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Home My WebLink AboutUST-PROPAIN EXCHANGE PROG. 12/12/2003· Complete items 1, 2, and 3. Also complete ~Agent item 4 if Restricted Delivery is desired. ~l Addressee · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. D. Is deliver~ from Item 17 1. Article Addressed to: If YES, enter delivery address below: ~NO Johnny's Food Mart 2612 Buck Owens Blvd. a. Bakersfield, CA 93308 I~.Certmed M~ [] F_xpmss [] Registered [] Return Reoelpt for Merchandise ,_ [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 2. ArtlcleNumber 7003 2260 0004 7652 3119 (rransfer fram ~en,/ce/abe~ ,: PS Form 381 1, August 2001 Domestic Return ReCeipt ~o2595-o24~-!s4o S*^TES POST^L S~RV,C I .... I First-Class Mail Sender: Please prin~~ddress, and ZIP+4 in this box · Bakersfield Fire Department Prevention Services 171,5 Chester Avenue, Suite 300 Bakersfield, CA 93301 ,..a ["~" Postage $ Certified Fee Postmark Return Reciept Fee Here (Endorsement Required) E~ Restricted Delivery Fee _n (Endorsement Required) ~ Total Po~ mm ~ i Johnny's Food Mart ~ t~'~'~;ti 2612 Buck Owens Blvd. or PO Box ~ . [~-~-! Bakersfield, CA 93308 December 12, 2003 CERTIFIED MAIL Johnny's Food Mart 2612 Buck Owens Blvd. Bakersfield, CA 93308 RE: Propane Exchange Program FIRE CHIEF RON FRAZE Dear Owner/Operator: ADM~"ISVRAT~VESERVlCES The purpose of this letter is to advise you of current code requirements for 2101 "H" Slreel Bakersfield, CA 93301 propane exchange systems, such as "Blue Rhino" or "Amerigas." This does not VOICE (661)326-3941 FAX (661)395-1349 , apply to large propane tanks, only propane exchange systems. SUPPRESSION SERVICES Over the past two years this office has noted a dramatic increase in the propane 2101 "H" Street Bakersfield, CA 93301 exchange system in the city of Bakersfield. It has also been noted, with great VOICE (661) 326-3941 FAX(661)395-1349 concern, that many of these installations are a clear violation of the UFC (Uniform Fire Code) and represent a danger to public health and safety. PREVENTION SERVICES FIRE SAFET~ SER1RCES · ENVIROI~IE~TAL SERVICES 1715 ChesterAve. Accordingly, procedures for storage of propane cylinders awaiting use, resale or Bakersfield, CA 93301 VOICE (661)326-3979 exchange, have been adopted through BMC (Bakersfield Municipal Code) and FAX (661)326-0576 adoption of the 2001 UFC. The procedures are as follows: PUBLIC EDUCATION 1715 ChesterAve. Storage outside of building for propane cylinders (1,000 pounds Bakersfield, CA 93301 VOICE (661) 326-3696 or less) awaiting use, re-sale, or part of a cylinder exchange point FAX (661)326-0576 shall be located at least 10 feet from any doorways or openings in FIRE INVESTIGATION a building frequented by the public, or property line that can be 1715 ChesterAve. built upon, and 20 feet from any automotive service station fuel Bakersfield, CA 93301 VOICE (661)326-3951 dispenser. (Note distance from doorways increases when FAX (661)326-0576 cylinders are over 1,000 pounds cumulatively.) TRAINING DIVISION 5642 Victor Ave. Cylinders in storage shall be located in a manner which Bakersfield, CA 93308 vOiCE (661)399-4697 minimizes exposure to excessive temperature risc, physical FAX (661)399-5763 damage or tampering (Section 8212, California Fire Code, 2001 Edition). When exposed to probable vehicular damage due to proximity to alleys, driveways or parking areas, protective crash posts will be required as follows (Section 8001.11.3 and 8210, California Fire Code, 2001 Edition): 1) Constructed of steel, not less than 4 inches in diameter, and concrete filled. 2) Spaced not more than 4 feet between posts, on center. h Lett¢ Owner/Operators of Propane Exc ange Systems Re: Propane Exchange Program Dated: December 12, 2003 Page 2 of 2 3) Set not less than 3 feet deep in a concrete footing of not less than a 15 inch diameter. 4) Set with the top of the posts not less than 3 feet aboveground. 5) Located not less than 5 feet from the cylinder storage area. Exceptions: Cylinders storage areas located on a sidewalk which is elevated not less than 6 inches above the alley, driveway or parking area, with not less than 10 feet of separation between the curb and the cylinder storage area.' "No Smoking" signs shall be posted and clearly visible (Section 8208, California Fire Code, 2001 Edition). Resale and exchange facilities must be under permit to verify compliance. All existing facilities will be checked and when compliance is confirmed, a permit will be issued. All new propane exchange systems must be permitted prior to installation. You will have 90 days (March 4, 2004) to comply with the procedures outlined. Once compliance has been confirmed, each exchange system will be issued a permit, which will be placed on the exchange system. Sites not conforming to current code, will be "red tagged" and must be taken out of service immediately. You should contact your Blue Rhino representative, Mr. Taylor Noland, or your local Amerigas representative. They are aware of current code requirements. If you do not have a propane exchange system, please disregard this letter. Should you have any questions, please feel free to contact me at (661) 326-3190. Sincerely, Steve Underwood Fire Inspector/Petroleum/ · Environmental Code Enforcement Officer ~='~Complete items 1,2, and 3. Also complete item 4 if Restricted Delivery is desired. ~'~Agent · Print your name and address on the reverse I-I Addressee SO that we can return the card to you. B. Received b' ' · Attach this card to the back of the mailpiece, or on the front if space permits. ,.'-.'~' D. Is delivery address item 1. Artic!e Addressed to: ;" If YES, enter delivery address JOI~NYS FOOD M~T 2612 BUCK OWENS BLVD. Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise ~ . [] Insured Mail [] C.O.D. ,, 4. Restricted Delivery? (Extra Fee) [] Yes 2. Article Number [ 7002 '1150 0004 9985 4995 f'i'ransfer from service label) I "~ " PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-154C ,.'/.~- ~ I Postacm. & Fees Paid I _~.'~F.~.'~/~~,.4 usP~'F.~%~,,~ I Sender: Please print y ess, and ZIP+4~lmtEisLbox~.~- Bakersfield Fire Department Prevention Services 1715 Chester Avenue, Suite 300 Bakersfield, CA 93301 r-~ Certified Fee I Postmark ~ Retum Reclept Fee I (Endorsement Required) I Here r-'l Restxl,~l Deliver/Fee I ICl (Endorsement R~:lulred) [ Total Post~ge' j JOHNNY'S FOOD MART ~J ISentro : 2612 BUCK OWENS BLVD I B ' ~- [~ir~£'~'t'~:i AKERSFIELD, CA 93308 ' Nov6mber 4, 2003 ' ~ CERTIFIED MAIL ..... -fo--hnny's Food Mart ) ~ ~:::261-2:Buck Owefis'Blv'dY-~,. :. Bakersfield,-GA~:93308 FIRE CHIEF ,;.ON FRAZE NOTICE OF VIOLATION ADMINISTRATIVE SERVICES I~ SCHEDULE FOR COMPLIANCE 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 Dear Sir or Madam, FAX (661) 395-1349 SUPPRESSION SERWCES Our records indicate that your annual maintenance certificatiOn on your leak 2101 "H' Street detection system was past due 10-11-03. Bakersfield, CA 93301 VOICE.(661) 326-3941 ~ FAX"(;~I) 395-1349 You are currently in violation of Section 2641(J) of the California Code of PREVENTION SERVICES Regulations. FIRE SAFETY SERVICES · EI*~IRONMEHTAL SERVICES 1715 Chester Ave. Bakotsfield,(gA 93301 "Equipment and devices used to monitor underground storage tanks shall be VOICE (661) 326-3979 FAX (661)326-0576 installed, calibrated, operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks at least once per PUBLIC1715 ChesterEDUCATIONAv~. calendar year for operability and running condition." Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661)326-0576 You are hereby notified that you have fifteen (15) days, November 19, 2003, to either perform or submit your annual certification to this office. Failure to FIRE1711NVESTIGATION5 Chester Ave.comply will result in revocation of your permit to operate your underground Bakersfield, CA 93301 storage system. VOICE (661) 326-3951 FAX (661) 326-0576 Should you have any questions, please fee] free to contact me at 661-326-3190. TRAINING DIVISION 5642 Vlctor Ave: Bakersfield, CA 93308 Sincerely yours, VOICE (661) 399-4697 FAX (661) 399-5763 Ralph E. Huey Director of Prevention Services By: ~~~ Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/db CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST !'715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME x~O~m~'~ ~'OOd ~lx'Jf INSPECTION DATE / 0 ~9~ 'O3 ! Section 2: Underground Storage Tanks Program [~ Routine [~ Combined ~[ Joint Agency [~ Multi-Agency [~] Complaint I~1 Re-inspection Type of Tank I~Off- Number of Tanks Type of Monitoring ,*t_~ Type of Piping OPERATION C V COMMENTS Proper tank data on file ~ /' Proper owner/operator data on file k,~/ Penn t fees current ~ / Certification of Financial Respousibility Monitoring record adequate and current Maintenance records adequate and current 4 0/~ ~'0~ 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/overspilt protection? C:Comp' iancf dV=V it, ,ation Y:Yes N=NO Inspector: =_ _ _ Office of Environmental Services (661) 326-3979 Business S le Party White - Env. Svcs.. Pink - Business Copy ' ~ Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION CHECKLIST I Enironmental Services '"' "'" ' ' ...... 1715 Chester Ave SECTION 1 Business'Plan and Inventory Program Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME I INSPECTION DATE I INSPECTION TIME FACILITYCONTACT ]Business ID Num~' / 15-021- ' : Section 1' Business Plan and Inven~ P~mm ~ Routine ~ Combin~ ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection C V /c=co~.,~el OPE~TION COMMENTS ~ V=Violation ~PPROPRIATE PERMIT ON HAND CORRECT OCCUPANCY OF QUANTITIES VERIFICATION OF ABATEMENT SUPPLIES ANO PROCEOUEES CONI~INERS PROPERLY ~BELED HOUSEKEE~NS ANY HAZARDOUS wASTE ON SITE?: l"1 YES (;~,No EXPLAIN: Inspector Badge No.. ' .............. White - Environmental Sen/ices Yellow - Station Copy Pink. Business Copy ½,-'or Use B'v AI/ Jurixdio[ions l;?irhin the State of Cal~ornio _.i~, ~5orirv C'//eo': Ohcipwr ~. 7, ~eo/th onc~ Sc~kO, Code; Ohop[er ] < Divis/o, 3, Title 23, Col~btwict Code oj'Reg,l,fions ~¥r~ t'nCtsc be used to doem~enr tesrkqg mxd servicing of monitoring equipment. ~ separate emxificafion or repo~x mus~ be~r~pm-ed mom~-m'tn~ system conn'ol pan~! by fi~e rectmieian who pertbrms the work. A copy of this lbrm must be provided ~o the tank own~r.;'operz,~or. The owner/operaroc must submit a copy o~' d~is form m the local agency regulating UST systems wit-bin 30 Conmc~ Person: Contact Phone No.: M:~k,:c:.r,,iodel o(Monirot'ing System: ./~d~ ~-/~ Dare ofTesth~g/Servicing: /W/ f Eq ip -' ~nvcntocy o u ment ~ested/Cerni~ed .k. ?~:.. ~J*~.:?J~5~[~'(a_ [~. ~o5S~ r~_indicare~pecific~le~A in_~e~[~fl~serviqe~t:__- i:,~i,, daugi,g Probe. Model: /~ ~ ln-Tm~k Gauging Probe. Modek /~~ .... :.L[mu[m' Space ct' Vault Seusor. Model: ~ ~nulm' Space or Vaul~ Sensor. Model: %ulnp: Trench Sensor(s). Model: ]~~ ~ Piping Sump / Trench Sensor(s). Model: 5tmlp Sensor(s). Model: ~ Fill Sump Sensor(s). · Model: t,:chmficat Line i_e~c Detector. Model: ~ff~~~ ~ Mech~ical Line Le~c Detector. Model: !..i,:-c'[romc Linc Le~& Detector. Model: ~ Electronic Line Le~ Detector. Model: (5,,.crr~!t/High-Level Sensor. Model: ~ Tm~k Overfill /hUgh-Level Sensm'. Model: kzpecif,,, equi >menr l)'pe m~d model in Section E on Page 2). ~ Other (specie, equipment type and model in Section E on PaCe 2~. ~O / Tank ID: P,,u} G}~t~:;~n~'3}o~e. Model: /~~ D ln-T~k Gauging Probe. Model: . ~!]tLiILtF SQfiGe or Vault Sensor. Model: ~ .~nular Space or Vault Sensor. Model: ..... Sump ,' Trench Sensot(s). Model: ~~ ~ Piping Sump / Trench Sensor(s). Model: ..... 5[mlp Sensorts). Model: ~ Fill Sump Sensor(s). Model: ~c,.-~c~ic~d Linc Le~ Detector, Model: .~ ~ Mechanical Line Leak Detector. Model: ~ t:.x:cr~c:nic Line Lc=~< Detector. Model: ~ Electronic Line Le~ Detector. Model: C,x erfilJ / High-Level Sensor. Model: ~ T~k Overfill / Hi~-Level Sensor. Model: ,,hSeL_~.s12%_i?E~EiE0~e:nj~Tpe ~md rno0el in Secrioa ~__pn Page 2). ~ Other (speci(v equipment u, pe ~d model in Secl.ipp g o~?~%~) . ID; _./~ X Dispenser ID: ~ ~ l)ispe~sc: Containment Sensor(s). Model: ~ Dispenser Containment Sensor(s). Model: X. ah'cks). ~ She~ Valve(s). " ()i::.p¢z~serS~qF)_t?~?x~Ef~loat(s) ~ld Chain(s). ~ Dispenser Containment FloaKs) and Chain(s), .Oi?cnser Containment Sensot(s). Model: ~ ~ispenserConrainmenrSensor(s), Model; Di~?S(~s~[ ~)~tFi_~J~5'm Float(s) mid Chain(s). D Dispenser Containment Float(s) and Chain(s), rD: Dispenser ID: DL~i)e~t~er Comainrnenr Sensor(s). Model: ~ Dispenser Containment Sensor(s). Model: V :dyers). ~ Shem-Valve(s). ~L)~=:.',on.sor: .................. Cont~immenr Flour(s) ~d Chain(s). ~ Dispenser Containment Float(s) ~d Chain(sS. ~ihc'Sfit> coma/ns more rm~ks or dispensers, copy rl~is form. Include information for every t~k ~d dispenser ar the ~aeiliD'. C:errii'icarion - I certify that the equipment identified in this document was inspected/serviced in accordance wiih the manufacn,'ers' gt~idelines. Attached [o this Certification is inlbrmnrion (e.g. manufacturers' checklists) necessary to veril~ that this information c ~' ,' ' ' ' "g 'Y' ' - ' "g q 'p . . ' '' y equipment capable of generating sucb repot*s, I have :ittached a copy of the report; (check all ttsu[ appOQ: ~System set-up '~arm his[orr report CompmxvNmne:. . RICH ENVZRONNENTAL PhoneNo.:(66t _). 392-8687 Si~c-:tJd:css:._a&.~ 6OC, E o',~ff~ g 6V~_ Date ofTestbg/Servicing:__~/~X/~' Page l of 3 03/0t ~.i ~.