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HomeMy WebLinkAboutMAJOR MOD 2004 CONTINUED (~ E:E~ .~ ST, ~N ~TH ..~TH} FILE WAYNE PERRY, INC. 8281 Commonwealth Ave. Buena Park, CA 90621 Phone (714) 826-0352 Environmental Remediation, . (800) 883-0352 . . Construction and Consulting - ,Fax (714) 523-7880 Lic.#CA 300345 - A B C61/D40 HAZ ' ' ' .BU~N~ p~RK ~ '. C~,~,.V~ CiTY JRM 1S 2004 9:49 BKSFLD FIRE PREVEMTIOM (661)852-2172 PERMI'RApPLICATION TO CONSTRUCT/MODIFY ,.~ B~er~field Fire Dept.  ~onment~ ~tce 1715 Chester Ave .~ .o. . ~. B~ersfield, CA 93301 Tel: (661)326-3979 ~PE OF APPLICATION (CHECK) ~ NEW FACiLI~ ~MODIFI~TION OF FACILI~ O NEW TANK INSTAL~TION AT ~ISTING FACILI~ ST~G ~TE ~ ~O~Q ~oN ~TE FACIUTY ~ME ~STING F~ ~MIT ~. ~TER TO FACILI~ ~ ~ OEPTHTO [~ J $OlLW~PEC~DATSlTE TO~'~OFINSTALLEDT~ ~ J ~E THEY~ ~s~R MOTOR~ ~ FUEL,~ (~ SP~ ~R~ENTION CO.OLd.AND COU~ER~ NO M~S~E$ ~N ~ RLE THIS SECT~N 18 FOR ~T~ FUEL I ~Z~ ooo 2 l~boo e~ ~ _ / 3 12, ooo- ~I ~ ' THIS SECT1ON I$ FOR NON MOTOR FUEL ~'ORAGE TANK8 TA~¢ NO. VQ. UME C~EUIC~L STO~E0 (NO BRAND NMaE) C.~SNO II; ~IOWN) CHEUICAL PREVIOUSLY STORED FOR OFFICIAL USE ONLY The applicant ha., r, ceived, understands, and will comply with the attached conditions of the p, rm£t and on. elbe state, l~al ~d~deral reg~ationa. This form h~ been completed under penalp of " ' perj~ qnd ,~ ~ ~ o/my &owledgo, i, tr~ and correct. ~ ~ , ~ ~ THIS APPLICATION BECOMES A PERMIT WHEN APPROVED ~ I SCOPE OF WORK 'i' 0 O BREAK OUT CONCRETE TO REMOVE (1) OPW POMECO ~, II (:~ FILL BUCKET ON 87 TANK " REPLACE CONCRETE AROUND I~P' OF (1) i~'I 0 $0 FEET COFFEE ROAD SCALE  DATE DRAWN FIGURE ~' 01/19/04 PLOT PLAN {' DRAWN BY ~ ,, CHEVROn. SERVICE STATION #20-$576 "'~ C,D nu~ 1125 CORREE RD. & BRIMHALL RD. PROJECT NO. ii 0,38081 PP BAKERSFIELD, CA 0,3.8081 Water Shroud. , Spiil Bucket Mounting'. Ring System SPILL t~UC~(ET .COVERS PWS WATER SHROUD u__ I ~' ,,,,,-, SCOPE OF WORK Q REPLACE (1') OPW POMECO FILL BUCKET ~ Q BREAK OUT CONCRETE TO. REMOVE (1) OPW POMECO ',l 13~ FILL BUCKET ON 87 TANK REPLACE CONCRETE AROUND De,.,. o ) I , ? I 0 ~P. OF O) 0 30 FEET COFF~,E .R O.2LD SCALE -'  OATE ORAWN FIGURE HO. o~/19/o4 PLOT PU, N DRAWN BY . ~ CHEVROII SERVICE STATION #20-$576 .... c,~ n,~ 1125 :ORREE RD. &: BRIMHALL RD. ~,.oJ[cr ~. 038081PP BAKERSFIELD, CA 03.8081' MUlti-POrt Spill Bucket Certified WaterShroud Spill Bucket Mounting Ring System . Spill Bucket Cove~ :'"' ':'~' SPILL ]~UCt(ET COVERS I~WS WATER SHROUD NOI~TFt~ SCOPE OF WORK ~ Q REPLACE (1) OPW POMECO ~ n~ euc~ ~ BUCK~ ON 87 T~K ' o 3o SCALE . DA~ ~ ~URE NO, 01/19/04 PLOT P~N D~ BY · CHEVROn' SERVICE STATION ~20-3576 ~ n~ 1125 bORREE RD. A BRIMHALL RD. ,~[~ 038081PP ~ BAKERSFIELD, CA 03.8081 New MUlti-POrt Spill Bucket .~~ EVR Certified- .. Water Shroud .. Spill Bucket Mounting Ring System' ,. ~ '0 Spill Bucket Covers SPILL I~UCI(ET-COVERS UPY]S Y]ATE.R SHROUD ~%..~' i ~-='-'--'--'-x~,,.~.=.,, ' , : SCOPE oF WORK ,_~_~ ~'~."~'?~: ~ ~ ~ ~ REP~CE (1) OPW POMECO~ BUCK~ ~ q ' ~ R~uov~ O) oPw ~ou[co 0 BR~K OUT CONCR~E TO ~ ~ ~ BUCK~ ON 87 T~K ' I" ~ . ~ ,~ ~ ~ST N~ ~LL BUCK~, AND , ,, 0 30 COFFEE RO~ SCALE ~ ~ DA~ ~ FIGURE J 01/19/04 PLOT P~N ~ D~WN ~ ~ ~ CHEVRO~ SERVICE STATION ~20-3576 .: 038081~ ~ B~K[RSFI[kB, C~ . 03.80~1 NeW MUlti-POrt Spill Bucket ' ' ~ .~...:~:~ ", ........... EVR Certified ,, =Water Shroud Spill Bucket Mounting Ring System ' Spill Bucket Covers SPI.LL t~UC]( T ·COVERS PWS WATER SHROUD - SCOPE OF WORK .~ '~"~"'~?'~, D===~" ~ ~ REP~OE (i') OPW POMEOOnLL BUCK~ ; q- ~ BRBK OUT CONcR~E TO ' ' ~ REMOVE (1) OPW POMECO } ~ ~ BUCK~ ON 87 TANK ~ ~ BUCK~ REP~CE CONCR~ AROUND 0 30 FE~ COFFEE RO~ SCALE . ~ DA~ ~WN ROURE NO. ' , 01/19/04 PLOT P~N 'i CHEVRO~ SERVICE STATION ~20-5576 , ~ ~ n~ 1125 ~ORREE RD. & BRIMHALL RD. .~E~ ~. 038081PP BAKERSFIELD, CA 03.~081 New MUlti-POrt Spill Bucket water Shroud.  S pili Bucket Mounting Ring System Spill Bucket Covers SPILL E;UCi{ET COVERS PWS WATE.R SHROUD TanknolOgy 8900 Shoal Creek'Blvd, Building 200 Austin, Texas 78757 Phone: (512) 451-6334 Fax: (512) 459-rl459 Date Printed and Mailed: 12/30/2003 BAKERSFIELD FIRE DEPARTMENT OFFICE Of ENVIRONMENTAL SERVICES INSPECTOR STEVE UNDERWOOD 1715 CHESTER AVE., 3RD FLOOR BAKERSFIELD, CA. '93301 Test Date: 12/19/2003 order Number: 3132546 'Dear Regulator, Enclosed are the results of recent ,testing performed at the following facility: CHEVRON 203576 1125 COFFEE RD. BAKERSFIELD, CA. 93308 Testing ,.performed: Leak detector tests 'Monitor Certification Sincerely, ~Dawn .Kohlmeyer. Manager, Field-Reporting 'ranknok ry CERT F C^TE OF 8900'SHOAL CREEK, BUILDING 200 AUSTIN, TE~S 78757 TELEPHONE (512) 451-6334 F~ (512) 459-1459 PURPOSE: COMPLI~CE TEST RESULT SUMMARY ,REPORT TES~ DATE: '12/19/03 WORK ORDER NUMBER: 3~32~6 CUSTOMER PO: CLIENt: CHEVRONU~S.A. SITE:'CHEVRON 203576 P .O. BOX 2292 1125 COFEEE RD. 145 S. STATE COLLEGE ~BLVB. BAKERSFIELD, CA 93308 BRE~ CA 92822-2292 JUDY 'BOWE 'M~AGER (7t 4)671-32~ 4 (661)588-9066 TEST ~PE: TLD-1 Product~P~e Tightness Test Results . I~ ~ .... ST~RES 87 2 REG ~E~ DW FIBERG PRESS~E S9 3 PLUS DW FIBER~ PRESS~E Existing Line Leak Detector Test 92 1 ~~OO~ 041505 87 2 VEEDERROOT 013649 P 89 3 VEEDERROOT 013652 P New Replacement Line Leak Detector Test : REP ~CED~D~ ~CTORJ~ ~ ~ ~ ~REE~ [CED~E~DE~ ;GTO For o~cr dc~ilcd rcpo~ info~ation, visit ~.~n~ology.com and select ~-Linc Rcpo~s-W~, or con.ct your local Tan~ology office. Tester Name: RHOME DESBIENS Technician Ce~ifi~tion Number: ~rinted ~30/2003 08:03 ,ilN:DIVIDUAL TANK INFORMATION AND TEST RESULTS TEST DAT, E:12/19/03 .8900 SHOAL,CREEK,:BUILDING 200 WORK GRDER:NUMBER~132546 CLIENT: CH]~'~ON O. S.A. AUSTIN, TEXAS 78757'(512) 451-6334 SITE: CHEVRON 2 0 3 57 6 Tank ID: 92 .3. Tank .manifolded: NO 'Bottom .to top fill :in inches: 3.65 .O Product: .SUPR~M'¢ Vent manifolded: .NO Bottom ,to ~grade in inches: 17 o. 0 Capacity in gallons: 3.2 ,,0 82 Vapor recovery manifolded: YEs Fill.pipe length :in,inches: 54.0 Diameter in inches: 111.00 Overfill protection: YES ,Fillpipe diameter:in inches: 4 ..0 Length in inChes: 2 9 2 Overspill :protection: ¥~.s Stage I vapor.recovery: DOAL Material: .~DW STEEL 'Installed: ATO Stage 11 vapor.recovery: .BAL~,WCE CP installed on: / / COMMENTS Start (in) :End (in) Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced *Dipped Product Level: L:D. #t L.D. #1 L.D. ~2 L.D. #2 Probe Water Level: Make: W]~DE]UZOO? Model: Ingress* Detected: Water Bubble Ullage Test time: S/N: o~5o5 Inclinometer reading: Open time in sec: VacuTect Test Type: NOT Holding psi: 24 VacuTect Probe Entry Point: TESTED Resiliency cc: NOT rest leak rate ml/m: 189.0 TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: 3. oo Water table depth .in inches: Results: PASS Determined by (method): Result: 'COMMENTS COMMENTS Material: DW FIBERO Diameter (in): 2.0 Length (ft): 22S .,o Test ,psi: Bleedback cc: Test time (m!n): *NOT NOT NOT ,NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump ,type: PRESSURE ~Pump make: RED JACKET COMMENTS Impact Valves Operational: O'mCNOWN Printed 12/30/2003 10:04 IiN!DI ID:UA L T N:K 'IN. FORMATION AND TEST RESUETS TEST DATE:12/~19/,,0 3 8900 SHOAL CREEK, BUILDING 200 ,WORK ORDER~NUMBERSi!3254.6 CLIENT:CHE'v'RON TJ'.S.~A: ,AUSTIN, TEXAS 78757 (512)451,6334 SITE:CHEVRON 2035?6 Tank ID: '87 :2 Tank manifolded: ,NO BOttom to ,top fill,in inches: 16'6.0 Product: 'RSe ONLEAD Vent manifolded: ,NO :Bottom to,grade :in inches: :171.0 Capacity'in gallons: 1.2,~o82 ,Vapor recovery manifolded: yes Fill,pipe.length~in~inches: 55.0 Diameterin,inches: 111..00 ' Overfillprotection: ,YES ,Filllpipe diameter,in:inches: 4.~0 Length in inches: 392 Overspill protection: YEs Stage I vapor recovery: ' DUAl, ~Material: DW ,STEE~. Installed: ate Stage II vapor recovery: E~.~'~CE CP installed on: COMMENTS 'Start (in) End (in) Dipped Water Level: ,New/passed Failed/replaced New/passed Failed/replaced Dipped Product ~Level: 'L.D. #1 ,L.D. #1 L.D. ,#2 'LID. ~2 Probe Water Level: Make: WSD-.~OO~ Ingress Detected: Water Bubble Ullage Model: Test ,ti me: SIN: o~3 ~ ~ ,Inclinometer reading: Open time in sec: Holding psi: 2~ YacuTect Test Type: ,NOT Resiliency cc: ~TOT VacuTect Probe Entry Point: TESTED Test leak rate mi/m: is9.0 TESTED Pressure Set,Point: Metering psi: Tank water level in inches: Calib. leak in gph: 3 .,oo Water table depth in inches: Results: ~ass Determined by (method): Result: COMMENTS COMMENTS ;Material; DW FIBER~ Diameter (in): 2 .'0 Length ,(ft): 225 .~0 Test ,psi: 'Bleedback cc: Test ,time (min): 'NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED ',End ·time: 'Final gph: 'Result: · Pump type: I~RESSURE 'Pump make: aED JACKET COMMENTS Impact Valves Operational: ONKNOW-~ Printed 12/30/2003 10:04 ';I;N, DI I DUA:L T.AN K IN,FORMATION ,AND TEST RESULTS TEs'F:DATE: 12/1,9:] 03 8900 SHOAL CREEK, 'BUILDING 200 ,WORK ORDER iNUMBER313254 6 'CLIENT:CHEV~0N ..U.:S .A. ..AUSTIN, TEXAS ,78757,(512) 451-6334 SITE:CH.]~"~ON '203'57 6 Tank !lDi '!8 9 3' Tank manifolded: ~NO !Bottom .to ,top fill .in inches: 165. '0 :Product: ,z~.us :Vent manifolded: NO Bottom :to.grade'in inches: 17 0 J0 Capacity in gallons: 12/082 . Vapor reCovery.manifolded: YES !Fill pipe :length in.inches: '54.0 Diameter'in :incheS: ' ,111.:00 Overfill protection: YES 'Fill pipe diameter in inches: 4.,o Length in inches: 292 Overspill protection: YES 'Stage :1 vapor recovery: DOAn. Material: :DW ~STEEL ,Installed: .ATG Stage '11 vapor,recovery: "BALANCE CP installed on: / / COMMENTS · Start (in) End.(in) Dipped Water Level: New/passed .Failed/replaced New/Passed Failed/replaced Dipped Product Level: L.D. #1 LD.#I L;D. ~2 'L;D. #2 Probe Water Level: Make: VE~DS~OO? Model: Ingress Detected: Water Bubble Ullage Test time: S/N: Inclinometer 'reading: Open time in sec: Holding psi: 2s VacuTect Test Type: NOT Resiliency cc: NOT VacuTect Probe 'Entry.pOint: TESTED Test leak rate mi/mi 189.0 TESTED .Pressure Set Point: Metering psi: Tank water level :in inches: Calib. leak in gph: 3. OD Water table depth,in inches: Results: ~ASS Determined by (method): Result: COMMENTS COMMENTS iMaterial: 'DW FIBERG Oiameter (in): 2.0 ~Length (ft): ~-2S .~0 Test psi: .Bleedback cc: Test ,time,(min): ,NOT 'NOT ,NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: ,Pump type: PRESSURE ',Pump make: 'RED JACK.ET COMMENTS 'Impact Valves Operational: o~.t~o~ Printed 12/30/2003 10:04 ~- ,~?l~-'r~13~ ' ,~Ii]ONI'TORING SY~FEM CER'TIFIGA~FION- ~ .F~se By All Jurisdictions Within the State of Califomi~ Authority Cited: Chapter 6.7, Hea-7th and Safety Code; Chapter 16, Division 3 Title 23, Ca-Tifornia Code of Regulations This form must be used to document testing and servicing of,monitoring equipment. If morethan one monitoring system control panel is installed at the facility, a separate certification or report must be prepared for each monitorin.q system centrol.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 capy of.this form tothe local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: CHEVRON 203576 City: BAKERSFIELD CA Zip: 93308 Site Address: lrl25 COFFEE RD. Contact Phone No:588-9066 'Facility Contact'Person: MANAGER .Date of Testing/Service: 12/19/2003 ;Make/Model of Monitoring System: TLS350 Work Order Number: 3132546 B. Inventory of Equipment Tested/certified Check the appropriate ,boxes to indicate specific equipment inspected/serviced TanklD: I Tank ID: 2 ~] In-Tank Gauging Probe. Model: [] In-Tank Gauging Probe. Model: X-]Annular Space or Vault Sensor. Model: 420 [] Annular Space or Vault Sensor. Model: 420  Piping Sump/Trench Sensor(s). Model: 208 [] Piping Sump/Trench Sensor(s). Model: 208  Fill Sump Sensor(s). Model: ' [] Fill Sump Sensor(s). Model: -'~ Mechanical Line Leak Detector. Model: [] Mechanical Line Leak Detector. Model: ~ Electronic Line LeakDetector. Model: 848480-001 [] Electronic Line Leak Detector. Model: 848480-001 ~ 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). Tank ID: 3 Tank ID: '-~ In-Tank Gauging Probe. Model: [] In-Tank Gauging Probe. Model: X'~ Annular Space or Vault Sensor. Model: 420 [] Annular Space or Vault Sensor. Model:  Piping Sump/Trench Sensor(s). Model: 208 [] Piping Sump/Trench Sensor(s). Model: Fill Sump Sensor(s). Model: [] Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: [] Mechanical Line Leak Detector. Model:  Electronic Line Leak Detector. Model: 848480-001 [] 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 IL): 1/2 Dispenser ID: 3/4 X~] Dispenser Containment Sensor(s) Model: BEAUDREAU 406 [] Dispenser Containment Sensor(s) Model: 406 X'~ Shear Valve(s). [] Shear Valve(s) "~ D!spenser Containment Float(s) and Chain(s). [~ Dispenser Containment Float(s) and Chain(s). Dispenser ID: 5/6 Dispenser ID: 7/8 X--~ Dispenser Containment Sensor(s) Model: 406 [] Dispenser Containment Sensor(s). Model: 406 X~ Shear Valve(s). [] Shear Valve(s). ---] Dispenser Containment Float(s) and Chain(s). [~ Dispenser Containment Float(s) and Chain(s). Dispenser ID: 9/10 Dispenser ID: 11/12 ~ Dispenser Containment Sensor(s) Model: 406 [] Dispenser Containment Sensor(s). Model: 406 X---'] Shear Valve(s). [] Shear Valve(s). '-]Dispenser Containment Float(s) and Chain(s). [] Dispenser Containment Float(s) and Chain(s). * If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this certification is information (e.g manufacturers' checklists) necessary to verify that this information is correct. and a Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the (Check all that apply): System set-up report; [] Alarm history report [~] PRINTED NAME:RHOME DESBiENS SIGNATURE: -~'~"~ COMPANY: Tanknoio~y PHONE NO: (800) 800-4633 page 1 of 3 Based on CA form dated 03101 ~ itering System Certification Site Address: 1125 COFFEE RD. Date Of Testing/Service:' 12/19/2003 D. Results of Testing/Servicing Software Version Installed: 116;02 Complete the following checklist: [] Yes [] No *1 Is the.audible alarm operational? [] Yes. [] No* IS the visual alarm operational? [] Yes ;[~] No * Were all sensors visually inspected, functionally tested, and confirmed operational? Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not []Yes r'--~ No * interfere with their proper operation? [] Yes [] No* ~ N/^ If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? · For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment :[] Yes; [] No * [] 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) [] SumpfTrench Sensors; [] Dispenser Containment Sensors. iDid you confirm positive shut-down due to leaks and sensor failure/disconnection? [] Yes [] No [] Yes [] No* [] N/A For tank systems that utilize the monitoring system as the pdmary tank overfill warning device (i.e.: no mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill points(s) and operating properly? If so, at what percent of tank capacity does the alarm tdgger? % [] Yes* [] No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. [] Yes* [] No Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) [] Product; [] Water. If yes, describe causes in Section E, below. [] Yes [] No *i Was.monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. [] Yes [] No * Is all monitoring equipment operational per manufacturers' specifications? · .In Section E below, describe how and when these deflciences were or will be corrected. E. Comments: page 2 of 3 rv~itering System 'Ce~ificatien Site Address: ri 125 COF, F, EE ,RD. Date of Testing/Service: t 2/19/2003 F. In-Tank Gauging / SIR :Equipment [] Check this box if tank,gauging is used only,for inventory control. [] Check this box if no tank gauging,or SIR equipment is installed. ,T, his section .must be comPleted if in-tank,gauging equipment is used to perform :leak detection monitoring. Complete the following checklist: [] Yes [] No * Has all input wiring'been inspected for proper entry and termination, including testing for ground faults? [] Yes! [] No * i Were all tank gauging probes visually inspected for damage and residue buildup? [] yes [] No * Was accuracy of system product level readings tested? []Yes [] No * Was accuracy of system water level readings tested? []Yes [-'-~No* Were allprobes reinstalled properly? [] Yes, []No* Were all items on the equipment manufacturers' maintenance checklist completed? · In the Section H below, describe~how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): [] Check this box if LLDs are not installed. Complete the following checklist: [-~ Yes [] No * r-"~N/A For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) Simulated leak rate: [] 3 g.p.h [] 0.1 g.p.h []0.2 g.p.h ' [] Yes [] No * ! Were all LLDs confirmed operational and accurate within regulatory requirements? [] Yes []No * Was the testing apparatus properly calibrated? [] Yes [] No * [] N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? [] Yes []No * [] N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ' [] Yes []No * [] N/A For electronic LLDs, does the turbine automatically shut off:if any portion of the monitoring system is disabled or disconnected? [] Yes []No * [] N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? [] Yes []No ' [] N/A For electronic LLDs, have all accessible wiring connections been visually inspected? r"~'Yes []No * Were all items on the equipment manufacturers' maintenance checklist completed? · In the Section H, below, describe 'how and when these deficiencies were or will be corrected. H. Comments: page 3 of 3 SITE DIAGRAM :8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST .DATE: 3.2 / 3. 9 / 0 3 WORK ORDER NUMBER3 3.3 CLIENT:CHE'V~O:R' U. S .,A. SITE: CH,~'V'~ON 203:576 L1 L2 L3 L6 UL ~ 12K PLUS Printed 12/30/2003 08:03 SBOWERS :~ ' ~Vork-Order: Tanlmology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 ,W:o~k Order: Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work :Order: B ,1. B 2:5 4,6 ~- ?DEC::', 9,, :; Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Dec-17-03 11:27A ANK Y 909 1239 P.01 m.¥ 1~ ~UU3 13;37 BKSFLD FIRE PREVENTION (66]]852-2172 p.~ ! ' f~~t~ CITY OF BAKEl~F~D - ~ OFFICE OF ENVIRO~AL SERVICES 1715 Chester Ave., B~ker~eid, CA (661) 32~-3979 APPLICATION TO PERFORM omo, To~z NA~_~,,'/~'~ .... DOm FA(III.rI'Y HAVI~ DISP1~SER PANS? YES, ,,'~, NO,, t_~ ' Postage $ (661) L 1 r'-t Certified Fee lr--I ' ' ' /i 0 Postmmt< ' t I-'-I ~-~ · Hare ' ~ I::l RestrictedDellver ~': ~..z"' ~. ~'o ~; ~''~ f-~,''%,; ~::'- Total Pestage & Fees $ I'~f~F, '/G'~; ~'~.; .......................... ' Chevron ~ or PO Box No. ........................... d [i; '~'~t'f¢~' 1125 Coffee Roa ~. I Complete items 1, 2, and 3. Also complete A. Signature ~ item 4 if Restricted Delivery is desired. X dmssee ; I Print your name and address on the reverse · s9 that we can return the card to you. B..Regeiv~t, by;(~lf~me) I C. Elate of Delivel3t · A~ach this card to the back of the mailpiece, L! [&\~i~ , or on the front if space permits. ,,'~ ' 1. A~iclo Addressed to: D.'