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HomeMy WebLinkAboutBUSINESS PLAN 4/21/2004 ![1~ PROGRAM IN CT~N ~EC~LIST ~1~ ~l~~ ~'~'~:~'~~**'~~=~:~ Enironmental Se~ces SECTION 1 Business Plan and Invento~ Program ~ Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME ~ . INSPECTION pATE INSPECTION TIME , ~ ...................................... ~- - -- PHOH~ ~o. Ho. of ~.c~u~co~.c~ 1 ~-0~ 1 - Section 1' Business Plan and Inventory Program Routine "~Combined [] Joint Agency ~1 Multi-Agency UI Complaint [] Re-inspection ( ~vCi(~lr~tl~ace) OPERATION COMMENTS APPROPRIATE PERMIT ON HAND BUSINESS PLAN CONTACT INFORMATION ACCURATE CORRECT OCCUPANCY VERIFICATION 0F QUANTITIES ..................................................................................................... PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILI~E VERIFICATION OF HAT MAT TRAINING VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES EMERGENCY PROCEDURES ADEQUATE ............................................................................................................................................. HOUSEKEEPING F~RE PROTECTION SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?; ]~[,YES [] No N? PLEASE CALL US AT (661) 326-3979 i i-~s~~ 0 0 ~fin ess Site I~sp°n sible'l~a"d~ (Plea se Print~-/~4f'~ I/'~["' ....... r (Please F~nnt)' - - ............. ~i-i;~r~-~-n~-~-~/~if{-~-~i~'~ ............... White - Environmental Services Yellow - Station Copy Pink - Business Copy Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: [] Hazardous Materials Plan [3 Underground Storage of HazardOus Materials E] Risk Management Program I-I Hazardous Waste On-Site Treatment PERMIT ID # 015-021-001179 ~ PENSKE TRUCK LEA~ ~,~.~ ~ LOCATION 2929 E ~B ~- 93307 TANK HAZARDOUS SUBSTANCE '~dA~~w ~¢ ~Ol'~P~N~R PAN MONITOmNG 015-000-001179-0001 DIESEL FUEL ~7 ~. ¥'~';, '~' ':~ 0~-~ DISP '~ 12~000 DISP P~ SENSCR~OmOS SHUTOFF 015-000-001179-0002 DIESEL FUEL ~2 ~': ~2-~ ~' ?,.:~ .. OFFICE OF ENVIRONMENTAL SER VICES' 1715 Chester Ave., 3rd Floor Approvedby: ~(~U~¥¢mey. D~~ ~s~ Bakersfield, CA 93301 om~¢ore~o,~ns~ - Voice (661) 326-3979 June 2OO3 FAX (661)326-0576 Expiration Date: City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (661) 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 16th day of May, 2001 to: PENSKE TRUCK LEASING Permit/4015-021-001179 2929 E. Brundage Ln. Bakersfield, California 93307 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 thc following information inthe format of I 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 2na day of November, 1998 to: ROLLINS LEASING CORP Permit #015-021-001179 2929 E Brundage Ln Bakersfield, California 93307 HazardoUs Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This I;mrmit is issued for the followin_.: E] Hazardous Materials Plan [3 Underground Storage of Hazardous Materials Permit ID #:: 015-000-001179 [] Risk Management Progmm ROLLINS LEASING CORP n Hazardous Waste On-Site Treatment LOCATION: 2929 E BRUNDAGE LN IELD TANK HAZARDOUS~SLJ'~§~ANG~ ,~,,., CZP~¢l'~:'?!~,.~,...:r.... DISPENS~ 015-000-001179-0001 DIESEL FUEL #2 ~"' ! ~' ';~ :~ .... ~ ...... <:.:.:'7.'~;f2~:~DiSP~';~-.P,..AN SENSOR WI, POS. SBUTOFF 015-000-001179-0002 DIESEL FUEL #2 OFFICE OF EN~R ONMENTAL SER ~CES  1715 Chester Ave., 3rd Floor Approved by: ~lpCHuey, D~ Issue Bakersfield, CA 93301 O~ceofEv~S~ic~ Voice (661) 326-3979 F~ (661) 326-0S76 Exp~tion Date: Permit to Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: LOCATION 2929 E B R U N DAG E~?':::';:~:'~?~'~'~: ~.??."~ ""~,: '-. '":" .~L....::~ ~?,~,,;~] ~ ~?,~ ~ ~AN K,~: ":::~ ,,:;~ TAN K PIPING PIPING PIPING PI TAN H~RDOUS SUBSTANCE cAPA~I~ ;':[, GAL ~;:~:-:}~::'~[~ ":~' :~;t ~,, ~'~}~~i~}~~ "~:~L ~.NiT~'R:: ::~ ONITOR TYPE TYPE METHOD 0 0001 DIESEL FUEL ~2 1~0~,.00 O:~k ...... ':,;=~'"~[~?~:~ ;~DW F ?:'?CED ,?.(.?::.~ ATG DW F PRESSURE CLM 0002 UNLEADED GASOLINE 8,~00.00 GAU',~::,. ...... '~..-,...., ~ DW F ?,,,?- ATG~'~?-,~,:?' CLM DW F ' PRESSURE ALD 0004 MOTOR OIL 6,0'~O~0b ~?:~t~:;;:~:';~)~/.?., :~= .~ DW. ::F~::~, .,4;;',?"" ATG'~,,.:?' CLM DW F SUCTION CUM 0015 DIESEL FUEL~2 12,000}00-GA~i~ .~i/:;L;~::~::::;:::~j~-(~ DW~}~:.~;~;;:':;~ .... ~G~/~ CkU DW F PRESSURE GEM '"~u"""" ' · '" ~:~:=¥'"" '"~" ~' " ' ~ ' ~ ' I ~ ~'~' B~ersfield Fke Depa~ment Approv~ by:  OFFI~ OFE~RON~AL S~ ~CES ph Huey, 1715 Chewer Ave., 3rd Floor ce of  Voice (805) F~ (805) 32~576 Exp~ationDate: June 30~ 2000 JOE DOMINGUEZ SERVICE MANAGER PENSKE TRUCK LEASING 2929 EAST BRUNDAGE LANE / BAKERSFIELD, CA 93307 TELEPHONE: 661-322-2600 / FA.X: 661-322-2743 www. pensketruckleasing.com 109755 ROLLING 140 2929 E BRUNDAGE BAKERSFIELD CA 80448302105001 ~ APR 21, 2004 10:36 AM SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL INVENTORY REPORT T I:DIESEL 1 SOUTH VOLUME = 6508 GALS ULL" ~ = 5086 GALS 90~, I~LAGE= 8926 GALS TO VOLUME = 6465 GALS HEIGHT = 49.58 INCHES WATER'VOL = 0 GALS WATER = 0.00 INCHES TEM~ = 74.4 DEG F T 2:DIESEL 2 NORTH VOLUME = 5905 GALS ULLAGE = 5689 GALS 90~ ULLAGE= 4529 GALS TC VOLUME = 5866 GALS HEIGHT = 46.40 INCHES WATER VOL = 0 GALS WATER = 0.00 INCHES TEMP = ?4.5 DEG F MAN I FOLDED TANKS INVENTORY TOTALS T I:DIESEL 1 SOUTH T 2:DIESEL 2 NORTH VOLUME = 1241,3 GALS TO VOLUME = 12,331 GALS ~ ~ ~ ~ ~ END ~ ~ * ~ ~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CltECKLIST 1715 Chester Ave., 3ra Floor, Bakerstield, CA 93301 Section 2: Underground Storage Tanks Program [21 Routine [~Combined ~ Joint Agency [~ Multi-Agency [2] Complaint [21 Re-inspection Type of Tank D~O F Number of Tanks Type of Monitoring O_,L.w'x Type of Piping OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on filc 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 ~ ~r · Omce of Oge&~ ~e.~661~-3979 Party Sep-25-03 07:52A TAN t_OGY 909 8 1239 P.01 nn, l,~ ,.'uu,~ [~:~'! UK~SFLU FIRE PREVEHTIOH (6611852-21'7:~ po~ CITY OF BAKERSFIELD OFFICE OF ENVIRONMEnt!, SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION 1;,,,c~.~.. ~<-~-~' ......... o',w~. N~,M~ ~'~~, , D0]~ PAC~[LITY HAVB DISP]~$1~R PAN$'~ YI~S NO _ .. Secondary Containment Testing Report Form - DRAFT This form ~ tntended for u~e by contractors performing periodic testing of UST secondary contatnmtnt systert~ U$¢ the appropr~ale pages of thiJ form to repor~ results for all components testec~ The completed ~rm, written tt~t procedureJ. and p~ntourJ ~om text~ ~ appltcable), ~hould be provMed to tht facilt~ owner/ope~tor ~r xubmittal to the local regulato~ agency. 1. FACILITY INFORMATION P~i~ Cont~t: " [ Phone: D~ ~g Affc~y W~ Notified of Tes~g: ~ ~G.CON~~R ~O~TION 4. 'lANK ANNULAI;~ Tcs~ Mcdaod Dc,.,¢lupcd By Tank Manu/actu[ct Indusu~' .~ndm'd .P~'o/ess[onal Ungincc~ ~CS~ ~C~ {]Scs Prcss~c~ I lydro~aHc O~cr Wai~ 6mc ~w~n applying pr~s~v~ou~wa~r and st~ing Co~n~ -.(incl~e info--rion on repairs ~ prior.to test~g~ 5. SECONDARY PIPE TESTING Test Method [)~vclopcd By Pq~mg M~nufactucc~ [ndusuy ~(aml~rd Professional ~.n~ ncc~ [~ss~ - I'c~ Med~ tJscs ~ Vacuum Ilyd~os~Oc Omct _ ~pi~ Run ~ Piping M~ufacturer: ~~ ~~ , Piping Diame~r: ~ ., k ~' ~ng~ of Piping Run: ~/~. /~" ~Y. /~0 e M¢~ ~ l~tion of . Writ fi~ ~tw~n ~l~ng T~t ~8 T~: . . '//~m '"' ""' //~m -" '' ,,. T~o,: . .:...~0' ~'l~, .. " :G~,' m~, ." .. · ~".'~}~'., : ~ ~, :.. " W ', Z' os.~ ,.C ¢~ ~ · ~: 5:0 s ~ ( ~'}' '~ l ~ ~.'* % ('. ".".~ )' . · ...~ ~.--:~,. ' .~ Co~en~'- (inct~e in/o~ation' on repairs ~de prior to te~)' . "' 'l ¢ ,,1 Nlc(hbxJ l )c vcloped II y ~ll(T~l~ Marlu[aC(u~cl In(luslJ y ~land~d ['ri)(c~i.mal I:nlp nec, 1'esl Mclhod Usc~ P~s~u~( V~uum HeiSt ~om T~k Top to Higher ~. Hci~hl ~om T~k Top lo Lowcs[ ,. . ,~mp ,~r dc~ ei~r pr~uc, .W~ ~ ~n ~plg~-" .. - .. · ' T~V~: ' /~:/: ' -/~ :"/~ W~ sensor remo*~a for ,orang? ..... ~ _~ k i.c < " ~J ~ 5 ............ Was ichor properly ~plac~ afl~ J .......... C9~.~ents.7 ~ m~l.'J/(~.~Yf~rmfftion.°,n re?ms .,(~d.e nf-,'?~.'_~O 7. UNI)EF,-DI,~PENSEJ{ CONTAINMENT (I, JD(.')I'I-i,NI'ING Height ~om ~ Bonom~ H~h~t Piping Pene~alion: Height ~om ~ Bottom to Co~ia0n of ~ pn~ to P~ion of ~ T~t~' ~OTT~ ~s ~iac abut do~ T~ine s~~ res~n~ . ~nE.'. · . .. . . · . ,, ,, ~g¢ ia R~diag (RrRo:. " w~ $cnsol removed-for Ws~ ~r proper'[y r~pl~cd Co~en~ - (include in~o~ntion on rez~n,r~ msde pr,or fo ~ezm~&k . 8. t"11,1, RISI';R CON'IAINMI'}NT SUM, P ]'c~l M¢lhc',d [.)c~clol~d FI), Sump Manula<lulc~ Indusuy Sland~d Piofcssional P.n~.Jncct T~SI M~ Uses. '--' ~css~ Vncuum O~hc~  Fffi Sum~ ~ Sum~l ......... Fill Sump D~IeL _. Sump ~pth: __ , Height ~om Tank T~p to High~{ Piping PeneeaUon: HeiSt flora Ta~ T~ to ~west El~cal Pen¢~ation: · ~ndifion of sump pn~ to ~tin$: . P~on of Sump T~t~ ~TO~ " 80'T'~O~ " ~OTYO~ S~ ~t~M: .. · _ .... W~t ~ ~w~ a~l~ng T~ $~W~: , · ,. ....... T~~: . ...:, ·. '. .... ,I ~$,~~: '.. . · .,:... .-. ... : ~;~a~sorin~? ...... . . '..~..:'.. ~'...'..;.' ,.: .. , · ~~~en ' '. ' .- .. ' - ei~'~u~ or wat~ is . " ~ ~ '.. . .. W~ ~n~or re~v~ for .. resting7 Was sen~ ~o~rly r6pl~ ~r testing?, · . · Com~n~ - (mcl~e in/o~tion on repairs made prior'~o ~esIing) 9. SPILIJOVER.FILI. CONI'AINMENT BOXES Test Method Developed By Spill Buckc~ Manufacturcr lndus~ S~nd~d ~ofcss~on~ ~ng~ncc~ Test Me~ U;es ' ~ssm¢ ,.Vacuum O~er (Speo~) pr~s~v~wa~r a~ l~tiM R~aI ~D: T~st ~d ~ad R~g (R,): ' ' -~~o~: , .+/:.~.oo~.:~ ,,.')'~.o.~.~C"-")· ~~ 7 (~clMe ~e~tion on repairs ~de p~°r'to, teSt~g) . . ...' .' '.... · l'hisi~ edt:It document intended for public rev;ew ,nrlcommenL Your input Pl~sr c~rccl any cot~en~ regar~ng this form I~)1 l" ~trcc . Box PENSKE 2929 F, BRUNDf~GE LN. OAKERSF I ELi) 01/06.,'2005 ii:~= AT; SUMP LEAK TEST REPORT PENSKE 2929 E. BRUNDAGE LN. UDC N BAKERSFIELD TEST STARTED 11:00 AM 0!/06/2003 TEST STARTED 0t/06/2003 BEGIN LEVEL 0.6405 IN SUMP LEAK TEST REPORT END TIME 11:15 AM END DATE 81/06/2003 Oo~ P-N END LEVEL 0.6485 IN LEAK THRESHOLD 8.882 IN TEST STARTED 18:88 AM TEST RESULT PASSED TE .... STARTED 81/06.'2803 BEGIN LEVEl_ 2.5890 IN ENO TIME 10:15 AM UDC MID END DATE 01/86/2883 END LEVEL 2.5897 IN TEST STARTED 11:80 AM LEAK THRESHOLD 8.882 IN TEST STARTED 81/06y2803 TEST RESULT PASSED BEGIN LEVEL o ~.o~~, IN END TIME 11:15 AM END DATE 81y86y2803 _ DSL P-S .... END EEVEL ~.8928 IN LEAK THRESHOLD 0.882 IN TEST STARTED 10:88 AM TEST RESULT PASSED TEST STARTED 01/8642883 BEGIN LEVEL 2..3197 IN END TIME 18:15 UDC S END DATE 81/86/2883 END LEVEL 2.3192 IN TEST STARTED 11:88 AM LEAK THRESHOLD 8.882 IN TEST STARTED 81~06/288~ TEST RESULT PASSED BEGIN LEVEL 2.1949 IN END TIME 11:15 AM END DATE 01/06/200~ END LEVEL 2.1952 IN LEAK THRESHOLD: 8.802 IN ' TEST RESULT PASSED I . .., ....... PENSKE " "I' ' '. 2929 E. BRUNDAGE LN. BAKERSFIELD' i "'/ " ' ' ' 'i .... PENSKE" '. '01/06/2003 11~31 AM '! .... l, 2929 E. BRUNDAGE LN, · SUMP LE~K TEST REPORT ~ .! .. ' ' L' 81/86/2003.. t0:48 AM. UDC N .' .. .~ ' '. SUMP'LEAK TEsT REPORT TEST STARTED 11:16 AM t i : TEST STARTED 01'/06/2003 DS~'P-N ' @EGIN LEVEL 0.6405 IN ! ' .... END-T}ME ...... 1i:5-t=AM TEST-STaRTED' -10:52 AM END DATE 01/86/2003 TEST'STARTED 01/06/2003 END LEVEL 0,640? IN BEGIN LEVEL 2.5235 IN LEAK THRESHOLD 0.802 IN . END' TIME 10:47 AM TEST RESULT PASSED END DATE 01.:"06/200~ END LEUEI_ 2.5234 IN LE~K THRESHOLD 8.882 IN UDC MID TEST RESULT PASSED TEST STARTED 1!:16 AM TEST STARTED 01/06/2003 DSL P-S BEGIN LEVEl_ 0.8921 IN END TIME 11:31 AM TEST STARTED !8:32 AM END DATE 0!/06/2003 TEST STARTED 01/06/2003 END LEVEL 8.8920 IN BEGIN LEVEL 2.3194 I~ LEAK 'THRESHOLD 0.002 IN END TIME 10:47 AM TEST RESULT PASSED END D~TE 01/06/2003 END LEVEL 2.3192 IN LEAK THRESHOLD 0.002 IH UDC S TEST RESULT P~SSED TEST STARTED 11:16 AM TEST STARTED 01/06/2003 BEGIN LEVEL 2.1951 IN END TIME 11:31 AM END DATE 01/06/2083 END LEVEL 2.1952 IN LEAK THRESHOLD 8.002 IN T~T ~Vq~H'F PASSED ~ ~ ~ ITORING SYSTEM CERTIFICATION - ~ ~', ~ ~, ' All Jurisdictions Within the State of California ~ /,t~ ~~'~ ~ Authority Cited: Chapter 6. 7, ~ and Safety Code; Chapter16, Division3 Title 23, Ca'1~F[lia Code of Regulations This for~l~ust be used to document testing and servicing of monitoring equipment. If more than one monitoring system control panel is installed atthe facility, a separate certification or report must be prepared for each monitoring] 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: PENSKE CA-094 City: BAKERSFIELD CA Zip: 93307 Site Address: 2929 E. BRUNDAGE Contact Phone No: 322-2600 Date of Testing/Service: 10/02/2003 Facility Contact Person: JOE Make/Model of Monitoring System: VR TLS -350 Work Order Number: 3131115 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced Tank ID: 1 Tank ID: ~ ] In-Tank Gauging Probe. Model: MAG I X--'] In-Tank Gauging Probe. Model: MAG1 r~ Annular Space or Vault Sensor. Model: WFT X'~ Annular Space or Vault SenSor. Model: WET ] Piping Sump/Trench Sensor(s). Model: VR-352 ~ Piping Sump/Trench Sensor(s). Model: VR-352 ] Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model:  Mechanical Line Leak Detector. Model: RJ-DL._~D. Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: ~ Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model: H Tank Overfill/High-Level Sensor. Model: Other (specify equipment type and model in Section E on page 2). ~1 Other (specify equipment type and model in Section E on page 2). T~nk ID: I")IF-PlPlN~ LT.,ank ID: OII PIPING ~.~ In-Tank Gauging Probe. Model: ~ In-Tank Gauging Probe. Model: ~ Annular Space or Vault Sensor. Model: VR-352 ~,.~ Annular Space or Vault Sensor. Model: Piping Sump/Trench Sensor(s). Model: Piping Sump/Trench Sensor(s), Model: VR-352  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 Overfill/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: 1 Dispenser ID: ?-SAT F Dispenser Containment Sensor(s) Model: ~'~ Dispenser Containment Sensor(s) Model:VR-322 ShearValve(s). ~] ShearValve(s) [~ Dispenser Containment Float(s) and Chain(s). "'] Dispenser Containment Float(s) and Chain(s). Dispenser ID: 1-SAT Dispenser ID: [] Dispenser Containment Sensor(s) Model: VR-322 ~] Dispenser Containment Sensor(s), Model: [] ShearValve(s). '~ Shear Valve(s). ] Dispenser Containment Float(s) and Chain(s). ~ Dispenser Containment Float(s) and Chain(s). Dispenser ID: 2 Dispenser ID: [] Dispenser Containment Sensor(s) Model: "~ Dispenser Containment Sensor(s). Model: [] ShearValve(s). ~] ShearValve(s). [] Dispenser Containment Float(s) and Chain(s), ~ Dispenser Containment Float(s) and Chain(s). * If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification 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 Site Plan showing the layout of monitoring equipment. For an~y.~equipment capable of generating,~ch reports, I have also attached a copy of the (Check all that apply): System set-up report; L~ Alarm history report xL~ PRINTED NAME.RANDY JAQUEZ SIGNATURE: (~ ~ ' ~'~'~/' COMPANY: Tanknoloq'/ PHONE NO: (800) 800-46~:~ page 1 of 3 Based on CA form dated 03/01 = M~ System Certification Site Address: 2929 E. BRUNDAGE Date of Testing/Service: 1 t3/C)2/2t3t")3 D. Results of Testing/Servicing Software Version Installed: 123.01 Complete the following checklist: [] Yes [] No* Is the audible alarm operational? [] Yes [] No* Is the visual alarm operational? [] Yes [] No* Were all sensors visually inspected, functionally tested, and confirmed operational? [] Yes [] No * Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? [] Yes [] No* []N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment [] Yes B No* BN/A monitoring system detects a leak, fails to..~operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (check all that apply) IXl Sump/Trench Sensors; IXl Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks ~ sensor failure/disconnection? [] Yes [] No [] Yes ~ [] No * [] N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.: no mechanical : overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill points(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? 9o % ~ [] Yes* [] 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 replacement parts in Section E~ below. [] Yes* [] No VV~s liquid found inside any secondary containment systems designed as dry systems? (check all that apply) [] Product; Water. If yes, describe causes in Section E, below. [] Yes D No * Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. [] Yes [] No IS all monitoring equipment operational per manufacturers' specifications? · In Section E below, describe how and when these deficiences were or will be corrected. E. Comments: page 2 of 3 ~ M~ g System Certification Site Address: 292;9 E, B~UNDAGE Date of Testing/Service: 10/O7/2(303 F. In-Tank Gauging / 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. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: r~Yes []No * Has all input wiring been inspected for proper entry and termination, including testing for ground faults? [] Yes []No * Were all tank gauging probes visually inspected for damage and residue buildup? [~ Yes ~]No * Was accuracy of system product level readings tested? [] Yes []No * Was accuracy of system water level readings tested? [] Yes DNo* Were all probes reinstalled properly? [] Yesi []No * Were all items on the equipment manufacturers' maintenance checklist completed? · In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): [] Check this box if LLDs are not installed. Complete the following checklist: [] Yes [] No * [~N/A i For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) Simulated leak rate: [] 3 g.p.h [] 0.1 g.p.h []0.2 g.p.h [] Yes [] No ° Were all LLDs confirmed operational and accurate within regulatory requirements? [] Yes [] No * Was the testing apparatus properly calibrated? [] Yes [] No * [] N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? [] Yes [] No * [] N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? [] Yes DNo * [] N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? [] Yes DNo * [] N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ['--] Yes DNo * [] N/A For electronic LLDs, have all accessible wiring connections been visually inspected? r~Yes DNo* Were all items on the equipment manufacturers' maintenance checklist completed? · In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: page 3 of 3 L~LSL sexo& 'u!lsnv 00~; gu!pi!nfl '~laoa;2) I~°qs 0068 ~ON-'($°l°U~luu& Tanknology SlT~SAFETY CHECKLIST, SERVICE AGREEMENT & OPERATOR VERIFICATION FORM s~e Name: I / , , Address: ?,"~ ~ W.O. ~: S~ . Ci ylST~. Date: / PRE-TEST PROCEDURES~ / POSr-TEST 1. ~ Dis~ss safe~ procedures with site pemonnel. '. ~em~a[' 'L~o~a~u,' dev~s. 2. ~ Prior to fuel deli~ries, the ~mplete lank system 2. ~Run all pum~ ~ ~fi~ there are no ~usl ~ placed ba~ into ~rking order, in S~P~ps. Mu~ ~ wltnes~ ~ site rep~sentatlve. 3. ~ All pumps, dispensers, and el~tri~l breakem of ~ Impa~ Va~e Test ~e product(s) to ~ test~ musl ~ disabled during ~ Leak ~te~or Threes the test(s). / Q Fun~ion~ Ele~nt & Relief Screw 4. ~S~ute entire ~rk area w~th 2W ~nes, flags, a~ 3. ~ install a lead w~e se~ on all test ~ugs & leak dete~ors that ca,fen ta~. were semi~. Count LD threads: 5. ~ Place fire ~tinguishem ~d "No Smoking" signs in L~ ~ .... ~ L4 _~ /the work area. 4, ~ Ensure lhal all lank s~lem ~m~nents are restor~ tO their 6. QTurn off ~d s~ure the drcuit breaker(s) of the nal slate (including): ~r~uct to ~ tested with I~ko~ d~lces and tags. ATG pm~s, sensom, & raps 7. ~ Pla~ "Out of Service" bags on the d~nser nozzles Ball floa~, dry'bma~ & caps of the p~oduct(s) to be fasted. Ca~ic pmt~on system is o~fationai 8. ~' VeH~ proof ~o~ago~ pr~edum is complete ~ ~ainment sumps am d~ ~ t~ng to ~rate pumps. 9. ~ Clo~ ball val~s or che~ valves on the produ~ ~ Dis~rs & ~S system Di~r ~els are replac~ piping Io be tested. Dr~ tub~, fill a~lers & ~s 10. ~ Remove the eleckical ~ayonel' conne~or from - Leak det~o~s & ~p~r vent tubes the ~P(s). ~M~le ~m and sump lids ~Monitori~ system is o~rationN Shea~ ~ves at t~ dinners Siphon fines a~ manifold ~ ~ Spill ~nlai~rs & drain v~s ~, / - STP ~ings a~ ~nel ~nnemors :,Work Order: 3131115 109755 ROLLING 140 2929 E BRUNDAGE B~KERSFIELD CA 80448302105001 OCT 2. 2003 11:01 AM SOI~I~IARE REVISION L~VEL VERSION 123.01 SOFT~ARE~ 346129,-100-B CREATED - 02.06.21.13.00 SYST6"I STATUS REPORT NO SOFTWARE MODULE ALL FUNCTIONS NORMAL SYSTEM FEATURES: PERIODIC IN-TANK TESTS INVENTORy REPORT ANNUAL [N-TAN)( TESTS T I:DIESEL I SOUTH VOLUME " 5439 GALS ULLAGE " 6~55 G~LS 90% UL~GE~ ~995 GALS TO VOL~E - 5356 G~LB HEIGHT - 48.66 INCHES WATER VOL - 0 GALS W~TER = 0,00 INCHES TEMP - 93.6 DEG F ~FT~RE R~IS~ON LEVEL ~ERS]ON ]23.01 ~FT~RE~ 3~6123-100-B T 2;DI~EL 2 NORTH CRATED - 02,06.21.~9.00 VOLUME ~ ~965 ULLAGE = 6629 NO BO~E MODULE 90~ ULL~E- 5469 G~LB SYSTEM F~TUREB: TC VOL~E - 4889 ~ER]ODIC IN-TANK TESTS HEIGHT = 40.83 ]NCH~ ~NNUAL IN-TANK TESTS ~TE~ VOL - ~ W~TER - 0.00 INCHES TEHP - 93.B DEG F M~N]FOLDED T~NKB INVENTORY TOTALS T I:D]ESEL I SOUTH T 2:DIESEL 2 NORTH VOLUME = 10403 G~LB TC VOLUHE - 10245 ~ ~ ~ ~ ~ END ~ ~ ~ Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 ,Work Order: 3131115 OUTPUT RELAY SETUP TYPE: STRND~RD ~ORmALLY CLO~ED I ~4-TANK ALL: LEAK RL/4RM ALL :HIGH I~iRTER ALARM T I:LO~ PRODUCT ALARM ALL:SUDDEN LOSS ALL:GRO~ TEST FAIL LIQUID SEh~OR ~LM~ L I:FUEL L 3:FUEL L 4:FUEL ALARM L 5:FUEL ALARM L 6:FUEL L ?:FUEL ALARM L ~:FUEL ALL:SE~OR OUT ALL:SHORT L I:HIGH LIQUID L 3:HIGH LIQUID ~L~PI L 4:HIGH LIQUID ~L~H L 5:~IGH LIQUID ~L~EH L 6:HIGH LIQUID L ?:HI~H LIQUID ~L~H L 6:HIGH LIQUID L ~:LO~ LIQUID RECOI~CILiATION SETUP AUTOMAT ! C DA I LV CLOS [ PiG TIME: 2:00 AH PERIODIC RECONCILI~TION MODE: MONTHLY TEMP COMPENSATION STaND,RD BUR SLOT FUEL HETER T~NK TANK MAP EMPTY Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 .Work Order: 3131115 SAT T 2:DIESEL 2 NORTH START TIME : lO:D0 P~ T I:DIE~EL I SOUTH PRODUCT CODE 2 TEST RATE :0.20 GAL/HR PRODUCT CODE I THERMAL COEFF .000450 DURATION : 2 HOURS THE~gAL COEFF .000450 TANK DIP~IETER 96,00 TANK DI~IETER 96,00 TAN}; PROFILE 4 PTS TST EARLy 5~OP:DIS~BLED TaNK PROFILE 4 PTS FULL VOL 11594 FULL VOL 11594 72.0 INCH VOL 10562 LEAK TEST REPORT ?2.0 INCH VOL 10562 48,0 INCH VOL 6177 4B.O INCH VOL 6177 24.0 INCH VOL 2394 ENH~qNCED 24.0 INCH VOL 2394 FLOAT SIZE: a,O IN. FLOAT ~]ZE: 4.0 IN. WATER WARN1NC : 2.0 WATER 'IA~RNING : 2,0 HIGH MATER LIMIT: 2.5 HIGH ~TER LIMIT: 2.5 MAX OR LABEL VOL; 11594 MAX OR LABEL VOL: 11594 OVERFILL LIMIT OVERFILL LIMIT : BS~; 10318 : 10318 HIGH PRODUCT HIGH PRODUCT : 94~ 10898 LIQUID SEi,L.~R SETUP : 1~890 DELIVERy LIMIT 12~ .......... ~ - DELIVERY LIMIT : : 1391 1391 L I:,?~,TELITE DISP PAN LOW PRODUCT : 1~0~ DU~L FLT, HIGH VAPOR LOU PRODUCT : 1000 LEAK ALARM LIMIT: 25 CATEGORy : DISPENE~ER PAN LEAK ALARM LIMIT: 25 SUDDEN LOSS LIMIT: 25 SUDDEN LOSS LIMIT: 25 TANK TILT : 1.25 TaNK TILT : 0.70 PROBE OFFSET : 1.25 PROSE OFFSET : 0.?0 L 2:0IL LINE T~I-~TATE (SINGLE FLOAT) SIPHON MANIFOLDED TANKS CaTEGORy : PIPING SUPIP SIPHON MANIFOLDED T~NKS T~: OI T~: 02 LINE MANIFOLDED TANKS LINE MAN[FOLDED TANKS T~: NONE L 3:PIPING MID PAN T,: NONE DUAL FLT. DISCRIMINATING CATEGORy : DISPENSER PAN LEAK MIN PERIODIC: 25~ LEAK MIN PERIODIC: : 2898 : 2898 LEAK MIN ANN~AL : 25~ L 4:E~ATELITE DISP PAN LEAK MIN ANNUAL : 25~ : 2898 DUAL FLT. HIGH VAPOR : 2BgB CATEC. ORy : DISPENSER PAN PERIODIC TEST TYPE PERIODIC TEST TYPE STANDARD STANDARD L 5:ANNULAR I TANK ANNUAL TEST FAIL DUAL FLOAT HYDI;)3STATIC ANNUAL TEST FAIL ALARH DISABLED CATEGORy : ANNULAR SPACE ALARM DISABLED PERIODIC TEST FAIL PERIODIC TEST FAIL ALARM DIR-~BLED ALARM DISABLED L 6:~TP SUMP I TaNK CROSS TEST FAIL DUAL FLT. HIGH VAPOR GROSS TEST FAiL ALARM DISABLED CATEGORY : STP SUMP AIJARM DISABLED ANN TE~T AVERAGING: OFF L ?:ANNULAR 2 TANK ANN TEST AVERAGING: OFF PER TEST AVER/-~ING: OFF PER TEST AVERAGIt~3: OFF DUAL FLOAT HYDROSTATIC TANK TEST NOTIFY: OFF CATEGORy : ANNULAR SPACE TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY : 5 MIN L 8:STP SUMp 2 TANK DELIVERY DELAY : 5 MIN PUMP THRESHOLD : 10.0~ DUAL FLT. DISCRIMINATING ~UMP THRESHOLD ; IO.OD~ CATEGORy : STP SUMP Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 ,Work Order: 3131115 SYSTEM SETUP OCT 2. 