng or excavnc~t soil:
a) Wlmt mterlsl will be used to line the ULUk pit and cover the stockpile?
b) What wlfl be rJ3e final de~ttnatio~ of the exeavate~t ~toci~plle?
~} Con,*m~a~ed ~J~fl Haza~us Wasm
,~ Address City_
trnone Lqo. {
I ~. F, I123 046 (lb~vJsed 08/13J~19}
I 12/10/02 TUE 09:43 [TX/RX NO 8709] ~]009
12/18/2882 89:39 2894683433 FIFTH FLOOR PAGE 88
1. (a) Is ~ere a L*IL~-EHD cou~acto~'s and ~ubconu'ac~or'e que~Umm.~tre on me or enclo~ ~ ~ NO I ]
~) Is ~ c~eut ce~fl~te oZ worker's co~sadon ~ce on ~e? ~S ~ NO ! ]
(c) Does ~e conffac~rpos~e~ a '~-~-~ ~~ ~v~ ~flon"? ~S ~ ~o i !
(~ H~ eve~ouc on st~.~clu~ff c~e~o~oe ope~,
M~rk on h~do~ ~ste stte ~ a~o~ce ~ CCR~e 87 ~S~ N0 I]
~ H~ a *~ He~ & S~e~ ~' for ~ Job sl~ been subdued? ~S~ X0iJ
4- H~ ~e courior ob~cd approv~ ~ ~c ~c~ ~e dep~ent ~ pc~o~ ~ cu~ ~ ] N~ !
5- ~e~owle~corevlde~eofle~e~m~e~s)~p~ ¢f~pleaseexp~)~[] N0~
6. If ~ resldu~ e~, ideu~ ~po~ ~ous ~tC
I
& ~ ~s) nd plp~ be decon~ted p~or ~ ~mov~? ~S~ NO [ ]
lden~ ~n~act~ ~r[o~
· ~ Des~be ~e~d m be ~ed for ~c0n~a~u~
~ Describe bow ~sam mte~ ~ be stored o~te p~r M m~es~ or. Ire:
~ed J~os~ ~c
~ ~ ~6 ~ed 0~1~) ~e 4
iZ/10/0Z T~-0fl:~3 [TX/~ NO 87001 ~008
12/18/2882 OcJ: ::1~ 20~4683433 FIFTH FLOOR PAGE 07
SAN JOAQUIN OOUNTY PUBLIC HEALTH SERVICES
ENVIRONMENTAL HEALTH DIVISION
APPLICATION FOR UND. ERGROUND STORAGE TANK CLOSURE PERMIT
THtffi PERMIT FOR PERMANENT/TEt~IPORARY CLOSURE OR ABANOONMENT IN PLACE O~= UNDERGROUND H~RDOU$ SUBSTANCF_~
STORAGE TANK(S) ~X,°IRES 90 DAYS FROM THE APPROVAL DATE. DO NOT Wt~JTE IN ANY SHAO~O ARE. AS. INDICATI~ PERMITTyPE:
[] REMOVAL I~TEMPORARY CLOSURE [] CLOSURE'IN PLACE
FACILITY I NFORMATic~I~
SAM~NGFIRM ~J~ I ~ONE
TANK IN'~ORMATION
T~K 10 ~. ~ ~ ~ANK Sl~ T~K CONTENTS'JP~E~ENT & P~T)' OA~ iNSTAtED m ,
39-
39-
39- . .......... .
: ~I~T &~ST PERFORM ALL w~ IN AC~RO~ WITH ~N JOAOU~ CO~ ORDIN~NC6S. ~TAT~ ~w~. F~O~L ~W$. ~ RUL~ ~O
~R~ T~T ~ ?HE P~RFO~NCE OF THE WO~ FOR WHI~ THIS PERMIT I~ ~U~. I 8H~L NOT ~LOY ~Y PE~ IN B~ A ~N~ ~
' 'APP dVEO - WiTM CO DmO ( )" o DISAPPROVED
CONDITIONS:
!
I lg/10/0Z TIJE 0fl:~3 [TX/IIX NO 8701tl ~]007
FIRE pERMIT
SAN JOAQUIN COUNTY COMMUNITY DEVELopMENT DEPARTMENT
1810 E HAZELTON AVENUE, STOCKTON CA 95205
~ BUSINESS PHONE (209) 468~3380'
Job Site Address: 405J N NEWTON RD STOC FP-0200567
Cross St: WILSON WAY APN: 092-1
Scope of Work: C~OSURE OF UO TANK
OWNER NAME AND ADDRESS APpLICANT NAME AND ADDRESS I
CONCORD, CA 94520-1120
ADDRESS:
Zip: Phone: Zip: Phone: 925-288-2109
CONTRACTOR INFORMATION DESIGNER INFORMATION
NAME:
ADDRESS:
LIc. No.: Phone:
PERMIT DESCRIPTION
THIS PERMIT MUST, AT ALL TIMES, BE KEPT ON THE PREMISES
1058F36 REMOVE UG TKSflNSTALL UG Permit Expires: 12/06/2003
This permit does not take the place of any License required by law and is not transferable. Any changes in use or occupancy of
new permit. This permit shall, in no way, relieve the party to whom it is issued from full responsibility for
FIRE pERMIT INFORMATION
Total Sq. FL: 0 Occupancy: Const Type: Fee: $95.00
Accepted By: T JR Approved: Applied Date: 12/1112002 Issue Date: 12/11 ~2002
~~ SUNNYVALE DEPARTMENT OF PUBLIC SAFETY
700 ALL AMERICA WAY
SUNNYVALE, CA 94088
,!
December 10, 2002
I Rob Delnag.ro
i The Shaw Group Inc.
4005 Port Chicago Highway
Concord, CA 94520
I Subject: Proposed Temporary UST Closure at Pacific Bell Facility, 1188 West
Evelyn Avenue, Sunnyvale, cA.
! ·
The workplan dated November 26, 2002, has been reviewed and approved. The
I Temporary Tank System Closure will expire one year after the completion of the
workplan. At that point the tank system will have to be removed or Put back into service
in compliance with all applicable laws and regulations. Notify this office 48 hours in
I advance to implementation of the workplan.
i If you have any questions please call me at (408)730-7218.
I HazMat Inspector
Bureau of Special Operation
I cc: Mr..Andrew Taylor, SBC Pacbell, PO Bo× '5095: Rm 3E000, San' Ramon, CA, 94583.
!
i publsfty@ci.sunnyvale.ca.us
(408) 730-71 O0
I;. SANTA .~ SERVIcES AGENCY.. ·
CRUZ
CO
HEA. L'TH
.' ENVmO~NTAL HEALTH' gERVICE
" '" 70i Ocean Street, Room' ~'~2, :sant~i cruz,. CA:~5060 (831 }454-2022 ·
" APPLICATION FOR' :PERMIT' TO MODIFY' ' A HAZARDOUS' MATERIALS FACILITY
[PERMIT EXPIRES'6 MONTHS FROM Dfi/TE OF APPROVAL]
i
~ilit~.,N~ · P~ C~6' ~~ ~ ." ..
ny Owner . ~G~Px~ CgCb Telephone
iCense Number· ~3q, 00~ ,,Telephone ~OO qqq -
neruilder sub~tted: [ ]Yes [ ] No ~ Not applicable
Decimation
~DIFICATION.BEING PROPOSED:
all ,quipment'proposed attach.manufacturers specifications sheets, and installation and maintenance instmCtions~
'materials of c6ns~ction:must be compatible with materifls Stored.
Monitoring Devic~System ~ OverfilVSpill ~ Secondary.ConminmentStruCture
.(Attach Monitoring Plan). Protection (Attach capacity calc sh~ and
identify' materials of. construction)
Repiping ~ AbovegrOund' Tank ~ Other
TITLE DATE
OE' T ' ~ ~ I ~ I I 'ATE: ~Z
0002 DATE:
i 052 ! $23~ .00 DATE:
ECK $23~.00 E- EHS YELLOW-,OWNER PINK'- FISCAL
20. CottonWood Street ." ' · Health Department
Woodlandl 'CA 95695 ' EnvirOnmental Health SerViCes
530,666,8646,
YOLOCOUNTY
PFRMIT
Type of Permit UST TEMP cLosuRE PERMIT {RENI PERMIT NUMBER' UST0276
Name of Business PACIFIC BELL - UA663 Issued 11/01l02
Owner of Business PACIFIC BELL Valid Through 10/31/2003
Business Location 1777 CEBRIAN ST
WEST SACl
This permit is issued pursuant to the Yolo Counl and laws. This permit is valid through the
date indicated above unless previously suspen¢ or suspend this permit to operate the
business listed above for any violation of any c Yolo County Environmental Health Service
of any change in equipment, operations, or mo( operation is subject to prior approval by .
Environmental Health Services. Unapproved ch This permit is not transferable and is valid
only to the owner listed above. New owner.~ mL ion.
Permits issued are subject to any conditiOns, if any, are incorporated into
this permit by reference.' For permits to operate un( tibn. form for each tank;
Bette Hinton, M.D., M.P:H.
Yolo County Health Officer
Thomas Y. To, R.E.H.S., M.P.H. _.~.~ (~)'~'~~"~"-
Director of Environmental Health EnVironme~'al Health Program Specialist
~'- 5010,rpt1,0,0:68.00
West Sacramento Fire Department PERMIT Date Issued ..'
1110 W. Capitol Ave. Date Expired /,~/,ftt~'-'
West Sacramento, CA 95691 617-4600 '
ISSUED TO: PACIFIC BELL 1777 CEBRIAN STREET W.SACRAMENTO 925-288-2103 :
This perrnit:~s issued pursuant to continual compliance with the requirements stipulated in the permit addendum contained within.
'. [] AUTOMOBILE DISMANTLING YARD [] GARAGES (Repair) [] RADIOACTIVE MATERIAL (Storage)
.' [] COMPRESSED GAS STORAGE [] GUNPOWDER (Storage) [] SPRAYING OR DIPPING
d5 Flammabl~/~ Oxidizing/~ Inert d~Corrosive d~Other [] HAZARDOUS MATERIALS [] TIRE RECAPPING
[] CRYOGENICS-STORAGE [] HIGH PILED COMBUSTIBLE STOCK [] H.,~!~/.~/.~ PERATIONS
FLAMMABLE/COMBUSTIBLELIQUIDS LPG [~Y~ER ~'~'~f ~
~ Inside Storage over 5 Gallons /~ Tank Installation
/~ Outside Storage over l0 Gallons /~ Dispensing
/~ Dispensing
" /~ Aboveground Tank Installation /~ Storage .
/~ Underground Tank Installation [-'1 LUMBER YARDS
' · /~ Underground Tank Removal [] PUBLIC ASSEMBLY (50-300 Persons)
. . [] PUBLIC ASSEMBLY (300+ Persons)
The violation of any requirement of the permit addendum or change in the use of the premises invalidates the permit as issued. Operating without a valid permit or in violation Of any of the provisions of a permit or the
Uniform Fire Code constitutes a misdemeanor. THIS PERMIT, WITH THE ENCLOSED REQUIREMENTS, TO BE POSF AT THE ABO~ION~.., 'J
.......... ~er / Fi~t~ctor
I
I
I
I ATTACHMENT 2
~ Inspection Forms
I
!
I
I
I
I
!
i CNCD:\SHARE\UST~03-0004.doc
. %".' _"~i:.:':~' '~'" OFFICIAL INSPECTION REPORT :
, FRESNO COUNTY HUMAN SERVICES SYSTEM "
DEPARTME, NT~ OF.'COMMUNi~ HEALTH ~ :ENVIRONMENTAL HEALTH:sYsTEM
=~ .-~.-~. P.O~Box 1.1867, Fresno'CA 93775-1867 :. :~:: ::~ ·
.=,- . -; 122i iFult°n Mall - (559) 445-3357' ·:.., .
~ ; .~ ~ .:. i: www. fresnohumanserVices.org ·
FacilitY: 7)4c~t~tc ~4/~. ' . Date! ~tc~,,B¢~ ~.-/, 2oo~
. Record ID ~:
Location: ~555 E O~ : ·
Mailing Address: ~0 ~o~ 5o~5 ~. ' 3go~ Census Tract: 3o
Owner/Operator: ~c/~t~ ~'~ ' .. Phone: [~,) ~S
program: ~/00 ~ RoU~NE :~REINSPECTION ~ cOMP~INT ~ CONSTRUCTI°N ~;~,
VIOLATIONS LISTED BELOWSHALL BE CORRECTED WITHIN DAYS I'IMMEDIATELY. ~ '
'~o°5o~5~- g. ooo g,,~ · o~~ . :....:~.. -
Received By: · (¢~'2<~ ~~ ~/~ ~': Analyst:
REINSpEcTION DAT~ ' ::,. : Reset Date: . '.
. · .:....~..j./~:~. ..~... ~: ~
.. : . : ~:. ~ ,~ '.. '. ~ .
( ~~1110 . ~':~; Valid For ~0 Da~. ~uthori~od.b~: ff~///~ ~"
( ) 8Uildin~ p~it~ ar~ r~quir~d forCo~etion o~ th~ itona~ and can b° obtainOd'att~* Ioeafi°n ~hown on th~
back o~ thi~ r~po~. CorreCtion, will not b~ approved until p~rmit~ ar~ finaled.
......... ' ..... OFFICIAL INSPECTIONREPORT .,...,
FRESNO COUNTY HUMAN SERVICES sYSTEM
DEPARTMENT OF !COMMUNITY. HEALTH,, ENVIRONMENTAL HEALTH sYSTEM
.... · P.O. BOx 1.1867, Fresno CA 93775-1867' ' '..:. =: .:- -. ' ·
-~ 1.221 .FultOn Mall - (559) 445.-3357:...:.. ...... ....
.:.,..;: . . Www~fresnohumanservices.org -.'. · ..~
Facility: ~c~*,,C 'S~cL Date: '~)¢c~;~ ?_~/,
Location: ")-5/5 <~. o~'~,c,¢:... "*' :' Record lD#~:~
Mailing Address: -Po 'B~.~ 50?5. ~, "~-~oo0~ .Census Tract: ~ t,zo . -
OWner/Operator: 'P/~c~-,c 'z'3~'z.~, Phone: '.': 5~9 ~,', ~'5~, - ~,~ ~'
Pro'gram: (¢~o :":' i D.ROuTiNE :j,.iREiNSPECTiON [] COMPLAINT [] CONSTRUCTION [~"/~,,,~..c/~--~ .Cl..t.~$u~'./~
VIOLATIONS LISTED BELOW SHALL:BE..CORRECTED WITHIN DAYS / *IMMEDIATELY. '"
: - :.. = . : .~ - .
~'~ -/~i~/c ~ ; · ,'.. .-.."' '
Received By:. . ~~... ~~ . . . - An,lyst: ,~,,,,___. _.. _
REINSPECTION DATE: ~ · .. Reset Date:
..- ;. ~: .-REINSPECTION:FEES WlLLBE CHARGED IFMULTIPLE
REINSPECTIONS 'BECOME NECESSARY DUE TO UNCORRECTED VlO~TIONS
RIM.PERMIT T~IC=UCD Valid For 90 Days. Authorized by:. ~;//,~ . .-.
.( ).Bui~di,g,e~i~, ,re ~equire~ ~or c°=ec~io, o~ ~,es~ i~e.., ,no c~. ~ o~mi,,0 a*l,~ ~oc~io, ~,ow,
back of this repo~. Corrections will not be approved until permits are finaled. ·
Original: O~ce~ile (Revised 1/99) H~t~ .. ..... Page of
- . OFFICIAL .INSPECTION REPORT .
, FRESNO COUNTY HUMAN SERVICES SYSTEM ·
DEPARTMENT.. OF' COMMUNITY HEALTH.~ENVIRONMENTAL HEALTH sySTEM.
- · .. P~O?Box 11867, Fresn° 'CA 93775-1867 ., ..,..;': i'.~
....' 1221Fulton Mall - (559) 445~3357 ..: ....-- - : . .i
~ * -.- www. fresnohumanserVices.org ·
Facility: 7~C/~>c ~&&L Date: ~)gCCe^~c~
Location: /~:zo 7"u'oL u,, ~,~: .... Record ID#:'I 7=~'003',zF$2
Mailing Address: ' 7~o '~oX ~Fo~ R~ · 3Eo~ Census Tract:
~nedOperator: .~ac~,c ~E~L Phone:. (.ff59~
Program: GfDl. ' '~ ROUTINE ~ REINSPEC~oN ~ COMP~INT ~ CONSTRUCTION
VIOLATIONS LISTED BELOW SHALL BE CORRECTED WITHIN DAYS I *IMMEDIATELY'
Received By: .,.'~"-~ · C ,_7 AnalySt:
REINSPECTION DATE: ReSet Date: .
.... lqOTICE:· REINSPECTION FEES WILL BE CHARGED IF MULTIPLE
REINSPECTIONS BECOME NECESSARY DUE TO UNCORRECTED VIOLATIONS
RIM PERMIT TO~-~"~~ Valid For 90 Days. Authorized by:
(.) Building permits are required for correction of these items and can be obtained at the locatiOn-shown on the
back of this report. Corrections will not be approved until'permits are:finaled.
Original: Office/File (Revised ~/99) Hss-m23 Page of
HAZARDOUS MATERIAL-S DISCLOSURE PROGRAM
REPORT
fj ENVIRONMENTAL RESOURCES
3800 CORNUCOPIAW~Y, SUITE C CALIFORNIA HEALTH & SAFETY CODE
MODESTO. CA. 95358 DIVISION, 20,. CHAPTER 6.95
(209) 525-6700 CALIFORNIA CODE OF REGULATIONS
...... ~ ............ FAX# (209) 525-6774 ~' T I Tn E 19
( ) Initial ( ) Annual ( ~ Reinspection/Notice follow-up ( ) Complaint/Re,est
Yes No BUSI~SS INACTION (SectioRs 25504, ~R 2729, 2731)
1. Business identification info~ation complete in business plan.
RESPONSE PL~ INFO~TION (Sections 25504, 25505, CCR 2731, 2732)
__ 2. · Emergency resPonse plans and procedures complete.
A) Emergency notifications. B) Local emergency medical assistance.
3. Mitigation, prevention, and abatement of hazards - written procedures.
4. Employee training program documented: annual and refresher courses est~lished.
__ 5. Business plan certified by appropriate person.
.~ I~R~ INFO~TION (Sections. 25505, 25509, 25509.3, CCR 2729)
6. Chemical inventory is compIetg, accurate and certified annual.ly.
7. Treatment, disposal, and waste codes reported.
~-- SITE/BUILDING ~ (Sections 25504, CCR 2729, 2730, 2731)
8. Site/Building map is complete and identifies:
Yes No Yes No
a. North designated f..DOT cOdes/UN ~s
b. Building, storage, rooms, and other g. Utility shutoff devices
-- , areas arc numbered or lettered ~ . ,
. ~ h. 'Dry wells storm drains, and
..... c. A~jacent streets and property x culverts
__ d. Details of each floor (access & egress) i. Fire hydrants and fire ext.
__ e. Evacuation routes and re-asSembly areas j. EmeEgency equipment ~..
OFFICIAL NOTICE
A~ ~BY' DI~E~ED ~ CORRE~ ~ DEFICIENCIES LISTED ~OVE WITHIN
DAYS
/ ~ .j eaz'~) ( S~CNa~RE )
4013-456 OFFICE USS O~Y: I.D. ~ CFIRS ~
DEPARTMENT OF ENVIRONMENTAL RESOURCES
Slanislaus County Hazardous Materials
- Deparlment of : (209)525-6700
Environmental Resources i..~ INSPECTION'REPORT Fax: (209)525-6774.
3800 Cornucopia Way. Suit~ CALIFORNIA HEALTH AND sAFETY CODE
· Modesto, CA 95358 ~ CALIFORNIA CODE OF REGULATIONS
...Insert: ( ) Initial (~) Annual/Biennial ( ) Recheck ( ) Permit ( ) Release
~-~'~ :: ~o HAZARDOUS MATERIALS DISCLOSURE PROGRAM
Business Activities Form (Sections CCR 2729.2)
Completed business activities form. (renewal date )
Business Information (Sections 25504 CCR 2729,2731)
Business owner/operator identification'form complete and accurate.
Response Plan Information (Sections 25504;25505, CCR 2731,2732)
. Emergency response plans and procedures complete, emergency coordinator information accurate.
Mitigation, prevention, and abatement of hazards - written procedures.
Employee training program documented: initial and annual refresher.
· BUsiness plan certir,~cl by appropriate person.
-- InventOry Information (Sections 25505,25509,25509.3, CCR 2729)
,.
Chemical inventory & chemical description is acCurate and complete. -
Treatment, disposal, and waste codes reported.. "
SitelBuildin~q Map (Sections 25504, CCR 2729,2730,2731)
· Site/Building map is complete and identifies all required areas.
Aboveground Storage Tank (Sections 25270.5 (c)).
Tank capacity >660 gal or total capacity > 1320 gal. (SPCC required-date comPleted )
yes UNDERGROUND STORAGE TANK PROGRAM '
· No Owner/Operator Contract Yes No Double Wall Tanks
UST facility form Daily audio & visual alarm check
UST tanks form Dally Monitorin_q
Financial cert. Daily visual check of monitoring system
Release procedure Annual Reports, Tanks (SW& DW) '
Written tank monitoring procedure Tank tightness test (SW)
.' Certified dispensing meters Annular space cerL (DW)
· SIR Tank monitor (SW & DW)
~ tank and meter readings Sump Probe cert. (SW& DW)
- Biennial lank test (due ) Cathodic protection cert. (SW-date
Uned Tanks (SW) Annual Reports~ Pipelines (SW & DW)
~ CathodiC protection tested every 60 days Leak detector cert.
Cathodic protection at 850mv or greater ;, Pressurized line test
Lining ceil. (due ) Triennial suction line test (due )
Pipeline auto shut-off cert.
OFFICIAL NOTICE
B vou He Y-Oi -eTeo COR. eCT THe OeFIClENCieS LiSTeO A OW WiTHiN.
~INSPECTOR ! 'L.j~ ~ ~ -- RECEIVED BY:~ ' h_/.,:-: :' ~,'. ~..-S ,. ~.~.;~..._.~:~
(Print) ' (Signature)
i:ii~~~i~ v,ws,on of Environmental Health · Fire DePartment (805) 781-7380
"~:~~ 'P.O..Box 1489 . ' ,lilall'J,lli~.~'}hJsv~
'~~~' :2'156 'sier~ Way-San Lu~ Obis~, CA 9
, ~ :: ~ ~ , : , .' .
::~~¢ Depa~ent of Agncultur~urement
~ ~ S~ar~ (80~) 781-59to ' Utiliti~ Depa~ent - (805) 781-7215
879 Morro strut ~ San Lu~ Ob~, CA 93~1
.'' :~ ~=' '~:"~ ~" ~'~ ........ ::~ "~ ~" 2156 Siev~ Way
Sui~ A ~San'Lu~ Ob~, CA 9~1
CERT~iED UNIF~DPROG~M XGENCY (cUpA) . J E~'
.Date: /~/ ~'/~'~ H~Z~RDOUS UATEaI LS· INSPECTION, FOaU.j ~t~ bY~
~ime: ~' "~ '. ' ~' · "' ~':~' ~' '"":~'"~'.~'~-:~:'~:.'~'"'": ' '
FACILITY ID NO::~ ~: . AG~3ICY INSPECTION TYPE
-FACILITY NAME~i P~ J~_~?/L '"~'" - ~:DEH ~oufine
~ CITY UT~ITIES ~ Other
PHO~:
. ' 'pROG~MS INSPECTED: ~ Brain.s'Plan ~ ~ ~nem~r ST ~ AGT ~ Tie. Perching
PE~ISSION TO ~SPECT:'Imp~ti0ns may involv~ obmMng ~p~,. revieWing~nd Copgng r~&~nd deter~ng
YES NO
I S ~ ~ BP02 .ventory of hamrdom materials, complete (HSC ,25504, Title 19 CCR ,2729)
~ ~ BP03 Site layoufffacility maps are accurate (HSC ~25504,:Title 19 CCR~'.2729)
T~INING PLAN
~ ~ ~ T~91 . Facffity has appropriate traiffi~ program (Title 19.'CCR~2732. ~ 22'cc~ ~66~s.m
~ ~ ~ TR02 Training d~umen~tion, is main~in~ on sitefor current personnel (Title 19 C~ ~2732 &
EMERGENCY:~SPONSE PLAN
~ ~ ~ ER01 Contingency plan ~ complete, u~at~ and main~ on si~ (HSC ~255~, Title 19 CCR
· -- ~2731 & 22 CCR ~66265.53/54)
~ ~ ~ ER62 Facility is operat~ and main~in~ to prevenffmi~tigate fire, explosion, or relic
of hamrdom w~te to the en~romen~ Main~ all r~ffir~ or appropria~ equipment
. inclu~n~ an alam and co~uffimtiom system (Title !9 CCR ~2731 & 22 CCR ~5.31-
'.~
Received t ~ Facili~' R~r~s~ma~iv¢ lh~n~d Name Date °f lnsl~:Cufin
ilnspR¢lx)rtSumma~2/12./3/1999 .. . Page I of ~
San ~ose Fire Depa~ment SUPPLEMENT .; ' :.
,~l~l~'~l.j~ Suite 1100 - ~onducted by Type of Inspection Emplo~e No. · :
!~ San Jose, CA 95113-1305 Code Enforc, HazMat~tE~ [][]EngineeringLi~e HazMatF/S Permit FI ~ One-Ti'me p~rm~t '~Permit [] [] 'Non-permitted ] :'
' Street Numi~-~f . Dir . Street Name. ' ' · Type . ' Zip ' , · ~uildi~j Unit ' : .
,~IOTIcE OF FIRE AND SAFETY HAZARDS AND/OR PERMITS REQUIRED:
provisions of Title 19, Title 23. Tit!e 24, or Title 25 of the California Code of Re~Jlatiofls. Chapte~ 6.7 and 6.95 of the Calilomia Health and Salety Code. or the Sa~ ~ose Munk~pal
CODE SECTION P/V OESGRIPTION APPR
". TIME ' NO FEE
~.. · ' OGG
~ ~[.~-J""~"I Suite 11 OD ' ,. . ' Conducted by Type of Inspection ' Empby~e No. :' '?
~2~ San ~°se' CA 95113-1305 .Co~Enf ....... tel ,El Engineedag F/SPermit F~ ~i~ bne-TimePcrmit I
I-lazMat.~ [] Une HazMat Permit 0 -[3 No~-permitled
· FI mc ·
· [.: NOT1CE oF FIRE AND SAFETY HAZARDS AND/OR PERMITS REQUIRED:
i '
CODE SECTION P/V DESCRIPTION · APPR DATE
~ . : ... ·
, ... . :~.
