HomeMy WebLinkAboutUST-REPORT 09/19/1989 GARY J, WICKS
Agency Director
(805) 861-3502
STEVE McCALLEY
Director
RESOURCE
2700 M Street, Suite 300
Bakersfield, CA 93301
Telephone (80S) 881-36.18
Telecopier (805) 861-3429
September 19, 1989
Chester Jost
320 Oak street
Bakersfield, CA 93304
Subject: Location :
Known As :
Permit :
Dear Mr. $ost:
320 Oak Street, Bakersfield, CA
Jost Floor Company
# 190001 '
The report submitted to this Department by B.C. Laboratories Soil Report
summarizing the site characterization and remediation activities at the above
referenced location has been reviewed. Based on curi'ent requirements and
'policies, no further action is required at this 'time,
It should be 'pointed out that this letter does .not relieve you of any
responsibilities mandated under the California Health and Safety Code and
California Water Code if existing, 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. .
Additionally, be advised that changes in the, present or proposed land use may
require further assessment and mitigation of potential public health impacts.
If you have any questions you may contact me at (805) 861-3636. '
Sincerely,
, ~Jora Darling, R.E.H.S. /
Hazardous Materials Specia~t . ,
HaZardous Materials Management Program
FD:cd
flora\jost~h.m40
t
I
· ~' ...... F: KERN COU ;4TY~ ,,,,-~ '
8ekersf~e]d, CA 93301 .Enviro~en~ He~ Semites uep~' ' · ~. -::
':'-: ;?-'OP UNDERGROUND HAZARDOUS ' ~:"::~~~~~ '::.". [,.'.-",:.' ~';' "':? "'"':.:;--:'::?-'~::::..:
SUBSTANCES S TO.GE FACILITY '~~~7 - ' ' 11''11
joS't"Flobr C°."'~';- :' ~-''' : '...','chester Jost :'?."',~ ;' ":'~/.,';.."-' ::~o~tS0n Construction
3 2 0 Oak'S t'; · ':;:~c.~?~.::~.-/:' ..,': ,:-.~?~'-. Oak St...':.~';,;~,h~ O1 ~ve Dr .~, ?~?~.~;~:%'.,~;%?~: ~.:,~,' '
field -,:;:CA .793 3.04 ..........
:..~ ...`-'~.. Dan Starkey ,, .,..-:,..~i~i,,,~??:..,;...
...............
CONDITIONS AS FOLLOW:
~. It is the responsibility of the Permittee t° obtain permits which may
required by other regulatory agencies prior to beginning work.
· 2. ..A copy of this permit has been provided to the Kern County Fire Department.
~ermittee must notify the County Environmental Health Department at (805)
861-3636 two working days prior to tank (removal) to arrange for required
inspection(s).
3. Permittee must obtain a City Fire Department permit, prior to initiating
closure action.
4. Tank closure activities must be per Kern County Environmental Health and
Fire Department approved methods as described in Handbook UT-30.
5. Soil Sampling
Any deviation from sample locations and numbers or constituents to
sampled for which are described below and in Handbook #UT-30 must receive
prior approval by the Environmental Health Department.
a. (Tank size 1,000 gallons or.less)-a minimum of two samples must be
retrieved beneath the center of each tank at depths of approximately
two feet and six feet.
6. If any contractors other than those liste~ on permit and Permit application
are to be utilized, prior approval must be granted by the specialist listed
on the permit.
7. Soil sampling (piping area)
A minimum of two samples must be retrieved at depths of approximately two
feet and six feet for every 15 linear feet of pipe run and also near the
dispenser area(s).'
' OF ~NENT CLOSURE '"'.'_ ';: ....... :::'? ~ '. ' ~. ::.'~ .....
::.:."3:;. UNDERGROUND HAZARDOUS .::,.~--::;':':':%"f::.::~:<:::::'<~:: ~:::~,-::_':::~?::::'::::"':::'~:::?"::::::-~ER~I~ NUMBER 'A901219
j. . .. . . . . . - ..... :.--.: . .... :;-._..< . .:~--' :::::~.~- ~,..: ·
'. 8. ' Sample Analysis ' ' · ,.- : :.....:. .
' ...':. ..,. a .... :.All (leaaed/unleaded) gasoline samples must be a~alyze~ for benzene,
' .:' ~::'-?.':-::::":'~'"':'J:'~'toluene, xylene, and total'~etroleum
' .- ~9..'~ :::~- Copies ':of "tran . . __ . hydrocarbons
I . ':-"-~ Department wi ~ ~..i _ . an~.fes~s ~ust .:be ::submitted
-: ........ ~ th~,, ~v= ' ~. ....... the Heal
~:, .-.? ...... ., da s of ..... ,. .......... th
. · .~ All applicable state laws for:':hazardous waste
- . ,' .." 'or,treatment must be adhered' to. . The _Kern County Environmental Health
:::;:2'::' '"'":'~'"::' ermlttee is responsibI~ o: 'making. sure
..:~c~rd".~.issued with this Permit is ~ro~e-~ ...... ~s~os: :racking
'1'~ ~a s of tan :. ~ ~ ~.~ ~ille~. ou= an~ retur '
~ ' .., Y ...... .. k removal. :-.,. :.::::.v.~..?> .... :-.. ..... '~_~. ned within
,' ' ~'.':" ' .. * .:,::~ .......... z ........', ate of ,:th "~'
hours advance, not~ .':~:::::~:~::~:~:,:~::e~,::"~:~::-~:::-::~:.?~,~:-~.,:~roposed ~:samplin~
' :.,::::::[,~:::i:::.:'.:-':,.'::",':.'-::'. '-. :3-:.::- -.' · ..... :..:.. ..... .,..: ::.. - ,.i:::- :.. :::':.., ".
/
DS: dr
dan~jost
KERN COUNTY H~ALTH DEPAR.TMENT ..
DIVISION OF F. JJVIHONMERTAL HEALTH
1700 FLOWER STREET, BAKERSFIELD. CA 93305
(805) 861-3636
INTERNAL USE ONLY:
APPLICATION DATE
THIS APPLICATION IS FOR
APPLICATION FOR PERMIT FOR PERMANENT
H~zLOSURE/ABANDONMENT OF UNDERGROUND '
,A~RDOUS. ~UB~'X'.A~NTC~--S ~TOR.~.~iE FAC T
[~ RENOVAL. OR [] ABANOONNENT IN. PLACE (PILL OUT ON_~E ,~PPLICATION PER FACILITY)
z
PACILITY NAME
ISEC/T/R
(RURAL LOCATIONS ONLY)
TANK REMOVAL CONTRACTOR
PROPOSED PROJECT STARTING' DATE
PRELIMINARY SITE ASSESSMENT CONTRACTOR
P/ORKER'S CONPENSATION ·
ADDRESS~
INSURER
COMPENSATION ·
INSURER
,
PHONE
( ) -
{
LABORATORY THAT WILL ANALYZE SAMPLES ADDRESS PHONE
CHEMICAL COMPOSITION OF MATERI,~ STORED
TANK ~ VoLuME CHEMICAL STORED (NON-CONNERCIAL NAMe)
DATES STORED
TO
CIiENICAL PREVIOUSLY STORED
WATER TO PAC:LITY PROVIDED BY , -- /'~ . ' IOEPTn TO GROUND#ATER
I
~lS "OR SOIL ~PE AND GROUNDWATER DEPTH DETERMINATION ~ - -~ ,
DESCRIBE BOTI! THE DISPOSAL METIIOD
PIPING
:'~'~'"""':";' ..... · -.::.AUTHORITY ~4UST BE I~IET DURING .THE TERI~ OF THIS ,PERM
NON--TRANSFERABLE
JUL [ '1 1996
DATE PERMIT MAILED:
DATE PERMIT CHECK LIST RETURNED:
ANALYSIS
PETROLEUM
*J°st Floor Covering
320 Oak St
Bakersfield, 'CA
Attention:
Lab'No.:
Sample Desc:
03-Aug-89
Constituent
Benzene
: Toluene
Ethyl Benzene
p-Xylene
m-Xylene
o-Xylene
Total Petroleum
<SOIL)
Analysis Report~
Results Level
6020-1
15' Jost Eloor -'320 Oak St -
8/03/89 @ 8:30 am
Re:x~rting
Units
ug/g none detected
ug/g none detected
ug/g none detected
ug/g none detected
ug/g none detected
ug/g none detected '
O. 02
O. 02
O. 02
O. 02
O. 02
O. 02
ug/g
none detected
5.00
TEST METHOD: TPH for gasoline by D.O.H.S.L.U.F.T. method.
'Individual constituents by EPA method 8020.
Dry Matter Basis
California D,O.H.S. Cert. #102
ENVIRONMENTAL HEALTH
LABORATORIES, INC.
J. J. EGLIN, REG. CHEM. ENGR.
4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308
BTX QUALITY CONTR05 DATA
PHONE 327-4911
Jost Floor Covering
320Oak St ~'
Bakersfield, CA
.Attention:
Lab No: 6020-1
Sample DeSc: 15' Jost Floor -.320 Oak St
8/03/89@ 8:30 am
Spike ID: 6059-4
Analysis Date: 04-Aug-89
Sample Matrix: Soil
Units: ug/g
Constituent
Benzene
Toluene
Ethyl Benzene
p-Xylene
m-Xylene '
o-Xylene
TFHGas
¢
Sample
Conc.
