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Home My WebLink AboutUNDERGROUND TANK-C-09/18/87 4~KERSFIELD FIRE DEPARTMENT BUREAU OF FIRE PREVENTION ~te APPLIC:ATION t Application No., In conformity with provisions of pertinent ordinances, codes and/or regulationS,* appl!cation is made S.T. Service Co.~ 217 HI:. Vernon Ave., ~18, Bakers£ield~* C& 93307 Nome of Company Address to display, store, install, use, operate, sell or handle materials or processes involving or creating con- ditions deemed hazardous to life or property as follows: remove old ~uel ~tne~ and replace ~ith ~ev located at Circle K, 100 Bernard, Bakersfield, CA .... Permit~ .................. //4>-/~.~ .......................... By ................. .~..-.~.~.:......~..~.~ ...................................... Date ~ Fire Marshal ~i~ENT!ON ' . '~ :~ .... U OF::FIRE;P / : m. '.-.---',.-':': - AFPLI ATION . "~' ':' "- in Conf°rmi~ ~i'~h .Pr~i~o~-of-~di~nt Ordinance;' c~.'6h~or:..r~ulations~-a~lic~tJ~ is made. .- ~:- --'.,'-' .. ' ::' :" "'" .' ) '%."~ ,--..,, --,,, ' -¥ .~"- .-~. -- ._ N~-~C~~-'' .. , 1.,..--....-:.. ?,,,~t_,.- ~:.., ~ . . . . . ingolVin~..0r ~r~ing .Com ': ' ~ '.~o displ~;'s~re in,tail, u~,.~rate ~11 °r handle ~atedals '~r. 'pr~e~s ' i I . - -diti~s deem~ hazar~us.,to'life:or prb~ as:-f~llows:' ~ '. ~:~ ~nllnn-'n~p~m~' ~n~nltn~ ~en~n~ 'tnn~.:;: .. · ~ -- .- FILE CONTENTS SUMMARY FAC'rL'~TY: C\ ~C_~_, '~ =~ ~~' ADDRESS : ~0 ~~~¢ 5~ PE~IT ~: OA~%T ENV., SENSITIVITY Activity Date # Of Tanks Comments GROUNDWATER - iN~.~ TECHNOLOGY · .,~ . VIA: Messenger UPS ~ ~~ ~ Blueprinter Next Day UPS ~ _ ~ ~ Express ~sil O~he~ ~ Pick Up Address17~0 el~,.- Attention-~GD~3 h, ea~m~ We are sending you: Herewith Under separate cover Prints Tracings Specifications Other These are: (Ag checked below): Approved For your approval Not approved For review and comment No excepti.ons observed Per'your request Make corrections observed For use on job .., Revise and resubmit For your files Return .... correc[ed copies Remarks If enclosures received are not as listed above, notify at once CC Very truly yours, · . ................................................................. ~ROUNDWATER..?~CHNOLOGY 1700Flower Street ERN COUNTY HEALTH DEPARTM HEALTH OFFICER Bakersfield, California 93305 ~' Leon M Hebertson, M:D: ' ' Telephone (805) 861-3636 .. ENVIRONMENTAL HEALTH DIVISION _ . ..' "'" DIRECTOR OF ENVIRONMENTAl. HEALTH Vernon S~ Reichard . PEI~IT FOR PEP3~LNENT CLOSURE " PEI~IT NUI~EE A526-07 '.'.':' OF UNDERGROUND HAZARDOUS . '.!.':' :~. ._... SUBSTANCES STORAGE FACILITY ~'- .... '~. [t ~ the responsibility o~ the Perma,tee [o ob~a~ permits ,h~ch~:may. be .2. Perma,tee mus~ ob~a~ a Bakersfield C~y ~tre Depar~me~ pe~m~ p~o~ ~o · ,'3..-Tank closure activities must be per Kern County Health and F/re.DePartment "4. A mtnlmum o~ ~our samples must be retrt'eved one-third of the way '~n .. 5..l~ any contractors other than those listed on permit and permit appilca~on .::....'.are to be utilized, prior approval must be granted by the specialls[ .listed '- 6. A minimum of t~o samples must be retrieved at depths of app~ximately': and six ~eet ~or every ~5 linear feet of 'pipe run and also 'near ~"?.' Ail ~asoline samples must be analyzed ~or benzene, toluene, -xylene,'?.-:and '~ · total petroleum hydrocarbons. . .--.'- ...... : ..... ~?- '8 'Copies of. transportation manifests must .be submitted :to-,:the'?::."Heal"th 9. All applicable state la~s ~or hazardous ~aste disposal, transport, at,On; · -treatment must be adhered to. The Kern County Health Departmen~ 'must be : ....notified before movin~ and/or dispos~n~ of any .contaminated soil. . DISTRICT OFFICES Delano . Lamont 'ake Isabella Mojave . Rldgecrest . Shafter . Taft 1700 Flower Street CERN COUNTY HEALTH 'DEPARTMiJI~I HEALTH OFFICER Bakersfield, California 93305 r Leon M Hebertson, M.D. Telephone (805) 861-3636 ENVIRONMF~[~L HF~LTH DIVISION Vernon S. Relchard September i8, 1987 Circle K Food Stores 5813' ~lanZan~ta ............................................... - ......... ' ................................. Carmicheal, California Dear Sirs: This is to advise you that this department has reviewed the project results for the fuel seepage investigation that was conducted at the Circle K Food Store, 100 Bernard Street, in