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HomeMy WebLinkAboutUNDERGROUND TANK FILE #1BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 TANK REMOVAL INSPECTION FORM CONTRACTOR ~ ~ IP~ CONTACTE~ ~, LABORATORY ~ C- # OF SAMPLES TEST METHODOLOGY S~, ~/;4~6- ;T/'/J?I), ~'~,'/ ~ P~LI~ARY ASSESSMENT CO. ~% {~,' - CO.ACT PERSON CO~ RECIEPT ~ ' LEL% /- PLOT PLAN CONDITION'OF TANKs CONDITION OF PIPING ~ ./ CONDITION O~ SOIl. ~.~ ~,'/ '~ ~~ COMMENTS ' %bATE 2/23183 BAKERSFIELD FIRE DEPARTM~ BUREAU OF FIRE PREVENTION APPLICATION In 'conformity with provisions of pertinent ordinances, codes and/or regulati°n~.~PP'l'i~atib~ is made , ~. Ad~lreSS'. '-, "· Name of Compony to display, store, install, use, operate, sell or handle materials or processes involving :or'.creating .con- ditions deemed hazardous to life or propertv as follows: (1.) 2,000 galZon d~.e-~e~.' l:an~ -= UT~ #,~063307. to be 1.ocated at BS&E ;.quLp~nt, /+!7 Kentucky, Bakerst~eld, .CA. Date ~ Fire Marshal *' '~ BAKERSFIELD FIRE D~PARTMENT '?:-: 13'~ 197S' BUR~U OF FIRE PR~ENTION - ..,-... . .... ~ ........ v -. .. ~te 'APPLICATION- . - ~limtlon NO:: .... "· In conformi~ with provisions of ~rtinent ordinances, c~es and/or· r~lat.~~s, appli~ti~:~i~[~a~  .. · Name of Company .Address- .' ..-.//"...' - :' '~ '"~:'- ' ' ' " processes inVolying Or '¢'reati~g' Con- '-~-.~d~splay, store, mstolt, use, operate, sell .or handle materials or ';diti°ns deemed.hazardous to life Or property as follows: Oon~m,-., Valley · gqnipeent " . .. · , ,~ !· ...... .............. Permit denied ....................... M.A."~' I~ R 1 2%.X=-. :5~ D I V-i- S t Ol'q S. D, JOHNSON FIRE CHIEF 2101 H STREET BAKERSFIELD, 93301 326-3911 TIME DATE: NAME: CHGD: ?!zo!+~ ,, ' ~ ¢,5 /¢/5/¢ ~ ,, '/ /,o COMMENTs: I CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT S. D. JOHNSON FIRE CHIEF October 8, 1992 2101 H STREET BAKERSFIELD, 93301 326-3911 B S & E 6319 District Boulevard Bakersfield, CA 93313 Attn: John Goon Dear Mr. Goon, This is to inform you that this department has reviewed the results for the site investigation of the unauthorized release associated with 'the closure of the waste oil/gasoline tank located at 417 Kentucky Street, in Bakersfield California. Based upon laboratory data submitted and with the provisions that the information provided to this agency was accurate and representative of existing conditions it is the position of this office that no further action is required at this time, with the following restrictions/conditions are met: 1. Current land use is unchanged; ,, A re-evaluation of potential risk would have to be performed before redevelopment of the property was considered. Be advised that this letter does not relieve you of any liability under the California Health and Safety Code, or any other Federal, State, County, and/or City law and/or ordinance for past, present, or futUre operations. Nor does it relieve the property owner of the responsibility to clean up existing, additional, or previously unidentified conditions at the site which cause or threaten to cause pollution or nuisance or otherwise pose a threat to water quality or public health. In addition, any future changes in site use may require further assessment or mitigation. It is the property owners respOnsibility to notify this department of any changes in site usage. If you have any questions regarding this matter, please contact me at (805)-326-3797. //// Hazardous Material Special£st Underground Tank Program CC: ~M. Selover RESNA 1500 So. Union Ave. Bakersfield, CA 93307 MEMORANDUM "WE CARE" October 9, 1992 TO: Valerie Pendergrass ~QO] ~ '~ %?'~"~ FROM: Joe A. Dunwoody SUBJECT: Billing for assessment oversight on work performed at the B S & E rental facility, 417 Kentucky Street, Bakersfield CA. The assessment phase with regards to the soil contamination at the B S & E rental facility is complete. A total of nine and one half (9 1/2) hours, at a rate of $47.50 per hour, have been spent on this project. The total amount is listed below. Please enter the amount on the computer, note the date on the memo and file when completed. cc:. Ralph E. Huey 9 1/2 hrs. * $47.50/hr. = $472.62 MEMORANDUM "WE CARE" October 9, 1992 TO: FROM: SUBJECT: Valerie Pendergrass Joe A. Dunwoody Billing for assessment oversight on work performed at the B S & E rental facility, 417 Kentucky Street, Bakersfield CA. The assessment phase with regards to the Soil contamination at the B S & E rental facility is complete. A total~f nine and one half (9 1/2) hours, at a rate of $47.50 per hour, have been spent on this projeCt. The total amount is listed below. Please enter the amount on the computer, note the date on the memo and file when completed.· 9 1/2 hrs. * $47.50/hr. = $472.62 cc: Ralph E. Huey CITY of BAKERSFIELD "WE CARE" FiRE DEPARTMENT S. D. JOHNSON FIRE CHIEF June 2, 1992 2101 H STREET BAKERSFIELD, 93301 326-3911 John Goon B. S. & E. Rentals 6319 District Blvd. Bakersfield, CA 93313 RE: Laboratory results' from site assessment performed in relation to the waste oil tank (designated tank93 on permit9 BR-0026) located at the B. S. & E. rental yard, 417 Kentucky St. Bakersfield, CA. Dear Mr. Goon, Recently submitted laboratory results from the single boring advanced at your facility failed to demonstrate that ~soil contamination was limited to the area immediately surrounding the location previously occupied by the tank. In addition, data revealed that ~constituents (gasoline) not previously.declared as being stored in the tank were present. Based on this information, this office has determined that the lateral extent of the contamination plume located Under the area previously occupied by the waste oil tank must be defined. This office requires (in accordance with chapter 6.7 of the California Health and Safety Code and chapter 16, Title 23 of the California Code of Regulations) that further assessment be done to define the vertical and horizontal extent of the contamination plume. Please submit a. work plan for further assessment, to this office, with in 30 days from receipt of this letter. The work plan should follow guidelines found in: Appendix A - Reports, Tri - Regional Board Staff Recommendations for Preliminary Evaluation and Investiqation of Underqround Tank Sites; Januar~ 22, 1991. If you have any questions, please call me at (805) 326-3979. S~cerely_, Joe A. Dunwoody Hazardous Material Specialist Underground Tank Program groundwater resources inc. ~ A RESNA Company ] 500 SO. UNION AVE. BAKERSFIELD, CALIFORNIA 93307 General Engineering Contractor Class A/Haz License No. 609572 Environmental Solutions Through Applied Science, Engineering & Construction February 13, 1992 Mr. Joe Dunwoody Bakersfield City Fire Department Hazardous Materials Division 2130 "G" Street Bakersfield, California 93301 RECEIVED FEB A,s'd ............ Re: Site Characterization Work Plan BS&E facility located at 417 Kentucky Street in Bakersfield, California Dear Mr. Dunwoody, RESNA/Groundwater Resources Inc. (RESNA) has been retained to carry out a site characterization for the BS&E facility at the above referenced site in Bakersfield, California. The following Work Plan is submitted for your approval. BACKGROUND In November 1991 BS&E removed one (1) 500 gallon underground waste oil tank from their equipment yard at 417 Kentucky Street in Bakersfield, California. Soil was sampled from beneath the tank per the requirements of the Bakersfield Fire Department (BFD). They were analyzed for Total Oil and Grease (TOG) and Total Organic Halides (TOX). Concentrations of TOG were reported in the soil samples that warranted further investigation. The following discussion details the procedures and protocols that RESNA will adhere to in the performance of a limited site assessment to evaluate the vertical extent of the total oil and grease impacted soil. PROPOSED BORING One (1) boring is proposed to complete the characterization of this site in accordance with BFD's requirements. Boring #1 will be centered in the location of the former tank site. It will either be advanced to an approximate depth of 30 feet, or ten feet deeper than the last field detectable oil and grease contamination as indicated by odors and readings recorded by a organic vapor analyzer (OVA). Boring #1 will determine the vertical extent of the oil and grease impacted soil. MAILING ADDRESS: P. O. BOX 9383, BAKERSFIELD, CA 93389 (805) 835-7700 FAX (805) 835-7717 Mr. Joe Dunwoody Bakersfield Fire Department February 13, 1992 Page Two PROCEDURES The boring will be made with a RESNA operated hollow-stem auger drilling rig. Samples will be obtained every five feet with a California split-spoon sampler. A RESNA field geologist will describe the samples, screen themwith an OVA detector and seal them in brass sleeves with teflon lined caps. The 15, 25, and 30 foot soil samples will be labeled and chilled on ice prior to transport to AppliedAnalytical Laboratory in Irvine, California, for analysis under a chain of custody document. The soil samples will' be analyzed by