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Home My WebLink AboutUNDERGROUND TANK '· ADVANCED .ENVIRONMENTAL CONCEPTS mNC· December'4',' 200.2 · -' 'i~ ',. · .inspector. Ste(/e UnderWood · . ~" ..,... , City of__Bakersfield· - '_ .:. ' . .. ... .- OfficeOf Environmental ServiceS ' : . ' ..... 1715 Chester Avenue .. .. :.: ' · Bakersfield, CA 93301'.. :' Re: Permit #BR-0294. ' ' ' . ., ., · Victory Outreach . · .- ' ,- ' Dear InspectorUnderWood~ ".. . '" ' ' Piease find enClosed'for, your review the following documentati0n for the tank removal performed on .. November 14, '2002 at the ViCtory Outreach located at 500 California Avenue, Bakersfield, California, ' . ~ . 1) ' Copy of City'of Bakersfield- Office of Environmental Services - Removal Permit #BR~0'294',' -.-, 2) Cop~ of Tahk Certificatioh from ocs Inc. along with C'ity of Bakersfield - Office ~of Environmental..- Services- Underground Storage'Tanks Closure Certification, . '3) Copy of Tank Disposal Form from Golden State Metals, Inc., - - : " 4) Copy Of Hazard°us. Was{e Ma.nifest #21.829840, - ~ ' ~ ' ' ' ~ r 5i Copy of laboratory.resUlis,'and '., - - . "' .6) . Site Map with sampling locations. . ' '. If you should require-any additional informaQon, please do.not hesitate to contact our0ffice at 831-1646. ~ncere~y., , ~ .. · . . Advanced Environmental Concepts, !nC.. "" "' -- I~/Project Geologist;' REA. !1 #20017 ' .... cc: Mr: Arnold Familian ~-.. · , -' ~ . · ENVIRONMENTAL coNCEPTS WITH DESIGN IN-MIND · · i-· 4400. ASHE ROAD. ~206 · - BAK.E. RSFIELD, CA 93:~13 661/831-1646 . · '" FAx 66.1/83'~-1771 PIUV Uti ~"UU,,' J JL: bill IJ, P IKE I-~KI-VI-I'I I JUfl I. bbl J I::lb:-'-~].'/~' CITY OF BAKERSFIELD OFFICE. OF ENVIRONMENTAL SERVICES 1715 C!fi~ster Ave., Bakersfield, CA (661) 326-3979 ...".. ':' !:JPERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK SITE IBJ~ORM~TION _ ~a t - - . ' wo~sc~o. ]~'q~'p ~- ]'3~,~¥ As~_~s~rr I~O~Tlo~ ',. ...... .~. . ,,,_ .. w~~SPo~~c~o~~ . . t~ ~S~ ~O~ON t~O~X[0N ~C~ 'DA~ For Official Use ~ . THE APPLIC~ ~S ~CE~D, ~E~TANDS, A~ WI~ ~MPLY W~ THE A~AC~D CO~ffiONS OF THIS PE~iT AND A~ OT HER $TAT~ L~AL ~D FEDE~U ~G~T IONS, THIS FO~ ~ BEEN COMP LET~ ~D~ P ~ALTY OF APPROV~ BY: ~ ~PLICA~ N~E (f~ // ~PLIC~ SIGNA~ THIS ~ICATION OIL ' CONSERVATION N 1196'. SERVICE INC. ENVIRONMENTAL SERVICES . CONSERVATION 3256 N. MARKS AVE, ..? THRU FRESNO, CA 93722-4919 RECYCLING (559) 485-5495 FAX (559) 485~5497 ENVIRONMENTAL PROTECTION AGENCY I.D. NO. CAD 980 673 842 DEPT. OF HEALTH SERVICES HAZARDOUS WASTE HAULER REG. NO 1943 TANK TEST CERTIFICATION· . ' Prod. Unl. Gas Manifest No.: ~q~. Invoice No.: ~1~ ' Held: Lead Gas Diesel EPAID No.: c~ ~ ~ ~' · WasteOil Address: City~~~ ~ Zip: Test No. 1 Time: ?'.'~,~ LEL: ~ % Initial: Test No. 2 Time: /~ =¥0 LEL: 2~ % 'Initial: Test No. 3 Time: LEL: % Initial: Test No. 4 Time: LEL: % Initial: Test No. 5 Time: LEL:. % Initial: O.C.S. Inc. certifies that at the time that this tank was tested by us it was free of flammable vapors. It may not remain vapor free. Treat this container with extreme caution, it may ·contain explosive gases, · DO NOT EXPOSE THIS CONTAINER TO FLAMES, SPARKS OR·EXCESSIVE HEAT, DO NOT. CUT 'OR WELD ON THIS TANK, lnspector's Signature CITY OF BAKERSFIELr~..~ OFi]". '.'.~OF ENVIRONMENTAL SL~.(~I~CES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS CLOSURE CERTIFICATION Page I. FACILITY IDENTIFICATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As} 3 ! PERMIT # ' It i' i i; i..!-' ' : '--~ANK-OWNER NA~E .......... 740 TANK OWNER AD~RESS- 741 TANK OWNER CITY 742 I STATE 743 ZIP CODE 744 II. TANK CLOSURE INFORMATION Tank ID ~ Concen~ation of Flammable Vapor ~ Concen~ation of Oxygen (A~ch add. hal ~p~s of ~is ~ge ~r ~m ~an ~me ~nks.) i Top Center BoEom Top ~ Center Boffom 745 ~ 746a 7~b 746c . 747a ~ 747b 747c TANK I ~ ATMOSPHERE ~ READINGS 74~ } ~49a 749~ 749c 750a ) 750~ 750c , On examination of ~e tank, I ce~ ~e ~nk is visuafiy flee from product, sludge, stole (~in, flaky residual of tank ~nten~), finseate and debris. I ~her ceffi~ ~at t~ information provided herein is ~e and acetate to the best of my knowledge. SIGNATU~OF C~FI~ STATUS OR AFFILIATION OF CERTIFYING PERSON ~ ~~ Ce~ifier is a represen~tiveof ~e CUPA, au~orized agency, or LIA: 760 '- ~ ~ Yes D No NAM~OF CERTIFIER (P~m) 754 ~ ~ -- Ci~ of Bakemfleld Fire Depadment - ~ce of Environmental Se~ices .i TITLE OF CERTIFIER 755 ¢[ I'~ ~5~ ~ If ~difier is o~er ~an CUPA / LIA check appropriate box below: 762 ADDRESS ~ a. Ce~fied Indus~al Hygienist (CIH) 1715 Chester Ave. 756 ~ b. Ce~ified Safe~ Professional (CSP) CI~ ~ c. Ce~ified Maline Chemist (CMC) '- ~:ersfield, CA 93301 757 ~ d. Registered Environmen~l Health Specialist (REHS) PHONE , ~ e. Professional Engineer(PE) (661) 326-3979 758 ~ f. Class II Registered Environmen~l ~sessor DATE 759 I CERTIFICATION