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Home My WebLink AboutUNDERGROUND TANK Fire Prevention Services CONDITIONS OF PERMIT ON REVERSE SIDE This, aermit is issued for the followina: , [] Underground Storage of Hazardous Materials ' ~ ' ~ ~ ~:~ ~*~' "~*'~"*'?~'~ ~ Risk Management Program :, ~ ~,.. ~.. ...... ~ ~ Hazardous Waste On-Site Treatment PER~ ~g 015-021-~2~ n n~ ~ %~ ,-~: ........ ~a-'4 ........... ~>~ ~%.:..--.k air Paint Spray Booth BROTHER'S M~I-ivl~ x~,.,".~' ~ Industrial Hood Suppression System ,. -,? ~f~. . ...... r~.- -., ~.~m~.u CA 9330? ~ ~ f, ~ t ~' - ' D: Issued by: ~AKBRS?IB, LD FIfE D~PAIIFIIEIlT Bakersfield Fire Department OFFICE OF PREVENTION SERVICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 852-2171 Expiration Date: June 30, 2006 JOB CARD POST CARD AT JOB SITE Bakersfield Fire Dept. Prevention Services 900 Truxtun Ave #201 Bakersfield, CA 93301 Tel: (661)326-3979 CITY BAKERSFIELD PHONE No. ADDRESS PERMIT No. (}I::" C3 z INSTRUCTIONS: PLEASE CALL FOR AN INSPECTOR ONLY WHEN EACH GROUP OF INSPECTIONS WITH THE SAME NUMBER ARE READY. THEY WILL RUN IN CONSECUTIVE ORDER BEGINNING WITH NUMBER ONE. DO NOT COVER WORK FOR ANY NUMBERED GROUP UNTIL ALL ITEMS IN THAT GROUP ARE SIGNED OFF BY THE PERMITTING AUTHORITY. FOLLOWING THESE INSTRUCTIONS WILL REDUCE THE NUMBER OF REQUIRED INSPECTION VISITS AND THEREFORE PREVENT ASSESSMENT OF ADDITIONAL FEES. INSPECTION I DATE I INSPECTOR TANKS AND BACKFILL BACKFILL OF TANK(S) SPARK TEST CERTIFICATION OR MANUFACTURES METHOD CATHODIC PROTECTION OF TANK(S) PIPING SYSTEM TYPE OF PIPING (~] FLEX ~] FIBERGLASS CATHODIC PROTECTION SYSTEM-PIPING DISPENSER PAN SECONDARY CONTAINMENT, OVERFILL PROTECTION, LEAK DETECTION CONTINUOUS VAPOR MONITORING ENHANCHED LEAK DETECTOR TEST LEVEL GAUGES OR SENSORS, FLOAT VENT VALVES FILL TIGHT FILL BOX(ES) PRODUCT LINE LEAK DETECTOR(S) LEAK DETECTOR(S) FOR ANNUAL SPACE-D.W. TANK(S) MONITORING WELL(S)/SUMP(S) - H20 TEST MONITORING WELLs, CAPS & LOcKs .... FILL BOX LOCK MONITORING REQUIREMENTS TYPE CONTACT ___~__Cf__~__~ ....d *~_~_ ~_ ............ : ........................................ PHONE NO. _~_~___-~_'_~/~_~'__~_ fd1743 15:~4 ~681 316 (.'$76 BFD HAZ )L4T DIV [~002 CITY OF BAKERSFIELD OFFICE OF ENVIROhrI~NTAJ.~ SERVICES t~,4r,~-C-~er Ave; Bakersfield, CA (661) 326-3979 PERMIT APPLICATION TO CONSTRUCT/MODIi~ UN'D~c/-ROUNI) STORAGi/; TANK IWPE OF APPLICATION (CHECK) [ ]NEW FACILITY '.~MODIFICATION OF F.~CILITY [ ]NEW'TANK iNSTALLATION Al' EXI~I'ING FACILITY ST~~ 7--~'---~OY~ ~OS~COMP~O. 0^~. 7-- ~ ._ FACIUTY'ADDRE~5 [c~OI ~, ~,~Z,.,~.~~ CITY ~_-~-~,~---~--;~.~/d ZlPCODE '~.~$,~' / TANK0~¢[~ ~:~AJ'Cit. C~,",4,~ ' PHONF. NO. 'X'~ ~ /~,/'~ CON~,,CtO~_ E,~%~ ~,~~~,,~ ..... c,,,uc'~se~_?_ a,5,~/~.~./ ~,lto~6. 5~F~ d/6~. .... a,,,g~m~-u~~su .c~j~,o. ~--~ .... S~ ~ION ~L ~ ~ ~~ P~N ~ ~ YES NO TANK NO, VOLUME UNLEADED RF.~ULAR PREMIUM DIESEL AVIATION '[ A~ NO. VOLUME FOP, OH~IC~ U$~ ONLY DATE FXC~ NO. ~. OF T~ F~ $ [ l THE APPLI~ficr HAS RECEIVED, UNDER,~ANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STA'IF=, LOCAL AND FEDERAL REOULATIONS. THIS FOJ~ HAS BEEN COMPLETED UNDER PENALTY OF PE, RJURY, AND TO THE BE~r' OF MY K~0WLEDGE, IS 1~'~ A~.'e~,LiCATIO~N IlltlCOME8 A PI~R.M~ ~ APPROVRD Enviro Construction 2700 Stagecoach Street Bakersfield, Ca. 93314 (661) 588-0108 Bakersfield City Fire Dept. Office of Enviromental Services 1715 Chester Ave. Bakersfield, Ca. 93301 Attn. Steve Underwood June 8, 2004 Project: Brothers Mkt. / Varsity Gas 801 East California Ave. Bakersfield, Ca. 93307 Mr. Underwood We have been contracted to install double-wall product pipe at this site. We are acquiring permits for this project on June 8, 2004. The planed start date for the project is July 6, 2004. If there are any problems with this plan or you would like to discuss this matter please give me a call (661) 472-1858. Thanks, Terry Cannady Enviro Construction ENVIRO CONSTRUCTION 2700 STAGECOACH ST BAKERSFIELD, CA 93314 (661 ) ,588-0108 2O85 DATE D February 13, 2004 FIRE CHIEF RON FRgZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES. ENVIRONMENTAl. SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Mr. Rawel Singh Brother's Market 801 E. Califomia Avenue Bakersfield, CA 93307 Re.' Failure to Perform Line Tightness Testing on Under-Dispenser Upgrade Dear Mr. Singh: Our records show you have not yet completed the required post construction line testing. They must be completed no later than March 1, 2004. Failure to comply will result in further enforcement action up to and including revocation of your permit to operate. Should you have any questions, please feel free to call me at 661-326-3190. Sincerely, Ralph E. Huey, Director By: Fcc'~ ~~__--/~ Steve Underwood, Fire Inspector/Petroleum REH/SU/db CITY OF BAK~SFIELD OFFICE OF ENVIRONMEN~rAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 INSPECTION RECORD POST CARD A'r JOB SITE City, Zip fl~. ~_~ ~..q~f.q~2~7 INSTRUCTIONS: Please call tbr an inspector only when each group of inspections with the same number are ready. They will run in consecutive order beginning with number I. DO NOT cover work i'br any numbered group until all items in that group are signed offby the Permitting Authority. Following these instructions will reduce the number of required inspection visits and therelbre prevent assessment of additional fees. TANKS AND BACKFILL INSPECTION ] DATE [ INSPECTOR ~[.!