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Home My WebLink AboutUST-REPORT 11/2/1998 Prevention Services Unified Permit SUBJECT TO CONDITIONS OF PERMIT THIS PERMITIS ISSUED FORTHE FOLLOWING: , ~,~.;~.-.* '..* .. **?'%~ ~ ~.~ [] Hazardous Materials Plan I:}I::I~IMIT II't ~/1t ~Jl~'l Jlttt ~'}t ~,' .... - · ....... . - .... -~, I~ Underground Storage of Hazardous Materials ~:.'r' ! .~ ~' ..~ ,~, :'-~ ~'~-' ,~,.-% ...... -' · '. ~,~. [] California Accidental Release Program FREEWAY LIQUORS ?,-.! .~.~:~i~i~' ',..-.~,-.-..~ ~:~,;~.,. ~}_:'.t.i~;, f~--.., ii~:, .,~ ~.:i!~,~,.., [] Hazardous Waste Generator and/or Treatment /*,,.: ~-:.~%,..~: .-:q ~ ................ ~ -., '"-~'*. ,~: .~.,.~: .,,.':.'. · .?,. [] Above ground Storage Storage of Petroleum ,4, ~ ~:"' ~::..;~ .,:;,,." ~-,. '?~ ~'~. ,~? -~.,. - ..... ..~' '.~'~ .., - 'f:. DPmntSprayBooth 2030 E. BRUNDAGE . ~.,., :,~ r~:, .:.~, ?:.~ .... . ..: : :,: .. ?'..~ ;~...~.:.....~. ~NE ~' ~ A ..~ ..... . ..... ~". ~' ~}- ::~ ~...- i ~ Industrial Hood Suppression System BAKERSFIELD, CA 93307 ,~, ,~-~ ::.? .,~.~,. ~: . '.:., .,,~'-... ~ .... ~ ~.~ ~, .5 ~ ..., . ,,, . 2. ~ular unlade, 15~- ~:DWF,Q'~pi~':.DWF.~TM ': '~ ~'~?~,,.. ,. ~:..,, ~ ~..~: ~s,~ ~,~ ~.... · *~...~. ~ .~ ,. .~.:,,~... . , ~ , ~ 1715 Chester Ave., 3rd Floor Approved by: u f, Director--~ ':..,~= F~ '.~;?; ~Ee~s~e[d, CA 93301 Prevention se~ices Voice (66;) 32~-3979 "' "~:.~:: .... ~:' June 30, 2006 ~:~;~'~* F~ (661) 852-2171 Explrofion Dote: ~,.., .... Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is Issued for the followin_.: [] Hazardous Materials Plan [] Underground Storage of Hazardous Materials Permit ID #:: 015-000-001321 [3 Risk Management Program FREEWAY LIQUOR STORE [] Hazardous Waste On-Site Treatment LOCATION: 2030 E BRUNDAGE LN ~: 'l '~. :.' i' . ' .~' .~-~:: -~,~ " -"' ~'~ TANK HAZARDOU~'S06~tAN(~ ,.-':.,,:,,. CAP~C~ ~?, DISPEN~ER:0~NS':MONITORING 01 5-000-001 321-0001 PREMIUM 015-000-001321-0002 REGULAR UNLE,~DED .¢'}~ ~,,~:.::~:.;;:::.:~ 0 :':~' ''!~' ?s~'"' :~ ~? :'~ '~ :' OFFICE OF EN~RONM~NTAL SER VICES · ~~O 1715 Chester Ave., 3rd Floor Approved by: Issue Bakersfield, CA 93301 OmceofEviron~S~ic~ r Voice (661) 326-3979 F~ (661) 326-0576 Expiation ~t~: Permit to Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ·............... ~?~,~,,?~,,,~,~, ................ This permit is issued for the following,~ ~,~'"'~i~:::i: i]C~:':~:~::~''~':'~':~:i ;~?~ii~,;~,. :.~ii!!! i~ ~} iii;;'-::} iii :,:~U~e:rground Storage of Hazardous Materials ............. ?!~ 'i[=' .~ FREEWAY LIQUOR STO~ i.; ................ ~i!!~!,i~!~:.:~ii:.~....:. il, ~ ",, ~', ~' ,~!~,~,.... ~:' ~' . .. , '~l~l~!~i~, "r'~'~" "' :~'' '""'"';~ ~T''' '' ''' '*~ ~ *'~' "~:' ,,if]'i~t~l~,i;;i ~il t"~ ........ "~'"'~" .:'.~ 3:.:::.: i;~ '.. T~K H~OUS S~ST~CE C~ACI~ "~ t,,~,,,~,~:4~,;i .,T~K T~K ..,0" ~ PIPING PIPING PIPING :*~:~Z~ ~ '%~ - .... 0001 Unleaded G~oline 15,000~:"::"'~/.~',~,, ,~aE?':;: ~:'~'ftO~ DW ...... ,:'"~',"~ .,,,,~'::5~'~''' .,d' ':,~ G D~lex P~SS~ ~D 0002 Supreme Unleaded 12,000 %.. ':~fl'"~r ,ffl/0f/~9:~::::::::;:: D~lex ':~t,.,.." ..-. "%,." .~I; 3~~',I ~';~' ;~I ~i~;,~,~;~~' ~i~, '.~ ".,,,~,"? ~ ; ~ B~ersfield F~e D~ment Approv~ by: [ gP:~ ~:~~ ' OFHCE OFE~RONME~AL ~ WCE$ 1715 Chewer Ave., 3rd Floor B~e~el~ CA 93301 ~ VoiceF~ (805)(805) 326-3979326.0576 Expiation Date: June 30.. 2000 City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (805) 326-3979 An upgrade compliance certificate has been issued in'connection with the operating permit for the facility indicated below. The certificate number on this facsimile matches the number on the certificate displayed at the facility. Instructions to the issuing agency: Use the space below to enter the following information in'the format of your choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility; facility identification number (from Form A); name of issuing agency; and date of issue. Other identifying information may be added as deemed necesSary by the local agency. This permit is issued on this 2nd day of November, 1998 to: FREEWAY LIQUOR STORE Permit #015-021-001321 2030 E Brundage Ln Bakersfield, California 93307 rmit Underground Hazardous Materials Storage Facility CONDITIONS ~i P~~~ ~ alEVERSE SIDE -:~::Cood~!~S.::;subject to change?m.:cegulat~s~? aAZAROOUS MATERIALS D~WS~ON ...................................... kkOYD G. CHIkDERS 1715 Chester Ave., 3r~ Floor FREEWAY LIQUOR STORE Bakersfield, CA 93301 (805) 326-3979 2030 E. BRUNDAGE ~NE BAKERSFIELD, CA 93307 Approved by: ~~. IsCoordinator Valid lrom: 12-22-03 to: 12-22-05 ls~a ~ UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD t UNE TESTING S6989 SECONDARY CONTAINMENT TESTING (TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. BAKERSFIELD FIRE DEPT. flR1 ~@V@II~OII ServiC@8 w~fall ! 900 Truxttin Ave., Ste. 210 ~. Bakersfield, CA 93301 Tel.: (661 ~ 326-3979 Fax: (661} 852-2171 Pape 1 d 1 ^ ENHANCED LEAK DETECTION ^ ^ S8-a64 SECONDARY CONTAINMENTTESTWG r--i ~ ~__~. ~. ..1............~.....".. ._. _ .. .. FACILITY NAME S PHONE NUMBER OF CONTACT PERSON ADDRESS ' OWNERS NAME OPERATORS NAME PERMIT TO OPERATE N0. NUMBER OF TANKS TO BE TESTED • Z ~,~.2r~- `~ 1 . ~.:.. YAN~.,TEST{NG CONtPANY • ,. .. _, NAME OF TES 0 C PAN NAME PHONE N R ONTACT PF,{2S N MAkINO AD S NAME S PHONE UMBER OF TESTER r SPECIAL INSPECTOR ~ CERTI (CATION i. DATE ~ TIME TES 0 E ONDUCTED ~ ` ~~~~ ICC ft:.~ n ~ ~ / ~ ¢U „r TEST METHOD v~ `'Y CJ SIGNATURE OR APpUCANT ~' DATEa APPROVED BY DATE FD 2095 (Rev. 09/05) UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING I SB989 SECONDARY CONTAINMENT TESTING (TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION BAKERSFIELD FIRE DEPT. ~~R~ Pr@ve11t10II Servic@8 AIrTM T 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 ,Fax: (661) 852-2171 Page 1 of 1 PERMIT NO. T t ' Q~~ O i ^ ENHANCED LEAK DETECTION ^ LI ^ SB-989 SECONDARY CONTAINMENT TESTING I-I T4NK TIf:HTNFSS TFRT Tn PFRFnRM Fl1FL M[]NITnRINC CFRTI ITE 1NFO R FACILITY ~% - NAME & PHONE NUMBER OF CONTACT PERSON ADDRESS ~ ~ .'- OWNERS NAME OPERATORS NAME PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOIN TO BE TEST D? YES ^ NO T ~V~L ME CONTENTS ~ _ ,_ u% v Z _ ~~'•-e_v~- `~ 1 TANK,TESTt NG COMPANY ,., ...: NAME OF TES G CO PAN ! NAME PHONE N R 0 ONTACT PERSON MAILING AD S r NAME 8 PHONE UMBER OF TESTER r SPECIAL INSPECTOR o --~~ CERTI (CATION #: DATE !i< TIME TES O E~ONDOUCTED ~ ~ ~~^, ~^ ICC #: ~~ ~ ~ / ~ ¢/~ ~ ~ '--( V TEST METHOD SIGNATURE OF APPL, ANT C' alit DATEa r' APPROVED BY ~;- DATE q FD 2095 (Rev. 09/05) i BILLING & PERMIT STATEMENT BpKERSFIELD FIRE DEPT. Prevention Services JR1R~ 400 Tnixriin Avenue, Suite 2I0 ?ERMIT NO.: ARTM f Bakersfield, CA 93301 Tel.: (6 11 3 6-3979 S Fax: 1661} 852-2171 • LOCATION OF PROJECT c}~ ~~ ~ 1 ' ~`~ - ~ • PROPERTY OWNER COMP DATE ~ START WC DATE . NAbE PROJECT NAME ~ ADDRESS PHONEN ~ ~QC~I pROJECTADDRESS n ~ _/ O ~ j' ~C.l ~ C n pL CtrY ~~ STATE ~ Z~ CAD ~ ~~ • • - CONTRACTOR NAME G LICENSE NO. • ~ ' • TYPE Of LICENSE. EXPIRATION DATE PHONE N0. CONTRACTOR COMP NAME / FAX N0. ~~ ~ ^ ~` ADDRESS CnY ~ 7JPCODE ~30 t< • ~ ~ 262 50 ^ ' i ~ Alamts -New 8 Modifications - (Minimum Charge) . $ 98 FL O 0 000 013125 = Permit fse S FL x ~ p ver 2 , Sq. q. . 98 ^ ~ M Ch i kl difi ti Mi i S s $210 00 ~ g n mum arge) n ons - ( pr er - New o . 98 ^ 5 O 000 S Ft S 042 = Permit fee Ft x ~ , q. ver q, . 98 ^ Minor S rinkler ModiflcatiorTS {< 10 heads) ection Only) 00 [Ins $ 83 ~ p p . sa ^ Commerdal Hoods -New & Modifications $ 39826 ~ 98 ^ Additional Hoods $ 3600 ~ . 98 ^ Spray Booths -New & Modifications $458 00 ~ . 98 O Aboveground Story a Tanks (IrrstalfaborTitnsp: l' Time) $165.00 82 ^ Additional Tanks ; 28.00 ~ 82 ^ Atxrveground Storage Tanks {Removairlnspectbn} $109:00 82 ^ Underground Storage Tanks (/nstailatian.llnspectionj $878.00 { rtarilc) 82 ^ Undergrourxl Storage Tanks (Modification) ~ $878.00 (per Sfte) 82 ^ Underground Storage Tanks (Minor Modfiwtion) $155.00 82 ^ Underground Storage Tanks (Removal) $675.00 ( rtank) 84 ^ Ollweil (Installation) $ 7200 ~ 84 Mandated Leak Detection (Testi } I Fuel Monit. CerL $ 81.00 (per site) BZ ^ TeMs $93.00 (percent} 84 ^ AftarhoursJnspectlon fey $922.00 ~ 84 ^ Pyrotet~inic - (Per evert, Plus insp. Fee ~ 590 per hour) $ 60.00 + (5 hrs. min. starve -by tee nnspecbon) _ $590.00 84 ^ REdNSPECTlON(S} /FOLLOW-UP INSPECTION(S) $ 53.00 (p>er hour) 8a O Portable LPG (Propane} NO.Ot= CAGES? $ 66,10 t34 O Explosive Storage $249:00 84 ^ Copying 8 File Researoh (File Research Fee 533.00 per hr) 25¢ per page ' 84 ^ Miscelianeous : 8a l~ 2021 IRev. 08/05) 1 -ORIGINAL 1NHITE (tb Trrassury) 1-YELLOW (Yo Flla) 1•PINK (to Cuntomerl u y.- _ .:~ ~~~ . MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of Cali ornia Authority Cite& Chapter 6 7, Health and Safety Code; Chapter 16, Division 3, Tit e 23, California Code afRegulations This form must be used to document testing and servicing of monitoring equipment. A separate certification ~r report must be areaare for each Inonitori~ system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information `' Facility Name: ~i~l/~WA`~ t_.Zt3UG~kS Bldg. No.: Site Address: ~'~l0 ~• 8,~~~'~G--~ E /_nl• _ f City: ~A - SF=~~~ Zip: ~ ~7 Facility Contact Person; ~EX G lk~L.D'!/+~~ Contact Phone No.: (_^~ Make/Model of Monitoring System: ~1---5 " ~SO Date of Testing/Servicing: ~1~1 Q~ S. Inventory of Equipment Tested/Certified _ INSPECTOR ON-SITE: YES/ 1~yAME: NDN ~ Check the appropriate bores to indicate specific eq[npmenl ~nspec[enBerviceo Tanl: lU: U~t- Tank ID: ~~ fii 'T'ank Gauging Probe. Model: _(~ fdl Annular Space or Vauh Sensor. Model: _ 4 ~ In-Tank Gauging Probe. Model; L^x- ~. Atvtular Space or Vault Sensor. Model: Piping Sump /Trench Sensor(s). Model: ~ Riping Sump /.Trench Sensor(s). Model: ~ .Fill Sump Sensor(s). Model: ~O'$ ~ Fill Sump Sensor(s). Model: ~ ,Mechanical Linz Leak Detector. Model: ~.~fl ~ ('~Gti~-'C Mechanical Line Leak Detector. Model: ~~~ ,)I~-~C~ ^ Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: ^ Tank Overfill /High-Level Sensor. Model: ^ Tank Overfill /High-Level Sensor. Model: ^ Other (s ecif ui invent t e and model in Section E on Pa e 2 . ^ Other s eci ui ment pe and model in Section E on Pa e 2 . Tank ID: Tank ID: ^ Tn-Tank Gauging Probe. Model: ^ In-Tank Gauging Probe. Model: ^ Annular Space or Vault Sensor. Model: ^ Annular Space or Vault Sensor. Model: Q Piping Sump 1 Ttench Sensor(s). Model: ^ Piping Sump /Trench Sensor{s). Model: ^ Fill Sump Sensor(s). Model: ^ Fill Sump Sensor(s). Model: ^ Mechanical Line Leak Detector. Model: ^ Mechanical Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model: ^ Tank Overfill /High-Level Sensor. Model: ^ Tank Ove~ll /High-Level Sensor. Model: ^ Other (specify equipment type and model in Section E on Page 2). ^ Other (specify equipment type and model in Section E on Page 2). Dispenser ID: ~ L~ Dispenser ID: ~ r~ ,Dispenser Containment Sensor(s). Model: _ '~ _ Dispenser Contai mn ent Sensor(s). Model: ._•_ [?3•.Sltear Valve(s). ~5hear Valve(s). ' ^ Dis nser Containment Floats and Chains . O Dis enser Containment Floats and Chains . Dispenser ID: Dispenser !D: ~ Dispenser Containment Sensor(s). Model: ($.Dispenser Containment Sensor(s). Model: a4 ~•Sltear Valve(s). Shear Valve{s). ^ Dispenser Containment Float{s) and Chain(s). ^Dis enser Containment Floats and Chains . Dispenser ID: Dispenser ID: ^ Dispenser Containment Sensor(s). Model: ^ Dispenser Containment Sensor(s). Model: ^ Shear Valve(s). ^ Shear Valve(s). ^Dis enser Containment Float(s) and Chain(s). ^Dis enser Containment Floats and Chain s). *lf the facility contains [Wore tanks or dispensers, t:opy this form. Include information for every tank and dispenser at the facility. C. CertiflCatlOri • I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this Information Is correct and a Plot Plan showing the layout of monitoring equipment..For any equi men[ capable of generating such reports, 1 have also attached a copy ot'tlte re ort (check all that apply).• f2~. ystem set-up ~tarm history report "technician Name (print): ~2Anj ,.,} ~ Signature: .%+T`..~ -,. Certification No.: ~~{T~3 s License. No.: sa~'~(~$d- t~ ~` Testing Company Name: RICH ENVIRONMENTAL Phone No.: {~~} 392-8687 Site Address: pZtlla© C $~t3NO~C-1~, ~N t '~E}k~'R~~Tr~E~-~ ,~A Date of Testis /Servicin ~ / Page I of 3 031U1 Monitoring System Certification _ ~, D. Results of Testing/Se//rvicing Software Version Installed: ~(O • O f'.__._~I_l_ aL_ r_11 _...:_.. .L.... t. 1...l. V Yes ^ o [s the audible alarrn o erational? Yes ^ o Is the visual alarm o erational? Yes ^ o Were all sensors visuall ins ected, functionall tested, and confin•ned o erational? Yes ^ o Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their roper o eration? ^ =Yes D o If alarms are relayed to a remote monitoring station, is alt communications equipment (e.g. modem) ~NlA operational? Yes ^ ~ For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment O NIA monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check alt that apply) ~. SumpJTrench Sensors; Dispenser Containment Sensors. Did you confirm ositive shut-down due to leaks and sensor failure/disconnection?,Yes; O No. ^ Yes ^ ~ For tank systems that utilize the monitoring system as the primary tank overfill warning device (i,e. no N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill oint(s) and o eratin ro erly? If.so, at what rcent of tank ca achy does the alarm tri er? ^ es No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer Warne and model for all re lacement arts in Section E, below. ^ es No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ^ Product; ©Water. If es, describe causes in Section E below. Yes O o Was monitorin s stem set-u reviewed to ensure ro er settin s? Attach set u re orts, if a licable , ~- Yes ^ o Is all monitoring equipment operational per manufacturers specifications? "' In ~ecnon 1J below, Uescrlbe how and wrien these aeticllencies were or wttl de corrected. E. Comments: Page 2 of 3 I 031 O I ~; .. _ (~~ay F. In-Tank Gauging /SIR Equipment: Check this box if sank gauging is used only for inventory control. 0 Check this box if no tank gauging or SiR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. ^ Yes-'v ^- o - Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ^ Yes ^ o Were all tank gauging probes visually inspected for damage and residue buildup? ^ Yes ^ o Was accuracy of system product level readings tested? ^ Yes O ° Was accuracy of system water level readings tested? ^ Yes O o Were alf probes reinstalled properly? ^ Yes © o Were all items on the equipment manufacturer's maintenance checklist completed? in the aectlon n, oelow, aescr~oe nuw anu wnen ~nese aeucleuc~cs wrro v, w,it uc c~~ ~ ~~.~... G. Line Leak Detectors (LLD): ^ Check this box if LLDs are not installed, !'mm~lwtw t6w fn lln~inn nfiwn 4liet• ,-Yes ^ N0' For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ^ N/A (Check all that apply) Simulated leak rate:.-3 g.p.h., ^ 0. 1 g.p.h , ^ 0.2 g.p.h. ,$.Yes O o Were all LLDs confirmed operational and accurate within regulatory requirements? Yes ^ o Was the testing apparatus properly calibrated? Yes ^ o For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^ N/A ^ Yes ^ o For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ~N/A ^ Yes O o For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ~- N/A or disconnected? ^ Yes ^ o For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions NIA or fails a test? O Yes ^ o For electronic LLDs, have all accessible wiring connections been visually inspected? N/A Yes O o Were all items on the equipment manufacturer's maintenance checklist completed? rn u1e aeclwn n, uelow, aescrtne now ana wnen tneSe aeuclenctes were or wilt de corrected. H. Comments: Page 3 of 3 03101 l 5 Cn ~ ~ Monitoring System Certification UST Monitori Site Address: Site Plan -- ------ --- ;~----- --- --------- ~_--_--`- - - i ----- - - -- - -- ------------- Date map wasdrawn: a / J(o /D7 Instructions If you already have a diagram that shows all required information, you may include it, rather than this page, with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes {if used for leak detection). In the space provided, note the date this Site Plan was prepared. Page ~ Of~ os~oo 3~ ~Sc~ag 5643 BROO)~S Gx 4~+~CElt9FIF.I+D, f.A.933p$ oF'k'~C7R (5623 3926687 & FAX (662) 35i~••06~2 M13~Fii~I51r~AS~.S~~K~S~gCmeR TX!g~_r 1~ORIt S~fEE'I' WJO#z a Fae:l.lity Nama~_~I~EEwA~' t.~I'fi~l~.. Fa~a;l.13.Ly ~.ddx~~ss; a~~O ~~„ 1 ~i2~N,pA(,-~E- L/~,-~1~ E,~°5F2EG~ jC/~ Proc;luaC Lirze ~P~ {3?ressuse, Buc#iozt, t~ravl.ty) ~/' ~y~~ PRC;IDUCT LEAK DETECTOR TX~Ii TEST TRT$ DABS; sl~t~ ~craaa~R 88LOW F8I OR .. ~/n ~xa~>~ c~R~ksr ~~ ~- 8~ - .:9E~tIAL # IYIEc:NAN~cA~- ~a /~ :P~ _ L/A ~'XPR ~ RGk£T S J'A8 , / ~ --• BRRZA,Te #l~FC1/ANS«4e.- 1Q0 ~~, Li L/D 'PYPI?~ YES PA88 s$RTAT, # kI0 )TA2L L/i.} TYPE ]tB8 $ASS 88R2AX~ # ___._..._...~ bf4 1RA,2L' I ::arti£y th.e ak~auP tests were ednducted on thia da•Ce acaoxdi.ng Ea Red .~aaket Pumps Field Lear. apPaxaGua testing pzocedure an limitat~.ona. TtbE! Mechanical Leak DetecCor. Test Pass / fail is detex~+nined by n~ing a la~u flow threshold tr~.p rate of 3 gallon Per hour or lase at 10 E~BI. I •:~cknowl~dg9 tkxat a]. ]. data oa~,laated 3e true axed aorreat to Glee .best of rr~~ knOWlEdg'P_ ..a ~ ~ a `~.. Tech : ~~_~(.J'n ~ t3.~i~ Sigu•:~Cuze: ~ ~~" Date x a-~~ -Q~ a~. 4 5 ~~~ SWRCB, January 2006 Spill Bucket fiesting Report Form This farm is intended for use by contractors performing annual testing of i/ST'spill containment structures The completed form and. printouts from.tests ({f applfcableJ, should be provided to the facility.owner/operatorfor submittal to the local regulatory agency. r~ •wK ~ raTY~ATiR f R'YAl-T ' j. 1•Li1~11-~11 l 11•~a' vau~a~ a a~va . Facility Name: }2E1:t~ t~1 L,t C>Z E2 Date ofTesting: al _. J -p Facility Address: ~ L( ~, . ~ N G ~~ ' C~l~ v9 Facility Contact: G G l., Phone: Date Local Agcncy W as Notified of Testing : ~, ' Name.of Local f~gency Inspector (i, jPresent during testing): ~ NOn1 E • 2. TESTING CONTRACTOR INFORMATION _Company Name /1 rGH l;~ ~ ~ '~~~ /nENT1~L-- ~ ~ ~ , .Technician Conducting Test: ~~/~~ /Ylt~Sp~ Credentials°• CSLB Contractor CSC Srern'ce Tec SWRCB Talc Tester CKher {Sped) License Number{s)• ~$+•t98 d ~ ~?'~ - ~ anrr t nYTnrr~~r ~r+acTrATn_ t•ns~nvMATTl1N Test Method Used: H drostari Vacuum Othei Test Egtupment U>;ed: V'~SV ~L Equipnieat Resolution: Identify Spill Bucleet (By Tank Number, Stored Product, etc. 1 ~ .7 2 ~ ~ 3 4 Bucket installation Type: Duec ontained in Direct I3 in S Direct Bury. Contained in S Direct $ury Contained in Sum Bucket Diameter. ~.~ „ / ~ ~ . Bucket Depth: •~ l a ~ ~ Wait time between applying vaanum/watar and start of test: 3U ~~ 3O n-~'/v Test start Time ('I'~: ,'3 v t~tr. 9.3 ~ H h'~ initial Reading (R,): ~ it q ~ ~ Test End Time (TF): ~~; 6 A-'~ ./d•:3~ M Final Reading (RF): 'c c/.'t Test Duration (Tp - T~: ~/~ Change in Reading (RF-R~: it 0 t~ Pass/Fai] Threshold or Criteria: Comments _ ('include informa ~, O t ~ 0 tion on repairs made prior to testing, and recomme nded follow~up for failed tests') • - ~. CERTIFICATION OF TECHNICYAN R1rSPONSIBLE FOR CONDUCTING THIS TESTING I hereby eertijy that all the injorxeatiox contained ix this report u bue, accurate; and in jell compliance with legd requirement Technician's Signature: "~ ~ ~ ^"~ ~ Dater-/b -d 7 1 State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requinenocnts may be more stringent. ~~ ~ IN PER}UDI~ : u , LEAK M ;~UFT6JARF. REV I S I t)N LEVEL CONth1UNICATI0PJ8 SETUP _ _ _ _ _ _ _ _ _ _ _ _ LEAK. MIIJ ANNUAL 25°~ ?Og 1 VERSION 16.05 SOF•fWAREp ~i46U16-~lUO-F ' ~`;kEATED - 98.08.21.15.55 PORT :;ETT I NGS : PER I GU 1 C TEST T`!PE STANDARD hJU SOFTWARE MUDDLE NUNS FOUND SYSTEM FEATURES: PERIODIC IN-TANK TEST kS-232 SEGURiTY AI+INUAL TEST FAIL ALARM DISABLED ANNUAL ICJ-TAND: TESTS CODE OGOOOU PERIODIC. TEST FAIL ALARM D I SF+BLECi GROSS TE~T ALARM DISABLED RS-232 END OF' IhESSAGE DISABLED APJN 'fF.::,T F-VERAG 1 NG : UFF PER TEST AVERAGING: OFF S:'S1'Eri :SETUP _ TANK TEST IVOT I FY : OFF FEFi 16. ''>oo? 11:43 AM TNK TST SiPHOIV BREAK :OFF DEL J VER'! DELA`! 1 P'1I tV S;`:~TEI°t UNITS U.S. SYSTEM LAPJ<~UAGE I N•-TAN}: SETI IP EIVGL I5H . SYSTEM DATE!'f 1 ME FORMF3T _ _ _ _ _ _ _ - - _ ~ - - P'IUJ'•I DD Y'i'Y'! HH:WII°I:SS x:hl T 1:UNLEADED kEGULF~R FREEWAY' LI+aUORS PRODUCT CODE ! '2140 E. BRUfJDAGE THERMAL COEFF :. UU07U0 BAKERSFIELD. CA TANK DIAMETER 90.OU • tiU5-323-0254 TAIVK PROFILE 4 PTS T 2:PREMIUhJ UNLEADED FULL VOI. 11527 PRODUCT CODE `'' SHIFT T 111E 1 l l : UO PI°1 67.5 I INCH VOL 9397 THERMAL COEFF :. UUO?UO SHIFT T } I°IE '? D [BAWLED 45.0 INCH VGL 585'7 TANk: D I AMF.TER 90 . UU SN I f T T I 1°1E 3 D 1 SABLEL; 22.5 INCH VOL 22£f9 TANk: PROFILE 4 PTS ~1H I h'T 'I' I ME 4 DISABLED FULL VOL 1 1527 5397 . r;7.5 INCH VOL TANK PER I UD I C tJARlV I 1VGS FLOAT SIZE : 4 . ~] I N . 849E. Q5.0 INCH VUL 5857 U I SABLED ?2.5 INCH VOL 22139 TANK ANNUAL WARN [ IVES WATER WARI'J1 NG 2. U DISABLED HIGH WATER LIMIT: 3,0 LAVE PERIODIC WARNINGS FLOAT S}ZE: 4.0 11V. 13gy6 DISABLED MFt;~: OR LABEL VOL : 1 1527 LINE ANNUAL WARNINGS OVERFILL LIMIT 95% WATER WARNING : 2•U DISABLED (0550 HIGH WATER 1.1M1T: 3.0 HJGH PRODUCE 95i PRINT Ti: VOLUMES 10950 J°tAX Ok LABEL VUL: 11527 C~ISABLED DELIVERY LI1°117 18 OVERFILL LIMIT 1 1U95G TEI°1P COMPEIVSATION 95 HIGH PkODUC7' VALUE CDEG F ): 60.0 LOW PRODUCT 500 1U950 STICK HEIGHT OFFSET LEAK ALARrI LIMIT: 24 DELIVERY LIM1T I'-~ D[SABI.ED SUDDEIV LOSS LIMIT: ~4 1383 DA1'L I GHT SAV I t•JV T I NIE TANk; TILT 0.00 ENABLED 500 LOW PRUDUi:T ' STAF.1' DATE MAN I FOLDED THINKS LEAK ALARM LIMIT : 24 APR WEEK t SUId Ttt: NONE SUDDEN LOSS• LIMIT: 24 START TIME TANK TILT O.UO 2:UU AM EIVD DATE MAN.1 FOLDED TA1Vb'S OCT WEE1<: 6 SUIV Tt3: PJONE ' EIVD 'f1ME 2:U0 AM LEAK M1N PERIODIC: U.°-b 0 f.;`(STEI°I SEA: UR 1 T`! t:vDE UUu000 LEAK M1 N F1NhJUAL 25%: 213131 ~ s~a~ PEk I OD I G T'ES'f TYPE Oll`fFUT' RELAY SETUP STAPJUARD - - - - - - - - - - - LI~aillD SEI'~4R SETUP A)VhIUAL TEST FA [ L - - - - - - - - - - - R 1 : D 1 SPENSER RELA'!S ALHRP'1 U 1 SHHI.EG TYPE L 1 : UIVLEADEG STF' SUMP STAIVDARD F'Ek 14U 1 C TEST FAIL TR I --STATE {SINGLE FLOAT' i NORMALLY GF'EPJ ALARM GIF:ABLED CF1TE~:;OkY S7'P SUMP Gk4S5 TEST F'H I L I Pl-TAhlK AL.ARI°iS ALARM U I SABLEU L 2 : PkEM I UP9 5TP SUMP ALL, :LEAK r;LARh1 TR 1 -STATE t `•~ I (NGLE F1.4AT' i ALL :HIGH 4JATER HLARM HPJN TEti I' AVEkAG I NG : UFF CAT'EGUk1c' STP :~U!°iP ALL : LGW PkODUr:T ALAkP•1 PER TEST' AVERAG l IVG : 4FF ALI, :GROSS TEST FA I L TANK TEST N4T1FY: 4FF L 3:UNLEHDED FILL SUMP L,IC~UID SEPJSUk ALMS TkI-STATE {SIhlC,L.E FLOATi L 1:FUEL ALARM TNK T5T S, I PHC3(V BF'.EHK :4FF CATEGORY PIPING SUMP L 2 : FUEL. ALAR('1 L 3 : FUEL ALARM DELI +dEk`! UELHY l NI I (•J L :FUEL ALARM L. 4:PkEMIUM FILL SUF1P L S:FUEL ALARM TR[-S'fHTE {SINGLE FLOAT) L 6:FUE[. ALARM CATEGORY P]PING SUMP L ?:FUEL ALARM L B:FUEL ALARM L S: U I SPEIVSEk PAN 1 .2 TR I --STATE { S 1 NGLE FLOA'!' i GATF:~~4R'l G ISPENSER F'AfJ L 6:UISPF.'NSER FAN 1.2 LEHK TEST METHOD TR1-STATE (SINGLE FL4ATi ' - - - - - ~- - - - - - - CATEGOk`! DISPENSEk PAN TE,T I°14(VTHLY.: ALL 'I'AIVK _ t"]EEk: 1 MON ' ALARM H I ~;T'ORY REP4R'f START T 1 ME 2::30 AM TEST RATE :0.20 GAL.iHR L 7:UISPEPJSEk PAN 5.6 ~----- IIV-TFONK r;LARhI -------- IiUkAT I OIV 2 HOURS Tk t -STATE { S ] PJGLE FLOAT' i CATEGORi' DISPEN:~ER PAPJ T 1 'U(VL£ADEI; REGULAR LEAK. PEST' REPORT FORMHT :~E'PUP DATA WAkNIIVC; MAR 12. 1y99 8:41 Arl EhJHANCEG L 8:DISPENSER PA1V 7.8 TRI-STATE tSINGLE FLOAT? LEAK ALAkPI CATEGORY DISPENSEk FAN N4V 6. ;?006 4:;30 AM NOL! 1 . 2004 a : 30 AM 8EP 6. 2004 6:38 AIH L 9:lJNI.E;~fiED HNNULHR OVERFILL ALARM NGRh1ALLY CLOSED . AUG 24, 20C16 1 :51 F'Pi ~ CATEGORY ANNULAR oFA~.E IV4V 25. 2005 4:12 PM NOV 3. '2005 2:15 PM L10:PREMIUh1 ANIVUL.AR ' ' LOW PRODUCT ALAP,I'1 NOV 10. 2004 8:24 AI°I Tkt-ST AT E tS1NGLE FLOATf JUN 1. 2004 5:54 PM GATEG4kY APJNULARPACE SEP 16, 2003 4:1`IU Phl ~u!)liEN JAIV 1 . LUS:~ A 2007 LARhI 4:22 AM ALHRhI H 1 STURY REP+~RT ALARM H J STUk'1 kEPOk'[' NUV 6. AUG 7. 200E, 200E 3:55 AM 4:12 AM -- SENE;UR A1.ARhl ----- _._-. ---•-- SEN,3UR ALARri °--- L 1 : UNLEADED STP Sl1MP L 4 : PREh1I UI~I F 1 LL SUMP HIGH PRUDUt;'I' ALARht STP SUI°1P P 1 P I NG SUMP AUG ~4. 2046 1:51 P!N FUEL ALARIH 35 AI'1 FUEL ALARM 2007 B 16 9:4U AM . NUV 25. 2005 4:12 PM FEB lb. 2007 9: FE . NUV 3. 2005 2:15 PNI SETUP DATA 6VARIVI NG FUEL ALARM ] IVVAL I G FUEL LEVEI. APR 6. '20u6 7:55 ~"1 FEB 20. 2006 1 I : U5 AM NUV 10. JUN 1 . 2004 2004 & : 06 Firi 5:28 PI°1 5E'fuP DATA WARIVi IVG FUEL ALARM ' SEF' 16. 2003 3:40 PM APR 5. 2006 12:04 PM FEB 20. 2006 I 9:36 AP FRUBE U UT ' UCT 6. 2004 1 :33 i%hl DEL 1 ~.IER'; NEEDED NUV '~2. `?OOb 4:15 PP1 JUN 2. 2006 sill Arr UCT 23. 2005 y:20 PNI Mai; PRODUCT ALARM ~ ~ ~ ~ ~ EIVD ~ ~ ~ ~ ~ *. ~ ~ ~ EhJU ~ 'HUG 10. 2004 6:5;:1 FNI JUL 11.. 2004 1:53 PIh JUIV 27. 2004 11:17 AM I.OW TEhIP WAR,IV I NG OCT 6. 2004 1:44 PM ALARM H1STpkY REPOk'T ----- SENSOR ALARM --. L 2:PREh11UM BTP SUMP STF' SUMP FUEL ALARM +~ ~ ri ErJG ~ ~ ~ n ~ FEB 10. 2007 9:37 AM FUEL HLARrI FEB 20. 2U06 9:36 AM I'UEL ALARM OCT t5. 2004 10:51 Arl ALF3Rhl H I STUk : REF'Uk'T AL.AP.I~I H I STUR :' REPURT ---•--- SENSOR HLHkrI -- L 5:UISPENSER PAN 1.2 'DISPENSER FAN FUEL ALARM FEB 16. 2007 10:19 AM FUEL ALARM FEB 20. 20u6 9:59 Arl FUEL ALARhI UCT 1: 2003 10:28 Art ---- IN-TANJ. F3LARf°1 -- --- T.~.: PkEM I UM UIVLEADED .* ~ x END ~ ~ ~ ~` * x ;~ ~ x ~ END ;c * x SETUP DHTA WARNING MHR 12. 1999 7:41 AM o1lERF' I LL ALARM rlAk 12. 1999 1:54 PM MAR l'?. 1999 1:51 PM MAR 12. 1999 1:47 FM SUDDEIV LOSS; ALARhI OC'I' i. 2002 4:07 AM 1 LAVAL I D Fl1EL LEVEL pL.f=lkhl H 1 S7'(ik`! REFUkT ALARhI H I ST(iRY REPURT JLII_ 1 U, 2006 6:26 ALAI - SENBUR ALARM •- --'-- -_--- SEIVSOR ALARI°t ------ PkUBE UUT L 3: UIVLEADED F I l.L SUhIF' L 6: D 1 SPENSEk PHN l. 2 UCT 6. 2004 1: 1 l Pr1 P 1 P i Nr; SUMP D I SPENSF.R PAN FUEL ALARM FUEL ALARhI FEB l6. 2007 tU:02 AM FEB 16. 2007 l0:1b Fih4 I)k,l. I VERY PJEEUEU JAIV 16. 2007 7:53 AM FUEL ALARM FUEL ALARM JAN ! 1 . 2007 12: ! 9 PNI IVUV 3, '~Ul-it:~ 1 ! : 5~ Ath FEB 20. 2006 9: 5b AM PEG' 12. 2006 5:5y FPM FUEL. ALARM FUEL i~LAkM - FEB 20. 20ur 9::i6 AM OGT i. 2UG3 10:27 Ahl r ~~ a~ HLAkri HiSTUkY REF•~~RT ` R1=P(?kT ` , ALARM HtSTUh ---_. - .~ENSUk ALARM -~ --••- L 7:1JISPENSEk Pi;N 5.6 - ,Etd£;i~R ALARM --- L I;;FENSER PAN L_ G : UNLEADF.Ii ANNULNR FUEi. HLAkM At1NULAR SF'HCE F'E$ l6. 2U07 (U:'~'9 Fd~t FUEL ALAF.M y:55 Ahl FEH 16: 20U7 FUEL HLAkM FEB 217. 20U6 I U:36 AI•I 1=L~L ALARM 11:5`7 HM NOV t3. 2006 FUEL r;LARM UCT 15. 2004 1 1 : l ] aM FUEL ALARI'1 ~- Apt 8: ,2 . PlOV 3• 2Q0G ;~+~x~~ENV,~x:~r.E *.;~ * * ;~ ~ ~ cNn *.,~ ALHkhI H[STURY kEF'ORT kEF•UkT ` ~ ALARM H1STt~k ---•..- BENSGt2 ALf;Rhl ----._. L B:DISPENSER D I SPEIVSER PAN PAN i'.8 ___ -• uEl`1SUk ALARM. ---~ I"I t Ut"1 ANI'1ULAR Ll U : PRE FUEL A1.AF.M ANNULAR SPACE F1:B 16. 20U? 10:32 AM SEP+ISOR BUT ALAW'I 11 :25 AI°1 F£H l ti. 2U07 FUEL HLARM f'EB 20. 2UU6 10:11 AfM FUEL ALARM 9:51 AM FEB 16. 2UU7 FUEL ALAkh1 MAk 3. 2005 4:58 r~!'1 FUEL ALARM _ 5:30 Plh FEB 7. 20U7 ~s~~~ MONITOR CERT. FAILURE REPORT _ ., SITE NAME• F1~~ WAS L`.r~U~1~ DATE: 2 -1 b-O'7 ADDRESS• rr~!)i-(O G• R~~~v~A(aE t-rVTECFIlVICIAN: 23/~A~~a.~ /"-'~f~~ON CITY•~!'~l~x'b~S°UL_~ SIGNATURE: ~-..-~ -- THE FOLLOWII~TG COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE TESTING. REPAIRS: ~vUN~- LABOR: NC7,~ G PARTS IIVTALLED: /UG ~~ NAME• TTTLE• SIGNATURE: THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF N07ZFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVII20NMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON-COMPLIANCE. A COPY OF THIS DQCUMENT HAS BEEN LEFT ON SITE FOR YOUR CONVIENENCE. UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING / S6989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION BAKERSFIELD FIRE DEPT. E~R~ Prevention Services ARf~I f 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Pie 1 of 1 PERMIT N0. ~~'" V ^ ENHANCED LEAK DETECTION ^ LINE TESTING ECONDARY CONTAINMENT TES n Teak TIGI-ITAIFRS TFaT n T(1 PFRFORM FI IFI MnN17nRWC; CFRTIFICATInN .SITE INFO RMATION FACILITY V2~ NAME HONE NUMBER OF CONTACT PERSON ADDRESS ' _ ~ Q 0.. - I ~~ OWNERS NAME OPERATORS NAME PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED9 ES ^ NO TAN # L E CON ENT L~ 2- ~PI~-e.,rY. - 9 l TANK TESTING COMPANY NAME OF TESTIN OMPA Y NAME 8 PHONE NUMBER OF CONTACT PERSON MAILING ADDRESS ~ r - C.. $ NAME PHONE NUMBER OF TESTER OR SPECIAL INSPECTOR m ~ CERTIFICATION #: DATE 8~ IME TEST TO BE CONDUCTED - . ©Oao.,m ICC #: TEST METHOD SIGNATURE OF APPLICA T C DATE ~ ©~ APPROVED SY DATE ~ ~L FD 2095 (Rev. 09/05) UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD i LINE TESTING SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION j~f!7y9 BAKER3FIELD FIRE DEPT. Prevention Services !-JRl ~irr f 900 'IYuxtun Ave., Ste. 210 ~- Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Pace 1 of 1 PERMIT N0. ~~,__.___-~---~- r,,.,-...~-- ^ ENHANCED LEAK DETECTION ^ LINE TESTING ECONDARY CONTAINMENT TE /-1 _.._.__._. _.._______ f 1 y.. ..~.,~i.n.. r.~~.-~ ..n.~rrne.un nco~nc~reTinu u in...~.wn...~..... ..~... ..~ ..-.. _ INF MATI N FACILITY Y~ NAME HONE NUMBER OF CONTACT PERSON ADDRESS ~ ~ p O~ !! OWNERS NAME OPERATORS NAME PERMIT TO OPERATE NO. NUMBER OF TANKS TO eE TESTED L- 2 ~~--e.,r~• ~ 9 ~ TANK7ESTING COMPANY NAME OF TESTIN OMPA Y NAME 3 PHONE NUMBER OF CONTACT PERSON MAILING ADDRESS S. NAME PHONE NUMBER OF TESTER OR SPECIAL INSPECTOR CERTIFICATION #: m DATE 8 IME TEST TO BE CONDUCTED ICC #: TEST METHOD (7f~QO,.Y1'1 SIGNATURE OF APPLICANT ~ C DATE ^ ©~ APPROVED BY DATE FD 2095 (Rev. 09/05) ~I~L1NG & PERMIT STATEMENT I/OL 1 Y?~!'9 - BAKERSFIELD FIRE DEPT. Prevention Services nnn m-......... e..anns C„itP 71 n PERMIT NO.: ~ tli~ARTy~r Bakersfield, CA 93301 - . _~ - •• ~ • LOCATION OF PROJECT PROPERTY O~VN yTARTWG GATE COMPLETION TE l= PROJECT NAME NAAAE S ADOR S PHONE IIO. PROJECTAODRESS a~ ~. ~ .. CONTRACTOR NAME CA LICENSE NO. • CIiY STATE a .. . TYPE OF LICENSE. ExPIRATION DATE TIPCOOE PHONE N0. r CONTRACTOR COMPANY NAME FAX N0.' ADDRESS CITY LP COO ~ • ~ 50 $262 i Ch ^ , ~ arge) nimum Alarms -New & Modifications - (M . sa 000 S 0 FL 013125 = Permit fee FL x S ~ p q. , Over 2 . q. 98 Minim Char d)fi s S i kl & M tl rs N $210 00 ~ A ge) - ( um pr n e ew o ca on - . 98 ^ r 5 000 S FL Ov Ft x 042 =Permit fee S ~ q. , e . q. 98 ^ kler Modifications (< 10 heads) M)nor S ri $ 93:00 [inspection Onl ] ~ p n y 98 t] Commensal Hoods -New & Modifications $ 398 26 ~ . 98 ^ Additional Hoods 00 S 36 ~ . 98 ^ Spray Booths -New & Modifications 00 $458 ~ . 98 D Aboveground Storage Tanks (tnstallatbnnnsp.-1°Time) $165:00 82 t1 Additional Tanks $ 26.00 ~ 82 ^ Aboveground Story a Tanks (Removaulnspedion) $109:00 ~ O Underground Storage Tanks (Instal/ationllnspeCtion) $878.00 (per tank) ~ 4 Und round Storage Tanks (AAodlficat)on} $878.00 (persite}. 82 ^ Underground Storage Tanks (Minor Modfication) $155.00 82 ^ Underground Storage Tanks {Removan $675.00 (pertank} 84 ^ Oilwell (InstaAation) $ 72.00 ~ 84 Mandated Leak Detection (Testing) /Fuel Montt. Cert $ 81.00 (per J 82 ^ Tents $ 93.00 (pertenQ 84 a Afterhourslnspection fey 5122.00 ~ 84 ^ Pyrotechnic -(Per event, Plus Insp. Fee ~ $90 per hour) $ 80.00 + (5 hrs. min. sand -by ree Mapectlora = $510.00 84 O RE-1NSPECTIDN(S) /FOLLOW-UP JNSPECTION(S) $ 93.00 (per hour} 84 d Portable LPG (Propane): N0. OF CAGES? $66.00 84 D Explosive Storage $249.00 84 O Copying & File Research (File Research Fee 533.00 per hr} 25¢ per page ' 84 p Miscellaneous ~ 84 FO 2021 (fteV. 09/05) 1 -ORIGINAL WHl'1'E (to Treasury) 1-YELLOW (to Ftle) 1-PINK (to Cuatomarf w _ ~ ~ If'ti'I„ 11~~1',~L: '.. l:}.I IItL~I,~ .. 1 ~tl.!~. ~~,. -s-, . ~ ,.l ~ 1 t t ~ ~, ~ r,l 1 .• l' .'.I't Ill.l l~fal - '+I I'., 111.1 r,..r r '% 1 . ~ :r9L; IIr,l'l:f< - I1.IIU Ifd!'flt::' i'L:111• - r;,'.l L~L:~~ 1 1 :':1}':F.I'1.1111 lili ~ r,l ~F.1~ it I it ll. 1 . .' sr,l Ill l.r t'.f: 111 ~'~~ ~:ril.:' `ill':., 111 } .. 1 `i'_' ~! _' ~ +r11 I ~n 1 ~ I I ~ ;ril . Ii;,ll:r LI.UII IfJ~ Ht :. - 1 r ,l, a . L _. - :i S~ti RCB, January 2002 ~~ '~~ f ~17v9~ Page ~ of 1 Secondary Containment Testiag Report Form 'ri,;s jnrm is intandad for use by contract~ats performing periodic resting of U5T'secondary containment .systems. Use the :<<~proprtate pages of [his form to report ,•esults for all components tested. The completedform, written testproeedures, and printouts from rests (rf applicable), shou!~l be provided to the facility owner/operator for submittal to the local regulatory agency. t C ~ f`1"r TTV TA1L`/lDlUr A TilIAY Facility Name: /LFg`tvi/'L/ LIQtX+(L ` DateafTestin : / ~ -d F'aciliry Address: a i yy ,~. d rQ/-v l..tJ / 9 -~D Facility Contact: Phone: Date Local Agency Was Notified of Testvig ::"Jamz of Local Agency Inspector (fpresent during testfnp~: Tn, L~~•7Lrn nAI~iTD ~ nTl1D i7~7L'/~D1UA TT/'7N Company Name:RTCH ENVIRONMENTAL Technician Conducting Test: (~Y~LI wl/f~ Credentials: ~CSL13 Licensed Contractor 0 SWRCB Licensed Tank Tester License Type. C611D9t:1 License Number: 809$50 Manufacturer anufactnrer ~i ainine Com onen s Date Trainin E Tres _ INCON INCON TS-STS 3_ SUMMARY nF TF~T RF~iJ1.T~ .. Component _ Pass Fail Not Tested Repairo Made Component Pass Pail Not Tested Repairs Made n~L n3+~t~ ^ ^ ^ L~7 1Li-- X ^ ^ ^ ~c~~91 titi ~ o a o ~~t,+r~ ~~~ o ^ ^ ^ (~i~i l ~ i ^ ~ ^ 0 ~~ ~ ^ ^ ^ ¢.~ gr l ~ ~~. ~ ^ ^ ^ ^ ^ o r 3 - ^ A ^ ~,-~ . ^ o a ^ ~n n r~ a a ^ o r t,~ -~ ^ d ^ ^ ^ o ~ rr nyarosranc testing was perfprmed, describe what was done with the water after completion of tests: RECYCLE AND REUSED CERTTFICATION OF TECTiNTCiAN RESPONSIBLE FOR CONDUCTING THIS'I'i;STING 7'0 1Ge best af-try knowledge, rite faces stated In tlrfs document art accuratt and In full rnmpliance with legal requlretnents Technician's Signature: '}-i - Date: ~~ ,~-l/ l ~17~!% SWRCB, January 2002 d TANK ANNiti,A12 TFSTTN(: Page _} of 7 , Test Method Developed By: p Tank Manufacturer ~! industry Standard D Professional $tlginear O Other (~ec~) Test Method Used: ^ Pressure ~ Vacuum D Hydrostatic O Other (Spec} Test Equipment Used: 4 i n . DIAL GAUGE Equipment Resolution: . 59b ';. `'`x`~"-' '~ ~ '".~' ~ `'~ Tank# VitfL~7 Tank;ei ~(C~,-~g/ Tank# Tank# is Tank Exempt From Testing? ~ D Yes '~(No ^ Yes Je~No D Yes ^ No 0 Yes G No Tank Capacity: Tank MatcriaL• r "/~(y(, Tank Manufacturer: v,J .tJbw1J U~CI w~J Product Stored: u~C„ ~""l'~/ Wait time between applying pressure/vacuum/water and stnrtin test: 30 y,,t+v ~(~ ,vt.t'tJ Test Start Time: ~= pi0 9.06 Initial Reading (R,): ~ / Test End Time: X0;0(, fiinal Reading (Rt:): f 'Test Duration: ~ ~ , Change in Reading (Rr-R,): Q Pass/Fail Threshold or Criteria: ~ (~ ~ Test Result: Pass 0 Fall ass ^ Faii 0 Pass ^ Fail 0 Pass ^ Fail Was sensor removed for testing? `Yes DNo ONA 'fjlCYes ONo DNA DYes pNo ONA OYes QNo f.?NA Was sensor properly rep}aced and verified functional aRer testin ? ~ Yes 0 No 0 NA 'Yes O No o NA O Yes ^ No DNA 0 Yes D No Q NA Comments - {include irrformvlion on r~alrs +nade prior ro 1estln~ and recomnrendedjollow-upfor jailed tes[s) ~ Secondary conIainment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such es systems that are bydrostatica2ly monttorod or under constant vacuum, are exempt from periodic containment testing, (California Code of Regulations, Title 23, Section 2637(a)(6)} ~~ 7y9 S WRCt3,lanuary 2002 c CF/`/l1VilAi2V PTPF TFCT7Nl'= Page ~ of Test Method Developed By; p Piping Manufacturer ~ Industry Standard 0 Professional Engineer 0 Other (Spec{fy) Test Method Used: ~ Pressure 0 Vacuum 0 hydrostatic 0 Other (Specjfy) Test $quipment Used: 4 i n . .; DIAL GAUGE Pipiae Ran # j Piping Run # ~ ~ Equipment Resolution: . 5% PJpJng Run # - Ptpiag Run # '~2 Piping Material: y7'~(~ P 17 ~ '~l Piping tvtanufacturer: ' !- (D `~ U~: Piping Diameter: -'' " 1S-' ~ ~ ~~S ~ Length of Piping Run: ~ ' ' 7 Product Storcd: vLb~ (~ ~.~ (Li~'.~--ig/ /tF.~t °l/ Method and location of i in -run isolation: U ( $d N I V 2J ... J tJ ~~"t- Wait time between applying pressure/vacuurtt/water and startin test: ~Q ~„t t'~.1 ~ U +"t t'lJ ~ ~ rn -'~.1 /Nl't-~ ~,~ Test Siart Time: c,.'1Lir, V 1L ~1 G L W L(L initial Reading (R,): ,~ ,Vp,j .~ _ Test End Time: Q ASS ~ v v(C,.~' Final Reading (Rr): tJ~ V (J tJ Test Duration: U ~tl r~. ~,~ Change in Reading (Rr-R,): PasslFait Threshold or Criteria: Q P~ r 0 / ~j~ (j Test Result: 0 Plus Fait 0 Past aft 0 Pass Fail 0 Pas! ail Comments - (!nclude rnjormation on repairs made prionnr'' J''o~~te'.rting•, and recontme~pdedjollow-up~j~orryja~!!ed lasts) ~~ L s~~ ~e ~ ~ .t ~J r W~ ~~ K 1 P~ a~S / ~ - 0%s>4~ I-.~ olsP~r.~- v a-s~ ~-rte ~~sP-~ ~- ~ n !~! 7~! 9 SWRCB, January 2002 Page ~f of Test Method Developed By: D Sump Manufactttrer yv 4 ®lndustry Standard D Professional l~ttginecr II Other (Spec~fyJ Test Method Used: D Presswe D Vacuum SI Hydrostatic ^ Other (Sped) Test bquipment Used: l:NCON TS -STS Equipment Resolution : , o0o in . Sump # C.fr7 Sump # .-tq Sump # Sutnp # Sump Diameter; 3 7 " ~ ~., Sump Depth: .S' " S Swnp Material: ~~f~ t1T'S ~ t Height from Tank Top to Top of Hi hest l'i in Penetration: f~ ~Q r ?Q Height from Tank Top to Lowest Electrical Penetration: ' /~ ^ ~ ~ r t.u,; Condition of sump prior to testing: ~, ~ 'tJ Portion of Sump Tested 1 M / Does turbine shut down when sump sensor detects liquid (both roduct and water ?~ Yes U No L] NA '6QYes ^No ^NA DYes ^No fJNA DYes DNo ONA Turbine shutdown response time ~ S ~,<, is system programmed for fail-safe shutdown?~ (Yes ^ No ^ NA 'Yes ^No ONA D Yes DNo ^NA DYes ^No DNA Was fail-safe verifted ro be o erational?~ '~ Yes DNo DNA ¢Yes DNo O NA D Yes ^ No DNA ^ Yes ^ No ^ NA Wait time between applying pressure/vacuum/water and starting test: ~~ ~ Y, J ~~ r,,t t , J Test Start Time: /," ,,,,r :)I(J ,,, : y-- lnitiaJ Reading {Ri): 3• ~, . ~ ~ f y, Test End Time: /•;f ',~,, Final Reading (Rf): ~ - ~,.~7 `~ ~/ Test Duration; / +wp.J , Mi t r~.7 Change in Reading (RF-R,}; . Q 11 r . O t(',.J ~ ,,~ Pass/Fail Threshold or Criteria: d-r,~J ~,,.U . ,v tti,1 ' Test Aesuit: 0 Pass 1!d1Fai! 0 Pass ~f Fall ^ Pass D Fal[ 0 1PQSS ^ Fail Was sensor removed for testing? Yes ^ N o DNA !~ Yes ^ No DNA ^ Yes DNo 0 NA D Yes ^ No DNA Was sensor properly replaced and verified functional after testin ? ayes ^ No ^ NA 1~(Yes 0 No ^ NA D Yes DNo DNA D Yes ^ No ^ NA Comments - (include information on repairs made~rior to resting, end recommended follow-ap for farted bests) .SrJr-t~.S t~-L /Ir~E T7~ r>~rKtil7wfJ ~9-~~r_~~3r~- ~L.~G'M./~~ 1 S r,~~-a- ,a-v o P~.~ ~~rc ,a.PP~i~._ , «~, ' it the entire depth of the sump is not tested, specify }tow much was tested. If the answer to ~ of the questions indicated with an ssterish (') is "NO" or "NA", the enure sump trust be tested. (See SWE~CB LG-160) l~7yg SWRCB, January 2002 ,-. r.rnnL+vnu n rn*rr A il-tMi,`NT nTi1(`l '1'FR'191T~IG Page ~ of 7 I. Vl`UIr.R~VWr G1\VUn vtsa. a~aa....a....a.~ .. _-_ ___ Test Method Developed By: D UDC Manufacturer i~ industry Standard D Professional Engineer C1 Other (Specify) -Test Method Used: O Pressure ^ Vacuum >gl Hydrostatic ^ Other (specify) Test Equipment Used: INCON TS-STS Equipment Resolution:.oooin. UDC # I .. UDC # ' ~ UDC # 1 UDC # ^UDCManufacturer. i~iVvl ~'v/rR°'tJ ~`~! "~ t UDC Material: ~- < <- l ~ ~ UDC De the ~ Height from UDC Bottom to Top ~ i ~ " G y ~ `i of Hi best Pi in Penetration: o Height from UDC Bottom to ,, ' ' " ~ ~~ Lowest Electrical Penetration: Condition of UDC prior to C Lti¢~t) L i/~i¢-~ C ~,~~ C ~ ~,v testin : Portion of UDC Tested M y o ..~ ~I Does turbine shut down when UDC sensor detects liquid (both Yes ^ No 0 NA ~AYes ONo ^NA ,Yes ^ No QNA Yes ^No ^NA roduct and water ?' Turbine shutdown res onse time L -~ ~ [s system programmed for fail- safe shutdown?~ ^~tYes ^No ^NA ".Yes DNa ^NA ~QYes ^No ^NA 'iJ]Yes DNo aNA Was fail-safe verified to be o erational?~ yes DNo ^ NA ~, ~I,Yes ONo ^NA ~i[Yes DNo ^NA i,~Yes ^No ^NA Wait time between applying pressure/vacuum/water and ~y 3V M ~ .J ~0 ~ t ~ ~`} ~ t~ "~ ~ 3Q ,,,,! t,~ Startin test - Test Start Time: Jtsv V t URt U I ~, - ( initial Readin (Tti : _ `~ Test End Time: 1LV I tJ i : `~ •% Final Readin RF : ~' ~-/. v y. Test Duration: r ,~ ,.,,.~ t •..% •~ r .•Ni•J l ant~J t +y++t) Chan a in Readin (RF-Rt); • ovQ .D Pass/Fail Threshold or Criteria: .,~ O ,+J „/ .til r-t.7 a! • OUA,i! . ~J..-~ Test Result: ^ Pass k~i Fail ^ Pass QCFaiI ^ Pass ,~ Fai! Pass D Fail Was sensor removed for testing? D Yes ^ No ^ NA ^ Yes DNo 0 NA D Yes DNo ^ NA p Yes DNo U NA Was sensor properly replaced and verified functional after testin ? D Yes ^ No ^ NA ^ Yes ~ No ^ NA ^ Yes O No ^ NA ^ Yes ^ No ^ NA Comments - include information on repairs made prior to resting, and reeommendedfollow-u for,~ailed tests} - ~ISP~ t-a. ~_y ~--~ __~15~,~-t_~_ r I~~D Oc~~' Try -~,Q?~2..~Ca~~Y des if the enrire depth of the UDC is not tested, specify how much was tested. If the answer to any of the questions indicated with an asterisk ('} is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG-160) l~{?erg SWRCl3, January 2002 n t.rr r ArcFU !'nNTAiNMFNT Srrl-~ TESTIIYG page ~ of~ Facili is Not ui d With Fill Riser Containment Stmt s ^ Fill Riser Containment Sumps arc Present, but were Not Tested 0 Test Method Developed By: ^ Sump Manufacturer Industry Standard 0 Professional Engineer 0 Other (Specify) Test Method Used: 0 Pressure 0 Vacuum ~ Hydrostatic A Other (specify} Test Equipment Used: INCON TS-STS Equipment Resolution:. i}OO i n. FIII Sum # v.~J[.fr7 Fill Sum # (l.E.•-t 9 Fill Sum # FYIt Sam # Sum piameter: ' Sum De the ~" " Height from Tank Top to Top of Fit lest Pi in Penetration: 11 1 Q /V / ~ 1 ~ 1~ Height from Tank Top to Lowest Electrical Penetration: ~ K h Condition of sump prior to testin : (, L,F~~.1 G L ;F''~- ~ q v Portion of Sum Tested ~t.•uc., ~ Sum Material: ~ Wait time between applying pressurelvacuum/waier aad startin test: ~i\ ~ ~ VV r;JO ~ Test Start Time: = j~ • Q~ ,,.:, Initial Readin ,): p y y „~ ,.~ y .~ Test End Time• : ! ~ ~ : / Finai Readin R ,~ .3 y3,-+.7 Test Duration- ,,,,, r Chan a in Readin R R,}: , d 7 ,J , ay pass/Fail Threshold or Criteria: , ba , po ,..~ .v Test Result: ^ Pass Fail Pass ^ Fail 0 Pass ^ Fail 0 Pass Ll Fai! Is there a sensor in the sump? ~ Yes 0 No ')~ Yes 0 No ^ Yes 0 No ^ Yes 0 No Does the sensor alarm when either product or water is detected? ~Ves ONo ^NA R1Yes QNo ^NA ^Yes ^No DNA ^Yes ^No ^NA Was sensor removed for testing? ,Yes ONo ^NA Yes ^No ^NA OYes ONo ^NA ^Yes ^No ONA Was sensor properly replaced and verifed functional after testin 7 Yes ^ No ^ NA ~jYes ^No DNA ^Yes ONo ONA ^ Yes ONo ^NA Cotnlnents - (include information on repairs made prior to resting and recommended follow-up~or failed rests) v-vt,~~ ~'ic.c_ <~~-~-tP ~,~-r~~ n~~ r~ ,a. ~ r~,~.,~ ter- r~,~~ l ~ ~~~ S WRCB, January 2U02 O CPii.Y InVFRF-T.T. r(1NTATNMF.IVT BOXES Page ? of Facili is Not E ui ed With S ilUOverfill Containment Boxes 0 Spill/Overfill Containment Haxes are Present, but were Not Tested 0 Test Method Developed By: ^ Spill Bucket Manufacturer ~ Industry Standard ^ Professional Engineer ^ Other {$pec~) Test Method Used: 0 Pressure ^ Vacuum ~ Hydrostatic ^ Other (S ec~) Test Equipment Used: INCON TS-STS *~~ -, r„ Spiii Box # l ~ Spill Box Equipment Resolution: . Oooin . Spill Box #1gi firs. Spill Bax #pt v Bucket Diameter: " jo1," / ~~ (y ~~ BuckctDepth: 1 t ~~ rls.~ t ~~ Wait time between applying p~rossureJvacuumhveter and siartin test: 30 ~,.t t1.~ ~~ wt t'L, ~Q wt t'lJ ,.^~ ~1 ~ v ~t 1v Test Stan Time: 9: y ;y 9: 1 : /f- ~ ;17 /l9-t Initial Reading (Rr): ~. ? ~ S , 9Y1.-v , 9 -v ~~ `'(U.S. ~• tiU51, •~ ~• ~ ~•'`~ 3'~ ~) '`~ Test End Time: 4.'S') /U:/ `)' 1 /U~.3~ / t ~-~~~""r / ' Final Reading(RF): ) .~. 7 ,U . g y ,~ ,yU`1iN j•`1' ,> ,ti7 3'?lb'7, Test Duration: t ~ - st1 t r~ 1 J I 'wt~•..7 Change in Reading(RF-Rr): ,per -~i't..! •htJCJ~-v •dGt~ . d0/.•J b .~ •d /..~ ,~ Pass/Fail Threshold or Criteria: • ~~.~/ -Gbd rv . d ~+~ • tldd,~ . Od 1.+~ ,OC~ ~ .GO •t1 - 00 Test Result: ~ Pass 0 Fail )~ Pass 0 Fail i~ Pass 0 Fail ~ Pass D Fail Comments - (include in ormalion an repairs mad_ prior to testing; and recommendedfollaw-up for failed tests) 91UPR TES7 STARTED 10:18 AM TEST STARTED 11/03/2006 BEGIN LEVEL 3.SB73 IN END TIME '- 10:33 AM '.ND DATE' 11/03/2006 Li~D THRE.SHOLO 0 082 IN TEST RESULT PASSED 91UPF' .......----- TEST STARTED 10:37 At9 TEST STARTED 11/032206 aEr,IN LEVEL 3.P870 IN END TIME 10:52 RM ~taD DATE 11/03/2006 END LEVEL 3.8879 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED 91SPiLL~ TEST STARTED 10:18 AM TEST STARTED 11/03/2906 BEGIN LEVEL 3.4053 IN END TIME 18:33 RM END DATE 11/03/200b END LEUEI_ 3.404$ iN LEAK THRESHOLD 0.002 IN __ ____TEST•. RESULT '_ PASSE~__ 91SPIL L TEST STARTED 10:37 AM TEST STARTED 11/03/2066 BEGIN LEVEL 3.424$ IN END TIME 10:52 AM END DATE 11/03/2006 END LEVEL 3.4050 IN LEAK THRESHOLD 0.222 IN TEST RESULT PASSED li/93/200b 3:46 PM SUMP LEAK TEST REPORT '1-Y TEST STARTED 3:31 Ph'i TEST STARTED 11/03/2006 BEGIN LEVEL 4.6589 IN EtiD TIME 3:46 PM END DATE li/031'L006 END LEVEL • • • •• 4.6585 IN LEAK THRESHOLD 9.002 IN TEST RESULT PASSED 11r03/2E~06 4:17 i't~t SUMP LEAK TEST REPOP,T '~' TEST STARTED 4:02 PI"i TEST STARTED 11/03/2006 BEr,I.N LEVEL 4.6555 IN END TIME 4:17 PM END DATE 11/03/200E FIJD LEt,~EL 4.6537 IN I.ERK THRESHOLD 0.00"L IN TEST RESULT PASSED 1 ll7~c~ 91FILL TEST STARTED 10:57 r'tM! TEST STARTED 11/03/2006 EiEG I N LEUEI_ 4. S3y2 I N END TIME 11:13 AM END DATE 11/63/2006 END LEVEL 4.5394 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED -- . .... -- QIFILL _._ .- ----- TEST STARTED 10:37 AM _.... _._., _:~' SST 57,~aR~E~.....1].!0 /2006 ----:.: BEGIN LEVEL 4.53$5 TN END TIME 10:52 APi END DATE 11/93/2906 END LEVEL 4.5383 TP! .LEAK THRESHOLD 0.002 IN TEST RESULT PASSED ~l7~lq a7uPR ,~ :1z,.7C1Rr. 2:00 PM 11: !3.'2006 i.: 18 Pt9 SUMP LEAK TEST REPORT TEST STARTED 9:58 AA1 TEST STARTED 11/03/2006 BEGIN LEVEL 5.9436 IN END TIME 10:13 AM END DATE 1ii03/2006 END LEVEL 5.9435 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED S!JM° LEAK TEST REPOR'!' ±*?