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HomeMy WebLinkAboutUST-REPORT 11/2/1998 Hazardous Materials/HazardOus Waste Unified Permit . CONDITIONS OF ~PERMIT ON' REVERSE SIDE This oermit is issued for the following: [] Hazardous Materials Plan [3 Underground Storage of H,~=rdOus Materials Permit ID #:: 015-000-001880 [3 Risk Management Program AM PM MINI MARKET #6: [3 .azardous Waste On-Site Treatment LOCATION: 2301 F ST !LD '~ '~ ~ ' ~ ~ . v'~?~ ~ "~' ' TANK HAZARDOU~S~~(;E '~CAP~~-. DIsPEN~'/~S~idl. ONITORING 015-000-001880-0001 GASOLINE 015-000-001880-0002 GASOLINE 015-000-001880-0003 GASOLINE OFFICE OF ENVIRONMENTAL SER VICES' ' 1715 Chester Ave., 3rd Floor · '-i:.'ApPmyedby::..';~ : (..Ralpl/Huey, D~'~'~-~i Issue Date Bakersfield, CA 93301 · Voice (661) 326-3979 ' ' . ' :~'~'~:''''~:~' ' .... FAX(661) 326-0576 .?:;:'EkP~ti0nDate: 'June 30.. 2003. '..~.. .-~,..-: ~,?.:,'-~- ~ .. =~~q~,r I CA Cert. No. 00570 I City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (805) 326-3979 An upgrade compliance certificate has been issued in connection with the operating permit for the facility indicated below. The certificate number on this facsimile matches the number on the certificate displayed at the facility. Instructions to the issuing agency: Use the space below to enter the following information in 'the format of your choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility; facility identification number (from Form A); name of issuing agency; and date of issue. Other identifying information may be added' as deemed necessary by the local agency. This permit is issued on this 2na day of November, 1998 to: PRESTIGE STATIONS INC #6356 Permit #015-021-001880 2301 F St Bakersfield, California 93301 June 10, 2004 Arco 2301 F Street Bakersfield, CA 93301 NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE m[ C,~EF Dear Sir: ?ON ::E'AZ E Our records indicate that your annual maintenance certification on your leak detection ADMINISTRATIVE SERVICES 2101 "H" Street system will be past due on 06-04-04. Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 852-2170 YOU are currently in violation of Section 2641(J) of the California Code of Regulations. SUPPRESSION SERVICES 2101 "Fl" Street "Equipment and devices used to monitor underground storage tanks shall bc installed, Bakersfield, CA 93301 VOICE (661) 326-3941 calibrated, operated and maintained in accordance with manufacturer's instructions, FAX (661) 852-2170 including routine maintenance and service checks at least once per calendar year for operability and running condition." PREVENTION SERVICES FIIIE SAFETY SERVICES · ENVIIIONMIENIAL SERVICES 900 Teoxtun Ave.. Suite 210 You are hereby notified that you have thirty (30) days to either perform or submit Bakersfield, CA 93301 your annual certification to this office. Failure to comply will result in revocation of VOICE (6611 326-3979 FAX (661) 852-2171 your permit to operate your underground storage system. FIRE INVESTIGATION Should you have any questions, please feel free to contact me at 661-326-3190. 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 Sincerely, FAX (661)852-2172 Ralph Huey TRAINING DIVISION Director of Prevention Services 5642 Victor Ave. Bakersfield, CA 93308 VOICE J661) 39%4697 by: ,~ Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/db .ad.~o Products Company Electronic Leak Detector Test Data Sheet Station #: 6356 Date: 6/2/2004 Address: 2301 F ST BAKERSFIELD Test Information 1 2 3 4 5 Pr uet Manufacturer ~ ~ Model ~I~-i ~ Line Bleed Back (mi) ~ ~ Check Valve Holding Pressure (psi) ~-=-- '""=- Test Leak Rate (al/mia) (gpa) ] ~. ( [~/~a. / PASS or FAIL ~A-~ ~'~q~5 Comments: _This letter certifies that the annual leak detector tests were performed at the above referenced facility according to the equipment manufacturers procedures and limitations and the results as listed are to my knowledge true and correct. The mechanical leak detector test pass/fail is determined using a low flow threshold trip rate of 3 gph at 10 PSI. Inspected By: Contractor: Tait Environmental Systems Technician ~--~0~ *-~-~~q. Lie# Signat~ MONITORING SYSTEM CERTIFICATION Fo~ U~e B~ Ail Juriadi~l~'on~ ~thin the ~tate of CalO'ornia ~thori~ Cited: Chapter 6. Z Health and ~fe~ Code; Chapter 16, ~¥iaion 3, Title 23, Cal~fornia Code of ~lah'o~ T~s fo~ must be used to doc~ent tes~g md se~cmg ofmo~to~g eq~pmeht. ~ sep~ate celestion or repo~ must be for each mo~to~g sy~em consol p~el by ~e tec~ci= ~ho peffo~s ~e work. A copy offs lo, must be pro~dedto sys~m o~er/operator. The o~ez/operatoz m~st s~b~t · copy offs fomto ~e loc~ ~gency re~a~g UST systems day~ ofte~t date. A. Gener~ Informa~on Faci~tyName: ~ ARCO PRODUCTS COMPANY { Se~ce Station No. : ~ite Ad.ess: i2301 F ST ~ Cit~ ~ BAKBRSFIBLD ~.~~] ~M~e~odelofMo~to~g~ystem:, ~' ~ ~ ~DateofTes~e~ce: ~ B. ~ventory of Eq~pment Teste~Ce~ed " ~S~aenchSensorit- ~Modet ZO~ ' [~gS~p~renchSensor(s): _ _~del: ~.!~c ~e Le~ ~.e?ct0y ..... j~odel: ] ~ [L~ ~e Le~_Detectif j Model: ~~~renchSensor(s): i Model: ~ff [] ~PipagS~p~renchSenso,~): ~Model: ~~~-- ~ Model: ['~ech~c,~eLe~Oetector. ~ Model: ~o~c~ere~Detectori'Model: ;, Il ~ec~o~c~eLe~Detector 2 Model~- , ~Ove~-levelSensor: ~ Model:_~ {]~Ove~i~-levelSens~ ~'~ii ~'0~, ~ec~ eq~p. t~e.~d model.~ ~ec~on [~ ~e ~ ~ ~O~ef, ~ec~ eq~p. t~e ~dmodel ~ ~ec~on 11 ~spenserlD: } . l - a {[ Dis~nserlD: { ~- y {] ~Disp ,met ~ ont~ent Floats) Md~s) Il ~Disp enser Cont~ent Flo'~s) ~ i ~ [[~ispenserCOnt~entSens~s): ~Model:'  DisE~nserlD: { t~ ' I ~ r [[ DispenserlD: i { ~-- / ~ c Il mDispenser Cont~ent Elo,~,) ~d Chis> · If~e fac~ty cont~s more t~s or ~spensers, copy ~s fo~. Include ~o~a~on for eve~ t~ ~d ~s~enser at ~s fac~ty. co.ct ~ a ~t ~ s~ ~ h~ut of ~m~ eq~at For ~y e~nt c~ of ~~ s~h ~om, D. Resets'of Tes~e~c~g es ~ ~o* ~e~e ~ seneo~ ~s~ed e~lo~ee~ ~o~ of ~econd~ con~en~ no~ ~e~e~e ~ ~e~ p~ope~ operation? / ~/A opera~on~? ~ ~ No* Fo~ press~ed pip~ systems, does ~e t~b~e a~tomaSc~y sh~t do~ F~e plp~ second~ cont~en~ N~A mo~to~ system detects a le~ f~s to operate, or is elec~c~y ~sco~ed? Ifye~; w~c~ ~e~o~s ~ate posiUve shu~do~? (Ch~ak all t~t a~l~~p~rench Sens°rs~n~~~t Sen~ors. Did you co~ positive shu~do~ ~e to le~s md sens~ f~e/~co~e~on? ~.~ No. ' ~ Yes .... o* For t~ systems ~at u~e ~e mo~to~g syst~ ~s ~e p~ t~ ove~ w~ de~ce ~.e. no /A mech~c~ ove~ prevention v~ve ~ p o~s) ~d op era~g prop ed~ If so, at wh~t percent of t~ cap ~city doe s ~e ~ ~e~ .... % ~. Yes* ~No Was ~y momto~g eq~pment replace~ If yes, iden~ spec~c ~ensors, probes, or o~er eq~pment replaced md hst ~e m~ct~er n~e ~d model for ~ replacement p~s ~ Section ~ below. ' ~ Yes* ~o W~shq~dfo~dmside'~ysecon~cont~entsystems Z Product; ~ Water. If yes, desc~be causes ~ Section ~ below. ~Yes ~ No* W~s ~o~to~g system setup renewed to ensue proper set. ds? ~ ~ No~ Is ~ mo~to~g eq~Pment operafion~ per mm~act~er's ~pec~cafions? E. Co~ents: ~ Pa~e 2 of $ o3~e I Site Add. ss: 16356:2301 F ST, BAKERSF~, CA 93301 '~ Date~fl~e_stin_~__r~i_'cin§:-. F. ~-T~Gau~g / S~ Eq~pmene ~Check~s boxFt~ ga~gis used o~y formvento~ conkol. ' ~eck ~s box ffno t~ ga~g or SIR eq~pment is ~st~ed. ~s sec6on mu~ be completed ff~-t~ gau~ eq~pment is ~sed to peffo~ le~ detection momto~. ~ Yes ~ No* Has ~Fut~gbeen~spec~dfor~roperen~d~a~o~clu~gtes~gfor~o~dfa~ts? ~ Yes ~ ~o* Weze ~t~au~pxobes~su~y~spectedf~d~age mdxe~dueb~dup? ~ Yes ~ No* Was acc~acy of system p~oduct level~ea~gs teste~ ~.Yes ~ Ho* Was ace~acyofsystemwate~level~ea~stested? ~ Yes ~ No* Were ~probesfe~st~ed~foped~ ' ~ Yes ~ No* ~efe ~ items on ~e eq~pmem m~act~ef's m~tenmce chec~st completed? * I~ t~ Sec~ H, ~elew, &sclc how ~i w~n ~e ~~s ~ er ~be G. L~e Le~ Detectors ~LD):. ~ Check ~s boxff~s ~e not ~st~ed. ~S ~ No* For eq~mem stoup of ~u~ e~pmem ce~cafio~ was a le~ s~ated N/A (~;~ ~lit~,SSiS) S~ate~e~a~:~.p~!;.~0.~ ~.~.h.~; ~0~ ~.~.h.~ Notes: 1. Req~ed for eq~pmem stoup ce~a~ ~d ~ ce~cafion. 2. U~ess m~dated by loc~ a~cy, ce~ca~on feq~ed o~y for elec~o~c ~ st~p. ses ~ No* Were ~ ~s co~ed opefafion~ ~d acc~ate ~ fe~ato~ feq~emems7 ~ No* Was ~e tes~g app~atus properly c~bf~d7 . . ~ Y~S ~o* For mech~cd ~s, does ~e ~ fes~ct product flow ~R de~c~ ale~ ~Yes ~ No* Fo~ elec~odc ~s, does me t~bme automagc~y shut off ~ my po~on of me mo~to~g system is ~sabled ~ ~ N/A of ~sco~ected? Yes ~ No* For elec~o~c ~s, does ~e t~bEe automa~c~y shut off~ ~y po~on of~e momto~g system m~c~ons -~ N/A of f~s a test? ~s ~ No' ~of elec~o~c ~s, have m accessibte ~g co~ec~ons been ~su~ ~spected? ~..N/A j~ ~' No* Wefe~ items on ~e eq~mem m~act~ef'sm~ten~ce chec~st completed? * I~ t~ Sec~ H, belew, ~sc~e hew ~d.w~ ~se ~~s ~ er ~ be Comments: Page 3 of 3 03~1 .Mo~it~rin~ S~stem Certification UST MOnitoring Site Plan ...... ..... a'~~'~'~, ..... . .......... .' · · · · ' '~ ' ~ · · · ...... ~."I'~ ...... ~ ........ ~ ................. ',.~ . .~- .... Instructions If you already have a diagram that shows all required information, you may include it, rather, than this page, with your Monitoring System Cesi~ication. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular Spaces, sumps, dispenser pans, spill containers, or other secondao, containment areas; mechanical or electr6nic line leak de~ec~ors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. Pa~e / of/ ..... SYSTEM ALARM PRINTER ERROR COMMUNICATIONS SETUP JUN 2,.2004 12:46 PM ............ PORT SETTINGS: LII:DISPENSER 5-6 NONE FOUND TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN RS-2@2 SECURITY CODE : 000000, L12:DISPENSER 7-8 SYSTEM SETUP TRI-STATE (SINGLE FLOAT) JUN 2. 2004 12:46 PM " CATEGORY : DISPENSER PAN RS-232 END OF MESSAGE DISABLED L13:DISPENSER 9-10 SYSTEM UNITS TRI-STATE'(SINGLE FLOAT) 'U.S. CATEGORY : DISPENSER PAN SYSTEM LANGUAGE .ENGLISH SYSTEM DATE/TIME FORMAT MON DD YYYY HH:MM:SS xM .. LI4:DISPENSER 11-12 TRI-STATE (SINGLE FLOAT) ARCO AM-PM CATEGORY : DISPENSER PAN 2301F ST. BAKERSFIELD CA.93301 805-863-0528 LIQUID SENSOR SETUP L15:DISPENSER 13-14 SHIFT TIME I : DISABLED TRI-STATE (SINGLE FLOAT) SHIFT TIME 2': DISABLED SHIFT TIME 3 : DISABLED L 1:92-87 ANNULAR ~ CATEGORY : DISPENSER PAN SHIFT TIME 4 : DISABLED TRI-STATE (SINGLE FLOAT) ' i CATEGORY : ANNULAR SPACE TANK PERIODIC WARNINGS DISABLED i LI6:DISPENSER 15-16 ~ TRI-STATE (SINGLE FLOAT) TANK ANNUAL WARNINGS CATEGORY : DISPENSER PAN DISABLED L 2:92 TURBINE TRI-STATE (SINGLE FLOAT) LINE. PERIODIC WARNINGS DISABLED CATEGORY : STP SUMP LI:NE::ANNUAL WARNINGS DISABLED L 3:87 TURBINE PRINT TC VOLUMES TRI-STATE (SINGLE FLOAT) DISABLED CATEGORY : STP SUMP TEMPCOMPENSATION VALUE"('DEG F ): 60.0 L 4:8? ANNULAR ST~iCKHEIGHT OFFSET TRI-STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE DISABLED DAYLfGHT SAVING TIME ' ENABLED sTaRT DATE APR WEEK 3 SUN L 5:87 TURBINE START TIME TRI-STATE (SINGLE FLOAT) · I ' '1:00 AM CATEGORY : STP SUMP END DATE OCT WEEK 3 SUN END TIME L 9:DISPENSER I-2 · 1:00 AM TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN SYSTEM SECURITY CODE : 000000 LIO:DISPENSER 3-4 TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN OUTPUT RELAY SETUP i OUTPUT RELAY SETUP SOFTWARE REVISION LEVEL R I:PREMIUM ! VERSION 15.01 SOFTWARE~ B4601§-IOO-B TYPE: ~ R B:UNLEADED CREATED - 97 10.23.08.56 STANDARD ' TYPE: ' NORMALLY CLOSED STANDARD NO SOFTWARE MODULE NORMALLY"CLOSED SYSTEM FEATURES: LIQUID SENSOR ALMS PERIODIC IN-TANK RESTS L I:FUEL ALARM LIQUID SENSOR ALMS ANNUAL IN-TANK TESTS L 2:FUEL ALARM ALL:FUEL ALARM L 4:FUEL ALARM ALL:SENSOR OUT ALARM L 9:FUEL ALARM ALL:SHORT ALARM' LIO:FUEL ALARM Ltl:FUEL ALARM LIB:FUEL ALARM LIB:FUEL ALARM , LI4:FUEL ALARM L 15: FUEL ALARM L16:FUEL ALARM ! ALARM HISTORY REPORT R 2:UNLEADED TYPE: i ..... SYSTEM ALARM ..... STANDARD I PRINTER ERROR .~ OUN 2, 2004 12:46 PM NORMALLY CLOSED OUTPUT RELAY SETUP i BATTERY IS OFF i JAN 1, 1996 B:OO. AM I LIQUID SENSOR ALMS R 2:UNLEADED L I:FUEL ALARM ' L B:FUEL ALARM TYPE: STANDARD L 4:FUEL ALARM NORMALLY CLOSED i L 5:FUEL ALARM L 9:FUEL ALARM LIO:FUEL ALARM LIQUID SENSOR ALMS ' Lll:FU£L ALARM LIB:FUEL ALARM ' ALL:FUEL ALARM LIB:FUEL ALARM ALL:SENSOR OUT ALARM L1.4:FUEL ALARM ALL:SHORT ALARM , LI5:FUEL ALARM LI6:FUEL ALARM R B:UNLEADED TYPE: STANDARD NORMALLY CLOSED LIQUID SENSOR ALMS L I:FUEL ALARM L B:FUEL ALARM' OUTPUT RELAY SETUP ALARM HISTORY REPORT~-~..-~:~:~ L 4:FUEL ALARM ...... L 5:FUEL ALARM ...... SENSOR ALARM L 9:FUEL ALARM R 1:PREMIUM L 1:92-87 ANNULAR' LIO:FUEL ALARM TYPE: i ANNULAR SPACE L12:FUEL ALARM NORMALLY CLOSED-~v~~. JUN 3, 2003 1:57 PM LIB:FUEL ALARM LI4:FUEL ALARM .FUEL ALARM L15:FUEL ALARM LIQUID SENSOR ALMS JUN 3, 200~ 1:56 PM LI6:FUEL ALARM ALL:FUEL ALARM ALL:SENSOR OUT ALARM FUEL ALARM ALL:SHORT ALARM OCT 30, 2002 1:04 PM ALARM HISTORY REPORT .ALARM HISTORY REPORT ALARM HISTORY REPORT ..... SENSOR ALARM ..... SENSOR' ALARM L 4:87 ANNULAR i ...... SENSOR ALARM~- .... L 2:92 TURBINE ANNULAR SPACE ~ L 6: STP SUMP FUEL ALARM ~ OTHER SENSORS FUEL ALARM JUN 3, '2003 2:01 PM JUN 3. 2003 1:55 PM FUEL ALARM FUEL ALARM OCT 30, 2002 OOT 30, 2002 12:51 PM FUEL ALARM FUEL ALARM OCT 30, 2002 JUN 10, 2002 B:06 AM ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ " ~ ALARM HISTORY REPORT i ..... _L,_ LT: OTHER SENSORS ' .i SETUP DATA. WARNIN(D APR 21, t999 8:26 PM ALARM H I STORY REPORT ALARM HI STORY REPORT ' SENSOR ALARM. ..... SENSOR ALARM L 5:87 TURBINE L 3: 87 TURB-I NE STP SUMP STP SUMP FUEL ALARM FUEL ALARM JUN 3, 2003 I :54 PM JUN :3, 200:3 1:5:3 PM FUEL ALARM FUEL ALARM OCT 30, 2002 12:51 PM ~ ~ ~ ~ ~ END ~ ~ ~ ~ OCT 30, 2002 12:51 PM FUEL ALARM FUEL ALARM JUN 19, 2002 2:57 PM JUN.lO, 2002 8:06 AM ALARM HISTORY REPORT ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ SENSOR ALARM ..... END ~ ~ ~ ~ ~ L 8: OTHER SENSORS ALARM HISTORY REPORT .i ALARM HISTORY REPORT ALARM HISTORY REPORT ..... SENSOR ALARM ..... SENSOR ALARM ..... - .... SENSOR ALARM L 9:DISPENSER 1-2' LII:DISPENSER 5-6 LIB:DISPENSER 9-10 DISPENSER PAN DISPENSER PAN DISPENSER PAN FUEL ALARM FUEL ALARM FUEL ALARM JUN 3, 2003 1:50 PM JUN 3, 2003 1:49 PM JUN 3, 2003 1:51 PM FUEL ALARM FUEL ALARM FUEL ALARM OCT 30. 2002 12:49 PM OCT 30, 2002 12:'48 PM OCT 30. 2002 12:50pM FUEL ALARM FUEL ALARM FUEL ALARM JUN 10, 2002 8:08 AM JUN 10, 2002 8:08 AM JUN 10, 2002 8:09 AM , ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ END.* ~ x ~. ~ ~ ~ ~ ~ ~ END ~ ~ ~ ALARM H ISTO~Y REPORT ~ ALARM H I STORY REPORT : ALARM HI STORY REPORT ..... SENSOR ALARM ..... SENSOR ALARM ..... SENSOR ALARM LIO:DISPENSER 3-4 LIR:DISPENSER 7-8 LI4:DISPENSER 11-12 DISPENSER PAN DISPENBE~ PAN DISPENSER PAN FUEL ALARM FUEL ~LARM FUEL ALARM JUN S, 2008 1:49 PM JUN ~, 2003 1:48 PM JUN S, 2003 ~:51 PM FUEL ALARM FUEL ALARM FUEL ALARM OCT ~0, 2002 12:49 PM · OCT SO, 2002 12:48 PM OCT ~0, 2002 12:58. PM FUEL ALARM FUEL ALARM FUEL ALARM JUN 1~, 2002 8:08 AM JUN 19, 2002 ~:3~ PM JUN 12, 2002 5:3~ PM ALARM HISTORY REPORT , i ..... SENSOR ALARM ~'IG:DISPENSER 15-1G DISPENSER PAN ~ FUEL ALARM ~ JUN 3, 2003 1:53 PM {, FUEL ALARM ALARM HISTORY REPORT { OCT 30, 2002 12:50 PM ..... SENSOR ALARM FUEL ALARM LI5:DISPENSER 13-14 'JUN 10, 2002 8:09 AM DISPENSER PAN FUEL ALARM JUN 3, 2003 1:52 PM FUEL ALARM OCT 30, 2002 12:50 PM FUEL ALARM JUN 10, 2002 8:09 AM ~ ~ ~' ~ ~ END ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ ARCO AM-PM 2301 F ST. BAKERSFIELD CA. 93301 805-863-0528 i JUN 2, 2004 12:49 PM SYSTEM STATUS REPORT ALL FUNCT I ONE NORMAl. · SWRCB, January 2002 Page L of ~_~ Secondary Containment Testing Report Form This form £~ intended for use by contractors pe.rforming periodic testing of UST ~econdary containment systems. Use the appropriate pages qf this.form to report results for all components tested. The completed form, written test procedures, and printouts from tests (~f applicable}, shouM be provided to the.facility owner/operator for submittal to the local regulatory agency. 1. FAC1LITY INFORMATION ! Facilit~Name. ~c5 ~ ~--~ ['DateofTesting: Facility Address: '2. '"5 0 ! ~ ,r, t y]ff~-~-~ Date Local Agency Was Notinea ofTesting: <~a8 ~_~ " - ' , Name of Local Agency Inspector (if present during t~sting): ~,,Y.-q~x-, · 2. TESTING CONTRACTOR INFORMATION Technician Conductin$ Test: <"-~k~l'~-'~ ~3t~ct~-~ . I Cre~ientials- . ~'/AC-~LB Licensed Contractor --I~, SWRCB LiCensed Tank Tester Manufacturer Trainine Manufacturer Compgnent(s) - Date Training Expires 3. SUMMARY OF TEsT RESULTS Component' Passi Fail Not Repairs :' Not.i [ Repairs Tested Made Component Pass Fait Tested Made c75/ er' [] [] n n D O [] [] [] [] [] D ,, O D O [] , D D [] D [] D [] [] [] D D D [] [] [] [] [] D. [] O · if hydrostatic testing was performed, describe what was done with the Water after completion &tests: CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING. To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements ~WRCB, January 2002 Page ~ of~ f/~ CO t~ t/~ 7 .~:v 9. SPIL~OVE~ILL COPAYMENT BO~S Facility is Not Equipped With Spiii/Oveffiil Con~inment Boxes Spill/Overfill Containment Boxes are Present, but were Not Tested Other (Spec~) Test Method Used: Pressure Vacuum Q Hydrosmtic~ Other (S~c~) Bucket Diameter: ~ { t ~ tl et~ ~t Bucket Depth: . { ~ It / q 1~ Wait time be~een applying sta~ing test: Initial Reading (R,): ~Y O ,t ~ o ~-~ Test End Time: ~: O~~ 2:00 Z:O0 g:O0 Change in Reading (R~-R0: ~ ~ O Pass/Fail Threshold or Criteria: ~~ ~V~ ~ ~ ~ ~ ~ ~. Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) BP West Coast Products LLC 4 Centerpointe Drive La Palina, CA 90623 June 25, 2004 Certified Mail #: 7003 1680 0000 4963 3781 Bakersfield Fire Deaprtment 1715 Chester Avenue, Third Floor Bakersfield, CA 93301 Attention: Inspector Steve Underwood RE: LEAK DETECTOR AND MONITOR CERTIFICATION TEST RESULTS ARCO Facility No: 6356 Facility Address: 2301 "F" Street Bakersfield, CA Test Date: June 2, 2004 This letter is to notify you that at the above facilities the Leak Detector and Monitor Certification Test passed the systems test as noted in the attached results. ARCO is committed to the compliance of all environmental laws that govern the safe operations of our facilities. Feel free to call me at (714) 670-5321. Sincerely, Mike Wilson Environmental Compliance Specialist Attachment 05-18-04 09:55am From-TAIT ENVlRO~:~NTAL 714-560-8237 '~, T-466 P.01/01 F-055 ;p 25 2002 10:52 5KSFLD FIRE PREVF_.HTIOH CITY OF BAKE~ELD OFFICE OF'ENVIRONMENTAL SERVICES_ 1715 Chester Ave., Bakersfield, CA (661) 326-397~ APPLICATION TO PEI~FORM FUEL MONITORING CERTIFIC~A..,.TION · ,, .' . ;~.; . ·; ~. .. · ....: ~ ..... OpEI~TOR$ NA1V~~f---~ OWNEaS NAMe,. .i.:.'~T ....... ' ' ~,.".... DO~S I~AC~I/T¥ HAVE DISPENS]ER.PANS? X~S .~'.: ........ " NO.._._ TA~ # VOL .UM~ NAME & PHONE NUlv~ OF CONTACT PERSON~.~x--~- p,~,~ .f~o~of~,~ ?/ APPROVED BY ............. .D.. ATE B!ON~ .TUI~ OF APPI./CANT ARCO AM-PM 2301F ST. BAKERSFIELD CA.93301 805-@63-0528 MAY 11, 2004 3:41 PM SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL INVENTORY REPORT NO ACTIVE TANKS ARCO AM-PM 2301F ST. BAKERSFIELD 0A.93301 805-863-0528 MAY 11, 2004 3:41 PM SYSTEM STATUS REPI ALL FUNCTIONS NORMAL INVENTORY REPORT NO ACTIVE TANKS CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 Section 2: Underground Storage Tanks Program [~1 Routine [~rCombined I~ Joint Agency 1~1 Multi-Agency [~l Complaint [21 Re-inspection Type of Tank ~DIA} ff Number of Tanks Type of Monitoring ~x~, I_, .~ Type of Piping OPERATION C V COMMENTS Proper tank data on file X ~'~, CJt.-~ lt~Z-.~"~O'~(5~ Proper owner/operator data on tilc ~ Permit t~es current ~ Certification of Financial Responsibility ~ Monitoring record adequate and cu~ent ~ Maintenance records adequate and current ~ Failure to co~ect prior UST violations ~ Has there been an unauthorized release? Yes No ~ Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS sPcc available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? ~!N~ ~ Bakersfield Fire Dept. , UNI'FIED PROGRAM ECTION CHECKLIST Enironmental Services ana nvento rogram Bakersfield, CA 93301 Tel: (661)326-3979 Section 1: Business Plan and Invento~ Program ~ Routine ~Combined ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection ~ ~ (C:Compliance~ ~~TION .-- ~v=wo~t,o~ ~ - ...... COMMENTS [ ~ ~ BUSINESS PLAN CONTACT INFORMATION ACCURATE ~ ~ VISIBLE ADDRESS  ~ CORRECT OCCUPANCY ~ ~ VERIFICATION OF QUANTITIES  ~ VERIFICATION OF LOCATION  ~ PROPER SEGREGATION OF MATERIAL ~ ~ VeRIFICAT~ON OF MSDS AVA~a,UWe ~ ~ VERIFiCATiON OF HAT MAT TRAiNiNG ~ ,~. VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ ~ EMERGENCY PROCEDURES ADEQUATE ~ ~ CONTAINERS PROPERLY LABELED ~ ~ HOUSEKEEPING [ ~ ~ SITE DIAGRAM ADEQUATE & ON HAND ANY H~ARDOUS WASTE ON SITE?: ~ YES ~No EXP~IN: QUESTIO~NSPECTION? PLEASE CALL us AT (661)326-3979 White - Environmental Services Yellow ~ Station Copy Pink - Business Copy 3:3 Pos~ge $ Certified Fee Postmark I r'~ Return Reciept Fee j r--~ (Endersement Required) Here /l:~ Restricted Delivery Fee (Endorsement Required) I I'M Total Postage~'~-- Sent To ir,- 's,s~-~c,~/,-t:-~o: AM/PM orPOBoxNo. 2301 F Street ~ '~i6,;'~i~;~'t'~ Bakersfield, CA 93301 · Complete items 1, 2, and 3. Also complete item 4 ii Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. ~ of Delivery · Attach this card to the back of the mailpiece, or on the front if space permits. D. is delivery address different from item 1 ? 1. Article Addressed to: if YES, enter delivery address below: [] No AM/PM 2301 F Street 3. Service Type Bakersfield, CA 93301 ~Certified Mail [] Express Mail ~.. [] Registered [] Return Receipt for Merchandise ~ [] insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 2. Article Number (-I'ransferfromservicelabeO ?DM3 i~i~6rl MDg4 71=5; PS Form 381 1, August 2001 Domestic Return Receipt 102595-02-M~15401 Sender: Please print your name, address, and ZIP+4 in this box ° Bakersfield Fire Department Prevention Services 715 Chester Aver~LTe, Suite 300 Bakersfield, CA 93301 D December 12, 2003 CERTIFIED MAIL AM/PM 2301 F Street Bakersfield, CA 93301 RE: Propane Exchange Program FIRE CHIEF RON F~ZE Dear Owner/Operator: ADMINISTRATIVE SERVICES 2101 ~H'Street The purpose of this letter, is to advise you of current code requirements for Bakersfield. CA 93301 propane exchange systems, such as "Blue Rhino" or "Amerigas." This does not VOICE (661) 326-3941 FAX (661) 395-1349 apply to large propane tanks, only propane exchange systems. SUPPRESSION2101 ',' StreetSERVICES Over the past two years this office has noted a dramatic increase in the propane Bakersfield, CA 93301 exchange system in the city of Bakersfield. It has also been noted, with great VOICE (661) 326-3941 FAX(661)395-1349 concern, that many of these installations are a clear violation of the UFC (Uniform Fire Code) and represent a danger to public health and safety. PREVENTION SERVICES FIRE SAFETY SERVICES · ENVIRONMEI~L SERVICES 1715 ChesterAve. Accordingly, procedures for storage of propane cylinders awaiting use, resale or Bakersfield, CA 93301 VOICE (661)326-3979 exchange, have been adopted through BMC (Bakersfield Municipal Code) and FAx (661) 326-0576 adoption of the 2001 UFC. The procedures are as follows: PUBLIC EDUCATION 1715 ChesterAve. Storage outside of building for propane cylinders (1,000 pounds Bakersfield, CA 93301 VOICE (661) 326-3696 or less) awaiting use, re-sale, or part of a cylinder exchange point FAX (661) 326-0576 shall be located at least 10 feet from any doorways or openings in FIRE INVESTIGATION a building frequented by the public, or property line that can be 1715 Chester Ave. built upon, and 20 feet from any automotive service station fuel Bakersfield, CA 93301 VOICE (661)3;26-3951 dispenser. (Note distance from doorways increases when FAX (661)326-0576 cylinders are over 1,000 pounds cumulatively.) TRAINING DIVISION ~n2 ~nctor^ve. Cylinders in storage shall be located in a manner which Bakersfield, CA 93308 VOICE (661) 399-4697 minimizes exposure to excessive temperature rise, physical FAX (661)399-5763 damage or tampering (Section 8212, California Fire Code, 2001 Edition). When exposed to probable vehicular damage due to proximity to alleys, driveways or parking areas, protective crash posts will be required as follows (Section 8001.11.3 and 8210, California Fire Code, 2001 Edition): 1) Constructed of steel, not less than 4 inches in diameter, and concrete filled. 2) Spaced not more than 4 feet between posts, on center. LettOTo: Owner/Operators of Propane Exchan rns Re: Propane Exchange Program Dated: December 12, 2003 Page 2 of 2 3) Set not less than 3 feet deep in a concrete footing of not less than a 15 inch diameter. 4) Set with the top of the posts not less than 3 feet aboveground. 