~ Backfill of Tank(s) ],{[~l. Spark Test Certification or Manufactm~-.s Method ~lf~f Cathodic Protection of Tank(s) PIPING SYSTEM Electrical Isolation of Piping From Tank(s) Calhodic Protection System-Piping SECONDARY CONTAINMENt, OVERFILL PROTECTION, LEAK DETECTION Liner Installation - Tank(s) Liner Installation - Piping Vault With Product Compatible Sealer Level Gauges or Sensors, Float Vent Valves Product Compatible Fill Box(es) Product Line Leak Detector(s) Leak Detector(s) for Annual Space-D.W. Tank(s) Monitoring Well(s)/Sump(s) - H20 Test _ Leak Detection Device(s) for Vadose/Groundwater _ Spill Prevention Boxes _ FINAL Monitoring Wells, Caps & Locks __ Fill Box Lock /' __ Monitoring Requirements Type TCf)/~/ I - 3 ~ Vy l~ -- I Authorization tbr Fuel Drop Vf ~7 '~' ~ {~- ~( / ~ - CONTRACTOR ~_..~O I i'O _~ O/A d4/', }'¢ 1tO ~v " LICENSE. CONTACT ~t~'~ &t/I/i~,.~.y PHONE# qi~' elo~ _ 2700 Stagecoach Street Bakersfield, Ca. 93314 ENVIRO CONSTRUCTION Phone (661) 588-0108 Fax (661) 588-0108 Dec. 24, 2003 Bakersfield Fire Dept. Environmental Service 1715 Chester Ave. Bakersfield, Ca. 93301 Tel: (661) 326-3979 Mr. Steve Underwood We have been contracted to install dispenser containment sumps atBrothers Market 801 East California Ave., Bakersfield, Ca. The plan is to have the project completed by 2/10/04. The modification permit for this project is #BI-0327. We would like to request an extension to operate at this location. If you have any questions or there are any problems please give me a call at (661) 472-1858. Thanks, Terry Cannady Enviro Construction COi:; ECTION NO ICE BAKERSFIELD FIRE DEPARTMENT O5O9? Name ~¥~)-~¢ r.q /~l~- You are hereby required to make the follov~ng corrections at the above location: _cot. No:J Completion Date for Corrections /. ~! '7/~)~ Date /~-/("1/0~_' _.~'~i~t~-z'¢-~_ ~ In~pe~or FO ~ 326-3951 ,i!',~i<i:T. RSF l E:!_i'-:'. C[-h. 933C~7 {~. 4/24.."' ! 999 i~: I}}0 ," ~)i_113"~ }i?,P,.~FF'FOff-:¥ SU?i PROD i 3'?~6, q:.~ ::'ROll) 2 288~.,,~. Gf~l... F'RCK',:, 3: 2586.2 CITY OF BAi~RSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME Section 2: Underground Storage Tanks Program Routine l~ Combined [21 Joint Agency Type of Tank OLOFC.'3 Type of Monitoring (5/- tx,x, [] Multi-Agency [] Complaint Number of Tanks '3 Type of Piping OOJlc [] Re-inspection OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file L, /'/' Permit tees current C., Certification of Financial Responsibility Monitoring record adequate and current ~ /,, Maintenance records adequate and current Failure to correct prior UST violations r/ Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S). AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance /,iV=Violation Y=Yes N=NO Inspector: c.~J-~ C'~ft~ Office of Environmental Services (805) 326-3979 White- Env. Svcs. Pink - Business Copy Business Site Responsible Party UNIFIED PROGRAM I~SPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME ' INSPE~CTIOI~DATE INSPECTION TIME ADDRESS PHO o. No. of Employees FACILI~CONTACT Business ID Numar 15-021 - ..... SeCtion 1: Business Plan and inventory Program ' Routine '~.Combined i"l Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection C V [C=Compliance~ OPERATION COMMENTS ~, V=Violation ~ APPROPRIATE PERMIT ON HAND USINESS PLAN CONTACT INFORMATION ACCURATE ~"[~ ~.VISIBLE ADDRESS ~ CORRECT OCCUPANCY ~-' VERIFICATION OF INVENTORY MATERIALS s. ..................................................................................................... {~PROPER SEGREGATION OF MATERIAL r'l ~ VERIFICATION OF MSDS AVAILABILITYE ~ i'1 VERIFICATION OF HAT MAT TRAINING r'l ~ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ [~ EMERGENCY PROCEDURES ADEQUATE ~ PROPERLY LABELED CONTAINERS '~' (-I SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?: ~ YES ~ No EXPLAIN: QUES.TI.