TIME ~ g. ~ntractors' State License Board li~nsed ~n~actor (wi~ 1(~ (C{- 0 ~' ~ . ~ ~ A~ hazardous subs~nce removal ~difi~tion) TANK PREVIOUSLY HELD F~M~BLE OR COMBUSTIBLE ~TERIALS ~es ~ No 763 (If yes, ~e tank interior a~osphem shaft be m~hecked ~ a combustible gas indicator prior to ~ ~ing conducted on ~e tank.) CERTIFIER'S TANK MANAGEMENT INSTRUCTIONS FOR SC~ DEALER, DISPOSAL FACILITY, ETC: 7~ A copy of this certificate shall accompany the tank to the recycling / disposal facility and ue provided to the CUPA. If there is no CUPA, copies shall be submitted to the LIA and authorized agency; owner / operator of the tank system; removal contractor; and the recycling / disposal facility. UPCF (7/99) {~ ~(7 ' (~3v~ [~ S:\CUPAFORMS\dtscI249.doc TANK DISPOSAL FORM GOLDEN STATE METALS, INC, P. O,' Box 70158 . 2000'E. BrundageLane Date i I / t ' Bakersfield, California 93387 t ~[-~ ! ~] '''~-- ',1'9---'~ Phone (805) 327-3559 · Fax (805) 327-5749 Contractor's Scrap Metals, Proeossing & Recycling License.No. Contractor's Phone No. DESTINA~ON: G.S.M. · '2000 E. BRUNDAGE LANE · BAKERSFIELD, CA 93387 HAULER: .. ~ LICENSE NO: -Q~ GALLONS SERIALNO. N~ TO~ EHSD PERMIT NO: 250 ' ~14 550 .24 1000 - 6 ff :61 ~ TANK INSPECTION ' . 2000 .97 ~ RESIDUALS PRESENT (REJECT) 3000 1.32 ~ LEL READING sooo 2.42 ~ OXYGEN CONTENT 7~00. 3.28 ~ 9000 3.82 12000 4,93 TOTAL All fees Incurred are per load unless specified. Terms are net 30 days from receipt of tank. Contractor's signatu[e r~prosont~accoptanm o[t,rm~ for palm,hr, and eonfirm~. that tank r~moval complio, with Stato CERTIFICATE OF TANK DISPOSAL / DESTRUCTION THIS'tS TO CERTIFY THE ~ECEIPT ANGI]ACCEPTANCE OF THE TANK(S) AS SPECIFIED ABOVE ALL MATERIAL SPECIFIED WIL. L BE COMPLETELY DESTRQYED. FOR SCRAP .RECYC<LIN(~'PURPOSES ONLY,. · ! ' , ~ ."l, /'~,,''~," ,~I " / L,.-' J..'.."!/,. ......... f! AUTH(':)RIZE~D RE~ ~? ] DATE WHI'I'E m Contractor Copy · YELLOW -- File Copy · PINK m Permanent Copy ' 'Siafe 6f Calit~0tn a~Env ronmenlb 'ProjeCt ~ ' Z. Transpo~e~ 2 Co'mpan~:Name ' ' ' ' 8. US '- .- r'Addi~i0~ha. ' .q~fi~'~en~tolor,: I ha~en ~i to h~mo~. SJate o~ Cal;~ocn;a--E~roe~menlal Protecfi, o, Agency Fo~ App,o~ed OM~ ~. ~5~0039 ~E~ir~ 9-30-99) S~ Instructions on back of pa I. ~ator's US EPA ID ~. ' MaeiJest D~ument No. 2. Page 1 l~t~n in ~e s~a~ areas '' i.8 84o . ,~ 8. Smfe ~flma~s ID S. Trampler 1 ~p~y 'No~ 6. US EPA ID N~be~ C. SN* 7. T~r 2 Core,fly Name 8. US EPA ~ N~r E. S~ Tmn~'s ' I IIIIIII III I I 1. US DOT De~cH~ {;~;n9 ~per Sh~p;fl9 N~, ~zo~ Class, a~ ID ~m~l No. T~ "' ~ Wl~d I L Wm~ Nu~ 0 II I .llll , '1 ~ ol 1 16, GE~T~'S ~il~nO~ hem~d~ret~ · al l ~. 19. Discr~n~ Indicofi~ F ~ A · C L 20'. ~=c~lity Ow~or Operant Cerl;l~n of '~e~* of ~a~ou~ me'rial, c~r~ ~ ~is~ni~t e~c~t as ~ in hem 19. ' T DO NOT W~ITE BELOW 7HIS LINE. O~ 80~ {1/~) Green: T~ANS~ER ~ETAINS EPA 87~22 ~~ ASSOCiATED LABORATORIES 806 North Batavia - Orange, California 92868 - 714/771-6900 FAX 714/538-1209 CLIENT Advanced Environmental Concepts Inc. (10022) LAB REQUEST 102368 ATrN: Jonathan Buck 4400 Ashe Road REPORTED 11/27/2002 #206 Bakersfield, CA 93313 RECEIVED 11/15/2002 PROJECT Familian- Victory Outreach SUBMITTER Client COMMENTS This laboratory request covers the tbllowing listed samples which were analyzed tbr the pa. rameters i..ndicat, ed on. the attached Analytical Result Report.' All analyses were conducted using the appropriate methods as indicated on the report. This cover letter is an integral part of the final report. , Order No. Client Sample Identification 392624 SKC-8' 392625 SKC-12' 392626 Laboratory Method Blank T. hank you I6r the opportUmty to be ot'serWce to your company. Please I~el Fee to call il'there are any questions regarding 'this report or if we can be of further service. ASSO LAB RILES by, Vice President NOTE: Unless notified in writing, all samples will be discarded by appropriate disposal protoco130 days from date reported. TESTING & CONSULTING 'l'herepo~ts or'the Associated Laboratories are conadentlal pmpeay of our clients and Chemical may not be reproduced or used tbr publication in part or in tifll without our written Microbiological permission. This is fi~r the mutual protection of the public, our clients, and ourselves. Environmental Lab request 102368 cover, page I of 1 Order #: ~ Client: Environmental Concepts Inc. Matrix: SOLID Client Sample ID: SKC,-8' Date sampled: 11/14/2002 Time Sampled: 09:30 SampLed By: Analyte Result DF DLR Units Date/Analyst 6010B ICP CAM Metals Only (16 Metals) Antimony ND 1 3.0 rog/Kg 11/25/02 KN Arsenic 1.76 1 0.5 rog/Kg 11/25/02 KN Barium 28.2 1 1.0 nag/Kg 11/25/02 KN Beryllium ND 1 0.5 nag/Kg 11/25/02 KN Cadmium ND 1 0.5 rog/Kg 11/25/02 KN ' Chromium 3.98 1 1.0 mg/Kg 11/25/02 KN Cobalt 3.12 1 0.5 nag/Kg 11/25/02 KaN Copper 4.37 1 1.0 rog/Kg 11/25/02 KN Lead 4.94 1 0.5 rog/Kg 11/25/02 KN .Molybdenum ND 1 1.0 rog/Kg 11/25/02 KN Nickel 2.76 1 1.5 nag/Kg 11/25/02 KN Selenium ND 1 1.0 rog/Kg 11/25/02 KaN · Silver ND 1 0.5 nag/Kg 11/25/02 KN Thallium ND 1 1.0 mg/Kg 11/25/02 YoN · Vanadium 20.3 1 0.5 nag/Kg 11/25/02 KN Zinc 58.6 1 5.0 rug/Kg 11/25/02 KN , 7471A Mercury in Solid Mercury I NDI 1 0.14 nag/Kg 11/20/02 MDI 8021B BTEX Benzene I ND[ 1 0.005 nag/Kg 11/20/02 LT Ethyl benzene ] ND[ 1 0.005 rog/Kg 11/20/02 LT Toluene I ND] 1 0.005 rag/Kg 11/20/02 LT Xylene (total) I NDI 1 0.015 rug/Kg 11/20/02 LT 8015M - Total Petroleuna Hydrocarbons Gasoline I NDI 1 5 nag/Kg 11/20/02 LT Surrogates Units Control Limits a,a,a-Triiluorotoluene I 901 % 55- 156 DLR = Detection limit tbr reporting purposes, ND = Not Detected below indicated detection limit, DF = Dilution Factor ASSOCI/I TED L,4 BOR,4 TORIES Analytical Results Report Lab Request 102368 results, page l or'3 Order #: [ 3926251 Client: ~-dvanced Environmental Concepts Inc. Matrix: SOLID Client Sample ID: SKC-12' Date Sampled: 11/14/2002 Time Sampled: 09:33 Sampled By: Analyte Result DF DLR Units Date/Analyst 6010B ICP CAM Metals Only (16 Metals) Antimony ND 1 3.0 rog/Kg 11/25/02 KN Arsenic 2.58 1 0.5 rog/Kg 11/25/02 K_N Barium 63.5 1 1.0 rog/Kg 11/25/02 KN Beryllium ND 1 0.5 rog/Kg 11/25/02 KN Cadmium ND 1 0.5 rog/Kg 11/25/02 KN Chromium 8.43 1 1.0 rog/Kg 11/25/02 KN Cobalt 5.10 1 .0.5 rog/Kg 11/25/02 KN Copper 6.45 1 1.0 rog/Kg 11/25/02 KN Lead 27.9 1 0.5 rog/Kg 11/25/02 KN Molybdenum ND 1 1.0 rog/Kg 11/25/02 KN Nickel 5.10 1 1.5 rog/Kg 11/25/02 KN Selenium 1.61 1 1.0 rog/Kg 11/25/02 KN Silver ND 1 0.5 rog/Kg 11/25/02 KN ThaLlium ND 1 1.0 mg/Kg 11/25/02 KN Vanadium 27.6 1 0.5 rog/Kg 11/25/02 KN Zinc 59.3 1 5.0 rog/Kg 11/25/02 KN 7471A Mercury in Solid Mercury ] NDI 1 0.14 rog/Kg 11/20/02 MDJ 8021B BTEX Benzene I NDI 1 0.005 rog/Kg 11/20/02 LT Ethyl benzene I ND[ 1 0.005 mg/Kg 11/20/02 LT Toluene I NDI 1 0.005 rog/Kg 11/20/02 LT Xylene (total) I NDI 1 0.015 rog/Kg 11/20/02 LT 8015M - Total Petroleum Hydrocarbons Gasoline [ NDI 1 5 rog/Kg 11/20/02 LT Surrogates Units Control Limits a,a,a-Tritluorotoluene I 1561 % 55 - 156 DLR = Detection limit tbr reporting purposes, ND = Not Detected below indicated detection limit, DF = Dilution Factor A,q,qOCIA TED LA BORA TORIES Analytical Results Report " Lab Request 102368 results, page 2 oi'3 Order #: [ '~ ~Environmental Concepts Matrix: SOLID Client Sample ID: Laboratory Method Blank Date Sampled: Time Sampled: Sampled By: Analyte Result DF DLR Units Date/Analyst 6010B ICP CAM Metals Only (16 Metals) Antimony I ND[ 1 3.00 rog/Kg 11/25/02 KN ~enic I ND[ 1 0.50 rog/Kg 11/25/02 KN Barium I NDI 1 1.00 rog/Kg 11/25/02 KaN Beryllium I NDI 1 0.50 rog/Kg 11/25/02 KN Cadmium I NDI 1 0.50 rog/Kg 11/25/02 KN Chromium [ NDI 1 1.00 rog/Kg 11/25/02 KN Cobalt I NDI 1 0.50 mg/Kg 11/25/02 KN Copper I NDI 1 1.00 rog/Kg 11/25/02 KN Lead I NDI 1 0.50 rog/Kg 11/25/02 KN Molybdenum I NDI 1 1.00 rog/Kg 11/25/02 KN Nickel I NDI 1 1.50 rog/Kg 11/25/02 KN Selenium I ND[ 1 1.00 rog/Kg 11/25/02 KN Silver I ND[ 1 0.50 rog/Kg 11/25/02 KN Thallium I NDI I 1.00 rog/Kg 11/25/02 KN Vanadium I ND] 1 0.50 rog/Kg 11/25/02 KN Zinc I NDI 1 5.00 rog/Kg 11/25/02 KN 7471A Mercury in Solid Mercury I ND[ 1 0.14 rog/Kg 11/20/02 MDJ 8021B BTEX Benzene [ NDI 1 0.005 rog/Kg 11/19/02 LT Ethyl benzene I NDI 1 0.005 rog/Kg 11/19/02 LT Toluene [ ND[ 1 0.005 rog/Kg 11/19/02 LT Xylene (total) I NDI 1 0.015 rog/Kg 11/19/02 LT 8015M - TOtal Petroleum Hydrocarbons Gasoline [ NDI 1 5 rog/Kg 11/19/02 LT Surrogates Units Control Limits a,a,a-Trifluorotoluene [ 122[ % 55- 156 DLR = Detection limit fbr reporting purposes, ND = Not Detected below indicated detection limit, DF = Dilution Factor /~_.~ ASSOCIA TED LA BORA TORIE,q; Analytical Results Report Lab Request 102308 results, page 3 or'3 A }OCIATED LABORATORI QA REPORT FORM (MS/MSD) Qc Sample: 102368-392624 QC# 112202S3 Matrix: SOLID Prep. Date: 11/22/02 Analysis Date: 11/26/02 Lab ID#'s in Batch: LR 102461, 102368 REPORTING UNITS = mg/Kg MATRIX SPIKE / MATRIX SPIKE DUPLICATE RESULT Sample Spike Matrix Matrix %Rec %Rec TEST Method Result ND Added Spike Spike D. Up MS MSD RPD Arsenic 6010B 1.76 89 89 90 98 99 1 Selenium 601 OB 1.50 U 89 82 82 92 92 0 Thallium 6010B 1.00 U 89 83 83 93 93 0 Lead 6010B 4.94 89 89 89 94 94 0 Antimony 6010B 3.00 U 89 88 88 99 99 0 Barium 6010B 28.20 89 119 118 102 101 1 Beryllium 601 OB 0.50 U 89 91 89 102 100 2 Cadmium 601 OB 0.50 U 89 89 89 100 100 0 Chromium 601 OB 3.98 89 94 93 101 100 1 Cobalt 601 OB 3.12 89 89 89 96 96 0 Copper 6010B 4.37 89 92 91 98 97 1 Molybdenum 6010B 1.00 U 89 90 91 101 102 1 Nickel 601 OB 2.76 89 90 89 98 97 1 Silver 601 OB 0.50 U 89 74 76 83 85 3 Vanadium 6010B 20.30 89 111 110 102 101 ! Zinc 601 OB 58.60 89 143 142 95 94 1 * = Outside QC limits, due to matrix Interference If Sample Result > 4 times Spike