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HomeMy WebLinkAboutUNDERGROUND TANK - 1986 '-'~ FILE CONTENTS SUMMARY , FACILITY:__ / / ADDRESS : ~ ~ ~/~ ~ / ~___ ~~ ~: ~~ ~v. s~s~w~: - ~ ..................... ~---~ ............. J .................... . ~ Ac'ttvity Date # Of Tanks Comments Flower Street tfleld, California 93305 ephone (805) 861-3636 iN COUNTY HEALTH DEP,ARTME - ENVIRONMENTAL HEALTH DIVISION HEALTH OFFICER Leon M Hebertson, M.D. DIRECTOR OF ENVIR~)NMENTAL HEALTH Vernon $. Relcherd November 11, 1986 Davies Oil Company 3305 Gulf Street Bakersfield, California 93307 Attn: Paul Linderfelder RE: SOIL CONTAMINATION DETECTED BEDCW UNDERGROUND TANK EXCAVATIONS. Dear Mr. Linderfelder: The laboratory results received on October 31, 1986, show soil contamination in soil samples retrieved beneath the excavations for the three. 10,000 gallon fuel tanks. To evaluate the extent of contamination present in these areas, you must prepare a site characterization proposal. This department does not approve any additional work in the area around the contamination either in defining the plume or providing a permanent cOver at the site until the site characterization proposal is approved.by this department. This department's outline for preparation of the site characterization proposal is enclosed. It may be used as a guide in preparing the proposal. Please submit your proposal to this department within 60 days. If you have any questions please call me at (805) 861-3636. SiNcerely, Environmental Health S~alist I Hazardous Materials Management Program 'AG:sw Enclosure al(ersfield onstrUction ...... LaborAtory No. P86-0148 Date Reported: 11-6-86 County of Kern Health Department Environmental Health Se{vices 1700 Flower Street Bakersfield, CA 93305 Attention: Mr. Richard Casagrande Subject: Additional test results for Davies Oil Co. Re: Our report dated October 24, 1986 Gentlemen: Enclosed are the. results of the additional contamination tests for Benzene that were requested by your office on the removal of three 10,000 Gallon Diesel Tanks at Davies Oil Co. on Gulf Street, Bakersfield, CA on October 14, 1986. ~// ?~w{e~-~e ~..~is~er v . 3012 Antonino Ave., Bakersfield, Ca. 93308 / (805) 324-1815 SMC Laborator?z P.O. Box 80835 Bakersfield, CA. 93~Z.80 (8£)5) 393-3597 Report of Laboratory Analysis · Customer Name: Bakersfield Construction Inspection .... Address~ _. :.' .... 3012- Antonio Avenue-Bak'ers~i. eld, CA 93.308 Date Sample Recieved : Date Analysis Completed: Date o.F Report : 10-15-86 10-17-86 11-5-86 Laboratory No. ~5514 through ~5525 ....... RESULTS OF ANALYSIS #5514 ID: TH Benzene TPH (Diesel P_D~E 0..34 48 ~ Method of Analysis: EPA ~0..0/80...0 TPH = Total Petroleum Hydrocarbons (Diesel) ~5515 ID: TH ~1 @ 6 Benzene TPH (Diesel) P, ~_ O. 34 46..3 Method of Analysis: EPA 5020/8020 TPH = Total Petroleum Hydrocarbons (Diesel) ~5516 ID: TH ~2 @~ '~ Benzene TPH (Diese'~) .p._p__m.. 0.66 167 Method of AnalysiS: EPA 5020/8020 TPH = Total Petroleum Hydrocarbons (Diesel) ~5517 ID: TH ~2 @ 6 Benzene TPH (Diese~ ppm 1.5 614 Method of Analysis: EPA 5020/8020 TPH = Total Petroleum Hydrocarbons (Diesel) $~5518 ID: TH ~Z'.; (@.,~ '-.~ Ben z eli e TPH (Diesel) Method of Analys~s: EPA ~0.-..)/80.-..~ TPH = Total F'etroleum Hydrocarbons (Diesel) ~,.~,-~.L9 ID: TH #:]', ~ 6 Bell zen e "[F'I-~ ( D i ese'L ) < (:). 1 < 10 Method of Analysis: EPA 5020/802i] TF'H = Total Petroleum Hydrocarbons ( Diesel ) +K.~,.~..'O ID". TH #~,~ (~ ..~")' ........ Be.nzene ................. TPH (Diesel) [~ZD..m.._ · <: 0. -t ......... 242 Method Of Analysis: EPA 5i}20/8020 TPH.-.~-Total F'etroleun Hydrocarbons ( Diesel ) S t.'. a r-~ Comer SMC Laborator ]{ P.O. Box 80835 Bakersfield, CA. 93380 (805) 393-3597 Report of Laboratory Analysis #5521 ID: TH #4 · 6' Benzene TF'H (Diesel) #5522 ID: TH #5 · 2' p_p_~ Method of Analvsis: EPA =']~']'8020 <0.1 TF'H = ]'otal Petroleum Hydrocarbons 2048 (DJ esel ) ~ Method of Analysis: EPA .................. Benzene ............... 40.1 .................... TPH-= Total Petroleum Hydrocarbons-- TPH (Diesel) 297 (Diesel) #5523 ID: TH #5 8.6' Bpm~ Benzene <0. 1 TPH (Diesel) ~= Method of Analysis: EPA 5020/8020 TPH = Total Petroleum Hydrocarbons (Diesel) ~5524 ID: TH Benzene <0.1 TPH (Diesel~ 12 #5525 ID: TH #6 @ 6' ppm Benzene <0. 1 TPH (Diesel) 13 Method of Analysis: EPA 5020/8020 TPH = Total Petroleum Hydrocarbons (Diesel) Method of AnalYSis: EPA 5020/8020 TPH = Total Petroleum Hydrocarbons (Diesel) St an Comer page ake rsfield onstruction nspect on Laboratory No. P86-0148 Date Reported: County of Kern ........... Health Department ......................................... Environmental Health Services 1700 Flower Street Bakersfield, CA 93305 Attention: Mr. Richard Casagrande Subject: 10-24-86 Soils Report and Logs for the removal of three (3) Diesel Tanks at Davies Oil Co. on Gulf Street, Bakersfieid, CA. Gentlemen: Submitted herewith are the soil contamination test results and loggings we performed on the removal of three (3) 10,000 Gallon Diesel Tanks at Davies Oil Company on Gulf Street, Bakersfield, CA. Ail samples for contamination were taken at depths of 2'-0" and 6'-0" below~ the bottom of the tanks. Each sample was put in a glass container and taken to Stan Comer,. Chemist/Consultant for testing. As shown on the test results, the soil under each tank contains some contam- ination. The water table in this area is approximately 50' according to the Kern County Water Agency, 1984 Water Supply Report. The soil logs, a drawing showing the tank location's and test results for con- 'tamination ~e attached. L. Wisher/ g 26 4~n-H~4Hanse~ 3012 Antonino Ave., Bakersfield, Ca. 93308 / (805) 324-1 Laboratory No. P86-0148 Date Report~ TEST HOLE #1 DIESEL,TANK ...................................... Soil. Description Silty Sand - medium brown when dry. Sand predomina~ with some medium-grained, trace coarse-grained. llty Samd - dark brown when dry. grained. Samd well graded Boring Terminated Laboratory No. ~P86-014~ Date Reported: TEST HOLE #2 DIESEL TANK 10-24-86 Soil Description . , . ~nd - Medium gray when dry. Sand coarse to fine'gPained.~."Trace gravel., Silty Sand - dark brown when dry. Sand coarse to fine-grained. Boring Terminated Laboratory No. P86~0148 Date Reported: 10-24-86 TEST HOLE #3 DIESEL TANK Soil Description Silty Sand - medium brown when dry. Sand fine to coarse grained. ~Sand ~ medium gray~when,~dry~sand ~oarse tQ fine. grained. ~Trace .......... gravel. , Boring Terminated Laboratory No. P86-0148 Date Re~, TEST HOLE #4 DIESEL TANK .......................... Soil._Descr~ption Silty Sand - Medium brown when dry. Sand predominate medium grained with some coarse-grained. Silty Sand - medium brown ..when ~d[y~_~_~_d_~_~%.~_9~ Gravel rare. Boring Terminated Laboratory No. P86~0148 Date Reported: 10-24-86 TEST HOLE #5 DIESEL TANK Soil Description Sand - medium to light gray when dry. Sand fine to coarse-grained. Silty Sand - medium gray when dry~' -Sand--predominately. fine.to medium grained with some coarse-grained. Some silt. Boring Terminated Laboratory No. Psg-o14s TEST HOLE #6 DIESEL TANK Date Reported:. 10-24-86 Soil Description Silty Sand - medium brown when dry. ASand predominately fine to medium-grained. Silty Sand - m~dium~o, ~g~t_~brown when dry. Sand fine to very coarse-grained. Trace gravel. Sbme §ilt. ~ ............................. Boring Terminated SMC. Laboratory STAN COMER Chemist/ConSultant P.o. Box 80835 Bakersfield, CA. 93380 805-393-3597 Report of Lab~ratoryAnalysis Customer Name: Bakersfield Construction Insoection Address : 3012 Antonino Avenue Bakersfield, CA 93308 Date sample receive~ : 10-15-86 Date analysis complete~: 10-17-86 .Date of report :10-17-86 RESULTS OF ANALYSIS '~5514 ID: TH ~1 @ 2' Diesel fuel residue 48 ppm (~gm/gm) Method of Analysis: S}~ 2Q ~5515ID: TH ~1 $ 6' Diesel fuel residue 46 ppm (ugm/gm) Method of Analysis: SMC 2Q · ~5516 ID: TH ~2 ~ 2' Diesel fuel residue 167 ppm (~gm/gm) Method of Analysis: S~E 2Q ~5517 ID: TH ~2 $ 6' Diesel fuel residue 614 ppm (ugm/gm) Method of Analysis: SMC 2Q ~5518 ID: TH ~3 $ 2' Dielel fuel residue <10 ppm (~gm/gm) Method of Analysis: SMC 2Q ~5519 ID: TH ~3 ~ 6' Diesel fuel residue ~ 10 prim (~gm/gm) Method of Analysis: SMC 2Q ~5520 ID: TH ~4 @ 2' Diesel fuel residue 242 ppm (ug~/gm) Method of Analysis: SMC 2Q ~5521 ID: TH .~45 6' Diesel fuel residue 2048 ppm (ugm/gm) Method of Analysis: SMC 2Q ~5522 ID: TH ~5 $ 2' Diesel fuel residue 297 ppm.(ugm/gm) Method of Analysis: S~E 2Q ~5523 ID: TH ~5 $ 6' Diesel fuel residue 25 ppm (ugm/gm) Method of AnalysiS: SMC 2Q Stun Comer SMC Laboratory Stan Comer " Chemist/Consultant P.o. Box 80835 Bakersfield. CA. 93380 ~5524 ID: TH ~6 $ 2' Diesel fuel residue 12.pDm (ugm/~m) Method of Analysis: SMC 2Q · ~5525 ID: TH ~6 $ 6' Diesel fuel residue 13 ppm (ugm/gm) Metho~ of Analysis: SMC 2Q .... Stan Comer ULII)E: I~,G~OULIr) TALIK I~.~'/AOVA, I_ I 1700 Flower Street Bakersfield, California 93305 Telephone (805) 861-3636 KERN COUNTY HEALTH DEPARTMENi .EA,TH OmCER ·eon M Hebe~son, M.D. ..... ENVIRONMENTAL HEALTH DIVISION PERNIT FOR TENPORARY OR PERNANENT CLOSURE/ABANDONNENT OF UNDERGROUND RAZARDOUS SUBSTANCES STORAGB FACILITY FACILITY NANE/ADDRESS: OIlIER(S) NANE/ADDRESS: -' ,CONTRACTOR: 3 T~KS AT ABOVE , , -~PROV~ DAT[ '~ October 3. 1986~ LOCATION. ..................... POST ON PRENISES CONDITIONS 'AS FOLLOWS: 1. Permittee must obtain a Fire Department permit prior to initiating abandonment action. 2. Ail procedures used must be in accordance with requirements of Standards and Guidelines' developed for Implementation of Kern County .0rdinance Code. 3. .A minimum of four samples must be retrieved beneath each tank at depths of approximately two fee: and six feet, one-third from each end. 4. All samples must be analyzed for benzene and total petroleum hydrocarbons. 5. Advise ·this office of the time and date of proposed sampling with 24 hours advance notice. ACCEPTED BY ~ DATE DISTRICT OFFICES ~.l.~ nc ,'._,~ .-.-, .~-tnl~,? hnheUn Moiave Rid~ecrest Shafter ' k~rn Cuunty tiealth De-partme~ Division of Environmental Hea~h 1700 Flair Street, Bakersfield, CA 93305 APPLiC-~TIGN FOR PERMIT FOR TE~R~ (AR PER~ HAZES SUBSTANC~ S7~E FA~ILIT~ Application Date No. of Tanks to 'be Abandoned Facility Name Facility Address T ~ R SEC Owner '~ ~3,~F ,'~ ~I~ ~, ........ ~rator_..,.,. ~0~%3 -~,~ ~dress ~. ~ ~_ _:Type of]Application .. (Fill_Out_One Application Per..Facili_ty) [-] T~orary Closure/Abandonme'~ ~Permanent A. Project Contact (name, area c~e, phone): ~ys Nigh~ Nearest Cross S~. [Rural ~ca~io~ ~ly) Tele~one ~- ' ~~, ~.. eD~9 Zip . ~ .. Tele~one ~% -~ - zip B. ~ter to Facility., Provid~ by '~ ~ ~~ ~p~ ~ Gro~dwatar Soil Characteristics at Facility ~o~ ~sis for ~il ~ and Gro~d~tar ~pth ~taminatio~ Ce Tank Removal Contractor V~/NrT.7-t~ ~WpT'0 C% License No. ;~dress 'TD I'~1 .J~ct,e~"~ ~.O 1,t.l q. Zip __~ Telephone Proposed S~arti~ ~te g/~/'~ · Pro~ ~pl~tion ~t~ /~]~/~ ~ . ~r~er's C~mnsation Car~if~at{on ~ ~/0~~~nsurer ~*'~7~, Env~rocmental AssesmenC ContraCtOr ~. C, ~ ~ License No. AAdress ~l q ~<~ ~o~,, Zip ~~ Telephone _~q - 1~ P~oms~ Starti~ ~t~ ~/~/a~ proms~ C~pletion Date ~'rker's C~ation Cer~ifida¢~ ~ ~7-do35~7o Insurer _ ~ Ch~ical Ccmposition of.Materials Stored Tank ~ Chemical Stored (non-commercial name] Dates Stored to chemical Previously Stored (if different) Describe Method for Retrievin~ Samples Samples Will ~e Analyzed for ~ Perform Analyses. of Samples ~)-r~,~ ~-~. ~..~.6~ Laboratory ~J~at Will This application for: .~removal or Telephone [] ab~n~donment in place ' * * PLL~SE PROVIDE INFORMATION R=r~UESTED CN REVERSE SIDE OF THIS SHEET BEFORE SU~'4£~ING APPLfCAT£CN FOR REVIEW. This form has been completed under penalty of perjury and to the best of my knowledge is true ar~/ correct. Signature '~-~'- 'Cicle Cate ~ro'~ide L~sc~[ptiun o£ /.~ical Layout of Facility Include 'All the FolloWi.~ [nfomnation: '"-Pr-o'po~ed Sampl'ing Locations Indicating Approximate Depth of Samples "- Nearest Street or Intersection ..... Any Water Wells or"Surface-Wa~'e~'Withi~ ldO' ility ............. .... ~ ............... KERN COUNTY HEALTH DEPT. .D~LY, J,,~)N C).F ENVIRONMENTAL HF.~H T700 FLOWER ST., BAKER__.S_F!E_L_.D.:._C~~ TELEPHONE: (805) 861-3636 .. * DATE JOB ADDRESS/LOCATION .... APPLICATION FOR A PERMIT TO CONSTRUCT, RECON~UCT, DEEPEN OR DESTROY A WELL~ PERMIT NOi OWNER'S NAME ...... Davies..OJ 1 ................................................. .'.....Bakersfield, CA. ADDRESS .__33_~Q.~.~....~_U] f_......S.~t..ee.~ ......... :_ TELEPHONE ...805..-_.323~6063 ........ CONTRACTOR__..L_~_Qe _W. es.t.eJ?_il ....... [ ........... L ...................... LICENSE NO.--4526.09..-L:-' .... ADDRES~ ._P_..__0.t___B0~x~__.3-~..!.~-~.~.~l:'-S 1~.i .el d ~ _~A __ TELEPHONE £05._-..32~..~.6026 .... TYPE OF WORK (CHECK) '-..~ ,NT-EN~E~;~E i CHECK)' .2 '.:. ' ."'.: 'l' ':"~;~'~!;!i:i;,:'?~O-POS. ED .WELr...D-.E,P.T.H~ .... . ,.?.r,:.-.:-:.:~ ·: ~,.:.. ...... 4... '-.', :" . :'.:J -:~, ~?/4'.-'-~,::, ~,/'~ii ';'c :':'"'T;;: ,: .:......g,,:::~.. ~," :-:DOMESTIC/PRIVATE .<~75~:~ ~ 4::':~:~t; I' ~ ~:~55 .: L~E¢ :.~6~-- -' R ,~ ' ' '- ' '~(CHECK) AGRIC.ULTU AL . ' .'._~ . . . ,.' ~ ~.....- ....~::.:. -r.' ...... OTHER .mQ,]Zo~.].ng._~_~l;~" -:" ':':":~' ":~: '~ ' '~ ' ?C::i;F'.:~?~ ,':'~ :r:~...~:~.~.:. ~.. FROM 2" above TO NEW WELL .i~ RECONSTRUCTION ':~ DEEPEN ~ '.DESTRUCTIONs_ FROM .... TO ...FEET ::: ~,E~T .HoD .O.F .c. oNSTRUC~ION (CHECK). DR~[[Ei~'J:Ho 1'1 (~'~.stem.· ' ?i~ORED ':i~'~. ~ ": I :? PROPOSE? CAS,NG ' "' I · D AMETER' 2'I'~';:,~'F;::'':' i!',.'::GAUGE/W.ALI" '.:.~::. :' I I~PE'C.'-Stal n 1 es s i.~'DEPTH ":::~" '-i'¢ :: ~-4~: ~ -"-~?!i,~sF~LIN~ MATERIAL i CHECK).)?.':~i!!'' ::. :' NE~T cEM'EN~ ~'~X' i !:'PUDDLED CLAY ~' '?' CEMENT GROUT '~ OTHER ......... ~:~ CONCRETE "~ .'(~ .' .... "-'-'- :'.