Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
UNDERGROUND TANK
City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (661) 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 1 ST day of April 2002 to: SAN JOAQUIN COMMUNITY HOSPITAL Permit #015-021-000552 2615 EYE STREET Bakersfield, California 93301 Hazardous Materlals/Haz~.rd°Us rWaSte Unified Permit CONDITIONS,OF .PERMIT ON:~REVERSE~SIDE~ -~' '- .: ·. ~. - . · ::*: .... *- ' *- n. Underground'Stomge of HazardOUs Materials Permit ID#:: 015-000-000552 :' * .SAN JOAQUIN COMMUNITY I r'lHazard°usWasteon'SiteTreatment LOCATION: 2615 EYE ST- :~.:~' ~ i '~:'' I TANK ''1 HAZARDOU ~ '~::E' I 0~S-000-000~5=-000~I DIESEL #2 (~, L':F'."> ' :,. '. . ..-- 1715 Chester Ave., 3rd Floor Appr°vedby: L~?~'Hu~y.~~ ~ssuc · Bakersfield, CA 93301 Omc~orE~,,~.~rs~,i~c, -- . Voice (661) 326-3979 .. FAX(661) 326-0576 ExpirationDat¢:. 'Jurle 30,. 2OO3 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS. OF PERMIT ON REVERSE SIDE ........ ~.=~ ....... This permit is issued for the following: ' T~K I H~--OUS S~ST~CE C~C~ T~K ~"'~ P'.G P.~G PIP.G ,~ ....... ,,~ .~E MATE~ ~PE ME.OD MOTOR ~ '~0015 Diesel ~2 '" . ..... D~ SUC~ON % .... · ~ B~emfield Fke D~ment Appmv~by: O~CE OFE~RO~L ~ 1715 Chewer Ave., 3r~ Flor B~el~ CA 93301 Voice {805) ~979 F~ (805) 31~576 Exp~tionDate: June 30.. 2000 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 inthe 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 7t~ day of December, 1999 to: SAN JOAQUIN COMMUNITY HOSPITAL Permit #015-021-000552 2615 Eye Street Bakersfield, California 93301 CONTINUED (See 2nd File) ELD. CONTRAJ~TOR SERVICE STATION ADDRESS " STATION NO. ' I PAGE REPORTED ~OBLEM __ WAS ~OB COMPLETED ? " . , d' . .d '~'h~ , '" SERVICE8 I: REPAIRS PERFORMED. LABOR C~ARG~ t ~ .... MATERIAL CHARGES ' -' MATERIAL DESCRIPTION . ' ' ~ MFG NAME8 & SERIAL NOS. IF PUMP TOTALI~R ~ CHANGED, 8H~ ~FORE & AFTER [O~UZER READINGS. TIME RATE AMOUNT QTY. PRICE' ' AMOUNT / ' , , T~ _ ~ ~0~ ~ . .... , , - ' ' : : ' -:' , . ~ ~ ~E ~ Lx/.' ~ ,: ,: ,' ,' ',' ~. ~ , , ; ' ,, ' , i '~?, '.. ' CORE CREOIT ', ,, . - ~ ~"~"~[, ;, ,. .... , NO. OF m , ', ~ILEAGE TO SITE SUBTOTAL m READINGS ~ TRAVEL TIME PERSONS ~- ~, , , AND TIME AT Sl~ MATERIAL TOTALIZER ENDING ODOMETER READING TOTAL ~ ~0 ~ 0 ITEM TIME .RATE ~ , h~¢R~ AMOUNT UA~RIAL ,' . · EQUIPMENT ; ; ~. ', SALES TAX ON "' ' ' RENTAL ~ ~ BEGI'~NING ODOMETER READING TOTAL MATERIAL ~ L~ C ~ ' CONTRACTOR , , , LABOR CHARGE , , , ~ ' TOTAL M,LEAGE TO SITE REMARKS CONTRAC IRMEO SERVICE CALL ~Ola[r~av[t I~[ , ~ TOTAL ' PERSON CONTACTED AT SITE DEPARTURE TIME FROM SITE.~ VENDOR'S EQUIP. PERS~ W~ PLACED CALL I TOTAL TIME AT SITE fOT~ ~, bE C C~ ~ ~) ~ L 0 BEFORE SIGNING FOR~' ~.o.,z[~ ,E.SO. ¢.,N..~.E) TOa VERIFY ARRIVAL TIME ' F~M 3-8B11 IR~. %94) PRI~EO ~ ~.SA. - D March 30, 1999 Bob Easterday San Joaquin Community Hospital ~RE C.~ 2615 Eye Street RON FRAZE Bakersfield, CA 93301 ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfield, CA93301 CLOSURE OF ONE UNDERGROUND HAZARDOUS SUBSTANCE VOICE (805) 326-3941 FAX (S05)395-1349 STORAGE TANK LOCATED AT 2615 EYE STREET. PERMIT #BR-0246. SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 Dear Mr. Easterday: VOICE (805) 325-3941 FAX (805) 395.1349 This is to inform you that this department has reviewed the results PREVEnTIOn1715 ChesterSERVICESAve. for the preliminary assessment associated with the closure of the tank Bakersfield, CA 93301 located at the above stated address. VOICE (805) 326-3951 FAX (805) 326-0576 Based upon laboratory data submitted, this office is satisfied with ENVIRONMENTAL SERVICES 1715 Chester Ave. the assessment performed and requires no further action at this time. Bakersfield, CA 93301 VOICE(805) 326.-3979 Accordingly, no unauthorized release reporting is necessary for this FAX (805) 326-0576 closure. TRAINING DMSION 5642 Victor Ave. If you have any questions regarding this matter, please contact me Bakersfield, CA 93308 VOICE (805) 399-4697 at (661) 326-3979. FAX (805) 399-5763 Sincerely, Ralph E. Huey, Director Office of Environmental Services REH/dlm cc: Y.Pan, RWQCB S. Underwood P. Goalwin, AquaGeosciences, Inc. S:~USTFORMS\UST, LI D February 9, 1999 F~RE c.~E~ San Joaquin Community Hospital RON FRAZE 2615 Eye Street ADMINISTRATIVE SERVICES Bakersfield, Ca 93301 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 P~: Compliance Inspection SUPPRESSlO. SERVICE~ Dear Underground Storage Tank Owner: 2101 'H' Street Bakersfield. CA 93301 VOICE (805) 325-3941 FAX (805) 395-1349 "['hecity will start compliance inspections on all fueling stations within the city limits. This inspection will include business plans, PREVENTION SERVICES underground storage tanks and monitoring systems, and hazardous 1715 Chester Ave. Bakersfield, CA 93301 materials inspection. VOICE (805) 326-3951 FAX (805) 326-0576 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. Bakersfield, 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. TINNING DM$1ON Should you have any questions, please feel free to contact me at 5642 Victor Ave. Bakersfield, CA 93308 805-326-3979. VOICE (805) 399-4697 FAX (805) 399-5763 Sincerely, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES 171 5 CHESTER AVENUE BAKERSFIELD, CALIFORNIA 93301 ~ERSFIELD FIRE DEPARTMENT ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA 9330! (805) 326-3979 TANK REMOVAL INSPECTION FORM FACILITY~~,.,;,~ ~"%~, R~p, ADDRESS JGI~' ~¥¢. 5~ O~R ~ PE~IT TO OPE~t CO~CTOR ~oo~, ~ ~oe~r,~ CO.ACT PERSON ~ ~O~TORY ~t e~ ~ ~ ~ OF S~LES ~ TEST ~ODOLOGY TP~% ~ ~ ~7 ' P~LI~Y ASSESS~ tO. ~c~e~ CO.ACT PERSON CO= ~CIEPT ~,~,I~ GO ~ LEL% ~ PLOT P~ CONDITION OF TANKS CONDITION OF PIPING CONDITION OF SOIL COMMENTS DATE ~'N~PECTORS NAME ',,,,'OI.,I...II"IE ;;' 1 .'_:h!~::i'?' IJL, I.,i:~CE ~ I 71 :]: (.;~':;1.1:; 9f_'1% I.IILI..~:.¥.';E-; 212:1 ~'2~4L:~ ......... 't'C ',,,,'OLI...IHE :: 132:3'S HE [(;;H'? .;~99, ,1[? I4aTEI;? "...,'OL ~- [I TEI"lP ~-, -- E,:3 ,~0 I[.,EG F' .~__~ T 2-"'; I,h., :."l'lT~-II"l I I'.1~¥'[' l ,;)N V(:'I., L/I"II~ - ,.19 (;~,.~ [, ,.c:~ TC ',,/C,L I..i/-11] .... -19 HEIOHT :,- ?', 22 1 TEI'"ll:' - 5i;,,1 I)E¥' F (~ONSERVATION SERVICE ENVIRONMENTAL SERVICES coNsFRVATION 32,56 N. MA~K8 AVE. TH~U F~ESNO, GA 9372~-4919 ~ECYCLING (209) ~-5495 F~ (209) ~5-~497 ENVIRONMENTAL P~OTECTION AGENCY I.D. NO. CAD 980 673 842 DEPT. OF HEALTH SERVICES H~A~DOU8 WASTE HAULE~ ~EG. NO. 1943 TANK TEST CERTIFICATION Date: ./~,~.//',,)~.~,.,~ C,,,/g Job No.: Tank No.: Tank Size: Prod. Unl. Gas [] Manifest No.: ~g,~ "7 ,.~ ~ ~ ~ Invoice No.: o~ tl ~ ~ Held: Lead Gas [] Diesel Waste Oil [] Other' EPA ID NO.: (~ ~ ~*'~. ,~ ~ 0.~ ~ Generator: n~ ('~,,~' Address: r~) L""~J' ~-~ - ; .~(L-T~_'~'_~xJ~ Phone:(,,~0~) ,.,~(~--- ~t~O .t Address: ~0,~.DJ "TY~._.~_ J~:~_ I~)/t.~[j _-~'_ J~ City: ~_~;0~0 Test No. ..1. Time: (.~; tit LEL: ~,.._~ % Initi Test No. 4 Time: LEL: % Initial: ' Test No. 5 Time: LEL: % Initial: O.C.S. Inc. certifies that at the time that this tank was tested by us it was free of flammable vapors. It may not remain vapor free, Treat this container with extreme caution, it may contain explosive gases. DO NOT EXPOSE THIS CONTAINER TO FLAMES, SPARKS oR EXCESSIVE HEAT. DO NOT CUT OR WELD ON THIS TANK. Generator's Signature: ~~ Contractor's Signature.:-'~v' County of: County Inspe'ctor's Signature: STATE OF CAUFORNIA ./~.~'"-~ ~'~ STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. [~7f- PERMA MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION NENTLY CLOSED ON SITE ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] S TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: I. TANK DESCRIPTION COMJ~LETE ALL ITEMS - SPECIFY IF UNKNOWN I ~. OWNER'S TANK I.D.# ~l-v"t.~. B. MANUFACTURED BY: U~t~'~-~ · C. DATE INSTALLED (MO~AY~EAR) ! ~ ~ ~ . D. TANK CAPAC'~ IN GALLONS: ~ ~ II. TANK CONTENTS ~F A-1 IS MARKED, COMPL~E I~M C. ~ ~ I MOTOR VEHIC~ FUEL ~ 4 OIL B. C. ~ la REGU~ UNL~ED ~IESEL ~ 6 AVIATION GAS ~ lc ~ UNL~9E9 ~ S J~TFUEL ~ S USS ~ ~ C.E~C~,ROOUCT ~ ~S UN~O~ ~ ~ W*STE ~ ~ ~SD ~ ~ O~R(~SC,~S~N~.~L0~ O. ~F (*.~)~S,OT MAR~D. ~"~" ,*~E O~ SUS~ANCE STO,~D C.*. S. ~: IlL TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, ANDALLTHATAPPLIESINBOXDANDE ~ I~IDOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 5 INT]~RNAL BLADDER SYSTEM [] 95 UNKNOWN A. TYPE OF SYSTEM ~ 2 SINGLE WALL [] 4 SINGLE WALL IN A VAULT [] 99 OTHER B, TANK E~i BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLE W/FRP (PrimaryTarlk) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER C. iNTERIOR [] 1 RUBBER UNED [] ~ALKYD LINING [] 3 EPOXY UNING [] 4 PHENOLIC LINING LINING OR [] 5 GLASS UNING [~6 UNUNED [] 95 UNKNOWN [] 99 OTHER COATING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES__ NO__ D. EXTERIOR [] 1 POLYETHYLENE WRAP [] 2 C~OATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC CORROSION PROTECTION [] 5 CATHODIC PROTECTION [~1 NONE [] 95 UNKNOWN [] 99 OTHER SP~I~I.x~J.~MENT INSTALLED (YEAR) OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) E. SPILL AND OVERFILL, etc. DFiOff'~.JBEFYES NO STRIKER PLATE YES NO DISPENSER CONTAINMENT YES __ NO IV.' PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPUCABLE A. SYSTEM TYPE A~/ 1 SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER B. CONSTRUCTION A(~ SINGLE WALl. A U 2 DOUBLE WALL A U 3 UNED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A U 4 FIBERGLASS PIPE C0RROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEF.,L W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION ~/95 UNKNOWN A U 99 OTHER D. LEAK DETECTION [] ~ M£C~W~,C~. UNE L~X [] 2 LINE TIGNTNESS [] 3 CO~INUO~S INTEP. STITL~. r'-'{ 4 E~CTI~O,IC LINE [] 5 A~rOM~C PUMP ~CTOR ~r. STING MONITORING ~ [F. AK 0ERECTOR S~UTOOWN [] 99 OTHER V. TANK LEAK DETEI~TION RECONCILIATION MONITORING GAUGING MONITORING TESTING I I~1 7 CONTII~'UOUS~f~I[~RSTITIAL [] 8 SIR [] 9 WEEKLY MANUAL [] 10 MONTHLY TANK [] 95 UNKNOWN [] 99 OTHER ~ ~ MONITORINI~ ' TANK GAUGING TESTING I 1. ESTIMATI~D DA'~ LAST~JBED. (MO/DAY/YR) 2. ESTIMATED QUANTITY OF YES O ~ ~ ~rz [ ?~ SUBSTANCE REMAINING ~ GALLONS INERT MATERIAL ? LOCAL AGENCY USE ONLY THE STATE LD. N~JMBER IS COMPOSED OF THE FOUR NUMBERS BELOW COUNTY # JURISDICTION # 'FACILITY # TANK # STATE I.D:# ~ I I I I I I I I I I I I I I I I I I TH,s ~o.,~ .UST.. ACCO..A.,.D .~ A PEN.,T APPUCA~O.- ~0.. A. U.L.SS A CU..~ ~0.. A .AS ..EN FIL... ~0.. C .US~.. CO.PL~r.D ~0. ~.STAL~T~O.S. TH,S ~0.. SHOULD SE ACCOMPANIED BY A PLOT PLAN. FIE THIS FOFIM WITH THE LOCAL AGENCY IMPLEMENTINO THE UNDEI]GROUNO STOl]AGE TANK REGULATIONS FORM B (6-95) STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORU FOR EACH TANK SYSTEM. MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] S CHANGE OF'INFORMATION ' ~ PERMANENTLY CLOSED ;~ON SITE" ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSORE [] 8 TAN DBA OR FACILITY NAME WHERE TANK IS INSTALLED: ,. ' . ' I. TANK DESCRIPTION COM~L~E ALL ITEMS - SPECI~ ~F UNKNOWN ,- ,NSTALLED MO AY 'EAR Iq D. TANK C^PAC, ,, GALLONS: II. TANK CONTENTS ~F A-~ ~S MARKED, COaP~ nM C. ~ 3 ,CHEMIC~ PRODUCT ~ 95 UNKNOWN ~ 2 WASTE ~ 2 LEADED ~ 99 O~ER (DESCRIBE IN fiE. DmBEL0~ D. IF (A. 1) IS NOT M~RKED, EN~R N~E OF SUBST~CE ~ORED C. ~ S. e: III, TANK CONSTRUCTION MARK ONE I~M ONLY IN BOXES A, B, AND C, ~D A~ ~A+ APPLIES IN SOX 9 AND E I. ~PE OF* , ~ OUBLE. WA~ ~ 3 SINGLE WALL Wire E~ERIOR UNER ~ 5 I~RNAL Bm~R. ~M ~ 95 UNKNOm S~S~ ' ~" ,~ 2 S)NG~ WALL ~ 4 siNGLE WALL IN A VAULT ~ 99 OTHER a. TANK. ~eARES~EC ~ 2 STAINLESS s~EL ~ 3 FIBERGlaS ~ 4 S~ELC~O W/FIBERG~SSREINFORCEDP~STIC 'MA~RIAL. ~ s CONCAVE ~ 6 'POLWINYL CHLORIDE ~ 7 ALUM)HUM ~ e 100% METHANOL COMPATmBLE W/FRP (Prima~Tank) ~. 9' BRONZE *~ 10 GALVANIZED STEEL ~ 95 UN~OWN ~ 99 O~ER C.i~ERIOR ' ~1 ~uBBER UNED ~~O LINING ~ 3 EPO~ UNING ~ 4 PHENOLIC LINING .' LINING OR ~ 5' G~SS LINING ~ 6 UNUNED ~ 95 UNKNOWN ~ 99 OTHER ?, '' COATING. IS UNING MA~RIAL COMPA~B~ WI~ 1~ ME~ANOL? YES~ NO~ ".. D, CORROSioN~RIOR ~ 1 POLY~YLENE .... ~p ~~NG ~ 3 VINYL WRAP ~ 4 FIBERG~Ss REIN~RCEO P~STIC PROTEC~0N ~ 5, CA~ODIC PRO~C~ON '~ 91 NONE ' ~ 95 UN~OWN ~ 99 O~ER SP~MENT INSTAL~D ~R) OVERFILL PREVENTION EQUIPMENT INSTALLED (Y~R) E, SPILL AND OVERFILL, GTC,. D~YES ,,, NO STRIKER P~TE YES ~ NO . DISPENSER CONTAINMENT YES ~ NO IV. PIPING INFORMA~0N ' C~.CLS A IF ABOVE GROUND OR U IF UNDERGROuND, BOTH IF APPUC~LE A. SYS~M ~PE ' A~ 1 S~C~ON A ~ 2 PRESSURE A ~ 3 G~VI~ A U 4 FL~IBLE PIPING A' U 99 OTHER B. C0NS~UC~0N A~ SING~ WA~ A U 2 ~U~E WA~ A U 3 UNED ~ENCH A ~ 95 uNKNoWN A U 99 OTHER C, aA~RIALAND A ~ 1 B~E~EL A ~ 2 STAiNLESS'S~EL A ~ 3 ~L~INYL CHLORIDE (PVC)A U 4 FIBERG~SS PIPE C0RROSl0N A u 5 ALUMINUM A U 6 CONCR~E A ~ 7 S~EL W/ COATING A U 8 .100% M~HANOL COMPATIBLEW~RP PROTEC~ON A U 9 ~LV~IZED ~EEL A ~ 10 CA~ODIC PRO~C~ON ~95 UNKNO~ A U '99= OTHER V. TANK LEAK D~E~TION - . RECONClUATION MONITORING GAUGING MONITORING ~S~NG ~ 7 CO~OU~RS~ 10 UON~LY TANK ~ 95 UNKNOWN ~ 99 OTHER ~ MONITORIN~ ' 8 sIR ~ 9 ~EKLY MANUAL ' TANK GAUGING ' ~S~NG VI. TANK CLOSURE INFOR~ATiON (.~RM~NT CLOS~URE IN-P~CE) ",~ ' '" THIS FORM HAS BEEN COMPLIED UNDER PENAL~ OF PERJUR~, ~ TO THE BEST OF ~ K~WLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY ~E STA~ I.D, ~ER IS COMPOSEE OF T"E FOUR NUMBERS BELOW . COUN~ ~ JURISDICTION ~ 'FACILI~ ~ TANK STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM A COMPLETE THIS FORM FOR EACH FACILITY/SITE [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [~ 7 PERMANENTLY CLOSED SITE MARK ONLY ONE ITEM [] 2 INTERIM PERMIT ~ 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE /v I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) DBA OR ~FACILITY NAME~;~~"~ ~ ~C ~NAME OF OPE~TOR ADDRESS PARC~ ~ (OP~O~L) NEAREST CROSS STREET CI~ NAME STATE ZIP CODE SITE PHONE ~ WITH AR~ CODE ~ ~X ~ CORPORATION ~ INDIVIDUAl ~ PAR~ERSHIP ~ LOCAL-AGENCY TO INDICATE DISTRICTS ' ~o~erolUST~apubl~age~,mmpletethefol~whg: ~eofs~e~rdd~bn, s~bnorofli~opemtestheUST EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY)- optional DAYS: NAME (~ST, FIRS~ ~HO~ WITH AREA CODE DAYS: NAME (~ST, FIRS~ PHONE ~ WITH AR~ CODE NIGHTS: NAME (~ST, ~RS~ PHONE ~ WI~ AR~ CODE NIGHTS: NAME (~ST, FIRS~ PHONE ~ WI~ AR~ CODE II. PROPER~ OWNER INFORMATION - (MUST BE COMPLETED) [NAM ~7 CARE OF ADDRESS INFORMATION MAIklNG Oa S~T ADDRESS ¢ ~x to ~ff~ta ~ INDIVIDUAL GENCY ~ STA~-AGENCY III. TANK OWNER INFORMATION - (MUST BE COMPLETED) MAILING OR STREET ADDRESS ~ ~xto hd~te ~ [NDIVlDU~ ~AL-AGE~Y ~ STATE-AGENCY I CI~N~~¢[~Cb. 0~ S~; ZIPOODE~.~ PHONE . WITH AREA OODE IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER - Call (916) 322-9669 if questions arise. (mK) HQ V. PETROLEUM UST FINANCIAL RESPONSIBILI~ - (MUST BE COMPLETED) - IDENTI~ THE METHOD(S) USED ~ 8 STATE.ND& CHIEFFIN~CIALOFFICERLE~ER ~ 9 STA~ND&CER~FICA~OFDEPOSIT VI. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is choked. THIS FO~M HAB B~N GOMPL~D UNDE~ P~NA~ OF ~dU~, ANO TO ~ B~BT OF M~ KNOWleDge, I~ T~U~ AND GO~GT LOCAL AGENCY USE ON~ / ~ COUN~ ~ JURISDICTION ~ FACILI~ STATE OF CALIFORNIA STATE WATER 'RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORM A COMPLETE TH!S FORM FOR EACH'FACILITY/SITE ' '. . MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORM,~TION ' ~ PERMANENTLY CLOSED. SITE ONE ITEM [] 2 INTERIM PERMIT ~] 4 ·AMENDED PERMIT [] 6 .TEMPORARY SITE CLOSURE I.~ FACILITY/SITE INFORMATION & ADDRESS- (MUST BE COMPLETED) DBA OR FACILITY NAME NAME OF OPERATOR ADDRESS . . , NEAREST C.~SS STREET PARCE.~. # (OPTIONAL) CiTY NAME- STATE t ZiP CODE SITE PHONE # WITH AREA CODE ' v' BOX [~ CORPORATION [~] INDIVIDUAL ~ PARTNERSHIP ~ LOCAL-AGENCY ~ COUNTY-AGENI~y' ~ STATE-AGENCY" [~ FEDERAL-AGENCY* . ' DISTRICTS ' ; ' ' ..~l I'"tlowner0fUSTisapubticagency, completethefoltowing: nameofsupewisorofdivisinn:sectionoroffi~ewhichopemtestheUST ~7~ ~::~.~T~ I,~ i ~ TYPE OF BUSINESS F~'I GASSTATION F--] 2.DISTRIBUTOR ~-' I r--1 v'.IFINDIANI#OFTANKSATSITE rE.P.~ I.D.#(optional)'' · EMERGENCY CONTACT PERSON (PRIMARY) ' EMERGENCY CONTACT PERSON ·(SECONDARY). optiOnal DAY~S: NAME (LAST, 2RsT) ~" .._PHONE # wITH AREA CODE DAYS: NAME (LAST, FIRST} PHONE # WITH ARISA CODE I ' NIGHTS:~NAME (LAST F~"R~T') - PHONE # WITH AREA CODE NIGHTS: .N~'ME (LAST, FIRST) PHONE #WITH AREA CODE .,'~. " ':' II.'PROI~ERTY oWNER INFORMATION- (MUST BE COMPLETED) ~,. '1 NAM~,,~ ' ~ ' ,j~ ,' C/~,~ OF ADDRESS !NFORMATION I MAILING OR STREET ADDRESS ~' . v' box'lo....~d~;at? [~] INDIVIDUAL AGENCY ~ STATE-AGENCY ~¢= !~ EY F "5~r',, rn co. PO~ATIO. rn PARTNERs.,P rn COU.~-A. ENCY rn ~EDERAL-A~ENCY ST ~ PHONE # WITH AREA CODE III, .TANK OWNER INFORMATION - (MUST BE COMPLETED) .' : . MAILING OR STREET ADDRESS ' . ~/box to indicate ~ INDIVIDUAL [--~ CORPORATION i--'1 PARTNERS,~P ~ COUN~-A~ENCY ' C] ~EO~,AL-AGENCY IV, BOARD OF'EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER ..Call (916) 322-9669 if questions arise. TY(TK) HQ --14~- . ... V. PETROLEUM USf FiNANCiAL RESPONSIBILITY, (MUS? BE COMPLETED)-I~ENT:!FY.THE METHOD(S) USED I ,X box~o~nd~i, I---i ~ SELF.iNSURED I---I 2 GU^R~¢rEE r'-I 3 INSUi~NCE i---I 4 SUR~i'CBOND ~ S LE'n'EROFCREDIT F-'q 6 F. XE~eT~ON F--I 7 sTATEFuND /.. · l--] 8 'STATEFUND&CRIEFFINANClALOFFICERLE1TER [--~ 9 STATEFUND&CERTIFIOATEOFDEPOSlT [~ 10 LOCALGOV'T MECHANISM [~ 99 OTHER. ~J~ ~'"'"'~"'/ ,,, . VI, 'LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification'and billing will be sent to the tank owner unless box I or:ii isFked. I CHECK ONE BOX INDICATING WHICH ABOVE.ADDREss SHOULD BE USED FOR LEGAL NOTIFICATIONS ~.D:'BI "ELING: '.[] IIi~ ILL:] .THIS FoRM HAS BEEN COMPLETED UNDER pENALTY OF pERjuRY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT. , . JURISDICTION tt ' FACILITY It LOCATION coDE . OPTIONAL CENSUS TRACT # ; OPTIONAL SUPVISOR - DISTRICT CODE . OPTIONAL· . .- ,,.THIS FORM MUST BE ACCOMPANIED BY'AT LEAST (1) OR MORE PERMIT'APPLICATION - FORM B, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. :., , ; .! '.'. i': OWNER MUST FILE TH S FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM A(6:95) ' ' ' CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-:t979 APPLICATION T~~LLL~ID/OR REMOVE ABOVE GRO~RAGE TANK(S) In conformity with provisions of pertinent ordinances, codes and/or regulations, permission is hereby granted to: Name of Company Address to display, store, install, use, operate, sell or handle materials or process involving or creating conditions deemed hazardous to life or property as follows: subject to the provisions and/or limitations as provided. Violation of pertinent ordinances, codes and/or regulations shall void this permit. Date · ' - Al~'plicant Si ~ Apphcant Name (print~ TillS APPLICATION BECOMES A PERMIT WltEN APPROVED CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 APPLICATION TO~I3L~AJ.I.LMAND/OR REMOVE ABOVE GROUND STORAGE TANK(S) In conformity with provisions of pertinent ordinances, codes and/or regulations, permission is hereby granted to: Nar~e of Company J ' ' ~ Add~ess to display, store, install, use, operate, sell or handle materials or process involving or creating conditions deemed hazardous to life or property as follows: subject to the provisions and/or limitations as provided. Violation of pertinent ordinances, codes and/or regulations shall void this permit. Pe~2 ~ 7-~'~~'- Date Applicant Name (print) "' - ~Ap~-licant Siguat~ THIS APPLICATION BECOMES A PERMIT Wl:IF~N APPROVED Pcrmit No. ,,~_ CITY OF BAKEi FIELD PERMIT APPLICATION FOR OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 REMOVAL OF AN UNDERGROUND STORAGE TANK SITE INFORMATION SITE _~o,v~ .-K'oo.~.~Jkv, Cor~x.~-~or-~.ADDRESS ~ ~ ZIP CODE ~O~ ~N FACILITY NAME ~~C~ ~.~s?, CROSS ST~EE~ TANK OWNE~OPERATOR -~ ~u'~ Co~~~,~ MAILING ADDRESS OO~-~t~ ~ CI~ R~~ CONTRACTOR INFORMATION, ADD~ESS ~¢5X ~c~V~ ~*- C]~ ~NS~ANCE CA~a~Ea ~% ~ ~'~-X~ WO~NS COMP NO. PRELIMINARY ASSESSMENT INFO~ATION A~.o~ ~ CO,mANY ~tc_~o~ [~a~~ PHO~NO. ADDRESS "g~ ~'W'~ ~ C~Y INSURANCECAR~ER ~~ ~ ~-~'~ WO~NS~O~NO. T,~ C~NC ~O~t~O~ COMPANY O~J ~5¢~'~ ~g' ,~' PRO'NO. ADDRESS ~~ N' ~cK~ ~~ CI~ WASTE TRANSPORTE~ IDENT~FICAT~ON ~E~ ~ P~ NAME OF RINSA~ DISPOSAL FACILi~ ~'t~ ~w~~ ADDRESS ~m%~ ~, ~k~5 ~ C[~ FACILITY IDE~IFICATION NU~ER ~ ~ ~ ~Q TANK T~NSPORTER INFORMATION co P, V LICENSE NO. ADDRESS C]W TANE OEST[NAT[O TANK INFORMATION C~MICAL DATES CHEMICAL ~~~~ AGE VOLUME., S~O~D STORED PRE~OUSLY STOOD For Official U.~ (.)Al}, 'ri I1.; API'I.ICANT l laS RECF. IVEI), UNDER. STANDS, AND WILl, COIv[PI,Y WTI'H TIE AI'I'ACIIED CONI)rrlONS OF TI IlS I'lLl~,Mrr AND ANY OTI II':R STA'I'I.:, I.OCAL AND [:EDI:.ILn. L REGULA'I1ONS. TI IlS I"( )RM I IAS III'.:EN COMI)LE'rI.:I) UNDER PENALTY OF PER~Y, AND TO TILE, BEST OF MY KN(')WI.I..'IX}I..' IS 'rRUI.: ANI ) Ct )l,tl{I ".