HomeMy WebLinkAboutBUSINESS PLAN C~TY OF E~AKERSF~ELD
0 ~
' N FILE
,
·ACTI VI T'~"SHEET ........ ~,
DATE ~ ACTIVITY INITIALSi TiME
Account Number
ACCOUNTS RECEIVABLEADJUSTMENT "' ::- ~. " : - , ~ ' .. , ' ".,. '
. - .... .: . ..-'_ .,., :/'. SerVice Change
From:-, ,- . '-.-. :-',.'.:': -, ':-:".-'-':..':-' "....,.i:./:Other di' .
Valerie Pender§r~ss -'- : .. :'-. ~ ...:.
.' -:",. Department/Division-. -.: .,- .:-.!:": . . '.':' '..:'~'.. : ''. :-. ': . "../~?'-'-.,'~:'.:.:,.i--:.:;~i?:::':':!:":".-: ~:.-:-:- ..
,. .. , Billing Name . ,'-:' -.-'.::,~', ...... :.'-:-:..:-, ::" _.:' '..' '.' ~:.:- :_. -. '~ - .'.:-',:; ,::,': .
· 4840 Brunda~;e'- Lane" .~' -":' ".;': ~. ,'":'..":'".'::- ". '' - '. ' . :'-' ;'" ;' ':'"'-'.
· .... '," .,.' Bisll~ Address '.'~, '..:: '-. :.,'.' ....... .',....:i '-',~.:!h:'.:~:::i .: ':':' '...':~..::.:::'~.::.-,, '.' L'-:.-.' '- ~= :.:"~" :i~,':,.- ,,' ~ "'":' "" :'" /':::: ': '
~ '.... ~::;:.".)! ......, . .',:: '.'~.,:-:: ...,--:. ~-- :..'..' :'"i:~:::::.'~::~:::--':~:'.:.'.~:.:~'- ...', :.:..:::~' .::. 'F..,. ".::..?_:.- '-.-::;:.~::: ": '.' ?::.:'.,'i::,'
Site Address - .... '
Parcel # (If Applicable) - '
" Landlord Name & Address if Applicable '
ADJUSTMENT ~ "' .......... ' '
ILast {Correct "" '~ IAdjustment ·/" iEffective Date "!
:..}Billed:: . IBilling · !To Billing ': IOf Change ~
Remarks: This business ended up never putting tl~e tanks in the ground or
opening the business - fees should be written of until which time they do
open.
728201
MR. FAST
$150.00
Dear Business Owner'
The Cit~ of Bakersfield has taken over the billing of the annual
fees for underground tank storage from the Count~ of ~ern. The
Citg is charging the same per tank fee that the Count~ charged
last gear. - .... ,
The Januarg 1, 1~92, billing for the hazardous materials
handling fee also included a cha~ge o~ $~0o00 pe~.tank ~o~ all
underground tanks at gou~ business iocation. UnfortUnatelg, the
chaeges ~eee not itemized on the invoice~ and the enti~e bill
appeaeed to be for hazardous mateeials handling ~ees.
This ove~si§ht has now been coe~ected and the~ total dolla~
~igu~e ~o~ you~ underground tank ~ee is noted above. .-
We' apologize ~o~ an~ inconvenience this e~o~ ma~ have caused -..
~ou. If ~ou have an~ fu~the~ ~uestions, please call the
Hazardous Materials Division at 32~-3979. ~
PERMIT #:~-~'~J047 ENV. SENSITIVITY:
Activity Date # Of Tanks Comments
BAKERSFIELD, CA 9330'1
APPLICATION FOR PERMIT TO OPERATE UNDERGROUND
[iAZARDOUS SUBSTANCES STORAGE FACILITY
T¥oe Of Application (check): .
~New Yasilitl~ ~Modiflcatlon Of Fact/lty ~Exist!ng Facility ~Tr~nsfer Of Ownership
A. gmerzencY 24-t[oup Contact ~ame, area code, phone): Days
Nights
Facility Name ~.~. ~,S~ No. Of Tanks
Type Of Business (check): ~Uasoline Statiou ~Other (describe)
Is Tank(s) Located On An Agricultural Farm? ~Yes ~No
Is Tank(s) Used Primarily For Agricultural Purposes? ~Yes
T ~g ~. R Z~ ~. _ SEC _ ~.~ (Rural Locations Only)
Tank Owner' 5%~ V~Q~]~ ~ Contact Person ~
Aadress Z~qo M~ l~" ~n City/State ~k'~[~. ~,~phone ~- 7~/~
Address .Zip Telephone ~31 - 7 ~ Y7
Soil Th~racterlsttcs At
Basis For Soil Type and Groundwater Depth Determl~atlons
C. Contractor .~, ~n~_~ CA Contractor's Ltce~{se No. ~2
Address /~Eo S~. ~{~'~,~ ~-~. ZIp ~50~ Telephon~
Proposed Startln~ Dat~ ~-~-~o Proposed Completion D~te ~-~- ~.o
Workeu~s Compensation Cer~lfication No. ~c~V'TC~'%-~ Insu=e~
D. If This Permit Is For Modiflc~tion Of An Exlstln~ Facility, Brtefl~ Describe
Modifications Proposed
E. Tank(s) Stor~ (check all %hut ~pply):
T~nk ~ 1~aste Product Motor Vehicle Unleaded ~ Premium Diesel Waste
Fuel Oi~
F. Chemical Composition Of Materials Stored (not necessar~ for motor vehicle fuels)
Tank ~ Chemical Stored {non-commercial name) CAS ~ ~lf known} Chemical Previously Stored
(If different)
Date Of Transfer Previous Owner
Previous Facility Name ~L~'. H~,,'(,, ~'~o/$
I, accept fully all obligations of Permit No. issued to
I understand that the PermittlnM Authority may review and
modify or terminate the transfer of the Permit to Operate this underground storage
facility upon receiving this completed form.