-:".. ::.. ~ (HEALTH DE~T~. CHEC~[() '..' '.. ~<~' .~ PROPOSED SEAL(S)/PLUG(S)' '" .......... ~ NSPE~ION RE~ RED .... ,;:... SURFACE~. . "' '. ".- .1'"':.'~=.' .:~':'.:~.~:~:~~~/~BY . ~ANNULAR;~ :' "" "'~=";~ ~::~: ~:. ~. :..'~=.:.~,~'?",* ".-' ..v'." .~. '~ l~' ~"~: .... ~ ~,'~ 2-',, "'~'"'~lJ'~:~j''' ;' ~;' :~u : ~ "' OTHER ~ ................................................ : _ FROM ...... 0 .......... TO ~.~ FEET_ COQC~.~='~ . BY ........... · " FROM .<.'; '- "'TO -"" FEET ':' ::.r,:. :::.?~ .... - .... ~. BY 'FROM TO FEET~ .... , ~ BY PROPOSED PERFORATIONS OR SCREEN '.. FROM :~ "' ~ 'TO.L_L ............~EET FROM TO .,-FEET ' <-i,DESTRUCT ON OF WELL _. .... "i ......... ........... ' "'.. '? ' CASING D AMETER ............. APPROX. DEPTH ' ' '~PENETRATES CORCORAN CLAY ' DESCRIBE MATERIALS AND PROCEDURES ...... L_~_._~_ ..................................................... ] .............................................................................................. - ... suBMITTED BY. ..... -- AS AGENT FOR '" ' ACCESS APPROVAL D~RPOSITION OF APPLICATION FLOOD PLAIN ZONING APPROVAL (FOR OFFICIAL USE ONLY) ZONING '. Ap p R~)~I~'~'~Z- DISAPPROVED .. APPROVED SUBJECT TO CONDITIONS HEALTH~F~ARTMENT . . · APPROVED~ -~' DISAPPROVED . ' APPROVED SUBJECT TO C©NDITIONS REPORT REASON(S) FOR DENIAL OR NECESSARY CONDITIONS HERE: REPORT REASON(S) FOR DENIAL OR NECESSARY CONDITIONS HERE: , ~;- .~ ,,:; .... ~,' £-'Z, ELECTRIC LOG REQUIRED YES (;' NC," ,.,,. BY. DATE __.~_~._?FEES. PAID ........ DATE .... CASH CHECK BANK # PERMIT EXPIRES ON NINETIETH (90) DAY AFTER DATE OF ISSUANCE IF WORK HAS NOT BEEN STARTED. KCHD #306 EH (9/78) · ' .... * SKETCH WELL LOCATION ON REVERSE SIDE BAKERSFIELD OFFICE : ~::~'...:~"~.=-""' ~ ~ OR .OTHER FEATURES AS NECESSARY, - .k,', !,2, · '~,;'.~ ~·,~,., ~ .... .':' ~ :~z= ~.-%.': =-'~' ", ,,~ _ ! ........... . A. LOCATION OF WELL IN' SECTION :". :"- '"'" '" I. ,.,:"'~:?-.'~(:[INES: ~[,OCATE WELL BY 'MEASURING .FROM PROPOSED WE[.L SITE 'TO TWO (.2) SECTION..LiNES,'OR .1'/4 SECTION'IF. ,A"ROAD(S_. J'l. 'J:~-,~- ~":" 'i ...,;;. ='~c':,:,-~.~'.~ ,,.,=, .-,--:..... ,,.' :-?-~"JORDERS::,~:.:.,.¢~:~.= THE LA ND;",'.THEi MEASUREME ~ T(S)-'SH0~ILD_ALso:. BE MADE 'FROM~ C[HE CENTER 'OF THE¢.~ 'RO.,~D;?.~;~!;.. ' :..i,' .,.:! !::,' '_. .f '. ::L.~.:., . :: i~:i6:.','v~:'';:''~':': ...... '" :'"~Zff ? :"" ~·'-?- "::~':':""--~ :' ' ,-z,~:~:~ii~.i!:~':-,.~:-...-.:'.-::! ~:~' · · .. ._' _,,,,~! ,i" k'.. '--- _ .... - ":-. ........ , .... · ~ ' . .' ....,. -- "~1/,~,5 "\ · \ . ' ....... : ..... .:'.- -: ' .'~-! .'z" · - '- '"' ' --': .... '-,'-- -'-': J ' I ')1' ;-.'~::.=; .z ....... · ......... · ................ - . ' ~ · - · . . ' '.*t'_ '~-jz -,.~ . . ' .... . . · i '..' ........ ~ ' -- - ~ ,'-,, . . ,\\ '--.=~,~. :..:" ,'.,-~ . ...... ~;;~"...~-. ..... . .... ' '-' ..' , ':-'" :;: i-:- ...." ,~ ' -: '~ ".~ ',' "- ' ': .,' .:'~,'-. ,~ :?:?'!~ .-'?? ; :-~-~'.~ ........... :":.=... Z' ix.;,';' ':-' :. .' .. ' .,', · ' :', ,-. '-'..-.. ' ' . '~' -:":'~,'"- -"-,: ~' .""~' '~" ""- ',% ': '~'~' ' .%1-~ ~J~ ";.:. .,..;.;:¥z~.: . . ' ...~.'..., ..:, . -. · ': j[ "',';::.: i'"'.' :".:"::' .... . :'\\ ':", . :i:': .... :.'._': - .~ ..... , ,::.. I _= :. ... '. "-~ . ' ~?"/~"'::-~':// ~,:'=. :'- . J .:'~S~ER LINES- GI~:~XA~ ~-:?=T:,:,?.'::: ,. ' ' J~ ~ J · ~ ~' "' ' ~ MEASUREMENT OF DISTANCES. ' "' '. ~- . I I.I. Ipl~l~l~ISJ I l.-Ot/~e I" · I . , .~' "%:.~ ".' . LOCATE WELL BY MEASURING ..FROM.PROPOSED WELL SITE TO ~O (2) PROPERT~.~. IF A ROAD(S) BORDERS THE PROPERTY, THE MEASUR~:MENT(S) SHOULD ALSO BE MADE FROM THE CENTER OF THE ROAD· ~ERN cOuNI:y HEALTH D~PT. . ~Ll'c~fic~' ~ORA if DIVISIQN OF'ENVIRONMENTAL HEt~ CONSTRUCT, RECON/~I~JCT, DEEPEN '~(~ 17~~WER'ST:, BAKERSFIELD, C~ .... OR DESTROY A' WELLt: _~' PERMIT NO. o .~oo7~,1. ~ ~ TELEPHONE: (805) 861-3636 .,. C.T ................. ~ ................................... .)~~ST~fl'fi~ .?'~.:~L;~';"*- ADDRESS :P.0. BOX 3216 Bakersfi el d, , CA ~LEPHONE 805-324-6026 TYPE OF WORK. (CHECK) ' '...'.INTENDEDU,~E- -~¢-- ' - ...:~-'... . ..::.'.. ?..~.. (CHECK).~. '~-~-'., ,.-. .... ;:',., · "' "" ~ '-.~' ' '-'; ' , .: .... '.'r,;~*' · %:! !' DOMESTI~,?PRIVATE :12_~L: . ' ' -_~_ ..... z~.. ..... DOMESTIC/PUI~1C NEW WELL ~,~ RECONSTRUCTION ~ · DEEPEN ~,. DESTRUCTION ;:' ~--,:,':z~ ;~ ~',~ .?...~..'-~:~.-¢.,'.::'~'~.~ ........ .: t:;: .~t-,-,:' J , ROTARY ~ "' ~X "?'. ??55 FEET:35/:MIN.,,_j::~t[~FEET J: DRILLED- Hol 1 ow ' ..PEN ~ES_~ORCORANC~y.~T-~t ....... ~B [ETO~ ~DR iVEN,---~J~ .:;AGRICULTURAL~ . , ~ . ,, ......... (CHECK) ,~4 "':" ::-' ' : .... ?;;~,PROPOSED CASING' ,. -' .~. ~¢.~- - ,.: .'~-~,,,.~?l¢.:j ~" ", .~?' ~' · ::~:,. DUSTRIAL '.. 7~,¥....q*.:,. ' -~ .,':;.=z~;:....... ,.~.~ ..,--_..~.~¢[~.~. ~,~ ~.- .¢ [<.~:?? DIAMETER -~ , ' -" 'OTHER. m~.n]_~.q~j. Qg.. w~l:~ '~'~ES '~ .' ':~: ;':'~ "'"NO~' ';". ~' ' TYPE _S_t.81 n l e_S_S NEAT CEMENT ';'~, ~,'PUDDLED CLAY '~,~'. I FROM ..2.!L_above_TO screen bot~T FROM__ __.TO. ':t ~ ,:. "t-,.,,FEET .. ·-¥. ', .. ':'. i INSPECTION REQL~ED ' .'.' .~:.~. PROPOSED SEAL(S)/PLUG(S) ,. :4::' '. ':',., 'j (HE~LTJ'I DEPT. S~IECK) :.,::suRFAcE ~. .' .-..z. ....... 't:...? .:~ .;~;:.:~c.(~~~:~;B~?~.... :ehf~' L,~,-'['::' -~" B ANNULAR~. -" OTHER FROM ' .'..~ .... TO ~ ,_5 _ FEET cg_n_c.F_eJ;_e.,~; .. .;-~;: BY '- FROM :: -:-~F TO ~' '.. ~:-~: ,'FEET FROM__ TO FEET ~ " BY CEMENT GROUT ¢~ '.. 'OTHER i !' ''~ CONCREll~... :. .... !~) i' ¥"-."'i;-'~.,' !:. · PROPO~D P~FORATION~' OR SCREEN ,..I FROM ' '~' '~ 'TO _ '~"] '-?=':'~ >'FEET · , FROM ' TO" ', FEET FROM ' ;y~TO. :, '. ~,'.: ~- ,::FEET · .' FRO~ :.~.~- ,; ,,,TO ...... ~..:,~,:. ~ FEET CASING DIAMETER ................... ~APPROX. DEPTH DESCRIBE MATERIALS AND PROCEDURES '. . DESTRUCTION OF WELL : ' - " .... · PENETRATES CORCORAN CLAY SUBMITTED BY .................................................................................... AS AGENT FOR · ' .......................... ACCEBS APPROVAL FLOOD PLAIN ZONING APPROVAL ZONING ZONE .~_.~._.--// APP RC~vE~)~._-_-i~D Isa P P ROVE D APPROVED SUBJECT TO CONDITIONS REPORT REASON(S)FOR DENIAL OR NECESSARY CONDITIONS HERE: DISPOSITION OF APPLICATION (FOR OFFICIAL USE ONLY) HEALTH DEP~ARTMENT ' . APPROVED__~' DISAPPROVED . APPROVED SUBJECT TO CONDITIONS REPORT REASON(S) FOR DENIAL OR NECESSARY CONDITIONS HERE: ELECTRIC LOG REQUIRED YES~ N~ BY........'..' ................ _._~ ................ DATE ........i____]_ ........ .................. I~'E~-~-~i'D ................ ___ ........... DATE · CASH .... CHECK ............... BANK// ........................................... * PERMIT EXPIRES ON NINETIETH (90) DAY AFTER DATE OF ISSUANCE IF.WO,RK HAS NOT BEEN STARTED, KCHD//306 EH (9/78) * SKETCH WELL LOCATION ON REVERSE SIDE BAKERSFIELD OFFICE '"~::_..," ': 'a. LOCATION'OF WEL[ IN'. SECTION .... " : ,. ': ~ -". ~' "' .... ::': ?.LINES. ,.LOCATE WELL BY MEASURING FROM 'PROPOSED WELL. SITE TO.TWO (2) SECTIOI~...LINES OR"1~/4 SECTION F..A..ROAD(Si ~ ~':]]~ "'" ':'BORDERS THE I~ND;?THE MEASUREMENT(:S)" SHOULD ALSO.BE MADE 'FROM:THE ~CENTER: OF THE ROAD."~'~'<i?:"~ ".- :':"~c:. ': ...... '- -.--' ' ' i -, ~ ,,,,-,,~ -~,. ' :..~_. :- .-- .-...~;- .~': .... -: :..,., :;:~:~,~ ~..~;~:~ ~.~.~ .... ' · ',:,.~O.~::.';F ',? :-.,'.' ';-::-':-' ":' ...:-,:':".~F,:F .. ":~.;'?.?"::.:.:-,: ,'-"-.-: ""(~) '" ~?~'.~S."~~"~ ~-; .' ',::... ,: :: '.-~.-.--:~'; :- ......... :,..: .-:' .%:::-' '":'-, · {.' -.-", .'.F , ~..i ........ i ..... ~ ~ . ~,, ...... ,,.~,~;.:~ .,._.','.::.v..: ~',:t-~:~;~.',_-..:. ' . ' . ."-::., i-'"' ;,,-,,-: · "..'"' :::', 't::.'-' "" "~ · J N' -;-~:~'~)-! '~ '"'-~' ."~ "! . ,~,,,-.,.,~., . ,'.. ~ ' :~: ,,,.~T~,~, -.X'-' "- ', ......... ' ...... ~ . · i- - '".' ..... -:"~__~1 ~ ,, ': - ~ ' -': .... ~: ' .... .... · ~ ~,,~ · · N, .- , .' -', . '"."" · · -.. ':"' '-'-~- '" .... ":-"-' I "J,,,,~'-:,~,~:.:'."~'i"N '~ ....... . '.':. ." . ':' .,': i; . . "-'- ...... '.. -: '-' ...... ~,,~,,~,1~ I~ . ,~, ' '.....:..-_':'.-:\- ; ' ' / '"-' ' . '. 4 v "..:." :. i:. '.: .' :_.'. '.'.,,~ . :?. : ~ :' , ., :..~ · . . . ;.~. -'~' , ~ .- _ . , ~.., : , .. '..~. ~., _, - = ',-'.,,..; -- - . ....... ... ......... ' .... "... · ~-.. ....... ~. ,....~.-,:_~:~.:,-~ ....... ~[~$~1, ': ..... ".".'+~ ~.' '%~ v.' :-' ":"".'- - · '?'.:'-:: - .... .~. ~.' t1~'~'~$~ ~: '-~ - '-"" .'~L~N-:'.~:~.:~.~;*:,~':..'..~ . .. "'~ ' -:~'.','~:'~..:' ' ':~:~ ":"'.'::',~8:.;';~,'~"qe,'I~J;?:':. -' ,. , · · . · ,~ . .. ~, ~. ~ ~ · ,~,~,.~. ~.,.~** ..... · , . ~;-. :.. .,T.,,.~,~ '*,T, .-~,~.;,.~,,~ . ·,~ -.-..--.. ..,~ · -,--..x.~ ".X." ... ..... ~-' . :","'.',': .~_, , ~,.v-- ..,.,.:..: ,_:,O ,.:...,~.. 'y-:-.:. ..- ,'.. ,--- ..,"~'~, "~'..'.,(":'~':'~,0 ...... ?' .-' :~::;~:- -.. "" :-'-: :'-:;' "' ' /.,c · .-:.:.::~..-....-,.,~ .;:?,...--..:~:.~.~..i.-:...-... ~,-~-..:-.:.:-.--:-..,~,~-'~' -. --.,' } ::,~:."' ....,~,~.-*,~,~ **. ;~':~'~ ',.'- ".' .. '" . ' -. · "'.; -.. .... : -.'- ::':':-:,~' .'..:./f't · ~/ i" .... -LEACH LINES OR ,SEEPAGE PIT;..:i.:? . - . . ....... ... .... . ,.:.. :. . ..:. .... ._~,..,.-,,,..~. '-! ~, ! ." . .... ,~:~,:.:... .; ..- . . ......... · .. ..... '~ '.'. _ .:::='c=.~: :..::.:.~:i. i',-""'""~'~ ....... .... :,.:..;:;.:.,. , -~.~- ..... ':,: ..... ABANDONED. WELLS, ST'REA~$,. ..'"i"*:' :-:-:F:':F.' . ',::- '~::"i:i!';;:~':'::':'~i~~ ':-:?l._.'q 'i:!~?::,:,~??'..i:.::F. Yx,'__:c.';--'::/::..::c&.!. ..SEWER.LiNES ;:GIVE EXACT ':'? ":.-:""--"?~':l '::' ": ?'" :'"~:.~ :-"' .'" :'::'l~_~ I "' ": " -': ?'* *:'?~? :":w,z'-.z ." '""/"' ' '-'" I ,,,,,^~,~,~,,T o, ,,,T^,~,S '. -I '.-. .... '.'.' - · · l~l .---~ '- '-' ,'>? ........ '.":..-I. '~O ~ROPOSED WELL ..... ~...-.. "-- ' "' ' - ". -:.- '~;.:" ' .':-..'.'.'.":' ~',':, "" ~.~... -.~.?. ".,:::...': '. '. '- L.,. ,..-:'." ..:.:" .'. "::'i."':, · . --.I. I''''- '''''':'':' :'': '- , · .... :--..:~- ~--"--~'~'~-~--S ~ ---' --- - ~ '-' ' ' :.-" ' o .':' ..' ~, . ... . ....... >..'~. _. : ... :." . ~:::;:.~,;,::..:. :.:, :..: ~. ,...:~.::.:~: ,..-.. :.. (_._,,f~., .· :,.-: ..... ~:,~,~....--..../.,::,.:::.: . ?.?.. ~_~ ~, ..-.:.:.n.:-., ..? ..~ ~:'r": ..... · -~:.'.,,-}.'.'c.-.,~'--':': "" .~. LO~A'ri6~"6i~'w~d. ON O',~N~'ROPERTY. ~ ' "' "~" · '"' '""' ': ~ :'"":"'"' ' '"" --4' :.": :. LOCATE WELL BY MEASURING FROM ?ROPOSED WELL SITE TO' TWO (2). PROPERTY LINES. IF A ROAD(S) BORDERS THE PROPERTY, THE MEASUREMENT(S) SHOULD ALSO BE MADE'FROM THE CENTER OF THE ROAD· STATE. OF CALl FOR N I A THE RESOURCES AGENCY --' .' ,' "~;.~.,~-- DEPARTMENT. OF'WATER' RESOURCES ' .[':~-Local-i~brmi~:Novor. Date...a'~//~~- . .. from cities, -WATER WELL DRILLERS REPORT destruction, material procedures in Item (4Q" PRopOSED 'LOCATION SI~TCll ; ~ Other [-1 ' ' Bucket {-~ · :('/)·.CASING Type of ft. I' :':. Was. SUrface. sanitary sea, provided? Yes ~ No [-1 H ,es, ,o dep,h · Were strata sealed~gainst pollution? Yes~ No [~1 ,Interval i...-~:.~aet~oa'o~ .,~, aconite, pellets ad '>.j}' (10)- WATER LEVELS: 16.5 [~-.:;,~Depth_ o! fi~st water, if known [-~??Standlng level after well comp]etlon {:?;:'(1!) WELL TESTS: Was well test' made? Ye, [] ~ No ~ I{ yes, by whom? L -- ~ (Well. ?n'lle~)'_~: '~- '.:;?.~'~'~'.:....'?' 7~.'"'. ~ ~ ~ · . Pump ~ : B~er ~ ., ~r ~ ~ . . NAME B~ ~ ~ - ....... :. - ........ ~ .......'.~:.- . , . . ,_ ~ -~- ...... - ': ,~' ....~; · : '... - ". ' - ~ '~'..' '-~?-,,'"- ...... ~ ... '?.-. :--'~' ~;.,,, ~ ..... B~rsfteld '~--,,.:.:~.>~,~;~.,! ...._. -'-~:"~':~oou~'~. :~ DWS lee (.ZV. 7.7S) IF ADDITIONAL SPACE IS NEEDED. USE NEXT CONSECUTIVEL~ NUMBERED FORM· ' :3:;" :'"N' ~" ' / . . . . ...~ -. ;::.-:~L:~.... - . - IalIAflI~IIDLIr-JTI 9TAT[ OFCALIFORNIA '- ' : ~:"'::~1~~~--"~" ' ' ' ~''' ' ,THE '' -'" __~~:~:%': * · ' .DEPARTMENT OF WATER RESOURCES :~:~,~>..~:.6.~,~.:.:;: · ~: ~ ~:.:,. ., .... L~'~..-.'~ ~:,~::~?~.:~,>; . ~.- ,,~.~,~. ...... :.~:~,,, .:,.~?~>~:~:~,~.;:/~.~,~:., ~be~ ~ =~e~t f~ a~ve ~' '" ?' '? '"~'~ ~: '" T ;:~.. ,'~' ..~ EQ~NT: (6) . ,-.. -~ ~- · , .'...'~:. ,..... '- 'Cable [] ' - ' ' ' Ai~ ' r] rD{ CI~ING INS'I',&I-I.~D: Plastic [~ Type of (9)-WELL SEAL: :.?: . ' ~ ...'... ' ' :'~ ..... ' ;'Wms:mneace sanitary seal ;~ovided? Yes ~-', No'l-I 'if yes, t;'depth "'0--~ ft. 7:~were strata sealed against pollution? Yes ~ No [-1 'Interval' f.~2~!('10> WATER LEVELS=. ' " ' ' '.: '::'" a]-l'~'~ :Depth ot e~t: water, if known '; '"" "' 16 _ 'i : -. ,. · .,. . · .,~' ~ ., - ~ . .- ,; ;,~ .! ' ::~.. -5' ~.~.':'..'. ,.'~ St,~I~._~ level:=~er well completion "' Was well test made? Yes [] N'o ~ If yes, by, whom? · Type o{ test ,- . ., Pump I-I Bailer i'-[ Air lift r'[ . i.::.::i~;thrTg water a start of te,t -" '~!:rk .:'&-.;"~ .'At ad of ~ ': :i''~..~.;'ft- ~'"' ~-.har~e "' '-: ' ~l'/mln. ~ter' ' ~ ' "hOu~' ' -~,:~1- .Water. temperatu~ · Wa~ electric log m~i.? yes [] N'o [] ;"~f yes, attach copy to this repo~ DWR 188 (REV. ?.76) · ~::,; ~..., IF ADDITIONAL SPACE IS NEEDED, USE NEXT CONSECUTIVELY NUMBERED FORM.. ~ ' :... .... ..... "':"': ~;'~:,,,:,'," .". - :-:'7.,,. Permit Questionnaire Normally, permits are sent to facility Owners but since many ~:=~n~.!~%_~!~_._~u~_i.d_e__Kern~_Co-unt~y .... =they may_choose to have~_e.~_=p¢..rmi~:s sent to the Operators of the facility where they are to be posted. Please fill in Permit # and check one of the following before returning this form with payment: Fbr PERMIT # ............................ ~..~ .... Send listed on invoice (if Owner is different than Operator, it will be O~ner's responsibility to provide Operator with pertinent informat ion ). 2. Send all information to following corrected address: Owner at the 3. Send all information to Operator: Name: Address: (Operator can make copy of permit Owner). fo~ 1700Flower Street KI=r~N COUNTY HEALTH DEPARTMENT' Bakersfield, California 93305 ~ ENVIRONMENTAL HEALTH DIVISION Telel~hone (805) 861-3636 ., ~T~R~ P~R~~ TO OPERATE = sToRAGE ~ACILITY HEALTH OFFICER Leon M Hebertson, M.D. DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Relchard 1::> 1~1R M Z T#0500'7 ~- C X S SUED: JULY 1, 1986 EXP I RES :JULY 1, 1988 " ' FACILITY: ~'. · ' ..... /";DAVIES OIL CO.,CARDLOCK SALES· 5 ' UNK NON-NVF I '. '" YES ,,. ; .