HomeMy WebLinkAboutUNDERGROUND TANK FILE 4DAZLYhHKTER
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DI F-SF-I 5.0895
INYO STREETAucUST 1 TAN K 9~935 (D I ES E L)
5O
VARIATION
z~O
50
2O
10
0
-10
-20
-30
-zl-O
-50
2 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30
, ~ 3/630~, 5 ~3
']38'3
.1303
1383
1353
~383'
]383
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'':J383 ,1383 ~ . 16479]i . 164791
1383 ~- 1383 164791 -164791
'.. "lS/63GAN 6 ,3,1 I./4'.
"' ' ' 19/VOOJ~' 7 20,.]/2
· ,, 20/$301H '1 20 3/8' ,
,.,,',,:',. ,' '/2]/6301H . '2, '~0 ]/3
1302 *1223'. .'164943'-' 164876 ,'1' :' ","'~67' , ~ '. " .. ' ' '
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,.' 27/$30~., -t 19 1/8" .!082
· 28/630AN · ~ 19 H, :':'10~9, .
· 31/630AR ' 5 1~ 3/4 ' · . 1043 . ;' 994
',, 17' i
FUEl I1
I NYO STREET '-FANK 1
AUOUST 1995
VARIATION
2O
15
10 -
0
-20
-25
-50
-55
2 2 4 6 8 10 12 14- 16 18 20 22 24 26 28 50
5. 4.1989
MSDS inc.
MATERIAl' SAFETY DATA SYSTEMS
Letter to MSDS Clients
September 5, 1995
4:55
Ladies and Gentlemen,
The purpose of this letter is to remind you of Our Senate Meeting on Tuesday,
September 26th at 9:30 A.M. in Frazier Park, CA (see enclosed m~p).
This meeting will deal extensively with proposed enhancements of our EMRS and INSP
software modules to accommodate the requirements of SB-1082. In addition, we will be
showing our q~w ~oftware product to accommodate the billing, compliance tracking,
permiting, and reporting requirements of SB-1082. This module (working acronym:
CUPA) will replace the current ADMN module for agencies who become CUPAs.
We will be able to show this new software (and the proposed enhancements) on screen
in software. For this reason, it ie extraordinarily important for a representative of
your agency to attend.
Please call If you have any questions or If you know of an agency or individual who
might be Interested in our software products.
Sincerely,
Eric Hutchins
Enclosures
P.O. BOX 6176, PINE MOUNTAIN CLUB, CALIFORNIA 93222
(805) 242-0420- (805) 242-0421 FAX
FRomM 5. 4.1989 4:56 P. 2
MSDS
inc.
MATERIAL SAFETY DATA SYSTEMS
The Date, Time, and Location of our
USER-GOVERNED SUPPORT GROUP MEETING
Our support group is organized according to the three levels of interest of our software
users: The Forum meets in the Northern, Central, and Southern regions in May and
November to receive new versions of each software module, review enhancements, and
discuss future enhancements. The Senate meets in central California every two months
to discuss and design software enhancements in more detail. First Responders meet
in the Central and Southern regions in June and December to review software operation
and suggest enhancements.
Next State-
Wide SENATE: ~ / ~-~/ ~-.~'
A.M. Frazier Park Rec..Center
Directions: Off Interstate $ at Frazier Park (between Lebec to the North and Gorman
to the South)..,West on Frazier Mountain Park Road approximately 3 miles to 4-way
stop at flashing red light,.,Left on Monterey Terrace 1 block to Park Drive.,,Right on
Park Drive approximately 75 meters to Frazier Park Recreation Center on your
right...Turn Right into parking lot.
N
P.O. BOX 6176, PINE MOUNTAIN CLUB, CALIFORNIA 93222
(805) 242-0420 · (805) 242-0421 FAX
EUELS TRVENTOR¥ RECORD~[NG SH~E~
~?: ::: L:s?:s f~:?~? :::::: ~::: :f:f~f~?fs~f~f~f:i:~?:~f~:?:~f~f~f:~:f~i~f~f:::~[~fL
i 0 CA'CIE I~O~Y I~RY ~I~ READING METE~D ~ST~N BEFORE ~TER I~ORY aAUGINO ~DUCTIOS ~OUGHP~ O~R OR S V~IATION CO~ COl 5
~ BALES DELI~R~ DELI~RY
5 DAY'OUR I~CHES CALLO~ ~tO~ GALLO~ ~ALLO~ ~ALLO~ G~LO~ I~C~S ~LO~ INCHES CALLONS ~ALLO~ INC~S GALLONS ~LONS ~LO~ t -- ++
7
6 01/600~ 7 47 1/2 46~8 4638 145974 145974 0 0 0 0 0 0 0 0 I 8
I0 ~KK I TOT~S XXX~XXXXX XXXXXXXXX~XXXXXXXX XXXXXXXXX~XXXXXXXXXXX~X~XXXXXXXXXXXXX XiXXXX~X 1008 939 -69 -7.35t 3 4 13
,I 08/600~ q 40 1/8 3630 3630 146926 ~46913 13 0 0 0 0 13 13 0
09/530~ L 40 1/8 3630 3580 146935 146926 9 0
'12 10/630~ ~ 39 3/4 3580 3363 14909~ 146935 159 0 * 0 0 ~19 159 -60 I 0
26
~/~ ~ ~OS~ ~ 31
~8
29 ~ 36
~0
~ ' 46
HO~H TOTALS XXXXXXXXXX XXXXXXXXXXXXXXXXXXX xxXX~XXXXXXXXXXXXXXXXXX~XXXXXXXXxXxxX xxxxxxxxx 1275 1118 -157 -14. o4~ 5 5 47
41 54
55
51 ~ 68
VARIA-I"ION
4O
,..50
2o
10
O
.... 10
.... 50
.... 40
-50
-60
..... 70
2. 1 2 5 4- ,.5>6 '7 8 9 1 0
~EB~IT $ 15001].C (~
FUELS INVENTORY RECORDING SHEET
.i;~i::.:.:: .: .... :..: : i:i~:,~:J:.i:F.;:. :. i:~::::.:~-:i~;i':: {{~;:~: ::i:.i.~ ............ :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
4 DATE D OPEHING OFENING CLOSING CLOSING HETER DAILY /~TER TOTAL ~I~ OAU~I~. ~AUfllN~ DELI~D NATER I~ORY TOTAL ~TE~D ~0~ PERCE~ ~ATI~ POSTI~
0 ~AU~I~ I~ORY I~ORY ~NG ~ADI~ ~TE~D ~ST~N BBFO~ ~TER ~OR~ CAUCING ~DUCTION THROUGHPUT O~R OR S V~IATION CO~ CO~
~ W ~ES DELI~RY DELI~RY
DAY/SOUR INCHES G~LO~ C~LO~ GALLONS G~LONS G~LONS GALLO~ INC~S ~LLONS INC~S ~ALLO~ GALLONS INCHES ~LO~ GALLO~ QALLO~ ~ -- ** 7
.............. ~0.~ ~3~4 ~5~~6~a63~ o O 9 O 0 9 o o ~ 8
~::::~::~::~:J:::~::::~:~:O~30~ ~::~::~::~3~:~ 3~8:::::~::~:~2~:::~:::~:~ ::::::::::::~e4~ ~:~:::~::::~::~:~:~::~:~::~::~::::::~:~:::.~:::~:~::~::~::~ ::~:~::::~::~ ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::: ~::~::~::~::~ :::::::::::::::::::::::::::::::::::::::::::::::::
9 ~::~:~::~:~::~:~:~::~:~::~:~:~::~::~::~:~3~:: ~::~::~::~:: ::::::::::::::::::::::::::: :::.~:::. ::~::::::~ :~:~:~::~:::~::~:eb~1~:~::~::~:'~:~:~::~:~::~ ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ~::::~::~::~::~?:~:: :::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::~:::::: ~i:: :::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::: ::~::::~::~:: :::: ::::::::::::::::::::::::::::: ::~:/: :~::~::~::~:: ::::::::::::::::::::::::: :::::::::::::::::::::::::::: ::~::~::~::~::~::~::~::~ ::::::~ 12,
I0 ~EK I ~O~S XXXXXXXXXX XXX~XXXXXXXXXXXXXXX XX~XXXXXXXXXXXXXXXXXXX~XXXXXXXXXXXXXXXX XXXXXXXXX 508 479
11 14
08/600~ 7 28 3/4 ~0~ 724 80111 80111 0 0 0 0 -17 0
09/530~ I 29 t/4 724 724 80111 80111 0 0 0 0 0 0 0 0 1
1~ 1,0/630~ 2 29 1/4 724 707 80123 80111 13 0 0 0 1~ 12 -5
~ :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
16 15/530~ ~ CLOSED
16/530~ I CLOSSD 22
17 ~7/945~ 2 CLOSED
18/7] O~ 3 CLOSED
18 19~10~ 4 CLOSED
27
~.~ ..~,,-**..~ ~. .............................. .............................................................. , , ~.;.;~...~...**. ..................... ;.;;;.;;.;.~;.;.;.;.;.~.;.;...;.~......,.......................;... ............. :.........:.:.:.......... ................ ;...;.;.;.;.;.;....;.;.;..........._ ........... ....;..._ .................................**................_..........._.... ............
Z2 24/755~ 2 CLOSED
25/755~ 3 CLOSED ~
~ 26~55~ 4 C~OS~D
27/755~ 5 CLOSED
~ ~8/755~ 6 C~OSZD ~ 32
:::~::~:~:::::~:: ::::::::.: :: ::::::: ::::::::::: ::::: :: ::~:::.::::::: :::::::::: :::::::::::::::::::::::::::::::::::::::~EK:~4: TOT~S :::::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: .X~X~XXXx:::::::::::::m::::::::::::::::::::::::::m:m::::::::m::~:::::::m:::::::::m:::::::::: :::::::::re:mm:
~7~ 36
18 [ 37
~ 40
= ~ ~::~:~i~i:.:!.:: ':. · ,i/io~o=. :': =' ~OS~b'-i: :i::::%;:,~:~: ~:'~; '~: ~ ~ ~'" "' ::~:' ~i::~;~i~.· ~ ::. ;;~::'?~';}~;~i;~ i~!~i! !~i~ ~i ~' ~ '~L~i~ii~}i~ ~:;i~:}~}~ii~i~i~iii~i~ii~iii~ii~i~iii~i~i~i~i~ii::ii~ii~i~::ii:ixi~i::~::i~;:~::~i::i::i::i~i::i::~i:=~:;i::i~i::i;;~::~i~?:~i~i~i~i~i::i~i:~;.~i::~i~:~:: :~; i~i~i~ii~ii~i~i~i~i~i~i~iii~ii}~i~i~iiiiii~i::i~i:`~}~i~i;iiii~iii~i}~ ~:;~; ~ ~i ~i~i~ ~ii ~ii~;ii~:
3~ ~EK 5 TOTgS XXXXXXXXI XIXXXX~X~IXXXX X~XIXXXXXgXXX~XXXXXXIffiXXXXXXXXXX X~XXIX 0 0 0 SDIV/OI 0 0 45
3~ ~ 46
HO~H ?O~LS ~XX~XXXXX XXXXXXXXXXXXXXXXXX~ ~XXXXXXXXXX~X~XXXX~X~X~X~XXXXXXXXX ~X~X~ ~ 508 49~ -~ -3.46~ 5 5 47
4oj ~
~7 I 62
63
70
INYO SI-REEl'-TANK
OCTOBER
094
1t}74(DIESEL)
VARIATION
20
10
5
0
-5
-10
--15
-20
2 1 2 5 4 5 6 7 8 9 10
FUELS INVENTORY I~¢OPJ)INO SHEET
PRRIRIT ~ 150011C
...... ; ............ SALES ............ ..~__DELIV~ELL~ER¥ ' - ~J ~
c, ALLoIq9 ~ALLONS, CALLONS CALLONS INCHES CALLONS INCHES CALLONS CALLON$ INCHES CALLONS
THROUCHPUT OVER OR S VARIATION COUNT COUNT
CALLO~ CALLONS ~ -- ,~
113253 113105 149 0 0 0
165
118 -17 I 0
~ I~EEK I TOTALS XXXXXXXXXX
8."710APl 2 33 3/5 2~I1 1535 113848 113667 ISl 0 0 , 0
555
2O6
181 -25 · I O~
10/625AM 4 30 l/Z 2378 2193 114202 '114003
0 165
200 15 0 I
15/630AH 2 25 5/8 1792 1662 114726 114557 169 ' ' 0 '0 '0
17/625A~ i 23 1493 1319 ., 115048 114918 130 ' 0
1171 9486 115342 115198 144 ,~ 19
130 , 169 39 0 1
164 130 -34 I 0
24/600A~ 4 62 3/4 9195 9142 115737 115639 98
a6/910~ 6 Sl 3/t 90~9 9062 115753 115737 16 .
2~/600~ I 81 9008 902~ 115813' 115792 ,, 31
:: ..;::..: !;:.: . ·
NEEK 5 TOTALS, XXXXXXEXXX XXXX~XXXXXXXXXXXXXXX gXXXXXXXEXXXXXXXXEXXXXXXXXXXXXXXXXXXXXXX , XXXXXXXXX~'
337 319 -18 -5.64~ 2 0
INY()
N()VI
50
4
?()
1 ()
()
.... 1 (')
...... 2(')
..... 4.0
50
60
2'.2 4 6 ~"~ 1(') 12 14 16 '1 ~ 22
. . :_., 7('.) ?. 4-
FUELS It~VEIq't'OR¥ RECORDII~C SHEE?
0 CAV¢INC IIqVEI~I'OR¥ INVE~?OR¥ ~M)IN~ EFADIlq~
~. DAy/HOUR *INCHE9CALLONS C/~LLONS CALLONS CALLOI~S
PERi, IT $ 1500~1C
METERED ~DJUS?MEN BEFORE AFTER INVENTORy CAUOINO REDUCTION THROUGHPUT OVER OB S V~IATIOH COUNT CO~
1/~2~ ..... ~--3~ 3/4 e~3 e09 62~03 62570 33 0 0 34 33 -1
1 O
0 1
S~71~-A~ ...... ~ 59 9/8 1926 1626 63196 63035 '1'/1 '/0 0 0 ~'
;0~'~ 2 46 3/9 1303 1306 6364.0 63533
102
$$
~6/~iOMI 6 65 IlS IS63 1~63 6~164 6~164
.27/630AN_ ..~_7_6,51Z8__.2____1863._ .... l~tk__$.tli9 .... 6~1~__
.EG/620AIq I 647i/4,,_ 1841 1835 64189 64199
27 1/3
66'/ 64 1/8 183~ '
o b ....
o -9_ 1 o
25 3 0 I
TOTALS XX~XXXXX~X .,XXX~XXXXXXXXXXXXXXX XXXXXXXXXXXXXXXEXXXF. XXgXXXEXEXXXXXXXXXXX X~XXXXXXX 106 '1~0 -$ -3.33~
~o~H_'rer,,u,$ ....... ~xx~xxxxxx~xxxxxxxxxxxxxxxxxxx-~xxx~xxxxxx~x~xx~xxxx~xxxxx~x`xxxxxxxxxxx~x~~1~ ........ _~_~....:___:~2 ..... r2.
2 0
15 18
INYO STREET TANK
NOVEMBER
# 5 (DIESEL)
1995
40
,~(')
2O
'1 ()
0
..... '10
2(.)
..... 50
..... ~t.()
.... 50
....... 60
VAI:~IA'I'ION
FUELS INVENTORy I~CORDING SHEET
1/$30A~ ........ 6~47~374 .... ~1'349'1'1~6~60721'::'-~ ........ 60541' '180 '0' 0 ...... k0' '185 --
2/800~ ?'42 1/4 '1164 11~1 60741 60721 20 0 0 0 ~1~ ~O 3~ 0 I
'8/645,,~ ..... 6' 2S'~172~'~699~-699-~-'6~1'91--'.
9/630.,'~' ? 28 1/2 699 691 61191 61191
;AH ...... r'28"174---~691'' 699 ..... 6Z191 ..... 61~9~
11/638f,~ 2 28 1/2 699 585 61311 '" ,61191
0 ,
~0'
120
0
~0
0
'0~-: ........~0~ '~0
0 ' ,0 0 8
'0~0 =8
O ;~ 0. 114
0 -$ I O
Il0 6 O I
17/$15~ .... 1"64 .............. 1835~1848' ~'61599~6Z599
18/658,~d,~ "2 64 1/4 1848 1694 61~40 61599
197625,~R ...... ~"3~58'~3/4 ........ 1694~1641~61809~$1740'
20/620,/~ 4 59 16~1 1506 ' '; 6191~ '~ '61809
'0 0
'0'
0 ~*0 0 0
0 i 0 154
0 ' ", O~ 135
103 -32
0 1
0~1
0
0~1'
1
25/$38,/~ 2 44 1/2 1240 11~8 62181 62167
2~/625,/~H · 4 39 1/4 1029 962 62450 62382
115 0
'100'
,68 0
~8~'
O, ,0 " 102
0 .... ~0"--"~--~109·
0 i O, 6'/
0 ...... & 85
68 I 0 I
P, OEITX TO~ALS
XXXXXXXXXX X,~XXXXXXXXXXXXXXXX XX~XXX,~XXXXXXXXXXXXXXXXX,%'XXXXXXXXXXXXX XXXXXXXXX
2058
2029
OCTOB'ER 1
4.0
..... 1(.) '
..... 1 5
2(. .
...... 2,) ...........
2 2 4 6 8 10 12 14- 16 18 20 22 2.4 26 2.8 ,30
FUELS ll~VEN']'OR¥ REC:ORDIMC SHEET
9AY/HOUR
0 GAUOINO Ii~'VEFI'OR¥ INVEM'i'OR¥ ' BEADINC READING
N I~CH~$ GALLONS O~.LLONS CALL,NS' GALLOWS
6 62 3/6 6687 6636 , 1100~1 110004 17
BEFORE AFTER REDUCTION , THROUCHPU?
16 -52
8/64b~
$ 57 3/4 6~'~'~ ~5753 ':* 110758 110635 123
0/630~1~__~__~ .55~.5~5~5~63. 5~.45 ,110l~4 IL0~5~
10/645~ I 55 1/2 57~5 5745 110782 110774
TOTALS
0
18 - 16
20'/ 182 -25
I 0
*0 ": ......
I 0
15/600.'~l '6 50 5/8 5071 4898 111579 111403 ,
17/515A.~ I 49 1/8 4863 4915 111511 111595
l ....... 2_49_1Z2~ ~!.5_ 4 ~.0.~ X~5~$ ........... ~,~1.~! 147
19/655A~ 3 48 4~07 4535 '111i26 111750
'0
' 0
.35 15 -19
208 147 -61
1~2 150 -22
I 0
' '1--0
I 0
24/610AH 1 43 4020 4030 ' 112424 :112412 12
28/545AH 5 40 3613 3445 112952 112800 152
143.
67' ' -51
WEEK 5 TOTALS
~X~X~ _~X~t~KXXXXX~XX ~XXXXXXXKXXKK~XXXXX__XX~XXXXXXXXXXXXXX~' ~'XXXXXXXXK
3391
3101 -290 -9,35{ 19 12
IN¥O STREET TANK #
OCTOBER 199,3
1
'120
'1 O0
80
d 0
2()
0
...... 20
...... 4.0
.... 60
--.80
.... 1
120
..... 14.0
..... '160
..... 18(3
RI "' (')
VAI AII..N
2 2 4 6 8 10 12 ! 4- ! (5 ! 8 '2('.) 22 2'4 26 28 30
FUELS XNVglt't08¥ RECOBDII~ SHEET
' .~[~ALES DELIVERY" 'DEL~ES~
'~ [/6151N $ 52 1/4 1498 1386 $4616 64810 , 106 0 0 0 109 106 -3
O/$38Alq .... ~4'~3-1~0~1'193~1049~6~947'+~"~66819' 128
9/6301N 8 39 7/e. 10~9 1000 64996 64947 49 ,
· IO/640AN~'~'6'~3?~3~6~IOOO'~OTO~GSO33~&4996' 3~
'',: 11/630~N 7 .1/2 " 970 966 68033 68033 0
0 0 0 4g 49 0
0 0 0 4 0 -4
I 0
~1~0~
0 1
0 *~1
I 0
'27/625AH 2 45 1/2~ 1274 1189 68762 65684
O' ' 0 "+ , 0 0
'0~~ 0~ O' .~7'~-~ :'0~
78 0 ; 0 0
'0' O' 0 0
, 0 0 0
--17., . 0 ............17'
~ 'fO'fALS
1499
1476
I NYO STREET TAN K
DECEMBER
1295
# ,5 (DIESEL)
1995
VARATION
50 ·
25
20
15
10
5
0
-5
-10
-15
-20
2 2
; ; ;
;
4 6 8 10 12 14 16 18 20
22 24 26 28 30
HOUR REPORTABLE VARIATXON/LOSS
NOT] F ] CATION
:ro_~
Bakersf.ie]d P'Jre l)epartment
Hazardous Materials 0ivision
2]0.1 "H" Street
}~akersfield, CA. 9330[
R E(-:AI{I)~! NG:
Fac~]~t_y_L _County of Kern ~.lnyo" St. (GAS) Fermi~.__~ ISO0]IC
Facil[~y Address: 230 '[n¥o.S/. Bakersfield, Ca.
Name Of Person ~'ilinq Repo[t: KAMEN GEYE~ CENTRAt SERVICES MANAGER
On ._[2/3[/93 O8:O0 AM , the above facility had an
(date and time)
~nventory variation/loss that. exceeded reportable limits as described below:
Tank
Amount of Amount of Amo~nt of
Daily Weekly M~hthly
Variation/loss Variatiop/Loss Variation/toss
Total Minuses
Line 3 of
Trend Analysis
-244 Gal. 108 Per.7
'( have/have--not stopped dispensing product and begun investigation procedures
required by the ~ermit. ting Authority.
,[, ·
. h].~ notification ~s in addition to the phone ceil I previously placed.
VARIATION/LOSS INVESTIGATION REPORT
~'acility: County of Kern "[nyo' St. Permit ~ i§00[IC
~'aci.].ity Address: 230 Inyo St. Bakersfield, Ca.
Tank(s) with ~)i. screpancy: ~ [ Da~e/'['ime of Discovery:'Ol/03/94 8:OOA~.
Name of Person ~'iling Report: Karen Geye~ CgNTRAL SMRVICEM MANAGER
l)escription Of l)iscrepancy: Monthly variation exceeded allowable limits using
LOW THROUGHPUT CHART. -244 Gal.
INV~:S'.t'iGA't'ION SUMMARY ~
'J'he fo]lowJng procedures must be performed within the specified times starting
at the time a reportable loss~, is discovered or should have been discovered:
6 Hours I Owner/Operator or other qualified person is to I Date I 'rime
I review records for errors before determining J 1/03/94.....~ 8:00AM .
I there is a reportable variation/loss.
'Performed By : Richard Brow~q
24 Hours
All product dispensers are to be checked for I Date
calibration and adjusted if out of tolerance I. o
Performed By :
Owner/Operator must verbally report I ~ate .I .'l'im~ ..
discovery to B~'DHM and follow up with written,-~/~
notification on form provided. _ ,~
Performed
Visual facility check to be performed,~usi~g I D~t~ I Time
checklist on the back of this form I [/03/94 I 8:30AM.
,Performed 8y : Richard Brown
I Time
48 Hours I
I
I
I
I
Piping to be leak tested using approved methodl
I
Contractor's Name
I'.icense # Test Performer's Name
I)escription of test performed
~3ate I '['i'me
* * ATTACH COPY 0~' ''"c"'
!g..,[ RES{J2'['S. * *
'1~ Hours
Tightness 7'estJng of Tank(s) to be performedl
using approved tester and method.
Contractor's Name :
I~icense ~ Test Performer's Name
Description of test performed
Date I Time
* * ATTACH COPY OF 't'EST RESULTS. * *
NO'[' E:
'['MRS REPOR'[' MUST BE SUBMITTED TO THE PERMIT'I'ING AU'rHORI"I'Y WITHIN_ 5 DAYS
OF COMPI'.ET.[ON OF INVESTIGATION PROCEDURES.
2. V'IEUAI, ]N,,PE(.I.IOR CHECKI.I~;T
A. Dispensers
....... ~__ A].] dispensers and their end doors visually checked for ].eaRs.
X All hoses and nozzles visually checked for ]eaRs.
X All t. ota]izer seals checked for ~ampering.
Results:
.... _X.__ All dispensers appear tight Richard Brown 1/03L94
signature/date
Dispenser(s) not tight as listed below
signature/date
_LD'[SP~.'NSER ~1 SER.EAI: .~
I
Tank Area
A]] turbine boxes ~nspected.
~_ All fills and vapor manholes inspected.
Results:
~_. Tank area appears tight with no product or liquid present·
Richard Brown 1/03/94
signature/date
Tank area does not. appear tight becatlse of the p~oblems/conditions listed
below: ,
signature/date
~I'I'ANK ~IPRODUCT~ICOMMENTS/RESULTS:
I I I
I I I
_1 I I
C. Pipin~ Type: J_[ Pressure 11 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, ba~ed on test(s) above, with problems/conditions
listed below.
signature/date
I)escription
10, 000 GAL.
PRODUCT UNLEADED
17 10 19
PERCEHT ~GA?I'VE POS?I'VE
3/600~ , , 6 74 9194 0102 ·116610 116557
I 73 ,' 0071 8110 116639 116636
30AR 3 72 3/8: 7993 7920 , 116914 116720
194
' . ,, 13/'540M4 1 60 3/0
"~'L , 14/62~ 3 67 6/0
7396 . . 7205 117467
117179
117309
16 r
· . 150
,, ".?: 31/626M,1 3 617/0
23/625AR 4 61
6619
6500
6500 110066
6466
WEEK3 TOTALS
117994
' 29~/'10AN 4 50 1/4
'~'' .... ~30/800~ 5 50
, :,REgK 4 ~'O'TAL$ UAAAA~.~,AA
6124 6107 119485 110403 93
6107 6090 110500 118485 '
31/800AH
6 50
6000 60?3 110500 110500
17 83 66 0 1
17 15 -2 I 0
AF..CEtVED
L
FUF-I I1 o 12_95
INYO STREET TANK # 1
DECEMBER 1993
VARATION
8O
6O
4o
-6O
-80
2 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30
INYO STREET-1-ANK #
AUGU$.T 1995
1
VARIATIONS
80 ~ .
-60
2 2 4 6 8 10 12 14 16 18 20 22 24
26 28 30
CAPACXTY 10o 000 GAl,. PRODUCT 'UHLKADED ~ .....
~t~dS? 1~93
3/630M~ 3 47 6/0 4666 4516 103093 103797
4~63M~4'"46'6,/9~4610~4431 ........ 104040 ........ 10389'2'
5/eOOAH $ 46 4431 4326 104141 104049'
6/~OOAH ......... 6~45-1~4~4329~4242 ........... 104'~e6 .... "~"104141~
7/eOOAIt 7 44 5/0 4342 4342 10410~ 104105,
95 0 0 0 130
156~ O' 0 0 07 --
93 0 0 0 0 , 103
45 0~ 0 0 04
0 ~' 0 0 0 0
96 -43 ,1 '. 0
93 -10 I ;, 0
0 0 0 I
13/eooM! 6 4.1 .1/3 3016 3647 .104765 104606
14/830Mi 7 40 .1/0 3630 ' 3680 .104020 104020
II'BSK 3 TOTM'$ X~:xx,*xxxxx
169
-.10 I ' 0
'$$':= := : =746 .......... ~G ..........
-60 ! 0
642 -~0 -3.12~ 3 4
31/00011l 7 34 3/6 3870
3070 105559 106559
32/0001~ .1 34 3/0 3070 · 2054 106660 106669
0 ~ ' 0 O. . 0 0 ' ,0
xxxxxxxxxxxxxxxxxxx ~xx_,xjKxxxxxxxXxxXxxx,~XXXX][][xx]cx~x~ ~ Ffl'xxY. V, XX 710 '
0 0 0 0 1~
,, 0 0 0
731 31 3, 07~ 2 6
0 . -16 I 0
l~gX 4 TOTAL9 a,va]maaa]~,A
'39/90011 I 37 l/O 1969 1968 10~402 106375 26
06402' 107
jLxkkxx~~ xx~x xxl~xxxx k xk~xx]flt'X'W~X'I~FA~"X~tlflL~EF~Z
0 0 0
0
902 8.17 -06 -10.40~ 4 3
35
0'1/ eO -7 I 0
]~ ~Wxxxx](x xxxKjt~Y,J~ ~
TO:
BaKersfield Fire {)epartraent
1 2 '/994
REGARDING:
· ' ,- the above facili-ty--had--a,n~
(date and time)
-204 Gal. ~Per.04
i have/have-not stopped dispensing product 'and begun investigation procedures
required by the Permitting Authority.
Facility: County of. Kern "lnyo" st .... Permit
Facility Address: 230 lnyo St. Bakersfield,: Ca.
TanK(s) with Discre I Date/Time of Discover'
150011~
8: O0/kl"l. '~
£NV~:MT'tGAT'[ON MUMPlARY
The fo] ocedures must be
-med within the s
'fled times start'
Hours ~ Owner/Operator or Other qualified person is to I
[ ue~iew_records for. errors before.deter g
there is a re variation/loss.
Date { Time
9: OOAM .
discovery to t4FOHM and follow-up with written]lO/.o3/94. [
notification on form provided. ,~.//
Performed ti : Richard Brown
13) AIl product dispensers are to be checked for
calibration and adjusted if out of tolerance
Performed $
0ate } Time
Contractor's Name
License % Test Performer's Name
Oescri of test
~!~o{' 72 Hours I Tightness Testing-of TanK(s) to be performedl oate { Time
~, { using approved tester and method. { [
,~? { Contractor's' Name : ........................................
Ail hoses and nozzles visually checked for leaks.
Ali totalizer seals checked for tampering.
]spense[
¸ow
signature/date
Richard Brown 1o/o3/94
signature/date
signature/date
Results:
n piping :Ion o
Piping tight based on test(s) above.
cage.
listed below.
'0
FAC:ILI'ff , I~ZO ST. ?A~]C '1
C~ACITY
10.000
10 11 13 13
14
1G
16'
A~av~! 1994
17
10
19
3/600~1t 4 34 3/e 2870 ~757 139673 139504
0~/$00~1~ 6 ~2 1/~ 3~9S 3408 130900 139049
06/600~q 7 31 3/0 3400 3510 13990~ 139908
O?/b30,1~l 131 6/8 ~19 3~7~ 139920 139908
169
176
59
0
0 0
0 0 0
0 0 0
0 0 0
113
159
110
-31
4'/
169
171
59
0
13
-$1
13/540~q .6 37 1953 1777 140643 140405
13/102~ 7 35 1/3 1777 1719 140653 140643
14/~30AR I 35 1719 1748 140673 140653
~ . '~gEK 3 TOTALS
10
30
0 0 0
0 0 0
0 0 0
X~X]~'~'xx~x XXXgXXXg'gXXgXXXXXXXXXX,~X~ ',~XX]OOOOLV. X
176
50
150
10
753
-16
-48
49
119 3/4 1043 ' 1031 141399
PEK 3 TOTALS
3 19' 5/9 1031 937 141603
141399
141399
XXmXr, CgX
10 0 0 O'
~'xxxx~xxx~J~ XXX'XXXXXXXXXXX'zF~_XXX'Zl~Xx~]c'z~yJCXXXY, XXX XXXXXXXXX
303 . 0 0 0
717
194
10
736
303
9
349
1
~E 4 TOTALS
39/630~ 3 10 1/9 306 9480 143331
30/640Atl 3 76 3/0 0400 0301 143464
143175
143331
146
143
767
143
43
-73
-36
6,40~
31/640AH 4 74 7/9 9301 8355 143561 143464
9? 0 0 O 0
97 51
0 I
INYO STREET TANK .#
AUGUST 1994
1
6O
40
2(.3
-6O
--8(.)
