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UNDERGROUND TANK FILE 6
Op rat rmit t Underground Hazardous Materials Storage Facility' '::::.... : .D ................. :.. '..~....J .... ~:::.':.'~':.: ...:":...::' ...'.':. :.. HAZARDOUS MATERIALS DIVISION COUN~ OF KERN 1715 Chester Ave., 3rd Floor GENERAL SERVICES GAUGE Bakersfield, CA 93301 230 INYO STREET (805) 326-3979 BAKERSFIELD, CA 93305 ~ppro~d b~: 12-22-0~ 12-22-08 TOTAL ' READIN~ itETERF. O. · AO.IIISf~tE'I~ · 10 '~ ,' 11 . ' i~ '~3 ' 14 ,'15 ~6 17 ,, 18.' 19 ~AUGXNG - , OAUGI'NG ' DELIV'gRED WATER "I~NTORY. TOTAL BETERBD AItOUNT 'P~CENT Is'BGAT~VE POsTi~E '. BEFORE · -'" ~TER .. .' INVENTOR~'~ ' ~U~IEG , REDI)CT[ON :' ' I'HROUG~UT. ' OVER OR S VARI6TION .COUNT COUp[ . DELIVERY · BZl 1VERY. ' ..... ', ~716~¢AH 3 13 3/8 2~t.2 908I? xx~xxxxxxx . ~x:ix~xxxx*xxxxxxix xxxxx~xxxxxxxxxx~xxxxxxxxxxxxxxxxxxxxx~x xxxxxxxxx. 161 2 - t't ',-2. Xxxx-~xxxxf xxxxxkxxxx×x×xxxxY, x xxxxxxxxRxxxxxXxxz','x×xxx~xxxx~xxxxxxxxxx x~xkxxxxk- · ::~. ' '"' ' ' ~ t ', '~ t~. . , .... ' : ' .65 ' ' ' ' ' - ,:.j '~ - '~ ', - ' l~ · 27 ¢ , ', , . .r. 9¢'7 889 · 8~5 ' 916V0. '95 36' 1 ': XXXXXXXXXX xxxxxxxxxxxX~o/xxxxx'! ~xx.xkx'xxxxgxxxxxxxxxxxxxxxxx~xxx'x:~x::xxkx xxx~xxxxx. I N YO .~f..:~-l-IR E I!!'~-'1 ...... I'"AN t,{ "1 L~ ~' 3 7 CAPACITY"," ' ~0~ 00~ GAL. , PRO?UCT 121 13. '.., 14 r 16 NOVEI~BER i995 ,., 02/600Mt ' ' 6 64 '- 04/700A1~ ~ 63 05/'IO0A~ J 62, 7~8 06/600A1'I · 2*62 7/~ 6971 6905' 6771 " 6754 ..6754 ' 6905 6771 .' 6754" 6754 6653 ,~68090' 168224 . 168232 ".168234 168280 168006 168090 168224 168232 ' . 84. - ' .134 * 2 46 1'34 ' 1'7; '0 101 1~'4 46 " 0 · =9 · O: 0 ! 0 ll/600Mt ·, 12/600M,'1 ' l~3/600,ajt . 14/530A~i 1'59 5,'*8 : 6313 2 59 .?/8 . 6347 3.59 1/4 ' 6261 .63/3 ,6347 6261, ' "6124 168592 168592 168679 ~68812' 168578 .1~0592 168592 168699' 14 87 133 ' 0 · 0 0 0 0 0 0 xxXxxxxxx ~ 86 .137 ' 14 0 lB'/ 1,33 '. 34 -4 ' -47 .0 20/600Alt 21/6OOAPK. 2 85 i/'2 ' 5'145 3 54 5/8' *' 562'5 ' 5486 169~93: wEEK 3 TOTALS '. 169154 169271. XXXgXXXXXX -XXXXXXXXXX~XXXXXXXX XXxxxxxxxXXXXXX~X~XXXXXXXXXXXXXXY, xXxxKXX XXXXXXXXX 0 0 - 139 .638 . 122 -17 -5'7 0 1 29/600A~, 30/6OOAM WEEK4 TO~ALS · ': 5226 '' 169650 '5~40 : '~69699 .L696~0 xxxxxxxxxx', xxxxxxxxxxxxxxxxxx~' xxxxxxlxxxxixxxxxxxxxxXXxxxxxxxxxxxxXXxx' xxxxXxxxx 90 ,0 ¥. 0 ' 0 '. · 90 49 DATE , TOTAL . ~EADING ' NETERED* ADJUSTt~N * -. SALES' 10. ~, C-:AUCING ', eEeoas~ · D~LIVERY" 11 * DELIVERY.. 'ri2. '13 , .:.' , 14 ',' '" 15 '16' 17 18' 19' '0~LIVEP"gD~ 'HATE~ INVEgTORY TOTAL HETERED AHOUNT .PERCENT NEGATIVE POSTIVE . ~v~ros~, ~AUO~ , REDOCTXO~ T~OUO~U? OYES,OS S VA~XAT~OW cover. COU~T. 06/530~ 6,79 2/4 8870 09/~30A~ ~ 7 79 3/8 ' 8827 8827 16'6389 "8827166389 ~EK 1 TOTALS 166329 . 60 .' ' 0 '"*'. " 0 ', 0 . : 43 ".166309' "i ' 0" -0, ' '0 0 ' 0 x~xxxxxxx: xx~xxx~xxxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxx~xx.x;axxxxxxxxxxxxx xxxxxxxxx . ' · 36'e. 60. 17 --3. 3711, WEEK 2 TOTALS 8361 8331 1668~4 8331'' -' 8255 *.' 166672 *' ' xxxxxXXxxx· kxxXXXxxxxXXxxXXXXx, xxxxxx~xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx :~xxxxxxxx ~6~eo~': "' :o '; ' ; o '' o - 'o' ':-' '' ''166804 '.. :" ,' 68 ~0 '0. '-'' 0 0 36 ' , O' ' ;'~o 76- ' .:, .' .68 -8. 1 0 I .'. ' 0.. ,, R2/600AN ' I ~3 ~'' . R3/630A~ 2 72.l/2 ': '24/600AM 3.91' 5/8 25/60OAti 4 70 1/4. ' '807]r '8009 '"-J671.1:7 8009 , '7899' ,167217 7899 '7725. .167334 ~725'· -7661.: 167399 ,.1671}4 . 167117 ,. 167217 , 167334 ', 65 0 0 0 0 0 . 62 0 0 .' · 110 0 · '. 174 · 0 · , 64 · 3: .100 -10 · , 117 ' -57 65 '0 ' 2 67.7/8 9418' 9303 167747 167621 i26 0 115 126 11 TOTALS . ~X,vJ~ XXXXX* ' xx~ xxxxxxXXXXxxxxxx xxxxxxxxxx.xxxxxxxxxxxxxx.{xxxxxxxxxxxxxxx .xxXXXxxxx, , ' 427 343 ' ' -84, . '24'-491 '0,' F U E.L_ '1 o. INYO. STREET- OQTOBBI~ 199,5 rANK #1 1995 80 60 40 20 0 .20 -40 -,60 --80 -100 2 2 4 6 8 10 12 4 16 18 20. 22 24 26 28 50 ·'SALES. ·¸9- l0 DELIVERY' It , "GAUGING 'DELIVERED ' WATER II~IENTORY · ~' 06/5302~ 07/530AN 664 1/8 1838 7 89 3/4 ,'- 1722 1~57 W~KK I TOTALS · , 89280 ' ~9357 · 'xxT, xx~xxx' 77. , '0 0 ' , 0 0' .- ' 0'. .. .0 . '~, 0 xXxXx}D[xixxxxxxxXxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxx ' '280 309'' ~9~ 9.39~ 4 3.' 15/530A~ ~ 46 1/8 2'46 3/8 :'1295' .. t303 WEEK'2 TOTALS 1303 '~' 89792 1198 89866 · x~,xxxxxxxx 89772' , 89772 ' xxx~xxXXxxxxxxxxxxx xxxx~xxxxxxxxXxxxxxxxxxxxxxxxxxxxxxxxxxxx ' xxxkixxxx 0 0 105 : 94 ,22/600AN I 37 '3/4 101 ~' 966 23/6302N 2 36 3/8 966 ' 868 , · . 24/6002N. 3 33 1~2 868 . 792' ,. 25/600AN 4 '31 l/4 ~92 745 ' 90109 '90216 90275, 90322 90059''' '., 90t09 90216 90275 ': 50 109 59 47 , '0 47 · 98 76 '47 · 50 · 3 107' .9 ' 59 ' -17 47 0 '*1 30/600Mt' 514 '~0452 : 91 · 0 0 · · xXxxxxxxxx xXXxxXXXxxxxx~x~xx xxxxxxxxxxxxxxxxxxxxxxXXxxxxxxxxxxxxl~xxx xxxx~xxxx ,.. -3 -1.855 RECEIVED D' BSEL'5o t 095 NYO STREET DIESEL... TANK OCTOBER 1995 4.0 30. 20 1¸0 -40 2' 2 4 6 8 .1'0 12 14 16 18 20 22 24 26 28 30 }:~akersfJeld Fire Department Hazav. dous MaterJ. als Division 2i0~[ "H" Street [$aKers'.t:field, CA. 93301 REGARDING: FacJlit. y: County of Kern "Inyo" St. (GAS). Permit % 150011C ~'acility Address: 230 Inyo St. Bakersfield, Ca. Name Of Person ~'iling.Report.~... [.,ARRy WERT. S, FtEET SERVICES SUPERVISOR On ..10/29/95 .... 6:00.A~ , the above facility had an (date and time) inventory variation/].oss that exceeded reportable ],imits as described be].ow: Tank Amount of Amount of Amount of Daily Weekly Monthly Variation/].oss Variation/Eoss Variation/Loss Total Minuses Line 3 of Trend Ana~[ysis I -84 Gal. 44 Per. 5 have/have--not stopped dispensing .proc~uct and begun investigation procedures required by the Permitting Authority.' ']'his notification is in addition to the phone ca].]. ]: previously placed. LARRY W~R'.[.~, E'[f~:f'~-'[ SERVIcEs SUPERVISOR GENERAL ~ERVICES, GARAGE DiViSION V~IATIO~/LOSS I~S?IGATION REPORT Facility: County of Kern "Inyo" St. Permit # 150011C ~'aci.kity Address: 230 Iny.o St. Bakersfield, Ca. Tank(s) with Discrepancy: I I Date/Time of Discovery: 10/30/95 7:30APL Name of Person Filing Report: Larry .Wer~,...F~EET.,SERVICES.SU~E~.ISOR ......... . l)escription Of Discrepancy: Daily variation exceeded allowable limits using .. LOW THROUGHPUT CHART. -84 Gal. Bad.stick reading ............ iNVESTI~Ai1ON SUMMARY '].'he following procedures' must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: 6 Hours ~ Owner/Operator or other qualified person is to I Date I Time I review records for errors before determining }!0/30/95 [.7:3OAM . I there is a reportable variation/loss. ~ 'Performed Dy : Richard Brown 24 Hours J.) Owner/Operator must verbally report I Date [ Time discovery to B~'DHM and follow-up with writ~.enl10/30/95...[ .9~00~ ... notification on 'form provided. Performed By : ~ Larry Werts 2) Visual facility check to be performed using [ Date [ Time checklist on the back of this form //~/~ }10/30/95....[.~ 8:30AM. Performed By'~" '. Richard Brown 3) Ali. product dispensers are to be checked for [ Date [ Time calibration and adjusted if out of tolerance I ~ Performed By : 48 Hours ~iping to be leak tested using approved method} Contractor's Name License ~ Test Performer's Name Description of test performed Date [ Time ATTACH COPY (.)~' TEST RESULTS. 72 Hours I I I I I Tightness Testing of Tank(s') to be performedl using approved tester and method. Contractor's Name : License $ Test Performer's Name · Description of test performed Date I Time * * ATTACH COPY OF TEST RESULTS. * * NOTE: TI*lIS REPORT MUSI BE SUBMII.[E£ TO THE PERMITTING AUTHORITY WITHIN 5 DAYS 0~' COMPLETION OF INVES.t].GAIIJN PROCEDURES. 2. VISUAL INSPECTION CHECKLIST A. Dispensers All dispensers and their end doors v'isually checked for leaks. All hoses and nozzles visually checked for leaks. Ali. totalizer seals checked ~orwt~mperin9. Results: All dispensers appear tight Richard Brown 10/30/45 . . signature/date Dispenser(s) not tight as listed below signature/date IDiSPENSER ~ISERIAL i. ICOMMENTS: I I i I I I I Tank Area All turbine boxes inspected. X__ All fills and vapor manholes inspected. Results: __ Tank area appears tight with no ct or liquid present Richard Brown 10/30/95 signature/date Tank a'~ea does not appear tight because of the problems/conditions listed be]ow: signature/date .1 'rANK ~ I PRODUC'r~ I COMMEN't'S/RESUL'r$: ~, I. C. Piping Type: ~1 Pressure J_[ Suction ........ Pressurized piping leak detector(s) tested for proper functioning and detection of leakage. Suction piping tested for indication of leakage. Results~ ... Piping tight, based on test(s) above. signature/date ... Piping not tight based on.test(s) abbve, with problems/conditions listed below. signature/date Description , ~., ~, ,, ~ ,:., Y~o~ t~c~s , ~cco~' ~.o~ ,.. ~co~ . ~ALLO~ ' ~ , ,',,,~'~ ' o~/6oo~ ' ~'~e ~/~ ,. ~9~ ~o~a ' ~le3 '. · t~ · . ,02/600~ 7' 18 1/2 ' t018 '1~6 ~ ' -' 165186 " 1651 v~, tv'~;;- :,:,~ ~.~}:~'.~; .~TaaQ~;~ '.A:ia::3/S '-:~:i~:~:.:=1006.':~: - ~ '~10t8;~~,' ,if;:~:'. ~sta6:,: :.'; ;~ ?-~6s1~""'~ ~ t~:;~,~!~i~.~ ~j:;:~ ~':~9s/~30~:','~. ~:.;,is- ~'~ F;:::.:~:'-;F¥~:~'ois:~. ':~?~:?.~;?.:~.?~¥:? :%~6~o ??~C :i~.., ~ ', c,,ii:~t'?"i~'~;,~:~':~;,.:i;:~o6/63o~;::::~:?:~, :4 ':.~;~'~206:.: 'T .~,[ ~,,, ; .' 0S/Sl0~ ''t 17 ~/S ' ~ ' ~10'; ' ' 1~t~4' ', ' 16~lla ,0 ,, "1 ' '1 0 ' , , ., ' .00 0 ' -24 :" '' ":. 6,' 30 '- : , 0" - 1' ' ' ~ : ~ "ti'i~{:, ' :?'.?: ,i'tll~lO~i::.:':.:~,:4~.i5'"IZt"','*~.,:' ::':1021[~':.~¥'~'~10107'>/,,?,~ * 165~17-:' ir :~:'~' ~ lt~l~t ::' .~'r ~" ' ' ~'~'~ """ ' ' ~;~:;: ::¥~':''~''~' ~g~:: *~ '':''" ~'?~'' ~'''': ~: ~:~' ?: '~: ~ :; ,~' ~i"~'' '~'''~ ~''.. ~ , ~ , 15~00~. 6 92 '1/4 10052 · ,, 10015 I6~10. '- · . 165366 ........... ~ : ~6' ' 16/830~ 7 91 3/4 ' ' 10015 - 10015 16~10 '16~10 ' 0 ' * ,oo,, ,oo,, ,,,,,o .... .~ .' ~ ' '*~ ' ' 19/630~ 3 90` 1/4 9899 ' - 9773 '" 165568 ' 165505 ' ' 0 . ,0. ' 0-" . ' ' ' .0 - · -19 r' .~ I l J; ' ' 20/650AN, 4 88 3/4 ' 9773 . 9751 165598 . 165568 . 30 '; O' ' ~ ' 0 ' ' 0 * ~ ' , ~21 0 ' ' ' ' ' ' "/'::"'~"Y,.~ ~ '/~.'.:~: :'~'~'?"::?~'~:~';'~ ~ '/~' 9'696 ~?~L:a:~:~?i~5~,;./~:L'L;:i'~5~'~:'::: ~:~i;~': '/: ~5: :: : '~'~:'; ', :/ "" "'0":~'' '~ "::' ' 0 ...... :'::' :'~' '::~ '"~' ~:'":"' ~':':"~5?:'' ' ~ ~' ":.'~? ,**', '.~:,'~7600~:' ::,'..7~7-'7/e~::,~b.~:=,::9~6':~::.~=:~:~f~:~6~e':,~",=~.,', ::,' ~5~7":- ".~.~,- i~5~77' :~-~ ' "': .' o '* '::~' "":: · -- ~ ~ '-'~' -' ' ' ~ ' ' ~;' * ,' ' ~. ' ~:':~.P' ' ',.:-- , ' ' '~ 'i" :'""~ ...... li~S~o~ ..... i ~T i~''.~' ~'~'"~1'~' ;-f~:':-:-;:-~. '::"l' ;::-~":' ~'' '~'"% .... ~:'-~: ,~- ~,~._.;..~, L ,:: ..' '.,.,. :: ..-~, '. ' · , .,:,~:' :~;~ .,,:i "~,.;~--:~ ~,.*? , ~5/630~ . ~ a~. 3/4 96e5 96~. ~65760 ~as~ '. al ' ' - ' , ~' ' ' ' , ~ ' 'L - ' { -$~ ,,~ ~ '~'*~ . ' ~71630~ · 4 85 '1/4 ' 9449 . 9&O0 * 165919, 165873 ' ~ 46' ' ' ' ' 0 ' ~ * ~ ~' ~ ' ' ' -~ " ' ~,,f~ ' 38/630~' 5 ~ 3/4 · 9400. "9399 ' 165955 ' 1659~9 .'' '~ , ' ' 0 "" ~ ' ~ ' ' ' i~ · . . ~ ,, . .~ I., , ,:~,~. · ', .. .,......,, F U '1 o 0 9.9'5 i NYO"ST.R E ET' TANK' #'1 · SEPTEMBER 1995 'VARIATION 60' ---20 --40 -60 -80 : : -120 2 2 '4 6 8 ~o ~2 14 16 18 20 22 24 26 28 '50 , ~-<.],' ~ ~ . ., . . . . . '.. .... . . . ' . . .. .' . ,.. , . ~. ' '. : :~ . ~ -:~... · .," . · ,' , . . . . . ,'. .- · . ..." .~ . .' . ,' ~ ' . .. '" ~ "'~: ~: ~, :~:~(' ~[??~J'F~C~L~::'~ [-'~ ' ~0: ~T~;~:~-?:'~' ~7;' "~ - · ' ~.~ ....... -.~- ~ ............ · / .- . ...... '. ' ' ' / ' ' ~ ' ' ' ~ · ' ' ~ ' ' . :' ' '"" > ' ' ' ' ' ' ' ' ' "' ..... ' = /?~: ~"' ';~f":[':.~;~:.~" ' ~': "~ ?'<~ ' ~ 2'~:'~ ?.'~:'::~ ~: ! · ~" .':~:,~ ~]~:~ ; ~t~;:~::" :~-~ '~AClTF:~'~' /'3 000 ~ 'Z :' ':~"~':~ .... ~ : ~:- ' '~=<~'~ - ..... ~ -,?, ', :. ~ , . , ' ' ' ...... "~ ~ ~ .... ~;','~:'~"~m~' ..... ,~ .:," - ,' .... ',~, /'-~ ' . ': ~.' · .... ,~:',~:i '¥'-:~=. 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"': ~? <':"?b ~ ~ ,i. :>~:.:~,:.../:..~:q~? · '?'::..~:.-: :::::::::::::::::::::::::::::::: ~::Z.~ ...... ': ,~)~ ".:~' ~: :," ~ :::: ~:: ~; "- : '::. L~ '~.-'u : '. . :., / . t. ,.. ., , ',. ~ ,~ .;:[ , .. :.~. ~- , · .. ~ : : ~: .<" ,, ~i:.:.. ~. :. ~ ( .. , ...~ · .: <'.* ~:'.): ~: ..:(. ~ :,.: ~.;'~:~. ':h ~: :~ ~.::: ..~: %::.:: ~,,-:i:.:[~:.~; ~..~ >: ~,...?~:.~:.~:~ r ........ T-~,,. .....~ '~'~*,~-* ~'~:'~'~'~--~:~::-"~:~,d:b;: :~.~fi.'-" -'.~:'.:,:.~'.:v '~* .~, '~::' :*~:'*'"' ~* .~ '-~." . , .~:..~:.' ' "~ .... : '.~ -' · '..,.'.- ' · ., '. ..'~ .~ ..... .: "-' ~ '"::*:/ .';- ~ ~' '" '" : ~. , ~ ' , '. ' . ' ~ , ., ' - ." , - '. ' '.. , . ' ' . . ~ - 59~ . ~5~ ~2 ~0 ~" ~3" ~ ' ' ' ' ~' '' ' ' . · :~" ~ ':.~: :'"'~-'~: ?~.:?:/F :5~::~';' ':~:. :t:::~:',, ': .~;'.?:::?< h.:~ ~i)::.:':~:~: ~::: ~?.'~ ~:<:: ':;." ': :~;'~.'~::":':':~:~:~¥:?~:~}~: ~:-.*~.:':::~:':.t:? :'::-..::'::~? ' '::';~.:..-)~..:?-' .~ ~:-:- '-: ::- '::L :::-~ ~'::',,?'¥"::'"*' '/:' ;*": ::'.c'~ "?:~ ": .':~ '~' ' ". ,. ::.' ': :~:.' ~::~..:?~': ':~.~ ,~, .::'.'~/'., ~ -:.~,,~:.~. ~:' .:?:~.~'~.:' ~*. ~ .~.- ,.¥ :~-.:~.:~ ..: ..~: ,..,~ .. .../.:-:'. *~ ':,~?~:.:'?~ >: :: :r. ;-,~-:~:.~ .;:<:~:, ;~ ,' '. , ."., ' . -' '."~ ~ ' ,- ~.:1 ': ? L..':. ~. ":~:,':::~ : ' .... ~ : . -~" ~ t ~ ,< ~' ' ~:': : ,. ' ~, . . . , · . · ., . . ', .. ,, . ·.. . ' ... ,' ~ ' , .-. .. : . , . , , , ,. ~ . . . ,.. . ,... ., ., .., INYO STREET TANK SEPTEMBER VARIATION 10 . 