- .,.. NOTE: ALL.INTERIM REQUIREMENTS ESTABLISHED BY :'.-. . AUTHORITY MUST BE NET DURING THE TERM OF THIS NON--TRANSFERABLE -'. DATE PERMIT MAILED: .:.' ... ', DATE PEI~ilT CHECK'LIST RETURNED: PEI~IT CHECKLIST Permit This checklist is p~ovided to ensure that all necessary packet enclosures were received and that the Permittee has obtained all necessary equipment to implement the first phase of monitoring requirements. Please .complete this form and retUrn to KCHD in the self-addressed envelope" provided within 30 days of receipt. Check: Yes ~No / ./ ,;,. A. The packet I received contained: '"'"l):Cover' Letter, Permit Checklist, Interim Permit, "Phase I Interim Permit : .~ ~-Monttoring Requirements, Information .Sheet (Agreement Between .Owner and · ,.-, ..... '~.".'~perator), 'Chapter 15 ' (KCOC.'~G-394i"),'~Explanatlon:''~''bf Substance Codes, ~ '~ "'~""~ ~ -Eouinment Lists and Return. Envelope. · '~ ... '~:~ ', , ~ i ~- ......... ~ .... 2)-S~an~ard .Inventory. Control. Monltorlng.H~d~oo'~'*UT.-~O~.~.- ~c~x-X with the following forms: .. " a) "Inventory Recording Sheet" b) "Inventory Reconciliation Sheet with summary on reverse" c) "Trend Analysis ~orksheet" / 3) Modified Inventory Control Monitoring Handbook #UT-15 with form: "Quarterly Modified Inventory Control Sheet" with "quarterly Summary on reverse" ~ 4) An Action Chart for each inventory method (to post at facility) /B. I have examined the information on my Interim Permit, Phase I Monitoring Requirements, and Information Sheet (Agreement between Owner and Operator), and find owner's name and address, facility name and address, operator's name and address, substance codes, and number of tanks to be accurately listed (if "no" is checked, note appropriate corrections on the back side of this sheet). C. I have the following required equipment (as described In Handbooks under "Before Starting") 1) Acceptable gauging instrument 2) "Striker plate(s)" in tank(s) 3) ~ater-flndlng paste ,J D. I have read the information on the enclosed "Information Sheet" pertaining to Agreements between Owner and Operator and hereby state that the owner of this facility is the operator (if "no" is checked, attach a copy of'agreement between owner and operator). E. I have enclosed a copy of Calibration Charts for all tanks at this ~acillty (if tanks are identical, one chart will suffice; label chart(s) with-corresponding. tank numbers listed on permit). F. As required on page 6 of Handbook #UT-10, all meters at this facility have had calibration checks within the last 30 days an~ were Calibrated by a registered device repairman i__~ out of tolerance (all meter calibrations must be recorded on "Meter Calibration Check Form" found in the Appendix of Handbook). G. Standard Inventory Control Monitoring (Handbook #UT-10) and Modified Inventory Control Monitoring (Handbook #UT-15) were started at this facility in accordance with requirements described on interim permit ¢ondl.~l~ff~. Signature of Person Completing Checklist: ~~~' Date: p~epa~ed by TANK DIAM£TER - 95.00 ln~hem produc:~: ~ ~ OI.L COMPANY iP.O. Box 80067 BakepsField~ Ca. 9~80 TANK L~NOTH = 336 tnchee TANK ANGL~ = 0.00 de~ree~ 0.00 0 0.~ 0.50 7 O. 75 1.00 ,19 2. O0 53 2.~5 3. ~) 74 38 110 3.75 136 ~.~ ~,~ 17~ 7. ~ 379 7.~ tO.~ ~0.~ ll.~ 11.~ 11.~ 710 11,~ 12.50 802 13.00 13.~ 873 13.50 897 13.79 i~.2S 970 14.50 i5.~ i~.~ 1i~7 16.~ 1173 i6.~ 16.~ 17.~ 1278 17.~ 17.75 i8.~ 1359 19.~ i~* i6~ ~1. ~ i69~ ~t.~ ~ 18~ 23.~ i~7 ;~. OO ~0~ :*4,~J ~076 24.50 2107 24.75 2137 ~. ~ ~167 : ~.~ ~. ~ ~. ~ 2351 ~7. ~ ~76 ~7. ~ ~2~7 · ~0 ~ ~97 ~. ~ ~76i ~,~ 2793 3~.~ ~.~ 30~ 3tla 3i~ ~17 ~.~ ~8.50 ~8.79 5327 49.~ 4g. ~ 50.~ 55~ ~.~ 51.~ 51.~ 5672 51.50 51.~ ~1 ~. ~ ~.~ 5912 53.~ 5~? 53.~ 5981 ~ ~15 5m.~ 60~ 6i18 61~ ~.~ ~.~ 6~ 56. ~ ~ ~ 6~ ~.~ ~.~ ~. ~ ~93 ~ ~ 6~7 67~8 67G1 59.~ 1OOOO gal. TANK CHART (BO9)323--6063 STICK POINT = 60,0~ 6861 60.~ 68~ 60, 50 6~28 60.75 6~! 6i.00 6~& 61. ~ 70~.7 61,50 7.360 61,75 7091 6~.00 7i26 E2,25 7159 60., 5O 7192 ~, 75 7225 ~. O0 7~57 ~3. ~ 7~JO ~. 5O 7~3 G4.79 7~ 65. ~ 75¢9 65. ~ ~81 69. ~ 7613 7676 67.~ 67. ~ 67. ~ ~.~ ~897 ~.~ 7~9 ~.~ 69.~ 69.~ 69.~ 8i~ 70.~ 8i4~ 70.~ 8i73 70.~ 70. ~ 71.~ 7i.~ 71.~ 7~00 8383 73.;~ 8~13 72.50 72, 75 8471 73.00 73.~ 8530 73. 50 8559 73. ~ 8588 74.00 8616 7~. ~'~ 8645 7L 50 8673 7~o 7S 8702 75. O0 8730 75. 89 8758 75.50 8786 75.~ 8814 76.00 88~3 76.2~ 8869 76. 50 8897 76.79 77,00 8~i 77,~J 8978 77.50 300'J 78.00 3058 78.~ 3085 76.90 78.79 9137 79.00 916.1 7~.~ 79.50 ~0.5O ~315 81.00 9364 81.~ 9389 81.50 81.75 8~. ;rS 9531 83.5O %OO 0 inches 8~.00 9645 8~.~ 9667 8~.50 3688 8~.79 9710 8S. 00 9731 ~. ~ 9773 85. ~ 97~ ~.~ 981~ 86. ~ 9834 ~.~ ~85~ 96. ~ 387~ 87. ~ 9893 87.~ 391~ 87. ~ 993i 87. ~ 89.~ i~ 89. ~ t~70 89. ~ ~.~ 101~ ~.~ 10117 ~.~ I01~ ~,~ lOl~ 91.~ 10161 91.~ 10174 31. ~ i~ ~.~ i~i3 ~. ~ 10~ t~ i~l ~,~ iO~ ~, ~ iO~ ~ 10310 GULF ST. CARDLOCK t product: EXXON EXTRA UNLEADED ' ~P.O. Box 80067 Bakepsfield~ Ca. 93380 p~epared by ,DAVIES! OIL COMPANY TANK DIAMETER - 74.00 l~ches TANK LENGTH = 0 lncheJ TANK ANGLE = 0.00 degrees 0.00 0 O. mi 0 0.50 0 0.75 0 l. O0 0 1.35 0 1.50 0 1.75 0 £.00 0 '~ 35 3.~ 100 3.35 113 3.50 125 3.79 i38 5°00 5.35 258 5.50 Z65 5. 79 273 6.50 6.79 3,33 7. L:5 0~ 5 8.00 8.35 445 8. 50 470 8.75 '. 9.00 520 9. L~ 5~) c).50 560 %75 580 10.00 6O0 !0.;~ 625 10.50 650 10. 75 67'J 11.0~ Il.mi 7~ 11.50 740 U.79 760 1~,00 780 1~.00 780 1~-~ 738 1~.50 81~t 1~.79 833 13.00 850 .13.~ 875 13.50 300 13.79 14.50 I01§ 14.;~ 1048 15.0~ 1080 15.50 IS. 7'J 1170 1%00 1300 17.~ 1330 17.50 1360 !~.75 1390 16.50 1~70 19.00 15~) 19.50 1560 1~.79 1560 ~.79 1713 21.00 I~"~) ;:'1. mi 17~8 21.50 21.~ 1863 23.00 ~.3.50 2100 23. 75 i~4. O0 2150 24.00 2150 Z4,35 2183 24. ~ ~ 3370 ~.~ ~.~ 2870 31.~ 31.~ 3110 3~ - 3170 510 ~.~ 8000 gal. TANK CHART STICK POINT 36,75 3813 48.75 5435 60.79 6879 37.00 3~ ~9.00 5V~ 61.00 6900 3?.mi 3888 49. mi 5510 61.~ 6930 37.50 ~ 4'{.50 5540 61.50 6960 37.73 ~ 49.~5 5570 61,79 6390 38. mi ~30 50.~ 2.630 63.35 7045 38.50 4060 50.50 2660 ~. 50 7070 ~,00 41~ 51.00 57~ 63.00 39. mi 4160 51.~ 57~3 63.25 71~,5 33.50 k~O0 51.50 5785 63.50 717{) 3~.75 42~) 51.75 ~I8 63.79 7195 ~.mi 43~ ~.mi 5883 64.~ 4~.50 4~70 5~.50 59i5 64.50 7:~70 ~).~ ~15 5~ 5948 64.~ 7~Y5 {11.00 ~ §3.00 5~8~ 65.00 7320 ~l.mi 4~83 53. mi 60i5 65'mi 7353 ~1.50 45~J 53.50 6050 65.50 7385 41.~'J ~528 53.]5 60~ 65.'75 7418 ~..00 4550 54.00 &i~ 66,00 7450 ~3. mi ~583 54, mi 6153 66. mi 7~.3 h2.~ ~615 54.~ 6185 66.50 ~3. mi ~?lO 55. mi 6375 67. mi 79~ 43. 50 47~ ~. 50 6300 67.50 43.75 4770 55. 75 63L~ 67. 79 7560 44.50 4875 56.50 6~00 68.50 7615 ~.75 4913 5G. 75 64~ 68. 75 7633 45.00 4350 5'%00 6450 63.00 7650 45. mi 4383 57. mi 6483 69.~ 7668 45,50 5015 5'7.50 6515 69.50 7685 45. 75 50~ 57.75 6548 69. 79 7703 46. mi 5i0~ 58.'L~ 659e 70.~ 16.~} 513~ 58.50 681~ 70.~ 7760 ~4,~ 5i5~ 5LT"J 6633 70.7~ ;~7,00 5180 59.0~ 6650 '71.00 7800 ~?.mi ~10. 59, mi 6688 71. mi 7813 ~7, edO ~40 59,50 ~Tmi 71.50 47, 7~ ~70 59, 73 ~7E3 71.,7~ 71L38 ~,OO 5300 ~0,00 6800 7:~,00 7850 ~.00 78~0 73. mi 7868 7:m. 50 788~ 73.00 7cJ~ 73. mi ~35 73.50 7T~O 73. 79 ~ 74.00 7u~80 0 inche! GULF ST, CARDLOCK ~" p~oducts DIESEL 15000 gal. TANK CHART p~epared by DAVIES,. OIL COMPANY P.O.,,Box 80067 Bakm~sfield, Ca. TANK DIAM£T£R =, 108,OO i~che,", .i O. OO 0 0.~ 0 0.50 0 0.~ 0 I. OO 0 I.~ 0 1.50 0 1.79 0 a. O0 0 a,~ too -3.25 3.50 150 3.75 175 4.79 5. GO 5.25 368 5.50 385 5.75 403 6. GO 6.25 6.50 465 6.75 *88 7. GO 510 7.25 5,1,1 ?.5O '~ 578 8.50 650 8.75 675 725 10. GO 800 10.25 10.50 650 10.75 879 Ii.00 ~)0 11.25 11.50 11.79 379 I&OO lOGO 12.15 1030 i~, 50 1060 IJ. 25 !145 13.50 1170~ 13'75 1195 14. OO 1~0 13.50 1~85} i~o75 13i8! 15. oo 15.~ 1415 16.00 16.25 1650 1550 16.79 17.00 16~ 17.25 1635 17.50 1650 17.75 16~ 18.00 1680 18.~ 17~.3 18.50 1765 19. GO 1850 19.~ 18~1 19,50 1915 19,75 l~W8 ~ 75 Z370 ~3.OO 2~00 2513 TANK LENGTH'.' O inchem ~.00 .:85O ~6.~ 2683 i76.50 L:'6. 79 ~7.00 ~'7.25 3015 P7.50 3050 27.75 3O89 28. OO 31:20 ~6.25 :t165 ~8.50 3~10 :29. 50 3360 30.75 ~518 31.00 31.50 31.79 32.~5 3730 32.50 3760 32. 79 ~. 79 I070 3~.25 4138 ~.50 4179 35,79 ~13 TANK ANGLE ' O.OO degreea (8011) 3;~3=6063 STICK POINT ' O tn,"'hee {6.00 4250 qB. GO 6150 60. GO 81~) 7~,OO ~ 84.04) 11654) 36.25 4,?.88 46.~ 61M 60.25 6145 7~,25 '~ 84.25 11688 ~6.50 43~ ~8.50 6~15 60.50 8170 7~50 398~ ~.50 llT~J ~79 4363 ~.79 ~ 60.75 8195 7;-79 10018 84.75 11763 37. OO 6~tO0 49. OO ~80 61.GO 8220 73,'OO 10050 &~OO 11800 37.25 4450 49.25 6330 61.~J 8~ 73':~q i(X)83 8ff,,~W !1838 37.50 4500 49.50 6380 61.50 8300 73,50 10ii5 89.50 I187~ 37.75 1,550 ~9.79 6130 ~1.75 8340 73.79 i01',8 69.75 list{ ]8.~J 4630 50.25 6~J ~.~"5 8430 74,25 10~15 ~6.25 11388 38.50 4660 50.50 6565 62.50 8~80 74.50 lO~-aO ~.50 1~~'~5 39.00 47~0 51.00 6650 63.00 8580 79.00 10320 87,00 l~100 3~.25 4769 $1.25 6688 63.25 86~.3 75.25 103~0 ({7.25 i~130 3~.50 i*Sl0 51.50 6725 63.50 8665 75,50 10~OO 87.50 1tl60 39.75 465~ 91.75 6763 63.75 8708 75.75 10440 87.75 40.25 4950 ,~..~ 6845 64.25 8788 76.~ 10515 88.~ 1~:'~] 40,75 50~0 92,79 6933 6~'.79 9863 76.75 10585 88.75 l~31B 4hoo 5100 ~.OO 6980 65. OO 8900 77, OO 10620 89,00 ~1.25 5145 ~.~ 7015 65;25 8930 77,~i t0660 89.25 1~383 41.50 5190 53.50 70'50 65.50 8%0 7'7,50 10?GO 89.50 1~i5 41.79 5~35 53,75 7085 65.75 8~W) 77.75 10740 89.75 ~%25 5315 ~.'~ ?160 66.~ 905,] 78,~t 108i5 ~.25 I~ii5 43.50 548~ 55.50 7363 67.50 9"c25 79.50 1100) 91.50 1~670 ~3.75 5518 ~.75 7~08 67.79 9263 79.75 11040 91.75 1~95 ~.~ 5588 56.,~t 7493 68.25 9350 80.~5 11130 9~.25 l~7'~ ~.75 %63 56.75 7578 68.79 ~50 80.75 tt~30 ~..75 128i8 45. OO 5700 57. OO 7G~°O 69. OO 9500 81,00 11~60 93.00 1~9,~ i5.~q 5'738 · 57.~ ?663 69.~ ~ 81,~9 li~]0 9~.~t 12883 45.50 5775 57.50 77i0 69.50 957~ 81,50 113~) 9~.50 1~i5 15.79 5811 57.79 7'755 69.75 %!{ 81,75 ii370 93.79 ~m. OO 5850 58.00 7800 70. GO ~ 8~OO 11~0 g6.00 1~980 46.~ 5888 58~q 7838 70.~ %8~ 8~25 i1~30 94,25 13015 4~.50 5~ 58,50 7875 70.50 9720 8~50 114~} 91.50 13050 46.75 596,1 58.79 791;] 70.75 9755 8~.,75 11490 ~.79 /*7.00 6000 5~.00 7550 71.00 97cj0 83.00 !15~ 95.00 131L30 17.25 60,18 5~.25 7~J3 71.25 ~ 8,1.25 11553 95.25 47.75 6113 5~.75 8078 71.75 u.888 Ik].75 11616 99.75 13218 %.Go 1325O .%.25 1326.1' %.50 1~!5 %.~J 133,8 57.00 1338O 97.~ t 3'~O5 ~7.50 13W30 97.75 131,55 ?8. GO 13~0 ~.~ 13510 i3570 136~ loG. GO 13700 100. 25 i3745 100.50 i3790 100.79 13833 i01.00 13880 t01,25 101.50 13930 10i. 75 i3955 i0~o 25 13~ i0~50 140i5 i(~. 79 1 40,T3 101.25 14~68 i03. 50 14O95 i03. 75 10~. 08 141~ 104.25 14140 104.50 14i60 t04.79 14180 105.25 t~ · tos. 75 ! T~.OO 143OO 106.~ 14;]13 t(Y~... 50 i4~ 107.00 14150 i07.25 t43~8 107.50 14385 107.79 lure3 p~epared by TANK DIAMET£R = 95.00 l~chem 0.00 0 0. L~ 0.50 0.7] 1.00 10 I.L~ 13 !.50 18 1.7] % 3.~0 3. 7] 69 ~. ~ 7~ 4.~ 6.~ 6.~ 7.~ 17~ 7.~ 7.~ m.~ 0 ~1~ 11,~ 11,~ t product~ { 5000 Q~I. DAVIE~ OIL COMPANY P. Oo ,Box 80067 Bakersfteld~ Ca. 9~80 TANK LENGTH ' 171 inchem TANK ANGLE - O.OO degreef 1~.7] ~ · 15. ~ 16.~ 597 17.~ ~7 ' 17.~ 17. ~ 678 18.~ 6~ 18. ~ 719 19. ~ 7~{ 19.~ 761 19. ~ ~.~ 81{ ~1. ~ ~1.~ ~ 1011 24.00 1041 2'I.~i 1057 24.50 1072 24.75 10~7 ~:5. 00 1103 ~5.~q 111{ ~,.50 il34 ~5.7] 1150 ~6.00 1165 ~6.~1 1181 26.50 1197 27.00 1~26 :~7, ~ 12~ 27.50 1260 27. 7] 1276 26.50 i3~4 ~J. 50 1389 30.50 145~ 30. 75 1471 31.00 1~67 31.~ i504 31.75 1537 3~,~5 1570 3~.50 1567 ~ 75 1671 1704 1721 1736 35.50 178~ STICK POINT - 0 inches 35.00 18~3 4&00 ~059 60.00 349~ 7?.00 ~ 84.00 38,~5 1840 4l.~{ ~67& 60,~3 3~)9 77..~ ~261 84.~ 49~) 36.75 -1874 ~8.7] ~711 60.7] 3'J43 7?_.75 ~311 84.75 494~. 37.00 189~ 49.00 ZTL:'9 61.00 3560 ' T3.00 43~6 6.~00 495,2 3'"7. ~S 1909 49, ~ 2716 61. ~q 3576 73. ~J 4341 65.,~1 4%3 37.50 i9~6 49.50 2764 6i. 50 359:{ 73. 50 43~ 8~. 50 4974 37.7'J '1943 49.75 Z781 61.7] .]6i0 7~.75 4370 89.75 38.~ i978 50.~ 28i6 ~.~ 38~ 7~.~ 4400 86.~ 5005 ,{8.50 i~ 50.50 2934 6~.50 36~0 74.50 4414 86.50 5015 3~.00 ~ 51.00 2669 63.00 36'~ 75.00 ~P~3 67.00 503~ 3~.~ ~47 51.~J 2687 6.].~ 3710 7].~9 4457 87. L~ 5045 ~. 50 2064 §1.50 ~ 63. 50 3727 75. 50 4471 67, 50 5054 3{.75 2081 51.7] ~ 63.7] 3743 75.75 4486 87.75 506~ 40.00 L~99 ~ O0 ~.19 6~. 00 3760 76. O0 ~.500 88. O0 5073 40. 50 2134 5~, 50 ;~J74 64:50 3793 76. 50 45~8 88. 50 5091 40.75",i 2151 .~.75 ~ 84.75 380~ 76.75 45/1~. 88.75 5100 41.00 2i68 53.00 3009 65.00 38c~ 77.00 4555 69.(X) §i08 41.~ ~186 53.~ 30~6 65.~J 38~ 77.~ 4569 8g.~ 5117 41.50 Z~).] 53.50 30~k 65.50 3858 77.50 ~503 89.50 51~S 41.75'3 .°',',',',',',',',~1 53.75 3061 65.75 3874 7'7.75 45% 89.75 5i3.1 ~2.00 ~238 5~.00 3079 66.00 3891 78.00 ~i0 90.00 5141 ~..~, ~-~ 5~.~ ~96 66.~ 3~7 76.~ ~ 90.~ 514g ~..~ ~ 54.50 3114 r~.50 39~3 78.50 ~ 90.50 51~ 4{-00 ~0~ ~00 314{ 67.00 ~ 7g. 00 4~ 91.00 §171 4{-~{ 23~6 ~9.~{ ~168 67.~{ 3971 79.~ ~676 91.~ §17{ ~.50 234{ 5~50 318,] 6%50 3~87 79.50 4689 9i.50 ~18~ 4;{.75 2361 5~.75 ~ 67. 7] 400{ 79.75 47~ 91.75 5191 ~.00 2378 56.00 3218 68.00 ~019 80.00 4719 9~,00 5197 45.00 ~44{ 57.00 ~287 69.00 ~ 81.00 4766 9{.00 ~5.50 3~,] 57.50 ~1 69.50 411] 81.90 4~! ~m_50 45.75 ~301 57.75 333a 69.7] 41~ ~1.75 ~03 9{.75 ~,.00 ~519 58.00 ~ 70.00 ~i~ 8~.00 ~i$ 94.00 ,~.37 ~6.~J ~ 58.~1 3373 70.~1 4160 8P...~S ~7 9~.~1 ~6.75 L~/I ' 5&.75 3407 70.75 4190 8~.75 t651 '94.75 47.00 ~:589 59.00 3~.4 71.00 ~ 83.00 4863 95.00 5247 47.~ L'606 59.~q 3441 71.~S 4~1 8{-.'.~ 4874 47.50 ~.4 59.50 3~56 71.50 ~ 83.50 4886 47.75 ~4,1 59.75 3475 71.73 f~l 8.1.75 4897 .~ --. --.~ ~~1~~~ vies Oil Company ~l~l~~l/~ Bakersfield CA 93380 CA R O LO C K F U E L ~// . 