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HomeMy WebLinkAboutUNDERGROUND TANK HAZARiUS MATERI ALS PE ITTING AND I ACTIVITY SHEET IANAGEMEN~ PECTIONS DATE 5.¢-~,at. ACTIVITY .... ' INITIALS ,I Permi[ Opera[ e Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ......... ~,~,,~,~?~,~,?.,~,,~,~, ......... This permit is issued for the following: PERMIT ID# 015-0214)01107 .~,~*it~*~i~"i,'i~i;,~!:;i~iiil,;i!iii!ii}iiiil;''' ..!!!!:!?~!~!i!!~::::i!!i!'.i~!?:;!!!!~?iiiiii~'~i~!~.~:~kii;M~agement Program . B P OIL FACILI~ ~11160 LOCATION 2688 OSWELL TAN H~RDOUS SUBSTANCE c~PACI~- ? GAL ' ~:~::-:'-'" :g6A~.~..~,,~:~:~',; i~ ~Sg;,'.~::~;~ ~ANK ,~{:': ..=::;~! TANK PIPING PIPING PIPING PI ~;:.::::~':~ '~ ~;,~*, ~'~ri~T~ ~~.~i~ ~!~O~ ::;:~?ONITOR TYPE TYPE METHOD O 0001 REGU~R UNLEADED GASO 12}0~0 GAg:~ ...... :;'~"":~;~;'.;:::':' ;pW F ,,e' ~lS ?:..,'",,~?~ 'MIR DW PRESSURE ALD 0002 UNLEADED PLUS 1 '~:~[ =::::~A.:.~,., "'" DW .,,,;;;;:'" VIS .,'~",':"~'= MIR DW PRESSURE ,ALD 0003 SUPER UNLEADED GASOLIN 10,O~b~',,,G~ ? ~;~::;::;;; DW ..... E,:.:::~,, .~.,,':.;,.'~" V S:', ',: ? MIR DW' PRESSURE ,ALU 0004 WASTE OIL 1,000'~g0 :::~U~,,~; ~ '~;,',:;;~;:;~ ~;;:~:~;::: DW ~::.~;;~;~,,i;~;':~;~,~ .... yiS. ='?~ MIR DW PRESSURE ALD Issu~ by: ~~ ~ B~ersfield Fke Depa~ment Approved by: ~~~~' OFFI~ OF~RON~AL S~ ~CES ~ , 1715 Chewer ~Ve., ~rd Floor B~emfiel~ CA 93301  Voice (805) F~ (80S)~26~S76 Expiration Date: dun~ ~0~ ~O00 D FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 SUPPRESSION SERVICES 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (805) 326-3951 FAX (805) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (805) 326-3979 FAX (805) 326-0576 TRAINING DMSION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (805) 399-4697 FAX (805) 399-5763 January 4, 1999 Mr. Edward C. Ralston Tosco Marketing Co. 1380 Lead Hill Road, Suite 120 Roseville, CA 95661 CLOSURE OF 4 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANKS LOCATED AT;2688 OSWELL STREET., PERMIT #BR-0218. Dear Mr. Ralston: This is to inform you that this department has reviewed the results for the preliminary assessment associated with the closure of the tanks located at the above stated address. Based upon laboratory data submitted, this office is satisfied with the assessment performed and requires no further action at this time. Accordingly, no unauthorized release reporting is necessary for this closure. If you have any questions regarding this matter, please contact me at (805) 326-3979. Sincerely, Howard H. Wines, III Hazardous Materials Specialist Office of Environmental Services HHW/dlm cc: Y.Pan, RWQCB J. Leifer, ERI 06/01/98 MON 14:53 FAX 949 457 8950 PRELIMINARY SOIL SAMPLE ANALYTICAL RESULTS TOSCO STATION #11160 2688 Oswell Street, Bakersfield, California ~oo3 SAMPLE NUMBER TPH-G (ppm) BENZENE {~'pm.) MTBE (ppm) PID,(p, pm) S-25-T1S ND<1.0 ND<0,005 0.19 27 _S--22-T2S .. ND<1.0 ,. ND<0.005 1.2 41 S-20-T3S ND<1.0 ND<0.005 0.26 0 Notes: Analytical results are from samples submitted for 24-hour turnaround ND- Not Detected PID - Photoionization Detector PPM - Parts Per Million 1886_T1.XL$ 06/01/98 MON 14:55 FAX 949 457 8950 