6 4 2 0 -2 ....... i ...... -4 -6 -: : : -10 -12 -14 2 2 4 6 8 10 12 14 16 1'8 20 : : : : 22 24 26 28 30 24 HO~R RKPORTi~BLE V/%I~IAT1ON/LOSS ~OTIFXCAT~O~ TO: Bake[siield Fire Department Hazardous Materials Division 210] "H" Street , BaKersfield, CA. 9330[ REGARDING: Facility: County of Kern "Inyo" St. (GAS) Permit FacJ. lit¥ Address: 230 Inyo St. Bakersfield, Ca. Name Of Person Filing Report: LA~R% WERTS, FLE£T SERVICES'SUPERVISOR On 09/30/~5 6:30AM , the above t'aci.l, ity had an (date and time) J. nventory variation/loss that exceeded reportable limits as described below:. '].'an k ~- Amount of Amount of Amount of Daily Weekly Monthly Variation/loss Variation/Loss Variation/Loss Total Minuses Line 3 of Trend Analysis -304 Gal. 29 Per.~ 4 .[ have/have-not stopped.dispensing Product and begun' investigation procedures required by 'the Permitting Authority. '].'his notification is in addition to the phone call i previously placed. BAKERF, F.[ELD Fl*RE DEPARTMENT HAZARDOUS MATERIALS DIVX$1'ON VARIATION/LOSS I'NVE~;TIGATION REPORT ~'ac~.[it'y: COunty of Kern "inyo" St. Permit ~ 15OOllC ~'aci].ity Address: '230~Inyq St. Bakersfield, Ca. Tank(s) with Discrepancy: ~ I Date/Time oF Discovery: 10/O2/95 Name of: Person Filing Report: Larry Wefts, FLEET SERVICES SUPERVISOR Description Of Discrepancy: Monthly variation exceeded allowable limits usinq LOw THROUGHPUT CHART. -304 Gal. Probable bad stick readinqs. TNVES'.t'IGA',L'£ON SUMMARY .'J'he ~ollowing procedures must be performed within the specified times starting at the 'time a reportable loss is discovered or should have been discovered: Within: I ...... 6 Hours I Owner/OperatOr or other qualified person is to I Date I Time I review records for errors before determining 1_1_0_/_92/95 ~ '/:~OAM I' there is a reportable variation/loss. ~/~ Performed Dy : Richard Brown 24 Hours J.) Owner/Operator must verbally report - I Date I Time discovery to Bb'DHM and follow-up with writt~llO/02/95 [ 8:0OAI~ . notification on form provided.~,.// Performed By : Richard Brown 2) Visual facility check to be performed using_ _1 Date I Time checklist on the back of this-form ~,~110/02/95 ~ 8:00AM. Performed By : Richard'Brown 3) Ail product dispensers are to be checked for I Date I '.['ime calibration and adjusted if out o~ tolerance Performed My : 48 Hours Piping 'to be leak tested using approved methodl '1 Contractor's Name License ~ '.['est Performer's Name Description of test performed Date I Time * *- A'i'TACH COPY Ol~"'.[k'Sl"" ...... RESUI...tS."' -* * '12 Hours I I I I I Tightness '].'esting o~ Tank(s) to be performedl using approved tester and method. Contractor's Name : License ~ '['est PerCormer's Name, Description o~'test performed Date I Time I * * A'.['TACH COPY OF TEST RES0L'I'S. * * NOTE: THiS REPOR'[' MUST BE SUBMITTED TO THE PERMZ'.t"I'ING AUTHOR ['.['Y WITHIN 5 DAYS OF COMPLETION OF [NVEST£GATiON PROCEDURES. 2. 'VISUAL INSPECTION CHECKLIST A. Dispensers All dispensers and their end doors visually checked £or leaks. ~ AIl hoses and ·nozzles visually checked ior leaks. All t°talizer seals checked i°~..~mpering'Results: . Ali dispensers appear tight Richard Iirown 10/02/95 signature/date Dispenser(s) not tight as listed below signature/date I DISPENSER II SERIAL tlCOMMEN'I'S: Tank Area AIl turbine boxes inspected. All t.'ills and vapor manholes inspected. Results: __ Tank area appears tight with no ct or liquid present Richard Brown 10/02/95 . signature/date Tank area does not appear tight because o~ the problems/conditions listed below: signature/date _[TANK ~:IPRODUC'r~ICOMMENTS/RESULT$: I I I C. Results: Piping Type: II Pressure II Suction Pressurized piping-leak detector(s) tested·for proper, functioning and detection of leakage. Suction piping tested ~or indication of leakage. Piping tight based on test(s) above. signature/date Piping not tight based on test(s) above, with problems/conditions listed below. signature/date Description R.£. HuEY HAZ-MAT COORDINATOR (805) 326-3979 FIRE SAFETY SERVICES & OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVE. BAKERSFIELD, CA · 93301 SEP 2 8 1995 FIRE MARSHAL (805) 326-3951 WARNING! CERTIFICATION OF FINANCIAL RESPONSIBILITY REQUIRED Dear Underground Storage Tank Owner: N C GEN S',,,~I::: .T. NYO .':3T F:LJEL. PL.ii'flPS 55'g,~:L i,,t [_':]:V]:C C:F_'NTEF~ DR ;34G ~i~fqhlT;q ;;~Nfq,~ C.3~q ROD HFqYD[£N Our records indicate that your business does not have a Certification of Financial Responsibility on file with this office. Please forward either a copy of your existing State approved mechanism to show financial responsibility or else complete the attached Certification of Financial Responsibility form. An attached letter from the State Water Resources Control Board lists the approved financial responsibility mechanisms required to pay for corrective actions resUlting from leaking underground fuel tanks. Remember, most tank owners only have to show financial responsibility for at least $10,000 of clean up liability, The Underground Storage Tank Clean Up Fund (UST~CF) may be used as the mechanism to cover the remaining accidental release liability. The total amounts of financial responsibility required (check boxes from section A of form) are as follows: If you don't sell product from you tanks, and you pump less than 10,000 gallons per month, check "$500,000 per occurrence". Else, or if you are in the business of selling from your tanks, check "1 million dollars per occurrence". For owners of 101 or more petroleum underground storage tanks, check the "2 million dollar annual aggregate" box. All others need only check the "1 million dollars annual aggregate* box. Please be aware that failure to provide the financial responsibility document to this office within 30 days will result In your Permit to Operate being revoked. (25285.1(b) California Health & Safety Code}. If you have any questions, or would like help in completing the Certification of Financial Responsibility, please contact Howard Wines, Hazardous Materials Technician, at 326-3979. Sincerely,, Hazardous Matenals Coordinator REH/dlm attachment '.l.'a n k 11 AIIlOI.ll'I I'. O I: A11101.11-11:. O 1~ AIIIOLII'I I:. (' 1! ' '1'O I:.,--J I I"] i rlH ~ O S .I I. have/.!-_L~..v.f~.j-..[.Lo..l:' sl:o[3[,')od c|i.F.,l.)elq:~i.r~t..'l pl.'oclL~:l; ,:.~r~c-t 13~:;~tx]l-i i.l-tw?sl:i.q,.-f,I;.i, ol-~ ~l:oc:c:,.dLIi.'e:-3 i.',-('iL! ~. ~;' ~:_~¢t by. l:.ho I/er*in i.. I; I; i. rlq Al] I:.t'tof .i. I:.y, ..... y p .I. a ct .r-,. d. '.1't~:~ ~.; r~ot.j J_ :i Cta'l;.J or~ J ~; .ir) addJ l,.J. ol-} t.o l'.h<? I?l'~or-le c:a I..I. .I. pr c:'vJ, otl~ ItlAK:P;RS~?'.tI~;LI) FJ..I{I~ t)EPAH.TI~IEI~IT.r HAZ/ld{UOU5 I"I/~TERI. AL5 ULV[5.tON VARJATJLONfLOSS JNVI--'s'rJGA'rlON HEPOR'.r '.l'he j.o.I..I.owjng pT;oc:oduro$ mulst, bo pertot:mod w~.t.h.tn the ~'"~, ' ' ~,[.c:.c].i.]ed ttJ. me~ st'.artJ, ng _-.~_!:__I_':.!;LO.. I__:_ij_np_...a_..~2e_12P. li!;_a_t2.]_. ~__J.._c2:&_s._.i__~_s _d i ~_cLo__v_e_kL_e:~[_9_L_S..b._o_!j_J..:.tJ_~!.B.y_c:4__b~._e_r_L_f~..~3gj?~ 2,4 Hour.s 0.1. ) OwrLoL'/ODeL'atc~L' must ve[ba.l..Ly L-epot:'l: ~L.__I)_o.L_'.CC .... _~ ..... '1~i[~LC4 ..... ... c) cii. scovet-~ I:o I]O'D[.]M and J~oJ. Lc)w--up with wcil:.'t:enb09/lg/95 ~_.~.0~ .... o nol:LfJ, cation on t'ol:m pl:ov.tded: ~.ff ' o PerLo[med By :~'~icha[d Brown 02) Visual :l:aci. J. ity check to be pe]:[ot'mect us.tl-~d 6 Date 6 Ti. Tile . 03} A_t.J. DL'odLIcI:. d.i. sDensers aue to be checked ~of o ca.l.i, bi.'al:i, on and aci]usted il: c)ul: o1: I:.c).l. erance o Pecl:oL'~ned t:~ : 4~} flours O 0 0 0 P.i. pir]q to be .Leak res ted tls.i, nq al)pt'ow'?d i[iothod~:'~ ......... !.).[%.t..t.~ ............. ~ ..... ~.~'.)~[[]~_ ......... Co~tL'aclLol:;' S N~B'IO ...................................................................................... ~. I, tc:ense 1~ .............. '['est Pol.'l:.ot'Taot''s Name ..................................................... I.)esct'J.p~.i.o~ o1: I:esl: poL'l:ol;~leCi ............................................................. =. 72 Hou[s O O O * * A.I. LACH'"' ' 'CC)PY. ()k' '.L'E~Y.I' RhoJl,'t'S."'l * * 'J.'ightness Je. tJ. ng oL Tank(s) t.o be perto[med6 Date 6 J. NLO us Lng appcoved tester' and mel:.hoct, b. b Contracl:o[-'s Name : [,i. censo I~ '.l'es~ PO['[OL'~LeL'~S Name I.)esct'iption ot test pertoumed NOTE: 'l'[-t.l.~; REPORT HUS'L' BE StJBI"I.I:'L"t'EI)'.t'O THE PERMJ.,I..LJ. NG A U ,L [-I (_ R .L .L Y W/TI'tJ:N 5 DAYS O~' C(.)MPI~Ir,.L.LON O1~' . J. NVE,., t I(,A.I .LON PR()(.::EI)I.IRES. *-2,. Vii ~.*;UAI., IN~PEC'.i'] ON C. HECKI..i~T ^. I) i::.~penset .., ...... _X._A..I.I d:ispc~nsers and their' end cioors vJsuaJ.ll c:t-~e(:keci .~:or .leaks. .... ~__. .ALII hoses and nozzJes visuaJ]y c:heckect ~or ].eaks. ..... ~__ ..AIl tot. a].J. zer seals checked lm:~mpering. Resu [ ts: .......... AJ.] dJ. spensers, appear tJ. ght v~i~hard ~rown og/l~Z~ ............................. sipnature/ctat, e ............ Dispenser(s) not t. ipht as ].J. st. ed belo~ signature/date (51),[SPENSgR 'I[6~ERIAL ~6COMMk:N't'S: 6 6 6 6 6 6' 6 6 B. 'rank ^rea _X .... A.I.I tur'bJne t0oxes inspect, ed. ~ A.I]. JJJ. J_].s and vapor mardSo].es J. ns~ecte.l. Resul ts: ~u '.l'ank a~'ea appeals tJ. ght. wJ. th no ct or lJ. ql.lJ.d preser~t: Richard Brown 09/19/9b s i. gna I: u r e/da i:. e 'l.'ank area does nol: appear I:ighU because o1: I:he prob.[ems/conditions Iisi:ed be .I. o~: .9_Z.A._N.._K.._...I[_o_P__R_O..I)_U_J:_I:. J}..9~.!?_IZI_N_~j_N..[ S / a~, S U L'L'S: o 6 6 s .[ gna tu,-e/da t e 0 6 6 6. 6 6 6 .. 6. C. Piping Type: 0"6 Pressure ~ Suction Pressurized piping leak detector(s) tested for pr_oper :functigning and ...... detect, i6~0i-2~affa~ge. - Suction piping tested for indication of leakage. Results: __ Piping tJ. ght based on test(s) above. signature/date PJpJ. ng not t:iglut based on test(s) above, wi. th problems/cor~dit:J, ons .I. i s I:ed be_Low. signature/date I)e s cr .[p I: kon TANK REPORT~' I have not done any major modifications-to this facility during the last 12 months. ~' Signature Note: AIl major modifications require a Permit to Construct from the Permitting Authority. 2../~_' have done major modifications for which I obtained Permit(s) to Construct from Permitting Authority Signature Permit to Construct · u~ ~o~ FAC I L I TY ~NU~L $7T Permit · ~$,oo 3. Repair and Maintenance Summary Att. ach a summary of all: --~'Routine and required maintenance done to this facility's tank, piping, and monitorlnK equipment.' -- Repair of submerged pumps or suction pumps. -~/Replacement of flow-restricting leak detectors with same. -~ Repair/replacement of dispensers, meters, or nozzles. -- Repair of electronic leak detection components, or replacement with emus, -- Installation of ball float valves. -- Installation or repair of vapor recovery/vent lines. ~ ~,~ Include the dateof each repair or maintenance activity. NOTK: AIl repairs or replacements in response to a leak require a Permit to Construct free the Permitting Authority as do all other modifications to tanks, piping or monitoring equipment not listed here. e Fuel Changes - Allowed fOr Motor Vehicle Fuel tanks Only. List all fuel storage changes in tanks,~ noting: Date(s),~tanknuuber(s), new fuel(8) stored. Se Inventory .control monitoring 18 rbquired for this facility on the Permit to Operate, and I have not exceeded any. reportable limits 88 listed In .the appropriate inventory control monitoring handbook during the last twelve months (if not applicable, disregard). Slanature 6. Trend Analysis Summary Please attach Annual Trend AnalySis Summary for the last 12 periods. 7. Meter Calibration check Form Please attach current, completed Meter Calibration Check'Form TANK # I TIME PERIOD: QUARTER ! TIME PERIOD: 6-'] ~ - ~ ~ to ~ ~ I PERIOD 1: Total Minuses This Period (Line 3) Action Number for this ~ertod (Line 4) ,PERIOD 2:. Total Minuses This Period (L~ne 3) Action Number for this Period (Line 4) PERIOD'3: Total Minuses This Period (Line 3) Action Number f~r this Period (Line 4) QUARTER 2 PERIOD 4: PERIOD B: PERIOD 6: PERIOD 7: PERIOD 8: PERIOD 9: TIME PERIOD: Total Minuses This Period (Line 3) Action Number for thl~ Period (Line 4) Total Minuses This Period~t~lne 3) Action Number for this Period (Line 4) TOtal Minuses This Period (Line 3) Action Number for this Period (Line ~) TIME PERIOD: (~k - ~ '- ~ ~ tO 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) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) QUARTER 4 'TI~ PERIOD: ~-'~,-~5 to PERIOD 10: Total Minuses This Per~od:.(Ltne. 3) Action N~ber for-this Period (Line 4) PERIOD 11: Total Minuses This Period (Line. 3) Action Number for this Period (Line 4) PERIOD 12: Total Minuses This Period (Line 3) Action N~ber for this Period (Line 4) I hereby certify this !s a true and ~curate report. ~'ACI LI TY TANK # / CAPACITY PRODUCT (~~.~' YEAR/PERIOD I NSTRUCTI ON'S ; PART A : 0vqRAGE/SHORTAGE Fill in all information at top of form. In the space for .year./ 1 , 16 period' indicate the year and the DAY DATE (+/-) , consecutive period ,of analys'ls DAY 1 /~-J~'-~ -~ being conducted (from 1 throug[ DAY. 2 ~-~,-~ .,- ~ 12 DUly). Transfer the .date and DAY 3 ,~--~-~.~ ~ the mien fro~ columns 1 and DAY 4 ~'1;~--~ ~ Reconciliation Sheet to col,~ns DAY 5~'~-~ · ~ at left. Use the .'table/beloM t~ DAY 6 ~ q~ ~ determine the action n~mber' for DAY ~ ~-~ - ~ ~ the 'peri'od b'e~ng analyzed. DAY 8~.~ ~ DAY 9 ~-~-~ ,~ ACTI ON NUMBER DAY 10 ~*~H - ~ ~ ' TABLE DAY 11 ~-~.- ~ ~ DAY 13 ~~ ~ ~ PERIOD NUMBER[ NUMBER DAY 14 ~-~ 9y ~ '~ ." - 20 DAY 15 ~-~. q~ ~ 2 ~ DAY 16 [.;:~ ~ ~ 3 = .54 DAY 18~ ~ ~ 5 = '85 ~ , 6 10i DAY 19, ~ ,- , " DAY 20 9 ~ ' .q¢.