Bakersfield, California. Based upon the findings described in the report, this department is satisfied that the assessment is complete and no significant soil contamination resulting from the fuel tank leakage exists at the site. Thank you for your cooperation tn this matter. Sincerely, ff] Janis Lehman ',~/ ~nvironmental Health Specialist Hazardous ~aterials ~anagement Program JL:aa DISTRICT OFFICES Delano . Lamont ake Isabella Mojave . Ridgecrest . Shafter . Taft Environmental Laboratories 09/01/87 RW PROJECT MGR: Ji~,~ Wad~ A division of Groundwater Technology, Inc. Groundwater Technology, Inc. Western Region 2646 Palr,~a Dr., Suite 440 4080-C Pike Ln., Concord, CA 94520 ' Venture, CA. 93003 ~ - :~-~-. - ~ : ..... :,:_ _ (415) 685-7852 ' PROJECT- ~#: 213-425-5002_-.1 In CA: (800) 544-3422 LOCATION: Bakersfield, CA; Outside CA: (800) 423-7143 SAMPLED: 08/P7/87 BY: J. Wada RECEIVED: 08/28/87 BY: K. Castro ANALYZED: 08/29/87 BY: J. Floro ~ MATRIX: Soil TEST RESULTS (ppis) ............................................... I_ .MDL -~LnB # . ~ .... 59t.3 ..... ~ ~_59t.4 ..... ~_ ..5~t~ COMPOUNDS I I I. D. # ! 1 I 2 I 3 I .4 I 5. I Benzene 0.5 < 0.5 < 0.5 < 0.5 ( 0.5 ( 0.5 Ethylbenzene 0.5 < 0.5 < 0.5 < 0.5 ( 0.5 ( 0.5 Toluene 0.5 < 0.5 < 0.5 < 0.5 < 0.5 < 0.5 Xylenes 0.5 < 0.5 < 0.5 < 0.5 < 0.5 < 0.5 TOtal BTEX 0.5 ( 0.5 ( 0..5 < 0.5 < 0.5 < 0.5 Ch lorobenzer, e ........... 1,2 DCB ............ 1,3 DCB ............ 1, 4 DCB ............ MEK ......... ~ -- MIBK ............ Misc. Hydrocarb,-,ns 0.5 < 0.5 < 0.5 < 0.5 < 0.5 < 0.5 <C4-12) - Total Volatile 0.5 < 0.5 < 0.5 < 0.5 < 0~5 < 0.5 Hydrocmrbons -- = Not Requested. MDL = Method Detection Li~it; co~npour, d below this level would not be detected. MEK = Methyl Ethyl Ketone MIBK = Methyl Isobut¥1 Ketone METHODS: Modified EPA Method 5030/8020/8015. Total Volatile Hydr,z, carbor, s is the sur,~atior, of Total BTEX and Miscellaneous Hydrocarbons. Environmental Laboratories A divisign of Groundwater Technolos~/, Inc. Page ~ of 4, Western Region PROJECT MGR: Jir,~ Wade 4080-C Pike Ln.. Concord, CA 94520 .... (415) 685-7.852 .............. PROJECT #:213-425-5002-I '-- .......... '-':- ....... In CA: (800) 544-3422 ..... ~ ....... LOCATION: "BAk-er'sfie'ld~' '~A. : ...... Outside CA: (800) 423-7143 TEST RESULTS (ppm> ~ I MDL ,ILAB # I 5918 I 5919 I 592.0 I 5921 I 5922 I COMPOUNDS I I I. D. # I 6 I 7 I 8 I 9 I 1'0 I Ethylber, zer, e 0.5 < 0.5 ( 0.5 ( 0.5 ( 0.5 ( 0.5 Toluene 0.5 < 0.5 < 0.5 < 0.5 < 0.5 < 0.5 Xylenes 0.5 ( 0.5 < 0.5 < 0.5 < 0.5 < 0.5 Total BTEX 0.5 < 0.5 < 0.5 < 0.5 < 0.5 < 0.5' Ch 1 orobertzene ........... 1,2 DCB ....... ' .... 1,3 DCB ............ 1, 4 DCB ............ MEK ............ MIBK ............ Misc. Hydrocarbons 0.5 < 0.5 < 0.5 < 0.5 ( 0.5 ( 0.5 (C4-C12) Total Volatile 0.5 < 0.5 < 0.5 < 0.5 < 0.5 < 0.5 Hydrocarbons -- = Not Requested DCB = Dichlorobenzene MEK = Methyl Ethyl Ketone MIBK = Methyl Isobutyl Ketone ¢ MDL = Method Detection Limit; compound below this level would not be detected. METHODS: Modified EPA Methods 5030/8020/B015. Total Volatile Hydrocarbons is the summation of Total BTEX and Miscellaneous Hydrocarbons. EnvirOnme. ntal Laboratones A division of Groundwater Technology, Inc. Page 3 of 4 Western Region PROJECT MGR: Jim Wada 4080-C Pike Ln., Concord. CA 94520 ......... (_4_15)_ 685-7852 _. PROJECT #: .- 1 ~,-4,- ~,-500.-- 1 , In CA: (800) 544-3422 ................. ~----: ....... LOCATIO~--B~W.e~fi'~d~-'CA Outside CA: (800) 423-7143 TEST RESULTS (ppr, l) .~ I MDL I LAB # I 5923 I 5924 I 5925 I 5926 i 5927 COMPpUNDS I I I. D. # I 11 I 12 I 13 I 14 I 18 Benze~ ...................... 0~. 5 ..................... <' '0.5 ........ < 0.5 ....... '(~'0~--5 ........ <~ 0.5 ....... Ethylbenzene 0.5 < 0.5 < 0.5 < 0.5 < 0.5 Toluene 0.5 < 0.5 < 0.5 < 0.5 < 0.5 Xylenes 0.5 < 0.5 < 0.5 < 0.5 < 0.5 ~1;~6 T°tal BTEX 0.5 < 0.5 < 0.5 < 0.5 <,0.5 ~.1~ ch lorobenzene ............ 1,2 DCB ............ 1,3 DCB ............ 1, 4 DCB ............ MEK ............ MIBK ............ Misc. Hydrocarbons 0.5 < 0.5 < 0.5 < 0.5 < 0.5 ,69~9. (C4-C12) Total Volatile 0.5 < 0.5 < 0.5 < 0.5 < 0.5 85.0' Hydrocarbons -- = Not Requested DCB = Dichlorobenzene MEK = Methyl Ethyl Ketone MIBK = Methyl Isobutyl Ketone MDL = Method Detection Li~it; co~pound below this level would not be detected. METHODS: Modified EPA Methods 5030/8020/8015. Total Volatile Hydrocarbons is the summation of Total BTEX and Miscellaneous Hydrocarbons. Sample #5987 was confirmed by second column. EnvirOnmental Laboratories A divi$[or~ of Groundwater Techno{o6~y, Inc. Page 4 of 4 Western Region ~ PROJECT MOR: Jin~ Wada 4080-C Pike Ln., Concord, CA 94520 PROJECT .... - - #-:'c 1-~-42~--- ~00c--- 1 .--. --_-- ..... -.. (415)-~85z785'2 .................... In CA: (800) 5~-3422 LOCATION: Bakersfield, CA. Outside CA: (800) 423-7143 TEST RESULTS (ppis) -' I MDL I LAB ~ I 5928 I I I I I COMPObNDS I I I. D. ~ I 17 I I I I I Benzene 0.5 < 0.5 Ethylbenzene 0.5 < 0.5 Toluene 0.5 < 0.5 .Xylenes 0.5 < 0.5 Total BTEX 0.5 < 0.5 Ch 1 orobenzene .... 1, ~ DCB -- -- 1, 3 DCB .... 1, 4 DCB .... MEK .... MIBK -- ' -- Misc. Hydrocarbons 0.5 6.8 (C4-C12) Total Volatile 0.5 6.8 Hydrocarbons -- = Not Requested DCB = Dichlorobenzene MEK = Methyl Ethyl Ketone MIBK = Methyl Isobutyl Ketone MDL = Method Detection Limit; co~pound below this level would not be detected. METHODS: Modified EPA Methods 5030/8020/8015. Total Vc, latile Hydrocarbons is the summation'of Total BTEX and / Miscellaneous Hydrocarbons. ' Z"~'~_~~' /q~ ~ ~ . ' ~ 11 i LEGEND SA~PLI~ %t ISAHPLE LOCATTON , I 1 2 FT. ~LEADED T~K WEST 2 ~6FT. ~EADED T~K ~EST 3 ~2FT. UNLEADED T~K EAST 4 ~i6 FT. ~LEAD.D T~K EAST I' 5 ~2FT. SUPE~ UNLEADED T~K WEST 6 ~6FT. SUPER ~EADED T~K WEST . 7 ~2FT. SUPEK UNLADED T~K EAST 8 '6FT. SUPER UNLEADED T~K EAST 9 ~2FT. ~EGULA~ T~K WEST 10 ~6FT.~EGULAR T~K WEST 11 2 PT.REGULAR T~K EAST 12 6 FT.REGUL~ T~K EAST 13 ~ FT. P~P ~e souse eoz~ ~s . ~ SA~ L~ON , ~ /TA~ ~ITImS PRIm TO RE~ I ...... ~ I SITE LOC.: T~ PIT ~ I DR~WN~BY BY DIVISION OP, TERVIRONMENTAL HEALTH I'{' ,. APPLICATION DAT . ~. / . 1'/00 FLO.k~R STREET. BAKERSFIELD. CA 93.~05 ~l OP TANKS TO BE ABANDONED {805) 861-3636 .. {LENGTH OF PIPING TO ABANDON HAZ~DOUS SUBST~CES STORAGE FACILITY THIS APPLICATION IS FO~ ~ ~0VAL. 0R ~ ~O0~ IN P~CE (FILL 0~ 0N~ ~PLI~TION ~ CONTA~ PHON~ s. . = ....... ~ ISEC/T/R (RU~ ~T[0NS ONLY) FACTLI~ ~g ~D~S OWNER · ~DR~S 'HON~ ,~OPOS~ PROJE~ ~T.NG ~ {~L~FORN~A-LZC~iSE ~{~RK~'S C~P~SATXON · - - ' IINS~ CHEMICAL COMPOSITION O~ ~T~l~ ~ORED WATER TO FACILITY PROVIDED BY DEPTR TO GROUNDMATER __ ~EAREST WATER WELL - GIVE DISTANC£ AND DESCRIBE TYPE IP k}lTfflN BO0 PEET BASIS FOR SOIL TYPE AND GROUNDWATER DEPTH DETERMINATION nESCRIBE~HON!-~.ESID[JE IN_T~UCK{~) ~_~,l,U PI~I.N¢ jS TO ,r;q~E R ~Fr~.~,,W.D.-AJ~D. DiS,~J)SED J;IF (INCLUDE ~NSPO~R'~I',ATION AND DISPOSAL CONPANIES); ~ESCRIBE BOTH THE DISPOSAL ICe, HOD AND DISPOSAL LOCATION FOR: .... { .=,~.~ l~Jf~.'~l~_ ~k?v'-~GO'~-~ tJ,u~t.~r4._ ~[~-, "· PLEASE PROVIDE INFORMATION REQUESTED ON REVERSE SIDE OF THIS SHEET BEPORE SUBNITTINO APPLICATION FOR REVIEW THIS- FORM 'HAS-BEEN COMPLETED-UNDER PENALTY OF PERJURY- AND TO THE BBET OF NY'KNOMTg~I]DE"'2S TRUE'AND- CORRECT: \ PROVID~E DRAWING OF PHYSIC '-- ~T OF FACILITY USING SPACE ED BELCW. ALL OF THE FOLLOWING INFORMATION MUST BE'INCLUDED IN ORDER FOR APPLICATION TO BE pROCESSED: · -' __ TANK(S) , PIPING & DISPENSER(S), INCLUDING LR~IGTHS AND DIMENSIONS PROPOSED SAMPLING I_DCATIONS DESIGNATED BY THIs SYMBOL "(~" ~ __ NEAREST STREET OR INTERSECTION -' __ ANY WATER W~T.r.q OR SURFACE WATERS WITHIN 100' RADIUS OF FACILITY .-%'T I~EE'T ,. ..~. " " '- ·" "" .SFJ%F_ I "',ZD ~!~'" ' .~ .'..: .j,..' . :. " - "- '::' ' ' F"C' ~' ' '" a.4 '~.. ' i: ' ' ; ' "..'&~.. .~;' ' :.,~.~. : ·: .. ,! .. : t ' · ?.,,f~ , . -.. :.. ~' · .~ '.'~ . .~,- , ' · "i* " ' .i. . ,, - 't - "-~;~ :' [ .... · ~ [1..! ~ .. .- ~ cC '; , ... T~blK ~1 '. RE&ULR'K lO.C00 6-1% Lo ~5' xP_5' :5-fEEL L.,J~q/_L TANK TRNK, ~% ', 5.L~KEME I0,0~, QAL. 8' x7_.5', STF,.EL DJRLL TI:IN& Tt=INf-, eA ', UNLERDEDD, OCO OR L ..~'x, 19..~' 5'iELC'L LtJRLL'TRNK 1700 Flower Street ~=RN COUNTY HE.ALTH [;)EPARTMEI~.~ HEALTH OFFICER Bakersfield, California 93305 ~. Leon M Hebertson, M.D. Telephone (805) 861-3636 ENVIRONMENTAL HEALTH DIVISION · . . ~ DIRECTOR OF ENVIRONMENTAL HEALTH · ~ Vernon S. Relchard Facility Name Kern County Permit · : . .' * *. UNDBRGROUND TANK DISPOSITION TRACKING RECORD ...f. "_-. Thi's form Is to be returned to the Kern Coun.ty Health Department ~ithin 14 5ectlon E - T~ b~ filled out ~ contractor "decontaminating tank(s): ~ Ta~ "Deoont,inatton" Contractor ~,~ ~~~ ' : Autho~ized representative of ~ontractor certifies b~ si~nin~ belo~ that ta~(s) have been de~ont~lnated tn accordance ~ith Kern Co~t~ Bealth .. . . "b i 1 u ; ilnld' '~ ~ authorized repvese.tative Of the treatment, s~oraEe, o~ disposal faclllt~ acceptln~ tank(s}: Date Tanks Received g-.