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Home My WebLink AboutUNDERGROUND TANK-C-12/14/89 BAKERSFIELD FIRE DEPARTMENT BUREAU OF FIRE PREVENTION 9 Dec 1976 ' FL079 Date APPLICATION Application No. In conformity with provisions of pertinent ordinances, codes and/or regulations, application is rnade by: Quality Meat Company 1200 K Street Name of Company Address to display, store, install, use, operate, sell or handle materials or processes involving or creating con- ditions deemed hazardous to life or property as follows: 1 - 1,000 gallon underground gasoline storage tank QUALITY ,MEAT CO. BAK£.$FI£LD; C~LIFO.NIA ~;, " FILE CONTENTS SUMMARY Activity Date # Of Tanks Comments Client Name: Charles R. Klassen, Inc. .' Address : 104 Lake Street Bakersfield, CA 93505 Date samples received : 11-28-89 Date analysis completed: 11-28-89 Date of report : 11-28-89 Laboratory No. 5267 through 5270 Projec RESULTS OF ANALYSIS #3267 iD: 2' East End ugm/gm MDL,ugm/gm Benzene ND 0.1 ~ Toluene ND 0.1 Ethylbenze~e ND O.1 p-Xylene ND 0.1 m-Xylene ND 0.1 o-Xylene ND O.1 Isopropylbenzene ND O.1 TPH (Gasoline) ND 1.0 #5268 ID: 4 1/2 ' East End ugm/gm MDL,ugm/gm Benzene ND 0.1 Toluene ND 0.1 Ethylbenzene ND 0.1 p-Xylene ND 0.1 m-Xylene ND 0.1 o-Xylene ND 0.1 Isopropylbenzene ND 0.1 TPH (Gasoline) ND 1.0 Method of Analysis for BTX/TPH (Gasoline): 5810/8020 (FID) MDL = Minimum Detection Level TPH = Total Petroleum HYdrocarbons ugm/gm = micrograms per gram ND = Not detected 3155 Pegasus Drive · Bakersfield, CA 93308 · (805) 393-3597 P.O. Box 80835 · Bakersfield, CA 93380 · FAX (805) 393-3623 Laboratory No. ~267'through 3270 Pro3ect: Oalif.& K. Street - Quality Meat RESULTS OF ANALYSIS ~269 ID: 2' West End ugm/gm MDL,ugm/gm Benzene ND 0.1 Toluene ND 0.1 Ethylbenzene ND 0.1 p-Xylene ND 0.1 m-~ylene ND 0.1 o-Xylene ND 0.1 Isopropylbenzene ND 0.1 TPH (Gasoline) ND 1.0 ~270,ID: 4 1/2 ' West End ugm/gm MDL,ugm/gm Benzene ND 0.1 Toluene ND 0.1 Ethylbenzene ND 0.1 p-Xylene ND 0.1 mzXylene ND 0.1 o-Xylene ND 0.1 Isopropylbenzene ND 0.1 TPH (Gasoline) ND 1.0 Method of Analysis for 8TX/TPH (Gasoline): 38~0/8020 (FID) MDL = Minimum Detection Level TPH = Total Petroleum Hydrocarbons ugm/gm = micrograms per gram ND = Not detected '' 006-450-12-00-8C GOLD ~OZELLE L "' 001-~0~ "'" ' 1 ~' AtF, 00000 5 .... ~87' 16000 78228 ":" 2519 ELM ST 00100100 BAKERSFIELD CA 93301 " 2519 ELM ST BAKERSFIELD CA 93301 iv ~97 17,497 '"' 1324 CALIFORNIA AVE ~AKERSFIELD .... PTN 392 "' STARK ~CTIVr 006-450-13-00-1C GOLD MOZELLE L "' 001-001 " 1 , ~1~ 250 00000 5 ..... 22:734 35040 78228 '" 2519 ELM ST 00/00/00 BAKERSFIELD CA 93301 " '' 2519 ELM ST " BAKERSFIELD CA 93301 ~' 38,184 38,1~4 " 1200 K ST BAKERSFIELD ..... ' PTN ~ 392 " STARK ACTIVE '' 006-450-14-00-~C GOLD MOZELLE L "' 001-001 " 1 . !4,3AR ooooo ,, 5 .,-, '. · 16000 78228 .... 2519 ELM ST 00/00/00 BAKERSFIELD CA 93301 " "' 2519 ELM ST. BAKERSFIELD CA 93301 20,630 20,630 :': 1216 K ST BAKERSFIELD ...... PTN '" 392 .... STARK. ;~ ACTIVE 006-450-15-00-76 GOLD WILLARD P & MOZELLE L " 5149-0025 001-001 ' 1 ~' 23,~92 00000 ': 5 .... ~ 10,177 02000 79103 '-" 2519 ELM ST 101311'78 BAKERSFIELD CA 93301 -. ,. '-. 2519 ELM ST ...... ,.~_. . BAKERSFIELD CA 93301 " "' 33,669 33,669 i '. 1220 K ST BAKERSFIELD .... ., PTN ,'. 392 "~'. STARK .- AC IVE ": 006-450-16-00-0C BROOKS RENTALS "' 5661-1755 [ ": 001-001 '.' -1 ". 6114-0725 14,070 · 85251 :" 5 ..... :' ~2,538 .... 01040 85123 -~:' 2821 BRUNDAGE LN 05/31/8~ --. BAKERSFIELD CA 93304 .... '.~ 2821 BRUNDAGE LN , ' BAKERSFIELD CA 93304 " :" 56,608 56,608 · ='- ';:~ 1228 K ST BAKERSFIELD .... ~ PTN ~.- 392 ..... STARK '.~ ACTIVE 5FIELD !~1-191-10-00-~ K 5T 5FIEL~ ~3~-DSI--'IU-§O-Z K 5T 6~B MOJfl~E- Z~-ISZ-OI~O0:O 5FIELD ~38-052-01-00-3 K 5T 703 BAKERSFIELD 009-261-08-00-0 5FI~LD IZl-I~Z-Ol-O0-5 K 5T 705 BAKERSFIELD -009-2~!-07-00-7 ~FIELD q38-351-11-00-5 K ST 719 BAKERSFIELD 009-261-0~-00-~ 5FIELD ~38-051-12-00-8 K 5T 723 BAKERSFIELD 009-26i-05-00-1 5FIELD "121-19l-I2-DO-O K 5T 7~7 BRKERSFIEL~ DDD-Z61-U~-OO:B CITY 212-2~0-27-00-~ K 5T 80~ BAKERSFIELD 009-232-01-00-7 CITY 212-2~0-29-00-D K 5T 805 BAKERSFIELD 009-231-16-00-~ qR'P]--~ 2Z~-31O-Dl-DC-1 K 5T BIO BAKErSFiELD DD9ZZ3Z-OZ-DO-O HAP! 222-320-01-00-~ K ST 81~ BRKERSF!ELD 009-232-03-00-3 'qRPI 222-5~0-03-00-6 K 5T TRE-I~F' 11~-312-11-00-2 K 5T N2D BAKERSFIELD 009-2~2-05-00-9 RI 112-311-12-00-8 K 5T 827 BAKERSFIELD 009-231-07-00-8 RI 112-312-10-00-~ K 5T 829 BR×ERSFIELD 009-231-06-00-5 THE THE RI !12-312-09-00-7 K 5T )O0 BAKERSFIELD 009-1~2-16-00-5 : RI 112-3.11-1~-00-~ K 5T 901 BAKERSFIELD O09-1WI-IO-O0-O THE RI IIZ-312-08-00-~ K ST THE R! 112-312-07-00-1 K 5T 910 BAKERSFIELD 009-1~.11-00-0 THE"RI THE RI 112-311-17-00-3 K 5T 920 BRKERSFIEL~ 009-1~2-0~-00-0 THE El 112-312-06-00-8 K 5T 925 BAKERSFIELD 009-1~1-06-00-9 -~Z'z3~[2c05-00-5 E 5T 928 BAKERSFIELD OOD-I~Z-05-OO'-3 THE El IIZ-311-18-00-G K 5T 931 APT A BAKERSFIELD 009-1q1-05-00-6 THE ~1 IIZ-312-02-00-~ K 5T 1002 BAKERSFIELD 009-112-01-00-2 THE El IIZ-312-01-00-3 K 5T I010 BAKERSFIELD OOD-IIZ-OZ-O0-5 THE RI IIZ-311-19-00-9 K 5T 1015 BAKERSFIELD 009-111-13-00-0 5F~ELD 019-311-36-00-5 K 5T 1020 BAKERSFIELD 009-1!2-0q-00-1 5F~li_D 010-311-q0-00-6 K 5T IOZI BAKERSFIELD 009-111-06-00-0 5~D 009-311-1q-00-1 K 5T 1025 BAKERSFIELD 009-111-05-00-7 5FIELd. 