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UST REP. 6/30/2003
Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This _=ermit is issued for the followin_=: [] Hazardous Materials Plan [] Underground Storage of HazardoUs Materials Permit ID #:: 015-000-001021 [] Risk Management Program BAKERSFIELD REGIONAL [] Hazardous Waste On-SiteTreatment '~¥~. LOCATION: 5001 COMMERCE DR IELD TANK "AZARDOU§'S0~'~AN(E ";¢':~'~"tCAp~Cmt~" DIsPEN~ER;*~NS!MONITORING I OFFICE-OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor ~Approvedby: . '~ ~y, D~, Issue ~te Bakersfield, CA 93301 " O~ceorEv~S~ic~" Voice (661) 326-3979 F~ (661) 326-0576 Expiation Date: Permil Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ......... ,~,~,~?!!i~,?? ,~,?, This permit is issued for the following: ' ~,~,~i???i:~:~!:~.! i;::~?~:'::;ii i;ili!ii~,~ .~; iii~, !{iiiiiii?i;r'i["ili~iiU~e[ground Storage of HazardOus Materials PERMIT ID0 015-021001021 ~i~i?i! ili~,i;":il;il;iiiiiil; !iii;'" ....... !?:ii!!!:i;:;i~:!ii!!!i!!!ii!!!i:! !!i::~.!!! iii,,~ ~'~ki ~agement Program BAKERSFIELD REGIONAL REH~B H~.SP~:.. ..... TAN H~RDOUSSUBSTANCE CA~'~:. ~?'~AL ~:~:}:::.~:.~ = :;':~ ~;:'~.~J ¢~NK ":':~::~ANK PIPNG PPING PIPING '~:;-::""::-~ '"~'"' ~:,}, "~'~IN~[~'~'~'~M~NI~O~::':::::":~NITOR TYPE TYPE METHOD PIP ON 0004 DIESEL 1,~00:i~0..~.... .. GA~:~,,,, '*."<,"":": ~ F ,CLM...,. .,,,,,.:"?"",,." ~TG DW F SUCTION CUM "~J~.' ..... "=~,::s'". · ' .. Issu~ by: ~~ B~ersfieldFkeDepa~ment. 171SCheaer Approvedby: ~ ~.~ -' Ave., 3rd Floor e o~~~ g B~ersfiel~ CA 93301 ' ~ Voice {805) 326-3979 F~ (80S)~6-0S76 Expiration~t~: dUn~ ~0, ~000 City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (805) 326-3979 An upgrade compliance certificate has been issued in connection with the operating permit for the facility indicated below. The certificate number on this facsimile matches the number on the certificate displayed at the facility. Instructions to the issuing agency: Use the space below to enter the following information in the format of your choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility; facility identification number (from Form A); name of issuing agency; and date of issue. Other identifying information may be added as deemed necessary by the local agency. This permit is issued on this 2na day of November, 1998 to: BAKERSFIELD REGIONAL REHAB HOSPITAL Permit/4015-021-001021 5001 Commerce Dr Bakersfield, California 93309 CONTRACTOR .... SERVICE STATION ADDRESS ' REPO~Eb ~LEM .... ~E ~t ~ ~ O~ ~0 i~ WAS JOB COMPLETED D ,o .. TIME ~TE AMOUNT QTY. PRICE AMOUNT J I , CORE CREDIT LABOR NO. OF ~" MILEAGE TO SITE SUBTOTAL TOTALIZER READINGS TRAVEL TIME . PERSONS ~, , ', ~ AND TIME AT SITE MATERIAL '~, Dt~,,SER VENDOR'S EQUIPMENT ' , , VEHICLE MARK J ' ITEM ~ME' RATE SUB- MARK ENDING ODOMETER READING TOTAL ~"~FORE ~ ~ [{ [ TOTAL UP % AMOUNT MATERiaL I: . ~ . EQUIPMENT ; ; ;,' SALESTAX ON ~ RENTAL ~ , , ; B'EGtNNING ODOMETER READING TOTAL MATERIAL AFTER : SUB. : : : : TOTAL · CONTRACTOR ; ' , , TOTAL MILEAGE TO SITE 'LABCR CHARGE .... '"' DATE ]TIME ~'::' ~ '" ~ ~c<-:' ~;I AM ARRIVAL TIME AT SITE AM TOTAL ' TOTAL ~ I ................... ~ PERSON CONTACTED AT SEE DEPARTURE TIME FROM Site AM VENDOR'S EQUIP. ' EQUIP. RENTAL ~ ' PERSON W~ PLACED CALL TOTAL TiME AT SITE ~ ~ J~"~ HRS. ~ 0 MiN. SUBCONTRACTOR ' ~i ~ ~, ~ ~ ~ ~ L ~ BEFORE SIGNING FORM,: AUTHORIZED PERSON (PRINT NAME3.. ..-" . .~'":.,.: TOTAL }, ~ ~RV~E ~RS~'S SlSNATURE ' SERWE PERSON'S S~NATURE DEPARTURE TIME, AND j AUT~RI~~E, "~ . DA~ ~ ' BAKERSFIELD FIRE DEPARTMENT N° ~ 0007 · Sub Div.(~"O0[ (~m~4?.~al~ _ Blk. . Lot You are hereby required to make the following corrections at the above location: Cot. No ~ Completion Dale fo,' Corrections ,1i/?_. ~/.C} ~ ,~at~, ~/..~/0~ ~.._~_.~.~-t~ ~ z ~' '~ - '- In~ector 326-3979 f " - TANK t'iF~H iTOF.: ::', ': iT~: .{ '::~ ' ~'~ ' ' ' ": -' ' I'. ' ?"!" WHILE YOU WERE'OUT. ' '- Tel ;,. ' ~ Telep~onea Will ~11 ... TRHK. t / ' ' T~ ESEL 2 Holaine on line ¢ ........... Ple~e ~11 7~:2', G~LCi}NS FUEL Lo.~ 8i~t~n~e ~11 Refurnea ~ur ~11 - - ..... - Came to see you ~aiting to see you :' :37,27 ;'".iNCHES FUEL F,R R DEGREES F ?' . : -' - Messag ..... .. " . ., ~....~.~~ ..... .~:~~~ ........ .. xE¢~~,..........~~ · . ~~ ~..~ . .;' PAS 5~ 1151 3~S-~* · 'i~i I.. "-:' / . ' ,, ' ......... I ~~ ' ~ ' ' ' ~ .... :~i~..__... ~,~~ ,//~ ~ ·/Z 0~: ~ , SEE YOU ~SIGNE~.~; ,/~?{q(& , TOPS~ FORM 4003 i ~ ~--~~ ..~ .... .- , ,,. ,! !1 '-~,-~x~ ~ o~ ~0~; .............. . _~/~ 1 .~ :.,~ . , ~ ,_,,..~ . ~~ ~-~-~ ~.1~~:.~'~' ,,~,. ~ ,,, ,,.,~ .'~ '' , "-~,~,- ~'1~ ~/'~"+~" ¥~C~; cc.~&' ~¥~,..~ ~ ~.:~,~.:d-,~:~t'~'' 1715 C~emcer Ave., Bake=a~ield, CA 93301 805) 326-3979 . FACILIT~ h OWNER : PERMIT TO OPERA .TE,9 - ~ ~ ~ CONCUR - - ' CO~A~ PE~ON ~k~[ ~~Ry~ ~ oF s~s ~sz ~o~~ ~ ........ PLOT P~ CONDITION OF TANKS CONDITION OF PIPING CONDITION o~', soil ~Y' ~' Bakersfield Fire Dept, PERMIT APPLICATION FOR REMOVAL OF AN ;~/'-~~'*~i[~~ Environmental Sezvices UNDERGROU ND STORAGE TANK '1715 Chester Ave ~ Bakersfield, CA 93301 Page 1 of 1 Tel: (661)326-3979 ~ PermitNo ZIPCODE SITE Health South ADDRESS 5001 Commerce 93309 CROSS STREET FAClLI~NAME Health South TANKOWNE~OPE~TOR PHONE No. APN HealthSouth Corp. aal-~-~nnn MAILINGADDRESS 5001 Commerce c~w Bakersfield ZIPCODE 93309 .~ ~ ,. :~ ~.~ :~: ::::::~.~.~.~..~.-.- ......................... :::::: ~+~.,.,:~ : ::::: :~ ~: :::::::: ~/~ :::::: COMPANY Franzen~Hill PHONENo. 559-688-2977 LICENS~7 ADDRESS 1~00 North J Street' c~w Tulare Z~PCOD~327q INSU~NCECARRIER W~lter Mortensen WORKMENS COMP No. qq2010802 LICENSE No. COMPANY Associated Soil PHONE No~59_688_1011 7277~8 ZIP CODE ADDRESS 11~1 Batavia Court cl~ Tulare INSU~NCECARRIER HRH bf Central CA WORKMENS COMP No. 390000q375011' PHONE No. LICENSE No. COMPANY O.C.S. 559-~85-5~95 1 ADDRESS Cl~ ZIP CODE 3256 North Marks Fresno 93722 INSU~NCECARR[ER EatSR 8 Eaton~ WORKMENS COMP No. PEC2722765-05 WASTE T~NSPORTER IDENTIFICATION NUMBER FACILI~ IDENTIFICATION NUMBER NAME OF RINSATE DISPOSAL FACILI~ 197q CAE000190816 RivePbahk ADDRESS ........ .,,, Cl~ ZIP ~ODE - ~uu ~aus KOaO ~-_~¥:=~'"::~'::L/:;~ I Riverbank COMPANY O.C.S. PHONE No559_485_5495 uo~g~ No. Cl~ ZIP CODE ADDRESS 3256 North Marks Fresno 93722 TANK DESTINATI~ ~ Tulare Iron Works : ::::::::::::::::::::::::::::::::::::::: :;~. : ~:::::, ::::::::::: :~:~ ~: ::: :;~ ::: ~-~'~:: ::: ::::::::: ..... .~ : ,,~.-'~ I ~. - :::~:~:~:*~'~::~:::: : :~ ~,:~ ~ ~: :,~ ....... ~ ~;.: ~::.,::: ::::::::: ~,~ : ~ .................. CHEMICAL DATES CHEMICAL TANK No. AGE VOLU ME STORED STORED PREVIOUSLY STORED 1 10 1,000 Diesel For ~ficial Use Only ..... ~ ~ ~:~ ,<~ ::::~ .... ., ............... ~:: :~::::: ....... :::::::::::::::::::::::::::2~? ::::::::::::::::::::: ~::. ~::: ::::::::::::.,,,~ .......... ================================= ~'~ , : ~" ..................... .......... :~ C g ~:Bo .,:::::": ~ :::~4~ ~. ....... ~ .: .......... ~TAB ~-~.~:~ ::::::::::::::::::::::: :: : ~,,,~::~ ~:~,~::: ::: :: ?:,, ~' ,~ '" /~ ~/,~,~::::~: :: ,,,.~: ..:~:: :: :::~ ,~,~:::: ;:; ,~ ~ :::::: :,~::.~ ........ ~ ............ ~:: ::~::::::, ......... ~,,~ ............. ::::::::::::::::::::::::::::::::::: .......... ::::::::::: ~ :;~e,::::: ::::,':~: :::%~::: ::::~t~::~:: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ................. THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE A~ACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE, LOCAL AND FEDERAL REGU~TIONS. THIS FORM HAS BEEN COMPLETED UNDER PENAL~ OF PERJURY. AND TO THE BgST OF MY KNOWLEDGE 18 TRUE AND C~RECT. PP~NTSI~ A~NT NAME/(PRINT) A G N~E ~~ED~~~ THIS APPLICATION WILL BECOME A PERMIT WHEN APPROVED · January 22,~2003 Bakersfield Regional Rehab FIRE CHIEF RON FRAZE 5001 Commerce Bakersfield CA 93309 ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 RE: Upgrade Certificate & Fill Tags VOICE (661) 326-3941 FAX (661) 395-1349 Dear Owner/Operator: SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA93301 Effective January 1, 2003 Assembly Bill 2481 went into effect. This VOICEFAx (661)(661)395-1326'3941349 Bill deletes the requirement for an upgrade certificate of compliance (the blue sticker in your windoW) and the blue fill tag on your fill. PREVENTION SERVICES FIRE $AFEI~f SERVICES * ENVIRONMEHTN. SER1/lCES 1715 ChesterAve. You may, if you wish, have them posted or remove them. Fuel Bakersfield, CA 93301 vendors have been notified of this change and will not deny fuel VOICE (661) 326-3979 FAX (661) 320-0576 delivery for missing tags or certificates. PUBLIC EDUCATION 1715 ChestorAv~. Should you have any questions, please feel free to call me at 661- Bakersfield, Ca 93301 326-3 1 90. VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. ~]ncerely, Bakersfield, CA 93301 --- ---~" VOICE (661) 326-3951 /,~, . FAX (661) 326-0576 TRAINING DIVISION Steve Underwood 5642 Vlctor Ave. Bakersfield, CA 93308 Fire Inspector/Environmental Code Enforcement Officer VOICE (661) 390469~ FAX (661) 399-5763 Office of Environmental Services SBU/dc DEC-- I ?--02 TUE I I .' 26 FROM I~ . $ . $ . R . I NC . P .~ 0 I OCT .~.5 ~OO2 8:3:~ BKSFL~] FIRE PREVENTION (GG]JG~-2&?~ .p.' ', O~ICE OF E~O~NTAL 1715 C~r Ave. Bake~d, CA (661) APPLI~TION TO PE~O~ FUEL MO~TO~NG CER~]~TION o~o~$ ~~ DO~ FA~Y ~ D~$~ PANS? ~~ NO~ - - _ .... [~..1~ -.~.'~_ .' DA~ SIGN OF ~~¢~'~24=02 'roe 9 ~ 27 FROM B . $ . $ . R. · NC . " , ..... ,.':: . . SSR, Inc. ., .., 6030 ~osu4a}e H~., ~'B,'Bi{e~ifi~'ldi C'A 9~3'0s Phone <661) 588.2777 Fax (66~) 588-2786 MONITORING SYSTEM CERTIFICATION :'l'hlg:(orm must be used to document testing and $orvicing of mohitoring equipment. ~.sova_ra.~ cc~ificat~o or r~oA ~t_~ i "]~,{~i '~ys~m 0whet/oporto,, ~[ o~er/operator m~t sub~t a copy of ~a Yonn ~ ~e local agency mguiaung :e~ed Vaul~ Se~r. '. =~cl: ......... O Annul~ Spa~ or Vault S~sor. Modch ......... ' .... Lln~ L{~ Dcteotor. Modd~ ...... ~ Mcchani~i Line Le~ D~tcctor. Model: ,{ne'Ld~ ~(~c~r. O Ei~tronic Lint Lc~ Oct~tor, Mod~l: ...... Sms0r. O Tank Dy{frill/Hish-~vcl Scn~r, Model: ' ' i~ Section ~ on = ~l model in Scctio~ M~cI: ~ {n-T~k OauSln~ Probe, Mod~: M~g3 O Annular S~cc or Vaull S~s0r. Mod~l: ....... .. . .... / T~h ~r(c) M~el: O Piping lump / Trench Sensor(s), Model: ,Scnso~s), M~ ,, , O Fill Sump Sensors). Modch ,1 Line L~k O~,cWr, M~d: ' ~ MccMnical Line Lc~ Detector. Model: ~ ' '.'.'l~ ?: .... .: . ' '..~ ' Dispenser ID: __ is). ~el: ...... ._ __ 0 Dis~nser Comainmcnt Sensors).' M~el: 0 Sh~ Valve(s). and Chain( ~' Model:. ~ Di;po~r Containmont $cn~o~s). Modal:. r' ~alvg(s). O Shear Valve(s), and Chain( ~ntainm~nt ired Container Sensors). Modch Q Dispenser ~nlainmcnt Se~s0~- Model: ' O Shear Valve(s), ' :" 'i[a. ~ility'i6n~ m0r~ timks or diSliC6SCrS, copy this form, lnolude in~rmation ~ =ve~ rank and disposer at ~ faciliiy, ,C~' - I ~ify ~t te ~uipm~t Identical in ~ document ~ i~p~/s~lc~ in ~ccoJ'~ w~h the :' guiddh~. A~ch~ to ~ts Cefliflc~Uon ~ information (e.g. ~nufacmre~' cb~RUs~) nect~a~ to ~t~ ~at ibis a'cor~et ~d a ~lot Plan shrug ~e layout of monltorl,g equipm~t. For nay equlp~nt ~bl~ of gene~g's~h J'have al~'at~d i ~Pi of the ~o~; (cA~k ~ ~iar a~p~): O S~m ~-up~ ~m hfst~ re~t Page ! of 3 0~i ' ~'0~t0rlng System Certification I~E~¢--24--02 TU£ 9 : 28 FROM 1~. $. $. R. I NC. P. 02 IL ln~7'ank Gauging / SIR Equipment: 0 Check th~s box il' ' ~ Check thi~ box if no ~ gaugi~g or SIR equipment ~ installed. This,$~tion must be completed if in-~ gauging ~uipment is us~ to Pertbt~ Ic~ detection mo~toring. ~ ~a ~; No* W~o aU't~"gaug~ng'p~es v~ually i.sg~a for damage a~ ~sidu~'buildup~...' ;", [ "j ~on H, bdow, d~ribe how and when ~ ~:~.~ ,' . . ~ ............ ]Page 3 of 3 03/01 I) EC*~ -- 24-- 02 TUE 9 : 29 ~ROM I~ - $ - $ . R . I NC . P . 0~ D; Results of Tes~ng/Servicing "" ~" "'~': loweg Eo~t of semn&, contaim*nt and positioned so ~at o~r equipment =~ ...... ' ....... ' .... -' ' -tm ess cd as m~i~? CM~ afl ~t app.) ~ .... ;}~.~:'1 . - - .t, ---T,, .. ' ' . :, ....... ~a . '...i" ': ;...~ .'. '~: :~. '.':' ' . ,',t g". ......... '.' .," : ' ,, .~ .. .~':. ., · . .--~ .... -..... · . ;.: .=: ...... ~.';'t ..... · c , . "~' :~.. '. . :...'.:' .~ ~.. .... . .... "' '?' :~' :' :... , :~1 ' ' ' '" :j'v':':: : ..: .... : ...... ~ .. '.:;..: ..'... '..~.......:~ .... . ,. '.... ..: ,,~: :'. ~;.:". :.. ':~ ..... ,.'.'~,~i .~. .;.;~ , ~,~ .' .~,~ Z. ~':' .':~''' ' ' . .: ' '. ~'~' '~. . t ~D~E~--24--O2 TUE 9 : ~0 FROM I~ $ $ R I ~4C p 0~1· ' ..',:i M~)~ttorlqg System CcrtificatiO~ ~ST Monitoring Site Plan ' ",' *,.'~;t',: - ' , .. ' .............. '~ ':: [ . .......... ........ ................. [ - ,~ ..... .:~.. ...... .. .,. ...... .. . ~ ~.~o~,~ ..................... , ~,~ ............... .'. .............. .,,... , ll.t . . . ~.~.~ J '.' "'" '" ~l ~/o~ "' '"'""' Dal~pw~_ __ -'- ' .. . :"~i' .i: -: ..., ' if: You .~dy have a dh~ ~at shows all [cqukcd infon~tion, you may include it, rad~cr t~ this page, .w}~ yo~' ;i.'[? ~.. "~'i ,~*" .... ~= s ace ~vidcd no~ ~c date' th~'~'Sitc Plaa ?..:.:.'