~ 9/69`tP TEST STARTED I:45 Pnp -;-c,T STARTED 11/93/2006 BEGIN LEVEL 5.195[ TN ENO TIME 2:00 PM END DATE 11/03/2006 tF•jD !_E~.1EL 4.9447 Thi LEAK THRESHOLD 0.H02 IN T~cT RESULT FAILED S7gpLLt ~;gg AM TEfiT c~`,TRCRi,TED 111U3/"~g~ ~ i SECZN ~-EVEL 310.13 AM F:r~D ~L.ME iligzi2006 END 9EU ~- 3.6750 IN THRESHOLD g'pA55ED LSAT R.ESUL: f TCS ~ ~ S7c,P ~ TEST STAP.TED 9.42 AM TEST STARTED 11/03/2006 BEGIN LEVEL 3.6754 IN END TIME 9:57 AM END DATE 11/03/2006 END LEVEL 3.6751 TN LEAK THRESHOLD 0.002 IN TrgT RESULT PASSED 87STP TEST STARTED 1:03 P!" TEST STARTED 11!03/200b BEGIN LEVEL ;,5596 IN END TIME '` 1:13 PM END DATE: 11%03/2006 ENO ! EVEL 3.5589 IN LEAK THRESHOLD 0.002 IN PEST RESULT FAILED ;.1!4x3; 2006 i : 35 PM SUMP LEAK TEST REPORT 87STP TEST STARTED 2:20 PM '"EST STARTED 11/03/2066 BEGIN LEVEL 3.5584 IN END TIr4E 1:35 PM END DATE 11/03/2006 END LEVEL 3,5483 IN LEAK THRESHOLD 0.002 IN TEST RESULT SAILED 87UPR TEST STARTED 9:42 Ar4 TEST STARTED 11/03/2006 BEGIN LEVEL 5.943 IN END TIME 9:57 AM END DATE 11/03/2006 END LEVEL 5.9437 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED $7FILL - --~ TEST STARTED y: 42 Arq TEST STARTED 11/03/2006 BEGIN LEVEL y~~,15 IN EHD TIME• .:x:57 Ahi END ~EVEL •' ~~/6vi~28F16 LEAP. THRES;~GLD 3'5831 IN TEST RESULT' ~ 0.'02 irJ -- - ~ .FAILED -- 87FILL TEST STARTED 10:18 AM TEST STARTED 11/03/2006 BEGIN LEVEL. 3,4059 IN END TIME 19:33 AM END DATE 11/03/2006 .. .-_. E,,ND-kc' ._,~..3,ti'~4•9:,IN BEAK THRESHOLD 0.002 IM TEST RESULT FAILED L _. - :i S~ti RCB, January 2002 ~~ '~~ f ~17v9~ Page ~ of 1 Secondary Containment Testiag Report Form 'ri,;s jnrm is intandad for use by contract~ats performing periodic resting of U5T'secondary containment .systems. Use the :<<~proprtate pages of [his form to report ,•esults for all components tested. The completedform, written testproeedures, and printouts from rests (rf applicable), shou!~l be provided to the facility owner/operator for submittal to the local regulatory agency. t C ~ f`1"r TTV TA1L`/lDlUr A TilIAY Facility Name: /LFg`tvi/'L/ LIQtX+(L ` DateafTestin : / ~ -d F'aciliry Address: a i yy ,~. d rQ/-v l..tJ / 9 -~D Facility Contact: Phone: Date Local Agency Was Notified of Testvig ::"Jamz of Local Agency Inspector (fpresent during testfnp~: Tn, L~~•7Lrn nAI~iTD ~ nTl1D i7~7L'/~D1UA TT/'7N Company Name:RTCH ENVIRONMENTAL Technician Conducting Test: (~Y~LI wl/f~ Credentials: ~CSL13 Licensed Contractor 0 SWRCB Licensed Tank Tester License Type. C611D9t:1 License Number: 809$50 Manufacturer anufactnrer ~i ainine Com onen s Date Trainin E Tres _ INCON INCON TS-STS 3_ SUMMARY nF TF~T RF~iJ1.T~ .. Component _ Pass Fail Not Tested Repairo Made Component Pass Pail Not Tested Repairs Made n~L n3+~t~ ^ ^ ^ L~7 1Li-- X ^ ^ ^ ~c~~91 titi ~ o a o ~~t,+r~ ~~~ o ^ ^ ^ (~i~i l ~ i ^ ~ ^ 0 ~~ ~ ^ ^ ^ ¢.~ gr l ~ ~~. ~ ^ ^ ^ ^ ^ o r 3 - ^ A ^ ~,-~ . ^ o a ^ ~n n r~ a a ^ o r t,~ -~ ^ d ^ ^ ^ o ~ rr nyarosranc testing was perfprmed, describe what was done with the water after completion of tests: RECYCLE AND REUSED CERTTFICATION OF TECTiNTCiAN RESPONSIBLE FOR CONDUCTING THIS'I'i;STING 7'0 1Ge best af-try knowledge, rite faces stated In tlrfs document art accuratt and In full rnmpliance with legal requlretnents Technician's Signature: '}-i - Date: ~~ ,~-l/ l ~17~!% SWRCB, January 2002 d TANK ANNiti,A12 TFSTTN(: Page _} of 7 , Test Method Developed By: p Tank Manufacturer ~! industry Standard D Professional $tlginear O Other (~ec~) Test Method Used: ^ Pressure ~ Vacuum D Hydrostatic O Other (Spec} Test Equipment Used: 4 i n . DIAL GAUGE Equipment Resolution: . 59b ';. `'`x`~"-' '~ ~ '".~' ~ `'~ Tank# VitfL~7 Tank;ei ~(C~,-~g/ Tank# Tank# is Tank Exempt From Testing? ~ D Yes '~(No ^ Yes Je~No D Yes ^ No 0 Yes G No Tank Capacity: Tank MatcriaL• r "/~(y(, Tank Manufacturer: v,J .tJbw1J U~CI w~J Product Stored: u~C„ ~""l'~/ Wait time between applying pressure/vacuum/water and stnrtin test: 30 y,,t+v ~(~ ,vt.t'tJ Test Start Time: ~= pi0 9.06 Initial Reading (R,): ~ / Test End Time: X0;0(, fiinal Reading (Rt:): f 'Test Duration: ~ ~ , Change in Reading (Rr-R,): Q Pass/Fail Threshold or Criteria: ~ (~ ~ Test Result: Pass 0 Fall ass ^ Faii 0 Pass ^ Fail 0 Pass ^ Fail Was sensor removed for testing? `Yes DNo ONA 'fjlCYes ONo DNA DYes pNo ONA OYes QNo f.?NA Was sensor properly rep}aced and verified functional aRer testin ? ~ Yes 0 No 0 NA 'Yes O No o NA O Yes ^ No DNA 0 Yes D No Q NA Comments - {include irrformvlion on r~alrs +nade prior ro 1estln~ and recomnrendedjollow-upfor jailed tes[s) ~ Secondary conIainment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such es systems that are bydrostatica2ly monttorod or under constant vacuum, are exempt from periodic containment testing, (California Code of Regulations, Title 23, Section 2637(a)(6)} ~~ 7y9 S WRCt3,lanuary 2002 c CF/`/l1VilAi2V PTPF TFCT7Nl'= Page ~ of Test Method Developed By; p Piping Manufacturer ~ Industry Standard 0 Professional Engineer 0 Other (Spec{fy) Test Method Used: ~ Pressure 0 Vacuum 0 hydrostatic 0 Other (Specjfy) Test $quipment Used: 4 i n . .; DIAL GAUGE Pipiae Ran # j Piping Run # ~ ~ Equipment Resolution: . 5% PJpJng Run # - Ptpiag Run # '~2 Piping Material: y7'~(~ P 17 ~ '~l Piping tvtanufacturer: ' !- (D `~ U~: Piping Diameter: -'' " 1S-' ~ ~ ~~S ~ Length of Piping Run: ~ ' ' 7 Product Storcd: vLb~ (~ ~.~ (Li~'.~--ig/ /tF.~t °l/ Method and location of i in -run isolation: U ( $d N I V 2J ... J tJ ~~"t- Wait time between applying pressure/vacuurtt/water and startin test: ~Q ~„t t'~.1 ~ U +"t t'lJ ~ ~ rn -'~.1 /Nl't-~ ~,~ Test Siart Time: c,.'1Lir, V 1L ~1 G L W L(L initial Reading (R,): ,~ ,Vp,j .~ _ Test End Time: Q ASS ~ v v(C,.~' Final Reading (Rr): tJ~ V (J tJ Test Duration: U ~tl r~. ~,~ Change in Reading (Rr-R,): PasslFait Threshold or Criteria: Q P~ r 0 / ~j~ (j Test Result: 0 Plus Fait 0 Past aft 0 Pass Fail 0 Pas! ail Comments - (!nclude rnjormation on repairs made prionnr'' J''o~~te'.rting•, and recontme~pdedjollow-up~j~orryja~!!ed lasts) ~~ L s~~ ~e ~ ~ .t ~J r W~ ~~ K 1 P~ a~S / ~ - 0%s>4~ I-.~ olsP~r.~- v a-s~ ~-rte ~~sP-~ ~- ~ n !~! 7~! 9 SWRCB, January 2002 Page ~f of Test Method Developed By: D Sump Manufactttrer yv 4 ®lndustry Standard D Professional l~ttginecr II Other (Spec~fyJ Test Method Used: D Presswe D Vacuum SI Hydrostatic ^ Other (Sped) Test bquipment Used: l:NCON TS -STS Equipment Resolution : , o0o in . Sump # C.fr7 Sump # .-tq Sump # Sutnp # Sump Diameter; 3 7 " ~ ~., Sump Depth: .S' " S Swnp Material: ~~f~ t1T'S ~ t Height from Tank Top to Top of Hi hest l'i in Penetration: f~ ~Q r ?Q Height from Tank Top to Lowest Electrical Penetration: ' /~ ^ ~ ~ r t.u,; Condition of sump prior to testing: ~, ~ 'tJ Portion of Sump Tested 1 M / Does turbine shut down when sump sensor detects liquid (both roduct and water ?~ Yes U No L] NA '6QYes ^No ^NA DYes ^No fJNA DYes DNo ONA Turbine shutdown response time ~ S ~,<, is system programmed for fail-safe shutdown?~ (Yes ^ No ^ NA 'Yes ^No ONA D Yes DNo ^NA DYes ^No DNA Was fail-safe verifted ro be o erational?~ '~ Yes DNo DNA ¢Yes DNo O NA D Yes ^ No DNA ^ Yes ^ No ^ NA Wait time between applying pressure/vacuum/water and starting test: ~~ ~ Y, J ~~ r,,t t , J Test Start Time: /," ,,,,r :)I(J ,,, : y-- lnitiaJ Reading {Ri): 3• ~, . ~ ~ f y, Test End Time: /•;f ',~,, Final Reading (Rf): ~ - ~,.~7 `~ ~/ Test Duration; / +wp.J , Mi t r~.7 Change in Reading (RF-R,}; . Q 11 r . O t(',.J ~ ,,~ Pass/Fail Threshold or Criteria: d-r,~J ~,,.U . ,v tti,1 ' Test Aesuit: 0 Pass 1!d1Fai! 0 Pass ~f Fall ^ Pass D Fal[ 0 1PQSS ^ Fail Was sensor removed for testing? Yes ^ N o DNA !~ Yes ^ No DNA ^ Yes DNo 0 NA D Yes ^ No DNA Was sensor properly replaced and verified functional after testin ? ayes ^ No ^ NA 1~(Yes 0 No ^ NA D Yes DNo DNA D Yes ^ No ^ NA Comments - (include information on repairs made~rior to resting, end recommended follow-ap for farted bests) .SrJr-t~.S t~-L /Ir~E T7~ r>~rKtil7wfJ ~9-~~r_~~3r~- ~L.~G'M./~~ 1 S r,~~-a- ,a-v o P~.~ ~~rc ,a.PP~i~._ , «~, ' it the entire depth of the sump is not tested, specify }tow much was tested. If the answer to ~ of the questions indicated with an ssterish (') is "NO" or "NA", the enure sump trust be tested. (See SWE~CB LG-160) l~7yg SWRCB, January 2002 ,-. r.rnnL+vnu n rn*rr A il-tMi,`NT nTi1(`l '1'FR'191T~IG Page ~ of 7 I. Vl`UIr.R~VWr G1\VUn vtsa. a~aa....a....a.~ .. _-_ ___ Test Method Developed By: D UDC Manufacturer i~ industry Standard D Professional Engineer C1 Other (Specify) -Test Method Used: O Pressure ^ Vacuum >gl Hydrostatic ^ Other (specify) Test Equipment Used: INCON TS-STS Equipment Resolution:.oooin. UDC # I .. UDC # ' ~ UDC # 1 UDC # ^UDCManufacturer. i~iVvl ~'v/rR°'tJ ~`~! "~ t UDC Material: ~- < <- l ~ ~ UDC De the ~ Height from UDC Bottom to Top ~ i ~ " G y ~ `i of Hi best Pi in Penetration: o Height from UDC Bottom to ,, ' ' " ~ ~~ Lowest Electrical Penetration: Condition of UDC prior to C Lti¢~t) L i/~i¢-~ C ~,~~ C ~ ~,v testin : Portion of UDC Tested M y o ..~ ~I Does turbine shut down when UDC sensor detects liquid (both Yes ^ No 0 NA ~AYes ONo ^NA ,Yes ^ No QNA Yes ^No ^NA roduct and water ?' Turbine shutdown res onse time L -~ ~ [s system programmed for fail- safe shutdown?~ ^~tYes ^No ^NA ".Yes DNa ^NA ~QYes ^No ^NA 'iJ]Yes DNo aNA Was fail-safe verified to be o erational?~ yes DNo ^ NA ~, ~I,Yes ONo ^NA ~i[Yes DNo ^NA i,~Yes ^No ^NA Wait time between applying pressure/vacuum/water and ~y 3V M ~ .J ~0 ~ t ~ ~`} ~ t~ "~ ~ 3Q ,,,,! t,~ Startin test - Test Start Time: Jtsv V t URt U I ~, - ( initial Readin (Tti : _ `~ Test End Time: 1LV I tJ i : `~ •% Final Readin RF : ~' ~-/. v y. Test Duration: r ,~ ,.,,.~ t •..% •~ r .•Ni•J l ant~J t +y++t) Chan a in Readin (RF-Rt); • ovQ .D Pass/Fail Threshold or Criteria: .,~ O ,+J „/ .til r-t.7 a! • OUA,i! . ~J..-~ Test Result: ^ Pass k~i Fail ^ Pass QCFaiI ^ Pass ,~ Fai! Pass D Fail Was sensor removed for testing? D Yes ^ No ^ NA ^ Yes DNo 0 NA D Yes DNo ^ NA p Yes DNo U NA Was sensor properly replaced and verified functional after testin ? D Yes ^ No ^ NA ^ Yes ~ No ^ NA ^ Yes O No ^ NA ^ Yes ^ No ^ NA Comments - include information on repairs made prior to resting, and reeommendedfollow-u for,~ailed tests} - ~ISP~ t-a. ~_y ~--~ __~15~,~-t_~_ r I~~D Oc~~' Try -~,Q?~2..~Ca~~Y des if the enrire depth of the UDC is not tested, specify how much was tested. If the answer to any of the questions indicated with an asterisk ('} is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG-160) l~{?erg SWRCl3, January 2002 n t.rr r ArcFU !'nNTAiNMFNT Srrl-~ TESTIIYG page ~ of~ Facili is Not ui d With Fill Riser Containment Stmt s ^ Fill Riser Containment Sumps arc Present, but were Not Tested 0 Test Method Developed By: ^ Sump Manufacturer Industry Standard 0 Professional Engineer 0 Other (Specify) Test Method Used: 0 Pressure 0 Vacuum ~ Hydrostatic A Other (specify} Test Equipment Used: INCON TS-STS Equipment Resolution:. i}OO i n. FIII Sum # v.~J[.fr7 Fill Sum # (l.E.•-t 9 Fill Sum # FYIt Sam # Sum piameter: ' Sum De the ~" " Height from Tank Top to Top of Fit lest Pi in Penetration: 11 1 Q /V / ~ 1 ~ 1~ Height from Tank Top to Lowest Electrical Penetration: ~ K h Condition of sump prior to testin : (, L,F~~.1 G L ;F''~- ~ q v Portion of Sum Tested ~t.•uc., ~ Sum Material: ~ Wait time between applying pressurelvacuum/waier aad startin test: ~i\ ~ ~ VV r;JO ~ Test Start Time: = j~ • Q~ ,,.:, Initial Readin ,): p y y „~ ,.~ y .~ Test End Time• : ! ~ ~ : / Finai Readin R ,~ .3 y3,-+.7 Test Duration- ,,,,, r Chan a in Readin R R,}: , d 7 ,J , ay pass/Fail Threshold or Criteria: , ba , po ,..~ .v Test Result: ^ Pass Fail Pass ^ Fail 0 Pass ^ Fail 0 Pass Ll Fai! Is there a sensor in the sump? ~ Yes 0 No ')~ Yes 0 No ^ Yes 0 No ^ Yes 0 No Does the sensor alarm when either product or water is detected? ~Ves ONo ^NA R1Yes QNo ^NA ^Yes ^No DNA ^Yes ^No ^NA Was sensor removed for testing? ,Yes ONo ^NA Yes ^No ^NA OYes ONo ^NA ^Yes ^No ONA Was sensor properly replaced and verifed functional after testin 7 Yes ^ No ^ NA ~jYes ^No DNA ^Yes ONo ONA ^ Yes ONo ^NA Cotnlnents - (include information on repairs made prior to resting and recommended follow-up~or failed rests) v-vt,~~ ~'ic.c_ <~~-~-tP ~,~-r~~ n~~ r~ ,a. ~ r~,~.,~ ter- r~,~~ l ~ ~~~ S WRCB, January 2U02 O CPii.Y InVFRF-T.T. r(1NTATNMF.IVT BOXES Page ? of Facili is Not E ui ed With S ilUOverfill Containment Boxes 0 Spill/Overfill Containment Haxes are Present, but were Not Tested 0 Test Method Developed By: ^ Spill Bucket Manufacturer ~ Industry Standard ^ Professional Engineer ^ Other {$pec~) Test Method Used: 0 Pressure ^ Vacuum ~ Hydrostatic ^ Other (S ec~) Test Equipment Used: INCON TS-STS *~~ -, r„ Spiii Box # l ~ Spill Box Equipment Resolution: . Oooin . Spill Box #1gi firs. Spill Bax #pt v Bucket Diameter: " jo1," / ~~ (y ~~ BuckctDepth: 1 t ~~ rls.~ t ~~ Wait time between applying p~rossureJvacuumhveter and siartin test: 30 ~,.t t1.~ ~~ wt t'L, ~Q wt t'lJ ,.^~ ~1 ~ v ~t 1v Test Stan Time: 9: y ;y 9: 1 : /f- ~ ;17 /l9-t Initial Reading (Rr): ~. ? ~ S , 9Y1.-v , 9 -v ~~ `'(U.S. ~• tiU51, •~ ~• ~ ~•'`~ 3'~ ~) '`~ Test End Time: 4.'S') /U:/ `)' 1 /U~.3~ / t ~-~~~""r / ' Final Reading(RF): ) .~. 7 ,U . g y ,~ ,yU`1iN j•`1' ,> ,ti7 3'?lb'7, Test Duration: t ~ - st1 t r~ 1 J I 'wt~•..7 Change in Reading(RF-Rr): ,per -~i't..! •htJCJ~-v •dGt~ . d0/.•J b .~ •d /..~ ,~ Pass/Fail Threshold or Criteria: • ~~.~/ -Gbd rv . d ~+~ • tldd,~ . Od 1.+~ ,OC~ ~ .GO •t1 - 00 Test Result: ~ Pass 0 Fail )~ Pass 0 Fail i~ Pass 0 Fail ~ Pass D Fail Comments - (include in ormalion an repairs mad_ prior to testing; and recommendedfollaw-up for failed tests) 91UPR TES7 STARTED 10:18 AM TEST STARTED 11/03/2006 BEGIN LEVEL 3.SB73 IN END TIME '- 10:33 AM '.ND DATE' 11/03/2006 Li~D THRE.SHOLO 0 082 IN TEST RESULT PASSED 91UPF' .......----- TEST STARTED 10:37 At9 TEST STARTED 11/032206 aEr,IN LEVEL 3.P870 IN END TIME 10:52 RM ~taD DATE 11/03/2006 END LEVEL 3.8879 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED 91SPiLL~ TEST STARTED 10:18 AM TEST STARTED 11/03/2906 BEGIN LEVEL 3.4053 IN END TIME 18:33 RM END DATE 11/03/200b END LEUEI_ 3.404$ iN LEAK THRESHOLD 0.002 IN __ ____TEST•. RESULT '_ PASSE~__ 91SPIL L TEST STARTED 10:37 AM TEST STARTED 11/03/2066 BEGIN LEVEL 3.424$ IN END TIME 10:52 AM END DATE 11/03/2006 END LEVEL 3.4050 IN LEAK THRESHOLD 0.222 IN TEST RESULT PASSED li/93/200b 3:46 PM SUMP LEAK TEST REPORT '1-Y TEST STARTED 3:31 Ph'i TEST STARTED 11/03/2006 BEGIN LEVEL 4.6589 IN EtiD TIME 3:46 PM END DATE li/031'L006 END LEVEL • • • •• 4.6585 IN LEAK THRESHOLD 9.002 IN TEST RESULT PASSED 11r03/2E~06 4:17 i't~t SUMP LEAK TEST REPOP,T '~' TEST STARTED 4:02 PI"i TEST STARTED 11/03/2006 BEr,I.N LEVEL 4.6555 IN END TIME 4:17 PM END DATE 11/03/200E FIJD LEt,~EL 4.6537 IN I.ERK THRESHOLD 0.00"L IN TEST RESULT PASSED 1 ll7~c~ 91FILL TEST STARTED 10:57 r'tM! TEST STARTED 11/03/2006 EiEG I N LEUEI_ 4. S3y2 I N END TIME 11:13 AM END DATE 11/63/2006 END LEVEL 4.5394 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED -- . .... -- QIFILL _._ .- ----- TEST STARTED 10:37 AM _.... _._., _:~' SST 57,~aR~E~.....1].!0 /2006 ----:.: BEGIN LEVEL 4.53$5 TN END TIME 10:52 APi END DATE 11/93/2906 END LEVEL 4.5383 TP! .LEAK THRESHOLD 0.002 IN TEST RESULT PASSED ~l7~lq a7uPR ,~ :1z,.7C1Rr. 2:00 PM 11: !3.'2006 i.: 18 Pt9 SUMP LEAK TEST REPORT TEST STARTED 9:58 AA1 TEST STARTED 11/03/2006 BEGIN LEVEL 5.9436 IN END TIME 10:13 AM END DATE 1ii03/2006 END LEVEL 5.9435 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED S!JM° LEAK TEST REPOR'!' ±*?~ 9/69`tP TEST STARTED I:45 Pnp -;-c,T STARTED 11/93/2006 BEGIN LEVEL 5.195[ TN ENO TIME 2:00 PM END DATE 11/03/2006 tF•jD !_E~.1EL 4.9447 Thi LEAK THRESHOLD 0.H02 IN T~cT RESULT FAILED S7gpLLt ~;gg AM TEfiT c~`,TRCRi,TED 111U3/"~g~ ~ i SECZN ~-EVEL 310.13 AM F:r~D ~L.ME iligzi2006 END 9EU ~- 3.6750 IN THRESHOLD g'pA55ED LSAT R.ESUL: f TCS ~ ~ S7c,P ~ TEST STAP.TED 9.42 AM TEST STARTED 11/03/2006 BEGIN LEVEL 3.6754 IN END TIME 9:57 AM END DATE 11/03/2006 END LEVEL 3.6751 TN LEAK THRESHOLD 0.002 IN TrgT RESULT PASSED 87STP TEST STARTED 1:03 P!" TEST STARTED 11!03/200b BEGIN LEVEL ;,5596 IN END TIME '` 1:13 PM END DATE: 11%03/2006 ENO ! EVEL 3.5589 IN LEAK THRESHOLD 0.002 IN PEST RESULT FAILED ;.1!4x3; 2006 i : 35 PM SUMP LEAK TEST REPORT 87STP TEST STARTED 2:20 PM '"EST STARTED 11/03/2066 BEGIN LEVEL 3.5584 IN END TIr4E 1:35 PM END DATE 11/03/2006 END LEVEL 3,5483 IN LEAK THRESHOLD 0.002 IN TEST RESULT SAILED 87UPR TEST STARTED 9:42 Ar4 TEST STARTED 11/03/2006 BEGIN LEVEL 5.943 IN END TIME 9:57 AM END DATE 11/03/2006 END LEVEL 5.9437 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED $7FILL - --~ TEST STARTED y: 42 Arq TEST STARTED 11/03/2006 BEGIN LEVEL y~~,15 IN EHD TIME• .:x:57 Ahi END ~EVEL •' ~~/6vi~28F16 LEAP. THRES;~GLD 3'5831 IN TEST RESULT' ~ 0.'02 irJ -- - ~ .FAILED -- 87FILL TEST STARTED 10:18 AM TEST STARTED 11/03/2006 BEGIN LEVEL. 3,4059 IN END TIME 19:33 AM END DATE 11/03/2006 .. .-_. E,,ND-kc' ._,~..3,ti'~4•9:,IN BEAK THRESHOLD 0.002 IM TEST RESULT FAILED - ~ ~~ ~~ ;, UNIFIED PROGRAM INSPECTION CHECKLIST~E SECTION 1: Business Plan and Inventory Program ^ YES '~NO FACILITY NAME // ~ INSPECTION DATE 1NSPECTI~N TIME f2.•GE~R+ L-I Q 1A 0+2,5_, ADDRESS Z I N G ~ 7 j6L ~ PHON NO. O OF EMPLOYEES gyn. >1 p!~ E L J FAC1L{TY CONTACT USINESS ID NUMBER / 15-021- 6 Sec#ion 1: Business Plan and inventory Program ^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION ~J C V ~ C=Compliance OPERATION V=Violation ~T ;~ ~, ~~~~ COMMENTS ^ APPROPRIATE PERMIT ON HAND L~ ^ BUSIII@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ,~ ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES (~ _ (~ ~D ^ VERIFICATION OF LOCATION o ^ PROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITY Q ~ VERIFICATION OF HAZ MAT TRAINING ~n-.ANN /NC, ~ar.~ ws ~,-~. ~ ~~ ~ _p Ot,t,..}. a ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ ~ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTION/~S, REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326.3979 /~i/L~M' /~° ~ -~ ) i Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station # sines Sit Respon le Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy , - FD 2155 (Rev. 09/05 Prevention Services e E R 5 F ,_ D -900 Truxtun Ave.> Suite 210 _.. FIRE Bakersfield, CA 93301 ~RrM r Tel.: (661) 326-3979 Fax: (661) 872-2171 tttlf-bU1J ~- INSPECTIONS B E R S F I L D BUSINESS PLAN & ~ rM r INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: ~'C.•E~+N~7 LI q,~ o2,s • Section 2: Underground Storage Tanks Program INSPECTION DATE: ~ 3( 0~ ^ Routine ^ Combined ^ Joint Agency ^ Multi-Agency ^ Complaint ^ Re-Inspection Type of Tank ~ ~ ~•ho ~ c~~ s Number of Tanks 2 Type of Monitoring~`~~~ ~G~ Type of Piping ~~.ESSu.2~ ~ ~+1 A~• S(4s s OPERATION C V COMMENTS Proper tank data on file Proper owner /operator data on file Permit fees 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) Type of Tank BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 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: V~G ~'"~~ '`~ ~ ~"~ Questions regarding this inspection? Please call us at (661) 326-3979 • White -Prevention Services Aggregate Capacity Number of Tanks tf u n s Sit esponsible Party Pink -Business Copy KBF-7335 FD 2156 (Rev. 09105) 1 ~ -~ ~ ~' i. M4NITQRING SYSTEM CERTIFICATIGN For Use By All Jurisdictions Within the State of California _~ituhorTty Cire& Chapter 6 7, Health and Safety Code; Chapter I b; Division 3, Title 23, Cal forma Code ofRegulafions This form must be used to document testing and servicing of monitoring equipment. A~epazgte certification or report m{~,b,-,gprgpare f or ~ac:z monitorine system control.panel by the technician who performs the work. A copy of this form must be provided to the tank sy>ten-[ owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 ;t;[~ s of test date. ~. ~eiueral Information Fii.:itiq• Nasne: F~..~A~~~~r~ ~~ _ Bldg. No. ~itc :address: e? ! U t7~ ~ . ~~Ztt1y~~.i,~~ City: ,~t,~ QC~•t--~ 4 ~ Zip: Q 3~? r«iiit} Contact Person: R~ 1-Yt~ ~F~~ Contact Pltone No.: t (~1 )~1~~9~ =~lai,;,:~~lodel of Monitoring System: T( _S 3~ Date of Testing/Servicing: ~/~P~ ,~. inventory of Equipment Tested/Certified ~'h~~~ [hz approLria[e boxes to indicate speciFic equipment inspected/serviced: ...'Cans: [11: f~t~( ~~ Tank ID: ~QIr.~MQ ~ f~'lrl-l~lcil:GaugingProbe. Model; ^ In-Tank Gauging Probe. Modcl: ~_ ~cutulsr Space or Vault Sensor. Model: ^ Annular Space or Vault Sensor. Madel: ~ ~; ~ 1'ipin_~ Swop /Trench Sensor(s). Model: ~~~ ^ Piping Sump / Tl'enclt Sensor(s). Model: cs7 ~>~ 1~ ill Siunp Sensor(s). Model: ~ ^ Fill Sump Sensor(s). Model: ! ^ ~;iechanical Line Leak Detector. Model; ni0 Pl , n 'S ^ Mechanical Line Leak Detector. Model: S ~i ^ Cae.;[ronic Lint Leak Detector. Model: ^ Electronic Line Leak Detector. Model: j 1':uil: Overfill /High-Lcvel Sensor. Model ^ Tank Overftll /High-Level Sensor. Model: iJnc~r (s tCi ' e ui ment a and model [n Section E on P e 2 , ^ Other s i ui ent and model in Section E on P e 2 . ! 'i:~nlc iD: TaaitlD: y 1_] 1n=1':uik Gauging Probe. Model: ^ Ia-Tank Ganging Probe. Model: i ^ :~[wulal• Space or Vault Sensor. Model: ^ Annular Space or Vault Sensor. Model: i U Yipi[tg Stunp /Trench Sensors}. Model: ^ Piping Sump / Trench $ensor(s}. Model: J riu ~utnp Sensor(s). Model: ^ Fill Stttnp Sensor(s). Model: ~ ^ A t~chanical Line beak Detector. Model : ^ Mechanical Line Leak Detector. Model: ;:-~ Lll'~[IOn1C Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model: I iJ C.uil: Overfill /High-Level Sensor. Model: ^ Tank Overfill /High-bevel Sensor. Model: j J iith~r (specify equipment type and model in Section E on Page 2 . ^ Other (speei uipment type and model in Section E on . e 2). i i,istr~u>er 1D: Dispenser ID: y '; ?~L,llispenser Contai[unent Sensors}. Model: ~-Dispenser Containment Sensor(s). Model: ! L4-~hc•,iC Valve(s). -k2'Shear Valve(s). iJ llis tn~zr Con[aitunent Floats and Cha' s . Dis eraser Containment Floats and Chains . i}isprnstr 1D: ~~(p Dispenser ID: i~Dupenser Containment Sensor(s), Model: t ~ i _ l~Dispenser Containment Sensor(s). Model: ~ ~-Jhz:u Valve(s). ~Sbear Valve(s). ~- ;:.1 Dispenser Containment Float(s) and Chain(s). ^ Dis eraser Containmcnt Floats and Chains . Dispenser iD: Dlspenser ID: U Dispenser Containment Sensor(s}. Model: ^ Dispenser Containment Sensor(s). Model: j .^ ~hr;u• Valve(s). l] Shear Valves}. UUi~pcnsrr ContainmentFloat(s and Chain(s). ^ Dis eraser Containment Floats and Chain s . `^1 f [ne raciliry contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. . Ccl'titiCatiOn -1 certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' ,uideliaes. Attached to this Certification is lnformatian (e.g, manufacturers' checklists} necessary to verify that thin Information is correct and a Plor Plan showing the layout of monitoring equipment. For any equipme~n# capable of geaerattng auc6 reports, I have also attached a copy of the report; (check al! that apply).• '~,l;yatem set-up ~Alarnt history report ~1'c.:iulii:i;:[n Name (print): ~('r~/~ ,~1~~ Signature: _ Ccrtifi::ation No.: ,j~p~C : ~ -~~,~~f~~~~e~ License. No.: 'i'es[in~, Company Name: NCH ENV]RO?.IMENTAL Phone No.: (~_) 3~2_868~ ~itr :ici~iress: (~i~ ~ f~ 1 wil~L}C.,K iw1_ 6:l~S,~,(~~.('~- Dato of Testing/Servicing: ~i~_~~ Page I of 3 U31U1 ;vionitvring system Certification 1 F~ 6 iL~. zesults of Testing/Servicing 5oin~ urc Version Installed: (+<D •(~'~ r:,-.,..,.. .a.., P.,u.,..,:......h..~4Hat- Yes ^ ° Is the audible alarrn o erational? ~ Yes ^ ° Is the visual alarm o etationai? -~ 1'e, ^ o Were all sensors visuail ins ected, functionall tested and conftn-ned o erational? Y L; ^ o Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their ro er o eration? it 1'es ^ o If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) ~ N/A operational? ~Z ;;; ^ o For pressurized pipinp; systems, does the turbine automatically shut down if the piping secondary containment ^ N/A monitoring system detects a leak, fails to operate, or is electrically discanneeted? If yes: which sensors initiate positive shut-down? (Check all that apply) ~ Sump/Trench Sensors; 1$~Dispenser Containment Sensors. 1 Did you confirm positive shut-down due to leaks and sensor failure/disconnection?Yes; O No. ;~ Ye; ^ o For tank systems th:,t utilize the monitoring system as the primary tank overfill warning device (i.e. no ~, N1A mechatrical overfill I•-evention valve is installed), is the overfill warning alarm visible and audible at the tank I~ fill oint(s) and o erasing properly? If so at what nt of tank ca aci does the alarm tri er? ~~ u~~cy" ~ No Was any monitoring equipment replaced? If yes, identify specific sensors, probes,, or other equipment replaced ~ and list the manufacturer name and model for all re lacement arts in Section E, below. _ ^ 'e~° ~No Was liquid found inside any secondary containment systems designed as dry systems? (Check al! that apply) ^ Product• ^ Water. If es describe causes in Section E below. ~4-Y'cs ^ o Was monitorin s ste~rr set-u reviewed to ensure ro er settin s7 Attach set u re orts if a livable ~1' cs ^ ° Is all monitoring equipment operational r manufacturers specifications? °° rn ~ectruu r: petow, descrine now and Nr.~ren these deuctenctes were or wtu ne corrected. L. on-rmezits: ~- - .~ Page 2 of 3 031 O 1 ::~. i a:? s o j . iri-Tank Gauging 1 SIR Equipment: ~' Check this box if tank gauging is used only for inventory control. ^ Check this box if no tank gauging or SIR equipment is installed. 1 hip section must be completed if in-tank gauging ecluipmenL is used to perform leak detection monitoring. Co;~~;~iete rl~e 1'ulluwine checklist: l G Y'es ^ o Has all input wiring been inspected for proper entry and termination, including testing for ground faults?. ^ ~'es ^ o Were all tank gauging probes visually inspected for damage and residue buildup? U Y'es ^ o Was accuracy of system product level readings tested? 1'e; ^ o" Was accuracy of system water level readings tested? G Y e~ ^ ° Were all probes reinstalled properly? ;~; Yes ^ o Were all items on the equipment manufacturer's tusintenance checklist completed? In the Sectiou H, below, describe how and when these deticieucies were or will be corrected. ~. i,ine Leak Detectors (LLD) C'~uunirte the t'otlowinQ checklist: -Check this box if LLDs are not installed. ~..1 Yes ^ Noy` For equipment start-up or annual equipment certification, was a leak simulated to verify LLD perfgrmance? ^ NIA (Check all that apply) Simulated leak rate: ^ 3 g.p.h., a 0.1 g.p.h , ~ 0.2 g.p.h. u Yes ^ o Were all LLDs confirmed operational and accurate within regulatory requirements? i.1 5'es ^ o Was the testing apparatus properly calibrated? 1'rs ^ o For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^ N/A J Yes O o For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ^ N/A i.j Y z s ^ o For electronic LLDs, does the turbine avtontatically shut off if any portion of the monitoring system is disabled ^ NIA or disconnected? '^ 1' es ^ o For electronic LLDs, does the turbine sutomarically shut aff if any portion of the monitoring system malfunctions O N/A or fails a test? L.1 Yes ^ o For electronic LLDs, have all accessible wiring connections been visually inspected? ^ N/A Ci Ycs ^ o" Were all items on the equipment ms's maintenance checklist completed? Iu the Section H, below, describe how and when these deIIciencies were or will be corrected. itr. Cumtnents: ts10 Qt_tv~Q'3 2~lS-t~~.~~,~ 1ti sr~_ t-EAc. ZFf~ ~ ~[O-r~r--rF1~ „-.. Page 3 of3 03tot a~$o Rionit~ring System Certification UST Monitoring Site Plan 5i~~ A,idress: I------------------ -------- -----------•------------ ------------------ _-_----~Nt~'}------ -------- ------~ ----~ ~r ---~-3--------- ---~---~------- -~ -~ A~N~ ---------- - - - ----------------------• -- _ yAA02 ~t-4~------- -------- __--------------___---- -- __ppO~t__P'e~r191----- -------- ----------------------- -- ~~ --- ~ - -F¢~•1---- ~- - ---------- A'~--- p~x~F, _. - -- ~~"`"~-P - _-- -- ---. ----- -------- --- --- •------ --- --- -- --- ------ -- - -- ------------------- -------------g'-------~--------- -- ------~~~T-~Q~~~~'~-~------------------------ -- Date map was drawn: o? I~~ro Instr._.-°ch ns lr you already have a diagram that shows all required information, you may include it, rather than this page, with your iVlonitoring System Certification. Oii your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tanlc;annular spai;es, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic dine leak d:.te~tors; and in-tank liquid level probes (if used for leak detection). l;n the space provided, note the date this Site Plan was prepared. Page of osioo . y. ` ' L i l:_'~F'l~t'L9tER FahJ F'IJEI- aLF,RI.9 FEB ''U, BODE, J:Fi9 Fil"I F'LIE:L HLHk'1"I +:'~"1' 1 . :'UU~~ 1 I_I : ~t~rir"1 r~Li-iJ~if°I FII~~1'~ak` I?EF°+i1"(' .... 1 p.}..-'rNfVJ: Hl_~i)r1•J ............ T 1::: 1'h:1=a"lI Uf'1 UI'•Jl_k;HLaEIi :>:-rl_Il~• >=i~'r~~ aaakrJlrJi rI~R 1'~'. 1y99 t:dl HP'i °laF' 1 '~ . 1 '~'t9 1:51 F%P1 f°iaR 1=. ly3ti 1:a8 F'I"I ~;UDlira'J LOE.~.1 ;~tt.r;I?P9 PRC~BL: C+UT L!k:t.l'~:iF~I?'i' PJEE1~ELi FE:H i, c'Ul_16 y : ~~;~ Al: FE:l:i -. '~UUG F.J: 5U r-tl~l ,L~1;f°t H I STi~k :' F?EF'?~k'1' L ':L1~aF'l:PlER F'aN 5.t LiI'FEP•1'~EP, F'HN FkJEL aLWRJ"l F'EB '~ri, 2006 10:36 al•I FL)EL. aLAkf"1 u~_T 1 ~. '~OU4 1 l : 11 ~I°! 1=11);L HLriR("1 -------- 5Er•Jti~Gk HL~kP't - L ~ : Ty I :PEfUSER !>aIV 7, E - LiISI%EN81'F' I'HN FUEL. AL.ARh1 FEB~0. 2u06 tU:ll AI`•I FUEL HLARt`9. I"lAk 3. .2DUJ. 4:5a~ ,tiP4 FUEL aLaRl"r .. .. '` _ ' ALHRPI H I ~~ I'Gk`i REFti RT L 2:PREI°11Uh1 :,TF ~:L1P'IP :~TF' ~;UrNF' FUEL aLHRI'1 FEri I.J. 20U6 :3r Ahl FUEL HLARPI '_'•'''T 15, ~'D04 10:51 ar•9 1'f_IEL Hl.r;kM ~~i.%T 1 . '~CICli3 1 U : "4 ahl HLrFh4 H T ST!?k'' F'tl'F'ti ~kT L I:UIVLEfiDELi ~;fF L;UI°IF' STP ;~Uf1F FUEL AI_AkI°l FEB 20. 2UOi; 9:36 HI'9 ;~E1'UF' L"~r;Tf-t l•JriRfd I NC3 MAF.' '?3. ~'C105 I :113 F'P'1 BE'I'UF' UATri 4.IµRf'JI Nia 1•'li=tk ',:.. 2005 7:5b F'hl tiLHRP1 HI;;TGRY IiEF`t'+kT L Ei:Li1SPENSEN: F'AN 1,2 IiISF'EIV:Ek F'AI'J FUEL ai.akhl FEB '!D. '?DU6 9:5E, F'.ra FUEL HLaRr1 F1,IEL r'-iL.r1RM HL.nRM H1'"1'uk'r xtr)1.~.~.gb ----- ~aEIV~'iJR t~L.HRI"1 --- .. L 10 : PkEP'I1 UI"1 t='+4VNULhR Hi'JNULHk ;PACE FUEL ALHI~?I~I F'EB 20. 'du06 9 : X15 AP'1 ,;.;EIVS(~R Gu•r ALAkr•I IVti'i1 2. 2DD5 1 t : a2 Hr'I SEIVS(rF. GUT HLtiRC9 CEP t~U. ';.'DU5 J: ~J Y~.•1 II iLARNI H 1 ST'_yRY kEPt1f?"I' I r L 4: FkEJ"I J l IM F I LI. IJhJP i F' t F' I ['Jia ~ Up'1F FUEL ALHRhI `FEB 'O. ~DU6 11 :05 ar°I i FUEL ALARf°t FEF~ '?u. 2Ui16 9::,6 hr°1 FUEL HLaRM JHN 1. 2006 4:4`?"' Phl ALikl"I HI:~'I'sj)',% REF'Gk'.T ---- --- fiE1VSGk HLHF.h1 - - . - L 9 : UNLEHliED tl'JIVl1I.iiR APJPIULAR SPHr::E FUEL ALARf•1 FEB 20. ?Dllb 9:45 al"1 FUEL. aLAR1~l ci~~T 15. '~DDa 10:4f3 aP~l FUEL AL~RJ"t GCT 1 , GUS 1I):I:J6 rIJ"1 HLaRf°1 H I ST«R;' I~EI:•;;F:'T _.._._._ EtV:Uk ALHRrH - -. L 3 : UIVLEHL~ED F I LI. 8111'il/ P I F' I fVu S UNIF FUEL ALAkP1 FE13 20,~'UU6 9:'3C, hl°I FUEI. tiLr;kl"i FUEL, aLahhl GGT 22.tD[J~ Ij;aS y art i • 'C •U : Pf•ET°1 [ I If°I IJtJhF';~iL~ED T'J1t_F:t°1riL. C~~EFF :.DUO'701.1 'TF;IJ}: i:, l F+t•IETIrk'. 5u . u0 ' 'f r-; hJF: F' kliF ! C.E T; 4 F FULL. +Jt±L 11527 r,'i' . 5 1 IVCH IFQL y:39 7 ' 45.0 [NC:H V+iI. C~-F n 5~r FL•>~i7' ;;ICE: 4.U IIV. N4y6 6:1~1'ER t:•Il;F'PJINid ~.U }IIGH 6Jr;TEF~ LIhll"I: 3.0 P1~r; ':~k LABEL 110t: 11Er~7 L LII°i I T '~ rEkF 11 5`'"~~ _ C, , 1095U 1~395U UkLI'uEkY LII°iIT ~ 1 E;3 r 1..~L~I,tI Fi?tjIiLl!T 51JU -`~ EH}: i-wLr~kt°l L 1 h'1 I T: I _ :~UDL;EN LGS:= LIMI'T~ 'I'r"iNK TILT U.OU ' I°1riNIF:~'i_DED 'THNKS 'Ttt: fJ<JNE (_Eh1; t91 P•1 PER I GL, I C : uLi ~! 5'l;: LF'Fyl': t•`111V r;l'dIVUAL ~ .,881 1- Ek l %L~ I i": 7'E~:'t' T`iF'k: :'TAtVIir~kD r;hdPJl.hL 'fES'f FriIL rLHRI~I L I S+BLED f•lrk:l~:iL~li_ 7'E:;T FHIL ALi•~kl°1 Ii I .;HEsI_ELi ALr-;Rh1 D I :hEILI:'L~ Afdf~J TF.:;T riVEkF;i~ I Nip : t~FF' PL'k 'f EST F-iVERAG [ tJi~ : GFF 'TAtdl; TENT hIGT 1 F:' : C;FF °1'tJ}~: l'.~T ~JIPH(iPJ BkEri}::C:'FF PEL t'~r1=:k` DELA'.'' 1 1°1I N t Iv-~'I'Hlvr; SE: i'1~1-' T 1 : UIVLEADEI? 1fEGI!Lri}' Pki:'UUi'1' COLE 1 `!'HERNIrJL i_'.GEFF :. Cl0U7U0 fAIVK GIHhIE`fEk 90.00 TAtJK. PkOF I I.E 4 PTS FULL 11GL ] f 5'27 67 .5 [ NCN VGI. 5x97 45.0 IfVCH +JOL 5857 ,~'~ . 5 INCH VGI_ '~''<65 FL(7FT :SIZE: 4.i1 IN. 24y6 r:.l~i fER WARN I PJ(i 2.0 HIi3H 4JATEk LIr°Il1': 3.0 f~1A:~; Gk, LABEL 'JOL.: 115'_7 t~1tEkFILL. LIMIT 55%Z 1IJ55U JiI~:~H 1>h-'CiDUi:•T 55"S 1 ij550 PEI_ I VEkY L 1 r1 I T' 1 °~~S 1383 LGbJ FkODUi;T 500 L.EF;}; ALHkPi L Ih91 T : 24 NLIUGEN LOSS LII°lI'T: 24 TrfJK T 1 LT 0.00 r°IrPJIFC+LDED Ti;hJ}15 T;t : AJOIVE LEHK r•9IlV PEk1UliIt:: u 0 L.E~+I' MIIV AMNUF;L ='S"4 ,_'88 ] FEk I OD i ~' TE:J'1' 'TYPE STHIVLk;RD s~tJiVUHL TEST F'HII. ALAkt°i D I SHBL.ED F'E'N". I OLi I i TEN"f FA I L ALriRF9 tiIC;HBLELi i~kGSS TE;;T FH I L HLAkI°I D I Sr;BLED r tV l'd TEST Ab'ERA~~ I iVu^ : OFF I~Ek TEST AVERHGING: OFF TtiIVK TEST IVGT I FY : GFF TtJK 'I ~T S 1 PHUN BkEr;K :OFF I~EL I'JEkY DELAY 1 M I N a~s,~b HLHkhI HI5'fCik':' kEPCJY',T __ _.. I N-THI'JK ALHkh9 -. _... _ _. T 1 : UIVLEFDEL~ kEGU1.AR SETUP DtiTr; IJAkP1 I NG t°IAF. 1.?. 199y 8:41 F,FJ LEHK ALF;khl i NOV 1. '2004 4:301 HNI SEF' b. '?004 8:38 tih9 ' SEP b. 2004 4:30 AM i OVEF.'FILL ALtiRM NOV ''5. ' 2005 4:12 PI°1 NOV 3. 2005 ' 2:15 PM OCT '~0. X005 1 :41' PI'1 LOW PRODUCT r'~T_AkM NGV 10. 2004 8:24 fd°J JUN 1. 2004 5:54 )'1'1 SEP 16. 2005 4:00 FI°i SULDEIV L.i?,S ~I_AkN1 DE(: 5. 2005 4:25 kh7 AFR 4. x'005 4:09 HWI NOV 1. 2004 3:55 Hh1 H 1 G H F'kOD UC"f HLHkM IVOV 25. 2DCIS 4:12 PM tVOV 3. 2005 2:15 FI°t OCT 20. 2005 1:41 PNl INVALID FUEL LEVEL NOV 10, 2004 B:OE AP~i JUN 1. 2004 5:2H Ph7 SEP 16. 2003 3:40 PM PF.GBE GUT Ot;T 6. 20U4 1 :33 Ph1 DEL1VEkY PJ£EDED QCT 23. ?005 9:~U Phi 4Cf 9. 20015 3:56 PI'q OCT 1. 2005 8:23 AM h1A:~S PkGDUCT ALARi°J :;UG 10. 2004 6:53 Phl JUL 11.. 2004 1:53 PNi JUN 27. 2004 I i : 18 At°t L.OW TEI"iP WHkN I Nry tiYC:T 6. 2004 1 :44 Fin :3.L:::a,L `WH.L-hll 'hIINM1Jti :?~.I_: r:3.1. :IN".L- N I ;? I iI•_> I ~3d ~;:I~f1.LH33 6J3.LS:CS 3'h1Q!::bJ 3::f"1'•LL,3!.!S GN !yry'rII 1. 'F'~I'I'o~ri - Q~.LN3~i :3-i:ICil-•ylr=labti ri3~yNl.L3U~; ~lI'•~l N•.ris~:~r~. T3:1:{'I I'~II ~, I S1 ii,~~ 13NNf'l.Ldflt-~ 1-'FL', :IJ-- '__lJfar. 'a:'.'1 :I,:}. r,'::;1' Er•1 Lied 1 "1':3 t~-'~• SY':~CEP'1 L'arirE.'I11^lt: FOh:I"lrT hKriV L~l:i 'i'f'f`r HH :I°1hl ::~.~ :-,I l i i C T l t'tI: 1 i 1: Uu F'I°1 ',='.H 1 F•f ;1' I h1T-: D 1 ;AF3LEL~ =,~lr-r III'1E '1'ril•Jh; T-'El~.'t~:LI~~ 6JFI.NIIV~~+ l:r I ;;~13LI:L I'r;IV}- i=tNl'JLIF;L r.~l~iRl'JIIdGS L~ 1:?~HHi..ED L. I IVE PEF:1 GL~ 1 r.; WAk W I PJL.S L~ 1:~r+1=1LEG L.1 PlE hlVl'dIJ~;1. 4.k;FaJ[ 1Vi.i~ I~ I =;rwf~LELr I~r;11Jr ~r~_- >.rt~i_Ui'lE~ f) I f'•hF''LpC~ •f~•,1T-' iiiP•11'LP•ISF1TILiP•I '.iiiL~.l~ i Lil=~~ F > ~ r~0 . U •;;Tli=}: HEIGH`f ~:>FF.~ET L~ I Sr~SLEG _, , j fd[; 'I' I1.1E Lti L I t;HT :.~~ f Ei'IrtBL.EL' ~Pk I:JEEI" 1 c;'1'hRT '1' 1 I"IE •~ : l1U ~I"i c,rr WEI}. b ES'JL~ 1' I hlE L:UU AI"1 ' ce~f~E Uq~tGUU UU'i'FU`f k)rL.r+ SETUP R 1 : I.i I SF'EIVSER RELAi`~ 'r`.'F'E STHNLiHkD NC>R11i~L:L'': :)PEI+I I Pd-•'1'Hf•Jl: ALARMS rtiLL :1_EHK tiLARNI r~Li.: H 1 ~H Wti fER ALARIW F,LL : LGW FRGDUCI' HLHRNI HL.L.: t~RC>5S TEST Fri I L L.IiaL11Lr :~EIVSGR HL.1"lS 1_ 1:FUEL ALF+RN1 L ' :FUEL FiLHRI°i L .3:FUEL ALARM L 4:FUEL 1;LARh1 L h:FUEC. ALARNI L, ~ :FUEL ILARNI L '7:F'UEL HLARNI L e :FUEL i~LARNI C'Oh1N1LIhJICr;"1'luN: SF.T'l1F' _ P;)1<:'f SET'!' I IVc>> I'JGI'JE FUUNU RFJ-':':=1 ' tUEi::UIzI'r`f ;:;jI:,E : OGUUGU L I ~iU i G SEPJ`~.fiR SETUF• L ! : UIVLEAD£:Ii ST1=' 'SUP'IP TR I -STATE i ::11VGLE FLUAT C:HTEGUF.`! ATP SUNIF L '2:F'REN11U1°1 :;TP iUMF' TRI -S~'TATE (SI NGI.E FI.UA'f ) CMTEGCyRY tJTP SUP'IP L a : UIVLEACiEli FILL r~UNIP TR I - ;THTE (S I PJr;LE FLUAT 1 CATEGGR;' PIPINi:~ SUMP L ~ : F'REM I UNI F 1 LL SUNIP TR I -SPATE <'~ I IViaLE FLUA71 CtiTEGGRY F' I P I IVU SUNIP L S:UISF'ENSER PAN 1.2 TF: I -S'fATE ~ ~~ I N~C.E FLUAT ) criTEGORY IaI5FE1VBEk PAN i ~ast6' ~" .J;;, .F~::);J]SP)~Nf~ER~-PHN 7•.;% ~ ' f~Z'I -STATE ' ! Fes' I IVGLE FLGF;T i ' CATEGURY DIS>/F.iV>ER F'AN L ?:DI SF'EPJSER FAN 6.6 TR I -STATE c S ] NGI.E F'LU+T ) j CF'rTEGURY IiISPEfV;_ER PAIV I. b:DISPEPJSER F'AN ?,>3 'I'R I -STATE (S I PJGI.E FLC)AT ) OF NIES,~Ac.E i ' ' , CATEGUk`I DI::PEN,SEk PAIV ) R;- EN ~:3~ Lr 1;,.,FtALEP ~ C.EAI: `t'F_ST' NIE:'fHC>Ii , L '~:111VLEF;DED AIVNULr;R _ ._ _ _ _ _ _ _ _ _ _ _ TR I -STATE t S 11VC:LE FI.CrAT r TEE:T t°1GJVTHLY tiLI_ TAf•IF: ~ C;HTEt;Uk:' ANNULAR SFACE WEEy; 1 NION :STAR"r T 1 J°IE ~ ::~Q r;I°1 TEST RFiTE :o.'~u uitiL!HR i; Cil.1F.AT I ia1V '% HGURS L1 U : F'kEl'I I UM ti1VIVULAR I"' 'TR 1 -STATE t ~ I IVGLE FLUAT ) i ~ CNTEiOk'i' ANNULAR SPAt1E LEHK TEST REP'JRT FGRI.9AT ENHtiNC:EPr ~. i -- --~--- ---- -- ~a~~o. MONITOR CERT. FAILURE REPORT SITE NAME: ~FZ~~al4`~ l,Zpu.E~ S DATE: ~(o~ml~Cv ADDRESS: ~~ N~ ~.~ftiID~G~ c~J~TECHNICIAN: ~T'~.UF~ ~~~~T- THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRF.D TO COMPLETE TESTING. REPAIRS: 1~1 F C (J T[~ r~_t.rl_.. ~ L -~.~~5 ~PR~Qu.LT' r=I~~r~ LABOR• r.10~.1 ~~ PARTS INTALLED• N Q 1~3 t- THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON-COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN LEFT ON-SITE FOR YOUR CONVIENENCE. +, "d UNDERGROUND STORAGE TANKS ~`~, `; :o-.~xt.ra.;n,c:.:, srvia::.s~zi~c:n:mnnxww~vrsr~,~a~mmm~xwru~amwwwsv0:nrmxsasoemscra/mr••~•.•w. •<~~ APPLICATION ~`~ TO PERFORM ELD /LINE TESTING 1 S8989 SECONDARY CONTAINMENT TESTING !TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. C~~~' ~~ ~/R/ /~ ! BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 ^ ENHANCED LEAK DEFECTION ^ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST TO PERFORM FUEL MONITORING CERTIFICATION FACILITY N 8 PHONE NUMBER OF CONTACT PERSON ADDRESS .~ ~ ~ ~ ~ ~ ~„I V OWNERS NAME 1 OPERATORS NAME PERMIT TO OPERATE N0. NUMBER OF TANKS TO BE TESTED IS PIPING GOING T E TE TED? YES ^ NO TA K # V U CONT ENTS I ~ p .; I L °' p TANK;TESTING COMPANY NAME OF TES ING CO PANY 4 MAILING ADDRESS (( V i ~ i \ ~ CAI N E 8 PHONE N BER ~ F CONTACT PERSON ~Rb~-~s~F7 ~~ '~C,~7( NAME & PHONE NUMBER OF TE TER ORS E I G AL INSPECTOR •r CERTIFI ION #: DATE & TIME TEST TO BE CONDUCTED ~ ,„~~ ICC #: TEST METHOD SIGNATURE OF APPLICAN ~~ .~.-~ ~' ~ ~ DATE 2 ., , ~ , ~ APPROVED BY DATE ~ I -© FD 2095 (Rev. 09/05) ~1LLIN~ & PERMIT STATEMENT PERiWiT NO.: BAKERSFIELD FIRE DEPT. Prevention Services AR ~ T 900 Truxtun Avenue, Suite 210 Bakersfield, CA 93301 Tel_~ f66]1 326-3979 S Fax: (6611 852-217] LOCATION OF PRQIECT v©Y PROPER WNER STARTING DATE ~ `COMPLETION DA . OV n /vv~l,, NAME ~-r ~~ ~~ ~~~ Y PROJECT NAME o .~ ADDRESS ai off. PHONE NO. ~ ~ PROJECTADDRESS~ e ~ ~ e ~ C e ~~ AT~ ~C~ O~ CONTRAC OR NAME CA UCENSE NO. TYPE;OF LICENSE. EXPIRATION DATE PHONE NO.~y ..--77 p ~y 6oL'G~17/ CONTRAC OR C ANY E ~~~' ~. f" FAX NO. a--o~~~ ADDRESS (~ ~. -t - ~ ~ C i' t' ~ ZIP CODE ~_ a • ~ ~ ^ Alarms -New & Modifications - (Minimum Charge) $262 50 • • ~ . 98 Over 20 000 Sq Ft Ft x .013125 =Permit fee Sq ~ ^ , . . - sa ^ Sprinklers -New & Modifications - (Minimum Charge} $210 00 ~ . 98 ^ Over 5 000 Sq Ft Ft x 042 =Permit fee Sq ~ , . . . . 98 ^ Minor Sprinkler Modifications (< 10 heads) $ 93.00 [Inspection Only] ~ 98 ^ Commercial Hoods -New 8 Modifications 26 $ 398 ~ . 98 ^ Additional Hoods $ 36.00 ~ 98 ^ Spray Booths -New & Modifications $458.00 ~ 98 ^ Aboveground Storage Tanks (Installation/lnsp: 1~` Time) $165.00 82 ^ Additional Tanks $ 26.00 82 ^ Aboveground Storage Tanks (Removal/Inspection) $109.00 82 ^ Underground Storage Tanks (/nstallation.llnspedion) $878.00 {pertank) ~ - 82 ^ Underground Storage Tanks (Modification) $878.00 (persite) 82 ^ Underground Storage Tanks (Minor Modfigtion) $155.00 82 ^ Underground Storage Tanks (RemovaQ $675.00 (pertank) 84 ^ Oilwell (installation) ~ 84 Mandated Leak Detection (festi ) I Fuel Monit. $ 81.OQ (persite) ~ ^ Tents .O~perta ~ ^ After hours inspection fee $122.00 84 ^ Pyrotechnic - (Per event, Plus Insp. Fee @ $90 per hour) $ 60.00 + (5 hrs. min. stand -by tee /Inspection) _ $510.00 84 ^ RE-INSPECTION(S) /FOLLOW-UP INSPECTION(S) $ 93.00 (per hour) 84 ^ Portable LPG (Propane): NO.OF CAGES? $66.00 ~ ^ Explosive Storage $249.00 ' ~ ^ Copying & File Research (File Research Fee $33.00 per hr) 25¢ per page ; 84 ^ Miscellaneous ; ~ FD 2021 (Rev. 09105) _ no~rlrunl WHITE It11 TraAR11N~ 1-YELLOW Ito File) 1-PINK (to Customer) 1 ~ -~ ~ ~' i. M4NITQRING SYSTEM CERTIFICATIGN For Use By All Jurisdictions Within the State of California _~ituhorTty Cire& Chapter 6 7, Health and Safety Code; Chapter I b; Division 3, Title 23, Cal forma Code ofRegulafions This form must be used to document testing and servicing of monitoring equipment. A~epazgte certification or report m{~,b,-,gprgpare f or ~ac:z monitorine system control.panel by the technician who performs the work. A copy of this form must be provided to the tank sy>ten-[ owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 ;t;[~ s of test date. ~. ~eiueral Information Fii.:itiq• Nasne: F~..~A~~~~r~ ~~ _ Bldg. No. ~itc :address: e? ! U t7~ ~ . ~~Ztt1y~~.i,~~ City: ,~t,~ QC~•t--~ 4 ~ Zip: Q 3~? r«iiit} Contact Person: R~ 1-Yt~ ~F~~ Contact Pltone No.: t (~1 )~1~~9~ =~lai,;,:~~lodel of Monitoring System: T( _S 3~ Date of Testing/Servicing: ~/~P~ ,~. inventory of Equipment Tested/Certified ~'h~~~ [hz approLria[e boxes to indicate speciFic equipment inspected/serviced: ...'Cans: [11: f~t~( ~~ Tank ID: ~QIr.~MQ ~ f~'lrl-l~lcil:GaugingProbe. Model; ^ In-Tank Gauging Probe. Modcl: ~_ ~cutulsr Space or Vault Sensor. Model: ^ Annular Space or Vault Sensor. Madel: ~ ~; ~ 1'ipin_~ Swop /Trench Sensor(s). Model: ~~~ ^ Piping Sump / Tl'enclt Sensor(s). Model: cs7 ~>~ 1~ ill Siunp Sensor(s). Model: ~ ^ Fill Sump Sensor(s). Model: ! ^ ~;iechanical Line Leak Detector. Model; ni0 Pl , n 'S ^ Mechanical Line Leak Detector. Model: S ~i ^ Cae.;[ronic Lint Leak Detector. Model: ^ Electronic Line Leak Detector. Model: j 1':uil: Overfill /High-Lcvel Sensor. Model ^ Tank Overftll /High-Level Sensor. Model: iJnc~r (s tCi ' e ui ment a and model [n Section E on P e 2 , ^ Other s i ui ent and model in Section E on P e 2 . ! 'i:~nlc iD: TaaitlD: y 1_] 1n=1':uik Gauging Probe. Model: ^ Ia-Tank Ganging Probe. Model: i ^ :~[wulal• Space or Vault Sensor. Model: ^ Annular Space or Vault Sensor. Model: i U Yipi[tg Stunp /Trench Sensors}. Model: ^ Piping Sump / Trench $ensor(s}. Model: J riu ~utnp Sensor(s). Model: ^ Fill Stttnp Sensor(s). Model: ~ ^ A t~chanical Line beak Detector. Model : ^ Mechanical Line Leak Detector. Model: ;:-~ Lll'~[IOn1C Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model: I iJ C.uil: Overfill /High-Level Sensor. Model: ^ Tank Overfill /High-bevel Sensor. Model: j J iith~r (specify equipment type and model in Section E on Page 2 . ^ Other (speei uipment type and model in Section E on . e 2). i i,istr~u>er 1D: Dispenser ID: y '; ?~L,llispenser Contai[unent Sensors}. Model: ~-Dispenser Containment Sensor(s). Model: ! L4-~hc•,iC Valve(s). -k2'Shear Valve(s). iJ llis tn~zr Con[aitunent Floats and Cha' s . Dis eraser Containment Floats and Chains . i}isprnstr 1D: ~~(p Dispenser ID: i~Dupenser Containment Sensor(s), Model: t ~ i _ l~Dispenser Containment Sensor(s). Model: ~ ~-Jhz:u Valve(s). ~Sbear Valve(s). ~- ;:.1 Dispenser Containment Float(s) and Chain(s). ^ Dis eraser Containmcnt Floats and Chains . Dispenser iD: Dlspenser ID: U Dispenser Containment Sensor(s}. Model: ^ Dispenser Containment Sensor(s). Model: j .^ ~hr;u• Valve(s). l] Shear Valves}. UUi~pcnsrr ContainmentFloat(s and Chain(s). ^ Dis eraser Containment Floats and Chain s . `^1 f [ne raciliry contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. . Ccl'titiCatiOn -1 certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' ,uideliaes. Attached to this Certification is lnformatian (e.g, manufacturers' checklists} necessary to verify that thin Information is correct and a Plor Plan showing the layout of monitoring equipment. For any equipme~n# capable of geaerattng auc6 reports, I have also attached a copy of the report; (check al! that apply).• '~,l;yatem set-up ~Alarnt history report ~1'c.:iulii:i;:[n Name (print): ~('r~/~ ,~1~~ Signature: _ Ccrtifi::ation No.: ,j~p~C : ~ -~~,~~f~~~~e~ License. No.: 'i'es[in~, Company Name: NCH ENV]RO?.IMENTAL Phone No.: (~_) 3~2_868~ ~itr :ici~iress: (~i~ ~ f~ 1 wil~L}C.,K iw1_ 6:l~S,~,(~~.('~- Dato of Testing/Servicing: ~i~_~~ Page I of 3 U31U1 ;vionitvring system Certification 1 F~ 6 iL~. zesults of Testing/Servicing 5oin~ urc Version Installed: (+<D •(~'~ r:,-.,..,.. .a.., P.,u.,..,:......h..~4Hat- Yes ^ ° Is the audible alarrn o erational? ~ Yes ^ ° Is the visual alarm o etationai? -~ 1'e, ^ o Were all sensors visuail ins ected, functionall tested and conftn-ned o erational? Y L; ^ o Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their ro er o eration? it 1'es ^ o If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) ~ N/A operational? ~Z ;;; ^ o For pressurized pipinp; systems, does the turbine automatically shut down if the piping secondary containment ^ N/A monitoring system detects a leak, fails to operate, or is electrically discanneeted? If yes: which sensors initiate positive shut-down? (Check all that apply) ~ Sump/Trench Sensors; 1$~Dispenser Containment Sensors. 1 Did you confirm positive shut-down due to leaks and sensor failure/disconnection?Yes; O No. ;~ Ye; ^ o For tank systems th:,t utilize the monitoring system as the primary tank overfill warning device (i.e. no ~, N1A mechatrical overfill I•-evention valve is installed), is the overfill warning alarm visible and audible at the tank I~ fill oint(s) and o erasing properly? If so at what nt of tank ca aci does the alarm tri er? ~~ u~~cy" ~ No Was any monitoring equipment replaced? If yes, identify specific sensors, probes,, or other equipment replaced ~ and list the manufacturer name and model for all re lacement arts in Section E, below. _ ^ 'e~° ~No Was liquid found inside any secondary containment systems designed as dry systems? (Check al! that apply) ^ Product• ^ Water. If es describe causes in Section E below. ~4-Y'cs ^ o Was monitorin s ste~rr set-u reviewed to ensure ro er settin s7 Attach set u re orts if a livable ~1' cs ^ ° Is all monitoring equipment operational r manufacturers specifications? °° rn ~ectruu r: petow, descrine now and Nr.