5) Located not less than 5 feet from the cylinder storage area. Exceptions: Cylinders storage areas located on a sidewalk which is elevated not less than 6 inches above the alley, driveway or parking area, with not less than 10 feet of separation between the curb and the cylinder storage area. "No Smoking" signs shall be posted and clearly visible (Section 8208, California Fire Code, 2001 Edition). Resale and exchange facilities must be under permit to verify compliance. All existing facilities will be checked and when compliance is confirmed, a permit will be issued. All new propane exchange systems must be permitted prior to installation. You will have 90 days (March 4, 2004) to comply with the procedures outlined. Once compliance has been confirmed, each exchange system will be issued a permit, which will be placed on the exchange system. Sites not conforming to current code, will be "red tagged" and must be taken out of service immediately. You should contact your Blue Rhino representative, Mr. Taylor Noland, or your local Amerigas representative. They are aware of current code requirements. If you do not have a propane exchange system, please disregard this letter. Should you have any questions, please feel free to contact me at (661) 326-3190. Sincerely, Steve Underwood Fire Inspector/Petroleum/ Environmental Code Enforcement Officer · - CITY OF BAKI~SFIELD , OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 INSPECTION RECORD POST CARD AT JOB SITE INSTRUCTIONS: Please call tbr an inspector only when each group of inspections Mth the same number a~ ready, /hey will mn in consecutive o~er beginning with number I. DO NOT cover work tbr any numbe~d group until all items in that group a~ signed offby the Pemitting Authority. Following these instructions will reduce the number of mqui~d inspection visits and the~lb~ p~vent ~essment of additional fees. TANKS AND BACKFILL Backfill Spark Test Ceaification or M~ufactu~ Method Cathodic Protection of Tank(s) PIPING SYSTEM Piping & Raceway w/Collection Sump ' Co.sion Proration of Piping, Joints, Fill El~tfical Isolation of Piping From T~k(s) Cathodic Proration System-Piping Dis~nser P~ SECONDARY CO~AINME~, OVE~ILL PROTE~ION, LEAK DETE~ION Liner Installation - Tank(s) Liner Installation - Piping Vault With Product Compatible Sealer Level Gauges or Sensor, Float Vent Valv~ Product Compatible Fill ~ox(es) Product Line Leak Detectoffs) Leak Detectoffs) for Annual Space-D,W. lank(s) Monitoring Well(s)/Sum~s) - H20 Test Leak Detection Device(s) for Vadose/Gmundwater FINAL Monitoring Wells, Caps & Locks Fill Box Lock Monitohng Requirements Type. Authorization tbr Fuel Drop I CO.T CT PERMIT APPLICATION T NSTRUCT/MODIFY Bakersfield Fire Dept. UNDERGROUND STORAGE TANK Rnvironmentat Service 1715 Chester Ave ,,RM,T,O. [~.-O0~l~ [ Bakersfield, CA 93301 Tel: (661)326-3979 TYPE OF APPLICATION (CHECK) ~ NEW FACILITY I~ MODIFICATION OF FACILITY ~ NEW TANK INSTAL~TION AT EXISTING FACILITY PROPOSED COMPLETION DATE FACILI~ ADDRESS [CiTY ZIP CODE TYPE OF BUSINESS ~ ~ ' ~ APN~ [ TANK O~ER - ~ (~ - PHONE NO I ADDRESS , ~ - ~ C~ CON/~CTOR I ~ ~ ( { ~ LICENSE NO. A~DRESS ~ i ~ ~ CI~ ~ , ZIP I BRIEFLY DESCRIBE THE ~RK TO BE ~NE NO. OF TANKS ~' ~E THEY ~ MOTOR FUEL SPILL PREVENTION CONTROL A~OUNTER M~SURES P~N ON FILE TO BE INSTALLED ~S ~ NO ~ES ~ NO THIS SECTION IS FOR MOTOR FUEL TANK NO. VOLUME UNLEADED REGU~R PREMIUM DIESEL AVIATION THIS SECTION IS FOR NON MOTOR FUEL STORAGE TANKS TANK NO. VOLUME CHEMICAL STORED (NO BRAND NAME) CAS NO (IF KNOWN) CHEMICAL PREVIOUSLY STORED FOR OFFICIAL USE ONLY The applicant has received, understands, and will comply with the attached conditions of the permit and an~othe state, local and federal regulations. This form has been complet~er penalty ~ perj~vu/ff~,,jand/~l.l~kO ]d[e.d)'~st of my know~ j~o_.~c_~ledge, is trqe and correct. / JX ~ ~ ~PPROVED BY: v v APPLICANT NAME (PRINT) ~ APPLICANT SlGNATLll~,~ THIS APPLICATION BECOMES A PERMIT WHEN APPROVED ~ CITY OF BAKERSFIELD IVlAIL TO: CALIFORNIA PREMISES MUST CONFORM TO ZONING. CITY OF BAKERSFIELD BLqLDING, FIRE AND HEALTH CODES. P.O. BOX 2057 CHANGE OF NEW BAKERSFIELD, CA 93303 OWNERSHIP [] BUSINESS [] CHANGE OF ADDRESS [] APPLICATION FOR BUSINESS TAX CERTIFICATE PURSUANT TO ORDINANCES OF THE CITY OF BAKERSFIELD PLEASE TYPE OR PRINT LEGIBLY IN INK (Separate Certificate Required for Each Locafion~ STREET CITY ~ ST ZIP · ' - STREET CITY ' ' ST ZIP KINDOF BUSINESS OR PROFESSION ( ~t \ '~ "CCC., ~-Q C TELEPHONE~,~C) - NAMES AND ADDRESSES Of ALL OWNERS/CORPORATIONS LIST OFFICERS- INCLUDE TITLES NAME HOME ADDRESS TELEPHONE / STREET CITY [ ST ZIP STREET CITY ST ZIP STREET CiTY ST ZIP TYPE OF ORGANIZATION: PAR'INERSHIP [-I CORPORATION [~ FEDERAL EMPLOYER IDENTIFICATION NUMBER INDIVIDUAL [] Name SSN I claim exemption from the Business License Tax for the organization or individual named above since it is [] Tax Exempt under Internal Revenue Code Section 501(C)(3) or under State of California Revenue & Taxation Code Section 23701 or; [] Considered a passive investment in the rental of Real Prop~ty under Internal Revenue Code Section 469. I understand I may be required to provide proof of continued exemption from the Business License Tax upon request. DATE COMMENCED BUSINESS IN BAKERSFIELD CALIFORNIA STATE CONTRACTOR'S LICENSE NUMBER, IF ANY SALES TAX PERMIT NO. ~(~0.~Rr.__0R~.~AL ) ALPHA NUMERIC SUB Sales or use tax may apply to your business activities. You may seek written advice regarding the application of tax to your particular business by writing to thc nearest State Board of Equalization office. For general information, please call the Board of Equalization at 1-800-400-'11 IS ESTIMATED ANNUAL GROSS RECEIPTS IN BAKERSFIELD / I SWEAR UNDER PENALTY OF PERJURY THAT TIlE FOREGOING IS TRUE AND CORRECT. Signature Owmr, Pmr, Ag~n.~t or Officer of Col~omtion License [ Code Stat. lh'Y OF BAKERSFIEL NO. STATEMENT OF COMPLIANCE FOR Name of Business I understand that having a Business License/Tax Certificate Application from the City of Bakersfield does not authorize me to conduct a business and I must fulfill all obligations for obtaining permits or approval to establish a business. The business premises must conform to zoning, sign, building, fire and health codes. I will. expeditiously comply with the requirements to obtain the permits that are applicable for the type of business covered by the Business License/ Tax Certificate Application before starting business. I have accurately disclosed the kind of business or profession and the location on the License/Certificate Application. The Business License Section must be notified in writing if there are changes in any of the following: Business Location ' Mail to: City of Bakersfield Mailing Address P.O. Box 2057 Ownership Bakersfield, CA 93303 Wastewater Discharge: In accordance with Federal and State mandated regulations, the City of Bakersfield ~.~de.'.~ed a Pretreatment Program to regulate industrial wastewater discharges within the City's sewer service area in order to protect the public health and the environment. Any wastewater that is discharged to the CitY's sewer system shall meet all the requirements in the Bakersfield Municipal Code, Chapter 14.12. Contact City Wastewater at 326-3249 Print Name [.~c:~ \ -~ ~-'~ .~ ~.~,~. L, Title .~ ~ ~ ~ ~ ~'5 ~ ~ signatUr _ -- Date //~/~ - ~ ~ The following are agencies most commonly involved in reviewing new business in Bakersfield. They will be glad to review your plans with you. - · City Wastewater 326-3249 County Environmental Health 861-3636 Utilities: City Environmental Services 326-3979 County Weights & Measures 861-2418 So. Cal. Gas (800) 752-2820 Alcoholic Beverage Control 395-2731 Franchise Tax Board 852-5711 P.G.E. (800) 743-5000 Air Pollution Control Board 861-3682 State Board of Equilization 395-2880 Pac. Telephone (800) 244-4515 California water service 396-2400 (Sales Tax) Original: B/L File Yellow: Applicant PARAGON PRINTING ~r: ~DAVI$ T~pe: OC Draft: 'gAte: ]~/2~/~3 e~ ~e~ip~ no: 53393' OL .O~.C l, IC - ~ Lie. 'Te~de~'det~i 1 ro~l ~ndered Trans date; ~i/.)7,/8~ MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6. 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form .to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: ARCO PRODUCTS COMPANY Service Station No.: 6356 Site Address: 2301 "F" Street City: Bakersfield Zip: 93301 Facility Contact Person: ~x.~ ~ ~ ,b~ Contact Phone No.: -~ t t( ~ ~'~0 Make/Model of Monitoring System: ~"C(~ '-~':J~)/[24~ - Q~-U Date of Testing/Service: B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced: Tank ID: '~t~'/ ] TanklD: ~7y -lin-Tank Gauging Probe: Model: ] [3In-Tank Gauging Probe: Model: ~ .~anular Space or Vault Sensor: Model: ~[ Oc~ ~ J~Annular Space or Vault Sensor Model: ~rO9 Eltaiping Sump/Trench Sensor (s): Model:" ZD~ I ,[~iping Sump/Trench Sensor (s): Model: I-1Fill Sump Sensor (s): Model: C1Fill Sump Sensor (s): Model: [3Mechanical Line Leak Detector. Model: F1Mechanical Line Leak Detector. Model: ,l~Electronic Line Leak Detector Model: O_.,~2~r' l-lElectronic Line Leak Detector Model: [3Tank Overfill/High-level Sensor: Model: F1Tank Overfill/High-level Sensor: Model: [3Other, Specify equip, type and model in Section E on Page 2 [~Other, Specify equip, type and model in Section E on Page 2 Tank ID: (-4 t/ Tank ID: I-lin-Tank Gauging Probe: Model: l-lin-Tank Gauging Probe: Model: p Annular Space or Vault Sensor: Model: t(O~ V1Annular Space or Vault Sensor Model: iping Sump/Trench Sensor (s): Model: Z.o~ [-IPiping Sump/Trench Sensor (s): Model: FIFill Sump Sensor (s): Model: F1Fill Sump Sensor (s): Model: [3Mechanical Line Leak Detector. Model: [3Mechanical Line Leak Detector. Model: ;[i~Electxonic Line Leak Detector Model: O~'~U [3Electronic Line Leak Detector Model: [3Tank Overfill/High-level Sensor: Model: F1Tank Overfill/High-level Sensor: Model: I-1Other, Specify equip, type and model in Section E on Page 2 [3Other, Specify equip, type and model in Section E on Page 2 Dispenser ID: i - ?--- Dispenser ID: '~ - 9' [5~;Dispenser Containment Sensors: Model: 2.o~ I~Dispenser Containment Sensor(s): Model: I~ Shear Valve(s). [~Shear Valve(s). F1Dispenser Containment Float(s) and Chain(s) U1Dispenser Containment Float(s) and Chain(s) Dispenser/D: ~' -g ~ '7 -~ Dispenser ID: ~-I0 f!-t l~[Dispenser Containment Sensors: Model: 2tgt5 I~Dispenser Containment Sensor(s): ! Model:  Shear Valve(s). I~'Shear Valve(s). Dispenser Containment Float(~) and Chain(s) FlDispenser Containment Float(s) and Chain(s) Dispenser ID: t 3 - t t/ Dispenser ID: / ar- ~ / ~ [~],Dispenser Containment Sensors: Model: ~ [~Dispenser Containment Sensor(s): Model: ~8hear Valve(s). [~ Shear Valve(s). FIDispenser Containment Float(s) and Chain(s) [2]Dispenser Containment Float(s) and Chain(s) *If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at this facility. C. Certification ~ I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, ! have also attached a copy of the report; (check all that apply): [~ System set-up ~i Alarm history re?egp_r.L~ Technician Name (Print): ~X:~b~.et ~:~.~z~-(-~. Signature: ~ Certification No.: OC~ O~"~C30 c.{ 2~- License No.: 588 098 Testing Company Name: TAIT ENVIRONM~ENTAL SYSTEMS Phone No.: (714) 560-8222 Page 1 of 3 03/01 SRe Add~ess: SS #6356, 2301 "F" Street, Bakersfield Date of Testing/Servicing: ~- ~ bO ~ .D. Results of Testing/Servicing Software Version Installed: [ ~, o ( Complete he following checklist: ~ Yes [] No* Is the audible alarm operational? ~ Yes [] No* Is the visual alarm operational? i~'Yes [] No* Were all sensors visually inspected, functionally tested, and confu'med operational? [~Yes [] No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? [] Yes [] No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) ~ N/A operational? l~es [] No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment [] N/A monitoring system detects a leak, fails to operale, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) [~.Sump/Trench Sensors;,~..']_Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and senSor failure/disconnection? ~lYes; [] No. [] Yes [] No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no ~ N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? ????% [] Yes* ~' No Was any monitoring equipment replaced? If yes, identify specific senSors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. [] Yes* {~,No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) [] Product; [] Water. if yes, describe causes in Section E, below. ~ Yes [] No* Was monitoring system set-up reviewed to ensure proper settings? l~[--Yes [] No* Is all monitoring equipment operational per manufacturer's specifications? * In Section E below, describe how and when these deficiencies were or will be corrected. E. Comments: Page 2 of 3 03/01 Site Address: SS #6356, 2301 "F" Street, Bakersfield Date of Testing/Servicing: .(o-~ ''~ '~ F. In-Tank Gauging / SIR Equipment: [] Check this box if tank gauging is used only for inventory control. /gT.~heck this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: [] Yes [] No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? [] Yes [] No* Were all tank gauging probes visually inspected for damage and residue buildup? [] Yes [] No* Was accuracy of system product level readings tested? [] Yes [] No* Was accuracy of system water level readings tested? [] Yes [] No* Were all probes reinstalled properly? [] Yes [] No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will bi corrected. G. Line Leak Detectors (LLD): [] Check this box ifLLDs are not installed. Complete the following checklist: ~L.Y'es [] No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? [] N/A (Check all that apply) Simulated leak rate: [i~3 g.p.h.~; [] 0.1 g.p.h.2; [] 0.2 g.p.h.2 Notes: 1. Required for equipment start-up ce--rtification and annual certification. 2. Unless mandated by local agency, certification required only for electronic LLD start-up. ,4~Yes [] No* Were all LLDs confu-med operational and accurate within regulatory requirements? 4~Yes [] No* Was the testing apparatus properly calibrated? [] Yes [] No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? d~ N/A ~ Yes [] No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? [] N/A ~Yes [] No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled [] N/A or disconnected? ~ Yes [] No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions [] N/A or fails a test?  Yes No* For electronic have all accessible connections been LLDs, wiring visually inspected? [] N/A ~_¥es [] No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 o3tot 'Site Address: SS #6356, 2301 "F" Street, Bakersfield Date of Testing/Servicing: Monitoring System Certification UST Monitoring Site Plan Date ~p was &a~: g /~ /° ~. Instructions If you already have a diagram that shows all required information, you may include it, rather than this page, with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes (if used for leak detection). In the space prov/ded, note the date this Site Plan was prepared. Page [ of{ OS/O0 OUTPUT REI.~"~ TRI-STATE (SINGLE FLOAT) I ; CATEGORY : ANNULARiSPACE ~ I;PRE~IuH SYSTEM UNITS ~ ' TYPE: · STANDARD U,S. NORMALLY CLOSED SYSTEM LANGU~GE L 2:92 TURBINE ENGLISH ; TRI-STATE (SINGLE FLOAT) '...~YJ~TEM..DATE2 ~.H£ FORI~T'~'--'~. CATEGORY : STP SUMP LIQUID SENSOR ALMS MON DD YYYY ~':MM:SS xM L I:FUEL ALARM ARCO.AM-PM T L 3:87 TURBINE L 2:FUEL ALARM -' ' .... L 4:FUEL 2301F ST, TRI-STATE (SINGLE FLOAT) L 9:FUEL ALARM BAKERSFIELD .:A.93301 CATEGORY : STP SUMP LID:FUEL ALARM B05-863-0528 LII:FUEL ALARM LI2:FUEL ALARM ~HIFT TIME I : DISABLED L 4:87 ANNULAR L13:FUEL ALARM SHIFT TIME 2 : DISABLED TRI-STATE (SINGLE FLOAT) L14:FUEL ALARM SHIFT TIME 3 : DISABLED CATEGORY : ANNULAR'SPACE L15:FUEL ALARM SHIFT TIME 4 : DISABLED LIA:FUEL ALARM TANK PERIO~I( WARNINGS i R 2:UNLEADED DISABL£D L 5:87 TURBINE TYPE: TANK ANNUAL ARNINQS TRI-8TATE (SINGLE FLOAT) STANDARD . DISABLED CATEGORY : STP SUMP NORPI~LLY CLOSED ~ LINE PERIODI IA%RNINGS ~ DISABLED ~ LINE ANNUAL ARNINC, S i L 9:DISPENSER 1-2 '~ LIQUID SEI~30R ALMS · DISABLED TRI-STATE (SINGLE FLOAT) L 1:FUEL ALARM ~: C~TEGORY : DISPENSER PAN. L 3:FUEL ALARM PRINT TC VOl ME8 "' ---. L 4:FUEL ALARM DISABLED I ' _ ................ =! ; L 5:FUEL ALARM TEMP COMPENS~TION .... ~: -"' L 9:FU£L ALARM .... LIO:DISPENSER 3-4 LID:FUEL ALARM VALUE (DEG F ):' 60.0 .= TRI-STATE (SINGLE FLOAT) LII:FUEL ALARM STICK HEIGHT OF~SF;T CATEGORY : DISPENSER PAN L12:FUEL DISABLED ~ LI3:FUEL ALARM DAYLIGHT SAV NG'TIME ~' L14:FUEL ALARM ENABLED LIS:FUEL ALARM ~TRRT D~TE LII:DISPENSER 5-6 L16:FUEL ALARM APR WEEK 3 ~UN TRI-STATE (SINGLE FLOAT) START TIME ~ CATEGORY : DISPENSER PAN ~ R 3:UNLEADED l:O0 AM , TYPE: ° END DATE ~ ' STAND~RD OCT WEEK 3 UN i NORMALLY CLOSED END TIME ' L12:DISPENSER 7-~ i 1:00 AM ! TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN LIQUID SENSOR ALMS iTY : ' L I:FUEL SYSTEM ~ECUR. ~ :· L S:FUEL ALARM CODE : O000O ~ " L 4;FUEL ALUM ; LI3:DISPEI%gER 9-10: i L 5:FUEL ALARM i TRI-~-~rATE (~INGLE FLOAT) i: L 9:FUEL ALARM CATEGORY : DISPENSER PAN :' LIO:FLIEL ~, : L12:FUEL ALAPJ"J LI3:FUEL AI..~RM L14:DISPENSER 11-12 LI4:FU£L ALARM TRI-STATE (SINOLE FLOAT) LIS:FUEL ~L.~H CATEGORY.,.~ ~S~ENB~ PAN L!6:FUEL COMMUNICATIONS SETUP '~' ~ · TRI-STAT£ (S1NGLE:,LO~'. ~ATEGORY : ~BPE.,NFpER PORT SETTINGS: ~.. J,~©NE FOUND LIA~5:SPEt.~SER ~'5:-1& CODE : OOOOOO C~TEGOR¥ : DIS~ENSE~: p~N' END 0 MESSAGE : S-O. FTwaR£t~ :34~ O15--100-B DIaPENSER P~N CREATED - 97, 0.213.0B.56 "FUEL ALARM 8YBTEM PEATU L 1:92-87 ~NNUL~R PERIODIc I 'TUNE TEAT8 , ~NN~ SPACE ~NNU~L IN-' 4k TESTS ~ FUEL , JUN ....... SE N~OF: ~L~R~ ..... PAN LI 5:DIBPEN~ER 1,3-14 JUN 3, 2[m03 I :48 PM FUEL A~M ~ I JUN 3. 2008 1:62 PR ~ L I :92-87 ANNULAR ANNULAR 8PACE ~-r M-1 :DIBPEN~ ER ~-6 '1 ..... ~ENBOR ALA~ ..... F~EL ALAR~ .... DISPENSER P~N : JUN 8, 200 :49 PM FUEL ALARM JUN ~, 2008 I :5~ P~ ..... 8EN~OR ~RRM ..... L 4:87 ANNULAR ANNULAR 8PACE "., FUEL ALARM 8UN ~, 20~ '2:01 PM DISPENSER Pa~ i L g:8? TURBINE FUEL ALA~" '[' .1 ,~. STP SUMP ..... 7~ JUN 8, ~003 1:53 PM ARCO AM-PM BAKERSFIELD CA. 93801 8Q5-868-0528 L 9 :DISPENBE~ / 8E~O~ ALARM ..... DISPE~ER PAN L 5:87 TURBINE FUEL ~M STP 8~IP JUN OG t:54 PM ~LL FUNC'T~ON~ D I~PBr.~gE~ P~N FIJE[. ~L~Rp~ L 2:92 TURBINE " JUN s~ ~_u. . ~ARCO Products Company Electronic Leak Detector Test Data Sheet Station # 6356 Date ~ - '~'- 20 o'~ Address 2301 "F" Street,Bakersfield Test Information 1 2 3 4 5 Product ~ ~:~ / Manufacturer ~ ~ Model [~-J~)~'"- ~T Line Bleed Back (mi) ~ ~ - Check Valve Holding Press~e ~si) ~ Test Le~ Rate (mVmin)(~h) {~~} ~' ~~] nss or Co~ents: This letter certifies that the annual leak detector tests were performed at the above referenced facility according to the equipment manufacturers procedures and limitations and the results as listed are to my knowledge tree and correct. The mechanical leak detector test pass/fail is determined using a low flow threshold trip rate of 3 gph at 10 PSI. Inspected By: Contractor TAIT ENVIRONMENTAL SYSTEMS Technician ~OO_.~ ~Q~ Lic# 7 2~'~ ~ Signatur~ J Revision 5/01 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 PERMIT APPLICATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK TYPE OF APPLICATION (CHECK) '~' [ ]NEW FACILITY [~MODIFICATION OF FACILITY [ ]NEW TANK INSTALLATION AT EXISTING FACILITY STARTING DATE PROPOSED COMPLETION DATE FACILITY NAME 0k~Co ,~ ~' !~ EXISTING FACILITY PERMIT NO. FACILITY ADDRESS ~,e~O~ ~ ~~ CITY ~c ~ ~E~ ZIP CODE TYPE OF BUSINESS ~ ~ ~1~ ~,~ APNg TANKO~ER ~ ~_~ ~a~ ~o~X~. L~ PHONENO.~~ ADDRESS~ ~~ ~ ~,o~ CItY L~ ~~ ZIPCODE ~R~ CONT~OR . ~ ~ CA LICENSE NO. ~ t 4 ~% ~ ADD~SS~I ~a~ ~O~4~ ~ CITY ~o~a~ ZIPCODE ~O~t PHONE NO.~I ~- ~ ~- O ~ ~ ~ BA~RSFIELD C~ BUSINESS LICENSE NO. WO~ANCOMPNO.~DO~'~-~ INS~ER ~ ~ BR1EFLY DESCRIBE THE WO~ TO BE DONE ..~ O,~~E ~p~a~ SECTION FOR MOTOR FUEL TANK NO. VOLUME UNLEADED REGULAR PREMIUM DIESEL AVIATION SECTION FOR NON MOTOR FUEL STORAGE TANKS TANK NO. VOLUME CHEMICAL STORED CAS NO. CHEMICAL PREVIOUSLY STORED (NO BRAND NAME) (IF KNOWN) FOR OFFICIAL USE ONLY APPLICATION DATE FACILITY NO. NO. OF TANKS FEES $ I THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATFACHEO CONDITIONS OF THIS PERMIT AND ANY OTHER STATE, LOCAL AND FEDERAL REGULATIONS. THIS FO'~ HAS B~EN~OMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEDE, IS ' APPROVED BY~ .APPLICANT NAME (PRINT) APPLICANT SIGNATURE THIS APPLICATION BECOMES A PE~IT ~E-N APPROVED .... ~ EQUIPMENT LIST ~ ~_ STAGE I VAPOR RECOVERY & FILL DETAIL (GASOLINE) O~ICE OF ENVIRONME~ SE~IC~: and ~or cons~ctlon and/or ~stallation thegn, 2I VERFILL A~RM [T.~ 5 TYPICAL TURBINE ELEVATION ~T.~ State Water Resources Control Board Division of Water Quality Gray Davis Winston H. Hickox 1001 I Street · Sacramento, California 95814 · (916) 341-5752 Governor Secretary for Mailing Address: P.O. Box 2231 · Sacramento, California · 95812 Environmental FAX (916) 341-5808 ° Intemet Address: http://www.swrcb.ca.gov Protection · The energy challenge facing California is real. Every Californian needs to take immediate action to reduce energy consumption. For a list of simple ways you can reduce demand and cut your energy costs, see our website at http.'//www, swrcb, ca. gov. ,ID[ j ? 2003 CERTIFIED MAIL 7002 0510 0000 0025 9834 Mr. Ryan N. Rietzel Environmental ComPliance & ASsitance BP West Coast Products LLC/ARC P. O. Box 6038 Artes~a, CA -9~)702 .......... APPROVAL OF REQUEST FOR RECONSIDERATION OF ENHANCED LEAK DETECTION (ELD) TESTING: AM/PM MINI MARKET #6356, 2301 F STREET, BAKERSFIELD, CA Dear Ms. Rietzel: This letter is in response to yoUr June. 10, 2003 Request for Reconsideration of the requirement to perfoff-h'ELD testing: We' have reviewed your request and the supporting documents you provided, and we have conSulted With the local permitting agency. As a result, we have determined that your underground storage tank (UST) facility is not subject to the ELD testing requirement. Based on the enclosed information, your request has been approved for the reason(s) indicated beloW. [~, UST system(s) is not within 1,000 feet of a public drinking water well. If you have any questions, please contact Mr.. Ahmad Kashkoli at (916) 341-5855. Sincerely, · Haven, Manager Underground Storage Tank Program cc: Mr. Howard Wines City of Bakersfield Fire Department '1715 Chester Avenue, Third FlOor Bakersfield, CA 93301 California Environmental Protection Agency Recycled Paper From: "Howard Wines" <Hwines@ci.bakersfield.ca.us> To: <kashkola@cwp.swrcb.ca.gov> Date: 7/7/03 10:47AM Subject: Re: Request for Reconsideration of ELD Testing I can confirm that Barrenda Mesa Water Dist. business office is °n"F St., a couple blocks south of the AM/PM at 2301 F St. Cai Water has well #126 in the area, but it's more than 1000' awav. JUM 18 2003 8: 10 BKSFd~ FIR~E PREVEHTIOM (SS1)852-21'71~ CITY OF BAKERSFIELD OFFICE OF ENVIRONM. ENTAI. SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 PERMIT APPLICATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK TYPE, OF ~PPLICATION (CHECK} [ ]NEW FACILITY - f ]MODIFICATION OF FACILITY [ ]NEW TANK INSTALLATION AT EXISTING FACILITY FACILITY NAME/~ ~ 0~' ~, $,5'--~ EX[STING FACILITY PERMIT NO. F^CrLITYADD~.~S ~7~0l ~' $/"/Zee~' CITY ~9~.eZZs~',~'~.O ZIPCOD£ ?¥PE OF BUSINESS . ~. /) /~ . -' APN # TAI~COWl'tER ~P a.~e'sz'¢cxg-Sz-- /'o/2oX>c~z--.5 PHONENO._ 77Z/- 67'~ -5-?2/ PHONE NO.- 7t'~- t;~(4 ? - ~/-4/.~, .... RAKERSF~ELD crrY BUS.eSS LICENSE NO. o WAT~RTO FACILrrv P~OVU)ED BY. , ~ (~ DEFr/t TO GROUND WATER ~/,",~ SOIL TYPE EXPECTED AT SITE ~ [/~ · NO. OF TANICS TO BE INSTALLED ,-~/[~2 . ARE THEY FOR MOTOR FUEL ..~/,~YES .~-~/~ NO SPILL PREVENTION CONTROL AND COUNTER MEASURF~ PLAN ON FILE .~)//~ YES~'~',/',~ NO s~ ,c'noN ~OR MoToR TANK NO. VOLUME UNLEADED REGULAR PREMIUM DIESEL AVIATION 2(~~ ~ t 5 g SECTION FOR NON MOTOR FUEL STORAGE. TANK8 TANK NO. VOLUME CHEMICAL STORED CAS NO. CHEMICAL PREVIOUSLY STORED (NO BRAND NAME) (IF KNOWN) FOi~ OFFICIAL USE ONLY IAPPLICATION DATE FACILITY NO. NO. OF TANKS FEES $ .i THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WIL~ COMPLY WITH THE ATTACHED CONDITIONS OF TEIS PF_.RMIT AND ANY OTHER STATE~ LOCAL AND FEDERAL REGULATIONS. THIS FOzl~flgl HAS BEEN COMPLETED UNDER PENALTY OF pERJURY, AND TOTHE 'O~BEST OF MY KN WLEDGE, IS TRUE A~ID CORREG'T~ - ~ APPP~O-VED BY: - .APPLICANT NAM~ (PRINT) ~APPLICANT SIONATURE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED 3UM 18 2003 8:10 BKSF FIRE PREVEM.TIOM (661)852-2172 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 PERMIT APPLICATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK TYPE. OF bI~PLICATION (CHECK) [ {NEW FACILITY [ ]MODIFICATION OF FACILITY [ ]NEW TANK INSTALLATION AT EXISTING FACILITY , FACILITY NAME/~F.C ~ ~t- ~, $.5-f~ . --. EXISTING FACILITY PERMIT NO. TYP£OFI I~E F flUS NESSC~, .-'/ D/; ........ -' ApN # .... AVDRF. SS ~ Ce~ol~e,e~,/~z" D/2~ve. c~rY /,/~ p,~Zm,O- ZrPCdDE 9o6.P3 . ' ADDP~SS /?fd~'.~. ,4Y,, e,uc'Y/~Le'~ ~7'- CiTY (2(g/'~.~[" ZIPCODE ........ PHONE NO. '71/-/- ~--O 7 - 5/-4 ~/,~ BAKERSFIELD CITY BUSINESS LICENSE NO. O WORKMAN COMP NO. 07.20oC)0[~'~'- INSURER ~'7-~/"~ C~,,v~/c' ~'..oS.. B...R. IEFLY_DESCRIBE THE..WORK TO BE DONE p/6:f'~ ~ ~ ~C/Zc o.2 75J/v .~' f& c ~ o,2. /./.xY Oe-,e~ oo,9 - o,~ WATER TO FACILrrY PROVIDED BY. .~../te~ ,, DEPTH TO aROUND WATER ~~/~ SOIL TYPE EXPECTED AT SITE ~ SPILL PREVENTION CONTROL AND COUNTER MEASURES FLAN ON PILE .~/1/~ . YES -~/,,~ NO S~-C'~OS, FO~ MO'rO~ TANK NO. VOLUME UNLEADED REOULAR PREMIUM DIESEL AVIATION ,,7~ ~tff 1 5 ~j~ ,~ECTION FOR NON MOTOR FUEL STORAGE TANKS T^NK NO. VO~UM£ CHEMICAL STORED CAS NO. CHEMICAL P~EVIOUSLY STORED FO{~ OFFICIAl, USE ONLY APPLICATION DATE FACILITY NO. NO. OF TANKS FEES $ THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE, LOCAL AND FEDERAL REG~TiONS. THIS FOJj[M HAS BEEN COMPLETED UNDER PENALTY OF pERJURY, AND TO THE BEST OF MY KNO~WLEDGE, IS TRUE.g~ID CORRECTJ ' APPI~O~ ED BY: - .APPLICANT NAME (PRINT) C~PP'"LI~ANT SIGNATURE THIS APPLICATION BECOMES A PERMIT WIIEN APPROVED 05-~'1-03 04:53pm From-TAIT EH NTAL ?!4-~60-~237 T-535 P.01/01 F-g47 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAl. SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326;-3979 Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION CHECKLIST / Enironmental Services "-' " ' ' ' '" 1 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 9330! Tel: (661)326-3979 FACILITY NAME ~ I INSPECTION DATE I INSPECTION TIME FACILITYCONTACT t~ua, · / 15-021- Section 1' Business Plan and Inventory Program ~3 ROutine ~ombined E) Joint Agency ~3 Multi-Agency ~3 Complaint I'1 Re-inspection C V ( C=Compliance '~ OPERATION COMMENTS ~. V=Violation ~ BUSINESS PLAN CONTACT INFORMATION ACCURATE  VISIBLE AOORESS [ .-~. P~OPER SEGrEgATiON O~ MATE~AL ~ ~ VERiFiCATiON OF MSDS AVA~LAB~UWE ~D EU[.GENCY ..OCE~U.ES AO~OU*T~ ~ CONTAINERS PROPERLY ~BELED ~ .......................................................... ~NY H~ARDOUS WASTE ON SITE?: ~ YES EXPLAIN: ° ,_.O_N_?.. P'_7- 7" White - Environmental Se~ices Yellow. Slation Copy Pink - Business Copy CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAl, SERVICES UNIFIED PROGRAM INSPECTION CltECKLIST 1715 Chester Ave., 3r" Floor, Bakersfield, CA 93301 FACILITY NAME Aaa~t~ ~1,, ~ INSPECq'ION DATE ~-.