~."1~ ~ Al~l'~ APPI,IRANT NAMI..' (PRINT) Tills APPLICATION BECOME A PERMIT WHEN APPROVED D December 2, 1998 Bob Easterday F,.E C.~EF San Joaquin Hospital RON FRAZE 2615 Eye Street ADMINISTRATIVE SERVICES Bakersfield, CA 93301 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 UNDERGROUND STORAGE TANK UPDATE SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 Dear Underground Storage Tank Owner: VOICE (805) 326-3941 FAX (805)395-1349 Three weeks from today, December 23, 1998, your current PREVENTION SERVICES 1715 Chester Ave. underground storage tank(s) will become illegal to operate. Federal law Bakersfield, CA 93301 requires that your permit be revoked and, after Janoary 1, 1999, it will be VOICE (805) 326-3951 FAX (805) 326-0576 illegal for any fuel distributor to deliver to any non-upgraded tank(s). ENVIRONMENTAL SERVICES 1715 Chester Ave. For those who will not make the deadline, this office suggests that Bakersfield, CA 03301 you start preparing for closure, i.e. emptying fueling tanks, careful VOICE (805) 326-3979 FAX (805) 326-0576 scheduling for last fuel deliveries. Your facility will not be permitted to pump fuel after December 22, 1998. TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 For more information regarding closure requirements, please VOICE (805) 399-4607 FAX (805) 399-5763 contact this office at (805) 326-3979. Sincerely, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm cc: Ralph Huey, Director L D I" October 28, 1998 Bob Easterday FIRE CHIEF San Joaquin Community Hospital RON FRAZE 2615 Eye Street Bakersfield, CA 93301 ADMINISTRATIVE SERVICES 2101 'H' Street Sakers,eld,CA 93301 UNDERGROUND STORAGE TANK UPDATE VOICE (805) 325-3041 FAX (805) 395-1349 Dear Underground Storage Tank Owner: SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 Having difficulty getting a return phone call from underground storage VOICE (805) 326-3941 FAX (805) 395-1349 tank contractors? Are contractors telling you that they arc booked until February and March of 1999? Has your price, that you were quoted six months ago, PREVENTION SERVICES almost doubled? 1715 Chester Ave. Bakersfield, CA 93301 VOICE (805) 326-3951 These are some of the concerns voiced by tank owners who are now FAX (805) 326-0576 trying to meet thc compliance deadline. With less than 53 days left, many will ENVIRONMENTAl. SERVICES fall short of being upgraded by December 22, 1998. 1715 Chester Ave. Bakersfield, CA 93301 VOICE (805) 326-3979 This office has started issuing compliance stickers to those owners who FAX (805) 326-0576 have upgraded or replaced their underground storage tanks. We regret Lhat you will not be receiving one. TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 For those who will not make the deadline, this office suggests that you VOICE (805) 399-4697 FAX (805) 399-5763 start preparing for closure. Your facilities will not be permitted to pump fuel ' after December 22, 1998. For information regarding compliance or tank closure, please feel free to contact this office at (805) 326-3979. sin 2 Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm cc: Ralph E. Huey, Director L D September 30, 1998 Bob Easterday San Joaquin Community Hospital 2615 Eye Street FIRE CHIEF RON FRAZE Bakersfield, CA 93301 ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfield,CA 93301 UNDERGROUND STORAGE TANK UPDATE voicE (805)326-3 1 FAX (805) 395-1349 Dear Underground Storage Tank Owner: SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (805) 326-3!M1 One month from today, this office will start issuing compliance FAX (805) 395-1349 stickers to those owners who have upgraded or replaced their underground PREVENTION SERVICES storage tanks. 1715 Chester Ave. Bakersfield, CA 93301 VOICE (805) 326-3951 We regret you will not be receiving one. On December 23, 1998, FAX (805) 326-0576 your current underground storage tank(s) will become illegal to operate. Current law would require that your permit be revoked and, without a ENVIRONMENTAL SERVICES 1715 Chester Ave. compliance sticker it will be illegal for you to receive fuel deliveries after Bakersfield, CA 93301 VOICE (805) 326-3979 January 1, 1999. FAX (805) 326-0576 After 90 days of closure, your tank will be considered illegally TRAINING DIVISION 5~2 Wctor Ave. abandoned and we will take action to properly close these tanks. If you do Bakersfield, CA 93308 VOICE (805) 399-4697 not comply with our tank closure requirements, we will find it necessary FAX (805) 39~-5783 · to take legal action, including, but not limited to citation and/or injunctive relief. Time is running out, you have 83 days before the deadline arrives. If this office can be of assistance, please do not hesitate to call me at 326- 3979. Sincerely, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services cc: Ralph E. Huey, Director L D August 31, 1998 Bob Easterday F~RE C,~EF San Joaquin Community Hospital RON FRAZE 2615 Eye Street ADMINISTRATIVE SERVICES Bakersfield, CA 93301 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 UNDERGROUND STORAGE TANK UPDATE SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 Dear Tank Owner: VOICE (805) 326-3941 unuer~rounu o,ora~e FAX (805) 395-1349 The City of Bakersfield wishes to congratulate those tank owners PREVENTION SERVICES 1715 Chester Ave. who have upgraded, removed or replaced their tanks in the second quarter Bakersfield, CA 93301 VOICE (805) 326-3951 . of 1998. This office is expecting an even bigger third quarter result. This FAX (805) 326-0578 commitment, has helped this office achieve an 84% compliance average for the underground storage tanks within the City. ENVIRONMENTAL SERVICES 1715 Chester Ave, Bakersfield, CA 93301 VOICE (805) 326-3979 For those who have still not upgraded, time is running out. FAX (805) 328-0576 December 22, 1998 is just three months away!! TRAINING DIVISION 5642 Victor Ave. If this office can be of any assistance, please d° not hesitate to call Bakersfield, CA 93308 VOICE (805) 309-4697 me at 326-3979. FAX (805) 399-5763 Sincerely, Steve Underwood Underground Storage Tank Inspector SBU/dm cc: Ralph Huey, Director, Office of Environmental Services BAKERSFIELD FIRE DEPARTMENT July 29, 1998 Bob Easterday San Joaquin Community Hospital 2615 Eye Street FIRE CHIEF MICHAEL R. KELLY Bakersfield, CA 93301 ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield. CA93301 UNDERGROUND STORAGE TANK UPDATE (80,5) 326-3941 FAX (805) 39~ 1349 Dear Underground Storage Tank Owner: SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA93301 You have been receiving monthly updates from this office, regarding the (805) 326.3941 underground storage tank compliance deadline, since December of 1997. I feel FAX (805) 395-1349 we must inform you of how serious an impact non-compliance will be to your PREVENTION SERVICES business. 1715 Chester Ave. Bakersfield, CA 93301 [805) 326-3951 On December 23, 1998 (December 22, 1998 deadline) this office will be FAX (805) 326-0576 forced to revoke your permit to operate, effectively shutting down your fueling ENVlRONMENTALSERVlCES operation. On January 1, 1999, Senate Bill 1491 takes effect, banning fuel 1715 Chester Ave. deliveries for those who have not met the compliance upgrade. Bakersfield, CA 93301 (805) 326-3979 FAX (805)326-0576 After 90 days of closure, your tanks will be considered illegally abandoned and we will take action to properly close these tanks. If you do not TRAINING DIVISION 5642 Victor Street comply with our tank closure requirement, we will find it necessary to take legal Bakersfield. CA90308 action, including, but not limited to citation and/or injunctive relief. (805) 399-4697 FAX (805) 399-5763 It is this offices sincere hope, that we do not have to pursue such action, which is why we continue to update you. Time is running out, contractors are booking 6-8 weeks in advance, and costs are climbing at an alarming rate. If this office can be of assistance, please do not hesitate to call me at 326- 3979. Sincerely, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm BAKERSFIELD FIRE DEPARTMENT June 30, 1998 Bob Easterday San Joaquin Community Hospital 2615 Eye Street FIRE CHIEF MICHAEL R. KELLY Bakersfield, CA 93301 ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA93301 UNDERGROUND STORAGE TANK UPDATE (805) 326-3941 FAX (805) 395-1349 SUPPRESSION SERVICES Dear Underground Storage Tank Owner: 2101 'H" Street Bake~fleld, CA 93,301 (805) 326-3941 The City of Bakersfield and Kern County Environmental Health will hold FAX (805) 395-1349 a Underground Storage Tank Workshop. PREVENTION SERVICES 17If Chester Ave. This will be the final opportunity, before the December 22, 1998 deadline, Bakersfield, CA 93301 (805) 326-3951 to ask questions regarding upgrade, removals, financing, and other related fAX (~) 32a0576 requirements. ENVIRONMENTAL SEIWICES 1715 Chester Ave. The workshop will be held on Friday, July 17, 1998, from 8:00 a.m. - Bakersfield, CA 93301 (805) 326-3979 12200 Noon. The location will be the Kern County Environmental Health tAX (805) 3264]576 Services Department, 2700 "M" Street, First Floor Conference Room. II~AINING DIVISION ,5642 VIctor Street Enclosed is a registration form. Please fill out and mail or fax before the Bake~field, CA 93308 registration deadline, July 17, 1998. (805) 3994697 FAX (805) 399-5763 I look forward to seeing you there. Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure cc: Ralph Huey, Director, Office of Environmental Services 0~/13/97 09:40 326 0576 BFD HAZ MAT OFFICE OF ENVIRONME~AL SERVICES UNDERGROUND STORAGE TANK PROGRAM 171S Chester Ave., Bakersfield, CA (80S) 326-3979 APPLICATION TO PERFORM A TANK TIGHTNESS TEST FACILITY San Joaquin Community Hospital Ad2)DR]ESS 2615 Eye Street, Bakersfield, CA 93301 PERJV[IT TO OPERATE ~ BT-0345 OPERATORS NAME Same OWNERS N A~N/[E Same NUMBER OF TANKS IO BE TESTED 1 IS PIPING GOING TO BE TESTED Y e s TANK ~ . VOLUME CONTENTS TANK TESTING COMPANY Confidenc_e US___~T Services, Inc. MAILING ADDRESS 417 Montclair Street,._B_a__k_e__r_._%f,_ie,!_d..,.._CA_9__3_.3_0_9 ..... NAME & PHONE N-b~vtBER OF CONTACT PERSON Cheryl Young; 634-9501 TESTNfETHOD AES System II -- Overfill NAME OF TESTER Douglas M. Young CERTIFICATION ~ 99-1076 DATE & TIME TEST IS TO BE CONDUCTED 2/12/9..8 ~ 8: 3~ a.m. C~I~E~,~]E U~T 'SE~:~ ~ ~C~ 417 MONTCLAIR STREET BAKERGFIEL. D~ CA 93309 <805) 631-3870 AES -- SYSTE~ ~ SAN JOAQUIN COM. HOSPTo SAN JOAQUIN COM. HOSPTo I~D. Nuab~ra N/A P~O. BOX 2615 2615 EYE STREET' te~hni~anaD. YOUNG BAKERSF~ELD~ CA "~ ~ 9~0,~ BAKERSFIELD, CA Te~h~861t6 Van~01 02-12-98 T~be Start~ 08:45 ~d: 11~5 Coun~y~ KE Faoili~y Phon~ (805) ~,=6-4..40 O~oundwat~ D~p~h: 144"+ BI~ Ppints~ N/A 0o~'~ ALETHIA REGAL D~e~T~e system w~s ¢illed~ 6+ HOURS 3000 DIESEL PASS PASS PASS N/A 0.00" SUCT. SWS Add~tio~al ~'~orma~io~ ~ TEST TECHNICIAN~ DOUG 'YOUNG O~ T~ T~ L~ (~>99-.-1076 ~TE LO~ TIME ~o~ Up Equtp~ 08:45 Bl~d Pro.duo~ Lines~ YES Blod V~por Linos~ N/A Bled Vo~ ltn~ YES ~led Turb~ne~ N/A ~l©d '~u~ien Pump~ YES Risers ~n~tall~d~ YES a) This systmm and mmthOd memts or exceeds the crit~ri'a in UGEPA 40CFR p~r~ 880, NFP. A 3~-87 and all applioabl~ sta't~ and leo.al ~odms~ b) ~ny ~ailuro lis~d above ~a.y require ~ur~hor aotton~ ohock with Copyright (o) 1~8~ by A~ ~n~. L,~val ~n~ F~or~ 1-To 300 $.o~p ~u~on'B ~t~o~ 1 To 300 '" ' ' ~ I*'" I~'' I'~ ' ...... ' .... "t]I ~::,,.:::,~:,, I"' / L,h~J L,I L,; J .... RP~~ .~ .,? .. J'.,I ~i~:~ ~' T T T :i, rr, e.. !..I ..., ~.,t I. '..: Change In Calibration Zone = 33 C,a~ib~a'Bion Unit(Bai/uni~) = 0~00160 ~tar~ing Temperature (F> ~ 52.982 Head Pressure(psi (B~li~)> ~ 3.64 . . ~,= 7 ~ur~¢a~e A~ea(sq. tn)~ 31~9 Temp. Chance(F/h> Lnvo~ vo~o(Bph) ~ 0.00 ~fo~itp. v~lu~(Bph) ~ 0.03 P~od,.~ L~no(Bph) ~ SUC]ION Copyright (c) 1989 by AES~ Inc. - .... . . ~'~ BAKE RS~: SAN JOAQUIN CORIMUNITY HOSPITAL ~ 26Z5 EYE STR=,_I 'THIS IS A HTGH LEVEL lEaF WTTH A 200 ML. CALZBRA'F~ON ADDED PRIOR TO THESE DATA. THE PRODUCT LINE IS FLOODED AND ~NCLUDED iN' THESE DATA. 05113197 09:40 ~S'81 32{5 057{5 BFD HAZ ,'4AT DIV · .. ~ , [~001 CITY OF BAKERSFIELD aK,. ~ ,-,~ OFFICE OF ENVIRONMENTAL SERVICES UNDERGROUND STORAGE TANK PROGRAM 1715 Chester Ave., Bakersfield, CA (805) 326-3979 APPLICATION TO PERFORM A TANK TIGHTNESS TEST FACILITY San goaquin Community Hospital ~ADDI~ESS 2615 Eye Street, Bakersfield, CA 93301 pERMIT TO OPERATE # BT-0345 OPERATORS NAME Same OWNERS NAM~ Same NUMBER OF TANKS IO BE TESTED. 1 IS PIPING GOING TO BE TESTED Yes TANK ~ VOLUME CONTENTS 1 3,000 Di TANK TESTING COMPANY Confidence UST Services, Inc. MAILING ADDRESS 417 Montclair Street, Bakersf,ie~[d~.__C_A 93309 NAME & PHONE N/JMBER'OF CONTACT PERSON Cheryl Youn~; 634-9501 TESTMETHOD AES System II -- Overfill N~kME OF TESTER Douylas M. Young CERT~ICATION ~ 99-1076 DATE & TIME TEST IS TO BE CONDUCTED 2/12/98 ~ 8:39 a.m.. BAKERSFIELD FIRE DEPARTMENT May 31, 1998 Bob Easterday San Joaquin Community Hospital FIRE CHIEF MICHAEL R. KELLY 2615 -v_,ye Street Bakersfield, CA 93301 ADMINISI~ATIVE SERVICES 2101 'H' Street Bakersfield, CA 93301 (80,5) 326-3941 FAX (805) 395-1349 UNDERGROUND STORAGE TANK UPDATE SUPPRESSION SERVICES 2101 'H° Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 Dear Underground Storage Tank Owner: I~RVEN110N SERVICES 1715 Chester Ave. Bakersfield, CA 93301 The City of Bakersfield wishes to congratulate those tank owners who (805) 326-3951 have upgraded, removed or replaced their tanks in the first quarter of 1998. This FAX (805) 326-0576 office is expecting an even bigger second quarter result. This commitment, has ENVIRONMENTAL SERVICES helped this office achieve a 75% compliance average for the underground storage 1715 Choster Ave. tanks within the City. This is a very "good start". Bakersfield, CA 93301 (806) 326-3979 FAX (805)326-0576 For the benefit of those who have not yet upgraded, the City of Bakersfield and Kern County Environmental Health, will conduct a Underground TRAINING DIVISION 5642 VIctor Stroet Storage Tank Workshop scheduled for Friday, July 17, 1998, from 8:00 a.m. - 12 Bakersfield, CA 93308 (805) 399-4697 noon. Look for our June letter for more details. FAX (805) 399-5763 Should you have any questions, please feel free to contact me at 326-3979. Sincerely, Steve Underwood Underground Storage Tank Inspector SBU/dm cc: Ralph Huey, Director BAKERSFIELD FIRE DEPARTMENT February 24, 1998 Bob Easterday San Joaquin Community Hospital 2615 Eye Street FII~ CHIEF Bakersfield, CA 93301 MICHAEL R. KELLY ADMINISTRATIVE SERVlCE~ 2 Ol '.' ee, UNDERGROUND STORAGE TANK UPDATE Bakersfield, CA 93301 (805) 326-3941 FAX (805)395-1349 Dear Underground Storage Tank Owner: SUPPRF~ION $[RVIC~ The City of Bakersfield has some exciting news regarding loan monies, which has just 2101 'H' Street Bakersfield, CA 93301 become available through the Small Business Loan Association (SBA). (805) 326-3941 FAX (805)395.1349 Pollution Control loans, thru the SBA, are intended to provide loan quarantees to eligible small businesses for the financing of planning, design, or installation of pollution prevention PREVENTION SERVICES 1715 Chester Ave. controls, which includes underground storage tank facilities. Bakersfield, CA 93301 (805) 326-3951 FAX (805)326.0576 The vast majority of businesses are eligible for financial assistance from the SBA. The SBA defines an eligible small business as one that is independently owned and operated and not ENVIRONMENTAl. SERVICES dominant in its field of operation. For those applicants that meet the SBA's credit eligibility 171,5 Chester Ave. standards, the agency can quaranty up to eighty percent (80%) of loans of $100,000. Seventy five Bakersfield, CA 93301 (805) 326-3979 percent (75%) of loans above $100,000. Lynn Knutson, Chief of Finance for the SBA says, "If FAX (805) 326-0576 customers apply immediately, and meet the requirements, funding is available". TRAINING DIVISION The City of Bakersfield hopes all of our underground storage tank owners take advantage 5642 Victor Street Bakersfield, CA 93308 of this opportunity. For more information on SBA, Pollution Control Loans, please call or write to: (805) 3994697 FAX (805)399-5763 Lynn Knutson, Chief Financial Officer Small Business Loan Association 2719 North Air Fresno Drive, Suite 200 Fresno, CA 93727 Phone # (209) 487-5785, Ext 130 Don't delay, start today!!! Sincerely, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services cc: Ralph Huey BAKERSFIELD FIRE DEPARTMENT February 13, 1998 Ri~ CHIEF utC.~t R. ~u.¥ San Joaquin Community Hospital 2615 Eye Street ~M~.m~mnsmncra Bakersfield, CA 93301 2101 'H' Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 sum~s~.smacn RE: "Hold Open Devices" on Fuel Dispensers 2101 'H' Street Bakersfield, CA 93301 (80~) 326-3941 Dear Underground Storage Tank Owner: FAX (805) 395-1349 n~-w.no. ~ The Bakersfield City Fire Department will commence with our annual 1715 Chester Ave. Underground Storage Tank Inspection Program within the next 2 weeks. Bake,'sflelcl, CA 93,~i (805) 326-3951 FAX (805)32~0576 The Bakersfield City Fire Department recently changed its City Ordinance concerning "hold open devices" on fuel dispensers. The Bakersfield City Fire m~ Ch~ ^,,e. Department now requires that "hold open devices" be installed on all fuel Bako~flol~0 CA93301 dispensers. The new ordinance conforms to the State of Califomia guidelines. (805) 326-3979 FAX (805) 326(]576 The Bakersfield Fire Department apologies for any inconvenience this 11~AINING DIVISION ,5642 Victor Street may cause you. Bakersfield, CA 93308 (805) 399-4697 FAX (~)3w-,~7~ Should you have any questions, please feel free to contact me at 326-3979. Sincerely, Steve Underwood Underground Storage Tank Inspector cc: Ralph Huey BAKERSFIELD FIRE DEPARTMENT January 29, 1998 Bob Easterday San Joaquin Community Hospital n~cn~ 2615 Eye Street MICHAEL R. KELLY Bakersfield, CA 93301 21Ol '.' s, eet UNDERGROUND STORAGE TANK UPDATE Bakeafleld. CA 93301 (806) 326.-3941 FAX (805) 395- i 349 Dear Mr. Easterday: 2101 'H* Street B~d.C^9ml The City of Bakersfield wishes to congratulate those tank owners who (805) 326-3941 have upgraded, removed or replaced their tanks in the month of January. During FAX (805} 395-1349 the month of January, our office had six sites (14 tanks) which are now in ~ S~t~CES compliance. This is a very big "first step". 1715 Ch~tot Ave. Bakersfield, CA 93301 (805) 326-3951 For those who have not yet upgraded, I would like to share some thoughts tAX (/505) 326-0576 on why it is so important to act right away: ENtflRONMENTAL SEI~qCE$ 1715 Chester Ave. 1. Licensed contractors are booking up fast, in some cases, up Bakeesfleldo CA 93301 (805) 326-3979 to three months in advance. FAX (805)326-0576 2. Supplies (pumps, dispensers, leak. detection equipment) may be scarce. 11~JNING DIV~ION 5642 VlctorStreet 3. The cost for upgrading or removing could go up as demand ~o~, CA 9~0~ increases. (805) 399-4697 ~AXc~-5;~ 4. Assembly Bill 1491 will ban fuel deliveries after January 1999 to non-upgraded owners. The good news, is there is still time!!! If there is anything this office can do to assist you in your planning, do not hesitate to call. Sincerely, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services cc: Ralph Huey, Director, Office of Environmental Services BAKERSFIELD FIRE DEPARTMENT December 22, 1997 San Joaquin Community Hospital 2615 Eye St FIRE CHIEF MICHAELR. KEILY Bakersfield, CA 93301 ~MIN~m~VE SE~CES Dear: Bob Easterday 2101 'H" Street Bakersfield, CA 93301 (805) 326-3941 FAX (~)39&l:M9 Last summer, you answered a survey, concerning your underground storage tank(s) stating that you would be (removing,,rePlaCing}..upgrading) your tank(s). SUPPRESSION S~ICES However, you did not give us a target date! In November, we invited you to a free 2101 'H' Street Bakersfield, CA 93~1 underground storage tank workshop, where State representatives discussed both the (80,5) 326-3941 FAX (805)395-1349 regulations and alternatives that you as a tank owner will have. - ..... You did not attend! ...... We are concerned! PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA93301 YOU will be receiving this letter on our about December 22, 1997. One year (805) 326-3951 from today, December 22, 1998, your current underground storage tank(s) will FAX (805) 326-0576 become illegal to operate. Current laws and code requirements would require that ENVIRONMENTAL SERVICES if your tanks are not (r~eplaeed, upgraded) by that date, your permit to 1715 Chester Ave. Bokersfleld, CA 93301 operate would be revoked, - - it will be illegal for any fuel distributor to deliver (805) 326-3979 fuel to your tank(s)~ - - and your tank(~)would then be considered illegally FAX (805) 326-0576 abandoned and require that action be taken within ninety (90) days to remove the TRAINING OIVI$1ON tank(s). 