~ ~ '-. i 7 = 11~ ' ' DAY 21 ~-,~ , ~',~ · -- ' 8 '= 133 DAY' ; i¢ -- 9 = z49 DAY 23 ?'9 '~¢ "-- 10 = 165' DAY 24 ~-~ '~¢ " ~ 1~ = 180 DAY - ..,~Y 27 ~- 15 ~'~, ~ , Circle appropriate period and DAY ~8 q' I~':'$~ ';' ~ action number. A full cycle ,'DAY 29 '~' t5 '~ .' ~' ~ade up of periods.. 1-12, after. .DAY 30 '9-'~-~ ~ which a new ·.cycle. begins' · Use TOTAL NINUSBS information to' 'complete Part 'B. PART B: ACTION NUNBER CALCULATION Line 1. Total minuses this period-part A .......... ' . . . Line 2. Cumulative minuses from'previous periods in this cycle. Line 3. Total minuses (add lines I & 2) ............. Line 4. Action number for this period (from table above) . . .' . Line 5. Is line 3 greater than line 4? [-]Yes o ,If Yes, you have a reportable loss and must begin notification and Investigation procedures in Kern County Health Department HANDBOOK "STANDARD INVENTORY CONTROL NONI-TORIN6'. Env. Health 580 4113 1016 (6/86) TREND ANALYSI ~ TANK # / CAPACITY /'tg,~/, ' ' PRODUCT YEAR/PERIOD I NS'TRUCTI ON'S : PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space for year/ 1 16 period indicate the year and the DAY DATE (+/~) , consecutive period of analysis DAY 1 ~-;~-q~ -- being conducted (from 1 through .,DAY ~- ~ ]~ ~V~ -]--' ,, 12 only). Transfer the date and DAY 3 '~ I~-~ ~ the sign from columns 1 and 16 of DAY 4 ~_~-9~ ~ Reconciliation Sheet to columns 'DAY 5 ~.,-iq~O~ ~ ~' at left. Use .the .table .below to DAY 6 ~-~ ~ determine the. action number for DAY 7' ~-~{ ~ ~ the period being' analyzed. DAY 8 ..DAY 9 ~-~5 -~ ~ ACTI ON NUMBER. DAY 10 ~-~- ~q -- ' TAB'LE DAY DAY DAY 15 DAY ~8 ".~P't ' fY ~ '5 = '85 DAY ,19 ~'~":~;::' ~ ' 6 = 101 ..... DAY il ~-'~'~- % --' 8 .- .133 DAY e~ ~-~--~' ' "~ --,- 9 = .149' DAY 23 ~:'~' ~, ~ ' ' 10 - .165 nay , 12 ' 196 DAY DAY 27 ~10-9~ '~. '~ Circle appropriate period, and DAY Z8 DAY' 29 ~-~ ~ sade up of periods 1-1.2, after ,.DAY 30 ~-~ ~ ~ which a ne~ cycle begins.' '.Use. .TOTAL MINUSES lnforsatlon to c0mplete Part' B. PART B: Line 1. Line 2. Line 3. Line 4. Line' 5. ACTIO~ NUMBER CALCULATION Total'minuses this period-Part A ............ Cumulative minuses from previOus period:~. in this cycle.' Total minuses (add lines I & 2) Action number for this period (from table above) .... Is line 3 greater than line 4? ~-]Yes ~No If Yes, you have ~ reportable loss and must begin notification and Investigation procedures as described Env. Health 680 4113 1016 (6/86) in Kern County Health Department HANDBOOK #UT-10 ....... '...~.~ "STANDARD INVENTORy. CONTROL MONITORING" ',.~"7t','C ~-'~.,~.e~, ~)(~~, A C X L X WY P X T. . # lt TANK # I CAPACITY //~K - PRODUCT YEAR/PERIOD I' NSTRUCTI oN's: PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space for year/ 1 16 period indicate the year and the DAY DATE (+/-) , consecutive period of analysis DAY 1 ~-I~-~ -~., being conducted (from 1 throug~ DAY. 2 F-I~'-~ ~ 12 on. ly). 'Transfer the date and DAY. 3 ~'I'~-~ '- ~ the s'i~n fro~ columns' 1 and 16 of 'DAY~ 4 ~-~ ~ Reconciliation Sheet to colusns DAY 5 ~-~-~' " ~ at left. Use ,the-table belo~ tc Iq~H,,? + determine the action ,number for DAY 6 ~-- '~' DAY 7 ~-~"~'~: ~ the periOd being analyzed. .DAY 8 ~' ~1'~"~'~;~ ,,DAy 9 ~-~;~ ~ ACTI ON NUMB, ER DAY 10 ~-~--~.~ ~ ' TABLE ..DAY 12 ~-~1~ .~ 30-DAY [ ACTION - DAY 13 ~-~--~ -- PERIOD NUMBERI NUMBER 'DAY 14~ ~~~'~ ~ '1' = '20. DAY 15 ~ 2 = 37 DAY 16 ~'~-~ ~ ~ = DAY 1~ ~-~ ~ ~ ,~ 4 = .69.//~" ' = '~'?' 85' DAY 18 ~1-~ ~ 5 ? DAY 19 ~- ~ ~ ~ ~ 6 10i DAY 20 ~-~ ~ 7 = 117 * '"' 'DAY 22 ~ ~ ~ ~ 9 - 149 " Day, 23 ~ ~ ~e + 10 = DAY 25 ~ '~ '~F : ~ 12 = 196 DAY 2; ~ ~ ~', ' ~ Circle approprla~e~, period and ,DAY 28 ~'~ ~ action number. ' A full cycle ..DAY 29 .~-;i~ ~ =ade up of periods 1~12, after DAY 30 ~--i~ ~ ~hich a ne~ cycle~beEins. Use' TOTAL NINUSE$ information to co=plete Part B. PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this Line 2. Cumulative minuses Line 3. .Total minuses (add Line 4. Action number for Line 5. Is line.3 ~reater than I.~f Yes, you have a notification and Investigation procedures in Kern' County Health Department HANDBOOK "STANDARD INVENTORY CONTROL MONITORING" Env. Health 580 4113 1016 (6/86i period-Part A ............ from previous periods in this cycle. lines I & 2) ............. this period (from table above) .... line 47~ ~]Yes' ~-]No reportable loss and must begin as described #UT-10 ,,.,,,cz T..z (.¢, -TN't/O 3'7'; TANK # I CAPACITY ,~){~ ' 'PRODUCT I N $ T I~.U C T'T PART A : OVERAGE/SHORTAGE Fill in all information, at) top o.f form. In the 'space for year/ 1 : 16 period indicate the.year and the DAY DATE (+/-) , consecutive .period of' analysis DAY 1 (~'~13--~ -- being conducted (from 1 througt .DAY 2 ~-~,~--f~ -~ ~ ., 12 DUly). Transfer the date and DAY 3 ~--~ ~ the sign from columns I and'16-of DAY 4 ~-/~_7~ . ~ Reconciliation 'Sheet to' 'cOlumns DAY 5 ~_F~ ~ at' left. Use the .table 'belo~ DAY 6 ~/~-?~ determine 'the action.number for ..... DAY 7 ~/~ ~ the period being analyzed. .. DAY 8 ~-~ DAy 9 ~]-~t-~'( ~ ACTI ON NUMBER DAY 11 ~-~ ~ ' ' · DAY* 12 ,*~-~-7~ ~ 30-DAY ~* DAY 13 ~.~-~' PERIOD NUMBER.~ .ACTION ~ 'NUMBER DAy 14 ~*~ ~- ~ ~ 1 - DAY 15 ~.~-~ ., ~ ~ 2 - * DAY 16 ~-lF~ff ~ 3 ~" DAY 1~ ~-~-?~. ~ ~ ~ ' ~" PAY x8 ~-~-~ -- ;, 5 =. 86.. DAY ~9 /O-/-%d* ~ ~ 6 ~ X01 ,DAY Z0 Io-1~' ~ ? * DAY 21 /0-,~- 7~ -- 8 = 133 DAY,22 ~-~-~ -- ,, 9 ~ Z49 , DAY 23 /~-~- ~¢ ~ ~0 = . ~65 DAY 24 /~&-9~ ~ ll = . .~80 . DAY 25 '/~-?-~ ~. 12 '= 196 .DAY 26 /~,g-.?~ ~ "." ~ DAY 29 /~-?-7¢ ~ Circle appropriate per!od, and DAY ~8 /~-/~-~ -- action number. A.f~UlI*~cycJe' DAY 29 '/~-//-~ "~~ ~m /~m made up of Perl,°ds~[,.::!.z:l'2,;.'/::;.P~'te DAY 30 /o*/A-~ ~/~/~ ~m ~~ ~hich a new TOTAL MINUSES /~ ' lnfor.atlon t0' "~'0a'~lete%~Part';~B'., PART B:' ACTION NUMBER CALCULATION Line 1. Tota'l minuses this Line 2. Cumulative minuses Line 3. Total minuses (add Line 4. Action number for Line 5. Is line 3 greater than I_~f Yes, you have a period-Part A . , ............ from previous periods in this cycle lines 1 & 2) . ............ this period (from table above) .... line 47 [-]Yes ~No reportable Xoss and must begin notification and. investigation procedures In Kern County Health Department HANDBOOK "STANDARD INVENTORY CONTROL MONITORING'*. Eflv. Health 580 4113 1016 (6/86) as described #UT-10, TANK # / CAPACITY /F). ooo' 'PRODUCT ~ ~ ~ac~CY~ YEAR/PERIOD PART A : OVERAGE/SHORTAGE Fill In all inforaati~n-'at 'top o! form. In the spa'ce,, ,for year/ 1 16 period indicate the,0ty~e'~r ',-. and'[ the DAY DATE (+/-) , consecutive perlod"~%:q'f' .anaiyel's DAY 1 /~/,~-~ &~/m.~ ~ ~2~ being conducted -(fros~' 1 thr.ou~t DAY' 3 /o-~] ] the slsn fro~ columns 1 and 16 of 'DAY 4 /~-/~-~ / ,, Reconciliation, Sheet~to colusns DAY 5 ~o-I~-~/ at left, Use. the :table beloe t~ DAY 6 ~v-I~-~& determine the~ action number for DAY' 7 /~./?-~ ~' , the Period being analyzed. DAY 9 /~-~/-~Z[ ACT~ O~. NUMBER ,,, DAY 16 ~ k~-~ · · 3 - 54 DAY 23 //- ~- ~[ 10 = 165 ' DAY 2.? //-~-9~ -- Circle appropriate . Peri.od and DAY 28 //-?~?~ ~ action number. A.'ful. 1 cycle*Is DAY 29 //~/~-~ ~ made .up of periods' :1~12., after DAY 30 //-//~ ~ ~ which a new cycle begins...-Use .TOTAL MINUSES ~ lnforsatlon to complete Part B. PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A ............ Line 2. Cumulative minuses from previous periods in this cycle. Line 3. Total minuses (add lines I & 2) ............. Line 4. Action number for this 'period (from table above) .... Line 5. Is line 3 greater*than line 4? oyes ~No I_~f. Yes, you have a reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK tUT-10 "STANDARD INVENTORY CONTROL MONITORING" . Env. HMIthSe04~$1016(6/e6) TANK · ] CAPACITY /OyO~O 'PRODUCT ~ YSAR/PaRIOD ' I NSTRUCTX'O'N~s'~ ........ PART A : OVERAGE/SHORTAGE FIll .In all. Information at top '- ' form. In the space, for yearl 1 16 period Indicate .~he..year and. DAY DATE (+/-) , consecutive period of' analysis DAY I ~/-/~-?~ .~ ~ being oonducted.?~(froa I througl DAY 2 I[,1~-~ ~ 12 only). Transfer', the date an~ DAY-3 ~-~-~* ~ ........ the sign from .col~umns.,1. and 16 DAY'4 · '~(-[~-~.,[ ~ Reconclllatl°n 'Sheet. to columns DAY 6' ~/_/~,?~.': ~u,', ~ ~ determine the act!on number fox DAY 7 ~ //-/?-?~ ~ .... the period being analyzed' DAY 13 -/I-)$-~ -'~, ~ PERIOD NUMBER~ NUMBER · , ' DAY 25 /~-7-~[ ~ L 12 - · 196 DAY 2,7 /A-.?-?~ ~ Circle appropriate perto'd'~ and DAY 28 /~-/0-7~, ~ action number. A ful,1 .cycle-is DAY 29 /~-//-~ ~ made up of period8 1-12'~ after TOTAL MINUSKS I~ information to. 'complete 9art, B. PART B: ACTION NUNBER CALCULATION Line 1. Total. minuses this period-Part A ........... .?Line 2. Cumulative minuses from previous periods in this cycle. Line 3. Total minuses (add lines 1 & 2) ' Line 4. Action number for this period (from table above) . .// ,, Line 5. Is. line 3 greater than line 47 E]Yes If Yes. you'. have a reportable loss and must beg.in notification and investigation:procedures in Kern County Health Department HANDBOOK "STANDARD INVENTORY CONTROL MONITORING'*. .~ Env. H~lth 680 4113 1016 (6/86) as described tUT-10 TANK # ' I ·CAPACITY. '10~ OOO. ·PRODUCT ~/~Le.de~ YEAR/PERIOD· I NSTRUCTI ON'S: PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In th'e space for year/ I 16 period indicate the year and the DAY DATE .'' (+/-) , consecutive period of'' analysis DAY.1 /2-1:~"~'( ~ being conducted (from i through ..DAY 2 /~lt/-~ ~- ,, 12 on__~). Transfer the"date and DAY 3 /~-/~-~ .. the sign from'columns 1' and.16'of DAY 4' /~-/~-?~ ,,, ,," ~ Reconciliation Sheet.:to .columnm ' DAY 5 /~-/7-~ ~ at left. Use the' table-belo~ to DAY 6 I~-I~-~~ ~' ' -- determine the action number for DAY 7 ~2-1~-~y ~. the period being analyzed. DAY 9 /~-~i-~ -- ACTI ON NUMBER "DAY 18 /2-~-]~ ~ PERIOD NUMBBR DAY 27 /~/~-~ ~ Circle appropriate period, and DAY 28 /-12-7,%~ ~ action number. A ful'l' cycle. DAY ~9 [-I~S ~ made up of periods '1-1~. after' DAY 30 /-~-~4--' ~ which a new cycle begins.. Use. TOTAL MINUSES /~ information to complete' part 'B. PART B: Line 1. Line 2. Line 3. Line 4. Line'5. ACTION NUMBER CALCULATION Total minuses this period-Part A Cumulative minuses from previous Total minuses,(add lines 1 & 2) periods in this cycle. Action number for this period (from table above) .... Is line 3 greater, than line 4? E]Yes ~No If Yes, ,you have ~ reportable loss and must begin nottftca~tion and. investigation, procedures'as described in Kern.~o'unty Health Department HANDBOOK #UT-10 "STANDARD INVENTORY CONTROL MONITORING". Env. I~alth 580 4113 1016 {6/86) , il 7 i- , ~: TRBND ANALYSX ~ TANK # ,, ,/, CAPACITOr 'PRODUCT YEAR/P R'IOD INSTRUCT! ON'S.: PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space, for year/ 1 16 period indicate the year and: the DAY DATE (+/-) , consecutive period .of' analysis DAY 1 /'~1'~- ~- being conducted (from' 1 t'hrOugh .,,DAY 2 1.2a-.~a~ - ,. 12 oply). Transfer. the date and DAY 3 I-~Y-~ the sl~n from columns I and 16 of ,DAY 4 [-~{-~ ~ Reconciliation Sheet to columns DAY 5 ~ -i~:~ -- at .left. Use the .table bel°~e DAY 6 [-~G~ -- determine the action number, for DAY 7 /-~7~ ~ ~ the period being analyzed. , DAY 9 I~. ~ -- ACTI ON NUMBER DAY Z2 '~1~ ~ . J~ 30-DAY ~ ACTION DAY 13 ~~-- ~ ~ PERIOD NUMBER( NUMBER DAY 22 ~-ll- 7~ ~ 9 = Z49 DAY 27 ~-/~-~ ~ Circle appropriate -period and .... DAY 28 ~-/~-~--' -- action number. . A'.full cycle .DAY 29 ~-/~-?~ ~ ~ade up of periods 1-12,.after DAY 30 ~-I~-~ ~ which a new cycle beztnsc "Use TOTAL MINUSES ~ ~ lnforsatlon to complete".Part PART B:. ACTION NUMBER CALCULATION Line 1. Total minuses this 'Line 2. Cumulative minuses Line 3. Total minuses (add Line 4. Action number for Line 5. period-Part A ............ from previous periods in this cycle. lines 1 & 2) ............. this period (from table above) .. ) Is line 3 greater than line 4? ~]Yes ~/No l._[f Yes,. YOU have ~ reportable loss and must begin notification and Investigation procedures as described In Kern County Health Department HANDBOOK #UT-lO "STANDARD INVENTORY CONTROL MONITORING'* ' Env. Health 680 4113 1016 (6/e6) TANK # I CAPACITY ! O. ooo PRODUCT ~&~ d'~, YBAR/P'~RIOD ~-~ I N,STR. UCTI O~'$ : PART A : OVERAGE/SHORTAGE Fill in all information at tOp. Gl form. In the space for year/ I 16 period Indicate the Year and the DAY DATE (+/-), consecutive Period of' analysis ,DAY 1 ~-~/-~ '~ being conducted (from 1 througt DAY 2 ~_~.~ ~ 12 only). Transfer the date and DAY 3 ~-~-7~ ~ the sign from columns.1 and 16 of DAY 4 7_~_~ ~ Reconciliation Sheet to coluans DAY 5 2-Z~-9~ ~ .... at left. Use the table, beloe t~ DAY 6' ~,,~/ - ,, determine the action.number for DAY '7 ~-)~- ~ *~ the period' being analyzed. DAY 2~ ~-/~-~ ~ Circle appropriate period and DAY 28 [-~~ action number. A full cycle is .,DAY 29 [-~ ~. ~ ~ ~ade up of periods 1-12, after DAY 30 ,~-~-.~/ ~ ~hlch a ne~ cycle begins. Use TOTAL ~INUSES /~ information to complete Part B. PART B: Line 1. Line 2. Llne 3. Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A ..... ~ ...... Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) ............. Action number for this period (from table above) . .. . .j/ Is line 3 greater than line 4? [-]Yes I_[f Yes, you have ~ reportable loss and must begin notification and investigation procedures as described in Kern. County Health Department HANDBOOK #UT~IO "STANDARD INVENTORY CONTROL MONITORING". Env. I-kmlth Ge0 4113 1'016 (6/66) · TANK # .* CAPACITY· I~ OO O 'PRODUCT V~ &¢el# ~ YEAR/PSRIOD ~ I NSTRUCTI 0l/'8 :' PART A : OVgRAGE/SItORTAGE Fill' ~n ~11 ~nforaation at top form. In the space for year/ 1 .. 