009-312-02-00-3 K 5T 1028 BAKERSFIELD 009-112-05-00,q ~?~?L.D ' 009-312-03-00-6 K 5T IIOZ ~AKERSFIELD 009~022-09-00-0 5t,.~LB 009-311-13-00-8 K 5T IIOG BAKERSFIELD 009-022-19-00-? ~FIEL~ OOD-312-Oq-O0-9 K 5T 1116 BAKERSFIELD . 009-022-11-00-5 5FI-EE~G~O-5 K 5T IIZZ BAKERSFIELD' 009-022-01-00-~ ~FIELD 009-312-05-00-2 K 5T I~00 ~LD 00~-~50-13-00~ 5FIELD 009-311-11-00-2 K 5T 1207 BAKERSFIELD O0~-q~O-II-O0-3~'-' '~?IELD 009-312-07-00-8 K 5T 1217 BAKERSFIELD 00~-~60-10-00-5 BAKERSFIELD --O0-~-W60-OD-OO-3-- EI.D 009-301-11-00-9 5T 1228 BAKERSFIELD 006-~50-16-00-0 0d-~50-17-00-3 2700 M Street '. HEALTH OFFICER Bakersfield, California ENVIRONMENTAL HEALTH DIVISION Leon M Hebertson, M.D. Mailing Address: .' 1415 Truxtun Avenue DIRECTOR OF ENVIRONMENTAL HEALTH Bakersfield, California 933~1 Vernon S. Reichard (805) 861-3636 April W. P. Gold %~ Las Gruces Avenue Bakersfield, Galifornia 93309 Dear Mr.. Gold: This letter is an official notice of your non-compliance with state and county laws relating to underground tanks. Upon review of our records, it was discovered that the 1988 Permit to Operate fees for Quality Meat Company, 1200 "K" Street, Bakersfield, California were not paid. Enclosed is a copy of 1988's invoice plus the 50% late penalty required by county ordinance. The second invoice is for this year's Permit to Operate fees. These invoices must be paid within 30.days to avoid further penalties and/or legal action. Be advised that. these fees must be paid even if the tanks are no longer in use. If the tanks are .not in use, a permit for permanent closure must be obtained from this office. Permanent closure requires either removal or closure in place of your tanks and assessment by soil sampling to determine whether there has been environmental damage as a result of unauthorized releases of hazardous substances from your tank site. The specific requirements for these activities are in Handbook #UT-30, available with your application. No closure activity can begin prior to the issuance of a permit from this office. If you have any questions or feel this assessment is in error, or if you would like an application and our handbook on permanent closure please call me at (805)861-3636. Your prompt attention to this very important matter is appreciated. Sincerely, Environmental Health Technician Hazardous. Materials Management Program DISTRICT OFFICES Delano · Lamont · Lake Isabella · Mojave · Ridgecrest · Shafter · Taft CIVIL ENGINEERING SURVEYING REMARKS: 1701 WESTWIND DRIVE · SUITE 103 · 19AKERSFIELD, CA 93301 [19051 323-6460 ' FAX (1905] 323-4723 · . , ,, · . , .,.. · . ,, '~,': -!.: · .. Laboratory No. ;3267 through ~5270 Projeot: Calif. & K. Street - .: "i ,",, :~''.:~.,';'~ ~ · . , ..:': : ND 'O. 1 , ;.~ ~". Hethod of Analysis for BTX/TPH (~asolin-): ~810/BO20 (FID MDL : Minimum Deteotion Level ~ :. TPH = Total Petroleum Hydrooa~bons .. ugm/gm = miorograms per 9ram ii~.-'.z 3155 Pegasus Drive · Bakersflel& CA 93308 · (805) 393-3597 ., ',: ,' '''~! · ..o. eox~08:~ · E~k~n,,tC*~,80· F~(~) ...... .; "~. ~.~ ~.~:',:'i i~,, ~ J'.~ :';" ', .'. ~ ...... '" :. ,:,.:' ~ ~ Laboratory No. 3267.~hrough 3270 Project: Calif. &. K. Street Quality Meat RESULTS OF ANALYSIS #3269 ID: .2' West End ugm/gm MDL,ugm/gm Benzene ND 0.1 Toluene ND 0.1 Ethylbenzene .ND ~0.1 p-Xylene ND' 0.1 m-Xyiene .. ND 0.1 o-Xylene ND 0.1 TPH (Gasoline) -- · ND . 1.O #3270 ID: 4 I/2 ' West End ugm/gm MDL,ugm/gm , Benzene ND 0.1 Toluene ND 0.1 :' Ethylbenzene ND 0.1 p-Xylene ND 0.1 .,'. m-Xylene ... ND O.1 ' o-Xylene ND O.1 Isopropylbenzene ND O.1 · TPH (Gasoline) ND 1.0 Method of Analysis for 8TX/TPH (Gasoline): 3810/8020 (FID) MDL = Minimum Detection LeveI TPH :TotaI PetroIeum,Hydrocarbons ugm/gm = micrograms per gram ND = Not detected Stan Comer State of California---Health and Welfare Agency . " Department of Health Services FO"~'" At "°red OMB N°' 2050~0039 (Ex'*--a 9'30~ ~t~ ' II Toxic Substances Control Divisior Pitusa p,T or type. (Form de~ee~l to~ 3e e~ -pitc~ t~l~,~ftac). ("~- . * Sacramento, Califomi,, .... ~'~'~ .' UNIFORM HAZARDOUS 1. GeneratoCa US EPA I~ No.. .. M.,nfest A. 2' Page1 IState ~. , ~, ,,* -, .,~ _ [ Document No. Infom~ation in the shaded areas WASTE MANIFEST,' ,,~' i/3..i tlf~lf.:lf.,,l..,i...-:t ¥1c),'lf)14'T?..l~l,~..rl;.:.! ~. of '1. isnot required by Federal law. 3. Generator's Name and. Mailing Address ..... ~ '" ..I~f,~u~.b .' '. :. :. · - I 9. Designated Fa~l~ ~ a~ SEe A~a : ~- '1~' ~ , '~ ~A ~ ~r : * .**.,..~ ~ .... . ~a ** 12. ~n~ 13. To~l 14. ~ ~ ...... ~,;:~ 11. U~ DOT ues.~ti~ 0~l~lng Proper ~ipping ~, ~za~ ~, ~ ~ Numbs) Stats. ~ .... ~ : < .~¢" '.~ ,';F ,.;' ':~/;~-"--. ' ..... ~'~D~ G E b. State ....... ..