. ~t~} and in-~ liquid leal prob~ (xfused for lc~ dctcc2on). ~ P P , ' ......... ' ,i . !.':i: ~:..: 'i ~a;5;~'*i~. ' ' ' ""' ::',,' '"(' FIRE CHIEF RON ~R~ZE December 3, 2002 ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfield, CA 9.3.301 VOICE (661) 326-3941 FAX (661) 395-1349 Brandon Neal SU~'PRESSION SERVICES Bakersfield Regional Rehab 2101 'H' Street 5001 Commerce Way . Bakersfield, CA 93301 CA 93309 VOICE (661) 326-3941 ~a~ersnela, FAX (661) 395-1349 Dear Mr. Neal: PREVENTION SERVICES FIRE SAFE'W SERVICES · ENY1RONI4EHTAL SERVICES 171 $ Chester Ave. Bakersfield, CA 93301 Enclosed, please find the California Code of Regulation, Title 23, voice (c~11325-39?9 Division'.3, Chapter 16 of the Underground Tank Regulation FAX (661) 326-0576 dealing with Secondary Containment Testing requirements. PUBUC EDUCATION 1715 Chester AVb. Bakersfield, CA 93301 I have highlighted the necessary information. Should you have VOICE (661)326-3696 any questions, please feel free to contact me at 661-326-3190. FAX (661) 326-0576 FlEE INVESTIGATION Sincerely, 1715 ChesterAve. _~ ~ Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION Steve Underwood ~2 wot^ye. Fire Inspector/Environmental Code Enforcement Officer Bakersfield, CA 93308 VOICE (661) 399-4697, Office of Environmental Services FAX (661) 399-5763 SBU/dc enclosure · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse [] Agent So that we can return the card to you. [] Addressee · Attach this card to the back of the mailpiece, B. Received c~ or on the front if space permits. ~ 1. Article Addressed to: D. Is delivery address different from item 17 If YES, enter delivery address below: [] No BRANDoN NEAL 15 KSFLD REGIONAL REHAB 5001 COMMERCE 3. Service Type / ~AKERSFIELD CA 93309 l-1 Certified Mail [] Express Mail ,.~ [] Registered' [] Return Receipt for Merchandise ~ [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 2002 0860 0000 1641 5486~ PS Form 3811, August 2001 , Domestic Return Receipt 102595.02.M.08351 UNITED STATES POSTAL SERVICE UsPsP°stageFirst'Class'& Fees Paid Permit No. G-10 · Sender: Pl~se print your name, address, and ZIP+4 in this box · DA~RSFIELD FIRE DEPARTMENT OFFICE OF ENVIRON~,~ENTAL SERVICES 1715 Chester Avenue, ~ ~ OFfiCiAL POStage Certified Fee Return Receipt Fee (Endorsement Required) Postma~ Here December 2, 2002 . _-:--. ...... ~ ~ Brandon Neal Bakersfield Regional Rehab 5001 Commerce Bakersfield, CA 93309 CERTIFIED MAIL NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE FIRE CHIEF i RON FRAZE ADMINISTRATIVE SERVICES ~---,: Failure to Submit/Perform Annual Maintenance on Leak iDetection System 2101 "H' Street Bakersfield, CA 93301 ~, VOICE (661) 326-3941 FAX (661) 395-1349 Dear Underground Storage Tank Owner: SUPPRESSION SERVICES 2101 "H' Street Our records indicate that your annual maintenance certification on your leak detection Bakersfield, ca 93301 system was past due on November 28, 2002. VOICE (661) 326-3941 I FAX (661) 395-1349 You are currently in violation of Section 2641(J) of the California, Code of PREVENTION SERVICES Regulations. FIRE SAFETY SERVICES · ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield. CA 93301 "Equipment and devices used to monitor underground storage tanks shall be installed, VOICE (661) 326-3979 FAX (661) 326-0576 calibrated, operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks at least once per calendar year for PUBMC EDUCATION operability and running condition." 1715 Chester AvCo. ; Bakersfield, CA 93301 l VOICE (661) 326-3696 YOU are hereby notified that you have thirty (30) days, January 3, ;2003 to either FAX (661) 326-0576 perform or submit your annual certification to this office. Failure ,to comply will result FIRE INVESTIGATION in revocation of your permit to operate your underground storage SYstem. 1715 Chester Ave. : Bakersfield. CA 93301 VOICE (661)326-3951 Should you have any questions, please feel free to contact me at 661-326-3190. FAX (661) 326-0576 I Sincerely, TRAINING DIVISION 5642 Victor Ave. , Bakersfield, CA 93308 Ralph Huey VOICE (661) 399-4697 FAX (661) 399-5763 Director of Prevention Services by: Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services cc: Walter H. Porr Jr., Assistant City Attorney CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE. OF'~ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME i'~tt t~\ ~rt~,)~ INSPECTION DATE Section 2: Underground Storage Tanks Program [] Routine [~Combined [] Joint Agency [] Multi-Agency [221 Complaint [] Re-inspection Type of Tank /)t~0~ Number of Tanks Type of Monitoring d~/../ex, Type of Piping 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 ,'~ 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 .~/,.V=Violation Y=Yes N=NO Inspector: ..,,,,,~.4~.4~ ~//~ ~~ Office of Environmental Services (805) 326-3979 Business Site Responsible Party White - Env. Svcs. Pink - Business Copy OFFICE OF ENVIRONMENTAL SERVICE.~ 1715 Chester Ava, Bakersfield, CA (661) 326-3979 APPLICATION TO PERFORM'A TANK TIGHTNESS TEST/ SECONDARY CONTAINMENT TESTING PERMIT TO OPERATE # OPERATORS NAME OW~RS ~A~ ~_ ~_~ .4'h.~~ NUMB~ OF TANKS TO BE TESltl} I IS PIPING C, OING TO BE TESTED_~ " -TANK # VOt.UME · September 30, 2002 Bakersfield Regional Rehab 5001 Commerce Bakersfield CA 93309 REMINDER NOTICE FIRE CHIEF RON FRAZE RE: Necessary secondary containment testing requirements by December 31, 2002 of ADMINISTRATIVE SERVICES 2101 "H' Street underground storage tank (s) located at the above stated address. Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 Dear Tank Owner / Operator, SUPPRESSION SERVICES If you are receiving this letter, you have not yet completed the necessary secondary 2101 'H' Street Bakersfield. CA 93301 containment testing required for all secondary containment components for your underground VOICE (661)326-3941 storage tank (s). FAX (661) 395-1349 PREVENTION SERVICES Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Health & Safety s,,m S~ES.E.,,.O."'.U~ s~,~:~s Code) of the new law mandates testing of secondary containment components upon installation 1715 Chester Ave. Bakersfield, CA 93301 and periodically thereafter, to insure that the systems are capable of containing releases from VOICE (661)326-3979 the primary containment until they are detected and removed. FAX (661) 326-.0576 PUBLIC EDUCATION Of great concern is the current failure rate of these systems that have been tested to date. 1715 Cho$~orAVb. Currently the average failure rate is 84%. These have been due to the penetration boots leaking Bakersfield, CA 93301 VOICE (661)326-3696 in the turbine sump area. FAX (661) 326O576 For the last five months, this office has continued to send you monthly reminders of this FIRE INVESTIGATION 1715 ChostorAve. necessary testing. This is a very specialized test and very few contractors are licensed to Bakersfield, CA 93301 perform this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. vOiCE (661) 3~6-3951 FAX (661) 326-43576 The purpose of this letter is to advise you that under code, failure to perform this test, by the TRAININO DiViSION necessary deadline, December 31, 2002, will result in the revocation of your permit to operate. 5642 Victor Ave. Bakersfield. CA 93308 VOICE (661) 399-469~ This office does not want to be forced to take such action, which is why we continue to send FAX (661) 399-5763 monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3 t90. Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services D ~ August 30, 2002 Bakersfield Regional Rahab 5001 Commerce Bakersfield, CA 93309 REMINDER NOTICE RE: Necessary secondary containment testing requirements by December 31, 2002 of underground storage tank (s) located at the above stated address. FIRE CHIEF R©N FRAZE Dear Tank Owner / Operator, ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield. CA 93301 If yOU are receiving this letter, you have not yet completed the necessary secondary VOICE (661)326-3941 FAX (661) 395-1349 containment testing required for all secondary containment components for your underground storage tank (s). SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Health VOICE (661)326-3941 FAX (661) 395-1349 (~5 Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to insure that the systems are PREVENTION SERVICES capable of containing releases from the primary containment until they are detected 1715 Chester Ave. Bakersfield, CA 93301 and removed. VOICE (661) 326-3951 FAX (661) 326-0576 Of great concern is the current failure rate of these systems that have been tested to ENVIRONMENTAL SERVICES date. Cun'ently the average failure rate is 84%. These have been due to the 1715 Chester Ave. Bakersfield, CA 93301 penetration boots leaking in the turbine sump area. VOICE (661) 326-3979 FAX (661) 326-0576 For the last four months, this office has continued to send you monthly reminders of TRAINING DIVISION this necessary testing. This is a very specialized test and very few contractors are 5642 Victor Ave. Bakersfield, CA 93308 licensed to perform this test. Contractors conducting this test are scheduling VOICE (661)399o4697 ' FAX (661) 399-5763 approximately 6-7 weeks out, The purpose of this letter is to advise you that under code, failure to perform this test, by the necessary deadline, December 31, 2002, will result in the revocation of your permit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Sincerely,_~. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services July 30, 2002 Bakersfield Regional Rehab 5001 Commerce Bakersfield CA 93309 REMINDER NOTICE FIRE CHIEF RE: Necessary Secondary Containment Testing Requirements by December RON FRAZE 31, 2002 of Underground Storage Tank (s) Located at ADMINISTRATIVE SERVICES the Above Stated Address. 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 Dear Tank Owner / Operator: FAX (661) 395-1349 If you are receiving this letter, you have not yet completed the necessary SUPPRESSION SERVICES 2101 "H' Street secondary containment testing required for ali secondary containment Bakersfield, CA 93301 components for your underground storage tank (s). VOICE (661) 326-3941 FAX (661) 395-1 349 Senate Bill 989 became effective January l, 2002, section 25284. l (California PREVENTION SERVICES Health & Safety Code) of the new law mandates testing of secondary FIRE SAI:ET3' SERVlCES* ENVIRONMENTAL SERVICES 1715 Chester Ave. containment components upon installation and periodically thereafter, to insure Bakersfield, CA 93301 that the systems are capable of containing releases from the primary VOICE (661) 326-3979 FAX (661)3260576 containment until they are detected and removed. "' PUBLIC EDUCATION Of great concern is the current failure rate of these systems that have been 1715 Chester Ave. Bakersfield, CA 93301 tested to date. Currently the average failure rate is 84%. These have been due VOICE (661)326-3696 to the penetration boots leaking in the turbine sump area. FAX (661) 326-0576 For the last four months, this office has continued to send you monthly FIRE INVESTIGATION 1715 Ch~sterAve. reminders of this neCessary testing. This is a very specialized test and very few Bakersfield, CA 93301 contractors are licensed to perform this test. Contractors'conducting this test VOICE (661) 326-3951 FAX (661)326-0576 are scheduling approximately 6-7 weeks out. TRAINING DIVISION The purpose of this letter is to advise you that under code, failure to perform 5642 Victor Ave. Bakersfield. CA 9330e this test, by the necessary deadline, December 31, 2002, will result in the VOICE (661) 399-469z revocation of your permit to operate. FAX (661) 399-5763 This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Sincere Steve Underwood Fire Inspector Environmental Code Enforcement Officer D June 30, 2002 Bakersfield Regional Rehab 5001 Commerce Bakersfield, CA 93309 REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 5001 Commerce. FIRE CHIEF RON FRAZE Dear Tank Owner / Operator: ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 The 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. l (California VOICE (661) 326-3941 FAX (661) 395-1349 Health & Safety Code) of thc new ]aw 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 are detected and removed. VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES Secondary containment systems installed on or after January 1, 2001 will be tested 1715 ChesterAve. upon installation, six months after installation, and every. 36 months thereafter. 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 1, 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 t° contact me at (661)326-3190. Steve Underwood · - ~, ' ......