[s~liverypdressdifferentfrom~-~l? F1Yes ' r. If YES, enter delivery address below: [] No : Mr. Bruce Carpenter i Chevron ~ ~.,! 1.25 Coffee Road 3. Sentlce Type ~ Bakersfield, CA 93308 ~ Certified Mail [] Express Mail " [] Registered [] Return Receipt for Merchandise " [] Insured Mail [] C.O.D. ;. 4. Restricted Delivery? (Extra Fee) [] Yes "2. Article,Number I , (Transfer from service /abel) t .7003 1680 Q007 4654 2188 PS Form 3811, August 2001 Domestic Return Receipt 102595-02,M-1540 December 15, 2003 CERTIFIED MAIL Mr. Bruce Carpenter Chevron 1125 Coffee Road Bakersfield, CA 93308 F~RE CHIEF RON FRAZE NOTICE OF VIOLATION ADMINISTRATIVE SERVICES ~ SCHEDULE FOR COMPLIANCE 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 Dear Sir or Madam, F~X (661) 395-1349 ~*, SUP, PRESSION SERVICES Our records indicate that your annual maintenance certification on your leak ~'l~akersfietd,2101 "H"cAStreet93301 detection system was past due 12-04-03. VOICE (661) 326-3941 FAX (661) 395-1349 You are currently in violation of Section 2641(J) of the California Code of PREVENTION SERVICES Regulations. FIRE~AFETY SERVICES · ENVIRONMENTAL ~ERVICES 1715 Chester Ave. .~ Bakersfield, CA 93301 "Equipment and devices used to monitor underground storage tanks shall be VOICE (661) 326-3979 ?n 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 PUBLIC EDUCATION calendar year for operability and running condition." 1715 Chester Ave. Bakersfield, CA 93301 voice (661) 326-36~ 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 FIRE INVESTIGATION comply will result in revocation of your permit to operate your underground 1715 Chester Ave. Bakersfield, CA 93301 storage system. VOICE (661) 326-3951 FAX (661) 326-0576 Should you have any questions, please feel free to contact me at 661-326-3190. TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 Sincerely yours, VOICE (661) 399-4697 FAX (661) 399-5763 Ralph E. Huey Director of Prevention Services Steve Underwood Fire Inspector/Environmental Code EnforcEment Officer Office of Environmental Services SBU/db © ? C AL USE ; ~ Postage $ ~ r'q Certified Fee ! I~1 Postmark I r--1 Return Reclept Fee ' (Endorsement Required) Here ir-1 Restricted Delivery Fee' ' ' Total Postag [c~ Iso. tro ! Chevron Station -I or eo'mx'[vg i · [ .............. :', Bakersfield, CA 93308 I city, State, Ztt ' i la Compl~)t.e. ms~l~,.;~, and ' item 4 if Res~fi~.Deliver~ [] Agent ~l Print your na~:ari~l:;address on [] Addressee · -.,.Lo that we can return the card to you;' Il Attach this card to the back of the mailpiece, o. '~ .... D. Is deli~3ry address different from item 17 r'"l Yes 1. /~ticle Add~ssed to: If YES, enter delivery address below: [] No ~hcvron Station- 1125 Coffee Road " ',11 a.. se.t~co Type Bakersfield. CA oqqa~ :: ....... .~ :l ~ ~'' [] Registered [] Return Receipt for Merchandise D December 12, 2003 CERTIFIED MAIL Chevron Station 1125 Coffee Road Bakersfield, CA 93308 RE: Propane Exchange Program FIRE CHIEF Ro~,~ ~F~E Dear Owner/Operator: ADMINISTRATIVE SERVICES 2101 "H'Street The purpose of this letter is to advise you of current code requirements for 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 2101 "H' Street Over the past two years this office has noted a dramatic inCrease in the propane 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~ SER~ICES * EN~t~ONMENTAL SER~CES 1715 Chester Ave. Accordingly, procedures for storage of propane cylinders awaiting use, resale or Bakersfield, CA 93,.c~ 1 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 Chester Ave. 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 Chester Ave. 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 VIctorAve. Cylinders in storage shall be located in a manner which Bakersfield, CA 93308 VOICE (661)399-4697 minimizes exposure to excessive temperature rise, 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. Lettel~l~To: Owner/Operators of Propane Exchange sygtems 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 al'~a. 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 11/11/2005 07:30 FAA 8777958 INCIDENT REPORT DESK ~001/001 ~ Number of pages including cover sheet f TO: County of Kem FROM: Josephine Wong CUPA /NC/DENT DESK Ralph E. Huey Environmental Safety & Health Director of the Office of Chevron Products Company Environment Services P.O. Box 6004 lire Dept. San Ramon, CA 94583-0904 Phone 661-326-3979 Pax 66~-326-0576 Phone (925)842-0785 Fax .... (877) 795-$400 REMARKS: [] Urgent [] For your review [] Reply ASAP [] Please Comment Regular Unleaded spill - 10/30/2003 Chevron Station 203576 - 1125 Coffee Rd., Bakersfield, CA 93308 Customer was pumping gasoline and spilled some gasoline onto the ground; approximately 1/2 pint of gasoline was spilled. Employee cleaned up the gasoline with absorbent. No gasoline went into storm drain, Please let me know if you have any additional questions. '~ C.S.I~CHE",/RON 1842 '~' 11~_,~5 [];OFFEE RI]). BAKERSF I ELI]', C;~. 92:312 80~-5,88-9066 SEP 22.. 2003 9:31 AM SYSTEM ,~T~TIJ~_, REPORT ALL FIJNCTIOI',IS NORMAL I N~SOR'7' REF'OR'F T 1 :SUPREME VOLUME = 4304 GALS ULLAGE = 5777 GALS 90:~:-; ULLAGE= 4768 GALS TC VOLUME = 4227 GALS HEIGHT = 43.05 INCHES [,,,lATER VOL = 0 G~LS [,,/~TER = 0.00 I IqCHES TEMP = . 85.5 DEG F T 2 :Pl..US VOLUME = 3839 GALS ULLAGE = 6242 GALS 90~.;; ULLAGE= 5233 GALS TO VOLIJME = 3768 GALS HEIGHT = 39,56 INCHES WATER VOL = 0 GALS WATER~ = 0.00 INCHES TE~ = 86.3 DEG F T 3:REGULAR VO[.UME = 7684 GALS ULLAGE = 2'397 GALS 90% ULLAGE= 1388 GALS TC VOLUME = 7574 GALS HEIGHT = 67.82 INCHES WATER VOL = 0 GALS WATER = 0.00 INCHES TEMP = 80.3 DEG F ~ ~ ~ ~ END ~ ~ ~ ~ ~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME t4/,~:O~'o,-/ SJrO,~lo/~f INSPECTION DATE ~-03'0 Section 2: Underground Storage Tanks Program [~l Routine ~'~ombined - [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank D~0~c..-6 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 ~ /' / Permit fees current Certification of Financial Responsibility k., Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations ~ ~" Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY' Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance/IV=Violation Y=Yes N=NO Inspector: Office of Environmental Services (805) 326-3979 '~usin~ss bX~te~'esp0nsible Party White - Env. Svcs. Pink - Business Copy ~_~"" ~ O,,, Bakersfield Fire Dept.  Enironment~l Semrlces 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME . I INSPECTION DATE t INSPECTION TIME Section 1: Business Plan and Inventory Program .. ~l Routine ~ Combined ~ Joint Agency ~ Multi-Agency I~1 Complaint i"l Re-inspectionl ' C V (vC_~vC~l"~t~nee) OPERATION COMMENTS ~ ~1 BUS~NESS PLAN CONTACT INFORMATION ACCURATE :' ' %~_71 CORRECT OCCUPANCY * . VERIFICATION OF LOCATION PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITYE VERIFICATION OF HAT MAT TRAINING VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES EMERGENCY PROCEDURES ADEQUATE CONTAINERS PROPERLY LABELED FIRE PROTECTION SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?: ~ YES '~No EXPLAIN: QUESTIONS ARDING T~IS II~SPECTION. PLEASE CALL US AT (661) 326-3979 ......... .............. _v_ ................. --- . Inspector Badge No., White - Environmental Services Yellow. Sa3tion Copy Pink - Business Chevron Products Company Benny Brar ESH Permit Specialist P.O. Box 6004 Attn: Permit Desk San Ramon, CA 94583-0904 Tel 925-842-9002 Fax 925-842-9585 Chevron ibrar~chevrontex, aco.com April 24, 2003 City of Bakersfield Office'of Emergency Services-U 1715 Chester Ave., Third Floor Bakersfield, CA 93301 RE: FINANCIAL RESPONSIBILITY FOR UNDERGROUND STORAGE TANKS Dear Sirs: Please find enclosed the following documents: 1) Proof of Financial Responsibility 2) Certificate of Financial Responsibility 3) Chevron Facility List under yOur jurisdiction These documents meet the financial responsibility requirements for all USTs owned by Chevron and have previously been submitted directly to the State. If you have any questions feel free to contact me. Benny Brar Enclosure ~" )~ ' ChevronTexaco Corporation John Watson 6001 B,ollinger Canyon Road Vice President and San Ramon, Ca 94583-2324 Chief Financial Officei' Tel 925 842 3232 Fax 925 842 6047 April 30, 2003 Chevro nTexaco UST FINANCIAL ASSURANCE To Whom It May Concern: I am the Chief Financial Officer of ChevronTexaco Corporation, 6001 Bollinger Canyon Road, San Ramon, CA. This letter is in support of the use of the financial test of self-insurance and guarantee to demonstrate financial responsibility for taking corrective' action and compensating third parties for bodily injury and property damage caused by sudden accidental releases and/or nonsudden accidental releases in the amount of at least $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate arising from operating underground storage tanks. Underground storage tanks at-the following facilities are assured by this financial test or a financial test under an authorized State program by this guarantor. All underground storage tanks owned by Chevron U,S.A. Inc. are assured by this .financial test: A financial test and guarantee are also used by this guarantor to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: EPA REGULATIONS AMOUNT Closure (§ §264.143 and 265.143) · 85,937,394 Post-Closure .Care (§ §264.145 and 265.145) 83,679,196 Liability Coverage (§§264.147 and 265.147) 8,000,000 Corrective Action (§264.101 (b)) 27,223,479 Plugging and Abandonment (§ 144.63) 5,340,000 California State Program Closure 209,640 Post-Closure Care 743,779 Liability Coverage 66,000,000 Corrective Action 0 Plugging and Abandonment - 0 Louisiana State Program Closure 4,968,415 Post-closure Care 853,978 April 30, 2003 Page 2 of 7 Liability Coverage 1,0001000 Corrective Action 0 Plugging and Abandonment 0 Total 283,955,881 This guarantor has not received an adverse opinion, a disclaimer of opinion, or a "going concern" qualification from an independent auditor on his financial statements for the latest completed fiscal year. : " April 30, 2003 Page 3 of 7- ALTERNATIVE II 1. Amount of annual UST aggregate coverage being assured by a test $ 2,000,000.00 and guarantee , 2. Amount of corrective action, closure and post-closure care costs, $ 283,955,881.00 liability coverage, and plugging and abandonment costs covered by a financial test and guarantee 3. Sum of lines 1 and 2 $ 285,955,881.00 4. Total tangible assets $ 77,069,000,000.00 5. Total liabilities $ 45,755,000,000.00 6. Tangible net worth $ 31,314,000,000.00 7. Total assets in the U.S. $ 28,870,000,000.00 Yes No 8. Is line 6 at least $10 million? X 9. Is line 6 at least 6 times line 3? X 10. Are least 90% of assets located in the U.S.? X (If"No", complete line 11.) 11. IS line 7 at least 6 times line 3? X 12. Current assets $ N/A 13. Current liabilities $ N/A 14. Net working capital (subtract line 13 from line 12). $ N/A 15. Is line 14 at least 6 times line 3? $ N/A 16. Current bond rating of most recent bond issue AA 17. Name of rating service Standard & Poors April 30, 2003 Page 4 of 7 · 18. Date of maturity of bond February. 15, 2008 Yes No 19. Have financial statements for the latest fiscal year been filed 'with X the SEC, the Energy Information Administration, or the Rurai Electrification Administration? I hereby certify that the wording of this letter is identical to the wording specified in 40 CFR part 280.95(d) as such regulations were constituted on the date shown immediately below, except that information concerning California and Louisiana was added to make disclosure more complete. sident, Finance April 30, 2003 April 30, 2003 Page 5 of 7 GUARANTEE Guarantee made this April 30, 2003, by CHEVRONTEXACO CORpORATION, a business entit~ organized under the laws of the State of Delaware, herein referred to as guarantor, to EPA Regional Administrators and/or state agencies implementing underground storage tank regulation for the states listed in Paragraph 2 (hereinafter collectively referred to as the "implementing agencies"), and to any and all third parties, and obligees, on behalf of CHEVRON U.S.A.'INC. ("CUSA"), of 6001 Bollinger Canyon Road, San Ramon, CA. RECITALS 1. Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d) and agrees to' comply with the requirements for guarantors as specified in 40 CFR 280.96(b).. 2. Guarantor owns or operates the following underground storage tanks covered by this guarantee: Alaska Arizona California Florida Georgia Hawaii Louisiana 'Nevada Oregon Texas Utah Washington This guarantee satisfies 40 CFR part 280, subpart H requirements for assuring funding for taking corrective action and compeniating third parties for bodily injury and property damage caused by either sudden accldental releases or nonsudden accidental releases or accidental releases arising from operating the above-identified underground storage tanks in the amount of $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate. 3. On behalf of our subsidiary, CUSA, guarantor guarantees to implementing agencies and to any and all third parties that: In the event that CUSA fails to provide alternative coverage within 60 days after receipt of a notice of cancellation of this guarantee and the Director of the implementing agency has determined or suspects that a release has occurred at an underground storage tank covered by this guarantee, the guarantor, upon instructions from the Director, shall fund a standby trust fund in accordance with the provisions of 40 CFR 280:108, in an amount not to exceed the coverage limits specified above. April 30, 2003 Page 6 of 7 In the event that the Director determines that CUSA has failed to perform corrective action for releases arising out of the operation of the above-identified tanks in accordance with 40 CFR 280, subpart F, the guarantor upon written instructions from the Director shall fund a standby trust in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified abovel If CUSA fails to satisfy a judgement or award based on a determination of liability' for bodily injury or property damage to third parties caused by sudden and/or nonsudden accidental releases arising from the operation of the above-identified tanks, or fails to pay an amount agreed to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor, upon written instructions from the Director, shall fund a standby trust in accordance with the provisions of 40 CFR 280.108 to satisfy such judgement(s), award(s), or settlement agreement(s) up to the limits of coverage specified above. 4. Guarantor agrees that if, at the end of any fiscal year before cancellation of this guarantee, the guarantor fails to meet the f'mancial test criteria of 40 CFR 280.95(b) or (c) and (d), guarantor shall send within 120 days of such failure, by certified mail, notice to CUSA. The guarantee will terminate 120 days .from the date of receipt of the notice by CUSA, as evidenced by the return receipt. 5. Guarantor agrees to notify CUSA by certified mail of a voluntary or involuntary proceeding under Title 11 (Bankruptcy), U.S. Code naming guarantor as debtor, within 10 days after commencement of the proceeding. '~ 6. Guarantor agrees to remain bound under this guarantee notwithstanding any modification or alteration of any obligation of CUSA pursuant to 40 CFR part 280. 7. Guarantor agrees to remain bound under this guarantee for so long as CUSA must comply with the applicable financial responsibility requirements of 40 CFR part 280, subpart H for the. above- identified tanks, except that guarantor may cancel this guarantee by sending notice by certified mail to CUSA, such cancellation to become effective no earlier than 120 days after receipt of such notice by CUSA, as evidenced by the retum receipt. 8. The guarantor's obligation does not apply to any of the following: (a) Any obligation of CUSA under workers' compensation, disability benefits, or unemployment compensation law or other similar law; (b) Bodily injury to an employee of CUSA arising from, and in the course of, employment by CUSA; (c) Bodily injury or property damage arising from the ownership, maintenance, use, or entrustment to others of any aircraft, motor vehicle, or watercraft; April 30, 2003 Page 7 of 7 · (d) Property damage to any property owned, rented, loaned to, in the care, custody, or control of, or occupied by CUSA that is not the direct.result of a release from a petroleum underground storage tank; (e) Bodily damage or prdperty damage for which CUSA is obligated to pay damages by reason of the assumption of liability in a contract or agreement other than a contract or agreement entered into to meet the requirements of 40 CFR 280.93. 9. Guarantor expressly waives notice of acceptance of this guarantee by the implementing agency, by any or all third parties, or by CUSA. I hereby certify that the wording of this guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. Effective date: April 30, 2003 CHEVRONTEXACO CORPORATION Watson By ~ance Assistant Secretary CERTIFICATION OF FINANCIAL RESPONSIBILITY CHEVRON U.S.A. 1NC. hereby Certifies that it is in compliance with the requirements of subpart H of 40 CFR part 280. The £mancial assurance mechanisms used to demonstrate financial rbsponsibility under subpart H of 40 CFR part 280 are as follows: Financial test and corporate guarantee of ChevronTexaco Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 30, 2002 and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 2004. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. April 30, 2003 CHEVRON U.S.A. INC. By Rich.. I~a~i~ Assi~tant Sec~_c_c_cre ~h~ J4dith L. Geisler Legal Analyst .~ Mar,24, 2003 IO:06AM PETRO BUILDERS . No.3664 P. 2 Secondary Containment Testing Report Form ThL~ form is intended for u~e by con.actors performing periodic testing of usr $~condary co~amment sysle~. Use the appropriate pagcq~' of thff ~ to reporl rea'ults ~r aH compomqn~' t, ste~ The complet~dJbrm, written t~t procedure, and printo~} ~om ta*a, (~ applicable), should be pro~,ided to lhe faeili~ owner/operator for ~bmtaal to the locM ~lalo~ 1. FACILITY ~ORMATION ..... . . . .... - ~.. I. TEST~ CONTRACTOR ~FORMATION CompdY Name: - ~ETRO B~LDE~' ' '" s~'N'IZ FE SPRIGS. Ch T~chnicim~ Co~u~htg Test: ~a'~Ce ~c.~ ~ Cr~tials: X CSLB Lite,ed Con~tor ~ sW~CB Llcen~d T~ Tester Manufacturer Trothing M~u~r Com~gp~t(s) D~e T~ining Expos ,3. SUMMARY OF TEST RESULTS Not, Rcpai¢~ Component Pass Fail l.~'.'.~gfi,, Made Component Pa~ Fail .'