VARIA"I"ION
..... ~' 22
2 2 4 6 8 1912 14 16 18 2.) . 24 26 28 30
fie
~" FACTL'r~ ~ ~0 ST. ~Xb~ J A ~ACITY ~0. 000 PRODUCY ~E~ED ~ ~FT~ ~994
O~ I 2 2 4~, 5 6 7 8 9 10 11 12 13 14 15
~9 03/~00~ ~ 71 3/4 7916 7915 1~3663 143863 0 0 0 0 0 0 0 0 0 1
05/53~/530~ 31 *11711/23/~ 7883791~ ?e~97883 14~e72 14~06~ 10 0 0 0 33 10 -33 I 0
9x~s67x 143873 -1 0 0 0 -~6 -1
~9 06/64~ 3 7X 5/6 ~69P *~66 143031 143871 160 0 0 0 143 160 17 0
t9 0'l/6~ ~ VO 1/3 7~56 V590 143154 143031 123 0 0 0 176 133 -53 I 0
aG X2/630~ 2 66 1/9 '1189 70~3 143~10 143~7~ ~3~ 0 0 0 166 232
G 13/630~ 3 64 7/0 70~3 6955 143067 143710 1~7 0 0 0 169 147
1~/630~ 4 63 5/9 6955 6721 14~005 143e5~ '' 146 0 0 0 ' X3~ 146 14 0
;G ~EK 2 ~T~ ~XXXX XX~X~XXX~X X~X~XXXXXX~X~XX~ ~ g~ 659 661
149 0 0 0 103 149
g~ ~"00~ 5 56 3/4 5,18 5790 144930 144~12 110 0 0 ~ 136 116 -,0 I 0 ·
~Z ~ t
Ot
6
FUEi o 09 9 4
INYO STR~T TANK # 1
SBPTBMBER 1994
VARIA'FION
8O
60
40
20
0
..... 20
-40
.... 60
80
-100
..... 120
2 2.. -t- 6 8 10 12 lZl- 16
18 20 22 2~ 26 28 30
~9 i~=:ii~i~i~=:ii~!:= ii!~::~::i::i~i~iiiiii!ii~ii~i~i::~iii i::~ii::i::l::i::l::i:=?:?:~::i::~::iii ~i~i:: ~ ~ ~ ~ ~ ~ ~ ! i i ~ i~[~}~i~llii~ii~::~::i::i::i::~::~i~ i i ~ i ~i~ii~il !!~]i iii lili~iii~i:=i~iiiii~i~i:=i~i=:~7~ ~ ~ii ~ i ~ iili~ ~ ~i~i~:i~:~:~:~i~ii::~.~:~i~:~i~i~i~i~::i~ii~i~i~i~i:~ i ~ ~::i~::i::~ ii~ ili i~ i~:/:~i:=i~::::i::::~ ~:::~::i~:::-i::~i~::~:=:-::iiii~i=:i~iii ~! ~::~:::=~=:~a=.~i:.:::.~::::i~i~::~i~i:=i;i~i:=~i ~==~:=i~:.==~i::~=::.i~ i ~ i i ~ %~ i i~i~i==~ai~:.~::~:.~a~i::i~!a~i~ai=:~=:~:=i=:i~i i~ ::~:.~i~:.~ i~==~:.~=:~::~ i ~iiil ~ iii ~ii~.~i~-~i::~ii~:i~:~ii~i~?~?~i~:~ i~i~!i%~
~s ,,~::~::~::~::~;::::;i:: ~:::~2~ 'i ;~ i~i~::::i~;:::~i::i~:::;::i~::~::~i~::::::i::::~::~ ~ i ~ ~ii~?:::::~::::::i::ii~;:i:: i~::~:::;i~ ~i:: i ~i~ i~i~::::~::::~::::~ii~i~iii ii ~ ~i ~ ~i ~ ili~ i i::i ::::~ili:=i~i~::[;i~ii~iiiii!:/:~::~ii::i~::iiii::~i ~ ~ ~![~ ~i~i::~ii i ::~ii~::~::~ii}~:/:i:/:!!i~iii~iiiii~i?:~iii~i~$i~l[ ~ ~i~i~i~:: i~ii ::~li~i:/:i~ii~:/:~:ii::}~::~::~ii ~ ~
P9 3/600~ 4 29 3/9 718 ~34 7~949 ~943 6 0 0 0 0 4 G J O
Eg OG/600~ 6 ~5 585 532 76174 76087 67 0 0 0 63 67 34 0
06/6Q0~ 7 Z3 5Z~ 494 ~6196 76174 2Z 0 0 0 ~9 ~2 -6 I 0
t9 0V/530~ I ~3/1/9 494 498 76196 q6196 0 0 0 0 -4 0 4 0 1
a~ i ~i0~:3~ } i a~ i'a :.t~i :: ii ~ ::~::~s~ :::::::::::::::::::::::::::: ~:::: ~ ~i!!J ::~::::i~i::::i~::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::ii::~! i i~ ~ ::iii~i~:~i}~i::~:~:~i:iii~ii~i~i~i~:~i~?~::i:/~/::/~i:~ii~:~::::~i~.~i ~i~ a ~ :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ?i iili~ i~::i~ ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::i$~i~i~
9G 13/54~ 6 Il 30~ 170l 76537 76443 94 10 1~9 59 1/l 1697 1528 31 94 60 0 l
X3/103~ 7 59 1701 1694 76537 7653~ 0 0 0 0 7 0 -7 I 0
GG X4/630~ I 59 3/4 '1694 1690 7653V 76537 0 0 0 0 4 0 -4 , I 0
PG ~EEK ~ ~7~S X~XX~X ~X~X~g~X ~X~X~~~X~XX~ XXXX~X~ 336 341 G 1.47~
~; :: :.~ ~6:~b~~::~.~::::~:///::::::::/:~::~::~::::~::::::~::::~:::::/:~.~::~:::/:~:::/:::~::~:/:~ ~::~::~::~::::~::~ ~ ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
9V ll/i~ I t9 1/4 13~8 1365 76846 76813 33 0 0 0 33 33 : 0 0 1
~ ~EK 3 ~S gX~X ~XXEX~XXXX ~XX~EXXXX~X~XX~XX ~XX 325 304 -21 -6.91~
WgEK 4 ~9 ~X~ ~X~XX~X~XgX XaAAA~XXXX~~~, XX~ 44~ 437 -15 -3. Glt 3 4
6~ 19/630~ 2 3S 1/8 933 9~ 77406 ~72~3 133 0 0 0 123 133 10 0 1.
, 30/640~ 3 31 1/2 800 683 77509 ~7406 X02 0 0 O~ XX7 102 -15
ZE 3X/6~0~ ~ 38 683 6GV 77534 77508 26 0 0 0 16 ~6 XO 0
~gt
'0
INYO STREET TANI~
AUGUST
(DIESEL)
VARIAI"ION
6O .
...... "(" 22
2 2 4 6 8 10 12 14 16 18 2] 24 26 28 30
~ FAC1LI~ ~0 SY. T~ ~ 3 ~ACI~Y ~. 000 PRODUC~ DIgSgL ~
04/530~ ~ 53 3/4 1542 /66/ ~7673 776~3 0 0 .0 -19 0
~9 05/5~0~ ~ St 3/8 1561 1~3~ 77673 "/7673 0 0 0 ~ 2~ 0
· 9 06/645~ 3 5~ 1/2 ~5~ 1336 77870 776'13 197 0 0 198 197 -1
t9 0'//600~ ~ 4~ 3/6 1336 1142 78083 77e?0 313 0 0 0 194 ~13
~ ~ ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: .......................
~ ~1/630~ ~ 15 5/8 303 1~1 79026 78096 129 O 0 0 13~ 139 -3
~P 79025 129 0 0 0 1~2 139 7
22/600~ 5 10 1/2 ' 1~1 ~9 79154 ] 3 14
5~ ~9/630~ ~ 51 1/2 1471 1291 79560 79375 1~5 0 0 '0 180 185
a~ 30/~00~ 6 ~6 1291 1215 79632 79560 ~ 0 0 ,0 76 72 -4
9L
OI
INYO STREET TANK
SEPTEMBER
O994
# 5 (DIESEL)
1994
VARIATION
20
15
0
- 1 0
..... 261
..... 2.5
.... 50
.... 55
-4.0
2
2 4 6
FUELS IHVENTOR¥ RE¢ORDINO SHEET
pEn~IT J ~sOOllC
DAY/I-IOUR
1/800~
O CAUOII~ INVENTORY INVE~I'OR¥ READINO READII~ HETEBED AD3USTNEN
~,W' ,SALES
INCH~S ~.LLONS OALLONS OALLOliS 0ALLONS OALLOI~ (~LLOHS INCH, ES
4 25 3/4 1806 1633 106766 106589 177
BEFORE AFTER II4V~I~/ORY , OAUOII~ REDUCTION THROUONPU? OVER OR S VARIATION COUI~ ¢OUN~
C~LO~ INC~S ~LONS CALLO~ INC~S CALLO~ ~LONS ~LONS
0 0 0 173 177
8/635AH 4 89 1/8
'I0/800AA 6 84
~EEK I TOTALS ' XXXXXXEXXX XXXRXXXXXXXXXXXXXXX XXXX~XXXXXXXXXXXXXXXXXXXXXXXSXXEXXXXXXXX XXXXXXXXX
9906 9616 10725~ 107114 143 0 0 0,
9388 9147 IO7~17 107457 70 :" 0 0 ' 0
548 525 -23 -4.38~ 3 4
190 lt3 -47 '' I 0
141 70 -?1 1 0
" 15/635Mt 4 ~9 3/4
17/000AN 6 76 1/4,
, 19/800AH I ,75 5/8,
8465 8331
9391 8391'
108178 107944 334 0 0
108367 ,' 108305 ' 63 ' 0 · 0
108387 108367 , 0 ' 0 ' ' 0
O' 387 334 -53 I 0
0 134 63 .73 ., , I . 0
0 .............. ~60~~0~60~ ............ ~0
0 ,, 0 0 '' 0 0
;14/630AH 6 69 1/8 7580 ?499 109307 109095 113
36/800,'z~ I 68 1/4 7467 7467 109307 109307 0
0 0 0 81
0 0 0 0
0 . 0 .... ' ..... 0 ......... liS,
0 0 0 50
113 31
O, 0
63 13 '
O 1
,1 . 0
O 1
~1~ ..... 0
O
TOTALS
XXXXXXXXXX XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXX 485
XX~X~X~XXX-~XXX](X~X~X~XXXX~XXXRXXXXXX~XX~XXX~XXXXXXX~XXXXXXX~XXX~XX~XXXXXX--~-`--~- 366~7
536 . 41 7. 798 0 1
'O
I::-U ~i I,,. I] o O 9 9 5
I N YO oT IR E. IZ-f' T A N K '
cEP'I-EMf{}t!{iR 199
VAIRIA'I'ION
80
60
4-0
20
0
--20
--60
.... 80
2 2 4 6 8
20 22 24
28 5O
24 HOUR RE, PORTABLE ~q%~I~TIoN~Lo~s
I~(~f].FICATION
Bakersfield Fire Department
Hazardous Materials Division
2110] "H" Street
Bakersfield, CA. 9330~
REGARDING:
f'acilit¥~ County, of'Kern "lnyo" St. (.GAS).. Permit ~ 150011C
Fac~l%ty-Address:_ 230 Inyo St. Bakersfield, Ca.
Name of Person Filing Report: KAREN GEYE, CENTRAL SERVICES MANAGER
On .10/08/93 06:45 AM , the above facility had 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 of
Trend Analysis
I 169.,qal,,. 4 Per. 58
[ have/have-not stopped dispensing' p.roduct and begun investigation procedures
required by-the Permitting Authority.
This notification is in addition to the phone call' 1 previously placed.
Si KAREN GE~,~ -C£1~I'RAL~iCE$ HANAGSR .....
GZ-~EI'~L SEI. tVlCl~, GAI~GE DIVISION
I3AIr~I~t~F:I:F. IoO F:I*t~E IDEPAI~TPI~Iq'r HAZAIIDOUS~ PIAT~-I;I.'I'AL~
VAR~ATJON/LOS-~ 1NVESTI~TTON REPORT
Facility: County of Kern '[nyol...St. Permit ~ 150011C
Facility Address: 230 Inyo St. Bakersfield, Ca.
Tank(s) with Discrepancy: # l__ Date/Time of Discovery: 10/09/9~. O9:45AM.
Name of Person Filing Report: Karen Geye, CENTRAL SERVICES MANAGER
Description Of Discrepancy: Daily variation exceeded allowable limits using .
LOW THROUGHPUT CHART. -169 Gal.
INVEST'[GAT[ON SUMMARY ~
The fo].]ow]ng procedures must be performed within the specified times starting
at the time a reportable loss is discovered or should have been discovered:
Within.~ t
6 Hours [ Owner/Operator or other qualified person is to I Date I Time
t review records for errors before determining 110/09/93 J09:45AI~
I there is a reportable variation/loss.
Performed By : Gilbert Alaniz
24 Hours
48 Hours
1) Owner/Operator must verbally report I Date [ Time
discovery to BFOHM and follow-up with writtenllO/09/93 [lO:30A~! .
notification on form provided.
Performed By : Gilbert Alaniz
2) Visual facility check ko be performed using I Date [ Time
checklist on the back of this form ~10/09/93 ~ IO:OOAM.
Performed By : Gilbert Alaniz
3) Al.[ product dispensers are to be checked for ~ Date ~ Time
calibration and adjusted i~ out of tolerance [ [
Performed 8y :
Piping to be leak tested using approved methodl
I
Contractor's Name ~
License ~ Test Performer's Name
Description of test performed
Date I Time
I
Hours I
I
I
I
I
* * AT'EACH COPY OF TEST RESULTS. * *
Tightness Testing of Tank(s) to be performedl
using approved tester and method.
Contractor's Name :
License % Test Performer's Name
Description of tes't performed
Date I Time
* * ATTACH COPY. ~OF TES'T.._RESULTS. * *
NOTE:
THiS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAY~
OF COMPLETION OF .iNVESTIGATION PROCEDURES.
2. V]'SUAI. INSPECTION CHECKLIST
A. 0ispensers
Ail dispensers and their end doors visually checked for leaks.
All hoses and nozzles visually checked for leaks.
A].I tota]izer seals checked for tampering.
Results:
All dispensers appear tight Gilbert Alaniz 10/09/93
signature/date
Dispenser(s) not tight as listed below
signature/date
IOISPENSER ~ISERiAL ~ICOMMEN'fS:
I
B. Tank Area
All turbine 'boxes inspected.
All fills and vapor manholes inspected.
Results:
X__ Tank area appears tight with no product or liquid present
Gilbert Alaniz 10/09/93
signature/date
Tank area does not appear tight b$cause of the problems/conditions listed
be]ow:
signature/date
ITANK ~ I PROI){JC'I'~ I COMM~:N'f..q/RESU LTS:
.J I I L.
C. Piping Type: Il Pressure J_[ Suction
__ Pressurized piping leak detector(s) tested for proper functioning and
detection of leakage.
Suction piping tested for indication of leakage.
Results:
__ Piping tight based on test(s) above.
signature/date
Piping not tight based oh test(s) above, with problems/conditions
listed below.
signature/date
Oescription
HOUR REPORTABLE
NOT [ F I'CAT ! ON
To:
Hakersfie]d Fire Department
Hazardous Materials 0ivision
210] "H" Street
Bakersfield, CA. 93301
REGARDING: ~
'Faci]jty: County of Kern 'ln¥o' St. (GAS). Permit ~ 150011C
Facility Address: 230 [n¥o St. Bakersfield, Ca. .
Name Of Person Filing Report: KAMEN GEY~, CENTRAL SERVICES MANAGER
On ....... 10/07~93 __06:.50 AM , the above facility had an
(date and time)
inventory variation/loss that exceeded reportable limits as described below:
Tank
Amount of Amoklnt of Amount of
Daily Weekly Monthly
Variation/loss Variation/Loss Variation/Loss
Total. Minuses
I.ine 3 of
Trend Analysis
+106 gal:. 4 Per. 58
I have/have--not stopped dispensing product and begun investigation procedures
required by the Permitting Authority.
This notification is in addition to the phone call I previously placed.
GENERAL SERVICES</ GARAGE DIVISION
VARIATION/LOSS II/VE$?IGATION REPORT
Facility: County of Kern "Inyo' St. Permit ~ 1§0011C
Facility Address: 230 In¥o St. Bakersfield, Ca.
Tank(s) with Discrepancy: ~ I 0ate/Time of Discovery: 10/09/93
Name of Person Filing'Report: Karen Geye,__CENTRAL SERVICES MANAGER
Description Of Discrepancy: Daily variation exceeded allowable limits using
LOW THROUGHPUT CHART. +106 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:
6 Hours I owner/operator or other qualified person is to I
24 Hours
Date I Time
review records for errors before determining 110/09/93 I09:45AM
there is a reportable variation/loss.
. Performed By : Gilbert Alaniz
[) Owner/Operator must verbally report I Date I Time
discovery to BFDHM and follow-up with writtenl~O/09/g3
notification on form provided.
Performed By ~'" Gilbert Alaniz
2) Visual facility~check to be performed using } Date ~ Time
checklist on the back of this form
Performed By : Gilbert Alaniz
3) All prOduct dispensers are to be checked for [ Date [ Time
calibration and adjusted if out of tolerance
Performed By :
~8Houcs[
I
I
I
I
Piping to'be leak tested using approved methodl
Contractor's Name
License ~ Test Performer's Name
Description of test performed
Date I Time
72 Hours I
I
I
I
I
* * ATTACH COPY OF TES'r RESULTS. * *
Tightness Testing of Tank(s) to 'be performedl
using approved tester and method.
Contractor's Name :
License ~ 'rest Performer's Name
Description of te$t performed
* * ATTACH COPY OF TES'C RESULT_~S. * *
Date I Time
NOTE:
THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHOR£TY WITHIN 5 DAYS
OF COMPLET_[ON OF .[NVEST'[GA'rlON PROCEOURES.
2. VISUAL INSPECT]ON CHECKLIST
A.~ Dispensers
AIl :dispensers and their end doors v~sua]ly checked for leaks.
AIl hoses and nozzles Visually checked for leaks.
AIl totalizer seals checked for tampering.
Results:
A]I dispensers appea~ tight Gilbert Alaniz 10/09/93
signature/date
l)ispenser(s) not tight as listed below
signature/date
B. Tank Area
X__ AIl turbine boxes inspected.
A]I fills and vapor manholes Inspected,
Results:
~,,, Tank area appears tight with no product or liquid present
Gilbert Alaniz 10/09/93
signature/date
Tank area does not appear tight bedause of the problems/conditions listed
below: i~
signature/date
JTANK ~]PRODUCT~ICOMMENTS/RESULTS: I.
..] I I :... L.
C. Piping Type: J_[ Pressure .]_i Suction
Pressurized piping leak detector(s) tested for proper functioning and
detection of leakage.
Suction piping 'tested for indication of leakage.
Results:
~ Piping t~ght based on test(s)~above.
signature/date
Piping not. tight based on, test(s) above, with problems/condiiions
listed below.
signature/date
Desccipt(on
24 HOUR REPORTABLE V'ARIA?ION/LOS$
TO:
Bakersfield Fire l)epartment
Hazardous Materials Division
2]0] "N" Street
Bakersfield, CA. 9330~
REGARDING:
FacJ].ityt Count~ of Kern ']'n¥o' St. (GAS) Permit ~ 150011C
Facility Address: 230 .[n¥o St. Bakersfield, Ca.
Name Of,Person Filing Report: KAREN GEYE, CENTRAL SERVICES MANAGER__
On ..0~/30/93_ ..0~..:~5 AM . , the above facility had an
(date and time)
inventory variation/loss that exceeded reportable limits as described below:
Tank
Amount of Amount of Amount of
Daily Weekly. Monthly
Vacia'tion/loss Variation/Loss Variation/Loss
1 -252 Gal. 4 Per. 53
Total Minuses
Line 3 of
Trend Analysis
have/have-not stopped dispensing product and begun investigation procedures
required by the Permitting Authority.
']'h].s notification is in addition to 'fhe phone call I previously placed.
KAREN GE¥~/~ENTRAL"~SEi~V~ MANAG~:R -
GEN~Ap SERVICES, ~ARAGE DIVISION
.-- %
I~AKEIt~I".[ELD F.[ItF. IDEPAltl'IeIEIqT HAZAItOOU:~ HATER~AL~
VAIt]'AT?ON/LOSS IlqV~;T]~T][.OIq ltl~POlt'F
Facility: County of Kern "Inyo" St. Permit g 15OOlIC
Facility Address: 230 In¥o St. Bakersfield, Ca.
Tank(s) with Discrepancy: g I 0ate/Time of Discovery:
Name of Person Filing Report: Karen Geye, CENTRAL SERVICES MANAGER
0escription Of Discrepancy: MONTHLY variation exceeded allowable limits using
{.OW THROUGHPUT CHART. -29t Gal.
.[NVESI.[(:Ai[ON SUMMARY
The fo]lowing procedures must be performed within the specified times starting
at the time a reportable loss is discovered or should have been discovered:
6 Hours I. Owner/Operator or.other qualified person is to I Date I Time
~ review records for errors before determining ]10/01/93 ]09:4§AM .
] there is a reportable variation/loss,
Performed By : Richard Brown
24 Hours
1) owner/Operator must verbally report I Date I Time
discovery to BFDHM and follow-up with writtenllO/04/93 ]10:30AM....
notification on form provided.
Performed By :
2) Visual facility check to be performed using I Date I 'rime
checklist on the back of this form 110/01/93 I !O:OOAI~i
Performed My : Richard Brown
3) All product dispensers &re to be checked for I Date ~ Time
calibration?.and adjusted if out of .tolerance { ~
Performed By :
48 Hours
Piping to. be leak tested using approved methodl
Contractor's Name
License # Test Performer's Name
Description of test perfo[med
* * ATTACH COPY OF 'PEST RESULTS. * *
Date I 'rime
72 Hours
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
I * * ATTACH COPY O__~F TEST RESUL'£S. * *
NOTE:
TH.IS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS
OF COMPf, ETiON Ob' INVESTfGATION PROCEDURES.
2. VISUAL [fNSPECT'ION CHECKLIST
A. Dispensers
A].] dispensers and their end doors visually checked for leaks.
Ail hoses and nozzles visually checked for leaks.
A]]' tota']izer 'sea].s checked for tampering.
Results:
Ali dispensers appear tight ~J~h~rd Brom, n 10/0.]~93
signature/date
Dispenser(s) not tight as listed below
signature/date
10(SPENSER ~.ISER£Ar, ~[COMMENTS:
! I
I I 1
I I
B. Tank Area
X A].i turbine boxes inspected.
~__ Ail fil].s and vapor manholes inspected.
Results':
Tank area appears tight with no product or'liquid present
.Richard B[.O~11 10/01/93
signature/date
Tank area does not appear tight because of the problems/conditions listed
be] ow:
signature/dato~
C. Piping Type: " ]_[ Pressure Ii Suction
__ Pressurized ptplng leak detector(s)tested for proper functioning and
detection of ].eakage.
Suction piping tested for indication of leakage.
Resulted:
~. Piping tight based on test(s) above.-,
signature/date
P~ping not tight based on test(s) above, with problems/conditions
listed below.
signature/date
Description
EUELS INV~NTOR¥ RE¢ORDINC SHEET
PEP, NIT $' 1SO011C
1/eOOAH 4 493/4 1414 1345
59035 58975 6O
6/635~! 4 41 l/S 1125 1062 59319 592622 57 0 ~ ...... ~ 0 . , 63 57 -6 ,."
10/e0OAN 6 36 5/8 974 9228 59446 59417 39 0 0 O' 46 229 -17
-0.?0~
· i$/635AN , 4 229 3/6 741 683 , 59696 59639 57
0 0 , 58 5 -1.
'?0 ..... t'!0-0 ............. 77-' - .?e ............... 1
0 ' [0 ' , 29 ~ ' 30 1
- '0 ...... --~0-~'' ~'* -S - 'o~e -
,0 ' t 0 . * 12 ' 0 -Iii .
24/630AN 6 59 1/8 1705 162226 602274 60191
,25~800AN~7'56-1~2~1'525 -1'619 ..... 602274 ..........
36/000AlI I 56 1/4 1619 16226 602274 602274
229/625AN 3 55 3/4 1603 1463 60434 602294
0 0
'220' ~-~ .... O'
140 0
0
'0 ....... 1 '~?
0
0 ........... 223
0 140
83 -4 O
0 7. O 1
'20 ..... 3'~ 1-~-- ~'~O
.1.40 0 0
~EEK 5 TOTALS XXXXXXX]L~ XXXXXXXX~XX
XXXXXXXXX., 114
107 -7 -6.54~ · 22 ' 0
D
INY()
C"l" IR !!i IZ-I ..... .1-A N K
c,..~ [{ PT E M"t¢ E' I'::R
0 9 9
"1
· 99{.5
VARIA'TION
'14.
12
10
8
6
2
0
.... 12
-14
..... 16
_18
2 2 4 6 8 10' 12 14- 16 18 20 22
24- 2.6 28 50-
ll 12 ~13
· 3/630A~ 3 52 1/2 '1503 i3S3 b~430 S7302 140 0 0 0 150
'~?**~'~61~57503 .... 5~30' ~7~ ........... ~ ......... O' '0 0-'~ .: '9~'
5/800~fl 5 45 1/8 1261 ' 1261 675o3 $7503 0 , 0 0 0 o~ 0
0~'~''-~ '"mO - -0 72'
"170 ....... '~ '1361'~1'1~9~57577~5~503' 74'~
16G -2 ]. , 0
0 0 0 1
0 0 0 ' I
0
O
13/900~R $ 37 1/8 991 936 ' 57826 ~7775~61
14/~0A/~ ? 31 5/G 804 ~09 57956
xx ......... ' ...... ~ . .... ~ .... ,~- . ........ ,~ v,~,vvvvw, 300
51 -4 , ' 1, 0
0 5 ' ., 0 I
379 I '-1 -0.36S 4 3
31/e00~ ? 16 3/8 334 ' 303 SG466 58447 19 . __ 0 0__ 0 0 21 19" -2 I 0
33/90~ 1 15 5/8 303 313 5~66 S~66 0 0 0__0 -10 0 10 0 I
~K 4 t*O~LB
29/800~ I 64 1/4 1569 1554 50939 68831
-.~3,rS4~*lTG~ISS4~i$~O'~$GO53-~,~'SGG39'
398 365 -33 -9.04~ 4 3
8 0 0 0'" 4,
e, 4 0
31/636AH 3 53 5/8 1538 1638 59863 66853 0
0 0 0
0 0 0 I
3o089 5
TANK # 3' (DiESeL)
AUOUST 199 5
VARIATIONS
2(}
5
-25
-50
2
'2 z~ 6 8 10 12 14 16 18 20 22 2z[ 26 28 30
C~ACX~
10. 000 ~.L.
1993
II~HES ~J..LONS gJ~LLONS , O. ALLONS
0 0
0 0
1'0~'
0
,0
114 -6 ! 0
'0~ ~ ""~0'. '0 ....
0 0 0
126 0
0
196 ·
20/6251H 3 61 6500
252 0
2'~6' '0
27/6301N ~ 54 5538 5434 ' 94996 94913
03 0 0 104
177 0 '0 ..... i:~":0~ 73
XXXXXXXXXX .... XXXXXXXXXXXXXXXXXXX'~XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX~XXXXXX]~X ........ 760
~090 -;~le - -7.06~ 16 , 14 ~'
Gar a,g,e--Se r,v,i-ces--Supre ry,i-S,o r
,Gener a-l-Se ~vi'ces-Ga~age=D-i-vi,s.i,on
FlClI. IY'Z
FWLS ~NV~ItrOR~ RgCORDIHO
, !t~Zo Si'. ?~ttg #
l'.O00 GAL,
PR~¢T
DAYs'HOUR
l/lO~l~l
INCHES OALLONS 'GALLO~J OALLOHS , ~I, LOHS
4~ $/8 1278 1249 $03~6 50356
~M. LONS GALLONS INCHES gALLONS· ' :INCHES'
~ . 30 ·
3/830AN ? 44 3/e 1236 1236 50399 50399 ·
5 35 7/8 949 843 5079~ 50699.
762 5085!
1 31 1/4 50917 50861
95
106 95 -11
:o~
147 149 O'
I 0
I 0
0
0
0
106
· · 51779 '
~?/630~H 3 46 1/2 1394 1~e3 :" ,5187.0~5179~
I~EK-4-YO'IAI;8'
55 '-~'0, 0 ~ '~ . ,
91. __,,,,,,, . 0 ~_~__
'tOTALS
3~.xxxxx3o~,~x~xx xxxxxx~,xxx~xxx=~x~xxxxx,ixx./.xxxxxx.,~ mixxxxxx
ndman
. Garag~ Services S~rvisor · .
General Services Ga~age.,,D~v~s~o~
INYO STREET TANK' IESEL)
APRIL 1993
VARIATION
50 . .
25
2O
15
10
5
0
-5
:
:
:
:
:
-10 ................................
-15
-20
-50
-35
2 2 4 6
8 10 12 14 16 18 20 22 24-
26
28
50
FUEl
INYO STREE-
APR
]
FUEL TANK
L 1993
1
VARI~,TION
60
4-0 ..................
¸2O
-20
-4O
-6O
-8O
2 2 4 6 8 10 12 14 16 18 20 22 24- 26 28 30
24 HOWl! REPORTABLE VARIATION/LOS5
NOTIFICATION
TO:
Bakersfield Fire Department
Hazardous Materials Division
2101 "H" Street
Bakersfield, CA. 93301
REGARDING:
Permit ~
Facility: COunty of Kern "Inyo' St. '(GAS) 1500'11C .
Facility Address: 230 Inyo St. Bakersfield, Ca.. ,~ .
Name Of Person Filing Report: JIM HINDMAN, GARAGE SERVICES SUPERVISOR .
On 05/06/93 08:00 A~ , the above facility had 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 Vari~tion/Loss
-86 GAL.
Total Minuses
Line 3 of
Trend Analysis
153 Per. 11 . ~
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 placed.
Sig~atu~_
HINDI~AN, G RVICES SUPERVISOR
GENERAL SERVICES, GARAGE DIVISION
[iAKERSFIELD FIRE DEPARTHKHT HAZARDOIJ5 flATERIALS DMSIOli
VARIATION/LOSS ~INVESTIGATIO# REPORT
Facility: County of Kern "Inyo' St. Permit # 150011C ..
Facility Address: 230 InYo St. Bakersfield, Ca. -
TanK(s) with Discrepancy: % 1 Date/Time of Discovery:
Name of Person Filing Report: Jim Hlndman, GARAGE SERVICES SUPERVISOR
Description Of Discrepancy: Dally variation exceeded allowable limits uslnq .
LOW THROUGHPUT CHART. -86 Gal. -
iNVESTIGATION SUMMARY
The following procedures must be performed within the specified times starting
at the time a reportable loss is disdovered or shoUld have been discovered:
within: J ~
6 Hours J Owner/Operator or. other qualified person is to ]
24 Hours
Date I Time
Io5/o6/~3 11~:30AM .
review records for errors before determining
there is a reportable variation/loss.
Performed By : Richard Brown
1) Owner/Operator must verbally report [ gate I Time
discovery to BFDHM and follow-up with.writtenl
notification on form provided.
Performed By : Harold Lawler
2) Visual facility check to be performed~using ~ Date I Time
checklist on the back of this form ~/,,~ J05/O6/93 ~ 12:00P~.
Performed B~ :~'Richard Bro~
3) All product dispensers are to be checked for I Date ~ Time
calibration and adjusted i'f dut of tolerance
Performed By :
48 Hours
Piping to be leak tested using approved method]
I
Contractor's Name
License % Test Performer's Name
Description of test performed
Date ] Time
[ * * ATTACH COPY OF TEST RESULTS. * *
72'Hours I
I
I
I
I
Tightness Testing of TanK(s) to be performed~
using approved tester and method.
Contractor's Name :
License % Test Pe[former's Name
Description of test performed
Date [ Time
* * ATTACH COPY OF TEST RESULTS. * *
NOTE:
THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS
OF COMPLETION OF INVESTIGATION PROCEDURES.
2. viSUAL INSPECTION CHECKLIST
A. Dispensers
X Ail dispensers and their, end doors visually checked for leaks·
X All hoses and nozzles visually checked for leaks.
X All totalizer seals checked for.~ampering.
Results: /_,~ '
X All dispensers appear tight ~ichard Brown 05/06/93
signature/date
Dispenser(s) not tight as listed below
signature/date
IDISPENSE~ ~ISERIAL ~ICOHHENTS:
B. ' Tan~ Area
X Ail turbine boxes inspected.
X. All fills and vapor manholes .lqspected.
Results:
Tank area appears tight with no product or liquid present
Richard Brown 05/06/93
~.J signature/date
Tank area does not,appear tight because of the problems/conditions listed
below:
signature/date
ITANK IPRODUCT [COMMENTS/RESULTS:
C. Piping Type: I[ Pressure [[ Suction
Pressurized.piping leak detector(s) tested for proper functioning and
detection of. leakage?
suction Piping teSted"f0t indication of leakage.
Results:
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
24 HOUR REPORTABLE VARIATION/LOSS
NOTIFICATION
TO:
BaKerSfield Fire Department
Hazardous Materials Division
2101 "H" street
BaKersfield, CA. 93301
REGARDING:
Facility: County of'Kern "~Inyo" St. (GAS) Permit ~ i50011C
Facility Address: 230~Inyo St. -Bakersfield, Ca. --' ...............................
Name Of PersonFlllnq Report: JIM HINDNAN, GARAGE SERVICES SUPERVISOR
On 04/30/93 08:00 ~ , the above facility-hadan
(date and time)
inventory variation/loss that exceed~ reportable limits as described below:
Tank
Amount of Amount of Amo6nt of
Daily -WeeKly M°~thly
Variation/loss Variatiog/Loss Variation/Loss
Total Minuses
Trend Analysis
........................... = ............. 2'18' GAL~
I have/have-not stopped dispensing product and begun investigation procedures
............ requ{Ted-by-the-PeFmit~ing-Author~ftY~ ................. ~ ....................................................................
This notification is in 'addition to the phone call I previously placed.
$ignatur
........................................... ~ ....... JIM'HIN
~ GENERAL SERVICES, GARAGE DIVISION
" ISAKERSF-rKLD' F'U'RK/~. DKpARTIsiKlfT. HAZARDous. i,,IATKR~./?'D'rVXS'FOM
Facility: County of Kern·'In¥o''St. Permit # ..I§O011C
,F a ci-t-i-t yzAdd r e ss~: [/--230'-ln¥o-St;--BaKe r sfietd~'--Ca= i s cov- ry :..:.!?'05': "1-93
Tan~(s) 'with Discrepancy: % l' ' Da. te/Time 'of D
9:45
SERVICES'h'SUPERVISOR
Name of .Person Filing Report: Jim HiD.dman, GARAGE
"De s c r i pt i on' 0 f D i s'CrePancy :"~=l~onthl¥'- varIati on-exceeded aTlo~able~l'iafts~uslnq
LOW THROUGHPUT CHART, ~2'18 Gal.' .......................
The follow, ing:..P~o'Cedu~!es<mUs't"be:.":Per;f°freed;within the speC~f:;iedi;t:i~mes~starting. ,
6 Hours I Owner/Operator or other qualified person is to I Date ~ Time .'--
................. : ...... ~_~ r ev.~ ew- re c o r ds-- fo r-e L~r 0 r s-be f o r e.-de t e r m i n i ng-~/~4'OS~'O'~-/93--~-grSO-9~l-;=-
· . ' ~Performed By
24 Hours 1) Owner/Operator-must verbally report ' I .... .Dat~ ........ I ..... Time_ .-'
discovery to' BFDHM'and follow-up with
3) All product dispensers are to be checked for-'l'~' Date ........ I ~"Tim~
............................... c a-l-i bra'ti~on-and -ad~ us t ed-i-f--out--o f--t o 1 e r ance. I I .. -
Performed By :
.......... 48-Hours "l ..... PiPing-to'~be-flea~'"tested'~us'ing-appr°ved'"meth6dl ......
I I -" I ....... I
I Contractor's Name - '
...................... ......... I ..... L-i-e e n s e--S=: 22 .... Test--Pe r-fo ~.me ~'~s-Name
· ' ' I Description of test performed . ' ·
72 Hours I 'Tightness '.Testing of Tan~(s). to be perfo~medl Date ...... I ~ Time .... .,
J * * ATTACH COPY OF TEST RESULTS. * *
· NO'£E:', THIS..REPORT~MUST'BE':SUBMITTED TO THE-·PERMITTING .AUTHORITY WITHIN 5 DAYS
'~ OF COMPLETION.OF INVESTIGATION PROCEDURES.