~ren these deuctenctes were or wtu ne corrected. L. on-rmezits: ~- - .~ Page 2 of 3 031 O 1 ::~. i a:? s o j . iri-Tank Gauging 1 SIR Equipment: ~' Check this box if tank gauging is used only for inventory control. ^ Check this box if no tank gauging or SIR equipment is installed. 1 hip section must be completed if in-tank gauging ecluipmenL is used to perform leak detection monitoring. Co;~~;~iete rl~e 1'ulluwine checklist: l G Y'es ^ o Has all input wiring been inspected for proper entry and termination, including testing for ground faults?. ^ ~'es ^ o Were all tank gauging probes visually inspected for damage and residue buildup? U Y'es ^ o Was accuracy of system product level readings tested? 1'e; ^ o" Was accuracy of system water level readings tested? G Y e~ ^ ° Were all probes reinstalled properly? ;~; Yes ^ o Were all items on the equipment manufacturer's tusintenance checklist completed? In the Sectiou H, below, describe how and when these deticieucies were or will be corrected. ~. i,ine Leak Detectors (LLD) C'~uunirte the t'otlowinQ checklist: -Check this box if LLDs are not installed. ~..1 Yes ^ Noy` For equipment start-up or annual equipment certification, was a leak simulated to verify LLD perfgrmance? ^ NIA (Check all that apply) Simulated leak rate: ^ 3 g.p.h., a 0.1 g.p.h , ~ 0.2 g.p.h. u Yes ^ o Were all LLDs confirmed operational and accurate within regulatory requirements? i.1 5'es ^ o Was the testing apparatus properly calibrated? 1'rs ^ o For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^ N/A J Yes O o For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ^ N/A i.j Y z s ^ o For electronic LLDs, does the turbine avtontatically shut off if any portion of the monitoring system is disabled ^ NIA or disconnected? '^ 1' es ^ o For electronic LLDs, does the turbine sutomarically shut aff if any portion of the monitoring system malfunctions O N/A or fails a test? L.1 Yes ^ o For electronic LLDs, have all accessible wiring connections been visually inspected? ^ N/A Ci Ycs ^ o" Were all items on the equipment ms's maintenance checklist completed? Iu the Section H, below, describe how and when these deIIciencies were or will be corrected. itr. Cumtnents: ts10 Qt_tv~Q'3 2~lS-t~~.~~,~ 1ti sr~_ t-EAc. ZFf~ ~ ~[O-r~r--rF1~ „-.. Page 3 of3 03tot a~$o Rionit~ring System Certification UST Monitoring Site Plan 5i~~ A,idress: I------------------ -------- -----------•------------ ------------------ _-_----~Nt~'}------ -------- ------~ ----~ ~r ---~-3--------- ---~---~------- -~ -~ A~N~ ---------- - - - ----------------------• -- _ yAA02 ~t-4~------- -------- __--------------___---- -- __ppO~t__P'e~r191----- -------- ----------------------- -- ~~ --- ~ - -F¢~•1---- ~- - ---------- A'~--- p~x~F, _. - -- ~~"`"~-P - _-- -- ---. ----- -------- --- --- •------ --- --- -- --- ------ -- - -- ------------------- -------------g'-------~--------- -- ------~~~T-~Q~~~~'~-~------------------------ -- Date map was drawn: o? I~~ro Instr._.-°ch ns lr you already have a diagram that shows all required information, you may include it, rather than this page, with your iVlonitoring System Certification. Oii your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tanlc;annular spai;es, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic dine leak d:.te~tors; and in-tank liquid level probes (if used for leak detection). l;n the space provided, note the date this Site Plan was prepared. Page of osioo . y. ` ' L i l:_'~F'l~t'L9tER FahJ F'IJEI- aLF,RI.9 FEB ''U, BODE, J:Fi9 Fil"I F'LIE:L HLHk'1"I +:'~"1' 1 . :'UU~~ 1 I_I : ~t~rir"1 r~Li-iJ~if°I FII~~1'~ak` I?EF°+i1"(' .... 1 p.}..-'rNfVJ: Hl_~i)r1•J ............ T 1::: 1'h:1=a"lI Uf'1 UI'•Jl_k;HLaEIi :>:-rl_Il~• >=i~'r~~ aaakrJlrJi rI~R 1'~'. 1y99 t:dl HP'i °laF' 1 '~ . 1 '~'t9 1:51 F%P1 f°iaR 1=. ly3ti 1:a8 F'I"I ~;UDlira'J LOE.~.1 ;~tt.r;I?P9 PRC~BL: C+UT L!k:t.l'~:iF~I?'i' PJEE1~ELi FE:H i, c'Ul_16 y : ~~;~ Al: FE:l:i -. '~UUG F.J: 5U r-tl~l ,L~1;f°t H I STi~k :' F?EF'?~k'1' L ':L1~aF'l:PlER F'aN 5.t LiI'FEP•1'~EP, F'HN FkJEL aLWRJ"l F'EB '~ri, 2006 10:36 al•I FL)EL. aLAkf"1 u~_T 1 ~. '~OU4 1 l : 11 ~I°! 1=11);L HLriR("1 -------- 5Er•Jti~Gk HL~kP't - L ~ : Ty I :PEfUSER !>aIV 7, E - LiISI%EN81'F' I'HN FUEL. AL.ARh1 FEB~0. 2u06 tU:ll AI`•I FUEL HLARt`9. I"lAk 3. .2DUJ. 4:5a~ ,tiP4 FUEL aLaRl"r .. .. '` _ ' ALHRPI H I ~~ I'Gk`i REFti RT L 2:PREI°11Uh1 :,TF ~:L1P'IP :~TF' ~;UrNF' FUEL aLHRI'1 FEri I.J. 20U6 :3r Ahl FUEL HLARPI '_'•'''T 15, ~'D04 10:51 ar•9 1'f_IEL Hl.r;kM ~~i.%T 1 . '~CICli3 1 U : "4 ahl HLrFh4 H T ST!?k'' F'tl'F'ti ~kT L I:UIVLEfiDELi ~;fF L;UI°IF' STP ;~Uf1F FUEL AI_AkI°l FEB 20. 2UOi; 9:36 HI'9 ;~E1'UF' L"~r;Tf-t l•JriRfd I NC3 MAF.' '?3. ~'C105 I :113 F'P'1 BE'I'UF' UATri 4.IµRf'JI Nia 1•'li=tk ',:.. 2005 7:5b F'hl tiLHRP1 HI;;TGRY IiEF`t'+kT L Ei:Li1SPENSEN: F'AN 1,2 IiISF'EIV:Ek F'AI'J FUEL ai.akhl FEB '!D. '?DU6 9:5E, F'.ra FUEL HLaRr1 F1,IEL r'-iL.r1RM HL.nRM H1'"1'uk'r xtr)1.~.~.gb ----- ~aEIV~'iJR t~L.HRI"1 --- .. L 10 : PkEP'I1 UI"1 t='+4VNULhR Hi'JNULHk ;PACE FUEL ALHI~?I~I F'EB 20. 'du06 9 : X15 AP'1 ,;.;EIVS(~R Gu•r ALAkr•I IVti'i1 2. 2DD5 1 t : a2 Hr'I SEIVS(rF. GUT HLtiRC9 CEP t~U. ';.'DU5 J: ~J Y~.•1 II iLARNI H 1 ST'_yRY kEPt1f?"I' I r L 4: FkEJ"I J l IM F I LI. IJhJP i F' t F' I ['Jia ~ Up'1F FUEL ALHRhI `FEB 'O. ~DU6 11 :05 ar°I i FUEL ALARf°t FEF~ '?u. 2Ui16 9::,6 hr°1 FUEL HLaRM JHN 1. 2006 4:4`?"' Phl ALikl"I HI:~'I'sj)',% REF'Gk'.T ---- --- fiE1VSGk HLHF.h1 - - . - L 9 : UNLEHliED tl'JIVl1I.iiR APJPIULAR SPHr::E FUEL ALARf•1 FEB 20. ?Dllb 9:45 al"1 FUEL. aLAR1~l ci~~T 15. '~DDa 10:4f3 aP~l FUEL AL~RJ"t GCT 1 , GUS 1I):I:J6 rIJ"1 HLaRf°1 H I ST«R;' I~EI:•;;F:'T _.._._._ EtV:Uk ALHRrH - -. L 3 : UIVLEHL~ED F I LI. 8111'il/ P I F' I fVu S UNIF FUEL ALAkP1 FE13 20,~'UU6 9:'3C, hl°I FUEI. tiLr;kl"i FUEL, aLahhl GGT 22.tD[J~ Ij;aS y art i • 'C •U : Pf•ET°1 [ I If°I IJtJhF';~iL~ED T'J1t_F:t°1riL. C~~EFF :.DUO'701.1 'TF;IJ}: i:, l F+t•IETIrk'. 5u . u0 ' 'f r-; hJF: F' kliF ! C.E T; 4 F FULL. +Jt±L 11527 r,'i' . 5 1 IVCH IFQL y:39 7 ' 45.0 [NC:H V+iI. C~-F n 5~r FL•>~i7' ;;ICE: 4.U IIV. N4y6 6:1~1'ER t:•Il;F'PJINid ~.U }IIGH 6Jr;TEF~ LIhll"I: 3.0 P1~r; ':~k LABEL 110t: 11Er~7 L LII°i I T '~ rEkF 11 5`'"~~ _ C, , 1095U 1~395U UkLI'uEkY LII°iIT ~ 1 E;3 r 1..~L~I,tI Fi?tjIiLl!T 51JU -`~ EH}: i-wLr~kt°l L 1 h'1 I T: I _ :~UDL;EN LGS:= LIMI'T~ 'I'r"iNK TILT U.OU ' I°1riNIF:~'i_DED 'THNKS 'Ttt: fJ<JNE (_Eh1; t91 P•1 PER I GL, I C : uLi ~! 5'l;: LF'Fyl': t•`111V r;l'dIVUAL ~ .,881 1- Ek l %L~ I i": 7'E~:'t' T`iF'k: :'TAtVIir~kD r;hdPJl.hL 'fES'f FriIL rLHRI~I L I S+BLED f•lrk:l~:iL~li_ 7'E:;T FHIL ALi•~kl°1 Ii I .;HEsI_ELi ALr-;Rh1 D I :hEILI:'L~ Afdf~J TF.:;T riVEkF;i~ I Nip : t~FF' PL'k 'f EST F-iVERAG [ tJi~ : GFF 'TAtdl; TENT hIGT 1 F:' : C;FF °1'tJ}~: l'.~T ~JIPH(iPJ BkEri}::C:'FF PEL t'~r1=:k` DELA'.'' 1 1°1I N t Iv-~'I'Hlvr; SE: i'1~1-' T 1 : UIVLEADEI? 1fEGI!Lri}' Pki:'UUi'1' COLE 1 `!'HERNIrJL i_'.GEFF :. Cl0U7U0 fAIVK GIHhIE`fEk 90.00 TAtJK. PkOF I I.E 4 PTS FULL 11GL ] f 5'27 67 .5 [ NCN VGI. 5x97 45.0 IfVCH +JOL 5857 ,~'~ . 5 INCH VGI_ '~''<65 FL(7FT :SIZE: 4.i1 IN. 24y6 r:.l~i fER WARN I PJ(i 2.0 HIi3H 4JATEk LIr°Il1': 3.0 f~1A:~; Gk, LABEL 'JOL.: 115'_7 t~1tEkFILL. LIMIT 55%Z 1IJ55U JiI~:~H 1>h-'CiDUi:•T 55"S 1 ij550 PEI_ I VEkY L 1 r1 I T' 1 °~~S 1383 LGbJ FkODUi;T 500 L.EF;}; ALHkPi L Ih91 T : 24 NLIUGEN LOSS LII°lI'T: 24 TrfJK T 1 LT 0.00 r°IrPJIFC+LDED Ti;hJ}15 T;t : AJOIVE LEHK r•9IlV PEk1UliIt:: u 0 L.E~+I' MIIV AMNUF;L ='S"4 ,_'88 ] FEk I OD i ~' TE:J'1' 'TYPE STHIVLk;RD s~tJiVUHL TEST F'HII. ALAkt°i D I SHBL.ED F'E'N". I OLi I i TEN"f FA I L ALriRF9 tiIC;HBLELi i~kGSS TE;;T FH I L HLAkI°I D I Sr;BLED r tV l'd TEST Ab'ERA~~ I iVu^ : OFF I~Ek TEST AVERHGING: OFF TtiIVK TEST IVGT I FY : GFF TtJK 'I ~T S 1 PHUN BkEr;K :OFF I~EL I'JEkY DELAY 1 M I N a~s,~b HLHkhI HI5'fCik':' kEPCJY',T __ _.. I N-THI'JK ALHkh9 -. _... _ _. T 1 : UIVLEFDEL~ kEGU1.AR SETUP DtiTr; IJAkP1 I NG t°IAF. 1.?. 199y 8:41 F,FJ LEHK ALF;khl i NOV 1. '2004 4:301 HNI SEF' b. '?004 8:38 tih9 ' SEP b. 2004 4:30 AM i OVEF.'FILL ALtiRM NOV ''5. ' 2005 4:12 PI°1 NOV 3. 2005 ' 2:15 PM OCT '~0. X005 1 :41' PI'1 LOW PRODUCT r'~T_AkM NGV 10. 2004 8:24 fd°J JUN 1. 2004 5:54 )'1'1 SEP 16. 2005 4:00 FI°i SULDEIV L.i?,S ~I_AkN1 DE(: 5. 2005 4:25 kh7 AFR 4. x'005 4:09 HWI NOV 1. 2004 3:55 Hh1 H 1 G H F'kOD UC"f HLHkM IVOV 25. 2DCIS 4:12 PM tVOV 3. 2005 2:15 FI°t OCT 20. 2005 1:41 PNl INVALID FUEL LEVEL NOV 10, 2004 B:OE AP~i JUN 1. 2004 5:2H Ph7 SEP 16. 2003 3:40 PM PF.GBE GUT Ot;T 6. 20U4 1 :33 Ph1 DEL1VEkY PJ£EDED QCT 23. ?005 9:~U Phi 4Cf 9. 20015 3:56 PI'q OCT 1. 2005 8:23 AM h1A:~S PkGDUCT ALARi°J :;UG 10. 2004 6:53 Phl JUL 11.. 2004 1:53 PNi JUN 27. 2004 I i : 18 At°t L.OW TEI"iP WHkN I Nry tiYC:T 6. 2004 1 :44 Fin :3.L:::a,L `WH.L-hll 'hIINM1Jti :?~.I_: r:3.1. :IN".L- N I ;? I iI•_> I ~3d ~;:I~f1.LH33 6J3.LS:CS 3'h1Q!::bJ 3::f"1'•LL,3!.!S GN !yry'rII 1. 'F'~I'I'o~ri - Q~.LN3~i :3-i:ICil-•ylr=labti ri3~yNl.L3U~; ~lI'•~l N•.ris~:~r~. T3:1:{'I I'~II ~, I S1 ii,~~ 13NNf'l.Ldflt-~ 1-'FL', :IJ-- '__lJfar. 'a:'.'1 :I,:}. r,'::;1' Er•1 Lied 1 "1':3 t~-'~• SY':~CEP'1 L'arirE.'I11^lt: FOh:I"lrT hKriV L~l:i 'i'f'f`r HH :I°1hl ::~.~ :-,I l i i C T l t'tI: 1 i 1: Uu F'I°1 ',='.H 1 F•f ;1' I h1T-: D 1 ;AF3LEL~ =,~lr-r III'1E '1'ril•Jh; T-'El~.'t~:LI~~ 6JFI.NIIV~~+ l:r I ;;~13LI:L I'r;IV}- i=tNl'JLIF;L r.~l~iRl'JIIdGS L~ 1:?~HHi..ED L. I IVE PEF:1 GL~ 1 r.; WAk W I PJL.S L~ 1:~r+1=1LEG L.1 PlE hlVl'dIJ~;1. 4.k;FaJ[ 1Vi.i~ I~ I =;rwf~LELr I~r;11Jr ~r~_- >.rt~i_Ui'lE~ f) I f'•hF''LpC~ •f~•,1T-' iiiP•11'LP•ISF1TILiP•I '.iiiL~.l~ i Lil=~~ F > ~ r~0 . U •;;Tli=}: HEIGH`f ~:>FF.~ET L~ I Sr~SLEG _, , j fd[; 'I' I1.1E Lti L I t;HT :.~~ f Ei'IrtBL.EL' ~Pk I:JEEI" 1 c;'1'hRT '1' 1 I"IE •~ : l1U ~I"i c,rr WEI}. b ES'JL~ 1' I hlE L:UU AI"1 ' ce~f~E Uq~tGUU UU'i'FU`f k)rL.r+ SETUP R 1 : I.i I SF'EIVSER RELAi`~ 'r`.'F'E STHNLiHkD NC>R11i~L:L'': :)PEI+I I Pd-•'1'Hf•Jl: ALARMS rtiLL :1_EHK tiLARNI r~Li.: H 1 ~H Wti fER ALARIW F,LL : LGW FRGDUCI' HLHRNI HL.L.: t~RC>5S TEST Fri I L L.IiaL11Lr :~EIVSGR HL.1"lS 1_ 1:FUEL ALF+RN1 L ' :FUEL FiLHRI°i L .3:FUEL ALARM L 4:FUEL 1;LARh1 L h:FUEC. ALARNI L, ~ :FUEL ILARNI L '7:F'UEL HLARNI L e :FUEL i~LARNI C'Oh1N1LIhJICr;"1'luN: SF.T'l1F' _ P;)1<:'f SET'!' I IVc>> I'JGI'JE FUUNU RFJ-':':=1 ' tUEi::UIzI'r`f ;:;jI:,E : OGUUGU L I ~iU i G SEPJ`~.fiR SETUF• L ! : UIVLEAD£:Ii ST1=' 'SUP'IP TR I -STATE i ::11VGLE FLUAT C:HTEGUF.`! ATP SUNIF L '2:F'REN11U1°1 :;TP iUMF' TRI -S~'TATE (SI NGI.E FI.UA'f ) CMTEGCyRY tJTP SUP'IP L a : UIVLEACiEli FILL r~UNIP TR I - ;THTE (S I PJr;LE FLUAT 1 CATEGGR;' PIPINi:~ SUMP L ~ : F'REM I UNI F 1 LL SUNIP TR I -SPATE <'~ I IViaLE FLUA71 CtiTEGGRY F' I P I IVU SUNIP L S:UISF'ENSER PAN 1.2 TF: I -S'fATE ~ ~~ I N~C.E FLUAT ) criTEGORY IaI5FE1VBEk PAN i ~ast6' ~" .J;;, .F~::);J]SP)~Nf~ER~-PHN 7•.;% ~ ' f~Z'I -STATE ' ! Fes' I IVGLE FLGF;T i ' CATEGURY DIS>/F.iV>ER F'AN L ?:DI SF'EPJSER FAN 6.6 TR I -STATE c S ] NGI.E F'LU+T ) j CF'rTEGURY IiISPEfV;_ER PAIV I. b:DISPEPJSER F'AN ?,>3 'I'R I -STATE (S I PJGI.E FLC)AT ) OF NIES,~Ac.E i ' ' , CATEGUk`I DI::PEN,SEk PAIV ) R;- EN ~:3~ Lr 1;,.,FtALEP ~ C.EAI: `t'F_ST' NIE:'fHC>Ii , L '~:111VLEF;DED AIVNULr;R _ ._ _ _ _ _ _ _ _ _ _ _ TR I -STATE t S 11VC:LE FI.CrAT r TEE:T t°1GJVTHLY tiLI_ TAf•IF: ~ C;HTEt;Uk:' ANNULAR SFACE WEEy; 1 NION :STAR"r T 1 J°IE ~ ::~Q r;I°1 TEST RFiTE :o.'~u uitiL!HR i; Cil.1F.AT I ia1V '% HGURS L1 U : F'kEl'I I UM ti1VIVULAR I"' 'TR 1 -STATE t ~ I IVGLE FLUAT ) i ~ CNTEiOk'i' ANNULAR SPAt1E LEHK TEST REP'JRT FGRI.9AT ENHtiNC:EPr ~. i -- --~--- ---- -- ~a~~o. MONITOR CERT. FAILURE REPORT SITE NAME: ~FZ~~al4`~ l,Zpu.E~ S DATE: ~(o~ml~Cv ADDRESS: ~~ N~ ~.~ftiID~G~ c~J~TECHNICIAN: ~T'~.UF~ ~~~~T- THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRF.D TO COMPLETE TESTING. REPAIRS: 1~1 F C (J T[~ r~_t.rl_.. ~ L -~.~~5 ~PR~Qu.LT' r=I~~r~ LABOR• r.10~.1 ~~ PARTS INTALLED• N Q 1~3 t- THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON-COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN LEFT ON-SITE FOR YOUR CONVIENENCE. To: Mailing List of Valued Customers Reminder Notice Re: Guidance for Unsupervised Dispensing April 10, 2006 Page 2 If you are currently having hours of unsupervised dispensing, you must comply with the above-mentioned requirements. . Starting April 15, 2006, this office will conduct rahdom checks of all fueling stations within the city limits for compliance. If you shut your station down after normal business hours and are not pumping fuel, please disregard this reminder notice. Should you have any questions, please feel free to call meat 661-326-3190. Sincerely; -- Ralph E. Huey, Director of Prevention Services ., ~ ~~ .~ By: Steve Underwood, Fire Prevention Officer REH/db / _ BAKER8FIELD FIRE DEPT. B_ a x_.~ P ' D Prevention 8er~rices FIRE ORDINANCE VIOLATION. ass ' „~~_ " ~,< wRrm .900 Trtzxtian Ave., Ste. 210 _ ' Bakersfield, CA 93301 ~ ~ ~ • .: Tel.: (661) 326-3979 X Fax: (661) 852-2171 OCCUPANCY': DISTRICT. BLOCK NO. DATE ~ c) l~ ~ / I TO f) ~~ CY ' TITLE - FIRM OR DBA , ~ • , ` (CITY, STATE, ZIP) ) ~ ~ ~ !'~ ~~~~ ~ ~^ ~ ~~ COMP ANY ADDRESS --} Cx BUSINESS PH NE ~*~~ ~y.~''~ H E PHONE CORRECT ALL VIOLATIONS vaLnnox REQUIREMENTS , ' CHECKED BELOW xo. TIBLE WA TE I DRY COM 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.) BUS S , VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage bt combustible waste and rubbish pending .its safe disposal. (U.F.C.) COMeusTIBLE STORAGE 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse boxlfire door (N.E.C.) (11.F.C.) 4 Relocate fire extinguisher(s) so that they will be in a conspicuous locati'o'n, hanging.on brackets with the top to the extinguisher not more than 5 feet above, the floor. (N. F.P.A. No. 10) ' EXTINGUISHERS _ 5 Provide and install (amount) __M approved (type 8 size) _____~_________~ poatable fire extinguisher to be immediately accessible for use in (area) ________________~_~__~~ (U. F.G.) ` g Re-charge all fire' extinguishers. Fire extinguishers shall be serviced at least once each year, and/or after each use, • by a person having a valid license or certificate. (U. F.C.) • 7~ . Provide and maintain "EXIT" sign(s) with letters 5 or more inches in height over each required exit (door/window) to 51GNS fire escape. (U.F.C.j g Provide and maintain appropriate numbers on a contrasting background and visible from the street to indicate the correct address of the building. (B.M.C.) (U.F.C.) ' g Repair all (cracks/holes/openings) in plaster in (location) ~__________________~_______________. Plastering FlR~E ~PARRA/T S y shall return the surface to.its original fire resistive condition. (U.B.C.) _ SE K)N ' 10 Remove/repair (item & location) ___________________~___~_ _ _ ~ _ _________.. Self-closing doors shall be designed to close by gravity, or by the action of a mechanical device, or by an approved smoke and - heat sensitive device. Self-closing doors shall have no attachrnents capable of preventing the operation of the closing device. (U. F.C.) ExrrS - 11 Remove all obstruction from hallways. Maintain all means of egress tree of-any storage. (U.F.C.) -- ~ 12 Provide a contrasting colored and permanently installed electric light'over or near required exit (location) ' _________________~___________ to clearly indicate it as an exit. (U.F.C.) SroRAGE 19 Remove all storage and/or other obstructions from fire escape landings and stairways stair shafts. (Fire • escapes/stair shafts are to .be maintained free from obstructions at alt times.) (U.F.G.) 14 Extension cords shall not be used in lieu of permanent approved wiring. Install additional approved electrical outlets ELECTRICALaPPLUwCES where needed. (N.E.C,) (U.F.C.) 15 Remove multiple attachment cords from specific electrical convenience outlet (one plug per outlet) (N. E.C.) (U. F.C.) oUTDOORBURNING 16 Violation of Section 1102 dealin with recreational tires or o en burnin U.F.C. FIREWORKS 17 Violations of Section 7802 U.F.C. or 8.49.040 of the Bakersfield Munici al Code B.M.C. re ardin fireworks: OTHER 18. - .~ ~'t ,/ ,/ )( I r.'•a / 1 7 ~ . r _t.^ w.~/` .~ r'- ~ r" f. s%''' , :' i'~,.~'1 `^'r- f ./ ~ ~ /~ ° w•1f/'~ % l ~ ' ,. ~ - ~ ~ .. f7~ ~~j°,~~-•'~tr 11 ."./ ~~f!'/J i'ii_.J ! rl/ ~ ~1.~. ~~ -dlf~C..t~ l ' . f' ~f /, }. ..•' - `fF'rC ~ J(~G-} f(,-~'01'..~J'l. r'.a~~l,~H^Nt...-+ ~`'s'>I•l «sr1'•>-9 .• ~ . - -` ''~ ON (DATE) ~ AN INSPECTION WILL BE MADE, IF NO COMPLUWCE HAS BEEN MADE, ADDTfIONAL f '' ' ~~N ~ REGULATORY ACTION MAY BE INfMTED. ', tr,,.^`r' O E RCM RD R VN L E NT BY C All P D A NG DA ~+~TURE AFTER VIOLATIONS ARE CORRECTED, RETURN THIS BY ORDER OF THE FIRE CHIEF ~~ DATIs COMFLETED~ ~ ~ NOTICE BY MAIL OR IN PERSON TO: ~ ~~~~ _ s ~~ ~ BAKERSFIELD FIRE DEPT. ~~~RSK+NAnRE ~---wsFECroRSIDNAnaiE OFFICE OF PREVENTION SERVICES LEDEND: ' C.F.C. CALIFORNUI FIRE CODE ~--•'. • 800 TRUXTUN AVE., SUITE 210 . u.e.c. uNtFOtan BUtLdNO CoOE ~ BAKERSFIELD, CA 9~D1 ' B.M.C. BAKERaFiELD MUNK~AL CODE - N.FPA. NATONAL FIRE iROTECTiDN Ati60C1AT10N ,j°'~ . ^' N.E.C. NATIONAL ELECTRIC CODE ~ - '; ~ ' White-Customer/Original Yellow-Station Copy pink-Prevention Services a^FD1818 (REV. Otlos) Pt~~R~ :®F~tGI#~AL _ _ , . '~ _, -' :. - ~~ .~_._ UNIFIED PROGRAM INSPECTION CHECKLIST ~' ~«i - . ~.., .. ...:. w.:, .... .... ..., ~Rrr SECTIORi 1-:- Business Plan and Inventory Program ~ BAKERSIF'IELD FIRE DEPT Prevention Services 900 Truxtun Ave., Suite 210 BakersSeld, CA 93301 Tel.: (661) 326-3979 - Fax: (661) 872-2171 FACILITY NAME ~ NSPECTION DATE INSPECTION TIME A ~g HONE NO. O OF EMPLOYEES "T ~ ~.C z 3-~~ S~ FACILITY CONTACT USINESS ID NUMBER 15-021- Section 1: Business Plan end Inventory Program ^ ROUTINE BINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C . ~V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND BUSIrI@SS PLAN CONTACT INFORMATION ACCURATE ~/^ VISIBLE ADDRESS 7~F9 CORRECT OCCUPANCY ~^ VERIFICATION OF INVENTORY MATERIALS I~1 /CI VERIFICATION OF QUANTITIES ~7/8 VERIFICATION OF LOCATION PROPER SEGREGATION OF MATERIAL 4S CJ VERIFICATION OF MSDS AVAILABILITY ^~8 VERIFICATION OF HAZ MAT TRAINING ~A~j-' IY IIYC7 VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES (~]/CT EMERGENCY PROCEDURES ADEQUATE CONTAINERS PROPERLY LABELED 4 HOUSEKEEPING LC~/^ FIRE PROTECTION 1~_ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES NO EXPLAIN: - - - --------- -----------•----- - ~, O STIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (t3t31) 32a-3979 I spector (Please Pn t) Fire Prevention / 1" In / Shift of Site/Stetion q Business Sit School Site Responsible PaAy (Please Prnt) White -Prevention Services Yellow - Station Copy Pink - Business Copy FD2049 (Rev. 02/05) ~+'~~` ~~'~ ~ CITY OF BAKERSFIF,I.D FIRE DEPARTMENT d ~ ~ ~~ OFFICE OF ~+;NVIRONNiEN'1'AL SERVICES ;° y+i1 UNIFIED PROGRAM INSPECTION CHF,CKLIST Aw ~gti,,!'~ 1715 Chester Ave., 3"' Floor, Bakersfield, CA 93301 FACILITY NAME fr,ZS_£wQc-~ ~ ~`o~in~GS INSPECTION DATE ~'~~°_~? __ Section 2: Underground Storage Tanks Program ^ Routine ~'6mbined ^ Joint Agency ^Mulfi-Agency ^ Complaint ^ Re-inspection Type of Tank ~kt~ wflil Number of Tanks'..-~ Type of Monitoring ~ Type of Piping ~~Efc~,~(~ OPERATION C V COMMENTS Proper tank data on file Proper owner,'operator data un file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current L,'` •7 w S GNU nJ ~"' re Maintenance records adequate and current ~ c r~Gy ~ ,~£ Failure to correct prior UST violations Has there been an unauthorized release? YeS NO :fd~ 8e ~, z ~,~,, Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling (s tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector:~/~ (J-Q~~~'" Office of Environmental Services (661) 326-3979 White - inv. sues. Pink - t3usiness C~~ry Business Site Responsible Party w _ ~ ~ If'ti'I„ 11~~1',~L: '.. l:}.I IItL~I,~ .. 1 ~tl.!~. ~~,. -s-, . ~ ,.l ~ 1 t t ~ ~, ~ r,l 1 .• l' .'.I't Ill.l l~fal - '+I I'., 111.1 r,..r r '% 1 . ~ :r9L; IIr,l'l:f< - I1.IIU Ifd!'flt::' i'L:111• - r;,'.l L~L:~~ 1 1 :':1}':F.I'1.1111 lili ~ r,l ~F.1~ it I it ll. 1 . .' sr,l Ill l.r t'.f: 111 ~'~~ ~:ril.:' `ill':., 111 } .. 1 `i'_' ~! _' ~ +r11 I ~n 1 ~ I I ~ ;ril . Ii;,ll:r LI.UII IfJ~ Ht :. - 1 r ,l, a . +, "d UNDERGROUND STORAGE TANKS ~`~, `; :o-.~xt.ra.;n,c:.:, srvia::.s~zi~c:n:mnnxww~vrsr~,~a~mmm~xwru~amwwwsv0:nrmxsasoemscra/mr••~•.•w. •<~~ APPLICATION ~`~ TO PERFORM ELD /LINE TESTING 1 S8989 SECONDARY CONTAINMENT TESTING !TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. C~~~' ~~ ~/R/ /~ ! BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 ^ ENHANCED LEAK DEFECTION ^ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST TO PERFORM FUEL MONITORING CERTIFICATION FACILITY N 8 PHONE NUMBER OF CONTACT PERSON ADDRESS .~ ~ ~ ~ ~ ~ ~„I V OWNERS NAME 1 OPERATORS NAME PERMIT TO OPERATE N0. NUMBER OF TANKS TO BE TESTED IS PIPING GOING T E TE TED? YES ^ NO TA K # V U CONT ENTS I ~ p .; I L °' p TANK;TESTING COMPANY NAME OF TES ING CO PANY 4 MAILING ADDRESS (( V i ~ i \ ~ CAI N E 8 PHONE N BER ~ F CONTACT PERSON ~Rb~-~s~F7 ~~ '~C,~7( NAME & PHONE NUMBER OF TE TER ORS E I G AL INSPECTOR •r CERTIFI ION #: DATE & TIME TEST TO BE CONDUCTED ~ ,„~~ ICC #: TEST METHOD SIGNATURE OF APPLICAN ~~ .~.-~ ~' ~ ~ DATE 2 ., , ~ , ~ APPROVED BY DATE ~ I -© FD 2095 (Rev. 09/05) :~ ~aaa~ ~i~~Lit`~~ & PERMIT STATEMENT ~~t~i~i~r No.: BAKERSFIELD FIRE DEPT. Prevention 8esvices AtT~If T 900 TYuxtun Avenue, Suite 210 Bakersfield, CA 93301 Tel_• !6611 326-3479 S Fast (6511 852-2171 I LOCATION OF PR~JECT C~tr P ER ~I STARI7NG OA7 E C PLETION OA NAME 2ROJcCT NAME p. ~~ 1c> ~~ ADDRESS a ~ PHONE NO• c~ : PF20JECTAOORESS'~ ~ ~ ~~ ~- Y t C (1 A~ 21P000 ~~ I CONTRACTOR NAME CA {JCENSt3 NO. i. ' 7YPE.OF LICENSE. EXPIRATION GATE PHONs: NO. ~'6~0 I ~ E CONTRACTOR C ANY ~t~~' f ~ KAX NO. a~0~'~-t ~ AllORtSS ~ c~• ~-~ ~, ,_ C ~ ZIPCODE J (Minim e) $262 5E) m Cha s w & Modfication ^ Al N ~ rg arm - u e s - . 98 p 000 S Over 20 Ft 013125 = Permit fee ft x 5q 6 q. , . I . . 9 ^ rinklers -New & Modifications - (Minimum Chan S e) $210 00 ~ g p I . 98 i ^ 000 Sq FL Over 5 042 = Permit fee S9 /=L x ~ , . . ri^ Minor Sprinkier Modifications {< 10 heads) $ 93 00 [Inspection Only) ~ . . 98 ^ Commercial Hoods -New & Modifications $398 26 ~ I . 9S i ^ ~ Additional Hoods $ 36 0'0 ~ ~ -- ~ . 98 - ' ^ Spray Booths -New & Modifications $458 00 ~ i i . !38 ^ Above round Storage Tanks (lnstaUatron/lnsp.-1"Tune) $165.00 132 ^ Additional Tanks $ 2E 00 132 r ^ Abov round Storage Tanks Remova/llns eg ( peWon} $109.00 132 ^ Underground Storage Tanks (fnstallationllnspection) $878.00 (pertank) 82 ^ Underground Store Tanks (Modirication) $878.00 (persite) 132 ^ Underground Storage Tanks (Minor Modir>cation) $955.00 82 i ^ Underground Storage Tanks (Removal) $675.00 (per tank) 134 ~_ Oilwell pnstallaUon) ~ 84 Mandated i.eak Detection (Testi ) I Fuel Montt, $ 81.00 (persife) 82 ^ Tents -_....,,_. 3~'(per~9~ 84 ^ After hours inspection fee $122Q0 84 ^ Pyrotechnic - (Per event, Ptus Insp. Fee ~ $90 per hour) $60.00 + (5 hrs. min. stand -by ree /111spr~iion) _$510.00 134 ^ RE-INSPECTIONjS) / FOLLOW~IP lNSPECTlON(SJ $ 93.00 {per hour) 84 ^ Portable LPG (Propane): NO.OF CAGESI $66.00 84 ^ Explosive Storage $249.00 • &~ ^ Copyi 8 Fife Research (File Research Fee $33.00 per hr) 25¢ per page ' 84 ^ Miscellaneous ~ ; sa FD 2021(Rsv. 09405) S'rVttC~.., .,<<~;uary 2003 Page ~ of ~• Secondary Contain-lnaent Testing Report Form 7'l~;:s ior~n is intended for acre by contractors parformirag pariodic tasting of UST'sacondary conlalhmant systems Usa tha cr~~t~opriare pages of this form to report resrtlts for all cotrrponents testad The oampleted forth, written testprocett~rns, and ;.~r;nrouts from tests ({jcpplicable), should be provided to thsfacility awrrer/operator forsubmrttal to the local regulatory agency. 1. FACILITY INFORMATION ~ticility Narae-. Date of T ~ it i=aeility Address: ai E , ,~.___.~ r l ;zCiluy Contact: Phone: ~ ~-(D(~, -- 3® Date Luca! Agency Was Notified ofTesiing : e?~ ~1 _ Name of Local Agency lnspcetor (if present durrngtes ' ~ ~} --- - 2. ~„ ~_ompany Name: R,TCH ENVIRONMEN~'AL t~~~,uucicn ~,~iiuu~ung ~~~~..~t w GN v~.~~..a~-~ ~o< <o ~o~ ~; Credentials: ~CSLB Licensed Contractor [] SWRCB Licensed Tank Tester icenseType. C611p40 - ~ I.icettseNuntber: $09650 ~ „ _, Ivlanufacturer Mannfactarer Tsaini~ .,,' Cotny~paottt(s) Dale ices _ ^~ ~ ___ _ I[VCON INCQN TS-STS p 3. SUMMARY OF TEST RESCJT,TS ~ Component Pass Fail Not Tested ~~~ Mode Component p~ Pod Not T Repairs de + '' l 1, IV ~ .I ~ ^ ^ D ~ O ,^ ^ ~ ^ ^ ^ ^ ^ ^ D '~ ~ D ^ ^ ^ ^ ^ ^ Q ~~ ~ ~ ^ ^ fl ^ D ^ ^ Ir ^ ^ ^ ^ o a ^ ^ 0 0 ^ D D 0 D 0 }~ ' D ^ 0 0 ^ ^ ^ 0 r;~ ^ a ^ o ^ ^ ^ o ^ ^ a ^ ^ ^ ^ D Ii' hydrostatic testing was parfgtmed, describe what was done with the water after completioa of tests: RECYCLE AND REUSFD~ ~~, -. CERTIFICATION OF TECIINICIAN RB.SPON$TBL>g FOIL CONDUCTING THIS TESTING . 7'v the best of my knowledge, the facts stated to tills do~cua~ttt are accurate and Lt full comEtUance with legal t+aquinmsnts 2'zctlnician's Signature:_~ Date: ~ ;~ ~ ~ m(~ ~WhCB, January 2002 9_ CP7T.TJ()VF;RFILL CfINTAINMF.NT R~XF,S Page ~ of ~ Facility is Not E tti ed with S iiUOverfill containment Boxes ~ SpilUOverfili Containment Boxes are Present, but were Not Tosted ^ i Test lvfethod Developed By: ^ SpiI1 Bucket IvlantifaCturer ^ Industry Standard ^ Professional Engineer ^ Oilier (Sped) 1 'l'est iwlethod Used: O Pressure Q Vacuum p Hydrostatic ~ O Other (Spec~y) " Test Equipment Used: Equipment Resolution: Spill Box # Spill Boz # Spilt Box # Spill Box # Bucker L~iatneter: ~ ` f o'1 ~' Bucket i7epttt; ~ a `~ (a~~ Va'uii time between applying przssure/vacuumJwater and Slurtlil I~SC: 3 ~ ~ ~~ ~ m ~j ~~ ~I~~SI St1t't Tune: , ~ "1 ,`p~: lof Initial Reading (RI): a?(p~ off, TesiEndTime: Sc~:t'lj~ ;ar'~ ~a.; Final Reading (RF): .$o~~ o~•r/-o? ~' ~ Test Duration: - ~ IV1~{J (s M~tJ ~! Cnange in heading (RF-RI): I • ~y11j~- Pass/Fail 'Threshold or -Criteria: ,~ , ~~ ~ r ~.. • ~~ a ~- i 1 es~t Xtesult: ~ ass ^ Fail ~i.Ppss p Fail L7 Pass ^ Fail [] Pass ^ Fai] ~,oaa~zuents -- (include urJormQtion oR r~airs nsade prior to testin& acrd recommendedfollox~-~ far failed tests) 4 .!E:,.~O,.~.2elEe 12:04 /~~~ G~ ;~Uh9P LFRK TEST REPORT 20r02r2906 12:20 SUMP LERK TEST REPORT ('A,NL ~~UMF 1 ~'~ TEST STnRTED uN ~ SUMP 1 ~~ ` TEST STARTED ii:49 29i02i2906 TEST STARTED 12:05 E~EGIN LEUEL EtdD ;IME 2.5261 IN TEST STRRTED 29i02f2906 ENf? DATE 12:04 BEGIN LEUEL 2.5253 IN END LEUEL 29/02x2006 END TIME 12:20 _~.nK THRESHOL 2.5280 IF; D END DRTE 29r02r2906 TE^T RESULT 9,002 IN END LEUEL 2.5271 IN PASSEf+ LEAK THRESHOLD 0.002 IN TEST RESULT PASSED _ P ~''~ suhlP 2 1 ~ p(Z~M SUMP ~ f TEST STARTED 11:49 2 TEST .;TARTER 'EGIN + 20xg2x2a06 TEST STARTED 12:05 ' ~ LE JEL ItD 1.8067 IN TEST STARTED 20!82/2896 i _. Tit9E ~. tNCj I;ATE 1204 BEGIN LEUEL 1.8951 IN - 20x02x2096 END TIME 12:20 ' ND LEUEL LE ' K 1.$059 iN END DATE 28r02r2885 ' r , THRESHOLC.~ 7E ST 0.092 IN END LE+JEL 1.8068 IN . RESULT pAgSED LEAK THRESHOLD 0.082 IN TEST RESULT PASSED F ,~ a r a~~ SB989 .TESTING FAILURE REPORT SITE NAME: ~!rr~A'~ ~-____~S DATE:~jc~CZY~C~ ADDRESS: ~ ~~~ F "~Q~ ;~~c--~„TECHNIC~~'E- - - ~~-'T THE FOLLOWING CO:VIPONENTS WERE REPLACED/REPAIRED TO COMPLETE TESTING. REPAII2S• NO/~-~~ LABOR: r 1;~rJ'~ PARTS INTALLED: ~~) ~ NAME: _ _ N I ~ TITLE: SIGNATURE: THE ABOVE NAMED PERSON TAKESFULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON-COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN LEFT ON-BYTE FOR YOUR CONVIENENCE, S'rVttC~.., .,<<~;uary 2003 Page ~ of ~• Secondary Contain-lnaent Testing Report Form 7'l~;:s ior~n is intended for acre by contractors parformirag pariodic tasting of UST'sacondary conlalhmant systems Usa tha cr~~t~opriare pages of this form to report resrtlts for all cotrrponents testad The oampleted forth, written testprocett~rns, and ;.~r;nrouts from tests ({jcpplicable), should be provided to thsfacility awrrer/operator forsubmrttal to the local regulatory agency. 1. FACILITY INFORMATION ~ticility Narae-. Date of T ~ it i=aeility Address: ai E , ,~.___.~ r l ;zCiluy Contact: Phone: ~ ~-(D(~, -- 3® Date Luca! Agency Was Notified ofTesiing : e?~ ~1 _ Name of Local Agency lnspcetor (if present durrngtes ' ~ ~} --- - 2. ~„ ~_ompany Name: R,TCH ENVIRONMEN~'AL t~~~,uucicn ~,~iiuu~ung ~~~~..~t w GN v~.~~..a~-~ ~o< <o ~o~ ~; Credentials: ~CSLB Licensed Contractor [] SWRCB Licensed Tank Tester icenseType. C611p40 - ~ I.icettseNuntber: $09650 ~ „ _, Ivlanufacturer Mannfactarer Tsaini~ .,,' Cotny~paottt(s) Dale ices _ ^~ ~ ___ _ I[VCON INCQN TS-STS p 3. SUMMARY OF TEST RESCJT,TS ~ Component Pass Fail Not Tested ~~~ Mode Component p~ Pod Not T Repairs de + '' l 1, IV ~ .I ~ ^ ^ D ~ O ,^ ^ ~ ^ ^ ^ ^ ^ ^ D '~ ~ D ^ ^ ^ ^ ^ ^ Q ~~ ~ ~ ^ ^ fl ^ D ^ ^ Ir ^ ^ ^ ^ o a ^ ^ 0 0 ^ D D 0 D 0 }~ ' D ^ 0 0 ^ ^ ^ 0 r;~ ^ a ^ o ^ ^ ^ o ^ ^ a ^ ^ ^ ^ D Ii' hydrostatic testing was parfgtmed, describe what was done with the water after completioa of tests: RECYCLE AND REUSFD~ ~~, -. CERTIFICATION OF TECIINICIAN RB.SPON$TBL>g FOIL CONDUCTING THIS TESTING . 7'v the best of my knowledge, the facts stated to tills do~cua~ttt are accurate and Lt full comEtUance with legal t+aquinmsnts 2'zctlnician's Signature:_~ Date: ~ ;~ ~ ~ m(~ ~WhCB, January 2002 9_ CP7T.TJ()VF;RFILL CfINTAINMF.NT R~XF,S Page ~ of ~ Facility is Not E tti ed with S iiUOverfill containment Boxes ~ SpilUOverfili Containment Boxes are Present, but were Not Tosted ^ i Test lvfethod Developed By: ^ SpiI1 Bucket IvlantifaCturer ^ Industry Standard ^ Professional Engineer ^ Oilier (Sped) 1 'l'est iwlethod Used: O Pressure Q Vacuum p Hydrostatic ~ O Other (Spec~y) " Test Equipment Used: Equipment Resolution: Spill Box # Spill Boz # Spilt Box # Spill Box # Bucker L~iatneter: ~ ` f o'1 ~' Bucket i7epttt; ~ a `~ (a~~ Va'uii time between applying przssure/vacuumJwater and Slurtlil I~SC: 3 ~ ~ ~~ ~ m ~j ~~ ~I~~SI St1t't Tune: , ~ "1 ,`p~: lof Initial Reading (RI): a?(p~ off, TesiEndTime: Sc~:t'lj~ ;ar'~ ~a.; Final Reading (RF): .$o~~ o~•r/-o? ~' ~ Test Duration: - ~ IV1~{J (s M~tJ ~! Cnange in heading (RF-RI): I • ~y11j~- Pass/Fail 'Threshold or -Criteria: ,~ , ~~ ~ r ~.. • ~~ a ~- i 1 es~t Xtesult: ~ ass ^ Fail ~i.Ppss p Fail L7 Pass ^ Fail [] Pass ^ Fai] ~,oaa~zuents -- (include urJormQtion oR r~airs nsade prior to testin& acrd recommendedfollox~-~ far failed tests) 4 .!E:,.~O,.~.2elEe 12:04 /~~~ G~ ;~Uh9P LFRK TEST REPORT 20r02r2906 12:20 SUMP LERK TEST REPORT ('A,NL ~~UMF 1 ~'~ TEST STnRTED uN ~ SUMP 1 ~~ ` TEST STARTED ii:49 29i02i2906 TEST STARTED 12:05 E~EGIN LEUEL EtdD ;IME 2.5261 IN TEST STRRTED 29i02f2906 ENf? DATE 12:04 BEGIN LEUEL 2.5253 IN END LEUEL 29/02x2006 END TIME 12:20 _~.nK THRESHOL 2.5280 IF; D END DRTE 29r02r2906 TE^T RESULT 9,002 IN END LEUEL 2.5271 IN PASSEf+ LEAK THRESHOLD 0.002 IN TEST RESULT PASSED _ P ~''~ suhlP 2 1 ~ p(Z~M SUMP ~ f TEST STARTED 11:49 2 TEST .;TARTER 'EGIN + 20xg2x2a06 TEST STARTED 12:05 ' ~ LE JEL ItD 1.8067 IN TEST STARTED 20!82/2896 i _. Tit9E ~. tNCj I;ATE 1204 BEGIN LEUEL 1.8951 IN - 20x02x2096 END TIME 12:20 ' ND LEUEL LE ' K 1.$059 iN END DATE 28r02r2885 ' r , THRESHOLC.~ 7E ST 0.092 IN END LE+JEL 1.8068 IN . RESULT pAgSED LEAK THRESHOLD 0.082 IN TEST RESULT PASSED F ,~ a r a~~ SB989 .TESTING FAILURE REPORT SITE NAME: ~!rr~A'~ ~-____~S DATE:~jc~CZY~C~ ADDRESS: ~ ~~~ F "~Q~ ;~~c--~„TECHNIC~~'E- - - ~~-'T THE FOLLOWING CO:VIPONENTS WERE REPLACED/REPAIRED TO COMPLETE TESTING. REPAII2S• NO/~-~~ LABOR: r 1;~rJ'~ PARTS INTALLED: ~~) ~ NAME: _ _ N I ~ TITLE: SIGNATURE: THE ABOVE NAMED PERSON TAKESFULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON-COMPLIANCE. A COPY OF THIS DOCUMENT HAS BEEN LEFT ON-BYTE FOR YOUR CONVIENENCE, i F/ICE 14 R rM t April 10, 2006 Mr. Rex Childress Freeway Liquors 2140 E. Brundage Lane ' Bakersfield, CA 93307 RONALD J. FRAZE REMINDER NOTICE FllZE CHIEF Re: Guidelines for Unsupervised Dispensinq Gary Hutton, Senior Deputy Chief Deaf Mr. Childress: Administration 326-3650 It has come to our attention that many convenience stores who sell gasoline, like yourselves, are closing late at night. If you are using card readers and leaving Deputy Chief Dean Clason your fuel pumps on, this is defined in the California Fire Code as: "Unsupervised Operations/Training DispenSlrg." 326-3652 Deputy Chief Kirk Blair Unsupervised dispensing is allowed when the owner or operator provides, and is accountable for daily site visits, regular equipment inspection and maintenance, Fire Safety/Prevention Services including any unauthorized release or spiNs, posted instructions for safe operation 326-3653 of dispensing equipment, and posted telephone numbers for the owner or operator: Signs prohibiting smoking, prohibiting dispensing into unapproved 2101 °H" Street containers and requiring vehicle engines to be stopped during fueling shall be Bakersfield, CA 93301 conspicuously posted within Site of each dispenser. OFFICE: (661) 326-3941 In addition, a sign shall be posted in a conspicuous location reading: FAX: (661) 852-2170 ' In case of spill or release: RALPH E. HUEY, DIRECTOR 1) Use Emergency Pump shut-off PREVENTION SERVICES 2) Report the accident FIRE SAFETY SERVICES • ENVIRONMENTAL SERVICES 900 Truxtun Avenue, Suite 210 3) Fire Department Telephone Bakersfield, CA 93301 4) Facility address OFFICE: (661) 326-3979 FAX: (661) 852-2171 During the hours of operatioh, stations having unsupervised dispensing shall be provided with a fire alarm transmitting device. A telephone not requiring a coin to David Weirather operate is acceptable. The fuel leak detection system must have a remote or Fire Plans Examiner phone modem to insure off-site monitoring during hours of unsupervised 326-3706 dispensing. During hours of darkness, sufficient lighting must be maintained so Howard H. Wines, III that all signs associated with fueling operation are conspicuous and readable. A Hazardous Materials Specialist gallon container of an absorbent material used for spills must be made available 326-3649 to the public during hours of unsupervised dispensing. Afire extinguisher with a minimum 2A, 2B, and 2C rating must be located on dispenser island during hours of unsupervised dispensing: ..~0Ji~lL~il1.Q ~ ~/l1~!I/1 ~(/l~i~~ c~~ e~'LL~ cJ/Gll/!Z v!L V812~~ „ Owner Statements of Designated Underground Storage Tank (UST) Operator and Understanding of and Compliance with UST Requirements Facility Name: '~,/',~/- ~ ,Gt ~- ,~ S Facility ID #: Facility Address: ~/~ v ~ ~~ iJnr~J.4 ~,L L ,-, l,3sf/C~ ? ' ti'/~~ ~ i -, ifl ~jj~ 7 Reason for Submitting this Form (Check One) t~ Change of Designated Operator Facility Phone #: ~ ~, / - ;3,2,3 -UZ y-y ^ Update Certificate Expiration Date Designated UST Operator(s) for this Facility PRTMARY Designated Operator's Name: . ~ Relation to UST Facility (Check One) Business Name (If different from above): ~UtY~~ ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: ~~ _ • (~ ed. ~ ,~ ~ L~Service Technician ^ Third-Party ' International Code Council Certification #: ~oZ ~(p~ ~,~ - l~ L Expiration Date: Il ~~a ~C7~ AT,TF.RNATE 1 (Ontinnall Designated Operator's Name: '~/~ ~ ~~ ~~p / 1 Relation to UST Facility (Check One) Business Name (If different from above): ~ {C:(~l~Nl% 11Qa/1/h~it-' ^ Owner ^ Operator ^ Employee. Designated Operator's Phone #: (p(P~ ~ '~] Ll 3 ' ~g' , ~ Service Technician ^ Third-Party International Code Council Certification #: ~i7Z ~g~ yV - l9 L Expiration Date: ALTERNATE 2 (Ontionaq Designated Operator's Name: ' Ph~s `~lG,-{ Relation [o UST Facility (Check One) Business Name (If different from above): ~ f, G H '~N (~ j ~ ^ 'Owner ^ Operator ^ Employee Designated Operator`s Phone #: (pGj(- ~~((©, - ~(p ~ ®' Service Technician ^ Third-Pally lntcrnational Code Council Certification #: ~~ / ~pe(!" UG Expiration Date: ~l ~ '^~[~. NU'I'E: THE LOCAL REGULA'I'UKY AGENCY MUST 13L NO'I'IF1EU OF ANY CHANGES TO THIS INFORMATION WITHIN 30 DAYS OF THE CHANGE. I certify that, for the facility indicated at the top of this page, the individual(s) listed above will . serve as Designated UST Operator(s). The individual(s) will conduct and document monthly facility inspections and annual facility employee training, in accordance with California Code of Regulations, title 23, section 2715(c) - (f). ~ ' Furthermore, I understand and am in compliance with the requirements (statutes, regulations, and local ordinances} applicable to underground storage tanks. NAME OF TANK OWNER OR OWNER'S AGENT (Please Print): ,~ SIGNATURE OF TANK OWNER OR OWNER'S AGENT: ~X LfI~ .y/~,~f DATE: ~ _ ~ - O ~ OWNER'S PHONE #; ~ ~ ~ "~ Z 3 -O L 5"'f September 2004 09/30/2004 12:37 , 6618363177 i REDWINE TESTING SVCS PAGE 02/02 ....- CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 '" .. , APPLICA TION TO PERFORM I FUEL MONITORING CERTIFICATION FACILITY Fru.&O~ ~ctlAb(" ADDRESS c1(~() E. ~rW\~L La..~L.'j ßcJ(.C{~t-\dJ CA '1330'1 OPERATORS NAME 1èa..X' C'..h.,\b.r;~ 1 OWNERS NAME, R..e..x C'.,k, id.~s NAME OF MONITOR MANUFACTURER_Ut.t44"- (G,ð+ I DOESFACn.rrY~VEDISPENSERPANS7 YES_ NO_ "--' , TANK# i , I' , ~ VOLUME I ;tl ~ 'joJ ~I ~ -~/),,\ CONTENTS f<~~ -Pro-PM t\A1'r\ NAME OF TES~G COMPANY Re.olwU'\.~ Tf.<J.-hlLj .sVV Lc...e.s, J:Y\c... CONTRACTORS UCENSE # 53:;.a 1 K ~ t±ð-z.. I NAME & PHONE ~UMBER OF CONTACT PERSON 7)~,..'W'-- ,-..,r K34-t. '1!12- DATE & TIIvŒ TEST IS TO BE CONDUCTEDjY\.rJt\tÁ~ lO-fS-Oc./ ~o :Oð Am t'! : J(t;:,@f¥¡) APPROVED:BY q ~d.<i ¥ () t./- DATE ~7v-- SIGNATURE OF APPUCANT -./ _ "i ,j_ ~:j MONITOR SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Aulhonty Cited: Chepter 6,7, Health and Safety Code; Chepter 16, Division 3, Title 23, California Code of Reguletions This form must be used.to dOCUment testinQ and servicinQ of monitorin¡¡ equipment. 1\,~r.!!l~ç£\iº!LQr.~P<;¡I:tffiY.n.b!!J1[!!~ 'for each monitorina~tem control canel by the technician who performs the work. A copy of this form must be provl<jed to the tank system owner/operator, The owner/operator must submit a copy of this form to the local agency regulatinç¡ UST systems within 30 days of test date A. General Information Facility Name: Freeway Liquor Site Address: 2140 East Brundage Lane Facility Contact Person: Rex Childers MekolModel of MonitorinQ System: Veeder-Root TlS-350 City: Bldg. No Bakersfield Contact Phone No, (661) Date of Testing/Servicing: Zip 93307 323-0254 10/15/04 SiN 81152306905003 B. Inventory of Equipment TestedlCertffied Check the a ro riate boxea to Indicate uI Tank 10' # 1 Regular x In- Tank Gauging Probe x Annular Space or Vault Sensor. x Piping SumplTrench Sensor(s), x Fill Sump Sensor(s), Mechanical Line Leak Detector, Electronic Line Leak Detector, Tank Overfill 1 High-level Sensor, Dispenser Conteinment Sensor(s), Shear Valve(s) Dispenser Containment Float(s) and Chain(s) Other s ci e ui ment t and model in Section E on P Tank ID In- Tenk Gauging Probe. Annular Spaca or Vault Sensor, Piping SumpITrench Sensor(s), Fill Sump Sensor(s). Mechanical Line Leak Detector, Electronic Line Leak Detector, Tank Oveñtlll High-Level Sensar, Dispenser Containment Sensar(s), Shear Valve(s), Dispenser Containment.Floatls¡' and Chain(s). Other s i 'ui nt i and model in sèction E on P edI&erViced : Model: Model: Model: Model: Model Model: Model: Model: OPW Tri State Mag Tri State Tri State Tri State Model: Model: Model: Model' Model: Model Model: Model: Tank 10: # 2 Premium ~ In-Tank Gauginç¡ Probe x Annular Space or Vault Sensor Piping SumplTrench Sensor(s). Fil' Sump Sensor(s) Mechanical Line Leak Detector, Electronic Line Leak Detector Tank Overfill I High-Level Sensor, Dispenser Containment Sensor(s), Shear Valve(s) Dispenser Containment Float(s) and Chain(s), Other UI ment and model in Section E on P Tank ID: In· Tank Gaug,ng Probe Annular Space or Vault Sensor, Piping SumplTrench Sensor(s), F'II Sump Sensor(s). Mechanical Line Leak Detector, Electronic Line Leak Detector Tank Overfill I High-Level Sensor Dispenser Containment Sensor(s). Shear Valve(s). Dispenser Containment Float(s) and Chaln(s) Other . u, ment t and model in Section E on P Model: Model: Model: Model: Model: Model: Model' Model: T ri State Tri State Tn State OPW T ri State 2, Model: Model: Model: Model: Model: Model: Model: Model: 2, C. Certification - t cer1ify that the equipment idØntifled in this doc:>Jment was inSPØC1ed1serviced in accordance with the manufecturer's guidelines. Attached to this Certification is Information (e,g. manufacturers' checkJi.ts) necessary to verify that this information is corract and a Plot Plan showing the layout 01 monitoring equipment. For any equipment capable 01 generating such reports, I have also attached a copy 01 the report; (Check all that apply): ' 0 System set-up o Alarm history report Technician Name (print): Mid1ae1 Moore TestIng Company Name' Redwine T eating Services, Inc. Peøe 1 of 3 Cert.ILíc. No, 562060899 Signature: ~ 'fY\.,j ~ Phone No,: (800) 582-6368 .- Monitor System Cef1IfIcatton Site Address: 2140 East Brundage Lane, BakBf1llield, CA D. Results of Testifl9lServlclng Software Version Installed: Veeder-Root TLS-350 # 81 152306905003 Dale of T estinQlSelvicing: 101151 04 Com lete the followi checklist: Yes No' Is the audible alarm 0 ational? NlA Yes No' Is the visual alarm 0 rational? Yes No' Were all sensors visuall in ed fundionall lasted and confirmed 0 rational? Yes No' Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their r ration? No' n alarms are relayed 10 a remote monitoring station, is all communications equipment (e.g. modem) operational? N/A No' HIA e. Convnents : CalBQOlY Form Regular Tri State Piping Sump 0794380-208 Tri State Fill Sump 0794380-208 TriState Annular 0794390-409 Premium TriState Piping Sump 0794380-208 Tri State Fill Sump 0794380-208 Tri State Annular 0794390-409 Dispenser 1 & 2 Tri Slate 079438Q.208 Dispenser 3 & 4 Tri State 0794380-208 Dispenser 5 & 6 Tri State 0794380-208 Dispenser 7 & 8 Tri Stete 0794380-208 Four (4) spill buckets tested conducted wet"" test Page 2 of 3 03101 MonItortng 8yatem ~catlon Site Address: 2140 East Brundage Lane, Bakersfield, CA Da1e of Testing/Servicing 10/15/04 o Check this box ~ tank gauging is used only for inventory controt. o Check this box if no tank gauging or SIR eQUipment is installed. This section must be complatad if in-tank gauging equipment is USad to perform leak detection monitoring F. In· Tank Gauging 1 SIR Equipment: lete the follow!n checklist: x Yes No' Has all in ut wiri for round faults? - Where visible x Yes No' Were all lank x Yes No' Was accur x Yes No' Was accur x Yes No' Were all reinstalled x Yes No' Were all ~ams on the i menufacturer's maintenance checklist lelad? . In the Sec:tlon H, below, describe how and when theM deflclencles were Of will be correc:ted, G. line Leak DetectOt"1lllLDj: ŒJ Check this box ~ LLDs ara not installed For electronic LLDs, does the turbine au10matically shut off ~ the LLD detects a leak? For electronic LLDs, does the turbine au1omat'cally shut off if any portion of the monitoring system is disabled or disconnected? F Of electronic LLDs, does the turbine automatically shut off if any portion of the monitor,ng system malfunctions or fails a test? For electronic LLDs, have all accessible wiring connections been visually inspected? leted? H. Commenta: Page 3 of 3 03001 ~'~;.~riØi3y"ea Cel11tkaóoo ~ "1..r;"J.~··· . ~l'-i(:' ~..,~~,~',' :" -'M·'t. ~,çt.;; . ~~~~'. , "~~~' . ~$,,!,:.iM Address: ~ L"' I ""'1~\ e h. \~ ~:.~;':>,"'" í.\ö ).:<'(\J{'\c ~r , ~~~I"¡';:" . ~,I'~., ',' ..,,~~,.,~, "f.. . . , . . . . . " . . . . ~·1 ¡~:;': .'~ ..:., \ ~"~'. UST MODitoring Site Plan flrq-~~~ ll.~l.\CW ,\~J~v:>F\c:-\J... ~A 'ì~~o 7 "D , , , '0' .~)'.. ,~. f , , . '~)' .~. " ,~~. · . . .~. .~, IS:(' ..~.~. t, . ,. ~.tI) , .~~, , . . . . . I . . · . :0: .0. "". .. , ;rl , :-rVy·\IJ[ ~~. . f . . . . . . . . . . 'f . : þ.:§:~: ~@:~. . f~\c.IL] )ì.Jilcft , . . . :~ .:@ ~:.: >.§ - '^- . . , ' j .v¡~ .: h,-, · . . . , . Dale IIIo'P 'frII drawø; J..Q./ .lí/ ~, lustrQctioas --" - .... ..... ~ _ __ i Tank No. , .:2-- REDWINE TESTING SERVICES, INC, (80S) 326-0446 TEST RESULTS , Capacity " (gaUons) . " ~ I I Test Type: ,.... . '/' . \AA DV\.. ~ v- C-eVt T, ~~QTI '" "-. Deficiency ReP9rt ~o. Contents U,^-L~ I t\r «::.c:. ~~ ~\ ~ V<;> V- 2 V{ 0 ~ \bv ~ \AàQ.ö '<... Test ~ ! 0 - ( 5 - 6 LI ---- r-~ LùL G lr,,-cJ J Sc,^, S w "Í'\ V\. "" ,..J Cr \r- \'¿G\.^ACV c.c\ \ VQ. \ lo ~ 0 r l.}.JQ-r ~ V' r VLow--. f\ \r\ V'0 \ v- \r \Le- ~ \c c. "- C1 \\ ,.." ru,^~-r\.o~ St>Ci.C ~ V\ 0 \r \.AA D...- L ~"." ~ d.~~ï 'è/ .. MONITOR SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6,7, HeeM and Safety Code; Chapter 16. Division 3, TiUe 23, California Code of Regulations This form must be used.to dOCUment lesting and servicing of monitoring eQuipment A_l§QQr.i!!U;§[\jfi~tÌQf1_Qf.~¡:>Qn.ffiI.llLt!!!.I![!I11.@[!!Q. '!Quech monitorina~tem control 08MI by the tect1nician whO performs the wOO< A copy of this form must be provided to the tanl< system owner/operator The owner/operator must &ubmit a copy of this form to the local agency reçulat'l"9 UST systems within 30 days of test date A. Generallnlormatlon Facility Name: Freeway Liquor Site Address: 2140 East Brundage Lane Facility Contact Person: Rex Childers MakelModel of Monitoring System: Veooer-Root TLS·350 B. Inventory of Equipment Tested/Certified SIN e 1 t 52300905003 City: _ Bldg. No. Bekersheld Contact Phone No (661) Date of T estinQiServicing: Model: Model: Model: MCCaI: Model: Model: Model: Model Mag Tri Slate Tri State rr¡ Stât\1 OPW T ri State ed/aerviced: Zip 93307 323-0254 to/15/04 Tank ID: # 2 Premium ~ In-Tank Gauging Probe x Annular Space or V 81.111 Sensor. Piping SumpfTrench Sensor(s). Fill Sum¡:> Sensor(si Mechanical line Leak Detector Electronic Line Leak Detector Tank Overfill/ High-Level Sensor. Dispenser Containment Sensor(s). Shear V alve( s) Dispenser Containment Float(S) and Chain(s) Other I 1.11 nl aOO model in Sectioo E on P Tank ID: In- Tank Gauging Probe Annular Space or Vault Sensor. Piping SumpfTrench Sensor(s). Fill Sump Sensor(s). Mechenical Line Leek Detector. Electronic Une Leak Detector. Tenk Overfill/ High-Level Sensor Dispenser Containment Sensor(s}. Shear Valve(s). Dispenser ContalOm&nl Floatls) and Chaln(s) Other s \.II ment t and model In Section E on P Model: Model: Model: Model: Model' Model: Model: Model' T ri State Tri StaIf;I TriState OPW T ri State Check the a ro Mate boxes to Indicate Tank ID' # 1 Regular x In-Tenk Geuglng Probe. x Annular Space or Vault Senscr. x Piping SumpfTrencl1 Sensor(s). x .;I! Sump Sen.or(s). Mect1anical Line Leak Detector. Electronic Line Leak Detector. Tank Overfill/ High-Level Sensor Dispenser Containment Sensor(s). Shear Velve(s). Dispenser Conteinment Float(s) aOO Chain(s), Other ci" ui ment \ and model in Section E on P Tank ID In· Tank Gauging Probe. Annular Space or Vault Sensor. Piping SumpfTrench Sensor(s). Fill Sump Sensor(s). Mect1anical Line Leak Detector. Electronic Line Leak Detector. Tank Overfill/ High-Level Sensor. Dispenser Containment Sensor!s). Shear Valve(s) Dispenser Containment FloatIS)' aOO Chain(s) Other s i ui nt i aOO rOOdel in sèction E on P Model: Model: Model: Model' Model: Model: Model: Model: 2. Model: Modei: Model: Model: Model: Model: Model: Model: 2. C. Certification· I certify that the eQuipment ióèntifoed in this document was inspected/serviced in eccot'danca with the manufacturer's guidelines. Attached 10 this Certification is ,rrfOf'lT)8\ion (e.g. manufactur9fS' checklists) necessary to verify thai this information is corract and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, i have also attached a copy of the report; (ch6çk all thai apply): . 