.l.'9?ted Made ~~~ ~ ~_ ~"'-'~ ' o _. o _ oo o ~':~ ...... vl~ ~_ ~ ~ ....O O U 0 .O O, D C D 0 0 D FI [l I] D D I"1 D D ~dng w~ pelleted, describe what was ~one with the wamr ~ completion o~s: CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING TI-IlS TEST,ENG To tire b~'t of ri.tv Iotowledgei dte facZv stated in t/tis document are accurate and itt J'ull compliance with legal requirements' Mar.24. 2003 10':06AM PETRO BUILDERS No,2664 P. sw~,cB, ~anu~ 2002 ~. PIPING S~ ~(} ' Test Me,od Used: ~ Pmsmm D Vacu~ ~.Iy~ostatic T~ Equipment Used: ~.:7~.~ ~ =:, "" ~A ~ ' ~l~mcnt ~so}?oa: +/-~ SumP "l,S.mp ~ Sump~ ,l Sump~ ,.. S~p Diamet~; __ ~ ~ ~ ' Stop Depth:. , ........ ~ ~t~~- ~ ~ ~i~ ~m T~ Top m Top of' ~ ~ '"' Hi,est Piping Pcn~tion: /~" ~eight ~rom Trak Top ~ Lowest Elec~i~l P~e~tbn: . ~ ee ~ ~ /~ PoSen o f S~p Test~~ /~ ~ /~ o Dom t~b~e ah~ down sumps~ord~o~sHquid~o~ ~Y~ UNo ~NA I~ UNo ~NA L'IY~ U~o ~ ~rodu~ ~d wat~)?' Issyste~Pm~medf°rlhil'~ ~Yes nNo BNA ~ ~No BNA BY~ nNo ONA BY~ f.lNo shutdown?* W~t~il's~v~iHaW~c ~Yos UNo DNA ~Y~ ONe nNA OYes ONe ~NA Wait ~o bc~o~n applying.' ..................... ~st: Tm End Time: 3:0 3...~ 3%~0~ .... Test ~alo,i __., [~ .. ~ g~ PasCall ~r~mld.~ Criteria: . ~/- 0.00~" ' +/- 0.0~2 ' , , +/- 0,002 = 4./- 0,002 W~so~rremovedfor~s~ng? ~Yes UNo ~NA ~Y~ ~No ~NA nY~ ~No ~NA W~s~orpmperlyr~la~d ~Yes ~No ~NA ~ DNo aNA .DY~ DNo DNA DY~ Co. meats. (indade in~m~ion on repa~ made prior to te,~tin& ~ reeom~ended follo~ for faded t~ts~. .. .~.~...~, ~ If the entire depth of the sump is not ~est~d, sp~ify how much w~ tested. If thc answer to ~ of the questions indicated with an akterisk (*) ia "NO" or "NA', the entire sump must be t~stod.. (See SWfCCB I,G-160) Mar.24, 2003 10'07AM P BUILDERS N0,3664 P. 4 SWRCB, Jmuary 2002 Pago 7. UNDER-DISPENSER CONTAIIh~ ~.aNT (Ltl)C) TESTiNG . 'rcst Method Developed By.'.' ..... [~"~I7~ Ma,ml:acmrcr ~I~ldust~ Standard 'J Profe,sional U Other (Specif?.~ . T~t Method Uso&. [] Pressure 0 Vacuum (~Iydro~aQc u Other (Specify) UDC Ma[eriai: Height from LIDC Bottom to Top o1' Higho~t ?iphlg Ponetradon: Ileight fi:om UDC Bottom to Lowest F,l~ctrkal Pcmetration: Condition of LrDC prior m tesfin$: Docs turbine shu~ down whoa ' ' ' ' UD¢ ~ensor detoots liquid (both F~NA produ~ and safelssyst°rapr°grammedf°r fail'shutdown?*__~es n'No'~/U NA_ ...........~[Yes nNo F1NA nY~ nNo ['INA 13Y~ rlNo Was fail-safe verified to be ~Yes ONo WNA ~Yes UNo Wi'iA OYes ONo DNA OYes UNo ONA operati0?._al?_*. ....... · Wait time bet-ween applying pressure/vacuum/water andoZ ,~'a,~'aO'"";' ' ~rti~ ~est . 4/0 r,~ .................. Test Start 'rime: /1/ 1/3,~ Change ,~...R..oa.. d.l._ng (Pr. KO: -- . 0006 {ii ~ OOO Pass/Fall Threshold or Criteria: +/~ 0.002 I-/- 0.00'2 +/- 0.002 +/- 0,062 ,._W. asscnsorremovcdforte.sfing? ..~...?:.? UNo DNA 't~'Yes UNo DNA DYes UNo DNA DYes 'UNo' BNA Was sensor properly replaced and verified fhnctional affertestin:._ g.~ F~Yes UNo ,..UNA.__ '~n~es ONe DNA OY~ UNo DNA aYes UNo DNA Comments - (~ncl~de inform~tio¢}.o. .~ r~falrs mad~ prior to testia~ ~nd recomme.ded./bHow-up Jbr faJled ' If the entire depth of the UDC is not tested, specify how much was tested, lfthe answer to mW Ofthe questions indicated with an a~isk (*) i~ '~O" or "NA", tho entire I. JIX2 must b~ te~ted. (See SWRCtl LG-160) Mar.24, 2003 IO'07AM PETRO BU{LDERS No.3664 P 5 Sw~cB, lauary 2002 Page 4 of 4 9. SP{U/OVERFILL CONTAINM]CNT BOXES -~i'l'i~y is'Not Equippe(i"~Vith Spill/Ov¢;~li Con,ainrnc-nt Boxe~, IJ ........................... SpBl/O¥orftll Containment Boxes a..m..pmsent, but were Not T~sted [] Tc.,t lViet~bd Uevelep~i'~y: U Spill Bucket Manufacturer '~dustry ,q~il~J,~ C3 Professional En{~ne~ Test Meltlod Us~' [] Pressure I't Yack,urn ['l Other (~pe¢ify) ~ Spill Box # g'~ Spill B~x # ~,~/,t/,~ Spill ]Box # Spill Box # Wait time between appl'~'il'~ pressure/vacuum/water and /l~ starting test: Pa.ss/Fail Threshold or Comments - (include information on r~pabw made prior to rgsting, and ree. ommended, fi,?~l, ow-up for failed ! r--~ Postage $ · · t nj Certified Fee '~ IZ1 Postmark I [Z] Return Reciept Fee Here i r--I (Endorsement Required) i D Restricted Delivery Fee t~ (Endo~eement Required) il'U Total Pos~~--~ "- i~3te~xi....~Se, tro !, c'I-IF. VRON STATIONRD l, 1'7-] r,- t~a~'t:', 1125 COFFEE 7'"1 ~ ~":'; ...... ;! ~. ~--- i ·' Complete items 1, 2, and 3. Also complete "-~/..Signature . ~' item 4 if Restricted Delivery is desired. ~ - v I] /-/x _J~ [] Agent ; · Print your nameand address on the reverse : A ,_~i~.~_~ [] Addressee i so that we can return the card to you " B 'J'?' ' 4..k, YtedName}' Ia na~-f · - . h, ece~vea Dy (~",r~ ..... o ~J ery t · Attach this card to the back of the mailpiece, ~ ~-., ~ ,~ '~ ,~__1 ,'"J [ ....... er'on the ,front if'space, permits. C_' _'~[;~f~_ .D_.k.j ~ \ ~,~r~ .{~//-~ (, ' ~.. Is delivery a~lress different f~n item1? I-I Yes 1. Article Addressed to: if YES, enter delivery address below: [] No CHEVRON STATION ~ 1125 COFFEE RD '3. Se~ Type  BAKERSFIEIJD CA 93308 u~ Certified Mail [] Express Mail ,~ ~_.~ · [] Registered [] Return Rei~eipt for Merchandise· ~ -' I [] Insured Mail [] C.O.D. ' ~ J_~lest~[ed Delivery? (Extra Fee) [] Yes 72~ ' 7DDa ;=4'l, rl DDD;= 1,=174 =I'I'=ID ~ PS Form 3811, Aug MSt 2001 Domestic Return Receipt .2ACPRI-03-Z-09.85 February 13, 2003 Chevron Station 1125 Coffee Rd Bakersfield CA 93308 FIRE CHIEF RON FRAZE Certified Mail ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 R~: Recent SB 989 Secondary Containment Testing FAX (661) 395-1349 SUPPRESS,O. SERV,CES SECOND REMINDER NOTICE 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 Dear FAX (661) 395-1349 ,.,wne, t,..,perator: PREVENTION SERVICES Our records indicate that you completed your secondary containment FIRE SAFEI~ SERVICES · ENVIRONblSHTAI. SERNlCES 1715 ChestorAve. testing on May 24, 2002. Our records further show a failed test. Bakersfield, CA 93301 VOICE (661) 326-3979 Therefore you are required to have your system repaired and re-tested FAX (r~l) 326-0576 as soon as possible. PUBLIC EDUCATION 1715 Chester Ave. This office requests an update with regard to repairs of your system. Bakersfield, CA 93301 Please be advised that repairs involving the replacing of components VOICE (661) 326-3696 FAX (661) 326-0576 must be under permit from this office. The repairs of your system 'are a condition of your permit to operate. Failure to repair and re-test will FIRE INVESTIGATION 1715 ChesterAve. result in the revocation of your permit to operate. Bakersfield, CA 93301 " VOICE (661) 326-3951 FAX (661)326-0576 Should you have any questiOns, please feel free to contact me at 661- 326-3190. TRAINING DIVISION 5642 Vlctor Ave. Bakersfield, CA 93308 Si~ ~ VOICE (661) 399-4697 FAX (661) 399-5763 ,. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc January 22, 2003 Chevron · ~,RE C,,EF 1125 Coffee RON FRAZE . - ' ' Bakersfield CA 93308 ADMINISTRATIVE SERVICES 2101 "H" Street Sakes,eld. CA 933O, PE: Upgrade Certificate & Fill Tags vOiCE (651) 325-3941 - FAX (661) 395-1349 Dear. Owner/Operator: SUPPRESSION SERVICES 21ol "H' Street Effective JanUary 1, 2003 AssemblY Bill 2481 went into effect. This Bakersfield, CA 93301 . VOICE (661)326-3941 Bill deletes the requirement for an Upgrade certificate of compliance FAX (661) 395-1 349 (the blue sticker in your window) and the blue fill tag on your fill. pREvENTION SERVICES ; Fro; sarm'sEm~cas · Emnaonatm'~l.s,mnc£sl 715 Clnester Ave. ,' You may, if you wish, have them posted Or remove them. Fuel Bakersfield. CA 93301 -. t .vendors have been notified of this change and will not deny fuel VOICE (661) 326-3979 FAX (661) 326-0576 delivery for missing tags or certificates. .' PUBLIC EDUCATION 1715 ChosterAvb. Should you have any questions,.please feel. free to' call.me at 661- Bakersaeld, c^ ~3Ol 326-3190. vo,cE (6~1) 326-3~ FAX (661) 326-0576 FIRE INVESTIGATION Sincerel~ 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 8900 Shoal Creek Blvd, Building 200 Austin, Texas 78757 Phone: (512) 451-6334 Fax: (512)459-1459 Date Printed and Mailed: 01/08/2003 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR STEVE UNDERWOOD 1715 CHESTER AVE., 3RD FLOOR BAKERSFIELD, CA. 93301 Test Date: 12104/2002 Order Number: 3126559 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CHEVRON 203576 1125 COFFEE RD. BAKERSFIELD, CA. 93308 Testing performed: Leak detector tests Monitor Certification Sincerely, Dawn Kohlmeyer Manager, Field Reporting ~-- TANKNOLOGY CERTIFICATE OFTESTING · Tan 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 TELEPHONE (512) 451-6334 FAX (512) 459-1459 PURPOSE: COMPLIANCE TEST RESULT SUMMARY REPORT TEST DATE: '12104/02 WORK ORDER NUMBER: 3126559 CUSTOMER PO: 4616790 CLIENT: CHEVRON UiS.A~ SITE: CHEVRON 203576 P.O. BOX 2292 1125 COFFEE RD. 145 S. STATE COLLEGE BLVD. BAKERSFIELD, CA 93308 BREA, CA 92822-2292 JUDY BOWE MANAGER (714)671-32'14 (66'1)588-9066 TEST TYPE: PTK-88 Product Pipe Tightness Test Results 92 I S~R~ DW FIBERG PRESS~E 87 2 REG ~E~ DW FIBERG PRESS~E 89 3. PLUS DW FIBERG PRESS~E 92 i VEEDERROOT L.L.D. 011505 P 87 2 ~EDERROOT L.L.D. 013649 P 89 3 VEEDERROOT L.L.D. 013652 P New Replacement Line Leak Detector Test For o~ dc~iicd report info~ation, visit ~.tan~o]o~y.com and select ~-Li~e EcpoAs-W~P, or contact your Inca] Tan~o]ogy Tester Name: RODNEY BREDESON Technician Ce~ifi~tion Number: ~rintod 0~/08/2003 08:50 SBOW~S · ~i~'~:Ll~ '~"~rJ~ ' . ~NITORING SYSTEM CERTIFICATION Fo~ By All Jurisdictions Within the Sta~e of Cafifornia Authority Cited: Chapter 6. 7, Health and Safety Code; Chapter 16, D/vision 3 Title 23, CaflTdmia Code of Regulations This form must be used to document testing and servicing of monitoring equipment. If more than one monitoring system control panel is installed at the facility, a separate certification or report must be prepared for each monitor/hq system control panel by the technician who performs the work. A copy of this form must be provided to the tank system ownefloperator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: CHEVRON 203576 City: BAKERSFIELD CA Zip: 93308 Site Address: 1125 COFFEE RD. Contact Iphone No: 588~.9066 Date of Testing/Service: 12/04/2002 Facility Contact Person: MANAGER Make/Model of Monitoring System: V.R. TLS350 Work Order Number: 3126559 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced Tank ID: 87 Tank ID: 89 X---] In-Tan~( Gauging Probe. Model: MAG 1 ' [] In-Tank Gauging Probe. Model: MAG 1 X~ Annular Space or Vault Sensor. Model: LS1 [] Annular Space or Vault Sensor. Model: 420 X---] Piping Sump/Trench Sensor(s). Model: 208 [] Piping Sump/Trench Sensor(s). Model: 208 '~ Fill Sump Sensor(s). Model: [] Fill Sump Sensor(s). Model: '"'] Mechanical Line Leak Detector.. Model: E~]' Mechanical Line Leak Detector. Model: %ri Electronic Line Leak Detector. Model: PLLD [] Electronic Line Leak Detector. Model: PLLD '-] 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). Tank ID: 91 Tank ID: _ X'~ In-Tank Gauging Probe. Model: MAG 1 [] In-Tank Gauging Probe. Model: X---] Annular Space or Vault Sensor. Model: 420 [] Annular Space or Vault Sensor. Model:  Piping Sump/Trench Sensor(s). Model: 208 [] Piping Sump/Trench Sensor(s). Model: Fill Sump Sensor(s). Model: [] Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: [] Mechanical Line Leak Detector. Model:  Electronic Line Leak Detector. Model: PLLD [] Electronic Line Leak Detector. Model: Tank OvenSll/High-Level Sensor. Model: [] Tank Overfill/High-Level Sensor. Model: Other (specify equipment type and model in Section E on page 2). [] Other (specify equipment type and model in Section E on page 2). Dispenser ID: 1/2 Dispenser ID: 3/4 xE~ Dispenser Containment Sensor(s) Model: BEAUDREAU [] Dispeniser Containment Sensor(s) Model: BEAUDREAU [] Shear Valve(s). [] Shear Valve(s) [] Dispenser Containment Float(s) and Chain(s). L---'I Dispenser Containment Float(s) and Chain(s). Dispenser ID: 5/6 Dispenser ID: 7/8 [] Dispenser Containment Sensor(s) Model: BEAUDREAU [] Dispenser Containment Sensor(s). Model: BEAUDREAU [] ShearValve(s). [] ShearValve(s). r~ Dispenser Containment Float(s) and Chain(s). [] Dispenser Containment Float(s) and Chain(s). Dispenser ID: 9/10 Dispenser ilD: 11/12 [] Dispenser Containment Sensor(s) Model: BEAUDREAU [] Dispenser Containment Sensor(s). Model: BEAUDREAU [] ShearValve(s). [] ShearValve(s). ~] Dispenser Containment Float(s) and Chain(s). [] Dispenser Containment Float(s) and Chain(s). · If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this certification is information (e.g manufacturers' checklists) necessary to verify that this information is correct. and a Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the (Check all that apply): System set-up report; ~ Alarm history report PRINTED NAME:RODNEY BREDESON SIGNATURE: :/F':, ; · ~., COMPANY: Tanknolocjy PHONE NC): (800) 800-4633 page 1 of 3 Based on CA form dated 03/01 M~ oring System Certification Site Address: . 1125 COFFEE RD. Date of Testing/Service: 12/04/2002 D. Results of Testing/Servicing Software Version Installed: 116.02 Complete the following checklist: I [] Yes [] No* IS the audible alarm operational? [] Yes [] No ' IS the visual alarm operational? [] Yes E~] No * Were all sensors visually inspected, functionally tested, and confirmed operational? [] Yes [] No* Were all sensors installed at lowest point of secondary containment and positioned S° that other equipment will not interfere with their proper operation? [] Yes [] No* ~ N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment [] Yes [] No * [] 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 confirm positive shut-down due to leaks a~l sensor failure/disconnection? [] Yes [] No [] Yes [] No * [] N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.: no mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill points(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? 90 % [] Yes* [] No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. [] Yes* [] No Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) [] Product; [] Water. If yes, describe causes in Section E, below. [] Yes [] No * Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. [] Yes [] No * Is all monitoring equipment operational per manufacturers' specifications? · In Section E below, describe how and when these deficiences were or will be corrected. E. Comments: Found liquid in 87 turbin sump and sensor raised. Reinstalled senor at lowest point....notified Chevron maintenance 12/3, to remove water and mount sump sensors...system is operational page 2 of 3 ring System Certification Site Address: 1125 COFFEE RD. Date of Testing/Service: 12/04/2002 F. In-Tank Gauging / SIR Equipment [] Check this box if tank gauging is used only for inventory control. [] Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: [] Yes []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? [] Yes []No * Was accuracy of system product level readings tested? []Yes r-'-~No* Was accuracy of system water level readings tested? [] Yes []No* Were all probes reinstalled properly? [] Yes [--~No' Were all items on the equipment manufacturers' maintenance checklist completed? · In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): [] Check this box if LLDs are not installed. Complete the following '.hecklist: [] Yes [] No [-"]N/A For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) Simulated leak rate: [] 3 g.p.h [] 0.1 g.p.h E~]o.2 g.p.h Yes [] No ~ Were all LLDs confirmed operational and accurate within regulatory requirements? Yes [] No * Was the testing apparatus properly calibrated? [] Yes E~]No* [] N/A For mechanical LLDs, does the LLD restrict pioduct flow if it detects a leak? [] Yes []No* [] N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? [] Yes []No* [] N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? [] Yes []No * [] N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? [] Yes E~]No* [] N/A For electronic LLDs, have all accessible wiring connections been visually inspected? ~-~ Yes []No* Were all items on the equipment manufacturers' maintenance checklist completed? · In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: page 3 ~)f 3 Work Order: Tanknology-NDE 8900 Shoa}Creek, Building 200 AUstin, Texas 78757 - ~ Work Order: 3126559 Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order;. 3126559 Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3126559 :' ~ ,I~ :,~ PR~ 0~ ,,~,:: ~:,~:~t~ :[:~:;:::: ::, :: : :~:~ ::z::t:~ : e~:::~' , :.::: [~,,: :a~;'~: .:: : ~ , ~: : r: :::~ T~olo~-~ ~00 ~ho~l ~r~k, Buildin~ 200 Aus~, T~ 7~7~7 Work Order: 3126559 Tanknology-NDE 8900 Shoal Creek, Building 200 Austin Texas 78757 Work Order: 3126559 Tanknology-NDE 8900 Shoal Creek, Building 200 Austin,.Texas 78757 " Work Order: 3126559 Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 '" Work Order: 3126559 Tanknology-NDE 8900 Shoai Creek, Building 200 Austin, Texas 78757 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE:12/04/02 WORK ORDER NUMBER3126559 CLIENT: CHEVRON U. S. A. SITE: CHEVRON 203576. COMMENTS Maintenance notified (12/3) to remove water from unleaded turbine sump and mount sensors PARTS REPLACED HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) Printed 01/08/2003 08:50 SBOWERS SITE DIAGRAM 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 12./0,~/02 - WORK ORDER NUMBER3126559 CLIENT:CI"IEVRON U.S.A. SITE: CHEVRON 203576 L1 L2 L3 L6 UL PLUS ~ 12K ~ C-STORE ~1 Printed 01/08/2003 08:50 SBOWERS -~ B Postage $ r-~ Certified Fee Return Recelljt Fee Postmark .j~ (Endm'sement Required) Here 1~3 · (E~d0rsement Required) ru Tota: ~~ · Complete items 11 2, and 3. Also complete / item 4 if Restricted Delivery is desired. [] Agent · Print your name and address on the reverse [] Addressee 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. Is delivery ~ from item 17 [] Yes cHEVRON STATION [ i~ ,.--' 1'125 COFFEE'RD t a. So_S_S~Tvpe I BAKERSFIELD CA 93308 I Ill'Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise ~ ) __ [] ~n~,.,r~ M~~ [] C.__O.D...~.. __ __ 4. Restricted Delivery? (Extra '~e) [] I Yes . .70.02 0860 0000 1641 5592 ! PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-0835 January 13, 2003 Chevron Station 1125 Coffee, Rd Bakersfield CA 93308 F)RE CHIEF ~ON F~AZE Certified Mail ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 -RE:Recent SB 989 Secondary Containment Testing FAX (661) 395-1349 SUPPRESS,O. SERVICES REMINDER NOTICE 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Dear Owner/Operator: PREVENTION SERVICES Our records indicate that you completed your secondarY containment FIRE SAFET~ SEffi/ICES · ENV~ONMENTAL SEffi/K;ES 1715 Chester Ave. testing on May 24, 2002. Our records further show a failed test. Bakersfield, CA 93301 VOICE (661)326-3979 Therefore you are required to have your system repaired and re-tested FAX (661) 326-0576 as soon as possible. PUBLIC EDUCATION 1715 ChosterAv~. " This office requests an update with regard to repairs of your system. Bakersfield, CA 93301 vOiCE (c~1) 32~-~ Please be advised that repairs involving the replacing of components FAX (661) 326-0576 must be under permit from this office. The repairs of your system are FIRE INVESTIGATION a condition of your permit to operate. 