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HomeMy WebLinkAboutUNDERGROUND TANK FILE #1 Hazardous Materials/Hazardous Waste Unified Permit . CONDITIONS OF PERMIT ON REVERSE.SIDE This permit is issued for the followina_: ~ Hazardous Materials Plan [3 Underground Storage of HazardoUs Materials Permit ID #:: 015-000-001146 - i3 Risk Management Program E) Hazardous Waste On-Site Treatment MR FAST LOCATION: 600 BRUNDAGE LN 'IELD :?,:. * ..... CAP~C !TY.: ;~..*'~, DISPENSER'P~SMONITORING TANK 015-000-001146-0002 GASOLINE ,... ~ ......... :%;;:~i~00 DIS'P i P~N'~SENSOR W/~.~OS: SHUTOFF. '~:' .... '.'~" 4 "~ '..~* .. ~.~ ~ ,. ,- .%.. '~** ?~' ;. ,~ ~. x . * .-,-~ ,~' ,,:*:-' · , ~ , OFFICE OF EN~R ONMENTAL SER VICES  1715 Chester Ave., 3rd Floor ' approveooy: Bakersfield, CA 9330~ · o~o~,~s~ Voice (661) 326-3~7~, F~ (661) 326-0576 Expiation Date: Permit to Operative Hazardous Materials/Hazardous Waste Unified Permit CON'DITIONS OF PERMIT ON REVERSE SIDE ~-::::.:~::~ '=' ~:~. ~T~i~;~ ~-~TE~ MO~iT~R':?ONITOR TYPE TYPE METHOD 0 0006 GASOLINE 5,~O:GO GAC~:;;~?. .... . .... :'-.*4; DW FCS .¢? CLM¢~'~'.,:.~? DW F PRESSURE ALD  B~ersfield Fire Depa~ment Approv~ by: O~ICE OF E~R O~AL S~ ~CE$ 2~ 1715 Chewer Ave., 3rd Floor e of~~ B~e~fiel~ CA 9~01 Voice (805) ~2~979 F~ (80S)~6-0S76 ExpkationDate: ~n~ ~O~ ~OO0 City of Bakersfield Office of Environmental Services 171 $ Chester Ave., Suite 300 Bakersfield, California 93301 (805) 326-3979 An upgrade compliance certificate has been issued in connection with the operating permit for the facility indicated below. The certificate number on this facsimile matches the number on the certificate displayed at the facility. Instructions to the issuing agency: Use the space below to enter the following information inthe format of your choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility; facility identification number (from Form A); name of issuing agency; and date of issue. Other identifying information may be added as deemed necessary by the local agency. This permit is issued on this 2nd day of November, 1998 to: MR FAST Permit #015-021-001146 600 Brundage Ln Bakersfield, California 93304 , .~,.,~ .,~ ?~?.~.~?~ ~:~% AKERSFIELD ~: FIRE~'.DEPARTMENT : '. - ~,~ · ..... . BUREAU OF FIRE',PREVENTION~ PPLICATION In* c0nfOrmi~with- provisiOns-of ~rtinent ~ordinon ces~ to disploy, store, instoll,' u~, o~rote; ~11 or hondle moteriOls'or diti~s *~e~ hozor~us to life or pro~ os follows: ~r~, ...~[ .... ~! ........ ~ ........ X.~... , '~' ..' ~",:,.. . :-', .~ ' / '- '. '.: '..'. :', *'-' ..' ,'APPLI~TIOH . .., * - ~.."':',: :.I ~on ~ J~ Prov *':.~i en rdi~ S, . n. foci w isions o n i '.0 a~ce c~es a r regal fi ,~ i ~iS : ' .:: .,.:.; by:.~ .-. '...-~- . ... ~. :..'~ ,..~ . .'..:~' ,-.... : . .. _-:.'~..,.::.-;. ,'..:: .... -~.:__-.~:~.:. ~..-?~-.~ .:.-. :.--: ,../.'..' -'. ' to displ~,' sto~; in,oil, 'u~, o~ote, sell orh~ndle materials .or:.pr~es~s i~vol~ing Or crating ~-. ",.,. ditions deem~d-.hazar~us fo life or pro~as .follows: Permit denied ,~I1~11 ~..~. .A~'~.~unt~Number ACCOUNTS RECEIVABLE ADJUSTMENT March 1, 1995 Date New Account New Addreu Esther Duren Cloee Account From Service Change Other Adjustments X Fire Department - Hazardous Materials Division Department/Division MR. FAST SERVICE STATION Billing Name 600 BRUNDAGE LN. Billing Address Site Address Parcel # (if Applicable) Landlord Name & Address (If Applicable) ADJUSTMENT last Billed Correct Billing Adjustment to Effective Date of Billing Change 356.50 0 < 356.50 · 02-15-95 J~pro)/ed ~ Remarks: PER RALPH HUEY PLEASE DELETE THESE CHARGES AS THEY WERE CAUSED BY AN UNAUTHORIZED WORK PLAN. ',?~'r~'E~URN pAyMENTS ~TO ~ . · ' '.' i' , ~,' ' ' ' , PLEASE MAKE CHECKS pAyABLE TO: CITY OF B/~KERSFIELD ,c; T ~ .... ~-- ~ .; .... ~'~'~,'~ '~4Al~;~ !ALSD]':'~v~ S[~N' ~ ;' .' . P.O; .BqX'20S7. CITY OF, BAKERSFIELD.., BAKERSFIELD, CA,93303~2057 AcCOUN NO. ,~ ,~)~0 0 ~5 9 ':~ ''~ ~ ..... , . .' ~ , . ' .%,;, :' ' ".'"' ~',~ ~", ," -', : : ' " : ' 7 '' ' ~ng C~g ~'~a.~:~ g~t~5t~ 'TOTAL a9~ Og~.' ,, ~' ILL · -. , ,.: ,~, ., .' ~ ! , . . ~,-. . ' .... .~, . .: -..... .... "- .5.' ' ' ' ' ' ' 'f4 ' I~VOICE NUMBER ' . .' '... ,. ' ' i.~ '.~ :','~ .,'.-', .... " COP "~iPRINTED ON REGENEsIS ~ POST CONSUMER RECYCLED P~PER' CUsTo U E R· Y' , -' - ~ . ..... · . .L...i. .., .. .... ,. . ;. . , . ,. ~"I~'. FAST ,S 0 E'~ E: R U r.i L':, A G E L A i"t E BRi-(ERSFIE!-O, CA 93304 .:,i ~r.. ~- ... ....... ,:, / -';, ~ .' '? CA 61 ¢i i ~.: .... i '" c:,',~ RE F'L"..RT 8 ;'";/4 / 2','] ~'~ £'~ i ('~: ,-17 PRE SUMP ',q,,... I- ,q.':, T 689 BRUNO~GELP, i'~E; E',AKERSFiELO, CA 95394" '. SITE ~ 00001 ',:',....' 2 ~..,' 2009 I ';_'~: 48 ,qLA Rr'1 REPORT ,,S/24/2000 18:48 .Rt'I A~.!ULAR October 23, 2003 Mr. Ki Chu Yi Mr. Fast Liquors 600 Brundage Lane Bakersfield, CA 93304 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES REMOVAL OF 2 UNDERGROUND HAZARDOUS SUBSTANCE 2101 "H" Slreet Bake,s,eld. C^ 93301 STORAGE TANKS LOCATED AT 600 BRUNDAGE LANE VOICE (661) 326-3941 FAX (661) 395-1349 PERMIT # BR-0299 SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 Dear Mr. Yi: VOICE (661.) 326-3941 FAX (661) 395-1349 This is to inform you that this department has reviewed the PREVENTION SERVICES results 'for the preliminary assessment associated with the February FIRE SAFETY SERVICES · ENVlRONMENTN. SERVtCES 1715 Chester Ave. 18, 2003 removal of the tanks lobated at .the above stated address. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX(661)326-0576 Based upon the information submitted, this office is satisfied .with the tank removal performed and requires .no further action at PUBLIC EDUCATION 1715ChesterAv~. this time. An environmental clean-up is on-going from a previous Bakers,eld, C^9~l fuel release. Clean-up oversight is being conducted through the VOICE (661)326-3696 FAX (661) 326-0576 Central ValleY Regional Water Quality Control Board. This letter does not pertain to the status of that clean-up. This documents that FIRE INVESTIGATION 1715 Chester Ave. all fuel tanks were removed from the site on February 18, 2003. Bakersfield, CA 93301 VOICE (661) 326-3951 F^X(661)326-O576 If yOU have any questions regarding this matter, please contact me at (661) 326-3979. TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 Since rely, VOICE (661)399-4697 FAX (661)399-5763 RALPH E. HUEY, Director of prevention Services Howard H. Wines, Ill Hazardous Matedals Specialist Registered Geologist No. 7239 Office of Environmental Services cc: J. Whiting, RWQCB S:\USTFORMS~UST.L1 California Regional water Quality Control Board ' ~" Central Valley Region.. .. ,' ....' WinSton H. Hicl~0x ~' ' :~' ;"· . ~ .R°bert Schneifier, Chair." - .. ::, Gray D?is Secreta~. .tbr · : ' . ~resn0'Branch Office ...... . ~ ' ' Governor Enviromnental . ,. Internet Addi'es's: http://www.swrcb.ca.gov/~rwqcbS' . =' · , ' ".. . Protection ¢' - 1685 E,Street, Fresnol california 93706:2020 ~. · z . ' ·: ' · ' ... ; Phone (559) 445-5116 o'FAX.(559) 445-5910 . ' 26 August 20,03, ' ,~.- .~ ': RWQCB. Case No. 5T150006i9 .: '. . '.~'. . ~.' %, ! ' Mr. Ki Chu Yi' Mr. Fast: service Station ' . ~, 600 Brundage Lane .' ....... UNDERGROUND STORAGE TANK RELEASE, MR.. FAST SERVICE STA TION~ 600 BRUNDAGE LANE, BAKERSFIELD, KERN COUNTY ;;· ' ' You submitted Installation. of Additional Offsite Rkmediation Sys~e. m 'Elements, First Quarter 200~ ~G-roundwater Monitoring Repo.rt and Remedial Status Report (Repoi-t) dated' 31. July 2003 and prepared by E2C Remediation, LLC, Bakersfield (E2C). The Report summai'izes, the results of the first quarter. 2003 groundwater monitoring event conducted on~ 24 F~bruary. 20031 andthe Progress' of on-site and off- ,site remediation SYstem installation or operati6n during the .first ~tUar[er 2003..We re.quest that quarterly groundwater monitoring continue. ~We concur that the on-site remedia~ion system gh0uld be shut down: We approve the installation and Startup of the revised Off-site remediati'0n system and request that you. contact us with a performance evaluation after one month~0f operation. :We previously req.uested that you submit a work plan to investigate impacted groundwater south of the State High,way 58 right-of-. way. We now request that you submit a work plan addendum for the installatibh:of ~ network of deeper monitoring wells within the exiSting monitoring network in addition to the "sentinel'? Well"gouth' of the Highway 58 right-of-way. Groundwater purging events' should be· O'sed to inveStigate the presence of "" floating product: We request that you Submit a'lett,er proposing purging-investigation techniques. A summary of the Report and our comments' folloW. · ,, , · · ' '.,.. ' Summary of the Report. ' First Quarter'2003 Groundwater Monitoring ' ', E2C conducted the fii:st quarter 2003. groundwater .m0nito'ring event at the site on 24 and-25 Fel~ruary 2003. Monitoring wells MW-15D, MW-16, and MW-17D were' dry:, Monitoring .~ell MW~I i has bee'n taken out of service and has been re~'laced by MW-1 IR:.' DePth-to-Water in shallow!monitoring weiis MW~ 1 through Mw-'12 ranged from 43.16 to 46.48 feet below, the . i ., ~ top of the cas~ng~s (below` TOC). Depth-.to-water in Shallow well MW~ 13 and nearby dee~ monitoring. ~eil'MW- 14 ~as 56.40. and 69.72 feet below TOC, respectively. D~Pth-to-water in downgradient shallow wells MW;'15S and MW-17S was measured at 71.92 and 60.50 feet below TOC, respectiyely. Depth.-to-water in ~teep Well MW-18, Califo ni E i On~ ntal,:Pr°'teeti Ag ' ~ ~' r a; nv r e on ency ' ~, .. ~' Recycled Pa/~er .' -'' ' ' ~ . ! ~ The energ~ ~ha'llenge facing Cal{fornid is real· Evm3, ~alifo~-nian needs.to thk~ immediate action to rednce energy consumpnon. For a list of simple ways:. you carl reduce demand and cut your energy c6sts, see our Web-site at http://www.sw,'cb.ca.gov/rwqcb5. . ~ Mr. Ki Chuy Yi - 2 - ~. 26 August 2903 which draws water from a deeper zone, was 115.09 feet below TOC. Groundwater elevation decreased .an average of 1.97 feet compared to the 5 December 2002 mbnit°ring event. Groundwater elevation in off-site wells decreased by an average 6f 2.44 feet. MW-15S w~s dry during the First Quarter 2002 monitoring event, but has contained water during subsequent events. MW-15D, MW-16, and MW-17D have been dry during the last six monitoring events. The water table slope, was calculated to be toward the south-southeast with a water table slope of 0.039 feet per foot from the site to off-site well MW-13 and at a steeper slope of 0.14 feet per foot from MW-13 to MW-15S in Fig Street. Groundwater samples collected from the wells Were analyzed for TPH-g by EPA Method 8015M, and BTEX, MTBE, tertiary butyl alcohol (TBA), di-isopropyl ether (DIPE), ethyl tertiary butyl ether was not discovered in the monitoring wells during the 24 February 2003 or 5 December 2002 events. TPH-g was not detected in MW-2 through MW-5, MW-9, and MW-17S and MW-18. TPH-g was detected at concentrations from 912 to 48,500 micrograms per liter (gg/L). The highest concentrations were detected in MW-11R (48,500 gg/L), MW-1 (15,600 ~tg/L), MW-8'(14,900 gg/L), and MW-~2 (11,700 gg/L). Benzene was detected at 1,200 and 24.8 gg/L from MW-13 and MW-14, respecti'eely, but was .not detected in wells upgradient or downgradient. Toluene, ethylbenzene, and xylenes were detected'in MW-7 and MW-11R through MW-14'. MTBE, TBA, DIPE, ETBE, and TAME were not detected. TBA was detected in one samPle. during the Second and Third Quarters of.2002 monitoring events at Concentrations up.to 500 gg/L. ' ... E2C concludes that groundwater is discharging from the perched water zone, based on the decreased groundwater elevation during the 24 February monitoring event. Groundwater elevation appears to be influenced by the. recharge from the unlined canal west of the site. Groundwater flow in the downgradient portion of the plume appears to be laterally discontinuous. TPH-g concentrations decreased this quarter, possibly due to declining groundWater elevation.. Hydrocarbon concentrations have generally decreased on-site, due to remediation system operation, but remain high off-site. E2.C--r¢¢ommends~.hat-quartefly.-gro undwater-monitorin-g-continu e~ On-Site Remediation System Operation The on-site soil vapor extraction (SVE) and air sParging (AS5 r~mediati0n system began operation On 10 April 2002. Influent concentrations rapidly decreased..The SVE and AS began intermittent ("cycled")' operation during May 2002. During the first quarter 2003, the systemwas "cycled" by operating one week per month. The SVE and AS system has ~been shut down since 3, April 2003, when E2C determined that operation was no longer economically .feasible. The system has removed apprOximately 2,000 pounds of hydrocarbons since startup. -.. " Off-Site Remediation System Operation . . The off-site SVE and AS remediation system began operation on.28 February 2003. During early March 2003, E;.C determined that operation of the thermal oxidizer was no longer economic based on removal V:\UGT~Prqjects\JDW_files\2003 Correspondence\City of Bakersfield Cases\MrFast GW-SVE2 8-03.doc Mr. Ki.Chuy Yi ....., - 3 - :26 Aug~gt 2003 .' rate: ',The sys~tem was shutdown.and remOved from the kite.. E2C installed afld tested an electric catalyti&,:: .. oxidizer ~(ECAT).o..n 9 April .2003. E2C determined that this more ehergy-efficien~ un'it was also not . e~dnomic since in fluent concentrations-of less than 100 p~ts per-million b7 volUme (.ppmv) were measured. The ECAT was removed from the site. E2C concludes that effluent vap0r'de~truction'omsite or',{3ff-site'is notecohomical t~sing a thermal or-, cata!ytic oxidizer. E2C plans to continue hydrOcarbon rer~oval and oxygenation 0.n-:siteli~ging tlae'AS''- system.. Hydrocarbons removed'from on-site and off, site by the AS .sys'fem will be captured bY the' off- site system. E2C will convert the c;ff-site system for effluen{ treatment by.granular activated'carbon (GAC).. E2C has submitted an amendment request to the San J0aquin Valley Air Pollution Control DiStrict (SJUAPCD) for conversion to GAC. ; We concur with E2C that quarterly gr0u.ndwater'monitoring ~hould continue. G~oundwater.'samples:" should be analyzed for TPH-g by EPA Method 8015M and BTEX by EP& Method 802 lB or 8260. GroundWater monitoring events may also be used to document payment milestones for.the Petroleum Underground Storage Tank Cleanup Fund's (Fund's) Pay for Performance pilot program. The low influent concentrations noted during the short operation of (he off-site SVE and AS remediation system perplexes us since the greatest hydrocarbon weight,Was believed to have migrated off-site as floating product. E2C receptly stated that the off-site systerfi wits actually .ope'rated for at least one month with high removal rates that ,maY indicate significant hydrocarbon removal. System: operating and inspection records were not made a-Tailable when the Report'was prepared. E2C suggests 'that theJew cumulative removal weight du[!pg the last week of February and first Week of March '2003 may actually relate to the brief operation 9f the ECAT system'. E2C.will review the available records, prepare ,an updated summary of system operatidns, and provide a written rekponse concerning this, issue. We request ~hat these items be provided by 26 September 2003. Floating preduct hag been nearly absent during the~last Several monitohng events and may have migrated. laterally from the monitoring network or m,onitoring points. We are also concerned that floating product .......... _:.:a.~nd dissolved concentrations of. pe.t.r, oleum .constitu. ¢nts may. havre ~igrate.d .vertically:,fromdaterally_ discontinuous perched zoiie.~ toward the regional water table at approximately_200 feet below ground surface (bgs). Variations in groundwater elevation, flow direction, watertable slope, andmonitoring , 'well production observed during off-site during monitoring events suggest t,l~at these discontinuities maY., exist. Impacted groundwater appears .to be flOwing beneath the State Highway 58 right-bf-w.ay toward a' mu i~ipal well a proximately 1,000 feet 'fUrther to the south. We' consider it n~ce.ssarY to further investigate potential contaminant fl0w pathways beneath the~pr, esent shallow monitoring network. By.our letter dated 18.October'2002, we requested that additional · - investigation be conducted' to define the lateral and vertical extent of impacted groundwater south of " State Highway 58. We now request that you submit awork plan addendum to instit, ll a deep monitoring network beneath the presen{,shallow network. 'At least four deep monitori.ng ~e!!s screened tO determine the vertical extent of impact, ed groundwater along the,lengtl-/' Of {he knoWn.plume and a sentinel-well south of State Highway 58 should be prop0Sed~· Submit the'work plan. addendum by 30 October'2003. :" ' ' . . ';. V:\UGTXProjectkXJDW filesk2003.C0rfesponddnce\city of B~kersf~ld C&es\MrFast'Gw~gk)E2 8-03.doc Mr. Ki Chuy Yi. - 4 ~ 26 August 2003 We understand that E2C removed impacted groundwater from off-site monitoring wells using a vacuum truck during the Second Qum'ter 2003 and will include results in their next submission. E2C also has indicated that they plan to continue these events. We request that E2C use these events to indicate whether floating product is present at or beneath the current water table in the 'area of the pumped wells. Floating product volume and high dissolved concentrations should be estimated, using a translucent holding tank or other method prior to rem. o~al from the site. -Groundwater sample analysis may be · appropriate. Depth-to-water should be measured in nearby monitoring wells during the events. Submit a brief letter proposing methods of investigation by 26 September 2003 or at least one ·week prior to the ' next event. Please contact me at least one week before the next event: We concur with E2C that on-site SVE operation cease and,that on-site AS operation continue concurrent with off-site system operation. We approve operation of the. revised off-site system using GAC for provide a performance evaluation and submit appropriate"da~a. Please contact tl~is office at least five days in advance of any fieldwork. Should you have any questions regarding this matter, please contact me at (559) 445-5504. JOHN D. WHITING Engineering Geologist '" R.G. No. 5951 cc: Ms. Barbara Rempel, SWRCB, UST Cleanup Fund, Sacr. amerito..,,,,. ' ::. Mr. Howard Wines, City of Bakersfield Fire Department, Bakersfieli~x,~ Mr. Philip Goalwin, E2C Remediation, LLC, Bakersfield File:UST/Kern/Minit Stop Market/2900 Union Avenue, Bakersfield/5T15000619 V:\UGTXProjectsUDW_files\2003 Con'espondence\City of Bakersfield Cases\MrFast GW-SVE2 8-03.doc , August 26, 2003 John Whiting Associate Engineering Geologist California Regional Water Quality Control Board Central Valley Region 3614 Ashlan Avenue Fresn°, CA 93726 RE: Addendum to First Quarter 2003 Remedial Status Report Mr. Fast Service Station 600 Brundage Lane Bakersfield, CalifOrnia Dear Mr. Whiting: IntrOduction E2C Remediation (E2C) presents this addendum to the First Quarter 2003 'Remedial Status Report for Mr. Fast Service Station, 600 Brundage Lane, Bakersfield, California. The information submitted in this letter replaces Section 4.2.5 of Installation of Additional Offsite Remediation System Elements, First Quarter 2003 Groundwater Monitoring Report.and Remedial Status RepOrt by E2C dated July 31, 2003. Remediation system monitoring data from several field data sheets beginning with startup of the offsite remediation system on January 29, 2003 were inadvertently not included with the previously submitted report. Table 7, Summary of Offsite VE/GASS Monitoring Data, has been revised to reflect monitoring data collected during the first month of system operation and is attached to this letter. Revision to Section 4.2.5 - Evaluation of Offsite Remedial Efficiency .The offsite remediation system began operation on January 29, 2003. System monitoring data collected during the first month of operation indicated high 'field influent readings ranging from 4,320 to 11,850 parts per million volume (ppmv) as measured with a photoionization detector (PID). System influent readings decreased to approximately 200 ppmv after one month of operation. Approximately 17,870 pounds of hydrocarbons were removed from the subsurface from system startup through March 6, 2003. Revised remediation system monitoring data are presented in Table 7 as an attachment to this letter. 'The declining trend in influent concentrations is .typical of startup conditions where removal rates are greatest as separate phase hydrocarbon vapors present in the.soil matrix and hydrocarbons liberated from high concentration groundwater through air sparging are initially extracted from Environmental Engineering Consulting & Remediation, Inc. dba E2C Remediation 5.300 Woodmere Drive, Suite105, Bakersfield, CA 93313 p: 661.831.6906 t: 66t .831.6234' Project Number 1801BK04 Auo_ust 26. 2003 the' subsurface. Influent concentrations tend todecline as vapor extraction begins drying the soil matrix and sUbsequently extracts hydrocarbons entrained in the soil moisture and adsorbed onto·soil particles. The rate of hydrocarbon liberation from the groundwater due to air sparging also slows as groundwater hydrocarbon concentrations decrease. By March 6, 2003, it was readily apparent that continued operatiOn of 'the thermal machine would be economically unviable as the ratio of supplemental propane fuel plus electricity (for the machine) to the hydrocarbon mass removed was extremely diSproportionate with only a maximum of 36.5 pounds of hydrocarbons removed for the one-week period from .February 28 to March 6, 2003. As such, the machine was shut down and the machine was demobilized. An electrical oxidizer ECAT 300 was mobilized to the Site on April 9, 2003 to evaluate its potential effectiveness. After a short period of operation (less than one day) it was found that the influent concentratiion was Iow (<85 ppmv) and that, as with the thermal unit, the ratio of electrical cost per maSs removed would also be extremely disproportionate. The ECAT was therefore shut down and demobilized from the Site. Revised Conclusion Based on the information presented above, E2C revises thefifteenth (15th) bulleted conclu, sion in the previouslY submitted report. The conclusion is revised as follows, "Based .on the week of offsite remedial system operation from February 28 to MarCh 6, 2003 where approximately 36 pounds of hydrocarbons were removed, it was apparent that operation of this machine was economically unviable due to a disproportionate ratio of fuel costs to mass of hydrocarbons removed." If you have any questions regarding this letter, please do not hesitate to call Mark Clardy or Phil Goalwin at (661) 831-6906. ReSpectfully Submitted, E2C Remediation, LLC Mark W. Clardy, .R.G #7(~55"~ / / Attachment: VE/GASS Data Table 7 - Sum~te Monitoring cc: Mr. & Mrs. Ki Chu Yi, Mr. Fast Service Station Howard Wines, City of Bakersfield Fire Department Bob Trommer, State UST Fund E2C, Inc. 2 Project Number 1801BK03 August 26, 2003 TABLE 7 SUMMARY OF OFFSITE VF. JGASS MONITORING DATA Mr. Fast Service Station 600 Brundage Lane Bakersfield; California · Cumulative CumulativeInlet Well Well Well Well Well Well Dilution Field Field Cumulative CumulativeCumulative Date Calendar Operating Operating Flow Chamber Stack YE-6 YE-7 VE-8 VE-9 MW-11 MW-12 Air TPHin TPHout LbsJHr~Lbs. Lbs. Gallons Monitored Days Hours Hours (scfm)% LEL Temp. (°F) Temp~ (°F) valve valve valve valve valve valve valve (ppmv) (ppmv) Extracted ExtractedDestroyed Extracted 1/29/03 0 1863 0 215 6.2 1623 1469 3/40 C O O O O O 11850 45 34.6 0.0 0.0 0.0 1/31/03 2 19il 49.5- 216 2.2 151'1 "14.55" ~3~4'0 'C O' 0 5 '5 ' '5 1030~" 40 ' 3~)~ -1'497.4 1491.6 23~'1' ' 2/6/03 8 200~' 145:5 215 2.3 1-515 '- ;1~8 ' 3/40 C C~ ' 5 -0 ' '0 O. 9750' 40 '- 2-8:~" '56~:4.5 5621.7 878,4 2/20/03' 22 2~8'~ ':~22.5 215 2.2 1~ .... ~-4~)---3/4'5' C 0 O '0-~ '~' (~- 43~ .... 15 ' -1~,'6-' '~655~'.3 16~03.4 257~.7" Notes: scfm = standard cubic feet per minute LEL = Lower Explosive Limit ppmv = parts per million volume Lbs./Hr. = pounds per hour O = Valve Open C = Valve Closed " 3/40 = Valve Open 314 ' E2C Reme~diation Table 7- I GOLDEN STA~TE METALS, INC. DISPOSAL FORM P.O. Box70158 · 2000E. BrundageLane Date "~._//~/(~3 ,19 Bakersfield, California 93387 Phone (805) 327-3559 · Fax (805) 327-5749 Contractor's Scrap Metals, Pro~ssing & Recycling License No. Contractor's Phone No. ADDRESS: DESTINA~ON: G.S.M. · 2000 E. BRUNDAGE LANE · BAKERSFIELD, CA 93387 LICENSE NO: WEIGHT CERT' NO: ~7~q~/ ~TE~G/ ' ' ' TOTAL EHSD PERMIT NO: QTY GALLONS SERIAL NO. NET TONS 250 .14 550 .24 1000 - 6 fl .61 2000 .97 ~ RESIDUALS PRESENT (REJECT) 3000 ~.32 ~.LEL READING 5000 2.42 OXYGEN CONTENT , oo......................................................... ...................... 9000 3,82  12000 4.93 . TOTAL AIl fees incurred are per Icad unless specified. Terms are not 30 da~ from r,e~ipt o[ tank. Contractor's ~i~natur, r~pr~s,nt~ aee~ptan~ oft~rm~ [or palm,hr, and eonfirm~ that tank removal complies with State laws. THIS IS TO CERTIF~E'RECEIPT AND ACCEPTANCE OF THE TANK(S) AS SPECIFIED ABOVE, ALL MATERIAL SPECIFIED WILL BE COMPLETELY DES~ FO~~ECYCLING PURPOSES ONLY' - ~ DATE WHITE-- ~on~actor Copy · YE~LOW-- Rle copy · PINK-- ~rma~nt Copy '"~'~'~~'~,,~.....~, ,~,. . CITY OF BAKERSFIELI ,~~]~ OF ENVIRONMENTAL ~~~r. 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 HNDERGROHND STOOGE IA~K8 GLOSHRE GERIIFIGATION Page __ of __ I. FACILITY IDENTIFICATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 '} PERMIT # . I'" I TANK OWNER NAME 740 TANK'OWNERADDRESS - 741 TANK ~WNER CITY ' 742 [ STATE '/43 ZIP CODE ?44 .. .... ~ ......... (Attach actditionatTankcopiesID # of this page ..... Co"n-~ h~a ti o'fl 6f Fl~m-abl~-QAP~r Concentration of Oxygen for moro than three tanks.) Top Center Bottom Top Center Bottom 745 746a 746b 746c 747a 747b 747c ATMOSPHERE !& ~ $~1,4 4-tX~ II-- 748 749a 749b 749c ] 750a 750b 750c READINGS 2. , 751 752a 752b 752c , 753a' 753b 753c 3 [ , On examination of the tank, I certify the tank is visually free from product, sludge, scale (thin, flaky residual of tank contents), rinseate and debris. I further certify tha/t?e information provided herein is true and accurate to the best of my knowledge. S GNAT .¢_.E._ OF . STAT S OR AFF .AT ON OF CERTiFY, Ne .ERSON NA'CJ~ (~F '~ER'I"'rFI'~F((P~nO - '-"" 754 V~ Yes [] .No ~ d dC__ d Name of-OUPA, authorized agenc~;gr UA: , ~ {,... ~'~ _ [' ~1~'~ ~1 City of Bakersfield Fire Dephrtment - Office of Environmental Services TITLE OF CERTIFIER 755 · .g,.-.~ ~..J/t ~¢ ~,"~'O Y"- If certifier is other than CUPA / LIA check appropriate box below: 762 ADDRESS ~ [] a'. Certified Industrial Hygienist (CIH) '- .... - 1715 Chester Ave.- .......... z56~ ...... D. b;- Certified _S_afe__~.P_rofessional (CSP.-) ...... CITY [] c. Certified Marine Chemist (CMC) Bakersfield, CA 93301 7s7 [] d. Registered Environmental Health Specialist (REHS) PHONE [] e. Professional Engineer (PE) (661) 326-3979 75~ [] f. Class II Registered Environmental Assessor DATE 759 I CERTIFICATION TIME [] g. Contractors' State License Board licensed contractor (with ___ _t~. -- tg * (~ 3 ] '~0'-{q 0 [ri4. hazardous substance removal certification) TANK PREVIOUSLY HELD FLAMMABLE OR COMBUSTIBLE MATERIALS [] Yes .E]d? 763 (If yes, the tank interior atmosphere shall be re-checked with a combustible gas indicator prior to work being conducted on the tank.) 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 CUPA. If there is no CUPA, copies shall be submitted to the LIA and authorized agency; owner / operator Of the tgnk system; removal contractor; and the recycling / disposal facility. 'UPCF (7~99) S:\CU PAFORMS\dtsc1249.doc p1010001 .jpg (1280x960x24b jpeg)' p1010002.jpg (1280x960x24b jpeg) p 1010003.jpg (1280x960x24b jpeg) p1010004.jpg(1280x960x24bjpeg)' p1010005.jpg (1280X960x24b jpeg) 1715 CheaCe~ Ave., 8a~ecs~leld, C~ ~3301 "'-- (805) 326-3979 ?MIK R,,~OV~., ZN~PEC~Z~FORM O~R ~ ~ PE~IT ~ OPE~ CO~~R ~P ~Ot~n~ CO~A~ PE~ON · P~L~~Y ~SSE~S~ ~0. ~f CO~ACT PERSON PLOT P~ I I CONDZTZON or TANKS O~dGc. 5 Ucc,, ~nn/ ! CONDITION OF, SOIL FEB !1 2003 12:20 BKSFLD FIRE PREVEM'TIOM (661)852-2172 p,2 CITY OF BAKERSFIELD '-~_ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., BakerSfield,'CA (661) 326-3979 e ,RmT AemcA oN REMOVAL OF AN UNDERGROUND' STORAGE TANK ~FI'E INFORMATION FACILITY NAME I'~'"~,T' CROSS STREET "[' 5~'~'~-~-~ TANK OWNER/OPERATOR Mr- ,~i Pk~'~ ~,; ' . P}IO. NEN0. ~)[ ~ ~Oc-'Z-e~.t.~'' PR~),~Y ~SSESSM~T.~FO~ON ,, ) ~. , ~Ot ~ ~ ~~ CO~P~ g~t~t~A~~ ~HO~NO.~-~7~~SENO.~ t - )~ ~~ ~o~nos ~D~SS t~o ~. ~ ~ c~ ~~e~h ;~ FACILI~IDE~ICA~ON~B~ C~ &~~t ~ '' CO~A~ ~ ~ . [ ~ ~) ~ PHO~ NO. LICENSE NO. ~D~SS ~ ,~+~ C~~~'~__ ZIP T~ ~ICAL DATES CHE~CAL T~ NO. AGE VOL~ STOOD STO~ . ~ P~OUSLY STOOD For Official Use Only , THE ~PLIC~T ~S ~CEIVED, ~E~T~DS, ~ WILL CO~LY WITH T~ A~AC~ ~NDITIONS OF THIS PE~IT ~D ~ ~HER STA~, L~ ~D FED~ ~G~AT IONS. · Complete items 1; 2, and~ A. Signature item 4 if Restricted Delivery is desired. X ~~'~am [] Ao~ent · .Print your name and address on the reverse . ~ [] Addressee so that we can return the card to you. ~'~ · Attach this card to the back of the mai!Piece, B. Received e) 1r- ate D~O~' or on the front if space permits. ~ ~'~(~'-- ~ ~-- ' 1'. Article Addressed to: D. Is deiivery address different from item1? [] Yes · if YES,'enter delivery address below: [] No MR KI C]~[I YI MR FAST SERVICE STATION 600 BRUNDAGE LN BAKERSFIELD CA 93304 3. Service Type r3[certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. _. 4. Restricted Delivery? (Extra Fee) [] Yes 70-02 2410 0002 1974 9107 PS_Form 3811, August 2001 Domestic Returr~ Receipt 2ACpRI-03-Z-0985 ~ ~ Postage & Fees USPS Permit No. G-lO · Sender: Please pdnt your name, address, and ZIP+4 in this box · BAKEI~SFIELD FIRE DE,PART~,~ENT OFFICE OF ENV!RO~,J,~Eh~TAL SERVICES 1715 Chester Avenue, Sui,;;e 300 Bakersfield, CA 93301 Po~tage $ nj ' ~ ~erllfied Fee Return Reciept Fee Postmark , F-1 (Endorsement Required) HEre I-'1 Restricted Delivery Fee r~ (Endorsement Required) r'L/ Total Postage & Fees February 5, 2003 Mr. Ki Chu Yi Mr. Fast Service Station 600 Brundage Lane Bakersfield, CA 93304 FiRE CHIEF RON FRAZE CERTIFIED MAIL ADMINISTRATIVE SERVICES 2101 "H" Street RE: Failure to Properly Close (Remove) Underground Storage Bakersfield, CA 93301 . VOICE (661) 326-3941 Tanks Located at 600 Brundage Lane FAX (661) 395-1349 NOTICE OF VIOLATON & SUPPRESSION SERVICES 2101 "H' street SCHEDULE FOR.COMPLIANCE Bakersfield, CA 93301 VOICE (661) 326-3941 . FAX (661) 395.1349 Dear Mr. Yi: PREVENTION SERVICES Our records indicate that you have ceased fuel operations as of FIRE SAFETY SERVICES · ENVIRONMENTAL SERVICES 1715 ChesterAvo. September 21, 2002. You are currently in violation of Section Bakersfield, CA 93301 7902.1.7.2.2 of the Uniform Fire Code (97 Edition). VOICE (661) 326-3979 FAX (661) 326-0576 "Out of Service 90 days. Underground tanks not used for a Period of 90 PUBLIC EDUCATION days shall be safeguarded or removed." 1715 Chester Avb. Bakersfield, CA 93301 VOICE (661)326-3696 Your 90 days were.up on December 21, 2002. This office has extended FAX (~1) 32~576 yOU every courtesy with regard to find a contractor. Howeverd you are FIRE INVESTIGATION now six weeks past the 90 days as code' states. 1715 Chester Ave. Bakersfield, CA 93301 Therefore~ prior to March IT 20031 you shall properly close (remove) ' 'VOICE (601) 326-3951 FAX (661) 326-0576 the tanks at the above mentioned address. Failure to comply will result in further enforcement action. TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 Should you have any further questions, please feel free to call me at 661- VOICE (661) 399-4697 326-3190. FAX (661) 399,5763 Sincerely, Ralph E. Huey Director~evention Services .~' Steve Undewood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services September 31, 2002 To: Bakersfield ~r~'d¢ ~0~ ©1~- c~o ~-~ oOIt ~+g Fire Department We are planning to close the gas station due to our inconvenience. The following reasons explain our decision for closing_the gas station: 1) The price of gasoline is spontaneous. At times the wholesale price for gasoline is ~o. _re. e~pe~s!ve t)~ t)e~ ret_~a!! p~c.e at 0t~?_r ~aj?? g~a,so. !!~e .stat!on.s. 2) The cost to meet all the gasoline requirements for the selling of gasoline is too muc. h~c0mpa[e~d t~ t~ m~Up_t we s~[l:~ we 0n~!y s~!!. abou..t 8.,00.0 g~l~.q .n.,s. period of two months. At this rate, it is difficult for us to pay for the permit, c,~ec~-~p~s? ~d 0t~er m~§_c~!!a_n_e0u_s te~sts.' Thank you, ~ x/ 89/38/2802 09:10 GG18737152 KERN VALLEY S S M PAGE 01 :- MONITORING SYSTEM CERTIFICATION For Use By .dH Jurisdictions Bqthln the State of California Authority Cited: Chapter 6. 7, H~alth and gafitty Code; Chapter 16, Division 3, Tttle 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A smaarate certification, or report ~nust b~ @rep_ ared for each monitoring_system control panel by the technician who performs the work. A copy of this form must b~ provided to tb.e tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A, General Information Facility Name: /~p,, /t~,g./--- Bldg. No.: SitcAddress: t~'~!;~O_ }/~r-~tnd~. ~-~¢.~_ City: ~a~/d . Facili~ Contaa Person: ~ a ~ ~ ~ ' Make/M~el of Monitoring S~em: ~~ ~ ~2~ ~te of Tostin~S~c~ng: B. lavento~ of Equipment Tested/Ce~ifi~ _ C.b.~kthe,a~oroo~at~ boxes t9 indieat~ ~pceific eqalpm~at iflapce~Oae~[ce~; I Tank ID: 7. ~..~ ~~ " Ta~iD~- ~ ~ ~o~ .~~ ~ Annular Spa~ or Vault Sensor. Model: ~-fJZ~ ~nul~S~orVault~r, M~el: ~-VZ~ .... ~ Pipi~ $ump/ Tr~ch Sensor(s). M~=l; ~/~ ~ Piping S~p / Trenoh Sear(s). Model:  iH Sump Senior(s). M~el: , ~/~ I ~ Fill S~p Send,a). Moth ~i~l Lin¢ M~ Det¢~or, Model: ~ ~5 ZD~[ ~ani~l Line ~ Deter. M~¢I: ~~ ~ El¢~onio ~n= ~k D6~or. M~el:.... I~ Elea~lc Line M~ Det~r, M~¢I: - ~ ~her {~oi~¢quipment ~ and m~l in 5e~tiofi~on pa$~2}. [ ~ ~(ap¢oi~.¢~uiPment ~ ~dm~l in Seaion ~on_pa~e'~ %nk 1D: Tank 1D: ~ h-T~k Gaugng Pmk. Model: ~ In-T~k Gaugng P~. Model: ~ Annul~ $pa~ or Vault S~nsor. Model: ~ ~ul~ gp~ ~ Vault S~aor. ~ Piping Sump / %~n~ ~n$~($). M~I: ~ Piping S~p / %~n~h 5~$). ~ Fill Sump $ensot(s). M~eh ~ HII 5~p S~sor(s). M~eh ~ Merrill Linc ~ak D~Or. M~el: ~ M~hani~ LM~ ~ak D~teot~, M~ch ~ El¢~ronlc Line ~ Dete~or. M~gl: ~ ~l~Oni¢ Line ~ Deter. ~ T~k Ove~ll / Hl~-~vel S~aor. Model: ~ T~k ~e~ll / Hi~-Lgv¢I Sg~r. M~cl: ~ Other ($p~i~ ¢~uipmcnt ~ ~d m~¢l in ge~{~ E on ~c 2~ ' ~ ~hcr (~oi~ ~quipm~nt ~ and m~,t in Semion ~ Dispenser ~ntainm~nt Sensoffs). M~eI: ~/~ ~ Dis~ns~ ~}al'nm~t $en~r(s). Model: ~She~ Valves). ~ ~ '' ' ~h~ V~v~s).ff~ ~ ' ~ Dis~nser Containment Hca~s} ~d Chain{s). ~/~ .... a Disp~na~L~m~nm~nt FloaK$) and ~ain(s). Db~{nser ID: Dispens~r ~ Dis~aa~r ContMnm~nt ~naor($). M~el: ~ Dis~nser C~mi~nt Sensors). ~ Sh¢~ Valv¢(s). ~ gh~ VMve($). ~ Dispenser ~n~nm~nt Fl~t~s) ~d Chain{s~. , , ,, ~ Dis~¢r Conmip_~t_F[oat~$) D~penser ID: ~ispeuoer ID: ~ Dispenser Con~nment ~n~r(s). Mod~l: ~ Diap~ C~mi~ent $~s~($). Mod61: ~Dis~ns~pp~m~nt H~a~s) ~d..~_~.). i ~ Dispens~ ~n~inmea Fl~tis) and *If the ~ility ~n~ins mor= t~ or digp~ns=rs, ~py this fo~. ~elude info~ion for eve~ ~k ~d dispenser at the reality. C. Ce~ifieation . I ee~lfy that the equipment identified in this d~ument ~s [~pecte~s~iced tn accordance with the manufac~rers' guidelines. Attached to thls Ce~fi~tlon is information (mS manufacture~' ~Mb~) nec~saO to veri~ that information i$ corrm a~d a Pint Plan showing the layout of monitoring ~uipment. For any ~u~menl capab{e ~ generating such ' r¢po~s, I bay, also ame~ a copy of t. ae report (check all ~ ~ply): ~ ~e~//q A~rm hls~ r~port Site Addre~: ~/~ ~ ~~t~ ~ ~ Date of W~ing/$~cing: Page I of 3 0a~l Monl~rlng System Certification 0S/30/2002 09:10 66157@?152 KERN VALLEY S S M PAGE 02 Results of Testlng/$ervlclng $o~e V~sion [ns~ll~: Corn de~ ~e foll~=~ ~es '~ No* W~e ali s~sors in~all~ at low~t poiot of ~ ~t~t ~d ~ition~ so that o~ eq~pment ~11 not ia~.~e witk~eir pro~ o~ation~ Yes ~ No* If al~s are relay~ to a r~o~ moait~ng ~tioa, ia all ~muoi~ti~s ~ulpm~t ~N/A o~ati~al9 ~ ~ ~o* For pr~s~iz~ piping syst~, d~a ~e ~b~e automati~lly ~m do~ if~e piping s~oaaa~ ~nm~m~t positive shm-do~ (Check aH that ~ly) ~8~r~ Sm~; ~ Di~ ~tainm~t Did you con~ positive shut-do~ d~ to I~s ~ ~s~ ~ii~di~oan~ion~ ~; ~ No. Yes ~ ~o' F~ tank s~ems ~a u~lize m~ moait~ing ~ ~ me ~a~ ~k °v~ll w~g device (i.e, no ~ N/A m~hauioal ov~fill prev~tioa valve ia ~s~lled), is the ov~fill warn~g ala~ visible ~d audible at ~e ta~ fill point(s) and op~ting ~op~ly~ If so, at ~at ~t of tank ~paoi~ d~s % Y~* ~No W= any monitor~g ~uipm~t repl~d~' If yes, 'id=t~ ~fic sd'so=, prom, or oth~ Y~* ~o Was llquta fo~d l~ide ~y secoa~ container ~t~a desired ~ ~ ~t~s9 {C~ck ~Y~ H No~. Was m~itor~g syst~ a~-ap r~iew~ m en~e ~.