~;~{ - ....... No. of Ta~s zed Representative · * * ~ILING INSTRUCTIONS: Fold In half and staple. Postage and aailtng label have already been affixed to 9utstde for your convenience. (Form $~P-150) . ; DISTRI~ OFFICES Delano . Lamont . Lake Isabella . Mofave . Rldqecrest . Shelter . Taft l?oonowerStreet ~ERN COUNTY HEALTH DEPARTME~ HEaLmOFF,CER Bakersfield. California 93305 r_ ,- Leon M Hebertson, M.D. Telephone (805) 861-3636 ,. ENVIRONMENTAL HEAL~ DIVISION .- DIRE~OR OF EN~RONMENTAL HEAL~ ~rnon ~ Relchard Facility N~e Kern County Per~tt ~ : '. * * UNDBRGROUND T~K DISPOSITION T~CKINO RECORD * * . ' . .~'" ,[':-- . .This ~ora Is to be returned to the Kern County Health Department within 14 . .:~,~.~-/' ..' ~..,;days of 'acceptance ..of tank(s) by disposal or recycltnE facility..-The (Z.~.~5~holder-: of--the . peralt-~I.th--nuaber'noted .above -.ls..~respons.lble--for-4nsurlng ' ..':r. f-:.:.~..,: that this for~ is completed and returned .... :~' ~" ' .... · : : ..~-.:-g.' .... .. ',z; SeXton I :~'.To be filled out ~ tank reaoval contractor: .'~i~{..'. [:7/ ' ' ¢. ~:('?-' ~ Iai'Re,oval Contractor: ~ ' .... ~ton 2 - I~ bJ filled out ~ contractor "decontamlnatinff tank(s): '.= .' Ia~ "DeCont~lnatlon'' Contractor ~,~q~ ~,~ ~~[ ~[ : ': Address ~, ~ ~~ Phone 8' (~ Authorized representative of contractor certifies by signing belo~ 'that ta~(s) have bee~decont~inated tn accordance ~tth Kern CounW ~ealth ~paetlent requt[e~nts. . ~ctlon S -To be filled out and signed ~ a~ authorized representative of the _ treatment, storage,, or disposal facility acceptln~ tank(s): : -': ~~~, O~" Zip Da,e Tank. Re%~ved ~/~O/~ 2 No. of ,a,k, Sl~ature '~, ~.~ Title ~ (Authorized Representative) · * * ~ILING INSTRUCTIONS: Fold tn half and staple. Postage and mailing label have alrehd~ been affixed to outside for your convenience. (Form $~P-150) . ; ~smtm omcts Oolano . Lnm~nt . Lako Isab,ll~ . MoJavo RId~er~st ~haf~or . Taft cLOSURE PEPd~IT PeR PEPJ4ANENT... SUBST~CES STOOGE PAClLI~ · ' 102':'f::}Permtttee Is responsible "for makin~ .sure 'that "tank disposition tracking lth this ..per,It - Is .properly'- fllled~.;out ~';:~f'i'~"~:?~':,~Results must "be :'submt[ted .?.to ':;thts' office within three .',da~s. ;':~ ~ ' DATE ' C ~ A CEPTED BY Permit # ~ e Environmenta~ Sensitivity .... "~ -inspection Time UND~ROROUND "~DOU8 8UBST~C~ 8TORAO~ '" ~ INSPECTION R~PORT ~o. o~ f~nk~ 0 Ie In~omm~tlon on Permit/Application Oom~eot? Yee ~ No ~ PemmJt Po~ted? Ye~ fype of ~n~peotJo~: Routine ~ '~omp&eJ~t ReIn~ect~on Comments: ITE~ V~OLAT~ONS ~OTED 1. Primary Contal~ent Nonltorin~: · ... · O. ,..,.;I ,.v..,o., ~..,.o, ,..,,o.., ' r,, c,,~, ,.,-- , ·' ..... C, NodJf/ed Inventory Control Nonltorln= I ~gC .... ~ ' I~ ..r'l~ .:;_..( .~/ 't}')~ I 1~ I'~( d. In-Tank Level Sensing Device * I ' .:' :.~f~ · . e. Orou~dwate~ :' :'-:" ' , -- 2.~econdary Con~alnmen~ Nonl~oeln~= a, Liner b, Double-~alled Tank a, Vaul~ '1 I ................... ~ ....................... 2_ ............ reesurlzed [ I b. Suction [ I - ~] ~- ~ .................. ~ -~ ....... ~ ...... . ....... ~ .............. ~ ........................ D'. ,~-~ n~ec,7[~] ~0/~ ~7~ ¢~t ~ ..~ ~. ;~'hU ~ ~ , ...................... ~ ................. ~ ,.~ c2...L2[L_.~ p_.2~.~_)~2q:D2~SE ~_~_~5i~_~oi2~ ~__dCs ,~_~ ....... 5. Tl~htneaa Testing ................................................................................................................................... 8. New ConstrucClon/Hodlflcatlon 7. Closure/Abandonaent ................................................................................. ~ ..................................................... 8. Unauthorized Release .......... ..... :'.~l .'(-.,~]~01 , r~('L~','c'~ :' ~((~( ,~: ~,,~'i t.-~ ~',,"<.'ff.:tL.c'.~ ~,' r'" t ,' ' ;' ~',' ,, ~ - ~ ~ ~elnapec~lon ached~led? Yea ~o App~oxlma~e ~elnspe~l~n Date '...' .,~'~.,~k ~.,~-¥~[ i~ ~, ,.,,-¢ . .~..... .-~ . 