I' .
2. VISUAL INSPECTION CHECKLIST '
A. Dispensers -..
X All dispensers and their end doors visually checked for leaks.
X ........ Al-l--hoses--:and-~nozztes-vis~uatty-checked-for--~leaks~ ....................
X Ail totalizer-.seals Checked f .. mpering.
Results: o~J
-X-...-All dispensers--appear.--tight ...... Richar~ Bro~na .05/0t/9.3' ' '-
signature/date
as listed below
Dispenser(s) not tight
[DISPENSER
~. Tan~ Area
~. Ail turbine boxes inspected.
X, .All.fi.lis.and-vapor manholes
Results:
inspected.
Tank area appears tight with no product or liquid present
B~own ..... 05
... '?~!gn.ature~date.
p~obI'ems~C°ndi]ti. Ons~i.l.is~ed~:
Tank_.area._does:;,~not.appear_.tlght_because_.Of....the..)~
below~
............................................................................................................................... signa u e da e
[TANK'~[PRODUCT$ICOMMENTS/RESULTS: "· ::.'"~"[.
Piping not tight based on test(s) above,
1.1sted-be,lo~.-
Description
[..
[.
C. Piping .Type: II Pressure II Suction
Pressur. ized-pip;ing.-.leak-detector(s).-tested.for...properf.unctioning, and
detection of-leakage.
Suction piping tested for indication of leakage.
.Results.:
..... · Plplng tight, based/On test(s,) above. :. ...
with problems/conditions
s ignature/date ·
EACILI?¥ IgYO $?.
?AIIX t I
CAPACITY ,10.000 OAL; '
3/630~J4 3 50 1/3 5053 4994 95506 95415 . 91
1/630,tJ~3-60~49S4~4863~9561~95506
5/635J~ 4 49 1/8 4963 ' 4535 " 95659 95617 343
.6/900~5-46~3/4-~-~--4535~.~4500--~-95936 ..... 95959
7/630J~! 6 46 1/2 4500 44~1 95982 95936 46
0 0 ~ 69 91 23' ' '~ 0 1
0~0: : --~~131~ ,111~10 ~ ' 1~0
0 0 ~i~ 339 343 ~86' '1 0
0 0 ~ 69 46 -23 ! 0
12/$35~ 4' 44 . 4157 3969 96393 96239 154
14/830~ 6 41 5/8 3933 3765. 96584, ' 96539 ' 48
MEEK 3 ?OTALS XxxxXXxxxx
0 0
O O
XXXXXXXXXXXXXXXXXXX XXXXXXEXXXXXXXX~XXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXX
189 154 ~-34 I . 0
136 ......... 146 ........ 10~ ...... 0 ~
68' 45 723 ' , I 0
666. · 602 ,~4 -1o.63~. 4 3-
21/830.~5 6 35 3951 3790 97503 97393
. MEEK 3 TOTALS XXXXXXXXXX
33/830~ 7 33 3/4 2790 393397503 "97503 0
XXXEX]CXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX ~ XXXLXXXXXX
16!
0 0 0 I
9?$
919 -56 -6,.09~ ' ' 3
0 33 0
39/800AH 7 38 1/2 3133 '3118 98326 99197
· 30/90OA~1-29-~e~3118 -~.3133~9833~ .......
XXXXXXXXXX
XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXY. XXXXXX
39
0
657 694 37 5,33~
4
31/405P~ 3 39 1/3 3133 3133 99336 99326 0 0 0
0 O. 0
0 I
er'v~ Ces, G~rage Oi.v!s~on
FUEl_ 1.059
INYO STREET TANK
MAY. 199,3
1
VARIA-I"ION
6O
4.0
2O
-6O
-8O
-lO0
2 2 4
6 8 1(:) 12 :'14 16 18 20 22 24 26 28 30
~.000 (IAI..
CAPACl?¥
.' PRODUC~' DIESEL~
3/630AH 2'39 3/4 1079 1013 5~14! · 5~063 ' 76
5/635N~ 4 34 1/2 90~ 838 5~301 5~145 55
. 7/630~ 6 30 749 , 703 5~422 5~371 51
111-
' , ' 64 55 -9 I 0
· 4~ 61 6 o I dlIAI
14/$30M,! $ l? 1/8 ' 345 296 52856 52993 63
k'EEK ~t YO?AL$ XXXXX~IEEX
0 +' · 0 O' ~ 53 49
~.. '' 0~--~0~ ~ 0~0 ' ' 100 ....... 106~6~:r
0 ' O, 01 ' '~0 63
XXXXXXXXXXXXXXXXX~X XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX~XXXXXXXXX 'XXEXXXXXX 428 434 '
I 0
0 .l
1 O'
13
31/O30AH $ 43 1155 1096 63298 532611
k'E EK, 3
23/830~ 7 40 1/4 1096 1104 53398 53~99
59 46 , -13 . ", ,~1
460 443:, '-18 -4,O7t 3 4
0 I
~EEK 4 TOTALS
29/600~'{ 7 28 603 6e3 53923 $3722 0
30XOOO,~L,--~--~I-28 ....... 603,' 699~53V23~53733~ 0
31/405PH 2 Ii6 1/2 699 695
5372~ 53922 0
0 ' 0 0 4
0 -4 I 0
INYO TANK
0595
MAY.. 1995
20
15
1'0-
5
0
-10
-15
-20
-25
VARIATION
2 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30
FA¢XLITY
I~ZO ST. TAII~ 4
13
P.~.ALT.-O-1.50013 C
!~0~ DgCE~gR 1993
..... q~SlTP~ ..... 5~3L,~'f8 ......... 2S19 ...... 3394 ........ 8343ii ......... 833S0 .......... 7ii ............... 0 .... ' ~0 ...... O~
~-~ q~/553PN 6 30 S/ii 3394 2316 ' ii3517 ii342ii ii9 0 0 ~
! 30 3316 3316 ii3560 ii353! 39 0 0
13/300pN I ~5 1719 1719 94093 94093 O 0
137 159 33 0
14 ......... 14 ..... ' . 0 ..... X
44 31 -13 1 0
0 0 0 0
30/500DH 4 67 1/3 7369 7369 ii5133 ii5113 20 , 0 0
0 ......................... 393 ................. 131 ........ ~X6l ...................... 1 .......... 0
0 30 30 0
FkJFI 1o 292
STREET TAN K2~
DECEMBE~ 199
1
8O
6O
4.0
2O
0
-20
--4-0
-60
-80
-100
-120
-140
-160
-180
VARIATION
[ : : ;
................................. : ................. : ........ :. ....... .. ......
: : :
: : : :
:
:
:
2 2 4 6- 8 10 12 14 16 18 20 22 24 26 28 30
24 HOUI~ ~POI~TABL~- VArIATION/LOSS
TO:
Bakersfield Fire Department
HazardoUs Materials Division
2101 "H" Street
BaKersfield, CA. 93301
REGARDING:
Facili. ty: County of Kern "Inyo" St. (GAS) Permit ~ 150011C
Facility Address: 230 Inyo St. BaKersfield, Ca.
Name Of Person Filing Report: JIM HINDMAN, GARAGE SERVICES SUPERVISOR
On ..... O1/O9/93 5:00 PM , the above fa6illty had 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 of
Trend Analysis
I -84 Gal. 97 Per. 7 .
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 placed.
JIM HI~DMAN, GARAGE SERVICES SUPERVISOR
~ENERAL SERVICES, GARAGE DIVISION
BAKERSFIELD ~IRE DEPAltl~ENT HAZARDOUS ~IATERIALS DIVlSIO~
VARiATION/LOSS I~STI~TION REPORT
Facility:" County of Kern "In¥o' St. Permit # 150011C
Facility Address: 230 In¥o St. BaRersfield, Ca.'
TanR(s) With~Discrepancy: # 1 Date/Time of Discovery: 01/10/93
Name of Person Filing Report: Jim Hindman, GARAGE SERVICES SUPERVISOR
Description Of Discrepancy: Daily variation exceeded allowable limits using .
LOW THROUGHPUT CHART. -84 Gal. -
INVESTIGA'££ON 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:
Within: [
6 Hours 'l Owner/Operator or other qualified person is to I Date I Time
~ review records for errors before determining.~z/.~zOl/IO/93 ~6:50 AM
I there is a reportable variation/loss. ~r~//
Performed By : Richard Brown
24 Hours
48 Hours I
I
I
I
I
72 Hours
1) Owner/Operator must verbally report { /Dote [ Time
discovery to BFDHM and follow-up with writtenl i~i~ ,_, [6 ~/5~
notification on form provided. , /..~ ~.~ ,~ .
Performed By :~~
2) Visual facility checR to be performed usin~{ Date { Time
checRlist on the bacR of this form ,~ {O1/10/9~ { 7~45 A~[.
Performed By : Richard Brown
3) All product dispensers are to be checked for I Date ~ 'rime
calibration and adjusted if out of tolerance ~ ~
Performed By :
Piping to be lea~ tested using approved methodl
Contractor's Name
License ~ Test Performer's Name
Description of test performed
Date } Time
* * ATTACH COPY OF TEST RESULTS. * *
Tightness Testing of Tan~(s) to be performedl
using approved tester and method.
Contractor's Name :
License ~ Test Performer's Name
Description of test performed
Date } Ti'me
* * ATTACH COPY OF 'rEST RESULTS. * *
NOTE:
THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN ~ DAYS
OF COMPLETION Of' INVESTIGATION PROCEDURES.
2. VISUAL INSPECTION CHECKLIST
A. Dispensers
Ail dispensers and their end doors visually checked for leaks.
All hoses and nozzles visually checRed for leaks.
All totalizer seals checRed for~t~mpering.
Results: '
All dispensers appear tight Richard Brown 01/10/93
signature/date
Dispenser(s) not tight as listed below
signature/date
IDISFENSER ~ISERIAL ~ICOMMENT$:
B. Tank Area
X . All turbine boxes inspected.
X All fills and vapor manholes inspec~ted.
Results: pr~0~uc
or liquid present
X 'rank area appears tight with no t'
Richard Brown 01/10/93
signature/date
Tan~ area does not appear tight because of the problems/conditions listed
below:
signature/date
]TANK #IFRODUCT ]COMMENTS/RESULTS:
C. Piping Type: [] Pressure ][ Suction
Pressurized piping lear detector(s) tested for proper functioning and
detection of leaRage.
Suction piping tested for indication of leakage.
Results:
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
24 HOUR REPORTABLE VABIATION/LO$$
I~OTIFICATION
Bakersfield Fire Department
Hazardous Materials Division
2101 "H" Street
Bakersfield, CA. 93301
REGARDING:
Faci]J~L County of Kern "Inyo" St. (GAS) Permit. ~ 150011C
Facility Address: _._2~ Inyo St. Bakersfield, Ca.
.~!!ll9._O_tj_P__e_.[.~iD ~jji__n_t_.~Sort.: JIM HINDMAN, GARAGE SERVICES SUPERVISOR
On ............. 1_2_/--2_9_/92 5:00 PM , the above facility had an
(date and time)
inventory variation/loss that exceeded reportable limits as described below:
· '.['ar~k ~
Amount of Amount of Amount of
Daily Weekly Monthly
Variation/loss Variation/Loss Variation/Loss
Total Minuses
Line 3 of
Trend Analysis
I -161 Gal. 93 Per. 7
~ 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 placed.
JIM HI,ND~IAN, GAt(AGE SERVICES SUPERVISOR
G~NERAL SERVICES, GARAGE DIVISION
[3a~KE~FIELD FIRE DEPARTPIENT HAZAltDOUS NATEllIALS DIVISION
VARIATION/LOSS IIqVES?I~ATIO1/ REPORT
Facility: County of Kern "Inyo' St. Permit ~ 150011C
Facility Address: 230 Inyo St. Bakersfield, Ca.
Tank(s) with Discrepancy: ~ I Date/Time of Discovery: 01/02/93 7:05 AM.
Name of Person Filing Report: Jim Hindman, GARAGE SERVICES SUPERVISOR
Description Of Discrepancy: Daily variation exceeded allowable limits using
LOW THROUGHPUT CHART. -161 Gal. Bad stick reading.
iNVESTIGATION SUMMARY
The fo]lowing procedures must be performed within the specified times starting
at the 'time a reportable loss is discovered or should have been discovered:
6 Hours I Owner/Operator or other qualified person is to I Date [ 'rime
{ review records for errors before determining 101/02/93 ]7:05 A[~
[ there is a reportable variation/loss.
Performed By : Richard Brown
24 Hours
48 Hours
72' Hours I
I
I
I
I
[) Owner/Operator must verbally report. { p~te I, Time .,,
discovery to BFDHM and follow-up with writtenlQ/?]ff'$ j. ~g¢3 .,,
notification on form provided. ~C~ ~~
Performed By : ~ f~_ _ _..
2) Visual facility check to be performed using [ Date I Time ' .
checklist on the back of this form 101~02/93 ~ 8:30 AM.
Performed By : Richard Brown
3) All product dispensers are to be checked for I Date I Time
calibration and adjusted if out of tolerance I ~
Performed By :
Piping to be leak tested using approved methodl
Contractor's Name
License ~ Test Performer's Name
Description of test performed
* * ATTACH COPY OF TEST RESULTS.
Date I Time
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
* * ~TTACH COPY OF TEST RESULTS. * *
NOTE:
TH.rS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS
OF C. OMPLETiON OF INVESTIGATION PROCEDURES.
2. V.1SUAL 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:
~_. AIl dispensers appear tight Richard Brown 01/02/93
signature/date
Dispenser(s) not tight, as listed below
signature/date
IDISPENSER tISERIAL ~ICO~EN'rS: I.
3._ I I I.
B. 'rank Area
X__ All turbine boxes inspected.
X__. All fills and vapor manholes inspected.
Results:
.X Tank area appears tight with no product or liquid present
Richard Brown O1/02/93
signature/date
'rank area does not appear tight'because of the problems/conditions listed
below:
signature/date
J 'rANK _~ I PRODUCT~J COMMENTS/RESULTS:
C. Piping Type: II Pressure Il 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) above, with problems/conditions
listed below.
signature/date
Description
24 HOUR RI~PORTABLE V~dlIATION/LOSS
NOTIFICATION
RakersfJ. e]d Fire Department
Hazardous Materials Division
2101 "H" Street
Bakersfield, CA. 93301
REGARDING:
~8~=~!.~_~y: County of Kern "Inyq~..St. (GAS) Permit # 150011C
.~[a~!...!!~% Address: 230 Inyo St. Bakersfield, Ca.
Name Of Pecson Filing. ~eport: JIM HINDP~AN, GARAGE SERVICES SUPERVISOR
On 12/24/92 5:00 P~ , the above facility had an
(date and time)
inventory variation/loss that exceeded reportable limits as described below:
Tank
Amount of Amount of Amot{nt of
Daily Weekly Monthly
Variation/loss Variation/Loss Variation/Loss
Total Minuses
Line 3 of
Trend Analysis
-161 Gal. 92 Per. 7
£ 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 placed.
JIM HINd)MAN. GArAgE SERVICES SUPERVISO~
(,.~NERAL SERVICES. GARAGE DIVISION
BAKEI~FIELD FIRE DEPARTPIENT HAZARDOOS PIATERIALS DIVISION
VARIATION/LOSS INVESTIGATION REPORT
Facility: Count~ of Kern "Inyo' St. Permit # 15OOllC
Facility Address: 230 Inyo St. Bakersfield, Ca.
Tank(s) with Discrepancy: ~ I Date/Time of Discovery: O~/02/93 6:50 AM.
.Name of Person Filing RepOrt: Jim..Hindman,~ GARAGE SERVICES SUPERVISOR
Description Of Discrepancy: Daily variation exceeded allowable limits using
LOW THROUGHPUT CHART. -161 Gal. Bad stick reading ....
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:
6 Hours ~ Owner/Operator or other qualified person is to { Date I Time
~ review records for errors before determining [O1/0Z/93 [6:50 ~ .
[ there is a reportable variation/loss.
Performed By : Richard Brown
24 Hours
48 Hours
72 Hours I
1) Owner/Operator must verbally report I ;Dgte I Time
discovery to BFDHM and follow-up with writtenli['?~
notification on form provided.
Performed By :
2) Visual facility check to be performed using I Date I Time
checklist on the back of this form 101/O2/93 I 8:30 AI~.
Performed By : Richard Brown
3) Ali. product dispensers are to be checked for I Date ] Time
calibration and adjusted if out of tolerance
Performed By :
Piping to be leak tested using approved met. hodl
Contractor's Name
License ~ Test Performer's Name
Description of test performed
Date I Time
* * ATTACH COPY OF TEST RESULTS.
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:
'/'HIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS
OF COMPI,E'~ION OF INVESTIGATION PROCEDURES.
2. V1SUAL .IN~;PECT~ON CHECKLIST
A,, I)ispensers
..... K.,_ AIl dispensers and their end doors visually checked for leaks.
X All hoses and nozzles visually checked for leaks.
.... ~_ Ali tota].izer seals checked for tampering.
Results:
..... ~ ..... All dispensers appear tight Richard Brown O1/O2/93
signature/date
Dispenser(s) not tight as listed below
signature/date
iQ.{~ KN_S~.a_..~_I s E a '[ A g # I c o~t~s N'rS:
_1 I I
1 ................... J I
..1_ ..................... J I
B. Tank Area
X__. A1.3. turbine boxes inspected.
.~_ All fills and vapor manholes inspected.
Results:
.~_ Tank area appears tight with no product or liquid present
Richard Brown 01/02/93
signature/date
Tank area does not'appear tight, because of the problems/conditions listed
be]ow:
signature/date
JTANK #leROI)UCT%ICOMMENTS/RESU£TS: I.
.J. I I I.
C, Piping Type: II Pressure Il 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) above, with problems/conditions
listed.below.
signature/date
Description
FACILITY/ IJffO S?. TANR 0 ~l CAPAC'rT~z
I 3 3 4 .5 6 ?
3.000 ~AL, PRODUCT DIESEL N(WTH/XBAR DECEHBER 1093
9 10 11 13 1'4 15 16 17
10 19 ·
3/609PR 4 47 3/4 1349 1395 4.43~3 44313 ~0 0 0 ~4 50 ' -4 ! 0
3/617PR ..... $-46~4/0 ......... 1396 ....... 1193 ......... ,14463 ......... 44363 100 ................ 0 ,0~-----~---~---0 ~103 100 ..........2 ........... ........ 1 ....... 0
4/... 6 4~ ~/e 1.~ ~1e5 44501 4446~ ~ ~ o ? ~ ~g ~ 0 . 1
5/500PR6/{0~PW .... ~ 1 4343 .......... llSS iI?S - 1165 IIU5 ...... ~501 44501 ........ 44~1 44~01 .................. 0 0 ................................... 0 0 ...................... 0 0 ......... ~ ........................ ~ ....................................... 0 0 0 0 ............ 1 1 ............................................. : .......
13/300PH I 30 1/4 758 758 44694 44694
14/400PN ....... 2~-.20-.1/4 ............... ~50 .......... 691 .............. &--44961 .............. 44804 .......
0 '0
.0 .......... 0
0
.0
20/416P!! I 18 1/4 37'/ 3?? 4537'/ 46277 0 ' 0 0 0 0 0 0
.......... 31/500PN ..... 3--IG 1/4 ....... 37"/ ......... 331 ............ 45335---~-'-' ........ 453'/7 ................... 40
30/50~H 4 45 1/4 1366 1130 45745 45607 138 0 0 0 0 136 13e 3 0 I
31/$00PW~5~41--1/4 1-130~1,1,13~45745~45~45'
........ 1"/ ....................... l ........ ·
INYO STREET TANK
DFCEMBER
1297
# ,5 (DIESEL)
1992
VARIATION
20 ·
15
10
5
0
--5
-15
-20
2 2 4 6 8
10 12 14 16 18 20 22 24 26 28 30
' OL/63OAH
0 ~,t~lM~ INV~TORY l~ R~.DII~ 9,~DIl~ ~T~I~D ~ '~F~ ~ I~R~ ~l~ ~D~I~ . ~ O~R OR S ~ :~ ~ ' ' '
3 36 X/4 3114 3016 69387 09~40 ~47 0 0 0 j 98 147 ' 49 0 ~' - ~,'~-~'Z~,~
',. 10/640~J~ ' 4 20 3/4 2163 ~0~7 90~12 900~6 14& 0 0 0
'15/43M 3 36 3/4 100~ 1690
17/630M! 1/4 1531 1397,
19/600~]~ 6 31 ' 1376 9?63
90691 904?0 0 0
90934'. 90~4 00 0 O
~136~ ' '
116
134
31
131 · ' '
o
, 34/656A~ 4 64 3/4 ~400 9~47 91605 91369
G 81
O~'O00AH~i--eO'Y/e~eozx~eo63 ~l??a ' 91773
134
0 0
,, 0
153
17i x6.s .-6
-X66' '103 -~3-.
__4o.~. o., o
FUEl 1..059
INLYO'STREET TANK
MARCH 1995.
1
50
4O
5O
20
10
0
-10
-40
-50
-60
-70
VARIATION
: : : : : :
2
2 4 6 8 10 12 14 16 18 20 .22
FUELS INVENTORY RSCORDINO ~HEttT
Ol/,S~oM! .2 ss 1/2 159~. 154~ 46616 4~656 60
0 0
OVBR OR S VARXATIOM C0UIIT
60 6 0
li~EK ~ TOTALS x~xxxxxxx
0 ~
0
00/6361~ 3 44 1333 ' IISI 49010 ,. 46917 93' · 0
~0916301H~3_41_718 1161~.1070~4~681~,--49010~.--~.~71~ ............. 0~--~
lO/640AH 4 39 1/3 1070 1008 ' 49133 49061 63 0
359 -14 -3. 908 " 3 6
15/6351H
l?/630MI
19/6001H
3 35 1/3 936 '766 49390 49335 166
4 3? 3/4 676 SOS 49547 49&87 60
6 33 1/4 ,630 453 49687 ; 49613 74 0
34/6551H 4 l? 1/4 349 1771 49884 49806 " 78 16 3/4
36/600M1~"~"6.$7 3/4~1&64 1603 ,, SOO'IS 49991 . 64
37
30,"6001] I 54 5/8 1669 "1680 60073 50073 0
3~ 65 3/6 1860 1636
0 ' ~' 0 , :' ~'I
o , ,' 0 .' Ol
113 78 -34
107~_._~_~10.7 '0.
61
34 a?_ -?
-19 0 19
~KI~ 5 "POTAL9 xxxxxxxxxx , xxxxxxxxxxxxxx]cx]rx]r xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxx ' 310 38'4 '~6 '9,168 $ 0
,®
INYO STREETivIAR C HTAN~g ~S3 (DIESEL_)
VARIATION
25 .
20
15
10
5
0
-5
-1
-1
---20
-25
-50
-55
: : : : : : :
: : : : : : :
:
:
:
:
:
:
:
:
:
: :
: : :
:
: : : : : : : : :
2
2 4 6 8 10 12 14- 16
18 20 22 24 26
: :
: :
: : :
: :
: :
28,50
1660 ' , ,1596 495S9 ' ' 4849V
~596 1596 48558 48559
g~::':~ 5:U:~5~} ~ g:¢:'~ ¥~::~::~!~¥5;5;~ ;::¢}.~ ~:~;;~g
i;~:: 'i~:[{'::}~:: ?~'[~: ~;:[:}~' !~}~ i~{}~¥/{~i ?~;;~:.:[¢~;'? }:~} i~::." i ~. ~}} ~?~ ~i-:
, ~ ,
~','.i: :~i::;:~:~¢::~:~:;~ :~:~::~:.¢~:f~: :~;~t :~::~:f:~:i::~f~¢:::::J:;:~:;It ~:i;:;;~ :;: :~::~:~:i:~:: ~.:~:: :~ :~: ~?.~::: ~ :I~:I~ :}.~::~;~ :I;:~:I~ :i~:, [:;[~['~:Ii~ i~:,; :[,:;)~ ~'.~:i~)~:'.::[~J;:,
.~:~ .:i::{~':::~;i~! ~i ~:[~ .:if?~i ~i* ~i~:::[~f~':~'~i~:~ :'ii¢~ifl ?~i !~!} i:::: ¢'~ ::'}~.~ ~
DIF-SEI 1'5o0.295
INYO .STREET TANK' #'5 (DI~SF'L)
FEBRAUAFiY 1993
15
10
5
0
-5
-10
---15
-20
-25
-50
VARIATION
2 1 2 3 4 5 .6 7 8.9 101112131415161718192021222324252627
' ' ' , T '. . . ' . .. ' ..
~:~.~.; ~.,.. :,.,=.~, .,~;:...~. ~. ,; ~ ~G '~ ~ ' ~ ' 0 ' ' ' ' ' ' '
0 0 0 I 2~ ·
~ . , . ' ,j...,, ; .... ,', ,,....,' ," ,'.h ....... ;~ :,..,..v ... ~ ,.,.~,'. ,.,...,..-,, ~ '
2~
~ = .... ~ ..... ~~,~ - '- - Z: · ' . ' '.,. .' ; ' ~C
":%;:~::~:~::~'?~:~::17~t~':~ ':~:,C~i~G::~::~.~:~'::~a:~::':~:%::~:.~:~Y .~h'~:::::~:~':':~;:¥~::::~%9 :~:~'~::? ::~:~ ::~::~:~ ::~'~:?,:~:~Y~:~,,~.i~ ~'~ ~:~:'~'~q:~:~'~:.:~:::':~':-~ .~ ':: ~:'~:: ~,::.~:.:: ~.:;~:>~-:% :.~c~:~ :~',~:¥:~ ~': :'~U :-~ ~. ::~:~:~ :~ ~:~.: :~ ,:~.~'~ ~r ~ .. '~:' ;,,''' ~; ,"- ...... ~, .
5 I :I ' :~14: 71~g~ 15~ , ~: ~ gl::~:L5 i~ I¢~ ):: ~ ~1~;~ 5:59~ 5 ~5: ~:~5: I~ ~ :: :~ ~5 ~i}}~I, :':'I ' ;Il i ¢~ :')~ ~ ¢il'i !5: : ':~'~ ~:~ ~ ¢I:~': * ~ 5~} ~: ~;): )i : ~':>~:'la' ~ ¢:* I¢ >' ~: i~I : ¢~ I: '~ ' :;}': ~'il '}:;: ~> := ~ ';i lj ')Z: }'~; ': j:'~ }~ 'I :? I;~4~ :'Il :~' ~ ~' ::, , }': ~I: : :' ~.: ~;~ i~ j~;¢i :: ~i }~ ' I[ : ~i }I~:: ~ :;:I; i g'{ I~[ };:~ 'II' ~' ; iq ; ~ ~4r; ::i . ~ :II: ~ :y.: g~ ~q} i Sy: ~ ~2'~I : ' ~ITZ~: I : ~I': i,,; }' 'TI i*~ :¢;:: :~I :' : {' q } :~ :; ~ ~* iI : ~ I ':' :¢ ~i1[i: ~, J' lq :: * ' i: * i ii : ~ '~I ~: :i I.: : ~3 :.il: I:i::: i . ~ J ~I j : :'~.I~ ~ t I ~ ~i~ l~q} ? :~ : ~'I* ~ [~'¢I }l~:I//~:~lq~~[ q:'~ 5~I~p>('¢ *>:} ~ ~I* :X 5;i '~<q :'~ :(''~5~'l:<lq:~: I
I NYO STREET TAN
FEBRUARY 1995
1
VARIATION
60 .
4O
-20
-4-0
-6O
--80
2 1
:
:
456
7 8 9101112131415161718192021222324252627:
TO:
Ba~ersl=ield Fire Department
Hazardous Materials Division
2101 "H" Street
Bakersfield,. CA. 93301
HAZ, MAT. DIV.
_Faci. l~t¥: (C. ounty of Kern "Inyo" St. (~AS?_ X~ermit # 15001kC
Facility,A~ress: 230 Inyo St. Bakel:sfield, C~.
~ali~e Of f ers"O~Fi_~li'nq -Repot t: JIH--HIND~', GARAGE SERVICES SUPERVISOR
O1] _02.~0.1_~93 09:00 AH , the above facility had an
(date and time)
lrlvel'lt°ry variatiog/loss that exceeded reportable limits as described below:
Tank
Amoun't of Amount of Amoun't of
Da i ly Weekly Montl] ly
Variation/loss Variation/Loss Variation/Loss
Total Minuses
Lilqe 3 of
Trend Analysis
-203 GAL. 101 Per. 7
£ have/have-not Stopped dispensing product and begun investigation'procedures
required by the Permitting Autho[-i'ty.
This notification is in addition to .the phone call I previously placed.
JIM HIN~HAN, GARAGE SERVICES SUPERVISOR
~NERAL SERVICES, GARAGE DIVISION
~I~ZRS~I~LO ~IR~ OEPA~TM£~q~ i~AZAROOOS Fh~TERIALS O~VIS~Olq
VARI'ATION/LOSS TNVESTIGATION REPORT
Facility: County of Kern "Inyo" St. Permit ~ 15OO11C
Facility Address: 230 Inyo St. Bakersfield, Ca.
Tank{s) with Discrepancy: ~ 1 Date/Time of Discovery: O2/O1/93 9:00
Name of Person Filing Report: Jim Hindman, GARAGE SERVICES SUPERVISOR
Description Of Discrepancy: Monthly variation exceeded allowable limits usinq
LOW THROUGHPUT CHART. -203 Gal. Bad stick readinq (January 1993)
INVESTIGATION SUMPlARY
The following procedures must be performed within the specified times starting
at the time a reportable loss' is discovered or should have been discovered:
wi-ti]in: - [- - ......... - ......
6 Hours I owner/operator or other qualified person is to J Date ] Time
[ review records for errors before determi[~i~lg [O2/O1/93 ]9:OO ~
I there is a reportable variation/loss.
Performed By : Harold Lawler
24 Hours
1) Owner/Operator must verbally report ~ Date I Time
discovery 'to BFDHM and follow-up with writtenlO2/O1/93 ~ IO:35AM.
notification on form provided.
Performed By : Harold Lawler
2) Visual facility check to be performed using I Date I Time
checklist on the back of this form J02/O1/93 ~ 10:35A~.
Performed By : Harold Lawler
3) All product dispensers are to be checked for I Date I Time
calibration and adjusted if out of tolerance I ~
Performed By :
48 Hours {
{
{
{
{
Piping to be leak. tested using approved method{
{
Contractor's Name
License ~ 'rest Performer's Name
.Description of test performed
Date J Time
I
* * ATTACH COPY OF TEST RESULTS. * *
72 HoUrs
Tigi]tness Testing of Tank(s) to be performed{
using approved tester and method. {
Contractor's Name :
License ~ Test Performer's Name
Description of test performed
Date I Time
* * AT'tACH COPY OF TEST RESULTS. * *
NOTE:
THiS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS
OF COMPLETION OF INVESTIGATION PROCEDURES.
2. VISUAL INSPECTION CHECKLIST
A. Dispensers
.... .~__ All dispetlsers al%d their elld doors visually checked for leaks.
X Ail hoses and nozzles visually checked for leaks.
X All totalizer seals checked for tampering.
Results:
X 'All dispensers appear tight Harold Lawler · 02/O1/93
signature/date
Dispenser(s) not tight as listed below
signature/date
_l I I
B. TanR Area
X All ttJrbil]e boxes
., .....All fills and vapor mal]hol_o J.~]spected.
Results:
_X_ Tank area appears tight with no product o~r liquid present
Harold Lawler 02/O1/93
signature/date
Tank area does not appear tight because of tt]e problems/conditions listed
below:
signature/date
.ITANK-J-L?_RODUCT~ICONMEN'£S/RESULTS: I--
...[__ I I I-
C. Piping Type: J_[ Pressure {[ Suction
.__ Pressurized piping lear detector{s) tested for proper functioning and
detection of leaRage.
Suctiol] piping 'tested for indication of leakage.
Results:
___ Piping tight based on test(s! above.
signature/date
Pip.iilg not tight based o1% test(s) above, with problems/conditions
listed below.
signature/date
oescr iption
O OAUOING II~,~N'FOR¥ INV~ItTOR¥I~ADINC ., RBADINC
DAY/HouR INCH~S GALLO~S C~LLONS G~LLoNs GALLONS
"I~TERED kDJUSTHEN BEFOI~ AF?ER
SA~ES~~ ': · ':~ ~'--'~DEI;IV~R¥~ '~
INCHES GALLONS INCHES GALLONS
~AUGI~ REDUCTION ,THROUGHPUT OVeR OR S VARIATION . COUNT COUNT
~LLOI~3 INCHES QM-LONS ~LLONS ~J. LONS t -- -.
1/500pN 6 40 3/4 1113 '~ 1130 45745 45745
0 O. 0 0 -17 O 17 O
~EEK I TO~LS XXXXXXXXXX
8/500PN 6 33 l/S 921 719 '46139 46037 IO3
'I0/500PH I 39 1/4 724.
'734 ~,. 46139 46139 ' 0
~v/soops ~ ~ 1/2 2e~. ~s~ ~ 4~5o~ 4~5o~ o ' o , o ' ', o -2, o 2 .