~.a~gs~ Aaach sa ~ r~ ~fappli~ble Y~ ~ Ho' Is all monitoring equipment ~atioaal per manu~'s ~ ~oa E below describe ~ and wbea these deficiendes were or ~11 ~ corr~t~. Comments: 09/30/2002 09:10 6618737152 KERN VALLEY S S M PAGE 03 F. In-Tank Gauging / SLIP, Equipment: li~Ch~:k this ~ if~ gauging is us~ ~ly for ~t~ oonuol. ~ ~ ~is ~x if no t~k gauging or SIR ~utpm~t is tnaall~. T~s ~tion man be cool,ted ~M-~ gaugMg ~pm~t is ~ to p~r~ ~ det~tion m~to~g. C~plete ~e foH~ing ~ec~st: ~ Y~ ~ No* ~s all input w~in~ ~en ~pe~ for ~oper ~ ~d t~ation, including t~ing ~ ~o~d ~ults? ..'~- ' ~ '~ W~e ali ta~-g~gM'~ ~r~b~s vi'susll~ ~!~.~ ~e ~d r~idue b~ldup? ~ Yes ~No* Was a~a~ ofsyam produ~ level r~ t~t~? ~ Y~ ~No* W~ ~acy ofsya~ ~ter I~el read~gs t~? ~ Yes ~ No~ Were all probes re~ll~ pr~erly? ~ Yes ~No* Wer~ all items on the ~uipm~t m~u~c~er's maMt~ ~eckllst ~mpleted? ........................... · Ia the ~efion ~ below, deseri~ how and when thee defleiend~ w~ or ~11 ba eorraetad. G, Line Leak Deteeto~ (LLD): ~h~k ~is ~x ifLLDs ~ n~ ~11~. )lete the ehec~ist~ ~--~S ~ NO* F;~ equipment sa~-up or ~ual eqMpm~t ~ific~({on, ~s a l~k s~Mat~ to v~i~ LLD ~ N/A (Cheek all tMt apply) $imulat~ I~ rae: ~ 3 g,p.h.; ~ 0.1 g.p.h; ~ 0~ g.p.h. ~Ym = No* Were all LLDs c~fi~ op~atl~ii';~'~';c~g ~.in r~ulato~ r~utr~t,? .......... O Y~ ~No' Was ae.t~ting app~at~ prop~ly ~librat~? ~ ~ No' For merrill LLDs, d~"i~e LLD r~ig produ~ flow if it det~ a I~? Q N/A Q Y~ Q No* For ele~r~ic LL~, does ~e ~bine am~sti~lly sba offif~e ~D ~g~ a ~N/A ~ Yes ~ No* ~or ~l~tronle LLDs, does me turbine automatically shut ~ ie~ ~ion of the monit~ing ~t~ ia dibbled ~N/A or ~ Y~ ~o* Pot ~l~on{c LLD:, do~ ~;"'~6M'¢ au~mMi~ll~ shut off if ~ p~'~ of thc monitoring ~ N/A m~mio~s or ~ila a ~ Yes ~ No* F~ el~onic ~Ds, have all a~ible ~ring ~necti0ns ~ ~lly insp~)' ~Yes ~ No* wet' all items o~ ~he';quipm~t m~ufact~'s mainm~ ~kli~ ~1~? · h the ~tion ~ ~iow, d~rl~ how and when th~ deficiencies were or ~! be ~rreete~ H. Comments: ~o ~ ~_~...~e P~3~$ ~ .~..~ ~ ~. · ..... Page 3 of 3 0a~ol C RRECTION NOTRE BAKERSFIELD FIRE DEPARTMENT N° 1 0 6 7 You are hereby recluired to ~nake the following cor~ctions at the above l~ation: Cot. No [ Completion Date for Correetion~ /0[~ C Date ~[~¢~ _~ 'r?~pect0r 326-3979 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME ./~'. ~"a.5'~ INSPECTION DATE ~" ~&"'" ~) "r. Section 2: Underground Storage Tanks Program [] Routine ~'ombined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank ~00~ Number of Tanks ~ Type of Monitoring d:/--tv',. Type of Piping ~ I~' OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit tees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations · Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S). AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance .. =Violation Y--Yes N=NO Inspector: ~ d~/~~ ---~ Office of Environmental Services (805) 326-3979 Business Site Re~"~sible Party White - Env. Svcs. Pink - Business Copy CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3r'~ Floor, Bakersfield, CA 93301 FACILITY NAME ~. ~Lt,+ INSPECTION DATE ADDRESS .(,:0_0 ~t'Ol~c~a.q~ klq PHONE NO. 3~(~'"c,~t'5''- FACILITY CONTACT' BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER oF EMPLOYEES Section 1: Business Plan and Inventory Program Routine ~ Combined ~ Joint Agency [~ Multi-Agency ~ Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand L/ . ,/ Business plan contact information 'accurate k// Visible address Correct occupancy Verification of inventory materials L,/ Verification of quantities Verification of location / Proper segregation of material ~,~ / Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: [~ Yes ~ No Explain: Questions regarding this inspection?' Please call us at (661) 326-3979 -~' Business Site esponsi e Party White - Env. Svcs. Yellow - Station Copy Pink - Business copy Inspector: ,~0S/23/2002 07:21 6618737i52 KERN VALLEY S S M ~ PAGE Bi CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 CheSter Ave., Bakersfield, ~CA (661) 326-3979. APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION FACILITY /~1/~', ,~.q,/"_ ~.-~_s__.~ ..~,_~,~ /~_.~... DO~ FAC~Y ~ D~P~$~ P~$? ~ ~ T~ ~ VOL~ C0~3 CONTrACtOrS uc~s~ # _~'FF,// , , ..... ~~ .... ~ ~ ~o~ ~~ o~ co~ ~so~~: ...... ~J ~,,,:, 0 ~ ~ [ ~PRO~ BY O~ SIONA~ OF ~p~C~ · Complete items 1, 2, and 3. Also complete Signature , [] Agent item 4 if Restricted Delivery is desired. ~( [] Addressee · Print your name and address on the reverse:~ - so that we can return the card to you. B. Received b! C. Date of Delivery · Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different 1. Article Addressed to: If YES, enter delivery address below: [] No M~.. Fast 600 Brundage Lane Bakersfield CA 93304 3. Service Type [~ Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 7002 0860 '0000 1641 6261 - PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-0835' I Postage & Fees Paid~ ,~' ' J USPS '----------- ~' "~ L Permit No. G~IO J · Sender: Please printyour name, address, and ZIP+4 in this box · BAKERSFIELD RRE DEPART~,~ENT OFFICE OF ENV~RONt~ENTA. L SERVICES · 1.715 Chester AVenue, &.~i~e 300 Bak3rsfi,~Nd, CA 93301 · ~.~ II I II ti Il il i t I I Il,II Il i i 1' C3 Postage $ Certified Fee ,_ .Return Receipt Fee Postmark [ ~ ~=no~re~ment Required) Here r:~ Restricted Delivery Fee 1~3 (Endorsement Required) FU Total Postage & Fees $ I r~ I Sent To. ~-[ MY. Fast ! ~g'~'~'~7~:~ ............................................................................. [or Po Box ~. 600 Brundage Lane [~f~'~7~'~ ..................................... ~ ...... %--~1-7~ ...... ~ ........... Bak&rsfield CA W3~O~ September 13, 2002 Mr. Fast ° 600 Bmndage Lane Bakersfield, CA 93304 CERTIFIED MAIL FIRE CHIEF RON FRAZE NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE ADMINISTRATIVE SERVICES 2101 'H' Streel Bakersfield, CA 93301 RE: Failure to Submit/Perform Annual Maintenance on Leak Detection System VOICE (661) 326-3941 FAX (661) 395-1349 Dear Underground Storage Tank Owner: SUPPRESSION SERVICES 2101 "H' Street Our records indicate that your annual maintenance certification on your leak detection Bakersfield, CA 93301 VOICE (661) 326-3941 system was past due on August 24, 2002. FAX (661) 395-1349 You are currently in violation of Section 2641(J) of the California Code of PREVENTION SERVICES Regulations. FIRE SAFETY SERVICES · ENV1R(~NMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 "Equipment and devices used to monitor underground storage tanks shall be installed, FAX (661)326-0576 calibrated, operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks at least once per calendar year for PUBLIC EDUCATION 1715 ChesterAvb. operability and running condition." Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 You are hereby notified that you have thirty (30) days, October 13, 2002, to either perform or submit your annual certification to this office. Failure to comply will result FIRE INVESTIGATION in revocation of your permit to operate your underground storage system. 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 Should you have any questions, please feel free to contact me at 661-326-3190. FAX (661) 326-0576 TRAINING DIVISION Sincerely, 5642 Victor Ave. Bakersfield. CA 93308 Ralph Huey VOICE (661) 399-469'Z FAX (661) 399-5763 Director of Prevention Services Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services cc: Walter H. Porr Jr., Assistant City Attorney SEP-- 1 0--82 TUE 8 : 4 i FROM B . S . S . R . I NC . P . 0 1 BSSR, Inc. 6630 Rosedale Hwy.,# B "Bake id 30,8 ,' . rsfie ,.CA 93 Phone # 661-588-2777 Fax, # 661-588-2786 facsimile ttal SEP-- 1 0--02 T U E 8 : 42 FlBOM B . $ . S . lB . I NC . P . 02 ' SECONDARY SYSTEM CERTiFiCATION FORM DATE .... FACILITY FACILITY ADDRESS ?~ ~. ~'::-,o~:f~.~" UST Annular Space .... ' Tank 1 Tank 2 Tank 3 Tank 4 Initial Pressure End Time .//;K'f . ...... . ,Final Pre~sure Certification .. Line 1 Line Start...Time //,?:3/ / ~ ~" '~'~" //", Initial Pr~sure End Time // Final Pr~sure ..... (Signature) Page ! of_ SEP-- 10--02 TUE 8 : 42 FROM B . S . S . R . INC. P . 0~ SECONDARY SYSTEM CERTIFICATION FORM FACILITY ID~.2~ FACILITY ADDRESS _.~.¢',,0, ~f~,"~. '~' /~"' /~'f~ ~'Y'-- Sump I Sump 2 Sump 3 Sump 4 Initial Height of Water Time Water Height Time Water Height Water Height ~,, (Signature) Overfill Bucke~ Overfill I Overfill Initial Height Water Height ~" ~ ~ ?-, 7 ~ ~ 5' ..~ 7~ ~ .'-~:') ~.~ SEP-- 10--02 TUE 8 : 45 FROM B . S . S . R . 'I NC . P . 04 . SECONDARY SYSTEM CERTIFICATION FORM ,DATE_~~ q-~ o-L. 'FACILITY IO_z'z~_~_. ~.s~-" FACILITY ADDRESS ~ o'~ ~,,,~,~. /~~/~. ( ~.~ .UDC TESTiNG .... DIS.P~SER 1 DISPENSER 2 DISPENSER ~ DISPENSER 4 I~TIAL WATgR WATER DISPENSER START TIME INITIAL HEIGHT OF WATER WATER I,IEIGHT TIME WATER :HEIGHT ?S!GNATU~) . Page 3 of~ SEP-- 1 0--02 TVE 8 ; 44 ~ROM B =-$ . $ . R . I NC . P . 05 8~KERSFIELD C~, '... 6,;J0 DRUNPAG~, LN SUMP L~flK TEST R~POR]' ' BflKERSFI~L~D TEST 81*~RTED ~: 1~ P~ END .TIHE ~: 2S PM ~ St'~' END DATE END LEU~L 6.7950 ~N TI::CT L~K THR~gHOL,~ ~,ge2 IN TEST STaRTeD TEST RESULT F~IL[D , a, GIN L,gUEL 'G, q"' END TI~E J.F:AI< 'FHR[:SHOIj) 8,0~ IN TEST ~TARTEO 3:10 PM TEST RESULT P~SS~D BEGIN LEVEL 7, 70~9 IN END TIME 3~25 PM ,,,'~ END DAT[ 09~04/2~02 END LCVE:t. 7,7055 IN TEST STARTED 2:~5 PM LEAK THR~:SHOLO 8.002 IN 'Fl,:? ST~t'ED 09/g4/20~2 TEST RESULT INCRERSE~ ~=[6IN LEVEL 7.4920 ~:]lqO 'F [ME 2:50 PM END DATE 09~'04/20~ 87 g~P END i_I~VEL 7.4746 I'N LEflK THRESHOLD TEST 8TF~RTED 3:18 PM TEST RESUI.T FAILED TEST STARTED 0~x84/2082 OEO~N L~UEL ,5.988;~ iN END TIME 3:25 P~ END D~TE 09/84/2002 END LEVEL ~.9751 IN J'ES':' F, TARTED 2:~5 PM TE8T R~$ULT F~ILED t LbS 4 LCUEL END FiME'' .2:5~ PM t:Nf) T:)Rl'~: 09~04/2802 LL','RK TMI(ESHDLD ~.gg2' IN ~TARTED ~; 10 PM tEST RESULT F~.,L,~D TEST STARTED es/e4/2e~2 "' BEGIN LEVEL 5.7825 ~N ~ND TIM~ $:25 Pm ':' END DATE 89/84/2082 END LEVD. ~. ?882 IN LEAK THR~SHOLB 8.8E~ IN TCST RESULT F~ILED CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1.715 Chester Ave., Bakersfield, CA (661) 326-3979 APPLICATION TO PERFORM A TANK TIGHTNESS TEST/ .... SECONDARY CONTAINMENT TESTING. FAClI JTY ~/~K?._~-"~ 5~ ADDRF_,SS Coo '~ o~D~(~ PERM1T TO OPERATE # OPERATORS NAME OWNERS NAME z , NUMBER OF TANKS TO BE TESTED ~q--~IS PIPING GOING TO BE TESTED TANK # VOLUME CONTENTS ! . ~ ~ o~ ,.~, ~ e~,~ ,... S'~<~c~- . ;_ ,/, ?~c~ ., ... ec~ . TANK TBS~G COMPANY ~T ~OD ~~ C~CA~ON ~ O ~ DA~ & ~ ~T IS TO BE CO~U~, ~PRO~ BY DA~ SIGNA~ OF ~P~C~ August 30, 2OO2 Mr. Fast 600 Brundage Lane Bakersfield, CA 93304 REMINDER NOTICE RE: Necessary secondary containment testing requirements by December 31, 2002 of underground storage tank (s) located at the above stated address. FIRE CHIEF RON F,RAZE De~ Tmtk Owner / Operator, 2101 *H" Street Bakersfield, CA 93301 If you are receiving this letter, you have not yet completed the necessary secondary VOICE (661) 326-3941 containment testing required for all secondary containment components for your FAX (661) 395-1349 underground storage tank (s). SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 Senate Bill 989 became effective January l, 2002, section 25284.1 (California Health VOICE (661)326-3941 ~ Safety Code) of the new law mandates testing of secondary containment FAX (661) 395-1349 components upon installation and periodically thereafter, to insure that the systems are PREVENTION SERVICES capable of containing releases fi.om the primary containment until they are detected 1715 Chester Ave. Bakersfield, CA 93301 and removed. VOICE (661) 326-3951 FAX (661) 326-0576 Of great concern is the current failure rate of these systems that have been tested to ENVIRONMENTAL SERVICES date. Currently the average failure rate is 84%. These have been due to the 1715 Chester Ave. Bakersfield, CA 93301 penetration boots leaking in the turbine sump area. VOICE (661) 326-3979 FAX (661) 326-0576 For the last four months, this office has continued to send you monthly reminders of TRAINING DIVISION this necessary testing. This is a very specialized test and very few contractors arc 5642 Victor Ave, Bakersfield, CA 93308 licensed to perform this test. Contractors conducting this test arc scheduling VOICE (661) 399-4697 approximately 6-7 weeks out. FAX (661) 399-5763 The purpose of this letter is to advise you that under code, failure to perform this test, by the necessary deadline, December 31, 2002, will result in the revocation of your permit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (66 l) 326-3190. Sincerel~y..~ Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services · July 30, 2002 Mr. Fast 600 Brundage Lane Bakersfield CA 93304 REMINDER NOTICE F~RE CHIEF RE: Necessary Secondary Containment Testing Requirements by December RON FRAZE 31, 2002 of Underground Storage Tank (s) Located at ADMINISTRATIVE SERVICES the Above Stated Address. 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 Dear Tank Owner / Operator: FAX (661) 395-1349 SUPPRESSION SERVICES If you are receiving this letter, you have not yet completed the necessary 2101 "H" Street secondary containment testing required for all secondary containment Bakersfield, CA 93301 components for your underground storage tank (s). VOICE (661) 326-3941 ~ FAX (661) 395-1349 Senate Bill 989 became effective January 1, 2002, section 25284.1 (California PREVENTION SERVICES Health & Safety Code) of the new law mandates testing of secondary FIRE SAFETY SERVICES, ENVIRONMENTAL SERVICES 1715 ChosterAve. containment components upon installation and periodically thereafter, to insure Bakersfield, CA 93301 that the systems are capable of containing releases from the primary VOICE (661) 326-3979 FAX (661) 326-0576 containment until they are detected and removed. PUBLIC EDUCATION Of great concern is the current failure rate of these systems that have been 1715 Chester Ave. Bakersfield, CA 93.301 tested to date. Currently the average failure rate is 84%. These have been due vOICE (661)326-3696 to the penetration boots leaking in the turbine sump area. FAX (661) 326-0576 FIRE INVESTIGATION For the last four months, this office has continued to send you monthly 1715 ChesterAve. reminders of this necessary testing. This is a very specialized test and very few Bakersfield, CA 93301 vOiCE (661) 3~6-3951 contractors are licensed to perform this test. Contractors conducting this test FAX (661)326-0576 are scheduling approximately 6-7 weeks out. TRAINING DI~nS~ON The purpose of this letter is to advise you that under code, failure to perform 5642 Victor Ave. Bakersfield, CA 93308 this test, by the necessary deadline, December 31, 2002, will result in the vOICE (661) 399-4697 revocation of your permit to operate. FAX (661) 399-5763 This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Steve Underwood Fire Inspector Environmental Code Enforcement Officer · June 30,2002 Mr. Fast 600 Brundage Lane Bakersfield, CA 93304 REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 600 Brundage Lane. FIRE CHIEF RON FRAZE Dear Tank Owner / Operator: ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfield, CA 93301 The purpose of this letter is to inform you about the new provisions in VOICE (661) 326-3941 FAX (661)395-1349 California Law requiring periodic testing of the secondary containment of underground storage tank systems. SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 Senate Bill 989 became effective January 1, 2002, section 25284.1 (California VOICE (661) 326-3941 FAX (661) 395-1349 Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure PREVENTION SERVICES 1715 ChesterAve. that the systems are capable of containing releases from the primary Bakersfield, CA 93301 containment until they are detected and removed. VOICE (661) 326-3951 FAX (661)326-0576 Secondary containment systems installed on or after January 1, 2001 will be tested ENVIRONMENTAL SERVICES 1715 Chester Ave. upon installation, six months after installation, and every 36 months thereafter. Bakersfield, CA 93301 Secondary containment systems installed prior to January 1 2001 will be tested by VOICE (661) 326-3979 , FAX (661) 326-0576 January 1, 2003 and every 36 months thereafter. REMEMBER! Any component that is "double-wall" in your tank system must be tested. TRAINING DIVISION 5642 Victor Ave. Bakersfield. CA 93308 Secondary containment testing shall require a permit issued thru this office and VOICE (661)399-4697 FAX (661) 399-5763 shall be performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (661)326-3190. Sinc~e~ Steve Underwood Fire Ins~pect?.~./.En. viro..nmental Code Enforcement Officer "Ehvironmental Services SU/kr D ) :'' May 29, 2002 Mr. Fast 600 Brundage Lane Bakersfield, CA,93304 RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 600 Brundage Lane FIRE CHIEF REMINDER NOTICE RON FRAZE Dear Tank Owner/Operator: ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 The purpose of this letter is to inform you about the new provisions in California VOICE (661) 326-3941 FAX (661) 395-1349 Law requiring periodic testing of the secondary containment of underground storage tank systems. SUPPRESSION SERVICES 2101 "H" Street Senate Bill 989 became effective January 1, 2002. section 25284.1 (California Bakersfield, CA 93301 VOICE (661) 326-3941 Health & Safety Code) of the new law mandates testing of secondary containment. FAX (661) 395-1349 components upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary containment until they are PREVENTION SERVICES 1715 Chester Ave. detected and removed. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 Secondary containment systems installed on or after January 1,2001 shall be tested upon installation, six months after installation, and every 36 months thereafter. ENVIRONMENTAL SERVICES Secondary containment systems installed prior to January 1,2001 shall be tested by 1715 Chester Ave. Bakersfield, CA 93301 January 1, 2003 and every 36 months thereafter. REMEMBER!! Any component VOICE (661) 326-3979 that is "double-wall" in your tank system must be tested. FAX (661) 326-0576 TRAINING reVISION Secondary containment testing shall require a permit issued thru this office, and 5642 Victor Ave. shall be performed by either a licensed tank tester or licensed tank installer. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (661) 326-3190.. Sinc~r,c~.. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/kr · - enclosures · California Regional Water Quahty trol Board Central Valley Region ~- ' Winston H. Hickox Robert Schneider, Chair Gray Davis SecretaryJbr Fresno Branch Office Governor Environmental Internet Address: http://www.swrcb.ca.gov/-m, qcb5 Protection . 3614 East Ashland Avenue, Fresno, California 93726 ' ' Phone (559) 445-5116 · FAX (559) 445-5910 13 May 2002 RWQCB Case No. 5T15000619 Mr. Ki Chu Yi Mr. Fast Service Station ............. B-r~nda~g - -600 e Lane Bakersfield, CA 93304 UNDERGROUND STORAGE TANK RELEASE, MR. FAST SERVICE STATION, 600 BRUNDAGE LANE, BAKERSFIELD, KERN COUNTY You submitted First Quarter 2002 Groundwater Monitoring Report (Monitoring Report) dated 9 April 2002 and prepared by E2C Remediation., LLC, Bakersfield (]~2C). The MonitoringReport describes the results of a quarterly groundwater monitoring event conducted on 18 and 19 February 2002. We request that quarterly groundwater monitoring be continued, that off-site remediation be implemented, and that the work plan for installation of an additional deep groundwater monitoring well installation and geophysical logging be submitted. Analysis for the fuel oxygenates should not be discontinued due to detection of a tertiary butyl alcohol during the Fi~s('Quarter 2002 monitoring event. A summary of the Monitoring Report and our comments follow. Monitoring Report Summary .E2C conducted the First Quarter 2002 groundwater monitoring event at the site on 18 and 19 February 2002. Monitoring Wells MW-15S, MW-15D, MW-16, and MW-17D were dry. Monitoring well MW- 11 .has been. taken .°Ut.of.se~ice and-has -been-replaced-byAVIW~- 1-1:R-.- Depth-to.waterAn-shallow monitoring wells MW-1 through MW-13 and MW-17S ranged from 45.18 to 61.50 feet below the top of the cas. ings (below TOC). Depth-to-groundwater in deep well MW-14 was 69.30 feet below TOC. MW-14 is located approximately 5 feet east of MW-13. E2C calculated groundwater flow direction to be toward the 'southeast at a sloPe of 0.041 feet per foot. Groundwater elevations in on-site monitoring wells and monitoring wells near Brundage Lane decreased by approximately 3 feet compared to the previous quarterly groundwater monitoring event. Groundwater elevations decreased 4 to 10 feet in off- site monitoring wells south of MW-1 iR and MW-12. The groundwater elevation in deep monitoring well MW-14 decreased by 0.8 feet. .California Environmental Protection Agency ~ Recycled Paper The energy challenge facing California is real. Every Californian needs to take immediate action to reduce energy consumption. For a list of simple ways you can reduce demand and cut your energy costs, see our Web-site at http://www.swrcb.ca.g0v/rwqcb5 Mr. and Mrs. Ki Chuy Yi - 2 - 13 May 2002 E2C suggests that the large variation in groundwater elevation observed between monitoring wells MW- 13 and MW-14 may result from groundwater flow from overlying sandy soils into a silt layer encountered at approximately 55 feet below ground surface (bgs). E2C also suggests that groundwater flow may be laterally discontinuous based on the dry monitoring wells, which are along Fig Street.. Groundwater samples collected from the Wells were analyzed for total petroleum hydrocarbons as gasoline (TPH-g) by EPA Method 8015M, and benzene, toluene, ethylbenzene, and xylenes (BTEX), and the fuel oxygenates methyl tertiary butyl ether (MTBE), tertiary butyl alcohol (TBA), di-isopropyl ether (DII~E), ethyl tertiary butyl ether (ETBE), and tertiary amyl methyl ether (TAME) by EPA Method 8260B. Monitoring wells MW-l, MW-7, MW-12, and MW-13 were not sampled since approximately 0.25, 0.12, 0.82, and 0.84 feet of floating petroleum product was measured in these wells, respectively. During the last quarterly monitoring event, monitoring well MW-12 was not sampled due to the presence of 0.13 feet of floating petroleum product. TPH-g was detected in all monitoring wells sampled except MW-17S. The highest concentrations were detected in MW-11R (28,000 micrograms per liter (gg/L)), MW-8 (27,500 gg/L), MW-2 (1,140 gg/L). TPH-g was detected at concentrations less than 1,000 gg/L in the remaining samples. Benzene was t~' detected in samples collected from nine wells. The highest concentrations were detected in MW-5 (360 gg/L) and MW-11R (140 gg/L). Other benzene concentrations detected were less than 55 gg/L. MTBE, DIPE, ETBE, and TAME were not detected in the samples. TBA was detected in the sample collected from deep well MW-14 at 100 gg/L. Analytes were not detected in downgradient well MW-17S along Fig Street. The remaining shallow and deep wells along Fig Street were dry. E2C concludes that impacted groundwater is a narrow, elongate plume primarily controlled by the steep groundwater gradient, with 'some lateral dispersion. E2C recommends that the soil vapor extraction and air sparging remediation system approved by the Regional Board by our letter dated 22 January 2002 be installed and operated offsite to remediate the floating gasoline, and that quarterly groundwater monitoring continue during remediation, and for four quarters thereafter. Monitoring Report Comments We concur with E2C that quarterly groundwater monitoring should continue during remediation and for four qu~arter_s_ after .rem. edia_~t~0~n syste_~s_hut-do~n.. _Ground~ater_monitoring_e_v. ents_may_also be _used to .... document payment milestones for the California Petroleum Underground Storage Tank Cleanup Fund's (Fund' s) Pay for Performance pilot program. We request that groundwater samples be analyzed for TPH-g by EPA Method 8015M and BTEX, MTBE, TBA, DIPE, ETBE, and TAME by EPA Method 8260B. By our letter dated 24 January 2002, we indicated that analysis for MTBE could be discontinued until verification monitoring is performed prior to site closure. E2C proposed discontinuing analysis for MTBE in Fourth Quarter 2001 Groundwater Monitoring Report and Additional Groundwater Characterization Report of Findings dated 11 January 2002 and prepared by E2C. We no longer approve discontinuing analysis for MTBE,. TBA, DIPE, ETBE, and TAME due to the detection of TBA at 100 gg/L this quarter in the sample collected form deep monitoring well MW-14. We request that analysis for the fuel oxygenates continue for two additional quarterlY sampling events. U:\UGTXJDW_files\2002 Correspondence\City of Bakersfield CasesWIrFst GW 4-02.DOC Mr. and Mrs. Ki 'Chuy Yi 3 13 May 2002 By our letter dated 24 January 2002, we requegted the installation of one deep groundwater monitoring well along the south edge of Fig Street to replace MW-15d, MW-16 and MW-17d, which have not regularly produced sufficient groundwater for sample collection. We also requested that downhole geophysical logging methods be employed to identify deeper water-producing zones below, perched. groundwater. The monitoring well should be designed to assess the presence of hydrocarbons in groundwater beneath the perching layer. We requested that you submit a work plan addendum for the installation of this well by 18 March 2002. As of the date of this letter, we have not received the work~ plan. We will provide an extension for submissionof the work plan. Please submit the work plan by 10 June 2002. .'. We approved the installation and operation of on- and off-site soil vapor'extraction/air sparging remediation systems by our letter dated 22 January 2002. The on-site remediation system began operation on 10 April 2002. We understand that the Fund has pre-approved the installation cost for the ...... off-site-remediation system:- Please contact' this-o'ffice p~ib~Fto 'iia~tallati6n Of 'the-~-~ffzgi-te 'rernediation .... system. . '. Please be aware that Sections 2729 and 2729.1 for Underground Storage Tanks were added to the California Code of Regulations requiting you to submit analytical and .site data electronically. As of the date of this letter, analytical data for this project has not been submitted electronically. Enclosed is our letter (Required Electronic Deliverable Format for Laborator) and Site Data Submittals to Re'gulating Agencies) explaining how to obtain information to implement the requirements. Please contact this office at least five days in advance of any fieldwork. Should you have any questions regarding this matter, please contact me at (559) 445-5504. JOHN D. WHITING Associate Engineering Geologist RG No. 5951 Enclosure: Required Electronic Deliverable Format for Laboratory and Site Data Submittals... cc: Ms. Barbara Rempel, SWRCB, UST Cleanup Fund, Sacramento, w/o enclosure.'~ Mr. Howard Wines, City of Bakersfield Fire Department, Bakersfield, w/o enclosureX, d Mr. Philip Goalwin, E2C Remediation, LLC, Bakersfield, w/enclosure U:\UGTVIDW_files\2002 Correspondence\City of Bakersfield CasesXMrFst GW 4-02.DOC April 17, 2002 Mr. Fast 600 Brundage Lane FIRE CHIEF Bakersfield CA 93304 RON FRAZE ADMINISTRATIVE SERVICES RE: Necessary Secondary Containment Testing Required by December 31, 2002 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 REMINDER NOTICE SUPPRESSION SERVICES Dear Tank Owner/Operator: 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 The purpose of this letter is to inform you about thc new provisions in California law FAX (661) 395-1349 requiring periodic testing of the secondary containment of underground storage tank systems. PREVENTION SERVICES 1715 Chester Ave. Senate Bill 989 became effective January I, 2002. Section 25284.1 (California Health & Bakersfield, CA 93301 VOICE (661) 326-3951 Safety Code) of the new law mandates testing of secondary containment components FAX (661) 326-0576 upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary containment until they are detected and removed, ENVIRONMENTAL SERVICES 1715 Chester Ave, Bakersfield, CA 93301 Secondary containment systems installed on or after January 1,2001 shall be tested upon VOICE (661) 326-3979 installation, six months after installation, and every 36 months thereafter. Secondary FAX (661) 326-o576 containment systems installed prior to January 1, 2001 shall be tested by January 1, 2003 and every 36 months thereafter. TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 Secondary containment testing shall require a permit issued thru this office, and shall be VOICE (661) 399-4697 FAX (661) 399-5763 performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at 661-326-3190. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/dm enclosures CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor,. Bakersfield, CA 93301 FACILITY NAME ~¢. ~'rL~,'¥ INSPECTION DATE ADDRESS ~ ~t)n~: ~ N. ' PHONE NO. ~q-~ ' FACILITY CONTACT BUSINESS ID NO. 15-210- ~SPECTION TIME NUMBER OF EMPLOYEES 'Section 1: Business Plan and Inventory Program [~l Routine [~[ Combined [~ Joint Agency [~ Multi-Agency ~ Complaint [~} Re-inspection OPERATION C V · COMMENTS Appropriate permit on hand ~ / Business plan contact information accurate ~,,/ Visible address L, f Correct occupancy ~ /~ Verification of inventory materials ~, / Verification of quantities {e// Verification of location ~ / Proper segregation of material [../ Verification of MSDS availability L /' Verification of Haz Mat training L, / Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection L/ ~k~,_ ,~¢.U~trt ~ '~0 d~x4 Site Diagram Adequate & On Hand ~, / C=Compliance V=Violation Any hazardous waste on site?: [~ Yes ~.No Explain: Questions regarding this inspection? Please call us at (661) 326-3979 Business Si~ble Party White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~t · F0.,6~ INSPECTION DATE Section 2: Underground Storage Tanks Program [] Routine [~ Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank O l~ FC~t) Number of Tanks Type of Monitoring (2/- fla. Type of Piping OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit tees current Certification of Financial Responsibility [.,/ / Monitoring record adequate and current Maintenance records adequate and current [,/ / Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V-Violation Y=Yes N=NO Office of Environmental Services (805) 326-3979 Business Site Responsible Party White - Env. Svcs. Pink - Business Copy -- '~x' ~b ~ ~ .~rvice Station Maintenance I ~'~tate Contractors Lie. # 569211 1!2_.;.. ; o Drive, Bakemfield, CA 93306 (661) L WorkPedormedAt: ~~~ ~ ~ ~ ~ Date Call Made Station~ RepairDate o /~ ~ ~ ~ ' ~ Street ~' ' ~ ""./ ~ ~/~ ~ ~ ~ ~o ~~~ ~ ~ ' ~e ,.o.~ ,nvoic~a,~ o C~ ~ .~ State Zip ~ ~ .~ / ~~~, ~, ~ ~ y, / / RepoSed ~ymptoms ....... ~_. ,-- . I, ~ ~ WorkPedo~~~~ ~~ ~~~~.~¢ ~/~ ~~ ~BOR Dat~ Nam~ Class HOURS ~oudy ~ate_ ~mount I~,//~Z,~ Arrived Departed ,.,o. Travel Total ~ :AN :AM :PM :PM :AM :AM Quanti~ OUTSIDE SERVICES- MATERIAL- RENTALS Each Amount LABOR If Applicable Total B J ~ ~ ~ ~ Invoice A~ B · C ,,,, ............. TOTAL ~J -- Make and Model Serial Number .~. Equipment T~ed Finish ( money) Finish (~a~lofis) ~st ~ow TotalJzer ~li~mtiom Checked Readings Sta~ (money) .Sta~ (gallons) Adjured Fast Slow Product Return to Storage(gallons) TotalizerSealed Meter Sealed YES , NO YES NO Verification: I hereby ce~i~ hours/materials shown are correct D~te:, 8i~natum X · August 27, 2001 Ki Chi Yi Mr. Fast CERTIFIED MAIL 600 Brundage Lane Bakersfield Ca 93304 NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE FIRE CHIEF RON FRAZE RE: Failure to Submit/Perform Annual Maintenance on Leak Detection ADMINISTRATIVE SERVICES Bakersfield, CA 93301 VOICE (661) 326-3941 Dear Ki Chi Yi FAX (661 ) 395-1349 SUPPRESSION SERVICES Our records indicate that your annual maintenance certification on your leak 2101 "H" Street detection system is past due. (August 24, 2001.) Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661)395-1349 You are currently in violation of Section 2641(J) of the California Code of PREVENTION SERVICF-~ Regulatl00-S~., ' ,. , ' ' '." :,'~ :.'_ Bakersfield, CA 93301 ;'Equipment and devzces used to momtor underground storage tanks shall be VOICE (661) 326-3961 FAX (661) 326-0576 installed, calibrated, operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks at least once per ENVIRONMENTAL SERVICES 1715 ChesferAve. calendar year for operability and running condition." Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 You are hereby notified that you have thirty (30)days, September 26, 2001, to either perform or submit your annual certification to this office. Failure to comply TRAINING DIVISION will result in revocation of yom- permit to operate your underground storage 5642 Victor Ave. Bakersfield, CA 93308 system. VOICE (661) 399-4697 FAX (661) 399-5763 Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph Huey Director of Prevention Services by: Steve Underwood. ., , . . ...-. ........ . ~lre Inspector/En~vironmehtal C0d~ Enforc~rneht'Officer .Office of Environmental Services '~c: Walt Porr, Assistant City Att0mey · Attach this card to the back of the mailpiece, I or on the front if space permits. 1. Article Addressed to: D. Is delivery address 17 I-lYes If YES, enter delivery address below: [] No Mr Fas t 600 Brundage Lane BakerSfield CA 93304 3. Service Type '~ Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. i 2. Article Number (Copy from service label) . 81 1, July '1999 ' D~)m~stJc' ~ ~ '-- -- ~'~--- 102595~99~M.1789 r: Please print your name, address, and ZIP+4 ~n this box · OFF/CE OF ENVIRONMENTALsuite SErVICEs ~ 715 Chester Avenue, Bakersfield,, CA 800 r~ Post~ge $ °34 ~ 2 10 I~' Certified Fee .~ . Postmark/ Return Receipt' Fee i . .5 0 ~ (End0mement Required] Here~ ~ Restricted Delivery Fee I"'t (Endomement Required) cm Tota, Po~ge & Fee, $ 3.94 u'i I Reclplent a Name 'Please Print Clearly) (To be completed by, ma#er) a [ 600 B~undage ~,ane r- ~ers~ield CA 93304 August 27, 2001 ~. , Ki Chi Yi ,. Mr. Fast " CERTIFIED MAIL 600 Brundage Lane · Bakersfield Ca 93304 NOTICE OF VIOLATION & SCttEDULE FOR COMPLIANCE FIRE CHIEF RON FRAZE RE: Failure to Submit/Perform Annual Maintenance on Leak Detection ADMINISTRATIVE SERVICES .System 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 Dear ICi Chi Yi FAX (661) 395-1349 SUPPRESSION SERVICES Our records indicate that yourannual maintenance certification On your leak 2101 "H" Street detection system is past due. (August 24,' 2001 .) Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 · You are currently in violation of Section 2641(J) of the California Code of PREVENTION SERVICE~ Regulations. 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 "Equipment and devices used to monitor underground storage tanks shall be FAX (661) 326-0576 installed, calibrated, operated and maintained in accordance with manufacturer's instructions, including'routine maintenance and service checks at least once per ENVIRONMENTAL SERVICES calendar year for operability and running condition." 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 . You are hereby notified that you have thirty (30) days, September 26, 2001, to either perform, or submit your annual certification to this office. Failure to comply TRAINING DIVISION ' will result in revocation of your permit to operate your underground storage 5642 Victor Ave. Bakersfield, CA 93308 system. VOICE (661) 399-4697 FAX (661) 399-5763 Should you have any questions, please feel free to contact me at 661-326-31.90.. Sincerely, Ralph Huey Director of Prevention services Steve Underwood Fire Inspector/EnvironmentafCode Enforcement Officer Office of Environmental Services cc: Walt Porr, Assistant City Attorney Kern le :: ~ ~? .- ~ Service Station Main~::~ ':~e INV.# State Contractors~J'c..#'5~211 ~, 11 ~3~Paladino Drive, Bakersfield CA ~3~,..~.'(6~) WorkPedormedAt: ~V ~ 'lDate~Call~Mad~ ' ' ~e~ir~at~ : L · ':. - . Stat on# i {-- , , ~me ;__ P.O.# Inv~iceDate Date. . Name Class · · ' HOURS HourlyRate ' Amount :PM :PM ~ · :AM :AM ~1~ '~M .~ ' · O~anti~. ouTSIDE SERVICES- MATERIAL- RENTALS. 'Each Amount SUBTOTAL ' ', :LABOR . : :: ::::::::::::::::::::::::: · ) " Materials .. MILEAGE ' SUBTOTAL Make and Model Serial Number · Equipment Tagged Tag ~ ~RED ~REEN ~ BLUE Finish ( money) Finish (gallons) . . Fast · ,Slow Totalizer " ' '- Callibration: ', . Checked Readings Start (money) Sta~ (gallons) ' ' ,.' ' ".' YES :NO . '~ 'YES NO '.. .J C ECTION NOTIFi E - ' I BAKERSFIELD FIRE DEPARTMENT N° 963 Location, ..]!/[.~. /~'~- Sub Div, (~a fl~&.~ ~ s~. . ~t You are hereby required to make the following cor~etions at the above l~ation: Cot, NO I ' Completion Date fo,' Corrections'~'//~/~ ~nspectOr 326-3979 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~'. ~'O~q'~ INSPECTION DATE ADDRESS (at)tO .I~VtII'~a.~,L [x~_~ ¢. PHONE NO. ~(./' g - FACILITY CONTACT BUSINESS ID NO. 15,210- INSPECTION TIME NUMBER OF EMPLOYEES r~ Section 1: Business Plan and Inventory Program [] Routine {~],Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address L/ Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training ~/' Verification of abatement supplies and procedures L, Emergency procedures adequate id/ Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation AnYExplain:hazardoUs waste on site?: [] Yes [] No[, ~~.A~4 "/,~ Questions regarding this inspection? Please call us at (661) 326-3979 Business Site/l~esponsible Party White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: v~O. to'~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, cA 93301 Section 2: Underground Storage Tanks Program [] Routine [~ombined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank lX/..OF:e.