ND 5.01
ND 5.03
ND 5.09
ND 5.02
ND 5.11
ND 5.03
ND 301.06
Conc. Spike
of Spike Dup
Spike % Rec % Rec
89.43 93.58
99.63 103.49
93.19 97.15
95.14 98.75
97.69 101.33
97.66 101.55
110.47 100.66
4.54
3.80
4.16
3.72
3.66
3.91
9,29'
QC Comments:
Spiked Sample Concentration - Sample Concentration
........ X 100
% Recovery = (Concentration of Spike)
RPD(Relative Percent Difference) =
Spiked Sample Conc _ spiked Duplicate SamPle Conc.
· X'IO0
(Average Conc. of Spikes)
Client:
Name:
Address:
Attn:
SamI
Name:
Address:
Lab # Description:
tt . ·
· BC CHAIN OF CUSTODY
fie Type:
Water
Soil
Sludge
Oil
Other:
'(specify)
Other Tests
NO. L- 2901
Analysis Requested:
n~~ Time:
White: Remm to Customer with Repon
Yellow: BC Lab Copy
Received By:
Date:
comments: .
Time:'
KeR~ .comrrv a~.Ta DePARTm~
e~IRO~m~ sr~u, Te OrWSrO~
CALL PLACED/REcEIVED BY:
( NANE TITLE),':
PARTY REPRESENTED:
TELEPHONE NUMBER:
SUBJECT:
,/'
E:d: EAE:F,F'ATOR I ES
F F: 0 ' ~, · - .
B C Laboratories, Inc.
3014Union Ave.
Baker~field, CA 93305
. ' ?. 15. 1989
LABORATORIES, INC.,
J. J. EGL1N, ItEG. CHEM. ENGR.
4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308
B,C_Lah~atorie~. Inc_z__.: .....
i~'~<~vidual sendin~ transmittal:
~:.,'~,~r of pages to follow: __ ~ ~ ....
PHONE 327:491 i
Amj problems with transmission, ple~e call (805) 327-4911 ext.'Z24
FAX Numer (805) 322-5444
CHEI, IIC. AL
PETI~OLEW¢
LABORATORIES, INC.
j. j,'EGLIN, REG,.CHEM. ENGR,
4100.PIERCE RD,,. BAKERSFIELD, CALIFORNIA 93308
PHONE 327-4911
Purgeable Aromatics
(SOIL) . ~.
Fortson Conmt~uction
3218 Renegade Ave.
Bakersfield, CA 93306
Attention:
~b~.:
4682-1
Jolt Floor Co, Oak
Fast Tank 2'
Dat~ of
RePort:
13-Jul-89
D~.~[ ~L~.
COLLECTS:
14-Jun-89
.onsti%uent
DATE SAMPLE
F~CEIVED @ ~:"
14-Jun-89
Analysis
Results
ug/g none detected
ug/g none de%ected
ug/g none de~ec~ed
u~tg none detected
ug/g none de~cted
ug/g none detected
DATE ANALYSIS
~XD:
27-Jun-89
Reporting
Level
0.04
0.04
0,04
0.04
0.04
O. 04
To%al Petroleum
none detected
5.00
TEST ~40D: TPH for ~a~c!ine by D.O,H.S, L,U.F.T.' me~.
Indivtd"~! constituents by EPA method 8020.
'Dry Ma=~er Basis
California D.C.H.S. Cert'. ~02
J, J. Eglin
.59
.EH~RON~N~L
PETROLEUM
LABO RATO'RI ES, INC.
' ' - J, ,I. EGLIN, ~EG. CI~£M.ENGR,
4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308
/ Fo~on ~on~%ruction
3218 P~negade Ave.
B~kersfield, CA 93306
A~ntio~:
P~rgeable Aromatics
(SOIL)
~ate of
Report
13-Jul-89
No.:
~le Desc:
4682-2
Jos% FlOOr Co. Oak St.'
East Tank 6'
PHONE 327-4911 ·
bATE
COLLECTED:
14-Jun-69
.,as'ti ~ent Unitm
DATg ~PLE
~IVED $ LAB:
14-Jun-89
Analysis
Result~
P~_ .,:e ~g. none de~ected
Toguene ug/g none d~d
Ethyl ~enzene ~/g none detected
p-X~lene 'ug/g 1,81
m-Xylen~ ug/g 2.94
o-Xylene ug/g 4.92
DATE ANALYSIS
COMPLETED:
27-Jun-89
Total Petroleum
Re~or~ng
~evel
0.04
0.04
0.04
0.04
0.04
0,04
588,92
5.00
TEST METHOD: ~ for ga~olin_e by D.O.H.S.L.U.F[T. method.
Individual constituent~ by EPA method 8020.
Dry Matter Basi~
California D.O.H.$. ~r'~. ~t02
J. J. Egltn
F. ortson Cormtr~ction
3218 Renegade Ave.
Bak~.rsfield, CA 93306
At~n%i~:
DATE SAMPLE
COLLECTED:
14-J~n-89
Constituent
LABORATORIES, INC.
J, j. EGLIN, REG, CHEM, ENGR.
4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911
P__~ ruble Aror~tics
(SOIL)
~: 13-Jul-89
4682-3
DATE SmiLE
~CEIVED @ LAB:
14-Jun"89
Reporting. Analysis
Unt~ Eesults
Benzene u~/g O, 77.
Toluene ug/g 1.22
Etb~l Benzene u~/g 1.94
p-Xylene ug/g 11.32
m-Xy!ene u~/g 18.80
o-Xylene ug/g 33.24
To~al Petroleum
DAT ANALYSIS
(X1MPSETED: .
'27-Jun-89
Level
O.04
O. O4
0.04
0.04
0.04
0.04
5.00
~T METHOD: ~ for gasoline by D.O.H.S.L.U.F.T. met,hod.
Individual constituents by EPA ~ethod 8020.
Dm ~%~r ~sis
Ca!iforni.~. D.O.H.S. Cert. ~I02
j. J., Eglin
r~J A~lyst
FRL-!~I BC LABORATORIES
CHEMtC,4L AN,~I,¥$15
Foz~cson C~nstruction
3218 Renegade Ave.
Bakersfield, CA
A%.%ention:
Gab No.:
. 13.i989, (%:
LABORATORIES, INC.
J. J. EGLIN, REG. CHEM. ENGR.
4100 PIERCE RD,, BAKrERSFIELD, CALIFORNIA 93308
Pur~eabl~ Aromat±cs ·
(SOIL)
93306
4682-4
Joa% Floor Co. 'Oak S%.
West Tank 6'
Date' Of
Repoz~c:
13-Jul-89
PHONE 327-49!I
DATE SAMPLE
OOLLECT~D:
14-Jun-89
DATE SAMPLE ·
R~CEIVED~ 5AB:
14-Jun-89
DATE ANALYSIS
COMPLETED: '
27-Jun-89
Analysis
Minimum
Level
Toluene
Ethyl Benzene
~Xytene
m-Xylene
o-Xwlene ·
ug/g
ug/g
ug/g
none detected
none detected
nc~e detected
none detected
none detec%M
none detected
0.04
0.0¢
0.04
0.04
0.04
0,04
Total Petroleum
Hydrocarbons
52.31
5. O0
TEST MSTHOD: TPH for gasoline by D.O.H.S.L.U,F.T, method,
Individual co~tit~ent~ by EPA method 8020
Com~nts:
Qah,ornia D.O.H. Cert, ~102
J. J' Eg!in
UNDERGROUND' STORAGE TANK UNAUTHORIZED RELEASE (LEAK) / CONTAMINATION SITE REPORT
q:.-
F~ILI~ N~E (IF APPU~RI ~
CROSSSTRE~ ' ' ' :
~PEOFAR~ ~ ~MMERC~L ~ INDUSTR~ ~ RU~ WPE~BUSINESS ~ R~NL~STA~ON
-' ~ .~s,o~.~,~ ~ o~. ~ ~. ~ o~.
L~AL AGENCY ;2 ..
(~) ' ' .... NAME
~ u~.o~
~ DATEOI~VERED [ ~WOi~RED ~ ,N~ORY~ROL : SU~RF~E MONiTOR.G ~ ~i~E~i~NS
DA~ DI~HARGE BE~N , ~ M~OD USED TO STOP D~HAR~ (CHECK ~L ~T
R~AIR
P~
~UR~ OF DI~HARGE. T~K80NLY~t~ ~RI~
~ PIPINGL~ <E YRS .'~S~EL ~ ~RROS~N
~ECK ONE ONLY
~ UNDE~RMINED ~ ~ILONLY ~ GROUNDWA~R ~ DRINKINGWA~R-(CHECKONLY!FWA~R~_L~HAVEA~LYG~NAF~D
~E~ ONE ONLY
~ ~ SI~IN~STI~TIONINPR~RESS(D~INING~OFPROB~M) ~ ~INPR~RESS~ SI~OFF(~pmMP~ORU.~
~ NO~TIONT~EN ~ POST~P~NITORINGINP~RE~ ~ ~FUN~AVA~PR~EO ~ ~UA~~RNA~
CHE~ ~PROPRIA~ ~TDN(S) (SEE BACK FOR ~TAI~)
~ CONTAINMENT BARRIER (~) ~ ~VA~&TREAT(E~ ~ PUMP'TR~TGROUN~A~R(G~ ~ RE--ESSaY(RS)
~ TR~ENTATH~P(HU) ~ NO ACTION REQUIRED (NA) ~ O~ER(O~
UNDERGROUND.STORAGE TANK.UNAUTHORIZED RELEASE (LEAK) I CONTAMINATION SITE REPORT
EMERGENCY '~ HAS STATE OFFIC~ OF EMERGENCY SERVICES ::i::ir-o R IJ,OCA ~ ~GEN C~ USE O N lJ,Y::i~:!i!!ii!iii::iiiii::~iiii~ilili~i~:ii::!::i::::i::ii?:iiii!ii i i i i i
NAME OF ~NDiVIDUAL F~L~ R~RT
~ A~R~SS ~:' A ~..~i ~;. "~ ;' ':: . E -~ ;; ~ - ' .... ;>.~ 9: ~ < 2.~' .