EPA Method 418.1 for Total Recoverable PetroleL~m Hydrocarbons. Detection limits suitable for the tests requested, and concentrations present, will be stated on the laboratory reports. Augers will be steam cleaned prior to boring activities to Prevent cross- contamination. Contaminated soil brought to the surface by the drilling operations will be place on plastic sheeting and covered or containerized in drums for later disposal at a properly licensed disposal facility. If contamination is found, the boring will be abandoned by filling it with a cement slurry by the tremie method. If no contamination is indicated, the boring will be backfilled with clean soil brought to the surface during the drilling operation. After field operations are completed and samples analyzed, a report will be prepared for your office with all results, interpretations and recommendations for remedial action if warranted. HEALTH AND SAFETY Ail RESNA employees have received the Health and Safety training required by OSHA for hazardous waste site operations (29 CFR 1910.120). While conducting the borings, personnel will be equipped with an OVA detector to monitor the air for organic vapors. Personnel will also be issued air-purifying respirators (APR) with organic vapor canisters which can be donned if conditions warrant. A "tailgate" safety meeting will be held at the site prior to commencing operations at which all site hazards and procedures to follow in event of an accident will be reviewed. Mr. Joe Dunwoody Bakersfield Fire Department February 13, 1992 Page Three If you have any questions or require further information, please call me at 805-835-7700. Respectfully submitted. RESNA/GROUNDWATER RESOURCES INC. Dale A. Johnson, R.G. Project Manager cc: Mr. John Goon - BS&E UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE (LEAK) ! CONTAMINATION SITE REPORT EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES [] YES [~~NO REPORT BEEN FILED ? [] YES [~0 :]HEREBy. CERTIFYTHAT]?HAVEDISTRIBUTED:I'HISINEORMATION:ACCORDINGTOTHE:iil ~i::!!:i ~ REPRESENTING ~ ~ COMPANY OR AGENC~,~E ~ ;( i OPERATOR ( ' )PHONE ADDRESS [~ ~ REGION~t~ BOARD PHONE ~ (1) / / ' ~.. , ~ ~, NAUE, ~ QUANT~W LOST (~LLONS) ~ ~. UNKNOWN ~ DATE ~I~HARGE BE~N M~HOD USED TO STOP DISCHARGE (CHECK ~L ~AT APPLY) ~ HAS D~SCHARGE BEEN STOPPED ? ~ REPAIR TANK ~ CLOSE TANK & FILL IN P~CE ~ CHANGE PROCEDURE ~RROSION ~ UNKNOWN ~ OTHER ~ ~ c.~CK ONE ONL~ ~ UNDE~RMINED ~OIL ONLY ~ GROUNDWATER ~ DRINKING WATER - (CHECK ONLY IF WATER WELLS HA~ AC~ALLY BEEN AFFEC~D CHECK ONE ONLY ~ ~ NO AOTION TAKEN ~ PRELIMINARYSI~ASSESSMENT~RKP~NSUBMI~ED ~ POLLUTIONCHARACTERI~TION ~ REMEDIATION PLAN ~ CASE CLOSED(CLE~UP~MPLE~DOR UNNECESSAR~ ~ CLEANUP UNDERWAY CHECK APPROPRIATE ACTION(S) ~ EXCAVATE & DISPOSE (ED) ~ REMOVE FREE PRODUCT (FP) ~ ENH~CED BIO DEGRADATION (1~ ~ <; ~ CONTAINMENT BARRIER (CB) ~0 ACTION REQUIRED (NA) ~ TREATMENT AT H~KUP (HU) ~ VENT ~IL (VS) ~ VACUUM EXTRACTOR) ~ OTHER (0~ z HSC 05 (8~90 P.O. BOX 6278 * BAKERSFIELD, CALIFORNIA93386 · (805)$89-5648 E'.CIEIYED DEC 2 I991 November 22, 199]_ Ans'd ............ Bakersfield City Fire Department ftazardous Material Division ATTENTION: Mr. Dunwoody 2].30 "G" Street Bakersfield, Ca. 93301 SUBJECT: BS & E, 47,..V Kent:ucky, Permit Dear Mr. Dl].~qwoo(]y: On November 12, 1991, Ci\LPI, Inc. removed three (3) .underg:Founc] :tanks, l - 2K gas, 1 - 2K diesel and ] - 550 wa. ste oil tanks 4].7 Kentucky Street, Bakersfield, Ca]i. forni.a 9..3.5 The tanks were decontaminated on site using a high pressure steam cleaner and ]netted with dry ice. Rinsate wa~. ,]~isposed o.f at Gib- so.n Re.[.]ning in BakersfJ. e/d, Californ;ia manifest {~899589.7,1. The tanks were Soil was sampled uno]er the direction of Bake.]:'e;f_ield C:it:y' F'ire l!l,:tzardous Material Di..vJsion, The sample::_; were ar,.a, lyzed at SM(; of Bakersfield for TVtt, BTX gas and diesel and oil and .grease and lead. A complete chemical analysis is enclosed. In addition to the lab .resl]!ts, copies of the manifest and chain of ...... ' ' ' ......... )--....,64.8 ~l~t.g, dy is enclosed. Plea:~e contact our main of[ice a'b ('o,).: ~o~ ~ i.f you have any quest:ior, s or require further information. El:lC ]. Of~tl]"(P: SMC ana].y.ses. Manif-'e~-l.- copy Chain of cu..tcdys * copy Santa Maria, California 93454 (805) 925-2231 · Bakersfield, California FAX (805) $89-$312 SMC Laboratory Analytical Chemistry Client Name: CALPI, Inc. Address: · P.O. Box 6278 Ba~ers f iel,], CA 93386 Date Samples Received : 11-12-91 Date Analysis Completed: 11-13-91 Date of Report : ]1-13-91 Attn: Mr. J.p. Mullhofer Project ~.: 4559 P.O. ~ : 03-3445-9! RESULTS OF ANAI,YSIS _sample.,,~ _ID 4209 4210 ~-2 TOTAL PETROLEUH HYDROCARBONS (Oil and Grease) mq/kq ~DL, mq/kg 6.9 5.0 ~ 5.0 Method of Analysis: 41~t.1 ND : None Detected mg/kq = milligrams per kilogram MDL = Minimum Detection Limit 'A~ge~a Horton AnalytJcal Chemist 3155 Pegas~ s Drive P.O. Box 80835 . · Bakersfield, CA 93308 ~a[:ersfield. CA 9338(I · .(805) 393-3597 FAX (805) 393-3623 Analytical Chemistry Client Name: CALPI, Inc. Address: P.O. Box 627,.q Bakers f'ield, CA 93386 Attentlon: ~{r. J.~'. H,111hofer Date Samples Received : ].1-12-91 Date Analysis COmpleted: 11-14-91 Date of Report : ] 1.-14-91 Project ~: 4559 P.O. g : 03-3445---91. RESULTS OF ANAI,YSIS Sample ~ ID 4209 #1 4210 ~2 TOTAI, uqm/qm ND LEAD MRL,uqm/gm 10. 10. Method of Analysis: 3050/7420 MRL : Minimum Reporting Level ugm/gm = micrograms per gram ND = none detected A6ge'l a Horton Analytical Chemis% 3155 Pegam,s Drive P.O. Box 80835 · · Bakersfield. CA 93308 E~akersfield. CA 93380 · (805) 393-3597 F/MX (805) 393-3623 SMC Laboratory Analytical Chemistry Client Name: Address : CALPI, Inc. P.O. Box 6278 Bakersfield, Ca. 93386 Date samples received :11-12-91 Date analysis complet:ed:ll-14-91 Date of report :] 1-14-91 Proje~_~t ~ :4559 P.O. ~[ :0'.3-3445-91 RESULTS OF ANALYSIS: ~4211 ID:~3 ugm/gm MDL,ugm/gm TPH (Diesel) ND 10. ~4212 ID:~4 ugm/gm HDL,ugm/gm TPH (Diesel) ND 10. ~4213 ID:~5 ugm/gm MDL,ugm/gm Benzene 0.028 0.005 Toluene 0.0057 0.005 Ethylbenzene ND 0.005 p-Xylene ND 0.005 m-Xylene ND 0.005 o-Xylene ND 0.005 Isopropylbenzene 0.0073 0.005 TPH (Gasoline) ND 1.0 TPH (Diesel) ND ]0. Method of Analysis ['or BTX/TPH (Gasoline): 8020 Method of Analysis for TPH (Diesel): 3540M/8020 MDL = Minimum Detection Level TPH = Total Petroleum Hydrocarbons ugm/gm = micrograms per gram (ppm) ND = None Detected Kevin Laga-r~ (~ Analytical ChemiSt (F D) 3155 Pegas,m Drive PO. Box 80835 · · Bakersfield, CA 93308 P. akersfietd, CA 93380 · .(805) 393-3597 FAX (805) 393-3623 RESULTS OF ANAI,YSIS: ~4214 ID'. #6 Benzene Toluene Ethylbenzene p-Xylene m-Xylene o-Xylene rsopropylbenzen{.? 'rPB (Gasoline) TPH (Diesel) ~4215 ID:~7 ~ Benzene Toluene Ethylbenzene p-Xylene m-Xylene o-Xylene Isopropylbenzene TPH (Gasoline) ~4216 ID:#8 ~ BenZene Toluene Ethylbenzene p-Xylene m-Xylene o-Xylene Isopropylbenzene TPH (Gasoline) Analytical ugm/gm ND ND ND ND ND ND ND ND ND ugm/gm 0.]] 0.6] 1.9 3.7 4.0 5.7 ugm/gm 0.0055 ND ND ND ND ND ND MDL,ugm/gm 0.005 0.005 0.005 0.005 0.005 0.005 0.005 1.0 ]0. PQL,ugm/gm 0.016 0.016 0.016 0.016 0.016 0.016 0.0]6 3.1 MDI,,ugm/gm 0.005 0.005 0.005 0.005 0.005 0.005 0.005 ].0 RESULTS OF ANALYSIS: #4217 ID,~9 /7'4~ Benzene Toluene E~hylbenzene p-Xylene m-Xylene o-Xylene Isopropylbenzene TPH (Gasoline) ugm/gm 3.6 20 25 43 60 50 31 680 PO.[,, ugm/gm 0.028 0.028 0.028 0.028 0.028 0.028 0.028 5.6 ~tate ot Calilornia--Health a~d Welfare Ageacy ~e Instructions on Back of Page 6 Dapmtment of Health Services ~ I ~ - fox,: ~ueetancea Oomro~ Dtv,aion Fom~ Appr~,ed O~ No. ~g ~. ~ and Front · 7 ' WASTE MANIFEST ~~l~l~J~l~lTl~... I I I I I I I I I I I I F.T~..~',~ ,,: ....,,,". 9. Des~l~ Ficili~ N~me and S~e A~f~ss . 10. I 12. Containers 13. Total 14. i. 1 I. U~ ~T Dee~ptl~ (Including Prop~ 5hipp~g Name, Hazard Clara. and .. /_ _ / No. Type ~/Vol ~/ E~ . ..... ~~ ;, A EPAI~h~ ~ i1 I I I II R EPA / ~r II I I I..! I ~~~.~,~,.L~.A~; I I I,, i I I I . .: .~;~ . . :,~..:~..,, ~. ~' ~-~ ~.~' :. ,,~., .. ~N[~A~'$ C[~~: I ~r~y ~clere fh~l the c~l~ I~ Ire classified, pack~, ma~, and labeled, and are in all Mli~ll govem~nt regulali~s. ff I im· large qulnl~ generate, I c~ify Ihs1 I have ~ pr~ram Iff place lo r~uce the volume and toxicity of wears generated to Ihs degree I have determined 1o be ec~o~ca~ ~acticeb~ lad l~l I have solecled t~ p~acticable meth~ ol t;eGtme~, sto~sGe, or disposal cu.ently ~vailGb~ to me ~ich minimizes the present and ~ture Ihreal to human heath and the environment; g~metl~ a~ 8e~ ~ hem wasle.managemeM meth~ thai is available to me and that I can afford. ~/T'yped Name ';"' ' ' " Month Day Year ~ 18. Trlfleffier ~ AcroSS, em~ of R~eipt 0f Materiall ~ P~ted/T~ed Nam~ E I ~ I I I I I I Ig. Dl~crepa~ I~icailon ~pace L .,~ / I ~. Facll~ ~ ~ ~1~ ~ical~ ot r~ei~ oi hazardous OHS 8022 A (1/88) EPA 8?00--22 (Rev, 9-88) Previous editions are obsolete. Do Not Write Below This Line W~ite: TSDF SENDS THIS COPY TO DOHS WITHIN 30 DAYS To: P.O. Box 3000, Sacramento, CA 95812 - Chain~ ,, of CU~-tody Rec rd PARAMETERS OTH~m:I AOORESS C.'