200:3 I0:59 AM RS-Z.j.. b.,~ ~ . COM;'tUN [ CAT ] ONE SETUP D I ~BLED ..... AUTO Dt~L A~ SYSTEM UNI TS U .~. ~RT SETT 1 ~S: ~T~ L~G~E D B:~EDER ROOT ENGLISH C~'t BOARD I <FXMOD> SYSTEM ~'['E/TJME FOR~T BAUD RATE 2400 IN-TANK ALARMS MON DD ~Y'~' HH:~I:SS :,:M PARl~ ODD ALL:LEA~ ALA~ ~TOP BIT [ STOP ALL:HIGH ~ATER RL~RH 109755 ROLLI~ 140 DATA LENGTH: ? DATA ALL:OVERFILL ALARM 2929 E BRUNDAGE ~-232 8ECURI~ ~;LOW P~D~ ALARM ~KERSFIELD CA CODE : DISABLED ~LL:~UDDEN LO~ ALARM 80448~02105001 DIAL TYPE : TO~E ALL:HIGH PRODUCT ALARM AN~JER ON : 1 R]NC; ALL:INVALiD FUEL LEVEL ~HiFT TIHE i : 5:45 AM HODEM SETUP STRING ALL:P~BE OUT SHI~ TIME 2 : DISABLED ALL:HIGH ~TER WARNI~ SHI~ TI~ 3 : DISABLED DIAL TONE I~ERVAL: 32 ALL:DELIvERy NEEDED SHIFT TIME 4 : DISABLED ALL:~x PRODUCT ALA~ ALL: ORO~ TE~ FA l L TANK PER TST NEEDED WEN RECEIV[R SETUP: ALL:PERIODIC T~T FAIL DISABLED ALL:ANNUaL TEST FAIL TANK ANN TST 1,~EEDED WEN ALL:PER T~T NEEDED DISABLED D 8:VEEDSR R~T (FMS ALL :PER TST NEEDED ALM i8003764255 ALL:NO C~LD IDLE TIME LINE RE-ENABLE ~THOD RCVR ~PE: COMPUTER ALL:C~LD INCA RATE WARN PA~ LINE TEST PORT NO: I ALL:A~U_CHART CAL RETRY NO: 5 ALL:REiN LiNE PER TST NEEDED WEN RETRY DELAY: 5 ALL:RECON ALARM D I ~BLED CONF I Rt~T [ ON REPORT: OFF ALL: L~ T~P WARN I NG LINE ANN TST NEEDED WAN ALL:GROSS FAIL LINE TNK D I ~BLED LIQUID 8E~OR A~ P~tNT TC VOLUH~ ALL:FUEL ALARM ENABLED RLL:~EI~oR O~ ALARM ALL :SHORT ALARM T~P COMPEI~AT ION ALL :~TER VALUE (DEC F ): 60,0 ALL:WATER OUT STICg HEIGHT OFFS~ DISABLED ALL :HIGH LIgUID ALL:LOW LIGUID ALARM H-PROTO~L DATA FORMAT AUTO DIAL TIME S~'UP: ALL:LIGUID WARNI/~ HE [ G HT DAYL IO~ SAVI NO T I ME RECE [ VER ALARHB ENABLED D 8:VEEDER ROOT (FHS) SE~ICE REPORT WARN START DATE DIAL ON ~TE ALARM CLEAR WARNI NC APR WEEK 1 SUN JUL 14, 20D3 ~ART TIME DIAL TIME : 6:59 PM 2: OD ~ RECE I uER REPORTS: ~T WEE~ 6 SUN ~ND TIME 2:00 ~ RE-DIRECT L~AL PRIntOUT D I ~BL~D EU~ PROTOCOL PREFIX S :S~STE]'I SECUR ['FY CODE : 000000 Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 .Work Order: 3131115 ALARM HISTORY REPORT ALAR~ HISTORY REPORT ..... SElq~OR ALAR-h'q ..... L ~:PIPING MID PAN ..... SENSOR ALARM ..... DISPENS£R PAN L 5:ANNULAR I TANK ALARM HISTORY REPORT HIGH LIQUID ALARM ANNULAR SPACE OCT 2, 2003 11:40 ~ LOll LIQUID ALARI~ ..... SEN?:~)R ALARM OCT 2, 20b3 I1:18 AM L ?:ANNULAR 2 TANK B£TUP DATA WARNING ANNULAR SPACE JAN ~, I996 8:Oa AM SETUP DATA ~ARN1NG LOW LIQUID ALARM JAN I, 1996 B:O~ ~ OCT 2, 2003 ti:l? ~ SETUP DATA JAN I. 1996 B:04 AM ALAR~J HISTORY REPORT ALARM HISTORY REPORT ..... SENSOR ALARM ..... L ~:SRTELITE DISP PAN S ..... SENSOR HLARM ..... DISPENSER PAI'I L fi:STP BUMP t TA*iK ALARlq HISTORY REPORT FUEL ALARM STP SUMP OC~ 2, 2003 11:33 AM~ FUEL ALARi~I ..... SENSOR ALARM ..... SETUP DATA ~RNING OCT 2, 2003 I~:l~ AM sTpL 8;~TPsLelpSUMP 2 TANK JBN 1, ~996 8:04 A~ FUEL ALARM HIGH LIQUID ALARM OCT 2, 200~ 11:14 AM OCT 2. 2003 11:12 AM SETUP DATA WARNII~ ~IGH LIQUID ALA~ JAN ~. ~99G 8:0a AH APR ~i, 2003 10:54 ~ SETUP DATA WARNI~ JAN I. 199G 8;04 ~ Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 11/03/2003 PAGE 0026 UNDERGROUND STORAGE TANK(UST) RPT #2 (AGENCY-DEFINED DATES) SiteID Business Name Location Container Activ TANK/LINE CP CERT. MANWAY IN UST MONIT. PERMIT ISS SB989 TEST PASS / FAI REPAIRS FI 015-021-001330 WHOLESALE FUELS INC 2200 E BRUNDAGE AN 001 Y 04/17/1996 09/03/1998 12/22/1998 10/08/2003 / / / / / / / / 001 Y 04/17/1996 09/03/1998 12/22/1998 10/08/2003 / / / / / / / / 001 Y 04/17/1996 09/03/1998 / / 10/08/2003 / / / / / / / / 015-021-002355 BIG COUNTRY CHEVRON 3300 WHITE LN 001 Y / / / / / / 10/08/2003 02/16/2003 03/06/2003 03/06/2003 / / 001 Y / / / / / / 10/08/2003 02/16/2003 03/06/2003 03/06/2003 / / 015-021-001304 CIRCLE DELI MART 1416 GOLDEN STATE 001 Y / / 08/28/2002 12/01/1900 10/10/2003 12/05/2002 12/09/2002 09/23/2003 / / 001 Y / / 08/28/2002 12/07/1900 10/10/2003 12/05/2002 12/09/2002 09/23/0302 / / 015-021-000552 SAN JOAQUIN COMMUNITY HOSPITAL 2615 EYE ST 001 Y 02/12/1998 / / 06/26/1996 10/15/2003 / / / / / / / / 015-021-001808 LA BARRATA MEAT MARKET 430 E CALIFORNIA AVE 001 Y / / / / / / 10/15/2003 / / / / / / / / 001 Y / / / / / / 10/15/2003 / / / / / / / / 001 Y / / / / / / 10/15/2003 / / / / / / / / 015-021-000827 U S POSTAL SERVICE 5601 STOCKDALE HWY 001 Y / / / / 02/10/1997 10/16/2003 / / / / / / / / 11/03/2003 PAGE 0025 UNDERGROUND STORAGE TANK(UST) RPT #2 (AGENCY-DEFINED DATES) SiteID Business Name Location Container Activ TANK/LINE CP CERT. MANWAY IN UST MONIT. PERMIT ISS SB989 TEST PASS / FAI REPAIRS FI 015-021-000512 JIMS MOBIL 3200 F ST 001 Y 03/03/1995 01/30/2001 12/22/1998 09/22/2003 10/14/2002 10/16/2002 10/16/2002 / / 015-021-001905 DEL TACO MOBIL 3624 CALIFORNIA AVE 001 Y / / / / / / 09/22/2003 08/28/2002 10/17/2002 10/17/2002 / / 001 Y / / / / / / 09/22/2003 08/28/2002 10/17/2002 10/17/2002 / / 001 Y / / / / / / 09/22/2003 08/28/2002 10/17/2002 10/17/2002 / / 015-021-001217 VONS FUEL CTR BAKERSFIELD #2512 2050 WHITE LN 001 Y 08/11/2002 / / / / 09/25/2003 01/29/2003 02/19/2003 02/19/2003 / / 001 Y 08/11/2002 / / / / 09/25/2003 01/29/2003 02/19/2003 02/19/2003 / / 001 Y 08/11/2002 / / / / 09/25/2003 08/11/2002 01/29/2003 02/19/2003 / / 015-021-000606 BARBER HONDA 4500 WIBLE RD 001 Y 11/13/2002 / / 12/22/1998 09/26/2003 12/06/2002 12/13/2002 12/13/2002 / / 015-021-000131 SPRINT BAKERSFIELD POP 715 SUMNER ST 001 Y 07/18/1990 / / 07/01/1999 10/03/2003 09/27/2002 09/27/2002 04/28/2003 / / 015-021-002850 GAS-N-GO 2601 WHITE LA/NE 001 Y 10/10/2003 / / / / 10/03/2003 I I I I I I I I 001 Y ,10/03/2003 / / / / 10/03/2003 I I I I I I I I 015-021-000017 CALIFORNIA HIGHWAY PATROL 4040 BUCK OWENS BLVD 001 Y 09/23/1994 / / 12/22/1998 10/06/2003 09/13/2002 09/24/2002 09/24/2002 / / 015-021-001330 WHOLESALE FUELS INC 2200 E BRUNDAGE LN 001 Y 04/17/1996 09/03/1998 12/22/1998 10/08/2003 I I I I I I I I 001 Y 04/17/1996 09/03/1998 12/22/1998 10/08/2003 / / / / / / / / 001 Y 04/17/1996 09/03/1998 12/22/1998 10/08/2003 I I I I I I I I 11/03/2003 PAGE 0024 UNDERGROUND STORAGE TANK(UST) RPT #2 (AGENCY-DEFINED DATES) SiteID Business Name Location Container Activ TANK/LINE CP CERT. MANWAY IN UST MONIT. PERMIT ISS SB989 TEST PASS / FAI REPAIRS FI 015-021-001231 FIESTA LIQUORS 2023 BAKER ST 001 Y 04/21/1997 08/29/2002 12/22/1998 09/02/2003 / / / / / / / / 001 Y 04/21/1997 08~29~2002 12/22/1998 09~02~2003 / / / / / / / / 001 Y 04/2111997 08~29~2002 1212211998 09~02~2003 / / / / / / / / 015-021-001038 KERN HIGH SCHOOL DIST TRANS DEPT 3701 E BELLE TERRACE C 001 Y / / / / 07/01/1999 09/05/2003 01/17/2003 02/13/2003 02/13/2003 / / 001 Y / / / / 07/01/1999 09/05/2003 01/17/2003 02/13/2003 02/13/2003 / / 015-021-000915 CARDLOCK FUELS #4 4600 STINE RD 001 Y 06/19/2003 / / 08/30/1998 09/09/2003 06/27/2002 08/23/2002 08/23/2002 / / 001 Y 06/19/2003 / / 08/30/1998 09/09/2003 06/27/2002 08/23/2002 08/23/2002 / / 001 Y 06/19/2003 / / 08/30/1998 09/09/2003 06/27/2002 08/23/2002 08/23/2002 / / 001 Y 06/19/2003 / / 08/30/1998 09/09/2003 06/27/2002 08/23/2002 08/23/2002 / / 015-021-000670 CORO TEXACO GOSFORD #11 4050 GOSFORD RD 001 Y 01/20/1997 03/09/1994 07/01/1999 09/11/2003 06/21/2002 06/27/2002 06/27/2002 / / 001 Y 01/20/1997 03/09/1994 07/01/1999 09/11/2003 06/21/2002 06/27/2002 06/27/2002 / / 001 Y 01/20/1997 03/09/1994 07/01/1999 09/11/2003 06/21/2002 06/27/2002 06/27/2002 / / o01 ¥ 0112o11997 031o911994 o71o111999 o911112oo3 06/21/2002 06~27/2002 06~27/2002 / / 015-021-000345 YOOS MOBILE 800 34TH ST 001 Y O811711994 / / O71O111999 09/19/2003 10/08/2002 04/18/2003 10/15/2003 / / 001 Y 08/17/1994 / / 07/01/1999 09/19/2003 10/08/2002 04/18/2003 10/15/2003 / / 001 Y 08/17/1994 / / 07/01/1999 09/19/2003 10/08/2002 04/18/2003 10/15/2003 / / 015-021-000512 JIMS MOBIL 3200 F ST 001 Y 03/03/1995 01/30/2001 12/22/1998 09/22/2003 1111412OO2 1O11612OO2 1O11612OO2 / / 11/03/2003 PAGE 0023 UNDERGROUND STORAGE TANK(UST)' RPT #2 (AGENCY-DEFINED DATES) SiteID Business Name Location Container Activ TANK/LINE CP CERT. MANWAY IN UST MONIT. PERMIT ISS SB989 TEST PASS / FAI REPAIRS FI 015-021-000649 FASTRIP #640 8001 WHITE LN 001 Y 08/03/1994 / / 07/01/1999 08/13/2003 10/11/2002 11/01/2002 11/01/2002 / / 015-021-000706 HOWARDS MINI MARKET #4 3200 PAN~2~A LN 001 Y 07/23/2003 06/21/1999 12/22/1998 08/13/2003 I I I I I I I I 001 Y 07~23~2003 06/21/1999 12/22/1998 08/13/2003 I I I I I I I I 001 Y 07~23~2003 06/21/1999 12/22/1998 08/13/2003 / I / / / / / / 001 Y 07~23~2003 06/21/1999 12/22/1998 08/13/2003 / / I / / / / / 015-021-000183 CHEVRON STATION #98109 1131 OAK ST 001 Y 08/17/1994 / / 09/28/1900 08/15/2003 05/16/2002 05/22/2002 01/31/2003 / / 001 Y 08/17/1994 / / 09/28/1900 08/15/2003 05/16/2002 05/22/2002 01/31/2003 / / 001 Y 08/17/1994 / / 09/28/1900 08/15/2003 05/16/2002 05/22/2002 01/31/2003 / / 001 Y 08/17/1994 / / 09/28/1900 08/15/2003 05/16/2002 05/22/2002 01/31/2003 / / 015-021-000346 STOCKDALE MOBIL #2 5401 STOCKDALE HWY 001 Y 08/22/2003 / / / / 08/15/2003 / / / / / / / / 001 Y 0812212003 / / / / 0811512003 I I I I I I I I 015-021-001462 K C GEN SERV - JUSTICE BLDG 1215 TRUXTUN AVE 001 ¥ 0411611994 I I 1212211998 0812212003 09/20/2002 10/04/2002 10/04/2002 / / 015-021-002412 COSTCO #0688 3800 ROSEDALE HWY 001 Y / / / / / / 08/26/2003 / / / / / / / / 015-021-001987 BAKERSFIELD HEART HOSPITAL 3001 SILLECT AVE 001 Y / / / / / / 08/27/2003 05/13/2002 05/20/2002 10/22/2003 / / 001 Y / / / / / / 08/27/2003 05/13/2002 05/20/2002 10/22/2003 / / 015-021-000301 34TH STREET CAR WASH 920 34TH ST 001 Y / / / / / / 09/02/2003 07/29/2002 08/01/2002 / / / / Sp T^.K.OLOe¥ CE.T r C^TE Or TEST .e 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 TELEPHONE (512) 451-6334 FAX (512) 459-1459 PURPOSE: COMPLIANCE TEST RESULT SUMMARY REPORT TEST DATE: 10102/03 WORK ORDER NUMBER: 3131115 CUSTOMER PO: CLIENT: PENSKE TRUCK LEASING SITE: PENSKE CA.094 P.O. BOX 7635 2929 E. BRUNDAGE READING, PA 19603 BAKERSFIELD, CA 93307 BRIAN YAZEMBOSKI JOE (610)603-8450 (661)322-2600 TEST TYPE: TLD-1 Prnd,Jct Pine q'inhtness Test Results LINE LINE LINE DELIVERY IMPACT TEST RESULT FINAL LEAK RATE (gph) VALVE ID PRODUCT MATERIAL TYPE A B C D A B C D FUNCTION i DIESEL FIBERGLASS PRESSURE 2 DIESEL E~;istjna Line Leak Detector Test EXISTING LEAK DETECTOR #1 EXISTING LEAK DETECTOR #2 LINE ID MANUFACTURER MODEL # SERIAL # RESULT MANUFACTURER MODEL # SERIAL # RESUL'I I RED JACRET D.L.D. 40292-9725 P 2 New Replacement Lirle Leak Detector Test RI;PI_ACED LEAK DE' lECTOR #1 REPLACED LEAK DE'I ;CTOR #2 LINE MANUFACTURER MODEL # SERIAL # RESULT MANUFACTURER MODEL # SERIAL # RESULT For owner detailed report information, visit www.tanknology.com and select On-Line Reports-WRAP, or contact your local Tanknology office. Tester Name: RANDY JAQUEZ Technician Certification Number: 10039 Printed 10/10/2003 12:45 SBOWERS INDIVIDUAL TANK INFORMATION AND TEST RESULTS TEST DATE: 10/02/03 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER3131115 CLIENT: P]~2~lb-'t~ TROC~ LP._.J~:~3 AUSTIN, TEXAS 78757 (512) 451-6334 SITE: P~NS]~ C~-09~, TANK INFORMATION Tank ID: i Tank manifolded: 3'¢s Bottom to top fill in inches: 96°0 Product: D'rEs~r. Vent manifolded: ta3 Bottom to grade in inches: Capacity in gallons: 11,59~, Vapor recovery manifolded: t~3 Fill pipe length in inches: Diameter in inches: 96.00 Overfill protection: Yzs Fill pipe diameter in inches: 4°0 Length in inches: 3'74 Overspill protection: Yes Stage I vapor recovery: NOta~ Material: ~w F'r~(3 Installed: A~3 Stage II vapor recovery: ~ CP installed on: / / COMMENTS TANK TEST RESULTSTest Method: 'V'ac~Te(=~. LEAK DETECTOR TEST RESULTS Test method: Start (in) End (in) Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: Probe Water Level: Make: aZD JACKZT Model: D.,.. D. Ingress Detected: Water Bubble Ullage Test time: S/N: Open time in sec: 2 o oo Inclinometer reading: Holding psi: 3.3 VacuTect Test Type: Resiliency cc: 3.00 VacuTect Probe Entry Point: ~__~T~ 'est leak rate mi/m: 3.89.0 Pressure Set Point: Metering psi: 8 Tank water level in inches: Calib. leak in gph: 3. oo Water table depth in inches: Results: t~ASS Determined by (method): Result: COMMENTS COMMENTS LINE TEST RESULTS Test type: TLD-1 Material: Diameter (in): 2.0 Length (ft): [00.0 Test psi: Bleedback cc: Test time (min): t,a:yz' ~ Start time: End time: Final gph: Result: Pump type: Pump make: ~ JACkeT COMMENTS Impact Valves Operational: Printed 10/10/2003 12:46 SITE DIAGRAM 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 10/02/03 WORK ORDER NUMBER3131115 CLIENT:PENSKE TRUCK LEASING SITE: PENSKE CA-094~ SYPHO DIESEL PIPING I ATTENDENT ~ [-']OO VENTS SHOP Printed 10/10/2003 12:46 SBOWERS FIELD REPORT TANKNOLOGY W.O.#: 3131115 ATG Inspection Form Date: 10102/2003 Location #: CA-094 Invoice Name: PENSKE TRUCK LEASING CO., L.P. Location Address: 2929 E. BRUNDAGE Invoice Address: Rt. 10 GREEN HILLS, P.O. BOX 7635 Location City, St, Zip: BAKERSFIELD, CA. 93307 Invoice City, St., Zip: READING, PA 19603-7635 Invoice Telephone: (610) 775-6406 ATG Manufacturer/Model: VR TLS 350 Electronic Line Leak Manufacturer/Model: DISPENSER #: ] ! 2 2 PRODUCT DISPENSED: D D D D DISPENSER TYPE: MAS SAT MAS SAT SENSOR AT DISPENSER (Y/N): No Yes No Yes SENSOR FUNCTIONING (Y/N): Yes Yes TANK #: 1 2 PRODUCT NAME: D D MANIFOLDED TO TANK #: 1 CAPACITY (gal): 11594 11594 I ATG TESTING FREQUENCY: PROBE IN TANK (Y/N): Yes Yes PROBE TYPE: MAGOMAGI MAGOMAGI PROBE FUNCTIONING (Y/N): Yes Yes SENSOR IN TANK INTERSTITIAL (Y/N): Yes Yes SENSOR FUNCTIONING (Y/N): Yes Yes SENSOR IN PIPING SUMP (Y/N): Yes Yes SENSOR FUNCTIONING (Y/N): Yes Yes ELLD TYPE: ELLD FUNCTIONING: MECHANICAL LLD PRESENT (Y/N) Yes POSITIVE SHUTDOWN For line below, when leak was simulated, did the system disable the turbine? ENABLED (Y/N)? Yes ATG SYSTEM (PASS/FAIL): PASS ELLD SYSTEM (PASS/FAIL/NONE): NONE RANDY JAQUEZ 10039 LEGEND: TECHNICIAN NAME CERTIFICATION # ATG TESTING FREQUENCY: DISPENSER TYPE: TANK PROBE TYPE: PRODUCT NAME ELLD TYPE: CSLD: CONTINUOUS STATISTICAL LEAK MAS: MASTER CAPOCAPI: CAPACITANCE PROBE D: DIESEL PPM4000: RED JACKET W: WEEKLY TEST SAT: SATELLITE MAGOMAGI: MAGNETOSTRICTIVE PROBE G: GASOLINE VR PLLD: VR PLLD D: DAILY TEST MO: MOTOR OIL S: SUCTION I: INTERSTITIAL SENSOR MONITORING WO: WASTE OIL NONE 10'3'755 ROI.LI NG' 140 2929 E BRIJND~-~GE BAI(ERSFI El.I! CA 80448302105001 MAY 2.. 2003 I :36 Pl"l ~',"'-~a'EM STATUS REPORT ali,:.' I--'UNCT I C.,NS NC, RMAL I NVEIqTO~:'/ F.,'Ef-'ORT T I:ISIESEL 1 SOUTH V~,}LUI"IE = 6256 GALS ULLAGE = 5338 ,:]ALS 90% ULLAGE= 41 ?S GALS TC VOLUME = 6215 GALE; HEIGHT = 4S.'38 INCHES ~,]ATER VOL = O GaLS 1.4ATER = O. 00 INCHES TEMP = 74.2 DEG F T 2:DIESEL 2 NORTH "i/OL Ij[I¢IE = 5'792 GALS ULLAGE = 5802 GaLS 90.'::~ U[.LAL-;E= 4642 GAI.,S TC ',,'.'-',I_,I.II'.IE = 5'75,5 GALS HEI = 45.74 INCHES [,,,JA~ .--..~'. VOL = 0 GALS 1.4ATER = 0. O0 I lq(?.HES TEMP = ?3.6 DEG F MANIFOLDED TANKS I I',I",/ENTOR'g TOTALS T 1 ;DIESEL, 1 SOLITH T 2:DIESEL 2 I'40RTH VOLUME = 12048 GALS TO VOLUME = 11'.972 (:-:ALS CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CItECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME Pei,kfikc. '"~O& !(_.8__q~'h~ INSPECTION DATE ~ ~ '0.3 Section 2: Underground Storage Tanks Program [] Routine [~Combined {~1 Joint Agency [] Multi-Agency , [~l Complaint 1~ Re-inspection Type of Tank ~0,.}F Number of Tanks Type of Monitoring kc/aA Type of Piping OPERATION C V COMMENTS / Proper tank data on file Proper owner/opel'ator data on file Penn it 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) 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:Compl ialtmj~. ~ Inspector: Office of Environmental S'~rvices (661)-326-3'-'-979 8usige~s~S~(e Rcspons~le Party White - Env. Svcs. Pink - Business Copy Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION CHECKLIST Enironment~ Services ,,~ ', 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 Tel: {661)326-3979 FF'~'CiLITY NAME~·_ I INS~.~PECTION DATE INSPECTION TIME Secti~ 1' Business Plan and Invento~ P~mm ~ Routine ~ Combined ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection C V /C=Co~¢,.ce~ OPE~TION COMMENTS k V=Violation ~ APPROPRIATE PERMIT ON HAND . VERIFIGATION OF QUANTITIES PROPER SEGREGATION OF MATERIAk VEa~f~C~nO. o~ MSDS AVAILAStLIWE VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES .................................................................................................. EMERGENCY PROCEDURES ADEQUATE ANY HAZARDOUS WASTE ON SITE?: '~ YES i'1 No S_GAROIN ECTION? PLEASE CALL US AT (661) 326-3979 QUESTIO Inspector Badge No., ............... B--~siness Site ~-~sponsib e arty .......... White - Environmenlal Services Yellow - Station Copy Pink - Business Copy 05/02/2003 10:31 909 930 TANK SPECIAL PAGE 02 Secondary Containment Testing Report I"orm. DRAFT This/otto I.~ tnttnded for uzt by contractors performing periodic re;ting o/~IST Jecondary ¢onta,nmtnt ;y;l~mZ. Use the opprOpri~le P~Rt$ of lhiJ ,Form fo rcporl tcJUtl~ fO# all eomponenf; tetrt.4 The compl,ttctt /oem. weitten Ittst Dro¢cdur¢$. and printouu )~'om tells (if oppllcoblcJ. JkouJtl bZ prOt~idtt~ tO the fo¢tltty owntr/operalor far xubminol to the local regulatory agency. 1. FACILITY INFORMATION / I D~ ~ a~ w~ No~ficd orT~l~j ~ I ~~ ~ ~o~ Co~~ , S~ L~ Tank T~ . , , IJ I IIIII I I.~ I .... I' ' ' ~~' '?~).. '. ,, .~w~ ,,.... .... ~,N~ ~~'~:.'..' · ,....... . : % ~ .. , . . , ,,.,~.. · , ' . ..,:.' .... .. :."'...... '.:."." ~.~. :;. ..... ... ....... .. , ". ...... : .. . '~; ...... ~ ...... " "' ,,,i · '," '~,,,' .......... ' ' · '_:.:' ' ,~ ....... ,' ' ...... ..,. ..... .. '../...' .;.. . . . . ~:..... ~ .. :: .'_._..;~_: ........ . .....:, ...... ....... .:.. .... ' ......... ~%_.. %_ : · . !..'.',:.,:..: .. ..... .-,.- . .... . ........ .,..;..... ..... . :.. ~. ~. ;'. , ,; ..... '~.~,., :. ~. ,. ,~,',. .. ..'.: ..... .~., ..." . .... , ..~...: . : ..'.:'.~ ......... : .: ...... . .. ....- .... , ~ ~, .,, ; : ':... ~ ' : . .. ~.orr~'.T~: ~' . ;...:;..=.:...'."...'.'. ':..:"'. ~~¢,~.~,,,~-~: '~ .'.'; '-' ~of~uh-~~, 2 .. '~:.. :~. '. , .,~,do,n,.B~[?.~:.~ ..... i ' ~~t .. ~ [~ ' corinth' ., ~~ ,~ ~j ' 05/02/2003 lB: 31 909 930 TANK SPECIAL PAGE 03 Tcs4 Mttht.,d I>o,~l'uf~d D~ '"~'ank M.m.7~.,,e~ ' ' lndust~ ~=ndgd I',t,~r~H0nal -Me~,n, ~u,pmeat Used rOf ~'~ ~ ~  Ta~ ~ ~ Tank i ~ T~nk $ .,' .. .'..%:,' i ~,l i! ~' ~ " 85/82/2883 18:31 9892738938 TANK SPECIAL PAGE 84 5. SECOND^RY PIPE TESTING ~ ~~~, R~n ~/~ ~oi~ Run m Piping M~uf~lurcr, ~~ ... ~~ ..... ~ping Dior: ~ ~ ~' ~~h~: ~_~, '~ooT ~ R)~, ~'Y .. " W~t ~ ~ Zm:.~ ~:' /O ~'" .... , : '~~~:. _~?, ~ .' ' :~7 :._z_~::'j~i~.i~-.~:~5= ..... ..... -' ". "'.: ' ..' · :"" ~~i ~):'_ ~' P.: ~",1'. "* ' ' "" . ' ' ....... ' ............... ¥.:: ~7'PiB,-IZ.," ' * 'rs.' .".. ..F.. . , .... .. ,. ."", 'E ....'. , · -,~ ',.~.~.'l ~ ...:.-:...........Ga~? ~ ~. .. ,. ;; ...: .. ..... ." ~ , ~=~ .,, .... .~:,'~';' ..'.;?'. i~,~6, j.. ~.. ,... .....?..;5 :~.~,~:....... ~.45~-~--/~~~.,~~:~, ,~ ~.." ....... ........~ ....... .. ...... ~ ............... ,~ .'.. :: ....... . ....... . ...... ~ ..... i.:].." . ... ~m~b-(~ct~( info~" ~7 P~'>;:~a~ priorto't=~R)' _ .... ." .... . . "' 05/B2/2003 10:31 909 930 TANK SPECIAL PAGE 05 T6~ MClhOd ~ - ~-- _ ........ _S,~ p~,~,~- .. . HeiSt ~om T~k Top to High~c ,. · ,~s~ .' ~:~"~'~'"'"" ~'~.- .~, ,,r'....'. "' '". ',"~ " .. ~;~,~,~_.., '.~.~o~, . .. ~ :~.!~ ~..., ,,, · ~.~ ~' la: I~ ,._ .... '1o :j~'....: · : .... Wu mnsor m~vcd for [cs~ing? _.~ .................... ~.~ g .................. Was scmor pr~erly 05/02/2003 10:31 909 930 TANK SPECIAL PAGE 06 H~isM ~om ~ Bottom 1o i~ .... ~ ,~ .... ~~? ..~JA ~/A _. ~t~ ,~' ...... ~.IA .... ~/A .~!~ ' [g' WU Sen~ rcmvcd Co~en~ - (include i,¢o~a,on on 85/82/2883 18:31 989 938 TANK SPECIAL PAGE 07 29~'g r,.. ~RUN~L4E 8~K~R~P IELD ~GIN LEU~ ~.~ IN ~MP LEDK mEST m~o~ ~ND LEaL 8.~ IN ~ ~ULT ~D TEST ~T~T~D ~OIN L~EL ~ TI~E 1B~ 15 AM END L~UEL 2. ~897 ] H ~ST ~TRRTED eI~ TE~ RESULT P~D ~IN LEVEL e.~19 IN ~ ~ 8,8928 IH BEGIN ~L ~D TIME UDC S g~ ~TR END ~ 2.$1~ IH ' ~T 3TART~ ll:.~ AM LEAK T~HO~. a,ee2 E~ LEVEL g,6497 IN BEOIN I~UBL 2.~' LEAK T~D ~,~ IN END TIM~ 1~:47 TEST R~T PASS~ [HO DfiT~ 91/~/~ .. EN~ LCUEL ~.~ U~ MID TEST RESIJkT TE~ STATE[' 1l:16 AH CND TIME il:~l ~ TEST STA~ED I0:~2 ~ ~UEL e.8928 IN BEOIN LEUEL 2.3194 IN L~K TH~HOLD 8,~ IN [~ TI~ i~:47 ~ST ~LT P~D END DflTF END LEVEL 2. ~192 LEMK THRESHOLD ~.~ IN IJDC S I~ST ~ES~T ~ST ~TART~ ~ 1 = 16 ~M ~GIN L~EL 2.1951 [N END TIME 11~31 tim END ~TE ~s'er: RightFAXUser Host: FAX ClaSs: Fax Job: !Q_HAZl D January 22, 2003 Rollins FIRE CHIEF ~ON FF~E 2929 East Brundage Ln Bakersfield CA 93307 ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 RE: Upgrade Certificate & Fill Tags ¥OtCE (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 (601) 326-3941 Bill deletes the requirement for an upgrade certificate of compliance FAX (661) 395-1 349 (the blue sticker in your window) and the blue fill tag on your fill. PREVENTION SERVICES FIRE SAFETY SERVICES · ENVIRONMENTAL SERVICES 1715 Chest.rAve. : You may, if you wish, have them posted or remove them. Fuel Bakersfield, CA 93301 vendors have been notified of this change and will not deny fuel VOICE (661) 326-3979 FAX (661) 326-0576 delivery for missing tags or certificates. PUBLIC EDUCATION 1715 Chest. rAve. ~ Should you have any questions, please feel free to call me at 661- Bakersfield, CA 93301 ' 326-3 190. VOICE (661) 320-3696 FAX (661) 326'0576 FIRE INVESTIGATION 1715 ChostorAve. Sin~ Bakersfield, CA 93301 VOICE (661) 336-3951 FAX (661) 326-0576 TRAINING DIVISION Steve Underwood 5642 Victor Ave. Bakersfield, CA 93308 Fire Inspector/Environmental Code Enforcement Officer VOICE (661) 399-4697 FAX (661) 399-5763 Office of Environmental Services SBU/dc t--I Postage $ r--I Certified Fee Postmark Return Receipt Fee Here ~ (Endorsement Required) cO Restricted Delivery Fee r--I (Endorsement Required) I'~ Total I~ -- ~1'~ ROLLINS/PENSKE r"[~i;~;i: 2929 EAST BRUNDAGE LANE ........... [!!?BAKERSFIELD CA 9330 [Eii;,"d& ............ Certified Mail Provides: · A mailing receipt · A unique identifier for your mailpiece · A signature upon delivery · A record of delivery kept by the Postal Service for two years Important Reminders: · Certified Mail may ONLY be combined with First-Class Mail or Priority Mail, · Certified Mail is not available for any class of international mail. · NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. · For an additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS postmark on your Certified Mail receipt is required. · For an additional fee, delivery m~J~ be re~kricted to the addressee or addressee's authorized agent. Advise the clerk-or mark the mailpiece with the endorsement "Restricted Delivery", · If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office for postmarking, If a postmark on the Certified Mail receipt is not rj~d, detach and affix label with postage and mail. IMPORTANT: Sal~liis receipt and present it when making an inquiry. PS Form 3800, April 2002 (Reverse) 102595-02-M-1132 December 1, 2002 Rollins/Penske 2929 East Brundage Lane Bakersfield CA 93307 FIRE CHIEF RON FRAZE CERTIFIED MAIL ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield. CA 93301 VOICE (661) 326-3941 F^x (661) 395-1349 FINAL REMINDER NOTICE su.PRESS,O. SERV,CES JANUARY 1, 2003 DEADLINE 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Dear Tank Owner/Operator: PREVENTION SERVICES FffiFSAFETySI=RVlCES*FOIV1RO~ME~.SERI/ICE$ You will be receiving this letter on or about December l 2002. One 1715 Cheater Ave. ' Bakersfield, CA 93301 month from today, January 1, 2003, your current underground VOICE (661) 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) 326-3951 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. -- -~Sincerelv, FAX (601) 399-5703 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc ' E~EC 04 2002 I6:57 BKSFLD FIRE PREVEMTIOM (6611852-2172 p.2 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 APPLICATION TO PERFORM A TANK TIGHTNESS TEST/ SECONDARY CONTAINMENT TESTING P~ TO OP~A~ ~ OP~TORS N~ ~O~[~ ~~~ ~~ OF T~S TO BE ~~ ~ m PmmG ~mG TO BE ~~~S T~ ~ VOL~ CO~S ©FF~C~AL LJS~ Postage $ Certified Fee Postmark Return Receipt Fee {Endorsement Required) Here Restricted Delivery Fee (Endor~ment Require)!