This form has been completed under penalty of perjury and to the best of my knowledge is true
and correct.
Facility Name ~q~ ' ~' Permit No. :~.~. C:, .
T~K: ~ ft:ll.I. OUT SEPA~TE FORM FOR E I T~
~OR r~ACH SECTION, CHECK ~J. ~PROP~A~ BO~S
H~ 1. Tan~ is: ( ) Vaulted ( ) Non-Vaulled ~Double-Wall ( ) Single-Wall_
2. Tank Matefi~t
( ) Carbon Stefl ( ) Stai~ess Steel ( ) Pol~yi Chloride ~ Fiberglass-Clad Steel
( ) Fiberglass-Reinforced Plas~c ( ) Concrete ( ) ~um~ ( ) Bronze ( ) Un~o~
( ) O~er (describe)
3. prima~ Containment
Date Installed ~ic~ess Onches) Capaci~ (Gallons) M~ufac~er
4. ~ank Seconda~ Containment
~ Double-W~ () S~edc L~er () Lined VaSt ( ) None (~ U~o~
( ) O~er (des~e): Man~ac~ir: ~0~ ~.~ ~ ,
( ) Matefi~ ~b~ ~+e~k ~ic~ess Onches) ~er '~. k,. Capaci~ (Gallons) JIZ/ ~
5. Tank Interior Lin~g
() Rubber (} ~kyd () Epo~ () Phenolic ()Glass ()Clay ~Unlined () U~o~
() O~er (des~be):
6. Tank Co~osion ~otecfio~
( ) G~v~ized ~ Fiberglass-Clad ( ) Polye~ylene Wrap ( ) ~m~ Wrapp~g
( ) Tar or ~ph~t ( ) U~o~ ( ) None ( ) O~er (describe):
Cathodic Protection: ~ None ( ) Impressed C~ent System ( ) Sac~3ci~ ~ode System
Describe S~tem ~d Equipment:
7. Leak Detection, Monitoring, and lntercepfioo
a. Ta~: ( ) Visu~ (vaulted t~s o~y) ( ) Gro~dwater Monito~g Well(s)
(') Vadose Zone Monito~g Well(s) ( ) U-Tube Wi~our L~er
( ) U-Tube ~ Compatible L~er D~ec~g Flow to Monito~g Well(s)*
( ) Vapor Detector* ~ Liquid ~vel Sensor* ( ) Conduc~ Sensor* ,.
~ ~ Sensor ~ ~n~ Space of Double W~l T~* ~;I ~ ~-3 ~ ~n ~
( ) Liquid Re~ev~ & Inspection From U.Tube, Monito~g Well or ~ Space
( ) Daily Gau~g & Invento~ Reconc~iafion ( ) Periodic Tighmess Tes~g
() None () U~o~ () O~er
b. Pip,g: ~ Flow-Res~cfing Le~ Detector(s) for Press~zed.Piphg* .-
( ) Monito~g S~p ~ Raceway ( ) Se~ed Concrete Raceway
( ) H~f-Cut Compatible Pipe ~ceway ( ) S~efic ~er Raceway ( ) None
() U~o~() O~er
*DescH~ M~e & Model: ~' ~~ ~ ~~e ~//~-OI 7
Has ~is T~ ~en Tighmess Tested? ( ) Yes ( ) No ( ) U~o~
Date of Last Tigh~ess Test Res~m of Test
Test N~e Tes~g Comply
9. Tank Repa~
T~ Repa~ed? ( ) Yes ( ) No ( ) U~o~
Date(s) of RepaY(s)
Describe Repa~
10. ~e~l Protecfio_ n
( ) Operator F~, Consols, & Visu~ly Monito~ ~vel
( ) Tape Eoat Gauge ~ Eoat Vent V~ves ( ) Auto Shut. Off Consols
( ) Capacit~ce Sensor ~ Se~ed F~ Box ( } None ( ) U~o~
) O~e~ List M~e & Model for ~ove De~ces
11. Piping
a. Under~o~d Pip.g: ~ Yes ( ) No ( ) U~o~ Matefi~
~ic~ess (~ches) Dimeter ~ a M~ac~er C , -
( ) Press~e ( ) Suction ( ) Gra~ Appro~ate Len~ of Pipe R'~
b. Under~o~d Pip~g C0~osion Protection: _
() G~v~ized ~ Fiberglass-Qad ( ) Impressed C~ent ( ) Sac~ci~ ~ode
( ) Polye~ylene Wra~ ( ) Elec~c~ Isolation ( ) V~ Wrap ( ) T~ or ~ph~t
( ) U~o~ ( ) None ( ) O~er (desc~be):
c.. Und~o~d Pip,g, Second~ Conta~ent:
( ) Double-W~ ~ S~efic L~er System ( ) None ( ) U~o~
() O~ (describe): . .