5642 Victor Street Bakersfield, CA 93308 (8D.5) 3994697 Of course, we have no interest in pursuing this route. We would like to FAX (805) 399-5763 have your tanks properly handled prior to this December 22,1998 deadline. Please review your situation and reply within two weeks as to the current (realistic) plans for your existing tank(S)~I As we get closer to the December 22, 1998 deadline, I would expect construction costs, as well as lead times to increase considerably. If there is anything this office can do to assist you in your planning, do not hesitate to call. Sincerely, Ralph E. Huey Hazardous Materials Coordinator REH/dm 03/13/97 09:40 '/:~805 326 0576 BFD HAZ MAT DIV ~001 CITY OF BAKERSFIELD ~ OFFICE OF ENVIRONMENTAL SERVICES UNDERGROUND STORAGE TANK PROGRAM 1715 Chester Ave., Bakersfield, CA (805) 326--3979 APPLICATION TO PERFORM A TANK TIGHTNESS TEST FACILITY San Joaquin Community Hospital ADDKESS 2615 Eye Street, Bakersfield, CA 93301 PERMIT TO OPERATE # BT-0345 OPERATORS NAME S am e OWNERS NAME Same NUMBER OF TANKS TO BE TESTED. i IS PIPING GOING TO BE TESTED Yes TANK # VOLUME CONTENTS 1 3,000 Ol ~.~l TANK TESTINGCOMPANY Confiden~_e 'U._ST Services, Inc. MAILJNGADDRESS 417 Montclair Street, Bakersf~.~_,__C_..A 93309 NAME & PHONE NUMBER OF CONTACT PERSON Cheryl Young; 634-9501 TESTMETHOD AES System II .-- Overfill N~ME OF TESTER Douglas M. Young CERT~ICATION # 99-1076 DATE & TIME TEST IS TO BE CONDUCTED 2/12/98__~ 8:30 a.m. UNDERGROUND STORAGE TAI~;~SPECTION Bakersfield Fire Dept. ........... Office of Environmental Services "~ ' Bakersfield, CA 93301 FACILITY NAME ,~(~1~ ~a,~t.~l~t ~4e~m~da,~.~ ~05m'~-a ~ BUSINESS I.D. No. 215-000 FACILI~ADDRESS ~1~ ~ .~T~.'P CI~ ~a,>r~c~ ZIPCODE FACILI~ PHONE No. '~ ~ ~iq~ ~ INSPECTION DATE ~.. IO[G[~ 7 Pr~ua Pr~u~ Pr~ua TIME IN TIME OUT ~c~c( Inst Date Inst ~te Inst ~te INSPECTION ~PE: t ~ ~ S~e Size Size ROUTINE ~ FOLLOW-UP /,~ 0~0 ,~ REQUIREMENTS yes no n/a yes no ~a y~ no ~a la. Forms A & B Submiffed ~ ~ lb, Form C Submiff~ lc. O~rating F~s Paid ~ ld. State Surcharge Paid le. Statement of Financial Res~nsibil~ Submiff~ ~ ~ lf. Wriffen Contract Exists ~een Owner & O~rator to Operate UST 2a. Valid O~rating Permit ~ 2b. Approved Wri~en Routine Monitoring Pr~edure ~ ~ 2c. Unauthoriz~ Release Res~nse Plan ~ ~ 3a. Tank Integri~ Test in Last 12 Months T~[ ~m~ e~l~ ~ 3b. Pressurized Piping Integri~ Test in Last 12 Months T~[ ~e e ~{ff ~ ~. Suction Piping Tightness Test in Last 3 Years ~. Gravi~ Flow Piping Tightness Test in Last 2 Years ~ V ~. Test Results Submi~ed Within 30 Days ~ 3f. Daily ~sual Monitoring of Suction Pr~uct Piping ~. Manual Invento~ Reconciliation Each Month ~. Annual Invento~ R~onciliation Statement Submiffed ~. Meters Calibrat~ Annually 5. Weekly Manual Tank Gauging R~ords for Small Tanks 6. Monthly Statistical Invento~ Reconciliation Results 7. Monthly Automatic Tank Gauging Results 8. Ground Water Monitoring V 9. Vapor Monitoring V 10. Continuous Interstitial Monitoring for Double-Walled Tanks ~ 11. Mechanical Line Leak Detectors 12. Electronic Line Leak Detectors 13. Continuous Piping Monitoring in Sum~ 14. Automatic Pump Shut-off Capabili~ 15. Annual Maintenance/Calibration of Leak Detection Equipment 16, Leak Det~tion Equipment and Test Methods List~ in LG-113 Series 17, Wriffen Records Maintained on Site,~ 18. RepoSed Changes in Usage/Conditions to Operating/Monitoring Procedures of UST S~tem Within ~ Days 19. Re~ded Unauthorized Release Within 24 Houm 20, Approved UST System Repairs and Upgrades 21. Records Showing Cathodic Protection Ins~tion 22. Secured Monitoring Wells .............................. RE-INSPECTION~TE~/~ _ RECEIVED BY: INSPECTOR: ~ ~ OFFICE TELEPHONE No. FD ~9 (rev. 9/95) Or E XVlrO E: lln services 1715 Chester Ave., Bakersfield, CA (80S) 326-3979 PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE 'rANK ~lt£ InformaTion SITE~~._.~ ADDRESS ~"7OO C~¢,,c 131,~e... ZTP CODE ~ ~N contractor INVOCATION INSTANCE CARRIER ~a~a_ ~. ~/)~t~%_ _ wO~NS COMP NO. ~WA ~ WA i~qql ~qq qol-0611~-06 O~.~o~ PRELIMInArY ASSESSMENT I~FO~ATION ~ -~ '~ COMPANY x ~ I ~ HIO~ NO, LICENSE NO. ADDRESS I~/,~ ~ C~ ZIP INSU~NCE CA~ER WO~NS CO~ NO, TANK CLEANING INFORMATION NAME OF RINSA~ D[5~SAL FACIL[~ ~ ~ ~ TAN K T~NSPORTER INFORMATION CON1PANY~~e~a~o~(~n C~o. PHONE NO. ~-~OO LICENSE NO. ~ i OGOl TANKDEST1NATION ~oJ~ ~ ~t% TAN K IN gORMA~ON C~M[CAL DATES C~MICAL TANK NO AGE VOLUME STORED STORED PRE~OUSLY STOOD For Oflic~al l.~ Only · '. ,'..': '. ,,,c~UW ~O.::'~.,' ~.~ o :r~.,, ,...,, ...... APPLICATION DAT~' ' i : ': F .F~'~'$Z~.._ I Tl[E A['PI.iC;\NT ~ [A,~ RI-.'CEIVr:I). t FNDERSTANrDS. ~LND W~LI, COM~I.Y WITII TIIE A'fi'AC! 13']D CONDI'II(~NS ()F TI IlS Iq{RMIT ANI) ANY t)'['! II';R S'l'A'ri-;. I,OCAI, .~ND FEDI"RAL REC UI.AT~ONS. Ti IlS I:( )RM I IAS I }l.'.[,.qq COMPI.171'ED [ INl')liR Iq..'NALTY OF PER.fURY. AND TO Tl IE BEST ¢31: MY KNOW] .I.~IX;E IS 'FRUI.: BAKERSFIELD FIRE DEi~-~-----~-- HAZARDOUS MATERIAL DIVISION )~Xb~0()(]~]~~ Bakersfield, CA 93301 5 Chester Avenue (805) 326-3979 Third Floor ~.~ ~. ~, .~ APPLICATION TO PERFORM A TIGHTNESS TEST /Hospital FACILiTySan Joaqu.in Community ADDRESS 2615 Eye Street, Bakersfield, CA PERMIT TO OPERATE # BT-0345 OPERATORS NAME sa~ ' OWNERS NAME Same NUMBER OF TANKS TO BE TESTED 1 IS PIPING GOING TO BE TESTEDYes · TANK# VOLUME CONTENTS 1 3,000 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 M. Youn9 CERTIFICATION # 86116 STATE REGISTRATION # 9~-1076 DATE & TIME TEST IS TO BE CONDUCTED 2/19/97 ~ 10:00 a.m. BY: DATE ~glGNAT~j~E CONFIDENCE UST SERVIOE~S~ ~NOo 417 MONTCLAIR STREET BAKERSFIELD~ CA 93309 (805). 631-3870 SAN JOAQUIN CON. HOSPT. SAN JOAQUIN GON. HOSPe~ ~oOo Nusbe~ N/A PoO. BOX 2615 2615 EYE STREET Te~h~ioia~D. YOUNG , BAKERSFIELD~ CA 9~0~ BAKERSFIELD~ CA T~ch~86116 Van~Oi 02-i9-97 Tt~o ~ta~%~ 10~00 En~ 12~30 Cou~ty~ KE Facility Phon~¢~ <805) 326-4140 Oroundwat~r Depth~ 144"+ Blu~ Ppint~ N/A ~o~~ ALETHIA. REGAL Oa~Tt~it@ ~¥s'~ ~s ~1l¢~ 6+ HOURS T~ ~ci~et%~ Produe% T~n~ Vapor L~no~ Ltn~ .Roeovo~y W~%or/T~nN Typo M~%ort~l I 3000 DIESEL PASS PASS PASS N/A O. 8B" SUCT. SWS Ad~i~i~nol In~op~io~ TEST TECHNICIAN~ DOUG YOUNG O~]%T~L~ ~99-1076~ Up Equip~ 10:00 P~oduc~ Ltno~ YES Vapor Ltnos~ N/A Riseps ~nstall~d~ YES part ~80~ NFPA ~=87 an~ all applicablo st~ ~nd 1o~1 codes. b> Any failure l~sted abovo may requi~ fu~thor ac~ton~ check with all regulatory agencieso Copy~i~h~ (~> 1989 by A~ ~n~. ~ 2446 - ~a~o,~ 02/19/97 Ti~ ~ !0~02~42 DMY Yank~ 1 Ta~k Dia~{i~)~ 75 3000 ~ad~ L~v~l(~,n)~ i=~ P~odu~-~ L, ov~i(t~>~ ll~ O~ Ta~k(i~)~ 0 Oravi~-y~ ~ 87 Ooe'~fic~t~n'~' O~ ~x'par~to~ 0~ 0004435 Va~u~(~l)~ 200 ~h~nne~ 1 S~a~tin~ To~p~atu~. (F)~ 54.109 H~ad Pros~ur~(psi (~))~ 3.71 ~up~a~o A~a(sq~ in) ~ 35~ 0 T~mpo Ohan~o (F/h) ~ -0~ 129 Lovol volu~(Bph) o -0.21 " T~p. volu~(gph) ~ -0. 17 P~oduo~ Lino(~h) ~ SUCTION N~ ~hango,(gph) ~ -00 04 SAN JoAQUZN'COi'~MUNITY' HOSPITAL v 26t5 EYE STREET ,~ BAKERSFIELD, CA~ THIS ~S A HIGH LEVEL TEST WiTH A 200 ML~ CALIBRATION ADDED PRIOR TO 'THESE DATA. 'TNE PRODUCT LINE IS FLOODED AND iNCLUDED IN THESE DATA: HAZARDOUS MATERIAL DIVISION )~M~~ Bakersfield, CA 93301 5 Chester Avenue (805) 326-3979 APPLICATION TO PERFORM A TIGHTNESS TEST /Hospital FACiLiTySan Joaqu.in Community ADDRESS 2615 Eye Street, Bakersfield, C; PERMIT TO OPERATE ~ BT-0345 OPERATORS NAME Sa~ OWNERS NAME Same NUMBER OF TANKS TO BE TESTED 1 IS PIPING GOING TO BE TESTEDYes · TANK# VOLUME CONTENTS 1 3,000 Diesel CONFIDENCE UST 417 Montclair Street TANK TESTINGCOMPANY SERVICES, INC. ADDRESS Bakersfield, CA 93309-177 TEST METHOD AES System II (Overfill) NAME OF TESTER Douglas M. Youn9 CERTIFICATION ~ 86116 STATE REGISTRATION # 90-1076 DATE & TIME TEST IS TO BE CONDUCTED 2/19/97 ~ 10:00 a.m. CONFIDENCE UST "Compliance With Confidence" SERVICES, INC. February 19~ 1997 CITY OF BAKERSFIELD Hazardous Materials Division 1715 Chester Avenue, Third Floor Bakersfield, California 93301 To Whom It May Concern: Enclosed please find original of Application to Perform a Tightness Test for approval, along with our check in the amount of $55.00~ as and for your permit fees herein. Please return issued permit and receipt to our office in the envelope provided. Should you have any questions, please feel free to contact me at 634-9501. Thank you for your attention herein. Yours truly, CONFID£NCE UST SERVICES, INC. Cheryl A. Y~ung~ Vic~Presid~ent Enclosures 417 Montclair Street · Bakersfield, CA 93309 (805) 631-3870 or (800) 339-9930 FAX (805) 631-3872 BAKERSFIELD FIRE DEPARTMENT November 15, 1996 Bob Easterday mi csl~F San ~oaquin Community Hospital MICHAEL R. KELLY 2615 Eye Street Bak~fidd, Ca 93301 ADMINISI~VE SEI~VICF.$ 2101 ~H' Street (805) 326-3941 We have rcvi~ed the plans and spccLScations fo; thc propos~ acid wast= hold~g t,,nk to SU~m~ON s;~v~;s be located at 2615 Eye Street as part of your emergency room expansion project. The proposed 2101 '~4' Street ~ does meet the curnmt UST regulations but, because of the intended use, this tank would be Bal(ersflold, CA 93301 (805) a26-394t g,,c~mpt from current regulations. ~:AX (BO,5) 395-1349 CCR, Title 23, Div 3, Chapter 16, excludes emergency tanlcs to be used for these purposes. mv~u~ou$;~eEs This office would therefore, not issue a permit for instafllafion or operation of the tm~k Your tank 1715 Chester Ave, 8ake~neld. C^ ~0~ imtallafion fee will b~ returned to you by the City of B~ersfield Finance 13epamnent. (80s) 32649~ YAX (8135) 32643576 However, in reviewing th~ proposal we see that this tank is intended for containment of fNVlI~ONI~EI~I~L $~1C~ runoff fi.om your decont~minntion shower. The drawings and Trico report however, indicate that ms Chaste, Ave. the tank is intended as an acid wrote storage system. There me two questions in mind: B~ke~sfield. CA 93301 (805) 3264979 F~X ts0~) ~26-0S76 A. Is the intended use of this tank for storage of acid wrote? ff so, the tank would have to be permitted. TRAINING DIVISION 5642 ~ctor Street ~oke~d. CA V~3~ B. ff the tank is intended to be used for &COntaminztion Waste water, is the "acid t~o$) ~-4697 waste" tank and piping adequate? The waste from hazardous materials ~ c~os) a~9-ST~ decontamination may be ~idic, but it may also be caustic, (high ph) as well as n~utral and toxic. In any case, please reply ffth~ system is intended for acid and waste storage. Furthermore, although the tank meets the current underground tank requirements, we do not intend to issue a permit, or oversee the imtallation because your umk is exempt. ffyou have any questions, pleme do not hesitate to ~,,11. Sincerely, // Hazardous materials coordinator cc: Howard Wines Henry Pacheco W~lace & Smith Contractors /.~~ Bakersfield Fire Dept ~i~ PERMit ~)~ ! ,~) OFFICE OF ENVIRONMENTAL SERVICES x~'.cx.~ ~-/ UNDERGROUND STORAGE TANK PROGRAM ~-~O~ PER~IT APPLICATION TO CONSTRUCT/~ODI~ UNDERGROUND STORAGE TANK a. w FAC,MW a O0, rC -T,O. O AC,L,W TA. ,.STALL T,O. AT AC,L,W STARTING DATE [~/I'l~ PROPOSED COMPLETION DATE ~ / 15/ FACILI~ NAME ~ ~FS~ C~,V~o'~ EXISTING FACILI~ PERMIT NO. ~ FACILI~ADDRESS %~¢~ ~%~ 5~, ~T~tcX~ ;G~. ZIP CODE ~PE OF BUSINESS H~'~ APN TANK OWNER ~6~ c~,~ %bs?~X PHONE No.~5-3~5-3~0 -- ADDRESS ~o ~ ~ ~. CI~( ~¢~'~ ZiP CODE CONTRACTOR ~%~ ~ ~'~ CA LICENSE No. ~ I ADDRESS %~ ~.~ ~, CI~ ~~i~, ZIP CODE PHONE No.%0~-~ - ~%G BAKERSFIELD CI~ BUSINESS LICENSE No. ~ o~ WORKMAN COMP. No. 0 ~- ~ G Ud,~oZ~SURER ~ ~o~ ~ BREIFLY DESCRIBE THE WORK TO BE DONE ~~ ~~ ~ ~n ~.~~ WATER TO FACILI~ PROVIDED BY~ ~'~ ~(~ ~ ¢~- %~v DEPTH TO G~OUND WATER ~D~ ~ SOIL ~PE EXPECTED~7:'SITE No. OF TANKS TO BE INSTALLED o~ ARE THEY FOR MOTOR FUEL ' OYES ~NO SECTION FOE MO;OR FUEL TANK No. VOLUME UNLEADED REGULAR PREMIUM DIESEL AVIATION SECTION FOR NON MOTOR FUELSTORAGE TANKS TANK No. VOLUME CHEMICAL STORED CAS No. CHEMICAL PREVIOUSLY (no brana name) (if known) STORED [~::~ii:~:~i~iii!:: i:.!:.::.:~:::. :~:~i:~ :~:~i~i~!i!!:!:!:~:iiii:i !:iii:!ii:!i!:f:! !i':!ii:f:~:!:?-~:i ::: :i ............... .i...i ........... i:':.:i:. ::i: :i:i:::.:i:i:i:i:...:::::i:i:ii:?ii ::iii~f!!i!!ii:i~:i:i:i:~ i:i~:ii!i t!~:::ii~i~i~!i~: ::i::i ................................. · ........................ !?:~!~f~fiiiii!i~iii:~!~i~i~!!i::!::ii!i!i!!i!~i!~:~!iiiiii:i~i:~i~:~:: ........................... i~?: !ii~iiii~:~ !~i: ~i~ ~:] THE APPLICANT HAS RECEIVED, UNDERSTANDS, A ND WILL COMPLY WITH THE AI'rACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE. LOCAL AND FEDERAL REGULATIONS. THIS FC~RM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY. AND TO THE BEST OF MY KNOWLEDGE. IS TRUE AND CORRECT. APPROVED BY: APPLICANT NAME (PRINT) APPLICANT SIGNATURE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED BAKERSFIELD FIRE DEPARTMENT November 15, 1996 Bob Easterday nRE C~E~ San Joaquin Community Hospital Mic14~L R. KILLY 2615 Eye Street Bakersfield, Ca 93301 ADMINISTRA/iVE SERVICES 2101 '14' Street Bakersfield. CA 93301 ]~ar MI:. (805) 326-3941 We have reviewed thc plans and spccificafions for thc proposed acid waste holding tank to SUPPRm~OH sErvicEs be located at 2615 Eye Strcc~ as part ofyo~ cmergcn~ room expansion project. Thc proposed 210~ 'H' Streef tank docs meet thc cun'ent UST regulations but, because of thc intended nsc, this tank would be Boke~field, CA 93301 (805) 326-3941 exempt from current regulations. FAX (K~5) 395-1~9 CCR, Title 23, Div 3, Chapta' 16, excludes enmrgeuey tanks to be used for these purposes. PRiV/HI1ON $[~/VlC~:$ This office would therefore, not issue a permit for installation or operation of the tank. Your tank 1715 Chester Ave. Bc]kemfield. CA 93301 installation fee will be returned to you by the City Of Bakersfield Finance DepartmcnL (805) 326-3951 FAX (805) 326-0576 [-Iowevcr, in reviewing the proposal we see that thi~ tank is intended for containment of ENVIRONMENTAl. SERVICES rl.lllO:~ J~om yOl.ll' delCOlll:l~millt&tion Sl~LOWer. The dl'a~v"i~gs and Ti'ice 1~o1"1; however~ Jn~icat~ t]:lat 1715 ch~t*r ^~e. thc tank is intended as an acid waste storage system. There arc two questions in mind: Bakersfield, CA 93301 (805) 326-3979 FAX (805] 326-0576 A. Is thc intended use of this tank for storage of acid waste? ff so, thc tank would have to be pcmfitted. TRAINING DIVISION 5642 Victor Street Bake~fle~, c^ 9.~08 B. If thc tank is intended to be used for decontamination waste water, is the "acid ¢805) 3~-~w7 wasl~:" tank and piping adequate? The waste from hazardous materials ~AX (~) 399-s~63 decontamination may be acidic, but it may also be caustic, (high ph) as well as nenn-81 and toxic. In any case, please reply if the system is intended for acid and waste storage. Furthermore, although the tank meets the current underground tank requirements, we do not intend to issue a permit, or oversee the installation because your tank is exempt. If you have any questions, please do not hesitate to call. Sincerely, // n,~zardous Mat~ial~ coordinator cc: Howard Wines Henry Pacheco Wallace & Smith Contractors BAKERSFIELD FIRE DEPARTMENT June 18,1996 FIRE CHIEF MICHAEL R. KELLY Dear Underground Storage Tank Owner: ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfield, CA 93301 (805) 326-3941 F,x(~)39~-~:~9 Enclosed is your updated Permit to Operate for the underground storage tank(s) located at the referenced place of business. SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA93301 Please take a moment to review the information printed on the permit (805) 326-3941 FAX(805)395-1349 to make sure everything is correct. If any corrections need to be made, please call the discrepancies to our attention immediately. Your Permit to P,EVEN.O. SERVICES Operate is a legal document and its accuracy determines whether you 1715 Chester Ave, - Bakersfield, CA93301 are in compliance with the law. (805) 326-3951 FAX (805) 326.0576 If you are the tank owner and not necessarily the tank operator at the ENVIRONMENTAL SERVICES site, please make a copy of this permit for your own files. Forward the 1715 Chester Ave, Bakersfield, CA 93301 original permit to the tank location so that it may be conspicuously posted on (805) 326-3979 FAX (805) 326.0576 site. TRAININGDIVlSlON If yOU have any questions regarding the Permit to Operate or your 5642 Victor Street Bol(ersfield, CAq3308 responsibilities as an underground storage tank owner, please call the Office (805) 399-~97 of Environmental Services at (805) 326-3979, or write to us at the letterhead FAX (805) 399-5763 address. Sincerely, Hazardous Materials Coordinator Enclosure rate Underground Hazardous Materials Storage Facility CONDITIONS ~::~ :pE~l~ ~!, REVERSE SIDE Tank Hazardous G~ii:°~ii:?;::%:.::::i? .... Yea~iii?:;i~::.::::, ::~? i~:Tank '::~;;:i;i:T:~i~i?::i!!:!::!!:~::~: Piping Piping Piping Number Substance C~:Pa~!i:~%.?:': I n s t a'lle:i~:;!':;-..:. ~ :i~.~T y p e M o h it:6:~:iri:g::i~:'.':::::'~:;;~: Type Method Monitoring 01 DIE SEL ~ [~[~ ~00~?:.~? :':~;~;;~;;::;:~:::~::~:~:.:.~;~;~;~;;::::~;;~ ? ??;?'~WF ......... C L~:::]~?:~?)~ ::':~] ;~DwF SUCTION ALD 02 DIESEL ~?? ~:,000 ~:?: ........ :::::::-:::~'9:7'2::~?.;::~;~?~:~;~? :.: .SWS .~ ?";~%MI~:' ~: :::::~:~WS SUCTION L~ .... %~?':?~::;~:~:::~:??'.::~? "~:""'::~.~ ~:?~?~:~]...:?~::~?:: .:~::::::?'"~ .?::issued To Bakersfield Fire Dept. ==%================`====?===================================:======================:====?==?====:===?=??= ......... HazaRDOUS aRTERiaLS DW~S~O. .........................SAM JOAOOl~ HOSPITAk 17~5 Caester ave., ara Floor 2615 EYE $TREET Bakersfield, CA 93301 BAKERSFIEkD, CA 93391 (805) 320-3979 ~alph~. H~terials Coordinator Valid from: 06-26-96 to: 06-.26-01 BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA '93301 (805) 326-3979 APPLICATION TO OPERATE AN UNDERGROUND STORAGE' TANK ~APPLICATION IS BEING SUBMITTED FOR THE FOLLOWING REASON: PREVIOUS TANK OWNER (if applicable) NAME ~ ,// PHONE ADDRESS {~-~. , ~ NEW TANK OWNER NAME ~x~n_v%~ C_~u~ ~o~\ PHONE ~05 - ~5 - ~0~0 ADDRESS ~%~ ~ ~. ~~%~: BILLING ~DRESS ~~ ~ ~~;~%% TANK OPE~TOR (if different from owner) N~E ~~ PHONE ADDRESS APPLICANTS N~E (if different from owner) N~E ~ ~ PHONE ADDRESS TANK LOCATION FACILITY N~ES~o~%~~.~.~DRESS ~%5 ~. ~~~. PHONE ~-~%5-%~o OPE~TORS N~E EMERGENCY CONTACT N~E ~~%%~~ PHONE ~o~-%%~q~ ADDRESS %~%t O~~° ~v~. ~~X% TANK INFO~TION tank~ volume date installed substance stored previous substance Do You Have a HAZARDOUS MATERIAL RESPONSE PLAN? ~ NO Do You Have an OWNER - OPERATOR AGREEMENT? N/& ~ NO Have You Filled Out a HAZARDOUS MATERIAL BUSINESS PLAN? NO date ~ name (print) 0 signatu~'~ 2130 G Street, .a ersz e d, ca T~ ~OV~ INSPECTION FO~ FACILI~ ~ ~u,J ~SF,~ ~DRESS O~R ~ ~o~u,~ ~. ~,~ PE~IT T00PE~TE~ C0~CTOR ~ ~J' C0~ACT PERSON~ ~BO~TORY ~ Cm6S ~ 0F S~PLES TEST ME~ODOLOGY ~ 7e~ ~ PRELI~ARY ASSESSME~ C0. %~'~ ~- C0~ACT PERSON PLOT P~N CONDITION OF TANKS C~C~r~ ~ooo., 5o~6 ~u~ ~w& ~o~o~ CONDITION OF PIPING CONDITION 0F SOIL ~c H.~.ARDOUS MATERIALS DIVISION INSPECTION RECORD POST CARD AT JOBSITE PHONE NO. PERMff ~ )NS~UCT1ONS: Please call for an ins~or only when each group of inspe~ons w~ ~e same numar ~re ree~. 'They will mn in ~nse~ve order ~ginning w~ number 1. ~ NOT cover wor~ for any numbered group un~l all ~ems in ~at group' are signed off by ~e Peking Au~o~. Following ~ese ins~ons will redu~ ~e number of required inspec~on visi~ and ~erefore prevent ~ssessment of add~onal fees. TANKS AND BACKFILL Bac~ll of Tank(s) Ga~o0ic ~rot~on of PIPING SYSTEM C~odic Protec~on System-Piping SECONDARY CONTAINMENT, OVERFILL PROTECTION, LEAK DETECTION Liner Installation - Tank(s) Liner Installation - Piping Vautt With Product Compatible Sealer Level Gauges or Sensors, Float Vent Valves Product,ne Leak' Detector <s) Monitoring Well(s)/Sump(s) - H~O Test Leak Detection Device(s) for Vadose/Groundwater FINAL Monitoring Wells. Caps & Locks Fill Box Lock SAI~~ 5A~-'UI N HOSPITAL 26 k_~,SYE STREET 'i BAKERSF I ELD, CA. 805-395-3000 JUN 26, 1996 9:2B AM SENSOR ALARM ..... SENSOR ALARM ..... L I:DIESEL L '2 :DIESEL MON I TOR WELL MON I TOR WELL LOW LIQUID ALARM '~ FUEL ALARM SYSTEM STATUS REPORT JUN 26, 1~96 9:24 AM JUN 26, 1996 ~:23 AM ALL FUNOTIONS NORMAL ' SAN JOAQUIN HOSPITAL SAN JOAQUIN HOSPITAL 2615 EYE STREET 2615 EYE STREET BAKERSFI ELD, CA. BAKERSFI ELD.. CA. 805-395-3000 805-395-3000 JUN 26. 