. . · . · I .~..
! ~ , i ,
·
.
'l ~' OCC
~:: ORDER TO COMPLY: .
I
CITY OF SUNNYVALE
DEPARTMENT OF PUBLIC SAFETY
P.O. Box 3707 - Sunnyvale, CA 94088-3707
*l INSPECTION PLAN CHECK
FIRE & ENVIRONMENTAL SERVICES [] Plan Check ONE STOP PERMIT CENTER
Fire Prevention Inspectors/Investigators ~lns 456 West Olive Avenue
1700 All America Way pection Fire Engineers (Construction)
! (408) 730-7212 -"/"¢,~)L. (~[.~.~ f'C (408) 730-7444
.... Occupancy# Business Name
i Address: .]]~ ~,I,)~ ~']' ~ d'd~j .~ /4-1J/_- Phone:
;1~ Contact
-~ person: ~)0~ ~.~-/~CD 'r~~ (~¢'OOp
i
1
~-' ~/ ~ ~ -
~, immediately. Failure to comply may result ~~Superior CouP.
~ Plans shall be revised~ to ;h, ow mmplianm to the a~re-submi,ed for
fees.
Inspector: / '-~ ' -"~~ Phone: Date:
.F~I~E ,TO CO~LY WILL RESET IN .POSSIBLE FURTHER LEGAL ACTION .
~.U~e~ POa~b~e legaI',.aC, tto~ '"' ' ' "'
[
'i~ ATTACHMENT 3
i ~ Rinsate Manifests
mate of C~di[~rnk~-Envi ...... roi Protection Agency See Instructions on back of - "-~--------
m~rm Approved OMB .No. 2050~039 (Expires 9-30-99) rag~z~ Department of Toxic S
~eos~ ~ri~t 0~' ~e : ' F~ ~igh~d ~ Use &n e~ite (12-pit~J ~it~. Sa.c~amento, C ~ .... :
'~' " '~UN ~ORM ]~. ~'IZ'Z =':.~.~ UUU :~ "-AR'--'S ]. G.er~or's US EPAID No. Mani~t D ..... tho. 2. Page1 Information in the shadee
is not r~uired by F~eral
~ ' WASTE ~NIFEST ~ ~f~= ~ ~
Cl Al ~ el 8l il 61 3l OI 41 l{ l{ 8 I 2 I 0 O 17 o, 1 '
7. Trans~Her 2 Company Name 8. US EPA ID Number ~:~~;~]
9 Desi noted F~ili~ Name and Si~Addr~s .~ 10. ~S EPA ID Number ~ . ~~:t.f j~ ~ :' '[=.=: .... .::t'
~ I ~1~ ~1~ ~ ~ I~1 [ I~l~l~l ~1 ~ ) ~ ~J ~ ~ ~ ~::~:.i.--'.:~:: "~1 ~t 'i'~<~(~'' '''-';' '"'
11 US ~T Description linc uding Proper Sh pp no Name, Hazara C ass, ana ID Numar} ........ . F,'
,~ ................. '~
I I I I I I / .
~:,::::;:~:~=~<;~2:i~~'::::~'~';'' ~ft2 / ' ' ' - ,
i ~ 4. GENE~TOR'S ~RTIFICA~ON: I ~lere tho{ ~e o~ ~is on~ de~d~ o~ve ond
hereS~
~ull~
pocked,
proof
~1 .... m?~_ond lo~e{ed, end ore in o{~ respecf~ {n pro~r condition [or tronspod ~y hi9~wW occord~n9 ~o opp{{co~{e ~nterno6onol Qnd ~iono{ 9overnmenl rqulotions.
~{ { om ~ Iorge quonfi~ ~enero~r, I ce~i~ ~ol I hove o pr~rom in ploce to r~uce t~e volume ond ~x{c{~ of wosfe 9enemfed lo ~e degr~ I h~e deferm~n~ ~ ~ ecoflomico{ly
' prbc6ce51e ~hd IGor I ~ve sel~ed Ihe procHcohle me,od o[ freotmen{~ s~roge, or dispo,ol currenfly ~oilohle fo me ~ minimiz~ ~e ~enl ond ~re t~r~t ~ humen heoh~
and ~e environment; ~, if I am a small quaflli~ generate, I h~e ma~ a good [ai~ effod ~ minimize my waste 9ener~ion and ~lec~ A best ~ste manogem~t melh~ th~ is
available ~ me and ~at I can afford.
Printed/Typ~ Name ~gnature ' :. ' ~ ~ Mon~ D~ Y~r
" I , · ._..,
~ t 7. Transpo,~ I Acknowldgement of Receipt of Matedals
~ Printed/Typ~ Name Signature I Mon~ D~ . Y~r
..... u - -u · l/ v~
I 20. Facil~ .... Operator Ce.ific~n of receipt of hazard .... ~ferials c .... ~ by ~is ~anifest except as noted ~ ~ 9. ~ / / .
SC802~ (1/99) White: TSDF SENDS THIS
DA~S:
COPY
TO.
DISC
W~HIN
30
A 87~22 To: P.O. Box 3000, Socram~/o, ~: :,95812.~ i..
Ira. rotate o~ Cali~orni~nvironmental Protection Agency
A~provnd OMB No. 2')50-0039~(Expires 9-30-99) . 'See Instructions on back of page 6. c~.~,en, of Toxic substances Contr¢
ease print or lype. Form designed for use on elite ( i 2-pitchJ typev~iter. Socramenta, CaJi~ornia
1. Generator's US EPA JD No. Manifest ~:x:umeni No. 2. Page ! Information in the shaded areas
- .UNIFORM HAZARDOUS
" WASTE MANIFEST J of ,~. is nat required by Fede,atl~,.
3. Genesato~s Name and Mailing Address
Pacific Bell
P.O. Box 5095; Room 3EOOO' San Ramon
4. GeaoratoFs Phone I ~16 I~l l'l l l l
!: 5. Tfansporler ! Company Name 6. US EPA ID Humber
7. T~mspode~ 2 Con~xmy ~ 8. US EPA ID Number
· · ::' 12. Containers 13. Total
111 US DOT [~Lscr~?',c~.'~.?linclud'm~ Proper Shipping Name, Hazard Class, and ID Numbe~l Quantity.
d.
!5. Special Handling Imlructions ~6d Addilional Informatioe
'~'__ ~ --~~ ' u~'" -:',lce'-~d.c~. ..... D~,~.
16. ~T~'S ~~ I h~ ~e ~at ~ c~h of ~is c~s~nment ~ ~ and ac~ ~,i~ ~e ~ ~ ~i~ ,~e and are dmsifi~,
ma~, and ~, and am in afl ~ in ~ ~ond~ti~ ~ ~s~ ~ highw~'~cmd~ ~ ~imble i~i~al a~ ~al g~t r~u~fi~s.
If I ~ q ~r~.q~nfi~ g~, I c~i~ ~m I'h'~ a pr~ .in p~ce ~ r~ce'~ ~l~me ~ ~xici9 al ~s~ g~em~ ~ ~e ~r~ I ~e de~rmi~ ~ ~ ~i~l~
~cable and ~t Iha~ ~1~ ~ ~ .~ al ~t, ~m~, m died c~r~ ~ilable ~ ~ ~ich minimizes ~e ~e~nl a~ ~re ~r~ ~ human h~l~
,. ~
19. O~r~n~ Ind[~ofl
on of rece~pI of hazardous materials covered by this manifest except as noted in Item 19.
8022A (1/99) . ' white: TSDF SENDS THIS COPY ID DISC '~VITHIN 30 DAYS
8700---22 . To: P O. Box 3000, Sacramento, CA' 95812
I$tate of California--Environmental Projection Agency
Farm Approved OMB No. 20.50-0039 tExpiees 9-30-99J See Instructions on back of page6~l 9§ ~.men, o~Toxic S.b., ..... Co.t.,
Iqease print or lype. Form deslgne~J for use on elite (12-pitch} typewriter.
Sacramento, California'
U~IFORM HAZARDOUS ~. Generalor's US EPA ID No. Manifest Document No. 2. page I I Information in the shaded'areas
..- WASTE MANIFEST of iJ is nnt required by Federal Iow.
3. Generator's Name and Mailing Address
.....: .... '. 22095582
:Lralh~,~e~~ & 6. us EP^ ID Non,~
7. TransPortm' 2 Company Iqame 8. US EPA ID
9. Designated F~cil ~/.~ame and Site Address 10. US EPA ID Number
Romic ]~vir~tal Teclmolocjies
~ast. Palo Alto, CA 9~303
!-~. US DOT Descrlptio, (i.cludi,g P,oper SKippieg Name, Hazard Clas~, a,d ID Number! 12. 13_ Total ·
Ouantily L Waste Number
a. liMTE FLAMABJ, K LIO~D$, II.O.$.(gASOLIIIK, DIESELI, 3 NIISS3 PglI- 213
b~ Stale
EPA/Other
c. Stale
d. Stale
EPA/Other
· K. Handling Codes for Wastes Listed Above
d.
emal$1alCT IF~POIISK CALL (800} ~41-1101
! 6. GENERATOR'S CERTIFICATION: I hereby declare that the c~,_ lee~ d this consignment :0re ~ully and accurately described above by proper shipping name and are classified, packed,
marked, a0d labeled, and are in all respects m proper, cendefion lo, transix~ b7, hq~l~/according 1o applicable international and naliona/ga-vernment ~egulation
1[' J am o large quantily generator, I cattily I~ol I Imve t' of wo$le generated to the degree I have determined le be economically
practicable and that Ihave selected Ihe lo me wt~ich minimizes the present and fulure threat to human beahfi
and the eflv~rons~ent; OR, if I am a ' ' ' wo~te 9enerotlo~ and select the best waste mcmogement me~Od
available lo me and that I can afford.
Mon~ Dar Year
Prin. ted/Typed Name I Month Day year
Printod/Typed Name Monlt~ Da)' . Year
ITem
~ ~T ~E-BEmW THIS UHE. "'
' .. Wh~le: /SDF SENDS THIS COPY TO DISC WITHIN 30 DAYS.
DTSC 8022A (1/99} ' ' ' To: P.O. Box 3000, Sacramento/CA 95812
EPA 87~22
Itete of CoJifo~:iia~Environme~tol Protection Agency
o~ ~ed ~ No- ~-0039 (e~oi~ 9-~0-.99! See Instructions On back of page 6. Deparlment o~ Toxic Substances Contra!
I~eas~ prinl or lype_ Form designed for use on elite (12-pitch) lypewriter. Sacramento, California
.UNIFORM HAZARDOUS ~. Generator's US EPA ID No. Manifest Document.No. 2. Page I Information in the sl~ ore~s
is eot required h9' Federal law.
WASTE MANIFEST of 1
3. Generalor's Name and Moiling Address
L=~ ~'~.T.
gO IKEK 5095, ~ I31D:X~0
.~ ~ne.oto;'. ~,0 ~SAH ~ CA 9e.583 ( 925 )823-8866
62 US EPA ID Number :
&
~ Name .i 8. US EPA ID Number
~ and Site Addcess ,: 10. US EPA ID Number
.... 12. Confainers
~nippJng Name, Hazard CJass, and ID Number) Quantily
LI§~BS, II.O.S.(~OLI]iK, DIKSKL), 3 glilgg3 1~!
~S~glSK CALL (800]
CERTIFICATION: I hereby declare thor ~e coflte~s of thi~ consignment are h~JJy and accurately described abo~e by proper shipping nome and are classified, packed, and ore in off respects in proper condition for tmesport ~y highway according to oppJicabla interflatiofloJ and natiofla~ governmen! regulations
I certify ~at I have a pFogmm in p~oce ta reduce the v~lume and toxicity o~ waste generated 0o~ de~re~ I ~ave de*~,'mine4 ta ~e ~:~omicolfy
the oractica~ ~t~-~J of ~ea~men~,~ st~rOge, or disposal currently available to me which minimizes the pt:esefll arid future fhrea! to human health
oR, if ! am 'a smaJl quantity generator, I hove made o goad faith effort to minimize my waste generation and
L 5 ~"'Ol~) ~ J.Signature ~ ~__~ Month Day Year
1 AcJmowlea~ement o~ Receipt Of Moterlals
il Signatere~ ~ Month Day Year
~ of Materials
· . . J Signature Month Day Year
I
,s materi01s
::L:~ ":'!': ::
L:.'~i.&% DO' NOT WRITE.BELOW-
2A (i/991 ' .. .. . while: ISDF THIS COPY Ia DISC WITHIN 30 DAYS_
"~i;~22 ' ' To: P.O. Box 3000, S ....... ,o. CA 95812
.seOCalifornia--Envi.,onmental Protection Agency
Approve/:J OMB No. 2050-0039 IFxpires 9-30-99l See Instructions on back of page 6. ' ~.rt.se.t
print ~)r type. Form designed ~or use on elite tl2-pitch) lypewriter. ~195 ,,~scramento, California
1. Generator's US EPA ID No.. Manifest Document No. 2. Page I Information in I~e shaded areas
UNfl:ORM HAZ~,RDOUS is not required by Federal law.
~. WASTE MANIFEST of
3. Generator's Name and Mailing Address
253.5 'SOUTH CmAlt(~ AVE:. /~c~o,~ ~' ~ £ Ooo
4. Oea*rator's ~oneFllJ~.SilO CA 93725 (o/~')~'~3_
~'6_ US EPA ID Number
7. Tronspofler 2 Company Name 8. US EPA ID Numbe~'
9. Designated FacJlit~ame and Site Address . 10. US EPA ID Number
Romic Environmental Teclmologi~
2081 Bay Road
East P~lo <o, CA
! 1. US DOT Description (including Proper S}nipping Name, Hazard Class, and ID Number] 12. Containers 13. Total
Quantity
Ub~ FUmRL~ LXOUlnS, i.O.S.Ie~SOLIIK, OXKSKI,), ] Ulil~3 PgXl
(no 8) net(128)
b.
15. Special Handling Instructi .... d Additiofl al Information
~ IESI~ISK CALL (800) ~tl-~lOl
! 6. GENEIL&TOR'S CERIIFICATION: I hereby declare thai ~e contents al this consignment are ~ully and accurately described above by proper shipping name and are classified, packed, marked, and labeled, and ore in ail respects in proper condilion fei transport by highway according 1o applicable international and national government reguJbfions.
If I am a large quantity generator, I certify that I have a program in place to reduc~ the volume and toxicity al wasto generated to the degree I have delermined to be ecoflomical~,
practicable .and thai I~ave selected the practk~able methed o~ treatment, storage, o~ disposal currently available to me w~ich minimizes the present and ~ture threat lo human health
and the envtronmefll; OR, if I am a small quantity generator, I Imve mbde a good .folth effort to minimize my waste generation and select the besl waste management method thai is
available to me and thai I can afford.
Acknowfedcjement o~ Receipt d Matedds ' //
of Receipt o[ Materials '
Jg. Discrepancy Indication Space
:>~ receipt al: hazardous materioJs covered by t~is monJfe$1 except as noted in Item 19. .- '
.. ' DO NOT 'WRITE BELOW THIS· LINE.
TSC 8022A (1/99) _ . white: ISDF SENDS THIS CoPY TO DISC WITHIN 30 DAYS.
II, PA 8700~22 - ~o: P.O. Box 3000, Sacramento, CA 958J2
2050-0039 IExpires 9-30-99} See Instructions on back of pag~ ~p,,m~et of Toxic Sub~,~,~
U~FORM H~RDOUS t. ~ea~r's US EPA ID No. ~ni~d ~umenl No. 2. Page I Information in ~e ~ ar~s
WASTE NIFEST clRI iOielOlOi213131alSJe 12 0 i o,
7. T~ 2 ~ny ~ ~. US EPA ID Number ~ ~ ~ ~~
I lllllllflll
............. m. US~P~m~ ~ ~ ~ ~
~ ~1~ ~, ~ 9~ !C1~1D1OlO19141512 ;6151.
I I. ~ ~T ~i~ I~cl~ing Pr~ shi~i~ ~me, ~rd ~ass, and ID Num~rJ ~. ' ' Ty~ Q~n~ · ~l/Vol
d
-~ ~ ~ (8~)-~17-7701 ~/~ A~~ : ~/~ ~u~ 0~
[ 6. ~[~[~T~ ~R~: I h~e~ ~ote ~at ~e contents o[ ~Js c~sJgnm~l me ~[[y aad accumtdy descri~ a~ by pr~ ~i~Jng ~me and are cJossi~.
~,' o~ [o~. and are Jn a~ re~ in pro~. c~ifi~ ~ lrans~ by h i~w~ ~cor~ng ~ oppJicab~ Jnfernafi~al ond na~l ~ern~ r~ula~,.
If I a~ ~ ~rge ~?nfi~ ~e~or, I c~ ~at I ha~ ~ pr~ram in p~ce ~ r~u~ ~e v~u~ and ~x~ o[ wos~ g~af~ lo ~e ~ I ~ d~,d *o ~
~e ~ ~ I[~. ~ ~e ~i~e mel~.d ~1. s~,. .... distal ..... ~ ~dl~e ~ .. ~ minimize ~e ~e~, and ~* ~r~ ~ bm.
a N ~t~mnl; OR. i[I am ,o ~ q~nfl~ ~n~O~, J' N~e m~ o ~ ~i~ e~ to minimize ~ was~ ~tofi~ on& ~ ~e ~I wa~ ~ment m~
~ailable ~ me and ~ I cm a~t&. '
i 7. Trans~ I Ac~nl o~ R~ei~ d Materials ,
Pr~y~ Na-- [.Signa~e ~ ~ Y~r
18. Tra~ 2 Acknow~emm d R~e~t d ~riols. ' ·
Pr~y~ ~me J Signo~e Mon~ ' ~y Y~t
I
19_ Discman~ Indication S~e ' '~J~ ~~ .
'
20. Facili~ ~n~ o~ O~rat~r Cmilic~'t~on d r~eipt oi hazard, s materials cov~ by ~is m~it~t except as nord in lira 19.
. ~ ~ ~y Y~r
-- ~. NOT WRITE. BELOW THIS .LINE.
8022A [I/99) · *- . · white: TSDF SENDS THIS COPY TO DISC WITHIN 30 DAYS_
87~22 . '. To: P.O. Box 3000, ~c~amento, ~
.,a--En~ironmenla! Protection Agency
i o~s ~. 2o~o0s9 Ir~oir~ ~*~-~) See Instructions on back of page 6,.
~ k UNIFO~ ~RDOUS L ~a~r% us EPA ~ ~. ~ni~est ~u~nl No. 2. P~e I Infraction ~n ~ sho~d ar~s
'~ 'I is not r~uir~ by F~eral law.
WA3~ ~NIFEST
cI~ITIOlSlOlO12131~I¢I318 12 I1 2 12
A c. '~ ' ·
) T
16. ~NE~T~'S ~R~I~TI~: I hereby ~lare ~ot ~e c~teflh of ~is consignment are ~lly and ~cura~y ~scri~ ~ve by ~oper shipping name and are clossifid, ~cked,
~, and ~1~, and are in all re~ in ~o~ con~on ~ b~s~ ~y highway ~c~ding ~ applico~ ingrafted and nafi~al governm~t regu~fions.
I~ I am a large quanfi~ generaf~, I ce~ ~m I h~e a pr~rom in place ~ red~e ~e ~lu~ and ~xicJ~ o~ was~ gen~at~ ~ ~e ~gr~ I have de~rmi~ ~ ~ ~omica))y
~ pr~tic~ o~ ~at Ihave seJ~ ~ pr~ficab~ ~ ~ ~1, stooge,' or di~ ~rren~y ~ai~ble to me ~ich minimizes ~ pre~nt and ~re ~r~t to humen heahh
a~ ~e ~vironm~f; ~, if I ~ a small quanfi~ gen~a~, I.~ve ~e a ~ ~i~ ~ ~ minimize my wade generafi~ a~
I
~ Prifl~/T~ Name Signature Mon~ Day Year
E
19. ~s~e~ Ind~n Space
I 20. F~ili~ ~ne~ratm Ceflificafion d r~eipt 'of hazar~us ma~ials coverd by ~is m~i~t ~c~t as not~ in I~ I ~.
TSC 802~ 11/99)I. ' While: TSDF SENDS THIS COPY TO DISC WITHIN 30 DAYS_
~PA 87~22 .- .. [o: P.O. Box 3000, Socroment~, ~A 95812
of caliJorni .a~-EnvironmenI~l Protection Agency
App,ov~I ot, m No. 20~0039 (Expi,es ~-3e9~) ' See Ins~ucti6ns¥o~ ~ck of page 6. ~.~ o~ ~o~ s~b~,~,
print ~ ~- From ~sig~ for use ~ eli~ (12-p;tchl ~ewriter. Sac~am~, California
J UNIFORM HA~RDOUS t_ ~.~o~', us ~ ~o ~o. ~.~t ~ ~. z ~o~ ~ ~.~ .... ~o. ~. ~ ~
I
~1~- ~1~ ~.1~ ~ ~ ,..::.,:.,
~ ~ ~'~'~,'~ (~, Do,e) ' 3~ ~n/~ ~ z z ~o ::-':'
E
-E~ ...... ,.,~;:~..:.:,.
R
. ; c. 0~ ..... :".~ ':'
a. ..~ :.~': .... ~."
:;,~: ~ -~. · ~, ~ .. · ~. · . ~ ·
:..,'..:...,.:, ..: .'."., :.., ......:.::: '...:.. .:.. :.: ...... :,,., ::
' Wear properpro~ect~ve eqmpmen~wblle bandhnq. Weights or ~o!umas are approximate. ~R~ ~ ~
24 houremergancy number: / ~/~ . ~ V ~ ~7 ~T~ ~A,,Or~.~~ f ~
16. ~NE~TOR'S CER~TION: I h~y ~clare ~at ~e conknk of ~is c~gnmenf ore ~lly and occurakl~ descri~ o~ve by pr~r ship~ing ~ and are c~ssi[i~, pack~,
minkS, ~d la~, and are in all re~ in pr~ condition for trans~ hi~y ~cording to ~plicable ~ternationol and nati~al government r~ulalions.
I~ J am a ~r~ q~ntJ~ ~era~, I c~fi~ ~at I have a program in place to r~uce ~e ~ and ~x~ci~ o[ wos~ g~rat~ Ia ~e d~r~ I h~e ~ermin~ to ~ ~onomic~ly
~c~ ~d ~ I bare ~ted ~ p~icobJe m~ of ~ent, s~, of d~s~ cu~f~y ~ai~able to ~ ~ich minimizes ~e ~esent end ~tu~e t~f~ to human
and ~e en~ronment; OR, if I am a small q~nti~ generate, I h~ m~e a g~ ~i~ eff~ ~ minimize my was~ gen~ation and s&le~ ~e ~st waste management meth~ ~at is
]9. Di~repan~ In~a~ S~ce ~ ' ..... ~
I 20. FaciJi~ ~ner or 0~ CerfiJic~i~ of r~eipI of hazar~us materials cove¢~ ~y ~is manifest exert as oote~ in Jfem J 9.
] Prin,ed/,y~ ~ JSIgno''e' ' I ~n~ Day Y~,
DO NOT WRITE BELOW THIS LINE.
I ASC 8022A (I/99} white: TSDF SENDS THIS COPY TO DiSC WITHIN 30 DAYS_
87~22 ' '. [o: P.O. Box 30~, Socramenlo, CA 9581 ]
-~' ,,~;:;..~.t~2-~h~.~,. '. ~. . . ' ...... ~c~
' Sm:rome~lo, California
.~ .. - . ~1~.1o1~191~.~ 1~121qi~l ~1~ ~.1~ .... .¥ .... '. - · -
' ';' - ' .s~~ ~,:~~' . '- .
'" '" qa ~ ~ q.310111 713 ..... ' .... ' :'"' .....
..
: Romic chem~ ~rooration ' '~ : : ~
:"
11. ~ ~l~J li~ ~~, , ~,'~ ~ ~J' .... ~. 1I~- ~ ........ ~.~-~ ; .~'~' .... 'i ~_' ~.~_~' ~ j.....~: .......
'~ ' : ~ : ........ ~ .~ ..~ .. " I I-.-
A ~.::~ ~... . . . .. . . . ~ ....... '::~,,;.,~
- ....... : · ; :'~ ' .~ I I I- I'1 I i'
' : '':~'''1 '
..... :.'~ I I .I. ' I" ~ ' ~-. .
:".~. .- ..-~ :;.; . .. .
..' . ~-; ,. >..,,.;.f.-, ,.-,.-, --.. -~ ~..- ,-_., , ~ ....... -.
~ I~. ~ia ~ I.~ ~ ~1 ~ . . . ' .........
: , .' :wearpm~Kpmte~ve eqmpment whfle-haPd~ng. Weigh~ or volumes, are.approximate ER~13.1~: .
' 24 hour:ememancy ~u.m~r: ~' ~W~.) ~t{ ...: - ' SITE.LOCATION:
24 hour emergency con.cc ~0~ 23~- ~3q3 EcZ.. ' · '
I 20. f~cili~ ~r M ~m~r Ce~i~afi~ of r~eipf of hOzmd~s ~6ols c~ by ~is ~nlbl uc~ os ~ in I~ ! 9_
T ~ I ~ !~"~ D°y Y-
7,-~. o~,- /~"~' /! ~1 ~i~ i°1~
II '-
~ NOT WRITE 'BELOW T~S_ UNE.
8022A.(1/991 . "' : While: TSDF SENDS THIS COPY TO' DISC Wt[HIN 30 OAY5.
~ 87~22 '" [o: P.O.
I ~9! · See InStructions on back of 6.
page
Toxi~
'Romic Che~ Cor~on ~ , - .
~ .
Oe~roper p~ve equ,p~'. ~h,!e handling.' Weights or
, ~ ~OT- W~!TE aE~OW THIS
~22' "'" lo: P.O. Box 3~, Sacfa~n~, CA 95812
sof Cali~ornia---Envb-°mnentol Protection Agency
Approved OMB Iqo. 2050-0039 IExpires 9-30-99) See Instructions on back of page-- -1956066' C~p..tment of Toxic ~b~tonces Ca.md
e print or type. Form clesigned for use on elite jl g'pltch) lYpewriter- Sacramento, California
J UNIJ~ORM HAZARDOUS 1 ~br's US EPA ID No. Manifest Doc .... t No. 2. Page ! Information in the shaded ....
is not required by Federal law.