~'~IEkNK, ~ .. (F~I,L OUT SEPARATE FORIV]I![~R E t TANk~
FOR, ?2ACH SECTION, CHECK ~d, ~PROP~A~ BO~S
' H'. 1. Ta~ is: ( ) Vaulled ( ) Non-Vauhed
~ 2. Tank MateHa]
( ) Carbon Steal ( ) Stai~ess Steel ( ) Pol~yl Chloride ~ Fiberglass.Clad Steel
( ) Fiberglass-Reinforced Plastic ( ) Concrete ( ) Num~ ( ) Bronze ( ) Un~o~
() O~er (des~be)
3, prima~ Containment
Date Installed ~ic~ess Onches) Capaciw (Gallons) M~ufac~er
4. Tank Seconda~ Containment
~ Double-W~ ( ) S~efic L~er ( ) Lined VaSt ( ) None () U~o~
() O~er (des~be): ' Man~ac~4r:~$~
( ) Matefi~ ~~ 5 ~e[ ~ic~ess ~nches)
5. Tank lnte~or Lin~g /
() Rubber () ~kyd () Epo~ () Phenolic () Glass () Clay ~Unlined () U~o~
() O~er (des~be):
6. Tank Co~osion ~otecfio~
( ) G~v~ized ~ Fiberglass-Clad ( ) Polye~ene Wrap ( ) ~m~ Wrapp~g
() Tar or ~ph~t () U~o~ () None ( ) O~er (describe):
Cathodic Protection: ~ None ( ) Impressed C~ent System ( ) Sac~ci~ ~ode System
Describe S~tem ~d Equipment:
7. Leak Detection, Monitoring, and Interception
a. Ta~: () Visu~ (vaulted t~ o~y) ( ) Gro~dwater Monito~g Well(s)
( ) Vadose Zone Monito~g Well(s) ( ) U-Tube Wi~out L~er
( ) U-Tube ~ Compatible L~er D~ec~g Flow to Monito~g Well(s)'
( ) Vapor Detector* ~ Liquid ~vel Sensor* ( ) Conducfi~ Sensor*
~~ Sensor ~ ~n~ Space of Double W~I T~*
[) Liquid Re~ev~ & Inspection From U-Tube, Monito~g Well or ~ Space
( ) Daily Gau~g & Invento~ Reconciliation ( ) Periodic Tighmess Tes~g
) None () U~o~ () O~
b. PipNg: Flow-Res~c~ng Le~ Detector(s) for Press~zed Pip.g*:
( ) Monito~g Stop wi~ Raceway (). Se~ed Concrete Raceway
( ) H~-Cut Compatible Pipe ~ceway ( ) S~e~c ~er Raceway ( ) None
() U~o~() O~er
8. Ta~ Tighmess ~'tlb~
Has ~is T~ ~en Tighmess Tested? ( ) Yes ( ) No ( ) 'U~o~
Date of Last Tighmess Test Res~ of Test
Test N~e Tes~g Comply
9. Tank Reva~
T~ Repa~ed? { ) Yes ( ) No ( ) U~o~
Date(s) of RepaY(s)
Describe Repa~
10. ~e~l Protection
( ) Ope~tor F~, Consols, & Visu~ly Monito~ ~vel
( ) Tape ~oat Gauge ~ ~oat Vent V~ves ( ) Auto Shut-Off Consols
( ) Capacitmce Sensor ~ Sefled F~ Box ( ) None ( ) U~o~
) O~e~ List M~e & Model for ~ove De~ces
a. Under~o~d Pip,g: ~ Yes () No ( ) U~o~ Matefifl
~ic~ess (~ches) Di~eter
( ) Press~e ( ) Suc~on ( ) Gra~W Appro~ate Len~ of Pipe R,~
b. Under~o~d Pip~g Co~osion Protection:
( ) G~v~ized ~ Fiberglass-~ad ( ) Impressed C~ent ( ) Sac~ci~ ~ode
( ) Polye~ylene Wrap ( ) Elec~c~ Isolation ( ) V~ Wrap ( ) T~ or ~ph~t
( ) U~o~ ( ) None ( ) O~er (describe):
c. Und~o~d Pip,g, Second~ Conta~ent:
( ) Double-W~ ~ S~eflc L~er System ( ) None ( ) U~o~
() O~ (describe):
.... 'I'ANK"~, ~ (FILl. OUT SEPARATE FORM FOP, E~,,.I't TANK)
"-' ' FOR EACH SECTION, CI-IECK AI.I. APPROPI~.IATE BOXF. S
H. 1. Tank is: ( ) Vaulted ( ) Non-Vaulted ]~Double-Wall ( ) Single-Wall._
2. Tank Material
( ) Carbon Steel ( ) Stainless Steel ( ) Polyvinyl Chloride ~ Fib~r~lass-Clad Steel
( ) Fiberglass-Reinforced Plastic ( ) Concrete ( ) Aluminum ( ) Bronze ( ) Unknown
( ) Other (describe)
3. Primary Containment
Date Installed Thickness (Inches) Capacity (Gallons) Manufacturer
4. Tank Secondary Containment ~ ~o~m~' '
~ Double-Wall ( ) Synthetic Liner ( ) Lined Vault ( ) None ( ) ,Unknown
Other ,(de_scribe): Manufacturer: ~c~x k,k~d,~.~m,q
(()) Material I'.oot~Ot,.~.~ ~\ Thickness 0riches) ~Ofl~t' ~ L, Capacity (Gallons) t
5. Tank Interior l,inin~
() Rubber () Alkyd () Epoxy () Phenolic ()'Glass () Clay ~]gj~Unlined () Unknown
() Other, (deccribe):
6. Tank Corrosion Protection
( ) Galvanized ~ Fiberglass-Clad (~) Polyethylene Wrap () Vinyl Wrapping
( ) Tar or Asphalt ( ) Un. kno~/n ( ) None ( ) Other (describe):
Cathodic,Protection: ~ None ( ) Impressed Current System ( ) Sacrificial Anode System
Describe System and Equipment:
7. Leak Detection, Monitoring, and Interceptio.n.
a. Tank: ( ) Visual (vaulted tanks only) ( ) Groundwater Monitoring Well(s)
( ) Vadose Zone Monitoring Well(s) ( ) U-Tube Without Liner
( ) U-Tube with Compatible Liner Directing Flow to Monitoring Well(s)*
( ) Vapor Detector* ~Liquid Level Sensor* ( ) Conductivity Sensor*
I~l ~ Sensor in Annular Si, ace of Double Wall Tank* ~, [ l:~v.~ '~/~',5
( ) Liquid Retrieval & Inspection From U-Tube, Monitoring Well or Annular Space
( ) Daily Gauging & Inventory Reconciliation ( ) Periodic Tightness Testing
() None () Unknown () Other
b. Piping: ~ Flow-Restricting Leak Detector(s) for Pressurized Piping~ ,-'
( ) Monitoring Sump with Raceway ( ) Sealed Concrete Raceway
( ) Half-Cut Compatible Pipe Raceway ( ) Synthetic Liner Raceway ( ) None
( ) Unknown ( ) Other
· Describe Make & Model:Re~ Z~c~c.4' L~K, be..t.o.,~e ~t~to · 17
8. Tank Tightness C~'tlbtoexT. a -/"~-~ -'/"o~ ~;,~.r, 5~/s
Has This Tank.Been Tighmess Tested? ( ) Yes ( ) No ( ) Unknown
Date of Last Tightness Test Results of Test
Test Name Testing Company
9. Tank Repair
Tank Repaired7 ( ) Yes ( ) No ( ) Unknown
Date(s) of Repair(s)
Describe Repairs
lO. Overfill Protection
( ) Operator Fills, Controls, & Visually Monitors Level
( ) Tape Float Gauge ~ Float Vent Valves ( ) Auto Shut-Off Controls
( ) Capacitance Sensor-(~ Sealed Fill Box ( ) None ( ) Unknown
/~) Other: List Make & Mode~for ~Ab, ove Devices
11. Piping
a. Underground Piping: ~t~ Yes ( ) No ( ) Unknown Material
Thickness (inches) Diameter .2 ~t Manufacturer 0 ['/-
( ) Pressure ( ) Suction ( ) Gravity Approximate Length of Pipe Run
b. Underground Piping Corrosion Protection:
( ) Galvanized ~ Fiberglass-Clad ( ) Impressed Current ( ) Sacrificial Anode
( ) Polyethylene Wrap ( ) Electrical Isolation ( ) Vinyl Wrap ( ) Tar or Asphalt
( ) Unknown ( ) None ( ) Other (describe):
c. Underground Piping, Secondary Containment:
( ) Double-Wall '~ Synthetic Liner System ( ) None ( ) Unknown
( ) Other (describe):
0;3/3.0/90 T,,qVOffCa Nb:". 390 ;3
9:39 am KERN COUNTY PLANNING & L3EVELOPHENT
2700 '~' Stree'~
Bakersffie~d, CA 93301 Tyoe o¢ Orde¢ ~
CASH REGISTER BSSR INC.
' ?ERMi~ TO CONSTRUCT PER FACIi '¢~ ~ - -
- _IT,¢ , 350 00 E 350 00
170A
Order Total 350.00
Amount Due 350.00
Check 350.00
FINAL INSPECTION CIIEC~I~T
,
Plot Diagram
Plot plan notes
Yes No
1. All new and existing'tanks located on plot plan7 J~J JZJ
2. Do'es tank product correspond to product labels on J~J J~J
plot plan7
3. Was there no modifications identified which were J~J J~j
not depicted on the plot plans?
If "No"described
4. Are monitoring wells secure and free of water and I~I I~l
product in sump?