~ .... Fire Inspector/.Environmental, Code Enforcement Officer ....................... , ..... ~ EnVironmental Services ~ _ SU/kr May 2% 2002 Bakersfield Regional Rahab 5001 Commerce Bakersfield, CA,93309 RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 5001 Commerce REMINDER NOTICE FIRE CHIEF RON FRAZE Dear Tank Owner/Operator: ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 The purpose of this letter is to inform you about the new provisions in California VOICE 1661) 326-3941 FAX (661) 395-1349 Law requiring periodic testing of the secondary containment of underground storage tank systems. SUPPRESSION SERVICES 2101 'H" Street Senate Bill 989 became effective January 1, 2002. section 25284.1 (California Bakersfield, CA 93301 VOICE 1661) 326-3941 Health & Safety Code) of the new law mandates testing of secondary containment FAX 1661) 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 Chester Ave. detected and removed. Bakersfield, CA 93301 VOICE 1661) 326-3951 FAX 1661) 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 vOteR (661) 326-3979 that is "double-wall" in your tank system must be tested. FAX (661) 326-0576 TRAINING DIVISION Secondary containment testing shall require a permit issued thru this office, and 5642 Victor Ave. shall be performed by either a licensed tank tester or licensed tank installer. Bakersfield. CA 93308 VOICE 1661) 399-4697 ~ FAX 1661) 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. Sincere/l~t, /~ - Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/kr ., enclosures - ' D April 17, 2002 Bakersfield Regional Rehab 5001 Commerce FIRE CHIEF Bakersfield CA 93309 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 Janua{y I, 2002. Section 25284. I (California Health & Bakersfield, CA 93301 VOICE (661) 326-3951 Safety Code) of the new law mandates testing of secondary containment components FAX (661) 320-0576 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 Seconda.ry containment systems installed on or after January I, 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. Sine ~ ,~ Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/dm enclosures ·" '30 Rosedalo Hwy, # B, Bakersfield, CA 93308 Phone (661) 55a-2757 Fax (661) 588-2786 MONITO G SYSTEM CERTInCATION- '~s b~ m~t ~ ~ to do~t ~g ~d s~cMg of mo~ito~g eq~pm~t A .~;-~.sy~em o~er/~m~r. ~e ow~~or must ~b~t a copy of wi~ 30 ~ys of ~t d~. A. Gener~ Idoma~on ~1~, ' B. Invento~ of~qulpment T~te~Ce~ed · Tank ~: Tank ~: ~ ln-T~k Gauging Probe. M~: ~ I~-T~k Oau~ng Probe. Model: a Piping Su~ / %~ch $e~(s). M~el: a PiPi~g T~k ~!I / High-Level Sensor. M~el: ~ T~ Oveffill / High-~el ~or. MOdel: ~ Di~nser Containment S~o~s). - Model: ~ Dis~nser Containment Senso~s). Model~'~';''' ~ Sh~r Valo~s). ODis . ~n~ntFIo s ~d~ains. ODb Bbp~ser ~: ~ Di~s~ Center Smso~$). M~oI: Q Dispen~r Con~nmmt S~so~s). M~oI: ~ She~ Valves) ' I ~ $h~r Valve(s). · ' ': · n~nment Flea s ~d ~n s. · · ~ns ~ Dis Ce~ficafion-No.: .biJ~-IO~=ll I~ .... License. No.: Page I of 3 03/01 Monitoring System Certification D~ Results of Testing/Servicing Software Vet'sion Installed: ~ .~ ~C) ,~ ~ checklist: -~'~Ye~ ~i' NO* ' Is the visual alm'm operational? --------- -~es 12. No* Were all sensors visuall 'ms ec flmctionall tested and confn'med operational? ~es 'El No* Were all sensors installed at lowest point of secondary conl~inment and positioned so that other'equipment will not ~i~,"ere with thekp~oper op~.-mtion? .. . ~. · .... ~ __ ~:2 YeS C! No* If alarms are relayed to a remote monit°~ing station, is all co~¢a~ons ~e~u~r':~ent~ (e.g. -- : -- imbiiio automatically ~hut d~,~if'the pip:,~ se¢/Yn-'~-ff ¢o~tninment , ~ N/A monitoring system detects a leak, fails to ope. rate, or is electrically disconnected? If yes: which sensors initiate ; i. positive shut-down? (Cl~ck all that apply) Ctgump/Trench Sensors; .CI Dispenser Containment Sensors. Did you c_~,'la~ positive sb~_~_t..down ~_~e to l_e~ks..~nd __~m__sor failureffdiscon-~nec~on? (2 Yes; CI No. 'I~'Y~ CI No* For tank systems that utilize the .ntonitozhg sys~eai as the p~iuia~-y t~nl~ 0verrdl Wa~}h~g device (i.e. no CI N/A mechanical overfill prevention valve is installed), is the ov~fill warning alarm vis~l° and'.audl~ole at the lank fill ~int(,s) ~ma o~__Ai-~ ~o~rly? If so, at what l~re~t oft~,,~ ~c-~c!~ does the.. a!arm trigger? .c~ I~'Yes*' ~ No 'Was any monitm'ing equipment replaced? If yes, id~iiaf~ specific seniors, probes, or o~.~ equi?.:.~eut ,md list tho m,mn~,eO~er ~,ar.~a ~d model for all replac~m_ent parts in 8ectiog E~ below. El Product; El Water. If de~n~oe ~auaes in Section E below_. ~. ......... _~ --- II~'Yes ~ Is ail monito ' ' t o tional er manufaclurer's s ecmcauons't · In geeiton E below describe how and when these deflelem w Page 2 of 3 E ln-Ta~k Gauging / SIR Equipment: ~ Check this box if tav, k gauging is used only for inventory control. , [2 Chock this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tan~ gauging equipment is used- to perform leak detection monitoring. ~ [2 No* Has all input wirin~ b_~_n inspe~ for proper eh_to/and.tmnlnation~ ino, luding.t~..ting, forlground faults? "· -~"Yes [2 Nb* Were all ,~.k §~.~i.g probes. 'via,sHy inspected for d..msge and residue bufl._l,_.~_.? ~es 51 'No. Was ac~acy 0f'iys~_em product level readlnEs it.~ied? . .. '~Yes [2 No* 'Was ac~.aiacy of SyStem ws~r level re__-~*d!~.~ tested? ~ I!~'Y~ ' [~ No. Were all probes ~¢ii~talled. prop~rly? · In the Section H, bdow, deseribe how and when these ~ G. IAneLeakDetectors(LLD): . ~/'Ch~,kthi~boxifL~I)sarenotinmlied. Complete the folio ~1 Yes- [2 No--''-'~ Was the testing apparatus properly cahtrrateA? ~'1 y'-'"-~ ~ Bio* For mechanical LLDs, does the LLD restrict product flow flit detects a t~l~ [2 No-''--~ For electronic LLD~, does the turbine automatically shut off if the LLD detects a leak? CI Yes [2 No-"--'--~- l~or electronic LLDs, does the tarbine antom~tic~ll¥ shut off if ~uy per, ion of the moni~ system i~ alibi ~ N/A malfim~ons or fails a tesF? --------- ~ Ci N--""--~- For ~Ie, otroni¢ LLD~, have ~11 aooesa~le wiring ¢o~uootion~ boon visually inspected? · I~ *he $~flon H below, describe . H. Comments: Page 3 of 3 °:~/°! ~l~r~ Sys~m Cer~tion · ' UST Monitoring Site Plan w~ p~pg~. Pa~ ~ of~ ]]'EC-- 4--00 MON 10 .' $6 FROM B.S.S.R. I NC. P. 02 ;~:~,.~.. .-. , ~. ~.,.] ..... .: .... . ........ . .,..,....:., . ,. '~;?' .....~. . ..... .~ .. ~, ~ ',~'..,~ :~ ,,... L~',,;,,,,;~,,.,,,,,,~,, ............................... , .............. " , .............. T~?~,',,'," '., ,:'" ,:'""~", ~ ~,:,' ';' ~':, ." ,' ....... ' '. , ','. ' : .'"'" ~ ~'~?:~.-.-.~.'. ;~'.;:. ~:.' %/':'. ..... J.,..C".'L.. '..:"',.'" ,,..,...~..:.... .'. ~., L__;~ .,: ..... "':~.F~::. ';:'." ~"~' .'.j..,.. ". ',' ':, :'.' ~': ';,- j.' . .... ...... ' ." ' ." ~' ~ ..... : ' ~.. , . ...'...;.; ';:':" '~,.,,...?. :.-;...:. . .;. t . · ,'~':.,~..:":J'~ '".:'~' ..!?..,... .... ..,......, ... ..., ,-,.. ., . ., ~ ....... .,..,. ,, : .......: .. ',;..~':;,, ...., ='.., . ,, .. ~ ,.~.... ~......,,..~., . ;'...:,,.~... ';. ' :;~..Cj.~,':v:' ~.~.,~,.~..........~..4.. · . .,...:..., ..~:::,,,:,..,., ...,,., .. i:.,..;.' ; .... .. .' ' ;,, ' .... ' ';' ' ' .' ............ ' ', ........ " m, ~?~):;.~'J~,.'~;~;~,~%.i':~.:::~F.:';'. .... ,. '.'..' '.'~'. ,....d ,.' ':.:.'=... ,' '.: .... ~). ' , ~:, .:F '..".: .': ,.. : ~..',"~".,:' .'. ~. : .-':::::::~_: ....... ,,,,,~,,;,:,, '.', ,: . ,, ........ ' ...... , ........ , :': '.,. : ~:",~,:,~":" ': .-~: 7..~:?'..~'F, '..~( h,,.~.;?,-~':,.:: b";';.:y '.{ ,.:".: .'" ." ' · j,.' "" ' ~ , "'". 4."." .'~:""~-:~'.' ;~;'::"'~'~ ~ ~":'::": e posl~veshu wn of ~e turbine?. ........ , .:~.,.,~: ...... I ~o~q .. . ,. ., .:, :j' '::': '.: .~:~' . .. ' "~' ' ~"~'.'t ,..;...~.:.~...~ ..:,.- .:.;....:.'.~,; ,:. ;~. NOV-30-O0 THU 02:52 PM BRANDON NEAL, FACILITIES FA.X:6616335253 PAGE ,~- CITY OF · O~FIG~ OF EN~RONMENTAL ~ERVICES 171S C~t~ A~., ~lki~flild, CA g~ol_(Ml) I ~F~ ~t ~NUFAC~RER CORROS~N ~ ~ - ~G~~M~,~). ~.:'"'" ~ ~L ~ '~ ~LE W~L'~ 46 ~ ~F~ ~ ~~~-~~ S~TEM F~U~ ~ ~ ~~N , Vl~ ~ ~ 1 ~. ~ [~E~ ~$T (O.l ~) ~ 1 B, ~ '~E~ TE$T (0.1 ~ :7, ~ V~UAL ~ , ~ 17. ~LY ....... "!~.g&~:X~ ".'~;~.;~ ' ::'~ ' ' ....... ~'~ '~' : .... 'k~: .':; '~,'." ~'~.:'~ .." ' ~': x ' ~ '"" ~.<~..~', .... ~,' ~ ~E~T~ BIONAIRE NOV-30-00 THU 02'53 PM BRA~DON NEAL, FACILITIES FAX'6616335253 PAGE 4 . 1715 Chester Ave., Bakersfleld,'CA 93301 (661) 326-3979. UNDERGROUND STOOGE TANKS- UST FACILI~ ACTION ~ 1. NEW SrTE ~RMIT ~3, RE~A~ ~R~T ~ S, ~ OF INFOR~TIG~ (~ ~. ~ 7. ~R~ I. FACI~ I S~ INFORMA~ON ...... ~ ~. INOWI~AL ~ e. STA~ AGENC~ L. V, P~OLEU~ UST R~C~L ~SPONSIBIL~ ~ol~ ~O~s) ~l, SE~URED O 4, SU~ND ~ 7. STATEFUND ~ 1o. ~ 2, ~EE ~ 5. LE~R O~ ~DE ~ 8. STATE ~ & ~O L~R ~ ~. OTHEr. VL LEGAL NOTIFI~TION AND MAILING ADDRESS ~l. APPLI~T S~NATURE I SERVI~ S'TAI~t ADDRESS ~ i~AGE REPO~D ~EM . '- -~~1 ~:) ~k ~ ~) ~0,~ WAS JO3'COMPLE~ ~ 8ER~CES I REPAIRS ~RF~MEP LABOR ~ARGES MATER~'L CHARGES ~ ... m~E,.,L ~ES~,T.,~N m AqO E ! , ~ :, %,, i '~" ~ : ' ' {Olat I , '" LA~OR CH~GE I : CORE ~BCtT ~ER-~ TRAVEL TIME ~ ~lO. OF I i t MILEAGE TO SI~ ~BTO. AL m ~ PERSONS ~ ~ ' ' ' J; ~ AND TIME AT SffE. ' ~,IA;ERiAL I iTE~, ~&~E ~ RATE TOTAL UP ~ REMA.9~ CONTR~OR CONFIRMED SEAVI~ CALL TflAVEL II~!E i )CA~' ~ Tl)~ .A)~I A~;VAL T"'E A1 GIIE TOTAL , 1 ... . . ........ : .- '"" """ -'.' ~OisC ....."' ' , ~E ~RS¢{ (~;NT ~UE) J SE~V~E PERS~ {PRINT )JATO1 BEFORE SIGN;NG FORM,'m AmHOR,~c P~s.~l (P~rYT l~ ~ CAF~ i'~ LL~ I m VER;FY ARR~AL TIME,m m m j -mo~[.~ ~R~iC[)~RSON'S S~A~RE SES~E PERS~S'~Gt?ATURE DEPARTURE TIME ~NO I A~.~o ~sc,;-s SIS~URE CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 Section 2: Underground Storage Tanks Program [] Routine [2~-Combined [2i Joint Agency [] Multi-Agency /[21 Complaint [] Re-inspection Type of Tank Ot/}F 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 V Certification of Financial Responsibility Monitoring record adequate and current L/ 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 V=Violation Y=Yes N=NO g~~~~ Inspector: ~~' ~~ Office of Environmental Services (805) 326-3979 usiness Site Responsible Party White - Env. Svcs. Pink - Business Copy ' ~ ' HAZARDOUS MATERI..ALS DIVISION~ ~ 2130 G Street, Bakersfield, CA 93301 ~.~?iO (805) 326-3970 ~UNDERGROUND TANK QUESTIONNAIRE RECEIVED I. FACILITY/SITE No. OF TANKS /' ~) HAZ. MAr DIV. DBA OR FACILITY NAME NAME OF OPERATOR ADDRESS NEAREST CROSS STREET PARCEL No.(OPTIONAL) . CI~ NAME STATE ZIP CODE ~ BOX TO INDICATE ~CORPO~TION ~INDIVlDUAL ~PARTNERSHIP ~LOCALAGENCYDIS~IC~ ~COUN~AGENCY ~STATEAGENCY ~FEDE~LAGENCY EMERGENCY G'ONTACT PERSON (PRIMAE~ EMERGENCY CoNTAcT PERSON (sECONDA~ optionol DAYS: NAME (~ST, FIES~ PHONE ~. ·WITH AR~ CODE DAYS: NAME (~ST, FI~ PHONE No. WITH AR~ CODE NIGHTS: NAME (~ST. FI~ PHONE ~. WITH AR~ CODE NIGHS: NAME (~ST. Ft~ PHONE ~. WITH AR~ CODE' II.PROPER~ OWNER INFORMATION (MUST BE COMPLETED). NAME CARE OF AODEE~ INFORMATION MAIUNG OR STRE~ ADDRESS ~ BOX ~ INDIVIDUAL ~ ~OCAL AGENCY ~ STATE AGENCY CIW NAME STATE [ ZIP CODE PHONE ~. WITH AREA CODE III. TANKOWNER INFORMATION (MUST BE COMPLETED) NAME . CARE OF ADDRESS INFORMATION MAILING. OR STREET ADDRESS .. ~ BOX . ~ INDIWD~AL'. ~ LOCAL AGENCY- - ~STATE AGENCY CI~ NAME STATE [ ZIP CODE PHONE No, WITH AREA CODE OWNER'S DATE VOLUME PRODUCT IN TANK No. INSTALLED STORED SERVICE YIN , YIN Y/N , . Y/N YiN I ~'~'~?~ Fill one segment t for each tank, unless~ al~anks and piping are Constructed of same'~materials, style and~ pe, then only fill' one segment out. ~please identify tanks by owner ID #. -I. TANK DESCRIPTION COMPLETE ALL ITEMS -- SPECIFY IF UNKNOWN A. OWNER'S TANK L o.# MANUFAC RED III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, G, ANDC,~DALLTHATAPPLIESlNBOXD A, ~PEOF, ~ 1 DOUBLE WALL 0 3 SINGLE WA~ WI~ E~ERIOR LINER ~ 95 UNKNOWN SYSTEM ~ 2 SINGLE WALL ~ 4 SECONDARY CONTAINMENT (VAULTED TAN~ ~ 99 O~ER B. TANK ~., ,ARESTEEL " 0 2 STAINLESS S.EL ~.FlaERG~S '~4 STEELC~D W/FlaERGLASSREINFORCEDP~S,,C MATERIAL ~ 5 CONCRE~ ~ 6 POLWINYL CHLORIDE ~ 7 ~UMINUM ~ 8 ~0 ME~ANOL ~MPATlaLEW/FRP ~ 1, RUBBER LINED 0 2 ~O LINING 0 3 EPO~ LINI~ ~ 4 PHENOL~ LINING LINING ' ' ~s UN~NG UATER,AL ~UPATmaL~ WITH ~ U~ANOL ~ ~ES ~ NO~ D. CORROSION ~; 1 mLYE~YLENE WRAP ~ 2 ~ATI~ . . ':'j~.~ 3 VI~L WR~ .~ ~ ~ 4 FIBERG~S REINFORCED ~STIC pROTECTION ~ 5 CATHODIC PRQTEcTION ~ 91 ~NE -: ~ ~ UN~OWN -. ~ ~ O~ER IV. PIPING INFORMATION CIRCm A IF ABOVE GROUND OR U IF UNDERGROUND, BO~ IF APPLICABLE A. SYSTEM~PE A U 1 SUCTION . A~2 PRESSURE ,A ~ 3 GRAVI~ A U ~ O~ER B, CONSTRUCTION A U I SINGLE WALL A~2 ~UBLE WA~ A U 3 LINED TR~CH A U ~ UNKNOWN A U ~ O~ER C, MATERIAL AND A U 1 ~RESTEEL A U 2 STAINLESS S~EL A U 3 ~LWINYL CHLORIDE (PVC)A~4 FIBERG~S PIPE CORROSION A U 5 ~UMINUM A U 6 CONCRE~ A U 7 STEEL WI ~A~NG A U 8 1~, ME~ANOL ~MPATIBLEW~RP PROTE~ION 'A U 9 ~LVANI~D S~EL A U 10 CATHODIC PROTECTION A U 95 UN~OWN A U ~ O~ER D. LEAK DETECTION ~ AUTOMATIC LINE LEAK DE~CTOR ~ 2 LINE T~H~ESS TESTING ~ 3 INT~S~L ~NffORING ~ 99 O~ER V. TANK LEAK DETECTION m~ 1 viSUAL CHECK ~ 2 INVENTORY RECONCILIATION ~ 3 VAPOR MONITORING ~ AUTOMATIC TANK ~UGING ~ 5 GROUND WA~R MONITORING I. TANK DESCRIPTION COMPLETE ALL ITEMS -- SPECIFY IF UNKNOWN · A. OWNER'S TANK I. D. # B. MANUFACTURED BY: C. DATE INSTALLED (MO/DAY/YEAR) D. TANK CAPACITY IN GALLONS: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, AND C. AND ALL !HAT APPLIES IN BOX D A. TYPE OF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EX'rERIOR·LINER [] 95 UNKNOWN SYSTEM []. 