Added, then "NC" ND = "U' - Not Detected RPD = Relative Percent Difference of Matrix Spike and Matrix Spike Duplicate ~ITS = 75; 125 %REC~MS&MSD = Percent Recovery of Matrix Spike & Matrix Spike Duplicate IRPD LIMITS = 20 12/2/2002 6010_1122s3 Page q of 2 A DCIATED LABORATORI LeS/MB REPORT FORM LCS Source(s): QC21-LOT#QC2/91/1 ;QC7-LOT7A92/1 Method Blank Element ] Method I Result ] %Rec [ L.Limit ] H.Limit MB I ND Silver 6010B 99 100 99 80% 120% 0.50 U Aluminum 6010B 195 200 98 80% 120% 20.00 U Arsenic 6010B 192 200 96 80% 120% 0.50 U Boron 601 OB 197 200 99 80% 120% 5.00 U Barium 601 OB 193 200 97 80% 120% 1.00 U Beryllium 601 OB' 205 200 103 80% 120% 0.50 U Cadmium 601 OB 195 200 98 80% 120% 0.50 U Cobalt 6010B 198 200 99 80% 120% 0.50 U Chromium 601 OB 198 200 99 80% 120% 1.00 U Copper 601 OB 194 200 97 80% 120% 1.00 U Iron 6010B 193 200 97 80% 120% 5.00 U Manganese 601 OB 196 200 98 80% 120% !.00 U Molybdenum 601 OB 194 200 97 80% 120% 1.00 U Nickel 601 OB 195 200 98 80% 120% 1.50 U Lead 601 OB 192 200 96 80% 120% 0.50 U Antimony 6010B 194 200 97 80% 120% 3.00 U Selenium 601 OB 187 200 94 80% 120% 1.00 U Thallium 601 OB 187 200 94 80% 120% 1.00 U Vanadium 6010B 197 200 99 80% 120% 1.00 U Zinc 6010B 193 200 97 80% 120% 5.00 U Notes: RESULT = Sample Result; TRUE = True Value; %Rec = lO0*Result/True L. LIMIT/ II. LIMIT = Low / High Control Limits MB = Method Blank; ND = "U "for Non- Detected 12/2/2002 6010 1122S3 Page 2 Of 2 ASSOCIATED LABORATORIES QA REPORT FORM QC Sample: 102368-392624 Matrix: SOIL Prep. Date: 11/20/02 Analysis Date: 11/20/02 ID#'s in Batch: LR 102368, 102426, 102338, 102339, 102407, 102440 MATRIX SPIKE / MATRIX SPIKE DUPLICATE RESULT Reporting Units = rog/Kg .. Sample Spike Matrix Matrix %Ree %Ree Test Method Result Added Spike Spike Dup MS MSD D , MERCURY , .,1 7471A ND [ 0.73 o.8, I o.,9 I 1,1 lO8 RPD = Relative Percent Difference of Matrix Spike and Matrix Spike Duplicate °/oREC LIMITS = 80 - 120 %REC-MS & MSD = Percent Recovery of Matrix Spike & Matrix Spike Duplicate RPD LIMITS = 20 PREPARATION BLANK / LAB CONTROL SAMPLE RESULTS PREP BLI~LCS Yalue | Result True I */oRee IL.Limit H.Limit I I I Value = Preparation Blank Value; ND = Not-Detected LCS Result = Lab Control Sample Result True = True Value of LCS L.Limit / H. Limit= LCS Control Limits 11/27/2002 7471_Hg_1120s ASSOCIATED LABORATORIES QA REPORT FORM QC Sample: 102368-624 Matrix: SOLID Prep. Date: 11/19/02 Analysis Date: 11/19/02-11/20/02 ~D#'s in Batch: LR 102368, 102313, 102465 MATRIX SPIKE / MATRIX SPIKE DUPLICATE RESULT Reporting Units = ug/Kg Sample Spike Matrix Matrix %Rec %Rec t,, Test I Method I Result I Added [ Spike [ Spike Dup[ MS [ MSD ] RPD,] ND = NOt ~ RPD = Relative Percent Differ~ce of Ma~x Spike and Mawl~ Spll~ Duplicate ~6R~C IdMITS = 70 - 150 [ ~REC-MS & MSD = Percent R~covery o£Matttr Spike & Mawlr $pl~ Duplicate Po°D LIMITS = $0 PREPARATION BLANK / LAB CONTROL SAMPLE RESULTS Value Result Tr~e %Rec L.Limit H.Limlt LCS ND 5.43 5 109 $0% 120% LCSD ND 5.52 5 110 $0% 120% LCS Resul~ = Lab Control Sample Rezult True ~ True lral~ of LC~ l~Llmit / H~lmit ~ £CS Control lda~t~ SURROGATE RECOVERY Sample No. AAA-TFT QC Limit $5-156 QA Sample 90 MS 150 MSD 149 Method Blank 122 LCS 64 LCSD 66 .4/Mo TFT = a,a,a- Dtfluorotoluene 1/27/2002 8015g__tph=l I los ASSOCIATED LABORATORIES QA REPORT FORM QC Sample: 102368-624 Matrix: SOLID Prep. Date: 11/19/02 Analysis Date: 11/19/02-I 1/20/02-11/21/02 LAB II~'s in Batch: LR 102368, 102313, 102465 MATRIX SPIKE / MATRIX SPIKE DUPLICATE RESULT REPORTING UNITS = mg/Kg Test Method Result Added Spike Spk. Dup MS MSD RPD Benzene* 8021 ND 0.04 0.030 0.025 75 63 18 Toluene 8021 ND 0.04 0.038 0.029 95 73 27 Ethylbenzene 8021 ND 0.04 0.046 '0.041 115 103 11 Xylenes 8021 ND 0.12 0.138 0.121 115 101 13 * Outside QC Lindts. Matrix Interference ND = Not Detected RPD = Relative Percent Difference of Matrix Spike and Matrix Spike Dup %REC ~IM1TS = 70 - 130 [ %REC-MS & MSD = Percent Recovery of Matrix Spike & Matrix Spike Duplicate RPD LIMITS = 30 PREPARATION BLANK / LAB CONTROL SAMPLE RESULTS PREP. BLqLCS LCSD Test MethodI Value I Result I TRUE I %R~ Result 1%Rec Benzene 8021 ND 0.022 0.02 110 0.023 115 Toluene 8021 ND 0.021 0.02 105 0.022 I l0 Ethylbenzene 8021 ND 0.021 0.02 105 0.021 105 Xyl.enes 8021 ND 0.071 0.06 lis 0.072 120 LCS = Lab Control Sample Result TRUE = True Value of LCS L. Limit H. Limit L.LIM1T / H. LIMIT= LCS Control Limits 80% 190% SURROGATE RECOVERY Sample No. [ AAA-TFT QC Limit[ 55-156 QA Sample 90 MS 113 MSD 116 Method Blank 122 LCS 126 LCSD 135 .4~4~-~VT = a,a,a-Trifluorotoluene 11/27/2002 8021 btex ll19s Cooler Receipt Form Date Cooler Received: i[!l~~ Date Cooler Opened:_ . . _ . Was cooler scanned for presence of radioactivity?O No a: Was radioactivity results abc~ve 25cpm? · .If cgoler had custody seal(s), were they signed and intact9 .... . .... ...