0 System set-up o Alarm history report Tect1nician Name (print): Mic/18e1 Moore -Testing Company Name: Redwine Testing Services, Inc. P-oe 1 of 3 Cer1./Lic. No. 562060899 Phone No.: (BOO) 582-ô368 Signature 'J -----1Y\.J ~ ,. Monitor System Certfcatlon Site Address: 2140 East Brundage Lane, Bakersfield, CA Date of Testing/Servicing: 10/15/04 D, Rnults of TestlngtServlclng Software Version Installed: Veeder-Root TLS-350 1/61152306905003 No· N/A No· For pressurized piping systems, does the lurt>ine automatically shut down if Ihe piping secondary containmenl N/A monitoring system detects a leak. fails to operate. or IS electrically disconnected? ~ yes: which sensors initiate positive shut-down? (Check all that apply) 0 SumpITrenc:h Sensors: D Dispen..... Containment Sensors. Did ou confirm sitive shut-oown due to leaks and sensor failure/dlsconnectlori? Dves' 0 No No' For tank systems that utilizéthe r;;ë;¡:'-,torlng-šÿ¿¡em as the primary lank overtlll warning device (Le no mechanical N/A overfill Pfevention valve is installed). is the overtill warning alarm visible and audibie al the tank fill point(s) end o~reting Pfo~, at what ~rcent of ta.~.~P~I!Y. doe~h.<'_ a.!!'!!!'J~I~r? 90 % No' Was eny monitonng equipment replaced? If yes. Identify specific sensors. probes. or other eqUipment replaced and list the manufecturer na~J!.nd model for alll~pl!"è9J11~!...e!'':1~~~.l9.~ E. .below. No' Was liquid found inside any secondary conteinment systems designed as dry systems? (Che<;k all that apply) D Product: D Water. ~ es describe causes in Section E below. No' Was monitori s stem set reviewed to ensure 0 r setti s? Attach set u re s if a licable Ves No' Is all monitonn ui ment ational manufecturer's lficalions? . In Section E below, describe how and when these deflclencles were or will be corrected. Is the audible alarm 0 ational? Is the visual alarm 0 rational? Were all sensors viauall in ed functionall tested and conflfmed 0 rational? Were all sensors installed at lowest point of secondary containment end positioned so that other equipment will not intertere with their r retion? ~ alarms are relayed to e remote monitoring stelien, IS all communications equipment (e.g. modem) operational? NlA E. Comments: Category Form Regular Tri State Piping Sump 0794360-206 Tri State Fill Sump 0794360-206 Tri State Annular 0794390-409 Premium T ri State Piping Sump 0794360-206 Tri State Fill Sump 0794360-206 Tri Slate Annullll 0794390-409 Dispen~r 1 & 2 Tri State 079436Q-206 Dispenser 3 & 4 Tri State 0794360-206 Dispenser 5 & 6 Tri State 0794360-206 Dispenser 7 & 6 Tri State 0794360-206 Four (4) spill buckets tested conducted watar tesl P-ve 2 of 3 03101 MonItortng System CertIfIcation Site Address: 2140 East Brundage Lane, B8kersfield, CA Date of Testing/ServiCIng 10/15/04 F, In-Tank Gauging I SIR Equipment: o ChecI< this box if tank gauging is used only for inventory control. o ChecI< this box if no tank gauging or SIR equipment is installed. This section must be completed if in·tank gauging equipment is used to perform leak detection mOnitoring x x x x for round feu Its? . Where visible ieted? G. Line Leak Detectors ILLD): IKJ ChecI< this box if LLDs ere not installed ormance For electronic LLDs, does the turbine eutomatically shut off if the LLD detects a leak? For electronic LLDs, does the turbine automalically shut off if eny portion of the "monitoring system is disabled or disconnected? F or electronic LLOs, does the turbine eutomatically shut off if any portion of the monitoring system malfunctions or fails a test? For electronic LLDs, have all accessible wiring connections been visually Inspected? leted? H. Comments: Page 3 of 3 030'01 ~ ~·~'f;"....wfÜIÍ t)f"ec(;e~ . );~~' ~, . . ~.1\/,·, ,;'S~·i..· .. ""~~~:,. .1 "'. . ~,~.~:'. ' .~.~ , ~~Y.¥.'.. . ~~ ~::~ Addms: tI LN. t~k;'~ \ l\ö e ß'vv{"\.-J(c,:y , ~l-:~1) .!'" "~*': '.' . ~~,;;~,~:, ;:'... , . , . . . . . . . . . . ~ '~'\' r ,. '?é) ; ·~},t(;I.:':., , . ,@:V: ' ¡: . .'~...;, 0 . .C{, . ~~"{;".'.:" ar .', ':'7: ¡;.:,;'; ?;', ",":', , ¥.i .... & ,'\-- i~~·:~ . . I~' ~~ :',~. . [rif;oI" ,..' . ~I'~~:::" ~ . .i.....,. iI~ :. .':. l·.}\. .:'. . ",.:'1: .' ." ~~. ;;~ ti;::·.. ;.), . ~ :':::: ~ " ~;';..<'; fJ.~ ' ~~~\~. ' {:"~., ri,~'r-. \t.!:~,. " r~:';": :.. ~:~~~~;~', '. . ·rif,~ already have. wagram that shows aU required information. you may include it, nrtber thaD this pase, with ·,i :Øw' Monitoring System CertifiC4tkm. On your site plan. show the general layout of t.tnks and piping. Clearly . '; :', ,'. . locations of the foUowing eqwpment, if installed: monitot1ng sy$t.em control p¡u)eJs; senson moaitoring î.~)t annular spaces, 5WDp~ dispen~ pam, spil1 coDtainm, or other secondary containment IUUI~ me<:h.nic.U or ~~~nic line J~ .d«ectors; and in-tank hqWd I~ probes (if used for leak detection), In the space provided, '~1P the date thiJ Site Plan wu prep&n!d. v·':·')·· ' . J-.i,:.....·· \ :,¡·:..'f:." ; ,'l''''í'' .: ~~,,,:y.,. , ~),'t~~"';,. ~~~? ~¡"" .,:)'..1',." ~~4!..~ . . . ,t't'!r. .. " . .~~. . , , , <N. ,~. I ~, 'f"~' . f . . .. . . UST MODitoriog Site PIID f\r~ç'~a.~ l\~~ov ,(sJ~\r~F\e...\j ~!\ \~--')07 '0' . . . . '~)' ,~. " , " '. . ~.U). ¡(v 'r--:- ~. .. --' . I . . :0: O. f\Z . · ., ,~I . :-f.Uy,\j)l ~,->, , I . . . , , . ", ,~.@, .~. Q . . . .. . .. , . . . . . . . , t . . ..,@.... '\c n . ,', ~ ~'" . . . . v-@.~ . . . . , . . f~\c.IL '7 J iß'Cfff . / .. j 'v¡~ ." h--.. >.§ - .........J . . Dee ~ 'fraI cnwø; ..lQ/ JJi./ i2..!::.. InstrQctiolU --' - ..... .... I ....... - " t' l' . REDWINE TESTING SERVICES, INC. (805) 326-0446 TEST RESULTS Tank NQ. . .2- Capacity .. (gallons) . " ~ I I Test T)12Çl ,.... . 'I' . Vv\ D\A \"CÕ v- ; C-eVt T, ~~*( ~ I.-. i I ! ! Deficiency Repprt :No. ~v~~Jcj ~GW-~c.J \ sQ\lo~ J\ 'v\ V'-- '-' \ ~ \r Re-?\cic~ i rVl.o~ ! Q t \ I r u '^ t..lw "'- I ! . Content~ UV\.-L~ (~-æ~sD r,'" :1 ..üuL <;c.V\.. <; 0 v or / t\r c:.~ w~ ~\ '\ lkt> Lr 2 V{ 0 E. ~ ~ \Ac\C:¡8 '<:... Test lliili; ! 0 - [5 - 6(/ t\- V\. '^ u ~ V- \r- ly..) Q:-L ~ V' S ~Q Co- -e..- V\ 0 \r v...A- D...- L FREEt,.!AY L 101JORS 2140 E. BRUNDAGE BAKERSFIELD, CA. 805-'.39:~- 0954 MAR 5, 9004 10:05 AM ~,~I'EI"I STgTUS REPORT ~,LL FUNOTIONS NORMF~L INVENTORY REPORT T 1: UNLEADED REGULAR VOLUME = 6868 GALS ULLAGE = 465'3 GALS: 90% ULLAGE= 0506 GALS HEIGHT = 51,14 INOHE~ I~ATER VOL = 00ALS WATER = O.O0 INCHE'.S TEMP = 69.1 DEG F T 2:PREI"ll UM UNLEADED VOLUME = 2716 GALB ULLAGE = 8811 GAL$ 90'>¢ "!.LAGE= 7658 Gt4LS HE Ik ' ~ = = ~o,4b INCHES ~IATER = 0. O0 INCHES TEMP = 76.0 DEG F CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CltECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME F('~V=. ~kJzP,/ ~.,1610 O ~r,~ INSPECTION DATE Section 2: Underground Storage Tanks Program [~[ Routine ~Combined [~[ Joint Agency [~ Multi-Agency [~1 Complaint [~ Re-inspection Type of Tank "i~[/k] ~" Number of Tanks ~. Type of Monitoring 0_-L- 144 Type of Piping ~ ~,~J ~' 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 K 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 Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compl,ance V:Violation Y:Yes N=NO inspector:, ,~]/'~'~//~~./~~ Office o El~y~onmental SetYvi~ (~)~w5~979 Bff~i~s Site Re~pon~ble Party White - Env. Svcs. Pink - Business Copy Bakersfield Fire Dept. ~G~M II~ECTION CHECKLIST Enironmental Se~ces 1715 Chester Ave SECTION I Business Plan and inventory Program Bakersfield, CA 93301 Tel: {661)326-3979 ~.~'.~'_~.~..~_~~ ..... ~,_~.~ ................................... ~ .......................... ~.~_~ ...... t.~._~_~.~'.._~_~.~ .... ADDRESS / ~ i {~ONE No. [ No. of Employees ~~ ~ ~ .................................... i~_~~ ........ _ ................... Section 1: Business Plan and Inven~ Pr~mm ~ Routine ~Combin~ ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection C V iC=C°~"~ia"c~ OPE~TION COMMENTS k V=Violation ~ APPROPRIATE PERMIT ON HAND ..................................................................................................... ~ ~ BUSINESS P~N CONTACT INFORMATION ACCU~TE ~ 3 VISIBLE ADDRESS ~ ~ CORRECT OCCUPANCY ~ ~ VERIFICATION OF INVENTORY MA~RIALS ~ VERIFICATION OF QUANTITIES ~ VERIFICATION OF LOCATION ~ PROPER SEGREGATION OF MATERIAL ~ VERIFICATION OF MSDS AVAILABILIWE ~ ~ VERIFICATION OF HAT MAT T~INING ~ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ ~ EMERGENCY PROCEDURES ADEQUATE ~ CONTAINERS PROPERLY ~BELED '~ ~ HOUSEKEEPING . ~ SITE DIAGRAM ADEQUATE & ON HAND ANY H~ARDOUS WASTE ON SITE?; ~ YES ~ No EXPLAIN: White. Environmental Services Yellow - Station Copy Pi~'- Business Copy HAZARDOUS MATERIAL DIVI. SION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 APPLICATION TO PERFORM A TIGHTNESS TEST 2' ~-'~ FACILITY FREEWA~ LIQUORS ADDRESS 2030 E. Brundage Lane PERMIT TO OPERATE 9' S1572-1-0 OPERATORS NA~4E Loyd Childers OWNERS NAME Loyd Childers NUMBER OF TANKS TO BE TESTED 3 IS PIPING GOING.TO'BE TESTED Yes TANK~ VOLUME CONTENTS 1 12,000 Unleaded 2 12,000 Supreme Unleaded usTSERVICES, INC. TANK TESTINGCOMPANYCONFIDENCE ADDRESS 501 Workman St., Ste. 108 TEST METHOD AES System II (Overfill) NAME OF TESTER Douglas Young CERTIFICATION % 86116 STATE REGISTRATION % 90-1076 DATE & TIME TEST IS TO BE CONDUCTED December 2, 1993; 2:00 E.m. ~' Certified Fee Postm~k . Here i~etum Reciept Fee (Emlorsement Requital) Rest~'Y~d Dettvery Fee (Endorsement Req~ire~) Tot~ poste,ge ~ 2030 e }~-Ko'E.~b? Bakersfield, CA 93307 t ............ ~,_ ~, I II III I · Complete items 1, 2, and 3. Also complete item 4 ),f Restricted Delivery is desired. Agent - · Print your name and address on the reverse ' Addressee SO that we can return the card to you. 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 from item 17 BI Yes , 1. Article Addressed to: If YES, enter delivery address below: [] No FI~_.EWA¥ LIQUORS 2030 E BRUNDAGE Bakersfield, CA 93307 3. Service Type ,~_ Certified Mail Express Mail r-I Registered [] Return Receipt for Merchandise ~ ............................................. y [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 2. Article Number 7002 3150 0004 9985 4964 (Transfer from service label) PS Form 3811, August 2001 Domestic Return Receipt 102595-02.M-1540 November 4, 2003 CERTIFIED MAIL Freeway Liquors 2030 E. Brundage Bakersfield, CA 93307 FIRE CHIEF RON ~ZE NOTICE OF VIOLATION ADMINISTRATIVE SERVICES & SCHEDULE FOR COMPLIANCE 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 Dear Sir or Madam, FAX {661) 305-1349 SUPPRESSION SERVICES Our records indicate that your annual maintenance certification on your leak 21Ol 'H' Street detection system was past due 10-08-03. 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 PREVEI~TION SERVICES Regulations. FIRE SAFETY ~ERv1C ES * ENVIRONMENTAL SER'VtCES '~ 715 Chester Ave. Bakersfield, CA 93301 "Equipment and devices used to monitor underground storage tanks shall be vOICE (661)326-3979 installed, calibrated, operated and maintained in accordance with manufacturer's FAX (661) 326-0576 instructions, including routine maintenance and service checks at least once per PUBLIC EDUCATION calendar year for operability and running condition." 1715 Chester Av~. Bakersfield, CA 93301 vOiCE (661)326-36~ 'You arc hereby notified that you have fifteen (15) days, November 19, 2003, to FAX (661) 326--O576 either perform or submit your annual certification to this office. Failure to FIRE INVESTIGATION comply will result in revocation of your permit to operate your underground 1715 Chester Ave. Bakersfield, CA 93301 storage system. VOICE (661) 326-3951 FAX (661) 326-0576 Should you have any questions, please fec] frec to contact me at 661-326-3190. TRAINING DlVlSION 5642 Vlctor Ave. o, a.~e;ncere'- yours, Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Ralph E. Huey Director of Prevention Services Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/db 9-18-2003 8:25A1~ FR~CALVALLEY EQUIP 16613252529 P. 2 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Cheste~~ Ave., Bakersfield, CA (661) 326~3979 APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION OPERATORS NAME~t,r OWNERS NAME . _So_.~,~.e ..... NAME OF MONITOR MAN UFACTURER DOES FACILITY HAVE DISPENSER PANS? YF,,S /,"' NO. TANK # VOLUME CONTENTS. ~ Oi U_/- ,, NAME OF TF:aSTINO COMPANY. Cml- Vtti/t~. _~. ot_~,me~,~' . . CONTRAil'ORS, LICENSE ~ 7Roi 7~ ~ .N~ ~ : N~E & PHONE NU~ER. OF CO~A~ PERSON...~F~ DA~&T~~TISTOBECONDU~ED 10-1-03 ~ O.q: O0 '~:::t~i.' '.~ ........t . . : [ ~, ..'.~ ~ : APPROV~ BY DA~ StONA~ O~ ~PH ~'~,,, ~" ": .~?...~: 'F~..~. :' Postege $ ,--r r-i ' Postmark Return Reclept Fee I~ (Endorsement Required) Here D ._Restricted Delivery Fee u') [~-ndome~t Reoulred) ~ REX CHII.DRESS ITl Total P~ nj FREEWAY LIQUORS c3~ 2030 E. BRUNDAGE LN r,- BAKERSFIELD CA 93307 L.,,.~.~.~ ' · Complete items 1, 2, and 3. Also complete .. JSidnature I ''~ ~ ~ '" " , |tern 4 if Restricted Delivery is desired. I F~/~,i ~ n Agent reverse [] Addressee . · Print your name and address on the ' C Date of Dehve ' so that we can return the card to you. ! I [~..Rece,~d'by (F~iqte~fl~lar~ ') cl. :'. ~ ,,~e~/ mailpiece, · Attach this card to the back of the ~¥ [ ~.1 /_UU~ .._ or on the front if space permits. | ] D. Is ~'eli-very address diffe;'ent from it'em 17 [] Yes 1. Articte Addressed to: ___.___.____~!l if YES, enter delivery address below: [] No rREX CHILDRESS FREEWAY LIQUORS 2030 E. BRUNDAGE LN AKERSFIELD CA 93307 ~ 3. Service Typo . ~a j~ · [] Certified Mail [] Express Mail ..... [] Registered [] Return Receipt for Merchandise , -- ...... l ~ [] Insured Mail [] C.O.D. / 4. Restricted Delivery? (Extra Fee) [] Yes : 7002 3150 0004 9985 3882 _ ~ ............ 2ACPRI-03-Z-0985 PS Form 3811, August 2001 Domestic Return Receipt May 8, 2003r - ' '~ Rex Childress Freeway Liquors 2030 E. Brundage Lane Bakersfield, CA 93307 CERTIFIED MAIL RE: Failure to Complete SB 989 Secondary Containment Repairs & Retest 7-iR7: CHIEF ~Cr'l FRAZE FINAL REMINDER NOTICE ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661)326-3941 Dear Underground Storage Tank Owner & Operator: FAX (661) 395-1349 Since January 1, 2003, this office has sent you monthly reminders SUPPRESSION SERVICES 2'101 "H' Street advising you of a failed SB 989 test. In that letter, this office also Bakersfield, CA 93301 requested an update with regard to repairs of your system. VOICE (661) 326-3941 FAX (661) 395-1349 This office further explained that repairs of your system are a PREVENTION SERVICES .,E s,,,',.', sE..',cEs. E.v,.o.,~.,,.,~.,,,~. condition of your permit to operate. Please be advised that you must 1715 ChestorAvo. have your system repaired and retested by June 15, 2003. Failure to Bakersfield, CA 93301 VOICE (661)326-3979 comply may result in further enforcement action up to, and including FAX (661) 326-0576 revocation of your permit to operate. PUBLIC EDUCATION 1715 ChesterAve. This office has extended every courtesy with regard to sending Bakersfield, CA 93301 VOICE (661) 326-3696 contractor information as well as one on one visit's FAX (661) 326-0576 FIRE INVESTIGATION Should you have any questions, please feel free to call me at 661-326- 1715 Chester Ave. 3190. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 Sincerely, TRAINING DIVISION 5642 VlctorAvo. Ralph E. Huey Bakersfield, CA 93308 VOICE (661) 3994697 Director of Prevention Services FAX (661) 399-5763 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc []- Postage $ _1' Postmark 1::3 Return Reciept Fee r-'t (Endorsement Required) I Here r-t Restricted Delivery Fee I.~ (Endorsement Required) m Vot~ po~ FREEWAY LIQUORS · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the revers0 so that we can return the card to you. II B~- I~ [C~Date of Delivery · Attach this card to the back of the mailpiece, i ,h~, ~_ or on the front if space permits. I 1, Article Addressed to: if YES, enter delivery address below: Itl No I~ FREEWAY LIQUORS ,2030 E. BRUNDAGE · BAKERSFIELD CA 93307 a. Service ~ [] Certified Mail ' Fl' Express Mail Fl: Roflisterod [] Return Roeaipt for Merchandise ---~ [] Insured Mail I"1 .C:.Q.D. 4. Restricted Delivery? (Extra Fee) [] Yes ,7002 3150 0004 9985 3172 ' PS Form 3811, August.2001 Domestic Return Receipt 2ACPRI-03-Z-0985 April 11, 2003 Freeway Liquors 2030 E. Brundage Bakersfield CA 93307 FIRE CHIEF CERTIFIED MAIL RON FRAZE RE: Recent SB 989 Secondary Containment Testing ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 voicE (661)32 -3 1 FOURTH REMINDER NOTICE FAX (661) 395-1349 SUPPRESSION SERVICES Dear Owner/Operator: 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 325-3941 Our records indicate that you completed your secondary containment FAX (661) 39s-1349 testing on December 11, 2002. Our records further show a failed test. PREVENTION SERVICF.~ Therefore you are required to have your system repaired and re-tested 1715 Chester Ave. Bakersfield, CA 93301 as soon as t,oss,~,,e. VOICE (661) 326-3951 FAX (661) 326-0576 This office requests an update with regard to repairs of your system. ENVIRONMENTAL SERVICES Please be advised that repairs involving the replacing of components 1715 ChostorAvo. must be under permit from this office. The repairs of your system are Bakersfield, CA 93301 VOICE (661) 320-3979 a condition of your permit to operate. Failure to repair and re-test will FAX (661) 326-0576 result in the revocation of your permit to operate. TRAINING DIVISION 5642 VictorAvo. Should you have any questions, please feel free to contact me at 661- Bakersfield, CA 93308 VOICE (661) 300-4697 326-3190. FAX (661) 399-5763 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc ~ C~rtlfled Fee -- Return Reclept Fee ~ _ (Endorsement R~ulred) Postrna~k ._R .e~fcted Delivery Fee ~ ~ Here {~nOorsement Required) Total po,~'~''-~'---- - - ~ FREEWAY LIQUORS * ^KERSFIELD Ca 933 ..... ;,.: "-_. :~[ricted Delivery is desired. I [] Agent · Print your name and address on the reverse -% [] Addressee So that we can return the card to you. B. R-e~ived by (Printed Name) I C. Date of Delivery / · Attach this card to the back of the mailpiece, I or on the front if space permits. D, Is delivery address different from item 17 [] Yes 1. Article Addressed to: if YES, enter delivery address below:' [] No~' - FREEWAY LIQUORS 2030 E. BRUNDAGE BAKERSFIELD CA 93307 , Service Type [3 Certified Mail [] Express Mail [] Registered [] Retum Receipt for Merchandise '~- ............ I [] Insured Mail [] C.O,.D. ~cted Defivery? (Extra Fee) [] Yes 7002 3150 0004 9985 2977 PS Form 3811, August 2001 Domestic Return Receipt 2ACPRM33-Z-0985 March 5, 2003 Freeway Liquors 2030 E. Brundage Bakersfield CA 93307 CERTIFIED MAIL FIRE CHIEF RON FRAZE RE: Recent SB 989 Secondary Containment Testing ADMINISTRATIVE SERVICES 2101 "H' Street Bakemfield, CA 93301 vo,cE 1661)326-3 1 THIRD REMINDER NOTICE FAX (661) 395-1349 SUPPRESSION SERVICES Dear Owner/Operator: 2101 "H' Street Bakersfield, CA 93301 voice (661)326-3341 Our records indicate that you completed your secondary containment FAX (661) 395-1349 testing on December 11, 2002. Our records further show a failed test. PREVENTION SERVICES Therefore you are required to have your system repaired and re-tested FIRE SAFETY SERVICES o ENVINONMEI~I'J~i. SERI~CES 1715 Chester Ave. as soon as possible. Bakersfield. CA 93301 VOICE (661) 326-3979 FAX (661)326-0576 This office requests an update with regard to repairs of your system. Please be advised that repairs involving the replacing of components PUBUC EDUCATION must be under permit from this office. The repairs of your system are 1715 Chester Av~. i' Bakersfield, CA 93301 ~ a condition of your permit to operate. Failure to repair and re-test will VOICE (661) 326-3696 FAX (661) 3260576 ; result in the revocation of your permit to operate. FIRE INVESTIGATION 1715 ChesterAve. , Should you have any questions, please feel free to contact me at 661- Bakemfleld, CA 93301 326-3190. VOICE (661) 326-3951 FAX (661) 326-0576 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc .Irt ru 13- .:1- .i-~. 13' · r-~ Postage $ ru Certified Fee r-~ Postmark .r-~ Return Reciept Fee Here r'~ (Endorsement Required) r-I Restricted Delivery Fee (Endorsement Required) ru FREEWAY LIQUORS m 2030 E. BRUNDAGE BAKERSF~LD CA 93307 · Complete items 1, 2, and 3. Aisc complete item 4 if Restricted Delivery is desired. [] Agent · Print your name and address on the reverse [] Addressee so that we can return the card to you. B. Received,by(Printedl)l~..me) 1 ~C; ~ate of Delivery · Attach this card to the back of the mailpiece, ~'~ .~ ~ C~ ~ ~'~ ' or on the front if space permits .... D. Is delivery address different from item ! ? [] Yes l~essed to: if YES, enter delivery address below: [] No FREEWAy LiQUORS 2030 E. BRUNDAGE B~KERSF~LD CA 93307 /3. Service Type l [] Certified Mail [] Express Mail ................. -~ [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. ~'. Restricted Delivery? (Extra Fee) [--I Yes 7002 2410 0002 1974 9213 PS Form 3811, August 2001 Domestic Return Receipt 2ACPRI-03-Z-09e5 February 13, 2003 Freeway Liquors 2030 E. Brundage Bakersfield CA 93307 FIRE CHIEF ,~ON ~R,ZE Certified Mail ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfiel0, CA 93..'.'.'.'.'.'.'.'.~)1 vOiCE (661) 326-394~ RE: Recent SB 989 Secondary Containment Testing FAX (661) 395-1349 suP.RESS,O. SERVICES SECOND REMINDER NOTICE 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 Dear FAX (661) 395-1349 uwnc.ul)craror: PREVENTION SERVICES Our records indicate that you completed your secondary containment F~E SAFE31f SERVICES. ENVIRONM~JTAL SERI/ICES 1715 ChestorAvo. testing on December 1 l, 2002. Our records further show a failed test. Bakersfield, CA 93301 VOICE (661) 326-3979 Therefore you are requiredto have your system repaired and re-tested FAX (661)326-0576 as soon as possible. PUBLIC EDUCATION 1715 ChesterAve. This office requests an update with regard to repairs of your system. Bakersfield, Ca 93301 Please be advised that repairs involving the replacing of components VOICE (661) 326-3696 FAX (661) 326-0576 must be under permit from this office. The repairs of your system are a condition of your permit to operate. Failure to repair and re-test will FIRE INVESTIGATION 1715 Chester Ave. result in the revocation of your permit to operate. Bakersfield, CA 93301 " VOICE (661) 326-3951 FAX (661)326-0576 Should you have any questions, please feel free to contact me at 661- 326-3190. TRAINING DIVISION 5642 Victor Ave. VOICE (661) 399-4697 . FAX (661) 399-5763 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc FREEWAY L ITLIOR$ 214B E. BRUI'4r3AGE BAKERSF I ELB .. _ .- .-~ q.- - .-, ~ .. US-:-'M ~ JAN .... , 2003 1:47 PM _ SYSTE!~I,,STATUS REPORT ALL FUIxiOTI©I"IS NORMAL INVENTORY REPORT T ! :IJI',ILEADEF:~ REGULAR V©LUME ~ 5604 t;;F~LS ULLAGE = 5923 90% LLL~GE= 4770 "'"" HEIGHT = 43.49 INCHES WATER V':)L = 0 GALS WATER = 0.00 INCHES TEMP = 62.7 DEG F T 2: PREM I UM OI'.ILE~DED VOLOME =' ~O~b GALS 90% U~AB~ 8348 H~IOH9 = ~0.61 INCHES WATER VOL = O GALS W~TER = 0.00 INCHES TEMP = 70.6 DEG F CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME .~tu/.~t,l ~,~.;/'~tS INSPECTION DATE i'- ~ I "0 71 Section 2: Underground Storage Tanks Program [21 Routine [~ Combined [] Joint Agency [] Multi-Agency [21 Complaint [] Re-inspection Type of Tank ._F~}I~ Number of Tanks ~ Type of Monitoring ~ ¢)h Type of Piping fJt_fl~ 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 Inspector: .~ f~ ~~R (,.~.,~..~.' ~.~~ Omce of Environmental"Services (805) 3"'-26-3979 espons~bl'e Party White - Env. Svcs. Pink - Business Copy Bakersfield Fire Dept. UNIFIED PROGRAM PECTION CHECKLIST Enironmenta] Sez~dces , ,"," , ,, ',,, -~''''"~ 1715 Chester Ave SECTION 1. Business Plan and Inventory Program Bakersfield, CA. 93301 'Tel: (661)326-3979 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS ~' P . NO. of Employees e. ....... ........... FACILITYCONTACT Business ID Number 15-021 - ' ' .... ' ...... S : s PI n d InventorY Progra , , ...~, ection 1 BUsines a .an m l"1 Routine '~ Combined ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection · C V (C=Comp,ancel OPERATION COMMENTS ~. V=Violation ./ [~ APPROPRIATE PERMIT ON HAND ~ 17 VISIBLE ADDRESS ~ [] CORRECT OCCUPANCY ~ ~ VERIFICATION OF INVENTORY MATERIALS ~[] VERIFICATION OF QUANTITIES [~ VERIFICATION OF LOCATION PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITYE VERIFICATION OF HAT MAT TRAINING VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES EMERGENCY PROCEDURES ADEQUATE CONTAINERS PROPERLY LABELED HOUSEKEEPING FIRE PROTECTION SITE DIAGRAM ADEQUATE ~ ON HAND ANY HAZARDOUS WASTE ON SITE,9; ~ YES I'1 No EXPLAIN: White. Environmental Services Yellow - Siation Copy Pink - Business Copy January 22, 2003 Freeway Liquors F~RE CHIEF RON FRAZE 2030 East Brundage Lane Bakersfield CA 93307 ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield. CA 93301 RE: Upgrade Certificate & Fill Tags VOICE (661) 326-3941 FAX (661) 395-1349 Dear Owner/Operator: SUPPRESSION SERVICES 2101 'H' Street Bakersfield, CA 93301 Effective January 1, 2003 Assembly Bill 2481 went into effect. This VOICE (661) 326-3941 Bill deletes the requirement for an upgrade certificate of compliance FAX (661) 395-1349 (the bluc sticker in your window) and the blue fill tag on your fill. PREVENTION SERVICES FIRE SAFET~ SERVICES · ENVIRONMENTAL SERVICES 1715 ChesterAve. You may, if you wish, have them posted or remove them. Fuel Bakersfield, CA 9'&301 vendors have been notified of this change and will not deny fuel VOICE (661) 326-0979 FAX (661) 326-0576 delivery for missing tags or certificates. PUBLIC EDUCATION 1715 ChosterAv~. Should you have any questions, please feel free to call me at 661- Bakersfield, CA 93301 1 90. vOiCE (e61) 326-3s~ FAX (661) 326-0576 FIRE INVESTIGATION Sincerely Bakersflold, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION Steve Underwood 5642 Victor Ave. Bakersfield, CA 93308 Fire Inspector/Environmental Code Enforcement Officer VOICE (661) 3994697 FAX (661) 399-5763 Office of Environmental Services SBU/dc · ~ Postage $ t'~ Certified Fee Return Receipt Fee Postmark I"-I (Endorsement Required) Here ~E! Restricted Delivery Fee --~ i--I (Endorsement Requirs~) · nj Total .~.r~T FREEWAY LIQUORS [i~i~ 2030 E. BRUNDAGE ............ ;;-~i BAKERSFIELD CA 93307 · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. [] Agent · Print your name and address on the reverse ~ Addressee SO that we can return the card to you. C. Date of Delivery ; · Attach this card to the back of the mailpiece, or on the front if space permits. Jelive*'ry address different from item 1 ? [] Yes 1. Article Addressed to: If YES, enter delivery address below: [] No FREEWAY LIQUORS 2030 E. BRUNDAGE 3. Service Type [] Certified Mail [] Express Mail BAKERSFIELD CA 93307 [] Registered [] Return Receipt for Merchandise ............. [~] Insured Mai__l ~ C.,__Q,D_~. ' ~ Delivery? (Extra Fee) [] Yes 2.~ 7002 0860 0000 1641 52~06 PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-0835 January 13, 2003 Freeway Liquors 2030 E. Brundage Bakersfield CA 93307 FIRE CHIEF ~o~ ~R~E Certified Mail ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 RE: Recent SB 989 Secondary Containment Testing FAX (661) 395-1349 suP..ESS,O. SERVICES REMINDER NOTICE 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Dear Owner/Operator: PREVENTION SERVICES Our records indicate that you completed your secondary containment FIRE SAFETY SERVICES * EHV]RONMENTAL $EFN1CE$ 1715 Chester Ave. testing on December 11, 2002. Our records further show a failed test. Bakersfield, CA 93301 VOICE (661)326-3979 Therefore you are required to have your system repaired and re-tested FAX (661) 326-0576 as soon as possible. PUBLIC EDUCATION 1715 ChosterAv~. This office requests an update with regard to repairs of your system. Bakersfield, CA 93301 VOICE (661)326-3696 Please be advised that repairs involving the replacing of components FAX (661) 326*0576 must. be under permit from this office. The repairs of your system are nRC I.VESTIaATIO. a condition of your permit to operate. 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661)326-3951 Should you have any questions, please feel free to contact me at 661- FAX (661) 326-0576 326-3190. TRAINING DIVISION 5642 Vlctor Ave. Sincerely, Bakersfield, CA 93308 ~ ~ VOICE (661) 399-4697 FAX (661) 399-5763 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc ~ Postage $ r-1 Certified Fee Postmark Return Receipt Fee Hem t'"l (Endorsement R~quired) cO Restricted Delivery Fee i-'1 (Endorsement Required) ILl Total Posit,~,~a~-,~,~ -~ . ,,~ ,", en[~- LLOYD CHILDRESS I r,-[._.:....:.:... FREEWAY LIQUORS ........ 11 ........ 11 · Complete items 1, 2, and 3. Also complete ,,~Signature ~ . item 4 if Restricted Delivery is desired. · Print your name and address on the reverse X ~,._~--K..~ V ~ ~ V~vt~/L_l Addressee so that we can return the card to you. B. Received by ( _Pr/nt, p.~d ,/',/arpe~ ~ [ C. ,.D.at_egf De~ery · Attach this card to the back of the mailpiece, or on the front if space permits. D. ts ~elivery address different from item 1. ?'9 Ye/s 1. Article Addressed to: If YES, enter delivery address below: [] No ~.~ 'LOYD CffILDRESS REEWAY LIQUORs 330 E BRUNDAGE LN 3. Sen/ice Type I-I Certified Mail [] Express Mail AKERSFIELD CA 93307 [] Registered [] Return Receipt for Merchandise L. __ __ [] Insured Mail [] C.O.D. :~ 4. Restricted Delivery? (Extra Fee) [] Yes 7002 0860 '0000 1641 5202 PS Form 3811, August 2001 Domestic Heturn r-leuu~pc 102595-02-M-0835 December 2, 2002 a~- Lloyd Childress Freeway Liquors 2030 E. Bmndage Ln Bakersfield, Ca 93307 CERTIFIED MAIL FiRE CHIEF RON FRAZE NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE ADMINISTRATIVE SERVICES 2101 Street RE: Failure to Submit/Perform Annual Maintenance on Leak Detection System Bakersfield, CA 93.301 VOICE (661) 326-3941 FAX (661) 395-1349 Dear Underground Storage Tank Owner: SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 Our records indicate that your annual maintenance certification on your leak detection FAX (661)395-1349 system was past due on September 18, 2002. PREVENTION SERVICES You are currently in violation of Section 2641(J) of the California Code of s~L~r't SERWCES. E~',.no#m:m'~ SEI~ICES 1715 Chester Ave. Regulations. Bakersfield, CA 9~301 VOICE (661) 326-3979 FAX (661) 326-0576 "Equipment and devices used to monitor underground storage tanks shall be installed, calibrated, operated and maintained in accordance with manufacturer's instructions, PUBLIC EDUCATION including routine maintenance and service checks at least once per calendar year for 1715 Chester Ave. Bakersfield, CA 93301 operability and running condition." VOICE (661) 326-3696 FAX (661) 326-0576 You are hereby notified that you have thirty (30) days, January 3, 2003 to either FIRE INVESTIGATION perform or submit your annual certification to this office, Failure to comply will result 1715 ChesterAve. in revocation of your permit to operate your underground storage system. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661)326-0576 Should you have any questions, please feel free to contact me at 661-326-3190. TRAINING DIVISION 5642 VIctor Ave. SIncerely, Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Ralph Huey Director of Prevention Services Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services cc: Walter H. Porr Jr., Assistant City Attorney Certified Fee ~m R~ Fee ~do~me~ R~l~ ~m R~ ~ F~ ~ment ~ut~ ~EWAY LIQUORS ~ ~~sFmm c~ 93307 .......... 1 .......... ~ ........ 1 December 1, 2002 Freeway Liquors 2030 East Brundage Lane Bakersfield CA 93307 FIRE CHIEF RON FRAZE CERTWIED MAIL ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 F^x (661)395-1349 FINAL REMINDER NOTICE su..RESS,O. SE.VICES JANUARY 1, 2003 DEADLINE 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Dear Tank Owner/Operator: PREVENTION SERVICES FIRESAFETYSER1/ICES*ENVIRONMENTALSERVICES You will be receiving this letter on or about December l, 2002. One 1715 Chester Ave. Bakersfield, CA 93.301 month from today, January 1, 2003, your current underground VOICE (601) 326-3979 FAX (661)326-0576 storage tank(s) will become illegal to operate. Current law would require that your permit be revoked for failure to perform the PUBLIC EDUCATION necessary Secondary Containment testing. 1715 Chester Avb. Bakersfield, CA 93301 VOICE (661) 326-3696 In reviewing your file, I see that you have received "Reminder FAX (661) 326-0576 Notices" since April of this year. This is your last chance to comply FIRE INVESTIGATION with code requirements for Secondary Containment testing prior to 1715 Chester Ave. Bakersfield, CA 93301 January 1, 2003. VOICE (661)32'3951 FAX (661) 326-0576 Should you have any questions, please feel free to contact me at 661- TRAINING DIVISION 326-3190. 5642 Victor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 --- -.Sincerely, FAX (661) 399-5763 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc <F~e~c 12 02 02:36p Franzen 559688146? Hill p.1 FRANZEN-HILL CORPOI~ATION 1100 North J Street Tulare, California 93274 (559) 688-2977/FAX (559) 688-1467 LETTER OF TRANSMITTAL TO : City of bakersfield Date :12/12/02 Office of Environmental Services Job No :Freeway Liquor 1715 Chester Ave ~0 ~C) C~. ~t~v~[~ I~akersfield, CA 93301 Attn .' Steve Underwood FAX#': 661-326-0576 Phone : 661-326-3979 WE ARE SENDING YOU ATTACHED VIA ~' FAX I-I Letter [] Plans [] Contract [] 5pecification~ [] Drawing~ [] Sub-Contract v'Te~t Re~ults Copies Date Description Secondary Containment Te~ting l~eport THESE ARE TRANSMITTED a~ checked below: I-tFor approval [] Return corrected prints ~For your u~e [] FOR BIDS DUE 2000 I~ As requested [] PRINTS RETURNED AFTER LOAN TO US [] For review [] Signature and I~e~urn COPY TO: l~ob Hill SIGNED: Iva Tucker Ext. 3002, Construction Secretary CITY OF BAKERSFIEIJ) OFFICE OF ENVIRONMENTAL SERVIC~ 1715 Chester Ave. Bakexsfield, CA (661) 326-3979 _ APPLICATION TO PERFORM'A TANK TIGHTNESS TEST/ SECONDARY CONTAINMENT TESTING FACILITY, ~"C ~ ~ ,]_, 't~LLOf~ ..... PERMrrTOOPERATE# ©~ - C~t '-"C)© I~__~i - , , oP~'~TO~ ~,~,m ~'e:~cm~ Li~t~ OWNERS N~ ~V':L~£L~ ~)fl, lA~31f~. TANK # VOLUME CONTENTS Dt~c 12 02 O:~:3Gp Fran~,en Hill SWRCB, January 2002 Page I of 7 Secondary Containment Testing Report Form This form is intended for use by contractors performtng periodic re. ting of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. I. FACILITY INFORMATION Facility Name: Freeway Liquor [ Date of Testingi. 12/11/02 Facility Address: 2140 E. Brundage Bakersfield Wag l 11057 Facility Contact: Rex [ Phone: 661-703-3093 Date Local Agency Was Notified of Testing: 12/09/02 Name of Local Agency Inspector (ifpre~ent during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: Franzen-Hill Carp 1100 North J Street Tulare, CA 93274 Techn ician Conducting Test: Felix Mendes Credentials: x CSLB Licensed Contractor 0 SWRCB Licensed Tank Te~ter License Type: A,B.C-61/D40 HAZ I License Number:. 304147 I ~'~ ..... - ~-- " ~nufacturer Trainine Manufacturer Component(s) Date Training Expires Environ Piping and Testing 10/03 Total Containment Piping and Testinl~ 10/03 Ineon Testing 09/04 Cadwell Testinl~ 3. SUMMARY OF TEST RESULTS Component Pass FallNot Repairs Not Repairs Tested Made Component Pass FailTeated Made O P g - !-7.- [] [] ~ [] [] r, [] If hydrostatic testin~ was performed, describe what w~s done wi~ the water after completion of~t~: CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To tire best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements T~h.~ci.n's Si~n.,.re:,~'~'~'~-'~~~ D.= fi- -/j-o 7-- nsc 12 02 02:3Gp Franzen Hill SSSG8814G7 p.3 SWRCB, Sanuary 2002 Page ~' of ~ ~. 4. TANK ANNULAR TESTING ~-' T'es't Method Developed By: D Tank Manufacturer ~ Industry S~andard ' ~ Professional Engineer [] Other (Specify.) Test Method Used: [] Pressure J~'Vaeuum Fl Hydrostatic [] Other (Specify) Test Equipment Used: Equipment Resolution: ~~~ Tank #' . ~,, '= · I,. ~ ] ...... Tank # .~- Tank # Tank # Is Tank Exempt From Testing?t [] Yes ~l, No n Yes ~ No [] Yes 0 No [] Yes n No Tank Material: Tzmk Mlmufacturer: Product Stored: ~7 " q~.. x .... Wait time between applying pressure/vacuum/water and startin$ test: ID P~(n ]0 tan;rs Test Start Time: 'Initial Reading (Ri): Test E.d T me: 13: co t ; 3 o ,,. Final Reading (R~): .= I q . '- I Iff .. Test Duration: 30 ~ [r~ 30 ~, ,~. Change in Reading (R~R,): Pass/Fail Threshold or Criteria: Teat Rea.rt.!t:- .. ,~ Pass [] Fail ~ Pass [] Fail' [] Pass [] Fail [3 Pass [] Fail Was sensor removed for testing? ~Yes ENo []NA ~Yea ON# ElNA EYes ENo GNA []Yes []No ONA Was sens°r pr°perly replaced and I~yes UNo []NA ~'Yes ENo E~NA [3Yes ENo [3NA OYes ENo ONA :: verified functional after testing? Comments - (include information on repairs mada prior to testing, and recommended follow-up for failed tests) ~ Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment testing. {California Code of Regulations, Title 23, Section 2637(a)(6)} Dec 12 02 02:36p Franzen Hill 558688146? SWRCB, Sanuary 2002 Page of '~ 5. SECONDARY PIPE TESTING Test Method Developed By: 1-1 Piping Manufacturer ~ Industry Standard [] Professional Engineer [] Other (Specify) Test Method Used: ~ Pressure [] Vacuum [3 Hydrostatic [] Other (Specify) Test Equipment Us'ed: Equipment Resolution: Piping Run # I Piping Run # ~- Piping Run # Piping Run # Piping Manufacturer: rc,4~ I (..~r~f-. To~ }' Piping Diameter: ~" ~" Length of Piping Run: "3'0" ~] ' Sto d: 7 5'A Method and location of piping-run isolation: Wait time between applying pressure/vacuum/water and starting test: Test Star~ Time: Initial Reading (R0: Test End Time: Final Reading (Re): Tesl Duration: Change in Reading (R~-R0: Pass/Fail Threshold or Criteria: TestRe~ult: ' [3 Pass E]F~,il [] Pn~s ri'Fall "::r:l~ P~ss:':. E)iFail. ..' [:].-'Pass Comments - (include information on repairs made prior to ~estlng, and recommend~d follow-up for failcd te~ts~ Dec 12 O~ 02:37p Fr~anzen Hill 558G8814G? p.S SWRCB, January 2002 Page L~ of 7 6. P~G S~ ~S~G Test' Method Develo~d By: ~ Sump M~u~act~er " ~ indu~ St~d D P~f~sional Engin~r '" 00~cr ~pec~) Test Me. od U~d: ~ ~ssure ~ Vacu~ ~ Hydms~tic ~ ~her (Sp~) .............. Test Equipment Used: 6 ~ 0 ~L Eqd'ipment ~solution: -Sump Diameter: Sump ~pth: ~ r~ ~0 ~r - HeiSt from Tank Top m Top of # Highest Piping PeneWation: HeiSt ~om T~k Top to Lowest Et~9~ical Pene~afion: Condition of sump prior to testing: Portion of Sump Tested' ~ J / ~ Il Does turbine shut down When sump sensor det~s liquid ~o~ ~Y~ ~No GNA ~Ym ~No DNA ~Y~ ONo ~A ~Ym DNo ~NA pr~uct and wmer)?' ,, T~bine shutdo~ mspon~ time Issys~m~medforfail-saf~ ~Yes ~No DNA ~Yes ~No DNA ~Y~ ~No DNA DY~ DNo ONA shu~own? W~ &il-sa& verified to be ope~tional?' ~Yes ~No DNA ~Y~ DNo ~NA DY~ ENo DNA DY~ ~No ~NA Wait time between apply~g preasur~vacuu~water and s~ing T~ S~Time: ~0 initial R~ding (Rb: .... T~ End Time:,, Final Reading (Rv): Test Dur~ion: ~0 m i~ ~0 m.'n P~lFail ~hold or Cri~ria: Wassen~rremov~fortesfing? ~Yes ~No DNA ~Ym UNo DNA ~Y~ DNo DNA DYes ~No DNA Was semor properly ropl~d ~d verified~nctionalaR~testin~.. ~Y~ DNo ~NA ~Yes ENo DNA EY~ DNo ,,,ENA ~Yes DNo DNA Comments - (include information on repairs made prior to t~tin~, and r~commended follow-u~ for ~ailed tests) J If the entire depth of the sump is not tested, specify how much was teste4t. If the answer to an_y of the questions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (See SWKCB LO-160) Dec 12 02 02:3?p Franzen Hill 559688146? p.6 sw~c~. ~a~, 2oo~ 7. ~DER-DISPEN~R CONTA~~ (~C) ~S~G Te~ Me~ ~velo~ By: ~ U~ M~u~t~er '~ lndu~ ~ard 0 Pmf~sional Enginee;'" ~ ~her (Spec~) Test Me'od Used: ..... ~ ~essu~ D Vacu~ ~ Hydrost~ic Test Equ[pmem Used: Equipment Resolution: - ~ '" uoc~ I.i'~- ~c~ z-~ uoc~ ~-~' .... uoc~ ~-~ UDC Manufae~rer: UDC ~pm: - , ...... ' j~,, - 3~,, ' ,,,~', Height ~om UDC Bo~ to Top of Highest Piping Pene~tion: HeigM ~m UDC BoSom to C~dition of UD~ prior to ..... Potion of U~ lTestedl ~es m~'i~ shut do~ when U DC sensor tie. cra liquid (bo~ ~Yes product ~d water)7' lssymmpro~mmedfor~il- ~es BNo ~NA ~Y~ ~No ~NA ~fesh~o~7* ~Yes ~No ~NA ~Y~ ~No ~NA W~ fail-~fe verified to operational?* ~Yes ~No UNA ~Y~ ~No DNA ~'Y~ ~No ~NA ~Y~ ~No ~NA Wait time be~e~ apply~g ~ssum/vacuu~w~er ~d ~a~ing T~t S~R Time: Initial Re~dJn~ (Ri): 1 Test End Time: Final Re,dins (Rv): ...... Test Duration: Ch~ge in R~ing (Rv-Rs): P~s~ail Thr~hold or Cfitefia'~ .... Was~nsor~mov~fo;iest~gT...' ZYes ~ ~NA SYes ~No ~NA ~Yes ~No =NA ~Yes ~No ~NA W~ ~nsor properly replaced and fives DNo ~NA ~Y~ ~No DNA ~Y~ ~No ~NA ~Y~ ~No ~NA v~fified ~nctio~l a~er testin$? .. Comments - (include information on repairs made prior to testing ~d recommended follow-up for failed t~ts) ' [rifle entire depth of the UDC is not tested, specify how much was tested. If the answer to ~ of the questions indicated with an asterisk (*) is "NO" or "NA", the entire UI)C must be tested. (See SWRCB LO-160) D~c 12 02 02:38p Franzen Hill SS86881467 p.? · SWRCB, January 2002 Page __~ of 8. FILL RISER CONTAINMENT SUMP TESTING Facility is Not Equipped With Fill Riser Containment Sumps 1-1 ~ Fill Riser Containment Sumps are Present, but were Not Tested [] Test Method Developed By: [] Sump Manufacturer ~Indu~'y Standard [] ProfeSsional Engi'neer [] Other (Specify) Test Method Used: [] Pressure [] Vacuum ~Hydrostatic [] Other (Specify) Test Equipment Used: 6/ 'l~')]a/~ Equipment Resolution: ~ ~ Fill S~np # t '~Vill Sump # ~ Fill Sump # Fill Sump # _Sump Diameter: ~ ~_ ~ c~ :~ '° Sump Depth: ~'~ p ~' ~ ~ ., Height from Tank Top to Top of Height from Tank Top to Lowest Electrical Penetration: Condition of sumP prior to ~)¢ ~'a.-~ I I~e ~za e~ I - testing: Co~q'~ ~,45 Portion of Sump Tested Sump Material: Wait time between applying pressureJvacuum/water and starting test: {6~ ~nn ;.', lO ',.v.,'.~ Test Start Time: Initial Re, Ming (Rt): Test End Time: Final,Reading (R~): ,dO t 'gllllSiaamm~ .Oall~ Test Duration: 30.,,i, an ,% -30/ ,-~ .'~ Change in Re..a..ding ~RrR0: PassffFail Threshold or Criteria: · OO O_~ , O~' ~- '. Teat ReSult: ~1 Pass O Fall ~ Pass [] Fail [] Pass . 'El Fall [] pass [] Fail is there a sensor in the sump~ '~ill Yes El No Ig Yes [] No r-1 Yes [] No [] Yes [] No Does the sensor alarm when either product or water is aqYes F1No ENA [ilYes []No ElNA F1Yes nNo F1NA OYes ENo ~NA detected9 Was sensor r'e-~ovod for testing? l~Yes 'DNo F1NA gY~ EINo DNA DYes ENo DNA DYes uno •NA Was sensor properly replaced and verified fimctionalaftertesting? ~Yes []No [3NA J~Yes ElNo F1NA EYes U~No E]NA EYes F1No DNA Comments - (include information on repairs made prior to testing, and recommended ~follow-uP for failed tests) ~ec 12 02 02:3Bp Franzen Hill 5596881467 p.B SWRCB, January 2002 Page '~ of 7 9. SPILL/OVERFILL CONTAINMENT BOXES Facil[~ is Not Equipped With Spill/Overfill Containment Boxes · ~" Spill/Overfill Containment Boxes are Present, but were Not Tested [] Test Method Developed By: [] Spill Bucket ManufaCturer D Industry Standard 0 Professional F~gineer .- [] Other (Specify) Test Method Used: U Pressure O Vacuum Et Hydrostatic [] other (Specify) Test Equipment Used: Equipment Resolution: ~i~~]~tl~gl~ Spill Box # Spill Box # Spill Box # Spill Box # Bucket Diameter: Bucket Depth: Wait time between applying pressure/vacuum/water and starting test: Test Start Time: Initial Reading Test End Time: Fina!, Reading Test Duration: chang.? in Reading (R~-R0: Pass/Fail Threshold or Criteria: xest~es~:. ~ Pa,. ~t~,~il ., :~ 'r~':"'~raii, ~i::~i:1 '..~,'r-~.~..::~,zan....,~,.. ,,. ': .:~ P=s .-'~ail Comment~ - (include information on repairs made prior to testing,, and recommended follow-up.for failed te. sts) Signature of Company Representative x.~ Date: ] ~-06-2002 9: 06~AM FROM CALVALLEY EQUIP 16~ 132,~2S29 P. 2 " MONITORING SYSTEM CERTIFICATION For USe By ~ll Juri,~dictio~ Within t~ State oJ'C~l~br~i~ . Authority Cited: Ch~ter 6. 7, Health end SaJ~O, C.~g, Chapter 16, Di~ston ~, ~t& 23, Cal~orma Coda of~la,o~ l~is 'form must be usc~ to d~um~nt tc~ting and ~crvicing of monitoring equipment. A s~ rustication or prepa~ for e~h monitoring~ys~m control p~ by thc tcchnician who pedo~s ~e wo~. A copy of~is fo~ must the ~uk system owner/o~rator. Thc owner/o~.r~or must ~ubmit a copy or ~is form to the local agency regul~lng UST s~tems within 30 days of test da~. A. Gene~l Information Facility N.me: ~e~.~__ Z,~ ~r~ ...... Bldg. NO.: Site nddl~s~: 21qg ~,..~r~e ' . .... City: ~rf~/~ Zip: Facility Contact P~son: ~,__. .... . Cont.~¢ Phone No.: ( .......... Makc/M~et of Monilortng System: ~~%~ ~~ Da. ofT~tin~Se~ioing:. ~ ~ / ~. B. lnvento~ of Equipment T~ted/cerfified Cheek ~he appropriate boxes to l.