5. Ia piping system pressure, suction or gravity?·
Yes No
6. Are Red Jacket subpumps and all line lea det for. I~1 I~1
accessible7
Type of llne leak detector If any
Overfill containment box as specified on :.~pl£cation? IZl IZl
If "No", what type and ~odel number:
a) Is fill box tightly sealed around fill tube?
b) Is access over water tight7 ]Z[ ]Z]
c) Ia product present in fill box7 I~1
8. Identify type of eonltoring:
a) Are manual monitoring Instruments, product and
water finding paste on premises7
b) Is the fluid level in Owens-Corning liquid level
eonltorlng reservoir and alarm panel in.proper
operating condition?
c) Does the annular space or secondary containment
liner leak detection system have self diagnostic
capabilities?
If "Yea", la it functional
If "No", how is it tested for proper operating
condition?
9. Notes on any abnormal' conditions:
Standard Compliance Check
Equipment to be installed:
Tank(s), Ft. of [-]Suction [-]Pressurized ~]Oravity, Plpin
Req'd Approved
Proof of Contractor's License - License #
Type of License
Proof of Contractor's Worker's Compensation Insurance
Primary Containment
~Ftberglass (FRP) Make & Model
l-]Fiberglass-clad steel Make & Model
[-]Uncoated steel Make & Model
[-]Other: Make & Model
Comment:
Additional:
Inspection:
Secondary Containment of Tank(s)
~]Double-walled tank(s) Make & Model
[]Synthetic liner Make & Model
[~Llned concrete vault(s) Sealer used
[~Other Type Make & Model
Comment:
Additional:
Inspection:
Secondary Containment .Volume at Least 100% of Primary Tank
Volume(s)
Comment:
Additional:
Inspection:
Secondary Containment Volume for More Than One Tank
Contains 150~ of Volume of Largest Primary Containment or
10~ of Aggregate Primary Volume, Whichever is Greater
Comment:
Additional
Inspection:
'Req'd Approved
Secondary Containment Open to Rainfall 'Must A~commodate
Hour Rainfall Total Volume Comment:
Additional:
I~spectton:
Secondary Containment is Product-Compatlble
Product Documentation
Comment:
Additional:
Inspection:
Annular Space Liquid is Compatible with Product
Product Annular liquid
Comment:
Additional:
Inspection:
Prlmary Containment of Piping
F~Flberglass piping Size & Make
~]Coated steel piping Size & Make
[~Uncoated steel piping Size
F-]Other
Comment:
Additional:
Inspection:
Secondary Containment of. Piping
[-]Double-walled pipe Size & Make
[~Synthetic liner In trench Size & Make
~'lOther
Comment:
Additional:
Inspection:
Corrosion Protection
[~]rank(s)
[~]Piplng & fittings
~]Electrtcal 'Isolation
Comment:
Additional:
Inspection:
Manufacturer-Approved Backfill for Tanks & Piping
Type Comment:
'Req'd Approved
Additional:
Inspection:
Tank(s) Located no Closer than 10 Feet to Building(s)
Comment:
Additional:
Inspection:
Complete Monitoring System
Monitoring device within secondary containment:
[~Llqutd level indicator(s)
~]Llquid used
[]Thermal conductivity sensor(s)
~-JPressure sensor(s)
[~]Vacuum gauge
l-lSu.p(s)
IGas or vapor detector(s)
Manua! inspection & sampling
Visual inspection
Other
Comment:
Additional:
Inspection:
Other Monitoring
~]Perlodlc tightness testing Method
[~Pressure-reducing line leak detector(s)
[~Other
Comment:
Additional:
Inspection:
Overfill Protection
[']Tape float gauge(s)
~']Float vent valve(s)
~]Capacitance sensor(s)
[~H'lgh level alarm(s)
[~Automattc shut-off control(s)
~]Ftll box(es) with,1 ft. 3 volume
[-]'Operator controls with visual level monitoring
Other
Comment:
Req'd Approved
Additional:
Inspection:
~onltorlng Requtreeents
AddltIo, na] Connents
Inspection:
Inspector Date
- 4 o
Extra [nspect~ons/Reinspecttons/Consu]tations
Date:
Purpose:
?
Comment:
Time Utlllzed
Date:
Purpose:
Comment:
Time Utl]lzed
Date:
Purpose:
Comment:
Time 'UtiJtzed
Date:
Purpose:
Comment:
Time Utilized
Invoice Date: Total Time:
Inspector Date:
R~r.~DALL L. ABBOTT 2700 M Street, Suite 300
Agency Director Bakersfield, CA 93301
(805) 861-3502 Telephone (805) 861-3636
Telecopier (805) 861-3429
STEVE Mc CALLEY
Director RESOURCE MANAGEMENT AGENCY
DEPARTMENT OF ENVIRONMENTAL
HEALTH SERVICES
September 13, 1990
BSSR, Inc.
1230 So. Union Avenue
Bakersfield, CA 93307
RE: Mr. Fast
Underground Storage Tanks
Gentlemen:
Before a construction permit can be issued to install underground storage
tank(s), the application must be reviewed and approved.
As states on the instruction sheet, the county must have on file an
contractor information as listed before the permit application can be processed.
Please submit the necessary information as soon as possible in order that a
construction permit can be issued for the new facility (Mr. Fast), at 4840 Brundage
Lane, Bakersfield.
If there are any additional questions please feel free to call at (805) 861-
3636, extension 566.