1715 Chester Ave. Bakersfield, CA 93301 vOiCE (661):m.3951 Should you have any questions, please feel free to contact mc at 661- FAX (661) 3264)576 326-3190. TRAINING DIVISION Bakersfield, CA 93308 ' VOICE (661) 399-4697 FAX (661)399-5763 Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc CITY OF BAKERSFIELD -F/L OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 PERMIT APPLICATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK TYPE OF APPL ICATIQI~CHECK) [ ]NEW FACILITY [V~MODIFICATION OF FACILITY [ ]NEW TANK INSTALLATION AT EXISTING FACILITY FACILITY NAME ~ ~7'A. ~Zg)~ ?~"'T& EXISTING FACILITY PERMIT NO. FACILITY ADDRESS [ ~ ~,~' ~ ~ CITY ~ ~'ttH_~ ZIP CODE TYPE OF BUSINESS ~,~ ~t- ~'/k~'oL,,l~l~::. ~ '~ ~ uD.,~?,,~ ' APN # TANK OWNER~, ~F-t~.l q:~-6bO~X 'c.~j. PHONE NO. (7{4~67( ADDRESS ~ O~ -~)C ~..~L.'2.- . CITY ~c-~ ZIP CODE CONTRACTOR ~f~_E)- ~O~6,~-~f' If.-~C~ CA LICENSE NO. ~ ADD.SS ~a6~ ~~ ~ C~TY~A ~ ~ Zm CODE ~70 PHONE NO.(~' ~ ~-~ BAKERSFIELD CITY BUSINESS LICENSE NO. WO~MAN COMP NO: ~d ~q 0~ ~SU~R ~~ ~ ~g~y I~, ~, B~EFLY DESCmBE THE WO~ $0 BE ~NE ~~ ~P~~ ~O~]~ fOHPS, .. WATER TO FACILITY PROVIDED BY DEPTH TO GRO~D WATER ~' SOIL T~E EXPE~ED AT SITE NO. OF TANKS TO BE ~STALLED ~ A~ THEY POR MOTOR FUEL ~ ~S ~ NO SPILL P~V~ION CO~ROL AND CO~ER MEASU~S PLAN ON FILE ~'- ~S ~ NO SE~ION FOR MOTOR FUEL TANK NO. VOL~E~LEADED ~GULAE P~MI~ DIESEL AVIATION 8E~ION FOR NON MOTOR F~EL STOOGE TANK NO. ~ VOL~E CHEMIC~ STOOD CAS NO.' CHEMICAL P~VIOUSLY STOOD ~O B~ND N~E) (IF ~OWN) FOR O~IC~L USE ONLY [ ~P~CAT~N DA~ ·. . FAC~ NO. :' ND. OFT~ ~ES$ THE APPLICANT HAS ~CEIVED, ~DERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PE~IT AND ANY OTHER 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 - APPROVED BY: APPLICANT N~E (PffiNT) ~ APPLICANT SIGNATU~ TffiS ~PLICATION BECOMES A PE~IT ~N ~PROVED , SITE DATA ~ SJTE SQUARE FOOTAGE: 41.125 SQ. F'r, (0,94 ACRES) ~. ~ LANDSCAPING SQUARE FOOTAGE: Z %/ [ WASH DECAL II ~ U ~ II ~ .WASH DECAL~ t~XL~ LANDSCAPING - wj ~ -~:= = ---',~ _ ,i ,I -'-~ ~ PARKING: REQUIRED PROVIDED WAS OFFICE ~ STORAGE ZONING DISTRICT: C-~ U~/~,~ NATURE OF BUSINESS GASOUNE SERV1CE STAllON ASSESSOR'S PARCEL NO.: ~ ~ · 0 5, 10 20 ~if GRAPHIC SCALE : C-45 MONUMENT ,' W/ LD. S~GN & i f APC (B'-O" TO TOP) OFF)CE OF ~8'xos' a .,,.. for cot~struction ~rld/or (3) 12.~0 ~ DBL. ~ ~NOPY ~ ~ ~ I~o,~u~&uoh ~hereo~, z _ 1) PLUS UNLEADED TURBINE SUMP TEST FAILED. REPAIR METHOD: NEW.'SSl FITTINGS AND FIBERG~SS AS NECESSARY. WORD~X (~.-~) 2) DISPENSER SUMP TEST FAILED AT POSITION 1-2. REPAIR METHOD: NEW SSI FITTINGS AND FIBERG~SS AS NECESSARY. 3) REGU~R, SUPER ~ PLUS UNLEADED SECONDARY PIPING TEST ~AILED. -' REPAIR METHOD: HELIUM TEST TO LOCATE FAILURE, EXPOSE PIPING, '' TIGHTEN FITTINGS AND/OR REPAIR WITH FIBERG~SS. 4) SUPER ~ REGU~R UNLEADED TANK INTERSTITIAL TEST FAILED. REPAIR METHOD: TIGHTEN RISER AND IF 2nd TEST FALLS REP~CE RISER. 5) REGU~R UNLEADED TANK VAPOR RISER BUCKET REQUIRE ADJUSTMENTS. / MAKE ADJUSTMENTS, AND RETEST. ¢-o~'-o'~ ......... GROUND ~ GRADE PLAN (~0'-7 ~LENAUE: 205576 I ~D June 30, 2002 Chevron Station 1125 Coffee Road Bakersfield, CA 93308 REMINDER NOTICE RE: Necessary Secondary Containment.Testing Requirement by December 31, 2002 of Underground Storage Tank located at 1125 Coffee Road. FIRE CHIEF RON FRAZE Dear Tank Owner / Operator: ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 Thc purpose of this letter is to inform you about the new provisions in VOICE (661) 326-3941 FAX (661) 395-1349 California Law requiring periodic testing of the secondary containment of underground storage tank systems. SUPPRESSION SERVICES 2101 "H" Street Bakersfield. CA 93301 Senate Bill 989 became effective January 1, 2002, section 25284.1 (California VOICE (661) 326-3941 FAX (661) 395-1349 Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure PREVENTION SERVICES that the systems are capable of containing releases from the primary 1715 Chester Ave. Bakersfield, CA 93301 containment until they arc detected and removed. VOICE (661) 326-3951 FAX (661) 326-0576 Secondary containment systems installed on or after January I, 2001 will be tested ENVIRONMENTAL SERVICES upon installation, six months after installation, and every 36 months thereafter. 1715 Chester Ave. Bakersfield, CA 93301 Secondary containment systems installed prior to January 1, 2001 will be tested by VOICE (661) 326-3979 FAX (661)326-0576 January l, 2003 and every 36 months thereafter. REMEMBER! Any component that is "double-wall" in your tank system must be tested. TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 Secondary containment testing shall require a permit issued thru this office and VOICE (661) 399-4697 FAX (661)399-5763 shall be performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (661)326-3190. . St~ve Underwood ..... -~ ............... "'",- ....... Fire~[nspector/'Environmental code~EnforCement Officer ......... Environmental Services SU/kr Tanknoio 8900 Shoal Creek Bird, Building 200 Austin, Texas 78757 Phone: (512) 451-6334 Fax: (512) 459-1459 BAKERSFIELD FIRE DEPARTMENT OFFIC'E OF ENVIRONMENTAL SERViCEs INSPECTOR STEVE UNDERWOOD 1715 CHESTER AVE., 3RD FLOOR BAKERSFIELD, CA. 93301 Test Date: 05/23/2002 Date Printed and Mailed: 06/05/2002 Order Number: 3122701 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CHEVRON 203576 1125 COFFEE RD. BAKERSFIELD, CA. 93308 Testing performed: Secondary Containment testing Sincerely, Dawn Kohlmeyer Manager, Field Reporting SB-980ECONDARY CONTAINMENT SU~/ARY RESULTS TEST DATE: 05/23/2002 WORK ORDER NO.: 3122701 CLIENT: CHEVRON SITE: CHEVRON 203576 P.O. BOX 2292 _. 1125 COFFEE RD. 14'5 S. STATE COLLEGE BLVD. BI~EA CA 92822 B/~KJERSFIELD CA 93308 CRAIG MORGAN 714,-671-3282 Tank Interstital Tests SUPI~EME Joor FAIL ~ REG UNLEAD Joor FAIL PLUS Joor PASS Piping Interstital Tests PLUS ~m/th FAIL REGULAR Sm/th FAIL sUPREME Smith FAIL Sump & Under-Dispenser Containment Tests PLUS western Fiberglass Fail 3/4' American Containment Pass SUP. Phil-Tire Pass REGWJL western Fiberglass Pass 1/2 American Contair-nent Fall SUPRE western Fiberglass Pass PLUS oPw Pass 11/12 A~erican Containment pass PLUS Phil-Tire IPass 9/10 American Contairnnent Pass REG. 0mw. Pass 7/8 American Containment Pass REG. Phil-Tire Fail 5/6 A~erican Containment Pass SUP. 0~w Pass Tanknology representative: Services conducted by: KEN MINTON DAVID LASKY ~ SECONDARY CONTAINMENT TEST RESULTS NAME: CHEVRON 203576 203576 05/23/2002 WORK ORDER: 3122701 SITE ADDRESS: 1125 COFFEE RD. BAKERSFIELD CA 93308 REASON FOR TEST: SB-989 Compliance Groundwater LeVel(" from ~lrade): TANK INFORMATION AND INTERSTITIAL TESTS Dia. Material Manufacturer I~e.p)t h Test Method Start Initial Finish Final Pass/ Tank Product Tank Size (" ) Time Level Time Result Fail 1 SUPREME 12082 111 DW STEEL Joor 63 Vacuum 1210 -10.04 'Hg 1230 0 'Hg FAIL 2 REG UNLEAD 12082 111 . DW STEEL Joor 62 Vacuum 1150 -10.03 'Hg 12! 5 0 'Hg FAIL 3 ~ PLUS 12082 111 DW STEEL Joor 58 Vacuum 1226 -10.06 "Hg 1326 -9.97 "Hg PASS 4 5 6 7 8 Comments: Above failures were performed at bottom of riser/top of tank. LINE INFORMATION AND INTERSTITIAL TESTS Dia. Len. Volume Start Initial Finish Final Pass/ Tank Product Material Manufacturer Test Method (" ) (feet) (~]allons) Time Level Time ~ Result Fail 1 PLUS 4.00 225 DW FG Smith 73 Pressure 1700 5 psi 1730 2 psi FAIL 2 REGULAR 4.00 225 DW FG ~mith 73 Pressure 1708 5 psi 1738 0 psi FAIL 3 SUPREME 4.00 225 DW FG Sm[th 73 Pressure 1720 5 psi 1758 0 psi FAIL 4 5 6 7 8 Comments: SECONDARY CONTAINMENT TEST RESULTS Work Order: 3122701 SUMP TESTS Type Tank or Disp Manufacturer Model or Diam./Width/Length Depth Test Method Start Initial Level Finish Final Pass/ # Material (" ) (" ) Time Level Chan,qe Time Result Fail STP Sump PLUS Western Fiberglass Fiberglass 43 58 VPLT 1115 ~ 13.5 " -.01823 1130 ,143 . gph Fail STPSump REGULAR Western Fiberglass Fiberglass 43 62 VPLT 1126 17 · -.00147 1140 .030 gph I Pass STP Sump SUPREME Western Fiberglass Fiberglass 43 63 VPLT 1132 16 -.00157 1148 .007 gph Pass Dispenser Sump 11/12 American Fiberglass 12.5X43 24.5 VPLT 1331 12 . -.00002 1345 .004 gph Pass Dispenser Sump 9/10 American Fiberglass 12.5X43 24 VPLT 1339 11,5 " ,00007 1351 -.001 gph Pass Dispenser Sump 7/8 American Fiberglass 12.5X43 2415 VPLT 1345 11 " .00006 1 340' -.005 gph Pass Dispenser Sump 5/6 American Fiberglass 12.5X43 24 VPLT 1426 10.5 a .00005 1438 -.003 gph Pass Dispenser Sump 3/4 American Fiberglass 12,5X43 24 VPLT 1619 11 a .00092 1632 -.022 gph Pass Dispenser Sump 1/2 American Fiberglass 12.5X43 24 VPLT 1705 5 . .00003 1720 -.004 gph Fail Spill Container PLUS FILL OPW Plastic 11 13 VPLT 1714 8 . -.00012 1729 .000 gph Pass Spill Container PLUS PhiI-Tite Plastic 11 13 VPLT 1720 9 . -.00006 1734 .000 gph Pass Spill Container REG. FILL OPW Plastic 11 13 VPLT 1746 10 · -.00071 1800 .001 gph Pass Spill Container REG. Phil-Tire Plastic 11 13 VPLT 1720 10 · 5' VISUAL 1730 5 gph Fail ~. Spill Container SUP. FILL OPW Plastic 11 13 VPLT 1748 7 · -.00000 1802 .000 gph Pass ,Spill Container SUP. PhiI-Tite Plastic 11 13 VPLT 1755 9 -.00065 1807 .001 gph Pass Comments: DISP SUMP 1/2 IS TROUBLESHOOTING TEST BELOW PENETRATIONS. THEREFORE NOT VALID AND A FAILURE., Work Order: 3:1.227 0:1. ,{ Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3122701 Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3:1.2270:1. Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 31.2270:1. Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 312270]. Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 '..,,: (512) 451-6334 FAX (512) 459-1459 TEST DATE:05/23/02 WORK ORDER NUMBEFI31 22701 CLIENT:CHEVRON SITE: CHEV'RON 2035'76 COMMENTS One 55 gallon drum left on site provided by Joe Rhodes. Three hours labor installing test boots under all dispensers. All line intersCitials failed. 87 and 91 tank annular spaces failed. 89 STP sun~ failed. Dispenser pan 1/2 failed. 87 vapor spill bucket £ailed. PARTS REPLACED · HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) Printed 06/05/2002 08:48 CCHAPA SITE DIAGRAM 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/23/02 WORK ORDER NUMBER3122?01 CLIENT:CII~n/'~O~ ~ SITE: C[-~'V'EOtq 2035'76 Printed 06/05/2002 08:48 CCHAPA May 29, 2002 Chevron Station 1125 Coffee Road Bakersfield, CA,93308 RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 1125 Coffee Road FIRE CHIEF REMINDER NOTICE RON FRAZE Dear Tank Owner/Operator: ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 Thc purpose of this letter is to inform you about thc new provisions in California VOICE (661) 326-3941 FAX (661) 395-1349 Law requiring periodic testing of the secondary containment of underground storage tank systems. SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA93301 Senate Bill 989 became effective January 1, 2002. section 25284.1 (Califomia VOICE (661) 326-3941 Health & Safety Code) of the new law mandates testing of secondary containment FAX (661) 395-1349 components upon installation and periodically thereafter, to ensure that the systems PREVENTION SERVICES are capable of containing releases from the primary containment until they are' 1715 ChesterAve. detected and removed. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 Secondary containment systems installed on or after January 1,2001 shall be tested upon installation, six months after installation, and every 36 months thereafter. ENVIRONMENTAL SERVICES Secondary containment systems installed prior to January 1,2001 shall be tested by 1715 Chester Ave. Bakersfield, CA 93301 January 1, 2003 and every 36 months thereafter. REMEMBER!! Any component VOICE (661) 326-3979 FAX (661) 326-0576 that is "double-wall" in your tank system must be tested. TRAINING DIVISION Secondary containment testing shall require a permit issued thru this office, and 9642 wctor Avo. shall be performed by either a licensed tank tester or licensed tank installer. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (661) 326-3190. si , Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/kr enclosures o5/16/02 THU 17:01 FAX 5123807188 Tanknolosy-Gulf Coast ~oo5 ' ~ 171~ ~~r Av~, B~~d, ~ (661) 326-3979 APPLICATION TO PERFORM A TANK TIGHTNESS TEST/ SECONDARY CONTAINMENT TESTING o~ ., TANK # VOLUME .~ C0~$ N.A..-"d~ & PHONE NUMBER OF CONTACT PERSON '~"~eJ~ _~ Prt. L.,a.,e.~' c~,,-, cl~-'~08-1'za"$ .. °'ZSq 0 ~o~ aY DA~ SIG~A~ O~ ChevrOn Products Company, Inc. April 30, 2002 PO Box tevron San Ramo ]-0904' Benny Licenses/Permits Specialist City of Bakersfield Phone No. 925-842-9002 Fire Department Fax No. 925-842-9585 1715 Chester Avenue, Third Floor- Bakersfield, CA 93301 . RE: FINANCIAL RESPONSIBILITY FOR UNDERGROUND STORAGE TANKS Dear Sirs: Please find enclosed the following documents: 1) Proof of Financial Responsibility 2) Certificate of Financial Responsibility 3) Chevron Facility List under yourjurisdiction These documents meet the financial responsibility requirements for all USTs owned by Chevron and have previously been submitted directly to the State. If you have any questions feel free to contact me. Sincerely, Benny Brar Licenses/Permits Specialist Permit' Desk Enclosure: as stated April 30, 2002 Page 11 ChevronTexaco C~:RT~'IC~TION OF FINANCIAL RESPONSIBrLrrY CHEVRON U.S.A. INC. he .r~by c~rtifies that it is in compliance with the requirements of SUbpart H of 40 CFR part 280. The financial assurance mechanisms used to demonslra~ financial responsibility under subpa~ H of 40 CFR part 250 are as follows: Fimm¢ial ~ and. cozt~rate guaraat~ of ChewrunTexaco Corporation in the amouni orS1 million per occurrence, $2 million anuual aggregate, for the period commeacing.A~3riJ 30, 2002 and which is anticipated to be ronow~ annually, with tl~ ne~t renewal scheduled to occur during the fu~t 120 days of 2003. Said guamat~ covers taking con~tive action and competing third parties .for bodily injury and property damag~ caused by either sudden ac~idenlal releases or nonsudden accidentsJ reloasos or accidontal roleases; April 30, 2002 · CHEVRON U.S.A. INC. gai Ana 04/30/02 ~ 14:04 [TX/RX NO 8561] .- ~ ~ Page 11 .. ChevronTexaco CERTII~ICATION OF FINANCIAL RESPON~O.~ CHEVRON U.S.A. INC. be .r~by cert/fies that it is in complianc~ with tho requirements of subpart H of 40 CFR part 280. The financial assurance mechanisms used to demonstrate financ/al respons~ility under subpart H of 40 CFR part 280 areas follows: Financial test and oorporato guaran~ of ChowenToxaco Corporation in the amount of $1 million per occurr~ce, $2 million annual asgreg~, for tho period COmm~l¢ing April 30, 2002 and which is anticipated to be renewed annually, with tho next renewal scheduled to occur during the first 120 'days of 2003. Said.guanmtee .covers talcing corrective ac/ion and compew~-i~g th/rd parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental reloas~ or accid~ml r=leases; April 30, 2002 · CHEVRON U.S.A. INC. .- Senior Counml 04/30/02 TIIE 14:04 [TX/RX NO 8561] Page 11 ChevronTexaco ~Eto'~iCATION OF FINANCIAL RESPONSIBH.rr~ CHEVRON U.S.A. INC. ~y ~ ~t it is ~ w~li~ ~ ~e ~men~ of ~bp~ H of 40 CFR ~ 280., ~e ~ci~ ~~ m~ ~ to d~o~ ~ ~~i~W ~r ~b~ H of 40 C~ pm 280 ~ ~ foHo~: F~c~ ~ ~ ~ ~ of Ch~T~ ~~on ~ &o ~o~ of $1 ~Bion p~ ~~ ~ ~ ~ ~, for ~e ~ ~mm~c~g ~ 30, 2~ ~d ~ch 120 for ~y ~j~ ~d April 30, 2002 -CHEVRON U.S.A. INC. Sonior Counsol ' · ,,,"3udith L. Geisler . ', 04/30/02 TIlE 14:04 [TX/R.X NO 85611 April 30, 2002 Pag~ I 1 ' ChevronTexaco CERTIFICATION OF FINANCIAL RF.~ONSIBn.rrY CHEVRON U.S.A. INC. he .r~oy certifies that it is in compliance with the requirements of subpart H of 4O CFR part 280. The financial assuranCe mechanisms used to d~monstrate financial r~spous~ility under subpart H of 40 CFR part 280 are as follows: Financial test and ootporate guarantee of ChowouT~ Corporation in tho amount of $1 million per occurrence, $'2 million annual ~, for tho period commencing April 30, 2002 and which is anfiGipated to be ~ annually, with lbo next renewal scheduled to occur during the first 120 days of 2003. Said guarantee ~overs taking con~ctive aciion and compensating third parties for bodily injury and property damago caused by either sudden accidental releases or nonsudden accidenial rel~.vos or accidental ruluases: April30,2002 · CHEVRON U.S.A. INC. ~enior Counsol 04130/02 TIIE 14:04 [TI/RI NO 85611 April 30, 2002 Pag~ l I ChevronTexaco cE~cl'IF~CATION OF I~IN~~ RESPONSIBH,1TY CI-~VRON U.S.A. INC. he .r~by certifies that it is in compliance with the requirements of subpart H of 40 CFR part 280. The financial assurance mecbzni.~ns used to demonstrate financial responsibility under subpart H of 40 CFR part 250 are as follows: Financial test and oorporato guarant~ of Ch~rro~Texaco Corporation in the amount of $1 million .per ocou;euce, $2 million anmud aggrog~, for the period commencing April 30, 2002 and which is antioipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 2003. Said guarante~ cove~s taldng con~cfive a~ion and compensming lhird parties for bodily injury and property damage caused by either sudden accidental r~leases or nonsudden accidental relea~s or accidental r~leases; April30,2002 · CHEVRON U.S.A. INC. ': //~udith L. Geisler . . 04~30/02 TUE 14:04 [TX/RX NO 8561] April 30, 2002 - Pag~ 11 ChevronTexaco CERTII~CATION OF FINANCIAL RESPONglBn.rl~ CHEVRON U.S.A. INC. he .r~by certifies that it is in complianco with tho requirements of subpart H of 4O CFR part 280. The financial assurance mechanisms used to demonstrate financial respons~ility under subpart H of 40 CFR part 280 are as follows: Financial te~t and oorporato guarantee of ChovrooT~ Corporation in the amount Of $1 million per occmrence, $2 million annual aggrega~, for tho period commencing April 30, 2002 and which is anticipated to be mnew~ annually, with ~ho ne~t renewal scheduled to occur during ~he first 120 days of 2003. Said guanmt~ covers taking corrective action and compensating third parties for bodily injury and prol~rty damago caused by either sudden accidental releases or nonsudden accidental releases or accidm~al roleases; April 30, 2002 · CHEVRON U.S.A. INC. -'B // Senior Counsel , ,/Judith L. Geisler . , 04/30/02 TIIE 14:04 [T//RX NO 8561] . April 30, 2002 · Page 11 ChevronTexaco CERTIFICATION OF FINANCIAL RESPONSIBH.rrY Ct-~VRON U.S.A. INC. he ~rpby c~rtifies that R is ~ ~li~ ~ &e ~men~ of ~bp~ H of 40 CFR ~ 280.' ~ ~e ~ci~ ~~ m~ni~ ~ ~ d~~ ~ ~~i.