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Home My WebLink AboutUNDERGROUND TANK FILE 1BAKERSFIELD FIRE DEPARTMENT BUREAU OF FIRE PREVENTION Date AFFLICATION In conformity with provisions of pertinent ordinances, codes and/or regulations, appliCation'is made .by: Name of Company .. '. Address to disploy, store, install, use, operate, sell or handle materials or processes involving or creating con- diti .OhS deemed.hazardous to. life or property, as follows: iSSued. Permit denied .~-'.~.~...~...~-~...-/'..~ ........ i ........ ~' Date " FILE CONTENTS SUMMARY Activity Date # Of Tanks Comments RE~URCE MANAGEMENT A~;ENCY RANDALL L. ABBOTT DIRECTOR DAVID PRICE !II ASSISTANT DIRECTOR Environmental Health Sewices Det~artment STEVE McCAi I Fy, REH$, DIRECTOR Air Pollution Control District WILLIAbl J. RODDY, APCO Phanning & Development Sen, ices Depazlmem TED JAbtES, AICP, DIRECTOR ENVIRONMENTAL Hmm~' SERVIC~S: DEpA~dTM~? ............. --'- ............. "~ ...... Laura Scudder's P. O. Box 14097 Orange, California 92613-1497 CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANK LOCATED AT 1101 INYO STREET IN BAKERSFIELD, 'CALIFORNIA. PERMIT # A856-14/140014 This is to advise you that this Department has reviewed the project results for the preliminary assessment associated with the closure of the tank noted above. Based upon the sample results submitted, this Department is satisfied that the assessment is complete. Based on current requirements and policies, no further action is indicated at this time. It' is important to note that this letter does not relieve you of further responsibilities mandated under the California Health and 'Safety Code and California Water Code if additional or previously unidentified contamination at the subject site causes or threatens to cause pollution or'nuisance or is found.to pose a significant threat to public health. Thank you for your cooperation in this matter. BARBARA HOUGHTON, HAZARDOUS MATERIALS SPECIALIST 2700 "M" STREET, SUITE 300 BAKERSFIELD, CALIFORNIA 93301 (805) 861-3636 FAX: (805) 861-3429 LAURA SCUDDER'S, INC, BORDEN, INC. SNACKS AND INTERNA'RONAL CONSUMER PRCDUC~ DIVI..~DN ENVIRONMENTAL HEALTH SERVICES DEPARTMENT 2700 "M" Street, Suite 300 Bakersfield, CA 93301 Attention: Ms. Barbara Houghton Dear Ms. H~ughton: This is to confirm that after extensive research, that to the best of our knowledge, the rinseate generated during the removal of the U.S.T. at our Bakersfield location was shipped and received by Gibson Oil/Refining Company in Bakersfield. The U.S.T. was removed in February 1989 and was located at Laura Scudder's sales warehouse at 1101 Inyo Street, Bakersfield, California. Sincerely, Director of Technical Services Borden Snacks/Laura Scudder's. GA J/dm ........................................................ ~ ............... ~ ......... ~'2-5 CITY DRIVE-SOUTH, IF I1~ BOP, BEN-ITS - POST OFFICE BOX 14097 (;0110 BE §000 ORANGE, CA 92613-1497 TELEPHONE: 714/385-5700 FAX: 714/385-5755 .'~.PS Form3800, June 1985 ::'?'!' '" " ' " .i.''. · ' '"' ' ' ..... -. ' . '. '' .' ' " '.' '"' ., ~ ...... ' ~'~'"':-:~ ~'.:"~"~-.'~'~'~-~ ~-a '- '~-..' : : -' ...... ' ' ' "." - '. ' ~' ...... · -.". -' - . - . · *~'. . . · -,,u z when additional ser..