19/400PH 3, 17 3/4 363 911 46554 46501 53 0 0 * 0 -~9 ' 53 ' 601
24/500PN ,158'1/3 1667
26/500PN 3 BT 1/4 1649
36/800MI 5 51 3/8 , 1467
1679 46708 46709 0 0 0 0 r 0 0 -S I 0
1536 46865 46754 fll 6 0 0 0 ' ' ' '1
" 133 105 ~lS 0
1433 46965 46.915 50 , 0 0 0 45 50 5 0 I
HEEK 5 'fO?ALS XXXXXEXXXE XXXXXEXXEXXEXXXEXXX XXXXXXEXXXXXXXXXXXXXXEXXXXXXEEXXEXXXXXXX XXXXXXXXX 98 , 103 '4 3.93~ ' I 3
FUELS II'~VEI'~ORY RECORDII~ SHEET
PERI'II? t 150011C '
~.~OM GAUCING Itq%*'EI~*TOR¥ IBVEtfI*OR¥ REM)I~ . READItiG P~TERED
'SALES
DAy/HOUR X)ICHES CM, LON~ CALLOt~I OALLONS · G~LLON~ GALLON5
GALLONS
1/500PH 6 68 7434 , 7369 65132 95133 0
BEFORE , AFTER
INCHES GALLONS INCHES GALLONS
XE, i~N'~RY, GAUOI~ HEDUC?ION 'fl~ROUGI~U? OVeR OR $ VARIA?ION COUif~ , CO~T
G~LLO)~. .,INCHES GALLOHS · G~LLONS G~LLOI~I t' -- **
0 65 0 -ES I 0
* WREK I TOTALS XXXXXXXXXX
IO/EOOPH I 64 1/2 6972 6972, 95456 65456 0
XXXYJCXXXXXX)UCMXXX XXXXXXXXXXXXX)QCXXXXXXXF, XXXXXXXXXXXXXXXXX XXXXXXXXX
378 263 -115 -43,73~' 3 4
0 -16
00 ~
0 0 0 0
45 61 0 1
0 0 0 I
17/$00P~* I 60 1/2 6432 6432 ' 85981 85981 ., O
19/400PH 3 60 1/4 6398 6565 86073 85991 92
0 0 ' 0 IO2 , 39 -63 I · 0
O 0 0 O 0 0 ,~. 0 1
0 0 O * L170- 92 362 0 1
~4/500PH I 58 6090 6004 ,, 86388 , ,' 86388
26/500PR ,3'E7 3/8 6004 5711 86636 86509
29/800AH 5 54 l/2 5607 5503 86883 96790
0
,154
0 0 O' 86
O- 0~ O O
0 0 '0 293
0 0 ' ' ,O~O t04
0 O 0 104
0 -66 ! 0
127 -166 X 0
154~--50 0 "
, 92 -12 I 0
b'EEK 5 ~TALS
XXXXXXXXXX XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXX 138 116 -22 -18.97~ 2 1,
X~'XXxX~X~X*~xxXX~xXXx~xXXxX~xXX~X~X~X~XXXXx~X~XXXxx~XxXXXXX~-~XXXXx~ ' ' 2069--,***,~165,6~--203~-10,68~14~ =:~1~7 '-- ~-',.*,~.~',
INYO STREET TANK
JAN UARY 1
).13
3 IESEL)
~93
8OO
-600~
400
2OO
0
.... 2OO
VARIATION
.... 400 .......................................................................................
-60O
.... 800
2 2 4 6 8 10 12 14 16 18 20 22
24 26' 28 30
FUEl I1.o01
INYO STREET TANK 1
JANUARY 1995
VARIATION
500 .
15o
1 oo
5o
o
-.-50
_100
--150
-200
-250
4 6 8 10 12 14 16 '18 20 22 24 26 28 50
24 HOUR _I~II:!PORTABI.E VARIATION/LOSS
NOTI F ICAT.I'ON
T0:
..N_ .,-.:Lt~.~. ~t ... &)_f,...... P_~.~: ~ .9..n..._ _[..i.,,.].J:.~!~L.B_e..~. ~L_qzt..:...:. ......................... _K..A_R_.~ _N_...G_b'_X .~ ,_ ........c.'_~ _Nf!'_R..~b_ .~.E B._VJ_c.'_tl ~.... ~ .A..N. _&.G....E..~. .....................
()ri .L.....[,:.O...../...;:]:]::/.~)....~] ............ ..0._.6'...:__2,_5.._._A..~ ......... :..: .............. : ......................................................... the above. [ a e i ]. i ty ha d an
( c'{al:.e arid time}
i nven'l:.,.~ry var J at'. i. on/] o.q.~ t.l'~,'."~l: exceeded i:epot: t.'.:~l}] e ] J m.i t.n aF, def:c!r J. bed be] ow:
'.l'ank #
Amour~t of Al~cnlnt. c)f Ar~]Otll'tt. of.
[)a J ] y Week ly M0r:,.th ly
Var tat iota/lc)ss Var i at. i cn-l/l'~o,.4s Var
'/'Oral MJF~LI:.~es
I,ine 3 of
Trend
5 Per. 72 .
.I. have/J:hi!..V..~:':._~7!.9.}: stopped dispensing product and begun investigat, iori procedures
required by the Permitting. Authority.
This notification J..~ in addition to the 13hone call 1 previously placed.
KAREN GE¥~,\------CEN'iRAL SE/i~/Vi1C~$ MANAGER
INV 'c"' '', ,, '
...... ...
'.l'he fo]lowing proceclures must be per. for'meal within the specJfi, ed times ~,t. artin9
.i~ iL. _)LI!.~... _ J~ ~J~m_..,)._...EfP.g_CL~L 'k ~..Ag.E.~_.._k~!_..~!.i.,1.f;~ ~.g..C~f!....2 E_..f.?u~ 2].;! ..hf~.~_h~.~ EL _..f)..!. EgLgx~..c~ .;l.;.
6 tlours I ()wrier/Operator o[' other qt~a]if, i ed person is to I ....... !).CLt...~ .......... L ....... 'J '. !. . BLe.. ...........
-I review
I i:.het-e i:~ a r."eportabl, e
I:'erf¢,L-med Hy : _...~!.q..h.~.!/.~...B.E~.~ .........................
Hour s
I. ) Owner/Operator must verba].l'y repo.rt I Il)at. 9 Time .
not~[icat.ton on [orm prov~ded.performed B~ :
2) Visual facilJ, t.y check t.o be performed
checklist on the back off this [or~
Per~ormed BY..': Bicha[~ Brown' .
calibration and act~usted i~ out o[ t. ole[ance I ......................... [ ........................
Pe[-[o[med Dy : .................................................................. ~..
48 HoI.II'$ I
I
I
I
I
P i. pir, g to be leak tested using approved methoc.1 .... I=):-A.R~9 ......... I ....... [[.L~.~ ......
I ............................. I ....... : ......................
Contr,~ctor's Name ~..
I, icense % "" '
()escrtpt~on o~ test performed
:~' * ATTACH COI.:'¥. Ol~' '['E'c,., ..... 1 1:~,1~:~.; LI[., l c, .... , *
72 ttou['s l
I
I
I
I
Ti gh'tness 'l'e.~t.i ng of Tank( s ) to be pe~:formedl ......... .!:).~!.~.~. .............. ! ...... J~[.~..~ .......... ~...
using approved t, est. ec and method. I ................................... J ........................................
(.:orl't:.racttol: ' S Na~e : ............................................................................................................................................................................
License ~ '.?est Performer's Name ..........................................................................................
I)escrtpti. on o[ t. est. perEoE~ed ....
J * * A[ I.A.,H 0[" l~..~,l RE,.,LILI~ *
..................... .~::~.~.~ ............................................................ ·
t'IOTE: '1't't I:L; RI-.:P()RT MLI,., tbi-:'" ,.,UbM1 l l I..:L) TO 1 Flk, Pb',RMI:'I'TI:[',IL-, AUTHOR.[T¥ .W.:.L.'.~,.I.'..I-J.,[_N...!~
(.)F C()MF'I',ETIZON OE' [blVh;:,'"""'"'] I.(.,A"'I.I. ON PR()CEI)LII:tES.
2.. V:ISUAI, :[N~;F~:C'I'.I. ON CHF, CK[,]~;"
A I.) '[ ?,.
.......... ..X. A:I..1 ¢t~ sp~nsers and t.t-~e.J r ~rd doors vJ .~ua] ]~ c'hecRed for leaks.
X All. hoses and nozz].os v.isua].ly check,c1 for ]eaRs.
.......... ~_.. All tota]Jzer seals c. thecl~ed for tampering.
Results:
X A]] dj :%[::~ensert, appear' t~ 9hr ...... Bj...gha. r..~._..B.r.9~Q ........ !).,~.),.~8..2% ..........................................................
s~.gnatLIre/date .
I)~spenser(s) riot tight as ].~st. ed be]ow
............... s ~.qnatur e/date
I.t. Tank Area
.,X ..... All. fi l.]s arid vapor marH-lo].es i]~l~pected.
Results:
....... ....Bi.~h~.r_4....B ~_9~_~ ...... .~,~.40!,Z~_~ .....................................
sJ. gnature/date
'l'al:lk area does r~ot appeal: tight be(';aLIse of the prob].e~s/coriditior~s list. ed
be. ] ow: ,,~
............ s ~ gnatur e/date
.,.L ...................... I ........ ...................... 1 ............................ . ..................................................................... - ............................................................................................
..[ ........................... L ....................... L ................................................................................................................................................................................ L.
C. Piping 'I've: _1._/ Pressure J,_].. Suction
l?cessurized piping leak detector{s) tested for p~ope~: functicming and
detectJon of leakage.
tiuc~:.ion piping tested for ].ncl~..a~.ion o'ff leakage.
Resu 1 ts:
......... P]pJng tight based on t.e~t(~) above.
~ signature/date
Piping not tJght based on test(s) above, with problems/cc~nditions
l~st. ed bel. ow.
s i. glaa t u~.- e/~]a t.e
Desc.'.t- ipt i on ......................................................................................................................................................................................... ·
24 HOUR REPORTP,13LE V~R~AT~ON/LO~s
NOT~FICAT~ON
Bakersfield Fire Department
Hazardous Materials 0ivision
210] "H" Street
Bakersfield, CA. 93301
REGARDING:
Fa___c. Jli~ County of Kern "Inyo" St. (GAS) Permit ~ 150011C
Facility Address: 230 Inyo St. Bakersfield, Ca.
Name-Of .Pe.~-s-on-~F-i-~{ng.-R~port: KAREN GEYE,- G~fRAL SERVICES MANAGER
On ...!..0/t4/93 06:45AM , the'above facility had an
(date and time)
inventory variation/loss that exceeded reportable limits as described belows,
Tank
Amount of Amount of Amount of
Daily Weekly Monthly
Variation/loss Variation/Loss Variation/Loss
Total Minuses
Line 3 of
Trend Analysis
I -216 qal 4 Per. 60
I have/have-not stopped dispensing product and begun investigation procedures
required by the Permitting Authority.
ThJs notifJcatjOh is in addition ~0 the Phone call l'previously placed.
GENEI~L SERVIClf~, GARAGE DIVISION
~AK~It~F~-.LD F~it~ D~-PAItTMENT HAZARDOOS MAT~-R~A[-~ OI~[SlO#
VAltlAT~OIq~LO~ ~NVI~T~I'ON RKPORT
Facility: County of Kern "In/o" St. Permit % 150011C
Facility Address: 230 [nyo St. Bakersfield, Ca.
Tank(s) with DiscrepancY: % I Date/Time of Discovery: 10/15/93 07:OOAM.
Name of Person Filing Report: Karen Geye~ .CENTRAL SERVICES MANAG£R
Description Of Discrepancy: Weekly variation exceeded allowable limits usinq
LOW THROUGHPUT CHART. -216 Gal.
INVEST'[GATiON SUMMARY
The fo]lowing procedures must be performed within the specified times starting
at the time a reportable loss is discovered or should have been discovered:
~%hin-q- ..... l ................................
6 Hours I Owner/Operator or other qualified person is to I Date I Time
{ review records for errors before determining {~.9~!.5~93 ]O.7:0OAM
I there is a reportable variation/loss,
Performed By : Gilbert Alaniz
24 Hours
1) Owner/Operator must verbally report I Date ] Time
discovery to BFDHM and follow-up with writtenllO/18/93
notification on form provided.
Performed By : Harold Lawler
2) Visual facility check to be performed using { Date [ Time
checklist on the back of this form 110/15/93 ~ lO:OOJM~l.
Performed By : Gilbert Alaniz
3) All product .dispensers are to be checked for I Date ~ .T~me ..
calibration and adjusted if out of tolerance
Performed By :
48 Hours
Piping to be leak tested using approved methodl
I
Contractor's Name
License ~ Test Performer's Name
Description of test performed
Date [ Time
I
I * * ATTACH COPY OF "['EST RESULTS. * *
Hours I
I
I
I
'1
Tightness Testin9 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
I * * ATTACH COPY OF TEST .RESUL'fS. *
NOTE:
THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY .WITHIN --5 DAYS
OF COMPLET£ON OF [NVES'£IGATION PROCEDURES.
2.. V1SUA], 1NSPECT].ON CHECKLIST
A..0[spensecs
AIl dispensers and their end doors visually checked for leaks.
AIl hoses and nozzles visually checked for leaks.
AIl tota]Jzer seals checked for tampering.
Results:
Ail d~spensers appear tight Gilbert A]aniz 10/1.5/93
signature/date
I)J. spenser(s) not tight as listed below
signature/date
]D£SPENSER tlSERIAL ,tICOMMENTS:
I
I I I
8. Tank Area
Ail turbine boxes inspected.
AIl fills and vapor manholes inspected.
Results:
X__ Tank area appears tight with no product or liquid present
Gilbert Alaniz 10/15/93
signature/date
Tank area does not appear tight because of the problems/conditions listed
be]ow:
signature/date
Lo
]TANK ~ ] PROI)UCT:~ I COMMENT$/RESULTL-;: [ -
I I I /.
C. Piping Type: I1 Pressure ]_[ Suction
Pressurized piping leak detector(s) tested for proper functioning and
detect~on of leakage.
Suction piping tested for indication of leakage.
Results:
__ Piping tight based on test(s) above.
signature/date
P~pJng not tight based on test(s) above, with problems/conditions
listed below.
signature/date
0escription
24: HOUR. BEPO[~TA~LI~- VA_I~TATTON/'LO~S
NoTrFTCATTON
TO:
Bakersfield Fire DePartment
Hazardous Materials Division
2101 "H" Street
Bakersfield, CA. 9330,[
REGARDING:
RECEIVED
JUN 2 8 1993
H~Z. ~4.4T. Of V.
Facflity: County of Kern "Inyo" St. (GAS) Permit ~ 150011C
Facility Address: 230 Inyo St. Bakersfield, Ca. .
Name Of Person Filing Report: JIM HINDMAN, GARAGE SERVICES SUPERVISOR .
On 06/20/93 08:00 AM , the above facility had 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 of
Trend Analysis
1 +98 1 Per. 1
£ 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 placed.
gnatur e ~ _-
JIM H~Iq~M~, G~R~GE SERVICES SUPERVISOR
CENE [. SERVICES, O OS O WS O.
[5~KE~FIELD ,FIRE DEPP, RI~EIqT ~Z~R~M)OS Ph~TERI~L~ .DIVISION
V~dqIATION/LOSSIN~STIC. ATION REPORT
Facility: County of Kern "In¥o" St. ~.Permit ~ l§O011C
Facility Address: 230 In¥o St, Bakersfield, Ca.
Tank(s) with Discrepancy: # 1 Date/Time of Discovery: 06/20/93 08:00AM.
Name of, Person Filing Report: ~ ~Jim Hindman,'GARAGE SERVICES SUPERVISOR .
Description Of Discrepancy: DAILy variation exceeded.allowable limits using
LOW THROUGHPUT CHART. + 98 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:
Within________i:
6 Hours { Owner/Operator or other qualified person is to [ Date ~ Time
I review records for errors before determining 106/Z0/93 ~II:35AP[
~ ther~ is a reportable'variation/loss.
Performed By : Scott Mitchell
Hours I1)Owner/Operator must verbally report I Date I Time
discovery to Bf'DHM and follow-up with writtenl~6/20/93 ~II:35AM
notification on form provided.
Performed By : Harold Lawler
2) Visual facility check to be performed using I Date I Time
checklist on the back of this form 106/21/93 ~ 08:I3AM.
Performed By : Scott Mtichell
3) All product dispensers are to be checked for I Date I Time
calibration and adjusted if out of tolerance IO__6~_~O/93
Performed By :
48 Hours [
Piping to be leak tested using approved methodl
.Contractor's Name
License ~ Test Performer's Name
Description of test performed
Date L Time
J * * ATTACH COPY OF TEST RESULTS. * *
72 Hours
Tightness ~esting of_ Tank(s_) to be_performed~
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:
THiS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS~
OF COMPLETION OF INVESTIGATION PROCEDURES.
2. VISUAl, INSPECT]ON CHECKLIST
A. Dispensers
All d~spensers and their end doors visually checked for leaks.
~All hoses and nozzles visually checked fo~ leaks.
All totalizer seals checked for tampering.
Results:
All dispensers appear tight Scott Mitchell 06/20/93
signature/date
Dispenser(s) not tight as listed below
signature/date
~DISPENSER gl. SERIAL ~{COMMENTS:
;
B.~ Tank-Area
X All turbine boxes inspected.
X__ All fills and vapor manholes inspected.
Results:
Tank area appears tight with no product or liquid present
Scott Mitchell 06/20/93
signature/date
Tank area does not appear tight because of the problems/conditions listed
below:
signature/date
{TANK gl PRODUCT{ {COMMENTS/RESULTS:
C. Piping Type: {{ 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) above, with problems/conditions
listed below.
signature/date
Description
·
· _to:
Hazardous ~aterials.~ivi'sion ..:..
21.01 "H" St. re~t, - HAZ M~'~ D~'
Bakersfield,. C.A.. 9330.1 _'.:' . '. :' ....... '
inventory variation/loss. ~hat exceeded reportable liaits, as
:' ', ' .' .. - ~ ..... ~ .... '...~.~: ' ' ~O · . . .... : '. '.....:..,.:~:,.....~;..:..~.,
.[ have/have-not stopped dispensing product and begun fnvest:igati.on proceduro.$.
.. requi.red by t.he._P_.ermitting Authority, .. .
Facility: ._C__o._~_nt¥ of __Kern "[_~p' St.__ Permit,.# ' 150011C
iFacility Address: 230 Iny0 St. Bakersfield,. Ca.
'.Name{ of' P~r s.on::.~F i'l i:ng:<Re~.or t:: ~
I)escript ion, of.' D i. scr epanCy
'.'" -'LON':THROUGHPUT< CHART.' '291: Gal'. ..:?.:~. - <.>:': :" :. .: '::' : ''~' .~ .. _
.'[ NVE ST.EGA'['.[ ON SU RY
6. Hours I. Owner/Op.gr~.a.~or .o[ other gua.!i_f, ig,d pgrs.o.n is.. to ..I Date I,, Time
....I review records-'for errors before de~ermihing' I,.07/01/93 .[09:451kq .
I there is a reportable variation/loss
I I notifi"eation on'form'"Provided:' ' .... ;-/~--0.:.,: .... . i
::?":," ' "~ ~ .' ' ' . I .";~".:.:: '":.'<.:.:~:~':':.":" "' 5: :::'.,. '"'. :..'~ ' perf~.m~ed ,'B~;:::"::'?'R~:f'~h~:'fd~)~B~':~:~?;~.?}??'~'75~'~:~:.:~ '.. '
1 3) A!!.p_rodu~t dispensers ar,9., to..b.e_gheck~d,..~p_[,. I Date I Time
I calibration and ad3usted i~ ou~. of to, leranee,I I
:-' . ..... I Performed B~ :
.. ... .. ::::,:'..
· .' 48 HoUrs .I Piping 't'o~:be'; leak. tested using',
. I contractor's Name
... I License ~ ....... Test Performer s Name
~ I Description of test ~erformed
· :~ '.-...:.' · · .. .:- . . ~-T~ ~:~' .~--..: ..... --"~-~- . . . " : .. · , -...:'. ?;.:?:'-'~.:.:,. '... .'~:..'- ~' :" '~'
,~,::,,~:::.;':_~..':..':. ' "'" '.' :'. .'-' "//."i.?'.'SL':...>fi.. ':"'..: :. ?':' :';:::" ':'7 :' . ':.. · ':'. ": ." '": ",: ./',' "':>'" ~."-:~ ':: f,;:.' ':":: .' ~ -. "':'i",
~;"~:":~': '"" " ' ":"~. :~ ' ' 8'"" ~'" '"~* ~ ' ' * ' ' "'' ' ~'r:' i' ", ~ ::: :, ..~ ;.. -
:.i:~i: ::...: '. '..~, . .".. '.. :. . ...". ?' .' :.;.:: .::' ':.., ¢.;.:'. ~,'<...,. ':c :5.'-"> .... 5..h .:?.' .....'~,~" ". ' ::'. ':..-: ."-:..'....~..'.'..-:'.: ... .:..:' ". }.:<:.:,:.:.sh.,-.;:.':..'. : .'. '.~ ....- . · .:..i
........... ~ .. H°ur s_.... I .... T i g,b ~Dg~.~...,:l',~s t lng.., o f...T,,~D~g.(A) _~.O...,~e ... pe [.fo
* * ATTACH COPY OF 'rEST RESULTS. * *
NOTE: THfS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS
. A.'..DJ spenserls
~ X Ali. di.~pen.~.~ers. and thei.~
~. X All"ho~e~ and nozzle~ visually checked for leaks.
--~ - <: '-- ..... ~c-~J:?'~i
Di sPensgr { .s..~_n9.~... ,.tight as..1.~isted ~ be!pw
"..'.::~:.>:':.':',']:?:,hc~:.:.::.'q'. .... ...,, ,<..>. :.: ,...:
B. 'ran~ Area
~'"' : ".X :: :All :fi:lis''and'lvapor 'manh'oles"'~nspected.' .' :.,'~
:... eressur iZed. piPiing ·leak' detect'°r( s ) tested for~<proPer.- .f-0nc,t~i0~'i:fig.' and
resultS., sucti...qn~_.p.i, pi_ng..tte.sted .f_gr._i.n.d_i.g._at.ign of. leakage .........................................
i i ........ PiPing 't']-ght"based' on tes't-f's ) "ab6~'i .... . . _ ....
:.: .. - ....... ~ ....... -~ '=';::..:".'~> :::.: ~U---"?~-7'~--~-:-~-:-~: ~ :.
I
FU~LS ILqVEIqTOR¥ RECORDING SHEET
CONTEL 9T. 'lANK e
CAP&CITY
10, 000 (IAL
PRODUCT ~4L~ADED
P~nmT o leOOliC
JUNE 1993
DAY/HOUR INGHEB OALLOI~ GALLOH9 GALLOI~ GALLOHS
i-aT.-l./a~3Ol, a .......... ~777 9951.2~90343
03/900~ S ~5 1/2 1777 166~ 99625 ' 96613
117
'169
113
0ALI, ONS 'rlqCH~6 (~ALLONS . GALLONS INCHES
0 ' 0 0
'0 ...... :~ ~'*'"~0 0
0 )~ 0 0 0
GALLOiq~ GALLOHS GALLON9 f~ -- .4.
131 i17 -4 1' 0
115 113 -2 I 0
06/635~J~ 3,23 1/2 1549 1439 96890 90790
,09/635AJt~4-22-1/2 1430~9937~,99996-~90690
10/900M! ' 6 99 1/2 9937 9626 99166' 99999
11/900AR~6-OT-I*/e~--~O620~~95Pi, :'~',-~9926t~'-~ ~99195
1~/900~ ? 96 l/O 9534 9534 99261 99~61
103
0 0 0
0 ' O0
0"~ 0 O
111 102 -9 I 0
369 ...... ~109 ~: '"61-*~**' ..... 1~O*
309 19? -22 1-- O
0 0 0 0
17/900AN 5 91 1/3 9062 9056 99896 99739 146
-16/eOOAR.-~--6-79-6/e--~eSSE,:- .... 6?43 999,10.-- ' : 99895, ' , 63
19/600Mt 7 79 6/0 9743 RE41 99040 99949 0
.20/8OOAN,---**-~1--79~1/2 ............ 6941~0799~999~P1*'~'---~=--:::-99946~=-:: :~:~:~6,
21/630~ , 2 79 l/~ 9?99 9612. .100117 999~ 163
0 ~ ~ ,; 0 0 0 : 306
0 0 O, -96
0 0 0
146 -60 I ,' 0
" 0 " 99 0 I '*
163 -34 I 0
36/000AN ' 7 73 0071 9071 ,100635 100614
6071--0071~00620 ' 10063~,
29/630All 2 73 9071 ~ ?977 100744' 100635
11 0 0 0 O, 11 11 0
o o ......... -.-~! ...... o ........ ; .... o o~o~o-*,*,,.---~ o ' 1
119 0 .!, ,0 0 94 . 119 25 0 1
t~BK 4 ',Z'OTAL$ XXXXXXXXEX , XXXXXXXXX,IOCXXXXXXXX XXXXXXXXXXXXXXXXXXX~XXXXXXXXXXXXXXXXXXXX XXXXXXXXX 636 627 -e -1,29~ 3 4
1~O~'~H -'~1'M.9 ' ,--~ XXXXXXXXXX~XXXXXXXXXXXXXXXXXXX--XXXXKXXXXXX]Dg]D~,XXX]~,Xii XXXXXXXXXXXXXXXXXRE~XXXXXXXXX ~30'10~'~'T~3749 ~ -291~' 10.'69~,~. ~1e~12
IlXlYO STIR~F-T TANK #
JUNE. 1995
1
VARIATION
100 .
40
20
0
--20
-40
-60
_80[
2
4 6 8
10 12
18 20 22 24 26 '28 30
* pg~lly 4 15001'1¢
DA¥~IOU~ INCHES ~,LLOHE ~,ALLONS OALLOHE ,~,LLONS
S 19 3/4 433 377 54038 53987
GALLONB
1'57
41
INCHES OM. LO~B
0
, 0
110 108 -3 , I 0
~63' '167-"~"-'-~'~-6~ '1 .... O'
45 41' -4 I O
08/$35M~ 3 61 1/4 1764 1709 54360 54310 $0
'09/G3r,~x~4~59-l~4~lTO~- 'i~"~'"1607~54348~4360 '68
. 'IO/800AH S 55 ~/8 1607 1668 54396 ~349 48
190~ ~60
12/9~ ' 7 S~ 1/4 1495 1467 ~405 ~4~ ~ 39
0 0
0 O0
?--~'0 : 0~
0 0
66 $O ~$ I 0
lO~ 88~Z3'
49 48 -~ '1 0
'6~' 60- ' ,-3 .... ~
38 39 I ' 0 . I .
17/800M~ . 5 43 1/8 1193 1138 54806 54766 ': 49
19/000~J~ 7 36 953 970 54986 64980 0
2 36 3/4 979 073 , 5soe~ 5~986 ge
36/900AH ' 7 19 7/0 435 407 55543 55533 30 O ~ . O 0
38/~302~i 3 19 1/3 414 313 55640 55643 ~ 103
WEEK 4 TO~ALS
101 103
559 ~3 3 0,53t 3 S
13.0693
INYO STREETjuNETANK1 9 ~ 55 (DIESEL)
VARIATION
4-5
4O
35
- 30
25
20
15
10
5
0
-5
-10
-15
-2O
2 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30
Facility
l.
TANK FACI LI T¥ ANNUAL REPORT ~ RECEIVED
',JUL 0 2
I have not done any maaor umdi¢cations ,t~/this ~~n~nE
Note: Ali aa~or aodi[tcatlp~ require ~ Perait to Constr~ct froa ' '
the Permitting Author~y. [ ,
I.have done major modifications for which I obtained Permttis) to
Construct from Permitting Authority.
Signature
Permit to Construct # Date
3. Repair and Maintenance Summary
A~ach a summary of all:
-- Routine and required maintenance done to this facility's tank,
piping, and monitoring equipment.;
--/'Repair of submerged pumps or suction pumps.
-/Replacement of flow-restricting leak detectors uith same.
-- Repair/replacement of dispensers, meters, or nozzles...
-- Repair of electronic 'leak detection components, or replacement
· y
with same.
-- Installation of ball float valves. ¥.
-- Installation or repair of vapor recovery/vent ~lne8.
Include the date of each repair or ~aintenance activity.
NOTK: All repairs or replacements in response to a leak require a
Permit to Construct from the Permitting Authority as do all
other modifications to tanks, piping or monitoring equipment
not listad here.
0
Fuel Changes - Allowed for Motor Vehicle Fuel tanks 0nly.
List all fuel et, rage changes in tanks, noting:
Date(s), tank number(s), new fuel(8) stored.
Inventory control monitoring is r~qutred for this facility on the
Permit to Operate, and I have not exceeded any reportable limits as
listed in the appropriate InventOry control monitoring handbook
during the last twelve months (if not applicable, disregard).
Signature
6.. Trend Analysis Summary
PZease attach Annual Trend Analysis Summary for the last 12 periods.
7. Meter Calibration check P°rm
Please attach current, completed Meter Calibration Check Form
ANNUAL TRI~ND ANALYS! S SUM//ARY
/ ·
0DARTER pERIoD:. . to
PERIOD 1: Total Minuses This Period (Line 3,), '/'~ , .....
Action'Number 'for this-~e~tod (Line 4)
Total Minuses This Period (Line 3)
Action Numbe~ for'this Period (Line 4) ~L~
Total Minuses This:.~Period (Line 3) ,:
Action Number f~r this Period (Line,4)
PERIOD 2:
PERIOD 3:
QUARTER 2
PERIOD 4:
PERIOD 5:
PERIOD 6:
QUARTER 3
PERIOD ?: Total MinuSes This Period (Line 3)
Action Number for this Period (Line 4)
PERIOD 8: Total Minuses This Period (Line 3)
Action Number for this Period (Line 4)
PERIOD 9: Total Minuses This Period (Line 3)
Action Number for this Period (Line 4)
QUARTER ¢ TIME PERIOD: ~3. I to
PERIOD 10: Total Minuses This Per,tod (Line 3)'
Action Number for this Period (Line 4)
PERIOD 11: Total MinUses This Period (Line 3)
Action N~ber for this Period (Line 4)
PERIOD 12: Total ~inuses This Period (Line 3)
Action N~ber for this Period (Line 4)
TIME'PERIOD:: to
Total Minuses This,Period (Line 3)
Action Number for thin,Period (Line 4)
Total Minuses This Period (Line 3) .
Action Number for this. Period (Line 4)
Total Minuses This Period (Line 3)
Action Number ior this Period (Llne,~) ./d /
I hereby cert}~fy this is 'a t~ue and accurate report.
,.1tm Hindman
Garage Services Supervisor
6eneral Services Garage Oivts~on
Date
KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
TREND ANALYSIS WORKSHEET
?
TANK # / CAPACITY ./~, oo C) PRODUCT ~ccc, J~ YEAR/PERIOD
I NSTRUCTI ON'S :
PART A : OVERAGE/SHORTAGE Fill in all informatiOn at top o!
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 throug[
DAY 2 ~-~&-~ d-- 12 only,). Transfer the date ani
DAY 3 ~-2-)-~. ~ ¥ the sign from co'lumns 1 and 16 .o{
DAY 4 ~-Z~-~ ~ Reconciliation Sheet to column~
DAY 5 ~ ~-~ ~ .,. at left. U'~se ,,the table belo,w
DAY 6 ~-~-~ ~ determine the action number fox
DAY ~ 7~/-~ the period being analyzed.
DAY 8 ~--~ - ~ ~
~AY 9 ~-~~ ~, ACTI ON NUNBER
DAY 10 7-f' ?L_ ~ ' TABLE
DAY 11 ~-~-- ~ ~ ~
DAY 12 7-~~ ~ 30-DAY } ACTION
DAY 13 ~~ / - PERIOD NUMBER[ NUMBER
DAY 14 7- F" 9~ ~ .~ = 20
DAY 15 7-~- O~ ~ 2 = ~
DAY 17 7-// ' 0 ~ ~ r 4 = 69
DAY 19 ~-~ ~ ~ 6 = 101
DAY 22 7-/~-~ ~ ~ 9 = 149
DAY 23 ~-/~- ~ ~ 10 = 165
DAY 24 7~/~~ ~ 11 = 180
DAY 25 7</~-~ ~ ~ 12 ~= 196
DAY 26 ~ d- ~
DAY 27 ~/- ~ ~ .~ ~ Circle appropriate period and
DAY 28 ~-~2-~~ action number. A full cycle
DAY 29 ~-~ ~ ~ . ..~ · .... made up of periods 1-12, after
DAY 30 7~-~ ~ 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 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 a reportable loss and must begin
notification and investigation procedures as described
in Kern County Environmental Health Services Department HANDBOOK #UT-10
"STANDARD INVENTORY CONTROL MONITORING''.
Env. Health 580 4113 012 (Rev. 6/90)
KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
TREND ANALYSIS WORKSHEET
FAC I LI TY Co~--r/ o~ ~'~"~ I~ o -f~-~ , PER}4I T # ~ ~ 0~/ ¢
TANK # } CAPACITY / t~y oo cd i~RODUCT ~J~ ct~e J YEAR/PERIOD
I NSTRU'CTI ON'S
PART A : OVERAGE/SHORTAGE Fill In all information at top ot
Form. In the space for year/
I 16 period indicate the year and the
DAY DATE .(+/-) consecutive period of analysis
DAY 1 7.~.~ ~C- being conducted (from 1 through
DAY 2 '7-Z~'/~ - - 12 only). Transfer the date and
DAY 3 7-Z~,~ ~ ~ < the ,sign from columns 1 and 16 of
DAY 4 7-~C-~'~ ~ Reconciliation Sheet to columns
DAY 5 7-~-5~ .. ~ at left. 0se the table below tc
DAY 6 ~-~O-~ ~ determine the action number for
DAY 7 ~'~/-~ ~ the period being analyzed.
,,DAY 8
DAY 9 ~ ~ ~ ACTI ON NUMBER
DAY 10 ~J- ~ ~ ~ TABLE
DAY 12
DAY 13 ~-~~ ~ PERIOD NUMBER, NUMBER
DAY 14 ~'7- ~ ~ ~ I = 20
DAY 17 ~-/O -~ ~ ~ 4 = 69
DAY 20 ~/~-~ ~ ' ~ = 117
DAY 21 ~,-/~5,~ ~ 8 = 133
DAY 27 ~-~D~'~ ~ Circle appropriate period and
DAY' 28
DAY 29 ~-~~ ~ ~ade up of periods 1-12, after
DAY 30 ~~ ~ ~hich a ne~ cycle begins. Use
TOTAL MINUSES ~ information to complete Part B.
PART B:
Line ~'.
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) ............. / 30
for this period (from table above) . . . /
Action
number
Is line 3 greater than Ii'ne 4? ~Yes ; ~JNo
If Yes~ you have a reportable loss and must be~in Iv~sr J-
~?~', ~ ';~'-s'
notification and inv~stigat±9n procedures as described
in Kern County Environmental Health Services Department HANDBOOK #UT-lO
"STANDARD INVENTORY CONTROL MONITORING".