$ Number of Tanks Type of Monitoring d£Wt Type of Piping OPERATION C V COMMENTS Proper tank data on file V' Proper owner/operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance recordsadequateandcurrent X/r /~'~ ,~t'~'l~,to,~ ~It~taf~. t0/x ~,tt~(. Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S). AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N--NO Inspector: ...... ~ D Office of Environmental Services (805) 326-3979 Business Site Responsible Party White - Env. Svcs. Pink - Business Copy - CITY OF BAKERSFIEL ,, -- FFICE OF ENVIRONMENTA SERVICES ' 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STO~GE TANKS - UST FACILI~ Page ~PE OF ACTION 1. NEW SITE PE~IT ~. RENTAL PERMIT ~ 5. CHANGE OF INFOR~TION (S~c~ c~ - ~ 7. PER~NE~Y CLOSED SI~ (Chock one ~em only) ~ 4. AMENDED PERMIT ~1 u~ on~). ~ 8. TANK RE~VED ~ 6. TEM~RY S~ CLOSURE N~REST CRO~ STREET ~1. FACIL~ O~ER ~PE ~ 4. LO~L AGENCY/DIS~IC~ ~ . ~. D 1. ~R~TION D $. COU~AGENCY' BUSINESS ~. ~S STA~ON ~ 3. FA~ D 5. ~M~RC~L ~2. IND~IDUAL ~ 6. STA~ AGENC~ ~PE D 3. P~TNERSHIP ~ 7. FEDE~ AGENCY* ~2. ~ 2. DIS~IB~OR ~ 4. PROCES~R ~ 6. OTHER 4~. TOTAL NU~ER OF TANKS Is f~li~ ~ Indian R~afl~ ~ *~ ~ ~ UST a public ~: n~e ~ sup~ ~ PHONE C~ 410. STA~ 411. ~ ZlP~DE 412. PROPERW O~ER~E ~. INDNIDUAL D 4. LO~LAGENCY/DISmI~ ~ 6. STA~ AGENCY 413. ~ 3. P~SHIP ~ 5. ~U~AGENCY ~ 7. FEDE~LAGENCY T~K O~ER~ 414. J PHONE . ~]L]NG OR S~E~ ~DRE~ 416. CI~ 417. STA~ 418. ZIP CODE 419. T~K O~ER ~E ~. IND~IDU~ ~ 4. LO~L AGENCY / DIS~I~ ~ 6. STA~ AGENCY 4~. D 1. ~R~TION ~ 3. P~ERSHIP ~ 5. ~U~AGENCY ~ 7. FEDE~LAGENCY ~ (TK) HQ 4 4 - Call (916) 322-9669 if questions a~ 421. INDICA~ ~O~S) ~ 1. SE~NSU~D ~ 4. SUR~BOND D 7. STA~FUND ~ 10. LO~L~C~ISM ~ 2. GUA~E ~ 5. L~ER OF CRED~ ~8. STA~ FUND & CFO LE~R ~ ~. OTHER: ~ 3. INSU~CE ~ 6. ~E~TION ~ 9. STA~ FUND & CD 4~. ~fi~tl~: I ~ that the Inf~a~ p~ h~n is ~e and ~mte to the b~t ~ my ~e. SIG~TURE OF APPLI~ ~ ~~ DA~ ' 424. PHONE '~ ~ ~' 4~. ~ME OF APPLI¢~ (pdnO 426. TI~E OF APPLI~T 4~. r STATE UST FACILITY NUMBER (For local use only) 428. 1998 UPGRADE CERTIFICATE NUlvi~R (For local use only) 429. r UPCF (7/99) S:\CU PAFORMS\swreb-a.wpd / Complete the UST r Facility page for all new permits, permit changes or any facility information changes. This page must be submitted within 30 days of permit or facility information changes, unless approval is required before making any changes. Submit one UST - Facility page per facility, regardless of the number of tanks located at the site. This form is completed' by either the permit applicant or the local agency underground tank inspector. As part of the application, the tank owner must submit a scaled facility plot plan to the local agency showing the location of the USTs with respect to buildings and landmarks [23 CCR )2711 (a)(8)], a description of the tank and piping leak detection monitoring program [23 CCR )2711 (a)(9)], and, for tanks containing petroleum, documentation showing compliance with state financial'responsibility requirements [23 CCR )2711 (a)(11 )]. Refer to 23 CCR 32711 for state UST information and permit application requirements. (Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages. These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C, the Business Section of the Unified Program Data Dictionary.) Please number all pages of your submittal. This helps your CUPA or local agency identify whether the submittal is c0rh~)i'ete and if ~ny' pages are separated. 1. FACILITYID NUMBER - Leave this blank. This number is assigned by the CUPA. This is the unique number which identifies your facility. ' 3. BUSINESS NAME - Enterthe full legal name of the business. 400. TYPE OF ACTION - Check the.reason the page is being completed. CHECK ONE ITEM ONLY. 401. NEAREST CROSS STREET - Enter the name of the cross street nearest to the site of the tank. 402. FACILITY OWNER TYPE - Check the type of business ownership. 403. BUSINESS TYPE - Check the type of business. 404. TOTAL NUMBER OF TANKS REMAINING AT SITE - Indicate the number of tanks remaining on the site after the requested action. 405. INDIAN OR TRUST LAND - Check whether or not the facility is located on an Indian reservation or other trust lands. 406. PUBLIC AGENCY SUPERVISOR NAME - If the facility owner is a public agency, enter the name of the supervisor for the division, section or office which operates the UST. This person must have access to the tank records.. 407. PROPERTY OWNER NAME - Complete items 407- 412 for the property owner, unless all items are 408. PROPERTY OWNER' PHONE the same as the Owner Information (items 111-116) on the' Business 409. PROPERTY OWNER MAILING OR STREET ADDRESS OwnedOperator Identification page (OES Form 2730). If the same, 410. PROPERTY OWNER CITY wdte "SAME AS SITE" in this section. 411. PROPERTY OWNER STATE 412. PROPERTY OWNER ZIP CODE 413. PROPERTY OWNER TYPE - Check the type of property ownership. 414. TANK OWNER NAME - Complete items 414- 419 for the tank owner,, uhless all items are the 415. TANK OWNER PHONE same as the Owner Information (items 111-116) on the Business 416~ TANK OWNER MAILING OR STREET ADDRESS Owner/Operator Identification page (OES Form 2730). If the same, 417. TANK OWNER CITY wdte "SAME AS SITE" in this section. 418. TANK OWNER STATE 419. TANK OWNER ZIP CODE 420. TANK OWNER TYPE - Check the type of tank ownership. 421. BOE NUMBER - Enter your Board of Equalization (BOE) UST storage fee account number. This fee applies to regulated USTs . stodng petroleum products. This is required before your permit application can be processed. If you do not have an aCCount number with the BOE or if you have any questions regarding the fee or exemptions, please call the BOE at (916) 322-9669 or write to the BOE at: Board of Equalization, Fuel Taxes Division, P.O. Box 942879, Sacramento, CA 94279-0030. 422. PETROLEUM UST FINANCIAL RESPONSIBILITY CODE - Check the method(s) used by the owner and/or operator in meeting the Federal and State financial responsibility requirements. CHECK ALL THAT APPLY. If the method is not listed, check Aother= and enter the method(s). USTs owned by any Federal or State agency and non-petroleum USTs are exempt fi-om this requirement. 423. LEGAL NOTIFICATION AND MAILING ADDRESS - Indicate the address to which legal notifications and mailings should be sent. The legal notifications and mailings will be sent to the tank owner unless the facility (box 1) or the property owner (box 2) is checked. SIGNATURE OF APPLICANT - The business owner/operator of the tank facility, or officially designated representative of the owner/operator, shall sign in the space provided. This signature certifies that the signer believes that all the information submitted is accurate and complete. 424. DATE CERTIFIED - Enter the date that the page was signed. 425. APPLICANT PHONE - Enter the phone number of the applicant (person certifying). 426. APPLICANT NAME - Enter the full pdnted name of the person signing the page. 427. APPLICANT TITLE - Enter the title of the person signing the page. 428. STATE UST FACILITY NOMBER - Leave this blank. This number is assigned by the CUPA as follows: the number is composed of the tw(>.digit county number, the three digit jurisdiction number, and a six digit facility number. The facility number must be the same as shown in item 1. 429. 1998 UPGRADE CERTIFICATE NUMBER - Leave this blank. This number is assigned by the CUPA. CITY OF BAKERSFIELD OF iE OF ENVIRONMENTAL S [VICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 '~-'~'~'-- UNDERGROUND STORAGE TANKS - TANK PAGE I Page -- of TYPE OF ACTION [] 1. NEW SITE PERMIT [] 4. AMENDED PERMIT [] 5. CHANGE OF INFORMATION) [] 6. TEMPORARY SITE cLoSuRE (Check one item only) [] 7. PERMANENTLY CLOSED ON SITE /J~,~ RENEWAL PERMIT (Specify mason, for local use only) (Specify change, for local use only) [] 8. TANK REMOVED 430 LOCATION WITHIN SITE (Oplfonel) 431 TANK ID # / 432 TANK MANUFACTURER 433 I COMPARTMENTALIZED TANK r--lyes r-iN• 434 ~ A ~' ~ J~O~-"~'/~J {'~J'~'~/'=~/~J'~"" I If 'Yes'. complete ooe page f~* eac~ compartment. DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY I/~I~ALLONS ' // ' R 436 [ NUMBER OF COMPARTMENTS 437 · TANK USE 439 PETROLEUM TYPE 440 (ff~. MOTOR VEHICLE FUEL ' ~J~la. REGULAR UNLEADED [] 2. LEADED [] 5. JET FUEL rked, complete Pel~leum Type) [] lb. PREMIUM UNLEADED [] 3. DIESEL [] 6. AVIATION FUEL [] 2. NON-FUEL PETROLEUM [] lc. MIl)GRADE UNLEADED [] 4. GASOHOL [] 99. OTHER [] 3. CHEMICAL PRODUCT [] 4. HAZARDOUS WASTE (Includes COMMON NAME (f~om Haza~clous Materials lnventoo~ page) - 441 [ CAS # (f~om Hazan~ous Materials lnvento~ page) 442 Used Oil) I [] 95. UNKNOWN TYPE OF TANK [] 1. SINGLE WALL - [] 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) .[~i~. DOUBLE WALL EXTERIOR MEMBRANE LINER [] 95. UNKNOWN [] 4. S~NC~_E WALL ~N A VAULT TANK MATERIAL - primary tank ~2~. BARE STEEL [] 3. FIBERGLASS / PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 444 'Checkone/temon/y) [] 2. STAINLESS STEEL .[~.~4. STEEL CLAD W/FIBERGLASS' [] 8. FRPCOMPATIBLEW/100% METHANOL []99. OTHER REINFORCED PLASTIC (FRP) TANK MATERIAL - secondary tank [] 1. BARE STEEL [] 3. FIBERGLASS/PLASTIC [] 8. FRPCOMPATIBLEW/100% METHANOL J-'] 9S. UNKNOWN 445 one ~tern only) 2. STAINLESS STEEL /1~4. STEEL CLAD W/FIBERGLASS [] 9. FRP NON-CORRODIBLE JACKET [] 99. OTHER REINFORCED PLASTIC (FRP) [] 10. COATED STEEL [] 5. CONCRETE' TANK INTERIOR LINING [] 1. RUBBER LINED [] 3. EPOXY LINING [] S. GLASS LINING [] 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING [] 2. ALKYD LINING [] 4. PHENOLIC LINING /1~6. UNLINEO . [] 9g. OTHER __ 'Check one item on/y) (For/oca/use on/y) OTHER CORROSION [] 1. MANUFACTURED CATHODIC [] 3. FIBERGLASS REINFORCE• PLASTIC [] 95. UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION [] 4. IMPRESSED CURRENT [] 99. OTHER 'Check one item only) [] 2. SACRIFICIAL ANODE . (For ~•cai use on/y) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (For ~•cai use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 Check a/I that apply) [] 1. SPILL CONTAINMENT ~ [] 1. ALARM __ [] 3. FILLTUBESHUTOFFVALVE __ [] 2. OROPTUBE ~ [] 2. BALL FLOAT [] 4. EXEMPT [] 3. STRIKER PLATE ~/~ IF SINGLE W~LL T~&IK (¢h~¢k zll ~zt z~ly): 45~ IF O00BI~ gOJA. ?~1~ OR T~NK ~TH BI.~DDER (Cheok o~ ~ only): 454 [] 1. VISUAL (EXPOSED PORTION ONLY) [] 5. MANUAL TANK GAUGING (MTG) r-J 1. VISUAL (SINGLE WALL IN VAULT ONLY) [] 2. AUTOMATIC TANK GAUGING'(ATG) [] 6. VADOSE ZONE J~2. CONTINUOUS INTERSTITIAL MONITORING [] 3. CONTINUOUS ATG " [] 7. GROUNDWATER [] 3. MANUAL MONITORING [] 4. STATISTICAL INVENTORY REcoNCILIATION (SIR) + [] 8. TANK TESTING BIENNIAL TANK TESTING []99. OTHER ESTIMATED DATE LAST USED (YR/IvlO/DAY) 455· ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallo~s [] Yes [] No UPCF (7~99) S:\CU PAFORMS\SWRCB-B.WPD UST - Tank Page 1 Complete the UST - Tank pages for each tank for all new permits, permit changes, closures and/or any other tank information change. This page must be submitted within 30 days of permit or facility information changes, unless approval is required before making any changes. For compartmentalized tanks, each compartment is considered a separate t~ink and requ!res completion of separate tank pages. Refer to 23 CCR 72711 for state UST information and permit application requirements. (Note: the numbering 'of the 'instructions follows the data element numbers that are on the UPCF pages. These data element numbers ara used for electronic submission and are the same as the numbering used in27 CCR, Appendix C, the Business. Section of the Unified Program Data Dictionary.) Please number all pages of your submittal. This helps your CUPA or local agency identify·whether the submittal is complete and if any pages are separated. 1. FACILITY ID NUMBER - Leave this blank. This number is assigned by the CUPA. This is the unique number which identifies your facility. 3. BUSINESS NAME - Enter the full legal name of the business. 430. TYPE OF ACTION - Check the reason the page is being completed. For amended permits and chan§e of information, include a short statement to direct the inspector to the amendment or changed information. 431. LOCATION WITHIN SITE - Enter the location of the tank within the site. 432. TANK ID NUMBER - Enter the owner~ tank ID number. This is a unique number used to identify the tank. It may be assigned by the owner or by the CUP^. 433. TANK MANUFACTURER - Enter the name of the company that manufactured the tank. 434. COMPARTMENTALIZED TANK - Check whether or not the tank is compartmentalized. Each compartment is considered a separate tank and requires the completion of separate tank pages. 435. DATE TANK INSTALLED - Enter the year and month the tank was installed. 436. TANK CAPACITY - Enter the tank capacity in gallons. 437. NUMBER OF TANK COMPARTMENTS - If the tank is compartmentalized, enter the number of compartments. 438. ADDITIONAL DESCRIPTION - Use this space for additional tank or location description. 439. TANK USE - Check the substance stored, ff MOTOR VEHICLE FUEL, check box I and complete item 440, PETROLEUM TYPE. 440. PETROLEUM TYPE - If box 1 is checked in item 439, check the type of fuel. 441. COMMON NAME - For substances that are not motor vehicle fuels (box I is NOT checked in item 439), enter the common name of the substance stored in the tank. 442. CAS # - For substances that are not motor vehicle fuels (box I is NOT checked in item 439), enter the CAS (Chemical Abstract Service) number. This is the same as the CAS # in item 209 on the Hazardous Materials Inventory ~ Chemical Description page. 443. TYPE OF TANK - Check the type of tank construction. If type of tank is not listed, check ^othe~ and enter type.. 444. TANK MATERIAL (PRIMARY TANK) - Check the construction material of the tank that comes into immediate contact on its inner surface with the hazardous substance being contained. If the tank is lined do not reference the lining material in this item. Indicate the type of lining material in item 446. If type of tank material is not listed, check ^othem= and enter material. 445. TANK MATERIAL (SECONDARY TANK) - Check the construction material of the tank that provides the level of containment external to, and separate from, the primary containment. If type of tank material is not listed, check ^othem= and enter material. 446. TANK INTERIOR LINING OR COATING - If applicable, check the construction material of the interior lining Or coating of the tank. If type of interior lining or coating is not listed, check ^other= and enter type. 447. DATE TANK INTERIOR LINING INSTALLED - If applicable, enter the date the tank interior lining was installed. This is to assist the CUP^ to develop an inspection schedule. 448. OTHER TANK CORROSION PROTECTION - ff applicable, Check the other tank co. rrosion protection method used. If other corrosion protection method is not listed, check ^othe~ and enter method. 449. DATE TANK CORROSION PROTECTION INSTALLED - If applicable, enter the date the tank corrosion Protection method was installed. This is to assist the CUP^ to develop an inspection schedule. 450. YEAR SPILL AND OVERFILL INSTALLED ~ Check the appropriate box and enter the year in which spill containment, drop tube, and/or .' stdker plate was installed. CHECK ALL THAT APPLY. 451. TYPE OF SPILL PROTECTION - Enter the type of spill containment, drop tube, and/or striker plate. FOR CUPA USE ONLY: 452. YEAR OVERFILL PROTECTION EQUIPMENT INSTALLED - Check the appropriate box and enter the year in which overfill protection was installed or whether there is an exemption from overfill protection. CHECK ALL THAT APPLY, unless tank is exempt. 453. TANK LEAK DETECTION (SINGLE WALL) - For single walled tanks, check the leak detection system(s) used to comply with the monitoring requirements for the tank. CHECK ALL THAT APPLY. If leak detection system' is not listed, check ^othem_- and enter system. 454. TANK LEAK DETECTION (DOUBLE WALL) - For double walled tanks or tanks with bladder, check the leak detection system(s) used to comply with the monitoring requirements for the tank. CHECK ONE ITEM ONLY. 455. ESTIMATED DATE LAST USED - For closure in place, enter the date the tank was last used. 456. ESTIMATED QUANTITY OF SUBSTANCE REMAINING IN TANK - For closure in place, enter the estimated quantity of hazardous substance remaining in the tank (in gallons). 457. TANK FILLED WITH INE~RT MATERIAL - For closure in place, check whether or not the tank was filled with an inert material prior to closure. ATTACHMENTS - 1. Provide a scaled plot plan with the location of the UST system, including buildings and landmarks. 2. Provide a description of the monitoring program. Ill*" '" CITY OF BAKERSFIELD · ~4 OFFICE OF ENVIRONMENTAL SERVICE~ Chester Ave., Bakersfield, CA 93301 (661) 3l~1979 UST - TANK PAGE 2 '?' Page of UNDERGROUND PIPING ABOVEGROUND PiPiNG SYSTEM TYPE 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY 458 [] 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY 4591 CONSTRUCTION/ [] 1. SINGLE WALL' [] 3. LINED TRENCH [] 99. OTHER 460 [] 1. SINGLE WALL [] 95. UNKNOWN 462 MANUFACTURER ~--2. DOUBLE WALL [] 95. UNKNOWN [] 2. DOUBLE WALL [] 99. OTHER MANUFACTURER 461 MANUFACTURER 463 [] I. BARE STEEL [] 6. FRP COMPATIBLE W/100% METHANOL [] 1. BARESTEEL [] 6.* FRp COMPATIBLE WI100% METHANOL MATERIALS AND [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL CORROSION PROTECTION [] 3. PLASTIC COMPATIBLE WITH CONTENTS [] 95. UNKNOWN [] 3. PLASTIC COMPATIBLE WITH CONTENTS [] '8. FLEXIBLE (HDPE) [] 99. oTHER ~. FIBERG .LASS [] 8. FLEXIBLE (HDPE) [] 99. OTHER [] 4. FIBERGLASS [] 9. CATHODIC PROTECTION iI'-~ 5. STEEL WI COATING [] 9. CATHODIC PROTECTION 464 [] 5. STEEL W/ COATING []'95. UNKNOWN 465 UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): []' 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK. LEAK. SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. ALARMS [] 2. MONTHLY 0.2 GPH TEST [] 2. MONTHLY 0.2 GPH TEST [] 3. ANNUAL INTEGRrrY TEST (0.1 GPH), [] 3. ANNUAL INTEGRITY TEST (0.1 GPH) [] 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS (Check all that apply): [] 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY [] 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST (0.1 GPH) [] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE sUcTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): [] ?. SELF MONITORING [] 7. SELF MONITORING GRAVITY FLOW: GRAVITY FLOW (Check all that apply): [] 9. BIENNIAL INTEGRITY TEST (0.1 GPH) [] 8. DAILY VISUAL MONITORING [] 9. BIENNIAL INTEGRITY TEST (O.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND ,10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (che~ one) (Check one) Aa. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b. AUTO PUMP SHU~r OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM [] b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION [] c. NO AUTO PUMP SHUT OFF [] c. NO AUTO PUMP SHUT OFF [] 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR 0 11. AUTOMATIC LEAK DETECTOR RESTRICTION [] 12. ANNUAL INTEGRfT~ TEST (0.1 GPH) [] 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: SUCTION/GRAVITY SYSTEM: [] 13. CONTli~IUOUS SUMP SENSOR + AUDIBLE AND VlSUAL ALARMS [] 13. CONTINUOUS SUMP SENSOR + AUDISLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply) EMERGENCY GENERAToRs ONLY (Check ell that apply) [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL VISUAL ALARMS ALARMS [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) RESTRICTION [] 16. ANNUAL INTEGRITY TEST (0.1 GPH) [] 16. ANNUAL INTEGRITY TEST (0.1 GPH) ' [] 17. DAILY VISUAL CHECK [] 17. DAILY VISUAL CHECK DISPENSER CONTAINMENT [] 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 4. DAILY VISUAL CHECK OATE I~ISTALLED 468 [] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS [] 5. TRENCH LINER / MONITORING ..~'"/:~O/~lr__ -- ~ CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER ' AUDIBLE AND VISUAL ALARMS [] 6. NONE 469 I certify that the information provided herein l~ true and accurate to the best of my know~edge. NAME OF OWNER/OPERATOR (print) ~' 471 TITLE OF OWNER/OPERATOR 472 UPCF (7/99) S:\CUPAFORMS\SWRCB-B.WP D UST - Tank Page 2 (Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages. These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C, the Business Section of the Unified Program Data Dictionary.) Please number all pages of your submittal. This helps your CUPA or local agency identify whether the submittal is complete and if any pages are separated. 458. PIPING SYSTEM TYPE (UNDERGROUND) - For items 458 and 459, check the tank=s piping system 459. PIPING SYSTEM TYPE (ABOVEGROUND) information. CHECK ALL THAT APPLY. 460. PIPING CONSTRUCTION (UNDERGROUND) - Check the tank=s piping construction information.· CHECK ALL THAT APPLY. 461. PIPING MANUFACTURER (UNDERGROUND).- Enter the name of the piping manufacturer. 462. PIPING CONSTRUCTION (ABOVEGROUND) - Check the tank=s piping construction information. CHECK ALL THAT APPLY. 463. PIPING MANUFACTURER (ABOVEGROUND) - Enter the name of the piping manufacturer. 464. PIPING MATERIAL AND CORROSION PROTECTION (UNDERGROUND) - For items 464 and 465, check the '465. PIPING MATERIAL AND CORROSION PROTECTION (ABOVEGROUND) tank=s piping material and corrosion protection. 466. PIPING LEAK DETECTION (UNDERGROUND) - For items 466 and 467, check the leak detection system(s) used 467. PIPING LEAK DETECTION (ABOVEGROUND) to comply with the monitoring requirements for the piping. 468. DATE DISPENSER CONTAINMENT INSTALLED - If applicable, enter the date that dispenser containment was installed. 469. DISPENSER CONTAINMENT TYpE - Check the type of dispenser containment monitoring system. SIGNATURE OF OWNER/OPERATOR - The owner or agent of the owner shall sign in the~space provided. This signature certifies that the signer believes that all the information submitted is true and accurate. 470. DATE CERTIFIED - Enter the date the page was signed.' 471. OWNER/OPERATOR NAME - Print the name of signatory. 472. OWNER/OPERATOR TITLE - Enter the title of the person signing the page. 473. PERMIT NUMBER - Leave this blank, this number is assigned by the CUPA. 474. PERMIT APPROVED BY - Leave this blank, this is the name of the person approving the permit. 475. PERMIT EXPIRATION DATE - Leave this blank, this is completed by the CUPA.  _ CITY OF BAKERSFIELD ~ · og s vIc s 1715 Chester Ave., Bakersfield, CA 93301 ~661) 326-3979 UNDERGROUND STOOGE TANKS - INSTAL~TION CERTIFICATE OF COMPLIANCE Pa~ ~ of ~ BUSINESS ~E (~me ~ FACIL~ ~ME ~ O~ - ~ng Bu~n~ ~) 3 ADDRESS (~r ~l u~ o~y) 476. (Check all that apply) .j~ The installer has been trained and certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered professional engineer having education and experience with underground storage tank installations. ~._ The installation has been inspected and approved by the Bakersfield Fire Department - Environmental Services. 4~0. [] All work listed on the manufaCturer's installation checklist has been completed. ~1~-- The installer has been certified or licensed by the Contractors' State License Board. 4~. [] The underground storage tank, any primary piping, and secondary containment was installed according to 4s3. applicable voluntary consensus standards and written manufacturer's installation procedures. Description of work being certified: I certify that the Information provided herein Is true and acoJrate to the best of my knowledge. SIGNATURE OF TANK OWNE~A~ ~ ~ DATE 484. NAME OF TANK OWNER/AGENT (print) c/ 485. TITLE OF TANK OWNER/AGENT 486. UPCF (7/99) S:\CU PAFORMS\swrcb-c.wpd UST Installation - Certificate of Compliance Complete this certification upon installation of an UST and piping. One certification is required for each tank system..This page may be completed by either the UST owner or representative. = Refer to 23 CCR 2635 for UST installation and testing requirements. (Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages. These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C, the Business Section of the Unified Program Data Dictionary.) Please number all pages of your submittal. This helps your CUPA or local agency identify whether the sUbmittal is complete and if any pages are separated. 1. FACILITY ID NUMBER - Leave this blank. This number is assigned by the CUPA. This is the unique number which, identifies your facility, 3. BUSINESS NAME - Enter the full legal name of the business. 476. ADDRESS - Enter the street address where the tank is lOcated. This is to assist the tank inspector in locating the. tank. 477. TANK ID NUMBER - Enter the tank ID number assigned by the owner. This is a unique number used to identify the tank. It may be assigned by the owner or by the CUPA. This is the same as item 432. 478. TRAINED.AND CERTIFIED BY TANK AND PIPING MANUFACTURER - Check if the tank installer provided evidence of being trained and certified by the tank and piping manufacturer. 479. REGISTERED ENGINEER INSPECTION - Check if the installation has been inspected and certified by a registered professional engineer, if necessary. 480~ UNIFIED PROGRAM AGENCY APPROVAL - Check if the installation has been inspected and approved by the Unified Program agency. 481. COMPLETION OF MANUFACTURER'S CHECKLIST - Check if all work listed on the manufacturer=s installation checklist was completed. 482. CONTRACTORS= STATE LICENSE BOARD CERTIFICATION OR LICENSE - Check if the installer has provided ' proof of CSLB certification or licensing. 483. INSTALLATION DESCRIPTION - Check if the UST system was installed according to applicable voluntary consensus standards and any manufacturer=s written installation instructions. Describe the installation in the space provided. Clarify the type and the extent of work completed at the facility, such as installation of dispenser containment, replacement of piping, or installation of turbine sumps. SIGNATURE OF TANK OWNER/AGENT - The tank owner or agent of the owner shall sign in the space provided. This signature certifies that the signer believes that all the information submitted is true and accurate. 484. DATE CERTIFIED - Enter the date that the page was signed. · 485. TANK OWNER/AGENT NAME - Enter the full printed name of the person signing the page. 486. TANK OWNER/AGENT TITLE - Enter the title of the person signing the page. ~-'TE CF CALIFORNIA WATER ~,ES0URCES CONTROL BOARD '"~ . UNDERGR D STORAGE TANK PERMIT APPLIC, N - fORM A · COMPL~ ~lS FORM FOR EACH MARK ONLY ~ 1 N~ PERMIT ~ 3 R~ PERUff ~ 5 C~ ONE ffEM ~ 2 ;~RIM PERMIT ~ 4 ~ENDED ~RUff ~ 6 ~M~ S~ C~SURE I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) " ~=.A OR FACILITY NAME NAME OF OPERATOR ADDRESS NEAREST CROS~ STREET PARCEL I C;~ NAME STATE ; Z;P CODE I SITE PHONE · WITH AREA CODE ./ BOX TO INDICATE ~ CORPORATION ,~. INDIVIDUAL ~ PARTNERSHIP ~- LOCAL-AGENCY ~ COUNTY.~GENCY ~ STATE.AGENCY E~ FEDERAL.&GE~CY DISTRICTS .'~'PE OF BUSINESS .~ I GAS STATION~1-- 2 DISTRIBUTOR I L~:~ RESERVATION~" IF INDIAN I ~ OF TANKS AT SITE I E. P.A. L D. · ~ 3 FARM ?""' , PROCESSOR ~ $ OT-:ERI OR TRUST LA/~ [I .~l,[' EMERGENCY CONTACT pERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECOND~U:IY). l DAYS: NAME (LAST. FIR~ST) PHONE I WITH AREA CODE DAYS: NAME (LAST. FIRST) PHONE · WITH AREA NiGH. TS: NAME (LAST. FIRST) PHONE · WITH AREA CODE NIGHTS: NAME (LAST. FIRST) PHONE · WITH AREA CODE *11. PROPERTY OWNER INFORMATION - (MUST BE COMPLETED! I ,AME Y i r CARE OF ADDRE. IN ORMAT . MA~LING OR STREET ADDRESS ,/ Ix~e;,-~ ~ INDNIDUAL J-~ LOCAL. AGEI~ ~ STATE-AGEnCY ! C;TY NAME STATE, j ZIPC.~F. I pi-loNE I ~ AREA COOl= IlL TANK OWNER INFORMATION- (MUST BE COMPLETED1 %AME OF OWNER I CARE OF ACORESS INFORMATION MAILING OR STREET ADDRESS I ~ CORPORAT~ ~___J PART~P [~ COUNWAGr~ r-9 FEDERAL,AGE~ CITY NAME i STATE [ Z~ ~_~_--.:.~ I pI,,IONE · WTTH AjqC~k C~X~ IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER · Call (916) ?39-2582 Jf ques~ons arise. V. LEGAL NOTIFICATION AND BILUNG ADDRESS Le~, ~=:.t!:ntion and billing will be sent to the tank owner unless box I or II is checked. CHECK ONE SOX ~ND~CATING WHICH ABOVE ADDRESS SHOULD nE USED ~On k--ga_ ~.OT~F~CATIONS AND roLL,AG: I. [] IL [] ,L ~ THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PEFiJ~.'RY. AND TO THE BEST OF MY KNOWLEDGE, IS TRUE ANO CORRECT l APPLICANI~S NAME (PRINTED & S,GNATURE, ~ -':=LICANTS TITLE I DATE MONTH/GAY/YEAR LOCAL AGENCY USE ONLY LCCATION cODE - OPTIONAl. CENSUS TRACT · · OPTIONAL ' SUPVISOR - DISTRICT CODE - OPT/ONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION- FORM B, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. :ORM A ~9-901 FORI~33A~R2 : STATE WATER IESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR EACH TA,qE( SYSTEM, MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF iNFORMATION [] 7 I~'RMANENTLY Ct, OBED ON SITE ONE iTEM [] : INTEnna PERMIT [] 4 ~J~ENOEO Iq;RMIT [] e TEMmRAnY TAN~ ct.ore,nE [] .,e T,~IK OBA OR FACKJTY NAME WHERE TANK IS DiSTALLED: I. TANK DESCRIPTION co~_~;~.nT~e- SPEC~:uxxNOwN II. TANK CONTENTS ~ ~.~ ~s UAnX~O. COO.~"m rt~ c. 'V~0~O ' [] 2 P~TROLEUM [] 90 EMI~TY [] I PROOUCT [] lbP t~'MIUM ~ [] 7 ML~THANOL [] 3 CHEMICAL PRODUCT [] es UNKNOWN [] 2 WASTE [] 2 ~~'~ 99 OTHER IlL TANK CONSTRUCTION A. TYPE OF ~ 1 DOUBLE WALL [] 3 SINGLE WALL Wl11.1 EXTERIOR LINER [] 95 UNKNOWN SYSTEM ~ 2 SINGII¢ WAI~ [] 4 SECONDARY C~NTNNMENT (VAULTED TN~O [] 69 OTHER e. TA~K [] 1 BARE ~'~I~ '[] 2 STAINLESS STEEl. [] 3 FIItER(~,.AS~ [] 4 s'r~LCU~)W/FIB~I~I.A~ REINI=ORC~}PT.~'rlc MATERIAL ~ 5 CONCRETE [] ; POLYWNYL Chl. ORI3E [] 7 ALUMU~U [] , ~oo~ ~ COM~ATlaLEW~=RP :p~.../~.~ [] , ..oN= [] ,o oALvA.,.,:o STEEL [] ~ UN~O~ [] . O~. [] I RU~OER LINED [] 2 ALKYD L"NG [] 3 EPOXY LINING [] 4 PHENOI. JC UNgdG C. INTERIOR O. CORROSION ~ 1 POLYETHYLENE Wl~lP [] 2 COATING [] 3 VINYl. ~ [] a, FIeEI~31.A~ REINFOR~ PROTECT]ON ~ 5 CA*n-,O0~ PROTECTION [] e~ NONE [] ~ ~ [] ~ OTHER IV. PIPING INFORMATION C~RCLE A ,= Am3V~O OR U A. SYSTEM TYPE A U 1 SUCTION (.,~:i~PRESSURE k U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U ~ $1~t.E WALL ~ Uj)C~.; wnu. A U ~ UNB:)TnE~C~ A U eS UNXI~OW~ A U C. MATERIAL AND A U ~ BAn;STEEL A U 2 STAWt.~SS STEEL A U 3 POt. Wtm'L C~.OmOE(P~tgB~LAS,~ PU~E CORROSION A U 5 ALUMINUM A U s CONCRETE A U 7 STEEL W/ COATING A U '8 100'/,, ~ COMPATIB&EW~:RP PROTECT[ON A U 9 GALVANIZED STEEl. A U lo CATHOOICPROTECTION A U eS UNNNOWN A U eS OTHER D. LEAK DETECTION ~ ! AUTOMATIC LINE LEAK DETECTOR,~ 2 UNETIGHTNESSTE$1'ING ~ 3 I/~irj~tiu~,.MoNn. ORiNG [] g9 o'n-IER V. TANK LEAK DETECTION I ~--] 1 VISUAL CHECK I,~. 2 INVENTORY ,ECONClUATION t,_~ 3 V,N:K3RMONITORINGr~ ' NJTOMATIC TANK GAUGING [] S GROUND WATER MONITORING J VI. TANK CLOSURE INFORMATION ~. ESTIMATED DATE LAST USED (MO/DAY/YR);I 2. ESTIMATED QUANT~ OFsuBSTANCE REMAINING GALLON~ Ii 3. WA~ TANK FILLED WITNiNERT MATERIAL ? YE~ [] THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE./S TRUE AND CORRECT . I APPLICANt'S NAME DATE (P;UNTED & SIGNATURE) LOCAL AG ENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW i COUNTY # JURISDICTION · FACILITY # TANK # · STATE I.D.# TI I] I I I I IIII i I I PERMIT NUMBER ! PERMIT APPROVED BY. DATE i PERMIT EXPIRATION [)ATE ;oRM e (9-eD) THIS FORM MUST BE ACCOI~ANIED BY A PERMIT APPUCATION · FORM A, UNLESS A CURREHT FORM A HAS BEEN fiLED. STATE WA'IT:R RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERUIT APPLICATION - FORUB COMPLETE A SEPARATE FORM FOR EACH TAM( SYSTEM, MARK ONLY [~ 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF iNFORMATION r-~ ? PERMANENTLY Ct.O~=D ON SITE ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLO~URE [] *, 6 TANK REMOVED DBA OR FACIUTY NAUE WHERE TANK IS INST.~I 1 I. TANK DESCRIPTION CO~ETE AL~ rrEus - SPEClW ,; UNXNOWN C. DA~ ~ 2 PET"O~EUM ~" EMPW ~ 1 "~T ~ I~PREMIUM~L~;D ~ 5 JET~ ~ 7 M~ · ~ 3 CHEMICAL PRODUOT ~ ~ UN~ ~ 2 W~ ~ 2 ~O~ ~ O~R ~RI~ ~ ~ ~ ~ D. IF (A.1) IS NOT MARKED. EN~R N~E ~ ~aST~ STOR~ C. ~ ~. ~: III. TANK CONSTRUCTION MARK ONE tTEM ONLY IN BOXES A, B. ANDC. AND ALL THAT APPLIES IN BOX D A. TYPE OF :~ 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM .~ 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULTED TANIO [] 99 OTHER ~ , BARE STEEL [] 2 STAINLESS STEEL ~ 3 FIBERGLASS ~ 4 STEEL CLAD W/FIBERGI.~ REINFORCED PLASTIC B, TANK MATERIAL ~ 5 CONCRETE [] 6 POLYVINYL CHLORIDE C 7 ALUMINUM [] ii 100% METHANOL COMPATIBLEW/FRP (Pri~t~'yTarlk) ~ 9 BRONZ~ [] 10 GALVANI2~D STEEL ~-~ 95 UNKNOWN [] g9 OTHER C. INTERIOR -- ~ 95 UNKNOWN [] 99 OTHER UNING ' ~ 5 ~ LINING [~ 6 UNLINED tS LINING MATERIAL COMPATIBLE ~NITH 100% METHANOL ? YES ~ NO__ =--' ~ 3 VINYL WRAP ~ 4 FIBERGLASS REiNFORCED PLASTIC --~ 1 POLYE*~YLENE WRAP I : 2 COATING D. CORROSION -~ -- PqOTECTION 7~, 5 CATHODIC PROTECTION I-----~ 91 NONE ~ 95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION C~RCL~ A IF ABOVE G~J~ND OR U IF UNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A U 1 S;JCTION ~ U~.j~PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL ~ 2~)OUSLE WALL A U 3 LINED TRENCH A Uf~'"'~95 UNKNOWN A U 99 OTHER A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)~FIBERGLAS~ PIPE C. MATERIAL AND CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COATING A U 8 100~ METHANOL COMPATIBI.EW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION ,~ 1 AUTOMATIC LINE LEAK DETECTOR~ 2 LINE TIGHTNESS TESTING ~ 3 MONITORINGINTERSTITIAL [] 99 OTHER V. TANK LEAK DETECTION "~ ~ V~SUAL C~ECK --- '~ .NVENTORY RECONCILIATION ~:*~ 3 VAPOR MONITORING ~. 4 AUTOMATIC TANK GAUGING [] 5 GROUND WATER MONITORING ; 6 TANK TESTING :NTERSTITIALMONITORING , gl NONE 95 UNKNOWN 99 OTHER VI. TANK CLOSURE INFORMATION I1. ESTIMATED DATE LAST USED {MO, CAY,¥R) 2. ESTIMATED QUANTITY OF i 3. WAS TANK FILLED WITH YES [] NO[] GALLONS ! INERT MATERIAL ? SUBSTANCE REMAINING T~IS FORM HAS BEEN COMPLETED UNDER PENAL D/ OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS 'I~UE.AND CORRECT LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OFTHE FOUR NUMBERS BELOW I COUNTY # JURISDICTION · FACILITY # TANK · STATE I.D.# [ ] I 11 · PERMIT APPROVED BY/DATE j PERMIT EXPIRATION DATE PERMIT NUMBER FORM e (g-go} THIS FORM MUST BE ACCOMPANIED BY l PERMIT APPUCATiON. FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. UNDERGROUND STORA*E TANK PER IT APPLICATION *O.M A COM~L~ ~lS FO~ FOR EACH FA~ffE  MARK ONLY ~ I N~ PERMIT ~ 3 R~ PERUff ~ 5 CH~ ~ INmRMAT~ ~ 7 ~RM~y CLOUD S~ ONE ITEM ~ 2 I~RIM PERMIT ~ 4 ~ENDED ~Mff i~ 6 ~M~ S~ C~SURE I. FACILI~ITE INFORMA~ON & ADDR~S- (MUST BE COMPLIED) ~BA OR FACiLI~ N~E NAME OF OPE~TOR ADDRESS NEAREST CRO~ STRE~ P~CEL C;~ NAME STATE ZIP ~DE SI~ P~NE I WI~ AR~ ~DE ~ ~X TO iN,CATE ~ CORYDON .~ IN~V~UAL ~ P~T<~P ~ L~AL-AG~CY ~ ~U~Y ~ ~A~-~ ~ F~E~Y D~TRICTS ~ 3 FARM ~ 4 PRaEtOR ~ 5 O~"ER~ ORTRUST~I/ E~GENCY ~A~ PER~N (PRIMARY) EM~G~CY ~A~ P~N I ~AYS:, NAME (~ST, FIR~ P~NE I WITH AREA ~DE DAYS: NAME (~T. FIRS~ NIGHTS: NAME (~T, FIRS~ P~NE t WITH AREA ~ NI~TS: N~E (~T. FIRS~ II. PROPER~ OWNER IN~RMATION- (MUST BE COMPL~D) MaiLiNG OA STREET ~DRESS ' ~ ~ ~ ~m ~ ~ND~U~ C;~ NAME ,~ STA~ ,~ Z~P ~E P~E I ~ AR~ ~E IlL TANK OWNER INFORMATION - (MUST BE COMPLIED1 ~AME OF OWNER ] CARE OF ADDRE~ INmR~T~N I MAiLiNG OR STREET ~DRESS ,I ~ COR~ ~ P~P ~ ~U~ ~ F~y IV. 6OARD OF EQUALIZA~ON UST ~ORAGE FEE ACCOU~ NUMBE~ - Call (916) 739-2582 if ques~ons ari~. TY(TK) HO ~-~ i V. LEGAL NOTIFICATION AND BILLING ADDRESS Leoa ~c:.:~fion and billing will ~ sent to the t~k o~er units ~x I or II THIS FORM ~S BEEN COMPLETED UNDER PENALTY ~ PERJURY. AND TO THE BEST ~ ~ KNOW. E, IS TRUE ~D ~RRECT LOCAL AGENCY USE ONLY I COUN~ · JURISD~CT;ON ~ FAClL~ LOCATION CODE - CP~ONAL CENSUS TRACT* - OPTIONAL ' ~ SUPVISOR.- DIS~T ~DE - THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR ~RE PERMff A~PLICATION · FORM B, UNLESS TH~ IS A CHANGE OF S~ ~FOR~ON ONLY. FORM A (9-~} F~A~2 STATE OF CNJFOI~ STATE WATER RESOURCES CONTROL BO/I.qD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B · cOMPLETE A SEPARATE FORM FOR EACH TAI~'SYSTEIL ' MARK ONLY r~ 1 NEW pERUIT i"--]- 3 RENEW~ PERUIT [] S ~ OF wr-ORUAllON ~ .7 I~'~IMENTLY CLOSED O~ srlT ONE ITEM[] 2 INTERIM PERMIT [] 4 AMENDED P~RMIT [] e TEUPORN~' TA.~ CLOSURE i---]' e T.eaC 0SA OR FACILITY NANE WHERE TANK IS g4SI'A' t I. TANK DESCRIFTION coum_~-TEAL~.rr~s- SPEC~'~;U"KNOW" C. DATE INSTALLED (MO/CAY/YEAR) ~*-~ O' ~ D. TANK CAPACilY IN GN. LONS: I~t ~)~) "~ I ~"~ II. TANK CONTENTS ' i~ A.~ ~UARK~O. COUm_r~rmU C. . UNLEADEDI I 4 GA~ ~ UIa. EADED $ JET FUEL [] 3 CHEMICAL PRODUC~; ' [] 95 UNKNOWN [] 2 WASTE [] 2 I..EAOEO~ 99 OTHER ~CRI~ IN n~ O. BELOW)q D. ~(A.~)~SNGTUARK~D. ENTER N~m O~__~_~TANC~ STORm C.A.S.~: III. TANK CONSTRUCTION UARKONE~UONLYINeOX~S~.a. ANGC. A~OALLTHATAPm. mS~eOXO ~ TYPE OF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM .1~ 2 SINGLE WALL' [] 4 SEcoNDARY CONTNNM, ENT (VAULTED TANK} [] 99 OTHER S. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGUI.R~ [] 4 STEEL CLAD W/FIBERGLJI~q~ REINFORCED PLA~TIC MATERIAL [] 5 coNCRETE [] 6 POLYVINYL CHLORIOE [] .7 ALUMINUM [] :8. 100% METHANOL coMPATIBLEW/FRP ~P~im~n/Tan~) [] g BRON~ [] 10 GALVANIZED STEEL' [] 95 UNKNOWN [] 99 OTHER C. INTERIOR ~ s ca. Ass UN~G [] $ UNUNED [] ~S ~ [] ~9 OTHER MNING IS LINING MATERIAl. COMPATIOLE WITH 100~ ME'il-IANOL ? YES ~ NO__ D. coRRosI0N ~ i 'POLYETHYLENE WRAP [] 2 coATING [] 3 VINYL WRN:m [] 4. FIBERGL.A,~ REINFORCED PIJ~TIC PROTECTION ~ 5 cATHODIC PROTECTION ~"~ 9! NONE [] 95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION ci~LE · LC ABOVE~CaJ~II~D OR U [FUN~ERGROUNO. BOTH IF APPUCa3LE A. SYSTEM TYPE A U I SUCTION (, U~PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U ~ S;NGLE WALL (~ U~.,~)DOUBLE WALL A'U 3 UNED TRENO~ A U SS UNKNOWN & U ~g OTHER C. MATERIAL AND A U I BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (P~IBERGLAS~, PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATI~.EW/FRP PROTECTION A U 9 GALVANIZED STEEL A U lo CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D.. LEAK DETECTION ~ 1. AUTOMATIC L]NE LEAK DETECTOR ~ 2 LINE TIGHTNE$$ TESTING [] 3 MONITORINGINT~Hm~L [] 99 OTHER V. TANK LEAK DETECTION '___.--'~ I VISUAL CHECK I~2 INVENTORY REcONcILIATION I----~ 3 VAPOR MONITORING ~ 4 NJTOMATIC TANK GAUGiNG [] 5 GROUNOWATERMONITORING ;E TIN . ,.TERSTmAL.O.,TOR,NG NC.E [] U.# OWN [] O ER VI. TANK CLOSURE INFORMATION I ,. ESTIMATED DATE LAST USED (MO/DAY/YR). ; 2. ESTIMATED QuANT1TY OFsuBSTANCE REMAINING GALLONS il 3' WAS TANK FILLED WITHINERT MATERIAL ? THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY * THE STATE I.D. NUMBER IS COMPOSED OFTHE FOUR NUMBERS BELOW COUNTY #. JURISDICTION # FACILITY # TANK # FO~U 8 (~-~0~ -. THIS FORMMUST BE ACCOMPANIED BY A PERMIT APPLICATION · FORM A, UNLESS A CURRENT FORM A HAS BEEN RLED. STATE WATER RESOURCES CONTROL BOARD UNDEFIGROUND STORAGE TAHK PEFIMIT APPLlCATIOH - FOFIM B COMR. ETEA SEPARATE FORu FOR EACH TANK SYSTEI& .:MARKONLY ~ ! NEWPERMIT [] 3 RENEWAL PERMIT [] $ CHANGE ~: INFORMATION [] 7 PERMJ~iENTLYCLO~DONSITEi ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTA~FD: I. TANK DESCRIPTION coMPtETE AU. ITEMS - SPECIFY IF UNKNOWN C. DATE INSTALLED(MO/DAY/YEAR) ,._~,..~) ,~ O. TANK CAPACITY IN GALLONS: II. TANK CONTENTS IFA-1 IS MARKED, COMPLETE ITEM C. MOTO. VEH,CLE FUN' [] . O,L B. C. [] ~.R~U~. ~ 3 O,ESE~ [] . AV~O.G~ A. 1 UNLEADEDI 1 4 GASAHOL [] ~ PETROLEUM ~., E.P~[] , PRO~T [] .~PRE.IU.u.L~ED [] S J~T~ [] 7 ME.~.OL [] 3 CHEMICAL PRODUCT .,r---'j 95 UNKNOWN [] 2 WASTE [] 2 LEADED [] 99 OTHER (OESCRIB~ IN ITEM D, BELOW D. IF IA.l) IS NOT MARKED. ENTER NAME OF SUBSTANCE STORED C.A.S. ~: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC. AND ALL THAT APPLIES IN BOX D A. TYPE OF ~ 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM .~ 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER B. TANK ~ 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS ~] 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC MATERIAL ..;---] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLEW/FRP (P~im~yTa.~l ~ ~ .RONZE [] ~0 GALVANIZED STEEL [] .5 UNKNOWN [] ~ OTHER -~ ~ RUB~R L,NED [] ~ AL~D L,N~O [] ~ EPO~ L,N,NG [] ~ PHE.O~ LININ~ C. INTERIOR !---~ 5 GLASS LINING ~ 6 UNLINED ~ 95 UNKNOWN [] 99 OTHER LINING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES_ NO__ -~ 1 POLYETHYLENE WRAP ~ 2 COATING ~ 3 VINYL WRAP ~ 4 FIBERGLASS REINFORCED PLASTIC D. CORROSION PclOTECTION ~ s CATHODIC PROTECTION ~ 9~ NONE ~ 95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION C~RC~' A IFABOVEGR~NDOR U IF UNDERGROUND. BOTHIF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION U~,~PRESSURE A U 3 GRAVITY A U 99 OTHER 8. CONSTRUCTION A U 1 SINGLE WALL /~ 2~UBLE,. WALL A U 3 LINED TRENCH A U~."'"'~,95 UNKNOWN A U 99 OTHER C. MATERtALAND A U 1 BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC~ FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CCNCRETE A U 7 STEEL W/ COATING A U 8 10(P/. METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION ,p~ 1 AUTOMATIC LINE LEAK DETECTOR.~ 2 LINE TIGHTNESS TESTING ~ 3 INTERST1TIALMoNFCORING [] 99 OTHER V. TANK LEAK DETECTION :_~' t VISUAL CHECK ~ 2 :NVENTORY RECONCILIATION ~ 3 VAPOR MONITORING ~ 4 AUTOMATIC TANK GAUGING [] $ GROUND WATER MONITORING i~ 6 TANK TESTING .~ :NTERSTITIALMONITORING ' = 91 NONE [] 95 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION I 1. ESTIMATED DATE LAST USED (MO, CAY/YR) 2. ESTIMATED QUANTITY OFSUBSTANCE REMAINING GALLONS I" 3. WAS TANK FILLED WITHiNERT MATERIAL ? YES r~ N°~-~ THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT I APPLICANTS NAME I DATE I {PRINTED & SIGNATURE) LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER 1S COMPOSED OF THE FOUR NUMBERS BELOW STATE I.D.# COUN~ # ',, I I : JURISDICTION. ii ~i FACILITY. TANi# j PERMIT NUMBER , !. PERMIT APPROVED BY/DATE I PERMIT EXPIRATION DATE FOR~ a (~O) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPUCATION - FORM ~ UNLESS A CURRENT FORM A HAS BEEN FILED. March 29, 2000 Mr. Fast 600 Brundage Lane Bakersfield, CA 93304 Dear Underground Tank Owner: Your permit to operate the above mentioned fueling facility will expire on..- June 30, 2000. However, in order for this Office to renew your permit, updated.forms A, B & C must be filled out and returned prior to the issuance of a new permit. Please make arrangements to have the new forms A, B & C completed and returned to this office by May 15, 2000. For your convenience, I am enclosing all three forms which you may make copies of. Remember, forms B & C need to be filled out for each tank at your facility. Should you have any questions, please feel free to contact me at (661) 326-3979. Sincerely, t Steve Underwood, Inspector Office of Environmental Services SU/dlm Enclosure 2:,: D February 4, 2000 Mr. Bruce E. Myers, CEG F~.E C.~EF CV - RWQCB RON FRAZE 3614 East Ashlan Ave. ADMINISTRATll/E SERVICES Fresno, CA 93726 2101 "H' Street Bakersfield CA 93301 VOICE (661) 326-3941 FAX (661)~395-1349 Re: Mr Fast at 600 Brundage Lane in Bakersfield ! SUPPRESSION SERVICES 2101 'H~ Street Bakersfield,/CA 93301 VOICE (6617 326-3941 FAX (661),395-1349 In regards to your January 4, 200'0 letter to Mr. Ki Chu Yi at the ' ! above referenced site, I noticed that you indicated "Data regarding soil PREVENTION1715 Che~terAve.SERVICES concentrators noted at the time of UST removal has not yet been Bakersfield,! CA 93301 provided." VOICE (661) 326-3951 FAX (661) ,326-0576 Enclosed, please find documentation related to the UST removal / and sampling at that time. Also included is narrative work description ENVIRONMENTAL SERVICES history, originally submitted to the Cleanup Fund, for your benefit as well. 1715 Che~;ler Ave. Bakersfield,ICa 93301 I appreciate all your efforts in helping to make this our # 1 priority VOICE (661) 326-3970 FAX (661) ~26-0576 clean up site in the City of Bakersfield. / TRAINING DIVISION 5042 Vicior Ave. Sincerely, Bakersfield,ICA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 ·,% _ Howard H. Wines III Hazardous Materials Specialist Office of Environmental Services HHW/mv cc: Ki Chu Yi (w/o) enclosures S:\FEBOO\Bmce E MyersL2 BAKERSFIELD FIRE DEPARTMENT February 13, 1998 RI~ 'CHIEF MICHAEL R, Kd~ll¥ Mr. Fast '600 Brundage Lane ,,~M~N~U, nW,~.,~ Bakersfield, CA 93304 2101 'H" Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 sumrmlON ~mc~ RE: "Hold Open Devices" on Fuel Dispensers 2101 'H" Street Bakersfield, CA 93301 (805) 326-3941 Dear Underground Storage Tank Owner: FAX (805) 395-1349 The Bakersfield City Fire Department will commence with our annual PREVENIION 1715ChosterAvo. Underground Storage Tank Inspection Program within the next 2 weeks. Bakersfield, CA 93,.a01 (805) 326-3951 FAX (805)326-0576 .The Bakersfield City Fire Department recently changed its City Ordinance concerning "hold open devices" on fuel dispensers. The Bakersfield City Fire ENVIRONMENTAl. SB~%qCES 1715 Chester Ave. Department now requires that "hold open devices" be installed on all fuel ~e~,c^~:~ dispensers. The new ordinance conforms to the State of Califomia guidelines. C805) 326-3979 FAX (805) 326-0576 The Bakersfield Fire Department apOlogies for any inconvenience this IIL~NING DIVISION 5642 VlctorStreet may cause you. I~kersfield, CA 93308 (805) 399-4697 FAX(805) 399-5763 Should you have any questions, please feel free to contact me at 326-3979. sincerely, Steve Underwood ' Underground Storage Tank Inspector cc: Ralph Huey BAKERSFIELD FIRE DEPARTMENT NO 6 2 9 Locatio~ /he. ~_~.51( Sub Div. ~3q 22 f I ~- . Blk . ~t You are hereby required to make the following cor~ctions at the above location: Cor. No Inspector 325-3979 N0¥--07--97 FRI 13 :20 MR. FAST . 8053242915 P. 01 State ctors Lic, ff 569211 11~20 Paladino Dr~e, ~kersfleld, CA ~3~ (805) 873-71 ~ r~epo~ed ~ymptoms ' PM Date Name Hourly Rate Amount Quanti~ OUTSIDE SERVICES- MATERIAL- RE~ALS Ea~ A~unt ~ofol LQbor Total B Materials Total c Mileage Handling TOTAL AMOUNT Invoice A& B & C ........ _~iles .... ~ Rate TOTAL HANDLING % TOTAL C TOTAL a TERMS N~T; Make and Model SePal Number Equipment Tagged Tag ~ :' ~RED D ~EN ~ CLUE ,, l'otalizer ~ Callibration: Readings Start (money) S[a~ (gallona) Checked ~. ~ .......... Adjusted Product Return to Storage(gallons) TotallzerSealed Meter Sealed YES ~O YES NO ' Vcrification: I hereby ¢e~ify hours/materials shown are correc~ Date; UNDERGROUND STORAGE TANK MONITORING PROGRAM This. momtormg program must be kept at th~ UST location at aH times. The informalion on thi~_ ~ program are conditions of the operating permit. The permit holder must notify the Office of Envinmmemal Se. rvi~ within 30 day~ of any ~ to th~ monitoring procedures, unless mlnired to O{~nin ap~oval be:fol~ making the change. Required by Sections 2632(d) and 26410a) CCR. Facility Name Facility Address ~v A. Describe the frequency of performing the monitoring:. Tank O~e__ ~v_~,u_ ~/~o ~,~t ,.hI~,-z~., s~.~4r~, daffy B. What methods and equipment, identified by name and model, will be used for perfoming the monitoring: Tank _T~e~u,. T.f=,- tOt00 Piping C. Describethe location(s) where the monitoring will be performed (facih'ty plot plan should be attache): " D. List the name(s) and title(s) of the people responsible for performing the monitoring and/or maintaining the equipment: E. Reporting Format for monitoring: Tank nu,,o,O Piping Ano,~, [ F. Describe the preventive maintenance schedule for the monitoring equipmenL Note: Maintenance must be in accordance with the manufacturer's maintenance sehednle but not less than every 12 months. '~rv~,~ -I-.5~/t~o tns~ll¢~ ~t,~l,,,vv ¥~ttc G. Describe the training necessary for the operation of UST system, inclUding piping, and the monitoring equipment: fl4.'~a. 4cm~,,,.[ vto,~ c- EMERGENCY RESPONSE PLAN UNDERGROUND STORAGE TANK MONITORING PROGRAM This momloru~ prosram must bc kepi at the UST location ai all times. Thc information on this momiormg program a~ conditions of the operating permit. The permit holder must notify thc Office of Env~omnental Sel~oe5 within 30 days of ally change5 tO the momtormg procedures, unless required to obtain approval before makes thc Change. R~quired by Section~ 2632(d) and 2041(h) CCR. Facility Name t~. Fa_~4. Facility Address t'~t>e~ 14~.~t'~.~¢ 1. If an unauthorized release occurs, how will the hazardous substance be cleaned up? Note: If released hazardous SUbstances reach the environment, increaze the fire or explosion hazard, are not cleaned up fi-om the secondary, containment within 8 hours, or deteriorate the secondary containment, then the Office of Environmental Services must be notified within 24 hours. ~,Ot~ ~.,. ~. ~,~ , ' 2. Describe the proposed methods and equipment t° be used for removing and properly disposing ofany hazardous substance. {J6e_ /-,/,/¥ I,-~c a~, ,~t,,, 3. Describe the location and availability of the required cleanup equipment in item 2 above. ~tC~ t,4~_~- ;~ ~.~f/~ ~ ,h ';'lb ~.¢ a,~ t~ 4. Describe the maintenance schedule for the cleanup equipment: ~/~ 5. List the name(s) and title(s) of the person(s) responsible for authorizing any work necessary under the response plan: UNDERGROUND STORAGE TAI NSPECTION Bakersfield Fire Dept. ............... ~,~,~,~,~,~,~i ~ ; ~ ;~,~,,, ~,~ ............ ........................ i ~'~' Office of Environmental Services -- ' Bakersfield, CA 93301 FACILITY NAME '(~'. {c'~6Jr BUSINESS I.D. No. 215-000 FACILITY ADDRESS ~3~) i~_l-d~a.~L~ Aau~_ CITY ~a~_,~-~,-~d~r{~ ZIPCODE FACILITY PHONE No.' ,D~ '~'~,1~ ,D~ '¢~,lL ,D~ INSPECTIONDATE /0//Ir~ ~? Product i Eroduct Product TIME IN TIME OUT ' O/~ ' {~:w~ , - Inst Date Inst Date Insl Dale INSPECTION TYPE: I ~ f~ Size Size Size ROUTINE FOLLOW-UP .' 9 00o ~ REQUIREMENTS yes no n/a yes no n/a yes no n/a · la. Forms A & S Submitted / lb. Form C Submitted lc. Operating Fees Paid ld. State Surcharge Paid' le. Statement of Financial Responsibility Submitted lf. Written Contract Exists between Owner & Operator to Operate UST ~ ' 2a. Valid Operating Permit V/ 2b. Approved Written Routine Monitoring Procedure ~/' 2c. Unauthorized Release Response Plan V 3a. Tank Integrity Test in Last 12 Months ~/, ~- ' 3b. Pressurized Piping Integrity Test in Last 12 Months~'1 ~ 3c. Suction Piping Tightness Test in Last 3 Years V"' ~ 3d. Gravity Flow Piping Tightness Test in Last 2 Years ~ "~ 3e. Test Results Submitted Within 30 Days V" · ~' · 3f. Daily Visual Monitoring of Suction Product Piping ~ _~ _z 4a. Manual Inventory Reconciliation Each Month V~ 4b. Annual Inventory Reconciliation Statement Submitted 4c. Meters Calibrated Annually ' ' 5. Weekly Manual Tank Gauging Records for Small Tanks ~/' 6. Monthly Statistical Inventory Reconciliation Results 7. Monthly Automatic Tank Gauging Results 8. Ground Water Monitoring . v,/ 9. Vapor Monitoring 10. Continuous Interstitial Monitoring for Double-Walled Tanks -~/ 11. Mechanical Line Leak Detectors V/ 12. Electronic Line Leak Detectors V~ 13. Continuous Piping Monitoring in Sumps V~ 14. Automatic Pump Shut-off Capability v/ 15. Annual Maintenance/Calibration of Leak Detection Equipment j~ ~¢ / V/ , 16. Leak Detection Equipment and Test Methods Listed in LG-113 Series ~//'" 17. Written Records Maintained on Site 18. Reported Changes in Usage/Conditions to Operating/Monitoring Procedures of UST System Within 30 Days ,~' 19. Reported Unauthorized Release Within 24 Hours , 20. Approved UST System Repairs a~d Upgrades [// 21. Records Showing Cathodic Protection Inspection 22. Secured Monitoring Wells I,/' 23. Drop Tube RE-INSPECTION D.~E . .~ ' RECEIVED BY: FD 1669 (rev. 9/95) Okersfield Fire Dept. OFFIC~~ OF ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 Date Completed 10/Iq/¢7 Business Name: ~t~ Location: &oO ~ro,~,~,~ ~. Business Identification No. 215-000 II 't (¢ (Top of Business Plan) Station No. Shift Inspector Arrival Time: Departure Time: Inspection Time: Ad te Inadequate Adeq~e Inadequate Address Visable el~ I-I Emergency Procedures Posted v, [] Correct OccupanCY ~ [] Containers Propedy Labled ~ [] Verification of Inventory Materials I~ [] Comments: Verification of Quantities ~ [] Verification of Location I~' I'1 Verification of Facility Diagram I~ [] Proper Segregation of Matedal I~ [] Housekeeping I~/ [] Fire Protection ~ [] Comments: Electrical ~ 1"1 Comments: Verification of MSDS Availablity i~' [] Number of Employees: ~ UST Monitoring Program [] Comments: t4c~¢ ~.,~.~1 l~a,JtJ Verification of Haz Mat Training 03/' Permits Bi/ I'1 Comments: Spill Control Hold Open Device 133/ [] Verification of I~ Hazardous Waste EPA No. Abbatement Supplies and Procedures [] Proper Waste Disposal ~' r'l Comments: Secondary Containment [] Secudty ~ [] Special Hazards Associated with this Facility: Violations: N~ ~, ~/,. 'q_~n ~: N~A7--- / . ~ All Items O,K Business O~eflManager PRINT ME Correc~on Needed ~Re-H~ Mat Div. Yellow-S~tion C~y Pink-Business Copy CONSTRUCTION ~. ~ ,_ JULY 1, 1996 JIJL 5 1996 By. BAKERSFIELD FIRE DEPT. HAZARDOUS MATERIAL DIVISION ATTN: MARK TURK 1715 CHESTER AVE. BAKERSFIELD~ CA. 93301 RE: PERMIT #BI-0020 _--MR EAS~T--MARKE~ 600 BRUNDAGE LANE BAKERSFIELD, CA. 93304 INSPECTOR TURK: FIND ENCOLSED THE RESULTS FOR THE TANK AND LINE TEST. IF ANY ADDITIONAL INFORMATION IS NEEDED PLEASE CONTACT ME. 1710 CALLOWAY BAKERSFIELD, CALIFO ~.,RNIA93312 (805) 589-5570 FAX (805) 589-1161 LIC. NO. 413913 JOB NUMBER : 000002 CUSTOMER (COMPANY NAME) : WEGENER CONSTRUCTION CUSTOMER CONTACT(LAST, FIRST): DAN ADDRESS - LINE 1 : 1710 C~J./~OWAY ADDRESS - LINE 2 : CITY, STATE : BAKERSFIELD, CA. ZIP CODE (XXXXX-XXXX) : 93312 PHONE NUMBER (XXX)XXX-XXXX : 8055895570 ******* C O M M E N T L I N HOT 90F CALM NO WATER MEASURED IN TANKS NEW CONSTRUCTION ""***~* S .I T E D A T A ******** SITE NAME (COMPANY NAME) : MR. FAST SITE CONTACT(LAST, FIRST) : MR. CHE ADDRESS - LINE 1 : 600 E. BRUNDAGE ADDRESS - LINE 2 :' CITY, STATE : BAKERSFIELD, CA. ZIP CODE (XXXXX-XXXX) : PHONE NUMBER (XXX)XXX-XXXX : GROUND WATER LEVEL (FT) : 40 NUMBER OF TANKS : 02 LENGTH OF PRE-TEST (MIN) : 30 LENGTH OF TEST (MIN) : 180 INVOICE #WC000002 TEST DATE: 06/14/96 REDWINE TESTING SVC., INC. P.O. BOX 1567 BAKERSFIELD, CA. 93302 TANK STATUS EVALUATION REPORT WEGENER CONSTRUCTION MR. FAST 1710 CALLOWAY 600 E. BRUNDAGE BAKERSFIELD, CA. BAKERSFIELD, CA. 93312 CONTACT: DAN CONTACT: MR. CHE PHONE #: 8055895570 PHONE #: ***** COMMENT LINES HOT 90F CALM NO WATER MEASURED IN TANKS NEW CONSTRUCTION CURRENT EPA STANDARDS DICTATE THAT FOR UNDERGROUND FUEL TANKS, THE MAXIMUM ALLOWABLE LEAK/GAIN RATE OVER THE PERIOD OF ONE HOUR IS .05 GALLONS. TANK #1: SUPER UNLEADED TYPE: STEEL RATE: .002613 G.P.H. GAIN TANK IS TIGHT. TANK #2: REG UNLEADED TYPE: STEEL RATE: .046879 G.P.H. GAIN TANK IS TIGHT. INVOICE #WC000002 TEST DATE: 06/14/96 REDWINE TESTING SVC., INC. P.O. BOX 1567 B~kKERSFIELD, CA. 93302 TANK STATUS REPORT -- ULLAGE TEST ***** CUSTOMER DATA ***** ***** SITE DATA ***** WEGENER CONSTRUCTION MR. FAST 1710 CALLOWAY 600 E. BRUNDAGE BAKERSFIELD, CA. BAKERSFIELD, CA. 93312 CONTACT: DAN CONTACT: MR. CHE. PHONE #: 8055895570 PHONE #: ***** COMMENT LINES HOT 90F CALM NO WATER MEASURED IN TANKS NEW CONSTRUCTION CURRENT EPA STANDARDS DICTATE THAT FOR UNDERGROUND FUEL TANKS, THE MAXIMUM ALLOWABLE LEAK/GAIN RATE OVER THE PERIOD OF ONE HOUR IS .05 GALLONS. TANK #1: SUPER UNLEADED TYPE: STEEL SN: .05 TANK IS TIGHT. t TANK #2: REG UNLEADED TYPE: STEEL SN: -.04 TANK IS TIGHT. TANK NO. TANK NO. TANK NO. TANK NO. 1 2 3 4 TANK DIAMETER (IN) 95 95 LENGTH (FT) 13.58 19.01 VOLUME (GAL) 5000 7000 TYPE ST ST FUEL LEVEL (IN) 78 83 FUEL TYPE SUP UNLD REG UNLD dVOL/dy (GAL/IN) 51.37 62.33 CALIBRATION ROD DISTANCE 1 10.65625 2 26.95313 3 41.93750 4 56.93750 5 74.93750 Ir REDWINE TESTING SERVICES. INC. LINE TEST WORKSHEET P.O. EO× 1567 AES PLT - 10OR BAKERSFELD. CA 93302 , (805) 326-0446 NAME: Mr. Fast LINE #1' TECHNICIAN: Mike McCarthy ADDRESS: 600 E. Brundac/e LINE #2: LICENSE NUMBER: 91-1061 CITY. ST: Bakersfield. CA LINE #3: TEST DATE: June 14. 1996 ;' THE CONVERSION CONSTANT IS FOUND BY: (60 MIN/HR) / (3790/MIL/GAL) = 0.0158311 (MIN/HR) (GAIJMIN) D~vide Ihe volume diferenlial by Ihe lesl lime (15 minutes) and multiply by 0.0158311. which will conved Ihe volume ditere~lial from milililers per minute Io gallons per hour. The conversion conslanl causes Ihe mil~T~ters and minutes Io cancel out. START VOL END VOL TEST VOL DIFF. PRODUCT TIME PSI (MEI (MEI (ML~ GPH C~AIN/LOSS PASS FAIL Unleaded/Rec~ 11:45 50 106 106 0 0 X Unleaded/Re~l 1290 50 106 106 0 0 X Unleaded/Recj ~ 12:15 50 106 106 0 0 X COMMENTS: START VOL END VOL TEST VOL DIFF. PRODUCT TIME PSI (MLI {ML) (ML) GPH GAIN/LOSS PASS FAIL Unleaded/Super 10:45 50 160 160 0 0 X r 11 :I)0 50 160 160 0 0 X 11:15 50 160 160 0 0 K COMMENTS: START VOL END VOL TEST VOL DIFF. PRODUCT TIME , PSI (ML} (ML} , {MLi GPH GAIN/LOSS PASS FAIL COMMENTS: REDWINE TESTING SERVICES. INC. L~"~IE TEST WORKSHEET P.O. BOX 1567 ALS PLT - ! OCR BAKERSFELD. CA 93302 (805) 326-0446 NAME Mr. Fast LINE #1: TECHNICIAN: Mike McCarthy ADDI:lt-_'L~S 600 E. Brundac~e LINE #2: LICENSE NUMBER: 91-1061 CII'Y. St: Bakersl,eld. CA LINE #3: TEST DATE: June 14. lg96 THE CONVERSION CONSTANT IS FOUND BY: (60 MIN/HR) / (37901MIL/GALi = 0.0158311 (MI~HR) (GAI.JMIN) D~vide Ihe volume diferenlial by Ihe tesl lime (15 minules) and multiply by 0.0158311. which will conved the volume ditermlial from mgililers per minule Io gallons per hour. c onve~sion conslant causes IhemiliMers and minutes Io cancel out. START VOL END VOL TEST VOL DIFF. PRODUCT TlklE PSI GPH GAIN/LOSS PASS FAIL {ME) {ME) {ML~ .U__nleaded/RecJ 11:45 50 106 106 0 0 Unleaded/Rec~ 12 DO 50 106 106 0 0 Unleaded/Re(~ 12:15 50 106 106 0 0 COMMENTS: START VOL END VOL TEST VOL DIFF. PRODUCT TIME PSI GPH GAIN/LOSS PASS FAIL (MLI {MLI {ML~ e.,ad ed/Super 10.45 50 160 160 0 0 K 11 .DO 50 160 160 0 0 11:15 50 160 160 0 0 COMMENTS: START VOL END VOL TEST VOL DIFF. Pf IODUCT TIME PSI GPH GAIN/LOSS PASS FAIL (ME) {ML~ {ML~  BAKtSFIELD CITY FIRE DEPAR~[/IENT ~1' -' OFFE~---------------~[ OF ENVIRONMENTAL sEtI~FICES INS~ECTI~N~ECOR~ POST CARD AT JOBSITE FACIL~ ~ ~~ OWNER INS~UCTIONS: Ple~e ~11 ~r an ins~r one when each group of ins~ons w~ ~e same numar are ready. They will run in ~nsecu~e order ~ginning w~ numar 1. ~ NOT ~ver work for any nuT,md group un~l all ~ms in ~at group are signed off by ~e Perm~ng Au~or~. Following ~ese ins~u~ons will redu~ ~e numar of required irishmen vis~ and ~ere~m ~event ~sessment of add~onal ~es. TANKS AND BACKFILL INSPECTION I DA~ I INSPEC~R [ S.r, Test C.~on or Manu.~,.. Mc. od ~/~/~.~ Ca~odic Pro~on of Tank(s) PIPING SYSTEM ~ Corrosion .ro.~on~lng, j.;,,~, ~;; ~ ,/~/,~ Ca~odic Pro~on Sys~m-Piping r Uner Ins~lla~on - Tank(s) ~ . ~,~ ~ner Ins~l~on - Piping ~ Vauff W~ Produ~ Com~fible Sealer . ~vel Gauges or ~nsom, ~at Vent Va~es ~ Produ~ ~ne ~.k ~.=r(., ~ ~ ~ak ~.~r(s)~r ~nular S.~-D.W. Tank(s) ~/ ~O.~ Men.ting Well(s,/Sump(s,-H.O Test . ~~ ~ak ~on ~vi~(s) ~r Vadose/Gmun~a~r FINAL Monitoring Wells, Caps & Locks ~ Monitoring Requirements ~/~/~ / ~'3~ "~~ ~'"--'~~ CONTRACTOR (~_t~ ~ ~1~¢4/t..,~ ~/L. LICENSE # CONTACT ~-----~'~_ PHONE WEGENER CONSTRUCTION BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION ATTN: MARK TURK 1715 CHESTER AVE. BAKERSFIELD, CA. RE: MR. FAST MARKET 600 BRUNDAGE LANE ON 5-30-96.WEGENER CONSTRUCTION PRESSURE TESTED THE PRIMARY AND SECONDARY CONTAINMENT PRODUCT LINES, THE VENT LINES, AND THE VAPOR RECOVERY LINE. THE FOLLOWING PROCEDURES WERE INITIATED THE 2 PRIMARY PRODUCT LINES, THE 2 VENT LINES, AND THE VAPOR RECOVERY LINE WERE AIR TESTED TO 80 P.S.I. WHEN THE 80 P.S.I; WAS MAINTAINED, ALL FITTINGS WERE TESTED USING A SOAP SOLUTION. NO LEAKS WERE DETECTED. LINES WERE LEFT UNDER PRESSURE. THE SECONDARY CONTAINMENT ON .THE 2 PRODUCTS WAS INSTALLED. AFTER ALLOWING TIME TO.CURE, THESE SECONDARY CONTAINMENT LINES WERE AIR TESTED TO 5 P.S.I. WAS, MAINTAINED, ALL FITTINGS WERE TESTED USING A SOAP SOLUTION. NO LEAKS WERE DETECTED. - ALL LINES PRIMARY AND sECONDARY WERE LEFT UNDER PRESSURE DURING BACKFILL OF TRENCH.AND TANK HOLE. ALL THE LINES MAINTAINED THEIR REQUIRED PRESSURE DURING BACKFILL.. THIS PROCEDURE MEETS OR .EXCEEDS;THE MANUFACTURERS' RECOMMENDED TESTING PRACTICES AND THE BAKERSFIELD FIRE DEPARTMENT TEST PROCEDURE IDENTIFIED IN TITLE 23, DIVISION 3, CHAPTER 16, SECTION 2636 E. IF ANY' ADDITIONAL INFORMATION Is~N~DED PLEASE CONTACT ME. SI ERELY, OWNER 1710 C/{~LLOWAY BAKERSFIELD, CALIFORNIA93312 (805) 589-5570 FAX (805) 589-1161 LIC. NO. 413913 FIF.:. FAST _~ F;ITE ~ 00001 %- iNUENTOR,.,., REPF$:T E:AKERSFIELE'.., C:A, 9:3.304 TANK ;'.40.' 2 G:AL :SiTF '-'.a 000R].' Ui'iLEADEE:, F;UF' c ..... 468 F ~ i:)ATER ~CL R 0 GAL NR. FAST 'SITE ~ 00F_¢J1 600 E:RUHE),'qGE LAHE i','l~,FAST ¢: --'~ ? 'lq'~F, FJ!: 45 ?t'i 6C~0 E:F-.:LihiDAGE LANE ALARf't ~..~.r ......... ¢,00 BRH!--iDAGE ...... NET F,~E,.=, 0 GAL O,-.-TE !'~'. FA'.'-;T PE'OF' LEUEL E:A Aq? IN SITE ~ 00001 I. ATER LELEL 0.000 IN Ai.iULAR i',iR. FAST SiTE ~ E~;i100! ..... ,,. TF~NK NO. 2 GAL UFILEADED ' .... oJr GF.'- BL:; 43!5.0 GAL NET 4246,. 4. GAL ................ . ...... ~-'KUC, LEVEL 76.294 iN [ ............................ . ..... -~ ............... ~ - ~ r ' .__~z~_ , ~_~w_~:~~~_~~.___ ~ _~._/z ..... : ............ I' ~ / ../ ' ........ ~g-,~ ';~, ?~,~' ~.~- ~ ~ h~.~ :_h~~ ................ _._ ~.~_ p ,~,-~q . ~ ........... . ............... ~_~-~~ ~,7.~ °~_~_a~ _.__::~_._~,:~_-~= ....... ,~ .... ~_~_~~ .... .¢~_:~_,,~_~ ...... !11 JUN-- ?--96 FR I 8 .' 08 WEGENER CONSTRUCT I 0_~ .P . 0'1 ..... ,,, ,,,,,:,, ...... ~ · ,~ ..... ~ LICENSE NO. 413913 WEGENER ................................................ , ~ 7~ 0 ~ALLOWAY / _ / , BAKERSFIELD, CALIFORNIA 93312 CONSTRUCTION FAX A I) 1) R i': ,S ,S T I",1, I,'.I'II()N E # I'I';R,~,;()N SENI)IN(; FAX · R}{,"IARKI; ANI) St'I';(;IAI, INSTRUC'I'I()NS: (lOVER): c~ PLEASE NOTIFY PERSON RECEIVING THE FAX THAT IT HAS ARRIVED JUH-- 7--96 FR I 8 : 09 WEgEHER COHSTRUCT I Oh P. 02 CONSTRUCTION JUNE 6, 1996 BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION ATTN: MARK TURK 17!5 CHESTER AVE, BAKERSFIELD, CA. 93304 RE: MR. FAST MARKET 600 BRUNDAGE I,ANE BAKERSFIELD, CA. 9,{304 ON 5-30-96 WEGENER CONSTRUCTION PRESSURE TESTED THE PRIMARY AND SECONDARY CONTAINMENT PRODUCT l,]Ng..g, TIiE VENT I, INES, AND THE VAPOR RECOVERY LINE. THE FOLLOWING PROCEDURES WERE ]'N]TIA'I'ED THE Z PRIMARY PRODUCT LINES, THE 2 VENT LINES, AND THE VAPOR RECOVERY LINE WERE AIR TESTED TO 80 P.S.I. WI~EN THE 80 P.S..I. WAS MAINTAINED, ALL FITTINGS WERE TESTED USING A SOAP SOLUTION. NO LEAKS WERE DETECTED, LINES WERE I.EFT 1]NDI~:R PRESSURE. THE SECONDARY CONTAINMENT ON THE 2: PRODUC, TS WAS INSTALLED, AFTER ALLOWING TIME TO CURE, THESE SF(.',ONDA~/Y CONTAINMENT LINES WERE AIR TESTED TO 5 P,S.I. WAS, MAINTAINED, ALL FITTINGS WERE TESTED USING A SOAP SOI.,UT1ON. NO LEAKS WERE DETECTED, ALL LINES PRIMARY AND SECONDARY WERi.; LEFT UNDER PRESSURE DURING BACKFILL OF TRENCH AND TANK BOLE. ^l.,l, THE LINES MAINTAINED THEIR REQUIRED. PRE$$1)R~: DURING BACKFILL. 'PHIS PROCEDURE MEETS OR EXCEEDS 'FHg MAN't;FACTURERs' RECOMMENDED TESTING PRACTICES AND '['HE BAKERSFIELD FiRE DEPARTMENT TEST PROCEDURE IDENT~F.I'..~:D I'N TITi,I/ 23~ DIVISION 3, CHAPTER 16, SECTION 2636 E. IF ANY ADDITIONAL INFORMATION IS NE~;i).ED PI.,~:ASE CONTACT ME, OWNER ~This Memorafiddm - is an acknowledgment that a Bill Of Lading has':been"issued and-is not {he Orig~n~i Bill~of :Lad~g, . : .'-..: ' nor a copy or a duplichte, covering the property na~qed herein and is intended solely for filing or record. . · ._ ' · RECEIVED, subject to classifications and lawfully filed tariffs in effect on the date of tt{e receipt b~ the carrier of the property ~escrib~d in;the Original Bigof4.ading ' {he property described below, in apparent good order; except as noted (contents and condition of center)ts of packages unknowni~ mark~d,·consigned, and de~tlfi~as indicated below, which said carrier (the word carrier being understood throughout this contract as meaning any I~e~is~n or cotillion in'P°ssession of the property u_rider the contract) agrees to carry to its usual place of delivery at said destination, if on its route, otherwise to deliver to another.carrier on the route td said destination. It is mutdal~ed, as to each carrier of.all or any of saidpropertyover-a or m~n'of-sa d route to destination, and as to eachpart¥-at any time interested in all or any of Said property,.that every service to be peri=oF~reunder shall-'be.subject.to all the terms and cond t one of the U~estic Straight Bill of Lading set forth (1) in Officml, Southern, Western and Illinois Freight Classifications in effect on the date hereof, ii~J~'. ~. a rail or a rail:water shipment, or {2) in the applicable motor carrier' cl~tion or tariff if this is a motor carrier shipment. .,. .Shipper. here~b.y, cert!~e? that he~ is f~.m.?ar with~ll_t~he ter?s~ ?nd~co?~dit~?.ns of ~ smd b. ill~o.f la~!ng. !.nclud. Ln~ tho.se on the back thereof, setll~ln the classification or tariff which governs the t~ansportation of This smpment, eno me .sam mrms anu conumons am nere~y agreed ;o Dy me snipper and accedmu ;or nlmseff 8no his assrgns. ..... - · . From P~O{~=R.~.~q=~~~C~'~ '.':.' '. DESIGNATEWffHAN.iX) : Date 5-23-96 1::l~:~4141 ~ ~p~AV~JE .... ': , By TRUCK[~ FREIGHT [-~-]' ShiPper's No. .2~1.~ At Carrier" "Modern t~etdtn~ Co o'f Ca Inc (ScAc) 'tarrier'eNo. Consigned .to 'Shields, Harper & CO' %~ Nr Fast, MarkeC Destination R~lr~.r,~-} ~ ! 0 -' .-- State Ca County . Route ..... Deli¥~ Address.~- 600. ~. Brundage Lane Delivering'Carrier *' -' Vehicle.or Car Initial' ./'ff~ -~ Nol ~i~?' ' ' ' "*' ''' ''' FCl~a~ll' C~]u~Ja Subjec ...... ion 7 of conditi .... No. of :* I 'L., '.: . :. Description. of-Attic!es, Special Marks and Ex. cepfions . ..,: ' isa -t~'~h~orr. j .. Shipping gaits I o I -: of applicable bill of lading, if this ship- '~ ~:.. 0 ~ ~'1 I~" .. ~. C (~1~, r-~ ~r- ~TM ~ ( .~.~: ' ' ' ' signee without .......... th ..... 1 ;I - 0' o ~. 'r'?e. )500# ' I I sig .... h ..... ,g ..... hall·sign the' -,~ oubl'e. 'Wail Jacketed GS 1746' Secondary . ' ofThthisshipmentiershalln°tmakedelivery - 'without payment of :[Contained' Underground-tank.- '' ' ' " '] "'l 'freightandallotherlawfulcharges. :1~[ z# L665873 I [ '" ' -: ' : Labe · ' ~ ' Per '" ; ' ..... ' ~' ' 't~ ~ t ' / .{Sig ....... ,Consignor., · ~'"]iVoc at shop:'t6'Vac at site: //r~ /~-~':2-~-' I I Ifcharg ..... ,o be prepaid, write - [G 1 f e i d '~~//~'~'~J' I [...... phere, "To be Prepaid." I las. cee .~ kit -,- 1 :.. ~'- I s at on.' Instr ~ .p~ e.r~ Bece~v~ ~ . }"35 v01 t.., holid_~Y to wi es'se by ~/~~ ,.~.~ ~'° apply'in prepayment Of thecharges on the property described : ' - ' hereon. . .. Total . Agent or Cashier' Pieces 9000 St tn 'd r :t "This is to certif that the above named materials are properly classified, described; packaged; marked and labeled, and are in I~roper ~:ofldition ~r t~ia~spoft~o'~, accor(~i~g to the . (The signature here-acknowledges. . · ' .° If the shipment moves b~tween two ports by a-carrier by water the law requires that the bill.of lading shall slate Whether it is ;'carrier's o~ shipper's Weight.'~ .- Charges Advanced: ~ Shipper's imprints in lieu of stamp; not a part of Bill of Lading approved by the Department Of'Transportation. ~- .-.': . _ . - NOTE - Where the rate is dependdnt on value, shil~pers.are required to state Specifically in writing the agreed or declared value Of the property.. ~ The agreed or ~eclared valae of the property is'hereby specifically stated bythe shipper to be not exceeding . - ' ' ~ ~ C.O.D.. S"IP~J~E"T: 'I If REMIT C.O;D. '[0: · ' :' C.O.D. Amt. · "'* - THIS. SHIPMENT, IS CORRECTLY.. OESCHIBEO~ ~ J- t The*fbreboxesusedforthsshpment~onformtothespeciflcationsset C 0 D CHARGE (*~HPP~ [] Collection Fee' '" .. · . ~ ~ forthin theb .... ker!s certificate th ...... d all other, requ[t .... ts of I T~ ;;;* PA D BY' ~ ·-YI-" _:_ ' .__ CORRECT WEIGHT IS" ' ' LBS ~ Item 222, of the Nationai Motor Freight ClassificatiO~..,~-?~;]. - .~' ~ ' CONSIGNEE [] Total Charges ' . ' ' ' ''' ' ' .Per //.Z'-~//~.///.,4,.,/~ ~ Per -.. Perma~eflt post office address'of.shipper . . . . . . ~'" r~.~- ~._.~~. . · MARK WITH "X': TO;DESIGNATE HAZARDOUSMATERIAL AS DEFINED IN TITLE'49.0F THE CODE OF FEDERAL REGULATIONS. ~~ OFF, OF ENVIRONMEN TAL S E--,I C ES UNDERGROUND STOOGE TANK PROG~M PERMIT APP~CA~ON TO CONS~UCT/~ODI~ UNDERGROUND STOOGE TANK PHONE No. ~ ,~-~ ~ BAKERSFIELD C~ BUSINESS LICENSE No. ~REtFLY DESCRIBE THE WORK TO BE DONE ~' WATER 70 FAC~LI~ PROVIDED BY- ~?~/~ OEPTH TO GROUND WATER /.~¢ ~ SOIL ~PE E(PECTED,~TSITE No. OF TANKS TO ~E iNSTALLED ~ ARE THEY FOR MOTOR FUEL '-~YES Q NO ~ ' SECTION FO~ MOrO~ FUEL TAN~ No. VOLUME UNLEADED ~EGULAR PREMIUM DIESEL AVIATION SECTION FOR NON MOTOR FUELSTOI~AGETANKS TANK No. VOLUME CHEMICAL ~,7CRED CAS No. CHEMICAL PREVIOUSLY (no ~rcn¢ ~,cme) (if known) STORED :,~ D I' ,. ,~ . .,, -. -_.-..: i. i~::::1:::::: :: .:iT::i:ii:::ii:i!:ii!:~:ili:!!i!~ ' - ~ ,---,rr ~ ,~ .:.::.~::~'~ :?~'~:~:~:::~?.~J~:~}:~:(.~:'h'~ :::~ ~::: ' :::~' ::::~:~' :::::::::::::::::::::::::::::::~'::::? ~':' THE APPLICANT HAS RECEIVED. UNOERSTANOS. ANO WILL COMPLY WITH THE A'ACHED CCNOITIONS OF THiS FE~MI/AND ANY OTHER STATE. ' ~ ' ~L AND¢~C~,AL ~GULAf[CNS. THtSFORMHA58EEN ~' :-=m -:. ,,,~v C~,.~PL.:.~ UNOER PENAL~ CF r.R..,~,. ,ANO TO THE 5EST CF MY KNOWLEDGE. IS TRUE AND CORRECT. Tu~e a=~aT~mu n~mM~ I P~MIT WHEN APPROVED ~~~_~ BaKersfie,3 Fire Dept O! CE OF ENViRONMENTA RViCES URDERGROUND STORAGE TANKlS'ROGRAM ~,.- PERMIT APPUCA~ON FOR REMOVAL OF AN UNDERGROUND STOOGE TANK SITE INFO~MA~ON SITE - ADDRESS ~ ~x~- ~P CODE ~ APN FACILI~ NAME ~ ~~~ CROSS STREET ~ ~ TANK OWNER/OPERATOR ~ ~/ ~ ~/' PHONE NO. ~- MAILING ADDRESS /~ ~/~ ~ Cl~ ~~ ~P CODE CON.ACTOR INFORMATION COMPANY ~(~~ ~~ PHONE No. ~-~5~ LICENSE No ~/~?/~ ADDRESS / ~/0 ~4 ~~ ~ ~~ ZIP ~ODE INSURANCE CARRIER ~~ ~,~ WORKMENS COMP No. PRELIMANARY ASSEMENT INFORMATION COMPANY ~ PHONE No. ~/-/~d& LICENSE No. ADDRESS ~ ~H~' ~.: ~ ~ CI~ ~c~ ZIP CODE INSURANCE CARRIER WORKMENS COMP No. TANK CLEANING INFO~MATION COMPANY ~~[~ ~L//L~ PHONE No~/~~ ADDRESS ~ ~ ~c~ ~c/~ CI~ ~~~ ZiP CODE WASTE TRANSPORTER IDENTIFICATION NUMBER ~/~ NAME OF RINSTATE DISPOSAL FACILI~ ~~ ADDRESS ~ ~~ Ci~ (~~ ZiP CODE FACILI~ INDENTiFICATION NUMBER ~ -~ ~~/~ ~ TANK ~ANSPORTEg INFORMATION COMPANY ~~ PHONE No. ~'~-~/ LICENSE No.~7~ ADDRESS ~5 ~~~ ~V Cl~ ~~ ZiP CODE TANK DESTINATION TANK INFOEMATION TANK No. AGE VOLUME CHEMICAL DATES CHEMICAL STORED STORED, PREVIOUSLY STORED / ~ ?~- lb o6o ~~_>,~= ~x~,~ ~ ~ ~~ ............................ -... ............ ................. ...... ............................................... FOROFFCIAL USEONLY .... ............................ -..'....' ........................... -:-.-~ ....... -: ......... ::: :::::;:;:::;::: :::::::: ::: :::::::::::::::: .:::::::.:::. :: :. :+ :. :. :. :.:. ::: ::. :. :. :. :. :: :, :. :. :, :-'. :. :.'. :. :. :-:-:-:-:. :, ::: ,:.:.:,:.:.:.:+:.:,:.:,:.:.:.:.:.:.:.:.:.:.:+ :.:.:+:.:.:.:.:.:.:: :::::::::::::::::::::::::::::::::: :. :. :.:. :. :. :. :. :. TNE APPLICANT HAS RECEIVED. UNDERSTANDS. AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMI~ AND ANY OTHER STAfE. LOCAL AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNOER PENAL~Y OF PERJURY, AND 1'O THE BEST OF MY KNOWtEDGF, I$ TRUE AND CORRECT. APPLICANT NAME (PRINT) /~_-APPLICANT'SIGNATURE ' THIS APPLICATION BECOMES_A.PERMIT_WHEN.APP_ROVED. ·. ,, ,.,- .-., ,,-.-.,.-,-. n^~.^o~ ,- Tm T~ ,,~_ITV Cfi= RAKI=R~FiI=LD" HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 APPLICATION TO PERFORM A TIGHTNESS TEST PEm~IT TO OPS~TE # SMO? OPERATORS NAME /< / C//~ ~/ OWNERS NAME NUMBER OF TANKS TO BE TESTED'~. IS PIPING GOING TO'BE TESTED ~/~J~ TANK# VOLUME CONTENTS TANK TESTING COMPANY R~,U6~ 7-6-~7-/~U6 /WADDRESS ~/~/L~VZO ~%~9~ TEST METHOD US~~ b¢00 ~ ~2 0~ N~E OF TESTER~,~<~ ~ ~~/CERTIFICATION % ~/-/DJ/ / STATE REGIST~TION % ~ ~ / DATE 'SI~ATURE OF APPLICANT W EG EN ER ,o. 4130,3 1710 CALLOWAY CONSTRUCTION BAKERSFIELD, CALIFORNIA ~312 (805) 589-5570 · FAX (805) 589-1161 ==== P R O P O S A L .... MR. FAST MARKET APRIL 8, 1996 600 BRUNDAGE LANE JOB NAME: MR. FAST MARKET BAKERSFIELD, CA. 93304 JOB LOCATION: 600 BRUNDAGE LANE BAKERSFIELD, CA. WEGENER CONSTRUCTION IS PLEASED TO SUBMIT PRICE PROPOSAL FOR THE JOB SCOPE LISTED BELOW. NEW FUELING INSTALLATION 1. FURNISH PLANS. 2. SAW CUT, BREAKOUT, AND DISPOSE OF ASPHALT FOR NEW TANK JUST EAST OF THE ISLANDS. 3. EXCAVATE TANK HOLE AND STOCKPILE SOIL ON SITE. 4. REMOVE THE EXISTING FUEL DISPENSERS ON THE NORTH EAST ISLAND. MODIFY THE ISLAND TO ACCOMMODATE NEW DISPENSERS. IMBED ONE DISPENSER CONTAINMENT BOX IN CONCRETE ON EACH END OF THE ISLAND. 5. SAW CUT, BREAKOUT, AND DISPOSE OF CONCRETE AND ASPHALT FOR NEW FUEL LINE TRENCHES AND NEW ELECTRICAL CONDUIT TRENCHES. 6. EXCAVATE TRENCHES AND STOCKPILE SOIL ON SITE. 7. FURNISH AND INSTALL ONE 12,000 GALLON DUAL COMPARTMENT 7000/5000 GALLON MODERN WELDING RED DOT 2 TANK. 8. FURNISH AND INSTALL TANK TOP EQUIPMENT. 9. FURNISH AND INSTALL FUEL PIPING. A. 2- PRODUCT LINES 2" PRIMARY WITH 3" SECONDARY CONTAINMENT B. 2- VENT LINES 2" PRIMARY ONLY C. 1- VAPOR RECOVERY LINE 3" PRIMARY ONLY 10. FURNISH AND INSTALL FUEL DISPENSERS. A. 2 NEW TOKHEIM 262AFL-2-RC-TWV DUAL PRODUCT DISPENSERS. B. 1 67B-8 TOKHEIM INTERFACE BOX C. 4 SETS OF COAXIAL WHIP HOSES, HOSES, NOZZLES, BREAKAWAYS AND RETRACTORS 11. FURNISH AND INSTALL INCON LEAK DETECTION AND TANK LEVEL MONITOR. 12. FURNISH AND INSTALL ONE NEW TOKHEIM VISION 100 CONSOLE WITH PRINTER, CASH DRAWER, AND CUSTOMER DISPLAY. 13. FURNISH AND INSTALL ELECTRICAL TO NEW PUMPS, DISPENSERS, CONSLE, AND LEAK DETECTION SYSTEM ONLY. 14. FURNISH IMPORT FILL, BACKFILL ALL EXCAVATED AREAS. 15. CONSTRUCT NEW CONCRETE TANK SLAB. APPROXIMATELY 432 SQ. FT. 16. REPLACE ALL CONCRETE AND ASPHALT REMOVED DURING CONSTRUCTION. 17. TEST TANK AND LINES AS PER GOVERNING AGENCIES REQUIREMENTS. 