16 period indicate the year and the DAY " DATE '' (+/-) , . consecutive period of' analysie DAY 1 Y-13. ?C ~ being conducted (from I throu~t DAY 2 Y-.z~-~ , ~, 12 only). Transfer the date DAY '3 Z-~F~ ~' ~ the sl~n from columns 1 and 16 DAY 4 ': ~'2(-~ ~ Reconciliation 'Sheet'to column, ..DAY 5 ?-~v-~ '. ~ at left. Use .the.:.table .below t~ DAY'6 y-R'~--q~ ~ determine the: action number fox DAY 7 .~-2~5f ~ the period being analyzed. DAY ZZ ,~.ff~'~ S'O-DAY' "[ ACTION DAY 13 'q~- ~ ~ PERIOD'NUMBSR[ ' NUMBER qAV X8 ~-~ ~ 5~ 5 = 85 DAY 23 ~-~-?~ ~ 10 = 165 DAY 26 ~-/7- ?~ -- .... DAY 27 ~-1~-9~- -- Circle 'appropriate period, rand DAY 29 ~LO '~C T made up of periods' 1-12,. after ..... DAY 3o y-%1-9~-- which a new cycle::bez~'ns[.-::Use .... TOTAL MINUSES /~ information to complete Part.B' PART B: Line 1. Line 2. Line 3. Line 4. Line.5. Env. H~lth 6604113 1016 (6/86) / ACTION NUMBER CALCULATION Total minuses this period-Part A ............ Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) ............. Action number for this period /from table above.i . / Is line 3 greater than line 4? [-]Yes I_~f Yes, you have ~ reportable loss and must begin 'notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-lO "STANDARD INVENTORY CONTROL' MONITORING". TRBND ANALYS ]L ~ . WU ~K'~ fl ~. J~'I 'rANK # CAPACITY I07 o~o ~PRODUCT Uv~k4eaed, YEAR/PgRIOD 9J'-lal -- '' " ! NSTRUCTI ON'$.: PART A : OVERAGE/SHORTAGE Fill In all information at top of form. In the space for year/ I 16 period Indicate the year and the DAY DATB " (+/-) , consecutive period* of* analys.ie DAY ,1 ~/-jl~_-?J~ ~- being conducted (from .1 throug~ ..DAY 2 ~-2~-~>~* '~ ,J 12 only). Transfer. the' date and DAY'3 ~-~-~' ~ ' the sign from columns 1 and 16 of DAY 4 ,~-/~ ~ Reconciliation Sheet to columne DAY 5 ~-~-~ ~ ' ' at left. Uae the table be, lo~ t~ DAY 6 ~.ZT~ ~ determine the action number for ~AY 7 ~, ~..~ ~ the period, being analyzed. DAY 9 ~-~-~ ~ ACTI O~, NUMBER DAY 13 fi-e- ~Y ~ PERIOD NuMBERI NUMBER DAY 16 ~-7-~s~ ~ 3 = 54 DAY 22 ~*1 ~' ~ ~ 9 = 149 I DAY' 27 _~-~*?~ ~ · Circle appropriate period and ,,DAY 28 ,~* ~9~ ~--~ ~ action number. A full c~c~e 19 ,,DAY 29 ~-~o-~ + mede up of 'periods 1-12',. after DAY ~0 ~-~l-~,~. 'l ~hlch e ne~ cycle'beg!ns. Use ..... TOTAL,,..MINUSES /3 information to complete 'Part'B. ~ART Line Line Line Line Line ACTION NUMBER'CALCULATISN in Kern County Health Department HANDBOOK "STANDARD INVENTORY CONTROL MONITORING'* Env. Health 580 4113 1016 (6/86) B: 1. Total minuses this period. Part A . . .' ....... '. . 2. Cumulative minuses from previous periods in this cycle. 3. Total 'minuses (add lines 1 & 2) ............. 4. Action number for this period (from table above) . . . .// 5. Is line 3 greater than line 47 OYes If Yes, you have a reportable loss and must begin notification and lnvestlzatton procedUres as described #UT-10 TANK # / CAPACITY ] ~., OO O PRODUCT U~t~-~t A YEAR/PERIOD '~S,I~, I NsTRUCTT ON'$ : PART A : OVERAGe/SHORTAGE FAll In ali inforaation at top o! *' form. In the space for year/ I 16 period indicate the year and the DAY DATE (+/') ,. consecutive period of' analysis DAY I %-~2-~-- ..... being conducted (from 1 tliroug~ DAY 2 %-2~'-~-- .... ~ 12 oply). Transfer the date and DAY 3 ~-2~-~ ~ the sign fro~ columns 1 and 16 of DAY 4 Y-y[ .~[' ~ Reconciliation Sheet to co'lu~ne DAY 5 ~,zc-~5 ~ at left, .Use the' table beloe DAY 6 J-~-.5~ ~ determine the action 'nusber for DAY 7 f-2~-~-- ~. the period being analyzed· 0AY 9 ~-1,0- ~-- ~ ACTI ON, N,,~~BER .DAY 10 ~-3~ ~5 ~ ' TABL,~ DAY 14 .[-~~ ~ 1 - 20 DAY 15 ~-~- ~ .~ 2 = 3~ DAY 16 G-g-9~ '~ 3 '= 54 DAY 1~ (- 7-5~ ~ .~ .4 .= 69 DAY '19 ~ * ~ -~' ~ ' 6 - 101 DAY 21 ~-//-? ~ ~ 8 = 133 ,,DAY ~ ~-(;-~: ~ 9 = DAY ;~ ~-/~-~: ~ ~0 = ~6~ DAY 24 (- f~- ? ~ ' ~ 11 - 180. ..,DAY 25 ~'~ ~ i ' ~ ' ..... DAY 26 ~-~-~Y DAY 2~ ~--f'~ ~ ~ ~ Circle appropriate period and ,.,DAY 28 ~-~[-~ ~ action number. A full cycle DAY 29 ~-/~~ ~ made up of pe~rlods 1-12'.'after .... DAY 30 ~-7 ~ ~ which a new cycle begins.' 'Uae ,TOTAL NINUSES ~ information to complete Part B. PART B: Line 1. Line 2. Line 3. 'Line 4. Line 5. "STANDARD Env, Health SBO 4113 1016 (6/86) ACTION NUMBER CALCULATION Total minuses this period-Part A ............ Cumulative minuses .from previous'periods In this cycle. Total minuses (add lines 1 & 2) ......... ..... Action number for this period (from table above) . . . .// Is line 3 greater than line 4? ~]Yes If Yes, you have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK tUT-10 INVENTORY CONTROL MONITORING". TANK tt ~- TIME PERIOD: ~-~ QUARTER ! TIME PERIOD: PERIOD 1: Total Minuses This Period (Line.3) Action Number for this ~egtod '(Line 41 PERIOD 2:--Total Mlnuseg~lhls Perlod,(L~ne 3) Action Number/for this' Period (Line 4) PERIOD 3: QUARTER 2 PERIOD 4: PERIOD PERIOD 6: QUARTER 3 PERIOD ?:" PBRIOD 8: PERIOD 9: QUARTER 4 'Total Minuses This Period (Line 3) .Action Number far 'this Period (Line. 4) ',, ' :"'~I~ PERIO0:__/ o - ;'_ __9 "t ,:o Total ~nuses This Period (Line 3) Action Number tot th~s eS'tiDal (line ,Action Naber for thts',period (Line 4) TI~B PERIOD: · ' ' to . -' ~:~:~..:'.'-'~,'.v..-:' ..... ' '- Total ~lnuses This Period JLlae 8) .. ..... Action Number for ·this Period (Line ' ~ ~ ? ~',';R;~ .%.7~.~q "]f~ ~ ~ ' :"'~ (Lineo~' ' ~lnuses This Period Action Number for this Period (Line 4) ' - TOtal Minuses This Period (Line 3) Action Number for this PerAod (Line 4) TIME PERIOD: to PERIOD 10: Total Minuses This Per~od (.Line 3) Action Number for this Period (Line 4) PERIOD'll: Total Minuses This Period (Line 3) Action Number for this, Period (Line 4) PERIOD 12: Total Mlnuse8 This Period (Line 3) Action Number for this Period (Line 4) hereby certify this is a true and ~ccurate report. signature ' --"; '~~ -' Date' TEST" '1 .'.:.: ..Wm.m,~..n¥..... I':WATER-fl~ND::S.::,::.X'S~-:'::./::?~t,;*:~q~I,:/,.'I..': ':.?ND - "'"'i-S'T'": ~-':::VOr:'u~U~'~::~'6~:/i'~:' · C~r-:~:T.Z: ':.;. ::~i<- :~ ..................................... - ........ ' ................ [.SHUT.-DOY~[~'- LE~F~I;' =GAUGE .... GAUGE J;.,_.C_ I ~ ? ~' ' ':~ ~ ~'; /' "¥ :/ :':':' (I,CL~E '.~) NOTED ON ~RSE RESU~TED IN: ' :; . ' :.l _ ~INCLUDE .YE~) NOTED ON ~E~RSE RE~U~TED ~:./.'::.;:./.'[?'.':;:..'2..::A'.:~.~.yE VOL~..C~GE (COL. llj~BOTTOM LINE)'OF ' :1 . ~. A C~TIVE VOL~.C~GE (COL. ~ ' :~>~;~I~ HEREB~:;C~TI FY--T~T~THE ~ ~O~NOTED: RESULTS 'REPRESENT. A--TRU~-~ .......... . .h..' [' - ......... I-- ~BY-- CERT I FY: T~T--- THE-- ~O~ -NOTED- RESULTS:' REPRESENT? ~ ~....... ~,.~ .~ ............. --::~ -._. ...... -;. ~:~:=. ~ . . . - ~ . : - ::.,:~,A.~CU~TE.:REPORT~::T~T THEY_~ NOT EXCEED THE REPORT~LE-LIMITS .:[ ACCU~TE .REPORT ~D T~T T~Y'~ NOT EXCEED -THE- REPORT~BLE'/glMITS :'~??:~CRIBED 1N.:,A' ,~ "B" ABOVE. - . ' ' - .:1 DESCRIBED IN "A" T~OUGH "D" ~0~. ~ '~'~../.:".:~'. ~.~.':~SIGNED" -~' -" '--' :~ ~ - . '.~ .:-:'TITLE - · ....... ' ......... :1 ..... SIONED .... : : - ~ ' TITTLE ~ ~;.Vc,. " ~ ' '~ i ' ::. / '~' . .'~' ~ -' - ..... ' ..................... '- , .... ....... -'~ ...... ; ................................ :" ~- ~. ?: / :'-': ..... .,./, ~ ?,:~.- · . . .. . .. .. ~. , .~ ~ - . ~/,.' . ...... -'. ~ ~ ...... S~IT A COP~,OF THIS $~Y WITH .FAClLITY~ REPORT ..... '~':'~. :~- .'~"'.~ :~':" '~'"~ ' ' ~TAIN THESE,RECO~S :AT THE'~PE~ITTED' FACILI~ FOR A NINI~ OF T~E Y~S '~ ; ~.,,~'/-:;~%;./~:.::.....~: . . , - :' ~ ,. . . , , . . -- · . -' , . . . . -. . ~ ,- - -'~:~:~?~;':~;~.';';" '. · ~ - : ' - ' ,;:~-.- ~ ,~>~ '' -?T'>~ ~ '.t'~'~::'~: ;~-:-~J.~/' '.. *'. '/ ' ~'~t-~; . !~ '~ ~ ' ~ ': '~.~ ~:~",~ ~ ~;~; . , '.. , ' ~.~7 '.: ' - ~ ~ :~n(~%:~¢~.~:~i::.i<:~ ......:7 .... .'-:,::- .'- - * * -. ~::.'~QU~TERLY MOD!-FI ED ~ ~NTORY...CONTROL SHEET..;- ,* : . . .- : . :- ........ ~"' :';':'~ -- * ~ -- ~ -- -- ' ' l~~ SUBST~CE STORED '''~ ~2~~ QU~TER/~~ ~a ~ :"~ff'~ :.:: :?..:~:~'.,~':[~::;:: .~::'(- .... t:': :.7'.::>- ~'~' ' , :~.~;'~: a~:.,~:~f~,~. .:,~-,~ .... ~. .- . ............ '~:::~%.~,-:~t'"'.~:A': ,-. ~' -'~'~, .~:~: '.':~ ~;~..~:"':'~"-~+~'~/.~.: .............. ' :?~: .... ' ':'.' ' '' ' ' . · . >-~'~ .'.>C~L:'.':~..~.':.:,,-~'~...2 .. ~ 'COL' - 0 ~COL 4 ~CoL ~ COL ' 6 ~cO~ 71 CO~." 8 ~CO~'.' 91 CO~, ~0 I COL. ...:,.:~?~:..~.,?~:........~ :~.'::~ ......... .'. ~ ........... :... ..... ~.. .... . .~..:... ~ ...... : ...... ~ ............ , ,.. ~. - ~....: ..... : ..... :~. ., ., . , ..-- . ......... , ..:... ....... ..... ~", TEST. -~ :' WEEKLY r'W~TE~:'=~-~::~ND :-:. ':~ ~T.:.:"::"..:r NCH .~ 2ND "::':~'S'T ' .::':::VO~~:~~~-~:~ [ .'CU~LAT:X .~.% .... ~ .... , .....~ ..;. ~.~ ........ , ,,:, . . -- . , . . ~.. .... . . .. . .,~. _ . . . . ~ ~--~~~ ......... · ~':* ~:: ....... ,:~'~-~ ~ =========================== ":':'.-'::::>~::::":.:%': '..':,: .... '~: .... '~::' - ; "~ '"" -~[ :' '~:" :"--: ' :':.:":.' :" '. ": [ 't :..::::~'::' "' ': ":' ." :'~ -. ::'.": ' "-: :.:~.--r- ~ . ..... '. ! · ? --' -!,'~ ~,: '_-: .' " :i':i:/~i ~. ':i i.~r._._i,~~ !---?'''~--:''~ .'-'. .... .- -:' ~: · -'.~.:~,' . .-- . . '.-: . · - /I ' ", '~OF';~+/r' 35'.~LLON~?OR'=NORE:"::'''~: [' ,~, ..' ..:'(/:37:.::..:..: ".-':' '"' '..;~:: : · ~ ' ~: F~:~-'~W-~-; .......~.'-~:~,::.-:-. --,~---~;.:*-~ ...... :-: ..... . ..... /- ....... ~ ............ [~ : :W~ ~:'({~ ~': ~:?: ~' ........... :~-; '::" ..... : ........ . .......... ;. :'- ~: ::~.', = :=~. - ___:, . . -~:'_ · . ......... . ~. . ' ..... ~ - . -, . ..'. ~...~. '..?- -.~ ... :*, .....: .. - - ...... -': .............. ~ : -/' :fi~2-~*''':'':. -' : * ~ i ' ' ;' - .. :: ' - ' ~=~' ' ~ ~- ~.~:'~'~:. ::~:;:~::~-:~ ..... ~-~ .~ .... '",:.=..-'-';... . . -:..~ :~:-. - _ .~ . . ~'~ . · .... -:~-~. ¥~-=z'...'-:-=-" ~;%::~.:'~- ~ ,.:~:*.._,:~!-~?-.:.~-, [ ~L~.;.::?.~:~i..=- ~,~ ' '_ ~2...~:~_//~.<=.,~ ' · . :.: '~, ~_:.~ ~: . . ::- ... ::: ./ ': ':.~' "' I ' - ~"-~',~."-)-"~' ..~ "~:? ..' '~ '.. '. ".'"., ' .~ '}~ --" -. "' ~: ~'~k~HE~BY¢C~TtFY-2~T-¢THE~ AB0~&NoT~ ~S~ REPRESENT,. A..TRU~ ~D ................ [':~::~.:/~:~:',:~' ACCU~TE~:3.~PORT.~~T, ,THEY.. ~ NOT ~CE~ THE. REPORTABLE LIMITS · · :-5:': /~z. 55-:*."- . . ' . · :.- ~. ~ ., ' '.. ..... s · ,.. * · '-. ..... ...-~ .. ~ ~:-' ..::~:(;~X~.~:.::~ .' -~ * : . , ' '. .... "..'~ ' . ....... ' · · ' [ ..... . ~--~ ....... :.,-'*:',-:--~,~- ..:'. : : .:~,~: -. .... ~ . . . , , .;. .... ~ ~ - ., - .. . ~ . '~.~'._:~:'~;?:..:;.:::.. , . . ~:~! . ~ . . ~,.~ '. - SUBMIT'A COPY OF THIS ~:¢~;'~'":::~:~ ' ', · ' : . ~TAIN THESE RECO~8 AT THE PEr.TED FACILI~ FOR ~ ~INI~ OF T~E ~S ~~:~7.~:¥'~';~'-:~'~'~-::*'~':~*:%-?:~:~?~':'~:~~'~''~''-~ .......................... ~ ............... ~i~,, · , QUARTER 1 PERIOD 1: PERIOD 2: PBR~OD 8: QUARTER 2 PERIOD 4: PERIOD PERIOD 6: QUARTER 3 TIME PERIOD: Total Minuses This Period (Line 3) Action Number for this ~qrlod (Line 4) Total Minuses This Period(Line 3) Action Number for this.period .(Line 4) Total Minuses This Period,,(Llne 3) Action Numberf~r'thts.pertod (LIne-4)' TIME PERIOD:~ '~/--')- ~/ to Total Minuses This Period (Line 3) Action Number' for thi~ Period (Line 4) Total.Minuses This Pertodl~litne 3) Action Number for this Period (Line 4) Total'Minuses This Period (Line 3) , Action Number got this Period (Line }) 4) ~~ PERIOD 9: Total Minuses This period (Line 3) . · .. Action Number for this Period (Line 4) · . QUOTER 4 .,. TI~ PERIOD: ~:-~ ~-'? ~- to' ~ < ~'~'~-'~'0~:'~':~"~>/ PERIOD' 10:' Total'Minuses This Period '(Line 3) Action N~ber for this'Period (Line 4) PERIOD 11: Total Minuses This Period (Line 3) Action Nuaber for this PeriOd (Line 4) PERIOD 18:: Total Minuses This PeriOd (Line 3) Action N~ber .for .this 'Period (Line 4) I hereby certify this ts a true and ~ccurate report. St~ature. ' Date · ,- ,'.! 11~',',, ~ v; ':..--.,', .", .' ~,,. ~. ? ..... *-. I I .. I ??f~,:' :~:-.~ TIME PERIOD: . /2~'/'~-~c( to Total Minuses This Period (Line 31 .,-~ O'..'~'y:,,~iJ~:,.::~ :; [:?.. :?~ ' Action Number for this eerZod (Line 4) Xotal Minuses This Period (Line 3) .ActiOn Number for this Period (Line 41' TREND ANALYS I ~:~ W t~ Il il. ~ tt t~ I~ 't' TANK # ~ CAPACITY ~_..~L ~'~ '. ' PRODUCT ~) ,~,- S.~'~ ( YEAR/PERIOD ' ' I NSTRUCTX ON'S : PART A : OVERAGE/SHORTAGE Fill in all information at top ol form. In the space for year/ 1 ~,, 16 · period indicate the.year and DAY DATE (+/-) , consecutive· per!od of analysis DAY I .~,--I1~--zi'~ -- being conducted (.from 1 ,througt DAY 2 ~ ~~ ~, 12 o~ly)._ Transfer/ the date and DAY 3 ~[7--~ -- the sign ~rom co,l,qm,,ns 1 and 16.of DAY 4' ~-('y-~ ~ Reconciliation. 'Sheet to columns DAY 5 /-~t~q~ % ' at left. Use the' table belo~'-;tc DAY 6 ~-~_~,~ ~ determine the. action number 'for DAY 7 ~'~'t~ ~ the per~od being 'analyzed. DAY 9 &.~-e~ ~ ACTI ON NUMBER DAY 12 '~*~-~ + 30-DAY [ ACTION DAY 13 .,~':~-~-~ ~ :PERIOD NUMBER[ NUMBER DAY 18 ~-~-~ ~ 5 = 85 DAY 22 ~ ~ ~ ~ 9 ~ ~49 DAY 23 ? 3' ~ ~ 10 = '-165 DAY 24 7 F ~ff ~ 11 = 180 DAY Z5 q ~ f~ ~ 12 = 196 DAY 27 . ~ ti Y~ ~ Circle appropriate period, and DAY 28 7 ~ d~ ~ action number. A full cycle .is ,.DAY 29 q IF ~ % made up of periods 1-1i';,'.after DAY 30 ~ I~ ~{ -- ~hich a nes cycle begins. Use ...... TOTAL MINUSES Information to complete Part 'B'. PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A ............ Line 2. Cumulative minuses from previous periods in this cycle, Line 3. Total minuses (add lines. 