Env. Health 580 4113 012 (Rev. 6/90)
O
KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
TREND ANALYSIS WORKSHEET ~
TANK # I CAPACITY-- ! CD., cO ~ ~RODUCT Ur, Ce,~ a YEAR/PERIOD
INSTRUCT! ON'S :
PART A : OVERAGE/SHORTAGE Fill in all information at top
form. In the space for year/
1 .16 ,. period indicate the year and the
DAY DATE (+/-) consecutive period of analysi-,
DAY 1 ~'~2. c[.~- ~ being conducted (fro~ 1 througl
DAY 2 ~-~ ~ 12 only). Transfer the date an(
DAY 3 ~-~-5~ ~ the sign from co',lumns 1 and 16 o]
DAY 4 ~-~-~ ~ Reconctltati,0n Sheet to columnl
DAY 5 ~-~-~ ~ at left. Use '...the table below t~
DAY 6 ~.~-~ ~ determine the action number fo~
DAY 7 ~'~O-~ ~ the period being analyzed.
DAY 8
DAY 9 ~/--~ ~ ACTI ON NUMBER
DAY 10 ~-~-~ ~ TABLE
DAY 11
DAY 12 ~-~-~ ~ 30-DAY { ACTION
DAY' 13 '~.-
DAY ~15 ~7- ~ ~ 2 = 37
=
DAY 21 ~/~ - ~ ~ ~ 8 = 133
DAY 22 ~/~~ ~ .. 9 = 149
DAY 23 ~/~'~ ~ ' 10, = 165
DAY ~24 ~--/~ - ~ lm = 180
DAY 25 ~-/7.- ~ ~ ~ 12 = 196
DAY 2~ ~/~-~ - ~ Circle appropriate period and
.DAY 28 ~-~~ ' ~ . action nu=ber. A full. cycle is
DAY 29 ~-2J-~ ' ~ade up of periods 1-12, after
DAY 30 ~-2~-~ ~ which a new cycle begins. Use
TOTAL NINUSES /7 lnfov;ation 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 period (from table above) .
Is line 3 greater than line 4?' ~]Yes
If Yes, you have a reportable loss and must be~in
notification and investigation procedures as described ~Z~$ Tb
in Kern County Environmental Health Services Department HANDBOOK #UT-10
"STANDARD INVENTORY CONTROL MONITORING".
I?
Env. Health 580 4113 012 (Rev. 6/90)
KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
~TREND ANALYSIS WORKSHEET
TANK # [ CAPACITY ] O/ ~,~ ,,. PRODUCT U~(~e~ YEAR/PERIOD
I NSTRUCTI ON'S :
PART A : OVERAGE/SHORTAGE Pill 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 I ~-2.~-~2- ~- being conducted (from I throug~
DAY 2 ~-2~-9~-~ ----"' 12 only). Transfer the date and
DAY 3 ~-~o~)~.- --~ -~ the sign from columns 1 and 16 of
DAY 4 ~-A6-9~ ~ Reconciliation Sheet to columns
DAY 5 ~-~7-~ ~ at left. .U'Se the table below tc
DAY 6 g.2~-9~ ~ ,~ determine the action number for
DAY 7 ~-2~-~ ~ the period being analyzed.
DAY 8 ~. ~O-9~
DAY 9 /~-/ ~9 ~ -- ACTI'ON NUMBER
DAY 10 /~-~-9~ -- TABLE
DAY 11 /~-~- 9~- ~ ' .'
DAY 12 /~'~-~ ~ 30-DAY { ACTION
DAY 13 l~'~' ~ . . ~ PERIOD NUMBERI NUMBER
DAY 14 10"~-~ ~ 1 = 20
DAY 15 /o- 7-9~ ~ 2 =
DAY ~6 /0- ~-~ ~ ~ 3 = 54
DAY 17 /0-9-9~ ~ { ~ = 69__
DAY 18 /O-/~-9~ ~ {~ 5 = 85
DAY 20 /~/~ 9~' ~ ' 7 = 117
DAY 21 /~-]~- ~' ~ 8 = 133
,DAY 22 /~:f~-~ ~ 9' = 149
DAY 23 ~'/~-~ ~ 10 = 165
.DAY 24 /~/~ ~ ~ 11 = 180
DAY 25 /~-/~-5~~ 12 = 196
,DAY 26 /~-/~-~L
DAY 27 ~-~-~ 2~ CircIe appropriate period and
DAY 28 ~d-~o-~ L ~ action nu;ber. A full cycle
DAY 29 /O-22-~ made up of periods 1L12, after
DAY 30 /O-~-~ ~ ~hich a new cycle begins. Use'
TOTAL ~INUSES ~ information to cosplete 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 period {from table above) ....
Is line 3 greater than line 4? [-]Yes ~o
If Yes, you have a reportable loss and must be8in, b~ ;fI-a ~'~'¢ ~
notification and investigation procedures as described~K¢
in Kern County Environmental Health Services Department HANDBOOK #UT-10
"STANDARDINVENTORY CONTROL MONITORING".
Env. Health 580 4113 012 (Rev. 6~0) '
KERN
" 'E //d.
TANK # J CAPACITY-- /,d.~ O0 O,, '~PRODUCT V)--Le.~,,,t-(",2' yEAR/PERIOD '~2 '~"'"
INST. RUCTI ON'S :
PART A : OVERA0~/SHORTAGE FIll in all information at top o!
,. form. In the space, for year/
[ I 16 period indicate the Fear and the
DAY DATE (+/-) .-~, consecutive period of analysi,
DAY I /~-2~-~2~ ~-- · · being conducted (from 1 throug[
DAY 2 /o-~/-~2~. ~-, 12 only). Tran.sfer the date
DAY 3 /~,~5'~ ~ > , the'sign from columns 1 and 16 of
' DAY 4 '{0-~1-~~ Reconciliation Sheet to columns
DAY 5 10-~-~~ ,. ~ at left. Use.~ the table below t~
DAY 6 /0-~-~ ~ determine the action number for
DAY 7 /,~.~'~ ~ the period beinz analyzed.
DAY 9 '/9-//-~ ~' ACT[ ON NUMBER
DAY 10 /I- /- ~ ~ ~ TABLE
DAY 13 //- ~/-~ ~ PERIOD NUMBER~ NUMBER .
DAY 19 }}-[0,qZ ~ 6 = 101
DAY 22 2/.-~]-~ ~ 9 = ~49
~ ~4 //-/~-~ ~. zz = z80
.... DAY 25 //'/~- ~ ~ 12 = 196
,.DAY ~I //-/~-~ ~ Circle app~opviate period and
DAY 28 ~'}- [~- ~ action number. . i full cycle
DAY 29 [{-~,~-~ ~ made up of periods '1-12, after.
DAY 30 ])-~)'~ ]" which a new 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 llnes~l & 2) .............
Line 4. Action number for this period (from table above) . /
Line 5. Is line 3 greater than'line 4? ~]Yes
I__f Yet, you have a reportable loss and must begin
notification and investigation procedures
in Kern county:Health Department HANDBOOK
"STANDARD 'INVENTORY cONTROL MONITORING".
as described
#UT-lO
Env. Health 580 4113 1016 (6/86)
KERN C OUN'X' Y
TREND ANALYS1
TANK # / CAPACITY
PART A : OVERAGE/SHORTAGE
DAY
DAY
DAY 2
DAY 3
DAY 4
DAY.5
DAY 6
DAY
DAY 8
DAY 9
DAY 10
DAY 11
DAY 12
DAY 13
DAY 14
DAY 15
DAY 16
DAY
DAY 18
DAY 19
DAY 20
DAY 21
DAY 22
DAY 23
DAY 24
DAY 25
DAY 26
DAY 27
DAY 28
DAY 29
DAY 30
TOTAL
£T, PERI~I! T # /~'O~1! c_
PRODUCT U~Ler~d'~J YEAR/PERIOD ,~2 * (,
I NSTRUCTI ON'S :
Fill in all information at top of
16
(+/-)
Jr'- ' '
form. In the space fOr year/
period indicate the year and the
consecutive, period of analysis
being conducted (from I through
12 only). Transfer the date and
the' sign from columns I and 16 of
Rec0ncilta~ton Sheet to column
at left. Use. the table belo~ t
determine the action number fo:
the period:being analyzed.
ACTION NUMBER
TABLE
MINUSES
30-DAY { ACTION
PERIOD NUMBER NUMBER.
1 = 20
2 = 37
3 = 54
4 = 69
5 = 85
8 = 133
9 = 149
10 = 165
1'1 = 180
12 = 196
Circle appropriate period and
action number. A full cycle is
made' up of periods 1-12, after
which a new cycle begins. Use
information to complete Part B.
PART
Line
Line
Line
Line
Line
periods in this cycle.
.............
B: ACTION NUMBER CALCULATION
1. Total minuses this period-Part A
2. Cumulative minuses, from previous
3. Total minuses (add lines I & 2)
4. Action number for this period (from table above) ...
5. Is line 3 greater than line 4? ~]Yes
l_~f Yes, yqu' have a reportable loss and'must begin
notification and investigation procedures as descr'ibed
in Kern County Health 'Department HANDBOOK tUT-10
"STANDARD INVENTORY CONTROL MONITORING"
Env. Health 580 4113 1016 (6/86)
KERN COUNTY ENVIRONMENTAL HEALTH SER~:ES DEPARTMENT
TREND ANALYSIS WORKSHEET
'pART A
TANK # I CAPACIT¥--IOi O · O P~ODUCT V~¢A i,~ YEAR/PERIOD q~°7
I NSTRUCTX ON'S :
: OVERAGE/SHORTAGE Fill In ~11 lntoraation at top of
~orm. Xn the 'space for year/
DAY DATE (+/7) consecutive period of analysis
DAY 1 }~-~-~ ~ being conducted (from I through
DAY 2 [1~'~*~[ ~' 12 onl~). Transfer the date and
I
}2-2~-~l -- the sign from c,olumns 1 and 16 of
/~-~-~1 ~ '~' Recpnclllation, Sheet to columns
5 /z-2~-~ -~ at left.. ~Use the table below to
6 /~-z~Z ~, determine the: action number for
~ /2--r1.'~--~% ~ the period being analyzed.
DAY 3
DAY 4
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
xo / 2-~/- ~
xx I- I- ~'~
'/-7-
7
DAY
DAY a7
DAY 28 /-)~- 9~
DAY 29
DAY 3 0
TOTAL MINUSES
ACTION NUMBER
TABLE
30-DAY J ACTION
PERIOD NUMBER NUMBER
I = 20
2 = 37
3 = 54
4 = 69
5 = 85
6 = 101
~ = 117
9 = 149
10 = 165
11 = 180-
12 = 196
Circle appropriate period and
action number. A full cycle 18
made up of periods 1-12, after
which a new cycle begins. Use
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 t~an line 4? ~]Yes ~o
I~ Yest you have a reportable loss and must begin. ~',$$e J
notification and investigation procedures as described ~¢ &~)r
in Kern County' Environmental Health Services Department HANDBOOK #UT-10
"STANDARD INVENTORY CONTROL MONITORING".
J I "
O
Env. Health 580 4113 012 (Rev. 6/90)
O ; SERV~ES
KERN COUNTY ENVIRONMENTAL HEALTH
TREND ANALYSIS WORKSHEET
DEPARTMENT
TANK # .I CAPACITY-- tO. ooo . PRODUCT v~le~d,4 YEAR/PERIOD
INSTRUCT:ION'S:
PART A : OVERAGE/SHORTAGE Fill in all information at top o!
form. In the space for year/
1 16 period indicate the year and the
DAY DATE (+/-) ' consecutive period of analysi~
DAY I /'~]-9~ ~ , being conducted (from' I throug.[
DAY 2 /~-~$ -~- 12 only). Transfer the date and
DAY 3 l-2~- ~ "/" the sign from columns I and 16 of
DAY 4 /~2 ~-~ ~ ~'- Rec~ncillation 'Sheet to columns
, DAY 5 /~S-~ -~- at left. .Use the table belo~ t¢
DAY 6 ~¢-~Z :;' ---- determine the~ action number for
DAY 7 /-~-~ ,,-7/-'- the period being analyzed.
.... DAY 9 /-z~- ?~ -- ACTI ON NUMBER
DAY 10 1-30-~ -- TABLE
DAy. 13 ~.,~- ~ PERIOD NUMBER[ NUMBER
DAY 27 Z-(~ -~ --~ Circle appropriate period and
DAY 28 ~1~ ~ ~ action number. A full cycle is
DAY 29 Z-! ~ ~ ~ made up of periods 1-12, after
DAY 30 z~l~f ~ ~hich a ne~ cycle begids. Use
TOTAL MINUSES /ff information to complete Par~ 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 period Ifrom table above) . . . ./
Is line 3 greater than line 47 ~'~Yes
If Y'es~ you have a reportable loss and must belin
notification and inve.stigation procedures as described
in Kern County Environmental Health Services Department HANDBOOK #UT-10
"STANDARD INVENTORY CONTROL MONITORING".
)J
133
Env. Health 580 4113 012 (Rev. 6/90)
KERN COUNTY ENVIRONMENTAL HEALTH SERVI~S
TREND ANALYSIS WORKSHEET
DEPARTMENT
·
" ~" ~. P~.~XT #
FAC I L ~ TY (O~TV o~ '~t,~ /~ V~Le~ d YEAR/PERIOD
TANK ~ ~ CAPACITY/ /~/ OD~ PRODUCT t
I NSTRUCTI ON'S :
PART A : OVERAGE/SHORTAGE Fill in all information at top o!
form. In the space for year/
I 16 ' period indicate the year and
DAY DATE (+/-) consecutive period of analysis
DAY 1 ~-~,-.[~-~ "----~ .... being conducted (from I throug[
DAY 2 2~-0'~{ ,-{-' ' ' 12 only). Transfer the date and
DAY 3 2-)-/-~,7 -~- , the ,sign from columns 1 and 16 of
DAY 4 ~. y_-z_- ~ ~ [ ~ Reconciliation 'Sheet to columns
DAY 5 ~-2J-~ ~ ...... ,, at left. Use the table .below tc
DAY 6 ~-~/ ~ ~~t'
.... "' determine the' action number for
DAY ? ~-~-.,F'-~ ~-'-' , the period being analyzed.
DAY 8 ~'~-~' ~
DAY 9 ~,-~,9~ ,, ~ ACTI ON NUMBER
DAY 10 a- 2~-~ ~ TABLE
DAY 11 ~- /- ~ ~ ~
DAY l~ f-~ ~, ~ ~ a0-OAY [ ACTION
DAY ~a ~-~- ~Y ~ ,~a~O~ NU~R[
DAY ~4 ~-~-~ ~ ~ = Z0
, DAY ~6 ~-~ 7 ~ ~ = ~4
DAY 17 ,~-~- ~ ~ ~ : 4 = 69
DAY ~ ~F~Y , ~ i~ 5 = 8~
DAY 20 fi-fo-q3 ~ , ~ = 117
DAY Zl ~//- ~ 3 ~ 8 = 1.38
DAY 24 7- /~-~3 ...... 11 -= 18~07~:', ":''·
DAY 25 ~ / b-' ~Y ~ 12 = 196::J"
UAY ~6 ' ~- / ~- ~ 5 ~ ,' ~ '
DAY 29 ~-/7-q ~ ~ Circle appropriate ' period and
DAY 28 ~-~'-~ ~ action number. A full c~cle
DAY 29 ~-/~ '~ made up of periods 1-12~ afte~
DAY 30 ~-~o-~'~ ~ which a new~ "e~cle begins. Use
TOTAL HINUSES , ~ in[ormation to conplete Part
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 I & 2) .............
Action number for this period {from table above) . .
· ~/
Is line 3 greater than itne 4? ["]Yes ~'~o
I__~f Yes~ you have a reportable loss and must besin ]w(; $$¢
notification and investigation procedures as described ~e~ ~ '"r-~ ~-f-(
in Kern County Environmental Health Services Department HANDBOOK #UT-10 ~
"STA~D^RD.I~¥E~TOR¥ CONTROL ~O~ITORING'.
Env. Health 580 4'113 012 {Rev. 6~0)
KEIRN C O UN'I' Y
TREND ANALYS 1
FAC'I L I TY
TANK # I
CAPACITY ~ ~O! O'~ P]~ODUCT V~Leadf tf YEAR/PERIOD
PART A : .0VERAGB/SIiORTAO[
1 16
DAY ( + / - )
DATE
DAY 1
DAY 2 ~
DAY 3 ~3-~ -f' ':'
DAY 4
DAY 5
DAY 6
DAY ?
DAY 8
DAY 9
DAY 10
DAY 11
DAY 12
DAY 13
DAY 14
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
DAY
TOTAL
I NSTRUCTI ON'S :
Fill in all information at top o!
form. In the space fo~ year~
period tn'dicate the year and th~
consecutive period of analysi~
being conducted (from 1 througl/
12 only). Transfer the date and
the sign from columns I and 16 of
Reconciliation Sheet to columnl
at left. Use the table below t~
determine the action number for
the period'being analyzed.
ACTI ON NUNBER
TABLE
30-DAY ACTION
PERIOD NUMBER NUMBER.
.20
37
54
69'
85
101
117
133
149
165
Circle appropriate period and';'
action number. A,full cycle is
made up of periods 1-12, after
which a new cycle begins. Use
Information to complete Part B.
PART B: ACTION NUMBER'CALCULATION
Line 1'. Total minuses this period-Part A ............
Line 2. Cumulative'minuses from, previous periods in. this cycle.
Line 3. Total minuses (add lines 1 & 2) . .. ............
Line 4. Action number for this period (from table above) . //
Line 5. Is line 3 greater than line 47 ~-]Yes
I_~f Yes~ ,you have a reportable loss and must begin
notification and investigation procedures as described ~$$e'J
in Kern County Health.'De:partment HANDBOOK #UT-10 g~
"STANDARD INVENTORY CONTROL MONITORING". ~"~
Env. Health 580 4113 1016 (6/86)
KERN CouNTy ~A~-i;~ ~;~.;A~'i'gE~'l
TREND ANAL¥S1 ~ WO~~"'!
ti'AC I L I TY
TANK # .. [
'(
CAPACITY lO, O O O PRODUCT
PART A : OVERAG~/SItORTAGE
DAY
DAY 1
DAY 2
DAY 3
DAY 4
DAY 5
DAY 6
DAY
DAY 8
DAY 9
DAY 10
DAY 11
DAY 12
DAY 13
DAY 14
DAY 15
DAY 16
DAY 17
DAY 18
DAY 19
DAY 20
DAY 21
DAY 22
DAY 23
DAY 24
DAY 25
DAY 26
DAY 27
DAY 28
DAY 29
DAY 30
'TOTAL
1
DATE
16
(+1-)
/~'PER~4I T #_J~'O0 I{ C,
'YEAR/PERIOD .c) 2-11
INSTRUCTION'S:
Fill in all information at top of
form. In the space for year/i
period Indicate the. year and the
consecutive period of analysis
being conducted (from 1 throug~
12 only). Transfer the date an~
the' sign from c. olumas 1 and 16 of
Rec0nclltat~ton Sheet to columns
at left. Use. the table belo~ t°
determine the action number fo~
the period being' analyzed.
ACTI ON NUMBER
TABLE
30~DAY I ACTION
PERIOD NUMBER NUMBER.
6 =
7 =
8 =
9 =
10
11 =
20
54
69
85
101
117
133
149
165
180
196
S-/~.-~ [ --~ Circle appropriate period and
~-/7-~ ~ [ --~ action number. A full cycle'is
~-/~- ~ ~ [ :. made up of periods 1-12, after
f-/~-~ [ , '~ which a new cycle begins. Use
MINUSES
';' ~.. Information to com lete Part B
PART B:
Line 1.
Line ~.
Line 3.
Line 4.
Line 5.
ACTION NUMBER CALCULATION , ~,,.:..~... ..... :.:
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
l__~f Yes, you have a reportable loss and must begin
notification and investigation procedures
In Kern County Health 'Department HANDBOOK
"STANDARD INVENTORY CONTROL MONITORING".
Env. Health 560 4113 1016 (6/86)
as described
N'~ i ~$e J
#UT-10 ~.
FACILI
TANK
TREND ANALyS 1
CAPACIT~ _ o4) '0 PRODUCT
PART A : OVERAGE/SHORTAGE
I 16
DAY DATE' (,+/-)
DAY I
DAY 2
DAY 3
PER~II T #_~. >001!
O,~L~..~de~ __ YEAR/PERIOD
INSTRUCT'ION'S:
Fill In all Information at top of
form. In the' space for year/
period Indicate the year and the
consecutive period of analysis
being conducted (from I through
12 only). Transfer the date and
DAY 4
DAY 5
DAY 6
DAY 7
DAY 8
DAY 9
DAY 10
DAYll
DAY 12
DAY 13
DAY 14
DAY 15
DAY 16
DAY 17
DAY 18
DAY 19
DAY 20
DAY 21
DAY 22
DAY 23
DAY 24
DAY 25
DAY 26
DAY 2
DAY 28
DAY 29
DAY 30
TOTAL MINUSES
the' sign from cplumns 1 and 16 of
Rec~nclliat,!on Sheet to columns
at left. Use, the table below to
determine the action number f.or
the period being analyzed.'
ACTI ON NUMBER
TABLE
30-DAY {' ACTION
PERIOD NUMBER NUMBER
1 = 20
2 = 37
3 = 54
4 = 69
5 = 85
6'' = '101
? = 117
8"~..- = 133
9 = 149
10 = ':'!.65.-
11 = 18.0
~ = 196
appropriate period
Circle and
action number. A full cycle is'
made up of periods 1-12, after
which a new cycle begins. Use
information to eom lete 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)
periods tn this cycle. }~ 5
.............. 17.-<'
Line 4. Action number for this period (from table above)
Line 5. Is line 3 greater than line 47 ~]Yes
I~f Yes, you ha'.ve a reportable loss and must begin
notification and 'investigation procedures as described ~,$$e
tn Kern CoUnty Heal th 'Department HANDBOOK #UT-10 ~d'~ 'T~
"STANDARD INVENTORY CONTROL MONITORING".
inv. ~alth 580 4113 1016 (6/861
ANNUAL
QUARTER 1
PERIOD 1:
PERIOD 9_:
PERIOD 3:
QUARTER 9_
· PERIOD 4:
PERIOD 5:
PERIOD 6:
QUARTER 3
PERIOD 7:
PERIOD 8:
TREND ANALYSIS
TIME PERIOD:
TINE PERIOD: ~ to ,
.
Total Minuses This Period (Line 3) /
Action Number for thts.{e~tod (Line 4) ~..
Total Minuses This Period (Line a) ~L~,,,
Action Mu'ber for'~hl, Perto~ (Line 4)
Total Minuses Thls~Per!od (Line 3) ,
Action Number far this Period (Line 4)
Total Minuses This,Period {Line al
Action Number for thin.Period ILlne ¢~ ~.,
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 ~) -
Total Minuses This Period (Line 3)., /~
Action Number for this Period (Line 4)
Total Minuses This Period (Line 3)
Action Number for this Period (Line'4)
PERIOD 9: Total Minuses This Period (Line 3)
Action Number for this Period (Line 4)
PERIOD 10: Total Minuses This Per&od (Line 3)
Action Number for this period (Line 4)
PERIOD 11: Total Mtnuaes This Period (Line 3)
Action Number for this Period (Line 4)
PERIOD 12: Total Minuses This Period (Line 3)
Action Number for this Period (Line 4)
/i o
I hereby certF¥ thi~ tS.a. tru~. and accurate report.
VGarage Services Supervisor
General Services Garage Division
Date
KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
TREND ANALYSIS WORKSHEET
FAC I LI TY.~ C Ov~"-Ty o-~: ~ e~- ~ ~11~.,~ 0~' _ST r'~P E R M I T #
TANK # CAPACITY 2/ ~ r)/) PRODUCT 1.~1 ¢ fec YEAR/PERIOD
INSTRUCTION-S:
PART A : 0VERAOE/SHORTAGE Fill tn all information at 'top of
form. In'the space for year/
1 1;6- · period indicate the year and
DAY DATE (+/-) consecutive period of analysis
DAY I ~-Z$-~--. - being conducted (from 1 throug~
DAY 2 ~-~-~ ~- 12'only). Transfer the date and
DAY 8 ~-~7-~ I,A~'/~rd ~ c~ ~;'~ the ,sign from co'lumns 1 and 16 of
,DAY 4 ~-~ ~'~ ~ ' Reconciliation 'Sheet to columns
DAY 5 ~-2~'~ ~ at left. Use the table below tc
DAY 6 ~0~7.~ ~ determine the action number for
DAY, 7 ~-/- ~.-- the period being analyzed.
,DAY 8 '7-"2 -'~
0Ai 9 Z~" ~ ~" , ~ ,, ACTI ON NUMBER
,,DAY 10 ~ ~'~ ~ TABLE
DAY
DAY 14 ~-~-~ '- ~.. = 20
DAY 15 ~- ~--~ ~ ~ 2 = 37
DAY 16 7-/0- ~ ~ ~ r ~3'=54
DAY 17 ~--~-- ~' ~ 4 = 69
DAY 18 ~-/~- ~ ~ ~ 5 = 85
DAY 19 7-~- ~' . ~ 6 = 101
DAY 20 7--/~- ~ - ~ 7 = 117
DAY 23 '7~/7-~ ~' ,,, ~ 10 = 165
DAY 24 ~/~ ~ ~ 11 ~ 180
DAY 25 7-/7-e~ ~ 12 = 196
DAY 26 ~-~ ~--g ~
DAY 2~ ~-~/~ ~ Circle appropriate period iud
DAY 28 ~-~-~ ~ action number. A full cycle
DAY 2~ ~-~.~-~ ~ made up of, periods 1-12, after
.DAY 30 ~-~~ ~ which a new cycle besins. Use
TOTAL MINUS.BS ~ information to complete Part B.
PART B:
Line 1.
Line 2.
Line 3.
Line 4.
Line 5.
ACTION NUMBER CALCULATION
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 ~o
If Yes, you have a reportable loss and must be~in
noti£~cation and ~nvest~gation procedures as described
in Kern County Env±ronmental Health Services Department HANDBOOK #UT-lO
"STANDARD ZNVENTORY CONTROL HONITORING".
E~. H~lth 580 41~3 012 (Re~. ~/~0)
I
KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
TREND ANALYSIS WORKSHEET
TANK # ~ CAPACITY' -~, O /2) C~ ..... '-~PROOUCT > ¢~¢ c. YEAR/PERIOD ?~.-~- .
.......I NSTRUCTI ON'$ :
~ : 0VERAGE/$HORTAOE Fill In all Information at top of
Form. In the space for year/
1 16 , period indicate the year and thc
,DAY DATE (+/-) ~ consecutive period of analysis
DAY I 7-J..y-ff~.~ -~- being conducted (from I through
DAY 2 -2.2.(~_ ~- .... 12 only). Transfer the date and
DAY 3 ~.~_~ ~ ~ ' the ,sign from cdlumns 1 and 16 of
DAY 4 ~.~.q~ ~ RecOnciliation 'Sheet to columns
DAY 5 ~-2~-~ .. ~ at l~eft. Use the table below t~
DAY 6 ~.~-~ ~ .... ~ determine the" action number for
DAY 7 ~-~/-~ ~- ~ the' period being analyzed.
DAY 9 ~--~ --~ ~ ~ , ACTI ON NUMBER
DAy 32 ~.~-~ ,'~ [ ~0-DAY { AcTIoN
DAY 13 -~_~~ ~ PERIOD NUMBER{ NUMBER
DAY 22 ~r y~-~ ~ ~ 9 ~ 149
.DAY 27 ~d-~ ~ Circle appropriate period and
DAY 28 ~.~y-~ ~ action number. A full cycle is
DAY 29 ~j.~ ~ made up of periods 1-12, after
DAY 30 ~-~-~ .. ~ which a new cycle beslns. Use
TOTAL MINUSBS ~ information to complete Par~ B.
PART B: . ACTION NUMBER CALCULATION
Line 1. Total minuses this period-Part ~ ............
Line 2. 'Cumulative minuses from previous periods in this cycle.
Line 3. Total minuses (add lines I & 2) ............. ~7
Line 4. Action number for this period (from table above) . .. .~
Line 5. Is line 3 greater than line 4? [-]Yes
If Yes, you have a reportable loss and must besin ]va ,$j~J ~'~ ,c
notification and investigation procedures as described ~z ''J ]~ ~ '-['o
in Kern County Environmental Health Services Department HANDBOOK #UT-10
"STANDARD INVENTORY CONTROL MONITORING".
Env. Health 580 4113 012 (Rev. 6~0)
KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
TREND ANALYSIS WORKSHEET
TANK # CAPACITY ~) 0 ~o PRODUCT ~l'e~'-~ ~ YEAR/PERIOD 9'2-J
I NSTRUCTI ON'S :
PART A : OVERAGE/SHORTAGE '~ " Fill in all information at top of
form. In the space for year/
I 16 ' period indicate the year and thc
DAY DATE (+/-) consecutive period of analysis
DAY I ~-~].~% ~ being conducted (from I througt
DAY 2 ~-23--~7.~ ---' 12 only). Transfer the date and
DAY 3 ~-~-~Z~ -~- ~,' the sign from coiumns 1 and 16 of
.DAY 4 ~-~-~.~ ~ Reconciliation Sheet to columns
DAY 5 ~-2~-~.~ ~ ~ at left. u~e the table below
DAY 6 ~.-2~-~ ~" determine the action number for
DAY 7 ~,~-~" ~ the period being analyzed.
DAY 8 ~-~/-~A
DAY 9 ~-/-~ ~ ACTI ON NUMBER
DAY 10 ~-~ -~ ~ .TABLE
DAY 12 ~ ~ ~ 30-DAY ~ ~
~ ACTION
DAY 13 ~~ ~ [PERIOD NUMBER[ NUMBER
DAY 14 ~~ ~ ~ 1 = 20
DAY 15 ~-~ ~. ~ 2 = 37
DAY 17 ~ 4 = 69
DAY 18 '?-/0 'fl~ ~ ~ 5 = 85
DAY 19 ~-//- ~ ~ ~ 6 = 101
DAY 20 ~/~-~ ~ ' 7 = 117
DAY 21 ~-/~ ~ ~ ~ 8 = 133
DAY 22 ~-/~-~' '~ ~ 9 = 149
DAY 23 ~- / 5---:~ ~ 10 = 165
DAY 24 ~--~ ~ 11 ~ 180
DAY 25 ~-17 -~ ~ 12 = 196
DAY
DAY 2V ~-y~-~ ~ ~ Circle appropriate period and
DAY 28 ~-~d~ ~ action number. A full cycle
DAY 29 ~]~ ~ made up of periods 1-12, after
DAY 30 ~-~2-~ , ~ 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 periods in this cycle.
Total minuses (add lines 1 & 2) .... .... .:~;~ .........
Action number for this period~,. ~,,,~(fr°m-- ., tab'l~e above) . . ~o
Is line 3 greater than line '~'~' ...... ' ~]Yes
If Yes, you have a reportable loss and must be~in ~/%
notification and investigation procedures as described ~
in Kern County Environmental Health Services Department HANDBOOK #UT-10
"STANDARD INVENTORY CONTROL MONITORING''.
Env. Health 580 4113 012 (Rev. 6/90)
KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
TREND ANALYSIS WORKSHEET
TANK # ' CAPACITY'~1 O00 PROD~CT ~,'~f~ t YEAR/PERIOD
pART A : OVERAGE/SHORTAGE Fill in all information at top of
form, In the space for year/
I 16 , period indicate the year and thc
DAY DATE (+/-) consecutive, period of analysis
DAY 1 ~-2,7-~}~ ~ being conducted (from 1 througt
DAY 2 ~-2~-~m- ~-' 12 only), Transfer the date and
DAY 3 ~-~,~-~/t~ ~ the :sign from c~lumns. 1 and 16 of
,DAY 4 ~-~ ~-~ ~ Reconciliation Sheet to column~
DAY 5 ~-~-~ ~ ~ at l'eft. Use the table below t(
DAY 6 ~_~-~ ~ determine the action number fo~
DAY ~ ~-,~-~ ~ the period betn~ analyzed.
,DAY 8
DAY 9 ACTI ON NUMBER
DAY 10
DAY 12 /~-~-~ ~ .... 30-DAY ~ ACTION
DAY 15
DAY 22 /OY~-~' ~ 9 = 149
DAY 24 /0-/~-~ ~ ~ 11 = 180
DAY 2~ /p-/~-~ Circle appropriate period and
DAY 28 /o~-~
DAY 29 /O-2/-~ ~ made up of periods 1-12, after
DAY 30 /~-~-~ ~ 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 ~ ............ [~
Cumulative minu.se..s from previous periods in this cycle. ~ ~:
Total minuses (add lines 1 & 2) ............. ff 7
Action number for this period (from table above) . , ~ ~
Is line 3 g, rea.ter than line 4? I-lyes
If Yes~ you have a reportable loss and must be~in ~'$~ fT' ',¢ It
notification and inVestigation procedures as described~¢~'''$~ '~* ~e
in Kern County Enviro~nmental 'Health Services Department HANDBOOK #UT-10
"STANDARD INVENTORY CONTROL MONITORING".
Env. Health 580 4113 012 (Rev. 6/90)
TANK t ~ .CAPACITY-- ~, 0 o 0 PRODUCT ~' e~ YEAR/PERIOD.
I NS TRUC'TI 'ON'S
PART A : OVERAGE/SHORTAGE' ~ill in all infor~ation at top of
form. In the space for year/
I 16 * period indicate the year and the
DAY DATE ~(+/-) consecutive period of analysis
DAY I ~-~-5~ ~ being conducted (from 1 through.
DAY 2 /~.-~-~ ~ 12 only). Transfer the date and
DAy 3 ~O-Zf-~.'~ ~; the, sign from columns I and 16 of
DAY 4 /~-~ ~-~ ~ Recdnciliat~on Sheet to columns
DAY 5 /~-~~ .;. ~ at left. Use. the table below to
DAY 6 /d-~C-5~ ~ 'determine the action number for
DAY 7 /o,~5-5~ .. ~. the period being analyzed.