: WASTE MANIFEST !Cl Ri Oi 91 el al al al el 91 01 31 a. i.2 I
! I. US DOT Deseriplion {including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers
o m nm:z,}
ii !$. S~pecial Handling lnslructions and Additional lnformation ~/ 7~
' m~rlr, ed, <3R<[ [aJ~e~e<J, e,n<~ are ia cll[ respects in proper co~ditia~ [or kanspoft ~y/~ighwoy acco4'ding to opplica~oJe internationo~ and national government regulations_
I~: ! a.m a, ?rge. ,q~anti!y generator, .! .cedily that] hav, e .a p. ro~ram in place to reduce the volume and toxicity ~f waste generated to Ihe degree I have deles'mined to be economically
: p .ra~_ fi, cable .and ~at Ihave. ?lected If!e practicable melhod al Irealment, s~orage,- or disposal currendy ayai~ble to me which minimizes the presenI .and ~uture threat to human health
i a~d.,#?.envlronment; OR, af I am a smog quanhty generator, I have made o good fa,th e~fod to mmlmlze my waste generation and select the best waste management method l~al is
avmtoble 1o me and that I can afford. '
Printed/Typed Name Si Month Day Year
I 18_ lraesporle~ 9 A¢inowledgement of Re<eipI ot ~c~e~ial:
l[ Printed/Typed Name " ' ISi~re I Month Day Year
I-50. FaciJit~lOV,~er or Opes~j~ Certificatkm Of receipt of hazardous materials'covered b'y this manifest except as noted in Item 19.
DO HOT WRITE BELOW THIS lINE.
8022A ll/99) ' ' I · White: ISDF SENDS THIS COPY 1'0 D~SC WIIHIN ~O DAYS.
700---22 .' 1'o: P.O_ Box 3000, Socfomento, CA 9§8J2
mate of Cali~'6rnia,Environmenlol Protection Agency
~0,m A~ .... d OMS No. 20S0-0039 (~i,.~ ~-~0-~ See Instructions on back of page 6. ; Department of Toxic Subst ..... ~n~ol
~t or ~;~o~ desi~n~ for Use on eli~ (12-pit~l ~i~. ~ Sacrament, ~lifornia
No. Information in the shad~ areas
. is not requir~ by Federal
I w~sz~ ~NIFEST Cl ~1 TI OI el OI OI ~1 41 3101 ole 1 2 1:o 9 I8 o, z
3. Generators Name and Mailing Address ~,~ ~men .... ~,~'~'~ ~ '~ ............ ....
~~, ~. IclAIDIOI613151417101916
7. Tr~,spoder 2 Company Name ' 8. US EPA ID Numb~
] 9] Oesig~a~ F~ili~ Name and Si~ Add .... ,_ 10. US EPA ID Number ~~~.-'~.,~'~~J~'~,?~:~
1 1, US ~T De~ipfion (including Proper Shipping Name, Hazard C~ss, and ID NumberJ 1No.2. ContainenT~e 1Quanfi~3. Total 1Wi/volt. Unit~~~~ ~
O :~. (O018)_....nGI{12S) . OlOli T I T~~ G
j ' t 6. GENE~TOR'S CER~FI~ON: I hereby d~lare ~at ~e cont~ts of this consignment are Mly and accurately described a~ve by prier shipping name and are'classified, packed,
ma~; and labeled, and are in all respe~s ~ proper c~dition for kans~ highway accordi~ to applicable international and national government regulafi0~. '
ti I am a I~rge quanti~ gener~or I cedi~.~at J ~ a pr~ram ~n place 1o reduce the volume and toxlci~ of w~e ~e~t~ ~ the de~r~ I have determined to ~ economlc~l~Y~ ?'
p ~ble and th~ I~ve ~d ~e pra~icable m~o~ ~t, storage, or disposal cu~ ~ailable ~ me ~ich minimizes the present and future ~r~ to human h~lth .'
and ~e environment; OR, if I am a small quanti~ gen~a~r, I ~e made a go~ fai~ efforf~ minimize my ~enerafion and sel~ ~e best ~ste managem~t method ~t is ".
I/121/
i I . Tra~spo~r 2 ~ckn~eflt of R~eipt of M~erials ~ /' -- ' -- ~ '
Print~/T~Name " ' m si9n°~,~ ~ff~~fl~a I Mon~ ~y
I 20. Facili~ ~r or Opera~r Ce~iflcation of r~ei~ of hazards m~rials c~ered
, _ bz ~is manifest ~cept as not~ in Ite~ 19.
DO NOT WRITE BELOW. THIS IT
802.(1/99} W~ite: TSDF SENDS THIS COPY TO DTSC DAYS.
WI~IN
30
70~22 To: P_O. Box 3000, Sacramento, CA
ii. State of CaliJomla-~'Cnvironmenta~ Protection Agency
IFo~ ~op,owd c~B ~o. ~0~0039 I~p~ ~-~0-~ ~e Inst~ctions on ~ck of page 6.
UNIFO~ HAiR,US ~ni~ ~u~l ~. 2. e~ i ~ ~ :~
5. T~ J ~ny Name 6. ~' ~A ID Nu~
Romic ~he~l ~oroora~on
2~1 Bay Road
E~ P~ Aeo , CA ~303
b.
~I~E ~recial Handlin. Ins~cfio~nd Addi~o~al Inform~ti ....
pm~rprotecave equipment wn,e handling. Weigh~ or volumes are approximate. ERG~ 1 ~ ! 28..
24 hour emergancy number:~/~
24 hour e~rgencY con,ct: ~)
a~ ~ ~i~t; OR, if I ~ a ~1 ~nfi~ g~ma~, I. h~ m~ a g~ Mi~ ~ ~ minimize my was~ g~ero~n a~ ~l~t ~e ~st was~ manogemem ~ ~ is
Prin~ N~ J ~ Day Y~,
o~ receif~t of hazardous materials covered by this manifest, except as noted in Item 19,
DO NOT WRITE BELOW THIS UNE.
,
T$C 8022A (I/?~J. . - ' white: TSDF SENDS THIS COPY TO DISC WITHIN 30 DAYS.
WPA 8700--22 .... '.' -" To: P.O. Box 3000, Sacrament6, CA 95812
Is~o~ of CoGk~,io-:E.vi~ir ..... on back of pooef:~. 195
rl~ pri~ ~ · " ' TM .. '' ': ~k ' '~ ' ' - ....
. - ' is ~t r~uir~ by F~ral law.
-. ..,. .. 22095564: .
~ ...:..:,?., ~:: .. : .
,' ~. :)' ~'~
· . · ' 12. C~miners 13. Total '
1t ~ am a Jorge quan6~ g~era~, J c~ ~11 h~e a ~mm iff d~e ~ ~'~'~ ~ ~ci~ o~ waste geflera~ ~ the degr~ J have determifl~ ~ ~ ~onomical~
, pradica~ ~d ~af I h~e MI~ ~' ~* ~ d b~, ~, ~ ~is~l ~.M~ ~i~ble ~ me ~ich m~nimJzes ~e pre.ill and ~re ~r~J to human
~d ~ ~on~nt; OR, if I ~ o ~ ~ g~a~; I ~.m~ a ~ ~ ~d ~ '~fllm~ze ~y wos~ 9efl~ot~ and seled ~e best waste m~gem~t ~e~ '~al
~aila~ ~ me and ~al [ can a~d.
~n~ ~y Year
~onth Day Y~f
~tmids -
19. Di~re~n~ I~ication S~e
~ozar~s ~ials ~*~ b ~ ~is moni~St ~1 as norm in Item 19.
~nth
~y
Y~
mow
' : White: TSDF SEFIDS IHiS COPY TO.DISC WITH}iq 30 DAYS'.
SC 8022A {1/99) -. ' ·
~PA 870~22 ' - ' - -: ' ~'' To: F.O Box 3000. Sacramer, to. CA 95812
ILte of California--Environmental Protection Agendy
r~ Approved OM8 No. 20SO~O039 I~pkes 9-30-~9i See Instructions on back of page 6.
se priht or ~e. Fo~'~ig~'~ru~one~i~12-pitc~)~e~r. ~95 Sacrame~o, Co~i~n~a
e- -~}~:~ l. ~nerato~s US ................ EPA ID No. ~ D~&~t No. 2. Page 1 Information in the shaded or~s
~ UNIFO~' HAZARDOUS] is not r~ulr~ by ~deral law,
! Cl~l~l°l'el°l°l 21 ~1 91 ~1 ~l I~ .I° Ie ·
wASTE
MANIFEST
8
9
3. Generator's Name an~ Mailing Addr~s '
7. T .... ~,er 2 Com~ny Name 8. US ~PA ID Numar
9. msignat~ F~ili~ N ..... d Site Aad .... m 10. US EPA ID Numhr
' 12~ Containers 13. Total
11. U5 ~T Descriplion (including Proper Shipping Name, H~ard ~ass, and ID Numar) No. T~e Quanti~ Wt~ol
R0 (~tB) nOl(~281 T I T ill
l°
15. Sp,ialHan~inglnslrucfi ..... dAddifionallnformation 5~T~ ~n~ ' 5Z~5 ~oy~
/
j 16. GENE~TOR'S ~RTIFI~RON: I here~y d~lare ~ ~e ~n~nH of ~is consignment are ~lly and accurately descried above by pro~r s~ip~ing name and are classified, packed.
m~k~. a~ labeled, and are in all res~ds Jn proper ~ndition for ~anspodby highw~ according to a~plicable in~mational and nationa/government regulations.
~ I[ I am a large quanti~ g~erator, t ce~i~ ~at I have a ~mm in place ~ redu~ ~e volume and toxici~ oF waste generat~ ~ ~e deg~ I have determined to be e~nomically
~ pr~ble a~ ~at I h~e se~ed ~e practicable me~ of ~ent, st~age, or dis~sal currently'available ~ me which minimizes lhe pre~nt and ~re ~r~t ~ human h~hh
~ and ~e envlron~nt; OR, if I am a small quanti~ gener~r, I h~e made a g~ ~i~ e~H ~ minimize ~ waste generation and select ~e ~st waste management me'od ~at is
~aila~e ~ me and ~at I can a~rd.
~ 17~Trans~r i Acknowl~emenl o[ R~eipt o[ Malerials
A P~nt~ Na~e % I Signa~re ~ /
18. Trans~r 2 Acknowledgement of Receipt of
T Print~.y~ Name I Signa~re ] Mon~ Day Year
20: F~i~ ~e[ or O~rolor ~erti~ico~on o~ r~ei~t o[ ~oz~ou~ mo~rio s covereb ~ I~ ~ moni~e~t except ~ nol~ in It~ ] P_
T P~ Name ~ ~ . ( I Signafur~ ~ ~ / /~ ~ I Mon~ Day Y~r
_1' I _
~ NOT WRITE BELOW
/
·
C 802~ (1/99) ~ white: TSDF SENDS THIS COPY TO DTSC ~THIN 30 DAYS_
~A 870~22 To: P.O_ Box 3000, Sacramento, ~ 95812 · .k :'
r~ed OMB No. 2050-4)039 {Expires 9-30-991 See Instructions on back of page 6~.. -_ Department of Toxic Substo .... Con
Pleas6printOr type~ F~rm designed for use on e//fe (12-p#ch] lypewrfter. I:~Jt) l ~) ' Sacramento, California
~ !. Generator's US EPA ID No. Man'['est Document No. 2. Page I Informatio. n in the shaded areas
UNIFORM HAZARDOUS is not required by' Federal Icrw_
WASTE MANIFEST of 1
3. Generator's Name and Mailing Address
PAC]~-'~C ~.L
7. Transporter 2 Company Name 8. US EPA ID Number '
10. US EPA ID Number
12. Containers 13. Total
] 1. US ~T Description (including Proper Shipping Name, Hazard C~ss, and ID Number] ~uanti~
~ (nOla)
15. Special Handling InstructiOns and Additional In~ormation
gBl~glgiCY EgSPONSE CALL (8001 947-TTOI ~
16. GENERATOR'S CERTIFICATION: I hereby declare t~at ~e contents of this consignm~t are ~lly and accurately describ~ a~ve by proper shipping name and ore classified, ~c~ed,
mark~, and labeled, and are in afl res~ in proper condition for ~ans~dby highway according ~o applicable international and national government regulations..
If I am a large quanti~ generator, I cedi~ that I ~ve a pr~ram in place lo reduce the volume and toxici~ o~ waste generated to the~degree I have determin~ to be economically
pr~ticable and that I have select~ ~e practicable meth~ of treatmentr storage/or disposal c~rrent~ available ~o me which minimizes ~e pr~ent and ~re l~reat
and ~e en~ronm~l; OR, {( { om a smog( qu~nti~ 9~otor, I ~ve ma~ a go~ ~Oi~ e~o~ to minimize m7 waste generation and seJ~ the best waste management me~od
available 1o me and ~at I can afford.
I S~ . / ~~/ . Month Day ' ~ear
Acknowledgement of Receipt of Materials
Printed~y~dName ' ISigna~r~.'~'~ ~U~ t Month Day Year
ipt of hazardous materials coverd~manifesl ekcept a~ noted in Item 19.
~~[ ~OO& . DO NOT WRITE BELow THIS LINE. / : ~
DTSC 8022A (1/99) While: ~DF ~END5 THI~ COPY TO DTSC WITHIN 30 DAYS.
EPA 870~22 To: P.O. Box 3000, ~acramento, CA 95812
lsat. See Instructions on back of pag~j61g
Cali~miC~"-Environmenla!
A~
[~ ~~P~~ ~ ~ ~ni~l~umenlNo. 2. P~e ! In~rmafi~ in ~ ~ad~ar~s
J ~UNIF~ H~RDOUS , ~ ~ ~ ~T~ ~ ~ . is~t~uir~byF~rol~.
~ ~1o ~, ~~ IClalDIOIO19141512 61517 ~
~ ~?; · .: .~:. .. . . ~;.~.:..~ .,,..;¥.' .......
15.~]~ial Ha~ling~sKIns~uctions~ad Additi~ollI00) ~g-llOll"~'m~ . . .~
16. GEN~TOR'S C~nFI~IION: ~her~a~ec~is~s~ment~re~a~mra~descri~veby~rshi~ingname~nd~red~ssifi~t~
mm~, ~d Ja~. and are in all res~ in ~ con~fi~ ~ ~y ~ig~ occordi~ ~ appJi~ble in~rnafional and ~ti~J governm~l r~u~fions.
~t ~ om o ~rge q~tJ~ genrad, I ce~ ~! I h~ a~r~ in ~e ~ r~C~ ~e vo~me ~d ~ici~ o~ waste genera~ ~ ~ d~r~ I ~e ~rm~n~ ~ ~ ~onomlcally
praclic~e a~ ~m Ih~e sel~ ~e ~ca~ m~ of ~1, ~,;or di~ cmren~ ~o~la~ ~ ~ ~J~ ~nimiz~ ~e ~e~nt and ~lure ~r~t ~ h~on h~l~
~ ~ ~vlr~m~t; OR, i~ I am a s~ll quanfi~.g~era~, I.~e ~ o~ fai~ ~ ~ minimize ~ ~s~ ~erali~ and ~t ~e ~st ~s~ ma~ement me~ Ihat is
~ 17. ~s~r 1 ~d~t of r~eipl of ~ials . . . , . .
Prifll~/Ty~a~ ~ ~n~ ~y Y~
~ ~t~k~ ~~ '~)~ ~l~l~lo I ~1~
~ 18. Trans~ 2 Ackno~e~nt d R~ei~ of ~t~ids' - · ' ' -- -- '
~ Prin~/T~d Na~ ' [ SignOre .
E
t
19. ~scr~ancy Indication ~ace
F
'1
I 20. focili~ ~ner m O~ro~r Ce,ificafion oi r~eipt of hazards martials c~er~ by ~is ~ni~ ~c~t as n~d in Irem 19.
~ Hot write BELOW mis Ute.
DTSC 8022A [1/991 ' White: TSDF ,SENDS THIS COPY TO DTSC WITHIN 30 DAYS.
' '' - To: P.O. Box 3000, Sacramenf0, CA · 95812
EPA 870~22 ·
~te of C~li f~rnia--Envireamental Protection Agency
Inn Approved OMB No. 2050-0039 (Expires 9-30-79~ .' See Instructions on back of page~lg§ Department of Toxic Substa .... Control '
~ or' iype/~?,?rm de'signed f6F'bse'on elite (12-pitch) typewritei': - Sacramento, California
.' ~--~.~". i .... .... 1. Generator's US EPA ID No. Manifest Document No. 2. Page ! Information in the shaded areas
~ ~! 0NIFORM HAZARDOUS is not required by Federal law.
WASTE MANIFEST Cl al ?1 al 81 al al ~-I Zt' 31 51SJ 0 I 2 I O ele ,.o~ ~
7. T .... ~,er 2 Company Name 8. US EPA ID Numb~ .
I i. US ~T De.fiplion linci~ing ero.r Shipping N .... .~ar' Classj and ID Numb., .o. 'T. Qeanti~
~G~C~ ~S~0NSE ~L (8001 947-770t ~ ~a / ~
16. GENE~TOR'S EER~FIEA~ION: ~ere~Y~ec~re~e~ec~nt~t~thi~c~ns~g~me~re~ccur~jYde~ri~ve~YPr~Per~iPPing~mee~rec~ssi~e~P~cke~
~&e~, an~ Io~ed, an~ are ~n Qli re~t~ in proper c0n~itiofl ~or ~flspofl~y ~ig~w~ qccor~flg ~ ~pp~i~le in*~o~ono[ ~n~ n~tioflo(goverflmen/r~uJotions.
~ t~ ~ ~m ~ ~o~9e quont[~ 9ener~Jor, I ce~]~ ~of I ~ve ~ p~mm ~fl piece to r~uce ~e voJume o~ ~x{c~ o~ w~ste geflerot~ ~ t~e ~gr~ I ~ve ~eferm~e~ lo ~e ec~om[c~
~ p ~*co~Je o~ ~ot I ~ve sel~e~ ~e prochc~le met~ ~F ~lment, storoge, o~ ~tspos~l cur~fl~ ~m~le ~ me whtc~ mlm~[ze$ t~e ~r~t ~n~ ~re ~r~t ~ ~um~fl
~n~ ~e envlroflmenl; OR, i~ I ~m o smoJJ quoflti~ gefleroter, ~e mo~e ~ g~ ~e f~ e~ fo m~fllm[ze mF ~ generation on~ 3el~ l~e ~est wOste monogem~f me~o~ t~t is
Pri~ Name
~nlh Day
8 18. TronspoH~ 2 Ac~ow~em~nt o[ ~eipt o[ Material~ ~ - - '
/I~R E Prlnted/Ty~d Name ISigna~reIM°"t~ I I t I I Day Year
20_ Fdcili~ ~er or O~ra~r CerfiRcafion o~ receipt~ hazardous mateHol[ co~r~ ~y ~is manifest ~c~t as holed in Item ] 9~
" ~C ~& DO NOT WRITE BELOW THIS UNE. / ~ Z 30~
~8802~ (1/99J W~ite: TSDF. SEND5 THIS COPY TO DTSC WITHIN 30 DAYS.
70~22 To: P.O. Box 3000, Sacramento, ~A 95812
seOf Califmnia--Env~rmimentaJ Prolection Agency
Approved OMB No. 2050-0039 IF..xpire~ 9-30-99! ' See Instructions on back of paget.195 O~po~ent of Toxic Substa .... Contra
print or lype. Form designe~ ~or useon elite ~12-pitch~ I),pewri~r. ' Sacramento, Colifornio
J. Genecator's US EPA ID No. Mam'~esl Document NO. 2. Page ! Information in ~e shaded areos
' ' 1 8 ~L is not required by Federal Iow.
i~ ~: UNiFORMwASTE HAZARDOUSMANIFEST Cl RI'ri 01 8101 °l II el 21 el 21 8 I 2 I z ~. I - J ~ o, ~- I
L- '
~ ~~-:~.:~;~;~:~,!~;~T~'-~ ,!, ,... s::':,:,.. . · . . ~,., ....
.~~;~.~ ..... ·
~t ~]o ~, ~ 94~ i.ci~iDiOiOlgi~iSl2~e, lSi~ ~ ~~~:;.. :__
{ I. US ~T ~ }i~luding Pr~ ~{~i~ Na~, ~zard C~, a~ ID ~m~) { 2. ~n~ine~ { 3. To~{ { ~.
o ~ (~.) n~(128) 01Pl I ~1 ~Ol/J~l~Oo ~:~2.,, . . . :"
~.- ~.; ..
' I I I:' I I I I ::?:.::,: · ...
~ I I I I I I I .~: ..... ,. '~
a. · :~: -' .... . ......
:~, .......
15. S~i~l Hadli~ Insets and A~ifi~al In~afion
.. ~ ~~/
I~ I am a ~r~ quanti~ g~ra~, { c~ ~af I h~e a p~ram in pl~ ~ r~'~ ~ and ~xici~ ~ was~ g~erat~ to ~e d~r~ { ~ &~rmin~ ~ ~ ~;cally
pr~cab~ and'~ Ih~ s~c~ ~e ~ac~c~le m~ Of ~t,. ~e, m dis~l ~ ~ila~e.~ me ~ich minimizes ~e ~e~nt and ~ ~r~t
a~ ~ ~vironm~t; ~, if I ~ a ~all q~nti~ ~, I ~e m~e a ~ ~ ~d ~ minimize ~ ~s~ genera~ and ~1~ ~e ~st ~ste management me~
ovaila~ ~ ~ and ~ai I can a~rd. '
I Print~/T~ Nome ' Si ' re ' ' ' I ~n~ Doy Y~r
' [ ] 8. Tronspoda 2 Ac[flowl~menf ol R~eipt ~ ~eriols I I I '
.: ' !'"- I- '''.,.,......
lg. Discre~ncy lndicofion S~e
F
I
t -
I 20. F~li~ ~ner or ~erolm ~rti~c*fi&n o{ r~eipt o~ hozordous moleriols c~ere~ by ~is menilest ~c~t os no~ in I~m 19.
0o NOT We~TE BEtOW mis
SC 8022A 11./991 · . . .. white: TSDF SENDS IMIS COPY TO DISC WITHIN 30 DAYS.
~A 87~22 . . 1o: P.O. Box 3000, Sacramento, CA 95812
BfaJe~.~li~ornia-S~nvi~'0nm~(~l Protection Agency:
~?~d OM~.No~.~0~ (e~-9~0~9~) ............................... ~ee ~ns~rucnon~ .. ~ of page 6. D~ar~ent o~Toxlc Subsl .... C~
~l~se ........ print or ~pe.: Eo~. desig~, for_~e~n:e!ite,[,l~:p~t~J~w_~ ............................................ ~ ~cramen~, California '
....... · '~".'-J.'. ' ':~"~.J~-,.:'~ ", .... :: '' ..' :']~(~nerafor'sUSEPA D~. ' ~tD~m~t~. 2 Page 1 Ink.aria? n~eSh~edareas
: ' .... ~ .. ; · .... · .... -': : ~-'::',~ ':-~ :?~:. :<:-::-:.~: .... :~ ..4: .t--: [. ============================
~ .. .... ':. ::i::t: :;:::". "·: -:
· :.c:E. ~;~i .->:,:; :::, ~. : ' .. ,'.. :..::,
I
"~': :::::::::::::::::::1::8:::::::::::::::;:::::::::::::::::: .... T 'T O
E , ' - ' .. :.:. ,...~
" . .'....:::... , t
................
i 16. GENERATOR'S CERTIFICATION: I hereby declare that the contenb of this consignment are ~lly and accurably d~crib~ a~ve by proper shipping came and are classified, pack~,
mark~ and labeled and are in all resp~ts in prier condition for trans~Hby highw~ according ~ applicable inlernafional and national governmenf r~u~a~ons. '
_ ~11 am o Jorge ~anfi~ generator, I cert ~ ~at I h~e a pr~ram in pl~e ~ reduce ~e volume and toxici~ of was~ generat~ ~ ~e d~ree I h~e det~min~ ~ be economi~lty
~ pra~icable and h~-Ih~e ~l~ed ~e practicable me'od 0f ~ent,-~rage, or d/s~sal curmn~ amilable to men.ich minimizes ~e present and ~re ~r~t to human ~1~'
~ and ~e environment; OR. i~ I am a ~aJl quanti~ genera~ I ha~ made ~ g~ ~i~ e~ to minimize my waste gen~ation and ~1~ the ~ ~s~ monagem~t meth~ ~at is
I Prinl~yp~ Nome Signa~re ~n~ O~ Y~r
~.
20. Facil;~ ~.er or Op~t Certific~o~{ r~eipt
DO NOT WRITE BELOW THIS LINE.
THIS :COPY TO DTSC WITHIN 30 DAYS_
White:
TSDF
SENDS
SC B022_A {1/99) To: P.O_ Box 3000, Sacramenlo, CA 95812 "
8700---22 -'
nv;ronmentol I'rolec~on Agency
No. 2050-0039 (E.q~res 9-30-9.9! . ' See Instructions on back of page 6. ~or~, of Toxic
pr'mt or type. Form a~sigaed for use on elile (12-pitch)/ypewrieer. S~crnmeqto, California
!. Gena~ator'$ US EPA ID No. Manifest Document No. 2. Page I Infermallon in the s~adecl areas
UNIFORM HAZARDOUS i, not requi,~l by Federal lay,.
· WASTE MANIFEST / at
Genarate~'s Nam~ and Mailing Address
Pa¢ll~ Bell
P.o. Box 5095; Room 3EOOO ~anRaman CA
4. Genem~s ~ I
5. Tmnsf~ter ! Company 6. US EPA ID Number
! 5. Special Handling Instructions and Additional In~rmatio~ ' :; }
Wear proper pro~.-tive - -: - '- "-;'
Hour telephone number 1-916-977-7777 (Pacific Bell) ERC~ 128
~ and ~ccurote~/described a~o~e [by p~ope~ s~ipping nome amJ'o~e c~o$$i~ed, packed,.
ma~ed, and labeled, and ore in afl respects in proper condition for Io applicable international and ~atinaal go'emmet_ t regulations.
I[ I am a la~ge.q.uanlily generator, I certify thai I have a program in place Io reduce the volume and toxicily of waste generated 1o the degree I have determined to .be economically
racticable and Ihat I liave selected Ihe rachcable method al Irealment stora · or d~s sal curren, a~edable w~,;~ L-
p '. . . p. ' . ,.. . g , ' po : .ly ' !o ~e .~jci,.min!mizes thip~resent and [ulure thre~t'to human health
aed ~lt~e~ ,eflwrnnme~..t;.OR, ,f I a.m. a .small quantity generator, I hove made a good faith e~fod to~l~imize mY wj~e generation and selecJl~e J~esl, waste management method I~at is
Printed/Typed Nanle . ~ - I Signature / I J IA/ J~l~l~l Da), Year
Acknowledgemeel of Receipt o[l~ateda $ .