~caec s~e~e eq~pmeat inspec~d/serviced~ Tank ID: ] ...... ~. . Tank M In:Tank Oauglng Pn~h~. Mod~l: ~- ~ lnCl'ank Gauging P~be. M~el: a Annular Sp,~ or Vault Sensor. M~el: E/~ S~-~ ...... a Annular Space or Vault Se~r. M~c~: ~ Pipi.g Sump / Trench Rcn~ir(s). Model: ~~0r ~ [qping Sump / Trench Scnso~s), Mctel: ~ Fill Sump $¢nsor(s). M~¢I: ....~S~e~ _._ ~ Fill Sump Saner(s), ~ Mc~h~ia~l lane Leak D~ctot. M~el;' ~ Mc~anical Lin~ I.~k l~t~tor. Mod~h ' ' ~ E~troaic I.inc ~k Detector. M~I: __ ~ El~onie Line 1.~ Dete~or, Model: : ~ 'l'at~ Overfill / I ligh-Level Sensor, M~cI: ~ T~k Overfill / Illgh-~vel 5e~r, Model: ~ Othm (q)eci~v cquipm~tt type an.d j~od~l in S~tion E on ~'.~c 2). ~ ()th~ ~eci~ ~uipm~t t~ ~d ~el Jn_S~tion E on P~e 2).. .... Tank ID: ~ Tanklg: ~ In,rank (}augtng Prl)~. Modch ~ ~ In-T~k Gaugin$ Pro~. M~el: ~ Annul~ Space or Vault So~)r. Modoh ~~~ ~ ~nul~ Spa~ or Vault Scn~r. Model: ~ IHping Sump/'l¥~lldl Sensors). Modal: ~~_~ ~ Piping Sump / Trvnch San~)~z). Modgl: ~ Fill ~un~p S~n~r(s), Modal: .~_ ~ lqll Sump ~n~o~s). Mod~l: O'MedlatlJcal Lille L~k ~)CteCtOr. Modcl: O M~hmHcal I.i~m Lcak D~cctor. Mudol: ~ Elect~nic Linc Le,k l)ctcctor. Model: ~ El~[nmic l,ine I~ ~tcctor, Modol: ~ '['m~k Overfill / High-level 5cg~l: Modcl; ._ ~ Tank Ovkrfill / Hi~-Lewl ~n~t. M~I: . ~ ~ (s~ify equipment type ~d model itt. Section E on Page 2). ~ ~h~ (s~clfy equlpmcnt ly~ and model in ~on Di~nser ID: .~ Dis~n~r lB: ~ ~ ~h~r Vulva(a). ~ Sh;~ V~v~s). Q Dlspen~r Conlntnm~t Float(s) ~d Chain(s). : ~ Diepc,~r C~n~inm~t Fl~t~s) ~d ~aln(e), ' ~ Disp~,~r ConteStant S~s). Modch' ~~ ~ Dispo~r ~,~inm~t ~s~(s). M~I: ~ $ho~ Vdv~(l). : ~ Sh~ Valves). a Dis~n.~r ContalRmc~?lout(s) ~d Chain(s). ,~ .... a Disp~r ~n~imn~t Ei~(S) and C~n(s)., ,.~. Dispen~r ID: ~ Dis~a~r ID: ~ Oispenx~ Comainm~nt 8~a). Model: ~~ ' ~ Disp~r ~n~a~nt ~n~(a), M~I: .. ~ Shnar Valvcis). : ~ She~V~v~s), ~Di~p~ ~tal~cnt g{o~(s) ~d Chain(s~. ,~ ~ Disbar ~n~nm~t Float(s) ~d Ohdn(s). ' , ;, , ,,~,,~',.. *lft~ ~cility eontuin~ot~ t~ or dis~nsa{~, ~,py ',O~is fbrm. Include info.etlon for ~v~y ~'~'~ ~s~na~ a[-~a' facility. C. Cert~ga~o~ - ! certify thai file ~lli{~ment Identified {n th~ d~cum~ni.was insp~/~rvi~d in ac~rdan~c wHh' manufnetumrs' g.ide{inms. Altmch~d ~ thk Ce~lfication is information (m.~. man.facturern' Check{{$~) ne~ary information is ~rre~t and n Plot Plan showing tho layout of monitoring ~qlipmenL For any mlnipment ~pnb~ of {efl~rnfl.g ~uch ~po~, I have also ~l~e~d a copy of the report; (c~eci allth~appl~): ~ System set-up ~ A~rm his~ re~rt Technician Name (p~nt): [~t ~ ..... Signatu~: ~~ 'l'~tiug Company Name: ~~[~' ~~Z Phon~ No.:(~__) ~ Site Add~s~: 2/~ ~. ~~ ~ ~~ .~, Date ofT~lin~Serv~ing~ ~/~ Page I of~ MortiSing System Certl~entlon ' 1 '~-01B-2002 9: 07AM F'ROM CALVALLE'Y EQU ! ~ 1BB 1 ~2B2~29 D. Results ofTestingtSe~icing So.are Version Ins~lled:. 1~,~ : Complete ti~e foliowin~ eh~klist: ~ Yes ~ No* Is the audible alarm, opc~tional? .... ~ Yes ~" No* is thc Visual alarm op~ational? ~ Yes ~N2* Were all '~o~ visuai]~..~nspected, fui)ctionall~ tes~, and ~nfi~ o~mti~al? ~ Yes ~ Were all sen~ In,ailed at lowest Poin[ o~s~onda~ containment ~d ~sitioned so th~ other eq~ipm~t will not [ntorl~re wi~ ~r.?op~ o~ration? ~ Yes "~ No* If ale,s a~ rela~ to'a remote monitoring station, is all ~nications ~uipment (~.g, ~ N/A o~ratbnal? : ~ ~'Y~' ~ N0* For pressuriz~ p'ipin'g systems; does the turbine automati~ily sfiut down if~e piping ~onda~ ~ N/A monitori~g sys~m de~c~,a leak, ~atl$ to o~rate, or is elec~cally disconnected? ifNe=: which p~itive $hut-down~ (CheCk Mt ~at ~/y) ~ump~mnch Sea.rs; ~lsp~r Coherent s~nm.. ....... Did you confi~ p~sitive shut-down due to leaE~ and ,eh,or fa~lur~dis~=~tion? ~Ycs; Q No.~ . ... , . ~ Yes ~ No* For tank s~stems ~at ut{llze ~e monit~ing s~st~ ~ the prima~ ~k overfill wami~ dev~ (J.e. ~o ~ N/A mechanl~l overflli~p~ve~tion valve is'insall~), is ~e overfill w~ning alarm visibl~ ad audibl~ ~ ~ ~ank fill ~Ja~s) and op&ating properly? If~, ~t ~?t ~nt o¢~nk capacity do~ tho al~ ~i~e~ ,I . "'~, ~ Yes* ~No W~ ~ moni~ring equipment replaced? If 7e$. id~ntifN ~ifl~ ~nSom, pro~, or o~er e~ipm~nt repined and, list th~ manufacturer n?~, ~d m~¢i f6r all ~pla~cmcnt pa~ in 8~tioa ~ bSl~: .... ' ;] ' ~Y~* Q '~'~ W~ liqui~ round inside ahy s~ond~ containment systems design~ ~ ~ sTatema? (C~ek ~ Y~ Q N0* Was monitoring s~tem sc~-~p ~yicw~ to ~sur~ proof setQn~? AR~ch set up mpu~, if ~ Yes ~ No· Is zdl monitorMg equipment operational per m~ufacm~r's sp~i~cation$? · la $~tioa E below daeri~ how and Wllen these deficiencies were or will ~ corrected. PmAe Z of 3 03~1 12-06-2002 9: 07AM FROM CALVALLEY EQUIP 1 SS 132~2529 F. in-Tank Gauging / SIR E(luiPmont~ · ch~k ihls ~x ~ftank ~augin~ is used only fur inv~t~ ~ Check lids ~x if no t~k gauging or SIR cqui~enz is hmtallcd. This section must ~ co~pleted if in-tank gauging equipment is u~ to ~rfo~ lc& detection monitoring. Complete th~ ,D~kli,t: , ~ Y~q ~ No* H~ all input wi6ng been inspocte~ for prop~ entry ~d t,m~nation, Including ~stlng for ground faults~ H 'Yes ~' N~~ W~r¢ all tank g~ging probes vlsualt~"Jhapeetcd for damage a;~d ~sid~ buildup¢ ~ Yes ~ No* Was a~uracy' ~fsymm produot level readings ~ Yes ~ 'No* Was ~cu'racy of sy~t*m water Id¢~i ~di~gs ~ y~ ~ No*' '~ere all pro~s rein'stalled ~ Y~ ~ No*' w~re all ilem~ o~'tl~ equipment ,nanh~aetdmt's mainten~c&"checklist, co~nplet~? · ia the ~ectiou H, below, d~cribe how aud wl~en ~ese deficlencl~ were or will ~ corrected. G, ~in~ Leak Deteeto~ (~): ~Ch~ck mis box If LLDs ~e not insmed. Complete the followin~ ~ ~ ~ ~o' I:or ~uipm~m slavt-up or annual ~quimne~t Certi~ation, w~ a leak simulat~ to vorily LLD ~fo~mance7 O N/A (ChecAallt~tapply) Simulated leak rate: O3g.p.h.; Q0.1 g.p.h; O0.2g.p.h. ~ Ye~" ~ N,* W~re a'U LL~ confirmed o~rational and a~urats w~t~in regulatory requirement? ' ~ Yes ~' ~* Was the tearing a~paraius pm~rly cali~rat~l? ........ ~- Yes ~ NO* ~or mC~anical CLDh,'~o'~a.the LLD restrict pr~uct flow it' it detec~ a leak? ~Wes- ~ No* F~r el~ctronlc LLDs, d&s the turbine automaticall~ shut'~ffifthe LLD detects a leak? ~ Yes ~ .'~o, For ekmtronic ~LD~, do~ thc turbine autmmid~ily shut off if any po~ion of ~ monitoring system Is disabl~ ~ N/A or dlsconnect~? '~ Yes Q N0* F~ elee~onic LLDs, at~u turbine automaically 'di[ut off if any poffion of ih~ m&itofing system ~. N/A malfunctions or ~ails a test? ~ Yes ~ No* for elec~nic'~LDs, have all accessible ~iring conn~ti.ons ~en vimaUy inspected? ': '" ~ ~e~' ~ No* Were ali im~ on thc equipment man~f~urer's mainframe ch~kiist c~pleted? · la the Seetlon H, below, describe how and when these defiOenei~ were or will be correct~. II. CoJnments:__ ~ , Page 3 of 3 O.M)I . "1~-06-2002 9:0~M FROM CALVALLEY E~IP 166132B2B29 . M~nitofiag Syslcm Certiflcttion UST Monitoring Site .Plan ~ '''' '''t .......... ' ....... ~ .... . . .,,~..~ ........ Date map was drawn: ~ / ~ Instructions If ~u already ha¥o ~ diagram that shows all mquir~ in~rmadon, you may include it, rather th~ this page, wi~ your Monitoring System Cortification. On your site pl~, show ~e general layout of mnk~ and piping. Ci~rl¥ id~nti~ ~adons of th, ~llowlng equipment, if installed: monitoring ~y,t,m control pan,Is; s,nsor$ monitoring tm~k ~nnular spa¢,~, ~umps, dis~n~r pans, sp}ll containers, or other s~onda~ containment a~as; mechanical or ,I,etro~ie line l~ak d~tors; and in-tank liquid I~v,I pr~s (if us~ ~r leak d~ction), in the spa~ provide, note the d~te ~i~ w~ p~pared. Page of October 31, 2002 Freeway Liquors 2030 East Bmndage Lane Bakersfield CA 93307 CERTIFIED MAIL REMINDER NOTICE F~aE C,~EF RE: Necessary secondary containment testing requirements by December 31, RON FRAZE 2002 of underground storage tank (s) located at the above stated address. ADMINISTRATIVE SERVICES 2101 'H' Street Dear Tank Owner / Operator, Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 If you are receiving this letter, you have not, yet completed the necessary secondary containment testing required for all secondary containment SUPPRESSION SERVICES 2101 "H' Street components for your underground storage tank (s). Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary PREVENTION SERVICES containment components upon installation and periodically thereafter, to FIRE SAFETY SEI~CE$ * ENYIRONMENTJU. SElf/ICES 1715 Chester Ave. insure that the systems are capable of containing releases from thc primary Bakersfield. CA 93301 containment until they are detected and removed. VOICE (661) 326-3979 FAX (661) 326-0576 Of great concern is the current failure rate of these systems that have been PUBLIC EDUCATION tested to date. Currently the average failure rate is 84%. These have been 1715 Chester Av~. Bakersfield, CA 93301 due to the penetration boots leaking in the turbine sump area. VOICE 1661) 326-3696 FAX (661) 326-0576 For the last six months, this office has continued to send you monthly FIRE INVESTIGATION reminders of this necessary testing. This is a very specialized test and very 171s Chester^ye. few contractors are licensed to perform this test. Contractors conducting this Bakersfield, CA 93301 VOICE (e61) 326-3951 test are scheduling approximately 6-7 weeks out. FAX (661) 326-0576 The purpose of this letter is to advise you that under code, failure to perform TRAINING DIVISION 5642 VlctorAve. this test~ by the necessary deadline~ December 31~ 2002~ will result in the Bakersfield, CA 93308 revocation of ,your permit to operate. VOICE (661) 399-4697 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. Sincere/l~, Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services · I"1 Postage $ r-I Certified Fee . .~ 1::3 , ~ .,~. Postmark Here Return Receipt Fee r--I (Endorsement Required) ~ -- cO Restricted Delivery Fe~ rt (Endorsement Require~j -- -- Total Postage & Fees ~ ~ ........... a..~.~.~~-.-.L~-~-"-p-~-s-- ....................... ~~'.o.'~o3o ]~. ]~-v~]~ ~'~ ................... t ~ i i~ ; ~ ~ i'~;'~ i["."i ........................................................... · Complete items 1,2, and 3. Also complete item 4 if Restricted Delivery is desired, ressee · Print your name and address on the reverse ,Name) so that we can return the card to you. · Attach this card to the back of the mailpiece, from item 17 Yes or on the front if space permits, is deliver~ if YES, enter delivery address beloW: ~No 1. Article Addressed to: ~~ ~QUO~ zo3o ~ ~m,m~ ~ BAKER$~IE'IJ) CA 93307 I°' ~ Mail E] Express_Mai! ..... hmndise 7002 0660 0000 1641 6650 ~ 102595-02-M-0835 Domestic Return Receipt ~11, August 2001 FIRE Freeway Liquors 2030 East Brundage Ln Bakersfield, CA 93306 CERTIFIED MAlL FIRE CHIEF ,~o~ ~.E NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 RJr: Failure to Submit/Perform Annual Maintenance on ~ Detection System VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES Dear Underground Storage Tank Owner: 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 Our records indicate that your annual maintenance certification on your leak detection FAX (661)395-1349 system was past due on September 18, 2002. PREVENTION SERVICES YOU are currently in violation of Section 2641(J) of the California Code of 1715 Chester Ave. Regulations. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 "Equipment and devices used to monitor underground storage tanks shall be installed, calibrated, operated and maintained in accordance with manufacturer's instructions, PUBUC EDUCATION 1715 Chester Av~. I. including routine maintenance and service checks at least once per calendar year for Bakersfield, CA 6330~ operability and running condition." VOICE (661) 326-3696 FAX (661) 326-0576 You are hereby notified that you have thirty (30) days, November 21, 2002, to either FIRE INVESTIGATION p~l~Orl'a or submit your annual certification to this office. Failure to comply will result 1715 Chester Ave. Bakersfield, CA 93301 in revocation of your permit to operate your underground storage system. VOICE (661) 326-3951 FAX (661)326-0576 Should you have any questions, please feel free to contact me at 661-326-3190. TRAINING DIVISION 5642 Victor Ave. Sincerely, Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Ralph Huey Director of Prevention Services Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services cc: Waiter H. Porr Jr., Assistant City Attorney September 30, 2002 Freeway Liquors 2030 East Brundage Lane Bakersfield CA 93307 REMINDER NOTICE FIRE CHIEF RON FRAZE RE: Necessary secondary containment testing requirements by December 31, 2002 of ADMINISTRATIVE SERVICES 2101 "H' Street underground storage tank (s) located at the above stated address. Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Dear Tank Owner / Operator, SUPPRESSION SERVICES If yOU are receiving this letter, you have not yet completed the necessary secondary 21Ol 'H' Street containment testing required for all secondary containment components for your underground Bakersfield. CA 93301 VOICE (661)326-3941 storage tank (s). FAX (661) 395-1349 Senate Bill 989 became effective January I, 2002, section 25284.1 (California Health & Safety PREVENTION SERVICES s,~m s~,,,c~..~.v~o.~,.~,~sE~nc~. Code) of the new law mandates testing of secondary containment components upon installation 1715 Chester Ave. Bakersfield. CA 93301 and periodically thereafter, to insure that the systems are capable of containing releases from VOICE (661)326-3979 the primary containment until they are detected and removed. FAX (661) 3260576 PUBLIC EDUCATION Of great concern is the current failure rate of these systems that have been tested to date. 1715 ChostorAve. Currently the average failure rate is 84%. These have been due to the penetration boots leaking Bakersfield. CA 93301 VOICE (661) 326-3696 in the turbine sump area. FAX (661) 326-0576 For the last five months, this office has continued to send you monthly reminders of this FIRE INVESTIGATION necessary testing. This is a very specialized test and very few contractors are licensed to 1715 Chester Ave. Bakersfield. CA 9,3,,301 perfoYm, this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. VOICE (661) 326-3951 FAX (661) 326-0576 The purpose of this letter is to advise you that under code, failure to perform this test, by the TRAINING Ol~SIOU necessary deadline, December 31, 2002, will result in the revocation of your permit to operate. 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661)399-469Z This office docs not want to be forced to take such action, which is why we continue to send FAX (661) 399-5763 monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Stoa% Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services 9-19-2002 9:16AM FROM CALVALLEY EQUIP CITY OF BAKERSF!~LD · OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION OPERATORS NAME ~{e,~.~~ , OWNERS NAME NA~ OF MONITOR MANUFA~URER DO~ FAC~Y HAVE DISPENSER PANS? YES__ TANK # VOLUME CONTENTS .. I NAME OF TESTINO COMPANY CONTRACTORS LICENSE # 7FSt/7~,~ NAME & PHONE NUMBER OF CONTACT PERSON DATE a TUd~ TEST ~S TO tm CONDUCTED APPROVED BY DATE SIGNATURE OF APPLICANT Poatage $ · 3 I.J'J Certified Fee 2 . ]. 0 Poatmark ru Return Receipt Fee ]. 5 0 Here r"t (Endorsement Required) · r-I Restricted Delivery Fee I'-I (Endorsement Required) C3 Tota~ Poetaae & Fees $ 3.94 m [ Sent To ' c= | Freeway Li.~.u. ors ~3 I~t';~'e'(,'X~'t'.'~,.7 ........................................................................ =/:.".ff..~f:.f.'.'. ...... .2..9.,3.9....!..!r..~.n..a...a.g...?.....ka,..n..~. ........................ I, I"1 City, State, ZiP+ 4 B'· · Complete items 1,2, and 3. Also complete j I~ived by (Ple~se~Pdnt Clearly) item 4 if Restricted Delivery is desired. [' (~ //% · Print your name and address on the reverse so that we can return the card to you. C. Signature · Attach this card to the back of the mailpiece, X ~ .~ ~1/~/~,A (~[~ [] Agent or on the front if space permits. ~,-~ % (.~J I~% [] Addressee D. Is delivery address different from item 17 [] Y~ 1. Article Addressed to: If YES, enter delivery address below: [] No Freeway Liquors ~'2030 East Brundage Lane 3. Service Type ~ Certified Mail [] Express Mail Bakersfield CA 93307 [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 7001 0360 0002 5244 7414 PS Form 3811, July 1999 Domestic Return Receipt 102595-00-M-0952 September 13, 2002 Freeway Liquors 2030 E Brundage Lane Bakersfield CA 93307 CERTIFIED MAIL FIRE CHIEF RON FRAZE NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE ADMINISTRATIVE SERVICES 2101 "H' Street Bakemfield, CA 93301 VOICE (661) 326-3941 RE: Failure to Submit/Perform Annual Maintenance on Leak Detection System FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H' Street Deal' Underground Storage Tank Owner: Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Our records indicate that your annual maintenance certification on your leak detection system is past due on September 18, 2002. PREVENTION SERVICES FIRE SAFETY SERVICES · ENVIRONMENTAL SERVICES 1715 Chester Ave. You are currently in violation of Section 2641(J) of the California Code of Bakersfield, CA 93301 VOICE (661) 326-3979 txegmauons. FAX (661) 326-0576 "Equipment and devices used to monitor underground storage tanks shall be installed, PUBLIC EDUCATION 1715 ChesterAvi). calibrated, operated and maintained in accordance with manufacturer's instructions, Bakersfield, CA 93301 including routine maintenance and service checks at least once per calendar year for VOICE (661) 326-3696 FAX (661) 326-0576 operability and running condition." FIRE INVESTIGATION You are hereby notified that you have thirty (30) days, October 13, 2002, to either 1715 ChestorAve. perform or submit your annual certification to this office. Failure to comply will result Bakersfield, CA 93301 VOICE (SS~) 326-395~ in revocation of your permit to operate your underground storage system. FAX (661) 326-0576 Should you have any questions, please feel free to contact me at 661-326-3190. TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 S· ,y;ncerel% VOICE (661) 399-469Z FAX (661) 399-5763 Ralph Huey Director of Prevention Services Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services cc: Walter H. Port Jr., Assistant City Attorney August 30, 2002 Freeway Liquors 2030 E. Brundage Lane Bakersfield, CA 93307 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 FRAZE Dear Tank Owner / Operator, ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 If yOU are receiving this letter, you have not yet completed the necessary secondary VOICE (66f) 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 1, 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 from 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 thc 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 are 5642 Victor Ave. Bakersfield, CA 93306 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 (661) 326-3190. Sincere~ Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services ~D July 30, 2002 Freeway Liquors 2030 E. Brundage Lane Bakersfield CA 93307 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 If you are receiving this letter, you have not yet completed the necessary SUPPRESSION SERVICES 2101 "H' Street secondary containment testing required for ali 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 SAFE~I SERVICES* ENVIRONMENTAL SERVICES 1715 Chester Ave. 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, PUBUC EDUCATION Of great concern is the current failure rate of these systems that have been 1715 ChesterAve. tested to date. Currently the average failure rate is 84%. These have been due Bakersfield, CA 93301 VOICE (661) 326-3696 tO the penetration boots leaking in the turbine sump area. FAX (661) 326-0576 For the last four months, this office has continued to send you monthly FIRE INVESTIGATION 1715 ChesterAve. reminders of this necessary testing. This is a very specialized test and very few Bakersfield, CA 93301 contractors are licensed to perform this test. Contractors conducting this test VOICE (661) 326-3951 FAX (661) 326-0576 are scheduling approximately 6-7 weeks out. TRAININ6 DIVISION 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 D June 30, 2002 Freeway Liquors 2030 E. Brundage Lane Bakersfield, CA 93307 REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 2030 E. 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 I, 2002, section 25284. l (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, [o ensure PREVENTION SERVICES that the systems are capable of containing releases from the primary 1715 Chester Ave. 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 l, 2001 will be tested ENVIRONMENTAL SERVICES 1715 ChesterAve. upon installation, six months after installation, and every 36 months thereafter. Bakersfield, CA 93301 Secondary containment systems installed prior to January l, 2001 will be tested by VOICE (661) 326-3079 FAX (661) 326-0576 January l, 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. si¢ Fire Inspector/Environmental Code Enforcement Officer Environmental Services SU/kr D May 29, 2002 Freeway Liquors 2030 E. Brundage Lane Bakersfield, CA,93307 RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 2030 E. 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 PREVENTION SERVICES are capable of containing releases from the primary containment until they are 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 DIVISION Secondary containment testing shall require a permit issued thru this office, and 5642 wctor^vo, 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. Sincerer, Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/kr enclosures D April 17, 2002 Freeway Liquors 2030 E Brundage Lane FIRE CHIEF Bakersfield CA 93307 RON FRAZE ADMINISTRATIVE SERVICES l~: Necessary Secondary Containment Testing Required by December 31, 2002 2101 "H" Street Bakersfield, CA 93301 VOICE (661)326-3941 REMINDER NOTICE FAX (661) 395-1349 SUPPRESSION SERVICES Dear Tank Owner/Operator: 2101 "H" Street Bakersfield, CA 93301 The purpose of this letter is to inform you about the new provisions in California law VOICE (661) 326-3941 FAX (661) 395-1349 requiring periodic testing of the secondary containment of underground storage tank systems. PREVENTION SERVICES 1715 ChesterAve. Senate Bill 989 became effective January 1, 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 ChesterAve. Secondary containment systems installed on or after January 1, 2001 shall be tested upon Bakersfield, CA 93301 VOICE (661) 326-3979 installation, six months after installation, and every 36 months thereafter. Secondary fAX (661) 326-0576 containment systems installed prior to January 1, 2001 shall be tested by January I, 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 performed by either a licensed tank tester or licensed tank installer. 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. Sinci~' 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 r~rttttncq txto~?ot,3.. INSPECTION DATE ADDRESS ~0~ 0 ~-' l~nt~a.tt ~ PHONE NO. ,~3.3" 02fi"q FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program I~l Routine [~ Combined I~ Joint Agency I~ Multi-Agency ~l Complaint [~l Re-inspection OPERATION C V COMMENTS Appropriate permit on hand [~. J Business plan contact information accurate L /~ Visible address L J Correct occupancy ~ ~ Verification of inventory materials ~ f' Verification of quantities L,, /' Verification of location Proper segregation of material Verification of MSDS availability f,. ~' Verification of Haz Mat training U,/ / Verification of abatement supplies and procedures / Emergency procedures adequate Containers properly labeled / Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: {~ Yes [~No Questions regarding this inspection? Please call us at (661) 326-3979 Business Site ~,esponsible 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 Section 2: Underground Storage Tanks Program [] Routine [~[ Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank /][1]~- Number of Tanks Type of Monitoring d/.-th. Type of Piping OPERATION C V COMMENTS Proper tank data on file ~ Proper owner/operator data on file L,., / Permit fees current Certification of Financial Responsibility [,, / Monitoring record adequate and current L., / 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=Complianclj~_. ~ V=Violation Y=Yes N--NO Inspector: .~g4,O.~ ~~0 ~~~~'~ Office of Environmental Services (805) 326-3979 Business Site Responsible Party White - Env. Svcs. Pink - Business Copy FREE,'iA'/ L I C-iUC:,RS 2140 E. BRUNDAGE BAF, ERSF I ELD. 8F_ 5-:'_:.: 2:3--. C 254 FEB 5, 2002 ;:3'Y'~;T~3'"l ,:,I ~-~ I _1~, REPORT T ff; DEL I ",/ER"Z T 1 :UNLEADED REGULAR VOLUME = [3404 GALS ULLAGE = 8123 GALS 90f.'..;~: ULLAGE= 6970 GALS, HEIGHT = 29,98 INCHES WATER V©L = 0 WATER = 0,00 INCHES TEP1P = E,i,8 DEG F T 2: PREMIUM UNLEAD'~ VOLLIME = 1303 i ~ ULLAGE = 10224 ] 90;~.~: ULLA(;E= 9071 ~ HE I GHT = 15.07~"I]~HES W~TER VOL = 0 GALB WATER = 0,00 INCHES TEMP = 68,5 DEG F / ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ :~ Ux¢ By ,411J,,'isdietion,~ l~'ithi, the ~ate ~ ~uthoriO, Cited: Chapter 6. 7, ~h and SaJbty Co&; Chapte; 16, D/vt,'ion 3, T~3, Cal~ornia Code of Regulations This Ibrm must be used m docmnenl lasting and servicing of monitoring equipmem. A separate ce~ification or r~port must be prepared for each monitoring system control panel by ibc lechnidm~ who performs ~he work. A copy of ibis fern must ~ provided to il~e tank system owner/operator, The owner/operator must submii a copy of this form to the local agency regulating UST systems within 30 days of t~t A. General Information FaCility Name: ~e ~¢~P~ gldg. No.: sit Za City: ~e~' t/~. Zip: Facility Conlacr Person: ~ Contact Phone No.: Make/Mead ,,r Monitorin System: .,~~~ F~~ DateorTesting/S r c ng: B. Invento~ of Equipment Tested/Certified Tank ID: _~ Tank An~ular Space or Vault Sensor. Mode~; _ ~ Annular Space or Vault Sensor. Model: Piping Sump / 'l'rend~ Sensor(s). Modek ~.¢~K ......... ~ Plp[ng Sump/'trench Sensor(s). Model: ~ Fill S.mp Sensor(s). MoOd: ~.~k~N~hrO~ ..... ~ Fill Sump Sen~o~(~), Model: ~ McchmficM Linc Leak Detector, Model: ~ O Mechanical Line Leak Octector. Model: ~ Elcclronic Line l.eak Detector, Modal: Q [lccironic I.ine Leak Detector. Model: O 'r~,nk Ovcrfil / I llgh-l.~vd Scn~or. Model: ~ Tank Overfill / High-Level Sensor. Mo(lei: ~ Olhcr ~spccJl~ equivmcnt type a.d model in Section E on Page 9) ~ Other (*p~cify cqulpmont,?pe and mod,el in Sect/oil E on Pag~ 2)i TanklD: ~ Tnnk ~ In-Tank Gauging Probe. Modck ~&O~,,, ~ ln-Taok Gaugi,g Probe, Model: ~ Annular Spac= or Vault Sensor. Model: ~'~t~~.__ ~ Ann.lac Spne~ ~r Vault Sen~or. Model: ~ Piping Smnp i Trench Sensor(s). Model: ~ ~e~0W ~ Piping Sump / Trench Sensor(s), Mndel: ~Fill Sump Sensor(s). Model: .~,~ ~J~.0~ ~ Fill Sump Set~sor(s). Modal: ~ Mechanica[ I.ine I,eak Detector. Model: ~ Mechanical Linc [.eak Dctcctor. Modcl: ~ Electronic I.Ine I..cllk Dctcctor. Modc[: ~ O Eleclronlc Line I.e~k Dctcclor. Model: O T~mk Ovcrlill / Iligh-Lcvcl Sensor, Modcl: ~ O Tank Ovcrfill/ IriSh-Level Sensor. Model: ~ Olher (specify equipment type and ~odcl in Sect[on E on Page, 2), ~ Other (specify equipment type and modal,,, in Section, E on Page 2), Dispenser ID: N2 Dispellser ID: ~ Dispenser Containment Sensor(s), Modcl: ~_~ (e~ ~ Dispcnser Containment Sensor(s]. Mudcl: ~ Shear Valve(s). ~ Shear Valve(s). ~ Dispenser Containment FIo~a(~) and Clmi.(~). . ~ Disp~?cr Contabmcnt Float(s) and Chain(~). Dlsl~enser ID: ~-~ Dispe.ser ID: ~ ~ Dispenscr Conlainmcnt Scnsor(s), Model: ~~0~ ~ Dispenser Contaimncnt Sensor(s), Model: ~ Shear Vntve(~} ~ Shear V,lvc(s). ~ Dispenser Co?tai.mcat Float(s) and Chain(s). , ~ Dispenser Containment Float(s) an~ Chain(~), , Dispenser ID: ~, Dispenser ID: __ ~ Dispenser Containmcnl Sensor(s). Model: ~ ~a~ ~ Diupcn~cr Containment S=.~m(~). Model: ~ Shear Valve(s). ~ Shear Valve(s). ~Di~penscr Contaimncnt Float(s) and Chain(s),. ~ Dispcnscr C00Iui.mcnt Float(s) and Chain(~). 'lf thc [~ility contains inert tanks or dispcllgcrs, copy (l~is llmn, hlclu'de ialbrmation for avery tm~k and dixpens~"~ II~e faciHI}, ' C. Certification - I certify that the equipmel~t it~enfified in il~is document was inspected/serviced manufacmr, rs' guiddines. Attached to Ihis Certificattion is i,formation (c.g. manufi~t, rers' checklists) necessary to verify that thl~ information b correct ~ntl n }'lot Ph, n short,lag tl~c layout oF nloslit trhlg equipment, g(,r any equipment capable of generating reports, I have also arrayed n copy ~f the rep.ct; (check n# that appt)9: ~ System set-up. ~ Alarm htsiory report Technician Name (print): ~C( ~~_. Signature: ._~~.~ Certification No.: , L/cerise. No.:. ~/:/O~ .,. SiteAddress:_,,20~O,~ [t~9~ .Z~. _ DateofTesting/Servicing: ~ /~~ Monitoring Syslcm Certificati(m FREEWAY LIGUORS 2141.3 E. BRUNDAGE BAKERSFIELI:), CA. 805-323-0254 MAR 15. 2001 9:14 AP1 SYSTEM STATUS REPORT ALL FUNCTIONS NORIflRL INVENTORY REPORT T I: UNLEADED RE(_--;UIL, AR VOLUME = 7834 GALS ULLAGE = 3693 GALS 90% ULL~qGE= 2540 GALS HEIGHT = 57.14 INCHES WATER VOL = 0 GALS WATER = 0.00 INCHES TEMP = 63.7 DEG F T 2 ;PREMIUM UNLEADED VOLUME = 3452 GALS UI.' ']E = 8075 GALS 9~LLRGE= 6922 GALS HEqGRT = 30.29 INCHES WATER VOL = 0 GALS WATER = 0.00 INCHES TEMP = 67.3 DEG F D - May 3,2001 Mr. Lloyd G. Childress Freeway Liquor Store 2030 E. Brundage · Bakersfield, CA 93307 CERTIFIED I~IL RETURN RECEIPT FIRE CHIEF ' ,. RON FRAZE Subject: Revocation of Underground Storage Tank Permit to Operator ADMINISTRATIVE SERVICES 2101 "H" Street Dear Mr. Childress: Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661 ) 395-1349 Your permit to operate the underground storage tank facility, located at SUPPRESSION SERVICES 2030 E. Bmndage, known as "Freeway Liquor Store" is being revoked effective 2101 "H" Street Monday, May 14, 2001, at 5:00 p.m. This permit to operate is being revoked due to Bakersfield, CA 93301 VOICE (661) 326-3941 failure to pay current as well as past due fees. FAX (661) 395-1349 PREVENTION SERVICES This action can be avoided by bringing your account current prior to that time. If you 1715 Chester Ave. have any questions, please feel flee to call me at (661) 326-3979. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 Sincerely, ENVIRONMENTAL SERVICES ~]p~~~~~r 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING5642 VictorDIVISIONAve. Office of Environmental Services Bakersfield, CA 93308 VOICE (661) 399-4697 RH~db FAX (661)399-5763 cc: Walter Porr, Jr., City Attorneys Office Steve Underwood, Environmental Services Esther Duran, Environmental Services · r-t Postage $ ~ Certified Fee , r'-t Postmark 'Return Receipt Fee Here r"'t (Endorsement Required) cD Restricted Delivery Fee r-l. (Endorsement Required) ru Total Po~ge & Feee ~ I:~ l Sent To I · Complete items 1,2, and L Also complete [] Agent item 4 if Restricted Delive, y is desired. [] Addressee , · Print your name and addr,?ss on the reverse so that we can return the card to you. Print.~,.d Name)'~ · Attach this card to the back of the mailp ece~ . or on the front if space permits. Is delivery address different from item 17 [] Yes 1. Article Addressed to: if YES, enter delivery address below: [] No I~AY LIQUORS 2030 F~T BRIJlqDAGE Ilq B/~RSFIELD CA 93306 I Service Type [~j[Oertified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] insured Mail [] C.O.D. · Restricted Deliver~? (Extra Fee) [] Yes 7002 0860 0000 1641 7282 102595-02-M-0835 -'~ust 2001 Domestic Return Receipt .... CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~'r~.t~ ~q I'~ ~t_ ~'~ INSPECTION DATE ! Section 2: Underground Storage Tanks Program [] Routine ~l Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank OC0 '~ Number of Tanks Type of Monitoring &L. tt/1. 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 Inspector: .~ ~ ~ ~ Office of Environmental Services (805~}'3~-3979 Bu[si~es~S~t"~e Resp-onsi~ole Party White - Env. Svcs. Pink - Business Copy CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME ~tc.c.0Jatu {ne o. uo~ ~t .,~ INSPECTION DATE ~q ~l._,c' ADDRESS ~o.30 ~. ' ~'onat~tft- ~tmt_ PHONE NO. ~t~3' Ogg'~ FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [~ Routine ~ Combined [~1 Joint Agency {~ Multi-Agency ~ Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location {.~/ Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping / Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?:Explain: [~l Yes [~No Questions regarding this inspection? Please call us at (661) 326-3979 Business Site Responsible Party White-Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: CERTIFICATION oF FINANCIAL RESPONSIBILi FOR UNOERGR~ND STOOGE T~S CO~NNING P~O~M ~ ~anlsms u~ ~ demote ~o'al mspo~si~ .... as ~d by'$e~ 2807 ~ as ~' 3tare US~ 3~ate US~ Cleanup ~u~d N/A ~o~ US~ ~995~000 State Yes Yes Yu~d ~.0. Box 944212 3ac~amento, CA ~und :' ~~ce :leanup Age,ate ~h&e~ ~loyd Ch&lde~s N/A ~ot th~s $5,000 A~ual,-.'~: Yes " Yes )fficer Bakersfield, CA 93306 . ~~c, N~e: if you ere using ~e SM Ie Fu~ as any pa~ of ~ de~gon ~ finandal re~~, ~ ex~on end submi~ of ~is ~E~fion also ce~es that ~u am ~ c~iance wi~ ei c~E~ ~ Pa~ in ~e Fund. ;' ~' ~ 2140 Eas~ B~undage Lane Bake~sffield~ CA 93307 .... . . f __ / _ LLOYD G. CHi. LDERS · 7 FILE; O~gl.a~- L~I ~en~ Copi~ Fa~i~t~(s~ ' ' - CERTIFICATION O~NDERGROU,ND STORAGE TANK MONITOR'ING .SYSTEMS ,DO NOT USE THIS FORM FOR AN ALARM RESPONSE. TANK sIZE U~L [ '0'gL OTHER SITE =Freewg¥ Liquor' 1 !1 ~t 527 87 ADDRESS '2140 E- Brundage Lane 2 11,527 92 ~ CITY Bakersfield,. CA 933.0~ · TANK/LINE MATEp~A~ines are Flex PRODUCT TANKS: PRODUCT LINES', 'E~' STEEL ~ SINGLE WALL- E~ .SINGLE WALL J~ FIBERGLASS [~ ' DOUBLE WALL ~ DOUBLE WALL .,~., ,.,' .CT TANK MONITORING SYSTEM M~NUFACTURER '¥eeder-Root CHANNEL. DESCRIPTION MODEL "CJ'..S- 3 5 0 1 SERIAL NUMBER . 88152306905003' 2 5 ' PROBE MODEL ?~g. ,,,,,, ,,: ...... 3 WET INTERSTITIAL MONITOR QTY .0 .VADOSE ZONE MONITOR QTY 0 DRY INTERSTITIAL MONITOR . QTY ' 2 TANK LEVEL MONITOR QTY 2 O.PERATIONA-L NON-OpERATIONAL ' Iii' P~ R~ O R M"~"b ..... REQUIRED STATUS ~ AR~!VA.L. x CORRECTIVE ACTION ' 'STATUS (~ DEPARTURE. ' ELECTRONIC LINE PRESSURE MONfT.O'R QTY NONE ' INTERSTITIAL MONITOR (SUM~ MONITOR) QTY 2 MANUFACTURER IF. APPLICABLE C~pERATIo'~A"L "' NoN-OpERATIONAL "I~'ERFORMED REQUIRED STATUS (~ ARRIVAL ~x CORRECTIVE ACTION STATUS ~ DEPARTURE r X .................. MEG.HANICAL LEAK DETECTOR MANUFACTURER . MODEL NONE [-~' DID YOU PLACE COMPANY COMPLIA'NCE STI'CKER ON BOX? Yes Bruce }{~nsley "1,':" ', CERTIFY'THE ABOvE'INFORMATION ANO oPERA'INg 'STATUS I$ REPRESENTATIVE REDWINE TESTING SERVICES, INC, '~: P,'O. BOX ~567 ' BAKERSFIELD. CA 03302 · ~661) 32t~044~ cONTRAcTORS LICENSE #532878 ORRECT ION NO CE BAKERSFIELD FIRE DEPARTMENT N°_ 966 Locatio~ E'Cc~u~k~ ~ You are hereby required to make the following cor~ctions at the above l~ation: Cor. No I ~k~ ~( ~c.r dFC. Completion Date fo,' Corrections//~ q~ i~-~(~ ~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME t'l~¢ O.~V INSPECTION DATE Section 2: Underground Storage Tanks Program I~] Routine [~/ombined I~1 Joint Agency l~l Multi-Agency I221 Complaint I~1 Re-inspection Type of Tank ,Du_}~" Number of Tanks Type of Monitoring d:/.-I'vX Type of Piping Oal F-- OPERATION C V COMMENTS Proper tank data on file k/~ Proper owner/operator data on file Permit tees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current q Failure to correct prior UST violations [,,/ Has there been an unauthorized release? Yes No 't// Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector: ~,.~.~, ..... Office of Environmental Services (805) 326-3979 Business SitkResponsible Party White - Env. Svcs. Pink - Business Copy CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME ~-t'~co, ta,, ~.l~OC~, INSPECTION DATE ADDRESS c00~lr) ~.'~tJ~Aae~ Att~,___ PHONENO. FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [] Routine [~l'C"ombined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address V Correct occupancy Verification of inventory materials [,,/ Verification of quantities Verification of location Proper segregation of material L/ ~ Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures V Emergency procedures adequate U Containers properly labeled t,/' Housekeeping ~'~ ' Fire Protection [/ ~__ e~%x~O~5~C¢.~ b~Ct~ Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: [] Yes [] No A , Explain: Questions regarding this inspection? Please call us at (661) 326-3979 B sp~,/~ '/'3: , arty White- Env. Svc~. Ye,ow - St~tio,, Copy Pi,,k - ~,,si,~¢ss Copy Inspector: O E OF ENVIRONMENTAL ~[!~ VICES 171~ Chester Ave., CA 93301 (661) 326-3979 . ~ ,, , ,~.. UNDERGROUND STORAGE TANK FACILITY r-] INEW$ITE ~'] 3 RENEWAL PERMIT r'~ $C?~d~EOFl.~ORM~A~TlON(.~lat, lype of chang®) [] 7PERMANENTI.YCI,.OSEDSITE TYPE OF ACTION PERMIT [] 4 AMENDEO PERMIT · - - ' · ' ' ~' J 400 ' ¢Chec~ one item only) [] 6 TEMPORARY SITE CLO~URE I. FACILITY I SITE INFORMATION NEAREST cRO~ STREE~ ' 'l ..... 4~'1 FACILITY O~ER TYPE I'1,4 LOCAL AGENCY/DISTR~C'I" [] 20I~'t"RISUTOR [] 4 PI~$SOR [] e COMMERCiAl. [] 3 PARTNERSHIP r-} 7 FEDERAL AGENCY* 402 TOTAL NUMSER OF TANKS I I.f~o~lndlan/~atl~to~'40~ 'lfownetofUSTapubll~age~c~.nameofsupe~¢of REMAINING AT SITE lt~? d~lo~ ~ ot ol~ce which opetate~ ~ UST. II. PROPERTY OWNER INFORMATION ~,U~,il.~NG. OI~STREETADI:IRESS - ~ . £ I 409 [] [] 1 CORPORATION [] 3 PARTNERSHIP [~] 5 COUNTY ~.GENCY. [] ? FEDERAL AGENCY III. TANK OWNER INFORMATION TANK NAME . 414 415 · ,.,,," r-,,,.oc,..,,,,,,,c.,,,,,,,..c.,. · [] 5 COUNTYAGENCY [] ? FEOERALAGENCY IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER V. PETROLEUM UST FINANCIAL RESPONSIBILITY INDICATE METHOD(S) r'~ 1 SELF-iNSURED F'~ 4 SURETY BOND J~? STATE FUND [~ 10 LOCAL GOV'T MECHANISM [~ 2 GUARANTEE ~--J $ LETTER OF CREDIT [] 8 STATE FUND & CFO LETTER [] 99 OTHER:. [] 3 INSURANCE [] 6 EXEMPTION [] 9 STATE FUND & CD 422 VI. LEGAL NOTIFICATION AND MAILING ADDRESS Cher. k o~e box ~o I~dlcale whlc~ addm~ Nx~d be ~ ~ legal notlflcatle~ and mailing. FACILITY [] 2 PROPERTY OWNER [] 3 TANK OWNER 42:} Legs! nolJflc~ll~n and m~g wll be ~ m I1~ t~4~'u~t box 1 VII. APPLICANT SIGNATURE '-SlGNA F Pt.I / % 424 r OFFICE OF ENVIRONMENTAL SERVICES · 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 Page ~ of -- TYPE OF ACTION [] 1. NEW SITE PERMIT I--] 4, AMENOED PERMIT ["] 5.. CHANGE-~F INFORMATION)__ [] 6. TEMPORARY SITE CLOSURE (Checkone,..only) ~:~.../~Ai~>~ f~/~Z.,~_.~PE,'NENTLYCLOSEDONS,TE [] 3, RENEWAL PERMIT (~oec~/~es~on - ~or ~c~/~se o~/~ ~p~ c~e~- ~/oce/~ ' ~ 8, TANK ~E~VED 430 LOCATION ~THIN SlT~(~m~/J ' Z ~ ~ 43~ I. TANK DESCRIP~ TANK ID ~ 432 TANK ~U~C~ER . ~ ~3 ~MPARTMENTALIZED TANK ~ Y~ ~ 4~ DATE INST~LLEO (Y~) 435 T~K ~ACI~ IN ~LLONS ~6 NU~ER OF ~ARTME~S ~7 II. TANK CONTENTS , TANK USE 439 PETROLEUM TYPE 440 MOTOR VEHICLE FUEL ~a. REGULAR UNLEADED [] 2, LEADED [] 5. JET FUEL f ma~ed, complete Peb~teum Type) ~ii PREMIUM UNLEADED F'J 3, DIESEL [] 6. AVIATION FUEL [] 2. NON-FUEL PETROLEUM MIl)GRADE UNLEADED [] 4, GASOHOL [] 99. OTHER [] 3. CHEMICAL PRODUCT COMMON NAME (from Hazanfous Materials Invena3~y page) 441 CAS # (from Hazan~ous Materials Invena~/ page) 442 [] 4, HAZARDOUS WASTE (Include~ Used 0#) [] 95. UNKNOWN .: , :'. ,,. '.;.~,,..:=.,: . .~,~,U~ TANK CO~S~UCrm~ . .~ :., ':' :.' . .... TYPE OF TANK [-1 1. SINGLE WALL [] 3. SlNGCE WALL WITH [] 5. SINGLE WALL W1TH INTERNAL BLADDER SYSTEM 443 'Check one/tern on/y) ~. DOUBLE WALL EXTERIOR MEMBRANE LINER [::] 95. UNKNOWN [] 4. SINCd. E WALL tN A VAULT [] 99. OTHER TANK MATERIAL * primmy tank r-I 1. BARE STEEL ~ FIBERC-d. ASS/ PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 444 Check one item only) [] 2. STAINLESS STEEL f~ I--I 4, STEEL CLAD W/FIBERGLASS [] 8. FRPCOMPATIBLEWI100%METHANOL []99. OTHER REINFORCED PLASTIC (FRP) TANK MATERL~L rank [] 1. BARE STEEL ~ FIBERGLASS / PLASTIC [] 8. FRP COMPATIBLE WI100% METHANOL [] 95. UNKNOWN 445 Check one item only) r'l 2. STAINLESS STEEL /[] 4. STEEL CLAD W/FIBERGLASS [] 9. FRP NON-CORRODIBLE JACKET [] 99. OTHER REINFORCED PLASTIC (FRP) [:::] 10. COATED STEEL [] 5. CONCRETE TANK INTERIOR LINING r-] 1. RUBBER LINED [] 3. EPOXY UNING [] 5. GLASS ENING [~UN~WN 446 DATE INSTALLED 447 )R COATING [::] 2. ALKYD LINING [:::] 4. PHENOLIC LINING r'] 6. UNLINED '~[-I 99. OTHER Check one/tent only) (For local u~e OTHER CORROSION [] 1. MANUFACTURED CATHODIC [] 3. FIBERC--d.~, S REINFORCED PLASTIC /~. UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION [] 4, IMPRESSED CURRENT 'L.J 99. OTHER ~Check one item only) [:::] 2. SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL [ YEAR INSTA~LLED 450 TYPE (Forlocal use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED ~/ 452 IF SINGLE WALL TANK ~¢hec/( e# ~a~ e~ly): 4~3 IF DOU~I.E WALL ?ANK OR TANK ~ BLADDER ~Check o~e/~ent only~.' 454 [] ~. ¥~SUAL (EXPOSED PORTION ONLY) [:] 5. MANUAL TANK C~UG~N~ (~TG) I [] ~' V~SUAL (SINGLE WALL IN VAULT ONLY) 2. AUTOMATIC TANK C~AUGING (ATG) [] 6, VADOSE ZONE I~' CONTINUOUS ~NTERSTITIAL ~v~3NITORING [] 3. CONTINUOUS ATO [] 7, GROUNDWATER ~[]3, MANUAL MONITORING , [] 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + [] a, TANK TESTING ~IENNIAL TANK TESTING [] 99, OTHER V, TANK CLOSUR~ IN~ORMA?ION / P~RMANENT CLO~UR~ IN PLA~E ESTIMATED DATE LAST USED (Y~MO/DAY) 455 ESTIMATED QUANTrrY OF SUBETANCE ~EMAINING 45~ TANK F~LLED W~TH ~NE~T MATER~AL? 457 UPCF (1/gg) Formerly SWRC8 Form El CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1716 Chester Ave,, Bakersfield, CA 93301 (661) 326-3979 U~l'. TAN! Page VI. PIPING CONSTRUCTION (Check al t/mt eeply) ' UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE I1"-] I. PRESSURE [] 2. SUCTION [] 3. GRAVITY 458 [] 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY 459 CONSTRUCTION/L[~/ . S NGLE WALL [] 3. LINED TRENCH [] 99. OTHER 460 r~ 1. SINGLE WALL [] 95. UNKNOWN 462 MANUFACTURERI'~2. DOUBLE WALL [] 95, UNKNOWN [] 2. DOUBLE WALL [] 99. OTHER · MANUFACTURER . . 481 I MANUFACTURER ------ 463 I~''] 1. BARE STEEL '. 1~]--8.. FRP'COMF~ATIBLE W/' 100% METHANOL I [] I. BARE STEEL .... [:~ ~., ~RP COMPATIBLE WI 100% METHANOL MATERIALS AND I[] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL I [] 2. STAINLESS STEEL [. · [] 7'. GALVANIZED STEEL ' - ' ~ 4. FIBERGLASS [] 8. FLEXIBLE (HOPE) I'"l ~. OT~F..R' ' ' '[] 4. FIBERGLASS ..... "'~]-'9. CATHODIC PROTECTION t[] 5. STEEL WI COATING [] 9. CATHODIC PROTECTION 464 I [] 5. STEEL WI COATING [] 95. UNKNOWN 465 ' ' · '" '..'. '~i:' -' ':' .:' VILFiPINGLEAKDETECTION[.Chec~. ,l[~atapp/y) .... .. UNDERGROUND PIPING "~ / ~ .... [.ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check all that apply):,:,~ , ', ~, ;," ~, PRESSURIZED PIPING (Check all that al~ply): [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR [] 1. ELECTRONIC LINE t'EAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SI'~UT OFF ~'=OR 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 INTEGRITY TEST (0.1 [] 3. ANNUAL INTEGRITY TEST (0.1 GPH) [] 4. DALLY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS (Check ell that apply): [] 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY [] 5. DAILY VISUAL MONffORING OF PIPING AND, P~tJMPING SYSTEM TEST (0.1 C-:-:-:-:-:-:-:-:-~H) [] 6. TRIENNIAL INTEGRITY TEST (0.1 Gl)H) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): [] 7. SELF MONITORING [] 7. SELF MONITORING GRAVITY FLOW: GRAVFFY FLOW (Check all that apply): [] 9. BIENNIAL INTEGRITY TEST (0.1 C_M:~) [] 8. DAILY VISUAL MONITORING [] 9. BIENNIAL INTEGRITY TEST (O.1 ~) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all Zhat apply): PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND 10. CONTINUOUS TU~INE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (chec~ one) ,~eck one) a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ~. AUTO PUMP SHUT OFF FOR LF. AK~, SYSTEM FAILURE AND SYSTEM [] ~. AUTO PUMP SHUT OFF FOR I..EAK~, SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION [] c. NO AUTO PUMP SHUT OFF [] c. NO AUTO PUMLP SHUT OFF I~ 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ~ FLOW ,SHUT OFF OR [] 11. AUTOMATIC LEAl< DE'rECTOR RESTRICTION [] 12. ANNUAL INTEGRITY TEST (0.1 GPH) [] 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ' ' SUCTION/GRAVITY SYSTEM: [] 13. CONTINUOUS SUMP SENSOR ', AUDIBLE AND VISUAL ALARM~ [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATOR,t ONLy (Check all if)at apply) EMERGENCY GENERATORS ONLY (Check all that apply) [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF ~' A001BLE AND [] 14. CONTINUOUS SUMP SENSOR WTI'HOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL VISUAL ALARMS ALARMS [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHQIJI' FLOW SHUT OFF OR [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) RESTRICTION [] 16. ANNUAL INTEGRITY TEST (0.1 Gl:q-I) [] 16. ANNUAL INTEGRITY TEST (0.1 Gl)H) [] 17. DALLY VISUAL CHECK [] 17. DALLY VISUAL CHECK · '~ ··' ~· ,' :. ~'~:~.:'?·:: ~·,'.~¥ ~-!:.~ ? ~::~:~,~:~:~:~A~DISI~.ENSER CONTAINMENT.:,: ~,~:' ·· ·: ....... ~'~.i,.' .::~,"~ ? '~ ': :r~>~ :"~ ...... "'··'.,: "·, ·.:':~'~:~:·.·· ~ ':.. DISPENSER CONTAINMENT [] 1. FLOAT MECHANIBM THAT SHUTS OFF SHEAR VALVE [] 4. OAILYVlSUALCHECK 0ATEiN,T_ALL~ED 468 [] 2. CONTINUOUS DISPENSERPANSENSOR+AUDIBLEANDVISUALALARMS [] 5. TRENCH LINER/MONffORING 1~3. CONTINUOUS DISPENSER PAN SENSOR Vttq'lr'H AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS [] 6. NONE 469 i( ~ IX. OWNER/OPERATOR SIGNATURE I certiF/that the information l~rovide~ herein is true and accurate ID the Beat c~ my know~eclge. SIGNATURE OF OWNER/OPERATOR [3ATE 470 NAME OF OWNERIOPERATOR (print) 471 TITLE OF OWNER/OPERATOR 472 Permit Num~)~" (For local use only) 473 Pezmit Approved (Fo,'/ocM uae only) 474 PezmiI Expiration Date (For local use only) 475 UPCF (I/9(:J) Formedy SVVRCB Form OFFICE OF ENVIRONMENTAL S 1715 Chester Ave., Bakersfield, CA 93301 (661) - 79 - Page ~ o~ __ TYPE OF ACTION [] 1. NEW SITE PERMIT [] 4. AMENDED PERMIT ~. CHANGE OF II~/FORM~ATIO//~ [] 6. TEM~RY SITE CLOSURE ~C~ec~one,~monly) r ~F~l~~~~ ~ 7. PER~NENTLY CLOSED ON SITE ~3. RENEWAL PERMIT (S~ec~ma~n-~r~caluseonly) (~ec~c~an~-~rl~aluaeon~) ~ ~ 8. TANKRE~VED 430 BUSINESS ~ME (~me ~ FACILI~ ~E m O~ - ~ng 8u~n~ ~) 3 FACIU~ ID I ~ [~ / / / 1 LOCATION WITHIN SITE (~0 ]. ~ I 431 TAN~ID e .... 