~.T.,,o't., :nc. ,~ ~ O BOX 6278 (805)589-5648 ' -' :~ S^M~L~.qS $1cnoture; ' ' / ~ ~j a OS$~--~'V^TIO~St i~RELINQUlSHEO 8Y i Signature // REUNCUISHED BY ! I I I OAT~ ,~ECEIVED 8Y $ignalu/e J 0ATE RELINQUISHED B'Y Signature Name Comoanv REUNQUISHED 8Y j Signalure i Printecl Name xi /I ~J OATE TIME OATE ,';ME RECEIVED ElY Signature Pdnte~ Name Com0any RECEiV. E:O BY (lal:x3mtory) ' Signature Name i! OATS ,'nME . I ,~ z/ z./ ITOTAl. NUMBER OF CONTAINERS MET'HOD OF SHIPMENT SPECIAL SHIPMENT/HANOUNG OR STORAGE REQUIREMENTS BAKERSFIELD FIRE DEPARTMENT / -- ._~./l~[/~I-- BuRr, Au OF FIRE PREVEHTIOH / Oc, te APPLIGATION A~iicmion No. In conformity with provisions of pertinent ordinances, f:odgs and/o~regulations, application is made . 'b~: ,~ ,../-?~J ~-~-~?'~7 / , \ / / Name of ~x~pany ; ~ ~'~'9/ Address - to disploy, store, instoll, use, operote, sell or hondle materials or processes involving or creQting con- ditio~ns deeme~/h~zzordous to life or 'property os follows: . ..._~ ~ .~. U¢ ' "~-.~: ~~/2 ~/~-~2 ~~.~.. .... ~ ..... /// - ' · / Authorized Representative' ............................ ......... o0,. ~y 'Z_ T- ............... F,..,.,~,: ........ ~ ........................... CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT S. D, JOHNSON FIRE CHIEF January 6, 1991 2101H STREET BAKERSFIELD, 93301 326-3911 John Goon B. S. & E. Rentals 6319 District Blvd. Bakersfield, CA 93313 RE: Laboratory results from preliminary site assessment performed in relation to the waste oil tank (designated tank#3 on permit~ BR-0026) located at the B. S. & E. rental yard, 417 Kentucky St. Bakersfield, CA. Dear Mr. Goon, Upon.review of the recently submitted laboratory results from your facility, this office has determined that the extent of the contamination plume located under the area previously occupied by the waste oil tank has not been adequately defined. This office requires (in accordance with chapter 6.7 of the California Health and Safety Code and chapter 16, Title 23 of the California Code of Regulations) that further assessment be done to define the vertical and horizontal extent of the contamination plume. Please submit a work plan' for further assessment, to this offiCe, with in 30 days from receipt of this letter. The work plan should follow guidelines found in: Appendix A - Reports, Tri - Reqional Board Staff Recommendations .for Preliminary Evaluation and Investiqation of Underqround Tank Sites; January 22, 1991. If You have any questions, please call me at (805).326-3979. Since~re~ly, / Haz_ardous Material Specialist / Underground Tank Program CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT S. D. JOHNSON FIRE CHIEF January 6,. 1992 John Goon B. S. & E. Rentals 6319 District Boulevard Bakersfield, CA 93313 2101H STREET BAKERSFIELD, 93301 326-3911 CLOSURE OF 2 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANKS LOCATED AT 417 KENTUCKY STREET, IN BAKERSFIELD, CALIFORNIA. PERMIT # BR0026 Dear Mr. Goon, This.is to inform You that this department has reviewed the results for the preliminary assessment associated with the closure of the two underground tanks designated #1 & #2 on the permit to remove #BR-0026.and containing gasoline and diesel fuel, respectively. The fore mentioned tanks are located at the above stated address. Based upon laboratory data submitted, this office is satisfied with the assessment 'performed and requires no further action at this time. This letter does not relieve you of any liability for past, present, or future operations. In addition, any future changes in site use may require further assessment or mitigation. It is the property owners responsibility to notify this department of any changes in site usage. If you have any questions regarding this matter,.please contact me at (805)-326-3797. ' S~nc~.aelY, Hazardous Material specialist Underground Tank Program BAKERFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION UNDERGROUND STROAGE TANK PROGRAM PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK Site Infromation Site Address 417 KENTUCKY FacililtyName B. S. & E. RENTALS Tank Owner/Operator B, S. & E. Mailing Address 6319 DISTRICT ZipCode 93305 APN Cross Street BA~E~ Phone q))-7~I~ City_~~_L~J~DipCode 9qqlq Contractor Information Company ... CALPIr INC. Phone 589-5648 License~ A5060~5 Address P~ O. BOX 6278 City]i~~L~ Code 933R6 InsuranceCarrier STATE FUND Workmans Comp ~ 10118~9 Prelimanary Assement Information Company CALPI, INC. Phone $89-5648 License%~qo6o95 Address P.O. BOX 627~ ' CitYBA~~P Code.....9338~ Insurance Carrier STATE FUND Workmans Comp #.1011809 Tank Cleaning Information Company CALPI~ INC_ Phone ~ ~ Address P. O. BOX 6278 CityRA~WI~P C ~....93~86 Wate Transporter Identification Number 207294 Name Of Rinsate Disposal Facility GIBSON REFININ~ Address END OF COMMERCIAL DRIv~ity_~LS~P Code 93308 Facility Identification Number '. CAD98~RRq177 Tank Transporter Information .. i, ,..~ Company ..... OFFSHORE.CRA~E'' ~' .......... Phone ~Q~ n~-~'~'..~ Address 1600 JAMES ROAD CityBA~ERSFI~{~ ~6d~ 93308 Tank Destination GOLDEN STATE METALS ~" ~' ~' ~ ~" ~' Tank 2 3 TANK INFORMATION 'age _.volUme Chemical 'Dates: Stored ' chemical .~,~,~.,~ ~..~Stored i_:'~:'~;~::-;i~::;:.~i, previouSly Stored 2,000 G~L. ~ 1960 ~o ¢~SENT For Official Use Only Application Date{D/l~,/g/ Facility %~l~? % of Tanks The applicant has recieved, understands, and will comply with the attached conditions of this permit and any other State, Local and Federal regulations. · This form has been completed under penalty of perjury, and to the 'best of my' knowledge, is true and correct. Approved ~ h . Applicant Name(print) Applicant Sig~ture THIS APPLICATION BECOMES A PERMIT-WHEN APPROVED PLOT PLAN Plot plan must show the following: 1. roads and alleys; buildings; 3.location of tanks, piping and dispensers; 4o utilit£es; 5. SCALE; 6. water wells (if on site); 7. any other relevant information. BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 CERTIFICATION STATEMENT OF TANK DECONTAMINATION I, ~, ~/~//~ an authorized agent of - ,name ~ contracting co. perjury that the tank(s)located at .~//7 ~r~ad~s~s~ being removed under permit# ~90 ~.~ has been here by a~test under penalty of and cleaned/decontaminated properly and a LEL (lower explosive limit) reading of no greater than 5% was measured immedi'~tely following the cleaning/decontamination process. ~ d&te name (print) signature/ MARK ONLY [] ONEITEM [] 2 INTERIM PERMIT STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM A ~ COMPLETE THIS FORM FOR EACH FACILITY/SITE *~ . - . , .... I NEW PERMIT [] 3 RENEWAL PERMIT ' "[] 5 CHANGE OF INFORMATION .~"'7. PERMANENTLY CLOSED SITE [] 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS- (MUST BE COMPLETED) ClTYNAME'~'"~ / /~ ' . . / . ' . ': "-; STATE .... I ZIPCODE ' ' -' SlTE PHONE # WITH AREA CODE . · ..;.::..,, ......... ..... ,.,,CA ,. ~' BOX .,~0 ' "." TO INDICATE RPORATION [~ INDIVIDUAL PARTNERSHIP ~.~ ~ LOCAL-AGENCY ~-;.~;~ [-'-1 COUNTYrAGENCY .~ ~ [---I STATE-AGENCY . - ~ FEDERAL-AGENCY , .'. - ' .~ .... DISTRICTS ' . ..... ="':.-.'-'} :'~.'~'' ' · 'c RESERVATION '" i~] 3 FArM [~] ~ P~ocEsso~' lEE] ~' OTHERJ J ~ J~'~ ". OR TRUS~ UmDS ' ~ ~', .~. EMERGENCY CONTACT PERSON (PRIMARY) .',,:i:;:,. ~-~'. :: .=4.~...~.:.:,...*.: EMERGENCY CONTACT PERSON (SECONDARY)- Optional DAYS: NAME (LAST, FIRST) PHONE # WITH AREA CODE ,.:? ;,.~: = . NIGHTS: NAME (LAST, FIRS~ PHONE # WiTH AREA CODE il. PROPERTY,OWNER INFORMATION -~UST BE COMPLETED) INAME tC I " III. TANK OWNER INFORMATION - (MUST BE COMPLETED) J D AYS: NAME (LAST, FIRST) ' NIGHTS: NAME (LAST, FIRST) PH~NI:: ~ WITH ARF:A c, nnF PHONE # WITH AREA CODE CARE OF ADDRESS INFORMATION ~ box m indicate t'--'1 INDIVIDUAL 1---I CORPORATION ' [~ PARTNERSHIP I---1 LOCAL-AGENCY I~ STATE-AGENCY ~ COUNTY-AGENCY ~ FEDERAL*AGENCY J J PHONE # WITH AREA CODE . J 2 NAME OF OWNER ' MAILING OR STREET ADDRESS cITY NAME ~ ........ ~ ~---~- .! CARE OF. ADDRESS INFO~RMATION · · ,,*" box to indicale INDIVIDUAL ' ~ CORPORATION PARTNERSHIP STATE ZiP CODE - · . ~ LOCAL-AGENCY [~] STATE-AGENCY [-'-I COUNTY-AGENCY i-'--I FEDERAL-AGENCY PHONE # WiTHAREA CODE IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER - Call (916) 323-9555 if questions arise. TY(TK) HQ ~--~- I II II V. PETROLEUM UST FINANCIAL RESPONSIBILITY - (MUST BE COMPLETED) - IDENTIFY THE METHOD(S) USED ~" box Ioindicate ~ I SELF-INSURED ~ 2 GUARANTEE [-'-1 3 INSURANCE I-'"'1 4 SURETY BOND i--'-I 5 LETTER OF CREDIT ~ 6 EXEMPTION ,~[;~'~'~"THER VI. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPLICANTS ~ME (PRINTED& SIGNATURE)/ /1 J AP~P~OANTS TITLE DATE MONTH/DAY/YE,~R LOCAL AGENCY USE 0~/ COUN~ . ~ +~L~A~ION CODE. OPTIONALCENSUS TRACT ~ - OPTIONALSUPVlSOR - DISTRICT CODE - OPTIONAL x-~ ~HIS FORM MUBT BE ACCO~PAfllED BY.AT LEAST (1) OR ~ORE PEflMIT APPLICATIO~ - FO~M B~ UNLESS THI~ I~ A CHA~GE OF SffE I~FORMATION ONLY. ' ~:~; ~ 7.