-.~ 5'O_..~ Section 2: Underground Storage 'ranks Program [] Routine [~ombined I~l Joint Agency [~1 Multi-Agency ~ Complaint I~ Re-inspection Type of Tank ()tlJ~- Number of Tanks '~ Type of Monitoring ~, tdt,4_ Type of Piping Otp_~ OPERATION C V COMMENTS Proper tank data on file ~, / Proper owner/operator data on file Permit tees current /, Certification of Financial Responsibility Monitoring record adequate and current / Maintenance records adequate and current .// Failure to correct prior UST violations Has there been an unauthorized release'?. Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S)_ AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Ad&quate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection'? Inspector: ~.J~C:Compliance V=Violation d~'~'''5 Y:Yes N:NO ~W"'~k 01/~~.//~ Omce of Environmental Services (661) 326-3979 Bffshhess ~'l~e-Respons~l~ ~-~r~y White - Env. Svcs. l:'ink - Business Copy II. NAME AND ADDRESS OF OWNER/OPERATOR SUBMITTING REQUEST MAILING :ADDRESS [] (MAILING ADDRESS S.~AI~ AS FACILITY ADDRESS) ................. .,'-~ ' ~,-,.", ~ .Plebe ch~ck r~o~s) why you ~ve ~t.~c ~fo~S~t~'Water R~so~C~ y0u~.~e reques~g reco~idemfion for ~om~2 ~gh '~, " ~Q~D ' DOC~A~ON, ..~O~.?~Q~T c0ssm~v ~co~c~ ~ ~.L S~ ~~V. ~CC~'~ ~H ~ S~ rO COSSW~R~S ~~ VO~ ~';~hafibn 262! of Title 23 ofae ~~-~bfRe~fio~,.For e=~ie, , . ,aPpU~b~e ~on(s): ~ ~ ~equest for ~c0~id~fion ~' b~e'd on e~den~ ~t :~e uST f~ ~m'a pubUc ~g ~ter w~'~ ~clude a demom~fion ~t ~e we~ h~d~ ~ ~ 1 . ( ) UST fac~ ~Co~Ctly"lo~t~ ~ O~Tmck~ ~b~e;'': '. '"". "' "" ':'" · ...~::( ) ~bUcD~g Waer WeU(s) ~co~fly lo.ted ~'oeoTmcker ~mb~e' .-?....: .., "' : ;' . . ::~::,.. ~ ,~ ..., ....:;:.~,/:'.. :., :; · ' .' NO~: · ,~.~:~ ':~, , :' · ; ~ "'~:~ ........ ,~. ' -: ' - ';4~ ~;,~'i' ~: Ce~fi~flon - l ~fy ~t the inf~ngon p~ ~n ' ~ing I~o~flon ~y ~ ~de~ a ~flon ~H~ ind Saf~ C~ ~on 2s2~, ~ble by fl~ N~E OF ~P~C~T ~fin0 ' ' i. ~mplet~ R~uat.for R~ide~tlon Fora: .':State Water. Reso~Ces ConSol Bo~d -'Di~sio of:Water , UST Proem , . ~A~.E~e~ Haven, UST EnviroSolve Mr. Ryan N. Rietzel Project No. AE.18.02 BP West Coast Products LLC / ARCO June 4, 2003 4 Centerpointe Ddve La Palina, California 90623-1066 Re: Nearby Public Supply Wells ARCO Station No. 06356 2301 F Street Bakersfield, CA 93301 Dear Mr. Rietzel: EnviroSolve Corporation (EnviroSolve) conducted a search of the state Geographic Information System and contacted well owner(s) in an effort to identify if public supply wells exist within 1,000 feet the referenced ARCO facility (site). This letter describes our procedures and findings. STATE GEOGRAPHIC INFORMATION SYSTEM SEARCH A search of the state Geographic Information System on the GeoTracker Web site ' (http://geotracker. swrcb.ca.gov/) was conducted on May 21, 2003. The state Geographic Information System lists public supply wells within a one-half mile radius of the site, but does not provide Iocational information due to increased concerns over potential threats to public water supplies since September 11, 2001. The following well was identified as existing within one-half mile of the site: State Well Number Local. Well Number Well Owner Well Owner Address 1503145-001 LOS HILLS - BERRENDA MESA 2100 F ST, BAKERSFIELD, PURCHASED WATER DISTRICT CA 93301-3800 GROUNDWATER Printouts of the GeoTracker UST and well reports are attached. INFORMATION FROM WELL OWNER I spoke with Debbie Navarrette, Treasurer of the Berrenda Mesa Water Distdct (681) 325-1284, on May 27, 2003. Ms. Navarrette stated that the water distdct does not operate any wells but does purchase groundwater from other agencies. The "Local Well Number" listed in GeoTracker indicates that this is purchased groundwater and not in fact a well. 15105 Lipson Avenue, Vis@lia, California 93292 , P.O. Box 1190, Visalia, California 93279-1 t 90 Phone: 559.798.4227 0 FAX: 559.798.4132 Mr. Ryan N. Rietzel Project No. AE.18.02 June 4, 2003 Page 2 CONCLUSIONS The one potential water supply well near ARCO Station 06356 listed in the state Geographic Information System is not a well but actually a record of purchased groundwater according to the listed well owner. No other wells were identified as occurring within 1,000 feet of the site. EnviroSolve appreciates the opportunity to assist BP West Coast Products LLC / ARCO with this project. Please contact me if you have any questions regarding this letter. Sincerely, EnviroSolve Corporation Kimball R. Loeb, R.O., C.E.G., C.H.G. Associate Attachments: - GeoTracker UST Report - GeoTracker Well Report - GeoTracker Public Water System Information l=%¢~ojects~AE-1 i UST Details Page 1 of 1 AM PM MINI MARKET #6356 2301 F ST BAKERSFIELD, CA 93301-3829 Facility ID: 215-000-001880 Local Agency: BAKERSFIELD, CITY OF Wells Nearby Dist To Water System Name Water System Well Name Common Well Name - ID LUFT BE REN A MESA WATER 1503145- LOS HILLS - PURCHASED 1503145 n/a DISTRICT 001 GROUNDWATER http://geotracker, swrcb.ca.gov/reports/ust.asp?identify= 19870 5/21/2003 · Well Report Page 1 of 1 Well Report BERRENDA MESA WATER DISTRICT (BAKERSFIELD) LOS HILLS - PURCHASED GROUNDWATER State Well Number: 1503145-001 Well Details [ Geographic Information I DHS Water Quality Data I PWS Detailed Information Local Name LOS HILLS - PURCHASED GROUNDWATER (1503145-001) Source Origin Status Purchased Groundwater Unknown Treatment Method Treatment Phase No Treatment/Non Applicable Water 22 LUFT Site(s) Estimated to be Nearby this Well · List These LUI~ Sites Geotracker Home [ Site/Facility Finder Case Finder ] MTBE/Casc Reports http://geotracker.swrcb.ca, gov/reports/well.asp?global_id=W0602903145&assigned_name= 15031 ... 5/21/2003 · Public Water System Informal' Page 1 of 1 Public Water System Information BERRENDA MESA WATER DISTRICT (BAKERSFIELD) LOS HILLS - PURCHASED GROUNDWATER State Well Number: 1503145-001 Well Details I Geographic Information ] DHS Water Quality Data I PWS Detailed Information Public Water System BERRENDA MESA WATER DISTRICT Water System Address: PWS Class: 2100 F ST Community Water System (CWS) BAKERSFIELD, CA 93301-3800 Ownership/Regulation Ownership: Local Government - Cities, Counties, Improvement Districts, Special Districts. Regulating Entity_: Service Area: State Residential Area Date Entered System: System Status: Active Deactivation Date: Last Revised: 3//3//1998 Connection Information Number of Service Connections: Population Served: 9 256 · List all wells for this Public Water System Geotracker Home I Site/Facility_ Finder Case Finder I MTBE/Case Reports http://ge~tracker.swrcb.ca.g~v/rep~rts/we~~-pws.asp?g~~ba~-id=~~6~29~3 ~ 45&assigned-name=... 5/21/2003 MONITORING SYSTEM CERTIFI 'ION For Use By All durisdictions Within the State of California AuthoriOJ Cited: Chapter 6. 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: ARCO PRODUCTS COMPANY Service Station No.: 6356 Site Address: 2301 F STREET City: BAKERSFIELD Zip: 93301 Facility Contact Person: ~ t/g.-~ i,.<)J [f. on) Contact Phone No.: .,~4~g..9,..o&~ 7 t q d, 7o 5'~S~ / Make/Model of Monitoring System: /./.~, f/~/,-lyO Date of Testing/Service: /t_o.~o .t ~_ B. Inventory of Equipment Tested/Certified ~:neck me appropriate noxes..!o mmcate specmc eqmpmem msl~ecteu/serv;ceo: [-lln-Tank Gauging Probe: Model: F'lln-Tank Gauging Probe: Model: ]g]Annular Space or Vault Sensor: Model: ~'Oq ~Annular Space or Vault Sensor Model: [i~jPiping Sump/Trench Sensor (s): Model: 2-) k-]Piping Sump/Trench Sensor (s): Model: U1Fill Sump Sensor (s): Model: FIFili Sump Sensor (s): Model: I--IMechanical Line Leak Detector. Model: [-IMechanical Line Leak Detector. Model: J~Electronic Line Leak Detector Model: ~/a-f -,~]Electronic Line Leak Detector Model: C.~a l~lTank Overfill/High-level Sensor: Model: t'?,.-,~#,~ t//~i,.,a~ ]/~Tank Overfill/High-level Sensor: Model: ~/~... FlOther, Specify equip, type and model in Section E on Page 2 FlOther, Specify equip, type and model in Section E on Page 2 /-lin-Tank Gauging Probe: Model: 1-lin-Tank Gauging Probe: Model: ["lArmular Space or Vault Sensor: Model;Q. ~,m ,~/,~{ F]Annular Space or Vault Sensor Model: ~/]Piping Sump/Trench Sensor (s): Model: 2~ FIPiping Sump/Trench Sensor (s): Model: [-]Fill Sump Sensor (s): Model: l-Will Sump Sensor (s): Model: F]Mechanical Line Leak Detector. Model: .~ FIMechanical Line Leak Detector. Model: [~lectronic Line Leak Detector Model: ¢/a 7' F1Electronic Line Leak Detector Model: I~ITank Overfill/High-level Sensor: Model: o/,--~ ~$~ F1Tank Overfill/High-level Sensor: Model: FlOther, Specify equip, type and model in Section E on Page 2 FIOther, Specify equip, type and model in Section E on Page 2 Dispenser ID: ~t? ,~ Dispenser ID: ~ ,,p ~Dispenser Containment Sensors: Model: 2~ I~]Dispenser Containment Sensor(s): Model:2~ I~l Shear Valve(s). ~ Shear Valve(s). I-'lDispenser Containment Float(s) and Chain(s) I-IDispenser Containment Float(s) and Chain(s) ,, Dispenser ID: ~'y *,,6, Dispenser ID: 9 I/t> ~Dispenser Containment Sensors: Model: .7~$" ~]Dispenser Containment Sensor(s): Model:~oJ' [] Shear Valve(s). , ~] Shear Valve(s). I-IDispenser Containment Float(s) and Chain(s) I-IDispenser Containment Float(s) and Chain(s) Dispenser ID: .~'.! 4 ~ Dispenser ID: //~/z DispenserContainment Sensors: Model: 2oJ, ,l~lDispenser Containment Sensor(s): Model:~,P Shear Valve(s). [] Shear Valve(s). I-IDispenser Containment Float(s) and Chain(s) [3Dispenser Containment Float(s) and Chain(s) *If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at this facility. C.', Certification - l certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generati~,such reports, I have also attached a copy of the report; (check all that apply): ~ System set-up ~ Alarm history rep~ Technician Name (Print): ~, t'tt~#,~*... Signature: Certification No.: J'eh ~p?:_~,_ License No..' 588 098 Testing Company Name: TAIT ENVIRONMENTAL SYSTEMS Phone No.: (714) 560-8222 Page 1 of 3 03/01 Monitoring System Certification , Site Address: SS//6356, 2301 F STREET, BAKERSFIELD Date of Testing/Servicing: / O ,~'O,O7. D. Results of Testing/Servicing Software Version Installed: /.,f, O ] Complete the following checklist: [] Yes [] No* is the audible alarm operational? 1~] Yes [] No* Is the visual alarm operational? ,~ Yes [] No* Were all sensors visually inspected, functionally tested, and confirmed operational? ~l Yes [] No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? [] Yes [] No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) I~ N/A operational? ~ Yes [] No* .-.-i For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment [] N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) [~Sump/Trench Sensors; ~l Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? [] Yes; [] No. [] Yes' [] No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no ~g] N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? 2?2?% [] Yes* [] No .Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. [] Yes* [] No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) [] Product; [] Water. If yes, describe causes in Section E, below. .~ Yes [] No* Was monitoring system set-up reviewed to ensure proper settings? I~ Yes [] No* Is all monitoring equipment operational'per manufacturer's specifications? * In Section E below, describe how and when these deficiencies were or will be corrected. · E. Comments: Page 2 of 3 03/01 · Site Address: SS/46356, 2301 F STREET, BAKERSFIELD Date of Testing/Servicing: / O,yO,o -~ F. In-Tank Gauging / SIR Equipment: [] Check this box if tank gauging is used only for inventory control. ~ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tm& gauging equipment is used to perform leak detection monitoring. Complete the following checklist: [] Yes [] No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? [] Yes [] No* Were all tank gauging probes visually inspected fo'r damage and residue buildup? [] Yes [] No* Was accuracy of system product level readings tested? [] Yes [] No* Was accuracy of system water level readings tested? [] Yes [] No* Were all probes reinstalled properly? [] Yes [] No* Were all items on the equipment manufacturer's maintenance checklist completed? * in the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): [] Check this box ifLLDs are not installed. Complete the following checklist: ~ Yes [] No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? [] N/A (Check all that apply) Simulatedleakrate:,,~3g.p.h.I; []0.1 g.p.h.2; [] 0.2 g.p.h.2 Notes: 1. Required for equipment start-up certification and annual certification. 2. Unless mandated by local agency, certification required only for electronic LLD start-up. .J~ Yes [] No* Were all LLDs confirmed operational and accurate within regulatory requirements? ~ Yes [] No* Was the testing apparatus properly calibrated? [] Yes [] No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? [] Yes [] No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? [] N/A [] Yes I~ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabi'ed [] N/A or disconnected? [] Yes ffi No*. For electronic LLDs, does the turbine automatically shut offifany portion of the monitoring system malfunctions [] N/A or fails a test7 [] Yes [i~ No* For electronic LLDs, have all accessible wiring connections been visually inspected7 [] N/A ]~ Yes [] No* Were all items on the equipment manufacturer's maintenance checklist completed7 * In the Section H, below, describe how and when these deficiencies were or will be corrected. Page 3 of 3 03/01 Site Address: SS #6356, 2301 F STREET, BAKERSFIELD Date of Test!,n.g/Servicing: Monitoring System Certification UST Monitoring Site Plan ............................... r~o'~ ..... ~'t~Z'x. · .... .... ........... ......................................... ::::::::::::::::::::::::::::::: ............. Date 'map was drawn: Instructions If you already have a diagram that shows al! required information, you may include it, rather than this page, with your Monitoring System Ce~ification. On your site plan, show the general layout of tanks and piping. Clearly identi~ locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. Page __ of __ o~/o0 ARCO Products Company Mechanical Leak Detector Test Data Sheet Station # 6356 Date / (9, ~O 20.0 Address 2301 F STREET,BAKERSFIELD Test Information 1 2 3 4 5 Product 9 ? Manufacturer ,vis Model C/' 'f C F'Ull Operating Pressure (psi) Line Bleed Back (mi) Trip Time (sec) Metering Pressure (psi) ~ F/E Holding Pressure (psi) Test Leak Rate (ml/min) (gph) ---- ~ .~, PASS or FAIL Comments: t~o C,~_ ~oa.$A,,.~ This letter certifies that the annual leak detector tests were performed at the above referenced facility according to the equipment manufacturers procedures and limitations and the results as listed are to my knowledge true and correct. The mechanical leak detector test pass/fail is determined using a low flow threshold trip rate of 3 gph at 10 PSI. Inspected By: Contractor TAIT ENVIRONMENTAL SYSTEMS Technician ~ffd'~J ~ Lic# Signature Revision 5/01 D January 22, 2003 AM/PM FiRE CHIEF 2301 F Street RON FRAZE Bakersfield CA 93301 ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 ]~E.' Upgrade Certificate & Fill Tags VOICE (661) 326-3941 FAX (661) 395-1349 Dca~ Owner/Operator: SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 Effective January l, 2003 Assembly Bill 2481 went into effect. This vOICE (r~l) 326.a341 Bill deletes the requirement for an upgrade certificate of compliance FAX (661) 395-1349 (the blue sticker in your window) and the blue fill tag on your fill. PREVENTION SERVICES FIRE SAFEr/SERlrlCES * E/ilt~iMENTAL SERVICES 1715 Chester Ave. You may, if you wish, have them posted or remove them. Fuel Bakersfield, CA gO301 vendors have been notified of this change and will not deny fuel VOICE (661) 326-3979 FAX (661)326-0576 delivery for missing tags or certificates. PUBLIC EDUCATtOH 1715 ChesterAv~. Should you have any questions, please feel free to call me at 661- Bakersfield, CA 00301 326-3190. voice (~1) 3~e-3~e FAX (661) 326O576 FIRE INVESTIGATION S~ ~ 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION Steve Underwood 5642 Victor Ave. Bakersfield, CA 93308 Fire Inspector/Environmental Code Enforcement Officer VOICE (061) 399-4697 FAX (661) 399-5763 Office of Environmental Services SBU/dc 10-23-02 04:S3pm Frofa-T~.lT EN¥1RO~N?AL 714-$60-823T T-161 P,04/08 F-$65 CITY OF BAKERSFIELD OFFICE OF ENXqRONM~NTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 3261-3979 ARCO AM-PM 2301F ST. BAKERSFIELD CA.9~30! 805-863-0528 SEP 23. 2002 12:30 PM STATUS REPORT ALL FUNCTIONS NORMAL INVENTORY REPORT NO ACTIVE TANKS ARCO AM-PM 2301F ST. BAKERSFIELD CA.93301 33-0528 OCT 21, 2002 11:52 AM SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL INVENTORY REPORT NO ACTIVE TANKS CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 FACILITY NAME ,.~ gt ~t~ INSPECTION DATE l0 '_~ ' O ~ ADDRESS ~ 30 { t ~-tt (~- PHONE NO. ~{o.~" 0~ {~ FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES -/! Section 1: Business Plan and Inventory Program ~ Routine ~ Combined [~ Joint Agency [~ Multi-Agency ~ Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials .., Verification of quantities Verification of location Proper segregation of material ,,.,' Verification of MSDS availability c,., Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping / Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: ~ Yes ~(o Explain: Questions regarding this inspection? Please call us at (661)326-3979 '"l~u~ess~i~-e/~. espo~pafl'~ White - Env. Svcs. Yellow- Station Copy Pink- Business Copy lnspector~MX.& CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME 31~ eR, k INSPECTION DATE Section 2: Underground Storage Tanks Program [~ Routine ]~ Combined [~l Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank ~I~ Number of Tanks ._7> Type of Monitoring d?../,VX. Type of Piping 0Ldi~ OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit lees current Certification of Financial Responsibility e,~ Monitoring record adequate and current Maintenance records adequate and current r'~~ " Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=C°mpliancl'/~' =Vi°lati°n{///IO~ ' . Y=Yes N=NO ~N~_x..~qO ~ ~9~ ~-~'1 Inspector: ~,. '"x_~-~,~,_~ k_0 ~ Omce of Environmental Services (805) 3~'6"~979 Busi~'ess~Site R~sP--onsible Party White - Env. Svcs. Pink - Business Copy ENVIRONMENTAL /SERVICES, INC. PMB 269 25422 Trabuco Road #105 Lake Forest, CA 92630-2797 (949) 450-I010 Fax (949) 450-1177 September II, 2002 Via UPS 2~d Day Air City of Bakersfield Fire Department ] 715 Chester Avenue, 3rd Floor Bakersfield, CA, 93301 ATTENTION: Steve Underwood RE: PRELIMINARY TEST RESULTS - SB989 COMPLIANCE ARCO Facility No.: 06356 Facility Address: 2301 F STREET, BAKERSFIELD, CA 93301 Per California Water Resources Control Board requirements, attached are results from secondary containment testing performed at the subject facility. ARCO is currently coordinating necessary repairs to satisfy testing requirements. Once repairs have been made, your agency will be notified of all scheduled re-testing. Test Date Pages 06/12/02 2 08/20/02 1 08/23/02 1 ARCO is committed to the compliance of all environmental laws that govern the safe operations of its facilities. Should you have any questions or concerns regarding testing activities at this facility, please do not hesitate to call Michael D. Wilson, BP Environmental Compliance Specialist for this facility at (714) 670-5321, or myself at (949) 450-1010. Sincerely, Belshire Environmental Services, Inc. U~g~d Storage Tank System Tanks, Piping, & Spill Buckets ~,Secondary COntainment Certification Form Page~ of Facility #: ~ City: ~c_~t~,%_~'~.e..~-(Lk Testing Contractor: ~/~fL.~{?~_ .~~[~o_o.~..~.~ TestDate: Facility Address: _,~_~[ ~. ?~-'~ Contractor Address:L~ UST Annular Space Secondary Piping Tank #1 Tank #2 Tank #3 Tank #4 Line #1 Line #2 Line #3 Line #4 Product' /~89 91 D ~8~D 87 89 91 D 87 89 91 D Product ~89 91 D (~89 91 D ~89 91 D 87 89(~ D ,,Capacity PipingType ~ Siphon Prim~ ~ Prim~.~ ~Siphon Manufacturer Manufacturer Test Start Time [ ~; ~ ~ O-'~ O~ Test Start Time Initial Pressure [ O ~ { ~ ~ Initial Pressure -- f ~ r Test End Time t{ ',~ [ [ ~ Test End Time ~..~ Final Pressure '~.~ ~ t,~ ~ FinalPressure ~0%~ ~ ~%~ ~ff~? Test Results ~ Fa~ ~ ~il Pass Fail Pass Fail Test Results e~s ~ ~ Fail Fail Pass~ ~1] Signature ~- ~ Signature $pill Buckets Overfill gl Overfill ~2 Overfill ~3 Overfill ~4 Seconda~ Piping Product ~8991 D ~ 8991 D ~ 8991 D 87 89~D Lineg5 Line ~6 Line~7 Line~8 Product ~89~ D ~..~ 87 8991 D 87 89 91 D Manufacturer Piping Type m~ '~ Prima. Siphon Primary Siphon Start Time (to) ~~ ~': ~ ~ ~ t ' ~ I~h Water Level ~ ~ ~{> (~aO~ l~g Manufacturer Time(tO ~¢~ ~' O~ //,.'~ g ~ ~ Test Start Time Water Level ~ ~ O O Time (t2) ~ ¢~ / / '~/ Initial Pressure ~'~ Water Level ~oD OOO Test End Time Time(B> ~ , , / [ '3~ FinalPressure Water Level CQ ~ (D ~ I Time (t4) ~ ~ ~ q / / : 3 ~ Test Results ~rFail~ail Pass Fail Pass Fail Water Level ~ ~ ~ Signature ~ - Test Results Pass ~ ~ Fail ~ Fail Pass ~ Rev. 11/01 ~ite - Orig~al Yellow -Arco Enviro~ental Compliance P~- Con.actor c-Underground Storage Tank System Turbine Sumps, Fill Sumps and Under Dispenser Containment ~,Secondary Containment Certification Form Page, of __ ~',~ ~ ' Facility #: ~_~JgZ~City: e~A X~_~ A ,<~ C-e.~' I c~ Testing Contractor: ,7~ ~,..,~C-~'~_ '~_.,~ ~O..,~ Test Date: Facility Address: _.~..~! ~ ~". ContractorAddress:~.l~? t.,L)' ,_~/oAIA~'0-L~c ~O1 Tech. Name: ID (north, slave, etc.) (J_~') (~ ID (north, slave, etc.) Manufacturer Manufacturer Start Time (to) l ~; ~"~ / "/'/'~ ' ~5-'~ Start Time (to) Water Level ~ ~ ~ O ~ ~ o '~ Water Level Time (tO I ~ O~ / ~ / ~ '~ Time (tO Water Level ~ 0 0 ~ 0 ~ 0 ~ Water Level Time (tz) ( ~ ~ /~ ~ ~ Time (t~) Water Level ~ O ~ ~ ~ D ~ O O Water Level Time(ts) [ :O~ ~ ~OI Time (t3) ~;~ /];~ ~/ I' Water Level ~O O ~O~ ~O ~ Water Level Time(tn) / ; I j ~dD 'D ~ ' O q Time (t4) Water Level O~ ~ OO 1 O O O Water Level T estResults ~ Fail ~ Fail~~ Fail Pass Fail T estResults ~ Fail ~ Fail ~ Fail Pass Fail ID (1/2, 3/4, etc.) ID (1/2, 3/4, etc.) Manufacturer Manufacturer Start Time (to) ~& ~-i~ ~3~ 3. 1~ Sta~ Time (~) Water Level ~ O~ Oo~ ~ ~D~ Water Level ~,~ ~tQO Time (t,) ~ L[.~ ~ ~ ~ ~ ~ Time (t0 Water Level !~, ~%~ ~O ~[ Water Level Time (t2) ~'~ t~ ~ 3 g~ Time (t~) Water Level ~ ~ ~ ~ { ~ C)O [ Water Level ~ ~ ~ ~ ~ ~& / Time (t3) .~'O ~ q ~ ~ ~O~ ~0 ~ Time (t,) W,t r Leve O t W,t r Level Time (t4) ~O~ q3 ~ ~ ~O~ ~ [ Time (t4) Water Level ~O [ ~ (~G( Water Level Test Results Pass ~~ Fail ~ Fail~ Fail Test ResUlts Pass Signature ~~-x ~ ~ Signature Rev. 11/01 ~ite - Original ~ Yellow- Arco Env~o~ental Comvli~ce Pi~- Con.actor UJ~dcrgrmmd Storage Tank System Turbine Sumps, Fill Sumps and Under Dispenser Contaimnent Secondary Containment Certifi/~ation Form Page of Facility #: ~.._~__~ City: _~~ ~ ~. ~.~-~ Testing Contractor:/~// f~~ ~~~est Date: ~~.-~ ] Contractor *ddress:~~ Test Results Pass Fail Pass Fail Pass Fail Pass Fail Test Results Pass Fail Pass Fail Pass Fail Pass ,Fail Siguature . Signature ~~ ~//~/DT~' ..... UDC~Li/~ ~/ UDC Start Time (to} ~tO; ~ Start Time Water Level ... '~~' Water Level Time fl,) lO.'~ %[ ~ ..... Time (t,) Water Level :~ ~t ~~ _Water Level Water Level ~C~( ~ Wa~er Level Time (t~) ]0~&~ ~ ~c] - Time {t~) Water Level .~ ~ ~ Water Level Time (h) ~; ~ ~ ~L Time _Tater Level ~~ ~ Water, Level _ Test Results ~ Fail ~ Fail Pass Fail Pass Fail ?est Results P~s Fail Pass Fail Pass Fail , P~s Fail Underground Storage Tank System Tanks, Piping, & Spill Buckets ~ Secondary Containment Certification Form Page~ of ,, ~ Facility Address:,~.'~.~'~. ~ 5T C · for Address:..~?~..~_. GJ ~Tcch. Name: f~._t~_/Qf~_./ UST.4nnular Space .... , Secondary Pipin~ ...... _ Tank #1 Tank #2 Tank #3 Tank I/4 Line gl Line 02 Linc/t3 Linc #4 Product 87 89 9l D 87 89 91 D 87 89 91 D 87 89 91 D Product 87 89 91 D 87 89 91 D 87 89 91 D 87 89 9.1 D Capacity Piping Type primary Siphon Primary Siphon Prim~, Sipl~on Primary Siphon Manufacturer Manufacturer Test Start Ti,ne Test Start Time Initial P~;essure ~ I,fitial Pressure .. Test End Time .. .. Test End Time Final Pressure ... Final Pressure -. Teat Results Pass Fail Pass Fail Pass Fail Pass Fail ' - ~ Test Results Pass Fail Pass Fail Pass Fail Pass Fail Sil~natu,'e Signature Spill Buckets' Overfill #1 Overfill #2 Overfill #3 Overfill #4 S._e. condar~ Piping Product 87 8 D 9 9l D 87 119 91 D 87 89 91 D Line#5 Line #6 Line#7 Line#8 Manufacturer Product 87 89 91 D 87 89 91 D 87 89 91 D 87 g9 91 D 1'. ff_)~ ~&: I# Piping Type Primary Siph.n Primary Siphon Primary Siphon Prima#' Siphon Start Time(to} Water Level r~~ ¢~'YL~ O_.) Manufacturer Time (h) ' ~_ ', t~ Test Start Time Water Level ~C0 ~ Time (h) 'L.~ ~..'/{~ Initial Pressure Water Level ~/_0 ~ Test End Time Time(q) ~.~l[ ~.,'lq '- Water Level ~(.~ _/12f. jr00 . Final Pressure Time (h) -J/ I ~-/-' 2_. ~ L. 7. Test Results Pass Fail Pass Fail Pass Fail Pass Fail Water Level ~(~<~O.') t~e 6) Signature ..... 