~_EGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ..... ,ispec~o~e~-~- ......... -~i~ ~n t-~l~-s t~.' ~/-~ ff~ ~ i~ White - Environmental Services Yellow - Station Copy Business Site Responsible Party (Please Print) Pink - Business Copy A. Signature [] Agent [] Addressee · Complete items 1,2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: RAWEL SINGH BROTHERS'MINI MART 801 E. CALIFORNIA AVENUE BAKERSFIELD, CA 93304 D. Is delivery address different from item 1 ? If YES, enter delivery address below: 3. Service Type I1~ Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 2. Article Number (Transfer from service label) PS Form 3811, August 2001 7002 3150 Domestic Return Receipt 0004 9985 5367 102595-02-M-1540 UNITED STATES POSTAL SERVICE IIII First-Class Mail Postage & Fees Paid l USPS Permit No. G-10 · Sender: Please print your name, address, and ZIP+4 in this box · Bakersfield Fire Department Prevention Services 1715 Chester Avenue, Suite 300 Bakersfield, CA 93301 ~Q.~ Q"' Post~ge $ r"l Postmark r--t Return Reclept Fee Here (Endorsement Required) r-~ Restricted Delivery Fee L.13 (Endorsement Required) rtl Total Postage f'---- ru RAWEL SINGH '~ [Sent ro . BROTHERS MINI MART '~- tg~rb'~'Ko'~'grd~' 801 E. CALIFORNIA AVENUE xx [?.,~,omx.n.?:... BAKERSFIELD, CA 93304 D November 5, 2003 CERTIFIED MAIL FIRE CHIEF P, ON FRAZE ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 . PREVENTION SERVICES FIRE ~?E'I~ SERVICES · ENVIRONMENTAL SER1/ICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Avb. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Rawel Singh Brother's Mini Mart 801 East California Avenue Bakersfield, CA 93304 REMINDER NOTICE Re: Deadline for Dispenser Pan Requirements December 31, 2003 Dear Underground Storage Tank Owner/Operator: A review of our files, indicate that you have not completed the retrOfit of your underground storage tank system. Current code requires that you install under dispenser containment pans prior to December 31, 2003. Further file review, indicates that you have been receiving Reminder Notices since April of 2002. With time growing short (2 months) this office is very concerned that insufficient time is left for you to hire a licensed contractor and complete the necessary retrofit. Currently, contractors are scheduling 8-10 weeks out. I strongly urge you to complete the repairs as soon as possible. Failure to comply with the state requirement could result in revocation of your permit to operate your underground storage tank system. If I can be of any further assistance, please feel free to contact me at 661-326-3190. Sini~~y°urs' Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/db pEkMIT APPLICATION NSTRUCT/MODIFY UNDERGROUND STORAGE TANK TYPE OF APPLICATION (CHECK) {~ NEW FACILITY ~ MODIFICATION OF FACILITY Bakersfield Fire Dept. Environmental Service 1715 Chester Ave Bakersfield, CA 93301 Teh (661)326-3979 NEW TANK INSTALLATION AT EXISTING FACILITY STARTING DATE TYPE OF BUSINESS ADDRESS J PROPOSEDj/ -- "~ -- ~"~COMPLETION OATE EXISTING FACILITY PERMIT NO. CITY ~-~X ZIP CODE ICONTRACTOR ~¢¢,,'~ ~,~ / PHONE NO. BAKEJ~SFIELO C~J.TY BUSINESS LICENSE NO. J WORKMAN COMP NO. J INSURER WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER tSOIL TYPE EXPECTED AT SITE NO. OF TANKS ~'t"~ ARE THEY FOR MOTOR FUEL TO RE INSTALLED C~ i-I YES i-I NO SPILL PREVENTION CONTROL AND COUNTER MEASURES PLAN ON FILE (~ YES ~ NO THIS SECTION IS FOR MOTOR FUEL TANK NO. VOLUME UNLEADED REGULAR PREMIUM DIESEL AVIATION THIS SECTION IS FOR NON MOTOR FUEL STORAGE TANKS TANK NO. VOLUME CHEMICAL STORED (NO BRAND NAME} CAS NO (IF KNOWN) CHEMICAL PREVIOUSLY STORED FOR OFFICIAL USE ONLY The applicant has received, understands, and will comply with the attached conditions of the permit and a¢~ othe stgte, local and federal regulations. This form has been completed under penalty of perj~an~ t~/Ith~, est ofj21)d knowled~, is true and correct. __ ~ P,ROV BY,- ME{PR,NT, ! , ",ATURE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED · Cqmplete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. '· Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: RAWEL SINGH BROTHERS MINI MART 801 E. CALIFORNIA AVENUE BAKERSFIELD, CA 93304 D. If YES, enter delivery address below: Is delive'r~ addres~'differen~ ~rom'ite'm l?,,~.~es 3..Service Type 2 J~ Certified Mail [] Ex, press Maid [] Registered [] Return Receipt for Merchandise [] Insured Maid [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 2. Article Number ~ransfer from service label) 7002 3150 0004 9985 4841 PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE IIII First-Class Mail Postage & Fees Paid USPS Permit No. G-10 · Sender: Please print your name, address, and ZIP+4 in this box · Bakersfield Fire Department Prevention Services 1715 Chester Avenue, Suite 300 Bakersfield, CA 93301 IT' Post~ge $ E:3 Certified Fee .. n~ Relum Reclept Fee ' P°stmar~ (Endorsement Required) Hem I~ Restricted Delivenj Fee I u"] (Endorsement Re~_~l~ ITl Total Postage 8 ~ I,se.