1 & 2) Line 4. Action number for this period (from table above) .... Line 5. Is line.3 greater than !the 4? ~-]Yes ~No If Yes, you have a reportable loss and must begin "STANDARD . Env. Health 580 4113 1018 (6/86) notification and Investigation procedures in Kern County Health Department HANDBOOK XNVENTORY CONTROL MONITORXNG'. TANK # .~' CAPACITY - PRODUCT ':YEAR/PERIOD .~,q-'~-~' I NSTRUC'?I ON'$: PART A : OVERAGe/SHORTAGE . Fill In all ln. forma.tIon '.at.top form. In the .iS,pace' for .year! I , 16 period lndlcat~.~the~ year and thc DAY . DATE (+/-) , consecutive period of analySi, DAY.1 .,-O I~-~ ~ be~ing.~ conducted' .(fr'om , ,1 througt DAY 2~ {~ ~~ , 12 only). Transfer the date and DAY 3 '~-I~ ?ff ~ · the sign from columns'l and"16 of ,DAY 4 ~' t~ ',9~ ~- Reconciliation -Sheet to ,.columns -DAY 5 ' 9-~l~ ~ ~ at left. Us~:-the table below DAY 6 9-~ ~ ~ · determine the acttonJ'number for DAY 7 ~ ~.{ ~ -* ~ the period.being, analyzed. DAY 13~ '9-~ ~ ~ '{PERIOD NUMBER{ NUMBER , DAY 16 ~.~0 ;~ -- 3 = 54 DAY 19 ~-~ ' {V -- ~ 6' = 101 DAY 26 ~- *~ ~ ~ . --' ,' DAY ~ ~-I~--{;~ ~ Circle appropriate period.' :;iand DAY ~8 ~-~(-'~"~ ~ action number. A ~fUll.-cYcle:~le.:. DAY 29 ~-f~--q~ = ~ made up of periods 'l~12';~;af~e.u' DAY 30 ~-t~--,~ ~ which a new cycle begins.,-Use: TOTAL MINUSES information to complete PART B: Line 1. Line 2. Line 3. Line 4. Line 5. ACTION NUMBER CALCULATION Total' minuses this period-Part A ........... .. Cumulative minUses from previous periods in this cycle. Total minuses (add lines I & 2) .............. Action number.,.for this period (from table above) Is line 3 greater than line 4? [~Yes I_~ Yes, you have a reportable lpss and must nottftcatton and Investigation pr,ocedures in Kern county. Health. DePartment HANDBOOK "STANDARD INVENTORY CONTROL MONITORING". · Env. Health 580 4113 1018 (6/86) begin '- as described #UT- 10:~..~ TANK e ~ CAPACITY ~ PRODUCT PART A .: OVERAGE/SHORTAGE Fill la all l.nformat/ion,at:.top of " form. In the space .for year/ 1 16 period Indicate'the year and'the DAY DATE ": (+/-) , consecutive period of' 'ana!y. sl ! DAY 1 ~~1~-~' --- being conducted "(-from 1.througt DAY 2 ~-I~. -- , 12 oql~). TranSfer the .date'and DAY 3 '~-(~' -- the siEn' from cOlumns 1 .and 16 DAY 4 ~-I~)' · ~ ' Reconciliation ~ Sheet',to' columns .~'~ at left. .Use the table below't~ DAY 6 ~'~'/~. ~ determine the 'action number for DAY 7 ~-~-~ ~ the period being analyzed. ,,DAY 12 t-~'~' ~ 30-DAY [ ACTION DAY 13 '~-~--~ :PERIOD NUMBER NUMBER DAY 22 q ~"~ ~ 9. = 149 DAY 23 ~ ~-q~ -- 10 = 165 DAY 27 ~ ~ ~ ' ~ ,",4~' Clrcle appropriate period .'and .DAY ~8 ~ /~ ~ ., ~ action number. A full cycle DAY 29 ~-~-~ , ~ made up o~ periods 1.1~, after ,,DAY 30 ~-~-~ ~ ~ ~hJch, a ne~ cycle begins. Use' TOTAL NINUBgS tnformatlo,n ~o cOmplete Part B. PART B: Line 1. . Line 2. · Line 3. Line 4. Line 5. ACTION NUMBER 'CALCULATION Total minuses this. period-Part A ............ Cumulative minuses from previous periods in this cycle. Total minuses. (ad:d' lines 1 i 2) ............. Action number for this perlod.(from table above) ' Is line 3 greater than line 47. oyes O-]No I_[f yes, you.'have a reportable loss and must begin notification and. Investigation procedures'as described In Kern.County He.alth Department HANDBOOK #UT-lO "STANDARD INVENTORY'CONTROL MONITORING*' : .. Env. Health 6eo 4113 1016 (6/86) · TANK # 3- CAPACITY ..~ .. .... 'PRODUCT p/ e.r, t_.. YEAR/PERIOD ~-'~ INSTRUCT! O~;~"S ~ PART A : OVERAGE/SHORTAGE Fill in all information at 'top of form. In .the space for .. 1 16 period indicate t, he year and. the DAY DATE (+/-) , consecutive period' of' analysis DAY 1 c~-{~ '~F ~- being conducted (fr.o~ 1 'through DAY 2 ~-~ ~. ~ , 12 o~ly). Transfer' the date.and DAY 3 ~-,~ ~ -- the sign from columns 1 '.and A:6.of DAY 4 ~_l(, F~ ~ jReconciltation shee~/.to., columns DAY 5 ' ~-I] -?~ ~ at left. Use the:table.bel.O~.':t0 'DAY 8 '~' ~ -~ ~ determine the'. act!on}"number"for .... DAY 7 ,- /9 ~9~ .~ the period' being analyzed. nAY e' ,, ...DAY 9 ~-~{ -~ -- ACTI ON .~'U~BER, , DAY 1o ~-~-~ ~ ' :, T~'~ 'DAY 12 .?-~y -?~ -- . ,. I 30-DAY' ' I ' ' ACTLON 'DAY 14 ' ~ 1 =. /:'20 = '3~ DAY 15 ~-7~-~ .. ~ 2 ~ DAY 16 ~-~-~' ~ 3 = · :~ DAY 17 ?-A?-~ ~ ; .t ~ = . DAY 18 ~,~_ ~ ~ : 5 =., 85 DAY 19 /~-/-'~ ~ ' 6' = 101 , DAY 20 t o-~- ~ g = ~'DAY 21 /~-3-'?~ ' . 8 = ~,133 DAY. 22 /~-~-?~ ~ 9 = ./1'49'. ~'DAY:~ 23 /~-~-~ ": -- 10 = .~ ,,,DAY 24 _/~-~- ~/ ' ~ 11 ' 180"~; ~'~DAY E6 /m~9~ ~ : ~ 12 '~' :'196 ..... DAY 26 /~-~-~ ~ " :... DAY 2~ /~-~'- ~ ~ Circle appropriate period;, and: DAY 28 /~-/~ ~d ""'" ~ action number. ..A fUll'+cYCle::i's. DAY 29 /~-//-~ · C/~' ~ ~,~ made .up of peri. 0ds~,::.. 1~12 ':DAY $0 i~-/~- ~ ~/~ ~' ~e/~ ~hich _a new cycI. e.:'beEtnS'., TOTAL NINUSE$ ~ lnforaation to' ~ap'lete~';.Part/B: B: ACTION NUMBER CALCULATION 1. Total minus'es this period-Part A cumulative minuses'from previous 3. Total minuses (add lines 1 & 2) 4. Action number for this 'Is line S greater than If Yes, you have a PART Line Line Line Line Line periods in this cycle. period (from table above) .... line 4? DYes ~No reportable loss and must begin as described "STANDARD . Env. Hmalth SeC 4113 1016 (6/e6) notification and investigation procedures in Kern County Health Department HANDBOOK INVENTORY CONTROL MONITORING'*. tUT-10 : . ) .; .... . :.: · :: -;: , . -, TR~-ND ANALY$! ~ .l~t.jttltb;tt~,-.JlY.,'l.' .TANK It ~_q CAPACITY 'PRODUCT ~) ie&~ / YEAR/PERIOD ~. I NS TRUCTZ'O,N'S: PART A : OVERAGE/SHORTAGE Fill in all information at top of ~i . form. In the space' for year/ I 16 period lndioate the year .and the DAY DATE (+/-) consecutive period:' ,of' analysis DAY 1' /O-y.~-~/ ~lc~..~cz:," ~ ~e~;~- being conducted. (from' 1 through DAY' 2 '/~-I'/-?~ /' . /fl ,. 12 only). Transfer 'the data,and DAY 3 '~1~-~ the sign from columns 1/ and* iG'~°f DAY 5 , Io-I~-~- ' : ,,, at left. Use'.the::table'belo~ 'to DAY'6, ~o-I~-~' determine the , act/on number for DAY 7 I~-]~-~'~" ~" ~ ~ ~ the per%od' belng analyzed.. DAY is / P RXOD SUre,R[ NU SSR DAY 23 //. ~- ~¢ 10 = 165 DAY 25 //-a-?~ ' .12 = ' 196 ,DAY 27 //-~- 7~ ~ ' Circle appropriate 'period..and DAY 28 //-~-7~ ~ action number. A full cycle DAY 29 //-/o-~ -- made up of periods' .1-12, .after DAY 30 //-//-~ ~'* which a new cyule*begins. TOTAL MINUSES , ~ ~ ._ information to complete Part'B. · PART B: Line 1. Line 2. Line 3. Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A ............ Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) ' Action number for this perlod (from table above) ..... Is line 3 greater than ltne. 4? ~]Yes ~No I_~f Yes, you have a reportable l'oss and must begin notification.'and investigatlon..procedures as described in Kern County Heal. th Department HANDBOOK ItUT-IO "STANDARD'INVENTORY CONTROL MONITORING"'. Env. Health 680 4113 101(i (6/86) TANK # ,, '~ CAPACITY ~;~oC~ PRODUCT ,/i)'ie...~e( YEAR/PERIOD 9~_1-5 I N S T R u'C TX' O'N;IS.: ~/~ : 0¥ERAOE/.SHORTAOE Fill In all lnforaatlon at top of ': - ' ' form. In the space for' year/ 1 16 period indicate the year and the DAY DATE (+/-) , consecutive period . of' analysis .DAY..1 //-~-?~ ~ being conducted .*(from I througt .~DAY 2 //~-5~ ~ ....... ,. 12 only). Transfer the date and DAY"3 It-,~-~ ..~ .... the sign from./.columns 1 and -.. Reconclllation'.sheet to .columns DAY 6 ]l' t~-~ .... ~ ..... determine the .ac.t~!on*:number. for DAY 7' ' //-/~-~ ~- . ...... the period being' analyzed. ,,.DAY 11 ~l-~ -~ ~ DAY 22 Iz'-~-~ ~ 9 = 149 DAY 23 {~-S-~ ~ 10 = 166 'i DAY 25 .12-7-~{ ~ 12 = 196 DAY 2~ /2~-~ ~ Circle appropriate, pe~i°d~' and ,DAY 28 /~-/~-~, action number, 'A full.cycle/~ DAY ,,~9 /2-//-~ .... ~ made up of-periods. .1~2, afte~/ DAY,,~O (~'f~:q~ ~ ~ which a new 'cycle begtns,~ 'TOTAL MINUSES .~ // information to'comPlete Pa~.t.:?'B*2 PART B: Line 1. Line 2. Line 3. Line 4. Line 5. { i . Snv. Health 9eo 41i3 1016 (6/e6) I ' ACTION NUMBER CALCULATION Total minuses this period-Part A ............ Cumulative minuses from previous periods in this cycle. Total sinuses (add lines I a 2) Action number for this period Ifrom table above) . . Is line 3 greater than line 4? [~Yes ~o If~ Yes, you have a reportable loss and must begin notification and tnvesttgatt'On. procedures as described' In Kern County Health 'Department HANDBOOK #UT-lO "STANDARD INVENTORY CONTROL MONITORING" TANK # :~ CAPAC*ITY ~.-* O o o ,, JPRODUCT .]); ¢$,4, .., .YEAR/PRRiOD /.,cji,..7 ' I NSTRUOTION'$ '~ PART A : OVERAGE/SHORTAGE l~lll in all 'lnformatlou-'at t°p of form. In the space ~for year/ I 16 period indicate the year and the '' co, nseCutlve period of" analysis DAY DATR (+/-') ' '1 being conducted fr 1' throusk DAY 2 I~..l~.'~ "]- , 12 only). Transfer the date and DAY $ /~*/~--?~/ ~- the sign from columns .1 and 16 of DAY 4 /~-/~-?~ -- Reconciliation. sheet .to. columns DAY 8 I~-/?'~ -~ · · at left. Use the table/belo#-te DAY 6 12?lP-q~ -~- determine the action number for DAY ? i~-~c)-~ the period being analyzed. DAY 8 DAY DAY,, 13 '1~-~-~ ~ ~P~RIOD NUMBER[ NUMBER DAY 29 /~1~ ~ Circle appropriate per. tod and DAY DAY ~9 ~-I~ ~ ' made up o~ periods 1.-~2, after DAY a0 /-A~'-~-- ~ ~hlch a nas cycle begins. Use ,TOTAL, MINUSES.. // information to complete ,~ar, t' B.~ PART B: ,Line 1. Line 2. Line 3. Line 4. Line 5. ACTION NUMBER ,cALcULATION T°tal minuses this period-Part A ............ CumulatiVe 'minuses. from previous periods in this cycle. Total minuses (add lines 1 & 2) ' Action number for this period (from table above) .... Is line 3. greater than line 4? ~]Yes ~No If Yes, you have a reportable loss and must begin notification and investigation'procedures as described. in Kern County Health Department HANDBOOK tUT-10 "STANDARD INVENTORY CONTROL MONITORING*'. Env. Flealth 880 4113 1016 (6/86) TRIiND Alq AL Y~$ I I$ ~ t~ t.~ 1~ v- ~:~ ~ts- ~': 'A TANK $ ~_~ . CAPAClT~ ~/000 ,, ~ PRODUCT D;e,Se/ 'Y. EAR/PKRIOD 'q.~'-~:~ ..... I NS-TRu,cT'I O'N'S: p~ :' OVERAGE/SHORTAGE . Pill in all infOrmation ast .top" of form. In the 8pace for year/ 1 16 period indicate the'year and the DAy DATE, {+/-) , consecutive period' of: analys.'.ls DAY 1, /-~1-~" -- being conducted {from 1 ,through .,,DAY 2,,! I-~a' ~ & . 12 only). Transfer 'the date.,and DAY 3 'l-~,~-5~ + the sign from columns ,1 and,:lG/.of DAY 4 ~-~--~ + Reconciliation Shee.t: to ' col. uane 0AY 5 ~-~,C-~ -- at left. Use the".,table.,below DAY, 6 /-~-?~' ~ determine the action number for DAy 7 l-~7-~-~ ~. the period being analyzed. DAY 8 I-~ ~- ~. DAY 9 I-~q-9~ ~ ACTI ON N'U~,,B,,,B,R DAY Il I-]1-9~ DAY 12 .'2-l-~ ~ $O-DAY '. I A~TIoN DAY 13 ~-A-~ ' ~ PBRIOD NU~BERI NU~BBR "DAY 14 ~.~ ~ ~ 1 - .20 DAY 15 ~-q- ?~ ~ 2 - '3~ , DAY'16 ~-~-~ ~ , ..... .8 = 54 DAY 17 ~-~-'~ ~ ~ .t 4 = 69 . D~Y 18 2~~ ]- ~ 5 = 85 , ,DAY 19 ~-~-~ ~ ..... ' 6 = 1.01 "DAY ~1 ~-f0-~ ~ DAY 2~ A-II'-~- ~ 9 ~ ~49 ' DAY za 2./~-,ff~ ~ 10 = i65 .DAY 24 2-1~-ff~ ~ 11 = 180 ' DAY ~6 ~-/~-5~ .~ 12 =' lg6' DAY 26 ~-~-9~ ~ , , DAY ~7 ~-I~-?~ -- Clrcle appropriate period and DAY ~.8 ~-/?-q,~ ~ action number. 'A'.full cycle Is DAY ~9 A-/~-P~ ~ made 'up of periods' 1-~2,' after. DAY 30 ~-~-~' ~ ~hich a nee .cycle) begins."" Use ,TOTAL. MINUSE$ I~ ~nformatlon to Complete Part PART B: ACTION NUMBER cALCULATION Line Line Line Line Line 1. Total minuses this period-Part A ............ 2.. Cumulative minuses from previous periods' in this cycle. 3. Tota,l minuses (add lines 1 a 2) ............. 4. Action number for"thl8 period (from table above) 5. Is line 3 greater than line 4? [}Yes If Yes, you have a reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-lO "STANDARD INVENTORY CONTROL MONITORING*'. Env. H~lth 580,1113 1016 (6/86J TANK- t J CAPACITY' ~/ O'oo PRODUCT D;er((' YEAR/PERIOD ~ ~NSTR'U~TIOt~'S: PART A : oVERAGE/SHORTAflE Fill la all Information at't°p.'of · ' form. In the space .~for year/ I 16 ' period indicate the year and the DAY DATE '' (+/-) . consecutive-'perfod of' analys-le DAY 1 ~-~/-9~ ~" heinz conducted ' (from 1 through 'DAY 2 ~-~-7~ ~- ,, 1~ o~ly). Transfer the-date and DAY 3. ~-~-~- -" the sl~n from columns l.and 16 of ,DAY 4 ~-t~-?~ .- ---- Reconciliation Sheet to colulne DAY 5', ~-~--~ ~ at left. Use:'~he table below te DAY 6~'2~-~ ~ determine the act/on number for DAY 7 ~.~-~ ,., ~ the period being analyzed. , 0Al 9 ~-/- ~ ~ ACTI ON NUNBSR DAY 12 ~-~ ~ ~ 30-DAY [ ACTION'~ DAY 13 ~ ~ ~ ~ + PERIOD NU~BERL NU~BSR .... DAY 21 ~-'t~ q~ ~ 8 = 133 DAY 27 J-/~ ~ Circle appropriate period and DAY 28 ~-20-~ ,, ~ action number. A full-cycle 18 DAY 29 ~-J/'~ ...... made up of period8 1-12, after DAY 30 7'~-~ ~ which a.new cycle be~ln8. Use TOTAL MINUSKS /~ Information to complete Part'B. PART B: Line 1. Line 2. Line 3. Line 4. Line ~. ACTION NUMBER CALCULATION Total minuses this period-Part A ............ Cumulative sinuses from previous periods in this cycle. · Total minuses (add lines 1 a 2) ............. Action number'for this period (from ,table above) . . _/' / Is line 3 Ereater than line 4? [']Yes [-~No If Yes, you have a reportable !pss and'must begin notification, and investigation procedures as described in Kern County Health Department HANDBOOK tUT-10 "STANDARD INVENTORY CONTROL MONITORING". Env. Health 5804113 1019 (6/86) TANK # . .~.. CAPACITil ~ 0 o 0 ·PRODUCT ~t" $*~- YEAR/PERIOD · I N'STRUCTX OH'S PART A : OVERAGE/SHORTAGE Fill In all Information at top form. In the space for year~ 1 16 period indicate the year and th~ DA~ DATE (+/-) , consecutive -period of' analysis DAY 1 ~'~-Y$ ~ being conducted* (from. ,1 througt ,,DAY 2 ~;z<~?f ,-- 12 onlY). Transfer~ the date an~ DAY 3 ~ ~~ ff the sign from columns 1 and 16 of DAY 4 ~-~-~ ~ Reconciliation Sheet to columns DAY 5 ~-~-~ ~-- ~ .... at left. Use the table belo~ DAY 6 J-~P.