HomeMy WebLinkAboutABOVEGROUND TANK FILE #1 - 12.2003 4= zl.~c, lvl FRO ALVAELEY EQU ~ P 16613252529 P. 2
-MONITORING SYSTEM E T IC ION
For U~e ~ All J~dictio~ Within t~ State of C~f~ia
.. Juthori~ Cited: C~pt~ 6 7, Health and Salty C~; C~Ier 16, Dlv~lon J, Title 23, Cal~ornia C~ of Rggulations
~ fo~ must ~ u~ m d~um~t t~sting mid a~icing of moa]Wring ~uipmenr A ~ep~ ~aification or mpon
p~a~ for ~ach mnnitodng system con~l ~nel by ~e ~vhnlci~ who periods lh~ work. A copy of~flz fom~ m~t ~ provid~ to
'~ tank sy~em ~ner/opemtor. ~e owner/o~ator must submit a copy of this fo~ to thy l~ agency regulating UST
wi~in 30 d~s of test date,
A.. Gene~l Information
Faclli~ Con~t Person: ~o'~ Contact ~one No,: ( .
M~Mel of Moni~ring System: ~ ~'~o ~'z~.~ Date o~Tesfln~Servicing: ~//~ /O~_
B, Inv~to~ of ~uipment Tested/Certifi~
_~k the agp~p~ate bo~ to Indicate ap~dflc cqulpment inslKct~d/~ked:
Tank ID: / - Tank ID:
~ In-T~k O~gi6g ~obo, Model: ~ ~O ~ In-T~k Gauging Pro~. M~I: .
· A~al~ 8pa~ or Vault 8~nsor, M~el: ~ ;~'~ & ~ AnnuIR 8pa~ or Vault ~n~r. M~el:
Piping 8mnp / Trench ~n~o~a}. Modal; ~/~.~ ~t~ .. O Piping Sump / T~nch 8~sm(s). Mode~:
~ El~nlc Line L~k D~r, Model: ~ Ble~mnic Line ~ ~tor. Model: .....
.~ .O~tr (s~cify equipment type ~ m~! in S~lon E on Page 2).__ ~ ~r,(~ify ~uipm~t ty~ =d model In ~ion E on P~e
Tank ID~ Tank IDt
~ ln-T~ Gnusin8 P~, M~el: ~ ~-T~k Gauging Pro~. Model:
'O Annul~ ~pac~ or Vault ~or. Model: ~ Annular 8~ of Vault ~nS~. Model: '
~ Piping Sump/Trench S~s~s). Model: ~ Piping Sump / T~ S~sor(~), M~el:
,~ Fill Sump ~n~s). Model: ~ Fill ~ump Smt~s), ~ Modet:
~ M~hanlcal Linc L~ ~t~mr. M~el: ~ Me~mfical Line ~ D¢t~or. ' Model:
~ ~nic Line ~k O~or. Model~ ~ Eloc~onic Line ~ ~t~lor.
~ T~k Overfill / Hi~-Level Sensor. Model: ~ 'r~k Overfill / High.wi S~sor. Model:
~ Ot~t_ (a~_~ip~ent ~p~ ~d m~el j~, Section E on P~c 2),... ~ Oth~ (s~cif~_~ipment ty~ and mode! In Serius E on P~e 2):_.
Dbp~s~lDt / -
Dhpenser ID:
~ Sh~ VMv~8)~ ~ Sh~ Vnlve(~),
Q D~ ~men~ F~n~) ~d Chain(s). ..O Disposer Contnin~nt Fl~t(s) ~d ,~n(s),
DIn~nser iO: Dispenser ID:
~ Dt~s~ Coalal,m~t $~s). M~I: ~ Disposer Conlai~ent 8~nso~s). M~el:
~ 8h~ Valves), ~ She~ Valve(s).
~ D~ ~n~nmcnt Fl~(~) ~d C~(s). ~ Dl~nser Containment'Floats) and Cha~(s).