18. ASSIST WITH START-UP AND OBTAIN FINAL INSPECTION. BID PRICE $84,400.00 TERMS: WEGENER ............... ~ CALLOWAY BAKERSFIEL'~TCALIFORN~ ~312 CONSTRUCTION (sos) 589-5570 · FAX (805) 589-1161 .... PROPOSAL PAGE 2 .... TERMS: $ 8,440.00, 10% DOWN $ 2,800.00, WHEN TIME TO ORDER TANK $11,500.00, WHEN TANK IS SET AND BACKFILLED TO TANK TOP $ 3,300.00, WHEN TIME TO ORDER DISPENSERS AND CONSOLE $13,300.00, WHEN DISPENSERS AND CONSOLE ARE READY TO BE SHIPPED $11,265.00, DUE AFTER FIRST WEEK OF CONSTRUCTION $11,265.00, DUE AFTER SECOND WEEK OF CONSTURCTION $11,265.00, DUE AFTER THIRD WEEK OF CONSTRUCTION $11,265.00, DUE UPON COMPLETION OF JOB, BUT BEFORE FINAL INSPECTION. NOTE 1) WE DO NOT ASSUME LIABILITY FOR ANY DAMAGED ELECTRICAL, WATER, SEWER, GAS, TELEPHONE, OR ANY OTHER SERVICE OR UTILITY LINES. UNDERGROUND SERVICE ALERT WILL BE NOTIFIED. 2) HANDLING, REMOVAL, OR DISPOSAL OF ANY CONTAMINATED SOILS WILL BE AN EXTRA CHARGE. 3) PRICE DOES NOT INCLUDE ANY SHORING, DEWATERING, OR TANK ANCHORS. 4) PRICE DOES NOT INCLUDE ANY PUBLIC ADDRESS SYSTEM, OR CONDUITS OR WIRE FOR THAT SYSTEM. 5) PRICE DOES NOT INCLUDE ANY SOIL SAMPLING OF ANALYSIS. SHOULD ANY BE REQUIRED, THEN THIS WILL BE CONSIDERED AN EXTRA, AND WILL BE BILLED AS SUCH, AT COST PLUS 10%. 6) OWNER TO FURNISH PERMITS. PROPOSAL MAY BE WITHDRAWN BY US IF NOT ACCEPTED WITHIN 60 DAYS. ACCEPTANCE OF PROPOSAL: - The above prices, specification and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. TERMS: ~~ .~ ~_4P SIGNATURE: DATE: CUSTOMER APPROVAL . - v , - ROVAL WEGENER LICENSE C^LLOW^V BAKERSFIELD. CALIFORNIA ~312 CONSTRUCTION (805) 58~5570 · FAX (805) 589-1161 ====PROPOSAL .... MR. FAST MARKET APRIL 8, 1996 600 BRUNDAGE LANE JOB NAME: MR. FAST MARKET BAKERSFIELD, CA. 93304 JOB LOCATION: 600 BRUNDAGE LANE BAKERSFIELD, CA. WEGENER CONSTRUCTION IS PLEASED TO SUBMIT PRICE PROPOSAL FOR THE JOB SCOPE LISTED BELOW. TANK REMOVAL 1. FURNISH PLANS. 2. INSTALL TEMPORARY FENCE AT TANK AREA. 3. REMOVE AND DISPOSE OF THE EXISTING FUEL DISPENSERS. 4. REMOVE AND DISPOSE OF CONCRETE AND ASPHALT OVER THE EXISTING TANKS AND THE FUEL LINES TO THE ISLANDS. 5. EXCAVATE AND EXPOSE 3 - 10,000 GALLON TANKS AND LINES TO ISLANDS, STOCKPILE EXCAVATED MATERIAL ON SITE. 6. TRIPLE RINSE TANKS AND DISPOSE OF RINSATE. A. DISPOSAL OF ANY SOLIDS IN TANK WILL BE BILLED AT AN ADDITIONAL COST PLUS 10%. 7. LOAD, TRANSPORT, AND DISPOSE OF THE TANKS AND LINES. 8. EXTRACT REQUIRED PRELIMINARY SOIL SAMPLES, PERFORM REQUIRED E.P.A. LABORATORY ANALYSIS. 9. USE SOIL FROM NEW TANK HOLE FOR DISPLACMENT OF TANKS, BACKFILL AND COMPACT EXCAVATED AREAS. 10. RESURFACE WITH ASPHALT, ALL AREAS STRIPPED OF CONCRETE AND ASPHALT. BID PRICE $20,600.00 TERMS: $2,060.00, 10% DOWN BALANCE DUE UPON COMPLETION NOTE 1) WE DO NOT ASSUME LIABILITY FOR ANY DAMAGED ELECTRICAL, WATER, SEWER, GAS, TELEPHONE, OR ANY OTHER SERVICE OR UTILITY LINES. UNDERGROUND SERVICE ALERT WILL BE NOTIFIED. 2) HANDLING, REMOVAL, OR DISPOSAL OF ANY CONTAMINATED SOILS WILL BE AN EXTRA CHARGE. 3) PRICE DOES NOT_INCLUDE ANY SHORING, DEWATERING, OR TANK ANCHORS. 4) PRICE DOES NOT INCLUDE ANY COMPACTION TEST OR REPORT. 5) IF ANY SOIL IS LEFT OVER FROM THE NEW TANK HOLE AFTER BEING USED TO BACKFILL EXISTING TANK HOLE, THE REMAINDER WILL BE LEFT ON SITE OR HAULED OFF AT AN EXTRA CHARGE OF COST PLUS 10%. 6) OWNER TO FURNISH PERMITS. PROPOSAL MAY BE WITHDRAWN BY US IF NOT ACCEPTED WITHIN 60 DAYS. ACCEPTANCE OF PROPOSAL: - The above prices, specification and conditions are satisfactory and are hereby accepted. You are authorized to do the work ~_s open'lied. Pa~Tment ;~;i!! be m-"-.dc =c cut!inc~ TERMS: SIGNATURE: DATE: CUSTOU~R *.PROWL 1NVOICE NO. INVOICE 813,o ---- INVOICE TO: ~~ Mr. Fast Service Station 600 Brundage Lane -ADVANCED ENVIRONMENTAL CONCEPTS INC= Bakersfield, CA 93304 ~' P.O. BOX 40672 BAKERSFIELD, CA 93364 Attention: Accounts Payable (1505) 831 ~ 1646 ] [ FEDERAL I.D. ~ 77-0234808 ~.o. mJ~ERi~ ~ Mr. Fast Service~l~l~il~qzx~A:~zoN P~O,TEC~ m~mER DATE Mr. Ki Chu Yi I 600 Brundage Lane, Bakersfield, CA AEC 96Cd649 03/29/96 DESCRIPTION UNIT PRICE TOTAL Drill and install throe .qroundwater monitorin.q wells. Project Date[s]: March 29, 1996 Professional Services Workplan/H & S Plan 1.0 Workplan 400.00 $ 400.00 Well Permits 3.0 Permit[s] 166.75 500.25 Travel '1.0 Hour[s] 65.00 65.00 Site Supervision [J. Dunwoody] 9.0 Hour[s] 65.00 585.00 [install wells] Site Supervision [J. Dunwoody] 3.0 Hour[s] 65.00 195.00 [purge/sample wells] Final Report '1.0 Report 750.00 750.00 Drilling Services Travel 1.0 Hour[s] '120.00 120.00 Rig Time 9.0 Hour[s] t45.00 1,305.00 Steam Cleaner 1.0 Day[s] 120,00 120.00 Materials 2" Screened PVC ['10' Joints] 30.0 Feet 2.77 83.10 2" Screened PVC [5' Joints] 10.0 Feet 3.9t 39.10 2" Blank PVC 110.0 Feet 1.82 200.20 Sand 20.0 Sack[s] 7.34 146.80 Bentonite 3.0 Sack[s] 8.89 26.67 Traffic Box 3.0 Each 61.50 t 83.15 Concrete 3.0 Sack[s] 5.00 15.00 Locking Caps 3.0 Each 17.00 5'1.00 Grout '1.0 Yard[s] 176.96 '176.96 PAST DUB INVOICES ~ SUBJECT TO LATE PAYMENT SERVICE CHARGES COM~UTED AT 1 1/2% PER MONTH (18% ANNUAL PERCENTAGE RATE) INVOICE NO. 8 37 2of2 I Mr. Fast Service Station eADVANCED ENVIRONMENTAL CONCEPTS 600 Brundage Lane ~' P.O. BOX 40672 Bakersfield, CA 93304 BAKERSFIELD, CA 93384 Affention: Accounts Payable (805) 83 !- ! 646 I I FEDERAL I.D. # 77-0234808 P.o. ~,~t Mr. Fast Service ~ ~x~c~zo~ t,~o,,-=c~ mm~sa I Mr. Ki Chu Yi 600 Brundage Lane, Bakersfield, CA AEC 96C-'1649 I 03/29/96 DES~PTION UNIT PRICE TOTAL Drill and install throe .qroundwater monitorin.q wells. Project Date[s]: March 29, 4996 Equipment Water Sounder 0.5 Day[s] 50.00 25.00 Pump and Generator 0.5 Day[s] 200.00 ~ 00.00 pH, Temp, Cond. 0.5 Day[s] 50.00 25.00 Laboratory Services TPH-g/BTXE (soil) 6.0 Sample[s) 57.50 345.00 TPH-g/BTXE [water) 3.0 Sample(s) 57.50 472.50 TOTAL AMOt NT DUE $5,629.73 Terms: DUE UPON RECEIPT P~ST DUE II~OIC~S ~ 8UB,.T~CT TO LAT~ P3tYI~NT SI~IIVlCE Cll~tOE8 C(X4PUTL~ &T 1 1/2% P~t HONTI~ (18% ~'tl~ PERC£N'f'&(3E RATE) R E C E I P T PAGE I Invo'ice Nbr. 1 156692 I 2:22 pm KERN CO RESOURCE MANAGEMENT AGENCY , 2700 'M' Street I Baket'$f'te]d, CA 93301 Type of Order' J ADVANCED ENVIRON CONCEPTS J CASH REGISTER I I ,, JCusto;::e, P O ~ J Nth By IOr'de~' Date J Sl~ip Date J Via J T~'m':~ JH0325951 J CSR J 03/2~/96 J 03/25/95 ICK 05859 DF I ,",IT Line Oescr'ipt'ion Quantity Pr'ice Unit Disc ! ~751 HAZ~IAT HELLS MONITORING 1 HELL 1 335.00 E 335.09 HMN003A 2 ~751 HAZMAT HELL MONITORI~JG >1 HELL 2 50.00 E HMH003B Or'der' Total ~35.2'2 Amount Due 435.00 Payment Made By Check; 435.00 THANK YOU ! ~U~ A E C April 1, 1996 4400As he Ro~ #206 Ba~e~s~i~, Ca. 93313 Inv.No. 4633 Ticket 83725 3/29/96 Bid for 600 Brur~age Sane $ 1,360.00 SMC Laboratory. Inc. Analytical Chemistry INVOICE 1 6 4 7. Advanced Environmental Concepts, Inc. JOBSITE: Mr. Fast 4400 Ashe Road, ~206 Bakersfield, CA 93313 I PR~ECTNO.: Attn: Jon Buck I Terms [Date [ Purchase Order No. Samples ~540-548 20 days, 5% 4-10-96 QUANTITY DESCRIPTION AMOUNT Soil samples BTEX/TPH gas $300.00 Water samples BTEX/TPH 9'as 150.00 $450.00 Thank you 211 Aviation Street · Shafter Airport · Shafter, CA 93263 (805) 393-3597 * (805) 393-3623 ,. ........... ,., .............. ~ GOLDEN EMPIRE CONCRETE CO. 23so3 P.0. B~ 12080, Bake~e~, CA 933892080 (805) 3256990 03 / 3 1 / 96 (805} 325~833 0~ 0~ ADVAEN SHIPPED TO: sAdYanced Environmental Concepts 600 Brundage o 144OO Ash® Rd #206 OBakersfield, CA 93313 T 118A 1.00 YD Neat Cement 101.52 101.52 201 1.00 Truck Rental 45.00 45.00 · . ,:NonTaxable Subtotal 45.00 " Taxable Subtotal 101.52 · . '" ..,'.,Tax (1:7 250 · ) 7 36 · ,; , - .; :~: .,. · ...... ~;,~ , .......... - ,: ....... -:::.-~,::LTotal :.:, ...... .~_,-,:4 ' 153.88 / 3/29 96 00340 2900 FAIRHAVEN DR., BAKERSFIELD, CA 93308 INVOICE 0329001 REMIT TO: P.O. BOX 2125, BAKERSFIELD. CA 93303 ~ · -- ' AMERICAN PHONE (805)323-0343 FAX: (805)323-0627 T ': PIPE&TUBING ~'~' "~ 005224 SOLD TO: SHIPPED TO: l.,F_~r WELL NO. ADVANCED ENVIRONMENTAL * SAME * CONCEPTS INC 4400 ASHE RD tt206 BAKERSFIELD CA 93313 8{)5 831-1646 REC'D BY ~ ': 30E 3 96 3 96 3 96 77 '00120 00000 · · ' "' 5 95 119 20 0;,. 031 ANSE 2112 SAND 000 ~ . . 'a. 0 ~. D31 ANSE MEDIUN BENTONITE CHIPS ;:ee~ ~,,, · 7.20 ~." 21.60 '3.0V D31 ANSE ~ 8" NELL COVERS lO00 ;.;, 49.50 148.50 ~.,, 110.00 D31 'ANSF 2" SCH 40 X 10' PVC CASING ;'000 ~: 1.47 ~:t:; 161.70 ~ " ; ~ 2" SCH 40 X Ze' PVC eze SCREEN ;Bee ~.,, 2 25 67 50 . e 2'-: 30. ee 031 ANSF ~ ,,~ ,. ~"~:,,, : . ~: . .:0 v-,,:. 10.00 ' D31 ANSF ~ 2" SCH 40 X S' PVC 010 SCREEN ~.000 ~,,':" 3.17 ~;:~ 31 [?;' C~LIFORNIA SALES TAX ~ 39 88 ~2. : -- ~. ~... ss~.oe 3~.r~ .oo .co . .o~ TOTAL ORIGINAL  PERMIT No. C Bakersfield Fire Dept S~ ~ ¥;xs~ (~ OF E OF ENVIRONMENTAL VICES .. UNDERGROUND STORAGE TANK PROGRAM i~- -oozo , ~ ~ ~/,/~ PERMIT APPUCATION TO CONSTRUCT/~ODI~ UNDERGROUND STORAGE TANK ~PE OF APPLICATION (CHECK) a NEW FAClLI~ a MOOIFFC~TION OFFACILI~ ~NEW TANK INSTALLATION AT EXISTING FACILI~ STARTING DATE ~ ~ ~ ~, ~OPOSED COMPLETION DATE /~ ~/ FACILI~ NAME ~/~ ~~/~~; EXISTING FACILI~ PERMIT NO. FAC1LI~ ADDRESS /~ ~¢/~~ ~ . ZiP CODE ~PE OF BUSINESS .~~2 -~ ~~ ~~/ APN TANK OWNER.S' ~/ ~ ~/ PHONE No. -- ADDRESS /~~ ~/~ ~ CI~{ ~~ ZiP CODE CONTRACTOR ~/~k~ ~4/~ CA LICENSE No. (/~/~ ADDRESS /7~ ~[~/~ CI~ ~5~ ZiP CODE PHONE No. ~ ~-~ ~ BAKERSFIELD CI~ BUSINESS LICENSE No. WORKMAN COMP~ No. ~/~ INSURER ~~ ~/~ ~ ' BRE~FLY DESCRIBE THE ~ORK TO BE DON~ //~~ ~/~/ ~ WATER TO FACILI~ PROVIDED BY ~/~ DEPTH TO GROUND WATER /~ ~ SOIL ~PE EXPECTED~?'SITE ~~ No. OF TANKS TO BE INSTALLED ~ ARE THEY FOR MOTOR FUEL .~YES aND-- SECTION FOR MOTOR FUEL TANK No. VOLUME UNLEADED REGULAR PREMIUM DIESEL AVIATION SECTION FOR NON MOTOR FUELSTORAGETANKS TANK No. VOLUME CHEMICAL STORED CAS No. CHEMICAL PREVIOUSLY (no brana name) (if known) STORED THE APPLICANT HAS RECEtVED, UNOERSTANO$. ANO WILL CO MPLY WITH THE AI-rACHED CONOITIO NS OF THIS PERMIT AND ANY OTHER STATE. LOCAL AND FEDERAL REGULATIONS. THISFO"RM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE ,AND CORRECT.  irEEMIT No. Bakersfield Fire Dept ~FICE OF ENVIRONMENT/~SERVICES ,~6,_~7 "[JNDERGROUND STORAGE TANK PROGRAM ~t2.- (DO~ PERMIT APPUCATION FOR REMOVAL. OF AN UNDERGROUND STORAGE TANK SITE INFORMATION SITE ADDRESS ~"~ ~./x/~/¢~./Z4LZIP CODE ~d APN FACILI~ NAME ~ ~~~ CROSS STREET :~ ~ TANK OWNER/OPERATOR ~ ~/ ~ ~/' PHONE No. ~- MAILING ADDRESS /~ ~/~ ~ CIW ~~ ZIP CODE ~// CON.ACTOR INFORMATION _ COMPANY ~~ ~/ PHONE No. ~-~5~7~ LICENSE No. ADDRESS I~/0 ~~ Cl~ ~~ ZIP CODE ~/~ INSURANCE CARRIER ~~ ~/~ WORKMENS COMP No. ~4~t~ PEEUMANAEY ASSEMENT INFOEMA~ION COMPANY ~ PHONE No. ~/-/~ LICENSE No. ADDRESS ~ ~~' ~. '~ ~ CI~ ~~ ZIP CODE ~t~ INSURANCE CARRIER WORKMENS COMP No. TANK CLEANING INFORMATION , COMPANY /~~ ~/~ PHONE No~/O~~O ADDRESS ~ ~ ~~ ~ CI~ ~~ ZIP CODE WASTE TRANSPORTER IDENTIFICATION NUMBER ~/~ NAME OF RINSTATE DISPOSAL FACILI~ ADDRESS ~ ~~ Ci~ ~~ ZIP CODE FACILI~ INDENTIFICATION NUMBER ~ ~ ~~/~ TANK TRANSPORTER INFORMATION COMPANY ~~ PHONE No. ~'~-1/ LICENSE No.~'7~ ADDRESS ~5 ~~~ ~y~ CIW ~~0 ZIP CODE TANK DESTINATION TANK INFORMATION TANK No. AGE VOLUME CHEMICAL DATES CHEMICAL STORED STORED, PREVIOUSLY STORED / ~ y~ /~ o60 ~~~/¢~ ~ ~ ~ THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE. LOCAL AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE. IS TRUE AND CORRECT. APPLICANT NAME (PRINT) ~PPLICANt'SIGNATURE THIS APPLICATION BECOMES A PERMIT_WHEN.ApPR___OVED. .' ...,~-~ ~, ,~"~,/c~ n^V^DI C Tn TI-Il: "~_ITV ('~1=' R&KI::R~FII::LD" Plot Plan must show the following: 1. Roads and alleys ~q' 3. location of tanks, piping, and dispensers 4. utilities 5. SCALE · 6. water wells (if on site) 7. any other relevent information BAKERSFIELD FIRE DEPARTMENT April 5, 1996 FIRE CHIEF MICHAELR. KELLY Mr. Ki Chu Yi Mr. Fast Gas ADMINI~RATIVE SERVICES 600 Brundage Lane ~ 2101 'H" Street - .~ Bake~,e~d, c,., 93~01 Bal~er~fiel-d, ~CA 93304 (80,5) 326-3941 FAX (80,5) 395-1349 RE: Monitoring requirements for underground storage tanks. SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA93301 Dear Mr. Yi: (805) 326-3941 FAX (805] 395-1349 Our records reveal that no precision tank testing has been ,,EVENnO, SERV~C~S performed on underground storage tanks located at 600 Brundage Lane. 1715 Chester Ave. Bakersfield, CA 93301 ~326-395~ Section 2643 2(A) of Article 4; Title 23, Div. 3, Chapter 16, CCR., FAX (805) 326-0576 requires that all underground tanks that do not utilize automated leak ENVIRONMENTAL SERVICES detection shall have a precision tank test annually. Additionally, 1715 Chester ^ve. pressurized piping shall be tested annually and non-pressurized piping Bakersfield, CA 93301 (805)326-3979 shail be tested every three years. FAX (8O5) 326.O576 Pipeline leak detectors and automated leak detection systems also TRAINING DIVISION 5642 Victor Street have to be certified to be in working order on an annual basis. Bakerstiela, CA 93308 (805) 399-4697 fAX ~ 3~-S~ Please make arrangements to brJng the tanks into compliance with state law. If you have any questions, please call me at (805) 326-3979. Sincerely, Howard H. Wines, III Hazardous Materials Technician HHW/dlm I MAR--12--96 TUE 11:54 MR.F~ST 805~242915 P.01 STATE OF CALIFORNIA-TRADE AND COMMERCE AGENCY PETE WlLSQN~ Govetr, or Office of Small Business 801 K Street, Suite 1700 Sacramento, Ca. 95814 {916) 323-9879 Ki Chu Yi 10904 Mirage Drive Bakersfield, Ca 93311 Re: Application for a loan under the RUST program Dear Mr. Yi: The Agency has given careful consideration to your application. Unfortunately, we are unable to approve the application for the reason listed on below. The specific reason for which the loan request is denied does not constitute a waiver of our right to deny the request for any other reasons. · Lack of reasonable assurance that the business can be operated at a rate of profit sufficient to repay the loan (and other obligations) from earnings. The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants or~ the basis of race, color, religion, national origin, sex, marital status, age (provided that the Applicant has the capacity to enter into a binding contract); because all or part of the Applicant's income is derived from any public assistance program, or because the Applicant has in good faith exercised any right under the Consumer Credit Protection Act. Loan Officer 09:51 ~$T ~L~P FUN~ ~ ~05 ~ 0576 N0~61~ ~01 STATE OF CALIFORNIA. CALIFORNIA ENVIRONMENTAL PROTECTION AGENC~Y PETE WILSON, Governor STATE WATER RESOURCES CONTROL BOARD D~VISlON OF CLEAN WATER PROGRAMS ~ 2014 T STREET, SUITE 130 P.O. BOX 944212 SACRAMENTO. CALIFORNIA 94244-2520 FAX TRANSMITTAL DATE: t"' ~ ~O '--q (~o FAX#: UST CLEA. NUP FUND FAX #: (916),~227.4530 PHONE #: ~(916) 227- NUMBER OF PAGES (including this page): '.~.~,~ ' vor your ~ntormation Per your request ?~"~:" I~l For your reri~ ~nd CALIFORNIA UNDERGROUND STORAGE TANK CLEANUP FUND COST PRE-APPROVAL REQUEST (Complete [on'n, enclose required items, slgn, date ~ re£um) TO: Fax: (916) 227-4530 UST Cleanup Fund, 2014 T Street, Sacramento~ CA 95814 i. CLAIH INFORMATION A. CLAIM NO. B. CLAIHANT C.CLAIH STATUS (complete appropriate'section) LOC ISSUED FOR $ ON PRIORITY LIST _ YES NO IF YES, PRIORITY CLASS J-'J A ~J B' [] C [] D NOT YET FILED, EXPECTED FILE DATE: CONTACT PERSON: pHONE: ADDRESS: _., FAX: II. TYPE OF REQUEST (check appropriate boxes) []]] PRE-APPROVAL ~ 3-BID REVIEW THE FOLLOWING DOCUMENTS ARE REQUIRED FOR THE SPECIFIED REQUEST. ALL DOCUMENTS UNPROCESSED. A, .REQUEST FoR PR..E.-APPROVAL OF ~PROPOSED COST~; - The following items are required before review and determination will be made by Fund sr. aff. i. _~__A complete ~igned copy of the proposed Investigation Workplan (IP) or Corrective Action Plan (CAP) (.~$ defined .~nd required by Ardde I I, Chap[er i 6, C. alifomia Underground Storage Tank Re,Jarl'OhS), Corrective A.c£ion Plans mu~t Include the required ~-easibilky ~tudy and chosen co, t-effective alternative. 2. ~A signed copy of [he over~i§h~ agency approvai Je£ter for :he IP/CAP. 3. __A compiete copy of ~he Request For Bids, Jncludin~ all a[~chmenLs. A list of all ill:ms requested to bid must be included. 4. ~Cornplete copies of ail bids and o~her correspondence submitted in response to ~he'Request For bid~. 5. ~A dine schedule, If not part or bid documenLs, anticipal:ed for project initiation and duration. 6. ~A derailed proiect budgeb which includes breakdowns of ~aff/~a~k/hour wkh associated estimated totals. B. THREE-BID_.REVIEW/EVALUATION/D_ETERMiNATIOIq. Fund staff will as~lsc any claimant requesting an evalundon ' of bids upon request. The followJn~ information must be submitted - 1, 2, 3 AND 4 as described in J~em A above. II1. _CERTIEICATIO~N I certify under penal~ of perjury that all information submkted with this reques~ Is complete and ac.curate and in accordance with all applicable laws and regulations. Signed Dated IJSTCF 028.CST O~,~SN£W UNDERGROUND STORAGE TAI~IqNSPECTION Bakersfield Fire Dept. ....... HazardousBakersfield, Materials CA 93301 Division FACILITY NAME /~ ~7I~ BUSINESS I_~,. No. 21S-000 //~:, FACILITY ADDRESS ~ ~c,~,~o_ J~, CIW ;~~~ ZIP CODE FACILI~ PHONE No. INSPECTION DATE ~ Pr~ Pr~ TIME IN TIME OUT ~ ~te In~ ~te Inst ~te INSPECTION ~PE: SEe S~e S~e ~OUTINE ~ FOLLOW-UP la. F~s A & B Su~ lb. F~ C Su~ 1 c. O~mting F~ Pa~ ld. State Sumharge Paid le. State,hr of Fina~al R~si~l~ Su~ lf. W~en Contract E~sts ~n ~er & O~t~ to O~mte UST ~. ~lid O~mting Pe~E 2b. Approv~ Wr~en Ro~ine MonR~ng Pr~um 2c. Una~ho~ Rel~ Res~n~ P~n ~. Tank Int~ T~t in Last 12 Months 3b. Pr~u~ Piping Int~ri~ Test in Last 12 Months ~. Suction Piping ~ghtn~s Test in Last 3 Yearn ~. Gmv~ F~ Piping ~ght~ T~ in La~ 2 Yearn ~. Test R~uRs Subm~ Within ~ Da~ 3f. Dai~ ~sual MonRo~ng of Su~i~ Pr~t Pipi~ ~. Manual Invento~ R~ncil~tion Each Month ~. Annual Invento~ R~nciliation Statement Su~ ~. Metem Calibmt~ Annually 5. W~y Manual Tank Gauging R~rds f~ Small Tan~ 6. Monthly Statisti~l Invento~ R~ciliation R~uRs 7. Month~ A~at~ Tank Gauging R~uRs 8. Gmu~ Water MonR~ing ~. ~r MonR~ing 10. Continuous InterstRial Monitoring f~ Doubl~Wal~ Tan~ 11. M~hani~l Line Leak Det~tom 12. El~tmnic Line Leak Det~tom 13. Continuous Piping MonRoring in Sum~ 14. A~omatic Pump Shrift Ca~bil~ 15. Annual Maintenan~Calibmtion of Leak Det~ Equi~nt 16. Leak Det~tion Equipment and T~ Meth~s Ust~ in LG-113 ~ 17. Wr~en R~rds Main~in~ on SRe 18. Re~ Changes in U~g~C~dRions to O~rati~R~ Pr~ures of UST S~tem WRhin ~ Da~ 19. Re~ Una~ho~ Relea~ WRhin 24 Houm Ap~ov~ UST S~tem Re~im and U~md~ 21. R~rds Sh~ng Cath~ic Prot~ti~ Ins~t~ S~ur~ Mon~oring Wells Dr~ Tu~ RE-INSPECTION DATE RECEIVED BY: INSPECTOR: OFFICE TELEPHONE NO. FD CXL FO "4L& TRAD< AND COMMERCE AGENCY / 3'2 z- 4 March 16, 1994 Ki Chu Yi 600 Bmn~ge B~ersfield, Ca 93304 Dear Mr. Yi · This office has finished the environmental review for your loan application. There are several issues that must be cleared before I can continue with your application review and issue a commitment on your request. The following are the concerns that must addressed prior to this office completing the re,,Sew of your loan request: · The San Joaquin Valley Unified Air Pollution Control District's perntit to operate expired on 11/30/93, you must provide a copy of your current permit. · The permit to operate from the Bakersfield Fire Department states that tank number 3 "Cannot be used to store fuel or any other hazardous material in its current state". We assume that the fire departments action is based on the failed Tank Tightness Test dated June 14, 1993. Also, the fire department indicated in its June 29,1993 letter that tank three leaks. To address this concern you must provide this office with evidence that you have the financial capaciV,., to pay for anv clean up caused by the tank three leak.' As _r mentioned to during mv site ~4sit, and based upon the documents you submitted with 3'our application, I thought that there would be problems getting an environmental approval for your request. At the time of my visit on 1/13/94, I suggested that you immediately start processing your application for the clean up fund. Upon approval for a grant bv the clean up fund your financial capacity to remedy any contamination found at the site. In closing, please let me know when or if you can satisfv the above mentioned concerns so that I can continue processing your loan request. Should you have an5' questions, please contact me at (916) 323-9878. ~/~.,.. t 700 Eric Watkins Associate Development Specialist ~ " COMMERCE AG~ ~ ~ "~ · ' UST 052193clc CALIFORNIA TRADE AND ENVIRONMENTAL ASSESSMENT UNDERGROUND STORAGE TANK LOAN PROGRAM Applicant: . . j // Address of the property for which this Assessment is being completed (the "Subject Property"): List the street address, use, and ownership interest in any other property owned by the Appl~ant (e.g.: 100 Main Street, Los Angeles~ 3 years rental as warehouse space).. If the list of other property includes additional properties with petroleum underground storage tanks, please include as Attachment A a copy of the most recent integrity test, air permit, and underground storage tank permit. If the property is located in a state which does not require one or more of these documents, please describe. Name(s) of individual(s) completing this questionnaire, their position(s), responsibilities, duties, and tenure with the Applicant: V.T C -ie ' K. The following questions are necessary to provide the California "l:rade and Commerce Agency (the "Agent'") with information concerning the environmental condition of the Subject Property. The Agency will require the person(s) comple .t:ing this statement to certify that the statement is tree and constitutes an accurate account of all known environmental matters related to the Subject Property and its vicinity. The Agency will rely on these answers as knowing representations of the Subject Property's condition. The questions should be answer~ by one or more persons who are most knowledgeable about the Subject Property. Such persons will be expected to conduct a "reasonable inquiry". The term "reasonable inquiry" shall include a thorough examination of the · ' ' Subject Property and all property records as well as all matters into which the Applicant has inquired for any purpose, or into which the Applicant has had the right or duty to inquire. "Reasonable inquiry' shall not require an environmental audit or the hiring ora consultant to respond to these questions. As set out more fully in the loan application and program regulations, the Agency may conduct an independent.investigation of the answers supplied in this statement at the Applicanfs expense. If such an investigation reveals problem areas not disclosed in this statement, the loan decision may be delayed. The Agency's r~liance on this statement shall not constitute a commitment to lend funds, nor shall it limit the Agency's right to conduct a site investigation at the Applicant's expense prior to issuing a loan commitment. The Applicant should disclose all known existing or potential environmental issues when answering the following questions. The Agency is aware that businesses that apply under the loan program will generate hazardous substances. When fully disclosed, the existence of hazardous substances on the Subject Property will not necessarily 'result in an automatic loan denial. The Agency, in its sole discretion, shall consider other factors as listed in the regulations when determining whether the proposed loan meets the program's goals and the Agency's acceptable liability risk. If the space provided for your response is insufficient, include an attachment to the questionnaire a.nd label the attactument with the number of the question you are continuing to answer. Exhibit A contains definitions of the terms used in this statement to aid the Applicant in - determining the scope of each question. Exhibit B contains a list of attachments to be included with this completed questionnaire. A. SCOPE OF APPLICANT'S "REASONABLE INQUIRY" 1. Is ti'as assessment being completed by someone familiar with the Subject Property and the business operations conducted at that properly? /~ Yes No If yes, describe why the person completing this assessment is knowledgeable (e.g.: - because that person owns and manages the business located on the ~roperty). 2 . 'B. ~OP£t~TYn, rFQRMATtON 1. ~ent ~nd FQ~er ~e~ ~d Us~ oFthe Subj~ ~rop~ nnd (a) Give the ~e of~e pr~ent o~er ~d ~te ~e ~ent use oF~e Subj~t Prope~. 0 Do you know who owned the Subject Property prior to the current owner7. .iff .Yes If'yes, state the names of all such former owners, the approximate dates of their ownership, and their uses of the Subject Property. Note especially any '" manufacturins or industrial uses, and any uses which required the use, storage; or ~po~ Ot'pesticia~ .hazaraous substan~/eS;':°r Petroleum'produCts}" (c) Are there or have there been tenants or easement holders on the Subject Property? Yes /~/ Do not know .. .- · If yes, ~tate the names of'present and former tenants, easement holders, etc. and their uses of the Subjec~ Property. Note especially any manufacturing or industrial uses, and any uses which required the use, ~orage, or disposal of - pesticides, ha~rdous substances, or petroleum products. , ' (d) What is the current zoning for the Subject Property? (e) Do you know the prior zoning of the Subject Property? Yes No If yes, please list the previous zoning and the dates when the zoning was changed. (f) If the property is used as a gas station, to the best of your knowledge how long has the property been used for this purpose? years (g) Approximately how far below the surface is ground water? (h) Are you aware of any previous environmental assessments, audits, or inspections of the Subject Property by any governmental entity, consultant, or other party? Yes NO If yes, please descn'be and include as Attachment B any reports, studies, plans, or other related documents. 2. Current or Proposed Use of Subject Property_ (a) Please describe all current and proposed activities that the'Applicant intends to conduct on the Subject Property. If the property is used as a gas station, please describe any automotive repairs conducted on the prerrfses. If automotive repairs were historically performed on the premises, but not presently, describe the adtomotive repairs and when ~ey ceased. (b) In addition to storing gasoline and/or diesel fuel in underground storage tanks, please list ali hazardous materials and waste on the premises. Examples of materials that should be listed are solvents and motor oil. Examples of wastes that Should be listed are spent solvents, waste oil, and oil covered saw dust. List ofbazardous materials: /")/) C) -/'-O r'. _ C~i ] i F) ~CZ~ ~]~ . List of hazardous wastes: For each hazardous waste listed above, include as Attachment C the two (2) most recent manifests obtainld from the transporter who picked up the · hazardous waste.' In the case ofwaste oil, the transporter may have provided you with a receipt in lieu ora manifest. If the hazardous waste is not picked up by a licensed hazardous waste hauler, please describe disposal procedures. 3. Physical Description of Prooertv (a) Please describe all structures on the Subject Property (including approximate age) and include as Attachment D facility map. Include in that map the location of any underground storage tanks, including a description of the size and use of the.tank (e.g.: 5~.,000 gallon, unleaded).. Co) In addition to the tanks identified in the Attachment C facility map, are there, or have there been any tanks, sumps, ponds, lagoons, or other containments (whether under or above ground, inside or outside of any structure) on the Subject Property? Yes I/yes, please include as Attachment E a Est describing such containments (including their size, age, and location) and, where possa'ble, list all substances known to be (or to have been) stored or deposited therein. (c) Do any of the structures, paved areas, and other work areas contain floor drains .. or other direct connections to drainage areas, sump, septic systems, or public sewer facilities? Yes If yes, please descn'be the drainage system, and the manner in which it is currently used in the Applicant's operation. (d) Has an asbestos expert or industrial hygienist inspected the Subject Property? Yes XNo If yes, include the report as.Attachment F. (e) Is' there any PCB equipment (transformers, capacitors, or other electrical equipment) in use or stored on site? Yes 'No Do not know If'yes, please list. C. Regulatory Information & ~.~s~orv 1. Retail gasoline dispensing facilities require permits fi.om the local air quality management district or air pollution control district Include as Attachment G a copy or'the current permit issued by the air dLuict for the business located at the Subject Property. 2. Owners of petroleum underground storage tanks are required to obtain a permit for these tanks. This permit is ismed by the city or county in which the tanks are located. Please include as Attachment H a copy of the current underground storage tank permit for the tanks located on the Subject Property. 3. Most cities require that gas stations obtain a permit for the storage of hazardous ' materials. Please include as Attachment I a copy of the hazardous materials storage permit for the business located at the Subject Property. If no such permit is required in your municipality, please state this below. 4. As a condition of the (~nderground storage tank permit discussed above under C.2., tank owners are required to monitor the tanks to detect leaks. In most cases, tank owners are required to conduct annual tank integrity tests of all permitted petroleum tanks. Please include as Attachment I a copy o['the three most recent integrity tests for all permitted tanks located on the Subject Property. If integrity tests are not required, please provide a copy of the instructions from the local permitting agency authorizing a monitoring technique other than integrity tests. If the method selected is dally inspection and maintenance of an inspection log, please include as Attachment J a copy of the December, 1990 log, and the log for the month just concluded. 5. Has any governmental agency issued any letter, notice, or verbal communication indicating that it intended to investigate or seek information concerning environmental matters relating to the Subject Property? Yes No If yes, please specify and include a copy as Attachment K. 6. Have any hazardous substances, pesticides, or petroleum products ever been spilled, deposited, leaked, leached, disposed of~ or otherwise placed on or in the Subject Property? - Yes No 7 .- If yes, please specify and detail response and cleanup activities undertaken including any governmental agencies contacted. Include as Attachment L copies of'any reports, studies, plans or other documents generated. 7. Is the Subject Property or any activity conducted thereon in violation of or subject to penalty under any law, ordinance, rule, or regulation relating to ha~:~rdous substances, or the protection of the en.vironment? //'es If yes, please specify and explain. 8. Has the Subject Property been designated, listed, or identified in any manner by the United States Environmental Protection Agency (the "EPA") or any other governmental .agency as a hazardous materials disposal or removal site, superfund or cleanup site, or candidate for removal or closure pursuant to any federal, state, or local law? Yes No If'yes, please describe. Include as Attachment M copies of any warnings, citations"'hotices of violation, enforcement actions, and administrative and judicial complaints or orders, and correspondence related to any hazardous substance or environmental law or regulation. 9. Are you aware of any litigation or threatened litigation pertaining to the Subject Property.? Yes No .- If yes, please describe. D. Applicant In.formation For each Applicant and each enterprise operating on the Subject Property, list the follovfing: 1. Ongoing or threatened environmental cleanup activities for which the Applicant is or may be subject to lawsuit, demand, liability, or responsibility for the conduct of cleanup or payment of cleanup costs. 2. List all related businesses of the Applicant..As used herein, the term "related" means that the Applic,'mt owns at least 51% of another business, or another business owns at least 51% of the Applicant. As the present owner of the Applicant or having an interest therein, or as an officer or as a general partner of the present owner of the Applicant (or the duly authorized representative of such owner), the undersigned, and each of them, individually certifies that he/she is familiar with the Applicant business and the Subject Property and with all of the operations presently conducted on the Subject Property, has made a diligent inquiry into the present and former uses and activities conducted on the Subject property, the present and former uses and activities conducted within the vicinity of that property, and all other matters relevant to a full disclosure of all environmental concerns and issues relative to the Subject Property, and that, to the best of the knowledge, information and belief of the undersigned, the information disclosed above is complete, true and correct. The undersig-ned acknowledges that the Agency intends to rely upon the disclosure made above or attached hereto in dete,,mining whether 'and on what ten:ns it will make a loan to the Applicant. . Applicant By: Title: Date: Exhibit A 1. Hazardous Substance. The terms 'Hazardous Substances" and 'Hazardous Materials" shall mean, inte. rchangeably, any hazardous waste, toxic substances, or related materials. The 'term shall include without limitation, any substance, material or waste which is or becomes regulated by any local governmental authority. The term 'Hazardous Material' shall also include without limitation, 'any material or substance defined as 'hazardous substances', 'hazardous materials' or 'toxic substances' in the Comprehensive Environmental Response, Compensation and Liability Act of 1980, as amended (42 U.S.C. § 9601 et seq.)("CERCLA'), the Hazardous Materials Transportation Act, as amended (49 U.S.C. § 1801 et seq.)("I-DdTA"), The Resource Conservation and Recovery Act, a~ amended (42 U.S;C. § 6901 et seq.)("RCRA"); those substances defined as 'Hazardous Waste' in Section 25117 of'the California Health and Safety Code or as "Hazardous Substance". in Section 25316 of'the California Health and Safety Code; and in the regulations adopted and publications promulgated pursuant to said laws. The term 'Ha;?dous Materials" Shall also include ... without limitation, any substances that, because of their quantity, concentration or chemical, radioactive, flammable, explosive, infectious, corrosive, reactive, or other characteristics constitute or may reasonably be expected to constitute or contribute to a danger or. hazard to the public health, safety or welfare, or to the environment, as well as all petroleum products and pesticides, whether otherwise included within the above definition or not. 2. Permit. The term "permit" shall include any permit, registration, certification or other filing or action which must be obtained from, or filed with any governmental agency, or is otherwise required in order for the Applicant to conduct operations, or own or operate any equipment or facility. 10 Exhibit B The questionnaire asks for several attachments. Please clearly identify all attachments and circle the letters below that correspond to the attachments enclosed. The descriptions are merely for reference, the full description of materials to be attached is listed in the questiormaire itself. Attachment Description A Integrity Test, Air Permit and Underground Storage Permit for Other Property with Underground Storage Tanks B Environmental Assessments C Manifests D Facility Map E Contairu~. ent List F Asbestos Report G Air District Permit H Under_m'ound Storage Tank Permit for the Subiect Property I Hazardous Materials Storage Permit I Tank Monitoring Reports/Inspection Log K Public Agency Environmental Letter L Corrective Action Reports M . ]Environmental Citations 11 PERSONAL HISTOKY/RESUME Please fill out the following information for officers, directors, or stockholders/partners with 20% or more ownership. If business is owned husband and wife, complete a separate form for each. Complete for any keg' management person, regardless of ownership percentage. ' Home Address: (street, c~ty, state,' zip)JOqO~ Dq~O-E ~-')~. . . -- Prior kddr%ss ~street,' c~ty, sta~e, zip) ~(~! ~ ~ Lived there from: (mon'tn/yaar)./-ku9, IGG.~ ' To: (mon~h/year[j~,~ Date of Birth 7-~-..~-~ ' ~a~e of Birth .~Oe [. ~6~Q- -- Are you a U.S. Citizen? Yes No X (Alien Registratio~ Have,oD ever been involved in bankruptcy' or insolvency proceedings? Yes~ No If yes, provide details as separate exhibit. Are'you o~ ~ur business involved in. any pending lawsuits? 'Yes.~' No__ If yes, provide details as separate eXhibit. Military Service: From To - Branch WORK EXPERIENCE/EDUCAtION List in chronological order beginning with your present employment. Emphasize accomplishments and responsibilities. 1. Company Name ~ From ~t~ )~q~ To ~Ie~'+ Title ~Ol, nF ~ Duties: ~ - 2. Company Name Address: From ]q~Q To i~ Title Duties: '~,'i,'n~ ~ .%ell:~¢ 3. Comgany Name Address: From To Title Duties: College and Training Attended Degree cr Name and Location From To Area of ~tudv Certifica~ Miscellaneous (Awards, Hcnors, etc.) Signature Da~e IR? 600 II. BUSINESS OPERATIONS / A. DESCRIPTION OF BUSINESS ' '. 