170OFIower Street r KERN COUNTY HEALTH DEPARTMENT HEALTH OFFICER Bakersfield, California 93305 Leon M Hebertson, M.D. Telephone (805) 861-3636 ' * ENVIRONMENTAL HEALTH DIVISION DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Reichard April 10, 1987 Circle K Food Stores Office Attn: Becky Bell 4824 Harris Road Bakersfield, California 93313 RE: PERMIT CHECKLISTS FOR UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANKS. Dear Ms. Bell, This department recently requested that three of your facilities complete the permit checklists that they had previously submitted to this office, The original checklists were incomplete due to the items listed on the enclosed copies of form 500. These facilities were sent new checklists to fill. out. As you can see from the' enclosed checklists, they again came back incomplete. We would appreciate your'immediate attention into this matter, as the completed checklists must be submitted to this department within 15 days. If you have any questions, please call me at (805) 861-3636. Sincerely, Lehman Environmental Health Specialist Hazardous Materials Management Program ............... J L~'~sw Enclosure DISTRICT OFFICES Oelano Lamont Lake Isabella . Mojave Rldgecrest . Shelter . Taft Permit z ~ Envlrom~ental Sensitivity Inspection Tine UNDERGROUND HAZARDOUS SUBST~kNCE STORAGE FACILITY * INSPECTION REPORT ?" . c-- oe I4FO No. of Tanks ~ la Information on Pereit/Applicat~on Correct? Yes -- No__ Per~/t Posted? Yes -- Type Gl Inspection: Routine ~ ' CoapIatnt Reinapectlon Consents: ITEM VIOLATIONS NOTED : Intercepting and Directing Syatee t ~ ~ ,~.~. .... 'd. In-Tank Level Sensing Device I :'~' ' e. Oroundwater Monitoring I , z' ' ' "'"~' : ..... ~ "' f. Vadose Zone ~onltorlng . / ~ ...."/,~. 1~ ,*~. f- C' ', ~,"i '~,~' "! L~ '~/ /~ (?/'~ 2.Secondary Containment Honltoring: a. Liner b. Double-Walled Ta~ c. Vault ressurlzed I b. Suction c. Gravity ........................................... J ............ :f .......................... ~; ..................... VI. Overfill Protection ,' -':'l /,'~ ~J~ "f'- -] "--' , ~1, ,f- ~- ' ~ ~'~ ~ (~,~ ~,t~,j: i,~ 5. tl~htne88 Tearing ..................................................................................................................................... 8. He~ Construction/Modification .............................................. 7. Closure/Abandonment ....................................................................................................................................... 8. Unauthorized Release - ....................................................................................... ................................................................................................................................... Co~ents/Reco~endattons: ' '" .... ~l --.'~' '~"~-'~' :- ~ '-~ ~: '~ "'" ' ' ' ' - '.--'-'-: '"'~ t: 'C/ ,~ ~L ~_ -~i c., //t~-L.t / ~'~ .~.~ ,,- !~./~/ ~ . . i Relnspectlon scheduled? Yes No Approximate Relnspeotlon Date -- INSPECTOR: REPORT RECEIVED (Form $H/~P-170) 1700 FIowercaliforniaStreet :tiN COUNTY HEALTH DEPARTM! / HEALTH OFFICER Bakersfield, 93305 ~: Leon M Hebertson, M.D. Telephone (805) 861-3636 ENVIRONMENTAL HEALTH DIVISION ', .. ' ' ~ DIRECTOR OF ENVIRONMENTAL HEALTH . ~ Vernon S. Retchard · INTERIM PERMIT .~. :PERMi'T~070002O ... :.' TO OPERATE = . , ..ISSUED: ::-' 'JL%Y 1, 1986 · EMPIRICS: 'JULY i, 1989 UNDERGROUND HAZARDOUS SUBSTANCES .'" . :.. · .'--: .... ::,:. ...-. . . .. ":?'::'.:'-' :;:' EAC'InITY- .' :.,'::-:... '." L- ' '/:' .'-'. ::, :' '. ::,: '.'!-~:h":: ~ '~ :>~ O~NER '?' ~' ': ''' "":' '-'~ " ":'-. - ~.-:. ° .... - - ' : ' ":: :: .... .' '---~-~'.:1 -";%: : ' ~ : ~ ,'>'" j:-:.'_ :~::~?~.":~:~':?~i.~>L? ..'~-....,"-::~ '. :.CIRCLE K #88? "" -'..:: ..... :'?~,1 :::::-.'.:.. CIRCLE K CopmOR~TTO~ :..::?,,:.,:,i.A,'.' :.'IO0.~BE~ARD STREET" : -':" : ::i'.l '>;'.::' ::!::_P.O. BOX 20230 :" :.} .: ?.':-~ ~<. <:--.'1-3 . :', :;. < .... ,-UNK ...... ,.:,: ', ':':x, . ..:::,.: MVF .3 ·" ..'-'",;': :' :'." · .... '~:-:'".~S: '"::...'<.~.:.:?'..', ~;-.:...:( :.': :..:..' '::: ::.,. :.:'.,:':.: <. ?: .~' '..': :::'...: ,::.::~ ,. :'. ': :.:1"~.'::';: ::~}:}:-.:,..:.c' ':.....: ~j/:-'./: ':..~' ,/:-:.. '<,::¢ ¢.':: ;: . :~..".i:,:,": ~, " ... ': .:, ,' -.:' ;:, :. '<. ,-<' t _ ..:, .'.~, ,, ?' ,-.:'.".i:,.:F>..::,-~::.:,.." u'.?,': :::t ':t,;c~ `''.l: :` 'J~>:4:% .".: ..: .' --,:::..