~]'o RAWEL $:[NGH ~ [o,'/=o~.x/vo.' ~0! F.. CALIFORNIA AVENUE October 15, 2003 CERTIFIED MAIL FIRE CHIEF ROm FP,,AZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 ~PPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FhRE SAFETY SERVICES. ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Avb. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 171,5 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Mr. Rawel Singh Brother's Mini Mart 801 E. California Avenue Bakersfield, CA 93304 REMINDER NOTICE Re: Deadline for Dispenser Pan Requirements December 31, 2003 Dear Underground Storage Tank Owner/Operator: A review of our files, indicate that you have not completed the retrofit of your underground storage tank system. Current code requires that you install under dispenser containment pans prior to December 31, 2003. Further file review, indicates that you have been receiving Reminder Notices since April of 2002. With time growing short (2.5 months) this office is very concerned that insufficient time is left for you to hire a licensed contractor and complete the necessary retrofit. Currently, contractors are scheduling 8-10 weeks out. I strongly urge you to complete the repairs as soon as possible. Failure to comply with the state requirement could result in revocation of your permit to operate your underground storage tank system. If I can be of any further assistance, please feel free to contact me at 661-326-3190. Sincerely yours, Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services sBU/db " so that we can return the card to vou. __ ~ / I I B~~e~ive~ oronthefrontifspacepermits. . ) ~ /~ / ~/~'/ /~ v l x ~ ~/ ' ~ 1. ~cle Addressed to: D. 'Is delive~ addm~ different from item 17 ~ Yes BROTHER'S MINI MART 801 E CALIFORNIA AVE BAKERSFIELD CA 93304 if YES, enter delivery address below: [] No 3. Service Type ~ Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 2. Article Number 7002 3150 0004 9985 (Transferfromservicelabel)~.~ .... ~,,,~,{!,..~...~.,,,!! PS Form 3811, August 2001 Domestic Return Receipt 4230 2ACP RI,.O3-Z-OS851 UNITED STATES POSTAL SERVICE IIII First-Class Mail Postage & Fees Paid USPS Permit No. G-10~' · Sender: Please print your name, address, and ZIP+4 in this box · Bakersfield Fire Department Prevention Services 1715 Chester Avenue, Suite 300 Bakersfield, CA 93301 I ITl Retum Reclept Fee (Endorsement Require') Here Restricted Delivery Fee (Endorsement Required) Total Postage & [sontro BROTHER'S MINI MART 801 E CALIFORNIA AVE ~'6~',~"d~" or PO Box No. BAKERSFIELD CA 93304 D September 8, 2003 CERTIFIED MAIL .--~RE CHIEF -~, 3' N FRAZE ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (66t) 395-1349 PREV~TION SERVICES FIRE SAFET~f SERVICES · EN~RONMENTAL SERVtCES 1Z15 Chester Ave. Bakersfield, CA 93,.~1 VOI(JE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Av~. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Brother's Mini Mart 801 E. California Avenue Bakersfield, CA 93304 REMINDER NOTICE Re: Deadline for Dispenser Pan Requirements December 31, 2003 Dear Underground Storage Tank Owner/Operator: A review of our files indicate that you have been receiving quarterly reminders from April of 2002 to December 2002. Our files further show that since January of this year you have been receiving monthly reminders. The purpose of this letter is to remind you of the necessary retrofit of your fueling system. Current code requires that you install under dispenser containment pans prior to December 31, 2003. You will not be allowed to pump fuel after December 31, 2003 unless you have completed the upgrade requirements. Contractors are already scheduling 8-10 weeks in advance. I urge you to retrofit your facility as soon as possible. Should you have any questions, please feel free to contact me at 661-326-3190. Sincer¢~ yours, Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/db · Complete items 1,2, and 3. Also complete item 4 if Restrict.ed Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attache, this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: BROTHER' S MINI MART '801E CALIFORNIA AVE BAKERSFIELD CA 93304 IA. Signature [] Addressee B.,,,~;~eived(b/y ( Printe~ Name) C. Date of Delivery I D. Is delivery address different from item 17 [] Yes If YES, enter delivery address below: [] No 3. Service Type ,,~ Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 2. Article Number (Transfer from service label) t 7002 3150 0004 9985 3318 Domestic Return Receipt PS Form 381 1, August 2001 102595-02-M-1540I UNITED STATES POSTAL SERVICE First-Class Fe. es Paid Postage & USPS Permit No. G-'10 · Sender: Please print your name, address, and ZIP+4 in this box · ~ Bakersfield Fire Department Prevention Services 1715 Chester Avenue, Suite 300 Bakersfield, CA 93301 Q'"' ~ Postage $ C~rtlfled ~ r'~ Return Reclept Fee r~ (Endorsement Required) r-~ Restri~ed Delivery Fee u3 (Endorsement Required) Postmark Here Total Postage & Fees ~ '~?'"'