ERI 004 EMERGENCY RESPONSE pLAN UNDERGROUND STORAGE TANK MONITORING PROGRAM This monitoring program mus~ be kept at the UST location at all times. The information on this monitoring program are conditions of the operaling permit. The permit holder must not/f3, the Office of Environmental S~vices within 30 days of any changes to the monitoring procedures, unless required to obtain approval before making tho change. ~ by. Sections 2632(d) and 264 l(h) CCR. Facility Name Facility Address If an -ns-thorized release occurs, how will the hazardous substance be cleaned up? Note: If released hazardous substances reach the environment, increase the fire or explosion b~rd, are not cleaned up from the secondary, containment within 8 hours, or deteriorate the secondary containment, then the Office of Environmental Services must be notified .within 24 hours. o Describe the proposed methods and equipment to be used for removing and properly disposing of any hazardous substance. 3. Describe the location and availability of the required cleanup equipment in item 2 above. 4. Describe the maintenance schedule for the cleanup equipment: List the name(s) and title(s) of the person(s) responsible for authorizing any work necessary under the response plan: WReN MONITORING PROCESS UNDERGROUND STORAGE TANK MONITORING PROGRAM Th~ momtorm$ program must be kep~ at the UST location at all times. The information on thi~ ~ program am condP/ons of the operming permit. The pm'mit holder must notify the Office of Envimmmmml S~/viges w~thin 30 ~ O~SJ~/cl~n~m~ tO ~ nlomtorill8 procedures, un~ required to old-in approval before making th~ clumg~. Requirod by Sectiom 2632(d) ami 2641(h) CCR. Facility Name Facility Address Describe the frequency of performing the monitoring: Tank Pipin~ What methods and equipment, identified by name and model, will be used for perfoming the monitoring: Tank Piping Co Describe the location(s) where the monitoring will be performed (facility plot plan should be attached): List the name(s) and title(s) of the people, responsible for performing the monitoring and/or maintaining the equipment: Eo Reporting Format for monitoring: Tank Piping Fo Describe the preventive maintenance schedule for the monitoring equipment. Note: Maintenance must be in accordance with the manufacturer's maintenanee sehednle but not less than every 12 months. G. Describe the training necessary for the operation of UST system, including piping, and the monitoring equipment: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES 171,5 CHESTER AVENUE BAKERSFIELD, CALIFORNIA 93301 /, B/ORSFIELD FIRE DEPARTMENT - ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 TANK REMOVAL INSPECTION FORM FACILITY lg~(L,~l( 1] q ADDRESS c9(~ ~ OWNER ~ PE~IT TO OPE~TE9 ~- CO~CTOR ~cm~( ~ CO.ACT PERSON ~e~ ~BO~TORY ~a ~ %OF S~PLES TEST METHODOLOGY ~ - ~ PRELI~NARY ASSESSME~ CO.~,~ ~e'~O~ACT PERSON CO~ RECIEPT ~ ~ LEL% ~ O2% PLOT PLAN CONDITION OF TANKS CONDITION OF PIPING CONDITION OF SOIL ~ 002 ~Permit No. CITY OF BA~RSFI~D ~ ~ ~. OFFICE OF ENVIRONMENTAL SERVICES ]- ~ ~ 1715 Chester Ave., Bakersfield, CA (80~) ~26-~979 ~ ~ ~dq PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK SITE INFORMATION SITE ~-~J;~ O~°b0~'~/-2-~ ADDRESS ~)/::J~-~I~-I/-.