1996 9:2S AM JUN 26, 1996 9:2S AM SYSTEM STATUS-REPORT SYSTEM STATUS REPORT ~ L I:LOW LIQUID ALARM L 2;FUEL ALARM L 2:FUEL ALARM SAN JOAQU1N HOSPITAL INVENTORY REPORT 2615 EYE STREET INVENTORY REPORT BAKERSF I ELD.. CA. T 1; D I ESEL 805-395-3000 VOLUME = 14082 GALS T 1 :DIESEL UL' "qE = 918 GALS JUN 26, 1996 9;36 AM VO' JE = 14082 GALS 9~ JLLAGE= 0 OAL~ U~;E = 918 GALS TO~LU~E = 13955 GALS 90~: ULLAOE= 0 GALS HEIGHT =106.60 INCHES TO VOLUME = 13955 GALS WATER VOL = 0 GALS SYSTEM STATUS REPORT. HEIOHT =106.60 INCHE~ WATER = 0.00 INCHE~ ............ WATER VOL = 0 GALS TE~P = 79.9 DEO F ALL FUNCTIONS NORMAL WATER = 0.00 INOHES TEMP = 79.9 DEO F ~ ~ * ~ ~ END ~ * * ~ ~ INVENTORY REPORT T 1 :DIESEL VOLUME = 1~082 GALS ULLAGE = 918 GAL~ 90~ LLAGE= 00AL~ TC~CUME = 13955 GALS HEIGHT . =106.60 INCHES WATER"VOL = 0 GALS WATER = 0.00 INCHES TE~P = 79.9 DEO F ..... SENSOR ALARM ..... L I:DIESEL MONITOR WELL ..... SENSOR ALARM LOW LIQUID ALARM L I:DIESEL JUN 26, 1996 9:26 AM MONITOR WELL LOW LIQUID ALARM JUN 26, 1996 9:26 AM SENSOR ALARM ..... L I:DIESEL MONITOR WELL ~AI,~,,_~OAOUIN HOSPITAL HIGH LIQUID ALARM 2615 EVE STREET JUN '26, 1996 9:26 AM BAKERSFIELD, CA. ~ 805-395-3000 JUN 26, 1996 9:26 AM SYSTEM STATUS REPORT L I:HIGH LIQUID ALARM SAN JOAQUIN HOSPITAL 2615 EYE STREET L I:LOW LIQUID ALARM BAKERSFIELD.. CA. 805-395-S000 L 2:FUEL ALARM JUN 26, 1996 9:26 AM INVENTORY REPORT SYSTEM STATUS REPORT .. -., T I:DIESEL VOl '"~E = 14082 (_]ALS L I:HIGH LIQUID ALARM I UL~ ~ = 918 (]ALS , 90~'~JLLAGE= O L I:LO~ LIQUID ~L~RM TC VOLUME = 13955 " HE I ~HT = 106.60 INCHES L ~UEL aLARM WATER VOL WATER = 0.00 INCHES TEMP = 99.9 DEG F INVENTORY REPORT ~ ~ ~ ~ ~ END T 1 :DIESEL VOLUME = 14082 GALS ULLAGE = 918 GALS 90~ ULLagE= 0 GALS TC VOLUME = 13955 GALS HEIGHT =106.60 INCHES WATER VOL 0 WATER = O. O0 I NOHES TEMP = 79.9 DEG F /<S~~¥~...~.:.X Rnkerst~eld F~e Dept. PERMIT APPUCATION TO CON~UCT/MGD[~ UNDERGROUND STG~GETANK ~ NEW FAC;U~ ~ MOCIFr~A'~CN OF FAC;U~ ~ NEW ~ANK [NSTAL~ION A~ ~XIST[NG START[NO OATE s/lol~¢ PROPOSED COMPL~ON DATE ~/l~J~ m WPE CF BUSINESS H~P~ APN ' " TANK OWNER,~~i~ ~~ ~ ff~~ PHONE No. ~ONTRACTOR ,. % )~{~ ~t~ ~~'~gk~sCA LICENSE No. PHONE No. ~'~) -']g~O BAKERSFIELD C;~ 8USINESS LICENSE No. WORKMAN COMP. No. ~'~%%5 ~NSURER ~O',k¥(5 ~~,~ ~O-~¢~ WATER TO FAC;LI~ PROVICED BY. C~t~O~ ~~ gEPTH TO GROUNO WATER ~ -~e_~ SOIL ~PE ~(PECTED AT S[TE No. OFTANKSTO ~E[NSTALLED 0 ~ ~ ARE THEY FOR MOTORFgEL .~YES ~NO /:. SEa?ION FO~ NON MOTOR FUEES?O~AG.E TANKS TANK No. VOLUME CHEMICAL STORED CAS No. CHEMICAL PR~m/ICUSL','' (no Orana name) (if known) STORED 6~& I~:co~) ,~,J,, :~'2.. g~c.,5',z.k CA, c:, b~H"g~-SH--~, N/A THE APPLIC,A Nl' HAS REC[iVEfl. UNOEHSTANO~, ANO WILl. CQMPLY WffH THE A~ACHED C~NOI~O NS CF~IJ F~MIT ANO ANY ()k~ THIS APPLICATION BECOMES A PERMIT WHEN APPEOVED S~ INFORMA~ON FACILI~ NAM~ ~C~ CROSS STRE~ ~ ~ ~ TANK OWNER/OPERATOR ~CH ~~ ~ PHONE No. ~ ~ MAlUNGADDRESS ~G~ ~ ~ Ci~ ~ ~ ZI~CODE CO~ACTOR INFORMATION '. COMPANY~~,~v[~,~~. PHONE No.~5-- ~'~O LICENSE No. H~ ~~' ADDRESS I~O.~, ~i~'~ '~, .. CI~ ~~~ ZIP CODE INSURANCE CARRIER '~',L¥{~ C~-~n c-~ ~.r,-~'~ WORKMENS COMP No. PR~IMANARY ASSEME~ INFORMATION COMPANY X ; I ~ PHONE NO. LICENSE No. ADDRESS I~ /.~ CIW ZiP CODE INSURANCE CARRIER WORKMENS COMP No. TANK CLEANING INFORMATION COMPANY ~~ ~~-~~'~-cLc-¢~5 PHONE No. ADDRESS 'i~C~O ~, O~ '~- Cl~ ~~ ZIP CODE WASTE TRANSPORTER IDENTIFICATION NUMBER ~ ~% 0%~ f~ ~ ~ - NAME OF RINSTATE DISPOSAL FACILI~ ~ ~ Corn ADDRESS %~,~ o~"~~L~A ~./,~ - c~w ~~A ZIPCODE FACiLI~ INDENTIFICATION NUMBER ~~ ~O~ TANK ~ANSPORTER INFORMA~ON COMPANY ~~~..~~ PHONE No. %~.-g'gO~ LICENSE No. ADDRESS ~[) ~. ~c~ CI~ .~~ ZIPCODE TANK DES~NATION ~o~-~ ~~ ~~ ~ TANK INFORMA~ON TANK No. AGE VOLUME CHEMICAL DATES CHEMICAL STORED STORED PREVIOUSLY STORED Ii~.:~``~~~`~:~.~:~:~m~:~:~.~:~:~::~.~:~:~.~:~:~:~:~:;~:::~:i~:~.~`~........ ~..:~..... ::::::::::::::::::::::::: THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATrACHED CONDITIONS OF THIS PERMIT ANO ANY OTHER STATE LOCAL AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLIED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT; THIS APPLICATION BECOMES A PERMIT WHEN APPROVE~ ..... · ,, n, ,--r,,-~ 'T'UC: .Z"I'I'V r't~ 05-15-1995 10:33AM FROM HFP ARCHITECTS TO 932605?6 P.O1 'FACSIHILE. TP-~NSMITT,A,L COVERSHE.ET NUMBER OF PAGES (INCLUDING COVERSHEET): hfp architects. 116-k mi~l[e road · mont~i~o, ca~il~r~i~ 85-15-1995 10:J4AM FROM HFP ARCHITECTS TO 932605?6 P,02 DIVISION 02000 SITEWORK SECTION 02700 MECHANICAL UTILITIES PART I - GEN~U%L The General Conditions, Supplementary General Conditions, and. Division i - General Requirements and Section 15010 - Mechanical General, are hereby made a part of this Section as fully as if repeated herein. 1.01 DESCRIPTION A. Work speci£ied in this section 1. Mechanical Utilities Work complete, including, but not necessarily limited to the following: a. Buried fuel oil tank installation and reconnec- tion of fuel oil lines b. Excavation and backfilling for Mechanical Util- c. Testing of Mechanical Utilities Systems d. Protection of Materials of this Section e. Restoration of damage B. Related work specified elsewhere: 1.. Excavation and Backfilling: Section 02221 2. Cast-In-Place Concrete Work: Section 03300 1.02 GENERAL REQUIREMENTS: Refer to Paragraph 1.02, Section 15010 1.03 QUALITY ASSURANCE A. Notwithstanding, any reference in the SPecifications to any article, device, product, material, form or type of construction by name, make, or catalog number, such ref- erences shall be interpreted as establishing a standard of quality and alternate items may be submitted for re- view unless listed item is noted "No SUbstitutions or Alternate Manufacturers Will Be Permitted" 1.04 SITE EXAMINATION A. Information for Bidders and as follows: 1. No allowance will be made for any costs incurred by the Contractor, subsequent to Contract award, due to his failure to have notified the Architect, prior to submitting his proposal, of all discrepancies encoun- tered between the Drawings, Specifications, and ac- tual site conditions which are discernible 1.05 PROTECTION OF MATERIALS AND PROPERTY A. Refer to Supplementary General Conditions B. Refer to General Conditions C. Refer to Division I - General Requirements PART 2 - PRODUCTS 2.01 PIPING A. General 1. All pressure piping shall conform to the requirements ~CHAN~CAL UTILITIES Section 02700-1 05-15-1995 10:34AM FROM HFP ARCHITECTS TO 932605?6 P.O~ of the ANSI Safety Code for Pressure Piping, B31.1; be commercially round and straight; be of uniform quality and workmanship; be free from all defects; and be identified 2. All fittings, flanges, and unions shall be standard manufactured products 3. Make all screwed joints with Teflon tape, applied'to the male threads. Gasket and bolt all flanged unions 4. Provide dielectric unions between ferroUs and non- ferrous piping 5. Pipe threads shall conform to ANSI B2.1, American Standard Pipe threads 6. Protect all buried steel and copper pipe with one coat of pipe primer and wrapped with two layers of 0.10 · inch thickness vinyl tape applied with second layer overlapping first layer by 50 percent. Primer and 'tape shall be applied in accordance with submitted data and manufacturer's recommendations. B. Pressure Piping: 1. Copper Tubing: ANSI H23.1; and hard temper type L for all piping; wrought copper, solder ~oint fittings, ANSI B16.18, cast-bronze, threaded, ground joint unions, ANSI B16.15. Solder shall be an alloy of vet containing no lead, zinc, cadmium 2. Ductile Iron with push-on Joint: ANSI A21.11 (AWWA C111), ANSI A21.51 (AWWA C151), thickness Class centrifugally cast, fittings shall be of same material and pressure classification as piping. The weight clas~ or nominal thickness, and casting period shall be.shown on each pipe. The manufacturer's mark, the year in which the pipe was produced, and the letters "D.I." or "Ductile" shall be cast or stamped on each pipe 3. Black Steel, Threaded: ANSI B125.2, Schedule 40, threaded black cast iron fittings and ground joint unions, ANSI B16.4, 125 pound class 4. Black Steel, Welded: ANSI B125.2, Schedule 40; steel butt-welded fittings, ANSI B16.9; steel welding flang es and flanged fittings, ANSI B16.5, 150 pound class; grooved type couplings where noted 5. Pre-insulated Steam Piping: Black steel, threaded, ANSI B125.2, Schedule 40 with black cast iron fit- tings. Pipe shall have outer PVC casing with void between pipe and casing filled with a minimum 2 inch thickness foam' insulation C. Pressure Piping systems shall comply with requirements hereinbefore specified for pressure piping and as follows: 1. water a. 3 inch and smaller: copper tubing b. 4 inch and larger: ductile iron 2. Natural Gas: Black steel, threaded I inch and small- er; welded 1-1/4 inch and larger 3. Storm Drain Pump Discharge: Black steel with victau- lic or similar grooved lock type fittings 4. Steam: MECHANICAL UTILITIES Section 02700-2 05-15-1995 10:35AM FROM HFP ARCHITECTS TO 932605?G .P.04 a. Buried: Preinsulated black steel b. Not Buried: Black steel 5. Fuel Oi1: i inch and smlaller: Black steel, thread- ed; larger than I inch: Black steel, welded. Buried piping shall be installed with an outer casing of PVC or fiberglass to provide a code conforming dual wall installation 6.F~el Tank Fill Pipe: Black steel, threaded 7.Fuel Tank Sounding Pipe: Black steel, threaded 8.Fuel Tank Vent Pipe: Black steel, threaded 2.02 VALVES: Nibco'(as noted), Walworth, Stockham, or equal A. General: 1. For copper tubing provide IPS-to-copper adaptor, sized for use with tubing and respective valve. Solder joint valves will not be permitted for water service 2. For flanged valves, provide streamline companion flanges, ANSI B16.5, 150 pound class, unless indi- cated otherwise 3.Provide valves rate at not less than 125 pound steam working pressure, unless indicated otherwise 4. Provide valve materials suitable for service and temperature of respective systems, especially with respect to discs, plugs, balls, linings, gaskets, and lubricants of globe valves, plug cocks, ball valves, etc. B. Valve Types: 1. Gate Valves: a. Two-inch and smaller: Figure T-124 threaded bronze, 125 pound steam, 200 pound W.O.G., solid wedge, union bonnet, inside screw, rising stem b. 2-1/2 inch and 3 inch: Figure F-619, IBBM 125 pound steam, 200 pound W.O.G., solid wedge, non- rising stem, flanged c. 4 inch and larger: Figure M-609, IBBM, 175 poung water, bolted bonnet, FM approved, U.L. listed 2. Gas Cocks: Walworth Figure 1796 or 1797F, Jenkins, Stockham Or equal lubricated plug valve. Valve shall be short pattern cast iron body and plug, valve shall be rated for 175 pound W.O.G. Figure 1796 shall be utilized with screwed piping and Figure 1797F with welded piping. Provide operator handle for each valve 2.03 CLEANOUT$: Smith as noted or equal A. Grade, Pedestrian Traffic Areas: Figure 4020U cast-iron cleanout with serrated cut-off ferrule, brass plug with neoprene seal, adjustable head and heavy duty scorinated cover secured with screws B. Grade, at all Vehicular Traffic Areas: Figure 4020 cast- iron cleanout with brass plug with neoprene seal and pol- ished brass frame and cover C. Cleanouts shall be line size up through 6 inch size and shall be 6 inch size for lines 8 inches and larger in size MECHANICAL UTILITIES Section 02700-3 05-15-1995 10:35RM FROM H~RRCHITECTS TO 932605?6 P.05 2.04 THRUST BLOCK~: As detailed on Drawings 2.05 MANHOLES: Pre-cast manhole and concrete base with galvanized steps; cast-iron manhole roing and cover per local City Stan- dards for pre-cast manholes. Refer to Drawing Details for adaitional requirements 2.06 VALVE BOXES: Each valve on buried piping, except where indi- cator post is shown, shall be provided with an adjustable cast-iron or precast concrete valve box of a size suitable for the valve on which it is to be used. The head shall be round and the lid shall have the word "WATER" or appropriate service cast on it. The least diameter of the shaft of the box shall be 5-1/4 inches. Each cast-iron box shall be given heavy coat of bituminous paint 2.07 UNDERGROUND FUEL OIL STORAGE TANK: Owens-Corning Fiberglass, Hydro Guard System A. Fuel Oil Storage Tanks: Construct tanks of fiberglass inforced plastic (FRP) to comply with NFPA 30. Under- ground fuel oil storage tanks shall meet the requirements of the State of California Health and Safety Code, Divi- sion 20, Chapter 6.7, Section 25850 (definition); Section 25284 to design and construct tanks for primary and sec- ondary containment of fuel oil and shall be double wall construction with area between walls available to accept the probe of a monitoring system and Section 25284.1 to furnish and install a monitoring system capable of detect- ing unauthorized release of hydrocarbons or intrusion of water flow from surrounding soil. Tank shall have manhole openings for fill, vent, section oil return, oil level gage. size vent pipes according to NFPA 30 but not less than 1-1/4 inches in nominal inside diameter B. Monitoring Syatem to Detect Hydrocarbon and Water Leaks: Veeder-Root, Model TLS-350 Complete, shall consist of an electrical/electronic control center and one sensor probe located at each end of the tank at the lowest corner be- tween outer and inner walls of double wall tank with con- necting cable, LED indicators for fuel oil (red), water (yellow) and air (green) with alarm audible at 2900 HZ, 75 dB on a scale above ambient noise level at 2 feet from control center. Additional detectors to be located at piping turns, at low point in piping and at other required locations. Control unit shall be located in Hospital En- gineer's office where directed in NEMA 4 enclosure and be available to accept power characteristics of 120 volt a.c. +/- 20 volts, 60 Hz, 8 watts minimum. Sensor probe shall be located on a float to detect fuel oil on dry bottom on tank or floating. Probe shall meet NFPA 70, Class 1, Division 1, GroUp D hazardous location requirements. Sen- sor response time to detect hydrocarbons shall be not less than 5 secons afterr sensor is covered. System shall be FM approved, UL listed C. Tank capacity shall be a nominal 15,000 gallons D. Oil Level Gage: oil level gage shall be a listed MECHANICAL UTILITIES Section 02700-4 85-15-1995 10:36RM FROM HFP RRCHITECTS TO 932685?6 .P.06 assembly, calibrated to match tank provided. The level readout shall be remotely located in the Hospital Engi- neer's office, where directed, shall read out in gallons as either a direct reading or a dial indicator reading E. Mechanical Contractor shall arrange for any electrical power, wiring, etc. and include it in his bid figures. Remote reading oil level gage assembly shall be install- ed completed and operable, as shal be detection monitor- ing system PART 3 - EXECUTION 3.01 IDENTIFICATION= A. Charts= Provide suitable sized identification char~s, framed with glass or plastic front. Valve identifica- tion chart shall list valve numbers and symbol for ser- vice corresponding to piping symbol. Charts shall be posted as directed by the Architect 3.02 TESTING A. General: 1. Provide all tests specified hereinafter and as other- wise required 2. Provide all test equipment including test pumps, gages, instruments and other equipment required. All test equipment, gages, meters, etc., shall have been calibrated within three months of tests. S~bmit cer- tification of calibration prior to commencing testing. Pressure gages used shall be graduated in incre~ments not greater than 5 pounds per square inch and shall have a range not more than twice the test pressure 3. Upon completion of testing, certify to the Architect in writing, that the specified tests have been .per- formed and that the installation complies with. the specified requirements B. Piping: 1. Remove from the systems, during testing, all equip- ment which would be damaged by test pre~sure. Replace removed equipment when testing.has been accomplished. The systems may be tested in sections am work pro- gresses; correct leaks by remaking joints with new material; makeshift remedies will not be permitted. Test time will be accrued only while full test pres- sure is on the system except where piping is contin- uation of existing system 2. Perform tests in accordance with the following sche- dule. Unless otherwise indicated, "Tolerance" shall be no pressure drop, except due to temperature change, in a 24 hour period 3.Pipe Test Pressure Schedule: MECHANICAL UTILITIES Section 02700-5 05-15-1995 10:36AM FROM HFP ARCHITECTS TO 932605?6 P.O? Test Test System Medium Pressure Tolerance Water Water 150 psig or as required by UPC Soil & Waste Water 10 foot No leak~ 24 hours Vent Water 19 foot No leaks 24 hours Natural Gas Air 50 psig Pumped Discharge Water 50 psig No leaks 24 hours Steam Water 150 psig No leaks 24 hours Fuel Oil Return Oil 200 psig White Cloth - i hr Fuel Oil Suction Air 25 inch Hg. vacuum C. Valves: 1. Test all valve bonnets for tightness. Test operate all valves at least once from closed-to-open-to-closed position while valve is under test pressure 2. Test all automatic valves for proper operation at the settings indicated in the presence of Engineer 3. Test pressure relief valves, safety valves and safety relief valves by self-actuation not less than three times in the presence of the Architect at time of testing equipment operation for which valves apply D. Piping Specialties: 1. Te~t all piping specialties for proper operation E. Hangers and Supports: 1. With system in normal operation, test all hangers, supports and rods to insure tha% they are plumb and supporting their proper share of the load. Addition- ally support, as required, system and equipment that sway, crawl or vibrate F. Hydrocarbon and Water Monitoring System Test: Cover the sensor probe in underground storage tank with fuel oil. and, subsequent to removal, in a separate test with water, visually verify sensor time and LED water, oil and hydro- carbon indicator actuation; and measure alarm audible level specified G. Other Equipment and Systems: 1. Test all other equipment and apparatus as specified herein, as recommended by the equipment manufacturer, and as otherwise necessary or directed by the Archi- tect to assure that they are complete, operable and ready to use 3.03 INSTALLATION A. General: 1. The entire installation shall be accomplished by per- sonnel especially trained and qualified in their res- pective trades 2. Install all material, equipment, and apparatus in an orderly correlated and neat appearing manner, with like elements and appurtenances.in similar location, position and elevation. Do not install any diagonal ~HANICALUTILITIES Section 02700-6 85-15-1995 10:37AM FROM HFP ARCHITECTS TO 932605?G P.08 or otSer~ise irregular work without written &99roYal.. from the Architect 3. Ail material, equipment, and apparatus shall comprise complete and operable systems. Provide all apparatus, parts, material, and accessories which are necessary to accomplish this result 4. Should any part of the installation result in an in- complete and operable system, or systems, provide additional material or equipment necessary to make the systems operational 5. Inspect all material, equipment and apparatus upon delivery and do not install any that may be ~ubject to rejection as a result of damage or other defects 6. Examine all Plans of all Divisions of these COntract Documents and become familiar with them as necessary for proper and prompt coordination of all installa- tions. Relocate as directed by the General Contrac- tor and as approved by the Architect all material, equipment and apparatus which are placed and which result in interference with other installations 7. Install new piping with a minimum 6" clearance above or below existing piping, conduits, duct banks, etc. that it may cross. Space between pipe and existing service shall be filled with compacted sand B. Welding: 1. All welding of pressure piping shall be done by weld- ers who have been qualified by a recognized agency within six months prior to date of the Contract. Per- form all welding in accordance with the provisions of the latest issue of all applicable codes, including ASHE Boiler Construction Code and the ANSI Code for Pres;ute Piping. Before any welding is performed, submit a copy of Specification for Welding Procedure to the Engineer with proof of its compliance with ap- plicable codes. Standard Procedure Specifications of, and operators qualified by, the National Certified Pipe Welding Bureau will be considered as compliance with the requirements of these Specifications. Annual renewal of certification during the contract period will be required 2. Where required, peen and wheel grind welds. Ragged edges with metal beads, poor alignment and other in- ferior work will be rejected. Perform welding with oxyacetylene or electric arc processes, continuously around the pipe. Use fittings for all bends and branch takeoffs C. Valves: 1. Insure that all valves are field checked for packing and lubricant and that the disc is for the service intended. Replace leaking packing D. Fuel Oil Storage Tank: Install storage tank, vents and other connections in accordance with NFPA 30, recommenda- tions and published instructions of the manufacturer an~ as indicated MECHANICAL UTILITIE~ Section 02700-7 85-15-1995 10:37AM FROM HFP ARCHITECTS TO 932605?6 P.09 3.0¢ ST~ILIZATION A. Noti£¥ the~chitect prior to sterilization of the water system so that the sterilization procedure may be witnes- sed B. Purge entire new portion of domestic water systems and sterilize with 4% chlorine solution injected into system to a concentration of fifty parts per million allowed to stand for 24 hours. After this period, purge throughout new system. Upon completion of sterilization, certify that the specified sterilization has been performed by lab test and certification END OF SECTION MECHANICAL UTILITIES Section 02700-8 ~AKERSF!ELD,~ SAN JOAQU!N COM=HOSDT. P=O. BOX 2615 R6~5 'SYiZ STREET "rn,,~',,,~'~'1?