=.-_--~~ '**~ ...... *;'.~*~" ~ ...' ' . .- '.'. ' · " · v,~uu are oeslred, a~d complete " " .' .," ' ['address edin the "RETURN TO' Space on th~ rever~e~' 'side. Failure' "~ to do' this will' -' :...,;~ ~{ ~ ~o~~~l~:~prevent this card '- .. ' ,.'.~ :: '~'". :~:::'. :.,.' .ddi,ion. I service,s} requested..,:~.~-:~, . erydto?~ '"" -...~,.,., ..... . .,.:,.. ~.,:..,. c~rg~)=.C;.~.~,,; ~. ....._ . '" "~ ""''" '"~' :' ~' '"~" -- ~- ~.. [~mo~ M~}~'- ~ '-.'...'/ :.., .,. :' . .... , .. ~,.~ ;., signLturea of addressee ;~..- rE .... ---: ?~,, ~: · ." ': ressee ..: . 'ess ', ,. ?',/:}.:,-'~/." .",..,2. .... "'~ ': ...... -.~ ":."~-~. ~ ~': . '~ A,-..~ ~= ' 4..~-:-': 7, . .- . .,. -. '.' .. :./..:..' ' ' -" . .... very ' ' ' '"; ~.';.-' -: ' . ' ' ' '": ' : '" "..' ': '.:. Apr. 1989 *USGRo ',',:' '... .. , ::',..' ' ": '" ,":' ,'. :':..'. ...'. :"....' ,' ,:~ '.'..::, :. -.'. ,,,:':' '--/ '.' .r' ~'. :~ :? '" '."~':?~m ,~'~''r:'~..,'~: ", -'.:'.', '...;"'..~' ' :'''"' .." RESOURCE MANAGEMENT AGENCY RANDALL L. ABBOTT DIRECTOR DAVID PRICE !II ASSISTANT DIRECTOR Environmental Health Services Depan'ment STEVE McC^~ ~ Fy, REHS, DIRECTOR Air Pollution Control District WILLIAM J. RODDY, APCO PL3nning & Development Services Department TED JAMES, AICP, DIRECTOR ENVIRONMENTAL HEALTH SERVICES DEPARTMENT Laura Scudder 625 City Drive, Suite 300 Orange, CA 92668 ATTN: George Jepperson Dear Mr. Jepperson: ' Thank you · / . any questions, ~/. BH:jg' ' In February, 1989, a tank was removed at the Laura Scudder's Warehouse located on ll01 Inyo S'treet, in. Bakersfield. To close out this case the Kern County Environmental Health Services Department needs a copy of the State of California Hazardous Waste Manifest form that documents the disposal of the tank rinseate. Once this information is received by this Department, a closure letter will be issued to your company concerning this site. Please send a copy of the manifest or letter giving the name of the disposal facility within fourteen days of this letter. for your cooperation in this matter. If you have please call (805) 861-3636, extension 5??. Sincerely, Barbara Houghton ~ Hazardous Materials Specialist Hazardous Materials Management Program 2700 "M" STREET; SUITE 300 BAKERSFIELD, CALIFORNIA 93301 (805) 861-3636 FA×. (R~q.q) P,~1-3429 RESOURCE MANAGEMENT AGENCY RANDALL L. ABBOTT DIRECTOR DAVID PRICE ili ASSISTANT DIRECTOR Environmental Health Senses Department STEVE McCAII ;Y, REHS, DIRECTOR Air Pollution COntTol Dist~ct WILLIAM J. RODDY, APCO Planning & Development Services Department TED JAMES, AICP, DIRECTOR ENVIRONMENTAL HEALTH SERVICES DEPARTMENT January 16, 199'1 Laura Scudder ATTN: George Jepperson : Dear Mr. Jepperson: In February, 1989, a tank was removed at the Laura Scudder's Warehouse located on 1101 Inyo Street, in Bakersfield. To close out this case the Kern CoUnty ~nvlronmental H~alth Services Department needs a copy of the State of California Hazardous Waste Manifest form that documents the disposal of the tank rtnseate. Once this information is received by this Department, a closure letter will be issued to your company concerning this site. Please Send~ a copy 'of the manifest or letter giving the name of the disposal facility within fourteen days of this letter. Thank you for your cooperation in this matter. If you have any. questions, please call (805) 861-3636, extension 577. Sincerely, BH:~g Barbara Houghton ._ Hazardous Materials Specialist Hazardous Materials Management Program 2700 "M" STREET, SUITE 300 BAKERSFIELD, CALIFORNIA 93301 (805) 861-3636 FAX: (805) 861-3429 ~,PR 2 0 19"" ._L ............ EnvimnmentaJ Health K~rn Co~]r~y Health ZAL.CO LABORATORIES, INC. Analycioal ~, Consultin~l Servioes ~ :: .: ...... ~ved: _.2-2-89 le Description: ~ ~~ W~~ 1101 ~o ~. ~fi~d, M~_hod: EPA 8020 Date Analyzed: 2-8-89 Ethyl Benzene Toluene Xylenes Benzene I.D. # Description ~/, ~/q 'g~/, ~/q Tank #1, 7500 g-d.]... (gasoline) 17891-1 #l-ASouthEr~ @ 2' 0.05 0.15 0.43 17891-2' . ~l-BSouthEnd @ 6' lab Accid~--nt 17891-3. #2-A North End @ 2' 0.93 2.69 7.74 17891-4 #2-B North End @ 6' 0.04 0.14 0.46 0.06 i.34 O. 08' Level Of Detection = 0.02 ~g/g Dante Analyzed: 2-8-89 Volatile Petroleum h~ns I.D. # Description as Gasoline, ~q/q Tank #1, 7500 g-al. (gasoline) 17891-1 #1-ASotrthEr~ @ 2' 3 17891-2 #1-BSouthEnd @ 6' Lab Accident 17891-3 #2-A NorthEnd@ 2' 51 17891-4 #2-B North End @ 6' 3 Level of Detection = 1 ~g/g '~.'d .......... ,.. i ~ 4309 Armour Avenue Bekersf e d, California 93308 APR I7 t989 FAX (805) 3SS-30S~) · (so5) 3s5-053~ ? ZALCO LABORATORIES INC. P,ye~: ............ ~Ana'l-y-tical--& Consulting Serv~ce-~ ..... ~:~' ...................... LAURA~SCUDDER~S ................. A4are,,: 4309' ArmoUr Avenue ,e,.,.~: G. Jeppsson (Jean)I Bakersfield, CA 93308 M.i~Ck. [], 0,,e 04/11/89 805 / 395-- 0538 ~R~P~o~ O.L a.A. ~. & ,. AmOUm ]000- $447 80' ~366 ' .(Underground tank) Ex.l,..,io.:, Environmental work ro,,~ A~o~., $447 · 80 N., ~mou., o~ C~.~k $ 447 · 80 Requeste~ by ~~ E~ere~ ~: Date Paid Check No. . Voucher No. D. Fairrington Form 6981 3/82 08-150-23-2C-A ,.,.,,, :..:%~..:: E.~rECTIVE JANUARY I t9~9 KERN COUNTY HEALTH DEPARTMENT_ 1700 Flower Street Bakersfield, California g3305 ENVIRONMENTAL HEALTH DIVISION Telephone (805) 861-3636 Fact 1try Name HEALTH OFFICER Leon M Hebertson, M.D. DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Relchard 'Kern County 'Permit #' *, * * ~IAILING INSTRUCTIONS: Fold In half and staple. Postage and mailing label have already been affixed to outside for your iconvenlencg. (Form #HMMP-150) . .... '- · O;STRICT OFFICES Delano . Lamont ' ~ke Isabella Mojave R dgecrest . Shafter . ~ft : ... ~.:..~i.: %:"' "i": ': '* * ONDER~ROUND TANK DISPOSITION TRACKIN6 RECORD *'* -,' " . :-'.' ~"Th~';' forB' la to ~e* returned tO ~h'; K;;~ Co..tY'-Hoalth D;part~e"t""ltht~ 14 '::~':"?' *,.':~"*~days of acceptance of .tank(s)"by-disposal [::°r recycling .facility. :~T~ holder o[ the-e~=it ~ith number ,noted above Is ~esponsible .for ,insuctng ,::&-~,:,-':: -*:Ga:~;.that this form i's completed and returned. :>::.: .< ::.:..:.~' . '~}:'~.SeCtion-x~54,~:~?~ '.~tiled ~ut'~ ~ank removal ~ntractor: / 2:~i:..~i~/:-:(?'::,.~':; ".~?%?:t?:'.~k;::::'?~:~:~2:' . ~ .... :~.:~'*~'. 5 *'~% .~''" / ~' ~:*~ -~: :. -- -.[: , - .. ~' .:,: ,c.~ · *:':: '-'/",'-". - % :. :: - '. ....... ~' ' ' '""->'~:" -'":"*: ';:~ ..... :"' ....... .*'.'of Tanks~~ { ' :.~' . ',:% ::~'.,:..