--Z_D ZIPCODE FACILITY NAME ' TANK OWNER/OPER/kTOR _ ~ CROSS STREET PHONE NO. MAILING ADDRESS ..~Jd.D.j~/~C) ~q ClTY~O_~-'~/~/ APN zip ~ c_onTractor InFOrmATIon ., comPanY m~?!~J2_~/d~-zcm~ T/~//~ P,OnE n°. 90~- V/~- OCs~/LIc~.nSe NOo INSURANCe cARRiER L,(~4 IC~/., ? ~JS..~ ~/~ WORKM~NS COMP NO. ,,.pRELIMINARy ASSESSMENT INFORMATiOn. ~']-~'i-~- COMPANY PHONE NO. LICENSE NO. ADDRESS, INSURANCE CARRJER CITY ZIP WORKMENS COMP NO. tan~ cLEAmNG reFORmatIOn WASTe Trans~r~r IDENTIFICATION ~ER NAMEOFRI~_DIS~SALFA~ILI~ ~~V ~ ~~N ADDRESS c~ FACILITY IDE~IFICATION NU~ER ~og~ess 3 zz~ ~l~ ~~ ' a~ ~~~ .... ~o. zn,~ Y~,?o ZIP TANK INFORMATION CHEMICAL DATES TANK NO. AGE VOLUME STORED STORED For official ! ~se (~nlv APPLICATION DATE ' '.i .... :..'"/...'FACiI'. NO: 'NO, OF.T ' :'"' FEE'S':.'" CHEMICAL PREVIOU~SLY STORED TI I1.: API'I,IC^NT llAS RECEIV~:D. I INl)ERS'l'ANl)S, AND W~.,L COMPI.Y WITII ~ A'iTACItED CO~)ITIONS~OF Tills I'I.]IMIT AND ANY ()TILER STA'I E. l.OC'~, ~D I:I~DI]RAL ~O~ONS TI lis I,'()RM l laS BEEN C()MPI. I~TEI) I/NI)ER PENAL~ OF PERtlY. A~ TO '~ BEST ()F MY ~OWI,I~IXJE ANI ) C()RRI THIS APPLICATION 8ECOM~ A PERMIT ~EN APPRO~D December 1, 1997 Attn: 2M2 Engineers Re: Authorized Agem Notification To Whom it May Concern: This memorandum will serve as formal authorization for Lupe Renteria to serve as an authorized agent for TOSCO Marketing Company. Lupe Renteria may act a~s an authorized agent to include signature authority for all permits, applications, and fee commitments up to $1,000.00. The duration for this authorizatkm will not exceed one year -- 12-1.-97 to 12-1-98. If you have any questkms, please feel free to contact the undersigned at y~mr earliest convenience. Cordially, Tosco Marketing Co. 76 Broadway Ave Sacramento, CA 9581g pH (91.6) 558-7600 Fax (916) 446-2559 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM A COMPLETE THIS FORM FOR EACH FACILITY/SITE MARKONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED. ONE ITEM []' 2 INTERIM PERMIT ~ 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) D.~oOR FACILITY NAME NAME OF OPERATOR ~. ~ BOX ~RPORATION ~ INDIWDU~ ~ PAR~ERSHIP ~ LOCAL-AGENCY ~ COUN~-AG~CY' ~ STATE-AG~CY * ~ F~E~-AGENCY' TO INDICATE DISTRICTS ' ~ o~er ol UST ~ a publ~ a~nw, ~mplete the lol~whg: ~e ot supe~or of d~n, s~n or office ~ operates the UST EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY) - optional IDAYS: NAME (LAST, FIRST} t PHONE # WITH AREA CODE INIGHTS: NAME (LAST, FIRST) PHONE # WITH AREA CODE II. PROPERTY OWNER INFORMATION - (MUST BE COMPLETED) DAYS: NAME (LAST, FIRST) PHONE # WITH AREA CODE INIGHTS: NAME (LAST, FIRST} PHONE # WITH AREA CODE MAU~NG OR STREET ADDRESS / CI'~NAME · v - III. TANK OWNER INFORMATION - (MUST BE COMPLETED) CARE OF ADDRESS INFORMATION box IQ ind..ate ~--~ INDIVIDUAL CORPORATION E~ PARTNERSHIP E~ LOCAbAGENCY E~] STATE-AGENCY r---ICOUNTf-AGENCY r-'-] FEDERAL-AGENCY NAME OF OWNER ~ CARE OF ADDRESS INFORMATION MAILING OR STREET ADDRESS ' I v' boxto indicate ~ INDIVIDUAL [-'-] LOCAL-AGENCY [~] STATE-AGENCY I r-~ CORPORATION E~ PARTNERSHIP r'~ COUNTY-AGENCY [~ FEDERAL-AGENCY I STATE ZIP CODE IPHONE # WITH AREA CODE CITY NAME IV. BOARD OF EQUALIZATION MST STORAGE FEE ACCOUNT NUMBER - Call (916) 322-9669 if questions arise. TY (TK)'HQ {~'TJ. 101312. 