~'z.i:',~-i:~,g S')'stcm Certification ,3i' Testing/Servicing ~'ollow ing checklist: No¥ Is the audible alarm operational? No¥ Is the visual atarm operariona[? ~'bio· ~¥ere all sensors visually hxspected, ftmcdonatly tested, m~d conI~nned operational? No¥ Were ali sensors ~sralled at [owes~ point of secondary conrai~en~ ~d positioned so that other equipment will"' nor interfere with their proper' operation? No"' if alarms ~e relayed to a remote monitorh~g station, is ail conm~unications equipment (e.g. modem) N,:A operational? No`~ For ptessmSzed piping systems, does the turbine atttomafica[ly shut down if the piping secondary cotttaim'nent 'N/A moni[oring system detects a teak, t~ails to operate, or is electrically discomxected? if yes: which sensors h-xitia~'e positive shut-down'? ('Check? rtll r)tr~r c~ppl3~ ~ Sump/Trench Bensors; ~ Dispenser Contaimnent Sensors. Did ~,"ou cont]m~ positive shu[-down due re leaks and sensor ~ailure/disco~ection? 0 Yes; 0 No. No~ For t~* systems that utilize the. monitorhxg system as the primary ra~ overfill warning device (i.e. N,'A mechanical overfill prevem[on vah, e is installed), is the overfill.warning alarm visible and audible at the fitl point(s) mad operating properly? if so, ar what percent of talc capaci~ does the alarm trigger? No Was any monitorh~g eqtdpmem replaced? If yes, identi~ specific sensors, probes, or other eqoipmenr replaced and list the manu'Gcmrer aame and model 1bt all replacement paros in Section E, below. (j:[?-~-~o Was liquid t~tmd ~side any secondly co'ntaimnenr systems designed as dD~ systems? (L'heck all r/'~(~ c~flj)l),? Prodt~ct; ~ Water. Ir'yes, descri'be causes in Section E, below, No Was monitoring system set-up reviewed ro ensure proper se~ings? Aaach set up repons, if applicable No,~ Is all monitorMg equipment operational per manufacturer's specifications? below, describe how and when these deficiencies were or will be corrected. Page 2 o1'3 113/01 SIR Equtpmen :: ~ Clxeck this bo.',: iftanl¢ gauging is used only for inventory corm-oL ~ Check this box [f no rard~ gauging or S~R equipment is installed. Z.i'~i~ section mus~ be completed if in-tank gauging equipment is used ~o pertbrm leak detection monitoring. ._7212~.~,i~-t~ 'the followin~ checklist: "~ ~-s ~ No:~ ~ Has all input wiring been inspected for proper entry and termination, including testhxg for ground 6au[ts? '~ cs ~ No:~ ~ Were all tat~< gauging probes visually inspected ~br damage and residue buildup? '~'~.s O No;" ~ Was accuracy of system product level read~gs rested? ~:-~}}}'-"~'~-~- ~ O No:~ / Was accm-acy of system water level read,ks tested? ~ os '~ No:~ Were allprobes reinstalled properly? ;~ No* Were all items on the equiprnenr manuthcrm'er's maintenmace checklist completed'? h, tt~c %ccdon B, belOW, describe how and when these deficiencies were or will be corrected. :__h~c i.,e;iK Detectors (LLD): Q Check. ibis box ifLLDs are not installed, C,.,~[oictc ft~e l'ollow'inE checklist: Yes Q No* For equipment sta~-up or amrual eqaipmem ce~ificafion, was a leak simtflated to yetiS, LLD performance? ~ N/A (Chec/i' ¢d/thee; r~R~/k9 Simulated leak rate: ~ 3 g.p.h.; ~ 0.1 g.p.h; Q 0.2 g.p.h, ~__".,:.?~ ~ No:~ ~ Were alt LLDs confirmed operational and accurate within reg~atory requbements? 'x es ~ N°'¢ I Was the testing apparatus properly calibrated? '~?~.~ Q No* ~ For mechanical LLDs, does the LLD restrict product flow if it detects a leak? '¥ ~-s ~ No* For elec~onic LLDs, does the rurbiae automatically shut offifthe LLD detects a Leak? ............... ~ N/A 5 ,~s ~ No· For etecn-onic LLDs, does the 'turbine amomaricalty shtli off if any potion of the monkoring system is disabled ............... ~,i'A or discom~ecred? ~ ~-5 G No* For elec~onic LLDs, does the turbine automatically shut offif any portion of the monitoring system malRmcrio~s ............ ~ N/A orhitsatesr? '~es ~ No,~ For elecn'onic LLDs, have alt accessible wking co~ections been visually inspected? '~'es ( ~ No* Were ali items on the equipment manut~cmrer's ma~renance chectdist completed? h~ rl~e Secdon B, below, describe how and when these deficiencies were or will be corrected. Page 3 of 3 t~'lcmi'~'o~-mg System Certification UST Monitorin Site Plan Instructions ~ou atreadv have a diagr~ ~hat shows all required information, yeu may include it~ rather than this page, w~rh Moaitoring System Cemfication. On your site plan, show the general layout of tanks and piping. Clearly l¢cafions cf rl~e following equipment, if installed: mon2or[ng system control pane[s; sensors monitoring tank annular spaces, sumps, dispenser pm~s, spill containers, o~' other secondary containment areas; mechaaicaI or electronic [~t~e derccror~; and in-rank liquid level probes (if used ~Br leak detection). In the space provided, note the date tlds ~ite prepared. Page qof ¢ i 261~IERCE RD, c ..... p--,c.c r., ]-., ,] ..... :, .._,1., PIERCE RD. ~- - oH .,. :.F. ..... I E,_.u, -¢. .,, .3 0 c, BAKER'.--;/_D, CA. 93308 ..... ' BAKERSFIELD, Ii:Cl. 93.300. .--'=~ f~ '~ 'SITE ~ 81360' K. MP ~t.tU.ARF.:I-J AMPM ",SITE ~ 81.~;60 2612 PiERI-:E RD. 'L2L,'23,"2F'_ff'J3, 13':56 PM ' 10,'2.3,'2£~0~ 12:57 PM BAKERSFIELD, CA. 93,308 10./25/2003. 12:54 PM TANK SETUP REPORT TANK SETUP REP3RT :E;ITE ~ L-".I$6FI TANI< RETUP.REPCIRT 1F1/27.;.,'206t3 01:%5 PM TANK till 1 12000 GAL TANK NO. 2 12000 GAL TANK NO. 3 12008 GALl -- - "- · · MANIFOLD B ]NLEADED SUP ALARM REPORT MAHIFOLD A UHLEADED PEG UNLEADED PEG TRNK TVPE O. C,. TANK'.:;I t0,"25,'2F'H33 01"='.5 PM TANK T".-'F'E O.C.TRNKS TANK DIMS ...... .', PLUS I_lN '.--:UMP TANK TVF'E O.C.TANKS TAIqK DIMS, '95 'X 4.35 TANK '.-SIZE ' 120FjO TANK DIMS 95 X 435 TANK SIZE 120F{0 TANK SHAPE STANDARDI TANK F;IZE 12000 TANK SHAPE STANDARD STANDARD · TANK SHAPE STANDARD STANDARD 19 PRODUCT UNLEADED SU~' STANDARD l":l'" PRODUCT UNLEADED REG OFFSET P 2.63 KMF' :'_r',-..i J. ARCO AMPM PRODUCT UNLEADED F,'EG I]FF'.-:',ET P .4.07 OFFSET W -0.71 - F,I ,D,.~ N 0 I'-t E 2612 PIERCE RD. OFFSET P 4.0~ OFFSET W -- ..... MANIFOLD ....... '-r,"-'~ELD CA '~3~F1G', OFF.SET I.,I -0. S4, ,'-,Hr.,=,,,.:,~ ..... MANIFOLD MANIFOLD B PROBE ST[:, 101 .:,_ E ~ B136F~ MANIFI]LD MAN!FOLD A PROBE STD lO1 FLOATS PROBE STD lO1 FLOATS 2 FLOAT T",:PE GASOLIHF 10,'23/'2003 01''~= PM FLOATS 2 FLOAT T'Y'PE . GASOLINE GRADIENT ,:,.~Jo: ALARM REPORT FLOATTF";'PE GA'.-]L-ILINE GRADIENT 9.0279 SENSCIR LENGTH 1Fil; GRADIEIqT 9.0359 SENSOR LENGTH 101 HIGH LIMIT 85.Ei0 10/23."2003 01:25 PM SENSOR LENGTH 101 HIGH LIMIT 85.00 LOW LIMIT F~.FiO ~' 85.00 PEG L,4L SUMP HIGH LIMIT LOW LDO'lIT 800,00 HIGH HIGH 90,00 LOW LIMIT 8Ft0,t,'10 HIGH HIGH 90,00 LOW LOW 800.F10 HIGH HIGH 90.8Fi LOW LOW 750.00 WATER LIMIT 4.08 LOkl LI]W 750.80 ,)ATER LIMIT 4.00 TEMP COMP APl 6B,'54B WATER LIMIT 4.80 TEMP COMP APl 68/548 APl GRAUITY 51.58 KMP INU.ARCO AMPM TEMP COMF' AF'! 6B,'54B APl GRAUIT,' 63.50 ALPHA 328.08 26,12 PIERCE RD. APl GRAUIT'Y' 63.50 ALPHA 320.00 NO. RTDS BAKERSFIELD, CA. 95308 ALPHA ~20.00 NIl. RTDS 5 RTl) LOC 1 11.4S SITE ~ 81~60 NO. RTDS 5 RTD LOC 1 11.49 RTl) LOC 2 30.95 RTD LOC 1 1!.49 RTD LOI': 2 30.93 RTD LOC ~ tO,"'2T'3/20B3 F~1:25 PM RTO LFH] 2 ~0 9z - - "'' RTD LOC 3 45,81 RTD LOC 4 E,O.~- ALARM REPFiRT RTl.', LOC 3 45.81 RTD LOC 4 6,0.47 -RTD LIDO 5. ,.-'7. RTD LOC ,4 6,8.47 RTE:, LOC 5 ,".'7.19 '~A..".-.'R.'2F1R7, 01:'~..5 F'M RTE LI]C .~ 77.19 ........... '- STRAPPING DATA F.:EFJ UHL SUMP ,-. ,- ..... STRAPPING DATA INCHES GALLOHS . · :,T,,:.~PF !NG [:,~TA " r' ~-'" INC~EF-i GALLOHS 8i 888 I H_.H:.:, GALLONS, 0. nOF~ 0.0 5.000 '~ ~ ~-~ F~. F1Fff_.~ .. 0.0 . ' 5,00F~ '"~ ~' ~ - - ..'.3 ~, ..' I 10, F-lO0 64'2, 5. OFlO 230.2 ' t0'!'000--~ '~' ...... .,4.":," t~,, 000 1170. 10.000 642.,." ": 15.000 "' ~ 1170.1: 20.~'%~0 176:6, 1.~. Fi00 1 '170.1 20. 000 '~,"F - - 1;o.,. 1 ')~ Fi00 2471. 2~. 000 1786.1 ~-'J' - 25.880 2471.~-, 25.00F'J 2471.3 30.000 3210. 30. 000 :7',210. i m.~. ~00 3993. 30. 000 3210. 1 35. 000 '~qq% .1 -- - 35. 000 3993. t ........ 40. 000 480F',. 40. 000 4F',OR. 7 40. 000 480R, ? 45,000 5644. -.i .4'5 Fi00. ..5A44~. 8=, 45. 000 5644.8 50. 000 6486. 50,000 6486.9 55.000 73',10 i 50,00B 6486. ':'., · 55.000 7310.9 60.000 :BI0:-_-:,: 55.000 7.T,~,0.9 60.000 8108.3 65,000 8';_',66. 60. F.100 '8108, ~ 65. 000 8866.7 70. 000 9574. 65. FJ 0 E'I F:P, 66.7 ~0. 000 9574.9 75. 000. 10220. 7F~. F'I03 'g~?4 '-] 75. 000 t ...... . ...... 1 80.000 - ='-'~ lkl,. ,-, ~,. _ __ 10,'.'~. i 80.000 10785.9 85.000 11248, 80. 000 1F~7 P,~. 9 o.~. ~ Fl~ 11 ,-4 .,. 4 gA. 000 11569. '-_-:5.000 11248.4 ~ 9.0.000 11569.0 '..3. [,~. F.~ .O 0 11569.0 "-'- "i ' KfqP INIJ.AR]O AMPM :.~,.nu iH,..,~r~.',' F.,..q'~r_ ALARM 1 OFF KMF' INV.ARCO AMPM ,,. ~ol~,.F!ERCE RD. TIMEi INL~TR ~'~':00 AM ALARM 2 OFF 2612 PIERCE RD. . c,.~9c, TIME2 'R : BAKERSFIELD, CA. ~ .... 12 80 AM ALARM .3 OFF BAKERSFIELD, CA. 93308 SITE ~ 81568 TIME5 12:88 AM ALARM 4 OFF SITE ~ 81.3,68 SI]HO INIJRI] NONE ALARM 5 OFF · *, ~':' T ! i8.'2;.."2885 1~ .... ¢ F'M ME1 INVRC 12:88 AM ALARbl 6 OFF 18/25/2FJ85 81: 92 F'I S'~¢STEM SETUP REPORT TlblE2 INVRC !2:88 AM ALARM 7 OFF ALARM HISTORY REPORT TlblE5 INVRC 12:88 AM S;FFTi,IARE UERSION 8.gql'8 SCHD CLHST NIDNE ALARM 8 OFF -- - -' - 18/4/288~ 82:28 Pi TIME1 [:,LHST 12:88 AM STD S%TEM FAIL LOCATION 1 KMP INU. TIME2 DLHST 12:88 AM ALARM I REG UNL SUMP PROBE S~?NC LOCATION 2 ARCO AMPM TIME5 QLHST 12:88 AM STREET I 2612 PIERCE SI]:HQ ALHST NONE ALARM 2 PLUS UN SUMP TANK NO. 2 STREET 2 RD. TIME1 ALHST 12:88 AM ALARM 5 F'RE UNL SUMP C!T? I BAKERSFIELD TIME2 ALHST 12:88 AM ALARM 4 NONE 18/4/'2885 82:21 Pi CIT'.,.' 2 TIME5 ALHST 12:88 AM ALARM 5 NONE S'¢STEM FAIL , ..... r~ CA. SCHD A~]T AL NI]NE ALARM 6 NONE PROBE SYNC .:.T~, c - ZIP I-;ODE 95588 TIME1 ACTAL 12:88 AM ALARM 7 . NONE TANK NO. 2 o. = 81368 TIME2 ACTAL '- .¢ITm ~ 12:88 AM ALARM ~ NONE 18/'4/2885 82:25 PI TIME5 ACTAL 12:88 AM ~JOL UNITS GALLONS SCHB ALST NONE SENSOR T?PE SYSTEM FAIL LEVEL UNITS INCHES TIME1 ALST 12:88 AM' SENSOR. 1 STQ PROBE S'.?NC TEMF' UNITS FAHRENHEIT TIME2 ALST 12:88 AM:~ SENSOR 2 STB TANK NO. 2 TIME ST'.¢LE 12' HOU~ TIME5 ALST 12:88 .~1_.~ SENSOR 5 STQ DATE ST'.,.'LE MM./C,Q/'¢? ' SENSOR 4 STD 18/4,."288~ 82:29 Pf [:,AN)LIGHT'SAV ENABLED CONFIDENCE ~9.81,:~ SENSOR 5 STQ S~?STEM FAIL SET TIME 12:59 PM LEAK TEST 8,18', SENSOR 6 :,TD PROBE SYNC SET DATE 18/25/2885 SCHO TEST SENSOR F STB TANK NOi o TANK 1 NONE SENSOR 8 STQ NO. TANKS ;] TANK 2 NONE 18/4,"2885 82:58 Pi LEAK LIMIT 2.98 TANK 5 NONE CONTROL OUTPUT SYSTEM FAIL THEFT LIMIT.- 1~%_8E; TIME TEST 6.RACE PERIOD 8 PROBE S~r'NC C, EL'iV LIMIT 288.88 TANK 1 12:88 AM TANK NO. 2 SNTNL MODE OFF TANK 2 12:88 AM LOW LOW 1 OUTPUT 1 START SNTNL 12:88 AM TANK .~ 12:88.AM LOW LOW '2 OUTPUT 2 ~8/4/"2885 92:58 F'I ,'. ,T~ i2: LOW LOW ~ OUTPUT 5 .,¢.:,TEM FAIL END .:,~',,,',L E~e AM .... OELIU DELA~r' 15 - ALARM LQW LOW 4 NONE PROBE SN¢NC ~=~n~-.= TIMEOUT 58 TANK NO. ~ ~mr_ ~.. C, ELIV DISABLED' REPORT ALRMS ENABLED HIGH LIM ON LI]W 1 NONE REPORT TESTS ENABLED LOW LIM ON LOW 2 /"] NONE 18/4."2885 92:51 PI fiD. OF ALARMS 18 HIGH HIGH ON; LI]W 5 NONE SYSTEM FAIL PRINT INTERVAL 5.88 LOW LOW ON~ LOW 4 NONE PROBE SYNC WATER LIM oN, TANK NO. 2 MODE CHAN 1 NATIVE LEAK LIM ON~ HIGH WTR 1 NONE BALi[:, CHAN 1 1288 S'¢SFAIL OFF~ HIGH WTR 2 NONE i8/4/'2885 82:51 PI DATA BITS 1 ?, THEFT ON HtGH WTR 5 NONE S%TEM FAIL STOP BITS 1 I HIGH WTR 4 NONE PROBE SYNC PARITV 1 NONE ;'.ELAN¢ TANK NO, 2 SECUR!T'¢ t TIMEOUT 15 HIGH I NONE ACCESS 1 HIGH LIM OFF HIGH 2 NONE 18...'4./2885 82:5i F'~ PHONE ! LOW LIM OFF HIGH 5 NONE S~?STEf'I FAIL REDIAL I DISABLED'. HIGH HIGH OFF HIGH 4 NONE PROBE SYNC "F:F' c.c.-~ 'LOW LOW OFF TANK HO 2 H ~ _. $ .~._. z ' PHONE 2 WATER LIM OFF HIGH HIGH 1 NONE: REDIAL 2 [:,ISABLEO LEAK LIM OFF HIGH HIGH 2 NONE 18,'4/2885 82:48 P~ 'l--C .... ~,¢~,FRIL OFF HIGH HIGH .~ NONE SYSTEM FAIL PHONE 3 THEFT OFF HIGH HIGH 4 NONE PROBE ~"~'~ REDIAL 5 DISABLED TANK NO, 2 AC:CESS 4 STB ALARM SYSTEM FAIL 'NONE PHONE' 4 ALARM 1 ON .... REDIAL 4 DISABLED. ALARM 2 ONe:. STB 1 OUTPUT 1 DIAL [:,ELIU ALARM 5 ON ':' .,-STB 2 OUTPUT '2 C, IAL ALARM ALARM 4 OFF STB 5 OUTPUT 5 DIAL LEAK'. ALARM 5 OFF STO 4 NONE ALARM 6 OFF STD 5 -NONE ALARM 7 OFF STO 6 NONE ALARM 8 OFF STQ 7 NONE )PY REQUESTED PLEASE FAX( 661 ) 392-0621 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 FAX (661) 326-0576 APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION OPERATORS NA~ ~ HM,O y ow~es NA~ ~ DOES FAC~Y HAVE DISPENSER PANS? ~S ~ NO TANK # VOLUME CONTENTS NAME OF TESTING COMPANY RICH ENVIRONMENTAL CONTRACTORS LICENSE #_~Xt NAME & PHONE N,UIvlBER OF CONTACT PERSON~,~AMES RICH ( 661 ) 392-8687 DATE & TIME TEST IS TO BE CONDUCTED /0~-~'3 ..-o'~ / ///ax APPROVED BY DATE ffGNATL~E OF APPLICANT MONITORING sYSTEM CERTIFI 'ATION For Use By All JurA'dictions Within the State of Cal~ornia ..-lm'horio, Cited: Ch~tpter 6. Z Health and Sc¢~ Code; Chapter 16, Divixion 3, Title 23, Califbrnia Code of'Regulations · l'[x{s ~ocm must be used to dot--ant rested ~d servicing of monitoring equipment. A separate ce~ification or repotx mosr be prepared Gr eact~ monirodn~ system con~ol panel by [he reclmictan who performs ~e work. A copy ofrh~ thrm must be provided ro the tank system owner/operator. The o~er/operaror must submit a copy of flxis form to ~e local agency resulting UST systems within 30 A. General laformarion Fac'itity Name: ~0 M~; k/'X ~~ aldg. No.:~ Facility Coarac[ Person: Contact Phone No.: Matcc.:Model of Monitoring System: ~ ~ --~ ¢& 5 Date of Testh~Servicing: /0 /~3 /~_ B. invent'cry of Equipment Tested/Certified .