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER B, TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVlNYL CHLORIDE [] 7 ALUMINUM [] 8 10(7'/o METHANOL COMPATIBLEW/FRP (PrimaryTank) [] 9 BRONZE [] 10 GALVANIZED STEEL []]'95 UNKNOWN . [] 99 OTHER [] 1 RUBBER UNEO [] 2 ALK~'D LINmNG [] 3 EPOxY LINING [] 4 PHENOL~ LINING C. INTERIOR [] 5 GLASS LINING [] 6 UNLINED · [] 95 UNKNOWN [] 99 OTHER LINING IS LINING MATERIAL COMPATIBLE WITH 1~o METHANOL ? YES__ NO__ D, CORROSION [~ 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION m---) 5 CATHODIC PROTECTION [-'---j 91 NONE [] 95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION C~RC~ A IFABOVEGROUNDOR U IFUNDERGROUNO, BOTH IF APPLICABLE A, SYSTEM TYPE A U 1 SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL- A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN . ,& IJ 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (~VC)A U 4 FIBERGLASS PiPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING .A U 8 10(~/o METHANOL COMPATIBLEW/FRP PROTECTION A U-9 GALVANtZED STEEL A U 10 CATHODIC PROTECTION A U'95 UNKNOWN A-I,J 99 OTHER D, LEAK DETECTION [-~ 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTITIAL . MONITORING [~ 99 OTHER . V. TANK LEAK DETECTION I:~ 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION []]]] 3 VAPOR MONITORJNG [] 4 AUTOMATIC TANK GAUGING [] 5 GROUND WATER MONiTORING :--'-] 6 TANK TESTING []'7 INTERSTITIAL MONITORING [~-] 91 NONE . ~ 95 UNKNOWN []]]] 99 OTHER ,0 D February 9, 1999 F~.E c.~EF Bakersfield Regional Rehab RON FRAZE $001 Commerce Dr A~mNISTaATn~ SF.R~CES Bakersfield, CA 933O9 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 32~-3~41 FAX (~05) 395-1349 RE: Compliance Inspection SUPPaESSlON s~mne~s Dear UndergrOund Storage Tank Owner: 2101 'lq' Strut Bakersfield, CA 9~01 VOICE (805) 326-3941 FAX (805) 395-1349 The city will start compliance inspections on all fueling stations within the city limits. This inspection will include business plans, .am~moN S~CES underground storage tanks and monitoring systems; and hazardous 1715 Chester Ave. materials Bak~,'~fie,", c^ 93301 ~nspecuon. VOICE (805) 326-3951 FAX (805) 3260578 To assist you in preparing for this inspection, this office is ENVIRONMENTAL SERVICES enclosing a checklist for your convenience. Please take time to read this 1715 Chester Ave. · Bakemfield; CA 93301 list, and verify that your facility has met all the'necessary requirements to VOICE (805) 326-3979 FAX (805) 326-0576 be in. cOmpliance. TRAINING DMSlON Should you have any questions, please feel free to contact me at 5642 Victor Ave. Bakersfield, CA 93308 ~U~)-~..O-..~/V. '. VOICE (805) 3994697 . FAX (805) 399-5763 Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~l.¢crS-~t¢t,( lleqto~a_[ ~el,,~.la INSPECTION DATE Section 2: Underground Storage Tanks Program ~1 Routine [~1 Combined ~/foint Agency ~ Multi-Agency [] Complaint [] Re-inspection Type of Tank 00O f: Number of Tanks · Type of Monitoring d~/-f//x Type of Piping OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit tees current b,/ Certification of Financial Responsibility record adequate and current Monitoring Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No v"/' 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? Office of Environmental Services (805) 326-3979 Business Site Responsible Party White - Env. Svcs. Pink - Business Copy /,/ I b:nVIU~ ~lAliUm AUUr~Cb~ ' ['i ~ 5fAIIUN NO. PAGE . ~ WAS JOB COMPLETED ,~ ~ ; ~." ...... ' ...... LABO~ CHA~GES MATERIAL GHA~GES · '. 's~RV ES 1 REPAiR~ P~"~R~':~b~ ~:~' :~;'~.L{;~,? ~} '-';: -;:. MATERIAL DESCRIPTION SHOW MFG. NAMES & SERIA~ NOS. IF.PuMP ~OTALI~ER IS c~ANGED, show BEF~hE &;A~ ~T~TAEIZER RE~DINGS. TIME' RATE AMouNT QTY. PRICE · AMOUNT ' : ; ~ ~ :~-:~15o¢- ~ ~-~d. .'<' ~.~ ', ', ', c.'-? .... ' ' ,' ,, ,, ,' ,, I I ~' ~ ' , , ' ' ,(,) TOTAL , CORE CREDIT *~ ' LABOR CHARGE ; NO. OF , , MILEAGE TO SITE SUBTOTAL , ". ..; :. i ' PERSONS D ,, ', ,, AND TIME AT SITE MATERIAL DISPENSER '. VENDOR'S EQUIPMENT '.:": ~ " " " NUMBERVEHICLE upMARK% ,, SERIALNO.. ': ' ...... : ' ' '* ' ~ ~ ~ ' "'"" ' : SUB; MARK ENDING ODOMETER READING TOTAL dTEM' ~ME 'RATE AMOUNT , B ." :.- ... , ' , TOTAL, UP % , MATERIAL EFORE EQUIPMENT ~ , , , , SALES TAX ON RENTAL , ~ ~ ~ BEGINNING ODOMETER READING TOTAL MATERIAL AFTER SUB- ' . ~ ~ ~ ~ TOTAL , CONTRACTOR ' , , ~ LABOR CHARGE ~ I ~ I TOTAL MILEAGE TO SITE CONFIRMEB SERVICE CALL TOTAL RKS CONTRACTOR TRAVEL TIME , DATE TIME AM ARRIVAL TIME AT SITE AM TOTAL , pM ¢/?~¢' ~ -, M~EA~ ; ~ ' ~_.. 'TOTAL DEPARTURE,TIME FROM SITE AM: VENDOR'S EQUIP. PERSON 60~CTED AT SITE , TOTAL HRS. MIN. SUBCONTRACTOR [ ' SERVIC~SO~ (PRI~AME) SERVICE PERSON (PRINT NAME) BEFORE SIGNING FORM, AUTHORIZED PERSON (PRINT NAME). TOTAL ~ ' ~:~ ~'~- VERIFY ARRIVAL TIME, ~%,'"" .-'5-<:~. ", SERVIC[~N'S SIGNAT~E SERVICE PERSON'S SIGNATURE DEPARTURE TIME, AND AUTHORIZ~~IGN~URE ....'~:;'/ DATE ~ / I SERVICES PERFORMED. ,, :- ..~/~/.E:...~:;..~ - -....., ." -.' FO~U 3-8~. (REV. 12-9~)PRINTED ,N U.S.*. ' ~ 2 - AC~OUNT~ PAYABLE CONFIDENCE U~T SERUllCES~. INC.. 41'7 MONTCLAIR STREE"F BAKERSFIELD, CA (805) 631'-3870 PRECISION TANK 8, LiNE TEST RESULTS SUmmARY lnvoi~e Address: Tank Location: "W'.O.~a ~.~408 HEAI_THSOUTH BAKFLD REHB HEAL. THSOU¥'H BAKFLD REHB I o O. Number: N/A '~', .... 5001 GOMMERCE DRIVE 5001 COMMERCE DRIVE Technician :D. YOUNG BAKERSFIELD, CA 93309 BAKERSFIELD, CA 93309 Tech.~:86116 Van~:Ol Da~e~ 1;~-11-96 Time S~a~ 14:30 .End~ 17:15 County~ KE Facility Phone~: (805)323.--5500 G~oundwatep Depth: 100"+ Blue P~,~int~: N/A Contact: BRANDON IgEAL ' ' DateITime symt~m ~a-~ flit-ed: 6+-HOURS- -- Tank Fill/Vent P~odu=~ Type Of Vapor Inches of Pump Tank Tank Capacity Produ=% Tank V~por Line~ Line' ~ Recovery Wa%er/Tank Type Material i 1000 DIESEL PASS PASS PASS N/A 0.50" SUCT, DW 4 Additional Infor~ation~ TEST ]ECHNICIAN~T.., " ' - .'F.L. ~90-1076 BITE LOG ~ TIME Bet Up Equip:' 15:00 Bled Product Lines: YES B).ed Vapor Lines: . N/A Bled Ven~ lines: YES Bled Tuebine: N/A Bled Suction Pump: YES Risers Installed: YES ~ a>' This system and method meets or exceeds the criteria in UBEPA 40CFR pa~ ~80~ NFPA ~9-87.and all applicable state and local ~odes, b) Any failure listed above may require further action~ check with all ~egulato~y a~encies. Copyright (c) 1989 by AEB, Inc. Certified Technician Signature ~' Date : 41'? ~NT~L~ZR BT~BET B~KERg~IELD~ Om 93~0B (80B) ~31--38~0 AES/System II Pre~isio6 leak Test Graph. (OverFill>' Invoice No.: 2408 Da~e: 12/1'1/96 Time : 15:06:39 Technician: DMY Tank: 1 Tank Diameter(i~)~ 65 Volume(gal): 1000' 'G~ade Level(in>: 100 Product Level(in): 9'7 Water Level On Tank(in)~ 0 Specific 8ravi~y~ .87 Coefficien~ Of Expan~ion~ 0.'0004492 Calibration Value(mi): 200 Channel: Level 8eBment From: 1 To 300 Temp Segment F~om~ 1 To 300 001 :.o ?Jhange In Calibra'tio~ ~one = 39 ~alibration Unit(gal/unit) = 0. R~ ~tar~ing ~empera~u~e (F)~ 56~84 Head PresSure(psi (B~m)): 3.05 Surface Area(sq. in) ~ 27.0 Temp. ~hange(F/h) ~ -0.036 Level volume(gph): 0.00 Temp, volume(gph) ~ -0.0i Produc~ Line(gph) ~ SUCTION Ne~ change (gPh) : 0.01 Copyright (c> 1989 by AES, Inc. HEALTHSOUTH BAKERSFIELD REHAB~ HOSPITAL' , 5001 COMMERCE DRIVE , BAKERSFIELD, CA~ THIS IS A HIGH LEVEL TEST WITH A 200 ML~ CALIBRATION ADDED PRIOR TO'THESE DATA~ THE PRODUCT LINE IS FLOODED AND INCLUDED IN THESE.DATA. ZAROOUS m?ERIm."OIVISIO ........ : ......... ~X)O(~0~0% Bakersfield, CA 93301 '.,, ~ 5 Chester Avenue~'::-;~;~:(805) 326-3979 .;. . '. ?~.< ~ APPLICATION TO PERFO~ A TIGRESS ~ST HEALTH SOUTH BAKERSFIELDJ~ FACILIT~_.RE~.B.I.L~T~ION_HOSP!.~A~DRESS~.~ C°mm~rue Drive OPE~TORS N~E same~ as above , ,.. O~ERS N~E Same as above ~ER OF T~S TO BE TESTED 1 ~IS PiPiNG' ~ING~'TO. BE .TESTED Yes CONFIDENCE UST 417 Montclair Street' T~TESTINGCO~ SERVICES, INC. ~DRESS Bakersfield, CA 93309,17~ TEST METHOD AES System II (overfill) N~ OF TESTER Douglas Youn~ CERTIFICATION $' 86116 STATE REGIST~TION ~ 90-1076 DATE & TIME TEST IS TUBE CO~UCTED December 11, 1996 ~ 3:00 p.m. Y., .DATE BAKERSFIELD FIRE DEPARTMENT HAzARDOus MATERIAL'DIVISION ~X~4~~ Bakersfield, 'CA 93301 5 chester Avenue (805) 326-3979 APPLICATION TO PERFORM A TIGHTNESS TEST' HEALTH SOUTH BAKERSFIELD FACILITY REHABILITATION HOSPITALADDRESS 5001 Commerce Drive PERMIT TO OPERATE ~ .1021 OPERATORS NAME' Same as above OWNERS NAME Same as above NUMBER OFTANKS'TO BE TESTED 1 IS PIPING GOING TO'BE TESTED Yes TANK# VOLUME CONTENTS 1 1K Diesel CONFIDENCE UST 417 Montclair Street TANK TESTINGCOMPANY SERVICES, INC. ADDRESS Bakersfield, CA 93309-17 TEST METHOD AES System II (overfill) NAME OF TESTER Douglas Young CERTIFICATION ~ 86116 STATE REGISTRATION % 90.1076 DATE & TIME.TEST IS TO BE CONDUCTED December 11, 1996 ~ 3:'00 p.m. UNDERGROUND STORAGE. T, KINSPECTI_ON ........ O' ,,i Bakersfield Fire Dept. . ' ' FAClLITYNAME.~)~I~£~/~;~{~ /~,~/ ~)e[~g, /~?,'~W BUSINESS-:kD. No. 215-000 /~ / FAClLI~ADDRESS ~[ ~~ /~ CI~ FAcILI~iNSPECTiON PHONE ~pE:NO' INSPECTION DATE ~ ~ TIME IN TIMEOUT ROUTINE ~ FOLLOW-UP REQUIREMENTS ~ ~ ~a y~ ~ ~a yes no ~a la. F~s A & B Subm~ ~, lb. F~ C Su~ lc. O~mting F~ Pa~ '~: / I ld. S~te Sum~r~ Paid ~ le. State~nt of Fina~ial R~sibil~ Su~)~ . ' ~.. If. W~en Contm~ E~sts ~n ~er & O~ to O~mte UST ~. ~lid O~mting Pe~ // ~'/ . · . . . ~ 2b. Appmv~ W~en Ro~ine Mon~ng ~r~ure 2c. Una~ho~ Relea~ R~n~ P~n ~. Tank Int~r~ Test in Last 12 Months 3b. Pr~ur~ Piping Int~ri~ Test in Last 12 Months ~. Suction Piping ~ghtn~s Test in Last 3 Y~m ~:.L,. ~. Gmv~ FI~ Piping ~ght~ T~t in ~st 2 Y~m ~. T~t R~u~s Subm~ Within ~ Da~ 3f. Dai~ ~s~l MonRoring of Su~i~ Pr~u~ Piping ~. Manual Invento~ R~ncil~tion Each Month ~. Annual Invento~ R~nciliation Statement Su~ ~. Metem Calibmt~ Annually / / 5. W~kly Manual Tank Gauging R~rds for Small Tan~ 6. Month~ S~tisti~l Invento~ R~ciliati~ R~uRs 7. M~h~ A~atic Tank Gauging R~u~s 8. Gmu~ Water ~R~ing ...... 9. ~r ~nRoring ' ~ ~U~U~ 16. 1111~°. Cont,nuousl~t~t,fisl~o~Ro~[~oubl~811~T~n~ ~-~ :¢.. ~ ~ ~ ~ $. 4. ~' 2. ~' ~1 ~o~stio [~k Continuous ~h~n,~l fil~ron,o D~t~tio~ ~,nt~C~liB~t,o~ [i~ ~P U~ ~,pi~fl [qu,p~snt [~ak k~k Shrift ~onRofin~ D~t~o~ ~t~ C~b,l~ ~d '~T.t ~f Su~ [~ak ~t~8 ~t~ [~t~fiqui~ffi ,n ~r~um~ o[ ~1 8~t~m Within ~ ~ . ~. ApProv~ UST S~tem Re~i~ a~ U~ 21. R~rds S~ng Cath~ic Prot~ti~ Ins~t~ ~. ~ur~ MonE~ing Wells ~. Dr~ mu~ RE-INSPECTION DATE ~ .' ~"~ ' RECEIVED BY: INSPEcToR: ~,~~.~' ~ ~ ~ ' OFFICE TELEPHONE No. - ' FD 1~9 :32~ GALS ULLAGE 64= ~, ~LGREES ~ .. ~} Bakersfield/Fire Dept. HAZARDOUS MATERIALS IN TION " '.~' ~ '~/~c_z o~ E~vv]Ro~r~E~vr,~Z SERVZ~S 1715 Chester Ave. B~ersfield, CA 93301 Date Completed ~],/~' Loca~on: ~/~ / ~ ~ ~ Business Iden~fica~on No. 215-000 /~/ (Top of Business Plan) · Sta~on No. ~ ~¢ Shi~ Inspector ~val Time: Depadure Time: Inspec~on Time: Adeauate Inadequate Adequate Inadequate Address Visable I:~ 1'1 Emergency Procedures Posted ~ [] Con'ect Occupancy ~ r-I Containers Propedy Labled D,-' [] Verification of Inventory Materials El'. [] Comments: Verification of Quantities El'"' [] Verification of Location fill// FI Verification of Facility Diagram ~ [] Proper Segregation of Matedal ~ [] Housekeeping ~ [] , Comments: ~1~@[~ '~]~B Fire Protection El---' [] ...... Electrical IZ~' [] Comments: Verification of MSDS Availablity I~'/ [] Number of Employees: ,' UST Monitoring Program [3-'"" [] Comments: Verification of Haz Mat Training 13/ [] Permits ~ [] Comments: Spill Control Ei.~-' El Hold Open Device ,~ ~ [] Verification of ~ ' Hazardous Waste EPA No. Abbatement Supplies and Procedures I~/ I'1 Proper Waste Disposal I~~''' [] Comments: Secondary Containment r"l.--- rn Secudty El~-'~ [] Special Hazards Associated with this Facility: ~,,~<:T_ '~"~. ~o/~/~¢,.,C/.,._.. .,~""~/,,~,.~"/r-~z. / ~ -, ~.,~ ~, ~' ', .~ Violations: / All Items O.K Business Owner/Manager PRINT NAME sIGNATURE Correction Needed VVhite~Haz Mat Div. Yellow-Station Copy Pink-Business Copy {~ITY of BAKERSFIELD "WE CARE" [:' January 30, 1995 FIRE DEPARTMENT 1715 CHESTER AVENUE M.F,RE R.C.,EFKE"Y W A R N I N G ! eAKERSF,E'". ~9119~01 CERTIFICATION OF FINANCIAL RESPONSIBILITY REQUIRED 215-000-001021 BAKERSFIELD REGIONAL REHAB HOSP 5001 COMMERCE DR i~AKERSF I ELD, CA ~330~ Dear Underground Storage Tank Owner: Our records indicate that your business does not have a Certification of Financial Responsibility on file with this office. Please forward either a copy of your existing State approved mechanism to show financial responsibility or else complete the attached Certification of Financial Responsibility form. An attached letter from the State Water Resources Control Board lists the approved financial responsibility mechanisms required to pay for corrective actions resulting from leaking underground fuel tanks. Remember, most tank owners only have to show financial responsibility for at least $10,000 of clean up liability. The Underground Storage Tank Clean Up Fund (USTCF) may be used as the mecha~nism to cover the remaining accidental release liability. The total amounts of financial responsibility required (check boxes from section A of form) are as follows: If you don't sell product from you tanks, and you pump less than 10,000 gallOns per month, check "$500,000 per occurrence". Else, or if you are in the business of selling from your tanks, check "1 million dollars per occurrence". For owners of 101 or more petroleum underground storage tanks, check the "2 million dollar annual aggregate" box. All others need only check the "1 million dollars annual aggregate" box. Please be aware that failure to provide the financial responsibility document to this office within aO days will result in your Permit to Operate being revoked. (25285.1 (b) California Health & Safety Code). If you have any questions, or would like help in completing the Certification of Financial Responsibility, please contact Howard Wines, Hazardous Materials Technician, at 326-3979. Sincerely, Hazardous Materials CoOrdinator REH/dlm Underground Hazardous Materials Storage Facility Tank Hazardous G.