Sincerely,
Hazardous Materials Specialist
Hazardous Materials Management Program
MD:cas
cc: Sun Valley Oil Company
\mr-fast. 1 tr
GARY J. WICKS 2700 M Street, Suite
Agenc'y Director Blkerlfleld, CA 93301
Telephor~e (805) 861-3~3~
(805) 861-3502 '""~" :";" .... Telecopler (805) 881-342~
STE~E McCALLEY ,;. -_.
O'r,:,o, R.ESO U RC E ~~~'.ENT AG EN CY
December 28, 1989
TO: All contractors involved with Underground Tank (U.T.) Construction or
Modification of an existing facility
FROM: Hazardous Materials Management Program (HMMP)
RE: Application for U.T. Construction/Modification
In order to expedite permit processing, before submitting your permit
application(s) for construction, check to see that all of the following are
addressed:
1. Applications must be fully completed or they will be returned, no
exceptions. The use of the answer "NA" (not applicable) is
unacceptable.
2. Permit fee(s) must be submitted with the application or it will be
returned.
3. Contractors must have current copies of'the following information on
file with this program:
A. Current pocket copy with expiration date clearly noted of one
of the following contractors license:
General A, C-61, & D-40,.C-36,
0 General B with restrictions.
B. Current copy of Certificate of Workers Compensation and liability
insurances.
C. Current copy of Cai-OSHA trench permit.
D. Site safety plans.
4. One tank sheet must be completed per tank and .all specific types of
equipment (i.e. tank, piping, monitoring systems) that will be used must
be noted with appropriate model numbers.
5. Provide 2 sets of a plot plan for the facility. This plan must include
location of property lines, all buildings and openings to each building
(such as windows, doors, vents, etc,) nearest road or'intersection, all
tanks, piping, any fixed source of ignition (i.e. water heaters, forced air
AC units, etc) all equipment to be installed, any source of water
infiltration, scale, north arrow, and a minimum of 100' radius around
all equipment. The minimum acceptable scale is 1" = 16'.
6. Provide 2 sets of site specific detailed drawings of proposed
construction. These drawings must show side and top views of tanks,
piping, secondary containment, leak detection and monitoring equipment,
overfill protection and all other equipment required. All equipment
must be clearly labeled. The minimum acceptable scale is 1" = 10'.
7. Certification by manufacture(s) of compatibility of tank(s), piping and
secondary containment materials with proposed stored hazardous
substances.
8. Information on chemical composition of stored product(s) if other than
motor vehicle fuels.
9. Completed applications received at the Public Services Counter are
routed through all necessary county departments for approval prior to
Environmental Health (HMMP) review. This may include Fire, APCD,
Building, etc. Environmental Health has no control over the amount
of times these reviews may take, however, once it is received by the
HMMP, it is our policy to endeavor to process completed applications
in no more than five (5) working days.
10. Make application to the Air Pollution Control District for any storage
tanks which will contain gasoline or aviation grade gasoline.
DS:cd
starkey\ut.con
Permit Application Checklist
Facility Name i ~,2
Facility Address ~ L~ l~'~l-3f~-,a k,'~
Application Category:
~K~_Standard Design Motor Vehicle Fuel Exemption Design
(Secondary Containment) -- (Non-Secondary Containment)
Approved ~
Permit Application Form Properly Cqmpl~ ' ,
Deficiencies:
Copies of Plot Plan Depicting:
Area encompassed''bY 'minimum 100 foot radius around tank(s) and
piping
All tank(s) ide~tffied by a number and product to be stored __
Adequate scale (minimum 1"=16'0" in detail)
North arrow
All structures within 50 foot radius of tank(s) ~nd ~iping
Location and labeling of all product piping and dispenser
islands
Environmental sensitivity data including:
*Depth to first groundwater at site
*Any domestic or agricultural water well within 100 feet of
tank(s) and piping
*Any surface water in unlined conveyance within 100 feet of tank(s) and piping
*All utility lines within 25 feet of tank(s) and piping
(telephone, electrical, water, sewage, gas, leach lines,
seepage pits, drainage systems)
*Asterisked items: appropriate documentation if permittee
seeks a motor vehicle fuel exemption"'~rom secondary
containment
Comments:
Approve~ ~
~'Co. pies of Construction Drawings Depicting:
-- - of Tank Ins~ail'atiOn 'wfth Ba6kfill, Raceway(s),
~ Side View
Secondary Containment and/or Leak Monitoring SYstem in Place
Top View'of Tank Inst~lla~io~' with Raceway(s), Secondary
Containment and/or Leak Monitoring System in Place
A Materials List (indicating those used in the construction):
-- Backfill -~_~..j ~
Tank(s) ~,~%_.~,) .~-~"b~. -~ 6~
Product Piping ~.. c,,~a--
Raceway(s) ~ I k ~,'
Secondary Containment
Lea~ Detector(s)
Overf'i'll 'Protectio-n
Gas or VaPor DetectOr(s)
~6nitoring 'Well(s) .