~ ~r subp~ H of 40 ~ p~ 2~0 ~ ~ fo~o~: . F~e~ ~ ~ ~ ~ of C~T~ ~~on ~ ~o ~o~t of $1 ~ion p~ ~~ ~ ~ ~ ~~ ~Or ~ ~M ~mm~ ~ 30, 2~2 ~d ~ch 120 ~ of 2~3. ~ ~~ ~ ~ ~~ a~ ~d ~m~n~ ~ ~ for ~y ~j~ ~d ~ ~ ~ ~ e~ ~ ~id~ ~1~ or ~~ ~id~ ml~ or ~idm~ m~; April 30,'2002 · CHEVRON U.S.A. INC. Senior Counsel . //Judith L. Geisler . '. 04/30/02 TUE 14:04 [TX/RX N0 8561] April 30, 2002 Pag, 11 ChevronTexaco CERTIF}[CATION OF FINANCIAL ~ONSIBH.rrY CI-IEVRON U.S.A. INC. he .r~by e. ertifies that it is in compliance with the requirements of subpart H of 4O CFR part 280. The financial assurance mee~ used to demonstrat~ financial responsibility under subpart H of 40 C~ part 280 aro as follows: Financial t~st and exngonm~ guaramoo of ChovronT~ Corporation in tho amount of $1 million per occ~ $2 million annual aggrogate, for tho period commellcing ~ 30, 2002 alld which is anticipated to be renewed annually, with.tl~ next rmewal s~hoduled to occur dining the first 120 days of 2003. Said guatant~ covers talcing corroctive action and compemaling flfird parties for bodily injury and ~ damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases; April 30, 2002 · CHBVRON U.S.A. INC. Senior Counsol , //Judith L. Geisler , ', Legal Ana 04/30/02 'rUE 14:04 ['IX/RX NO 8501] ri; ChevronTexaco Corporation John Watson 3 "~'- ' 575 Market Street Vice President ~ San Francisco, CA 94105-2856 Chief Financial Officer · Tel 415 894 3232 Fax 415 894 6017 ChevronTexaco April 30, 2002 UST FINANCIAL ASSURANCE To Whom It May Concern: I am the Chief Financial Officer of ChewonTexaco Corporation, 575 Market Street, San Francisco, CA. This letter is in support of the'use' of the financial test of self-insurance and guarantee to demonstrate · financial responsibility for taking corrective action and compensating third parties for bodily injury and property damage mused by sudden' accidental releases and/or 'nonsudden accidenlal releases in the amount of at least $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate arising from operating underground storage tanks. Underground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized State program by this guarantor -- all underground storage tanks owned by Chewon U.S.A. Inc. in the United States are assured by this financial test. A: financial test and guarantee are also used by this guarantor to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: EPA REGULATIONS. AMOUNT Closure (§§264.143 and 265.143) 91,323,697 Post-Closure Care (§ §264.145 and 265.145) 80,968,710 Liability Coverage (§{}264.147 and 265.147) 8,000,000 Corrective Action (§264.101 (b)) 22,164,100 Plugging and Abandonment (§ 144.63) 1,562,960 California State Program Closure 207,359 Post-Closure Care 735,685 Liability Coverage 66,000,000 Corrective Action 0 Plugging and Abandonment 0 04/30/02 TUE 14:01 [TX/ILl NO 85601 .,-. ...... t '*to o~,~ oOeu ,.~tl~Vt<U~ tJUt<t'.~ [~002 April 30, 2002 Page 2 ChevronTexaco Louisiana State Program Closure 4,914,355 Post-closure Care 844,687 Liability Coverage 1. ,000,000 Corrective Action 0 Plugging and Abandonment . 0 Total 277,721,553 This guarantor has not received an adverse opinion, a disclaimer of opinion, or'a "going concern" qualification from an independent auditor on his financial statements for the latest completed fiscal year. 1. Amount of annual UST aggregate coverage being assured by a test $ 2,000,000.00 and guarantee 2. Amount of corrective action, closure and post-closure care costs, $ . . 27_7,721,553.00 liability coverage, and plugging and abandonment costs covered by a financial test and guarantee 3. Sum of lines 1 and 2 $ 279.721.553.00 4. Total tangible assets $ _ 77,354,000,000.00 5. Total liabilities $ 43,614,000,000:00 6. Tangible net worth $ ' 33,740,000,000.00 7. Total assets in ~he U.S. $ 32,629,000,000.00 Yes No 8. Is line 6 at least $10 million? X 9. Is line 6 at least 6 times line 3? X 10. Are least 90% of assets located in the U.S.? X (If'~No", complete line I 1.) 11. Is line 7 at least 6 times line 3? X 04/30/02 TIlE 14:01 [TX/RX NO 8560] 't'uP5 t;~:a7 VAX I 415 894 5640 CHEVRON CORP. [~1003 April 30, 2002 Page 3 ChevronTexaco 12. Current assets $' N/A 13. Current liabilities $ N/A 14. Net working capital (subtract line 13 from line 12). $ N/A 15. 'Is line 14 at least 6 times line 3? $ N/A 16. Current bond rating of most recent bond issue ~ 17. Name of rating service Standard & Poors 1 $. Date of maturity of bond October Ii 2004 Yes N__~o 19. Have Financial statements for the latest fiscal year been filed with X the SEC, the Energy Information Administration, or the Rural Electrification Adminis~ation? I hereby certify that the wording of this letter is identical to the wording specified in 40 CFR pan 280.95(d) as such regulations were constituted on the date shown immediately below, except, that information concerning California and Louisifina was added to make disclosure more complete. i~ Wa~n ' ' ' -Vice President, Finance April 30, 2002 04/30/02 'rUE 14i01' [Tx/ILl NO 85601 Tt)E tZ:57 b'A,~ 1 415 894 5640 CHEVRON' CORP. April 30, 2002 Page 4 ChevronTexaco GUARANTEE Guarantee made this April 30, 2002, by CHEVRONTEXACO CORPORATION, a business entity organized under the laws of the Slate' of Delaware, herein referred to as guarantor, to EPA Regional Administrators. and/or state agencies implementing underground storage tank regulation for the states listed in Paragraph 2 (hereinafter collectively referred to as the "implementing agencies"), and to any and all third parties, and obligees, on behalf of CHEVRON U.S.A. INC. ("CUSA"), of 575 Market Street, San Francisco, CA. RECITALS 1. Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or(c) and (d) and agrees to comply with the requirements for guarantors as specified in 40 CFR 280.96Co). 2. CUSA owns or operates the following underground storage tanks covered by this guarantee underground storage tanks at various facilities in the states of: Alaska Arizona Califomia . Florida Georgia Hawaii Louisiana Nevada Oregon Texas Utah Washington This guarantee satisfies 40 CFR part 250,.subpart H requirements for assuring funding for taking corrective action and compensattng thtrd parUes for bodily injury and property damage caused by either' sudden accidental releases or nonsudden accidental releases or accidental releases arising from operating the ab0ve-ideatified underground storage tanks in the amount of $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate. 3.. On behalf of our subsidiary, CUSA, guarantor guarantees to implementing agencies and to any and all third parties that: In the event that CUSA fails to provide alternative coverage within 60 days after receipt of a notice of cancellation of this guarantee and the Director of the implementing agency has determined or 04/30/02 TUE 14:01 [TX/RX NO 8560] uJ,/3o/o2 TUE tV:58 .FAX t 4i5 894 5640 CHEVRON coRP. {~]005 - " April 30, 2002 Page5 ChevronTexaco suspects that a release has occurred at aa underground storage tank covered by this guarantee, the guarantor, upon instructions from the Director, Shall fund a standby trust fund in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. In the event that the Director determines that CUSA has failed to perform corrective action for releases arising out of the operation of the above-identified tanks in accordance with 40 CFR 280, subpart F, the guarantor upon'written instructions from the Director shall fund a standby trust in accordance with the provisions 'of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. If CUSA fails to satisfy a judgement or award based on a determination of liability for bodily injury or property damage to third Parties caused by sudden and/or nonsudden accidental releases arising from the operation of the above-identified tanks, or fails topay an amount agreed to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor, upon written instructions from the Director, shall fund a standby Wust in accordance with the provisions of 40 . CFR 280.108 to satisfy such judgement(s), award(s), or settlement agreement(s) up to the limits of coverage specified above. 4. Guarantor agrees that if, at the end of any f'~scal year before cancellation of this guarantee, the guarantor fails to meet the financial test criteria of 40 CFR 280.95(b) or (e) and (d), guarantor shall send within 120 days of such failure, by certified mail, notice to CUSA. The guarantee will terminate 120 days from the date of receipt 6f the notice by CUSA, as evidenced by the return receipt. 5. Guarantor agrees to notify' CUSA by certified mail of a voluntary or involuntary proceeding under · Title 11 (BankruPtcy), U.S. Code naming guarantor as debtor, within 10 days after commencement of the proceeding. 6. Guarantor agrees to remain bound under this guarantee notwithstanding any modification or alteration of any obligation of CUSApursuant to 40 CFR part 280. 7. Guarantor agrees to remain bound under this guarantee for so long as cusA must complYwith the applicable financial responsibility re.quirements of 40 CFR part 280, subpart H for the above- identified tanks, except that guarantor may cancel this guarantee by sending notice by certified mail to CUSA, such cancellation to become effective no earlier than 120 days after receipt of such notice by CUSA, as evidenced by the return receipt. 8. The guarantor's obligation does not apply to any of the following: . (a) Any obligation of CUSA under workers' compensation; disability benefits, or unemployment compensation law or other similar law; 04/30/02 TUE 14:01 [TX/RX NO 85601' ~4/au}u:z "vu~ Iz:5~ ~'AA ~'4i5 894 5640 CHEVRON CORP. ~006 April 30, 2002 Page 6 ChevronTexaco (b) Bodily injury to an employee of CUSA arising from, and in the course of, employment by CUSA; (c) :Bodily injury or property damage arising ~om the ownership, maintenance, use, or entrustment to'0thers of any aircraft, motor vehicle, or waterera~; (d) Property damage to any property owned, rented, loaned to, in the care, custody; or control of, or occupied by CUSA that is not the direct result of a release fa*om a petroleum underground storage tank; (e) Bodily damage or property damage for which CUSA is obligated to pay damages by reason of the assumption of liability in acontract or agreement other than a contract or agreement entered into to meet the requirements of 40 CFR 280.93. 9. Guarantor expressly waives notice of acceptance of this guarantee by the implementingagency, by any or all third parties, or by CUSA. I hereby certify that the wording of this guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. Effective date: April 30, 2002 CHEVRONTEXACO CORPORATION Vice President, Finance Assistant Secretal~ 04/30/02 TUE 14:01 [TX/RX NO 8560]' u4/:~u/uz TUg 12:5~ FAX l 415 8.9,4 5640 CHEVRON CORP. ~]007 "" April 30, 2002 Page 11 ChevrOnTexaco CERTllelCATION OF FINANCIAL RESPONSIBILITY CHEVRON U.S.A. INC. hereby certifies that it is in compliance with the requirements of subpart H of' 40 CFR part 280. The financial assurance mechanisms used to demonstrate financial responsibility under subpart H of 40 CFR part 280 are as follows: Financial test and Corporate guarantee of ChevronTexaco Corporation in the amount orS1 million per occurrence, $2 million annual aggregate, for the period commencing April 30, 2002 and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 2003. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. April 30, 2002 CHEVRON U.S.A. INC. //Judith L. Geisler Legal Analyst 04/30/02 TUE 14:01 [TX/RX NO 8560] April 17, 2002 Chevron 1125 Coffee FIRE CHIEF Bakersfield CA 93308 RON FRAZE ADMINISTRATIVE SERVICES RE: Necessary Secondary Containment Testing Required by December 31, 2002 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 REMINDER NOTICE FAX (661) 395-1349 SUPPRESSION SERVICES Dear Tank Owner/Operator: 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 The purpose of this letter is to inform you about the new provisions in California law FAX (661) 395-1349 requiring periodic testing of the secondary containment of underground storage tank systems. PREVENTION SERVICES 1715 Chester Ave. Senate Bill 989 became effective January 1, 2002. Section 25284.1 (California Health & Bakersfield, CA 93301 VOICE (661) 326-3951 Safety Code) of the new law mandates testing of secondary containment components FAX (661) 326-0576 upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary containment until they are detected and removed. ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 Secondary containment systems installed on or after January 1, 2001 shall be tested upon VOICE (661) 326-3979 installation, six months after installation, and every 36 months thereafter. Secondary FAX (661) 326-0576 containment systems installed prior to January 1, 2001 shall be tested by January 1, 2003. and every 36 months thereafter. TRAINING DIVISION ~ 5642 Victor Ave. Bakersfield, CA 93308 Secondary containment testing shall require a permit issued thru this office, and shall be VOICE (661) 399-4697 performed by either a licensed tank tester or licensed tank installer. FAX (661) 399-5763 Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at 661-326-3190. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/dm enclosures 8900 Shoal Creek I~lvd, Building 200 Austin, Texas 78757 Phone: (512) 451-6334 Fax: (512) 459-1459 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR STEVE UNDERWOOD 1715 CHESTER AVE., 3RD FLOOR BAKERSFIELD, CA. 93301 Test Date: 12/07/2001 Date Printed and Mailed: 12/28/2001 Order Number: 3119819 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CHEVRON 203576 1125 COFFEE RD. BAKERSFIELD, CA. 93308 Testing performed: Leak detector tests Monitor Certification Sincerely, Dawn Kohlmeyer Manager, Field Reporting CERTIFICATE OF UNDERGROUND STORAGE TANK SYSTEM TESTING 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST RESULT SITE SUMMARY REPORT TEST TYPE: TLD-1 PURPOSE: COMPLIANC~.. TEST DATE: 12/07/01 CUSTOMER PO: 4605253 WORK ORDER NUMBER: 3119819 CLIENT: CHEVRON U.S.A. SITE: CHEVIAON 203576 P.O. BOX 2292 1125 COFFEE RD. 145 S. STATE COLLEGE BLVD. BAKERSFIELD, CA 93308 BREA, CA 92822-2292 JUDY BOWE MANAGER (714) 671-3214 (661) 588-9066 The following test(s) were conducted at the site above in accordance with all applicable portions of Federal, NFPA and local regulations Line and Leak Detector Tests 92 i SUPREME Y P 87 2 REG b-RLEAD ¥ P 89 3 PLUS Y P Tanknology appreciates the opportunity to serve you, and looks forward to working with you in the future. Please call any time, day or night, when you need us. Tanknology representative: Services conducted by: KEN MINTON RICHMOND PHILLIPS .............. Reviewed: Technician Certification Number: 91-1071 Printed 12/28/2001 07:28 SBOWERS INDIVIDU -r= TANK INFORMATION AND Tt:ST RESULTS TEST DATE:12/07/01 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER3119819 CLIENT:cH~,~-RON O. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:CH~.~RON 203576 Tank ID: 92 i Tank manifolded: NO Bottom to top fill in inches: 165.0 Product: so-~n~ Vent manifolded: NO Bottom to grade in inches: ZT0.0 Capacity in gallons: 3.2,082 Vapor recovery manifolded: 3rEs Fill pipe length in inches: 54.0 Diameter in inches: 3.3.3.. 00 Overfill protection: ~s Fill pipe diameter in inches: 4.0 Length in inches: 292 Overspill protection: ¥'gs Stage I vapor recovery: DO~ Material: DW STEEL Installed: ATG Stage II vapor recovery: ~T.~C~. CP installed on: / / COMMENTS Start (in) End (in) Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced Dipped Product Level: L.D, #1 L,D, #1 L,D, #2 L,D. #2 Probe Water Level: Make: w~.e~.~oo~ Model: P.~..D. Ingress Detected: Water Bubble Ullage Test time: S/N: o~o5 Open time in sec: Inclinometer reading: Holding psi: VacuTect Test Type: NOT Resiliency cc: NOT VacuTect Probe Entry Point: TESTED Test leak rate mi/m: T~ST~D Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: Water table depth in inches: Results: p~ss Determined by (method): Result: COMMENTS COMMENTS Material: DW FIBERG Diameter (in): 2. o Length (fi): 3.00. o Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: ]~aE S SO-'aE Pump make: aED JACKET COMMENTS Impact Valves Operational: UNKNOW~ Printed 12/28/2001 07:28 INDIVIDUAT_ TANK INFORMATION AND"rl=ST RESULTS TEST DATE:12/07/01 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER3119819 CLIENT:CHEVRON U. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:ctt~.VRON 203576 Tank ID: 87 2 Tank manifolded: NO Bottom to top fill in inches: 166.0 Product: REG ~ Vent manifolded: NO Bottom to grade in inches: 171.0 Capacity in gallons: 12,082 Vapor recovery manifolded: ~s Fill pipe length in inches: 55.0 Diameter in inches: 111.00 Overfill protection: ~s Fill pipe diameter in inches: 4.0 Length in inches: 292 Overspill protection: ~z'gs Stage I vapor recovery: DUAL Material: DW S'I~I~.L Installed: ATG Stage II vapor recovery: CP installed on: / / COMMENTS Start (in) End (in) II Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced Dipped Product Level: L.D. #1 L.D. #1 L.D. #2 L.D. #2 Probe Water Level: Make: VEEDEP~OOT Model: P.L.D. Ingress Detected: Water Bubble Ullage Test time: S/N: o~.3e~ Open time in sec: Inclinometer reading: Holding psi: VacuTect Test Type: NOT Resiliency cc: NOT VacuTect Probe Entry Point: TESTED Test leak rate mi/m: TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: Water table depth in inches: Results: ~xss Determined by (method): Result: COMMENTS COMMENTS Material: DW FIBERG Diameter (in): 2. o Length (fi): 100.0 , Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: P~.Es SURE Pump make: RED JACKET COMMENTS Impact Valves Operational: Printed 12/28/2001 07:28 I INDIvIDU TANK INFORMATION AND REsULTs TEST DATE: 12/0"//01 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER31198[9 CL)ENT:CH~..VRON O. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:cI-I~..VRON 203576 Tank ID: 89 3 Tank manifolded: No Bottom to top fill in inches: 165.0 Product: PT,US Vent manifolded: No Bottom to grade in inches: 170.0 Capacity in gallons: 12,082 Vapor recovery manifolded: YEs Fill pipe length in inches: 54.0 Diameter in inches: 11-1.00 Overfill protection: Y~s Fill pipe diameter in inches: 4.0 Length in inches: 292 Overspill protection: Ms Stage I vapor recovery: DUAL Material: DW STJ~.T, Installed: ATG Stage II vapor recovery: BA~.~NC~. CP installed on: / / COMMENTS Start (in) End (in) I Dipped Water Level: New/passed , Failed/replaced New/passed Failed/replaced Dipped Product Level: L.D. #1 L.D. #1 L.D. #2 L.D. #2 Probe Water Level: Make: VZ~.D~.