~ii::~i:;?iii::::i::!::?:::::-? ..... V .e.:~a~:~?~iiiii.~:~::, :ii ~'.~Yrank ======================= :~.::~:~ i:':i!i!!}:::: Piping Piping' Piping Monitoring Number Substance C~:pa:~:!!~%.:i::?::' In'~'{~ii~'i!::..':::,. !i:[?Type Moiii{:~i~:i~i~:':'i:':i::i:!~i~: Typ: Method Issued By: ' ~' ~:.'.~ ::~:~::':~' :. Bakersfield Fire Dept. ":%:~::::~::;:::;.:;:~::~.:~:~: :~::::.~: :.~:::::.:::~::::;:::: ~?::? HAZARDOUS MATERIALS DIVISION ............................................................ ~kq~ 1715 Chester Ave., 0rd Floor ~,~b~ Bakersfield, CA 93301 (805) 326-3979 ~OI ~<~ Ralph E. Huey, Hazardous Materials Coordinator Valid from: ..... C ERTIFICATION OF FINANCIAL RESPONSIBILIIY FOR UNDERGROUND 8TOFIAGE TANKS CONTAINING PETROLEUM A. I am required to demonstrate Financial Responsib~Ry in the mqulred amount~ as specified in Section 2807. Chapter 18, Div. 3, Title Z3, CC.R: ~ $00,000 doaars per occurrence ~11 minion dollars annual a~egate ~ ! m~on doll.ars per occu~ence -. -: _-. . ' 'F=~ 2 minion dollars annual a~elate' B. .~xl/' .z~.4/~7~... ~.~/~/~~/,/ ~-(~f~' ~ '~-~Z~hereby certifies that it ~s in compliance with the requirements of ~ection 2807, Article 3, Chapter 18, Division 3, 7'tEe 23, California Code of Regulations. The mechanisms used to demonstrate financial responsibility as required by Section 2807 are as follows: · . ' FEB 61995 ,! Note: If you are using the ~tate Fund as any part of your demonstration of financial responsibility, your execution and submiss~n .... of t,~is cerZ~n~t/on ~,!_~o ce.~.ifies*that you. are in cornpliance.with all cond~ions for participation in the Fund D. Faci~Nsae . ' CERTIFICATION OF FINANCIAL REsPoNsIBILITY FORM PLease type or print cLearLy aLL ~nfomation on certification of Financial ResponsibiLity form. ' ALL UST facilities and/or sites otmed or operated may be Listed on one for~; therefore · separate certificate is ncc 'required for each site. DOCUMENT INFORMATIO# '- ,' -~ -,.. - ' A. /mou~t Required - Check the appropriate boxes.' B. Ii;me of Tank Ouner - FuLL name of either, the tank oimer or the operator. or Operator ' C. Nechanis~ Type - Indicate ~hich State approved ~echanism(s) are-being used to shoe financial responsibility either as contained in the federal regulations, ~,0 CFR, Part 280, Subpart #, Sections 280.90'.through 280.103 (See Financial Rpensibitity Guide, for more information), or Section 2802.1, Chapter 18, Oivision 3, TitLe 23, CCR. Ila~e of Issuer - List aLL names and addresses of companies and/or individuals issuing 'coverage. --t.L Nechan~sm Ilueber -~ Lig~ i~ent]~nb n~ber for' each mechanism u-~ed. E~(amp~-~i ~nsurance~p~ii~y-n~e[ or file nt~ber as indicated on bond or document. (If using State CLeanup Fund (State Fund) Leave blank.) .... ;.. Coverage Amxett - Indicate amount of coverage for each type of mechanism(s). If more than one mechanism is indicated, total must equal 100~ of financial responsibility for each ; facility. Coverage Per~ed'- Indicate the effective date(s)of aLL financial mechanism(s). (State Fund coverage · . ~ouLd be continuous as tong as you maintain c°ePtiance and remain, eLigibLe to continue participation in the Fund.) ~.orrectJve Action - Indicate yes or no. Ooes the specified financial aechanis~ provide coVerage for corrective action? (If using State Fund, indicate ,,yes".) Third Party - Indicate ye~ or n°. Does the specified financial mechanism provide coverage for Ccapencation third party compensation? (If using State Fund, indicate -yes".) O. FacJEJty - Provide aLL facility and/or site names and addresses. Irrfomat Jori E. Signature B[ock- Provide signature and date signed by, tank o~ner or operator; printed' or typed name and title of tank o~ner or operator; signature of ~itness or notary and date signed; and printed or typed name of ~itness or notary (if- notary signs as ~itness, please place notary seal next to notary's signature). I~ere to Nai[ .Certification: PLease send origina~ to your LocaL' agency (agency ~ho issues your UST pereits). Keep a copy of the QuestlOll~ If you have questions on financial responsibility requirements or on the certification of Financial .-. Responsibi.Lity Form, please contact the State UST Ct'eanup Fund at (916) 739-2~,75. Note: penalties for failure to c_~¥ uitb Financial Re~,;~sibil~t~R~.e~i=~ts: . FaiLure to comply may result in: (1) je, pardizJng~c:i.a~noetlgtbi~C th~ State UST CLeanup Fund, and (2) L i abi t i ty for c i vi L pena L t i es of up ~ o:;~i O[O'O0~Mg~r~l~;~t~lay~~.~_~_,.g,~ound storage t. ank, _fo.r each day of violation as stated in ArticLe 7, S~:'t';t~;~g~l~(tlltl~l~h~~.~i(HeaLth and Satety co~e. ~ ~S WEE OF INFOR~TION ONLY AND Three Z~zkway ~E$ a,ecow. ,, -. ~ B BT. PAUL ~RC~RY ~ E A ~~ FK06401720 7/01/94' 7/01/95 =~~ ' ~ 3~ooao ~ & ~~s ~. ~ ~~ ' s 1000000 ~ ~. ,. ~~~) s. so0~ ~. ~ ~ ~ I SO~ B ~m~ FK0640120 7/01/~4 7/01/95 I ~ ~ ~le I ~ 00oooo0 ~ PX~ & ~LXED eK06401720 7/01/94 7/01/95 See Description (SEE REVERB ~D/OR ATTACHED) 5 O0 1 Co~erc · D FLvo"'~2 ~, fl~ FML~ ~ ~L S~ ~TI~ A~tns Van Osborn ~ Lt~ILI~O~Ym~U~E~P~y C~RtJEJC~t~ JBB?i (CO,tiNgeD) INSURED : NOVACARE INC. HOLDER : Bakersfield Regional Rehab Hospital 5001 Commerce Drive Attn: Van Osborn Bakersfield, CA 93309 Property: Blanket Building & Contents - $82,245,051~ All Risk Coverage ~ubject to $2,500 Deductible. Institutional Professional Liability: $1,000,000 Each Medical Incident/ Evidence of cove[age with respect to the Easton & Moran Physical Therapy (2) locations at. 2301F Street, Bakersf£eld, California 91301; and 8200 Stockdale Highway, Suite B1, Bakersfield, California 93311. PAG~: 2 OF 2 kersfield Fire Dept; UNDERGROUND ST GE TANK INSPECTION Hazardous Materials Division Date Completed Operating Permit: l ~ ©O ~q, Business Name: ~~~e~~ ~e~ ~ Location: ~ [ ~o~e,~. Business Identification No. 215-000 I. ~ % ~ (Top of Business Plan) Number of Tanks. [ T~e: ~ ~[ ~P ~ Con~inment: ~ ,,~ Lines: ~ ~q~ ~.~~ CONTACT INFORMATION Emergency Contact: ~c ~~ ~u~ Ad~~, Inadequate Mon~orinfl ~roflram , RECORDS Maintenance ~~/ 'r'l , Testing Inventory Reconciliation ~/'~' / / RESPONSE PLAN Emergency Plan Violations: ~ -/ ~ All Items O.K. Busin~er/ Corre~on Needed Wh~e - H~ Mat Div Pink - Business ~py BAKERSFIELD FIRE DEPARTMENT HAzARDous MATERIAL DIVISION PERMIT TO OPERATE UNDERGROUND HAZARDOUS STORAGE FACILITY Permit No.: 180024C State ID No.: 180024 Issued to: BAKERSFIELD REGIONAL REHAB HOSPITAL Location: 5001 COMMERCE DR. BAKERSFIELD, CA 93309 Owner: REHABILITATION SYSTEM INC. 3607 ROSEMONT CAMP HILL, PA ~ 17011 Operator:. BAKERSFIELD REGIONAL REHAB HOSPITAL 5001 COMMERCE DR. BAKERSFIELD, CA 93309 Facility Profile: Year Is Piping Tank No. Substance Capaci~. Installed Pm~tgimt 1 DIESEL 1,000 GAL 1989 YES This permit is granted subject to the conditions listed on the attached summary of conditions and may be revoked for failure to adhere to the stated conditions and/or violations of any other State or Federal regulations. Issued by: Ralph E. Huey Issue Date: JULY 1, 1991 rdous Materials Coordinator Expiration Date: JULY 1, 1994 POST ON PREMISES NONTRANSFERABLE KERN COUNTY HEALTH DEPAI NT i -~'~~'~<'~'. E[r~Ilq~.~,,.,~,]_,J.' .,.m~7' HEALTH DEPARTMENT ENVIRONMENTAL IIEALTII DIV SION ~L~ '~ 2700 "H" ST'REET, SUITE 300 HAZARDOUS SUBSTANCES SECTION~ ~ ~ ~_~ ~ k ~ ~SFIE~, CA. 93301 -- '. INS.~CTION' R~D'- ~t~'~' ~ . . POST ~ARD~AT J'OBSITE' ADDRESS ~ ~ ~(:~-L~. ~L~[ ADDRESS ~.~:~ -~.~,~.,~ . PHONE NO. INSTRUCTIONS: Please call for an inspector only<when each Mroup of inspections with the same number are ready. They will run in consecutive °rder~ beginning with number 1. DO NOT cover work for any. numbered 'group until' all items ~that Mroup are signed off by the PermittJnM Authority. Following these ~instrutlons will reduce the number of required inspection' visits and therefore ~prevent assessment of additional fees. - TANKS & BACKFILL - . "%~,Baokfi 11 of Tank(s ) iC~ ~-~'~ II,Spark Test Certification ~ ~-~ Cathodic Protection of Tank(s) '/ ~ ' ' ~'- PIPING SYS~M ~, ~ Piping a Race.ay ~/Collection Sump (~-~ ~ [tOa?~~~.'"~_k .,~_~ ~ Corrosion Protection O~ Piping, Joints, Fiji Pipe~C~-:~7~ ~',.:.v~,.~L.~' ~ ' Electrical Isolation of Piping From Tank(s) -~ ~(~'~.', r~-.C~. ~~.-~ Cathodic Protection System-Piping ,~ : .. . - SECONDARY CONTAINMENT, OVERFILL PROTECTION. LEAK DETECTION - ' Liner Installation .- Tank(s) - Liner Installation - Piping Vault ~ltb Preduct Campat~]e.3ealer. .............. x.,:~ i/ ~ ~ ~ ..... '_ Product Compatible Fill ~('es~ ~' ~C~/~k~,.~c~:~) . ~groduct Line .Leak Detector(s)~~ ~k~ ~", ~/ ~ '-' ':~eak Detector(s)for Annular Space-D.~,'~al~k(s~'~.?~ ~,~,_0~0 ~~ MonltorinR ~ell(s}/Sump(s} ~ · Leak ~ection Devioe{s) Fo~ Vadose/'Oround~at~.! , ,, , / ~M%~~'"~6i'i'~, Caps & Locks i~ Fill Box Lock ~i~ '' ~'l Monl torins. Requirements ~ CONTACT ~,'~ ','-'. ~:~>"<:,~.."- ~ ~., PH ~ ~ ~T~ ~ ~--v ~ :: .. GARY & WICKS 2700 M Street, Suite 300 Agency Director Bakersfield. CA 93301 (805) 861-3502 . . ~- ~::~,~'~,~-,~. 'Telephone (805) 861-3636 ',~-- .~ :':,.*,~,,,~ Telecopler (805) 861-3429 Director R E S'O' U"R C E : ,M:! r~' ~ ' , : A G E N C Y DEP ARTME~ '~0'' '~"~-- -- F-~Nv:i'~:b~ DENT AL o PERMIT TO CONSTRUCT UNDERGR U -~,~:::?::~,:;~:" PERMIT NUMBER 18002 STORAGE FACILITY FACILITY NA~/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: Bakersfield Rehabilitatioa System Rehabilitation System Inc. HPS Plumbing Service 5001 Commerce Way 3607 Rosemont P.O. Box 6386 Bakersfield, CA 93309 ~mp Hill, PA 17011 Bakersfield, CA 93386 LICENSE NO. 477948 PHONE g PHONE X NEW ADDRESS PE~IT EXPIRE~ November 25~ 1989 CHANGE OWNERSHIP RENEWAL APPROVAL DATE Auqust 25, 1989 MODIFICATION . __ OTHER APPROVED BY ~_ /~ Turonda. ~. Crumpler, R.E.H.S. Hazardous Materials Specialist ................................................................................... POST ON PREmiSES ............. ~ ................... ~ .................. ~ .................. CONDiTiONS AS FOLLOWS: S[~ndard Ins[ruc[ions 1. h ~s [he respons~bH~[y of [he permk[ee ~o ob[~in permi[s ~hich m~y be required by o[her ~o b~innin~ work. 2. AH cons~ruc[ion [o be ~s per [ac~H~y p~ns approved by ~his depar[men[ and verified Dy inspec~i°n 5y Au~hori[y. 3. AH ~quipmen~ and ma[eria~s in Ibis cons[~uc[ion mus[ be ~ns[~H~d in ~ccordance ~i[h ~H m~nuf~c~urers~' specifications. 4. Perma,tee mus~ con[~c[ Permi[~in~ Au[hori~y for on-si~e inspec[ion(s) wi[h 48-hour ~dv~nce no[ice. 5. B~ckfiH m~[~r~a~ for pip~n~ ~nd ranks [o b~ as p~r m~nuf~c[ur~rs' specifications. 6. F~oa[ yen[ valves ~re required on ven[/v~por Hnes of UnderEround [anks ~o preven~ ov~rfHHn~s. 7. Cons[ruc[ion inspection record card is included wi[h permi[ ~iven [o Pe~mi[~ee...This c~rd mus[ prior [o ~n~[i~ inspec[ion. P~rmi[[e~ mus~ con[~c[ Permi~n~ Au[hori[y ~nd ~rr~n~ for:each ~roup of required inspec[ions numbered as per ins[ruction on card. O~ner~Hy, inspec[ions ~H~ be m~d~ of: Tank ~nd b~ckfiH b. Pip~n~ sys[~m wi[h second~ry conminm~n[ c. Overfill protection and leak detection/monitoring d. Any other inspection deemed necessary bY'Permitting Authority. KERN dOUNTY HEALTH DEPARTMENT ~00 F~OWER STR£ET ENVIRONMENTAL HEALTH DI~IO~ ,~KERSFIELD. CA 93305 HAZARDOUS SUBSTANCES SE~ION PHONE (805) 861-3636 INSPECTION RECORD · "~ ~ '~" ,'i. ~ POST CARD'~AT JOBSfTE , ~. " :,./ ' ' ' Bakersfield Rehabilitation System i80024B ~' RehatilitatiOnsystem Inc. FACILITY PERMIT # OWNER ADDRESS 5001 Commerce Way ADDRESS .3607 Rosemont CITY Bakersfield, CA CITY Camp Hill, PA 17011 PHONE NO. " INSTRUCTIONS: Please.call for ~an ~nspector only when each group of insPections With the same number ,are ·ready... They will run in co'nsecutive order beginning· with number 1. ' DO NOT cover work for any numbered ,group until all items in" that group are signed ioff !?'by. the Permitting Authority.·.Following ~.~these instrutions' will reduce'~/the ·number of required inspection visits, and therefore prevent assessment of additional fees. · '"'= · '-' TANKS & BACKFILL - . INSPECTION DATE INSPECTOR 1 Backfill of Tank(s) ' 1 Spark Test Certification ~Cathodic Protection of Tank(s) 1 ULNumber from tank 1 Pressure test on tank - PIPING SYSTEM - 2 Piping & Raceway w/Collection Sump (water test) 2 Corrosion Protection of Piping, Joints, Fill Pipe Electrical Isolation of Piping From Tank(s) iCathodic Protection System-P/ping 2I Pressure test on Primary Pipinq 2t Tiqhtness test on second~ry pipinq - SECONDARY coNTAINMENT, OVERFILL PROTECTION. LEAK DETECTION - Liner Installation - Tank(s) '. Liner Installation - Piping Vault With Product Compatible Sealer 2 Level Gauges or Sensors, Float Vent Valves ' 3 Product Compatible Fill Box(es) 3 Product Line Leak Detector(s) 2 Leak Detector(s) for Annular Space-D.W. Tank(s) · Monitoring Well(s)/Sump(s) Leak Detection Device(s) For Vadose/Groundwater 2 Undercfround conduct packing & seal 2 Dispenser 2 Alarm Panel Location 3 Leak Detection System - FINAL - Monitoring Wells, Caps & Locks Fill Box Lock 4 Monitorin/ Requirements CONTRACTOR H~SPlumbing LICENSE # 447948 CONTACT T.M. Ashlock PH # '(805) 324-2121 .. PERMIT TO CONSTRUCT '. PERMIT NUMBER 180024 B ' uNDERGROuND:STORAGE FACILITY... :. ·. ~,, . 