$ ?o~l ~o~ge & ~ee, Sent To ROLLINS PENSKE ~i~;;i; ~i~'tT~&:~ ............................................................................. L?-'.-':-~..-B-~--~-°-'- ....... ~.~.:f..~..~.~....,.~.,.~_~. .................... Certified Mail Provides: · A mailing receipt · A unique identifier for your mailpiece · A signature upon delivery · A record of delivery kept by the Postal Service for two years Important Reminders: · Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. · Certified Mail is not available for any class of international mail. · NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail, · For an additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS postmark on your Certified Mail receipt is required. · For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk or mark the mailpiece with the endorsement "Restricted Delivery". · If a postmark on the Certified Majl. I receipt i.%desired, please present the arti- cle at the post office for postm[il'l~ng. If ~!f postmark on the Certified Mail receipt is not needed, detach and affix label with postage and mail. IMPORTANT: this receipt and present it when making an inquiry. PS Form 3800, April 2002 (Reverse) 102595-02-M-1152 · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. of Delivery · Attach this card to the back of the mailpiece, I ~0~,- or on the front if space permits. Is delivery address different from item 1 ? ~_~,,Yes D. If YES, enter delivery address below: '~ No 1. Article Addressed to: ROLLINS PENSKE 2929 EAST BRUNDAGE LANE BAKERSFYELD CA 93307 3. service Type ]~3 Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee). [] Yes 7002 0860 0000 1641 7015 PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-0835 UNITED STATES POSTAL SERVICE First-Class Fees Paid Postage & USPS Permit No. G-10 · Sender: Please print your name, address, and ZIP+4 in this box ° October 3 l, 2002 Rollins/Penske 2929 East Brundage Lane Bakersfield CA 93307 CERTIFIED MAIL REMINDER NOTICE FIRE CHIEF 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 no.~t yet completed the necessary SUPPRESSION SERVICES secondary containment testing required for all secondary containment 21Ol 'H' Streot components for your underground storage tank (s). Bakersfield, CA 93,301 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 SERVICES * ~IaENTN. SERVICES 1715 ChostorAve. insure that the systems are capable of containing releases from the 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 Avb. Bakersfield, CA 9.3.301 due to the penetration boots leaking in the turbine sump area. VOICE (661) 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 1715 Chester Ave. few contractors are licensed to perform this test. Contractors conducting this Bakersfield, CA 93301 VOICE (661) 326-3951 test are scheduling approximately 6-7 weeks out. FAX (661) 326~)576 TRAINING DIVISION The purpose of this letter is to advise you that under code, failure to perform 5642 Victor Ave. this testn 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. Since7' ; Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services -- ,tnonty. Cited: Chapter 6.7, Health and Safety Code: Chapter 16, Dtvtxion 3, Title 23, California Code of Regulations ~'7 '~ ' :ust be used to document testing an,'~kwicing of monitoring equipment. A ~afion or r orr must be rared ? ,an m~monitorin~ system control vanel by th'[!l~'chnician who performs the work. A ~~ be provided to the tank ~y~e~m owner/oper'~t0'r. The owner/oPerator must submit a copy of this form to the local agency regulating UST systems within 30 days o£test date. A. General Information Facility Name: ~,~_~.~ ~ . , Bldg. No.: Site Adckess: ~ ~.,,~ f~.. ~.~, ~,..~_ City: '~>,~,.Lo--s .~')~[~-, Zip: Facility Contact Person: Contact Phone No.: ( ) MakedModel of Monitoring System: ~/'~zLo- ~ T-L.5 -s.'~.;¢4~,,-. Date of Testing/Servicing: lO/cJ/ 02.. B. Inventory of Equipment,Tested/Certified . ... wlate boxes to Indicate s {B-In-Tank Gauging Probe. Model: "/'t.-~f,~ ~--ln-Tank Gauging Probe. Model: "/'-&.. ~ · iI~Annulat SPace or Vault Sensor. Model: ~,~" ~,x~- ~q,3,~ 8~-Annular Space or Vault Sensor. Model: ~ I~.PipingSump/TrenchSensor(s). Modeli ~"~\ ' O PipingSumP/Tren,:hSensOr(s). Mode!: 121 Fill Sump Sensor(s).. Model: ~ F,.'II Sump-Scnsor(s);-- ~ .... Model: rn Me~aniCal LineLetk Detector. .Model..' 0 .M~hanicalLine ~ Det~tor. Model: CI Electronic Line L~akk Detector. .Mod, eh .,. '. 121. Electronic'!~ne !'~k' .,;~',.(.-'. 0 T~ilkOverfili I Hi~-Le~el'sensor: Model:" ~and .': O ': '!-:"?!:~T Y.:"~ ti'.-;:;. :>~ ,'~ :"i." '.'!.: '. '.,,' ":"':." .. irSh~.Vaiv~(s). · - " .... :,51 Dispiatser Containment Float{s) and Chain(s). ].ri Dispenser Containment Float(s} ~nd Chain(s)~, Oispenser ID: I Dispenser ID:. Iq Dispenser Containment Sansor(s). Model: ri DiSPenser Containment.Sensor(s). Model:~' 3 Shear Valve(s). ~ Shear Valve(s). 3Dispenser Containment'Float. ()s and Chain(s). CI Dispenser Containment Float(s) ami Chain(s~. if the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. Certification - 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 equipment capable of generating such reports, I have also attached a copy of the report~(cdteci all that apply): C~gystem set-up [~--Alar~ hisz~ :chnician Name (print): ~-5,.,~. '-J', ~(~l/,¢(~. Signature: ~rtification No.: -'{ ['~ o, ¢ ~'l fi/. License. No.: Page lof3 ' '/~'~m '~ 03101U.8 onitoring System Certification , Cl 'No* Is the audible alarm o. peranona . . . Yes El No* Is the visual alarm operational? ~L Yes ~! No* Were all sensors visually inspected, functionally t~sted, ~nd confu'med operational? Yes El No* Were all sensors installed at lowest point of secondary containment and Positioned so that other equipment will not interfere with their proper operation? .. Yes El No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) El N/A operational? Yes El No* For pressurized piping systems, does the turbine ~utomatically shut down if the piping secondary containment El N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors in/tiate positive shut-down? (Check all that apply) ~:-Sumpfrrench Sensors; ~-Dispenser Containment Sensors. Did you confu'm positive shut-down due to leaks anted.sensor failure/disconnection? .~Yes; El No. Yes ~! No* For tank systems that utilize the monitOring system as the primary tank overfill warning device (i.e. no I~ N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating proper,l~....Ifs9, at What percent of tank capacity does the alarm trigger? % Yes" ~ No Was any;monitoring eqUipment replaced?. Ii'yes, identify specific sensors, probes, or other equipment replaced and list the' manufacturer name and model for~.all replacement part,-in-Section E, below. Yes* ~1 No Was-liquid found inside,any secondary c~fi'~nt'Syst.ems designed as dry sys!ems? (Check Ml"that apply) Product;-~,'Water. If,yes, describe caus~:in,Section:E~..below,. , . .: ,' · . ' ' YES:' el. No* : : '" ..... '" ""'"' .... "~' ................. "' ~ ............ · · ' Was momtonng ,sy~ tern set, up :rev~eweti to'ensure proper, setting.. Attach set up .reports,. if apphcable Is all momtonn~ eqmpment ol~eratiorial..per~cture~r;'.s;specifications?' yes '..j 12 :;No~'. ..... "" ..... ' ......... ' ~'~''''':- ......... ' '"~: ............. :'""'!:'?~ ?-'.. ":i:... In S~lonE',l~low; descrtlje'h~w and,when these deficient, les ~ete o~ ~'im corrected. ~ ':C ':,'-.;' .. ' , .. ". · .', '.,', , ': , .., .' . ., . : ~',d;":':.'~,':: i,' ;-'%~:';'~",.' ' '. , . · ' - - .... ,' ' ' ~ ~ ' . -' ' '%'; f ;'- i':' '-'. , .- ', . ' ' ' ' .' ,.... ;'.'.~'"-; .. ..... ' ..... :'.: .,:¢tsc,"?i'-..A' , ,.d,v :- '-, .. ' ,' ',~ 3 ' · , . ,~' ',' · ,.,,.':;."',';"":',:,~','.'.~-'-. ':.? .;./ -. !;; .."...'.'.: .... ...:,,~,:?.~:;,.,:.. ...:-:..-.... i ""-?. : . .: . . .......... ::- ,'. ,,'-.. .: Page 2 of 3 03/01 This*section must be completed if in-t. gauging equipment is used to perfo ..l~eak detection monitor/ng. ~Complete the following checklist: ~! Yes ~ NO; 'Has all input ~4ring'b'een insPec't'ed'f'or'proper entr~ anti"tern~tion, 'incluiiing't~s'ting fo;ground faults? .... ~ Yes 121 'No* Were all tankgauging probes visually inspected for damage and residue buildup? ~ Yes Fl No* Was accuracy of system product level readings tested? 121 Yes FI No" Was accuracy of system water level readings tested? 0 Yes Fl No* Were all probes reinstalled properly.'? O Yes Q No* Were all iterm on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): Cl Check this box ifLLDs are not installed. Complete the foll0wing checklist: 021' Yes '[ Q No* For equipment start-up Or annual equipment ce .~cation,-w aa a 'leal~ Simulated 'to, verify LLD performance? [~ N/A (Check all that apPlY)' Simulated leak rate: ~'3g:p.h.; ~-0:l:~.p/h-~l~10.2g.p.h.. a Ye,. :l'a No'. Were ,il, .~LLDs co~d.op, cmfioml an.~d~ a-~.t;e ~ rc~to~.req~eme..n~?.,...'i ii' ""' "' ' ' " a Yes't'~''N°,; ' Was~et~ga~...mm.,,nm,.prop~rlycah~m,.,~d.?..:.:.,, i- . : .''.- '..: .'., :.." ::?"~;[i~". '.'.:.',5 ' '. .. H. ,Comments: Page 3 of 3 03/0t _Ufi. T Monitoring Site Plan ,.Site h~tdress: ~' 2 ~' ~' ~ X' , ~ ~ '- - · ................................. ...... :.:.:. ?~:::: .:~.-~::: :.~:':.: .: ::::: :':: .... [,, ~,,, ,.,., ~ ..... ........:....: ,~..~... ...... ~.......,.............: ~): :~7~;:,:.:~5.:¢;3~:,5~,~~ ~;~:?-~.?~,. : · ...,:,~ ,:~,?,j..~ ~.::~'('~., . . :/¢.:?-.~.~-...,... .... .. · ?,., ~:.,~ :: ¥:,.:~:.. :?~:?:¢~.:;,:,,L~.~,.~;,~,;.'~.: 7%~..~:., :.,.;'.. ~ ~,,.:, . ' . '.. '; '.%'..;~,¢¥~;'}:4:-:i'.,'~' :.,".'; :-./'?;';$'. :~ ,.;:'. ...... ',. ,,..:~ ~'.. ' '- ...... ,":".'~'f "V "' :~:;'. i:; "" ' ' ; Y" ~ ""'. "" ~ ':"' '" ............. ; ............ Date mp ~ &a~: [0/~/~ Instructions 'you already have a diagram that shows all required information, you may include it, rather than this page, with your tonitoring System Certification. On your site plan, show the general layout of tanks and Piping. Clearly identify cations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular laces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electr°nic line leak 'rectors; and in-tank liquid level probes (if used for leak dete'efion). In the space provided, note the date this Site Plan _~s prepared. Page . of .. 0si00 ...... SENSOR ALARM ..... L 6:TURB SUMP I TANK STP SUMP HIGH LIQUID ALARM OOT 4, 2002 9:51 AM ..... SENSOR ALARM ..... SYSTEM SETUP L I:SATELITE DISP PAN .......... DISPENSER PAN OCT 47 2002 10:04 AM HIGH LIOUID ALARM OCT 4, 2002 9:57 AM SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH ..... SENSOR ALARM SYSTEM DATE/TIME FORMAT L 5:ANNULAR ! TANK MON DD Yyyy HH:MM:SS xM ANNULAR LOW LIOUID ALARM. 1097S5 ROLLING 140 OOT 4, 2002 .9:52 AM SENSOR ALARM '- .... 2929 E BRUNDAGE L 2:0IL LINE BAKERSFIELD CA PIPING SUMP 80448302105001 FUELALARM OCT 4, 2002 10:01 AM ..... SHI~T TIME 1 : 5:45 AM ~; SHIFT TIME 2 : DISABLED · .' - SHIFT' TIME 3 :.DISABLED .. DISABLED ..... SENSOR ALARM I"TANX PER rET NEEDED .URN DISABLED L. 7:ANNULAR 2 TANK · ', TANK ANN TST NEEDED WAN ANNULAR SPACE., J · LOW.LIQUID 'ALARM t. ,' .. ' DISABLED OCT ..4; 2002 9:54' AM 'i09755 ROLLING 1"40 .~ LINE'RE-ENABLE'METHOD. : ' 2929':E'BRUNDAGE.' "'., I :PASS LINE TEST LINE ANN'TST. NEEDEDWRN ..... SENSOR ALARM ..... 'SYSTEM'STATUB 'R~PORT.' ENABLED L :TURB'SUMP 2 TAN ' : -' : BTP SUMP I :TEMp COMPENBATiON HIGH LIQUID ALARM ~ , ' ' ~' /i/..'i .... VALUE (DEG F ): '60.0 '-. BTICKHEIGHT OFFSET OCT 4, 2002 9:55 AM !' DISABLED H-PROTOCOL DATA FORMAT HEIGHT r, ENABLED ~ ~ START DATE ~ APR WEEK 1 SUN :' '" ~TART TIME 109755 ROLLING 140 2~00 AM ..... SENSOR ALARM 2929 E BRUNDAGE END DATE L 4~SATELITE DISP PAN S BAKERSFIEL~ CA OCT WEEK 6 SUN DISPENSER PAN @044B30210500! END TIME HIGH LIOUID ALARM 2:00 AM OCT 4, 2002 9:55 AM OCT 4, 2002 10:03 AM ~ RE-DIRECT LOCAL PRINTOUT DISABLED SYSTEM STATUS REPORT D 8:ALARM CLEAR WARNING SYSTEM SECURITY CODE : 000000 ..... SENSOR ALARM ..... L 3:PIPING MID PAN DISPENSER PAN HIGH LIQUID ALARM OCT 4~ P002 9:5~ AM COMMUNICATIONS SETUP IN-TANK SETUP ...... AUTO DIAL TIME'SETUP: ............. T I:DIESEL 1 SOUTH PRODUCT CODE : 1 PORT SETTINGS: D 8:SIMPLICITY CENTER THERMAL COEFF :.000450 DIAL ON DATE COMM BOARD : 1 (RS-232) APR 29, 2002 TANK DIAMETER : 96.00 BAUD RATE : 2400 DIAL TIME : 6:08 AM TANK PROFILE : 4 PTS FULL VOL : 11594 PARITY : ODD RECEIVER REPORTS: STOP BIT : 1 STOP 72.0 INCH VOL : 10562 DATA LENGTH: 7 DATA 48.0 INCH VOL : 6177 24.0 INCH VOL : 2394 COMM BOARD : 2 CF×MOD) BAUD RATE ': 2400 PARITY : ODD RS-232 SECURITY FLOAT SIZE: 4.0 IN. B496 STOP BIT : 1 STOP CODE : 000000 · DATA LENGTH:' 7 DATA '' MATER MARNING : 2.0 DIAL TYPE : TONE ...... HIGH WATER LIMIT: 2.5 . ANSMER., ON : I RING - '"- t' MA× OR LABEL VOL: 11594 ' 1 OVERFILL LIMIT' : AUT© TRANSMIT SETTINOS: 'RS-2B2 END OF MESSAGE : 11014 ' DISABLED ...... · .... , .......... HIGH PRODUCT AUTO LEAK ALARM LIMIT ' : 104B4 DISABLED .AuTo DI~L ALAR~ SETUP DELIVERY LIMIT. : . 12g AUTO HIGH'MATER. LIMI~ - - - ~ - - ' 'Los .PRODUCT : 1391 DISABLED ~. '....- i '- .' '- ' ' - ' : ' hUTO OVERFILL LI~I.T' . i I D.B:SIMPLICITY CENTER . 1000 ' ' J ]"' ' ' ' ' I" "~E~KALARM LIMIT,~.. 25 AuToDIS~LED'Lo~ PRODUCT "~ ' .., '. . .. ['.IN=T~NK RL&~MS . · j:?.S~DDEN'LOSS LIMIT: 25 DISABLED .. '-',." [" ~LL:LEAK'~L~RM ,:~ :T~NK-~,ILT "- : -'5.40 AUTO THEFT LIMIT. "-, /"'.~LL:~DDEN LOSS ALARM · '": {"'~ :PEOLL' ,BE OUT''. . 'MANIFOLDED TANKS · DISABLED ..... .:'. /,-,'., ..~ ~UTO'DELIVER¥ST~RT"~ ' . t:" ALL:GROSS'TESYFAIL' , T~: 02 DISABLED ." ~,.": ~LL:PERIODIC TEST FAIL 'AUTO DELIVERY'EN~' ALL:NO,CSLDIDLE TIME DISABLED · ' , . ~LL:CSLDI-NCR RATE MARN .LE~K SIN PERIODIC: 25g AUTO EXTERNAL INPuT.ON. ' ,ALL:~CCU_CH~RT CAL MARN' ~.. :.. ' : 289B DIB~BLED " .~LL:LOM TEMP W~RNING · AUTO EXTERNAL INPUT OFF ALL:GROSS FAIL LINE TNK 'LEAK'MIN ANNUAL : DISABLED : 289B ~UTO SENSOR FUEL ALARM LIQUID SENSOR ~LMS DIBABLED 'ALL:FUEL ALARM AUTO SENSOR MATER ~LARM ALL:SENSOR OUT ALARM PERIODIC TEST TYPE DISABLED ALL:SHORT ~LARM STANDARD AUTO SENSOR OUT ~LARM ALL:MATER ALARM DISABLED ALL:MATER OUT'ALARM ANNUAL TEST FAIL ALL:HIGH LIQUID ALARM ~LARM DISABLED ....... ~LL:LOM LIQU.!D_AL~RM ALL:LIQUID MARNING --' PERIODIC TEST FAIL ALARM DISABLED RECEIVER ALARMS RECEIVER SETUP: SERVICE REPORT MARN GROSS TEST FAIL ALARM CLEAR M~RNING ALARM DISABLED D B:SIMPLICITY CENTER ANN TEST ~VERAGING: OFF 18003764255 PER TEST AVERAGING: OFF RCVR TYPE: COMPUTER PORT NO: 2 TANK TEST NOTIFY: OFF RETRY NO: 5 RETRY DELAY: § TNK TST SIPHON BRE~K:OFF CONFIRMATION REPORT: OFF DELIVERY DELAY : 5 VERSION 19.05 T,2:DIESEL 2 NORTH .PRODUCT CODE : 2 , I:SATELITE DISP PAN SOFTWARE~ 346019-100-F THERMAL COEFF :.000450 ~UAL FLT. DISORIMINATING CREATED - 00.02.25.12.24 TANK DIAMETER : 96.00 ~ATEGORY ; DISPENSER PAN ;90 SOFTWARE MODULE TANK PROFILE : 4 PTS SYSTEM FEATURES: FULL VOL : 11594 PERIODIC IN-TANK TESTS 72.0 INCH VOL : 10562 48.0 INCH VOL : 6177 L 2:0IL LINE ANNUAL IN-TANK TESTS 24.0 INCH VOL : 2394 TRI-STATE (SINGLE FLOAT) CATEGORY : PIPING.SUMP ALARM HISTORY REPORT ..... SYSTEM ALARM ..... FLOAT ~IZE: 4.0 IN. 8496 L 3:PIPING MID PAN PAPER OUT ~ATER ~ARNING' : 2.0 DUAL FLT. DISCRIMINATING AUG 1~, 2002 3:27 PM HIGR ~ATER LIMIT: 2.5 CATEGORY : DISPENSER PAN PRINTER ERROR AUG 10, 2002 3:27 PM MAX OR LABEL VOL: 11594 BATTERV I8 OFF OVERFILL LIMIT : 95~ dAN 1, 1996 8:00 AM : 11014 L 4:SATELITE DISP PAN S HI~R PRODUCT : 90~ DUAL FLT. DISCRIMINATING : 10434 CATEGORY ~ DISPENSER PAN DELIVERY LIMIT : 12~ LO~ PRODUCT ~ 1000 L 5~ANNULAR 1 TANK LEAK ALARM LIMIT: 25 : DUAL FLOAT RYDRO~TA~I© ......... SUDDEN LOSS LIMIT: 25 CATEGORY : ANNULAR SPACE i TANK TILT : 2.30 i MANiFoLDED TANKS L'6~TURB BUMP 1-T~NK I ~RM HisToRy REPORT · · DOAL'FLT, DISCR.IMI~ATIN~ t ..... ~ENSOR ALARM . CATEGORY ~ST~ SUMP' i' L I:SA~ELITE :mP PAN . L ?~ANNULAR 2 TANK: '" ,-. OCT' ANNL~L TE~T. FAIL. CATEGORY ~.~TP SUMp · " ALARM DISABLED PErIODIC.TEST FAIL ALARM DISABLED ~ OUTPUT RELAY SETUP ~ROBB TEST'FAIL ALARM DISABLED R I~AKARM TYPE~ ANN TE~T AVERAGING~ OFF ~TANDARD ~ ~ ~ PER TE~T AVERA~ING~ OFF NORMALLY CLOSED TANK TEST NOTIFY~ OFF ........ IN~T~NK ~L~RM~ TNK TBT SIPHON BREAK,OFF ALL,LEAK ~LARM AL~RH HISTORY REPORT ALL,HIGH ~ATER ALARM DELIVERY DE~Y ~ 5 MIN ALL:LO~ PRODUCT ALARM ..... SEN~OR ALARM ..... ALL,SUDDEN LOSS ALARM L 2~OIL LINE ALL:GRO~S TEST FAIL PIPING SUMP FUEL ALARM LIQUID SENSOR ALM~ OCT 4, 2002 1~1 AM ~EAK TEST METHOD L I~FUEL ALARM L ~:FUEL ALARM TEST ~EEKLY : ALL T~NK L 4~FOEL ALARM ~UN/' ? L ~FUEL ALARM START TIME ~ 2~ AM L 6~FUEL ALARM TEST RATE ~0.10 GAL/HR L 7~FUEL ALARM D~RATI. ON~ ~ 4 HOURS L B~FUEL ALARM L I~NI~H LIQUID ALARM ~= L 3:HIGH LIQUID ALARM L 4:NIGH LIQUID ALARM LEAK TEST REPORT FORMAT L 5:HIGH LIQUID ALARM ~ ~ ~ ~ NORMAL L 6:HIGH LIQUID ALARM L 7:HIGH LIQUID ALARM L 8:HIGH LIQUID ALARM L 5:LO~ LIQUID ALARM L 7:LO~ LIQUID ALARM RL~RI"I H I STORY REPORT .....SENSOR RL~RH ..... L 3:PlPlNG HID DISPENSER P~N HIGH LIQUID RL~RH OCT 4, 2002 9; 5~ RH RLRRH HISTORY RE~ORT FUEL RLRRH ..... SEN~OR RLRRH ..... ~UN 16, 2002 5;32 ~H L.6:TURB SUH~ 1 TRN~ ST~ SUH~ ~ENSOR OUT RLRRH HIGH LIQUID RLRRH RUG 7, 2001 2;14 '~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ '-RLRRH HISTORY REPORT SENSOR ALARH !. 'L 4:SATELITE DISP PAN S ' ALARM.HISTORy REPORT .DISPENSER PAN i' HIGHLIQUID ALARM ..... SENSOR ALARM" . .OOT' 4, ~002 9:§§ AR '.i L ?:ANNULAR ~ TANK ANNULAR SPAOE~ · · ~AN'.II, 2001 8.:4~ AM' 'i [.?'OOT. 4;."20~:' '9,§~.AM '"!' SENSOR'OUT~ALARM ' ~AN.II, 2001 8:~0 AM t: " '-';' '"./.'.":'."',":. ' t ~i. ':' '" ~ ~ ~ ~ ~ END ~ ~ ~'~ ~ RLARR HISTORY REPORT ..... SENSOR -L. 5.:ANNULRR _1. T~N~ ___ RNNULRR SPACE LO~ LIQUID OCT 4~ 2002 9:52 RR ALARR HISTORY REPORT LO~ LIQUID ALARR ..... SENSOR ALRRR DEC 21, 2001 ~:12 AR L 8:TURB SURP 2 TAN~ STP ~URP LO~ LIQUID ALRR~ HIGH LIQUID DEC 14~ 200~ 9:0! PR OCT 4~ 2002 9:55 September 30, 2002 Rollins/Penske 2929 East Bmndage 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 2101 "H' Street Bakersfield. CA 93301 containment testing required for all secondary containment components for your underground VOICE (661) 326-3941 storage tank (s). FAX (661) 395-1349 PREVENTION SERVICES Senate Bill 989 became effective January 1, 2002, section 25284. I (California Health & Safety F~ s~msE~Es.~,~o~l~.~sE~ncEs 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) 326-0576 PUBLIC EDUCATION Of great concern is the current failure rate of these systems that have been tested to date. 1715 ChesterAv~. 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) 3260576 For the last five months, this office has continued to send you monthly reminders of this FIRE INVESTIGATION 1715 ChesterAve. necessary testing. This is a very specialized test and very few contractors are licensed to Bakersfield, Ca 93301 perform this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. VOICE (661) 326-3951 FAX (661) 326-O576 The purpose of this letter is to advise you that under code, failure to perform this test, by the TRAINING DiViSIOn necessary deadline, December 3 I, 2002, will result in the revocation of your permit to operate. 5642 Victor Ave. Bakersfield, CA 9.3.308 VOICE (661)399-4697 This office does 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. Sincerely~./. ~ Steve Underwoo Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services 10/03/2002 08:28 909~417 TANK SPECIAL PAGE CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326.3979 APPLICATION TO PEI~FORM FUEL MONITORING CERTIFICATION OPERATORS NAM~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME INSPECTION DATE c~/~O]- /O ?_ Section 2: Underground Storage Tanks Program [] Routine ~ombined [] Joint Agency [] Multi-Agencyt t [] Complaint [] Re-inspection Type of Tank .~_t01'~ Number of Tanks "/ Type of Monitoring ~/,-g4 Type of Piping ./0Ld~- OPERATION C V COMMENTS Proper tank data on file L Proper owner/operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current r... 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? Office of Environmental Services (805) 326-3979 [ ~.l,~'Iness Site Re~!y White - Env. Svcs. Pink - Business Copy CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 ADDRESS ~O~.-':~"'~.-g-r'dln/t:a_,,. L/~t PHONE NO..9~}a-cq60~'}~- FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBEROF EMPLOYEES fl Section 1: Business Plan and Inventory Program ~ Routine ~Combined [~ Joint Agency [~ Multi-Agency ~ Complaint [~} Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate L. Visible address Correct occupancy Verification of inventory materials -., Verification of quantities ~' / Verification of location Proper segregation of material j ,. Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures ~' r' , Emergency procedures adequate ,,,, / Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: [~es [~]No ~.~ ~~ Explain: Questions regarding this inspection? Please call us at (661) 326-3979 ~' BuSiness Site Responsible Party ..... u }~'L~;'I.,I.. ! I'IG 140 2'97~ E BE'UNDt:~GE BAKE~SF IELI) Ca 80448302105001 SEP 26.. 2082 9:23 AH SYSTEH S'I'e~TUS F,'E~ ...... T ALL FUN(:TIONS NO,...,4L I NVENI'ORY REPORT T t:DIESEL 1 ~:;OUTh VOLUP1E = 6291 GALS ULI..~-t~] E = 5303 90% ULLAGE= 4143 TC VOLUr.tE = 6202 {;;ALS HEIGHT = ,:18.54 INCHES I,dATER VOL = 0 G~LS t,dATER = O. O0 INCHES 'FEI"IP =: 91.5 DEG F T 2:DIESEL 2 NC, RTH VC, LUHE = 5898 GaLS ULLAGE = 5896, GALS 90:¢-.; IJ[,L¢:~GE= 4?36, GALS TC VC',,LIJI"IE = 5615 0*' S HEIGHT = 45.18 ;~tES t.,JRTER VOL 0 G~S IgRTEF: = O. O0 INCHES TEHP = 92.0 DEG F I'.'IRN 1 FC;,LI-)E[.~ TPd',iKS 1 I"iVEN'I'©RY TOTALS T ]:DIESEL 1 SOUTH T 2:DIESEL 2 NORTH VOLUHE = 1 1989 GALS TO ',,/OLUI'IE = 11817 GALS ~ ~ ~ ~. i~ END ~ ~ ~ ~ ~"~u~# ~ easing May 10, 2001 Bakersfield Fire Department Environmental Services Steve Underwood, Fire Inspector 1715 Chester Ave. Bakersfield, CA 93301 RE: Penske Track Leasing, 2929 E. Brundage Lane, Bakersfield Dear Mr. Underwood, In response to your letter dated May 1, I have enclosed the new owner-operator information. If you have any questions regarding this submittal or require any additional information, please don't hesitate to call me at 610-603-8450. Sincerely, Brian Yazem3~ Facility Compliance Engineer Cc: File PENSKE TRUCK LEASING CO. / ROUTE 10 GREEN HILLS / P.O. BOX 563 / READING, PA 19603 TELEPHONE: 610-775-6000 FRANK COCUZZA SENIOR VICE PRESIDENT FINANCE To Whom It May Concern: I am the chief financial officer of Penske Truck Leasing Co., L.P., located at Route 10, Green Hills, Reading, PA 19603. This letter is in support of the use of "the financial test of self-insurance" by the use of alternative 1, to demonstrate financial responsibility for "taking corrective action" and "compensating third parties for bodily injury and property damage" caused by "sudden accidental release" and/or "nonsudden accidental release" in the amount of at least $1 million per occurrence and $2 million annual aggregate arising from operating (an) underground and/or aboveground storage tank(s). Underground and/or aboveground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized state program by this "owner or operator": (See attachment A). A "financial test", is also used by this "owner or operator," to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR Parts 271 and 145: EPA Regulations: Amount Closure (264.143 and 265.143) .................. $ N/A Post-Closure Care (264.145 and 265.145) ........ $ N/A Liability Coverage (264.147 and 265.147) ....... $ N/A Corrective Action (264.101 (b)) ................ $ N/A Plugging and Abandonment (144.63) .............. $ N/A Authorized State Programs: Amount Closure ........................................ $ N/A Post-Closure Care .............................. $ N/A Liability Coverage ............................. $ N/A Corrective Action .............................. $ N/A Plugging and Abandonment ....................... $ N/A TOTAL .................................... $ N/A PENSKE TRUCK LEASING CO. / ROUTE 10 GREEN HILLS / P.O. BOX 563 / READING, PA 19603-0563 TELEPHONE: 610-775-6100 / FAX: 610-775-5064 Page 2 This "owner or operator", has not received an adverse opinion, a disclaimer of opinion, or a "going concern" qualification from an independent auditor on his financial statements for the latest completed fiscal year. ALTERNATIVE 1 1. Amount of annual UST aggregate coverage being assured by a financial test, and/or guarantee ....................... $ 2,000,000 2. Amount of corrective action, closure and post-closure care costs, liability coverage, and plugging and abandonment costs covered by a financial test, and/or guarantee ........................ $ 0 3. Sum of lines 1 and 2 ................... $ 2,000,000 4. Total tangible assets ................. $ 4,382,926,000 5. Total liabilities (if any of the amount reported on line 3 is included in total liabilities, you may deduct that amount from this line and add that amount to line 6) ................................ $ 4,258,323,000 6. Tangible net worth (subtract line 5 from line 4) ................................. $ 124,603,000 Yes No 7. Is line 6 at least $10 million? ......... X 8. Is line 6 at least 10 times line 3? ..... X 9. Have financial statement for the latest fiscal year been filed with the Securities and Exchange Commission? ................ X 10. Have financial statements for the latest fiscal year been filed with the Energy Information Administration? ............. X Page 3 11. Have financial statements for the latest fiscal year been filed with the Rural Electrification Administration? ........ X 12. Has financial information been provided to Dun and Bradstreet, and has Dun and Bradstreet provided a financial strength rating of 4a or 5A? (Answer "Yes" only if both criteria have been met) ........ X I, hereby certify that the wording of this letter is identical to the wording specified in 40 CFR Part 280.95(d) (and Missouri 10 CSR 20 - 11.095(4))as such regulations were constituted on this date, shown immediately below. Since~y, ? ~ Chief Financial OfficeJ/ April 1, 2001 EMERGENCY RESPONSE PLAN UNDERGROUND STORAGE TANK MONITORING PROGRAM This monitoring 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 Enviwnmental Services within 30 days of any changes to the monitoring procedures, unless required to obtain approval before nmking the change. Required by Sections 2632(d) and 264 l(h) CCR. Facility Name ?e ~s Jce '-[-~,., c /~ FacilityAddress ,2Cl.2. cl ~. ~£ono[o,~e.. 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 be notified wit .h.in24hours. ~.~ J-~e s~,'[[ /~ ..c,,~,~][; ?e.~]ce fcrso,,~.,~[ 2. Describe the proposed methods and equipment to be used for removing and properly disposing of any_ hazardous substance. ~,, ,?~/~ Io~.~,,v., ~o~ t~,'~ ~,,,'1/ /~,'~ ~,~,'~ 3. Describe the location and availability of the required cleanup equipment in item 2 above._ 4. Describe the maintenance schedule for the cleanup equipment: E,.,._,..,.g.'..~ ~o..~/l,,'.,., /'~ ~,~,~ ~,~,,, /-~ .~t,,,'11 ~ ~ ,x ,..,., ~,.l,'.. t~ I,.,, rq, I,-~' og. " 5. List the name(s) and title(s) of the person(s) responsible for authorifing any work necessary under the response plan: UNDERGROUND STORAGE TANK MONITORING PROGRAM This momtormf program mus~ Im kept at tbz UST location a~ ail times. Thz in--on on ,hit ~ program ar, couditiom of tim operating permiL. Tho pmnit holder ~ no,fy tho Oflic, of Eaviroumm~ai Se~cea within 30 days of any dmnles to the monitoring procedures, tmless required to ~ approval before maktn8 the ctumge. Required by Sections 2632(d) and 2641('n) CCIL A. Describe the ~//.equency of performing the .mo.nktoring:_ _. ~ ..... Tank B. What methods and equipment, identi~ed by paine and model, will bz used for pzrfoming the monitoriagi Tank L]o..2o, IGloo. TLs-35'o- ,, ,, ,, ,, _ Pipiag Vee~er ~oo/: TLS ' ;~.To ~-~ t.~'.~l-; ,' C. Describe ~e loca~o-(s) whe'e the moaitoria8 will be performed (facilit7 plot plaa abould be attached): D. List the name(s) ~d title(s) of the people respomible for pefformin8 the moaitotia8 a~d/or maimaiam' g the equipm .ent: E. Reportiag pormat for monitoring: F. Descdbe the preventive maintenance schedule for the monitorin8 equipment. Note: Maintenance mu~t be in accordance with the m,a~,~faeturer'~ mMatemmee ~ehedMe but not less than every 12 months., O. DesCribe the training neCe~sar~ for the opgratiPn of ,oST sTstem, ~¢ludia8 pipi~,~a~i the monitoring equipmenr ~ J'l ~ I EXHIBIT A  State of California State Water Resources Control Board Division of Clean Water Programs P.O. Box 944212 Sacramento. CA 94244-2120 (Instructions on rm, c~c) I I CERTIFICATION OF FINANCIAL RESPONSlBILIIY FOR UNDERGROUND STORAGE TANKS CONTAINING PETROLEUM A,. ] am rcqmred to demonslrmc Finaflc~al Responsibilir,.' in thc required amounts as specified th Sect:on 280'7, Chapter 18, Div. 3, Tide 23, CCR: [ '" i$00,000 dollars per occurrence [ !1 million dollars annuaJ aggregate I million dollars per occurrence 2 million doUars armua] ag~'e~te B. hereby ce~fies that it is.in compliance with the requirements of Sect;on 2807, Article 3. Chapter 18, Division 3, Title 23, California Code of F~egulafions. · The mechanisms used to demonstrate financial responsibility as required by SectiOn 2807 am as follows: C. Mechanism Name and Address of Issuer I Mechanism I C°verage' Coverage Corrective i Third Party ' ' i Number t Amount · Period Action Comp..J Type Insuranc~ ~ ID ~ree,. k{o'l; $ Note: If you are using the State Fund as any part of your demonstration of financial responsibility, your execubon and submission ~ of this..certification also certifies that you are in compliance with all conditions for participation in the Fund. F aClll~' ~ame ' ' ' ' IFacib .l~Addxe~a ___SEE ATTACHED LiST I ~ SEE A~TAC~RD T,T._qT F~"d,tT Nam: IFacdm., AddJ'~ · 1715 Chester Ave., Bake~fleld, CA 9~01 (661) ~26-~979 UNDERGROUND ~TO~GE T~KS - UST FACILI~ L FACI~ I ~ INFO~ON TOTAL ~ OF T~ ~~~ *~U~~~~ RE~INI~ AT $~ ~? ~ ~ ~ ~ ~ ~ ~ U~. ~U~ OR ~ ~ -- ~ T~O~ UPCF (71~) S:XCUPAFORMS~a.~ Complete the UST - Facility page for all n~w permits, permit changes or any facility information changes. This page must be submitted within 30 days of permit or facility information changes, unless approval is required before making any changes. Submit one UST - Facility page per facility, regardless of the number of tanks located at the site. This form is completed by either the permit applicant or the local agency.underground tank Inspector. As part of the application, the tank owner must submit a scaled facility plot plan to the local agency showing the location of the US'I"s with respect to buildings and landmarks [23 CCR )2711 (aX8)], a description of the tank and piping leak detection monitoring program [23 CCR )2711 (aX9)], and, for tanks containing petroleum, documentation showing compliance with state financial responsibility requirements [23 CCR )2711 (aX11)]. Refer to 23 CCR )2711 for state UST information and permit application requirements. (Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages. These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C, the Business Section of the Unified Program Data Dictionary.) Please number all pages of your submittal. This helps your CUPA or local agency identify whether the submittal is complete.and if any pages are separated. 1. FACILITY ID NUMBER - Leave this blank. This number is assigned by the CUPA. This is the unique number Which identifies your facility. 3. BUSINESS NAME - Enter the full legal name of the business. 400. TYPE OF ACTION - Check the reason the page is being completed. CHECK ONE ITEM ONLY. · 401. NEAREST CROSS STREET - Enter the name of the cross street nearest to the site of the tank. 402. FACILITY OWNER TYPE ~ Checkthe type of business ownership. 403. BUSINESS TYPE - Check the type of business. 404. TOTAL NUMBER OF TANKS REMAINING AT SITE - Indicate the number of tanks remaining on the site after the requested action. 405. INDIAN OR TRUST LAND - Check whether or not the facility is located on an Indian reservation or other trust lands. 406. PUBLIC AGENCY SUPERVISOR NAME - If the facility owner is a public agency, enter the name of the supervisor for the division, section or office which operates the UST. This person must have access to the tank records. 407. PROPERTY OWNER NAME - Complete items 407- 412 for the property owne~', unless ali items are ' 408. PROPERTY OWNER PHONE the same as the Owner Information (items 111-116) on the Business 409. PROPERTY OWNER MAILING OR STREET ADDRESS Owner/Operator Identification page (OES Form 2730). If the same, 410. PROPERTY OWNER CITY write 'SAME AS SITE" in this section. 411. PROPERTY OWNER STATE 412. PROPERTY OWNER ZIP CODE 413. PROPERTY OWNER TYPE - Check the type of property ownership. 414. TANK OWNER NAME - Complete items 414- 419 for the tank owner,, unless all items are the 415. TANK OWNER PHONE same as the Owner Information (items 111-116) on the Busihess 416. TANK OWNER MAILING OR STREET ADDRESS Owner/Operator Identification page (OES Form 2730). If the same, 417. TANK OWNER CITY ' write 'SAME AS SITE' in this section. 418. TANK OWNER STATE ' ' 419. TANK OWNER ZIP CODE 420. TANK OWNER TYPE - Check the type of tank ownership. 421. BOE NUMBER - Enter your Board of Equalization (BOE) UST storage fee account number. This fee applies to regulated USTs stodng petroleum products. This is required before your permit application can be p~. If you do not have an account number with the BOE or if you have any questions regarding the fee or exemptions, please call the BOE at (916) 322-9669 or write to the BOE at: Board of Equalization, FUel Taxes Division, P.O. Box 942879, Sacramento, CA 94279-0030. 422. PETROLEUM UST FINANCIAL RESPONSIBILITY CODE - Check the method(s) used by the owner and/or operator in meeting the Federal and State linandal responsibility requirements. CHECK ALL THAT APPLY, If the method is not listed, check Aothers_- and enter the method(s). USTs owned by any Federal or State agency and non-petroleum USTs are exempt from this requirement. 423. LEGAL NOTIFICATION AND MAILING ADDRESS - Indicate the address to which legal notifications and mailings should be senL The legal notifications and mailings.will be sent to the tank owner unless the facility (box 1 ) or the property owner (box 2) is checked. SIGNATURE OF APPLICANT - The business owner/operator of the tank facility, or officially designated representative of the owner/operator, shall sign in the space provided. This signature certifies that the signer believes that all the information submitted is accurate and complete. 424. DATE CERTIFIED - Enter the date that the page was signed. 425. APPLICANT PHONE - Enter the phone number of the applicant (person certifying). 426. APPLICANT NAME - Enter the full printed name of the person signing the page. 427. APPLICANT TITLE - Enter the Uae of the person signing the page. 428. STATE UST FACILITY NUMBER - Leave this blank. This number is assigned by the CUPA as follows: the number is composed of the two digit county number, the three digit jurisdiction number, and a six digit facility number. The facility number must be the same as shown in item 1. 429. 1998 UPGRADE CERTIFICATE NUMBER - Leave this blank. This number is assigned by the CUPA. .. . ._~i~, CITY OF BAKERSFI£LD :. ~l,?r~ 1715 Ches{er Ave., Bakersfield, CA 93301 (661) 326 3979 --' ~ '~' UNDERGROUND STOOGE TANK~ - TANK PAG~ 1 OfllllCl OtI ENVIRONMENTAL. SEI t71~ Cl~llr Av~., ~Rlrlflel4, CA t3301 32~-3e7g , UNOER<3AOUNO I~PtN*3 ABOvEGROUNO ~PfNO SYSTEM r'fPE P~E~UR~ C~ 2. SUCTION ~ 3. ~ 4~ ~ t. ~E~SURE , ~NUFACTURERI~2. ~U~E WALl. ~ ~. U~ ~ 2. ~U~E WALL ~ ~. O~ER ~FA~URER ~ I ~UFAC~RER ~TER~S~ ~ 2. ST~E~ S~EL ~ ~. ~V~~ ~ 2. STA~E~STEEL ~ T. ~V~O~EEL U~~ ~ ~UND ~ ~ · ~Y02~ ~ 3. ~~~(0.I~ ~ 4. ~Y~~ TEST(0.1C.d:~) [] 8. TRJF. NNt~INTEGRITY~(0.1GPH) SAFE SUCTION SYSTEM~ (NO V~ ~ 7. ~O~ · - ~ r. ~~' ~v~ ~O~  : A~O ~ ~ OFF ~ A ~ ~ ~ a. A~O ~ ~ OFF ~ A ~ ~U~ D~~ ~ ~ ~A~O~~F ~ ~ ~O~O~ ~ST~ ~ ~2. ~~~(0,~ ~ 13. ~~~~*~~~ REd. ICON / ~ ~~E~T~ 81GNA~RE ,~TU~~~. OATE UPCF (7/9g) S:~CUPAFORM~WRC-,~.WP D 1715 Chester Ave., Bakersfield, CA 93301 (661) 326 3979 UNDERGROUND STORAGE TANK~i . TANK PAGE 1 ~ ~.ll~ ~ CITY OF 8AKERgFIELO 1715 CheiMe' UNOER~ ~ A~Vfi~UNO ~uF*CTURER;~z. ~U~EWALL ~. U~ ~ 2. ~U~EWALL ~. O~ER ~FA~RER ~ t ~NUFAC~RER CORRO~N TEST(0. S O~) [] e. T~ENM~Lt~rEG~'YTEST(O. 1 ~E ~N ~ (~ V~ ~ ~_~ ~ ~ ~ ~N ~ (~ V~S IN ~W ~UND ~ z. ~ ~o~ ~ 7. ~ ~o~ ~v~ ~ ~ ~ (~ ~ ~t ~): ~ g. a~~(o.1~) ~ · ~Y~~O~ ~ e. ~~~(o.s ~~Y ~ ~ ~Y ~NED (~ ~) · 10. ~S ~ ~ ~R  ~ ~ ~ OFF ~ A ~ ~ ~ a. A~O ~ ~ OFF ~ A ~0 ~ ~ OFF F~ ~. ~ F~ ~ ~ ~ b. A~O ~ ~ ~F ~ ~ c ~X~O~~F ~ c ~O~O~ ~ S2. ~~(0.1~) ' '. ~ S~ ~~~(0.1~ UPCF (7/gg) 8 RCUPAFORM~WRCS'B.WP D OTHER TANK INFORMATION (ACTIVE TANKS OF ACTIVE BRANCHES) REGION_NO 021 OVERFILL PREVENTION ~fPE SATELLITE SATELLITE AST BRANCH CITY TK TANK TANK TANK CATI~. PROT. SPILL BUCK. OVERFILL AUTOMAT LEVEL BALL LINE LINE SECOND SHEAR NO NO CODE CAPAC TYPE INS.DATE INS. DATE INS SHUTOFF ALARM FI~O^T LOCAT MONITOR CONTAT VALVE 105 A BURLINGAME 01 UDF 12126 MODERN WE 11/11/11 4/21/89 4/21/89 U/G RED JACKET Y 106 A SAN DIEGO 01 UDF 10000 PLASTEEL 11/11/11 2/1/90 2/1/90 Y Y U/G RED JACKET Y 106 A SAN DIEGO 04 UDF 10000 PLASTEEL 1t/11/11 4/1/93 4/1/93 Y Y U/G RED JACKET Y 107 B SAN MARCOS 02 UOF 20000 XERXES 11/5/96 11/5/96 Y Y U/G VEEDER ROOT Y 108 A RIVERSIDE 01 UDF 20000 OWENS COR 11/11/11 8/10/91 8/10/91 Y y Y U/G RED JACKET Y 108 A RIVERSIDE 02 UWO 600 OWENS COR 11/11/11 8/10/91 112 A CITY OF INDU 01 UDF 20000 OWENS COR 11/11/11 9/1/93 9/1/93 Y U/G RED JACKET Y 114 A LA MIRAOA 07 UDF 20000 XERXES 11/11/11 10/10/94 10/10/94 Y U/G RED JACKET Y 138 B SAN JOSE 01 UDF 14783 OWENS COR 11/11/11 2/3/86 2/3/86 Y y Y U/G RED JACKET Y 138 B SAN JOSE 02 UDF 14783 OWENS COR 11/11/11 2/3/86 2/3/86 Y Y Y U/G RED JACKET Y 140 C BAKERSFIELD 01 UDF 12000 OWENS COR 7/1/98 7/1/98 N Y N U/G RED JACKET Y 140 C BAKERSFIELD 02 UDF 12000 OWENS COR 7/1/98 7/1/98 N Y N U/G RED JACKET Y 141 B OAKLAND 01 UDF 20165 N/A 11/11/11 4/19/90 4/19/90 U/G NONE - Y 142 A W. SACRAME 06 UDF 20000 N/A 11/11/11 9/20/93 9/20/93 U/G RED JACKET N Y 142 A W. SACRAME 07 UDF 20000 N/A 11/11/11 9/20/93 9/20/93 U/G RED JACKET N Y 145 A MONTEBELLO 11 UDF 15000 XERXES 9/16/96 9/16/96 Y y Y U/G RED JACKET Y 145 A MONTEBELLO 12 UDF 15000 XERXES 9/16/96 9/16/96 Y y Y U/G RED JACKET Y 146 B ANAHEIM 07 UDF 20000 XERXES 10/11/95 10/11/95 Y Y Y U/G VEEDERROOT Y Y 147 B TORRANCE 01 UDF 20168 N/A 11/11/11 6/18/91 6/18/91 Y U/G RED JACKET Y 148 A EL MONTE 08 UDF 15000 XERXES 5/15/97 5/15/97 Y U/G RED JACKET Y 151 A ONTARIO 06 UDF 20000 11/11/11 7/5/91 7/5/91 Y Y Y U/G SHUTOFFVALV Y 151 A ONTARIO 07 UDF 20000 11/11/11 7/5/91 7/5/91 Y y Y U/G SHUTOFF VALV Y 156 A SANTAANA 01 UDF 12000 ACE BUELER 11/11/11 10/1/87 10/1/87 Y Y U/G Y 156 A SANTA ANA 02 UDF 12000 ACE BUELER 11/11/11 10/1/87 10/1/87 Y Y U/G Y 156 A SANTAANA 03 UDF 12000 ACE BUELER 11/11/11 10/1/87 10/1/87 Y Y U/G Y 166 A HAYWARD 01 UDF 20000 XERXES 7/28/99 7/28/99 Y Y N U/G 7/28/99 Y Y i Fdday, February 16, 2001 Page 1 of 1 Trunk L easing October 4, 2001 City of Bakersfield Office of Environmental Services 1715 Chester Avenue Penske Truck Leasing Co., L. P. 2929 E. B_~ndage Lane ~ersfield, CA93307 % W~m~rn: Attac~ yo~ ~6 fine t~e City of Bakersfie[d forms for c~nge of owners~i~ and underground storage tanks. I also include a copy of our Financial Responsibility letter. Please update your records accordingly. If you have any question please contact me at 610-775-6409. Sincerelyyours, // Environmental Records Clerk 610-775-6409 Rita. TruppC~PensI~e.com PENSKE TRUCK LEASING CO. / ROUTE 10 GREEN HILLS / P.O. BOX 563 / READING, PA 19603 TELEPHONE: 610~775-6000 / www.penske.com r CITY OF BAKERSFIELD ~" C~ICE OF, ENVIRONMENTAI~RVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY Page -- of TYPE OF ACTION 1. NEW SiTE PERMIT [] 3,. RENEWAL PERMIT ~ 5. CHANGE OF iNFORMATION (Specify change - [] 7. PERMANENTLY CLOSED SiTE (Check one ~tem only) [] 4. AMENDED PERMIT local use only) [] 8. TANK REMOVED 400. [] 6. TEMPORARY SITE CLOSURE I. FACILITY I SITE INFORMATION NEAREST CROSS STREET 401. FACILITY OWNER TYPE [] 4. LOCAL AGENCY/DISTRICT' L coRPoRA T,o.[] ,. COUNTY AGENCY' 21~t~¢~"~ ~ ~'/"1~' [] 2. iNDIVIDUAL [] B. STATE AGENCY' BUSINESS [] 1. GAS STATION [] 3. FARM [] 5. COMMERCIAL TYPE [] 3. PARTNERSHIP [] 7. FEDERAL AGENCY' 402. [] 2. DISTRIBUTOR [] 4. PROCESSOR .~ 6. OTHER 403. TOTAL NUMBER OF TANKS I IS facility on Indian Reservation et 'If owner of UST a public agency: name of supervisor of REMAINING AT SITE I trusilands? division, section ~ office whic/n o~erates the UST. (This is the contact person for the tank records.) oz []Yes . ,o,._ .... A,d,e,,, 6. _C,,//o,., II, PROPERTY OWNER INFORMATION PROPERTY OWNER NAME 407. I PHONE 408. MAILING OR STREET ADDRESS '~ 409. CITY 410. STATE 411. ZIP CODE 412. PROPERTY OWNER TYPE [] 2. INDtVIDUA[~ [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY 413. ] '1. [] 3. PARTNERSHIP [] 5, COUNTY AGENCY [] 7. FEDERAL AGENCY CORPORATION IlL TANK OWNER INFORMATION TANK OVVNER NAME 414, t PHON/= 41~. MAILING OR STREET ADDRESS M/ 416. /9.0, /~ox 7~'3~'- ciTY/~ ~. 417. STATE/~/~41B. J~,PCODE ¢-, ,,, e./ TANK OWNER TYPE ~ [] 2. INDIVIDUAL [] 4. LOCAL AGENCY/DISTRICT [] 6. STATE AGENCY 420. Jl. [] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL AGENCY CORPORATION IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER (TK) HQ { 4 4 - Call (916) 322-9669 if questions arise TY V. PETROLEUMUST FINANCIAL RESPONSIBILITY INDICATE METHOD(S) .,l~. SELF-INSURED [] 4. SURETY BOND .J~7. STATE FUND [] 10. LOCAL GOV'T MECHANISM [] 2. GUARANTEE [] 5. LETTER OF CREDIT [] 8. STATE FUND & CFO LETrER [] 99. OTHER: [] 3. INSURANCE [] 6. EXEMPTION [] 9. STATE FUND & CD 422. VI, LEGAL NOTIFICATION AND MAILING ADDRESS Check one box to indicate whiOn address should be used for legal notifications and mailihg. [] 1. FACILITY .,~ 2. PROPERTY OWNER [] 3. TANK OWNER 423. Legal notifications and mailings will be sent to the tank owner unless box 1 o¢ 2 is checked. · 'VII, APPLICANT SIGNATURE Certification: I certify that t~'~l~ inf..m,o..~malion provided herein is true and accurate to v .; best of my knowledge. N~ c:, ,,,-r'LI _~4NT (p~int) 426. TITLE OF APPOCANT ~' 427. STATE UST FACILITY NUMBER (Forlocaf uso only) 428. 1998 UPGRADE CERTIFICATE NUMBER (Forlocal use only) 429. I UPCF (7/99) S:\CU PAFORMS~S'Wrcb-a.wpd C~Tt' OF 8AKERSFIELO O~FICW O~ ENVIRONMENTAL SERVICI~ S C~ A~., ~ke~fleld, CA ~3301 (M1)~79 CONS UC O .~ ' ~NU~ACTUnER~2. ~U~EWALL ~. U~ ~ 2. ~UBLEWALL ~. 0~ t ~FA~URER ~1 ~UFAC~RER ~TER~LS~ 2. ST~E~ S~EL ~ 7. ~V~~ 0 2. 5TAI~E~ STEEL ~V~ ~TEEL CORROS~N'1 ~ (~ ~) RES~ICT~N / ~ ~~E~T~ 81GNA~RE CF (7~) 8:~CUP~ORM8~~'~D  CITY OF BAICERSFIELD . OF~CE OF ENVIRONMENTAL~RVICES - 1715 Ch,~er Ave., Bakersfield, CA 933~(661) 326-3979 .... UNDERGROUND ~TO~GE TANK~ - TANK PAGE 1 ~0~ ~CT~N ~ h ~IT~T ~ 4. ~O~R~T ~. ~O~I~O~N) ~ ~. rE~Y~T~o~~ LO~ r~N ~ ~ ~ · OFFICl C)~ ENVIRONMENTA, SERVICq~ 1~ C~ A~., ~kemfleld, CA 93301 (~1)~79 CONSTRUCTIO~O L ~I~EW~L O 3. LI~DT~ O~. o~en 4~ O h SIDEWALL 095. U~ .~NUFACTURER~ 2. ~U~E WALL ~ ~. U~ ~ 2. ~uece w~cc ~ ~. O~ER ~ ~FA~URER ~t ~NUFAC~RER 7. ~V~D ~EEL CORRO~N 9. ~TE~N TEST(0.1 G/~I) [-I 6. TRI~ INTEGRrI"Y TEST (0.1 GPH) SAFE SUCTION SYSTEM~ (NO VAL~r.~ IN 8ELOI~ O/:K)UNO PI~NG): SAFE SUCTION SYb'TI~MS (NO VALVES IN ~LOW GROUNO F~PING): [] 7. SELF K)~'ro~uNG . ~1 T. SELF uoNrro~,~3 GRAVITY FLOYd. GRAVTTY FLOW (Check d that i"] g. mENNU~ u~EoRrrY TEST (O.1 10. CONTINUOUS T1JRSJN~SUMP.IE/,~OR~I'THAUDfBLEANDVlSUALALA.RM~AHO · 10. CONTINUOUSTURBING SU1b~SENS~RW~'TltAUDIBLEAHOV~SUALALARM~ANO(CMK~' (Chec~ ane) I'"l a. AUTO PUI~c~ SHUT OFF WHEN A LF. A~OCOJR~ E] a. AUTOPUI~oSHUTOFFVVHF-/CA LF-AKOCCURS ~t~ O. AUTO PUMc) SHUT OFF FOR LF. AJ~. SYSTEM FAJU.~E AND SY~rF.M ~-] b. AUTO PUMP SHUT OFF FOR LF_AJC3, SYSTEM F,4~URE AND SYSTEM D~SCONNECTION I"') C NOAUTO PU~P SHUT OFF I--] c. /~')AU*TOPUM:)SHUTOFF · .. I~ 12. )Je,~L~m~(0.1 'CF (7/9g) $:~,CUPAFORMSL,qWR~'WPD ~ .~~ CITY OF' BAKERSFIELD :,; ' OFfiCE OF ENVIRONMENTAL~i~RVICES I~_y~~..... 1715 Cheer Ave., Bakersfield, CA 933~(661) 326-3979 , UNDERGROUND STO~OE TANKS - TANK PAGE FRANK COCUZZA SENIOR VICE PRESIDENT FINANCE To Whom It May Concern: I am the chief financial officer of Penske Truck Leasing Co., L.P., located at Route 10, Green Hills, Reading, PA 19603. This letter is in support of the use of "the financial test of self- insurance" by the use of alternative 1, to demonstrate financial responsibility for "taking corrective action" and "compensating third parties for bodily injury and property damage" caused by "sudden accidental release"_ and/or ':sudden accidental release" in the amount of at least $1 million per occurrence and $2 million annual aggregate arising from operating (an) underground and/or aboveground storage tank(s). Underground and/or aboveground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized state program by this "owner or operator": (See attachment A). A "financial test", is also used by this "owner or operator," to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR Parts 271 and 145: EPA Regulations: Amount Closure (264.143 and 265.143) ............................................................. $ N/A Post-Closure Care (264.145 and 265.145) ............................................... $ N/A Liability Coverage (264.147 and 265.147) ................................................ $ N/A Corrective Action (264.101 (b)) .............................................................. $ N/A Plugging and Abandonment (144.63) ...................................................... $ N/A Authorized State Pro.qrams: Amount Closure ............................................................................................ $ N/A Post-Closure Care ............................................................................. $ N/A Liability Coverage ............................................................................. $ N/A Corrective Action .............................................................................. $ N/A Plugging and Abandonment ................................................................ $ N/A TOTAL ........................................................................................ $ N/A PENSKE TRUCK LEASING CO. / ROUTE 10 GREEN HILLS / P.O. BOX 563 / READING, PA 19603-0563 TELEPHONE: 610-775-6100 / FAX: 610-775-5064 Page 2 This "owner or operator", has not received an adverse opinion, a disclaimer of opinion, or a "going concern" qualification from an independent auditor on his financial statements for the latest completed fiscal year. ALTERNATIVE 1 1. Amount of annual UST aggregate coverage being assured by a financial test, and/or guarantee ......................... $ 2,000,000 2. Amount of corrective action, closure and post-closure care costs, liability coverage, and plugging and abandonment costs co_ver_e_d _by_a _ . _ financial t~st, and/or guarantee ............ -- ~ - 0 3. Sum of lines 1 and 2 .......................... $ 2,000,000 4. Total tangible assets ........................... $ 4,382,926,000 5. Total liabilities (if any of the amount reported on line 3 is included in total liabilities, you may deduct that amount from this line and add that amount to line 6) ................................................ $ 4,258,323,000 6. Tangible net worth (subtract line 5 from line 4) ................................................. $ 124,603,000 Yes N._9o 7. Is line 6 at least $10 million? ............. x 8. Is line 6 at least 10 times line 3? .......... x 9. Have financial statement for the latest fiscal year been filed with the Securities and Exchange Commission? x 10. Have financial statements for the latest fiscal year been filed with the Energy Information Administration? .............. x PENSKE TRUCK LEASING CO. / ROUTE 10 GREEN HILLS / P.O. BOX 563 / READING, PA 19603-0563 TELEPHONE: 610-775-6100 / FAX: 610-775-5064 OCT. 15.2001 10:41AM EMV & FACILITY DEPT MO.B4B P. 1 · lro: Steve Underwood From: Brian Yazemboski Fax: 661-326-0576 IPalleS: 4 ~ Bakersfield, CA ") Re: 2929 Brundage Lane / CC~ ,,...,.,,. Steve: Per your request, I have attached a copy of our annual ATG Certificate for the above referenced facility. If you have any questions regarding this information, please don't hesitate to call me at 610- 603-8450, Thanks, Brian Yazemboski, Facility Compliance Engineer Penske Truck Leasiri9, Co, L.P I:{oUte 10 Green Hills, P,O. Box 7635 Reading, PA 19603 Phone: (610) 603-8450 Fax: (6113) 775-6442 Email: brian,yazemboski@penske,com gtAMERICAN ENVIRONMENTALgr ' TANK TESTING Hotlinc Leasing Job Worksheet Dat~ & Time /0 -- 5~ - O Site ~,a~ /~_X k ~ I ~ O c lq ~ er ^ r Site Phone Number & Contact G ~ [ ~ ~,~,- ~ (a. 00 ~ LeFT o ~ (~'b 5ox~ b~ w~t~ to be Ch~d at ~h ~) T~ Inaction N~r of T~ ~ UST 8~o ~ UST/A~ ~ Syst~ M~ Elec~onic Monitoring to bc ch~ Nmb~ of Pmb~ LK Sc~[cc T~ning Si~amm of Se~ce Manag~ ofchcc~g site Date/0 - ~/ Co~ or S~tc R~l~o~ Not~ Hnd~d_ Ta~ and S~ 2 V~r. Re~n~. _ T~na_ and ~~n~ 2038 N. Milb Ave. ~ ~52 Clmmont, CA 9171 ! 80~8-~0 F~:80042~ - r EmCa2 ENVIRON~~,~ Continuous Monitoring Device Certification TEST DAT~ () · ~ ~,, c~rv ~g~SFtE~B CA, z~cons q~3~q_ .... TANKI TAN~ TAN~ TANK4 ~e of P~duct hlno: (Gravl~. Suction, Pressure). ' .... ~ ~f , INDICATE LOCATION OF THE MONITO~NG SENSORS T~STED DY PLA~G A YES OR NO ~ APPLICABLE BOX: Annular Space Sensor Sump Sen~or / / ~/~ Dispenser Containment Sensor ....... Electronic Overfil~Level ~ / .... f v.~..~ Electronic In.Line Leak Detector ~ .q ~_~ Meehnnlcal Line Leak D?eetor , '~. / In Tnnk Gaucn~ Device .... INDICATE THE FOLLOWING BY PLACING A YES OR NO IN APPLIC.~BLE BOX: / Does the turbine automnCenlly shut -down If lite system detects mJenk, failes to opernte or is electronically disconnected? I, the monitoring system installed to prevent unauthor~ed tampering?y D mWhich con'~nuous monitoring devices Initiate positive shut-down of the turbine? 2058 N. Mffis Ave. Ste 4S2 Claremong CA 91711 B0~T3~600 Fax: 90~931-2491 '~ 'EtAMERICA N ENFII~ O NME N TA L ~ O_ OATA CHART FOR TANK S/STEM TIGHTNESS TEST .< L~ ClJENT: OWNER OR DEALER ~q/.~'/t~ ~ T/~. L/C~ /~ L~/~,~'/A/'~- DATEOFTEST /0 L~ --C) [ m ADORE~(NO.&STREE1) 3 c[ ~Cj F L~I?.U,RI'Dt'~C.,-t.P ,L,A~ WEATHER .~.C) 7'0 ~r CITY AND STATE ~,i:'CZl].~ FtE/~.-cl C8 TEMPERATURE ~ Q0 ' z:: TANK INFORMATION: TANK NO. /4-"~. OF ~ CAPACITY(NOMINAL) //, ~0~ ~/~A C ~ GALS. .,~ZEOF'TE~TOPENING' CONTENTS *'~ )~'~-~*'"~. · TOP OFFTIME TANK MA'EERIALS . OIMENS ONS.' DIAMEVER ^p '.OX MA'rE AGE PUMP SYSTEM ('TYPE) LAYOUT CHART NOTES: , SYMBOLS: T- TANK NUMBER X~' LINE TEST ATTACHED U -- UNLEADED S -- PREMIUM "~' TEST OPENING /~ MANIFOLD R -- REGULAR O ~ DIESEL CIlSPENSER -~.~ EMERGENCY SHUT-OFF WO -- WASTE OIL N -- NEW OIL r-~ TURBINE C~v VENT PIPE X -- OTHER (SPECIFIY) 09/24/2002 09:57 9095905417 TANK SPECI~ '~TS PAGE 02 ~ CITY OF B~~F~LD O~ICE OF E~O~~ SER~~ ~71~ Ch~r Ave., B~e~dd, CA (661) · PP~~ON TO P~O~ ~L MONITO~G CER~CATION OP~RS N~ ~ o~ MO~ ~A~ X./~Ae_ c '~ ~ ~ ~,,, . ~ FA~ ~ D~S~ P~S? ' ~~ NO . (,. T~a~# vo~ co~ -' 30, 2002 Rollins / Penske 2929 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 (66t)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 <~g Safety Code) of the new law mandates testing of secondary containment FAX (661 ) 395-1349 components upon installation and periodically thereafter, to insure that the systems are PREVENTION SERVICES capable of containing releases fi.om the primary containment until they are detected S~E~ S~CES.ENW~m,U. S~nCES 1715 Chester Ave. and removed. Bakersfield, CA 9,3,301 VOICE (661) 326-3979 FAX (661)326-0576 Of great concern is the current failure rate of these systems that have been tested to date. Currently the average failure rate is 84%. These have been due to thc PUBLIC EDUCATION 1715 ChesterAvb. penetration boots leaking in the turbine sump area. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661)326-0576 For the last four months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are FIRE INVESTIGATION 1715 Chester^ye. licensed to perform this test. Contractors conducting this test are scheduling Bakersfield, CA 93301 6-7 weeks out. VOICE (661) 326-3951 approx]matety FAX (661) 326-0576 TRAINING DIVISION The purpose of this letter is to advise you that under code, failure to perform this test, 5642 VlctorAvo. by the necessary deadline, December 31, 2002, will result in the revocation of your Bakersfield, CA 93308 VOICE (661) 399-4697 permitto operate. FAX (661) 399-5763 This office does not want to bc 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. sin~~ Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services ! ~D July 30, 2002 Rollins/Penske 2929 E Brundage Lane Bakersfield CA 93307 REMINDER NOTICE FraE CHIEF RE: Necessary Secondary Containment Testing Requirements by December RON FRAZE 31, 2002 of Underground Storage Tank (s) Located at ADMINISTRATIVE SERVICES the Above Stated Address. 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 Dear Tank Owner / Operator: FAX (661) 395-1349 SUPPRESSION SERVICES If yOU are receiving this letter, you have not yet completed the necessary 2101 "H' Street secondary containment testing required for all secondary containment Bakersfield, CA 93301 components for your underground storage tank (s). VOICE (661) 326-3941 FAX (661) 395-1349 Senate Bill 989 became effective January 1, 2002, section 25284.1 (California PREVENTION SERVICES Health & Safety Code) of the new law mandates testing of secondary FIRE SAFELY' SERVICES · ENVIRONMENTAL SERVICES 1715 CheslerAve. containment components upon installation and periodically thereafter, to insure Bakersfield. CA 93301 that the systems are capable of containing releases from the primary VOICE (661) 326-3979 FAX (661)326-0576 containment until they are detected and removed. PUBLIC EDUCATION Of great concern is the current failure rate of these systems that have been 1715 Chester Avb. Bakersfield, CA 93301 tested to date. Currently the average failure rate is 84%. These have been due VOICE (661)326-3696 to the penetration boots leaking in the turbine sump area. FAX (661) 326-0576 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 VOICE (661) 326-3951 contractors are licensed to perform this test. Contractors conducting this test FAX (661) 326-0576 are scheduling approximately 6-7 weeks out. TRAINING 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 Rollis / Penske 2829 E. Brundage Lane Bakersfield, CA 93307 REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 2929 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 (861) 326-3941 FAX (661) 395-1349 California Law requiring periodic testing of the secondary containment of underground storage tank systems. SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 Senate Bill 989.became effective January 1, 2002, section 25284.1 (California VOICE (661) 326-3941 FAX (661) 395-1349 Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure PREVENTION SERVICES that the systems are capable of containing releases from the primary 1715 Chester Ave. Bakersfield, CA 93301 containment until tbey are detected and removed. VOICE (661) 326-3951 FAX (661) 326-0576 Secondary containment systems installed on or after January 1,2001 will be tested ENVIRONMENTAL SERVICES upon installation, six months after installation, and every 36 months thereafter. 1715 Chester Ave. Bakersfield, CA 93301 Secondary containment systems installed prior to January l, 2001 will be tested by VOICE (661)326-3979 FAX (661) 326-0576 Janual'y 1, 2003 and every 36 months thereafter. REMEMBER! Any component that is "double-wall" in your tank system must be tested. TRAINING DIVISION 5642 Victor Ave. Bakersfield. CA 93308 Secondary containment testing shall require a permit issued thru this office and VOICE (661) 399-4697 FAX (661).399-5763 shall be performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (66 I)326-3190. Fire Inspector/Environmental Code Enforcement Officer Environmental Services SU/kr D May 29, 2002 Rollins / Penske Truck Rental 2929 E. Bmndage Lane Bakersfield, CA,93307 RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 2929 E. Brundage Lane Frae CHIEF REMINDER NOTICE RON FR~_E Dear Tank Owner/Operator: ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 Thc 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 arc 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 Scconda.l'y containment systems installed on or after January 1,200 ! 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-wail" 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 Victor Ave. shall be performed by either a licensed tank tester or licensed tank installer. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (661) 326-3190. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/kr enclosures D April 17, 2002 Rollins 2929 E Brundage Lane FIRE CHIEF Bakersfield CA 93307 RON FRAZE ADMINISTRATIVE SERVICES RE: Necessary Secondary Containment Testing Required by December 31, 2002 2101 "H" Street Bakersfield, CA 93301 vo,cE (661) 326-3941 REMINDER NOTICE FAX (661 ) 395-1349 SUPPRESSION SERVICES Dear Tank Owner/Operator: 2t01 "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 thc 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 thc 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 arc detected and removed. ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 Secondary containment systems installed on or after January 1, 2001 shall be tested upon VOICE (661) 326-3979 installation, six months after installation, and every 36 months thereafter. Secondary FAX (661) 326-0576 containment systems installed prior to January 1, 2001 shall be tested by January 1, 2003 and every 36 months thereafter. TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 Secondary containment testing shall require a permit issued thru this office, and shall be VOICE (661) 399-4697 FAX (661) 399-5763 performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Fire Inspector/Environmental Code Enforcement Officer SBU/dm enclosures BF~t:':£ RF~ F I ELL, 804qE:UU2105001 ,cJEP 7. 2001 2':49 T 1 :L,I~S!SL I S©UTH VC)L [ I["iE = 58F:7 G~::1LS ULL,,',,_-;E = 5907 GALS 90~ LIL. L~:,';E= 47,l? GALS TO k/OLUI"IE = 5599 GALS HEIC;H1 :- 4b.t2 INCHES MR'FER W,','..L - 0 GALS MRI"LF: O. O0 INCHES TEF1F' ~ 94.2 DEG ~ T 2:DIESEL 2 NORTH VOI;.UME: = 5! 4E, GALS ULi.~,,:-~E = 6448 GALS 90?,.. L.IL. LAC.;E= 5288 GALS TC 'v'OLUME = 5063 ¢ S HEIOWI' = 41,92 ~HES MATER x.,'OL = 0 G~LS I, dRTER = 0. O0 INCHES TEf"IP = 96.7 DEG F l"l~:tl'.l t FOLDED 'I'AFIt(S I I'4VEN'I'C>Ry TC>'I"ALS T 1 :DIESEL I SOUTH T 2:DIEE;EL 2 NORTH VOL. UI'IE = l 0833 GF~LS TC; VC, LLJP1E = 10662 G~LS ~ ~ ~ ~. ~ El'ID ~ ~ ~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 ADDRESS _,.9.¢_~lq fll'O~t~aft Ltl PHONENO. ~j-~O;'"O 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 I~1 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 l 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 [.J Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous,waste.on site?:_ 1~ Yes [~] No ~ Explain: ~{/Og.~ (0 ti ~ ~ l~ ~ ' Questions reg~ding ~is inspection.'? Please call us at (661)326-3979 /B~sihess Site~~sible Pa,y White - Env. Svcs. Yellow - Station Copy Pi.k- nusmess Copy Inspector: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME .Od_tn.4~' t_ ~'-P,,)dL ~xtr~q_t~ INSPECTION DATE Section 2: Underground Storage Tanks Program [] Routine ~1 Combined [] Joint Agency [21 Multi-Agency [] Complaint [] Re-inspection Type of Tank D(,0~' Number of Tanks Type of Monitoring eLI, vt Type of Piping .flex/t= 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 I...~.,/ Section 3: Aboveground Storage Tanks Program TANK SIZE( l k 6 } _~r~ ca [( AGGREGATE CAPACITY Type of Tank "(d/., [ q Z.. ('_ }~(~t ~O/c ~ 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 White - Env. Svcs. Pink - Business Co D January 22, 2001 FIRE CHIEF Rollins RON FRAZE 2929 E Brundage Lane ADMINISTRATIVE SERVICES Bakersfield Ca 93307 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 P~: Dispenser Pan Requirement December 31, 2003 Underground Storage Tank Dispenser Pan Update SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 Dear "- -Underground Storage Tank Owner: VOICE (661) 326-3941 FAX {661) 395-1349 You will be receiving updates from this office now, and in the future with PREVENTION SERVICES regard to the Senate Bill 989, which went into effect January 1, 2000. 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 This bill requires dispenser pans under fuel pump dispensers. On December 31, 2003, which is the deadline for compliance, this office will ENVIRONMENTAL SERVICES be forced to revoke your permit to operate; effectively shutting down your 1715 Chester Ave. Bakersfield, CA 93301 fueling operation. VOICE (601) 326-3079 FAX (661) 326-0576 It is the hope of this office, that we do not have to pursue such action, TRAINING DIVISION which is why this office pla:ns to update you. I urge you to-start planning 5642 Victor Ave. ' Bakersfield, CA 93308 nOW to retro-fit your facilities. VOICE (601) 399-4697 FAX (661) 399-5763 If your facility has upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at 661-326-3190. Steve Underwood, Inspector Office of Environmental Services SBU/dm (Chi Ck in boxes indicates what has mbc choked at each gtc) Tani: Informatio~ Number of Tanks ~_.UST AST Size'. Tk # UST/AST LK Syltem Mech, ~ Tk u:s~ PIpe t=~ CP ~ Ce~dl~ ed de~ecmr :em Etc~'tm~ic Mouitod.nS ~o bc checked _ Numar ~f ~m~s · ' Dat= SI~ Of SC~ ~cr d ch~ckin~ st ~o~ed ~ Permit n~d _ MONTHLY COMPLIANCE REPORT £or Rollins Leasing 8/7/00 Site No. 109755 Alternate Site No. 140C Site: Rollins Leasing Customer: Rollins Leasing 2929 E. Brundage Lane PO Box 1791 Bakersfieldi CA Wilmington, DE 93307 19899 Sensor Status Sensor Catel~orv Sensor Label Date Status Dispenser Pan SATELITE DISP PAN 08/05/2000 Normal Piping Sump OIL LINE 08/05/2000 Normal Dispenser Pan PIPlNG MlD PAN 08/05/2000 Normal Dispenser Pan SATELITE DISP PAN S 08/05/2000 Normal STP Sump TIJRB SUMP 1 TANK 08/05/2000 Normal STP Sump TURB SUMP 2 TANK 08/05/2000 Normal This report documents tank and line tests performed at the above location for the indicated date and period. This report and the tests performed are part of the Rollins Leasing compliance program. This report and the tests performed are intended to satisfy local state and federal EPA UST release detection and recordkeeping requirements for automatic tank gauge (ATG) and automatic line leak detector (LLD) systems. VEEDER-ROOT COMPANY 125 Powder Forest Drive Simsbury, CT 06070-2003 Page 2 of 2 (860)651-2700 s ,wc s MONTHLY COMPLIANCE REPORT for Rollins Leasing 8/7/00 Site No. 109755 Alternate Site No. 140C Site: Rollins Leasing Customer: Rollins Leasing 2929 E. Brundage Lane PO Box 1791 Bakersfleld~ CA Wilmington, DE 93307 19899 In-Tank Results Tank Product Date Test Type Results 1 DIESEL 1 SOUTH 08-05-2000 Sensor Normal 2 DIESEL 2 NORTH 08-05-2000 Sensor Normal Line Leak Detection Results Line Product Date Test Type Results This report documents tank and line tests performed at the above location for the indicated date and period. This report and the tests performed are part of the Rollins Leasing compliance program. This report and the tests performed are intended to satisfy local state and federal EPA UST release detection and recordkeeping requirements for automatic tank gauge (ATG) and automatic line leak detector (LLD) systems. VEEDER-ROOT COMPANY 125 Powder Forest Drive Simsbury, CT 06070-2003 Page 1 of 2 (860) 651-2700 ;D STATES POSTAL SERVICE First-Class Mail Postage & Fees Paid usPs Permit No. G-10 · Sender: Please print your name, address, and ZIP+4 in this box · BAKERSFIELD F~RE DEPART~V~ENT OFFICE OF ENV~RONF~IENTAL SERVICES '1715 Chester Avenue, Suite 300 9skersfield, CA 93301 · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse C. Sign~qJiure . ,~ / so that we can return the card to you. /~_~./~,~ ~ · Attach this card to the back of the mailpiece, X , ~ [] Agent or on the front if space permits. [] Addressee D. Is delivery address different from item 17[] Yes 1. Article Addressed to: If YES, enter delivery address below: [] No DAVID COUS INEAU ~ ROLLINS LEASING CORP. 2929 E BRUNDAGE LANE BAEERSFIELD CA 93307 3. Service Type ~Certified Mail [] Express Mail [] Registered [] Return Receipt for Memhandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes PS Form 381 1, July 1999 Domestic Return Receipt 102595-99-M-1789 Z 410 946 OS Postal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not use for International Mail (See reverse cous s . u P~~I~c °~A 93307 Postage $ - 3 2 Certified Fee ]. 10 Spedal Delivery Fee Restricted Deliver/Fee Return Receipt Showing to ]- Whom & Date Delivered Retum Receipt Showing to Whom Date, & Addressee's Address TOTAL Postage & Fees $ 2.5 2 Pos~ark or Date Stick postage stamps to article to cover First-Class postage, certified mail fee, and chargesforanyselectedoptionalservices(Seefront). ~1 1. If you want this receipt postmarked, stick the gummed stub to the right of the return address leaving the receipt attached, and present the article at a post office service r window or hand it to your rural carrier (no extra charge). ~ 2. If you do not want this receipt postmarked, slick the gummed stub to the right of the return address of the article, date, detach, and retain the receipt, and mail the article. 3. If you want a return receipt, write the certitied mail number and your name and addressi on a return receipt card, Form 3811, and attach it to the front of the article by means of the, gummed ends if space permits. Otherwise, affix to back of article. Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee, endorse RESTRICTED DEUVERY on the front of the article. 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt, if return receipt is requested, check the applicable blocks in item 1 of Form 381~. 6. Save this receipt and present it if you make an inquiry. 102595-98-M-054~ September 19, 2000 David Cousineau Rollins Leasing Corp 2929 E. Brundage Lane CERTIFIED MAIL Bakersfield, CA 93307 FIRE CHIEF RON FROZE RE: Failure to Provide Certification of Annual Maintenance on Leak Monitoring System ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 NOTICE OF VIOLATION & VOICE (661)326-3941 FAX (661) 395-1349 SCHEDULE FOR COMPLIANCE SUPPRESSION SERVICES Dear Mr. Cousineau: 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 A compliance inspection was performed on August 18, 2000. During that FAX (661) 395-1349 inspection, you had indicated that your corporate office had the annual PREVENTION SERVICES maintellance certification on your. underground storage tank leak detection system. 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 AS of this writing, we still have not received verification of testing. Accordingly, FAX (661) 326-0576 you are now in violation of Section 2641 (J) California Code of Regulations, Tide 23, Division 3, Chapter 16. ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 "Equipment & devices used to monitor underground storage tanks VOICE (661) 326-3979 FAX (661) 326-0576 shall be installed calibrated, operated, and maintained in accordance with manufacturer's instruction, including routine TRAINING DIVISION maillt~lla~ce and service checks at least once per calendar year for 5642 Victor Ave. Bakersfield, CA 93308 operability or nmning condition." VOICE (661) 399-4697 FAX (661) 399-5763 You have thirty (30) days, October 19, 2000, to provide documentation or perform testing. Failure to comply will result in revocation of your permit to operate. Should you have any questions, please feel free to contact me at (661) 326-3190. Sincerely, Ralph Huey, Director Office of Environmental Services by: Steve Underwood, Inspector Office of Environmental Services 109755 ROLL!NG 140 2929 E BRUNDAGE BAEERSFI ELD CA 80448302105001 AL,,] lB. 2000 12:50 PM SYSTEM STATUS REPORT AI.L FUNCTIONS NORMAL I N',..~EI,ITOR",.'' REPORT VOLLII'.'IE = 4486 C'".,~L,jO ULLA(~ " 7108 9E~:'~ IJLLAGE= 5948 GA~.~ T(' VOLLIME = 4418 GALS :HEIG-R'I .... = 37,94-INCHES WATER = 0.00 Ih~' T :D ESEL 2 VOLUME = 3982 GALS IJLLAGE = 7612 GALS 90~ ULLAGE= 6452 GALS TC VOLUME = :3921 GALS HEIGHT = 34.81 INC;HES HATER VOL = 0 GALS HATER = 0.00 TEMP = 93.9 DEG F MANIFOLDED TANKS INVENTORY TOTALS T I:DIESEL 1 SOUTH T 2:DIESEL 2 NORTH VOLU~E = 8468 OALS TO VOLUME = 8338 GALS ~ ~ ~ ~ * END ~ * ~ QORRECTION NO CE BAKERSFIELD FIRE DEPARTMENT N° 965 Sub Diw C~ q~ Blk. Lot You are hereby required to make the following corrections at the above location: Cot. 14o Completion Date for Corrections~ ~J~'~/O~)/'° Date ~/[c~/O~ -~J /~tor 326-3979 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 I Section 2: Underground Storage Tanks Program ~l Routine ~C/ombined [21 Joint Agency [] Multi-Agency ,~ Complaint [] Re-inspection Type of Tank . i/)A)~ Number of Tanks Type of Monitoring ClL/4A Type of Piping ./}t015:; OPERATION C V COMMENTS /. Proper tank data on file Proper owner/operator data on file ~t,// Permit fees current L,/' Certification of Financial Responsibility I k,// Monitoring record adequate and current Maintenance records adequate and current 7 Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S)( i~. IOflO ~,1 ~Cil '~00 ?do&skd( AGGREGATE CAPACITY' 150{3 Type of Tank {_)t.. { ~7-- Number of Tanks OPERATION Y N COMMENTS SPCC available V/ SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling V/ / Is tank used to dispense MVF? V/ If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Office of Environmental Services (805) 326-3979 B White - Env. Svcs. Pink - Business Copy CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3r~ Floor, Bakersfield, CA 93301 FACILITY NAME ~([l~.C~ JxcO,,e, tn'~ INSPECTION DATE ~[t~ ADDRESS ~q3cl flttl~4~? I PHONE NO. _'~- _~_i~OO FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [~l Routine ~'~ombined [~l 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 Explain:Any hazardous waste on site?: [~lYes [~ No Questions regarding this inspection? Please call us at (661) 326-3979 4~usiness White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: ..... CITY OF BAKERSFIELD ~,~~ )FFICE OF ENVIRONMENt. SERVICES · 1715 Chester Ave., Bakersfield, CA ~'~301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY ~ ~ NO~FICA~ON ~D M~UNG ~DRE~. ~L ~PUC~ 8~NA~RE UPCF (7~) S:~CUPAFORMS~.