Printed/Typed Name I S!gnote~e Month Day Year
I
! 9. Discrepancy ledicatina Space
Certification of receipI d hazardous materials covered by this maniFed exce~o! as noted in Item 19.
DO NOT WRITE BELOW THIS UNE.
DTSC:8022A (I/99) White: TSDF SENDS THIS COPY TO DISC WITHIN 30 DAYS.
EPA 8700~22 To: P.O. Box 3000, Sacramento, CA 95812
Dorm Approved OMB No.'2050-0039 (Expires 9-30-991 See Instructions back'
~lease print or ~pe. From ~sign~ ~r u~ on eli~ (12-pitch) ~ewri~r.
- UNIFORM H~ARDOUS L ~e,ator's US EPA lO ~: ~ni~. D~u~q~
- WASTE ~NIFEST
5. qrQns~ I C~ny Name 6/ US EPA ~ Numar
7. Iraus~r 2 C~ny ~M 8- US EPA ID Numar
9. Designa~ Facili~ ~e a~ SiM Address 10_ US EPA ID Numar
15. Special Handling k, struclions and Additional In[orma6on
16. GENE~TOR"S CER~FI~ON: .... ~ -' "
I hereby decJare ~ol She con~enls o~ ~s consignment ore ~lly and ~curatdy de~fl~ able by ~o~ sh~pp~ ~ ~ are cJassd~, ~c~,
mork~, and la~led, and are in all res~ in pro~r condition ~r ~ansporl by highly a~ordi~ ~ a~iicable interna~flal and nali~al g~emmenl ~u~lions.
Il I ~ a large quan~ genera~r, I cedi~ that I have a pr~ram in place lo r~e ~e volume and ~xicJ~ d waste gen~at~ lo ~e ~r~ I hove de~min~ ~ ~ K~om;coily
prociica~e and ~al I~e ~fed ~e 'pr~tlCa~ie melhod o~ ~enl, storage, ~ di~o~J' cuer~y avaiiob~ ~ me ~ic~ miflimi~ ~e pre~t and ~re ~r~t ~ human
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available io me and ~at I ~n
Printea/Ty~ Nome O~ G'~ML ~ ~ ~n~ ~y Ymr
Mon~ Day Y~r
of R~eipt o~ Materials -
~ed Name Month Day Y~r
19. Discre~n~ Indication S~ce
,t of hazor~us materials covered by ~is manilesl e~ce~ os not~ in Item
DO NOT WRITE. BELOW THIS LINE.
j IWhite: /SDF SENDS THIS CO~Y TO DTSC WITHIN 30 DAYS.
'. _: . To: ~.O. ~OX 3~0, Sac~omenfo,' CA 95812
.20.50-0039 (Ex~ires 9~30-~9) See Instructions on back of pag~5
'UNIFO~ H~R~US ~. ~ne~3 US EPA ID ~_ ~ni~st ~ .... t No. 2. e~ I In~rm~on in ~e s~d areas
' WASTE ~IFEST A · O 80 0 Z 8 2 of Z is not r~uired by Fderal Iow.
4. ~n~r's P~ (
6, US EPA ID N~ber · -".
7. Trans~2Com~nyNa~ 8. US EPA ID Num~r . . :~ ~.~..
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l& ~iol Handling Insk~ions and AddltionoJ
16. GENERATOR'S CERTIFICATION: ~herebyded~r~thatthec~ntents~fthisc~nsignm.e~.t.orefu~jyan'd.accu~ate~.des~ri.beda~ve.byPr~per.sh~p~ing?~meandorec~.ssified~pocked.~
ma~ed, and ~be~ed, and are m all respects m proper coati,hen for transpaC.by h~ghway according to applicable mlernattonal and natsonal gavemment regulahons_
If I am a large quantily generate, I ceeti~y that I have a program in place to reduce the volume and tox~city of wa$1e generated to the degree I have determined Ia. be economica!~/
practicable and that Ihave selected the practicable method o[ treatment, storage, or disposal curry, tJy .available to me which minimizes lhe present and future ht~re~t to human
and ~ environment; OR, i~ I am a sma~ quaflfi~y genera~or, I Jtave made a good fai~ e~ort to 'minimize my waste generation and seleci ~he best waste management method thai
available to me and ~at I can afirrord.
~t ot Mal~rial$
1,. Di$¢re~am-'~ Indlcation Space P'~¢~
t of receipt of hazardous materials covered by t~is manifest except as noted-in Item 19.
Oo .oTmow mrs
wh;ie. TSDF SENDS IH!S COPY TO DISC WITHIN 30 DAY.'
DTSCG022A (1/99) '' ' 7o: ~.O Bo~ 3000. Sacramento, CA 95812
EPA 8700--22 '
rovecl OMB I~o. 2050-0039Pr°tecli°~[E~pit~A~']r9-~99) ~e Ins~ucfions on
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9. ~s~na~ F~ili~ Name a~ Si~ A~rms 10. US EPA ID Num~
15. ,Special Handling Instructions and Additional Info~malion
16. GENERATOR'S CERTIFICAI1ON: I her~ dec are ~ Itm c¢~...~mA o~ .I~s ~jare ~lly and accurately described above by proper shipping name and are dassitind, packed,
marked, and Jabeled, and are in all respecls ia ~ c~di.'!~o~ Jar Imnspd~, ~ according to appJicable international and national government regulations.
practicable and ~nat Ihove selected Ihe-.l~rac~cabte-meehod ~~~~-curren~y available ~o me which minimizes the present and tutere threat Ia'human health
and the en~ro~menl; OR, if I am a small quantdy I~, I ~: ~~!~ ~ Io minimize my waste generalio~ and select the best waste management method II, at is
available lo me and Ihat I can afford. ' ' ·
! Acknow~ement of Race'pt
Prln~d/TypedName ' ' I 'Jl~i~~ ; I ~ II ~ ~ Day Ve~r
Printed/Typed Name Month Day Year
19_ DiScrepancy Indication Space l
of ~a~ae'dous ~?ve~'ed:l:m~., ~ thi .... i[est except .... led in Item 19.
' ~ ~ ~TII WRITE BELOw THIS UNE.
TSC 8022A 1!/99J . . .' . White: TSDF SENDS THIS COPY TO DTSC WITHIr~I .30 DAYS.
· . ' To: P.O. Box 3000, 'Sacramento, CA 95812
EPA 8700~22 '
Ho. -on bock of page 6~ . ~._ C)~p*,~nent of To~,i¢ SubS~,~ns Cod,
0
L
. . W TffiS LINE.
T C 8022A (.1/99} '. ~ ~ White: TSDF SENDS THIS COPY TO DISC WITHIN 30 DAYS.
EPA 870~22 To: P_O. Box 3000, Socrgmenlo, CA 95812
See 'Instructions on bock of Pagq'~'~'195
2050-0039 (Expires 9-30-99!
Depar~nent of Toxic Substances Contrd
I~ose I:~nt or lype. Form deslgded ~m' Use ae~ el/l~ ll2-pifchJ typewr/fet'. ,Sacramenlo, California
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J 6. ~N~Y~'S ~n~: I h~y ~re ~=f ~e con~ ~ ~i~ c~s;gflmefl~ Qre ~1~ =fid occum~ de~i~ o~ye by p;o~r ~Mpp;ng nome Qfld ore clos~i~i~, ~ckeJ.
mo~. and Sa~, ~d me in o~ r~ in ~r ~ti~ ~ ~ns~ ~ig~ ~ng ~ oppJlco~e in~rnafionol o~ notio.~ g~rnment r~ulot~ons.
Itl ~ a lar~ q~nfi~ ge~tm. I ce~ ~at I h~e a pr~ in ~e ~ r~e-~e vo16~ and toxici~ of was~ general~ ~ ~e d~r~ I h~e de~rmin~ Io ~ ~onomica[Jy
~ ~ficable a~. ~m.l~ave ~d ~e ~ticoble me~ d ~t.. ~e. 'm dls~sol curren~ ~ai~ble ~ me ~i~ minimizes ~ pre~nt and ~mre ~reat io human health
~ and ~'~vi~t: ~;~f.I ~ a sma~ q~nti~ g~, I ~e m~ 'a g~'~i~ e~ ~ minimize my ~s~ gener~ and se~t ~e ~sl waste management
~ ' 0 ! G. Tro~s~ 2 Ac~~ d R~pt ~ M~iols-
' 19. Di~r~n~ Ind~i~ S~ce · ' ' '
I .
t ,
~ NOT WRITE BELOW THIS tINE.
'~)~ 80~ (I/991 ' . ' Whi~e: ~SDF SENDS THIS COPY ~O DISC WITHIN 30 DAYS-
~PA 87~ '' ~o: P.O. Bo~ 30~, Socrom~to, CA 95812
!
I
RESPONSIVE TO THE NEEDS OF ENVIRONMENTAL MANAGEMENT
I
I
I
I UNDERGROUND STORAGE
TANK REMOVAL REPORT
i PACIFIC BELL FACILITY
5650 ALDRIN COURT
BAKERSFIELD, CALIFORNIA
I
Prepared for:
I Pacific Bell
3707 Kings Way
I Sacramento, California 95851
I Prepared by:
i IT Corporation
2055 Junction Avenue
San Jose, California 95131
Walter Gage
I Project Geologi~i~7 ,. ....
I Matthew
Call fornia Registere~~~- S'~.~
Geosciences Manager
I IT Project No. 765901
I September 1996
I
Table of Contents
List of Tables ...................................... · ............ ii
List of Figures .................................................. ii
List of Appendices ............................................... ii
1.0 Introduction ................................................ 1
1.1 Site Description 1
1.2 Objective .............................................. 1
1.3 Permits ........................................ · ...... 2
2.0 Field Activities .............................................. 2
.2.1 Tank Removal ' 2
2.2 Soil Sampling .......................................... 3
2.3 Sample Analysis and Results . . · ............ ~ .................. 4
2.4 Soil Disposal ........................................... 4
3.0 Extent of Petroleum Hydrocarbons in Soils.... ......................... 4
4.0 Conclusions ................ .~ ............................... 5
4.1 Observations 5
4.2 Reporting Requirements .................................... 5
List of Tables
Table Title
1 Soil Sample Analytical Results in ppm
List of Figures
Figure Title
1 Site Vicinity Map
2 Site Plan Map With Sample Locations
List of Appendices
Appendix Title
A Tank Removal Application and Permit
B Hazardous Waste Manifest for Rinsate Disposal
C ACceptance Letter and Landfill Weight Ticket for Tank Disposal
D Laboratory Analytical Reports, and Analysis Request/Chain of Custody
E Bills of Lading and Landfill Weight Tickets for Soil DispOsal
ii
1.0 Introduction
As part of Pacific Bell's underground storage tank (LIST) upgrade program, IT Corporation (IT)
was contracted by Pacific Bell to provide environmental consulting services for the removal and
disposal of one 5,000-gallon diesel underground storage tank (lIST) and one 12,000 gallon
gasoline UST and the associated conveyence piping. A new double-wall, 12,000-gallon UST and
I a new double wall 5,000 gallon UST were installed at the same location. In addition, Pacific Bell
contracted Aronson incorporated (Aronson) to provide and operate equipment to perform the tank
removals and installations, and R.H. Lee and Associates (R.H. Lee) to provide engineering and
permitting support. Field activities described in this report were performed on May 7, 8, 22 and
23, 1996.
1.1 Site Description
The Pacific Bell facility is located at 5650 Aldrin Court in Bakersfield, California (Figures 1 and
2). The site is used as a fleet maintenance and equipment storage site for their field services
division. The Site is occupied by an administrative building and a maintenance facility surrounded
by an asphalt paved parking lot for fleet vehicle, equipment, and material storage. The two
single-walled, fiberglass USTs were installed in the parking lot to the east of the maintenance
building (Figure 2). The USTs were used to supply gasoline and diese1 fuel to Pacific Bell
vehicles.
The property surrounding the site is largely residential and light industrial. The nearest surface
water is the Kern River, located approximately 2.75 miles north of the site. Local groundwater
flow direction is unknown but assumed to be northwest, towards the Kern River. Depth to
groundwater fluctuates with seasonal rainfall and from agricultural irrigation, but is believed to
I be approximately 150 feet below grade (fbg).
II ~.2 Objective
The objective of this project was to remove and dispose the existing UST system, assess if
II p
etroleum hydrocarbons were presen! in soils surrounding the USTs, and to install new USTs in
compliance with regulatory requirements.
1.3 Permits
Permits for tank removal were obtained from the City of Bakersfield Fire Department (CBFD)
by R.H. Lee prior to initiating tank removal activities. Mr. Howard H. Wines of the CBFD
observed the tank removal procedures. Copies of the tank removal and reinstallation permit
application A, B and C forms, and the associated permits are presented in Appendix A.
2. 0 Field Activities
2.1 Tank Removal
Prior to excavation activities, Pacific Bell had removed the tanks contents (gasoline and diesel
fuel) to the extent possible. Representatives of Aronson began excavation activities on May 6,
1996, by disconnecting the piping and removal of the soil overburden covering the tank. The.
piping was observed to be in good condition without'any obvious holes or cracks. During tank
excavation activities, approximately 100 yd3 total of tank overburden soil was removed and
temporarily stockpiled on asphalt adjacent to the tank pit (Figure 2).
Prior to removal, the tank was triple rinsed by IT representatives on May 7, 1996. The rinsate
was removed using a vacuum truck provided by Evergreen Environmental Incorporated
(Evergreen). The volume of rinsate generated was approximately 250 gallons, and was
transported under Hazardous Waste Manifest No. 96274499 (Appendix B) to their refinery in
Newark, California, for recycling.
On May 8, 1996, the internal atmosphere of the 12,000 gallon tank was inerted with 250 pounds
of dry ice and the 5,000 gallon tank with 100 pounds. The percent Of the lower explosive limit
and oxygen content were measured inside the tank under the direction of Mr. Wines. PermisSion
to remove the tank was then granted by Mr. Wines.
Upon removal, the tanks were scraped of exterior soil and inspected by Mr. Wines. The tanks
appeared intact, without staining, cracks, holes, or other signs of leakage. The nati.ve sOil
consisted of clayey sand. No root holes or other potential pathways were noted in the excavation.
Additionally, no stained soils or odors were observed during the tank removal.
The removed tanks were broken uP with a backhoe and the pieces were placed in ff rolloff box
provided by MP Environmental Services Incorporated (MP) of Bakersfield. The rolloff was then
transported to Bakersfield Metropolitan Sanitary (Bena) Landfill and the tank pieces disposed.
The acceptance letter authorizing disposal of the UST material at the Bena Landfill, issued by the
Kern County Environmental Health Services Department, and the landfill weight ticket are
included as Appendix C.
2.2 Soil Sampling
Soil samples were collected from the tankpit excavation and the former dispenser location under
the direction and supervision of Mr. Wines on May 8, 1996. As required~ by the CBFD, soil
samples were collected from native soils at aPproximately at 2' and 6' beneath the base of the
USTs. Samples were collected from three locations under the 12,000 gallon LIST and one location
under the 5,000-gallon UST and the dispensers. Sample locations and designations are shown in
Figure 2. Samples .from the tankpit excavation were collected Using the excavator bucket to bring
the soil to the surface. A brass sleeve was then pushed into the soil until it was full. The samples
from the soil stockpile were collected by scraping approximately one foot of soil from the pile and
driving the brass sleeve into the pile until it was full. After each sample was collected, the sleeve
ends were covered with teflon tape and a polyethylene cap was placed over the ends of the sleeve
Soil samples PBA-TP1-2' and PBA-TP2-6' were collected approximately 15 feet in from the east
end of the 12,000 gallon UST excavation, at approximate depths of 14' and 20'. Samples PBA-
TP3-2' and PBA-TP4-6' were collected from the center of the former 12,000 gallon UST at
approximate depths of 14 and 20 fbg. Samples PBA-TP5-2' and PBA-TP6-6' were collected
from under the center line of the former UST, approximately 15 feet in from the west end of the
UST, at approximate depths of 14 and 20 fbg. Samples PBA-TP7-2' and PBA-TPS-6' were
collected from beneath the center of the former 5,000-gallon UST, at approximate depths of 14
and 20 fog. Soil samples PBA-D 1-2' and PBA-D2-6' were collected from between the two fuel
dispensers at depths of 2 and 6 fog. Four discrete soil samples were collected from the soil
stockPile with designations PBA-SP1 through PBA-SP4. These samples were composited for
analysis.
After collection and labeling, the samples were entered onto a chain of custody and hand delivered
to the onsite mobile laboratory. Samples were analyzed on site by a mobile laboratory operated
by Sparger Technology, Inc. (DOHS 2017) of Sacramento, California. Chain' of custody
documentation accompanied samples from collection to delivery to the on site mobile laboratory.
Copies of the laboratory reports and chain of custody records for the samples analyzed are
presented in Appendix D.
2.3 Sample Analysis and Results
Soil samples were analyzed for total petroleum hydrocarbons as diesel (TPH-D) or total petroleum
hydrocarbons as gasoline (TPH-G) using modified EPA Method 8015, with a diesel standard or
gasoline standard respectively; and for benzene, toluene, ethyl benzene, and xylenes (BTEX)
distinction using EPA Method 8020. Samples collected under the former gasoline UST were
analyzed for TPH-G and BTEX. Samples collected from under the former diesel UST were
analyzed for TPH-D and BTEX. The dispenser samples and the stockpile samples were analyzed
for TPH-G, TPH-D, and BTEX.
Petroleum hydrocarbons were not detected in any soil samples analyzed except for 0.011 ppm of
xylenes in soil sample PBA-D2-6'.
2.4 Soil Disposal
During tank removal efforts, an overbUrden soil stockpile containing approximately 100 yd3 soil,
was generated. Since the new UST installation required pea gravel, the stockpile was disposed
offsite. During the installation of the new UST Aronson .reported problems with excavation
stability. As a result of caving of the'excavation, an additional 409 yds of soil required remOval
from the excavation and offsite disposal. The soil was transported'May 22 and 23, 1996, by MP
to Hondo Chemical Inco/porated (Hondo) of Bakersfield, California for recycling. The bills of
lading and weight tickets for the transport and disposal are included in Appendix E.
3.0 Extent of Petroleum HYdrocarbons in Soils.
Analysis of soil samples collected from beneath the USTs fuel dispensers on May 8, 1996
indicated no petroleum hydrocarbon constituents were present other than a sample with a very
low concentration of xylenes. No other detectable petroleum hydrocarbon concentrations were
present in samples collected from the tank excavations or beneath the fuel dispensers.
I
4. 0 Conclusions
4.1 Observations
The USTs were found to be intact upon inspection, with no detectable cracks or holes. Petroleum
staining or odors were not noted during the excavation or UST removal. Analytical results from
soil samples, collected from the tank excavation floor and the soil stockpile, s, indicated no
detectable concentrations of petroleum hydrocarbons.. A very low concentration of xylenes
(0.011 ppm) was present in a sample collected from beneath the fuel dispensers,
Based on results of the soil analyses, observed soil conditions, and the condition of the tank, there
are no indications that petroleum hydrocarbons are present in the soil under the former UST
location.
4.2 Reporting Requirements
Copies of this report and its attachments should be forwarded to the following regulatory agency:
· Mr. Howard H. Wines
Bakersfield Fire Department
1715 Chester Street
Bakersfield, CA 93301
T,*,BL-E.$
TABLE 1
Soil Sample Analytical Results in ppm
Pacific Bell- Aldrin Court
Bakersfield, California
IT Project No. 765901
Sample Date Depth of TPH TPH. Ethyl
Number Sample Location Collected Sample Diesel Gasoline Benzene Toluene Benzene Xylenes
PBA-TPI-2' East End Gasoline UST 5/8/96 14 fl~g NA ND1,0 ND0,0~~ -NDoo~ NDo.oo~ NDo~
PBA-TP2-6' East End Gasoline UST 518196 20 fbg NA ND, o NDooos NDo.oos NDooos NDo.oos
PBA-TP3-2' Center Gasoline UST 5/8/96 14 fl~g NA ND,.o ND0,oo~ NDooos NDo.oos NDo. oos
PBA-TP4-6' Center Gasoline UST 518196 20 fl~g NA NDi,0 NDoo~s NDooos ND~o~ NDo~
PBA-TPS-2' West End Gasoline UST 518196 14 fbg NA ND~.o NDooos NDo.~o~ NDoo~s NDo~
PBA-TP6-6' West iEnd Gasoline UST 518196 20 fbg NA NDi,o NDo.oos NDo.o~ NDo oos NDo.~
PBA-TP7-2' Center Diesel UST 5/8/96 14 fbg ND~.o NA NDo. oos NDo oo_~ ND0.o~ NDooo~
PBA-TPS-6' Center Diesel UST 518196 20 fbg NDe.o NA NDooos NDo.~ NDooo~ NDo~
PBA-DI-2' Fuel Dispensers 518196 2 fbg ND, o NDe,o NDooos NDo.oos NDo_o~s NDo~
PBA-D2-6' Fuel Dispensers 5/8/96 6 fbg NDt,o ND, o NDo~s NDo~os NDo_oos 0.011
PBA'SP-I,2,3~4 Soil Stockpile 518196 1' bps NDi.o. ND~.o NDo.oos NDo.oo5 NDo. o~
Notes:
NA =not analyzed
ppmTMparts per million
TPHTMtotal petroleum hydrocarbons
NDx'= none detected above "x" method detection limit
bps = below pile surface
fbg = feet below grade
PiGURE$'
MING
SITE
-< ~ LANE
NOTES
BAKERSFIELO AhlO KERN COIJNTY
COHPASS MAP SITE VICINITY ~IAP
PuLol~shed b',j Comp~:s~s Hops.
117~ K~n..s.ms Ave. M,3d,~.sL,a. Cml~F,3,mu~. l'r JOB NO. 765gt~l
l'.gg3 Ed~kuon. PACIFIC BELL FACILITY
F3AI<E~'SFIIEI_D. C/~LIFOPr IIA
INTERNATIONAL
TICCIINOLOG
PBA-SP2
· PARKING/ SOIL '
J STOCKPILE
PBA-SP3 ·
Vehicle ~olnLen~nce 8uttdtne PBA-D i-2.'
PBA-O2-6'
PBA- PBR-TP,-2'% -- [ DISPENSERS FUEL
FORMER AND PRESENT - [~ / EXCAVATION
FORHER AND PRESENT
PBA-TPs-2' PBA-TPt-2'
PBA- TP6-6' PBA- TP3-2' PBA- TP2-6'
PBA-TP4-6' ·
pARKiNG
PARKING
~ORK CENTER
BUILD[NO
ff[GU~[ 2
SOiL SAMPLE LOCATION SAMPLE LOCATIONS
IT JOB NO. 7659~1
PACIFIC BELL FACILITY
565~ ALORIN COURT
BAKERSFIELO. CALIFORNIA
APPROXIMATE ,SCALE
INTERNATIONAL
TECHNOLOGY
~ ~ ~ET CORPORATION
APPENDIX
Appendix A
Tank Removal Application and Permit
'
UNDERGROUND STORAGE TANK PERMIT APPLICATION FORM A
,~ COMPLETE THIS FORM FOR EACH FACILITY/Sll:E
ONE ITEM ~ 2 I~RIM PERMIT ~ 4 ~ENOEO PERMIT ~ S ~MmRARY Sl~ CLOSURE
I. F~CILITyISITE INFORMATION & ADDRESS- (MUST BE COMPLETED)
D~A OR FACILI~ NAME NAME OF OPERATOR
ADDRE~~'~,~ ~~ NEA~EST~ROSSSTREET
~ ~X ~RATION ~ ~ ~ P~INERSNJP' ~ L~AL.~GENCY ~ COU~.AGE~Y ~ STA~.AGENCY ~ ~GE~Y
TO Ifl~CAT[
D~T~CTS
RESERVATION
EBERGENCY CONTACT PERSON (PAIMAEY) EMERGENCY CONTACT PERSON (SECONDARY)-
NIGHTS: N~ME (LASi. FmRS~ P~E · WiTH AA~A COOL NIGHTS: NAME (~ST. FIRS~
,,. P,oPE,TY OWNER INFO,MATION-(MUST BE COMPLETED)
~AtL/NG CR STREET ADC~ESS i ~ m~ ~,m~:~ ~ INg~VIDU~L ~ L~XL.~ENCY
Ill. TANK OWNER INFORMATION- (MUST BE COMPLETED)
J ',~E OF OWNER j CARE OF ADDRESS INFC~IZATICN
MA~LING OR ,STREET ADDRESS ~ ~z o~a)e ~ INDIVIDUAL ~ L~AL.AGENCY ~ STA~-~NCY
IV. BOARD OF EQUALIZATION UST STO~AGE FEE ACCOUNT NUMBER- Call (~16) 323-~555 if questions arise.
~ 5 ~ OFC:E~T ~ ~ ~E~PTION ~ ~ OTHER
VL LEGAL NOTIFICATION AND BILLING ADDRESS Leg~ nofifi~fion and billing will be senl (o lhe lank owner unless box J of II.~ ch~ed.
THIS FORM HAS BEEN COt~PLETEO UNDER PENAL TY ~ PERJURY. ANO TO THE BEST ~ MY KNOWLEDGE, IS TRUE AND CO~ECT
LOCAL AGENCY USE~NLY /
COUN~ i JURISDICTION ~ FACILI~ J J
L~O~ CODE - OPriO~t JCENSUS m~CT · - ~DO~t j SUPWSO~ · O~S~mCT CODE .
THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION FORM B, UNLESS THIS I~ A CHANGE OF S~E INFORMATION ONLY.
~AT[ OF CAMFO~I A
STAI~. WAT~.R RESOURCES CONTROL
UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B
~MPL~E A SEPARATE FORM FOR EACH TAN~ SYS~
I
~AOR FACIL~ NA~ WHERE TANK IS ~STA~ED: ~ ~ Fi ~. ~
I. TANK DESCRIPTION couPLE~ ~ ,~S -
C. DA~ INSTALLED {MO~AY~EARI '~ , O. TANK C~AC~ IN G~LONS: '
II. TANK CO~E~S IF A-1 IS
UNLADED 5 JET FUEl.