~.ti_~c~ ~)~S)~r°priate Boxes to iadicate specilic equipment insj~ected/s~rv~eed: ~ tn-Tank Gauging Probe. Model: ~ ~ In-T~k Gauging Probe. Model: ~ Ammku' Space or Vault Sensor. Model: ~0~ ~nul~ Space or Vault Sensor. Model: ~ Piping Sump /Trench Sensor(s). Model: [ ~ Piping Sump / Trench Sensor(s). Model: ~ Fill 5mnp Sensor(s). Model: ~ Fill Sump Sensor(s). Model: ~ Mcchm~ical Line Le~ Detector. Model: ~ Mech~ical Line Le~ Detector. Model: ~ ~::lccn'onic Linc Le~ Detector. Model: ~ Electronic Line Le~ Dewcmr. Model: ~ l':mlc Overfill / High-Level Sensor. Model: ~ ~ Tm~k Overfill / High-Level Sensor. Model: ~ 0.rn~r_~spcci¢ equipment r),pe m~d model in Section E on Page 2~; : ,~ Omer (speci~ equipment type and model in Section E on Parc 2), ....... ~ in-l'~k Gauging Probe. Model: ~ Ia-T~k Gauging Probe. Model: ~Ammlar Space or Vault Sensor. Model: ~ ~nul~ Space or Vault Sensor. Model: ~ Piping Sump / Trench Sensor(s). Model: ~~ ~ P¢ing Sump / Trench Sensor(s). Model: O Fill Sunlp Sensorts). Model: ~ Fill Sump Sensor(O. Model: ~ Mcchm~ical Linc Le~ Detector. Model: ~ Mech~ical Line Leak Derecmr. Model: ~ Elco'tronic Line Le~ Detector. Model: ~ Electronic Line Le~ Detector. Model: ~ T~mk Overfill / High-Level Sensor. Model: ~ T~k Overfill /Hi~-Level Sensor. Model: ,_~ 5)[~}c~'~E~i~'' equipment type ~d model in Section ~n Page 2? ~ Other (speci~ equipment Wpe ~d model in Seclion E on Page2). Dispenser iD: Dispenser ID: ~ Dispeastr Conrainmenr Sensor(s). Model: ~ Dispenser Containment Sensor(s). Model: ~ Shear Valve(s). ~ She~ V~ve(s). _~ ~_5~ns~r Containment Float(s) ~d Ch~n(s). ~ DiEpenser Containment Floa[¢) and Chain,s). Dispenser ID: Dispenser ID: ~ D/spenser Comaimnem Sensor(s). Model: ~ Dispenser Containment Sensor(s). Model: 0 Shear ValYe(s). 0 She~ Valve(s). .G DiSpS[~er Coniainmenr Floar~s) m~d Chain{s). ~ Dispenser Coatainmem Flames) ~d Chain(s). Dispenser ID: Dispe~er ID: ~ Dispenser Conraiamenr Sensor(s). Model: ~ Dispenser Containment Sensor(s). Model: ~ Stxcm' V~dveLs). ~ She~ V~ve(s). .~p~spenser Cantonment Float(s) ~d Chain(s). ~ Dispenser ComaMmenr Float(s) ~d ChMn(s). qfrhe fi~cility conrMns more rmx~ or dispensers, copy this form. Include information/bt eve~ t~k ~d dispenser ar the C. Certification - I certify that the equipment identified in this document was inspected/serviced.in accordance with the manulheturers' guidelines. Attached to thi~ Certification is inlbrmation (e.g. manutheturers' checklists) necessary to veri~ that th~ infarmation correct at~d a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, 1 haw also ar[ached a copy of the repot; thec~ all that apply): ~ System set-uP ~ ~rm h~torv_r~ort Cerrii2c'arion No.: ~O / ~qG Lice~e. No.:~C6 l/D40-~-$ ~I'esrhx~CompmwN'mne: RICH ENVIRONMENTAL phoaeNo.:(661 .). 392-8687 Sk~ Xddress: 20 1 ~ ~~ ~W~S ~O Date of TesthffServicing:/0 /~/9~. Page 1 of 3 03/ol !vtoni[oring System Certilication £{¢szttts of Testing/Servicing So£t~:~re Version Installed: Com?tpt'c rile following checklist: ._ "/'es [ El No* Is the audible alarm operational? Yes { CI No* is the visual alarm operational? \'~-s { ~ No* Were all sensors visuall.yh~spected, ftm'~tion'.all¥ tes.t, ed, m~d confirmed operational? -- Yes [ ~ No'* Were all sensors h~stalled at lowest point of secondary containment and positioned so that other equipment I not interfere with their prol~er op,erafion? Yes C] No* If ahu'ms are relayed to a remote monitorh~g station, is ail conu-nunications equipment (e.g. modem) ~I13~ N/A operational? '/'es j~, No* For pressurized piping systems, does the turbine atttomatically shut down if the piping secondary comaimnent l'3 N/A monitoring system detects a leak, faits to operate, or i~ elecn'ically discormected9 If yes: wtxich ,ensors hxiriate positive shut-down? (Check ~ll d't~r c~oivly) ~1 Sump/Trench Sensors; IZl Dispenser Contaim~ent Sensors. Did you confirm positive shut-down due to lealcs and sensor failure/discormection? ~1 Yes; Cl No. Y3.~'-- t-I No* For rank systems that utilize the monitoring System. as the prhnary tank overfill warning device (i.el no ~ N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the fill point(s) m~d operatin~g properly? if so, at what percent of tank capacir,/does flw alm'm n'igger? . . Yes:~ [ ~1~ No Was any monitorh~g equipment replaced? If yes, idemify specific sensors, probes, or other equipment replaced- and list the manut:acturer name and model tbr all reDlacement parrs in Section E, below. Yes:~ I ,~ No Was liquid fotmd inside any secondary containment systems designed as dry systems? (Checl' all thai ~ppbO Product; ~ Water. If yes, describe causes, in Section E, below. .._ Yes [ ~ No* Was monitoring s.ystem set-uP rev!ewed to ensm'e proper settings? Attach set up reports, if applicable Yes [CI No* is all monitoring equipment operational per :manufacturer's specifications? ]tn Section E below, describe how and when these deficiencies were or will be corrected. Page 2 of 3 0310 1¢. ia-T~'mh: Gauging / SIR Equipment: ~ Cl~eck ~is box iftardc gauging is used only for inv,ntory ¢orl[rol. Ci~eck this box if no tank gauging or SIR. equipment is installed. Tla'~s sec[ion must be completed if in-ranlc gauging equipment is used to perform leak detection monitoring. Cotnl)l/~t'e the following checklist: ID Yes I [] No'; Has 'all input wi[in} been inspected for Prop;r entry and termination, ineludi,~g testing for ground faults? Ct Yes ICI No* Were all rank gauging probes visually inspected for damage and residue buildup? Ci "rcsI CI No* Was accuracy of system product level r~adings tested? - Ct 'Yes ICI No'* Was accuracy of system water level readings tested? ID \"es I L3 No* Were allprobes reins[ailed properly? C~ \'es I © No* Were all items on the equipment manuthcturer's mah~tenance checklist completed? '* i~ tile Section FI, below, describe how and when these deficiencies were or will be corrected. C. ki,-~c Leak Detectors (LLD): ~1, Check this box ifLLDs are not installed. Complete tl~e following checklist: O Yes Q No* i%~' equipment start-up or mmual equipment~ ~ 'certification, was a leak simulated to v;rify LL~ p~rfomam~ce? l-1 N/A (Check all thar apply) Simulared leak rate: rq3g.p.h.; Cl0.1g.p.h; Cl0.2g.p.!a. -~ Yes I [] No.* Were all LLDs confirmed operational and accurate within regulatory requLrements? [] Yes [ ~ No* Was the testing apparatus properly calibrated? ~ Yes Q No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? Cl N/A ~ Yes ~ No* For electronic LLDs, does the turbine automatically shut offifthe LLD detects a leak? CI N/A [] '¥'es I [] No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled [] N/A or disconnected? O Yes I-1 No* For electronic LLDs, does the turbine automatiCatly shin offifany portion of the monitoring system mal~imcti°nS [] N/A or fails a test? [] Yes I [] No* ~or electronic LLDs, have all accessible'wiring connections been visually inspected? [] N/A ~ Yes { ~ No'* Were all items on the equipment manufacturer's maintenance checklist completed? ' · *' In the Section H, below, describe how and when these deficiencies were or will be corrected. ]~]~. Coii]tlll ¢1i1[s; Page 3 of 3 A'lonitoring System Certification UST Monitoring Site Plan Instructions 1I' 50tt already have a diagrm ~ar shows all required information, you may include it, rather than this page, with yot~t' Monitoring System Ce~ificarion. On your site pimp, show the general layout of tanks and piping. Clearly locations of the following equipment, if installed: monkoring system control panets; sensors monitoring tank annular spaces~ sumps, dispenser pm~s, spill containers, or other secondly containment areas; mechaaical or electronic [~ne leak detectors; and in-lank liquid level probes (if used ~Br le~< detection). In flae space provided, note the date this Site Ptan xYas prepared. Page q of,¢ 05/oo *coPY REQUESTED PLEASE FAX( 661 )392-0621 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Av, e., Bakersfield, CA (661)'326-3979 FAX. (661) 326-0576 APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION OPERATORS NA~ ~ ~M,O y NA~ OF MONITOR MAN,ACTOR. ~.~ =~oT --~4S- ~O DOES FACn,ffY ~VE DISPENSER PANS? ~S ~ NO TANK # VOLUME CONTENTS /o,,aoo Ux,,/,- te ,. 3 ,. /~) az, o &-~,,t4.~ NAME OF TESTING COMPANY.,,, RICH ENVIRONMENTAL CONTRACTORS LICENSE ~__ NAME & PHONE NUMBER OF CONTACT PERSON___JAMES RICH .( 661 ) 392-8687 DATE & TIME TEST IS TO BE CONDUCTED ! ]~_%o 3 _ _ .. APPROVED BY DATE ~GNATE~(~ OF APPLICANT · Complete items 1, 2, and 3. Also complete item 4 if Re~,tricted Delivery is desired. · Print your n~me and address on the reverse ,J so that we can return the card to you. Addressee i Attach this ca, rd to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: fron ' delivery address below:r. [] No JOHNNY'S FOOD MART 2612 BUCK OWNENS BLVD 1 ~ype . BAKERSFIELD CA 933q8 J I ~ Certified Mail [] Express Mail I ~ Registered [] Return Receipt for Merchand se Mail [] C.O.D. 2. Article Number } 4. Restricted De,very? (E,*a Fee) fTransferfromse~vicelabel) ~-----~TDD2 3],5B DDD4 '9965 '-------' ------- 4254 .i PS Form 381 1, August 2001 Domestic Return Receipt 102595-02-M- 1540 Bakersfield Fire Department Prevention Services ~1;715 Chester Avenue, Suite 300 Bakersfield, CA 93301 FIRE J~,~ R r~ r July 31, 2003 ~;~-- ~J~-h~ny' s Food ~t .... CERTIFIED MAIL ~2~6__12_B uck~O_Wens Boulev_ard~ Bakersfield, CA 93308 NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE F~RE C,~EF RE: Failure to Make Repairs'on SB989 Test RON FRAZE Dear Customer: ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 Our records indicated that you had a failed SB989 Secondary Containment test on VOICE (661) 326-3941 FAX (661 ) 395-1349 03 - 17-03. SUPPRESSION SERVICES You have not completed your repairs and re-test. You are, therefore, required to have the 2101 "H" Street repairs completed by September 15, 2003. Failure to comply may result in additional Bakersfield, CA 93301 · VOICE (661) 326-3941 enforcement action, which could include revoking your ?crmit to Operate. FAX (661) 395-1349 PREVENTION SERVICES Should you have any questions, please feel free to contact me at 661-326-3190. 1715 Chester Ave. Bakersfield, CA 93301 ~- -~Rincerelv, VOICE (661) 326-3951 FAX (661) 326-0576 Ralph Huey ENVIRONMENTAL SERVICES Director of Prevention Services . 1715 Chester Ave. '" Bakersfield, CA 93301 FAX (661) 326-0576 : ' TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 Steve Underwood FAX (661) 399-5763 Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/db SECONDt/R¥ SYSTEM CERTIFICATION FORM .... ~~ ~ .......... ,, P~ 2 SECONDAg¥ SYSTEM CERT[FICATION FORM ~C T~NG WAT~ "' D~~ DI~~Ra D~P~SERT' D~~RS WaTeR . '. WATER ~GHT 0~/P0 39~d 'I~90~B£I99 BP:El EOOE/BI/EO January 22, 2003 AM/PM FIRE CHIEF 2612 Buck Owens Blvd RON FRAZE Bakersfield CA 93308 ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfield, CA 93301 R.E: Upgrade Certificate & Fill Tags VOICE (661) 326-3941 FAX (661) 395-1349 Dear Owner/Operator: SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 Effective January l, 2003 Assembly Bill 2481 went into effect. This VOICE~^x (~(~61)~) ~s-326'a9411349Bill deletes the requirement for an upgrade certificate of compliance · (the blue sticker in your window) and the blue fill tag on your fill. PREVENTION SERVICES FI~E SAFETY SERVICES ° ENVIRONMENTAL SERVlCF..8 rtl5 ChestorAvo. You may, if you wish, have them posted or remove them. Fuel Bakersfield, CA 93301 j vendors have been notified of this change and will not deny fuel VOICE (661) 326-3979 FAX (661) 326-0576 t delivery for missing tags or certificates. PUBLIC EDUCATION 1715 ChesterAvi~. .. Should you have any questions, please feel free to call me at 661- Bakersfiold, CA 93301 326-3 1 90. VOICE 1661) 326-3696 ' FAX (661) 326-O576 FIRE INVESTIGATION sin~ . 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION Steve Underwood 5642 Victor Ave. Bakersfield, CA 93308 Fire Inspector/Environmental Code Enforcement Officer VOICE (661) 399-469Z FAX (661) 399-5763 Office of Environmental Services SBU/dc 11/27/2002 16:20 6613920021 'PAGE OCT U7 EOO2 14{~ BKSFLD FIRE PREVEMTIOM 1715 ~~ Av~, B~e~~ ~ (~1)3~3~9 A~I~ON ~ MO~O~G ~~~ON ~~ N~ ~ ~ ~_ ................... O~ N~_ ~ ~ ~-.- · ~ ......... ~ PA~ ~~~~s~ ~~ ~o 12/82/2882 88:45 6613920621 PAGE 02 .. MONITORING SYSTEM CERTIFICATION For Uze dy All Jurisdictions Within tl~ Stale of California Authority Cited: Chapter 6, 7, tt~alth and gaf~Y Cod~; Ch~t~' 16, D~ion 3, ~tle 23, Cal~ornia Cod~ of ResistleSs Th~ fo~ must bo used to document tesfi~g and servic~g of mo~itor~g equipm~L A se~ ~tion or r~ must b~ propped for ~a~ m~itor~ system coa~ol pauel by fl~ tech~ic]an who ~o~s the walk.- ~ogy of this fo~ mu~ b~ p~°vi~d to ~e tank system owner/apparel. ~e ow~ev/op~tor muse submi~ a copy of th~ fo~ to ~he local agency tegulat~g UST wi~ 30 day~ of test date. ~ General Information Facility N~e: _ ~ ~ ~ldg. No.: Facili~ Comact Persoa: Contact Hlonc ~o.: ( ) ~k~odc] ofM~ito~g Systcm: .~,~ . . ~ ~ Date ofT~ting/Se~ic~g: ,~ / ~l /~ B. Invento~ of Equipment Tested/Certified Cbcck the ~pprop~te box~ t~ Indicate ~peeifie equi ment inn~ceted/.crvlee~ _ , ~ In-T~k G~ugi~ P~be. Model:~- && ~ In-Tank Gauging ~ob~, Mo~l: ~. & ~ & ' Ansi Jar vault Sensor. Mod~l: ~ ~ Annular Sp~e or VauR Sensor. Mo~l: ~ - ~ ~ Pipiag Sump / Trench $e~or(s), Modal:~ ~Pipi~ Stl~p / T~n~h S~ot(s). Model: ~ ..... ~ Fill Sump S~or(s), Model: ~ Fill Su~ S~o~s). Mod~i: ~ M~l~ic~ Line ~ D~otor. Modal: _~~ ~ ~ Mcch~ic~ LiRe L~k D~r, Modal: ~ El~t~ma Line Le~ Data.or. MMeI: ~ Electric Lino Leak D~or. Model: ~ T~ Ov~]ll / High-Level 8~r. Model: ~ Tank Ov~fill / ~-~wl S~sor. Model: ~ Oth~r (speci~ ~uipm~t ~pe ~d model in 8cctlon E on Pag~ 2). ~ O~ (speei~ cqu3p~, ~ ~d m~el ~ $e~on E on PagE~). ~ lu-T~k ~gJng ~o~o, ~!: T~ ~- ~ ~ ~ O ~-T~k Gaug~g Prob~. Model: ~ Aonul~ Space ~r Vault S~sor, Mod~: ~- ~ ~ ~ Auuul~ Space or V~lt ~sor, Model: ~ Piping Sump [T~nch $enso~s). MMeI: ~ ~ ~ Piping Sump/T~nch S~o~s). Model: ~ Fit Sump S~so~s), Mod~]: ~ Fill Sump Sanso~s). ~ Merrill L~c L~ D~ctor. M~cl: ~~~ ~ Meclmnic~ L~a L~ Detac~or. M~eI: ~ Etcc~oaic L~ Leak De~e~r. M~el: ~ Bio,tronic Line Leak ~or, Mod~: D T~ Ove~ll / Hi~.Level ~ensor. Model: ~ Tank Ov~fi]l / High-~vel S~sor. Model: ~ ~h~ (ag~i~ equipment ............ ~p~ ~d m~el ~n S~ction, E on~ Page 2). ~ ~er (specify equipment W~ and model in Scion E on P~,~). Disp~Coa~tnmcnt Sc~or(s). MMc]: ~ ~ Dl~ns~ CantOnment S~so~s). Model: ~Sh~ Val, v~s). ~ Sh~r Valve(s). ' '" ~ D~p~ Con. inmont Float(s) and Cha~(s), _ ~ Di~ Coat.omit Floa~s} ~d Ch~n(s). ~ Di~p~r Containment 8~sor~s). Modcl:~O ~~ ~DJ~p~r Conuinmeot Senso~(~), Mo~e]: ~ ~Sh~ Velvc{s), ~ Sh~nr Valv~), O Dispcnmcr Conmi~cnt Float<s) ~d ~ain(a). , ............. ~ ~im~,n~ Cpnain~nt Float(s) and Ch~n<a~. , ,, , Disinter ID: Dispenser ~; ~ She~ Valve(s). 0 5h~ V~v~). ~D~p~r Con~inmant Float(s) ~d Chain(~). ~ Disbar Con~inme~ ~(s~,~d 'If ~ f~l~' contains mo~ t~s ot disp¢~rs, copy th~ fo~. Indud~ info~ti~ f~ cvc~ ~nk ~d dis~r at ~e faci{i~. ' ........... C. Ce.ification - I certify that the equipment ideufified in this document Was inmpecied/{e~ig~ i. ae~rdance with manufa~urers' guideline. Attached ~ thb Certification is infermetiun (e.{. maaufacturers' checMimts) ae~sma~ t~ varify that this Information is cur~ and a Plot ~lan aho~ng thc layout of menitu~ng eqaipmenK For any ~aipment capable of ~narating such raper~,lhawa{soaitat~dacopyot~er~pari;(chtck~iih~t~ply); ~S~te~t-up ~ Al{m~btoq re~rt Page 1 of~ Monitoring System Certificslion ¸ii 12/02/2002 08:45 6S13920S2! PAGE ~03 D. Results of Testing/Servicing Complete file following checklisl: Yes O No* Is ~.e audible alarm op~r~ioual? Yes ~ No* Is the vi~al ala~ op~ational? "' ~'~cs ~ No* Wero all s~rs visually i~spe~ed, ~nctionally tested, and confi~ed operaliona[v ~ Yes ~ No* We~'all sensors lnst~led at lowest point of s~onda~ conta~ment ~d posi~oned ~o ~ai'~er equipment will- not hlteffe~ wi~ their pmptr operatic? ~ Yes ~'~o* If ala~s a~ relayed to a ~ote moni.t~ing station, is all commUnicalons equipment (e.g. modem) ~ H/A opelational? -~ Yes ~ No* For pressurized pipi~ systems, does ~ ~b~e auWmati~ll~"sh~t"~o~ ~'~e .pipi~ seconda~ coherent ~ N[A monitor~g ~a~ d~e~ a leak, fails to op~mlc, or is clcc~lly d~co~ec~ed? If yes: which senso~ i~tiatc positive shut~own? (Ch~ci ~# ~ apply). ~ Sump~nch $~o~; ~ Dispznser ~ntainm~nt S~nsors. Did you conf~ po, i~ivc ~hut-down duc ~o le~ ~d sensor failu~sco~ion? ~Y~s; ~ No. ~ Yes ~ No* For l~k ~slems ~at uti]i~ ~)e monitorin~ system as ~e prima~ ~nk o9~11 w~ing device ~ N/A mechanical ova'fill prewnt[on valve is installS), is ~e overt[ w~ing alarm ~ible ~d audibl~ a the ta~ ~[ po~t(s) and operating properly? If so, at ~a percent of~k capaciW do~ the alarm ffi~er? ~ Y~l* ~ N~ W~ ~y monitoring equipment repla~d? Ify~, idenfi~ sp~ifiu se~o~, probes, or ~er e~ipm~t r~l~ed ~d list ~e manufa~rer n~e and mod~l for all r~ement p~s in Section E, ~]ow. O Yes* ~ No Was liqui~found i~id~ ~y s~conda~ contai~nt sys~s d~sign~d as d~ systems? (C~t ~11 th~t ~ ~?~ ~ Wa~r. Ify~s, d~scrib~ cat, s in S~ion E, b~low. ~ Yes ~ No* W~ monitoring sys~m s~t-up r~iewed to e~ ~per se~s? A~h set up ~po~, i~ appli~bl~ ~ Yes ~ No' Is El 'monitor~g ~quipment o~ation~i'per m~u~c~r's specifi~ons? ~ I~ Section E below~ describe how and when thee deficiencies w~re or will be corr~ted. E. Comments: 12/02/2002 08:45 6613920G21 PAGE 04 F. In'Tank Gaugihg / SIR Equipment: ~L ~eck this box iftal~k gauging is used only for i~ventory control. ~ Cheok thi~ box ifno tank gauging or SIR equipment This s~cfion must be comp~ted if in-~ ga~ng equipment is u~ to ~rform l~a~ d~tection monitor~g. Corn ~l~te the following checklist: ~ Yes ~ No* H~ all ~put wiring be~n ~spected f~ proper efl~ ~d retention, ~clud~g t~stJng for ~o~d faul~ .~ Yes ~ Noi Wer~ all'~ gaugi~ probes risk'ilk'impend for d~agc and rosiduc buildup? ~ Yes ~ Ho* W~'ac~cy of sy~m produ~ l~i"~ad~s"~sted? ~ Yes ~ ~'"' W~s accuracy of System water level, read~$~ tes~?' ~ Yes ..... ~ No* W~v ~t probes ~s~allgd prop~ly? ~ Yes ~ No* Wge fll items on the ~quipmen~ m~ufac~cr's maint~n~e ~eckiist completed? * In the S~tion H, below, d~ribe bow and when thee deficiencies wcre or will be ~o~ected. G. Line Leak Detectors (LLD): ~ ~ ~is box ifLLD~ ge not installed. Complete the following checklist: ~ Yes a No* For oquipm~t '~'~Jup'or ~l'c~ipmcnt ~ification, was a lc~ s~ula~d to'¥~ LLD ~ H/A (Ch~k all th~ apply) S~utat~d I.e~ rote: ~ ~ g.p.h.; ~ 0.1 g.p.h; ~ 0.2 g.p.h. ~ ~cs ~ No* Were E1LLDs c~ed ~ation~ and~curat~ ~iflt~ re~lato~ requirementS? '" ~ Y~ ~ 'No* W~ the tea~g ~p~,s pmp~iib~/ed7 ....... ~ '~cs ~ No* For mechanical LLDs, does the LL~"~s~ict product flow if h d~cc~ a leak? .... ~ Yes ~ No* For elec~nic LLDs, does ~e'~rb~.c auW~atica~y shut off if the LLD de~s a leak? ~ Y~ O No* ~or el~c~o~io LLDs, do~'~ mrb~o automatically shut off if ~y poaion of ~e moniWr~g system is dbabied ~ N/A 0r ~sconneaed? ~ Yes ~ ~o* For elo~onic LLDs, does ~e"~rbine' auto~tically shut off if any potion of ~e mon~o~g sysmm ~ Yes ~ No* For electric LLDs, havo all accessible w~ing ~nnect~on'a ~en ~su~ly in~pec~d9 '"~' ~Yes ~ ~o* W~e all item~ on ~.~ ~qu~ment m~u~ac~rs'~a~to~nco checkl~t ~omplet~d? ....... * In the Sec~b ~ ~e[~, d~c~ how and when thee defieienci~ were or will be eorrect~. H. Comments: Page 3 of~= 12/02/2002 68:45 6613928621, PAGE 05 System Certification _ UST Monitoring Site Plan .............' .' ,. .' .' .,~ , , .~' . . , 2 ~ ,. ,. ~ ~ ~ ,, ~ ~ 2 2 2 2 2; ~ ~ 2 2 2 ?~2 ............................... Datemap wasdrawn: }l~ / l l / 0~. Instructions If you already have a diagram that shows all required information, you may invlude it, rather than this page, with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. ClearLy identify locations of the following equipment, if installed: monitoring system control panels: sensors monitoring tank annular spaces, sumps, dispenser pans, spill, contain.ers, or other secondary containment mean; mechanical or electronic lb're leak detectors; and tn-tank liquid level, probes ([fused for leak detention). In the spa~ pmvJ.dod, note the data this Site Plan was prepared. Page...__q of C~ 12/02/2002 88:45 6613920621 PAGE 06 RICH 554.3 BROOKS CT B/%K~RSF~LD, CA. 95308 OFFiC~.(661) 392_8687 & FAX (661) 392-0621 W/0%' P~ODUC~ LEAK DETECTOR TYPE 'T~sT' TR~P PASS ~ERIALNUMS~a BELOW PS~ OR _.~ GPH FAIL 'YES ~Ass ' I certify ~he above tests were conducted on this date according to a low ~l~w ~hreshold triD rase of ~ ~allon pe~ h~u~ or less mi 10 PSI. Of my knowledge. Tech: J~S.J, BICH ___ State License;~~ 12/8272882 88:45 6613928621 PAGE 18 OCT O~ ~OU~ 14:~ ~KSFLD FIR[ PRE¥£~TIQH OFFICE OF' ENVIRONMENTAL 1715 ~~ Av~, ~~~ CA (~1) A~ICA~ON TO P~~ ~ MO~O~G ~R~~ON 0~~ I~ ~ ~ ~ 0~~ ?. . ~_/~ ~ o _ ~-,~.. ~ . /~,,,~ ..... ~-~. ..~ ' I2/02/2002 88:45 661392062i PAGE 09 KMP I, NV.ARCQ AHPM 2;.,12 PIERCE RD. BAKERSFIELD, CA. 95'588 18/11/2~2 ~7:~6 AM ALARM HISTO~ ~'~'$TEM FAIL ~RO~ TANK NO, 2 9/29/2~2 SYSTEM PAIL , PROBE TANK NO, 2 " 9/23/2~42 ~1:12 PM S?STE~ FAIL PROBE SYNC TANK NO, 2 SVSTEH FRJL PROBE SYNC TANK NO. ~Y23,'2882 ~ l ~ 14 PH SVST~ FRIL PROBE SYNC TANK NO. 2 SYSTEM FAIL PROBE SYNC T~NK HO. 9zZ9Y28~2 11~ lm3 PH SYSTEM FAIL PROBE SYNC TANK NO. }/29/2882 l~,: 19 PM SYSTEM PAIL PROBE SYNC NJ. 2 PRO~ SYNC TA~K NO. 2 10Y2/2882 ~7:~ ~VST~ FAIL ~ROBE TANK NO. 2 ~ 12/02/2002 08:45 6613920621 PAGE 08 ................. ""~ K~ IHV,~R~O AMPM ol~H~ UH~ KM? iNV.AR~:;O ~ItPH TIME1 INUTR I2100 AM 26t2 PIE~C:~ RD. ~CHES GALLON~ 2612 PIERCE RD. TIME2 INVTR 12:00 AM BAKERSPIELD, ~.B~ 8.0 ~A~ER~FIEL~, CA. ~3~08 TIME~ INUT~ 1~:00 AM SITE # 5.BBB ~,2 SITE # 81~$~ SCHD iNURC NONE m.eee e4~.? TIME~ INV~C ~:0@ A~ ~e/tl~2eo~ ~§.aeo ~lZe.~ 1o~1~250~ ~?:$~ A~ T~ME2 INURC 12:0~ AM SYSTE~ SETUP REPORT 28.880 1786,1 ALAR~ REPOR~ T~ME$ INURC J2:08 AM 25,0~ 2471.3 S~N~ DLHGT NONE SOFTWARE VERSION ]0.000 ~218.1 1~/11/2882 ~7:5~ AM TIMEr DLHST 12:~ AM ~,Be9 ~$93.1 PRE UNL SUmP TIME2 DLHST 1~:0~ ~M ~B.~90 4098.? LOCATION 1 KMP IHU. a5.090 5644.9 TIME~ DLHST 12:89 AM LOCATION 2 ARCO AMPH 50.~0 ~40&.~ $~HO ALHST NONE STREEl 1 2~]2 PI~R~E 5~.0~0 751~.~ TIMEI ALHST 12:0~ AM STREET 2 RD. TIME2 ALHST 12:80 AM CITY I BAKERSFIELD ~0.99~ $L98,7 KMP INU.ARCO AMPM TIME~ ALHST 12:~0 AH CITY 2 65.089 88~&.? 2~12 PIERC~ R~. $CHD ACT AL NONE STATE CA, ?e.eee 9574,9 BAKERSFIELD, C~. 9=$65 TIHEI ACTAL 12:08 A~ ZIP CODE .?~.90g 19220,1 SITE # 81360 TtHE2 ACTAL 12:~0 AH SITE # 81368 B0.0~9 19755,9 TI~E3 A~TAL 12:00 AM B~.900 11248.4 10/11/2~02 07t$¢ A~ SCHD ALST ~ONE VOL UNITS GALLONS' ~0.000 I'156~.0 ALARM REPORT TI~[ ALST 12:~0 AM LEVEL UHITS INCHES TINE2 ALST ~2:88 A~ TEMP UNIT~ FAHRENHEIT 1~/11/2002 0?:54 A~ TI~E~ ALST 12:00 AM PLUS UN SUmP TINE ~TYLE I~ HOUR DATE STYLE ~M/DD/YV KflP INV,ARCO AMPH CONFIDENCE ~9.0% DAYLIGHT SAY ENABLED. 2$12-PI£RCE RD, LEAK TEST 0.~0 SIT TIME 7~3G AH BAKERSFIELD, CA, ~08 SeND TEST SET DATE t0/11/20~2 TANK ! NON£ SITE ~ $1~60 KMP IN~,ARCO AMPM TANK 2 NONE NO. TANKS ~" 2612 PIERCE RD. TANK'3 HONE LEAK LIMIT BAKERSFIELD, CA. 33308 TIME TEST THEFT LIMIT 10.0~ ,. SITE # 81368 TANK 1 12~08 AM DELIU LIMIT 200.0E TANK 2 12:00 AM SNTNL MODE OFF 10/11/2002 07:56 A~ TANK 3 12:09 AM ALARM REPORT ~TART SNTNL END SHTHL ~2:80 ALARH DELIU DELA~ 10/11/2002 07:56 AH TtHEOUT JR REPORT DELIU DISABLE[ REG UNL SUMP HIGH LIM OH REPORT ALRMS ~HABLE{ LOW LIH OH REPORT TESTS ENABLE[ HIGH HIGH ON NO. OF ~LARM~ LOI~I LOW ON PRINT IHTERUAL 5.0~ ~IATER LIH ON LEAK LIM ON MODE CHAN,1 NATIU~ $YSFAIL OFF BAUD CHAW[1 120~ THEFT ON DATA BITSI~ STOP.BiTSi~ RELAY PARITY I { NON[ ~I~EOUT 15 SECURITY l HIGH LIN OFF ~CCE~S ! LO~ LI~ OFF PHONE ! HIGH HIGH OFF ~EDtAL 1 DISABLEI LOW LOW OFF ACCESS 2 WATER LIM OFF PNOHE 2 LEAK LI~ OFF REDIAL 2 SYSFAIL OFF ACCESS 3 THEFT OFF PHONE 3 REDI~L 3 DISABLE ACCESS 4 PHOHE 4 RE~[AL 4 DISABLE ~IAL ~ELIV DI~L ALAR~ DIAL LEAK i~ 12/02/2002 88:45 6613920G21 PAGE 07 LARM 1m ON HIGH HIGH 2 NONE INCHES · LARH 2 ON HIgH HIGH 3 NONE ~.~00 ~,0 T~NE SETUP REPORT LARM $ OH HIGH HIgH 4 NONE $.00~ 230.2 LAEM 4 OFF lO.Gee 642.7 TANK No, a 12800 8~L LARM ~ OFF SYSTEM FAIL NOME 1~.00B 1178.1 UNLEADED SUP LARM 6 OFP , 20.8~B 1756.1 LARN 7 OFF STO ! OUTPUT I ~.000 ~471.~ TANK TVP£ O.C.TANKS LARM 8 OFF STD 2 OUTPUT 2 30.00~ $~10.1 TANK DIMS -95 X STD $ OUTPUT ~ 55.000 J993,1 TANK SIZE 12888 D RELAV STD 4 HONE 40,B~0 4808,7 TANK SHAPE STANDARD LARM l OFF STD ~ NONE 4§,800 ~644,8 STANDARD 19 LARM 2 OFF STD 6 NONE 5~.000 6486.9 PRODUCT UHLEADED SUP LARM 3 OFF STD 7 NONE 55.000 7318,? oFFSET P LARM 4 OFF STD 8 NONE ~B.000 8108.~ OFFSET ~ -8.7~ $5,9~0 8506.? ~ANIFOLD NOHE LARM 5 OFF ?B.~90 9574,9 PROBE STD LARM ~ OFF 7~,B~8 10220,~ FLOATS LARM ? OFF 8B,~00 107~5,g FLOAT TVPE GASOLINE LARM 8 OFF ~RADIENT 8;9569 KMP INV.ARCO AMPM 85,000 11245.¢ D ~6t2 PIERCE RD. 90.000 11569.0 SENSOR LENBTH 101 HIGH LIMIT 85.00 LARM 1 RE~ UNL SUMP BAKER$FIELD, GA. 9~08 LOW LIMIT 8.90 LARM 2 PLUS UN SUMP SITE # 81360 HIGH HIGH 90.89 LARM ) PRE UNL SUMP LOW LOW 889.08 .LARM ¢ NONE 10~1ix2092 07~41 AM WATER LIMIT 4,08 · LARM $ HONE TANK SETUP REPORT KMP INU.AR¢O AMPM 261~ PIERCE RD. TEMP COMP APl .LARM 6 ,NONE API BRAUITV .LARM ? NONE TANK NO. ~ 12080 GAL 9AKERSFIELD, tn. 933~8 iLARM 8 NONE MANIFOLD A SITE # S1~60 ALPHA 320.00 HO. RTD$ UNLEADED REG 10x11/~02 07=43 AM RTD LOC I 1~.47 :NSOR TYP~ RTD LOC 2 ,ENSOR I STD TANK TYPE O.C,TANKS TANK SETUP REPORT ETD LOC ~ 45.$1 EN$OR 2 $ID TANK DIMS 95 ~ 435 RTD LOC 4 60.4? ENSOR 3 STD TANK SIZE 12808 TANK NO. 2 1200~ GAL EN~OR 4 ~TD TANK SHAPE 9TANDARD MANIFOLD B RTD LOC ~ 77.1~ UNL~AD~D RE8 EN~OR 5 STD STANDARD 19 STRAPPIN~ DnTA EN$OR 6 STD PRODUCT UNLEADED RE8 INCHES GALLON~ ENSOR ? STD OFF~ET P 4,04 TANK TVPE O,C. TANKS £N$OR 8 ~TD OFFSET ~ -@.$4 TANK DIMS 95 X 435 8.808 MANIFOLD MANIFOLD A TANK SIZE ~2000 5.Bee 238.; NTROL OUTPUT PROBE STD 101 TANK SHAPE STANDARD ~e.008 642.' RACE PERIOD ~ FLOATS 2 STAHDARD 19 [5.~0B ti?e, I FLOAT TVPE BASOLINE PRODUCT UNLEADED RE~ 28.000 1786. O~ LOW 1 OUTPUT'! ~ADIEHT 9.0359 OFFSET P 4.0? 25.~00 247[.' OW LO~ 2 OUTPUT 2 SENSOR LENGTH 10] OFFSET W -~.88 30.890 3210. OW LOW 3 OUTPUT ~ HIgH LIMIT s5.00 MANIFOLD MANIFOLD B ~5,90~ OW LOW 4 NONE LOW LIMIT 800.00 PROBE STD 181 ~0.99e 4888. HIGH HIGH ~0.00 FLOATS 2 45.000 56~4. ow t NONE LOW LO~ 7s0.00 FLOAT T'¢PE ~ASOLINE 58.888 OW 2 NONE WATER LIMIT ~.ee 6RAOIENT $.0279 55.000 7~10. O~ ~ NONE TEMP COMP API 60/540 SENSOR LENOTH tel 60.000 81~. OW 4 NONE PPI GRAUITV 63.50 HIGH LI~IT 85.~0 $5.008 8866. ALPHA ~2~.~8 LOW LIHIT 800.08 70,000 9574. ISM WTR 1 NONE NO. RTDS ~ HIGH NIGH ~8.08 ~.080 10228. ISH WTR 2 NONE RTD LOC 1 11.49 LOW LOW ?58,08 80.080 t0785. ICH WTR 3 NONE RTD LOC 2 38.93 WATER LIMIT 4.89 85,088 11248. ISH WTR 4 NONE RTD LOC 3 45.81 TEMP COMP API 60/540 98,088 li569, RTD LOC 4 68,47 API GRAVITY 6~,58 IGN 1 : NONE ETD LOC 5 77.19 ALPHA ~20.00 ICH 2 NONE NO. RTDS 5 RTD LOC 1 IGH ~ NONE RTD LOC 2 ~0.95 ISH 4 NONE RTD LOC 3 45.9~ RTD LOC 4 60.47 ETD LOC § 77.19 11/27/2002 1~:20 ~13S20~2! PA~E 02 MONITORING SYSTEM CERTIFICATION For Use By ~411Juri,~dlctions WltI~in the Stata of California ,~uthority Cited: Chapt~ 6. ~ HeMtb and Safety C~; Chapter 16 D~iMon ~, ~t[e 2$. Cal~ornta Code of R~gulatiogs Th~ form must b~ used to doc~ent test~g ~d servicing of monitor~g cquipm~t, ~ sep~ta ~cation or r~o~ must be prcp~d for e~h monitori~ system canal panel by ~e toolmiciau who pe~orms ~e work. A copy of this fo~ must be ~ovtdcd to the t~ system owner/operator. Thc owe, er/operant must submit a copy of ~is lena to the local agency regulat~ DST syst~s with~ 30 days oft~nt date. A. General Information Fa~.iity Name: ~ e ~ Bldg. No.: Facili~ Coutact Person: Contact Phone No.: ( Mak~od~l of Moaitor~g System: ~g_O~ .. ~' ~ Date of Tes~Se~i~Mg: .ID /~/~ B. Inven~o~ of Equipment Tcst~d/Ce~ified ~beck the nEEyoprinte boxes to indles~.speeiac =q~pm?t ins~$ervleed: · Annul~'In'T~k Gaugingspnc~ Pro~vautt Sen~or, Modot:M°del: ~~ ~ ln-T~k Oa~ing ~b¢. "~o~l:~_.'