432 T~K AC~RER. O3 COMPARTMEmALIZED TANK ~ Y~ ~No 4~ D~IN~LLED~ ~(~) ~ 435 T~K~./~PAC~ ~'~IN ~LLONS ~6' ~/ NUMBER~OF~MPARTME~S~ ~7 ~DD~IO~L DESCRI~ION (~ ~1 uae 0~) / 4~ (Ifma~ed, ~mple~ ~leum T~) ~, ~EMIUM UNL~ED ~ 3. DIESEL ~ 6. AV~TION FUEL ~ 2. ~N-FUEL ~O~UM . MI~E U~DED ~ 4. ~HOL ~ ~. OTHER ~ 4. H~R~US W~ (l~udes Used 0~) ~ 95. UN~ 'Check one ~em ~) . ~UB~ W~ ~ 4. SING~ W~ IN A VAULT D ~. O~ER 'Cbeckone~monly) ~ 2. STAINLE~STEEL ~-4. ~ELC~W~IBERG~S ~ 8. F~A~B~WlI~%~L ~. OTH~ ~INFORCED ~C (FRP) TANK~TER~L-~k~ 1. ~ESTEEL ~. FI~RG~SS/~STIC ~ 8. F~ATIBLEW/I~%M~L ~U~ Check one ~m o~) D 2. STAINLESS STEEL STEEL C~ W~IBERG~ ~ 9. F~ ~ODIBLE JAC~ ~ ~. O~ ~INFORCED ~S~C (FRP) ~ 10. ~A~D ~EL TANK I~RIOR LINING ~ ~. RUBBER LINED ~ 3. ~ UNI~ ~ 5. ~ UNING ~N~ ~ DATE INSTeaD ~7 OR ~ATING ~ 2. ~ LINING ~ 4. mE~UC LINING ~ 6. U~NED / ~ ~. O~ER Check one ~m o~) · (~r ~l use only) OTHER ~RROSION ~ 1. ~UFACTU~D ~ODIC ~ 3. FIBERG~S REINFORCED ~TIC ~. UN~ ~8 DATE INSTALLED ~OTECTION IF ~t~ ~OTE~ION ~ 4. IM~SSED CURRE~ O~ER Check one ~m on~) ~ 2. ~CRIFICI~ ~OOE (For ~cal use only) SPILL AND OVERFILL Y~ INSTALLED 450 ~PE (Forlocal use o~y) ~1 O~1~ PROTECTION EQUIPME~: Y~R INST~LED :452 'Checka//matapp/y) ~..~' SPILL ~.AINME.DROP.BE :[~ [./ ~ 1. A~M2. ~L FLOAT__-- ~LL TUBE SHUT OFF VALVE . .~ 4. ~EM~ IF SINGLE W~L T~K (Check a8 ~at apply): ~ IF ~UBLE WALL TANK OR TANK ~ B~DDER (Check one ~m only): ~ 1. VISUAL (~SED ~ION ONLY) ~ 5. ~U~ T~K ~UGING (~G) ~ ~ 1. VISUAL (SINGLE WALL IN VAULT ONLY) 2. AUTO~TIC T~K ~UGING (ATG) ~ 6. VALSE ZONE ~INUOUS INTERSTITIAL ~NITORING ~ 3. CONTINUOUS ATG ~ 7. GROUN~ATER '1~3. ~UAL~NITORING ~ 4. STATISTI~L I~E~ORY RE~NClL~TION (SIR) + ~ 8. T~K TESTING BIENNIAL TANK TESTING ~ ~. OTHER V. TANK CLOSURE INF~MATI~ I PER~NENT CLOSURE IN P~CE ESTI~TEO DATE ~Sr USED (Y~IDAY) 455 ESTI~O QUA~ OF SUBSTANCE RE~INING 458 T~K FILLED WITH INERT ~TERIAL? 457 UPCF (1/99) Formerly SWRCB Form B CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES " :: .... *~' 1715 Ch®eter Av®.~ Bakersfield, CA 93301 (661) 326-3979 UBT - TANK PAGE 2 ~ VI. PIPING CONSTRUCTION (check ~1 that aa~ly) ' ' UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE ~r~'l PRESS R ~ TI '"" ~ · U E I I 2. SUC ON , L..J, 3 GRAVITY 458 [] 1;,PRESSURE [] 2. SUCTION [] 3. GRAVITY 459 CONSTRUCTION/'[] 1. SINGLE WALL [] 3. LINED'T~REN~H' ' [] 99. OTHER · 460 ~]' I. SINGLE WALL [] 95. UNKNOWN 462 MANUFACTURE~L~2. DOUBLE WALL _~. [] 95.,U~IKNOJ~ , / [] 2. DOUBLE WALL [] 99. OTHER ,~M~NUFACTURER J,d~_/~, .'~'~ ,~ ~/,,,'"~'~'~ 461 MANUFACTURER 463 [] 1. BARE STFpEL 1~ ~S. FRPCOMPATIBLE 100% ,METHANOL [] I. BARESTEEL , [] 6. FRPCOMPATIBLE'W/100% METHANOL MATERIALS AND [] 2. STAINLESS STEEL [] ?. GALVANIZED STEEL ~.. [] 2. STAINLESS STEEL [] 7. rGALVANIZED STEEL CORROSION '" · PROTECTION I~-'] 3. PLASTIC COMPATI*BLE Wl'I:H CONTENTS' . [] 9'5. UNKNOWN [] 3=,.,, ,F~LASTIC COMPATIBLE WITtY.CONTENTS · [] '8. I~LEXIBLE (HOPE),, ,, ~[] 99. OTHER FIBERGLASS [] 8. FLEXIBLE (HOPE) [] 99. OTHER I-J 4. FIBERGLASS ~[] 9. ~CATHODIC-PROTECTION STEEL W/COATING [] 9. CATHODIC PROTECTION 464 [] 5. STEEL W/COATING "%' [] 95. UNKNOWN 465 ' ·", -- - ,'- ABOVEGROUND PIPING UNDERGROUND PIPING ; ' ' -.. ' SINGLE WALL PIPING 466 ~SINGLE WALL PIPING ' · 467 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WTTH AUTO PUMP SHUT OFF FOR [] 1. ELECTRONIC NINE [:F_AK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT (~FF r ~ LEAK. SYSTEM FAILURE, AND SYSTEM DISCONNECTION ',. AUDIBLE AND VlSUAL SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS ALARMS [] 2. MONTHLY 0.2 GPH TEST ~_2. [] 3. ANNUAL INTEGRITY TEST (0.1 GPH) MONTHLY O.2 TEST 3. ANNUAL INTEGRITY TEST (0.1 C4:q-I) [] 4. OAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS (Check all that apply): · [] 5. DALLY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRFI'Y [] 5. DALLY 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): [] 7. SELF MONITORING [] ?. SELF MONITORING GRAVITY FLOW: GRAVITY FLOW (Check all b~at apply): ~9. BIENNIAL INTEGRITY TEST (0.1 C_.-:.-:.-:.-:.-:.-~H) [] 8. DAILY VISUAL MONITORING [] 9. BIENNIAL INTEGRITY TEST (O.1 GPf. I) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPIN? PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Chec~ one) 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (chec~ one) [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] a. AUTO PUMP SHUT OFF WHEN A I.EAK OCCURS '~i' AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM [] b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION . NO AUTO PUMP ~HUT OFF [] c. NO AUTO PUMP SHUT OFF [] 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR [] 11. AUTOMATIC LEAK DETECTOR RESTRICTION '~I~ 12. ANNUAL INTEGRITY TEST (0.1 C-:-:-:-:-:-~H) [] 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: SUCTION/GRAVITY SYSTEM: 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALJ~RMS [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATOR~ ONLY (Check all that apply) EMERGENCY GENERATORS ONLY (Check all that apply) [] 14. CONTINUOUS SUMP SENSOR WTT~ AUTO PUMP SHUT OFF + AI~DIBLE AND [] 14. CONTINUOUS SUMP SENSOR WITH~I,~T AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL VISUAL ALARMS ALARMS [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH~I~/T 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. DALLY VISUAL CHECK DATE INSTA_J,.LED 468 [] 2. CONTINUOUS DISPENSER PAN S~R + AUDIBLE AND VISUAL ALARMS [] 5. TRENCH LINER I MONITORING "DC OWNER/OPERATOR SIGNATURE I cmlify Irlal the i.,nfom~atlon providm:lJ:l~',e(~ is t~n.m,~ncl accurate to the trust o/my Imovam:lge. 470 JPermi! Numi~er (For/eca/uae on/y) 473 Permit ApprovegJ (For/ecl/~ on/y) 474 Permit E. xpiraUon Dale (For Ioca/uae on/y) 475 UPCF (1/99) Formerly SWRCB Form B CITY OF BAKERSFIELD ~/~~,~. OFF'E[ OF ENVIRONMENTAL SE.ICES ~ 1715 'Chester Ave., Bakersfield, CA 93301 (661) 326.3979 UNDERGROUND STORAGE TANKS -iNSTALLATION CERTIFICATE OF COMPLIANCE One form per tank I. FACILITY IDENTIFICATION . BUSINESS NAME (Same as FA¢ILJ~TY NAME or DB~,. - I~l~g Buslna~ As) II. INSTALLATION Check ell that apply The installer has been certified by the tank and piping manufacturers. The installation has been inspected and certified by a registered professional engineer. The installation has been inspected and approved by the City of Bakersfield Office of Environmental Services, All work listed on the manufacturer's installation checklist has been completed. The installation contractor has been certified or licensed by the Contractors State License Board, Another method was used as allowed by the City of Bakersfield Office of Environmental Services. Identify_ method: III. TANK OWNER/AGENT SIGNATURE ~i5~'~k~-x-5~'a~'~"l'-'~7 ............................ T'i~fi~- ..................................................................... -~-~-'- ..................... ............................................. ~ .... ~ . ~ ................................................................................... Fon~ C 4 ~t CITY OF BAKERSFIELD ~ ' 1715 Chester Ave., aak. ersfleld, CA 93301 (661) 326 3979 UNDERGROUND STORAGE TANKS - INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank Page I. FACILITY IDENTIFICATION BUSINESS NAME (Same as FACILITY NAME or Dl~k~ - Doing Business As) II. INSTALLATION " Check all that apply * ~ The installer has been certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered professional engineer. The installation has been inspected and approved by the City of Bakersfield Office of Environmental Services. All work listed on the manufacturer's installation checklist has been completed. The installation contractor has been certified or licensed by the Contractors State License Board. []Another method was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: IlL TANK OWNER/AGENT SIGNATURE I certify that the in!.o..r~_ati..o..n. _p..m.T!~_e_d._h_em.~j~__t ~e .&_ .~<;ura_~te~ the best of my knowledge Form C '" CERTIFICATION OF FINANCIAL RESPONSIBILITY FOR UNDER~elOUND ~TORAGE TANK~ CONTAININ{a PETROLEUM or AND ( or ~ 1 mi~ion doLlar~ per occuTence ~'~ 2 minion doUm-s annul o~rupte '/' ,_4C/,; '/ Article 3, Chapter 18, Division 3, TTtle 23, California Code of Regulations. The mechanisms used to demonstrate financial responsib//ity as required by Section 2807 are as follows: I.:-.=:....-..:.,.::.:: .................................................. ..:.:.::. .................................................. .................. ;?~;i~iiii::::i~!'i?~iiii::~Number':i:~' :::~:~!~??:~i~i~t~:?ii~::~Amo~i~t~:i:::i:;~: iiiiiiii!iii?P~n'od::~ii~!i!~il :=i?~ii!i!;~;i:? !~ii!ili¢~m~; Note: If you are using ~ ~ate Fund as any par~ of your dernonstmtion of financial responsibilily, your execution and sul~rnission of this certification also certifies that you are in compliance with all conditions for participation in the Fund. Fa~i~yName ..... ' TNHTRUCTTONS .- · C~t~'X. F1:~'roli' OF FZ~MICLltL RESPONSZBLT, Z~ FORM PLease type or prtnt ctem-ty eLL i~lfOrestton on Certification of Financial ResponsibiLity for~. ' ALL UST facJtitJel end/or sites ouflad or operated may be Listed off one form; therefore a separate certificate lo not required for each site. DOOJNEtI? ItlFOI1HATIOId A. Ammmt bqUjred - Check the appropriate boxes.. S. ,nee of Ta~ (bmr - FuLL name of either the tank o~ner or the operator. or Operator C. XeclmflJm Type * ZndJcate ,hich State approved mechanism(s) are being used to show financial responsibility either 8s contained in the federal regulations, /.0 CFR, Part 280, Sulaaart H, Sections 280.90 through 280.10] (See FJrmnciai IIFx)risibility Guide, for~ more information), or Section 2802.1, Chapter 18, Division 3, Title R3, CCR. Name of Issuer - List aLL names and addresses of companies and/or individuals issuing coverage. Pledmnia limber - List idonti~n~ nmber for each mechanism used. ExampLe: insurance po[icy mJnber or file ntmeer as indicated on bond or docunent. (If using State CLeanup F~d (State F~cl) Leave blank.) Coverage Almmt - Indicate amount of coverage for each type of mechanism(s). If more than one mechanism is indicated, total must equal 100~ of financial responsibility for each faci L i ty. Coverage Period - Indicate the effective date(s) of aLL financial mechanism(s]. (State FLied coverage ~ouLd be continuous as Long as you maintain compliance and remain eLigibLe to continue participation in the Fund.) Corrective Actim - indicate yes or no. Does the specified financial mechanism provide coverage for corrective action? (If using State F~d, indicate "yes".) Third Party - Indicate yes or no. Does the specified financial mechanism provide coverage for Camponlatiofl third party compensation? (if using State Fraud, indicate "yes".) D. FaciLity - Provide aLL facility and/or site names and addresses. Informntim E. Signature BLock - Provide signature and date signed by tank o~ner or operator; printed or typed name and title of tank o~ner or operator; signature of witness or notary and date signed; and printed or typed name of witness or notary (if notary signs as uitness, please place notary seat next to notary~s signature). ~ to Xai~ Corcificacion: please send original to your Local agency Cagency who issues your UST parmtts). [e~ s copy of the certification at each facility or site listed on the form. If you have questions on financial responsibility requirements or on the Certification of ~jnanciaL . Responsibi.iity Form, please contact the State UST CLeanup Fcr~t at (916) 7~9-247~. No~e: Perm~t~es for FaiLure to Cmq)ty with Fi~iaL Re~?;~ibJt~tyRequJrmumts: FaiLure to comply my result in: (1) jeopardizing claimant eLigibiLity for the State UST CLeanup FLed, and (2) LiabiLity for civil penalties of qo to $10,000 doLLars per day~ per undergrcflJ~d storage tank, for each day of violation as stated in ArticLe ?, Section 25299.76(a) of the CaLifornia HeaLth and Safety Cede. This momtormg program must be kept at the UST location at ail ~ TI~ information on rhi_, nmnimting progrnm ar~ conditions of the o~ma$ penmt Thc permit holder must notify the Off,ce of Env~mnnm~ S~ w~thin 30 da~ of airy ~ to ~ n~onitoti/l~ proo~hll~ I~!]~ feql~ to o~ ~ ~ making the change. Required by Sec~ons 2632(d) and 2641(h) CCR. / B. What methods and equipment, identi~ed by name and model, will be used for perfoming the monitoring:, C. Describe the location(s) where the monitoring will be performed (Facility plot plan should D. Li~l th~ nam~) and fifl~,) of th, people r~pomibl, for p~rformin~ th, monitori~ and/or maimaininRIl~ ~luil~mem: E. Reporting Forrr~ ~t for monit~'ing: F. Describe the preventive maintenance schedule f6r the monitoring equipment. Note: Maintenance must be in aceordanl;e ~vith th~manufa~rer's mainteslnnee sehednle but not less ,h&n every 11 ~ont~// ~ / ~,- ' ,' ~.. ~. - G. Describe the training neces_.~'y for the oI~rntior~ of U~T syst~>, inc. lu .di~ pipin~ a~l_ ..~e ,/ / EMERGENCY RESPONSE PLAN UNDERGROUND STORAGE TANK MONITORING PROGRAM This momtoring program must be kept at the UST location at all times. The information on this monitoring program are conditions of the operating permit. The permit holder must notify the Office of Environmental Services within 30 days of any changes to the monitoring procedures, unless required to obtain approval before making the change. Required by Sections 2632(d) and 2641(h) CCIL Facility Name 1. If an unauthorized release occurs, how will the hazardous substance be cleaned up? Note: If released hazardous substances reach the environment, increase the fire or explosion hazard, are not cleaned up from the secondary containment within 8 hours, or deteriorate the secondary containment, then the Office of'Environmental Services must b~ notified nX4mo r,. / / 2. Describe the proposed methods and equipment t/o/be u~d for/re/moving .and~roperly disposi~.g,o.f any hazardous substance., q")k/',~f./~ ,.d,~/.~?) / '-- -~-.w._F'~,,-~:n',e,-'.// / 3. Vesc~be/~fie locatiop and availab'flitg(_of~e re/qu?d~yt~, up eq~pment in ip)rnr2 abovy,~ / 4. I_/F-//~c~ ~_f.~d'~d~ L' for t_h0, cleanup gquipmgnt: Describe the maintenance schedule ,'~.~ 5. List the name(s) and title(s) of the personL~ responsible-for, authorizing any work S~IDER: I also wish to receive the · ~plete items 1 and/or 2 for additional services. · ~'"~,,~rnplete items 3, and 4a & b. following services (for an extra · Print your name and address on the reverse of this form so that we can fee): return this card to you. · Attach this form to the front of the mailpiece, or on the back if space 1. [] Addressee's Address does not permit. · Write "Return Receipt Requested" on the mailpiece below the article number 2. [] Restricted Delivery · The Return Receipt will show to whom the article was delivered and the date delivered. Consult postmaster for fee. 3. Art,?,e Addressed to: 4a. Article Number P024 368 611 E -- LLO¥1) C~'[[~)E~S 4b. Service Type ~g'~7A¥ LI~QUORS [] Registered [] Insured ][~ Certified [] COD ._~ 2030 EAST ~R1]NDAGE /~IE [] Express Mail [] Return Receipt for Merchandise BAKJ~RSFIE]J) CA 93307 7. Date of Delivery '~ ~ ' JUL 2 5. Signature {Addressee) 8. Addressee's Address {Only if requested .~ and fee is paid) ~ .... I N-TAN}~ ALARM ..... 6~ignat g t) I-- DELIVERY NEEDED , '~ AUG PS Form 381 1, December 1991 ~u.s.~PO:~g~--~-7~, DOMESTIC RETURN RECEIPT t FREEWAY L IQUOR~ 2140 E. BRUNDAOE BAk'ERSF I ELI).. CA. P 024 368 611 805-323-0254 Receipt for ~uc 18, 2000 1 :~9 Ce~ified Maim-' i No Insurance C~ ~ge Provided ~ Do n~u~for/ ~rnational Mail ~Y~TEP1 8T~TU~ REF'~ ' (See Reverse~,,~ - ........ ~ _ 'sam ~o ' ' T ''~: DEL ~ VErY NEEDED ~[0~ C~Z~[ES ............. _ BR~ACE ~E . I. HVEI'.FFOR'~'- REPORT P.O., ~tate and ZIP Code B~RS~E~ CA 93307 T 1 :UNLEADED REC;IJL~R Postage ~ .~2 VOLLIP1E = 6450 C~rtili~ F.~ LILLAC;E - 5077 OAL~ 1.10 90:::'~ IJLL~C;E~ :3924 G~L~ Special Delivery Fee HEIGHT = 48.60 INCHES . WATER V':L = 0 GALS Restricted ~livery F~ WATER = O. O0 I NCHE~ TEHP = 87. ~ DEG F Return Receipt Showing to Whom & Cate Celivered ~ ~0 R.tum R.~oip~ Showi.e m Whom, T. 9; PRE["I ~ UP1 UNLEADED Cate, and Address~'s Address VOLUME = ~1351 TOTAL Postage ULL~C;E = l 0176 ~F,,~ ~ 2.52 90~,~ ULLAGE= 9023 OALB Postmark or Date HEIGHT = ~5 48 [NCHE~ . W~TER VOL = 0 GALS W~TER = 0.00 INCHES TEMP = 89,5 DEG - ~ ~ ~ ~ ~ END ~ ~ .O July 21, 1999 Lloyd Childers Freeway Liquors FIRE CHIEF 2030 East Brundage Lane RON FRAZE Bakersfield, CA 93307 ADMINISTRATIVE SERVICE8 2101 'H' Street CERTIFIED MAIL Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 RE: Failure to Submit Underground Storage Tank Documentation suP..ESS,O. SE.VICES NOTICE OF VIOLATION & 2101 'H' Street Bak. .eld. C^ 93301 SCHEDULE FOR COMPLIANCE VOICE (805)326-3941 FAX (805) 395-1349 Dear Mr. Childers: PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 Our records indicate that you have not submitted the necessary documentation VOICE (805) 326-3951 associated with your recent tank upgrade. Per Title 23, Division 3, Chapter 16 of the FAX (805) 326-0576 California Code of Regulations, the following documentation is required: ENVIRONMENT.N. SERVICES 1715 Chester Ave. 1. Forms A,B,C Bakersne~¢ C^ 933O1 2. Statement of Financial Responsibility VOICE (805) 326-3979 FAX (805) 326-0576 3. Written Routine Monitoring Procedure 4. Unauthorized Release Response Plan TRAJNING DMSION 5642 Victor Ave. This Office will not issue your permanent permit to operate until the above Bakorsfield, CA 93308 VOICE (805) 399-4697 mentioned items are submitted to this office. Failure to respond within thirty (30) days FAX (805) 399-5763 (August 21, 1999) will result in revocation of your temporary permit. For your convenience, I am enclosing the necessary documentation. Should you have any questions, or need assistance, please feel free to call me at 326-3979. Sincerely, Ralph E. Huey, Director Office of Environmental Services by: Steve Underwood, Inspector Office of Environmental Services SBU/dm enclosures ...... SENSOR L 1-~U NL£~DED STP SUMP --- ,~- FUEL ALARM I"IRR 12.. 1999 3:08 PM ..... SENSOR ALARM ..... ,, L 6:DISPENEER p~N 1..2 DISPENSER PAN I ,, F dEL ~L~RI'"I k ~ I'.'IAR 12 · 1 q99 3: 03 pPI FF:EE ..l~',' [, ,}U(;,RS " B3KERSf'~EIL,..'h. 80 5 ~ :32:3 - 02 5 4 MAR 1c'=, l'~qq_ . _. :3: 10 PM S":/STEM STATUS REPORT ..... SENSOR ALARM k,_~. ............. L 5:DISPENSER PaN 3,~ L i:FIJEL ALi~RI"I D i SPENSER I::'RN L 2: FUEl. ~LARI"I FUEL MAR 1 '? t q'~q 3:04 PM ..... L 5:FUEL ALARM L E,:FOEL ALARM L ?:FUEL ALARM L ..... SENSOR ALARP1 ..... I I,I~;EI~],_,R~ REPORT L ?:DISPENSER PAN DISPENSER PAN T I :LINLERDED REGULAR FUEL ALARM MAR 1 o~.. 1999 3: 05 PM V(:,LUMEuLLAGE == 106,73854 GALsGALS 90% ULLAGE= 0 GALS HEIGHT ??.69 IN.,HEM bOATER VOL =, 0 GALS ;~,.-./' '. WATER = 70. O0 INCHES .... TEMP "77- "~'~7,-~-"-ffEG--P---' ' T 2 :PREMIUM UNLEADED ..... SENSOR ALARM ..... VOLIJME = 10500 GALS 8 L~. r-., ~-:5'SP'¢'I'1S~'R PAN 5,6 ULLAGE = 1027 GALS L 90::'~; ULLAGE= O .,ALS II'SPENSER pAN HEIGHT : 76.12 INCHE~ FUEL aLARId MAR 1'2, 1 - - WATER = 0.00 INCHES TEPlP = 58.9 DEG F ..... SENSOR ALARPl L 2:PREMIUM STP SUI~ir' FUEL ALARM I,,I~R - FREEt,.,.iaY L 1 2140 E, BRUNDRGE BaK, ERSF I ELD. 805-:323-0254 MaR 12. 1999 :3:10 PM SYSTEM STATUS aLL FUNCTIONS NORMAL KBF-7171 CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT N° ~ ' 0 1 1 8 , Loca~io~ :2 140 Sub Div.. Blk. Lot You are hereby required to make the following corrections at the above location: Coz. No Comple.tion Da~e for Corrections -~//~ /~'~ D February 9, 1999 ~R~ c.,~F Freeway Liquor Store RON FRAZE 2030 E. Brundage Lane ADMINISTRATIVE SERVICES Bakersfield, CA 93307 2t01 'H' Street Bakersfield, CA 93301 VOICE (805) 320-3941 FAX (805) 395-1349 RE: Compliance Inspection SUPPRESSION SERVICES Dear UndergroUnd Storage Tank Owner: 2101 'H" Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 The city will start compliance inspections on all fueling stations within the city limits. This inspection will include business plans, PREVENTION SERVICES underground storage tanks and monitoring systems, and hazardous 1715 Chester Ave. Bakersfield, CA 93301 materials inspection. VOICE (805) 326-3951 FAX (805) 326-0576 To assist you in preparing for this inspection, this office is ENVIRONMENTAL SERVICES enclosing a checklist for your convenience. Please take time to read this 1715 Chester Ave. Bakersfield, CA 93301 list, and verify that your facility has met all the necessary requirements to VOICE (805) 326-3979 be in FAX (805) 326-0576 comp,lance. TRAINING DIVISION Should you have any questions, please feel free to contact me at 5642 Victor Ave. Bakersfield. CA 93308 805-326-3979. VOICE (805) 399-4897 FAX (805) 399-5783 Sincer~y, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure · Piping Specs (Dwg No. 3) · Typical Installation Details(Dwg No. 4) · Typical Installation Details(Dwg No. 5) As usual, we want to put the full court press on obtaining the permit. Call if you have any questions. ard~ Cameron Reagor ~.~~..~ ~ ~ ~ FAX Transmittal Cover Sheet BAKERSF ,,- -- CALIPORNIA Bakersfield Fire Dept, Fire Safety Control ' Prevention ' Fire Investigation 171§ Ohester Ave. ' Bakersfield, OA 95301 FAX No. (805) 326-0576 · Bus No. (805) 326-3951 Today's Date (~.//-z.,//~ ~' _Time No. of Pages d_e~R R ECTIO N eJklOTI C E BAKERSFIELD FIRE DEPARTMENT N° 9 1 7 Sub Div. Blk. . Lot You are hereby required to make the following corrections at the above location: ,,.. Cor. No Completion Date for Corrections Date~~ ~ InspectOr S26-S979 KBF-7171 CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT N° 9 1 7 ' Location_~OSO ~, I~(&dA/DAG~' Sub Div. BIk. . YOU arre hereby required to make the following corrections at the above location: Cor. ~o Completion Date for Corrections ~0~ Inspector ~oS~ O~ S ~T~ 326-3979 ~ ~ ,. 12/21/98 09:19 ~805 326 0576 BFD HAZ MAT DIV ~001 *************************** *** ACTIVITY REPORT TRANSMISSION OK TX/RX NO. 9720 CONNECTION TEL 5899513 CONNECTION ID START TIME 12/21 09:17 USAGE TIME 01'39 PAGES 2 RESULT OK CITY OF BAKER~IELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 ~NSPECTTON RECORD POST CARD AT JOB 81TE City, Zip ! Spark Te~ ~~ ~ ~ of T~s) ~ ~1~ - Pi~$ .... vau~t wi~ ~ c~bl~ ~ ~/~ ~wl ~gm ~ S~ ~ C~bl~ Fill ~ ~) for ~ S~D.W. Fill ~ ~k 12/21/98 09:31 '~714 632 7133 ~l~ES-ANAHEIM ~001/006 /_ TNCLUDZNG COVER: ~ CORPORATION PHONE: ('714) 630.-0012 FA.X: (714,) 632-7133 FROM: Jim Anderson .;..-_Z /. ~ ... / //' - · .: ' / ~ -~/~"~¢~ 7~ -; - /'-/2- ~-g'o--,~r.~ ~- ~ ~.,~.-- .. . 12/21/98 09:31 9714 632 7133 XER~ES-ANAI{EI}I ~]002/006 ALTERNATE BACKFILL ( IMPO~: S~ De~e~ F~ ~ (~12) 887-1870. CU~OMER Si~ ~DRESS CON~CTOR .. S~nature Pfint~ N~e P~ , APPROV~' ~O~GM~ , ~a ~o~ pr~am~ in ~is ~ppl~ am ~ ~e S~~on Table [0~ f~r ~e Jn~li~n of X~es' ~n~ wh~ ~i~ basil ~ec ~n ~e appmv~ ~d o~n~ ~ Xe~ Sieve S~e % Pa~ing (' suopl~e~ i~m~=~ m~ be us~ ~ mnj~n ~8', 1~', 314' Mix [ No 'less ~n 70% w~ ~e ~~ Xem~ I~la2n ~ W~ ~ {.18~ 70-100 ~ w~ pmv~ions of NFPA 30 and 3~. ~00 (.~02') No mare ~an ~% ~e l~ling ~nb d~or m~ ~me ~t ~e ~eda ~ met aha the supgleme~al f~m~ ~e f~ 'R may ~m ~ to. b~ fla ~re t~, 30% =y .. ,Jeigm af ~ve ~ in~es ~8'. 1/~ aha I. ~~ ~4" s~e ~n~ ~e 30% ~n ~e a ~mamadon of · ' ~e ~em~e ba~ll mat~al b ~ ~ s~d. a ~ s~. I~e ~v~ ar s~ w~ g~ ~s~ ~ SP II. ~l~ing so~~: Wh~ ~ at:e~e ba~E ~edal is us~. i: mus~ a. It m~ ~e ~e~ a~ weU ~u~. ~. ~e m~mum s~e (in I~ ~e~g~) ~ Use ~ a~t~ m~ani~l v~ C. It mu~ be [ree of ~ay, ~m, ~h, [~e ~ 8 ~t ~ ~o t~ ~ON: 0o nat s~nes, sill stone s~gs or d~ shews, ~a ~er~pe ~mpa~Dm. ~ral. pumice, so~ ~me~ne s~~. stag, ~e~, ina~ w~. a~ ~ or ~. ~mp~ ~e mattel to a~flie~ ~ M~edal m~ not be ~an a~ s~ ~e d~s~ ~ ~ ~ I~ ~ be ~ ay ~ ~ fr~ of ice ~un~ ~ ~. ~epe~ t~t~ ~to~ ~i~ ~e h~ll~ is res~i~le f~ pm~n~ a steve ~ ~e ~ m~ {AS~ 02~). a an~s~ ~ ~e sugplier ve~ ~ ~e ~ ~ ~e I~ re~As m~t be ~1~ with ~i ~t~ace matedal meem ~e sp~ns in ~e ~~ ~ ~ s~t to c~e 12/21/98 09:32 'Z~714 632 7133 XERXES-ANAHEIM ~003/006 ;n~ 1~ ~ ~ ~e. (1) ~w~ ~~ ~~ 111. INfO. ON (O~Y H~) (3) W~ =~ns w~ ~ ~. ~n ~ ~ ~ ~ ~e ~ mate~ to p~e a lav~ 1~ ~ t~ m~~e ~ f~fa for ' c. ~d ~e F~ 12" I~ ~ baSIL R~ ~ne~ It is the r~ib~ ~ ~e ~k S~ 5 mf the S~ Ma~al. ~i~ o~ln~ ~e p~ g~ ~nar or the~ i~ ~~r to deta~e piing and ~ ~ ~a~ ~er ~e , w~er ~ ~ ~ g~ ~e s~ ~Pa~ ~1 ~e way ;o su~e. Use ~ Xem~ ~ ~~ ~ all tan~ ~e . piping, s~ps, ~d ~~. S~ IL(b) ~ ~ S~n 7 ~t ~e S~n~ f. Comgl~e ~e In~lla~n Che~ f~ ~ In~n M~ua ~ an~ng ~ideanes. XeroX' Standam I~n I~ (suogli~ with tank ~en snip~). ~ AR~ ~a ~ ~ I~ ~ ~Or~ N. INVASION ~ HQ~ II1.{~. Re~ S~n 6 of t~e S~ I~ ~n~ ~d foflaw atl aeomg~e se~ ~ ~ON: C~ ~a ~ d~ pe~i~ ' ~mpa~en. T~ nem~a~ .taps if ~e a. ~e ~ole must bo mai~ ~ a ~. ~nk ~gm~ ~~ ~u~ "' ~l~ o~ ~ ~ S~ In~ll~n ~nd~Jon d~ng ~e i~talla~ pmk. In~m~. 12/21/98 09:32 "~'714 632 7133 XERXES-ANAHEIM ~004/006 The bac. kf~ material surrounding a tank is a a'itic~l lm~rt of a fiberglass tank installation. This brochure gives guidelines for choosing the best material to use when installing fiber- glass tanks° Xerxes specifies that gravel or crushed stone be used as a backfill matzrial. 1. PEA GRAVEL (mix of rounded particles) must have a minimum dim, neter of Ps" and a maximum diameter of 2. STONE CRUSHINGS should be washed and ~ree flowing. The mix of angular particle-size should be between ~" and IA' and must meet ASTM C-g3 paragraph 9.1 requirements. 3. No mom than 5% of the backf:fll shall pass through a No. 8 sieve. COARSE AGGREGATE is a more technical t~m for the material that meets Xerxes' back~ size requirements. The American Society for Testing and Materials (ASTM) and The Arrt~rican Association of State Highway Transpor'mtion O~ .tills (AASHTO) have spec~cations for standard sizes of coarse aggregate. The standard sizes of coarse aggregate that meet Xerxes' pea gravel spera~tion$ are given in Table I, The standard sizes of coarse aggregate that meet Xerxes' cxushed stone specifications are given in Table II. Some quarries may produce materials that meet Xerxes' requirements but are not iden- tiffed by a standard coarse aggregate size number. The quarry should be able to provide a specitication that identifies the size or gradation of the material. If a speci~cation for the matedal is not a'0-ailable, an independent testing laboratory can provide a sieve analysis per- formed per ASTM C-136 on a sample of the back~, material. The sieve analysis or material speci~icmtion can then be compared against Xerxes size requirements for the pea gravel or crushecl stone. Another knporimnt characteristic of good badcfill material is hardness or stability when exposed to water or loads. Most materials have no problem meeting the hardness requirement. Mater~ls like soft limestone, sandstone or shale should not be used as back~ because they break down over time. 12/21/98 09:33 ~714 632 7133 XERXES-ANAHEIM ~ 005/006 TABLE I Standard Sizes of Coarse Aggregate That Meet Xenres PEA GRAVEL Specification2 This table identifies standard sizes of coarse aggregate that meet Xerxes' pea gravel ~ecification. The first column identifies standard sieve sizes that are used to grade aggregate material. The remainder of the columns have a standard aggregate size number at the top of the column. For each aggregate size, the amount of material finer than each laboratory sieve ~ squ~re openings) is given as percentage of the total weight of the sample. These percentages ~'e an indication of the pm-t~e size distribu-~on or gradation within a given aggregate size. T.'sing aggregate size number 6 as an example, we can expect 20% to 55% of the sample I measured by weight) to pass through a l/_, inch sieve. Aggregate Size Numbers Sieve 5t~e 6 67 7 Im. 100% 100% -- ¥~ m. 90 to 100 90 ~o I00 ":'-. ~,~ in. 20 to 55 -- 90 to 100 ; ~ :"::~(" ¥~ in. 0 to I5 20 to 55 40 to 70 .' ':'? No. 4 (0.I87 in.) 0 to 5 0 to 10 0 ro 15 ,.:.~. No. $ (0.094 i~) 0mS 0to5 NOTES ~. Standard sizes of coazse aggregate per Ab-TM D-448, ASTM C-33 and AASI4TO M 43. 2. PEA GRAVE,L, (mix of rounded particles) must have a minimum diam=t= of Vs" and a maximum =tiameter of ~A. No mom than 5% of the back611 shall pass through a No. 8 sieve. 12/21/98 09:33 '~714 632 7133 XERXES-ANAHEIM ~006/006 TABLE I! Standard Sizes of Coarse Aggregate That Meet Xerxes CRUSHED STONE Specification2 This table identifies sta~cJ~rd sizes of coarse aggregate that meet Xerxes' crushed stone specification. The first column identifies ~ sie3m sizes that a~ used to grade aggregate material. The remainder of the columns have a standard aggregate size number at the top of the columr~. For each aggregate size, the amount of mata~ial finer than each laboratory siew (square openings) is given as percentage of the total weight of the sample. These percentages give an indication of the particle size distribution or gradation within a giwa-t aggregate size. Using aggregate size number 7 as an exarflple, we can expect 0% to 15% c~ the sample (measured by weight) to pass through a No. 4 sieve. standard Sizes of Coarse Aggregate Sieve Size 7 78 /~ ~/~ Lrr 100% 100% -- V2 in. 90 to 100 90 to I00 100 _ :~,: '/,in. 40to70 40ro75 85to 100 No, 4 (0.187 to 15 5 ro 25 to in.) 0 10 30 ~ No. 8 (0.094 in.) 0to 5 Oto5 Oto5 NOTES 1, Standard sizes of coarse aggx~gat~ per AS'I-M D-448, ASTM C-33 and AASHTO M 43. 2. STONE CRUSHINGS should be washed an~ fr~e flowing. The mix of angular particle size should be between Vs" and ~* and must meet ASTM C-33 paragraph 9.~ ~quizements. No more than 5% of the backfill shall pass through a No. 8 sieve. XERXES® mONE: < ) TANK ACCEPTANCE... BY CARRIER LOADING OF TANK AT PLANl / ... , "~ · · supervlsm' a~ Xerxes. ' '" ':>' '"':~" · " TANK DESCRIPTION: ~ ,~""""""""'~" [.],2K~ ~W~AF' ~'~:~-'~4" NPT 'SI~L F I'~"'~ t~::,~,~ DRIVER: (printJ .. ....... ' ,x, HOLD D01~ 8TRAPS: , ~time frame DATE ANt) TiME gRIVER ARRIVED RT JOB SITE: ON-SITE ACCEPTANCEINBPECTION o~:/.z- -<2 -,9~ T,ME:~.m. ~,..,. · Ihe tank(s), A. "OWWASTAmlUm. OADED ,B. ~mEw~s.pur.,~ · ~.~w/,~..,~ ..................... [] .o.,.,~ ....................... [] · . m,,~ .................................... ~ .o.m~ ...................................... [] · 8YI~KHOE ................................ E] · I~I$1MSS ................................... [] · ~ USIHG ~ ......................... [] .. ~ G~VEL .................................. [] · ~Y O~E~ .................................... [] · iH mH~ m~.F ............................... WAS THE TANK CHOCKED? ~[,ES []NO MARK OR LISTALL DISCREPANCIES oBSERVED. IF NONE - MARK "NONE". PROBLEMS/DISCREPANCIES MUST BE REPORTED WITHIN WHO CHOCKED THE TANK(S)? ~ CUSTOMER ~COI~ ~RIVER 48 HOURS OF TANK ACCEPTANC£. yOUR SIGNATURE ;THAT THE TANKS WF. RE RECEIVED BRINE LEVEL CHECK WAS THE TANK DELIVERED *'ON TIME"? AND ACCEPTED. i:;;;;¥E$ ~:}NO ~ MEASURE THE erin LEV~ IN 1HE R-L~ERVOm. DATE ~ (FROM 1HETMIK TOP) TIME: ................. '..~a.~N. if]p.m. BRINE LEVEl. Al' DELIVERY .................. COMPANY: RESERVOIR OF BRINE TANK NOTE'TO DRIVER AND CUSTOMER: ALL ITEMS MUST BE IRLLED OUT COMPLETELY SHIPPED FROM: ANt) ORIGINAL FORM SENT BACKTO "SHIPPED FROM" PLANTTO ATTENTION OF :~.~.':~,~ ,~,~ ~S .~,~01<~' ~ ~IE "UST COORDINATOR", ~t,~,~-~E:I~,~ C~ 92::30'7 ~.~.L.[fAGE;~ 150 QISTRIBUTION: WUlTE - PLAN? CO~Y PINK- CUSTOMER COPY YELLOW- CARRIER COPY BLUE- RETURN TO PLANT CBF 1416 (Rev, 11/96) _BILL OF LADING - NON-NEGOTIAJ~LE ITH SHIPPER FOR THE TRANSPORTA~ OF THE FREIGHT DESCRIBED BELOW, 'fH~ tERMS AND CONDITIONS ON THE REA~SE SIDE OF THIS BILL OF LADING SHAL'L~NOT APPL ,J ~ 3~ * The property described below is received subiect to the Bill of Lading Terms and Conditions printed on the back hereot or any Shipper/Carrier From ,~.~, ~:;:'XE~!',;, ('~0~" ~ ';"~ 4'~'~;O'~'~'O0~t'~;~ Agreement in effect on the date of shipment. The property described .'~ '?~{,;~ ~,~!:/~;~ ~ ~'L~!FI";~i~'t ¢~L~: below is also received in apparent good order and condition, unless ~%~;¢~t;i~'~i~'~ ~{~ ~';;~irCY7 otherwise indicated below. Carrier agrees that it will deliver the freight or cause it to be delivered from place of origin to place of destination, If there is a Shipper/Carrier Agreement in effect on the date of shipment, it is ....~.~..~,, ~ mutually agreed, as to each Carrier of said freight, over all or any portion ORDER NUMBER: ~ ..... i~.[,..,O,, of said route to destination, and as to each party at any time interested in ORDER DATE: .~ ?/0~) z"~'~:~ said freight, that every service to be performed hereunder shall be subject CUST ORDER: ,,~'~.~::i;;:,;~I~.~.~ to the terms of Shipper/Carrier Agreement and any amendments thereto. CUST. NUMBER: '~<ki,~.~f¢i;~.,~ All transportation services provided by any Carrier shall be without SHiP DATE: ~)~ ?/O~:i~/'~':"~:~ recourse against Xerxes Corporation for payment of any accessorial, lay SHIP VIA: ,: time, demurrage, detention, or other such charges, unless agreed to in RELEASE NO: (i;~...~::[~(~ ~ 1L writing by Xerxes Corporation. ......................... ~- pRbDUcT NUMBER DESCRIPTION WEIGHT QuANTIT~'~H~PED }elivery Instructions: Gonsequential damage~ may occur in th~ event of later-than-requested delivery. )ate: /' ~ime: Phone~: n~s is to ce~iiy lhal the above-described freight i~ propedy cla~ifie~, described, packaged, ma~ed a~d labeled and C~ec~ Applicable ; in proper condition for transpod~tion acco~ing to the applicable regulations of the Depa~ment of Trans~aat~on. ',erxes CorPoration S~ipper, Per ~ COD Amount lame of Carrier ~/t~',-~.// ~.,t ~ COD Fee Prepaid [~} COD Fee Cottec ;arner acknowledges that it~driver is expre~Jy authorized to a~ept this shipment on its behalf.) ~ Freight Collecr~L..~? Third P~trty~ :H~DOT MC¢: ~ Prepaid ~J Customer Pick Up~' )river's , ~--,; ,~,_ ~o Recourse to Xerxes Subiec, to Section C7 on Reverse ;ignature Date *~'Signature, Xe~es Corpbration Comments/Exceptions :?; Note: It the shipment moves between ~o ports by a carrier water, the law requires that the Dill of Lading shall sial .:. whether it is carrier's or shipper's w¢~[: ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 TANK REMOVAL INSPECTION FORM FACILITY ~/~6:~_~J~ ~t~DUo~_ ADDRESS ~D~O ~. OWNER l~_oVo c(.~,co~ PERMIT TO OPERATE# CONTRACTOR ,~6c CONTACT PERSON LABORATORY ~ ~/~ # OF SAMPLES TEST METHODOLOGY ~-~, ~T~ ~ PRELIMANARY ASSESSMENT C~. 4~cA CONTACT PERSON CO~ RECIEPT LEL% -~' O~% PLOT PLAN CONDITION OF TANKS --~-~ DATE INSPECTOR8 NAME 8, IGNATURE Sent by: ICES 805-861-9774 08/06/98 8:09AM Job 532 Page 2 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK FACILI~ NAM~ ~ff~ ~ ~ ~s ~o0~ CROSS ~RE~ TANK OWNE~O~ER ATOR MAll.lnG ADDRE~S ~ ~ ~, ~g~ ~ CI~ ~~~ ZIP~O~ no~ss F.O. 2 co~nv ~~ TAN ~ CLEAn lng INFORMATIQ~ ~Do~ss 2~ COMPANY ' .O.aox ADDRESS TANK DE~INATION ~ANK ~FOR~ATIO~ ~MIC~ 'DA~5 CHEMICAL TANK NO. AGE VOLUME ~O~D STORED P~WOUSLY ~O~D p ..... .. ~:., '. ~. ' .~"-h ',.:~':~' .~' ~:--~ '~3.C~:~,~'? ',.' '. "~,';.,... ~. · .. TI IE AI'I'I,I~A~I' tlA~ ~CEIVEI). PErMrl' ANt) ANY OT! II(R ~'l'3'1'1~, Al i'r(~~ ~'I'i.ICANT Tfl~ APPLICATION B~COMK A PERMIT WHE~ APPRO~D Bakersfield Fire Dept - OFFIIL~ OF .ENVIRONMENTAL SI~tVICES ~--O( .. UNDERGROUND STORAGE TANK PROGRAM PERMIT APPLICATION TO CONSTRUCT/M_ODIFY UNDERGROUND STORAGE TANK TYPE OF APPLICATION (CHECK) C] NEW FACILI~ ~ MOOIF~A'TION OF FACILI~ ~EW ~ANK INSTALLATION AT EXISTING FACILI~ STARTING DATE PROPOSED COMPLETION DATE FACILI~ NAME ~~A ~ '~/~u O ~ EXISTING FACILI~ PERMIT No~ TANKOWNER Ltokld &HZub[~S PHONE No. CONTRACTOR~. ~. ~. ~, CA LICENSE No. ADDRESS ~ ~O/ ~~ ClW ~& ZIP CODE PHONENo..~R ~~ BAKERSFIELD CI~ BUSINESS LICENSE No, ¢~~/ WORKMAN COMP; No./~G~/~¢ -J INSURER ~~ B~EIFLY DESCRIBE THE W~RK TO BE DONE /~ o ¢~ ~ ~/~ ~ ~ ~ ~ DEPTH TO GROUND WATER SOIL ~PE EXPECTED~TSITE No. OF TANKS TO BE INSTALLED ~ ARE THEY FOR MOTOR FUEL . ~S Q NO SECTION FOR MOrOR FUEL TANK No. VOLUME' UNLEADED REGULAR PREMIUM DIESEL AVIATION SECTION FOR NON MOTOR FUELSTORAGETANKS TANK No. VOLUME CHEMICAL STORED CAS No. CHEMICAL PREVIOUSLY (no brand name) (if'known) STORED ... THE APPLICANT HAS RECEIVED. UNDERSTANDS, ANO WILL COMPLY WITH file AIl'ACHED CONDITIONS OF THIS PERMIrANO ANY OTHER STATE. LOCAL ANO FEDERAL REGULATIONS. THIS FO'RM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND rD file 8EST OF ,MY KNOWLEDGE, IS TRUE AND CORRECT. .;.5'.: APPLICANT NAME (PRINT) APPLICANT SIGNATURE ... - ; THIS APPLICATION BfiCOMES A PERMIT WHEN APPROVED ' --~-:' INDUSTRIAL CONTAMINATION EXTRACTION SERVICES, INC. BUSINESS OFFICE 7401 Rosedale Hwy ~ P.O. Box 20370, Bakersfield, California 93390-0370 Phone 805-589-9039 ~ Fax 805-589-9015 CA LIC. NO, A-726775 HAZ/A-7091 BAKERSFIELD FIRE DEPT. Hazardous Materials Division 1715 Chester Ave. Bakersfield, CA 93301 Attention: Steve Underwood Subject: Permit Application for Freeway Liquor, 2030 E. Brundage Dear Mr. Underwood Industrial Contamination Extraction Services, Inc. will be responsible for the following: · Permits; · Sawcutting; Excavation; · Backfilling; · Removal of 2x12000 gallon and lx10000 gallon tanks; Removal of existing dispensers (6); · Installation of 4MPD's X 3 Product Dresser Wayne dispensers with blenders, card readers and dispenser pans; · Purchase and Installation of an INCON tank monitoring System with positive line shut down with all associated conduit and wiring as required; · Purchase and install geoflex double wall piping with fittings from tank to dispensers to include bumper posts and islands; · Purchase and install overfill and overspill containment; · Purchase and install new double wall tanks, lx12000 gallon and lx15000 gallon with all tank trim; · Replace any disturbed asphalt and concrete; · Relocate product ,vapor and electrical lines; · Remodel current canopy with a 4 foot extension on each end with new decking and lighting to facilitate installation of new dispensers; We are enclosing the permit applications for tank removal and facility modification along with 2 copies of the following drawings: · Existing Plot Plan · Proposed Plot Plan iCORRECTION I~TICE BAKERSFIELD FIRE DEPARTMENT Sub Div. ~'Z~z~ ,~ J~'~':~k. . Lot You are hereby required to make the following cor~ctions at the above location: Cot. No J 17 ' ' , / Date 326-3979 UNDERGROUND STORAGE T~II~ !NSPECTION ~ Bakersfield Fire Dept. ', "~'~'"~"~'~'=.','"'"' ~'~'"' :~ ' Office of Environmental Services, ~ Bakersfield, CA 93301 FACILITY NAME ~.~(,~J~,~,~r-,2,~,~.. BUSINESS /.D No 215-000 ] ~/,;, FACILITY ADDRESS ~'~-©-a~ L" ~ ~'~,.~ ~.--{,~a z~. CITY .~P.~5"~, ~ Ir-'/' ZiP CODE FACILITY PHONE No. ~D~ ~D~ INSPECTION DATE (~}/ ~" ~ P,[~_oduc! Product Product TIME IN TIME OUT /~-~'a ~' //£ (?J- '~'V/~E Inst Date Insl Dale'"'5 Insl Dale' INSPECTION TYPE: /9' ?~ / ~O Size Size Size ROUTINE ~ FOLLOW-UP /~ ! ~ / _~./2/~E /~ REQUIREMENTS yes no n/a yes no n/a yes no n/a la. Forms A & B Submitted ~/ ~ ~'~ 1 b. Form C Submitted '/ ~ lc. Operating Fees Paid ~/ / ,~ ld. State Surcharge Paid ~ ~' ~_.~'~.. c~ ~ 1 e. Statement of Financial Responsibility Submitted ~ ,-~ lf. Written Contract Exists between Owner & Operator to Operate UST c~ 2a. Valid Operating Permit ~ ~' 2b. Approved Written Routin~ Monitoring Procedure ~/ ~ ~" 2c. Unauthorized Release Response Plan ~ ~ aa. Tank ,ntegrity Test Last Months 3b. Pressurized Piping Integrity'Test in Last 12 Mo0ths ~ ~ 3c. Suction Piping Tightness Test in Last 3 Years ~-~ ~- ~-~" 3d. Gravity Flow Piping Tightness Test in Last 2 Years ~"[ ~' 3e. Test Results Submitted Within 30 Days / ~ 3f. Daily Visual Monitoring of Suction Product Piping ~ ~'~ ~" 4a. Manual Inventory Reconciliation Each Month >x,~, ~ t,.,-- 4b. Annual Inventory Reconciliation Statement Submitted ~/ ~ 4c. Meters Calibrated Annually -~ 4,.., ~' .... 5. Weekly Manual Tank Gauging Records for Small Tan, ks, ~ o,.,-' >,~- 6. Monthly Statis~Jical Inventory Regon.cOi~ation~ I~e,s~lts~ ~';~b'~'~tC{ t"A~~, /-"(;~/ " ~''~'~] ~,~- ~,-~ ~r~,- ~ /;' ~' .~ z~ 4 ~ " 7. Monthly ,~ut6m atlOTanl~,~{jfff~-~ / suits / ~- 8. Ground Water Monitoring ~,' ~,-- 9. Vapor Monitoring ~ ~- ,', 10. Continuous Interstitial Monitoring for Double-Walled Tanks t,,- ~ ~'" 11. Mechanical Line Leak Detectors LL~. ~,~'~ ~;~;~i~. ~ ~ ~ 12. Electronic Line Leak Detectors o-,'"' ~-"/ 13. Continuous Piping Monitoring in Sumps ~,- ~ 14. Automatic Pump Shut-off Capability ~' ~ 15, Annual Maintenance/Calibration of Leak Detection Equipment >~--' ~,-' 16. Leak Detection Equipment and Test Methods Listed in LG-t 13 Series ;,- ~,m 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 .~- ,v,.,-' 20. Approved UST System Repairs and Upgrades ~.,- c~ 21. Records Showing Cathodic Protection Inspection ~ ~- 22. Secured Monitoring Wells .~ ~,~ 23. Drop Tube v/ . ~-~ RE-INSPECTION DATE . ,/ RECEIVED BY: /<, , .' / ~.~-- : ...... _ -~ ,,.-' ,.-.- ./~,~..~ _.~ . ~J. ~ INSPECTOR: ../.z. a-:.~,~ ~,'~: ~-~/~__,, ._. ,,/.~-.Z.,~/r___- OFFICE TELEPHONE NO. ,~,,.~-.3F FD 1669 (rev. 9/95) RECORD OF TELEPHONE CONVERSATION Location: ~___0 ~0 '~ ~Pu~ ['~x~.E. ID# / ~ Z( Business Name: ~~}/ ~'~ Conta~ Name: ~ ~, ~ Business Phone: ~ ~ ~ - 0 ~4 F~: Inspe~or's Name: ~ Time of C~I: Date: ~- ~ -~ d Time: ~ 5~ ~ Min: ~ Type of Call: Incoming [ ] Outgoing [~] Returned [ ] Time Required to Complete Activity # Min: BAKERSFIELD FIRE DEPARTMENT July 29, i 998 Lloyd Childers Freeway Liquors 2030 E. Brundage Lane FIRE CHIEF MICHAEL R. KEU.Y Bakersfield, CA 933 87-0097 ADMINISTRATIVE SERVICES 2101 'H* Street Bakersfield, CA93301 UNDERGROUND STORAGE TANK UPDATE (805) 326-3941 FAX (805) 395-1349 Dear Underground Storage Tank Owner: SUPPRESSION SERVIC~ 2101 'H" Street Bakersfield, CA 93301 You have been receiving monthly updates from this office, regarding the (805) 326-3941 FAX(805)395-1349 underground storage tank compliance deadline, since December of 1997. I feel we must inform you of how serious an impact non-compliance will be to your P,EVEnnON SErviCES business. 1715 Chester Ave. Bakersfield, CA 93301 (805)326-3951 On December 23, 1998 (December 22, 1998 deadline) this office will be FAX (80,5) 326-0576 forced'to revoke your permit to operate, effectively shutting down your fueling ENVIRONMENTALSE.VICES operation. On January 1, 1999, Senate Bill 1491 takes effect, banning fuel 1715 Chester Ave, deliveries for those who have not met the compliance upgrade. Bakersfield, CA 93301 (805) 326-3979 FAX (805) 326-0576 After 90 days of closure, your tanks will be considered illegally abandoned and we will take action to properly close these tanks. If you do not TRAINING DIVISION 5642 Victor Street comply with our tank closure requirement, we will find it necessary to take legal Bakersfield, CA 93308 (805) 399-4697 action, including, but not limited to citation and/or injunctive relief. FAX (805) 399-5763 It is this offices sincere hope, that we do not have to pursue such action, which is why we continue to update you. Time is running out, contractors are booking 6~8 weeks in advance, and costs are climbing at an alarming rate. If this office can be of assistance, please do not hesitate to call me at 326- 3979. Sincerely, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm BAKERSFIELD FIRE DEPARTMENT June 30, 1998 Lloyd Childers Freeway Liquors 2030 E. Brundage Lane F~;; c,1~ Bakersfield, CA 933 87-0097 MICHAEL R. KELLY RE: 2101 'H' Street Bakersfield, CA 93~1 ( )326-3 4 UNDERGROUND STORAGE TANK UPDATE FAX (805) 395-1349 SUPPI~ON SEll'VICES 2101 'H' Street Bakersfield, CA 93301 Dear Underground Storage Tank Owner: (805) 326-3941 FAX (805) 395-1349 The City of Bakersfield and Kern County Environmental Health will hold ~'w~moN SEmC~S a Underground Storage Tank Workshop. 1715 Chester Ave. Bakersfield, CA 93301 (805) 326-3951 This will be the final opportunity, before the December 22, 1998 deadline, FAX (805)326-0576 to ask questions regarding upgrade, removals, financing, and other related ENVII[~3NMENTAL SEWICE$ requirements. I 715 Chester Ave. Bakorsfield, CA93301 The workshop will be held on Friday, July 17, 1998, from 8:00 a.m. - (805) 326-3979 FAX (805)326-0576 12:00 Noon. The location will be the Kern County Environmental Health Services Department, 2700 "M" Street, First Floor Conference Room. I'iL~NING DIVISION 5642 Victor Street 8aker~eld, CA 93308 Enclosed is a registration form. Please fill out and mail or fax before the (80,5) 399-4697 FAX C805) 399-5763 registration deadline, July 17, 1998. I look forward to seeing you there. Sincerely, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure cc: Ralph Huey, Director, Office of Environmental Services ~TATE OF CAI. JFO~MA ,5'fATE ~VA'tF. It IIIE:~OUgGE$ CONTROL BO4RO CERTIFICATION OF COMPLIANCE ' " .', I=OR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEr'~ARATE FORM FOR EACH TANK SYETEM I. SITE LOCATION U II. INSTALLATION (mark a.[ ~hat apply): ,~he installer has bean certified by the tank and pipir~g manulacturers. ~ The insta[lation has been inspected and cart!fled by a registered professional engineer. F---.__;.~ T~e instal:at:or~ r~as been inspected and appraved by the implementing agency. ,1~ work listec on lhe manufacturer's !ns!al!etlon checklist has been completed. e installation'~'~',..,~n[ractor r, as been certified ct licensed by the Contractors State License Board. ~-"~_ Another method ws$ used as allowed by the impiementing agency. (Please specily.) Iil. OATH I certify that the information provided is true Io the :~est of my belief and knowledge. LOCAL AGENCY USc. ONLY ,STATE CodNT~ # JI~I-'IISOICTION, FACILITY # TN~K ~ TANK I.D. ~ [ f ' I ~.~ ~.--L ;o4u C ~7~:~ THIS FORM ML:ST BE ACCOMPANIED BY P~aMIT APPL[CAT~N FCR~ A & B UNLESS THEY HA~E BEEN FiL~ PREV;OUSLY F~O~SC7 - STA~ WATER RESOUR~S CONTROL UNDERGROUND STORAGE TANK PERMIT APPLICATION . FORM B - ~L~E A S~ARATE FORM FOR ~CH T~NK S~ ~ OR FA~ NA~ ~ TANK 15 A. SYSTEM 2 s~ w~ - ~ 4 s~v ~TA~ENT ~A~O TA~ ~ ~ ~a " ~ SPLL ~OVERRLL SPI~ CONTA.~ ~T~O ~AR} ~ ~ O~LLPR~ E~MENT~T~ ~ ~V. PIPING INFORMA~ON c~ A F~EGR~O~ U ,~~O.~mlFA~C~E :-' ~ S~M~PE A U 1 Suc~ A~2 PR~E A U 3 G~V;~ A U ~ ~ - B. ~N~RU~ION X U t S~LE WA~ A(U/2 ~ WA~ 'A U 3 L~N~ T~ X C. ~IALANO A U ~ ~L A U 2 STA~SSS~ A U 3 ~L~O~A U 4 V. TANK LEAK D~E~ION VL TANK CLOSURE INFORMA~ON ~lS ~RM HAS SEEN COMPL~D UNDER PE~AL~F PERJURY, AND TO ~EST ~ ~ ~~ IS ~UE ~D ~T L~AL AG ~CY USE ONLY T~ S~ I.o. ~U~E~ ~ COM~OS~O OF T~E FOU~ ~UM~RS C~ ~ JURISD~TION a FAC[~ a . T~K ~oR~ s ff-g,I THIS FORM ~ST 8E ACCO~IED BY A PERU~ ~PUCATION. FORM A, UN~ A CURRE~ ~M A ~ ~ F~, /,,~'~ ,~,b 10/22/97 14:07 '~S05 326 0575 [l}.'l) H,~/, ,'dAT DIV ~002 STA~ WATER ~ESOUR~ CONTROL UNDERGROUND STORAGE TANK PERMIT APPDCATION - FORM ~ - ~L~E A S~A~ATE FORM FOR ~CH TANK ~ OR FA~ NA~ ~E TANK iS IN~: '" {";' ' L TANK D~CRI~[O~ cou~,~T~.s- :..:{~:~;,.,::~, , .. ~ ~3 TANK L O. s ~ 8, ~NUF~R~ '. '~.:~:.:~'.: ."' fl. TANK CO~E~ ~ Is MA~O.