~;"~'~"~'"~T_;2 ......... l ~\'~:'.~; ~;~A .......... '~', ................................... D July 8, 2003 FIRE CHIEF ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX,(661) 395-1349 PREVENTION SERVICES 17.,1,5 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 .,~ ENVIRONMENTAL SERVICES · ' 1715 Chester Ave. ~ ~'~ Bakersfield, CA 93301 VOICE (661) 326-3979 ~, FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 CERTIFIED MAIL Brother's Mini Mart 801 East California Avenue Bakersfield, CA 93304 REMINDER NOTICE Re: Deadline for Dispenser Pan Requirements December 31, 2003 Dear Underground Storage Tank Owner/Operator: A review of our files indicate that you have been receiving quarterly reminders from April of 2002 to December 2002. Our files further show that since January of this year you have been receiving monthly reminders. The purpose of this letter is to remind you of the necessary retrofit of your fueling system. Current code requires that you install under dispenser containment pans prior to December 31, 2003. You will not be allowed to pump fuel after December 31, 2003 unless you have completed the upgrade requirements. Contractors are already scheduling 8-10 weeks in advance. I urge you to retrofit your facility as soon as possible. Should you have any questions, please feel free to call me at (661) 326-3190. Sincerely, Ralph Huey Director of Prev. ention Services By: Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SU:db O June 5, 2003 Brother's Mini Mart 801 East California Avenue Bakersfield CA 93304 F~RE CHIBF RON FROZE ADMINISTRATIVE SERVICES 2101 "H" Street E, akersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395o1349 SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREvENTIoN SERVICES FIRE SAFE'Cf SERVICES · ENVIRONI~NTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 REMINDER NOTICE Deadline for Dispenser Pan Requirements December 3 l, 2003 Dear Underground Storage Tank Owner: A review of our files indicate that you have been receiving quarterly reminder notices since April of 2002. Effective January 2003, you can expect them monthly. The purpose of this letter is to remind you of the necessary retrofit of your fueling system. Current code requires that you install dispenser pans prior to December 31, 2003. You ..will not be allowed to remain open after December 31, 2003 unless you have completed the upgrade requirement. Contractors are already scheduling work 6-8 weeks out. I urge you to start planning to retrofit your facility as soon as possible. Sincerely, Steve Underwood Fire Inspector/Environmental Services Office of Environmental Services SBU/rs May 7, 2003 Brothers Mini MarffRawel Singh 801 E. California Avenue Bakersfield CA 93304 FiRE CHIEF ~.ON FRAZc ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES · ENV1RONIJ~NTAI. SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 REMINDER NOTICE RE: Deadline for Dispenser Pan Requirements December 31, 2003 Dear Underground Storage Tank Owner: A Review of our files indicate that you have been receiving quarterly reminder notices since April of 2002. Effective January 2003, you can expect them monthly. The purpose of this letter is to remind you of the necessary retrofit of your fueling system. Current code requires that you install dispenser pans prior to December 31, 2003. You will not be allowed to remain open after December 31, 2003 unless you have completed the upgrade requirement. Contractors are already scheduling work 6-8 weeks out. I urge you to start planning to retrofit your facility as soon as possible. Sincerely, Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc D April 10, 2003 Brothers Mini Mart/Rawel Singh 801 E. California Avenue Bakersfield CA 93304 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICE8 * ENV1RONUENTN. SERVICE~ 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester AvE. Bakersfield, CA VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 REMINDER NOTICE RE: Deadline for Dispenser Pan Requirements December 31, 2003 Dear Underground Storage Tank Owner: A Review of our files indicate that you have been receiving quarterly reminder notices since April of 2002. Effective January 2003, you can expect them monthly. The purpose of this letter is to remind you of the necessary retrofit of your fueling system. Current code requires that you install dispenser pans prior to December 31, 2003. You will not be allowed to remain open after December 31, 2003 unless you have completed the upgrade requirement. Contractors are already scheduling work 6-8 weeks out. I urge you to start planning to retrofit your facility as soon as possible. Sincerely, Steve UnderwOod Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc D FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES. ENVIROt, IMENTN,. SER~ICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCA~ON 1715 Chester Av~. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE 'INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 March 25, 2003 Rawel Singh Brothers Mini Mart 801 East California Avenue Bakersfield, CA 93304 REMINDER NOTICE RE: Deadline for Dispenser Pan Requirements December 31, 2003 Dear Underground Storage Tank Owner: A Review of our files indicate that you have been receiving quarterly reminder notices since April of 2002. Effective January 2003, you can expect them monthly. The purpose of this letter is to remind you of the necessary retrofit of your fueling system. Current code requires that you install dispenser pans prior to December 31, 2003. You will not be allowed to remain open after December 31, 2003 unless you have completed the upgrade requirement. Contractors are already scheduling work 6-8 weeks out. I urge you to start planning to retrofit your facility as soon as possible. Sincerely, Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc D March 5, 2003 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES · ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Avb. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION - 5642 VictorAve. Bakersfield, CA 93308 VOICE (661) 399-469~ FAX (661) 399-5763 Central Cali Market 801 East California Ave Bakersfield CA 93304 REMINDER NOTICE RE: Deadline for Dispenser Pan Requirements December 31, 2003 Dear Underground Storage Tank Owner: A Review of our files indicate that you have been receiving quarterly reminder notices since April of 2002. Effective January 2003, you can expect them monthly. The purpose of this letter is to remind you of the necessary retrofit of your fueling system. Current code requires that you install dispenser pans prior to December 31, 2003. You will not be allowed to remain open after December 31, 2003 unless you have completed the upgrade requirement. Contractors are already scheduling work 6-8 weeks out. I urge you to start planning to retrofit your facility as soon as possible. Sincerely, Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc TYPE OF ACTION [] 1. NEW SITE PERMIT {Check one ~tem only) - CITY OF BAKERSFIELD . O ICE OF ENVIRONMENTALnJERVICES-- 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY [] 3. RENEWAL PERMIT [~4. AMENDED PERMIT [] 5. CHANGE OF INFORMATION (Specify cllange. local use only). [] 6. TEMPORARY SITE CLOSURE Page ~ of ~ [] ?. PERMANENTLY CLOSED SITE [] 8. TANK REMOVED I. FACILITY I SITE INFORMATION BUSINESS NAME (Same as FACILITY NAME ~ DBA - Doing 8usinass As) 3 NEAREST CROSS $¥1.<Et::Y 401. TYPE L~. GAS STATION [] 3. FARM [] 5. COMMERCIAL [] 2. DISTRIBUTOR [] 4. PROCESSOR [] 6. OTHER 403. FACILITY ID # FACILITY OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 3. PARTNERSHIP [] 4. LOCAL AGENCY/DISTRICT' [:::] 5. COUNTY AGENCY' [] 6. STATE AGENCY* [] 7. FEDERAL AGENCY* TOTAL NUMBER OF TANKS REMAINING AT SITE ls facility on Indian Re~,ervatton a~ I *If ownes' cd UST a public agency: name cd sul:)e~asof cd tmstlands? I division, section ~ office wflich agerates the UST. (This is the contact person for the tank recorcls.) II. PROPERTY OWNER INFORMATION"'",.. ':,,",i. = . PROPERTY OWNER NAME PROPERTY OWNER TYPE E] 1. CORPORATION PARTNERSHIP [] 4. LOCAL AGENCY/DISTRICT [] 5. COUNTY AGENCY 407. J PHONE 40~. I 409. 411. I ZIPCODE [] 7. FEDERAL AGENCY 412. 413. III. TANK OWNER INFORMATION 414. PHONE 415. 6(0 I' - MAILING OR ~TREET ADDRESS TANK OWNER TYPE [] 1. CORPORATION INDMDUAL PARTNERSHIP [] 4. LOCAL AGENCY I DISTRICT [] 5. COUNTY AGENCY [] 6. STATE AGENCY [] 7. FEDERAL AGENCY 416. 