-~ o; ~ ~nular Sp~ or Vault S~sor. Modal: ~~ ~ Piping Sump / T~ch Scn$o~$). Model: I~ L ~ .... ~Piplng Sump / Tr~h Scnaar(~). M~¢I; ~ & ~ ~ Fill ~urnp 8~or(a). Model: ~ Fill Sump S~aor($). Model: ~ Me~i~ Line ~ Dete~tor. Model: ~ ~ M~hanieai Line L~k D~r. Mod~l: ~ EIccwoni¢ LMe Le~ Det~or. Model: ~ E{e~mnia Lin.~ Le~ Drafter. Model: ~ T~ Ov~]ll / l~igh-L~vgl S~sar. Model: ~ Tank eye, l[ / High-~wl S~or. Model: ~ O~¢r (~pcei~ ~ui~ment W~ ~d ~],in Scction E on Page 2). ~ Oth~r (speai~ oquipm~t ~pc ~d model in So,ion E on P~¢ 2). ~ ln-T~ Oa$~ pmbc. Mod~h Y~ P'['.. ~ ~ ~ __. Q lnem~k Gauging Probe. Model: ~ Anaular Sp~c or Vault S~sor. Model; ~ ' ~ Q Annular Spa~ or Vault Sensor. M~e]; ~ Piping Sump/T~n~ ~so~s). Model: ~ S Q Piping Sump/T~ch Seiners). Model: ~ Hit Sump S~s). MadeI: Q F~I Sump 8~sor(s). Model: ~ Mechani~l Lin¢L~D~c~r. Model; D~). I ~ ~ M~h~ical Line La~ Det~or. Mo~l: ~ E]¢~ironlc Li~ L~k D~ctor. Model: ~ Elec~nic Line Leak Detector. ~ T~ Owffill/ltlgh-Ley~l ~n~r. Model: ~ T~k Overfill / High-Levvl Sensor. M~eh ? O~er (~e~i~ ~quipm~t ~p~, ~d mode in S~on E on P~ge 2). ~, ~r ~eci~ e~u[~ment ~pc and m~ in Section E on Page 2). Dis~n~rlD: ] ~ ~ ' - Dbpen~erlD: .~ - ~ ..... ~Disp~r~niainm~ntSensor(s). M~el:~~~ ~Dis~ns~C~n~nm~tSen~r(s). Model:~~ ~ Sh~ V~dw(z). -- ~ Shear V~vc(s). ~ Dis~n~r Containment Floa~$} ~ GhgnO). ~ Disp~r Containment Fioat{~) and Chain(i): ~ Dispenser ContMmcnt ~n$or(:). MMel:~~~ ~ D~p~aer ~m~nt Sensor(s). Model: DisO<$~~ ~oat~nm~t Float,s) ~d'Cbain(~). ~ Di~n$~r Conminm~t ~Io~s) an~ DIspsnser ID: Dilpcnser ~: '" ~ Dis~fl~r ~ntgnment Senso~s). Me, el: ~ Diaper Comaln~¢nt 8~flso~s). Model: ~ 8ho~ Valves). ~ Shear VMva(s). DDi~a~ser Cm}?inm~t Ftoat(~} ~d ~n($)a n Dispen~r Cantonment .~}ont(s) and · If the f~ility vontains mo~ t~ks or d[s~¢nsc~, copy ~is fo~. include infom~ation for ave~ tank ~d diso~ns~ ~ fl~e faoili~. C. Certification . I certify that thz ~quip~ent identified ~ this document was Insp~d/semieed in accardan~ with tl~e manufacturers' guidelines. &tracheal ~ ibis Certifi~iion is information (e.g. ~anufaeturers' ~ae~li~) ~c~aa~ ~o varify that inbrmafion is correct and a Plot Plan showing the layout of monRor~g equipment. ~or any equipment ~pable af ~eae~ilng such repor~ I have also a~ a ~py of the report; (c~ aU thm app~): ~ $~te~et-up $ A~rm~tory ~port T,sti~[ ~m~y Name:._ ~IC ~' ~ O 1~ ~ ~ Phone No.:(~ ~- ~ ~ Pag~ 1 of~ Monfforing Systm Ce~ification 11/27/2882 16:28 6613920621 PAGE 03 Results of Testing/Servicing Complele thru roi{owing check{ist; Yes ~ Noi Is the audible ala~ operatlo~al? Yes ~ No* Is ~e visual ala~ o~tionai? ..... Yes ~ No~ we~ all"~o~ visually inspeC~d, f~ctlonfl~y tested, m~d con~ed operational? Yes ~ No; Were all sensom ~stalled et low6st ~oint of s~onda~ contat~ent and posi~One~ so fllat other equipment will not intgfere with th.ei~ propo[ operation? Y~ ~ No* If al~s a~ relay~ to a r~otc monhoring station, is all ~mmunications ~quipm~t (e.g. modem)- ~ N/A operational? Yes" ~ No*' Fo; pr~surizcd pi~ing systcms, does the turbine automati~lly sh~ down if~e ~ N/A monitor~g syst~n ~tccLs a leak, fails to opemto, or is elec~ically disco~ected? If yes: whl~ sensors initiate positiw shut-do~? (Check ~I/float op~l~) ~Sump~r~ch Sen~n; ~ D~pcnser Conta~men: Semom. Did you confu'm posiave shut-down due to leaks and sensor failu~dlsco~e~lon? ~Yes; ~ No. Y~s ~ No* For {~k systems ~at utilize ~e monitoring: system ~ the pdma~ t~k ~ N/A mechanical overfill p~veaion valw is ~stal[ed), ~ ~e overfill w~i~ alan. visible and audible at the fill point(s) and o~e~ti~g pro~r]y? ..If so, g what pement of tank capaoiw does th~ a[~ ~ger? .. % Yes* ~ No Was a~y monit~ng ~uipment replaced? 1lyes, identi~ sbecific sensors, probes, or o~g equipment repla~td and Ust ~e manuscript name and model for all r~hcement p~ in Section E, below. Yes* ~ No Was liquid found inside ~y se%nda~ con~in~ent systems'deSigned ~ ~ syst~? ~ Product; ~ Wa~r, If yes, describe causes ~ Sexton E, below. Yel ~ No* Wa~ moniWri~g system. Set-up ~viewed to ensure proper sc~ngS? A~ch s~t up rep°~, if appli~ble' Yes ~ No* ls a~ m~toring oquipm~t op~tional per n~anufacm~r's speoifi~t~ns? la Seciioa k below, describe bow an~ when these deficiencies were or will be cortaid. " - Comments: Page 2 of~ / 01/01 11/27/2002 16:28 6613B20621 PAGE 04 F. In-Tank Gauging / SIR Equipment: lgl Check this box if tatlk gauging is used only for inventory control. [2 Check chis box if no tank gauging or SIR equipm~t is ~alled. This s~on m~t be completed if in-t~ gauging equipm~t is ~ed to p6fform leak detection monitor~g. Comptete the following checklist: ~ Yes ~ ~o* H~ all ~put w~ing' ~ ~spected for proper ~n~ and ~afion, i~lu~g ms~ng for ~o~d fault? ~ Yes ~ No* Were aii't~ g~g~g probes visually/nsp~ted'fo~ d~age and r~idue buildup? ~ Yes ~"' No* W~ ae~y of sys~m p,,oda~t ]vVel macps tested? ~ Yes ~ ~o* Was aeeu~ey ofz~stam wa~er ~e~ol read~ t~ted? ~ Yes ~ ~'o* Were all ~b~ ro~stalifid properly? -- ~ Yes ~ ~o* Were all items on the equicor m~u~mrer's m~n~ee ehec~t eomplot~ G. Line Leak Detectors ~LD): ~ ehcc~ ~ box i~LLDs ~ ~ot eom )lete the following ehec~ist: ~ Y~s U" No* For equipiii~t ~t-u~ or ~Ual cquipm.ent c~ifi~Oon, was a le~ s~ulawd to ~ Y~s ~ No* Wer~ all LLDs con.ed op~tional ~d a~umte wi~ re~lato~ gq~cments? ~ Y~s ~ No' Was thc tesfi~"~pa~i~s p~p~ calibrated? ~ Yes ~ No*~ F~ mech~c~ LLDs, ~e~ ~e LLD~s~i~ product flow if it dete~ a leak7 ~ Yes ~ No* For el~nic LLDs,'~oes ~e ~bine automatically shut off ift~e ~D de~cts a le~? Q Y= Q Ho* For =l=~orfi~ LLDs. d~ ~= turb~e aumm~cally shut offif ~y ~ion of~e monimri~ sys~ is dbabled ~ ~A or dbco~ea=d? Q Y~ Q N0* F~r cleo=ohio LLDs, doos thc mrbin=' automa~c~lly shut dff tf =y potion of ~ N/A mal~nc~oas or fa~z a test? ~ Yes Q"No* For elec~oiiic LLDs, havo all =cessibl= wi~ ~o~ec~ons been ~u~ly insp~cgd? ~ N/A ~=s ~ No* W~ro all ii=~ns on th~ equi~nent m~fac~rer's ma~tca~ce che~list comPloted? . r .g=e .... =*" H, below, d~cribe how and when these dgficieng~s were or will be Comments: Page 11/27/2882 1G:20 6613920621 PAGE 05 Monitoring Syslem Certifiea UST Monitorin. g Site Plan . ~ .................. lnstruetiom tf you already have a dia~am ~at shows all required info~ation~ you may include it, rather th~ ~is Page, with your Monitoring System Ccnifi~tion. On your site plan, show the general layout of mn~ ~d p~ing. Cle~ly identify locations of ~e following equipment, if installed: monitoring system ~n~ol panels; sensom monitoring ~nk annular spaces, sumps, disposer p~s, spill ~ontainers, or other secondly con~inment ~teas; mec~nic~l or el~tm~ic line detectors; and in-t~k liquid level prob~ (if used for leak d~eotion). In the space provide., note the date ~is $i~ was preparcd. ' Page __~._ of~ 05/00 11/27/2882 16:20 6613920621 PAGE 06 R_ . I CH .ENV Z R O NI ENTAL 56'43 ~ROOKS CT ~AF~ERS~ZLD, CA. 95508 OFFICE(661)~92-868T & FAX (661)392-0621 w/o#: PRODUCT L~ DETECTOR TYPE TBST ' TRIP PASS SERI~ ~Ea BELOW PSI OR $. ~PH ._ FAIL "' ~Es L/D TYPE ....... I certify the above tests were conducted on this dace accorOin~ Co Re~ Jacket Pump~ field ~esc ag~aratus %e~tin~ procedure ~ l~m£ca~ions. The Mechanical Leak DeteCtOr Test pam~ / fa~l i~ determined Dy using a Iow flow threshold triD ra%e of 3 gallon per hour or less a[ 10 PSI. I acknowledge that all data collected is true and correct to =he bes~ of my knowledge. Tech: J~ES J. RI~ __ State License:#-~ -- ~r-~ 11/27/2002 16:28 6613020G21 PAGE 07 ALARm I ON NIOH HIGH 2 NONE INCH[~ ~ALLONS ALARM 2 ON HIGH HIGH 3 NOHE 0.980 ~.8 TANK SETUP REPORT ALARM 3 ON HIBH HIBH 4 HONE 5.000 ALARM 4 OFF 10.08~ 642.7 TANK NO. 3 12eeo GAL ALAR~ 5 OFF SYSTEM FAIL HONE 15.88~ 1170.1 UNLEADED SUP ALARM 6 OFF , 20.8~0 l?GG.l . ALARM 7 OFF STD 1 OUTPUT 1 25.80~ 2471.~ TANK TYPE .. O.C.TANKS ALARM 8 OFF STO 2 OUTPUT 2 ~0.00~ 32I~.~ TANK DIMS 95 STD 3 OUTPUT $ 35.00e 35~.1 TANK SIZE 12000 TD RELAY ST~ 4 NOME 48.000 4~o8.? TANK SHAPE STANDARD ALARM I OFF STD § NOHE 45.888 5~44.8 STANDARD ALARM 2 OFF STD 6 NONE 58,888 6486,~ PRODUCT UNLEADED SUP ALARM 3 OFF STD 7 NONE 55.088 7318.~ OFFSET P 2.63 ALARM ¢ OFF STD ~ NONE 60.808 8108.~ OFFSET W -0.71 ALARM 5 OFF 65.808 8866.7 MAHIFOLD NONE ALAR~ 6 OFF 70,880 9574.~ PROeE STD 101 ALARM ? OFF 75.0~ 10220.1 FLOATS 2 ALARM 8 OFF 80.B00 10785.9 FLOAT TYPE 6A$OLINE KMP INV,ARCO A~PM 85.800 1~24~.4 GRADIENT TD ' 2612 PIERCE RD, ~0.080 11369.8 SENSOR LENGTH t~l HIGH LIMIT $5,0~ ALARM 1 RE~ UNL SUMP BAKERSFIELD, CA. 93505 LOW LIMIT 8,8( 4LARM 2 PLUS UN SUMP SITE # 81568 HIGH HIgH 98.8( ~LARM $ PRE UNL SUMP LOW LOW $~.0( ~LARM 4 NONE 1~/11/2002 87;41A~ 4,8E ~LARM 5 NONE TANK SETUP REPORT K~P INU. ARCO AMPM WATER LIMIT %LARM 6 ,NONE 2612 PIERCE RD, TEHP COHP ~PI 60/54~ %LARM 7 NONE TANK NO, I 12808 GAL BAKERSFIELD~ CA. 93308 AP[ GRAVITY %LARM 8 NONE MANIFOLD A SITE # 8t360 ALPHA HO, RTD$ UNLEADED ~NSOR TYPE 10/11/2002 ~7:¢~ AM RTD LOC 1 I1.4~ ~ENSOR 1 STD TANK TYPE O.C.TANKS TANK SETUP REPORT RT~ LOC 2 50.~2 RTE) LOC 3 45.8: ~EN$OR 2 STD TANK DIMS ~§ X 435 60,4; )ENSOR $ STD TANK SIZE 12808 TANK NO, 2 12~8 ~AL ~TD LOC 4 ~ENSOR 4 STD TANK SHAPE STANDARD ~AN]FOLD B ETD LOC 5 77.1' )EN$OR 5 STD STANDARD 15 UNLEADED REG STRAPPING DATA )EN$OR 6 ~TD PRODUCT UNLEADED RE6 INCHES GALLON~ )EN$OR 7 STD OFFSET P 4.04 TANK TYPE O.C,TANK$ ~ENSOR $ STD OFFSET id -8.84 TANK DIMS 95 X 4~5 8.8~0 MANIFOLD MANIFOLD A TANK SIZE 12000 s,oe8 238.: )NTROL OUTPUT PROBE STD 181 TANK SHAPE STANDARD 18.808 642,' ;RACE PERIOD o FLOATS 2 STANDARD 19 I5,880 1~70, ~ FLOAT TYPE GASOLINE PRODUCT UNLEADED REG 28,800 .OW LOW 1 OUTPUT 1 GRADIENT 9,8359 OFFSET P 4.87 25.000 2471. .OW LOW 2 OUTPUT 2 SENSOR LENGTH I81 OFFSET W -~.88 38.080 3218, .OW LOW 3 OUTPUT $ HIGH LIMZT 85.00 MANIFOLO MANIFOLD B $5.080 ~. .0~ LOW 4 NOHE LOW LIMIT :)00.~8 PROSE STD ~81 ¢~.800 4808. HIGH H~GH ~0.~e FLOATS 2 4~.00~ 56~4. .0~ 1 NONE. LOW LOW ?~0.00 FLOAT TYPE GASOLINE 50.000 OW 2 NONE WATER LIMIT 4.00 GRADIENT 9.8279 ~5.080 7~1~, OW 3 NONE TEMP COMP AP1 6~Y~48 SENSOR LENGTH 101 68,080 OW 4 NONE APl GRAUITY 63.50 HIGH LIMIT 85.88 65.0~0 8866, ALPHA 328.88 LOW LIMIT 800,00 78.000 95?4, IGH WTR 1 NONE NO, RTD$ § HIgH HIGH 90.08 75,800 18228. I~H WT~ 2 NONE RTD LOC 1 11,49 LOW LOW 750.88 88,000 16H HTR 3 NONE ETD LOC 2 $8.93 WATER LIMIT 4.00 85,808 11248. .IGH ~TR 4 NONE ETD LOC ~ 45.81 TEMP COMP APl 68Y548 98.000 11569. RTD LOC 4 68,47 AP! 8RAUITV 6~,50 IGH 1 : NONE ETD LOC 5 77,19 ALPHA 320.88 I6H 2 NONE NO. RTDS 5 IGH 3 NONE ETD LOC 1 ~1.49 IGH 4 NONE RTD LOC 2 ETD LOC 3 45.81 ~T~ LOC 4 68.47 RTD LOC 5 77.1~ 11/27/2002 16:28 6613B2BG21 PAGE 88 · AMP~ ,,,.,.L KMP INV.RRGO RMPM INBHE~ 8ALLONS 2612 PIERCE RD. TIME2 INVTR 12:00 AM BAKERSFIELD, 0.o80 8.0 BAKERSFIELD, CA. ~3~B TIMES INVTR 12:00 AM 5.008 230.2 SITE # 81360 SITE # 81~60 lo.cee G¢2.? SOHO INURC NOHE iS.Be@ II?B.l 10/11/2882 07:$$ AM TIMEr INVRC I2:Be AM 10/11/2002 2'O. BBB t?SG, l ALARM REPOR~ TIME2 INURC 12:88 AM SYSTEM SETUP REPORT 23.000 , 2471.3 TIME3 IHURC 12:88 AM SCHD DLHST NONE $OFT~ARE UER:~ION 0.~91~ $$.00030'085 =993.152i0'I PRE~e/llx2002UNL SUMP 07:5~ AM TIME1 ~LHST i2:00 AM 48.eBe. 4808,? TIME2 DLHST 12:8B AM LOCATION 1 KMP INV, 45.80~ ~64~.8 TIME3 DLHST 12:@0 AM LOCATION 2 ARCO AMP~ 5~.~88 648~.9 SOHO RLHST NONE STREET I 2612 PIERCE ss,cee 73t8,~ TIMEI ALHST Z2~00 AM STREET 2 RD, TIME2 ALHST !2:00 AM CITY 1 ~AKERSFIEL~ 60.B00 8108.3 KMP INU.ARCO AMPM TIMES ALH~T 12~08 AM ~ITY 2 65, BB@ 8866,7 ~12 PIERCE RD. SCHD ACT AL NONE STATE OR. ?~,8~0 9574,9 BAKERSFIELD, CA. 93388 TINEI ACTAL 12:08 AM zs.eee t8220,1 SITE ~ 813~0 ZIP CODE BB.@B8 10785,$ TIME2 ACTAL 12:8B AM SITE # 85,888 11248.4 10/11/2082 87;54 AM TIME~ ACTAL 12:00 AM $¢HD ALST NONE VOL UNITS OALLON:~ 90,808 1'1369.8 ALARM REPORT TIMEi ALST 12:80 AM LEVEL UNITS INCHE~ TIME2-~LST 1~:80 AM TEMP UNITS FAHRENH~I1 1~/11/2802 07:~4 AM TIME3 ALST 12:00 AM PLUS UN SUMP TIME STYLE 12 HOU~ DATE STYLE MM/DP/Y; KMP INU.ARCO AMPM CONFIDENCE gg,0% DAYLIGHT SAU ENABLE~ 2512.PIERCE RD., LEAK TEST 0.10 B~KERSFIELD~ CA. 9~300 $CHD TEST SET TIME 7:38 A~ SET ~ATE 10/I1/200; SITE ~ 81~6~ KMP INV.ARCO AMPM TANK I NONE ~-- TANK 2 NONE NO, TANKS 2G12 PIERCE RD. TANK 3 NONE 8AKERSFIELD~ CA. 93~$ TIME TEST LEAK LIMIT THEFT LIMIT 1~.~ , SITE # 81368 TANK 1 12:@8 AM DELIU LIMIT TANK 2 1~:8~ AM SNTNL MODE OFF 18/11/2002 07:~ AM TANK 3 12:00 AM ALARM ~EPORT START SNTNL ALARM END SNTNL 12;08 ~0~002 07~6 AM TIMEOUT 30 DELIU ~ELA¥ REG UNL SUMP REPORT DELIU DISABLED HiGH LI~ ON REPORT ALUMS ENABLED LOW LIM ON REPORT TESTS RNA@LEO HIGH NI~H ~N NO. OF ALARMS LOW LOW ON PRINT [HTERUAL !~ATER LIM ON LEAl LIM ON MODE CHAN.1 NATIVE SYSFAIL OFF BAUD CHANtl 1280 THEFT ON DATA BITS|I 8 ~ELAY STOP BIT$i! TIMEOUT 15 PARITY ~ / NONE HIGH LIDI OFF SECURITY ! LO~ LIM OFF ACCESS ! HIGH HIgH OFF PHONE ! REDIAL [ DISABLED LOW LD~ OFF ACCESS 2 WATER LIM OFF PHONE 2 LEAK LIM OFF REDIAL 2 DISABLED SYSFA~L OFF THEFT OFF ACCESS ~ PHONE ~ REDIAL ~ DISABLED ACCESS 4 PHONE 4 EEDIAL 4 DISABLED DIAL DELIV DIAL ALARM DIAL LEAK 11/27/2002 16:20 6613920621 PAGE 09 'i KMP ~NU. AR¢O ANPM 2612 PIERCE RD. BAKERSFIELD, CA. 95588 SITE ~ 81368 10/11/2002 ALAR~ HISTORV 9/29/20~2 11:11PN SYSTEM FAIL PROBE SYNC TANK NO. 2 SYSTEM FAIL PROBE SVN¢ TANK NO. 2 " 9/'29/'2002 11:12 PM SYSTEM FAIL ' PROeE SYNC TANK NO. 2 9/29/2¢02 11:14 SYST[H FAIL PROE:E SYNC TANK NO. 2 ~/2s/28o2 1I:14 S¥STE~ F~IL F'~OBE TRNK NO. 2 9/29/2082 11:15 PN SYSTE~ FAIL PROBE SYNC TRNK I,lO, 2 9,'2g/2002 ll:I~ PM SY:~TE~ FAIL PROBE SYNC T~NK NO, 2 9/29/2002 11:1'~ PN SYSTEM FAiL PROBE SYNC TA~K NO. 2 SVST[~ FA~L P~OB~ SY!uc ~ANK NO, 2 le/2/2882 SYSTEM FAIL PROBE SYNC TANK NO. 2 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~tCO Am, ~,x. INSPECTION DATE Section 2: Underground Storage Tanks Program [] Routine [~ Combined [] Joint Agency [21 Multi-Agency [] Complaint [] Re-inspection Type of Tank ,~)~,~ Number of Tanks Type of Monitoring ~ ¢.fl/x Type of Piping ~ OPERATION C V COMMENTS / Proper tank data on file Proper owner/operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current' Failure to correct prior UST violations Has there been an unauthorized release? Yes' No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) 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? V=Violation Y=Yes N=NO C=C°mpliance/ff~ ~ Insp;ctor: ...