...... '-'
~E~ , ' C~
" ~ ~PEOFAR~MMERC.L=.DUSTR'~RU.I ~. OF BUSiNESS ~ .~AiLFUELSTA~ON
: : ~' * ~ RESIDENTI~ ~ O~ER ' ' ~ F~M ~ O~ER ' '
L~AL A~NCY
(1) ·
~ ~ NAME QU~ L~T
~ ~ U~NO~
~ DA~DI~RED ~ ~WDI~RED ~ IN~ORY~ROL ~ SU~RF~EMONITOR~G ~ ~ISA~E~NDIT~NS
DATE DI~HARGE BE~N ~ M~D ~ED ~ S~P DI~HARGE (CHECK ~ ~T
~S O,~.ARGE BEEN STOPPED ? ~ ~PAIR T~K ~ REPAIR .~,NG ~ CH~ PR~EDURE
~ ~UR~ aF DI~HARGE ~ T~ aNLY~I~ MA~R,~ C~SE(S)
~ ~-.- R~R~AILURE
~ ~E~ONEONLY
o~ ~ UNDE~RMINED LONLY ~ GROUNDWA~R ~ DRINKINGWA~R-(CHECKONLYIF~R~LSHAVEAC~LYBEENAFFECmD)
~ ~ Sl~ IN~STI~TION mN PR~RESS (DEFI~mNG ~ OF PROB~M) ~ IN PR~RESS OFF (m~NUP ~MP~D OR UN~AR~.
~ ~ .O~T,O.T~E. ~ POST:~P.O..yOm.~,NP~R~m ~ m~U.mAVA~TOPR~ED ~ EV~UAT~mCmmUP~mR.A~S
~ ~ C~SI~(CD) , ~ ~VA~&D~E(ED) ~ REMO~FR~PROD~T(F~ ~ EN~EDBIODEG~ATION(I~.
~G ~ ~NTAINMENTBARRtER(~) ~ ~VA~&TREAT(E~ ~ PUMP&-TR~TGROUNDWA~R(G~ ~ REP~E SUPPLY (RS)
.
~ TH~ENTAT~P(HU) . ~ NOACTIONREQUIRED(NA) ~ O~ER(O~
Z -
HSC O5 (4~'
1700 Flower Street
Bakersfield, California 93305 ,.
Telephone (805) 861-3636
KERN COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH DIVISION
Facil.~ Name
· Address' '~ ~~-
* * UNDERGROUND TANK DISPOSITION TRACKING RECORD * *
'i' 'This form is to be 'returned to the. Kern County 'Health Depar'tment wl~ht~n
-. '~ :" days of acceptance of tank(s)' by disposal or recycling factll-~.
,.. holder of the permit with number noted above is responsible for insuring
~ . ..... :~-.that this form is completed-and'returned. ~ ~, , ~ . ~ . ' ~ ~':~'
'?: ...... ~ ~7' ' . ~.~ ............ ~.~.~, - - '- - "~:~,.;. , ?A~. · :. ~ . ~: ,,- ~ L,'; 4 ~..: ~ '..'. -:~ , :..-.V,~ '. '.:'~..~'F;=~
,~Sect~on 1 - To be filled out ~ ·tank removal contractor: -' ..... ..' .'
. -'-'. ........ "' Tank Removal Contractor: '~r~ ~E~, .... ~
Da~e Tanks Removed ~'/~-~ __'N°' o~ Tanks
.Section 2 - To be fii'led out ~ contractor "decon~aminatlnff ~ank(s):
Address ~~ Phone ~
_ Zip
Authorized representatlve of contractor certiftes by slEnlng belo~ that
tank(s) have been decontaminated Jn accordance ~th Kern .County ~ealth
Department requirements.
' '. -
....... .'... ......... ......
Section $ -To be filled out and signed ~ a~ authorized representative of the
treatment, storage, or.dlspasal faclllt~ aceeCtlnff tank{s~:
/
Date Ta~ks Rece~ve~'/~-~ _ ~o. of Ta~ks
(Authorized Representative)
HEALTH OFFICER : ' '
DIRECTOR OF ENVIRONMENTAL HEALTH . ·
Kern County Permit # '.- :'
* * * MAILING INSTRUCTIONS: Fold tn half and staple.
(Form #IIMMP-150 )
DISTRICT OFFICES
.3.
4.
5.
2700 '~' Street, Ste. 300
1Bakersfield, CA 93301
(805) 861-3636 "
PERMIT FOR PERMANENT CLOSURE
OF UNDERGROUND HAZARDOUS
SUBSTANCES STORAGE FACILITY
FACILITY NAME/ADDRESS:
Jost Floor Co.
320 Oak St.
Bakersfield, CA 93304
PERMIT FOR CLOSURE OF
~ TANK(S) AT ABOVE
LOCATION
KERN COUNTY.f
~o~en~He~Se~icesDeparlme~
PERMIT NUMBER A901-!9-
OWNER (S) NAME/ADDRESS:
CONTRACTOR:
Chester Jost
320 Oak St..
· Bakersfield, CA 93304
Phone: 805-327-7701
Fortson' Construction
8030 Olive Dr.
Bakersfield, CA 93308
License # 468665.
Phone: 805-393~4518
PERMIT EXPIRES July 1, 1989
APPROVAL DATE f'-~] A~ri/ 1.~' 1989
APPROVED BY ~ ~ '
Dan Sta~k~/
POST ON PREMIfE~ ...........................
CONDITIONS AS FOLLOW:'
1. It is the responsibility of th~ Permittee to obtain permits which may be
required by other regulatory agencies Prior to beginning work.
2. A copy of this permit has been provided to the Kern County Fire Department.
Permittee must notify the County EnvirOnmental Health Department ~% (805)
861-3636 two working days rl~ tottank (removal) to arrange for required
inspection(s). ' '
Permittee must obtain a City Fire DePartment permit ~ to initiating
closure action.
Tank closure activities must be per Kern County. Environmental Health and
Fire Department approved methods as described in Handbook UT-30
Soil Sampling
Any deviation from sample locations and numbers.or constituents to be
sampled for which are described below and in.Handbook #UT-30 must receive
prior approval, by the Environmental Health Department.
a. (Tank size 1,000 gallons or.less)-a minimum of two samples must be
retrieved beneath the center of each tank at depths of approximately
two feet and six feet.
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 minimu____m of two samples must be retrieved at depths of approximately twc
feet and six feet for everydl5 linear feet of pipe run and also' near the
dispenser area(s).
-PERMIT FOR PERMANENT CLOSURE
OF UNDERGROUND HAZARDOUS
SUBSTANCES STORAGE FACILITY
PERMIT NUMBER A90 !-!9
ADDENDUM
11.
12.
13.
Sample.Analysis
~a. Ail (leaded/unleaded) gasoline samples must be analyzed for benzene,
toluene, xylene, and total petroleum hydrocarbons.
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 Environmental Health
Department must be notified before moving and/or disposing of any
contaminated soil.
Permittee is responsible for making sure that ,,tank dis 'osit
record,, issued with this ~ermit is ........ .... P ion trackin
- ~ ~up~y ~£e~ out and returned withi~
14 days of tank'removal
Advise this office of the time and date of the proposed sampling with 24
hours advance notice.
Results must. be submitted to this office within three 'days of analysis
completion.
ACCEPTED BY:
DS:dr
dan~jost
DATE
Questionnaire
Normally, permits are sent to 'facility Owners but since many
Owners live ou't~ide Kern county, they may choose to have the .permits
sent to the Operators of the. facility where they are to be posted..·
Please fill in Permit # and check one of the following before
returning this form with'payment:
For P[RM[r
1. Send all information to Owner at the address
listed on invoice (if Owner'is different than
Operator, it will be Owner's responsibility
to provide Operator with pertinent
infOrmation).
2. Send ail information to Owner
follo~_~ corrected address:
at the'
3. Send all information to Operator:
Name:
Address:
(Operator r.~ m::ke copy of permit
Owner).
fo?
PEIOIlT CHECKLIST
Facility' ~~ ~/~_~/ ~_~. Permit s
This checklist is provided to ensure that all necessary packet enclosures were received
an~. that the Persittee has obtained all necessary equipment to l~ple~ent the.first phase of
monitoring requirements..
Please conplete this forn and return to KCHD tn the self-addressed envelope provided
within 3~days of receipt.
Check:
Yes
A. The packet I received contained:
· 1) Cover Letter, Permit Checklist, Interim Permit, Phase I Interim Pernlt
Monitoring Requirements, Information Sheet (~greement Between O~ner 'and
Operator), Chapter 15 (KCOC tG-3941), Explanation of Substance Codes,
Equipment Lists and Return Envelope. .