419. IV. BOARD OF EQuALIzATION UST STORAGE FEE ACc'oi~NT NUMBER . V. pETRoLEuM .U~T FINANCIAL RE~SP°N'siBILITY?!!!''': :',.:": INDICATE METHO0(S) ~1. SELF-INSURED [] 4. SURETY BOND [:~. STATE FUND F"I 2. GUARANTEE [] 5. LE,Yt:R OF CREDIT [] 8. STATE FUND & CFO LETTER [] 3. INSURANCE [] 6. EXEMPTION [] 9. STATE FUND & CD 421. [] 10. LOCAL GOV'T MECHANISM [] 99. OTHER: VI. LEGAL NOTIFICATION AND MAILI. I.I~G ADDRESS Check one box ID indicale whtc~l addrass should 13e used fo~ legal notifications and m=illng. ~ [] FACILITY 2. PROPERTY OWNER Legal notiflcallons and mailings will be sent to the tank ov*qer unless box 1 o~ 2 ia c~ec~ed. [] 3. TANK OWNER 423. VII. APPLICANT SIGNATURE Certification: I cagily thai the information provided hecein is true and accurate to the bast cd my knovdedge. SIGNATURE OF APPLICANT 1'1 NAME Eh~"APPLfCANT (print) ,r~, 426. TITLE OF APPLICANT STATEUSTFACILITYNUMBER(Forlocaluseonly) 428, 1998 UPGRADE CERTIFICATE NUMBER (For local use only) UPCF (7/99) S:\CU PAFORMS~swrcb-a.wpd WR~EN MONITORING PRO~DURE$ UNDERGROUND STORAGE TANK MONITO~G PROGRAM makin8 the chnn_~.. Requited by Sections 2632(d) and 2641(h) CCIL Facility Name Facility Acldreu Be Describe the freqpency of peffo~8 the monitoring: Taak ~ 0t^4tt~ oe$ Piping What methods and equipment, identified by name and model, will be used for perfoming the monitot~g:/- Piping Describe the location(s) where the monitoring will be performed (~ilit~ plot plan should be a~acbed): List the name(s) and tide(s) of the people responsible for perfotmin8 the monito~m& Reporting F. ormat for monitoring: Tank Piping ~../.--I'k Describe the preventive maintenance schedule for the monitoring equipment. Note: Maintenance must be in accordance with the manufacturer's mafntenance~sehednle but not less than every 12 months. Describe the trainin8 nece_~ary for t~he ooeration ofUST sy~.._em,,includin8 pipins, and the monitoring equipment: EMERGENCY RESPONSE pLAN UNDERGROUND STORAGE TANK MONITORING PROGRAM This monitoring program must be kcp~ at thc UST location at all times. The information on ukis monitoring program are conditions of the operating permit. The permit holder must notify the O~ce of Environmental Services within 30 days of any changes to the momtormg procedures, unless required to obtain approval befor~ m~fing the change. Required by Sections 2632(d) and 264 l(h) CCR. If an unauthorized release occurs, how will the hazardous substance be cleaned up? Note: If released hazardous substances reach the environment, increase the fire or explosion hazard, are not cleaned up from the secondary containment within 8 hours, or deteriorate the secondary containment, tlaen the Office of Environmental.Services must be n. otified within 24 hours. . .~l'ha (( .q, olll~;. ~ ,rl(~.~t~r(Ot~t^~ t. ot[[ Describe the proposed methods and equipment,to be use~ for removing, and properly disposinl~ofany}azar/tous substance, k_~ ~.~/ /~,.'¥tc . t~£ t'A a q Describe the location and av~ability oftthe re.quirel:l cleanup ec).uipme?t in item 2rlabtve. Describe t~,e mai~_.tenanc~ schedule for the cleanup.equipment:_ o List the name(s) and title(s) of the person(s) responsible for authorizing any work necessary under the response plan: ,~~ L g,/~ ~ CERTIFICATION OF FINANCIAL RESPONSIBILITY , ,~r#cle 3. Chepw~' t~. Oivieion 8. ~ 23. Callomia Code o!Regulations. The t'nectlanJlll~ ~ to ~ I~llllcJII Iltl~lll/l~ld ' b~ ,Section 2807are a.~ foilov,~: UNDERGROUND STOOGE TANK5 - TANK PAGE 1 I'1 ~ ~)~JsW~NT1.Y CJ. OMO ON ~'E l I Ill I/Fl'-ill I, TANK 09s. u~ O ~. I~ADED IL TANK CON~NI)GIX~ 441 I:]~. o~.~ rn~o~ T~M( 0 s. eI~I. EWN. L EXTERIOR ~ U~R 0 4. ~NOI~WALI. INAVAI~.T I'11. Nuee~U~D ON. c~'/,~ Y ~:~LL ANO O~ERFtl,.I. I'1 ~. MANU~L?ANK(~UOINO(LffO) 0 & O& i-I 2. AUToMATIGTMI((WJ(iI~(ATO) I--I ]. O 4. ~r^rfsr~ WOAY ~ONOLMT~ (~) * V. TANK Cl.0~II~ INFORMATION I PIRIMNINT CU:)IURI IN PLACI a3TIMATIO 0ATE ~ ~ Ov# O~ OPCF (7tOO) ~I:[CUPAFORM,t~qwRCB-II.WP 0 Ci'i-~; OF ~AKER3FIEL0 OFI~Cl Ol~ INVIIIONMENTAI. Avl.. ~kerslleld. CA t3,10~ (H1) L O 2. S~K:TCN O 2. aAAVTTY 4M C:] , ~ESSUWE ~] Z. SUCTfON O ]. 4 ON. ~ L &ARE STEEL O 2. STAINI.ES~ STEEL ~"1 3. ~..AS~C 'lEST (0.~ ~ SA.ce .~,JCTION ~I'$TEM8 (NO VALV~..~ I~ 8~U3W ~I~0UNO PE~iE~ ,~ C]c. NO aUTO PUIdP S~U'T OFF . EMEROENGY OENEi~I'O~I ONLY (¢llledr M I~ 4lff~ SYS'I'T.M FaJ,,URE.. a/,,IO ,~"'r'~ ~' E:a4 O4~::O~Id~C'I'IOH 4, adJOIOLE aJ40 VtSt,U~ AI..~FUA~ 0 z MO#TN.YO.2aPH'r~m' 0 4. OALYV~C~ r"l e. OAJLYV~U4.~ I"! ~ 8~a~YUU..~-OmTYTF. Sr(O.~ aPH) 10. 0 c NOAUTOPUIJPS~UTOF~ 0 lZ a/MMUAL~TE~T(0.1 0 1~. C01~mleJOIJSSU~PM~ISOR*NJOISI~A.NOV~U~.ALPJ~48 BiENGENGY (]EN~RATON~ ONLY (CMGt M I~ ~My) r'"l 14. COI'/T1NUO~ M~EN~O~AUTOII~JMP~HUTOFI=*AU~ANOVISUAL IX. OINNER/OPERATOR SIGNATURE ~ (~IF*.-~J~I~g_R~TOR 01nnq 471 Tm.i OF OVVNER~P~RATOR ~ Pe~l Nu,.~ (Fa'~oc.M UN ~) JPCF (7/99) 474 S:~CUPAFOR,M~SWRC~B.WPD · W'~~n' 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 --' ~ '"--' UNDERGROUND STORAGE TANKS- TANK PAGE ~I'E 0.0~ Ct. OMO ON rmv( ~,EMOYE0 L TANK Oz~ O ~. ~ 0 & ^~o~ ~. IL TANK (:(~I~lUJGTl~ 441 ; T'n~0F T~K 0 t. ~w~u. 0 4. J~ PL~(FRP) 0 s. ~o~-m 0~~ 0 ~. Fm, cm4,A~wn~,~rH~u~c Om. 44~ SP~Lt. ANO Ov~RJqU. ~ TYPEfF~IoM/UMOd~) 4~1 OVF.,qFlU. PROTECTIONE(:~JLo/.f=NT:YEARIN~T)JtFO [~ t. v~U~. (IXI~D PONTION OeI. Y) nz. ~JTOM~TC?