'rcst l~esults ~ Fail :"7~ Fait Pa~s Fail Pass Fail .... "' Rev. 11/01 ". White - Original Yellow - Arco Environmental Compliance Pink - Contractor Ru~ 17 D2~ 05:21p bp SB 989 TESTING PROGRAM AGENCY NOTIFICATION SHEET Notification Date: / /~ . No~fcafion For: / ~ ~ ~ / _ ~" ' ~ ~( ~ ~]~~ Repaim: ~RCO Fa~: ~~ R~mst: S~te: ,, ~ Agency Name: ~%',~,¢~~t;~ C}~~m~ No~fca~onMe~od: Pemon :on~cted: ~ Fax .... '- ' ' - ' ~ E-ma J J: Time Con~cted Verbak Tank A~nular Fill Sumps Seconda~ Piping Spill Bucke~ Turbine Sumps UDC R~air Scope (des~e ~ents and ant~pat~ Dis~ibutJcn: OdginaJ to Agency COpy to Bleshire Envimnmen~ Se~vicas · FEB ~ 8 2002 CITY OF BAKERSFIELD ~Bv OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 SECONDARY CONTAINMENT TESTING PE~ TO OPERA~ J OPERATORS N~ ~ ~:R OF T~S TO ~E :S~ :S PmmC ~ma TO ~E ~S~ T~ ~ VOL~ CO~S TANK TESTING COMPANY ~A~m & rno~ ~ER or co~rrACT rERSO~ TEST ~rET~OD ~ NA~ OF ~S~R OR SPEC~ CER~CA~ON ~ /0~ DA~ & ~ ~ST IS TO BE ENVIRONMENTAL ~~~ /SERVICES, INC. PMB 269 25422 Trabuco Road 11105 Lake Forest, CA 92630-2797 (949) 450-1010 Fax (949) 450-1177 July 10, 2002 Via UPS 2nd Day Air City of Bakersfield Fire Department 1715 Chester Avenue, 3rd Floor Bakersfield, CA, 93301 ATTENTION: Steve Underwood RE: PRELIMINARY TEST RESULTS - SB989 COMPLIANCE ARCO Facility No.: 06356 Facility Address: 2301 F STREET, BAKERSFIELD, CA 93301 Per California Water Resources Control Board requirements, attached are results from secondary containment testing performed at the subject facility. ARCO is currently coordinating necessary repairs to satisfy testing requirements. Once repairs have been made, your agency will be notified of all scheduled re-testing. Test Date Pa~es 06/12/02 2 ARCO is committed to the compliance of all environmental laws that govern the safe operations of its facilities. Should you have any questions or concerns regarding testing activities at this facility, please do not hesitate to call Michael D. Wilson, BP Environmental Compliance Specialist for this facility at (714) 670-5321, or myself at (949) 450-1010. Sincerely, Belshire Environmental Services, Inc. Un3~i~nd Storage Tank System Tanks, Piping, & Spill. Buckets Secondary Containment Certification Form Page of. FacilityAddress~. ~E~( ~' ~ ContractorAddress:L~'~ CO.-~-~.~tlt~ ~O'U Tech. Name: k~.~F" : UST ~nmdar Space .. Seeonda~ Pipini. _ Tank gl Ta~k.. g2 Tank g3 Tank g4 Line ~1 Line g2 Line ~3 Line g4 product ~89 91 D ~~D 87 89 91 D 87 89 91 D Product 8~ 91 D ~89 91 D ~9 91 D 87 gg~ D Manufacturer ._ . Manufacturer ~~ ~ - Test Start Time tO;~ ]~' O~ Test Start Time { ~',O~.. ~'~ C* [0~'O l~O'O Final Pr~sure '~'~m ~ L'~ ~ Final Pressure (30~ ~ ~'P %', ~.~ ~ Signature ~. ~ Signature ,iHBuckets .... ~' "~- ~ ~ . overfill gl Overfill g2 Overfill g3 Overfill ~4 Secondary Piphti Product .(~89.~. 91 D ~ 89 91 D ~89 91 D 87 89~)D.,. .... Line~5 Line g6 LineS7 Lin~g8 Manufaetnrer - Product ~ 89~ D ~~ 87 89 91 D 87 89 91 D : Piping Type Prima~ Siphon PriSOn Prim8~ Siphon Prim~ Siphon .. ~ .. Start Time (t~) ~~ ~10~ It ~ ~~ Manufacturer &.~,.~ ~ Water Level ~ ~ 00{:, "~0 ~~ Time(h) ~b' ~ C~'.OV It,:;1 ~r~ test Start time { ~ ,[~) Water Level ~e ~) O O Time (h) ~ ~ ~ / I,'.,~/ Initial Pressure ~; ~ ..... Water Level ~0D 00 O Test End Time Time(h) c{ ~ ~ // :3~ ~ O~ ~ ...... FinaIPr~sure ' · -~ Water Level C~ D~ {% ~ ~ ~~ .. Time (h) ~k. ~t~ / / ~ 3 ~ Test Results ~ Fail il Pass Fail Pass Fail Water Level . OO~) ~O ( Signature ~ - ,TestRemlts Pass ~ ~ Fail ~ Fail P~s ~ - - Rev. 11/01 ~ite - Original Yellow - Arco Environmental Compliance Pi~ - Con,actor tgn,~erground Storage Tank System Turbine Sumps, Fill Sumps and Under Dispenser Containment Secondary Containment Certification Form Page~ of ~ c Facility Address: ~.:.3~ { t-- ' -' .. ~...,~ Manufacturer Manufacturer Start Time (io) l~; ~q / .' q~ , ' ~'5'~ " Start Time (tn) ~'~' Water Level ~) ~&~ ~ ~ ~ ~ o D Water Level ~)~ ~ Water Level ~"... ~ O ~ ~ ~ ~ ~ ~ . Water Level ~;~, Time (la) ( L~ /~ ~ ;~ ' Time (t~) c~ //:/~ Water Level ~ ~ D' ~i~ D ~ ~ ~ Water Level C)~ Time (b) /; O ~' ~ 30 I '" Time (t~) c5; ~ //':~ j~ I ~ q / _~ater Level ~c~ ~ ~D'D ~ ~ Water Level ~)f Time {tO [:i] ~2OD ~ :~q Time (tn) ~0,~ //.: ~ ]~.' q~ · Water Level O e~ ~ OO 't ~O ~ Water Level ~ Teat Results ~ Fail ~ Fail ~) Fail P.a Fail Test Res. It, ~ Fail ~ FMI ~1 Fail P., Fail I' ' I ~ ' / Manufacturer Manufacturer Start Time (t0) ~:~ ~'1~ .3 ~ ' 3'. } ~ Start Time (t0) X _~ater Level ~ O~ 00 tD O~ ~30~ Water L~vel ~ Time(tO ~{~6~ q.~'5 ~ ~ & ~ Time(tO ~~ Water Level , ,!~ ~ ~ ~%~ k ~00 (0 ~ I Water Level~ ' _~atar Level ~ ~ ~ ~ { ~ ~)0 ~ W~ter Level ,~ ~ ~ ~C~ ('~/, Time(t4) '5'0~;~- ~3%. q ;0q .L~ I" ' Time (t4) Rev. 11/01 , ~dte- Od~inal Yellow- Arco Environmental Cnmnliance Pink - Cnn.actor ..... D June 30, 2002 AM / PM 2301 "F" Street Bakersfield, CA 93301 REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 2301 "F" Street. FIRE CHIEF RON FRAZE Dear Tank Owner / Operator: ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93a01 Thc purpose of this letter is to inform you about thc new provisions in VOICE (661) 326-3941 FAX (661) 395-1349 California Law requiring periodic testing of the secondary containment of underground storage tank systems. SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 Senate Bill 989 became effective January 1, 2002, section 25284. l (California VOICE (661) 326-3941 FAX (661) 395-1349 Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to e.nsure PREVENTION1715 GhosterAve.SERVlCES that the systems are capable of containing releases from the primary Bakersfield. CA 93301 containment until they are detected and removed. VOICE (661) 326-3951 FAX (661) 326-0576 Secondary containment systems installed on or after January 1, 2001 will be tested ENVIRONMENTAL SERVICES 1715 Chester Ave. upon installation, six months after installation, and every 36 months thereafter. Bakersfield, CA 93301 Secondary containment systems installed prior to January 1, 2001 will be tested by VOICE (661) 326-3979 FAX (661) 326-0576 January 1, 2003 and every 36 months thereafter. REMEMBER! Any component that is "double-wall" in your tank system must be tested. TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 Secondary containment testing shall require a permit issued thru this office and VOICE (661) 399-4697 FAX (661)399-5763 shall be performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (661)326-3190. Sfeve Underwood Fire Inspector/Environmental Code Enforcement Officer Environmental Services ,, _ SU/kr May 29, 2002 Arco AM/PM 2301 "F" Street Bakersfield, CA,93301 RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 2301 "F" Street FIRE CHIEF REMINDER NOTICE RON FRAZE Dear Tank Owner/Operator: ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 The purpose of this letter is to inform you about the new provisions in California VOICE (661) 326-3941 FAX (661) 395-1349 Law requiring periodic testing of the secondary containment of underground storage tank systems. SUPPRESSION SERVICES 2101 ~H" Street Bakersfield, CA 93301 Senate Bill 989 became effective January l, 2002. section 25284. l (California VOICE (661) 326-3941 Health & Safety Code) of the new law mandates testing of secondary containment FAX (061) 395-1349 components upon installation and periodically thereafter, to ensure that the systems PREVENTION SERVICES are capable of containing releases from the primary containment until they are 1715 Chester Ave. detected and removed. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 Secondary containment systems installed on or after January 1,2001 shall be tested upon installation, six months after installation, and every 36 months thereafter. ENVIRONMENTAL SERVICES 1715 Chester Ave. Secondary containment systems installed prior to January 1, 2001 shall be tested by Bakersfield, CA 93301 January 1, 2003 and every 36 months thereafter. REMEMBER! ! Any component VOICE (661) 326-3979 FAX (661) 326-0576 that is "double-wall" in your tank system must be tested. TRAINING DIVISION Secondary containment testing shall require a permit issued thru this office, and 5642 Victor Ave. Bakersfield, CA 93308 shall be performed by either a licensed tank tester or licensed tank installer. VOICE (661) 399-4697 FAX (661) 399-5763 Please be advised that there are only a few contractors who specialize and have thc proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (661) 326-3190. Sincer~ . Fire Inspector/Environmental Code Enforcement Officer SBU/kr enclosures D April 17, 2002 Arco AM/PM 2301 F Street FIRE CHIEF Bakersfield CA 93301 RON FRAZE ADMINISTRATIVE SERVICES ~J~: Necessary Secondary Containment Testing acquired by December 31, 2002 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 REMINDER NOTICE FAX (661) 395-1349 SUPPRESSION SERVICES Dear Tank Owner/Operator: 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 The purpose of this letter is to inform you about the new provisions in California law FAX (661) 395-1349 requiring periodic testing of thc secondary containment of underground storage tank systems. PREVENTION SERVICES 1715 ChesterAve. Senate Bill 989 became effective January 1, 2002. Section 25284.1 (California Health & Bakersfield, CA 93301 VOICE (661) 326-3951 Safety Code) of the new law mandates testing of secondary containment components FAX (661) 326-0576 upon installation and periodically thereafter, to ensure that the systems aye capable of containing releases from the primary containment until they are detected and removed. ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 Secondary containment systems installed on or after January l, 2001 shall be tested upon VOICE (661) 326-3979 installation, six months after installation, and every 36 months thereafter. Secondary FA)((661) 326-0576 containment systems installed prior to January I, 2001 shall be tested by January 1, 2003 and every 36 months thereafter. TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 Secondary containment testing shall require a permit issued thru this office, and shall be VOICE (661) 399-4697 performed by either a licensed tank tester or licensed tank installer. FAX (661) 399-5763 Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at 661-326-3190. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/dm enclosures · -' bp O BP West Coast Products, LLC Environmental Compliance Department 4 Centerpointe Drive La Palma, California 90623-1066 April 1, 2002 Via USPS RE: Certification for Financial Responsibility for ARCO Facilities Enclosed is a copy of the current Certification of Financial Responsibility, which covers all ARCO facilities in your area (see final page for a detailed list). This Financial Responsibility is active through January 1, 2003. If you have any questions regarding the enclosed document, please contact me at (714) 670-5336. Best Regards, Nora Koskenmaki Environmental Compliance Specialist BP West Coast Retail Business Unit Enclosure: Certification of Financial Responsibility with Attachments bp 8P Amoco Corporal~on HSE Group Resource 801 Warrenvdle Road L~sle. IL 60532-4323 February 4, 2002 U.S.E.P.A. Regional Offices/State Implementing Agencies Dear Sir or Madam: BP West Coast Products, LLC. - Financial Responsibility Documentation Petroleum Containing USTs - 40 CFR Part 280 The enclosed document comprises the financial assurance mechanism by which BP America Inc. demonstrates financial responsibility pursuant to 40 CFR 280 Subpart H for taking corrective action and compensating third parties for bodily injury and property damage caused by accidental releases arising from the operation of petroleum underground storage tanks. This document is believed to be complete and accurate. However, considering the number and geographic dispersion of USTs covered by BP America Inc.'s financial responsibility, it is possible that errors of omission have occurred and the tank listings will not always be current as of the date of the review. In any case, it is the intent of BP America Inc. to provide the mandated financial responsibility requirements for all USTs subject to 40 CFR 280 Subpart H. (see attached list of facilities. All tanks maintained at each of these facilities are assured by this mechanism) If you have any questions regarding the information submitted, please contact Michelle Bien at 630) 434-6181. Sincerely, 3erome cp. Yfouren Jerome P. Houren Manager, HSE - Financial & Performance Improvement Enclosures M. F. Burke, San Diego, CA S. D. Comley, T2-129, Long Beach, CA R. H. Halsey, 4-463, La Palma, CA L. C. Hernandez, 4-469, La Palma, CA M. J. Lowe, 869, Midland, TX N. Norcross, Carson, CA D. Portello, Richmond, CA V. C. Slayman, 4-460, La Palma, CA J. D. Starr, Cantera I, Warrenville, IL R. M. Walker, South Gate, CA.. Name & Address: See Attachment 7 .A and 8.A for names and addresses of each covered UST location. Policy ~umber: Contact facility representative or Jeff Hall at MARSH (312-627-6080) for copies of all UST waste facili'-y liability endorsement policy numbers. Period o~ Coverage: Janua-~y 1, 20o~ t~rough January !, 2003 Name of Insurer: INA Surplua Insurance Com1~a~y Address of Insurer: 1601 Chestnut street Ph/ladelp~ia, PA 19101-1484 Name of Insured-- BP America Itc. Addres~ of Insured: 200 E. Randolph Drive, Chicago, IL 60601 Cert if i_c_ ~_i__o_n; .. 1. INA Sttrplus Irisur~/lce Company, the Insurer, as id~n~ified above, hereby certifies ~2L~= it has issued liability insurance covering r-he following tt~lder~jround atorage tank (m): (see A~uachrae~s 7.A and 8.A) for taking correc~iv~ action and compensating third parnies for bodily injury and property damage caused by a¢cid~n=al releases ariain~ from operating the under, round s~ora~e tank(~) identified above. The limits of liability are $ 1,000,000 per occurrence a~d annual aggregate $ 2,000,000, exclusiv~ of lag. al costs, which are .~ub~ct to a separate llm~ u~ the poiicy. Thia coverage i~ prov!~c~ under (policy number). The effective da~e of said policy is January 1, 200m. 2. The In~urer £urnhe~ carnifie~ =he following with re~pec= to r_he . in~urance d~=crlbea in Par~grapk 1: a. Bankrup=cy or insolvency of the in~ured shall non relieve the INA Surplu~ Insurance company of its obligationz ~nder t~a policy to w~4¢~ th~ c~rt{~cate applies. b. The Insurer is liable for =he payment o= amounts wi=hit any deductible applicable to the policy =o the provide~ of Corre¢~ive ac=ion or a damaged %hirdparty, wizh a right of reimbursement by the insured for any such payment made by =he Insurer. This provision ~oes not apply with respect to that amount of any deductible for which coverages, is demons=re=ed under another mechanism or combinati~.~n of mechanism~ as specified in 40 CFR 280.~5280.102. : c. Whenever reque==ed by (a Direc:or of an implementing ' age, ny), th~ In~urer a~raes to furnish =o (the Director) a si~ned auplicate original of =he policy and all Cancellation or any other termination-of :he ~naurance by :he Xnzurer, except for nonpayment o£ premium or upon %rtl:ten ~Dzice a~d only after the expiration of 60 misrepresenza~icn by ~e i~_~ured will be effective ouly upc~ writte~ mo=ice and cn~ly after expira~io~ of a m{nimum of 10 days after a copy of such written notice is received e. The ina-ufa=ce covers claims o~harwlse covere~ ~y the policy ~_hat are reported to th8 Insurer with~_~ si~ mo~th~ of the effective daze of cancellation or nonranewal of =he policy exCepZ where the ~ew or renewed policy has ~he auma retroacnive date earlier than uhaU of the prior policy, and which ari=e ou~ of ~ny ¢overe~ occurrence tha~ commenced after the policy retroactive ~a=e, if applicable, an~ prior =o such policy re.n~w~l or termination date. Claim~ reported durin~ ~uch extended repor=in~ perioa are &-object to the terms, eo~tions, limits, including limits of .. liability, and exclusions of =he policy. the wor~in~ i~ 40 CFR 280.97(b)(2) a~d r_hat the Insurer is lice:se~ to transac= the b~siness of insurance in on~ or more states. Authorized Repress:taPirs of I~surer Monroe, Chic_a..q0, .~L_6960~ - of ReDresenta:~ve  ,q, latc of California For State Usc Only State of Water Resources Control Board Division al'Cie;hi Water Programs P.O. Box 9,14212 SacralllCllto, CA 94244-2120 (Inslmclmns on reverse side) CERTIFICATION OF FINANCIAL RESPONSIBILITY FOR UNDERGROUND STORAGE TANKS CONTAINING PETROLEUM A. I am required to demonstrate Financial Responsibility in the Required areal, nfs as spccilicd in Section 2807, Chapter 18, Div. 3. Title 23, CCI{: [~]] 51)0,000 dollars per occurrence ~'] 1 million dollars annual aggregate or AND or ~ I million dollars per occurrcncc ~ 2 million dollars anntlal aggregate B. BP Corporation North America Inc. hereby certifies that it is hq compliance with the requirements of Section 2807, (Name of Tank Owner or Operator) Article 3, Chapter 18, Division 3, Title 23, California Code of Regulations. The mechanisms used to demonstrate financial responsibility as required by Section 2807 are as follows: C. Mechanism Mechanism Coverage Coverage Corrective I-hird Party Type Name and Address of Issuer Number Amount Period Action Comp INA Surplus Insurance N/A $1,000,000 per Certificate of Company occurrence 01/01/2002- Yes Yes Insurance 1601 Chestnut Street 01/01/2003 Philadelphia, PA 19101-1484 $2,000,000 annual aaareaate Note: If you are using the State Fund as any part of your demonstration of financial responsibility, your execution and submission Of this certification also certifies that you are in compliance with all conditions for participation in the Fund. D. Facility Name Facility Address SEE ATTACHED LIST OF SITES Facility Name Facility Address Facility Name Facility Address ; E. Signature of Tanl~Owner or Operator Date Name and Title of Tank Owner or Operator ~-'~~'y/'.~O"¢ / ~/~ Glen VanderVeen, Environmental Compliance Manager, West .... ~ ~'(.~2~.-t-~"~~-~-~-- ~--~" Coast Retail Business Unit Signature of Witness or Notary Date Name of Witness or Notary ~-~.-~~___~ ) '~t ~ ~' ~, O L.- Nora Koskenmaki, Environmental Compliance Specialist CFR (Revised 04/95) FII,E: Original - Local Agency Copies - Facility/Site(s) DECLARATIONS [X] INA Surplus Insurance Company UNDERGROUND PETROLEUM STORAGE TANK POLLUTION LIABILITY POLICY An ACE Company (Scheduled Tanks) PRODUCERS NAME: Marsh USA Inc. eot.zcv mva, mv~c^nor~ 500 West Monroe Street PLI G20308175 Chicago, IL 60661 THIS IS A CLAIMS - MADE POLICY - PLEASE READ IT CAREFULLY. THIS POLICY COVERS ONLY SCHEDULED TANKS. ITEM 1 NAMED INSURED BP Amoco PLC BP America Inc. ADDRESS Mail Code 2304 200 East Randolph Drive Chicago, IL 60601-7125 ITEM 2. Policy Period From January_ 1, 2002 To January_ 1, 2003 12:01 A.M. standard time at the address of the NAMED INSURED shown above. ITEM 3. RETROACTIVE DATE This insurance applies only to "bodily injury," "property damage" or "environmental damage" caused by an "Underground Storage Tank Incident" when the "Underground Storage Tank Incident"?commences on or after the Retroactive Date shown below. Retroactive Date: January_ 24,1989 (In the absence of an entry, the Retroactive Date will be the date this policy takes effect) DI~CLARATIONS PoLscY mE~rmc^~-sor~ UNDERGROUND PETROLEUM STORAGE TANK PLI (320308175 POLLUTION LIABILITY POLICY (Scheduled Tanks) PAGE 2 ITEM 4: Limits of Insurance In return for the payment of premium indicated below, we agree with you to provide the following coverage(s) at the limits shown, subject to all of the terms and conditions of this policy. Coverage A - Bodily Injury and Property Each "Underground Storage Damage and Coverage B - Mandated "Corrective $ 1 ~000,000 Tank Incident" Action" Combined Single Limit Coverage A - Bodily Injury and Property Aggregate Limit for all Damage and Coverage B - Mandated "Corrective $ 2,000,000 "Underground Storage Action" Combined Single Limit Tank Incidents" combined. ITEM 5. Defense Expense Limit $ 500,000 Aggregate Limit for all "defense expense." ITEM 6. Deductible Amount Coverage A-Bodily Injury and Property $ 1,000,000 Each "Underground Damage and Coverage B-Mandated Storage Tank Incident." "Corrective Action" Combined Deductible ITEM 7. Scheduled Locations(s) SITE gl See Underground Petroleum Storage Tank SITE//2 Pollution Liability Certificate Endorsement No. 4 thru 7 SITE//3 See Scheduled Tanks. ITEM 8. Scheduled Petroleum Storage Tanks See Schedule of Tanks attached : ITEM 9. Advance Premium $ 2,500 at inception. ( $2,500 ) Flat ( N/A ) Adjustable Minimum Premium $ 2,500 DECLARATIONS UNDERGROUND PETROLEUM STORAGE TANK PLI G20305175 POLLUTION LIABILITY POLICY (Scheduled Tanks) PAGE 3 ITEM 10. Audit Period: Annual unless otherwise stated: . Not Applicable ITEM 11. Forms and Endorsements attached to policy at inception: Endorsement No. CG00420798 Underground Petroleum Storage Tank Pollution Liability Coverage Form CCI El5 Deductible Endorsement 1 CC1E15 Nuclear Energy Liability Exclusion Endorsement (Broad Form) 2 CC 1 E15 Schedule of Tanks and Locations 3 Underground Tank Endorsement 4 Underground Tank Endorsement 5 Underground Tank Endorsement 6 Above Ground AndUnderground Tank Endorsement 7 Amendatory Endorsement 8 Underground Tank Endorsement 9 Underground Tank Endorsement 10 LD-SS23e Signature Endorsement 11 XS3496b Service of Suit Endorsement 12 XS 1U93d Surplus Lines Notification 13 This Declarations and the Coverage Form and Endorsement(s), if any, listed above complete the above numbered policy. Countersigned: AUTHORIZED REPRESENTATIVE DATE Endorsement Number 4 Name: Underground Tank Endorsement Address: Per list attached Policy Number: Claims Made PLIG 20308175 Period of Coverage: 1/1/2002- 1/1/2003 Insurer: INA Surplus Insurance Company Address: 1601 Chestnut Street Philadelphiat PA 19101-1484 Name of Insured: BP America Inc. Address of Insured: Mail Code 2304 200 East Randolph Drive Chicagot Illinois 60601-7125 1. This endorsement certifies that the policy to which the endorsement is attached provides liability insurance coverage for the following underground storage tanks in: Per list attached for taking corrective action and/or compensating third parties for bodily injury and property damage caused by either sudden accidental releases or non-sudden accidental releases or accidental releases. The limits of liability are $1~000,000 each OCcurrence $2t000~000 annual aggregate exclusive of legal defense costs This coverage is provided under policy number Claims Made PLIG 20308175 The effective date of said policy is January 1 t 2002 ~ 2. The insurance afforded with respect to such occurrences is subiect to all of the terms and conditions of the policy, provided however, that any provisions inconsistent with subsections (a) through (e) of this Paragraph 2 are hereby amended to conform with subsections (a) through (e). ~ a. Bankruptcy or insolvency of the insured shall not relieve INA Surplus Insurance Company of its obligations under the policy to which this Endorsement is attached. b. INA Surplus Insurance Company is liable for the payment of amounts within any deductible applicable to the policy to the provider of corrective action or a damaged third-party with a right of reimbursement by the insured for any such payment made by INA Surplus Insurance Company. This provision does .not apply with respect to that amount of any deductible for which coverage is demonstrated under another mechanism or combination of mechanisms as specified in 40 CFR 280.95-280-102. c. Whenever requested by a director of an implementing agency, INA Surplus Insurance Company agrees to furnish to the Director a signed duplicate original of the policy and all endorsements. d. Cancellation or any other termination of the insurance by INA Surplus Insurance Company will be effective only upon written notice and only after the expiration of 60 days after a copy of such written notice is received by the insured. e. The insurance covers 'claims for any occurrence that commenced during the term of the policy that is discovered and reported to INA Surplus Insurance Company within six months of the effective date of the cancellation or termination of the policy. I hereby certify that the wording of this instrument is identical to the wording in 40CFR 280.97Co) (1) and that INA Surplus Insurance Company is licensed to transact the business of insurance or eligible to provide insurance as an excess or surplus lines insurer in one or more states. Rbbin R. Soss Assistant Vice President ACE Excess & Surplus Insurance Services, Inc. 1601 Chestnut Street Philadelphia, PA 19101-1484 O bP Attachment 7 Financial Assurance for Corrective Action and Third Party Compensation for Underground and Aboveground Storage Tanks Owned, Operated or Guaranteed by BP Corporation North America Inc. or Subsidiaries Regulated by State Administered Programs Location: BP Amoco Chemical Company BP Amoco Chemical Company Chocolate Bayou Storehouse Alvin, TX Chocolate Bayou Storehouse 2,600 gallons Alvin, TX Capacity: FRP 4,000 gallons Construction Material: Diesel Fuel FRP Substance Stored: 1982 Gasoline Installation Date: 1969 Location: BP Amoco Chemical Company BP Naperville Complex Chocolate Bayou Administration 150 West Warrenvilie Road Alvin, TX Naperville, IL Capacity: 2,000 gallons (see tank listing at regional office) Construction Material: Steel Substance Stored: Emergency Diesel Fuel Installation Date: 1982 Location: BP Amedca Production Company BP Products North Amedca Inc. 4502 E. 41st. St. Toledo Refinery Tulsa. OK Toledo, OH Capacity: 40,609 gallons 10,000 gallons Construc~Jon Material: Fiberglass Substance Stored: Diesel Fuel Installation Date: 1990 Location: BP America Production Company BP America Production Company Tulsa, OK 4502 E. 41st St. Tulsa, OK Capac~y: 10,000 gallons 40,609 gallons Construction Material: Substance Stored: Diesel Fuel Diesel Fuel Installation Date: 1991 Location: BP Amedca Production Company BP Amedca Production Company 7575 N. Lakewood 4502 E. 41st. St. Tulsa, OK Tulsa, OK Capacity: 500 gallons Construction Material: 3,000 gallons Substance Stored: Diesel Fuel Waste Oil and Oily water Installation Date: Location: BP Amedca Production Company **Jeff Hall, MARSH, maintains copies of _- Earth Science Lab ALL UST facility liability endo~ement 11611 West Little York policies. 