· · Yes/No ~pper s packing slip attac,:cd to the coOler? yes-~ Cooler was packed with: Icc'X/ Ice Packs Bubble Wrap____ styrofoam--- Paper None Other ' Temperature of cooler: 0.1~ ' · Cooler needs to be received @ 4°¢ with an acceptable range of 2°-6°~· Were all samples sealed in plastic bags? Did all samples arrive intact? If no, see below ~No Were all samples labeled correctly? (ID, Dates, Times)If no, see below y~~o Can the tests required be ran with provided containers? If no, see below Y~No Was sufficient volume of sample sentin all containers? ~_~/No Were any VOA vials received with headspace? ~YesiNo Were correct preservatives used? (~/Yes/'No · If no, see pH Log for a list of samples and container pH..' · . Any'o/her important information:, , · , "..-:..i'.:~.*:.'..'...' :.2' .. '. ·' : ' '.:-:'-: S~gned: ". . Date: I . CHAIN-OF-CUSTODY RECORD Pr°j[ct Name' ~l. ~/~ ~ _I~ ~ ~~ Client Pr°jest' ~ Page [ °f ( ~ ~ [~ [~ ' ,urn Around Requested: ~e~ ~ E Lab Use Only. , - ~ = · Sample Condition - ~ 24-Hour-Rush '~ o ~~ ~ ~48-Hour-Rush ~ ~ ~ asreceived: SampleFs Signature~ ~t ~ ~ '~ormal~ Mobile Lab ~ ~'~ ~ ~ Sealed ~/No 0 Relinquished by: (~~. '*~ Dat~ ~ ~ R~ived by: (Signa~r~ Date · ~~ ~U~ ][[[ ~ ~~~~~ ~ /~./~ ~ ~ TotalNumber of Containers ~~0~ L~ ~ Ti~e ] ~. 661/831-1646 ,. ASHE ROAD.,206 Tim ~ Company: ~ F~ 661/831-1~1 BAKERSFIELD. CA 93313 . E-maih a~nced ~lightspeed.net BAKERSFIELD Map Source: Thomas Bros. Maps L - Location Map - FIGURE Victory Outreach Church 1 .~ C~.C~TS ~.C.500 California Avenue ADVANCED ENVIRONMENTAL CONCEPTS of Kern Bakersfield, CA P.O. BOX 40672 BAKERSFIELD, CA 93384 County Umits of Excavation ~ 0.5KC @ 8' ~---"~$KC @ 12' · ~_~ 5OO gal UST Church Building (Vacant) ' AsphaJt !, To Califomia Avenue /~ o ,o' ~o' V Scale: 1" = 20' //~L~~'-. ' - Site Map- FIGURE Victory Outreach Church 2 .~D~.o~.~co.c~s,.c. 500 California Avenue ADVANCED ENVIRONMENTAL CONCEPTS P.O. BOX40672 BAKERSFIELD, CA 93384 County of Kern · Bakersfield, CA December 11,2002 Arnold Familian FIRE CHIEF RON ~R~ZE 1666 20th Street, Suite 100 Santa Monica, CA 90404 ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661)326-3941 FAX(661)395-1349 CLOSURE OF 1 UNDERGROUND H,~.ARDOUS SUBSTANCE STORAGE TANK LOCATED AT 500 CALIFORNIA AVE, sU.PRESSIO. SERVICES BAKERSFIELD CA. PERMIT # BR-0294. 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 Dear Mr. Familian: F^X (661)395-13,9 PREVE~mO. SERVICES This is to inform you that this department has reviewed the results FIRE SAFETY SERVICES ° ENV'I~ONMENTAL SERVICES 17150hesterAve. for the preliminary assessment associated with the closure of the Bakersfield, CA93301 tanks located at the above stated address. VOICE (661) 326-3979 FAX (661) 326-0576 Based upon laboratory data submitted, this office is satisfied with PUBLIC EDUCATION ~T~C~e-te,',,,v'e. the assessment performed and requires no further action at this Bake,.,eld. C^~o~ time. Accordingly, no unauthorized release reporting is necessary VOICE (661) 326-3696 EH (661) 32~0~76 for this closure. FIRE INVESTIGATION 1715 Chester Ave. If yOU have any questions regarding this matter, please contact me Bake,~.~,c^~mo~ at (661) 326-3979. vo,cE (r~) ~6-~6~ FAX (861)326-0576 Sincerely, TRAINING DIVISION ~ ~ 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-469~ FAX (661) 399-5763 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services HHW/dlc cc: John Whiting S:tUSTFORMS~.UST.LI ,~F Z ~.D FZR.~ 1715 Cges~er Ave., Bake=a~ield, CA 93301 (805) 326-3979 ~~ ZNSPECTZ~ FO~ OA~ I~P~Cl~P~ ~ 8Z~NAI'URf CITY Of B~LERS~L~rm~t~N~°' OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK SITE I FO TION ' -~' ROSS STREET FACILITY NAME TA~ O~OPE~TOR ~r~ld ~d~o. PHO~ NO. CONT~CTOR ~FO~TION ~ / COMP~ ~S~CE C~Eg P~L~Y ASSESS~NT ~FO~TION T~K CLE~G,~FO~TION PHO~ 0 co~ WASTE ~SPORTER mE~WICA~ON ~ER N~E OF ~SATE DI~POS~ FACILI~ FACm~ mE~OA~ON T~K tmSeO~TZ~ ~O~TXOS COMP~ T~K ~FO~TION CHEMIC~ DATES CHEMIC~ T~ NO. AGE VOL~E, STO~D . STOOD P~VIOUSLY STOOD For Official Use Onl]/ THE APPLICANT HAS ~CEIVED, ~DERST ANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OWNER STATE, LOCAL AND FEDE~L ~GULAT IONS. THIS FO~ HAS BEEN COMP LETED ~DER PENALTY OF PENURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE APPROVED BY: ~PLICANT NAME (P~NT)~ APPLICANT SIGNATU~ TfflS ~PLICATION ~L BECOME A PE~IT ~EN ~PROVED Health & Safety Plan Introduction: A Site Safety Plan (SSP) has been designed to address safety provisions needed during the site soil assessment/remediation. It's purpose is to provide established procedures to protect all on-site personnel from direct skin contact, inhalation, or ingestion of potentially hazardous materials that may be encountered at the site. The SSP establishes personnel responsibilities, personal protective equipment standards, decontamination