~,-,)~ YI]UNG ~ 30~0 DIEBEL PASS PASS PO~GS N/~ G. 0~': SUCT~ SWS 4 A~l~lonal In~'o~-ma~lon~ TEST TECHNiCIANL DOUG YOUN~ 8XTE LOB TINE ~c,~ Up. Equip,q 08:30 ~l~d P~odu~ Linos~ YES D%o¢1 Vapor Ltnosn N/A ~lod Von~ l~nos~ YES Blo~ Tuv, bino ~ N/A Dlod ~';,~,t~n Pm;~p~ YES Riso~s ~n~'~al 1~ ~ YES all ~opyrigh~ (o) l/liD Teohn~c~a'n~ DFtV Tank~ 1 Tank ~)~ameter(in)~ 75 Volur~o(gal): ~E~00 ~ado Lavel(in), 120 Ha'~ L~vel On TanH(in)~. 0 ~pooi~i~ 8~avi~y~ .87 Ooo'~'Fio~o~ 0 L . ,. ,1:. Il "I:::l ........ I ......... ',,,, ,I-, .... - ..... i" O~a~tino T~pera'~ur~ (F) ~ 78.786 Head Pr~,ssu~,~o(psi (~g~)) ~ 3.42 ~u'rfao~ Ar~a(sq.' !n)~ 7.2 Tempo Chance(F/h) ~ 0.019 Level volu~o(gph)~ -0.02 To~p. volu~o(g, ph)~ 0.02 P~,odu~ Line(~ph)~ SUCTION No~ ohanf~o (~Dh) o -0.04 Copyrigh~ (c) 1~89 ~y A~S~ SAN JOAQLi!N COMMUNITY HOSPITAl_ ,, 2615 EYE STREE~ ~ L~A~4ERSFZELD~ CA,. 'THIS .S A HIGH L=VcL TEST W~TH A LO0 ML. CAL. i~RAT~.~Jh:. . THE PRODUCT LINE IS FLOODED AND t~CLUDED iN THESE DATA~ BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION )~~~ Bakersfield, CA 93301. 5 Chester Avenue (805) 326-3979 Third Floor APPLICATION TO PERFORM A TIGHTNESS TEST SAN JOAQUIN FACILITY COMMUNITY HOSPITAL ADDRESS 2615 Ey~ PERMIT TO OPERATE # OPERATORS NAME Same OWNERS N~4E Same NUMBER OF TANKS TO BE TESTED 1 IS PIPING GOING TO BE TESTEDYes TANK% VOLUME CONTENTS CONFIDENCE UST 417 Montclair Street TANK TESTINGCOMPANY SERVICES, INC. ADDRESS Bakersfield, CA 93309-179 TEST METHOD AES System II (Overfill) NAME OF TESTER Doug YounQ' CERTIFICATION ~ 86116 STATE REGISTRATION % 90-1076 DATE & TIME TEST IS TO BE CONDUCTED April 1996 ak 8:30 a.m. BAKERSFIELD FIRE DEPARTMENT April 5, 1996 FIRE CHIEF MICHAEL R. KELLY Mr. Bob Easterdag ADMINIS/ltATIVESERVICES San Joaquin Community Hospital 2]0] 'H' Street Bake=.,d. C^ 93~01 2615 Eye Street (805) 326.-3941 FAX(~)395-~349 Bakersfield, CA 93301 SOP.REmONSE.V~CES CLOSURE OF ONE UNDERGROUND HAZARDOUS SUBSTANCE 2101 'H* Street Bakersfield. CA 93301 STORAGE TAN K LOCATED AT 261 5 EYE-STREET. .... ~. (805) 326-3941 PERMIT # BR-0127. FAX (805) 395-1349 PREVENTION SERVICES Dear Mr. Easterday: 1715 Chester Ave. Bakersfield, CA 93301 (805)326-3951 This is to inform you that this department has reviewed the resUlts ~AX(~)326~76 for the preliminary assessment associated with the closure of the tanks located at the above stated address. ENVIRONMENTAL SERVICES 1715 Chester Ave. Based upon laboratory data submitted, this office is satisfied with the Bakersfield, CA 93301 (805) 326-3979 assessment performed and requires no further action at this time. FAX (805) 326-0576 If you have any questions regarding this matter, please contact me TRAINING DIVISION 5642 Victor Street at(805)326-3979. Bakersfield, CA 93308 (805) 399-4697 FAX (805) 399-5763 Si n cerely, Howard H. Wines, III Hazardous Materials Technician HHW/dlm cc: Jason Castillo, RWQCB EtNIRONMENTAL TECI~NOLOGIES CORPORATION March 20, 1996 Mr. Bob Easterday San Joaquin Community Hospital 2615 Eye Street Bakersfield, California 93301 Subject: UST Closure Report San Joaquin Community Hospital 2615 Eye Street Bakersfield, California Permit No. BR-0127 Mr. Easterday; On June 22, 1995 Smith Environmental Technologies Corporation of Bakersfield, California (License #A/Haz 510801) removed one 750 gallon diesel underground storage tank (UST) and associated piping from the subject site (Plate 1 & 2). This closure report contains the analytical results of soil samples taken beneath the former tank location, information on the disposal of rinsate, and the disposition of the UST. BACKGROUND The UST stored diesel fuel which supplied fuel to an emergency generator. An'upgrade of the facility was in order replacing the 750 gallon UST with a 15,000 gallon double-walled UST. The new UST was installed in July, 1995 by Smith Environmental and a copy of the tank integrity test report dated November 5, 1995 is enclosed. TANK REMOVAL Before the tank was removed proper permits were obtained from the City of Bakersfield Fire Department (permit No. BR-0127). The tank was triple rinsed with high pressure steam wash before removal (see enclosed Certification Statement of Tank Decontamination) . The rinsate was taken to Gibson' Environmental in Bakersfield, California for disposal (see enclosed Uniform Hazardous Waste Manifest #05236008). The tank was transported to Golden State Metals in Bakersfield, California for recycling (see enclosed Tank Disposal Form). 6313 Schirra Court · Bakersfield, CA 93313 (805) 835-7700 · fax (805) 835-7717 sM're SOIL SAMPLING Soil samples were collected under the direction of a City Of Bakersfield Fire Department inspector. Soil sample A-2 was collected at a depth of approximately 2 feet, beneath the former UST location. Soil sample A-6 was collected approximately 6 feet beneath the former UST location. Plate 2, shows the locations of the soil samples. The soil samples were collected in new glass sample containers, sealed, labeled and placed in a cooler with ice. The soil samples were transported under a Chain of Custody document to BC Laboratories. of Bakersfield, California. The soil samples were analyzed for Total Petroleum Hydrocarbons as diesel (TPHd) by EPA Method 8015m, and for Benzene, Toluene, Ethylbenzene, and Xylenes (BTEX) by EPA Method 8020. LABORATORY ANALYTICAL RESULTS Analytical results indicated no TPHd concentrations in the 2 foot sample (A-2) and only 10 parts per million TPHd at a depth of 6 feet (A-6 sample). No BTEX concentrations were reported in any of the soil samples analyzed. Appendix A contains the laboratory reports and chain of custody's for the samples. RECOMMENDATIONS Based on the analytical results of soil samples collected and analyzed beneath the former UST location, Smith Environmental recommends the closure of this site. It is recommended that a copy of this report be submitted to the following regulatory agency: Mr. Howard Wines City Of BakersfieM Fire Department Hazardous Materials Division 1715 Chester Avenue Bakersfield, California 93301 If there are any questions concerning this project please contact Smith Environmental at (805) 835-7700. Sincerely, Smith Environmental Technologies Corporation Robert J. Be r, R.G.//5076 District Manager I:\SJTCLOS.DOC 2 SM H Enclosures: Plate 1, Location Map Plate 2, Plot Plan Analytical Laboratory Results Rinsate Manifest Tank Decontamination Letter Tank Disposal Form Tank Testing Report I:\SJTCLOS.DOC 3 ~/£L ~ iEDALE ' 5-- JORD 0 SMTH Environmental Technologies San Joaquin Community Hospital PLATE Riodel Division 2615 Eye Stroot 1500 S. Union Avenue Bakersfield, California Bakersfield, California DATE; 5-23-95 r PROJ~Numm ~42 LOCATION MAP N ::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::: H S Excavation ~ ~ Former Location Of T Driveway ~ 750 Gallon R Diesel UST E E T Soil Samples A-2 & A-6 NOT TO SCALE e San Joaquin Community Hospital PLATE 8~11 2615 Eye Street 2 , ~,~o~,~ ~,~ ~,~,~ Bakersfield, California RIEDEL DMSION r !'~ro:ect Number: 8642 ' Plot Plan ~age ~ of ~ Date: 3/16/96 SCOTT DICKSON SMITH ENVIRONMENTkL TECH. CORPORATION 1500 S. UNION AVENUE BAKERSFIELD, CA 93307 Dear Scott, The samples(s) listed on the Chain of Custody report were received by BC Laboratories, Inc. on 06/22/95. Enclosed please find the analytical data for the testing requested. If you have any questions regarding this report please contact me at (805)327-4911, ext. 204. Any unused sample will be stored on our premises for 90 days (excluding bacteriologicals) at which time they will be returned or disposed~qf .up~on your re ques t. '~?[~ Please refer to submission number 95-07581 when calling for assistanc~i '"'"' Sincerely, ~C Laboratories, Inc. '~ ~'~' Page 1 LABORATORIES Purgeable Aromatics and Total Petroleum Hydrocarbons SMITH ENVIRONMENTAL TECH. CORPORATION Date Reported: 06/28/95 1500 S. UNION AVENUE Date Received: 06/22/95 BAKERSFIELD, CA 93307 Laboratory No.: 95-07581-1 Attn: TOM HOLLENBECK 805-835-7700 Sample Description: PROJECT ~8642:A-2 SAMPLED BY JOE O'DELL Sample Matrix: Soil Date Collected: 06/22/95 @ 09:05AM Date Extracted-8020: 06/28/95 Date Analyzed-8020: 06/28/95 Date Extracted-8015M(d): 06/26/95 Date Analyzed-8015M(d): 06/27/95 Practical Analys i s Report lng Quant it at ion Constltuent s Results Unit s Limlt Benzene None Detected mg/k~ 0. 005 Toluene None Detected m~/kg 0. 005 Ethyl Benzene None Detected mg/k9 0. 005 Surrogate % Recovery 96. % 70-130 ~!!ii.i~ Total Petroleum Hydrocarbons (diesel) None Detected mg/k~ 10. Surrogate % Recovery 96. % 64-137 TEST METHOD: TPH by D.O.H.S. / L.U.F.T. Manual Method - Modified EPA 801~ii~iii.~ii:' Individual constituents by EPA Method 5030/8020. ~.~. California D.O.H.S Cert. ~1186 ~:~::~'~'~ '~ ......... ~ ,~.,:.~ "'ii~:~ -~: . . All results listed In this report are for the exclusive use of the submitting party. BC Laboratories, Inc. assumes no responsibility for report alteration, separation, detachment or third party Interpretation. 41 (DO Atlas Cc. · Bakersfield, CA 93308 - [805) 327-4911 · FAX [8C)5) 327-1918 LABORATORIES · Page 1 Purgeable Aromatics and Total Petroleum Hydrocarbons SMITH ENVIRONMENTAL TECH. CORPORATION Date Reported: 06/28/95 1500 S. UNION AVENUE Date Received: 06/22/95 BAKERSFIELD, CA 93307 Laboratory No.: 95-07581-2 Attn: TOM HOLLENBECK 805-835-7700 Sample Description: PROJECT ~8642:A-6 SAMPLED BY JOE O'DELL Sample Matrix: Soil Date Collected: 06/22/95 ® 09:15AM Date Extracted-8020: 06/28/95 Date Analyzed-8020: 06/28/95 Date. Extracted-8015M(d): 06/26/95 Date AnalyZed-8015M(d): 06/27/95 Practical Analysis Reporting Quantitation Constituents Results Units Limit Benzene None Detected mg/kg 0. 005 Toluene None Detected mg/kg 0. 005 Ethyl Benzene None Detected mg/kg 0.005 Total Xylenes None Detected mg/kg 0.01 Surrogate % Recovery 98. % 70-130 Total Petroleum Hydrocarbons (diesel) 10. mg/kg 10. Surrogate % Recovery 103. % 64-137 TEST METHOD: TPH by D.O.H.S. / L.U.F.T. Manual Method - Modified EPA 8015 Individual constituents by EPA Method 5030/8020. California D.O.H.S. Cert. ~1186 'ii~ ~ ~!~i~ ~ All results listed in this report are for the exclusive use of the submitting party. OC Laboratories, Inc. assumes no responsibility for report alteration, separation, detachment or third party Interpretation. 4'1 O0 Atlas Ct;. · E3aker'sfield. {~A 93308 · .[80~] 3P7-4911 · FAX {805) 327-1918 '~'~"'~"~~'~'"~" CHAIN OF CUSTODY RECORD AND ANALYSIS REQUEST PROJECT NO. PROJECT NAME/SITE ANALYSIS REQUESTED [ P.O. #: SAMPLERS (SIGN) /~ ]"~' '~'" ,4 0 zW nUJ ~, SAMPLE IDENTIFICATION DATE TIME ~ < PRES. m ~ O ~ USED u ~ ~ EMARKS RELINQUISHED BY: DATE TIME RECEIVED BY: REQUESTED TURNAROUND TIME; RELINQUISHED BY: DATE TIME RECEIVED BY ~BORATORY: RECEI~ CONDITION; PROJECT MANAGER: ~'BC LABORATORIES. . ..][NC .MPLE RECEIPT FORM- SItlPPING SPECIFICATIONS SHIPPING CONTAINER Federal Express [] UPS [] Itand Delivery ~ Ice Chest [] Box [] BC Lab Field Service [] Other [] (Specify) None ~ Other :~ .. ,:. :.....;:,w.,,'. SAMPLE CONDITION "' '~' Temperature Ice ~ Blue Ice ~ None~ If teml)erature is not I)etween 2 and 6 C please explain: Custody Seals: ice Ch~t ~ Containers~ None.~ SAMPLE CONTAINERS QT PE PT PE ~P QT INORGANIG MI;TAI~ ., PT INORGANIC N FORMS TOC TOX COD PIIENOL TRIP BL~K VOA VIAL VOA ~ OIL & GREASE ODOR RADIOLOGICAL B A 504 I 515.118150 5~/6~18270 531.1 QA/QC QT AMBER 8 07~ JAR 32 OZ. JAR SOIL SLEEVE £TY' of BAKERSFIEL .... WE CARE" S. o. 0OHN~N B~XRSFIELD FIRE DEPART~ F~AE CHIEF ~ZARDOUS ~TERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 CERTIFICATION STATEMENT OF TANK DECONTAMINATION I, /~K: VO~I~ an authorized agent of name ,~n~/~H ~qlPd~3/~'A/P~L 7~CHA3Og ~¢~lC~fere by attest under penalty of- Contracting Co.' perjury that the tank(s) located at ~l~._q'd)~ ~7~, ~/~. and ! Address being removed under permit~ -~-- O ~-7 has been ..... ~ cleaned/decontaminated properly and a LEL (lower explosive limit) reading of no greater than 5% was mea-sured immediately following the cleaning/decontamination process. Date Name (print) Signature Conformation by: ~ ~~~ _c. ct. ~/~_ City' of Bakersfield State of Californio~-Environmen~al Protection Form Approved OMB No. 2050-0039 (Expires 9-30-96) See Instructions on back,__of page 6. Depanm~t of ~se i~int or type. Form d~gne~ ~or'use on elite ~1 fypewrlter. Socrorl~ato0 ColJfort~a ~ 1. Generator's US EPA ID No. Manifest Docu'~l~t No. 2. Page 1 informatlo~ in the shaded areas UNIFORM HAZARDOUS is ,~ required by r~aero~ ~,,. WASTE MANIFEST ('-IAI~IOI'"/4~I.%I2-1J~IC)~I~I~I (-ol O 'O I{::]' ~ of ~ 3. Generator's Name and Mailing Addrest~ 'A~ 5' fronsp°rter' CampanyName ~ '" US EPA ID Number 7. Transporter 2 Company Name 8. US EPA ID Number E. Stat, T ~C~;,, ~4~,~Z,, 9. Designated Facility Name. and Sit~ Address 10. US EPA ID Number G .St~ F~ili~i ID;~:'? 11. US DOT Des¢riptlon (including Proper Shipping Name, Hazard Class, and ID Number) 12. Containers ' 13. Total 14. Unit No. Type Q~antity Wt/Vol E 0101~ 1' Fr' ~1¢,,11 ~ ~, E · ^ II I l Ill · ~ T c. 15. Special Handling Instructions and Additional Information -~' 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment ore fully and accurately described above by proper shipping name and are classified, ~ pocked, marked, and labeled, and are in oil respects in proper condition for transport by highway according to applicable international and natlcmal government regulations. If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste geeerated to the degree I have delermlned to economlcolly proctlcable and that I have seleded the practicable method of treatment, storage, or disposal currently available to me which minimizes the preseat and future threat to human health and the envlronmenb OR, if I am o small quonfi~y generator, I have made a good faith effort to minimize my waste generation and select the besl waste management method that is available to me and that I con afford. Printed/Typed Name t Signature Mord~ Day Ye 1' 17. Transporter I Acknowledgement of Receipt of Materials OP 18. Tronsl:~er 2 Apnawledgement of Ref<:elpt of Materials ~ /'° /i/ ' Printed/Typed Nom'e ' J Signature JMo~ Day ¥, I J I J 19. Discrepancy Indication Space F A C I L 20. Facility Own .... Operator Certification of receipt of h .... dous materials...r.~v.~red by.~hiJ'~o~ifest ex~l~t as n~ted~ Item 19. ,, ' ~,,.,~,,,~.~ ~o~ _ ~ o ~~ ~'~ --~- - ~ I'~"~°~ ~ ~ ~'~~ -~~~-- ~ "~_ _ ~ I~~ ~,~ ~ ~, ~,-,- - DO NOT WRITE BELOW THIS LINE. " DTSC 8022A (9/94) EPA 8700---22 '¢,'hite: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DA' To: P.O. Bo>. 3000, Sacramento, CA 95812 WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity wee weighed, measured, or counted by a wei~lhmaster, whose signature is on this certificate, who s a recognized authority of accuracy, aa prescribed bjLChapter 7 (commencing with Section 12700) of Division the California Business and Professions Code administered by the Division of Measurement Stan/ of the California Department of Food and Agrlcu tufa. WEIGHMASTER' CERTIFICATE TRUCK SCALE * * * * I N T A K E * * * * .! "Purchased From: TICKET #: T95103 GOLDEN SLATE METALS RC~3~,~,I SM[TH ENV. TECHNOLOGY P.O. BOX 70158 BAKERSFIELD. CA 9338? COMMOOiTY SROSS TARE NEl ADJ REASON PD WT RD CNT RD ~,~ c,¢,, 7q60B 700 700 0 0. ..... ~ ~bu i L..' L~ 700 Time .,.."'~_______ . ....... GOLDEN STA~METALS, INC. DISPOSAL FORM P. O. Box 70158 · 2000 E. Brundage Lano Date ' ,19 Bakersfield. California 93387 'Phone (805) 327-3559 · Fax (805) 327-5749 Contr.l,',..,{(~,~- - -- Scrap Melals, P~ocessing & Rocycling License No. I Phone No. DESTINA~ON: G.S.M. · ~000 E. BRUNDAGE LANE · BAKE~FIELD, CA 03387 WEIGHT CERT. NO: TOTAL EHSD PERMIT NO: ,~/A~ QTY GALLONS SERIAL NO. NET TONS ,~ I/ 25O .14 COUNTY: 50 ,24 SPECTION & DRY (ACCEPT), OR ...... ~ /,~ RESIDUALS PRESENT (REJECT) /~LEL READING IC~// ~ OXYGEN CONTENT. ~ DISPOSAL FEE ~. SCRAP VALUE OTHER TOTAL .............................................................. ............................, .,....... ................ , ..-.~ ..?...~...~.....-~.,::.~:~.,p.:.~ net 30 days from receipt of tank. Contractor's s!gnat.ure !:~:.~:~!~:~:~..'~!:~:~.. .................... . ......................... :::'::: ................ .. ~:::~:::::~:::~:~:~::~:::::::::::r~.`..::~:.:.:;`.~.~::~:~.~.:::`~1~.~i:~1.~. ' ........ :::: : : ::::::::::::::::::::::::::::: represents acceptance of terms for payment, and confirms ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::~1 that tank removal complies with State laws ........ .. ,................,,....,...........................::!i:~::!::~::ii!iii~i::i::i~ii:.::i![::~i::::::::!:~i~::i:.~i~:~f!i!i:.~ii~i~i~i~:ii~!iiiii!i~::~iii!~::i!~i::i~fi::iii :: ::i::::iii ............. :~:./. :i: ;iiii :: ::: ::i': i: :: !iii:.i:.ii~i!i::iii::i::~::i~i;: ::::::::::::::::::::::::::::::: :~ :; ............. ~:~:~.~: :: :~ '~'>: ~'~ :..-,.':~:.;~ :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ............ ================================================================ :: : ~:: ~ ,- CERTIFICATE OF TANK DISPOSAL / DESTRUCTION . THIS:~ T~ .EP-z-TIFY THE REC.~IPT AND ACCEPTANCE OF THE TANK(S) AS SPECIFIED ABOVE. ALL MATERIAL SPECIFIED WILL BE COMPLETELY ?OYJ~D li/'OR/S~RAP ,CIg/CYCLING PURPOSE~ ONLY. ~ ,/~ · WHITE-- Con or Copy · OW -- F~Ie Copy · PINK -- Permsnenl Copy NOV 07 'i995 · .. -.- IBEX Precision Tank Test BROCKWAY'S TANK TESTING Bakersfield, CA. USA (805) 324-1062 performed for:- San Joaquin Hospital Test Location: 2615 Eye St. Bakersfield, CA Test Identification : SJHosp-1 Test Date : 11-05-1995 Start Data Collection : 09:4?:42 Ending Test Period : 11:52:18 Time Filled for Test : 24 hfs ---- Tank Data --- TANK .ID. : Generator CONTENTS : Diesel Volume : 15000 Diameter : 125 Depth Bury :36 Product level :133 Groundwater :> 15 FT Pump Type :Suction Tank Type :2 W.FG. Water in Tank :0 Test Fluid :Diesel Vapor Recovery :N/A ** Test Report ** Average Rate of Change is based on 243 Data Points Standard Deviation .............. 0059 Gallons - Volume change, of Tank Contents - Net Volume * ( 60 min/Test Time) -.0237 Gal. * ( 60/ 61.32 min.) = -.0231 Gph. - Volume change due to Temperature - Avg. Temp. * Volume * Coef. of. Expn. * (60 min./ Test Time) -.0035 Deg. F * 15000 Gal. * 0.00044 * 60/ 61.32 = -.0224 Gph. Net change = Level Volume - Temperature Volume NET CHANGE . . . --. OOO7 GPU. Based on the Information provided and the Data Collected This Tank & Flooded Lines Test has ...... PASSED Certified Tester : Robert Brockman # 92-1251~'-~_~ This Test complies with U.S.EPA and NFPA requirements. No other warrantees are expressed or implied. [dO SJI4o~p .... Te~p, - -,0224 Gph, Tank · P~o'ck~ct D~e~el ?e~t' Date Level P~ec ~~5 Te~p, P~ec ~al,,, , ~ 5 ~al , ..... /.....--~- ---~. · ~ame: San Joaquin Hosp. PLOT PLAN ~. Underground Stooge T~ ~oca~ za~ s ~, st Reference: Smi~ Env. NW Cor of Main Hosp. Ho Pang : .o~ Broc~ay's I015 C~l~m ~ ~ ~ I5I ~,. · HAZARDOUS MATERIAL DIVISION ~15 Cllester Avenue (805) 326-3979 Third Floor ~..~__. _ 0 ~.~.