1'7,131 V. PETROLEUM~UST FINANCIAL RESPONSIBILITY - (MUST BE COMPLETED) - IDENTIFY THE METHOD(S) USED ~' box to indicate ~ 1 SELF-INSURED ~ 2 GUARANTEE ~ 3 INSURANCE ~ 4 SURETY BON .D [~ 5 LETrEROFCRED[T ~ 6 EXEMPTION [-'-'{ 7 STATEFUND [~ 8 STATEFUND& CHIEFFINANCIALOFFICERLE'n'ER ~ 9 STATEFUND&CERT~FICATEOFDEPOSlT ~ 10 LOCALGOV'T. MECHANISM r-~ 99 OTHER. VI. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked. ICHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILLING: THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT TANK OWNER'S NAME (PRINTED & S, IG~JRE)//"-'-~ LOCAL A~ENCy use 0~ -I~-- ~ - COUN~ ~ JURISDICTION LOCATION CODE . OPTIONAL JTANK OWNER'S TITLE JDA(~,~/ il~Y/YEAR ,1 _._ FACILITY # CENSUS TRACT # o OPTIONAL SUPVISOR - DISTRICT CODE . OPTIONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION - FORM B, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. OWNER MUST FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM A (6-95) ~i ' !' ' ' ,. STATE OF,CALIFORNIA· ! STATE WATER RESOURCES CONTROL BOARD : ?' : . UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORU A. ' ' COMPLETE THIS·FORM FOR EACH FACILITY/SITE MARK ONLY E~'-'I'- NE,W PERMIT [] 3 RENEWAL PERMIT []. 5 CHANGE oF INFORMATION E~' 7 PERMANENTEY CLOSED. SITE · ONEITEM', [] 2' !NTERi,M PERMIT ~ 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION &ADDRESS-(MUST BE CoMpLETED)· . ~i .. ' '"' '" osOR FACILITY NAME ' , NAME OF OPERATOR ADDRESS" · '' ' TO INDICATE ' - "' ,' DISTRICTS. ' ~PE OF BUSINESS ~ ~ GAS STATioN 2 DISTRIBUTOR ' ~ .,RESEBVAnON .' ,~ 3 FARM 4 PRocEssoR . ~ '5 OTHER' , OR TRUST ~NDS EMERGENCY CONTACT PERSON (PRIMARY) · ID_AYS: NAME (LAST. FIRST) , · ... II, PROP~R~ O~N~R.IN~OR~ATION- .i?' ,~; '.~;; ;:?..~EMERGENCY CONTACT PERSON(SECONDARY) -o ptional- , DAYS!' NAME (LAST, FIRS~ ' PHONE #.WITH AR~ CODE NIGHTS: NAME (LAST, FIRST) · .' , PHONE # WITH AREA CODE CARE OF ADDRESS INFORMATION v' box to incr~cate,' ' ~ INDIVIDUAL :~[~ LOCAL-AGENCY r'"-] STATE-AGENCY ~] c0RPoR~lON 'E~ P,~RTNERSHII~ t; '~'' [~ COUNT'C-AGENCY E~ FEDER~t'-AGENCY . IV; BOARD '~OF EQUALIZATION US~"~;i'~RAGE'FE~ ACCOUNT NUMBi~R- Call (9i 6) 322:9669 if 'questi0ns.arise. TY (TK)HQ ~-~-]~ '0 ,.~ ;~," f~ "'].~L~ '. ._. . .;~.~. ~,. -.' ,,, , , , . .. . · .. V. PETROLEUM~USTFINANCIAL RESPONSIBILITY- (MUST BE COMPLETED) - IDENTIFY THE METHOD(S)USED J~ I.v" box to indicate ~ ,1 SELF-INSURED. [~ .2 GUARANTEr~ [~'3 INSURANCE [~] 4' SURETY BOND· [~] 5 LETI'ER OF CREDIT "[--~ 6 EXEMPTION i [~ 7 STATE FUND, . , , [--1 8 STATEFUND&CHIEI~FINANClALOFFICERLETrER ~ 9 STATE FUND & CERTIFiCATE OF DEPOSlT ' [---] '10 LOCALGOV'T. MECHANISM ~ 99 OTHER .' VL LEGAL NOTiFICATION'~,ND BILLING ADDRESS Legal notification and billing will be'sent to the.tanl~ owner unless box I or II is checked. CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS sHouLD BE USED FOR LEGAL NOTIFICATIO ,NS AND BILLING: I. [] IIi'E~ ill. [] THIS FORM HA S BEEN.cOMPLETED UNDER PENALTY OF PERJURY, AND 70,THE BEsT OF MY KNowLEDGE, IS' TRUE AND CORRECT ; .;"i~, ' TANK OWNER'S NAME (I I I LOCAL AGENCY USE .......... : · LO.?