~-~ .., STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY [] 1 N~N. PERMIT [] 3 RENE~NAL PERMIT [] 5 CHANGE OF INFORMATION ONE ITEM [] 2 INTERIM PERMIT .. [] 4..AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE ~ TANK REMOVED I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN f A. OWNER'S TANK '.0., I B. MANUFAC REO BY: 'C. DATE INSTALLED(MO/DAY/YEAR)1 ? D. II. TANKC~TE~S IFA-11SMAR~D, COMPLE~ITEMC. ;'Z..::'?~' ' .... .... :..." . ,?'~ ~.:-~':*,~.~<'?:::~*~7 ,,*: C ..-'~..:'-~ ~* ~' ' D. IF IA,l) IS NOT MARKED, ENTER 'NAME OF SUBSTANCE STORED C.A. S, III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B. ANDC, ANDALLTHATAPPLIESINBOXDANDE A. TYPE OF SYSTEM - [] 4 SECONDARY CONTAINMENT (VAULTED TANK) .. [] 99 O'S'HER '" ] 1 DOUBLE WALL  '?2~SINGLE WALL ,,~ 1 BARE STEEL B, TANK MATERIAL [] 5 CONCRETE (Pflma~yTan~) [] 9 BRONZE [] 2 STAINLESS STEEL [] [] 6 POLYVINYL CHLORIDE [] [] 10 GALVANIZED STEEL' ~-~ 3 FIBERGLASS - [] 7 ALUMINUM [] 95 UNKNOWN [] 4 STEEL CLAI~ WI FIBERGLAss REINFORCED PLASTIC 8 100% METHANOL COMPATIBLEW/FRP 99 OTHER C. INTERIOR LINING ' [] I RUBBER LINED [] 2~D LINING [] 5 GLASS LINING ~ UNLINED IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL? [] 3 EPOXY 'I-INING '~--~ 4 PHENOLIC LINING ' [] 95 UNKNOWN [] 99 OTHER .... YES__ NO__ D. CORROSION [] 1 POLYETHYLENE WRAP [] 2-COATING "[] 3 VINYL WRAP ' [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION yNONE ,, [] 95 UNKNOWN ' :"' F--1 99 OTHER ...... ' :; E. SPILL AND OVERFILL SPILL CONTA~INMENT INSTALLED (YEAR) ?/_~ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) IV. PIPING INFORMATION C~RCLE A IFAEIOVEGROUNDOR U IF UNDERGROUND, BOTH IF APPLICABLE A, SYSTEM TYPE ~ SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER Bo CONSTRUCTION /1~)1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN C. MATERIAL AND ~ BARE STEEL A U 9g OTHER A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A U 4 FIBERGLASS PIPE CORROSION PROTECTION D. LEAK DETECTION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEI~W/COATING · A U 8 100% METHANOL COMPATIBLEW/FRP A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER r--'~ 1 AUTOMATIC LINE LEAK DETECTOR [---]2 LINE TIGHTNESS TESTING E~3 INTERSTITIAL MONITORING V. TANK LEAK DETECTION ' [] I VISUAL CHECK [] 2 INVENTORY RECONCILIATIONL__.J~[] 3 VADOZEMONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUNDWATER MONITORING [] 6 TANK TESTING [] 7 INTERSTITIAL MONITORING ~:~'91 NONE [] 95 UNKNOWN '- [] 99 OTHER . VI. TANK CLOSURE INFORMATION ///1 ¢)/'~ / SUBSTANCE REMA,N,NG LLONS ,NERT MATER,AL; THIS FOF~M~IAS ~EEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRI.~AND CORRECT APPLICANT'S NAME ~ I'~ . /'2 ~'1 , . COUN~ ~ JU~DICTION ~ FACILI~ ~ TANK ~ PERMIT NUMBER J PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE / FORM B ~-gl) THIS FOR~ ~UST BE ACCOMPANIED BY A PERMff APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FOROO34B-R5 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY ONE ITEM [] I NEW PERMIT [] 3 RENE~NAL PERMIT [] 2 INTERIM PERMIT , ', [] 4 AMENDED PERMIT 5"CHANGE OF TANK CLOSURE f , ~8 TANK REMOVED INFORMATION ~:;'~', [ [] 7 PERMANENTLY CLOSED ON SITE ] 6 TEMPORARY I. TANK DESCRIPTION COMPLETE ALL ~TEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I.D.~ '--~ B. MANUFACTURED BY: 7' ' ' ' ......... ' "' "" II, TANK CONTENTS IFA-11SMARKED, COMPLETE ITEM C. '~ ...... ... :. - ". .... ;- ,,-f: 7: ~, ~ ...... , ......... ~ .... ": 1:~ ~.:.:'~ .~ IA. MOTOR VEHIGLE.~,FUEL ~ ,:¢¢,,~. :~.~ ~IL. ;"+~' .~ B ..... ' , .- C. ~ la.~ ~.~DIE~EL .... ~ 6 AVIATION GAS I D. IF(A.1) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED c'A's'~: . "; '~L · ', · :~ ~ IlL TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, ANDALLTHATAPPLIESINBOXDANDE A. TYPE OF SYSTEM UBLE WALL: % '~:~D "3:*SINGLE WALL WITH EXTERIOR LINER GLE WALL [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER BARE STEEL [] 2 STAINLESS STEEL [] :3 FIBERGLASS []'4 STEEL CLAD W/FIBERGLASS REINFORCED PLAST[C B. TANK. MATERIAL [] s CONCRETE (PrimaryTank) . [] 9 BRONZE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLE W/FRP [] 10 GALVANIZEO STEEL [] g5 UNKNOWN *' [] gg OTHER .... '71'.' ~'1'; ':',."7'. [] I RUBBER LINED [] 2. ALKYD LINING [] 3 EPOXY LINING INTERIOR [] 5 GLASS LINING ~UNLINED [] 95 UNKNOWN LINING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES__ NO__ []..4 ,P. HEN?L[C LINING ] 9g OTHER '' D. CORROSION [] I POLYETHYLENE WRAP [] 2, COATING ; [] 3 VINYL"WRAP PROTECTION [] 5 CATHODIC PROTECTION ,.E~~-ONE [] 95 uNKNoWN [] '4 FIBERGLASS REINFORCED PLASTIC [] '99 OTHER : : f OVERFILL PREVENTION EQUIPMENT INSTALLED {YEAR) E, SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) IV, PIPING INFORMATION CIRCLE A IFABOVEGROUNDOR U IF UNDERGROUND, BOTH IF APPLICABLE ~ SYSTEMTYPE ~1 SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A~:)~ SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND CORROSION PROTECTION D. LEAK DETECTION A ~(,~,,4 BARESTEEL A U 2 STAINLESS STEEL A U'3 POLYVINYL CHLORIDE(PVC)A U 4 FIBERGLASS PIPE A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP A U g GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER [] I AUTOMATIC LiNE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTITIAL MONITORING .,~"~ OTHER ~ V. TANK LEAK DETECTION I [], v,SUAL CHEDK. -INVENTORY RECONCILIATION ~"~ 3 VADOZE MONITORING []4 AUTOMATIC TANK GAUGING [] 5 GROUND WATER MON,TOR,NGI I [] 6 TANK TESTING-~r--~[] 7 INTERSTITIAL MONITORING [] 91 NONE ' [] 95 UNKNOWN [] 99 OTHER I VL TANK CLOSURE INFORMATION ~ /// ~/? / . SUBSTANCE REMAINING - GALLONS INERT MATERIAL ? THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE. AND CORRECT IAPPLICANT'S NAME ~1 '~ / 'l" I DATE I COUNTY # JURISDICTION # FACILITY # TANK # STATE I.D.# ~ ~ ~" I ¢--.~01¢101 ~, PERMIT NUMBER PERMIT APPROVED BY/DATE' PERMIT EXPIRATION DATE FORM a (7-91) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FORO(3348-R5 STATE OF CALIFORNIA S~'ATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B -:~-., ..- COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. tMARKONLY [] I NEW PERMIT [] 3 RENEWAL PERMIT 'F'-] 5 CHANGE OF INFoRMATION.~.j:'~F~ .17. PE~J~ANENTLY CLOSED ONSITEI ONE]rEM- [] '2 INTERIM PERMIT;," · [] 4 AMENDED PERMIT '?-. [] 6 TEMPORARY TANK:CLOSURE '. '~-~ TANK REMOVED I I. TANK DESCRIPTION ' COMPLETE ALLITEMS ~ SPECIFY IF UNKNOWN OWNER'S TANK I. O. # ,~ . "~ -~'"'~ - ' II. TANK CONTENTS IF A-1 IS MARKED, COMPLETE ITEM C;*'~ L~ ~:?[~' *'~?' ~L I , - ~ -- C ' []' 1',."55U.~,"~ ,,[] 9 D~ES,L .... ," F-I e ^WAT,ONGAS l ~ I '" ~ ,'¢--,. ,~,' UNLEADED ..~ 5 .JETFUEL . .~; -. · ./ ' u. .ow. I ,TN. I D. IF (A.1) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED ' C.A.S.~: ....... "' ~ ' '" :' "' m III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, ANDALLTHATAPPLIESINSoXDANDE A. TYPE OF SYSTEM UBLE WALL- ~: -. :_:.. ~ ,3 SINGLE WALL WITH EX'FERIOR LINER - ;', El 95. UNKNOWN .~"¢; ~'-*-~,~ .! ~;~ GLE WALL LJ 4 SECONDARY CONTAINMENT (VAULTEDTANIO .., F'~. 99 O'~E~ '"" :.:' ~'''''? :~'"~:':') .,,~BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS ' ' ' [] 4 STEELCLAD W/FIBERGLASS REINFORCED PLASTIC B. TANK ° , .... MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLE W/FRP (PrimaryTank) [] 9 BRONZE [] 10 GALVANIZED STEEL' [] 95 UNKNOWN [] 99 OTHER C. INTERIOR [] 5 GLASS LINING ~ 6 UNLINED [] 95 UNKNOWN [] 99 OTHER LINING ' IS LINING MATER~AL COMPATIBLE WITH loft'/. METHANOL ? YES__ NO__ - '-' I~''~' :'i* ' ' D. CORROSION [] ~ POLYETHYLENE WRAP ~ ',' [] 3 VINYL WRAP []', F.BERC~LASS RE,NFORCED PLASTIC PROTECTION r-'] 5 CATHODIC PROTECTION ~,,9~I,NONE ..... i.~i.,r---] g~ UNKNOWN" '[] ~9 OTHER j'" " 5 E, SPILL AND'OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) ~ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) IV. PIPING INFORMATION CIRCLE A IFABOVEGROUNDOR U IF UNDERGROUND, BOTHIF APPLICABLE . A. SYSTEM TYPE A U I SUCTION A U 2 PRESSURE 0 GRAVITY A U 99 OTHER B. CONSTRUCTION A _ 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER MATERIAL AND J~/"lJ~/1 BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A U 4 FIBERGLASS PiPE CORROSION A U 5 ALUMINUM 'A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION [] I AUTOMATIC LINE LEAK DETECTOR [] 2 LINE T~HTNESS TESTING [] 3 INTERSTITIAL [~J~THER MONITORING . . __ V. TANK LEAK DETECTION..~ [] e TANK TESTING [] 7 INTERSTITIAL MONITORING ~ [] 91 NONE [] 95 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION J 1. ESTIMATED D~/T~ L~/ST USED (MO/DAY. R) 2. ESTIMATED QUANTITY OF 3. WAS TANK FILLED WITH YES [] // o/ SUBSTANCEREMA,N,NG. --' GALLONS ',NE.TMATER,AL: THIS FORM HAS BEEN COMPLETED UNDER PENAL~ OF PERJURK AND TO THE BEST OF ~ KNOWLEDGE, IS TRUE AND CORRECT  APPLICANTS NAME I ,~ ~ .~') - ' COUN~ · JURISDICTION ~ FACILI~ ~ TANK ~ THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FORM B (7.91) FOROO34B-R5 ' ::~'~"':' :':''Note' AIl naJor aodiflcations require a r_=~'-_~_-... ,- : ..-')'?'~'::/ i ~".~ :;':.~':?i'-~..1--~' '" . the Permittinl AuthoritY, ....~_(' .... '.~:-~.~-.':'[~:.(':~L~A ::;~ ~/[;'(;~ ~:~ . ,~ruc~ froe Pernltting iuthortW Y ~;;_:~.. ~,..i~./;' .'.~, f ;~'Routine ~d requlre~ maln~enm~u .