312-627-6000'* Houston, TX Capacity: 4,000 gallons Construction Material: Fiberglass : Substance Stored: Diesel Fuel Installation Date: 1964 Page 11 2002 Financial Assurance " 2/4/2002 Attachment 7 (continued...) Location: BP West Coast Products, LLC. BP West Coast Products, LLC. US Logistics Terminals in CA, WA, OR, AZ ARCO Retail FacJlities in CA, WA, OR, AZ, (see tank listing at regional office: NV, UT 1306 Canal Blvd. Richmond, CA) (see tank listing at regional office: 4 Centerpoint Ddve, La Palina, CA) Location: BP Exploration (Alaska) Inc. BP Exploration (Alaska) Inc. Anchorage, Alaska Anchorage, Alaska Capadty: 15,000 gallons 4,000 gallons Construction Material: Fiberglass Fiberglass Substance Stored: Installation Date: 19~4 1984 Location: BP Chemicals Amoco Pipeline Green Lake Fadlity B~an, Texas Port Lavaca, TX (see tank listing at regional office) Capacity: 7,600 gallons Construction Material: Fiberglass reinforced plastic Substance Stored: Unleaded Gasoline Installation Date: 1981 Location: BP Amoco Chemical Company BP Chemicals Joliet Truck Terminal Green Lake Facility Joliet. IL Port Lavaca, TX Capacity: 10,000 gallon 7,600 gallons Construction Material: Fiberglass Fiberglass reinforced plastic Substance Stored: Diesel Fuel Diesel Fuel Installation Date: 1993 1981 Location: BP America Production Company, **Jeff Hall, MARSH, maintains copies of Westlake I 501 Westlake Park Blvd. ALL UST facility liability endorsement Houston. TX policies. 312-627-6000" Capacity: 10.000 gallons Construction Material: Fiberglass Substance Stored: Diesel Fuel Installation Date: 1982 Page 12 2002 Financial Assurance 2/4/2002 Sites in Kern County Covered Under the BP Corporation Certification of Financial Responsibility FAC FAC ADDRESS CITY STATE ZIP COUNTY 00371 12698 MT VERNON BAKERSFIELD CA 93306 KERN 00583 }220 MING AVE BAKERSFIELD CA 193304 KERN 01960 1701 BRUNDAGE LANE BAKERSFIELD CA 93304 KERN 03054 1129 UNION AVE BAKERSFIELD CA 93307 KERN 03090 3333 UNION AVE BAKERSFIELD CA 93305 KERN 05365 4010 WIBLE RD BAKERSFIELD CA 93309 KERN 05420 6450 WHITE LANE BAKERSFIELD CA 93309 KERN [}5496 4800 FAIRFAX BAKERSFIELD CA 93306 KERN 05526 900 MONTEREY BAKERSFIELD CA 93305 KERN 05657 35300 7TH STANDARD RD BAKERSFIELD CA 93308 KERN ~}5751 2800 PANAMA LANE BAKERSFIELD CA 93313 KERN 06218 4203 MING AVE BAKERSFIELD CA }3309 KERN 06353 3125 CALIFORNIA AVENUE BAKERSFIELD CA )3302 KERN 06356 2301 F STREET BAKERSFIELD CA }3301 KERN 06208 20650 S TRACY AVENUE BUTTONWlLLOW CA }3206 KERN 05634 2241 GIRARD ST DELANO CA ~93215 KERN 05674 16300 SIERRA IU~VY MOJAVE CA 93501 KERN 06150 ~101 ROSAMOND BLVD ROSAMOND CA )3560 KERN 2002 Financial Assurance Updated 1/1/02 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION Page of I. IDENTIFICATION FACILITY(Agency UseIDonly) # I. 01/01/02BEGINNING DATE lOO. ENDING DATE BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3. BUSINESS PHONE 1o2. Arco Facility No. 6356 661-863-0528 BUS1NESS SITE ADDRESS lo3. 2301 F Street CITY lO4. CA ZIP CODE los, Bakersfield 93301 DUN & BRADSTREET 1o6. SIC CODE (4 digit #) lO7. 09-720-0401 5541 COUNTY 1o8. Kern BUSINESS OPERATOR NAME lo9. BUSINESS OPERATOR PHONE John T. Gannon Jr. 661-863-0528 Il. BUSINESS OWNER OWNER NAME 111. OWNER PHONE BP West Coast Products LLC 714-670-5402 OWNER MAILING ADDRESS 113. P.O. Box 6038 CITY 114. I STATE ns. I ZIP CODE 116. Artesia I CA I 90702-6038 III. ENVIRONMENTAL CONTACT CONTACT NAME 117. CONTACT PHONE 118. Carlos Rodriguez 714-670'-5402 CONTACT MAILING ADDRESS i 19. P.O. Box 6038 CITY 12o. STATE 121. ZIP CODE 122. Artesia CA 90702-6038 -PR/MARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123. NAME 128. John T. Garmon Jr. ARCO MAINTENANCE TITLE 124. TITLE 129. Franchisee MAINTENANCE BUSINESS PHONE ~25, BUSINESS PHONE ~3o. 661-863-0528 (800) 272-6349 24-HOUR PHONE* 126. 24-HOUR PHONE* 13L Same (800) 272-6349 PAGER # 127. PAGER # 132. N/A N/A ADDITIONAL LOCALLY COLLECTED INFORMATION: 133. Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. SIGNATURE OF OWNER/OPERATOR OR DESIGNATED REPRESENTATIVE DATE 134. ] NAME OF DOCUMENT PREPARER 135. ~/~ ~ A>~4~'~-~- 12/26/01 I David Chambers NAME OF SIGNER (print) 136. TITLE OF SIGNER 137. Carlos Rodriguez Environmental Compliance Specialist * See Instructions on next page. UPCF hwf2730 0/99) - 27/29 http://www.unidocs.org Rev. 04/17/00 UNIFIED PROGRAM CONSOLIDATED FORM TANKS UNDERGROUND STORAGE TANKS - FACILITY (One page per site) Page of__ TYPE OF ACTION [] 1~ NEW PERMIT [] 3. RENEWAL PERMIT [] 5. CHANGE OF INFORMATION [] 7. PERMANENTLY CLOSED SITE 4oo. (Check one item only) [] 4. AMENDED PERMIT (Specify change) Name Change [] 8. TANK REMOVED [] 6. TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3. [ FACILITY Arco Facility No. 6356 I ID# NEAREST CROSS STREET 401. FACILITY OWNER TYPE [] 4. LOCAL AGENCY/DISTRICT* 402. 24th/F [] 1. CORPORATION [] 5. COUNTY AGENCY* BUSINESS [] 1. GAS STATION [] 3. FARM [] 5. COMMERCIAL 403. [] 2. INDIVIDUAL [] 6. STATE AGENCY* TYPE [] 2. DISTRIBUTOR [] 4. PROCESSOR [] 6. OTHER [] 3. PARTNERSHIP [] 7. FEDERAL AGENCY* TOTAL NUMBER OF TANKS 404. Is facility on Indian Reservation 405. * If owner of UST is a public agency: name of supervisor of division, section or 406. REMAINING AT SITE or trust lands? office which operates the UST. (This is the contact person for the tank records.) 3 [] Yes [] No II. PROPERTY OWNER INFORMATION PROPERTY OWNER NAME 407. PHONE 408. BP West Coast Products LLC 714-670-5402 MAILING OR STREET ADDRESS 409. P.O. Box 6038 CITY 410. STATE I ZIP CODE 412. Artesia CA I 90702-6038 PROPERTY OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY 413. [] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL AGENCY III. TANK OWNER INFORMATION TANK OWNER NAME 414. I PHONE 415. BP West Coast Products LLC I 714-670-5402 MAILING OR STREET ADDRESS 416. P.O. Box 6038 CITY 417. STATE 418. I ZIP CODE 419. Artesia CA I 90702-6038 TANK OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 4. LOCAL AGENCY/DISTRICT [] 6. STATE AGENCY 420. [] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL AGENCY IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER TY (TK) HQ 44- I I I ' I I I I Call (916) 322-9669 if questions arise 421. V. PETROLEUM UST FINANCIAL RESPONSIBILITY INDICATE METHOD(s) [] 1. SELF-iNSURED [] 4. SURETY BOND [] 7. STATE FUND [] 10. LOCAL GOV'T MECHANISM 122. [] 2. GUARANTEE [] 5. LETTER OF CREDIT [] 8. STATE FUND & CFO LETTER [] 99. OTHER: [] 3. INSURANCE [] 6. EXEMPTION [] 9. STATE FUND & CD VI. LEGAL NOTIFICATION AND MAILING ADDRESS Check one box to indicate which address should be used for legal notifications and mailing. Legal notifications and mailings will be sent to the tank owner unless box 1 or 2 is checked. [] 1. FACILITY [] 2. PROPERTY OWNER [] 3. TANK OWNER 423. VII. APPLICANT SIGNATURE Certification: I certify that the information provided herein is true and accurate to the best of m, knowledge. SIGNATURE OF APPLICANT DATE 424. I PHONE 425. ~,/~.~ ~ ,~t>,-,~-e~o-- 12/26/01 I 714-670-5402 NAME OF APPLICANT (print) 426. TITLE OF APPLICANT 427. Carlos Rodriguez Environmental Compliance Specialist STATE UST FACILITY NUMBER (Agency use only) 428. 1998 UPGRADE CERTIFICATE NUMBER (Agency use only) 429. (See Data Element 1, above. UPCF hwf2730 (1/99) - 26/29 http://www.unidocs.org Rev. 04/17/00 .,.?~- 01-ARE-003: Bakersfield Site List 12/27/01 00371 2698 MT VERNON COLUMBUS/MT VERNON BAKERSFIELD 'CA 93306 00583 3220 MING AVE WIBLE RD/MING AVENUE BAKERSFIELD CA 93304 01960 1701 BRUNDAGE LANE "H" ST/BRUNDAGE BAKERSFIELD CA 93304 03054 1129 UNION AVE CALIFORNIA/UNION AVE BAKERSFIELD CA 93307 03090 3333 UNION AVE 34TH/UNION BAKERSFIELD CA 93305 05365 4010 WIBLE RD WHITE LANE/WIBLE RD BAKERSFIELD CA 93309 05420 6450 WHITE LANE ASHE/WHITE LANE BAKERSFIELD CA 93309 05496 4800 FAIRFAX AUBURN/FAIRFAX BAKERSFIELD CA 93306 05526 900 MONTEREY BEALE/MONTEREY BAKERSFIELD CA 93305 05751 2800 PANAMA LANE DENNEN/PANAMA BAKERSFIELD CA 93313 06218 4203 MING AVE STINE/MING AVE BAKERSFIELD CA 93309 06353 3125 CALIFORNIA AVENU CALIFORNA/OAK BAKERSFIELD CA 93302 06356 2301-F-STREET--.) 24TH/F BAKERSFIELD CA 93301 Page I CERTIFICATE OF INSURANCE Name & Address: See Attachment 7oA and 8oA for names and addresses of each covered UST location. Policy Number: Contact facility representative or Jeff Hall at MARSH (312-627-6000) for copies of all UST waste facility liability endorsement polic~ numbers. Period of Coverage: January 2002 through January 1, 2003 Name of Insurer: Insurance Company of North America Address of Insurer: 195 Broadway, New York, NY 10007 Name of Insured: BP America Inc. Address of Insured: 200 E. Randolph Drive, Chicago, IL 60601 Certification: 1. Insurance Company of North America, the Insurer, as identified above, hereby certifies that it has issued liability insurance covering the following underground storage tank(s): (see Attachments 7.A and 8.A) for taking corrective action and compensating third parties for bodily injury and property damage caused by accidental releases arising from operating the underground storage tank(s) identified above. The limits of liability are $ 1,000,000 per occurrence and annual aggregate $ 2,000,000, exclusive of legal costs, which are subject to a separate limit under the policy. This coverage is provided under (policy number). The effective date of said policy is January 1, 2002. 2. The Insurer further certifies the following with respect to the insurance described in Paragraph 1: a. Bankruptcy or insolvency of the insured shall not relieve the Insurance Company of North America of its obligations under the policy to which this certificate applies. b. The Insurer is liable for the payment of amounts within any deductible applicable to the policy to the provider of corrective action or a damaged thirdparty, with a right of reimbursement by the insured for any such payment made by the Insurer. This provision does not apply with respect to that amount of any deductible for which coverage is demonstrated under another mechanism or combination of mechanisms as specified in 40 CFR 280.95280.102. c. Whenever requested by (a Director of an implementing agency), the Insurer agrees to furnish to (the Director) a signed duplicate original of the policy and all endorsements. d. Cancellation or any other termination of the insurance by the Insurer, except for nonpayment of premium or misrepresentation by the insured, will be effective only upon written notice and only after the expiration of 60 days after a copy of such written notice is received by the insured. Cancellation for nonpayment of premium or misrepresentation by the insured will be effective only upon written notice and only after expiration of a minimum of 10 days after a copy of such written notice is received by the insured. e. The insurance covers claims otherwise covered by the policy that are reported to the Insurer within six months of the effective date of cancellation or nonrenewal of the policy except where the new or renewed policy has the same retroactive date earlier than that of the prior policy, and which arise out of any covered occurrence that commenced after the policy retroactive date, if applicable, and prior to such policy renewal or termination date. Claims reported during such extended reporting period are subject to the terms, conditions, limits, including limits of liability, and exclusions of the policy. I hereby certify that the wording of this instrument is identical to the wording in 40 CFR 280.97(b) (2) and that the Insurer is licensed to transact the business of insurance in one or more states. Authorized Representative of Insurer December 21, 2001 195 Broadway, New York, NY 10007 Address of Representative O bp Attachment 8.A Financial Assurance for Corrective Action and Third Party Compensation for Underground and Aboveground Storage Tanks Owned, Operated or Guaranteed by BP Amoco Corporation or Subsidiaries Regulated by State Administered Programs Location: BP Amoco Chemical Company BP Amoco Chemical Company Chocolate Bayou Storehouse Alvin, Chocolate Bayou Storehouse TX Alvin, TX Capacity: 2,600 gallons 4,000 gallons Construction Material: FRP FRP Substance Stored: Diesel Fuel Gasoline Installation Date: 1982 1969 Location: BP Amoco Chemical Company Chocolate Bayou Administration Alvin, TX Capacity: 2,000 gallons Construction Material: Steel Substance Stored: Emergency Diesel Fuel Installation Date: 1982 Location: BP Amoco Corporation BP Oil Company Naperville Site Toledo Refinery Naperville, IL Oregon, OH Capacity: (see tank listing at office) 10,000 gallons Construction Material: Fiberglass Substance Stored: Installation Date: 1990 Location: Amoco Production Company Amoco Production Company 4502 E. 41st. St. 4502 E. 41st. St. Tulsa, OK Tulsa, OK Capacity: 40,609 gallons 40,609 gallons Construction Material: Substance Stored: Diesel Fuel Diesel Fuel Installation Date: Location: Amoco Production Company Amoco Production Company Tulsa, OK 4502 E. 41st. St. Tulsa, OK Capacity: 10,000 gallons 500 gallons Construction Material: Substance Stored: Diesel Fuel Waste Oil and Oily Water Installation Date: 1991 Location: Amoco Production Company Amoco Production Company 7575 N. Lakewood Earth Science Lab Tulsa, OK 11611 West Little York Houston, TX Capacity: 3,000 gallons 4,000 gallons Construction Material: Fiberglass Substance Stored: Diesel Fuel Diesel Fuel Installation Date: 1984 Location: Amoco Production Company, Westlake I 501 Westlake Park Blvd. Houston, TX **Shirley Tse, MARSH, maintains Capacity: 10,000 gallons copies o£ALL UST facility Construction Material: Fiberglass liability endorse~en~ policies. Substance Stored: Diesel Fuel 312-627-6247'* Installation Date: 1982 Page 17 2001 Financial Assurance 12/28/01 Attachment 8.A (continued...) Financial Assurance for Corrective Action and Third Party Compensation for Underground and Aboveground Storage Tanks Owned, Operated or Guaranteed by BP Amoco Corporation or Subsidiaries Regulated by State Administered Programs Location: ARCO BP Exploration (Alaska) Inc. California, Nevada, Washington, ;%nchorage, Alaska Arizona, Utah and Oregon UST facilities Capacity: (see tank listing at regional 4,000 gallons Construction Material: office) Fiberglass Substance Stored: Installation Date: 1984 Location: BP Exploration (Alaska) Inc. Amoco Pipeline Anchorage, Alaska Bryan, Texas 15,000 ~allons Capacity: Fiberglass Construction Material: (see regional office for tank Substance Stored: 1984 listing) Installation Date: Location: BP Chemicals BP Chemicals Green Lake Facility Green Lake Facility Port Lavaca, TX Port Lavaca, TX Capacity: 7,600 gallons 7,600 gallons Construction Material: Fiberglass reinforced plastic Fiberglass reinforced plastic Substance Stored: Unleaded Gasoline Diesel Fuel Installation Date: 1981 1981 Location: BP /~noco Chemical Company Joliet Truck Terminal Joliet, IL Capacity: 10,000 gallon **Shirley Tse, MARSH, maintains Construction Material: Fiberglass cop/es Of A~LL UST facility Substance Stored: Diesel Fuel liability endorsement policies. Installation Date: 1993 312-627-6247'* Page 18 2001 Financial Assurance 12/28/01 Endorsement Number 4 Name: Underground Tank Endorsement Address: Per list attached Policy Number: Claims Made PLIG 20308175 Period of Coverage: 1/1/2002 - 1/1/2003 ~, Insurer: INA Surplus Insurance Company Address: 1601 Chestnut Street Philadelphiat PA 19101-1484 Name of Insured: BP America Inc. Address of Insured: Mail Code 2304 200 East Randolph Drive Chicago~ Illinois 60601-7125 1. This endorsement certifies that the policy to which the endorsement is attached provides liability insurance coverage for the following underground storage tanks in: Per list attached for taking corrective action and/or compensating third parties for bodily injury and property damage caused by either sudden accidental releases or non-sudden accidental releases or accidental releases. The limits of liability are $1tO00,000 each OCcurrence $2~000~000 annual aggregate exclusive of legal defense costs This coverage is provided under policy number Claims Made PLIG 20308175 The effective date of said policy is January 1, 2002 2. The insurance afforded with respect to such occurrences is subject to all of the terms and conditions of the policy, provided however, that any provisions inconsistent with subsections (a) through (e) of this Paragraph 2 are hereby amended to conform with subsections (a) through (e). a. Bankruptcy or insolvency of the insured shall not relieve INA Surplus Insurance Company of its obligations under the policy to which this Endorsement is attached. b. INA Surplus Insurance Company is liable for the payment of amounts within any deductible applicable to the policy to the provider of corrective action or a damaged,third-party with a right of reimbursement by the insured for any such payment made by INA Surplus Insurance Company. This provision does not apply with respect to that amognt of any deductible for which coverage is demonstrated under another' mechanism or combination of mechanisms as specified in 40 CFR 280.95-280-102. c. Whenever requested by a director of an implementing agency, INA Surplus Insurance Company agrees to furnish to the Director a signed duplicate original of the policy and all endorsements. d. Cancellation or any other termination of the insurance by INA Surplus Insurance Company will be effective only upon written notice and only after the expiration of 60 days after a copy of such written notice is received by the insured. e. The insurance covers'claims for any occurrence that commenced during the term of the policy that is discovered and reported to INA Surplus Insurance Company within six months of the effective date of the cancellation or termination of the policy. I hereby certify that the wording of this instrument is identical to the wording in 40CFR 280.97Co) (1) and that INA Surplus Insurance Company is licensed to transact the business of insurance or eligible to provide insurance as an excess or surplus lines insurer in one or more states. 'Rbbin.R. Soss Assistant Vice President ACE Excess & Surplus Insurance Services, Inc. 1601 Chestnut Street Philadelphia, PA 19101-1484 ARO0 AM-PM NOV 9, 200! 8:28 AM STATUS REPORT ALL FUNCTIONS NORMAL INVENTORY REPORT NO AOTIVE TANKS ARCO AM-PM 2JO1F ST. B~i~I~RSFIELD cA.gJJo1 NOV 9, 200! 8:29 AP1 SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL INVENTORY REPORT NO ACTIVE TANKS CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3r'~ Floor, Bakersfield, CA 93301 FACILITY NAME /~lv, 0tYX INSPECTION DATE ADDRESS _~-%0 I "~- ti ,-~T" PHONE NO. ~b ~ -- FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBEROF EMPLOYEES LC) .. Section 1: Business Plan and Inventory Program 1~ Routine {~ Combined ~1 Joint Agency ~ Multi-Agency ~ Complaint {~1 Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate ~,~ Visible address ~ ' Correct occupancy Verification of inventory materials k.,/ Verification of quantities Verification of location ~, Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate ~"" Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: ~}Yes ~No ~~_~ ~ Explain: Questions regarding this inspection? Please call us at (661) 326-3979 "/ 'Business Site/~espons)bl~Party , ,I/ f' White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspeotor:=gdO'_,t CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 Section 2: Underground Storage Tanks Program ~l Routine ~ Combined [] Joint Agency [21 Multi-Agency [] Complaint [] Re-inspection Type of Tank ,0L~d ~ Number of Tanks _~ Type of Monitoring ~ k I1,~ Type of Piping ~0d{'~ OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file ~ /' / Permit tees current / Certification of Financial Responsibility / Monitoring record adequate and current Maintenance records adequate and current ~, Failure to correct prior UST violations Has there been an unauthorized release? Yes No Q.~J__ Section 3: Aboveground Storage Tanks Program TANK SIZE(S). AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=C°mplianTe~V=;~/~.a/~.n _, 5Yes N=NO ~J~~ ~~ Inspector: _~J~,.~ [,/J-X. tfJ_~P~ ) Office of Environmental Services (805) 326-3979 Business S~te Responsible Party White - Env. Svcs. Pink - Business Copy "~~'ARCO Products Company This letter certifies that the monitor(s) is/are in place, the probes are in corr~ :t position and the system is op~ratin$ properJy. Station # ~-~5-./P Date ~'-~..-o ~. 19 . - Ad~ss_~. ~ ~ Type Inspection; Recheck . ..M~ System Fan~tion Tan~ Annul~ Space n T~k P~s Fail N~A Pros F~I Midgr~ ~ Sup~mc -'~ ~ " W~te Oil ~' - O~cr ~ ~' ~ ProdUct L~es ~r~ine Sump In-Lin~ Fill Sump P~ F~ N/A P~; Fail N/A P ss Fail R~gul~ Mid.de ,, J - ~ ~ - Supmm~ ~ ~ ~ '~ -' ~ Waste Oil ~ ~ ~ .... Other .... ~ ...... ~ ~-- ~ When monitor is turned off or in alum, is ~here positive shutdown of turbinel ? Yes ~ No If No, were p~cision product tine tests p~rformed? Yes ,, No... Mo~tor Panel Is the monitor psnel m~ntc~ ~d labclcfl co~ectly7 /~ Does monitor al~ horn function properly? Is panel ~cessible and visible tv station personnel? ~'l'-- R~placed all failed probes? Yes ~ No - N/A ~ ~ No, probes to be repl~e~rep~red by (Date) Technician Signature S~VlC_.ES I~,FO~D (ttr~.~,s ONLY)_ NUMBER OF PERSONNEL __TOTAL TRAVEl, TIME LESS M~[~ T~ ..... P~ N~ OF D~ p~ ~ OF OR ST~ ~O~ OR STO~ ~LO~ , ~NA~ OF D~ ~ ST~ E~0~ SIONA~ ~ D~ OR ~30~ SIG~v ~ AP~ov~ o~ ~ DONL CO~g ~ ~:S~ON~B~ FOR ~G c ~m-~ ~m~'m~ ARCO OD ~i03S MaAs CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME _' .~...~ 0/1~ ~;~-' INSPECTION D~TE /f'[ '00 ADDRESSO3 ! PHONENO. ~_63~ 0Sc0~ FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ~l Routine ~"'ombined [~l Joint Agency ~ Multi-Agency [~ Complaint [~ Re-inspection OPERATION C V COMMENTS / Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material / Verification of MSDS availability Verification of Haz Mat training L / / Verification of abatement supplies and procedures / Emergency procedures adequate Containers properly labeled Housekeeping tr Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: [~l Yes ~o Explain: Questions regarding this inspection? Please call us at (661) 326-3979 ~'/Business SitjrJRes >o)asi~le Party White- Env. Svcs. Yellow- Station Copy Pink- Business Copy Inspector: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~IIt {)~x ~l ~'~-- INSPECTION DATE Section 2: Underground Storage Tanks Program [] Routine [~ombined ~l Joint Agency [] Multi-Agency [] Complaint [] Re-inspection Type of Tank ~ ~' Number of Tanks Type of Monitoring d: LgA. Type of Piping ,Dr0 OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit f~es current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current V / Failure to correct prior UST violations k,~ / Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? Inspector:C=C°mpliance "u ,~ '~'.~~~?'/ V=Vi°lati°n Y=Yes N=NO'/~--- ~ ~~d~d /'~._. Office of Environmental Services (805) 326-3979 J Business Site Responsible Party White - Env. Svcs. Pink - Business Copy ~~ Motor Certification Inspection ARCO Products Company This letter certifies that the monitor(s) is/are in Place, the probes are in correct position and the system is operating properly. · Station # ~ "~ ~, Date Address ..,o 5~t9! i~"'<j,~., Type Inspection: {'~a'~,~-de!e,~ / ("',::1 , Annual /~ Permit Recheck Leak Type & Model of Monitor System Function .... K,,...7, ' Tanks Annular Space' In Tank Pass Fail N/A Pass Fail N/A Regular '~ Midgrade Supreme .~' . Waste Oil ~" Other ~ '-~ ' Product Lines Turbine Sump In-Line Fill Sump  ss Fail N/A Pass Fail N/A Pass Fail N/A Regular ~ .. "(' Midgrade "/c Supreme ¥ ~ Waste Oil x/C Other ~ 7 ...'X ~, 'X .... When monitor is turned off or in alarm, is there positive sh~i~own of turbines? Yes._~ No If No, were precision product line tests performed? Ye~No_.~ Monitor Panel Is the monitor panel mounted and labeled correctly? Does monitor alarm horn function properly? Is panel accessible and visible to station personnel? / -- Replaced all failed probes? Yes ~ No ~ N/A If No, probes to be replaced/repaired by (Date) / / Inspected By: Contractor. Technician Signature APC-3~4 (~96} ~FFICE OF ENVIRONMENTOSERVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY P~:~e ~ of TYPE OF ACTION ~'~ I. NEW SITE PERMIT [] 3. RENEWAL PER/~IT [] 5. CHANGE OF INFORMATION (,.So ~ c~a~. ~ 7. ~R~NENTLY CLOSED SITE (Check one ,~m only) ~ 4. AMENOED PERMIT local use only) [ ~ 8. TANK RE~VED 4~, .:~-'~ ~ 6. TEM~RY SITE CLOSURE I. FACILI~ I SITE INFORMATION ~ ~. COR~TION ~ 5. ~U~ AGENCY' ~ 2. INDIVIDUAL ~ 6. STATE AGENCY' BUSINESS ~. ~S STATION ~ $. FARM ~ $. ~MMERC~L ~ ~. PARTNERSHIP ~ 7. FEDE~LAGENCY* ~2. ~PE ~ 2. DISTRIBUTOR ~ 4. PROCESSOR ~ 6. O~ER ~3. TOTAL NU~ER OF T~KS 18 f~li~ ~ Indi~ Rmfim ~ ~ ~ d UST a public ~: n~e d su~ d I1. PROPER~ O~ER INFORMA~ON TANK O~ER ~ ~ O 2. INO~ ~ 4. L~L A~IOIS~IO O 6. STA~ AGENCY 4~. ~. ~T~N ~ 3. P~ER~IP ~ 5, ~U~ A~Y ~ 7. FEDE~L AGENCY ~. BO~D OF EQUATION UST STOOGE FEE ACCOU~ NUMBER ' ' V. pmoLEuMUST FiNANCaL RESmNSlBI~ ' ' INDI~TE~S) ~ SE~-INSURED ~ 4. SUR~ND ~ 7. STA~NO ~ 10. ~ 3. INSURE ~ 6. ~E~ION ~ 9. STATE FUND & CD 4~. VI. LEG~ NO~FICA~ON AND MAILING ADDRESS VII. APPLICANT SIGNA~RE UPOF (7/~) SACUPAFORMS~c~a.wpd ~ / ~ (~ICE OF ENVIRONMENTA~iSERVICES ~.~._. 171S C~ester Ave., Bakersflel~ CA 93~1 (661) 326-3979 UNDERGROUND ~TO~GE T~K~ - T~K PAGE 1 ~0~ (~'~~) (~~*~~) ~ ~. T~~O I. TANK DESCRIPTION OATE INSTA,U.F.D ('Y~.,~M~lq~ ,~ TANK C, APACI'TY IN iCrTY OF ~AKERSFIELD . OFFICE OF ENVIRONMENTAL. ~EAVICE~ IS ClIHtlr Avl., kkitlflild, CA g3301 (6el) 32~T~ i ~lT · TANK PAQf co~s~uc~A~,~J_/~ ~. ~C4.EWAU. O 3. ~U~F.D~RLN(:H Cleo. OTHER 4aa I-1 ~. $~NGLEWAU. I--I~. UNKNOV~ ~NUFACTUR~200Um.a WALL I--I ge. UNKNOWN ) C] 2. ~OUBLEWAU. [] 9e. OTHE~ MATERIALS ANO 'O 2. ST~~ 0 ?. ~V~~ 0 Z ST~~ 0 7. ~V~~ ~S~N TEST(0.1C~1~) 0 6. T~ENN~INTC-(31~TY~(O.¶ ~ -' I--I 7. Srd/~ r'] ~. SELFMOHnOFm~ C:] g. B~'E~TEST(0.t QPH) C] L C)AJLYV~hK3flrrO~ C]o. B~B~TES'r(o.s GPfl) UPCF (7/90) S:&CUPAFORIVlS~~.WPC ~~. l?lS OTestev Ave., Bakersfield, CA 9331~1 (661) 326 3979 UNDERGROUND STORAGE TANKS - T~K PAGE 1 ~0 ~ ~. ~ ~ ~OM~) ~ 4. ~Y ~ ~0~ i crrY OF BAKEI~SFIFI. O (X'IqCI OF ENVIRONMENTAL SERVICES ~ Che~ter Ay1.. Bikimfleld. CA 13301 (M1) SYSTEM TYPE ~ P~ESSURE I--I 2. SUCTCN i--I ]. GRAVrTY 4M I--I ~. ~E~IU~E ["! 2. SUCTCN ~] 3. O~.VTTy CONSTRUCT)O~,~-I~.