~. IF [A. 1) IS NOT MARKED. [N~R NAME ~ ~SS'kNCE STORE~ C.A.S. I:
IlL TANK CONSTRUCTION
T~K
LINING
E. SPILL AND OVERFILL SPILL CONTROVERT ~STALLED [YEAR) ~ ~ OVERFILL PR~ENT~ EOUIPMENT
IV. PIPING INFORMATION c;=c~ A ~= ~s:v~ a~ou~oon U
k. SYSTEM TYPE ~ SUCT,O~ A U 2 Pn[SSUn~ ~ U 3 G~v:~ A g ~ O~En.
C. MATERIAL AND A U 1 8A~E STE~L A U 2 STAINLESS STE~L A g 3 ~L~N~L
CORROSION A U 5 ~u~lNuu A U 6 ~NC~E~ A U 7 STEELW,'~ATING A U ~ ~ ME~A~L ~UPATlaLEW~P
V. TANK LEAK DETECTION
VI. TANK CLOSURE INFORMATION
~. ESTIMATED CATE LAST USED ;uO,'OAv,w ~) ' 2 EST=u~TEC O~A~TITY O; J 3. WAS TANK FI~EO W~TH
' SubSTANCE ~EVAiNING ~LLONSJ INERT MATERIAL
THIS FO~M HA S BEEN C OMPL ET~ U~'DE~PENA L ~ OP FE~JU~ A ND TO THE BLS T OF ~ KNOWLEDGE, IS T~&'E A.'JD, COndEC T
I 1~IN~OI SlGNATU~[~ ~ ' '~ -- ' / ~" · ,I Y / '
LOCAL AG ENCY USE ONLY THE STATE LO. NUMBER ~ COMPOSED OF THE FOUR NUMBERS BELOW _
COUN~ ~ JURmSD)CT)ON J FAClL~
THIS FORM MUST BE ACCOMPANIED BY A P~R~T APPUCATION · FORM A, UNLESS A ~RR[NT FORM A HAS SEEN FI~D.
FILE THIS FORM WUH THE L~AL AGENCY IMPLEMENTING THE UN~RGROUNO STORAGE TANK REGULAT~
¢Onug I~2 g~)
5'T&TE OF CAMFOR~IA
STATE WATER RESOURCES CONTROL BOARD '
UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B
COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM.
~ OR FAC~L~ ~A~ WHERE TANK ~S mSTX~D: ~ ~ 6 ~ ~ ~/
I. TANK DESCRI~ION COMPLE~S- SpECIFY IF UNK~
II. TANK CO~E~S ~ A-~,S U*~D.~;~T~UC.
A. MOTOR ~HICLE FUEL ~ 4 OIL 8. C. ~UNLEAD~D 4
~ 2 PEIROLEUU ~ , EUP~ ~ PROD~T ~ ,bPREMIUM~ ~ 7 u~OL
UNLADED I , 5 JET FUEL .
O. , IF (A,1) IS NOT MARKED, EN~R NAM~ ~ ~'$$TANCE S~ORED C.A.S. e:
IIL TANK CONSTRUCTION
A. ~PE OF ~ I ~UgLE WALL ~ 3 SINGLE WA~ WI~ E~ERIOR LINER
SYSTEM ~ SmNGLE WALL ~ 4 SE~N:A~Y ~TAiNMENT ~AUL~DTAN~
IS LINING MATERIAL ~U=~T,~.E ~TN 1~ METHANOL ~ YES~ ~
E. SPILL AND OVERFILL smut CONTrOvErT INST~LLE~ (YEAR) ~//~ OVE~ILL P~ENT~ EOUIPVENT INSTatED ~EA~)
IV. PIPING INFORMATION C~R¢'_E A ~: A-:O:': ~ROu.<~ OR U
~ sucT~o~ A U ~ ~ssu;E A 3 O~w~
SYSTEM
TYPE
U
U
O~ER
B. CONSTRUCTION ~ SINGLE WALL A U 2 ~J8LE ~ALL A U 3 LINED TaENCH A
C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 ~L~t~L ~LORI~E ~VC)A U
CORROSION A U 5 ~MIN~M A U 6 ~CR~ A U 7 STEELW.'~TIN~ A U 8 1~ ME~ANOL ~uaATIBLEW~aP
PROTE~tON [ U g ~LVAN;~ S~EL A U ~0 CAT~O=~C P~CTECT~ ~S UNKNOWN
V. TANK LEAK DETECTION
VI, TANK CLOSURE INFORMATION
I
THIS FORM HAS BEEN COMPLETED UNDER PENAL ~ OF PEgJUgY. ANO TO THE ~EST OF MY KN'O;VL~G& ;S , ~ .... ~D CO,RED T
~ .
LOCAL AG ENCY USE ONLY THE ST~TE LO, ~UMeER ~ CO~OSED 0¢ THE ¢OUR UU~eE~S BELOW
PEau*l NuuBER ~ PERUII APPnOVED 6Y~TE
THIS FORM MUST 8E ACCOMPANIED 8Y A PER~T APPUCA~ION. FORM A. UNLESS A CUnnENT FOR~ A H~S BEEN FI~O.
FILE THIS FORM W~H THE L~AL ACENCY IMPLEME~ING THE UN~RCROUND STORAGE TANK REGULAT~
m STATE WATER RESOURCES CONTROL BOARD
UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM
COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM.
~A OR FACIL~ NA~ WHERE TANK IS ~STA~ED: ~_ ~ & ~ ~ ~%~1 ~
2
P~TROLEUM
A. ~PEOF ~ 1 ~uabE WALt ~ 3 S=~G~ w~ w~ [~mO~ L,NE~ ~ ~ UN~OWN
LINING
E. SPILL AND OVERFILL SPILL CONT~V~NT INSiZLL[~ (~) ~//~ OVE~ILL P~ENT~ EOUIPUENT INSI~LED FE~) ~/~ ._
IV. PIPING INFORMATION
SYSTEM TYPE
A
U
I C. MATE~{ALAND A U I BA~ESTEEL A U 2 STA:NLESS STE~L A g 3 ~L~N~L ~LORIDE~VC)A U 4 FI~E~G~S PIPE
PRQT[~ION ~ U g ~LVAN;~g S~EL J U ~0 CAT~C;ICP~CT~CT~ ~5 UNKNOWN [ ~ ~ OSE~
D. LEAK DETECTION ~ ~ AUTOU~T,CUNEt~<~E~CTO~ ~ ~ L'NET~ESSTEST~NO ~ 3~.~O~G~STK~L ~ ~ 'O~
I V, TANK LEAK DETECTION
VI. TANK CLOSURE INFORMATION
i THIS FO~M HAS ~EEN COMPLETED UN~ER PENAL ~OF PErJUrY. AND TO ~E ~E3T ~F MY KN'~'L~. I~ T~'~ ~.'10 CORRECT
LOCAL AGENCY USE ONLY THE S~ATE LO. NUMBER ~ CO~POSED OF THE FOUR NUMBERS BELOW
COUN~
I STATE ImD.,
m imf5 FORM MUS) BE ACCOMPANIED BI A PER~[ APPUCA[ION · FORM A, UNL~S~ A CURRENT FORM A HAS BEEN FI~D.
FILE THIS FORM W~H THE L~AL AGENCY IMPLEMENTING THE UN~RCMOUN0 STORAGE TANK RECULAT~
i SI'A~ OF CJkUFOP~JA
STATE WATER RESOURCES CONTROL BOA,CID
UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B
COMPLETE'A SEPARATE FORM FOR EACH TANK SYSTEM.
m MARK ONLY [] ! NEW PERMIT F-'la RENID, N~I~ PERMIT [] ~, C~NG~ C)~c INFORMATION E~ ~R"ANEN?LY~.o~o o. Sl~I
ONE rrEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 8 TEMPORARY TANK CLOSUR~[~"'"1 TANK
I. TANK 0ESCRIPTION COMPLE,~ ALL rT['~S - SPECflrY IF UNKNOWN
A. ~ MOTOR VEHICLE FUEL I-'-~ 4 OIL ". C, [] "REGULAR ~ DIESEL ~ , ,VU~TIO~ GAS
m ~ UNLEADED [.__.J 4 GASAHOL
~ UNLADED ~ I 5 JET FUEL
D. mF tA.~) tS NOT MARKED, EN~R NAWE ~ ~EST~NC~ ~TO~ED C.A.S. m:
IlL TANK CONSTRUCTION
A. ~PE 0F ~ ~UBLE WALL ~ 3 S:NGLE WA~ Wl~ [~[RCR LINER ~ ~ UN~OWN
SYSTEM ~ 2 SINGLE WALL ~ 4 SE~N~ARY ~TAINMENT ~AUL~DTAN~ ~ ~
m. T~K ~ 1 ~"E STEEL ~ 2 STAINLESS S~L ~ FIBErGLaS ~ 4 STEEL C~O W/FIBER~
LINING
E. SPILL AND OVERFILL SPILL CONT~UENT m.~ST~LLED (YEAR) ~/~ OVER~ILL PR~ENT~ EOUIPUENT INSTatED ~E~)
IV. PIPING INFORMATION c:~c:~ A ;=~ovEa~ou~:o~ u
m ~ SYSTEM TYPE ~ suc:,o~ ~ U 2 P~ESSUnE ~ U 3 O~w~ ~ U ~ O~ER
B. CONSTRUCTION ~l SINGLE WALL ~ U 2 ~;BLE ~ALL ~ U 3 L(NED TME~C~ ~ U ~ UNKNOWN
m
'm c. MATERIAL AND ~ U 1 BA~E STEEL ~ U 2 STAINLESS STEEL A U 3 ~L~'~L ~LQRI~ ~VC) ~ u 4 FIBERG~ PIPE
CORrOSiON' A U 5 ~Uu)N~ ' A U 6 ~AE~ A U 7 STEEL W;~TI~G A U ~ l~ ~E~A~L ~u=~TIBLEW~RP
PROIE~iON A U 9 ~LVAN:~D S~EL ~ U ~0 CATWOOC ~CTECT~ ~ UNKNOWN A U ~ O~ER
D. LEAK DETECTION ~ 1 AUTO~AT~ LINE LE~K DE~CTOR ~ 2 LiNE T~ESS TESTING ~ 3
V. TANK LEAK DETECTION
VI. TANK CLOSURE INFORMATION
TH/S FORM HA~ BEEN COMPLETED UNDER PENAL ~ OF PE~JU~ A~D TO T~E BEST OF MY KNO~EDGE IS T~UE AND CC~ECT
~ LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER ~ COURSED OF THE FOUR NUMBERS BELOW
COUN~ · JURISDICTION ~ FACIL~ ~ TANK
m THIS FORM MUST BE ACCOMPANIED BY A PER~T APPUCATION · FORM A, UNLESS A CURRENT FOaM A HAS SEEN FI~D. '
FILE THIS FORM W~H THE L~AL AGENCY IMPLEME~IHG THE UN~RGROUNo STORAGE TANK REGULAT~
I CERTIFICATION OF COMPLIANCE .
FOR UNDERGROUND STORAGE TANK INSTALLATION
I FORM C
I COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM
I. SITE LOCATION
STREET _ ~'~,--~c) /1-,._1-'~,"-J ~-.~,J.~' T'
CITY _~.~' ~,,t--,~', ~'~_,") COUNTY ~-~'.~J
11. INSTALLATION (mark all that ap.~'.y):
F--'] The installer has been ce,lified by the tank and piping manufacturers.
~ The installation has been inspected and certified by a registered professional engineer.
~ The installation has been inspected and approved by the implementing agency.
~ Ail 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 implementing agency. (Please specify.)
Ill. OATH I certify that the information provided is true to the best of my belief and knowledge.
,~ .
Print NameC¢,,.4,,;, h/z,.C~/7:/./~t.://- L)C.'pC-.~T Ii. LC'z-- r ,~....:y..-¢ Phone (
I
Address jl ~'~ ~J /'lc I~.r., "~- ~ F¢'~_ vJD. i'~:l,J~ Ur_~a, 4% ~-
LOCAL AGENCY USE ONLY
STATE COUNTY ~/ JURISDICTIOt~ # FACILITY ~ TANK #
~on~ C 17/g~) THIS FORM MUST BE ACCOMPAtiI£D BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY
' .... * STAT[ OF CALIFORNIA - ~~,~..
I STATE WATER RESOURCES CONTROL BOARD · ' ....... ;" ~-
CERTIFICATION OF COMPLIANCE , ~.' ~
i FOR UNDERGROUND STORAGE TANK INSTALLATION
FORM C
I COMPLETE'A SEPARATE FORM FOR'EACH ;rANK SYSTEM
II. SITE,LOCATION .
STREET ~::~ .~.Dg,, t
I CITY I~.~1: ~ ~-,'~.~ COUNTY
I
II. INSTALLATION (mark all t,.~t ~,.o:y).
[] The installer has been certified by the tank and piping manufacturers.
I [] The installation has been inspected and certified by a registered professional engineer.
~'""The installation has been inspected and approved by the implementing agency.
I ~ All work listed on the m'anufacturer's installation checklist has been completed.
¢'-}f The installation Contr,%tor has been certified or licensed by the Contractors State License Board. "
I [] Another method was used as allowed by the implementing agency,. (Please specify.)
I Print Name~"~2./~'c~ 'r-lc:~r'~,/' ~,.'~,.z ;- I.~. f.~,:-~ ,'?'~-._c'.c..Phone ('"Trio)-~.-"5' I(.,'/-,' C,
Address /Ib'l /..J. h'/c' D,-.~',:.,.-- P-,,.._vD 'l")¢r/~.[r¢
I
ILOCAL AGENCY USE ONLY
STATE COUNTY # JURISDICTION # FACILITY # TANK ~
~on~ c (?,~) THIS FORM MUST BE ACCOMPAhlIED BY PERMIT APPLICATION FORMS A & 8 UNLESS THEY HAVE BEEN FILED PREVIOUSLY
I
.~~ OFFICE OF ENVIRONMENTAL SERVICES
PERMIT APPUCAmON.FOR RmOVAL 0~ ~ U~DERGROUND STOOGE TANK
TANK OWNER/OPERATOR ~,'m~
C,O~A~TOe INFOEMA~Q~
COMPANY ~ ~ ~~~ PHONE No. LICENSE No.
ADDR~S
INSURANCE CARRIEE WOEK~ENS~OMP No,
COMPANY ~ ~ m~H~ PHONE No. LICENSE No.
ADb~ESS C~ ~P CODE
INSURANCE CARRIER WO~KMENS COMP No.
TA NK CLEANING INFORMA~ON
COMPANY ~ ~ ~~t~ PHONE NO.
ADORESS CI~ ZIP CODE
WASTE TRANSPORTEE IDENTI~ICA~ON NUMBER
NAME OF ~IN~ATE DISPOSAL FACILI~
ADD~ESS CI~ ~P CODE
FACILIW INOENTIF1CA?iON
COMPANY ~_ ~~~~E~ ~ PHONE No. LICENSE No.
ADDreSS C~ ZiP CODE
TANK D~S~NAT,ON
TANK IN,ORMATION
TANKNa. AG~ VCLUM~ CHEMICAL DAT, S CHEMICAL
STORED STORED PREVIOUSLY STORED
THE APPLICANT Hg RECE~. UNO[~TA NOS. AND Wlt~ COMFY Wlf~ THE A~ACHED COND~IONS ~ TH~$ P[~Mfl AND AN~ OTN~i
AP ~ APPLICXNT NAME [PRIN~
THIS APPLICA~ON BECOMES.A~~.WHEN AP~OVEO.
" ........ ~.E~'~ ~c.'- ................
B kersfield Dept
OFFICE OF ENVIRONMENTAL SERVICES
UNDERGROUND STOOGE TANK PROG _
PERMIT APP~CATIQN ~ CONS~UCT~ODI~ UNDERGROUND STOOGE TANK
~P'E OF AP~LICA~OH (CHEC~
~ NEW FACILI~ ~OOIF~ATIONOF FACIL[~ ~ NEW ~ANK 1NSTALLATIQN AT EXISTING FACILI~
STARTING DAlE ~~-I'q~ PROPOSED COMPL~ION 0ATE ~;~o
FACILI~ NAME ~]~t~ .~- - ~ISTING FACILIW PERMIT No. -
FAC)LI~ADDR~SS ~ ~,~ CT ZiP
~PE OF BUSINESS _MT~L~ ~,~on~,[ APN
TANK OWNER gn~,~;~ ~ ' ~ _ ' - PHON~ N~.
CONTRACTOR ~ ~ ~j~!u~O CA L]CENS~ No.
ADO~ESS ClW Z1P CODE
PHONE No. ~AKERSFIELO C;~ BUSINESS LICENS~ No.
WORKMAN cOM~. No'.
BREIFLY DESCRIBE 1HE WOR~TO~ DON~ ' 12eH~.C~ J G~,~ ~. I g~ ~%~
WATE~ TO FACILI~ P~OVJOEg BY. '
DEPTH TO GROUND WATE~ J~ ~ ~_ ' ..... SOIL ~PE
No. OF TANKS TO B5 iNSTALLED ~ A~ THEY FO~ MOTOR FUEL '~ES O NO
SEC~ON FO~ MOTOR FUEL
TANK No. VOLUM~ UNL~A'DED ,EGU~E P,EMIUM DIESEL AV1AIION
SEC~ON FOR NON M~TOR FU~STORAGE TANKS
TANK NO. VOLUM~ CHEMICAL STO~EO CAS NO. CHEMICAL PREVIOUSLY
(no DrQnd nome) '(i~ known)
, ,., ~ ., ~..: .......,,~.,.-.'.,..... ,, ~C~EQ~tv ........,..;-=.~ ......... ~- ...~,...~.,~.~'. ,..' .... . =~, .~
~ -'..~ '~ , ..... Y .C;:C '~ · - ..... :~z~;~' ..... : .;~..~:.~.,~.~'. -~;~..t .. ~ "' ~ ..... ';:; :' 'Z'"~ /-'-,.-',.c' ~;.: .>~-~'.'.;~;,'~,?~'~-.,.,-, .~:t.'.';.~ .......
~' · ' ' " ~'. ;: -.;-.~..~',;;~"~'~',.;.~:~'~";;~'"" ' ' ....... ' ~.:.'. '~.:;~',* .5':~;;': ...-..."'";~ ....... ..'.'".'"': ..... ,~...::;;~'.; .... ~.' ';*~:.~.,....,;,.'2.~
j...~..~..' ::-.:~: ...~;-~y~'?,,'../,. ~; :; ...... :: .?.~,~.,.=,;...,.;..... ,'~ :.::.: ,..'.'..~.:.:.~ ~:~~"::.': ..,.::~;.'.... ~ .. ':...;,.?~,¥. ~.,;~ ~....'.~.:.;
STAT~ LOCAL AN0~E0~AL ~EGULA~ION$.
~ ~ ,~S ~;;~ co~PL~EO u~O~ PENAL~ ~ P~U~Y, AN0 rD THE ~e~r o~ ~ ~NOW~ CS ~U~ ~NO CQ~ECT~
APP~~ ApP~i~AffiT NAME (PRIN~ '- ' APPLICANT SIGNATURE
THIS APPUCATION BECOMES A PERMIT WHEN APPROVED
APPENDIX
___mm__mm ~mm - [ I _ I - _/ I ! I l II --mm ~
Appendix B
Hazardous Waste Manifest for Rinsate Disposal
.State. of..C~!iforg!~ ~o~--~n~Nronmentol Pro~'ection Agency ~.
Form Approved ams'No. 20,~0-O0q9 (l~xpJre, 9-30-96) ...... See 'instructions on back o,; page 0. . Oeportmed~ To,lc
P]e~e print or type. Form demigned for u~e on elite (12-piN:h) ~,pewri*er. Sacramento, Cali~ornla
4~ UNIFORM HAZARDOUS 1. Generator's US I~PA ID No. Manifest Document Ne, 2. Page I Information in the shaded areas
i* not required by Federal law.
~O~ox ~9~ -~cor,, IN~OI I~ ' .... * ~ .' ~,
5. Transporter I Company Name 6. US EPA ID Number ,C;:'$tate Tmnspo~!
7. Tran~poder 2 ~o~a;W Name -"~."U$ EpA ID Number '
1 I, .US DOT Description (including Proper Shipping Nome, Hazard Class, and ID Number) 12. Containers 13. Total 14. Unit "~' .:';,;
No. Type Quantity Wt/Val I]
N b. ~ State
~J;.:AddlfionaI.De~crlpNons for/V~fedals .:~.:ti"~i;'~?..z'.'.L' :. '..t' 'j K 'Handllng'Codas for Wastes
15. Special Handling Instructions and Additional Information
UCc? ~.,,-q ._%; u .',' c" - · ' ,-
16. Gi:NERATOI~'S CERTIFICATION: I hereby declare that the content~ of this consignment are fully and accurately described abo~e by proper shipping name and are classified,
pocked, marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable ir.ternational and national government regulations.
If I am a large quantity generator, I certify ~at I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be
economically practicable and that I have salaried the practicable method of treatment, storage, or, disposal currently available to me which minimizes the present and fuh~re
j- threat to h .... health and th .... i ...... t; OR, itl am a small quantity g .... ator, I have m/ode a go~,~.Faith eft7 to minimize my waste g .... arian and select the best
I waste management method that is available to me and that I can afford. / / , /'
Printed/Typed Namel . I Sigr)o~re , z - ~" ' '
/ 7Y'/",,.- W':/ _. Mo~ Day Yea,
~ : .. C.--,";,., '
, Prln,d/Typed Name I Si re ~//~/~ Month~ Day Y~a~
~0 18:-Tranip'o~ter~'~Ack~owe~dgem~,~f~Receipt-ofMateria-s ~. ~/v .......... x. "'"' .... /. "'"" ~',,'*'~ ~,._.
~ Printed/Typed Name J Sign~Sure (...) Month Day Year
,,. 0,,c,. ancy ,nd,cat,on S ac.
P
A
C
I
L
I 2'0. Facillfy Owner or Operator C.rfiticafio. of re<eipt ali hazar4ous materials covered by ~hil maniJe,~t except as r~oted in Item 19.
¥
DO .NOT' WRITE BELOW THIS LINE.
IOrSC llg22A (I/9~) Blue: OL:NI-:RATOR SENDS THIS .COPY TO DI',~C WITHIN 30 DAYS.
EPA 870G----22 /'m P.O. 6ox 400, Sacramento, CA 9~HI2
APPENDIX
/'
Appendix C
Acceptance Letter and Landfill Weight Ticket
for Tank Disposal
ENVIRONMENTAL HEALTH SERVICES DEPARTMENT RESOURCE MANAGEMENT AGENCY
~ ~ R.E.H.S., Director ~ DA VID PRICE III, RMADIRECTOR
2700 "M" STREET, SUITE 300 ~ Engineering & Survey Services'Department
flAKERSRELD, CA g3.-]0! ~ Environmental Health Services Department
Ph0ne:(805)862-8700 . Planning Departmanl
FAX: (805) 862-8701 Road~ Department
May 6, 1996
Walter Gage
IT Corporation
2055 Junction Avenue
San Jose, CA 95131 W.O. #782
SUBJECT: Disposal of Fiberglass Tanks at Bakersfield Metropolitan Sanitary Landfill
(BENA)
Dear Mr. Gage:
Our Department has no objection to the disposal of two fiberglass tanks (12,000-gallon and
5,000-gallon), removed from 5650 Aldrin Court, at the .Bakersfield Metropolitan Sanitary
Landfill (BENA), provided the following conditions are met:
1. The tank has been triple rinsed, certified clean by, the City of Bakersfield, Fire Department,
Hazardous Materials Division.
2. There is no residual water or petroleum adhering to the tank remains.
3. The tank has been crushed to pieces no larger than three feet square.
4. The waste conforms to information submitted to our Department.
The Kern County Waste Management Department, as landfill operator, reserves the~ right to
adopt more stringent waste acceptance criteria. Please contact Lyn Beurmann at (805) 862-8957.
A waste acceptance fee of $80.00 will be invoiced at a later date. If there are any questions,
please contact Diana Wilson at (805) 862-8734.
Sincerely,
Steve McCalley} Director
By: William O'Rullian, R.E.H.S.
Environmental Health Specialist IV
Solid Waste Program Supervisor
cc: Lyn Beurmarm, Waste Management Department
' wilson\gage.let
~",.Fdr Accounting Questions Call: J"-' F~r Wi~te Management Ouedfl°n~ Call:
. ,, (805) 881-3S02 (~5) 861-2159
' . g868.:0
7. ' eee~e3e~tS~ ~P~ ~ " COUNTY.OF ~ERN
N P'. VRCU~RUCK BEEr %CE WASTE MANAGEM~.BE~.
~4me MAWR ~T. , 27~ "M" 8t,¢'~e BO0
i 8RKERSFIELD'. ,. CR' 933e~ -Bakersfleid,(~5) 881-~10A 93301~59 '
~ P VACUUM TRUCI' BERVIOE' " 0: ' , ROT~.
RFD'
MAY 6 1996
APPENDIX
Appendix D
Laboratory Analytical Reports,
and Analysis Request/Chain of Custody
er Analytical Laboratory DMsion
logy Mobile Laboratory DMslon
Techno ,nc.
W/th Automation in Mind
Mobile Laboratory
AnalySis Summery Report
TPHgasoline I. TPHdiesel
BTEX
/
Atten: Walter Gage Date Sampled: May. 8, 1996
Project Mgr. Matt Hopwood Date Received: May. 8, 1996
Company IT Corporation Date Analyzed: May. 8, 1996
Address 2055 Junction Ave.
'San Jose, CA 95131
ProjeCt: Pacific Bell Aldrin Ct.