'ADDENDUM. 8. All underground metal connections (e.g. piping, fitting, fill pipes) to tank(s) must be electrically isolated, and wrapped to a minimum 20 mil thickness with corrosion-preventive, gasoline-resistant tape or otherwise protected from corrosion. . 9. Spark testing (35.000 volts) required at site prior to .installation of tank(s). Test(s):must' be certified by the manufacturer, and a copy of test certification supplied to the Permitting Authority~ 10. The following equipment and materials must be identified by manufacturer and model Prior to their installation:. a. UL number of tank " " · ' 11. No product shall be stored in tank(s) until approval:is granted by the Permitting Authority. 12. Contractor must be certified by tank manufacturer for installation of fiberglass tank(s), proof to be submitted before installation, or tank manufacturer's representative must be present at site during installation. 13. Monitoring probe must be loCated at the lowest point in the containment sump. 14. Monitoring requirements for this facility will be described on final 'Permit to Operate". ! TRC:cd crum pier \ 180024.ptc :~E~R~COUNTY HEALTH ~EpARTMENT '00 FLOWER STREET ENVIRONMENTAL HEALTH D SIO~ ,aKERSFIELD. CA 93305 HAZARDOUS SUBSTANCES I0N PHONE (805)861-3636 I~SPECTION RECORD ~ ' ' ~...~'' POST CARD AT JOBSITE - -' Bakersfield Rehabilitation System~.180024B Rehatilitation SyStem Inc. · FACILITY '~ PERMIT # {OWNER ~ ' ADDRESS 5001 Co~nerCeWay ~' ADDRESS 3607R°sem0nt CITY Bakersfield, CAiCITY Camp Hill, PA 17011 PHONE NO=' INSTRUCTIONS: Please,:call for~'~an inspector 0nly when each group of inspections with ~he 'same number .are .ready 'They will run in consecutive order beginning with number 1. DO NOT cover, work for any' numbered group until all. items in that group are signed~off'."bY the Permitting Authority.,Foil°wing /these instrutions' will reduce'-the '.number of required inspection visits and therefore Prevent assessmen~ of additional fees. . INSPECTION DATE INSPECTOR 1 Backfill of Tank(s) 1 Spark Test Certification Cathodic Protection of Tank(s) 1 UL Number from tank 1 Pressure test on tank - PIPING SYSTEM - 2 Pipin~ & Raceway w/Collection Sump (water test)' 2 Corrosion Protection of Piping~ Joints~ Fill Pipe Electrical Isolation of Pipin~ From Tank(s) Cathodic Protection System-Piping 2 Pressure test on PrimarY piDinq 2 Tiqhtness test on secondary pipinq - SECONDARY coNTAINMENT~ OVERFILL PROTECTION, LEAK DETECTION - ~ Liner Installation - Tank(s) Liner Installation - Piping Vault With Product Compatible Sealer 2 Level Gauges or Sensors, Float Vent Valves 3 Product Compatible Fill Box(es/ 3 P~oduct Line Leak Detector(s) 2 Leak Detector(s) fo~ Annular Space-D.W. Tank(s) Monitorin~ Well(s)/Sump(s) Leak Detection Device(s) Fo~ VadOse/Groundwater 2 Underqround conduct packing & seal 2 Dispenser 2 Alarm Panel Location 3 Leak Detection System - FINAL - Monitorin~ Wells~ Caps & Locks Fill Box Lock .. 4 Monitorin~ Requirements CONTRACTOR HPS PlUmbing LICENSE # 4479~8 ' CONTACT T.M. Ashlock . PH-# '(805) 324-2121 ARROW TANK. WORKS P.O. ~X $~ * ANDERSON, CALIFORNIA ~ -'(916} 365~5434 Shop ~s~ 0a~ 9/28/89 ~e~a ~1~/~9 .... ,.,, _~. One. 1.~O ~'~'_ double w~l fibergl~..coate ~~i~s ~ A ~34. ~.~.~-J39338~ ..... ' : ~~, c~ ... ~:- .... ,~...~,.... ~ ,,.. ~...' '. ........ '~ ~ -'-'- ..... ~~ a~ O~ shop. ~e test ~d o~ repa~ p~- ';~: ' ~,, .... ~. , ..,... . i., " ri{IN: 1701 SOUTH BARNEY STREET ' ANDERSON, CALIFORNIA ~ x M~NhOLE ~ ' ~" SOUNDING " w/~" ~ ~ov~t ,- ~0 ~LEcF~I~ / 12' ~ ~ILL CONTAINER ~ LiNE FOR .. D"~ WAT~TI~HT .AND FILL LOCKI~ CAP GAUGE STICK M~l~ w~ VENT N. - ~7 IZ FT. A~OVE .... GRADE ,. GRADE 4" FILL DNE ]000 GALLON CAPACITY DOUBLE .WALL STORAGE ANK , '' " ~ MINIMUM DISTANCE t0'-0" ~" SUCTION LINE (~ FROM ANY BUILD. FOOTINGS · - 4" DROP TUBE ---LEAK DETECTION PROBE HOLDING S~RAP ', DIELECTRIC ~ ~PEA GRAVEL FiLL '- . ' BUSHING ~~OU~D [NT~E ~" ~TU~ u~ ........ -. ~, --SENSOR PROBE . ' OF SAND OR PEA C;RAVEL TURN BUCKLE ' ' "CONCRETE PAD(~I~I~ / ]ANK O'N ALL SIDEg~ "WITH BARS AT t2"0.C TOP AND BOTTOM A/4" ~ R.BAR ~!/14" ] I ' ' ~,~u ~ i~;' ;~--~L......../., ...../.......... -, ' ' · : ' ~ · /fi'tM . : ': ." · ' ' ' '"' '~ / ~' ~ ~T~' .NOTE: SEE STRUCTURAL FOR ,A::~ . ".' . ".' ' .." ' ·" {~Y~ ~ ~) . ..... SUPPORT DETAILS -' .., ~ I/4" CONDENSATE .,. ~LiTSi,.2E AIR EXTENSION .- ,,u$1' ' ' RS I~, RL DOWN C ONgEtl$,.t't'E . 16' · ..~., ~ G v.j~.z z' : · ~ , ...: ....... -...., !, . ........ ,'~'.'.'...C ........ '' .' ~. ~. . .~'-.:. '.'- .....r,-'' ~ . ' BELOW GRADE ~ ~ '~ [~..~,.,u?~:.-~ GENERA~U~ './ L NI~ r,, ',,..] ~,-, - v ' FUEL sTO -' - . j~ : ~ '- .":.- .. : <:- ... . ... -...: .'. . MAIN -- . i005 (~ ~-o7~ ~x co~ ~-~3~ 6- 5'89 .. .. ~" . ., QUOTE VALiD,FOR 30 ~ DAYS ': ~ · SAN [EANDRO, CA ~577 , SACRAMENTO, CA 958~ .: ' . ' ' (415) 357-2167 FAX (416) 357-31~ (glG). ~7-~ FAX (g16) ~ I~, -- HP5 Plumbing .. _' -~ . -. DELIVERY 4-'6 weeks o DESORII~TION ARR0~- 1,000 gal. underground, Underwriters ]abe]ed 5' . diesel fuel s~o~age tank, double.wall (360o.w~ap) Type 11 U.L. 58, 8" x 8" s~ike~ p]'a~e unde~ ;' each opening, lifting lugs, hold down stoa. ps with . ancho~ bo]ts, fiberglass exterior coating 125 mils ' '" o¢ fiberglass,' 35,000 Volt spa~k year warrantY, isOlation bushings,lest, tect~on, 24" cathodic p~o' manway with containment piping Sump and t~affic cove~ at grade with two 9" access hand ho]es, pipe pene~a[ions through sump. walls F.0.B ................ Job S~te. Not~: Arrow does not belong ~c, the Steel Tank'Znstitute, therefore Arrow cannot affix their ']abe]. We'do, . however, coat our [anks in the same manner 'and ' use the same materials. The tank wil marked for UL. ~58, weight and capacil'be clearly All penetrations in the 24" x 32" piping sump will be electrically isolated. PLUS ALL APPLICABLE TAXES The~~~ve~rder~s~r~vedand!ssubjec~termsandc~ndi~ns~n~ever~"s~d`~~~--------- ,~ ~^,~ omcE i~,ROPOSAL 77 v~s r TH,.OSTnEET 100.6- (70~ ~2-07.f 1 FAX (70~ ~-g3~ " QUOTE-VALID FOR i '30 DAYS 27~8 TEAGARDEN 9TREET ' ~ W. ~TAOIUM ~NE SAN LEANORO, CA ~577 ' ' '~ACRAMENTO, CA 95~ '" ~PS Plumbing DELIVERY ~-6 weeks f-fl~R. PT Manll~arfil~/.lnf~0 JOB: ---.-~ ITEM )T'~' DE,q. CRIPI"ION UNIT PRICE / TANK TR~H Fill- .-400 0PW - Spill containment with inner drain ,34TT- " 4" fill cap, Duratuff '085 ,33T- " 4" fill pipe adaptor Duratuff. '185 ' ;1T- " 4" x 10' drop tube '266 Sounding Line- 34TT- OPW - 4" fill cap, Duratufi: 085 ,33T- " 4" fill pipe adaptor., Duratuff '185 ~ Vent- 33VSS- OPW - Float vent valve - e>:tractor assembly includes: 070 4" x 4" x 2" extract{)r and ball valve 1/8'! 16-708 " 4" pipe cap, Duratuft: 9-0033 " 1½ extractor wrench )-0033 " 2" vent cap ~LUS ALL APPLICABLE TAXES ' The above order is approved ;]nd is subject to terms and conditions on reverse side. Accepte JOTCO PETROLEUM EQUIPMENT CO. By By . , WHF~E~!JST~ER .CAr4ArlY/ACCF PT~NCF Plr,~<~ rlAr )~,H m ] ' ' ~. M^,~ OmCE L .pROPOSAL SANTA ROSA, CA 95401 (707} 542-07,~1 FAX <707) 544-g384 FQUO'rE VALID FOR DAyS Q r..1 TERMS: 'MPANY' .. 2718 TEAGARDEN STREET- 709W. STADIUM t.~NE '. SAN LEANDRO. CA ~4577 ; SACnAMENTO. CA g51t~4 (415) 357-2167 FAX (415) 357-31E1!(g$8) 927-2204 FAX (916) 64~-1284 TO: HPS Plumbing Y JOB: rrEM C 'FY. DES CRIPTION UN IT PRICE TOTAL Leak Detection- 78-1610 UNIVERSAL - 16" water tight manhole ..... F.O.B.-warehouse ' Sump- ',2-SXX CNI-----2~¢" manhole with 2~}9,~.(~j~/~S ~o~er '~ F,-~.B~ctory 11_)0:~~ " Leak Detector- GILBARCO - Tank monitor and leak detector with printer.· (same as TLS 250i, both made by Veeder Root) SENSOR - Annul os probe up to 8' depth " Sump probe up to 3' depth Tank gauge probe Cap and ring kit F.O.B.- Gilbarco Factory *cable needed 103-12 UNIVERSAL - Tank gauge 12" 11-20 " Suction Line strainer 21' 12B-20 " Nipple check wlve PLUS ALL APPLICABLE TAXES The above order is approved and is subject to terms and conditions on reverse side. JOTCO PETROLEUM EQUIPMENT CO. Accepted ' . By "By L~NE FOR ~" ¢ WATERtigHT /~O ~LL LOCK:~ C~~ GAUGE STICK H~IT~N~ ~ EX}END VENT ~A¢~ I~ FT. AUOVE GRADE GRADE .IOOO GALLON CAPACITY DOUBLE ,WALL STORAGE ~ ~M ' ~" SUCTION LINE FROM ANY BUILD, FOOTINGS '4" DROP :'TUBE ~ ~LEAK DETECTION PROBE HOLDING S~RAF : -- ~' ,D ACC~ v~A~DL~ .. - DIELECTBIC ~~PEA GRAVEL FiLL / · .. "' BUSHING AROUND ENTIRE TANK SENSOR PROBE TURN BUCKLE " OF SAND OR PEA 3RAVEL~ ,. - TANK ON ALL S DEo W~TH ~/~;' ~ R,B~ ~J/14" ~ BARS AT 12"0.C TOP,AND ~OTTOM L : ~?!;!!T t~,o ~w~sr'm,,OSTn~ETMA'~'~ OFFICE ''i~HO'POSAL ' ' ~'0 0 ~' SANTA ~OSA, CA 9~01 .' E _ . 6~ 5- 8~. · ' ~.' ~ ~2-o7.,, FAX(70~-~ -' "' I~OTE vALID FOR 30 DAys TERMS: ' Pending - 27~8~ROENSTREET ~ 7~'W. STADIUM SAN LEANDRO, CA ~577 " . SACRAMENTO, CA 958~ (415) 357-2167 F~ (416) 357-3t6~ (918) ~7-~ F~ (918) ~1~ ' ,* ' ~ '~' .. '"~PS Plumbing '~:: DELIVERY- ' 4-6 weeks , F:0;B_ pT · Man,m~arhm~=/.ln~rn , " JOB: rTEM ~1~¢. DE,~,;CRIPllON UNIT PRICE TOTAL TANK TRIM Fill- .-400 0PW - Spill containment with inner drain ;34TT- " 4" fill cap, Duratuff '085 ;33T- " 4" fill pipe adaptor, Duratuff '185 ;1T- " 4" x 10' drop tube '266 Sounding Line- 34TT- OPW - 4" fill cap, Duratufl: O85 ,33T- " 4" fill pipe adaptor.,. Duratuff '185 Vent- 133VSS- OPW - Float vent valve - e~;tractor assembly includes: . 070 4" x 4" x 2" extract~)r and ball valve 1/8" 16-708 " 4" pipe cap, Duratufl: ;9-0033 " 1½ extractor wrench - '.3-0033! " 2" vent cap PLUS ALL APPLICABLE TAXES The above order is approved and is subject to terms'and conditions on reverse side. . JOTCO PETROLEUM EQUIPMENT CO.~ _Accepte . '. BY WHITF/cusToME_ FI : CANAny/ACCFPTANCF Pli',,IK,",R RAI'ICH ' . (7on ~-o*,;~ ~AX i~o~ ~-**-- I QUOTE VALID F~R' DAYS ILEUM · 'MPANY ~. iEAmROEN gAN LEANOnO. CA ~577 SACnAMENTO. CA (415) 357-2167 FAX (415) 357-31~11 . (916) 927-~ FAX {916) ~2~' TO: HPS Plumbing DELIVERY JOB: ITEM Q~'~' DESCRIPTION UNIT PRICE I TOTAL- I Leak Detection- z8-161C UNIVERSAL - 16" water tight manhole' F. O. B. -Wa rehou se Sump- ':25X~( CNI-~4-"-x-24"' manhole wi'th 2~(~t:r, li~S ~over F.-O~B~c.tory il_}<.')q'- ' Leak Detector- GILBARCO - Tank monitor and leak detector with printer. (same as TLS. 250i, both~made by Veeder Root) SENSOR - Annul os probe up to 8' depth " Sump probe 'up to 3' depth Tank gauge probe Cap and ring kit F.O.B.- Gilbarco Factory *cable needed 103-12 UNIVERSAL - Tank gauge 12' 11-20 " Suction Line strainer 2" ': 12B-20 " Nipple check valve " PLUS ALL APPLICABLE TAXES The above order is approved and is subject to terms and conditions on reverse side. ~,~ ~,\ JOTCO PETROLEUM EQUIPMENT Co. ByAccepted ~ . WHII F~CtJSI(']MF I1 ~ANAnY/ACCFPiANCF PINIK~ flAi,K;I I . .; ' ::.'...,,' MA. a . , Plumbing DELIVERY 4 . 6 Weeks. · ~' F;O.B. PT- ManUfacture/Jotco:* DESCRIPTION UNIT'PRICE TOTAL ARROW - 1,.000 gal. underground., Underwriters labeled diesel fuel~storage-~tank,, double wal!:(360Owra@) Type 11U.L. '58, 8" x 8" striker plate under'each opening, lifting lugs, hold down straps with' anchor bolts, fiberglas's exterior coating 125 mils of fiberglass, 35,000 volt spark test, thirty year warranty, isOlation bushings, Cathodic pro- tection, 24" manway with containment piping Sump, and traffic cover at grade with two 9" access hand holes, pipe penetration.~ through sump'walls F.O.B ................ Job site. Not______~e: Arrow does not belong tc the Steel Tank Institute, therefore Arrow cannot affix their label. We do, however, coat our tanks in the same manner and use the same materials. The tank wi.ll be clearly marked for UL. #58, weight and capacity. All penetrations in the 24" x 32" Piping sump will be electrically,isolated. PLUS ALL APPLICABLE TAXES --~'~' The above order is approved and is subject to terms and conditions on..~evem~ side, x~--":' ~J01~CO PET~UM EQUIPMENT Co :' '" Erf~Tracy ~ '.. . ,~UST , . C,U..U~ . R ' RLgOWN · .~..----~ . ~ ~'O'OiF CAP . -----~ ' ' - ......... ,.., ,L. ::::::::: ...... ~'" ' . G~.UG~ ~R~DE. IN~'"~" CONOU'" --,~ ~OS ~ND FON_..?[-~,Y,R' , .~ / ~ ~191E. RGF-NCY OF_NLM ~"" . / BELOW FUF-L ' ' ' ' (::~" ' ' FILE coNTENTS INVENTORY. Pecmit to Abandon. { ,of Tanks Date Permi Permit to operate ~ · .. ~ Date-- ~-- · Application to Abandon Tank(s) 0ate -. ApPlication to Construct .. " Application~ to Operate Tank Sheets. " Plot~Plans ' Amended Permit Conditions Annual RePort Forms Copy of Written Contract Between Owner & Operator' Inspection Reports Correspondence -Received Date Date Date Date Date Correspoudence - Mailed Date Date . i. Date Date Da'te Unauthorized Release Reports Abandonment/Closure Reports Sampling/Lab Reports MVF Compliance Check (New Construction Checklist). STD Compliance Check (New Construction Checklist) .' MVF Plan Check (New Construction) STD Plan Check (.New Construction) MVF Plan Check (Existing Facility} ' STD Plan Check (Existing Facility) "Incomplete Application" Form Permit Application'Checklist Permit Instructions Discarded Tightness Test Results Date Date Date Mouitoring Well Construction Data/Permits EnvironmentaJ Sensitivity Data: Groundwater Drilling Boring Logs ~ Location of Water Wells Statement of Underground Conduits Plot }'lan Featuring Ail Environmentally Sensitive Data Photos Construction Drawiugs Location: Miscellaneous GARY J. WICKS . . 