- .... . ;.-~.:..~Plpinz, and ~ni~orin~ ~';?~-->=--'~'.:'.::.' ............ .-- Replacenen~ of floc-restricting l~ak de~ec~ors sith acenent of dis~nsers, neters, or nozzles. :':';~;.4'~::~::~,~?:,: "'~. -~" Re atr/repl n~s,': or 'rep u: ~" -:~' ";'" ~;:;~':'~";;'¢~ ~ ~'~:?"? ~" '----~ ~a~iou of ball floa~ vary · .-. ' '. ;' . _ -,=___ .~. ~"'., ~'; ':'~ .... ., ;Include ~he da~e or each repa, r.y~- ~ .... . ;.... :....; .:: ~ ,~.=., .-~ .~.~.-.. :... "~ u~: &il re-airs ~ar'rePlacenents }n response to ale~ re,ire a ~:'r.<'' ~.'.. '.'';':'~: ' "' . Pernit ~O Construct fron the Pernittin~. Authority as do all .-.: . .?-. .' o~her nodificattons to ta~s, piping or Boni~orinf e~ipuen~ " ":':' not listed here, ' 4. Fu Chafes _ Allowed for Motor Vehicle Fuel tanks ~, .Lls~ all fuel storaEe chants In ta~s, noting: .. Date(s), t~ n~ber(s), new fuelis) stored 5. Inventory control aonitorin~ is -required for this per, it to Operate; and I have n~ot exceeded any reportable lllits as listed in the appropriate inventory control ,onitoring handbook during the last twelve aonths (if not applicable, disrezard). l$t~nature 6, Trend Analysis $US~ary ' ' ' Please attach Annual Trend Anal:si8 Summary for'~he last 12 periods,. ?~ -M~e~-C ~ 1-1 b~t-ib ~-~Ch'~ For- Please attach current, co,pleted Neter Calibration Check Eom i !:1,5"/' .. ' · ~-, ~, ~. .', :..~'[, ~: ,':.'' .'.: .... 'METER. CALI BRATI ON :: 'CHECK .!! I~ORM.:..ii,;.;:~?¥,',',,; .:~-,~'~ ' ' '~ ': ..... '"'~: ~ ~'~' '.,: :. ~.:: ...... '~.:"E ~:~ - :.~ ~., ,~-:..~z . -' . .~. *~' ~. ".-:~ ~¥~-~E'?.:~ .." ;..~'~/E~.,~,~:~ ~doL~~':~ ?":.:~-'~':'~ .;~ . 1. , All' ~eters ~ust huve callbretfon' checks, a"~lni~u~, of:.-tsice'~.year.', shich.n , :~: include checks done b~ the ~e~a~eut o~ ~eights and ~easures~.,~. :. .:,' ~. ~..'~:~.' . ''.' ~."~; Before 'starting calibration rubs, set :the~.callbrat~on.,caB ~ith .Prod~Ct~'~e -; w,...... ~'~.:-~un ~ ~allons ~ nozzle s~de o~eu iU~0~:~hS 'and~cu~c ... ~ : .,~. ' ' . '.C ' ": " .... "" :'~''. 4?{:~Run 5 gallOhs with the.nozzle one-half opeh'Urinto ' 'cubic inches dra~n, and return product to storage. :Q · ,..',,.. ~ '; 5'~""..After. all product for one calibration check, la '"'~.reSe~b P ' ' ?"' " ' ' -~ ...... : .... ~' to record the v°luse returned to storage",,, in. colu~n¥.~9 ,' of, the 'Invento~y ~ i-'7 ":-~-" ~. ,., Recording Sheet ..... · . .' .,~' ' . ~.~:,;~ .'::}~:~',~? 3,,,,~'7~~. ,'. · '~ 6.,' If the volume measured tn a B-gallon' calibration can".is'more, than 6.cu~tc Cinches above or belo~ the B-gallon mark., the meter' requires calibration b~ a . .~, registered device repairman. :, .. , . ..... 4,., .. ';"~,;~ ~: .i ;',~ ',~' '~,*., .. ,' , 'P i Hose or Tank #/ Fast Flow. Slow Flow Volume Returned Callbrat~ion 'Device RePairman 'Date of Date/TIm~~ ,, . - Used ;for !Calibration , Pump # prOduct] .5-Ballon Draft 5'Gallon Draft to S, toraRe Required?. ~'..:. Gals Cu. Inches. 6als'Cu, Inches{ Gallons Yes 'NO 'ii~'. : Calibration ~,. ,- ....... :. ,, ~ner;~.~ ~ ~ ~.°r Operator SignatUre... S~IB~IT A COPY OF TllIfi FORM ~TTII *- ANNUAL TREND ANALY$I$ !")~ TANK # TIME PERIOD: ';'" [ to $ UlVllVL%R Y to / :[: ~ QUARTER I TIME PERIOD: :::"i; PERIOD 1: Total Minuses This Period (Line 3) ~' H :;~':.' ' · '--' ' ~ ' J ' - ~ . ' · :.::. .. ~ ', ' PERIOD ~0: To~al Enu~es Thi~ Period (:lne ~) PERIOD 1~: To~al ~inuses This Period (Line 3) ~ :': ::: Action Number for 'this Period, (Line 4) .'.' Action N~ber for: this Period (Line 4) [ ~ ..... .' " . :' [~9_~b.~_ce n~y~i M-~a 4r-ue~eccurate-~L, NK FACI LI TY i~UNNUAL REPORT ~ve not da any laJor lodlflcattons to ~18 fac{1/t~ dur/n~ the ' ,..: ~}: :;::,J::~:,: ,:::::::':.:.'. . . the Pernttttn~ Authority. · . __ .-:- :<-.::~-,??,.:~,_=: .- , ... .. ' : . -..-. .:::,:-.. ~:' "::.:-:: ":':':(. :L C.j :I have done major aodtflca[ions ,f which I obtained Pemltls) to Pe~it to Construct S ":~":"""[" L.:.:' :..:-'--, :': .::Date ":? "-:':' ?% .... · .:.._:;: . "'::Re.air____ -- ___~d N~lnten~ce___ ___ ..... : ......":' :.-::: "::':' ?':: ::':": ' ..... :'" :: ~ '--"... '-~ .::-", . -'".- :. · ." < .... ;.. , . ..... 't .: ' . .:' , :-, ' :' : -.' Attach a s~a~ of all: ':j:'.:??:,.,:-:"-'" :'T.' ','-" '....:-"' '-":::: 3: ":.:':: ':' j:Y.?O' :: '>--Routine ..~d required iatntefi~ce"done to' this facility's 'Piping, 'and ~nltorin~ e~tp.ent.. ", '-.-: .:. '?':: ..... ~' ~ ':~. '-,:-'-..':::.c:.:x aepair of sub~erzed pumps or suction p~ps. .-... . :" ../?-.~;i<?.:::~. ?::::::/:::?::-- Repatr/replaceaen~ of diaperers, ~eters, or nozzles. ~. ::['~ ,: ::,::~:,:::::,.?~,:~::,~-:-e::':,'--.- Repair .of electronic leak detection components,., or rep ."" ~?'::' "':';"-"~:'":: -- Installation or repair of vapor recove~/v~nt lines. '<'" :., .... . ...... Include the date of each repair or ~atntenance activity..~ ."" ::. :,.::. ~- .... ~- ..- · N~' 111 rep~lr~ or replacements tn response to a le~ re.ire a .... "" Permit to Construct from the Permitting. iuthorit~ as do all other modifications to tanks, piping or monitoring equipment 4. Fuel Changes - Allowed for' Motor Vehicle Fuel tanks 0nly. : List all fuel storage changes in tanks, noting: , Date(s), tank number(s), new fuel(s) stored. .:.:::_::-~, 5. Inventory control monitoring is iequired for this facility on the Permlt to Operste, and I have not~ exceeded Shy reportable limits as listed in the appropriate inventory control monitoring handbook during the last twelve months (if not applicable, disregard). ; Signature Please attach Annual Trend Analysis Summary for '~he last '12 periods. :' :':'"':" ~,:L: M~ter-Ca,ttbra~ion-Check--~orm , Please attach current, coapleted Meter Calibration Check - , ...... ~ '..-:,..>.-'..'.-':';,?c' :"'.:"-.. "~,~",:,'."'-'..,'-' : : . ' ' '. ..... ' .' ,.. ;'~,,,.- .~;' ;-,.' ;..' :'.' '~t',.~,.O~;,../:~ ':.~ ...... r' .,,. '.'~, ' ':'- ' · '- I ' ' ~ .., ,' .4, (. ' , ' .,: · .~ .... ~. . . :~. -: ,, ,- · .,~z,.~S~..,~. , s .~ .~', .~.,i,~.~;f~t. ~t~' :.~-'~-.,- ; O;.,C~ '~;~ .' ., ' 4 J , - 1. All meters Bust have calibration check"::a' -infe~ "of"~wlce,~'aff'year':~ Which' include check8 done by the Department of Weights and Neaaureo. - 2. Before starttnf calibration runs. met 'the calibration can~ with product nd r~turn prodUct to storage. . .: .: ~,.. 3. Run 5 gallons with nozzle wide open into' the can j:}/ Notef'ghllon8 and cut~tc " Inches drawn, and return product to stsrase. ' ,'~" , ~, : 4. Run 5 fallon8 with the nozzle one-half open l~to 'the/'can.., Note gallon8 nd cubic inches drawn, and return product to storage. , , ,, ~,_ '~- After all product for one calibration check la returned to~' storage,, remem to record the volume returned to storage in column 9 ~or the InventOry -. Recording Sheet. 6. If the volume measured in a ~-iallon Calibration. can is'~to~e tflan 6 cut lc Inches above or belo~ the 5-1~11o~ ~irk, the aster requires calibration b~ relistered device repairm~n. · ..t. _ ,. , i Date/Tt~e lioae or Tank #/ l~ast Flow Slow ~low Volume .Re~u~ned,Gallb~a~lon Device man Da~e o~ ~ Pump * Product 5-Ga!Ion Draft 5-Oalloq Draft to Storage ReQuired? ........... Use~ _~qF._ ...... Calibration ~ . Gals;Cu. Inches Oals',Cu. Inchel Gallons .... Yes- -No~ Calibration · :~:.~ ,..~*~.~,~.~,. .' T~..;~ ' ~",' '[-' ."' .~ , ', COUNTY OI'"KERN · i "~: ,. ~j~:~?:~:..~ '""./.~. :,:....~ ' '~'..~';;)1116 East Cali~mia Avenue Bakersfield,9~ FILE ,_'ONTENTS INV,~ITONY ~Pegmit to abandonl NO'.' o[ Tanks ' ~endod Permit CondiUions ~Permit Application Form, ~ ~ Da te Date Date Tank Sheets, ~IoF 'Pl~s ._ ~ "~_ ~anks(s) Date~ Between Owner & Opersto'r ~ ' ' I-ICopy o~ Written Contract [:]lnspe;tion Reports [:]Correspondence - Received : -- Date Date "~ . Date ' ...... Dete ' ' ...... Date · 8Unautho~t~i4 Release Reports , , , AbAndonment/Closure Reports CheCkl Checkl Sst) Sampl lng/Lab Reports Compliance Check (Hew Conltr~;Ction Complienoe Check (Ne~ Construction Plan Check (Me~ Construction) Plan Check (Ney Construction) Plan Check (Existing Facility) Plan Cheok (.Bximti~ Facility) ~Permit Application Checklist Pe~mi~ lnstruc~iona ~Disca~ded Tightneil Tilt Relult.I --" I~Honitocing Well Construct(on Dsts/Perml~s [:]Bnviron~enta! Sensitivity Data: Groundw&tec Drilling Boring Logs Location of Water We;ls I']statement of Underground Conduits ~Plot Plan Featuring All Environmentally I-I Photos rlConscruct ion Drawings I-IHal£ sheet showing date received and ~]H'I scel laneous ' Da te ' ' Date m Sensitive Data Location: tally of i.nspection tim'd,--lc F~C I L I TY REPORT ! have not done mo~atlons to this facility the =~'~:?'~':~ Note: All major modifications re~lre a Permit to Construct-fro. ~<'" ':::.