DAY 9 fo-f/-%~ ~ ACTX ON NUmBeR
DAY 13 //-~- ~ ~ 'PERIOD NU~BERt NUMBER
DAY 22 1~-/3~ ~'~ ~ 9 = 149
DAY 27 //-/~ ~ ~ Circle appropriate period and
DAY 28 )I-I~-~ ,~ action number. A full cycle is
DAY 29 l~-Zo-~ ~ ~ade up of periods 1-12, after
DAY 30 ~],2)-~ ~ ~hich a ne~ cycle begins. Use
TOTAL NINUSE$ :' /.~. information to complete 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 I & 2)
Line 4. Action number for this period (from table above) ....
Line 5. Is line 3 greater than line 47 [~Ye, s
If Yes, .you have ~ reportable loss and must begin /v miffed
notification and investigation procedures as described ~
in Kern County Health Department HANDBOOK #UT-10 /~ ~T~
"STANDARD INVENTORY CONTROL MONITORING"
{[nv. Health 580 4113 1016 (6/86)
periods in this cycle.
TANK # CAPACITY
~ ~..'~ o"
PRODUCT
PART A : OVERAGE/SHORTAGE
1- 16
DAY
DAY 1
DAY 2
DAY 3
DAY 4
DAY 5
(+/-)
Jr"
DAY 6
PERI~II T # I~-O01/C-
~l' ¢C¢ t- YEAR/PERIOD
INSTRUCTION'S:
Fill in all information at top o
form. In the space for year,
period indicate'the year and the
consecutive period of analysis
being conducted (from I throug~
12 only). Transfer the date and
the sign from c, olumns I and 16 o
Reconctlia~ion Sheet to column
at left. Use the table belo~ t
determine the action number fo:
DAY ?
DAY
DAY
DAY
DAY
8
9
10
11
DAY
DAY 13
DAY 14
DAY 15
DAY 16 7~~ ~
DAY 1~ ~
DAY 18 /2~ ~
DAY 19
DAY 20 -)l-'~.
DAY 21
DAY 22
DAY 23
DAY 24
DAY 26
DAY 27
DAY 28
DAY 29
DAY 30
TOTAL
the period' being analyzed.
ACTION NUMBER
TABLE
30-DAY
PERIOD NUMBER
2 =
3 =
4 =
' 5
6
~ =
8
9
10
12
ACTION
NUNBER,
2O
54
69
85
lOl'
= 133
= 149
= 165
= 180
= 196
Circle appropriate period and
action 'number. A full cycle is
made up of periods 1-12, after
which a new cycle begins. Use
information to com lete 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 period (from table above) ....
Is line 3 greater than line 4? [~Yes
,
I__[f Yes, you have a repOrtable loss and must begin /,~,;~f~ 5~
notification and investigation procedures as described ~e~d~5~
in Kern County Health 'Department HANDBOOK'#UT-lO ~-~ ~-T-e
"sTANDARD INVENTORY CONTROL MONITORING".
Env. Health 580 4113 1016 (6/86)
I NSTR'UCT ION'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 DAT1/ {+/-) ' consecutive period of analysis
DAY 1 /~t-~;~-'~-- -~ being conducted (from 1 througl
DAY 2 /;t-2~o~/-~,.- ~ 12 only). Transfer the date ani
DAY 3 /~-~-~ ' ~ ~ the~sign from co'lumns 1 and 16 of
,,,DAY 4 I~~~ ~ '~ Reconciliation "Sheet to columns
DAY 5
DAY 6 /~'~-~ ~ '~' determine ,the~ action number for
DAY ~ /~'~,~'~ ~ the period being analyzed.
DAY 10 /~-~]-~ ..... - TABLE
DAY 12 }'~-~ ~ ,, ; 30-DAY I ACTION
DAY 13 /-~-~ ~ ]PERIOD NUMBER[ NUMBER
DAY ~8 / -C~ ~ , ~ ~ 5 = 85
DAY 20 /
DAY 27 i ~/~-~ ~ Circle appropriate period and
DAY 28 /-/~~ action number. A full cycle is
DAY 29 /-/~-~C ~ made up of periods 1-12, after
DAY 30 /~2o--~ '~ which a new cycle begins. Use
TOTAL ~INUSBS .~ o information to, coaple, te 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 period (from table above) .... . .//,,
Is line 3 greater than line 47 ~]Yes
If Yes,, you have a ~eportable loss and must be~in
notification and investigation procedures as described
in Kern County Environmental Health Services Department HANDBOOK #UT-10
"sTANDARD INVENTORY CONTROL MONITORING".
'1-,,
Env. Health 580 4113 012 (Rev. 6/90)
KERN COUN~ENVIRONMENTAL HEALTH SERV~[~E$ DEPARTMENT
' o" I 'o c
TANK ~ ~ CAPACITY-- ~ o~ PRODUCT ~c~,~ YEAR/PERIOD
INSTRUCT,! O N,,~S
PART A : OVERA~J~/SI4ORTASE Fill
form. In the space for year~
1 16 " period indicate the year and the
DAY DATE (+/-) ' consecutive period of analysis
DAY 1 I-2 ).c~ gf "~ .... being conducted (from 1 througl
DAY 2 ]~2~-~ ~ 12 only). Transfer the date an~
DAY 3 ~-~'5~ ~ - the sign from columns I and 16 of
DAY 4 /'2~/'~ :~ Reconciliation 'Sheet to columns
DAY 5 /~-~ ~ at left. ,Use the table below tc
DAY 6 /-2~-~ '~' ~ determine the action number for
DAY 7 /~,~-~ ~ the period being analyzed.
..DAY 8 /-2
DAY 9 [-2~-~3 -- ACTI ON NUMBER
DAY 10 ~-~d -~ ~ TABLE
DAY ~2 ~'l'- ~.~~ ; i 30-DAY { ACTION
DAY 13 ~-2-~ ~ PERIOD NUMBERI NUMBER .,,
-nAY 14 ~-~'?~ ~ ~ = 20 ~ ' '
DAY 15 ~'q-~3 ~ 2 = 37
DAY 16 ~-~-~ 3 ' ~ 3 = 54 '
DAY 17 ~- g'~ ~ 4 = 69
DAY 18 z '?- ~ ff ~ I U = 8U
DAY 20 ~-~-q 7 .~ ~ 7 = 117
DAY 21 ~l°- q~ ~ , 8 = 133
,,DAy 24 q-'{~ ~ ~ 11 = 180
DAY 25 a- /~'-~Y ~ t2 = 196
.DAY 2~ l-/(-5J -- Circle appropriate 'period and
.DAY 28 ~-17-~ ~ action number. A full cycle is
DAY 29 Z-/~-~Y ~ made · up of periods 1-12, after
DAY 30 ~[~-~J ~ 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 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? r-]Yes
If Yes.~ you have a reportable loss and must be~in
notification and investigation procedures as described
in Kern County-Environmental Health Services Department HANDBOOK #UT-10
"STANDARD INVENTORY CONTROL MONITORING".
Env. Health 580 4113 012 (Rev. 6/90)
TREND ANALYSIS WORKSHEET
DEPARTMENT
PART B: ACTION NUMBER CALCULATION ,:,.
Line 1, Total minuses this period-Part R ............ -/~
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 o
If Yes~ you have a reportable loss and must be~in ~'155e ~
notification and investigation procedures as described ~¢~$~
in Kern County Environmental~Health Services Department HANDBOOK #UT-10
'"STANDARD INVENTORY CONTROL MONITORING".
Env. Health 580 4113 012 (Rev. 6~0)
I NSTRUCTI ON'S
PART A' : OVERAGE/SHORTAGE Fill in all information at top o!
form. In the space for year/
I 16 ' period.indicate the year and th~
DAY DATE (+/-) consecutive period of analysis
DAy 1 ~-/~-~ ---' being conducted (from 1 throug{
DAY 2 2-~o-~ ":-' 12 only). Transfer the date an¢
DAY 3 .;z-21-~7--y ~ the sign from columns I and 16 o!
DAY 4 ~ z-t-~_.T ~ Rec~nciliation .Sheet to columns
DAY'5 z-2 ~-~ ) ~ at left. Use the table below tc
DAY 6 ~-zq-97 determine the'~ action number for
DAY 7 ~-z~-~ ~ the period being analyzed.
DAY 9 Z~-2~. ~ ~ ACTI ON NUMBER
DAY 10 ~-2~- ~ ~ TABLE
DAY ,11 ,~- '~'- ~ ~ , _
DAY 12 ~-- ~ ~ ~ ~ : 30-DAY I ACTION ,
~.,DAY 13 ~-~.~ ~ ' ~ PERIOD NUMBER, NUMBER
DAY 14 ~--.~ ~ - .-' 1 = 20
DAY 15 ~- ~- ~ ~ 2 = 3~
DAY 16 ~" ~- ~ ~ 3 = 54
DAY 17 ~- 7-~ ~ 4 .= 69
DAY 18 7- f~ ~ ~ I~ 5 = 85
DAY 20 Y;/~- ~ -- ~ 7 = ~, 117
DAY
DAY 23 ' 7-~-,~~ T~ = ~165
DAy 24 ~-/'/- ~J' ~ 11 = 180
DAY 25 f-/Y' ~ ~ 12 = 196
DAY 27 ~-/~'~ -- Circle appropriate period and
DAY 28 ~-/~-~ ~ action number. A full cycle is
DAY 29~o~'~-~ ~ ' -- made up of periods 1-12, after
DAY 30 ~ which a new cycle begins. Use
TOTAL MINUSES [~ tnfovmatton to coeplete Part B.
TANK # ~ CAPACITY _~/. ,_~d ~ PRODUCT ~i ¢,re(- YEAR/PERIOD
KERN COUN'FY ~~u'l'~ ~ut~'l'~BN~I.
TREND ANAL¥$1 ~ ~O~~~''!
TANK CAPACITY-- 2.. 00(~ PRODUCT ,,. ~)~'(~$~, YEAR/PERIOD
' I"NS TRUCT I' ON'S.,:
p/kRT A : OVERAGE/SHORTAGE Fill In all information at top ct
· form. In the space for year/
1 16 period indicate the year and the
DAY DATE (+/-) consecutive period of analysil
DAY 1 Y-~-I-~ ~ -~ ~ ' being conducted (from 1 througl
DAY 2 .Y-2'1-~ 3 ~ 12 only). Transfer the' date and
DAY 3 Y-Z~-~J :~ the~ sign from columns 1 and 16 of
DAY 4 j.~_~y ~ Reconciliat,!on Sheet to column~
DAY 5
DAY 6 ~-2g-~ ~ ~ determine the action number fox
DAY ~ ~-2~-~, ~ - the period bei'n8 analyzed.
.,DAY 8
DAY 9 J-~-~ ~ ACT] ON NUMBER
DAY 10 ff-~ o-~7 ~ TABLE
DAY 12 .~-/-- ?~ ~ ' { 30-DAY { ACTION
DAY 13 ~_~ ~ ~ PERIOD NUMBER] : NUMBER, I
DAY 14 ~-~-~ ~ 1 = 20 '
DAY 15
DAY 16 ~-~- ~y ~ . 3 = 54
DAY 1~ ~-~-~ff ~, ~4 = 69
DAY 18 ~- y- VY ~ ,5 = 85
DAY 19 ~-~J ~ , 6 = 101
DAY 20 ~-~- ~ - 7 = 117
DAY 22~-/]- ~ ~ 9 = 149
DAY
DAY 24
rAY 26 ,.
DAY 2~ ~-/g-~ '~ Circle appropriate period and
DAY 28
DAY 29 q-[~-~ ~ ... made up of periods 1-12, after
DAY 30 H-I~"~~ ~ ... which a new cycle begins. Use
I~ information to complete Part B.
TOTAL
MINUSES
PART B: ACTION NUMBER CALCULATION '
Line 1. To'tal minuses this period-Part A ............
Line g. Cumulative minuses from previous periods tn this cycle.
Line ~. Total minuses {add lines 1 & ~)
Line ~. Action number for th'ts period {from table abovel ....
Line 5. Is line 3 greater than line 47 OYes
If Yes, you have ~ reportable loss and must begi ~$$f~
notification and investigation procedures as described
in Kern County Health Department HANDBOOK #UT-10
"STANDARD INVENTORY CONTROL MONITORING"
'~ Env. Healt~ 580 4113 1016 (6/86)
I>l
KERN C 0 UN'I'Y
TREND
· ,'ACT T¥ 77 T c..
TANK # CAPACITY
I NSTR'UCTI ON'S :
PART & : OVERAGE/SHORTAGE Fill in all information at top o!
form. In the space for year/
1 16 period indicate the. year and th~
DAY DATE (+/-) , consecutive period of analysim
DAY I ~-$'o-Sg ~- being conducted (from I throug{
DAY 2 ~o2{-~ ~ ,,, --- 12 only). Transfer the date an/
DAY 3 ~'2~-~ :'---. the~ sign from columns 1 and 16 of
DAY 4 ~.2'$-~J ~-- Rec~nciliatjon Sheet to columnm
DAY 5 ~-2~-~ -~'.~. ' at left. Use~ the table below t(
DAY 6 ~-~"-~ ~ +- determine the' action number for
DAY 7 ~-~-5~, ~-, the period being analyzed.
DAY 9 q-,~-,~ .. ' - ACTI ON NUMBER
DAY 10 ~.~ ~ ~ . TABLE
DAY 12 ~- ~.~ ~ ~ 30-DAY { ACTION
DAY.. 13 ;-2-~ 3 ~ ~PERIOD NUHBER[ NUMBER,
DAY 15 X- ~-~ ~ ~ 2 = 37
DAY 27 Y-/(- ~Y .~ Circle appropriate period and
DAY 28 ~/y-~7 .: ..... action number. A full cycle is
DAY. 29 ~-/F-~ ~ made up of periods 1-11, after
.DAY 30 /-/~-~2 / . ~ which a new 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) ........... · . . ,,, { ff~
Line 4. Action number for this period (from table above) . .// /~> O
Line 5. Is line 3 greater than line 4? ~]Yes
I._[f ,Yes, you have a reportable loss and must begin
notification and. tnv.esti'gation procedures as described
in Kern County Health Department HANDBOOK #UT-10
"STANDARD INVENTORY CONTROL MONITORING".
Env. Health 580 4113 1016 (6/86)
KERN C O UN'I' Y
TREND ANALYS
'ACX LITY /~Ou~T~ O:~" $7. PERI II T # l o.ollC
TANK # ~ CAPACIT~ ~) o0.0 PRODUCT ~)l' ¢$~ ~- YBAR/P~RIOD ~.~.-It-,
INSTRUCT! ON'S :
PART A : 0VER~0E/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 ~-~-~3 ~- being conducted (from 1 through
DAY 2 ~-~/-c/-7 ------ 12 only). Transfer the date and
DAY 3 ~-~Y_7 --/- ~, the~ sign from columns 1 and 16 of
DAY 4 ~-~J-~. ~ Rec0nclltat~ion Sheet to columns
DAY 5 ~-~-~ Y ~ ~, at left. Use,, the table below t~
DAY 6 ~Zs ~ { ~ determine the action number for
DAY 7 ~-~-~ 2 ~ the period being analyzed.
.... DAY 9 ~-~-~.~ ~ ACTI ON NUMBER
DAY 10 ~-~'~ } TABLE
DAY 12 f-~/--~ 3 ' 30-DAY { ACTION
,DAY 13 ~-/-- ~ ~ ~ PERIOD NUMBER[ NUMBER.
DAY 14 g- ~ -~ 7 ~ I = 20
DAY 15 ~ ~ ~ 7 ~ 2 = 3~
DAY 23 ~7}-~ - { 10 = 165
DAY 2~ ~-~/~ ~ ~ ~ Circle app~opr iat'e period and
DAY 28 ~;/~-~ ~ action number. A full cycle is
..DAY 29 ~J7-~ ~ made up of periods 1-12, after
DAY 30~ ~/~-~ ~ ~hich a ne~ cycle begins. Use
TOTAL ~INUSE$ /~ 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 I & 2) .............
Action number for this period (from table above)
Is line 3 greater than 'line 4? ~]Yes
I_~f Yes, you have a ~eportable loss and must begin
notification and investigation procedures
in Kern County Health Department HANDBOOK
"STANDARD INVENTORY CONTROL MONITORING".
'Env. Haalth 580 4113 1016 (6/86)
INYO ST. REPAIR HISTORY
TANK ~1, 2 & 3 PER~IT ~iSO011C
YEAR PERIOD.JULY 1992 THRU JULY. 1993
WORK COMPLETED
, 7/0s/92
v/zs/92
Check for low flow U/L pump.
Check nozzle, replace boot clamp.
Changed worn keylock assy.
I ~6729
I S6830
I S6955
Tested both di~Spensers and KeYloCk operation worked.
fine. No leaks found under pumps. Leak detector maybe tripped..
.... 10/26/92 [ Clean screen & replace Diesel pump filtersl S7781
_~1~2__5/92 ...I Pump contaminated fuel fron Diesel tank. I 39564
...... ~_~_21~93__L.] Furnish ~g_uqe. ~ick I S8595
__1,26/93 I Replace plugged filter on Diesel pump I S8639
2/23/93 ..~ Chanqe filter and clean screen on diesel ' I S8883
3/29/93 I .Replace'droptube ,qaskets I S9233
5~24/93 [ Chanqe screen and perform vac test on pump~ S9650
:B~KERSFIELD
'.,- :'. ~..,-.7' :;:' :,-'¢? ;~,,.;/ .. '::;....::;~,~, .' ?'; ~.~::~";:;~:' ..,r. "~ ~: ':.. 'F.'~:' f',¢'.:.:" ;': '7~: h:?'? .,.."-:: :,: .
;~fe:: .... ~" '2'"' ' ,'.,-~r ~ ~ '~'~':' ;'-'" ':~ ""' " ' ' -' '"M' :' ?:~ .(~ .,.;.
. ~~ "' ."~~".'.~,.~,/.~:. ':.f:,',',-~'~.'~,~t> ;~;'-,,,."=.." ~-~-'~ .'HOURS
:.r ,,....,-,.,, ...~ ........ '"'" "'"~ '"''~: ....... ''~ "'."~'."'~','~'*;~:'':"~ ............ ':' ........ "': ..... ' .... ~' "" ",~' '.': ".."' ',:~ '-'
'" ' ' " ~' '," ' ~ ....... :'" ' ~'"
:. ....... . ..... .... ~ .... .. ~.,,:t. :--: '':';'~ " .... ; ' ,"' ""' '.' ""~ .... ' '
[:~'~~'~T~!t ' '" ....... ;:'~ ':-:. P ART.NO,,'.,:.':' ;'" ......... ' :' ~' . ' ' ' ~ ' ~ ~'' I' ~ '' '' '~'''':' ~ ............... '' ''''-- ''-- ' ' ,...,~ '~ ''' ' '' '''' + ~ ' ''''" ~'~' ' '': ' ' '"'' ' 'I ' ' '~'': ~ .... .............. '' '''''' ' D~SCR ' PT ...... ON '';'I'~ ' :': :~ ' ''' : ' 'I~': ':: '': '.' ......~: ~'' '. : .~ :::I''; ~' ' '.' . '~.: I ' : :' ' ''II ..... ' 'I .... I I i , '' ~''" '' ' ~ .......... .'.I :. ~ , . ,. '~::..'.' ,' . '~.:r: ' ' ' ~ r'
i
r'"] COMPUTER CHANGE O CALIBRAT,ON Record of Computer Change, Meter Change, or Calibration
r~ MI~TERCHANGE D W/M NOTIFIED
PUMP-MAKE AND MODEL 'J SERIAL NUMBER CALIBRATION
MONEY GALLONS FAST I SLOW' FAST I SLOW
FINISH '
TOTALIZER ~ ~ ('//~)""~ '~! ,'
READINGS MONEY GALLONS TO'rALIZER SEALED METER SEALEO
START [] [].o [] ,ES '[] NO
PRODUCT PUMP # TOTAL GALLONS RETURNED TO STJ~)RA'GE
puMp*MAKE AND MODEL ' ' SERIAL NUMBER
, CALIBRATION
~ CHECKED ~ ADJUSTED TO
READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED
START [] YES [] NO i-I YES [] NO
PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE
I II
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 rn YES [] NO i'-] YES [] NO
PRODUCT PUMP · TOTAL GALLONS RETURNED TO' STORAGE
PUMP-MAKE AND MODEL . SERIAL NUMBER CALIBRATION
TOTALiZER FINISHM°NE¥ 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
FAST' CHECKED - ADJUSTED TO
FiNiSH MONE~Y GALLONS [SLOW FAST I SLOW,
TOTALIZER "~-. ..
READINGS MONEY GALLONS TOTALIZER SEALED . METER SEALED
START , ~ [] YES [-i NO [] YES [] NO
PROOUCT PUMP # TOTAL GALLONS RETURNED ~'O STORAGE
PUMP-MAKE AND MODEL ! SERIAL NUMBER CALIBRATION
CHECKED ADJUST.ED TO
TOTALiZER FINISHMONEY GALLONS FAST ISLOw FAST '1 SLOW
READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED
START [D YES [] NO '" [] YES [] NO
PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE
II
DEALER'S SIGNATURE . MAINTENANCE. MAN'S~SIGLNAUTR E
.... ~'~ .' ' ." :: ~':' "~ '-'~ ...... ~; ...... '-" .'"':.~ ~"'~l~..,: ~;,'E' ~:', ~,~ '':, ~ E"~ ."~:'~'. :: *? ,:~:~ t.~:~ ,E:~;,m~ '~:~,~ .,%~ ..,~-~,,~, .... -s~.-x,..~-:.,,. :~:.~,.~ ~.;~ :~:,¢~ ~¢~%YEJ~:'F~~ ~ ~ :%
, . , ' ~ ' ' ,~ ~ ..... · ..... ~:~e~:' :m'~'~:,%~ .',~ ~6~:~';:i~.:a:x~';
,,, ' ' '~ ,, ' ' ' ', ' ' ........ ', , ' ' ' ,' ~f;~D~i~
, ......... ~,,,¢,~ ~,,,,~,~w=~. ,~ :.~ .,.... ,. ~ .~ , , - _ ~.~,-t~.~..,:~?~.~..~,~E~~ ~2-~4~
I
r' ' '~ '''' ' .~?¢, '''¢ ~, ..... '~''" ' '~';;~ ''..~~'' '": ''' '"'?~''" '' , ''" .%'* ' ~''' '', .' i. ~ ''~ ,,~~ .... · '~''. ~, ' .[ .,.~l'r~ ..... ""'' I ~'~'' '':'' . ' , .... ':'''" ,%. "' , . .....,. ,~ . ¢,, ':'T ''' ,,.,, ~'~' ' ~~ ' '' '''' "~%~¢ ' ' ",¢' ~.'~,, ~' ~'~;' '"''' '' '"' '' r' "'',, '''+' %~' ~ ~'[~ '' '' '~ ........ "~ "' '~:'''' '' * ~ S.,~,~,,,, "' '~'''~ '' ,,*,. , :,~,.'' ,~,.,; ,'..,, '~:~ * '~' ~ ~ '~;~'', ~r~ ,, .~X~ ~'~*~'* ' ~;:~; ~ ''':~' '~ :'*'' '"' '" ~' '*1~' ~' ~:':~"' '' '%'' ''~'" ~' f~ ' ~*' ''~:~ :~'~' S? *¢~,,, :~, *~,¢~:~ ~¢'" '%~' ~:*~, ~e~l" '''f '
~..~ i ............. : .......... : ............ ; ............... ~ ...... """" '"' ..... ? ............ ~ '%;' ~''''? ...... .,..~,~¢,¢,,, ~t~:~.:(~'~¢~
I
OISPATGH
NO.
COMPANY.
PUMP?MAKE AND MO~'~L /' --I S'I~RIAL NUMBER CALIBRATION
7~' ~ GALLONS ~ O' * TOTALIZER SEALED METER SEALED
5TART ~ONEY ~. 0 ~ ~ ~' ~ YES ~ NO '~ YES ~ '0,
PRODUCT ' PU~P · TOTAL GALLON~ RETURNED TO STORAGE /
PUMP-MAKEAND MODEL SERIAL NUMBER . . ' 'CALIBRATION'~;?' ,': ':, . '
CHECKED ,~ '. ADJUSTED TO ',
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 · ;ADJU~TED~O''
FiNiSH MONEY GALLONS FAST ISLOW
,%, , : '~:" 9,?
' READINGS START MONEY GALLONS TOTALIZ'ER S~LED METER ~LEo?-, ' '.
6 YES D .o '~ YEa(~::;~ NO
,. '. ',
P~DUCT PUMP * TOTAL GALLONS RETURNED TO STOOGE ~ j: ~.::.
'PUMP-MAKE AND MODEL , SERIAL NUMBER ' ': ' CALIBRATIONP- ~ ¢: ;:
' CHECKED' ' ADJUSTED ~0
:,~." FINISHMONEY GALLONS FAST IsLOW FAST
TOTALIZER
READINGS ' START MONEY . ~ GALLONS TOTALIZER SEALED METER ~LED
~ YES ~ NO ~ YES ~ NO
~RODUCT PUMP · TOTAL GALLONS RETURNED TO STOOGE .'
PUMP-MAKEANDMO~EL ' SERIAL NUMBER '' '' 'CALIBRATION ::'" :~:''
CHECKED ADJUSTED'TO.
TOTALIZER
READINGS MONEY GALLONS TOTALIZER S~LED METER S~LED
START ~ D YES D NO ~ YES D NO
~ODUCT PUMP · TOTAL GALLONS RETURNED TO STOOGE
CHECKED ADJUSTED.TO'
TOTALiZER FINISH MONEY GALLONS FAST I SLOW ' FAST I~Ow
READINGS MONEY GALLONS TOTALIZER SEALED METER ~LED
START ~ YES ~ NO ~ YE~ ~ NO
PRODUCT PUMP · TOTAL GALLON~ RETURNED TO ~TO~GE
D~LER'S SIGNATURE -; :'v ': * ' I MAINTENANCE MAN'~SIGNAUTRE . _ ~ / ~ ' ., ·:
INVOICE;
~RK',TO' BE: PERF. ORMED:
}M~-M~.K~.:~N. OMODEL' '. -'- '/..":.~' SER,ALNUMeER '' / '" I '~ ' ' 'CALIBRATION ' '" ' '"
". :; ~' "' ' ; 'i:'~':':"i ' ._.~--~'735-'~ .' CHECKED " , ADJUSTED.'~'O"'
i",? '"' ?:' ') '
i T;OTALIZER:
! .'~.EAOINGS ..
Ioa_uc.:r .
FINISH
START
TOTALIZER SEALED
METER SEALED '
'" FINISH ' ' , . .:.
READiI~i'I~;~" .MONEY, ~^LLONS
START '.
"CALIBRATION'. :":'* -'
CHECKED ' ' 'ADJUSTEDTo~
· , [OIAI.IZEII SEAL~O METER SEALED
O,Es 0.o 'O'Es 0.o
~TO~LIZER ' · '; : .:''" : '
"11' I J I I I' I I II I~ III
L.'...'. ' ~;':''" ' '
I I m I I ,
'. CHECKED :' * ADJUSTED TO
; .'- % · .; ~ ."~ MO~EY .'-_: '.. CA,LOftS FAST SLOW FAST " SLOW,
~flE~'DINGS "',. ':" :; MONEY ' · .' ', " GALLONS "" TO3ALIZERS~LED ' METER SEALED
;{~'.:2.~ .. CHECKED ' , ADJUSTED TO
MONEY ;'.: ,]¢:~.~;.." ,~ GALLONS ---- FAST* . [sLow FAST
:~EADINGS.'.;' ~ONCY ' ~, -- GALL[)N~ ' -- ' IOIAI.IZ[H SFAL~D ME~ER SEALED "
II/I II I I' I ..... J I " II i
COMPUTER CHANGE
O CALIBRATION ~.------J=lecord of Computer Change, Meter Change, or Calibration
METER CHANGE W/M NOTIFIED ,
COMPANY . ' J STATION NO. J DATE ~ DISPATCH NO.
I
PUMP-MAKE AND MODEL / SERIAL NUMBER / ' CALIBRATION
TOTALIZER O~- 4
READINGS START MONEY GALLONS ~ ~ ~ TOTAUZE~SEACEO METER SEACEO
PRODUCE , PUMP · TOTAL GALLONS RETURNED TO STORAGE
I
PUMP*MAKE AND MODEL SERIAL NUMOER ' · · ~ " ' .
· " ,CHECKED ~ : ..- ADJUSTED TO
FINISH MONEY ';' GALLONS FAST ~ SLOW FAST ~ SLOW
TOTALIZER ~ ,
I
I
READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED
START ~ YES ~ NO ~ YES ~ NO
PRODUCT PUMP · TOTAL GALLONS RETURNED TO STORAGE
I
PUMP-MAKE ANO MODEL SERIAL NUMSER CALIBRATION
READ I NGS MONEY : GALLONS TOTALIZE~ SEALED METER S~LED
START D YES ~ No D YES D NO
PRODUCT PUMP · TOTAL GALLONS RETURNED TO STOOGE '~ ' '
CHECKED ADJUSTED TO'
READINGS MONEY GALLONS TO{ALIZER SEALED METER S~LED
START ~ YES D NO ~ YES D NO
PRODUCT PUMP * TOTAL GALLONS RETURNED TO STOOGE
PUMP-MAKE AND MODEL : S~R~AL NURSE. ' ' :.CA[IBRATION -' ','.,
= CHECKED ADJUSTED TO
FINISH ~ONE~ GA~[ONS , ~ST ~ ~[OW ~AS~ ~ SLOW
TOTALIZER
I
I
READINGS MO,~Y ~LO,~ tOt~UZER S~LEO M~t~ S~[~O
START ~ Q YES Q NO Q YES Q NO
PRODUCT PUMP · TOTAL- GALLONS RETURNED TO STORAGE
PUMP-MAKEANO MODEL " s~ ,UMBER · ' CALIBRATION.
CHECKED ADJUSTED TO
I'
, FINISH MONEY, ., GALLONS FAST SLOW FAST SLOW
TOTALIZER
READINGS MONEY GALLONS TOTALIZER SEALED METER S~LED
START Q YES ~ NO ~ YES ~ NO
PRODUCT PUMP e. TOTAL GALLONS RETURNED TO STOOGE
~K ,T.O:BE. PERI:
r"J COMPUTER CHANGE r"J CALIBRATION :,~ RecOrd. Of computer Change, Meter Change, or Calibration
. . ~ ' .: ~ .
I-1 METERC.A.GE l--1 W.M.OT,F,EO
PUMP-MAKE AND MODEL I SERIAL NUMBER CALIBRATION
MONEY GALLONS FAST ~ SLOW' FAST . · I SLOW
TOTALiZER FINISH R:)L//iJ! 7~-,' o~.J J
READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED
8TART ~ Z./ I I (~ ?: ~ a YES [] NO a YES a NO
PI~UCT~ · PUMP J TOTAL GALLONS RETURNED TO STORAGE · ·
PUMP-MAKE AND MODEL SERIAL NUMBER '"~ '
To o 3' C.EOKED "' ADJUSTED To
F,N,SHMO.EY ,~' ~ALLO.S FAST J SLOW ~ FAST .. . J SLOW
TOTALIZER O 7 7 ~.O 9
READINGS START MONEY 'e GALLONS TOTAUZER SEALED METER S~LED
~ ~ 7 ,¢~0 ~l I r~ YES [] NO' I'] YES r'l NO
PRODUCT PUMP # TOTAL GALlO.NS RETURNED TO STORAGE '~
puMI~MAKEAND MODEL ' . ' SERIAL NUMBER ' CALIBRATION
~ 'CHECKED '~ ADJUSTED TO'
' FiNisH MONEY GALLONS FAST SLOW FAST
TOTALIZE R
READINGS MO~iEY GALLONS TOTAUZER. sEALED METER SEALED
START r'l YES ri NO ri YES ri'NO
PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE
PUMP-MAKE AND MODEL ' ' ' ' ' SERIAL NUMBER CALIBRATION :' :"::"' .:' :",' -'
: ' ' '" ' CHECKED ADJUSTED TO. ~''
FINISH MONEY GALLONS FAST SLOW FA~T ~l. OW
TOTALiZER ·
READINGS MONEY GALLONS TOTALIZER SEALED METER ~r. ALEO
START ri YES ri NO ri YE8 ri NO
PRODUCT . P'UMP · TOTAL GALLONS RETURNED TO STORAGE
PUMP-MAKE AND MODEL SERIAL NUMSER. 'CALIBRATION ' .
CHECKED ADJUSTED TO
FINISH MONEY GALLONS FAST SLOW FABT SLOW
TOTALIZER ·
READINGS ; MONEY GALLONS TOTALIZER SEALED METER SEALED
START ~ ri YES ri NO ri YES ri NO
PRODUCT PUMP # . TOTAL GALLONS RETURNED TO STORAGE ..
PUMP-MAKEAND MODEL ' ; ' SERIAL NUMSER ' CALIBRATION, '
CHECKED ADJUSTED TO
FINISH MONEY GALLONS FAST SLOW FAST S!.OW
TOTALiZER
READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED
START ri YES l-1 NO ri YES [] NO
PRODUCT PUMP # TOTAL GALLONS RETURNED TO STORAGE
DEALER'S SIGNATURE ~~ · '. .
· I DATE ~.~.Z,7 I ~.?PA TC H NO.