procedures and emergency action plans. Advanced Environmental Concepts, Inc. seeks to enter the property described above for the purpose of conducting a site assessment, consisting of a tank removal followed by soil sampling. Undisturbed soil samples will be collected to assess the extent of hydrocarbon impacted soil at the subject site. Each sample to be chemically analyzed will be collected in a brass sleeve, capped with lined plastic lids, sealed with tape, and placed under refrigerated storage pending delivery to the analytical laboratory under Chain-of-Custody protocols. Excavation equipment will be brought to the site and operated by: Advanced Environmental Concepts, Inc. 4400 Ashe Road #206 Bakersfield, California 93313 (661) 831-1646 Contractor's License # A-720492 exp: 03/31/04 This SSP describes means for protecting all on-site personnel from deleterious contamination of personal injury while conducting on-site activities. As described below, we will strive to meet all requirements promulgated by the California Department of Health Services. Responsibilities of Key Personnel: All personnel on-site will have assigned responsibilities. Mr. Jonathan L. Buck will serve as Project Manager and on-site geologist. He will also serve as Site Safety Officer (SSO). As SSO, Mr. Buck will assure that on- site personnel have received a copy of the SSP. Personnel will be required to document their full understanding of the SSP before admission to the site. Compliance with the SSP will be monitored at all times by the SSO. Appropriate personal protective equipment, listed below, will be available and utilized by all on- site personnel. Prior to beginning work, the SSO will conduct a training session to assure that all are aware of safe work practices. In the training session, personnel will be made aware of hazards at the site. Mr. Buck will also be responsible for keeping field notes, collecting and securing samples and assuring sample integrity by adherence to Chain-of-Custody protocol. All on-site employees will take reasonable precautions to avoid unforeseen hazards. After documenting their understanding of the SSP, each on-site employee will be responsible for strict adherence to all points contained herein. Any deviation observed will be reported to the SSO and corrected. On-site employees are held responsible to perform only those tasks for which they believe they are qualified. Provisions of this SSP are mandatory and personnel associated with on-site activities will be required to adhere to these guidelines. Job Hazard Analyses: Hazards likely to be encountered on-site include those commonly encountered when operating any mechanical equipment, such as the danger of falling objects or moving machinery. Simple precautions will reduce or eliminate risks associated with operating such equipment. A drilling contractor has been employed to deliver and operate all drilling equipment. Qualified personnel only will have any contact with this equipment. All on-site personnel, including the excavation contractor and his employees, are requiredto wear hard hats when in close proximity to excavating equipment. Latex sampling gloves will be worn by persons collecting or handling samples to prevent exposure to contaminants. Gloves will be changed between samples and used ones discarded, to avoid cross-contamination. Proper respiratory equipment will be worn if vapor contamination levels on-site exceed action levels as determined using a Photoionization Detector (PID). Action levels requiring respiratory apparatus will be 10-ppm above background level, in the breathing zone. Furthermore, no on-site smoking, open flame or sparks will be permitted in order to prevent accidental ignition. Risk Assessment Summary: Exposure to chemicals anticipated on-site include gasoline, diesel, and benzene, toluene, and xylene (BTX). These chemicals represent a hazard because they are moderately to extremely toxic and most are highly flammable. Threshold Limit Values (TLV's), Short Term Exposure Limits (STEL's) and Toxicity levels (LD50, oral-rat), all in mg/kg (ppm), are listed below: Compound TLV STEL Toxicity Gasoline 200 300 .... Diesel 50 75 .... Benzene 1 25 4894 Toluene 100 150 5000 Xylene 100 150 4300 Benzene is considered an extreme cancer hazard. Exposure Monitorinq Plan: A PID will be used to monitor vapor concentrations around the site. Should concentrations exceed TLV's, protective measures will be taken. Passive dosimeter badges will be placed in downwind locations if PID readings indicate levels of volatile organics in the breathing space in excess of TLV's. Personal Protective Equipment: Personnel on-site will have access to respirators with organic vapor cartridges. Replacement cartridges will be available on-site as needed. When handling samples, the on-site Geologist