~T,ON COOE CENSUS TRACT,-- O~"~O~,~'. . . O~'T~O~,~ ..... . suPv SOR- D STR CT CODE- O~'~'~O~,~' THIS FORM MUST BE ACCOMPANIED By AT LEAST (1) OR MORE PERMIT APPLICATION - FORM B,'UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. FORM A (6-95) oWnER MUST FILE THIS FORM WITH THE LOCAL AGENC,Y' IMPLEMENTING'THE UNDERGROUND. . . STORAGEs, TANK REGULATIONS . STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUNDSTORAGE TANK PERMIT APPLICATION - FORM A COMPLETE THIS FORM FOR EACH FACILITY/SITE MARKONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION ONE ITEM [] 2 INTERIM PERMIT ~ 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE 7 PERMANENTLY CLOSED, SITE I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPELLED) .~osOR FACILITY NAME NAME OF OPERATOR ADDRESS ' ~ - , - N~ST CF OSSC~~ PARCEL , (OP~ONAL)  NAME .,' STATE ZIP CODE SITE PHONE ~ WITH AR~ CODE TO~INDICATEBOX ~RPORATION ~ INDIVIDUAL ~ PAR~E~SHIP ~ DiSTRIOTs.LOCAL'AGENCY ~ COUN~-AG~CY' ' ~ o~er of UST ~ a pubt~ a~e~, ~mplete lhe lol~w~: ~e d s~eMsor Ct dMs~n, ~n or offi~ wh~ ope~les the MST ~PE OF BUSINESS ~ 1 GAS STATION...~ ................ 3 FARM ~ ~ 42 DISTRIBUTORpRoCESSOR '~. :.'~50~ER, x. '1 ' ~ORRESERVA~ON'~ IF INDIAN I' O~NKS AT'SITEf~UST_. , ,~,~,-~NDS.~ EMERGENCY'CONTACT PERSON (PRIMARY) .... . .~ *:.". "-" ':';': 'EMERGENCY CONTACT PERSON '(SECONDARY) - optional IDAYS: NAME (LAST. FIRST) I PHONE # WITH AREA CODE - DAYS: NAME ..... ' ' ..... (LAST. FIRST) I NIGHTS NAME'(LAST FIRST;}- ( , PHONE # WITH AREA CODE ,PON 2,t,;O.',LSp. I II. PROPERTY OWNER INFORMATION - (MUST BE COMPLETED) PHONE # WITH AREA CODE NIGHTS: NAME (LAST, FIRST) PHONE # WITH AREA CODE C~ARE OF ADDRESS INF~)RMATION :' ' '-' ~ IMAILING OR STREET ADDRESS CI'T~Y\NAM E ' ' ~xto ;.~6'~.~ie i---] INDIVIDUAL '~] LOCAL-AGENCY [~ STATE.AGENCY CORPORATION [~ PARTNERSHIP ~ COUNTY-AGENCY ~ FEMORAL-AGENCY IlL TANK OWNER INFORMATION- (MUST BE. COMPLETED) NAME OF OWNER ~ , r ~'~ ~ /PHONE #~WITH AREA COI)F.. I/ boxto(in?ate',!" I~ INDIVIDUAL [--'-I CORPORATION I'~ PARTNERSHIP STATE ZiP CODE '~: ' PHONE # WITH AREA CODE MAILING OR STREET ADDRESS CITY NAME :- i-'-]:LOCAL.AGENCY r-'] COUNTY-AGENCY STATE-AGENCY FEDERAL-AGENCY IV. BOARD OF EQUALIZATION UST 8~)RAGE FE~ ACC~OUNT NUMBER- Call (916) 322-9669 if questions arise. ' - ' ,T~.~ (TK) HQ Io.' L3 · PETROLEUM.UST FINANCIAL RESPONSIBILITY . (MUST BE COMPLETED) - IDENTIFY THE METHOD(S) USED ~* boxtomdicate. [~'~1 SELF-INSURED [~] 2 GUARANTEE [~] 3 INSURANCE r--I 4 SURETYBOND r-15 LETRER OF CREDIT r-I 6 EXEMPTION t*---} 7 STATE FUND [~ 8 STATE FUND & CHIEF FINANCIAL OFFICER LETTER {-~ 9 STATE FUND & CERT~FICATE OF DEPOSiT [~ 10 LOCALGOV'T. MEcHANisM ~ 99 OTHER VI. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked. CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOOED BE USED FOR LEGAL NOTIFICATIONS AND BILLING: I. [] II. [] III. [] THIS FORM HAS BEEN COMPLETED UNDER.~PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDG, E, IS TRUE AND CORRECT LOCAL AGENCY USE oNL~ OOUN~ .,... [1'1 I I I I I I I - OPTIONAL OENSU8 T~AOT ~ - OPTIONAL 8UPVlSOR - DISTRIOT CODE - OPTIONAL THIS FORM MUST.BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION. FORM B, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. FORM A (6-95) OWNER MUST FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND S~TORAGE TANK REGULATIONS STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY [] 1 NEVV PERMIT [] 3 RENEWAL PERMIT ONE ITEM E~ 2 INTERIM PERMIT [] 4 AMENDED PERMIT ] 5 CHANGE OF INFORMATION ] 6 TEMPORARY TANK CLOSURE [--1 7 PERMA. ENTLV CLOSED ON S,TEI [] 8 TANK REMOVED / DBA OR FACILITY NAME WHERE TANK IS INSTALLED: '~ ~= I [ I [~ I. TANK DESCRiP¥iON COMhLETE ALL ITEMS- SP~C~ ~ U.K.OWN C. DA~ 'NST~D (MO~AY.~) t~g.O_ D. TANK C~AOI~ IN ~LLONS: II. TANK C~N~S ~ a-~ ~ ~K~g, CO~.~ ~ C. ' A. ~ 2 P~O~uMMOTOR VEHIC~ FUEL ~ ~4 OILEMP~ B. PRODUCT C. ~b PR~IUM UNL~ 4 ~S~Ok ~ 7 M~ANOL lc MI~EU~ ~ 5 J~FUEL ~ 8 Ma5 ~ 3 CHEMIC~pRODu~ ~ 95 UNKNO~ ~ 2 W~E ~ 2 ~ED ~ ~ O~ER~C~iB, IN~MD.B~0~ D. IF (~1) IS NOT M~D, E~R N~E OF SUBSTANCE STO~ED C. ~ S. ~: Ill TAME P~&I~I A. TYPE OF HU~0N MARK ONE ITEM ONLY IN BOXES A. B. AND C. AND ALL THAT APPLIES IN BOX D AND E I~ ' ~ou..; wu [] 3 S,NGU~ WALL WITH EX~R,OR UNER [] 5 ,~..AL E~. s~s~ [] .5 UN~.OWN SYSTEM [] 2 SINGLE WALL [] 4 SINGLE WALL IN A ,VAULT ~ [] 99 OTHER e. TANK [] 1 BARE~II=t:L J' J 2 STAINLESS STEEL J~3 FIBERGLASS [] 4 STEELCLAD W/ FIBERGLASS REINFORCED PLASTIc MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLE W/FRP (PrtmaryTank) [] 9 BRONZE '[] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER C. INTERIOR [] 1 RUBBER UNED [] 2 ALKYD LINING [] 3 EPOXY uNING [] 4 PHENOLIC UNING LINING OR [] 5 GLASS UNING [] B UNUNED [~ 95 UNKNOWN [] 99 OTHER COATING IS UNING MATERIAL COMPATIBLE WITH 100% METHANol? YES ~ NO~ D. EX-~ I:HIOR ] 1 POLYETHYLENE .WRAP [] 2 COATING ] 3 VINYL WRAP CORROSION [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION E~ 91 NONE [] 95 UNKNOWN [] 99 OTHER SPILL CONTAINMENT INSTAl i ~n (YEAR) ~ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) UN ['~ E. SPILL AND OVERFILL, etc. DROP TUBE YES NO STRIKER PLATE YES NO DISPENSER CONTAINMENT-Y[=S NO IV. PIPING INFORMATION A. SYSi~-M TYPE A U 1 SUCTION · B. CONSIHUC~ON A U 1 SINGLE WALL C. MATERIAL AND CORROSION PROTECTION D. LEAK DETECtiON CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPUCABLE A ~2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING' A U 99 OTHER A (,.U~2 DOUBLE .WALL A U 3 UNED TRENCH A U 95 UNKNOWN A U 99 OTHER A U 1 BARES'~E~-L A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A~ 4 FIBERGLASS PIPE A U 5 ALUMINUM * A U 6 CONCRETE A U 7 STEELW/COATING A U 8 100% METHANOL COMPATIBLEW/FRP A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECT]ON A U 95 UNKNOWN A U 99 OTHER i'~1 I~CH~'ICN. UNE LEAK DETECTOR [] 2 MNE TIGHTNESS J-~ 3 CONTINUOUS IN~-~iliLM. [] 4 E[ECm0~C U~E [] 5 AUTOI4~C PUMP TE~ ~ MONITORING LEAK OETECTOR . SHtrrDOWN [] 99 OTHER V. TANK LEAK DE J ~-CTION [] 1 VISUAL CHECK [] 2 MANUAL INVENTOHY [] 3 VADOZE RECONCIUATION MONITORING [] 4 AUTOMATIC TANK [] 5 GROUND WATER [] 6 ANNUAL TANK GAUGING MONITORING TESTING [] 7 CONTINUOUSMoNiTORiNG INTERSTITIAL' [] e SIR [] 9 WEEKLY MANUAL [] 10 MONTHLY TANK C--J 95 UNKNOVVN [] 99 OTHER TANK GAUGING ~t:;~ ~ ~NG VI. TANK CLOSURE INFORMATION (.ERMANEm' CLOSUhE IN-PLACE) 1. ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTITY OF 3. WAS TANK FILLED WITH YES [] NO [] SUBSTANCE REMAINING GALLONS INERT MATERIAL ? THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF P. ERJURYy.~_.~V. ~O.~TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT J TANK OWNER'S NAME ~-~ / -' - ' DAT LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW I COUNTY it JURISDICTION # FACILITY # TANK # STATE .D;# III II I I I I I I i-I I I Iii I THIS. FORM MUST BE ACCOMPAHiED BY A PERMIT APPUCATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN RI.ED. FORM C MUST BE COMPLETED FOR INSTAU..ATIONS. 'THIS FORM SHOULD BE ACCOMPANIED BY A PLOT PLAN. FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM B (6-95) · - ' -" '* STATEWATER RESOURCES CONTROL I~ARD :: ,~-':"-:,- .'. '-" UNDERGROUND STORAGE TANK PERMIT APPLICATION -FORM.B-- : ·" ' . '. ". --:' · COMPLETE A SEPARATE FORM FOR EACH TANK SySTEM; :: . MARK ONLY ' [] I I~E-W PERMIT [] 3 RENEWAL PERMIT - i~"1' 5. CHANGE OF:INFORMATION ONE ITEM [] . 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARy TANK CLOSURE DBA OR FAClUTY NAME WHERE TANK IS INSTALLED: ~"L)~ '=~ I ~ I L~C:) · [] 7 PERMANENTLY. CLOSED ON'S~TEI,' ] 8 TANK .REMOVED. · I. TANK DESCRIPTION COMbLETE ALL ITEMs - SPECIFY IF uNKNOWN ~ OWNER'S TA,K LD., [~C~0 '- '. B. 'MA"UPACTURED:.BY:":' b:-.. · I~:~ULUI~/""" ': . ·~1 :... II. TANK ~N~S ~ A-IlS ~D COMP~ I~M C. : r ' ' : ' ~ 2 P~O~UM '~ .~ EM~- ~'~' PRODU~ ~ ~ ~"lbpR~M.~.. ~[4 ~OL' ~: 7'M~N0~ ~ 3. CH~IC~PRODUCT ~ 95 UN~O~ '-'~ 2 W~ ' ~:' ~"~CM~Eu~':~"5'J~'FUEL '~"8'M85"~ ":~- ' . ' ~ 2 ~ED · ~' ~' O~CRIBEIN~D D. IF(~I)IS'NOTM~D, E~R ~E OFSUB~CE ~ORED· C.~S.~: · IlL TANK CONSTR~J~TION- MAR~ONEITF'Mo"LYINBOxESA. B, ANDc, ANDAII=THATAPPLIEsiNBoxDANDE. , ' .- '~ .A. TYPE OF ' ~'~ ~1 DOURL~' WAll · ' ' '['~---1'.' 3 SINGLE"wAIl WITH EXTERioR UNER :. ' [] 5 INTERNAL BLADDER SYSTEM . 95 UNKNOWN r ~' 3 ' primat,~ Tank)~SYSTEM. . [] "2 S~NGLE 'WALL B."TANK ' '"' [] :'l' s~ES~EL MATERIAL ' [] s CONCRETE ] 9 .BRONZE '' [] '2 STAINLESS STEEL ~ I' I 3 FIBERGLASS. [] 4 .sTEELCI~AD W/FIBERGLA~SREINFORcEDPLA~TIC i'~ 6 POLY%qNYL CHLORIDE. [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBEEW/FRP [] 10 GALVANIZED.STEEL [] 95 'UNKNOWN .: .'. [] ~9 OTHER' ~-'" C. INTERIOR [] 1- RUBBER UNED [] 2 ALKYD LINING· ' [~ 3 EpoxY 'UNING [] J,. pHENOLIC'UNING LINING OR- [] 5 GLASS UNING ' ' [] 6 'UNUNED. I'TI: 95. UNKNOWN' · '['-TI 99, OTHER" ' ~" COATING · -is MNING MATERIAL 'COMPATIBLE WITH 100% METHANOL ? YES ~ NO__' ' · D'EXII"HIOR [] 1 PoLyETHyLENE ~ [] 2 COATING -. · [] 3 VINYL WRAp [] 4 'FBERGLASS RENFORCED PLASTIC CORROSION . ' . · · PROTECTION [] s CATHODIC PROTECTION [] 9'~ HONE., ,,.,,, [] 95 UNKNOWN [] 99 OTHER" _' ,,/., E SPILL AND OVERFILL etc' SP~LL CONT,~INMENT INSTALLED (YEAR)- L~'%~ ~ .. OVERFILL PREVENT1ONEQUIPMENTINSTALLED (YEAR) }?~,l~.[ .