["::['"'~. I have· done major' aodlf~oations for-,htch I obtained Permit(s) to Attach a summary of all: ' ' -~ Routine and required maintenance 'done to thle facil~ty'e 'tank piping, and monitorin~ equipment. -- Repair of submerged pumps or suction pumps. -- Replacement of flou-restrictin~ leak detectors ~ith sane. -- Repair/replacement of dispensers, meters, or nozzles. -- Repair of electronic leak detection components, or replacement with sue. -.. *- Installation of ball float valves. -- Installation or repair of vapor recovery/v~nt l~nes. Include ~he date of each repalr or maintenance activity. NOTE: All repairs or replacements in response to a leak require a Permit to Construct from the Permitting. Authority as do other modifications to tanks, Piping or monitoring equipment ' not l~sted here. ' Fuel Changes - Allowed for Motor Vehicle Fuel tanks Only. List all fuel storage chan~es in tanks, notin$: Date(s), tank member(s)., new fuel(s) stored. 5. Inventory control monitorinz 18 required for this facility on the Permit to Operate, and I have no.t exceeded any reportable limits as listed in the appropriate inventory control monttOrtnf handbook during the last t~elve months (if ~o~applif~.ble, dlsre:ard~: · St~atur~ ..... 6' Trend~aly'i' sU~a~ ~ / ~_" i" Ple~e attach Annual Trend~n~l~8 Su~-ar¥ for the le8t 12 periods. ?. Meter Cal!bration _Check..~orm ........... ~sase attach current, completed Meter Calibration check Pbrn TANK FAC!L!T¥ A_NNUA.L REPORT :"~-' the Pe~lttinl Authority ..?r~: .- .,~.--.': ,,~ ....... :'~-~.. ~,,,,,.. .~. 2 I ~ve done ~Jor modifications for ~hlch I, obtained Pernlt{a) ~?,. '~'.~.:._..:~ ".'' ,Construct from Pernittin~ iuthorit~ '- - ' . . . ' :.~!~;~::::~:?/.::j'.': :.~.',- Routine an~ required lainten~ce .dOne to this facillW~s [ ~?...~" ~'~ -- Repair of sub. er~ed ~p. or auction ps. ps. .-- ,"~'~ -- Replacement of flo~-resCrlc~tn~ le~ detectors with -- Repair/replacement of dispensers, meters, or nozzles. .'."~'' -- Repair of electronic leak detection components, or -,.~:. -..:-_.-- .. with lee. - - :' ..... : ' -- Installation of'ball' float valve .,.,~ ' -- Installation or repair of vapor recovery/v~nt lines. Include the date of eachrepair or maintenance acttvlW. NOTE: All repairs or replacements in response to a leak require a Permit :to Construct free the Pereittin~. Authority aa do all other modifications to tanks, pipinE or eonttortnE equipment - not listed here. Fuel Changes - Allowed for Motor Vehicle Fuel tanks Only. List all fuel storaEe chanfes in tanks, noting: ~ ...... ..: "Date(s), tank number(s), new fuel(a) stored. Inventory control monitorial is required for this facility on the Perult to Operate, and I have not exceeded any reportable limits aB listed in the appropriate inventory control eonitorin~ handbook durlnE the last twelve months (If no~/~ppllp~ble, dlmreKard). St~natur .Trend Analysts Sussary ,. Please attach'~nnual Trend Analysis Summary for'~he last 12 periods. Meter Calibration Check Pore Pleaee-.attach~Current,~-coeploted. Meter Calibratton-Check-Form--~ ' ~:' '~ ...... ~'"' ' QUARTER 1 ...W~:" PERIOD ~NUAL ./" TREND ANALYS Total Minuses This Period (Line Action Number for this Period (Line 4) $ U~[IW.~RY PERIOD 2: PERIOD Total Minuses This Period (Line 3) Act'ion Number for this Period (Line 4) 37 Total'Minuses This Period (Line 3) Action Number for this Period (Line 4) ~'~ PERIOD 4: Total Minuses This Period (Line 3) PERIOD 5: Action Number.for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) PERIOD 6: Action Nusber for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) TIME PERIOD: /(~2- 2 to 't~? Total Minuses This Period (Line 3) Action Number for this Period (Line 4)' Total Minuses This Period (Line 3)' il 7 i I . - . -'u" * ';'~' '~'- QUARTER 3 PERIOD 7: PERIOD 8: PERIOD 9: QUARTER 4 TINg PERIOD: to PERIOD 10: Total Minuses This Period (Line 3) Action Nusber for this Period.(Line 4) PERIOD 11: Total Minuses This Period (Line, Action Number for this Period [Line 4) PERIOD 12: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) his ts a true .and accurate report. CAr-X 'TX CHECK Fa'; lilt : Note: - ":: .'~ .... .,.?. ?r-'~': .... ,:~ ' ;,:~;;. . ; · ].~ Ali meter~ must have calibration ch~cka a minimum o~ t~lce a ~ear,_ ~htch. may: ............. ..... ~.~: Before ~tartin~'calibration runs, '~et the calibration can ~ith product and ;~ return product~.to storage.. ' ' - 3.; ~un 5 EailOna~lth nozzle ~lde open into the can. ~ote ~allon~ and cubic, ~ inches dra~n, ~nd:return product to storage. 4. ~Run 5 gallons ~ith the nozzle one-half open 'into the can. Note. gallons and cubic Inches d~a~n, and return product to storage. 5. ~:After all product for one calibration check Is returned to storage, remember ~ to record the~. volume returned to storage In column 9 of the [~ventory ~.~Recording Sheet~, ·. 6. j~(lf the volume measured In a 5-gallon calibration can la more than 6 cubic inches above or below the 5-gallon mark, the meter requires calibration by a ~ registered device repairaan, Hose or Tank #/ · Fast Flow. Slow Flow Volume Returned Calibration Device Repairman !Date of Date/Time Pump -.# PrSduct 5-Gallon Draft 5-Gallon Draft to Storage Required? Us.e.d for Calibration !!, Gals Cu, .Inches Gals Cu, ,Inches Gallons Yes No Calibration' ,~' : -. . . .~ . :~ ~ . '' ~ " ~ I:" "~..' ~IETER': CALIBI?U~TI ON CHECK FOR~I 1. ~,~11' meters ~ust'. have .calibration cheeks ~ ~lnl~u~ of t~lce a year,, which may ' '-: :~lnclude checks ~one bF the Dep~rtment ~[ ~elghts and ~easures. Z.~Before st~rtlng,c~llbr~tlonL runs~: pet the.c~llbr~tlon can ~tth product and ~return product to storage. 3.;~Run 5 gallons ~th nozzle' ~]de open ~nto the can. Note gallons and cubic ~Jnches dra~n,~ ~nd.return product ~o storage. 4. ~Run 5 ga]Ions .~]th the nozzle one-halt open 1nfo the can. Note. gaJlons and ~cubJc inches dra~n, and return product to storage. .. 5'. ';iAEter a11 product for one calibration* check Is returned to storage. remember ,~to record the*~ volume returned to stora;e In column 9 of the i~ventory [Recording Sheet :~ 6. ~;~ the uoJu;e ;essured Jn a 5-gaJJon caJJbratJon can Js more than 6 cubic ~'~]nches above or~ belo~ the 5-gallon mark. the me,er requires calibration by a ?egistered device repair=an. Hose or Tank #/ Fast Flow- ' Slow Flow Volume Returned calibration Device Repairman Date of Date/Time Pump .# Prqduct 5-Gallon Draft 5-Oallon Draft . to Storage Required? U. se.d for' Ca~llbratlon ~' Gals! Cu. Inches Gals Cu. Inches Gallons Yes No Calibratio'n- ~ , : ~ '-- ..;:Y[,,- ~ . , ~ _ : ~NNUAL TREND A_N~I.Y$I$ SUI~[i~IARY PERIOD: ?frS? - I . PERIOD - to Total Mlnuses This Period (Llne 3) · 'QUARTER 1 ~' .. Actlon Nuaber for this Period (Line 4) ' :~"": PERIOD 2: Total Minuses This Period (Line 3) ~ ..... . Action N~ber for this Period (Line 4) .... ;. . .~gRIO~ 3: Iota1 ~inuses This ~er~od (Ltn~ 3} /¢ :%. $lgnature QUARTER 4 PERIOD 7: Total Minuses This Period (Line 3) Action Nuaber for this Per~od (Line 4) PBRIOD 8: Tota! Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) PERIOD 9: Total Minuses This Period (Line 3) Action Nueber for this Period (Line 4) TIl~ PERIOD: /~g~' / V tO PERIOD 10: Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) PERIOD 11: Total Minuses This Period (Line 3) Action. Musher for this Period (Line 4) PERIOD 12: Tots! Minuses This Period (Line 3) Action Number for this~Period (Line 4') ,.,~,, . .:a- Action Nuaber for this Period (Line 4) },'-:-J:,,',- P~IOD 4: Total Minuses This Period (Line 31 ' ":" ' PERIOD 5: Total Minuses This Perlod (Line 3) .~ ,' ~' PERIOD 6 Total Minuses This Period (Line 3) ~-" ..- lo'ion ~aber rot ghls Period (Line 4) 1700 Flower Street Bake'rsfield, California 93305 Teh ~hone (805) 861-3636 Don Pharos P. O. Bo:4 3~17 Leon M Hebertson, M.D. ENVIRONMENTAL HEALTH DIVISION ~ DIRECTOR OF ENVIRONMENTAL HEALTH /~7~~ Vernon S. Reichard April 16, !987 ., Bakersfzezc, California 9338c ';: .............. De-~r:~-Mr'":'-- ?'ha res< ................................................................................................................. After careful review of the repo~~~ory,v~z~ations at'your facility .oc=~a at e~, ...e~c~y S~,e_~_(perm.~OC~%C)~ ~::~= Depa=~men, This letter is to advise you tha,t you will be cranted a "mrovisionai exemption" from the standard reporting described in your mermlt packet. This Department is currently undert%king a study of the inventory _ _ ' . t= ~= a copy control urobiems of 'iow-throughout tan~s To faciii -~_ th!s~ of reconciiia~ion worksheets for tanks lis~ed on the attached outline must be sent to this Department monthly so that we may add this information to our data ·base. Please send ail submittals to my attention. Our preliminary i~=ormatlon indicates that = change ~n reportable variations is necessary.I when the throughput of a tank is less than 2,000 gallons Der week and less then iO~OCO cai!ohs Der month. The accompanying "'~cw-m%_~.=o~g:.~ ......... ~=:~:~ ~e~ing.. .-- ~ Outline" describes these chan~es. A revised action chart and an example of a changed summary sheet (on the back of ~ ...... ~ ' ~=ve also been enclosed for .=.,I .... o_ ; reco~.ci~ :etlon your convenience. ?!e.=-se make these changes on your worksheets for weeks in which you have iow. throughput. Be advised that this;~ov~s-'.onai~. .. ...... ~-~i,~:._<~o:.