~. -.:.. · o !1 I IIII '": ................... ' . . ....,". %:~,..- . EP'A/~her ..- EPA/~er ;;;: .?c,,~; .. , II I IIII "' . · . ~ ~ndl~ ~ f~ Wastes L~t~ Above~:'~: J. Additional Des~p~s. f~ Materials UstC.. ~ ' ' ';' '"' ::~::~J'.-'.-' ' ' ': ' ' · :.: .' . a. b. · · .. : . :::. .... .... ...:?::-..;.: 15. Special Handling Instructions an~ Additional Information .','..¢;..- //'¥ :,- .;~ .: 'm .... ~ ;~: .,,, '~: :..-' -.";.,& "..~ / · .' ,, .' - 16. ~ENERATOR'S CE~FICA~ON: I hereby declare that the cost.ts of this consignment are ful~ and accurately descdb~ above by proper shipping name and are classified, pack~, marked, and labeled, and are in all rests in proper condition for transpo~ by highway acc~d~g to applicable international and national governmenl regulations. If I am a large quantity generator, I ce~i~ that I have a program in place to r~uce the volume and toxicity of. waste oenerat~ to the degree I have determined to be economically practicable and that I have sele~ed the practicable method of treatment, storage, or disposal cu~ently available to me which minimizes the present and future threat to human health and the environment; ~, if I am a small quantity generator, I,have made a go~ faith effo~ to minimize my waste generation and sele~ the best waste management method that is avai~ble to me and that I can afford. ~ Printed/Typed Name I S~nature ,, Mo~th Day I NA Printed/Typed. . ~ Name I Signature.._. ~ .. .. .~...' Month Day Year s ". ~ 'I I'"1 ;'! 'P ITM].'" ~ 18. Tr~nspoder 2 Acknowledgement of Receipl ~t M~te~als -, -.. ~ Printed/Typed Nlme ~ 8io~ll~re · ~th ~ll 19. Discrepancy Indication Space A C ..-;~ '~ ' '( .-...~ ./ ,-." .. . ., ~. /T__ ~ 20~ F~cilily ~ner o¢ O~alor ~ificalion gl receipl ot nrdous ~l~ls c~ed by this manliest except as noted in Ilem 19. T / y ~d/Typed Name ~ ~ignature ./' . ..... Mo~fh O~y o~s 8022 A 0/~) Do Not Write blow ~is Line EPA 8~0~22 '.: (Rev. 9-88) Previo,~ editio.~ ire GREEN: HAULER RETAINS ~ 1700Flower Street " ..... KERN COU .' OFF~a Bakersfield, California g3305 . ;; LMm M I · · .... -, .... ':-~ ,,<.; ~ ~ . ~ i ~ :';::~.~ llty Name County' Permll -. -, ::; ': UNDERGROUND · tthe )erm: '-: ,AddreS~ "~;~:~,:Authortzed .representative of :'contractor certifies by~st~tng "b, :~,~;,.ta~'~(~) .have..been decont~tnated In accordance wi~ ~ern county"~;althTM -Section 3 : To be fl'l'led out "and ' sl~ed ~ "an :'huthorl'zed :"r~presentatlve "'6'f. 'the . ............. ;' (/*-- GARY J. WICKS 2700 M Street, Suite 300 Agency Director Bakersfield, CA 93301 (805) 861-3502 .. Telephone (805) 861o3636 ~;'~ Telecopior (805) 861-3429 STEVE Mc CALLEY Oi,e or RESOURCE MANAGE, ME N'T AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH SERVICES December 14, 1989 Willard Gold 2519 Elm Street Bakersfield, California CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANK LOCATED AT 1324 CALIFORNIA AVENUE IN BAKERSFIELD, CALIFORNIA. PERMIT # A1083-16/160063 This is to advise you that this Department has reviewed the project results for the preliminary assessment associated with the closure of the tank noted above. Based upon the sample results submitted, this Department is satisfied that the assessment is complete. Based on current requirements and policies, no further action is indicated at this time. It is important to note that this letter does not relieve you of further responsibilities mandated under the California Health and Safety Code and California Water Code if additional or previously unidentified contamination at the subject site causes or threatens to cause pollution or nuisance or is found to pose a significant threat to public health. Thank you for your cooperation in this matter. TURONDA R. CRUMPLER, R.E.H.S., HAZARDOUS MATERIALS SPECIALIST cc: Charles R. Klassen, Inc. GARY J. WICKS eet, Suite 300 Agency Director ~1~ ~ ~ B4dr, e~,~ld, CA 93301 ~,.(805) 86~,-3502 .. ..~.~,.~-~?~::.. Telephone (805) 861-3636 STEVE McCALLEY , .~,~'/*~" ~ "~ Telecopier (805) 861-3429 Director R E S O U R C E ,~",~~:~E N-T A G E N C Y DEPART MENTAL PERMIT FOR PERMANENT CLOSURE '~~? PERMIT NUMBER A 1083-16 OF UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY ,.~:' , ~' .., FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: Willard P. Gold Trustee for Estate Willard Gold Charles R. Klassen Inc. -1324 California Avenue 2519 Elm Street 104 Lake Street . . . ':,..~'i?'.'....,. Bakersfield, CA Bakersfield, CA " Bakersfield, CA License #259978 Phone: (805) 327-3665 Phone: (805) 327-4034 PERMIT FOR CLOSURE OF PERMIT EXPIRES .February 16, 1990 1 TANK(S) AT ABOVE APPROVAL DATEj. November 16, 1989 LOCATION ' ~ti Turonda R. Crumpler, R.E.H.S. Hazardous Materials Specialist ..................................................................................... POST ON PREMISEs .......................................................................... CONDITIONS AS FOLLOWS: i. It is the responsibility of the Permittee to obtain permits which may be required by other regulatory agencies prior to beginning work. (i.e., City Fire and Building Departments) 2. Permittee must notify the Hazardous Materials Management Program at (805) 861-3636 two woi'king days prior to tank removal or abandonment in place to arrange for required inspections(s). 