Project #: ?65001
I~B ID: 141M
SOILS
ETHYL- TOTAL TPHg Surrogate TPHd
Lab ID, CLIENT ID BENZENE TOLUENE BENZENE XLYENES Gasoline Rec Diesel
mg/Kg mg/Kg mg/Kg mg/Kg mg/Kg % mg/K,g
141M-1 PBA-TP1-2' ND ND ND ND ND 75% ' *
141M-2 PBA-TP2-6' ND ND ND ND ND 83% *
141M-3 PBA-TP3-2' ND ND ND ND ND 76% *
141M-4 PBA-TP4-6? ND ND ND ND ND 78% *
141M-5 PBA-TPS-2" ND ND ND ND ND 70% *
141M-6 PBA~TP6-6' ND ND ND ND .ND 78% *
141M-7 PBA~TP7-2' ND ND ND ND * 103% ND
141M-8 PBA-D1-6' ND ND ND 0.011 ND 80% ND
141M-9 PBA-TP8-6' ND ND ND ND * 79% ND
141M-10 PBA-D2-2° ND ND ND ND ND 77% ND
· 141M-11 PBA-SP-1,2,3,4 ND ND ND ND ND 85% ND
Detection Limit 0.005 0.005 0.005 0.005 1.0 1.0
ND = Not Detected
..... = Analysis not requested for this sample
- '
R. Allan Morrison Jr., Principal Chemist Date Reported
SPARGER TECHNOLOGY ANALYTICAL LABORATORY. INC. IS CERTIFIED BY THE STATE OF cALIFORNIA
DEPARTMENT OF HEALTH SERVICES AS A HAZARDOUS WASTE TESTING LABORATORY
(Ced~ficabon No. ~)17)
File Ci/c'le, ,~ul'lO 'I'12 · b'(_Tc~¢]n'l(gf)/o, Cc_fli/(.)fr)/~ 9,5~L)7 · (9~6) 362-8947 · FAX (9~6) 362-0947
APPENDIX
E
Ii,' Appendix E
I Bills of Lading and Landfill Weight Tickets
I for Soil Disposal,'
.. ~A~ON~ -- ANALYSIS REQUEST AND Reference Document No..~.~
. TECHNOLOGY
cobb, op.,noN '/I~ /z-// CHAIN OF CUSTODY RECORD* Page ~ °f ~
Sample Team Members~_ ~. ~q~ Lab Destination ~__~~
Profit Center No ~ ~G~ ~O Lab Contact ~ ~q~
Project Manager" ~, ~¢ Project Contact/Phone ?~_~,/._~~.~ Repo~ to:~P_~_~. ~.~. ....................
Purchase Order No. ~ Carrier/Waybill No ~3 ~oS~ ~+,'~ ~
Sample ~ Sample 15 Oate/~ime~6 Contai~erl?Sample~ pr~ ~9 ~equesteg Testing 20 Condition on 21 Disposal
Number Description/Type Collected Type Volume sedative Program Receipt Reco~ No.
Special Instructions: aa
Possible Hazard Identification: 2, Sample Disposal: 2s
Non-hazard ~ Flammable J Skin Irritant J Poison B !J Unknown ;~ Return to Client.'J Disposal by Lab~ Archive ........ (mos.)
Turnaround Time Required: 2s [ QC Level: 27
Normal 'J _Rush ~I I.~ II.IJ IIl.~J Project Specific'(sPeci~)~
1. Relinqui.~',ed by 2a ~~ Date: _~/_~ 9 ~__~_._ 1. Received by 2a Date:
2. RelinquF~';=.~d by Date: 2. Received by Date:
[S~gn~ture/Affi,.=: .... ... Time: {Signature/Affiliation} ~ /° ' Time:
....... '/ ~"7
3. Relinquished by Date: 3. Received by/~/~ff/~ ~~ ~/ ' Date:
INTERNATIOlqAL ANALYSIS REQUEST AND Reference Document No.
TECHNOLOGY
¢o~o~o~ CHAIN OF CUSTODY RECORD (cont.)* Page ~q of _~
Proiect Name ~)~c '~.]]__~_~_(~f~\?! ....... Project No. ~OI . Samples Shipment Date
Sample~4 Sample ~5 Oate/Time16 Containerl7 Sample18 Pre.19 Requested Testing 20 Condition on 2~ Disposal
Number Description/Type Collected Type Volume servative Program Receipt Record No.
. ' 800-972-5284 .:.:., :.-"!i '....:?:..,-,
'W~, Liquid ' ' ' ~duS~al CA 221 .- Gal
W~ut ~ch
~U~IFi~ ' ' ' ' : .... ~m ' ':. · ' '~ '~'~ ' :"":
~ ' · ' - .: ' ' · : -' ' : .:. .'-:; .... ' .',"' -: . . ' : ,t.' :- ', :'. ', :.. ''". ... 't .-':
~: : - . . .': .. ... .. , .~. '. ., . .. . ,~: :'. : ?': ..... ., .., :[. 7.- .. ,,.,, : :",:'
~o~=,~o.~ ~.~o~. NET 7 DAYS TOTAL
, ,,,, ~na~a~no .-..
Accoun~ng Office 510-795-4400 Please Pay From This Invoice
6880 Smith Avenue "' co~ ~c ~d ac~atc ~om of ~c w~. ~1 rclcv~ ~o~don
rc~n8 ~o~ ~ sus~d h~ ~ia~ wi~ ~c w~c h~ ~ di~l~,
Newark, CA 94560 ~i, fu~ ~ ~ na~cai~ ~ ae a~vc liquid w~ ~ b~ ~ I~d *:
EPA~ CAD980887~ 18 . dls~l pumu~t m Tide 22 Sc~tion 6626g.7.(ag 10). 1 ~ ~o~l~ge ~t I ~w
[ ROUTE g 'DRI~ERS~G~ATU GENE~TOR'SStGHAT~E' ' .... . Pm~T N~. ,. '
- ,......... ,. ., . ....,..) . ......:.: :.. .... , ., · :.-;~,,...:,,,,,~
i ........... ~ IS TOC~T~'¢~nt the f,3. ewlng desc~. 0ed o3mmo~.h~ waswo ghed, moa~bmd, at ~0un,'~ Dy awe ghmaste~, whose signalize ' ........
I
I'~ on this cerUflc~te, who Is a re~gnlzed au~orl~ o~ al~uracy, as prescribed by Chaple~ 7 (~mmendng
Dlvlelon 5 o! ~e Call~omla Dy ~lnees and Pro~esslons C~e, admlnlslered by ~e Division ot ~asuremen! S~andmds of ~e C~l~omlm
Oepa~enl of Food ,',nd Agrlcul~re.
,o.oo,.o. 3 9 0 7 7
20807 STOCKOALE HIGHWAY
I [~AKERSFIELD. CA93312 (805) 58g-~042
TRUC.,~LICENSE TRAILER LICENSE / TRAILER NO. 2 LICENSE
I ~I~HE0 ~OR (SELLER) ~ELtVER~D TO (6UYER) TRUCK CARRIER
IT CORP HONDO MP
I HONDO CHEMICAL INC. WEIGHMASTER 9:1:3 RI'I 05 22 96
~ oEPu~ ~,' .3,3 lb m~ GROSS L~.
,, " T~R~ L~.
STOCKDALE HIGHWAY '
BAKERSFIELD, CA 93312 CAs~ ~AI0 CHARGE SALE
~LTER'NATE STRAIGHT BILL OF LADING--SHORT FoRM--ORIGINAL3NOT NEGOTIABL~ 'Shippec No.
.ame of Cardem C~~~
~MP ENVIRONME~AL SERVICES
TO Consignee: FROM Shipper: ~ ' ~ / ~ ,1
~treec
3900 ALLEN RD 5650 ALDRIN CT-BAKE~FI'E_D, CA
estination Zip Code {Emer;enc'/
BAKE~FIELD, CA 93312 800/458-3036
~oute: Vehicle No.
iNO. uS~PsP,ng Kind of Package, Description of Artic!es, Special Marks and Exceptions 'Weight (Sub. co Corr I RATE ¢ CHARGES
iEND DUMP NON-HAZARDOUS, SOIL
i '
i~EMIf C. 0. O. C.O.O. FEE: TOTAL
;.0. O. TO: A~T: PREPAID
,0DRESS COt. LECT 13 $ CHARGES:
~.~,,llf,r ,,t,: ,.'.r ,,Lh,:l ii. ,'; ,...'l'.,~., l'h,~ ,I, II'r',:d ,;f' ,D',:I,u','II /,Ih.~ ,fl 'h" ;,r' :,," '¢ , . :',~l,j';.r,,j '.L,¢.,:m,',,t
7,,I,*l*,~,,I IH, I TIll*. ,,~.1 ~," ',, , .11.1 , ,u.hl i,.s, ,~1 ,' h*'$ ,'h' ,IH;,',',l ~,l I,,, '' ,, .hi ,,,I ,, , ~l ,',i ',,, ',,,,,
. II .... ,,,,,,,,,l,,,I,,,r '',, ,I,,i.,,r,,.,,,,,I,,,,I,',n¢, ..',.,,t,,',l.'h.,I h t,,,t, ,,~,,,,,I
,,,,,' ............. ~,,~ .......... ,,,, ', .... ~,'l ........... , ..... ,,.,,,,.,,,,,-~,, ~ % ....
, · ~ ~ '~
, ...................... .
' ' ' ~,,, .,,,',,,,,, :.,,,;,,,,,.. ,,,,,,,:,,.',,,';~,,~l,,,,,,,;. . '
THIS IS TO CE RT IFY .hat [he !ollowlng de sG"ibe d commodity was wclghed, measured, or counled by a welghmaster, whose ~Jgneture ....... .
on this certificate, who Is a recognized au[ho.'l~ of accuracy, as prescribed by Chaplet 7 (commenting wl[h Sectlon 12700) Of
Division 5 Bi the California Business ~3d Professions Code admlnls e,rod by Ulo O v a on of Measqremen! Standards of [he CaJlfomla
Depar~mon! of Food and AgflculE/re.
.o,oo.,o. , NQ 3 9 0 7 8
20807 STOCKDALE HIGHWAY '
8AKERSF~ELO. CA93312 (805) 589.1042
TRUCK LICENSE TRAILER LICENSE TRAILER NO. '2 LICENSE
W~IGHEO FOR {SELLER) 0ELIVERED TO (BUYER) TRUCK CARRIER
IT CORP HONDO MP
I HONDO CHEMICAL INC. WEIGHMASTER 9:[6 Iql"l 05 22 96
TIME
0^TH X~,/ ' " :;;0460 lb
I
DATE
i DATE //'?/;//'7 _c02S0 lb HET
TARE
LBS.
WEIGHED AT 20807 " J
STOCKDALE HIGHWAY XX
NET I.BS.
BAKERSFIELD, CA 93312 ! CASH PAIO CHARGE SALE
I . COMMODI'I~
SOIl'.
REMARKS DR/~Ey '
I ..
lame of Carrier: Carrier's No. Date Shipper NO.
MP ENVIRONMENTAL SERVICES c/! ,../~ ~:]~
TOConsignee:,HOND0 CHEMICAL " FROM Shipper:~2 ~ ~'4~ Il
'3900 ALLEN RD 5650 ALDRIN CT-BAKERSFIELD, CA
lestination Zip Code Emergenc': gespcnsa Phcne No.
BAKERSFIELD~ CA 9~$lf~ gOO/45g-50~6
-J~oute: Vehicle No.
i No. Sh,pDmg ~1 Kind of Package. Oescription of Articles. Special Marks and Exceptions ~Weight (Sub. :o Corr) RATE -¢ CHARGES
I- END DUMP NON-HAZARDOUS SOIL .
I "
i
I%MIT IC. O. 0. TOTAL
O.
FEE:
.0. TO: JAN1T: PREPAIF3 i] iCHARGES: $
RESS COLLECT ~3 :~
','¢,ll:,¢uf;:,h',,I,;,U','.H'h't','¢.d.,:l' LI.~ ,hqJl'¢r';,'"~":~; "' '. ';.~-~m'': "."/' "'""'1 ':',"h':'~,",,",""l"~'.~,',:,:,,',,,m,',",v,:':, "~':''"";'~I FREIGHrCHARGES
,.,11 J I(.*~ .'.l.,:t.l~*H d. ,' .... U~',t:I' , th,..uj4',.,xl ,,,' d,.ul.,,u,~ ¢.~h,. ,, r.t,. :l,, .,....' , 4'. ',.rl,,w,,,,; .r.,r.r',,,,',,L J]Jl~:ck /~jJpl'J]J)l'hJl;I]
'", ,""' I~ ,:,',,,,m,:u,',,,~,,,,i ~
.... .,.'h,,i.:, ,'.',~',:~7,1 :, ::,~..';;, ,.:'; ,,'.,?,S',;:;'.;[2~ L"~'..L,',':.;',, ~'~ ............................... . .......................... .' ~tt'~ ~'"~' ~ ............ .'
........ THISISTOCERTIF'Y'l~alt~f°ll°Wk'~"~desc-4badc°mmodllyw'~swelgned me'asured-orcounmdbyawe~ohmasler whos'esigna~?e '.
Is on ~ls cer~l~m, wh~ Is a re~gntzed au~ort~ ot a~um~, as prescribed by Chepler 7 (~mmendng wl~ Sec~on 12700).ot
DMslon 5 of ~e California 0uslnes~ ~d P~esslona C~e, admtnlstmed by ~e Division ot ~asuremenl S~and~ds of ~e C~lf~la
Oepa~ment el F~d and Agrlcul~re.
.o.~o..c: . N~ 3 9 0 7,9
~807 STOCKOALE HIGHWAY
8AKERSFIELO. CA g~12 (~5) 589-1~2
~UCK LICENSE TRAILER LICENSE TRAILER NO. 2 L~EN~E
~IGHEO FOR (SELLER) 0ELIVEREO ~O (SUYER~ ~RUCK
CARRIER
[~ COR~ HONDO Hp
HONDO CHEMICAL INC. WEIGHMASTER 9:40 ~H 05 22 96
5~ 2~ 96 '~ ~.u~ 3&~O [b T~ ~ROSSL~.
OA,, ~ItA~I., :,9160 lb HET
STOCKDALE HIGHWAY
BAKERSFIELD, CA 93312 CASH PAl0 CHARGE SALE '
COM~DI~
SO[G
RE~RKS
TO Consignee: FROM Shipper:
kreet "' ~ -
3900 ALLEN RD 5650 ALDRIN CT-BAKE~FIELD~ CA
~estination Zip Code · Em~r;ency'~ ~esponse ~hcc~ No.
~BAKE~FIELD, 'CA 93312 800/458-3036 , "
No. Shipping Kind of Package, DescripUon of Ar:ides, Spec:al Marks and ~ceotions 'Weight [Sub. co Corr.) RATE V CHARGES
u~,~s
I-E~ gflMP NON-~AZARgOUS SO~L
EMIT C.O.D. FEE:
.0.0. T~: C.O.D.AMT: PREPA~O 13 TOTAL
[3[}RESa COLLEC~ t; ''~ CHARGES:
~ , ,,~ , , ,~ ' ' ~ ,i' ,;", , ,," ; ' , ' , '
;,, ?
,,,,,,,,,,, ,,,, , , .....
_~ .... '.iI'HI,W. Ih. ' '- ---,_-"z'~ r "'- "~'
,., .......... ,. ,,,,..,. .,,,,,~.,,,,,,,~.,.., ,,, .,,,,,,,,, .... . ...... . ~.,~,.., :,,.. ,.~ .,, .... , .... , .... .,.,,,,...,~,~,. ¢
WEIGHMASTER CERTIFICATE
I THl$1STOCERTIFYthaHl~ei'ollowlngdescclbedcommo(llt.fwaqwelgh~d measured orcountedbyawelghmasler who~e~lgna~e
Is on ~1~ cerUfl~te, who Is a ~e~gnlzed au~orl~ ot a~umcy, as prescribed by Chapter 7 (~mmendng wl~ Se~on 12700) ot
. DMslon 5 of ~e California ~uslness ~d Pmtesslon~ C~e, admlnls ered by ~e Division of ~asuremenl S~and~ds o~ ~e C~lfoml~
Depa~ent of F~d and Agdcul~te.
N 3 9 0 81
' ~7 STOCKOAL~ H~GHWAY
8AKERSFIELD. CAg~12 (805) 589-1~2
~UCK LICENSE [RAILER LICENSE TRAILER NO. 2 LICENSE
.~ SP27000 G~I 8853
I
~IGHED FOR (SELLER) DELIVERED TO (BUYER) TRUCK CARRIER
IT Hondo MP
I HONDO CHEMICAL INC. WEIGHMASTE~ /' t 1:20 ~H 0b ~ ~
5, 23 96 , E.ur. c .... o,~ GROSS L~.
STOCKDALE HIGHWAY X NET ~.
BAKERSFIELD, CA 93312 CASH PAI~., j CHARGE SALE
I COM~DI~ Sol 1
~LTERNATE STRAIGHT BILL OF LADING'SHORT FORM~ORIGINAL--NOT. NEGOTIABLE [
Shippe~
ame of Carrier: . Carrier's No. Date
TO Censignee: FROM Shippem
estination ~ Zip Code ~,~J,~'~LO C~ ~,r~O0
Rou:e: Vehicle
I NO. Shipping I ;
.Units i , i Kind of Package. Description of Articles. Special Marks and ~ceptions -Weight (Sub. to ~..1 RATE CHARGES
IEMIT ~ C.O.D. C.O.O. FEE: TOTAL
LO.O, TO: ]AMT: PREPAIO Q $
,OGRESS ~ COLLECT Q $ CHARGES:
I
WEtGHMASTER CERTIFICATE
I TTtlS I"~TOCERTIFYtheltheI011ewlngdescdbedcn3mmodl~YWaswelghed measured orcountodb¥ awelghmasle¢ whose~lgna~e
ia on ~ls cerflfl~te. ~o Is a te~gnlzed au~od~ o~ a~u~acy, as p(e~cHbed by Chapte~ 7 (~mmen~ng wl~ ~ecffon
ONIslon 5 ot ~e California Duslneaa ~d Pmtesslons C~e, administered by ~e Division o~ ~asu~emen~ S~and~ds ot ~e C~lf~la
Oepa~ent of F~d ~d AgHcul~te.
,o,oo,.c. 3 9 0 8 3
~807 STOCKDALE HIGHWAY
~AKERSFIELD. CA 93312 (~5) 58g.
TRUCK LICENSE TRAILE~ LICENSE TRAILER NO. 2 LICENSE
SP27000 GT18852 .
~IQHED FOR (SELLER) DELIVERED TO (SUY~R} TRUCK CARRIER
IT Hondo MP
I HONDO CHEMICAL INC. WEIG~MA~TE~
, ' -' ' ' ~.,~.~ lb TIME I DATE
5 ,21 , 9 6 /. ~ ~-~/.~/~~ ~ TARE L~.
STOCKDALE HIGHWAY
BAKERSFIELD, CA 93312 CASH PA{G / I CHARGE SALE J
COM~DI~
~ Consignee: ' FROM Shipper:
IHO~O CHEMICAL
~treet
~estination Zip Code I ~mer~ency Response 2hone No.
Route: Vehicle No.
I NO. Sh,ppmg
~ Units ~;..~ Kind Of Package. Description of Articles. Special Ma~ks and ~cepcions 'Weigh~ [Sub. ~a Corr.) RATE CHARGES ·
-
~MIT C.O.D. COD. FEE:' TOTAL
~ F~ ~'~: AMT: PREPAID ~
'77:~,- .,~ COLLECT ~ $ CHARGES:
/
WEIGHMASTER CERTIFICATE
I II:liS I$ TO CE RTIFY'tt~aI the following descz'bed commodlS, was weighed, moasured, o~ counled by a welghmaster0wl3o~e slgna[u're .......
I$ on this cortlllcate, who Is a recognized authorl5, of accuracy, aa prescribed by Chaplet 7 (commencing with SecMon 12700) of - .
Division 5 ot the Call!orals Du slnees and Proi'esslons Code. administered by the Dlvl sion ot Measurement Slande~da Gl the Calltomle,
Department o! Food and Agriculture.
Ho,oo,,c. NQ 3 9 0 8 4
20807 STOCKDALE HIGHWAY
I .. BAKERSFIELD. CAg3312 (805) 589-1042
I 9C21085 1VH2703
WEIOHED FOR (SELLER) DI::LIVEREO 1'0 (I]UYER) ,TRUCK CARRIER
IT Hondo MP
HONDO CHEMICAL INC. WEIGHMASTER -
· '~: 1
DATE ~ ~' ~ ~ l b . -, TIME / DATE
5 22 ,96 ~'-'c;:/~.~.6~u~ 342:20 ~b TR
0*T~ ~ '" 41900 lb NET GROSS L~.
WEIGHED AT 20807 J '"' ~.' 'XX ~C/ NET~.
STOCKDALE HIGHWAY ,
BAKERSFIELD. CA 93312 CASH aA~0 CHARGE SALE
co~mw S o i 1
iREMARKS J DRIVER
-~LTERNATE STRAIGHT BILL OF LADING--SHORT FORM--ORIGINAL--NOT NEGOTIABLE IShipper No.
~Jame of Carrier: Carrier's No. JDate
~MP ENVIRONMENTAL SERVICES J
~HOND0 CHEMICAL .
~;treet
3900 ALLEN RD 5650 'ALDRIN CT-BAKERSFIELD,'CA
J eAstinatian Zip Code J Emergency ~espcnse ~hone
KERSFIELD, CA 93312 J 800/458'-3036 ."
Route: Vehicle No.
No. Shipping ~;,I Kind o~ Package. Description of Articles. Special Marks and Exceptions 'Weight (Sub. ~o Corr.) RATE. v' CHARGES
~. Units
I-END DUMP NON-HAZARDOUS SOIL
joM C.O.O. C.O.D. FEE:
TOTAL
TO: AMT: PREPAID O
~bR~ss
COLLECT ~ ~' CHARGES:
J
I
Y
~' w .. ' I ~ ', rr,, , ..04 , ,,r,.~t ' .',, , ' "' . . /
'lh,.. ,.. ~,, ,',.t~dv Lh,,, *h,, ,~h,~w~ nd...d ,f~,dq.lhd., ..,~ i.',q.,tly ,,I,l'.'al..d. ,~,, ,, ~,l.,d I,.. ~.ul, td ,~ .~*'d .ul I.*h,,I,.d ,iHI .,, 41 I''q'~l ,'~..hl.u;l h.~l ,~,tlu,iJ,.~ ,I ,,HI ,iO:,IldUUI IAI tlllf
I. ,,,,,,
w ~-1~ HMA$ ]'ER CERTIFICATE
i.................. ]3-tis iS TO ~;E RTIF Y th~[ trle following desG'lbed commodl~ wa'~ wel~hed, measured, or counled by a welghma:aie¢,whose eig~a~uce
Is on this certificate, who Is a reCOgnized authortty of accuracy, as prescribed by Chaplet' 7 (commencing w[~ Section 12700) of
Division 5 of Ihe California Ou slnee,, and Professions Code. adm!nlslered by U3e Dlvlalon of tvleaauromon! Stand.'da of ~e Ca~lfomla
Department of Food and Agriculture.
.o,oo,,c. NQ 3 9 0 8 6
2080;' STOCKOALE HIGHWAY
I 8AKEflSFIELO. CA933t2 (805) 589.1042
TRUCK LICENSE TRAILER LICENSE TRAILER NO. 2 LICENSE
SP27000 GT18853
I WEIGHED FOR (SELLER~ OELIVEREO 'rD (BUYER) TRUCK CARRIER
IT CORP HONDO MP
TIME / DATE
HONDO
CHEMICAL
INC.
WEIGHMASTER
IDATI= ./'1// // I 1:07 F'H 05 ""~ 96
":'
5, 22~ 96 ~,;L/L,. ,--~.~- ] '-'" '
,../. 0E~,u'r,, :30060 lb TR' GROSSLY.
o^,, "?' '/// I 5t040 ].b HET
5, 22,96 ~('r ~/~~'~-~'-----------~ OEPUTY ' TARELBS.
STOCKDALE HIGHWAY ~'
.,,x. NET LBS.
BAKERSFIELD, CA 93312 I CASH PAIO [ CHARGE SALE
COMMODIT~
$OIB
~U..TERN~T~'$TR~IOHI BILL OF LADING~HORT FORM--ORIGINAL--NOT NEGOTI~BL~ ShiCper ~o.
~lame of Carrier: Carrier's No.
HOllO CHEMICAL
IIStreet
3c700 ALL~ ~ ~0 AL¢RIN CT-SAK~RSFIEL~, CA
l estination Zip Code Emergency ,~esponse Phone Na.
BAKERSFIELD, CA 93312 I '800/458~3036
Rou~e: Vehicle No.
i-EfCP DUMP NON-HAZARDOUS SOIL
EMIT C.O~. COD. FEE; TOTAL
.O.D. TO: AMT: PREPAIO ~
OORESS COLLECT O $ CHARGES:
,ll';~,~'ml.U'c'.i Eh,It 1,1.? I.II ,il h.hnll~ tht~ ..jo:mi ,.' ,bti;h~i',fH ¢.~l,.~ ol t. ,, ;u' ~p"" t ,.~ Lh,~ ,.h~,';.Jn,.' thc cu.';Hpulr ;~.111
· t,,I,,w,,,,I .r..,r.,~,,,,~t,t
:;,.,.,.,., ,,,.,,.,,,,. ..... , ...... , ..... , ..... ., ...... ,,.,,..,,,,.,,, ............ . ........... , .......... ,,, ........ ,,,,, .,, ..... ,..,, , . ,,..,.,...., ....... ,,
i ~MIS IS TO'CE RriFY ~aithe ~oll~wlng des~lbed ~mmodl~ ~s weighed, measured, or coun~ by a welghmasler, whose slgna~ ' '
[~ on ~la carUR~te, who I~ a [e~gnlzed au~od~ of a~umcy, as p~escdbed by Chaplet 7 (~mmendng wl~ Sermon 12700)
DNIslon 5 et ~eCallfomla Bualneea ~d P~lesslons C~e, admlnlaiered by ~e Division et ~aauremeni S~nd~da of ~e C~lf~la
Deponent et F~d and Agrlcul~re.
N 3 9 0 8 7
' ~807 STOCKOALE HIGHWAY
I BAKERSFIELD. CA 93312
58g.
~UCK LICENSE ITRAILER LICENSE TRAILER NO. 2
. ~I~ED FOR (SELLER) 0ELIVERED TO (BUYER) TRUCK CARRIER
~ CORP. HONDO
I HONDO CHEMICAL INC. WEIGHMASTER
o,~ ~x~ 1:2:3 P~ 0~ ~'~ ~ TIME/DATE.
5~ 80920 lb
WEIGHED AT 20807 ' '" ' "~ .~ ' I OEPU~ TAREL~.
I
STOCKDALE HIGHWAY I ~ ~ XX'
TO Consignee:.. , . FROM Shipper: "
Zip Code Smsr~nc,~ ~esponsa ~hcne No.
Rou~e: Vehicle No.
I
IIi UnitsShipDIng~ ~3. ~ J'~ Ol~Kind of Package,~[ ¢,~ ~ q~Oescripd°n of -~'LArticles' Special Marks and ~cepCions I 'Wetghc [Su~. co CorrJ RATE .' CHARGES
I
EMIT C.O,D.