~ is subject to change as further data becomes available to the Health Department. =f, however, a listed tank at env time e~:ceeds tko defined iow-throughput amounts, you must revert to ccmpllance with the original reporting reculremerf%s. If you have any questions retard!nc this correspondence = can be reached at (o~o) 8611-3636 between 8 am - 9 a~. Sincerely: ., -- Mark J. Pishinsk:f ...~ ,_ o_.ne ..... ;-'_e a ! t n c' ~-' Hazardaus Materials Management DISTRICT OFFICES Lake Isabella Mojave Ridgecrest De!ano . Lamont Shafter Taft Low-Thr oughput Tank ReDo r t lng Ou t i i ne These amended permit requirements are only applicable to tank(s) ~nd~catea below when weekly throughput is less than 2000 gallons and mon~h!y throughput is less than 10,00©, gallons: '!-Facility Permit # 140005C i Tank # 1 , Recular ~ # 2 Diesel Tank # ~n.~a , n/~ .. Tank # n/a Amended ?ermlt Recuirements: 1. Revised inventory reconciliation monitoring worksheets are to be submitted to the Health Department on a monthly basis. 2. Revised Action Chart is to be posted at facility 3..Al!' variations evc=~i~-r ~rr ~-g the fo!iowinq amounts must be reported as described on page 16, Part "2" of Handbook #UT-10. DAILY - 75 gallons WEEKLY - !$0 gallons MONTHLY - 200 gallons TRE~D A?[ALYSES - No change "~ 1700 Flower Street . Bakersfield, California 93305 ~.'".: ~-~: ~:: Telephone (805);861-3636 .~7~.'' .~ .~-~':'.~: ": ~ ''-~.~' .' -" .~i-'~: .. ": ': -. · . .. ~ ':~?;~:UNDERGROUND~ ~ZA~OUS SUBSTANCES DEPARTMJ~' NEALTH OFFICER Leon M Hebertson, M.D. ENVIRONMENTAL HEALTH DIVISION . . : .-~: - :-:..-,*' . ",~:" * ': '. ::: '- : ~ - DIRECTOR OF ENVIRONMENTAL HEALTH ;OMPANY 'BROTHERS. ~321 ~ IN'YRS iSTANCE AL~.:INTERIM REQUIREMENTS ]THORITY..MUST.,~BE ME~.-:DURING ANSFERAB -':THE 'PERMIT.TING Kern County Healt~h Departmel'( ...... Permi~ ( Division ct Enviro~ental H~, Applicatio~t~ 1700 Flo~r Street, Bakersfield, ~ 93305 ~. " '~PLI~TION FOR PE~IT ~ OPE~TE ~E~R~ ~ ' ~~US SUBST~CES S~E FACILI~ T~ of Appli~c~tion (ch~k): ~Ne~ Facility ~dification'of Facility ~sti~ Facility ~ansfer of ~ership A. ~ergen~ 24-~ur Contact (n~e, area c~e, ~one): Nigh~ ~ of B~iness (check): ~'~line S~tion Is Tank(s) ~cat~ on ~ Agricultural Fa~? Is Tank(s) Us~ Pri~rily for ~ricultural ~r~ses? ~Yes T . ~:~' R SEC (R~al ~ations ~ly) ~il ~aracteristtcs' at Facility {) ~0~ ~sis for Soil ~ a~ Gro~ter ~p~ ~teminatio~ ~~'O(m~ ...... C. Contractor Pro~s~ ~rti~ ~te pro~s~ C~pleti~ ~rker's C~~ti~ Certification ~ I~urer Pro~ .... Tank(s) Store (check all that apply)-- Tank ! l~aste Product Motor Vehicle Unleaded ~ premi,~ Diesel Waste Chemical C~mposition of Materials Stored (not necessary for motor vehicle fu~ls) Tank % Chemical Stored (non-co~nercial name) CAS ! (if kno~) Chemical Previously Stored (if 'differS'hr) Transfer of OWnership Date of ~-~nsfer Previous Facility Name I, modify or terminate the Previous Owner accept "fully all o6fi-gattons Of permit No. issued to · I understand that the Pemitttrg' Authority may review and transfer of the permit · to Operate this t~derground storage facility_u_pon receiving this ccmp.leted form. This form has: been completed under penalty of true and correct. Sig na~tur, e "~ ~. perjury and to the best of my knowledge is Facility Name %~ ~_j ~r TANK ~ (FILL OUT SEPARATE FORM E~H TANK) ~ FOR EACH SECTION, CHECK ALI. APPROPRIATE BOXES H.1. Tank is: [-]Vault~ [']Non-Vaulted []Double-Wall ~lngle-Wall 2. ~ MateriaI  Carbon Steel I~Stainless Steel []Polyvinyl Chloride ['~Fiberglass-Clad Steel Fiberglass-Reinforced Plastic [] Concrete [~ Altluin~ml [] Bronze ['lUnknow~ Other (describe) 3. Primary Containment - A Date Installed Thickness (Inches) Capacity (Gallons) Manufacturer []Double-Wall •Synthetic Liner •Lined Vault ~one •Unkno~a~ ~]Other (describe): Manufacturer: :: ~lM~'terial ' Thickness (Inches) Capacity (Gals.) 5. Tank Interior Lining I. ---~Rubb~r "OAlkyd ~Epoxy []Phenolic •Glass []Clay [3%l~lil~d ~~ ~ic Proration: ~ne ~pres~ ~rent S~t~ ~cr'ifici~ ~ ~"' 7. Leak ~t~tion, ~nitori~, a~ Interception .... · ~ ~:"~ ~Vi~l (vaUit~~ o~y) ~Gro~ter ~itori~ ~(s) ~V~ose Z~ ~ftori~ ~ll(s) ~~ Wi~ut ~ner' ~1 L~lquid Betrieval & Inspection Fr~n U-Tube,_Monitoring Well or Am~lar S~ace ~aily Gauqinq & Inventory Reconciliation Iq Periodic T~h~ness Testin~ [] None [] ~nknown [] Other b. Piping, Flow-Restrictirg Leak Detector(s) for Pressurized Piping'. [] Monitorir~ ~p with ~ace~y [] Sealed Concrete Race~y · [3Half-Cut Compatible Pipe Raceway []Synthetic Liner Ra~y ~tmknown ~ O~her · Describe Make & en Tightness Tested? '~Date of Last Tightness Test Results of Test Test Name Testing Company 9. Tank Repair · ~]f4o~[] ' Tank Repa~ed? []Yes Unknown Date(s) of Repair(s) Describe Repairs 10. Overfill Protection ~f~ator Fills, Controls, & visually Monitors Level. []']Tape Float Gauge []Float Vent Valves [] Auto Shut- Off controls  Capacitance sensor ~sealed Fill Box ~None []Unknown Other: List Make & Model For Above Devices a. Underground Piping: ~Yes U1No []Unknown Material Thickness (inches) ~;~'~zjDi~meterf/NF~,~m,~3Manufacturer [3Pressure [3Suction [3Gravity Approximate Length of Pipe b. Underground Pipir~ Corrosion Protection : . · 9 1nknYethylene Wrap E]Electrical Isolation []Vinyl Wrap' []Tar or Asphalt own []None rTother (describe): c. Underground Pipirg, Secondary Containment: I-3DOuble-Wall [3Synthetic Liner System rTNone [3Other (describe): TANK ~ (FILL OUT SEPARATE FORM L~d TANK) FOR EACH SECTION, CHECK ~r.r. APPROPRIATE BOXES H. 1. Tank is: [~Vault~d [']Non-Vaulted [~Double-Wall le-Wall 2. ~ Material --~Carbon Steel ~mstainless Steel [']~olyvinyl Chloride l,iFiberglass-Clad Steel Fiberglass-Reinforced Plastic []Concrete [~]Al~in~n ~Bronze Other (describe) 3. Primary Containment Date Installed Thickness (Inches) Capacity (Gallons) ....... :-'"' -~. Tank Seconaary Contair~.ent ...... ~'" ....... [-~Double-Wall []Synthetic Liner ~Lined Vault mother (describe): ~. ~]Material Thickness (Inches) 5. Tank Interior Lining '..i. --ORubber mAlkyd []Epoxy []Phenolic mGlass , ....... ~' mother (describe): Manufacturer ............. [~ne I-I Unkno~ Manu'facturer: Capacity (Gals.) [][]Clay []Urllinad ~ Tank Corrosion ProtectiOn . . ...... · nTar or Asphalt [~kno~ [-lNone [-]Other (descrihe): ' Cathodic Prot~tion: ~ne ~es~ ~rent S~t~ ~crifiCial Describe'. System & EClUilznent: __Leak. Detect~on, Monitoring, .and__ Interce a. Tank: ~Visual (vaulted tanks only) ~]Groundwater Monitorir~' Well(s) [~]Vadose Zone Monitorir~ Well(s) ['~U-Tube Without Liner F.]~U-Tube with Ccmpatible Liner Directing Flow to Monitorin~ Well(s)* va~or Detector* m Liquid Level Sensors ~ Conductivit~ Sensor' " '~':~ [] Pressure Sensor in Annular Spac~ of Double Wall Tank . . '"::i:. ~l'Liquid l~trieval & Inspection Fr~m U-Tube, Monitoring Well or Annular Spac~ ~i1¥ Gauging & Inventory .Reconciliation [~Periedic Tightness Testing [-1 None [] t~kno~ [] Other b. Piping: Flow-Restricting Leak Detector(s) for Pressurized Piping' ~Monitorin~ S~up with Race~y [[]Sealed Concrete Rece~y []Half-Cut Compatible Pipe Race~a¥ [[]Synthetic Liner Race,my I-INca [~'r~,no~m mother *Describe Make & Model: 8. ~en ' Tightness Tested? EYes reno ~o~n Date of Last'Tightness Test Test Name Results of Test Testing Ccmpany ml Auto Shut- off Controls []None mu.kno~ List Make a ~odel For Above Devices 9. Tank ~ ~Repaired? mYes ~No--"'[]unknown Date(s) of Repair(s) Describe Repairs 10. Overfi~ll Protection ~Sperator Fills, Controls, & Visually Monitors Level []Tape Float Gau~e mFloat vent Valves B capacitance sensor []sealed Fill Box Other: I1. Piping a. ~nderground Piping: ~ []NO ~Unknown Material Thickness (inches) ~//l/~:~f~/cDiameter¢~'~/,~glanufacturer []Pressure l.lSuction []Gravity Approximate Length of Pipe b. Underground Piping Corrosion Protection -. , [] Ga I'QXn'i~Z~d [~ ~[-] Fi be-fg Ia~ss~cl ad ..... [~Impressed-cAi~ rer~t--~[] ga-cfi f f6'fal [']Polyethylene Wrap [-]Electrical Isolation [2]Vinyl Wrap [~Tar or Asphalt ~nk~o~! []None []Other (describe): c. Underground PiPirg, Secondary Contair~nent: , Q']Double-Wall. [~Synthetic Liner System []None []Other (describe): ( TANK ~ (FILL OUT SEP~TE FO~ ~ T~K) ~R ~ SE~I~, ~ECK ~L~. ~PROP~IATE ~XES H. 1. Tank is: ~Vaul't~ ~VaUlt~ ~uble~all ~Si~l~all 2. ~ ~terial  Car~n Stol ~S~inless Steel ~l~inyl C~oride ~Fi~rglass~l~ S~i : Fi~rglass-Reinforc~ Plastic ~ Concrete ~ ~in~ ~ Sron~ O~er (de~ri~) 3. Pri~ry~, Contai~nt ~te Ins~ll~ ~ic~ess (Inches) Ca.city (~11o~) ~ufacturer ._ , .. ~~ ~~ ~ · .... ...... ~.,~,~... . .., 7. L~k ~t~tio~, ~ttori~, a~ Interce~ion ~Vadose Z~ ~itori~ ~ll(s) ~~ ~i~ut ~U-~ ~i~ C~tible Liar Dir~ti~ Flo~ ~ ~nltori~ ~l(s)* .- ~Va~t ~t~tor* ~ ~id ~el ~rs ~ C~tivi~ ~r' ..... '" ~ Li~id ~tri~al i Ins~c~ion ~ U-~, ~nitori~ ~11 ~ ~~ ~ :. b. Pipit: Fl~estricti~ ~ak ~t~tor(s) for Pre~i~ P ~ ~nitori~ ~p ~ ~ce~y ~ ~al~ ~re~ ,~o~ ~ri~ m~ i ~el: 8. ~ ~te of ~ Tigh~ Test Resul~ of ~ ' '~'. Test ~e ~sti~ ~y 9. ... ~(s) of ~lr(~) " --. 10. ~erfi~I Pro~ction -- ~rator ~ills, C~trols, & Vis~lly ~nitors ~vel ~Ta~ Fl~t ~e ~Fi~t Vent Valv~ ~Auto ~hut- Off controls O~r: List ~ ~ ~al ~ &. Umierground Piping: UlYes UINo ~--'~wn Material Thickne~ (i~hes) Dieter ~nufacturer ~essure ~tion .