~ _ ~ .~.j~k~_,.-~%~ ~ Office of Environmental Services (805) 326-3979 Business Site Responsible Party . 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 FACILITY NAME J~_~ A~ ~tl~ INSPECTION DATE ADDRESS ,~la ' J3t.t~{C ~t. OCn '~ PHONE NO. 5~(,., - FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ~ Routine ~ Combined [~ Joint Agency [~ Multi-Agency [,..~ Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand "-' / Business plan contact information accurate '~/ Visible address L,, / Correct occupancy Verification of inventory materials ~.J Verification of quantities Verification of location ""' / Proper segregation of material ~ ~/ Verification of MSDS availability ( Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping / Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: [~ Yes [~]~No Explain: Questions regarding this inspection? Please call us at (661) 326-3979 Business ~i~esp~2ble Party w,ite- S.v. Sv~s. vel,o,,,- statio, cov~, Pin~. - ausi.ess copy Inspector: c - MONIT G SYSTEM CE - ~(~,,~k.~ ~ For Use By All Jurisdictions Within the State of California .x~ Authority Cited: Chapter 6. 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment: A separate certification or report must be ~epared 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 Nanle: _ .l~, ~ ~-..-~")~ Bldg. No.: Site Address:. ~ ~ I ~. ~_L~.. ~.~ ~_0{~. ' ~3t.~S City: l~/~Jl~'i~..( P~/~' & .t~ Zip: Facility Contact Person: Contact Phone No.: ( ). Make/Model of Monitoring System: ~"~t:O~"t ~"',~"- fg~t0~} Date of Testing/Servicing: IlO / fl /~__~ B. InventOry °fEquipment Tested~Certified Check the appropriate boxes to.!ndicate specific equipment inspected/serviced: tTankID: t, Jtl~L- ~ TanklD: /)l~//-- ~'~' . ~. In-Tank Gauging Probe. Model: ~,~ tO-' K/,3 ~ In-Tank Gauging Probe. "Model: ~S'~'-- [tl~ Annular Space or Vault Sensor, Model: /~" '~ ~' ,~ Annular Space or Vault Sensor. Model: /.,~ tl~ Piping Sump / Trench Sensor(s). Model: I_/' t _.~ ~'Piping Sump / Trench Sensor(s). Model:/~/.. _~ [21 Fill Sump Sensor(s). Model: ~ Fill Sump Sensor(s). Model: IJ iii~ Mechanical Line Leak Detector. Model: ~,}:_~..~/n~ ~ Mechanical Line Leak Detector. Model: El Electronic Line Leak Detector. Model: D Electronic Line Leak Detector. Model: D Tank Overfill / High-Level Sensor. Model: ~ Tank Overfill / High-Level Sensor. Model: [ D Other (specify equipment type and model in Section E on Page 2). ~ Other (specify equipment type and model in Section E on Page 2). ~ In-Tank Gauging Probe. Model: ~'.'g ~, /,/~ ~ ~ In-Tank Gauging Probe. Model: ~ Annular Space or Vault Sensor. Model: I~ -, '~ - El Annular Space or Vault Sensor, Model: 2~ Piping Sump / Trench Sensor(s). Model: b//, ,$ El Piping Sump / Trench Sensor(s). Model: Fill Sump Sensor(s). Model: El Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: ~/t )-- I ~',-~" ~ Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: .... 121 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: ,? - ~ t Dispenser ID: ~Dispenser Containment Sensor(s). Model: _AJ O ~'~,&t~t~ ~ Dispenser Co~ainment Sensor(s). Model: .A.}O ~t' Shear Valve(s). ~ Shear Valve(s). El Dispenser Containment Float(s) and Chain(s). ~ Dispenser Containment Float(s) and Chain(s). 1 D.~ispenser ID: ,.~'"' ~ ~ispenser ID: ~'~ '~ Dispenser Containment Sensor!s) Model:d/J00~ll'~oSt~t~.. ~. Dispenser Containment Sensor(s). Model: )~0 ill, Shear VaNe(s). ' t~f Shear Valve(s). ~ Dispenser Containment Float(s) aaffChain(s):. ~ Dispenser Containment Float(s) and Chain(s). t Dispenser ID: Dispenser ID: ~i~ Dispenser Containment Sensor(s). Model: D Dispei~ser Containment Sensor(s). Model: D Shear Valve(s). 12 Shear Valve(s). DDispenser Containment Float(s) and Chain(s). ~ Dispenser Containment Float(s) and Chain(s). *If the facility contains more tanks or dispensers, copy this fo~m. Include information for every tank and dispenser at the facility. C. Certification - ! 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 attaclllld a copy of the report; (check all that apply): J~ S_v.~tera~set-up ~ Al§rm~history report Teclmician Name (print):_ ~1~ r~/ql_ .~, ~45a/'~ Signature::~ ,~~~. , Site Address: :~_~.~ le~ rl ~' 1~.6'~' ('~J i"~11~'i ,- ,/r/Sff Date ofTesting/Servicing: ,t~"]]-'~ Page I of~ 03/01 Monitoring System Certification D. Results of Testing/Servicing Software Version Installed:. · '~q ]0 complete tne lolluwmg ~.,ecklist: .... Ji~ 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? ,ffii Yes [] No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will aot h~terfere with their proper operation? [] Yes ~ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) ~ N/A operational? ~ Yes [21 No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment [] N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) ~ Sump/Trench Sensors; [] Dispenser Containment Sensors. Did you confum positive shut-down due to leaks and sensor failure/disconnection? ~ Yes; [] No. ~ Yes ~ No* For tank systems that utilize the monitoring system as the primary tank ok, drfill warning device (i.e. no ~ N/A mechanical oveffill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? % {21 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* tfiil No Was liquid found inside any secondary contaimnent systems designed as dry systems? (Check all that apply) ~ Product; [] Water. If yes, describe causes in Section E, below. JS, Yes ~1 No* Was monitoring system set-up reviewed to ensure proper settings? Attach set up repol~s, if applicable ~ Yes ~ No* Is all monitoring equipment operational per manufacturer's specifications? · In Section E below describe how and when these deficiencies were or will be corrected. E. Comments: ; Page 2 of ~' 03/01 F. In-Tank Gauging / SIR Equipment: lg[ Check this box if tank gauging is used only for i~ventory control. Fl 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 me tonowm~ checklist: ~ Yes I I--I No* Has all input wiring been'inspected for proper entry and termination, including testing for ground faults? )i~ Yes ~ No* Were all tank gauging probes visually inspected for damage and residue buildup? ~i~ Yes FI No* Was accuracy of system product level readings tested? ~ Yes O No* Was accuracy of system water level readings tested? Yes rl No* Were all probes reinstalled properly? Yes [21 No* Were all items on the equipment manufacturer's maintenance checklist completed? e In the Section H, below, describe how and when these encl G. Line Leak Detectors (LLD): Cl Check this box if LLDs are not installed. t~omptet~ t.~ followin~ checklist: ~1 Yes F1 No* For equipment start-up or annual equipment ce~[ification, was a leak simulated to verify LLD performance? CI N/A (Check all that apply) Simulated leak rate: ~[ 3 g.p.h.; ~ 0.1 g.p.h; [21 0.2 g.p.h. ~ Yes ~ No* Were all LLDs confirrned operational and accurate within regulatory requirements? ~ Yes Fl No* Was the testing apparatus properly calibrated? ~I~ Yes ~ No* For mechanical LLDs, does the LLD restrict productflow if it detects a leak? Fl N/A ~ Yes [21 No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ~ N/A I21 Yes Fl No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ~1~ N/A or disconnected? r'l Yes [] No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system ~ N/A malfunctions or fails a test? ~ Yes ~ No* For electronic LLDs, have all accessible wiring connections been visually inspected? .~ N/A ~ll~Yes CI No* Were all items on the equipment manufacturer's maintenance checklist completed? e In the Section H, below, describe how and when these deficiencies were or H. Comments: Page 3 of~ 03/01 Monitoring System Certification UST Monitoring Site Plan . Date map was drawn: Instructions If you already have a diagram that shows all required information, you may include it, rather than this page, with your Monitoring System Certification. On your site plan, show flae general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank atmular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak . detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan Was prepared. Page ~ of¢ 05/00 RICH ENVIRO1V~NTAL 5643 BROOKS CT BAKERSFIELD,CA. 93308 OFFICE(661)392-8687 & FAX (661)~92-0621 w/o#: Facility Name:--~~'~ Product Line Type (pressure, Suction, Gravity)_ p----RODUCT LEAK DETECTOR TYPE TEST' TRIP PASS SERIAL NUMBER BELOW PSI OR $ GPH FAIL P~SS SERIAL #~~ N FAIL -' L/~ ~'~ ,-- ~ '" I certify the above tests were conducted on this date according to Red Jacket p,~mps field test apparatus testing procedure an limitations. The Mechanical Leak Detector Test pass / fail is determined by using a iow flow threshold trip rate of 3 gallon per hour or less at 10 PSI. I acknowledge that all data collected is true and correct to the best of my knowledge. Tech: j~ES J. RICH State License:#~ Signature: ' I ALARM I ON HIGB Hi 2 NONE INCHES GALLONS -- ALARM~2 ~ '~ ON HIGH ~ NONE 0.(~00 ~ 0.0 TANK SETUP REPORT ALARM ~ ON HIGH HIGH 4 NONE 5.000 ~-230.Z 12m~F~ GAL ALARM 4 OFF 18. E~8 ~4;... ..... ALARM 5 OFF ~.~TEM FAIL NONE ..... ALARM 6 OFF ~ 28. EiE18 !786.1 ALARM 7 OFF S'TD I AUTPtIT 1 25.000 2471.3 TANK TYPE O.C.TANKS - -' 38.880 321~.1 TANK DIMS 95 X 435 ALARM 8 OFF STQ 2 OLITPUT 2 ~S ~qq~.l TANK SIZE 12~8~ . STD 3 OUTF'LIT 3 .~._.888 ....... STD RELAY STD 4 NONE 40.El~ 4888.7 TANK SHAPE STANDARD ALARM 1 OFF STD 5 NONE 45.88~ 5644.8 STANDARD 19 ALARM 2 OFF STD '6 NONE 58.808 64S6.9 PRODI]CT UNLEADED SUP ALARM 3 OFF STD 7 NONE 55.~80 ~31E1.9 OFFSET P 2.63 ALARM 4 OFF STD 8 Nr~NE 6~.~88 '8188.3 OFFSET W -0.71 ALARM 5 OFF - 65. Et~ 8866.7 MANIFOLD NONE ALARM 6 OFF 7El. OOE1 9574.9 PROSE STD ALARM 7 OFF 75.E108 18220.I FLOATS 2 ALARM 8 OFF 88.E~88 18785.9 FLOAT TYPE GASOLINE KMP IN,~.ARCO AMF'M S5.088 11248.4 GRADIENT 8.9569 STD 261~ PIERSF S'D q~:~.~:~m~ 11569.~ SENSOR LENGTH 1~1 ALARM 1 REG UNL SUMP 8AKERSFIELD~ CA. 933~8 LOW LIMIT ALARM 2 PLUS UN SUMP SITE ~ S1368 HIGH HIGH 90.88 ALARM 3 PRE UNL SUMP LZ~ LOW ALARM 4 NONE 18,'11.,'2082 07:41 AM ~ATER LIMIT 4.~t~ ALARM 5 NONE TANK SETUP REPORT KMP INU.ARCO AMPM -- ALARM 6 ~NONE 2612 PIERCE RD. TEMP COMP API 6B.,'54B ALARM ~ NONE TANK NO. 1 12808 GAL E'.AKERSFIELD~ CA. 933~78 API GRAUITY 51.3~t ALARM 8 ~ONE MAHIFOLD A '.SITE ~ S1360 ALPHA 32~.(18 . NO. RTDS 5 UNLEADED REG SENSOR TYPE 18,"i1..'2882 87:43 AM RTD LOC ~ 11.49 SENSOR 1 STD TANK TYPE ,.-. TAHK SETUP REPORT RTD LOC 2 38.93 b.L..TANKS RTD LO~: 3 45.S1 SENSOR 2 STD TANK DIMS 95 X _ 4c,, . " 12E188 GAL RTD LOC 4 SENSOR 3 STD TANK SIZE. 12808 TANK NO SENSOR 4 STD TANK SHAPE STANDARD MANIFOL[:. 8 RTl:. Lr]c 5 7~.19 SENSOR 5 -STD STANDARD lq UHLEADED REG · -. ' STRAPPING DATA SENSOR 6 STD PRODUCT UNLEADED REG GALLONS SENSOR 7 STD OFFSET P 4.84 TANK TYPE 0.~ v,-~K~. INCHES SENSOR 8 STD OFFSET W -8.84 TANK OIMS 95 ',;.( 435 E~.(~8(~ ~'~ MANIFOLO MANIFOLD A TANK SIZE 12888 5.8~0 238.2 ;ONTROL OUTPUT PROSE STD I81 TANK .SHAPE STANDARD l~.8;~Et 642. .~ STANDARD 19 15. ~J~30 GRACE PERIOD 0 FLOATS ~ FLOAT TYPE GASOLINE PRODI_ICT UNLEADED REG 20.000 1786.1 LOW LOW 1 OUTPUT 1 GRADIENT 9.0359 OFFSET P 4.87 25.000 24~1.3 LOW LnW 2 OUTPUT 2 SENSOR LENGTH 101 OFFSET W -0.89 30.000 3210.1 ' 8 35.800 3993. ! LOW LOW 3 OUTPUT 3 HIGH LIMIT .~: :: MANIFOLD MANIFOLD LOW LOW 4 NONE LOW LIMIT 808.00 PROBE STD 101 40.000 ~,:.~,:.., - ~ ..... 45.m:~0 F, 644.8 HIGH HIGH 90.08 ~ L 3HT.:, 2 -- LOW'I NONE LOW LOW 758.88 FLOAT TYPE GASOLIHE 58.888 LOW 2 NONE WATER LIMIT 4.88 GRADIENT 9.(~279 55.888 7318.9 LOW 3 NONE TEMP COMP AF'I 68/.54B SENSOR LENGTH 181 68.888 8188.3 LOW 4 NONE APl GRAUITY 63.58 HIGH LIMIT 85.88 65.888 8866.? ALPHA 328.88 L'JW LIMIT 888.88 78.888 9574.9 HIGH WTR 1 NONE NO. RTDS 5 HiGH HIGH 98.88 75.888 18228.1 HIGH WTR 2 NONE RTD LOC 1 11.49 LE~I,I LOW 758.88 88.888 18785.9 HIGH WTR 3 NONE RTD LOC 2 38.93 WATER LIMIT 4.88 S5.888 11248.4 HIGH WTR 4 NONE RTD LOC 3 45.81 TEMP COMP APl 68.'548 98.888 11569.8 RTD LOC 4 68.47 API GRAUITY 63.58 HIGH 1 : NONE RTD LOC 5 ??.19 ALPHA 328.88 HIGH 2 NONE NO. RT[:'S 5 RTD LOC I 11.49 HIGH 3 NONE RTD LOC 2 38.93 :HIGH 4 NONE RTD LOC 3 45.oi RTD LOC 4 68.47 RTD LOC 5 77.19' ........................... ~z KMF' IHU.AF.':O AMF'M o~.:Hi-'r'~,u UH:H KMF' IHV.AR. CO AMF'M TIME1 INUTR 2:(18.AM 2612 PIERCE RD. INCHES GALLONS 261~ERCE RD. TIME2 INUTR ,2:8~ AM 8AKER8FIEL[:,, CA..'~AF', 0.000 ' '~ 0.0 BAKERS~C,, CA. 93598 TIME3 INUTR 2:~ AM ...... 5.008 250.2 SITE ~ 81560 '.SITE ~ 81560 18.808 642.7 8C:HD IHURC HONE 15.880 1178.1 10/11/2002 07:55 AM TIME1 INURC 12:00 AM 10,"1'1.,'2802 07:z:q AM 20.008 1786.1 ALARM REPOR~ TIME2 IN~PE 12:¢~¢$ AM q ~ . ....... ._,~TEM 8ETUP R. EF;ORT 25.088 2471.