COQ
FilE:
.O.D. T~: AMT: PREPAID
ODRES,~ COI_LEC~ G $ CHARGES:
WEIGHMA$~ER CERTIFICATE
......... THI31STOCERTIFYtr~aHhefollowlngdesc~0edcommodl~.waswelghed, mea,~ured orcounledbyawelghma~[er whose~lgna~re
Is on ~ls corUfl~te, w~ Is a feminized au~orl~ Of a~u~acy, as prescribed by Chaplet 7 (~mmendng wl~ SecUon 12700)
OMslon 5 of ~e California 0uslnesa ~d Professions Code, admlnlslered by ~e Division of ~asuremonl Stand~ds ot ~e C~lgomla
Oepa~ent ot F~d and Agrlcul~re. '
HONDO INC.
=.o, ~o~,,..~.~ No 39089 '"
mUCK LICENSE TRAILER LICENSE TRAILER NO. 2 LICEN3~
SP27130 G~I 8852
~eH~O FO. rELLE.) 0~UVE.~0 ~O (aU~E.I mucx
IT Hondo .~ MP
HONDO CHEMICAL INC. WEIGHMASTE~ ~" '~
,5 22 96 / ~g~ x 29600 lb TR GROSSLY.
~5 ~2 96 ~,~ [b HET /' .TAREL~.
WEIGHED AT 20807 ~~ ~ 7J "
STOCKDALE HIGHWAY ~ NET
BAKERSFIELD/CA 93312 cAs~ PAID /' ~ CHARGE SALE
'~ILTERNATE STRAIGHT BILL OF LADING--SHORT FORM--ORIGINAL--NOT NEGoTIABlE
amc of Cardem Camel's No. Oa~
MP ENVIRONME~AL. SERVICES '
Consignee: FROM Shipper" ~ /
~0~0 CHEMICAL . ' ro-~ ;~; ~-
.~treet
~estinat~on Zip Code /Emergency ~espense ~hone No.
~AKERSF~ELD~ CA 933~2 ~800/458-3036
ROute: Vehicle No.
No.~,ng _~.: Kind of Package. Description of Articles. Special Marks and ~ceptions 'Weight (Sub. :o Corr.] RATE CHARGES
I,~;N~ OUMP NON-HAZAROOUS SOIL
~u~r c.o,~, coo ~[:
~00 TO: AMT: PREPAID Lq ~ CHARGES:
7, L}[}RESS COLLECT
H' 'L;Irt,l,.., ' mir,,'~:~' . ,~ "h'HHI''';'rr'H''~q~m'':'lL'l''L'llht''l)''':H'''lll/'~f~r'~ mI ,';'.,Jh,,d"h~,;~',:d',)~h,,,,,r,,jt,,:,~..,~,Lh,.,,L,',,,;,~nr',c
1
~ ,I,,I, ,,'* h,',,'h .... 'i,,h,", ,h,,r h,* ,., ~ i,,,,h,l~ ,v,rh ,l 'h*. I,,,,,r, ,,,,I, ,,~,,Id.,,,,, ,,I Ih,, ,,, Il,l{ ,,I ,d ..... · I .....· . ' t
. . . .,., :,. .,.,.;., ,,. .... . ....... ;,..,..,.~.,.,..,~:,.~.%,:..,,.. ..... ':,."' ..... ..., ;.:.....,..,,.. ,,..~¢..~.:,, .
WEIGHMASTER CERTIFICATE
THIS I$ 'ro~.E RTIF¥ ir, at the lollowtng described commodity was weighed, measured, or countod by awalghmaster,whose signatUre
la on this cer'~.ficste, ~,ho.i,~ a recognized aulhodrf of accuracy, aa prescribed by Chapter 7 (commenting with Se'c~on 12700) o!
Oblslon 5 o! ~ne Catllornla Buslnes s and Prol'esslons Code. aclmlnlslered by the Division o! Measurement Stand.ds ol the GaJll'omla
Department ol Food end AgHcullure.
,o,oo,.c. N°- .39091
20807 STOCKDALE H~GHWAY ,
BAKERSFIELD,CAg3312 {805) 569-$O42
TRUCK LICENSE TRAILER LICENSE TRAILER NO. 2 LICENSE
WE.d-tED FOR (SELLERJ OELIVERED TO {BUYER) TRUCK CARRIER
IT CORP HONDO MP
HONDO CHEMICAL INC..WEIGHMASTER TiME / DATE
5,2 2, 9 6 DE.ur~ 1: ::i6 PIt 0~ 2'2 96 GROSS LBS.
WEIGHED AT 20807 / / . XX
STOCKDALE HIGHWAY 42d,:~'0 lb HFT /, NET LBS.
BAKERSFIELD, CA g3312. , , CASH PAID " CHARGE SALE
COMMODITY -2 .~.~.. :
SOIL
Page __ of
(.Name o~ career) (SCAC) Oale
BASIC DESCRIPTION TOTAL QUAN~ WEIGHT CHARGES
NO~ Un~s } I ~1 Proof Shipping Name, Hazard Class. {Wmghk V~ume. ISu~ m ,to, C~",e'
& ~ T,~e Identification Number (UN or NA). Packing Group, ~r 172.101,172.202, 172.203 Gal/~s. eft } C~r~i~) Use O~p
REMIT
PLACARDS TENDERED:YES I-~NO [] coo To:
ADORESS
~ COD FEE.
.................... ~ .............................................................. g ........COD
PER ~ ~ .......... pER
~ I...~ l~ .....q
~f' w ~utlMA~ 1151{ CERT{FICA[E '
.................. THIS IS TO CE RTIFY ~1 tne'toflowlng des'r, dbed'commodlly waq welghed, mea,~uredo ~r counled by a welghmasler,whose ~Jgneluce
Is on ~1. cerUllcate, who Is a ~e~gnlzed au~orl~ ol a~u~cy, as prescribed by Chaple~ 7 (~mmendng wl~ Sec~on t2700)
DMalon 5 ol ~e Calllomla Buslneea ~d Pretensions C~e. administered by ~e DIvlalon of ~asuremen~ S~nd~da ot
Deponent o~ F~d ~d Agrlcul~e.
,o.oo,,c. 3 9 0 9 2
~807 S~CKDALE HIGHWAY
BAKERSfiELD, CA g3312 (805} 589-1 ~2
~UCK LICENSE TRAILER LICENSE TRAILER NO. 2 LICENSE
'
~IQHED FOR {SELL[R) ~EL[~ER[O TO {gU~ER) TRUC~ CARRIER
IT Hondo MP
HONDO CHEMICAL INC. WEIGHM~S~ER' , I -
D~T~ ' /' [ [:~ ~[~ I~ 22 ?~' TIME I DATE
o :34[~0 tb 'T~ GROSSLY.
5 ,22~ 96 ":~ '~f ff~d~Puw] 40000 lb NET TAREL~.
STOCKDALE HIGHWAY . [: ( ~?';' ~O' NET
BAKERSFIELD, CA 93312 '
CAS~A~0.-' J CHARGESALE
COM~DI~ D"
RE~RKS ORIVE~
TO Consignee: ' FROM Shipper:
,0 0
;freer - '
3900 ALLEN ~ 5650 ALDRIN CT-BAKERSFIElD CA
BAKERSFIELD~ CA 93312
Vehicle No.
No. Shipmng ~ >;.~ Kind o~ Package, Description o~ Articles, Special Ma~ks and ~cep~Jons 'Weigh~ (Su~, ~ Cern) RA~ ~ , CHAR~S
Units '
'
~u.u. TO: AMT: PREPAIO O TOTAL
~REss ,COLLECT O $ CHARGES:
t,w~ 0orr:; by .i c;jrr.,, hy w;n.u~.. Lh~t ~;h,I)0mm'; ,Ir~! r(.iumr~d t() '~t.)t,~ :;I),'(:mfm,;.,Ih/,n nr q.m,.I .'; t 0 h~) ,h=h'. m,)d t,) th,~, :un';~qn~,) wn:h~)ut rt~c()tn-.;,) FREIGHT CRARGES
m
~'H' r-V ~' ~r*"+l ({a{,v~ t,4, , , , ~,,l,,',h'r ,,.l:4:il. ,l',fl, lt.~'lt Ii:{iHL~,iiI.: .xH{J,illllhlm,lll,ll,,tlll'ml.,, ih{. Il "' ( ItlW, t {~ 'ii ~ ',l[l{{'l ,111,
,
_. ~r IH ~1', I~,.' ~ "'
I ,:~ ' .,' r','~ .h.I .hi , .? Ifh~[l' :;~ jlll![ d;
Wi=IGHMASTER CERTIFICATE
I TJ'ilSIS'J'OCERTIFYihallh~ollowlngdesc,'lbedcommodlJywaswelghed measured orcoun[odbyaweighmaaler who~esigne~e
I'~ on thl~ Cer~fl~te, who I$ a re~gnlzed au~ed~ of a~umcy, es ~escHbed by Ch6pter 7 (~mmendng wl~ Sec~on 12700)
ONlalon 5 of th,~ Cal~tomla Business ~d Pm~osslon$ C~e. administered by ~e Division of ~asurement Sland~ds el ~e C~If~Ia
Oepa[~ent cf F~d ~d Agrlcul~re.
,o,oo,,c. N~ 3 9 0 9 6
~07 STOCX~ALE HtGHWAY
~12 {805) 58g-1~2
CA
TRUCK LICENSE TRAILER LICENSE . TRAILER NO. 2 LICEN3E
SP27000 GT18853
~ ~QH~D FOR (SELLER) ~ELIVERED ~O (aUY~R} TRUCK CARRIER
IT Hondo MP
~, HONDO CHEMICAL INC. WEIgHM~ER $2~20 [b (~.'" ~ -TIME./ DATE
OAT~ .~;J313130 iD TR
STOCKDALE HIGHWAY . , , ·.
BAKERSFIELD, CA 93312 cAs~ ~A~9 ~ C~ARGE
J cou~o,~so~
..
LTERNATE STRAIGHT BILL OF LADING--SHORT FORM--ORIGINAL--NOT NEGOTIABLE r~,.
tame of Carriec: ' Carrier's No. ~Oa~e ~bn,pper No.
MP ENVIRONMEh~AL SERVICS ClIgAq3 I ~-~%-~ J.
~OConsignee:, ' FROMShipper: ~~ l
~ HO~O CHEMICAL ~
~treet
3900 ALLEN RD 5650 ALDRIN CT-BAKE~FIELD, CA
lestination Zip Code JEmergeno/~es~onse Phcne No.
BAKE~FIEL~, CA 93312 J 800/45~-5056
Route: Vehicle No.
JNo. Sh~opmg Kind of Package. Description of Articles. Special Marks and ~ceptions 'Weight (Sub. Co Corr.} RATE CHARGES
.-l., .
~iEN~DUMP NON-HAZARDOUS SOIL
j C.O O. FEE:
~I3RESS COLLECT ~] $ CHARGES:
I
"l ...... ,,, .,i,h,. ,..,I ..... ,,,,.,,l,,,,,,h,,,.,., .,'h,',-I.~,l,,,h,,n., ,m',m,,,', .,,I .... i,,,u" . ...... ,I .... m~ ...... ,,... '/ '1 '
"" ............... "" ........ ' '"'"" .... ................ '""'"""'F: .... Jf~ ) /.t /
.................................. ~;JllJllll'l' 'J ~ ................ ~ ......../~lJt'lll,; J IH'
.................. ~:~: ............................ ~(
"- ..... : ............... W*EIG HM ASTER-C ERTIFICATE
· I THIS IS TO CE FtTIFY thai the following de s~iOed ccmmodlly was we g had, measured, or counled by a welghmaslar, who~e slgnalure
Is on Ibis cedlflcate, who Is a recognized aulhorlly of accuracy, as prescribed by Chaplet 7 (commencing with Section 12700) of
Division 5 of Ihe California O'uslness and Professions Code, aOminlsto~ed by ~he Division of Measuromon! Standards of I~e CaJlfomla
Ooparlmen! of Food and Agrlcullure.
I ,o,oo,,c. N" 39097
20807 STOCKDALE HIGHWAY
0AKERSFIEL0. CA 933 t 2 (605) 589- t 042
TRUCK LICENSE TRAILER LICENSE TRAILER NO. 2 LICENSE
I %'PZ?_Z/O
WEIGHED FOR (SELLER) 0£LIVERED TO [BUYER) TRUCK CARRIER
,IT Hondo MP
HONDO CHEMICAL INC. WEIGHMA~TER ..... ' .-,..:,. ~_..-~c PH 0S.. '"'"'...... 96
· / -,,,;' / .. TIME I DATE
O^T~ / ///Z/'////' " /~" 7,9940 lb (l ;'
/~ .'3:3~:.00 lb TR
5 ~2 2 ! 9 6 -' ,/~ //':%',."". ~Puw - 'GROSS LB~.
I o^m / C,///. "/,', ×' 45:340 lb HET
5 ,22,96 ~ ' .'.>/.'.'//" /
'~-' ' .- .- '..' ,-',./oEPu~ .. ~. TARE'LBS.'
WEIGHED AT 20807 - &.-...----
STOCKDALE HIGHWAY /':' XX c~ c~. G NET
CASH PAIO J CHARGE SALE '
i 'BAKERSFIELD, CA 93312
COMMODITY ',
Soil
II~LTERNATEIName of Carrier:STRAIGHT BILL OF LADING--SHORT FORM--ORIGINAL--NOT:carrier.s No.15-10a't-~z_~NEGOTIABLE iShipper No.
MP ENVIRONMENTAL SERVICES -~
HONDO CHEMICAL _ __ _
Street
3900 ALLEN RD 5650 ALDRIN CT-BAKERSFIELD, CA
IOestination Zip Code I ~mercencv ResF~onsa Phone No.
BAKERSFIELD, CA 955i~ I 80(~/458-3056
Route: Vehicle No.
I No. Sh,m3,ng Kind of Package, Description of Articles. Special Marks and Exceptions *Weight (Sub. :o Con'.) RATE CHAPGES
I-END DUMP NON-HAZARDOUS SOIL
I tPO I
·
rEMIT . C.O,O. TOTAL
C.O.D.
FEE:
~.0. O. TO: ' ' AMT: PREPAIE) I-J
AOORESS COLLECT F3 $ CHARGES:
I ',:;'i,;:'.';hv.Ic;u'r'l,~rh'l'A~l. !f' ~le ';hlllJll'r";,Jl'l.~ 'f I I '~Id ,t';.It!';H'Ol :)1,t,~ .'~ ,:HI,I ,','ohl~,l,fl~,,~r.~dl:llLh~l:rllv;Hjlt*!,!wd:hr)utl'l;t:Hur';l! FREIGHF CHARGE,S
I
.il. Ill .I..l(.l~ whltl, hf!t' il. t:; JLii'i'ii]I' !; th,! .llll'l:l]ll I)f' ,h'~;I.u',!d vdhn~ ,)1 l.I]~] i;l'Uli,.1%'i r; IIJIIII'/VIIllI ,t..ff.,!ln,tlll. Ciluck AIJpI'OI]I'iLI[I,~
i '1; [,,,. Fr,:,lhr. i]l.,~l];jll] . Cnlh.'ct
~ ¥
,. I I
.Ih, , ,.. , ~t , .,~1 dy I h.d. Lb.! ,d.*~! H.IH.'d ,ndl ,~11,*l , ,n .'.4~f. ll~l ly ,.I,l,.,,,In,II .h..,~.l ,In.d ~,. ~.,n ~'d ,.,n k~'d nnl I,dn.l..d ,ll.I ,n ~! nl n ,~ ..' ,.~.nln..~n hn' ~J.Jl, .~J~ n.n.I, ,..~.,,.,hHq I,~
II ( I Illll 'h'l I' I1' ' ' IJ~lll / ~ ' /]
~l I~; ~ ~ ' ' '
..... · Ihllll) !', ~' _ ...... --. -- l~(Jl!fll:, t'IIH' . .:
II"l'Hhlln!lll. Illl';I. dfflO; ,llhh'l!!;'.i ,Il ';lullll,~l' ,',l.n ', . .... ''' '~ :' , ;' ,~ ,"*'~ ,, : ;. ,' ..... .,I ,. h.h.,...I ,, In.!,, 1' I ,~ ','.h,, *1 1,.,;,, ,, ~-.F~7',/iTM
I Tl{IS'lSTO~CERTIFYtha[mefollowlngdoscrlbodcommoditY~;'aswolghod measured orc~untOdbyawelghm~ste¢ whoseslg~a~Jre' " "'
la on this certificate, who la a rec~gnlzod au~orRy of accuracy, aa prescribed by Chaplet 7 (commencing with Socl~on 12700) et
Dlvlelon 5 of tho California Ouslness ~'~d Professions Code, administered by the Olvlelon of Measurement Standards of the C~lfomla
Oepartmenl el Food and Agriculture.
,o,oo,,o. NQ 3 9 0 9 8
20807 STOCXDALE HIGHWAY
I (805) 589-1042
BAKERSFIELD, CA 93312
rRUCK LICENSE TRAILER LICENSE TRAILER NO. 2 LICENSE
SP271 30 GT18852
I WEIOHE0 FOR {SELLER) DELIVERED TO (I~UYER} TRUCK CARRIER '
IT Hondo, MP
I HONDO CHEMICAL INC. WEIG, HM~[STER" :3::34 PFI 05 22 96
· · ," .. : 7764F1 lb'<3,'. TIME / DATE
DATE ' /~"'--¥~-~:' , / ~/ ' I '
5 22 ~96 " -' /"," '" '
4,:,t43 Z~ NET
DATE
5 2 2 ~ 6 .:'~':?'?o~p~l D-/ TARE L~.
W~IGH~ ~T 20807 ' 'XX
STOCKDALE HIGHWAY ,-/ ' '
NET
BAKERSFIELD, CA 93312 CAS~ PAID I CHARGE SALE
{kLTERNATESTRAIGHT elLL O1: LADING--SHORT FORM--ORIGINAL--NOT NEGOTIABLi~ [ "--'' '
Shipper
No.
game of Carrier: Carrier's No. ' Oat~.--/' /
MP ENVIRONMENTAL SERVICES
I H0~DO CHEMICAL : ;,C... ~
~ree~
3900 ALLEN RD 5650 ALDRIN CT-BAKERSFIELD, CA
I )estination Zip Code lErner;eec7 ~es~cnsa .=~one No.
BAKERSFIELD, CA 93312 800/458-3036
Route: Vehicle No.
No. Shipo,ng Kind of Package, Description of Art:icles. Special Marks and Exceptions 'Weight (Sub. to Con-.) RATE v' . CHARGES
~ ~Jnits ~ ,I . .
-END DUMP NON-HAZARDOUS SOIL
i IEMIT C.O.O. C.O.O. FEE: TOTAL
',. O. D. TO: AMT: PREPAIO O
,OORESS COLLECT O $ CHARGES:
'~ r,,',' ~ F,'e,r~ht pr,~p~.,l ~ C(31h?ct .
· I IS on I~lls corgflcale who Is a recognized au~orlly of accuracy, as prescribed by Chaplet 7 (commenting with Section 12700) ot
DMalon 5 of ~e California Business ~d Professions C~e, admthlale~ed by ~e Otvlalon of ~aauremenl Sland~ds of ~e Cdlf~la
Oepa~ent of F~d and AQrlcul~re.
i ~807 S~CKDALE HIG~AY '
BAKERSFIELD. CA ~3 ~2 (8051 ~9-
~UCK LIC~SE ~ TRAILER LICENSE ] TRAILER NO. 2 LICENS~
I ~IQHEO FOR (SELLER) DELIVERED TO (BUYER) I TRUCK CARRIER
IT ' Hondo I MP
WEIGHED AT 20807 C. d~ '~ [ ~ TARE L~.'
STOCKDALEHIGHWAY q' · ' ] XX
BAKERSFIELD, CA 93312 [ CASH PAID ] CHARGE SALE
COM~DI~ Soil ~" · '
' ALTERNATE ~ Shipper No '~"
STRAIGHT RILL OF ~DING--~HORT FORM
Original--Not Negotiable ~ ~ . . Carrier No.
(Name of CarrieH · --
TO: - FROM: '
Consignee ~~o ~~/~ (. Shipper ~(
Destination ~ K~~[' Zip Code I Origin -- ' Zip C~e
"Route: '
~_N°: [ , Kind of Packaging ~riptian of A~ic!es .~ig~
Umcs S~c~al Ma~ks and ~cept~ans ~ Cocmction] ' , ·
........ - ,.
COD. TO: [ I PAEPAIO Q ~ I '~ ~ $ (kit ',
ADDRESS J COO Am~: $ [ COLLECT rj ~ CHARGES: [ L ,
WEIGHMA5 ['EH GEHTIF CA[E
I.................... THIStSTOCEFtTIFYthatlhe'~ollowlnode~cdbedcommodl~/waswolghed 'measured orcount~byawelghm~ter who~e~lgna~e
Is on t~ls corflfl~to, whp I~a re~gnlzed au~orl~ ct a~umcy, as prescflbed by Chaple~ 7 (~mmendng wl~ Section 12700) of
OMslon 5 of ~e Calltomle Dualnees ~d Professions C~e. administered by ~e Division of ~asutement Slend~da of
Oepe~ont of F~d end Agrlcul~re.
,o,oo,,c. N' 3 910 3
~807 STOCKOALE HIGHWAY
BAKERSFIELD, CA93312 (~5) 589-1~2'
~uc~EHsE I TRAILER LICENSE TRAILER NO, 2 LICEN3E
~IGHED FOR ~SELLER} OELI~ER~ IO
HONDO CHEMICAL INC. WEIGHMASTER ) 4: [2. F't~ Ob zz ~o -
~' ' ~ "~ ~ -. TIME I DATE
' ' '~" x '340~,0 tb .TR
"" :'-
BAKERSFIELD, CA 93312 ~ Al0 CHARGE SALE
COM~DI~
0 C~nsignee: ' FROM Shippec:
~creet
estination Zip Code
Route: Vehicle No.
I No. Shipping I - I
~ Units ] ~M I Kind °f Package' Descripti°n °f Articles' Special Marks and ~cepti°ns 'Wei'ht {Sub' '° C°m) RATE CHARGES
'iMIf C.O.D. C.O.O. FEE: TOTAL
ICC. TO: AMT: IPREPAIO O $ ',
~ORESS ICOLLECT Q $ CHARGES:
~,,I IHH'f:, hV .I C;H'rlf:F UV /~;If.~F I.huI '¢,pp*w'; .,'~f r~:q~i,',HI ~O ';tdtU ';pm;d,;jli'/ ,n ¢¢mr.H,l~ ,'; '.u hq dulu,.~ ,~d tu Lh,~ c~,~:;H~n~e WH.tH,fl: vm;Hur";uI FREIGHT CHARGES
'~ H,.' ~ ',,,; ............. r C,,,',,u,,,'I [~ I:r'eHJhl;
1,~ ',n~',.~ h'l,~, .r~ '~hWl' ',4 'llll~ll.,
'w r-~ttMA3 TEH CERTIFICATE
.......... ' .... '~" T}'llSISTOCERT!FY~l[tHhetolloWlngdosc.4L~odc~mmcc~ltyw;~swelghed, r,~easuted orc0unledbyawelghmasfar whose~lgna~re
Is on this cerfl~te, who Is a re~gnlzed au~orl~ o~ a~uracy, as preacrlbod by Charier 7 (~mmendng wl~ Se~on
O~lelon 5 gl ~e Callfoml~ Ouslneas ~d Professions C~e, administered by ~e Olvlalon of Measurement S~nd~ds 0f ~e C~If~Ia
Depe~ent af F~d ~d Agrlcul~fe. -
~; S~CKOALE HIGHWAY
BAKERSFIELD. CA93312 {805) 58g-1~2
TRUCK LICENSE TRAILER LICENSE TRAILER NO. 2 LICENSE
SP27130 CT18852
~[~0 FOR ~SE~ER) ~E~IVERED TO {BUYER) TRUCK CARRIER
IT CORP HONDO MP
HONDO CHEMICAL INC. WEIGHMASTER -
5,23, 96 .:,.~,:,~
WEIGHED AT 20807 ' ' ',I ~ J 0~.Uw --~ TARE L~.
STOCKDALEHIGHWAY I ~ I XX qt:~413 !b HET ~,'~/ NET~,
BAKERSFIELD, CA 93312 ~ CASH PAiD J CHARGE SALE - - '
~LTERNATE STRAIGHT BILL OF LADING~SHORT FORM--ORIGINAL--NOT NEGOT~BL~
'~ame of Carrier: Carrier's No. O;~~'Sh'pper No.
~MP ENVIRONME~AL SERVICES
H0~O ~HEMICAL PACIFIC BELL TELEPHONE
~ 5650 ALDRIN CT
3900 ALLEN ROAD BAKERSFIELD, CA
estinat~on Zip Code ~ Emergent'/~espo~s~ ~hone No.
BAKE~FIELD, CA 93312 I~00/458-3036 '"
Vehic N
No. unitsShipping _~,:· Kind of ~ackage. Description of Articles. Special Marks and ~cepcions 'Weight [Sub. ~o Co~.]
7 E/~ NON-HAZArdOUS SOZL
EMIT C.O.O. C.O.O. FEE; TOTAL
.QO. TO: AMT: P~EPAIO Q
O0~ESS COLLECT Q $ CHA~GES: _
I
W. EIGHMASTER C EF1.TSFICATE
I THl$1STOCERTIFYthlltthefollowlngdes~lbedoommoclltywaswelghed measured orcouniodbyewelghmasler who~eelgnalure
Is on this cerlJflcate, wilD Is a recognized authority of accuracy, as prescribed by Chaple¢ 7 (commencing wllh SeclJon 12700J of
Division 5'o~ the Call!omi= I]ualneaa and Protes$1on~ Code, admlnlslered by the Division of Meaauromen! Sland~da of the Ca~lfomlm
Oepertmon! of F, ood and Agrlcul~¢e.
I ,o,0o,.c. HQ 391'12
20~07 8TOCKDALI:: HIGHWAY
RAKERSFIELD. CAg3312 (B051 5Sg. t042
TRUCK LICEN,~iE ] ?RAILER LICENSE TRAILER NO. 2 LICENSE -
I $P27000 CT1 8853
WEIGHED FOR (SELLER) DELIVERED 1'O (BUYER) TRUCK CARRIER
IT CORP , HONDO MP
I
HONDO CHEMICAL INC. WEIGHMASTER
~ ~" TIME I DATE
-'.' GROS~ LBS.
c,.:,1,0 lb (4)
5, 23 96 ....... o~u~ ....