2) Standard Inventory Control Monitoring Handbook tUT-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 '(Agreement between Owner and Operator), and
find owner's name and address, facility name and address, operator's name and
address, substance codes, and number of tanks to be accurately listed (if '~no"
is checked, note appropriate corrections on the back side of'this sheet).
C. I have the following required equipment (as described 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). ~
E. 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) with corresponding
, /
tank numbers listed on.permit). ' ~
F~' As required on page 6 of Handbook tUT-I~, 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 Calibr~tio~ Check Form" found in the Appendix of Handbook).
G. Standard InventorY' Control Monitoring was started at this facility in accordance
with procedures described in Handbook tUT-lO.
Date Started J~,tev. ~ ~:~l "
Signature offPerson Completing Checklist:
Title:
A DIVISION OF GRAVER TANK & NFG. CO.
~ UA L I TY YOU CAN .$ ~ ~ '':' : ' '
321 WEST KATELLA'AVENUE. O~ANGE,
~. O. BOX 19'35
D
3
., 550 GALLON GAUGE CF_ART - 48", dia. x 72" long'
Denotes depth of contents in inCh~s. ~ i
Denotes contents at that depth.
D
3 !7
15 19
179 ' '~
208
D
4
.5
31
20
2!
222
237
36-
37
"6 41 22
'252
35
51 23 267
39
8
9'
62 24 282
73 25 297
40
41
10 85 26.
312
42
11
12
13
16
97
110
123
137
151
165
27
28
29
30'
31
32
327
342
356
385."'
399 ---. - -"..
43
44
'45
46
47
48
441 . ..
454.
457
47.9
4.91
502 '
513
523
533
'542
549
556
561
564.
JOST
· HARDWOOD FLOORING
® LINOLEU#
STATE LIC. NO. 368296 · 320 OAK STRE
. ,1' from JOST" ' '
· DRAPERY
~93304 · PHONE (805) 327-7701
August.29, 1986
Kern County Health Dept.
'1700 Flower' St.
Bakersfield, CA 93305
Gentlemen:
This is to notify yOu that we are working with RLW Equipment on the.
necess.ary requirements to bring pumps and tanks up to your requirements.
We have been told that parts for pumps and stri'ker plates are on order
and they are waiting for delivery. We have received tank charts and are
waiting .for items to be installed and Provided by RLW Equipment Co in
addition to this~the pumps must be calibrated. ·
Ca/sh
Yours truly.,
Chester Jost
2700 'X° Street, Ste. 300
8akersfie]d, CA 93301
(805) 861-3636 ,-
KERN COUNT~ .....
Env~ron~enr~[ Ite~lth DePar~ent
Mr. Chester Jost
320 Oak Street
Bakersfield. CA 93304
Jul~ 19, 1989
SUBJECT:
Location: 320 Oak Street
Bakersfield. CA 93304
Known As: Jost Floor Company
PERMIT ~: 190001
Dear Mr. Chester Jost:
This letter ls an officlal notice to inform you that the Property described above
has been determined by Kern County Environmental Health to be the site of an
unauthorized release of hazardous materials from an underground storage tank. This
notice is sent to you because our records indicate that you are a responsible party
for this property.
As a responsible party, you must provide for all studles and work relating to the
above described property and the cost for oversight of these activities California
Health and Safety Code Chapter 6.7 and Kern County Ordinance Code Chapter ~.48 require
a determination of the threat to the environment as a result of thisrelease. THE
RESPONSIBLE PARTY SHALL. ON A TIMELY BASIS, DEVELOP A SITE CHARACTERIZATION,
FEASIBILITY STUDY AND REMEDIAL ACTION PLAN FOR KERN .COUNTy ENVIRONMENTAL HEALTH'S
'REVIEW .4~ND APPROVAL BEFORE THE WORK IS INITIATED. 'Enclosed you will find attachment
"'A". Handbook UT-35, which states' the minimum required site'workplan activities, the
necessary requirements for s%lecting environmental contractors qualified to perfOrm
this work. a glossary of terms, example illustrations, and a section discussing the
answers to commonly asked questions'
The cost incurred by Kern County Environmental Health for the oversight of the work
for the site characterization, feasibility study, remediation action plan. site
remediation, and ongoing monitoring is not covered by any fees or permits. These costs
are recovered by Kern County Environmental Health in one of the two ways described
below. It is your responsibility to select the method of'oversight cost recovery under
the terms of the (A) State contract or (B) County of,Kern Local Agreement Oution. These
options ONLY pertain to costs assbciated with ove~rsight. '
(A) . 'STATE CONTRACT.
The State Leaking Underground Storage 'Tank. Pilot Program provides~a mechanism for
the State to reimburse the County for County oversight. The County will conduct the
necessary oversight and bill the State Water Resources Control Board under this State
contract. The State will then charge you, a responsible, party, fo~ both the costs
incurred by the County and the State pertaining to your slte.
(S) COt,,'ST~ LOCAL A~.~NT '"
Kern County Environmental Health is providing this option for those who prefer to
pay the County directly and avoid the addition of State costs. Prior to the,County's
perfor'mance of services,' this option requires your deposit of $1,000.00 (one thousand
dollars) with the County to be held in the Local Option Trust Account. Charges for
County oversight are made against this account. In this option, a responsible party
must enter into a County agreement, attachment "B".
To safeguard the environment,'the environmental sensitivity (Attachment "C') of this
site has been reviewed by Environmental Health to determine the potential threat for
groundwater contamination. Only sites determined to be non-environmentally sensitive
may enroll in the, Local Option Agreement. The site described above Is not in an'
'environmentally sensitive area and may be enrolled in the Local Option'Agreement;
however, th~ County of Kern reserves the right to cancel any Local Option Agreement,
should it be discovered-that groundwater contamination or a unique, complex
hydrogeological condition exists. In such Cases, Environmental Health will utilize the
State contract to pay for County oversight activities. The County of Kern reserves this
right for any site even when the site is located in a non-environmentally sensitive
area. '
It is necessary for you to respond in writing, within ten (10) calendar days of
r-eceipt of this letter to advise Kern County Environmental Health-of your choice:
either the State Contract or the County's Local Agreement option. If you select the
County's Local Agreement, please sign the Local Agreement, enclosure 'B'. and return
it with'your check for $1,000.00 (one thousand dollars) made payable to thb County of
Kern. addressed to Kern County Environmental Health 2700 M Street. Suite 300.
Bakersfield, CA 93301, Attention: Underground Storage Tank Contract Administrator.
If you select the State Contract, please indicate that you have'made this selection
and that you have read.attachment "D", the official noti~icati0n, in a letter sent to
the address indicated above.
Failure to respond in writing to this notice within ten (lO)'calendar days will
automatically result in oversight cost recovery for your site(s) to be placed under
the terms of the State Pilot Program for Leaking Underground Storage Tanks. Enclosure
"D" will then serve as the official notification of your enrollment into the State
Pilot Program for Underground Storage Tanks.·
If you should have any questions regarding this matter, please contact Richard
Casagrande Program Manager, at (805) 861-3636.
SincerelY,
Steve McCalley, Director
Environmental Health Services Department
attachments
At tacl%men~ "B"
KERN COUNTY LOCAL AGREEMENT OPTION
BETWEEN
KERN COUNTY ENVIRONMENTAL. HEALTH
(Kern COunty Underground Storage Tank Permitting Authority)
AND
Mr. Chester Jost
Responsible Party for Underground Storage Tank
for: Jost Floor Company
'Permit ~ 190001
This facility has experienced an unauthorized release of hazardous
substances from an underground storage tank. Action is necessary to protect the
public health and the environment of the County, pursuant to Chapter 6.7 of the
California Health and Safety Code and Chapter 8.48 of the Kern County Ordinance
Code.
THE WITNESS FOR THE COUNTY AND SIGNATURE(~) FOR A RESPONSIBLE PARTY OF THE
SUBJECT FACILITY DESCRIBED ABOVE DO HEREBY AGREE THAT:
Kern County Environmental Health shall act as the lead agency for
regulatory oversight for the:
a)
b)
Site characterization: the study of a site, including sampling of
subsurface soil and water where contamination is found in order to
fully assess its extent and threat to the environment. It shall
include a discussion of the relative risk to biological receptors
and possible pathways of exposure. It may include remOval or in-
place closure of the tank, disposal or on-site treatment of
contaminated backfill or adjacent soil, removal of hazardous
substances floating on groundwater, and the drilling of groundwater
monitor wells.
Feasibility study: the identification and evaluation of feasible
alternatives for cleaning up the site and remedying threats to,public
health and safety.
c)
Remedial action plan: the most cost effective, appropriate Plan to
lessen, .alleviate, abate, correct or clean-up the effects that a
release of hazardous substances may, have on the environment, based
on the feasibility study.
d~
Remediatlon: the action chosen by t~e responsible party and approved
by Kern County Environmental Health for the mitigation and clean-up
of contamination resulting from an unauthorized release of hazardous
materials and any ongoing monitoring of the site. .
The responsible party shall do the following:
a.. Conduct all Work as directed by Kern County'Environmental Health
pursuant to State and local law and in conformance with appropriate
regulations to assess and remediate'the contaminated site.
b. Deposit with the Kern County Environmental Health Leaking underground
Storage Tank Local,Option Trust Fund t .