~ CITY OF' BAKERSFIELD__ ~. O~ICE OF ENVIRONMENTA~ERVICES C~ter Ave. Bake~flel~ CA 93~1 (661) 32~3979 UNDERGROUND STOOGe T~KS T~K PAGE 1 ~M) F~ I J ~ J J ~ I J J J J J L TANK DESGNImON T,ANKIOd. 432 J T,A/dKMAJ~JIrm . 433 / CC)~AD~A&IZ~O?A/dK ~ 03.~~ 0~.~ ~~ · . .. 0~~ 0~~~ O~i 0~ ~ 0~~~ 0~ O~ ~~ .. ... ~.~..~ ~. ~,' ~:~up~~.~o crrY oF BAKERSFIELD OPlqG! OP ENVIRONMENTAL ChMW Aw.. IM~nhld. CA fl,101 SYSTI~M TYP~ ~. IIIl~_~_~l_Jl~ I"I 1. ~.ICTION I'""1 ~. Q~A~?Y 4~ I'~ I. CONST~UC~'IO~W'.~ ~' ~ WAU. I'"! 3. UNED ~ r"l el, OTHEA 4eO I-I ~. ~ ' M ANUFACTURERI[~2. {3(3UII.E WAL~ ~ N. ~ ~ 2. DOUBLE ~ F~ESS(J~EO FqfPWO (them M OtM dPdW): JnRE.ISU~ PFINO LEAK ~117.M FMJJ/~. AND ~YSTEM ~ * NJ011.E M4D VleUAL SYSTEM F~ NdD 8YQ~Vu4 D~CCqddE~ * AIX)IBLE AND VISUAL .4LAM4S 0 z MON~LYU~HT~T 0 ~. A~BnT;oRn'Y't~(0.1(aPH) · 0 S. C)~A.YY~UALkI:XdTOi~I~G(:N~WSYSTEM+~PIPINO~ 0 5. OAJI.yVI~UALklONITOi~I~K)OFPII~I~K),N~DPUMI~I~K)~'T,~=M TEST (0.1(3PH) r'l & 'rRJENiqkM. IN~-ORn'YI~ST(0.1OPH) SAFE Suc'noN ~-,Oi=d8 (NO VAL~ I,f BeU:)W O~OUNO PIP~): s~-E ~,CTK~ SYSTEMS (NO V~.~q ~N Be, OW G~C)UND ~): 0 7. sEu:~ 0 7. ~].FMONnom~ 471 I T~ OF ~~ _ ,. 472 UPCF (7/90) S:~CUPAFORMS~WRCB.B.WPf~ .~~ CiTY oF BAKeRSFiELD .,' O~ICE OF ENVIRONMENTAki~ER¥1CES ~ 171S C~ter Ave. Bake~flel~ CA 93~ (661) 32~3979 --'~ '~' UNDERGROUND STOOGE T~K8 - TANK PAGE L ~ COM~JAI'MENT.qJZED rANI( I-I ¥1 i~No -- ~ 03.~~ ~ '"' '~ O~ ~ -.. Oz~m .. 0~~~ 0~~~ '0~ -Oz~~ 0~~~ O~I 0~ ~ 0~~~ 0~ &~'..;:~:.~~v...?'.~'.~~i.;~~~~;,~4,~..~,.,:.'~. · >:<,.~:. ~.~ ..~. ~. ,. ~.~....,~-~.. / UPCF (7~) i Gn'Y o~ IAKERSFIELD olqqol OF INVINONMENTAL {ERVICE8 ,~ I ChMM~ Av~ kkmllleld, CA 13301 (MI) ~ { - CON$?RUC?IOIw'I"J''~L~%L ~NI31~WALL I'1 3. I.JNEDTI~.NOt r'lel. OTHER 400 I-1 t. ~NG~EWAL/. l"l ~. UNKNOtM~ MANUFACTUI~E;,;~ 2. ~ WAL,/. ~] e~. ~ ~ 2. OOUI. E WALL ~-} ~. OTHE~ iO 1. I~i~IT'~E~ ri ~ IqI~C~IIIATII.~m{00~M~'T~IANOL 0 1, BARESTEEl C] ~. I~TECTION ~ 3. Iq,.A..~TlCC(2MPATII~WITHCO#TlfT~ OM). UM(NOWN ~] 3. PI.A~'IGCOMPATILEWITHGOI~fl'ENT~ I'~ ~ ~~ O~. ~ C:] ~a. ANNUALNTEGRn'YTE.IT(0.1GPH) I""] ~. AN~U)U. lnC-GRJTYTES'T(0J GPH) [] 77. I:~dLYV~U,M.C/,tC~ 'ri 17. DAA.YVI~UAJ. C~ m~=P. NMACONTAJNMENT C] 1. I,t,OAT~TK~TI~UTI(:~FWVaL~ 0 4. DAI.YVlUN. CHEC~ ~~ M ri ~l. ~I~IeW~~ 0 &.TR~NCNLIJERll40~ / \ ~ OWNIN/OPERATO~ IIONATURI UPCF (7/99) .~ CITY OF BAKERSFIELD~ OI~CE OF ENVIRONMENTAL ~VICE$ 17t5 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS-INSTAM.A'I'ION CERTIFICATE OF COMPLIANCE One form per tank I. FACILITY IDENTIFICATION 81.1SINES~ NAME (Serr4 Id FAC~J. ITY Nt~Vt~ of ~ . ~ ~ A~) .~ , II. INSTALLATION Check a//~hat ep~/y · The Installer has been certified by I~e tank and piping manufacturers. The installation has been inspec~,~l and certified by a registered professional engineer. The installation has been inspect~ 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 lhe Contractors State License Board. Another method was used as allowed by the City of Bakersfield Office of Environmental Services. |dentif¥ method: IlL TANK OWNER/AGENT SIGNATURE !"~o~~---'~-" ,- I T~, O, T"~ o~.~r ................ ~ -- CITY OF BAKERSFIELD ~' OI~CE OF ENVIRONMENTAL ~I~VlCE$ 1715 Cheeter Ave., Bakersfield, CA 93301 m, mmm (661) 326-3979 UNDERGROUND STORAGE TANKS-INSTALLATION CERTIFICATE OF COMPLIANCE .' One form per tank Page ~ et - I. FACILITY IDENTIFICATION II. INe1'ALLA110N Tha Installer has been certified by Iha tank and piping manufacturers. The installation has been inspec*~l and certified by a registered professional engineer. ~ The Installation has been Inspected and approved by the City of Bakersfield of Environmental Services. All work listed on the manufacturer's installation checklist has been completed. IX The installation contractor has been ced]fled or licensed by lhe Contractors State License Board. Another method was used as allowed by the City of Bakemfleld Office of Environmental Services. III. TANK OWNER/AGENT SIGNATURE STAT£ OF CAI IFORNJA ~ '7 ~-- STATE WATER .ESOURCES CO.TROL ~NDERG~ D STORAGE TANK PERMIT APPLlCA~N - FORM l . · COMPL~E ~lS FORM' FOR EACH M~K ONLY ~ 1 N~ PERMIT ~ 3 R~ PERM~ ~ 5 C~ ONE ITEM ~ 2 ]~RI~ PERMIT ~ 4 ~ENDED ~RMIT ~ 8 ~M~ S~ CLOSURE I. FACIL~ITE INFORMA~ON & ADDR~S- (MUST BE COMPLIED) D~A ~ FAClLI~ N~E ~ . ~ NAME OF OPE~TOR A~DRESS ~~ '' NEARESTCRO~ STRE~ C; ~ STATE ~ ZIP ~DE SI~ P~NE e WI~ AR~ ~DE TO ;N~CATE O~T~CTS RESERVAT~ ~ 3 FARM ~ ~ 4 PRaEtOR ~ 50T~ER~ OR TRUST I I E~GENCY ~A~ PER~N (PRIMARY) EM~G~CY ~A~ PER~N (S~ND~ · ~ti~d J DAYS: NAME (~T. FIRS~ P~NE I WITH AREA ~OE I DAY~: NAME ~T. FIRS~ P~E  N~TS: NA~ (~T. F}RS~ ' P~NE ~ W~ AREA ~DE N~TS: N~E (~q. FIRS~ -P~E II. PROPER~ O~ER IN~RMATION - (UUST BE COMPL~ED~ CARE ~F ADORE~ ~R~N ~AME -- . MAILING OR STREET ~DRE~S ~ ~ ' : ~ ~x ~,~ II1. TANK OWNER INFORMATION - (MUST BE COMPLIED) } ~AMEOF OWNER I CARE~F ADORE~ INFOR~T~N MA;LINGORSTREET~R~S ~ ~ ' ~ ~ IV. BOARD OF EOUALiZ~ON UST ~ORA~E FEE ACCOU~ NUUBER - Call (916) 739-2582 if questions ari~. V. LEGAL NOTIFICATION AND BILUNG ADDRESS Legal nc:;fimfion and billing will ~ senl to the t~k owner unless ~x I or II g ch~. CHECK ONE BOX INDICATING ~H ABOVE ADDRESS SHOULD BE USED FOR LEGA. ~OTIFICATIONS AND BI~G: I. THIS FORM ~S BEEN COMPLIED UNDER PENALTY ~ PENURY, AND TO THE BEST ~ ~ KNOW. E, IS TRUE ~D CORRECT LOCAL AGENCY USE ONL~ COUN~ ~ JURISDICT;ON ~ ~ACIL~ LOCATION CODE . OP~ONAL CENSUS TRACT ~ - OPTIONAL ~ SUPVISOR - THIS FORM MUST BE ACCQMPANIEO BY AT LEAST (1) OR ~RE PERMff APPLICATION- FORM B, UNLESS ~B IS A CHANGE OF SffE ~FOR~ON ONLY. F~ FORM A (9-~) '~" * ': S'TAT! OF i,"'~ STATE WATER flESOURC~S CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B - COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEU. MARK ONLY ~ ! NEW PERMIT [--'] 3 RENEWAL PERMIT [] S CHANGI= OF INFORMATION [] 7 ONE ITEM L_~ 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] a T~MPORARY TANK CLOSURE [] a TANK REMOVED DBAOR FACILITY NAME WHERE TANK IS INSTAI I ED: /~(~////~ Z~/~J ~/~/':.Z:~. Z~ Y~' I. TANK DESCRIPTION COM~-rE ALL ITEMS - SPECIFY IF UNKNOWN II. TANK CONTENTS ~FA.~ ts MARKED. COMPLETEITEM ¢. ,. ~ , MOTOR ~H~LE FUEL [] , O~ n. C. [] ,,,:,EO,.,~RUNL~ED ~ ,3 C.~oLO'ESEL [] , Av~o,~ UNLEADED $ JET FUEL [] 3 CHEMICAL PROOUCT [] ~ UNKNOWN [] 2 WA~I~ [] 2 LEADED~L 9g OTHER (DESCRIBE IN rTEM O. BELOW) i o. ,F (A.,, ,s NOT MAR.ED. EN;R .~ O~ =,STANC~ S,O.ED ~ ~/C 4)// C. < ~.: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOX~=S A, S, ANDC. ANOALLl14ATAPPt-lEsINBoxO A. TYPE OF [] $ DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 ~ECONDARY CONTAINMENT (VAULTED TANK) [] 9g OTHER B. TANK [] I BARE STEEL [] 2 STAINLESS STEEL I~ 3 FIBERGLASS [] 4 STEEL ClAD W/FIBERCd. ASS REINFORCED PLASTIC MATERIAL ~ s CONCRETE [] S POLYVINYL CHLORICE [] 7 ~UMINUM [] a ~00% METHANOL COlaPATISLEW/FRP :Primaq'tank) [] e SRGICZ~ [] 10 GALVANIZED STEEL [] ~ UNleqOWN [] ~ OTHER [] ' RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY LINING [] 4 PHENOLIC LINING , c. ~n'ERIO~ [] s ~ LIN,~ [] s UNLINED [] , UN~OWN [] ~ OTHER UNING · I~ LINING MATERUM. C~PATIBLE ~ 100% UE"FHANO(. ? YES_ NO__ D. CORROSION [] I POLY~n~LENE WRAP [] 2 COA~NG [] 3 VlNYt. WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] .5 CATHODIC PROTECTION [] 91 NONE [] g~ UNKNOWN [] 99 OTHER IV. PIPING INFORMATION c~,c,c A IFABOVEGROUNDOR U IFUNOERGROUNO. BOTH IF APPLICABLE A. SYSTEM TYPE ~ U I SUCTION A U 2 PRESSURE A~3 GRAVITY A U 9g OTHER B. CONSTRUCTION A. U 1 SINGLE WALL A~..~ 2 DOUBLE WALL ~ U 3 LINED TRENCH A U 95 UNKNOWN.~ _ A U ~ OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL & U 3 POLYVINYL CHLORIDE (PVC)A ~4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 8TEEL WI COATING A U 8 100'% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U g5 UNKNOWN A U g9 OTHER O. LEAK 0ETECTION [] 1 AUTOMAT1CLINELEAKOETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTE,:~mIAL MoNrro;ING [] 99 0114ER V. TANK LEAK DETECTION ! I'~] , VISUAL CHECK ~ 2 INVENTORY RECONOILIATION ~ 3 VAPOR MONITORING r'~] 4 AUTOMATIC TANK GAUGING [::] 5 GROUND WATER MONITORING ] ~ 8 TANK TESTING ~ 7 INTERSTITIAL MONITORING [] 91 NONE [] g5 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION I h ES TIMATEO DATE LAST USED.(MO/DAY/YR) 2. ESTIMATED QUANTITY OF I3' wA'9 TANK FILLED wITH YES[r---) NO J--'-~ 1 THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY. AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT ..-...o..---.------ I I LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW _ I COUNTY # JURISDICTION # FACILITY # TANK # STATE .D.# CT-] I I I I I I I I I I I I I I. tilt I FORM a ¢~g(~ THIS FORM MUST BE ACCOI~ANIEO BY A PERMIT APPUCATION · FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. ~I'AI~ OF cAUFORMA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION. FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM, MARK ONLY ~ I NEW PERMIT [] 3 RENEWAI. PERMIT [] $ CHANG~ OF INFORMATION [] 7 PERMANENTLY CLOSED ONE ITEM L_~ 2 INTERIM PERMIT E~] 4 AMENOED PERMIT [] 6 T~MPORAflY TANK CLOSURE ~ 8 TANK REMOVED OBAOR FAClLm.AM~WHERETANK~S~STA"ED: ~o ///nS /_~a.,r/o6~ Cz~r-~9. ~r,t/ /4/OC, I. TANK DESCRIPTION COM~.L~ ALL ITEMS - SPECIFY IF UNKNOWN c. °ATE ,.STALLEO,M Y EA,, IqgO 0. TAN, IN LO.S: (,, II. TANK CONTENTS ~r A-~ ~S MAR~O. COMPLETE ~T~ C. A. ~ I MOTOR VEHICLE FUEL [] 4 OIL B. C. [] Il REOMLARUNLEADED ~ 4:3 GA~AI-IOLOIESEL [] , AVIATION Gd~ [] 2 PET"OLEUM [] . ~,.~. [] , P.OOUCT E3 ,bPREM,UM r-1 [] 7 [] 3 CHEMICAL PROOUCT [] ~5 UNKNOWN [] 2 WASTE [:~ 2 LEA~°~ 99 OTHER (D~$CRIB~ IN I~M 0. BELOW) O. IF(AA) IS NOT MARKED. ENTER NAME OF SUBSTANCE STORED /"~,)7~/"'" ~ / / III. TANK CONSTRUCTION MARK O~E ITEM ONLY IN BOXES A, a, ANO¢,ANOALLTHATAPPt. IESlNBOXD A. TYPE OF [~ I DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER ~ 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULTEO TANK) [] g9 OTHER B. TANK [] I BARE STEEL [] 2 STAINLESS STEEL [;~ 3 F~BEROLAS$ [] 4 STEEL CLAD W/FIBERCII.A~ REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] O POLYVINYL CHLORtO~ [] 7 ALUMINUM [] 8 100~ METHANOL COMPATJBII:W/FRP ~p,,..,yr.~ [] ~ a,D.= [] ,o ~.vAN=° sTEEL [] ~ UNKNOW. [] ~ O'mER c. ~ER~OR [] ~ ~ L,,.~ [] ~ UN~,,~O [] . U.KNOW. [] . OTHER MNING 18 LINING MATERIAL. COMPATIBLE ~ 100% METHANOl. ? YES ~ NO~ D. CORROSION [] 1 POLYETHYLENE WRAP r~ 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PROTECTION [--] 5 CATHOOIC PROTECTION [] 91 NONE [] 96 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION cIRCCE A IFA~OVEGROUNDOR U IFUNOERGROUNO. BOTHIFAi~SLIOABLE A. SYSTEM TYPE A~(~I SUCTION A U 2 PRESSURE A U 30RAVlTY A U ~e OTHER B. CONSTRUCTDN A. U '1 Sll,~:~r: WALL A~'~2 CIOIJBLE WALL A U 3 LINED TR~H A U 95 UNI<]'dOWN . A U 95 OTHER U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC)A~U~4 FIBERGLASS PIPE C. MATERIAL AND CORROSION A U ,5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A~J 8 100% METHANOL COMPATIBLEW~FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CA~ICPROTECTK:)N A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION [] t NJTO~IAllCLINELEAKDI-'TECTOR [] 2 LINE TIGHTNESS TESTING ~ 3 ~rr~lll~4, uo~ffoR~ [] 99 OTHER V. TANK LEAK DETECTION [] I VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VAPOR MONITORIN~ [] ' AUTOMATIC TANK GAUGIN° [] 5 °,OUNOWATERMONITORINO [] , TANK TESTING [] 7 INTERSTITIAL MONITORING [] 91 NONE [] 9S UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION THIS FORM HAS BEEN COMPLE~D UNDER PENAL~ OF PERJURY, AND ~0 ~E BEST OF ~ KNOWLEDGE, IS TRUE AND CORRECT I LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW , COUN~ ~ JURISDICTION ~ FACIL~ ~ TANK ~ PERMIT NUMBER I PERMIT ~PROVED BY,ATE [ PERMIT EXPI~T~N ~TE ;o;u a {~ T~S FORM ~ST BE ACne.lED BY A PER~ ~PUCA~ON · FORM K ~LESS A CURRE~ FORM A ~8 BEEN FI~D. - ~" ~TATE OF CAUFORMA STATE WATER RESOURCES CONTROL BOARO UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY ,~ ~ NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OI= INFORMATION [] 7 PERMANENTLY CLOSED DNSIT~I ONE ITEM L.~ 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE ~ 8 TANK REMOVED OBAOR FAC;L TY,A EWHERETANK SU"STA"ED; ,drp. I. TANK DESCRIPTION COMPLETE ALL ~TEM$ - SPECIFY ~F UNKNOWN c. DATE ,NSTALLEO(M~OAY~EAR~ / q ~0 O. TANK CAPACITY IN ~LONS: ~l II. TANK CONTENTS ~FA-~ ~S MAR~D. COMPLETE~TEM C. ' o,o. v <LE FUEL [] , C. ,.RE U ,R D,ESEL [] , A. UNLEADEDI I 4 GASAHOL [] 2 PETROLEUM [] 80 EMPTY I~]- ' PRODUCT [] lb PflEMIUM ~ [] 7 METHANOL UNLEADED 5 JET FUEL [] 3 CHEMI~LPRODUCT [] 95 UNKNOWN [] 2 WASTE ~] 2 LEADED~1 gg OTHER (DESCRIB~ IN FrEM O. BELOW) D. ]F(A.I)ISNOTMARKED, ENTER NAME C~ SUSSTANC~ STORED C.A,S.#: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. E. ANDC. ANDALLTHATAPPLIESlNBOXD A. TYPE OF ~ ~ 0OUSLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WAU. [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] gg OTHER B. TANK [] t BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLAS~ REINFORCED PLASTIO MATERIAL [--'} 5 CONCRETE [] ii POLYVINYL CHLORIDE ~ 7 N. UMINUM [] 8 100% METHANOL COMPATIBLEW/FRP :Pl'ima~/?attk) I-'"-I 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 95 OTHER [] ! RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY LINING [] 4 PHENOLIC LINING C. INTERIOR F---] S GLASS LINING [] e UNt. INED [] 95 UNKNOWN [] 95 OTHER UN~G · I~ UNIN43 MATI=RtAL COMPATIBLE WITH 100% METHANOL ? YES ~ NO~ O. CORROSION F'--] 1 POLYETHYLENE WRAP [] 2 COAT1NG [] 3 ~ WRAP [] 4 FIBERGLASS REINFORCED PI. ASTIO PROTECTION ~ 5 CATHO01C PROTECTION [] 91 NONE I-'-1 95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION C~RCLE · ~FAaOV~(~ROUNOOR U ~FUNO~ROROUNO. aOTH~FA~'LIOAaU-' TYPE A U 1 SUCTION A(.~_~ 2 PRESSURE A U 3 GRAVITY A U 9g OTHER A. SYSTEM B. CONSTRUCTION A. U ~ SU~?a.E WALL A(,~ 2 DOUaLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 95 OTHER C. MATERIAL AND A U ! BARE STEEL A U 2 STAJNLES$ STEEL A U 3 POLYVINYL CHLORIDE (PVC)J~ 4 FIBERGLASS PiPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 8TEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHOOIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION Ig~ ! AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING ~ 3 en'ERS'nT~L MON~TORe~G [] gg OTHER V. TANK LEAK DETECTION ! [] I VISUAL CHECK ~<~:------] 2 INVENTORY RECONCILIATION r--] 3 VAPOR MONITORING ['~"] 4 AUTOMATIO TANK GAUGING C~] 5 GROUND WATER MONITORINGI [] ' TANK TESTING [] 7 INTERSTITIAL MONITORIN(3 [] 91 NONE r-'] 95 UNKNOWN [] 95 OTHER VI. TANK CLOSURE INFORMATION THIS FORM HAS BEEN COMPLET~UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, I$ TRUE AND CORRECT LOCAL AGENCY USE ONLY T'~E STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW /qF'l~/r~.f __ I COUNTY # JURISDICTION # FACILITY # TANK # / PERMIT APPROVED BY/DATE } PERMIT EXPIRATION OATE I PERMIT NUMBER FORM a (g-g~ TI~S FORM MUST BE ACCOI~ANIED BY A PERMIT APPUCA'I10N - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. March 29, 2000 Rollins 2929 East Brundage Lane Bakresfield, CA 93307 Dear Underground Tank Owner: Your permit to operate the above mentioned fueling facility will expire on June 30, 2000. However, in order for this office to renew your permit, updated forms A, B & C must be filled out and returned prior to the issuance of a new permit. Please make arrangements to have the new forms A, B & C completed and returned to this office by May 15, 2000. For your convenience, I am enclosing all three forms which you may make copies of. Remember, forms B & C need to be filled out for each tank at your facility. Should you have any questions, please feel free to contact me at (661) 326-3979. Sincerely, Steve Underwood, Inspector Office of Environmental Services SU/dlm Enclosure February 9, 1999 ~IRE C.I~F Rollins Leasing Corp RON FRAZE 2929 E. Brundage Lane ADMINISTRATIVE SERVICES Bakersfield, CA 93307 2101 'H' Street ~kemfleld, CA 93301 VOICE (805) 326-3941 FAX (~0S) 398-1949 RE: Compliance Inspection SUPPRESSION SERVICES Dear Underground Storage Tank Owner: 2101 'H" St~t Bakemfleld, CA 93301 VOICE (805) 326-3941 FAX (805) 395-~349 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 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 FAX (805) 326-0576 be in compliance. TRAINING DIVISION Should you have any questions, please feel free to contact me at 5642 Vict~ Ave. Bakersfield, CA 93308 805-326-3979. VOICE (805) 399-4697 FAX (805) 399-5763 Sincerely, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure D r December 21, 1998 Mr. Ralph E. Grant Rollins Leasing Corp. FIRE CHIEF P.O. Box 1791 RON FRAZE Wilmington, DE 19899 ADMINISTRATIVE SERVICES 2101 'H' Street ~d,C^933Ol CLOSURE OF 3 UNDERGROUND HAZARDOUS SUBSTANCE VOICE (805) 326-3941 FAX (805)395-1349 STORAGE TANKS LOCATED AT 2929 EAST BRUNDAGE LANE IN BAKERSFIELD. PERMIT #BR-0217. SUPPRESSION SERVICES 2101 'H' Street Bakersfield, CA 93301 Dear Mr. Grant: VOICE (805) 326-3941 FAX (805) 395-1349 This is to inform you that this department has reviewed the results PREVENTION SERVICES 1715 Chester Ave. for the preliminary assessment associated with the closure of the tanks Bakersfield, CA 93301 VOICE (805)326-3951 located at the above stated address. FAX (805) 326-0576 Based upon laboratory data submitted, this office is satisfied with ENVIRONMENTAL SERVICES 1715Chester Ave. the assessment performed and requires no further action at this time. Bakersfield, CA 93301 VOICE(S05) 326-3979 Accordingly, no unauthorized release reporting is necessary for this FAX (805) 326-0576 closure. TRAINING DIVISION 5642 Victor Ave. If you have any questions regarding this matter, please contact me Bakersfield, CA 93308 VOICE (805) 399-4697 at (805) 326-3979. FAX (805) 399-5763 Sincerely, Howard H. Wines, III Hazardous Materials Specialist Office of Environmental Services HHW/dlm cc: Y.Pan, RWQCB SENDER: o Complete items 1 ~lil~or 2 for additional service~ ~ I also wish to receive the o Complete items 3~4a & b. services (for an extra · Print your name ad~'dress on the reverse of this form so that we can 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. Article Addressed to: I 4a. Article Number MR RALPH GRANT P 024 368 515 ROLLINS LEASING CORP I 4b. Service Type [] Registered [] Insured P O BOX 1791 ~Lf[Certified [] COD WILMINGTON DE 19899 [] Express Mail [] Return Receipt for ~ndise 7. Dat 5. Signatt~re_(Ad~ressee). __ . 8. Ad~e~ fee's A~:J~{~ss ¥]iti~l¥ if requested d~,is pai(~ j PS F~m 38i 1, Decembe~ 1991- ~;u.s. GPO.~a--asa-?,, DOMES~I'I~'~'URN RECEIPT Official Business PENALTY FOR PRIVATE USE TO AVOID PAYMENT OF POSTAGE, $300 Print your name, address and ZIP Code here ·CItY OF BAKERSFIELD FIRE DEPT · OFFICE OF EbIVIRO~TAL SERVICES 1715 CHESTER AVENGE SUITE 300 BAKERSFIELD CA 93301 ll,l,,,,ih,,lhil,,,,,,ll,l,l,,,l,l,,,lllh,,,,,ll,t,l,ll,,,I P 024 368 515 Rec~p~ Certified. Mail No Insurance Coverage Provided · ~l~ Do not use for International Mail (See Reverse) S~pH GRANT Street Bnd No. P O BOX 1791 P,O,. State end ZIP Code WILMINGTON DE &99 Postage $ .32 Certified Fee' 1.10 Special De(ivery Fee Restricted Delivery Fee Return Receipt Showing I. 10 to VVhom & Date Delivered Return Receipt Showing to Whom. Date, a~l Addressee's Address TOTAL Postage & Fees $ 2.52 Postmark or Date STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTiFiE0 MAIL FEE. AND CHARGES FOR ANY SELECTED 0PTI0~AL SERVICES (se, frent). 1. If you want this receipt postmarked, stick the gummed stub to the right of the return address leaving the receipt attac~d end present the article at a post office service window or hand it to your rural carrier (fig extra charge). 2. If you do not want this receipt postmarked, stick the gummed stub to the right of the retur,n address of the article, date, detach and retain the receipt, and mail the article, ~ 3. If you want a return receipt, write the certified mail number end your nome and address on ~ return receipt card, Form 3811, and attoch it to the front of the article by means of tho 9ummelt~ ends if space pmmits. Otherwise, affix to back of article. Endorse front of article RETURN RECEIPT' REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee, endorse RESTRICTED DELIVERY on the front of the article. 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If return receipt is requested, cbecl[ the applicable blocks in item 1 of Form 3811. 6. Save this receipt and present it if you make inquiry. 102595-93-z-0478 November 3, 1998 Mr. Ralph E. Grant FIRE CHIEF Rollins Leasing Corporation RON FRAZE P.O. Box 1791 ADMINISTRATIVE SERVICES Wilmington, DE 19899 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 RE: 2929 Brundage Lane in Bakersfield, CA., Rollins Truck Leasing (Br #140C) FAX (805) 396-1349 CERTIFIED MAIL SUPPRESSION SERVICES 2101 'H' Street Dear Mr. Grant: Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 The intent of this letter is to inform you of the necessary deadlines for the submission of documentation to this office related to the decontamination, removal, PREVENTION SERVICES disposal and laboratory analysis for 3 underground tanks at the above referenced 1715 Chester Ave. Bakersfield, CA 93301 property. VOICE (805) 326-3951 FAX (805) 326-0576 Our records indicate that you were required to submit the documentation to ENVIRONMENTAL SERVICES this office within five (5) days after the results are available. Since your underground 1715 Chester Ave. Bakersfield, CA 93301 tanks were removed on June 5, 1998, sufficient time has elapsed for these documents VOICE (805) 326-3979 to have been submitted as required. Failure to submit the documentation in a timely FAX (805) 326-0576 manner may cause the data to become suspect and may result in a full characterization TRAINING DIVISION of the site to be required by this office. 