-" '" """ -' --'" '.' ': "-'. :"<.: ":-"'?. "~. :l?:? -'?:'>".' .::' :. '..:: :. '?5:?' '<.? :',:/ ?:::f:<':': ::: '4's.<~::YCr .:.::...' ..':::...'-:...' : ::-'- :..~:..~.-. .......... .:,. ::'. :..-,.: ..... . :,._-:-.'..: ..... .: . ':,. ( .~'.:::.}.:;¢:.~}~:.::::..:.:.:~:~:? :. ... :,..:....~:~-<e,.:::::::::.,~ ~. . ..... ..,'::?..:~::'~::::"< :.:NOTE: ALL INTERIM REQUIREMENTS ESTABLISHED BY THE PE~ITTING , :.:..'. ".>:~'./'.:.::.:::.:..:: "' ::..:.:: < AUTHORITY MUST .BE .ET DU~:NG THE TE~ OF. TH~S PE~T =========================================== · . . .::'.e · t, :' ' ' ' ' ...... -':';L :':'~ '-%'. ;:8:' .-' ' ":"~'. ....... .'~-C' '-~".' ',:- :' .' : .: ,c?. :: :.'?: [:"1% < .,:. ':. '- ' :' :' ' ' :' ' ' : DA: P~IT ~TT,m: JUL 2 1 1986 ,. DA~ P~IT ~K LIST ~~: _'..: : '.. : '.' ,;: . , . .::_/. ..:..'_1-:-:. ': : - <:<:.:-:.:--- · , ,,,:.x-.,. ;'~ ,:<+;.:-:::' ):<:: .:,. ' PERMIT CHECKLIST Facility C, CC~.~'~ ~(~~~b~ Permit# This checklist is provided to ensure that all necessary packet enclosures ~ere received and that the Permittee has obtained all necessary equipment to implement the first phase of monitoring requirements. Please complete this form and return to K~HD in the self-addressed envelope provided Check: Yes No A. The packet I received contained: 1) Cover Letter, Permit Checklist, Interim Permit, Phase I Interim Permit Operator), Chapter 15 (KCOC #G-3941), Explanation of Substance Codes, Equipment Lists and Return Envelope. W~ 2) Standard Inventory Control Monitoring Handbook #UT-10. w/ 3) The Following Forms: a) Inventory Recording Sheet b) Inventory Recording Sheet with summary on reverse c) Trend Analysis Worksheet 4) An Action Chart (to post at facility) Wz B. I have examined the information on my Interim Permit. Phase I Monitoring Requirements, and Information Sheet (Agreement between Owner and Operator), and find owner's name and address, facility name and address, operator's name and address, substance codes, and number of tanks to be accurately listed (if "no" is checked, note appropriate corrections on the back side of this sheet). C. I have the following required equipment (as described on page 6 of Handbook): ~ l') Acceptable gauging instrument ZY..~/~. 2) "striker plate(s)" in tank(s) i/z 3) Water-finding paste D. I have read the information on the enc]osed "Information Sheet" pertaining to Agreements between Owner and Operator and hereby state that the owner of this facility is the operator (if "no" is checked, attach a copy of agreement between owner and operator). · ~'"E. I have enclosed a copy of Calibration Charts for all tanks at this facility '(if tanks are identical, one chart will suffice; label chart(s) with corresponding tank numbers listed on permit). -~/-~ F. As required on page 6 of Handbook #UT-lC, all meters at this facility' have had calibration checks within the last $0 days and were calibrated by a registered device repairman if out of tolerance (all meter calibrations must be recorded on "Meter Calibration Check Form" found in the Appendix of Handbook). G. Standard Inventory Control Monitoring was started at this facility in accordance with procedures described in Handbook #UT-lC. AES/Bro man Preci si o Leak Test ~ Order # 767b Tank # 5 ~ Calibration. Value___________ I Date 06/27/S6 time ~O.s I System Variation ~ Scale ~ OPH I Product U/L I Tank 0nly __?_~. ':'~=~: "~'~- -Gal 1 ons --=-~OC~O " .... =-'-'- -' I" -"-PP'od~-' L-i~-e ..................... i Gallons Added 2000 I Non Pressure Lines · ,~ .......... . ................ ._~ I Hfs Since Added 8 i Notes 50 - AES/,Br-oc ~an Preci si o,~ILeak Test ~_ .... ~__. ~ate 06/27/86 time ~0.8 ~ System Variation Product P/U/L ; Tank 0nly Gallons 10000 I Product Line Gallon~ Added 50008 I Non Pressure ~ines Hfs Since Added 8 I Notes 25 ' AES/Brock~nan Precision Leak Test Order # 767A Tank # 1 ;. Calibration Value ~ ~./)~Gal. Date {}6/27/86 time 61..5~ I System Variation I Scale Product REGULAR I Tank ~nlY I I Gallons 10000 I Product Line I I Gallons Added ~000~ I Non Pressure Lines ' Hfs Since Added 7 I Notes ' " . P.O. Box 151 :: Associated Environmental Systems Bakersfield, CA · 93302 . .... PRECISION TANK & LINE TEST RESULTS 8051325-2212 Invoice Add~ess~ Tank Location: . ' IW.O.