~:~." .... ' . ' ~ . ~:~ ,. , .' :-.~:~ .... . .. ~,.- ......... '. ~.:c,~.;:~5;:~.:: ..-,;,,,,:.;-,7:,.':. · ~:: · .,,>.,.':..:. ~,:~,?,.%., ~,~:: . .- . . ~':'-'.':'. ..... . .' . . . . * ~ -.,,~?.. .; . . ;- . . ~ . ,. ...~ ..~ .-.. ~cttoa 2 ' T~ be filled ~u~ ~ contractor "d'~con~a~lnatlnff tank(s).: .- -" . ' ' Tank "~egonta~inatton" Contractor' ..'.~. Address Phone t _ Zip ': -"."~ ,~Authori~urepvesen~a~l~,.of'~co~tractor certifies by signing below that tank(s) have been decontaminated tn accordance ~ith Kern County Health . .. Department requirements. ~: ': ~ ~' ,~:: ., .... .'.. ... Signature [' Title . . ::.:.:. Section ~ -T~ b~ [illed out sad signed ~ a~ authorized represeatatlve o( 'the treatment, storage, o: disposal [actltty acceptJn~ tank(s): .:. :' zip ' Date Tanks Recked ~-3 ~'Y NO. of Tanks / :, .-. {AUth~z;'d Representative ) / ..' "'"- ' KERN COUNTY 2?00 'M' Street, Ste. 300 Bakersfield, CA 93301.., " Environmental Health Department ..... --. :-..:";:.'-:'::: ..... ".'-'. '-'-, ??.-~:',:'.'.?:.:'.~.~:":'.~' :~.: .' .: ,~.::.-/.t~'~%,/L~?,i.j,.l'~,~'~'~ ....' " ' ', "~ *~':" ' ' ":~. : - '-~ ' -~ .~.'"-~ :' I~¥~.~=~k.i.~,of/~_~\ "- ..... : -- - ..". ....... .'-:- '. - " · - -- ' ' · -\~~~7,~7 -": . ; ,: -. ::L'-::-2%';;,-2 : :~'~::?'~-:'~,~,'.:..::??,!:.:-: : OF. UNDERGROUND .HAZARD.0.U.S ...-,;,.;? ~:;::, :-~., .~::.>.~.~,T; ,::4.?. .... f:"'.1101 ~;Inyo St .... i25 'No, ::RaYmond [~:e~;:(,["';~, . ~ox'"57; .. BakerSfield, 'CA :'?r'~'"' :'" i'i":' [:'i:. 'Anaheim , .'CA ' -;'" -: :'?i?.~'?'t~':':i~'':':':':~'Edison, '¥'CA' '93220 ..: ._. ..... - , .... ~:' ?'...i:,.;:;.:.':' ~,.-.- , .'-...-, ..:',: .-. :.-.,..',:.J,., ~.:;-'.:--:::'~;.~l:;-:[':~:;.~:-- nicene ~A534641 .:,T.~ %'. - pER~XT' ~OR CLOSURE 0~ - :" PER, mT mXP~RmS '" ': '-'"'~priz"~,' ~'989 ...... :'"'?:::., ..';' . ':: .... ,,t-.'.'_.. :::,-..:-/ .:' :. ". ,.. ::[:;."?. :;~/i'[. '.'. ' ' ', '-:'.'.':.l .... '::' '~':" "'-". ..... :'"~Ja~ary' 23',":'1989':~?f?~ :;f:::" ..' ! T~NK(S) ' ,~T ~BOVE - .~ .-:: ~PPROVA~ DATE . .. . .. .,... :--. .. ._ , . ..[... . . . ..,. -~ Janis Lehman - . .-,.-:.:~' .... :. -,"-;(.,:.-7:,' :::-':'::-..L --::.?t',: ;. ""-'' _:. ', :"- .' ." :: ;.-.' "-.' '- :/,':':-;- :' ?~,?..-~'-,? t.-'-. "."." :'": -"'~:-: "': t~-[ 'fl '~.-~ "J-'l"'; POST ON PREMISES. ;~:. ';';: .,: ~: .. · ~'". ............. ~ '-, -; t. ', · . "-. CONDITIONS AS FOLLOWS: .:.':.: ?' j:"::' ..:: ...;,'.':....'~..-', ".;v ::~;,:,-.'.'.~:.'t;;~... : .... . ':.?" ..... -.~-n 1 · It is. the responsibility of .the Permittee to Obtain Permits-which may be '.',:2::~equired bY other'.regulatorY agencies prior to beginning work "'-"' ::: ?:-.-.- . ..~:,~ . .. . , .... · 2. :.~.Permittee must obtain a City Pire Department Permit prior to ':initiating · _ ' ' closure action. ' :; ::- :.' '.::'L. '- "-:'.'"' .:, ' "':.' ':'"'':::-'~':::':t:-'""" ' '"~"'-~ ......... ' 3. "Tank closure activities must'be Per Kern county Heal~h"and Fire. Department . , . .. :... .-, ? '-:.'., ..3-. ".% .'~.'~:...... -:...' '~. approved methods as described in Handboo~ UT-30. :~.- .... ....: ' :4 ' ' ' ..::..:. ~ S o i i Samp i lng ::: .~".' ':.:: ~:.-t ~: ..... '-: .~ . ...: :,.. :.,. :.... ~; .: .:. ~.':::?:~ .:.-::(:.::.:' ~' ..'