3. Tank closure activities must be per Kern County Environmental Health and Fire Department approved methods as described in Handbook UT- 30. 4. It is the contractor's responsibility to know and adhere to all applicable laws regarding the handling, transportation or treatment of hazardous materials. 5. The tank removal contractor must have a qualified company employee onsite supervising the tank removal. The employee must have tank removal experience prior to working unsupervised. 6. ff any contractors other than those listed on permit and permit application are to be utilized, prior approval must be granted by the specialist listed on the permit. Deviation from the submitted application is not allowed. 7. Soil Sampling: a. Tank size less'than or equal to 1,000 gaUons - a minimum of two samples must be retrieved from beneath the center of the tank at depths of approximately two feet and six feet. b. Tank size greater than 1,000 to 10,000 gallons - a minimum of four samples must be retrieved one-third of the way in from the ends of each tank at depths of approximately two feet and six feet. c. Tank size greater than 10,000 gallons - a minimum of six samples must be retrieved on-fourth of the way in fr°m the ends of each tank and beneath the 6enter of each tank at depths of approximately two feet and six feet. 8. Soil Sampling (piping area): A minimum of two samples must be retrieved at depths of approximately two feet and six feet for every 15 linear feet of pipe run and under the dispenser area. PERMIT, FOR PERMANENT CLOSURE PERMIT NUMBER A 1083-16 OF UNDERGRO. UND HAZARDOUS ADDENDUM SUBSTANCES STORAGE FACILITY 9. Soil Sample analysis: a. All soil samples retrieved from beneath gasoline (leaded/unleaded) tanks and appurtenances must be analyzed for benzene, toluene, xylene, and total petroleum hydrocarbons (for gasoline). b. All soil samples retrieved from beneath diesel tanks and appurtenances must be analyzed for total petroleum hydrocarbons (for diesel) and benzene. e. All soil samples retrieved from beneath waste oil tanks and appurtenances must be analyzed for total organic halides, lead, oil and grease. d. All soil samples retrieved from beneatfi crude oil tanks and appurtenances must be analyzed for oil and grease.. e. All soil samples retrieved from beneath tanks and appurtenances that contain unknown substances must be analyzed for a full range of substances that may have been stored within the tank. i;n'gfimetable lists ' " " IO. The follow pre-and post-tank removal requirements: ' . ' Complete permit application At least two weeks prior to closure ' submitted to Hazardous Materials Management Program Notification to inspector listed on permit of date Two working days . '. . .... .... . ; and time of closure and soil sampling .- "'"-- ' Transportation and tracking forms sent to Hazardous No later than 5 working days for trausportation and 14 working Materials Management Program. All hazardous waste days for the tracking form after tank removal manifests must be signed by the receiver of the hazardous waste Sample analysis to Hazardous Materials Management No later than 3 working days after completion of analysis Program 11, Purging/Inerting Conditions: a. Liquid shall be pumped from tank prior to purging such that less than 8 gallons of liquid remain in tank. (CSH&SC 41700) b. Tank shall be purged through vent pipe discharging at least 10 feet above ground level. (CSH&SC 41700) c. No emission shall result in odors detectable at or beyond property line. (Rule 419) d. No emission shall endanger the health, safety, comfort of repose of any person. (CSH&SC 41700) e. Vent lines shall remain attached to tank until the inspector arrives to authorize removal. RECOMMENDATIONS/GUIDELINES FOR REMOVAL OF UNDERGROUND STORAGE TANKS This department is responsible for enforcing the Kern County Ordinance Code, Division 8 and state regulations pertaining to underground storage tanks. Representatives from this department respond to job sites during tank removals to ensure that the tanks are safe to remove/close and that the overall job performance is consistent with permit requirements, applicable laws and safety standards. The following guidelines are offered to clarify the interests and expectations for this department. 1. Job site safety is one of our primary concerns. Excavations ace inherently dangerous. It is thc contractor's responsibility to know and abide by CAL-OSHA regulations. The job foreman is responsible for the crew and any subcontractors on the job. As a general rule workers are not' permitted in improperly sloped excavations or when unsafe conditions exist in the hole. Tools and equipment are to be used only for their designed function. For example, backhoe buckets are never substituted for ladders. 