#: -~ '-~' , "~"~-' ~" '- '" -'~T~' ' ' ITechnician:. , · .. . .... ¢~ ~ ..... ... ~&nk [Cap. P~od, Tank Li~e' p/L High Ca1 ~w Ca1 VlR~ prod+ .Pump Ha~ P dia, ~.,.~,~.:,.,. .~:.. :.": '-.- ~~ ~ ~-.~-~~~ ,.. ,. .,. '~ . _ '. ~ ' ~) These re~ul~s obtained using ~he patented ~.~.S./Brockman system. " ' 'd) This s~s~em and me~hod mee~s ~he criteria se~ ~or~h fn NFP~ 8329... ,. .JLB1 ' 07ooo CERTIFICATE OF PRECISION LEAK TEST ~ 86767 ........................ As~;oci'~.ted En-~ironmentat-Systems--ha'.~-'~est~l a~nd' ~ertifie$ .... : .......'--'~' this tank and line system Tight. Date: 06/27/86 Codified Tester: G.L. Shrider ~ 86111 .................. Location:. Circle K ~887, 100 Bernard, Bakersfield, .CA Tanks: 1. I~K RPg_ 4. ~ U/L Rece~ification Date Recommended: ~. tank nnly 5. --.~3' I~K P/,,/, 6. ~,~, /~ 06/27/87 ~ ~',~'' - _ . Associated Environmental ~ys[ems Asso**~ea Environmental Syste~ ~Home Office · P.O. Box 151 8~ersfieid, Ca. 93302 · 805/325-2212 em. C. ount~ Health Department _ ivlslon O~ Environmental HealJi/ Application 700~Flower Street, Bakersfield~' 93305 APPLICATION FOR PERMIT TO OPERATE UNDERGROUND ~ HAZARDOUS SUBSTANCES STORAGE FACILITY · i Type of Application (check)': , [] Ne--~ Facility [] Modification of Facility .[~] Existing Facility r~Transfer of Ownership .. E~ergency 24-Hour Contact (name, area code, phone}:. Days <'~Z,';'?O No. of Tanks ~ ,- ':-:~' Of B~i~in~ss~'(c]seck)-:- -:-'~3 GaS°'l in'e-':S~a ti0n -.'[~ or, er "(a'e~rlb~) ..... - - - .... Is Tank(s) Located on an ~gricultural Farm? l-~Yes [~]No Is Tank(s) Used Prima_rily~for kgricult~l Pu~rposes~ 'l-lYes T R SEC '~Rural Locations f~nly) /~ -- Owner ~ n,om~ ~ K ~.OPPO?,,.ATION Contact Person~_~. ~,-))~ ~!L.'-/~)~.-~ Address ~m~p-T~-~.~.'~(t;AG,_--.;.~£N ~' S~,~',.'i~5 ' Zip T~lep~one {~;~/Q- zj.~'/.- OPer~ator ~.0 Rox 20230 Pho3nm, AZ ~bu~o .C°ntact Address ........................ Z ~p ............ ~= Water to Facility Provided by Depth to" Groundwater .~ Soil (33aracteristics' at Facility Basis for 'Soil Type ar~ Groundwater Depth Determinations - - I. Contractor CA Contractor's L~cense N~. .- Address Zip Telephone Proposed Start'lng Date Propos6d Completion Date Worker' s C~pensatio~ .Certi fl'6ati°n ! Insure¢ ). If This Permit Is For'Modif~ca:tton Of An Existing Fac~lity,.Br~efly Dascr~be Modif~cati ~Os Proposed Tank(s) Store (check all that apply): Tank ! Waste Product Motor Vehicle Unleaded Regular Premi~a Diesel _ Waste r-! .__ri ._. [] ?.. Chemical .Cc~p0sltton of Materials Stored (not necessary.for -~tor vehicle fuels)'-:f:.:_-,~L,- _ Tank ~ Chemical Stored' (non-co,mercia1 name)-CAS ! (if known)- Chemical Previously Stored (tf"dif£eren~) ..... _ - Transfer of Ownership Date of Transfer Previous Owner - Previous Facility Name I, accept fjfly all obligations of ~er~it No. issued to · . I understa~] that the Permitting Authority may review and modify or terminate t~e transfer of the Permit to Operate this undergro~d stor~e ...... fa¢i!! t~ulmmu-r, ecei.uing __th i s_cC~ pl.e,._ted_.fo~rm Tnis fora has been completed under penalty of perjury and to the best of my knowledge true and correct. ~0~AS ,~. COSC'~JV~, Signature ~<~-----~ ~, ~'~----~ ~ Title~0?£p,W ~A,~,:.',,~ ti SI T~K ~ ~ ~FILL OUT SEP~TE FO~ T~K) ~R ~ SE~I~, ~ECK ~LL ~PROPRIATE ~XES 2. ~ ~ter~al ~Car~n Stol ~ S~inless' Steel '~Fi~rglass-Reinforc~ Plastic ~Concrete ~~in~ ~Bron~ ~O~er (de~rf~) 3. Priory Conta f~nt ~te ~ps~ll~ ~ic~e~(Inche~)__ Ca~c~ty (~11o~) ~Other (de~ri~): ~ufacturer: ~ter~al ~ic~ess (Inc~s) ~cfty (Gals.) 5. Tank Interior Linf~ " b. Pipit: Fl~Restr~ct~ ~ak ~t~tor(s)-for Pre~6~iz~ Pipit" ..... '- ~te(s) of ~lr(s)~-: ~ ....... -~ ~Ta~ Fl~t ~e '~Fl~t Vent Valv~ ~-Auto Shut- Off Controls -':- -' 11. Piping a. t~derground PiPing: [~Yes l-]No I~Unknown .~atefial ..... Thickness (inches) Diameter - Manufacturer ---: _:-=- [~P~essure---[~Socti°ni-~Gravity .... Approximate-Largth Of' Pipe 'R~x~ b. Underground Piping.Corrosion Protectio~ : -~ - [-]Galvanized []Fiberglass-Clad F]Imlxessed Current [2]Sacrificial Anode ~Polyethylene Wrap - ~Electrical Isolation [']Vinyl Wrap {-]Tar or Asphalt [~Unknown {-]None [-]Other (describe): ¢. Underground Pipits, Secondary Contairment: {-]Double-Wall F]Synthetic Liner System [~]None [']Unknown- rqOther Cde~ribe]: FOR EACH SECTION, CHECK ALL APPROPRIATE BOXES · 1. Tank is: [-]Vaulted" ~Non-Vaulted [~Double-Wall [~Sir~le-Wall 2. ~ Material ' Carbon Steel ~-] Stainless Steel [] Polyvinyl Chloride [] Fiberglass-Clad Steel Fiberglass-Reinforced Plastic [[]Concrete [2]Al~in~ [[]Bronze [~Unknowrt ~ Other (describe) 3. Primary Containment Dste Installed Thickness (Inches) Capacity (Gallons) Manufacturer ...... 