. :'.:' .. 2, :-;'-'f: ?:.~ :::[ ::.?_::.[.~' ~:T"~ ~ny deviation from Sample 'locations ' and 'numbers or Constituents':::'to'::be :'.:~ ~,.'::?~;,~.::::.'.?aampled for which are described below and in Handboo~ UT-30.must receive '.'~': '-:-"; :"~:'";,%pr i or' approval by ~he Health Department ..' ::[~¢;~;?-~[~:~(??::?'~': '~:'.:':.::':~?,~:~':? ' : ':"~-:: ":' a. (Tank, size between ~,000 ~o 10,000 g~110nS)'"~'.minimum o~ :~our samples ".:' ,"-.. ~: .' '.'must be retrieved one-third o~ the way in fro~nds of each " . " ...~'. -at depths o~ approximately t~o ~ee~ and si~ ~ee~. :. --"."..~.' .... '5. " ' ~ any contractors or dispoS~l facilities other than those listed on permit by the specialist listed on the permit~ Delano · Lamont · L~ke I~:alla · Mojave · Ridgecrest · Shafter · Taft · 'i':i~-7~'a. '.. :'A/ii (leaded/unleaded) gasoline. Samples must be analyzed for benzene, · ~'~.ij?!.~/?i[%i~:i:toluene, xylene, and total petroleum hydrocarbons.-',,--. ..... i:i~,:8. Dies ~-of .*:;~transportation '!~%'manifests ~must .be submitted ,;~to .the Health ~art:~ent"~tthtn five day~".of :Waste '~tspoSal. ' .............. ~:" 1 ~appllcable 'state ..'laws :~for hazardous waste diSp0sal'?:~t=ansportdtton? -:~'~--C0r :treatment must be 'adhered to..:,:,.::-~n 'Kern County Health~epart~en " "~;'be "nottft.d before moving and/or disposing of any contaminated 10. ...-:~Permtttee ts responsible 'for making sure that "tank disposition tracking · ~_-~;;/~=eco=d". issued with ~his permit ts.properly f~lled out and returned within -: -~ *:' ..:::.L:i4 days of tank removal.' ': ~:'~'-.'.:~:::':' ........ * . .' .... ~:: '~ :'~:~:--' ' 11~' '/.')'.Advise this office of the tt~C'and date of the proposed sampllng with 24 ~--. hours advance notice.' ':.:'..~ "' ' ' - . :~'-: 12' : '-~[:R~sults ~ust be submitted to thls offtce within three days of analysts ~IC~ COJq~l?lOII Ig JfJJllJJ ItlJJllJ TAm[ · vg, ims C~IxIc~, 8TmI~ (lUl-(nllm:ZAL IdOlS) s I GL~TUR~ fi TITL~ ( [~011 ~lO01P- 140 ) , CLIENT PROJECT SUBJECT JOB NO. SHEET · MADE BY CHECKED BY ....... REVISED. BY, Of DATE DATE DATE F1 88 KERN COUNTY ENVIRONMENTAl. HEALTH DEPARTMENT. -, :., . _:: - · -, .,.: .- . , ,, .., :.;',;':.. ; ' ' ,. · , ' : . '., ':-:~ ':-:.'.,-..;;:'~',C. F. II.E ,JONTEN'rS IN~,'E~ITOH¥ Op~'~at. i /~/~ . ' Date Date No. of Tanks Date Fac t ! i c¥ I~lPerm i t to [']Construction Permit ! [~Permit to abandon! [~Amended Permit Conditions I~elPermit Application Form, ~Appllcation to Abandon ............ f'] Annua 1. =Rep_o.r-t=-_E orm s / .... ~a ~'k' She's t s', P Icr~ tanks(s) Date , , , ,, .... ,,~ ' ~, I-1Copy og Hritten Contract C]lnspect ion Reports ,, C]Correspondence - Received "Between owner"& 0per~toF .... I"lCorreapondence - Nailed " Reports Unsuthorised Release 'Abandonment/Closure Reports '.' , ,., i,.. [1] Sanpl lng/Lab Reports I"l#vi~ Co~pliance Check (#e~' 'CoflnttUctX'o'n Checklist) r'lSTO Compliance Check (New Construction Checklist) I-INVLe Plan Check (Mew Construction) [~]IITD Plan Check (New Construction) C]NVr plan Check (Existing Pacllit¥) STD Plan Check (.Bxisti~q Facility) ~ Incomplete 'Appl · - Date I-l~ermit Application Checklist Pormlt Instructions r'lDi scarded Tirjhtneas Test Results ...... [~JHoflltorln9 t~ell Construct't'ofl Data/pe'~mits ~Enviro~ental Sensitivity Oata~ Grouad~ater Drilling, Boring Logs ~Statement o~ Underground Conduits Date Ds'ti .... Date Da te - ~]Plot Plan featuring All environmentally Sensitive Data l-]Photos l'lConscructl°n Drawings Location: I-IHalf sheet showing date received and tally of inspect(on time,' ~tc C]Hi scel laneous ~ , ~ 170oFl°wer Street HN COUNTY HEALTH DEPARTMENt' HEALTH OFFICER Bakersfield, California 93305 Leon M Hebert-~on,*M.D. Telephone (805) 861-363~ · ENVIRONMENTAL HEALTH DIVISION - :...~' ' ~ DIRECTOR OF ENVIRONMENTAL HEALTH .....~ ' . . , : ':'.....' *'" "':' f~ ,' Vernon. S. Reichard * UNDERGROUND HAZARDOUS SUBSTANCES \~~~/ ' . "' .' ...... ~-.~=~S.T~ORAGE_.F~ACILI.TY__ . ;-:i~~-~ ........ NUMBER._OF TANKS= i *~ , .' '- *: LAURA "SCUDDER!S, INC. *,~:-*~?:'.~'..?:5~::~:k,, ~,: ..;" ,~,'~'::~.:-..~?<.*~. '~ ~ :. ~ 'i ~ : . * . . .. -' ..': . ' .. '. . ' ','~.' -: :.. '**"L"" ~ NOTE: ALL :~NTERIM REQUIREMENTS ESTABBISHED BY THE PERMITTING - DATE PERMIT MAILED: iAUG 2 5 .. . DATE PERMIT CHECK LIST RETU~TED: 1986 Kern County Health Department [~ivision ot Environmental Hea ~..Facility~..N~__me.' .Laura Scudder's, ..I_nc._ ............... ._ _ ...... :No. of Tanks 1 Type of Susiness (check): [2]Gaso~ine Station ~Other (describe): Warehouse IS Tank(s) Located on an Agricultural Farm? [~yes ~]No Is Tank(s) Used Primarily for Agricultural Purposes? DYes [] NO Facility Address 1101 Inyo St. ' Nearest Cross St. Kentuck7 T R SEC (Rural Locations Only) Owner Laura Scudder ' s, Inc. Contact Person Bill Ludwig Address 1525. N. Raymon. d Ay.e.., Anahiem Zip 92801 Telephone 714/772-5151 ~.~Oper~t_o.r Same .. · ' .Co_n. ta.¢_%_.._.~.~on -- Address --- Zip -- Telephone -- Application 1700 Flower Street, Bakersfield, CA 93305 "~PPLICATION FOR PERMIT TO OPERATE UNDERGRC~iND HAZARDOUS SUBSTANCES STORAGE FACILITY Type o__~fApplication (~heCk): D-]New Facility []Modification 'of Facility []Existing Facility D']Transfer of Ownership A. f~nergency 24-Hour Contact (name, area code, phone): Days Don FairringTon 805/3Z4-9Z46 Nights Don Fairrington 805/397-9142 B. Water to Facility Provided by City of BakeYsfield --- Soil C~aracteristics at Facility Unknown Basis for Soil Type and Groundwater Depth Determinations C. Contractor -- Address Proposed Starting Date Worker's C~mpensatio~l Certification J -Do Depth to Grou~lwat~r Unknown CA Contractor's License NO. Zip Telepho~ Proposed C~pletion t~te Insurer If This Pemit Is For Modification Of An Existing Facility, Briefly Describe Modifications Proposed N/A · ~.. Tank(s) Store (check all that apply): .Tank J Waste Product Motor Vehicle Fuel Unleaded Regular Premium DieSel Waste F. Chemical C~mposition of Materials Stored (not necessary for motor vehicle fuels) · Tank J Chemical Stored (non-co~ercial name) CAS J. (if known) Chemical Previously Stored ' . (if df'fferent) Transfer of Ownership Date of ~-ansfer Previous Facility Name I, Previous Owner m~dify or .terminate the facility'upon receiving this-c~mpleted form. accept fully all Obligations of Permit No. issued to I understand that. the Permitting Anthoritymay review and t~ansfer of the Permit to Operate this ~dergro~d,storage is This fora has been c~npleted under ~.,nalty of true and correct. // perjury and to the best of my. knowledge Director Tech Title Services Date 4/10/80 TANK ~ .