PUMP-MAKE AND ~D~L ' Z ' I SERIAL NUMBER CALIBRATION
GALLONS FAST ] SLOW FAST I SLOW
PUMP · TOTAL GALLONS RETURNED TO STORAGE
PUMP-MAKE AND MODEL SERIAL NUMBER ' ~ CALIBRATION ' :' ' ..... :; '
' CHECKED '~" ADJUSTEDTO
TOTALiZER FiNiSH MONEY '"GALLONS FAST ISLOW '"'';AST ISLOW
READINGS MONEY GALLONS TOTALIZER SEALED METER SEALED
START ~ YES ~ N0 ~ 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 FA. ISLOW ,
READINGS MON~ GALLONS TOTALIZ~R S~LED METER ~LED
START ,D YES ~ NO ~ YES
PRODUCT ~ PUMP · TOTAL GALLONS RETURNED TO STOOGE
I
TOTALIZER
READINGS MONEY GALLONS TOTALIZER S~LED M~R ~LED
START ~ YES ' O NO ~ YES
PRODUCT · ~ PUMP · TOTAL . ,, ,~: ~ .. GALLONS RETURNED TO STOOGE "
CHECKED ADJUSTED~TO
FINISH MONEY GALLONS FAST I SLO~. . FAST I SLOW
READINGS MONEY GALLONS TOTALIZER 8~LED ~''; M~ER ~LED
START ' ~
~ YE8 O N0 ~ YE~ ' ~ NO
PRODUCT "' PUMP · .TOTAL GALLONS RETURNED TO STOOGE
PUMP-MAKE AND MODEL SERIAL NUMBER :.:..CALIBRATION '
CHECKED¢~.,~' ", ..... 4- ADJUSTED TO
FINISH MONEY GALLONS FAST SLOW .:~ F~T.' SLOW
TOTALIZER ' ·
READINGS MONEY GALLONS TOTALIZER S~LED M~ER ~LED
START ~ YES ~ NO · ~ YES ~ NO
' PRODUCT PUMP e r TOTAL ~ ' GALLONS RETURNED TO STOOGE . ~-.
COMPUTER CHANGE O CAL'BRAT'ON Record of Computer Change, Meter Change, or Calibration
D METER CHANGE D W/MNOTIFIED
C FINISH MONEY GALLONS FAST ISLOW FAST ]SLOW,
TOTALIZER ~ 7 ~ ~Z'~' ' .
READINGS .MONEY , GALLONS__ ~~,./ TOTALIZER SEALED METER SEALED
START
~ ./~~ ~YES ~NO OYES ~NO
/
~ CHECKED ~ ..... ADJUSTED TO
TOTALiZER FINISH MONEY '~' GALLONS :FAST. ISLOw ~ FAST IsLOw
READINGS MONEY GALLONS TOTALIZER SEALED' METER SEALED
START ~ YEs ~ NO ' ~ YES ~ NO
PROOUCT PUMP · TOTAL GALLONS RETURNED TO STOOGE ,
I
pUM~MAKE AND MODEL SERIAL NUMBER ' , ' cAlIBRATION",: ". ".' :: '~:'::'-.'
CHECKED 'ADJUSTED TO
=1
FINISH MONEY GALLONS ;FAST ISLOw' FAST; ' ;~1 SLOW
I
i
TOTALIZER
READINGS MONEY GALLONS TOTAUZER S~LEO METE;
START ~ YES ~ NO ' D YES D NO
PUMP-MAKE AND MODEL ' ". '~' SERIAL NUMBER '' /'CALIBRATIONT: ...../,_.?;..::
CHECKED',' ADJUSTED TO
FINISH MONEY GALLONS FAST [SLOW' F~T -, [SLOW
TOTALIZER
READINGS MONEY GALLONS TOTALIZER S~LED M~ER ~LED "'
START ~ YES ~ NO ~ YES ~ NO
PRODUCT PUMP · TOTAL GALLONS RETURNED TO S~O~GE . .
PUMP-MAKEAND MODEL ' ' ~ERIAL NUMBER ~ :: 'CALIBRATION: "~ ·
CHECKED ADJUreD TO
MONEY I GALLONS FAST I SLOW FAST I 8LOW
FINISH ~
TOTALIZER '
READINGS MONEY GALLONS TOTALIZER ~LED METER
START ~ ~ YES ~ NO ~ YE8 ~ NO
PRODUCT PUMP · TOTAL GALLONS RETURNED TO STOOGE
PUMP-MAKE AND MODEL SERIAL NUMBER ~ CALIBRATION "
CHECKED ADJUSTED TO
FiNiSH MONEY G~LLONS FAST SLOW FAST SLOW
TOTALIZER
R~DIN GS MONEY GALLONS TOTALIZER S~LED M~ER ~LED
START ~ YES ~ NO ~ YES ~ NO
PRODUCT PUMP · TOTAL GALLONS RETURNED TO STOOGE
D~LER'S SIGNATURE:' MAINTENANCE MAN. 'S S~~~ '.* ' : ' ,. .
COMPUTER C.A.~E C'] C^UeR^T,O~ Record °r Computer Change, Meter Change, or Calibration
METER CHANGE 0 W/M NOTIFIED
i I STATION NO. OATE I DISPATCH NO,
COM~a~Y
PUMP-MAKE ANO M~EL I S[RIAL NUMB[R CALIBRATION
I
TOTALIZER
READING8 START MONEY GALCN¢'"O ~ ;' 7 rOrAL}ZER SEALED , MEfER SEALED
PRODUCT : PUMP · TO~AL GALLON8 RETURNED TO STORAGE
PUMP-MAKE AND MODEL .' ' "· ... , CALIBRATION' ,,'
~/ '7~' ~0 ~'~ , CHECKED ,~ ' ADJUSTEDTO'
TOTALIZER , ,
RE~DING8 START ~ONEY' GALLONS. ~OTALIZER SEALED M[~E~
P~DUCT PUMP ~' TOTAL GALLONS RETURNED TO STOOGE
PUMP-MAKE AND MODEL SERIAL NUMBER . CALIBRATION "'"- """
" ~ - "' CHECKED' ..... ~'AD~STED TO
FiNiSH MONEY GALLONS .AS, [,LOW AS,
TOTALiZER L .
READINGS START ~ 'MONEY GALLONS TOTALI~ER S~LED M~ER ~LEO '
PRODUCT PUMP · , ~O~AL GALLONS RETURNED TO STOOGE "~
PUMP-MAKE AND MODEL SERIAL NUMBER
CHECKED ' ' ADJUSTEDT'~ ':' .
FINISH MONEY GALLO~S FAST' "r~ 8LOW FAST ~0~.
TOTALIZER
READINGS START MONEY GALLONS TOTALIZER S~LEO M~ER
PRODUCT PUMP · T~TAL GALLONS RETURNED TO STOOGE
PUMP-MAKEAND MODEL ' ' SERIAL NUMBER '"CALIBRATION,, ~ '
' CHECKE~ ADJUS~D TO
FiNiSH MONEY GALLONS FAST JSLOW FAST, 'JSCOW
TOTALIZER ,,
READINGS MONEY '~ ' GALLONS TOTALIZER S~LED M~ER ~LED
START ~ ~ YES ~ NO ~ YES ~ NO
PRODUCT PUMP · ' TOTAL ~ ~ALLONS RETURNED TO ~TO~GE
PUMP-MAKE AN~ MODEL SER~L NUMBER
" CHECKED ::.: ' '~'',' dA~USTEO TO'.
FiNiSH MONEY GALLONS FAST 8LOW 8L~,, ·
TOTALIZER ' '~
READ I ~ G~ MONEY GALLON8 TOTAUZER 8~LEO M~R ~LEO
8TART ~ YE~ ~ NO ~ YES
~RODUbT PUMP ~' 7OTAL , GALLONS RETURNED'TO STOOGE'
TANK
ANNUAL
&.
TREND
TIME PERIOD:
ANALY$ I S
S U~RY
to 6-zc- 73
QUARTER 1
PERIOD 1:
PERIOD 2:
PERIOD 3:
QUARTER 2
PERIOD 4:
PERIOD 5:
PERIOD .6:
QUARTER 3
PERIOD 7:
PERIOD 8:
TIME PERIOD: to
Total Minuses This Period (Line 3)
Action'Number for this-Pe~iod (Line 4)
Total Minuses This Period (L~ne 3)
Action Number for'this Period (Line 4)
Total Minuses This,'Period (Line 3) ~
ActionlNumber f~r this PeriOd (Line,4)
TIME'PERIOD: i0/.~/~,., to
Total Mlnuses This Period (Line 3)
Action Number for thA~.Period (Line 4)
Total Minuses This Period (Line 3)
Action Number for this Period (Line 4)
Total Minuses This Period (Line 3)
Action Number lot this Period (Line:4)
TIME PERIOD: 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)
PERIOD 9:. Total Minuses This Period (Line 3)
Action Number for this Period (Line 4)
QUARTER4 TIME PERIOD: ~/f~/Q_.~ to
#
PERIOD 10: Total Minuses Thi~
· Period (Line 3)
Action'Number for this Period (Line 4)
PERIOD 11:, Total Minuses This Pertod,(Ltne 3)
Action Number for this Period (Line 41
PERIOD 12: Total Minuses This Period (Line 3)
Action Nmaber for this Period (Line 4)
I hereby certify this Is a true and accurate report.
Signature
Date·
FAC I L I ?Y
TANK# ..
CAPACI.TY ./0., ~O'O V '- SUBsTANcE "STOR'~D U-~t ¢.~,~
PE~ZT # I IS' o o tl C
I , COL 2
coL'. zI .
I I ICOL. ' 7I COL $ ICOL.
I COL 3ICOL' ,4ICOL 5I 'COL .6I I ' I
9I COL. 10I - COL. 11
TEST
~EEK
I WEEKLY
I S HUT-DOWN
INC~.S
3
- I I
I ' !
4
. IDATE/i~ ?-27"~;0,,~I
I ~ !.
I
I
I
I
I
12 ',
13
GALLONS GALLONS
CUlVlIJLATIVEI
C'~N~E I
GALLONS I
lt"I
'I
I
//
I
I
I
I'
//
/>-
· .... ' "QU,~I~TERLY SU~RY
.... :" '.-:.' - ' FILL',OUT THE 'FOLLOWING REPORTING sUMMARy APPLICABLE .TO THE .TANK. NOTED ON REVERSE (CHECK ONE ONI,Y).: ~:<¥,~--..: '~:y:' :~
TANK'MoNITORED [SA WASTE-OIL OR NON-MOTOR VEHICLE FUEL' TANK' , , , TANK MONITORED IS A MOTOR VEHICLE FUEL TANK{
..... j. .. · : ~,. ....... :~. -.
...... ]~EPORT TO THE PERMITTING AUTHORITY MITHIN '24 HOURS-IF: "'~ ........... REPORT'TO~ THE. PERMITTING AU'I'~0RITY MITIIIN ~24 {{oURs ~IF: - ~-,':': .................
A. voLUME CHANGE (COl, ~) IS +/- l0 GALLONS OR'MORE .~ A TANK 0F 1000 G~LLONS. OR LESS A I?Y VOLURE 'CHANGE (COL.
B. CUMULATIVE VOLUME'CHANGE (COL. 11) IS +/- 100 GALLONS OR MORE ..' - B TANK OF ~00! TO 5000'GALLONS cAPAClT¥~,-HAS. A VOLUME CHANGE (COL,' 9)
,~ ' - ' ~" OF +/- ' 35 GALLONS OR MORE
..................................... C' ,TANK OF-OVER,5000 OALLONS'CAPACITy-HAS-A'VOLUME.c ~HANGE'"(COL.~'"9) OF
,- ~-/- 50 GALLONS OR MORE ~ . ~'..~'~-', ',
· ,'. - D. ANY TANK HAS A CtmrdLATIVE VOLU~m, cHANGE. (COL... l!):.OF. ,/-2SO OALLONS
......................... _. ",{-.',' .,'~' OR MORE OVER' THE QUARTER' TIME FR~E REPRESENTED ON ,REVERSE.'"".
".',',: SUMMARY - SUMMARY
MONITORING SE_TWEEN DATES OF AND MONITO~I]~-~TW~'EN ~TES' OF ?/~/??,, : ' ANU-
(INCLUDE 'YEAR)'NOTED ON REVERSE 'RESULTED-tN: ......... " · ...... (INCLUDE-YEAR) NOTED ON REVERSECRE.SULTED~'-I~:~?~ "'~ .=.:/<!'.... :
~. A )t~Xim~iwEEKLy VOLU~E CHANGE' (COL. 9) OF GALS. m.' A MAXIMU~ WEEKLY voLU~E CHANGe. (dOi,~ '9) O~ "~ '~,' -oALs
2. A C~MULATIVE VOLUME CHANGE. (COL. 2~, 'BOTTOM LINE)-OF ........ 2. A CUMULATIVE VOLUME .CHANGE (COL. ~1'~,.'~BOTTOM LINE)'.OF-
' GALLONS - / ~ OALLONS - .... "'
' = '!- 'I HEREBY'-CBRT-{FY THAT THE ABOVE,NOTED RESULTS REPRESENT'-A 'TRUE AND'
I HEREBY CERTIFY~THAT THE ABOVE-NOTED RESULTS REPRESENT'A TRUE AND .
ACCURATE REPORT AND :THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS / ACCURATE .REPORT AND'THAT THEY DO NOT EXCEED i THE REPORTABLE.LImITS
DESCRIBED IN "A" AND "B" ABOVE. 'DESCRIBED IN "A" THROUGH .'.'D" ABOVE. - ....... ':-: 'j~
~ · ~. . ~ .", .. SUBMIT'A cOpy OF -THIS ,$~Y WITH FACILITY ANNUAL REPORT ~ ' ~
..... '- '. .... .". , ' :-.' RE?AIN THESE RECORDS AT THE PERMITTED-FACILITY FoR-AMINIMUM'OF--THREE YEARS -'~ .....'-: ':'i
FACI L! TY
TA/~K# ~
COL. 1
TEST
WEEK
SUBST,~d~CE
COL .. 3
COL.
COL.
6
WEEKLY WATE:R-[ 2ND" 1 ST INCH
SHUT-DO~TN LEVEL IGAUGE ~-GAUGE =-CHANGE
TI~E PERIOD-;:" ..... INCHES ....
..- I~I~ Lo-z~-:~Y~ . ,~ .. ~1:.,.,-' !
I~A~E/~' "'"' '~'~ ": I ,- !' I
I~/~/~-2~:~ I :~. I I
- -Imm~-t~ '6"'~~ I':'"~.. : '1 ~ :' ::::: :=~ .I '" . .I
I~~ I1,~- ~ I .,.~:~ :. I '. ........ i .I
!~/~ ~!~'-:"~°' '"~ ~ I>'~ i ~ I
CONTROL
'COL '7 [ COL~ 8[CO'L. 91 COL..10 J
' I ' .I I' I
- 2ND 1 ST
VOL UME -VOL UlV[E
GALLONS I GALLONS-
I
I
I
!
:VOLUI~_E ' '-: ' ':,, .:
+SUB T O TAL =
H,~NG
g
COL. ! I
C UNIT3L AT I VE
C HANG E
'-GALLONS -
GALLONS":-. "-:[ GALLONS '
8
I
9
10
InA'rE/HR
I TO
i DATE/HR
InATE/m~
I ~o
I 2... '::.{ ~z_ '
// /f
M
./
12
13
I DATE/HR 1:2 -/7./' 5';o0
J DATE/~ . I :~',~'"'~': '~ o I
I to I.
IDATE/HR 12>2-9' ~...:jq, l
IDATEim~ ,.I-~.-,~'o.~,oo I
I ~ )./' ..C:o~lI
I pATE/HR
I
I
!
I
I
!
! !
! i
I !
I !
I
!
I
I
!
TANK' MONI'I~ORED [S-A' WASTE-OIL~ OR. N~N._-M~T~R"VEH~~LE FUEL. TANK
REPORT TO THE' PERMITTING 'AUTHORITY' WITHIN :24 'HOURS
A. VOLUME CHANGE (COL. .9) iS +/- 10 GALLONS OR MORE.
FiLL OUT THE FOLL~WINO'REPORTI~"i~
-
'B. CUMULATIVEJ'VOLUME CHANOE (COL., 11) IS ~/~'IOOGALLONS'OR MORE
!
MONITORING'BETWEEN DATES OF '~.. AND
(INCLUDE YEAR) NOTED ~ON REVERSE RES~JLTED IN:
1. A MAXIMUM'~EEKLY VOLUME CHANGE (COL.' 9) OF
2.
A CUMULATIVE VOLUME CHANGE (COL.
' "' GALLONS
'GALS.
~,' BOTTOM LINE)· OF' '
I HEREBY' CERTIFY' THAT THE"ABOVE-NOTED'RESULTS'REPRESENT'A"TRUE AND .
ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS
DESCRIBED IN "A" AND "B" ABOVE.
SIGNED
-. {
TITLE
DATE
-TANK'MONITORED IS. A MOTOR. VEHICLE- FUEL~TANK
:J'~I~)RT-.~ 'Tile' PERMITT'fNa AuTiiORITY'#ITltlN 2._~4 HOURS'IF':
Co
A. TANK OF 1000 GALLONS ORLESS CAPACITY HAS A VOLUME CHANGE (COL. 9)
'OF +/- 25 GALLONS O~ MORE
· ..' B.,~ TANK-OF-IO01~ TO~5000 GALLONS CAPACiTY:H~S"A"VOLUMECHANGE .(COL. 9)
OF +/- 35 GALLONS OR MORE ''- ~'- :'~
TANK OF OVER 5000 OALLONS CAPACITY HAS A VOLUME CHANGE-(COL. 9)
~/- §0 GALLONS OR MORE
OF
ANY TANK HAS A CUMULATIVE VOLUME CHANGE: '(.COL:~-': 11 )- OF_. :'+:/- ' 250" GALLONS
OR MORE OVER'THE' QUARTER TIME FRAME- REPRESENTED ON. REVERSE.~ ~
'~ ........ ; i .... ":" /":" ~'' "
; SUMMARY .......... !~ ' :'
(INCLUDE YEAR) NOTED ON REVERSE RESULTED IN:' : ....... :..
{:. A ~IMtm WEEKLY VOLUME crL~GE (COL?'Si i"J:-:;"
· GALS.
2.' A CUMULATIVE voLUME CHANGE.(COL. Ii,- BOTTOM LINE)..OF'
.............. :,~'" * GALLONS ............ : i- : ': "):':":':' '. "'" '
I- HEREBY-CERTIFY· THAT-. THE, ABOVE-NOTED RESULTS'REPRESENT,' A-.~RUE ,AND ....
ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE-~EPORTABL.E"LIMITS
DESCRIBED IN "A" THROUGH "D" ABOVE. '"
...... · ............... . ....... ~ ....... '. ....... .;..__: ... ~J '""' :.:" ..z ....... ;" ,.:..:.. ,. ................. -'
--S ' :" '?
,..--/. . ,,,,....-. .;- / )..
Seneral ,.$.ervices G~rage Oivi$~on .' ._,
SUBMIT A COPY OF THIS SUM~Y WITH FACILITY ANNUAL REPORT
RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS
FAcILITy
COL.'II COL 2
I '
WEEKLY
HUT -D O l~rS'
~ ~ QU~RTERLY . MODI FI ED 'f NVENTORY CONTROL
cAPAcITY /~ 00 0 SUBST~CE STORED ~ L e<~e ~
'COL, $ !COL 4 !COL 5 I COL.
I~'ATER'-I - '2ND - '1 ST
LEVEL [GAUGE -GAUGE
6 [iCOL.
[. TIME PERIOD ::"-
8!COL- 91 COL ~0 [ COL. 11
INCH
-- CHANGE IVOLU~IE-VOLUME 'CHA}IGE+sUBTOTAL=
· I '::~"'INCHES
C U~IIILAT I VE
C HANG E
:DATE/HR ~-q--?: oo I
· To .-~ &_~:. a o I
'. DATE/HR
9
i
DATE/HR f" ~'/'::0° . I
DATE/HR ~f -Ip.~ ~ ~-o o
TO'
DATE/HR ~-)0- ~.o0
1o
I
!
I
?,./
I
I
i
DATEIHR
0ATE/HR 7~2- ?- ~ o o
I
I
!
I
- I
I '"7
I
I
! I
!DATE/HR '~-z-e': :roi
TO I
-7
-7
I
I/ -
~l.
I
l~l
I
I
I
I
I
I
'!
.......... TANK:, MONITORED [S"'A WASTE;OIL OR- NON-MOTOR; VEHICLE' 'FUEL'~
~' :-;2!. L[. ,·':, ':'-':'"IN ~ :-,J'~.'~ ::HO I '~' UR$v'''
.... REPORT: TO 1'BE PERJ~ITTING:AUTHORITY #ITll F:'''=[~-- '
A. VOLUME CHANGE (COL. 9) IS +/- 10 GALLONS OR MORE
B. 'C[J~ULATIVE VOLUME' CHANGE'(COL. 11)' IS+/~"IO0'GALLONS OR MORE
TANK' #' -,- PERMIT. ~ " ' "
MONITORING ~BET~EEN DATES OF ". AND
(INCLUDE YEAR) NOTED ON REVERSE RESULTED IN:
1. A NAXI~rM':~E~KLY-- VOLUME C~GE (COL. 9I) OF
2.
A CUMULATIVE VOLUME CHANGE (COL.
GALLONS
': GALS.
11, BOTTOM LINE) OF'
I HEREBY CERTIFY THAT THEABOVE-NOTED RESULTS REPRESENT'A' TRUE'AND'
ACCURATE REPORT ANDTHAT THEY DO NOT EXCEED THE REPORTABLE LIMITS
DESCRIBED IN "A" AND "B" ABOVE..
SIGNED ' :' TITLE
' ' '- .... DATE-
A. T~K OF IOO0 GALLONS.oR'LESS· C~ACITY HAS Ai~OLU~E ~GE (COL. 9)
OF +/- 35 GALLONS OR MORE "' : .... ":~' "' "' ' '
c. T~K o~ OW~ 5000 OAL~ONS C~ACI~ ~S A VOLUM~ C~'N~.-(COL. 9) OF
U. ~ T~K ~S-A C~LATIW VOL~ C~N~E"(COU":'~) O~['~'/Z-Z50 OA~LONS
OR. MORE .OVER'THE QUOTER TIME F~E REPRESENTED ON REVERSE.
~. A ~IV~ VOL~ 'cnsa~ (COL. nl '~OTTOff
ACCURATE REPORT AND T~T THEY'DO NOT-EXCEED THE'REPORTABLE[' LIMITS
DESCRIBED IN "A" THROUGH "D" ABOVE. ~" '~:'
General Services G~rage
SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT
RETAIN THESE RECORDS AT THE PERMI.TTED .FACILITY FOR A MINIMUM OF THREE YEARS ::
'
COL. :11 '
TEST I I~/EEKLY I'-W:A?ER I :~:.2NDf::' ',-~' ' 1ST - ...... :INCH
WEEK ISHUT-DO~ ! LEVEL IGAUGE-GAUGE = CrinGE
MODI FI ED .
.X_'7-'' ............. . PEI~'~[~:I.)T # ' /~'"' O0 // ~
SUBST~CE _STORED ~ ~ C e.. J~, ~ OU~I~TER/~R Air. -- '~'OA ¢
COL. ~ .co~. e CO~. ei COL. ~O ~ CO~. '~
2ND 1 ST "VOLU~ ' :" ~A CU~LATI VE
VOLU~-VOLU~ =CrinGE*SUBTC~ ' L= CrinGE
4,
6
'7'
8
9
10,
:1:!.
-12
iDATE/~R ff:,~2 -
I~r~.lim ' ~-lo-D: ~o I
I :'"-4'TO'"4::~i DATE /HR ~'-/,,2'""' '5" (/'~2 {
I
I I
! '7 !
la
I
I DATE/HR
I ~o. ~_2~.g, oo'I
lOATh/aP, i
I TO I
IDATE/HR I
[ '-' "":'INCHES
I
I
I
GALLONS
I GALLONS '! 6ALLONS':' ! GALLONSI .... !'
GALLONS
I
.O
.I
!
.4- ,
I
FILL O~ THE FOLLOWING REPORTING"S~ ~PLiCA~i' {~' THE' T~"NOTED ON REVERSE : ': .... '
(CHECK' ONE ONLY)
T~ NONITO~D iS A ~ASTE-OI~-OR NON-~OR VEHICLE 'FUEa.T~K-' - , '- I ....... .T~K NONITORE. p:.IS "A N6TOR"vEHICLE ~UE~.T~ ....
A. VOL~ C~NGE (COL."9) IS +/- 10 G~LONS OR MORE -[ A. T~K OF 1000 .GALLONS OR LESS C~ACI~ ~S A VOLUME C~GE (COL' 9)
:' ] OF +/- 25 ~LONS OR MORE
S. C~ULATIVt VO~p~ C~ (COL. il) IS */: i00 ~ALLONS OR ~OaE ' [ 'S.-.-~ '~-. OF 1001: TO 5000:6iL~b~S C~ACiTY.~"i"VO'~O~ .C~-(COL. 9)
{ OF +/- 35 GALLONS OR MORE
'[ C. T~K OF OVER' 5000 ~LLONS C~ACI~ ~S A VOLU~ C~GE'.-(COL. 9) OF
[ OR MORE OVER'THE QUOTER .TIME F~ REPRESENTED .O~ REVERSE.
S~y ~ } ; . ~ S~Y ~
(INCL~E YE~) NOTED ON REVERSE RESULTED IN: ' { (INCLUDE Y~) NOTED ON REVERSE RESULTED IN:
: ~. ..~ · ' - I - ~-'T'~'-' ~'~.,~'~ ......
2. A C~LATIVE VOL~ C~GE (COL. 11, BOTTOM LINE) OF ~{ 2. A C~IVE VOL~'C~GE (COL. 11, ~OTTON LIN~):.O~.-;
I
HEREBy
tBOvE-NoTED
~SULTS 'REPRESENT A-TRUE. ~- - {. ...... I-HEREBY-cERTI~:'T~T THE' aOX-NOTED RESULTS. Ri~iESENT?i.:'~,~LaD::.:
CERTIFY-THAT
THE
ACC~TE REPORT ~'-T~T THEY DO NOT EXCEED THE REPORTABLE LIMITS ii ACCURATE REPORT ~D T~T THEy DO NOT EXCEED THE' REPOR~BL~ ~IMITS .-;~
DESCRIBED IN "A' ~ "B' ABOVE. '[ DESCRIBED IN "A" T~OUGH "D" ~OVE..
" I ./'- -/ // - · ' -~.~:~ ~
~neral Services Garage Oivtston
~ . SUBMIT A COPY OF THIS S~Y WITH FACILITY ~AL REPORT ~L ~ ~
~TAIN THESE RECORDS AT THE PE~ITTED FACILI~ FOR A MINI~ OF T~EE
CITY of BAKERSFIELD
"WE CARE"
FIRE DEPARTMENT
S. D. JOHNSON
FIRE CHIEF
February 19, 1993
2101H STREET
BAKERSFIELD, 93301
326-3911
john Mellow
Kern County Risk Management
1115 Truxtun Avenue
Bakersfield, CA 93301
Dear John:
'Per our conversation please find a set of blank Business Plan forms for the drums
of Diesel that will remain at 1530 14th Street. I have enclosed a second set of forms for
the old Kern County Welfare Department building at 230 Inyo Street. You have
underground fuel tanks at that location John, and we do not have a plan.
Thank you for your assistance.
Sincerely Yours,
Ralph Huey
Hazardous Materials Coordinator
encl:
RH/dlm
24 HOUR REPORTABLE VltlIIATIO~/LOSS
I~OTIFICATIO~
TO:
RECEIVED
Bakersfield Fire Department
Hazardous Materials Division
2101 "H" Street
Bakersfield, CA. 93301
:EB 0 i 1993,
HAT. ~,,~A,T. OtV.
REGARDING:
E'acility: County. of Kern "Inyo" St. (GAS} Permit ~ 150011C
.~a___C..~ty Address: 230 Inyo St. Bakersfield, Ca.
Name Of Person Filing Report: Jill HINDllAN, GARAGE SERVICES SUPERVISOR
On ___. O1/26/93 5:00 Pll , the above facility had 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 of
Trend Analysis
I -166 Gal. 104 Per. 8
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 placed..
Signature "/' /"~'~ .
Jill HI,N~llAN, GJ~GE SERVICES SUPERVISOR
NERALSERVICES, GARAGE DIVISION
BAIERSFIELD FIRg DEPARTflENT HAZARDOUS RATERIAL5 DIVISION
VARIATION/LOSS INVESTIGATION REPORT
Facility: County of Kern "Inyo' St. Permit #,.~, 15001lC
Facility Address: 230 Inyo St. BaRersfield, Ca.
TanK(s) with Discrepancy: ~ I Date/Time of Discovery: 01/28/93 6:15 A~.
Name of Person Filing Report: Jim Hindman, GARAGE SERVICES SUPERVISOR
Description Of Discrepancy: Daily variation exceeded allowable limits usinq .
LOW THROUGHPUT CHART. -166 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:
within.. ]
6 Hours ] Owner/Operator or other qualified person is to ] Date ] Time
] review records for errors before determining ]01/28/93 ]6:25 ~ .
] there is a reportable variation/loss.
Performed By : Richard Brown
24 HOURS
48 Hours
72 Hours ]
I
I
I
I
1) Owner/Operator must verbally report ] ~ate, ] Time .
discovery to BFDHM and follow-up with written] //~.~',o[~_~] IK~.~ .
notification on form provided. ~ ~~_~
Performed By : .
2) Visual facility check to be performed using I D~ [ Time
checklist on the back of this form ]01/28/93 ] 8:00'A[~.
Performed By : Richard Brown
3) All product dispensers are to be checked for ] Date ] Time'
calibration and adjusted if out of tolerance ] ] '
Performed By :
Piping to be leak tested using approved method]
I
Contractor's Name
License ~ Test Performer's Name
Descr'iption of test performed
Date [ Time
* * ATTACH COPY OF TEST RESULTS. * *
Tightness Testing of Tan~(s). to be performedl
using approved tester and method.
Contractor's Name :
License 9 Test Performer's Name
Description of test performed
Date I Time .
* * ATTACH COPY OF TEST RESULTS. * *
NOTE:
THiS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 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·-.
All totalizer seals checked for tampering·
Results:
All dispensers appear tight Richard Brown 01/28/93
signature/date
Dispenser(s) not tight as listed below
signature/date
JDISPENSER ~ISERIAL ~ICOMMENTS:
B. Tank Area
All turbine boxes inspected·
All fills and vapor manholes inspected·
Results:
X__ 'rank area appears tight with no product or liquid present
Richard Brown O1/28/93
signature/date
Tank area does not appear tight because of the problems/conditions listed
below:
signature/date
ITANK [PRODUCT [COMMENTS/RESULT$:
Results:
Piping Type: [[ Pressure [[ Suction
Pressurized piping leak detector(s) tested for proper functioning and
detection of leakage.
Suction piping tested for 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
24 HOUR REPORT~tBLE ~IIIATION/L~S
I~)TIFICATION
TO:
Bakersfield Fire DePartment
Hazardous Materials Division
2101 "H" Street
Bakersfield, CA. 93301
REGARDING:
f'acility: County of Kern "Inyo' St. {GAS) Permit ~ 150011C .
Facility Address: 230 Inyo St. Bakersfield, Ca. .
Name Of Person Filing Report: JiM HINDMAN, GARAGE SERVICES SUPERVISOR .
On 01/25/93 5:00 PM , the above facility had 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
1 +121 Gal.
Total Minuses
Line 3 of
Trend Analysis
103 Per. 8
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 placed.
JIM HINg~IAN, GAI~A~E SERVICES SUPERVISOR
, ~NERAL SERVICES, GARAGE DIVISION
BAKERSFIELD FIRE DEPARTflENT HAZARDOUS PIATERIALS D'rvIs'I'O#
VARIATION/LOSs INVESTIGATION REPORT
Facility: County of Kern "Inyo" St. Permit % 150011C
Facility Address: 230 Inyo St. Bakersfield, Ca.
TanK(s) with Discrepancy: ~ I Date/Time of Discovery: 01/28/93 6:15 AH.
Name of Person Filing Report: Jim Hindman, GARAGE SERVICES SUPERVISOR
Description Of Discrepancy: Daily variation exceeded allowable limits using .
LOW THROUGHPUT CHART. +121 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:
Within: ~
6 Hours [ Owner/Operator or other qualified person is to I Date I Time
I. re~iew records for errors before determining 101/28/93 ~6:20 ~ .
~ there is a reportable variati.on/loss.
Performed By : Richard Brown
24 Hours
48 Hours I
J
72 Hours
1) Owner/Operator must verbally report I 9at~ [ Time
discovery to BFDHM and follow-up with writtenl ~/~-~5 [ /~:~,-~ .
notification on form provided.
Performed By :'-~--~.c~~. _
2) Visual facility check to be performed using I Date I Time.
checklist on the back of this form 101/28/93 [ 8:00 A~.
Performed By : Richard Brown
3) All product dispensers are to be checked for [ Date [ Time
calibration and adjusted if out of tolerance [
Performed By :
Piping to be leak tested using approved method[
· I
Contractor's Name
License ~ 'rest Performer's Name
Description of test performed
Date I Time
* * ATTACH COPY OF TEST RESULTS. * *
Tightness Testing of TanK(s) to be performed[
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:
THIS REPORT MUST BE SUBM£TTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS
OF COMPLETION OF INVESTIGATION PROCEDURES.
2. VISUAL INSPECTION CHECKLIST
A. Dispensers
Ail dispensers and their end doors visually checked for leaks.
All hoses and nozzles visually checked for leaks.
All totalizer seals checked for tampering.
Results:
All dispensers appear tight, Richard Brown 01/28/93
signature/date
Dispenser(s) not tight as listed below
signature/date
IDISPENSER ~IS£RIAL ~.ICOMMENTS:
I
B. ~an~ Area
X__ All turbine boxes inspected.
X__ All fills and vapor manholes inspected.
Results:
X__ Tank area appears tight'with no product or liquid present
· Richard Brown 01/28/93
signature/date
Tank area does not appear tight because of the problems/conditions listed
below:'
signature/date
ITANK IPRODUCT ICOMMENTS/RESULTS:
Results:
Piping Type: 11 Pressure J_[ Suction
Pressurized piping leak detector(s) tested for proper functioning and
detection of leakage.
Suction piping tested for 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
24 HOUI~ I~I~PO~TI~BL~- V~d~IATION/LOSS
NOTIFICATION
TO:
Bakersfield Fire Department
Hazardous Materials Division
2101 "H" Street
Bakersfield, CA. 93301
REG~diDING:
Facility: County of Kern 'Inyo' St. (GAS~ Permit ~ 150011C
Facility Address: 230 Inyo St. Bakersfield, Ca. .
Name Of'Person Fi-ling Report: JIM HINDMAN, GAI~GE ~SERVICES SUPERVISOR .
On O1/24/93 5:00 PM , the above facility had 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 of
Trend Analysis'
1 -86 Gal. 103 Per. 8
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 placed.