__I.(.~I ~l.E WALL. ~1 3. UI~D TI~.NCH I-J 9e. OTHER 4~0 [~ 1. SINC~.E WAU. I'~ ~. UNKNOWN ~S~N 0 3. ~~~~ 0 4, ~Y~~ TEST(0.1 ~ C]e. TR/ENMAJ. li~'T~G(3~'[Y TEST (0.1 Gi~H) l'1 e. MMM. NTE(amYTES'r¢o.~ (a~ r-i c NO AUTO ~M' S~rT OFF 0 c NOagTO/'UkI'S~UTO(:i= I"1 ~_ )d~AJ*J. KTE(am~TEST(O. lCa~H) I-1 r'l 13. CC)f~MJCX~SENSOR+W~IDVlSU~L)LAMA8 ' / ~ O~iCE OF ENVIRONMENTA~ERVICES -~. 1715 Crester Ave., Bakersfield, CA 93~171 (661) 326-3979 UNDERGROUND STORAGE TANKS - TANK PAGE 1 rY~ oF 4CROON C] ~. N~VV ~T~ ~J~AT 0 4. Ak/ZM3eO ~nk/JT '~['~2_ ~ OF ~lq3~,4A'nON) 0 e. TEW~:~4~Y $nl ~0~ CITY OF BAKERSFIELD O~FlCl OI. ENVIRONMENTAL SERVICE8 SYSTEM :~s~, ~0 ~. ~~~~ 0~, w ~ ~. ~m,~~s 0 · ~(~ Om. o~ 0 3. ~~~s~ 0 ~. ~Y~~. e. ~~~(o.s ~ ~ ~ ~y~~ ~ · w~~(o.s 14. ~WW~~~eW~ ~ 14. ~~~ 0 1. ~T~~T~~V~ 0 ~ ~Y~~ UPCF (7/99) S:~CUPAFORIi~WRCS,'B.WP C CITY OF BAKERSFIELD 1715 Chester Ave., Bakersfield-CA 93301 r (661) 326-3979 UNDERGROUND STORAGE TANKS-INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank - I. FACILITY IDENTIFICATION II. INSTALLATION " Check e/I Ihat app/y · [3 The installer has been certified by I~e tank and piping manufacturers. [3 The installation has been inspects! and certified by a registered professional engineer. /~ The installation has been inspected and the City of Bakersfield Office of Environmental Services. approved by All work listed on the manufacturer's installation checklist has been completed. The installation contractor has been certified or licensed by the Contractors State License Board. 13 Another method was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: III. TANK OWNER/AGENT SIGNATURE SIGNATURE OF TAN~ OI~N~N~//~ OATE ~ ~rr~ o~ ~.~^~.~~" ................. CITY OF BAKERSFIELD  O~ICE OF ENVIRONMENTAL~I~RVICES 1715 Chester Ave., Bakersfield-CA 93301 · (661) 326-3979 UNDERGROUND STORAGE TANKS-INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank - I. FACILITY IDENTIFICATION 8USlNES8 NAME (Same as ~=AC;LrrY NAME ~ OaA - Doing 8uane# A~) II. INSTALLATION " Check all t~at ai~ * 1:3 The Installer has been certified by the tank and piping manufacturers. 1:3 The installation has been inspec~l and certified by a registered professional engineer. The Installation has been inspected and approved by the City of Bakersfield Office of Environmental Services. AJI work listed on the manufacturer's installation checklist has been completed. ~ The Installation contractor has been certified or licensed by ~e Contractors State License Board. I:] Another method was used as allowed by the City of Bakersfield Office of Environmental Services. Ideqtifv method: IlL TANK OWNER/AGENT SIGNATURE ! ~:~~-~ .... ............. CITY OF BAKERSFIELD 1715 Chester Ave., Bakersfleld,'-CA 93301 · (661) 326-3979 UNDERGROUND STORAGE TANKS-INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank - I. FACILITY IDENTIFICATION FA~ ID # II. INSTALLATION E] The Installer has been certified by the tank and piping manufacturers. The installation has been inspec~l and certified by a registered professional engineer. The installation has been inspected and approved by the City of Bakersfield Office of Environmental Services. All work listed on the manufacturer's installation checklist has been completed. The installation contractor has been certified or licensed by the Conlractors State License Board. Another method was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: III. TANK OWNER/AGENT SIGNATURE $1GNA~ OATE NAME OF ~ER/AGENT ~ 4~5 ~ OF TANK OWNER/A~.NT .......... D 'r April 4, 2000 Arco EnvirOnmental Compliance FIRE CHIEF RON FRAZE Best Shaman P O Box 6038 n~n~w~ ar.~ncr, a Artemia CA 90702 6038 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 Fax (~os) 39s-13~9 Dear Compliance Coordinator: SUPPRESSION SERVICE8 21Ol -.- str~ You have been identified as the compliance coordinator for the Bak~. CA ~01 facility/facilities referenced in the attachment. VOICE (805) 3263941 The permits to operate this facility/facilities will expire on June 30, 2000. PREVENTION SERVICE8 1715 c~,tor ^~. However, in order for this office to renew your permit, updated forms A, Bak~sfl~l. CA VOICE (805) :~!-3~1 B, & C must be filled out and returned prior to the issuance of a new F~ (~os) ~-o~76 permit. ENVIRONMENTAL SERVICE8 lZlS c~.t.. ^~,. Please make sure that you are sending the updated forms which are Bak~mfl~ld. CA 9:~01 VOICE (~0S) 32~-a~79 indicated by the date 7/99 in the lower left hand comer. Please complete 3~-0576 and return to this office by May 15, 2000. Failure to comply, will result in 'r~nING Dl~lSION a delay of issuance of your new permit to operate. 5642 ~ Bakerafl~ld, CA VOICE Caos) 3~? Should you have any questions, please feel free to call me at 661-326-3979. Sincerely, Steve Underwood, Inspector Office of Environmental Services SU/dam attachment Facility Address AM/PM ~2301~F"-S:t~¢_et_,-_B~akersfield, Ca 93301 AM/PM 1129 Union Ave, Bakersfield, Ca 93307 AM/PM 3333 Union Ave, Bakersfield, Ca 93305 AM/PM 2698 Mt. Vernon Ave, Bakersfield, Ca 93306 AM/PM 4010 Wible Road, Bakersfield, Ca 93309 AM/PM 6450 White Lane, Bakersfield, Ca 93309 AM/PM 4800 Fairfax Road, Bakersfield, Ca 93312 AM/PM 900 Monterey Street, Bakersfield, Ca 93305 AM/PM 4203 Ming Ave, Bakersfield, Ca 93309 AM/PM 2800 Panama Lane, Bakersfield, Ca 93313 AM/PM 1701 Brundage Lane, Bakersfield, Ca 93304 AM/PM 3125 California, Bakersfield Ca 93304 Arco Individual Contacts AM/PM ' 13001 Stockdale Hwy, Bakersfield, Ca 93312 AM/PM 4100 California Ave, Bakersfield, Ca 93309 AM/PM 2612 Buck Owens Blvd, Bakersfield, Ca 93308 AM/PM 7851 Rosedale Hwy, Bakersfield Ca 93308 OranQe Count:¥ Tank .Test:ina .' .lnc ~ 225 North Loara Street~ Anaheim~ California 9280! (714) 77&-0500 TEI SYSTEM 5.~BB .... 8UMM'~RY ..... ~HEET Non-Volumetric Underground Storage Tank System Leak Test Client: ATLANTIC RICHFIELD 4 CENTERPOINTE DR. LA PALMA,CA Date: 4-28-98 County: KERN Site: ARCO SS#&JS& 2501F STREET BAKERSFIELD,CA Tank Product Tank Tank Product Line Leak # Description Capacity Liquid Ullage Rate/Result Detector UNLEADED 20,000 PASS PASS -. 08! PASS Signature:___~V~_~ Tech. License #: 92-ili8 Technician Name: R.DODGE Date: ~~ ~ ~_~__~ ~, Comments: DOUBLE WALL TANK AND LINES~POSITIVE SHUT DOWN SYSTEM. MANIFOLDED PRODUCT LINE ON UNLEADED #1 AND #5 TANKS. The Non-volumetric threshold for PASS FAIL is 0.020 GPH as listed by the third party evaluation report and the test procedure. This precision tank testing system exceeds the criteria required by Local, State and Federal NFPA #529 and EPA UST Technical Standards Part 280 foF precision testing systems. Oran(3e County Tank ?estina 225 No. Loara Street~ Anaheim, CA 92801 (7!4) 77~-0~00 TEI SYSTEM 41t11~!!~1 SIJMM~IRY SHEET Precision Underground Storage Tank System Leak Test Owner: ATLANTIC RICHFIELD 4 CENTERPOINTE DR. LA PALMA,CA Date: 4-28-98 County: KERN Site: ARCO 2501F STREET BAKERSFIELD,CA Tank Product Tank Tank/Lines Product ,Line Leak # Description Capacity Rate/Result Rate/Result Detector 1 UNLEADED 10,080 +.056 PASS -.881 PASS 2 PREMIUM I0,000 -.~42 PASS -.~85 PASS 4 5 Signature:~ State License #: 92-I118 Date: ~/~~.~''--~~~ Technician Name: R.DODGE Comments: DOUBLE WALL TANKS AND LINES,POSITIVE SHUT DOWN SYSTEM. A TEI ULLAGE TEST WAS CONDUCTED ON TANKS~VENTS AND VAPOR LINES. ALL TANK SYSTEMS PASSED THE TEI ULLAGE TEST AT I PSI ~VACUUM. This precision tank testing system exceeds the criteria required by Local, State and Federal NFPA #529 and EPA UST Technical Standards Part 280 for precision testing systems. TEI SYSTEM 4000 ANALYSIs SHEET TANK INFORMATION: Product : 1UNLEAD Date: 04/28/98 Capacity : 10000 TimeI 08:12:49 PRODUCT INFORMATION: Diameter (in.) : Product Level (in.) : 105" above tank bottom. % = 94.0 Specific Gravity : 0.750 Coef. of Expansion : 0.000&&09 Water on Tank (in.) : 0" above tank bottom. Starting Temp. CF) : 72.047 Resolution (Gallons): 0.0040000 Head P~essure (PSI) : 2.9 at tank bottom Delta Temp. (F/Hr.) : -0.0111 COMPUTER ANALYSIS RESULTS: Level Rate (GPH) = -0.055 Temp. Rate (GPH) -- -0. Final Rate (GPH) = 0.05~ 0 30 ~0 ~0 120 150 I 1 ~e-~l nut e~ TE'I SYSTEM '4OOO ANALYBIS SHEET TANK INFORMATION: Product : 2PREM Date: 04/28/98 Capacity : 10000 Time: 08:12:49 PRODUCT INFORMATION: Diameter (in.) : 118 Product Level (in.) : 98" above tank bottom. % = 88.8 Specific Gravity : 8.758 Coef. of Expansion : 0.008&~09 Water on Tank (in.) : 0" above tank bottom. Starting Temp. (F) : 71.751 Resolution (Gallons): 0.0052099 Head Pressure (PSI) : 2.7 at tank bottom Delta Temp. (F/Hr.) : 0.0197 COMPUTER ANALYSIS RESULTS: Level Rate (GPH) = 0.07~ Temp. Rate (GPH) = 8.115 Final Rate (GPH) = 0 30 ~0 ~0 120 150 Time-minute~ ~/~:--' ~,, ,,, , ,, ,.__ ~ , ,,,, , , ,,. ........ ..... ~,:~~.~ ... , .~ · FIRE r February 9, 1999 r~ae CH,eF Prestige Stations [nc RON FRAZE 2301 "F" St ADMINISTRATIVE SERVlCE8 Bakersfield, Ca 93301 2101 'H' Street Bakersfield. CA 93301 VOICE (805) 326-3941 FAX (8o5) 395-1349 RE: Compliance Inspection SUPPRESSION SERVICE.8 Dear Underground Storage Tank Owner: 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 The city will start compliance inspections on all fueling stations within the city limits. This inspection will include business plans, 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 bc in FAX (805) 326-0576 com_g)llance, TRAINING DIVISION 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 Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure BAKERSFIELD FIRE DEPARTMENT July 21, 1998 REE CHIEF MICHAEL R. KELLY ADMINISllb~IV£SF.,I~VICF..S Ms. Kateri Luka 2101 'H' Street ARCO Products Bak~. c^9ml bompany (~) 326-3941 4 Centerpointe Drive FAX (805) 395-1349 La Palma, CA 90623-1066 SUPPI~SSION SEEVICE$ 2101 'H' Street RE: Former ARCO Station No. 00128, 2301 "F" Street in Bakersfield Bakersfield, CA 93301 (805) 326-3941 F~X C~) ~9v1~9 Dear Ms. Luka: PI~EVEN/ION SERVICF.~ 1715 Chester Ave. I have reviewed the quarterly monitoring report for the above referenced Bakersfield, CA 93301 (805) 326-3951 site. FAX (805) 326-0576 Please continue with the quarterly groundwater sampling and preparation ENVIRONMENTAL SEEVICES 1715Chester Ave. of quarterly status reports for at least two more consecutive quarters. If at the end ~e~s~a, CA 9~1 of two more quarterly sampling events, you or your consultant wish to make (805) 326-3979 FAX (805)326-0576 further recommendations, this office will review those recommendations with you at this time. TRAINING DIVISION 5642 Victor Street Bakersfield, CA 93308 Sincerely, (805) 3994697 FAX (805) 399-5763 ~~~7 ~.~_~ Howard H. Wines, III Hazardous Materials Specialist Office of Environmental Services cc: J. Bollier ARCO ARCO'-ProductsCom Environmental Compliance 4 Centerpointe Drive La Palina, California 90623-1.066 Mailing Address: Box 6038 Artesia, California 90702-6038 May 20, 1998 Bakersfield Fire Dept. Haz. Mat. Division 1715 Chester Ave. Bakersfield, Ca. 93301 Re: Owner/Operator Agreement for Operation of UG Tanks with Monitoring Procedure Used Gentlemen: Enclosed, for your records, is a current copy of the new subject Agreement which is currently in effect for the following facilities: Fac. Num. Address Arco Plan(s) 6356 2301 "F" Street, Bakersfield X & SC Very truly yours, Willi a Environmq~ ~mpliance Administra~ encl cc: Dealer with Attach (For Yellow Box) ARCO Products Company is a Division of AtlanticRichfieldCompany ARCO .PrOducts Company Division of Atlantic Richfield Company AMENDMENT TO LESSEE PMPA FRANCHISE AGREEMENT/DEALER/PREMISES LEASE OPERATION OF UNDERGROUND STORAGE TANKS CALIFORNIA This Amendment, dated !~{'~0..~ ~ ~ ,19 c~ % , is attached to, incorporated in and made a part of the Lessee PMPA frahjchise Agreement/Dealer/Premises Lease ("PMPA Agreement"), in effect as of the date of this Amendment or, if applicable, to become effective concurrently with this Amendment, between Atlantic Richfield Company, a Delaware Corporation, through its division ARCO Product Company, ("ARCO"), and Prestiqe Stations Inc. #6356 ("Franchisee"), covering premises located at 2301 "F" Street, Bakersfield, CA , In return for good and valuable consideration, each party's receipt of which is hereby acknowledged, the parties agree as follows: 1. The parties have entered into this Amendment in accordance with legal requirements imposed on ARCO and Franchisee concerning operation of the underground storage tanks at the above- referenced location. 2. ARCO has provided Franchisee a copy of: (a) California Health and Safety Code Section 25299 or an approved summary concerning civil and criminal penalties for violating terms of any permit to operate these underground storage tanks and relevant statutory and regulatory requirements; (b) the following listed documents, a copy of which is attached and initiated by Franchisee: Monitoring and Response Plan -"X" and "SC" 3. Where ARCO has provided Franchisee with a copy of the permit to operate the underground storage tanks, Franchisee has read and understood its responsibilities as operator under the permit and agrees to comply with each of the provisions of the permit. Irrespective of whether Franchisee has received and reviewed a copy of the underground storage tank operating permit, Franchisee hereby expressly agrees to do the following: (a) monitor the underground tanks as required by law; (b) maintain all required records and make such records available to the federal, state, and local government agencies and to ARCO at all reasonable times; (c) follow all reporting procedures as required by law; (d) mail, when submitted to, ARCO, at the address specified in paragraph 1 of the PMPA Franchise Agreement/Dealer/Premises Lease, a copy of all reports submitted to overnment agencies; CA (1/92) I of 2 PARSSW (e) follow all oper ~ng procedures specified by ARCO; (f) immediately report to ARCO all suspected or confirmed releases from the tanks and connected piping system, unusual operating conditions, release detection signals and environmental conditions suggesting a release may have occurred, and any spills and overfills that are not contained and cleaned up; (g) properly close the underground tanks as required by law; and, (h) comply with all federal, state, and local legal requirements relevant to the operations of the underground tanks and all amendments to any permit to operate. 4. With respect to the operation of the underground storage tank system and monitoring equipment, Franchisee hereby acknowledges and agrees: that ARCO has provided Franchisee with training on each of the items described in the attached Monitoring and Response Plan, that Franchisee understood the content of the training, and asked any questions necessary to facilitate his understanding, that Franchisee indicated to ARCO at the time of training any subjects addressed by the training which Franchisee did not fully understand, and that Franchisee received complete training and information necessary for Franchisee to fully understand the subject of operating underground storage tanks. 5. ARCO has provided Franchisee a copy of and Franchisee agrees to maintain on the Premises the Certificate of Financial ReSponsibility (as required by the United States Environmental Protection Agency in Subpart H, 40 CFR, Part 280 and California Health and Safety Code, Chapter 6.7, Section 25292.2). 6. Except to the extent that conflict with, or are less rigorous than the terms of this Amendment, all of the terms and conditions of the PMPA Agreement, as previously or hereafter amended or supplemented, remain in full force. IN WITNESS WHEREOF, ARCO and Franchisee have executed this Amendment. ARCO Products Company a division of Atlantic Richfield Company ARCO WITNESS: Manager ./ WITNESS: Prestige Statio,~s Inc. #6356 DATE: CA (1/92) 2 of 2 PARSSW MONITORING AND RESPONSE PLAN - X ARCO PRODUCTS COMPANY FACILITY WITH SECONDARY CONTAINMENT OF UNDERGROUND STORAGE TANKS & PRODUCT LINES WITH SUBMERSIBLE PUMP SHUTDOWN This plan is designed to meet the monitoring and response requirements of Section 26:32, Article 3, Title 23, CCR. 1. MONITORING EQUIP .MENT . Secondarily contained storage tanks and lines at this facility are monitored by a continuous electronic leak detection system which consists of an alarm panel, sensors and associated electronics. Liquid sensors are installed in the annular space of each double wall tank and product line piping sump. Whenever a sensor detects the presence of a liquid there is both a visual and audible alarm at the control panel. In addition, the continuous monitor on the product piping system will shut down the pump and activate the alarm system when a release is detected or if the continuous product piping monitoring system fails or is disconnected, the pumping system will shut down. Automatic line leak detectors are installed on the secondarily contained pressurized product piping. The line leak detector will detect a loss of pressure in the product lines and restrict the flow of product. 2. MAINTENANCE SCHEDULE OF MONITORING EQUIPMENT The continuous electronic leak detection system including line leak detectors will be inspected according to the manufacturer's instructions by an outside contractor once during each calendar year. 3. ROUTINE MONITORING PROCEDURE On a daily basis the facility operator shall: A. Inspect the control panel for visual and audible alarm signals to confirm that the unit is operating. B. Inspect island and tank fill areas for signs of spillage or petroleum sheen. C. Record the inspection observations on the Daily Visual Monitoring Log (Form APPC- 765: attached.) 4. RESPONSE PLAN OPERATOR RESPONSIBILITIES A. LEAK RECORDING AND REPORTING PROCEDURE Whenever an alarm is activated, station personnel are to immediately: a. Contact ARCO Maintenance or its designated agent by using the telephone number previously provided. b. If any visible indications of petroleum products or vapors are noticed call 911. c. Make an entry in the Recordable Discharge Log (Form APPC-765-1: attached) indicating the action taken. d. Complete the Recordable Discharge Log when and as the source of the alarm is known. ARCO RESPONSIBILITIES B. METHOD OF REMOVING AN UNAUTHORIZED RELEASE FROM THE SECONDARY CONTAINMENT a. Any unauthorized release into the secondary containment system of a product tank will be removed by pumping. Uncontaminated product may be returned to the tank. Contaminated product may be returned to the refinery to be recycled or may be disposed of following procedures in accordance with California Health Safety Code requirements. In the event of an emergency, a pumping conractor or truck will be available immediately. In all other cases, equipment availability will be within 12 hours. b. ARCO Maintenance will be responsible for authorizing and selecting contractors for the work to be performed. 5. TRAINING In addition to the training covering subjects mentioned in Sections 3 and 4 above, training needed for the operation of the tank system and monitoring equipment includes: How to: - Take tank level measurements - Read dispenser meters - Inspect equipment - Recognize warning signs: dispenser hesitations, meter spins and odors - Manually close dispenser impact valve - Replace dispenser filters - Shut down the system with and location of: AKCOmatic switch, electrical panel breakers, and emergency shut off switch - Test the electronic monitor 6. RECORDS RETENTION Written records of all monitoring, testing, and maintenance performed shall be maintained on- site or off-site at a readily available location for a period of at least 5 years. These records must be made available, upon request within 36 hours, to the local agency or the Board. 7. PARTY RESPONSIBLE FOR PERFORMING THE MONITORING _Manager on Duty_ Name Title 8. PARTY RESPONSIBLE FOR MAINTAINING EQUIPMENT ARCO Maintenance 1-800-ARCO-FIX (272-6349) Name Title 9. NAME AND MODEL OF THE MONITORING EQUIPMENT Tanks: '{e_e~2~' 5-~.%- ~0 Lines: 10. LOCATION WHERE THE MONITORING WILL BE PERFORMED: Monitoring will be performed in the rear service area of the station; not accessible to customers. See attached Plot Plan. '~ ~ /[.RCO Products Company ~ Daily Visual Underground o,.,.,o.o,A,,..,,=.,c.,.,~c~.... ~torage Tank Monitoring Log I Montt~/~ear ARCO facility no. {Dealer/Franchisee System condition I Inspector Comments Day Operational Alarm' initials 1 5 6 ? ,I 2~ 22 25 2§ 27 ~8 2~ 'NOTE: IF ALARM CONDITION EXISTS IMMEDIATELY NOTIFY ARCO MAINTENANCE OR lis AGENT DESIGNATED AND MAKE ENTRY ON ALARM ACTIVATION/DISCHARGE LOG APPC-765 (5-89) ARCO lucts Company '~' RECORDABLE DISC 3GE LO~ o,A,,a~,,cR,ch,~.,~co..,.n, DOUBLE CONTAINMENT Uk ~ROUND STORAGE T~,... SYSTEM' A~ICO Facility no. Dealer/Franchisee Dale/Time Reported to Daterl'lme Description of conditions Correcllve acllon taken of Discovery CALIFORNIA HEALTH AND SAFETY CODE DIVISION 20, CHAPTER 6.7 SECTION 25299 Any pperator of an under, round tank system shall be li~J~le for a civil penally of not less than five hundred dollare ($6D0) or more than five thou.~and dollars ($S,000) tot each underground storage tank for each clay of violation for any of the following violations: ( 1 ) Operating an unctergrouncl mnl~ system w,~cn ~ mi peen ~ssued a permit, In violation of this cl~apter. ( 2 ) Violation of any of the applicable requirements of ~he permit issued for the operation of the underground tank system. (3 } Failure to maintEdn recorcls, as required by this chapter. ( 4 ) Failure to report an unauthorized release, as required by Sections 25294 and 25295. (5 } Failure to properly close an underground tank system, as required by Section 25298. ( 6 ) Violation of any applicable requirement of this chapter or any requirement of this chapter or any regulation adopted by the bosrd pursuant to Section 2529g.3 (? } Failure to permit inspection or to perlorm any monitoring, testing, or reporting required pursuant to Section 25288 or 25289. (8) Making any false statement, represanlallon, or certification in any Itppllcation, report, or other Ciocumant submitled or required to be maintained pumuant to this chapter. Any owner of an underground lank s~tem Shall be liable for a civil penally of not less five hundred dollars (SSOD) or more then five thousand clollars ISS,O00) per day for each underground storage lank, for each day of violation, for any of the following violations: ( 1 ) Failure to ol~tain a permit as specified by this chapter. ( ~ ) Failure to repair or upgrade an underground tank system in accorclanee with this chapter. ( 3 ) Abandonment or improper closure of any underground tank syslem subject to this chapter. ( 4 ) Knowing failure to take reasonable and necessary steps to assure compliance with this ohaptor by the operator of an undergrouncl tank system. ( $ ) Violation of any applicable requirement of the permit Issued for operation of the underground tank system. ( 6 ) Violation of any applicable requirement of this ct~apter of any regulation adopted by the board pursuant to Section 25299.3. (7) Failure to permit inspection or to perform any monitoring, testing, or reporting rec~uired I~Ursuant to Section 2528B or 25289. (' 8 ) Malting any false statement, representation, or certification in any apl)licatton, record. report, or Other documen! submitted or reclutred to be maintained I~ursuant to this ¢llagte~, (c) Any person who Intentionally tails to notify the board or the lo,al agency when required to do so by this chapter or who submits false Inlormation in a permit application, amendment, or renewal, pursuant to Section 25286, Is liable for a civi/penal~y or not more than five thousand dollars ($5,000) for each unclergmund storage tank for which notification Is not given or false Information is subm~ed. (d) Any person who falsifies any monitoring records re~luired by this chapter, or knowingly fails to report an unauthorized release, shall, upon conviction, be punished by e fine of not less than five thousand clollar$ ($5.000) or more.than ten thousand dollars ($I0,0000, by iml~risonment in the county Jail for nol to exceed one year, or I:)y both that fine and Imprisonment. (e) In determining both the-civil and criminal penalties imposed pursuant to Ibis sac'lion, the court shall consider all relevant circumstances, Including, but not limited to. the extent of harm or I~otentlal harm caused I~y fi~e violation, the nature of the violation and the pedocl o1' time over which It occurred, the frequency of past violations, and the corrective action, it any, taken by the person wino holds the permit. (f) Each civil penalty or criminal fine imposed Dumuant to this section for any separate violation shall be separate, and in addition to, any other civil penalty or crimtnal fine imposed pursuant to this section or any other provision of law. and shall be paid to the treasury of the local agency or state, whichever is represented by the office of the city attorney, ~:listrict attorney, or Attorney General bdngtng the action. All penalties or fines collectecl on behalf of the board or a regional board I~y the Attomey General shall be Clelx~lted in the State Water Pollution Cleanup and Abatement Account in the 8tare Water Qualily Conu'ol Fund, and am available for expenditure by the l:x:mrd, upon appropriation, pursuant to Section 13441 of the Water Code. (g) This section shell become operative on Janumy 1, 1991. (Added by Stats. 1988, c. 296 Section 3, operative Jan. 1, 1991. Amencled by Stats. 1989, o. 11397, Section 19, operative Jan. 1, 1991.) MONITORING AND RESPONSE PLAN - SC ARCO PRODUCTS COMPANY FACILITY WITH DISPENSER SPILL' CONTAINMENT DEVICES ARCO Facility: ~ ~ Address: This is a monitoring and response plan of action for facilities with spill containment device~ installed beneath the dispensers. 