~ t~ ~ determine the action number' for DAY ~ ~-~-9~ ~ the period being analyzed. DAY 9 J~$,~ ~?S ( ...... ACT/ ON DAy 12 .~TJ-~ ~ ~ 30-DAY ~ ACTION DAY 13 ~-~-~ ~ ~ PERIOD NUMBERI NUMBER , DAY, XU q.~.~ ~ 2 = 39 DAY 18 ~-~-~ ~ 5 = 85 DAY 22 ~-1~-~ ~ 9 ~ 149 ..DAY g~ ~-l~' ~ ~ Circle appropriate· 'period and DAY 28 ~-/~-~ -- action number. A full. cycle DAY..,29 q.gO~Y~ -- made up of periods 1-12, after DAY 30 ~-~/-~ff -- which a new cycle:'begtns. Use TOT&L MINUSES /~ information to complete' Part 'B. PART B ACTION NUMBER CALCULATION Line 1. Line 2. Line 3. Line 4. Line 5. {;' "STANDARD t ' £nv. Hmalth 880 4113 1016 Total minuses this period-Part' A ............ Cumulative mlnuse's from previous periods in this cycle, Total minuses (add lines 1 a 2) · ./ Action number for this period (from table above) . . / / Is-line 3 greater than line 4? [-]Yes IqNo I_~f Yes, you have a reportable loss and must begin notification and investigation Procedures as described .in Kern County Health Department HANDBOOK #UT-10 INVENTORY CONTROL MONITORING" TANK # ~ CAPACITY' . O O .... "PRODUCT ~); ase~. yEAR/PERIOD w I NSTRucTI ON'S: ~ : OVERAGE/SHORTAGE . Fill In all information at top of form. In the space for year/ I 16 period indicate' the year and the DAY DATE (+/-) , consecutive period of' analysis DAY 1 ~-)~o~_~- - being conducted (from 1 through DAY 2 ~/'-~ff'-5,~ ~ , 12 only). Transfer the date and DAY ,3 ~.~-~ ~ the sign from columns 1 and 16 of DAY 4 ~-~-~ ~ Reconciliation Sheet to columns DAY 5 ~~ ~ at left. Use the table belo~: t~ ,,DAY,..6 ~'. ~*~,*.~ ~ determine the action number for DAY T ~, ,~,~ . ?..~ ~, ~ the period being analyzed. DAY 8 ~.Z~- ~.~ ~ .,,DAy 9 ~-~0-~~ ACTI ON NUMBER DAY 10 ~' ~' }~ ~ ' TABLE DAY 11 ~'~- ~ ~. DAY Z2 ,'g-~*-~ ~ ~ 30-DAY ~ ACTION ' DAY 13 $-~- ?~' ~ ~ PERXOD NUMBER~ NUMBER DAY 14 ,~ .~ ~Tb~ ~ ~ 1 - 20 ,DAY 15 ~-~-~ ~ 2 ~ 3~ .~DAY 16 ~- ~-~ ~ 3 = 54 DAY 17 ~ P- q~ ~ .~ 4 = 69 DAY 18 ~' ~ ~ ~ 5 = 85 DAY 19 ff-/~* ~- ~ ~ 6 = 101 ..DAY 2Q ~-//~,.~ .~ 7 = llT DAY 21 ~'-.,~'~9' ~ 8 ~ 133 DAY 22 ~-/~-~ ~ 9 = 149 DAY 23 ~- ff~ 10 = 165 DRY 24 = .,.DAY 25 - 196 DAY 26 DAY,. 27 ,~-I~-~ ' ~ Circle appropriate' period and ..DAY 18 ;r-I~-~ ~ action nueber. A full cycle ia ..DAY 29 ~-zo-?y ~ sade up of periods 1-12, after DAY a0 ~-'~1-~~ which a new cycle, begins, Use TOTAL MINUSES ,. ./~ information to cosplete Part B. PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A Line 2. Cumulative minuses from previous Line 3. Total minuses (add lines 1 & 2) Line 4. Action number for this Line 5. Is line 3 greater than If ¥~, ~ou have a periods in this cycle. period (from table above) .... line 4? ~]Yes ~o reportable loss and must begin as 'described tUT-lO notification and investigation procedures In Kern County Health*Department HANDBOOK "STANDARD INVENTORY CONTROL MONITORING" Env. Flealth 580 4113 1010 (6/86) TREND VAC I L~TY ~0~?;/ o~:~ J~',,- PERMI T TANK # 'CAPACITY /~ o o ~ PRODUCT ~[~J,~ .~ YEAR/PERIOD INSTRUCT! ON'S : PART A : 0VERAOE/SHORTAGE Fill in all information at top o! form. In the space for year/ I 16 period indicate the year and thc DAY DATE (+/-) , consecutive period of' · analysis DAY 1 ~-~2-~ ---- being conducted (from 1 throug~ ..D, AY 9. 5-2/-~~ ,~- ,, 12 only). Transfer the date and DAY 3 ~-~t-~-- ~ the sign from columns 1 and .16 of DAY 4 Y~/~- ~.~ ~ Reconciliation Sheet to column~ DAY 5 ./?...~.~-'f~" ~ at left. Use the table belo~ t~ DAY 6 .~'Z~-'~ ~ determine the action number for DAY ~ ~2T-~ ~ the period beln8 analyzed. ...DAY 9 ~JO-~ ~ ACTI ON ~U~BBR .... DAY 12 ,'~'2- ~ ~ SO-DAY I ACTION DAY 13 ~- ~- f ~ ~ PERIOD NUMBER[ NUMBER DAY 21 d-//- ~S ~ 8 = 133 DAY 22 ~-I~-~ ~ 9 = 149 DAY 27 (-~- ~ ~ Circle ·appropriate period·, and ...DAY 28 &l[-~~ ~ action number. A full cycle* DAY 29 ~-/~-~- ~ ~ade up of periods 1-12, after DAY 30 d-~-?~ ~ ~hlch a ne~ cycle begtns~ Use TOTAL MINUSES ..... ~"~' [~ Information to complete Part B. PART B: ACTION NUMBER CALCULATION Line 1' Total minuses this ,period-Part A . . . ..... . . ". Line 2. Cumulative minuses from previous periods in this cycle, Line 3. Total minuses (add lines 1 & 2) ............. Line 4, Action number for this period (from table above) . ~ Line 5. Is line 3 greater than line 4? ~]Yes ~No I.~f yes, you have a reportable loss and must begin notification and investigation procedures as described #UT-10 in Kern County Health Department HANDBOOK "STANDARD INVENTORY CONTROL MONITORING'* Env. Health 580 4113 1019 (6/86) INYO ST. REPAIR HISTORY TANK ~1, 2 & 3 PERMIT ~150011C YEAR PERIOD JULY 1994 THRU JULY. 1995 DATE I WORK COMPLETED I iNV. 'z/18/94 I REPLACE DIESEl'. F.[LtERS/CA.iBRATE FUEl] PPIPI $4506 CHECK DIESEL LEAK - REPLACED METER I S4559 8/03/94 I REPAIRED U/L NOZZEL - REPLACED BOO't'/CLEANI S4645 8/15/94 8/24/94 DIESEL SCREEN PLUGGED - CLEANED 5 GALLON PUMP TEST. NEW GAUGE S'['ICK I S4'/68 1/O4/95 I ~'U[{NISH 1.3 FOOT GAUGE S'I'ICK ,L/[O/9~ [ Remove water :[rom qas and diesel 'tanKs, drain on diesel fill box. J S5882 replaced [ S5925 2/02/95 I ChecKed ca]Libration on Unl. & 0iesel pump[ S6120 3/07195 ~/0.L/95 Oelive['ed 2 gauge s'tic~s to '[nyo S't. Replaced bad un.Leaded nozzle. I S6324 I S'1032 ~EQU!PME ?2080 SC ~,BAKERSFIELD~ CA' MAINTENANCE .'? :~'!:. ',, '.', :¢,.~AL:IE::CON,,TRACTOR$ LIC:: NO. 2'94074~ SEB.V, IC[ .... ' NUMAR.: I~IVoIcE' NO; ~;...e..:~,:~ r:~:?.l,~./~)',?/,~', ¢,.~:Y'. I~*~ ~ ~.~',~,' C~-'r-"~-,~ ':' ~t~l' ~ ~'~ .......... ' '. ..... ': '''~ '~'~'~*"*" ......... [;:,;~'.~'. ~,-,~ ~'¢'*~*:¢ ... ',:, ,~'.' .".. . ....... '.. ' .' ....... . . ,,, ..- ....... . ........ ?.. . , . ..,. . ... ............. , .., ..... ¢. :,.,.,, ,. ~,~::,;-. · ' . "..'' . . Y'".:";"' :'Cf',..'"" '.'..' ', ..," - ''"; .-, .': ', '~ ~" ' . ' ' . - . - ~": . .': ~;;.~ '~¢':.:?'?-~"...7.'" .'~:..~?,' :',;~:,~.~,,:, ¢~,~ ~¢~"7' '*"" ; ...... ::~ '.'" " ' ' ~UH~ ' ' ' . .......... ", "', ...... · - ' , , - ~', - r. .,,., r ...... . , ~ ', · . ' ' - , ' ',' ' ' ' . ','". ,, r;'- '-,:~?~ ¢' ' ;%~' ,~,; ,'. ' ',L:( -:' ~'. '2~: '47~',:¢E?; ./.:":'. '. ':;',~'.:? ':',::;,;':',?:-. :"' ".':."~,,~'.'4'~'~; ':::"'"~,.?."."..-.','" :- "' .' 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PuMP"MAKEAND MODEL ~ '~ SERIA~NUMBER ~' ~ [ CALIBRATION TOTAUZER O~ f~ ~ ?. ~ ~ ~ ~ PUUP-aAK6 ANO MODEL SERIAL NUMaER CALIBRATION TOTALIZER /~g~ 7D' I , ~ES Q ~o ~ES O no PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE PU~P-MAKE AND MODEL SERIAL NUMeE~ CALIBRATION ' CHECKED ADJUSTED TO TOTALiZER FINISH MONEY GALLONS FAST IsLOw FAST ISLOw READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START D YES D NO ~ YES D NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER CALIBRATION' "~?~,~.~"':~' CHECKED ADJUSTED TO TOTALiZER FINISH MONEY GALLONS FAST ISLOw FAST ISLOw ' READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START D YES ~ NO ~ YES . D NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER : CALIBRATION CHECKED - ADJUSTED TO TOTALIZER FINISH MONEY GALLONS FAST I SLOW FAST .';~?.. I SLOW,'. -. READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START ~ YES ~ NO ' ,,~., ~ YES ~ NO ' PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE · PUMP-MAKE AND MODEL SERIAL NUMaER CALIBRATION~ :',' ' CHECKED ' ' ADJUSTEDTO '. · FINISH MONEY GALLONS FAST ~ SLOW FAST ~ SLOW TOTALIZER I READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START ~ YES D NO D YES D NO PRODUCT PUMa-e:: TOTAL GALLONS RETURNED TO STORAGE '~ !2080 SOi'U Ni0N"A~'~,' ,'i'' ~iCA 93307 (805),~834'+,1'~:'1,00 :~,'..!:,/.:. ' ".', ~ ..... . .... , - .. , .. ~', ,' . ~ ~ _ EQUIPMENTdNSTAL[A~ION':~, MAINTENANCE.:.'. .... ~' ':', ';!'CALl .'CO~RAC oR~ L REQUESTED BY?- ~'"; ~;~'.~' ':,L r' PHONE NO; ":' ~ -~,' L ;..,'~ ~'~, ,LORDER NO,-" '."' ;,?'),~:~,', ,..~,~ ~ ', ;.;'b'~,;;', f.:~',/' ,';.'~L: ~:~ ' , ?'~" ~ :~?';:-:'Y~C: ~/.',~:~':. ::.'~.,,., ' ':' :":; -r '.": ,',,, ",:..: ~:~ ::: :,.'. 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' ..................................... , J>.', ¢,7-..;:::~'",.;; ';~:~.'> ,. ~ .'¢ "'- ,.':~ .:t~-,'..,,.t~- .y-:,:..,~;~ ~. :~,~.~:;~ ,: ,;~.,~,. ,~ Date, Completed~/~echnic an(s) . ~ .... ~ . ~~~ ~,- . .~ ...... eOM P.~U. fE R,CHANGE ~ Record of Computer Change, Meter Change, or Calibration I SERIAL NUMBER CALIBRATION START ' O YES ~ NO 0 YES 0 NO PUMP-MAKE ~NO MOOEL SERIAL NU~aER CALIBRATION CHECKED ADJUSTED TO FINISH ~ MONEY GALLONS FAST [ SLOW FAST [ SLOW TOTALIZER I READINGS ~ONEY ' GALLONS TOTALIZER SEALED METER SEALED START ~ YES ~ NO ~ YES' ~ NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE PUM.-MAKE ANO MOOEL 'SE.~At NUMBE. CALIBRATION CHECKED ADJUSTED TO TOTALiZER FINISHMONEY GALLONS FAST ISLOw FAST ISLOW READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START D YES D NO ~ YES ~ NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER CALIBRATION CHECKED · ADJUSTED TO TOTALiZER FiNiSH MONEY GALLONS FAST ISLOW FAST [SLOW READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START D YES ~ NO ~ YES ~ NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER READINGS S~ART MONEY GALLONS TOTALIZER SEALED METER SEALED ?"' PRODUCT PUMP * TOTAL GALLONS RETURNED T0.~[O.R~,~ ~UM.-~AK~ ~NO ~OOEL [ SE"~AL NUMe~R .,C.~ CHECKED ADJUSTED'TO ~... ,'. ~INISHMONEY GALLONS FAST ISLOw FAST ISLOw TOTALIZER READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START D YES D NO ~ YES D NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE METER CHANGE D CALIBRATION ~; ~,~ · Record of Computer Change, Meter Change, or Calibration ~*' MONEY GALLONS .~ ~ FAST I SLOW FAST I SLOW TOTALIZER (~ I I READ,.GS START MONEY GALLONSo 7 TOTAL, ERSEALED METER SEALED , [-1 YES [] NO [] YES r-i NO ...CT PUMP # TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER CALIBRATION CHECKED ADJUSTED TO TOTALiZER FINISH MONEY GALLONS FAST !SLOW FAST ISLOW READINGS MONEY GALLONS TOI'ALIZER SEALED METER SEALED START [] YES C1 NO [] YES [] NO PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER CALIBRATION CHECKED ADJUSTED TO FINISH MONEY GALLONS FAST I SLOW FAST I SLOW TOTALIZER I I READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START [] YES [] NO [] YES [] NO PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER CALIBRATION CHECKED ADJUSTED TO TOTALiZER FiNiSH MONEY GALLONS FAST ISLOW FAST [SLOW READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START [] YES [] NO [] YES [] NO PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE PUMp-MAKE AND MODEL SERIAL NUMBER CALIBRATION CHECKED ADJUSTED TO TOTALiZER FINISH MONEY GALLONS FAST ISLOW FAST ISLOW READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START [] YES [] NO [] YES .it NO PRODUCT PUMP # TOTAL GALLONS RETURNED TO STO.R~, GE PUMP-MAKE AND MODEL SERIAL NUMBER CALIBRATION CHECKED ADJUSTED TO FINISH MONEY GALLONS FAST I SLOW FAST I SLOW TOTALIZER I I READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START [] YES [] NO [] YES [] NO PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE DEALER'S SIGNATURE MAINTENAN~~ .... ,~ ,,, <~.o~.'; >',~ 5', ~,,~ ~ /;.~ ~';~ ,,,.,.,~',,.~'~%~;':~ .,..~,~,~';.:' .:;,~., : '.;'~?? ,'., ,' ?=, ,,~. ~ ; ~,.~.:~ ~" ',,., !. 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I DISPATCH NO. PUMP-MAI~ AND ~OEL ) SERIAL NUMBER - , CALIBRATION READINGS .ONE~ ¢J ~ GALLONS. .OTAL,ZE. SEALED PUMP-MAKE AND MODEL SER)AL NUMBER CALIBRATION CHECKED "x. ADJUSTED TO TOTALiZER FiNiSH MONEY GALLONS FAST [SLOW FAST [SLOW READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START ~ YES ~ NO ~ YES ~ NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER CALIBRATION o..c,.o ,o,,s,...o READINGS MONEY GALLONS TOTALIZER SEALED , METER SEALED - START ~ YES ~ NO ~ YES . ~ NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER CALIBRATION;' '. FINISH MONEY GALLONS FAST LOW FAST TOTALIZER ' ' READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED . START ~ YES ~ NO ~ YES ~ NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STOOGE ,: ; PUMP-MAK~ ANO MODEL SERIAL NUMBER ' :' ' CALIBRATION CHECKED ADJUSTED TO FINISH MONEY ~GALLONS . .: FAST J SLOW FASZ J SLOW TOTALIZER , I i READINGS START MONEY GALLONS ...;'" TOTALIZER SEALED METER SEALED ';:" ~ YES ~ NO ~ YES ' ~ NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE PUMP.MAKE AND MODEL SERIAL NUMBER ' CALIBRATION CHECKED ADJUSTED TO TOTALiZER FINISH MONEY GALLONS FAST ISLOW FAST ISLOW READINGS START MONEY GALLONS TOTALIZER SEALED METER SEALED PRODUCT PUMP · TOTAL ~ GALLO S RETUR ED T STORAGE · [~1 CALIBRATION Record of Computer Change, Meter Change, or Calibration r'"l METER CHANGE D W/M NOTIFIED _.T~'~ ~.~ I~,~ COMPA.Y STAT,ONNO. D,SPATC, NO. ]SER,ALNUMS. iS.p OA 'BRAT'ON · MONEY GALLONS FAST ] SLOW FAST I SLOW FINISHI J ' READINGS START MONEY GA 1. [] YES [] .O [] YES [] .O PRODUCT/ . PUMP # TOTAL GALLONS RETURNE~i~-O'STORAGE . ' CHECKED ADJUSTED TO TOTALiZER FINISHMONEY GALLONS FAST !SLOw FAST !SLOW , READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START [] YES [] NO r"l YES i-~ NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL ' SERIAL NUMBER CALIBRATION' CHECKED ~ ADJUSTED TO F~N~SHMD.MY ,GALLO.S FAST I SLOW 'FAST '.