~ D~n~ Containment ~r(s). Model: O Disp~ Containment ~n~r(s). M~I:
~Dia~a~ ~n~nm~t ~I~(~) and ~n(a). ' ~ Di~nS~ Con,smear Fl~{s) ~d
C. Ce~ification - ! cartlfy that ~e ~ujpment identir~d in tbs document was ins~t~/~rvlc~ la ne~an~ with the
msnuhctu~' guldellnes~ Afl~ch~ to this C~rtiflentlon b informntioa (~S, manuh~urer8' checkJb~) ~e~snty ~o.VnrJfy last
inbrm~flofl Js ~rr~ nnd a Plot ~an ~owlng the layout of moni~ri~ ~uyment. Fof any equipment ~pable of 8enurating Such
rep~b~ l have oho attached · copy of the ~port; (ch~ek ~11 ~of ~): ~ 5~tem set-up ~ Als tm hbtory
Page ! of 3 03/01
Monitoring System* Certification
2-12-2003 ~.: zt 1 ~M FRO ALVAI_LEY EQU ! P 16~6132,~2~29
D. R~Ul~ of T~tin~e~icing
~0~~e Vemion Ins~lled:
Complet~ the following
~ Y~ ~ No* -i~-~udible alar~ operational9
Y~.. ~ No* Were all s~ vbuaJly ins~t~, functionally t~ted, ~O conff~ o~rational? ......
~ Y~. ~ Ho* ~er~ all Sens~ ms,lied at lowest ~mt of s~onda~ ~n~inment ~d ~sition~ ~ ~a ol~r ~quipmen~ will
not in~rfere wi~ ~eir pmPcr o~mti~? .
Y~-' Q No* it ~la~s a~ relayed to a remote monitoring s~tion, is all communi~tions-~ipment (e.g.
~ ~A op~tlo~al?
Ye~ ~ No* For pressuri~d piping s~tems, d~ the ~b[n~'~omatJ~lly shut down if the pJPlng s~nda~'
~ N/A monitoring Syste~ detects a leak, fails to o~rate, or is electrically disconnec~d? If yes: which sen~rs inmate
positive shut-down? (Ch~c~ ~E l~ot o??iy) ~S~m~rench Senso~; ~Dis~nser Containment
Did ~o~ co~fl~ ~s[tlve shoc-d~n.d? ~9 le~s and ~nsor fallure/di~onnection? ~; ~
Y~ ~ No* For ~k systems flint utilize fl~e monitoring s~t~ as ~e pHma~ rank ~ve~ w~in~ device (i.e.
~ N/A m~i~l ov~fill prevention valve is Jns~ll~), is the overfill w~ing ala~ visible and audible at the
fiil_poipt(s)~.op~mti,g properly? I~o, ~t ~t pc~cnt of tank capacl~ dom ~e ala~ UJg~er?
Y~ ~ No Was any monitoring equipment replaY? If yes, identi~ specific s~r~ probc~ or other equlpmenl replaced
and list ~e maaufactumr name and m~cl for all r~taccment p~s in 8e~ion E, below.
Yes* ~ No W~ ffquid found inside any ~con~ ~ntninment ~St~s designed as dry $Y~'~sT' (C!~eck all't~t
Y~ ~ No* Was monitoring system set-up mvi~ to ensure p~.p~{ se~in~? A~ac~'-~'6p re~m, ifapplicabte
~'Y~. ~ No* Is ali monitoring e~u~mc~t,~ational per manufac~rer's Specifications? ...
ln.$~tion [ below~ d~erl~ how and when these defielenei~ were or will be corrected.
Pag~ 2 of 3 03~0t
12-1 2-2003 4.: ,421:>M F'RO ALVALLEY EOU I P 1 66132S25~29 P. '4.
· , .,/ ..... ~ ..... :. ~ "
F. In-Ta~ak C~augin~ / SLR Equipment: 4~ Check this box If tank gau~illg is used only for inventory control.
~] Check this box if no tank gauglnS~ or SIR equipment is In,ailed.
This se~tlon must be completed if in-t~nk gnu§lng equipment is used to perform leak dete~tion monitoring.
Complete the following checklist:. ' '
n Yes n Nob Has all input wiring been inspected for proper entry m~d termination, including testing for ground faults?
C] 'Yes C3 No* Were all tanl~ gauging probes visually inspected for damage and reSidue buildup?
' 12 Yea. C! No· Was accuracy 0fsystem product level readings testicle; ................
C] yea 12 lq.oe Was accuracy of system water level readings tested? .........
C) ~e~' 12 No~ Were all. probea reinstalled prol~rly? ..
Cl Yes C3 No~ Were ali it~n~s c;~ It~e ~'qu'ip'ment manu~'acturer's maintenance checklist completed?'
' below~ " .........
· In the See0on !1~ deaetlbe ~ow and when ti~ese defieienclea were or will be corrected. '"
G. Line i~.ak De~ector~ (LLD): ~' Che~k ~is box if LLOs are not i~taHed,
Cum the followin che¢ldL~t:
(:~ Yes C~ 'No* For equipment start-up or annual equipment certification, was a leak simulated to verity LL, D performance?