Department,s o,,~ ..... he sum of $1,00
~ v 0.00. The
: account at th -~k~%%~A~lvltles will be charged against
8.04 e .... ~~ued by Kern County Ordinance Code Cha~
(currently $42.00 per hour).. ~onthly statements will be
- er
· prepared detailing the activities and services provided and the
remaining credit balance.
Kern County Environmental Health shall provide the following services
a. Oversight of all activities to characterize the site's threat to
the environment and/or the groundwater, and coordination with the
apPropriate State, County and local regulatory agencies.
b. Serve as the single contact point for the responsible party's
representatives and other regulatory agencies for the activities
described in "a" above. If during the Department,s review of the
site characterization/remedial action plan, it is determined that
a permit may be required by another agency', the responsible party
shall be referred to that Permitting agency.
c. ·Review ceports, conduct inspections, and oversee monitoring until
the site poses no further environmental or public health threat. An
official certification letter shall be given to the responsible party
~hen the site is determined to no longer pose a significant threat
to the engironment.
d. The responsible party ~ill be officially noti'fied by Kern County
Environmental Health when:
1. Necessary oversight is completed. A final statement will be
provided to the responsible party. If there remains an
unexpended balance of the deposit made by the responsible party
in the Leaking Underground Storage Tank Trust Fund,· a refund
for the unexpended balance will be issued;
- or -
2. Seventeen (17) hours of billable time has been reached. This
will give notice that the available funds will be exhaus
after Ylve ($) additional hours of billable time at ...... ~ed
the agreement will expire' A statement esti'mating the amount
time necessary to complete any remaining oversight work will
be sent. The responsible party will then have another
2
opPortunity to renew their agreement with the CoUnty.
Failure to enter into another agreement .shall require Kern
County Environmental Health to utilize the. State Water
Resources Control Board Pilot Project for which the responsible
party may be billed 'by the 'State directly for the. cost of
County services as well as State costs.. ·
Kern County Environmental Health reserves the right to cancel this
agreement at any time for any reasons, including groundwater contamination or
a uniquely complex hydrogeological condition. If an unexpended balance remains
on deposit from the responsible party under the terms of this agreement, a refund
for the unexpended balance'will be issued and the agreement terminated. Once the
agreement is cancelled, you, as a responsible party,
State Leaking Underground Storage Tank Pilot Program, will be enrol~,e~ in the
see enclosure O .
This agreement may be cancelled anytime by either party by certified
registered return receipt letter to the other party-within five days of said
.notification.
I, '~ (responsible Party), have read and agree to
the conditions of this agreement for the contaminated site desCribed as:
Site Name
Site Address
.'
Owner "
Owner's Address
Operator
Te_~l e hone ZiU
Tel_.~.~p_hone
Billing Address Attn:
Permit #
In order for this agreement to be executed,, l't must be signed and accompanied
by the deposit of one-thousand dollars ($ 1000.00).
Responsible Party:
Date:
For the County of Kern:
Date:
3
2700'H' Street. Ste. 300
Bakersfield, CA 93301
KERN C OUNT~~ -'
EnvironmentAl Hea/th Deparl~ent
ATTACHMENT 'D"
July 19, 1989
Mr. Chester Jost
320 Oak Street
Bakersfield. CA 93304
SUBJECT: Location: 320 Oak Street
Bakersfield, CA 93304
Known As: Jost Floor Company
PERMIT #: 190001
Dear Mr. Chester Jost:
This letter will serve as the official notification concerning reimbursement
requirements for a responsible party enrolled in the State Leaking Underground. Storage Tank
Pilot Program. As mentioned in the introductory letter; by either not responding to this
package within ten (10) calendar days or through your own selection of the State Contract
option, your site will be placed under the terms explained below:
Whereas the Legislature has appropriated funds from the California Hazardous Substance
Clean-up Fund to pay the local and state agency administrative and oversight costs
associated with the cleanup of releases'from underground.storage tanks: and Whereas
the direct and lndirect costs of overseeing removal or remedial actlon at the above
site are funded, in whole or in part. from the Hazardous Substance Cleanup Fund: and
Whereas the above individual(s) or entity(les) have been idwntified as the party or
parties responsible for investigation and cleanup of the above site: YOU ARE HEREBY
NOTIFIED that pursuant to Section 25360 of the Health and Safety code, the Above
Responsible Party or'Parties shall reimburse the. State Water Resources Control Board
for all direct and indirect costs incurred by any and all state and local agencies
while overseeing the cleanup of the above underground storage tank site. and the above
Responsible Party or Partles shall make full payment of such. costs within 30 days of.
receipt of a-detailed invoice from the State Water Resources Control Board.
If you should have any questions .regarding this matter, please contact Richa'rd
Casagrande, Program Manager, at (805) 861-3636.
Sincerely,.
Steve McCalley. Director
Environmental Health Services Department
attachments
2700 'WI~* Street, Suite 300
Bakersfield, CA 93301
(805) 861.3636
(805) 861-3429 Fax Number
COUNTY,OF
Environmental Itealth' Se~wic
July 14, 1989
Department
Fortson Comtruetion
3218 Renegade Ave.
Bakersfield, CA 93306
Permit Number: ,A901-19
Dear Jim:
On July 12, 1989, this Depamx~ent received the results of the laboratory analyses for soil
samples taken at 320 Oak Street, Bakersfield, California.
The laboratory anal3,zed the soil samples for total ?etroleum hydrocarbons (TPH) fgr diesel
for. underground storage tank that contained gasol[ne. The sample should have been analyzed
for TPH for gasoline. After investigation it was discovered the error was due to an incorrectly
marked chain of custody, form filled out by B.C. Laboratories. In the future, additional' soft
samples and analyses maybe required When incorrect analyses are performed and results submitted
to this Depamnent.
If you'have anyquestions, please do not hesitate to contact me at (805) 861-3636. Your
cooperation is much appreciated.
Turonda R. Crumpler, R.E.H.S.
Hazardous Materials Specialist
Hazardous Materials Management Program
TC:cd
ce: B.C. Laboratory
crumPlerkfortson.let
ANAL Y$15
PETROLEU¥
LABORATORIES, I r-lc.
J. J. EGLIN, REG. CHEI~A. ENGII.
4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-49il
Petroleum Hydrocarbons
(SOIL)
FortsonCor~t~ction~
3218'Renegade Ave
*Bakersfield, CA 93306
Attention:
[mb'No.:
Sa~pleDesc:
4682-1
Jost Floor C~. Oak Street
East Tank 2'
Date of
Re~rt:
05-Jul-89
DATE SAMPLE
CO[ ,r ,~.CTED:
14-Jun-89
DATE SAMPLE
RECEIVED @ LAB:
14-Jun-89
DATE SAMPLE
EXTRACTED:
26-Jun-89
Reporting. Analysis
Constituent Units Results
Benzene ug/g
Toluene ug/g
Ethyl Benzene ug/g
p-Xylene ug/g
m-Xylene ug/g
o-Xylene ug/g
none detected
~one detected
none detected
none detected
none detected
none detected
Total Pet.
Hydror~rborm ug/g 41.00
DATE ANALYSIS
COMPLETED:
03-Jul-89
Reporting
Level
0.04'
0.04
0.04
0.04
0.04
0.04
10,.00
TEST METHOD: .rTPH for Diesel by. D.O.H.S.L.U.F.T M~.ml Methyl
(C~rbon Disulfide Extraction). Individual c~rmtituents by
EPA Method 8020.
Dry Matter -Basis
Cor~nts:
TOTAL PETROLE[~HYDR~A~BONS: Q~tification of petroieumhyd~-~arbo~
utilizing a diesel standard as outlined.by'the California D.O.H.S.
The petrole,m~hydrocar~r~ are in addition ~D t~ constituents.
specifically defined.
California D.O.H.S. Cert. $102
Analyst
ANAL ISIS
PET#OLEU¥
LABORATORIES, Inc.
J. J. EGLIN, REG. CHEM. ENGR.
'4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911
Petrole~a Hydrocarbons
(SOIL)
Fortson Construction
3218 Renegade Ave
Bakersfield, CA
Attention:
Lab' No.:
Sample De2sc:
93306
4682-2
Jost Floor Co'. -Oak Street
East Tank 6'
Date of
Report: 05-Jul-89
DATE SAMPLE
COLLECTED:
14-Jun-89
'Constituent
Benzene
Toluene
EthYl Benzene
p-Xylene
m-Xylene
o-Xylene
DATE SAMPLE
RECEiVED@LAB:
14-Jun-89
DATE SAMPLE
EXTRACTED:
26-Jun-89
Reporting Analysis
Units Results
ug/g none detected
ug/g 0.04
ug/g 0.12
ug/g 0.97
ug/g 1.00
ug/g 5.20
DATE ANALYSIS
COMPLETED:
· 03-Jul-89
Reporting
Level
0.04
O. 04
O. 04
O. 04
0.04
O. 04
Total Pet.
Hydrocarbons ug/g 558. O0 10. O0
TEST METHOD~. D.O.H.S.L.U.F.T Manual
Meth~t
(Carbon Disu~-~ion). Individual constituents by .
EPA Method 8020.
Dry Matter Basis
C~tm~nts: Sa~le exhibits
Gasoline Chro~rmtographic Fir~erprint
TOTAL pETROLEI~ HYDROCARBONS: Quantification of pet~v~le~a hYdr¢"~arbons
utilizir~g a diesel standard as. outlined by the California D.O.H.S.