2700 M' Street. Suite 300' Agency Director ., ' Bakersfield; CA 93301 (805) 861-3502 ?, :'?,~' "~- · /,,,V~d~:T~?~:...' -Telephone (805) 861-3636 ., h' ,~ .,~.: .,~ -..,,,. Telecopler (805) 86i-3429 · ,,,.c,o, R E S O U R C E M~',:~:~A:~.:.G..~E N T AG 'E N C'Y DEPARTM~:OE~N~ RO~MENTAL PE~IT TO CoNsTRucT UND~RGROUND:f:L~~~;,: .. PERMIT NUMBER 18002 STORAGE FACILITY FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: Bakersfield Rehabilitation System Rehabilitation sYstem Inc. .HPS Plumbing Service 5001 Commerce Way 3607 Rosemont P.O. Box 6386 'Bakersfield, CA 93309 ~mp Hill, PA 17011 - Bakersfield, CA 93386 LICENSE NO. 477948 PHONE ~ P~OND · X ~D~ ~DDRESS ~D~I~ DX2I~S ~ovember 25 t 1989 CH~GD O~DRSHI2 .' REaD,AB ~22ROV~B D~D ~uqus~ 25 ~ 1989 ' OTHER APPROVED BY.. ~. ~~j · .Turonda R. Crumpler, R.E.H.S. Hazardous Materials Specialist ................................................................................... eosr ........................ · .......... ........... : ........................ CONDITIONS AS FOLLOWS: Standard Instructions 1. It is the responsibility of the permittee to obtain permits 'Which may be required by other regulatory agencies prior to beginning work. 2. All construction to be as per facility plans approved by this department a~d verified by inspection by Perm~mn="' ' ,, Authority. 3. ~1 equipment and materials in this construction must be installed in accordance with all manufacturers' specifications. 4. Permittee must contact Permitting Authority for on-site inspe'cti°n(s) with 48-hour advance notice. 5. Backfill material for piping and tanks to be as per manufacturers' specifications. 6. Float vent valves are required on vent/vapor lines of underground tanks to prevent overfillings. 7. Construction inspection record card is included with permit given to Permittee. This card must be posted at jobsite prior to initial inspec[iom Permin~e m~st contact Permitting Authority and arrange for each group of required inspections numbered as per instruction on card. Generally,' inspections will be made of: a.~ Tank and backfill b. Piping system with secondary containment c. Overfill protection and leak. detection/monitoring d. Any othe[ inspection deemed necesmry by Permitting Authority. PERM'IT TO CoNsTRUCT '' PERMIT,NUMBER 180024 UNDERGROUND STORAGE FACILITY " ADDENDUM 8. Ail underground metal connections (e.g.' 'p~ping,. fitting, ..fill pipes) to tank(s) must be electrically isolated; and wrapped to a minimum 20 mil thickness with corrosion-preventive, gasoline-~resistant tape or otherwise.protected from corrosion. 9. Spark testing (35.000 volts) required at site prior to installation of tank(s). Test(s) must :be certified· by the manufacturer, and a copy of test certification'supplied to the'Permitting Authority. I0. The following equipment and materials must be identified by manufacturer and model prior to their installation: a.' UL number of tank 11. No product shall be stored in tank(s) until approval is granted by the Permitting Authority. 12. Contractor must be certified by tank manufacturer ifor installation of fiberglass tank(s), prOof to be submitted- before 'installation, or tank manufacturer's representative must be present at site during installation. 13. Monitoring-probe must be located at the lowest point in the containment sump. 14. Monitoring requirements for this facility will be described on final "Permit to Operate". TRC:cd ' crumpier\I80024.ptc KERN COUNTY HEALTH DEPARTMENT 1700 FLOWER STREET' ENVIRONMENTAL HEALTH DI Ir ' ..... :BAKER'SFI~LD, CA 93305 HAZARDOUS .SUBSTANCES S ON PHONE (80S) 861-3636 .':~ '~, ~ INSPECTION RECORD. :' ,~ ' POST CARD AT JOBSI.TE .. ..Bakersfield Rehabilitation System 180024B " Rehatilitation SYstem',Inc. FACILITY PERMIT ~ OWNER. ADDRESS-5001 CommerCe Way . '-~ ~' ADDRESS 3607 Rosemont , CITY . Bakersfield, CA .- CITY Camp Hill, PA 1/011 PHONE NO. , ~ , ' '~ .,. :?. '..' ,...~ !'. '~.~:..: !, k.' . . ' INSTRucTIoNS.: i:Please,'call lot':an inspector only when each group el'inSpectiOns with the same number.are ready. They 'will run in .consecutive.order beginning with number I. ,.D_90 NOT cover' work' for any numbered Zrou'p until all' items 'in, that group, are signed.' .off .... by · the Permi.tting Authority.. Following these , instrutions will'-reduCe the,'number of required inspect'ion visits .and therefore '! prevent assessmen'~ of additional fees. .... - TANKS & BACKFILL - " ' INSPECTION DATE 1 Backfill of Tank(s) 1 Spark Test Certification Cathodic Protection of Tank(s) 1 ULNumber from tank , 1 Pressure test on tank ~' - PIPING SYSTEM - 2 Piping & Raceway w/Collection Sump (water test) 2 Corrosion Protection of Piping, Joints, Fill Pipe i Electrical Isolation of Piping From Tank(s) Cathodic Protection System-Piping - ... '2 Pressure test on Primary Pipinq 2 Tiqhtness test on secondary pipinq - SECONDARy CONTAINMENT~ OVERFILL PROTECTION' LEAK DETECTIOh - Liner Installation - Tank(s) Liner'Installation - Piping · Vault With Product Compatible Sealer 2 Level Gauges or Sensors, Float Vent Valves ' 3 Product Compatible' Fill Box(es) 3 Product Line Leak Detector(s) 2 Leak. Detector(s) for Annular Space-D.W. Tank(s) MonitorinK Well(s)/Sump(s) Leak Detection Device(s) For Vadose/Groundwater 2 Underground conduct packing & seal 2 DiSpenser 2 Alarm Panel Location ~ r~ m~^~^- System - FINAL - Monitoring Wells, Caps &~Locks Fill Box Lock 4 Monitoring Requirements CONTRACTOR HPS Plumbing ~* LICENSE # 447948 CONTACT T.M. Ashlock. 'pH # (805). 324-2121 ' ' Division of linvironmcntal ~lth .: ..' ' Street, BakeS "]Id, CA 93305 17OO Flower ~' . ~ .. APPI, ICA'rloN FOR I'lii~HI.T T0 OPERATE' UNI)EI~GROUNI) ; . HAZARDOUS SOBS'rANGES STORAGE FAg[LITY - ~;~ FaciliLy ~Alodtrtca~Jon Of ,aCtlitY ~xisting I:aciZi~y ~'rrmmr.r Of Ommrship Is Tank(s) l,ucaCetl On ai~ Agricultural Farm'? .. ~V's. ~No' .. Is Tank(s) Used I'rin, arti~ For hgriculturnl i"url.,oses? ~ycs ~lNo . '. -." T R SEC (Rural l;ocaLJons Ouly.) Operator ~-O01 ~o~.~e~e~ ~ ~ Cun~act Person Address ~a~{f((~ ~ ' Zip ~30~ Telephone ~'OS) B. lVater To Facility I'rovtded By CI~F ~$~e~o./dAc ~/~e~ l]epl:h to G.rouud~vaLer Basis For Soil Type and Gcoun,i~atec D~p~h I)e~crmina~Lons~_ ~.>~.c......~.-,; ~qoL'ker' s Coml)ensation Cert'ifidation No. ~0-~7 ~--~ Insurer t). Ir 'this Permit Is For ' Modification Or An . .Existing Fac.i 1 ] tM, Ilrief.lx, Nodificatlons Proposed E. Tnnk(s) Store (ghegk all that apply): .......... Fue.I . 0 0 0 13 E} 13 'lTJ I~.1 Cl o o o o o .o 0 0 0 0 0 O. F. Chtmit:al Composition Of. blaterials St. oved (not necussary for motor vehicle fuelS) Tank ~ Chemicat 3toted (non--commercial nnme) CAS ~. (if knot~n). Chemical PrcE.~.gliEly' Stored (if ali fl'event} ' (;. 'l'rausrer Of Ot~ncrshlp Previous Facility Name ] I. accepk ruJ J y iii ] ol)lilp,t..io,m or I'crmi t No. __ ....... isa;trod I understnn,I that the-I)evmitting Aul:h0t:ity may t'evi,n.~ mod i I'y or Lel'minate the trmml'er of the I'erm:i k Lo Olmx'aLt~ this mtdevlirutmd facility upon receiving this completed form. .' This fot'm hn~ been completed under p,mnl.ty or perjury and Lo the be:;k o'f my kllmqli~dp, e "CU : (:nfl)on St:t,t,.t.- [2 St:a.inless SL(:Cl . ] I,oiyv.iny'l (;h.lt)ridu ~1 F:il.,er~'~iuSs-t;lad Stool 3. EEIma~TY.. ................... (Ga'l Ions) · · · huhher 12'alkx'd ~l~poxy 12 phm,.]i,:. IZI t;i.ss 12 (;thy ~ U,~ii,,,,I I~ Unknow OLher (describe): -~ On.lva~ized ~ FjberKJass-Ulati ~ I;t)tyt~LhyL(nte Wrul) ~ Vinyl Wrupping ~1 'r,,. t)e AspJmlt ~ UllkllOWil ~ NOlle ~ Other (dusuribe): CaLhod.~i/ l't-uLecLi()n: ~ Nmm ~ lmt)t'uss~d' Curt'ertL i;ysLum ~ Sacrificial Anode Syskem j~] D~sut'ibe SysLem & liquil)menL:, a. ~ I~] Visual (w,ult(~d t:u,,ks only) C] (;,-m,,tdwater M,,uit:urit,g We:tits) 'UI pressure Senst)r tn An.nulal' Si)acil ()17 [)[))tl)lc Wnll 'l'anl{ ~ l, tquid lit~Lrieval a .ll{sl)(=i:tlon i/ri., ti--Tut)e. 1~ I)a.tly UaUl~inl~ & Inv~nt()rY Rei;t)n(;illat. it)n ~ Puri,)di(: Til.:hLnt~LltH!.' {~ None ~ Unknown ~ Other b. I)il)in[~: ~ l~l()w_l~eskrlct:ing Leak l}etcctor(s) Ft, r I)ressurizod I'll)int~* ~ Monitorinl~ SUml~ Wi-kh. liat:cwuY ~ ,', led CollCl.'tlL(! ~ Ilalf-Gu~ COral)uti. hie' Pipe RaCeway ~ Synthetic Liner ItacewaY ~ None [~.] Ilt~l~t~()t~J~ El 0tlmr 8 ............... [~] nt)w Ilns This ~ Been 'ril.lhtness Tested? ~ Yes ~ Itltte {If' f,lls t.x'rlllh(:net;~; Tos{: . 'i'(~:; t. inF. {jt)llullally Bate{si 0{' Ecl)air 1~. Over[ill I, ro[t~t;tJ, tJn ~ {)l)er~tLor Flits, Ct)hi:reis. & Visultlly Mc~nit. t)rs I.evel · 1~ Tape Float: Guul:e ~ [Clout VenL Va.lvus {7] Attt. u :;h'ul.-tlf[' G~)ni. rt)is ~ Gal)nt:itance Sensor ~- Sealed fill I)ux ~] No,m I~]' Unk~,m~n' . · I, ist Makt~ .& Modt~l For Abovn Devl(.:c tither: a. Ulu.lerground I'ipiiql: ~ Yea ~ Nu [~ IJnklmWn Thickness ( ln(:hus ) l) i amc Liar ~ Mitsiul'acturer {~ i)ressur(~ ~ Suction El {;rnviLy Al,l)ruxJmaLt~ l.~niith (Jr I'il)e RUn jell5' b. Underlground Ptplntl Corrosion ~] t;nlvanized ~ Fil)erl:l;~ss-t:lad 1~ 'lml)ressed Curr(mk ~ Sacrificial Ano~' UJ i,ulyethylel~e Wrap ~ lil. eckricnl Isolation I~ Vinyl wrau ~ 'rut or.AsP!m ' U] Unknown ~] Nt)tm ~ .Oth-t' (chmct'ihe}: . ~ llt)ui)lt~=Wu}l J~ Synthet.i(~ l, iner System · El Nt)nu J~ Unknown . HPS PLUMBING SERVICES INC. P.O. BOX 6386 BAKERSFIELD, cALIFORNIA 93386 . . (805) 324-2i21 August 21, 1989 :. .- Kern County Health Dept. 2700 M Street 9300 Bakersfield, CA 93301 Attn: Toronada Crumbler Re: Underground Fuel Tank APplication· 5001 Commerce Way Dear Ms. Cpumbler Enclosed are three revised attachments to accompany my application .to install a 1000 gal-lon'diesel tank. In ~the package are three copies of: 1. A site plan at 1/16"=1'. This shows bare land. parking lot, portions of a street, Off'ice Park Court, and a corner of the'building within the 1OO' radius of the tank. 2. Details of the'piping at the tank. .. 3. An 'uncluttered site p~an, showing the rel-ationship between the tank, the generator, and the building. 4.-A three page list of equipment and appurtenances to be used in the installation of the tank and monitoring system As you already have the'application and the check, this should complete the package required for processing 'the application. The City of Bakersfield has reviewed this project in its approval processes. All items have been approved on their part. HPS PLUMBING SERVICES, INC. cc: 3s2 rile U12 5 1969 FROM _ '----- -..,, ~ $,re.t'COrnp,nY ' . General Contractors " . :'. FAX coMMUNICATION. -' . · · ,. '! i~ .. ::'i:SX{l~gT$ IN THIS TRANSMISSION INCLUDING THIS COVER SHEET - FROM . P..5 .i ' rn"pany. ' '" .. ,::iODevltt $ street Co .. "' .",'l~ieneral Contractors ' - ':"- ' ,.. . "' FAE coMMUNICATION .;",,<1 .: . :'::'"... '. ~ ;. ~ ~~_~_~ .. ~ ~,~~ . ':~.':?/.7 :: ' '~:.$.~EEIS IN ~IS T~SMISSION INCLUDING ~IS COVER SHEE~ :. ]~.. ' ~ ..... % , ~.. ~-~. "'. ~ ~--I- ,:: '~/ ~ . ,?'.~; ~ .,, ,~. :'. :'~J ..:.,;:: ~,;,;: '. · ,/~:~V~... ;~vitt & Street Co. ' HPS PLUMBING SERVICES' INC. Po. BOX 6386 BAKERSFIELD. CALIFORNIA g338e (805) 3~4.~.'~ ~ ., FAX (805). 322-5648 FAX COVER I.A'ITER TOTAL PAGF..S TRANSMIITED (INCLUDING COVER LETI'I~) ~ PLF_J~E CALL IF ALT. PA('~-q ARE NOT RIDCI~IVI~. " TRANSM/TTED BY: L.._-~ ~ 'G~RY J. WICKS 2700 M Street, Suite 300 Agency Director . Bakersfield. CA 93301' 861-3502 ,;~~'. ' . Telecopier (805) 861-3429 Dlroctor R S .O UR C E M~;~'A:G. ~'~M'E N-T A G E DEPARTMENT~OE. ENy~R~NMENTAL ' HE~SER~ICES~_~ , 'August 14; 1989 Mr. Tim Ashlock HPS Plumbing Service P. O. Box 6386 Bakersfield, CA 93386 SUBJECT: Permit'Number 180024B Dear Mr. Ashlock: This Department has reviewed the application and plans submitted for the underground storage tank facility, located at. 5001 Commerce Way, known as Bakersfield Rehabilitation System. Based on this review, your application cannot be'accepted as complete for the following reasons: Lack of workmans' documentation and a copy comDenSat ion of your current, contractor pocket license on file at the [ /~'~[- - Kern County Environmental Heal th Services Department. ~ Lack of equipment make and'models for piping, pipeline leak detector, ~r-~sion protection 3ester~ overfill, overspill, and ball float vent vai~e.-- . The manufacturers' certification and description of tanks and compatibility with proposed hazardous substanCes is lacking. ~k~ ~-4~. Plot plan of facility not !'egible. (plof diagram must ~l~2.