CI N/A (C'A~¢Aa~']~'A~¢n~'y) $imulatcd leak rate: ClJ§.pJ~.; ~0.1g.p.h; C]10.2g.p.ho
¢1 yea 12 No* Were ell LL.Ds confT~'t~'~ '~C~:~tional and a~curate within reguiatory requiremenL~?
12 Yes C] No· Was the te~ting apparatus properl? ~llbrated? ...... '
CI. Yes CI No'~ For m~chm~Jcal LLDs, does the LLD res~t~ci product flow if i~J~'e'cts'a' leak?
12 Yea [] Noe For electronic LLDa, does th¢"~'~"rlJine automatically shut- off il'the LLi~'dete~ts a leak?
CI
~C~--~eS C3 No· For electronic LLDs, does the turbine autom'~,ticall!y shut off if any portion of t'l~ monitoring system t~ disabled
12 N/A or di~:onnectcd?
CI Yes 'C~" Nob For' electronlc '~.LL~s, does the ~urbine autocratically shut off it' any ~:~ttion of the monitoring aystem
~ N/A malfunctions ot fails a teat?
[] Ye~ CI N~. For elecU'oni~ LLDa, hav~ al! accessible wiring oonne~;tions been visually inspccte'd?
C~ ¥~a" 'C3 N°~ Were ~1i ~hecklist¢ompleted? ....
'items on the equipment manufacturer's maintenance'
In I~e Secttoa H, I~elew~ deacribe how and when the~e deflelenelea ~ere or will be corrected.
H. Comments:
Page ;3 of
12-12-2003 ~:4~ FR ALVALL~ E~IP 16613262S29
~ ~, .o.~. ~ " ........
MOnitoring System Certification
usT Monito~ng Site Plan .,
Date map was drawn: / ~_. / /~.- / ~.
Instructions
· If you already have a diagram that shows all required infonnatioq, you may include it, rather than this page, with your
Monitorin8 System Certification. On your site plan, show the general layout of tanks and p!ping. Clearly Identify
locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular
spaces, sUmps, dispenser pans, spill COntainers, or other seco,ldary contalntnent areas; mechanical or electronic llne leak
· detectors; and in-tank liquid, level prob. es (if used for leak detection). In the space provided, note the date' this Site Plan
was prepared ....
r~ ¥ or 9' O~oo
'November 2003, January 2004
30 I 1 2
2 3 4 5 6 7 5 6 7 8 9. 10
9 10 11 12 13 14 15 11 12 13 14 15 16' 17
16 17 18 19 20 21 18 19 20 21 22 23 24
23 '24 25 26 27 28 25 26 27 28 29 30 31
Sunday r Monday I Tuesday I'Wednesday I Thursday I Fraday I Saturday
~- December 2003 '
7 I 8 ] 9 I lOl ~11 12J 131
® (9:00 AM - ~ (9 (8:30 AM - (9 (7:00 AM - ® (8:30 AM - ® (9:00 AM -
10:00 AM) 12:00 PM) Truing 8:00 AM) Final 11:00 AM) 10:00 AM) Meet
Secondary piping Dave & Esther Arco 40101 wible Training Dave & Steve Chavez in
Fiesta (9 (1:00 PM - Esther front of PD
(9 (10:00 AM- 3:30 PM) UST (9 (8:00 AM - (9 (11:00 AM- (9 (11:00 AM-
11:00 AM) Meet Inspections 9:55 AM) Admin. 1:30 PM) Esther 12:00 PM) Final
Mike Delta Esther (9 (10:00 AM - UST Inspections at 2209
Energy old house 12:00 PM) (9 (2:00 PM - Snowdrop
to home re: Meeting with 3:00 PM) contact Lelie
propane system Jaco oil Meeting for 978-5136
(9 (1:00 PM - (9 (1:00 PM - Business Plan (9 (12:00 PM -
2:00 PM) Final 2:00 PM) field old Merlwe 1:00 PM)
on AST @ Pep check sta.#15 for Haggard Luncheon in
boys AST Installation Office
(9 (3:00 PM - (9 (2:30 PM - ~ (2:00 PM -
4:00 PM) 4:05 PM) UST 3:00 PM)
Meeting with Pat Inspection with Secondary
sullivan 2929 F Esther Piping & Lake
St. Test Fiesta
Liquors 2023
Baker St.
~ (3:00 PM -
4:00 PM) Final
on EVR Buckets
2222 F ST.
[] 10:00 am
Secondary
Piping Inspection
10 union Ave.