1 ~/-~-~'~ Pump ~ /~ ~/~,~ ./~ Pump ~n~sh (money) Finish (gallons) PtoOuct eturn to Stor~e (gallonsf ~ake ~nd MoOel Serial Numar ' Pump Pro~uct Ret~n ]0 Sl6¢age (gallons)' Pump Fin,s~ (money) Fimm~ (9allonsl R~t~ 5tar~ (monev~ Start (gaTIods) - ' PtO~t Relu;n tO Storage Mike and MoOel - ' Serial Num~t Puree Finlbh (money) F~msh (gallons) J~2 ~, i Product ~ Return tO S~orage (~IIo~s) Pump RI~I~S Start (money) Start (9a/Ions~ O~t~u~on:Original (while) Invoice Copy Duphca~e (canary) File Copy Record of Computer or Meter Change Number Total,zer Sealed J Meter Sedled ~ 'Fagg~o Tag ~ E']Rea ~a,ee. OBI.e Ca(Ibratlon; F as! Slow Fast Slow AdluSted To Totahzer Sealed I Meter *Seeled Taggea Tag ~ Calibration: Checkecl _-/ I Slow / Slow ragged I Tag # nNo · CDecgeO F AdlUSteO T ,IggeO j Slow Meter Sealed Tag ar L-~No C~Rea OGree,, OBlue '"'""":F_" t I"? . P.O. Box 80067 Record of Computer · Bakersfield CA 93381) or Meter Change ~1~~ Slat~on number (;late I ,-, Jog) Number CA R D LOC K ~U E L L., Co~np~re~ Change ~// ~-,,,'-,~ ~ ~-, Make and Model Serial Number Tagged ~msh (monevl Finish (gallons) Calibration: Fdst Slow ._~l~l~S-. .Start Imonev) ........................ Start.(gal ohs ..... : '~ -~'-: .................. ~'~i(d '- F.asi ...................... Stow Pump ~Ree ~Green ~alue R~l~t Starl (money) Start (gallon~ / Aalustea Fast Slow Make an~ Model Serial Numar Tagged Pump 1 ~o~t Retutn to Storage (gallons) Pump ~Re~ ~G~een ~Bluo Finch (money} Fimsn Igallons} Calibration: Fa~t /1 Slow L Product Return tO Storage (gallo~s) To~ah~r Se~l+'~ Meter Sealed Finish (money) Finish (gallons) Calibration: Fast Slow Rt~I~ Sla~l (monevl SI~I (g~llonsj Adiutted F~sI ~low . _ .,:-,: ..... D~strlbutlo~: ~" Ongmal (whale) invoice Copy Duplicate (canary) File Copy . .ivision o£ Environmental Healfl Application 700 Flower Street, Bakersfield, CA 93305 ~° APPLICATION FOR PERMIT TO OPERATE UNDERGROUND HAZARDOUS SUBSTANCES STOR;~E FACILITY Type of Application {check): []New Facility ~lModification of Facility ~Existing Facility []Transfer of O~nership · Emergency 24-Hour Contact (name, area code, phone): Days 3~3-f'~&3 .. · Contractor Address Proposed starting Data Worker' s Ccmp~amtic~ .Certificatfoa I CA Contractor's License !~. Zip Telephotos Proposed' Caapletion flare Insurer If This Permit Is For Modification Of An Existing Facility, Briefly I)~cri~ Nodificatimm Propoaed ..... Tank(a) Store (check all t~at apply): %~ast~ Product Unleaded Regular Pr~ml~ Diesel ~aste Tank ! Notor Vehicle ---- Fuel " Chanical Ccmpoa!t;io~ of Materials Stored (not nacesaary for ~otor vehicle fuels) .... Tank: # Chamicel Stored. (no~-cc~ercial name)-,~ ! fir kno~). ~ Transfer of Ownership Date o--f-~-anafe~ Previous Facility Name modify or terminate the transfer of the facility upon receiving this completed fozm. This fo~m has be_~en com~e~j~ under penalty of true and co~~~ //~ Previous O~er accept fully all oblig'ati~ns of permit 1~. ' issued to I understand that the Permitting Authority may review and pemit to Operate this ~dergro~d storage' perjury and to the best of my knowledge is )ivision of Environmental He~ Application :700 Flower Street, Bakersfield, CA 93305 · .. APPLICATION FOR PERMIT TO OPERATE UNDERGROUND HAZARDOUS SUBSTANCES STOPJV3E FACILITY .. .... ~ ....... Ty~e~'of-Business--(check}-~~ ~lGasoline 'StatiOn' =[ilOthec ~slTank(s) ~ocated on an Agricultural Faro? OYes []No Is ~Tank(s) Use~ Primarily for Agricultural Purposes? []Yes ?9 No Type of A~3plication (check): [:]tat-~ Facility ['1Modification of Facility .[]Existing Facility ~ergency 24-Nour Contact (name, area code, phone): Days , i · Nights ' ' '- ' ~ -.' Facility Nam~ ~Vlr~ 01L 'CO (~,G~-OLOC_~- ~ft~__~ 'No. of~ 'Tan~s '-':' ~ Nearest Cross St. ':' (RU~'~l Locations (~ly) .... ' i ' Contact Pers~ '": ' ''Zip 'A~lephone ........... .. ,I , ,, ,~ ~/~ , Basis for ~oil ~ and Groundwater D~p~h Deteminatio'ns "" ~e~ Zip ~le~ pro~ S~r~' m~ ......... Pro~~ti~ ~ ~rkec' s Cm~tim certi'fl~ti~ i l~rer .. Water to ~ac provided by DepU1 i } ~: If This Famit Is For ~xIiflca'tion Of An Existing Facility, Briefly D~cribs I~diflCatien~ Propo~! . i Tara(al Store (check all ~t a~ly): , ~ I ~s~ Pr~uct ~r Vehicle Unlea~ R~ar p~i~ DI~X T~ S C~l StOrm~ (n~c~rcial ~ ~ t ~a~fer o~ ~ar~tp ~l~y or teml~te "~e facility u~ r~ivi~ ~ls cmple~ fora.. [ ~ - mm mm mm m ........ T ............................. : ..... ~ ....... m - · ~hls fora has been c~mpleted under penalty o£ true and correct. Signature perjury and ~o the best of my knowledge Title Date i (if kno~m} ~ , accept 'fully &lf obliga'ti'~ns of 'pemit NO. "' ism~d to · I understand that the Pemitting ~thority ma~ reVim~ and' transfer of the Permit to Operate ~his mdergro~d s~orage l~acil/ty Address r R SEC Ope~ato~ .......... Acldreaa .......................... ~ ........ Lz ' {e~n County Health Departmentt )ivision of Environmental 'Heame~ LTO0 ~lower Street, Bakersfield, ~A 93305 Permit Application · , ~PLICATION FOR PERMIT TO OPERATE UNDERGROUND · . HAZARDOUS SUBSTANCES STOP, fIE FACILITY T~13e of ~ (check'): - r-INeW Facility ~Modlficatlon of Facility ff~Existi~g FaCility m 1'9 Trana~er o~, Baergency 24-Hour Contact (name, area code, l~one): Days ~T~(S) ~a~ on ~ ~ricultural Fa~? ~Y~ ~ Is{Tank(s) Us~ ~i~rily for ~ricul~ral ~r~ses? ~Yes FaCility ~dre~ N~re~ m m m m m m mm m m ) Cm~im certifl~ti~ g ' I~rer Pro~ ~(=) S~re (~k all ~t a~ly)~ ~a~fer of ~er~ip H. 1. 2. TANK ~ / (FILL OUT SEPARATE FORM FOR ~CH TANK) --'~R EACH SECTION, CHECK ALL APPROPRIATE BOXES 4. Tank Secondary Containment [-~Double-Wall ['~Synthetic Liner []Lined Vault ~None [-1Unknown []Other (describe): []Material Thic'kness (Inches) "5. Tank Interior Li'ning ---~Rubber []Alkyd []Epoxy []Phenolic DGlass []Clay []t~lim~d []t~known D']Other (describe): 6~ .... Tank Corrosion Protection --~Galvanized 7e Tank is: Iq.Vaulted ~J~Non-Vaulted DDouble-Wall '~Single-Wall ~ Material {~Carbon Steel [] Stainless Steel ~olyvinyl Chloride D-]Fiberglass-Clad Steel [] Fiberglass-Reinforced Plastic [] Concrete [~ Altm~inum [] Bronze D']Unknown [] Other (describe) Primary Containment Date Installed Thickness (Inches) Capacity (Gallons) Manufacturer Manufacturer: Capacity (Gals.) 10. ~ass-C. lad []Polyethylene Wrap []Vinyl WrapDir~ '" ~Tar or Asphalt []-]Unknown ~None []Other (describe): Cathodic Protection: ~None []Impressed Current System ~l~acrtfi¢ial 9~xle System Describe System & Equipment: Leak Detection, Monitoring, and Interce~>tion a. Tank: []Visual (vaulted tanks only) ~Groundwater Monitorirg' Wail(s) [~Vadose Zone Monttorimg Wall(s) []U-Tube WithoUt Liner []']U-Tube with Compatible Liner Directin~ Flow to Monitorirg Wa,il(s)* [] Vapor Detector* [] Liquid Level Sensor' [] Conductivit~ Sensor [] Pressure Sensor in Annular Space of Double Wall Tank- [] Liquid Bstrieval & Inspection Fr~m U-Tube, Monitoring Well or Annular Space Daily & Inventory Reconciliation [] Periodic Tightness Testtr~ Gauging None Unknown ['] Other b. Piping: Flow-Restricting Leak Detector(s) for Pressurized Piping' [] Monitoring S~p with Race~y [] Sealed Concrete Race~y []Half-Cut C~mpatible Pipe Raceway []Synthetic Liner Race,my ~None [] Unknown [] Other *Describe Make & Model: Tightness Tested? []Yes ~No []U~known Date of Last Tightness Test Results of Test Test Name Testi~ C~upany Tank ~ Tank Repaired? []Yes ~]No []Unknown Date(s) of Repair(s) Describe Repairs Overfill Protection ., []Operator Fills, Controls, & Visually Monitors Level []Tape Float Gauge []Float Vent Valves []Auto Shut- Off Controls  Capacitance Sensor []Sealed Fill Box []None []Unknown Other: List Make & Model ~or Above DeviCes 11. Piping a. Underground Piping: ~Yes []No [qtmknown Material ~ Thickness (inches) Diameter Manufacturer ~J~Pressure []Suet'ion DGravity Approximate Length of Pipe Rt~ b~--- Underground Pipirg-~Cor rosion-P~tec t i on-->- []Galvanized []Fiberglass-Cia! []Lm[xessed Current [2]Sacrificial Anode . DPolyethylene Wrap [2]Electrical Isolation [~Vinyl Wrap '[~Tar or Asphalt []Unknown '[]None DOther (describe?: c. Underground Piping, Secondary Conta'~ent: [~Double-Wall DSynthetic Li~,~,r %~/s, .~r~ ~None []Unknown DOther~ (describe): TANK ~ ,~ .. (FILL OUT SEPARATE FORM FOR E~ TANK) 'FOR EACH SECTION, CHECK ALL APPROPRIATE BOXES ~Carbon Steel []Stainless Steel SPolyvinyl Chloride l~Fibe;glass~Clad Steel Fiberglass-Reinforced Plastic I-]Concrete [] Altmlint~! [] Bronze I'lUnknown [] Other (describe) 3. Primary Containment Date Installed Thickness (Inches) Capacity (Gallons) -' 4. Tank Se~o'ndary Co~{tair~nent "~ [~-----~uble-Wall '•Synthetic Liner ['1Lined Vault ~'None []Unkno~ []Other (describe): Manufacturer: []Material Thickness (Inches) Capacity (Gals.) ' 5. Tank Interior 'Li~ing ' ~ ~R6bber ['1Alkyd •EPOxy rqmenolic •Glass []Clay ['lL~lined rl~ ~ii:.: []Other (describe) .. ~i;..: i~..i 6. --Tank -Corrosion Protection --~GalVanized --~-~--~ass-Clad ['1Polyethylene Wrap [~Vinyl Wra[~lng " ~Tar or Asphalt . [~Unkno~n [~None ~qOther (describe).- Cathodic Protection: ~None rqlmpressed Current Syste~ r~sacr'i'ficial Describe System & Equi[mlent: 7. Leak Detection, Monitorir~, and I~tercepti0n a. Tank: [2]Visual (vaulted tanks only)~Ground~ater Monitoring' I~ll(s) []Vadose Zone Monitoring l~ell(s) ['1U-Tube Without Liner []U-Tube with ComPatible Liner Directing Flow to Monitoring Well(s)* [] Vapor Detector* [] Liquid Level. Sensora [] Conductivit~ Se~o~* [] Pressure Sensor in Annular Space of Double Wall Tank ~ Liquid Retrieval & Inspection From U-Tube, Monitoring Well or Annttlar Space Daily _Gauging & Inventory Reconciliation ~Periodic Tightnm~ None LJ Unknown ~ Other b. Piping: Flow-Restricting Leak Detector(s) for Pressurized PID~ng Monitoring St~D with Race~y D Sealed Concrete Race%~y fiHalf-Cut C.patible Pipe Race.y USynthetic Liner Race.y [] Unkno~ [] Ocher *Describe Make & ModeI~ Manufacturer 10. en Tightness Tested? ['lYes ~No ~Unkno~ Date of Last Tightness Test Results of Test Test Name Testing Ccmpany ....... 9. Tank ~ Tank Repaired? ~]Yes [~No ~lUnknown Date(s) of Repair(s) Describe Repairs ' Overfill Protection [-1Operator Fills, Controls, & Visually Monitors [~vel ~Tape Float Gauge ['1Float Vent Valves [Auto Shut- Off Controls B Capacitance Sensor [2]Sealed Fill Box []None ~Unkno~ Other: List Make & Model [~o~ Above a. Underground Piping: ~Yes [~No ~Unkno~l Material ~ . Thickness (inches) Diameter Manufacturer ~P~essure ~Suction' [~Gravity Approximate Length of Fi[~e ~ _b.~Undergro.und_P. iping Corrosion Protection ~:~, ' •Galvanized 'i2]m xessed Current [2]Sacrificial Anode []Polyethylene Wrap [:]Electrical Isolation [:]Vinyl Wrap [~Tar or Asphalt [:]Unknown []None [:]Other (describe): c, Underground Piping, Secondary Contairment: [:]Double-Wall [:]Synthetic Liner STstem [~None [:]unknown ' i~Other (describe): Facil fry Name T~K__ ~ .. ~' (FILL OUT SEP~TE FO~ ~R ~ T~K) . ~R ~ SE~I~,~ECK ~ ~PROPRIATE ~XES  Car~n Stol ~ S~inless Steel ~l~inyl ~o~ide ~Fi~rglas~l~ Stol Fi~rglass-Reinforc~ Plastic ~Concrete ~ ~in~ ~ Bronze O~er (de~ri~), , ..... priory Contai~nt · ~te Ins~ll~ ~ic~ess (Inches) Ca.city (~11o~) ~nufacturer Tank Secondary Contai~ent ~Other (de~r~): ~ufacturer: Tank Interior Lini~ ,,:!: ~'i?< ~ [:]Other {describe): . ....... "6%.=:Tank Corrosion Protection ................................ '- ............... '' 'I ~Galvanized --~~----~ass-Clad []Pol~thylene Wrap [:]Vinyl Wrapping . ~Tar or Asphalt []unknown []None []:]Other (describe): .... Cathodic Protection: ~None [-iimpressed Current System ~l~acr'ificial 9~Kxie Systm' Describe System & Equil~ent: 7. Leak .Detection, Monitorir~, .and Interception ~: 'Tank: [[]Visual (vaulted tanks Only) DGround~ater Monitoring' Well(s) [']Vadose Zone Monitoring Well(s) ' [~U-~ Without Liner []U-Tube with Ca~.patible Liner Directir~ Flow to Monitoring We.Il(s)* ['] Vapor Detector' [] Liquid Level Sensor [] Conductivit~ Sera,or" . :. [] Pressure Sensor in Annular Space of Double Wall Tank-. · ': .... [] Liquid ~etrieval & Inspection Frau U-Tube, Monitoring Well or 9zln,&lar Space · ] Daily Gauging & Inventory Reconciliation [] Periodic Tightness Tuting ' ,,= [] None [~ Unkno~a~ [] Other .~i b. Pipirg.' Flow-Restricting Leak Detector(s) for pressurized Piping' []Monitoring S~ap with Race~y []Sealed Concrete Raceway []Half-Cut Compatible Pipe Race~ay [] Synthetic Liner Race~y ~N(xle' [] Unkno [] Other · Describe Make & Model'~ 8. Tank Tightness ~-This Tan~ Been Tightness Tested? [']Yes ~]No [~Unknown Date of Last Tightness Test Results of Test Test Name Testing Canpany 9. Tank Re~air Ta---~]~Repaired? []Yes ~]No [~]Unkno~n Date(s) of epair(s) .... ~ Describe Repairs 10. Overfill Protection []Operator Fills, Controls, & Visually Monitors Level [-]Tape Float 'Gau~e []Float Vent Valves ~Auto Shut- Off Controls  Capacitance Sensor []Sealed Fill Box []None ~Urtkno~el Other: List Make & MOdel For Above Devices 11. Piping a. Underground Piping: ~Yes ~']No [']Unknown Material _T~ . · Thickness (inches) Diameter Manufacturer ~]Pressure ~-]Suctton []Gravity Approximate Length of' Pipe 'Rl~l ' b.,-l-Undergrou/%d-Piping-Cor~rosio~Protect-i-on . []Galvanized I-]Fiberglass-Clad []Impressed Current CTSacrificial-Anode [2]Polyethylene Wrap [~Electrical Isolation ~Vinyl Wrap ~Tar or Asphalt: []Unknown [~None [']Other (describe): c. Underground Pipirg, Secondary Contair~ent: ~Double-Wall [-]Synthetic Liner System ~None [-]Unknown []Other (describe): Other (describe) 3. Primary Containment Date Installed 'Thickness (Inches) 4. Tank secondar~ Co~tai'nme'nt [2]-----~uble-Wall [~ S~nthetic Liner Facility Name ~ ',,~V~,.~-,~ ~-~j_~,~c_~_. ,~f17~.~. ~ Pe~it ~.~ ~ T~K ~ .~ (FILL OUT SEP~TE ~ T~K) 2. ~ ~terial · ~ca'f~n Stol ~ s~inless steel ~l~inyl ~o~ide ~Fi~rglass~l~ Stol ~in~ ~.Bronze ~~  .Fi~rglaSs-Reinforc~ Plastic ~ Concrete ~ ~ci~y (~11o~) ~nufa~uref .: ..... ,,.,,, -, -.. ......, :' _.. ~lLined Vault ~None DUnknown rlOther (describe): Manufacturer.' U1Material Thickness (Inches) Capacity (Ga'Is.') '' 5. Tank Interior ~ ....... ---~R6bber' 'DAlkyd ~lEpoxy ~lmenolic ~]Glass DClay Dtl~lifled :': '. Do ibe) ili:! ther (descr : t:i0n ............. ' ' -'~ ..... Tank Carrasion~.