1. CONTAINMENT EQUIPMENT Dispenser spill containment devices [box{es)] are located beneath each dispenser to contain any leaks from components and fit-tings inside the dispenser cabinet. A mechanical sensor is located in the box. When the sensor detects the presence of a liquid, it will activate the impact valve and shut the dispenser down. 2. MAINTENANCE SCHEDULE The containment devices will be inspected according to the manufacturer's.instructions by an outside contractor once during each calendar year. 3, ROUTINE MONITORING PROCEDURE On a weekly basis the facility operator shall: A. Inspect each containment box for the presence of a liquid. B. R~move debris from the containment box. - If any liquid is found, manually close the impact valve, place the dispenser "out of service", and call ARCO Maintenance immediately. 4. RESPONSE PROCEDURE - CONTAINMENT BOXES OPERATOR RESPONSIBILITIES In the event the impact valve is activated and shuts down a dispenser, station personnel immediately: A.Contact ARCO Maintenance or its designated agent by using the telephone number previously provided-. B. Tag the dispenser "out of order" until the liquid has been removed by authorized persons. ARCO RESPONSIBILITIES Method of removing an unauthorized release from the spill containment device: A. Any ur, authorized release into the containment box will be removed by ARCO in accordance with California Health and Safety Code requirements. In the event of an emergency, a pumping contractor or truck will be available immediately. In all other cases, equipment availability will be within 12 hours. B. ARCO Maintenance will be responsible for authorizing and selecting contractors for the work to be performed. 5. TRAINING .... All employees must be trained in the subject mentioned in Sections 3 and 4 above. Training needed for the operation of the dispenser containment devices shall .include how to inspect the equipment and to manually close ,*he dispenser impact valve. CASTD$C.DOC 8/94 STATE OF CAUFORNIA / Z~.~' t ~"~ STA WATE. RESOURCESCO.T"O'SOA.D / IAY 1 0 1998 UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORM A CO.PL~S~OR~ FOR~CHFAC~L~ lBY. MARKONLY ~1 N~ PERMIT ~ 3 RENEW~ PERMIT ~S CHANGE OF INFORMATION ~ 7 PERMANENCY CLOSED SITE ONE ~M ~ 2 IN~RIM PERMIT ~ 4 AMENDED PERMIT ~ 6 ~MPO~RY SITE CLOSURE I. FAClLI~/SlTE INFORMATION & ADDRESS - (MUST BE COMPLIED) DBA OR FAClU~ NAME . N~E OF OPEneR N~REST CROS~ STRE~ PARC~ 1 (OP~O~) ADDRESS ~ ~ ~ C,~ NAME~ ~ ~XN~ STATE ZIP CODE SITE .H~E .Wl~ AR~ CODE ¢ ~X ~OORPO~TION ~ IND~ ~ PAR~SHIP ~ L~AL-AGE~Y ~ COU~-AG~CY' ~ ~TA~-AG~CY' ~ FEDEX-AGENCY ' TO I~IOA~' % DIS~IOTS 'PE OF BUSINESS ~ I ~S STA'ON~ 3 F~M ~ 2 DISTRIBUTOR4 PR~ESSOR ~ 50~ER I~ORRESERVA~ON~UST~ IF IND'AN "OF T~KS AT S'~ I E' P' A'~NDS ,' ~ I.D..(optional) EMERGENCY CO~ACT PERSON (PRIMAR~ EMERGENCY CONTACT PERSON (SECONDARY) - optional DAYS: NAME (~ST, FIRS~ ~HONE ~ WI~ AR~ CODE DAYS: NAM~ (~ST, FIRS~ PHONE ~ WI~ AREA CODE NIGHTS: N~E (~ST,~FIRS~o~ ~ ~os~PHO~ J Wl~.~~ CODE NIGHTS: NAME (~ST.[j FIRS~ kJ PHONEi[ ~ Wl~ AR~ CODE[. jL II. PROPER~ OWNER INFORMA~ON - (MUST BE COMPLETED) srXr[ I ZIP CODE I PHONE ~ITH AR~ COqE II1. TANK OWNER INFORUA~ON - (MUST BE COUPLETED) I CARE OF ADDRESS INFORMATION MAILING OR 8~E~ADDRESS ~ J ~ ~xto ~te ~ ~D~ V .~, ~ ~O 3~ ~CORPO~ON = ,AR~ER~HIP ~ LOCAL-AGE<Y ~ STATE-AGENCY ~ COU~-AG~CY ~ FEDER~-AGENCY Cl~ NAME~~ J~l STA~E J ~--~J ZIP CODE~J PHONE ~ Wl~ AREA CODE IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER - Call (916) 322-9669 if questions arise. V. P~ROLEUM UST FINANCIAL RESPONSIBILI~ - (MUST BE COMPLETED) - IDEN~ THE M~HOD(S) USED J V~x~, ~lS~'INSURED =2GUA~E ~31"SU~E =4SUR~B~O ~5~ROFCR~ff ~6~EM~ ~7STA~ND ~8 STA~&mlEFF~CI~OmCEH~H ~ 9 STA~&CEH~FIm~OFDEPOSlT ~ 10 L~GO~.~ECH~IS~ ~ 99 O~ER VI. LEGAL NO~FICATION AND BILLING ADDRESS Legal notificmion and billing will be sent to the tank owner unless box I or II is checked. THIS FORM HAS BEEN COMPL~D UNDER PENAL~ OF PERJURY, AND TO ~E BEST OF MY KNOWLEDGE. IS TRUE AND CORRECT ~RINTED & SIGNA~RE) TANK OWNER'S ~T~~ ~[~IIIDATE ~J~J~ ~MqNT~AY~EAR LOCAL AGENCY USE ONLY COUN~ ff FAClLI~ ~ L~A~ON CODE - OPTION~ CENSUS ~ACT ~ * OP~ONAL SUPVISOR - DISTRICT CODE - OPTION~ ~IS FORM MUST BE ACCOMPANIED BY AT L~ST (1) OR MORE PERMff APPLICA~ON - FORM B, UNLESS ~IS IS A CHANGE OF S~ INFORMATION ONLY. OWNER MUST R~ THIS FORM W~ THE LOCAL AGENCY IMPLEMEN~NG ~E UNDERGROUND STORAGE TANK REGU~ONS STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM A · COMPLETE THIS FORM FOR EACH FACILITY/SITE MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT ,,~]~5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED SITE ONE ITEM [] 2 INTERIM PERMIT r--J 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE L FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) NAME OF OPERA~.,tOR ADDRESS ~' ~.~ ~, NEAREST CROSS STREET PARCEL II (OPTIONAL) t/ BOX ~/CORPORATION r~J INDMI~JN. ~ PARTNERSHIP r"'J LOCAL-AGENCY J---J COUNTY-AGEI~Y' J--1 STATE-AGENCY' ~ FEDERN..AGENCY TO INDICATE'% ' DISTRICTS ° ltownerol USTis a pubr,,.agency, m:mplet, lt~lo~g: r~,ned supen~or~l ~r~sion, secti~torolflce whichopemleslhe,UsT I t/IF INDIAN I' OF TAN~ AT SITE I E' P' A' I'D''(°Pp°nal) TYPE OF BUSINESS 1~ 1 GAS STATION j'--'J 2 DISTRIBUTOR ~ RESERVATION 3 FARM [--'1 4 PROCESSOR j---J 5 OTHER OR TRUST LANDS EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY) - optional DAYS: NAME (LAST, RRST) J~HONE,J WITH AREA CODE DAYS: NAME(LAST, FIRST1 PHONE il WITH AREA CODE NIGHTS: NAME (LAST, RRS~ ~,PHON~ il WITH AREA CODE NIGHTS: NAME (LAST, RRS~ PHONE il WITH AREA CODE II. PROPERTY OWNER INFORMATION - (MUST BE COMPLETED) MAILING OR STR v' Jx~l~ ~cate ~ INDMDUN_ r~J LOCAL-AGENCY J---J STATE-AC, ENCY III. TANK OWNER INFORMATION - (MUST BE COMPLETED) MAIMNG OR STREE'.~,ADORESS t~, V' l~xto imlicate r-"} INDMDUN. ~ LOCAL-AGENCY J'""} STATE.AGENCY ¥.b, co ., ..BENCY ER,. ERCY CiTY NAME~.,~ ~.C~- ~STATE ZIP~.)..~'~-~:)O'''~C~CODEJJ PHONE il WITH AREA CODE IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER - Call (916) 322-9669 if questions arise. V. PETROLEUM UST FINANCIAL RESPONSIBILITY - (MUST BE COMPLETED) - IDENTIFY THE METHOD(S) USED STATE FUND & CHIEF PJ~IN~IClN. OFFICERLET"IT~R r--J 9 STATEFUND&CERTIFlCATEOFDEPO$1T r~J 1~ LOC/~.GOV'i'.MECHANISM J~J ~9 OTHER VI. LEGAL NOTIRCATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked. ~cHECK~NE~~~~ND~~ATINGWH~~~A~~VEADDRE~~$H~ULD~EU~EDF~RLEGA~N~TIF~~ATT~NsAND~~LL~NG: "E:~ II.E~ THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT \,.f.S NAME (PRINTED & SIGNATU RE) TANK OWNER'S TITLE DATE MQNTI-I~.DAY/Y EAR LOCAL .~ENCY USE ONLY ' COUNTY # URJSDICT1ON # FACILITY # LOCATION CODE · OPTIONAL J CENSUS TRACT il - OPT/ONAL 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, OWNER MUST RLE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERUIT APPLICATION - FORM A .COMPLETE THIS FORU FOR EACH FACILITY/SITE ! MARKONLY ,~ 1 NEW PERMFr ' ~-'~ 3 RENEWAL PERMIT ,,~ S CHANGE OF INFORMATION r-"'] 7 PERMANENTLY CLOSED SITE ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) NAME OF OPERA~'~OR ADDRESS 4' ~r~ ~ NEAREST CROS~ STREET PARCEL # (OPTIONAL) CIT'Y NAME v' BOX *~CORPORATION ~ b~IDIV~DUN. ~ PARTNERSHIP ~] LOCAL-AGENCY ED COUNTY-AGENCY ° [~ STATE-AGENCY · r'-I FEDERN..AGENCY TO INDICATE~ D~TRICTS · IlownerolUSTisapub[cagency. cc~np~eltlefollow~ n~neeisupen~or~r~.seclionorofflc~whic~oper~esl~e UST TYPE OF BUSINESS ~ 31 GAS STATIONFARM [~}['-"J 2 DISTRIBUTOR4 PROCESSOR [~] 5 OTHER I[~]ORRESERVATIONTRuSTV'IF INDIAN I' OF TAN~ AT SITE I E' P' A'LANDS "D''(°Pt~°nal) EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY) - optional NIGHTS: NAME (LAST. FIRST) -- [PHONF~ # WITH AREA CODE I NIGHTS: NAME (LAST, FIRST) PHONE # WITH AREA CODE II. PROPERTY OWNER INFORMATION - (MUST BE COMPLETED) CITY NAME STAT[ I ZIP CODE I PHONE #,k~/ITH AREA COqE ,t III. TANK OWNER INFORMATION - (MUST BE COMPLETED) ~ CARE OF ADDRESS INFORMATION ] STATE I 7JP CODE I PHONE # WITH AREA CODE IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER - Call (916) 322-9669 if questions arise. STATEFUM)ICHIEF~OFRCERLETrER ~ 9 STATE FUND I CERTIFICATE OF DEPOSIT r"-] lo LOCALGOVI'.UECHANtSM ~ g90'~IER VI. LEGAL NOTIRCATION AND BILUNG ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked. I (~HECK ONE Box INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND I. IL THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, iS TRUE AND CORRECT PRINTED & SIGNATURE) TANK OWNER'S TITLE I DATE MQNTH(DAY/YEAR LOCAL AGENCY USE ONLY COUNTY # # FACIUT'Y # LOCATION CODE - OPTIONAL ICENSUS TRACT # - OPTIONAL SUPVISOR - DISTRICT CODE . OPTIONAL TH;s ~o.M =us~ BE ACCOMPA.,E= BY A; ~EAS; I~l OR MORE PE.M~ APP',C^~O.- ~O.M ~, U..ESS ~.~S ~S A CHANGE O~ S~E ~.~ORUA~O. O..Y. OW.ER ~US; ~= ~.;S ;OR= wn~ THE ~OCA~ A=E.CY ~M.~EME.~NG TH= U.DER=ROU.D S;O.AG~ ~A.~ R~GUU~ONS STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED ON SITEI ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] S TANK REMOVED DBA O. FAClL...AMEW.E.ETA.KIS,.STALLED; I. TANK DESCRIPTION COMP~ ~ ImMS- SPECI~,P UN~OWN C. DAm INSTALLED (M~AY~EAR) ~O~ ~ D. TANK C~ACI~ IN ~LLONS: II. TANK CONTENTS ~F A-1 IS M~KED, COMPL~ I~M C. ~ lb PREMIUM UNL~ ~ 4 GASAHOL ~ 7 ME~ANOL D. IF (A. 1) IS NOT M~KED, ENTER NAME OF SUBSTANCE STORED C.A.S. ~: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, AND C, AND ALL THAT APPLIES IN BOX D AND E A. TYPE OF ~ 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR UNER [] 5 INTERNAL BLADDER SYSTEM [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SINGLE WALL IN A VAULT [] 99 OTHER a. TANK [~ 1 BARE STEEL [] 2 STAINLESS STEEL [~ 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] S POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLE W/FRP (Primary Tank) [] 9 BRONZE [---'] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER C. INTERIOR [] 1 RUBBER UNED [] 2 ALKYD LINING [] 3 EPOXY UNING [] 4 PHENOLIC UNING LINING OR [] 5 GLASS LINING [~6 UNLINED [] 95 UNKNOWN [] 99 OTHER COATING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES_ NO__ D. EXTERIOR [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [~4 FIBERGLASS REINFORCED PLASTIC CORROSION PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER SPILL CONTAINMENT 1~3JSTALLED (YEAR) t~tCt ;'~ OVERFILL P~EVENTION EQUIPMENT INSTALLED (YEAR) ~"~ ~ E. SPILL AND OVERFILL, etc. DROP TUBE YES ~,~ NO STRIKER~LATE YES V NO DISPENSER CONTAINMENT YES__ NO__ IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IFAPPLICABLE A. SYSTEM TYPE A U 1 SUCTION A~_j 2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A~_..J 2 DOUBLE WALL A U 3 UNED TRENCH A U 95 UNKNOWN A U 99 OTHER A U 1 BARES'rEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A~t4 FIBERGLASS PIPE C. MATERIAL AND CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ 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 [] 1 I~ECHN~CAL UNE LF-AK ~ 2 UNE TIGHI'NESS ~ 3 CONTINUOUS INTERSTITIAL ~] 4 ELEC1~ONlC UNE ~;;~5 AUTOMATIC PUMP · D~-I~CTOR ~ TESTING ~ MON~TORING LEAK DETECTOR ~ SHUTDOWN [] 99 OTHER V. TANK LEAK DETECTION I ~1 ViSUALOHECK [] 2 MANUALINVENTORY [] 3VADOZE [] 4 AUTOMATIC TANK ~---~5 GROUND WATER F~6 ANNUALTANK RECONCILIATION MONITORING GAUGING MONITORING ~STING CONTINUOUS.NTERSTIT.AL [] . S,R [] WEEKLY MANUAL [] .0 MONTHLY TANK [] 95 UNKNOWN [] 99 OTHER MONITORING TANK GAUGING TESTING VI, TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACE) I 1. ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTITY OFsuBSTANCE REMAINING GALLONS I3' WAS TANK FILLED WITHINERT MATERIAL ? YES[] NO~ THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER ~s CO~IPOSEB OF THE FOUR NUMBERS BELOW I COUNTY #JURISDICTION # FACILITY # TANK # STATE I.D:# ~-~ I I I I I I I I I I I 1; i. SHOULD BE ACCOMPANIED BY A PLOT PLAN. RLE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM B (6-95) STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM El cOMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY [] 1 NE'W PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED ON SITI ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED L TANK DESCRIPTION coum~-m ~L ~TEMS - SPECI~ IF UNKNOWN C. DA'I~ INSTAI_~ (MO/DAY/YEAR) ~:) ~ 3 <~ D. TANK CAPACITY IN GALLoNs: t (~t . (:~ ~:~ O ,t~ ,.TANK CONTENTS ,FA-,,S~'~KED. COMPL~,~MC. ~ ~' ~ZO~OOO ~\. ~"C ~ [] ~ MOTOR V~",CLE ~UEL [] ~ O,L E. C. [] ~ ,;~U~ UN'~ [] ~ D'ESEL [] ~ AV,ATIONGAS - - lc MIDGRADE UNLEADED [] 5 JETFUEL [] 8 Ma5 [] 3 CHEMICAL PRODUCT [] g5 UNKNOWN [] 2 WASTE [] 2 LEADED [] 99 OTHER (DESCRIBE IN ITEM D. BELOW) O. IF(A. 1) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED C. A, S. #: IlL TANK CONSTRUCTION ~K ONE ITEM ONLY IN BOXES A, B, AND C, AND ALL THAT APPLIES IN BOX D AND E A. TYPE OF '~ 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 5 IN'~-RNAL BLADDER SYSTEM [] 95 UNKNOWN S~STE~ [] 2 SINGLE WAI. L [] 4 SINGLE WALL IN A VAULT [] 99 OTHER & TANK [--~' 1 BARE STEEL [] 2 STAINLESS STEEL [~ 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLY~INYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLE W/FRP (l~Tallk) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER c.l~n'~:lloR [] 1 RUBBER UNED [] 2 ALKYD LINING [] 3 EPOXY UNING [] 4 PHENOLIC LINING B~aGOR [] 5 GLASS MNING ~B UNUNED [] 95 UNKNOWN [] 99 OTHER · COAI'~G IS UNING MATERIAL COMPATIBLE WITH 100% METHANOL? YES~ NO~ D. EXTERIOR [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP ~4 FIBERGLASS REINFORCED PLASTIC CORROSION PROTECTION [] 5 CATHODIC PROTECTIO, [] 91 NONE [] 95 UNKNOWN [] 99 OTHER SPILL CONTAINMENT 1~STALLED (YEAR) tO[Ct ~r~ OVERFILL P~EVENTION EQUIPMENT INSTALLED (YEAR) : .:t..~-t~"~ E, SPILL AND OVERFILL, GtC. DROPTUBE YES ~ NO STRIKER PLATE YES ~' NO .... DISPENSER CONTAINMEN~ Y,-~ v' NO__ IV, PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND. BOTH IF APPLICABLE · . SYSTE~ TYPE A U I SUCTION A~____I 2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER B. CONSTRUCTION A U 1 sINGLE WALL A~ 2 DOUBLE WALL A U 3 UNED TRENCH A U 95 UNKNOWN A U 99 OTHER A U 1 BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A~.,)4 FIBERGLASS PIPE MATERL~J. AND CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP DE~ECi'OR TEST1NG MONITORING LEAK DETECTOR ~ SHUTDOWN [] 99 OTHER V. TANK LEAK DETECTION RECONCILIATION MONITORING GAUGING MONITORING L._.J TESTING CONTINUOUS INTERSTITIAL [] 8 SIR [] g WEEKLY MANUAL [] 10 MONTHLY TANK [] 95 UNKNOWN [] 9g OTHER MONITORING TANK GAUGING TES~NG VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACE) [ 1. ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTITY OF I3' WAS TANK FILLED WITH YES[] NO[] SUBSTANCE REMAINING GALLONS INERT MATERIAL ? THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST MY KNOWLEDGE, /S TRUE AND CORRECT LOCAL AGENCY USE ONLY mE STATE LD. NUaBEn ~S CO~POSED OF THE FOIJR NUMI COUNTY # JURISDICTION # TANK # STATE I.D:# ~--~ ~ ~ PERM~ NUMBER I PERMIT APPROVED BY/DATE EXPIRATION DATE TNIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED, FORM C MUST BE COMPLETED FOR INSTALLATIONS. THIS FORM SHOULD RE ACCOMPANIED BY A PLOT PLAN. FILE THtS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM S (6-95) STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERUIT APPMCATION - FORM B " cOMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY [] 1 NEW PERMIT [] :3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED ONSlTEI ONE n'EM I-'-I 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED DBA OR FACILITY NAME W~IERE TANK IS INSTALLED: L TANK DESCRIPTION CC~4PLETE AU. ITEUS- SPECIFY ~F UNKNOWN $ ~ I--I , ~OTOR v~.,c,~ FUEL [] 40,L B. C. ~ '" .&UL~ u.~o~o [] 3 DIESEL [] 6 AV,ATIO. G~ 2 P .O,.UM [] EMPT PRODUCT ,b U. O 0 [] 4 GASAHOL [] . METHANO' 1¢ MIDGRADE UkLF. ADED r~l 5 JETFUEL [] 8 M85 [] 3 CHEMICAL PROOUGT [] 95 UNKNOWN [] 2 WASTE [] 2 LEADEDJ====1 99 O'II.IER(0ESCRIBEINrrEMD. BELOW) O. IF (A. 1) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED C.A.S. # IlL TANK CONSTRUCTION MARK ONE ITEM ONLY ~N BOXES A, E. ANOC, ANOALLTHATAPPLIEEINBOXOANDE A. TY~E OF 'J~ I ooua. E wAu. [] 3 S~.GLE W~ WTH EXTERIOR UNER [] S ~ s~OER ~s'r~ [] ~6 UN~'~ SYSTEM I"-I ~ SINGLE W~ [] ,, s~.o,, w~ ~. A VAULT [] . OTHER B, TANK [] 1 BARE STE~L [] 2 STAINLESS STEEL ~ 3 FIBERGLASS [] 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC MA~I'~I:IIAL [] 5 CONC. JtETE [] 6 POLYV1NYL CHLORIDE r'"l 7 ALUMINUM [] 8 100% METHANOL COMPAllBLEW/FRP (Pflmle/Tank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER C. INTERIOR [] ~ RUBBER UNEO [] 2 AJ-KYO UNiNG [] 3 EPOXY UNING [] 4 PHENOLIC UNING Lei~eoR [] 5 ~LAss UN,.6 ~. UNUNED [] ~S UNKNOWN [] ~ OTHER COAT~6 ,S UNI.a ~TE.~ COMP^=DLE W~TH ~00~ MEmANOL? Y~S__ NO__ '~' OD E~"]T~JOR [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [~4 FIBERGLASS REINFORCED PLASTIC CORROSION PROTECTION [] 5 GATHOOlC PROI~iCTION [] 91 NONE [] ~5 UNKNOWN [] 99 OTHER SPILL CONTAINMENT t~ISTALLED (YEAR) [~[O[ ~A OVERFILL P~U~VENTION EQUIPMENT INSTALLED (YEAR) ~-~ ~ . E. SPILL AND 0VERF]LL, et~ DROP TUBE YES V NO STRIKER PLATE YES ~/ NO DISPENSER CONTAINMENT YES ~/~ NO __ IV. PIPING INFORMATION CtRCLE A IF ABOVE GROUNO OR M IF UNDERGROUND, BOTH IF APPMCARLE ~. SYSTEM l"~PE A U I SUCTION A~____j 2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER ~. CONDUCTION A U 1 SINGLE WALL A~ 2 DOUBLE WALL A U 3 UNED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MAI?'~t~IALAND A U ~ BARE.rEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A U~I4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP ~ROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 Oi'HER D. LEAK DETECTION I--)~ ~c~ u~ ~ E::] 2 u~ ~.¢~ss [~3 coNnNuovs ~n~t f~l 4 a~crRo~c u~ J:~5 ^~O~A~C PUMP {~-CI'0R TESTING MONITORING ~ ~ DEI~CTOR S~Ur0OWN ' [] 99 OTHER V. TANK LEAK DETECTION [[1 VISUAL CHECK [] 2 MANUAL INVENTORY [] 3 VADOZE []4 AUTOMATIC TANK []5 GROUND WATER [] 6 ANNUALTANK RECONCILIATION MONITORING GAUGING MONITORING TESTING WEEKLY MANUAL [] 10 MONTHLY TANK [] 95 UNKNOWN [] 99 OTHER 7 CONTINUOUSMoNiTORiNG INTERSTITIAL [] 8 SIR [] 9 TANK GAUGING TESTING VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACE) I 1. ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED OUANTITY OF I3' WAS TANK FILLED WITH YES E~ SUBSTANCE REMAINING GALLONS INERT MATERIAL ? · THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST~2¢ MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE i.D. NUMBER ~S OFTHE FOUR NUM~J~S BELO~ I STATE I.D:# l-F-1 I II I I I I I I I I III I I THIS FORM.MUST BE ACCOMPANIED BY l PERMIT APPLICATION - FORM A, UNLESS l CURRENT FORM A HAS BEEN FILED. FORM C MUST BE COMPLETED FOR INSTALLATIONS. THiS FORM SHOULD BE ACCOMPANIED BY A PLOT PLAN. RLE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM 8 (6-9.5) STATE WATER RESOURCES CONTROL BOARD . UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B ? :' cOMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. ~:~' MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED ON SITE ONE ITEM [] 2 INTERIM PERMIT [] '4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: L TANK DESCRIPTION co~*~=~ ALL ITEMS # SPECIFY IF UNKNOWN II. TANK CONTENTS ,F A., ,S U~O. COUPLE~ ,TEU C. '~' ,,. [] I MOTOR w~cLE .JEL [] , O,L ". C. [] ",~U~ U,L~ I~ 3 D,ESEL [] , ^V,ATIONC~S ~ IF(~I)ISNOT~. ~ ~E OFSUB~CE ~ORED C.~ S.~: IlL TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC. AND ALL THAT APPLIES IN BOX D AND E A. TYPE OF '~ 1 DOUBLE WAIL [] 3 SINGLE WALL WITH EXTERIOR UNER [] 5 INTERNAL BLADDER SYSTEM [] 95 UNKNOWN SYSTI~ [] = S;N~LE W~U. [] 4 S~NGLE W~J. IN A VAU,T [] ~ OTHER ~. TA~K [] I BARE STEEL [] 2 STAINLESS STEEL ~ 3 FIBERGLASS [] 4 STEEL CLAD WI FIBERGLASS REINFORCED PI.ASTlC MATERIAL [] 5 CONCRETE [] 6 POLY¥1NYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPAT1BLEW/FRP ~4aII~TIIIlD [] 9 BRONZ~ [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER C.~i'FERIOR [] 1 RUBBER UNED [] 2 ALKYD UNING [] 3 EPOXY UNING [] 4 PHENOUC UNING U~a(] OR [] 5 C.L~S U.~.~ ~)'. U.U.ED [] ~ UNKNOWN [] ~ OTHER COATING is UNING MATERIAL COMPATIBLE WITH 100% METHANOL? YES__ NO__ D. EZTE~IOR [] I POLYETHY1.ENE W~AP [] 2 COATING [] 3 VINYL WRAP [~4 FIBERGLASS REINFORCED PLASTIC CORROSION PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER SPILL CONTAINMENT 1~ISTALLED (YEAR) I. CtOt '~ OVERFILL P~EVENT1ON EQUIPMENT INSTALLED (YEAR) t-'."l ~ ,. F- SPILL AND OVERRLL, et~ DROP TUBE YES ~ 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. SYSTEU TYPE A u I SUCT1ON A~j 2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER B. CONSTRUCTION A U 1 SIHGLE WALL A~ 2 DOUBLE WALL A U 3 UNED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U I BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A U~I4 FIBERGLASS PIPE CORROSION A U $ ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECT~0N & U g GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 O*~'HER D. LEAK DETECTION [--~ ~F,G'4/~C,N.'UNELEN{ {----12 UNET~HTI~SS j~3 COt~Z~:~JSI.'~r.qSTITL~ ~]4 EI. EC~O~CUN; j~;~SA~OUA~CPU~ I~11;CTO~ I~S~NG ~ uO~aTOR~G ~ FETECTOR ~ S~UTOOWN ' [] 99 OTHER V. TANK LEAK DETECTION I ~1 VISUALCHECK I---~ 2 MANUALINVENTORY r"~3VADOZE [] 4 AUTOMAT1CTANK r-15 GROUNDWATER 1-~6 ANNUALTANK RECONClLJATION MONITORING GAUGING MONITORING TESTING 7 CONTINUOUS INTERSTITIAL [] 8 SIR [] 9 WEEKLY MANUAL [] 10 MONTHLY TANK [] 95 UNKNOWN [] 99 OTHER MONITORING TANK GAUGING TESTING VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACE) I 1. ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTITY OF I3' wAS TANK FILLED wITH YES[] ,O~-~ · SUBSTANCE REMAINING GALLONS INERT MATERIAL ? THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST~Z~ MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OFTHE FOUR NUM~'ERS BELO~ J COUNTY it JURISDICTION # FACIL~,TY # / TANK # STATE I D # FORM 8 (~.gs) ~*--~ ~ STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED ON SI ONE rrE~l [] 2 INTERIM PERMIT r--1 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED I. TANK DESCRIPTION CO~PLE~ ALL ITEMS- SPEC=FY IF UNKNOWN C. DAI~ INSTALLED(MO/DAY/YEAR) 50 ~(3~ D. TANK CAPACITY IN GALLoNs: tO Ii, OOO II, TANK CONTENTS *FA-~mM~KED, COMPLETE~TEMC. 'lC ~p~X~- 2J~OOO ~1~\, A. [] 1 MOTOR VEHICLE. FUEL [] 4 OIL B. C.~[] la REGULAR UNLEADED [] 3 DIESEL [] 6 AVIATION GAS PREM~JM UNLEADED 4 GASAHOL 7 METHANOL ~¢ MIDGP~DE UNLEADED [] 5 JET FUEL [] 8 M85 [] 3 CHEMICAL pRODUCT [] 95 UNKNOWN [] 2 WASTE [] 2 LEADED [] 99 01~IER (DESCRIBE IN ITEM D, BELOW) 0. IF (A. 1) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED C.A.S. #: III, TANK CONSTRUCTION MARKONE ITEM ONLY IN BOXES A, B, ANDC, AND ALL THAT APPLIES IN BOX D AND E A. T~13E OF '~ I DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR UNER [] 5 INTERNAL BLADDER SYSTEM [] 95 UNKNOWN ~Y~11~ [] 2 sINGLE WALL [] 4 SINGLE WALL IN A VAULT [] gg OTHER B. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL [~ 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC ~TERUU. [] s coNORET~ [] 6,0.'~NYL CHLORIDE [] ~ ALUMINUM [] 6 ~00% ME~ANOL CO~P^~BLEW~=RP (~--~rT=~) [] ~ BRO.Z~ I---1 lO GALVAN,ZED STEEL [] ~S UNKNOWN [] e~ OTHER C.~NTERIOR [] ~ RUBBER UNED [] 2 ALKYD UN~NG [] 3 EPOXY UN~NG [] ~ PHENOUC UN~HG MNINGOR [] s GLASS UN,Ne [~S UNLINED [] S5 UNKNOWN [] 99 OTHER COATIN(~ ~s UN~NG ~TER~^L COaPA~BLE W=TH 100% METH^NOL? YES~ NO__ ~. F.X"m.R~OR [] ~ POL~E'mYLENS W~' [] ~ COA~NG [] 3 WNYL WRAP ~'~ FmERGLASS RE~NFORCED PLASTIC CORROSION PROTECTION [] s CATHOR~CPROT~C~ON [] ~ NONE [] SS UNKNOWN [] ~ OTHER SPILL CONTAINMENT I.~STALLED (YEAR) ~.O[O[ ~ OVERFILL P~EVENTION EQUIPMENT INSTALLED (YEAR) E. SPILL AND OVERFILL, etc. DROP TUBE YES ~ NO STRIKER PLATE YES ~ NO DISPENSER CONTAINMENT YES IV. PIPING INFORMATION CIRCLE A ~F ABOVE GROUND OR U ~F UNDERGROUND, BOTH ~F APPUCABLE A. SYSTE~I'¥PE A U 1 SUCTION A~____j 2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER ~. COnSTrUCTION A U 1 SINGLE WALL A~ 2 DOUBLE WAU. A U 3 UNED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARESTIEEL A U 2 STAINLESS STEEL A U 3 POLYVlNYL CHLORIDE(PVC)A~i4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COAT1NG 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 (3~CTOR TESTING !I4OMTORING LEAK 0ETECTOR SHUTDOWN - V. TANK LEAK DETECTION I' ~17 VISUAL CHECK [] 2 MANUAL INVENTORY '[] 3VADOZE rI~ 4 AUTOMATIC TANK [~-___~5 GROUND WATER ['-~6 ANNUALTANK RECONCILIATION MONITORING GAUGING MONITORING TESTING CON~NUOUS=NTERSTITIAL [] 8 S~R [] ~ WEEKLY MANUAL [] 10 MONTHLY TANK [~i~ ~ UNKNOWN [] ~ OT~ER ' MONITORING TANK GAUGING TESTING VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE ~N-PLACE) I1' ESTIMATED DATE LAST USED (MO/DAY/YR) I2' ESTIMATED QUANTITY OFSUBSTANCE REMAINING GALLONS. 3. WAS T.LNK FILLED WlTHiN,r~RT MATERIAL ? YES= NO[~ THIS FORM HAS BEEN COMPLE'rED UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KI¥C)WLEDGE, IS TRUE AND CORRECT I TANK OWNER'S NAME t\ ~ . ~,~ !~ ~ rm.- I DATE ~[ I LOCAL AGENCY USE ONLY ~E STATE ~.D. NUMBER ~S CO~POSED OF THE FOUR NO'ERS I ,O~W I COUNTY # JURISDICTION # FAClI~TY # TANK # STATE I.D.'# . F-T--1 I I1 I I I'-[I [i. I I I ~ NUMBER I PERMIT APPROVED BY/DATE PERMIT EXi~: :~ATION DATE i THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION. FORM A, UNLESS A 0URRENT FORM A HAS BEEN FILED. FORM C MU'.! ' ~IE COMPLETED FOR INSTALLATIONS. THIS FORM SHOULD BE ACCOMPANIED BY A PLOT PLAN, FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGR" ND STORAGE TANK REGULATIONS FORM B (6-g5) STATE OF CAUFORNIA ~ ~' ~ ' ~ STATE WATER RESOURCES CONTROL BOARD UNOERGROUNO STORAGE TANK PERMIT APPLICATION - FORM' B COMPLETE A FORM FOR EACH TANK SYSTEM. sEpARATE BARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED ON SITE** O~E rrE~ [] 2 INTERIM PERMIT [] '4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED DBA OR FACIMTY NAME WHERE TANK '$ INSTALLED: A~::~ I. TANK DESCRIPTION comPLeTe Au.~TEuS - seEclrr ~F UNKNOWN c. O,T~ INST~.EO (~V~) 50 5'~, o. TANK C~oAClW ~N C. AU.O,S: t C) ~ C50 0 '~' ,.TANK CONTENTS ,PA-,,S .COMP'"T ,TEMC. -O,O00 · P O';UM [] l g'' PRODUCT G . OL [] ?M ANOL 1¢ MIDGRADE UNLEADED ~ 5 JETFUEL [] 8 M85 [] ~ CHE~ICALPROOUCr [] e~ UN.OW" [] = WAST~ [] ~ ~0~ o. i~(~.