~OOT Model: P. ~..D. Ingress Detected: Water Bubble Ullage Test time: S/N: 013652 Inclinometer reading: Open time in sec: Holding psi: VacuTect Test Type: NOT Resiliency cc: NOT VacuTect Probe Entry Point: ~'~STSD Test leak rate mi/m: TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS Material: DW ~'TB~,R(~ Diameter (in): 2.0 Length (ft): 100.0 Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: R~D JACKET COMMENTS Impact Valves Operational: Tu-~OT~ Printed 12/28/2001 07:28 j~[ Use By All Ju#sdic~ons Within the State of Califoj~ Authority Cited: Chapter 6.7~lth and Safety Code; Chapter 16, Division 3 Title 2~afifornia Code of Regulations This form must be used to document testing and servicing of monitoring equipment. If moro than one monitoring system control panel is installed at the facility, a separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: CHEVRON 203576 City: BAKERSFIELD CA Zip: 93308 Site Address: 1125 COFFEE RD. Contact Phone No:588-9066 Date of Testing/Service: 12/07/2001 Facility Contact Person: MANAGER Make/Model of Monitoring System: TLS-350 Work Order Number: 3119819 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced  nk ID: Tank ID: 2 In-Tank Gauging Probe. Model: MAG-1 'X-J in-Tank Gauging Probe. Model: MAG-1 Annular Space or Vault Sensor. Model: 420 X---'J Annular Space or Vault Sensor. Model: L-3 RONAN Piping Sump/Trench Sensor(s). Model: 208 X---] Piping Sump/Trench Sensor(s). Model: 208  Fill Sump Sensor(s). Model: --'J Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: ~ Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: PLLD [] Electronic Line Leak Detector. Model: PLLD J ~ Tank Overfill/High-Level Sensor. Model: MAG-1 J~={ Tank Overfill/High-Level Sensor. Model: MAG-1 [] Other (specify equipment type and model in Section E on page 2). ~J Other (specify equipment type and model in Section E on page 2). ~ In-Tank Gauging Probe. Model: MAG-1 JJ~J In-Tank Gauging Probe. Model:  Annular Space or Vault Sensor. Model: 4;~0 j'~ Annular Space or Vault Sensor. Model: Piping Sump/Trench Sensor(s). Model: 208 N Piping SumpFFronch Sensor(s). Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector.' Model: Electronic Line Leak Detector. Model: PLLD ~J Electronic Line Leak Detector. Model:  Tank Overfill/High-Level Sensor. Model: MAG-1 Tank Overfill/High-Level Sensor. Model: Other (specify equipment type and model in Section E on page 2). '-1 Other (specify equipment type and model in Section E on page 2). Dispenser lO: 1/z ulspenser IL): ll~ 'Z=J Dispenser Containment Sensor(s) Model: 406 ~CJ Dispenser Containment Sensor(s) Model: 406 ~ Shear Valve(s). '~J Shear Valve(s) !J-'--J Dispenser Containment Float(s)and Chain(s). j~ Dispenser Containment Float(s)and Chain(s). ulspenser IL): JU~spenser IL): ~/lU [] Dispenser Containment Sensor(s) Model: 406 NOT WORKING ._J~. Dispenser C~nta~ment Sensor(s). Model: 406 [] ShearValve(s). [] ShearValve(s). 'J~J Dispenser Containment Float(s) and Chain(s). j"--J Dispenser Containment Float(s) and Chain(s). Dispenser ID: 5/..~6 L~spenser ID: 11/12 [] Dispenser Containment Sensor(s) Model: 406 .L~_J Dispenser ~ ~. Model: 4_06 [] ShearValve(s). ~ ShearValve(s). I['--J Dispenser Containment Float(s) and Chain(s). [] Dispenser Containment Float(s) and Chain(s). * If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this certification is information (e.g manufacturers' checklists) necessary to verify that this information is correct. and a Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, have also attached a copy of the (Check all that apply): System set-up report; J-'Z-J Alarm history report J~J PRINTED NAME:RICHMOND PHILLIPS SIGNATURE: COMPANY: Tanknology PHONE NO: (800) 800-4633 page 1 of 3 Based on CA form dated 03/01 /,=, - '~ )nitoring System Certification Site Address: 1125 COFFEE RD. Date of Testing/Service: 12/07/2001 D. Results of Testing/Servicing Software Version Installed: rl/a Complete the following checklist: r,j~ 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? Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not [] Yes [] No * interfere with their proper operation? [] Yes [] No* [] N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment [] Yes [] No * [] 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 confirm positive shut-down due to leaks and sensor failure/disconnection? [] Yes [] No I [] Yes [] No * [] N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.: no mechanical overfill prevention valve is installed), is the overt'ill warning alarm visible and audible at the tank fill points(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger?. % [] Yes* [] No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. [] Yes* [] No Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) [] Product; [] Water. If yes, describe causes in Section E, below. [] Yes [] No * Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. [] Yes [] No * IS all monitoring equipment operational per manufacturers' specifications? · In Section E below, describe how and when these deficiences were or will be corrected. E. Comments: replaced unl annular sensor, water was in turbine sumps, disp 3/4 controller on stand alone sensor doe not work needs to be replaced. page 2 of 3 onit°ring System CertifiCation Site Address: 1125 COFFEE RD. Date ,of Testing/Service: 12/07/2001 F. In-Tank Gauging / SIR Equipment [] Check this box if tank gauging is used only for inventory control. [] Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: [] Yes [] No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? [] Yes [] No * Were all tank gauging probes visually inspected for damage and residue buildup? [] Yes [] No* Was accuracy of system product level readings tested? []Yes []No* Was accuracy of system water level readings tested? [] Yes []No* Were all probes reinstalled properly? [] Yes [] No* Were all items on the equipment manufacturers' maintenance checklist completed? · In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): [] Check this box if LLDs are not installed. Complete the following checklist: For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? [] Yes [] No* [~]N/A (Check all that apply) Simulated leak rate: [] 3 g.p.h [] 0.1 g.p.h r---~0.2 g.p.h [] Yes [] No * Were all LLDs confirmed operational and accurate within regulatory requirements? [] Yes [] No * Was the testing apparatus properly calibrated? [] Yes [] No * [] N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? [] Yes []No * [] N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? [] Yes [~No * [] N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? [] Yes []No * [] N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? [] Yes []No* [] N/A For electronic LLDs, have all accessible wiring connections been visually inspected? [] Yes ~ ~--~No * Were all items on the equipment manufacturers' maintenance checklist completed? · In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: page 3 of 3 SITE DIAGRAM 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 12/07/01 WORK ORDER NUMBER3119819 CLIENT:CHEVRON U.S.A. SITE: CHEVRON 203.676 C-STORE ~1 Printed 12/28/2001 07:28 SBOWERS UST Agency: City of Bakersfield STEVE R THORNE, INC. 91536 3 Party 2~700 OSWELL ST BAKERSFIELD,. CA 93306-2702 (661) 871-1200 CHEVRON STATIONSiNC#1920 98109 Co-Op 1131 OAK ST. BAKERSFIELD, CA 93304-1063 (661) 324-7621 STEVEN R. THORNE,INC. ' 99702 3 Party 5201 OLIVE DR BAKERSFIELD, CA 93308-2919 (661) 399-9056 CHEVRON STATIONS INC.1830 201527 Co-Op 6601 MING AVE BAKERSFIELD, CA 93309:3446 (661) 831-1270 LUBE MANAGEMENT CORP 201921 3 Party 6601 MING AVE BAKERSFIELDi CA 93309-3446 .CHEVRON STATIONS INC#1842 203576 Co-Op. 1125 COFFEE RD BAKERSFIELD, CA 93308-5747 (661) 588-9066 CHEVRON STATION INC 1857 205673 Co-Op 13003 ROSEDALE HWY BAKERSFIELD, CA 93312-0000' (661) 587-9593 CHEVRON STATIONS INC 1849' 206561 Co-Op 3360 PANAMA LN BAKERSFIELD, CA 93313-3695 (661) 396-7047 Chevron .~ Chevron Products Company, Inc. PO Box 6004 San Ramon, CA 94583-0904 APril 30, 2001 Carmelita Garcia' Licenses/Permits Specialist Phone No. 925-842-9002 Fax No. 925-842-9585 City of Bakersfield " Fire Department 1715 Chester Avenue, Third Floor Bakersfield, CA 93301 RE: FINANCIAL RESPONSIBILITY FOR UNDERGROUND STORAGE TANKS Dear Sirs: Please find enclosed the following documents: !) Proof of Financial Responsibility 2) Certificate of Financial Responsibility 3) Chevron Facility List under your jurisdiction These documents meet the financial resPonsibility requirements for all USTs owned by Chevron 'and have previously been submitted directly to the State. If you have any questions feel free to contact me. Sincerely, Carmelita P. Garcia Licenses/Permits Specialist Permit Desk Enclosure: as stated Chevron Chevron Corporation 575 Market Street' San Francisco, CA 94105-2856 John $. Watson Vice President, Finance April 23,2001 UST FINANCIAL ASSURANCE To Whom It May Concem: I am the Chief FinanCial Officer of Chevron Corporation, 575 Market Street, San Francisco, CA. This letter is in support of the use of the financial test of self-insurance and. guarantee to demonstrate financial responsibility for taking corrective action and compensating third parties for bodily injury :.and property damage caused by sudden accidental releases and/or nonsudden accidental releases in the amount of at least $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate arising from .operating underground storage tanks. · Underground storage tanks at the folloWing facilities are assured by this financial test or a financial test under an authorized State program by this guarantor -- all underground stOrage tanks owned by Chevron U.S.A. Inc. in the Un/ted States are assured by this financial test. A financial test and guarantee are also used by this guarantor to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271. and 145: EPA REGULATIONS AMOUNT Ciosure ({}{}264.143 and 265.143) $ 116,960,130.00 Post-Closure Care ({}{}264.'145 and 265.145) $ 56,990,555.00 Liability Coverage ({}{}264.147 and 265.147) $ 8,000,000.00 Corrective Aktion ({}264.101 (b)) $ -0- Plugging and Abandonment ({} 144.63) $ -0- 145631 / F:~JULMB4DB01 !.DOC California State Progr~ Closure ' $ 202.890.00 ' Post-Closure Care ' $ 719,850.00 Liability Coverage $ 66.000.000.00 Corrective Action $ '-0- .Plugging and Abandonment $ -0- Louisiana State Program Closure $ . 4,808,560.00 Post-Closure Care $ 826,500.00 Liability Coverage ' $ 1,000,000.00 Corrective Action $ -0- Plugging and Abandonment $ -0- Total $ 255,508,485.00 This guarantor has not received an adverse Opinion, a disclaimer of oPinion, or a "going concem" qualification from an independent auditor on his financial statements for the latest completed fiscal year. Page 2 of.4 ' ALTERNATIVE II 1. Amount of annual UST aggregate coverage being assured by · $ 2,000,000.00 a'test and guarantee 2.~ Amount of corrective action, closure and post-closure care $ 255.508,485.00 costs, liability, coverage, and plugging and abandonment "costs covered by a financial test and guarantee 3. Sum of lines 1 'and 2 $ 257.508,485.00 4'. Total tangible assets $ 41,116,000,000.00 5. Total liabilities $ 21,339.000,000.00 6. Tangible net worth $ 19,777,000,000.00 7. Total assets in the U.S. $ 20,673,000,000.00 Ye~ No 8. Is line 6 at least $10 million? X 9. Is line 6 at least 6 times line 3? X 10. Are least 90% of assets located inthe U.S.? X (If"No", complete line 11.) 11. Is line 7 at least 6 times line 3? X 12. Current assets $ N/A 13. Current liabilities $ N/A 14. Net working capital (subtract line 13 from line 12). $ N/A 15. Is line 14 at least 6 times line 3? $ N/A 16. Current bond rating of most recent bond issue AA ~ -7 Name of rating service Standard & Poors 18. Date of maturity of bond October 1, 2004 __ Page 3 Of 4 Yes No 19. Have financial statements for the latest fiscal year been filed X · with the SEC, the Energy Information Administration, or the Rural Electrification Administration? I hereby certify that the wording of this letter is identical to the wording specified in 40 CFR part 280.95(d) as such regulations were constituted on the date shown immediately below, except that information concerning California and Louisiana was added' to make disclosure more complete. Vice President, Finance April 23, 2001 Page 4 of 4 GUARANTEE Guarantee made this-April 23, 2001, by CHEVRON CORPORATION, a business enti¢' organized under the laws of the State of Delaware, herein referred to as guarantor, to EPA Regional Administrators and/or state agencies implementing underground storage tank regulatiOn for the states listed in Paragraph 2 (hereinafter collectively referred to as the ,implementing agencies"), and to any and all third, parties, and'obligees, on behalf of CHEVRON U.S.A. INC. ("CUSA"), of 575 Market Street, San Francisco, CA. RECITALS 1. Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d) and ' agrees to comply with the requirements for guarantors as specified in 40 CFR 280.96(b).. 2. CUSA owns or operates the following undergroUnd storage tanks covered bY this guarantee., underground storage tanks at various facilities in the states of: Alaska Louisiana Arizona Nevada Califomia Oregon Florida Texas Georgia Utah Hawaii Washington This guarantee' satisfies 40 CFR part 280, subpart H requirements for assuring funding for taking corrective action and compensating third parties for bodily injury and property damage caUSed by either sudden accidental releases or nonsudden accidental releases or accidental releases arising from operating the above-identified underground storage tanks in the amount of $1,000,000.00 per occurrence and $2,000,000~00 annual, aggregate. 3. On behalf of our subsidiary, CUSA, guarantor guarantees to implementing agencies and to any and all third parties that: In the event that 'CUSA fails to provide altemative coverage within 60 days after receipt of a notice of cancellation of this guarantee and the Director of the implementing agency has determined or suspects that a release has occurred at an underground storage tank covered by this guarantee, the guarantor, upon instructions from the Director, shall fund a sta::dby trust fund in accordance with th6 provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. I~ d~e event that the Director determines that C'USA has failed to perform corrective action for releases arising out of the operation of the .above-identified tanks in accordance with ' -'. .......... 4OCFR 280, subpart F, the guarantor upon written instructions from the Director shall fund a · Page 1 of 3 standby trust in' accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. If CUSA fails to satisfy a'judgement or award based on a determination of liability for bodily injury or property damage to third parties caused by sudden and/or nonsudden accidental releases arising from the operation of the above-identified tanks, or fails to pay an amoUnt agreed to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor, upon written instructions from the Director,. shall fund a standby trust in accordance w/th the provisions of 40 CFR 280.108 to satisfy such judgement(s), award(s), or settlement agreement(s) up to the limits of coverage specified above. 4. Guarantor agrees that if, at the end of any fiscal year before cancellation of this guarantee, the guarantor fails to meet the financial test criteria of 40 CFR 280.95(b) or (c) and (d), guarantor ~ shall send within 120 days of such failure, by certified mail, notice to CUSA. The guarantee will terminate 120 days from the date of receipt of the notice by CUSA, as evidenced by the remm receipt. 5. Guarantor agrees to notify CUSA by certified mail of a voluntary or involuntary proceeding under Title 11 (Bankruptcy), U.S. Code naming guarantor as debtor, within 10 days after commencement of the proceeding. 6. Guarantor agrees to remain bound' under this' guarantee notwithstanding any modification or alteration of any obligation of CUSA pursUant to 40 CFR part 280. 7. Guarantor agrees to remain bound under this guarantee for so long as CUSA mUst comply with the applicable financial responsibility requirements of 40 CFR part 280, subpart H for the above-identified tanks, except that guarantor may cancel this guarantee by sending notice by' 'certified mail to CUSA, such cancellation to become effective no,earlier than 120 days after receipt of such notice by CUSA, as evidenced by the remm receipt. 8.- The guarantor's obligation does not apply to any of the following: (a) Any obligation of CUSA under workers' compensation, disability benefits, or unemployment compensation law or othersimilar law~ (b) Bodily injury to an employee of CUSA arising from, and in the course of, employment by CUSA; (c) Bodily injury or property damage arising from the ownership, maintenance, use, or entrustment to others of any aircraft, motor vehicle, or watercraft; (d) Property, damage, to any property oWned, rented, loaned to,. in the care, custody, or control of, or occupied by CUSA that 'is not the direct result of a release from a petroleum underground storage tank; Page 2 of 3 (e) Bodily d .amage Or property damage for which CUSA is obligated to. pay damages by reason of the assumption of liability in a contract or agreement other than a contract or agreement entered into to meet the requirements of 40 CFR 280.93. 9. 'Guarantor expressly waives notice of acceptance of this guarantee by the implementing agency; .by any or all third parties, oi' by CUSA. I hereby certify that .the wording of ~his guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. 'Effective date:~ April 23, 2001 CHEVRON CORPORATION iceS. Watson President, Finance Assistant Secretary · Page 3 of 3 CERTIFICATION OF FINANCIAL RESPONSIBILITY CHEVRON U.S.A. INC. hereby certifies that it is in compliance with the requirements of subpart H of 40 CFR part 280. The financial assurance mechanism used to demonstrate financial responsibility under subpart H of 40 CFR part 280 is as follows: Corporate guarantee of Chevron Corporation in the amount of $1' million per occurrence, $2million annual aggregate, for the period commencing. April 18, 2001 and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 2002. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. April 18,2001 CHEVRON U.S.A.' INC. Counsel Judith L.