~ TIMES INURC !2:80 AM SCHD [:,LHST NONE :-FT AR~ UERSIOH 8.qq1¢t ~0.000 S210.1 10/11/2882 07:55 AM TICE1 OLHST 12:08 AM ......... ~5.800' ~995.1 PRE UNL SUMP ' 48.080. '4808.7 TIME2 [:,LHST 12:00 AM LOCATION 1 KMP INU. 45.808 5644.8 TIMES OLHST 12:08 AM LOCATION 2 ARE] AMPM 50~000 6486.9 '.SC:HQ ALHST-. NONE 'STREET 1 2612 PIERCE 55.000 7~10.9 TIME1 ALHST 12:00 AM E;TR. EET 2 RI:,, TIME2 ALHST 12:80 AM CITV 1 BAKERSFIELD 68.088 8108.S KMF' INU.ARCO AMPM TIME~ ALHST 12:0A AM T'~ 65.800 8866.7 2612 PI=R_.= RD. SC:HD ACT AL HONE - '.STATE CA. 70.000 9574.9 BAKERSFIELD, CA. '~55~:~:q TIME1 AC:TAL ~2:~t~l AM 75.888 10220.1 .SITE ~ 81568 ' -- ZIP CODE 95508 88.000 10785.9 TIME2 ACTAL 1~:00 AM SITE ~ 81360 85.888 11248 4 18/11,~ 87:54 AM SC:HO ALBT NOHE ~.;OL UNITS GALLOn'S8' . ,.-,-~lo TIMES ACTAL !2:88 AM 98. 888 1'1569.8 ALARM R. EPORT TIME1 ALBT 12:88 AM LEUEL UNITS INCHES TIME2 ALBT 12:AF~._ AM TEMP I]N~T._' q FAHRENHEIT 18/11/2882 87:54 AM TIMES ALBT 12:88 AM PLUS UN SUMP ~IME .ST?LE 12 HOUR DATE '.S T'¢ L E M M,'DD,"'¢V " K~P INV.ARCO AMPM COHFI[:,EHC:E 99.8~,~ DAVLI~HT SAJ ENABLED 2612-PIERCE RD., , LEAK TEST 8.18 '.SET TIME 7:58 AM BAKERSFIELD, CA. 95588 '.SC:H[:, TEST SIyE ~ 81~68 TANK 1 NOHE .C KMP IHU.ARC:O AMPM TANK 2 HONE NO. TANKS 2612 PIERCE RD. TANK 5 NONE BAKERSFIELD, CA. 93308 TIr;1E TEST LEAK LIMIT 2.08 THEFT LIMIT 18.08 SITE ~ 81368 TANK 1 12:8E~ AM [:,ELIU LIMIT TANK 2 12:8(~ AM SNTNL MF~DE ~qFF 1E~/11./2002 (~Z:56 AM TANK 3 12:8E~ AM - - ALARM REPORT :START SNTNL . 12:8~ AM EHD SNTNL 12:88 AM ALARM ' C, EL It) DEL A'-~ ~5 18/11/'2802 8F:56 AM T I MEOUT SR. ,.PEF'ORT_ DELIU D I.:,HB_cC,'-'" I~' REG iJNL SLIMP HIGH L!M ON REPORT ALRMS EHABLED !_ 0 W L t M 0 N REPORT TESTS ENRBLED HIGH HIGH ON NO. OF ALARMS PRINT INTERUAL ' 5. ~;ATER LIM ON L E A K L I M 0 N E',~IJ[:, CH~N 1 1280 THEFT 8TOP BITS ll 1 RELRY P4RIT'¢ 1 ~ NONE TIMEOUT 15 F;EPlIRiTt~ ~ HIGH LIH OFF .... RC:CEBS 1 LOW L IM OFF PHONE 1 HIGH HiGH OFF REDI4L 1 DISABLED LO,I LOW OFF ~CCEBS 2 W~TER LIM OFF F'HOHE~ ~ LERK LIM OFF REDI~L 2 DISABLED S'.,~S F 41 L OFF ~CC:EBS 3 THEFT OFF PHONE 5 REDIAL 3; DISABLE[:, AC:C:ESS 4 PHONE 4 REC, IAL 4 DISABLED OlAL DELI] DIAL ALARM DiAL LEAK KMP .T,,NL.~. RRCO AMPI,1 2,E_'.12 PIERCE R[:,. BAKERSFIEL[), CA. 933E~8 .' ~L~RM HISTORY REPORT PROBE SYNC TANK -NO. 2 SYSTEM F~IL PROBE SYNC T~NK NO. 2 " PROBE SYNC TANK NO. 2' SYSTEM F~IL PROBE SYNC " T~NK NO. 2 SYSTEM F~IL PROBE SYNC T~NK NO. 2 SYSTEM F~IL PROBE SYNC TRNK NO. 2 ' PROBE SYNC TANK NO. 2 SYSTEM FAIL PROBE SYNC S","S TEM FAIL F'ROBS SYNC TANK NO. 2 · S'.~.S T E H FAIL PROBE SVi. IC ~ CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661)326-3979 APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION FACILITY ADDRESS ~ OPERATORS NAM~ ow~ ~~ DOSS ~,~ APFROVt~D BY DATE APPLICANT < :~-0@-212Y'2 1 1 ~ OE:,AM FROM R I CH ENV I RONMENTAL ~ 1 +392+~621 P. 2 OCT O? 2002 14;24 ]~KSFLD FIRE PREVEHT~OH (6G1)852-217.2 p,! ocT'08 2002 12:56 BKSFLD FIRE PRE'VEMTIOM (661)852-21'72' p.1 SECONDARY SYSTEM CERTIFICATION FORM DATE 9-24-2002 FACILITY ID Johnny's Food Mart~ -FACILITY ADDRESS 2612 Buck Owens Blvd, Bakersfield CA 93308 UST Annular Space '[Tank 1 unl 87 Tank 2 un1 87 Tank3prem 91 Tank4 Start Time 8: 30 AH 8: 40 AH 8: 50 AH Initial PressUre l0 Hg 10 Hg 10 Hg End Time 9: 30 AH 9: 40 AH 9: 50 AH Final Pressure 10 Certification Pass Pass Pass (Signature) Secondary Piping Line 1 Unl 87 Line 2 unl 87 Line 3 Prem 91 Line 4 Start Time 8: 55 AH 9: 00 AH 9t,05 AH Initial Pressure 5 psi 5 psi 5 psi End Time 9:55 AH 10:00 AH 10:05 AH · - -'Final P~essure 5 psi 5 psi 5 psi Certification Pass Pass~..,///,//~..~Pass Page 1 of 3 SECONDARY SYSTEM CERTIFICATION FORM DATE 9-24-2002 FACILITY ID Johnny,s Food Mart FACILITY ADDRESS 2612 Buck Owens Blvd, Bakersfield, CA 93308 Turbine Sumps ;. Sump 1 unl 87 Sump 2 Unl 87 Sump 3Prem 91 Sump 4 StartTime 10:10 AM 10:10 AM 10:10 AM Initial Height 4.778 in 4.256 in 4. 201 in of Water Time 10:15 AM 10:15 AM 10:15 AM Water Height 4.561 in 4,101 in 4.189 in Time 10:20 AM 10:20 AM 10:20 Water Height 4.418 in 3.967 in 4.178 in Time 10:25 AM 10:25 AM 10:25 AM Water Height 4.222 in 3. 871 ' in 4. 169 in Certification Fa i led Fa/~d Fa i led (Signature) Overfill Buckets Overfill 1 Unl 87 Overfill 2 Unl 87 Overfill 3 Prem c. IOverfill 4 Start Time 9: 30 AM 9: 30. AM 9: 30 AM Initial Height Unable to hold of Water water at all 1.689 in 2.037 in Time 9: 40 AM 9: 40 AM 9: 40 AM Water Height 1.688 in 2.037 in Time 9:45 AM 9:45 AM 9:45 AM Water Height 1.688 in 2.037 in Certification Failed Pass// Pass There is a large cra~: in overfi~ ~xUnl ~ 'th · "Page 2 of._3 SECONDARY SYSTEM CERTIFICATION FORM DATE 9-24-2002 FACILITY ID JOhnny's Food Mart FACiLiTY ADDRESS 2612 Buck Owens Blvd, Bakersfield, CA 93308 UDc TESTING DISPENSER 1 DISPENSER 2 DISPENSER 3 DISPENSER START TIME 1: 00 PM 1: 00 PM 1: 00 PM 1: 00 INiTIAL HEIGHTOF 2.148 in 1.606 in 3.017 in 2.119 in WATER TIME 1:10 PM 1:10 PM 1:10 PM 1:10 PM WATER HEIGHT 2.148 in 1.605 in 3.016 in 2.1'19 in TIME i:15 PM 1:15 PM 1:15 PM 1:15 PM WATER HEIGHT 2,148 in 1,604 in 3.016 in 2.119 in CERTIFICATION Pass Pass/~ // P/a~s Pass DISPENSER 5 DISPENSER 6 DISPENSER 7 DISPENSER 8 START TIME INITIAL HEIGHT OF WATER TIME WATER HEIGHT TIME WATER HEIGHT CERTIFICATION (SIGNATURE) Page 3 of' ~ , ~P~ ~3 ~00;~ ~3:00 BFIKERSFIELD FIRE DEPT GS~ 32605?8 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 FA~ johnny's ,Food Narc. PERMIT TO OPERATE ~, 308 OPERATORS NAME Haing Yam OWNERS NAME ~ ,',~ w~ NUMBER OF TANKS TO BE ~ ,. 3. IS PIPING OOINO TO BI~ TESTED,,,, Y?' TANK # VOLUM~ CONTENTS ~ ..12, 007, Gallons Unleaded 2 12,000 'C~llons Utaleadod 3 12,000 Gallons Premi~n N^NI~ & ?HOI~. NIJI~F..R OF CONTAC~ PF.R$ON r~jan, '~-n~r TF. ST METHOD ]:ncon N~dl~ OF T~TI~ OR SPECI.~ IlqSPECTOR , CP'RTIFIcAT~ON # __C(/n~..~cto_r?~...Li..c~.nse ..... 532878 A FAZ DATE & TIAO~ TEST I$ TO BE CONDUCTED, Tuesday, September 24, 2002 g:00 AM APPROVED BY DATE SIGNATURE OF APPLICANT CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326--3979 APPLICATIONTO PERFORM A TANK TIGHTNESS TEST/ SECO'NDARY CONTAINMENT TESTING FACILITY Johnn%' s Food Mart ADDRESS 2.612 Bll('~lc (~(::mn.~ Blvd., B~k~_r~qf~eld, CJ~ PERMIT TO OPERATE # · 308 OPERATORS NAME Haing Yam OWNERS NAME ~ ~ nc~ Y~m NUMBER OF TANKS TO BE TESTED 3 IS PIPING GOING TO BE TESTED Yes' TANK # VOLUME 'CONTENTS 1 12,000 Gallons Unleaded 2 12,000 Gallons Unleaded 3 12,000 Gallons Premium TANK TESTING COMpANy Redwine Testing Services, Inc. MAILING ADDRBSS P.o. Box. 1567, Bakersfield, CA 93302-1567 NAME & PHONE NUMBER OF CONTACT PERSON Dugan. Turner 661-834-6993 TEST METHOD Incon NAME OF TESTER OR SPECIAL INSPECTOR James J. Rich 90-1072 CERTIFICATION # Contractors License 532878 A HAZ DATE & TIME TEST IS TO BE CONDUCTED. ~uesday, September 24, 2002 9: 00 AI~ APPROVED BY DATE SIGNATURE OF APPLICANT · ' Complete items 1, 2, and 3. Also comPlete .- B. Date of Delivery item 4 if Restricted Delivery is d~ir(~d. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, [] Agent or on the front if space permits. ., [] Addressee 1. Article Addressed to: [] Yes [] No Johnny's Food Mart 2612 Buck Owens 3. Service Type Bakersfield CA 93308 ~ Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes i 7001 0360 0002 5244 '~438 '~-S, PS Form 3811, July 1999 Domestic Reiurn Receipt 102595-00-M-0952 o · ~2' ~8 ~EP-,.~'i~,% Sender: Please pnnt yourk,Ctame, add/r, ess, and ZlP+--'-4-1'~11fs~box~i'~_ BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Avenue, Suite 300 Bakemfleld, CA 93301 _-I' Postage $ · 3 ~ rtl Certified Fee 2 · 10 I..rl Postmark Return Receipt Fee ]. · 5 0 Here (Endomement Required) t--'l Restricted Delivery Fee i-1 (Endorsement Required) I--1 Total Postage & Fees $ 3.9 4 rrt Sent To c31 Johnny's Food Mart /t~i;~'g'A'R:'~7 .............. : ........ - ..................................................... ~--~r-'ll°rPOe°xN°'l 2612 Buck Owens Blvd ~. ~,ff~,,"S't'~;'~'l'~*4 Bakersfield CA 93308 ~D September 13, 2002 Johnny's Food Mart 2612 Buck Owens Bakersfield, CA 93308 CERTIFIED MAIL FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE 2101 'H' Street Bakersfield, CA 93.301 VOICE (661) 326-3941 RE: Failure to Submit/Perform Annual Maintenance on Leak Detection System FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H" Street De, al' Underground Storage Tank Owner: Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Our records indicate that your annual maintenance certification on your leak detection system was past due on September 5, 2002. PREVENTION SERVICES FiRE SAFETY SEI~/tCE$ · F. NI~ONMENTAL SERVICES 1715 ChesterAve. YOU are currently in violation of Section 2641(J) of the California Code of Bakersfield, CA 93301 VOICE (661) 326'3979 r~egmauons. FAX (661) 326-0576 "Equipment and devices used to monitor underground storage tanks shall be installed, PUBLIC EDUCATION 1715 ChesterAve. calibrated, operated and maintained in accordance with manufacturer's instructions, Bakersfield, CA 93301 including routine maintenance and service checks at least once per calendar year for VOICE (661) 326'3696 FAX (661) 326-0576 operability and running condition." FIRE INVESTIGATION YOU are hereby notified that you have thirty (30) days, October 13, 2002, to either 1715 Cl~esterAve. perform or submit your annual certification to this office. Failure to comply will result Bakersfield, CA 93301 VOICE (661) 326-3951 in revocation of your permit to operate your underground storage system. FAX (661) 326'0570 TRAINING DlVlSlON Should you have any questions, please feel free to contact me at 661-326-3190. 5642 Victor Ave. Bakersfield, CA 93308 S. ,~:ncere~-, VOICE (661) 399-4697 FAX (661) 399-5763 Ralph Huey Director of Prevention Services Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services cc: Walter H. Port Jr., Assistant City Attorney August 30, 2002 Johnny's Food Mart 2612 Buck Owens Blvd. Bakersfield, CA 93308 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 (661) 326-3941 containment testing required for all secondary containment components for your FAX (661) 395-1349 underground storage tank (s). SUPPRESSION SERVICES 2101 'H" Street Bakersfield. CA 93301 Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Health VOICE (661)326-3941 (~5 Safety Code) of the new law mandates testing of secondary containment FAX (661) 395-1349 components upon installation and periodically thereafter, to insure that thc systems are PREVENTION SERVICES capable of containing releases from the primary containment until they arc detected 1715 Chester Ave, Bakersfield, CA 93301 and removed. VOICE (661) 326-3951 FAX (661) 326-0576 Of great concern is the current failure rate of these systems that have been tested to ENVIRONMENTAL SERVICES date. Currently the average failure rate is 84%. These have been due to the 1715 Chester Ave. Bakersfield, CA 93301 penetration boots leaking in the turbine sump area. VOICE (061) 320-3970 FAX (661) 326-0576 For the last four months, this office has continued to send you monthly reminders of TRAINING DIVISION this necessary testing. This is a very specialized test and very few contractors are 5642 Victor Ave. Bakersfield, CA 93308 licensed to perform this test. Contractors conducting this test are scheduling VOICE (661) 399-4697 approximately 6-7 weeks out. FAX (661) 399-5763 The purpose of this letter is to advise you that under code, failure to perform this test, by the necessary deadline, December 31, 2002, will result in the revocation of your permit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services July 30, 2002 Johnny's Food Mart 2612 Buck Owens Blvd Bakersfield CA 93308 REMINDER NOTICE FIRE 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 (Califomia PREVENTION SERVICES Health & Safety Code) of the new law mandates testing of secondary FIRE SAFETY SER~ICES, ENVI~ON~NTAL SERVICES 1715 ChesterAve. containment components upon installation and periodically thereafter, to insure Bakersfield, CA 93301 that the systems are capable of containing releases from the primary VOICE (661) 326-3979 FAX (661)326.0576 containment until they are detected and removed. PUBLIC EDUCATION Of great concern is the current failure rate of these systems that have been 1715 Chester Ave. Bakersfield, CA 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 FIRE INVESTIGATION For the last four months, this office has continued to send you monthly 1715 ChesterAve. reminders of this necessary testing. This is a very specialized test and very few Bakersfield, CA 93301 VOICE (661) 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 · OF ENVIRONMENTA~RVICES 1715 Chester Ave.' Bakersfield, CA 93301 (661) 326-3979 · . UNDERGROUND' STORAGE TANKS - TANK PAGE 1 i"YPE OF ACT~N ~ 1. ~ SITE ~T ~ 4. ~O ~R~T ~ S. C~ OF INFOR~TION) ~ 6. TE~Y SITE ~O~T~N ~JN ~ (~) - ' I. TANK DE~ ~0~~ ~ ~ ~ : OFFICE OF ENVIRONMENTAL SERVIC__/ 15 Cheitir Ave.. Bake/lfleld, CA 93301 (661)~L~3979 - ' SYSTEM ~PE ~ 1 ~ESSURE ~ 2. ~CTION ' ~ 3. ~Vl~ 4~ ~ 1. ~ESSURE ~ 2. SUCTION ~ 3. ~V~ 45S ~NUFACTURE~ 2. ~UBLE WALL ~ ~. UN~ ~ 2. ~UBLE WA~ ~ ~. 'OTHER - * ~TER~SAND ;~t 2. STNNLE~.~EL . ~ 7. ~V~~ ~EL ~ 2. STAINLE~ STEEL ~ 7. ~V~D ~EEL ~E SU~N ~ (~ v~ ~ ~ ~U~ ~ ~ ~N ~ (~ V~ ~N ~ ~U~ REST~T~ ~STRICT~N ~ 17. DAILY ~SUAL CHE~ ~ 17. ~ILY VISU~ ~ECK SI~TURE~F 0~~TOR OA~ , 470 ~ OF O~E~TOR (p~t) 471 T~E OF 0~E~TOR ' 472 UPCF. (71~) ' · S:~CUPAFORMS~C~B.~D .... ,. FICE OF ENVIRONMENT ERVICES 1715.Chester Ave., Bakersfield, CA 93301:(661) 326-3979 UNDERGROUND STORAGE TANKS - USTFACILITY Page ~ of TYPE OF ACTION [-] I. NEW SITE PERMIT [] 3. RENEWAL PERMIT [] 5. CHANGE OF INFORMA'[ION (~l)ecify change. [] ?. PERMANENTLY CLOSED SITE (Check one item only) . ~ · local use only)· [] 8. TANK F~EMOVED 400. ,~ 4. AMENDED PERMIT a 6. TEMPORARY SITE CL6SURE I . I. FACILITY I SITE INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - 0Ding Business.. As) .3 FACILITY ID # . ' . 