Addi't ional:
Documentation of Product Performance
Additional Comments
Reviewed By Date
SITE INSPECTION: Approved Disapproved
' C'o'mments:
Inspector Date
RANDALL L. ABBOTT 2700 M Street, Suite 300
Agency Director Bakersfield, CA 93301
(805) 861-3502 Telephone (805) 861-3636
Telecopier (805) 861-3429
STEVE Mc CALLEY
Director RESOURCE MANAGEMENT' AGENCY
DEPARTMENT OF ENVIRONMENTAL
HEALTH SERVICES
PERMIT TO CONSTRUCT PERMIT NUMBER 230047B
UNDERGROUND
STORAGE FACILITY
FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR:
Mr. Fast Sun Valley Oil Company BSSR, Inc.
4840 Brundage Lane 3940 Rosedale Hwy. 1230 S. Union
Bakersfield, CA Bakersfield, CA 93308 Bakersfield, CA 93307
License # 562900
Phone No. 805-327-7212 Phone No. 805-327-4659
X NEW BUSINESS PERMIT EXPIRES December 28t 1990
CHANGE OWNERSHIP
RENEWAL APPROVAL DATE September 28 t 1990
OTHER APPROVED BY ~ %~. ~
M'~cb:ael' D~£g'gs - [lU
Hazardous Material~'Specialist
........................................................................... POST ON PREMISES ............................................................................
CONDITIONS AS FOLLOW:
Standard Instructions
1. All construction to be as per facility plans approved by this department and verified hy inspection by
Permitting Authority.·
2. All equipment and materials in this construction must be installed in accordance with all manufacturers'
specifications.
3. Permittee must contact Permitting Authority for on-site inspection(s) with 48-hour advance notice.
4. Backfill material for piping and tanks to be as per manufacturers' specifications.
5. Float vent valves are required on vent/vapor lines of underground tanks to prevent overfilling.
6. Construction inspection record card is included with permit given to Permittee. This card must be posted
at.job site prior, to initial inspection. Permittee must contact Permitting Authority and arrange for each
group of required inspections numbered as per instructions on card. Generally, inspections will be made
of:
a. Tank and backfill
b. Piping system with secondary containment
leak interception/raceway
c. Overfill protection and leak detection/monitoring
d. Any other inspection deemed necessary by Permitting Authority.
Standard Instructions Permit No. 230047B
7. All' underground metal connections (e.g. piping, fitting, fill pipes) to tank(s) must be electrically isolated
and wrapped to a minimum 20 mil thickness with corrosionTpreventive, gasoline-resistant tape or otherwise
protected from corrosion.
8. Spark testing (35,000 volts) required at site prior to installation of tank(s). Test(s) must be certified by
the manufacturer and a copy of test certification supplied to the Permitting Authority.
9. The following equipment and materials must be identified by manufacturer and model prior to their
installation:
a. Sealer used to secure fill box(es)
10. No product shall be stored in tank(s) until approval is granted by the Permitting Authority.
11. Liner shall be installed by a trained experience liner contractor and installation at site approved by the
Permitting Authority.
12. Monitoring requirements for this facility will be described on final "Permit to Operate."
13. Monitoring wells on "Typical Drawings" are not allowed unless monitoring probes are installed and
functioning. Construction must be in accordance with Hazardous Materials Management Program standards
as per UT-50.
/
MD:ch
driggs\230047B.ptc
RANDALL [. ABBOTI 2700 M Street, Suite 300
Agency Director Bakersfield, CA 93301
(805) 861-3502 Telephone (805) 861-3636
~ Telecopier (805) 861-3429
STEVE Mc CALLEY
Director RESOURCE MANAGEMENT AGENCY
DEPARTMENT OF ENVIRONMENTAL
HEALTH SERVICES
PERMIT TO CONSTRUCT PERMIT NUMBER 230047B
UNDERGROUND
STORAGE FACILITY
FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR:
Mr. Fast Sun Valley Oil Company BSSR, Inc.
4840 Brundage Lane 3940 Rosedale Hwy. 1230 S. Union
Bakersfield, CA Bakersfield, CA 93308 Bakersfield, CA 93307
License # 562900
Phone No. 805-327-7212 Phone No. 805-327-4659
X NEW BUSINESS PERMIT EXPIRES December 28/ 1990
CHANGE OWNERSHIP
RENEWAL APPROVAL DATE September 28, 1990
.¢
OTHER APPROVED BY ~ ~. ~
M'{ch'ael' b~ig'gs - [1~.
Hazardous Material~ Specialist
........................................................................... POST ON PREMISES .................... ~ .......................................................
CONDITIONS AS FOLLOW:
Standard Instructions
1. All construction to be as per facility plans approved by this department and verified by inspection by
Permitting Authority.
2. All equipment and materials in this construction must be installed in accordance with all manufacturers'
specifications.
3. Permittee must contact Permitting Authority for on-site inspection(s) with 48-hour advance notice.
4. Backfill material for piping and tanks to be as per manufacturers' specifications.
5. Float vent valves are required on vent/vapor lines of underground tanks-to prevent overfilling.
6. Construction inspection record card is included with permit given to Permittee. This card must be posted
at job site prior to initial inspbction. Permittee must contact Permitting Authority and arrange for each
group of required inspections numbered as per instructions on card. Generally, inspections will be made
of:
a. Tank and bac'kfill
b. Piping system with secondary containment
leak interception/raceway
c. Overfill protection and leak detection/monitoring
d. Any other inspection deemed necessary by Permitting Authority.