~ Geisler Legal Analyst CUSA UST FINANCIAL RESPONSIBILITY April 23, 2001 bcc: J.M. Baue/' L. T. Brown J. P'. Casey R. Cochran H. P. DaVis Jr. K.J. Diaz A. G. Fredeluces C. P. Garcia (2 copies) M. Leong P. T. Liang S. E. Merritt A. R. Mora D. A. Newell I. O. Ng W. C. Ishimoto J. M. Randall A. M. Rutter D. T. Sherman S. W. Strader Arizona Dept. of Environmental Equality UST Section Attention Brian Kelley (replaced Jeff Schmidt) 3033 N Central Avenue Phoenix, AZ 85012 (602) 207-2214 April 30, 2001 RE: - CERTIFICATE OF FINANCIAL RESPONSIBILITY FOR UNDERGROUND TANKS- To Whom It May Concern: Chevron Corporation hereby certifies that it is in compliance with the requirements of Underground Storage Tank financial responsibility regulations. This certificate covers all tanks in the States of California, Alaska, Arizona, Florida, Georgia, Hawaii, Louisiana, Nevada, New Mexico, Oregon, Texas, Utah and Washington owned by Chevron Corporation. The financial assurance mechanism used to demonstrate financial responsibility required under State and Federal regulations is as follows: Corporate guarantee of Chevron is the amount of $1Million per occurrence, $2 Million annual aggregate.. Said guarantee covers taking corrective action And compensating third parties for bodily injury and property damage caused By either sudden accidental releases and non sudden accidental releases or Accidental releases. This guarantee is renewed annually (within the first 120 days of the year): Copies of the renewed certificate and a complete list of the facilities' are sent to the governing agencies yearly. Sincerely, By: '~a Licenses/Permits Specialist ~~~!'i ot z d y: Susan R. Weber, Notary April 30, 200l. RE: - CERTIFICATE OF FINANCIAL RESPONSIBILITY FOR UNDERGROUND TANKS- T° Whom It May Concern: Chevron Corporation hereby certifies that it is in compliance with the requirements of " Underground Storage Tank financial responsibility regulations. This certificate covers all . tanks in the States of California, Alaska, Arizona, Florida, Georgia, Hawaii, Louisiana, Nevada, New Mexico, Oregon, Texas, Utah and Washington owned by Chevron Corporation. The financial assurance mechanism used to demonstrate financial responsibility required under State and Federal regulations is as follows: Corporate guarantee of Chewon is the amount of $1Million per occurrence, $2 Million annual aggregate. Said guarantee covers taking corrective action And' compensating third parties for bodily injury and property damage Caused By either sudden accidental releases and non sudden accidental releases or Accidental releases. ' .- This guarantee is renewed annually (within the first 120 days of the year). Copies of the renewed certificate' and a complete list of the facilities are sent to the governing agencies yearly. Sincerely, Notarized by: '~~L4,A~/~ ~ Susan R. Weber, Notary ~ ~._._..,.~ Mi~i~NITOR SYSTEM CERTIFIC~iiii~ON ~ TANKNOLOGY Test Date: 12/12/2000 Work Order #: 3114793 Client: CHEVRON U.S.A, Site: CHEVRON 203576 P.O, BOX 2292 1!25 COFFEE RD, BREA, CA, 92822 BAKERSFIELD, CA, 93308 Overall System Operation The pumps; Shut down automatically ff the system detects a leak, fails to operate, or is electronically disconnected. [ X ] Yes [ ] No The system has functioning audible and visual alarms. [ X ] Yes [ ] No The circuit breaker for the system is properly identified. [ X ] Yes [ ] No The system is certified operational per manufacturer's performance standards. [ X ] Yes [ ] No Product Tank Monitoring: [ X ] Double wall [ ] Single wall Make: VEEDER-ROOT Model: SINGLE Type: ANNULAR SPACE LIQUID How many: 3 Operational: [ X ] Yes [ ] No (Automatic tank gauge, annular space vapor probe, annular space liquid probe, hydroguard system, vadose zone monitor well, groundwater monitor well) Comments: 3 ATG's operational Product Piping Monitoring: [ X ] Double wall [ ] Single wall Make: VEEDER-ROOT Model: PLLD Type: ELECTRONIC LINE How many: 3 Operational: [ X ] Yes [ ] No (Piping sump liquid sensor, piping trench liquid sensor, electronic line pressure sensor, mechanical line leak detector) Comments: 3 turbine sump sensors operational. Other Monitoring Systems: Make: Model: BEAUDREA Type: SUMP LIQUID S~NSOR How many: 6 Operational: [ X ] Yes [ ] No Comments: 'dispenser sump sensors stand alone type. ~.!r .. /,.7~:.-,::>.~:-,~' %:~........o:. / ................ Technician: STEVEN SCOTT BAUGHN Technician Signature: SITE DIAGRAM 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 12/12/00 WORK ORDER NUMBER3114793 CLIENT:CHEVRON U.S.A. SITE: CHEVRON 203576 C-STORE Printed 01/03/2001 08:18 R JOHNSON C.S.I.CHEVRON 1'842 1125 COFFEE RD. BAKERSFIELD ,CA. 93:31 '2 8o5--5a8-9o6~ DEC;~ 5. 2000 1:51 SYSTEPI STATUS REPORT ALL FUNCTIONS NORNAL INVENTORY REPORT T 1 :SUPREI"IE VOLUPI£ = '-'59';~ ~ (gALS ULLAGE = 7489 GALS: 90~-':'-ULLaGE= 6480 ,:gALS .,AL,_, T(~ )LUME = 2580 (-'" o HE'r,~/-rI' = 29. ?8 INCHES WATER VOL = 0 GALS :--WATER ...... =~ :.c3~ :~¢I N(?HES -~ TEP1P = 66.5 DEG F T 2 :PLUS VOLUP1E = 3183 GhLS ', ULLAGE = 6898 (gALS 90~; ULLAGE= 5889 GALS ' TC VOLUP1E = 3168 GALS HEIGHT = 34.51 INCHES WATER VOL = 0 GALS WATER = O. O0 INCHES TEP1P = 6E,.4 DEG F VOLUP1E = 5498 (gaLS ULLAGE = 458:3 GaLS 90~-~' ULLAGE= 35?4 GALS TC VOLUP1E= 5473 (_,aLo ..... HEIGHT = 51.81 INCHES WATER VOL = 0 GaLS , WATER = O. O0 INCHES ~ TE[',lP = E, 6.4 DEG F ~ ~ ~ ~ ~ END ~ :~ ~ ~ ~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME C~LCvOvx 6~lrtO~x INSPECTION DATE I g { ADDRESS i l~ (~o~ae PHONENO. 5~'-qOfib FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [] Routine ~ Combined [~l Joint Agency [~l Multi-Agency [] Complaint 1~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand V / Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials ~, /' Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: [] Yes Explain: Questions regarding this inspection? Please call us at (661) 326-3979 Business Site,gesponsible Party White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: ~//~ .. CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME Clx¢OtO~x. ,~Jtto~ INSPECTION DATE Iol{O.~[(lO Section 2: Underground Storage Tanks Program [] Routine [~ Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank _l~t}~ Number of Tanks ~ Type of Monitoring C~/- gA. Type of Piping lfiO3 ~ OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit tees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations t,/ Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY' Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance Inspector: . Office of Environmental Services (805) 326-3979 Business Site Responsible Party White - Env. Svcs. Pink - Business Copy PROGRAM CONSOLIDATED TANKS UNDERGROUND STORAGE TANKS - FACILITY (one page per site) Page 1 of 1 TYPE OF ACTION [] 1. NEW SITE PERMIT [] 3. RENEWAL PERMIT [] 5.CHANGE OF INFORMATION [] 7.PERMANENTLY CLOSED SITE (Check one item only) [] 4. AMENDED PERMIT specify change local use only [] 8. TANK REMOVED [] &TEMPORARY SITE CLOSURE 400 I. FACILITY / SITE INFORMATION BUSINESS NAME (s FACILITYNAMEorDBA-DoingBusi As) 3 ] FACILITY ID# .... .... 0 O M 0I 0 0 : Chevron Station #203576 0 0 NEAREST CROSS STREET 401 FACILITY OWNER TYPE [] 4. LOCAL GENCY/DISTRICT* 1125 COFFEE ROAD ~BRIMHALL 93308 [] I. CORPORATION [] 5. COUNTY AGENCY* BUSINESS [] 1. GAS STATION [] 3. FARM [] 5. COMMERCI,~L [] 2. INDIVIDUAL [] 6. STATE AGENCY* TYPE [] 2. DISTRIBUTOR [] 4. PROCESSOR [] 6. OTHER 403 [] 3. PARTNERSHIP [] 7. FEDERAL AGENCY* 402 TOTAL NUMBER OF TANKS Is facility on Indian Reservation or *If owner of UST is a public agency: name of supervisor of division, section or office which REMAINING AT SITE trustlands? operates the UST (This is the contact person for the tank records.) 3 [] Yes [] No 405 406 II. PROPERTY OWNER INFORMATION PROPERTY OWNER NAME ao? PHONE Chevron Products Company, Attn: Permit Desk 925-842-9002 MAILING OR STREET ADDRESS 409 P.O. Box 6004 CITY 4~0 STATE 411 I ZIP CODE 412 San Ramon CA [ 94583 PROPERTY OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY [] 3. PARTNERSHIP [] 5. COUNTM AGENCY [] 7. FEDERAL AGENCY 413 III. TANK OWNER INFORMATION TANK OWNER NAME 4~4 PHONE 4is Chevron Products Company, Attn: Permit Desk 925-842-9002 MAILING OR STREET ADDRESS 416 P.O. Box 6004 CITY 4~7 ] STATE 4~8 ] ZIP CODE 419 San Ramon I CA I 94583 TANK OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY 420 [] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL AGENCY IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER TY (TK) HQ 44- I 0 I 3 [ 1 { 9 I' 1 { 3 { Call(916) 322-9669 if questions arise 421 V. PETROLEUM UST FINANCIAL RESPONSIBILITY INDICATE METHOD(s) [] 1. SELF-INSURED [] 4. SURETY BOND [] 7. STATE FUND [] 10. LOCAL GOVT MECHANISM [] 2. GUARANTEE [] 5. LETTER OF CREDIT [] 8. STATE FUND & CFO LETTER [] 99. OTHER: __ [] 3. INSURANCE [] 6. EXEMPTION [] 9. STATE FUND & CD , . 422 VI. LEGAL NOTIFICATION AND MAILING ADDRESS Check one box to indicate which address should be used for legal notifications and mailing. Legal notifications and mailings will be sent to the tank owner unless box 1 or 2 is checked. [] 1. FACILITY [] 2. PROPERTY OWNER [] 3. TANK OWNER 423 VII. APPLICANT SIGNATURE Certification~I.,,r/certify that the information ~rovided.~./herein is true anj,c~accurate to the best of m, knowledge. SIGN~[/U~CANT ~__~./~~ DATE 424 I PHONE 425 04/26/2000 562-694-9195 NAME OF APPLICANT (print) - ~ 426 TITLE OF APPLICANT 427 Chevron Products ~Company/RES~I . ' Retail ESH Specialist STATE UST FACILITY NUMBER (For local use only) 428 1998 UPGRADE CERTIFICATE NUMBER (For local use only) I 429 UPCF (1/99 revised) 171 Formerly SWRCB Form A PROGRAM CONSOLIDATED TANKS UNDERGROUND STORAGE TANKS ' TANK PAGE 1 (two pages per tank) Page I of 6 TYPE OF ACTION [] 1 NEW SITE PERMIT [] 4 AMENDED PERMIT [] 5 CHANGE OF INFORMATION [] 6 TEMPORARY SITE cLOsuRE (Check one item only) [] 7 PERMANENTLY CLOSED ON SITE [] 3 RENEWAL PERMIT (Specify reason- for local use only) (Specify reason- for local use only) [] 8 TANK REMOVED 430 BUSINESS NAME(s .... FACILITY NAMEorDBA-DoingBusi .... As) 3 0 0 ~[ 0 [ 0 0 711!17~7'I 0 0 0 0 0 0 1 Ch'evron Station #203576 FACILITY ID: I '! I LOCATION WITHIN SITE (Optional) 431 I. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be subrhitted to the local agency.) TANK ID # 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK [] Yes [] No 434 1 JOOR ~f "Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 02/17/94 12,000 0 ADDITIONAL DESCRIPTION (For local use only) 438 II. TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 [] 1. MOTOR VEHICLE FUEL [] la. REGULAR UNLE~ADED [] 2. LEADED [] 5. JET FUEL (If marked complete Petroleum Type) [] lb. PREMIUM UNLEADED [] 3. DIESEL [] 6. AVIATION FUEL [] 2. NON-FUEL PETROLEUM [] lc. MIDGRADE UNLEADED [] 4. GASOHOL [] 99. OTHER __ [] 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS# (from Hazardous Materials Inventory page ) 442 [] 4. HAZARDOUS WASTE (lnc~ude~ Used Ut0 REGULAR UNLEADED 800-61-9 [] 95. UNKNOW~ III. TANK CONSTRUCTION TYPE OF TANK [] 1. SINGLE WALL [] 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) EXTERIOR MEMBRANE LINER [] 95. UNKNOWN [] 2. DOUBLE WALL [] 4. S1NGLE WALL IN VAULT [] 99. OTHER __ TANK MATERIAL - primary tank [] 1. BARE STEEL [] 3. FIBERGLASS / PLASTIC [] 5. CONCRETE · [] 95. UNKNOWN 444 (Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPATIBLE W/100% METHANOL [] 99. OTHER REINFORCED PLASTIC (FLIP) TANK MATERIAL -secondary tank [] !. BARE STEEL [] 3. FI[SERGLASS / PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 445 (Check one item only) [--12. STAINLESS STEEL []4. STEEL CLAD W/FIBERGLASS []8. FRP COMPATIBLE W/I 00% METHANOL []99. OTHER REINFORCED PLASTIC (FPP) [] 10. COATED STEEL [] 5. ~CONCRETE TANK INTERIOR LINING [] 1. RUBBER LINED [] 3. EPOXY LINING [] 5. GLASS LINING [] 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING ' [] 2 ALKYD LINING~ [] 4 PHENOLIC LINING [] 6 UNLINED [] 99 OTHER (Check one item only) (For local use only) 448 448 OTHER CORROSION [] I MANUFACTURED CATHODIC [] 3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN PROTECTION he APPLIC~BLE PROTECTION [] 4 IMPRESSED CURRENT [] 99 OTHER (Check one item only) [] 2 SACKIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (local use only) 451 (~VERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all that apply) [] I SPILL CONTAINIVIENT 1994 [] I ALARM [] 3 FILL TUBE SHUT OFF VALVE ~ [] 2 DROP TUBE 1998 OPW 61-SO-4 [] 2 BALL FLOAT [] 4 EXEMPT [] 3 STroKER PLATE Tank Mfg IV. TANK LEAK DETECTION (^ description of the monitoring program shall be submitted to the local agency) IF SINGLE WALL TANK (Check all that apply) 453 1F DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one item only) [] I VISUAL (EXPOSED PORTION ONLY) [] 5 MANUAL TANK GAUGING (MIG) [] I VISUAL (SINGLE WALL IN VAULT ONLY) [] 2 AUTOMATIC TANK GAUGING (ATG) [] 6 VADOSE ZONE' [] 2 CONIINUOUS INTERSTITIAL MONITORING [] 3 CONTINUOUS ATG [] 7 GROUNDWATER [] 3 MANUAL MONITORING [] 4 SIATISTICAL INVENTORY RECONCILIATION [] 8 TANK TESTING (SIR) BIENNIAL TANK TESTING [] 99 OTHER IV. TANK CLOSURE INFORMATION / PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (yR/Mo/DAY) 455 I ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERI MATERIAL.9 457 gallons [] Yes [] No UPCF (1/99revised) 173 Formerly SWRCB Form B PROGRAM CONSOLIDATED TANK UNDERGROUND STORAGE TANK PAGE 2 VI. PIPING CONSTRUCTION (Check all that apply) Page 2 of UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE [] 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY 45g [] 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY 459 CONSTRUCTION [] 1. SiNGLE WALL [] 3. LINED TRENCH [] 99. OTHER 460 [] 1. SiNGLE WALL [] 95. UNKNOWN 462 MANUFACTURER [] 2. DOUBLE WALL [] 95. UNKNOWN - [] 2. DOUBLE WALL [] 99. OTHER MANUFACTtr~, R AO Smith 461 t,~NUFAcTURER__ 463 [] 1. BARE STEEL [] 6. FRP COMPATIBLE w/loo% METHANOL [] 1. BARE STEEL [] 6. FPP COMPATIBLE W/10o% METHANOL [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] Unknown [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 99. Other [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 8. FLEXIBLE (HDPE) [] 99. OTHER [] 4. FIBERGLASS [] 8. FLEXIBLE (HDPE) [] 4. FIBERGLASS [] 9. CATHODIC PROTECTION [] 5. STEEL W/COATING [] 9. CATHODIC PROTECTION 464 [] 5. STEEL W/COATING [] 95. UNKNOWN 465 VII. PIPING LEAK DETECTION (Check all that apply) (A description of the monitoring program shall be submitted to the local agency.) UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP · OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. AUDIBLE AND VISUAL ALARMS. [] 2. MONTHLY 0.2 GPH TEST [] 2. MONTHLY 0.2 GPH TEST [] 3. ANNUAL INTEGRITY TEST (0.1GPH) [].3. ANNUAL INTEGRITY TEST (0.1GPH) [] 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS (Check all that apl~ly) [] 5. DAILY VISUAL MONITORING OF PUMPiNG SYSTEM + TRIENNIAL PIPING iNTEGRITY TEST (0.1 GPH) [] 5. DALLY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUND PIPING): [] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) [] 7. SELF MONITORING SAFE SUCTION SYSTEMS (NO VALVES iN BELOW GROUND PIPiNG): GRAVITY FLOW [] 7. SELF MONITORING [] 9. BIENNIAL INTEGRITY TEST (0.1 GPH) GRAVITY FLOW (Check all that apply): [] 8. DAILY VISUAL MONITORING [] 9. BIENNIAL iNTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ALARMS AND (Check one) [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION []c. NO AUTO PEFMP SHUT OFF []c NO AUTO PUMP SHUT OFF [] 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT [] 11. AUTOMATIC LEAK DETECTOR OFF OR RESTRICTION [] 12. ANNUAL INTEGRITY TEST (0.1 GPH) [] 12. ANNUAL iNTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply) EMERGENCY GENERATORS ONLY (Check all that apply) [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF * [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF * AUDIBLE AND VISUAL ALARMS . AUDIBLE AND VISUAL ALARMS [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) SHUT OFF OR RESTRICTION [] 16. ANNUAL iNTEGRITY TEST (0.1 GPH) .I-I 16. ANNUAL INTEGRITY TEST (0.1 GPH) [] 17. DAILY VISUAL CHECK [] 17. DAILY VISUAL CHECK VIII. DISPENSER CONTAINMENT DISPENSER CONTAINMENT [] 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 4. DAILY VISUAL CHECK DATE INSTALLED 468 [] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS [] 5. TRENCH LINER / MONITORING 02/17/1994 [] 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS [] 6. NONE 469 IX. OWNER/OPERATOR SIGNATURE I certify that t~q~tormation provided herein iyt~e and ...... te to the bes~/my knowledge. I 470 04/26/2000 NAME {3F O'WNF, K/OPERA'3T~R (pr~t~f') /] - TITLE OF OWNERJOPERATOR 472 Chevron Products Company/REgH · . Retail ESH Specialist Permit Number (For local use only) 473 Permit Approved (For local use only) Permit Expiration Date (For local use only) 475 UPCF (1/99 revised) 174 Formerly SWRCB Form B PROGRAM CONSOLIDATED TANKS UNDERGRO STORAGE TANKS - TANK PAGE 1 (two pages per tank) : Page 3 of 6 TYPE OF ACTION [] 1 NEW SITE PERMIT [] 4 AMENDED PERMIT [] 5 CHANGE OF INFORMATION [] 6 TEMPORARY SITE CLOSURE (Check one item only) [] 7 PERMANENTLY CLOSED ON SITE [] 3 RENEWAL PERMIT (Specify reason - for local use only) (Specify reason - for local use only) [] 8 TANK REMOVED ' 430 BUSINESS NAME (Same as FACILITy NAME or DBA - Doing Business As) FACILITY ID: "~i~ ChevronStation#203576 0 0 0 0 0 .. 0 0 0 LOCATION WITH1N SITE (Optional) 431 I. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID # 432. TANK MANUFACTURER 433 COMPARTMENTALIZED TANK [] Yes [] No 434 2 JOOR ~f"Yes", complet .... page for each compartment. DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 02/17/1994 12,000 0 ADDITIONAL DESCRIPTION (For local use only) 438 Il. TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 [] I. MOTOR VEHICLE FUEL [] la. REGULAR UNLEADED [] 2. LEADED [] 5. JET FUEL (lf marked complete Petroleum Type) [] lb. PREMIUM UNLEADED [] 3. DIESEL [] 6. AVIATION FUEL [] 2. NON-FUEL PETROLEUM [] 1 c. MIDGRADE UNLEADED [] 4/ GASOHOL [] 99. OTHER -- [] 3. CHEMlCAL PRODUCT COMMON NAME (~'rom Hazardous Materials Inventory page) 441 CAS# (from Hazardous Materials Inventory page ) 442 [] 4. HAzapa)ous WASTE (~nc~udes Vied Oil) MID-GRADE UNLEADED 800-61 ~9 [] 95. UNKNOWN Ill. TANK CONSTRUCTION TYPE OF TANK [] 1. SINGLE WALL [] 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 4.43 (Check one item only) EXTERIOR MEMBRANE LINER [] 95. UNKNOWN [] 2. DOUBLE WALL [] 4. SINGLE WALL IN VAULT [] 99. OTHER__ TANK MATERiAL - primary tank [] 1. BARE STEEL [] 3. FIBERGLASS/PLASTIC [] 5. CONCRETE 1'-195. UNKNOWN ,~44 (Check one item only) [] 2. ~STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPATIBLE W/100% METHANOL [] 99. OTHER REINFORCED PLASTIC (FRP) TANK MATERIAL - seco~xdary tank []' I. BARE STEEL [] 3. FIBERGLASS / PLASTIC [] 5. CONCRETE ' · [] 95. 