~rotec ---~Galvanlzed -]~7~"~'~ass-Clad DPol~thylene Wrap ?.Vinyl Wra[~lng ', ~Tar or Asphalt ['lUnknown ~None ~70ther (describe) ._ '~-' ',' ""' <~ · ' Cathodic Protection: ~one DImpressed Current System [~Sacrlficlal DesCribe System & Equipment: 7. Leak Detection, Monitoring, and Interce~ti'or{ ~i 'T~. ~isual (VaUlted' ~nks onlY) [qGround~ater Monitori~' [~Vadose Zone Monitoring Well(s) [~U-Tube Without Liner " i-ltl-Tube ~ith C~patible Liner Dlrecti~ F~o~ to Monitorin~ ~le~(s)~ ' · I-i Vapor Datector' I-] Liquid Level Sensor' D ¢o~d~ctivit¥ Sen~o~' . i-1 Pressure Sensor in Annular Space of Do~bie Wall Tank [] Liquid Bstrieval & Inspection Fr~m U-Tube, Monitoring Well or ~ar S~sc~' ' ~Daily Gauging & Inventory Reconciliation ['l Periodic TightRmsB T~till~ r'lNone [] ~known [] Other b. Piping: Flo~-Restricting Leak Detector(s) for Pressuri~-~d PiPing; ........ [.']Monitoring S~,p with Race~y []Sealed Concrete Race~y ~Half-Cut C~mpatible Pipe Race~ay [']Synthetic Liner Race,my ~No~Ie [] Unkno~ [] Other .. . *Describe Make & M~del~ 8. Tank Tightness P~S This Tank Seen Tightness Tested? ~Yes ~No [-1unknown Date of Last Tightness Test Results Of Test ............. ! , · Test Name s ny 9. Tank ~ Tank Repaired? DYes ~No 1'Tunknown Date(s) of Repair(s)~' ..... , Describe Repairs . . i. . 10. Overfill Protection UlOperator Fills, Controls, & Visually Monitors Level []Tape Float Gauge DFloat Vent Valves [] Auto Shut- Off Controls  Capacitance Sensor ~Sealed Fill Sox DNone ['~unkno~ · Other: List Make & Model [~or Above DeviCes a. ~nderground Piping: ~Yes ~']No ~Unknown Material _ ~ Thickness (inches) Diameter Manufacturer ~j~Pressure DSuction [2]Gravity Approximate I~ngth of I~iPe'"l~m ' ' b. Und~_rg.rg_u3~_ ~R!pi rg_.~orrOsion_~Protection.. ~: [']Galvanized [2]Fiberglass-Clad [-lImpcessed Current [2]SaCrificial Anode ~Polyethylene Wrap [~Electrical Isolati~ DVin¥1 Wrap ~ar or Asphalt DUnknown ['7None ~Other (describe): . 1 c. Underground Piping, Secondary Containment: - [2]Double-Wall DSynthetic Liner System ~None []Unknown DOther (describe): TANK ~ (FILL OUT SEPARATE FORM FoRe, ACH TANK) --F~R EACH SECTION, CHECK ALL APPROPRIATE BOXES H. lo 4. ~ank Sec0'ndary Containment Llne Tank is: [']Vaulted ~J~Non-Vaulted [~Double-Wall ~]Single-Wall ~ Material ' Carbon Steel [-~ Stainless Steel [~Polyvinyl Chloride ['~Fiberglass-Clad Stol Fiberglass-Reinforced Plastic [] Concrete [] Aluminum [] Bronze []Unknown Other (describe) .. . - primary Containment Dste Installed Thickness (Inches) Capacity (Gallons) Manufact.ur?r. -, ................. ........ "-7 [']Other (describe): ClMaterial .. 5. Tank Interior Li'~{ing O DEmx¥ .':::~:"'.'/~/i' · []Other (describe): ........ ::~: ~.---Tank-CorrosiOn Protection [-]Lined Vault ~"None []Onkno~ " Manufacturer: ' ' ! , Thtcknes-~ (Inches) .... _ Cagacity' OP~enOllc [:]Glass OCla¥ r~L~lined rltl~no~ Liner Di Flow to Monitorin~ ~ll(s)* [] Liquid Level 0 Condu~tivit~ Sensor . :.:" ' B Pressure Sensor in Annular' Space of Double Wall Tank ,, Liquid Retrieval & Inspection Fr~m U-Tube, Monitoring ~e'll or ~m~lar S~ee ~ Daily Gaugin~ & Inventory Reconciliation [] Periodic Tightnem Tmti~ ONone [] E] Other .... ! . b. Pipirg: Flo~-Restricting Leak Detector(s) for Pressurized Pipin~ , [] Monitorin~ S~p with. Race,my [] Sealed Concrete Race~m¥ []Half-Cut C~mpatible Pipe Raceway []Synthetic Liner Raceway [] Unknown [] Other ........ i ... *Describe Make & ModeI~ .. Tank Tightness ~-~-This Tan~ Been Tightness Tested? []Yes ~]No []t~kno~ Date. of Last Tightness Test Results of Test Test Name Testing Company _ 9. Tank ~ ~ Repaired? []Yes ~]No []Unknown Date(s) of Repair(s) ...... Describe Repairs 10. Overfill Protection []Operator Fills, Controls, & Visually Monitors Level []Tape Float Gau~e []Float Vent Valves' 7q Auto'Shut- Off Controls  Capacitance Sensor [~Sealed Fill Box ~]None. []Unknown " iOther: List Make & Model For Above 11. Piping 'i a. Underground Pipirg: ~Yes Ii]No DUnknown Material ~ _ Thickness (inches) Diameter Manufacturer i ~]Pressure •SuctiOn []Gravity Approximate Length of Pipe !~1{': ": i b.---Underground- Piping-Corrosion-Protection--: · []Galvanized ~Fiberglass-Clad []Iml~essed Current []Sacrificial Anode []Polyethylene Wrap [~Electrical Isolation [~Vin¥1 Wrap ~ar or Asphalt! [-IUnknown []None []Other (describe): Underground Piping, Secondary Containment: []Double-Wall []Synthetic Liner System ~None []Unknown []Other (describe): Describe System a Equi[~ent: , Leak Detection, Monitoring, and InterceptiOn " ' a. T~-~ ~"~is~i (Vaulted ~nks °nl'y) "[~lGroundwater Monitoring' W~ll(s) FqVadose Zone ~onitorin~ Well(s) •t~,rube Without Liner []~ O-Tu~ with .C~patible rectin~ Vapor Detector" Sensor' ---~Galvanize~l --~"F~'~ass-Clad []Polyethylene Wrap []Vinyl Wrappin~ ,, I~Tar or Asphalt []Unknown []None •Other (describe): ' ' '.".';'"' Cathodic Protection: ~l~one []Impressed Current System ~lsecrfficial 9~ Systems" Facilfty Name ~3.~)~ {_~.L.:~¢'~ ~__~_,-.~L- Permit T~K ~ (FILL OUT SEP~TE ~ ~R~ T~K) ~~ ~ SE~I~ ~ECK ~ ~PROPRIATE ~XES H. 1. Tank is: ~aul't~ ~Vault~ ~uble~all ~Si~l~all 2. ~ ~terial ' . ~Car~n Stol ~ S~inless Steel ~l~inyl ~oride ~Fi~rglas~l~  Fi~rglass-Reinforc~ Plastic ~Co~rete ~ ~in~ Other (de~ri~) 3. Priory Contai~nt ~te Ins~ll~ ~ic~ess (Inches) Ca,city (~llons) ~nufa~urer 4. Ta'~k Secondary Contai~nt ~ ~1~11 ~thetic Liner ~Lin~ Vault ~ne ~Other (de~ri~): ~ufacturer: ~terial ~'i%~ess (Inc~s) 5. Tank Interior Lini~ --~--~-6..--' Tank Corrosion'-Protecti~-*'-: .............................................. ~Galvani'z~ ~a~l~ ~l~yl.~ ~Tar or ~lt ~~ ~No~ ~Other (de~ri~) Ca~ic Prot~tion: ~ne. ~pres~ ~rent S~t ~ri~' Syst~ & ~ui~ent: 7. Leak ~t~tion, ~nitori~, and Intg~ception a. Tank: ~Vis~l (vauit~ ~ks only) ~Gro~ter ~nitori~' ~Vadose Zone ~itori~ ~ll(s) ~~ Wi~ut ~ner ~U-~ wi~ C~tible Liner Dlr~ti~ Flow ~ Pressure ~n~r in ~ular S~ of ~uble Wall Ta~- [] Liquid Bstrie~al & Inspection Fr~m U-Tube, Monitoring Well or Annular S~ce ~ Daily _Gauging & Inventory Reconciliation [] Periodic Tightness TNtimJ i~< rq None [] Unknown1 [] Other ...... :< b. Piping: Flow-Restricting Leak Detector(s) for Pressurized Piping , []Monitoring St~p with Race~sy [] Sealed Concrete Race,my [~Half-Cut Compatible Pipe Raceway []Synthetic Liner Raceway {~Nmle [] Unkno~m [] Other ... *Describe .Make & ModeI'~ l~te of I.~: ?i~htness ?e~t Results of 'l~c ..... ~ Repaired? F'lyes lffiNo []unknown l~t~(s) of l~pelr(s) ............. Describe Repairs , ,,, ~' 10. Overfill Protection []Operator Fills,' Controls, & Visually Monitors Level · []Tape Float Gauge []Float Vent Valves [] Auto Shut- Off Controls  Capacltance Sensor []Sealed Fill Box []None []Unkno~e~ Other: List Make & Model For Above Devi~es a. ~nderground Piping:. ~Yes []No []Unknown Material_ j~ Thickness (inches) Diameter Manufacturer ~j~Pressure [-]suc[ion [~Gravity Approximate Length of Pipe i%~ ' ' , ' ............... b.---Underg round--P-ipi ng Cor. rosion-Protecti on~-: .................. [~]Galvanized []Fiberglass-Clad [~Imp~essed CUrrent [2]Sacrificial A~ode [~]Polyethytene Wrap [qElectrical Isolation []Vinyl Wrap ~Tar or Asphalt.. ~Unknown [']None [~Other (describe): c. Underground Pipirg, Secondary Contairment: [~Double-Wall []Synthetic Liner System ~None []Unknown i [-~Other (describe): T~K ~ (FILL OUT SEP~TE Fo~ . ~R ~ SE~I~, ~ECK ~. 1. Tank is: ~.vaul~ ~Vault~ ~uble~all ~Sl~l~all ~ 2. ~ ~terial Car~n Stol ~ S~inless Steel ~ ~l~inyl ~oride ~ Fi~rglass~l~ StOl Fi~rglass-Reinforc~ Plastic ~Concrete ~ ~in~ ~ Bronze ~k~ O~er (de~ri~) 3. Primary Containment Date Installed Thickness (Inches) Capacity (Gallons) ...... ~ ...... ~ ..... ~- ....... ~='_ - .... -'~-70] U~O', Tank S~ Containment C]Double-Wall [] Synthetic Liner '' 4. ['1 Other (describe) []Material Tank Interior Lining []Lined Vault ~'None Thickness (Inches) []~henolic []Glass Manufacturer Manufacturer: Capacity (Gals.) ,., []Clay •unlined 0~. - --']~'Galvanized --~'f~-~ass-Clad rT~olyethylene Nrap rTvinyl Nrappin~ ..., ~.:. '-i' ~Tar or Asphalt .[]Unknown •None []Other (describe): '~'" Cathodic ProtectiOn. ~None []Impressed Current System ~Sacrl'~icial, ~ ~tem'" Describe System & Equii~ent: 7. Leak Detection, Monitorit~, and Interce~)tior{ ' ~. ~a-~ ~'~isual (vaulted' ~ks only) E]Groundwater Monitoring' Wall(s) [] Vadose Zone Monitoring Well (s) ~7 U-Tube Without Liner []U-TUbe with C~.patible Liner Directing Flow to Monitoring [] Vapor Detector* [] Liquid Level Sensor' [] Conductivit~ Sen~or . .. ,. [] Pressure Sensor in Annular Space of Double Wall Tank ' [] Liquid Retrieval & Inspection Fr~ U-Tube, Monitoring Well or Annular Space Daily Gauging & Inventory Reconciliation ['1Periodic Tightna~ T~ting None 0 Unknown [] Other b. Piping: Fl~w-Restricting Leak Detector(s) for Pressuri'zed PiPits' ..... [] Monitoring S~p with'Race~y [] Sealed Concrete Race, my []Half-Cut C~mpatible Pipe Raceway []Synthetic Liner Raceway [] Unknown [] Other *Describe Make & ModeI~ 8. Tank Tightness Has This Tank Seen Tightness Tested? Date of Last Tightness Test Test Name [-[Yes i~No Or. known Results of Test Testing Company 9. Tank ~ Tank Repaired? []Yes ~]No []Unknown Date(s) of Repair(s) ..... Describe Repairs ..... i , , 10. Overfill Protection " []Operator Fills, Controls, & Visually Monitors [~vel []Tape Float Gauge []Float Vent Valves ~qAuto Shut- Off Controls  Capacitance Sensor [-]Sealed Fill Box [']None []Unknown. Other: List Make & Model For Above Devices a. Underground Piping: ~Yes C]No [~Unknown Material _ j~ Thickness (inches) Diameter Manufacturer ~]~Pressure []Suction [-1Gravity Approximate bength of Pi'pa ~ b.. Underground Piping Corrosion protection .: ..... . []Galvanized ~Fiberglass-Clad []Impressed Current [-1Sacrificial Anode C]Polyethylene Wrap [~Electrical Isolation [-]Vinyl Wrap ~Tar or Asphalt []Unknown []None []Other (describe): c. Underground Piping, Secondary Contairment: .[]Double-Wall []Synthetic Liner System ~None [-]Unknown []Other (describe): TANK ~ (FILL OUT SEPARATE FORM FOR~c~ TANK) · FOR EACH SECTION, CHECK ALL APPROPRIATE BOXE_____~S is: ['].vaulted ~Non-Vaulted []Double-Wall []Single-Wall "~.~ H. 1. Tank 2. ~ Material · ·  Carbon Steel []Stainless Steel D Polyvinyl Chloride [~Fiberglass-Clad St~l Fiberglass-Reinforced Plastic [']Concrete []Altmlin~t []Bronze [-~Unknown Other (describe) 3. Primary Containment Date Instaifed ~hickness (Inches) Capacity (Gallons) Manufacturer 4. Tank Seconda¥~ Cor{ta'inment .' .[]Double-Wall [-I Synthetic Liner ~lLinedVault ~None []Unknown1 [-~Other (describe) .' Manufacturer.' , ,, [1Material Thickness (Inches) . . _ Capacity (Gals.) 5. Tank Interior Lining .. ---~ber []Alkyd. ~]Epox¥ ~]menolic [~]Glass 77Cla¥ []unlined ~1~ -..., ~Tar or Asphalt [']Unkno~ []None []Other (describe): Cathodic Protection: ~None ~llmpressed Current System ~l~aCrlElcial';%~e System Describe System & Equil~ent: []']Other (describe) -Tank-Corrosion Protecti'oh Leak Detection, Monitoring, and Interce~)tion ~. 'T~nk: [~visua'l (vaulted' ~nks only) [~Grour~water Monitorir~' Hall(s) ~'~ Vadose Zone Monitori~ Well(s) [] U-Tube Without Liner  U-Tube with Compatible Liner Directing Flow to Monitorin~ Ha~ll(s)e Vapor Detectors [] Liquid Level Sensors [] Conductivity[ Sensor :.. ~ pressure Sensor in Annular Space of Double Wall Tank . [] Liquid Retrieval & Inspection From ti-Tube, Monitoring Well or &vmlar Space ? Daily Gaugir~ i Inventory Reconciliation ['}Perio~ic Ti~htneas Testirs] None [] ~kno~ [] Other , , b. Piping~ Flow-Restricting Leak Detector(s) for Pressurized Pipits]= [~Monitorir~] S~p with Race~ay [Sealed Concrete Race~ay []Half-Cut Cempatible Pipe Race~ay []Synthetic Liner Raceme¥ ~Nor~ []Unknown [] Other , *Describe Make & ModeI~ en Tightness Tested? ~]Yes ~No []Unkno~ Date of Last Tightness Test Results of Test ,, : · Test Name Testl~ Ccmpany , Repaired? ['lYes ~]No []Unknown Date(s) of Repair(s) ..... Describe Repairs. ~' . . -' 10. O~erfill ProtectiOn []OPerator Fill'~,' Controls, & Visually Monitors Level []Tape Float Gauge []Float Vent Valves [] Auto Shut- Off Controls ['~Capa¢itance Sensor []sealed Fill Box ['~None ~tttkno~ ' [qOther: List Make & Model For 11. Piping a. Underground Pipir~: ~Yes []No [~Unknown Material Thickness (inches) Diameter Manufacturer . ~]~Pressure [~Suc~ton [~Gravity Approximate Length of Pipe ~ b ..... Underground. Piping Corrosion -protecti. o~ .................................... UlGalvanized []Fiberglass-Clad [-llmpressed Current ['lSacrificial Anode [Polyethylene Wrap U1Electrical Isolation ~Vinyl Wrap ~Tar or Asphalt ~lUnkno~ []None UlOther (describe): c. Underground Piping, Secondary COntairment: []Double-Wall []Synthetic Liner System ~[None []unknown []Other (describe): TANK ~ (FILL OUT SEPARATE FORM FOR ~ TANK) · ---~--R ~ACH '~EC~ON,~ECK ALL APPROPRIATE BOXES 1. Tank is: [].vaulted ~J~Non-Vaulted ~]Double-Wall ~Single-Wall 2. ~ Material " ' I --~Carbon Steel [] Stainless Steel []Polyvinyl Chloride [)Fiberglass-Clad Steel Fiberglass-Reinforced Plastic . [] Concrete [] Altmin~ [~] Bronze []Unknown Other (describe) . , 3. Primary Containment Date Installed Thickness (Inches) Capacity (Gallons) Manufacturer 4o Tank Sec0ndar~ Co~t~ir~ent [')Double-Wall ri Synthetic Liner ['1Lined Vault ~'N°ne [~nkno~ . 1 []Other (describe): Manufacturer:I''l : r]Ma~erial Thickness (Inches) Capacity (Gals.) 5o Tank lnterior-Linin~ . '':. ',~[Rubber ['1Alkyd 77Epoxy 'F] Phenol ic [']Glass C]Cla¥ []tt~lined .::.,: ...:.. i . ~lOther (describe): ...... f.=L~['. {.'-'6. ?