~4K(aAU(iII~?O) [~ 4. ~I'ATI~TIC~, INVINTQIIY I~ECI:)NClUA?IQN (~111) · 81EM4IN. T~I( TI~TIN(3 ie s?t~.~ r~o o~rl t.~f ~eeo {'nl&~Od~Y} TA~K FI~I0 WITH ~e~T M~TEIlU~? C]~# UPCF (?~0) crrY OF ~KER3FIELD eO~ICl C~ ENVIRONMENTAL SERVICE~Mi~ CWW Av~.. kkltl~tld. CA t3301 (641) ~ W C~NIT~UCT~N (C~d M ~t ~ ~ 2. ~UC?ION O ]. OAAVnY ~M C~ , PqEssu~E I~ 3. UNED TqNC~ I'] g~. 01't'~R MO ~ 2. qUCTION MArERM/.SANO '~ 2. STAJNI~I ~l'gm CORROSION P~qoTECTION I-1 3. p~nc (:OMPAT~.EWITHCONTEml OM, UNKNOWN STEEL !~. Fs~ 0 L FLEX.ZOOm) C]oo. O~ER · STEE~ w; COAT~NO 0 o. CATHODe mOT~CT~ON ~M ~1 3. P~A.ITIC CC~MPATII~.E ~ CONTENTS I~] ~. ~ (~ 0 5. STEEL VWCOAT1N(~ C~ 9d. UNKNOWN VII. ~ LEAK DET~ClY~N 0 e. ~:m, COMPATm4.E W~ '(X)~ ~ r. O,~.V, UdZEDSTEEL ,0 9. B~NT~TEST(0.1 ~o. CO~?MJOUS TUl~a~ ~MIP MN~OR WII~ AUO~LE ~ ~ ~ A~ 0 PUla~ SHU'T OFF ;;~;::N A LP.N( ~ 0 o. A~TO PUMP S~N/T(:3f'FFORLEAK~ ~TEMFaJ.UI~ANO~'aiM ,see 0 z Coe(nNUCXJOOJSPF. NMAPMSOd~(~*AUOISLEANOVtSUAL)~U~S r'! & TRENC~LM~/MONn'O~K) I'1 3. ~OD~"e~MAPANMN~O~WITHAUTOS~rroFFFO~0~J~-~°Auom~EANoV~uA~AL/~J~ ~ NONE IX. OWNER)C~ERATC~ $1ONATURE I Pen~4N~maM/F~C41UMM~) 472 I P end AO0mwd (/r~M(~ m Mil)') ,, 474i WPCF (7/99) S:~CUPAFORIViS~WRCB-B.WPO -~ CITY OF BAKERSFIELD ~_~.,- OFF~E OF ENVIRONMENTAL ~RVICES 1715 Ches~r Ave., Bakersfield, CA 93301~661) 326-3979 UNDERGROUND STOOGe TANKS. YANK PAGE C~ $, ~ 0¢ tMO~MATY)N) ----- Cl z t~q~o Cl ~. ~ 0 & AV~AT~Om'Ue. 0 ~. ¢~t 0~.o~ , T~MATE~A~'~mO 1. i'] t. AU'rOMA'nC ?,e~ aAuae~ (~TO) El ]. CONT~MJO43AT(] I~ 4. ~I'Ar~:slY.~.~I~CONOUAT~(~* 0 I. VLqUAL(~I~K~L~WALLINVAULTOI~Y) ¥. TANK ~MUN~ INFO,MATiN I PIAMANINT CU34UNff m PLAC~ ~$t,M~rto OATI ~4T UMO (YN&ICM)AY) 44 IITIM~TID Q~w(rTTY (~ ~.~T.~r.J N~WNIIO M4 MM Or# G1-i-1~ OF BAKERSFIELD O~I~Cl OP INVIRONMEHTAL SERVICE3 Avl,. ~lklrlfllld. CA t,1,101 (1~1) 33~17g VI. PINNG CCNITRIJCllC~ (C~d ~ mt ~m~ ~ ~, o~vrrY 4M ~ , ~m~ssu~a C:] I. $1NGLI= WALL C] 2. OOU~L; WALL (-I t. &ARE STEEL /'~ 2. ~TAINLES.I STEEL ' ~ESSURtZ, ED PIPING (Check l"! 3. ANM~I~E(3/~'TY~(G,1c]/q~) C] z uo, m~.vo~m,HTEsr 0 · oAa. vveu~.c~c-c~ TEST (OJ S/,~E SUCTX3N SYStW. MS (NO VAL VE~ ~N _~a___eW O~OUNO ~ 0 7. SEU: RESTRICTION [] ~e. ANNUAL ~ ~ST(0.; ~) . 0 17. ONLY~S~E~ O~N~M~ 0 I. ~T~~T~~V~ 0ATE ~aT~0 ~ IX, OWNER/OPERATOR SIGNATURE P.nn4 Num~4~ (Fo~ ~ uN 473 I PinM~#'~JKMu#on¥) JPCF (71gg) o,,TE 471 474 7~,,,~ 7./,~_~.A_, OMi (FO~, ~,~,G,. ~ ~,,-~/~ 4~ S:tCUPAFORMSL,flWR~B.WP D FEB-2?-2E~3(THU) 12:17 · ~ ScI~/-Jules of Insurance James G Parker Insurance Associates Oo. Brothers Mini Mart 584 5835 P. 082/804 2/271206 page Customer Information 801 E California Ave Bakersfield, CA County: Kern Bus: (661) 861.1614 Policy Information Bacome Insurance Agency Lice/0554959 P O Box 1129 Hanford, CA 93232 Policy # CPK603 .... Effective Expiration 02/14/2003 07./14/2004 Company Clarendon National Ins. Co Line of Business/Premium: Commerclal Package $8,345.00 ~amed ~[nsured -' Named Insured I Rawel Singh 2 Brothers Mini Mart Locations Entity Type Individual Doing Business As Loc # Bldg # 1 00001 Address 801 E California Ave., Bakersfield, CA 93307, Kern County Natu'rc of Busincss ' Nature of Business/Description of Operations by Pr~m!~e(s) Convenience Store with Gas sales. New venture operated ~by son with 15 years experience. Those schedules ara providod as a brief outline of your policy. You must refer to tho provisions found in your policy for tho details of your coverages, terms, conditions and exclusions that apply. 4.535.t ~,EEB~_7-2003 (THU) 12:18 Bacome Insurance Schedules al Insurance ' Jarr~s G Parker Insurance Associates Co. (F/~X) 559 584 5035 P. 003/004 Brothers Mini Mart 2/271200 page Covered Property Subject Of Insurance Cause Of Loss Business income Special form C-Store Special forth Canopy special form Business Personal Property Special form Purnps special form Valuation Amount Deductible Ded Type 100,000 Property -.A.d.d. !_tional Other Interests Interest In Interest Type 00001 00001 Mortgagee/Loss Payee Name Hedtage Bank of' .. Coh?,mer,ce' ' ' . ,, .., Cencr~l Liability Coverages Limit "..; . General Aggregate 1,000,000 Products/Completed eps Aggregate Personal & Advertising Injury Each Occurrence 1,000,000 1,000,000 1.000.000 1000 Ded... ......... Fire Damage 50,000 10rx) Ded. 't Replacemen[ 393,000 1000 80 Cost .Replacement 1.5,000 1000 80 Cost Replacement !0,0~000 1000 80 Cost Replacement 20,000 1000 80 Cost ~ Coins. % Address Attn: SBA Lending, 150 Ajmaden Blvd, San.Jose, C~ 95113 · -. ! Those schedules ara provided as a brief outline of yaur pa!J¢~/~...You must refer to tho provisions found in your policy for the details of your coverages, terms, conditions and excluslorYS"that Apply. ' 4.535.1