1,JNKNO~/~N 445 (Check one item only) l'--}2. STAINLESS STEEL [5~4. STEEL CLAD W/FIBERGLASS []8. FRPCOMPATIBLEW/100%METHANOL []99. OTHER REINFoRcED PLASTIC (FRP) [] 10. COATED STEEL [] 5. CONCRETE TANK INTERIOR LINING [] 1. RUBBER LINED [] 3. EPOXY LINING [] 5. GLASS LINING [] 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING [] 2 ALKYD LINING [] ,~ PHENOLIC LINING [] 6 UNLINED [] 99 OTHER (Check one item only) (For local use only) 448 448 OTHER CORROSION [] 1 MANUFACTURED CATHODIC [] 3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN PROTECTION IF APPLICABLE PROTECTION [] 4 IMPRESSED CURRENT [] 99 OTHER (Check one item only)~ [] 2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (local use only) 451 , [ OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) [] I SPILL CONTAINMENT 1994 [ [] 1 ALARM [] 3 FILL TUBE SHUT OFF VALVE __ [] 2 DROP TUBE 1 998 OPW 6 1-SO-4 [] 2 BALL FLOAT [] 4 EXEMPT [] 3 STPdKER PLATE Tank Mfg IV. TANK LEAK DETECTION (a description of the monitoring program shall be submitted t~ the local agency.) IF S1NGLE WALL TANK (Check ail that apply) 453 IF DOUBLE WALL TANK OR TA~-NK WITH BLADDER 454 (Check one item only) [] 1 VISUAL (EXPOSED PORTION ONLY) [] 5 MANUAL TANK GAUGING (MTG) [] 1 VISUAL (SINGLE WALL IN VAULT ONLY) [] 2 AUTOMATIC TANK GAUGING (ATG) [] 6 VADOSE ZONE [] 2 CONTINUOUS INTERSTITIAL MONITORING [] 3 CONTINUOUS ATG [] 7 GROUNDWATER [] ~ MANUAL MONITORING [] 4 STATISTICAL INVENTORY RECONCILIATION [] 8 TANK TESTING (SIR) BIENNIAL TANK TESTING [] 99 OTHER IV. TANK CLOSURE INFORMATION / PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YRJMO/DAY) ' 455 ES'TIlVIATED QUANTITY OF SUBSTANCE REMAINING ' 456 [ TANK FILLED WITH INERT MATERIAL? 457 galldns I [] Yes [] No UPCF (1/99 revised) . 175 Formerly SWRCB Form B dIED PROGRAM CONSOLIDATED FC TANK UNDERGROUND STORAGE TANKS - TANK PAGE 2 VI. PIPING CONSTRUCTION (Check all that apply) ~ Page 4 of 6 UNDERGROUND PIP1NG .ABOVEGROUND PIPING SYSTEM TYPE [] 1. PRESSURE ' [] 2. SUCTION [] 3. GRAVITY 458 [] 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY 459 CONSTRUCTION [] 1. SINGLE WALL [] 3. LINED TRENCH [] 99. OTHER 460 [] 1. SINGLE WALL [] 95. UNKNOWN 462 MANUFACTURER [] 2. DOUBLE WALL [] 95. UNKNOWN [] 2. DOUBLE WALL [] 99. OTHER MA~FACTUREa AO Smith 461 MANUFACTURER 463 [] 1. BARE STEEL [] 6. FPP COMPATIBLE w/100% METHANOL [] 1. BARE STEEL [] 6. FPP COMPATIBLE W/IOO% METHANOL [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] Unknown [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 99. Other [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 8. FLEXIBLE (HDPE) [] 99. OTHER [] 4. FIBERGLASS [] 8. FLEXIBLE (HDPE) [] 4. FIBERGLASS [] 9. CATHODIC PROTECTION [] 5. STEEL W/COATING [] 9. CATHODIC PROTECTION 464 [] 5. STEEL w/COATING [] 95. UNKNOWN 465 VII. PIPING LEAK DETECTION (Check all that apply) (A description of the monitoring program shall be submitted to the local agency.) UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. AUDIBLE AND VISUAL AL,ARMS. [] 2. MONTHLY 0.2 GPH TEST [] 2. MONTHLY 0.2 GPH TEST [] 3. ANNUAL INTEGRITY TEST (0.1GPH) [] 3. ANNUAL INTEGRITY TEST (0.1GPH) [] 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS (Check all that apply) [] 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) [] 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUND PIPING): [] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) [] 7. SELF MONITORING SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): GRAVITY FLOW [] 7. SELF MONITORING [] 9. BIENNIAL INTEGRITY TEST (0.1 GPH) GRAVITY FLOW (Check all that apply): [] 8. DAILY VISUAL MONITORING [] 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ALARI~S AND (Check one) [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION []c. NO AUTO PUMP SHUT OFF []c NO AUTO PUMP SHUT OFF [] 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR RESTRICTION [] 11. AUTOMATIC LEAK DETECTOR [] 12. ANNUAL INTEGRITY TEST (0.1 GPH) [] 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply) EMERGENCY GENERATORS ONLY (Check ~,ll that apply) [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF * [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF * AUDIBLE AND VISUAL ALARMS AUDIBLE AND VISUAL ALARMS [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR RESTRICTION [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) [] 16. ANNUAL INTEGRITY TEST (0.1 GPH) [] 16. ANNUAL INTEGRITY TEST (0.! GPH) [] 17. DAILY VISUAL CHECK [] 17. DAILY VISUAL CHECK VIII. DISPENSER CONTAINMENT DISPENSER CONTAINMENT [] 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 4. DAILY VISUAL CHECK DATE INSTALLED 468 [] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS [] 5. TRENCH LINER / MONITORING 2/17/1994 [] 3. CONTrmJous DISPENSER PAN SENSOR WITH AUTO SHUi OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS [] 6. NONE 469 IX. OWNER/OPERATOR SIGNATURE provided herein is SIGNATURE' 04/26/2000 470 TITLE OF OWNER/OPERATOR . 4?2 Chevron Products Retail ESH Specialist Permit Number (For local use only) 473 Permit Approved (For local use only) Permit Expiration Date (For local use only) 475 UPCF (1/99 revised) 176 Formerly SWRCB Form B PROGRAM TANKS UNDERGROUND STORAGE TANKS - TANK PAGE ! (two pages per tank) Page 5 of 6 TYPE OF ACTION ' [] I NEW SITE PERMIT [] 4 AMENDED PERMIT [] 5 CHANGE OF INFORMATION [] 6 TEMPORARY SITE CLOSURE (Check one item only) [] 7 PERMANENTLY CLOSED ON SITE [] 3 RENEWAL PERMIT (Specify reason - for local use only) (Specify reason - for local use only) [] 8 TANK REMOVED 430 3 ' l BUS1NESS NAME (s .... FACILITY NAME or DBA - Doing Busi .... As) FACILITY ID: 0 0 0 0 0 0 0 0 0 0 0 Chevron Station #203576 Ii::? · LOCATION WITHIN SITE (Optional) 431 1. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) .TANK ID # 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK [] Yes [] No 434 3 JOOR ~f"Yes", complet .... page for each compartment. DATE INSTALLED (YEAR/MO) 43s TANK CAPACITY 1N GALLONS 436 NUMBER OF COMPARTMENTS 437 02/17/1994 12,000 0 ADDITIONAL DESCRIPTION (For local use only) 438 II. TANK CONTENTS TA, NK USE 439 PETROLEUM TYPE 440 [] 1. MOTOR VEHICLE FUEL [] la. REGULAR UNLEADED [] 2. LEADED [] 5. JETFUEL (Ifmarked complete Petroleum Type) [] lb. PREMIUM UNLEADED [] 3. DIESEL []6. AVIATION FUEL [] 2. NON-FUEL PETROLEUM [] I c. MIDGRADE UNLEADED [] 4. GASOHOL [] 99. OTHER __ [] 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS# (from Hazardous Materials Inventory page) 442 [] 4. HAZARDOUS WASTE 0nc~udes Used m) PREMIUM UNLEADED 800-61-9 ~' [] 95. UNKNOWN III. TANK CONSTRUCTION TYPE OF TANK [] 1. SINGLE WALL ['-1 3. SINGLE WALL Wj-TH [] 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) ' EXTERIOR MEMBRANE LINER [] 95. UNKNOWN [] 2. DOUBLE WALL [] 4. SINGLE WALL 1N VAULT [] 99. OTHER __ TANK MATERIAL - primary tank [] 1. BARESTEEL, ,[]3. FIBERGLASS/PLASTIC []5. CONCRETE []95. UNKNOWN 444 (Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPATIBLE W/100% METHANOL [] 99. OTHER REINFORCED PLASTIC (FRP) TANK MATERIAL - secondary tank [] 1. BARE STEEL [] 3. FIBERGLASS / PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 445 (Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPATIBLE W/100%'METHANOL [] 99. OTHER REINFORCED PLASTIC (FRP) [] 10. COATED STEEL [] 5. CONCRETE TANK INTERIOR LINING [] I. RUBBER LINED [] 3. EPOXY LINING [] 5. GLASS LINING [] 95. UNKNOWN 446 DATE INSTALLED 447 OR cOATING [] 2 ALKYD LINING [] 4 PHENOLIC LINING [] 6 UNLINED [] 99 OTHER (Check one item only) (For local use only) 448 448 OTHER CORROSION [] I MANUFACTURED CATHODIC [] 3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN PROTECTION IF APPLICABLE PROTECTION [] 4 IMPRESSED CURRENT [] 99 OTHER (Check one item only) [] 2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (local use only) 451 I OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) [] I SPILL CONTAINMENT 1994 [ [] I ALARM [] 3 FILL I~JBE SHUT OFF VALVE __ [] 2 DROP TUBE 1 998 OPW 6 1-SO-4 [] 2 BALL FLOAT [] 4 EXEMPT [] 3 STRIKER PLATE Tank Mfg IV. TANK LEAK DETECTION (A description of the monitoring program shall be submitted to the local agency.) IF ~;INGLE WALL TANK (Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one item only) [] 1 VISUAL (EXPOSED PORTION ONLY) [] 5 MANUAL TANK GAUGING (MTG) [] 1 VISUAL)(SINGLE WALL IN VAULT ONLY) [] 2 AUTOMATIC TANK GAUGING (ATG) [] 6 VADOSE ZONE [] 2 CONTINUOUS INTERSTITIAL MONITORING [] 3 CONTINUOUS ATG [] 7 GROUNDWATER [] 3 MANU,~L MONITORING [] 4 STATISTICAL INVENTORY RECONCILIATION [] 8 TANK TESTING (SIR) BIENNIAL TANK TESTING [] 99 OTHER IV. TANK CLOSURE INFORMATION / PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons [] Yes [] No UPCF (1/99 revised) . 177 Formerly SWRCB Form B PROGRAM CONSOIJDATED TANK UNDERGROUND STORAGE TANKS - TANK PAGE 2 VI. PIPING CONSTRUCTION (Check all that apply) Page 6 of 6 UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE [] 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY 458 [] 1. PRESSURE [] 2. sucTION [] 3. GRAVITY 459 CONSTRUCTION [] 1. SINGLE WALL [] 3. LINED TRENCH [] 99. OTHER 460 [] 1. SINGLE WALL [] 95. UNKNOWN 462 MANUFACTURER [] 2. DOUBLE WALL [] 95. UNKNOWN [] 2. DOUBLE WALL [] 99. OTHER MANUFACTURER AO Smith 461 MANUFACTURER 463 [] I. BARE STEEL [] 6. FRP COMPATIBLE w/t00% METHANOL [] 1.'BARE STEEL [] 6. FRP COMPATIBLE W/lOO% METHANOL [] 2' STAINLESS STEEL [] 7: GALVANIZED STEEL [] Unknown [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] 3. PLASTIC COMPATIBLE W/CONTENTS ' . [] 99. Other [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 8. FLEXIBLE (HDPE) [] 99. OTHER [] 4. FIBERGLASS [] 8. FLEXIBLE (HDPE) [] 4. FIBERGLASS [] 9. CATHODIC PROTECTION [] 5. STEEL W/COATING [] 9. CATHODIC PROTECTION 464 [] 5. STEEL W/COATING [] 95. UNKNOWN 465 VII. PIPING LEAK DETECTION (Check-all that apply) (A description of the monitoring program shall be submitted to the local agency;.) UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT [] 1. ELECTRONIC LINE LEAK DETECTOR 3'.0 GPH TEST WITH AUTO PUMP OFF FOP- LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. AUDIBLE AND VISUAL ALARMS. [] 2. MONTHLY 0.2 GPH TEST [] 2. MONTHLY 0.2 GPH TEST [] 3. ANNUAL INTEGRITY TEST (0.1GPH) [] 3. ANNUAL INTEGRITY TEST (0.1GPH) [] 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS (Check all that apply) [] 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) [] 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUND PIPING): [] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) [] 7. SELF MONITORING SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): GRAVITY FLOW [] 7. SELF MONITORING [] 9. BIENNIAL INTEGRITY TEST (0.1 .GPH) GRAVITY FLOW (Check all that apply): [] 8. DAILY VISUAL MONITORING [] 9. BIENNIAL INTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ALARIVIS AND (Check one) [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION []c. NO AUTO PUMP SHUT OFF []c NO AUTO PUMP SHUT OFF [] 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT [] 11. AUTOMATIC LEAK DETECTOR OFF OR RESTRICTION [] 12. ANNUAL INTEGRITY TEST (0.1 GPH) [] 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply) EMERGENCY GENERATORS ONLY (Check all that apply) [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF * [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF * AUDIBLE AND VISUAL ALARMS AUDIBLE AND VISUAL ALARMS [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) SHUT OFF OR RESTRICTION [] 16. ANNUAL INTEGRITY TEST (0.1 GPH) [] 16. ANNUAL INTEGRITY TEST (0.1 GPH) [] 17. DAILY VISUAL CHECK [] 17. DAILY VISUAL CHECK Vlll. DISPENSER CONTAINMENT DISPENSER CONTAINMENT [] 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 4. DAILY VISUAL CHECK DATE INSTALLED 468 [] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS [] 5. TRENCH LINER / MONITORING 2/17/1994 [] 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS [] 6. NONE 469 IX. OWNER/OPERATOR SIGNATURE ,~ best of my knowledge. DATE 47O 04/26/2000 TITLE OF OWNERIOPERATOR 472 Chevron Products ~H Retail ESH Specialist' permit Number (For local use only) 473 Permit Approved (For local use only) Permit Expiration Date (For local use only) 475 UPCF (1/99 revised) 178 Formerly SWRCB Form B TANKS UNDERGROUND STORAGE TANKS - INSTALLATION CERTIFICATE OF COMPLIANCE (one page per tank) Page 1 of 2 I. FACILITY IDENTIFICATION BUSINESS NAME (same as FACILITY NAME or DBA - Doing Business As) 3 Chevron Station #203576 ADDRESS (For local use only) 476 1125 COFFEE'ROAD, BAKERSFIELD 93308 FACILITY ID# ~5~ i TANK ID # 477 1 Regular Unleaded II. INSTALLATION (Check all that apply) 478 [] The installer has been trained and certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered professional engineer having education and experience 479 with underground storage tank installations. 480 [] The installation has been inspected and approved by the Unified Program Agency. 481 [] All work listed on the manufacturer's installation checklist has been completed. [] The installer has been certified or licensed by the Contractors' State License Board. [] The underground storage tank, any primary piping, and secondary containment was installed according to applicable 483 voluntary consensus standards and written manufacturer's installation procedures. Description of work being certified: Ill. TANK OWNER/AGENT SIGNATURE ! certify that the information provided herein is true and accurate to the best of my knowledge. SIGN~ OWN~ DATE 484 04/26/2000 NAME OF TANK OWNER/AGENT (~nt) 485 TITLE OF TANK OWNER/AGENT 486 I/ Chevron Products Company/RESH Project Engineer ~. UPCF (1/99 revisedl~ 177 Formerly SWRCB Form C PROGRAM CONSOLIDATED TANKS UNDERGROUND STORAGE TANKS - INSTALLATION CERTIFICATE OF COMPLIANCE (one page per tank) Page 2 of 2 I. FACILITY IDENTIFICATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 Chevron Station #203576 ADDRESS (For local use only) 476 1125 COFFEE ROAD, BAKERSFIELD 93308 FACIL1TY ID# ~ ~ I TANKID# 477 2 Plus Unleaded II. INSTALLATION (Check all that apply) 478 [] The installer has been trained and certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered profess!onal engineer having education and experience 479 with underground storage tank installations., 480 [] The installation has been inspected and approved by the Unified Program Agency. [] All work listed on the manufacturer's installation checklist has been completed. 482 [] The installer has been certified or licensed by the Contractors' State License Board. [] The underground storage tank, any primary piping, and secondary containment was installed according to applicable 483 voluntary consensus standards and written manufacturer's installation procedures. Description of work being certified: III. TANK OWNER/AGENT SIGNATURE I certify that ~information provided,herein is true and accurate to the best of my knowledge. SIGNATUI~E/OF TANK OWNE~i~GENT ~ DATE 484 · /'~ ~~~ 04/26/2000 NAME OY TANK OWNER/AGENT (pr~jl~) ; - -- v 485 TITLE OF TANK OWNER/AGENT 486 Chevron Products Company/RESS-I Project Engineer UPCF (1/99 revised).., 178 Formerly SWRCB Form C PROGRAM CONSOLIDATED TANKS UNDERGROUND STORAGE TANKS - INSTALLATION CERTIFICATE OF COMPLIANCE (o~e page per tank) Page 1 of 2 I. FACILITY IDENTIFICATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 Chevron Station #203576 ADDRESS (For local use only) 476 1125 COFFEE ROAD, BAKERSFIELD 93308 FACILITY ID# ,~ "~ i TANK ID # 477 ~': 3 Supreme Unleaded II. INSTALLATION (Check all that apply) 475 [] The installer has been trained and certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered professional engineer having education and experience . 479 with underground storage tank installations. 48O [] The installation has been inspected and approved by the Unified Program Agency. 481 [] All work listed on the manufacturer's installation checklist has been completed. 482 [] The installer has been certified or licensed by the Contractors' State License Board. [] The underground storage tank, any primary piping, and secondary containment was installed according to applicable 483 voluntary consensus standards and written manufacturer's installation procedures. Description of work being certified: IlL TANK OWNER/AGENT SIGNATURE I certify that the information provided herein is true and accurate to the best of my knowledge. SIGNAT OF TANK OWN AGENT DATE 484 ~ ~ 0~--~ 04/26/2000 NAME OF TANK OWNER/AGENTi~rintT[ ' ' 485 TITLE OF TANK OWNER/AGENT 486 Chevron Products Company/RESH Project Engineer UPCF (1/99 revised!~ 177 Formerly SWRCB Form C April 30, 2000 RE: CERTIFICATE OF FINANCIAL RESPONSIBILITY FOR UNDERGROUND' TANKS · To Whom It May Concern: Chevron Corporation hereby certifies that it is in compliance with the requirements of underground Storage Tank financial responsibility regulations. This certificate covers all tanks in the States of California,. Alaska, Arizona, Florida, Georgia; Hawaii, Louisiana, Nevada, New Mexico, Oregon, Texas, Utah and Washington owned by CheVron Corporation. The financial assurance mechanism used to demonstrate financial responsibility required under State and Federal regulations is as follows: Corporate guarantee of Chewon is the amount of $1 million per occurrence, $2 million annual aggregate, Said gUarantee covers taking corrective action And compensating third parties for bodily injUryand property damage caused By either sudden accidental releases and non sudden accidental releases or Accidental releases. This guarantee is renewed annually (within the first 120 days of the year). Copies of the renewed certificate and a complete list of the facilities are sent to the governing agencies yearly. Sincerely, By: C. P. Garc~ Environmental Compliance, Permit Notarized by: Susan R. Weber, Notary April 4, 2000 Chevron Products Co FIRE CHIEF Mr. Brace Carpenter RON gRAZE ? O Box 2833 ,,~m.~'.anv~ ara~ncB La Habra CA 90632 2101 'H' Streel Bakersfield, ~ ~1 VOICE (~) 3~1 F~ (~) ~1~ De~ ~. C~enter: 8U~ION 8E~ 2~o~ '.- s~ You have been identified ~ ~e compli~ce coord~ator for ~e ~. ~ ~ facili~/f~ilities referenced ~ ~e aRac~ent. VOICE (~5) 3~I F~ (~5) 3~1~9 ~~ s~ The pe~i~ to operate ~is f~iliyf~ilities will expke on J~e 30, 2000. . 1715 ~ter A~. However, ~ order for ~s office to renew yo~ pemit, updated fo~s A, .;~., ~k~, ~ ~1 VOICE (~) ~t B, & C mint be filled out ~d ~ prior to ~e iss~ce of a new F~ (~) 3~7a pe~it. ~RONM~ 8~ ms ~ ~. Plebe m~c ~c ~at you ~c scnd~g ~c up&t~ fo~ which ~e ~k~. ~ ~1 vo~c~ (~s) 3e~ ~dicat~ by ~e date 7/99 ~ ~e lower left h~d comer. Plemc complete ~ (~) 3~ ~d re~ to ~is o~ce by May 15, 2000. F~l~e to comply, will result ~ ~ a delay of issuee of yo~ new pemit to operate, VOICE (~) 3~7 Should you have ~y questiom, pleme feel flee to call me at F~ (~) 661-326-3979. Sincerely, Steve Underwood, Inspector Office of Environmental Services SU/dam attachment Facility Nam0 Address Chevron 3360 Panama Lane, Bakersfield, Ca 93313 Chevron ff~$~~, Bakersfield, Ca 93308 Chevron 6601 Ming Avenue, Bakersfield, Ca 93309 Chevron · 1131 Oak Street, Bakersfield, Ca 93304