5642 Victor Ave. Bakersfield, CA 93308 VOICE (805)399-4697 Therefore, within seven (7) days of this letter, please submit the necessary FAX (805) 300-5763 , documentation relating to the aforementioned underground tank removal. If you have any questions regarding this notice, please call me at 326-3979. Sincerely, Howard H. Wines, III Hazardous Materials Specialist Office of Environmental Services HHW/dlm cc: Scott Tingle, H.B. Covey Co. From: Howard Wines To: "Ralph_Grant@rollins.com"@ClTYDOM.inet Date: 10/30/98 2:04PM Subject: Re: Documentation UST Removal / Upgrade Thanks for the message. I have not recieved any lab results from the samples taken under the 3 old tanks & old dispeser areas. I have the old tank disposal receipt, but no copy of the rinsate manifest. H.B. Covey was contractor, Ackerman Labs of Pomona, CA should have performed analysis & I don't know who cleaned the tanks or where the waste was disposed of. A new permit will be issued once all this gets resolved. >>> "Ralph Grant" <Ralph_Grant@rollins.com> 10/30/98 09:52AM >>> To: Mr. Howard Wines City Of Bakersfield, Ca. From: Ralph Grant Rollins Leasing Corp. Subject: UST Removal/Upgrade Documentation - Rollins Leasing Corp. 2929 Brundage Lane, Bakersfield, Ca. Mr. Wines This subject facility is the facility in which we are now operating and was formerly operated by Ryder. This is not to be confused with our former facility at 2200 E. Brundage where we are also working with the City to close out a piping release earlier this year. Please advise if the City requires any further information regarding the removal of three tanks and all piping runs, as well as the upgrade of two existing diesel tanks at the site. We would like to close out our file in this manner. Your attention and response in this matter is appreciated and should you have any questions, or require additional information, please advise. Regards Ralph E. Grant Dir. Environmental Affairs Rollins Leasing Corp. One Rollins Plaza Wilmington, De. 19803 302-426-2899 fax 302-426-2757 From: "Ralph Grant" <Ralph_Grant@rollins.com> To: "Hwines@ci.bakersfield.ca.us" <Hwines@ci.bakersfie... Date: 10/30/98 9:52AM Subject: Documentation UST Removal/Upgrade To: Mr. Howard Wines City Of Bakersfield, Ca. From: Ralph Grant Rollins Leasing Corp. Subject: UST Removal/Upgrade Documentation - Rollins Leasing Corp. 2929 Brundage Lane, Bakersfield, Ca. Mr. Wines This subject facility is the facility in which we are now operating and was formerly operated by Ryder. This is not to be confused with our former facility at 2200 E. Brundage where we are also working with the City to close out a piping release earlier this year. Please advise if the City requires any further information regarding the removal of three tanks and all piping runs, as well as the upgrade of two existing diesel tanks at the site. We would like to close out our file in this manner. Your attention and response in this matter is appreciated and should you have any questions, or require additional information, please advise. Regards Ralph E. Grant Dir. Environmental Affairs Rollins Leasing Corp. One Rollins Plaza Wilmington, De. 19803 302-426-2899 fax 302-426-2757 EMERGENCY RESPONSE PLAN UNDERGROUND STORAGE TANK MONITORING PROGRAM This monitoring program must be k~t at thc UST location at all tunes. Thc information on this monitoring program ar~ c~nttilions of the operating permit. The permit holder must notify thc Offic~ of Env~onm~nlal S~'vi~s within 30 days of any chang~ to the monitonng proc~ur~, unl~s.s r~lnir~ to ot~tain approval I~'or~ lll~l~llg ~ t'hange. ~ ~ S~ctions 2632(d) and 264 l(h) CCR. 1. If an unauthorized release occurs, how will the hazardous substance be cleaned up? Note: If'released hazardous substances reach the environment, increase the ~re or explosion hazard, are not cleaned up from the secondary, containment within 8 hours, or deteriorate the s~condary containment, then the Office o£Environmental Services must be notified wi~hi,, 24 hours. .Z'£ /~;, ~-F,'// ,'~ .~,..//; ~'o//,~.~ C/e,.,a t' ~/ ,Z 2. Describe the proposed methods and equipment to be used for removing and properly disposing of any hazardous substance. 3. Describe the location and availability of the ~equired cleanup equipment in item 2 above. 4. Describe the .m~.' tenance schedule for the cleanup equipment: ;;<,,z:'Z. <"", 5. List the name(s) and title(s) of the person(s) responsible for authorizing any work necessary under the response plan: £,./,,4 E. G,.,,.. ~=. ~;,, ,~/' ~,... I '-' GE~TIFIGATION OF FINANCIAL ~SPONSIBILIIY ~R ~D~OUND ~GE TANK8 CO~NIN~ P~O~M A~=le 3, C~er 18, D~n 3, TSle 23, ~l~orn~ Code of Regulation. ~e m~n~ ~ ~ de~te fi~i res~ibil~ as r~uir~ by S~tion 2807 a~ as bllo~: Note: If you are using the Slate Fund as any part of your demonstration of financial responsibili~, ~ur execuSon and sul~t~s~on of ~ cetl~rt~#on al~o certi~s tlmt you are/n compliance v~h all condiff~r~ ~r t:~t't~i~a~t~n irt t.~ Fut.. ' ZNaTRUCT'rONS .......... C~3i:~r_Fz~'rGN OF FZ~ilt]iCY. J~ RF, SFON'~ZBZZ,Z22' FORM Ptesse type or print clairiy all ~forltton on Certification of Ftnoflclal Responsibility for~. Ail UST facilities end/or iitma ouned or operlted my be Listed o41 one for~; therefore a separate cartfflcate ia not required for eich lite. DOC~HqNT [HR~HATZON A. Almmt leffJfred - Check the ~ppropriate boxes.. B, mae of Tank O~er - Full nam of either the tank o~ner or the o~erator. or C~er~ter C. Wism Type - Indicate ~hich State approved mochanismCs) are Ming used to show financial respotmibtliW either as contained in the federal regulations, &O CFR, Part 280, Subpart H, Sections Z80,90 through 280.103 CSee Financial Rponsibftity Guide, far more information), or Section 2802.1, Chapter 18, Division 3, Title 2.~, CCR. Balms of lstuer - List all SOMAS and addresses of companies and/or individuals issuing coverage. Nedmnism II~ber - List tdenti~n~ numer for each mechanism used. Example: insurance policy nuaber or file r4MMr as indicated on bond or detriment. (If using State CLearmp FLrd CState F~ncl) Leave blank.) W J~ai~tt - Indicate amount of coverage for each type of mechanism(s). If more than one mechanism is indicated, total must equal IOOZ of financial responsibility for each foci [ t ry. Coverige Period - Indicate the effective dateCs) of all financial mechanism(s). (State F~YI coverage would be continuous as Long as you maintain compliance and remain eligible to continue participation in the Fund.) CaeTective Action - indicate yes or no. Does the specified financial mechanism provide coverage for corrective action? (If using State F~mYI, indicate ,yes,'.) Third Percy - Indicate yes or no. Does the specified financial mechanism provide coverage for ~tian third party compensation? (If using State Fund, indicate "yes".) D. Facility - Provide all facility and/or site names and addresses. Inf~rm-tion E. SJgn~ttl'e Bra(dc - Provide signature and date signed by tank o~ner or operator; printed or typed name and title of tank owner or operator; signature of witness or notary and date signed; and printed or typed name of witness or notary (if notary signs as witness, please place notary sea( next to notary/s signature). lA,ere to,_lM, ii Certification= Please s.m~ cr~gi.~ to your t~c~, egeflcy (agency who issues your ~T permits). Keep a copy of the certification at each facility or site Listed on the form. questions: If you have questi°ns on financial responsibikity requirements or on the Certification of Financial Responsibi. Lity Fom, please contact the State UST CLeanup Ftz~ct at (916) 739-2/,75. No~e: Petmttiel for Failure to C~ly uith Financial eet~ensibi[ityRequirelents: Failure to comply may result in: · (1) jeopardizing c/ain~ant eligibility for the State UST CLeanup F~YI, and (2) Liability for civil penalties of up to~SlO,O00 dollars par day, per taYlergro~d storage tank, for each day of violation as stated in Article 7, Section 25299.76(a) of the Californfa Neeith and Safety Code. STATE OF CALJFORNIA STATE WATER RESOURCES COI~'ROL BOAjlli~ CERTIFICATION OF COMPLIANCE' FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET 2~{ ~-~ ~- '~ r'Ol~CtO..c~ L-V~ CITY ~'~ ~-~--~$ ~ ~[ ~ COUNTY I1. INSTALLATION (mark 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 implementing agency. [~ 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 implementing agency. (Please specify.) III. OATH I certify that the information provided is true to the beSt of my belief and knowledge. Tank Owner/Agent Date PrintName c4phC__. G-¥' lqk,-L)lrcc r o1: v r nffr_ ,l Phone Address ' )~1.[ }I'S ' LOCAL AGENCY USE ONLY STATE COUNTY # JURISDICTION # FACILITY # TANK # FOnM C 17,'~) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY W]~FFEN MONITORING PR~EDURES UNDERGROUND STOI~GE TANK MONITORING PROGRAM This momtormg program must be ~ at ttu= UST location at afl ~ Th~ infmmaxion on thief ~ program am cond~uom o~ fl~ olxza~g permit. Th, permit holder m,.u uoOfy t]~ Offim o~ ~vimnmmnl S~viC~S within JO df)nj of 31ly rl~qn? to LI~ momtoriflg p~ iJJ~Jg~ ~ to obrJtin 2pl~OyRi ~ making the change. Rgquimd by S~ctiom 2632(d) and 2641(h) CCIL ~ Des~be ~e ~u~ of p~o~g ~e mo~o~g: ~ . B. ~ m~ ~d ~pm~ id~ by ~-~e md m~ · e mo~to~g: C. D~fib~ ~e lo,on(s) wh~e ~e mo~to~g ~ be be a~ach~): D. List ~e ~s) ~d fifths) of~e p~ple respo~ble for p~ing ~ mo~~ ~or ~~g ~e ~pm~t: , · E. Repo~g Fo~t for~o~to~g: Pip~g ~L * ptp~n~. F. Desc~be the pr~enfive m~te~ce scheme for ~e mo~o~s ~pm~. Maintenance must be in acco~ance with the m~ufa~m~s m~~m ~~e but not l~s than eve~ 12 months. ~U/~ ~ mo~tofing eq~pment: ~vlceJ 6ranrh ~ana~cs STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE-TANK-PERMIT APPLICATION - FORM A COMPLETE THIS FORM FOR EACH FACILITY/SITE .~ 1 NEW PERMIT MARK ONLY ONE ITEM ..._~ 2 INTERIM PERMIT ~ 4 AMENDED PERMIT J-~ 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) DBA OR FACILITY NAME NAME OF OPERATOR ADDRESS I NEAREST CRO~S STREET P&RCEL m IOPTtONAL) CITY NAME STATE ZIP CODE SITE PHONE # WITH AREA CODE TOINDICATE ~ CORPORATION ~ INDIVIDUAL E~ PN~TNERSHIP E~ LOCAL-AGENCY ~ COUNTY41g~ENCY E~ STATE-AGENCY ~ FEOERAL4kGENCY DST~CTS EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY) · optional DAYS: NAME (LAST, FIRST'/ PHONE ! WiTH AREA CODE DAYS: NAME (LAST. FIRST) 'E)om~cwc.~., 3"o~.. 6'05- NIGHTS: NAME.'(LAST. FIR~'F) PHONE a~ WITH AREA CODE NIGHTS: NAME (LAST. FIRST) PHONE # WITH ARI:A COD;; II. PROPERTY OWNER INFORMATION- (MUST BE COMPLETED) NAME CARE OF ADDRESS iNFORMATiON MAILING OR STREET ADDRESS ~' il~lo r'-'] INDIVIDUAL E~ L~AL-AGENCY ~ STATE-AGENCY CITY NAME STATE ZIP CODE 'I PHONE e WITH AREA CODE I1~. TANK-OWNER.INFORMATION - (MUST BE COMPLETED) NAME OF OWNER ~ CARE OF ADDRESS INFORMATION ~oilins L~c~slno Ca,wp. ,- I I~cd~h E. C.rrr~rff MAILING OR STREET ADDRESS ~ ' ,/ mxl~inecae ~ INDIVIDUAL E~ LOCAL-AGENCY ~ STATE-AGENCY CITY NAME STATE ZiP CODE PHONE I WITH AREA CODE vqi Im fn ro- ! IV. BOARD OFEOUALIZATION MST STORAGE FEE ACCOUNT NUMBER - Call (916) ~23-9555 il questions arise. ~ 5 LETTER OF CHEDIT ~ e EXE~'ION ~1 ~ OTHER VI. LEG AL NOTIFICATION AND BILLING ADDRESS Legal notiticmion ~d billing will be sent to the t:~nk owne~ unless box I or il is checked. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGE'~ICY USE ONLY cou.~'. ' ' ~umsmCTiO.. .... ~^c,.~ ' LOCATION CODE - OPTIONAL CENSU-'~-~RACT'I - OPIDNAL SUPVlSOR - DISTRICT CODE - OPT/ONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR'~RE PERMIT APPLICATION - FORM B, u~LEss THIS tS A CHANGE 0"~ SITE INFORMATION O'"~LY'--~. FORM A (5-91) FOR0033A,$ STATE WATER RESOURCES CONTROL BOARD /;t~.~'~.~ ~-~ · UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM COMPL~E A SEPARATE FORM FOR EACH TANK SYS~  MARK ONLY ~ 1 N~ PERM~ ~ 3 REN~ PERMIT 5 CHANGE OF INFORMATI~ ONEffEM ~ 2 )~RmM PERMIT ~ 4 ~ENDED PERMIT 6 ~M~RARY TANK CLOSURE ~ 8 TANK REMOVED DBAOR FACIL~NA~WHERETANKISINSTA~ED: ~ [~i~ L~J~( ~ ~o~ - JHO~ I. TANK DESCRI~ION c~ ALL ffEMS- S.EcmFv ~ UN~NO~ c. ~ INs~ALLE~~.~ Iq~ ~ ~' ~"" c~c,~ IN ~o.s: 12. OOO ~l O~s ...... ~1 II.TANKC0~E~S ~ ~.~ ~s.,,~o,~,LE~ ~TE, c. UNLEADED ~ 2 PETROLEUM ~ . EMP~ ~ I PRO.CT ~ lb PREMIUM 7 MET~NO, UNLEADED ~ 3 CHEMICALPfl~T ~ ~ UN~OWN ~ 2 W~ ~ 2 ~O ~ 99 OTHER (DESCRiB~ t~' tT~M ~. BELOW~ D. tF (A.1) IS NOT MARKED. E~R NAME ~ SUBSTANCE STORED C.A.S.;: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. S, ANDC, ANDALLTHATAPPLIESlNBOXDANDE A. TYPE OF ~ 1 DOUSLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULTED TANK) ' ['~ 99 OTHER a. TANK [] 1 BARESTEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEELCLAO W/ FIBERGLASS REINFORCED PL.~.Sl:C MATERIAL [] 5 CONCRETE [] S POLYVINYL CHLORIDE [] ? ALUMINUM [] 8 100% METHANOL COMPATIBLE WIFR= (PHml~fTank) [] g BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER ~ , RUBBE. L,.ED [] 2 AL~D L..G [] 3 EPO~ L,N,NG [] , PHENOLIC L,N,NG C. INTERIOR [] 5 GLASS LINING [] S UNLINED [] 9S UNKNOWN [] gg OTHER IJNING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES ~ NO~ D. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] , FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER E. SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) I ~ ~[40 OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR} { ~ ~[,~ IV. PIPING INFORMATION CIRCLE A IFABOVEGROUNOOR U IF UNDERGROUND. BOTHIF APPLICABLE A. SYSTEMTYPE A U 1 SUCTION A(~2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL AC2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLY¥1NYL CHLORIDE(PVC)A(~ 4 FIBERGLASS PiPE CORROSION A U 5 ALUMINUM J~ U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATI~LEW/FRP PROTECTION A U 9 GALVANIZED STEEL ~ U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION ~ ~ AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3MONffORINGINTER$71TIAL ~ g9 OTHER V. TANK LEAK DETECTION ~ I VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VADOZ~ MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUND WATER MONITORING __~ 6 TANK TESTING ~' 7 ,NTERSTITIALMONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION THIS FORM HAS BEEN C. OM~PLETED UNDER(.~E. NAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW COUNTY ~ JURISDICTION # FACILITY # TANK # PERMIT NUMBER I PERMIT APPROVED BY,'~AT~ ! PERMIT EXPIRATION DATE FORM B (?-gl) THIS FORM MUST BE ~CCOM~ANIED BY A PERMIT APPUCATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. STA~ WATER/~SOURC~.S CONTROL BOARD ~; ~'~'~ UNDERGROUND STORAGE TANK PERM~ APPLICA~0N - FORU B ~ ~..-~'., ~ l SEP~/~ FORM F~ ~ T~ S~k MARK ONLY [] 1 NEW PERMrT [] 3 RENEWAL PERMIT ~ 5 CHANC-~ OF INFORMATION r--- ? pERMAN.=.KTL ONE ITEM [] 2 INTERIM PERMIT [] 4 AI~IENDED PERMIT [] 6 TEMPORARY TANK CLOSURE .~r 8 TANK REMOVED DBAOR FACILITY NAME WHERE TANK IS INSTALLED: ~-oll~n.~ L~c~ dr'O,. ]~r I. TANK DESCRIPTION coM~t~-TE ALL IT~US .; SPEC~-'Y.= UNKNOWN C. DATE INSTALLED{MO/DAY/YEAR) ~(:~ ! D. TANK CAPACITY IN GALLONS: I ~, O(::~ ,~L~l II. TANK CONTENTS I~A.~ IS MARKED. COMPLETE FFEu c. t "--"1 la REGULAR ~ 3 DIESEL .... A. ~;~ ~ UOTOR VEHC~E ~UEL [] 4 DU. a. c. ~ uNLEADeD ...... ~ 2 PETROLEUM ~ ~O EMP'~f [~1 PRODUCT [] ,bPREMtUMuNLEADED ~ 5 JET FUEL -- ~ 3 CHEMICAL PRODUCT [] ~ UNKNOWN [] 2 wASTE [] 2 LEADED ~ , gg OTHER (DESCRIBE ~.' D. Il: (A.t) IS NOT MARKED. ENTER NAME OF ~U~$TANCE STORED C.A.S. e: .... Ill. TANK CONSTRUCTION M&IqKONE ITEM ONLY IN BOXES A. S.~NOC,ANOALLTH~TAPPLEslN$OxO&NDE A. TYPE OF [] 1 DOUBLE WAI.L [] 3 SINGLE WALL WITH EXTERIOR LINER [] eS UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SEDOND&RY CONTAINMENT (VAULTEDTANKI' [] g9 OTHER B. TANK ~ 1 BARESTEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEELCLAD W/ FIBERGLASS REINFORCED PL A~ ;C MATERIAL [] 5 CONCRET~ [] 6 POLYVINYL CHLORLOE ~"~ ? 4L.UMINUM [] e l~O"& METHANOL COMPATIGLEW4:R: (PrimaryTlM) ~ 9 BRONZ~ [] 10 G~t, LVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER c.I.TEmOR ~ ~ GLASS U.,.~ [] e U.L~ [] BS U.KNOWN [] . OTHE. LINING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES ~ NO~ D. CORROSION ~ 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [:~ 4 FIBERGLASS REINFORCED PLASTIC PROTECTION ~ 5 CATHODIC PROTECTION [] 91 NONE [] g$ UNKNOWN [] g9 OTHER E. SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR). IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A U ~ SUCTION A(~2 PRESSURE A U 3 GRAVITY A U g9 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A(~ DOUBLE WALL & U 3 LINED TRENCH AU 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVlNYL CHLORIDE(PVC)A~4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7. STEELWlCOATING A U 8 100% METHANOL COMPATIELEW/FRP PROTECTION A U 9 GALVANIZED STEEL & U 10 CATHOOIC PROTECTION & U 95 UNKNOWN & U 99 OTHER -- ~ $ INTERSTITIAL i D. LEAK DETECTION ~, 1 AUTOMATIC LINE ti=AK OET~CTOR ~ 2 LINE TIGHTNESS TESTING ~ MONrTORING [] 99 OTHER .... V. TANK LEAK DETECTION ~ ~ v,s~L C<CK ~ ; INV~NTO...EDO.C,.,AT~. ~ VA°O= ~O.,TO.,NG []. ~UTO~.T~ TANK ~.NG [] ~ GROU.O WATER ~O.,.OR,N~ : 6 TANK TESTING ~ 7 'NTERSTITIALMONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION THIS FORM HAS BEEN COMPLETED UNDF~ PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE LO. NUMBER IS COMPOSED OFTHE FOUR NUMBERS BELOW COUNTY # JURISDICTION t FACILITY ~ TANK · PER. IT NUMaEfl I PERMIT APPROVED .Y&3ATE I PERMIT EXPIRATION DATE FORM. C?-9~) THIS FORM IWJST BE' ACCOMPANIED B~' A PERMIT APPUCATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FG,lO(~q4 B-RS 03/i3/97 09:40 2~'805 32~ 0576 BFD HAZ ~AT D[V ~001 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES UNDERGROUND STORAGE TANK PROGRAM 1715 Chester Ave., Bakersfield, CA (805) 326-3979 APPLICATION T° PERFORM A TANK TIGHTNESS TEST FACILITY Rollins Truck Rental-_Laasing ADDRESS 2929 E. Brundage_Lane, Bakersfield, CA 93309 PERMIT TO OPERATE # OPERATORS NAME Same OVdlNr~Rs NAM]~ same TANK # VOLUME CONTENTS 1 12K Diesel 2 12K Diesel TANK TESTING COMPANY Confidenc_e _US~ Services, Inc. MAILINGADDKESS 417 Montclair Street, Bakersfield, CA 93309 NAME & PHONE NUMBER OF CONTACT PERSON. Che_rx_~..Yp.un.~ (805) 634-9501 TESTMETHOD Underfill 1000/1.050x Ullaqe NAME OF TESTER Douglas M. Young CERTn~ICATION # AL/TX 123 DATE & TIME TEST IS TO BE CONDUCTED 6/26/98 at 6:00 a.m. CONFID UST SERVIC INC. 417 Montclair Street , Bakersfield, CA 93309 , 800-339-9930 or 305-631-3870 :FINAL TEST RESULTS: ALERT 1000 / ALERT ULLAGE 1050X / AES PLT-100R / AES SYSTEM II CUSTOMER ADDRESS: WORK ORDER: 2845 SITE ADDRESS: H.B.Covey, Inc. Rollins Truck Leasinc 350 E.Commercial Street TEST DATE: 06-26-1998 2929 East Brundage Lane Pomona, CA 91767 Bakersfield, CA 93307 SITE CONTACT: Jim Gonzales PHONE ~3MBER:909-623-2502 TECHNICIAN: Doug Young PHONE NUMBER:800-339-9930 LICENSE:99-1076 WATER IN BACKFILL: 0.00" DATE & TIME OF LAST FUEL DELIVERY:20+ hours TANK INFORMATION: (WETTED) TANK i TANK 2 TANK 3 TANK 4 Diesel Diesel PRODUCT TYPE: ~OTAL GALLONS: 12000 gallons 12000 gallons PRODUCT LEVEL: 60 inches 59 inches PERCENT FULL: 67% 65% TEST METHOD: Alert 1000 Alert 1000 WATER IN TANK: 0.00" 0.00" TANK MATERIAL: Fiberglass Fiberglass P.S.I.@ BOTTOM: 2.16 psi 2.124 psi TEST DURATION: 2.1 hours 2.1 hours FINAL LEAK RATE: +0.008 gph +0.027 gph TEST RESULT: PASS PASS TANK INFORMATION: ALERT 1050X ALERT 1050X ALERT 1050X ALERT 1050X (ULLAGE) U/F ONLY 4016 gallons 4174 gallons ULLAGE GALLONS: START PRESSURE: 1.5 psi 1.5 psi END PRESSURE: 1.5 psi 1.5 psi TEST RESULT: PASS PASS PRODUCT LINES: AES PLT-100R AES PLT-100R AES PLT-100R AES PLT-100R LINE TYPE: Pressure Syphoned START TIME: 09:25a to END TIME: 09:55a Tank 1 TEST PRESSURE: 50 psi FINAL LEAK RATE: -0. 004 g~h TEST RESULT: PASS PASS MECHANICAL LEAK DETECTORS: Red Jacket FTA Red Jacket FTA Red Jacket FTA Red Jacket FTA MODEL: SERIAL NUMBER: CHECK VALVE PSI: BLEED OFF ml: LEAK RATE TESTED: TEST RESULT: A) These systems and methods meet or exceed the criteria in USEPA 40CFR parts 280, NFPA 329-87 and all applicable state codes. B) Any failure listed above may require further action, check with all regulatory agencies. 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ALERT TECHNOL OGLES PLOT OF ULLAGE TEST DA TA Roll~ns Trucks 2929 E.Brundage Lane Bakersfield, CA 22000 GALLON Diesel TANK ~2KHz AMPLITUDE RATIO 25KHz AMPLITUDE RATIO 0 75 ~.5 750+ 0 75 ~ 5 750+ I I N N U U T T E 3 E 3 S S 5 5 12KHz DETECTION RATIO = 1.00 25KHz DETECTION RATIO = .999 TEST RESULT = PASS DATE AND TIME OF TEST: 06/26/98 9:36AM BEGINNING BOTTLE PRESSURE = 2200 ENDING BOTTLE PRESSURE = 2000 BEGINNING TANK PRESSURE = 1.5 PSIG ENDING TANK PRESSURE = ~.5 PSIG ALERT TECHNOL OGLES PLOT OF ULLAGE TEST DA TA Rollins Trucks 2929 E.SrunOage Lane BakersfielO. CA ~2000 GALLON Diesel TANK ~2KHz AMPLITUDE RATIO 25KHz AMPLITUDE RATIO 0 75 ~ 5 750+ 0.75 ~ 5 750+ N N U U T T E 3 E 3 S S 5 5 ~2KHz DETECTION RATIO = .992 25KHz DETECTION RATIO = ~.02 TEST RESULT = PASS DATE AND TIME OF TEST: 06/26/98 9:43AM BEGINNING BOTTLE PRESSURE = 2200 ENDING BOTTLE PRESSURE = ~900 BEGINNING TANK PRESSURE = ~.5 PSIG ENDZNG TANK PRESSURE = ~.5 PSZG E;ITY OI= DAKEROI~IELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVENUE BAKERSFIELD, CALIFORNIA 93301 ROLLINS LEASING 140 2929 E.BRUNDAGE LN. BAKERSFIELD,CA.9$B07 $22-2600 JUN 29, 1998 4:31 PM ROLLINS LEASING 140 2929 E.BRUNDAGE LN. SYSTEM STATUS REPORT BAKERSFIELD,CA.9$BO,,__y 822-2600 L i:FUEL ALARM JUN 29, 1998 4:82 PM L 2:FUEL ALARM L S:FUEL ALARM SYSTEM STATUS REPORT L 4:FUEL ALARM ALL FUNCTIONS NORMAL L 6:FUEL ALARM L 8:FUEL ALARM INVENTORY REPORT T I:DIESEL 1 VOLUME = 8362 GALS ..... SENSOR ALARM ULLAGE = 8252 GALS L 6:TURBINE SUMP TANK 90% ULLAGE= 2072 GALS STP SUMP TO VOLUME = 8S55 GALS. FUEL ALARM HEIGHT = 58.72 INCHES JUN 29, 1998 4:33 PM WATER VOL = 30 GALS WATER = 1.03 INCHES TEMP = 79.2 DEG F T 2:DIESEL 2 VOLUME = 9923 GALS ULLAGE = 167l GALS 909 ULLAGE= 511 GALS TC VOLUME = 9913 GALS ..... SENSOR ALARM ..... HEIGHT = 67.59 INCHES L 8:PIPING SUMP TANK WATER VOL = 0 GALS PIPING SUMP WATER = 0.00 INCHES FUEL ALARM TEMP = .80.9 DEG F JUN 29, 1998 4:33 PM -- - .... SENSOR ALARM ._ L 2:SENSOR. OIL LINE PIPING SUMP FUEL ALARM JUN 29, 1998 4:$5 PM SENSOR ALARM ..... L 4:SATELITE DISP PAN $ DISPENSER PAN FUEL ALARM JUN 29, 199B 4:34 PM ..... SENSOR ALARM ..... L ?:TANK 2 ANNULAR "-' ANNULAR SPACE '~ ~ HIGH LIQUID ALARM JUN 29, 1998 4:$6 PM ..... SENSOR ALARM L S:PIPINGSENS MIDISLAND PIPING SUMP FUEL ALARM JUN 29, 1998 4:$4 PM ..... SENSOR ALARM ..... L 5:ANNULAR TANK 1 ANNULAR SPACE HIGH LIQUID ALARM JUN 29, 1998 4:$6 PM ...... SENSOR ALARM L I:SATELITE DISP PAN-" DIG:PENSER PAN FUEL ALARM JUN 29, 1998 4:35 PM SENSOR ALARM L 4:SATELITE DISP PAN S DISPENSER PAN FUEL ALARM · JUN 29, 1998 4:$8 PM BAKe.l= ELDClTYFIREDEPAI(, '-T HAZARDOUS' MATERIALS DIVlSI'o N INSPECTION RECORD POST CARD AT JOBSITE FACILITY ('~cJ'L~ -"-I~ "TC~ d'C,..~J ~ (~ OWNER ADDRESS "2-~ ?--ct ~--- ~ ~2`-d'~'/O~ ADDRESS CITY, ZIP CITY, ZIP PHONE NO. PERMIT # .~'"~ '""(~) [ / ~,- INSTRUCTIONS: Please call for an inspector only when each group of inspections with the same number are ready. They will run in consecutive order beginmng with number 1. DO NOT cover work for any numbered group until all items in that group are signed off by the Permitting Authority. Following these instructions will reduce the number of required inspection visits and therefore prevent assessment of additional fees. TANKS AND BACKFILL INSPECTION I DATE I INSPECTOR Spark Test Certification or Manufactures Method ~///~ Cathodic Protection of Tank(s) PIPING SYSTEM Corrosion Protection of Piping, Joints, Fill Pipe Electrical Isolation of Piping From Tank(s) Cathodic Protection System-Piping ~ SECONDARY CONTAINMENT, OVERFILL PROTECTION, LEAK DETECTION liner Installation - Tank(s) liner Installation - Piping Vault With Product Compatible Sealer Level Gauges or Sensors, Float Vent VaNes *-"~-f.. ~, - ~r,...~ ,I,, Product Compatible Fill Box(es, ~- [ ~'-~ ~' J~ 6~J~-~ Product line Leak Detector(s) ~ Leak Detector(s) for Annular Space-D.W. Tank(s) ~ ~ Monitoring Well(s)/Sump(s) - H~O Test (~- I ~" ~ ~' ~ Leak Detection Device(s) fOr Vadose/Groundwater FINAL Monitoring Wells, Caps & Locks Mon~ringRequiremen, T~-~O PHONE CALL ) ~FOR '"H' .... ("~~ DATE ~ { ~ TIME It: OO P.M.A'M'-' YOUR CALL AR~ EXTENSION ~ ~Eg~ ~ ~ PLEASE CALL ~ WILL CALL AGAIN TO SEE YOU WANTS I-1/~" ~IE~EL TO PI~ SEE DET. 1-i~" x I-I~" , L.C. ~ETER DI$C{::>NNECT~ L I FUEL I~LOC-..K-. AT T'I'P. ~;~ E,. I. UEL~:>EI::) OUTLET. TEE. ' DUAL FILTER, T"Ff='. OF 2. CI~'I-TEf~ CENTURION III I-lOSE TC~ NOZZLE. ~ METER STAND ELEVATION ,. ~...--i I/2" C:HE~,EL I~II~ING 'TO ~==IF='E ,~UIc=:~l=:'C)l~="i'. 1'O ITE SATELLITE ELEVATION N.T.~. 