[] CUPA
coordination
meeting
141 151 161 17l 181 19J 201
(9 (8:30 AM - (9 (9:00 AM - ® (10:00 AM -
11:00 AM) 11:00 AM) =3:00 PM) Tank
Training Dave & ESther UST Pull 3621 Calif.
Esther Inspections Ave.
® (11:00 AM - (~ (11:00 AM -
4:00 PM) Esther 6:00 PM) Leave
UST Inspections for
Hanford,LEPC
Meeting
21 I 22 I 231 24[ 251 261 271
(9 (8:00 AM - (9 (8:00 AM -
5:05 PM) Holiday 5:05 PM) Holiday
281 291 30r 31 I I I 2 I 3 [
(9 (8:00 AM - ~ (8:00 AM -
4:55 PM) Holiday 5:00 PM) Holiday
Steve Underwood I 12/12/2003 - 1:29 PM
12-12-2003 12: 1 ,d. PM . FR A VALLEY EQU I P 16G 13252529 P. 1
CAE-VALLEY EQUIPMENT "~;'
3500,GILMORE AVENUE ..
BAKERSFIELD, CA 93308,
(661)327-9341 F/~O(: (661) 325-2529
CONTRACTOR'S LIC.#784170 A HAZ
Eax, ~Z~ ~ 0~ - P~., ~ INCLUDING COVER
· ,-,
D O~ent ,~or Rem 0 Pleaee Comment O Plea~ R~Iy ' ~ ~eele Resole
Comments,:
12.12-2002 12:1~PM R ALVA LEY EQUIP
~.~~.~~~~ .~ CITY OF BAKERSFIELD
OFFICE' OF ENVIRONMENTAL SERVICES
~~~. 1715 Chester Ave., Bakersfield, CA (661)326-3979
APPLICATION TO PERFORM
FUEL MONITORING CERTIFICATION
DO~ ~AC~TX HAVE DISPE~SE~ PA~S~
TANK # VOLUME CONTi~NT$
/ '_ ....
CITY OF BAKERSHELD
OFFICE OF E~ON~NTAL SER~CES
1715 Chester Ave., Bakersfield, CA (805) ~2~-3~9
APPLICATION TO [NSTALL AND/OR REMOVE
ABOVE GROUND STORAGE TANK(S)
In conformi~ with provisions of pertinent ordinances, codes and/or resulations, permission is
h~reby ~nted to:
Name of Cotnpany Address
to display, stere, install, use, operate, sell or handle materials or process involving or crt~ting
conditions deemed hazardous to life or property as follows:
mbj~t to the provisiom and/or limitations ~ provided. Violation ofp~rtinem ordinance, cod~
~l/or resulations shall void this p~mit.
F~R,~OM.~:~.THE SOURCE GROUP PHONE NO. : Aug. 26. 1998 10; 15AM Pi
~ The Source Group, Inc.
187 E, Wilbur Road -
Suite 16
Thousand Oaks, CA 91360
U.S.A.
Telephone No.: (805) 373~9083
Facsimile No.: (805) 373-9073
FACSIMILE
Page I of ~
From: MarkLabrenz Attached: ~.~6~0/ ~1~,~'~ ~"
FRQI"I'~.~,~.THE ,s, OURCE GROUP ' fitug. 26 1998 :/..0."16R1"1 P2
~-"¢-"." '"~u/i,.':'~,~ i~.u~ ~uv~, i,...,,.,,,.., PHONE NO. :
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERViCES
· 1715 Chester Ave., Bakersfield, CA (805) 326-3979
AppLICATION TO LNSTALL AND/OR REMOVE
ABOVE GROUND STORAGE TANK(S)
In conformity whh provisions of l:erfi~ent ordinates, codes ~or re~fion~ p~on is
h~by ~ m:
~1~ o;c ~. ¢3oZ. ~ ~1~ ~%~,~ ~, ~;~
~ of C~y ~ss
subj~t to ~e pro~ ~tor ~t~do~ ~ ~ro~ded. Vio~Qon of ~mt o~c~, c~
~or re~xions m~ void ~s
FROM THE SOURCE GROUP PHONE NO. : Rug. 26 1998 08:30RM P1
~ The SourCe Group, lnc,
187 E. Wilbur Road
Suite 16
Thousand Oaks, CA 91360
U.S.A.
Telephone No,: (805) 373-9083
Facsimile No.: (805) 373-9073
FACSIMILE
Page
Facsimile No. i/~O~') 3Z(~-O.57~c~ Telephone No.