The petroleu~n hydrocarbons are in addition ~ the cor~stituents
specifically defined.
Analyst
~,#£¥1~,Al A#ALy$1$
PETI~OLEUIJ
LABORATORIES, InC.
J. J. EGLIN, REG. CHEM. ENGR.
4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308
PHONE 327-4911
Petz~leum Hydrocarbons
(SOIL)
FortsonConstruction
3218 Renegade Ave
Bakersfield, CA 93306
Attention:
Lab .No.:
Sample Desc :'
4682-3
Jost Floor Co. Oak Street
West Tank2'
Date of
Report: 05-Jul-89
DATE SAMPLE
COLLECTED:
14-Jun-89
Constituent
DATE SAMPLE
RECEIVED @ LAB:
14-Jun-89
Reporting
Units
Benzene ug/g
T6luene ug/g
Ethyl Benzene ug/g
p-Xylene ug/g
m-X¥1ene ug/g
o-Xylene ug/g
'Total Pet.
Hydrocarbor~ ug/g
DATE SAMPLE
EXTRACTED:
26-Jun-89
Analysis
Results
0.77
1.22
1.94
11.32
18.8O
33.24
DATE ANALYSIS
'COMPLETED:
03-Jul-89
Repo~0ing·
Level
0.04
0.04
0.04
0.04
0.04
0.04
10.00
TEST METHOD: TPH for Diese___%l by D.O.H.S.L.U.F.T Manual Methc~l
(Carbon Disulf'ide EXtraction). ' Individual constituents by
EPA Method 8020. '
D~y Matter Basis
Con~nts:
Sa~le exb~ bits
Gasoline ChroJrm~ographic Fir~erprint.
TOTAL PETROLEUM HYDROCARBONS: ~antification of petrole~a?~drc~arboms
utilizi~ a diesel star, dard as outlined by the California D.O.H.S.
T~ petroleum hydrocarbons are in addition to. the constituent~
specifically defined.
C~lifo~ia D.O.H.S. C~rt. ~102
A~mlyst
CtI£MICAI A~AI );SIS
PETROLEUM
Fortson Co.nst~cti°n
3218 Renegade Ave
Bakersfield, CA 93306
Attention:
Lab ~No.:
Sample Desc:
LABORATORIES, Inc.
J. J. EGLIN, REG. CHEM. ENGI~.
4100 PIEIK:E RD.,. BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911
Petroleum Hydrocarbons
(SOIL)
Date of
Report: 05-,3~1-89
4682-4
Jost Floor Co.
WestTank 6'
Oak Street
DATE SAMPLE
COLLECTED:
14-Jun-89
DATE SAMPLE
RECEIVED @ LAB:
14-Jun-89
DATE SAMPLE
EXTRACTED:
26-Jun-89
DATE ANALYSIS
COMPLETED:
03-Jul-89
Minimum
Reporting Analysis Reporting
Constituent Units ReSultm Level
Benzene ug/g
,Toluene ug/g
Ethyl Benzene ug/g
p-Xylene ug/g
m-Xylene ug/g
o-Y~vlene ug/g
none detected
none detected
hone detected
none detected
none detected
none detected
Total Pet.
Hydrocar~Dns ug/g
0.04
O. 04
0.04
O. 04
O. 04
O. 04
33.00 10.00
' TEST METHOD: ~for Diesel~. D. O.H.S.L.U.F. T Manual Method]
(Carbon Disul rac xon). Individual constituents by
EPA Method 8020.
Matter Basis
S~mple e,m[~ibits
GaSoline Clmromato~aphic FingerPrint ~; ·
T(YFAL PETROLEUM HYDROCARBONS: ~z~ntification of pe. trole~n ?~;drc~carborm
utilizir~ a diesel standard as outlined ~:, the' california D.O.H.S.
The ,petrole,mm hydrocarbons are in addition to tk~ cor~tituent~'
Specifically defined. . .
California D.O.H.S. Cert. ~102
Armlyst
Date Rec'd: BC CHAIN OF CUSTODY NO. L- '
Client: Sampler: Sample Type: Analysis Requested:
~ (fO~fx~' ' ' Water Other:
Address: Addres . 8 Sludge
Oil
Lab # Description:'~O W ~0~~ CO. 0 ~(~ S'~- Other Tests
.Re~nquish~ By: Date: 'Tree: Receiv~ By: Date:
White: Rcmm to Customer wi~h Report
YelloW: BC Lab Copy
~ See Instructions on L of Page 6 Department of Heelth Service,-
Sta~.e of Call;dais--Health and W~lfare Agency Toxic Subatancae Control Diviaio;
Form Approved OMB No. 2050---003g (Expires 9-30-,. ,~ and Front of Page 7 SaEramento, Callforni:
' ........ RM HAZARDOUS I . G ' A ID NO. Manileet
UI~III'U . ~ I Document No. I -f I
R//I, Transporter t Company Name' _ "- e. US EPA ID Number . G. State
~ Designated Facility Name ,~d, Site A~es~, , 10. US EPA..ID Numb--
12. ~ta~e~ 13.. Total
1 I. U~ DOT Description (l~luding Proper ~hippiog Name, ~za~d Clads, and ID Num~)
~/ ~. '-
Special Handling Instructions and Additional Information
GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name
' and are classified, packed, marked, and labeled, end are in all respects in pr.oper condition for transPort by highway according to applicable international and
national govern,meet regulations.
If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined
0 . to be economicaiiy practicsbie eno ~i~at I have selected the praclicable method of treatment, storage, or disposal currently avaimble to me which minimizes the
generation and select the best waste management method that is available to me and that I can affo~'d.
Prin pad Name ' ~ x Month Day Year
17. Transporter 1 Acknowledgement of Receipt of Materials
.,o,,:..,,,., ¥..r
Printed/Typed Name p? · .
0p
Iz~ 0 18. Tran~sporter 2 Acknowled~,T, ent of Receipt of Materiaia
~l ~ IPrinted/Typed Name I Signatu[e t~o~th Day Year
.dj =. / ,,,,,,
z_ ·
19. Discrepancy Indication Space
'_ . · , q.
DHS ~022 A (t/8~) Do Nor Wrife E~low This Line
EPA 8700---22
(Rev. 9-88) Previous editions are obsolete.
Month day Year
White: TSDF SENDS THIS COPY TO DOHS WITHIN 30 DA'
/" KERN .COL~
- '27°% 'H' Street, Ste. 300
('~ ,
: Bakersfield. CA 93301 -'-' vironmentai Health
i (805) 861-3636
~ '-. -" .....
-':...---'-- ' ' ' ' - .',:..
. NAME/ADDRESS. . ':~'"O
.... . ........ - ( ) AME ADDRES
.-.., t Floor Co. . :: ........... ':Ch_Z~. '.?u
~:~?:-.~ ~ .Oa~ .S~u' ,:., .-':-.::f':.' ~. :(":~:~,320 Oak
"~a~ersmield, CA 93304 ';: .... " ieZ2' ?
r FOR.CLOSUREOF
'TANK(S) AT'ABOVE
LOCATION ~.
2.7'J'770
.... APPRovED
Olive Dr
sfield, ::
3e;# 4'6866~
805-39:
Dan Starkey .,,-
CONDITIONS AS FOLLOW: · ' .'.
1. It is the responsibility of the Permittee to obtain permits which may be
required by Other regulatory agencies prior to beginning
2. A copy of this permit has been provided to the Kern County Fire Department.
Permittee must ~LO_~ the County Environmental. Health Department at ('805)
861-3636 two working days'rp_~to tank'(removal) to arrange for required
inspection(s).
Permittee must obtain a City Fire Department permit ~ to initiatino
closure action. ·
Tank closure activities must be per Kern County Environmental Health and
Fire Department approved methods as desCribed in Handbook UT-30
Soil Sampling .
Any deviation from sample locations and numbers or constituents to be
.sampled for which are described below and in Handbook #UT-30 must receive
prior approval by the Environmental Health Department.
a. (Tank size 1,000 gallons or.less)-a ~ of two samples must be
.! retrieved beneath the Center of each tank'at depths of approximately
two feet and'six feet.
6. 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.
7. Soil sampling (piping area) ~'' ':' ..::;
A 'n~ of two samples must be retrieved at depths of approximately, two
feet and six feet for every 15 linear feet of pipe run and also near the
dispenser area(s).
PERMIT FOR PERMANENT CLOSURE '-.'.-.:' ~ ·
-- · · .. ,-:u ~.~-,~,.hb~?~-p
' ~-L~,,'OF UNDm.~-~n u~,~ .... ~.,.: ...... .,.~,~,.,,~:,~,,~.~_?,~:~i,.,,~ .~,~: :~.~::-::,~,C-:;.~.;~-.,~./:~.- ERMIT NUMBER A901-19
~ 8. Sample Analysis ' . ~ ' · -?- . :-.~ .-~,~..:~ ..