~ APPLICATION TO PERFORM A TIGHTNESS TEST SAN JOAQUIN FACILITY COMMUNITY t~OSPITAL ADDRESS PERMIT TO OPERATE # OPERATORS NAME Same OWNERS NAME Same NUMBER OF TANKS TO BE TESTED 1 IS PIPING GOING TO BE TESTEDYes · TANK# VOLUME CONTENTS CONFIDENCE UST 417 Montclair Street TANK TESTINGCOMPANY SERVICES, INC. ADDRESS Bakersfield, CA 93309-17 TEST METHOD AES System II (Overfill) NAME OF TESTER Doug Younq CERTIFICATION # 86116 STATE REGISTRATION % 90-1076 DATE & TIME TEST IS TO BE CONDUCTED April.4, 1996 at 8:30 a.m. ONFIDENCE UST "Compliance With COnfidence" SERVICES, INC. ~ebruary 21, 1996 CITY OF BAKERSFIELD Hazardous Materials Division i715 Chester Avenue, Third Floor Bakersfield, California 93301 Whom it May Conce'rn: Enc. iose~ please find original of Application to Perfo'rm a 'T'igh~.-.r~ess Test for approval, along with our check in the amount c.f ':~55,00, as and for your permit fees herein. As you can see~ ~:he test is scheduie~ for .April 4, i996 a'~ 8:30 a.~. at San Joaauin Commuity Hospital, 2615 Eye S'bree~b~ Bakersfield, California 93301. Please return issued ~ermit and receipt to our office in the envelope provided. Should you have any questions, please feel free to (:-on~ac.t ~,~e at 634-~501. 'Thank you for your attention herein. CONFIDENCE UST SERVICES, INC. 417 Montclair Street · Bakersfield, CA 93309 (805) 631-3870 or (800) 339-9930 FAX (805) 631-3872 . NOV' 1995 recision Tank Test By. BROCKWAY'S TANK TESTING Bakersfield, CA. USA (805) 324-1062 : Performed for:- San Joaquin Hospital Test Location: 2615 Eye St. Bakersfield, CA Test Identification : SJHosp-1 Test Date : 11-05-1995 Start Data Collection : 09:47:42 Ending Test Period : 11:52:18 Time Filled for Test : 24 hrs ---- Tank Data --- TANK ID. :Generator CONTENTS :Diesel Volume :15000 Diameter :125 Depth Bury :36 Product level :133 Groundwater :> 15 FT Pump Type :Suction Tank Type :2 W.FG. Water in Tank :0 Test Fluid :Diesel Vapor Recovery :N/A ** Test Report ** Average Rate of Change is based on 243 Data Points Standard Deviation .............. 0059 Gallons - Volume chang9 of Tank Contents - Net Volume * ( 60 min/Test Time) -.0237 Gal. * ( 60/ 61.32 min.) = -.0231 Gph. - Volume change due to Temperature - Avg, Temp. * Volume * Coef. of Expn. * (60 min./ Test Time) -.0035 Deg. F * 15000 Gal. * 0.00044 * 60/ 61.32 = -.0224 Gph. Net change = Level Volume - Temperature Volume NET CHANGE . . . --.0007 GPM. Based on the Information provided and the Data Collected This Tank & Flooded Lines Test has ...... PASSED ~-~. Certified Tester : Robert Brockman # 92-1251~ ~~ This Test complies with U.S.EPA and NFPA requirements. No other warrantees are expressed or implied. [40 SJHosp--~'-~Te~l~, -- -,9224 Gl~h, Tank N.o, 1 P~oauct D~e~el Test D~te 11-85-1995 9'----'..~ .... ,--,.-,,-.--..--,.--...---.,.i,qmiam LevelLen~th (Mi*'!P~ee?s on 61:.32 ~9011 Te~p, Preo~szon 0013 25 sal, .......... Liquia Level 133 ~ 0 .25 gal. . .. ~ame: San Joaquin Hosp. " PLOT PLAN Ci~: Bakcrsflcld, CA Underground Storage Tank T.ocatioa: 2615 Reference: Smith Ear. · NW Cor of Main Hosp. No t Tank Relmenc~ 27th St, I J DIESEL J ~Z~OUS ~TERIAL DIVISION 1715 CHESTER AVE., BAKERSFIELD, CA 9230~ (80~) ~6-~79 APPLICATION TO PERFO~ A TIG~S~ ~ST PERMIT TO OPERATE $ ? ~ER OF T~S TO BE TESTED [ IS PIPING ~ING TO'BE TESTED % ~ VOL~ CO~S~S STATE REGIST~TION -/AP~~ DATE S IGNATU~ OF ~PLI~T RECORD OF TELEPHONE CONVERSATION Location: ~,~ _~7~ ID# / Business Name: ~__~ ~ / Conta~ N~e: ~ ~4~~ ~ Business Phone: ,~ - ~/'~ F~: Insp~or's N~e: /~ /~ Time of C~I: Date: ~//~¢ Time: ~.'D.¢ Type of Cai: Incoming [ ] Outgoing [~ Returned [ ] Content of C~l: ~ ~( ~ ~ ~ / / / Actions Required: · Time Required to Complete Activity # Min: /(~ · ~ac~o~.o. Thomas E. Hollenbeck bisect Op~ations Manager 1500 South Union Avenue B~ersfielcl, CA 93307 -- phone (805) 835-7700 · fax (805) 835-7'/1'/ toll free (800) 926-0802 · pa~er (805) £n~ned~tn~ * Cofl~uldflg · Reme~iadon · ~on~rruc~ion - ,' -----~- THE INSPECTION ~ CONNECTION 3115 Weedpatch Hwy Bakersfield, CA 93307 JOHN J. BREWER (805) 363-6430 OSHPD reg. A-10402 Dig. Pgr. (805) 636-9423 7 .~RSFIELD FIRE DEPARTMEN~ IZARDOUS MATERIAL DIVISIOW~ 2130 G Street, Bakersfield, CA 93301 (e05) 3~-6-3979 TANK REMOVAL INSPECTION FORM FACILITY ~ ._%oa4~u,J ~JoSe,-rn~., ADDRESS ~-~lS" ~6 OWNER 5~~3 Ao~u,~ db,,--,,,,,. ~se.~ PERMIT TO OPE~TE~ CO~CTOR ~ ~J' CONTACT PERSON'~ ~BO~TORY ~ ~6S ~ OF S~PLES ~ " TEST METHODOLOGY b~s~ ~ ~ ~ : PRELI~NARY ASSESSMENT CO. $~,~ ~- CONTACT PERSON ~m CO: RECIEPT ~~ ;~ LEL% b-- ~ 0~% PLOT PLAN CONDITION OF TANKS CONDITION OF PIPING CONDITION OF SOIL CO~ENTS ~ 6ge,~o~ DATE INSPECTORS NAME SIG~ UI~D~GFIOUND STORAGE: TANK~ROGRAM .--~) PERMIT APPUCATION FOR REMOVAL OF AN UNDERGROUND STORAGE TAN SITE INFORMATION FACILITY NAMe',~:~3'C_H' -- CROSS STREET ~'7 ~ 'H TANK OWNER/OPERATOR ~ ~C~ 1~::1,3~1~ ~t,,.l'-E"l'~ PHONE No. ~::~'~ ~,2_(., "-/--/I MAIUNG ADDRESS ~(,=( ~ ~_.%r~_. ~1- CITY ~ '- ZIP~CODE CONTRACTOR INFORMATION COMPANYS~ ~.~v[~-(~-,m~-~(~'T~.Jn, PHONE No. <~'~5-- -)"~00 LICENSE No.. /-J~ ADDRESS I~0-~, i~-,,~iev~ ~J~, . CITY i~¢~,e~-~c~'~-\~ ZiP CODE INSURANCE CARRIER ~',[[i~, ('~-¢~.x-~,~ c.~ ~.r¢-~'~Co WORKMENS COMP No. ~;:~,C~ ~.'~"~5 PRELIMANARY ASSEMENT INFORMATION COMPANY t ; i Z PHONE NO. LICENSE NO. ADDRESS I~,J /./--~ CITY ZIP CODE INSURANCE CARRIER WORKMENS COMP No, TANK CLEANING INFORMATION COMPANY ~h~'~ -~__~,~;,c~cc~\"~"~-c--~Y~b~,"~-5 PHONE NO. ADDRESS ~O ~ O~ '~' CIW ~~ ZiP CODE WASTE TRANSPORTER IDENTIFICATION NUMBER ~1~ ~% ~ ~ ~ ~ NAME OF EINSTATE DISPOSAL FACILI~ ~Ce~ ADDRESS ~ ~'~~~ ~'~ - CIW ~~ ZIP CODE FACILIWINDENTIFICATION NUMBER ~ ~ ~O ~ ~'~ TANE ~ANSPORTER INFORMA~ON COMPANY ~~~;~,~~ PHONE NO. ~G~-~'~ LICENSE NO. ADDRESS i%~ %. ~~ CIW .~~ ZlPCODE TANK DES~NATION ~-~ %~~ ~~ ~ TANK INFORMA~ON TANK No. AGE VOLUME CHEMICAL DATES CHEMICAL STORED STORED PREVIOUSLY STORED ~:!:::~::.:~!::-':.~ . .. .. ::-:.-.-. ~:;~ .. "'~:::;::i ;:"; :!""' '~" · '!'%'"' ' .~ ! .,.'.,.......~ ! ! !:! ~ .....- ...~::::;: ~.,.;::;. ::;:::~::;:::~ ~ '.:::~:>.:;~.:;::;..>.~ ::;:;.~::::~:..'A,.~., ;-;.. ~. THE APPLICANT HAS RECEIVED, UNDERSTANDS, A ND WILL CO MPLY WITH THE ATrACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE LOCAL AND FEDERAL REGULATIONS, THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE I$ TRUE AND CORRECT. APPLICANT NAME (PRINI~ (-J - APPLI~ANTSiGNATI~.._ '~. THIS APPECAIION BECOMES A PERMIT WHEN APPROVEB Si ~zs~ Bs~ers~ield FLre Dept. ~:..~m~T No. ~~; UND~ ~BOUS.MAT~IALS ~iVIS~I [GROUND STO~G~ TANK PROGRAM PE~MIT APP~CATION TO CONS~UCT/MOB[~ UNDERGROUND STOOGE. TANK ,~ NEW FAC:L[~ ~ MOO[F~QN OF FAC:L[~ ~ NEW TANK [NSTAL~TiON AT STARTING DATE .5/[6!~¢ PROPOSED COMPL~ON OATE , ~ll~[~ _ FAC[L[~ NAME ~C~ ~ISTING FAC[U~ PERMIT No. FAC[LI~ADDRESS 891& ~ ~% , ZiP COOE ~PE OF BUSINESS ~P~ APN TANK OWNER.~ ~1~ ~~ ~ R~~ ~HONE No. ~-~ PHONE No. ~'~¢~ -'~'~Oo 5AKERSFiELD C;~ 8USlNESS LICSNSE No. WATER TO FAC;LI~ PROVIDED BY- C~t~O~l~ ~~ nEP~U .... TO GROUND WATER %~ i~e~ SOIL ~PE E(PECTED AT SiTE No. CF TANKS TO BE INSTALLED ~1 ) / AR~ THEY FOR MOTOR FUEL . ~YES ~NO TANK No. VOLUME U~EAOED REGULAR PREMIUM ~IES~ AVIAUQN SECTION FOR NON MOTOR FUELSTORAG.ETANKS TANK NO. VOLUME CHEMICAL STORED CAS No. CHEMICAL PRD/IOUSLY (no arcnc: nome) (if known) STORED !i:.i ii!.:!::; ~!~ ~:i :i:~i 3 ;::!::!::~iiiii::i! :.:.!:!i i! i; !!!: !?i:!?!i !: !i ]i i?i~i:i:!:! :?:!:!: ;~ :i :~ .-.':. E:i :!:!:E:i:i (:!:] ::..!:!? ::::~:]:~:! :! :!: ?:i: i:::::::: :: ::::: ::.-.~ ::::.: :: :::::::::::::::::::::::: :::::::::::::::::::'. ::::: :::: :::::::::::::::::::::::::: :.:.:. :.:.:.:. :. :.:. :.: ~ ~..._.,~ :::::.':::::-~::?-'.:.'.:.::E~::?:~:!::~(~-~-:;..~..i:::i:.'-~:~i!i~.!:i.i:i i i:i.i.~:i.;.;.::!': ! j:;: i::~. ?u~:`ta~:c~T~;:~:~;:~:~:~.~:~;:~.~:~;~::~:~:~:~:.~:~:~:~:~:~:~.: ~:~N===============================================================================~r~r`~?~:;~:~~ ............................. ? THE APPLICA NI' HAS RECE~"VEO. UNOERSTANO~. ANO WILL C~MPLY WITH THE At'~ACMEO CO NOITIONS OF 11-115 PERMIT ANO ANY OrHE~ STATE. L(~CAL AND FE'DE~AL RE(DUL,ATI(DN$. · A~PpOzVE~ APPMCANf NAME (PRINT) "~ . APPLICANT $iGNAflJI~_~ THIS APPLICATION BECOMES A PERMIT WHEN APPROVED I ' Op erat Underground Hazardous Materials Storage Facility CONDITIONS ~!!P:~~i~ ~i~ REVERSE SIDE ':~?:i:?:;?:cond~ii~ns subie~i'";t~:~' change in HAZARDOUS MATERIALS DIVISION 2615 EYE STREET 1715 Chester Ave., 3rd Floor BAKERSFIELD, CA 93301 Bakersfield, CA 93301 (805) 326-3979 Approved by: , als Coordinator Valid from: 12/22/93 to: 12/22/98 CONFIDENCE UST "Compliance With Confidence" SERVICES, INC. ~ April 6, 1995 CITY OF BAKERSFIELD APR 1 0 1995 II// Hazardous Materials Division 1715 Chester Avenue, Third Floor Bakersfield, California 93301 By_ To Whom It May Concern: Enclosed please find original of Application to Perform a Tightness Test and copy of "AES -- System II Precision Tank & Line Test Results Summary re testing conducted April 6, 1995, at San Joaquin Community Hospital, 2615 Eye Street, Bakersfield, CA 93301. Yours truly, CONFIDENCE UST SERVICES, INC. By . ice-P~ Enclosures cc (w/o enclosures) SAN JOAQUIN COMMUNITY HOSPITAL P. 0. Box 2615 Bakersfield, CA 93303 Attn: Bob Patwell, Plant Operations 417 Montclair Street · Bakersfield, CA 93309 (805) 631-3870 or (800) 339-9930 FAX (805) 631-3872 ~ '~'~ HAZARDOUS MATERIAL DIVISION ~,":~ ~X~X~;~, Bakersfield, CA 93301 ~715 Chester Avenue (805) 326-3979 Third Floor FACILITY San Joaquin Comm. Hosp. ADDRESS 2615 Eye Street ............................. Bakersfield,_ CA 93301 PERMIT TO OPERATE # OPERATORS NAME San Joaquin Comm. HospoWNERS NAME Same NUMBER OF TANKS TO BE TESTED 2 IS PIPING GOING TO'BE TESTEDYes · TANK# VOLUME CONTENTS 1 700 2 3,500 D~sel Confidence UST 417 Montclair Street TANK TESTING COMPANY Services, Inc. ADDRESS Bakersfield, CA 93309 TEST METHOD AES System II - Overfill NAME OF TESTER Doug Young CERTIFICATION ~' 86116 STATE REGISTRATION % 90-1076 DATE & TIME TEST IS TO BE CONDUCTED 4/6/95 ® 8:00 a.m. CONFID£NCE UST SERVICES, INC. 417 MONTCLAIR STREET ~ BAKERSFIELD, CA 93309 (805) 631-3870 AES -- SYSTEM II PRECISION TANK & LINE TEST RESULTS SUMMARY Invoice Address= Tank Location= W.O.#= 1856 SAN JOAQUIN COM. HOSPT. SAN JOAQUIN COM. HOSPT. I,D. Number= N/A P.O, BOX 2615 2615 EYE STREET TechnicianID. YOUNG BAKERSFIELD, CA 93303 BAKERSFIELD, CA Tech.#=86116 Van#cO1 Date= 04-06-95 Time 8tact= 08:00 Endl 12:30 County= KE Facility Phone#= (805) 326-4140 Groundwater Depth= 144"+ Blue Prints= N/A Contact= BOB PATWELL DatelTime system was ftlledl 6+ HOURS Tank Fill/Vent Product Type Of Vapor Inches of Puap Tank Tank Capacity Product Tank Vapor Lines Line Recovery Water/Tank Type Material I 700 DIESEL PASS PASS PASS N/A. 0.00" SUCT. SWS ~ 3000 DIESEL PASS PASS PASS N/A 0.00" SUCT. SWS 4 Additional Information= TEST TECHNICIAN: DOUG YOUNG O.T.T.L. #90-1076 SITE LO8 TIME Set Up Equip= 08:00 Bled Product Lines= YES Bled Vapor Lines= N/A Bled Vent lines= YES Bled Turbine= N/A Bled Suction Pump= YES Risers Installed= YES a) This system and method meets or exceeds the criteria in USEPR 40CFR part 280~ NFPA 329-87 and all applicable state and local codes. b) Any failure listed above may require furthe~ action~ check with all regulatory agencies. CoPyright (c) 1989 by AES, Inc. Certified Technician Signature = ~/7~ Date = -- -- -- -- - 2?th STREET ' -- -- -- Ti ___L S~N ,TO~QUTN COHHUHITV HOSPIT ~UST I~-~--.J~ T Io o T!: ?tab G~L, DTESEL AL 'q~' T2: 31ala6 Gtll, DTESEL L ST, , E¥ I EYE',ST' I Site la~oul; For ', 2GtS EYE STREET, ])~KERSFIEL]), Ct1, AEC/System Z! Pv'ec::Ls:Lon leak Tet'b Graph (OverF:L11) Zngoice No., 1856 Date, 04/06/95 Time I 08:16:58 Techniciin: DMY Tank: 1 Tank Diamete~-(in): 65 Volume(gal), 700 8fade Level(in), 100 Produmt Level(in)j 96 Water Level On Tank(in)J 0 8pemifi~ 8ravityl .87 Coeffi~ient Of Expansion! 0.0004465 Calibration Value(ml)~ 100 Channel! 1 Level Segment From~ 1 To 275 Temp 8eDment Froml 1 To 275 ,l', :',1 Change In Calibration Zone = 69 Calibration Unit(Dal/uni%) - 0.00038 8tarring Temperature (F) J 55.694 Head Pressure(psi (Btm))~ 3.02 Surface Area(sq. tn)~ 7.6 Temp. Change(F/h) I -0.001 Level volume(gph)~ 0.00 Temp. volume(gph)~ 0.00 Produe~ Line(gph)~ SUCTION Net mhange(gph) ~ 0.00 R m~ult ----) m::'A88 P/L ----) PA88 Copypight (~) 1989 by AES~ In~. ** Notes ** SAN JOAQUIN COMMUNITY HOSPITAL ~ ~615 EYE STREET ~ BAKERSFIELD, CA. THIS IS A HIGH LEVEL TEST WITH A 100 ML. CALIBRATION. THE PRODUCT LINE IS FLOODED AND INCLUDED IN THESE DATA. I CONFI DENSE UI~IT ~l~- RVI C~ NC. ~ES/System II P~ecision leak Test GPaph (OverFill) Invoice No.= 1856B Datem 04/06/95 Time I 10:26:00 Technicianm DMY Tank~ 2 Tank Dtamete.(in)~ 75 Volume(gal): 3000 Orade Level(in)~ 120 Product Level(in)m 115 Water Level On Tank(in)~ 0 Specific Oravity~ .,87 Coefficient Of £xpansion~ 0.0004465 Calibration Value(mI)~ 100 ChannelI 1 Level Segment From~ 1 To 275 Temp Segment From! 1 To 275 Fl ...... II . ' .... I'"' ~"'. I'"' I .,, I'" ~,.,, t.J .,.~ c i'. L.I,I, ~::..,:::, ~::,. ~1 I. L ',',!!il . . IJ I',,I '.:::,,'i' ~,, ,,." ' ........ '" :1 .... "" 0 [ 1 m ~:::' .... ~"[ u.~ L.I I"' :=. Change In Calibration Zone ! 66 Calibration Unit(gal/unit) m 0.00040 Starting Temperature (F)= 53.793 Head Pressure(psi (Btm))~ 3.61 Surface Area(sq. in)~ 8.0 Temp. Change(F/h) ~ -0.010 Level volume(gph)! 0.00 Temp. volume(gph)m -0.01 Product Ltne(gph)~ SUCTION Net change(gph) = 0.01 Copyright (c) 1989 by AES, Inc. ** Notes ** SAN JOAQUIN COMMUNITY HOSPITAL , 2615 EYE STREET , BAKERSFIELD, CA. THIS IS A HIGH LEVEL TEST WITH A 100 ML. CALIBRATION. THE PRODUCT LINE IS FLOODED AND INCLUDED IN THESE DATA. BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION " ~X~X~J~N~, Bakersfield, CA 93301 5 Chester Avenue (805) 326-3979 Third Floor APPLICATION TO PERFORM A TIGHTNESS TEST FACILITY San Joaquin Comm. Hosp. ADDRESS. 2615 Eye Street Bakersfield, CA 93301 PERMIT TO OPERATE # OPERATORS NAME San Joaquin Comm. HosPGWNERS NAME Same NUMBER OF TANKS TO BE TESTED 2 IS PIPING GOING TO BE TESTEDYes · TANK~ VOLUME CONTENTS 1 700 2 3.500 D~ms~l Confidence UST 417 Montclair Street TANK TESTING COMPANY Services, Inc. ADDRESS Bakersfield, CA 93309 TEST METHOD AES System II - Overfill NAME OF TESTER Doug Young CERTIFICATION ~ 86116 STATE REGISTRATION % 90-1076 DATE & TIME TEST IS TO BE CONDUCTED 4/6/95 ~ 8:00 a.m. .-- 3/9/95 '" T A~P RO~ DATE ~- ~Cij)RRECT[ON NO~CE BAKERSFIELD FIRE DEPARTMENT Sub l~v.~.t~ ~ a.~ ..- , . Blk. Lot You-~re :;rebyi~equired to make the following corrections at the above location: Cot. No /.'). ~,~. .... ':' / Completion Date for Corrections.. Date Inspector 326-3979 UNDERG UND STORAGE iKINSPECTION iii.. , uaKerstleld Fire Dept. I Hazardous Materials Division i Bakersfield, CA 93301 FAClLITYNAME ..~C~v, ~-~'~, ,/~(~nY~,^~;~ FACILI~ PHONE No. INSPECTION DATE I/~1/~ ~ p . . ~~ ~ TIME IN TIME OUT ~nd ~te INSPECTION ~PE: //~ SEe ROUTINE / FOLLOW-UP REQUIREMENTS y~ la. F~s A & B Su~ 1 b. F~ C Su~ lc. O~mting F~ Pa~ ld. State Sum~rge Pa~ la. S~teme~ of Fi~ial Res~sibil~ Su~ lf. W~en Contract E~sts ~n ~er & O~mt~ to O~mte UST ~. ~lid O~mting Pe~ ~. Approv~ Wr~en Ro~ine Mon~ng Pr~ure 2c. Una~ Relea~ Res~n~ Plan ~. Tank Int~ Test in Last 12 Months ~. Pr~u~ Pi~ Int~ri~ Te~ in ~st 12 ~hs ~. Sucti~ Piping ~ghtn~ T~t in Last 3 Yearn ~. Gmv~ F~ Piping ~ghtn~ T~t in Last 2 Yearn ~. T~ R~uEs Submiff~ Within ~ Da~ ~f. Dai~ ~sual Mon~odng of Su~i~ Pr~ Piping ~. Manual Invent~ R~il~t~ Each ~th ~. Annual Invento~ R~nciliati~ Statement Su~ ~. Metem Calibmt~ Annually 5. W~k~ Manual Tank Gauging R~rds f~ Small Tan~ 6. Monthly Statistical Invento~ R~ciliation R~uRs 7. M~h~ A~atic Tank Gauging R~uRs ~ t 8. Ground Water Monit~ng 9. ~r Mon~oring 10. Continuous Intemtitial Monitoring f~ D~WalI~ Tan~ 11. M~hani~l Line Leak Det~ 12. El~tmnic Line Leak Det~tom 13. Continuous Piping MOnRo~ng in Sum~ 14. A~atic Pump Shrift Ca~bil~ 15. Annual Maintenanc~Calibmtion of Leak Det~t~ Equi~ 16, Leak Det~tion Equipment a~ T~t ~t~s List~ in L~113 Se~ 17. Wr~en R~rds Main~in~ on S~e 18. Re~ Changes in U~g~Cond~ions to O~mti~~ Pr~ur~ of UST S~tem W~Nn ~ Oa~ 19. Re~A~ Una~ho~ Relea~ W~hin 24 Houm ~. Approv~ UST S~tem Re,irs a~ U~md~ 21. R~rds S~ng Cath~ Pr~t~ Inset~ ~. ~ur~ ~n~oHng Wells ~. Dr~ Tu~ + ./, 71 Underground Hazardous· Materials Storage Faclhty CONDITIONS!~iP~!!~I~i ~!a;~EVERSE SIDE Number Substance Ca~D,~!!~%.:]::' In'~'t~ii:6]a;~?.'::::..~?.?Type Mohi{~]~:i~:?;:':~':~?:: Type Method Monitoring , ~;~ ~'~ "~:" :::~ '~'::: ......... '::~:" ': :':~':'::~??:;5~'~''::'::':'::'::'',''~:'m ~:~ ~':'"';~' ~ ~ ~ , n , Issued By: 3a~ ~oa~o~ <o~,~ ......... l~5:.Sp,'lal HAZARDOUS MATERIALS DIVISION .................... ~':~:~-~.::~::.:~:-~-:~-:~:~ ..................... '~ 1715 Chester Ave., 3rd Floor k~l..9 Eye Bakersfield, CA 93301 (805) 326-3979 ~ks~~ , (~ Approved by: Ralph E. Huey, Hazardous Materials Coordinator Valid from:-. 'c < ~- '~ '~ to: " ~ '~Z~OUS ~TER~L DIVISION ~2~ ~,, 2130 G $~reet, Bakersfield, CA 93301 ~ (805) 326-3979 APPLICATION TO PERFORM A TIGRTNESS TEST PERMIT TO OPERATE ~ T~ $ VOL~E C 0NTE~S / J.5~ ~c ...... December 1, 1993 To Whom It May Concern: I-'~-n~ tt~-c]aief Fin~i~a];O~f~c~r ~'~' Sa~j~)a-~u-in C-immunity Hospital, 2615 Ey~ Stree(, l~.6f Box 2615, Bakersfield, California 93303-2615. This letter is in support of the use of the Underground Storage Tank Cleanup Fund to demonstrate financial responsibility for taking corrective action and/or compensating third parties for bodily injury and property damage caused by an unauthorized release of petroleum in the amount of at least $490,000 per occurrence and $990,000 annual aggregate coverage. Underground storage tanks at the following facilities are assured by this letter: San Joaquin Community Hospital 2615 Eye Street Bakersfield, CA 93303-2615 1. Amount of annual aggregate coverage being assured by this letter $ 10,000 2. Total tangible assets $ 55,571,861 3. Total liabilities $19,813,057 4. Tangible net work $ 35,758,804 I hereby certify that the wording of this letter is identical to the wording specified in subsection 2808.1 (d) (1), Chapter 18, Division 3, Title 23 of the California Code of Regulations. I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge and belief. Executed at Bakersfield, California on December 9, 1993. Kenneth E. Gibb Vice President, Finance A Member of Acivemist Health System/West .:'b I 5 ~ve ~reet Pos~ Office Box 2615 ~aker*field, California q330~-2615 $~'~ V,'a~r Resources G~oi Board ' ' - ~ UNDERGROUND ST~ TANKS CONT~NING P~O~UM B. San J~in C~ni ty Ho~ital ~reby ~ ~t ~ ~ in ~m~e ~h ~ r~~ of ~n 2~7. Self- l~an Joa~in C~.~i~y Hosp .tal $10,~ ~ontinuou~ yes yes P.O. Box 2615 Bakersfield, ~ 93303-261~ State $490,~/ Continuou~ yes yes ~d $990,0~ Note: ff you are ~ing t~ ~ate Fu~ ~ any ~ of your de~tmtDn of fi~l r~i~l~ ~ur ~Dn a~ subm~Dn S~ .J~in Comity Hospital 2615 ~e Street Bakersfield, ~ 93303-2615 / ~ / I Kenneth Gibb, ~ of Fin~ce CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT 2101 H STREET S. D. JOHNSON BAKERSFIELD, 93301 FlEE CHIEF October 11', 1991 326-3911 Dennis Gardner San Joaquin Hospital 2615 Eye Street Bakersfield, CA 93301 CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANKS LOCATED AT 2615 EYE STREET IN BAKERSFIELD, CALIFORNIA.' PERMIT # BR0003 Dear Mr. Gardner This is to inform you that this department has reviewed the results for the preliminary.assessment associated with the closure of the tanks located at the above stated .address. Based upon laboratory data submitted, this office is satisfied with ' the assessment performed'and requires 'no further action at this time. If you have any questions regarding this matter, please contact me at (805)-326-3797. Sincerely, Joe A. Dunwoody Hazardous Material Specialist Underground Tank Program ~_--'~ ... ,,'L~ BAKERFIELD CITY FIRE DEPARTMENT 7~' ~DERGRO~D STROAGE TANK PROG~M PERMIT APPLICATION FOR REMOVAL OF AN ~DERGRO~D STOOGE TANK Site Infromation Site Address 26]5 Eye Street ZipCode 9330] APN FacililtyName San Joaq.uin Hospital Cross Street Tank ~ner/Operator San Joaqu~n Hospital Phone 805/326-4]40 Mailing Address P.O. Box 26]5 City BakersfieldziDCode 9330~ Contractor Information Company RESNA/Groundwater Rec. Phone805/835-7700 License~ 609572 Address ]500 s. Union Avenue City. Bakersfie~p Code 93307 Insurance Carrier Workmans Comp ~ Prelimana~ Assement Info,etlon Company ~SNA/Groundwater R~c. Phone 805/835-7700 License~ 609572 Address ]500 S. Union Avenue CityBa~ersfiel~ip Code 93307 Insurance Carrier ~erican Home InsuranceWorkmans Comp ~ wc581629& Tank Cleaninq Info~ation CompanyKESNA/Groundwater Resources Inc. Phone 805/835-7700 Address ~500 S. Un,on Avenue City BKFD. Zip Code 93307 Ware Transporter Identification Nu~er Quality Vacuum - CAD58 ]629& Name Of Rinsate Disposal Facility. Gibson 0~1 & RefininE Address 3121 Standard Road City BKFD. Zip Code 93308 Facility Identification N~er CAD980883177 Tank Transporter Info,etlon Company RESNA/Groundwater Resources Inc. Phone 805/S35-7700 Address ]500 s. Un,on Avenue City BKFD. Zip Code 93307 Tank Destination Valle7 Tree TANK INFORMATION Tank ~ age Volume Chemical Dates Stored Chemical Stored Previously Stor~ ] unknown 500 Easol~ne unknown none I F~r Official Use Only · ~ Application Date 8/8/$/ Facility %/~/~# of Tanks [' Fee$~.O.