2yyZIJ
lb
TR
TA~E
WEIGHED AT 20807
STOCKDALE HIGHWAY I ~x I ×X S,:.'-;2fi0 lb NET ~ ~ ~' NET LBS.
m BAKERSFIELD, CA g3312 ~ CASH PAIO I CHARGE SALE
COMMODITY
SOTT,
~LTERN~T~ STR~i~HT 8ILL OF LADI~--$HC)RT FORM--C)FII~iN~L--NOT NE~C)TIABL£,
BAKERSFZELD, CA 93312 8001458-3036
No. Shicpmg. ~-~1 Kind of Package. Description of Articles. Special Marks and Exceptions 'We,ghl: CSub. co Con'.] RATE ~/ CHARGES
Units
i i E/D NO.N-HAZARDOUS SOIL.
.!
iEMIT C.O.O. C. O, O. FEE: TOTAL
0.0. TO: AMT: PREPAIO [] $
~ DOR ES,"3 COLLECT r3 ''~ CHARGES:
,.,..,...~.~,~ . ,,m ,,'~,,~,,,- ~ .
.,WEIGHMAS~ER CERTIFICATE .. .
THIS IS TO CE RTIFy thai the following das~lb~d commodl~f was weighed.measured or counted by a welghmasier whose ~lgna[u~'e
Is on mis cm'Utlcate, who Is a recognized aumortly of accuracy, as prescribed by Chaplet 7 (commenting wire Section 12700) of
Division 5 of mite California Business and Professions Code, admlnlslered by me Division o! Measuromonl Standm'ds of
Oepa~"nenl of Food and Agrlcultu~'e.
,o,oo,,o. No 3 9113
20807 STOCKOALE HIGHWAY
8AKERSFIEL0. CA 93312 {805) 589-1042
TRUCK LICENSE TRAILER LICENSE TRAILER NO. 2 LICENSE
I SP221 95 DT935'24
· WEIGHED FOR (3ELLERI 0ELIVERED TO (BUYER) TRUCK CAnRIER
IT CORP HONDO MP
I HONDO CHEMICAL INC. WEIGHMASTER
OATE ~ ' ~ /" TIME I DATE
ct ' 7 ~' q 6 i~""-/'~'x./' DEPUTY .... GROSS LBS.
5,2 3, 9 6 . oE,uw :::~~.:c40 .l b TR TAnE LBS.
STOCKDALE HIGHWAY XX ~,.:,.:,c,O I b HET
~ NET LBS.
CHARGE SALE '
i BAKERSFIELD, CA 93312 CASH ~A~O
COMMODITY
SO IL
IIILTERNAT~ STRAIGHT BILL OF LADING2-SHORT FORM--ORIGINAL--NOT NEGOTIABLE ]Shipper No.
lame .:'~ Carrier: Carrier's No.
I
MP ENVIRONMENTAL SERVICES --,
Consignee: ' ' FRObl Shipper:
0NDO CHEMICAL PACIFIC ~BELL TELEPHONE
SJtreet 5650 ALDRIN CT
3900 ALLEN ROAD BAKERSFIELD, CA
l estination Zip Code I~mergency Response Y'hcne No.
BAKERSFIELD, CA 93312 800/458-30~6 '
' __I E/D NON-HAZARDOUS SOIL
i% MIT, C.O O. C O.O. FEE: TOTAL
O. TO: AMT: PREPA[O. O .
RESS COLLEI]T ~ $ CHARGES:. $
I " ~ ............ THiS~ST~CERT~F~¥(~1aHhe~w~ngde~c~bedc~mm~dI~fv~sw~ghed~ea~ured~c~un~edbyawei~hma~qer who~dlgna[ur~
Is on ~ls cer~fl~te, who Is a re~gnlzed au~on~ ot a~umcy, a~ prescribed by Chaplet 7 (~mmendng wl~ Sec~on 12700)
ONIsl~ 5 o~ ~e California Business ~d Professions Code, admlnls[e[ed by ~e OMslon ot ~asurement S~andmds at ~e CNItomla
Oepanmon~ o~ F~d and Agrlcul~re. '
~807 STOCKOALE HIGHWAY
BAKERSFIELD, CA 9~ 12 (805) 589.
~UCK LICEN3E TRAILER LICENSE TRAILERNO, 2 LICEN3E .
~ SP271 30 G~18852
~IGHED FOR (SELLER) DELIVERED TO
(BUYER)
TRUCK
CARRIER
It Hondo /~- MP
~" '29:3E-0 lb TR TARE L~.
STOCKDALE HIGHWAY XX - - - NET
BAKERSFIELD, CA 93312 cAs~ PAIO,' CHARGE SALE
iMP ENVIRONME~AL SERVICES
~0 CHEMICAL , PAC,,,~ BELL TELEPHONE
~ee~ 5650 ALDRIN CT
3900 ALLEN ROAD BAKE~FIELD, CA
BAKE~FIELD, CA 93312 ~ 800/458-~36
sure: Vehic~e~~ ~ ~.~
~ NO. Shipping ;~ I
~ Units . ;; Kind of Package, Description of Articles. Special Marks and ~ceptions, *Weight [Sub. to Corr.]
M lC. O.O. · - TOTAL
IT
C.
O.
O.
FEE:
.O. TO: iAMT: PREPAIO ~ '
RESS I COLLECT ~ $ CHARGES:
I
I
............. THtSISTG'CERTtFYtt~a[ii]efollowingclesc~lbedc~mmodiWwaswdghed,mea'Sur~d orcountedbyawelghmn'~ter wh~se~gne'~e '
IS on ~ts cerflfl~te, who Is ~ re~gnlzed au~orl~ of ~u~, as prescflbed by Chaplet 7 (~mmendng wl~ Sec~on 12700~ o~
DNIsI~n 5 of ~e ~llromla Dualness ~d P~tesslons C~e, admlnlslered by ~e Olvlslon o~ ~asuremen~ S~nd~ds of ~e C~lfomle
Oepe~ent o~ F~d ~d A~Hcul~e.
HOUOO,NC. "N 39117
~7 STOCKDALE HIGHWAY
~AKERSF~LO. CA ~12 (~5)
~UCK LICENSE TRAILER NO. 2 LICEN~
TRAILER LICENSE
~I~EO FOR (~ELLER) [ DELIVERED TO (BUYER) TRUCK CARRIER
IT CORP ~ HONDO MP
HONDO CHEMICAL INC. WEIGHMASTER
' . ,. / . TIME. I DATE
DATE
7:~7E'.0 i b ( ~ ) ·
WEIGHED AT 20807 ' ~ ~ ~
STOCK~ALE H~aHWAY ~ ~ . XX '~9200 L b HET
BAKERSFIELD, CA 93312 [ CASH PAmD cHaRGE SALE
COM~DI~
SOIL
DRIVER
, ,~.~ ·
Sh~pper
~o.
IOate
MP ENVIRONME~AL SERVICES C ~/5'~ ~7 ~- Z~'~
~ondgnee: F~O~ Sh~pper:
0 CHEMICAL' PACIFIC BELL TELEPHONE
5650 ALDRIN CT
3900 ALLEN ROAD BAKERSFIELD, CA
l)estination Zip Code
BAKE~FIELD, CA 93312 800/458-)056
~0ute: Veh(c(e
No. Sh(pp,ng K~nd o~ Pscksge. Des~r~pC~on of Aftra)es Ssec~d ~arks an~ ~cepc~ons '~e~ (Sub. ~o Corr ) ~AT5 CHA~GES
Un,ts
I E/D NON-HAZARDOUS SOIL
~EMIT C.O.O. r~.~oT~EE
0.0. TO: AMT: /PREPAiO O ,~ TOTAL
~ORESS JCOI.LECT ;l~ CHARGES:
W EtGI'tMASTER CERTIFICATE
i.............. THIS IS TO CE RTIFY ~,at the following desc.'tbed commodity was we ghed measured or coun[ed b · wel hmasfer whose si nature
. , Y g , g
Is on this certificate, wko Is a recognized authodiy of accuracy, es prescribed by Chapte¢ .7 (commenting wlLh Sec,(In 1270Q) of
Division 5 oi' the California I]uslnesa and Protesslon,, Code. administered by the Division of Measuremenl Standards ol' the CaJll'omll
Departn~en! o¢ Food and Agriculture.
HONDO INC. ' I~IQ
I BAKERSFIELD. CA~3312 (~05) 58g-t0,42
~ TRUCK LICENSE TRAILER LICiiNSE I TRAILER NO. 2 LICEN-qI~ · -
SP27000 CT18853 I
· W~IO~ED FOR (SELLER) ~ELIVERED TO (8UYER) ]I TRUCK CARRIER · '
"' IT Hondo E 'MP
I HONDO CHEMICAL INC. WEIGHMAS~ER/ ~ I . '
I 0A'TE ' /'"'~'.~ ~' // J 'J ~.: 59 Al"1 0_c; 2:.2,, 96 TIME / DATE
DATE · - ~'"r,. ~- x . ' '
· / "? .. . / /.//""~./~/. ,6~PUTYI ,-,?-,.,-, ,~.. ~. ,"'-r . -'7 TARELBS.
II WEIGHED AT 20807 I . ( ~ t:..' ' ' / -.'..,.::.~'_'l~., F',c./ --'-' /
STOCKDALE HIGHWAY I C'"'--~,. ' XX / ,,/').~
NET
LBS.
II BAKERSFIELD, CA 93312 . I CAS, PAID / I C.,~R~ SALE
I COMMOD~Tw ' _ .
SO~L1
REMARKS I DRIVER~7
i , !
I~LTERNATE STRAIGHT BILL OF LADING--SHORT FORM--ORIGINAL--NOT NEGOTIABLE ~_.
· ~mpper ~o.
~.ame of Carrier: ' Carrier's No. IOate
MP ENVIRONMENTAL SERVICES I _<'--g_.~.~Zr
iTC Consignee: '" ' FROM ~hipper: - .
I~0 CHEMICAL PACIFIC BELL TELEPHONE
~ 5650 ALDRIN CT
$~00 ALLEN ROAD BAKERSFIELD, CA
I )estination Zip Code J Emergency ~esponse ~hone No.
BAKERSFIELD, CA 93312 I 800/45~-3036 '
Route: ~ Vehi~le No,
No. Shipping ~/I Kind of Package Description of Articles. Special Marks and ~xcepcion~ *Weight [Sub. :o Corr.) RATE CHARGES
~ Units
1 E/D .NON-HAZARDOUS SOIL
1
I%MIT C.O.O. C.O.D. FEE: TOTAL $
.0. TO: AMT: PREPAIO [:] $ CHARGES:
RESS COLLECT [] .?
I,,, "' '; :' ',, i I', ';','~ ' ,I ......,.,,,I,,.,I,,,'l.,,',.,~',,,~ ...... f,h,.',,',,,,.,', ,.,, r~ .... ',,,',, ,¢,'" "~ .... ',,,', ...... '/,,,, ",,,, ,h,.I
I, ,, .: "~,; .;; .,'., . ·..;. ,... r,,, .,, ,.,,,, ,,. ,,,,,:,.,,.,,,, ,.,4 ...... , ,.,,,, ,,,-,,~,.r,.¥ ,,; ~,,,, ....... ~ ';,,,,,.,,/f,,,,;' / · I Ch,:ck
...... '"':'"""'"' ..... '""": '"'"'"~* ~ ?~"/ '"Y"' "'!;'"'" '~'"""""' 't '
I ,, x tWN1Z(,'?~Jfft:f, tl C^l~,,,,,,, I
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Ill I II II I H I I f I I ; J I
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'""" ....... "'"'"""'" ....... ~'" '""'"'"""' ...... "'" '""""'""T'" / F h ////?
IPACtFIC BELL ';)"" ' ";~,~%,d~9~J=,=~/X"~"~ ~ ./:- MP ENVIRONMENTAL 'A,, ,,' ,,, XL./L/-4;c./~.~.~, %..
~ ..... __ .... · II ;'. ; ':7 ~ -~ J ~ ', :r _ _ . ,----~
.,.,,,.,,.,,,.,.,,,,,,,.,.,,,.,.,,,,,.,,.,,,..,,,,,,,,,, .... .,~.~..,.~_,,,,,,,~ ....... ,,.,,., ...... ,,,,, ..... ,.,~,, .... ,,,, .......
"~tlSISTOCERTIFYtnalthero,~lngdos~lbod~mmodl~w~lghe~ measured orcounl~by~welghma~or whose~gna~re
on ~ls certl~ta, who Is a ~e~nlzed au~o~l~ et a~umcy, as p~escrlbed by Chaplet 7 (~mmen~ng wl~ Secaon 12700) at
Division 5 et ~e California Business ~d Pmtesslons C~e, administered by ~e 0tvlslon of ~asu~emenl Stand~ds et ~e CNIf~la
Depar~ent el F~d end A~rlcul~re..
UONOO,NC. N3 912 0
~807 STOCKOALE HIGHWAY ,
93312(805) 58g-1~2
8AKERS~tELD,
CA
TRUCK LICENSE TRAILER LICENSE T~ILER NO. 2 LICENSE,
SP22195 DT93524
~IGHED FOR {SELLER) DELIVERED TO (GUYER) TRUCK CARRIER
IT Hondo MP
I HONDO CHEMICAL INC. WEIGHMASTER
/' ,' ,-" ) TIME I DATE
O^TE ' ' ~."'// 12:02 PM OS 2:3 96
( :",' GROSS LBS.
DATE /k_.-~/;* ,' --'- x --,
5 2 ~ 9 6 /~/~/' '.. oEo, cry 46:3 1 b TR 4" TARE LBS.
..,_,,.~., lb NET/
WE,GHED 20807 -:/XX AC', }
STOOKDALE HIGHWAY NET LBS,
BAKERSFIELD, CA 93312 CASH PAl0 J,' . CHARGE SALE
I COMMODITY So i 1
I REMARKS DRIVE/~.//~..~.~_. ~_.~.~ ~__~.,
TO Consignee:' ' FROM Shipper:
I HON~O CHEMICAL PACIFIC BELL TELEPHONE
~ree'c 5650 ALDRIN CT
3900 ALLEN ROAD BAKERSFIELD, CA
m )estination Zip Code [Emergent'/Response ~hcne No.
BAKERSFIELD, CA 93312 800/458-3036 '"
Route: ' Vehicle No.
m
NO. Shipping ~l Kind of Package. Description of Art:icles, Special Marks and Exceptions 'Weight [Sub. to Corr.) RATE ~/ CHARGES
Units
E/D ~ON,HAZARDOUS SOIL
!
I
i EMIT C.O.O. C, O.O. FEE: TOTAL
.O. 0. TO: AMT: PREPAId O -
ODRESS COLLECT ~ $ CHARGES:
m . w , · .... fh~ ,r~ ri,cd dr d~,l;hu'ml v, lh.) ,J/ Lh,r Hr,~ :,rr '/ ii; h Ih 'lmnr ';~,lr m~nm)r~ J ~ l~ck A )fl) ]l'lgCt) ~OX.
~ .'. h, ' ;¢.. ~ ';, ' ' ' ..... ) ~,,,',,t,v m,,,:,h,;.,),/~:.,,.,,,~ ),v ,.~,', .',,,,.,' '.~ ', ...... ,. ,,,,,:~.-r~,,'jh.,V.,./,.,F,~,:m,.,,,.7, ~,:h,,~
; = .~ '.,': , h" I,t. .*~ :J..,I
· · WEIGHMAST,-'R CERTIFICATE
TTtI:S IS TO CE RTIFY that tho followln~ described oommodl~ wa s weighed measured or counted by a welghmastat whose signa~re "
Is on thlq cortJflcate, who la a °ecognized au~odt'y of accuracy, as prescribed by Chaplet 7 (COmmenting with Secdon t 2700)
. Division 5 of the California 0uslnesa a~d Professions Code, Gdmlnlslered by the Division of Measutemont Standards of the CaJll'omla
Departnlent Gl' Food and Agrlculfute.
I HONDo ,NC. N
20807 STOCKOALE HIGHWAY
BAKERSFIELD, CA 93312 (805) 589.1042
TRUCK LICENSE TRAILER LICENSE TRAILER NO. 2 LICENSE
I SP221 95 DT93524
WEIGHED FOR (SELLER) 0ELIVERED TO (BUYERI TRUC~< CARRIER --
IT ~ Hondo MP
I. WEIG~MASTER 1:42 F'H O~ 23 96
HONDO
CHEMICAL
INC.
' .'' TIME I DATE
D^~E / ~... ,-" :~',-':I~':,0 lb <1 .'.'
~ ,2~ ,~ / ,-'"'~'~' o~.~ .......
o ~. 4.~-,3 l,, iR GROSS LBS.
'1 -
5/ 2 ~ c) 6 ~/' DEPutY ~,,_~ .'.0 ~ I: HET TARE LBs.
F I
STOCKDALE HIGHWAY / X~ NET I..O~.
CHARGE SALE
I BAKERSFIELD, CA 93312 C~H
COMMODITY
$o±1
~LTERNATE STRAIGHT BILL OF LADING--SHORT FORM--ORIGINAL--NOT NEGOTIABLE .ishipper No. - .......
~Xlame of Carrier: Carrier's No.
I
MP ENVIRONMENTAL SERVICES
i O ConSignee:~ FROM Shipper:
HONDO CHEMICAL PACIFIC BELL TELEPHONE
~Street 5650' ALDRIN CT
3900 ALLEN ROAD BAKERSFIELD, CA,
tB estJnacion Zip Code
AKE~SFIELD, CA 93312 I 800/458-3036 "'
Route: Vehicle No.
NO. ~hi~l)ing
-- un,ts ~-~.1 Kind of Package. Description of Articie~. Special Marks and Exceptions *Weight (Sub. to Corr.) RATE v' i CHARGES
7 E/D NON-HAZARdOUS SOIL
'I
i E,"vll r C.O.O, FEE:
'lC TO: C,O.O.AMT: iPREP/~iO [] TOTAL $
.. >~ESS ]COLLECt ~ $ CHARGES:
'.. ,h,l,,,'.,,~ ..... ~v,r. t;u,.'m,,,, NOtE Wh,:,',~ ~.t,,~ ,'.,(.,~ ,.; ,l,:r,:,,,~,~,,, ..... ""'"'. I 'i,,hl,,::.':,J';,:,:,;.,, /d,,
I
· ' ......... '""' "'"~ ",~'//'/"~ ;" "' ,' ...... ;"
'"----,"'" ~-£/'Z -/.-Z-- ~'"...-"';::v~. ~~ / ~ ~: ',;,,~: ,,,',,,,,,,,, f'-] :,ii: :~.
~--,,, ........... ,, ~ ~ ~ ~ :~, u~-%-c,,~~~ :~,-~:~;-'::~;i::;':;:,-:;-:,,-i",-::-?i-,,,,
............ lltlS I$ OCE Y thaHho following described c~mrnocfl[y w.as.wo ghed. measureD;or counted by a we ghmaste¢, whose Slgnei1,i,e'
la on ~ls co~U~te, who Is a ~e~gnlzed au~or~ of a~umcy, as prescribed by Chapter 7 (~mmendng wl~ Sector 12700} of
O~lsion 5 of ~e Caitt~l~ ~u~nes~ ~d P~fe~lon~ C~e. administered by ~e'Dlvlalon of ~aauremenl Stand~da of ~e C~lt~la
Oopa~onl ct F~d and Agrlcul~re. ,
3 912 3
~80~ STOCKOALE HIGHWAY
8AKERSF ELO, CA ~2 (~5) 589. ~2
~UCK LICENSE TRAILER LICENSE TRAILER NO. 2 LICENSE
SP~7.1 30 G~I 8852
~IGHEO FOR {SELLER} OELIVEREO ~O (BU~ER) TRUCK CARRIER
IT coRP HONDO MP
HONDO CHEMICAL INC. WEIGHMASTER 1'2:47 PH 05 '~'~'
,~ , , TIME I DATE
5 ,~3, 96 ~//F/C~2~/ oEPum 293C,0 lb T~ GROSSLY.
5,23,96 ,~ - o~Puw i TARE L~.
WEIGHED AT 20807 ' ' ~l~ I
STOCKDALE HIGHWAY ~ ZX
BAKERSFIELD, CA 93312 ~ CASH PAl0 CHARGE SALE
RE~RKS ~ DRI // ....
~LTERNATE STRAIGHT BILL OF LADING--SHORT FORM--ORIGINAL--NOT NEGOTI'A'BL~ , "~" ': .... "
Jame of Carrier: Carrier's No.
~-- /---
_TO Consignee: FROM Shipper:
HO ~O CHEMICAL PACIFIC BELL TELEPHONE
~ 5650 ALDRIN CT
3900 ~ALLEN ROAD BAKERSFIELD, CA
~estination Zip Code
~BAKE~FI.ELD, CA 93372 "
Units H~t ' Kind of Package. Description of Articles. Special Marks and ~cep~ions 'Weight (Sub. :o Co~.} RA~.
No. Shipping
:EMIT IC.O.O' C.O.D. FEE:
.O.O. TO: ~AMT: PREPAIO ~ TOTAL
OORESS COLLECT ~ $ CHARGES:
WEIGHMASTER CERTIFICATE ' '
THIS IS TO CF FtTIFY thalthe following described oommodl~ was weighed measured or counted bi' a Welghmasfor whole
la on ~ls cerUfl~te, w~o la a re~gnlzed au~orl~ ot a~um~, as prescribed by Cheple~ 7 (~mmendng wl~ Se~on 12700) of
O~lalon 5 of ~e California Duslnesa ~d Protesslona C~e. administered by ~e Division of ~aauremen( Stand,da of ~e CNIf~la
Oepu~ent of F~d ~d Agdcul~re. . ~
~ STOCKOALE HIGHWAY
BAKERSFIELD, CA 93312 (~5) ~
TRUCK LICENSE ~RAILER LICENSE ~RAILER NO. 2 LICENSE
SP27000 GT1 8853 ' .
~IGHEO FOR (SELLER) DELIVERED tO (BUYER) TRUCK CARRIER
IT Hondo MP
HONDO CHEMICAL INC. WEIGHMA$~E /) 2:'3'~ F'H 05 '2:3 96
.'. '~ · · '" TIME I DATE
o,m~ ~),:.00 lb TR GROSS
WEIGHED AT 20807 I / ~ "
,p
BAKERSFIELD, CA 93312 C~SH PAIO I ' CHARGE SALE
I'LTERNATE,IameMP ENVIRONMEIkfT'AL°f Carrier:STRAIGHTsERViCEsBILL OF LADING--SHORT FORM--ORIGINAL--NOTcarrier,s No.IIOate'NEGOTIABLE [Shipper No.
-i~O Consignee: FROM Shipper: .
.~0 CHEMICAL PACIFIC BELL TELEPHONE
"~treet 5650 ALDRIN CT
3900 ALLEN ROAD BAKERSFIELD~ CA
I )est:ination Zip Code {Emergency Response ,=hone N0.
BAKERSFIELD, CA 933~2 800/458-3036
Route: Vehicle No.
J N°'~.'r.P~'ng Kind of Package. Description of Articles. Scecial Marks and Exceptions 'we,gnt (Sub. :c Core.) RATE
__ I E/D NON-HAZARDOUS S01L
O. TO: AMT: PREPAIO O CHARGES:
,,}ORESS r. OLLF~-. O :S
........... , -. . .... . .................... ~,'",~, , ,. ................... ~.. ...... , .... , ............... · ...... , .........
'""""'"" ' ...... ............ ' '" '"" '"" ................ ' '"'""""" ~i', / / _ 2
W EIGHMAS]'ER CERTIFICATE '
TIllS ISTOCERTIFYtha~'iilefollowingdesc~lbodoommo(lJtywaswelgt~ed measured orcoun[edbyawelghma,,[er who~e~lgna~re
ia on ~1s cerU~te, who Is a re~gnlzed au~ort~ ct a~uracy. ~s prescribed by Chaplet 7 (~mmen~g w(~ Se~on ~2700) of
Division 5 of ~e California Ouslnee$ ~d Professions C~e, admMIstered by ~e Olvlsion of ~a~emenl S~and~d$ ot ~e C~ltomla
Oepa~ont of F~d and Agrlcu~re.
~7 STOCKDALE HIGHWAY
flAKERSglELD. CA93312 (~5) 58g-1~2
~UCK LICENSE ~RAILER LICENSE TRAILER NO. 2 LICENSE
IT CORP HONDO MP
HONDO CHEMICAL INC~ WEIGHMASTER 42 FH O~ '~"~ 96
~ATE .., ~' ,- ~. -. ~.-, TIME I DATE
5 ,~'o,~' 96 - _ 0~Puw 29:360 lt. T~: ~ GROSSLy.
5,2 3/ 9 6 . - o~u~ ..... ' TARE k~.
~EIGHED AT 20807 ' I .~' I
STOCKDALE HIGHWAY - 'l, ~' ~ XX
NET
BAKERSFIELD, CA 93312 I cxs~ PA~O CHARGE SALE
SO IL
RE~RKS I DRIVER
amc of Carrier: ' Carrier's No. IOate _ Shipper No.
MP ENVIRONME~AL SERVICES (~//7~L7
~0 Consignee: FROM Shipper:
~HO~O CHEMICAL' PACIFIC BELL TELEPHONE
'~ee~ 5650 ALDRIN CT
3900 ALLEN ROAD B~KERSFIELD, CA
'estination Zip Ccde~
8AKE~FZEL~ CA ~5~12 ~ ~00/4~-~0~6
out : v .ic, No. /.f /
No. ff~,~,ng Kind of Package. Description of Articles. Special Marks and ~ceptions 'Weight [Sub. to Coma RATE V-. CHARGES
~....
,__I E/D , NON-HAZARDOUS SOIL
~IT:~ES.] COLLECT 0 $ · CHARGES:
~,~ ;.. ".. hv .~ :m'r rr hy w ~. ~ '. : ,¢ .;lUpl,:r.; ..'.~ r,~qu,',~d t;o ';t,ff.e :;In,:'.h,;,,l't ,~ ,'~r~r.,,I r; '.:,)hc ,~,,,,.,',,t ~.z~ '.~.~ ~:.,;;,;,,,~ ',~,~.~,,,: ,',o).,";C FREIGHT CHARGES
Ill {;I {VI I }. ',llh g?,:t. ~.ll 1.1,,, , Li:,',iIIi:,II.II:IV, .lltlJ I,iwhdl'/ hh~J I..wdf'; Ils ,'Ih'Lt. ,,, '1,,~ ,I,It.tt ,,f ?.lll~ ,',',uIf ,If I ,q;*'ll~l~f.'t
','," ............. ," .......... ;'" '"" '~", ................. ' '"'"""""""'~' I ~ J /