~. ~ show location of property l'ines, building nearest and or ~D~ intersection, all tanks, piping, e_ouiDment, any possible sources of water infiltration. [e.g. drainage systems, f k~Y~ wells, seepage pits,' waterways, etc.] scale and north ] arrow). Plot diagrams must show all pertinent data listed above located within a minimum 100' radius around tank PiPinG, and monitoring wells. The minimum acceptable scale is 1' = 16" per foot. Mr~ Tim Ashlock Page Two August 14, 1989 The original permit aoolication and Plans are.being returned. After making required corrections and/or modifications, the application maybe resubmitted for review.. .. If you have any questions regarding'our requir'ementS, please call me at (805) 861-3636. .. , ~ Sincerely, Turonda R. Crumpler Hazardous Materials Specialist, Hazardous Materials Management Program TRC:jg enclosures OUTSIO ~IR EXTENSION · ~0 ~ ': · 'w~TER ~E&TER fLUE' coNOENS ROOF' CAP ~' CORUU' · ,, '~S AND B~LOW GR~OE iN - ' * ~ NCv GENLHnJ'~" · ' E~RGE ' FUEL sTORAGE TANK ' ,. L~NE FOR W' ~ W&T~TI~HT IZ FT. AUOVE GRADE GRADE __ 'JOOO GALLON CAPAClT~ -- DOUBLE WALL STORAGE ' ' TANK I N I MU' ..,, SUCTION LiNE N CE lO .... ' DROP;TUBE .... DIELECTRIC ~PEA GRAVEL ': BUSHING PROBE ' OF SAND OR PEA .GRAVEL TURN BUCKLE , ' ' CONCRETE PAD(~ " T~NK 'ON ALL. SIDES WITH ,A RE~NFC . :. BARS AT 12"O.C TOP AND BOTTOM --2.~' SOUNDING ~'~-- W/~" GRADE ~¢~ I~.FT. ABOVE " : ~ / GRADE ,~ .~~ E~H ' 'JOOO GALLON CAPACITY .'"' ,.:?:~ DOUBLE WAL'L STORAGE' . INIM "' .";~." ~" SUCTION LINE FROM ANY BUILD. FOOTINGS ' .:,. "' . DROP'TUB ' --LEAK DETECTION PROBE ' · ' T BUSHING '/ AROUND ENTIRE TANK '.'.," . .' ' '.' . --SENSOR PROBE ., OF SAND OR PEA GRAVEL -~.. TURN BUCKLE . , · ". , · · ~ ",,' . _ BARS AT R ~ C E ~ P T ~AG~ 1 1"-~/09/'89 invoffc~ Nbr'. '1. 212-20 8:54' a'm KERN COUNT-Y-PLANNING & DEVELOPMENT 1- 2700 'M' Street' 8akersf~e]O, CA 9330~ Type of Oroer N t' (805) 861-2615 CASH REGISTER HPS . . Customer' ~.0..~ t ~cn By' fOrder Oa~e Shffp Dace I .YEa I Terms. i OLG i 08/09/89 08/09/89 j I' 'NT TANK P~AN CHECK 1 100.00' E 100.00 .amoun~ Due ·100.00 Payme~ !~ade 8y Check ,u0.00 "- Permit Application Che~cklist Facility Name .j. ~ i ~ · Facility Address \i~[~~~.~ - '~'~ Application'Category: '~ ' Standard Design ~ Motor Vehicle Fuel Exemptioh Design (Secondary Containment) . (Non-Secondary Containment) - Approved ~ermit Application Form Properly Completed%, ~ _ _~ . ~' De. ficiencies: \~ ~.f~. ~-~--~ fh\~Y~~_~, \~)~..~Q~J. ~~a~ / Area enc~s~ by minimum 100 foot radius around tank(s) and Z ~ ~ ) All ta?~.~entif~% ~ nd'tuber and product to be stored 3~equate~cal%e (minimum 1"=16'0" ~etail) ~~'~~ North. arrow ~'~~ ~~tures within 50 foot radius of tank(s)and piping '' /Locatio~and labeling of all ~product piping and dispenser ~islands lEnvironmental sensitivity, data including: *Depth to first groundwater at site *Any domestic or agricultural water well within 100 feet of tank(s) and piping .~ Any surface water, in unlined conveyance within 100 feet of tank(s) and piping *All utility lines within 25 feet of tank(s) and piping (telephone, electrical, water, sewage, gas, leach lines, seepage Pits, drainage~ systems) · *Asterisked items: appropriate documentation if permittee seeks a motor vehicle fuel exemption from ~.econdary containment Comments: .~?-~ ~'-.. ~ .. ~ ~ ~ Copies~of.-Construction Drawings 'Depicting- ~-i~-~ Vi~-~ ~-~ ~-~-J~ ~aiiation with Bac'k'~ili, Raceway(s) SecondarY C°ntainment and/or .Le~k Monitoring System in Place~ Top View of Tank Installation wi.th Raceway(s), Secondary... Containment and/or Leak MonitOring System in place ' ~aterials 'List (indicating those~Sed in'the construction) .... , U .' ~oduct ~iping . Raceway(s) ': S~aler (s) /econdary Containment_ ~~% >~[. ~~' .... ~~~ak Detector,s) ~~] ~-~'~- .... ~aerfilt Prot'ection ~,~ ~ ~C4~ Gas or Vapor Detector(s) ~/~ ~mp(s) ~ ~ ~ ~ A'. ~3~ Additional: Documentation of Product Performance -~~m \ Reviewed By . Date SITE INSPECTION: Approved Disapproved. Comments: Inspector Date Standard Compliance Check '~'":" :""' ~' "' ~ ~'~:dl~ ' EqulPa'en',t to'be ~lnst.a'l ' ' ' R~ 'd' ~eo~d· ~~~. ., P~oof of Contractor'a License - License $ ~po o~ License ~ Proof of Contrac'tor'8 ~orker'~ Compensation Inaurance ~ Prl~ar~ Containment · ~Flberglass (FRP)' ~ake h Model. ~Flberglass.-clad steel ~ake ~ Nodel ~Uncoated s~eel ~ake ~ ~odel Coz~ent: Ad'dltlona]: 'Inspection: Secondary Contalnlent of Tank(s) ODoub']e-wa]led' tank(s) .Make &.Model []Synthetic liner Make &' Model [-]L/ned concrete vault(s) sealer used [~Other Type Make & Model Comment: Additional: Inspection: Secondary Containment Volume.,at Least 100~ of Primary Tan Volume(s) Comment: Addltionai: · Inspectlo",: Secondary C~ at:~t:~me.nt Volume for More Than One Tan, Contalns I OX of' Volume of 'Largest Prliary Containment 0 lOX of A 're ate Primary Volume, Whichever Is Great'e' Comment Addltlo ,,, Inspect Req'd Approved _ · ' ' ' S:econdary Conta!nment Open to Raln'fal-1 Must Accomm0da'te *Hour Rainf-al.1 Total Volume Comment: - Additional: _ Inspection: Secondary Contalnlent Is Product-Compatible Product Documentation Comment: -- Additional: Inspection: -kfiK~'~ Annular Space' Liquid is Compatible wi. th Product Product Annular liquid Comment: ~ Additional: r . Inspection: ~c~ IU~_ Primary Containment of Piping OFlberglass piping Size & Make "' OCoated steel piping Size & Make OUncoated steel piping Size []Other .. Conment: Additional: . , Inspection: Secondary Containme~L of [~Double-walZed pipe $~ze & Nake " I-]Synthetic llneU in trench Size & Make [~Other · _ Comment: , Additional: Corrosion Protection ~]Tank ( s i ~]Plplng & flttlngs ~]Electr" cml Isolation Comment: Additional: InspeCtion: ManUfacturer- ~)prove'd Backfill for Tanks & Pi'ping Type Comment: .- Req'd ApPr.owed' - ' L' . . . -,~ :' ," Addltlo'nal. ' ' " Inspectl'°n:' .. ., " > ment:- . , Additional: " " Inspection: __ Complete NonitOring System Monitoring device within secondary Con'talnment: ~]Llquld level Indicator(s) OLlquld used · ~Ther~a] conductivity senSor(s). : ~Pressure sensor(s) ~Vacuu~ gauge ~Sump(s) Gas o~ vapor detector(s) i ~enua[ ~nspect~on & S:lsual lnspectl°nther~ : Additional: _ Inspection: Other ~onitorin8 ~Periodic tightness testln~ ~ethod ~Pressur.-reducin8 line 1.ak detector(9) Other Comment: Additional: Inspection: ~~ Overfill Protection ~Ta~e float zauEe(s) ~Float vent valve(s) ~~ pacttancc sensor(s) gh level alarm(s) ~V~A~ ~Automatlc shut-off control(s) ~Flll box(~s) with 1 ft. 3 volume ~~r co~tvols with visual level monitoring Other Comment: ~, ~_ Req,d' ' ApProv.ed. ~. Addlt!:onal:~ · . ~ : Inspection: ' . . Monitoring Requlrelent.s Add.ltl. onal Comments ' Inspection: Inspector Date .. · ~.', ~ Extra' Inspectlons/Relnspectlons/Consu]tati-ons ~ . Date: Purpose: ~ . ~r COmment: 'Time Uttllzed Date: PurpoSe: Comment: Tlae Utilized Date Purpose: Comment: Time Utilized Date: '. Purpose: Co~ment: Time Utilized Invoice Date: -- __ Total Ti~e: Inspector Date. __'/ MANHOLE ~ N LINE FOR D"~ WATD~TI~HT // FL)~L ~IL GRADE .... ..I, O00 GALLON CAPACITY DOUBLE ,WALL STORAGE MINIMUM DISTANCE I0'-0" ' 'S0CTION LINE FROM ANY BUILD, FOOTINGS 4" 'DRop :TUBE --LEAR DETECTION PROBE HOLDING STRAP' ' " ' DIELECTRIC ~ PEA GRAVEL FiLL 2" BUSHING ~AROUND ENTIRE TANK - VALVE-- SENSOR PROBE TURN BUCKLE ' OF 'SAND OR PEA 3RAVEL [ / TANK ON ALL S,DES WfTH ' ' ~ BARS AT 12"O,C TOP AND BOTTOM ,~ENT TO ROOF C~P ' ~0 ~ t6" w~T~R .E~TER rL~JE~ S^L 1005 77' TH R)$TnEET .. '"~" ' 6-5-89 SAN,~ ROS~, CA g~O1 : ' ) ~2-o741 F~X ~O7) ~-g3~ - ' :QUOTE VALID FOR 30 DAYS' iNY .' ' ''27'"~AG~RDENSTREET ~ : '~ TERMS: Pendin~ - 7~ W. STADIUM ~NE - ' ' . . : SAN LEANDRO. CA ~577 ' ~ACRAMENTO. CA g58~ . ' ~ : (415) 357-2187 FAX (4~ 357-31~ (glS) ~7.~ FAX ~18) ~8-12~ ;. ' " ): HPS Plumbing ' DELIVERY 4 '6 weeks _F:O.B; PT - Nanufac~ure/Jo~co DESCRIPI'ION UNIT PRICE TOTAL ARROW - 1,000 gal. undergrounds, Underwriters labeled diesel fuel:storage'tank, double wall.(360O.wrap) Type 11U.L. 58, 8" x 8" striker, plate under'each opening, lifting lugs, hold .down straps with anchor bolts, fiberglass exterior coating.125 milS : of fiberglass, 35,000 volt spark test, thirty year warranty, isolation bushings Cathodic pro' tection 24" - ' , manway with containment piping sump and'traffic cover at grade with two 9" access hand holes, pipe penetrations through sump'walls F.O.B .............. Job site. 'Not~: Arrow does not belong'tc the S[eel Tank Institute, therefor~ Arrowcannot affix their label. We do, however, coat our tanks in the same manner and use the same materials. The tank will be Clearly . ' marked for UL. #58, weight'and capacity. All penetrations in the ;~4" x 32" piping sump will be electrically isolated. PLUS'ALL APPLICABLE TAXES The above order is approved and is subject lo terms and conditions on .~ever~' side /~....,.'~JO'l:~o PET~iDI_'/EUM EQUIPMENT C0 · '. w~rr~cu~C~:n : .' ,.' Erf~'Tracy J/ %NTA ~OSA, CA 95401 __ __ (?on,~-o?,,., tAX (?O?)r~-g3~, --J- QUOTE vALID FOR '30 DAYS I TERMS ?end,n!' 271~ TEAGARDEN STREET 70~ W. STADIUM LAN~ SAN LEANDRO. CA 9457? ~ACRAMEN?O, CA 95834 ~ (4~5~ 357-2~? FAX (415) 357-318~! (gill) g27-2204 FAX (95~) 646-~264 - . · · DELI'VERY 4-6 weeks HPS. P1 umbing F: dOB: ITEM DE,'i;GRIPTION , UNIT PRICE I TOTAL TANK TR~N . . .-400 0PW - Spill containment wi:~h' inner drain ;34TT- " 4" fill cap, Ouratuf~ '085 ;33T- " 4" fill pipe adaptor, Duratuff '185 ;1T- '" 4" x 10' drop tube '266 Sounding Line- 34TT- 0PW - 4" fill cap, Duratufi: ·085 ,33T- " 4" fill pipe adaptor~, Duratuff Vent- 133VSS- OPW - Float vent valve - er, tractor assembly includes: 070' 4" x 4" x 2" extractor and ball valve 1/8" 16-708 " 4" pipe cap, Duratuff ',9-0033 " 1½ extractor wrench '.3-0033 " 2" vent cap PLUS ALL APPLICABLE TAXES The above order is approved ~nd is subject to terms and conditions on reverse side. , ~ JOTCO PETROLEUM EQUIPMENT CO. Acoepte · ' . ' BY By . . . . WHITF,'C, USTOM?.FI . '~ CANAFIYIACCFPTANCE Pll'4KfitlqMICII : ~ANTA ROSA, CA g~O1 '~ : .', ~ 27{8 TEAmRDEN sTREET ' ~7~W. STADIUM ~NE .TERMS: SAN LEANORO, CA ~577 SACRAMENTO. CA (415] 357-2187.F~ (415) 357:g~1 (g16) ~7-~ F~ (916)'~&12 S bing DELIVERY Leak Detection- -' ~8-1610 UNIVERSAL - 16" water tight manhole F. O.B.-warehouse Sump- , Leak Detector- GILBARCO - Tank monitor and leak detector with printer.· (same .as TLS 250i, both made by Veeder Root) SENSOR ' Annulos probe.uP to-8"depth " Sump probe up to 3' depth Tank gauge probe · Cap and ring kit F.O.B.- Gilbarco Factory · cable needed 103-12 UNIVERSAL - Tank gauge 12' 11-20 " ' Suction Line strainer 2" I2B-20 " Nipple check valve PLUS ALL APPLICABLE TAXES The above order is approved and'is subject to terms and conditions on reverse side. JOTCO PETROEEUM EQUIPMENT CO. , A~'ente,4 · By .-r By.. · ' - WHIIF/C, USTCA/IFFI'' ~Af,IArlY/AC~FPIANCI: ' PIHK4~ftAHCIt " '- ~" · May 16, 1991 Environmental. Health Services Department 2700 "M" Street Suite #300 ~Bakersfield, CA 93301 Re: Inspection Report permit #180024B Dear Sirs: Enclosed., 'find a copy of Bakersfield Service Station Repair, work Order #2180. As.noted .on· the work order, the deficiencies noted on. the inspection.report have been corrected as of May 14, 1991. Sincerely, Charlie Lay Plant Operations CL/jD Enclosure A Rehab SYstems Hospital 500 Commerce Drive Baker'sfield, California 93309 (805) 323-5500 · - BAKERSF~E"D SERWCE STATIC. REP^'" ~ . " ' . 1230 SOUTH UNION AVE.,. BAKERSFIELD, CALIFORNIA 93307 T ' " ' .LO~TiON . . . STORE ~ DATE ORDERED WORK'ORDERED BY TECHNICIAN ~ATE COMPLIED ' ~ Finish (money) Finish (gallons) *. Calibration: Fast. ' Slow · To~b '' 'Check.' Readlng,~ney) ' Sta, (gallons) Adjusted ~ Fast To .' Product ~ Return to Storage(gallons) J Totali~r~ ~S~~~ No ~ Meter.~Sealedyes ~ No 0 iZSri~ini'sh(m°ney)'' ~ /~ Finish(gall°ns)~~ti°n: Fast/ ~Slow T ta i .~ ;hacked Fast Reading~ Sta~ (money)- ~ Sta~ (gallons) Adjusted Slow To Product Totalizer Sealed Meter Sealed ~ ~ Yes ~ No ~ Yes ~ No Totalizejr~ Finish (money) Calibration: Fast Slow Reading~ Sta~ (money) . Sta~ (gallons) To Fast SI0w Product Return to Storage (gallons) Meter Sealed ~ ~ ~ No ~ Yes C No Finis~ (mom .. Finish (gallons) Calibration: Slow Totallzerl ~/' CheckRd Readlng~money) Sta~(gallons) . Adjusted-To ~ Slow 'T Return to Storage ~ Met~ied Pro ct (gallons) Totalizer Seal~ ~ Yes ~ No . ~Y~ *~ No ED PROBLEM: . DESCRIPTION OF WORK: ~ . / -~' ~ ' ~- ' . ~": , , ' ?' .' , . , QUANTITY PARTS NEEDE~ ~ PRICE AMOUNT ~OTAL MATERIAL TOTAL MIL~GE · TOTAL T~ TOTAL " '~"M" ;BT. FEET, SUITE 300', BAKERSFIELD, CA.9.3301 , " " " ~' OUND HAZARDOUs SUBSTANCE.STORAGE FACILITY ,, , ~, ~ INSPECTION REPORT ~ ~--~4'~ 'TIME ~N Z~Z~ TIME OUT ' NUMBER OF TANKS; 1 ~: FACILITY NAME:SAKER~R[ELD REHAbiliTATION' SYSTEM ............. : ......... L .......................... ' FAC~LI, TY ADDRESS:5001 COMMERCE NAY ,. BAKERSFIELD, CA ONNERS NANE':REHA8 SYSTENS ZNC OPERATORS'..~ANE: BAKERSF Z ELD ' REHAB Z LZTAT; ON SYSTEN PRIMARY CONTAINMENT r~NITORING= . ~ ~~F/~ a. Int~rc~DtiDg' an directing .-, .. Groundwater Monitoring ~ ~ ~. Vadose Sene Monitoring -. ' ~ :~C~NOAR, uON,A~NME,tT MONI:ORING: a. Liner DouDle-Nailed tank ' c. Vault PIPING MONI:ORi,lu: ~ Pr~ssUl'ized .. Suer!on ,:. Gr~vit't '- NEW CONSTRUCTION/MODIFiCATiONS ~ ~ '' CLOSURE~ABANDONMENT UNAUTHORIZED ~ELEASE '~b · MAINTENANCE, GENERAL SAFETY, OPERATING CONOITION OF .... v