4. Tank 'Secondar~y Co~{tair~nent ~Double-Wall [-]Synthetic Liner ~Lined Vault [[]None [~13nkno~t DOther (describe): Manufacturer: [~Material Thickness (Inches) Capacity (Gals.) 5. Tank Interior L~ [[]Rubber ~Alkyd [-][]Epoxy [[]Phenolic DGlass DClay []Unlined DOther (describe): ' ..... 6 ..... Tank Corrosion Protection --~G~lvanized--[2[~t~-[~rass-Clad []Polyethylene Wrap [[]Vinyl Wrappir~ DTar or Asphalt J~Unkno~n [~None []Other (describe): x Cathodic Protection: ~-INone [-~Impressed Current System [~aCrtt[i~ial' At, de ~', Describe System & Equil~ent: 7. Leak Detection, Monitoring, and Interception &. Tank: ~Vlsu~l (vaulted "~nks only) '[[]Groundwater Monitortr~3' Well(s) [.]Vadose Zone Monitorir~ Well(s) OU-Tube Without Liner ..... : ' -- .. []U-Tube with C~gpatible Liner Dlrecttr~ Flow to Monitorir~ Well(s)' [~]Vapor Detector* O Llquid Level Sensor* [~Co~ductivit~ [~ Pressure Sensor in Annular Space of Double Wall Tank [] Liquid l%~trieval & Inspection Fr~m U-Tube, Monitorir~ Well or Annular ~pace Dally Gauging & Inventory Rec~nciliation [] Periodic Tightness Testin~ ~one FlUnkno~an ['1other ~JT'('.~ , z3C,~r~-~,~ · - b. Piping= Flc~e-Restricting Leak Detector(s) for Pres~_6fized Pipin9' []Manitoring Strip with ~ace~y.-~-lSealed Concrete []Half-Cut Caupatible Pipe Raceway [] S~n~et:i= Liner' Race~a¥ -;l']Nor~ ..----~--~--~= Date(s) of l~pair(s) -- --= ...... I--ITape Float Gao~e ' •Float Vent valves :O Auto- Shut- O£f Controls - - __ ~ . _ [-]Capaci~ance S~nsor []Sealed Fil~ Box .=.[]None · ~l~kno~--.-.- :--'-=--- D-]Other: List Make & Model For Above Devices -- a. Underground Pipir~: ~Yes []No []-]Unknown -" . Material Thickness (t~ches) Diameter Manufacturer ~: [~'Pressure [[]Suc[ion [2]Gravity Approximate Ler~jth of b;~- Undergrotux~Pipin~Cc~rrosion Protection ~: ......... ~ ' ..................... '- ~lGalvanized [2]Fiberglass-Clad' [[]Impressed Current- [-]Sacrificial Anode. [Polyethylene Wrap -[[]Electrical Isolation- []Vinyl Wrap [[]Tar or Asphalt l~]Unkno~n [2]None [2]Other (describe): c. U~derground Pipir~j, Secondary Contairment: []Double-Wall [2]Synthetic Liner Syst~n [-1None. [~Unknowr~ [qOther (describe): acilizy :~,~e ,, .~ /, /,' /<' -,-~/7~.? Permit No.," T~K ~ ~ .FILL OUT SEP~TE ~ , T~K) --~R ~ SE~I~, ~ECK ~r-~- ~PROPRIATE'~X~ .. 1. Tank is: ~Vault~' ~n-Vault~ ~uble-Wall ~Si~le~all 2. ~ ~teri~l Car~n Stol ~ S~inless Steel ~l~inyl ~oride ~Fi~rglass~l~ ' Fi~rglass-Reinforc~ Plastic ~Concrete ~ ~in~ ~Bron~ 3. Priory Contai~nt ~te ,Ins~ll~ ~ic~ess (I~es) Ca.city (~llons) Fanufacturer 4. Tank--~ ~Secondary Contai~6nt~'~ - ~ ~l~Wall ~thetic L~ner ~Lin~ Vault ~ne ~o~ ~0~er (de~rt~): ~ufacturer: ~te[~al ~iC~ess (Inc~s) ~cfty (Gals.) 5. Tank Interfo[ ~ini'~ ~~r ~k~ ~xy ~enolfc ~Glass ~Clay ~l~n~ ~O~er (de~ri~): 'Z ..... 6, ..... Ta~ Corrosion Protecti~ ~Galva~t~ ~ass~l~ ~l~yle~ ~ap ~Vinyl ~a~i~ '. ~Tar or ~p~lt .~~ ~No~ ~Other (de~rl~): ~ Cath~ic Proration: ~ne ~pres~ ~rent S~t~ ~crificfal ~ ~t~ :', ~ri~ Syst~ & Equi~ent: ~ 7. Leak Detection, ~nttori~, an~ Interception a. Ta~: ~Vis~l (vaul~ ~ks o~y) ~Gro~ter ~nitort~ ~ll[s) _. ~Va~ose Zone ~nitorl~ ~11(~) ~~ Wi~ut' ~ner~ -- .. ~-~ wt~ C~t~ble Liner Dlr~tig ~o~ ~ .onitorig ~11(~] ~ Pre.ute Sen~r In ~ular S~ of ~uble Wall T~- b. Pipit: Fl~Restricti~ ~ak ~t~tor(s) for-Pre~fifiz~ PIpit" n: ~nitort~ ~p ~ ~ce~y ~al~ .~re~ ~ce~y ' *~ri~ ~ g ~el: = - 8. Tank Tigh~e~J=::5 --) =~'-<~"': ~te(s) of ~ir(s) ....... '? -10.- -~e~ffll Protection - '- : u- z' - ~-'- < % -- O~rator Fills , :'Controls-; ~' V~s~lly ~nitors ~vel~:.-:'::-~~ '- -' OTa~ Fl~t ~e OFl~t Vent Valu~ OAuto Shut- Off Controls L'" .' O~cl~e ~r O~al~ Fill ~x ~ne · ~o~'- '-" ~O~er: " List ~ & ~el F~ ~e ~lc~ 11. a. ~ergro~d Pipit: .-~Yes ~ ~o~ ...~terial ':' -. Thtc~e~ { i~hes) ' - Df~ter Manufacturer -- _.--- ~lvaniz~ ' ~Fi~rglass~l~ ~ess~ ~rent- ~crificial ~Polye~yle~ Wrap -~El~trical I~lati~ ~Vinyl Wr~ ~Tar or ~lt ~U~o~ ~None ~er (~ri~): c. U~ergro~ Pipit, Seco~ary Contai~nt: ~l~all ~~etfc ~ner ~st~ ~ ~o~ ~Other {de~rt~):