(FILL OUT SEPARATE FORM FO ~H TANK) FOR EACH~ SECTION, CHECK ALL APPROPRIATE BOXES H. 1. Tank is: OVault'~d []Non-Vaulted []Double-Wall []Single-Wall 2. Ta~ Mater ia'l [] Carbon Steel [] stainless Steel [] Polyvinyl Chloride [] Fiberglass-Clad Steel ~ Fiberglass-Reinforced Plastic []C, oncrete [] Aluminum [] Bronze [~Unknown' ~] Other (describe) . 3. Primary Containment 'Date Installed Thickness (Inches) Capacity (Gallons) Manufacturer 1966 Unknown 7500 Unknown ........ ~-. .... Tank Secondary ~'0~tainment []Double-Wall ~Synthetic Liner []Lined Vault ~]None []UnknOwn []-]Other (describe): Manufacturer: [] Ma ter ial Thickness (Inches) Capacity (Gals.) 5. Tank Interior Lining ---~Rubber '[]Alkyd' ~Ep~xy. [']Phenolic []Glass Ii]Clay [[]Unlined [~]Unknown []Other (describe): 6. Tank Corrosion Protection. []-]Tar or Asphalt []Unknown ~lNone [[]Other (describe): Cathodic Protection: [~None []]Impressed Current system ['1Sacrificial Anode System Describe System & Eguilauent: 7. Leak Detection, Monit0rin~, and Interception a. Tank: ~Visual (vaulted tanks only) ~Groundwater Monitoring' Well(s) []Vadose Zone Monitoring Well(s) []U-Tube Without Liner Se 10. ~[~U-Tube with C~patible Liner Directin~ Flow to Monitoring Well(s)* Vapor Detector* ~ Liquid Level Sensor [] Conductivit~ Sensor* , [] Pressure Sensor in Annular Space of Double Wall Tank- ' [] Liquid Retrieval & Inspection From U-Tube, Monitoring Well or Annular Space ~-]Daily Gauging & Inventory Reconciliation [~Periodic Tightness Testing [] None ~ Unknown ['] Other b'. Piping: Flow-Restricting Leak Detector(s) for Pressurized Piping' [] Monitoring S~np with Raceway . [] Sealed Concrete Race~ay I-]Half-Cut Compatible Pipe Raceway []Synthetic Liner Raceway ~]None [] Unkhown ~ Other · Describe Make & Model: ~en Tightness Tested? [~]Yes []No •Unknown Date of Last Tightness Test Results of Test Test Name Testing Ccmpany Tank Repair Tank Repaired? ['lyes [-]No ~]Unknown Da te (s) of Repa ir (s) Describe Repairs Overfill Protection ~--Operator Fills, Controls, & Visually Monitors L~vel '- []Tape Float Gauge [']Float Vent Valves []Auto Shut- ,Off Controls [-]Capacitance Sensor '[].Sealed Fill Box []None [~]Unknown []Other: List Make & Model For Above DeviCes 11. Pip:ng a. Underground Piping: []]Yes []No []]unknown Material Thickness (inches) Diameter ~,, Manufacturer []Pressure []Suc~i'on [']Gravity Approximate Length of Pipe R~ b. Underground Piping Corrosion Protection : ............................... []Ga!vanized .... [-]Fibergl'ass=Cl~ad .... []Impressed-~Cur.rent '[]Sacrificial'~:An~de ' BPolyethylene Wrap []Electrical Isolation ~Vinyl Wrap []Tar or Asphalt Unknown [~]None []Other (describe): c. Underground Piping, Secondary Contai~uent: · []Double-Wall []Synthetic Liner System ,[~None ~]Unknown []Other (describe): Facility Permit# PERMIT CHECKLIST This checklist is provided to ensure that all necessary packet enclosures were received and that the Permittee has .obtained all necessary equipment to implemen{ the first phase of monitoring requirements. Please complete this form and return to KCHD in the self-addressed envelope provided within 3__qO days of receipt. , Check:. . ~- .. ~ .., ..,¥., Yes No '~ .."' ..:~ .