~)~s NOT ~tA.~O, ENTER .AME OF SUEST~CE STORED C. III. TANK CONSTRUCTION ~UU~ONEIT~MONLY~NSOXES~,^NOC,~OAU.~AT~PUESINaOXO~DE A. TYPE OF '~ 1 DOUBLE WAIL [] 3 SINGLE WALL WITH EXTERIOR UNE" [] $ INTERNAL B~ SYSTEM [] 95 UNKNOWN ~STaa [] ~ s~,~u; wm. [] 4 SINGLE W,U:. ~N ^ VAULT [] . OT.ER & TMa( [] I BARE STEEL [] 2 STAINLESS STEEL I~ 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC I~'I'E~IAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLEW/FRP {131I'iI~TIItl0 [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER C, INTERIOR [] 1 RUBBER UNED [] 2 ALKYD UNING [] 3 EPOXY UNING [] 4 PHENOLIC UNING U~INGOR [] 5 GLASS UNING {~6 UNUNED [] 95 UNKNOWN [] 99 OTHER COA'r~IG is UNING MATERIAL COMPATIBLE WITH 100% METHANOL? YES~ NO~ O. EXTE~IOR [] 1 POLYETHYt. ENE WRAP [] 2 COATING [] 3 VINYL WRAP ~)'~4 FIBERGLASS REINFORCED PLASTIC CORROSION I:iROTECTiON [] 5 CATHODIC PROTECTIO~I [] 91 NONE [] 95 UNKNOWN [] 99 OTHER SPILL CONTAINMENT I~TALLED ~YEAR) ' t. CtCt "'~ OVERFILL P~,EVENTION EQUIPMENT INSTALLED (YEAR) F- SPILL AND OVERFILL, etc. DROP TUBE YES ~/ NO STRIKER PLATE YES ~ NO DISPENSER CONTAINMENT YES ~ NO __ IV. PIPING INFORMATION C~RCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPUCABLE A. SYSTEM TYPE A U ~ SUCTION A(~_.j 2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER ~. CONSTRUCTION A U 1 SINGLE WALL A~ 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~I4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 8 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP ~I~ROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER 0ETECTOR TESTING UOMTORING LEAK OETECTOR ::HUll)OWN [] 99 OTHER V. TANK LEAK DETECTION E~, ~,suAL CH;CK [] ~ MA. uAL ,.VENTDR¥ [] ~ V~ZE []. ,,UTOMA~C TAN. E-.~ = GROU.D WATER [] ~ =.UALTANK RECONC,L,^T.ON MONITORI.= G^UG,N~ MONITORING TES~NG ~ Co.*n.uous I.TERS~TIAL [] . SIR [] ~ W~EKL~ MANUAL [] ~0 MONTHL~ TANK i:'~ == ~NKNOWN [] ~ OTHER ~NITOR~N~ TANK ~^UG~N~ TESTING VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE ~N-PLACE) '. ESTIMATED DATE LAST USED.'(MO/DAY/YR) 2. ESTIMATED QUANTITY OFsusSTANCE REMAINING GALLONS I3' wAS T'''NK FILLED wlTHINi~RT MATERIAL ? YES ~--) NOi- THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KIV.; ;WLEDGE, IS TRUE AND CORRECT , 'LOCAL US'= 0,L' % STATE I D # THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPUCATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FORM C MU: ' tE COMPLETED FOR INSTALLATIONS. THIS FORM SHOULD BE ACCOMPANIED BY A PLOT PLAN. RLE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGP .'~lO STORAGE TANK REGULATIONS FORM B ,~ .~ STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE FORM FOR EACH TANK SYSTEM. MARK O~L¥ [] ~ N~ PE~r; .. [] 3 RENTAL PERMIT [] S CH*aGE OF ~NFORMATION [] ? PERM~ENT~V CLOSED O~ ~ ~ 3 I~U ~T ~ '4 ~DED PERMIT ~ 6 TEU~RY T~K CLOSURE ~ 8 T~K REMOVED D. IF [~I} IS NOT M~D, E~R N~E ~ SUB~CE ~ORED C.A. S, ~: IlL TANK CONSTRUCTION MARK ONE ITFJ~ ONLY IN BOXES A, B, ANDC, AND ALL THAT APPMES IN BOX D AND E A. TYPE OF ~]~ 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR UNER [] 5 INTERNAL BLADDER SYSTEM [] 95 UNKNOWN SYSTaa [] ~ s~.~LE w~ [] 4 SI.GLE W~ ,. ^ VAULT [] . OT. ER B. T~K [] 1 BARE STEEL [] 2 STAINLESS STEEL ~ 3 FIBERGLASS [] 4 STEEL CIAO W/FIBERGLASS RBNFORCED PLASTIC aA'raiL [] s coNcaEn~ [] s POLW~N~L C,LOR, DE [] 7 ALUM,NUM [] B ~00~ METHANOL COMPA~BLEW~P (~lltal~Taltk) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER C. INTERIOR [] ~ RUBBER UNED [] 2 ALKYD UNPEG [] 3 EPOXY UN~NG [] 4 PHENOUC LINING UmNGOR [] s ~ss UN~.a ~T<~'B UNUNEO [] SS U.r~OWN [] ~. OTHER COATING IS UNING MATERIAL COMPATIBLE WITH 100% METHANOL? YES~ NO__ ~, ~RROSiON PROLCON ~ 5 ~ICPRO~ON ~ 91 NONE ~ 95 UN~OWN ~ ~ OTHER SPI~ CO~NNME~TAL~D ~R) ~ ~ OVERRL~ P~VEN~ON EQUIPMENT INSTALLED (Y~R) ~ sPl~ AND OV~F[LL, etc. DROP ~BE YES NO STRIKER~ YES ~ NO DISPENSER CONTAINMENT YES ~ NO IV. PIPING INFORMA~ON c~ A ~SOVeG.OUNOO. U *~UND~.~.OUND,~O~APPUC~ ~ ~Y~E A U 1 ~ON A~ 2 PRESSURE A U 3 G~VI~ A U 4 ~IBLEPIPING A U 99 O~ER ~ ~U~0N A U 1 SI~ W~ ~2 ~UB~ WA~ A U 3 UNED ~ENCH A U 95 UNKNOWN A U ~ O~ER A U 1 ~E~ A U 2 STAIN~SS ~EL A U 3 ~L~I~ CHLORIDE(PVC)A~4 FIBERG~SS ~~D PIPE ~ION A U 5 ~NUM A U 6 C~ A U 7 ~W/COA~NG A U 8 1~ M~OL COMPA~B~W~RP ~ON A U 9 ~V~ ~EL A U 10 ~ODICPRO~ON A U ~ UN~O~ A U ~ O~ER V. TANK L~K D~C~ON RECONCIUATION MONITORING GAUGING MONITORING ~S~NG MONITORING TANK GAUGING ~S~NG VI. TANK CLOSURE INFORMA~ON (PERMANENT CLOSURE IN-P~CE) I1' E~o oA~ ~T USEO''(M~AY~R) I2' Es~MA~D oUA~ OF I3' wAS T'''NK ~LLED ~TH YES ~ NO~ SUBSTANCE RE~INING ~LONS IN~RT MATERIAL ? ~IS FORM HAS BEEN COMPL~D UNDER PENAL~ OF PERJURY, AND TO THE BEST OF MY K~',: ~WLEDGE, IS TRUE AND CORRECT I TeK O~ER'S N~E ,~ ~ · ~/ ~ & '~ ~ I DATE ~[ COUN~ ~ JURISDICTION ~ FACI~ ~ ~ TANK ~ " STATE I D ~ { ~ ~ MUST BE ACCOMPANIED BY A PERM~ APPUCA~ON - FORM A, UNLESS A CURRE~ FORM A HAS BE~ FILED. FORM C MU: ' tE COMPLIED FOR INSTALLATIONS. THIS FORM SHOULD BE ACCOMP~[EO BY A PLOT P~N. RLE ~S FORM WI~ THE LOCAL AGENCY IMPLEMENTING ~E UNOERGF q0 STORAGE TANK REGU~TIOHS F~M B (~95) STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION ~,,~,.,O ~'~C.-.~' ~OOS~O STREET ~<'~O \ "'~ ~'~. C,TY cou.TY II. INSTALLATION (mark all that apply): The installer has been certified by the tank and piping manufacturers. The installation has been inspected and certified by a registered professional engineer. The installation has been inspected and approved by the implementing agency. All work listed on the manufacturer's installation checklist has been completed. [] The installation Contractor has been certified or licensed by the Contractors State License Board. [] Another method was used as allowed by the implementing agency. (Please specify,) III. OATH I certify that the information provided is true to the best of. Jqy belief and knowledge. Tank Owner/Agent k~' C,~ [[~'(~ ~.-~. ~ Date Print Name ~J~,'~X,.~,,t~- ~'x~.'~ ~ Phone ~ Address D .(~) .' ~, C.~\~ too'3,~~4~.-'~,,~ Let. fio no z - LOCAL AGENCY USE ONLY STATE COUNTY # JURISDICTION # FACILITY # TANK # FORM C (7/91) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOROO35C7 BAKERSFIELD FIRE DEPARTMENT May 13, 1998 RI~ CHIEF MICHAEL R. KELLY ADMINISTRATIVE SER%qCES 2101 'H" Street Bakersfield, CA 93301 (806) 326-3941 ~Ar __ FAX (805) 395-1349 xvxanager Arco AmPm SUPPRESSION $EEVlCES 2301 "F" Street 2101 'H' Street Bakersfield, CA93301 Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 Dear Sir or Madam: PREVENTION SEI~ICES 1715 Chester Ave. Please be advised that the following documentation must be submitted Bakersfield, CA 93301 (0o,~)326-3~1 within thirty (30) days. (June 12, 1998). FAX (805) 326.0576 [.VIWNMEmAt SEI~/ICES l. Business Plan 1715 Chester Ave. 2. Forms A&B Bakeesfield, CA 93,301 (805) 326-3979 3. Statement of Financial Responsibility lAX C805) 326-0576 4. Written Routine Monitoring 5. Unauthorized Release Response Plan 11~NING DIVISION 5642 Victor Street Bakersfield, CA 93308 Please make arrangements for the above mentioned items to be sent to the (805) 399-4697 FAX C805)399-5763 Office of Environmental Services. Failure to comply within thirty (30) days, June 12, 1998, will result in further enforcement action. Should you have any questions, please contact me at 326-3979. Sincerely, Steve Underwood Underground Storage Tank Inspector SBU/dm Orange County Tank Testihg2Inc. 225 N. Loara S~eet, Anaheim, CA 92801 714-776-0300 Test Your Tank at 0% to 100% Product Level Tank Testing · Pump Calibration · Monitoring System Product Line Testing Ta~k Be~va~ Larry P. Henry ORANGE COUNTY ORANGE CO~,.,~TY ' TANK TESTING, SERVICE STATION _iNC. EQUIPMENT AND INSURED · ESTABLISHED 1973 LARRY R HENRY TELEPHONE: 714-776-0300 ZZ5 N. LOARA ST. FAX: 714-778-5105 ANAHEINt. CA 92801 TO _ I r~ATE[ _ .LTIME~ ,, CAM P , Y-~-~ ~. ~ ..... 0 ~:~ ................... :~,~.~0 ¢ o  B~t(ERS? I ELIS, CA. 9:3'3' ' 805- a68-0528 ..... SENSOR ALARM ~-- ARO0 AM-PM .. L14:DISPENSER 11-12 2301 F ST. ~-R D I SPENSER PAN BAKERBF805_868_05281 ELD CA. 98301 APR 28, 1998 8:20 AM APR 25, 199812:17 AP1. BYS'!EM STATUS R~P3RT A~L i SYSTEM STATUS REPORT INVENTOR, P:EPORT ~LL FLI~'.IOTIONS NORI'q~ NO ~OTIVE T~NKS I NVENTCiR'~' REPORT ARCO AM-PM NO A~i:~_I~'~.T~NKS ..... 2~01 F ST. BAKERSFIELD CA. 93301 805-~63-0528 APR 28, 1998 8:23 ~YBTP1 STATUS REPORT .. 2301 F ST. L14 :FL~L -AEARM ....... BAKERSFIELD C:A. 9330i ~ROO APlzPi"I ' 805-863-0528 2301 F ST. ~PR 2q.. 1998 :R:0:3 PM B~KERSF I ELD C~. 9:3301 805-863-0528 ~PR 25. 1998 12:17 AM SYSTEM ST~TLIS REPORT ~LL FUNCTIONS NORMnL SYSTEM STATUS REPORT ~RCO ~F'I-PM ~LL FUNOT]ONS NORMNL 2801 F ST. B~KERBF I ELD C;~. 93301 INVENTORY REPORT 805-863-0528 NO ~CTIVE gPR 28, 1998 8:40 ~M aR...O ~M-PM 2301 F ST. _= .......... BgKER~FIELD C:~.J3301 SYSTEM STATUS :.r~c~ ~LL FUNCTIONS NORMAL ~PR 24, 1998 4:20 PI"I INVENTORY REPORT (-.- NO ~OTIVE T~NKS ~' SYSTEM STATUS REPORT ~LL FUNCTIONS NORMAL INVENTORY REPORT NO aCTIVE TANKS 0~/22/1S98 08:~6 818-562-~ TRIANGLE P~GE 81 BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION / 2130 G Street, Bakersfield, CA 93301 -' (805) 326-3979 APPLICATION TO PEaFOR~ A TIGHTNESS TEST FACILITY ARCO . ,., ADDRESS 2391 F .st. PERMIT TO OPERATE # .... OPERATORS NAME ARCO , . OWNERS NA~ ARCO ,,, NUMBER OF TANKS TO BE TESTED 3 IS PIPING~OING TO'BE TESTED'YES TANK% VOLUHE CONTENTS I ...20. don UNLEAD ,. Llnlead ZANKTSSTINGCOMPAN~0r~n~elCn ~nk Ta~t~P~$S 22D N. Loara St. Anaheim, Ca 92801 TEST M~T~OD TEI-4000 ~ ~.O00..Sys~em .... NAM~OF TESTER Rober~ Dodo.e CERTIFICATION # 016 STATE REGISTRATION # 92-1118 DATE & TIM~ TEST IS~BE CO~UCTED 4/2~/98 8:50 Am Environmental, Inc. g TEI SYSTEM 4000 Certificate of Completion This document certifies that: Bob Dodge has successfully completed the TEI System 4000 training program and has been trained in the fundamentals of the TEI System 4000 brand of tank testing procedures and equipment operations and is now considered a manufacturer certified technician with a rating of: TeChnician ~016 Originally issued October 1, 1991 Renewed this 1st day of January, 1995, by ~- Michael Lessley, President 172 W~EST VERDUGO AVE., BURBANK, CA 91502.2132 · TEL: (818) 840-7020 · FAX: (818) 840-6929 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (80~ 3263979 INSPECTION RECORO POST CARD AT JOB SITE T~ ~ PIPING ~EM SECONDLY CONT~NME~. O~LL pROTE~ION, Co~ble Momtomg Well(syS~s) - H20 T~ FIN~ CONTRACTOR CONTACT  ~-~RMIT AP (CATION TO CONSTRUCT/MQDI~ UNDERGROUND STOP~G~ TANK ~ NEW.FACILIW '. Q MODIFF~A'TION OFFACILIW Q NEW ~AN~ iNS~ALLA~CN STARTING DATE Il-l- ~ , PROPOSED COMPL~ON FACILIW NAME A~ ~~.: - · ~ISTING FACILIW P~Mi~ ~o. ADDRESS ~ Clef ~ CCO~ PHONE No. ~ '. BAKERSFIELD CI~ BUSINESS LtC~NS~ WORKMAN COMR~. No. . INSURER BRE]FLY DESCRIBE 'F~HE WORK TO BE DONE I'~~O~ DEPTH TO GROUND WATER ~ + .. SOIL ~PE No. OF TANKS TO BE INSTALLED ~ ARE THEY FOR MOTOR FUEL - SECTION FOR MO[OR FUEL TANK'NO. vOLUME ' U~LEA~ED ' .PREMIUM '. 5?L AVIATI'ON' '. ,SECTION FOE NON MOTOE FUELSTORA~E TANK No. VOLUME CHEMICAL STORED CAS FID. C:aEM~CAL PREVIOUSLY (no b[Qnd n~me) (if known) ~ORED · . .. · .;:. ~. ~ .~ cC~ CFF C',AL USE (~tJLY ~ ~ ..................... ..:...,.. · · ......... .. THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE A~AC:AED CCb~OIT~Cb:S CF T:~IS F~,~lr AND ANY OTHER STAJ~. LOCAL ANOFEDERAL REGULA[IONS, '[HIS FO'RM HAS SEEN COMPLETED UNDER PENAL~ CF PERJURY, AND [O [HE 8EST C~ MY X~ICV/LEOG~. JS T~UE .Ab;O CORRECt. THIS APPLICATION BECOMES A PERMIT WHEN APPROVED .. CITY OF BAKERSF~LD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 ~NSPECTION RE¢OI~ T~ ~D BA~ ~SPE~ON I DA~ ~SPE~R PIPING ~EM EI~ Di~ SECONDLY CONT~NME5~. O~ILL PROTE~ION. L~ DE~ON Lm~ ~1~ - T~s) ~vel Gaug~ ~ S~ ~ V~t V~v~ ~ ~s) for ~ Sp~-D.W. T~s) Momtomg Well(s~S~s) - H20 T~ Spill ~ev~tion FIN~ CONTRACTOR LICENSE # CONTACT PHONE # SEP-25-'9'7 THU 1,4:47 ID: NO: ?936 P02 , ' "' '.' ,.-~. Bakersfield'Fire Dept ~ OFFIC~ OF ENVIRONMENTAL SENVICES . UNDERGROUND STOOGE TANK PROG~ ~., PERMI~ A~LICA~ON TO CONSTRUCT/~ODI~ UNDERGROUND STOOGE TANK ~PE O~ AFPLI~A~ON --~ N~ FACILIW '. Q MODIF~A~ON OF FACILI~ Q NEW TANK INSTAL~ON AT ~S~NG FA~ILI~ STARTIN~ DATE 'J -1- PROPOSED COMPL~ON DAT~ ~t-~ FACIU~ NAME ......... ~' _ _ _ ' ~STIN~ FACILI~ PERMIT'No, ' ~ACIU~ ADORGSS O --- -- . O ' ~ ,.',WPE OF BUSINESS ' , ' ' -- .~ ~ ~- ' ~~-It~ -OO~~' TANK OWNG~ ~ ~U~_ ~ PHONE CONT~ACTO~ _ ~~_ ~~~~, ~.. CA PHONE No.~~ AKE~ F~LDCl~ BUSINESS LICENS~ WORKMAN COM~LNo. ~-~t-~-~ ~INSURE~_~~_ ~~ . : " - BEE1FLY DESCRIBE ~E WOrK TO BE DONE ~~U~~J C~~2~ ~ ~ ~. - WATER TO FACILI~ PROVIDED BY. ~~&_ ~~ ~~ DEPTH TO GROUND WATER ~ ~ .. SOIL ~PE ~XPECTED~;TF No, OF TAN~S TO BE IN3TALLED ~, ~ , ARE THEy FOR MOTOR FUEL ;~ YE~ ~ NC BECKON ~Q~HOTOR FU EL .. ..... ~ ~ ' ~~. · .. .. "~ANK'N~. VO~U~e "''U~L~4O~ ' .~U~,~. -- ~ , -~~ __ . ~ .... TANK No, VOLUME CHEMICAL STORED CAS No. CNEM:CAL PREVIOUSLY (no b~on~ nome] (if known) STORED .~ ~ .~?..'. .... ..... . I'HE APPtJCAN! HAS RECEIVED, UNDERSTANDS, AND Wit[ COMPtY WITH IHE A~ACNED CON~II~CN~ CF ~S ~ ~:~lr ANO ANY ' '/HIS ~0~ HAS ~N COMPLETED UNDER PENAL~ OF PERJURY, AND TO tHE BE=T C.~ ~Y K~GWL~DG~ ~S ~UE .~,~o CCgRECr. THIS APPLICATION BECOMES A PERMIT WHEN APPROVED  ' '- Bakersfield.Fire Dept~__ -- .~R~,~T /,~ OFFIO,~ OF ENVIRONMENTAL 5'E:H VICES. ~-~ .. UNDERGROUND STOOGE TANK PROG~M '.. PERMIT AP-PLICAT[ON TO CONSTRUCT/~QDI~ UNDERGROUND STOP. GE TANK ~PE OF APPLIC'A~ON, (CHEC~. ~ NEW.FACILI~ "~ MODIFF~A'TION OF FACILI~ ~ NEW TAN~ INSTALb~ON AT ~STI~G ~ACILI~ STARTING DATE Il-i- q~ PROPOSED COMPL~ON DAT~ FACILI~ NAME ~~ · ~ISTING FAClLI~ P~gMiT No. ADDRESS~~~ ~~~~, ~ FACILI~ '~PE OF BUS~NESS ~ ~u~ ~~ ~. '~'~' A~N ~-~ -OO~~ TANK OWNER ~ ~~~ ~~~ ' ' 2HONE No. ~t~-~O. · . ~DDRESS ~ ~~~~ ~. CI~ ~~~ .~P. CCO~ ~- CONTRACTOR ~, ~o ~ ~~~" CA ~_iCCN ADDRESS J~ CI~ ' PHONE No.~ ~ BAKERCFIELD CI~ BUSINESS LICENSE WORKMAN COMP:. No. .INSURER BRE!FLY DESCRIBE i~HE WORK TO BE DONE i'~%~~O~J ~~~~ WATER TO FACILI~PROVIDED BY- ~o~ ~~ ~~~ DEPTH TO GROUND WATE~ ~ + ~. SOIL ~PE: ...... :~=~:, ~,,~ . No. OF TAN~S TO BE INSTALLED ~ ~E~ THEY FOE MOTO~ FUEL ' SECTION FOR ~O;OR FUEL ' -~ , ~'~A,'" ' CJ~'~ ' AVIATION' TANK'NO. voLUME U~LEADED ,~ · :~=,~,u,-,, '' · ' C~ / ~oo~ .-'X. ' SECTION FOR NON MOTOR FUELSTORAGE TANK No. VOLUME CHEMICAL STORED CAS No. .~=~:~.:.C~L PREVIOUSLY (no brand name) (ff known) STORED THE APPLICANT HAS [~ECEIVEO. UNDERSTANDS. AND WILL COMPLY WITH THE Ai-i'ACHE D CC,NCIT]C h'S CF THIS 2~MI[ AND ANY OTHER SLATE. LOCAL AND FEOERAL REGULATIONS. '[HIS F0~M HAS. SEEN COMPLETED UNDER PENAI~ OF PERJURY. AND [O [HE BEST CF MY X~C:.'/LECG E. ~S TRUE .:.,':O COfiREC~. APPLICANT NAME (PRIND ~ ~ ' THIS APPLICATION BECOMES A PERMIT WHEN APPROVED ,, EDA ENGINEERING DEVELOPIVIENT ASSOCIATES September 19, 1997 Ralph Huey Bakersfield Fire Department Environmental Services, Third Floor 1715 Chester Avenue Bakersfield, CA 93301 Re: ARCO Facility #6356 Underground Storage Tank Program Permit Application 2301 "F" Street, Bakersfield, California [EDA No. 2-2060-000] Dear Mr. Huey, On behalf of ARCO Products Company, we are submitting an application to install underground storage tanks at the above-noted facility. Enclosed please find a completed application, 3 sets of associated plans and the application fee of $1,240.00. Complete building plans have been submitted to the City of Bakersfield Building Department. We anticipate beginning construction in early November, therefore any assistance in expediting review and approval of these plans would be greatly appreciated. Thank you for your assistance on this project. If you have any questions or comments contact me or Jeff Lee of this office. Sincerely, Engineering Development Associates George F. Garcia, AIA enclosures c:\jlee~...~arco\...\subrnit.doc PLANNING . CIVIL ENGINEERING D LAND SURVEYING 1320 NIPOM0 ST. ° SAN LUIS'OBiS'PO', 93401 "805-549-8658 ° FAX 805-549-8704 744 OAK ST. "PASO ROBLES, CA 93446 "805-237-1033 ° FAX 805-237-3797 STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM A COMPLETE THIS FORM FOR EACH FACIUTY/SITE MARK ONLY ~] I NEW PERMIT [~] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED SITE ONE ITEM [] 2 INTERIM PERMIT Ir~ 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) 'D~A OR FACILITY NAME NAME OF OPERATOR ADDRESS NEAREST CROSS STREET PARCEL it (OFTIONA!.) ~" CITY NAME STATE I ZIP CODE SITE PHONE e WITH AREA CODE ~' 8ox TO INDICATE [~ CORPORATION [~] INDIVIDUAl. ['--'1 PARTNERSHIP ~ LOCAL-AGENCY [~] COUNTY-AGENCY' ~ STATE-AGENCY' ~ FEDERAL-AGENCY' DISTRICTS' * if owner ol MST is a public agency, oomple~e the following: name of Supervisor of division, section, or office which operates the UST TYPE OF BUSINESS [~] I GASSTATION C-~ 2DISTRIBUTOR ~ ~/IFINDIANI#OFTANKSATSITEIE. P.A.I.D.#(optional) RESERVATION ~] 3 FARM r'-'-I 4 PROCESSOR ~ 5 OTHER OR TRUST LANDS I I EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY). optional I GAYS: NAME PHONE # WITH AREA CODE DAYS: NAME FIRST) PHONE WITH AREA CODE (LAST, FIRST) (LAST, # NIGHTS: NAME (LAST, FIRST) PHONE # WITH AREA CODE NIGHTS: NAME (LAST, FIRST) PHONE # WITH AREA CODE II. PROPERTY OWNER INFORMATION- (MUST BE COMPLETED) MAILII v' box t01ndicate ~ INDIVIDUAL [~ LOCAL-AGENCY [~ STATE-AGENCY C~l ~C' ~..,~-'~_~'~-----"~l:::~t.~._.~-~'~. : ~ CORPORATION [:~ PARTNERSHIP ~ COUNTY-AGENCY F-] FEDERAL-AGENCY STATE ZIP CODE PHONE # WITH AREA CODE MAILING OR STREET ADDRESS ~ ~-__...~-'~.~__..,~::::~)~ ~ ~' box ~oi~icate C-] INDIVIDUAL E~ LOCAL-AGENCY E~ STATE-AGENCY ~ ~ -'[~..~--~/ / ,~--,--2_~'~_ J~[CORPORATION ~ PARTNERSHIP [~ COUNTY-AGENCY [~ FEDERAL*AGENCY CITY NAME STATE ZIP CODE PHONE # WITH AREA CODE IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER - Call (916) 322-9~9 if questions arise. F TY(TK) HQ J~-J~- I I I I I I V. PETROLEUMUSTFINANCIAL RESPONSIBILITY-(MUSTBECOMPLETED)-IDENTIFYTHEMETHOD(S)USED r~ 5 LEI-rER OF CREDIT ~ 6 EXEMPTION C-) 99 OTHER VI. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to lhe lank owner unless box I or Il is checked. J CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILLING: I. [-~j II. C-J ,11. J~ THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY rL COUNTY # JURISDICTION # FACILITY # OCATION CODE - OPTIONAL CENSUS TRACT # - OPTIONAL SUPVlSOR - DISTRICT CODE - OPT/ON, N. THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPMCATION · FORM B~ UNLESSTHIS IS A CHANGE OF SrI'E INFORMATION ONLY. OWNER MUST FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND s'rORAGE TANK REGULATION8 FORM A (3/93) FOR0~3A-R7 STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED ON SITE ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: ,~__.~ ~-/~,--~ I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I. D. # -~ B. MANUFACTURED BY: C. DATE INSTALLED(MO/DAY/YEAR) j_ )~.C~:) D. TANK CAPACITY IN GALLONS: II, TANK CONTENTS IF A-1 IS MARKED, COMPLAN I~a C. ~ ~ 1 MOTOR VEHICLE FUEL ~ 4 OIL B. C. ~ la REGU~ UNL~ ~ 3 DIESEL ~ 6 AVIATION GAS ~ lb PREMIUM UNL~ ~ 4 GASAHOL ~ 7 METHANOL ~ 3 CHEMICAL PRODUCT ~ g5 UNKNOWN ~ 2 WASTE ~ 2 ~ADED ~ 99 0~ER(DESCRIBEINffEMD. BEL0~ g. IF IA.l)IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED C.A.S. IlL TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. B, ANDC, AND ALL THAT APPLIES IN BOX D AND E A. TYPE OF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR UNER [] 5 INTERNAL BLADDER SYSTEM [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SINGLE WALL IN A VAULT [] 99 OTHER B. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEEL CLAD W/ FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] S 100% METHANOL COMPATIBLEW/FRP (PrJmaln/Tarlk) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER C. INTERIOR [] 1 RUBBER UNED [] 2 ALKYD LINING [] 3 EPOXY LINING [] 4 PHENOLIC LINING LINING OR [] 5 GLASS LINING [] 6 UNLINED [] 95 UNKNOWN [] 99 OTHER COATING ~s LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES_~ NO__ O, EXTERIOR [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC CORROSION PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER SPILL CONTAINMENT INSTALLED (YEAR) jc~ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) E. SPILL AND OVERFILL, etc. DROP TUBE YES__ NO ST'RIKER PLATE YES __ NO DISPENSER CONTAINMENT YES NO IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPLICABLE A, SYSTEMTYPE A U I SUCTION A(~)2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A (~ 2 DQUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER A U 1 BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A(~4 FIBERGLASS c, MATERIAL AND PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ 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 []1 MEC~,~ U.E ~ [] 2 U.~ ~.~ss ~3 CONT,NUOUS ,~.S~^L F--14 ~cmo..c u.~ m-~s ^~O~T~C PUM~ DETECTOR TESTING MONITORING ~ 'LEAK DETECTOR SHUTDOWN [] gg OTHER V. TANK LEAK DETECTION J[] 1 VISUAL CHECK [] 2 MANUAL INVE'TORY [] 3 VADOZE [] 4 AUTOMATIC TANK [] 5 GROUND WATER [] 6 ANNUALTANK RECONCILIATION MONITORING GAUGING MONITORING TESTING ,~ 7 CONTINUOUS INTERSTITIAL [] fl SIR [] 9. WEEKLY MANUAL [] 10 MONTHLY TANK [] 95 UNKNOWN [] 99 CT'ER - ' MONITORING TANK GAUGING TESTING VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE mN-PLACE) J 1. ESTIMATED DATE LAST USED (MO/DAY/YR) I2' ESTIMATED QUANTITY OFSUBSTANCE REMAINING GALLONS I3' WAS TANK FILLED WITHINERT MATERIAL ? YES[] NO[] THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STAT~ I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW I COUNTY # JURISDICTION # FACILITY # TANK # STATE I.D.'# ~ ( I I I I I I I I I I I I IIII J THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FORM C MUST BE COMPLETED FOR INSTALLATIONS. THIS FORM I SHOULD BE ACCOMPANIED BY A PLOT PLAN. FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM B (6-95) FOROO34B-R? STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY ~ 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED ON SITE ONE ITEM~ 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED I. TANK DESCRIPTION COMPLE~ ALL ITEMS -- SPECIFY iF UNKNO~ A. OWNER'S TANK I.D.~ ~ B. MANUFACTURED BY: C. DATE INSTALLED(MO/DAYNEAR) I-I~-~ ~~ D. TANK CAPACI~ IN G~LONS: II. TANKCONTE~S IF A-1 IS MARKED, COMPLETE ITEM C. A. ~ 1 MOTOR VEHICLE FUEL ~ 4 OIL B. C. ~ ,a REGULAR ~ 3 DIESEL ~ 6 AVIATION GAS UNLEADED ~ 5 JET FUEL ~ 3 CHEMICAL PRODUCT ~ g5 UNKNOWN ~ 2 WASTE ~ 2 LEADED ~ gg OTHER (DESCRIBE IN ITEM D. BELOW D. IF IA.l)IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED C.A.S. ~: III. TANK CONSTRUCTION MARK ONE ITEM ONLY iN BOXES A. B, ANDC, ANDALLTHATAPPLIESINBOXD A. TYPEOF ~ 1 DOUBLE WALL ~ 3 SINGLE WALL WITH E~ERiOR LINER ~ g5 UNKNOWN SYSTEM ~ 2 SINGLE WALL ~ 4 SECONDARY CONTAINMENT (VAULTED TAN~ ~ gg OTHER B. TANK ~ 1 BARE STEEL ~ 2 STAINLESS STEEL ~ 3 FIBERGLASS ~ 4 STEEL CLAD W/FIBERGLASS REiNFORCED PLASTIC MATERIAL ~ 5 CONCRETE ~ 6 POL~INYL CHLORIDE ~ 7 ALUMINUM ~ 8 10~/~ METHANOL COUPATIBLEW/FRP (Pr)maryTank) ~ g BRONZE ~ 10 ~LVAN)~D STEEL ~ g5 UNKNOWN ~ 99 OTHER C, INTERmOR ~ 5 GLASS LINING ~ 6 UNLINED ~ 95 UNKNOWN ~ gg O~ER LINmN~ IS LINING MATERIAL COMPATIBLE WITH 10~/~ METHANOL ? YES [ NO__ D. CORROSION ~ 1 POLYETHYLENE WR4P ~ 2 COATING ~ ) ViNYl WR~ ~ 4 FIBERGLASS REINFOROED PLASTIC PROTECTION ~ 5 CATHODIC PROTECTION ~ gl NONE ~ gS UNKNOWN ~ 99 O~ER IV. PIPING INFORMATION CIRCLE A IF ABQVE GROUND OR U IF UNDERGROUND, BO~ IF APPL[CABLE A. SYSTEM TYPE A U 1 SUCTION A~ PRESSURE A U 3 GRAW~ A U gg OTHER B. CONSTRUCTION A U 1 SINGLE WALL A~ DOUBLE WALL A U 3 LINED TRENOH A U 95 UNKNOWN A U 9g OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS 8TELL A U 3 POLYV~NYL CHLORIDE(PVC)A~4 FIBERGL~8 PIPE CORROSION ~ U 5 ALUMINUM A U 6 CONORETE A U ? STEEL W/ COATINO A U B 10~/~ ME~ANOL COUPAT)BLEW/FRP PROTECTION A U g OALVANIZED STEEL A U 10 CATHODIC PROTECTtON A U g5 UNKNOWN A U 99 OTHER D. LEAK DETECTION ~ 1 AUTOMATIC LiNE LEAK DETECTOR ~ 2 LINE I)GHTNESS TESTING ~ 3 INTERSTITIAL UON~ORiNG ~ gg OT~ER V. TANK LEAK DETECTION ~ 6 TANK TESTING ~ 7 'N~RSTITIALMONITORING ~ 91 NONE ~ 95 UNKNOWN ~ 99 OTHER VI. TANK CLOSURE INFORMATION ) 1. ESTIMATED DATE LAST USED (UO/DAYRR) 2. ESTIMATED OUANTI~ OF 3. WAS TANK FILLED WITH YES ~ NO SUBSTANCE REMAINING GALLONS INERT MATERIAL ? THIS FORM HAS SEEN COMPLETED UNDER PENAL~ OF PERJURY, ~ND TO T~E 8EST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE I.D, N~BER IS CO~POSED OF ~HE FOUR NU~ERS BELOW COUNTY ~ JURISDICTION ~ FACILITY PERUlT NUMBER ~ PERMIT APPROVED BY/DATE PERUlT EXPIRATION DATE FORM B (9-.0) THIg FOR~ ~UgT BE AO~PANIED BY A PEH~ ~PLIOATION · FOH~ A, UNLEgg A OUHRENT FOH~ A HAg BEEN FILED. STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET CITY "~::,A,,~~--~ '~--'~ COUNTY II. INSTALLATION (mark ail that apply): [] The installer has been certified by the tank and piping manufacturers. The installation has been inspected and certified by a registered professional engineer. [] The installation has been inspected and approved by the implementing agency. [] All work listed on the manufacturer's installation checklist has been completed. [] The installation Contractor has been certified or licensed by the Contractors State License Board. [] . Another method was used as allowed by the implementing agency. (Please specify.) III. OATH I certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent Date Print Name Phone ( ) Address LOCAL AGENCY USE ONLY STATE COUNTY # JURISDICTION # FACILITY # TANK # FORM C (7/91) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOR0035C7 III . IIII IIIII I I II Telefax Transmittal (805) 549-8704 II I I . I III III I II Date: =1.7.,~. c~--/ # of Pagea (InGlucllng mi, pag.) _ ? ,t To:: Company/Attention: kl~ ~L~.'~ I~AX Number: 'E~O~=::~, '~'7..~, ~,~Lo Yma'File# Prom: .,~~ L,~,,~_. EDAJob# EDA 'NGI#i~I~I;IING DEVELOPMENT ASSOCIATES 1320 NIPOMO"ST., SAN LUiS OBISPO, CA 93401 PH:(SOS) ~49 _ _"~r~__ FAX:(SG~) 5496704 744 OAK BT., PASO ROBLES, CA 93448 PH: (805) 237-1033 FAX: 237-3797 I