~ ~ The applicant has recieved, understands, a~d will comply w~th the a~:ached conditions of ~his peri: and any o%her S%a%m, h~al an~ Federal regu%a~lonm. This fo~ has been comple=e~ under penal:y of perJu~, and to the bes= of ~ kn~l~ge, is ~rue and corr.:. /Approved ~y: ~ Applicant Name (prin~)~p!icant S~ure : THIS APPLICATION BECOMES A PE~IT WHEN APPROVED //~groundwater resources inc. RE CE IVED ~ A RESNA Company JIJL 2 6 1991 EnvironmentaISolutions I S()O S¢ ). UNK.)N AVE. I~AKERSI:IEt.I), CAI.IF()RNIA 93307 Through Applied Science, c; ......... I ~n~i ....... i,~. Co,~,.w~r ~'d ............ Engineering & Construction July 16, 1991 Mr. Joe Dunwoody ~( Bakersfield Fire Department ~ (~(~1~ Hazardous Material Division ' 2130 G Street ~ Bakersfield, California 93301 ~!~~( RE: San Joaquin Hospital 2615 Eye Street Bakersfield, CA Dear Mr. Dunwoody, A 500 gallon underground diesel fuel storage tank that once serviced a back-up generator system at the san Joaquin Hospital is scheduled to be abandoned in place pending City of Bakersfield Fire Department approval. The tank, located adjacent to an alley that is situated south west of the Chester Avenue/26th Street intersection, is presently not in use. It is located beneath the generator system and near an adjoining refrigerator system and cannot be removed without dismantling these systems. Hand auger equipment will be used to advance a shallow angle boring to depths of 2 feet and 6 feet beneath the tank base ( or approximately 8 feet and 12 feet below grade). A slide hammer will be used to retrieve undisturbed soil samples at these depths. The samples will be contained in brass sleeves, sealed with teflon and plastic caps, chilled, and transported under a chain of custody to Applied Analytical Laboratory. The samples will be analyzed for benzene, toluene, ethylbenzene, total xylenes, and total petroleum hydrocarbons (diesel) using EPA Method 8015/8020. Pending the results of the soil samples, the tank will be drained and then decontaminated using a high pressure steam cleaner. The resulting finsate will be hauled under manifest to Gibson Oil and Refining. The tank will be inerted with-25 pounds of dry ice and then filled with a cement/sand slurry. If you have any questions or require any further information please call 835-7700. Very truly yours, Thomas A. Mele Project Geologist TAM/tab:macpvt cc: Mr. Dennis Gardner 3?5' $ooo MAILING ADDRESS: P. O. BOX 9383, BAKERSFIELD, CA 93389 (805) 835-7700 FAX (805) 835-7717 26th STREET :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: '"" '"'"'"'"'""'"'"" ............ ~ I 8 ~?~:~:~:~:~:~:~:~:~:~:~:~:~?~:~:~:~:~? .................. ~ 500 gal diesel ~ ~ ~~ = ~ SAN JOAQ~N HOSPIT~ PLATE ~roun~water resources, inc. BA~RSFIELD~ CAL~ORN~ L environmental/geotechnical semites P~oj~c~ mm.m PLOT PLAN BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 CERTIFICATION STATEMENT OF TANK DECONTAMINATION I, ~%~% ~'~_.a~ an authorized agent of name --~.%~~~%u~~¢c~here by attest under penalty of contracting co. perjury that the tank(s) located at ~ ~'~ ~-~/~'/ .~"~ ~and address being removed under permit# ~- ~OO~ has been cleaned/decontaminated properly and a LEL' (lower explosive limit) reading of no greater than 5% was measured immediately following the cleaning/decontamination process. date name (print) signature BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 TANK REMOVAL INSPECTION FORM OWNER - ~4~,'~ y ' ' PERMIT TO OPERATE# /6 ~O/'~ CONTRACTOR ~.~ ~ J~- /~-..c,,-],-,~/ CONTACT PERSON LABORATORY ~, ~. # OF SAMPLES ~ .. TEST METHODOLOGY ~-/D,~_.~. ~ z-~ ~ PRELIMANARY ASSESSMENT CO. '~/.~/~ CONTACT PERSON/~. --%/w ~',~(__~ CO2 RECIEPT /~.d.~_ LEL% ~ . 02% PLOT' PLAN STATE WATER RESOURCES CONTROL BOARD ' UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM A COMPLETE THIS FORM FOR EACH FACILITY/SITE [ MARKONLY ~] 1 NEW PERMIT [---'] 3 RENEWAL PERMIT [~ 5 CHANGE OF INFORMATION ~; PERMANENTLY CLOSED SITE ONE ITEM [~ 2 INTERIM PERMIT ~ 4 AMENDED PERMIT [] 6 TEMPORARY SiTE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS- (MUST BE COMPLETED) DBA OR FACILI'rY NAME * / ~'~ NAME OF OPERATOR ~ BOX ~;~"~RATION ~ INDIVIDUAL ~ PARTNERSHIP ~ LOCAL-AGENCY [~] COUNTY-AGENCY r'--] STATE-AGENCY ~ FEDERAL-AGENCY TO INDICATE _ DISTRICTS RESERVATION [~ 3 FARM [~ 4 PROCESSOR OTHER ORTRUSTLANDS EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY) - optional DAYS:NAME (LAS~ F~I~S.,v~- PHONE,WITH AREA CODE., ~ DAYS:NAME (LAST, FIRS'r) PH~NF # WITH ARFA NIGHTS: NAME (LAST, FIRST) PHONE # WITH AREA CODE NIGHTS: NAME (LAST, FIRST) PHONE # WITH AREA CODE II. PROPERTY OWNER INFORMATION - (MUST BE COMPLETED) INFORMATION y I MAILING OR STREET ADDRESS ['~ LOCAL-AGENCY ~ STATE-AGENCY III. TANK OWNER INFORMATION - (MUST BE COMPLETED) NAME OF OWNER J CARE OF ADDRE~ iNFORMATION I MAILING OR STREET~DRESS ~ ~ mx m i~e ~ INOlVlOU~ ~ L~AL-kGENCY ~ S~A~-AGENCY ~ ~ CORmRA~O~ ~ P~N~RSH~P ~ COU~-~G~Y ~ ~E~[-A~E~Y C~W NAU~ ~ STA~ Z~P'CODE P~ONE ~ W~T~ AREA CODE / IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER - Call (916) 323-9555 if questions arise. V. PETROLEUM UST FINANCIAL RESPONSIBILITY- (MUST BE COMPLETED) - IDENTIFY THE METHOD(S) USED ,,' box lo indicate ~ 1 SELF-INSURED ~ 2 GUARANTEE [~] 3 INSURANCE ~ 4 SURETY BOND ~ 5 LETTER OF CREDIT ~ 6 EXEMPTION ~ VI, LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked. CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILLING: I. ~~-~1 THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY ~ ' ~ ' COUN~ ~ JURISDICTION ~ FACILI~ ~ LOCATION CODE - OPTIONAL CENSUS. TRACT · - OPTIONAL SUPVlSOR - DISTRICT CODE - OPTIONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION - FORM B, UNLESS THIS IS A CHANGE OF SEE INFORMATION ONLY. FORM A (5-91) FOR~33A-5 //~goundwater re sou rces inc. R~J~NA A RESNA Company ~vironmen~l Solutions 1500 SO. UNION AVE. BAKERSFIELD, CALIFORNIA 93307 ~rough Applied Scienc~ Class ~Haz License No. 609572 0Ct October 8, 1991 HA7, ~AT. DIV. Mr. Joseph A. Dunwoody Bakersfield City Fire Department Hazardous Materials Division 2130 "G" Street Bakersfield, California 93301 Re: Tank Removal San Joaquin Hospital 2615 Eye Street Bakersfield, California Dear Mr. Dunwoody: On August 15, 1991, RESNA~Groundwater Resources, Inc. removed one 200-gallon underground storage tank from the subject site under permit # BR-0003. The tank had previously been used to store gasoline. The tank was decontaminated in place using a high pressure steam cleaner and was inerted with dry ice. Rinsate was transported by Quality Vacuum Service (CAD5816294) for disposal to Gibson Oil Refinery in Bakersfield, California under hazardous waste manifest # 89582095. RESNA transported the tank to Golden State Metals, Inc. in Bakersfield, California for disposal. Copies of the manifest and the tank disposal form are attached. After tank removal, soil samples were collected at depths of two feet and six feet below the center of the former tank location. The samples were submitted under Chain of Custody protocol to BC Laboratories, Inc. in Bakersfield, California and were analyzed for Total Petroleum Hydrocarbons as gasoline and for benzene, toluene, xylenes and ethylbenzene. No hydrocarbon detections were reported. copies of the analytical reports are attached with the Chain of Custody Record. Please call if you have any questions on this project or if we can be of further assistance. Sincerely, Jc~H./~el oyster Project Geologist MAILING ADDRESS: P. O. BOX 9383, BAKERSFIELD, CA 93389 (805) 835-7700 FAX (805) 835-771 7 27TH STREET Hospital Administration Building former location of tank Driveway ~~~~l SAN JOAQUIN HOSPITAL PLATE ml~~r~"~ 2615 EYE STREET Environmental Solutions BAKERSFIELD, CALIF. Through A, oplio~ DATE: 9-13-91 Engineering&Construction PLOT PLAN PROJECT NUMBER: 3691-2 >. Report To: ~ Analysis Requested I~ Name: Project: ~' b SD Lab~ Sample Description Date & Time Sampled I I -- Relino/~shed b~j,~ Received by: (~ Date: Time: heceived b~.' (SignatUre) O City//'~r,-.~.~; ,~'¢~-e/J Sta~e C ~ Relinquished by: (Signature) Received by: (Signature) Date: Time: ' 5 A.ention: ~C ~;U~' ~ Relinquished by: (Signature) ~ Received by: (Signature) Date: Time: Time: ' ' Miles: Relinquished by: (Signature) I Received by: (Signature) Date: Time: Sample Disposal P.O.¢ ~t~--~ . .. Relinquished , ' 3 BO Ois~sal~ 5.~ ea. ~ ~ etum to client ENVIRONMENTAL LABO RATO RI ES. IN C. J. J. EGI. IN, REG. CHEM. ENGR. PETROLEU~I 4100 ATlaS CT., O~K[RSFiE[O, ~[I~OR~I~ 03308 PHON[ (60~ 327;4911 F~ (~5) 327-1918 Petroleum Hydrocarbons Groundwater Resources, Inc. 111 Date of P. O. Box 9383 Report: 08/28/91 1500 South Union Avenue Lab #: 9211-2 Bakersfield, CA 93307 Attn.: MARC SELOVER 835-7700 Sample Description: PROJECT: S.J. HOSPITAL (PROJECT ~3691-2) - T-6, SAMPLED 8/15/91 1:40 PM BY MARC SELOVER TEST METHOD: TPH by D.O.H.S. / L.U.F.T. Manual Method - Modified EPA 6015 Individual constituents by EPA Method 5030/8020. Sample Matrix: Soil Date Sample Date Sample Date Analysis Collected: Received ® Lab: Completed: 08/15/91 08/15/91 08-27-91 Minimum Analysis Reporting Reporting Constituents Results Units Level Benzene None Detected mg/kg 0'.005 Toluene None Detected mg/kg 0.005 Ethyl Benzene None Detected mg/kg 0,005 o-Xylene None Detected mg/kg 0.005 m-Xylene None Detected mg/kg 0.005 p-Xylene None Detected mg/kg 0.005 Total Petroleum Hydrocarbons (gas) None Detected mg/kg 1. Comments: .' California D.O.H.S. Cert. ~1186 ENVIRONMENTAL J. J. EGLIN, REG. CHEM. ENGR. PETROLEUM 4100 ATLAS CT., BAKERSFIELD, CALIFORNIA 93308 PHONE (805) 327-4911 FAX (805) 327.1918 Petroleum Hydrocarbons Groundwater Resources, Inc. 111 Date of P. O. Box 9383 Report: 08/28/91 1500 South Union Avenue Lab ~: 9211-1 Bakersfield, CA 93307 Attn.: MARC SELOVER 835-7700 Sample Description: PROJECT: S.J. HOSPITAL (PROJECT ~3691-2) - T-2, SAMPLED 8/15/91 1:35 PM BY MARC SELOVER TEST METHOD: TPH by D.O.H.S. / L.U.F.T. Manual Method - Modified EPA 8015 Individual constituents by EPA Method 5030/8020. Sample Matrix: Soil Date Sample Date Sample Date Analysis Collected: Received ® Lab: Completed: 08/15/91 08/15/91 08-2~-91 Minimum Analysis Reporting Reporting Constituents Results Units Level Benzene None Detected mg/kg 0.005 Toluene None Detected mg/kg 0.005 Ethyl Benzene None Detected mg/kg 0.005 o-Xylene None Detected mg/kg 0.005 m-Xylene None Detected mg/kg 0.005 p-Xylene None Detected mg/kg 0.005 Total Petroleum Hydrocarbons (gas) None Detected mg/kg 1. Comments: California D.O.H.S. Cert. ~1186 Department Supervisor~ --- N_ GOLDEN STATE METALS, INC. DISPOSAL FORM Bakersfield, California 93387 - Phone (805) 327-3559 · Fax (805) 327-5749 Contractor's ~ - Scrap Metals, Pro~ssing & Recycling License No. Contractor's DESTINA~ON: G.S.M. · 2000 E. BRUNDAGE LANE · BAKERSFIELD, CA 93387 HAULER: ~C h I LIOENSE NO: WEIGHT CERT. NO: g~ be ~ TOTAL ~ ~~ QTY GALLONS SERIAL ,O. NET TONS EHSD PERMIT NO: 550 .24 1000 - 6 ~ .61 -- 2000 .97 ~ RESIDUALS PRESENT (REJECT) 3eec ~.~2 O LEL ~EADIN~ ~000 2.,2 OXYGEN CONTENT 7~00 ~.2s DISPOSAL FEE ~000 3.~2 12OOO 4.93 TOTAL net 30 days from receipt of tank. Contractor's signature represents acceptance of terms for payment, and confirms that tank removal complies with State laws. CONTRACTOR'S SIGNATURE ~ CERTIFICATE OF TANK DISPOSAL / DESTRUCTION T~IS IS T~ ~RTIFY THE RECEIPT AN~CCEPTANCE O~TANK(S) AS SPECIFIED ABOVE. ALL MATERIAL SPECIFIED WILL BE COMPLETELY ~ ~OR S~AP RECYCLIN~ ~URP~ES ON~. ~ ' AUTHORIZED REP. DATE WHITE ~ Con,actor Copy . YELLOW ~ ~ie Copy . PINK-- Perma~nt Copy .~,: Form Approved OMB N ~39 (Expires 9-~-91) Toxic Substances Conlrol Division , '.? Please ~rint or type; ~0rm d~gned:for uae on elite (I typewriter). : ~ Sacramento; Calilornl ~'[" ' 0NIFORM HAZARDOUS '1" ~r,,o,', US EPAIDNo. ~.~ ~Doc.me.tManile'lNo. ~age, 10,ormalio. l. the shaded areas 3. Generator's Name and M~iling Address ~ A. Slate Manliest Document Number Sm',. Joaquin.H~spital .. ; 89582095' 5.. Transpolar t Company Name 8. US EPA ID Number C. Stale. Transpo~er'a~D -].~)l ~ ~/O[,<~ ' 7. Transpolar 2 Company N~ 8. US EPA lO Number E. State Traaspoder's ID 9. ~ionated Fscjliiy N~mff.and ~ite. Addre~ tO. US EPA ID Number ' G. State Fscility's ID ,.',; 11, US DOT Description (~clud~g' Proper ~hippioo Name. Hazard Clas8, and ID Number) Quantity Unit ' Waste No. : No, Type WI / Vol a. . ~late R A EPAI~Aer ' , R c. ; aisle d.' Slate Protective' ~ter Wear Gibson '"~"" " ' GENERATOR'S CERTIFICATION: I hereby declare that the conleal~ of thi~ consionment are tully and accurately described above by proper shippin9 name . and are cl~88ilied, packed, marked, en~ labeled, and afc in ~11 respects in proper co~dilio~ for Iranspo~ by hiOhw~y ~ccordin~ Io ~pplicable inlem~lio~al and '. ' national government regulations. . ~. . . If I am a large quantity generator. I ce,i~ that I have a program In place to reduce the volume and toxicity of w~ete generated to the degree I have dete~ed to be economically practicable and thai I have selected the practicable method q treatment, slorage, or disposal~ufrenlly available Io me which minimizes I,e . present and fatare threat to human health and the environment; ~. it I am a smd I quamity generator. I have ma de~ 9nod leith silo. to minimize my waste generation and select the best waste management meihod Ihat is available Io m~ [and that I can alford. / ' ~8. ~ra~apo~e~ 2 Acknowleggeme~l el R~eipl el Malefials ~ ~ Printed/Typed N~me ] Signature Month Day Year 19. Discrepancy Indicalion Space, ' , ' 'F L I 20. Facility Owner or Operator*Ce~lticetion of receipt of hazardous materials covered by this manifest except as noted in Item 19. y Prinled/T~ped Name Signature Month Day Year OHS 8022 A (tl88), · Do Not Write Below This Line EPA 87~22 ' (Rev. 9-aa) Previous editions are obsolete. Blue: GENERATOR SENDS THIS COPY TO DOHS WITHIN 30 DAYS ~. ~,.. To: P.O. ~x 400, Sucromento, CA 958~2-04~ BAKER-~FIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION (805) 326-3979 APPLICATION TO PZRFORM A TIGHTNESS TEST PERMIT TO OPERATE~ OPERATORS NAME ~/~/zT~ OWNERS NAME NUMBER OF TANKS TO BE TESTED ~' IS PIPING GOING TO'BE TESTED TANK $ VOLUME CONTENT D~0~¥93 13.::~0 '~805 326 0576 . ~ BFD HAZ ~AT DIV ~002 ~ V "~ ~ c~'~ 2130 G street Baker=fiel~, CA 93301 , ~PLICA~ION ~ PE~0~ A T~G~SS' TEST PE~iT TO OPiaTE 0PE~TORS N~ ~~ O~ERS N~ / . ;<. 5101 SILLEE3T AVE. AES -- SYSTEM II P~CISION T~NK. ~ LINE T~ST Ir, voice Address: Tank E~AKERSFIELD~ CA. 93303 BAKERSFIEL. D, CA. Dat~: 2-4-94 Ti;'~ ~tart: 08:30 ~r,d: 1~:00 Cour~ty: KE Facility Ph~r,~: (805>32&--~140 ~rour~dwa~er Depth: 20' ~iue P'rirr~: N/A Contact: BOB PA'l-WELl_ Date;Tim~ syste;0 was t"ill~d: 1~ HRS.+ Tank Fill/Verst Product l'~pe Of Vapor Ir~hem of Pump Tank Tank Capacity Product Tank Va~r Lines Lire Rectory Water,/'fank Type Matepial I 700 DSL. PASS PASS PASS NONE O. 0 :' SUC r. SWS ~ 3.5K [ cL. PASS PASS F H~S NONE O. 0" SUCT. SWS Additional Imformatiom: GRC~LJNJJWA'I'E~< DEP'TH WAS K)E"f'ERI~'ilNE. L) }3Y hI[.iK, F:'i]RL. ENE, EE.]F(iJkJE~. SITE LOG TIME.. Se% Up Equip: 08:45 ~led Product Lines: 0~:40 Bled Vapor Lines: N/A . Bled Ven't lines: N/A ,:, B~ed Turbine: N/A Bled Suctio~ Pump: Risers Installed: N/A ail regulatory agencies. Technician License No. : 91-1069 Water C:al-~. b~ at i c,n · Level. vo'.l. LImO (C:t N e t c h a n g e ( ~:;1 r.) h ) ." 0 ,, Net ,: hange (qqph) : ..... · TE ..... W I-I-H A MI .... ALI_ LI '~I.F:.:S ~F?E F"i_C)ODEF) AND TNC:L. iJDE!0,, HAZARDOUS MATERIALS DIVISION 2130 G Street, Bakersfield, CA 93301 (S05) 326-3970 !~/~~ UNDERGROUND TANK QUESTIONNAIRE JUL 0 2 1991 HAZ. MAT. DIV. I. FACILITY/SITE No. OF TANKS DBA OR FAClLIIY NAME NAME al: OPERATOR ADDRESS NEAREST CROSS STREET ! PARCEL No.(OPTIONAL) C~ NAME STATE ~IP CODE ~'BOXTO~NDICATE ~CORPORATION QINDIVIDUAL QPARTNERSHIP [~LOCALAGENCYOISTRICTS [~ COUNTY AGENCY [~ STATE AGENCY [~FEDERALAGENCY EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY~ optional DAYS: NAME (LAST, FIRST) PHONE No. WITH AREA CODE DAYS: NAME (LAST. FIRST) PHONE No. WITH AREA CODE NIGHTS: NAME (~ST.~I~ PHONE ~. WI~AR~ C~dE NIGHTS: NAME (~ST. FI~ PHO~E No. WiTH AR~ CODE II. PROPER~ OWNER INFORMATION (MUST BE COMPLETED) NAME CARE ~ ADDRE~ INFORMATION MAILING OR STRE~ ADDRESS ~ BOX ~ INDIVIDUAL ~ LOCAL AGENCY ~ STATE AGENCY TO INDICATE ~ PARTNERSHIP ~ COUN~ AGENCY ~ FEDERAL AGENCY CI~ NAME STATE ZIP CODE PHONE No, WITH AREA CODE III. TANKOWNER INFORMATION (MUST BE COMPLETED) NAME CARE OF ADDRE~ IN~RMATION MAILING OR STREET ADDRESS ~ BOX ~ INDIVIDUAL ~ LOCAL AGENCY ~ STATE AGENCY TO INDICATE ~ PARTNERSHIP ~ COUN~ AGENCY ~ FEDERAL AGENCY CI~ NAME STATE ZIP CODE PHONE No. WITH AREA CODE OWNER'S DATE VOLUME PRODUCT IN TANK No. INSTALLED STORED SERVICE Y/N Y/N' Y/N DO YOU HAVE FINANCIAL RESPONSIBILITY? Y/N TYPE '~-z-~ constructed of the~me materials, style and , then only fill one segment out. please identify tanks by owner ID #. I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY iF UNKNOWN C. DATE mNSTALLEO(a~DAY~EAR) II1. TANK CONSTRUCTION UA.KONE~ONLY~N~XESAa, ANOC,~DALLTHATAP~ES~NaOXD A. ~PEOF ~ 1 ~U~LE WALL ~ 3 SINGLE WA~ WI~ E~ERIOR LINER ~ 95 UNKNOWN SYSTEM ~2 SINGLE WALL ~ 4 SECONDARY ~NTAINMENT (VAUL~DTAN~ ~ 99 O~ER B. T~K MATERI~ ~ 5 CONCREm ~ 6 ~L~INYL CHLORIDE ~ 7 ~UMINUM ~ 8 1~ ME~ANOL ~MPATIB~W~RP (Primary Tank) C. INTERIOR ~ 5 G~ LINING ~ e UNLINED ~ eS UN~OWN ~ ~ O~ER ENING D. CORROSION ~ t mL~LENE WRAP ~ 2' ~ATI~ '~ 3 ~L ~ ~ 4 FIBERG~S REINFORCED ~STIC PROTEC~ON ~ 5 CATHODIC PROTECT~N ~ ~E . ~ g5 UN~WN ~ ~ O~ER IV. PIPING INFORMA~ON c~,c~ A IFABOVEGR~NOOR U IF UNDERGROUND. BO~)FAmL~ABLE A. SYSTEM TYPE ~ 1 SUCTION A U 2 PRESSURE A U 3 G~VI~ A U ~ O~ER B. CONSTRUCTION A ~ SINGLE WALL A U 2 ~UBLE W~L A U 3 LINED TRENCH A U 95 UN~OWN A U ~ O~ER C. MATERIAL AND A~ ~RE STEEL A U 2 STAINLESS S~EL A U 3 ~LWINYL CHLORIDE (PVC)A U 4 FIBERG~S PIPE CORROSION A U 5 ~UMINUM A U 6 ~NCRE~ A U 7 STEEL W/ ~A~NG A U 8 I~, ME~ANOL ~MPATIBLEWmRP PROTE~ION A U 9 ~LVANIZED S~EL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U ~ O~ER D. LEAK D~ECTION ~ 1 AUTOMATIC LINE LEAK DE~CTOR ~ 2 LiNE T~H~ESS TESTING ~ 3 INT~Sm~L ~.~OR[NG ~ ~ O~ER V. TANK LEAK D~ECTION I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN C. DATE INSTALLED (MO/DAY/YEAR) ~l'7~' D. TANK CAPACITY IN GALLONS: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. B. ANDC. ANDALLTHATAPPLIESlNBOXD A. TYPE OF [~/~ DOUBLE WALL [] 3 SINGLE WALL Wll~ EXTERIOR LINER [] 95 UNKNOWN SYSTEM [~ ~ SINGLE WALL [] 4 SECONDARY CONTAINMENT IVAULTEDTANK) [] 99 OTHER 8. TANK MATERIAL [] 5 CONCRETE [] 6 POI'YVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLEW/FRP (PrimaryTank) [] ~ BRONZE [] '0 GALVANIZED STEEL [] g5 UNKNOWN [] 99 OTHER [] , RUB.ER LINED L,.,NG[] 3 EPO L,.ING [] . PHENOL'= L,.,NG C. INTERIOR ~ 6 UNLINED [] 95 UNKNOWN OTHER LINING [] 5 Gm. ss LINING [] IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES__ NO__ D. CORROSION [] 1 POLYETHYLENE WRAP ATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION ~ 91 NONE [] 95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION C~RCL~ ,IL IFABOVEGROUNOOR U tFUNDERGROUNO. 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 tJ 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C, MATERIAL AND A U ~ BARE STEEL A U 2 STAINLESS STEEL A U 3 POLY~/INYL CHLORIDE (PVC)A U 4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING . A U 8' 100% METHANOL COMPATtBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION [] 1 AUTOMATIC LINE tEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTITIAL MONITORING [] 99 OTHER V. TANK LEAK DETECTION .......1 , VISUAl. C,ECK I~T~2 INVENTORY RECONCILIATION ~ 3 VAPOR MONITOR,NG ~4 AUTOMATIC TANK GAUGING ~ 5 GROUNDWATER MONITORING) ) 6 TANK FF:STING (---~._j 7 INTERSTITIAL MONITORING ~ 91 NONE ..... t'~ 95 UNKNOWN )____;'~% 9g OTHER .... .~.