~ a. All (leaded/unl~ad~d)'gasoline samples must'be'analyzed for benzene,
~"'-"'-'-, ":'~ ,. :' 'toluene xylene and total petroleum hydrocarbons.."" ~"~ .......... ~' ....~' ..........
v(.9' .. "Copies of transportation 'manifests must .be submitted 'to ~the ~Health
· ~ ~. ~Department within five days of waste disposal. '?:~::~
';?~Cl'0.~')~:"~All applicable state laws fOr 'hazardous waste
. .- or'~treatment must be adhered to. · The Kern County ,Environmental Health
contaminated ,soil '
tree '~s ~kesponsible ~aking sure
.~re~ord" .,issued with this permit is properly filled; Out and returne~ within
,.~, v~se .th~s off~ce -of,,.,the ,time and .- ................... ?'~,~J~'~,,,~..-~,~ -
~.~,~ ................. ~,, .~ ........ ~ .......... =date ~of.,~the ,~roposed ~,sam lin
.,..:., ~e~UltS mu~t .be submitted to 'this. office within
, , . completion. '.' ' '.. .... ' .,. .... _,,.,:: ....... ,',~.~'~ . ....
' . · , . ,_ _ . ,.. , ' ~. ,~ ,; ,.;-y..; ;>.~., ·
DS: dr '
danhjost
Kern Count~ Health Department . Pemit
Division o£ Environmental He9
1700 Flower Street, Bakersfie'~, CA 93305
'~APPLI~ATION FOR PERMIT TO OPERATE UNDERGROUND
HAZARDOUS SUBSTANCES STORAGE FACILITY
Type of APPlication (check):
[]New Facility •Modification of Facility ~Existing Facility nTra~fer of O~ership
A. ~f~nergency 24'~our Contact (name, area code, phone): Days Chester J0st (805) 327-7701
Nights _ /805) 831-57-35
Facility Name ,lncf ~lnow Cn · lq•. Ot~ Tankl~ ' 2
Type of Susines~-(cheCk): [3Gasoline Station ~Other (describe) FI•or C0veri~ Co.
Is Tank(s) Located on an Agricultural Farm? C]¥es ~]NO
Is Tank(s) Used Pri~rily for Agricultural Purposes? []Yes ~] No
FacilityAddre~
T ~ R O~St
.Owner .~hp~t~r
;~z:lclress Rh7 ,lmmaica Way~ Bakersfield
Operator David Jost
Address .7500 Saddleback, Baker~fie]d
Nearest Cross St. Oak & Oak PlaCe
(Rural Locations ~ly)
contact Person Chester J0st
Zip 93309 Telephone (805) 827-7701
Contact Person
Zip 93309 Telephone [SUb) 83Z-16b6 '
Water to FacilitY Provided by 'California Water Co.
~il ~racter~stics'at ~ciltty Sandv Loam -', .....
~sis for Soil ~ ~ Gro~ter ~p~ ~temi~tio~ "
C. Contractor '~ ~ntractor's ~e~. ,
~rker's C~~ti~ Certificati~ ~ I~urer
D. If This Pe~it Is For Modification Of An Existing Facility, Briefly Da~ribe Modifi~ti~
Proposed ·
T~k(s) Store (check all that apply):
Tank ! Waste Product Motor Vehicle
Fuel
[] [] []
[] [] O x 3x
[] O '0
O' O. [] i9
Unleaded Regular Preml~ Diesel -WaSte
Ch~t~l Om~osition of Materials Stored (~t ~es~ry for ~tor vehicle f~ls)
Tank ! Cheml~l Stored (no~co~m~rcial name) CAS $ (if kno%~) .~i~a~
" ' , (if-differ~))
B
Stored
Transfer of Ownership
Date of ~--ansfer Previous Owner
Previous Facility Name - ,
I, accept fully all obligations of'Permit[ No. issued to'
, . I understand that the Pemitting Authority may reviaw and
modify or. terminate the transfer' of the Permi~ to 'Operate this ~ergro~l stora~e
facility upon receiving this ccmpleted form.
This form has been campleted under penalty of
true and correct. /7
Signature _ { ,~ /~-----
perjury.and to the best of my knowledge- 'is
· Title Precedent
Date 3-E 95
Facility Name
( (FILL OUT SEPARATE FORM F~i ZACT{ TANK)
TANK ~ ~
FOR EACH SECTION, CHECK Ar.r. APPROPRIATE BOXES
[] Fiberglass-Clad Steel
Pr imar~_ Containment
1.' Tank is: []'Vaulted []Non-vaulted rqDouble-Wall ~fingle-Wall
2. ~ Material
'~C_~rbon Steel [] Stainless steel []Polyvinyl Chloride
'L-] Fiberglass-Reinforced Plastic [] Concrete [] A1tmlin~ [] Bronze []Unknown
[:]Other (describe) -Wraped 15Ih. fe]~ & not tar
Date Installed Thickness. (Inches)
1971
Tank Secondary Containment
[]Double-Wall X[~ Synthetic Liner
r~Other (describe):
Thickness (Inches)
[:]Phenolic r~ Glass
OMaterial
5. Tank Interior 'Lin~
..:.. E]mkya. E]SP°xy
Capacity (Gallons) Manufacturer
500 · r~r rt~th.!,',
[]'Lined Vault []None [-]Unkno~
Manufacturer:
Capacity (Gals.)
[]Clay FTt~lined ['~[~kno~
7,. L_.eak. Detection, ~nit~, a__~_~ Interception
a. Ta~nk~..FTVi_sual (va.~i-fed tanks only)' [:]Groundwater Monitorir~' Wall(s)
,, va~ose zone Monitoring Well(s) I-IU-Tube Without Liner
. i~.U._-__T~e~ _w.ith. C.a~,Pa_tible Liner Directing Flo, to Monitoring
vafx}r i~tecUOr - II Liquid Level Sensor' [:] Conductivity .~,-~,* ....
8_P.re .ss~_ e Se.nsor in Annular'Space of Double Wall Tank~.. ....
~i~:.i.d_~t~lev?l_, In.spect_ion Fr. u-Tube,_~nitoring Well Or amular
8NoneY ~al~l~nn~o~r~a I~;[y l{.conciltatlon gl Periodic Tightne, Test'.
[]Other (describe):
Tank Corrosion Protect£on '
[] Synthetic Liner Race.my Fl~x~
[2]Yes XOl~o I-IUnkno~l
. ' I~sults of Test
Testin~ Ccmpany
b. Piping: Fl~w-Restricting Leak Detector(s) for Pressurized Pipits'
r~ Monitoring, S~a~p with Raceway [] Sealed Concrete Race,my
[1 Ralf-Cut C~:atible Pipe Raceway
[] Unknown [] Other
*Describe Make
8. ~en ~ightness Tested?
Date of Last Tightness Test
Test Name --
Repaired? [:]Yes ~ F3~nknown
Date(s) of Repair(s)
Describe Repairs
10. Overfill Protecti6n
· > X-'~-~rator Fills, Controls, & Visually Monitors Level
[:]Tape Float Gau~e []Float Vent Valves [] Auto Shut- Off Controls
[']Capacitance Sensor []Sealed Fill Box []None []Unkno~a~
UOther:
List Make & Mc~ei Fo~ Above Devices
ll. Piping
0
-C.
Underground Piping: []Yes [-]No E]unkno~n Material
Thickness (inches) . Diameter Manufacturer .............
· []Pressure )~ction [-]Gravity -~----P-~imate Length 0f pipe l~. 10 ft.
Underground Piping Corrosion Protection :
polvantzed FWFiberglass-Clad []Impressed Current ~Sacrificial
lyethylene Wrap ~Electrical Isolation ~Vin¥1 Wrap []Tar or A~lt
Unknown [-]None [-]Other (describe):
Underground Pipirg, Secondary Contai~uent:
[]Double-Wall [:]Synthetic Liner System [:]None [-]Unknown
[']Other (describe):
Facil ity Name
TANK ~ ~ (FILL OUT SEPARATE FORM FOR ~ACH TANK) FOR EACH SECTION, CHECK ALT. APPROPRIATE BOXES"
He
1. Tank is: [[]Vaulted ['1Non-Vaulted []Double-Wall X[]Single-Wall
2. ~ Material
i a'~bon Steel D Stainless Steel [] Polyvinyl Chloride [] Fiber.glass-Clad Steel
iberglass-Reinforced Plastic [] Concrete [] Al~in~ [] Bronze [-]Unknown
ther (describe) wraped 15lb.' felt &'not tar
3.' Primary Containment
pale InStalled Thickness (Inches)
1971
Tank Secondary Cor{tair~ent
---~Double-Wall X~Synthetic Liner
[]Other (describe):
[]Material
5. Tank Interior Lining
[]Other (describe):
Tank Corrosion Protecti°h ..
--]~[Galvan{zed ~ass-Clad []~olyethylsne Wrap [~Vin¥1 Wrapping
~Tar or Asphalt [']Unknown [~None []Other (describe) '
[]ImPressed Current System :[]Sacrificial
Cathodic
Protection:
~lNone
~.o
e
Capacity (Gallons) Manufacturer
500 Mc£arthv
[]Lined Vault []None ' [-]unknow~
Manufacturer:
Thickness (Inches) Capacity (Gals.)
[~]~henolic []Glass .[]Clay []Unlinsd
Leak Detection, Monitorinc~, and Interception
a. Tank: [-1Visual (vaulted tanks only) OGround~ater Monitoring'
[]Vadose~Zone Monitoring Well(s) [2]U-Tube Without Liner
[] U-Tube with Ccmpatible Liner Directing Flow to Monitoring Well(a)w
ri vapor Detector* [] Liquid Level Sensor' O conductivit~ Se~or'
[] Pressure Sensor in Annular Space of Double Wall Tank
[] Liquid ~etrieval & Inspection Fr~m U-Tube, Monitoring Well or ~e~lar Space
[] Daily Gauging. & Inventory Reconciliation [] ~eriodic Tighr.~e~ Tmstir~
[] None [] Unknown [] Other.