will wear latex gloves. Hard hats will be worn by all personnel on-site when in proximity of drilling equipment. Work Zones and Security Measures: Access to the site will be restricted to authorized personnel. A set of cones, placards, or wide yellow 'caution' tape surrounding the site will define the perimeter, if needed. The Project Manager will be responsible for site security. Decontamination Measures: Avoidance of contamination whenever possible is the best method for protection. Common sense dictates that on-site personnel avoid sifting, leaning or placing equipment on potentially contaminated material. All personnel will be advised to wash their hands, neck and face with soap and water before taking a break or leaving the site. Respirators will be washed with soap and water following each day's use. Drilling and sampling equipment used will be decontaminated by steam-cleaning Sampling equipment will be decontaminated before each sample is collected. General Safe Work Practices: On-site personnel will be briefed each day in "tailgate" meetings as to the day's goals and equipment to be used. Anticipated contaminants and emergency procedures will be reviewed. Appropriate personal protective equipment will be put on and verified correct by SSO, including respirator fit. Drilling and sampling equipment will be steam-cleaned before arriving on-site. Split-spoon sampling equipment will be cleaned before each use. Augers will be steam-cleaned between borings. The on-site engineer will oversee operations and log borings. The Sample Coordinator will assure that proper protocol is used at all times in collecting and handling samples. Training Requirements: The SSO will conduct a pre-site training session which will include contaminant properties, warning signs, health hazard data, risk from exposure and emergency first aid. All chemicals are to be covered and the SSO will assure that everyone fully understands site hazards. Medical Surveillance Pro_~ram: According to CFR 29, 1910.120, Paragraph (f), employees who wear respirators thirty (30) days or more during one (1) year or who have been exposed to hazardous substances or health hazards above established permissible exposure limits are required to be monitored medically. All site personnel will be required to have had a complete chemical physical within the past year. Record Keeping: Documentation will be kept on personnel exposed to contaminant hazards on the job site according to OSHA regulations. These will include documentation that employees have received training on the SSP, respiratory protection, MSDS forms and all emergency procedures. These will be reviewed during the pre-site training meeting. Exposure records on each job will be kept for thirty (30) years to meet requirements. Included will be names and social security numbers of employees, medical evaluations, on-the-job logs from entry to exit, first aid administered, visits on-site by outside persons and personal air monitoring records. Contingency Plans: In the event of an accident, injury, or other emergency, the Project Director, Senior Project Manager, or other person, will notify the appropriate government agencies or individuals as follows: 1. Police, Fire, or Ambulance Emergency 9-1 -1 2. Emergency Hospital: Memorial Hospital 420 34th Street Bakersfield, California (661) 327-4647 3. Kern County Environmental Health Department 2700 M Street Bakersfield, California 93306 (661) 862-8700 I have read the preceding Health and Safety Plan and undemtand the contents herein: NAME: COMPANY PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Frenkel Of California ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE Environmental Risk Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 725 S. Figueroa Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Los Angeles CA 90017 Phone: 213-787-1100 Fax: 213-787-1.164 INSURERS AFFORDING COVERAGE INSURED INSURERA: American Int'l Specialty Lines INSURERB: Lincoln General Ins. Co. Advance.d Env. Concepts, Inc. INSURERC: American Int'l Specialty Lines 4400 Asne Road #206 INSURERD: Bakersfield CA 93313 I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDrrlON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER LIMITS DATE ~MMIDD~) DATE GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERClAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ 100,000 I CLAIMSMADE ~-~ OCCURc~C~%?[. MED EXPlAnyone person) $ 25,000 X Contr. Poll.Lia~. 6190747 ~.~ ~u~ 12/21/00 12/21/02 PERSONAL&ADVINJURY Slf000,000 ~\~ GENERAL AGGREGATE $ 2 000 000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 X I POLICY ~ PRO- JECT [---] LOC AUTOMOBILE LIABlUTY COMBINED SINGLE LIMIT B ANY AUTO (Ea acddent) $ i, 000,000 X ALL OWNED AUTOS BODILY INJURY .... SCHEDULED AUTOS (Per person) $ X HIRED AUTO'S .... 