-Tank Corrosion Protection .................................................... --~Galvanfzed ~ass-Clad ~Polyethylene Wrap ~Vinyl Wr&[~ing ~Tar or Asphalt . [']Un~ []None ~]Other (describe) --_ ' . i i ~'':' Cathodic Protection. ~lone OImpressed Current System n Sacrificial 11. Piping a. Underground Pipin~: ~Yes ~]No [']~kno~n Material ~ _ Thickness (inches) Diameter Manufacturer ~]Pressure []Suction Ii)Gravity ApproXimate Length of Pipe ........... b. -.-Underground Piping. Corrosion--Protection-: [:]Galvanized ~]Fiberglass-Clad ~Iml~essed Current W]Sacri~icial Anode [[]polyethylene' Wrap [~Electrical Isolation ~Vinyl Wrap [~Tar or As~lt:. []Unknown [']None ~]Other (describe): . c. Underground Piping, Secondary Contairmentl: [~]Double-Wall []Synthetic Liner System ~None ~Unknown [~Other (describe): - 10. Overfill Protection. ~]Operator Fills, Controls, & Visually Monitors Level []Tape Float Gauge ~]Float Vent Valves [] Auto Shut- Off Controls BCapacitance Sensor [']Sealed Fill Box ['lNone [']~nkno~n Other: List Make & ,Model For ~ove DeviCes 9. Tank ~ i ~ Repaired? [~]Yes ~]No r'lunknown ' I Date(s) of Repair(s) · i : , I l Describe Repairs ~ Results of Test Testing Ccmpany Date of Last Tightness Test Test Name Describe System & Equil~ent: l T. Leak Detection, Monitoring, and Interception s. Tank: ['i~isual (vaulted' tanks only) I ~]Groundwater Monitoring'. I~ell(1) ~Vadose Zone Monitoring Well(s) ~U-Tube Without Liner .. []U-Tube with Can. patible Liner Directing Flow to Monitoring ~eF(I)* I'l Vapor Detectors rTLiquid Level Sensors rlConductivit~ Sensor . [] Pressure Sensor in Annular Space of Double Wall Tank ,,, [] Liquid Retrieval & Inspection From ~-Tube, Monitoring Well or ~anular Sp~ca [] Paily Gauqing & Inventory Reconciliation ~Periodic Tightness Testing ~] None ~ Unkno~ [] Other , , , Pi ing: Flo~Restricting Leak DeteCtor(s). for' pressurized Piping b. [] Monitoring Simp with .Race~ay [] Sealed Concr. ete .Race~_a_ y _ []Half-Cut Ccmpatible pipe Race~ay [] Synthetic Liner .ace~m¥ [] Unkno~ [] Other ,. *Describe Make & 8. ~en Tightness Tested? ['lYes [~No []t~kno~ OR oTHER FEATURES AS NECESSARY, .: .-. ] · . .?. . , .-. :' _.~,,,. ~ . B. [~)'~/i,1;iO1~1~ (5'{: W£~ ON oWNERS PROPERTY.. '"~. LOCATE'WELL 'BY MEASURING FROM PROPOSED WELL SITE TO TWO (2) PROPERTY LINES. IF A ROAD(S) R('qgD, r~'~ TNF: PPC~PFPT~ THE MEASUREMENT(S~ SHOULD ALSO BE MADF FROM THE CENTER O~ THE ROAD. ;'SKETCH'BUILDINGS, SEPTIC TANK;~ '""' :; SEWER LINES--'GIVE EXACT' MEASURF. MENT OF DISTANCF,5 TO PROPOSED· WELL. '-' "" .'"' :. i.'". r .... , - ....... :: :' 112 MILE: >i .......... , i"I ~..,-~:'-...- .- ""' ~-' ~.w~,.~. ~,s~c,,o~ .-'- . ..... -. .... - . - '- -. - - ...... ' '-"' · , ~ , _ A LOCATION O .: PROPOSED WELL"S TE TO·TWO (2) SECTION: I~I.NES OR'114 SECTIONrlF.-'~.ROAD(S) '"" -'. '"" ' ES -'EOCATE WELL BY MEASURING-FROM- .. . - ' ...... ~**T::: .'" :--',.'".~. .~,..-:.. . .,:~,I. IN ',:' ' ''" : ' ' " LSO' BE MADE FROM THE CENTER'OF THE ROAD.. ,-",': -v:;' "':~'t "-':=~'~' '-,':?iBORDERS THE LAND, THE. MEASURE. M.E~T(S) .SHOULD ,~....... ", ~i.).:~ '.' ~".'::?*'-.,..~ (?~:~:~-".-.'..'-' '-.;",.~:~.:~ T'" ""'.'. ";' .'"'-" "'"'-""~'" ........ ®'~'""'~'-' :-:: ' '";:! i /-'. / ' v- ' _.:"i -,-r-x ' . \-'..-. - .' '.-_'- - . -.-...-?:'~.~---.--,.:-.': ".:"'-':--- '-.,:':-"-~:-"..-,,_. · '..- ' -"- :*: '. " U,I~ ...,I. ~..' .,--/..'...I:'. :~. ' '- .... ' .' ' :>' ~'-'-" ' :.-' "' .~, - · '-'-'"1"' o ' "':' ..". "~7-':-':' --,-' - '.'~"'¢,'.." ': :: -.'-' ..... ' .... " ' ':' .~:"':." -~;' ',. =- . ::.'. ', ,:- ...- . :': :,: '"'57 .... d ...-...:....... ..... :,: :., . -., · '~,~,.." -' .. .... ..'"t::"'":',.:,':g,.: :';' :' .,_*5.'. : "~ ,;' · :'. -: -.' "' · ..: : . .' · -" ~-: · ':.... ':~.-' "~-"'::": '~J..-" ;'::" ..... ':.'" .... I' :' ..... '.- .. --,-,:.--./.~s. I. oc~'t'i~\ U'..: "': ~ I~le.'.n'~* ' -' -" "~ :f' :. ' '"I ".,-~ "' d ' X.x, -"'"\ : ': "' ' ' . ' ' - ra,~c~,So,, '- · .. ..... . . :'.. ' ....... -- .- .,.'..--. '- -.': ': ~ ' ' ~.- -'"~ .... $' ;,,' ', · . -.',, ~ . '. __~ ,~t, -,.. ,.,.,..:. 'i~ .,.: - . ....... .-, ..... .,..'F~:/~ l~t'\ -x' .... :,.. · x =. ~J ...... ...... , -..- ,, ......... .., .... >;. t,.5 .'. ~? ':"-:~5~ ~.~ ,'. ,' ' · . -~.~' _:,=-.._-::1~ .......... :..:..:..,.....:.V'~,:,o,,/,,e, sX ......... .--.x. ..,, ........ · ~I- ' ':':~ :1::~"'":.":'" ~,'~ '\.' it'l~ '."- '::'=~_m~/~: : KERN COUNTY HEALTH DEPT. APPLICATION FOR A~i~RMIT TO I~IVISION OF ENVIRONMENTALHE=~i~T)H CONSTRUCT, RECONJ~_UCT, DEEPEN ~'FLOWER ST., BAKERSFIELD, C~ OR DESTROY A WELL~ .~, PERMIT NO. :[ ' _~lay._21,. i9.86 ......... C~. "' ""' I OWNER'S NAME ' Davj.~s Qi!_ - Bakersfield', CA l:J 'J APPLICATION ~tATE, J' ADDRESS 330-~-~]'"~:~]'~i'""~'~'6e;r.- ..................... . ............ ~ ........ TELEPHONE '805-323-6063 ~,1 'l ', June' ~0 '.t]986 ' ". :'J CONTRAC~'"i"['~-~'~'[~-: ........... ~'=-"~ LICENSE N~~'~ ,! I ~.Ju~e:....J.3 ....... J986 ................. =.~==z.. I ...... : :-, ,' .... , ..... .' :-.. J L * PROPOSED COMPLETION DATE -=': ..... ~.:-j, . -~ ::-~.~ .,-f..:,- . ,( :+.- :':.. :...., . . . J J · : - JOB ADDRESS/LO~T ON ' ' ' -"'::?"' ~':':='~"':~r~'~'.~ ": 99S 'R '~497E 'SEC 9~ '":" ·'40 ACRE SUB ' ~ ~ ~ ' ''~'~' ' '" -' ':, ':%2 , ~,':~,.~~' ~~~~~:7~ , , C.-' ' - ~ .'~ ,, ..,,-', ..... ' ,'-, ;~" · ¢.' J ' ~' ~'"~ '~:" ~'~' '~': ':~"~ ~ ~'~': ~~ ~ ~:~ 'Y ~'~%-~'~':'f' "/' 'i.' '' 'L":"~:~' ~-~A~:'' ~' ' '%:"/'J'-z%~*' ~*~"'~ >"~:c:"<~ ':' ' ''~'~'~ ~ ''~: ~">k~ ::* '~ ..... ~' ""~' ' '~'- ' ~"' ~:~:'~'~ L. ~Z'-,r-: '"' ' :.~zf~" '~"~' ...." ~ ~' .... -~,c-,, - --:' ~PE.OF' WORK ~'CHECK)'" ...... .-'"~:"'~.".:.-'",~E~,WELL'~ .:'.RECONSTRUCTION ~ DEEPEN i~ i,::DESTRUCTION ! / ! ':J'"-';.~. ',lflNTEND~SE..(,GHECK) t<':~":?' :,:'~'::~':J:~."~,r:~¢tp,,PRQRQ~EQ,~[LL]~EP]H..j~Z~,~:.:~~' '-:~' ~HOD OF, CQNSTR~]ION, (CHECK)-".;~'J . , , ~ ~,z';~~ :,?,-': '~ -.-~ -,?, :; ~;~, ~ .... -,~-,~ ~:,, ~;?,,. ,~:=~.:~,,,,,.~-.,.,~,-, .:...,, ~: ~,--t., ROTARY ~ -;'~,,.~DUG ~ ,-', .~. I I . ~. :.~ ~-HOLE ~?~:~:,,~:;~. '-b..:,:,..~ ~;..:,-- ~::~ - T~: ~<~7-~,~'~':,,,~. ,~.--.,-.~',,.;~r~-,m~:,:~,,-,, !, ,?~:..,' S~LING ~RIAL,,(CHECK) ' '.' . ~" ~ ~ ? -' > ' '. ..... ~ ...... %-r'~;3~~ ~ ~;~;.:': 7~ .... ? '~;.-T ','~'~':¢~-:" ..... ~)~.j, -~.~r,~ : -' ,~' - -,,~, ,;. /' ' .... '_ :'.,.. ' ;. j' - gX _TO ROUT- "OmaR :, · "'- ~ L ,.' :: ":' :L,'.--'~'v'.:~ "','~(::~ '. '"' ",,, j;;.~ROM ..,,, '?' ='c.'TO ',':.. ' :'6'""FEET CONCRETE .):'~ · .:.'- ~ ~ ,- .;,, .... ~f,~,~:;.::;;:;~: -,,~ INS~Q ON REQ IRED .: .~,~. ..-~ ..,-.:, :.,..~:'PROPOSED S~L(S)/PLUG(S) ':~::f~v~:'; ~ <:'s:¢s:,'~ ~'IHEAITH DFPT [~KI-.;¢Z;'[~'~::- 'INS~D PROPOSED P~FORATIONS OR SCREEN "::~:. , ~-~ --~-r: ~ ...... :' .,: ,.-,---= ,,;.,. . ,~, : .__ ~ FROM', '<J ',:~,~TO OTHER 9 ...................... ' ..... :. :-,' FROM .....' :::' >":~O · -."'"; FROM ' 0 ~ - ~O T .5 ,,:-FEET concr_e~ , :~.~: "BY ~.';;' FROM "' - .TO '- '.;-. ::-FEET .,:¢ F OM ..,, ..... , .... _.~.TO ~,-,~ , , zFEET ,,:.. :,,;,.(~.~-,~ ~,,~.,-: ...,.:¢BY._- ....... ::,* FROM ?,:.-~,:-TO · -.':: ~;FROM .... '.,,,[,?. ;'.: ,'TO ., :~ FEET . .,,.~,,./4...' .~ ~'?Cr' ~ ".'"..' :'BY _ '~ '5' ',above '~ater"tabl~=,~o'~.-10' . . ..... ,. :.... .... . ....... :,DESTRUCTION OF WELL :.-::.._: ..... t..',~. ;:m, below. ~:J?~:~,,~:,~; ,,~,~ ........ ~..,, CASING DIAMETER -., APPROX. DEPTH ..... PENETRATES CORCORAN C~Y ..... -; ..... DESCRIBE MATERIALS AND PROCEDURES ~,__~i,_L~ ............ ~,~._:_,,~,~,~, .................... ~_'. ' ' ' · -'.SUBMITrED BY .... ,~,' ~"~'.,,'-!~:~ ..... '- '": ', ', :'~'' AS AGENT FOR AC~ J~?ROVAL DISPOSITION OF APPLICATION · - .:F:;F%DOD PLAIN ZONING APPROVAL ; (FOR OFFICIAL US.E ONLY) .' · ; . · .i" ..'·' '/.;i:, ZONING --~ .: '' .-....".:!;'i:";":~Z:~.';"'t-,!~::~.,~?-:.::''~' :::: :'.:'.'" '..'-'. :'i' :'. . I~E.A.L, THj~p~RTMENT i'. i~!:'":',i.ii~i:~?!!'.:~,,:. "':;::''~:"ZONE._A'/~./,... '-"": ,-: ' ':,':!:~':,: .,':',~':'" :',i:,~".;':!'::i:, ":'.~' ".' APPROVED~I~- ;";2:fDISAPPROVED';' ""' ':~: ;';' ' .. ·APPROVED DISAPPROVED .... ?~'~".~:'r:~ ,,, ' "' '. APPROVED SUBJECT TO CONDITIONS :.-': 't~. ~:.v.: APPROVED SUBJECT TO CONDITIONS___/~,, ' REPORT REASON(S) FOR DENIAL OR N[CESSARY CONDITIONS HERE: "REP_ORT REASON(S) ~R DENIAL OR'NECESSARY CONDITIO, NS H~E: :..:- '~ ~:..: ' ELECTRIC'LOG' REQUIRED YES :::~' N~': . ,~ ~':,.. .......... ~:,.-~ ,.,~ ::~ "~..,~ ,r' ',,,.,-' "t, ' ' ' . . '.~ ,- ".' -,' ' "?'-.' ' '.':..' ",.- ~ . '-~ , ....... '.,- ~v BY "" ' '" .,~':DATE L~---'::--FEES-PAl 'CASH EXPIRES ON NINETIETH '(~O) DAY AFTER PERMIT . DATE OF ISSUANCE IF WORK HAS NOT BEEN · STARTED. ........ · - KCHD//306 EH (9/78) . ,, i .... * SKETCH WELL LOCATION .:. ~:4; '. ON REVERSE SIDE · ... " - .......... ':'1/2 MILE;5't;"?-":¢':%\:":(~:C':"' :~:7:.;'1/2 MILE '"':" ' ' - ~ _ ~ .';..:q~.':----~"', '-' . ..... :. '.':':;-' ' - :7~,::. i ;'-:.. '~. % . ...... _ .' - ' . ' ' : ............. -' '~ ~">~A- .'I' ~.. ~ ':-' .. ..... A.-LOCATION OF WELL'.IN~.SECTION ',-:',':.::;?'~':.?~.:. ~.~' .'r:: ...... ". ~' .:'.'. :" ~.."':'...v.,. 7: .... .:.. _'.',::.~,~ "~ ,;; ' *:- *~INES, :'b[OCATEWELL BY ~E~SO~ NG 'F~** ~¢~-¢,,.~, ';.,~'.-.~_._ t_ : ..... ~: .',.~ *~,,,,..~ ...... ,¢:,>::',w.~-' :~'~' ~':' %,~; ';' ';"~ BORDER 'tH~ ~N~U~,'~¢~ ~--~ ....... x; '_':-.'_... :-.. -- ' (,,) ~IO~-~IN~ ; ' -' I ' ' ~ L I ~_.'r' N '"' ':/' ';, I : ':~'," ' ' ' - ; . - · - -' ' · .,. ,~ ~,'.. ;- , - .. ~,.;~ .' ., . - , . .. ,-: ,.- ..... . . ... - ~..-... . . ,'."',/*,'_-- .'~":f,~':~:"..'~:,~t:." :,"~' ':-~:~'~%~"~ '~"..~..: .' ,' "- ; ; .~':~.'t,.~',.?;:'~,.,.~¥~,~.~','%": .--,-:. ",--71 '< t~)~,,,:',.~,.",>~ , ,,~. ,..' :.,;, - .... -': %: ',.,:'I'.. ·., ,.,.-:.. :' ,<.:.,,.... ::"'-':- .::X~..,:,,,:~,~,,, , .,.::.: ,,'. I '-'-':,:::~?:,.,.:: ,, ' . · t "'7' ..... ~:¢~:~ '~"~'~' . ~,", ' ::.~ ,'~E~ -. ,' -'%'" , L:.-% :'::':: - ......... -~:". ~e e ~ - :'::~ ...... ,,...,~-, - - . ....::~ ';. :::,-, 2 ;%v;.,: .. . ."', ": ...'.':: .. ..:, .-..-_:. ........ . ....-:.:~ ,. ,.. ....- ::::.:': ;' ~ ..:..,:~.,,,,:: :.,~.: ...... . .-.: . :. -SKET~' B~IEDINGS, SEPTIC :: . . .; .. . : :~,::: ' '_i:C. :" "~ ~ ':~'': ~'~'~ ............ : ...... "" :' ....... '7: '-~- '. .... 'L.~"~' ~,~, ~:,: . ":.. _ .- .~...,~,,~ ..:, .. %._., ,:,.. ... '- ~ ' "':' · ' ' q't '-'" ~-' · . '... ': .~...,.'.,.~. .0 ~jce .: ". : . . . .... ,,~.-, ~.:~ >. :-_: .: ~..,..:,:".C~>~:~,:~.: ,-:.., · - ' - . ,. , LOCAT ON O~ W~L~ ON'OWNErS P~OPE~TY. ~'' -''~' :-" ~'~'~ '" :: ::~':-"'>" '~ ~ - :' 'c'>.. ~:7~: ':.' ",:'..~ ~..~". ~OC~T~ W~"~ ~SU~N~ ~0~ ,~O~OS~ W~ S~'T© TWO ~ ~O~T~ UN~S. ~ ~ ~O~S~'"~'"" BO~DE~S THE P~OPE~TY, "TH~ ~EA~u~E~ENT(S) SHOULD ALSO B~ ~ADE F~OM THE CENTE~ O~ T~ ~ ' KERN COUNTY HEALTH DEPT. DIVISION OF ENVIRONMENTAL HE,f~Ij~ . 1700 FLOWER ST., BAKERSFIELD, C~ ' TELEP~: (805)861-3636 .~' . APPLICATION DATE June, 10,-- '~ ?,PROPOSED-STARTING DATE ,. APPLICATION FOR A Pjii~IT TO CONSTRUCT, RECONSrl~I~CT, DEEPEN OR DESTROY A WELL~-PERMiT NO. OWNER'S NAME __D.,a..v,j.,~]i.,0.~]._.,_: ............. i..._.._B..a,,,k.~,~,.,Sf_~ e ].d, CA ADDRESS ~' 3305½. Gu I f Street "TELEPHONE "'__8~.5_.-.._3'_23.._.-...6,0_.6_~ CONTRACTOR~k~,y.ITe_~e s_.t,e.~.~.]'~.'~ .:.i ,'.--"~, LICENSE .NO. 'ADDRESS .-L~..~-~-~-.`?-.~`~.X-:!```3-[J~.6`....L~-B~``a.```k.~e.r..~s~`~j.~`e~]~d*Z.~-.~ TELEPHONE '-J u ne :"1 ..3., '!.'J:~.~,§_.2.Zd:::"fLL.'Z:.:,L!L.L .-:. ':--:~';:~"'~" '~ '-:- :' -' ' ' ' ..... * PROPOSED ............................... COMPLETION DATE , .: "..'.: "' ::'~ [ '": :'":'<'"'~ .... '~"" :"'""::" : "'"':: ':" . :.JOB ADDRESS/LOCATION '- ::' '.'::.-~::q:.~ :::,~:~.,?:. ,q~-¥-.'::-~Z'~L':~:'=;ii~?~-.~'7~-~::t~EC-'-~,:..23 . ..-,~n .xi.,~'~'mi;~':'-.~, ' .,;'::.':.:: .. ::"'L:..L':-:;'NEW WELL'( RE~:ONSTROCTION ~i:'DEEPEN'~'- :DESTRUCT ~ ' TYPE OF WORK'(CHECK~ . ., .. ION~: DOMES.TJG/~UBL C ~.~, : 5:: :AGR I( :;ENETRATES- ~©RCC ' G~:2: PROPOSED DIAMETER FRO/~ :':2' ,.]aboW" ~O screen .bottj~r FROM NEAT CEMEN:~''~ '~ '"':F~"I~UDDLED CLAY CEMENT GROUT CONCRETE · ;: ."i~::c'~:"::~?PROPOSED SF_~L INSPECTION ~ PROP0~ED. PERFORATIONS. OR' SCREEN :.Z?~ANNU~R~?~ ~e~-t-~emen~~' C"' .,. .... ., FROM:"~'~-:~":~;t . OTHER ?''~ ~ ,. , . ,. -. :.:.'?: '7' '- '" :'~'.- FROM ,/z~L~,'::TO- " - FEET-': ·/.- -,:::FROM' +:,:': ,;..0, :~.,.'.~0 -= ~:::' r, 5 '," FEET. -' concrete~ :' '~ ~,:~?~,. '.::: :" BY · ,. - -' EROM: ,.:': ' ;:("J"t,,TO .' :,~ :...;3...,~f:FEET : '~t'FROM~~''.· TO -~ ? '.-.- FEET. : : 4-,'"~":'~",.,'.'"t'~?~:?:-~"::L'BY' : :: 5' :.~bove ibli CASING DIAMETER '.-":L-'.' ,. APPRO~(]' 'DEPTH "'~ · . PENETRATES CORCORAN CLAY ' ' .:.%': '" .( :':.. :' DESCRIBE MATERIALS AND PROCEDURES · ...: .. ~:~ : . -- ,.~ . ': " .? ,: · .':.':'- -.: '.". , ". -- " . ......... .:...- ...... r ........ ,'i~::. ':' ",.:. -:. :. '.';-'-.' ;,'-. , :': .:.",~ ,., ............ ~ :' .... ' ' ; .,:,F::~ .':..!-~', .':'-: ?.'..~ .i?:': :'-/'-',, /-~---"~,-',..'-,.'.;'~ ,.~,. ·-.~ ';.'::z~t.:"' '::..'.':' !: :':.?'"SUBMII'rED BY '"'..:'t :.~. ....... :'~' '~"' :';'~ :' ".:~" !::::,?"::tL;~i?,'L='~/.:'' AS AGENT F6R AC~ APPROVAL . D,,ISPOSITION OF APPLICATION · FLOOD PLAIN ZONINGAPPROVAL .: (FOR OFFICIAL USE ONLY) ' , I ,"- .....,i ,.: !,,' :':. ' ' '~,:'i .. ,:'/ .., .--":::: . HEAi~T ..,' :' ZONE~. ..... ~ .... .. ,L.' ",/ ' "',--' '" :.:,T~:;/'"':t "':~:]''"" .,-.. - ,- :-~'":':";.. APPROVED '~'~'..,,;. ',DISAPPROVE~ APPROVED DISAPPROVED ' ' -': . .: APPROVED SUBJECT TO CONDITIONS ". , APPROVED SUBJECT TO CONDITIONS '~ ' ' - ' REPORT REASON(S) FOR DENIAL OR NECESSARY CONDITI'~S:HERE~ · :., RmORT ~EASON(S) FO~ DEN~AL OR NEC~S~(~-~[TeNSLh~RE: ::"t:." '-':' "- ELECTmC LO~ REnU RED YES :D: NO . , ........ , ..... , :~P~~.j~--;~:~'-: . .,.. ....=... : ...~=..,:~.. ,,..:: ,~.,..~.