2. Properly licensed contractors are assumed to understand the requirements of the permit issued. Thc job foreman is responsible for knowing and abiding by the conditions of the permit. Deviation from the permit conditions may result in a stop-work order. 3. Individual contractors will be held responsible for their post-removal paperwork. Tracking forms, hazardous-waste manifests and analyses documentation is necessary for each site in order to close a case file or move it into mitigation. When contractors do not follow through on necessary paperwork, an unmanageable backlog of incomplete cases results. If this continues, processing time for completing new closures will increase. f - OWNEROR AGENT ' DA"~E ' TRC:cas \a1083-16.ptc ,' ~ ., .~' ' ~ '~ . - ~ ...... ~ . ~ ~ . ~., . ~47 ~"~' ~ .: , ~. · ' . borato " ~ .......... , -.' ... . . ..:~. · .. ,.~ -.'..... ; ~ ,~ ,.,,~. ,, ....,..~-.,.~,~t~.~,,.,..<., Client Name= Charles R. KlasSen, Ins. ,:~ '.'· .,':-, ':.~..-?-¥[~..~-,~,t..~:, .. :..:;. .. :: gddress = 104 Lake Street ~j .... , ..;.-,,..:_'~ . . ';.: ..~ ::.; ;_ -.~-.7 :-'~;' .,. .. ~ Date samples received' :. 11-28-89 " . · .... ~..,,. .. . Date analysis completed: li-28-89 .. .;:~: .' : .:'.~:'.~;. -', ,.:-... , . .. . .... ,' . . ;:...., .~;~ ..~ Laboratory No. 3267 through 3270 proje°t= Calif. & K Otree~ . ,-.~.~.,-~.. ............ .._.~ .... ~T~ "~ ;~;"~,;3~:-'w.~--~'~+;-' ~.-.~.;;e~;~ .-,- , - .. ' ',-'' ~ ...... :.. ? .... ' -. ~: . ,~.' . _- . ..~..~ ..~ ~ ~,~.~ ~ ~-'~enzene , ND 0.1 -:~ "' . i. p-Xy-Zene ND O. ~ , .. · ,.:..~ ".~ m-X~lene ND O. · :. o-XyZene ND O. ~ '~ ".,.~ ZsopropyZbenzene ND 0. ~ '~ '~. ;. : TPH (Gasoline) ND ~.0 .-. :: . . .... , ~; . :. :~ ~268 ID: 4 1/2 ~ East End ugm/gm NDL,ugm/gm Benzene ND O. L ': ~..~. :~ ,.7% "' ' ; ';''? ~ ' " ND O. -:. .Toluene ~ :.:. ':.~ Ethylbenzene '~ ND O. 1 :','::..": ' ' ' ' ND "" 'O.1 ;~; ':';' ::' .' ::; ':"' p-Xy[ene ....... :: .' .~":~ ~hod of gnaly~t~ for 8~X/IP~ {~a~ol~n~)~ MDL = Minimum Detection Level TPH = Total Petroleum Hydrocarbons ugm/gm = micrograms per gram ND =.No~ detested . ~ . ~ . .. ,.;.;.. :'-,.:~:,.'. : '". 3155 P~asus ~e · ~kersflel~ ~ 93~ · (805) 39~3~ ; l'.' '~'~.'."., ~i.~'~ ? ...".~ · · ..... ....~ .~ '~ .;, ~ ~ . ~ i~.''' '~ · ~. .~.-~--. .~ . . · ~.~,.. .. ~ " · ' .... Laboratory No. 3267. ough ~270 Project: Calif. & K. Street '" ' ' Quality Meat ..RESULTS OF ANALYSIS ~. - .. ".i..'#~26~ ID: 2' West End .ugm/gm MDL,ugm/gm Benzene ND O.l -. .: ' Toluene ~- .. ND. Ethylbenzene [ ND 0.! pTXylene ND 0.! m-XyIene · ND 0.! o-Xy!ene ~ ND 0.! "~"~' ....... '"'':'""TPH (Gasoline) -. .~ 'ND #3270 ZD: 4 Z/2 ' Nest.End ugm/gm MDL',ugm/gm Benzene ND 0.! Toluene ND 0.! Ethylbenzene ND 0.! p-Xylene ND 0.! " m-Xylene ND o-Xylene ND O.1 Zsopropylbenzene ND 0.! TPH (Gasoline) ND l.O Method of Analysis for BTX/TPH (.Gasoline):-~810/8020-(FID) MDL : Minimum Deteotion Leve! TPH = Total Petroleum HYdrocarbons ugm/gm = micrograms per gram ND = Not detected Start Comer : _.1 TANK(S) ABOVE ~ . _. .... :- ...: ..... ...... DATE · . ..... .... . -. .: . ~ .:,~.: : · . .~ . ..'.:.:.:~. ...." . ................. ~ ....... ~: ~,,,.,.. ,?-.... ~.~ ............ ~.. ~.. ...... , ........... ~ ...... ~%, ..... ~:. ..... ~ -~ ..:.. ~ ~uro~da R. Crum let, R.E.H.S. ....... ' ................................ o ate t ........................................... ;....' ..................................... POST ON PREmiSES ........... ; .................. ....... . '1'. :. [t is thc r~ponsibility ~ the P~mit~ to obtain ~rmits which may be r~uir~d b7 other rcgulato~ agcn~ prior to-beginning work. (i.e;, City 2. Pcrmi~t~ must no~iry thc Hazardous Materials Mana~cmc~ Program at (80S) 861-363~ two working dayz pHor to tank remove! or abandonment 3..4.. Tan~ cl~urc activiti~ mus[ bc per Kern Count7 Environmcnlai Hcalth and Fire Department approved methods as d~cHbed in H~ndb~k UT- '.. . . ~'. 30. - ~ 1~ :' ': t' : ,.' '- ' " .: '..". ' ' ':.':; ,' ': ... ' .'": --:" -":. ' ::~:. ~.:'.~?:- ':.' ." ::.:'-'-:':-...'¥:,~.~].~ :.:f:.':~ '~t" t:::..: .: :: >.~.-~,~ej?.~.~.:: ,,: "'.4. · .-.Il i~ ~he con~rac~or'~ r~ponsibi]i~y ~o know a~d adb~c ~o all applicable la~ regarding ~hc ha~d]i~g, ~rans~r~a~io~ or ~rca~me~ ~ hazardous ~'..S. "The tank removal contractor must have a quali~ company cmploy~ onsite su~isin~ th~ tank r~moval. Thc~mploy~ must have tank ~movai experience prior to working unsupc~ised. ... ~-.- .' '.. , ',:, .. ~...: :.':'. '.;;~. 6. If any contracto~ other than th~ lis~cd on p~mit and permit application arc to b~ utilized, p~or approval must ~ granted by the specialist ::.,. - .'-- :'_listed on the permit. Devia[ion from thc .... :-: · ' ...... ~"'~: - ' ~- .... ~':~'-;' ~'~'~'~ ........ - .... .. ..' '~ a. ,~:~;~: ~Tank size 1~ tha~ or ~ual to 1,0~ gallo~s - a minimum of ~wo a~mpl~ mus~ b~ r~t~ from b~n~a[h the ~nler ~ the tank at depths '.~' ?:'~.'?