~ [SLOW TOTALIZER " ,, READINGS START MONEY GALLONS TOTALIZER SEALED METER SEALED ' , , .. ': · [] YES [] NO ' [] YES' [] NO PRODUCT· PUMP # TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER CAi~iBRATiON,'~-:T::! u CHECKED · ' ADJUSTED'TO TOTALIZER READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START [] YES [] NO [] YES [] NO PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER CALIBRATION : CHECKED ADJUSTED FINISH MONEY GALLONS FAST [ SLOW FAST I SLOW TOTALIZER , -I I READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START [] YES [] NO [] YES [:3 NO PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER ' CALIBRATION ' CHECKED ADJUSTED TO FINISH MONEY GALLONS FAST I SLOW FAST ' I SLOW TOTALiZER I I READINGS MONEY · GALLONS TOTALIZER SEALED METER SEALED START [] YES [] NO [] YES [] NO PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE · BAKERSFII CoMpUTI~I~.CHANGE RATION [] METER CHANGE [~] W/M NOTIFIED Record of Computer Change, Meter Change, or Calibration PUMP-MAKE AND MODEL TOTALIZER 07~~- ~ m READINGS UON~Y START ~ ~ ~ YEs ' ~ NO , ~ YES ~ NO. P~DUCT PUMP e TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMadE CALIBRATION CHECKED ADJUSTED TO FINISH MONEY G~LLONS FAST ~ SLOW FAST ~ SLOW I TOTALIZER READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START ~ YES ~ NO ~ YES ~ NO PRODUCT PUMP · TO~AL GALLONS RETURNED TO STORAGE .Ua.-MAK~ AND MODEL S~R~AL NUMe~R CALIBRATION CHECKED ADJUSTED TO FINISH MONEY GALLONS FAST SLOW FAST SLOW TOTALIZER READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START D YES ~ NO ~ YES ~ NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER CALIBRATION CHECKED ADJUSTED TO TOTALIZER I I READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START Q YES Q NO Q YES ~ NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO ~TORAGE PUMP-MAKE AND MODEL .... SERIAL NUMBER ,./' CALIBRATION CHECKED ADJUSTED TO TOTALiZER FINISHM°NEY GALLONS FAST IsLOw FAST ISLOW READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START ~ YES ~ NO ~ YES . ~ NO PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER CALIBRATION ' CHECKED ADJUSTED TO TOTALiZER FiNiSH MONEY GALLONS FAST ISLOW FAST [SLOW ' READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED ' · START ~ YES ~ NO' ~ ~ES ~ NO PRODUCT PUMP · TOTAL GALLONS RETURNE~STORAGE . DEALER'S SIGNATURE MAINTENANCE MAN'S SI ,~OM,.~rHISit! FI'~,~p~TE~O.A.GEI----I Record of Computer Change, Meter Change, or Calibration -- ' M~NEY SLOW FA SL FINISH -'. P~u~T _ __ PUMP? TOTAL GALLO,SRETURNE~ TO STORA* .,i'?!!; i.i' ; . 7~/4~7~ 77~ C,ECKED' AD, USTEDTO GALLO.,I.'"~Zq~, ~OTAL,ZERSEALED METE. SEALED READ,,GS START MONEY .~. ,_:~Y~'2r~' i ,YES o.o ~ES °NO PUMP-MAKE AND MODEL SERIAL NUMBER 'CALIBRA'TiON'i ' CHECKED ~".{:" ~'&,ADJUSTED TO FINISH MONEY GALLONS FAST SLOW , READINGS I"' MONEY ' GALLONS TOTALIZER SEALED : 'Al":'-' ' ", 'METER SEALED . PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL ; SERIAL NUMBER ' CALIBRATION CHECKED ADJUSTED TO F~N~SH MO.EY GALLO.S FAST I SLOW FAST IS'OW TOTALIZER READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED START [] YES [] NO I-'1 YES i-I NO PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE PUMP-MAKE AND MODEL SERIAL NUMBER CALIBRATION CHECKED ADJUSTEDTO {. 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':' ,'" Y~ ' [" ~ff': -: ' ' ~U~I~ ' :' ' ~UO~ DELI~D ~R ' I~ TO~ ~D ~0~ P~RCE~ '~ [~?:'::::::?~":~?[:::i;?':~:~::,:~:::~/,:',: <~'~-:."~!~:'::~-~:.~::..,::~u~'f: ::::::::::::::::::::::: ':::~'.:~':~: ',.. :~W': .,:~ :' ~' RE~ou :~ , .:',: ~: .-:' -., :~ ,':~vc~ '-~,,.~DvcnoS '~o~e~-" o~a' ~ ~ J UA~ I~CH~S CALLO~ ~ALLO~ G~LO~ G~LLONS G~LO~S ' - ~LO~ ' I~S O~LLO~ ZNC~S ~LONS ~LONS Z~CHE~ ~ ~ ~L~ ....... ~ .... ~O~ ,~[ 1/600~ 7 65 5/8 7122 7105 ~59472 159450 22 0 O O 17 22 5 O 2/700~ 1 ~5 1/2 7105 6989 159588 159472 116 0 0 0 LI6 116 0 0 1 3/630~ 2 64 5/8 6989' ' 6838 -1597J2- 159588 . 124 ' ' 0 0 0 J~ 0 151 ~24 -27' 0 1 ' O ~' ~ ~.;:.-:::::::'~:~:.:.:::~30~: ' >'~'':~.~.''r/~: :~:::' -~f:' ~l~.:':):: :: ::~i~3 :: ~::?:.':~: ~:6O0~~ :::' :~':.'::~j~:' ".-:;: .:f".-:~" ::' .... :' :' :'. ": -'.:-"'. o -- · · / :. -. ~ ' . ~ :'~ . . .: ..... 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'.',~ ?':?~?.~:':. ~:::~.: :~[:~Wf?.:.'*' :~*?" ~: :'~....::~?~??~.':~'~:~-:*~::'~'~ ......... ~ ~:~.:~':**;'*~'~,,,,.:~**~:*[,*~**~Y .................. *~ ~* -./.? ? * . ~.' *~ ' .k,.:'. * ..~.. .................. *:. *' * ' *, ":** ~ · *" ~' ................ ' t - ~' "'~ *.~" ~ .... ~ ...................... .'": '*.-~ :~ ..... ~. ~ ~ .~.~-.:: ~,..>~ ,,~.. ~-..r/>. ~/.-.-:... :..:.~:: ~,. :.?~..~q.... , ~: ~.::, ~ [.:~: ~., ':~[~.~'.':"..~('~.~.C .:~:,?~n~ ::~, L:::~'~>:: '.,..;~.::.,'~. ~.' ·-..~3:., :..- ~..:..~ .....~ ',: . ..x ',-~.. · :':~ ', ' . . :,:' · .. ~::~: % ~ '~ :.. :~.~ ~ '..'~ >. ' INYO STREET TANK 0495 -//3 {DIESEL) 1995 VARIATION 5O 25 15 ' 10 5 0 -5 -10 -15 . . . -20 2- '2 ~4 6 8 10 12 1~ 16 18 20 22 2Zl- 26 28 30 FIRE DEPARTMENT M. R. KELLY FIRE CHIEF CITY of BAKERSFIELD "WE CARE" January 30, 1995 WARNING! 1715 CHESTER AVENUE BAKERSFIELD, 93301 336-3911 CERTIFICATION OF FINANCIAL RESPONSIBILITY REQUIRED 215-000-~Z~00t04 ~.So ~tdyo sm. K C GEN SVC DEPT GARAGE DIVISION 14.1.5 TRUXTUN AV BAKERSFIELD, CA 93301 Dear Underground Storage Tank Owner: Our records indicate that your business does not have a Certification of Financial Responsibility on file with this office. Please forward either a copy of your existing State approved mechanism to show financial responsibility or else complete the attached Certification of Financial Responsibility form. An attached letter from the State Water Resources Control Board lists the approved financial responsibility mechanisms required to pay for corrective actions resulting from leaking underground fuel tanks. Remember, most tank owners only have to show financial responsibility for at least $10,000 of clean up liability. The Underground Storage Tank Clean Up Fund (USTCF) may be used as the mechanism to cover the remaining accidental release liability. The total amounts of financial responsibility required (check boxes from section A of form) are as follows: If you don't sell product from you tanks, and you pump less than 10,000 gallons per month, check "$500,000 per occurrence". Else, or if you are in the business of selling from your tanks, check "1 million dollars per occurrence". For owners of 101 or more petroleum underground storage tanks, check the '2 million dollar 'annual aggregate" box. All others need only check the "1 million dollars annual aggregate" box. Please be aware that failure to provide the financial responsibility document to this office within 30 days will result in your Permit to Operate being revoked. (25285.1 (b) California Health & Safety Code). If you have any questions, or would like help in completing the Certification of Financial Responsibility, please contact Howard Wines, Hazardous Materials Technician, at 326-3979. Sincerely, Hazardous Materials Coordinator REH/dlm PEP~IT t 120011C ' 1~ 8/6~0~ '4 66 ,1683 18~ 81656 81651 ~ 9/530~ 5 64 3/4 1854 1854 81658 81658 0 0 ,0 0 0 0 0 0 1 Lt/S30~ 7 64 3/4 18~ 1841 e1668 8166g 0 O. 0 0 L3 0 ~s;; .t6/630~ 5 59 5/8 LTL9 1708 .8L806 81792 14 0 .0 0 1~/600~ 659 1/4 1708 '~683 '81821 81806~ 15 0 0 0 35 . 15 -10 I 0 ~" ~ ~7 ~t L8/530~ 7 583/8 t683 1679 818~1 81G21 0 0 - 0 0 ,4 0 ~4 I 0 1.9/530~ ']581/4' ]679 169~ ', 81821 81821 0 0 O' 0 *18 - 0 . 18 0 1 0 ri: ~0/630~~ 2 58~/~ t697 ~657 8t845 8t83t' · - 24 - . 0 0 0 . '40 . ~4 ' -16 . - ~ . . ~5/600~ ~ 55 1/4 1588 t592 81904 819~ "0 0 ..... 0 .... ~ ............. -4 '{~ ~6/6]0~ ] 55~/8 t593 laO~ 8190~ e1904 0 ' 0 ' '0 O ' -11 O It 0 X , ~ - ' ~ 27/630~ 2 553/4 t603 1565 819~6 8[904 ' 12 O' 0 0 0 38 21 -16 ' 1 0 '~: '~. =~' 28/6~0~ 3 541/2 ]565 1560 '81949 - 81926 . 23 - 0 0 0 " 15 23 8 O* D FSEI 5. 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' :~..:' '....:/ ....:~r~..':L-: :~. /~:: ' ....... ': · ~,.,.~: . '. . . :." 0 .... ' · .~ . ·: :,~ o '- ' 0 '. . ' ...... '."j .,~1.. . .. ..' ,. :, ~2.. . "~. . .:,...' ':, .:.:,. 0:.:.~.. ,:-<~::1.,;: .: ', '.~ .: N~ ~ ~:: :%'.f'~ ,..'~' ":~:' :.',' ~ ~:: "~ : :J::'~.~:: ' , · ';... ': :'.~.:~ ';'~a:~'~ (.~'': . :.J:: '/U'~" ~':'~.:';~ '~:'.:~ '~ ~:~,' ~' .;:..:~'::" '~'::' .~:/:"..:/:~..~L.~:~L': %:-:? ],. :~...' :." ' .~ .': '., ~:: : ~." '~- .':.. '..' .' .. ,?..: ', . ' ' . ,; .... ": ..: -: ..... "" ~ ,": · · . ' .' ,, · ' ·: '~ '.,. :. ~'. . . : -:~.: · .. ~ '~': ' '..,~':' ', ~ ~'~:",~:.. :'-':~,:::~ :-.: .-:~L~:". ,-: %~,.:~'~:}v' ~.:.. ,~::.V:'".:-:L ~:Y"..:'~?:::,,. '~:.~:~ ~' '.~.,'.:~.~'....v .',/~..'- '~h~ " '" ':' ' ~:" ' ' · '' " ' ' :" ' " "" :'' ~"' :'".-' "'~" '' ' ''- .... ';: '~"; '~" ' : '"~ , -": ~ '.- · ." u--':" '::- ~:'.' .':~,'~ ~' .' ::~"~ ~.?>.:::!~;~ .'%' ~ ::-'~, ~; '-,. :~.:~: ,'-.' .~'>:- :~:"-~:" - ' .:: .:-' ,~ : ...... '-'.'", ~- "' - ' ' :., ': ' ~,..' . : ·'~ .... . ' '" .." .' · . . .. ~-" ' ':': -: ' . " .' ' · :' .: ' ~ ,~ .' :., : ' ~';~'.: .'f. ":..' "L'.-.::~.:~::' "~:'~Y" '::':":X~.~.'~O~fY~:~::~?Y'~.~.~:L: ~ ~:~"~: ?~Y;'.::::':~.~:. ~::-. ','~.~,'...".'"'. '". J":' '7:,' .'/ '.' ',' :' , .."~., . ' '. ', ' ~ "' . : .~ .,...'.:' '~, '~'",, .'. · '..': ",. ".:~.':-:/ '~.-:'..~.:.' '. - 35 - ~0~ T~S X~ XXXX~XXX~X~XX~X XX~XX~X~X~XX~X~XX~X ~X~X 3266 3093 -173 ;5.59~ 16 X5 ..,~ - . . . .- . ; . . - . , . : ::'.. : ',' ~:..~ ~ · FUELI1.0595 INYO STREET TANK # 1 MARCH 1995 6O 2O 0 -20 -4O -6O -8O VARIATION 2 , i . I .I . i I i I I I I I . . I I . 2 4 6 8 101214 16 18 20 22 24 26 28 30 INCHgl; C'ALLoNS 4 33 7/8 8~1 6 33 851 · 872 6 33 8/8 872 ' 856 7 33 1/8 886- '- 873 1 33 5/8 8'/3 868 3 33 1/3 86e 838 3 32 5/8 838 830 30AN ' 17~530AM : '~ J 9/600AM .... ':tO/CLOSED ' '.,. 21/630AN 32/630M~ 36/600M~ .... :' ~7/63o~ 830 787 _787 "- 779. 783 783 763 .4' 30 ' . 749 ' '8 30. 749 ,6 28-3/8 696 7 26 7/8 646 I 36 7/8 646 · 2'CLOSED CLO~ED,' 3 26 3/4 - ~% 4 36 ,1./2 634 6 35 1/4 693 I869 61510 81491 19 6 34 1:/2 869 6i67 elis21 81510 11 0 0 0 12 11 -1- I O' ' 3~ 24 ' , 653 isl4 81561 ':' ' -: 'I - ' " 6 7 ,, 8 9 1~) 11 12 - 13 .14 . 16 16 17 18' 19 CLO~IIlG N~I'RR~ILY ~R ............. ~ ..... - ....... '""~ - ;,~:"" ~,':: '7' ? ';:.'} ;'" ~o~.. ~LO~. ' ~LO~ ~S .- ~ ' ~LO~.'. L ..:~,' ~C~ ~0~ '~'~'~':' .'~'"" ' -- ~.,..,' -* '- . 81204 81204 0 - - 0 0 ' '. ' ".' -21 912~ '812~ % 0 - 0 - '~ *' 0 812~ 812~ ' 0 0 0 0 4 0 -4 ' I 0 %-% 81234 812~ 30 '0 0 ,,~ ~ 0 30 30 0 0 I - : c' 81249 812. ~gg I ~S , , ~ x~xxxx~ ~~~xx~~ ~ 51 44. -7 alE. 91~ 4 3 - ~a~ "a11~6 S1~9' I ' 78V 81296 81296 . ' . 0 0 . 0 ' 0 '*' : ' ' 0;:" 0 ."' .: 1: ; .'-*JO',' '~ .'" I .. '. ,: ~. ' ".' '0 7V9 81196 81196 - 0 0 0 , ' .... ,8 - ~. '- - '* . 0"'-8 ' -',: 1: *'. *" ,0-' ~' "; . *' - .. q83 81~96 81~96 0 0 0 ~ "- ' . . -.. 81~96 0 0 - 0 ,0' ',* 753 81327 81296 .... 749 .8132~ 81327 0 0 0 . ~EK 2 ~S ~ ~xxx~ ~~~~X~xxx~ ~ 81 78 -3 -3.858 2 - 5 749 81330 813~7 12 0 0 * } 0 0 ~2 ~2 ' 0 ~ ' ' -' 696 81376 ,-91339" '642' 81433 81433 _ 0 0 593 81491 81446 ' 0 0 0 TOTALS DIFSEI,13o0295 INYO STREET TANK # 5 (DI£SEL) FEBRUARY 19'95 VARIATION 25. 15 10 5 0 -5 -10 -15 -20 2 : : : : : : : 1 2 3 4- 5 6 7 8-9 101112131415161718192021222:32425262728 IS/630AH 16/830A/¶ '17/530AN 18/600M! 19/600MI 20/CLOSED 21/630AN 22/630AH 23/530AH 24/530MI 27/630AH · - 28/630AH · IHCHKS CALLOHS GALLOHS · '·7 1/2 4638 5 46 1/2 4500 6 45 1/2 4363 7 44 3/4 4259 I 44 3/4 4259 2 44 3/8 4208 3 43 1/4 4054 4 41 1/8 3?65 4500 153912 · 363 154047 4259 154124 · 259 'I~4146 4208 IS4212 4OS& 1~&383 3?65 154534 NKKK I TOYALS 3698'164594 l~V 77 ' ' 1~134 '"' Z~146 66 1~212 171 1~383 ' Zo.ooo ~L'. 9' G~LON8 10 .... 18op_uCT 10 BEFORK - DI~i~iVKRY. INCHES 'GALLOHS 0 0 0 0 O 0 0 0 0 , - 104 7? ~27: I .0 0 0 51 66. 0 0 0 154 171 17 0 1. 0 0 289 141 '-148 I 0 xXx~Xxxxxxxxxxx~x~,~j~xxxxxxxx~ ~ 873 ~67 -106 .'-13.82~ 3 · 67 ~o'~ z'.. o 15 16 17 18' 19 13 . 14 RATER Zli'~I%~I~RY ?OTAL /'~TERRD APIOUNY . PE~ ~TX~ PO~ ~I~ ~DUCTION ~ O~R OR S ~TIOH CO~ C~ ~S', - ~Lo~ - ~.~0~ ' .'~0~', :-:' :"'~.; :' '" '*' '" .. ''-- .' ~: . .,.' :.:',.,....~- ....,[ ':.: .--, , .,:, , ., "-: ,.. 13~ ' :' 165 .... t7 '.".. [' ' ',' . 0 . 1 13~ " 135 '"' -~ '- ' · 1' ' "- 0" .-,.r · . O0 100" '49":" :'* '~' · "0 i. - 154773 154694 79 ~' :', ' . .. ~' ~ .... 154788 '154773 15 " ./' ' 12', ::'" ~ ,."12.:: '-'~"~ ...~ '.¥ ,':: O: '. '1''.; :i-.'.' .... ?' '.'~'..~:.F ', ~"' ,~'..[ ' ']:~" 1~89~ 'l~eO0 ' ' 9~ - 0 =- t 0 ' 0 155018 1~897 ' ' 111 0 0 100 121 21 0 1 , · 2 ~S xxxxXxxXX~ xxxxx~~ X~xx~xxxxxxxx~Xxxxxx~ xxxxxx~ 469 4~ 15 3.10~. 3 4 ' 155206 155018 188 0 0 0 230 188 -42 -' ~ r 1553~ 1552~ ( '1~ 0 0 *0 ...... 82 .... ;*' 160 .....Z 68"-- 15~8 155356 83 : 0 0 0 146 ' ''81 *: ''~ ~64.: ', 0 0 i' "'* 16 '6' ....'10 ' ~EK 3 ~g : ~ -- - ~~xxx~ ~~k~xxx~xxxXx~ ~xxx~ 6~ 617 -17 -2.76~ 4 3 155635 115 0 O. 0 111 116 4 . 0 1 155V50 90 0 0 0 110 90 -~0 I 0 155840 160 0 0 0 140 160 20 0 156~0 13 ' O' ' 0 ~ ' ' ~; 0 '- .'0 ....... : -13 ' ~13'~- 166013 4 0 0 0 31 ' 4, ~7 15601~ lql 0 0 0 15~ ' 171 . -.19 *, - O* -~ · ,; -. .- ......... · ..... . .....~, -....,.~ "~' : ~ .... '... ~;. ~:t~ .. ;,.. }*.kd'i:.. ': ".. ._ ' ' L' .' ' - ..... . _ ' ' ' . '.."". . .'. ~xxxxl . m~x~ix~ ~XXxxX~xxxxxxxxxxxxxxxxxxxxxxxt~ Xxxixxxu 2718 2596 ' =125 ' =4~,835 ~ ":' :'-'1:~ "~, :' '. ' i6.::' ' .... -':-" -' L . .... :~' "'~' ' ' :': i .... . - . . ~ . ~ -, . ~ , .- ,. ,~ , . =,'.~:~'~; :: ~!., - ;; ,' , , . *. · ' ~ ' . }'~ '~'.'< .... . "' '.':~ '~ ~- .... ,' "/ :"2'. ..... 5 40 8/8 6 40 1/4 7 39 1/2 . I 39 1/2 2 ' 39 3 38 3/8 37 5/8 35 7/8 35 1/4 34 1/8 34 1/4 CLOSED 34 1/8 4 32 3/4 5 31 7/8 6.31 7 39'7/8 I 29 7/8 2 29 5/8 3 28 3/8 3698 36·7 36·7 3846 3846 3546 3846 3~46 3846 3396 3396 3296 3296 3066 3066 298& 2984 2838. 