~PLE~ITEM C. ":;ttC;4:'~--..-:.. ' . , -' " "~ ' -- -'.'. ':~:.",, "~:-.'r:. :" [ ~PE OF ~ , ~ w~ · ~ ~ s,~ w~ w~ ~nm u~. ' ',.,,~;)-'. A. · . . './: :.?:.~,-~..' ,, . ... , - . :,"}::~'::;;~::.':~:'~ ~ [ E sPLL~ OVEfl~LL SPILL CONTAa~NT ~T~O ~AR) O~LL PR~ :':.: '~'- .... :..~: -;. ~ ....... ..... , , ,, ':,':~':'.~:~V.'TANK LEAK D~E~ION ' ,:.'' . '.. ., .:'::,:'/ ~)~ / _~ ~ ; /, ~.~.~,~~ ~1 '~<? '- ~ '-~ / '-:,'}~'?Lt"., , '1 ~s~e , ~':~" , / / '~'- ~ / ...--- · ~ ~z,~r ~ ~-~"' ~'~~~~ O~ · JURISDICTION · PAG~ ~ TANK ~ '..:'('~ ~ ',~" THIS FOfl~ ~ST BE ACCOMP~IED BY A ~ER~ ~DOATIOfl - FOfl~ A, UN~ A CUflflE~ ~ A ~ ~ F~, ' :' ,,~.~ ..FO~U e ~.,~ , ,/-~ .,t~~' 10/22/97 14:07 '~ 326 0576 Ill:l) IIAZ .XAT Plk' ~002 sr~ W~TER a~soua~s CONTaOL ~O UNDEaGaOUNO STOa~GE TINK PERglT ~PPLIC~TION - FORM -- - ~L~E l S~AR/TE FORM FOR ~CH TANK ~l OR FA~ NA~ ~E TANK 15 IN~: 8. ':;?j.:.~: ' .:'.',.-::::,'}). L~AL AG ~CY USE ONLY T~ STATE LO. NUMBER ~ COMPOSED OF THE FOUR NUMfER5 BELOW , . C~ ~ JURiSdICTION x ._ FACL~ a. T~K * · , "'~.? ,'FOnU a C.g, THIS FORM ~ST BE ACCOUP~IED BY A PERM~ ~PUCATION · FORM A, UN~ A CURRE~ ~M A ~ g~ F~. : ';.:;. ' ~ .CTATE OF CAUF0,r~,~A STATE WATER RESOURCES CONTROL UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORM B i ~:::' ' . 11. TANK CONTENTS ,F A-' '$ &IAFU(ED. COMPL ~l~glrEMc· -- U~..E. AO~D t'& T"YPE OF [] ! DOLIB4J~ WALL ' [] 3 SINGLE WALl. WffH EX'rE,q~)R LINER" F""I' . SYSTEM [] 2 ,.~IN<~,.~ WAJ. L [] 4 SE. CO/',~OARY CCNTA~¥MENT (1]Ab'I..TEDTA/,,~~ 'E~ .. , :::~:?~'.' i;.l' E; SP£L AND OVERFILL StaLL CONTA~4MENT ~<STALLEO (YEAR) -- OVERIqLL PR~IZ~ EOU]PMENT I~3TALLED (YGAR) ... ' ":' :'. :' )'.:: X'."' ._.. ...... :':?!~0".. a (7.;,) THIS FOFlU ~,~ST BE ACCOUPANIEO 8Y A PERUrr AppUcATION· FORU A, UNLESS A CUR A t0/22/97 14:08 ~"305 326 0576 I~1:1) IIAZ MAT DIV [~003 STITE WI~ ~ESOU~CES CO~0L UNDERGROUND STORAGE TANK PERMIT APPLICA ON -'FORM A I. FACI~ffE INFOR~N & ADDR~S- (MU~ BE ~MPL~ED) Il. PROPE~ O~R IN~R~N · ~UST BE COMPL~D) IlL TANK OWNER INFORMATION- (MUST BE COMPLIED) I V. LEGAL NOTIFICA~ON 4NO BILUNG ADDRESS Lega ~::,fi~fi~ ~d billi~ wi~ ~ s~ Io lhe l~k omer m~s ~ I ~ II i ~. THiS FO~ ~ ~EN ~L ETED~NDER P~AL ~ ~ PE~'URY. ANO TO THE 8EST ~ ~ KNEE, IS ~ ~O LOCAL AG~CY ff~E ONLY ~ ,. LCCAT~N C~E . ~L CENTS TRACT ~ - ~N~ :SUPV~OR - O~T ~ · ~ T~9 FORM M~ BE A~OUPANIED BY AT LEA~ (I) OR ~AE PERMff APPL~A~N · FORM ~, U~ESS ~ IS A C~NGE OF 9~ ~ON ONLY. =ORM A ,,'L 10/22/.97 14:07 9505 326 0576 BFD ttAZ XAT " STA~ WAT~ RESORTS CONTROL ~O UNDERGROUND STORAGE TANK PERMIT APPUCATION - FORM ~. - ~L~E A S~AflATE FORM FOR ~CH TANK UN~D SYSTEa ~ 2 S~ W~ ~ 4 S~Y ~TA~ENT ~A~D TA~ UHI~ E SPLL ~ OVEflRLL spoil co~ ~T~D ~AR) O~LL PR~ ~ S~M~PE A U 1 SUC~ A ~ 2 PR~E k U 3 G~V~ 8. ~N~RU~ION A U ~ S~LEWA~ A~2 ~W~ 'A U 3 L~N~T~ A U ~ ~ C. ~IALAND A U ~ ~L A U 2 STA~SSS~ A U ~ ~~O~A U ~ROSION A u S ~ A U e ~ A U 7 ~A~ A U 8 ~ ~ V. TANK LEAK O~E~IO" VL TANK CLOSURE INFO~MA~ON L~L AG ~CY USE ONLY T~ STATE LD. ~U~E~ · COUPOSED O~ T,E FO~ NUMBERS BELO~ C~ · JURISD~TION · FAC[~ ~ T~K BAKERSFIELD FIRE DEPARTMENT May 31, 1998 Lloyd Childers Freeway Liquors FIRE CHIEF 2030 E. Lane MICHAEL g. KELLY t~mnaage Bakersfield, CA 93307 ADMINIS/P. ATIVE SERVICES 2101 'H' Street Bake~fleld, CA 93301 (805) 326-3941 FAX (805) 395-1349 UNDERGROUND STORAGE TANK UPDATE SUPPRESSION SERVICES 2101 'H' Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 Dear Underground Storage Tank Owner: PREVENTION SERVICES 1715 Chester Ave. The City of Bakersfield wishes to congratulate those tank owners who Bakersfield, CA 93301 {805) 326-3951 have upgraded, removed or replaced their tanks in the first quarter Of 1998. This FAX (805) 326-0576 ' '." office is expecting an even bigger second quarter result. This commitment, has ENVlRONMENTALSERVlCES helped this office achieve a 75% compliance average for the.underground storage 1715 Chester Ave. tanks within the City. This is a very "good start". Bakersfield, CA 93,301 (805] 326-3979 FAX (805)326-0576 For the benefit of those who have not yet upgraded, the City of Bakersfield and Kern County Environmental Health, will conduct a Underground TRAINING DIVISION 5642 Victor Street Storage Tank Workshop scheduled for Friday, July 17, 1998, from 8:00 a.m. - 12 Bakersfield, CA 93308 (805) 399-4697 noon. Look for our June letter for more details. 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 SBU/dm cc: Ralph Huey, Director BAKERSFIELD FIRE DEPARTMENT February 24, 1998 Mr. Lloyd Childers Freeway Liquors 2030 E. Brundage Ln FII~CHIEF Bakersfield, CA 93307 MICHAEL R. KELLY a,. avEsav m UNDERGROUND STORAGE TANK UPDATE 2101 'H' Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 Dear Underground Storage Tank Owner: SUPPRESSION SERVICES The City of Bakersfield has some exciting news regarding loan monies, which has just 2101 'H' Stroot become available through the Small Business Loan Association (SBA). Bakersfield, CA 93,301 (805) 326-3941 FAX (805) 395-1349 Pollution Control loans, thru the SBA, are intended to provide loan quarantees to eligible small businesses for the financing of planning, design, or installation of pollution prevention PREVENTION SERVICES 1715 Chester Ave. controls, which includes underground storage tank facilities. Bakersfield, CA 93,301 (805) 326-3951 FAX(805) 326-0576 The vast majority of businesses are eligible for financial assistance from the SBA. The SBA defines an eligible small business as one that is independently owned and operated and not ENVIRONMENTAL SEEVICES dominant in its field of operation. For those applicants that meet the SBA's credit eligibility 1715 Chester Ave. standards, the agency can quaranty up to eighty percent (80%) of loans of $100,000. Seventy five Bakersfield, CA 93301 (805) 326-3979 percent (75%) of loans above $100,000. Lynn Knutson, Chief of Finance for the SBA says, "If FAX (805) 326-0576 customers apply immediately, and meet the requirements, funding is available". TInNInG DI¥1$1ON The City of Bakersfield hopes all of our underground storage tank owners take advantage 5642 Victor Street Bakersfield, CA93308 of this opportunity. For more information on SBA, Pollution Control Loans, please call or write to: (805) 399-4697 FAX (80,5) 3W-$763 Lynn Knutson, Chief Financial Officer Small Business Loan Association 2719 North Air Fresno Drive, Suite 200 Fresno, CA 93727 Phone # (209) 487-5785, Ext 130 Don't delay, start today!!! Sincerely, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services cc: Ralph Huey BAKERSFIELD FIRE DEPARTMENT February 13, 1998 FIRE CHIEF MICHAELR. KELLY Freeway Liquor Store 2030 East Brundage Lane ~M~N,Sn~.v~smacra Bakersfield, CA 93307 2101 'H' Street Bake~'fleld, CA 93301 (805) 326-3941 FAX (805) 395-1349 s~ma~o~ s~mc~ RE: "Hold Open Devices" on Fuel Dispensers 2101 'H° Street Bakersfield, CA 93301 (~) 32~-3941 Dear Underground Storage Tank Owner: FAX (805) 395-1349 ~'w~no~ s~mc~s The Bakersfield City Fire Department will commence with our annual 1715 Chester Ave. Underground Storage Tank Inspection Program within the next 2 weeks. Bakersfield, CA 93301 (805) 326-3951 FAX (805) 326-0~76 The Bakersfield City Fire Department recently changed its City Ordinance mwmNMEm~Sa~w-ra concerning "hold open devices" on fuel dispensers. The Bakersfield City Fire 1715 Chester Ave. Department now requires that "hold open devices" be installed on all fuel Bake~fleld0 CA 93301 dispensers. The new ordinance conforms to the State of Califomia guidelines. (805) 326-3979 FAX (805) 326-0576 The Bakersfield Fire Department apologies for any inconvenience this TRAINING DIVISION 5642 Victor Street may cause you. Bakersfield, CA 93308 (805) 399-4697 F~X(~) 3W-S76a Should you have any questions, please feel free to contact me at 326-3979. Sincerely, Steve Underwood Underground Storage Tank Inspector cc: Ralph Huey BAKERSFIELD FIRE DEPARTMENT January 27, 1998 Mr. Lloyd Childers FI~ CHIEF MICHAEL R. KELLY Freeway Liquors 2030 E. Brundage Lane ADMINISTi~J1VE SERVICES Bakersfield, CA 93307 2101 'H' Street Bakersfield, CA 93301 (805) 326-3941 rAx c )3 -laa UNDERGROUND STORAGE TANK UPDATE SUPI~ESSION SERVICES 2101 'H'Street , Dear Mr. Childers: Bakersfield, CA 93~1 (805) 326-3941 tAX (805)395-1349 The City of Bakersfield wishes to congratulate those tank owners who have upgraded, removed or replaced their tanks in the month of January. During ~o. SEmCES the month of January, our office had six sites (14 tanks) which are now in 1715 Chester Ave. Bake~elcl, CA 93301 compliance. This is a very big "first step". (805) 326-3951 FAX (805) 326-0676 For those who have not yet upgraded, I would like to share some thoughts ENVIRONMENTALSERVlCES on why it is so important to act right away: 1715 Chester Ave. Bakersfield, CA 93,301 C805) 326-3979 1. Licensed contractors are booking up fast, in some cases, up FAX (805) 326-0576 to three months in advance. TRAINING DIVISION 2. Supplies (pumps, dispensers, leak detection equipment) 56~2 Victor Street may be scarce. Bakersfield, CA 93,308 C805) 399-4697 3. The cost for upgrading or removing could go up as demand tax c~) 3~-s76a increases. 4. Assembly Bill 1491 will ban fuel deliveries after January 1999 to non-upgraded owners. The good news, is there is still time!!! If there is anything this office can do to assist you in your planning, do not hesitate to call. Sincerely, Ralph ~.Hub~~ Hazardous Materials Coordinator Office of Environmental Services cc: Kirk Blair, Assistant Chief BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION G Street, Bakersfield, CA 93301 (805) 326-3979 TANK# VOLUME CONTENTS N~E OF TESTER~C~ STATE REGIST~TION ******* C U S T O M E R D A T A ******** JOB NUMBER : 000232 CUSTOMER (COMPANY NAME) : ARCO CUSTOMER CONTACT(LAST, FIRST): ADDRESS - LINE 1 : 2030 E. BRUNDAGE ADDRESS - LINE 2 : CITY, STATE : BAKERSFIELD, CA. ZIP CODE (XXXXX-XXXX) : PHONE NUMBER (XXX)XXX-XXXX : ******* C O M M E N T L I N E S ******* ******* S I T E D A T A ******** SITE NAME (COMPANY NAME) : ARCO SITE CONTACT(LAST, FIRST) : ADDRESS - LINE 1 : 2030 E. BRUNDAGE ADDRESS - LINE 2 : CITY, STATE : BAKERSFIELD, CA. ZIP CODE (XXXXX-XXXX) : PHONE NUMBER (XXX)XXX-XXXX : GROUND WATER LEVEL (FT) : 0 NUMBER OF TANKS : 1 LENGTH OF PRE-TEST (MIN) : 30 LENGTH OF TEST (MIN) : 180 ******* T A N K D A T A ******** TANK NO. TANK NO. TANK NO. TANK NO. 1 2 3 4 TANK DIAMETER (IN) 95 LENGTH (FT) 32.59 VOLUME (GAL) 12000 TYPE ST FUEL LEVEL (IN) 94.75 FUEL TYPE REG UNLD dVOL/dy (GAL/IN) 16.47 CALIBRATION ROD DISTANCE 1 10.65625 2 26.95313 3 41.93750 4 56.93750 5 74.93750 INVOICE #LA000232 TEST DATE: 09/15/97 REDWINE TESTING SVC., INC. P.O. BOX 1567 BAKERSFIELD, CA. 93302 TANK STATUS EVALUATION REPORT ***** CUSTOMER DATA ***** ***** SITE DATA ***** ARCO ARCO 2030 E. BRUNDAGE 2030 E. BRUNDAGE BAKERSFIELD, CA. BAKERSFIELD, CA. CONTACT: CONTACT: PHONE #: PHONE #: ***** COMMENT LINES ***** 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: REG UNLEADED TYPE: STEEL RATE: .000663 G.P.H. GAIN TANK IS TIGHT. OPE~TOR: ~ ~ SIGNATURE INVOICE #LA000232 TEST DATE: 09/15/97 REDWINE TESTING SVC., INC. P.O. BOX 1567 BAKERSFIELD, CA. 93302 TANK STATUS REPORT -- ULLAGE TEST ***** CUSTOMER DATA ***** ***** SITE DATA ***** ARCO ARCO 2030 E. BRUNDAGE 2030 E. BRUNDAGE BAKERSFIELD, CA. BAKERSFIELD, CA. CONTACT: CONTACT: PHONE #: PHONE #: ***** COMMENT LINES ***** 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: REG UNLEADED TYPE: STEEL SN: .31 TANK IS TIGHT. OPERATOR: S I GNATURE: -~.~-. ~-~-~-J--'~J:~ / ******* C U S T O M E R D A T A ******** JOB NUMBER : 000219 CUSTOMER (COMPANY NAME) : ARCO CUSTOMER CONTACT(LAST, FIRST): ADDRESS - LINE 1 : 2030 E.BRUNDAGE ADDRESS - LINE 2 : CITY, STATE : BAKERSFIELD, CA. ZIP CODE (XXXXX-XXXX) : PHONE NUMBER (XXX)XXX-XXXX : ******* C O M M E N T L I N E S ******* ******* S I T E D A T A ******** SITE NAME (COMPANY NAME) : ARCO SITE CONTACT(LAST, FIRST) : ADDRESS - LINE 1 : 2030 E.BRUNDAGE ADDRESS - LINE 2 : CITY, STATE : BAKERSFIELD, CA. ZIP CODE (XXXXX-XXXX) : PHONE NUMBER (XXX)XXX-XXXX : GROUND WATER LEVEL (FT) : 0 NUMBER OF TANKS : 2 LENGTH OF PRE-TEST (MIN) : 30 LENGTH OF TEST (MIN) : 180 ******* T A N K D A T A *~****** TANK NO. TANK NO. TANK NO. TANK NO. 1 2 3 4 TANK DIAMETER (IN) 95 95 LENGTH (FT) 32.59 27.16 VOLUME (GAL) 12000 10000 TYPE ST ~ST FUEL LEVEL (IN) 89 81 FUEL TYPE PLS UNLD SUP UNLD dVOL/dy (GAL/IN) 78.24 95.01 CALIBRATION ROD DISTANCE 1 10.65625 2 26.95313 3 41.93750 4 56.93750 5 74.93750 INVOICE #LA000219 TEST DATE: 08/31/97 REDWINE TESTING SVC., INC. P.O. BOX 1567 BAKERSFIELD, CA. 93302 TANK STATUS EVALUATION REPORT ***** CUSTOMER DATA ***** ***** SITE DATA ***** ARCO ARCO 2030 E.BRUNDAGE 2030 E.BRUNDAGE BAKERSFIELD, CA. BAKERSFIELD, CA. CONTACT: CONTACT: PHONE #: PHONE #: ***** COMMENT LINES ***** 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: PLUS UNLEADED TYPE: STEEL RATE: .002980 G.P.H. GAIN TANK IS TIGHT. TANK #2: SUPER UNLEADED TYPE: STEEL RATE: .026409 G.P.H. LOSS TANK IS TIGHT. ~VV~ OPE~TOR: ~ D~ SIGNATURE: INVOICE #LA000219 TEST DATE: 08/31/97 REDWINE TESTING SVC., INC. P.O. BOX 1567 BAKERSFIELD, CA. 93302 TANK STATUS REPORT -- ULLAGE TEST ***** CUSTOMER DATA ***** ***** SITE DATA ***** ARCO ARCO 2140 E.BRUNDAGE 2140 E.BRUNDAGE BAKERSFIELD, CA. BAKERSFIELD, CA. CONTACT: CONTACT: PHONE #: PHONE #: ***** COMMENT LINES ***** 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: PLUS UNLEADED TYPE: STEEL SN: -.02 TANK IS TIGHT. TANK #2: SUPER UNLEADED TYPE: STEEL SN: .41 TANK IS TIGHT ~A&4. ' ~.~ ~ON~.~.~ ' l REDW'INE TESTING SERVICES. INC. P.O. BOX 1567 AES PLT - IOOR BAKERSFIELD. CA 93302 · (80,3-) 3'z6-04~ THE CONVERSION CONSTANT IS FOUND BY: (60 MIN/HR) J (3790/MIb'GAL) = 0.0158311 (MIN/HR) (GAIJMIN) ~ the volume dilefential by lhe lesl lime (15 minules) and rnuJiply by 0.01,~311. which will convefl the volume cJet~-,nlial fi.om millers per rrtJ't~e to gaJons per ho~. The com.,emio~ col~tanl causes the miile~s ~ rrmules lo cancel out. START VOL END. VOL TEST VOL DIFF. PRODUCT TIME PSI GPH GAIN/LOSS PASS FAIL (ML} (ML) (MLI (~9(.,'a /2:5o S¢ /7o /~J- 5- ~.o0.¢ ,,,.- COMMENTS: START VOL END VOL TEST VOL DIFF. PRODUCT TIME 1:51 GPH GAIN/LOSS PASS FAIL (ML) (ML) (ML) a/2u~ i~:~.~ ~-o /~¢ /~y 2_/ ~-o~/ ~ / COMMENT~: START VOL END VOL TEST VOL DIFF. :~cJODUCT TIME PSI GPH GAIN/LOSS PASS FAIL (MU1 (ME) (,MU) COMMENTS: UNDERGROUND STORAGE TANi ISPECTION Bakersfield Fire Dept. Office of Environmental Services Bakersfield, CA 93301 FACILITY NAME ~'rceu~au /-~o0~ .5 BUSINESS I.D. No. 215-000 1.3'.~ / FACILI~ADDRESS 3030 ~. /~~ ~,~ CI~ ~(~ ZIPCODE FACILI~ PHONE No. ~ - 0~ ~ ~ ~ INSPECTION DATE Pr~.a Pr~u~ Pr~ua TIME IN TIME OUT ~r¢¢~ d~ Insl Date Inst Date Inst INSPECTION ~PE: t ~O [ q¢O ROUTINE ~ FOLLOW-UP siz. siz. /~1~o i0 ~o /~, REQUIREMENTS yes no n/a yes no ~a y~ no ~a For s A · S Sub i. lb. Form C Su~i~ lc. O~rating F~s Paid ld. State Surcharge Paid le, Statement of Financial Res~nsibili~ Submiff~ lf. Wriffen Contract Exists ~een Owner & O~mtor to Operate UST 2a. Valid O~rating Permit 2b. Approved Wriffen Routine Monitoring Pr~edure ~ ~ 2c, Unauthoriz~ Release Res~n~ Plan ~~ 3a. Tank Integrity Test in Last 12 Months f( 15 {q 7 ~1~ ~ ~ 3b. Pressurized Piping Integrity Test in Last 12 Months ~ ~e~ ' ~ ~ ~. Suction Piping Tightness Test in Last 3 Years ~ ~ ~. Gmvi~ Flow Piping Tightness Test in Last 2 Yearn ~ ~, Test Results Submiff~ Within ~ Days 3f, Daily ~sual Monitoring of Suction Pr~uct Piping ~. Manual Invento~ R~onciliation Each Month ~. Annual Invento~ R~onciliation Statement Submiffed ~. Meters Calibrat~ Annually 5, Weekly Manual Tank Gauging R~ords for Small Tanks 6. Monthly Statistical Invento~ Reconciliation Results 7. Monthly Automatic Tank Gauging Results 8. Ground Water Monitoring 9. Vapor Monitoring 10. Continuous Interstitial Monitoring for Double-Walled Tanks 11. Mechanical Line Leak Detectors 12. El~tronic Line Leak Det~tors 13. Continuous Piping Monitoring in Sum~ 14. Automatic Pump Shutoff Capabili~ 15. Annual Maintenance/Calibration of Leak Detection Equipment 16. Leak Det~tion Equipment and Test Methods Listed in LG-~13 Series 17. Wri~en Records Maintained on Site 18. Rended Changes in Usage/Conditions to Operating/Monitoring Procedures of UST System Within ~ Days 19. RepoSed Unauthorized Release Within 24 Hours 20. Approved UST S~tem Repairs and Upgrades 21. Records Showing Cathodic Protection Ins~tion 22. Secured Monitoring Wells 23. Drop Tu~ RE-INSPECTION DaTE -- RECEIVED BY: ~ -~, FD 1~9 (rev. 9/~) WRITTEN MONITORING PROCEDURES UNDERGROUND STORAGE TANK MONITORING PROGRAM This momtormg program must be kept at the UST location at all ,m~. The information on this monitoring program are conditions of the operating permit. The permit holder must notify the Office of Environmental Services within 30 days of any changes to the monitoring procedures, un/ess required to obtain approval before m~icing the change. Required by Sections 2632(d) and 2641(h) CCR. A. Describe the frequency of~performin~g the moni~t,~,ring: Piping B. What methods and equipment, identified by name and model will be used for perfoming the moni.t~___g: · v/-- ',,-~ ~~,./" 9~"-._Z~/~-" C. Describe the location(s) where the monitoring will be performed (fadlity plot plan should be attach~ed): ,. .-~ /Jr ~ /~ ~Z/ Mx'// ~~ )- ..~x' ~-,~_,?' ×~/4_ D. List the name(s) and title(s) of the people responsible for p~rforming the mom'toring and~orc~aint aining~h~,gqu~p m/gnt: E. ReportinKFqrr~at for moAnitoring: Piping' '/ ..... , / F. Describe the preventive maintenance schedule for the monitoring equipment. Note: Maintenance must be in accordance with_the manufacturer's maintenance schedule but a~t less th,a ever 12 monm. ///5~ ~/~--./e ,~75-,~,o'?,-- //'Y~,, / / /~,.-., ,,/,-' / . ~ v ,, f ! - - t t -2 ~ ~ ' -- G. Describe the training necefiagxy fo~ the opera~on,_,of/US~..sy~em, including piping/and the · . · -/ · _ . //-_ EMERGENCY RESPONSE PLAN UNDERGROUND STORAGE TANK MONITORING PROGRAM This monitoring program must be kept at the UST location at all trines. The information on this momtoring program are ~onditions of the operating permit. The permit holder muaX notify the Office of Environmental Services within 30 days of any changes to the monitoring procedures, unless reqmred to obtain approval before making the change. Required by. Sections 2632(d) and 2641(h) CCtL Facility Name /~.et- ~_.- ~4/~. ,~,?.,.~ 1. If an unauthorized release occurs, how will the hazardous substance be cleahed up? Note: If released hazardous substances reach the environment, increase the fire or explosion haTard, are not cleaned up from the secondary comainment within 8 hours, or deteriorate the secondary containmem, then the Off:me of Enviro ,nn~,ental Services must be notified · · //4',// / :- - / 2. I~;escribe the proposed methods and equipment to be used £or removing and properly disposing of any hazardous substance. 3. Describe the location and availability of the required cleanup equipment in item 2 above. 4. Describe the oaa/ntenan~ schedule £or the cle4nup equipment:, ("/D~cz 5. List the name(s) and title(s) of the persorl(-s)s'esponsiblef.0r/au, th, grizing any wg)~_ . necessary under the response plan: .// / /: HAZARDOUS MATERIALS INSPEt )N [kerst~eld l~i~e Dept. OF ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 Date Completed ?/it~/¢ 7 Business Namei Location: ~o3~ ~, /~n~/~fc Amc, Business Identification No. 215-000 I,-3~1 (Top of Business Plan) Station No. Shift Inspector Arrival Time: Departure Time: Inspection Time: Ad te Inadequate Adeq~te Inadequate Address Visable eli~ I-I Emergency Procedures Post(dL~ r'l Correct Occupancy I~ [] Containers Propedy Labl(d (2~ [] Verification of Inventory Materials ~ i'l Comments: Verification of Quantities I~/ r'l Verification of Location ~ r'l Verification of Facility Diagra: n Proper Segregation of Material O~' [] Housekeepiqg I~__ [] F~re Protection El Comments: Electrical ~ [] Comments: Verification of MSDS Availablity [] [] Number of Employees: ¢.! UST Monitoring Progra,m ~ [] Comments: / Verification of Haz Mat Training~ [] Permits ~ [] Comments: Spill ContrOl ~ [] .I Hold Open Device ~ [] Verification of Hazardous Waste EPA No. Abbatement Supplies and Procedures ~ [] P .... roper waste u~sposa Comments: Secondary Containment ~ [] Secudly ~ [] Special Hazards Associated with this Facility: Violations: ~ k L.O£,~.~ ~ All Items O.K ~ '~ Business OwnedManager PRINT NAME SIGNATURE Correction Needed [] ~ White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy ,*-, t.l_ ~ =-TATE OF CALIFORNIA '"~O WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION RM A ~ COMPLETE THIS FORM FOR EACH FACIMTY/SrrE MARK ONLY ~ I NEW PERMIT [] 3 RENEWAL PERMIT ~ 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED SITE ONE ITEM ~-~ ___j 2 iNTERIM PERMIT [~[] 4 AMENDED PERMIT ~ 6 TEMPORARY SITE CLOSURE I. FACiLITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) i NAME OF OPERATOR DBA OR FACILITY NAME ADDRESS ' I NEAREST CROSS STREET PARCEL#(OI~3ORAIJ CiTY NAME ° [ STATE /ZIP CODE SITE PHONE · WITH AREA CODE · ./ BOX TO INDICATE ~ CORPORATION ~ INDIVIDUAl. ~ pN~tNERSHIP Z LOCAL-AGENCY [~ COUNTY-AGENCY r~] STATE-AGi~ICY I---] FEDERAL41,CaENCY D~STRICTS RESERVATION ~ 3 FARM ~ 4 PROCESSOR ~ 5 OTHERI OR TRUST LANDS 131 EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY) - optioaal NIGHTS: NAME (LAST, FIFiST) PHONE · wITH AREA CODE NIGHTS: NAME (LA~T. FIRST) PHONE # WITH AREA CODE II. PROPERTY OWNER INFORMATION-(MUST BE COMPLETED) NAME CARE OF ADDRESS INFORMATION MAILING OR SfREET ADDRESS ~' I~ ~ l~i~m [~ INDIVIDUAL [--] L0C.~L. AGEi~ [~ STATE~ENCY III. TANK OWNER INFORMATION-(MUST BE COMPLETED) NAME OF OWNER j CARE OF ADDRESS INFORMATION I MASL~JG OR~TREET~ADDRESS j ,./ ~x I~rmicam ~ INDtVIO/JAL ~ I.~-AGE~ ~ STATE-AGENCY CITY NAME I STATE ZiP CODE PHONE · wrrH AREA 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 wilt be sent to the tank owner unless box I or II is checked. CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILLING: I. [] IL [] IlL [] THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY I COUNTY # JURliDICTION # FACILITY # LOCATION CODE - OPTIONAL · CENSUS TRACT · - OPTIONAL I SUPVISOR- DISTRICT CODE - OPTIONAl. ! " THIS FORM MUST SE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION - FORM B~ UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. FCR0033A.R2 FORM A (9-90) BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 APPLICATION TO PERFORM A TIGHTNESS TEST FACILIT¥~ ADDRESS ~93D ~s~x~ ~o O~S~TS , ~ ~ 572- ~-0 , ~BER OF T~S TO BE TESTED 5 IS PIPING ~ING TO'BE TESTED TANK# VOLUME . . CONTENTS _ . TEST METHOD AF-.~'~ NAME OF TESTER~ruA, ~;~/,u CERTIFICATION # 5%1%2 STATE REGISTRATION # DATE ~ TIME TEST IS TO BE CONnUCTED DATE SIGNATURE OF APPI~ICANT BAKERSFIELD FIRE DEPARTMENT Juh' 30. 1997 Lloyd Childcrs Frccxvav Liquor Store - FIRECHIEF 203¢) E. Brtmdagc Lane MICHAEL R. KELLY Bakcrsficld. (iA 93307 ,~d~MINl$11~,ll~ SERVlCT~ 2101 'H' 8tl~ot RE: Underground Storagc Tank Compliancc Bakersfield, CA 93301 (805) 326-3941 FAX (~os) 3~1349 Dcar Mr. Childers: SU~ON ~vlcra This officc acknoxx'lcdgcs 3'our cftbrts to obtain a RUST loan with the Vallcv 2101 'H' Strut Bakersfield, CA03301 Small Business Devclopmcnt Corporation. However, this effort docs not relicvc you of (805) 326-3941 rcsponsibility f'or compliance of vonr existing underground storage tank svstcm This FAX (805) 395-1349 ' office has cxtcndcd cvcrv courtesy to your business in delaying cnforccrncnt of currcnt P~Vaunou s~v~cts regulator' rulcs, pending loan approval. Hoxx'cvcr. having received no finn date any time 1715 Choster Ave. $OOI1. ~,'(2 IllLIS[: enforce current rcguJatiOllS. Bakersfield, CA 93301 (805) 326-3951 FAX (805)326-13576 TO avoid rcvocation of your undcrground storagc tank pcrnfit, thc t'olloxvmg correct ohs nmst bc made: ENVIRONMENTAL SERVICES 1715 C~ester Ave. Bakersfield, CA93301 I ) An annual undcrground tank and piping system tightncss test bc (80,5) 326-3979 pcrtbrmcd at your thcilitv. Our rccords indicatc that you have not FAX (805) 326-0576 pcri~brmcd an annual tightness tcst since January 6. 1995. This nuu~ ~v~o~ annual tightness test is a condition of your permit to operate. 5642 Victor Street 2) Submit your annual inventory rcconeiliation statement as Bakersfield, CA 93308 (805) 3~-z~97 rcqui red. FAX (805) 399-5763 3) Sublnit to this officc a xx:rittcn routine tank inonitoril~g plan. 4) Subnut to this office a writtcn spill rcsponsc plan. To avoid additional rcgulatoD' action, you must makc the abovc mcntioncd corrections within 30 days. by Scptcmbcr 2, 1997. I will bc schcduling a compliance mspcction on Scptcmbcr 3. 1997 at I:00 pm. If you bavc any qucstions, plcasc l~cl frcc to contact mc at 326-3c}7t}. Sincerely. S(cvc Undcm'ood Inspcctor SBLi/dln Valley Small Business Development Corp. A Business and Financial Company March 24, 1997 Bakersfield Fire Department: I would like to certify that Mr. Don Childers is in the process of applying for a State RUST loan with Valley Small Business. He has been working with us since the summer of 1996. Due to so'me miss,~communication and structure changes the completion of the application had been ~layetk.. I~ now expect the application to been submitted in the next few weeks. P~'i.f you, have any questions regarding this matter please feel free to call me at 322-7889. Sincerely, Marc Schnaidt Loan Officer/VSBDC 3417 W. SHAW, SUITE 100 ° FRESNO, CALIFORNIA 93711 · (209) 271-9030 · FAX (209) 271-9078 BAKERSFIELD OFFICE: 1706 CHESTER AVE., SUITE 200 · BAKERSFIELD, CALIFORNIA 93301 · (805) 322-7889 · FAX (805) 322-7892 UNDERGRO STORAGE TANK PERMIT APPLICATI(31q- FORM B COMPLETE l SEPARATE FORM FOR EACH TAHK SYSTEM. MARK ONLY -m 1 hEW PERMIT [] 3 RENEWAL PERMIT ;"--'-, ~: CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED ON SITE ONE ITEM ~ 2 INTERIM PERMIT [] 4 AMENDED PERMIT ~ $ TEMPORARY TANK CLOSURE [] 8 TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: I. TANK DESCRIPTION CCMPLE~ ALL ~TEUS - SPECIFY '= UNKNOW~ ~ B..MANUFACTURED By: A. OWNER'S TANK L D. # ~, i D. TANK CAPACITY !N GALLONS: C. DATE INSTALLED (MO/DAY/YEAR) II. TAN K CONTENTS ~F A-~ ,S MARKED. CCMPLETE ITEM C. ~ -- ~aREGULAR ~ 3 DIESEL [] 6 AVIATION GAS A. ~ 1 MOTOR VEHICLE FUEL ~ 4 OIL :L C. ~ UNLEADED ) ] 4 GASAHOL r~l 2 PETROLEUM ~--"-! 80 EMPTY ~ ', PRODUCT ; ~ lb PflEMtUMuNLEADED [] 5 JET FUEL [] 7 METHANOL I [] 3 CHEM,=ALPRODUCT ---~ ~5 UNKNOWN __ 2 WASTE ---;__ 2 LEADED [] 990~ER ~SCmSE ~N ~TEM D. SELOW~i D. IF (A.I) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED C.A. $. ·: IlL TANK CONSTRUCTION MARKCNEITEMONLYINBOXESA.~.ANOC. ANOALLTHATAPPUESINBOXOANDE -~ 1 DOUBLE WALL ~ 3 SINGLE ",';ALL WtTH EXTERIOR LINER ~ 95 UNKNOWN A. TYPE OF ~ SYSTEM ~ 2 SINGLE WALL !_~ 4 SECONDARY CONTAINMENT (VAULTED TANK~ L_~ 99 OTHER -~ 1 8ARE STEEL ~'~ 2 STAINLESS STEEL ~ 3 FIBERGLASS I,~ '4 STEEL CLAD WI FIBERGI.AS~ REINFORCED PLASTIC B. TANK MATERIAL ~ ~ s CONCRETE ~ S POt~:!NYL C~LOmDE ~ ? ALUMINUM ~ ~ mO~ METHANOL COMPA~IBLEW~=RP r---- g5 UNKNOWN ~ 9g OTHER C. INTERIOR ~ s GLO. SS L~N~ ~--] ~ UNUN~ UNING ;S LINING MATERIAL COMPATIBLE WITH 100% uET'HANOL ? 'YES__ O. CORRO$10N-----i 1 POLYETHYLENE WRAP I~ 2 COATING ~7--t 3 V;NYL WRAP ~ 4 FIBERGLASS REINFORCED PLASTIC PROTECTION ~ 5 CAT;~OCICPROTECT:ON ~ 91 i~;O~:E ~ 35 [;NKHOWN ~ gg OTHER E. SPILL AND OVERFILL ?~;'_ 3,?JTA'~,~ENT INSTALLED ('~ E4 ;~ '. E-~;;LL PREVENTION EQUIPMENT INSTALLED (YEAR) IV. PIPING INFORMATION C:RC'~ A IPABOVEGROUNDCR U ,~ LJ~.~ERGROi. IND. BOTN!F ~PPLICABLE A. SYSTEMTYPE A U ~ S~CT[CN A U 2 P.~E$SURE ,~ d 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U ~ S.NGLE ;','ALL A U 2 .'O~JBLE W~LL A U 3 L~ED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U ~ BARE STEEL A U 2 STAINLESS STEEL A U 3 POL'~¥INYL CHLORIDE {PVC)A IJ 4 FIBERGUI.~ PIPE CORROSION A U 5 ALUMINUM A U $ CCNCRETE A U 7 STEEL W/ DOATING A U 8 100% ME3HANOL COMPATIBLEW/FRP PROTECTION A U .3 GALVANIZE~ STEEL A U 1~ ;ATNGC:CP.-XOTECTIQ~I A ~1 ~5 UNKNOWN A U 99 OTHER O. LEAK DETECTION ;-~ .. A~TOMATiC L.NE LEAK DETECTOR ~-- ; ;.:;E TIGHTNESS TEST:,'~G ~-~I 3 MONITORINGINTERSTIT1AL [] 99 OilIER V. TANK LEAK DETECTION j ~ 6 TANK TESTING ;-- 7 ',TERST.T;ALMONITORING _~ 5; ',C~';E --- ~5 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION , ~ SUgSTANCE REk!A~NING ,2ALLCNS i INERT MATERIAL ? THIS FORM HAS BEEN C'~MPLETED UNDER PEA/AL ~' OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE. IS TRUE AND CORRECT I APPLICANTS NAME DATE (PRINTED & $;GNa, TURE) LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER )S C.%lPCSE9 OF THE FOUR F!UMBERS BELOW COUNTY # _'URISDiCT!DN # FACILITY · TANK · J PERMIT NUMSER : PERMIT A~-IOVEC. F,~ DATE . PERMIT EXPIRATION DATE =aRM a ¢7-9~) THIS FORM MUST I3E ACCC]~,IPANIED BY A PERMIT APPLICATIO~ · FORM A. UNLESS A CURRENT FORM A HAS BEEN fiLED. o(l~mm~ STATEWATERRESOURCESCONTROLROARD I iJNDERGR D STORAGE TANK PERMIT APPLICA~N- FORM a COMPLETE A SEPARATE FORM FOR EACH TAHK SYS~ MARK ONLY ~ 1 ~ PERMIT ~ 3 REN~ PERMIT ~ 5 CHANGE OF INFORMATION ~ 7 ~RM~ENTLY CLOSED ON SITE ONE ITEM ~ 2 IN.RIM PERMIT ~ 4 ~ENDED PERMIT ~' 6 TEMPORARY TANK CLOSURE ~ 8 T~ REMOVED DBA OR FAClL~ NAME WHERE TANK IS INSTATED: I. TANK DESCRIPTION cc~.L~ ALL ~TEUS - SP~C~ '~ A. OWNER'S TANK I. D. ~ ; E. MANUFAC~RED C. DA~ INSTALLED (M~AYNEAR) ~ D. TANK CAPACI~ ~N G~LONS: II. TANK CO~E~S ~ A-I iS MARKED. COMPLE~ ITEM C. A. ~ 1 MOTOR VEHICLE FUEL ~ 4 OIL 9. . C. ~ :aREGU~R 3 DIESEL ~ ~ UNLADED ~ 6 AVIATION GAS ~ 2 PETROLEUM ~ ~ EMP~ ~ PRODUCT ; ,~ ~bPREM/UM 4 ~ ~ ~ UNLADED ~ 5 JET'EL ~ 7 M~m~L ~ 3 CHEM~ALPRODUCT ~ 95 UNKNOWN __ 2 WAS~ ; ~ ~ 2 L~DED ~ ~ O~ER ~SCRIBE IN ITEM D. BELOW) O. IF (A.1) IS NOT MARKED. EN~R NAME OF SUBSTANCE STORED C.A.S. ~: I!1. TANK CONSTRUCTION MARK CNE I~M ONLY IN BOXES A. g. ANOC. AND ALL THAT APPUES IN BOX D AND E A. ~PE OF ~ ~ ~UBLE WALL ~ 3 SINGLE WA~ '.'~m~ E~ERIOR L~NER ~ ~ 95 UNK~WN SYSTEM ~ 2 sl~ WALL ~ 4 SECONDARY CONTAINMENT ~VAULTEDTAN~ ~ ~ O~ER ~ I BARESTEEL ~ 2 STA;NLESS S~ ~ 3 FiBERG~S ~ '4 STEELC~DW/FIBE~REINFORCEDPL~TiC B. TANK ~ ~ 5 CO~RE~ ~ 6 POt~'NYL CHLORIDE ~ 7 ALUMINUM ~ 8 1~ ME~A~L ~A~B~W~RP MATERI~ ~ ~ (Prim~Tank) ~ g BRON~ ~ 10 ~L~'AN;~D S~EL i.~ 55 UNKNOWN ~ 9g O~ER ~ 1 RUB~R LINED ~ 2 ~D L;r;~G ~ ~ 3 EPC~ L(NI~ ~ 4 PHE~L~ LINI~ C.I~ERIOR ~ 5 G~ LINING ~ 6 UNLIN~ ~ 95 UNKNOWN ~ 99 O~ER UNING ~ ;s LINING MATER~AL COMPATIBLE WITH 1~. UE~NOL ? 'r'ES ~ ~;O~ D. CORROSION ~ 1 ~LYE~LE~E WRAP ~ 2 CCAT=~G ~ 3 V;NYL WR~ ~ 4 F{BERG~8 REINF~ ~ST~ PRO~ION ~ 5 CAT~OCICPROTECT:ON ~ 91 N~"E ~ ;5 i;NKHOWN ~ 99 O~ER ~ E, SPILL AND OVERFILL ~;LL CC~TA'~,~ENT INSTALLED {~ E4;, '. ~=:LL F~EVE~T]ON EQUIPMENT INSTALLED ~R) IV. PIPING INFORMATION c:ac:~ A iFABOVEGROU~OOa U 'F~h~ERGROUND. BOTH [F APPLICABLE A. SYS~MTYPE A U ~ ~;CTICN A U 2 P=ESS~RE ~ U 3 GRAVI~ A U ~ O~ER B. CONSTRUCTION A U ' S.NGLE WALL A U 2 ~C~LE WaLL ~ U 3 L=~ED TRENCH A U 95 UN~WN A U ~ O~ER C. MA~RIALAND A U ~ SARESTEEL A U 2 STAINLESS S~EL A U 3 POL~INYL CNLORIDE(PVC)A U 4 FIBE~ PIPE CORROSION A U 5 ~UMINUM A U 6 CC~CRETE A U 7 STEEL W/ ~ATING A U 8 1~ ~L ~MRATISLEW/FRP PROTE~ION A U ~ ~LVANI~ STEEL A U l0 C~T~GC:CPROTECTIOH A U ~5 UNKNOWN A U ~ O~ER O. LEAK D~ECTION ~: A, TOMAT,C L.NE LEAK DETECTOR ~ 2 ;.;~E TIGHTNESS T~ST:NG ~ 3 ~NffORINGINTERS~AL ~ ~ O~R V. TANK LEAK DETECTION ....'~ I VISUAL C~ECK ~ ~ '~vE~TC=Y ~ECONCIL[ATICN ~ ~ '.:~EMON~TCR;~G ~ ~ ~ ~UT~MATICTANK~UGING ~ 5 ~UNDWA~RMONITORING ~ 6 TANK TEST;NG ~ ' ',TE~ST.T:~LMONITORING ~ ~: ',c~;~ _~ 95 UNSOWN ~ ~ O~R VI. TANK CLOSURE INFORMATION I. ESTIMATED DATE L~ST USED ~MC CAY/YR~ ~ 2. EST.'J~TE~ CjA~T:~ OF ' '~ S~S-~CE ~EUA~NI~G ~ALLCNS ~ 3. WASiNERTTANKMA~RiALFtLLED WI~? YES THIS FORM HAS BEEN C~MPLETED UNDER PE~AL~' ~F,=ERJURY. AND ~0 THE BEST OF MY KNOWLEDGE, IS ~UE AND CORRECT APPLICANTS NAME DA~ (PRINTED & S~GNATURE) LOCAL AGENCY USE ONLY THE STATE I.D. NIJMBER ~S C;~,IPCEED ~F THE FOUR ~JU~aERS BELOW COUNTY ~ .'UR~SD:CT~CN · FACILI~ = TANK I PERMIT NUMBER ~ PERMIT AF~;OVED 6~ DATE . PERMIT EXPIRAT~N DATE :ORM B (7-91) THIS FORM ~tUST 8E ACCOMPANIED BY A PERUff APPLICATION. FORM A. UNLESS A CURRENT FORM A HAS BE~ R~D. 2TATE OF CALIFCANIA O~J~ STATE WAT~'.RFiESOURCESCONTI:IOLEtOARD I~J iJNDERGR D STORAGE TANK PERMIT APPLICA ~ ~"~N - FORM B COMPLETE l SEPARATE FORM FOR EACH TAHK MARK ONLY ~ 1 [~ PERMIT ~ 3 REN~ PERMIT ~ 5 CHANGE OF iNFORMATION ~ 7 ~RM~ENTLY CLOUD ON SITE ONEITEM ~ 2 IN.RIM PERMIT ~ 4 ~ENDED PERMIT , 6 TEMPORARY TANK CLOSURE ~ 8 T~ REMOVED DBA OR FAClL~ NAME WHERE TANK IS INSTATED: ' ' I. TANK DESCRIPTION cC~aPL~ ALL ~TEMS - SP~C~,V '~ A. OWNER'S TANK I. D. ~ ; B. MANUFAC~RED C. DA~ INSTALLED(M~AY~EAR) ~, D. TANK CAPACI~ ~N G~LONS: A. ~ 1 MOTOR VEHICLE FUEL --~ 4 OIL ~. __ , C. ~ :aREGU~RuNL~DED 43 ~LDIESEL ~ 6 AVIATION GAS ~ 2 PE~OLEUM ~ ~ EMP~ ~ ~ PRODUCT ; ~ lbPREMIUMuNL~DED ~ 5 JET.EL ~ 7 METHYL ~ 3 CHEM~AL PRODUCT ~~ 95 UNKNOWN ~ 2 WAS~ ; ~ ~ 2 L~DED ~ ~ O~ER ~RIBE IN ITEM D. '8ELOW~ O. IF (A. 1) IS NOT MARKED, EN~R NAME OF SUBSTA~E STORED C.A.S. ~: III. TANK CONSTRUCTION UA,KCNEI~MONLYINBOXESA.~.ANOC. ANOALLT~ATAPPUESINBOXOANOE ~ 1 ~UBLE WALL ~ 3 SINGLE WA~ '.%'t~ E~ERIOR LINER ~ 95 UNK~WN A. ~PE OF ~ ~ SYSTEM ~ 2 SING~ WALL ~ 4 SECONDARY CCNTAINMENT (VAULTEO TAN~ ~ ~ O~ER ~ 1 8ARE STOL ~ 2 STA;NLESS S~ ~ 3 FIBERG~S ~ '4 STEEL C~D WI FIBE~ REIN~ED PL~TIC 8. T~K MATERI~ ~ 5 CONC~E~ ~ S POt~'~NYL CaLO~lOE ~ 7 A~UU,NUU ~ e ~ UE~L (Pri~Tank) ~ 9 8RON~ ~ 10 ~L~*ANI~D S~EL ~i~ ~5 UNKNOWN ~ 9g O~ER ~ ~ RUB~R LINED ~ 2 ~D L;N~G ~ 3 EPO~ LiNI~ ~ 4 PHE~L~ LINI~ C. INTER~R ~ 5 G~ LINI~ ~ 6 UNLINED ~ ~ g5 UNKNOWN ~ 99 O~ER UNING :s LINING MATERIAL CCMPATIBLE WITH 1~. ktE~HANOL ? YES ~ ~;O~ D. CORROSlON~ ~ 1 POLYE~YLENE WRAP ~ 2 CCAT;NG ~ ~ ~ V:NYL WR~ ~ 4 FIBERG~S REINF~ ~ST~ PRO~ION ~ 5 CAT~O~ICPROTECT:ON ~ gl ~:C"E ~ ~5 i;NKNOWN ~ 99 O~ER E. SPILL AND OVERFILL EP;LL CGNTA'~'MENTINSTALLED (~EA;' ' EA=;LLF~EVENTIONEQUIPMENTINST~D~~R) IV. PIPING INFORMATION c;~c~ A IPAaOVEGROUNDOa U ,FU~.CE~GROU~:D. BOT~ ~PPL~CA8LE A. SYS~MTYPE A U ~ S~CTICN A U 2 P=ESS~E ~ d 3 G~AVI~ A U ~ O~ER B. CONSTRUCTION A U ~ S.NGLE WALL A U 2 3OUSLE WALL A U 3 LINED TRENCH A U 95 UN~ ~ U ~ O~ER C. MA~RIAL AND A U ~ gARESTEEL A U 2 STAINLESS S~EL A U 3 PO[~INYL ~LORIOE(P~)A U 4 FIBE~ PIPE CORROSION A U 5 ~uMINUM A U 6 CONCRETE A U 7 STEEL WI ~ATING A U 8 1~ ~L ~MPATIB~W~FRP PROTE~ION A U 3 ~LVANI~D STEEL A U ~0 CAT~GO:C~AOTECTIO~I ALI 95 UNK~WN A U ~ O~ER 0. LEAK D~ECT10N ,~'~: A~TOMAT,C L.NE LEAK DETECTOR ~ ~ ~.;~E TIGHTNESS TEST:NG '~ 3 INTERS~AL~N~ORiNG ~ ~ O~R V. TANK LEAK DETECTION ~ ~ 6 TANK TESTING ~ ~ ',TEAST.T:ALMONITORING ~: '.CXE 95 UNK~WN ~ ~ O~R VI. TANK CLOSURE INFORMATION ; SUBSTANCE AEMA~NING :3ALLONS ~ INERTMA~RIAL ? THIS FORM HAS BEEN COMPLETED UNDER PE~/AL ~' OF PERJURY. AND 70 THE BEST OF MY KNOWLEDGE. IS ~UE AND CORRECT APPLICANTS NAME ~ (PRINTED & S;GN~TURE) LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER ~S C:~,IPCS~D 0F THE FOUR NUMBERS BELOW COUNTY ~ j~RiSD:CT~C~ ~ FACILI~ ~ TANK ~ERMIT NUMBER ~ PERMIT AF¢~OV[B 3~ DATE . PERMIT EXPIRAT~N DAT~ :ORM B (7-91) THIS FORM MUST BE ACCCMPANIED BY A PERMff APPLICATION- FORM A. UNLESS A CURRENT FORM A HAS B~ R~D. BAKERSFIELD FIRE DEPARTMENT December 4, 1996 F~RE CN~EF Lloyd Childers MICHAEL R. KE~Y Freeway Liquor Store 2030 East Brundage Lane ADMINISTI~TIVE SERVICES 2101 'H' Street Bakersfield, CA 93307 Bakersfield, CA 93301 (805) 326-3941 F~X{~>39~-13~9 RE: Underground Storage Tanks located at 2030 East Brundage Lane. SUPPRESSION SERVICES 2~01 'H' Street Dear Mr. Childers: Bakersfield, CA 93301 (805) 326-3941 FAx{~39~m9 As I am sure you are aware, all existing single walled steel tanks that do not meet the current code requirements must be removed, replaced or upgraded to PREVENTION SERVICES ~71s Chester A~e. meet the code by December 22, 1998. Your tanks do not currently mee~ the new Bakersfield, CA 93301 code requirements and therefore fall into the remove, replace or upgrade category. (805) 326-395! ~ t~5~ 32~,-0~7~ Your current operating permit expires on or before that date and of course will not be renewed until appropriate upgrade of'your tank system is accomplished. ENVIRONMENTAl. SERVICES 1715 Chester Ave, Bakersfield, CA 9330~ In order to assist you and this office in meeting this fast approaching (B05) 326-3979 F~x ~0~ 32~o~ deadline, I have attached a brief questionnaire addressing your plans to upgrade these tanks. Please complete this questionnaire and return it to this office by TRAINING DIVISION Thursday, December 19, 1996. 5642 Victor Street Bakersfield, CA 93308 CB0~ ~-,~9~ If yOU have any questions concerning your tanks or if we can be of any FAX (805) 399-5763 assistance, please do not hesitate to contact this office. Sincerely, Ralph E. Huey Hazardous Materials Coordinator Office of Environmental Services attachment USA 19 CITY OF BAKERSFIELD Ralph E. Huey, Haz.Mat. Spec. Bakersfield City Fire Dept. 2130 -G- Street Bakersfield, CA 93301 ~ CONFIDENCE UST SERVICES,~NC. 417 Montclair Street Bakersfield, CA 93309-1796 Telephone: (800) 339-9930 or (805) 631-3870 FAX: (805) 631-3872 NOTICE OF UNDERGROUND STORAGE TANK TEST Date: j~nuar~y 6~995 Time: 12.:09 ~.~ Site: Freeway Liquors 2030 East Brundage Lane Bakersfield, CA 93307 FIRE SAFETY SERVICES & OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVE. · BAKERSFiELD, CA · 93301 SEP 2 8' 1995 r~.E. HUEY R'B. TOBIAS, . -MATcoo.o,.A.o FINAL NOTICE!!! (805) 326-3979 (805) 32{)-3951 REVOCATION OF UNDERGROUND STORAGE TANK PERMIT WILL FOLLOW IN 30-DAYS IF VIOLATION PERSISTS Phmee be aware that flllure to provide the finanoial responsibility document to this office within 30 day~, Will result In your Permit to Operate being revoked (2S28S.1(b) California Health & Safety Code). 215_000_00132-1 ...... FREEWAY LIQUOR STORE 2030 E BRUNDAGE LN BAKERSFIELD, CA 93307 LLOYD CHILDERS Dear Underground Storage Tank Owner: Our records indicate that your business does not have a Certification of Financial Responsibility on file with this office. Our records also indicate that you have been issued at least one warning letter pdor to this notice. Please forward either a copy of your existing State approved mechanism to show financial responsibility or else complete the attached Certification for Financial Responsibility form and return it to this office within 30 days. An attached letter from the State Water Resources Control Board lists the approved financial responsibility mechanisms required to pay for corrective actions resulting from leaking underground fuel tanks. Remember, most tank owners only have to show financial responsibility for at least $10,000 of clean up liability. The Underground Storage Tank Clean Up Fund (USTCF) may be used as the mechanism to cover the remaining accidental release liability. The total amounts of financial responsibility required (check boxes from section A of form) are as follows: If you don't sell product from your tanks, and you pump less than 10,000 gallons per month, check '$500,000 per occurrence". For owners of 101 or more petroleUm underground storage tanks, check the "2 million dollar annual aggregate" box. All other need only check the "1 million dollars annual aggregate'. If you have any questions, or would like help in completing the Certification of Financial Responsibility, please contact Howard Wines, Hazardous Materials Technician, at 326-3979. Sincerely, Hazardous Materials Coordinator REH/dlm attachments UT808201 I I Account Number ----_, ;OUNTS RECEIVABLE ADJUSTMENT May 18~ 1995 Date New A=count New Address Esther Duran Close Account From Service Chan.qe Other Adjustments X Fire Department. Hazardous Materials Division Department/Division FREEWAY LIQUOR STORE Billing Name 2030 E 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 <.60> 05-01-95 Remarks: WE ARE ADJUSTING OFF ALL OUTSTANDING FINANCE CHARGES BEFORE TRANSFER TO THE NEW SYSTEM. TY of BAKERSFIEL · "WE CARE" January 30, 1995 FIRE DEPARTMENT 1715 CHESTER AVENUE M. R. KELLY F, RE C., F WA R N I N G ! CERTIFICATION OF FINANCIAL RESPONSIBILITY REQUIRED FREEWAY LIQUOR STORE 2030 E BRUNDAGE LN BAKERSFIELD, CA 93307 Dear Underground Storage Tank Owner: Our records indicate that your business does not have a Certification of Financial Responsibility on file with this office. Please forward either a copy of your existing State approved mechanism to show financial re~oonsibility or else complete the attached Certification of Financial Responsibility form. An attached letter from the State Water Resources Control Board lists the approved financial responsibility mechanisms required to pay for corrective actions resulting from leaking underground fuel tanks. Remember, most tank owners only have to show financial responsibility for at least $10,000 of clean up liability. The Underground Storage Tank Clean Up Fund (USTCF) may be used as the mechanism to cover the remaining acoidental relesss liability. The total amounts of financial responsibility required (check boxes from section A of form) are aa folloa~: · If you don't sell product from you tanks, and you pump less than 10,000 gallons per month, check "$500,000 per occurrence". Else, or if you are in the business of selling from your tanks, check "1 million dollars per occurrence". For owners of 101 or more petroleum underground storage tanks, check the '2 million dollar annual aggregate" box. All others need only check the "1 million dollars annual aggregate' box. Please be aware that failure to provide the financial responsibility document to this office within 30 days will result in your Permit to Operate being revoked. (25285.1 (b) California Health & Safety Code). ' If you have any questions, or would like help in completing the Certification of Financial Responsibility, please contact Howard Wines, Hazardous Materials Technician, at 326-3979. Sincerely, REH/dlm I / ~z./r~,'r/ Division of Clean Water Programs ! ~.~J P 0 Box 944212 · I _~ ~ Sac~:amento, CA 94244-2120 (Instructions on reverse) CERTIFICATION OF FINANCIAL RESPONSIBILITY ~ . : . FOR UNDERGROUND STORAGE TANKs CoNTAINiNG PETRoLEuM ' · : · A. I am required to demonstrate FmznciaJ R¢sponsibiliff in th~ required ~ouns ~ specified in ~ ~ ~ ] million dollars per occa~¢ncc ~2 million doll.s ~ a~egate ~. ~ ~ 0 ~ /~ ~ hereby ce~ifies that it is in compliance with the requirements of Section 2807, A~i~l~ 8, Ch~p[er ~, Division 3, Ti~lo 23, G~li~omi~ ~o~ ~ mo~n~m~ u~ ~o ~omonstr~t~ financial ~pon~ibility ~ required ~ ~o~tion ":..TVPe .... ::::::::::::::::::::::::::::::::::::::: : '.:' ::::::::::::::::::::::::::::::::::::::::::::::::: pe~i~;::::]:~::~::~:~:~:~::~{:~n: :~' ~:~::::.~ ~r~ ~ ~r~ ~/~~ ../ ~ ?¢~ ~~'" ~" "'" '~t /" Note: If you are using the State Fund as any part of your demonstration of financial responsibility, your execution and submission of this certification also certifies that you are in compliance with all conditions for participation in the Fund. Facih~.. Name Fnciliw Address Facilih.. N~e Facilib' Address .. Sign.~lure of Tnnk/0~ ncr or Op¢~a~or //I / . Dale Name and Tide of T~.nk 0~vaer or 0~ralor CFR~*,',)~ v - - -- -- FILE: Original,- Cecal Agency ' -Copies - F~cili[y/STte(M' · Page 26 , ~ EXHIBIT B The Chief Financial Officer or the owner or operator must sign, under penalty of perjury, a letter worded EXACTLY as follows or you may complete this letter by filling in the blanks with appropriate information: LETTER FROM CHIEF FINANCIAL OFFICER I am the Chief Financial Officer. /~]--ee_09/4o . _ _ (Business name/bu~m~s~ ad-~ress~and correspondence addj'ess of o~ner or operatflr) - This letter is in support of the use of the Under~ound Storage Ta~ Cleanup Fund to demomtrate financial responsibility for taking corrective action and/or compensat~g t~rd parties for bodily injury and property damage caused by an unauthor~ed release of petroleum in ~e amount of at least $ , ~D. ~ per occurrence and $ , ~~ ~ a~ual aggregate coverage. (Dollar Amoum) (Dollar ~ount) Underground storage tanks ,at the following facilities are assured by this letter: , .'. / . / · ' (Nam~,~naradd'res'~ of each facility for which financial reipofis~iiity is b~in~?'monstrated.) ' 1. Amount of annual aggregate coverage being assured by this letter ...................................................... 2. Total tangible assets ............................................ 3. Total liabilities ................................................... 4. Tangible net worth (subtract line 3 from line 2. Line 4 must be at least 10 times line 1) ..................... I hereby certify that the wording of this letter is identical to the wording specified in subsection 2808. l(d)(1), Chapter 18, Division 3, Title 23 of the California Code of Regulations. I de~clar__e under pena!ty of pe_rju_r_y .th_a~t t__he .fo_regoin_g !_s_true and correc_t ~t_o the best of my knowledge and belief. - (Place of Execut~n)' ' (D-ate) (Printed Namp)/ (Title) UST OI,FR REVISED 4/95 Page 29 CONFIDENCE UST SERVICES, INC. 417 MONTCLAIR STREET BAKERSFIELD, CA 93309 (805) 631-3870 AES -- SYSTEM II PRECISION TANK & LINE TEST RESULTS SUMMARY Invoice Address: Tank Location: W.O.#: 1802 FREEWAY LIQUORS FREEWAY LIQUORS I.D. Number: N/A 2030 EAST BRUNDAGE LANE 2030 EAST BRUNDAGE LANE Technician:D. YOUNG BAKERSFIELD, CA 93307 BAKERSFIELD, CA Tech.#:86116 Van#:O1 Date: 01-06-95 Time Btart: 12:00 End: 15:00 County: KE Facility Phone#: (8~) ~.,=~-~-0,=~.