~.,~ ' "' CASH '~;~-"-~ANK ~ PERMIT EXPIRES ON NINETIETH (90) DAY AFTER DATE OF ISSUANCE IF WORK HAS NOT BEEN STARTED. KCHD//306 EH (9/78) ...... '.' * SKETCH WELL LOCATION '" ' '¥~.'::'~ ~;-:. ..... - .... . . ~ON REVERSE'SIDE ' BAKERSFIELD OFFICE ~-,v- -~\ 1700 Flower Street Bakersfleid, California 93305 Telephone (805) 861-3636 KERN COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH DIVIC~ION May 15, 1985 HEALTH OFFICER Leon M Hebertaon. M.D. DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Relcttard 'Stephen B. Smith Davies Tire Company 3305 Gulf Street Bakersfield, CA 93308 Dear Mr.. Smith: This is to advise you that this department has reviewed the final report on the investigation of subsurface contamination at Olive and Knudsen Drives conducted by Krazan and Associates, The investigation included both visual on-site inspection and laboratory analyses of s~il samples. Based upon the results of this investigation and data on depth to ground water as determined by on-site exploratory borings and documentation from the Kern County Water Agency, we concur that there does not appear to be significant soils contamination beyond the 10' depth in the area of test hole #23. Removal of the soil to approximately 10' at the subject location wou~d serve to effectively minimize future environmental threat. Soil to be removed must be properly manifested and disposed of .in a manner consistent with California State Department of Health Services' regulations. Please provide docu~ mentation to this office of proper disposal, Thank you for your cooperation in this matter. Sincerely, Ann Boyce, R.S. ~ Environmental Health Specialist II Hazardous Materials Management Program AB:re cc: Krazan & Assoc. OISTRICT OFFICES 1700 Flower Street Bakersfield, California 93305 Telephone (805) 861-3636 COUNTY HEALTH DEPARTME,-, ENVIRONMENTAL HEALTH DIVISION May 7, 1985 HEALTH OFFICER L/on M Hel~rtson, M.D. DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Relch.,rd Mr. Pau! Lingenfelder P.O. Box 5188 Bakersfield, CA. 93388 Dear Mr. Lingenfelder: Regarding our phone conversation on May 3, 1985, your request for an e×tension on nine (9) invoice payments has been granted. Invoice.numbers 050062C, 050072C, 090021C, are due May 26, 1985. Invoice numbers 320018C, 330075C, 330087C, 350026C, are due June 26, 1985. Invoice numbers 240009C, 460012C, are due Ju!y 26, 1985. If you have any further questions concerning this matter, please contact me at (805) 861-3636. Sincerely, JW're Jane Warren DISTRICT OFFICES Oelano . Lamortt . Lake Isabella . Mo~aYe . RIdgecres~ Shar~e.r Tart April 10, 1986 ce-~ ~rxO., ,YE_,_ ,AVENUE SZ F.aUL. b1N 55114 -~HCNE 612!645-3601 Kern C~unty Health Department 1700 Flower Bakersfield, California 933g5 Attn: Subj i ~'!s. Anne Boyce Proposed Hydrogeolo~ic Investigation Davies Oil Company Bakersfield, California TC'£ ~4231 86-183 Claim #21-83Z-9 Dear Ms. Boyce: 1.0 Introduction In response to a suspected ~aso!ine loss, Twin City Testin~ Corporation (TCT~ is transmitting to you a description of the pr~posed investigative work to he completed at Davies Oil Company, 3305 1/2 Gulf Street, Bakersfield, California. 2.0 Objective The objective of the hydro.~eologic investization is to define the horizontal and vertical extent of gasoline contamination that may have resulted from the uncontrolled 'release of gasoline. The proposed ink, estimation will address the potential environmental impact that the loss may impose on the surrounding biotic and abiotic community. The investigation will qualify and quantify gasoline contaminated soils and provide information re~arding the areal extent of free gasoline and dissolved ~asoline com,.oonents. 3.0 Background Information Based on inventory reconciliation, Davies Oil Company detected a losin~ trend in the regular system during the winter, months of 1985. In response , ....... test.~d · to this trend Davies Oil Company p~re. ssure ,~- the tanks and ~i_~ 'The results of these tests indicated leakage of the regular grade dispensing line. Subsequently, this line was repaired. Shortly thereafter, inventory' reconciliation a~ain indicated product losses. On Uarch 3, 1986, the tanks and lines were again tested, and a leak was detected ~n the vapor lines. Repair was completed on this line and the llern County Health Department (KCHD) was notified of the loss. Davies Oil Company estimates that 2500 gallons of regular ~asoline may have been lost at this site. Kern County }lealth Department April lO, 1986 Page Two 4.0 Proposed Investi%ation 4.l General The proposed investigation will address both the saturated and unsaturated zones. Considering the estimated depth to ground water, around 45', TCT suspects that if the 2500 gallon estimated loss is a valid figure, some gasoline may have imoac~-_~~ water. In view of this, KCHD' Form #3067~'~'~ will be completed and forwarded for :your review. As pertinent topographic maps are received by our office, this form will be processed. The purpose of completing the monitorin~ well installation request form at this time is to ensure the smooth progression of the investigative phase of this project. 4.2 Soil~ Investigation TCT proposes to drill a minimum of three soil borings to a depth whereby zero readings are recorded on an organic vapor analyzer (calibrated to benzene). If ~round water is encountered and gasoline contamination is detected, TCT recommends a field option be exercised to complete the boring as a monitorinM well or tremie-grout the boring to the surface. Each borin~ will be drilled usin% hollow stem auger methods. Split barrel samples will be collected at 2 1/2' intervals to a depth of approximately 15' and thereafter at 5' intervals. All soil samples will be collected and preserved such that chemical analysis can be performed. All borings not completed as monitoring wells will be tremie grouted to the surface with a neat cement mixture. Ail soil samples submitted for chemical analysis will be analyzed for benzene, toluene, xylene, total hydrocarbons expressed as gasoline and ethylene dibromide concentrations. Ail drilling and samplin~ equipment will be steam cleaned prior to entering the site, and before initiating new borings. Spilt spoon sampling equipment will be decontaminated with trisodium phosphate followed by a clean water rinse between samplin~ intervals. 4.3 Ground Water Investigation If soils near the water table contain gasoline contamination, TCT proposes to install a minimum o~ one up-gradient monitoring well, and two down- gradient monitoring wells. Additional monitoring wells may be necessary to adequately triangulate ground water flow, and outline the migrating contaminant plume. A proposed mo~itoring well construction schematic is attached which will also be included on KCHD Form #306. Generally, TCT proposes to construct ail monitorin~ wells with 2" I.D. flush threaded PVC casing and screen. Each well will be fitted with a 15' screen Kern C~unty U~alth Department April lO, 1986 Page Three and installed such that 10' of the screen penetrates the water table, and 5' remains in the unsaturated zone. This screening interval may be adjusted if additional' information becomes available regarding unusual fluctuating ground water conditions, or if an unseasonably high or low water table is encountered. Filter gravel will be placed around the screen up to 2' above the screen. A 1' thick seal of bentonite will be placed on top of the filter gravel and the remainder of the annulus around the PVC casin~ will be tremie grouted up to apprpximately 2' below grade. A locking steel casing will then be cemented in place over the 2" PVC. The cement will be finished at grade such that surface water will .flow away from the casing. The relative elevations of the monitoring wells will be surveyed so as to allow determination of ground water flow direction. Water levels will be measured to the nearest Ail monitoring wells not containing free gasoline will be sampled with dedicated Teflon bailers after four bore volumes have been removed, and stabilization is documented. The water samples will be analyzed to determine benzene, toluene, xylene, total hydrocarbons expressed as gasoline, ethylene dibromide (EDB), and total organic lead. If you have any questions regarding this proposal, please feel free to contact me at (6]2) 641-9372. Very truly yours, Twin City Testing Corporation Mark S. Mason Environmensal Geologist/Project ?.~anager MSM/rj r Encs cc: 1-Federated Insurance Company Attn: Mr. Courtney Clagg 1-Davies Oil Company Attn: Mr. Rick Davies OSED MONITORING DAVIES OIL COMPANY WELL GROUND SURFACE ELEVATION TOPOF RISER PIPE ELEVATION (with cap removed) NTED CAP i~'rlv! C.~ lNG ~fl~h A~ Gmu~ KNESS AND TYPE OF SEAL DIAMETER AND TYPE OF RISER PIPE 4" ~t~el 4' 2' ,2'-1' Bentonite · ~, - 0 Cnn£rete 2" F.T. PVC L2 TYPE OF BACKFILL AROUND RISER Neat cement L3 :KN£SS AND TYPE OF SEAL DEPTH TO TOP OF FILTER SAND TYPE OF FILTER AROUND SCREEN FYPE OF MONITORING WELL SCREEN GAUGE OR SIZE OF OPENINGS (SLOT NO.) :TER AND LENGTH OF SCREEN 2' Bentonite 2' above screen Filter sand PVC ~10 ~lnt 2" x 15' DEPTH TO BOTTOM OF MONITORING WELL )EPTH TO BOTTOM OF FILTER SAND SS AND TYPE OF SEAL NA L DIAMETER OF BOREHOLE I:uJirl C:lt:¥ April 10, 1986 Kern County :~=al~h Department 1700 Flower Bakersfield, California 933D5 Attn: ~'!s. Anne Boyce Sub j: Proposed Hydro~eoloEic Investigation Davies Oil Company Bakersfield, California TCT ~423! 86-183 Claim #21-83Z-9 Dear Ms. Boyce: 662 C~QMWELL AVENUE S'E PAUL. MN 55114 PHONE 512/6,45-3601 i:.-' / .,~ ,. '( .~ I ::-, ,.j ' :> · 1.0 Introduction in response to a suspected gasoline loss, Twin City TestinE Corporation (T~,¢ is transmitting to you a description of .the pr~posed investiEative work to be completed a[ Davies Oil Company, 3305 1/2 Gulf Street, Bakers£ield, California. 2.0 Objective The ob~ectLve of the hydro~eologic investic, ation is to define the horizontal and vertical extent of gasoline contar.~ination that ma)' have resulted from the uncontrolled' release of gasoline. The proposed inw~'stiT, ation will address the potential environmental impact that the loss may impose on the surroundinf~ biotic and abiotic community. The investigation will qualify and quantify gasoline contaminated soils and pravide informatir, m re~arding the areal extent of free gasoline and dissolved Easoline components. 3.0 Background Information Based on inventory reconciliation, Davies Oil Company detected a losin~ trend in the reEular system during the winter months of 1985. In response to this trend, Davies Oil Company pressure tested the tanks and lines. "The results of these tests indicated leakage of the regular grade dispensing Iine. Subsequently, this line was repaired. Shortly thereafter, inventory reconciliation aEain indicated product losses. On Uarch 3, 1986, the tanks and lines were again tested, and a leak was detected in the vapor lines. Repair was completed on this line and the Kern County Health Department (KCHD) was notified of the loss. Davies Oil Company estimates that 2500 gallons of regular gasoline may have been lost at this site. Kern County ~le~lth'Department April ]0, 1996 Page Two 4.0 Proposed investi~ation 4.l General The proposed investigation will address both the saturated and unsaturated zones. Considering the estimated depth to ground water, around 45~, TCT suspects that if the 2500 gallon estimated loss is a valid figure, some gasoline may have impacted ground water. In view of this, KCHD Form #306 will be completed and forwarded for ~your review. As pertinent topographic maps are received by our office, this form will be processed. The purpose· of completing the monitoring well installation request form at this time is to ensure the smooth progression of the investigative phase of this project. 4.2 Soils Investigation TCT proposes to drill a minimum of three soil borings to a depth whereby zero readings are recorded on an organic vapor analyzer (calibrated to benzene). If ground water is encountered and gasoline contamination is detected, TCT recommends a field option be exercised to complete the boring as a mon£torin~ well or tremie grout the borin~ to the surface. E'ac~ borin~ will be drilled usin~ hollow stem auger methods. Split barrel samples will be collected at 2 1/2~ intervals to a depth of approximately 15~ and thereafter at 5~ intervals. All soil samples will be collected and preserved such that chemical analysis can be performed. All borings not completed as monitoring wells will.be tremie grouted to the surface with a neat cement mixture. Ail soil samples submitted for chemical analysis will be analyzed for benzene, toluene, xylene, total hydrocarbons expressed as gasoline and ethylene dibromide concentrations. Ail dri!linK and samplin~ equipment will be steam cleaned prior to enterin~ the site, and before initiating new borings. Spilt spoon sampling equipment will be decontaminated with trisodium phosphate followed by a clean water rinse between~samplinK intervals. 