2838 3884 '2854 2838 'CLOSED CLOSED ~838r · ,26~2 2662 285I 155750 2551 2441 155840 2441 2301 156000 2301 ** 2301' 156013 2301- 2270 186017 2270 . 211a z56188 2118 ·1923 156357 .RKEK 4 .TOTM,5 MRKIC $ TOTALS ~ONTH ~TALS FUEl I1.0295 INYO STREET TANK # FEBRUARY 1995 1 'VARIATION 60 --40 20 0 -20 -40' -60 -80 -100 -120 -140 -160 2 123456 7 8 9 10111213141'516171819202122232425262728 mi.m. = o.o ~l!~'~i~~;.:.~..~b~~ ~ ~KERSFIELD, CA 93307 , " ~;~~~ ~. ~' (SOs) aa44 ~ ~ERVICE IN~ICE UTOMOTIVe~~~,INDUS~RIAL a~m~.~uMP~ROLEUM (SOS) ~a-1 QUIPMENT1NSTAELATION MAINTENANCE A _ ,' .o: ':'T:.T:~c 17t~ ' J l ' .... ...... _ .... ~ . .~gb ,i ~-::: : ;' ' ' ' ~'R vIC£ ": . · m~ .... ~ x ,,~ , . ,. .... '.:.:. ' Ol~! Fee ~[ l ~E:~RM~: Net due upO. Re~il:i PLEASE RLW EQUIPMENT / :': ' ': ........ Flfll~ Chl~e ~ ~pet H~th REMIT TO ~,~, eox - I~A~E D OPEniNG OPZ~NO ' CLOSING CLOSING ~TE~ DAILY ~TE~ ~OTAL ~ ,. GAUGI~ GAUGI~C D~X~D WATER '~EN~O~Y TOT~ ~E~D ~OU~ PERCE~ ~GAT~ POST~VE 8092~ 0 0 0 - 5/530~ ' 5 41 1/2 1138 7/600~ ' ~ 41 3/8 1134 1138 80927 8092~ "0 ' 0 , 0 O~ -e u · ' 23/6~0~ 2 37 ~II8 lOt7 989 81097 81045 32 ' ' ~", 24/630~ 337 987. 989 8]085 810~7 . '8 '0 . - 0 0 0 . 0 8 8 - ' 0 1 .: ,~ ~' 29/530~ ] 36 ]/2 9TO 30/630A~ 2 37 98~ 932 5 'TOTgS ~XXXXXXXX XXXXXXXXXXRXXIXXXXX XX~XffiXXXX~XXXXXXXX~XXXX~X~XXRX ~XXXXX 89 105 16' 15.24~ I 2 1o 01,9 INYO .STRtl{i[{/]-I'ANK JANUAIRY 1995 P1 ",VABiA!iON 2O .0 -2O --60 ~ ....... ' ..... ~,. 2 2 4- 6 8 1{) 12 14 16 18 20 22 2q 26 2b DATE D_. OPENING OPENING CLOSINO CLOSI~ PETERDAILY'PETER TOT~ ~I~ ~U~ING ' ~AUCIH~ DELI~D WATER' I~NTORY TOT~' ~TE~D ~0~' PERCE~ ~GATI~ POSTI~ - . ~AU~XN0 ~E~RY_ X~E~ORY - ~ADING ~ ~I~ ~E~D ~T~N , BEFO~ '~ER i~N~RY CAUSING ~DUCTION THROUGHPUT O~R OR S ~IATION' COU~ CO~ ' . ' " 0 ' ' '.' - -'O = .-:1./6oo~ ' 'l.c~zB ' "' .- ~ ' '"- o'" ' ~ "" .... o " " '~' ' ''o .. '. "' '0' ,~ ..,'L~,~- '..,' ~" ~. - '~:'.. ' i, ,..,3~600~ ,' 2 CLOSED '. ~ ~: O . 0' ......""( ' ' ', ':' 0 '. ' ' .- 0'... ~ /0-~'..''- ,~' .O '-~.~,~ l' . .... ..: ". ,. - '-g. t',' [~.. . :¥ ','.:.:' ,, ....-: ' .=3/~30~. 3 52 ~/4 ' . 5~65 . ~ "5~Z6 1}~2~0 · . 1511ii ..~..~ .... :_ 138 - : .... ,~ ......... . - .: ~ ,, . :. 139 . , 5/530~ 5 51 1/8 5140 5019 151498 151368 130 0 0 -' 0[ . 0 121 130 9. O' 6/530~1~1 6501/4 5019 4880 151654 tS149E ]L56 0 O " 139 156 17 0 7/600AN 7 49.1/4 4880 4811 151668 1516E4 14 ' '- O 0 0 69 14 -ES I O ' ' ' ' ' ' [' 5 6 WEEK I TOTALS ' XXXXXXXXXX - XXXXXXXXXXXXXXXXXXX XXXXXXXXXXKXXXXXXXXRXXXXXXXXRXXXXXXXXX]C~ XXXXXXIQ(X 554 2 ' - - · i,z!i~.':~/53;0A~, ' 1 '48 3~'4 ' *'4811 4~/80' ' 151668 '151668 "" "0 ''" ' ' '"' " ' * '~ 0" ' ' ' 0 ~ ' - ' .'" "' * ':4,69 ' '"" '" 0 · :'::~69 .' ":~"1"..9/630M< 2 49 ~,/4 ":"' 488~) "4690 , 151801 ' 151668~ - * ' · ).33' '" J ' ' "0 " ' ' .-'.' - 0 ' ' ' ' '(} , . ' .' :' ~. - ~190'.. :.: ". ,~i';!' 1.33 · :" 10/630AN '3'47' '//8 ': . .4690.' ·4483 ' /52015 , '151801 ": !' 2i:4:: ...... ' · ' - · '; . '* 0 : · - ,' ' 0 ' ' ".' ":{~ I .1/8 .: .,' .; ' ' ;20'7" ' ::,. · 21.4~ .',.. [~ ': '/.,., !~.~' ..:;, -,?":,, ,,'~.:c ,,0,,.x!." ::,:.;]1....~.' .. ,. :'::' ;:~'.:. '::"!.:" :.' ~:"" '., ,:.;.'i .:,. :i ~:<::.'. ' I,': : , .']:t/a30A/t ~' 46 3/8 ' :'. '4483 :: 4363 ' i520~1 .... 182015 :' , ' ' 66, ':'-40 ' ' ' ' ' O' ': ' :' *' ': 0 ', ' 0 "' ' . ' ' : '' * ',1{tO '", ':i~ :'106 * '<'' .: ," i:*I~/600AH . 5'4~'1./2 :. ~4363 ' . 4225 :' i52231 *:151081 ' ,'" :150 .' ": '- . ' :' .'.- ~ , ',. O' ''<:'. '0~ . . ':. ',-: .',)`38 "'. ":' .':.:tSO' 14/600AN 7 43 1/2 4088 4088 1523'/3 15235'/ ' 0 /1~ ' 16 16 O 1' · +. 16 0 0 ~EK ;lTOTALS XXXXXXXXXX XXXXXXXXXXXXXXKXIIXX XXXXXXEXXXXXXXXXKXXEXXXXXXXI~XXXKI~XKXXXR [' XXXXXXXXX 723 746 22 . ., .1 ~3 1./2~ 4088. 40~1. 15237.3 15237 O - 0 - 0 0 17 . 0 -17 ' 1 . .2 C~OSgO '. 0 ' ...~ 0 0 ' ' '~ '~:''0..~ -' "; ...... ..... O 0 ~ ~ "0 "" ' ' 6~.''*~-."='" '~Y':'-~':' .i9,.' 40?1 -4003 1524~O 1523~3 97 :' 0 0 4:'4~ 6 40.1/4 '364~ - 347~ . ' 152919:' "152~82.. ' ~ ' .' ' 14~ · ' " ' ~' ' "*'" ' ':168 '" ~4~ ':::'~2:i ' "'" *-':"' _,~.~' ~_~_34,~P _34~9 ~' 152946 . ,.' _'1.52929_.: ~ lq ; 0 "0 .' · WEEK 3 TOTALS XXX~XXXXXX XXX~RXXXXX~RXXXXX XXXX~X~X~XX~X~XXXXXXX~XXXX, XXXXXXXXX .' 609 '' 573 -36 -6.28~ ~ 22/530~ I 39 , 3479 3463 ' 152955 152946 9 ' ' 0 ' " 0. ~ ' 16 9 -7 1 23/630~ 2 38 ~/8 3463 3296 * ~530~3 152955 118 ' 0 0 O O ' ~67 ~18 -49 . 24~630A~ '.*3 37 5/8 3296. 324~ 153156 1530q3 83 .' 0 0 0 ' .. 50 ' ' 83 ' 33 0 2~6~b~ -~ *~**~' 1/4~ *--~3~4~.'" .'~3098'** ~' iS3~7~ ' : 15~56'. · "*~. 1'iS . ;..~'' *. ~'.' '~"' .' ~: ';.~ ': ~* .' ' 0'~ : ~ -'~ .... .~';:~ . .... . *' ~48 ..... = ~11'8 ....... ~3~* **~ 2~530~ '5'*36' 1/6' ~ 3098 ' '29~' ~' * i533q8' ' ' · ~532'~4. *,- ' '* '? .' !04. * ..... :~" 0 '' " */ ' ; 0' '. '.O ~' , '* . ~ . '. 114' '' :'· "' 10~*' "' '<"~0' **~ -'.'. ~"27/6b0~: ';~ :' 6' 36'~/~': * ' ~2~ -. 4~84. '1~509 '. ;.~i~33~8 . · - -~31. ** *' *' .,35 · .. 2951. 50 1/8 ' ' *: .5002 ' "205~ *-' . ; ' ' '. ** ~ ' ' ' ': 131 ;~* ~0 :j'* ' ~/600~~ ' '~ r .50 ' ': ' '~' 49e~ 4967 '..~5~525' . . ~53S09.' ~.': ':1'6 : .... '.' , '. : ~ . ' ' :. 0 '.' 0 . , , ' . .' '~ ~: ~ :~ ~ '~' ~: 29/530~ 1' 49 'q/8 - 4967 4949 ~53526 153525 I 0 0 ~ 18 I -17 t 30/630~ 2 49 3/4 4949.- 4~94 153651 [5~5~6 L25 0 0 . 0 L55 125 -30 l ' WEEK 5 ~OYALS' XX~XXXX X~XXXXXXXXX~X~XX XXXX~XX~X~XXXXXX~XX~XXXXXXRXX~ ~ XXXXX~XX 329 ~32 -97 -4 ~ ~ ." - ~ :. '~ -~ ,. :':' '.:: , :~ .-,.' :- ~"':" -'. ; ~ ' -'' ' . , : ".' : / '.?~-~ ' -:'":.':'.%~ -~"'~:" · T- '.' ~'';" . :~ ~ :':_L ~_~::,_~ .,~' ',,X .... ~:~ '_'~_.~"~: :_ , _~ ~. _'_X,_'_ :~,__~ ': ~:_/.~:'2 .~_ '-~.~_-~.;~_',.' :~ '~:L ._.'~ _. ',': '; '._;,. ...... ~- ';'; -~'-:~; .... '-~' '-':- ~ ' . '~." .: ~. ~- DIFSELI3o01 INYO STREET TANK # ,3 JANUARY 1995 VARIATION - 12 14. 16 2(. -.,' ...... 2 2 4 6 8 10 18 20 22 24 26 28 30 24 HOUR REPORTABLE VARIATION/LOSS NOTIFICATION Bakersfield Fire Department Hazardous Materials Division 2101 "H" Street :.Bakersfield, CA. 93301 REGARDING: Facility: County of Kern 'Inyo" St. (GAS) Permit # 15OO11C ~'acility Address: 230 Inyo St. Bakersfield, Ca. Name Of person Filing Report: KAREN GEYE, CENTRAL SERVICES MANAGER On 02/07/95--- 6-:00AM ............ _the ab. ore facility_ha_ci an (date and time) inventory variation/loss that exceeded reportable limits as described below:' Tank Amount of Amount of Amount of Daily Weekly Monthly Variation/loss Variation/Loss Variation/Loss Total Minuses Line 3 oi Trend Analysis -138 Gal. 109 Per.8 [ have/have-not stopped dispensing product and begun investigation procedures required by 'the Permitting Authority. 'l'hJs notification is in addition to the phone call I previously placed. KAREN GEYE{ tCENTRAL SER~kES MANAGER ' GENI SE.WCES GARAGE DIVISION B~dCERSFIELD FIIIE DEP~RTN_ENT [5~Y.~II/)OUS ~TEIiI~LS DIVISION V~d~IATION/LOSS INV]~S?ICA?ION REPORT Facility: County of Kern "Inyo" St. Permit # 150011C E'acility Address: 230 Inyo St. Baker.s~ield, Ca. Tank(s) with Discrepancy: ~ I Date/Time of Oiscovery: 02/08/95 Name of Person Filing Report: Karen Geye, CENTRAL SERVICES MANAGER Description Of Discrepancy: Dailey variation exceeded allowable limits usinq LOW THROUGHPUT CHART. -138 Gal. INVESTIGATION SUMMARY The following procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: ~ith~n: I 6 Hours J Owner/Operator or other qualified person is to J Date J Time -. J- review-records fo~-e.rrors before determinimg J.O2/OB/gSJ~IO:3QAf4 I there is a reportable variation/loss. Performed By : Richard Brown 24 Hours 1) Owner/Operator must verbally report I Date J Time discovery to BFOHM and foJ. low-up with writtenJO2/08/95 JlI:OOAM notification on form provided. Performed.By : Richard Brow~ 2) Visual facility check to be performed using I Date I Time checklist on the back of this form J02/08/95 J lO:30Af4. Performed By : Richard Brown 3) Ail product dispensers are to be checked for I Date I Time calibration and adjusted if out of tolerance I ~ Performed By : 48 Hours I I I I I PiPing to be leak tested using approved methodJ I Contractor's Name License ~ Test Performer's Name Description of test performed Date J Time I * * ATTACH COPY OF TEST RESULTS. * * '12 Hours I I I I Tightness Testing of Tank(s) to be performedl using approved tester and method. Contractor's Name : License ~ Test Performer's Name Description of test performed Date J Time * * ATTACH COPY OF TEST RESULTS. * * NOTE: THiS'REPORT MtJ.~T BE SUBMI'.['TED TO '.['HE PERMiTTiNG AUTHORITY WI'CHIN 5 DAYS OF COMPLETION OF INVESTIGATION PROCEDURES. 2. ViSUaL INSPECTION CHECKLIST A. Dispensers All dispensers and their end doors visually checked for leaks. 'All hoses and nozzles visually checked for leaks. 'AIl totalizer seals checked for tampering. Results: All dispensers appear tight Richard Brown .02/08/95 signature/date Dispenser(s) not tight as listed below signature/date JDiSPENSER #ISERIAL ~ICOMMEN'I'S: ..! I. ...[,.:.,_: B. T~nk ~_ All turbine boxes inspected. ~_ All ~i].ls and vapor manholes inspected. Results: Tank area appears tight with no product or liquid present Richard Brown 02/08/95 signature/date Tank area does not appear tight because of 'the problems/conditions listed below: signature/date I ,I J TANK_ ~ I PRODUCT~ I COMMENT~/RESULTS: I · C. Piping Type: }1 Pressure J_[ Suction ... Pressurized piping leak detector(s) tested for proper functioning and detection oi leakage. Suction piping tested ~or indication of leakage. Result T __ Piping tight based on test(s) above. signature/date Piping not tight based on test(s) above, with problems/conditions listed below. signature/date Description TO: Bakersfield Fire Department Hazardous Materials Division 2101 'H' Street BakerSfield, CA. 9330£ REGARDING: .... ., Facility~ County of Kern "Inyo" St. (GAS) Permit ~., Facility.. Address: 230 lnyo St Bakersfield, Ca. Name Off Person Filinq Report: KARE~ GENE, CE~T~L On _~.1/27/V~ ~:O0~ , the above facility h~d 'an (date and ti.~e) . J. nv~nt, ory v~riat'i'on/loss.'that e~6'eeded reportable limits as descr.ibed beloW: Tank 'Amount of Amount of Amount of Daily Weekly Monthly Variation/loss Variation/Loss Variation/Loss 1 +80 Gal. Total' .'Minuses Line.,.3 of 'l'r. end:,:'~Analysi s · .82:,Per.8 -'U.. i have/have-not stopped dispensing product and begun investigation, procedures. required by the Permitting Authority. '.. "":' This notification is in addition to the phone call I previously pla'~ed.' '.'":'~ BAKERSFXELD IFXRE DEPAItl'HEI/T VARIATION/LOSS II~VESTI~ATION. REPORT'"'.?>;::.: Faci.[ity: County of Kern "Inyo" St. f'acility Address: 230 lnyo St. Bakersfield, Ca. : 'rankfs) with Discrepancy: $ Name of' Person Filing Report':--- ~en Geye, CENT~L Description Of Discrepancy: Dailey variation exceeded alloWable-;':,lf~':~[,.J:.~s':i,~q';t.".~.fY' :'~' L ~HROUGHPU~ C~. 80 Gal. ...... .... . .... ,..:_.,,..;~. iNVESTIGATiON SUMMARY The following procedures must be performed within the specified'...t!.me$:>s[~ar~'ing'.' .'i at ~he time a reportable loss is discovered or should have been'df~'c6ver, e~:..", Within: I 6 Hours I Owner/Operator or other qualified person is to I' 24 Hours 48 Hours 72 Hours Date '1 'rime I review records for errors before determining ,101./30/95 108:IsAM . I _the_re__i_s._a _r[eRo[t_ab_le~ v~_ariation/loss. __ _,-..~.~ ' _.:_~i,',-~ _. '. Performed By : 'Richard~"Bro~=, . 1) Owner/Operator must verbally~report I Dat'e--'~-":~ :Time discovery to BFDHM and follo~up with writtenlOl:/30/95.:.[09:'30~: notification on form provided. ,'B .. Performed By : icha 2) Visual facility check to be performed using~ ] :Date~-'.':.J:,' Time' , checklist on the back of this form ~//.f ~OlZ~O.fgp{?-O8:35~ Performed By : -Richard"Br.o~:... ', 3) All product dispensers are to be checked for calibration and adjusted if out of tolerance Performed By : PiPing to be leak tested using approved methodl Contractor's Name License # .Test Performer's Name Description of test performed Date>>.:'".':[ .Time Date "[Time * * ATTACH COPY OF TEST RESULTS. * * Tightness Testing of Tank(s) to be performedl . Date.. '.[ .Time using approved tester and method. Contractor's Name : ~ License ~ 'rest Performer's Name Description of test performed * * ATTACH COPY OF TEST RESULTS. * * NOTE: THiS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY OF COMPLET]'ON Of' TNVEST]'GAT/ON PROCEDURES. wiTHIN:,.~ 'DAYS:, 2. VISUAL iNSPECTION CHECKLIST A. Dispensers Ali. dispensers and their end doors visually checked for leaks. Ail hoses and nozzles visually checked ~or leaks. All totalizer seals checked for 3~al~pering. ReSults: . All dispensers appear, tight ~6hard Brown 01/30/95 , signature/date Dispenser(s) not tight as listed below signature/date DISPENSER #ISERiAL '~ICOMMENTS: I ] I l _t I I I B. 'rank Area { ........... i~'l. A][F-rnrbin-e 'boxe-s--J3nspect-e-d~ X Alii. fills and vapor' manholes inspected. Result's: __ Tank area appears tight with no p~:~uct or liquid present Richard Brown, 01/30/95 ~f~, signature/date Tank area does not appear tight because of the problems/conditions listed below: signature/date ITANK ~IPRODUCT~,ICO~EN'rS/RESUL'r~: I I I I I I ResultS7: detection ot leakage. Suction piping tested for indication of leakage. Piping Type: II Pressure .11' SuCtion Pressurized piping leak detector(s) tested for proper functioning and Description Piping tight based on test(s) above. s i gnat ur e/date,..- Piping not tight based on test(s) above, with problems/cOndi~;i}6ns listed below. signature/datel