2510000'7'~4_0 -' 12/21/0'1 12/21/02 BODILY INJURY $ X NON-owNEDAuTOS (Per acddent) PROPERTY DAMAGE (Per acddent) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABIL~Y EACH OCCURRENCE $ i, 000,000 C X IOCCUR ~ CLAIMS MADE 6190861 12/21/01 12/21/02 AGGREGATE $2,000,000 $ DEDUCTIBLE $ RETENT ON $ $ WC STA1 U- (flTH- WORKERS COMPENSATION AND TORY L M TS ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT E.L. DISEASE- EA EMPLOYEE $ E.L. DISEASE- POLICY LIMIT $ OTHER A CLAIMS MADE: EA CLAIM: 1,000,000 PROFESSIONAL LIAB. 6190747 12/21/00 12/21/02 ANN AGG: 1,000~0~0 DESCRIPTION OF OPERATIONS/LOCATIONS~ERICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS GENERAL INFORMATION CERTIFICATE ONLY. CERTIFICATE HOLDER I N I ADDITIONAL INSUREO; INSURER LETTER: __ CANCELLATION GENI:NFO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES' BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER V~LL ENDEAVOR TO M~L * 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL GENERAL INFORMATION ONLY IMPOSE NO OBLIGATION OR LIABILITY OF ANY KJND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. I AUTHORIZED REPRESEN~.~~r~ A~TI E ACORD 25-S (7/97) ORD CORPORATION 1988 PRODUCER . AS A MAI'I'ER OF INFORMATION iHRH of Central California 41 m(~HTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND : P O BOX 18 8 6 ALTER THE COVERAGE AFFORDED BY THE PCRJCIES BELOW. Bakersfield, CA 93303 ,661 328-1300 INSURERS AFFORDING COVERAGE i,NSUREO ,NSURERA:State Compensation Insurance Fund Advanced Environmental Concepts, Inc. INSURER B: 4400 Ashe Road #206 ~NSUR~RC: Bakersfield, CA 93313 ~NSURER ~. I INSURER FJ COVERAGES THE POEC~SC~JSURANCE USql~ BELOW HAVE BEEN E~tJED TO THE IN~URED NAMED ABOVE F'O~THEPOUCYPI~OD ~DICATED. NOllN~4~TANDING ANY REQU~qEMENT, TERM OR CONDFI1ON OF ANY CONTRACT OR OTHER DOCUMENT W~H R~SPECT TO WHICH THIS OERI~F~ATE MAY BE IS~IJED OR MAY PERTNN, THE ~SURANCE AFFORDED BY THE POLICIES DESCRIED HERE~N ~ SUBJECT TO ALL THE 11~aas, EXCLU~ONSAND CC~DmONsO~ SUCH POLKaed. AGGREGATE UM~$ t~HOWN MAY HAVE BEEN R~DUCED BY PND CLNMS. JNSR POLICY EFFECTIVEPOLICY EXPIRATION ;LTR TYPE OF iNSURANCE POLICYNUMRER DATE IMM/DD~i~ OATEIM M/DD~J LIMITS GENERAL L]ABILITY EACH OCCURRENCE $ COM MER CIAL G E~ ~RAL LIABILITY FIREOAMAGE[AnyOneflre) $ I CLAlUS UADE[~]OCCUR UED EXP(Anyo~ep~so.) S PERSONAL&AOV~NdURY $ G EN ERAL AGGREGATE $ G EN'L AGGREGATE LIMIT APPLIES PER: PRO, OUCT~ -COMP/DP AGO AUTOMOBILE UABILITY COMBINED SINGLE LIMIT ;$ ANY AUTO (Ea. e, cc~denf) ALL OWN ED AUTO~ BODi LY INJURY $ SCHEDULED AUTOS ~Per per~o~] -- HIRED AUTOS i BODILY iNJURY $ NON -OWN ED AUTOS : [Per accidenlJ __ PROPERTY DAMAGE GARAGE LIABILITY AUTOONLY- EAACCIDENT $ '---1 ANY AUTO OTHER THAN EAACC . AUTO ON LY: AGG $ EXCESS LIABILITY EACH OCCURRENCE _~ OCCUR ~-~ CLAIMS MADE ,AGGREGATE S $ DEDUCTIBLE $ RETENT, ION $ i $ A WO.K£RSCO.PENS^T.ONA. O 158478002 07/01/02 07/01/03 X WCSTATU- EMPLOYERS' LIABIUIY EL. EACH ACCIDENT ! $1 ! 0 0 0 , 0 0 0 F_LDISEASE-EA EMPLOYEE I $1,000,000 SL.D~B~SE-PO,~CVUV~ ~1~ 000 ~ 000 OTHER DESCRIPI~ON O'F OPERATIONS/LOCA'TION$~f'EHIcL ES/ExCLUSIONS ADDED SY £NDORSEMENT/SPEGIAL PROViSiONS For Informational Purposes Only CERTIFICATE HOLDER I I ADDII~ONAL II'UR ED;, INSURER LETTEF~ CANCEU~110~ ;HOU LDANYOFTH EABOVE DESCRIB EDFOLICiES B E~ANCELLED BEFORE t'H E EXP~RA*r[oN Advanced Environmental )A*EIHEREOF. ~HEISSUING INSURER WiLL ENDEAVOR TO MAIL~ DAYSWRITIEN Concepts, Inc. flOTiCETOTHECERIqFICATE HOLDERNAMEDTOTHELEFT. BUTFNLURETOOOSOSRALL MPO$ E NO OBLIGATION OR LIABILITYOF ANYKINO UPON I'flEINSURER, IT$ AI~iENIS OR REPRESENTATIVES. A UTHORIZ ED R EPR ES ENTAT]¥E ACORD2S-SU/97) l Of 2 #S209872/M209871 LLB eACORDCORPORATION~Sa8 · ' CONTRACTORS STATE LICENSE B RD .z~,~ ACTIVE UCENSE .;~ ..... :..-,. , ....... ,-.... . ,.,, ¢ .... ~ ' ~720492 -, CONCEPTS INC ~ ~ '-..~ S Hour --' Hazwoper Refresher 10/1812002 "?~ Name: Jon Buck . - .. SS~: 550-84-3842 · 'AOVANCED ENVIRONMENTAL CONCEPT8 INCm ' / FIELD ACTIVITY DALLY LOG ~ SHEET OF ~,~ ~c~,~,~s~.~c~: ~ ~,6~~ ~- ~' / ~'z ~" o~sc.,.~.o.o, o~.~r ~c~v,~,~s ~.o ~w.~s: ~ . .... _ ........ ~ ...... ......... .......... ~ ....... .~ ....... .... .................. .~ ............... ......... ......... ............................... s.._~ ...... ~ ......... ................ ........... ~ ............. ~ ............. ~ .............. ~ .............. ~ .................................................................. ~ ................................................................ ~ ......................................... ~ ....................................... ....................................... ~ ............................................... ............ . .......... VI~ITO~ ON ~ITE~ CHANG~ F~O~ PLAN~ AND ~PGOIFIOATION~, AND OTH~ ~P~OIAL O~DG~ AND I~PO~TANT ~ATH~ OONDITION~ I~PO~TANT T~L~PHON~ OALL~ A~O P~ONN~L ON ~IT~ SUP~VI~O~ DAT~