Piping:. Flow-Restrictirg Leak Detector(s) for Pressurized Pipits' ~ Monitoring .S~p with ~ace~y [] Sealed Concrete ~ace~y
[~Half-Cut Compatible Pipe ~ace~ay []Synthetic Liner Race,my []None
[] Unkno~ [] Other
*Describe Make & ~odel:
8. ~e" Tightness Tested?
~¥es ~ I"i~nknown
Results of Test
Testin~ C~mpan¥
Date of Last Tightness Test
Test Name
Repaired? I-lyes xJ~No []Unknown.
Date(s) of Repair(s)
Describe Repairs
Overfill Protection
>~9perator FiI1s, Controls,& Visually Monitors 'Level
[]Tape Float Gauge []Float Vent Valves [] Auto Shut- Off Controls
Capacitancs Sensor [-]Sealed Fill Box •None C]Unkno~a~
Other: List Make & ~kx~el Fc~ ~ Devices.
11. Pipi~
a. Underground piping: i-lyes l-iN• ~Unknown Material Galvanized metal
Thickness (inches) Diameter Manufacturer
~Pressure X~-~Suct'i'on [~Gravity Approximate Ler~]th of 'Pipe ~ 10 ft.'
b. Underground Piping Corrosion Protection :
X[~-~alvanized []Fiberglass-Clad [2]ImPressed Current []Sacrificial Anode
[]Polyethylene Wrap ~Electrical Isolation [2]Vinyl Wrap ~Tar or Asphalt
[]Unknown []None []Other (describe):
c. Underground Piping, Secondary Containment:
[']Double-Wall []Synthetic Liner System ~]None DUnknown
[]Other (describe):
Permit #
Facility Name
No. of Tanks '
Type of Inspection:
Comments:
Environmental Sensitivity .' ' ,---~ Date
.. Inspection Time / ~;/~.,, .
UNDERGROUND HAZ~LRDOUS SUBST~NCE STORAGE FACX LI TY
~ ~ ~/ ~ ~ INSPECTION REPORT
~ Address ~
Is Information Permit/Application Correct? Yes ~ No ~ Permi~ Posted?
Routine Complaint Relnspection
Yes ~ No ~
ITEM
Primary Containment Monitoring:
Intercepting and Directing System
· 1 Standard Inventory Control Monitoring
Inventory Control Monitoring
Modified
d. In-Tank Level Sensing Device
e. Groundwater Monitoring
f. Vadose Zone Monitoring
2. Secondary Containment Monitoring:
a. Liner
b. Double-Walled Tank
c. Vault
O Piping Monitoring ,,a. Pressurized
Suction
c. Gravity
O Overfill Protection
~ New Construction/Modification
7. Closure/Abandonment
vIOLATIONS NOTED
/ 4,"~- ?' . ,
/, .,~,'",Y,," A.~ ':;:' ~2 ,' // ~ i /I i f ,~ .../ ,'T~ /.. , /;/.~..,: ~ f, ,. -_! '. .,~' ~. ~.
. I ~ .... '~"~ ~"~l//~/lg~
~ /~' ,, ~ , - . .
8. unauthorized Release
::::::::::::::::::::::::::::::::::::: ....... ................... ., ................... : ....
Operating Condition of Facility ~' b~ ~
J
Relnspectlon schedaled? /Yes No 'Approximate Relnspectlon Date
/,,4,'.,'. '?' . 7 ,' ,
/: '.-..,~/, .¥- ,,'.- ~.,.~,. ~/:~.
INSPECTOR: REPORT RECEIVED BY:
(Form tHM,MP- 170)
2700 M Street, Suite 300 .
Bekersfleid, CA 93301
TelephOne (105) 141,34~14
Telecop~ef (I0~) M1-342l
AGENCY
September 19,. 1989
Chester ~lost
320 Oak Street
Bakersfield, CA 93304
Subject: Location
Known As
Permit
: 320 Oak Street, Bakersfield, CA
: Jost Floor Company
: # 190001
Dear Mr..lost:
The report submitted to. this Department by B.C. Laboratories Soil Re0ort.
summarizing the site characterization and remediation activities at the above
referenced location has been reviewed. Based on current requirements and
policies, no further action.is required at this time.
It should be pointed out that this letter does not relieve you of any
responsibilities mandated under the California Health and Safety Code and
California Water Code if existing, 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.
Additionally, be advised that changes in the present or proposed land use ma},
require further assessment and mitigation of potential public health impacts.
If },ou have an), questions you may contact me at (805) 8151,3636. Sincerely,
ora Darling,
Hazardous Materials Specifier
Hazardous Materials Man(fgcmcnt Program
FD:cd
florakjost,h.m40 ~
GAFLY J, W!CK$
A~enc¥ DIrErCtO~
'(",05) IE, I-$$0Z
STEVE McCALLF. Y
Olr~cto~
2700 M Street, Su~t* 300
Blkerlflff~d. CA 13301
· Telephone (~0S) 161.3434
Telecol~er (IQS) 841-34~'~
SePtember 19, 1989
Chester ,lost
32'0 Oak Street
Bakersfield, CA 93304
Subject: Location
Known As
Permit
: 320 Oak Street, l~akersficld, CA
: Jost Floor Company
: # 190001
Dear Mr. lost: .
The report submitted to this Department by B.C. Laboratories Soil Report.
summarizing the site characterization and remediation activities at thc above
referenced location has been reviewed. Based on current requirements and
policies, no further action is required at this time.
It should be pointed out that this letter does not relieve you of any
responsibilities mandated under the California Health and Safety Code and~
California Water Code if existing, ..additional· or previously unidentified
contamination at the Subject .site causes or threatens to,.causc pollution,, or
nuisance, or is found to pose a significant threat to public health.
Additionally, be advised that changes in the present or proposed land use may
require further assessment and mitigation of potential public health impacts.
If you have' any question_s you may contact me al (805) 861-3636.
ora Darling, R.E.H.S. ·
Hazardous Mater!als Specig~i{t
Hazardous Materials' Management Program
FD:cd
'flora~ost-h.m40
(sq~0I)
s~aoH
.,~,-!:. ,,~o~ X~obS~
,i;ooq).Su,rpu~
I # eeXoid, u~E
Permit #
Employee ~ /&.~ ...'~
Employee signatur~~.
lte N~e or M~ess~,
~g (~cal, ~of F~eral)
Site Specific Status Changes:
~ ~ Activi~yy 'Hours
Date ~eeg°ry / . ;,~
i Code Description (1Orbs)
Data Entered By: Date:
KERN COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH DIVISION
MEETING/CONFERENCE RECORD
DATE:
TIME:
SUBJECT:
FILE:
CALL PLACE~
(NAME TITLE): :
PARTY REPRESENTED:
TELEPHONE NUMBER:
/jr
MMUNICATIQ iiUR. CO NV-I~ ENCE
FLOORING I FLOOR ~'11.~
INOI. EUM I C..e~i~P~'rlNG · I~J~,RY
CALIFORNIA
'"'!'~""'"~' ~ :": :' ........ ~" '" ' '" '-' ~:-';" .... ' ' ' ~' ' .. '...: ~ ~-~ ..... : .. .... ~,~.~.~:..~.~-:'~:~--.~r~.
~:~ ' ':':' '"' :':'"' ': .. -..:':-~..:..~'.?.,~.L~. -.,, .'~ - ,.":~::~?:~-:r4~.!~:~i-:..c'.
.... ~:...~,,-~.:.:..,,:~...- .... -..:-':~ !: /' :'d" Ti:HIS
Employee. Signature i
Site Name or Adaress~
(Local, State, of F~deral)
Site Specific Time Accoun=~ng ~nee= ·
' Site Specific Status Changes:
Permit
CONTRACT OPTIONS FOR LEAKING TANKS
Site Specific Time Accounting Sheet
Site Specific Status Changes:
Employee Signature
Site Name or .~.aares~
~ing'(~cai'~ S~te, of F~eral)
-- ' .......... Hours
Category Activity (10tbs)
Date Code Code Description
Data Ente~ By: Da~e:
SERVICE AND COMPLAINT FORM
[] Service Request -r-'~ co'm plaint
Location
Directions
Reporting Person
KERN COUNTY HE/~LTH DEPARTMENT
DivisiOn of Environmental Health.
'
.- -;-' .'.'.".'~,~': .'
Address
Property Owner': '' Address '
' · . ' ~ '. ~CHD580 2760 372-[H'(~.~ Z'~80)
PROVID_ lNG 0___F pHYSICAL!' YOU~T O_~..F FACILITY_ USING SPACE PJ~ "IDED BELOW.
ALL OF ,THE FOLLOWING INFORMATION MUST BE INCLUDED IN ORDER FOR APPLICATION TO JE
' ~/'~ TANK(~), PIPING & DISPENSER(S), INCLUDING
PROPOSED SAMPLING LOCATIONS DESIGNATED BY THIS SYMBOL "~'
~// NEAREST STREET OR I .NTIS. ECTION . ' 100' RADIUS OF FACILITY
~ ~ WATm ~ o~ SU~AC~ ~TERS '~,I~m~
~ NORTH ARROW