4.3 Ground Water Investigation If soils near the water table contain gasoline contamination, TCT proposes to install a minimum of one up-gradient monitoring well, and two down- gradient monitorin~ wells. Additional monitoring wells may be necessary to adequately triangulate ground water flow, and outline the migrating contaminant plume. A proposed mo~itor~n~ well construction schematic is attached which will also be included on KCHD Form #306. Cenerally, TCT proppses to construct all monitorin~ wells with 2" I.O. flush threaded PVC casing and screen. Each well will be fitted with a 15' screen Kern C~unty U~nlth Department April 10, 1986 Page Three and installed such that 10' of the screen penetrates the water table, and 5' remains in the unsaturated, zone. This screening interval may. be adjusted if additional information becomes available regarding unusual fluctuating ground water conditions, or if an unseasonably high or low water table is encountered. Filter gravel will be piaced around the screen up to 2' above the screen. A 1' thick seal of bentonite will be placed on top of the filter gravel and the remainder of the annulus_around the PVC casing will be tremie grouted up to approximately 2' below grade. A locking steel casing will then be cemented in place over the 2" PVC. The cement will be finished -at grade such that surface water will flow away from the casing. The relative elevations of the monitoring wells will be surveyed so as to allow determination of ground water flow direction. Water levels will be measured to the nearest 0.01'. Ail monitoring wells not containing free gasoline will be sampled with dedicated Teflon bailers aft.er four bore volumes have been removed, and stabilization is documented. The water samples will be analyzed to determine benzene, toluene, xylene, total hydrocarbons expressed as gasoline, ethylene dibromide (EDB), and total organic lead. If you have any questions regarding this proposal, please feel free to contact me at (612) 641-9372. Very truly yours, Twin City Testing Corporation Mark S. Mason Environmental Geologist/Project Uanager HSi.i/rj r Encs cc: 1-Federated Insurance Company Attn: Mr. Courtney Clagg 1-Davies Oil Company .Attn: Hr. Rick Davies GROUND SURFACE ELEVATION L] MONITORING DAVIES 0EL COHPANY WELL TOP OF RISER PIPE ELEVATION (with cap removed) NTED CAP PROTECTIVE' CASING Diameter In~ Tyl~e To~I Le~l'th ICKNESS AND TYPE OF SEAL DIAMETER AND TYPE OF RISER PIPE 2" F.T. PVC Bentonite" Cnncrete L2 I TYPE OF BACKFILL AROUND RISER Neat cement L3 THICKNESS AND TYPE OF SEAL DEPTH TO TOP OF FILTER SAND TYPE OF FILTER AROUND SCREEN E OF MONITORING WELL [£N GAUGE OR SIZE OF OPENINGS (SLOT NO.) LENGTH OF SCREEN DEPTH TO BOTTOM OF MONITORING WELL TO BOTTOM OF FILTER SAND ESS AND TYPE OF SEAL 2' Bentoni~ 2' above screen Filter sand PVC #10 slnt 2" x 1~' NA DIAMETER OF BOREHOLE t:uJin city t:2St:lnCl KERN COUNTY ENVIRONMENTAL HEALTH SRVCS. ATTN: RECORDS CUSTODIAN 2700 'M' STREET SUITE 300 BAKERSFIELD, CA 93301 CERTIFICATE OF RECORDS I, the undersigned, am the'duly authorized custodian of records for KERN COUNTY ENVIRONMENTAL HEALTH SRVCS., and I hereby certify to the following: The records pertain to ** W.P. DAVIES OIL COMPANY, and (b) That, including this certification, all records called for in attached Subpoena or Authorization are in my custody and have been released for documentation on.microfilm to the deposition notary, MAJOR COPY SERVICE. (c) That to the best of my knowledge, all records were prepared in the ordinary course of business by authorized persons or personnel at or near the time of the act. condition or event. I declare under penalty of perjury that t~e foregoing is true and correct. · Executed on Decembe,T 04 , ,, 1990 , at Susan Gonzales Type or Print Custodian's Name Signed Custodian OR NO RECORDS CERTIFICATE (d) I hereby declare under penalty of perjury, that after a thorough search of my files, I do not have any necords as described in the attached Subpoena or Authorization. Executed on 19 . at Signed Type or Print Custodian's Name Custodian AFFIDAVIT OF PROFESSIONAL PHOTOCOPIER I declare that I am an employee of MAJOR COPY SERVICE and that the records called for in the Subpoena or Authorization are true copies of records produced to me Dy the Custodian of Records for KERN COUNTY ENVIRONMENTAL HEALTH SRVCS. and that these.records will be distributed to the authorized persons/entities. Executed on 19 , at Type or Print Photocopier's Name Signed Photocopier X-J6300-1 1. Records believed to be in your possession or under your control are being subpc outlined in the attached documents. 2. The first document (following these instructionS) is the deposition subpoena. Th' indicates the case name, date, time, and place for the production of records, as' what trte records pertain to and exactly what records are needed with identifyincj Refer to this document when complying. ~Personal aOoearance is not reauired, if you comply with these guidelines.) 3. Send us the records as requested. Copies are acceptable 9r~ly if.they are clearl, original records are not being requested. 4. Send ail financial statements if requested. 5. Do not send X-rays or other related exhibits unless specifiCally requested. The attached certificate must be signed and returned with the records. If you requested records you must sign the certificate in section "D" and promptly retur nearest you. 7. The subpoena rec~uire~ that the requested records be produced by the date and the subpoena. For your convenience, please send records to our office nearest you: MAJOR COPY SERVICE 180'Howard Street San Francisco, CA 94105 (415) 495-6633 MAJOR COPY SERVICE 1333 Howe Avenue #211 Sacramento, CA 95825 (916) 648-9980 MAJOR COPY SE 3435 Camino del; San Dieao, CA 92 (800) 660-7033 MAJOR COPY SERVICE 4222 W. Alamos Street #206 Fresnq, CA 93722 (800) 454-7034 MAJOR COPY SERVICE 416 East Broadway, Suite 100 · Glendale, CA 91205 (800) 660-7033 8. If necessary, you may arrange for one of our professional photocopiers to copy your facility by simply calling the office nearest you. Please, if you have any questions, or if you cannot comply by the date and time subpoena, call us immediately to avoid any possible consequence for non-coml: very important court directive. PLEASE REMEMBER TO ENCLOSE THE SIGNED CERTIFICATE WITH THE RECORDS, THANK YOU FOR YOUR COOPERATION AND PROMPT ATTENTION MAJOR COP': · ~ X-J6300-1 I ROBERTA J. DUFk-~ t131165 r-SA~DELL & YOUNG . . [9:]9 "L" St:reel:, Suil:e A 205904 re o C 9 9-1 [.mr~o~r, StllperZor colitis, County si Kern I ~----1415 TrUXthn Avenue s.~~ ~akersf~eld~CA 9~301 ' _~IICTIFF/pETJ~ONFJ%~]P. DAVI='S OIL COMPANY, an~ FEDERATED MUTUAL INSURANCE COMPANY O~0~Nr/~ESPO~0~¥:S. T. $~RVI.CE COMPANY,-et al. · mE R[op~ 0F'ma s'rA~ OF Ca. lr-OnN~ 1'0 0...e~:K~RN COUNTY ENVIRONMENTA~ H~AL~H DE~T 3700 M ~(r~e~.~ Suite 300~ ~akeiraf:l. ald~ CA 93301 1:3£POSlTION SUBPENA 25O 1. YOU N~E ORDF~ED TO PRO~)U¢~ THE 8USINE~ RECORDS des~b~ ~ ~ 3 as ~o~: _A~res~4222 W. _Ala~°3 S~ree~ ~206, Fresno,__ CA 93722 By deliverillg · true. ligit~fe, and durable copy of t~e ~ai~eGa records de~ribeO lA item 3. e~lo=ed in a a~dre~ Iff Item 1. · a ~tnass~ ~l~.'On/ecs, pt of p~nt In cash ~ by chec~ or the reasonable costs et preparmg the copy. as data~nl~ u~ EviCe~e ~ode section a~y's representative aaa permittin9 CO~n9 at yOUr ~sinasa a~ess un,er raaso~te cofloJhon84urir,g ~mal business ~ -~' T~e rec~ to oe~o~q~ ~ ~scd~ a~ ~gows: Ross=ds pe~taintn~ ~o: W.P. Davies Co~pany, znc., 33~5 Gul~ S~eet, ~akersfiel~, Califo~ia= All writings an~ records, Lncluding all memorand~s, correspo~dence~ ~otes~ ~aper~, books~ and ~epo~=s relating ~O inves%/ga~ion,. ~¢sttng, leakage, tnvento~, inventory ' r~conCil~a=~ons, and/or r~view per~o~ed by you in connection with any invento~ uontrol monitoring ?rocedure~ and/or any leakage of pr~ucts a~ the W.P. Davies 0~1 Company, Inc. prope~y located Gulf-S=r~et, Bakersfield, California~ All ~les, a~/o~ re~la=lons an~ ordinances one has b~e~ re~ired to follow for inv~nto~y control monitoring and/or petroleum pr~uct leak which is di~covere~ In an undergro~d gasoline %ank, product line. or vapor ~Confinu~on~ttac~,t~ IF YOU ~ ~ Q~STIONS, P~E ~L: _ ~OR ~PY SERVI~ (800) 454-7034 ~ OF F~ H~NDRED DOL~S ~0 ~ D~GES R~SULTING F8OM YOUR FAILURE TO 08~, _ Fer ~n ut~ DateeNove~ber 16, 1990 RDB~RTA J. DUFYY . . (see reverse for proof or ser~ica) DEPO~I~ON SUBPE~ -- BUSINESS RECORDS ~.,~c~,.~ ,~o~,]. oJ. 9Nf'lOA ~ -l'~BrlN~ HL%X-~ 91 :Zt OF SERVICE BY MAIL- 1013a, STATE OF CALIFORNIA ) COUNTY OF SAN FP~ANCISCO ) I am a resident of the county of San Francisco, I am over the age of eighteen years and not a party to the within action; my business address is: 180 Howard Street, San Francisco, CA 94105 On the date set forth' below, I served the within copy of'NOTICE OF TAKING DEPOSITION, including Notice to Consumer pursuant to CCP 1985.3 (if applicable), on the following parties in said action, by having placed a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid and causing to be mailed in the United States Post Office .at San Francisco, California as follows: LAW OFFICES OF ROBERT E. KING KATHERINE O. GIBSON, ESQ. 5329 OFFICE CENTER COURT SUITE 200 BAKERSFIELD, CA 93389 HURLBUTT, CLEVENGER, et al. JEFFREY S. NELSON, ESQ~ 615 S. ATWOOD STREET P.O. BOX 1471 (93279) VISALIA, CA 93277 ROBINSON, PALMER AND STANTON WILLIAM D. PALMER, ESQ. 3434 TRUXTUN AVENUE SUITE 150 BAKERSFIELD, CA 93301' I declare under penalty of perjury that the foregoing is true and correct~ Executed on 11/16/90 at San Francisco, California. Luis G. Medrano Major Copy Service X-J6300 -1- NOTICE TO 1. PURSUANT TO CCP 1985.3 (IF APP~ABLE) This Notice serves to advise you that 'those entities or witnesses shown On the Notice of Taking Deposition and Deposition SuDpoena are to provide your personal records. If you object to the entities or witnesses furnishing the described records as indicated on the attached papers, you must file with the appropriate court prior to the date specified on the subpoena. If the party who is seeking the records will not agree in writing to cancel or limit the Subpoena you.should_c.onsult_.your~attorney about your interest in protecting your right to privacy. PROOF OF SERVICE RE: NOTICE TO CONSUMER IN ACCORDANCE WITH CCP 1985.3 On the date set forth below, I complied with Section 1985.3(b)(1)(3) and (c) of the Code of Civil Procedure by giving prior Notice to the Consumer named herein whose records are being sought, by causing to be delivered to said Consumer or by mailing to said Attorney of Records as indicated, a copy of the Notice of Taking Deposition, Deposition Subpoena and the above Notice to the Consumer that his/her records are being sought. I DECLARE UNDER THE PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT. CONSUMER'S NAME: ** W.P. DAVIES OIL COMPANY · CONSUMER'S AI-FORNEY OF RECORD: LAW OFFICES OF ROBERT E. KING 5329 OFFICE CENTER COURT SUITE 200 BAKERSFIELD, CA 93389 DATE DOCUMENTS WERE SENT TO ATTORNEY OF RECORD: SIGNED: 11/16/90 LUIS G. MEDRANO MAJOR COPY SERVICE A DIVISION OF MAJOR.LEGAL SERVICES X-J6300 2~O J. DUFFY 3.1-65 DELL & YOUNG ,~9 'L" Street, Suite A re o C 9. ~-~n~ 1415 T~xth~ Avenue ~~ ~akersfield ~ 93301 ~AI~/P~TJ~fON~W.p, I=~ OIL COMP~Y~ an~ FEDE~TED ~UAL INSU~CE COMP~ D~N0~F~S~T:S. T. S~RVI.CE COM~Y, et al. 1 205904 DEPOSITION SUBP£NA RDBERTA J. DUF~Y . . Attorne.~_ far ~.T._..~RVTCR (see rovers~ for proof of service) DEPOSI~ON sUBPE~-- BUSINESS RECORDS 9t:E~ C~6T-~T-F~N Pated:Novezltber 16, 1990 134E ~OPI.~ OF TNB STAT~ OF CALIFoRNIA, TO(r,a~):KF, RN COUNTY ENvIRoNMENTA~ HEALTH DEPT. ' 3700 M Street, Suite 300, ~akezsfleld, ~ 93301 t YOU ~E O~ED TO ~ODUC~ ~E R~INE~ ~CORDS des~b~ ~ ~ 3 no ~o~: ' Oate:DeCe~er 6, 1990 ~i~= 10:00 ~ares=4322 W, Alamcs S2ree= 1206, Fresno~ CA 937~2 & '~ by delivering a t~. ~ib~e. an~ du~abla ~py cf t~e ~sine~a records de~dba~ in l~am 3. e~lesed in a seale= inn~ wtap~r with the ~fll and number et tho actlo~ na~ of ~{tne~. aaa mate ot ~bpena clearly ~ritten on iL The vaPp~ I~all then be e~los¢a sn ~ outer envem~ or ~a~r. seale~ ~d aaJlga to the dQ~osition o,;¢er u aa~re~ In Item 1, ~. ~ by ae~vering 8 ~e. legib~, ~nd au~a~e ~p~ ef the ~uane~ rec~a~de~rJ~ea in i~e~3 te t~e ~8pe~tion offi¢~ ~e wJtnes~ ~e~..on rec~pt ef paymen~ In caen ~ ~ checX or ~e reasona~ll ¢~sta et ~epari~g the ¢O~y. ~etermnea u~ Evidence ¢~e section a. ~ ~y m~ t~a QM~ ~,ness r~or~ aeseri~e~ in Item~ available for inspection at your ~uoines8 ad~re~e ~y the & ~e recta to ~eoro~ced ~ ~escdb~ a~ ~gows: ~6Oords per~a~ning ~o: W.P. Davies"Comp~n~' Inc.; 3305 G~I~ SCree~, ' ~=kersfie1~, Califo~ia: All writings an~ records, including all memorand~s, correspondences. ~otes, ~aper$, books, and ~epor~s relating ~e inves%iga~iun,.=esting, leakage, inven~e~, inven~ory =econoilia=ions, and/or revfe~ perfo~ed by you In connection with any invento~ ~ontrol monitoring procedures ~nd/or any leakage of ~eCroleum 9r~ucts a~ the W.P. Davies Oil Co~gany, Inc. pro~e~y lecate~ a~ 3305 an~ ordlnance~ one has b~en re~lre~ to follow for inventory control monitoring and/or ~etroleum pr~uct le~k which Is d!~cove~e~ la an underground gasoline tank, product line or vapor ~ConMnue~onattachment~ IF YOU ~ ~ Q~STIONS, P~E ~L: ~OR C~PY SERVI~ (800~ 454-7034 ' O~SO~NC'~ o~ ~lS ~UBPE~ MAY BE PUNISHED ~ CO~ BY ~lS COUP. YOU wp~ AL~O BE' ~IABLB FOR THE ] S~ OF F~ H~NORED DOL~$ ~0 ~L D~GE~ R~SULT~G FaOM ~OUR FAILURE TO OBEY. _ I CERTIFICATE OF RECORDS ~ I, the undersigned, am the duly authorized custodian of records for KERN COUNTY ENVIRONMENTAL HEALTH SRVCS., and I hereby certify to the following: la) The records pertain to ** W.P. DAVIES OIL COMPANY, and (b) That, including this certification, all records called for in attached Subpoena or Authorization are in my custody and have been released for documentation on microfilm to the deposition notary, MAJOR COPY SERVICE. (c) That to the best of my knowledge, all records were prepared in the ordinary course of business by authorized persons or personnel at or near the time of the act, condition or event. I declare under penalty of perjury that the foregoing is true and correct. Executed on December 04 z 1990, at ~~ /~ Susan Gonzales igne · Type or Print Custodian's Name Custodtan~/ ~/ OR NO RECORDS CERTIFICATE (d) I hereby declare under penalty of perjury, that after a thorough search of my files'j I do not have any records as described in the attached Subpoena or Authorization. Executed on 19 , at Type or Print Custodian's Name .Signed Custodian AFFIDAVIT OF PROFESSIONAL PHOTOCOPIER I declare that I am an employee of MAJOR COPY SERVICE and that the records called for in the Subpoena or Authorization are true copies of records produced to me'by the Custodian of Records for KERN COUNTY ENVIRONMENTAL HEALTH SRVCS. and that these records will be distributed to the authorized persons/entities. Executed on 19 , at Type or Print Photocopier's Name Signed Photocopier X-J6300-1