1 NEAREST CRt~[S' STRt=ET ~ - 401. FACILITY OWNER TYPE [] 4. LOCAL AGENCY/DISTRICT' ,~ 1~.[~ '' [] 1. CORPORATION [] COUNTYAGENCY' ~/,,3(-[t*u,~.L ,,---. [] 2. INDIVIDUAL [] 6. STATE AGENCY' BUSINESS ~',1. GAS STATION ' '[] 3. FARM [] 5. COMMERCIAL TYPE [] -2. DISTRIBOTOR [] 4. PROCESSOR [] 6. OTHER 403. [] 3. PARTNERSHIP . [] 7. FEDERAL AGENCY' 402. TOTAL NUMBER OF TANKS . is facility On Indian ReservatiOn m' 'If owner of UST a public agency:, name of supervisor of REMAINING AT SITE b'usflends? · ~ivisiofl, sectiOn m' office which operates the UST. (This is the contact pe~on for the tank records.) · : ': ;: II. PROPERTY OWNER INFORMATION ·"i::...'(:; :"'/.:~: .(:,::.' . PROPERTY OWNER NAME .' 407. I PHONE'* 408. MAILING OR STREI=T ADDRESS · - 410. STATE 411. ZIP CODE 412. PROPERTY OWNERTYPE ~/'2. INDIVIDUAL [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY 413. [] 1. CORPORATION [] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7: FEDERAL AGENCY : · ' - :.'' ::i"(':?:::.ii. :.'. ,..' !.IlL TANK~Ei~ iNFORMATiON: 7:,::.~.! :~' . .,':- ,. , TANK OWNER NAME 414. [ PHONE 415. -- 416. MAILING OR STREET ADDRESS CITY 417. STATE 418. ZiP CODE . 419. TANK OWNER TYPE ~ 2. INDIVIDUAL [] 4. LOCAL AGENCY/'DISTRICT [] 6. STATE AGENCY 420. []. 1. CORPORA?ION [] '3. PARTNERSHIP [] 5. COUNTY AGENCY ~] 7. FEDERAL AGENCY IV. BOARD OF EQUALIZATION UST STORAGE FEEAccOUNT NUMBER INDICATE METHOD(S) ~' 1. SELF-INsURED · [] 4. SURETYBOND [] 7. STATEFUND [] 10. LOCAL GOV'T MECHANISM 2. GUARANTEE [] 5. LE~I'E~ OF CREDIT [] 8. STATEFUND&CFOL~ilP..R '[] 99. OTHER: [] 3. INSURANCE [] 6. EXEMPTION [] 9. STATE FUND &CD 422. VI. LEGAL NOTIFICATION AND MAILING ADDRESS Cbec~ one ~ox to indicate whict~ address should be uSeCl fro' legal notifications and mailing. ~ 1. FAClLn~ [] 2. PROPERTY OWNER [] 3. TANK OWNER 423. Legal notifications and mailings mil be sent to the tank owner unle~ box 1 or 2 is ~ectted. · VII. APPLICANT SIGNATURE CetliflcatiOn: I certify ~at ~e informatiOn provided herein is true and accurate to the best of my knowledge. SIGNATURE OF APPLICANT DATE · / ' [ , ' 424. I PHONE 425. NAME OF ~PPUC,,~a~ (pant) 428. TI/i'L~ OI~'APPLI(~,AI~' I - ' 427. STATE UST FACILITY NUMBER (Forlocel uas only) 428. 1998 UPGRADE CE. RTiFJCATE NUMBER (Forlocel use only) 429. '. UPCF.(7/99) : S:\CUPAFORUS~swrCb'a'wpd. O ,CITY OF BAKERSFIE[,~, · " ' ;:":[ OF ENVIRONMENTAi]~RvIcEs '~"~ 1715 Chester Ave., Bakersfield, CA 933.01 (661) 326-3979 · UNDERGROUND STORAGE TANKS.- TANK PAGE 1 L TANK UPCF (7~)' S:~CUP~ORMS~Ca~.~O .... ; ' OFFICE OF ENVIRONMENTAL SERVICt - ~' ~1~ Chafer Ave., Bakersfield, CA 93301 (661)~['~3979 ~/ .... ~T - T~ P~E 2 UNDER~OU~ ~Pl~ A~VEG~UND PIPI~ SYSTEM ~PE ~. ~ESSURE ~ 2. ~CTION ~ 3. ~Vl~ 4~ ~ ;, ~ESSURE .' ~ 2. SUCTION * CONSTRUCT~t ~ 1, SINGLE WALL, ~ 3. LINED T~~ - ~ ~. O~ER 4~ ~ 1. SI~E WALL ~ ~. UN~ ~NUFACTURER ~ 2. ~U~E WALL ~ ~. U~ ~ 2. ~UBLE WALL ~ ~. OTHER /~FA~URER 461 ~UFAC~RER 463 ~ 1.~STEEL ~ ~. F~ATI~WII~~L ~ 1, ~E~EEL ~ 6. FRP~ATIB~Wltm%~L~ ~T~R~Ls COR~S~N I ~ ~CTION ~ ~ 3. ~STIC ~A~ ~ ~ ~ ~ UN~ ~ 3. ~STIC ~ATI~ ~ ~S ~ 8. ~IB~ (H~) ~ ~. O~ -. 5. S~EL W/COATI~ ~0~ ~N ~ ~ 5, S~EL WI COATI~ ~ ~. UN~ ~ . .,.. . , .... . . .' .. : . · . U~E~UND ~ ~OUND ~E~UR~D PI~~ (~ ~ ~t ~): , ~R~D ~ (~ d ~at aM): · ~ 1. E~NICU~~OR3.0~~O~~FOR ~ 1. ~NICU~~OR3.0~~A~O~OFFFOR~' ~ ~ F~U~ ~ ~ ~~ * ~ ~ ~ ~ FNLU~ ~ ~ D~E~N ~ 2.~Y0~ ~ 3.~~(0.1~) . , ~ *.~LY~E~ , ~ ~. O~LY ~ ~0~ OF ~ ~ · ~ ~ ~ ~ ~. ~iLY ~SU~ ~N~ OF ~ ~ ~ ~M TEST (0.~ ~) ~ 6. ~ENN~ ~ ~ (0.~ ~) ~ ~E ~N ~ (~ V~S iN ~w ~ ~ ~E ~N ~ (~ V~S IN ~OW ~UND ~): ~ 7. ~ ~N~O~ ~ T. ~ ~O~ ~ ~OW (~ ~ ~t ~): ~ 9. BI~~(0.1 ~) ~ e. ~LY~~O~ ~ ~. ~~~(o.~) ~O~LY ~ ~ SKO~LY ~NED A~O ~ SH~ O~ FOR ~, ~ F~LU~ ~ ~ ~. ~. A~O ~ ~ OFF FOR ~, ~ F~LU~ ~ ~ OI~NNE~N DI~DN ~ ~ ~ ~0 ~ ~ OFF '~ ~ ~ ~0 ~ ~ O~ · SUCT~~ ~ ~~ ~ ~ 14. ~S~U~R~~~*~~ ~ ~4. ~US~~R~A~O~O~+~O~~ ~ ~S. AUTO~CLINELW~OR(3.0~~~W~O~OR ~ 15. RESTRIGT~N ~ 16. ~NU~ I~EGR~ ~ST (0.1 ~) ~ ~'6. ~NU~ I~GR~ ~ (0~L1 ~) ~ ~ 7. D~LY VISU~ GHE~ ~ 17. ~LY VI~ ~E~ OlS~N~R~~ ~ I..~T~I~T~~V~ ~ 4. ~LY~E~ DATE IN~T~ ~ ~ 2. ~N~S Ol~ P~ ~ + ~ ~O ~ ~ * · ~ S. ~N~ UNER I ~N~ORI~ ~ OF O~E~TOR (~ ~ 471 T~E OF O~~OR 472 UPCF (7~) S:~CUPAFORMS~C~B.~O: · ' OF ENVIRONMENTAI-~RVICES 1715 Chester Ave., Bakersfield, CA 93301 (66 !) 326-3979. UNDERGROUND STORAGE TANKS- TANK PAGE 1 ' FYI:~ OF ACTION ~ t. NLm~f ~ITEP~RMIT'T" 4. ~D~R~T * ~ ~. C~OFINFO~TION) '~ 6. TE~Y SITE C~O~RE' 4~ , L TANK DESCRI~ TANK ~O ~ ~2 ] T~ ~FAC~RER ~ / ~T~D T~ ' ~ Y= ~ ~ '4~ ~ ] - T~ ~AC~ IN ~0~ ~ ~. u~ ~~ ~ ~~ ~ 4. ~W~AV~ 0~ ~ ' '~. ~.,; ~;~'.~ .~ ~, ' ~. ~.~,~,~.'.~:..,~:'.:~:~.~: ~:~)~ ~~~- ~.:~ :~'~..., .'... . · :.?.,:. ;~:~?..~;~ · :.., '.'.~.~:~;~, ~'.' / .~.'...4~.: . ~ ~.:,~ ~. ",. ¥~:,~ ':L.?L "~'~ .:'~:~LI~ ~'~ ,~ .'~.~'~ 3'.~.; ...'. :'.: '. '' .'.'.... ~W.'~.~:~, ..:, :, .".>'..; '.'. ~,,~ , , ' t~ :'~ ,,, · "~' "~ ...... '~'~'~,, ~ * .... , ~ ..... ~ ..... ~ ]. ~~ATG ~ ?. ~A~ ' U 3..' ~ ~NffORi~ '," · ~ 4. ~A~ ~ ~<i~T~N (~) · ~ ~.' t~ ~T~ ' mENN~ r~ ~ . ~ ~. 0~ ' ~ OY. UpcF (7/gg) · ' S:~CUPAFORMSL.qWRCB-B.WPO ENVIRONMENTAL sERVICI~ · . , :~1~ Choler Avl., Blkerlfleld, CA 93301 (~1) 3~3979 ' ' -. uIT. TANK PAGE 2 UNOER~OU~ ~Pl~ A~VE~UNO PlPI~ SYSTEM ~PE [ I..~ESSURE' ~ 2. ~CTION ~ 3, ~ 4~ ~ 1. ~ESSURE ': ~ 2. SUCTION' ~ I. ~, ~- ~NUFACTURER~. ~UBLEWALL ~. U~' ' ~ 2. ~UBLEWALL ~. OT~ER ''- ' J ~UFA~RER ' ~1 ~FAC~RER ~63 ~TER~LS ~D ~ 2. STAIN~~ S~EL ~ ?. ~V~ ~ ~ 2. S~AIN~~ STEEL ~ 7. ~V~ED STEEL CORROSION ~ 2. ~YO~ '~ 3. ~~~(~) ~ 3. ~1~~(0.1 ~). ~ 4. ~LY~E~ . ~ 7. SE~ ~N~O~ ~ 7. ~ ~0~ " CERTIFICATION OF FINANCIAL RESPONSIBILI~ P~ of thi~ ce __~____P~_n ~_~_ certlAPx that you are A? complla .~__ with a# con~__A~nf for ~. A? me ~-un~. s o rrOR a PR O S UNDERGROUND STORAGE TANK MoNiTORING PROGR, H B. What methods and equipment, identified by name and model, will be used for perromin$ the monitoring: .Piping ~l/~c n(/X C. Describe the location(s) where the monitoring will be performed (facility plot plan should' be attached): D. List the name(s) and tide(s) of the people responsible for performing the monitoring and/or ~laintaining the equipment: E. Reporting Format for monitoring: Tank ~/_~ Piping d/-- ~ F. Describe the preventive maintenance schedule for the monitoring equipment. NoW: Maintensnce must be in accordsnce wi~ the manufacturer's m~daW, a~ace sch~ul~ , but not I~s t~aa every 12 months. ~ff ~h. . t~ O. Describe the training neces~...sary for the operatio~t of UST system, including piping, and the - monitoring equipment: !.t~_eo, c¢[ ~, 'l~ c~,r ~7. 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 Ol~ce of Enviroamental Services within 30 days of any changes to the monitoring proc~ures, unless required to obtain approval before making the change. Required by Sections 2632(d) and 264 l(h) CCR- Facility Address 1. ffan unauthorized release occurs, how v'ill the hazardous substance be cleaned up? Note: If released hazardous substances reach the environment, increase the fire or explosion b_~Turd, are riot Cleaned up fi.om the secondary containment within 8 hours, or deteriorate ' the secondary cont '_mnment,, then the Office o£Environme.ntal Services m~ust, be notifi~ within 24 hours. ~(net,,~lid,.. r),,~ ~t ~_e._ 1- ~o/~ec. (~-(-- 12a(~cc. ' -'~,,tl--,,~,1( -~at(' -ql'/ . ' ' '" 2. Describe the proposed methods and equipment to be used for removing and proper!y disposing of any hazardous substance 3. Describe the location and availability of~e required cle, anup equipmem in item 2 above. 4. Describe the maintenance schedule for the cleanup equipment: 5. List the name(s) and title(s) of the person(s) responsible for authorizing any work necessary under the response plan: 9 DI$1~.~ GON$"IGUOUSLY AT PI.AGE OF BUSINESS F(~II-IIGH ISSUED CALIFORNIA STATE BOARD OF EQUALIZATION ~ SELLER'S PERMIT J ACCOUNT NUMBER I 7/31/2OOl SR ARH 97-8790~+ -1 JOHNNY'S ARCO HA I NG YAH, ET AL THIS PERMIT DOES NOT 26 ] 2 BUCK OWENS BLVD AUTHORIZE THE HOLDER TO E N G A GE IN ANY BAKERSFIELD, CA 9.~.308 BUSINESS CONTRARY TO I I osiNESS OR TO POSSESS OR OPERATE ANY ILLEGAL DEVICE. IS HERESY AUTHORIZED PURSUANT TO SAI. E~ AND U~E TAX LAW TO ENGAGE IN THE BUSINESS OF SELLING TANGIBLE PERSONAL PROPERTY AT THE ABOVE LOCATION THIS PERMIT IS VALID UNT1L REVOKED OR CANCELED BUT IS NOT TRANSFERABLE. IF YOU SELL YOUR BUSINESS, OR DROP OUT OF A PARTNERSHIP, NOTIFY US OR YOU COULD BE RESPONSIBLE FOR SALES AND USE TA,~S Not valid at any other address OWED BY THE NEW OPERATOR OF THE BUSINESS. FOR GENERAL TAX QUESTIONS, PLEASE TELEPHONE OUR INFORMATION CENTER AT 1-800-400-7115. BOE-442-R REV. 13 (6-00) NOTICE TO INDIVIDUALS REGARDING INFORMATION FURNISHED TO THE BOARD OF EQUALIZATION The Inform&tion Practices Act 9f 1977 and the Federal P~;vacy ,Act requires this agency to provide the following notice to individuals ~.~.~o are asked by the State Board of EquaJization (Board) to supply information, including the disclosure of the individual's social security account number. Individuals applying for permits, certificates, or licenses, or filing tax returns, statements, or other forms prescribed by this agency, are required to include their social security numbers for proper identification. [See Title 42 United States Code Section 405(c)(2)(0)(i)]. It is mandatory to furnish all the appropriate information requested by applications for registration, applications for permits or licenses, tax returns and other related data. Failure to provide all of the required information requested by an application for a permit or license could result in your not being issued a permit or license. In addition, the law provides penalties for failure to file a return, failure to furnish specific information required, failure to supply information required by law or regulations, or for furnishing fraudulent information. Provisions contained in the following laws require persons meeting certain requirements to file applications for registration, applications for permits or licenses, and tax returns or reports in such form as prescribed by the State Board of Equalization: Alcoholic Beverage Tax, Sections* 32001-32556; Childhood Lead Poisoning Prevention Fee, Sections 43001-43651, Health & Safety Code, Sections 105275-105310; Cigarette and Tobacco Products Tax, Sections 30001-30481; Diesel Fuel Tax, Sections 60001-60709; Emergency Telephone Users Surcharge, Sections 41001-41176; Energy Resources Surcharge, Sections 40001-40216; Hazardous Substances Tax, Sections 43001-43651; Integrated Waste Management Fee, Sections 45001-45984; International Fuel Tax Agreement, Sections 9401-9433; Motor Vehicle Fuel License Tax, Sections 7301-8405; Occupational Lead Poisoning Prevention Fee, Sections 43001-43651, Health & Safety Code, Sections 105175-105197; Oil Spill Response, Prevention, and Administration Fees, Sections 46001-46751, Government Code, Sections 8670.1-8670.53; Publicly Owned Property, Sections 1840-1841; Sales and Use Tax, Sections 6001-7279.6; State Assessed Property, Sections 721-868, 4876-4880, 5011-6014; Tax on Insurers, Sections 12001-13170; Timber Yield Tax, Sections 38101-38908; Tire Recycling Fee, Sections 55001-55381, Public Resources Code, Sections 42860-42895; Underground Storage Tank Maintenance Fee, Sections 50101-50161, Health & Safety Code, Sections 25280-25299.96; Use Fuel Tax, Sections 8601-9355. The principal purpose for which the requested information will be used is to administer the laws identified in the preceding paragraph. This includes the determination and collection of the correct amount of tax. Information you furnish to the Board may be used for the purpose of collecting any outstanding tax liability. As authorized by law, information requested by an application for a permit or license could be disclosed to other agencies, including, but not limited to, the proper officials of the following: 1) United States governmental agencies: U.S. Attorney's Office; Bureau of Alcohol, Tobacco and Firearms; Depts. of Agriculture, Defense, Justice; Federal Bureau of Investigation; General Accounting Office; Internal Revenue Service; the Interstate Commerce Commission; 2) State of Caiifomia govemmentaJ agencies and officials: Air Resources Board; Dept. of Alcoholic Beverage Control; Auctioneer Commission; Employment Development Department; Energy Commission; Exposition and Fairs; Food & Agriculture; Board of Forestry; Forest Products Commission; Franchise Tax Board; Dept. of Health Services; Highway Patrol; Dept. of Housing & Community Development; California Parent Locator Service; 3) State agencies outside of Caiifomia for tax enforcement purposes; and 4) city attorneys and city prosecutors; county distdct attorneys, sheriff departments. As an individual, you have the dght to access personal information about YOu in records maintained by the State Board of Equalization. Please contact your local Board office listed in the white pages of your telephone directory for assistance. If the local Board office is unable to provide the information sought, you may also contact the DiSClosure Office ih Sacramento by telephone at (916) 445-2918. The Board officials responsible for maintaining this information, who can be contacted by telephone at (916) 445-6464, are: Sales and Use Tax, Deputy Director, Sales and Use Tax Department, 450 N Street, MIC:43, Sacramento, CA 95814; Excise Taxes, Fuel Taxes and Environmental Fees, Deputy Director, Special Taxes Department, 450 N Street, MIC:31, Sacramento, CA 95814; Property Taxes, Deputy Director, Property Taxes Department, 450 N Street, MIC:63, Sacramento, CA 95814. · All references are to the Ca/ifornia Revenue and Taxation Code unless otherwise indicated. BOE-324-A REV. 9 (8-97)