~:? <. . A.. The packet I received contained: ~ 1) Cover Letter, Permit Checklist., Interim ,.-Permit, Phase I Interim Permit . ' Monitoring Requirements,. Information Sheet (Agreement Between Owner and ....... -bp~ra't~'},"~":C~a~t~e~-'' 15 .... (KC0C ~#G'~3941")'; ..... EXpIanatid~=~'~'f'-:~ubs'~nc~':-C~a~s; Equipment Lists and Return Envelope. 2) Standard Inventory Control Monitoring Handbook 8UT-10. 3) The Following Forms: a) Inventory Recording Sheet b) Inventory Reconciliation Sheet with summary on reverse c) Trend Analysis Worksheet 4) An Action Chart(to post at facility) B. I have examined the information on my Interim Permit, Phase I Monitoring Requirements, and Information Sheet (Agreemen~ between Owner and Operator), and find owner's name and address, facility name and address, operator's name and address, substance codes, and number of tanks to be accurately listed (if "no" is checked, note appropriate corrections on the back side of this sheet). C. I have the following required equipment (as descri.bed on page 6 of Handbook): 1) Acceptable gauging instrument 2) "Striker plate(s)" in tank(s) 3) Water-finding paste D. I have read the information on the enclosed "Information Sheet" pertaining to Agreements between Owner and Operator and hereby state that the o~ner of this facility is the operator (if "no" is checked, attach a copy of agreement between owner and operator). I have enclosed a copy of Calibration Charts for all tanks at this facility (if tanks are identical, one chart will suffice; label chart(s) wi~h corresponding tank numbers listed on permit). F. As required on page 6 of Handbook #UT-10, all meters at this facility have had calibration checks within the last 30 days and were calibrated by a registered device repairman if out of tolerance (all meter calibrations must be recorded on "Meter Calibration Check Form" found in the Appendix of Handbook). G. Standard Inventory Control Monitoring was started at this facility in accordance with procedures describ~ in Handbook #UT-10. ' Sisnature of Person Completin~ Checklist: Date: TAIT & ASSOCIATES, INC...' j( ~ '~"~ ~::,[ ~ X,] .["~ . SHT. OF PR; :CTLA~A DATE I (2- "L ',~- ~ .BY 'J'' '~' PLoT 'PLA~ , ~ues t i onnai re Normally, permits are sent to facility Owners but ~'ince many Owners live outside Kern C°unty, they may choose to have the permits s'e~ '~-:i'h~-:~Per~b.~s '"of the- 'fac i=I i'ty where'- they' ar~ t'0 --b~-:' pbs t:'ed ':~-~-~ -=-=:..:-' ...... ----~ 'Please fill in Permit # and check' one of the following before returnin~ this form with payment: . .:,'i. '- ". Operator, it will be Owner's responsibility --!.'.- :.. · ' ' '-'~"["... to provide Operator 'with information).. 2. Send all information to -. following corrected address: O~ner 3. Send all information to Operator: Name: Address: ' · · : (Operator can m~e enp¥ of' uermtt for / ~101 In. Street, Bakersfield, CA; .:~. ~J. 'L. / /' ' copies of information to: .Ms. Ami Mehta, ~ " / c/o Laura~cudder's,' 1525 North Raymond Avenue, '-/ / Anaheim, ~A 92801. 'Any questions, please call.~ /