~b.'Z'~:?Ta~k size ~tar tba~ 1,0~ to I0,~ gallo~ "a minimum of four'Sampl~ must be rCt~ed ~e:third ~ ~he ~a~ in ~rom 't.hc 'en~s 0[ "' .... '.":..: '::[~:'::'."cach tank at depths of approximately two f~t and six ~ '. ...... .': .... ' :-... -.'-"...: '?.. '., ..:,-~ ,'~:::~ c; ;~.l:te.~:~Tank ~ize ~t~ [ba~ 10,~ gallo~ - a minimum of six sampi~ must bc rct~cd o~-founh of thc way i~ from thc cBds of ~ch tank ; , ,.' ~:'::?:~.~.i?:':~:(':~:~]~::and beneath thc center of ~ch tank at d~pt'hs ~ approxima~cl7 two f~t and six {~t..~.: ~::~:~]~:t~:?~'~[~'~:' , .. '?::~: ?:[:A minimum ~ two sampl~ must be'retrieved at depths ~ app~ximately two {~t and six f~t for ~ 15 liner ~t of pipe ru~ and under thc ~:: dfs~nscr area. :-h'~2..'hl. ,'~4z:,''. ....... ' r'; , ." ::' : ., ",; :. ,. ' : <?' ": ',~.- -: .... ,- ' -" ,' ':?-.': .: -- ~ ,: < . :-,-:,?,q:~,,~)..~.~:'~ ,,:, .¥ ,:, * ,',;' _' ' [, : '~ :: ': ~ '. ~: ~' . .". ."' "*.' ,' ~- . ? ~'- t'-[.,jh~' · ., :.*,. , _ - .- . - ,*-. .......... . , .. ,.. ,, ,, . , .: . :: .., ~: .':;: -:.,ff -~.*~:~.?-? ,[ : .. ~ PERMIT FOR PERMANENT CLOSURE PERMIT. NUMBER A 1083- OF UNDERGROUND HAZARDOUE '" SUBSTANCES STORAGE.FACILITY Pies retrieved from beneath gasoline a~ :mrtenances must ...... petroleum hYdrocarbons (for gasoline).' s0il sam belii~ath diesel must, ..... . ......... ppur.tenances must ..... ple~'['etrieved:from bendaihi'crUde i~ii tanks'nhd, a soiF~am that t~bmitted, t¢~' Hazardous Materials! Mans sent: to Materials Managen~ent Program.i.:All "for-~h~ trackingform must be signed by the receiver oi the waste Mans ;~;: ,.-:s. ' ,.-,; :Liquid shall be pumped from tank prior to purging such. ihat less than 8 gallons of liquid t~main i~ tank "(CSH&SC ;~i-~qb. '~ C:;}~';~q~::Tank shall be purged through vent pipe discharging at least 10 feet above ground level. (, :SH&S H& 41700) ':'~- i,?,~.::::e~ .: ;.-":'. Vent lines shall remain attached to tank until the inspector arrives to authorize removal. This depart meat is responsible for enforcing t he Kern County Ordinance Code, Division 8 and state regulations pertaining to underground storage tanks. iRepresenlatives from this department respond to job site~ during tank removals to ensure that the tanks are safe to remove/close and that the'Overall job performance is consistent with permit requirements, applicable laws and safety standards. The following guidelines are offered to clarify the interests and expectations for this department. . , :,;,,~.]:j::;2.::(~:~,,.... .1. ~Job site safety is one of our primary .concerns. 'Excavations are inherently dangerous. It is the contractor's responsibility to know and abide by '.: ,-,'?i-CAL-OSHA regulations. The job foreman is responsible [or the crew and any subcontractors on the job. As a general rule workers are not ':" '.?permitted in improperly sloped excavations or'when unsafe conditions exist in the hole. Tools and equipment are to be used only for their designed 2. Properly licensed contractors'are assumed to understand the requirements of the permit issued. The job foreman is responsible for knowing and "abiding by the conditions of the permit. Deviation from the permit conditions may result in a stop-work order. - .;;:-:-;%,,?(~:;}'[¢i¢"_:?;i~:)i:':-;(~:~s!,-.,- ,, ..3. ,,'..Individual contractors will be held responsible for their Post-removal Paperwork. Tracking forms, hazardous-wast~ 'ha;if=iS'ina anali, ses i~i .~;?.'. :..k)]~z; documentation is necessary for each site in order to close a case me'or move it into mitigation. 'When contractors do not follow through on '::-'?~-i:}'}~'~necessary paperwork, an unmanageable backlog of incomplete cases results. · If this continues, prOCessing time for completing new ~losures will GARY J. WI'~KS 2?00 M Streel, Suite 300 Agency Director Bakerelleld. CA 93301 · Telephone (805) 861-3636 Dlreclo, R E S O U R C E -~-~,'A:, G'~'~' E N T A G E N C Y OF UNDERGROUND llAZA~DOUS SUBSTANCES STORAGE FACILITY NAMEIADDRESS:° OWNER(S) NAME/ADDRESS: FACILITY CONTRACTOR: Willard P. Gold Trustee for ~tate Willard Gold Charles R. Kla~en Inc. 1324 California Avenue 2519 Elm Street 104 Lake Street. .:.. ~.. '... ~ Bakersfield, CA Bakersfield, CA Bakersfield, CA - .. ..... License ~259978 Phone: (805) 327-3665 Phone: (805) 327-4034 PERMIT FOR CLOSURE OF PERMIT EXPIRES February 16, 1990 _1 TANK(S) AT ABOVE APPROVAL DATE November 16, 1989 LOCATION APPROVED BY. // Turonda R. Crumpler, R.E.H.S. / Hazardous Materials Specialist · . ..................................................... : .............................. POST (}N PREMISES .................................................. ~ ....................... CONDITIONS AS FOLLOWS: !. it is tile responsibility of thc Pcrmittcc to obtain pcrmits which may be rcquired by other regulatory agencies prior to beginning work. (i.e., City Fire and Building l)cpartmcuts) .2. PcL'mil Icc must ~!Oti[y Ihc I [azardous Materials Managcmcnl Program at (805) 861-3636 two working days prior to tank removal or abandonment in placc lo arrange for rcquircd inspections(s). 