1. TYPE OF ORGANIZATION 6. PROPOSED FUTURE OPERATIONs 2. DATE OF FORMATION 7. SERVICE AREA 3. LOCATION 8. COMPETITION 4. PRODUCT OR SERVICE 9. CUSTO~.~ERS 5. BRIEF HISTORY OF BUSINESS 10. SUPPLIERS B. MARKETING PLA3; 1. MARKET SIZE AND LOCATION 2. YOUR COMPETITION (YOUR COMPETITIVE EDGE) 3. YOUR POTENTIAL ].tA_D. KET SHARE (SAr~ES POTENTIAL) 4. ~3~KET STRATEGY - HOW WILL YOU REACH YOUR CUSTOMERS? (PEOPLE, PRODUCT, LOCATION, PRICE, PRO~OTIO~, DISTRIBUTIO~ PLAN, SERVICE AND WA_RRA.NTY POLICY). -- C. ADMINISTRATIVE MANAGEMENT. 1. ORGANIZATIONAL CHART (EXHIBIT PROVIDED) 2. ~3~AGEMENT RESUMES .3. PERSONNEL POLICIES 4. CREDIT POLICIES 5. REPORT/CONTROL SYSTEMS 6. INSURANCE PLA~S 7. LEGAL/ACCOUNTING SERVICE PROVIDERS_ l/alley ,>mall usiness m'elopment C Loan Application PART A. I. Information Abou~ Your Comoany ~QOF~ O%~ership: Co%~ora=ion =--" of Account-. Bank Con~ac~: Telephone: Ti. Oescr{n~inn of L~nn Request R-~ques:ed Loan .~.~,oun~' $ !ii. Required Info~a~ion . Applican: mus: submig ghe following' 1. A shor~ history and descrip:ion of the business. . 2. A completed Personal His~o~ S~azemenr of all officers and/or o~mers of 20% more of company (forms will be provided). 3.A balance shee~, prov;~ & loss s~a:emen~ and bu~ine~ ~ax ~hree year~. 4. Current balance ~hee: and Rrofic & loss Include ~gin~ of Accounts ~eceivable and ~ccoun~s Payable ~ART Page J 5. Projected profit & loss statement for two years· 6. Names of affiliates or subsidiary companies and previous 2 years financial statements from each. / 7. Resumes of ~rincipals involved in management. 8. Completed Schedule of Current Debt for all exis=ing loans of greater than one year maturity (form will be provided). 9. If a franchise, co~y of franchise agreemen= and FTC Disclosure 10. Current personal financial scatemen= for each proprietor, par=net, or stockholder w£th 20% or §rea=er o~nership. 11. If a corpora=ion, corporate resolution au=horizing the company to borrow. 12. For corpora:ions: A copy of Articles of Incorporation. For partnerships: A copy of ParTnership Agre_ement and identifying partners. 13. Purchase Agreement & Escrow InsTructions for real estate being purchased. 14. Site plan and estimates of coscs for new consTruccion/remodelling. 15. Vendor quotes of costs for machinery, equipment, furnishings or fixtures. 16. Bank or other lender s%a~emen~s documen~in§ refusal to provide required financing. 17. Indapenden~ appraisal of real estate offered as collateral for loan. 18. Completed form FmHA &00-1 "Equal Opportunity Agreement." 19. Completed form FmHA 400-4 "Assurance Agreement." 20. Completed form F~%~ 19&0-20 "Reques~ for Envircr.~anza! Informa%ion." 21 S~atemen~ describing economic benefi.~s ~ · an,/o_ emp!o3~en: opportunities which wi!! be avaiable to lcw-income persons, farm families, or displaced farm families as a result of The loan. ' 22. Have you or any officers of your company ever been invplved in bankruptcy or insolvency proceedings? Yes / No ' If yes, provide details. · : .PART A. -. Page 3 ~V. ~qreement and Certification / I/We Agree and/or Certify: That all information submitted in application for this loan is accurate and complete to the best of my/our knowledge. To authorize disclosure of information submitted in this app!icatio~ to other participating financial institution(s). That proceeds of -loan, if approved, will be used as set forth in this application and as disclosed to the VALLEY SMALL BU$I~S$ DEVELOPMENT CORP. To pay such fees as are disclosed to the applicant by VALLEY SF-%LL BUSINESS DEVELOPMENT COR.:. and authorized by the U.S. Farmers ~ome Administration, including loan origination fees and legal fees. As consideration for any Management and Techn%cal Assistance that may be provided, to waive all claims against the VALLEY SY~LL BUSINESS DEVELOPMENT CORP, its officers, directors, and members. That no owner or officer of my/our company or members of their immediate lam/lies are currently employees of the U.S. Farmers Home Adm/nistration or employees or directors of the VALLEY.SMALL BUSINESS DEVELOPMENT CORP. That the VALLEY SMALL BUSINESS DEVELOPMENTS, its officers or directors, have no ownership interest in my/our company. By: Attest: Title: Title: Date: ~' -. REPAIR UNDERGROUND STORAGE TANK APPLICATION 1. List each undcrground storagc tank (UST) owned or operatcd by thc bnsincss applying for a loan from thc Agcncy. Thc list shall includc thc address of each UST, thc numbcr of USTs at each location, and indlcatc which USTs will be includcd in thc projcct usir thc loan funds (project tanks). Also providc a copy of any corrcspondcnce bet~vccn thc applicant and public agcncics concerning a.r. UST owned or operated by thc apPlicant. 2. For each UST, includc a copy of thc currcnt permiL Evidence o£a currcnt permit shall consist ofonc of thc following: a.) A copy of a current permit issued by thc county of city agency charged ~vith rcsponsibility for uS'rs (local agency); or b.) l~oth of the following: 1.) ,4. complcted State Water, Resources Control Board Form .4. & B, signed by an authorizcd rcprescntativc of thc local agcnc. and 2.) Evidenc~ that the lx:rrnit f~ has be~n paid for each UST for the current year, consisting ora canceled check or a rcceipt the local agcnqy. 3. .4. description ofany unauthorized releases from a UST owned or operated by the applicant, including copies ofcorrespondcnc~ thc local agcncy, and reports made to insurcrs. : · 4. Ird'ormation regarding the project for which funds is being rcquestcd (pt:oject), including a dcscflption, o1' thc.reasons why: a.) Thc project tanks either currcntly are not, or in thc future will not be, in compliance with fcdcral, state, o~: local standards. b.) The project will result in project tanks which are in compliance with federal, state, or local standards. .. 5. Describ,: the projcct in detail, including: a.) A list of the project components, with the cost and time line for the completion of each'component. b.)' The name and applicable e.x-pericnce of the individual or firm prcparing thc cost cstimates, and copics of any supporting invoi.'. estimates or contracts. c.) A list of any pcrmits necessary to carry out the projcct. 6. A. protect can consists of the upgrade,' repair or removal of a UST used to store pctrolcum. The project can also include corr~tiv= action. Corrective action can include any action taken to correct an unauthorized release from a UST used to store ~troleum, including: evaluation and investigation of az~ unauthorized rele. a~e, initial corrective action measures, clean-up of the rele..a_~, an'.,' actions n~:essar'7' to inves'dgate and remedy any r~idual eff~ts remaining after the initial corrective action and post clean-up monitoring. If the project includes corrective action measures, provide the follox~-ing information: a.) A description, budget, and time line for each segment or activity comprising the corrective action, and the identified sour~ cf funding for each segment or activity. b.) A copy of any cor'acdve action plan ~ed with a public agency. 7. Provide a copy o£ all monitoring rel:Orts conducted on any project tank during the last th.fee years. -: .- IND DUAL FINANCIAL STATI ENT i~T°: -(Lender} Name: Date of Birth Address Zip Code _ CHECK AS APPLICABLE .Applicant is applying for this loan: ['-i Individually, without a co-signer or quarant¥ of a relative or other person(s) or entity. /.. [-] ,Jointly, with the co-si~Inature or fluaranty o[ one or more persons or entities (including any existing ~luarantor$) NAMES OF OTHER PERSON(S) AND ENTITY(lES) PLEASE INDICATE OR PROVIDE EXPLANATION RELATING TO ANY ASSETS OWNED ,JOINTLY OR LIAB[LITIE~ OWED WITH OTHERS. (ATTACH ADDITIONAL SCHEDULES AND EXPLANATORY NOTES IF NECESSARY.) STATEMENT OF FINANCIAL CONDITION 6F .AS OF ASSETS j AMOUNT I LIABILITIES j AMOUNT- sc ot ^' j Notes sc o'J - & Loans Cash In this Institution Payable Notes Payable Io Bank~ FOther Than3 - Other Banks or Savings & Loans I_Real Estate/ Notes & Loans Payable (Other] SCI'I~-L)UI-EB j SCHEDULEC j -- Stocks Insurance & Bonds btarketable Sec'aP:ties Loans Other~ sc uu c I I Insurance Cash Value Accounts Banl~cha~e Cards Accounts SCHEnULED .j &Bllls & Payable O~en & Revc!v~ng Ac==unts Notes Receivable Other Real Ruidefice(s) Real Estate Residence(s) Estate Unimproved Land Notes & Uniml~roved Land Cont:racts · Income ProperW(ies] Payable Income Pro~e.-.y(ies} Other Other Other ' Other A~se~.~ Other. A.~et~ & Liabilities P~..,:~o hal Prol:e,,-'y . RE-CAP OF INCOME AND EXPENSES U~'."~.'~,.S-SE~-~)~AJ~i:L~)'. · See no~ce b~/w befor~ comple~ang Other Income. "ANNUAL LNCOME FOR Y~_.S,.R 19 A,N'NI-tA[. F-XP--~NSE$ FOR Y=_..kR 19 CONTINGENT ~LIA~[LITIE5 SaJa~'? or Wac. les j Pro~ ~-'W Tax & Ass~,sments j As ~'~dcrser on Nc~es/Con.-ac~ j [~lvldencLs or Interest J [ Fed. &Sm:e Income Tax j A~ Guarantor on Nc:es/Con~.-c'~ J ~,,entaLs (Gn:~ [nc=me} J R-,al E..~..a:,~ Loan Pa,;ments J F~e Taxes j Eusiness (Net [nc=mol J Pa~"min:~ on Con:rat'.s/Notes J Other (IDeSC~..l:e! J O tAer Income (IDa',tribe) ' J E.s,dma:ed Li'~.r:.c3 Ex=enses J TCTAL [NCOHE J$ TOTAL ECFSNSES J S TOTAL j $ · t~ C.-'T ' A.%~..ony. chgd supl=or~ or maintenance payment ~ncome need not ~e revealed :.I ~: ~n,s ,,-.,.-..~ ,{..~1 ~,1o1.~;~.~ ycu do n~t wish to have it considered as a ~asis for re~a~ing this o~:~c~ation. · SCHEDUI.E'A CASH STATUS OF BANK TOTAL $ TOTAL $ /". S'c~E-I~'I~:~' STOCKS AND BONDS (Include Interests In An~ Closel~r Held Business D~-~,~kl~ Ne. Shafe~ J~ ~J~,;~ ;~ bi N~pm4. e( So~rc~ MValeado~ D~le Prlc~ P~f S~.lte To~al Val.-~ ]qar~l~ o~ P~dt TOTAL SCHEDULE'C LIFE INSURANCE S~H~D-~.E D' ACCOUNTS AND NOTES RECEIVABLE I I I I~ I I I I, t I I I, ~ Yr.: ~~ NOTES AND LOANS PAY~ TO B~KS AND OTH~S S TOTA~ s SC-~FH~"~' ACCOU~S AND BI~ PAYABLE (In~iudina Bank Cards) Pevab~ To [ Acc~nl ' SC'H~D~ I: OTHER I, .. I I, ~. t I, ~.. I I, ~. I I' I I I I I Applicant is L_J m~rried L.J separated l--] unmarried (includes single, divc~rced and widowed). Co-ApPlicant, If any, is J-I marr~rated J-J unmarried (includes singl~vorced and widowed). Amount oE alimony, child s~,~,-o.~ and m~Lntenance pay-mcr, t income. NOTE: Alimony. child suppo~ or maintenance payment ~come need not be reveale~'~ you do not wish to have I~ considered as a basis for repa~4ng this obi, gallon. $ lqame and address of payor of any alimony, child support or maintenance payment income clisc!osed ~,bove as source of repayment. Alimony. child support, separate maintenance received under n court order n w~itten agreement 1-1 Income (salad, pension, social secure, dividends. Integer, etc.) Source: $ per monlh Have you ever bo~owed lrom any ocher branch of d~is Institution? Name Location Dare Number o! dependenLs ,Ages Have you made a w~li'? Name o! personal representative Have you guaranteed or endorsed the notes o! any o~'.er perscn?. : Do you have any other contingent liabilities? Have any ac:ions or suiLs been filed against you or ate ~ere any unsalLsfied judgemenLs or donees enlered against you. or have you been adjudged bankrupt or made any assl, nmems for creditors? Names of References: Addresses: AmoUnt o( a~mony, ch~d suTpa~ and m~imenance p~en~ ~came. ~OT~: AZimony. ch~d supga~ or m~imen~nce payment income nee~ not be r~ealed ~ you do hoc ~sh ~o h~ve ~ c=~ere~ as a b~sis far reTa~ng th~ ab~a~an. Name and a~re~ of pa~r af any a~many, ch~ su7~c~ cr maincenancz paymem income d~c~ase~ aba~ as source of reTaymen~. A~mc~y. ch~ sugpo~, separate ma~ntenanc~ recelve~ c~E~: ~ c=u~ or~: ~ wdnen a~eeme~t ~ cral {nccme {salad/. pension, soc~ sera, dry. ~i~Een&s. interest. S ~er mcmh Have 7cu ever bc~owe~ 5om a~y o~her br~nch o( ~ Ins~u~an? Hame Location NumSer of Ee7e~en~ {nat ~:e~ by app~cant) Ages ~ave you ma~e a wild Name o[ personal re7resema~ve Have you gu~anteed ar endarse~ ~e notes o~ any o~ ~cn= Do you have any other contingent Have any a~o~ or s~'be~ ~ed aga~st you ar are ~e ~y u~Red juEgemen~ or de~e~ e~ter~ aghast you. or ~ve you been a~juEged ban~Tt ct made any ass[gnmen~ for Hames of Rdetenc.s: J [ (we) hereby a~ ~at ~e ~cre~cing infc~a~[cn c=~:~[~e~ ~ t~.~ finan~aI statement ~ pr~ented [or the pu~ose ~e ~a:a [n~ica(e~ an~ ~ ~e. complete a~ cc~e~. I u~e~a~ Lender ~ re!yi~g on t~ statement of my · '.~, . ~ .... t,,a~ p~cse. Lencer may ~cse to any ot~er [ntereste~ pa~es Lender's ~xTedence i~fc~ ~e Lender imme~iat~y o~ any ma~er w~h ~j ~ any significant change in my ~n~ con&[Ucn. retain th~ ~nand~ ~atement whether or not ~e~it ~ ~qted. A~=~caP4's $;c~nat~re ~ Dare Co-Ap~:~cam's S~na~u."~ Date Consent (II ~ou are reining on income from a person who is no( an applicant above, plebe have that person complete this. sec~ion so ~ha( we ma~ ve6r~ their credit.) ..... cr... Le~der to m~ke a~y inves~at[cn a[ ~y cre~t e~t~er ~rect!y cr throuch a~y ace~c/emplcs, e~ by Le~der fcr that pur~cs~ in connect(ca ~th th~ credit applicon(on. - - - 0a:~ Signature Scc~a[ Securitv Number OIIIGIIIAL OItlOlllhh i'lli".S El'IT IIITIClIEST IIATUI{I'i'¥ IIOtITllLY AIIHUAL, COLL, ATEIIAL, CIJ{ilIEIIT AIIOUW DATI~ BAl.! lCl'~ HATE DATE PAYIIEIIT DF-BT SV SE:CUB DEl SCHEDULE OF CURRENT DEBT .-,,.. , As of * Loan applicalion for: Financial informalion for: " CREDI I'Oll OltlGINAL ORIGINAL I)RdSlJNf INfEHEST MAi URITY MONTHLY P&I ANNUAL COLLATERAL CURRI~N T Name and eddleaa DATE AMOUNT BALANCE RATE DATE PAYMENT DEBT SERVICE OR DELINQUENT TOTAL PRESENT BALANCE** * Same as interim financial statement. · * Total must agree with balance shown on ihterim balance sheeT. I (we) certify that tlie above information is correct and complete to the best of my (our) knowledge. " OUIce of Small Business ' O? Dlrecl Loon Application _,_,, lease check ('4) the loan program for ,,ddch you are applying.. . . ' RUST,~ CLEAN r3 ENERGY r-] HAZARDOUS WASTE BUSINESS DATA LO.~I AuOu~l' S Fuu. 8~m~lT AlXmll~ TIL~ft~t~ No. 0~. A.D, COAL') · I DAlr~ OUJINE $$ WA~ E rTA~ LISHI~D (Attach additional page~ for affiliate~ and ~bsidiades.) PERSONAL DATA FOR ALL O~ER{S), COSIGNERS, and GUA~NTORS (~ff Is defined as a sole-propflelort Bmr! pa~n~s), or any sharehold~s) x~ffi 10% or more ortho outstanding sh~es.) I H~E ~E~ ADO~eSS C~ ~A~ I ZiP ~DE Y~ S T,EaE J I I ~PtO~'l ~l {IF DIFFE~ ~ APPLIC~ ) ADagEs$ I Y~ ~ ~ ~P~ P~m~ I (Attach additional pages for other miners, co-signers, and ~tamnto~.) Signed nmi dated financial statements not older than nlnc~ (90) (lays Business (Applicant, a~liates, and subsidiaries) · ~ersonnl (All o~ers, cosigners, and ~mrantors) .... Signed and complete copies eftl~e three ~) most recent federnl tax returns Business (Appllbant, a~llates, and subsidiaries) Pcnonal (All o~crs, cosi~cn, and gtmrantors) ~ebl schednles correspomllng to the flnnncl~l statements " Business (Applicant, a~llates, and subsidiaries) Personal (All o~ers, cnsigne., nnd ~mrantors) U,o .fProceeds Dcsc~pll~n of hmv the proceeds from this lonn %~!1 be used. Tnchtde the e~ecled x~seful Il ~e of nny equipment or fi~res.. eopie, of m~ppofllng invoices and contracts. For constmctian loans, Joel,de copies of plans, ~ecificntions, and a cost bre~kdox~. ~gal Copy ortho legal desc~ptio~ x~lh the prope~ o%~e~ nnme ~e real estate occnpied by the bnsiness. All real estate o~ered ns collateral. A copy n[lhe most cu~ent sl~ed lease ~or tim real estate o~tupied by the ~usinesx, Environmental . .. -_ . Signed and dated ~nvlronmentnl Assessment Questionnaire ~h suppling d~umentnlion. . '. OENERAt. INFORMATION C 3NCERHING APPLICANT, OWN~TRS, COSIGH~RS, AN~ GUAt]ANTORS Are any assets held In Tmst3 Yes Are nny assets pledged er debts scented except ns shm~? Yes.. Have you ever had n repossession? Yes lfnve you ever hnd n bnn~lptcy or hnd n judgment ngnlnst you? ~es lTave you ever been n principal orguflrflntor o~a fi~ that declared bflnkmplcy? Yes Are you pn~ lo nny clnlm or IAWSUiIS? Yes~ lTflve been audited by Ihe ~S In the past lhree (3) years? Y~ No Iryes, is lhe Audit seUled? Yes ~o' Please Include An explnnnlion on n sepnrafe page ~or each "yes" nnswe~. · l~you are mn~ed, complete nil inro~nlion for yoursel~nnd your spouse. You do not have lo list you~ spouse's sepnrnte prope~ unless cosigner or ~mrnntor. You do not have to list income from alimony, child suppo~, or separate maintenance unless you x~nt pu~oses or this application ~or credit. Your spouse is not required to ~ n he.ewer, cosi~er, or ~mrnntor unless he/she is nn m~er o~e business. I rct~resent and declare trader penalty of perjmT under lite laws ofthe State or California that this is a true anal correct statement of the currenLfinanclal condilion of the prospective borrower and its owners, cosiguers, and guarantors..~ny existing or titreatened litigation, claim or circumstance which might reasonably be expected to affect by condltton in the future is fu. lly described below or in an attachCC stalement. I will Immediately notify yon tn ,~wtting if there is a material change in my financial condliion. In the absence of such notice, this shall constitute bolh a new and contlmdng statement of my financial condition if I become obligated to you or you rely, to any extent whatsoc on this statement of my financial condition. I agree that my present and future obligations to you may become Immediately dt~e and payable, at your sole discretion, if: (a) I, or any cosigner or guarantor of any ofm~, obligations, at any time fail In business, become insolvent, commit an act of bankruptcy, or die; (b) writ of allachment, garnishment, execution or other legal process Is Issued against a malerial portion of my property;, (c) any act for the · - collection ofdelinquent taxes is taken against me; (d) any representation tc~ you by me or a cosigner or guarantor of my obligations pray be misleading or untrue; (e) I fall to notify you of any material change in my financial condition or there is a matefially adverse change my condition; (01 sell or transfer any interest in my current business; or (g) any other action or condition contained in the loan agreem~ which is executed by me. I waive the right to notice of any action taken by you in enforcing these rights. Ym~ may verify lite Information contained in this statement with any third party. ! am anthorlzed to ~wl)mit this application on the part or the applicant business. DAT~ SIQtd~D DAT! SIOt41~D PLEASE TELL US HOW YOU HEARD ABOUT THIS PROGRAM REGIONAL DEVELOPUENT CORPORATION ["l I SUALL BUSINES~ DEVELOPMENT CENTER ~ CONTACTING TRADE AND COUUERCE A REG ~ULAI'ORY BODY (PLEASE SPECIFY) I NEWS AR1,1CLE (WHAT PUBLICA?ION?) ^DV~RI'ISEUENT (WHAT PUBLICATION?) O~.J:LER (PLEASE SPE(~IFY) INFORMATION FOR GOVERNMENT MONITORING PURPOSES Thc following Information is requested to monitor compliance with the equal credit opportunity laws. You are not required to furnish tl Information, bat are encouraged to.do so. The law provides that a lender m,qy neither discriminate on the basis of this ird'ormation, nor whether yon choose to furnish it. TTowever, ifyon choose not to furnish it, and you apply in person, this lender will note race and sex at basis of visual observation or sttrnnme. ]'fyou do not wish lo furnish the information, please check the box below. I'11 do not wish to furnish this information. . Race/National Orlflln: I-'! American Indian ~sinn or Pacific Tslander Gender: [] Female ~ Black, not Hispanic origin ' I-1 Hispanic [] While, not Hispnnic origin .~'~ale [] Other (specify) Please see Part 2 for the type of loan for which you are applying. oppffca.~t1~ PAT?~OLL EZPE~SES ......... ~vE~lSl~ ~ P~[EII~ .... - ......... .~ j ' .............................................. OUES [ SUbSCriPtIOns ............................................ TELEPhOnE Ecu [ PP~RT LEASES ........... - ......... . .......... DEPZEC IAT 1CN/~C~ [~T ] C~ ...................... I~CE ........... RENT ........... [~TE~EST O~ L~S ALLO~CE FO~ ~COLLECTASLE ACC~T~ TOTAl. ~E~SES (Li~ S tflm ~) ~ET P~OFIT BEFORE 1~ T~ES (Line 3 CASI( FLO~J PROJECT[OHS FOR : .................. .~ ............................................................................ : .............................................. *: ..................... : .......................... : .... I¢onth I~ Honth 2 ~ H~th ~ ........... Honch ~ , ........... H~th 5 ~th 6 ~h 7 ~th 8 Honth 9 ~th 10 ~:nth 11 ~th 12 TOTAL 1. NET ~ONTHLY SALES (For Reference ~[y) ' ................................ ~ ~ ~ _ ..................... .~:_~L~?~: ..........~ ............. C~sh I 4. Cash Sates ~ I 5. Cr~it Cott~ti~ - 30 DAYS -_ 8. Lo~n Pr~ 9. Othe~ ~ ~ 10. TOTAL ~SR AVAI~aLE (Li~ 3 thru Li~ 9) ~;. '"'~ ...... I ........... I L I I I I I ' ..................... - I ~ZZZ~ZZ~ ~ZZ~ ...................... .............................................. ~ ............................ 4~' ......... i ...................... I ................... ' ................................. ~.ti.~ ~,~ ~ iZ ............... _ ............................... I I I ........... 15. Loan Pri~i~! .............. ~ .... 7 ........................................ ::::::----',-----------:::::l::::::::::: ...... ,.. ............................................ ............. ,~. ,..~o~,~..~ ........... -----------, .................................................................. ~ ...................................... ~ ................... . ~[[o~ ~ l~x ..... - .......... . ........................... 18. ~ers Ora~ ) ...................... - ................................ 19. Other ................ : ......................................., , 21. TOTAL ~a RE~Ia~ {Li~ 1~ th~ Li~ 20) ........................................................................................ ' ZZZ~I~ZZZ'~ZZ~Z ............................................. ~. NET ~8 FL~ (Li~ lO 8i~ Line 21) ......................, rate Underground Hazardous Materials Storage Facility Issued By: Bakersfield Fire Dept. HAZARDOUS MATERIALS DIVISION KI CHU YI 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 MR. FAST (805) 3~6-3979 600 BRUNDA6E ~NE BAKERSFIELD, CA 93304 Approved by:~~ ~Ral~ E. Huey~~aterials Coordinator Valid from: 12-22-93 to: 12-22-98 SUMMARY OF CONDITION/PROHIBITIONS CONDITIONS/PROHIBITIONS; MONITORING REQUIREMENTS; I. The facility owner and operator must be familiar with all conditions specified within this permit 1. Any underground storage tank not utilizing interstitial monitoring or a State approved automated and must meet any additional requirements to monitor, upgrade, or close the tanks and associated tank gauging method shall be monitored utilizing the following method: piping imposed by the permitting authority, a. Standard Inventory Control Monitoring (tank gauging five to seven days per week). If 2. If the operator ofthe underground storage tank is not the owner, then the owner shall enter into a needed forms can be obtained from the Bakersfield Fire Department. Inventory reconciliation writlen conlract with the operator, requiring the operator to monitor the underground storage tank; and/or tankgauging shall not be used on any tank for leak detection after December 1998. maintain appropriate records; and implement reporting procedures as required by the Department. 2. All tanks shall be tesled annually utilizing a tank integrity test which has been certified as being 3. The facility owner and operator shall ensure that the facility has adequate financial responsibility capable of detecting a leak of 0.1 gallon per hour with a probability ofdetection of 95 percent and insurance coverage, as mandaled for all underground storage tanks containing petroleum, and a probability of false alarm of 5 percent. The first test shall be completed before December 31, supply proof of such coverage when requested by the permitting authority. 1992, and subsequent tests completed each calendar year thereafter. All tank integrity tests 4. The facility owner must ensure that the annual permit fee is paid within 30 days of the invoice date. completed after Septenlber 16, 1991, shall be compleled under a valid, unexpired Permit to Test 5. The facility will be considered in violation and operating without a permit if annual permit fees are issued by the Bakersfield Fire Department. not received within 60 days oftbe invoice date. 3. Manual tank gauging and/or inventory reconciliation for purposes ofleak detection shall nol be 6. The facility owner and/or operator shall review the leak detection requirements provided within allowed after 1993 for tanks located in areas where the highest historical ground water is with in this permit. The monitoring alternative shall be implemented within 60 days of the pemfit issue twenty feet of the bottom of the tank. date. 4. All suction piping shall be monitored for the presence of air in the pipeline by observing the suction 7. The facility underground storage lanks must be monilored, utilizing the option approved by the pumping system for the following indicators: permitting authority until the tank is closed under a valid, unexpired permit for closure, a. The cost/quantity display wheels on the metered suction pump skip or jump during g. Any inactive underground storage tank which is not being monitored, as approved by the operation; permitting at,thority, is considered improperly closed, proper closure is required and must be b. The suction pump is operating, but no motor vehicleTuel is being pumped; completed under a ponnit issued by the pem~itting authority, c. The suction pump seems to overspeed when first turned on and then slows down as it begins 9. The facility owner/operator must obtain a modification permit before: to pump liquid; and a. Uncovering any underground storage tank after failure ora tank integrity lest. d. A rattling sound in the suction pump and erratic flow, indicating an air and liquid mixture. b. Replacemenl of piping. , 5. All underground slorage tanks containing motor vehicle fuel shall be retrofitted with overspill ' c. Lining the interior of the underground storage linde, containers, over fill protection, automated tank gauging/inventory control and/or interstitial d. Any other work which alters the lank or piping, monitoring devices and corrosion protection by December 1998, or shall be removed and replaced 10. The lank owner must advise the Bakersfield Fire Dopas~ment within 10 days of transfer of with a system that meels new construction standards specified by the State regulations. All tanks ownership, containing a hazardous substance other than motor vehicle fuel shall have secondary containment 11. Any change in state law or local ordinance may necessitate a change in permit conditions. The and meet all other State standards by December of 1998. owner/operator will be required to meet new conditions within 60 d~ys of notification. 6. AIl equipment installed for leak datection shall be operated and maintained in accordance with 12. The ovmer and/or operator shall keep a copy ofall monitoring records at the facility for a minimum manufacturer's inslmctions, including routine maintenance and service checks (at least once per ofthree years, or as specified by the permitting authority. They may be kept offsite ifthey can be year) for operability or running condition. obtained within 24 hours of a request made by the local authority. 7. An annual report shall be submitted to the Hazardous Material Division of the Bakersfield Fire 13. The owner/operatnr must ropoa any unauthorized release which escapes from the secondary Department each year after monitoring has been iniliated. containment, or from the primary containment if no secondary containment exists, which increases the hazard of fire or explosion or causes any deterioration of the secondary containment within 24 hours of discovery. ANY QUESTIONS, RELEASE REPORTS, ETC. SHOULD BE SUBMITTED TO THE: HAZARDOUS MATERIAL DIVISION BAKERSFIELD FIRE DEPARTMENT Code Explanatinm: 1715 CHESTER AVE., BAKERSFIELD, CA 93301 (805) 326 3979 Tvoes of Tanks and Pinin~ DWI: = Double Wall Fiberglass Monitoring Methods FCS = Fibeq~lass Clad Steel ALD = Automatic Leak I~tector LPT = Lined Piping Trench ATG = Automated Tank Gauging SWF = Single Wall Fibeq~lass CLM = Continuous L~k Monitor SWL = Single Wall w/Liner LTT = Line Tightness Testing SWS = Single Wall Ste~l MIR = Manual Xnventoty Reconciliation MTG = Manual Tank Gauging SIR = Statistical Inventory R~conciliation 'FIT = Tank Tightness Testing lc U~derground' Hazardous Materials Storage Facility State I.D. No. mit N CONDITION~ iP ! ~EVERSE SIDE Issued 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 ~ ~ Approved by: Ralph E. Huey, Hazardous Materials Coordinator Valid from: '~c BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 APPLICATION TO PERFORM A TIGHTNESS TEST FACILITY ~/+3I ~J./~'/'-)/~ ADDRESS .~ CxO tfJ/~L'7~l._.)/=). ~/,~-- .Zl~,"~f'' ,Z~~/~ PERf~IT TO OPERATE # 5"~d ~-600/--~ O .OPERATORS NAME ~J- -~/~O'- ~ OWNERS NAME ,~ C/f&' yZ NUMBER OF TANKS TO BE TESTED 3 IS PIPING GOING TO'BE TESTED y~-J TANK# VOLUME CONTENTS ,~ /4/d)O ~J ~'C,~ /~. e-/~0~ x,..z'-d' 7 HAME O~ TESTE~I)II/¥~'. '/Z)~/8~? C~Z~ZC~ZOH ~ STATE REGIST~TION ~lff~ ~/-/66/ DATE & TIME TEST IS TO BE CO~UCTED ?~'/~(..' 30',~' /0~ /~ ~ F~/~ JU~'c ~/~'~ ~ ?~J ~.'~,~. S~ Ws~r R~u~s ~ntml ~ HAZ, ~AT. DIV. CERT FICATION OF F NANCIAL RESPONSIBILliY ' FOR U~DER~ND STO~ TANK8 CONTAINING p~UM ~t mialoa dollars manual or ~ 2 slalom dollars annul a~e~te 1 albion dollars ~r ~u~n~ B. ~ ~ ~ ~ ~reby ce~ t~t ~ ~ /n compete w~h t~ r~u/re~n~ of ~t~n 2~ Ty~ · = $1,000,000.00 D~ 1 ~000,00( Note: If ~u are ~/ng t~ ~ate Fu~ ~ any ~ of ~ur de~tm~n of fi~l [~ibil~, ~ur exxon a~ suA,~n F~ 19 April 94 To Whom it May Concern, This letter is to show proof that I am capable of meeting the financial responsibilities in case of a underground storage tank spill. The State of California, State Water Resources Control Board only requires that I show an ability to be able to come up with the initial Ten Thousand Dollars towards the state clean up fund. I have enclosed copies of; the Certification of Financial Responsibility and also a letter from my bank. The letter from bank states that ov- er the last three months, I have had an average balance of Eighteen Thousand Three Hundred Dollars and Ninety Five Cents per day. Which is way over the minimum amount that is required on my share of the financial responsibility. My business is capable of providing the necessary money that may be required in case of a spill. If you have any more questions or anymore statements that may be required please feel free to contact me at 805-324-2915 or please write to my place of business at 600 Brundage Ln. Bakersfield California 93304. Sincerely Yours, K± Chfi ( Owner ) Bakersfield AgH-Center Branch Ki Chu Yi In Suk Yi 600 Brundage Lane . ~.~.~.~. Bakersfeild, CA 93304 Dear Mr. and Mrs. Yi: '' The balance in your Cash Maximizer account .:'r ~04197--09957 is $20,629127. The average balance for the last 90 days is $18,303.95 ..... Sincerely, * .. ~'. Rapp Assistant Vice President Branch Manager 240 Chester Avenue Bakersfield, California 93301 BAKERSFIELD FIRE. DEPARTMENT HAZARDous MATERIAl, DIVISION PERMIT TO OPERATE UNDERGROUND HAZARDOUS STORAGE FACILITY Permit No.: 200006C ~ State ID No.: 8317 Issued to: MR. FAST Location: 600 BRUNDAGE LN BAKERSFIELD, CA 93304 Owne~. KI CHU YI 600 BRUNDAGE LN BAKERSFIELD, CA 93304 - Operator:. MR. FAST 600 BRUNDAGE LN BAKERSFIELD, CA 93304, Facility Profile: Year Is Piping Tank No. Substance Capaci ,ty Installed 1 GASOLINE 12,000 GAL 1974 YES 2 GASOLINE 12,000 GAL 1974 YES. 3 Cannot be used to store fuel or any other hazardous material in its current state. This permit is granted subject to the conditions listed on the attached summary of conditions and may be revolad for failure to adhere to the stated conditions and/or violations of any other State or Federal regulations. Issued by: Ralph E. Huey. m Issue Date: JULY 1,. 1991 Expiration Date: JULY 1, 1994 POST ON PREMISES NoSTa sn anaL UN~EF-~GF.C'-tIND STORAGE TAN~. PROGRAM PERMIT APPLIOATION TO CC, NSTRUOT/MOr~IFY U 1~DERGROUN D ST~ ~GE TANK '~"NEW FAC',U,-Y C] MODIFFC'A'T1ON C FFACILh'¥ :~ NEW TANK~NSTALL~TiON AT EXL~T;.*~ FACILITY STARTING DATE DEC 1. I 993 PROPOSED COM?L='-iION DATE MAR 31 1 994 FACILITY NAME _~4R _ FACILITY ADDRE~, , ZIF CSDE I'YPE OF BUSINE-~ f4~RWET & GA~q ~.~';~mTQN APN TANK OWNER_ K~ CEIU ¥I PHONE Nc. [8:05)324_2915 ...ADDRESS 600 CONTRACTOR P'~eO-WINDSOR . __ _ CA ZIP CSOE 93304 .- CaRP . CA UCE~SE-No. 653'866 - ADORESS,45f~ ~.~.gNANr)'o CT C;TY ~ ZIFC,SOE 91204 PHONE No. I ~ ~,) 74n_¢;1 n? 5,&KERSFIEUD CITY 8USINESS : - . 8REIFLY DESCRISE THE. WORK TO BE ~C~ ~¢~ ~ - INSTALL ~:EW FUELING '~r.t~ AND' CANOPY W~ TO FAC?~ P~OVIDED BY- QEPTN TO GRO~D WATE2 SOIL ~PE ~ECTED AT SITE · ~': No. OF TANKS ~Q BE INSIALLED 2 A~E ~EY FO~ MORON F'0EL ' ~ YES ~ ~C $:ECIION FO~ MOTOR FL~ . TANK No. VOLUME 'UNLE.~DED RE~UtA~ PREMIU~ DIE~_ AVIATION 1 ~0,000 5~00 5,000 2 6~00 ~00~ SECTION FOR NON MOTOR FUELSTORAGETANKS TANK No. VOLUME C' "~ ,=~=v~ICAL STORED CAS No. CHEMICAL PREVIOUSLY (r,c brand ~me) (if known) STORED i'M[ APgLICA NT HA~q EC[IWED. UNOEI~STANDS. A,%.'~ WILL CaMl~t~l' WITH THE ATTACI4EQ CC~NOITIONS OFT'HIS =~MffANO ANY STAff. LOCAL AND.m-..BEIi~AL REGULAflONS. . - ~ ~ .&=. MCANT NAME (PRINT) / AP~AN'~ ~GNATLIREI - APPLICATION BECOMES A- P : I JlT WNEN APPROVED " STATE OF CALIFORNIA · ~ STATE WATER R'ESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION. FORM A COMPLETE THIS FORM FOR EACH FACILITY/SITE MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT ~ 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED SITE ONEITEM [] 2 INTERIM PERMIT E~] 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) DSAOR FACILITY NAME NAME OF OPERATOR ADDRESS ' CITY NAME~ r~e~F,~/j_ .STATE ZIPOODE CA ~'3,....~ ~. SITE PHONE,WITH AREA CODE · / BOX TO INDICATE . [~ CORPORATION E~"~OIVIDUAL I---I PARTNERSHIP ,r-"q LOCAL-AGENCY ~ COUNTY-AGENCY [~ STATE-AGENCY ~] FEDERAL-AGENCy DISTRICTS RESERVATION [~ 3 FARM [~ 4 PROCESSOR ~'~ 5 OTHER OR TRUST LANDS EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY). optional NIGHTS: NAM'E (LAST, FIRST) PHONE # WITH AREA CODE NAME (LAST, FIRST) PHONE # WITH AREA CODE I1. PROPERTY OWNER INFORMATION- (MUST BE COMPLETED) NAME V/' tOARE OF ADDRESS INFO RMATION MAILING OR STREET ADDRESS / ,/ box bindicate ~ INDIVIDUAL [~ LOCAL-AGENCY [~ STATE-AGENCY CITY N~AME -/::~',~ ¢--- ,~¢ ?/,e la ("¢,, - ?~ 3o? STATE Z'POODE PHONE,W,THAREAOODE III. TANK OWNER INFORMATION- (MUST BE COMPLETED) NAME OF OWNER .~_..,~/,_ ,~.,. ~?-- . CARE OF ADDRESS INFORMATION MAILING OR STREET ADDRESS ¢" box to i~ica!e E~ INDIVIDUAL E~ LOCAL-AGENCY E~ STATE-AGENCY [~ CORPORATION r---I PARTNERSHIP ~] COUNTY-AGENCy F--I F~OERAL-AGENCY CI'I-Y NAME ' t STATE ZIP CODE PHONE # WITH AREA CODE IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER. Call (916) 739-2582 if questions arise. V. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY ' COUN ,'TY Ct JURISDICTION Ct FACILITY Ct LOCATION CODE - OPTIONAL CENSUS TRACT# - OPTIONAL SUPVISOR - DISTRICT CODE - OP~7ONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION . FORM B, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. FORM A (9-90) . FOR0033A-R2 PERMIT APPLICATION Fq~REMOVAL OF AN :~i PERMIT No. '-~ ~ ~ U N D E R G R O U N D STOR AG'~' TAN K ]3a.l-:~-sf/e]d Fiz'e DepL ~ H~~S MA~RIALS DIV[StON ~ UNDERGROU~ STOOGE TANK PROG~M SITE INFORMATION LN SITE MR, FAST ADDRESS 600 RRUND[IC~I~. ZiP CODE 9;3304 APN FACILITY NAME MR. FAS~ - CROSS STREET T STREET TANK OWNER/OPERATOR KI CHU YI PHONE No.(805)324_2915 MAILING ADDRESS 600 BRD~1DAGE LN ClTYBAKERSFI~D ZIP CODE 9330-_ CONTRACTOR INFORMATION COMPANY PICO-WINDSOi~ CaRP PHONE No(81 8 )240-6102 LgCENSE No653866 ADDRESS .5.~NDO Cm CITY ~T.~.NI")AT.? ZIP CODE _q 1 2 n ._-.. INSURANCE CARRIER ,~t-7~-~,~ ~/~.~P~f.~ WORKMENS CO~'AP No.NNC21 0224-00 ! PRELIMANARY ASSEMENT INFORMATION · COMPANY ~)?Co--~.VA/DS, o,~ c.o~/'~ PHONENo.("g'~_,,)'z;z°-Z/~g'- LI~-,.NSE No.~/..¢ ADDRESS '~"'~ /~-~-~'~z~,.~,t'o ~---77. CITY ~'~m/~...~ ZIP CODE ~/'/A"~/-- INSURANCE CARRIER ~./'~)~,~-¢'~"~ ,_~,~/~ ~'~. ~,. WORKMENS CONffi NO. TANK CLEANING INFORMATION COMPANY PHONE No. ADDRESS CITY ZIP CODE WASTE TRANSPORTER IDENT~CATION NUMBER NAME OF RINSTATE DISPOSAL FACILITY ADDRESS CITY ZIP CODE FACILITY INDENTIFICATION NU?MBER TANK TRANSPORTER INFORMATION COMPANY PHONE No, LICENSE No. ADDRESS CITY ZIP CODE TANK DESTINATION TANK INFORMATION TANK No. AGE VOLUME CHEMICAL DA'ES CHEMICAL STORED STO~D PREVIOUSLY STC2~D 1 19YR 12 ,~'00 MOTOR VEHICLE FUEL MOTOR' VEHZ.~., F. FUEL 2 I gYR I 2; 0:00 MOTOR VEHIU. T,E F[TF.L // 3 · I qvR I 2; 0:OO MC~TOR VRT-I'TC.T,E FTT1~.T, i:i:i:'":?' ':'-"-': ?::'""::?': i" ~"':'"'"~'::"::i:'"'"::!:'":~""'" i' ~:~:!:! :!:! :!:~: i:~: ~:~:~:i:]:i:~:~:~:~]ii~:..:-'..:~i~:iiii~ ~:.f_-'if f i~ii':! :':fl! :'~! !::::':':]:' :'! !' :':" :' :: i':i~i i' :: ]i :'!:!:~:]~f i~f~i ~ ~::~f~:.~ i ] fii~i]ii!i!!¢ ~!:': :!':'! :f :i:i!! !]i.':-z'~i:::-':::'-: ':':': '":i .::.! i!]-::.]!~ !]!!!ii~.-;"¢i~!~f]!':;:i:':;:i :':~ :~i~:"' ::! :": ~;~:~i!: i:~'-:.::.:i :.:;.:.:.~i' THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY. WITH THE Ai"J'ACHED COND~QN$ OF TNB PERMIT AND AN~' C~.~HER STA~E, LOCAL AND FEDERAL REGULATIONS.  