~ G~oundwater Depth 144"+ Blue Prints: N/A Contact: REX CH!LDERS Date;Time system ~as ~illed: 6+ HOURS Tank Fill/Vent P~oduct Type Of Vapop Inches of Pump Tank Tank Capacity P~oduct Tank Vapo~ Line~ Line Recovepy Water/Tank Type Material 1 12000 REGULAR PASS PASS PASS II 0.00" TURB. SWS ~ 12000 SUPREME PASS PASS PASS II 0.00" TURB. SWS ~ 10000 MIOGRAD PASS PASS PASS II 0.00" TURB. SWS 4 -- 6 Additional Info~mation: TEST TECHNICIAN: DOUG YOUNG O.T.T.L. ~90-1076 SITE LOG TIME ~et Up Equip: 12:30 Bled Product Lin~s: YES Bled Vapor Lines: YES Bled Vent lines: YES Bled Turbine: YES Bled Suction Pump: N/A Risers Installed: YES a) This system and method meets or exceeds the criteria in USEPA 40CFR part 280, NFPA 329-87 and all applicable state and local codes. b) Any failure listed above may require further action, check with all regulatory agencies. Copyright (c) 1989 by AES, Inc. Certified Technician Signature 1~ Date : Si l;e Lagoul; Fo~: 2838 E~ST BRUHDI~6E L~HE, B~KERSFIELD, C~ In¥oi~e No, s 1802 D&tes 01/06/95 Tlse s 12~2s10 Technicians DMY Tanks 1 Tank Dlamete~iin) s.96 Volume(gal)l 12000 Spade Level(in)s 134 Ppoduct Level(tn) s 131 Water Level On Tank(tn)l 0 Specific 8ravttys ..75 Coefficient Of Expansions 0.0006630 Calibration Value(mI)s 200 Channel~ 1 Level Segment From~ I To 250 Temp Segment Froms I To 250 Change In Calibration Zone = 39 Calibr&tion Unit(Bal/unit) m 0.00135 8tarring Temperature (F) s 68.479 Head Pressure(psi (Btm))m 3.55 Surface Area(sq. tn)s 31.3 Temp. Change(F/h) m -0.004 Level volume(gph)s -0.01 Temp. volumm(gph)s -0.03 Produc~ Line(gph)s -0.002 Net chan~e(gph) s 0.02 Resul~ ----) P~:~EBEB P/L ----> P~:~EBEB Copyright (c) 1989 by AES, Inc. ** Notes ** FREEWAY LIQUORS , 2030 EAST BRUNDAGE LANE , BAKERSFIELD, CA. THIS IS A HIGH LEVEL TEST WITH A 200 ML. CALIBRATION. RES/System II Precision leak Test Graph (OverFill) Invoice No.I 1802 Datel 01/06/95 Time ~ 12:42:10 TeChnician! DMY Tankl 2 Tank Dtameter¢in)! 96 Volume(gal)t 12000 Grade Level(tn)~ 139 Product Level(tn)~ 135 Water Level. On Tank(tn)~ 0 8pmcific 8ravity~ .,75 Coefficient Of Expansion! 0.00066?3 Calibration Value(mi), 200 Channel~ 2 Level Segment From! 1 To 250 Temp Segment From! I To 250 Change In Calibration Zone = 64 Calibration Unit(gal/unit) = 0.00082 8tarring Temperature (F)~ 61.370 Head Pressure(psi (Bte))~ 3.66 Surface Rrea(sq. tn)l 19.1 Temp, Change(F/h) t 0.003 Level volume(gph)! 0.00 Temp, volume(gph)! 0.02 Product Llne(gph) l -0.003 Net change(gph) a -0.02 R esul~ ----) P~=~E~E~ P/L ----) Pi:~E~E~ Copypight (c) 1989 by AES~ Inc. ** Notes ** FREEWAY LIQUORS ~ 2030 EAST BRUNDAGE LANE ~ BAKERSFIELD~ CA. THIS IS A HIGH LEVEL TEST WITH A 200 ML. CALIBRATION. A£8/System IX Precision leak Test 8raph (OverFill) Xnvoi~e ~o.I 1802A Datel 01/17/95 Time I 13:56:50 Teehni=ianl DMY Tankl 3 Tank DiameterCin) t~ 95 Volume(gal)t 10000 Grade Level(in)t 141 Product Level(tn)l 136 Water Level On Tank(in)! 0 8pe~ifi~ Gpavttyl .,75 Coeffi~tOnt Of Expansion! 0.0006705 Calibration Value(mi)t 200 Channell 1 Level Segment F~om! 1 To 275 Temp Segment From! 1 To 275 , ...... ,,...,l.... I: I'll. I...il..,I.,.! II..IL'~.". L pill..,I, tJ IJ I',,I ,mi ,I 0 :1,. 0 .',.% 0 'T'i ~,l,.':: Ill iI ii. Change In Calibration Zone = 24 Calibration Unit(gal/unit) = 0.00~20 8tarring Temperature (F)~ 56.182 Head Pressure(psi (Btm))t 3.68 Surface Area(sq. in)t 50.8 Temp. Change(F/h) j 0.017 Level volume(gph)l 0.13 Temp. volumo(gph)t 0.11 Product Line(gph)l -0.003 Net chango(gph) t 0.02 Copypight (c) 1989 by AES~ Inc. ** Notes ** ~REEWAY LIQUORS ~ 20~0 EAST BRUNDAGE LANE ~ BAKERSFIELD~ CA. THIS IS A HIGH LEVEL TEST WITH A 200 ML. CALIBRATION. ~ CDNFIDENCEtI~T SERVICES, INC. o 501 WORKMA~'~8 Bakersfield, CA 9330'/ Date I-(~-~-' Invoice Number [ ~O~- AES PLT-100R HYDROSTATIC PRODUCT LINE TEST WORK SHEET TEST P'RODUCT ~ START ~ END START END TEST VOL. NO. ~ ~TIME ~ TIME VOL. (ML) VOL. (ML) DIFF. (ML) I I I I I I Divide the volume differential by the test time ( 15 minutes) and multiply by 0.0158311, which will convert the volume differential from milliliters per minute to'gallons per hour. The conversion constant is found by : (60 min/hr)/(3790 ml/gal) = 0.0158311 (min/hr) (gal/ml) The conversion constant causes the milliliters and minutes to cancel out. Ex. If the level dropped 3ml in 15 minutes then: 3/15 ml./min. X 0.0158311 (min/hr) (gal/ml) = 0.003 gal/hr. RESULT~ OF THIS WORK SHEET TO BE COMPILED ON RESULTS SHEET. B~ERSFIELD FIRE DEPARTMENT ~ZARDOUS ~TERIAL DIVISION 71'5 ~~~~, Bakersfield, CA 93301 Chester Avenue (805) 326-3979 Third Floor APPLICATION TO PERFORM A TIGHTNESS TEST FACILITY FREEWA~ LIQUORS ADDRESS 2030 E. Brundage Lane PERMIT TO OPERATE # S1572-1-0 OPERATORS NAME Loyd Childers OWNERS NAME Loyd Childers NUMBER OF TANKS TO BE TESTED 3 IS PIPING GOING TO BE TESTED Yes · TANK# VOLUME CONTENTS 1 12;000 UDle~ded 2 12,000 Supreme Unleaded 3 10,000 Premium Unleaded Confidence UST 417 Montclair Street TANK TESTINGCOMI~ANY Services, Inc. ADDRESS Bakersfield, CA 93309-179f TEST METHOD AES System II (Overfill) NAME OF TESTER Douglas Young CERTIFICATION #' 86116 STATE REGISTRATION # 90-1076 DATE & TIME TEST IS TO BE CONDUCTED 12/29/94 at 2:00 p.m. BAKERSFIELD FIRE DEPARTMENT /'. HAZARDOUS MATERIAL DIVI. SION ~ ,. 30 G Street, Bakersfield, CA 93301 APPLICATION TO PERFORM A TIGHTNESS TEST FACILITY FREEWAY LIQUORS ADDRESS 2030 E. Brundaqe Lane PERMIT TO OPERATE % S1572-1-0 OPERATORS NAME Loyd Childers OWNERS NAME Loyd Childer's NUMBER OF TANKS TO BE TESTED 1 IS PIPING GOING TO' BE TESTED Yes TANK~ VOLUME CONTENTS 1 10,000 Premium Unleaded CONFIDENCE UST TANK TESTINGCOMPANY SERVICES, INC. ADDRESS 501 WorkmaD St., Ste. 10~ TEST METHOD AES System II-Overfill NAME OF TESTER Douglas Young CERTIFICATION ~ 86116 STATE REGISTRATION # 90-1076 . DATE & TIME TEST IS TO BE CONDUCTED 12/23/93 at 12:00 o.m. CC)~IFII~I~ U~T ~ERYII'CE~s 1'NCo .501 WORKMAN ST. ~108 '~ BAKERSFIELD, CA 93307 (805) ~31-3870 P~CZSI~ T~ & LZE TE~T RE--T5 S~RY Invoice AddreeSl Tank Location; W.O.#1 1367 FREEWAY LIQUORS FREEWAY LIQUORS I.D, Nueberl N/A 2030 EAST BRUNDAGE LANE 2030 EAST BRUNDAGE LANE TechnicianlD. YOUNG BAKERSFIELD, CA'93307 BAKERSFIELD, CA Tech.#186116 Van#lO1 Datel 12-23-93 Time Startl 12:00 Endl 17:00 Countyl KE Facility Phone#~ (805) 323-0254 Groundwater Depth~ 144"+ Blue Prints~ N/A Contact, LOYD CHILDERS DatelTime system was filledl 6+ HOURS Tenk Fill/Vent P~educt Type Of Vapor Inches of Pump Tmnk Tank Capacity P~oduct Tank .Vapor Linee Line Recovery Hater/Tank Type Haterial I 12000 ! REGULAR PASS PASS PASS II 0.00" TURB. SHS ~ 12000 SUPREME PASS PASS ;'ASS II 0.00" TURB. SWS 3 10000 MID/GRD PASS PASS PASS II 0.00" TURB. SWS Additional Information, TEST TECHNICIAN: DOUG YOUNG O.T.T.L. #90-1076 TANKS I & 2 WERE TESTED 12-02-93, W. 0.#1353. SITE LOG. TIME Set Up Equip, 13:40 Bled Product Lines, YES Bled Vapor Linesl YES Bled Vent lines, YES Bled Turbine, YES Bled Suction Pump, N/A Risere Installed, YES a) This system and method meets or exceeds the criteria in USEPA 48CFR' part ~80~ NFPA 3~9-87 and all applicable state and local codes. b) Any failure listed above, lay require further action~ check with .. all regulatory agencies. Copyright (c) 19~9 by AES~ Inc. Certified Technician Signature I Date , ~ --- Il: t~ 6AL, /HI])-6R~])E FREEIdA¥ L]:QUOR$ I ~ES/Bys~eB II P~ecision le&k Test G~&ph (Ove~Fi11) Invoice No.s 1367 D&tel 12/23/93 Time s 13:45:40 Technicians DMY T&nks 3 Tank Diame~e~(in)~ 95 Voluee(gel)s 10000 G~&de Level(ln)s 141 Product Level(in)~ 133 W&te~ Level On T&nk(in)l 0 Specific G~&vityl .76 Coefficimnt Of £xp&n$1ons 0.0006598 C&lib~&tion V&lue(ml)s 200 Channels 2 Level Segment F~oms 25 To 275 Temp Segment F~om~ 25 To 275 Change In C&ltb~&tton Zone - 23 C&libr&tion Unt~(gal/unit) - 0.00230 St&rting Temper&tu~e (F)~ 51.386 Held Pre~sure(psi (B~m)); 3.65 Eu~face R~ea(sq. tn)~ 5~.~ :. , Temp, Change(F/h) ~ 0.005 Level volume(gph)l 0.00 Temp. volume(~ph) ~ 0.03 P~oduc~ Llne(~ph) ~ -0. 004 Ne~ change(gph) ~ -0.03 Copyright (c) 1989 by AES, Inc. FREEWRY LIQUORS ~ ~3~ ERST BRUNDR~E LRNE THIS IS A HIGH LEVEL TEST WITH A ~00 ML. CALIBRATION. CONFIDENCE T SERVICES, ING. 501 WORKMAN #8 Bakersfield, CA 9330? AES PLT- t 00fl HYDROSTATIC PRODUCT LINE TEST WORK SHEET TEST PRODUCT I START END I START END TEST VOL. NO. ~' I TIME TIME I VOL. (ML) VOL. (ML) DIFF. (ML) I I 'T'3 I ,'1 I '1 I · I % I I I I I I I I I I I I I I I Divide the volume differential by the test time ( 15 minutes) and multiply by 0.0158311, which will convert the volume differential from milliliters per minute to gallons per hour. The conversion constant is found by : (60 min/hr)/(3790 el/gal) = 0.0158311 (ein/hr) (gal/ml) ~ The conversion constant causes the milliliters and minutes to " cancel out. .Ex.~ If the level dropped 3el in 15 minutes thenl 3/15 ml./ein. X 0.0158311 (m~n/hp) (gal/el) = 0.003 gal/hr. RESULTS OF THIS WORK SHEET TO BE COMPILED ON RESULTS SHEET. BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVZSION 2130 G Street, Bakersfield, CA 93301 .(805) 326-3979 8~p ] , APPLICATION TO PERFORM A TIGHTNESS TEST ' '"'/4 r 0ii4. ; :- FACILITY= FREEWAY....LIQUORS ADDRESS 2030 E. Brundage.... ,,Lane PERMIT TO 0~ERATE ~ S1572-1-0 OPERATORS NAME. Loyd Childers OWNERS NAME Loyd Childer.~ NUMB~.R OF TANKS TO BE TESTED. 3 ,,, 18 PIPING GOING TO'BE TESTED Y~s TANK~ VOLUME CONTENTS _1 12,9.00 , Unleaded 2 . 12_,.000 Supreme Unleaded usTSERVICES, INC. TANK TESTINGCOMPANYCONFIDENCE ADDRESS 501 Workman St., Ste. TEST METMOD AES System II (Overfill) NAME OF TESTER Douglas Young CERTIFICATION # 86115 STATE REGISTRATION ~ 90-1076 DATE & TIME TEST. IS TO BE CONDUCTED December 2, 1993; 2:00 ~.m. I~ IRVlCr~v 11~, 501 WORKMAN ST.#lO8 · ' BAKERSFIELD, C~ 9330? (805) 631-3870 PRECIBICIN TI:INK & ~I~ ~BT ~~TB ~Y Invoice ~d~e~8 T~nk ~o~ationt ~.0.~, 13~3 FREEWAY LIQUORS FREEWAY LIQUORS I.D. NumbmPm N/A ~030 EAST BRUNDAGE LANE ~030 EAST BRUNDAGE LANE Tmchnt=tanmD. YOUNG BAKERSFIELD, CA 9~07 BAKERSFIELD~ CA TeQh.~86116 Vanl~Ol Da~os 12-0~-93 Time Bt~l 14:00 End0 ~0:15 Countyl KE F4ctltty ~onee, G~oufldwate~ Depths 144"+ Blue P~tntsf N/~ Contacts LOYD CHILDERB DmtelTlme system was filled, 6+ HOURS T~k Fill/Vent ~~ Type Of ~a~r in. et of Pulp Tank Tank~ ~tty ~~ Tank ~i~ Lines Line R~ovo~ ~ter/Tlnk Ty~ I 1~ ~ ~R ~S ~SS PASS II 0.~" TURB. SWS 3 5 ~ditional Inform~tion~ TEST TEC~ICIAN~ DOUG YOUNG O.T.T.L. ~98-1876 .' SITE LOG TINE Bet Up Equip, 17:45 Bled Product Llnesl YES Bled VapoP Ltnesf YES BIed Vent lines, YES Bled Turbines YES Bled But. ion Pumps N/A a) This system and method meets or exceeds tho criteria tn USEPA 40CFR par~ 280~ NFI~I 329-87 and all applicable state and local codes. b) ~ny failure listed above may require further action, c. he~k with all ~egulato~y agencies. Copyright (c) 1~8~ by d:~Bo Inc, " Certified Technician 8ionature Date I -- Ei~T ~ L~ -- -- '-- -" -- '-- -- ,,, I CONF 1' --,r---NCE: UI~IT EIERI. I EliI~ :[ NC. M~B/gystel Il P~-ecision leak Test 8raph (OverFill) No. I 13,53 Dater 1~:/0~/93 Time t 18101,05 L~s N so ~ ~' ~ ............ 0 i. 0 2. O' Change In Calibration Zone - 63 C&ltb~mtion Unit(gal/unit) ~ 0.00084 8ta~'~lnB Telpe~atu~e (F) I ~?.~74 He&d P~elsu~e(pe~ (~tl))l ~.~0 Outface ~i&(iq.'ln) l 19.4 Telp, Change(F/h) I 0.001 Level volule(gph)l 0.01 Temp. vOlUle(gph) l ,0.00 P~oduct Llne(gph)i -0.00~ Net change (Bi)h) i 0.01 Reue~l~ ----> :~:Copyright (c) 1989 by ~ES, Inc. ee Not e· FRE£WA¥ LIOUORS v a030 £AST BRUNDAG£'LAN£ v BAKERSFIELDv CA. THIS IS A HIGH LEVEL TEST WITH A aOO Mk. CALIBRATION. I~OblI=I~E:NC$£ UItT flERYZI:iElt~ ZNC:. GIEB/Bysteu il P~eeision leek Test graph <OverFill) nvoice No.I 1353 Dater 12/02/93 Tine ! 18101,0G Techniciinl DHY Tankl 2 Tank DlalOter(ln)l 96 Voluuo(gal)l 12000 grade Lovol(in)l 139 Product Lovel(ln)l 153 i W&~e~ Level On T&nk(tn) t · i 9pacific Oravityt .75 Coefficient Of E~p&noion8 0.0006765 i .Calibration Valuo(el)t ~00 Channelt 2 Love1Boggont Froal 25 To ~50 ToBp 80guont FPOBI 25 To 250 ~ ' ~' Pr c, duc~ SUPREHE / LI N ;n ,T " Ti ~e-Hour ~ Change In Calibration Zone - 92 Cmlib~&tion Unit(gel/unit) - 0.00057 Stirring Telper&turo (F) i 46.279 Heed Pressure(pst (Btl))l 4.14 Surface Area(lq. in) l 13.3 Telp.. Change(F/h) I -0.004 Le¥II ¥olule(gph) l -0.05 Teep. volule(gph) l -0.03 Product Llno(gph)l -0.004 Net chango(gph) I -e. 02 IIIIIIIiBMB~ Copyright (c) 1989 by ~ES, Inc. FREEWAY LIQUORS , ~O30 EAST BRUNDAG~ LANE , BAKERSFIELD~ CA. THIS IS A HIGH LEVEL TEST WITH A ~O0 ML. CALIBRATION. CONFIDENC~T SERVICES, INC. 501WORKMA)~#8 Bakersfield, CA 93307 ( 805 ) -631-3070 AES PLT-100R HYDROSTATIC PRODUCT LINE TEST WORK SHEET I TEST I PRODUCT I START I END I START I END I TEST VOL. I · I NO. I I TINE ~ I TINE'~ I ¥OL, (NL) I VOL. (NL) I D[FF, (NL) I I I I I I I I I I I I I I I I I I~... I I I I I I I ........ I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I [~ I I I I I I I I I I I I I I I I I I I I I I I .I I I I I I I I I '. I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Divide the volume differential by the test time ( 1~ minutes) and multiply by 0.0150311, which will convert the volume differential frOt milliliters per' minute to gallons per' hour. The conversion constant is found, by ~ (60 lin/hr)/(3790 Il/gal) - 0.0158311 (min/hr) (gal/m1) The conversion constant causes the iilliliters and linutes to cancel out. ' Ex. If the level dropped 3al in 1~ linutes thent .... 3/15 mi./lin. X 0.0150311 (mtn/hr) (gal/ml) - 0.003 gal/hr. i~' RESULTS OF THIS WORK SHEET TO BE CO~4PILED ON RESULTS SHEET, CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT N~ Sub Div. Blk. . ~t You are hereby required to make the following corrections at the above location: :xt. ~ f' . :, t~. ~ ~;gp ~k~-¢ ~.~,'~/~a C~ ¢,'//~ . ~"' Completion Date for Corrections j ~~/~ ~ ' .':.,~ :: Date ,1~/~ ~/~ . ., 326-3951 BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVZSION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 APPLICATION TO PERFORM A TIGHTNESS TEST FACILITY FREEWAY LIQUORS ADDRESS 2030 E. Brundaqe Lane PERMIT TO OPERATE % S1572-1-0 OPERAToRs NAME Loyd Child~rs OWNERS NAME Loyd Childers NUMBER OF TANKS TO BE TESTED 1 IS PIPING GOING TO'BE TESTED Yes TANK% VOLUME CONTENTS 1 10,000 Premium Unleaded CONFIDENCE' UST TANK TESTINGCOMPANY SERVICES, INC. ADDRESS 501 Workman St., Ste. 108 TEST METHOD AES System II-Overfill NAME OF TESTER Douglas Young CERTIFICATION % 86116 STATE REGISTRATION % 90-1076 DATE & TIME TEST IS TO BE CONDUCTED 12/23/93'.at 12:00 D.m. JSA 19 CITY OF BAKERSFIELD Ralph E. Huey, Haz.Mat. Spec. Bakersfield City Fire Dept. 2130 -G- Street Bakersfield, CA 93301 © USPS 1~9~I,, II,h,,,lh,,Ihll,,,,,,Ihh,II ~CON~IDENCE 0ST SERVICES, INC. 501~Workman ~tr~ee.t, Suite 108 BaJ~ersfield, yea 93307-6818 Telephone: (800) 339-g930 or (805) 631-3870 FAX: (805) 631-3872 NOTICE O? UNDERGROUND STORAGE TANI~ TEST Date: December 23, 1993 Time: 12:00 p.m. site: Freeway Liquors 2030 E. Brunda~e Lane Bakersfield, CA 93307 UNDER. GROUND ST GE TANK INsPECTIoN "~i kcrsfield :Fire Dei)t' Hazardous Materials Division Date Completed Operating Perm,: Business Name: ~,~.~ ~~ Location: ~ E. ~~ /~ Business Identification No. 215-000 I~/ (Top of Business Plan) Number of Tanks. ~ Type: ~(~ ,~.~1(~, ~,~_ ~J :/~ Containment: ~ Lines:. ,~ ]~ ./,j~//~ . .~_.~ CONTACT INFORMATION ~er: ~/~ ~,'/~ / Emergency Contact:~ ~ ; /~ Adequate Inadequate Monitoring Program ~ , ~ / · ~ RECORDS Maintenance [~ ~ Testing ~ ~ Inventory Reconciliation I--~ ~~'"'~ ~ RESPONSE PLAN Emergency Plan Violations: i~~~~ ~ AIl Items O.K. Bus Correction Needed White - H~ Mat Div Pink - Busies Copy ENVIRONMENTAL HEALTH SERVICES DEPARTMENT PERMIT TO OPERATE UNDERGROUND HAZARDOUS STORAGE FACHJTY Permit No.: 230033C State ID No.: 2001 Issued to: FREEWAY LIQUOR No. of Tan~: ~ Location: 2030 E. BRUNDAGE BAKERSFIELD, CA Owner: CHILDERS, LLOYD 2030 E. BRUNDAGE BAKERSFIELD, CA 93307 Operator: CHILDERS~ LLOYD 505 BOBWHITE COURT BAKERSFIELD, CA 93309 Facility Profile: Substance Tank Tank Year Is piping Tank No. Code Contents CapaciW Installed Pressurized' 1 MVF 1 GASOLINE UNKNOWN UNK UNKNOWI' 2 MVF 1 GASOLINE UNKNOWN UNK UNKNOW1~ 3 MVF 1 GASOLINE UNKNOWN UNK UNKNOWl~ This permit is granted subject to the conditions and prohibitions lhted on the attached summary of conditions/prohibitions By: _ Steve McCalley Issue Date: September 23, 1991 ' ' Title: Director, Environmental Healt epartment Expiration Date: September 23, 1996 -- POST ON PREMISES -- NONTRANSFERABLI~ 2700 "M" STREET, SUITE 300 BAKERSFIELD, CALIFORNIA 93301 (805) 861-3636 FAX: (805) 861-3429 HAZARDOUS UNDERGROUND STORAGE FACHATY PERMIT SUMMARY OF CONDITIONS/PROHIBITIONS CONDITIONS/PROHIBITIONS: 1. The facility owner and operator must be familiar with all conditions specified within this permit and must meet any additional requirements to monitor, upgrade, or close the tan~ and associated piping imposed by the permitting authority. 2. If the operator of the underground storage tank is not the owner, then the owner shall enter into a written contract with the operator, requiring the operator to monitor the underground storage tank; maintain appropriate records; and implement reporting procedures as required by the Department. 3. The facility, owner and operator shall ensure that the facility has adequate financial responsibility insurance coverage, as mandated for all underground storage tanks containing petroleum, and supply proof of such coverage when requested by the permitting authority. 4. The facility owner must ensure that the annual permit fee is paid within 30 days of the' invoice date~ 5. The facility will be considered in violation and operating without a permit if annual permit fees are not received within 60 days of the invoice date. 6. The facility owner and/or operator shall review the leak detection requirements provided within this permit. The monitoring alternative shall be implemented within 60 days of the permit issue date. 7. The facility underground storage tanks must be monitored, utilizing the option approved by the permitting authority, until the tank is closed under a valid, unexpired permit for closure. 8. Any inactive underground storage tank which is not being monitored, as approved by the permitting authority, is considered improperly closed. Proper closure is required and must be completed' under a permit issued by the permitting authority. 9. The facility owner/operator must obtain a modification permit before: a. Uncovering any underground storage tank after failure ot' a tank integrity test. b. Replacement of piping. c. Lining the interior of the underground storage tank. 10. The tank owner must advise the Environmental Health Services Department within 10 days of transfer of ownership. 11. Any change in state law or local ordinance may necessitate a change in permit conditions. The owner/operator will be required to meet new conditions within 60 days of notification. 12. The owner and/or operator shall keep a copy of all monitoring records at the facility for a minimum of three years, or as specified by the permitting authority. They may be kept off site if they can be obtained within 24 hours of a request made by the local authority. 13. The owner/operator must report any unauthorized release which escapes from the secondary .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. AEG:jrw (green~n~rmit.p2) 2 MONITORING REQUIREMENTS:(Mvnsm) 1. All underground storage tanks designated as MVF 1 within the first page of this permit shall be monitored utilizing the following method: a. Standard Inventory Control Monitoring (Tank gauging five to seven days per week). Kern County Environmental Health Services Department forms shall be utilized unless a facility form can provide the same information · and has been reviewed and approved by the Environmental Health Services Department. (Monitoring shall be completed in accordance with require- ments summarized in Handbook UT10.) - This option cannot be used aRer January 1, 1993. AND b. All tanks shall be tested annually utilizing a tank integrity test which has been certified as being capable of detecting a leak of 0.1 gallons per hour with a probability of detection of 95 percent and a probability of false alarm of 5 percent. The first test shall be completed before December 31, 1991, and subsequent tests completed each calendar year thereafter. Ail tank integrity tests completed after September 16, 1991, shall be completed under a valid unexpired permit to test issued by the Environmental Health Services Department. c. After January 1, 1993, each tank shall be equipped with an in-tank level sensor, which is to be utilized on a monthly basis to monitor for releases. The equipment must be certified as capable of detecting 0.2 gallons per hour, defined' at any normal operating product level in the underground storage tanks with a 95 percent probability of detection and a 5 percent probability of false alarm. d. (If present) Pressurized piping systems shall install pressurized piping leak detection systems and ensure that they are capable of functioning as specified by the manufacturer. The mechanical leak detection systems must be capable of alerting the owner/operator of a leak by restricting or shutting off the flow of hazardous substances through the piping, or by triggering an audible or visual alarm, detecting three gallons or more per hour per square inch line pressure within one hour. e. All pressurized piping systems shall be tested annually unless the facility has installed the following: 1. A continuous monitoring system within secondary containment. 2. The continuous monitor is connected to an audible and visual alarm system and the pumping system. 3. The continuous monitor shuts down the pump and activates the alarm system when a release is detected. 4. ' The pUmping system shuts down automatically if the continuous monitor fails or is disconnected. The first test shall be completed before December 31, 1991, and subsequent tests completexl each calendar year thereafter. 2. All equipment installed for leak detection shall be operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks (at leas~ once ,per year) for operability or running condition. 3. A monitoring response plan shall be developed and submitted to the department for review and approval within 90 days of the issuance date of this permit. 4. An annual report shall be submitted to the Kern County Environmental Health Services Department each. year after monitoring has been initiated. The owner or operator shall use the form provided along with the permit, unless another has received prior approval. 5. (If present) Suction piping shall be monitored for the presence of. air in the pipeline by observing the suction pumping system for the following indicators: a. The cost/quantity display wheels on the meter suction pump skip or jump during operation; b. The suction pump is operating, but no motor vehicle fuel is being pumped; c. The suction pump seems to over speed when first turned on and then slows down as it begins to pump liquid; and d. A rattling sound in the suction pump and erratic flow, indicating an air and liquid mixture. R E C E I P T PAG~ 1 2:15 pm KEEN COUNTY PLANNING & DEVELOPNENT 2700 'M' Street (805) 961-2615 ,.CASH REGISTER FREEWAY LIQUORS ~tomm~--P~..O.:~ I Wtn 8y [Order Date i Ship Date I Via ) Terms ,'"(230033-92 .; I YKN ( 08122,/91 ( 08/22/91 I I NT Line Description Quantity Price Unit Disc Total 1 5730 UNDERGROUND TANKS. ~TATE SURCH 3 56,00 E 168.00 ZZZ001 O~dep Tot'al !~8,0 Amount Due t68. Payment Made By Check 168, THANK YOU AND HAVE A NICE DAY! ~'*' J ~:~:~, ENVIRONMENTAL HEALTH . 0 ( o.. om~ P 131 452 000 - - RECEIPT FqJJ~GC--MeFIFIED MAIL JJ~'"~'RN COUNTY HEALTH DEPARTME~j NO INSURANCE COVERAGE PROVIDED HEALTH OFFICER ........... ~'~*' '~ --. ....... ENVIRONMENTAL HEALTH DIVISION Leon M Hebertson, M.D. ?OSTAGE STAMPS TO ~BTIC~ TO C~VER FIRST ~C~SS POST~ DIRECTOR OF ENVIRONMENTAL HEAL~ .L ~EE, AND CHARGES FO~ ANY SELECTED OPfIONAL SERVJ~ Vernon S. Reichard ~,~;/pt PoSlmarkea, s,ick Ihe gummeO s,ub to [h~ rign, o~ '/ :his receJp~ Po$zn~rk'e~, sdck [i~e gummed s~ .. receip[, wd[e me certitied 112~1 ii4¢ Hay · 2~ , :~'¢ices requw M~ Lloyd Childers 208 Ray S~ee~ ,~r~. Bakersfield, Cali forn'i~' 93308 Dear Mr. Childers: This letter is an official notice of your non-compliance with state and county laws relating to underground tanks. Upon review of our records, it was discovered that the 1988 Permit to Operate fees 'for Freeway Liquor, 2030 E. Brundage Lane, Bakersfield, California were not paid. Enclosed is a copy of 1988's invoice plus the 50% 1. ate penalty required by county ordinance. The second invoice is for this year's Permit to Operate fees. 'These invoices m~st be paid within 30 days to avoid further penalties and/or legal action. Be advised that these fees must be paid even if the tanks are no longer in use. If the tanks are not in use, a permit for permanent closure must be obtained from this Office. Permanent closure requires either removal or closure in place of your tanks'./ and assessment by soil sampling to determine whether there has'been environmental damage as a result of unauthorized releases of hazardous substances from your tank site. The speclf~c requirements for these activities are in Handbook #UT-30, available with your application. No closure activity can begin prior to the issuance of ~ permit from this office. If you have any questions or feel this assessment is in error, or if you would like an application and our handbook on permanent closure please call me at (805)861-3636. Your prompt attention to this very important matter is appreciated. Sincerely, J rren Hazardous Materials Inspector Hazardous Materials Management Program DISTRICT OFFICES ~0Fk,~'t COUNTY HEALTH DEPARTM ' .~.~.*r. Baker. field, California 9330~ ENVIRONMENTAL HEALTH DIVISION La. aa M ~ ~D. TM~ (~5)M1-36~ D~ M E~IW~AL WLTH V~ ~. R~ ' *, ~ ~; ~ ~, HAZARDOUS MATERIALS MANAGEMENT~ PROGRAM U d r o.nd Address ~.~ ~-: ~ ~'~'~'(~¢~ :~;~ ~¢~, ~,~: A~sessors Parcel ~ ~- ~O( Person Interviewed '~ ~'~.~ ~ .... NOTICE. OF VIOLATION AND ORDER TO COMPLY The following conditions or practices obsewed this date are violations of one or more sections of the California Health and Safety Code, Div. 20, or the California Administrative Co~e, Title 22, Div. 4, Chap. 30, relating to the "storage, handling, transpo~ation, and disposal of hazardous waste" or Ordinance Code of Kern County, Div. 8, "Underground Storage of Hazardous Substances." Conditions or practices' must be corrected within the times ordered below: t, Your signature acknowledges receipt of a copy of this report'and collection of any samples described above, and is not an admission of guilt. Failure to fully comply with this "~lotice and Order" may result in further legal'action b~,.County or State officials. .: t ...?. ;, m, ' c ~' '-~ Ageni ~f the K~rn County Health 6ffice ~ner or Au~o(ized Representative White -- Original Cana~ -- FaciliW file Pink -- Specialist CHICCA JERRY U & BETTY R 339-444-02-00-J O0-O00000-O0-O CHILD DqulD R & PATRICIA ANN CHICCA ~OUI_,:~._T_BS. 059-140-13-01-G 00-000000-00-0 CHILD EUANGEL. ISH FELLOWSHP INC -C~iCC~ HAR~ HA'RGIE A 3G~s271-12-OO-8'' O0':O00000-gOsO CHILD. GUIDANCE GUILD B~K 'iNC--- CHICCA TONY o~o-os3-0m-ao-2 oo-oooooo-oo-o CHILD HAROLD L C..~]CCA TONY P JR & JETTA {4S-~3~-TZ-O0-O 00'000000-00-0 'CHILDERHOSE 0 D & HARIAN F. -CH!CCA TONY PJR & JETTA U Ozi=4Zl-zo=oo-o oo-0'oooo0=oo=o CHILDERHOSE OSBORNE D-&' HARION CHICCITT DOUGLAS J 344-360-03-00-m O0.-OOO000-O0-O CHILDERS BILLY B & HARLENE E CHICHESTER BEN H ' ~8~-24 C -C-~ICHESTER KENNETH -22s00-4' 00-000000-00~0 CHILDERS 6 LUCELLE P-- CHICHESTER LEONARD & HELEN JSJ-O~O-03-O0-3 00-000000-00-0 CHILDERS CLEHENT 6 & LUCELLE P ~HICHESTER ~ARK 05~ER 389-~20-29,00-4 00:00000~:00:0 -CHILDER5 ~ONALP L'-& ~!ELLY CHICHESTER RO6ER J ~83-202-09-00-[ 00-000000-00-0 CHILDERS 6ARL~ND CHICK LEO R & RITA L 3J?'490-32-00-5 00-000000-00-0 CHILDERS HARRY HILOR · . ~ENI5 HARRY 6 & ~ARY ]46,2~2-J~-00-9 00-000000-00-0 CHILDERS HERBERT C & UIUI~N~J_ :~ CHICKY ~ILLIAH ~ & CHERYL 08J-22J-Jg-O0'8 00-000000-00-0 ~HILDERS JOHN CHICKY ~ILLIA~ ~ & CHERYL CHICKY ~ILLIA~ N & CHERYL ~ 0~1-22~-35-00-4 00-000000-00-0 CHILDER5 JOHN T Ill & THIPHOL P~GE 559 NAHE /.~CEL NUHBER...--B-IL't'-14DFtlJEI~"~. NAHE CHILDERS L G & D L & R L~ _I~I)_r_2-J)cJ)~L--~--OD:~IiOJ]O:BD=O~'-"CHILDRESS JIHHIE D & EUELYN CHILDERS LLOYD G III-Zd4-3Z-O0-4 00-000000-00-0 CHILDRES5 JIHHIE D & EUELYN .CHILDERS LLOYD g 388-121-27-00-8 00-000000-00-0 CHILDRE55 JIHHIE 0 & EUELYN CHILDER5 LLOYD G & DONALD L 129-041-02-00-3 "DD=DODODO-DD-D CHILDR£5$JIHHIE g & EUELYN CHILDERS LLOYD G JR · !'40-340-06'00-§ 'OO-DDDDDD-DD-IlrJ~CHILDRE55 JIHHIE'D"&'EUELYN CI:LJLBER5 LLOYD G JR & REX R 112-2P1-12-00-3 00-000000-00-0 CHILDRESS JOHN H Ill & LUCY CHILDER~ LORR i & KOELZER LOU'I86-183=IO-DD'=§ OD-DDDDDD-DO-D "CHILDR£55 LARRY R & EDENR LEA CJ:IILDERS PHILLIP N & SUSAN K 331-212-14-00-P 00-000000-00-0 CHILDRE55 HILgRED E CHILBERS ROBERT F 124-093-11-00-3 O0-O0000O-OO-O CHILDRES5 PRTSEY & EUBRNKS C _CI::LLLDERS ROBERT F JR 149-303-04-00-4 O0-O00OO0-OO-O CHILDRESS RANDY J &RNNR H CHILDERS ROY 172-102-26-00-3 OD-DOOOOD-DD-D CHILDRE55 RICK D CHILDERS S JOYCE 022-163-14-00-9 00-000000'00-0 CHILDRESS ROBERT H & PATSY _CI:IJI.-DERS THURHRN & ANITA 113-033-23-00-0 O0-O00OO0-O0-O CHILDRESS THOHRS NILLIRH CHI~DERS THURHRN T 148-260-0§-00-7 OD-DOOOOO-DD-D "CHILDRE55 NILLI5 H & KRTHRYN CHILDERS TROY L & RLLENE R 111-081-08-00-4 OO-OOOOOO-O0-O CHILD5 CHESTER D & RAGNA 0 CHILDERS TROY L & RLLENE R 111-123.08-0~-9 RR-R~R~R-nn-n rN~n~ nn~o~n ¢ ~',.~o~mm , ~, TRACT 1646 25% ZNT N.R. IN LOTS 47 TO 59 . ~ ., ~' 2216 LARCUS AVE 8AKERSFIE~ .... 0000 '" 000 ~' 00000 ~ STATUS=7 1 - ..... 17 " "~ 1349 ~ * A O? A 07 A 07 * ~ A 08 140-340-05-01-4C NETZEL WINIFREO N "' 4873-2428-- ~' "~ 141-031-14-00-5C FLORES EUGENE J $ SOLEDAD S TR 056-055 ~: '" ~ 25,021 "056-§72 ':" 1 Z FLORES EUGENE & SOLEDAO TRS 00000 ' 5 .... 56,917 ~ 00000 ~ 5 ~ 26000 78228 ~ 8536 KERN CANYON RD 850 12131174 ~ ~' '~ 01010 81030 ~' 926 JOTCE DR 07114186 BAKERSFIELD CA 93306 ....... BREA CA 92621 " - 8536 KERN CANYON RD 150 ......... "' 926 JOYCE DR " BAKERSFIELD CA 93306 ~ ~ 79,945 79,945 ' ~ aREA CA 926~1 " "BEG AT SE CON SEC33 TH N 332.7 T-N 661.6 TAX DEFAULTED 1988 ~ ." '~ 2214 LARCUS AVE BAKERSFIEI " ..... 0033" 029 "- 00028 ' 3.31 ACTIVE 0 ...... 0000 '" 000 ~' 00000 140-340-05-02-3C ECHENIQUE JOHN P & LOUIS N .... u .... 141-031-15-00-8C SPADY NARV[N C 056-055 ....... ~' '; 056-072 ~- 1 '" 00000 ..... ~ 00000 " $ 82020 ~ 402 S CHESTER AVE 00100/00 ~ ~ 01010 78228 2212 LARCUS AV 00100/00 BAKERSFIELD CA 93304 ..... BAKERSFIELD CA 93307 "H 701 " 402 S~CHESTER AVE ....... ': 2212 LARCUS AV BAKERSFIELD CA 93304 ~ ~ -- ~e~ BAKERSFIELD CA 93307 " - 25Z XNT N.R. BEG AT SE CON SEC TH N 332 ~' 2212 LARCUS AVE BAKERSFIEI ...... 0033" 029 '' 00028 ACTIVE ~1 ...... 0000" 000 "~ 00000 140-340"06-00-8C CHELDERS LLOYD G JR -' 6141-0411 ~ ~' '-' 141-031-16-00-1C YNXGUES ANTONXO B - 61~7-0~ 001-003 ~ B BAXNTON DOUGLAS J ~ '~ 55,203 "056-072 .... 1 84251 .... 55,203 ~ 00000 '~ 5 "' 23010 86211 ~ 505 BOBWHITE CT 07/11/88 ~ ~ "01010 75228 2210 LARCUS AVE 05~31188 BAKERSFIELD CA 93309 ....... '" BAKERSFIELD CA 93307 FRON PARCEL ~ 505 BOBWHITE CT ,,. .... ~' 2210 LARCUS AVE 140-340-06-02-6 BAKERSFIELD CA 93309 ~ 110,406 110,406 ~ BAKERSFIELD CA 93307 .... PTN SEll4 EXCL OF ~R TAX DEFAULTED 1984 ...... 2210 LARCUS AVE BAKERSFXEI B--1" 33 "' 29 "' 28 ACTIVE I B--1 ,. 0000 '" 000 '~ 00000 140-340-08-01-3: 3-g PROPERTIES " 5620-1281 .... --' 141-031-17-00-4C LEE PATRXCXA gONG - 4859-05 056-090 '~' ' Z NXCHAUD NORNAN L .... 165,611 .......... "056-072 ~' I 88254 ..... 408,153 ~ 00000 " 5 '~' 37010 88084 ~ RT 6 aOX 5480 01131/84 .... '-. 01010 78228 3701 CENTURY DR 09/50174 BAKERSFIELD CA 93307 ....... ~'" BAKERSFIELD CA 93306 ~ RT 6 DOX 5480 ......... ~' 3701 CENTURY DR BAKERSFIELD CA 93307 ~ 573,764 573,764 ...... BAKERSFIELD CA 93306 .... Nll2 OF NII2 OF E1/2 OF SE1/4 ~ SE1/4 EX ~ ~, " ~ 2208 LARCUS AVE 'BAKERSF%EI ...... 0033 "' 029 '~' 00028 4.55 ACTIVE ...... 13 .... 1349 140-340-08-02-2C BLODGET VIVIAN A ET AL ~ 5416-1524 .... '"~- 141-031-18-00-7C WAGNER BEATRICE S 056-090 ~ ~ 5283-0397~ "' 056-072 ~: 1 CIO TWIST FRED 00000 ..... ~ 00000 ~ 3 --' 82020 ~ P 0 BOX 66 11/30/81 ~ ~ '~ 01010 ' 81030 2202 LARCUS AVE 00/00/00 BAKERSFIELD CA 93302 ...... '" BAKERSFIELD CA 93307 "H ?0( -, P 0 BOX 66 ......... 22O2 LARCUS AVE · BAKERSFIELD CA 93302 ..... BAKERSFIELD CA 93307 - 50~ INT #.R. Nl/2 OF Nll2 OF E1'~2 OF SEll - ~ ~ ' ..... 2202 LARCUS AVE BAKERSFZEI 003~ "~ 029 -- 00028 - ACTIVE 1ii ...... 0000 '~ 000 ~- 00000 14~o340-09o~"~6~~ BLODGET VIVIAN A ET AL ~ 5416-1524 ~ '~: 141-031-19-00-0C JACKSON VERNON 056-089 ~' ~ 5283-039? ......... '" 056-072 '~ 1 00000 - ~ -- '- 00000 " 5 82020 ~ P 0 aOX 66 ~11/30/81 ~ .~ O1O1O ?8228 ~ 715 CHZCO ST O0/O0/O0 .... BAKERSFIELD CA 95303 BAKERSFIELD CA 93302 i: ~ 715 CHZCO ST P 0 aOX 66 ~ BAKERSFIELD EA 93302 .... BAKEHSFIELO CA 93305 502 INT N.R. Ell2 OF SEl/4 OF SEll4 EXC E - ~ ~ 1103 NT VERNON AVE BAKERSF'ZEI ...... 0033 o' 029 -- 00028 - ACTIVE 1 ...... 0000 '" 000 '-: 00000 B O? B O? B 07 * n 00~ PAGE 537 .... 140-340-09-02o5C ALNA %NVESTNENT CO "4331-0236~ ~' '"' 141-031-20-00-2C SANDOVAL PETRA ' 5875-1 '" 056-089 ~' I .............. 056-072 '" 1 ~ 00000 " 5 ..... 88260 '~ 5 ..... "82020 ~ 3~5 S CHESTER AV 10/31169 .... 01030 88105 709 NT VERNON 05122186 o,. BAKERSFIELD CA 93304 ....... " BAKERSFIELD CA 93307 "H 70 ' 325 S CHESTER AV ' ....... 709 NT VERNON BAKERSFIELD CA 9330& ;~ ...... BAKERSFIELD CA 93307 · ., ' 25~ %NT N.H. EII2 OF SEll4 OF 114 EEC N ....... " 709 N1 VERNON AVE GAKERSFIE .... '" 0033" 029 "~ 00028 ~ ACTXVE 1 ...... 0000 '' 000 '" 00000 FREEWAY ~LIQUOR I CHILDERs', LLOYD .. '-... 2030 E. BRUNDAGE I 208 RAY STREET .... .. :. BAKERSFIELD,' CA I OILDALE, CA.. 93308 ' .' .. TANK ~ ~IIN YRS[ SUBSTANCE CODE PRESSURIZED PIPING? - 1-3 UNK MVF '1 UNK NOTE; ALL INTERIM REQUIREMENTS ESTABLISHED BY THE PERMITTING... . AUTHORITY MUST. BE MET D~RINO THE TERM O~ .THIS PERMIT ' ., ,..:.'.;.:.:~:.. :.,...-:'.... ..' ..... . . . : :{ : . : ' '.: . . . . ...:. ., .-.':':':.,..'.'.: ..' .. : . .' .,: ...., '-..-.,,:..'...'....: :.:, , .... '. :: ...' '' -.' ~:T&:.: ...~. ~ :':'..'.".:.',.. '.:' ' .. ' ' - . '. .. '. ' .... .. "- '..'. / .'~ ~..~- '.~ . .-.' . '. , .. - ..' .. ~... ..... · .. . . ~. .. ....,~ .' .. PE~IT CHECKLIST Facility Permit # ~B~90~3 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 days of receipt. Check': Yes No A. The packet I received contained: 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. 2) Standard Inventory Control Monitoring Handbook #UT-10. 8) The Following Forms: a) Inventory Recording Sheet b) Inventory Reconciliation Sheet with summary on reverse c) Trend Analysis Worksheet _ 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 required equipment (as described on page 6 of Handbook): / ~/ 1) Acceptable gauging instrument 2) "Striker plate(s)" in tank(s) i// ., 3) Water-finding paste / D. I have read the information on the enclosed "Information Sheet" pertaining to Agreements between Owner and Operator and hereby state that the owner of this facility is the operator (if "no" is checked, attach a copy of agreement between owner and operator). E. I have enclosed a copy of Calibration Charts for all tanks at this facility (if tanks are identical, one chart will suffice; label chart(s) with corresponding tank numbers listed on permit). ..l/ F. As required on page 6 of Handbook ~UT-IO, all meters at this facility have had calibration checks within the last 30 days and were calibrated by a registered device repairman if out of tolerance (all meter calibrations must be recorded on "Meter Calibration Check Form" found in the Appendix of Handbook). ,/ 0. Standard Inventory Control Monitoring was started at this facility in accordance with procedures described in Handbook #UT-10. Sfgnature of Person completing Che~c'_~st: ~ ~ / / . X~Date: ,W .... Kern County Health Departmen~ Permit Division o£ Environmental He~ Application .~. 1700 Flo~r Street, Bakersfield, CA 93305 APPLICATION FOR PERMIT TO OPERATE UNDERGRO~ HAZARDOUS SUBSTANCES STORAGE FACILITY 7~pe of Application (check): DNew Facility DModification of Facility .~EXisting Facility [~Transfer of Ownership A. ~mergency 24-Hour Contact (name, area code, phone): DaYs ~.3 23-O~/ Nights Dg? Facility Name e"'~"--~C~ &C'~" V ~., ¢ uo((~ ' No. o~f Tanks Type of Business (check): ~lGasolih~ StatiOn ~Othe.r (deSCribe) Is Tank(s) Located on an Agricultural Farm? EYes '~No ' Is Tank(s) Used Prima_r~ly for ~Agricultu,ral Purposes? ~Yes [2]No Facility Addre _.earest Cro T R SEC (Rul~l Locations ~nly) Owner ~ IO%/~ (.~l.~t~[r~ ~'~..~ ~ Contact Person ~A~ Operator ~/~.~ ~__ ...... Contact Person Address Zip Telephone B. Water to Facility Provided by C~<] /, [~y~,~-k/ Depth to Groundwater Soil C~aracteristics at Facilit~ - ~ ' ' Basis for Soil Type and .Groundwater Depth Determinations C. Contractor CA Contractor' s License No. Addr ess Zip Telepbone Proposed Starting Date Proposed Completion Date Worker's Compensation Certifi6ation ! Insurer D. If This Permit Is For Modification Of An ExiSting Facility, Briefly Describe Modifications Proposed E. Tank(s) Store (check all that apply): Tank ! Waste Product Motor Vehicle Unleaded Regular Premium Diesel Waste Fuel F. Ch~iCal Composition of Materials Stored. (not necessary for motor vehicle fuels) Tank % Chemical Stored (non-commercial name) CAS % (if known) Chemical Previously Stored (if different) G. Transfer. of Ownership0 Date of Transfer Previous Owner Previous Facility Name I, accept fully all obligations of Permit No. __ issued to · I understand that the Permitting Authority may review and modify or terminate the transfer of the Permit to Operate this t~dergrot~d storage facility upon receiving this completed form. This form has been completed under penalty of per)ury and to the best of my knowledge is true and corree~. S igna t ure ~ ~-~ ~ ~ Title ~~C4~t Da t e ~//~/~ TANK #~ ~d-- (FILL OUT SEPARATE FORM _F~V2%CH TANK) ----"~--R ~ECT-~-O~, ~ECK ~i,. APP-~R~A--~_ BOXE~ 1. Tank is: ~lvaulted [-1Non-Vaulted []Double-Wall [-ISingle-Wall '~, 2. ~ Material 'carbon Steel [] Stainless Steel [~]Polyvinyl Chloride [~]Fiberglass-Clad Steel Fiberglass-Reinforced Plastic [-] Concrete [~ Alt~nintml [] Bronze ~3nkr~wn Other (describe) ..... 3. primary Containment Date Installed ~ Taickness (Inches) Capacity (Gallons) Manufacturer 4. Tank Secondary Co~{~atnment ['TDouble-Wall []Synthetic Liner []Lined Vault []None ~Unkno~ l'7Other (describe): ~ Manufacturer: ~lMacerial ThiCkness' (Inches) Capacity (Gals.) 5. Tank Intertorl~O..-~ '--~Rubber ..... [] . []Epoxy []Phenolic' ['lG!ass U1Clay []t~llned [~Other (describe) ~ 6. Tank Corrosion Protectl'on ...... r or Asphalt l~[Unkno~n [:]None ~DOther (describe)~ .' Cathodic Protection-- [:]None []Impressed Current System r~sa'crif[l¢lal Anode System Describe SYstem & Equil~ent: ')~ 7. Leak Detection, Monitoring, .and Interception . ' ..... a. Tank.."'~lVisual (vaulted' ~ks only) []Groundwater Monitorir~' ['lvadose Zone Monitoring Well(s) [~U-Tube Without Liner [~tl-Tuba with C(~m. patible Liner Directirg Flow to Monitorirg Well(s)~ Vapor Detector* [] LiqUid Level Sensors [] Conductivit~ Sensor' [] Pressure Sensor in Annular Space of Doub,e Wall Tank .Liquid Retrieval & Inspection From tl-Tube,_Monitoring Well or Annular Space.' ~ugi~ & ~nventory Reconciliation ~ ~eriodi¢ [] None [] ~nkno~ [] Other bo. Piping~ ~low-Restricting Leak Detector(s) fo~ P~essurized Piping' ~TMonitoring S~p with Race~y ~TSealed Concrete Raceway nkn lf-Cut ¢~mpatible Pipe Raceway [] Synthetic Line~ Raceway []None om ~ O~her ,, ~ *Describe Make & Iqodel=' ' 8. Tank Tightness HaS ~ls ran~ seen Tightness Tested? E]¥es []No ~[~nkno~n Date of Lasf Tightness Teat Results of Test Test Name -Testing C~npany 9. Tank Repair ..... Tank ~ePaired?'rTYea rTNo ~Unkn0. m Dace (s) of Repair (s) Describe Repairs 10. Overfill Procecti~ " []Operator' Fills, Controls, & Visually Mon~Jtors Level []Tape Float Gauge []Float Vent Valves [~LAuto Shut- Off Controls Capacltance Sensor []Sealed ~tll Box []None []Unkno~ Other: List Make & Model For Above Devices 11. ~ ............... ~ a. Underground Piping: []Yes []No ~tlnknown. Material Thickness (Inches) Diameter Manufacturer []Pressure []Suction: [:]Gravit7 Approximate Length o'~ Pipe ~ - b. Underground Piping Corrosion Protection : [:]Galvanized rTFiberglass-Clad [:]Impressed Current ['lSacrilicial Anode ethylene Wrap ['lElectrlcal Isolation []Vinyl Wrap []Tar or Asphalt own []None [:]Other (describe): c. Underground Piping, Secondary Contal~nent: [:]Double-Wall []Slmthetic Liner 5~stem []None E~nknown ~Other (describe): TANK # ~ (FILL OUT SEPARATE FOIl4 _F~ TANK) 1. Tank is: I-]Vaulted [[]Non-Vaulted E]Double-Wall []Single-Wall 2. ~ Material 'carbon Steel I-]stainleSs steel' [']Polyvinyl Chloride [-IFiberglass-Clad Steel Fiberglass-Reinforced Plastic [] Concrete [~] Alumin~[~] Bronze ~Unknown Other (describe) 3. Primary .Containment ~ Date Installed Thick~ess (Inches) Capacity (Gallons) Manufacturer 4. Tank Secondary Co6tainment ~lDouble-Wall []Synthetic Liner []Lined Vault []None ~Unknow~ ['1 Other (describe): Manufacturer: ~'~Material Thi6kness (Inches) Capacity (Gals.) 5. Tank Interior L~ [~Rubber []Alkyd []Epoxy [2]Phenolic DG!ass [~Cla¥ [~t~li~ [3Other [de~rib,): 6. Tank Corrosion Protection ---~Galvanized ~ass-Clad ~Pol~thylene Wrap []Vinyl Wrap~in~ [~Tar or Asphalt. ]~kn~m~ ['1None ~Other (describe): Cathodic Protection: ['~None []Impressed Current System ["ls~cr'lficial' A~s system Des~ri~ System & Equipment: / 7. Leak Dete~tion, ~, .and Int~ . .a. "Tank:. []ViCed' ~'~ onl~-~Ground~ater Monitoring' Well(s) r~vadose Zone Monitoring Well(s) '[]U-Tube Without Liner [~]U-Tube with Canpatible Liner Dlrectirg Flow to Monitoring Well(s)* [] Vapor Detector* [] Liquid Level Sensor' ~ Cond~ctivit~ Sensor' [].Pressure Sensor in Annular Space of Deub~e Wall Tank .. l'~ LiqUid. 9etrieval & Inspection From U-Tube, Monitoring Well or ~nnular Space. Dall¥ Gauging &Xnventor¥ Reconciliation ~]Periodtc Tightness Testing' None [~] Unknom [] Other b. Piping: [~Flow-Restrictin~ Leak Detector(s) [or Pressurized Piping' []Manitoring S~p with Race~a¥ []Sealed Concrete Race~y I-~Ralf-Cut Compatible Pipe Race~a¥ [~] Synthetic Liner Race~a¥ []None *Describe Make & Model: 8.. Tank Tightness Bas Tt~s Tank Been ?i~hkness Tested? []yes [1NO ~'UnRno~m Date of Last Tightness Test Results of Test Test Name Testing Canpan¥ ~ '-- --l~epaired? :DYes I-INo ~_Onknown Date(s) of ~epair(s) ~escribe Repairs 10. Overfill Protection. ~lOperator Fills, Controls, & Visually Monitors Level [[]Tape Float Gauge ~'lFloat Vent Valves ~[~uto Shut- Off Controls Capacitance Sensor []Sealed Fill Box [2]None Other: List Make & Model For Above Devices ll. Piping "~ ' ' a. Underground Piping: ~¥es []No ~gknown Material Thickness (inches) Diameter Manufacturer []Pressure []Suction ~]Gravit¥ Approximate Length of Pipe b. Underground Pipin~ Corrosion Protect[on : [']Galvanized ~lFiberglass-Clad [[]Impressed Current ~Sacrificial Anode []Polyethylene Wrap [2]Electrical Isolation [2]Vinyl Wrap []Tar or Aspl~alt ~nknown [2]None []Other (describe): c. Underground Pipit], Secondary Contal~ent: [2]Double ;','all [[]Synthetic Liner ~s~em [2]None. ~Unknown [']Other (describe): , \ TANK ~ (FILL OUT S~]PARATE FORM FG~'~CH TANK) FOR EACH SECTION, CHECK A!-f- APPROPRIA~ BOXES {. 1. Tank is: []Vaulted F~Non-Vaulted []']Double-Wall F]Single-48all 2. ~ Material Carbon Steel [] Stainless Steel [] Polyvinyl Chloride [] Fiberglass-Clad Steel Fiberglass-Reinforced Plastic [] Concrete [] Al~inum [] Bronze ~[Jnknown Other (describe) 3. Primary ~ Containment Date Installed Thickness (Inches) Capacity (Gallons) Manufacturer 4. Tank seconda'ry containment '[]Double-Wall F1Synthetic Liner FT Lined Vault FTNone ~Unkno~t []Other (describe): Manufacturer: [] Mater lal ThiCkness (Inches) Capacity (Gals. 5. Tank Interior L-'~ [~Rubber []Alkyd FTEpoxy FTPhenolic [-]Glass [.']Clay []Unlined ~Unkno~ r~other (describe): . 6. Tank Corrosion Protection ~_~-[~-~~-~ass-Cled [[]Polyethylene Wrap r'lvtnyl Wrapl~lng [qTar or Asphalt ~Unknown DNone DOther (describe): Cathodic Protection:' ~]None DImpressed Current System ['1Sacrificial Anode System ~.. Describe System & Equi~ment: 7. Le~k Detection, MOnitoring, .and Interception .... a. Tank: r~visual (vaulted tanks only) FqGroundwater MOnitorir~j' Wail(s) FTVadose Zone MOnitoring t~ell(s) FTU-Tube Without 'Liner [].U-Tube with Compatible Liner Directing Flow to Monitoring C1 Vapor Detector* ri Liquid Level Sensors [] Conductivit~ Sensors r7 Pressure sensor in Annular Space of Doubie Wall Tank l'1 Liquid Retrieval & Inspection Fr~m U-Tube, Monitoring Well or Annular Space. Dally Gauging & Inventory Reconciliation FI periodic Tightness Testing None unk"o Oother ,,, .,,. b. Piping: FIFlow-Restricting Leak Detector(s) for Pressurized Piping" DMonitoring S~np with Race~y rqSealed Concrete Race~¥ []Half-Cut Compatible pipe Raceway FTSYnthetic Liner Racebmy ['lNona E[Unkno r7 Other ~ *Describe Make & l~odel: Ti hmess sted? O es D~te of Last Tic~htness Test ~esults o[ Tes~ Test Name Testing Ccmpany 9. Tank Repair . ' Tank Repaired? FTYes rTNo [~Jnknown Date(s) of Repair(s) Describe Repairs 10. Overfill Protection []Operator Fills, Controls, & Visually Mo._n~tors [~vel . r~Tape Float Gauge []Float Vent Valves ~Auto S.h~_t- Off Controls [~]Capacitance Sensor [2]Sealed Fill Box []None ~nkno~a~ ~Other: LiB[ Make & Model For Above Devices a. Underground Piping: FqYes ['~No ~[~known Material Thickness (inches) Diameter Manufacturer D']Pressure []Sucti'on ~Gravity Approximate Length Of ~Pipe b. Underground Piping Corrosion Protection : ~Galvanized [2]Fiberglass-Clad [[]Impressed Current r'lSacrificial Anode [-~Polyethylene Wrap ~Electrical Isolation [[]Vinyl Wrap []Tar or .Asphalt ~nknown [[]None DOther (describe): c. Underground Piping, Secondary Containment: ~Double-Wall nsynthetic Liner· System [~None ~Unknown ['~Other (describe): ~ ' &F ~ r BAKERSFIELD FIRE DEPARTMENT.- '~ ' - Dote APPLICATiON..~: -..:.'.~ . . .:- ..:'.... ' .. :,-?:. =?~: ".. In conformity with 'provisions of pertinent ordinonces, codes ond~or', regulOtions; - - Nome of Compony Addres~s.'-. to disploy, store, instoll, use, operote, sell or hondle moteriols, or.. processes:q .nvolving'~°~-creoting,.con- ditions deemed hozordous to life or property os follows: ~"' ~;~;i~ ' ~presentotive " ........... Perm~ . I-- ~- 'IC~ By ...... ..~....~.......~..~ ........ ~ ............................... Dote Fire A/~rsl~l