~Gravity ~roxi~te b. U~ergro~ pipi~ Corros~ -~lv~niZ~ "~Fi~rglaSs~l~ ~ess~ ~ren~ .... ~rfficiai"-~-~'~ .............. ~p~ye~yle~ wrap ~El~trical I~latim ~viny1 wr~ ~Tar or ~o~ ~None ~er (~ri~): c. U~ergro~ Pipit, Seco~ary ConCai~nt: ~1~11 ~~etic Liner ~Other (de~ri~): Facility. B.S.,..&'E'. CO., INC. PERMIT CttECKI, IST Permit # .140005C This checklist is provided 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 · : .Check: [ ~. .... '.. Operator), Chapter 15 (KCOC #G-3941), Explanation of Substance .TCodes, :'. ' .?~' '; "" Equipment Lists and Return Envelope. : < t.:-...~.:.:~.:h~:~..~.. ...... / X .. 2) Standard Inventory Control Monitoring Handbook #UT-10 ;.X ~) The:Following Forms: ' .. a) ~nventory Recording Sheet ...... ' b) ~nventory Reconciliation Sheet with summary on reverse c) Trend Analysis Worksheet '-- X 4) An Action Chart (to post at facility) : ' " - ! . . - · · . ..'.. ~.:. - _,::, ~...di.~..l,~,::v:.~.. -..' .-: . X B. I have examined the information on ny Interim Permit, Phase I..~onitoring SEE BACK 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 descr'ibed on page 6 Of Handbook): X 1) Acceptable gauging instrument -%- ~ 2) "Striker plate(s)" in tank(s) X ~) Water-finding paste ~-'X D. I have read the information on the enclosed "Information Sheet". pertaining to -SEE BACK 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 al!. tanks at this facility (if tanks are identical, one chart will suffice; label chart(s) with'-corresponding tank nffmbers 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 80 days and were calibrated by a registered device! repairman ~f 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 was started at this facility in accordance with procedures described in Handbook #UT-10. Signature of Person Completing Checklist: "~-'x ~a~ Title: President" ~ ., , Date: CORRECTIONS TO BE MADE ON PERMIT 1. OWNER OF TANKS IS B. So & E. CO., INC. · :ches~ 2 9 --4 .- ............... - ........ 2'4 5 33 6 43 7 54 8 ~ 66 9 78 0 '~ 90 ! 103 '- '2 ............... - ................... 3 131 .4 ~- 145 '5 159 6 174 7 188 8 ~ 203 9 218 9 233 .. I 248 2. 264 3 280 ~ 296 5 311 $ 326 7 341 3 357 ) 371 ] 386 L 400 ~ 414 ] 428 ~ 442 ~ 456 ) 468 ~ 480 ~ 492 '-) 504 ) 514 L 524 ? 532 ) 540 + 546 } 551 ~AL:'-'~.~{)N'-CI{AR? iO00 / 2000 / 2500 Call. ohs 11on // G ,11o,,s S -"--"3- 6 7 15 15 18 2o 27 32 34 36 ' :---: .... -'- = --- 41 '. ...... - 41 ':' .... -':':--":?-::::5 2 .............. :-~--:'::57 57 · 53 72 78 75 75 94 110 95 84 118 126 115 10,5 143 157 137 137 170 205 '159 158 '199 236 75% x 158 3000 Gallons 7'5~ x 209 4000 Gallons 182 179 228 267. ': ,' 354 ~.06...................... 20'0'-': ...... :"=-259 "'-~-""--:':':+-299 ............ 230 232 290 346 255 .255 ' -323 " 378 281 284 .357 425 114 1.46 187 2O8 271 -' ,.. 312 391 472 "I~"605 426 504 667 462 551 730 499 598 792 536 630 834 574 677 ??-.::'897 612 724 "959 650 771 1022 688 819 1084 726 866 1147 765 913 '1210 80~ 960 1272 843 1023 1356 883 1086 1418 923 1118 1481 963 1165 1543 1003 1.212 1606 1044 1275 '1689 1085 1323 1752 1127 1370 1815 1169 1417 1~77 1212 1480 1961 1255 1527 ~ 2023 1290 1575 2086 1341 1622 2148 1388 1669 2211 1425 1732 2294 1425 1779 2357 1507 1827 2420 1547 1874 2482 307 306 333 338 361 369 389 400 417 422 446 453 476 485 507 517 537 548 567 580 595 612 623 644 651 685 678 717 704 749 730 781 756 812 780 855 804 886 828 917 850 950 872 992 893 ,1023 913 1055 932 108~ 949 1118 964 1161 977 1192 988 1224 996 1255 1002 Puml~ - Mete,, - Reels - Oayco Ho~e - Alemite Lube Equipment - Kamlok Quick Couplings. Red Jacket Pumps 2130 G Street, Bake[.,~fleld, CA 93301 ~/ (80S) 326 3970 ' R E C E I UNDERGROUND TIONNAIRE AUG ~ 1991 A,. ............ /1~ FACILITY/SITE NeW, TANKS ! D~ OR,ACI.TY NAME ' ~.s. ~ ~. co., ADDRE~ 405-417 NAME OF OPERATOR NEARF~ CROSS STEEET INYO PARCEL N~.(OPT1ONAL) CITY NAME.BAKER~ F~IELD ~' BOX TO INDICATE TYPE OF BUSlNF. SS STATE ZIP CODE CA. PARTNERSHIP C~ {~COUHTYAGENCY {~] STATE AGENCY (~FEDERALAGENCY GAS STATION KEEN COUNTY PERMIT / ~.,^RM EEl' 140005C-91 q'/C~9 EMERGENCY C¢ DAYS: ~ME (LAS[ FI~ GOON. JOHN N~H~: NAME (~. FIR~ GOON, JOHN II. PROPERTY OWNER INF( NAME ~0UTHERN PACIFIC TRANS~ MAILING OR STREET ADDRESS FILE 61855 P.O. CiTY NAME SANFRANCISCO III. TANKOWNER NAME INC. MAILING OR ST;~EET ADDRESS 6319 DISTRICT BLVD. CODE 322-7035 CODE ;055 60000 N (MUST BE COMPLETED) CITY NAME BAKERSFIELD EMERGENCY CONTACT PERSON (SECONDAR~ optional DAYS: NAME (LAST, FIRST) NtGHT$: NAME (LAST. RRSl~ PHONE No. WITH AREA CODE PHONE No. WITH AREA CODE COMPLETED) CARE OF ADDRF.~ INFORMATION CARE OF ADDRESS ~ LOCAL AGENCY ~ STATE AGENCY PARTNERS ~ COUNTY AGENCY (~ FEDERAL AGENCY PHONE NO. WITH AREA CODE i0-1855 (415) 541-1229 or 541-1136 ~' BOX [~ [~ LOCAL AGENCY [;~ STATE AGENCY TO INDICATE [~ PARmERSNI. F'~ COUN~ AGENCY OFEDE~L AGENCY 'X CgRPO~TION' ~ ~A~ ZIPCODE I ~ONE No. W~ AR~ CODE CA I 93313 ~ (805) 834-2700 I OWNER'S DATE VOLUME PRODUCT TANK No. INSTALLED STORED * _EEQIZL~{ 1.976 ? 2,000 GAL. REGULAR * DIESEL ~ 2,000 GAL. _ DIESEL * WASTE OIL UNKNOWN 500-550- ~ WASTE OIL WE IDENTIFY OUR TANKS BY PRODUCT INSTEAD OF NUMBER DO YOU HAVE FINANCIAL RESPONSIBILITY? YIN TYPE IN SERVICE ~)! N ¥/N .. , Fill one segmen~ut for each tank, unless' ~ tanks and piping are ~% constructed of ~ same materials,, style af~'type, then only fill ~' one segment out. please identify tanks by owner ID ~. I. TANK DESCRI~ON COMPL~ ALL I~S - SP~I~ IF UNKNO~ A. OWNER'S TANK t D. ~ . ~G~ ~D DIESEL ~ ~UF~R~ aY: ~KNO~ C. OAS INSTALLED (M~AY~R) gEE F~RST PAGE ' m T~K ~ IN ~ONS: 2 ~ 000 EA. Ill. TANK CONSTRUCTION MARKONEI~MONLYIN~XES~B. ANOC,~OA~ATAP~IESINBOXD A. TYPE OF [] 1 DOUBLE WALL SYSTEM [] 2 SINGLE WALL [] 3 SINGLE WALl. WITH EXTERIOR LINER [] 95 UNKNOWN [] 4. SECONDARY CONTAINMENT (VAULTED TANt0 [] 99 OTHER B. TANK [] i BARE STEEL MATERIAL [] 5 CONCRETE (PrimaryTank) [] g BRONZE [] 2 STAINLESS STEEL [] :3 I=IBERGLASS [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] lO GALVANIZED STEEL [] g~ UNKNOWN ] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC ] 8 100% METHANOL COMPATIBLEW/FRP ] 9~ OTHER [] 1 RUBBER LINED ~F~ 2 ALK'YO LINING ~["-'] 3 EPOXY LINING c. INTERIOR [] 5 ~ LINING ~l-'-I 6 UNLINED ~ g~ UNKNOWN UNiNG IS UNING MATERIAL COMPATIBLE WITH I~O'X. METHANOL ? Y'E$_ NO__ ] 4 PHENOLIC LINING [] 99 OTHER O. CORROSION [:~ I POLYETHYLENE WRAP [] 2 COATING PROTECT]ON [] 5 CATHODIC PROTECTION [] 91 NONE 'E~ 3 VINYL WR/~ .. [] 4 FIBERGLASS REINFORCED PLASTIC []~ ~wN -[] . OTHER IV. PIPING INFORMATION C,RC~ A IFASOVEGROUNDOR U IFUNOERGROUNO, BOTH IF APPLICABLE A. SYSTEMTYPE A~_~) 1 SUCTION PRESSURE A U 3 GRAVITY A U g~ OTHER B. CONSTRUCTION A U 1 SINGLE WALL A U 2 DOURLE WALL A U 3 LINED TRENCH A(.~.) 95 UNKNOWN A IJ 99 OTHER C. MATERIAL AND CORROSION PROTECTION A U ! BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A U 4 FIBERGLASS PiPE A U 5 ALUMINUM .~ U 6 CONCRETE .~ U 7 STEEL WI COATING A U 8 100% MEl%.IANOL COMPA'FIBLEW/FRP A U 9 GALVANIZED STEEL A tJ 10 CATHODtC PROTECTIQN A~95 UNKNOWN A U 99 OTHER D. LEAK DETECTION [] 1 AUTOMATIC LiNE LEAK DETECTOR [] 2 LINE~ESST~STING [] 3 INTERSTrFIAL MONITORING [] 9~ OTHER V. TANK LEAK DETECTION I[] , viSUAL CHECK [] 2 IN NTO RECO.ClL TIO. [] V 'O. MONITORING [] · TO. ATIOTAN GAUGING [] GROUNDWA R.ON.OR,NG F-! TANK TES.NG [] , ,. .ST,TIALMON,TORING [] ,, [] -- UN wN [] oTHER I. TANK D ESCRIPTION COMaLE~ ALL ~TE~S - SPEC~ ~F UNKNOW. A. OWNER'S TANK L O. # B. MANUFACIIJRED BY: [4A RTV. OTT, l_ _fl~T~N (3t,fl',I C. DA~ iNSTALLED(MO/DAY'EAR) ~ FIRST PAGE O. T~K C~ IN ~ONS: ~_~O OUESs II1. TANK CONSTRUCTION ~A.~ ON~ ~M ONL~ IN aO~S ~ a. AN~ C. ~D~LL~T AP~ES ~N aOX 0 A. TYPE OF [] 1 DOUBLE WALL SYSTEM .~ 2 SINGLE WALL [] 3 SINGLE WALL WITH EX~RIOR LiNEn [] g5 UNKNOWN [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER B. TANK [] 1 SASE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM (PrimaryTank) [] g SRONZE [] 10 GALVANIZED STEEL [] 9.5 UNKNOWN [] 4 STEEL CLAD W! FIBERGLASS REINFORCED PLASTIC ] S 100% METHANOL COMpATIGLEW/FRP ] ~ OTHER r~ 1 RUSSE. LINED ]-~ 2 ALKYD LINING ~ 3 EPOXY UNING INTERIOR C. ~'~ 5 GLASS LINING r'~ 6 UNLINED UNING IS UNING MATERIAL ~MPATIB~ ~ 1~ M~OL ? ] 4 PHENOLIC LINING ] 9~ OTHER 'D. CORROSION [] , POLYETHYLENE WRAP [] 2 COATING PROTECTION ~ 5 CATHODIC PROTECTION [] gl NONE ] 3 VINYL WRN ~'~g5 UNKNOWN ] 4 FIBERGLASS REINFORCED PLASTIC ] 99 OTHER IV. PIPING INFORMATION C~.c~E A IFAEIOVEGROUNOOR U IFUNOERGROUNO, BOTH IF APPUCABLE A. SYSTEM TYPE A U i SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER NO PIPING B. CONSTRUCTION ' A U 1 SINGLE WALL ~ U 2 DOUBLE WALL & U 3 LINED TRENCH ~ U 95 UNKNOWN ~, U 9g OTHER MATERIAL AND CORROSION PROTECTION D. LEAK DETECTION A U ~ SARE STEEL A U 2 STAINLESS sTEEL A U 3 POLYVINYL CHLORIDE (PVC)A U 4 FIBERGLASS PIPE A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COATING A U 8 100% METHANOL COMPATISLEW/FRP A U g GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U g5 UNKNOWN A U 99 OTHER [] I AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTITIAL MONITORING [] 99 OTHER V. TANK LEAK DETECTION