From: Mark Labrenz Affached:
FROP1 : THE SOURCE GROUP PHONE NO, : gug. 26 1998 08:~lgP1 P2
CITY OF BAKERSHELD
OFFICE OF ENVIRONMENTAL'SERVICES
1715 Chester Ave., Bakersfield, CA (805) 326-39~9
APPLICATION TO INSTALL AND/OR REMOVE
ABOVE GROUND STORAGE TANK(S)
Ia conformity with provisions ofpe~ti~ent ordinances, codes and/or regulations, permi~ion is
hereby graated to:
to d~play, store, i~, u~, opgste, sell or
c~tioas d~m~ ~do~s to life or prope~ as fo~o~:
.~bj<t to ~e pro~o~ ~ ~tafions ~ proMded, VioM~ of~em o~, c~
~or re~tions s~ vc~ ~s p~t.
Perrrfit Det~ed.
AFprove~ by: Applicant Name (print) AFpli~ Sigmttu.re
T]~ APPLXCAT[ON BECOMES A PERM1T ~v'HEN APPROVED
FROM : THE SOURCE GROUP i PHON~ NO.': Aug. ~ 1998 08:31AM PJ
AUG-'_~-I.~,~ ~: -~ FROf'I"'":BAKEW.%F'IEL,.... TANK CO TO ~'"'7398",'/.:3 F~. 84
TOTAL
APPURTENANCE SCHEDULE
ITEM OREN, QTY. ~ZE PROd. IIOT/G]I ~ DESCRIPFIO,~ SERVICE
* I 2' I' 2'" FNPT ._,
-- I) .... I 2" 1'~ -- 2" I~'Pr .....
E I~ 6' ~' MNPT ~MARY ~G.
~'~ ....... ~. ~ !' ~' mPl ..... ~!~'"
/
....
FROM : THE SOURCE GROUP PHONE NO. : Aug, 26.1998 08:32AM P5
00 CAL. FREE-PRODUCT
E¢OVERY' AST
CONCRETE
~iT ~ CUTTER
........ SALES
OFFICE ' .
rMENT
~" AIR
~ COUP.
ASPHALT
MAINTENANCE · - ~'"~:~
~ BUILDING -- 1 K GAL. MOTOR
OIL AST
ABSORBENT /. AST
~ FUEL DISPENSER
CONCRETE "V" -,, .,.
GUTTER 000 GAL. ~
WATI[R FLOW TO ~ [~ ~
ATION POND
SCALE: 1' = 60'
::}UNOARY '~ FIRE ExTINCUISHER
LINK fENCE LINE ~ FIRE HYDRANT
~AiNAC£ SWAIL . CONCRETE CRASH POST
JR PLANTER AREA ~ STORM WATER FLOW DiRECTiON
UNPA ED E 'PAN PACIFIC PETROLEUM ...,-.
FROM : THE SOURCE GROUP PHONE NO. : Rug. 19 199B 02:28PM,P1
~) The Seurce Group, Inc.
187 E. Wilbur Road
Suite 16
Thousand Oaks, CA 91:360
. U.S.A.
Telephone No.: (805) 373-9083
Facsimile No.: (805) 3739073
FACSIMILE
I I lll Il I Ifil ' I III I
Page I of
FROM : THE SOURCE GROUP PHONE NO. .' Aug. 19 1998 02:29PM P2
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (805) 326-t979
APPLICATION TO LNSTALL AND/OR REMOVE
ABOVE GROUND STORAGE TANK(S)
~ conformi~ witlt provisions ofperti,~ent ordimmce~, codes a~cl/or regulations, permi~on is
h~rcby ~ranted to:
~o d~$pl~y, ~o~e, i~ us=,.op~'"~e, s~]l or haadle ma~ia~s o~ pro~s ~v~ or
condi~on~ d~m~ ~dous m life or prope~ a~ ~o~:
subj~t m ~ pro~ho~ ~or ~fiom ~ pro~ded. Viola~n of~en~ o~, c~
~or re~fions ~ void ~s p~t,
permit Denied
DaI~
Approv~ by:. Applic~t N~'ne (.pri~) Applie.~ Si~n.~tte
THIS APPLICATION BECOM]~ A PERMIT WHEN A/'PROVED
~ HORIZONTAL DOIJDLE WALL TANK SCHEDULE'
zd I I ~ ..... VENT SIZING
Z -{
OP~0NAL FsNI~ ~T ~ BE A P~RC~[ '5t5 ~ ~' 4" 1 i/4'
I ~033 6' 6'
) ........
D ·