DER PENALTY OF PERJURY, AND TOTHE BEsT OF MY APPLICANT NAME (PRINT) THIS APPUCATION BECOMES' A PERMIT WHEN APPROVED Make checks payable ~o "C~ty o['Baher~l~ld" ?/ I L,~' .', , :,~,;,' , , l ' : ~ ~T& R ~'O~Y !'; .'2;.'; ~:>: .., ', b".: I o'maa ~ .......................... ['~ ....... ' ' -' ' ' UNDER~ROUND STORA TA~ ~ ~' ~ HA~DOUS ~A~!AL9 UND~e~OUND ~O~A~E TANK '" :-.".:'" ~Af"J'¢ ~ ~*~ ~,,~~.~. ~',% PHONE NO ~ ~'~ ~°'~'L!C~<~'t; '~ '. ...... :[ ............... ..,. .... --: ...... : ...... : ................ ~.....;_.: ...... : ....... :, ~,, ..- ...... ,,~ PAhW- .............. PH''''''~: .,'~r: C,F ' ~-"~ f~ FaC, fy :'~,.' ~' ';NY ...............................PHON~ No. I ...... ,~" .... . ...................... L,m-, oE No. ' ~-: Ar~,- V:d Uf,,ic CH~: ,a~,..A~ DATES CHE;'vIIC > .... :__.: : ::ZE:: ::::::::::::::::::::::::::::: ...... ........ , - i< /,":r'~ i': '. .." .. .:..' ~.: :,: : ,:,:.,,,-..: ....... : :' :. ' ...:..::: :::~.x:;:~.~.:'u:;.h-;~:c¥, ,::q ' ~" t~:t' :~ ::' ':4' t:"~'~..::x::::., ::;?~:: :~ ;:;~, ~,~'? ' ' :<,a,, ,t'~: :~ ': ': ::': '; '"~<.'U'~: " ~ ~,~V .m '... :~',.:,;..',..-',,-.~.>.,..> ...... ~* · r- ,~ .t,.~,.,,~J~S, AND ,~,tL ..... ,k~,~, Wif~'fHf: ? F'. BY ',r ,- ...., ..... ,.,,^r,o:tfl,," '; :r:FJA, . ii.iRE RECEIVED ~ov 0 3, 1993 HAZ. MAT. DIV. PERMIT APPLICATION FOR REMOVAL OF AN ~ ~ ."r~mttuNo- SITE INFORMATION '/ COMPANY .~[2/L"~-cC2/'.XJZ)~ ~ PHONE No ..ADDRESS ~~~ .... INSURANCE CARRIER . N . ..... :_: ' C~NY'~fI~.~ ~.,~~ ~. PHONE N0,[q~H)~Z~?LICENS{ NO. ~ ~ ~~ ~ESS Iq~e._~.~ '~'~.~ '~, a~ ~I~Y .~H~ ?~. ZIP C~DE .~'~. iNSURANCE CA~IER ~t ~ ~ c ~ S ~ I ~ ~H ~q ~ WO~KMENS COMP No, COMPANY .:'~ ---'' PHONE No, -AOO~ESS - CI~Y 'ZIP CODE WAS~ ~RANSPORTEE IDENTIFICATION NUMBER NAME OF RINS~A~E DISPOSAL FACILITY · , ADDRESS ~ITY ZIP CODE FAClLEY INDENTIFICATION NUMBER ........ ~K' TRANSPORTER INFORMATION . cOMPANY PHONE No, L~ENSE No,~ ADDRESS , C~W Z~P CODE ..... TANK DECLINATION TANK !N~O~MATION  ~IANK No, AGE VOLUME CHEMICAL DATES CHEMICAL ~TORED STORED PREVIOUSLY STORED ~H~ APPt~A~ HAS ~ECENED, UND~RSZANDS. AND W{~ COMitY W~H ~N~ A~ACH~O CONDff~NS ~ ~H~ PEEME AND A~ $TAT~, ~OCA~ANO FEDER~ THffi ~O~M HAS BE~N COMPLETED UNOE~ PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, ~ T~UE AND CORRECT, ~P~ED BY: APPLICANI NAME (PRIN1)' ' ..... APP'L~CANT THIS APPLICATION BECOMES A PERMIT WHEN APPROVED Make che~ks payable 1o "C~7 '-~ STATE OF CALIFORNIA. -, ' . STATE WATER RESOURCES CONTROL BOARD - - -' UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORM B -, - . COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM, MARK ONLY [] 1 NEW PERMIT ' Eli 3 RENE~VAL PERMIT '[~: cHANGE OF INFORMATION r'-'] 7.PERMANENTLY CLOSED ON SITE " ONE ITEM [] 2 INTERIM PERMIT r--] 4 AMENDED PERMIT . [] 6. TEMPORARY TANK CLOSURE~ 8' TANK REMOVED ' DBA OR FACILITY NAME WHERE TANK IS INSTALLED: J'~. Fo....~ ~" , i. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I. D. # - / B. MANUFACTURED BY: '. c. DATE INSTALLED (MO, DAY. EA~ ? -- 7'.q o. TANK CAPACl~ ,N GALLONS: / 2. ,~ ooo II. TANK CONTENTS ~: A-'I tS MARKED, COMPLETE ITEM C. A. E~> MDTOR VEHICLE FUEL '. [] ,' O'LB. C. [] ,a REGULAR [] S D,ESEL ' [] ~ AWAT~ONGAS UNLEADED [] , GASAHOL ' UNLEADED [] 5 JET FUEL []]]] 3 CHEMICAL PRODUCT []]]] 95 UNKNOWN []]], 2 WASTE [] 2 LEADED [] 99 OTHER (DESCRIBE IN ITEM D. BELOW D. IF (A.1)IS NOT MARKED, ENTER NAME' OF SUBSTANCE STORED C.A.S.#: III. TANK CONSTRUCTION MARK ONE iTEM ONLY IN BOXES A, B, AND C, AND ALL THAT APPLIES IN BOX D A. TYPEOF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM ~ 2 SINGLE WALL [] 4 SECONDAR~ CONTAiNMeNT (VAULTED TANK) [] 99 OTHER B. TANK [~ 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEEL CEAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLEW/FRP" (PrimaryTank) [] g BRONZE [] JO GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER [] 1 RUBBER LINED · [] 2 ALKYD LINING [] 3 EPOXY LINING '[]]]]. 4 PHENOLIC LINING C. INTERIOR LINING [] 5 GLASS LINING UNLINED [] 95 UNKNOWN [] 99 OTHER IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES__ NO__ O. CORROSION ,, ~] ~ POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCE~ PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN ~ 99 OTHER ~l~_./b ~(.~,~10~(.~ ~.,~ ' IV, PIPING INFORMATION CIRCLE A 'IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTEM TYPE A U I SUCTION A~I,I~2 PRESSURE A U 3 GRAVITY .. A U 99 OTHER B. CONSTRUCTION A U I SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A(~95 UNKNOW~ A U 99 OTHER C, MATERIALAND A U 1 BARESTEEL A U 2 STAINLESS'STEEL A U 3 POLYVINYL CHLORIDE{PVC)A U 4 FIE~ERGLASS PiPE . . CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION []] 1 AUTOMATIC LINE LEAK DETECTOR ~ LINE TIGHTNESS TESTING [] 3 INTERSTITIAL MONITORING [] 99 OTHER V. TANK LEAK DETECTION [] ~ WSUAL CHECK [~'~ INVENTORY RECONC,UAT~O" [] ~'VAPOR MON~TOR,NG []~ AUTOMAtiC TANK GAUG~N~ [] ~ GROUND WATER MON~TOR,NG [~ANK TESTING . [] 7 INTERSTITIAL MONITORING [] 91 NONE [] 95 UNKNOWN' [] 99 OTHER VI. TANK CLOSURE INFORMATION · I 1. ESTIMATED DATE LAST USED (MOIDAY/YR} 2. ESTIMATED QUANTITY OF 3, WAS TANK FILLED WITH I YES [], NO SUBSTANCE REMAINING GALLONS INER~ MATERIAL ? THis FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND. TO THE BEST-OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE I.D.,NUMBER IS COMPOSE'D OFTHE FOUR NUMBERS BELOW '. I COUNTY # JURISDICTION # FACILITY # TANK # Il STATE I.D..fi' 0 / ! 101 131/ ,7 ' / . pERMIT NUMBER .- '' I PERMIT APPROVED BY/DATE i PERMIT EXPIRATION OATE FORM B (9-90) "THIS FORM MUST BE ACCOMPANIED By A PERMIT APPUCATION - FORM A, UNLESS A CURRENT 'FORM A HAs BEEN FILED." ' - - FOR0034 B-R4 -.,, 5~f~,TE OF CALIFORNIA :_ STATE WATER RESOURCES CONTROL BOARD ... ,UNDERGROUND. . . STORAGE TANK PERMIT, APPLICATION- FORM B COMPLETE A SEPARATE FORM'FOR EACH TANK SYSTEM, MARK oNLY' [~ 1 NEW PERMIT [~ 3 RENEWAL PERMIT CHANGE OF INFORMATION ~ 7 PERMANENTLY CLOSED ON SI'~E ONE I;rEM · [] 2 INTERIM PERMIT ~ '4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE ~ 8 TANK REMOVED DBA'OR FACIUTY NAME WHERE TANK IS INSTALLED: jU~/p% ~..~ ~ , . I. TANK DESCRIPTION COMPLET~ ALL ITEMS -- sPEc'iFY IF UNKNO~ ' ~ · A. OWNER'S TANK I. D. ~ ' ~' ' B'. MANUFAC~RED II. TANK CONTE~S iF A-1 IS M~RKED, COMPLETE I~EM C. A. '~OTOR VEHICLE FUEL ~ 4 OIL B. C. ~.laREGULAR ~ 3 DIESEL ~ 6 AVlATIONGAS - UNLADED ~ 4 GASAHOL ~ 2 PETROLEUM ~ 80 'EMP~ ~ 1 PRODUCT ~ lb PREMIUM ~ 7 M~H~OL UNLEADED ~ 5 JET FUEL ~ 3 CHEMICAL PRODUCT ~ 95 UNKNOWN ~ 2 WASTE ~ 2 L~DED ~ 99 OmER (DESCRIBE IN I~M D. BELOW Ill.'TANK CONSTRUCTION MAR~ O~E ~TEM ONLY ~N BOXES A. a, ANO C, AND AL~ T~AT A~PUES ~N ~OX D A. TYPE OF ~ 1 DOUBLE WALL . ~ 3 SINGLE WALL WITH E~ERIOR LINER ~ 95 UNKNOWN SYSTEM ~ SINGLE WALL ~ 4 SECONDARY CONTAINMENT (VAULTED TAN~ . ~ 99 OTHER B. TANK ~ BARE STEEL ~ 2 STAIN'LESS STEEL ' ~ 3 FIBERGLASS ~ 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL ~ 5 CONCRETE ~ 6 POLWINYL CHLORIDE ~ 7 ALUMINUM ~ 8 1~/. METHANOL COMPATIBLEW/FRP ~ ' "UBBE" LINED ~ 2 AL~D LINiN~ ~ 3 ERO~ LmNING ~ ~ PHENOLiO LININ~ C. INTERmOR ~ 5 GLASS LINING ~ UNLINED ~ g5 UNKNOWN LINING Is LINING UATERIAL OOUPATIBLE WITH l~/. ME~ANOL ~ YES__ NO__ D. OORROSION ~ 1 POLYETHYLENE W.AP ~ 200ATING ~ 9 VI~L Wn~ ~ 4 FIBE~OLASS ~EINFOnOED P~STIO PROTECTION ~ 5 CATHODIC PROTECTION ~ 91 .ONE ~ 95 UNKNOWN IV. PIPING INFORMATION . C~RCLE A ~FASOVE~O~ U A. SYSTEM TYPE A u 1 SUCTION ' A~ PR[SSURE ' A U 3 GRAVI~ A U 99 OTHER B. CONSTRUCTION A U 1 S~NGLE WALL A U 2 DOUBLE WALL A U 3 UNEO'TRENCH ~9~ UNKNOWN .A U 99 O~ER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3' POL~[NYL CHLORIDE (PVC)A U 4 FIBERGLAS PIPE CORROSION A U 5 ALUMINUM A U' 6 CONCRETE A U 7 ~LW/COATIN~ A U 8 10~/~ METHANOL.COMPATIBLEW/FRP ''PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION . ~95 UNKNOWN A U 99 OTHER D. LEAK DETECTION ~ ~ AUTO~ATIOUNE LEAK DETECTOR ~ LINE TIGHTNESS TESTING ~ 3 I~T~RSTITIAL · , MONffORING ~ 99 OTHER .V. TANK LEAK DETECTION ~ TANK,TESTING ~ 7 [NTERSTITIAL MONITORING ~ 'gl NONE ~ 95 UNKNOWN ~ 99 O~ER VL TANK CLOSURE INFORMATION [ 1. ~STIMATED DATE LAST USED (MO/DAY~R) 2. ESTIMATED OUANTI~ OFSUBSTANCE REMAINING GALLONS 3. WAS TANK FILLED WITHiNERT MATERIAL ? . YES ~. NO ~ THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AG ENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS-BELOW : COUNTY # JURISDICTION Ct FACILITY Ct TANK Ct STATEI.D.# ~ lol ltl lc4o1¢131ll71' I I Ilot PERMIT NUMBER j PERMIT APPROVED BY/DATE t PERMIT EXPIRATION DATE FORM B (9-90) THIS FORM MUST BE ACCOMPANIED BY A PERMff ~PMCATION - FORM A, UNLESS A CURRENT FORM A HAS BE~N FI~D. FORO~ ., STATE OF CALIFORNIA ' STATE WATER RESOURCES CONTROL BOARD .' UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORM B ,' - COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEI~ - MARKONLY [] 1' NEW PERMIT [] 3 RENEWAL PERMIT CHANGE CF iNFoRMATION [] 7 PERMANENTLY CLOSED ON SI~E ONEITEM [] 2 INTERIM PERMIT ~ 4 AMENDED PERMIT ~'--~' 6 TEMPORARY TANK CLOSURE ~-~ 8' TANK 'REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: ·; ' I. TANK DESCRIPTION COMPLETE ALL ITEMS ;- SPECIFY IF UNKNOWN ~;. DATE iNSTALLED (MO/DAY/YEAR) . ~ -- ' ~' D. TANK CAPACITY IN GALLONS: ,. TANK CONTENTS IF A-I.IS MARKED. COMPLETE iTEM C, A. ~'"C'MOTOR VEHICLE FUEL [] 40'LB. c. [] ~aREGULAR [] 3 DIESEL [] , AVlATION GAS UNLEADED [] 4 GASAHOL ' [] 2 PETROLEUM [] 80 EMPTY [] 1 PRODUCT [] lb PREMIUM . [] 7 METHANOL · UNLEADED. [] '5 JETFUEL [] 3 CHEMICAL PRODUCT [] g5 UNZNOWN i [] 2 WASTE [] 2 LEADED [] gQ OTHER (DESCRIBE IN ITeM D. BELOW D. IF (A.1) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED C; A. S. #: III. TANK CONSTRUCTION MARK ONE iTEM ONLY IN BOXES A, B.ANOC. AND ALL THAT APPLIES IN SOX D A. TYPEOF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [--'-~/.,,n"~2 SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER . B.. TANK ~ ~ BARE STEEL [] 2 STAINLESS STEEL [] 3 FISERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 coNcRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 10~/o METHANOL COMPATIBLEW/FRP (PrimaryTank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER C~. INTERIOR [] 5 GLASS LINING ~/____~6 UNLINED [] 95 UNKNOWN [] 99 OTHE, LINING iS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES__ NO__ D. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING ~ [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN IV. PIPING INFORMATION CIRCLE A iFABOVEGROUNDOR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTEMTYPE A LJ 1 SUCTION ~__~ PRESSURE A U 3 .GRAVITY A U gg OTHER B. CONSTRUCTION- A U 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A (~5 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARE STEEL ' A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC) A U 4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 'STEEL WI COATING. A U 8 100% METHANOL.COMPATISLEW/FRP PROTECTION A U g GALVANIZED STEEL A U 10 CATHODIC PROTECTION Al~)g5 u~NKNOWN D. LEAK DETECTION ~ 1 AUTCMATIC LiNE LEAK DETECTOR ~ LINE TIGHTNESS TESTING ~'3 INTERSTITIAL MoNrl'ORING I.~9. OTHER. V. TANK LEAK DETECTION I []~6 VISUAL CHECK ~L__~2' INVENTORY RECONCILIATION ~ 3 VAPORMONITORING[] 4 AUTOMATICTA. NK~AUGiNG [] 5 GROUNDWATERMONITORING TANK TESTING [] 7 INTERSTITIAL MONITORING .[] gl NONE [] 95 UNKNOWN [] g9 OTHER VI. TANK CLOSURE INFORMATION " I1. ESTIMATED DATE LASTUSED (MO/DAY/YR) I 2. ESTIMATED QUANTITYOF 3;WAS TANKFILLED WITH ~ YES []. NO [] [ SUBSTANCE REMAINING GALLONS iNERT MATERIAL ? ' THIs ~ORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF M~ KNOWLEDGE, IS TRUE AND CORRECT LOCALAGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NU ~lyl~,L~S BELOW COUNTY # JURISDICTION # FACILITY # ~-. .TANK # ' I PERMIT NUMBER [ PERMIT APPROVED BY/DATE I PERMIT EXPIRATION DATE FORM B (9-90) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION- FORM A, UNLESS A cURRENT :ORM A HAs BEEN FILED:' ' : FOR0(334~R~ .& ~~ ,, '~" 2130 G Street, Bakersfield, CA 93301 ,~,,, \D UNDERGROUND· TANK_.QuESTioNNAIRE RE. CE I VEIl ~FACILIW NAME · ' ~ ~ NAME ~ OPE~OE ; EMERGENCY CONTACT PERSON {PEIMAE~ EMERGENCY CONTACT PERSON (SECONDAE~ DAYS: NAM~ (~ST. FI~ PHONE ~. WITH AR~ CODE I DAYS: NAM~ (~ST. FI~ PHONE ~, WITH AR~ COOE II. PROP~ OWNER INFORMATION (MUST BE COMPLETED) " NAME . CA~E OF ADDEE~ III, TANKOWNER INFORMATION (MUST BE COMPLETED)' >" NAME . CAE~ OF AODEE~ IN~RMATION . - ' I BOX ~DIVIDUAL Q LOCAL AGENCY a STAT~'X~ENCY CIW NAME ~ . STATE ZiP CODE ~_ PHONE No. WITH AR~ CODE OWNER'S DATE VOLUME PRODUCT IN TANK No. INSTALLED STORED SERVICE YiN Y'/N ~ YIN DOYOU HAVE FINANCIAL RESPONSIBILITY? YiN ~PE Fill one segment / for each tank, unless all~nks and piping are i~ constructed of th~same materials, style and ,~pe, then only fill one segment out. please id._ent_ify_tanks by owner ID TANK DESCRIPTION COMPLET~ ALL ITEMS - SPECIFY IF UNKNOWN III. TANK CONSTRUCTION MARK ONE I~M ONLY IN BOXES ~ B ANDC ~DALLTHATAPPLIESIN8OXD A. WPE OF ~ I DOUBLE WALL ., ~ 3 SINGLE WA~ WI~ E~ERIOR LINER ~ 95 UN~OWN SYSTEM ~ 2 S~NGLE WALL ~ 4 SECONDLY CONTAINMENT (VAUL~DTAN~ ~ ~ 8. MATERI~ s CONCRE~ ~ 6 ~LWINYL CHLORIDE ~ 7 ~UMINUM ~ a 1~ ME~ANOL ~MPA~B~W~RP (P~imaryTank) ~ 9 BRON~ ~ 10 ~LVAN'~9 S~ ~ 95 UN~OWN - [] ~ OmER C. INTERIOR ~ s ~ UN~NG ~ S UNLINED ~ 9S UN~O~ ~ ~ UNING IS LINING ~ATERIAL ~..~rmUE WITH 1~ UE~ANOL ? YES_ NO~ D. CORROSION ~ I ~LYE~YLENE WRAP ~ 2 ~A~NG '': ~ 3 ~L WR~: ~ 4 FIBERG~S REINFORCED ~STIC PROTEC~ON ~ 5 CA~ODIC PROTECTION ~ 91 NONE .. ~ 95 ~OWN · ~ ~ O~ER IV.' PIPING INFORMATION C~RC~ A IF ABOVE GROUND OR U IF UNDERGROUND. aO~ IF APPLICABLE A. SYSTEMTYPE . A U , 1 sucTION ~ A ~ 2 PRESSURE & ~ 3 GRAVlW . A ~ ~ Q~ER B. CONSTRUCTION A U 1 SINGLE WALL A U 2 ~UBLE WALL A U 3 LINED TR~CH A C. MATERIAL AND A u 1 ~RE STEEL A ~ 2 STAINLESS S~ A U 3 ~L~I~L CHLORIDE(PVC)A ~, 4 FIBERG~S PIPE CORROSION A ~ 5 ~UMINUM A U 6 CONCRE~ A U 7 STEELWlCOAT[NG A ~ 8 1~ MEdrOL ~MPATIB~W/FRP PROTECTION A U 9 ~LVANI~D S~EL A U 10 CATHOD~CPROTECTtON A ~ 95 UN~OWN A ~ ~ O~ER D. LEAK D~ECTION ~ AUTOMATiCLtNELEAKDE~CTOR ~ 2 L[NET~H~ESSTEST~NG. ~ 3 ~]~5t'H~L~NffOR[NG V. TANK LEAK D~ECTION ~ 1 VISUAL CHECK ~ 2 'N~NTORY RECONCILIATION ~ 2 VAPOR MONITORING ~4 ~TOMA~OTANK~UGING . ~ 6 TANK T~STiNG ~ 7 IN~RSTITIALMONITORING ~ gl NONE ~ 95 UNKNOWN I. TANK O ESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I. O: # S. MANUFAC,~IJRED BY: C. DATE INSTALLED (MO/DAY/YEAR) O. TANK CAPA(~ITY IN GALLONS: II1. TANK- CONSTRUCTION MARK ONE IT~M ONLY IN BOXES A, B, ANDC. ANDALLTHATAPPLIESlNBOXD A. TYP~ oF ~'~' 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95' UNKNOWN SYSTEM [] 2 SINGLE WALL . [] 4 SECONDARY CONTAINMENT (VAULTED TANIO [] g9 OTHER B. TANK [] 1-BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4. STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100'/o METHANOL COMPATISLEW/FRP (PrimaryTank) ~'~'9 BRONZE [] 10 GALVANIZED STEEL [] 9'5 UNKNOWN [] 99 OTHER [%] , RUBBER L,NED [] 2 AL O L..,.G [] 3 EPo L,NING [] . .HENOL LIN.N C. INTERIOR E~' 5 GLASS LINING [~. 6 UNLINED [] 95 UNKNOWN E~'99 OTHER LINING ' IS LINING MATERIAL COMPATISLE WITH 100% METHANOL ? YES__ NO__ D. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC pROTECTION [] 91 NONE [] 95 UNKNOWN [] gg OTHER ,, IV. I~IPING INFORMATION. C~RCLE A IFABOVEGROUNDOR U IF UNDERGROUND, BOTH ~F APPLICABLE A. SYSTEMTYPE A U I SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 9g OTHER B. CONSTRUCTI.ON A U 1 SINGLE WALL ,8, U 2 DOUSLE WALL A U 3 LINED TRENCH ~ IJ 95 UNKNOWN A A U 1 BARE STEEL A U 2 STAINLESS s'rEEL A U 3 POLYVINYL CHLORIDE(PVC) A U 4' FIBERGLASS PIPE C. MATERIAL AND CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100'/. METHANOL COMPA~BLEW/FRP PROTECTION A U. 9 GALVANIZED ST~EEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION [] 1 AUTOMAT1C LINE LEAK DETECTOR [] 2 LINE TtGHTNESS TESTING [] 3 INTERSTITIAL MONITORING [] 99 OTHER V. TANK LEAK DETECTION .... 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION ~ 3 VAPOR MONITORING [] 4 AUTOMATIC TANK GAUGING ~f'--~ 5 GROUNDWATER MONITORING " i ANK ,NTERSTmA MONmTOR'NGNONE UNKNOWN O ER I,..TANK. DESCRIPTION COMPLETE - SPECIFY IF UNKNOWN . Ii A. OWNER'S TANK L D. # a. MANUFACTURED · C. DATE INSTALLED (MO/DAY/YEAR) ,. ' ................................ D. TANK C;~°ACITY IN GALLONS: III. TANK CONSTRUCTION MARKONE ITEM ONLY IN BOXES A. B ANOC ANOALLTHATAPPt. IESINROXD A. TYPE OF [] 100USLE WALL [] 3. SINGLE WALL WITH EXTERIOR LINER ' [] SS UNKNOWN SYSTEM [] 2 ' SINGLE WALL [] 4. SECONDARY CONTAINMENT (VAULTED TANK) [] 99 O'i'HER B. TAI'IK [] I BARE, STEEL [] 2 STAINLESS STEEL · [] 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINyL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLEW/FRP ' (Primary Tank) [] g RRONZ~ []-10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER [] I RUBBER LINED [] 2 ALKYD LINING [~' 3'EPOXY LINING [] 4 PHENOLIC LINING C. INTERIOR [] 5 GLASS LINING [] a UNLINED [] 95 uNKNOwN [] 99 OTHER IJNING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES_ NO__. D. CORROSION [] 1 P~)LYETt-iYLENE WRAP [] 2 COATING [] 3 VINYL WRA~~ [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION. [] 5 CA:rHODIC PROTEcTIoN [] 91 NONE '. [] 95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION CIRCLE A IFABOVEGROUNDOR U IFUNDERGRQUND. BOTH IF APPLICAELE A. SYSTEMTYPE A U 1 SUCTION A IJ 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. C0NSTRUCT'ION A U 1 SINGLE WALL A IJ 2 DOUBLE wALL A tJ 3 LINED TRENCH A IJ g5 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A IJ 2 STAINLESS STEEL A IJ 3 POLYVINYL CHLORIDE (PVC) A IJ 4. FIBERGLASS PiPE CORROSION A IJ 5 ALUMINUM A IJ 6 CONCRETE .' A U 7 STEEL Wl coATING A U 8 100% METHANOL COMPATlaLEW/FRP PROTECTION A IJ g GALVANIZED STEEL A U 10 CATHOOIC PROTECTION A I.I 35 UNKNOWN A U 99 OTHER O. LEAK DETECTION [] 1 AUTOMATIC LINE LEAK OETECTOR [] 2 LINETiGH'I'NESSTESTING [] 3 INTERSTITIALMoNR. ORiNG [] g9 OTHER V. TANK LEAK DETECTION I [] 1 VISUAL CHECK [] 2 IN~/ENTORY RECONCILIATION [] 3 VAPOR MONITORING {:~ 4 AUToMATIC TANK GAUGING .[~ 5 GROUND WATER MONITQRING [] `5' TANK TESTING [] 7 ,NTERSTrnALMO.,TOR,NG ' [] ~ NONE [] ~ UNKNOWN [] 99 OTHER. I. TANK O ESCRIPTION COMPLETE ALL ~TEUS- SPEC~ ~F UNKNOWN A. OWNER'S TANK ~. D. · t a. MANUFACTURED BY'. · C. DATE INSTALLED (MO/DAY/YEAR) I D. TANK CAPACITY IN GALLONS: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN aOXES A. B. ANDC. ANOALLTHATAPPLIESlNaOXD A. TYPE OF [] I DOUBLE WALL [] 3 SINGLE WALL 'WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] '2 SINGLE WALL [] 4. SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER B. TANK [] ~ BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEEL CLAD W/F~BERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE / [] S POLYV~NYL CHLORIDE r--~7 ALUMINUM [] 9 ~0(3S'o METHANOL COMPATIBLEW/FRP (PrimaryTank) '[] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] g§ OTHER [] . RURRER L,NEO [] 2 AL~D L,.ING [] 3 EPOXY LINING [] 4. PHENOL~ LIN,NG C. INTERIOR [] 5 GLASS LINING [] S UNLINED [] 9,5 UNKNOWN [] 99 OTHER LINING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES ~ NO__ D. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5'CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 oTHER * IV. PIPING INFORMATION C=RCL~ A IFASOVEOROUNDOR U [F uNDERGROUND. BOTH~FAPPLICAaLE ~ A. SYSTEM TYPE A U 1 SUCTION A tJ 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A [J 2 DOUBLE WALL A IJ 3 LINED TRENCH A U 95 UNKNOWN A [J- 99 OTHER i C. MATERIAL AND A U I BARESTEEL A [J 2 STAINLESS'STEEL' A IJ 3 POLYVINYL C~LORIDE(PVC)A U 4 FIBERGLASS PIPE ~ .CORROSION A U 5 ALUMINUM A [J 6 CONCRETE' A tJ 7 STEEL WI COATtNG A IJ 9 i00% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A [J :95 UNKNOWN A IJ 99 OTHER D; LEAK DETECTION r'--I i AUTDMATIC LINE LEAK DETECTOR [] 2 LINE T}GHTNESS TESTING [] 3 MONITORING ~ 99 OTHER V. TANK LEAK DETECTION ~ ~ WSUAL CHECK [] 2 ~NVENTORY RECONC~UAT~ON .[----] 3 VAPORMON~TOR~NGI----i ~ AUTOMATIC TANK GAUGING [] 5 GRDUNDWATE~UON~TORING i~ ~ TANK TESTING [] ~ ,NTERST~T,ALMONITOR,NG [] 3. NON~ [] ~ UNKNOWN ' [] ~ O~ER Permit : e Environment,al Sensitivity Inspection Time. -'" .-~ ~' ...... .UNDERGROUND HAZARDOUS SUBSTANCE STORAGE FACILITY ~.~ .'' * INSPECTION REPORT * No. of Tanks :'~-~-- :': ' Is Information on Permit/Application Correct? Yes __ No Permit Posted? Yes No Type of= I nspecfion: Routine ':, Complaint Reinspaction ITEM VIOLATIONS NOTED c. Modified Invento~ Control Monitoring ~ .~.., e. Groundwater Monitoring '-- · · a. Liner . b. Double-Walled Tank c. Vault 3.Piping Monitoring: a. Pm~rized - b.- Suction c. Gravity 6. N~ Con,ruction/Modification ~ '"*" ' ~" 7. Closure/Abandonmen~ '.- .,. B. Unauthorized Relea~ 9.Maintenance, General Safety, and Operating Condition of Facility .Comments/Recommendations:' , : i. ........ :~."~ ,. · ~.' -~ "' ": ':7!_.F ., '~/~'~ .-~,\~ .... , . .,~' ~ ,., ,,~ .... ,.. ..... -~ ".,': .'.'.~.-'.-' ' ' '-' ~ -' "'~::i: ':'"'.::'.",' ' '~' '"':'" .... ~' .":- ~ ~ "',. ~ -- ~ ~ ' , ',. ',, : . , .. ~. -": ~ '.. ,~ ~ Reinspection scheduled'? ' Yes No Approximate Reinspectio~2~ate, I~SPECTOR: ~:{: .~ ~:-- -' ", REPORT RECEIVED Health.580 4113 170 {7-87) I =LYING J INC. ,oC^T,O" ..... ' >DAILY SALES REPORT l COMPANY NOi REPORT DATE / ~'~1 I (WE) HEREBY CERTIFY THAT THIS REPORT IS TRUE AND I STATION NO. ACCT'G MO.' CORRECT. I 'REPORT NO. STATE MANAGER'S SIGNATURE REGULAR UNLEADED PREMIUM UNL. PREM. DIESEL #2 PROPANE DIFFERENCE TOTAL ,,, PUMP PUM, -~ NUMBER 532-05 532-06 532-03 532-04 534-13 501-27 532-05 DOLLARS ! 3 3 4 4 5 5 7 7 8 8 9 9 10 10 11 ' / 11 I 12 13" 13 .,/ 14 . 19 READ~NGS i ~' TOTAL 20 20 PREVIOUS REPORT 7 GALLONS ADO PUMP 3 3 500-00 21 ;'1 " s , . ,o, , 23 PUMP PRICE 5 ~" 10 $ 24 TOTAL DUE 4 / ./--''" 28 CASHON HAND REPORT) i.. ~ 536-22 27 27 CASHON HAND (END)NG) ~ 28 AMOUNT DEPOSITED ! sALES-CLOTHING 536-46 28 · ~9 AMOUNT DEPOSITED 101- SALES-BEER 536-53 29 :30 AMOUNT DEPOSITED 101- SALES-TABACCO 536-54 3O ~i AMOUNT DEPOSITED 101- SALES-GROCERIES 536-56 31 32 AMOUNT RECEIVABLE 110-0i SALES-DELI 536-72 ,32 33 SALES-TAPES 536-78 33 34 VIDEO MOVIE DISCOUNTS 548-75 SALES-SUNDRIES 536-80 34 35 PLANT SUPPLIES 641~01 SALES-GIFT & SOUVENIRS 536-81 35 361 MAINTENANCE & REPAIR BLDG. 642-01 SALES-MAGAZINES 536-85 36 37 I MAINTENANCE & REPAIR EQUIP. 642-02 ARCADE GAME REV. 548-51 37 38 i POSTAGE & PRINTING 646-01 MOVIE/VCR RENTAL 548-72 38 39 OFFICE SUPPLIES 646-C3 MEMBERSHIP REV. 548-73 39 40 (OVER) & SHORTCASH 650-01 BAD CHECK COLLECTION 651-01 40 41 ? 41 421 4.3 44 44 45 45 46 46 47 NON EXEMPT DIESEL 307- 47 48 STATE PROPANE TAX 309- 48 49 GALLONS DOLLARS FEDERAL PROPANE TAX 509-06 49 50 OFF HIGHWAY FUEL DIESEL EXCISE TAX 310-13 501 51 LESS STATE TAX 307- ' ¢ PROPANE EXISE TAX 310-27 ~Z, ~2_ _LE.~._q EEDERAL-TAX~ -~q07,06- - ' ~,¢ ---~3-10-27~ 5~- 53 ADD SALES TAX 305- · % ( ) 53 54 TOTAL RECEIPTS (BOTH AMOUNTS MUST AGREE) $ TOTAL RECEIPTS (BOTH AMOUNTS MUST AGREE) $ 54 55 SUMMARY OF INVENTORY ACTIVITY REGULAR UNLEADED PREMIUM UNL. PERM. DIESEL #2 PROPANE 55 56 ,.~,?:~' ~.'~:/ 05 06 03 04 '~3 ~7' se S? GALLONs ON HAND' lUNE 58 FROM PREVIOUS / ~///./~ z~ ,~/,./,//~ i$? . REPORT) ~ 58 '58 GALLONS RECEIVED CONVERTEO TO 59 GALLONS SOLD ~/.-~' /4' ,~,_,~"- . 59 60 BOOK INVENTORY (LINE 55 , 56 LESS 57) Il 60 61 ACTUAL GALLONS ON HAND (STICK READING) ' .9 ,,~'~- ~ 61 62 {OVER) SHORT /~ /~'~- ,!' ~¢~'.~.. 62 63 STICK READING IN INCHES ' ~ :.~' ,- ?~ 63 64 TANK TEMPERATURE 64 (FOR ADDITIONAL REMARKS PLEASE USE OTHER SIDE) 02-SA001 (REV. 10/84) :, L-t:>~..¢ ,,"' ~'~ :' ,, "'."'.'' " ' : ~ : ': :i'-'. . ' ':" ' Facility Name Flying J Gal ine Station Permit TANK (F LL OUT ~H. 1. Tank is: ~'Vaulted- ~Vault~ '~uble2Wall ~Si~le~all ~ 2. ~ ~terial '. ~a~n Stol ~ S~inless Steel ~l~inyl C~o~ide '~Fi~rglass~l~ Steel ~ Fi~rglass-Reinforc~ Plastic ~Concrete ~ ~in~ ~Bronze ~- ~ Other (de~ri~) Contai~nt 3. Pr i~ r~all~ ~ic~ess .(-Inches) Ca--city (~llons) ~nufacturer 4. 'Tank 8ecohdar~ Cont ~l~all ~eheeic L~ner ~Lin~ Vault ~ne . ~o~ ~Oeher {de~ri~): ~ufacturer: ~te~ial ~ic~ess (Inc~s) Ca,citY (~ls.) 5. Tank Interior Lini~. ~~r ~Mk~ ~xy ~enolic ~Glass ~Clay ~i~ '~~ . ~Other '(de~ri~): 6. Tank Corrosion Protecti~h' ~Galvanfz~ ~ass-Cl~ 'S~l~yle~ ~ap ~Tar or ~p~lt ~k~ ~No~ ~ther (de~ri~): ' Ca~ic Protection: ~ne ~pres~, ~'rent S~t~ ~cr c a e- ~ri~' Syst~ & ~ui~nt: 7. Leak Det~tion, ~nitori~, and Interception a. Ta~: ~Vis~l (vault~ t~ks only) ~Gro~ter ~nitori~' ~ll(s) ~ ~Vadose Zone ~itori~ ~ll(s) ~U~ Wi~ut ~ner U-~ wi~ C~tible Liner Dir~ti~ F10w ~ ~nitori~ ~ll(s)* Va~r ~t~tor* ~Li~id ~vel ~n~ra ~ Cond~tivit~ ~r* ~ Pressure Sen~r in ~ular S~ce of ~uble Wall Ta~- ~ ~uid ~tri~al & Ins~ction Fr~ U-T~, Monitori~ ~11 ~ily ~i~ & I~entory Re~nciliati~ ~ ~ri~ic T~h~e~ T~ti~ ~None ~o~ ~er b. Pipit: Fl~Restricti~ ~ak ~tector(s) for Pre~uriz~ ~nitori~ S~p with .~ce~y ~al~ ~crete ~ce~y ~lf~t ~ible.~~tic Lin~ ~y *~ri~ ~ & ~el: 8. Tank Tigh~e~ - ~ls ~ ~en Tigh~eSs-~st~? .~Yes ~ ~te of ~st Tightne~ Test Results of Te~ Test ~e ~sti~ ~ny 9. T~k Re~i r ~ Re~ir~? ~Yes ~ ~kno~ ~te(s) of ~ir(s) ~ri~ Re, irs 10. ~erfill Prot6ction ~rator Fills, Controls, & Vis~lly Monitors ~vei ~Ta~ Fl~t ~e ~Fl~t Vent Valves ~ Auto Shut- Off Controls  citance ~r ~al~ Fill ~x ~ne Other: List ~ke & ~el F~ ~e ~ices 11. PipI~ a. .~ergro~d Pipi~: ~es ~ ~o~ ~terial Thick~ (i~hes) Di~eter Manufacturer ~essure ~tion ~Gravity ~pro~i~te ~ 6~ 'Pi~ b. U~ergro~ Pipi~ Corrosion Proration .: ~lvaniz~ ~Fi~rglass-Cl~ ~ess~ ~rent ~crificial ~e ~P~e~yle~ Wrap ~Electrical I~lati~ ~Vinyl Wrap '~Tar or ~lt ~0~ ~None ~her' (de~ri~)~:~ . c. Undergro~ Pipit, Seco~ary Contai~nt: ~ ~~ ~!~all ~~etic Liner ~st~ '~ne ~Other- (de~ri~): ~ TANK ~ ~ ~ (FILL OUT SEPARATE FORM FOR ~CH TANK) --FOR EACH SECTION, CHECK ALL APPROPRIATE BOXES H. 'i. Tank is: [-]Vaulted ~n-Vaulted . ~]Double-Wall I-]Single-Wall 2. ~ Material ~L~n Steel [] Stainless Steel F]Polyvinyl Chloride [']Fiberglass-Clad Steel [] FiberglaSs-Reinforced .Plastic , [] Concrete [-] Altmlin~ [] Bronze 'I-]Unknown [] Other (describe) 3. Primary Containment ,Da~e~Iqstalled~_ L~ Thickness (Inches) Capacity (Gallons) Manufacturer 4. contag en []-----~uble-Wall [] Synthetic Liner [] Lined Vault [] None ~n~nkn°~ []Other (describe): Manufacturer: []Material Thickness (Inches) Capacity (Gals.) 5. Tank Interior Lining " ----~Rubber []Alkyd [2]Epoxy []Phenolic [][]Glass []Clay []t~lined [-]Other (describe): 6. Tank Corrosion Protection ~Galvanfzed .~ass-Clad [qPol~hylene Wrap []V~nyl .Wrap~in~ []']Tar or Asphalt []Unknown []None ~ther, (describe):~~ Cathodic Protection: []None []Impressed Current Syste~ LJSacrl£%clal ~e--s~ribe System & Equi~ent: 7. Leak Detection, Monitoring, and Interception · ' .- ~. ;~-~ ~-~isual (Vaulted tanks only) ' ~Groundwater Monitorin~' Wmll(s) []Vadose Zone Monitoring Well(s) []U-Tube Without Liner ~lU-Tube with C~mpatible Liner' Directing Flow to Monitoring Wmll(s)¢ [] Vapor DsteCtor* [] Liquid Level Sensora [] Condu.-ti.¢it~ Sensor* [] Pressure Sensor in Annular Space of 'Double Wall Tank iiuid Retrieval & Inspection From U-Tube, Monitoring Well or Annular Space ly Gauging & Inventory Reconciliation []Periodic Tightness Trusting [] None [] Unkno~ ~ Other b. Piping: Flow-Restricting Leak Detector(s) for Pressurized Pipits' [] Monitoring S~p with Race~ay [] Sealed Concrete Raceway []Half-Cut C~m~atible Pipe Raceway [~]Synthetic Liner Race,my []None . munkno. Describe Make& Model: (7 --- 8. Tank Tightness ~is TanR Been Tightness Tested? [qYes [']No ~known Date of Last Tightness Test Results of Test Test Name Testing C~pany 9. Tank Repair Tank Repaired? []Yes ~' []Unknown Date(s) of Repair(s) Describe Repairs 10. Overfill Protection []OperatOr Fills, Controls, & Visually Monitors Level []Tape Float Gauge []Float Vent Valves[] Auto Sh__ut~.~ff Controls  Capacitance Sensor []Sealed Fill Box []None Other: List Make & Model For Above Devices' 11. ' Piping · a. Underground Piping: ~ees []NO ~Unknown Mater ial Thick. ss (inches) · Diameter Manufacturer ~gressure []Suct'i0n []Gravity Approximate Length of Pipe b. Underground Pipirg Corrosion Protection : []Galvanized []Fiberglass-Clad [-]Imp~essed Curren~ []Sacrificial Anode. ~Pj~yethylene Wrap []Electrical Isolation []Vinyl Wrap []Tar or As~lt .-. . ~nknown []None []Other (describe): c. .Underground Piping, Secondary Containment: i [']Double-Wall []Synthetic Liner System' I-]None '~'n~own · ~ · []Other (describe): ' TANK ~ ~ (FILL OUT SEPARATE FORM FOR rsACH TANK) " FOR EACH SECTION, CHECK ALL' APPROPRIATE BOXES ' H. 1. Tank is: []Vaulted ~n-Vaul ted [']Double-Wall I-]Single-Wall 2. ~ Material ~rbon Steel [] Stainless Steel [] Polyvinyl Chloride [] Fiberglass-Clad. Steel [] Fiberglass-Reinforced Plastic [] Concrete [] Al~in~n [] Bronze []Unknown · [] Other (describe) 3. Primary .Containment Dat.~ InsDalled Thickness (Inches) Capacity (Gallons) Manufacturer .-. Conta ' 4. Tank Secondary '[]Double-Wall ~Synthetic Liner [2]Lined Vault []]None ~known [-]~Other (describe): Manufacturer:' [] Ma ter iai Thickness. (Inches) Capacity (Gals.) 5.. Tank 'Interior. Lining ---~Rubber []Alkyd [[]Epoxy []Phenolic []Glass []Clay ~lined FTtl~kno~. []Other (describe): 6. Tank Corrosion Protection ---~alva~i'zed -]~F-~r---~g-Tass-Clad []Pol~e.thyiene Wrap [-]Vigyl .Wrap~i~g -- . , ar or Asphalt []Unknown [~None ~0'ther (describe): ~AF~- Cathodic Protection: []None []Impressed Current System ~1~ ~rlbe System & Equipment: 7. Leak Detection, Monitorir~, and Interception a. Tank: []Visual (vaulted tanks only) []Groundwater Monitoring' W~ll(s) []Vadose Zone Monitoring Nell(s) [qU-Tube Without· Liner ~[~U-Tube with Compatible Liner Directing Flow to Monitoring ~ll(s)* Vapor D~tector* []']Liquid Level Sensor~ ~Conductivity Se~or* ~ Pressure Sensor in Annular Space of Double Wall Tank- 'quid Retrieval & Inspection From U-Tube, Monitorir~ Nell or Annular fpace ily Gauging & Inventory Reconciliation [-]Periodic Tightness Testing [] None [] Unkno,,~ ..[~ Other b. Piping: Flow-Restricting Leak Detector(s) for Pressurized Piping' ~Monitoring.S~p with Race~y []Sealed Concrete Race~y DHalf-Cut Compatible Pipe Raceway []Synthetic Liner Race~y *Describe Make & Model: ' ~ .... 8. ~en · Tightness Tested? [] Yes D]NO ~nown Date of Last Tightness Test Results of Test TeSt Name Testing Company 9. Tank RePa i r Tank Repaired? []Yes ~ []unknown Date(s) of Repair(s) Describe Repairs . 10. Overfill Protection .[]Operator Fills, COntrols, .& Visually Monitors [~vel []Tape Float Gauge []Float Vent Valves []Auto Shut-~Off Controls B Capacitance 'Sensor []Sealed Fill Box [-]]None ~known ~ Other: . List Make & Model For Above 'DeVices 11. Piping a.~ Underground Piping: ~es I-]]NO []]unknown Material Thickj~ss. (inches) · Diameter Manufactur..~r ~ressure []Suction ~Gravity Approximate Length of 'Pipe b, Underground Piping Corrosion Protection : : · DGalvanized []Fiberglass-Clad [[]Impressed Current: []Sacrificial Anode [']PD~tyethylene Wrap []Electrical Isolation [2]Vinyl Wrap [~Tar or Asphalt - ~nknown []None [-]Other (describe): "c. 'Underground Piping, Secondary Contair~ent: I-]Double-Wall ~]Synthetic Liner SYstem [-]]None ~nown [']Other.-'(describe): ~'~ PERMIT CHECKLIST Facility This checklist is provided to ensure that all necessary packet enclosures were. received and that'the Permittee has obtained all necessary equipment to implement the first phase of monitoring requirements. Please complete this form and return to KCHD in the self-addressed envelope provided within 30~davs of receipt. · Check: Yes. No / A. The packet I received contained: P/ 1) Cover Letter, Permit Checklist, Interim Permit, Phase I Interim Permit ~ ' Monitoring Requirements, InfOrmation Sheet . (Agreement Between Owner and .Operator), Chapter 15 (KCOC #G-3941), Explanation of Substance Codes, Equipment Lists and Return Envelope. ~/f,' ~ 2) Standard Inventory Control Monitoring Handbook~#UT-lO. ~/ 3) The Following Forms: a) Inventory Recording Sheet .i bi Inventory Reconciliation Sheet with summary on reverse ,,' c) Trend Analysis Worksheet u/ 4) An Action Chart'(to post at facility) '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 reouired equipment (as described on DaMe 6 of Handbook): t//~.· 1) Acceptable gauging instrument /' / 2) "Striker'plate(S)'' in' tank(s) 3) Water-finding paste D. I have readl the information on the enclosed "Information Sheet" pertaining .to ' Ayreements between'0wner and Operator and hereby state that'the owner of this facility is 7the 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 correspondin~ tank numbers listed, oh permit). / ~/ F. As 'required on page 6 of HandboOk #UT-10, all meters at this facility have hac calibration checks within the last 30 days and were calibrated by a registered device repairman ~f 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 describe~ i~-Handbook #UT-10. Signature of Person Completlnff Checklist: ...'~'~"~.~.l," FILE CONTENTS iNVEN'FORY' ~Pe~mit to Operate ~ ~0000~ Date ~Construction Permit ~ Date ~Permit to abandon~ No. of Tanks _ Date ~ended Permit Conditions *~' Permit Application Form, ~ Tank Sheets ~]~$~~ ..... APplication to Abandon· tanks'(s) Date ~Annual Report Forms [-]Copy of Written Contract Between Owner & Operator [~ Inspection Reports [-~Correspondence - Received " Da te -. Da te · - Da te [~Correspondence - Mailed Date Date Date [~Unauthorized Release Reports [-~ Abandonment/Closur e Reports []Sampling/Lab Reports []MVF Compliance Check (New Construction C]~ec'klist) []STD Compliance Check (New Construction Checklist) [~MVF Plan Check .(New Construction)' [] STD Plan Check (New'Construction) []MVF Plan Check (Existing ~Facility) [-]STD Plan Check (Existing Facility) ~'Incomplete Application" Form []Permit Application Checklist [] Permit Instructions [2]Discarded []Tightness Test Results Date Da ~e Da te [-]Monitoring Well ConstruC~i0n Da~a-/pe'rmits [']Environmental Sensitivity Data:. DGroundwater Drilling, Boring Logs [2]Location of' Water Wells []Statement of Underground Conduits · []Plot Plan Featuring All Environmentally Sensitive Data []Photos Construction Drawings Location I-]Half sheet showing date received and tally of inspection time, etc [-~ Mi scel laneous Inches Gallons Inches Gallons Inches· Gallons 1 22 33 3662 65 8672' 2 62 34 3814 66 8820 3 112 35 3968 67 8968 4 1.72 36 4122 68 9114 5 238 37 4276 69 9258 6 312 38 4432 70 9400 7 .. 394 39 4588 71 9542 8 480 40 ~746 72 - 9680 9~ 570 41 ....... 4902 73 9818'~ l0 664 42 5062 74 9952 ll '764 43 5220 75 10,086 12 868 44 5378 76 10~216 13 976 45 '5538 77 1~,344 14 1086 46 5696 78 10,470 15 1200 47 5856 79 10,594 16 1318 48 6010 80 10,71~ 17 1438 49 6176 81 10,806 18 156~ 50 6336 82 10,932 19 1688 51 6496 '83 11,058 20. 1816 52 6654 84 11,164 21 1946 53 6814 85 11,268 22 2080 54 6972 86 11,368 23 2216 55 7130 87 11,462 24. 2352 56 728~ 88 11,554 2'5 2492 57 7444 . 89 11,640 26 2632· 58 7600 90 11,720 27 2776 59 7756 91 11,794 28 2920 60 7912 92 11,862 29 3066 61 8066 93 11,920 30 3212 62 8218 94 ,. 11,972 31 3360 63 ~-· 8370 95 12,010 32 3512 64 5522 96 12,032 unleaded, tanks ...... . h'i~ 1700 Flower Street KERN COUNTY HEALTH DEPARTrv,...NT HEALTH OFFICER ~ Bakersfield, California 93305 . ' Leon M Hebertson, M.D. Telephone (805)861-3636 ENVIRONMENTAL HEALTH DIVISION DIRECTOR OF ENVIRONMENTAL HEALTH . ' ~ Vernon S. Reichard INTERIM PERMIT FERMI T~e2 oooO6c TO ..OPERATE: ISsuED: JULY 1, 1986 ~ · EXPI RES: JULY 1, I989 UNDERGROUND. HAZARDOUS SUBSTANCES STORAGE FACILITY NUMBER OF TANKS= 3 FACILITY.: I OWNER: FLYING J., INC. I FLYING J., INC. 600 BRUNDAGE ROAD I P.O. BOX 678 BAKERSFIELD, CA ' I BRIGHAM, UT 84302 TANK # AGE(IN YRs) SUBSTANCE C0DE PRESSURIZED PIPING? 1-3 l! MVF 3. YES NOTE: ALL INTERIM REQUIREMENTS ESTABLISHED BY TEE PERMITTING AUTHORITY. MUST BE MET DURING THE TERM OF THIS PERMIT NON--TRANSFERABLE * * * POST ON FERMIS.ES DATE PERMIT MAILED: AUG 2 ~ i~8~ DATE PERMIT CHECK LIST RETURNED: :. No~e: 1. hll meters must have calibration checks a minimum o~ t~i-ce ~ year, ~hich may include checks done by the Department of Weights and aeasures. 2.Before starting calibration runs, wet the calibration can wi~h product and return product to storage. 3.Run 5 gallons with nozzle ~ide open into the can. Hote gallons and cubic inches drawn, and return product to storage. 4.Run 5 gallons with the nozzle one--bali .open into the can. Hote. gallons and cubic inches drawn, and return product to storage. 5. After all product for one calibration check la returned to storage, remember to record the volume returned to storage In column 9 of the Inventory Recording Sheet. 6. If the volume measured tn a 5~gallon calibration can Is more than 6 cubic inches above or below the 5-gallon mark, the meter requires calibration by a registered device repairman- Hose or Tank ~/ Fast Flow Slow Flo~ Volume Returned ~ibratlon] Device Repairman Date of Date/Time Pump t Product 5-Caliph Draft 5-~allon Draft to Storage ReSEed?] Used for Calibration Owner operator OU lgna ture GRISANTI & ASSOCIATES INC. 1509 Draper St. Suite A ~ingsburg, Ca. 93631 109 897-5873 · Mr. Allen Jun~ Mr2 Fast {6 Liquor & Deli I N'V 0 I C E 4018 Cilifornia Ave. Bakers~ield, CA 93309 TOTAL BILL Re: Assessmemt Mr; Fast Mini Mark Terms: 1%, net 30 days DATE ACTIVITY TIME TITLE RATE COST EIPFJ{SES/ TOTAL (HMS)' (S/HR) (LAHOR) MILAHE' COST Billin~ as of 2/6/92 as per prnposal of Jznuary 6, 1992 Field Work and Analysis Env A~sessor 24.00 guy Assor $75.00.'