Standard Instructions Permit No. 230047B
7. All underground metal connections (e.g. piping, fitting, fill pipes) to tank(s) must be electrically isolated
and wrapped to a minimum 20 mil thickness with corrosion-preventive, gasoline-resistant tape or otherwise
protected from corrosion.
8. Spark testing (35,000 volts).required at site prior to installation of tank(s). Test(s) must be certified by
the manufacturer and a copy of test certification supplied to the Permitting Authority.
9. The following equipment and materials must be identified by manufacturer and model prior to thei~
installation:
a. Sealer used to secure fill box(es)
10. No product shall be stored in rank(s) until approval is granted by the Permitting Authority.
11. Liner shall be installed by a trained experience liner contractor and installation at site approved by the
Permitting Authority.
12. Monitoring requirements for this facility will be described on final "Permit to Operate.~
13. Monitoring wells on NTypical Drawings~ are not allowed unless monitoring probes are installed and
functioning. Construction must be in accordance with Hazardous Materials Management Program standards
as per UT-50.
MD:ch
driggs\230047B.ptc
aLRN COUNTY HEALTH DEPARTMENT 1700 FLOWER STREET
ENVIRONMENTAL HEALTH DWSION BAKERSFIELD. CA 93305
HAZARL£~S SUBSTANCES SEETION PHONE (805) 881-3636
INSPECTION RECORD.
POST CARD AT 30BSITE
FACILITY~ / ~ PERMIT · OWNER
INSTRUeTIONfi: Please call for an inspector only when each ~roup of inspections
~ith the same number are ready. They ~ill run in oonseeutive order ~esinnin~
~ith number 1. DO NOT cover ~ork for any numbered ~roup until all
that group are signed off by the. Permitting Authority. Following these
instrutions ~ill reduce the nuaber of required inspection visits' and therefore
prevent assessment of additional fees.
- T~KS & BACKFILL -
INSPECTION DATE INSPECTOR
] ~Backfill of Tank(s)
:Spark Test Certification
~Cathodic Protection of Tank(s) ..
- PIPING SYSTE~ -
~ Piping & Race~ay w/Collection Suap
~Corrosion Protection of Piping, Joints, Fill Pipe
Electrical Isolation of Piping Froa Tank(s)
Cathodic Protection System-Piping
- SBCON~ARY CON?A/~BN?, OVERFILL PROTECTION. LE~ DETECTION -
Line~,insta~]~o~ -T~nk(s) ....
Vault W~th P~oduc~ Compatible Seale~
~ Level Gau~es or Senso~s~loat Vent
L~oduct Compatible F~ll ,Box(es)
~ P~oduct Llne Leak Detector(s) .,
'Leak Detector(s) fo~ Annula~ Space-D.W. ?ank(s)
~ Monitoring Well(s)/Sump(s)
~Leak Detection Device(s) For Vadose/6roundwater
- FINAL -
Monitoring Wells, Caps & Locks~}.~)~5~
Fill Box Lock '
Monitoring Requirements ~A/~'/~CJ~&~,~ 95
e.e /c_ &4sFe q,.
KERN COUNTY HEALTH 1700 FLOWER STREET
ENVIRONMENTAL HEALTH DIVISION BAKERSFIELD, CA 93305
HAZARDOUS SUBSTANCES SECTION PHONE (805) 861-3636
INSPECTION RECORD
POST CARD AT JOBSITE
FACILITY PERMIT # I (I~NER
ADDR ESS I ADDRESS
CITY I CITY
PHONE NO. ',PHONE NO.
INSTRUCTIONS: Please call for an inspector only when each group of inspections with the same
number are ready. They will run in consecutive order beginning 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 & BACKFILL -
INSPECTION DATE INSPECTOR
IBackfill of Tank(s) ~-~ ~ .~-~ f~c~_ ~ ,.?.~.~-~ ~7
~Spark Test Certification-~,~ ~ ~ ',
',Cathodic Protection of Tank(s) ~ ~ ~ ~e.~ ~
~Corrosion Protection of Piping, Joints, Fill ~ipel~~'
',Electrical Isolation of Pipin~ From Tank(s)-~~ ,
~Cathodic Protection Syste~Pipin~ , ,
- SECONDARY CONTAIN~NT, OVERFILL PROTECTIONs, LEAK DETECTION -
~Liner Installation - Tank(s)~ ~~ , ,
;Liner Installation - Piping-- ~r,~ ~
'~Vmult ~fith Product Compatible Sealer
;Level Gauges or Sensors, Elo~.~ V~~- ~e~
;Product Compatible Fill Box(es) ~.~.~ ~
;Product Line Leak Detector(s) ' ~ ~.
~Leak Detector(s) for Annular Spac~D.W. Tank(s)
;Monitoring Well(s)/Sump(s) ~ w-~.7.~'-~ ~w-~.
',Lemk Detection Device(s) For Vadose/Groundwater
~PVC Sleeve Pipin~
~Leak Detector(s)-- ~..~f ~ .~ ~r.r~W~
~KMonitorin~ Wells]' Caps & Locks ~ ~~
Monitorin~ Requirements -~-~/:~ ~.. ~ -~ ~
I
CONTRACTOR LICENSE #
CONTACT PH #