2-6 OI~TCE OF ~RO~~ S~CE~ 1715 Chea~e~ Ave., Bakersfield, ~ 93301 (805) 326-3979 CERTIFI~TION STAT~ OF T~ DECO~I~TZON ' ~~ an authorized agen~ of p~O.~ r~J ~',~,wm.~'~/her. by a==..= under pe~lt~ of con=fac=lng Co. Ad.ess being removed under pe~i=~ ~-09~ has been cleaned/decon=~ina=ed properly and a LEL (lower explosive 1~) ~eading of no grea=er =ban 5% was measured l~edia=ely following cleaning/decon=~ina=ion p~ocess. DaCe N~e (~rinc) signature Clg~ of Bakersfield .ff., :~,r,' ~NON HA~-ARDOUS MANTFEST . -,.. ..  CO~SZG~O~O~ ~I~, N~e & Address TRANSPORTER, Name & Add~es~' ' ' I ' ' (b) n '~rdous ~or~X' .Xn occordn.ca ~tth cae TtrXe 22. 66004. ' " · '":' ' ' ~. ' ~o) ~ e~gdo~ ~owl~* In nacordnnco ~lrh ~9 CFR 171.0 oE ~ho Fedornl Re[u~o~' ** ':'; · : ' / , . '... {d~..doea.noC concaln vold opnco (o) ln. vhtch oho nCmoophoro conCotno componon~ ~ ezoeao / . ' ~.f~r~ de.nra ~c oho conoltn~nc ~o In ell 'roopocco In oho propor condlc~on rot ~anop~ b~;' .' . : . I '2": V~ey.~ee I ~nsUiucci% Company '" :' &RSFIELD FIRE DEPARTMEN~~' ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-39?9 TANK REMOVAL INSPECTION FORM CONTRACTOR fi, ~,- ~ u~ ' CONTACT PERSON T~u~ TEST METHODOLOGY ~r~ ~, T~ 0 We~ PRELIMANARY ASSESSMEN+f CO. ~,~. (~#~ CONTACT PERSON CO~ RECIEPT ~95'0 ~ ~,a~,~ 'LEL% ~ O~% PLOT PLAN CONDITION OF PIPING ~u~ e~¢~l(¢~ $~.~ ~ CONDITION OF SOIL 4~{v. ~'a~ DATE INSPECTOR8 ~E 8IG~TURE  Permit No. CITY OF BAKER IELD ~' OFFICE OF ENVIRONMENTAL SERVICES 17 I$ Chester Ave., Bakersfield, CA (805) 326-3979 PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK sn'x INFORMAl'ION {.'O~TU^C'rou ~O~MA'r~oN INSL!RANC~.CA~RRIER (pLg~'~'-A.l~l WORKMENS COMP NO. ~0~_ ~;T~i PRELIM INARY ASSESSMENT INFORMATION A~RESS crr¥ ~NSUR^NCF C^RR~ER WO~a~a~NS COrm ~O. · r^sK CCE^N,Na ~NgORMAT~ON, ADDRESS C~7Y ZI~ WASTE TRANSPORTER IDENTIFICATION NUMBER NAME OF RINSATE DISPOSAL FACILITY ~ wx~,.~ ~..e'~ ~ ADDRESS CITY ZIP FACILITY IDENTIFICATION NUIVl]3ER · r^N~: TR^NSPOaT~'a ~NgORMAT~ON C'O~IP^NY PHO~a~ NO. C~CENSE t~O. ^OORESS CITY Zm TAN~ TAN K IN I~ORMATION CI-[EMICAL DATES CHEMICAL TANK NO. AGE VOLUME STORED. STORED PREVIOUSLY STORED /'1 I1.: AIq'I.R.'^N'I' I I^S RFC£[VEI). [J'NDERSTANT.,'~. AND W[I.L COMPLY WITH THE A'i'rAcHI':D CONI)I'rIONS OF' TI lis I'1 .;RMrI' ^NI ) ANY ()'1'111.;R .'.IT^TI.;, I.OCAL AND FED[".RAL REGULATION'8. ~'l H~ F( )RM I IA.~ I JEEN COMI)I.I":TI":I) UNDER PENALTY OF PER.R!RY. AND 'TO TI IE B[L<{'I' OF MY ICN()WI.I:.IXH~ i.',; 'FRUI.; AI'I'I<~;~.~-_.~ AI'I'i.I¢^NT NAME (PIUNT) AI'PI,ICAN'r SIGNATURE THIS APPLICATION' BECOME A PERMIT WHEN' APPROVED 326 05~6 BFD HAZ MAT DIV [~]002 '~,~ CITY OF BAKERSFIELD OFFIC'E OF ENVIRONMENTAL SERVICES 715 Chester Ave., Bakersfield, CA (805) 326-3979 PERMIT APPLICATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK oF A PL CAT ON (CH CX) I ]NEW FACILITY ~(~MODIFICATION OF FACIlATY [2~NEW TANK INST.,!3 ATION AT EXISTING FACILITY' STARTING DATE _ S/'7/~]~ PROPOSED COMPLETION DATE ~/!/~ FACmrTY NAME (~ol ~ ;~/ ~-r- ar ~.'~-~ EXISTING FACILr~r~, PERMIT NO. PHONE NO.-('qO%"~ (-7.,_~ --? _~-'l~[ BAKERSFI~-~r} crl~ BUSINESS LICENSE NO. WORKMAN COMPNO. (~50~ ~-O%~'2L)O INSURER ~%e,, BR.[EF'LY DESCRIBE TH~ WOKK TO BE DONE "X~x~,.~%% ¢%~ ~k}o,e ~a~.~v,O.- DE~[ TO GRO~ WA~ SO~ ~E ~~ AT NO. OF T~ TO BE ~STALL~D ~ ~ ~Y FOR MOTOR ~ SP~L P~~ON COBOL ~ CO~ ~~S P~ ON ~. ~ ~ NO SEC~ON FOR MOTOR ~L T~ NO. VOL~ ~ED ~0~ ~ D~ A~ON SECTION FOR NON MOTOR FUEL ST0]~JkGE T~ ~ ~. ~NO. VOLLrlVfE CHEMICAL STOKED CAS NO. CHEMICAL PREVIOUSLY STORED (NO BKAND N~A~. ,) (~ ~NOWN) _-- I -:,.':' ' .' . "'2':'2.... :' .' ,'~J:~i~:::'::.. : · . · . ' ~ ;. iL::..i:::: ~i!iiH'Hiiiihiiiiiiiiiqi{~ ':':'::::q ~ ::~ ~i~ } H}i:ii~!~ill ~:~i ~ ~PLIC~ ~S ~C~, ~E~T~S. ~ ~ CO~LY ~ ~ A~AC~ CO~ON$ OF ~S PE~ ~ ~ O~ STA~, L~ ~ ~~ ~ tis FO~ ~S BEEN CO~LE~D ~ER ~~ OF P~Y, ~ TO ~ B~T OF ~ ~O~E, ~ m~ A~ CO.CT, ~ THIS APPLICATION BECO~S A PE~T ~N ~PRO~D CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 APPLICATION TO INSTALL AND/OR REMOVE ABOVE GROUND STORAGE TANK(S) In conformity with provisions of pertinent ordinances, codes and/or regulations, permission is hereby granted to: Name of Company Address to display, store, install, use, operate, sell or handle materials or process involving or Creating conditions deemed hazardous to life or property as follows: subject to the provisions and/or limitations as provided. Violation of pertinent ordinances, codes and/or regulations shall void this permit. ~___.. Permit'De~ed ~"'l ~- fg Date - Approved by-~' Applicant Name (print) Apphcant Signature THIS APPLICATION BECOMES A PERMIT WI:IEN APPROVED Leasing Rollins Wilmington, De 19899 Fax: 302-426-2757 Environmental Department E-mail: Kristy_Westley@rlc-corp.com Thursday, April 16, 1998 Ralph E. Huey Bakersfield Fire Department Hazardous Materials Division 1715 Chester Ave, 3rd FI. Bakersfield, CA 93301 RE: Storage Tank Permit Application 2929 E. Brundage Lane, Bakersfield, CA Dear Mr. Huey Rollins Leasing Corp. has just recently acquired the former Ryder Transportation and Truck Rental facility located at 2929 E. Brundage Lane in Bakersfield California. The purpose of this correspondence is to enclose an Underground Storage Tank Permit Application reflecting the new ownership information, and to provide you with additional information regarding the underground storage tanks at the facility. There are currently five empty underground storage tanks at the facility: 2 diesel fuel tanks, i unleaded gasoline tank, one motor oil tank, and one waste oil tank. Rollins is currently planning to permanently remove the gasoline, waste and motor oil tanks. The two diesel tanks will be upgraded with new leak detection equipment as per Rollins policy to meet all federal, state, and local requirements. All tanks upgraded for service will be tested prior to being placed back into operation. Upon conclusion of the proposed upgrades, Rollins will submit an amended registration as required. Please call ffyou have any questions. Thank you for your attention to this matter. Sincerely Environmental Supervisor cc: Br. # 140 file STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM A COMPLETE THIS FORM FOR EACH FACILITY/SITE MARK ONLY ,[~ 1 NEW PERMIT [] 3 RENEWAL PERMIT ~ 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED SITE ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) DBA OR FACILITY NAME NAME OF OPERATOR ADDRESS '-/ NEAREST CROSS STREET PARCEL # (OPTIONAL) 2~Zq e.. 15rundct~e.. I..n. CITY NAME STATE ZIP CODE SITE PHONE # WITH AREA CODE 'i~(.tKev'sRc Id; _F.~ q ~80:/- CA .,/ BOX ~ CORPORATION ~ INDIVIDUAL ~ PARTNERSHIP ~ LOCAL.AGENCY ~ COUNTY-AGENCY ~ STATE-AGENCY l---I FEDERAL-AGENCY TO INDICATE DISTRICTS [TYPE OF BUs'NESs [-~ ' GAS sTAT'ON[~ 3 FARM ~ ~ 42 D,~i'RI~UTORpROCESSOR ~ 5 OTHER I~-'10RRESERVATIONTRUST'/IF '~D AN i' OF TANKS AT SITE I E' P' A'LANOS 5 EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY)- optional DAYS: NAME (LAST. FIRST) PHONE # WITH AREA CODE DAYS: NAME (LAST, FIRST) NIGHTS: NAME~{LAST. FIRST) PHONE # WITH AREA CODE NIGHTS: NAME (LAST. FIRST) .. PHONE # WITH AREA CODE I1. PROPERTY OWNER INFORMATION-(MUST BE COMPLETED) NAME ee, ll~n$ I-cct.cln~fl [o~p' i CAREOFADDRESS,NFORMAT,ONI Zalph ~. C-ccctrnf- [~] L6CAL*AGENCY [~ STATE-AGENCY MAILING OR STREET ADDRESS ,/ ~x I~ indicate r'--} INDIVIDUAL ~COUNTY-AGENCY P. O, 150~L I~q I [-~COR.ORA~O. r~ PAR~.ERS.~P FEDERAL-AGENCY CITY NAME STATE I ZIP CODE PHONE # WITH AREA CODE ,~. TANK OWNER ~NFORMAT~ON- IMUST BE COMPLETED) I NAME OF OWNER [ CARE OF ADDRESS INFORMATION leoll~ns I.z~s~no £nr~ - ] i~cdoh E:. MAILING OR STREET ADDRESS '~J - * ./ mx ~oindicati ["--I INDIVIDUAL [--"1 LOCAL-AGENCY ~ STATE-AGENCY g.O. t5o~. I"~ I ~ CORPORAnO. r~ .ART.ERS.,. r~ COUNTV-AGENCY ~ FEDERAt-A~ENCY I CITY NAME - STATE ZIP CODE PHONE # WITH AREA CODE IV. BOARD OFE. QUALIZATION UST STORAGE FEE ACCOUNT NUMBER - Call (916) 323-9555 if questions arise. v. us'r us ,, ~ 5 LETTER OF CREDIT ~ 6 EXEMPTION ~ 99 OTHER VI, LEGAL NOTIFICATION ANB BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked, I CHECK SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILLING: I. [] II. [] III. [] ONE BOX INDICATING WHICH ABOVE ADDRESS THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY. AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGE'J~IOY USE ONLY .... OOUNTY # ,JURISDICTION # FAOILITY # LOCATION CODE - OPTIONAL CENSUS TRACT # - OPIIONAL SUPVISOR - DISTRICT CODE - OPTIONAl THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION - FORM B, UNLESS THIS IS A CHANGE ~F SITE INFORMATiO~ ONLY. FORM A (5-91) FOR0033A-5 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B ~ COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. ~'"~" MARK ONLY ~ 1 NEW PERMIT ~ 3 REN~ PERMIT ~ 5 CHANGE OF INFORMATION ~ 7 PERMAnenTLY CLOS[~ 0~ ONEITEM ~ 2 IN~RIM PERMIT ~ 4 ~ENDED PERMIT ~ 6 TEMPORARY TANK CLOSURE ~ 8 TANK REMOVE~ DBA OR FACILI~ NAME WHERETANK IS INSTALLED: ~ ~ i I ~ ~1 ~ ~0~ ' J I. TANK DESCRIPTION COMPLETE ALL ~TE~S - SPECifY ~F UNKNO~ A. OWNER'S TANK I.D.I O I ~. MANUFACTURED BY: ~ II. TANK CONTE~S ~F A-1 IS BARKED, COMPLETE ITEM C. ~ 3 r;HEHICAL PRODL'~T ~ g~ UNKNOWN ~ 2 WASTE ~ ~ LEADED ~ gg OT=:IER ~DESCRIRE D. IF (A.1) IS NOT MARKED, EN~R NAME OF SUBSTANCE STORED C.A.S. ~: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, AND ALL THAT APPLIES IN BOX D AND E A. ~PE OF ~ ~ DOUBLE WALL ~ 3 SINGLE WALL WITH E~ERIOR LINER ~ 95 UNKNOWN SYSTEM ~ 2 SINGLE WALL -- ~ 4 SECONDARY CONTAINMENT (VAULTED TANK) ~ 99 OTHER B, TANK ~ 1 BARE STEEL ~ 2 STAINLESS STEEL ~ 3 FIBERGLASS ~ 4 STEEL CLAD W/FIBERGLASS MATERIAL ~ 5 CONCRETE ~ 6 ~LWINYL CHLORIDE ~ 7 ~UMINUM ~ 8 1~7. METHANOL COMPATIBLE WIFR~ (PrimaryTank) ~ 9 BRONZE ~ 10 GALVANIZED STEEL ~ g5 UNKNOWN ~ 99 OTHER~ C. INTERIOR ~ 5 GLASS LINING ~ 6 UNLINED ~ g5 UNKNOWN ~ gg OTHER LINING Is LINING MATERIAL COUPATIBLE WITH 1~/. UE~ANOL ? YES__ NO__ D. CORROSION ~ 1 POLYETHYLENE WRAP ~ 2 COATING ~ 3 VINYL WRAP ~ 4 FIBERGLASS REINFORCED PLASTIC PROTE~ION ~ 5 CATHODIC PROTECTION ~ 91 NONE ~ 95 UNKNOWN ~ 99 OTHER E, SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR} I ~ ~ OVERF{LL PREVENTION EQUIPMENT iNStALLeD (YEAR) { ~ ~ _ IV. PIPING INFORMATION C~RCL~ A IF ABOVE GROUND OR U IF UNDERGROUND, ~OTH IF APPLICABLE A. SYSTEMTYPE A U 1 SUCTION A~2 PRESSURE A U 3 GRAVI~ A U 99 OTHER B, CONSTRUCTION A ~ 1 SINGLE WALL A~2 ~UBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVCIA~ 4 FIBERGLASS PiPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 lOm/~ METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN ~ U 99 OTHER n LEAK DETECTION ~ ~t,To .... ~,,~ F*~nCTC~T~n ~ 0 L~4FT~HT).[ESSTESTING ~ 3 INTERST)TIAL V. TANK LEAK DETECTION VI, TANK CLOSURE INFORMATION [ 1. ESTIMATED DATE LAST USED (MO/DAY. R) I2' ESTIMATED oUANT.~ OFSUBSTANCE REMAIN,NG GALLONS 3. WAS TANK FILLED WITHiNER, MATERIAL ? YES ~ NO~ THIS FORM HAS BEEN C~ETED UNDER~ENAL~ OF PERJURY. AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPL'CAN~SNAME ~='~~ ~ ' ' IDATE LOCAL AGENCY USE ONLY THE STATE I.D, NUMBER IS COMPOSED OF THE FOUR NUMBERS aLLOW COUNTY 8 JURISDICTION 8 FACILI~ · TANK ~ STATE I.D.~ ~ { I I I Jl m PERMIT NUMBER [ PERMIT APPROVED BY. ATE ~ PERMIT EXPIRATION DATE FORM B (7-91) THIS FORM MUST BE ACCOMPANIED BY A PERMff APPLICATION. FORM A, UNLESS A CURRE~ FORM A HAS BEEN FILED. FOaO~B.R5 STATE WATER RESOURCES CONTROL BOARD /~'~'~'~'~'~.' ', UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPL~E A SEPARATE FORM FOR EACH TANK SYS~ MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION__ ~ 7 PERMA~-=-N'TL¥ CLOSED ON $ -:' ONE ITEM [] 2 INTERIM PERMIT [] 4 NvlENDED PERMIT [] 6 TEMPORARY TANK CLOSURE ~ 8 TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: ~---Oilll~.~ 'L~.o~.c=/1~ (--~Y'Pl ];~Y' ~ I N0 ~ I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN C. DATE iNSTALLED (MO/DAY/YEAR) I~1~ D. TANK CAPACITY IN GALLONS: I 2, OOO ,~O31 ORS J II.TANK CONTENTS IF A-1 I$ MARKED,COMPLETE ITEM C. ,,, la REGULAR :3 DIESEL A. ~ 1 MOTOR VEHICLE FUEL [] 4 OIL S. C. UNLEADED ~ 2 PETROLEUM [] 80 EMPTY [~ 1 PRODUCT [] lbPREMIUM L..] 4 GASAHOL 7 MET~IANO, UNLEADED ~ 5 JET FUEL [] 3 CHEMICAL PRODUCT [] 9.~ UNKNOWN [] 2 WASTE [] 2 LEADED L~ g9 OTHER .~DE,SCRfSE I~,' ITE~,I D BEL,'~W~ D. IF (A.1) IS NOT MARKED. ENTER NAME OF SUBSTANCE STORED C.A.S. #: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. S. ANDC. AND ALL THAT APPLIES IN SOX D AND E A. TYPE OF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL '- [] 4 SECONDARY CONTAINMENT (VAULTEO TANK) [] 99 OTHER B. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL ~] 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REIN~RCEDP~.AS~;C MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] S 100% METHANOL COMPATIP, LEW~FR:3 (,rimaryTank) [] g SRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 9g OTHER [] .RussER L,.EO [] ~ AL~D LIN,NO [] '~ EPOX~ LiN,NG [] . .HENOL~ L,N,NG C. ~NTEmOR [] S GLASS U.~NG [] ~ U.LINED [] e5 UNKNOWN [] ~ OTHER LINING IS LINING MATERIAL COMPATIBLE WITH I(XPA METHANOL ? YES_ NO~ D. CORROSION [] ~ POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [~ 4 FIBERGLASS REINFORCED Pt. ASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 9~ NONE [] 95 UNKNOWN [] e9 OTHER E. SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) IV. PIPING INFORMATION CIRCL~ A IFABOVEGROUNDOR U IF UNDERGROUND. BOTHIF APPLICABLE U 1 SUCTION A~/'~2 PRESSURE A U 3 GRAVITY A U 99 OTHER A. SYSTEM TYPE A B. CONSTRUCTION A U 1 SINGLE WALL A~)2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER A U 1 BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVlNYL CHLORIDE(PVC)A(~4 FIBERGLASS C. MATERIAL AND PIPE CORROSION A U 5 ~UMINUM A U 6 CONCRETE ~ U 7 STEELWlCOATING k U 8 I~ METHANOL COMPATIBLEW/F~P PROTE~ION A U 9 ~LVANI~D S~EL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER ~ 3 INTERSTITIAL D. LEAK DETECTION ~ 1 AUTOMATIC LINE LEAK DETECTOR ~ 2 LINE T~HTNESS TESTING ~ MON~O~tNG ~ 99 OTHER V. TANK LEAK DETECTION ~ 6 TANK TESTING ~ 7 INTERSTITIAL MONITORING ~ gl NONE ~ 95 UNKNOWN ~ ~ O~HER VI. TANK CLOSURE INFORMATION [ 1. ESTIMATED DATE LAST USED (MO/DAY~R, 2. ESTIMATED OUANTI~ OFSUBSTANCE REMAINING GALLONS I3' wAS TANK FI~ED wlTHINERT MATERIAL ? YES ~ THIS FORM HAS BEEN COMPLETED UND~PENAL~ OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT I APPLICANTSNA ',-' I DAT~ I LOCAL AG ENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW COUNTY · JURISDICTION · FACILI~ · TANK ~ ~oa~ ~ ~-9~) THIS FORM MUST BE ACne,lED BY A PERMff APPUCATION - FORM A, UNL~ A CURRE~ FORM A HAS BEEN FILED. STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD k~,~ ..~'-,el ~**,~.~ UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORM B ,,.,,~*~...~-. COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT ,~[ 5 CHANGE OF INFORMATION ~ 7 PERMAN.=.N;LV CLOSE,~ ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE I'-~1 8 TANK REMOVED OBAOR FAC~Lrn'.A~WHERETA"KIS I.STALLED,= I~01 h~ ~/']<;1~ ~, ~r~- ~ IqOL, I. TANK DESCRIPTION COMPLETE ALL ITEMS- SPECIFY ~F UNKNOWN A. OWNER'S TANK ,. D." 05 B. MANUFACTURED BY: Utl/~(/'N~ .......... c. DATE ,N~TALLED~MO,DAY~EAR) Ifl~Lo o. TANK CAPAC,'~ ,N GALLON-~: 8, ~ ot~lons II.TANK CONTENTS ~FA.~ iS MARKED. COMP,Wn~ITEM C. .r-q ~ PETROLEUM [] ,0 EMP'n' [] , PRODUCT [] ,,~PREM,UM ,,'. , ~SAHOL .... ? UNLSADED 5 JET FUEL ~ 3 CHEMICAL PRODUCT ~] 9~ UNKNOWN ~ 2 WASTE ~ 2 LEADED gg OTHER (DEgCR!~E hV ITE~ D. D. IF (A.1) IS NOT MARKED. ENTER NAME OF SUBSTANCE STORED C. A, S. #: II1. TANK CONSTRUCTION MARK ONE ITEM ONLY IN EOXES A. B. ANDC. ANDALLTHATAPPLIESINBOXDANDE A. TYPE OF .~ 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL *- [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER e. TANK [] ', BARESTEEL [] =' STAINLESS STEEL ~ -"' mERGLASS [] 4 STEELCLAD W,F~BERGLASSRE,N;O~C~OPt.~S'~:C MATErnAL [] s CONC,ETE [] S POLW~NYL C,LORIDE [] ? ~UM~NUM [] ~ '~ METHANOL COMPA'r~BLEW,FR= (Pri,,.,'yT,,~,l [] o BRONZE [] ',0 mLVAN~ZED STEEL [] "S UNKNOWN [] B~, OTHER [] , RUBBER L,NED [] = AL,",'D LIN,NG [] '" EPO~' L,N,NG []., PHENOL,° ,-,NING C. INTERIOR [] 5 GLASS LINING [] 6 UNLINED [] 95 UNKNOWN [] ag OTHER LINING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES ~ NO~ D. CORROSION ~'~ 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 9'~ NONE [] ~S UNKNOWN [] e~ OTHER E, SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) I ql~:~ , OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) J,~ ~ ~ IV. PIPING INFORMATION C~RCL~ A IFABOVEGROUNDOR U IF UNOERGROUND. BOTHIF APPLICABLE A. SYSTEMTYPE A U 1 SUCTION A(~ 2 PRESSURE & U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A(~200UBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A I.I 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC)A ~)4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U ? STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FI4P PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION ~ 1 AUTOMATIC LINE LEAK DETECTOR ~ 2 LINE TIGHTNESS TESTING ~'~ 3 INTERSTITIAL MONI'I'ORING [] 99 OTHER V. TANK LEAK DETECTION .-n , v,SUAL C,ECK [] ~ ,NV~NTORY RECONO,.,AT,ON [], VADOZE MON,TOR,NG [], AUTOMAT,C TANK ~UG,NG [] ~ GROUND WATER ,,~ 6 TANK TESTING C~ 7 INTERST]TIALMONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION [ 1. ESTIMATED DATE LAST USED (MO/DAYNR) 2. ESTIMATED QUANTITY OFsuBSTANCE REMAINING GALLONS I3' WAS TANK FILLED wIIHINERT MATERIAL ? YES ~---]. TH/S FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AG ENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW COUNTY e JURISDICTION # . . FACILITY # , 'rANK # ' PERMit NUMBER I PERMit APPROVED BY/DATE [ PERMIT EXPIRATION DATE FORM S (7-9~) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FG;~OOc14 B-RS STATE WATER RESOURCES CONTROL BOARD · UNDERGROUND STORAGE TANK PERMIT APPLICATION FORM COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEf,/L MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT ~' 5 CHANGE OF INFORMATION - ONE fiLM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE ~ 8 TANK REMOVED DBAOR FACILITY NAME WHERE TANK IS INSTALLED= ~201 [11/'~ L~JL~,Ir')~ (~)~p, ~ ~ I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK ,. O. ,~ OH B. MANUFACTURED BY: U~'l J~J/~,,~l C. DATE INSTALLED (MO/DAY/YEAR) I q B~O D. TANK CAPACITY IN GALLONS: II. TANK C0NTENTS IF A-1 IS MARKED. COMPLETE ITEM C. UNLEADED [] 2 PETROLEUM [] 80 EMPTY [] , PRODUCT [] 'I:) PREMIUM UNLEADED ~ 3 CHEMICAL PRODUCT [] 9~ UNKNOWN ~ 2 WASTE ~__ 2 LEADF. D ~ 99 OTHER (DESCRLCJE rN ITE~, D. EEL,~WIJ o. ,F (A.',,S NOT MARKED. ENTER NAME OF SUSSTA,CE STORED '~Y.~y.... 0'. I, C.A.S. II1. TANK CONSTRUCTION MARKONEITEMONLYINBOXESA. B. ANDC. ANDALLTHATAPPLIESlNBOXDANDE EA. TYPE OF .[~ 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL - [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER lB. BARESTEEL [] ~ STAINLESS STEEL [] 3 F~BERGL~S [] ~ STEELCLAD W~F,,ERGLASSRE,N~ORCEOPLAS'~=C 1 TANK MATERIAL [] 5 CONCRETE [] 6 POLYVlNYL CHLORIDE [] 7 ALUMINUM [] 8 'tOm.~ METHANOL COMPATIBLE W;FR= (,rimaryTank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER [] , .UBBE. L,NED [] . ALKYD L,N,NG [] '. EPO~ LI.ING []., PHENOLIC L,N,NG C. iNTERIOR [] 5 GLASS LINING [] 6 UNLINED [] 95 UNKNOWN [] 99 OTHER LINING IS LINING MATERIAL COMPATIBLE WITH 10(~ METHANOL ? YES__ NO~ D. CORROSION ~ 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER E. SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR} [ ~ ~ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) IV. PIPING INFORMATION CIRCLE A IFABOVEGROUNDOR U IF UNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION ~, U 2 PRESSURE A(~3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A(~ 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC)A(:~ 4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A [J 6 CONCRETE A U ? STEEL W/ COATING A U 8 10{7Yo METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION .~ U' 9.5 UNKNOWN ,~ U 99 OTHER D. LEAK DETECTION [] 1 AUTOMATIC LINE LEAK DETECTOR r'~ 2 LINE TIGHTNESS TESTING ~ 3 INTERSTITIAL ~-- UONrTOR~G ~ 99 OTHER.._:_ .............. V. TANK LEAK DETECTION ~ 1 VISUAL CHECK [] 2 INVENTORY REcoNCILIATION [] 3 VADOZE MONITORING [] , AUTOMATIC TANKGAUGtNG [] 5 GROUND WATER MONITORING ~ 6 TANK TESTING ~ 7 INTERSTITIAL MONITORING [] 91 NONE [] g5 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION I1.ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTITY OF I 3. WAS TANK FILLED WITH SUBSTANCE REMAINING GALLONS INERT MATERIAL ? YES THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPLICANT'S NAME ~ ~ -- ~ "~ DATE LOCAL- AGENCY USE ONLY THE ST'"A~E I.D. NUMBER IS COMPOSED OF' THE FOUR NUMBERS BELOW COUNTY #JURISDICTION # FACILITY # TANK # STATE I.D.# ~ I1' I . IIIIII i ill... FORM B (7-91) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. STATE WATER RESOURCES CO.T.OL BOA. D UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORM COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY ~ I NEVi/ PERMIT [] 3 RENEWAL PERMIT ONE ~EM ~ 2 IN.RIM PERMIT DBA OR FACIL~ HA~ WHERETANK IS INSTATED: .~~ I. TANK DESCRIPTION C~PLE~ ALL fiLMS - SPECIFY IF UNKNO~ A. OWNER'S TANK I.D.' C. DATE INSTALLED (M~DAY~EAR) I II.TANK CONTENTS iF A-~ ISMAR~D, CO~PL~TEITEM C. A. ~ 1 MOTOR VEHtCLE FUEL [] 4 OiL S. C. [] ,aREGULARuNLEADED ~=~-~ 3 DIESEL ..... ~ 4 ~SAHOL .... ~ 2 PETROLEU~ ~ . EMP~ ~ , PRODUCT ~ lb PREMIUMuNLEAD~D ~ 5 JET FUEL ~ 3 CHEMICAL PRODUCT ~ 95 UNKNOWN ~ 2 WAS~ ~ 2 LEADED ~ 99 OTHER (DEgCR{~E II1. TANK CONSTRUCTION MARK ONE I~M ONLY IN BOXES A. B. ANDC.~DALLTHATAPPLIESINBOXDANDE A. ~PEOF ~ ~ ~UBLE WALL ~ 3 SINGLE WA~ WITH E~ERIOR LINER ~ 95 UNKNOWN SYSTEM ~ 2 SINGLE W~L '- ~ 4 SECONDARY ~NTAINMENT (VAUL~DTANK) ~ ~ OTHER IS. TANK ~ 1 BARESTEEL ~ 2 STAINLESS STEEL ~ 3 FIBERGLAS ~ 4 STEELCLAD W/FIBERGLASSREINFORCEDPLAg];C MATERI~ ~ 5 ~NCRE~ ~ 6 ~LWI~L CHLORIDE ~ 7 ~UMINUM ~ 8 1~ METHANOL COMPATIBLE WlFR~ (Pri,a~Ta~k) ~ 9 BRON~ ~ I0 ~LVAN~D S~EL ~ 95 UNKNOWN ~ ~ OTHER ~ 1 RUBBER LINED ~ 2 ~D LINING ~ ~ EPO~ LINING ~ 4 PHENOUC LINING C. INTERIOR ~ 5 G~SS LINING ~ 6 UNLINED ~ 95 UNKNOWN ~ 99 OTHER LINING tS LINING MATERIAL ~MPATIBLE WITH 1~ ME~ANOL ? YES ~ NO~ D. CORROSION ~ 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER E. SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR} OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) IV. PIPING INFORMATION C~RCLE A IFABOVEGROUNDOR U IF UNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A (~1 SUCTION .~ U 2 PRESSURE J~ U 3 GRAVITY ,~ U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A(~2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVlNYL CHLORIDE (PVC)A(~ 4 FIBERGLASS PIPE CORROSION A u 5 A~.UMINUM J~ U 6 CONCRETE ~, U ? STEEL W/ COATING J~ U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN ~, U 99 OTHER D. LEAK DETECTION ~ 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [~ 3 INTERSTITIAL MONFrORING [] 99 .OTHER .................... V. TANK LEAK DETECTION ~ 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VADOZE MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUND WATER MONITORING ~.~ 6 TANK TESTING ~. 7 INTERSTITIAL MONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION [ I. ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTITY OFsuBSTANCE REMAINING GALLONS I3. wAS TANK FILLED wI'HINERT MATERIAL ? YES ~. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT I APPLICANT'S NAME ~ ~ '~'~X DATE LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER 15 COMPOSED OF THE FOUR NUMBERS BELOW STATE I.D.~ ~ I" I I 11 I I I I 1 FORM B ff-91) THIS FORM MU~ BE ACne'lED BY l PERMff APPUCA~ON - FORM A, UNLESS A CURRE~ FORM l HAS BEEN FI~D. FO~o~8.R5