< ~'~ If"I'ANK DESCRIPTION COM~L~TE III. TANK CONSTRUCTION M. ARK ONE ITEM ONLY IN BOXES A. B. ANDC. ANOALLTHATAPPLIESINOOXO A, TYPE OF [~x/~ D~UBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER ' [] SYSTEM ~'/,~SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULTED TANK) ~ 99 OTHER 8. TANK [~ 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 [] 8 100% METHANOL COMPATIBLEW/FRP (p~in]aryTank) [] g BRONZE [] 10 GALVANIZED STEEL UNKNOWN [] 99 O'h-tER [] , RUBSER LINED ~ AL~'D L..G ~] 3 ~OX~ L,N"~ [] 4 ~ENOL~C LINING C. INTERIOR [] 5 GLASS LINING ~ e UNLINED ~5 UNKNOWN [] 99 OTHER UNING · IS LINING MATERIAL COMPATIBLE WITH I(X~. NO__ D. CORROSION [] 1 POLYETHYLENE WRAP [] WRAP [] 4 F~BERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION NONE · 95 UNKNOWN. [] 9g OTHER IV. PIPING INFORMATION C~RC~ ~, BOTH~F~'.P,L~-,~a.~ · · A, SYSTEM TYPE A A U A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A WALL A U 2 DOUBLE WALL A IJ 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A~ i STEEL A U 2 STAINLESS STEEL A IJ 3 POLYVINYL CHLORIDE (PVC)A U 4 FIBERGLASS PIPE CORROSION A 5 N_UMINUM A U 6 CONCRETE 'A I.I 7 STEEL WI COATING A U 8 1(x3% MEI~IANOL COMPATIBLEW/FRP PROTECTION u 9 GALVANIZED STEEL A U tO CATHOOIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK [] 1 AUTOMAT?~,LiNE LEAK DETECTOR [] 2 UNETIGHTNESSTESTtNG [] 3 INTERSTIT~L ~.~OR~.~ [] 99 OTHER V. TANK DETECTION ~,SUAL OHECK [~= IN'~.TORY RECO"ClL~'T,ON []= VAPOR.ON,TOR'NO [] '. =TOM*T.:TANK~'~'GINO []~ ~ROUNOWATERMON,TOR,NO ~ TANK TEST,NG [] ~ ,NTERST,~A'~O.,TOR'NO [] ~..O.E [] ~ ~N~OW. [] ~ OTHER I. TANK D ESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I. D. # I B. MANUFACTURED BY: C. DATE iNSTALLED (MO/DAY/YEAR) D. TANK CAPACI~' IN GALLONS: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC. ANDALLTHATAPPLIESINBOXO A. TYPE OF [] 1 DOUBLE WALL [] 3 SINGLE WAll WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SECONOARY CONTAINMENT (VAULTEOTANk3 [] 99 OTHER B. TANK [] 1 BARE STEEL [] 2 STAIhLESS STEEL [] 3 FIBERGLASS [] 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIOE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLEW/FRP (PfimaryTank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] ~5 UNKNOWN [] 99 OTHER [] , RUBBER LINED [] ~ AL~D L.I"G [] . EPOX~ LIN,NG [] 4 ~ENOL~ LINING C. INTERIOR [] 5 GLASS LtNING [] S UNUNED [] a5 UNKNOWN [] 99 OTHER LINING ~s UN'NO MATER=AL COMPATIBLE WITH ~00~. METHANOL ? YES ~ NO~ D. CORROSION [] ~ POLYETHYLENE WRAP [] ~ COAT~ [] 3 W~L WR~ [] ~ F~eERaLASS RE~NFORCED PLaSTiC PROTECTION [] ~ CAT.OD~C PROTECTION [] ~ NONE [] gS UNKNOWN [] 990T~ER IV. PIPING INFORMATION C~RCL~ A ~FABOVEOROUNOOR U ~FUNOEROROUNO, aOTH~FAPPUCAELE A. SYSTEM TYPE A U ~ SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER R. CONSTRUCTION A tJ 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A IJ 95 UNKNOWN A U 99 OTHER A U 1 BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A D 4 FIBERGLASS PiPE C. MATERIAL AND CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION ~ ~ AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTi~rlAL V. TANK LEAK DETECTION E_~ ' ~,SUAL C.ECK [i~ ~ ,NV~NTORY RECONC,L,AT,ON [] ~ VAPOR MON,TOR,NG []. ~UTO.AT,C TANK ~UG,N~ [] i.-~_~ 6 TANK TESTING [~ 7 'NTERsTITIALMONITORING [] 91 NONE [] 95 UNKNOWN [] ~09 OTHER BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION · 2130 G Street, Bakersfield, CA 93301 (805) 3~.6-3979 APPLICATION TO PERFORM A TIGHTNESS TEST PERMIT TO OPERATE ~ OPERATORS NAME ~/~/79~- OWNERS NAME · NUMBER OF TANKS TO BE TESTED c~ IS PI2ING GOING TO'BE TESTED TANK# VOLUME CONTENTS ~Q , ,700 ~D/f~E c TEST METHOD ~ ~5 ~ V5 ZC~ ~ N~E OF TESTER, Tony ~/n~/ CERTIFICATION ~ , STATE REGIST~TION ~ ~/- ~,TE ~ T~EE TEST ZS TO BE CONDUCTED ~/93 0800 .' K3f// ~'. ,FII. K ..'ONTENT.'~. IN~/ ~. CI ~ I~ee~mit co Opecate' ! /~,~g-/~ ' i ' Date rlconstructton Permit J Date rlPermtt to abandonl No. o[ Tanks DaCe I-1Amended Perelc Conditions .' J~eecmtt &ppttcation Fo[m, '~_~ .... 1'a'nk Sheet's', 'Ple~' PlcxnSf'//r . BAppt lcat ton ~..to..._&bandon ......... tanks(s) Date _ " .... :-:-:--=-':":j Annual 'Report forms ......... · -' ..... ......... :':-: .... - ........... ' B Copy ot blrttten Contr~act Between"'Ovner & Operator Inspection Repo~te .:_...=1~ Co r r eai~enaence _:,.,:.._Rice L vid .............. ; ......... . ............................... ' . : .... Date ........· .. Dllte ~,. :. I'lCo,reepondence' - Nailed -o. Date ........ Da ts ' ' Unauthottl~;ed ReXeaae '~eporta Sampl Lag/Lab Reports r~#vf CompZtan~e Check (14s'w 'Con'~tructZo'n 'Che'ck~lat) ..... l~5?1) Compliance Check (Ney Construction Check, let) I'l#Vf Plan Check (Ney Construction) 1'I57D P:lan Cheek (Ney Conltruction) l'l#vf Plan Cheek (Existing facility) B STD P~an Check (lxistirMj Facility) I-Ipermtt &ppltcatton ChecklLlt B Permlt Znatruct toni ODI scarded ?t~jhtneaa Teat Result" .... Date ' ~- Date Da te - .l~Honttoting He:ti Constructt'on Data/Permits ' I'lllnvtromaenta! Seneit[.~lty Oats; B Groundvater Driiltng Boring Logs Location of~ Hate~ I'JStatement o£ Unde;ground Conduits ~Plot Plan ~eaturing Al! Enviro~enta[iy Sensitive Data ~Photoa ~ConsCructlon D~a~ings Location: ~.ale .heet ehovtng date ~ece'tved and taZty oe inspeCt'tOn ~Mt ice[ [aneou. , 1700 Flower Street "RN COUNTY HEALTH DEPARTME..~I~- HE. ALT. OFFICER Bakersfield, California 93305 Leon M Hebertson, M.D. * .'. ~:...", . Telephone (805) 861-3636 .... ENVIRONMENTAL HEALTH DIVISION ..~ ~ , · . . .~... ·. :;... ' '.,~. ..... ' .....SAN :UIN COMMUNITY HOSPITAL '~;~:;;I .,r:[.?~:;~;t-7];~".SAN JOAQUIN C0~UNITY ,.HOSPITAL -" '- NOTE: ALL INTERIM REQUIREMENTS ESTABLISHED BY THE PE~ITTING '....": . . " ' 'AUTHORITY MUST BE MET DURING THE TERM 0F THIS PE~IT '" NON--TRANSFERABLE '~ ~ ' '"POST 'v'ON'~"'PREMISES .- ~.. DA~ P~IT ~: AUG 2 5 1~6 DA~ P~IT ~K LIST ~~: Corporation 2615 EYE STREET· P.O. BOX2615· BAKERSFIELD, CA93303-2615 PHONE (805) 327-1711 SE? 1 8 198 Se'ptez~er 16, 1986 KERN COUNTY FiF. ALTH DEPT. Bakersfield, CA 93305 De~r Ms. Boyce: As per our telephone conversation of Monday, September 15, 1986 it was noted that o~r underground tanks are used for deisel storage to operate emergency generators' only and thus does not ccme under the classification of metered storage tank~. We will retain the penmit we have received. Please find enclosed th~ material that was originaly sent to us for records. Thank you for your help. Sincer~y, __ .? __ Curtis E. Flint, Chief Engineer Permi.t ~ues t i °nnai re _.~:::! Normally,. .permits are sent to facility Owners but since many sent to the Operators of the facility where they are to be posted. Please. fill in Permit # and check one of the following before returning this form with payment: For pERMIT $ ~60016C lis~ed on invoice (if Owner is different than .. Operator, it will he Owner's responsiSility to provide Operator with pertinent .... -. ., information).' ." 2. Send all information to Owner at the followin~ corrected address: 3 Send all information to Operator: Name: Address: (Operator can make copy of. permit for Owner). ~- Permit No.~ /~ PCP Kern County Health Department Division ot Enviro~ental Heal Application 1700 Flo~r Street, BakersfieL 93305 ~PLI~TION FOR PE~IT ~ OPE~TE ~~US SUBST~CES S~E FACILI~ T~ of Application (ch~k'): ~Ne~ FacilitY ~ification of Facility ~isti~ Facility ~ansfer of ~ership ~ ~ergen~ 24-~ur Contact (n~e, area c~e, ~one): ~ ~.~L{a~-~0~7-f711~ ~11 FaCility ~ ~n ~O~tn ~~~ ~0~%~ ~. of T~ks .... _ ~= ~f-B~i~gSS. (.ch&~'k).. :::L_~line/s~t ioh... ~er., (dearlY)~.-_:..~[ ~-'~-~s Is Tank(s) ~cat~ on ~ ~gricultural Faa? ~Y~ Is Tank(s) Us~ ~i~rily for ~ricultural ~r~ses? ~Yes ~ ~ ~z~ Nearest Cro~ St. Facility ~dre~ g~15 g e T R SE~~ ' (R~al ~%'io~ ~ly) '~il ~aractertsCtcs' at ~ctlity ~ ~~ ~sis for Soil ~ a~ Gro~ter ~ ~te~i~tto~ " C. Cuntra~tor ~Xd ~~ ~ ~.tra~tor's ~e~e m. Pro~s~ S~r~i~ ~te .Pro~s~' C~eti~ ~rker's C~~ti~ Certificatio~ [ I~ure~ D. If ~is ~mit Is For ~ification Of ~ ~isti~ ~cility, ~rtefly ~rt~ ~ifi~ti~ Pro~ E. Tank(s) S~re (~eck all ~t a~ly): Tank [ ~s~ Pr~uct ~tor Vehicle Unlead~ R~ular Pr~i~ Die~l ~ste - ~el F. Ch~i~l ~sition of ~terials Stor~ (~t ~ces~ry for ~tor v~icle ~ls~ Tank ~ Chemi~l Stor~ (no~c~rcial ~e) ~ ~ (if kn~) ~1~.1 Pr~iously (if different) G. Transfer of Ownership N/~ Date o--~nsfer Previous Owner Previous Facility Name I, accept fuli'¥ all 0bli'g~%ions of Permit No. issued to . I understand that the Pemitting Authority may review and modify or terminate the transfer of the Permit to Operate this %~ldergrot~ld storage facility upon receiving this c~pleted form. true and corr~(~t./ / // / ~ -- ?d Date Facility Name Permit No. TANK ~ (FILL OUT SEPARATE FORM FO~CH TANK) FOR EACH SECTION, CHECK ALL APPROPRIATE BOXES N.1. Tank is: []Vaulted FIN•n-Vaulted [~Double-Wall [~Single-Wall 2. ~ Material Carbon Steel [] stainless Steel l~Polyvinyl Chloride []Fiberglass-Clad Steel Fiberglass-Reinforced Plastic [] Concrete [~ Al~elinum [] Bronze rlUnknown Other (describe) 3. Primary Containment Date Installed Thickness (Inches) Capacity (Gallons) Manufacturer 4.Tank Secondary Cor{tainment . - rlDouble-Wall []Synthetic Liner []Lined Vault [~None [] Other (describe): Manufacturer: ~lMaterial Thickness (Inches) Capacity (Gals.) 5. Tank Interior Lining ---~Rubber []Alkyd ~lEpoxy []~henolic []Glass []Clay []Utllined []L~known []Other (describe): --~Galvanized ~ass-Clad U]Poly~thylene Wrap F]Vinyl Wrapping 0 rlTar or Asphalt [~Unknova~ []None []Other (describe): '-. -. Cathodic Protection: l'lNone riImpressed Current System rqSaCrifl¢'lal 911ode System Describe System & Equi~ment: L)NILu0~ 7. Leak Detection, Monitoril~, and Ih~erce[;tion a. Tank:. []-]Visual (~aulted tanks only) rqGroundwater Monitoring. ~ll(s) []Vadose Zone Monitoring Well(s) ['lL~-Tube Without Liner []U-Tube with Cc~.~.patible Liner Directing Flow to Monitoring We.Il(s)* [-i Vapor Detector* [] Liquid Level Sensor* [] Conductivity Sensor' - [] Pressure Sensor in Annular Space of Double Wall Tank- [] Liquid Betrieval & Inspection From U-Tube, Monitoring Well or Annular Space [] Daily Gauging & Inventory Reconciliation [] Periodic Tightness Testing ~ None~ Ullknown [-! Other b. Piping: Flow-Restricting Leak Detector(s) for Pressurized Piping' · [~ Monitoring St~p with Race~y [] Sealed Concrete Race~y []Half-Cut C~mpatible Pipe Raceway [] Synthetic Liner Raceway []None ~ Unknown []Other . ·Describe Make & Model.. 8. ~en Tightness Tested? []Yes []No ~tlnknown Date of Last Tightness Test Results of Test Test Name Testing C~mpany 9. Tank ~ Tank Repaired? []Yes ~ []Unknown Date(s) of Repair(s) Describe Repairs ..... 10. Overfill Protection []Operator Fills, Controls, & Visually Monitors Level ~Tape Float Gauge []Float Vent Valves [] Auto Shut- Off controls Capacitance Sensor []Sealed Fill Box [~None []Unknown Other: List Make & Model For Above Devices a. Underground Piping: ~Yes [~No []Unknown Material C~Fec Thickness (inches) U~Diameter U~u0~Manufacturer ~Pressure ~Suction rlGravity Approximate Length of Pipe ~ ............... b..~ _.Underground- Piping Corrosion. Protection.~:~ [']Galv. anized []Fiberglass-Clad ~ImpcesSed Current []Sacrificial Anode []Polyethylene Wrap [qElectrical Isolation [-]Vinyl Wrap '[-]Tar or Asphalt [~3nknown []None l-]Other (describe): c. Underground Piping, Secondary Contairment: I-]Double-Wall ~Synthetic Liner System [']None [-~Unknown [-]Other (describe) :. TANK ~ (FILL OUT SEPARATE FORM FO TANK) FOR EACH SECTION, CHECK ALL APPROPRIATE BOXES H. 1. Tank is: ~]Vaulted [~Non-Vaulted l-]Double-Wall ~Single-Wall 2. ~ Material Carbon Steel [-] Stainless Steel [~Polyvinyl Chloride []Fiberglass-Clad Steel Fiberglass-Reinforced Plastic [] Concrete [] Al~m~in~ [] Bronze [-~Unknown Other (describe) 3. Primary Containment Date Installed Thickness (Inches) Capacity (Gallons) Manufacturer 4. Tank Secondary contafr~ent ...... []Double-Wall []Synthetic Liner []Lined Vau!t ~-~None []Unknown [] Other (describe): Manufacturer: [~Material Thickness (Inches) Capacity (Gals.) 5. Tank Interior Lining ---~Rubber ~]~ []Epoxy []Phenolic []Glass []Clay []~nlined []Other (describe): "- ............ 6'~-'~-~ank Corr6si'On Protection ........................... -~Galvanized "~r~---~ass-Clad [~ol~thylene Wrap ~]Tar or Asphalt ~Unkno~n []None [~Other (describe)': "~ ': Cathodic Protection: []None []Impressed Current System ['1Sacrificial ~e System Describe System & Equil~ent: 7. Leak Detection, Monitorin~, and Interce~)tion a. Tank: []Vis~al (vaulted tanks only) ~]Ground~ater Monitorir~' Well(s) [~Vadose Zone Monitoring Well(s) ['~U-Tube Without Liner ['1U-Tube with Compatible Liner Directi_n~ Flow to Monitori~:3 We.Il(s)* [] Vapor Detector* [] Liquid Level Sensor [] Conductivity [-] Pressure Sensor in Annular Space of Double Wall Tank' [] Liquid Betrieval & Inspection Fr~m U-Tube, Monitoring Well or Annular Space [-~ Daily Gau~inc~ & Inventory Reconciliation ['~Periodic Tightness Testing None [] Unknown F10 her b. Piping: Flow-Restricting Leak Detector(s) for Pressurized [] Monitoring S~p with l~ace~y [] Sealed Co~crete Bace~y []Half-Cut C~mpatible Pipe Race~ay [] Synthetic Liner Race,my []None [g Unknown [] Other *D~scribe Make & Model: 8. ~en Tightness Tested? []Yes []No r~Unknown pz~so~ Date of Lest Tightness Test Results of Test Test Name Testing Company 9. Tank Re~air .' Tank Repaired? []Yes ~]No []Unknown Date(s) of Repair(s) Describe Repairs 10. Overfill Protection ~--Operator Fills, Controls, & Visually Monitors [~vel []Tape Float Gauge []Float Vent Valves'[] Auto Shut- Off Controls B Capacitance Sensor []Sealed Fill Box ~None []Unknown Other: List Make & Model For Abo~e De~iCes a. Underground Piping: ~Yes []No []Unknown Material Thickness (inches) Diameter Manufacturer []Pressure []Suc~i'on []Gravity Approximate [~ngth of Pipe ..................... b'; Underground-Piping Corrosion-. Protection : []Galvanized []Fiberglass-Clad []Imp[essed Current []Sacrificial Anode Polyethylene Wrap []Electrical Isolation []Vinyl Wrap []Tar or Asphalt Unknown []None []Other (describe): c. Underground Piping, Secondary Contairment: []Double-Wall []Synthetic Liner System ~None ~qUnknown ~Other (describe): Facility Name ~~gr'~ Permit No. TANK ~=' (FILL OUT SEPARATE FORM FOR~nACH TANK) FOR EACH SECTION, CHECK A~.T. APPROPRIATE BOXES H. 1. Tank is: [-~Vaulted [~Non-Vaulted []Double-Wall []Single-Wall 2. ~ Material 'OCarbon Steel [] Stainless Steel []PolyvinYl Chloride I-]Fiberglass-Clad Steel i Fiberglass-Reinforced Plastic [] Concrete [] Aluminum [-] Bronze ~lUnknown [] Other (describe) 3. Primary Containment ................... Dote Installed Thickness (Inches) ...... Capaci_t¥ ~._(._Gg_!.lOns) Manufacturer 4. Tank Secondar~ Containment []Double-Wall r-lSyntheti¢ Liner l~Lined Vault []None I'lunkno~ i-lOther (describe): Manufacturer: []Material Thickness (Inches) Capacity (Gals.) 5. Tank Interior Lining ---~Rubber []Alkyd [']Epoxy [']Phenolic []Glass []Clay []unlined ~]t~no~n · []Other (describe): ......... ~', ~-'Tank Corr(~sion ProteCtion ' --]~GalvaniZed ~ass-Clad ~Pol~thylene Wrap [']Vinyl Wra[:~in~ '.i · [']Tar or Asphalt []Unknown []None ~]Other (describe): Cathodic Protection: []None []Impressed Current Syst-m ~l~acriflclal ~ System ~e--s~ribe System & Equi~:ment: 7. Leak Detection, Monitoring., and Interception ' a. Tank: []Visual (vaulted tanks only) [qGround~ater Monitorin~' Well(s) []Vadose Zone Monitorin~ Well(s) []U-Tube Without Liner ~]U-Tube with Co~.patible Liner Directirg Flow to Monitorirg Well(s)* Vapor Detector* [-]Liquid Level Sensor* ~lConductivit~ Sensor" []Pressure Sensor in Annular Space of Double Wall Tank. [] Liquid Betrieval & Inspection Fr~m U-Tube, Monitoring Well or A~ar Space ~Daily_C~u~in~ & Inventory Reconciliation []Periodic Tight~ess Testing [] None Iq Unkno~ [] Other b. Piping: Flow-Restricting. Leak Detector(s) for Pressurized.Pipingw []Monitoring S~a~p with Race~y [']Sealed Concrete Race~y []Half-Cut Compatible Pipe Raceway ~]Synthetic Liner Raceway []None [] Unkno~ [] Other · Describe Make & Model: 8. ~en Tightness Tested? '[']Yes []No []Unknown Date of Last Tightness Test Results of Test Test Name T~stirg C~mpany 9. Tank Re~air Tank Repaired? []Yes ~No []Unknown Date(s) of Repair(s) Describe Repairs 10. Overfill Protection []Operator Fills, Controls, & Visually Monitors Level []Tape Float Gauge []Float Vent Valves [] Auto Shut- Off Controls Capacitance Sensor []Sealed Fill Box []None [-]unkno~n Other: List Make & Model For Above Devices a. Underground Piping: [~Yes []No [qUnknown Material Thickness (inches) Diameter Manufacturer ~-]Pressure [-]Suct'i0n' ' ~Gravity Approximate Length of Pipe ~ b. Underground Piping Corrosion Protection : []Galvanized []Fiberglass-Clad [~Im[xessed Current .[]Sacrificial Anode []Polyethylene Wrap [~Electrical Isolation Ii]Vinyl Wrap [-]Tar or Asphalt []Unknown [']None []Other (describe): c. Underground Pipirg, Secondary Containment: []Double-Wall []Synthetic Liner System []None []Unknot. [-]Other (describe): ,BORING I BORING DATE DRILLED . A~'il 2, 1970 0ATE ORILLEO .,~prll 2, 3,1end 9, 1970 EQUIPMENT USED' 24"-D~m~er ~ EQUIPMENT USED :24"-Di~fer ELEVATION 1~2~ ; ELEVATION 1~.2. , , SANDY SILT - r~tleh to 6', ~ ~ey , SANDY SILT - ~e r~tleh, ~ey ~ F~ I~ge ~lel [COEING ~CKET U~D) J i .5 ~ORING TE~I~,~D ~E TO ~VING) !' ~ ' LOG OF BORING LOG OF BORING ' BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 9330~ (805) 326-3979 APPLICATION TO PERFO~ A TIGHTNESS TEST ~.~ ............ PERMIT TO OPERATE # OPERATORS NAME ..,~,,~,'~ OWNERS NAME ~,,q,'~' T~K~ VOL~ CONTENTS Associated Environmental Systems, Inc. P.O. Box 80427 Bakersfield, CA 93380 (805) 393-.2212 AES -- SYSTEM II PRECISION TANK & LINE TEST RESULTS SUMMARY Invoice Address: Tank Location: W.O.~: 16181 SAN JOAQUIN HOSPITAl_ SAN J[]AQUIN I-IOE:;PlTAL I.D. Number: N/A P.O. BOX 261'5 2615 EYE ST. Techni~ian:BWH BAKERSFIELD~ CA. 93303 BAKERSF:IELD~ CA. Temh. $~:88142 Van~:O117 Date: 3--19-92 Time Start: 08:00 End: 14:00 County: KE I ~ Facility Phone~: (8~)326-4140 Groundwater Depth: 120"+ Blue Prints: N/A Contact: BOB PATWELL Date;Time system was filled: 48 HRS.+ Tank Fill/Vent Prod,~ct Type Of Vapor Inches of Pump Tank Tank Capacity product Tank Vapor Lines' Line Recovery Water/Tank Type Material 1 3.5K DSL PASS PASS PASS I .5" SUCT. SWS ~ 700 DSL. PASS PASS PASS I .75" SUCT. SWS Additional Information: SITE LOG TIME Se~ Up Equip: 08:15 .. Bled Product Lines: 08~10 Bled Vapor Lines: N/A Bled Vent lines: N/A Bled Turbine: N/A Bled Suction Pump: 08:10 Risers Installed: N/A a) ALL PRODUCT LINES WERE TESTED USING THE PLT-100R b> This system ~nd method meets the crite¥~ia ~et forth in NFPA ~$3~9. c> Any failu~'e ].i~ted above m~y require 'Further action, check with all regulatory agencies. Copyright (c) 1989 by AES, Inc. California O.T.T.L. Number : 91-1069 BRUCE W. HINSLEY Certified Technician Signature :.~~_ _~//~ Date : ASSOCT"A'TEI3 E'NVZRONNENTAL SYSTEMS :31)SL',5;K ~ 0 VENT 26i5 EYE ST, SAN JOAQUIN HOSPITAL -- ---- VENT 0 ])SL, ?00 GAL, Site Layout For': SAN 30AQUIN HOSPITAL BAKERSFIELD, CA, As s co i.st ~,d ~E~ v i ~ .... on.re', n I nc_. AES/System Il P~-ecision ].eak Test Graph (OverFill) Involute No. : 16181 Date: 0~/19/92 Time : 08:42:00 Technician: BWH Tank: 1 Tank Diameter(in): 74 Volume(gal): J~5'(~0 Grade k. evel(in): 112 Product Level(in): 110 Water Level, On Tank(in): 0 ~peoifio ~ravity: 0.85 Coe'F"~icient O~ ~xpansion: 0.0004611 Calibration Value(mi): 40~Z Channel: 1 ~evel Segment R~-om: 1 To 270 Temp Segment ~-om: 1 To 270 Change In Calibration Zone ~: 212. Calibration Unit(gal/unit) = 0.00050 Btarting Temperatu~^e (F): 64.383 Head Pressure(psi (B'~m)): 3,,38 Surface Area(sq. in): 10.2 'l'emp. Change(F/h) : V],,005 Level volume(gph): 0.00 Temp. volume(gph): 0.00 Product Line(gph): SUCT. Ne~ change(gph) ~ 0.00 · Copyr'ight (~) 1989 by AE~ · * Not es ** SAN JOAQLJIN HOSF'I"FAL. 2615 EVE ST. BAKE~:F~:~I::'IIZL. D, CA. THIS IS A 2HR. HIGH LEVEl_ TEST WITH A 4~ZlO MI .... CAI ...... AES/System II Precision leak Test Graph (Over'F~ill) Invoice No.: 16181A Da'~e: (~<~/19/92 Tim~ ~ 11:19:14 Technician: BWH Tank: 2 'T'a~lk Diameter(in) ~ 6.3 Volume(gal): 700 Grade L. evel (in): 94 Produc~ Level (in): 92 Wa~er Level On Tank(in): 0 Specific Gravity: 0.85 Coefficient Of Expansion: 0.0004601 Calibration Value(mi): 500 Channel: 1 ~evel Segmen~ F'rom: 1. To 250. :l'e~,p Segment From: 1 To 250 Change In Calibration Zone = 232 Calibration Unit(flal/uni~) = 0.0D. 057 S~arting Temperature (F): 67.949 Head Pressure(psi (Btm)): 2.82 Surface Area(sq. in): 11.6 Temp. Change(F/h) : .... 0.005 Level volume(gph): 0.00 Te.mp. volUme(gph): ~.00 Produc'b Line(gph): SUCT. Net change (gph) : 0.00 Copyrigh~ (~) i98~ Oy AES~ Inc. SAN 3OAQUIN HOSPI'I"AL 261 = EYE ST ': ....... ~, . BAKER~,," IELD, CA. THIS IS A 2HR HIGH LEVEL TEST WITH A 500 htL.