V~II~IATION/L~S II~WESTI~TION llEPOIIT
Facility: County of Kern "Inyo" St. Permit ~ 15OOllC
Facility Address: 230 Inyo St. BaKersfield, Ca.
TanK(s) with Discrepancy: 9 I Date/Time of-Discovery: 01/28/93 §:15 APl.
Name of Person Filing Report: Jim Hindman, GARAGE SERVICES SUPERVISOR
Description Of Discrepancy: Daily variation exceeded allowable limits uslnq .
LOW THROUGHPUT CHART. -86 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:
Within: {
6 Hours { Owner/Operator or other qualified person is to [ Date { Time
.- _{ _re~ie~ records for err. ors before determining-- {O1/28/93 {6:15 APl .
{ there is a reportable variation/loss.
Performed By : Richard Brown
24 Hours
48 Hours
72 Hours
3) Ail product dispensers are to be checked for
calibsation and adjusted if out of tolerance
Performed By :
1) Owner/Operator must verbally report { ~Sat9 [ Time
discovery to BFDHM and follow-up with written[ f/~f~k_~ /~5~
notification on form provided. . __;~ _' .~ '~.3 ,
2) Visual facility check to beeperfOrmed, uSing. ~ Date~ i Time.P rformed BV _ ~~
checKl'ist.on the back of this form [01/28/93 ] 8:00 APl.
Performed By : Richard Brown
Date I Time
Piping to be leak tested using approved methodl
Contractor's Name
License % Test Performer's Name
Description of test performed
Date ] Time
* * ATTACH COPY OF TEST RESULTS. * *
Tightness Testing of TanK(s) to be performedl
using approved tester and method.
Contractor's Name : ~
License 9 Test Performer's Name
Description of test performed
Date ~ Time
* * ATTACH COPY OF TEST RESULTS. * *
NOTE:
THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS
OF COMPLETION Of' INVESTIGATION PROCEDURES.
2. VISUAL INSPECTION CHECKLIST
A. Dispensers
Ail dispensers and their end doors, visually checked for leaks.
All hoses and nozzles visually checked for leaks.
All totalizer seals checRed for tampering.
Results:
All dispensers appear tight Richard Brown 01/Z8/93
signature/date
Dispenser(s) not tight as listed below
signature/date
IDISPENSER ~ISERIAL ~ICOMMENTS:
B. Tank Area
X Ail turbine boxes inspected.
All fills and vapor manholes inspected.
ResUlts:
Tank area appears tight with no product or liquid present
Richard Brown 01/28/93
signature/date
TanR area does not appear tight because of the problems/conditions listed
below:
signature/date
ITANK PRODUCT ICOMMENTS/RESULTS: I-
C. Piping TyPe: t| Pressure [[ Suction
Pressurized piping lear 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) above, with problems/conditions
listed below·
signature/date
Description
24 HOUR REPORTABLE VARIaTION/LOSS
NOTIFICATION
TO:
Bakersfield Fire Department
Hazardous Materials Division
2101 "H" Street
Bakersfield, CA. 93301
REGARDING:
.~acil. ity:. County of Kern "Inyo" St. (GAS) Permit.# 150011C
.Facility Address: 230 Inyo St. Bakersfield, Ca.
Name Of Person Filinq Report: JIM HINDMAN, ,GARAGE SERVICES SUPERVISOR
On O___1~20/93 5:00 PM , the above facility had 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
3 -605 Gal.
Total Minuses
Line 3 of
Trend Analysis
93 Per. 7
.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 placed.
J~M HIN~AN, GARAG~g'SERVICES SUPERVISOR
G~NERAL SERVICES, GARAGE DIVISION
[h~iEIL~FIELD FIRE DEPARTPiENT HAZARDOUS HATERIP~LS DIVISION
VAltIATION/£OSS INVESTIGATION REPORT
Facility: County of Kern "Inyo" St. Permit ~ I§O011C
Facility Address: 230 Inyo St. Bakersfield, Ca. ~
Tank(s) with Discrepancy: ~ 3 Date/Time of Discovery: O1/2,1/93 6:20
Name of Person Filing Report: Jim Hindman,. GARAGE SERVICES SUPERVISOR
Description Of Discrepancy: Daily variation exceeded allowable limits using
LOW THROUGHPUT CHART. -605 Gal. Bad stick reading on, O1/19/93.
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:
_W~thin: I
6 Hours { Owner/Operator or other qualified person is to { Date ~ Time
{ review records for errors before determining, ~ {,01/21/93 ~6:20 AM .
{' there is a repdrtable variation/loss.
Performed By : Richard Brown
24 Hours
~)
3),All product dispensers are to be checked for [
48 Hours
72 Hours I
I
I
I
I
Owner/Operator must verbally report I ~atq [ Time .
discovery to BFDHM and follow-up with writtenl'l/~l/~5 _1 0~t7~, .
notification on form provided, z '~{'"~ t~ O.
Performed By
Visual facility check to be performed usi~g~ [ D~te [ Time .
checklist on the back of this form ~//~, 101/21/93 ~ 6:30 AM.
· Performed By : -Richard Brown .
Date I Time
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 I Time
I
* * ATTACH COPY OF TEST RESULTS. * *
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 TES'r RESULTS. * *
NOTE:
THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS
OF COMPLETION OF INVESTIGATION PROCEDURES.
2. VISUAL INSPECTION CHECKLIST
A. Dispensers
X Ail dispensers and their end doors visually checked for leaks.
X All'hoses and nozzles visually checked for leaks.
X All totalizer seals checked for tampering.
~esults: ~
X All dispensers appear tight Richard Brown 01/21/93
signature/date
Dispenser(s) not tight as listed below
signature/date
JDISPENSER ~ISERIAL ~ICOMMENTS:
Tank-~Area ....
All turbine boxes inspected.
X__ Ail fills and vapor manholes inspected.
Results:
Tank area appears tight with no product or liquid present
Richard Brown O1/21/93
signature/date
'rank area does not. appear tight because of the problems/conditions listed
below:
signature/date
I'.['ANK gl PRODUCT~ICOMMENT$/RESULTS: I ·
~ I I I.
C. Piping Type: II Pressure II 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) above, with problems/conditions
listed below.
signature/date
Description
24 HOUR REPORTABLE VARIATION/LOSS
NOTIFICATION
TO:
Bakersfield Fire Department
Hazardous Materials Division
2101 "H" Street
Bakersfield, CA. 93301
REGARDING:
f'aci]ity: County of Kern "Inyo" St. {GAS) Permit ~ 150011C
Facility Address: 230 Inyo St. Bakersfield, Ca.
Name Of Person f'iling Report: JIM HINDMAN, GARAGE SERVICES SUPERVISOR
On 01/20/93 5:00 PM , the above facility had 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 of
Trend Analysis
I -217 Gal. 101 Per. 7
I have/have-not stopped dispensing product and begun investigation procedures
reqdired by the Permitting Authority.
This notification is in addition to the phone call I previously placed.
JI. H~N~AN, GA[~GE SERVICES SUPERVISO~
t(~ENERAL SERVICES. GARAGE DIVISION
B~KERSFIELD FIRE DEP~It~I~E~IT [h~Z2~ItDOUS Ph~TERI2~LS DI~-ISION
VAI~IATION/LOSS INVESTI~TIOI~ REPORT
Facility: County of Kern "Inyo" St. Permit # 150011C
Facility Address: 230 Inyo'St. Bakersfield, Ca..
Tank(s) with Discrepancy: ~ I Date/Time of Discovery: 01/21/93 6:05 AM.
Name of Person Filing Report: Jim Hindman, GARAGE SERVICES SUPERVISOR
Description Of Discrepancy: .Daily variation exceeded allowable limits using
LOW THROUGHPUT CHART. -217 Gal. Bad stick reading on 01/19/93
INVESTIGATION SUMMARY
The following procedures must be performed within the specified times starting
at th6 time a reportable loss is discovered or should have been discovered:
Within: I
--6 Ho6rs I Owner/Operator or other qualified person is to I Date I Time
I review records for errors before determining~ IO1/21/93 ~6:O5 AM .
, there is a reportable variation/loss. ~(./~
Performed By : Richard Brown
24 Hours
1)
2) Visual facility check to be performed using [ Date
checklist on the back of this form ~ ~01/21/93
Performed By : Richard Brown
3) All product dispensers are to be checked for I Date
calibration and adjusted if out of tolerance I
Performed By :
Owner/Operator must verbally report I 'D~te. I Time
discovery to BFDHM and follow-up with writtenl /[~!~ [ O~{~-- .
notification on form provided. · _ ,~_ ~~_ ' 0 _
Performed By
I Time
~ 6:30AM
Time
48 Hours
Piping to be leak tested using approved methodl
'Contractor's Name
License ~ Test Performer's Name
Description of test performed
Date I Time
* * ATTACH COPY OF TEST RESUL'rS. * *
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
I * * ATTACH COPY OF 'rEST RESULTS. * *
NOTE:
THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN ~ .DAYS
OF COMPLETION OF INVESTIGATION PROCEDURES.
2. VISUAL INSPECTION CHECKLIST
A. Dispensers
Ail dispensers and their end doors visually checked for leaks.
Ali hoses and nozzles visually checked for leaks.
Ail totalJzer seals checked forAt~mpering.
Results:
All dispensers appear tight chard Brown 01/21/93
signature/date
Dispenser(s) not tight as listed below
signature/date
IDISPENSER ~ISERIAL ~ICOMMENTS:
B. Tank Area
.~_ Ali turbine boxes inspected.
X__. All fills and vapor manholes inspected.
Results:
X__ Tank area appears tight with no product or liqUid present
Richard Brown 01/21/93
signature/date
Tank area does not appear tight because of the problems/conditions listed
below:
signature/date
~ITANK ~J PRODUCT~ I COMMENTS/RESULTS: I ·
C. Piping Type: II Pressure ~1 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) above, with problemS/conditions
listed below.
signature/date
Description
TO:
24 HOUR HEPORTABLE VARIATION/LOSS
NOTIFICATION
Bakersfield Fire Department
Hazardous Materials Division
210]. "H" Street
Bakersfield, CA. 93301
2 6 1993
REGARDING:
f'acility: County of Kern "Inyo" St. (GAS) Permit ~ 150011C
~'acility Address: 230 Inyo St. Bakersfield, Ca.
Name Of Person Filing Report: JIM HINDMAN, GARAGE SERVICES SUPERVISOR .
On 3'O!/19/93 5:00 PM , the above facility had 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 of
Trend Analysis
1 +262 Gal. 100 Per. 7
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 placed.
aim HI~D~iAN, GAI(A~E SERVICES SUPERVISOR
~NERAL SERVICES, GARAGE DIVISION
BAKER~F[ELD FIRE DEPARTMENT. HAZARDOUS HATEItI~LS DIVISION
VARIATION/LOSS INVESTIGATION REPORT
Facility: County of Kern "Inyo" St. Permit ~ 150011C
Facility Address: Z30 Inyo St. Bakersfield, Ca. .
Tank(s) with Discrepancy: ~ 1 Date/Time of Discovery: 01/Zl/93 6:00 AM.
Name of Person Filing Repo'rt: Jim Hindman~ GARAGE SERVICES SUPERVISOR
Description Of Discrepancy: Daily variation exceeded allowable limits using .
LOW THROUGHPUT CHART. +26Z Gal. Bad stick reading.
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:
Within: I
..... ~--H-o-~rs ] Owner/Operator or other qualified person is to I Date I Time
I review records for errors before determining. ~ ~101/21/93 ~6:O0 AM
I there is a reportable variation/loss. ~./l
Performed By :VRichard Brown
24 Hours
1) Owner/Operator must verbally report I ~at9 I 'Time
discovery to BFDHM and follow-up with writtenl ;/~;/.~ ~ ~ [;-'
notification on form provided. ~_ ,~_~_~3 ~,
Performed By 'n,~.~~
2) Visual facility check to be performed us~o~g~ I Date I Time
checklist on the back of this form ~/// 101/21/93 ~ 6:30AM
Performed By : Richard Brown
3) All 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 method]
Contractor's Name
License ~ Test Performer's Name
Description of test performed
Date ] Time
* * ATTACH COPY OF TEST RESULTS. * *
72 Hours
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
I * * ATTACH COPY OF TEST RESULTS. * *
NOTE:
THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS
OF COMPLETION OF INVESTIGATION PROCEDURES.
VISUAL INSPECTION CHECKLIST
A. Dispensers
Ail dispensers and their end doors visually checked for leaks.
All hoses and nozzles visually checked for leaks.
All totalizer seals checked for~t~mpering.
Results:
All dispensers appear.tight Richard Brown 01/21/93
signature/date
......... Dispenser(s) not tight as listed below
signature/date
J. DIS~ENSER ~ISERIAL ~ICOMMENTS:
B. Tank Area
~g_.. Ail turbine boxes inspected.
.g .... All fills and vapor manholes inspected.
Results:
.g_ Tank area appears tight with no product or liquid present
Richard Brown 01/21/93
f/~ signature/date
'rank area does not appear tight because of the problems/conditions listed
below:
signature/date
ITANK ~IPRODUCT~ICOMMENTS/RESULTS: I-
C. Piping Type: J_[ Pressure ~ Suction
__ Pressurized piping leak detector(s) tested for proper functioning and
detection of leakage.
Suction piping tested for indicatio~ of leakage.
Results:
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
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 ~ 150011C
Facility Address: 230 Inyo St. Bakersfield, Ca.
Name Of Person Filinq Report: JIM HINDMAN, GARAGE SERVICES SUPERVISOR
On _O1/19/93 5:00 PM , the above facility had 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 of
Trend Analysis
+601 Gal. 92 Per. 7
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 placed.
aim HIND~ANo GAP,~G~" SERVICES SUPERVISOh
G~ERAL SERVICES, GARAGE DIVISION
B~tI(EitSFIELD FIB]~ DEPJtqT~IEI~'r I{A~-i~3{DOUS I~A?ERIALS DIVISION · rJtI{IATIONAOSS INVES?It~A?ION REPORT
Facility: County of Kern "Inyo' St. Permit ~ I§O011C
Facility Address: 230 Inyo St. Bakersfield, Ca.
Tank(s) with Discrepancy: # 3 Date/Time of Discovery: 01/21/93 6:15 AM.
Name of Person Filing Report: Jim Hindman, GARAGE SERVICES SUPERVISOR
Description Of Discrepancy: Daily variation exceeded allowable limits'using
LOW THROUGHPUT CHART. +601 Gal. Bad stick reading. .
INVESTIGATION SUMMARY
The fo]lowing procedures must be performed within the specified times starting
at the time a reportable loss is disco'vered or should have been discovered:
6 Hours I Owner/Operator or other· qualified person is to I Date I Time
I review records for errors before determining_ ~ 101/21/93 ~6:15 AM .
I there is a reportable variation/loss. ~/~
Performed By :v~--Richard Brown
24 Hours
48 Hours
72 Hours I
I
I
I
I
1) Owner/Operator must verbally report I ~atg I Time .
discovery to BFDHM and follow-up with written[ //~2/~.~. Obi?_, .
notification on form provided. '
Performed By :
g) Visual facility check to be performed using I Date I Time
checklist on the back of this form /~_. 101/21/93 I 6:30 AM.
Performed By : 'Richard BrOwn
3) All product dispensers are to be checked for I Date I Time
calibration and adjusted if out of tolerance I ~
Performed By :
Piping to be leak tested using approved methodl
I
Contractor's Name
License ~ Test Performer's Name
Description of test performed
Date I Time
* * ATTACH COPY OF TEST RESULTS. * *
Tightness Testing of Tank(s) to be performed[
using approved tester and method. [
Contractor's Name : ~
License ~ 'rest Performer's Name
Description of test performed
Date I Time
* * ATTACH COPY OF TEST RESULTS. * *
NOTE:
THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS
OF COMPLETION OF INVESTIGATION PROCEDURES.
VISUAL INSPECTION CHECKLIST
A. Dispensers
X Ali dispensers and their end doors visually checked for leaks.
X All hoses and nozzles visually checked for leaks.
X All totalizer seals checked for tampering.
Results: ~ic~h
___g_. All dispensers appear tight ard Brown 01/21/93
signature/date
Dispenser(s) not tight as listed below
signature/date
IDISPENSER ~SERIAL #ICOMMEN'rS:
B. 'rank Area
X All turbine boxes inspected.
.X__ All fills and vapor manholes inspected.
Results:
~_ Tank area appears tight with no product or liquid present
Richard Brown 01/21/93
signature/date
Tank area does not appear tight because of the problems/conditions listed
be].ow:
signature/date
ITANK ~IPRODUCT~ICOMMENT$/RESULTS:
J I I
C. Piping Type: {I Pressure {~ 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) above, with problems/conditions
listed below.
signature/date
Description
ADDRESS
PERMIT #=
FILE CONTENTS SUMMARY
ENV. SENSITIVITY:
Date # Of Tanks
Comments
RESOURCE MANAGEMENT A,. ENCY
RANDALL L. ABBOTT
DIRECTOR
DAVID PRICE I11
ASSISTANT DIRECTOR
EnvironmentaJ Health Services Department
STEVE McCA! ~ Fy, REHS, DIRECTOR
Air Pollution Control District
WILLIAM J. RODDY, APCO
Planning & Development Sen~:es Department
TED JAMES, AICP, DIRECTOR
ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
January 17, 1991
Jim Peterson
SBD Group
901 West Civic Center Drive
Suite 340
Santa Ana, CA 92?03
SUBJECT:
Underground Storage Tank Facility
230 Inyo Street, Bakersfield, California
Permit #: 150011
Dear Mr. Peterson:
During our conversation of January' 16, 1991, you expressed a
desire to undertake option #3 as outlined in the October 26, 1990,
letter you received from this department;. Please have the manifold
disconnected and the south tank emptied before February 20, 199~.
Continue to use the standard inventory method on the north tank and
begin the modified inventory method on the south tank.
Hopefully this will correct the recurring inventory problems
at your facility. If, however, inventory problems persist option
#1 and #2, as outlined in the October 26, 1990, letter~ may become
necessary to bring your facility into compliance.
Thank you for your cooperation in this matter. If there are
any additional questions, please feel free to call me at (805) 861-
3636, extension 509.
Sincerely,
Carrie Georgi
Hazardou~ Materials Specialist
Hazardous Materials Management Program
CG:jg
2700 "M" STREET, SUITE 300
'BAKERSFIELD, CALIFORNIA 93301
(805) 861-3636
FAX: (805/ 861-3429
N~MBER OF TANKS AT THE SITE: .................................
EMERGENCY CONTACT,PERSON:
~^~: ....... _~..~.~.-._~_% ...... ~½~~ ........................................................
~o~ ~~: .~.~..a,..s:.].......~.~..L-_..;Z.,.~...~..~ ................................................
TANK CONTENTS:
TANK ~ MANUFACTURER YEAR INSTALLED CAPACITY CONTENTS
~L
TANK CONSTRUCTION:
TANK g TYPE (dw, sw, sec.Cont.) MATERIAL INT. LINING CORROSION PROT.
LEAK DE; ECTION:TANKS: VISU IL ........... GROUNDWATER MONITORING WELLS
VADOSE ZONE MONITORING WELLS U-TUBES WITH LINERS
-------U-TUBES WITHOUT LINERS VAPOR DETECTORS LIQUID SENSORS
CONDUCTIVITY SENSORS ....................... ~RESSURE SENSORS IN ANNULAR SPACE
.... ~IOUID RETRIEVAL SYSTEMS IN U-TUBES, MONITORING WELLS OR ANNULAR SPACE
· ?~ONE UNKNOWN OTHER
PIPING INFORMATION:
TANK~ SYSTEM TyPE CONSTRUCTION MATERIAL
(suc., pres.,gray.)
I .? y-~ ~ A. o. ~,~,:.->~,, .0_" ~~ ~ I~.~
LEAK DETECTION:PIPING: FLOW RESTRICTING LEAK DETECTORS FOR ~RESSURIZED
PIPING MONITORING SUMP WITH RACEWAY
SEALED CONCRETE RACEWAY HALFCUT COMPATIBLE PIPE RACEWAY
SYNTHETIC LINER RACEWAY NONE UNKNOWN
........ 7~-~.. OTHER - c~J'~- ~c~ ~ ~-'~! ~-a ~
~AS THE SITE EVER REPORTED VA LEAK OR HAD A'LEAK DOCUMENTED? YES ......
DISCUSS THE STATUS OF THE INVESTIGATION:
TIGHTNES TEST:
HAS ONE BEEN DOCUMENTED FOR THIS SITE.~,,_YES NO
DATE O~ LAST TEST_].~..,~_~ DID THE TES~~:.-OR FAIL? ...... ~,,,,ff'ES NO
COMMENTS ON TEST .........................................................................................................................................
H A s ~ A c z L'i'YY'"'~'~'~-'7~'~'~-~-f'~T:Z::~Z:"~'~ .................. ~-6 .............................................
w,s ~HE ~,CZbZTY MO~O~ZN~ ~H~ ~A~s~:ZZ'.7$.: .....................................................................................
WAS THERE CONTAM~NAT[ON OBSERVED DURING THE INSPECTION? YES ~ NO
................... ~:'~:r~"'
n[:C[l'~S VIOLATIONS OBSERVED: ..................................................................................................... ~.~..~..,-
RESOURCE MANAGEMENT A~I~NCY
RANDALL L. ABBOTT
DIRECTOR
DAVID PRICE !!!
ASSISTANT DIRECTOR
Environmental Health Services Department
STEVE McCALLE¥, REHS, DIRECTOR
Air Pollution Control District
WILLIAM J. RODDY, APCO
Planning & Development Services Department.
TED JAMES, AICP, DIRECTOR
ENVIRONMENTAL HEALTH SERVICES' DEPARTMENT
December 27, 1990
Mr. Jim Peterson
SBD Group
901 West Civic Center Dr., Suite 340
Santa Aha, California 92703
SUBJECT:
Underground Storage Tank Facility
230 Inyo Street, Bakersfield, California
Permit No. 150011
Dear Mr. Peterson:
On November 1, 1990, in the course of our phone converSation, you requested a week
or so to review the October 26, 1990, letter you received from this Department. The letter
outlined various options available to SBD Group regarding the underground storage
tanks located at 230 Inyo Street in Bakersfield, California.
Despite several attempts to contact you by phone, this Department has not received any
correspondence by phone or letter from you or anyone else at SBD Group. The
inventory monitoring variance continues to be a problem at this facility. It is essential that
a course of action is agreed upon and initiated to bring this facility into compliance.
Please contact me at (805) 861-3636, Ext. 509, before January 28, 1991, to have your
input on this matter considered. Otherwise the county will decide which course of action
will be employed to resolve this facility compliance problem.
Sincerely,
Carrie Georgi
Hazardous Materials Specialist
Hazardous Materials Management Program
CG:ch
georgi\peterson, let
2700 "M" STREET, SUITE 300
BAKERSFIELD, CALIFORNIA 9330!
(805) 861-3636
FAX: (805) 861-3429
· RANDALL L. ABBOTT
DIRECTOR
DAVID PRICE III
ASSISTANT DIRECTOR
REL~ iCE MANAGEMENT A'~
Environmental Health Services Department
STEVE McCALLEY, REHS, DIRECTOR
Air Pollution Control District
WILLIAM ,J. RODDY, APCO
Planning & Development Services Department
TED JAMES, AICP, DIRECTOR
ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
October 26, 1990
Mr. Jim Peterson
SBD Group
901 West Civic Center Drive, Suite 340
Santa Ana,'CA 92703
SUBJECT:
Underground Storage Tank Facility
230 Inyo Street, Bakersfield, California
permit No. 150011
Dear Mr. Peterson:
During our conversation of October 16, 1990, you expressed a desire for options
other than the one stated in the August 28, 1990, correspondence. After reviewing
the facility file and the recurring inventory problems, the Department will concur
with any one of the following recommendations:
Empty and remove both tanks within the next six months.
Maintain'both tanks, manifolded as they are now, and conduct a tightness
test every six months.
e ·
Disconnect the manifold and empty the south tank. Use the modified inventory·
method on the south tank and the standard inventory method on the north tank.
If this·option does not correct the north tank's inventory problems, Option
I or 2 above may be necessary.
If SBD Group has any options they would like the Department to consider, such as
In Tank Level Sensors or any other method, please submit your suggestions for
review. We hope we can work together to bring this facility into compliance.
If there are any additional questions, please feel free to call me at (805)
861-3636, Extension 509.
Sincerely,
Carrie Georgi
Hazardous Materials Specialist
CG:jrw
(hazma(\georgi\l$001 l.~bd)
2700 "M" STREET, SUITE 300
BAKERSFIELD, CALIFORNIA 93301
(8O5) '861-3636
FAX: (805) 861-3429
RANDALL L~ABBOTT
Agency Director
(805) 861-3502
STEVE Mc CALLEY
Director
RESOURCE MANAGEMENT
DEPARTMEI~iT~OF'' ENVIRONMENTAL
HEALTH sERVICES
AGENCY
2700 M Street, Suite 300
Bakersfield, CA 93301
Telephone (805) 861-3636
Telecopier (805) 861-3429
AuguSt 28, 1990
SBD Group
901 West Civic Center Drive
Suite 340
Santa Ana, CA 92703
SUBJECT:
Underground Storage Tank Facility
230 Inyo Street, Bakersfield, California
PERMIT # 150011
Gentlemen:
Despite strapping the tanks, new calibration charts and a ·
tightness test (January 27, 1990), which was .inconclusive,
reportable inventory deviation is continuing to be a problem with
the underground 'storage tanks located at 230 Inyo Street·
After reviewing the facility file and past inventory problems
that have been occurring, it is again the recom3nendatlon of this
Department that the suction piping between the two tanks be
dismantled· The north tank would continue to be operated and
monitored using the new calibration chart. The south tank would
be emptied and monitored using a modified inventory control method
until removed per Kern County Handbook UT-30.
It is further recommended a tightness test be performed on the
north tank and system after the modification has been completed.
Hopefully this will eliminate the inventory deviations that
have been occurring.
If there are any additional questions please feel free to call
at (805) 861-3636 ext. 566.
MD:jg
CC:
Sincerely,
Hazardous Materials Specialist
Amy Green
Kern County Pr'operty Management
Kern County General Services - Larry JohniCan
2700 M sTREET
MAILING. ADDRESS
'1415 TRUX'I'UN AVENUE
BAKE?SFIELD. CA 93301
(805) 861-3636
PERMIT FOR PERMANENT CLOSURE
OF UNDERGROUND HAZARDOUS
SUBSTANCES STORAGE FACILITY
COUNTY HEALTH DEPARTMEN~
ENVIRONMENTAL HEALTH DIVISION
HEALTH OFFICER
Leon M Hebertson, M.D.
DIRECTOR OF ENVIRONMENTAL HEALTH
Vernon S. Reichard
PERMIT NUMBER A?72-15
FACILITY NAME/ADDRESS:
OWNER(S) NAME/ADDRESS:
CONTRACTOR':
Human Services Satellite
230 In¥o St.
Bakersfield, CA 93305
PERMIT FOR CLOSURE OF
SBD Group
901W. Civic Ctr. #340
Santa Ana, CA
Phone: .?14-935-4'040
PERMIT EXPIRES
RLW Equipment
2080 So. Union
'Bakersfield, CA 93305
License # 294044
Phone:'
December [2~ [988
PIPELINE-AT ABOVE
LOCATION
APPROVAL DATE
APPROVED BY
September 12i 1988
Janis Lehman
................................ POST ON PREMISES ...........................
CONDITIONS AS FOLLOW:
It is the responsibility of the Permittee to obtain permits which may
be required by other regulatory agencies prior to beginning work.
Permittee must obtain a City Fire Department permit prior to initiating
closure action.
Tank closure activities must be per Kern County Health and Fire
Department approved methods as described in Handbook UT-30.
If any contractors other than those listed on permit and 'permit
application are to be utilized, prior approval must be granted by the
specialist listed on the permit.
Soil Sampling (piping area)
a minimum of two samples must be retr'ieved at depths of approximately
two feet and six feet. for every 15 linear feet of pipe run and also
near the dispenser area(s).
Sample analysis~
a. All (leaded/unleaded) gasoline 'samples must be analyzed for
benzene, toluene, xylene, and total petroleum hydrocarbons.
DISTRICT OFFICES
,i! ,
PERMIT FOR PERMANENT CLOSURE
OF UNDERGROUND HAZARDOUS
SUBSTANCES STORAGE FACILITY
PERMIT NUMBER A?72-15
ADDENDUM
-10.
Copies of transportation manifests must be submitted to the Health
Department within five days of waste disposal.
All applicable state laws for hazardous waste disposal, transportation,
or treatment must be adhered to. The Kern County Health Department
must be notified before moving and/or disposing of any contaminated
soil· . "
Permittee is responsible for making sure that "tank disposition
tracking record" issued with this permit is properly filled out and
returned wi.thin 14 days of tank removal. ..' ""-'.".
Advise 'this office of the time and date of the proposed samplingi'with
24 hours advance notice. .
Results must be submitted to this office within` three days of analysis
completion.
SPECIAL SITUATIONS:
(Verbal Order Given to Tank Owner)
Hlghwater Table- (for Environmental Assessment Contractor)
If the water table is encountered either during the exploratory boring
or during .sampling, water samples must be retrieved by a method
approved by this department.
Waste water from flushing lines shall be directed into tank and
disposal of in a manner consistent with state laws. A. copy of the
transportation manifest shall be provided to the Kern County Health
Department with three days. The identification .tag provided by the
Kern County Health Department shall be affixed on the tank and signed
by responsible person at destination. The signed tag shall then be
returned to the Health Department.
JL:cd
ACCEPTED BY:~~~'~~/~/~~
PROOUCER
INSURED
RL~ Equipment Inc., P~W ~terprises
Robert L. ~e ~ ~ N. ~e
P.O. ~x 6~ '
(MM/DD/YY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERT~CATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PO4JCtES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY ~.
~m~R ~ciflc ;mployers Insurance
COMPANY
~-~ER B United Pae/fle Insurance Ccmpany
COMPANY
COMPANY I)
COMPANY
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PO{JCY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH TI. US CERTIFICATE MAY
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFOIM)ED BY THE POUCIES DESCRIBED HEREIN tS SUBJECT TO ALL THE TERMS, EXCLUSIONS, ANO CONDI-
I R~'Y £1:I~ECTNE PI~JCY EY,,'~t~'P~I LIABIUTY UMITS ~ ~~
~ ~~ ~ D161~ ~1-~ ~1~
~ ~ED ~ (~. P~.)
~ ~IL~ m & PO
! BI & PD
DESCRiPTiON O~ OPERATIOI~S/L~T~H~CIAL ITEMS
1700 t~'[Z:~ STRKET
~Id[~I;.~F/ELD, CA 93305
__ - .
PBOVIDE DRAWING OFP_HYSICKL ~U_T O__F FACILITY USING SPACE Pi~I3VIDED
i~:L OF ~, F~ING :NFORMAT1I' :, 3T, BE .INC~D]~:) IN ORDER I iATION TO BE
_.~ SAMP~ IZIIATI(:~ D~I~ BY TI-IfS $112.~ #(~ #'
/{,'~ AI~. NATISR W-~r.rs OR SUI~'AC~ ~I~TF~ WITI~iN 100' RADIUS OF FACILITY
A])PLI
J~LIC~
C~f~f~Tl~f8 ·
uofutlit'! G~IP~?IOII s
.B rllll~ll8 Bill ntt ~ll~l Ill TAIIK(II) i) PIPII6 18 S'U Ii ~ d&i) DI,,SP08IO OI ( !Jll~. 'I~TI~ ~ 91~ ~~I~)~
!1~ ~ ~ D.pe.li. mmoo ,us) D~m'--~. ur. mm, ~, .... . ' ' ' : "
11:mu.) .
~ I ' PlPllO ' · ....
· ,,Oll61~lS . .p~ .- TITLI ~ I~k'l~ ~'~/~:
PI%OVIDE DRAWING OF PHYSICAL ~T ~'u FACILITY O~n~ ~,~_ =~' ~ ..........
~T.T, OF THE FOLI~ING INFORMAT MO~'~ BE INCLUDED IN ORDER FOR PL ATION TO BE
· ~-'/TANK(S) ,. PIPING & DISPENSER(S)', INCLUDI~S LENGTHS AND DIMENSIONS
~/NEAREST STREET OR INTERS~TI~
~./c) ANY WATER WFr,~S OR SURFACE WATERS WITHIN 100' RADIUS OF FACILITY.
/ NORTH ~
DIVISION OF ENVl#ONMKNTAL HKALTH
1';00 FLOMSR~STRS'I~T. RAKE.qSFISLD. CA
.,
(80frs) 861-3e,36
93305~ _~
IAPPLICATION
· OF TANKS TO BS~tNDONED
LKNGTH OF PIPING TO
APPLI CATI ON FOR PERMIT~ FOR PERMANENT
CLOSURE/ABANDONMENT OF UNDERGROUND
HAZ~I;tDOUS SUBSTANCES STORAGE IPACI LI TY
THIS APPLICATION IS POR RF. MOVAL. OR ABAND~qO(SNT IN PLACE (II'ILL OUT ONE APPLICATION PER FACILITY)
Clf~MICAL COMI~:)SITION OJ~ MM'~tlALS STORSD
cnxlcAL sTmum (uoN-cmmmtclAL ~,~!
i
DA~ ST~ED' CIiKNICAL PRKVIO~SLY ~
)ESC3IIBE BOM HKfllDOK IN TANK(S) AND PIPIN6 IS TO BE RKMOVKD AND DISPOSKD OF (INCLUDE TRANSPORTATION AND DISPOSAL
DF. SCRIBE BOTH TEE DIS'~ MLTIMM~.*,]~ DISPOSAL LOCATION FOR:
TdJ~(S!
PIPING
-,
THIS FO~M HAS B~EN CG~PLA~ UNDI~q P~TY OF PEIL,VUNY dJfl) TO THB BP`ST OP NY KNOMLEDGE IS TRUE AHD CORRECT.
(PorB #HMMP-140}
,:-MANLE¥ TESTING SERVICES, INC.
)x 1567
rlE1~, C&., 9330~
HOFU4ER EASY TESTING METHOD
" WORK SHEET
, · ~TATE,- ~ CC)DI,
CONTROLS
'-"., FX 898413
Wd 9