3. Tauk closure activities must bc per Kern Counly Environmental llcalih and Fire Department approved methods as dcscribcd in Handbook UT- 4. It is the contractor's responsibility to know and adhere to all applicable laws regarding thc handling, transportation or treatment of hazardous matcrials. $. ']'he tank removal conlractor must have a qualified company employee oflsile supervising the tank removal. The employee must have tank removal experience prior lo workin§ uns.@ervised. 6. If any coqtractors other than Ihosc listed on pcrmil and permit applicalion are to b~ utilized, prior approval must be granted by the specialist listcd on tile pcrmit. Dcviatiou from thc submitted application is not allowed. 7. Soil Sampling: a. Tank size less than or equal to 1,000 gallons - a minimum of two samples must be retrieved from beneath thc center of the tank at depths of approximatcly two fcet and six feet. b. Tank size greater than 1,000 to 10,000 gallons = a minimum of four samples must be retrieved one-third of the way in from the ends of cach lank at dcpIhs of approximately Iwo fcct and six [cci. c. Tank size greater than 10,000 gallons - a miqimuut of six samples must bc rctricvcd on-fourth of thc way in from thc cads of each tank anti beneath tim ccnlcr of cach tank at depths of approximately two fcct .and six fcct. 8. Soil Sampling (piping area): A minimum of two samples musl be retrieved al depths of approximately two feet and six feet for every 1:5 linear feet of pipe run and under the dispenser area. ~ ~/RECYCLING, INC~/ .. 'TANK DISPOSAL FORM 2202 SouthMilliken Avenue --~ '"~'-~ - .- Date: . ~ ~Ont'ario, C~ 91761 '"~ -' - ': ·. ~ '..'~ '~ , · '~ ,-.: Job ~ ' ':%~.~-'.. :': ?.-~...':~L~:~=,'.:.. -: , .... .?.' . RO. 8 " ·: ".:~ :. ·.... · ADDRESS: ..........--~~ . " '.',, ':.-,.'.:'.-.;,~ ~ST~NAT~ON: . . 2202 S. Ave., Ontario, A 91761 ~:".:.='=.." '~ -"~.~:%~';:.~-;9;-~;~=~:? -' ' TIMfi I~: : ' SPECIAL INSTRU~IONS: ~IME OU~ ~<<~ C~?~ ~'~ .d~ ' '" " '" ~ TANKS RECEIVED QTY. GALLONS TYPE NET TONS T~AL F*S' 5~ 0 0 .24 ~ / 1~-12 ft. 0 ~ .44 1~ D ~ .87 2~ D ~ .97 ~ 2~ D D 1.14 3~ ~ D 1.32 4~ ~ ~ 1.64 5~ D D · 2.42 .... ~~~~~~~~~-=-~~~~~; 60~ 0 0 2.84. 7500 B B 3.26 8O0O D D 3.44 ~0 0 0 3.82 All fees incurred are per Icad unless specified. 10~ D D 4.33 Terms are net 30 days from date of invoice. 12000 D D 4.93 Contractor's signature represents acceptance of terms for payment, and confirms that tank NO. OF TANKS T~AL NET TONS removal complies with State laws. CONTRA~OR'SSlGNATURE *F -- FIBERGLASS ST EL = ;.' : CERTIFICATE OF TANK DISPOSAL I DE~RU~ION THIS IS TO CERTIFY THE RECEI~ AND ACCE~ANCE OF THE TANK(S) AS SPECIFIED ABOVE. ALL MATERIALS SPECIFIED ~.. ,,v~ ~. co~,=,~=~ ~s~.o~o ~o. sc.,,,u.,os~s o.~. ,. .~7oo~,,,~ SUoet KERN COUNTY HEALTH DEPARTMENT H~L31iOFFICER Bakerslleld, Callforn~ g3~5 . ' ~n M He~, M.~ Tele~e {~5) ~1-3~6 . EN~RONME~L H~L~ OI~SION .. Facility Rame Kern County Permit t ... holder of the per. It ~lth nuaber noted abow Is responsible ~o~ tnsu~tn~ ,:~:~ ..... Aothorized representative .or contractor certifies b~ St~ntng below' that' '.~':;-"::?;:~':';~;': 'tank(s) have been decont~lnated In accordance with Kern Count~ Health '" ~ectton a -To be fl'lied ou~ and sl~ned ~ a~ authorized ~epre~ntattve '~ the ' treatme'n~, storage, or disposal factlit~ 'a~ce~tln~ ~ank(s): .... * * * ~I~'ING INSTRUCTIONS: Fold in hal~ and etaple. : (Form J~P-ISO) 8AKE~F[ELD, g3301 861-~636 (806) - =,, ~,. ~G~f OF PTPT~ ~ :LOSURZ/ABANDONMENT OF UNDERGROUND -:.- ," APPLiCATiON ~S POR ~ R~AL, OR ~ A~DD~ IN P~C~ IPf~ O~ DN~ APPL~T~DB P~R PROJE~ CONTA~ jPflONE e JSEC/T/R IRU~L LO.IrONS I ~'~'327-~36 _- ~S R. ~S~' , ,~n,,T~- Willard P'. ~ld T~stee for Est~t~~ 1324 ~lifomia ~1 '~" Street Willard Gold '- Trustee ; '~ .... 2519 Elm street '- ........ I ( 805) 327-~665 ., , I""°"~ r,.~ ,,ov,~ c.~,,~o, ,on,, .: ~ I ' ( 805 327-~34 ~rles R. Klassen~ Inc.i I' 104 ~ke Street I a: A.S.A.P. ~ 259978 I 003705-89 ' I State C=p Ins Fu~ ~ Wilson & Associates ~00 ~st~ Drive ' (805)' 3231 6460 ~ WORKER'S CONPEHSAT~ON I INSURER PHONE ~ file ( ~ - ~OORATORY TIIAT WILL ~ALYZE SANPL~ ~DRESS PIIONE S.M.C. 3155 Pegasus ~805 > 303~3597 C]IEHICAC COHPOSITION OP gT~lll~ STORED ~' ]TANK ~ VOL~E ~I~]~L ~RED (NON-CO~ERCIAL NANE) OA~3 S~R~D C]I~/CA~ PR~TOUSLY ~ORED I ~].ifomi~ W~ter g~ic~ 169 feet average ~ ~arter of a mile all directions ~ sandy lo~ vis~l inspection[, I & g~nz~n~. Toll~nene, [vlene. Total Petro Hg~rocarbms for gas i ~i-pressure rushed b~ B $ L Vacua, disposed at G~bson Ref~ne~ ', I ~ A.M,R. ALL OF THE FOLLGWING INFOI~tATICN MUST BE INCLUDED !'~ ORDER FOR APPLICATION TO ,BE PRCCESSED: X PRO~S~ S~LING ~TIONS DESI~A~ BY ~IS S~L ~" ~ X ~ WATER ~.~-~ OR SU~A~ ,WA~ WI~IN 100' ~IUS OF FACILI~ .............X ~R~ ~ ' -- ~~ ~ Zl~.t ~ ~ , ,~ .. :,, - lfltlllj/)/f/lJ/Jill/llllit/ J~ W I . ~Cu~tome~ P,O,,g ] Nth 8y ~O~de~ D. te I Sh~. Date J- VI. 'l' Terms """ I tH1;11589-1 I .ELS I 11/15/89 I 11/15/89 I ." "'.1., NT.