$1,800.00 $1,800.00 Env. Spec 8.00 Hp~¢ I $35.00 $280.00 ~280.00 . Env. Spec II 22.00 Spec II $28.00 $616.d0 $616.00 Field Tech 14.00 Fld Tech $25.00 $350.00 $350.00 Samplin~setup , $100.00 $I00.00 Drill Ri~ 12.00' Rig' $90.00 $1,OHO.O0 $1,080.00 Photos, bentonite, dr~s, steam.cleanin9 $640.00 $640.00 Travel, per diem $603.00 $603.00 Analytical $1,i00.00 $I,100.00 +10~ $110.00. {!lO.O0 +interest 4 months $400,74 ~400.74 Total $4,126.00 $2,953.74 $7,079.74 'mila?~ $.45 per/mile. Phone chis at cost and as rec'd. } - THANI YOU FORYOUR BUSINESS! -! A 1.5% per month charge ~ill be added to all pa~t. due accounts TREND ANALYSIS I~ORKSHEET FAC I L I TY ~-/~, ,.~~ P'ERMI T TANK # C~PAC?ITy~/~, _.~/~-~ PRODUCT ~_~/=~ YEAR/~ERIOD INSTRUCTION'S:' ~ART A : OVERAGE/SHORTAGE Fill in all information at top o form. In the space for/ year' 1 ~ i6 period indicate the year and th DAY DATE (+/') consecutive period of analysi DAY 1 ~/~' ~ ~ being conducted (from 1 throug .DAY 2 ~ 12 only). Transfer the date an DAY 3 -- the sign from columns 1 and.16 o DAY 4 ~ Reconciliation Sheet to column DAY 5 ~ at left. Use the table below t DAY 6 ~ determine the action number fo DAY 7 ~ the period being analyzed. DAY 8 DAY 9 ~ ACT I ON NUMBER DAY 10 ~ TAB L E DAY 11 DAY 12 ~ 30-DAY [ ACTION- DAY 13 ~ PERIOD NUNBER] NUNBER DAY 14 ~ 1 = 20 DAY 15 ~ 2 =' 37 DAy 16 ~ 3 = 54 DAY 17 -.~ 4 = 69 DAY 18 ~ 5 = 85 DAY 19 .~ 6 =' 101 DAY 20 .~ 7 = 117 DAY 21 ~ 8 = 133 DAY 22 ~ 9 = 149. DAY 23 -~ 10 = 1-65 DAY 24 ~ 11 = 180 DAY 25 ~' .~ 12 = 196 DAY 26 , DAY 27 ~ Circle appropriate period and DAY 28 ~ action number. A full cycle is DAY 29 ~ made up of periods 1-12, after DAY 30 ////W~ ~ which a' new cycle begins. Use TOTAL NI'N~S~S information to com~lete Part PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A ....... · ..... Line 2. Cumulative minuses from previous periods in this cycle. Line 3. Total minuses (add lines 1 & 2) .............. Line 4. Action number for this period (from table above) .... Line 5.' Is line 3 greater than line 47 ~Yes ~o If Yes, ypu have a reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK ~UT-10 "STANDARD INVENT, 0RY CONTROL.MONITORING" ~nv. H~a[th ~80 ~113 ~0~6 (6/86) KERN COUNTY HEALTH DEP. ARTMENT '; ~ TREND ANALYSI S ·WORKSHEET FAC I L I T Y Fl?' ~Fe __J, PERMIT I NSTRUCTI ON-S.: pART A : OVERAGE/SHORTAGE Fill in a.ll information at top o~ fbrm. In the space for year/ I 16 period indicate the year and the DAY DATE (+/-) consecutive period of analysi~ DAY i . /J// s 7~- being conducted (from I throug? DAY 2 '~ 12 only). Transfer the date anc DAY 3 -- the sign from' columns 1 and 16 ct DAY 4 -- Reconciliation Sheet to column~ DAY 5 ~- at left. Use the table below DAY 6 ~ determine 'the action number for DAY 7 -- the period being analyzed.. DAY 8 DAY 9 ~ -~ ACTI ON NUMBER DAY 10 -- TAB n E DAY 12 -?'- 30-DAY 'ACTION DAY 13 -- PERIOD NUMBER NUMBER DAY 14 ~ 1 = 20 DAY 15 -~ 2 = 37. DAY '16 --'~ 3 = 54 DAY 17 --- -4 = 69 DAY 18 -~ 5 = 85 DAY 19 '~- 6 = 101 DAY 20 __',~ 7 = 117 DAY 21 .~-~, 8 = 133 DAY .22 '--'' 9 = 149 DAY23 -~ 10 = 165 DAY 25 -~ 12 = 1'96 DAY 26 ,. DAY 27 --' Circle appropriate period and DAY 28' ~ action number. A full cycle is DAY 29 ~ '~ ~ made up of periods 1-12 after DAY 30 ~/f~ '~ which a new cycle begins. Use TOTAL MINUSES information to com lete Part B. PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A ............ Line 2. Cumulative minuses from previous periods in this cycle. Line 3. Total minuses ,(add lines 1 & 2) ............. Line 4~' Action nu'mber for this period (from table above) .... Line 5. Is line 3 greater than line 4? ~]Yes If , Yes, ygu have a reportable loss and must begin notification and investigation procedures as described in'Kern County Health Department HANDBOOK #UT-!0 :, "STANDARD INVENTORY CONTROL MONITORING .... Env.'H~lth 580 4113 1016 (6/86) _ Fill in.al,1 information at top of PART A : OVERAGE'/~ORTA~E ~': -' :' ~ form. In the space for year/_,' 1~ , 16 period indicate the year and the DATE t (+/-) consecutive period of' analysis DAY i:' DAY 1 /~/! ~~ being conducted (from 1 througk DAY 2 T' 12 only). TranSfer the,date and DAY 3 .-- the sign from columns 1 and 18 of ~DAY 4. ~ Reconciliation Sheet to columns DAY 5 ~ at left. Use the table below tc DAY 6 ~ determine the action number for DAY ? ~- the period being analyzed. DAY 8 DAY 9 .~ A CTI ON N UI~IBER DAY 10 - TAB L E DAY 12 · ~" 30-DAY I ACTION DAY 13 '-~ PERIOD NUMBERI NUMBER DAY 14 -- 1 = 20 DAY 15 -- 2 = DAY 16 oC 3 = 54 DAY 17~' 4 = 69 DAY 18 ~,_ [ 5 = 85 DAY 20 ~ 7 = 117 DAY 21 ,,~- 8 = 133 DAY 22 .__['~_ 9 = 149 DAY 23 ~ 10 = 165 DAY 24 ~ 11 : 180 DAY 25 -- 12 = 196 DAY 26 ~-~ DAY 27 --- Circle appropriate period and DAY 28 ---- action number. A full. c~cle is . made up of periods 1-12 after DAY 29 ~. , DAY 30 /~f~ which a new cycle begins. Use TOTAL MINUSES ---~ ' information to complete Part-B. PART B:. ACTION NUMBER CALCULATION , " ~-,'~ Line 1. Total minuses this period-Part A ............ Line 2.. Cumulative minuses from previous periods in this cycle. Line 3. Total minuses (add lines 1 & 2) .......... · .. · Line 4. Action number for this period (from table above) . . . Line 5. Is line~ 3 greater than line 4? [~YeS ~No I_~f Yes, you have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-10 "STANDARD INVENTORY CONTROL MONITORING" Env. H~lth ~80 4113 1016 (6/86) " : K'ERN COUNTY , HEALTH DEPARTNENT . i LYSXS WORKSHEET ~AKEI:P3F~ELD, CA 9.~.~tM FAC I L I TY PERMI T -. NSTRUCTI. ON-S : PART A : OVERAGE/SHORTAGE Fill in all information at.top.o form. In the space for year 1 16 period indicate the year and t'h. DAY DATE . (~-) consecutive period of analySi DAY I ~- being conducted (from 1 thr0ug DAY 2 /~-- 12 only). Transfer the date an DAY 3' ~--~ /~ the'sign from columns I and 16 o DAy 4 Reconciliation Sheet to column DAY 5 at left. Use the table below t DAY 6 -- determine the action number, fo DAY 7 ---- the period being analyzed. DAY 8 DAY 9 -~ ACTI ON NUMBER DAY 10 ---- TAB L E DAY 11 DAY 12 ,~-~ 30-DAY ACTION DAY 13 -- -~ PERIOD NUMBER NUMBER DAY 14 ~ 1 = 20 DAY 15 ~ 2 = 37 DAY 16 '~ 3 = 54 DAY 17 )~ 4 = 69 DAY 18 ~ ~ 5 = B5 + , DAY 19 ~ 6 = . 101 DAY 20 ~ 7 = 117 DAY 21 ~ 8 = 133 DAY 22 ~ 9 = 149 DAY 23 ~ 10 = 165 DAY 25 ,~-' 12 = 196 DAY 26 DAY '27 ~ Circle appropriate period and DAY 28 ~ action number. A full cycle is DAY 29 ,-~ made up of periods · 1-12, after DAY 30 '*~ which a new cycle begins. Use TOTAL MINUSES information to co lete Part B. PART B: ACTION NUMBER CALCULATION Line 1. 'Total minuses this period-Part A '/ -Line 2. Cumulative minuses from previous periods in' this cycle. Line 3. Total minuses (add lines I & 2) Line 4. Action number for this period (from table above) .... .~-~ Line 5. ..Is line 3 greater than line 4? ['~Yes o Lf Yes, you have a reportable loss and must begin notification and investigation procedures as described in Kern. County Health Department HANDBOOK #UT-lO "STANDARD INVENTORY CONTROL MONITORING" Env. Health 580 4113 1016 (6/86). . · .. ' KERN COUNT.y~' HEALTH DEPARTI~IENT TREND ANALYSI S I~ORKSHEET ' ' DAY DAT~ (+'-) consecutive period of analysi DAY I ,~ being conducted DAY 2 ~ 12 only). Transfer the date an DAY 3 ~ the sign from colUmns I and 1~6 o DAY 4 ~ Reconciliation Sheet DAY 5 ~ at left. Use the table below t DAY 6 '~ - determine the action number fo DAY 7 ~' the period bein~ analyzed. DAY 8 ~ DAY 9 ~ '-' ACT I ON NUNBER DAY 10 ~ TABLE DAY 11 DAY 12 '~ 30-DAY { ACTION DAY 13 '~ PERIOD NUNBER[ 'NUNBER DAY 14 ~ I = 20 DAY 15 ~ 2 = 37 DAY 16 ~ 3 = 54 DAY 17 ~ ~ 4 = 69 DAY 18 $~ 5 = 85 DAY 20 ~ 7 ' 117 DAY 21~ {~ 8 = 133 DAY 22I ~ i 9 = 149 DAY 24 ~-- [ 11 = 180 DAY 25 ~, i 12 = 196 DAY 26 DAY 27 '~ ~ Circle appropriate period and ' DAy 28/~ action number. A full cycle is DAY 29 ~ ~ made up of periods 1-12, after DAY 30 ~ ~ which a new cycle begins. Use TOTAL MINUSES ~ information to complete Part B. PART B': ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A ............ Line 2. Cumulative minuses from previous periods in this cycle. Line 3. Total minuses (add lines 1 & 2) ~ine 4. ~ction number for this period {fro~ table above) .... · Llne 5. Is line a greate~ than line 4~ ~Yes I'~ ~es, ~ou ha~e a reportable loss and ~ust begin n°tification and in~estlgatlon procedures as described in Kern Countg ~ealth Department H~DBOOK OUT-10 "ST~D~RD I~vE~TORY CO~TROL/~O~ITORI~G" -~' '" KERN COUNTY HEALTH DEPARTNENT TREND .ANALYSIS r~IORKSHEET TANK # ~ CAPACITY ~ ~,CZO PRODUCT ~L~C~( ~-~ YEAR/PERIOD I N~.TRUCTI ON'S : pART A : OVERAGE/SHORTAGE Fill in all. inforaation at top ' form. In the space for year ~J 1 16 period indicate the year ~and tb DAY DATE (+/-) consecutive period of analysi DAY 1 ~ being conducted (f~o~ 1 throug DAY 2 "' 12 only). Transfer the~ dare an DAY 3 ' ~ the sign fro~ columns I and 16 o DAY 4 ~ Reconciliat'ion Sheet to column DAY 5 ~ -' at left. Use the' table belo~ t DAY 6~ ~ determine- the action number fo DAY'7 .... :' the period being analyzed. DAY 8 DAY 9 ~. ACTI ON NUNBE'R DAY 10 ~ ': TABLE DAY 11 DAY 12 ~ 30-DAY { ACTION "DAY 13 ~"~ PE~IOD NUNBER] NUNBER 'DAy 14 '~ 1 = 20 DAY 15 ]~ 2 = 37 DAY 16 ~ 3 = 54 DAY 17i,~ 4 = 69 DAY 18 ~ ~ 5" = 85 DAY 19 ~ ~ 6 = 101 DAY 20 ~ { 7 = 117 DAY 21 ~ ~ ~ 8 = 133 DAY 22 ~ ~ 9 = ~49 DAY 23 ~ 10 = 165 DAY 24 '~ ~ 11 =, 180 DAY 25 ~ ~ 12 = 196 9AY 26 DAY 27 t ~ Circle appropriate period and DAY 28 ~ ~ action number. A full cycle is DAY 29 ~ ~ ~ made up of periods 1-12, after DAY 30 ! ~ which a new cycle begins. Use TOTAL NINUSE$ } info~ation to coa~lete Part B. PART B: . ACTION NUMBER CALCULATION Bino 1. Total ~inusos this perSod-Part A ............ 2. Cumulative ainuses from previous periods in this cycle. Line Line 3. Total minuses (add lines 1 & 2) ·., Line .4. Action number ,for this period (fro~ table above) .... Line 5. Is line 8 greater than l~ne 4~ ~Yes o I~ Yes, ~ou have a reportable loss and ~ust begin notification and investigation procedures as described in Kern 'County Health Department HANDBooK ~UT-10 "STANDARD INVENTORY CON~ROL' MONITORING"; Env. M~[t~ 580 4113 ~0~6 (6/86) ' . .,.KERN COUNTY HEALTH DEPARTI~IE. NT~ .. T. RE'ND' ANALYSI S ~.ORKSHEET pART A : OVERAGE/SHORTAGE Fill in all infovmation..at top c " form. In the .space for year 1- 16 period indicate the.yea~ and DAY - DATE (+/-) consecutive period of DAY 1 ~ ~ being conducted (from 1 throu~ DAY 2 ~ ~ 12 only) ' Transfer the dare,an DAY 3 ~ ~ the sign from colunns 1 and ~6.c DAY 4 ~ ~' Reconciliation Sheet to column DAY 5 ~ I at left. Use the table below t DAY 6 ~ ~ determine the ac~io.n number fo DAY 7 ~ ~ the period bein~ analyzed. .DAY 8 DAY '9 ' ~ :~ -Oi,~~ A CTI ON N'UMBER DAY 10 ~ ~ T ABL E DAY 12 ~ ~ 30-DAY [ ACTION DAY 14 ~ ~ ~ = 20 DAY ~5 ~ [ 2 = 37 : DAY ~6~ ~ 3 = 54 DAY 17 ~ 4 = 69 DAY 19 ~ 6 = 101 DAY 20 ~ f 7 = 117 DAY 21 t ~ 8 = 133 DAY 22 ~ ~ 9 = 149 DAY 23 ~ 10 = 165 DAY 24 .~ : 11 = 180 DAY 25 ~ ~ 12 = 196 DAY 26 .DAY' 27 ~ i Circle appropriate period and DAY 28 ~ ~ action number., A full cycle DAY 29 ~ ~ made up of periods 1~12, after DAY 30~ i ~hich a new cycle begins. Use TOTA~[MINUSES [ information to complete Part B. PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A ............ Line 2. Cumulative minuses, from previous periods in this cycle. Line 3. Total minuses (add lines 1 & 2) . ......... Line 4. 'Action number for this period (from'table above) Line 5. Is line 3 greater than line 47 ~]Yes No If Yes, you have a reportable loss and must beg notification and investigation procedures as described in Kern County Health Department HANDBOOK ~UT-10 ' ' ~"sTANDARD INVENTORY CONTROL MONI'TORING" En¥. Healt~ §80 41,13 1016 (6/86) KERN COUNTY HEALTH DEPART~I~ENT' -TREND ANALYSIS WORKSHEET ,. I NSTRUCTI ON'S : PART A : OVERAGE/8~ORTAGE Fill in all information· at top form. In the space for year/ 1' 16 period indicate the year and th~ DAY .-DATE (+/-) consecutive period of analysi~ DAY 1 -~- ~ being conducted (from '1 througk DAY 2 ~- I 12 only).. Transfer the date DAY 3 i -'- the sign from columns 1 and 16 DAY 4 _L~ ! Reconciliation Sheet to column~ DAY ,5 t ~ at left. Use the table belo~ tc DAY 6 ~ f determine the action number for DAY 7 ' ' the period being analyzed. DAY S 4~ ! ACTION NUMBmR 'DAY ~0 ~ ~ T ABL~ DAYll , ~ . 0-OA DAY 14 i ~ 1 = 20 DAY 15 ~ ~ '2 = DAY ~6 ~ ~ 3 = 5~ ~ 4 = 69 ~ 5 = 85 DAY J8 ~ ~ ; 6 = 101 DAY 19 DAY 20 ~.~ 7 = 117 DAY 21 .~ ~ 8 = 133 DAY Z2 ~ ~ 9 ff ~9 DAY ~3 ~ 10 = 165 DAY Z5 j~ 1~ = ~96 DAY ~6 ~ ~ DAY Z7 ~ ~ Circle' appropriate period and DAY, Z8 ~ ~ action number. A full cycle is DAY M9 ) ~ made up of periods 1-~, after DAY 30 ~ ~ ~hich a ne~ cycle begins. Use TOTA~ MINUSES ~ ~ information to complete'Part B. PART'B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A ...... ...... ~ ~ Line 2. Cumulative minuses from previous periods in this cycle '~ ~ Line 3. Total minuses (add lines 1 a 2) ........... ' L~ine 4. Action number for this period (from table above) .... . f Line 5. Is line 3 .greater than line 47 ~Yes ~N° If Yes, ~ou have a reportable loss and must begin notffication and investigation procedures as described inKern Count~ Health Department HANDBOOK ~UT-10 "STANDARD INVENTORY CONTROL MONITORING.". '- KERN CO'UNT~ · HEALTH DEPARTMENT/. I NSTRUCTI ON-S : PART A : 0VERAG~/Sfl0RTAGE FiII in aII information at top o: · form. In the space for 1 16 period indicate the: ~ear and th, DAY ..DATE {~/-) consecutive period of anaiysi: DAY 1 '~ --' bein~ conducted (from 1 througi DAY 2 -¢- ! 12 only). Transfer the date ant DAY 3 ' ~ the sign from columns I and 16 o! DAY 4 ~- I Reconciliation Sheet to column: DAY 5 I ~ at left. Use the table below t~ ~ DAY 6 t ~ determine the action number fo~ DAY 7 ~ ~ the period bein~ anal~[zed. DAY 8 ~ ~ DAY 9 ~ ~'{~ ACTI ON NUMBER DAY l0 ~ ~ TABLE DAY 12 ~ ~ 30-DAY ~ ACTION DAY 14 ~ ~ = 20 DAY ~5 ~ ~ ~ 2 = 37 DAY ~6 ~ ~ 3 = 54 DAY ~7 ~ ~ ~ 4 = 69 DAY ~8~ ~ ~ 5 = 85 ,DAY 20 ~ ~ 7 = DAY 2~ ~~. 8 ~ = ~33 ' DAY 22 ~' ~ 9 = ~49 DAY 23 ~ ~ . ~0 =. 165 DAY 24~ ~ ~' ~ ~ 180 DAY25 ~ ~ 12 ~ 196 DAY 26 ~ DAY 27 ~ Circle appropriate .period and DAY 28 ~ ~ acti'o'n number. A full Cycle DAY-29 ~ ~ ~ade up of periods ~-~2~ after ~ ~ ~hich a new cycle begins. Use DAY 30 TOTA~INUSES ~ ~ info~atio~ ~o complete Part B. PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A ............ Line '2.~ :Cumulative ~inuses fro~ previous periods in this c~cle. ~'~ Line ~. Total ~nuses (add lines 1 ~.2) ............. Line 4. Action number for this period (from table above) .... hlne 5. Is line ~ greater than line 47 ~Yes If Yes, ~ou have a reportabie loss and must beg notification and investigation procedures as described ~' .. in Kern'Count~ Health Depart~ent'flANDBOOK ~UT-10 "STANDARD INVENTORY ~ONTROL ~ONITORING" KERN COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET TANK CAPACITY.- ..... PRODUCT YEAR/PERIO INSTRUCTION-S: PART A : OVERAGE/SHORTAGE Fill in all information at top form. In the space for year, 1 16 period indicate the year and DAY DATE consecutive period of. analySi. DAY~ 1 --- being conducted (from 1 thro.ug. DAY 2 -~ 12 only). Transfer the date an~ DAY 3 ~ the sign from columns 1 and 16o DAY :4 ~ Reconciliation Sheet to column:. DAY. 5 ~ at left. Use the table below t:' DAY 6 ~ determine ~the action number fo DAY 7 ~ the period being analyzed DAY 8 DAY 9 -- - AC. TI ON NUMBER DAY 10 ~ T A S n S DAY 11 DAY 12 -- 30-DAY [- ACTION DAY 13 ~ P~RIOD NUMBER[ NUMBER DAY 14 ~ 1 = ~0 DAY 15 2 = 37 DAY 16 ~ = 54 DAY 17 4 = 69 DAY 18 ~ 5 = DAY 19 6 = 101 OAY 20 ~ 7 = DAY 21 ~ 8 = 133' DAY22 ~ 9 = 149 DAY 23 ~ 10 = 165 DAY 24 ~ 1~ = 180 DAY 25 ~ 12 = 196 DAY 36 DAY 27 ~ Circle appropriate period and DAY 28 ~ action number. A full cycle DAY 29 ~ made up of periods 1-12, after DAY 30 ~ ~hich a ne~ c~cle begins. Use TOTAL ~INUSES information to complete Part PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period. Part ~ ............ ~ine 2. Cumulative ~inuses fro~ previous periods in this cycle. Line O. Total inuses (add lines 1 · 2) ....... ...... Line 4. Action number for this period (fro~ table above) ..... Line 5. Is line 3 greater than line 4¢ ~Yes~ ~No If Yes, ~ou have a reportable loss and ~ust begin notification and inVesti~atSon procedures as described in Kern C'ounty He'alth DePartment HANDBOOK ~UT-10 _ - "STANDARD INVENTORY CONTROL ~ONITORING" [n~. H~altn 580 4113 101~ (~/8~) : KERNCOUN-~TYHEALTH DEPARTMENT TREN-D ANALYSI S v~IORKSHE-ET FAC I L I TY PERMIT. TANK ~ ~ CAPACITY ~~ PRODUCT ~0 ~~ YEAR/PERIOD INSTRUCTION'S:. PART A : OVERAGE/SHORTAGE Fill in all inforaation at top o form. In the space for year 1. 16 period indicate the Year and th, DAY DATE consecutive period of ,analysi. DAY 1 being conducted (fro~ 1 throug' DAY 2 ~ 12 only). Transfer the date-an DAY 3 the sign f~om columns 1 and 16 o DAY 4 ~ Reconciliation Sheet to column DAY 5 at left. Use the. table below t DAY 6 ~ determine the action number.fo DAY 7 the period being analyzed.' "DAY 8 DAY 9 ~ A CTI ON NUMBER DAY 10 ~ T ABL-E DAY 1~ DAY 13 ~ P~RIOD NU.BSRI NU.B~R DAY 14 1 = 20 DAY 15 2 = 37 DAY ~6 ~ 3 = 54' DA~ 17 ~ 4 = 69 DAY ~8 ~ 5 = 85 DAY 19 6 = 101 DAY 20 ~ 7 = 117 DAY 21 8 = 133. DAY 22 ~ 9 = 149 DAY 23 ~ 10 = 165 DAY 24 ~ 11 = 180 DAY 25 ~ 12 = 196 DAY 26 DAY 27 Circle appropriate period and DAY ~8 action number' A full cycle is DAY 29 made up of periods 1-12, after DAY 30 ~ which a new cycle begins. Use TOTAL MINUSES info'marion to com ,lete Part B. PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A : Line 2. Cuauiative ainuses froa previous periods in [his cycle. Line 3. Total minuses (add lines I e 2) ............. Line 4 Action number for this period (from table above) ' Line 5. Is [ine 3 ~reater than line 47 ~Yes ~No If Yes, you have ~ reportable loss and mus~ begin notification and investigation procedures as described . in Kern County ~eai[h Depar~en~ HANDBOOK ~UT~IO "STANDARD INVENTORY CONTROL ~ONITORING" Env.,Health 580 4113 1016 (6/86) ' I KERN COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET BAKE,ReJFIELD: CA 93304 TANK # I CAPACITY '-~-~-!OOf2~- PRODUCT ~ YEAR/PERIOD ~ = I NSTRUCTI ON'S : PART A : OVERAGE/SHORTAGE Fill in all information at form. In the space for year 1 .16 period indicate the year and th DAY DATE (+/-) consecutive period of analysi DAY 1 ~- being COnducted (from ! throug DAY 2 w 12 only). Transfer the date an DAY 3 -~ the sign from col.umns 1-and 16 DAY 4~- Reconciliation Sheet to column: DAY 5 '" at left. Use the table below t DAY 6 -" determine the action number fo: DAY 7 '~ the period being analyzed. DAY 8 DAY 9 '" - ' ACTI ON NUMBER DAY 10 ~- T asn E DAY 12 { 30-DAY } ACT 0N DAY 13 '" PERIOD NUMBER{ NUMBER DAY 14 ~' 1 = 20 DAY 15~ 2 = 37 DAY 16 '" 3 =' 54 DAY 17 -'- '4 = 69 DAY 18 -~ 5 = 85 DAY 19 6 = 101 DAY '20 -- 7 = 11.7 DAY 21 "~ 8 = i33 DAy 22 --' 9 = 149 DAY 23 ""- 1_0 = 165 DAY 24 "' / 11 = 180 DAY 25 ~L 12 = 196__ .DAY.26 ~-~ DAY 27 .~ Circle appropriate period and DAY 28-~ action number. A full cycle is DAy 29 "'- made up of periods 1-12, after DAY 30 ~" which a new cycle begins. Use TOTAL MINUSES information to complete Part B. PART B: ACTION NUMBER CALCULATION L~ne 1. Total ~inuses this period-Part A ............ Line 2. Cumulative minuses fro~ previous periods in this c~ele. Line 3. Total minuses {add lines 1 & 2) ............. Line 4. Action number for this period {fro~ table above) .... Line 5. Is line 3 greater than line 47 F-lYes t~No If Yes, you have a reportable loss and must begin notification and investigation procedures as described in Kern County ~ealth Department HANDBOOK ~UT-10 "STANDARD INVENTORY ~ONTROL MONITORING" Env. Health 580 4113 1016 (6/86) -. KERN COUNTY HEALTH DE'FARTi~ENT TREND ANALYSI S~ WORKSHEET TANK # ~ CAPACITY \~ PRODUCT ~ ~ . YEAR/PERiOD-~I~ I'tNSTRUCTI ON*S· PART A : QVERAGE/SHORTAGE Fill in all information at top form. In the 'space for~ yea~ 1 16 period indicate the year and DAY DATE (+/-) consecutive period of anal,¥s DAY. 1' '~- being conducted (from 1 throu~ DAY 2 ' ---- 12 only). Transfer the date ax DAY 3 ~] ~f-* the sign from columns 1 and 16. ( DAY 4 ~- Reconciliation Sheet to · columr DAY 5 . ~ at le~t. Use the' table below DAY 6 ~ ~ determine the action number-fo DAY 7 ~ the period being analyzed. DAY 8 DAY 9 ~ ACT I ON 'NUMBER DAY 10 ~ T. A BL S~ DAY 12 ~ 30-DAY ] ACTION DAY 13 ~ PERIOD NUMBERI NUMBER DAY 14 ~ 1. .= *20 DAY 15 ~ 2 = 37 DAY*16 ~ ] 3 = 54 DAY 17 ~ ~ 4 = 69 DAY 18 ~** 5 = 85 DAY 19 ~ i 6 = 101 DAY 20 ~ 7 = i17 DAY 21 ~ 8 = 133 DAY 22 ~ 9 = 149 DAY 23 ~ 10 = 165 DAY 24 ' ~ 11 = 180 DAY 25 ~ 12 = 196 DAY 26 ~ ~ DAY 27 ~ Circle app~opriat'e period ant DAY 28 ~ act/on number. A full cycle DAY 29 made up* of pe~i0ds 1-12, after DAY 30 which a new. cycle begins. Use TOTAL HINUSES information to complete Part B. PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A .......... . . . Line 2. Cumulative minuses from previous periods in this Cycle, ~ { Line 3. Total minuses (add lines 1 & 2) Line 4. Action ,umber for this period (from table above) .... Line 5. Is line 3 greater-than line 47 ~Yes ~No I~ Yes, ~ou have ~ reportable loss and must begin . notiflcation and investigation procedures as described In Kern.County Health~ Department HANDBOOK ~UT-10 · "STANDARD ,INVENTORY CONTROL MONITORING .... :. KERN CObNTY HEALTH DE~ARTI~IENT. 'TREND. ANALYSI S WORKSHEET .... · "- F A C. I L I T Y ~AKER~FIL~.D. CA ~ : P E R lVX I T ~ ~ OO ~: C' TANK = ~ .CAPACITY ' ~:~j__~ PRODUCT )~~____ YEAR/PERIOD ~ ~ NST'RUC'TI O'N'~ : .PART A : OVeRAGE/SHORTAGE Fil1 in all information ~t top form. In the. space for ~ea:' 1 16 peciod indicate the year and t DAY 'DAT~ (+/-) consecutive ,periOd of anal~s DAY1 ~ being conducted (from 1 ~hrou DAY 2 ~ 12 onlT). Transfer the da~e a DAY 3 ~ the sign from columns 1 and 16 DAY 4 ~ Reconciliation Sheet to colum: DAY 5 '. ~ at left. Use the' table belo~ DAY 6 '~ determine t'he action number f, DAY 7 ~ the period being analyzed. DAY~8 DAY 9 ACTI ON NUMBER DAY 10 ~ TAB L E DAY 11 'DAY 12 ~~ 30-DAY [ ACTION DAY 13 ~ PERIOD NUMBER NUMBER DAY 14 ~ 1 = 20 DAY 15 2 = 37 DAY 16 ~ 3 = 54 DAY 17 ~ ~ 4 = 69 7 = 117 DAY 20 ~ '" DAY 22~ '- [ 9 = 149 DAY 24 ~ 11 = 180 DAY 25 - 12 : 196 DAY 26 DAY 27 ~ Circle approprfate' period DAY 28 ~ action number. A full cycle i: DAY 29~ aade up of periods 1-12, afte~ DAY 30 which a new. cycle begins, uS~ TOTAL MINUSES info~mation to complete Part B PART B: ACTION NUMBER CALCULATION ~tne 1. Total minuses this period-Part A ............ ~tne 2. Cumulative minuses from previous periods in this cycle. 'Li'ney3. Total minuses (add lines 1 a 2) ............. · : ' Line 4 ' Action number for this period (from table above).~. Line 5, Is line 3 greater than line 47 ~Yes ~No If Yes~ you have ~ reportable loss and must begin notification and investigation procedures as deScribed in Kern County Health Department HANDBOOK ~UT-10 "STANDARD INVENTORY CONTROL MONITORING" TANK #. CAPACITY ~ PRODUCT ~:~,~\~ . YEAR/PE~IOD~ - I NS TRU'C T ION'S : -PART A : OVERAGE/SHORTAGE Fill in ali information at top form. In the space for year/ 1 16 period indicate the year and the DAY DATE (+(-) consecutive period of analysi~ 'DAY 1 -- being conducted (from i throug! DAY 2 : ~- A- I/ Yransfer the date an( DAY 4 . ----- %on sheet to -6olumn~ DAY 5 ~ !se the table below DAY B .~- //.~. ihe action number fo, DAY 7 -~-~ ,eing analyzed. · DAY 8 - DAY 9 .~- ON NUMBER DAY 10 .~ TABLE DAY 11 DAY 13 ---~ PERIOD NUMBER NUMBER -DAY 14 -~- 1 = 20 DAY 15+ 2 = 37 DAY 16 -~ 3 = 54 DAY 17 -~ 4 = DAY 18 ----~ 5 = 85 DAY 19 ~ 6 = 101 DAY 20 -~-, ~ = 21 q-- = DAY 22 -~ 9 = 149 DAY 23 .~ 10 = 165 DAY' 24 -~ 11 = 180 DAY 25 ~ 12 = 196 DAY 26 DAY 27 -- Circle appropriate period 'and DAY 28 -~. action number· A full cycle is · DAY 29 -~ made up of periods 1-12, after .DAY 30 which a new cycle begins. Use TOTAL MINUSES information to complete Part B. PART B: ACTION NUMBER CALCULATION Line 1'. Total ·minuses this per/od-Part A ............ Line 2. Cumulative minuses from previous periods in this cycle Line ~. "Total minuses {add lines 1 & 2) ............. Line 4. Action number for this period' {from table above) . . .-. Line $. I.s line 3 greater than line 4¢ [~]¥es I._~.f Yes, you have a reportable loss and must begin notification and investigation procedures as described · in'Kern County Health Department HANDBOOK #UT-10 "STANDARD INVENTORY CONTROL MONITORING" Env. Health 580 4113 1016 (6/86) . . . :..~',':...:',' .:...",, , .., :.,,:.-,~ ~.~ · , . · · .. ', '., ,~.. .: ~ . , ' . - .:~,.:~ ,.-.. .... .."~' ': '. :".':''."' '. ,' ' ·":". ':'r'.' ' N ~1 ~ ~' ~ . ' ~ ' ' · "' ' ' · ' · · '.' "'" "' :' .:" .~ "." ':"' T~ ~ ' ~ ~ ~ - ' ' "; '. i '' · ':': .' . '-" ' ' ' : '~ ' ~ ~ ' ' .' . . " ........ ~ , {) ~ . . ... . . .'..: ..... : . .... '~ ,.~'.:{ ~ . . ~ ~ . .:'~ Use of this de~ce Is prohibited b~ state law and ~ ~ ~ ~ fP ~r~a ~ ~[x ~ n t~n~:i~ authorized removal of this tag or use of this equipment ., n~ ~11 constitute a ~olation of the law punishable b~ a ]~.'. ' ma~mum cml fine of $1,000 per da~ or a ma~mum ~: repai~ere: . .'...[ I declare under penal~ of pe~u~ that the de~ce tagged . :..[.'... ' ~ ~s not used, nor ~s the ta~ removed, until the required Tota zer'Read ng at ~me of Repa r .'.;: .-:.., . ~:..: '., '::::. :, :, ...:. :.: ~.' : ~ . Repal~ made If repmrs were made to the no=le ~d~ ~ou must noti~ Tag Number ate Time Station ame- ' Operators Name f?")l'l'~f~"'.~-7~,.~l-~,~l I('"'~ · -- ' ' '' Major Cross Stree~'~(''1_ ~_~4~x('~_ ~.' ~..' (,,) . : . . ." i '.' .. . , .. . Defect ~ ' ' ' Totalizer Reading ~en ~~G ' ~'' ''~ ' ' '"'' :'~'' '1':'' ":.'..~': gged / ' '" . . WARNING Use of this de~ce Is prohibited by s~ate law and un- · . : authorized removal of this tag or use of this equipment ' ~11 constitute a ~olation of the law punishable by a ..... ' · ma~mum ci~l fine of $1,000 per day or a ma~mum criminal fine of $500 per day and/or six months in jail. '' I declare under penalty'bf peduW that the de~ce tagged ,. ,'.. ..... ' : .- . ~ ,. : . ., , was nol used. nor was the tag removed, until Ihe required : '--,,~, . ~ .... .: .: . .. repairs were effected and the district notified ' Repaired by Title (Please print) Signature -. . ': :'.'":...'-'. Date ~me., .. Totalizer Reading at ~me of Repair . Repaim made " ' '.' . .~.......~ ...:' BEFORE USING ~IS D~Telep~ne vo~local '' pollution control district at_ ~-~1 -' =~ air .. If repairs were made to the no~le body you must noti~ ' ' the County Department of Weights and Measures. : ..., : , . . ,. -;..:. . . . .; _ ::..::~;... :'.. ~':', ..:::. -..:,'.. . .... ' ~, ':~ .. ' . · .: :.~ ' ,:' ~. , .':: ':. . . . '~- ~ ' '. -:. : ·-' ..,',. .',,~.r~.r,=,L¢ ~9;%,~-* "'H:*-'<. ...... ZE.;C'V~ & ,-:. .:* '"" ~'~-i '.LT..,-'! ..... ,*..T'?~,! '..n- "':=:"'~ ._..;',~'"""~" '~i :' .,= ;; ;';..-¢,~ ,', :~'r .... ., , .... ,- :;::',3T;';Az'..;','T ,;LCL,E(:3';' "m', .... ' ....' - "~-"-' ...... '"'"':'"':" SE -'"683 " ....... ~ 700 FtOW~.~ 5¥RI-Ei COHPLETENESS CHECK IncomPlete ln~otmat~,,n on ~its~ p~qe o~ _ entitled '~ppl teat ~on ~-' Permit ~ Operate Underground Storage Facility" The information r~guired is noted in ~e~ on enclosed copy. , '~ Incomplete in~mat ~on ~n second page(s)' application.-"Tank Sheet" Th~ ~nfo~mation requ red is noted in re~ on e~ciused copy. ~lot Pldll lackiqg, o~ i~lcompIete. Refer to ' tnstructl'on~t en~.'Ios~d. ' Other: ,-' m REDWINE TESTING SVCS., INC. TEST METHOD: HORNER EZY-CHEK I PO BOX 1567 BAKERSFIELD, CA. 93302 (805) 326-0446 CLIENT: MR. FAST CALIBRATION BAR OR LIQUID: BAR 0.02~ LOCATION: 800 BRUNDAGE LANE CHARTCALC (A): 0.025/ 21 = 0.0012 CITY, STATE: BAKERSFIELD CA TEST LEVEL: 125.00" (SYSTEM) TEMP CALC (B): 0.00059 X 10000 = 5.9 SIZE: 10000 PRO DUCT: U NLE ADE D PROJECT NO:: BT-O108 PRODUCT TEMP: 72 TOTAL LINE CHANGE: 62 COEFFICIENT: 0.00059 X 10000 -; 5.9 TANK TEST #: 3 RUNS DISPENSERS 1,3 AND 7 LEVEL LEVEL GAIN + x(A) LEVEL TEMP. TEMP. GAIN + x(B) TEMP FINAL START END ' ' LOSS - x(A) RESULT START END LOSS - x(B) RESULT RESULT TIME 53 - 100 = 47 x 0.00i2 = 0.0560 0.056 - 0.OB7 = 0.011 x 5.9 = 0.0649 -0.00884 1455 42 - 55 .= 13 x 0.0012 = 0.0155 0.067 - 0.071 = 0.004 x 5.9 = 0.0236 -0.00B12 1501 55 - 8'1 28 x 0.0012 = 0.0310 0.071 - 0.076 = 0.005 x 5.9 = 0.0295 0.001452 1507 29 - 60 = 31 x 0.0012 = 0.0369 0.076 - 0.082 = 0.006 x 5.9 = 0.0354 0.001504 1513 60 - 93 = 33 x 0.0012 = 0.0393 0.082 - 0.08~ = 0.006 x 5.9 = 0.0354 0.003885 1519 51 - 82 = 31 x 0.0012 = 0.0369 0.088 - 0.094 = 0.006 x 5.9 = 0.0354 0.001504 152~ 57 - 80 = 23 x 0.0012 = 0,0274 0.094 - 0,100 = 0.006 x 5.8 = 0.0354 --0~00801 1531 24 -- 68 = 44 x 0.0012 = .0.0524 0.100 - 0.110 = 0.01 x 5.9 = 0.059 -0.00661 1537 68 -- 100 = 32 x .0.0012 = 0.0361 0. I 10 - 0.120 = 0.01 x 5.9 = 0.059 -0.02090 1543 45 - 73 = 28 x 0.0012 = 0.0333 0.120- 0.13~ = 0.015 x 5.9 = 0.0IE)8~ -0.05516 1549 73 - 98 = 2~ x 0.0012 = 0.0298 0.135 - 0.1~0 = 0.015 x 5.9 = 0.0885 -0.0~873 15~3 46 - 73 = 27 x 0.0012 = 0.0321 0.150 - 0.165 = 0.015 x 5.9 = 0.0885 -0.0~835 1601 73 -- lO0 = 27 x 0.0012 ~ 0.0321 0.165 - 0. t80 = 0.015 x 59 = 0.0885 -0.05635 1607 39 -- 67 = 28 x 0.0012 = 0.0333 0.180 - 0.1~ = 0.015 x 5.9 = 0.O885 -0.05516 1813 67 -- 93 = 26 x 0.00t2 = 0.0310 0,195 - 0,210 = 0.015 x 5.9 = 0,0885 -0.05754 1619 A, TANKBOT TO GRADE: 130.0 ' F. DEPTH FOR TANK SAMPLE: 83.3 ' RESULTS PER HOUR: -0.37337 B. TANKTOP TO.GRADE: 3~.5 ' G. TEMPERATURE PROBE DEPTH: 40.5" TIGHT: NO C. TANK DIAMETER: 93.5 ° H. TEST LEVEL TO TANK BOTTOM .... 125.00" NET TEST PRESSURE: 3.3750 D. TEST LEVEL ABOVE GRADE:. 0.00" I. GROU ND WATER ABOVE TANK BOTTOM 0.000" STANDARD DEVIATION 0.0241 E. DEPTH OF WATER IN TAN)~c 0.00" J- PRODUCT PRESSURE PER 1" HEIGHT: ~.~2~ PSi TEST DATE: -98.0000 ~' ~O/V~ ~ TECHNICIAN: McCARTHY REDWINE TESTING SERVICES INC. P.O. BOX 1567 BAKER~I~ CA. CLIENT: MR. FAST Cf ~i TECHNICIAN: McCARTHY ADDRESS: 600 BRUNDAGE LANE LICENSE NO: '94-1061 CITY, STATE: BAKERSFIELD CA, DATE: 6-14-93 TEST TYPE: HELIUM TANK DESCRIPTION: 10000 GALLON UNLEADED TANK # 3 TECHNICIANS REPORT I REMOVED THE DROP TUBE FROM THE TANK THEN MEASURED THE FUEL LEVEL, I RECORDED A FUEL LEVEL OF 33 INCHES BASED ON A STICK READING. I THEN PREPARED THE TANK FOR A HELIUM TEST. THE HELIUM TEST BEGAN AT 1242 HOURS, I HAD PRE-DRILLED THE TANK TOP FOR TEST BORINGS, AND IMMEDIATELY 'STARTED SAMPLING THE TANK TOP AREA, I FOUND NO HELIUM IN ANY OF MY TEST BORINGS, I C?CLED THROUGH ALL 25 BORE HOLES THREE TIMES BETWEEN 1245 HOURS AND 1345 HOURS, AT 1345 HOURS I FOUND 4 PER CENT HELIUM UNDER DISPENSER NUMBER THREE, DUE TO. WIND CONDITIONS, THE READING FLUCTUATED BUT INDICATED A DEFINITE LEAK UNDER DISPENSER NUMBER THREE, AT THE END OF THE TEST I REMOVED THE HELIUM EQUIPMENT AND REMEASURED THE FUEL LEVEL, DURING THE TIME OF THE HELIUM TEST THE TANK FUEL LEVEL HAD DROPPED TO THIRTY INCHES. THIS WOULD INDICATE A TANK BOTTOM LEAK, THERE WAS NO FUEL PUMPED OR REMOVED IN ANY WAY FROM THIS TANK DURING THE TIME OF MY TESTING. MY ONLY CONCLUSION IS THAT THE TEST PRESSURE OF 1.8 PSI HELIUM PUSHED THE FUEL OUT OF AN OPENING IN THE BOTTOM OF THE TANK. THIS WOULD EXPLAIN THE THREE INCH DROP IN THE FUEL LEVEL. REDWINE TESTING ~VCS., INC. TEsT METHOD: HORNER EZY-CHEK! PO BOX 15~7 BAKERSFIELD. CA. 93302 * * CLIENT: MR. FAST CALIBRATION BAR OR LIQUID:. * *.' BAR . 0.02~ LOCATION: ~)0 BFIUNDAGE LANE CHART CALC (A): 0.025 !. 17 -- 0.0019 CITY, STATE: BAKEFISRELD CA TEST' LEVEL:' 150.00 ' (SYSTEM) TEMP CALC (El): 0,00059 :X .... :-. 10000 ,,, 5.9 81ZE: 10000 PRODUCT: " UNLEADED PROJECT NO.: BT-0109 PRODUCT TEMP: 72 TOTAL LINE CHANGE: 51 COEFFICIENT: 0.00058 X. 10000 = 5.9 TANKTEST ~: 2 . · ~N8 mS~;NS~m 2.8. ANo8 * . · LEVEL LEVEL GAIN + x(A) LEVEL . TEMP. TEMP. GAIN ¥ x(~B) TEMP -: FINAL START END LOEB - X(A) RESULT 8TART END LO$8 - x(l~ FI~SULT .RESULT TIME 30- 82 = ~2 x 0.0015 -- 0,0912 0.872 - 0.881 = 0._ri_n9 x 5.9 - 0.O531 0.038078. 1711 33 - 87 ,,, 54 x 0.0015 -- 0.0784 0.88t -- 0.882 = 0.011 x 5.8 -, 0.0649. 0.014511 1717 42 ' 88 ,= 46 x 0.001~i -, 0.067~ 0.892 -- 0.801 ,= 0.009 x 5.8 -, 0.0531 0,014547 '1723 32 - ~5 -- ~3 x 0.0015 -- 0.048~ 0.801 - 0.908 ,= 0.007 x 5.8 - 0.O413 0.007229 '1729 ~ - 97 ,- 32 x 0.00t5 -- 0.0471 0.908 - 0.917 = 0.009 x 5.8 -- 0.0531 -0.00604 1735 28 - 92 = 34 x 0.0015 -- 0.O~X} 0.9t7 - 0.924 =, 0.007 x 5.9 -- 0.0413 0.0087 1741 82 - 98 -- · 36 x 0.0015 ,= 0.0~29 0.924 - 0.932 = 0.008 x 5.9 -- 0.0472 0~00~741 1747 29 - 58 - 30 x 0,0015 - 0.0441 0.932 - 0.938 ,- 0.007 x 5.8 -= 0.0413 0.00'2817 17~3 .~ 58 - 90 -- 32 x 0.0015 -= 0.0471. 0.938 - 0.846 -, 0.007 x 5.9 - 0.0413 : 0.00~758 1759 .. 34 - ~0 - 28 x 0.0015 -- O.O382 0.846 -. 0.852 = 0.O06 x . '~ 5.8 ,= O.O354. ~: 0.(~02835 1805' · 0 - 88 -- 28 x 0.0015 -- 0.O412 0.952 - 0.958 -, 0.006 x 5.9 -- 0.0354 '~ :.. 0.005778 " 1811 33 - 58 ,= 22 x .0.0015 ~- 0.0324 . ' O.9~8 -- 0.961 ,= 0.003 x 5.8 -- 0.0177 .~ .. i 0.014~52 1817 55 - 78 ,,, 23 x 0.0015 -, 0.0338 0.961 - 0.886 = 0,005 x 5.8 =- 0.0295 ' 0.004323 1823 -. 78 -' 100 ,,, 22 x - 0.0015 - 0.0324 0.966 -- 0.971 = 0.005 x 6.9 -- 0.029~ 0.002852 1829 20 - ~ '-, 15 x O.0015 ~- 0.0221 0.971 - 0.976 -' 0.005 x 5.8 ~ * 0.0295 '0.05744 183~ A. TANK BOT TO GRADE: 125.0' · F. DEPTH FOR TANK SAMPLE: 77.8" RESULT8 PER HOU R: 0.04~02 ' ' B. TANKTOP TO GRADE: 30.5 ' G. TEMPERATURE PROBE DEPTH:' 34:5" TIQHT~ YE8 C. TANK DIAMETER: ... 94.5 ' H. TEST LEVEL TO TANK BOTTOM t~0.00 ' .- NET TEST P RES,.,~JRE: 4.0500 ' D. TEST LEVEL ABOVE GRADE: 25.00 ' !. GROUND WATER ABOVE TANK BOTTOM 0.000" ~ STANDARD DEVIATION 0.00~3 E. DEPTH OF WATER IN TANK: 0.90 ' J. PRODUCT PRESSURE PER 1" HEIGHT: 0.027 PSI TEST DATE: 8-10-83 '., . ' '' - A.~,,~,4__&AAA TECHNICIAN: McCARTHY .. ,...:.: . ..' . . · ' :. ':.' j::.'.~.'~' ... '~'._,~__i ..- I:~, . . .-.. ,.. . . .- · _::~..,...' , '- : ': ._- ' ' "REDWINE TESTING SVCS., INC. · TEsT'METHOD: HORNER EZY'CHEKI PO BOX 1567 BAKERSFIELD, CA. 93302 CLIENT: MR: FAST (~05) 326:-0~,4,6 '- · CALIBRATION BAR OR LIQUID: BAR .,0.025 · ,, . LOGATION: $O0 SI~NDAGE ' CHART. , CALC. (A): .0.0~ / 15 = 0.0017 CITY, STATE: BAKERSFIELD CA TEST LEVEL: 150.00" (SYSTEM) TEMP CALC (B): .0.00059 X 10000 OIZ~: 10000 PRODUCT: UNLEADED SUPREME .. PROJECT NO.: BT - 0109 PRODUCTTEMP: 72 TOTAL LINE CHANGE: ' 44 ' COEFFICIENT: 0.00059 X 10000 = 5.9 TAN K TEb"T ~: LEVEL LEVEL GAIN + x(A) LEVEL TEMP. TEMP. GAIN + x(B). TEMP . FINAL " :', START,. END:. LOSS - x(A) RESULT START END LOSS -. x(E~ RESULT RESULT TIME 57 - 60 = 3 x 0.0017 = 0.0050 0.228 - 0.229 = 0.001 x 5.9 = 0.00~9 -0.0009 161(~ j'..,~ , 60 - 62 = 2 x 0.0017 = 0.0033 0.229 - 0.229 = 0 x 5.9 = 0 0.003333 t616 .~ 62- 65 = 3 x 0.0017 = 0.0050 0.229- 0.230 = 0.001 .x 5:9 = 0.0059 --0.0009 1622 '-:" 6:5 - 66 = I x 0.0017 = .0.0017 0.230 - 0.230 = 0 x 5.9 = · 0 0.001666 1628 · 66 - .67 = 1 x 0.0017 = 0.0017 0.230 - 0.230 = 0 x 5.9 = 0 0.001666 1634. · ' 67 ' 67 = 0 x 0.0017 = 0.0000 0.230 - 0.230 = 0 x 5.9 ~'- 0 ' 0 164,Q' 67 -- 67 = 0 x 0.0017 = 0.0000 ' 0.230 - 0.231 ' = 0,00! x 5.9 = 0.0059 -:0.0059 1646 ': 67 - 66 .= -I x 0.0017 = -0.0017 0.231 - 0.231 = 0 x 5.9 = 0 -0.00166 1652 66 - 65 = - 1 x 0.0017 = -0.0017 0,231' - 0.231.- = 0 .x 5.9 = 0 ': -0.0016~ 1658 ' 65 --' 64 = -l'x 0.0017 = --0.0017 0.231 - 0.231 = 0 x 5.9 = 0 : .-0.00168 i704 . 64 - 64 = 0 x 0.0017 = 0.0000 '0.231 - 0.231 = 0 x 5.9 = 0 ~' 0 1710 ~ 'r'~ -- 61 = :--3 X 0.0017 ---- --0.00~0 0.231 .-- 0'231 = 0 X 5.9 = 0 --0'005 1716 61 -- ' 59 = --2 X 0.00t7 = --0.0033 0--231 -- 0.231 = 0 X 5.9 = 0 --0'00333 ' 1'722 59 - 56 = -3 x '0.0017 = -0.00.50 0.231 - 0.23.1 = 0 x 5.9 = ~:0 -0.005 1728 56 - 56 = 0 x' 0.0017 = 0.0000 0.231 - 0.232 = 0:001 x 5.9 = 0.0059 -0.0059 1734 :. A. TANK BDT TO GRADE: 123.0" F. DEPTH FOR TANK SAMPLE: · 76.0" REsuLTs PER HOUR: . -0.03013 B: TANKTOP TO GRADE: 29.0" (3. TEMPERATURE PROBE DEPTH: 33.0" TIGI-f'~: YES .C: TANK DIAMETER: 9~1..0 ~ H. TEST LEVEL TO TANK BO'I-I'OM t50.00" NET TEST PRESSURE: . 4.0500 D. TEST LEVEL ABOVE GRADE: 27.00" I. GROUND WATER ABOVE TANK BOTTOM 0.000" STANDARD DEVIATION. 0.0022 " E. DEPTH OF WATER IN TANK: 0.00" J. PRODUCT PRESSURE PER 1' HEIGHT: 0.027 PSI TEST DATE: 6-11-93 .*.," i~.,&A,4,4 ,a, TECHNICIAN: McCARTHY -.., . ~...~*_'~V~RO~..~_~.*'~.~_.d . . CALIF. LIC. NO. 94- 1061 ' " q'~l /,"~r'~v'*""~"~...v~.'''~-''''x 1~'~ ~,, '. uL -q' ... . *,. - 7._.- : . City of Bakersfiel~-- ~iDate ........~..~.~..z... ......................... TRANSMITTAL SLiP Fro m~ ~.....~..~..~. ~.-.~....-...~,~,e~....~.~.~/... ................. ~,~°~ar,:u~-: []^~,o~ ~'or~ mo,,o~ O Please:-- [] Return [] See Me [] Follow Up I-1 Prepare Answer Copy to: ..... ~ .................................................................................................... Memo: .......................................................................................................... .... ~[.~ .......................................................................................................................... · ( Bus ine s s) ~ BUSINESS NAME SITE .LOCATION ACCO~T~N~ERS INVOLVED ~% f~/~ q ~ ~ ~ ' ' THIS INFO~TION IS TArN FROM-'THE DAILY ~PORT ~D SHOED BE ~RIFIED PRIOR T0 ~Y C~GES. : DISTRIB~ION: Sani:ation Wastewater BuSiness Licenmes Mazardous ~:erials