~:,'..;......- Lfne Desc~iPtfon -- Quantity ..... ' "Pn~ce"Llnf.t Disc 1 TANK PLAN CHECK 1' 100,00 E' ' ' ,.100.00 ' 170A · Orde- Total !00,00 Amount Due 100.00 P~yment Made 8y Check 100 O0 THANK YOU ., . ~ oo s .... ':,-KERN COUNTY HEALTH DEPARTME;;;,( <.:.~,,.~<~,:~i!:~': HEAl' OFRCER , /":':?:?:::I NT EEI M' ~?PEEMI T :PEEMI T~I ]6 0 0'2 ..::UNDERGROUND HAZARDOUS ' SuBsT~cEs ~ STORAGE FACILITY FACILITY UALITY .MEAT COMPANY ::,?! K"..~}STREET :{~S. ~_:CRUCES' BAKERSEi~.LD S][KERSF i]~,~): # 'IN YES CODE :ED '.:!NON--TRANSFERABLE '~'* * * ST PREMISES .:..¢<.-: .:',. ,. :. ~.-::,.,>:... Kern County Health Depar*-men~ Division ot Environmen~. He~ 1700 Flower Street, Bakersfielo, CA 93305 .. APPLICATION FOR PERMIT TO OPERATE UNDERGROOND -' HAZARDOUS SUBSTANCES STORAGE FACILITY Type of Application (check): [~Ne--~ FaCility ['1Modification of Facility ~Existirg Facility []Transfer of Ownership A. ~ergency 24-Hour C~ntact (~name, area code, phone): Days 3.~-7 Facility Name' - No. of TankS f . "' Type of Busin~~ ~' S~t'- ~o-n ~Othe_~r (describe) Is Tank(s) Lo~ Agricultural Farm? D~es ~ . . ' ' Is Tank(s) Used Primarily for A~ricultural Purposes []Yes ~ Facility /LC , , , .earest St. T .. 'R ~ S, EC ~ (Rural Locations (l~ly) . ~ ' Operator .... i ' ' ' Co tact Person" Address .~ ~-~'%; %~- Zip Telepho~{a .... Soil ~racteristics at Facility Basis for Soil Type and Groundwater Dep~l~ Det6rminations ......... C. Contractor CA Contractor's License Addr ess Zip Telephone ....... Proposed "Starti~ Date P.roposed C(m~pletion Bate Worker' s Compensation Certi~i6ation { ' Insurer D. If This Permit Is For Modification Of An Existing Facility, Briefly Describe Modifications Proposed. E. Tank(s) Store (check all that apply):' Tank ! Waste Product Motor Vehicle Unleaded Renu.let prmmium Diesel Waste / [] F. Chemical Canposition of Moterials Stored (not necessary ~or motor vehicle fuels) Tank ~ Chemical Stored (non-co~nercial name) CAS ! (if gno~). Chemical l>reviousl¥ Stored ' '~[if different) G. Transfer of Ownership Date of ~-ansfer PrevioUS Owner previous Facility Name I, accept fuil'y all obligations of 'Permi~ No. __ issued to . I understand that the Permitti~ Authority may review and modify or terminate the transfer of the Permit to Operate this undergro~d storage facility upon receiving this completed form. ~ true and correct. //. // Signature T~tle Date TAN~ ~ (FILL OUT SEPARATE ~-~ACH TANK) --FOR E~ SECTION, CHECK ALL APPROPRIATE BOXES 1. Tank is: I-I.vaui'ted l"lNon-Vaulted FlBouble-Wali :ingle-Wall .J~c~arbon Steel [] stainless steel I'-IPolyvin¥1 chloride F1Fiborglass---Cli~:l Steel ~] Fiberglass-Reinforced Plastic [] Concrete [] Al~in~ [] Bronze []Unknown [] Other (describe) 3. Primary Containment Thicknes nches) 4. Tank Secondary Contalr~ent []D0uble-Wall []Synthetic Liner []Lined Vault []None ~3nknown []Other (describe): Manufacturer: [-~Material ThiCkness (Inches) Capacity (Gals.) 5. Tank Interior Lining ---~Rubber ~----~ ~Ep~xy []Phenolic []Glass []Clay []Unlined ~kno~ 6. Tank Corrosion Protection ' ' --]~Gal'vanized -~~ass-Clad []Pol~thylene Wrap []Vinyl Wra in~ ' - DTar or Asphalt ~Unknown []None []Other (describe) "_ '~:' Cathodic Protection:' []None []Impressed Current System :~lSac'rtfi¢lal Allode System Describe' System & Equi[m~ent: 7. Leak Detection, Monitoring, and Interception ~. 'Ta---~: ~-~isUal (Vaulted' ~-~ks only)" r~"Groundwater Monitoring' Well(s) r~vadose Zone Monitoring Well(s) [~U-Tube Without Liner [] U-Tube with Ccmpatible Liner Directing Flow to Monitoring Wa,II(s)* [] Vapor Detector* [] Liquid Level Sensora [] Conductivit~ Sensor [] Pressure Sensor in Annular Space of Double Wall Tank7 [] Liquid l%etrieval & Inspection Fr~m U-Tube, Monitoring Well or Annular Space NDaily ~uging & Inventory Reconciliation []Periodic Tightness Testing one [~ Unknown [] Other b. Piping: Flow-Restricting Leak Detector(s) for Pressurized Piping'" [']Monitoring S~ap with Race~ay []Sealed Concrete Race~y []Half-Cut Compatible Pipe Raceway [~Synthetic Liner Race~ay []None li~;nknown r7 Other *E~escribe Make & Model: 8. ~en Tightness Tested? ~es []No []Unknown Test Name Testing Company ~-~_ ~. ~. 9. Tank ~ Tank Repaired? . []Yes ~ []Unknown Date(s) of Repair(s) Describe Repairs 10. Overfill Protection T~a rp~F°r Fills, Controls, & VisuallyM°nit°rs Level ~oat Gauge []Float Vent Valves [] Auto Shut- Off Controls B Capacitance Sensor [~Sealed Fill Box []None []Unknown Other: List Make & Model For A~ove Devices UndergroUnd a. Piping: ~Yes ~qNo [-]Unknown Material Thickness (inches) Diameter Manufacturer ~Pressure [-]Suct'i~on []Gravity Approximate Length of Pipe ~ b. ' ~Underground~ Piping Corrosion Protection : [-]Galvanized ~Fiberglass-Clad []Impressed C%]rrent ~Sacrificial Anode [-]Polyethylene Wrap ~Electrical Isolation [-]Vinyl Wrap [-]Tar or Asphalt /~nknown [-]None []Other (describe): c. trnderground Piping, Secondary Contair~ent: []Double-Wall []Synthetic Liner System [~None ~Unknown []Other (describe):