~.._.. " . ~ · DROP TUBE YES' -~ · NO STRIKER PLATE YES ... '.NO ' :DISPENSERCONTAINME~ ~' ~' . UNO OR U IF UNDERGROUND, BOTH I1~ APPUCABLE . ' ' ' IV. PIPING INFORMATION CIRCLE A i~ ABOVE/~RO A, SYSTEM TYPE AU 1' SUCTION A~T'~* PRESSURE. , A U 3 GRAVITy A U. 4-FLEXIBLEPIPING A U 99 OTHER' ~ r B. CONSTRUCTION A U .. 1 SINGLE WAIl' A ~ DOUBLE WAIl ~ A U '3 UNED TRENCH A U 95 (I~KNOWN . A U 99' OTHER' C. MATERIAL AND A U'. 1 BARE STEEL · A U 2 S'I:AINLESs sTEEL A U 3 POLYVlNYL CHLORIDE(PVC)A ~ 4-FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U '6 CONCRETE A U 7 STEEL WI COATING - A U S 100% METHANOL COMPATIBLEw/FRp PROTECTION A U' '9 G.~LVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOW. N . A'U 99. OTHI~-R ..... · D. LEAK. DETEcTiON.'. [] 1 ~-'T~CTORMECH~BC~ LINE ~ [] 2 TEs~UNE ~I~S~. ~'3 C0~NU~MOt~T~iN~ I~llllN. L.-_J ~ 4 :ElrCl~0N]¢.UNE'.IF_AK ~TEC'~OR [] 5 AUTOMAT]Cshl/~DOWN PUM~.. [] 99 ~)THER ' ." .... , · V. TANK LEAK DETECTION ' I[] 1 'VISUAL CHECK [] 2 MANUAL INVENTORY [] 3 VADOZE . [] 4 AUTOMAT1C"¥ANK'[~] 5 GROUND WATER .[] 6 ANNUALTANK - RECONCIUATION MONITORING GAUGING '. . MONITORING *' TESTING.' [~. ' CONTINUOUS INTERSTITIAL [] , SIR [] ' WEEKLY MANUAL [] 10 MONTHLY TANK VI. .1. -LOCAL AGENCY USE ONLY STATE I.D:# PERMIT NUMBER [] g5 UNKNOWNs. [] 99 oTHER' '' TANK CLOSURE INFORMATION (PERMANENT CLO-~URE IN-I~LACE)' ' '' ESTIMATED ~ATE LAST USED (MO/DAY/YR) '1 2: ESTIMATED QUANTITY OF :' ~. 3:'WAS'TANKFILLEDWlTH YES[] N~).[] . 'SUBSTANCE REMAINING GALLoNs ' 'INERT MATERIAL ? THIS-FORM HAS.BEEN'COMPLETED UNDER PENALTY OFiP./~_ JURY~,/ATVD~O THE BEST oF.My KNOWLEDGE, iS, TRUE AND CORRECT TANK OWNE 'S NAME ~ ' ' ' ~ DAT,.~ THE STATE I.D. NUMBER IS COMPOSED OFTHE FOUR NUMBERS BELOW COUNTY # JURISDICTION ~t FACILITY # ** ' TANK # * *~ .' ,. PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE , THIS FORM MuST BE ACCOMPANIED BY A PERMIT APPUCATION - FORM A, UNLESSAcI~RRENT FORMA .HAS BEEN RLED. FORMC:MUSTBECOMPLETEDFORINSTALLATIONS~,THIS FORM .SHOULD BE ACCOMPANIED BY A. PLOT PLAN. RLE THIS FORM WITH THE LOCAL AGENCY·IMPLEMENTING THE'UNDF~¥GROUND STORAGE TANK REGULATIONS FORM B (6-95) ': ' ' * STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERUIT APPLICATION -FORU B ' COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY --~; [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED ON SITE{ ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED DBA OR FACILrrY NAME WHERE TANK IS INSTALLED: ~'~,J~ ~ I ~ I ~::) ..~ ' I. TANK DESCRIPTION cOmPLETE ALL ITEMS - SPECIFY IF UNKNOWN I. OWNER'S TANK,.D., C. DATE INSTALLED(MO/DAY/YEAR) D. TANK C*,AC,TY ,. GALLO.S: 10 OOO II, TANK C~ONTENTS IF A*I IS MARKED, COMPLETE ITEM C. [] 2 PETROLEUM [] 80 EMPTY PRODUCT [] ,c MIDGRADE UNLEADED [] 5 JET FUEL [] 8 M85 ' i---"1 3 CHEMICAL PRODUCT [] 95 UNKNOWN [] 2 WASTE [] 2 LEADED [] 99 O~tER(DESCRIBEINiTF. MD. BELOW) D. IF (A. 1} IS NOT MARKED. 'EN'~'ER NAME OF SUBSTANCE STORED C.A.S. #: IlL TANK CONSTRUCTION MARK ONE ITEM ONLY ]N BOXES A, B, ANDC, AND ALL THAT APPLIES IN BOX D AND E A. TYPE OF - , '[~. 1. DOUBLE WA~ SYSTEM [] 2-SINGLE WALL . .TANK . MATERIAL (Primary Tank) c. iNTEmOR LINING OR COATING ] 5 CONCRETE ] 9 BRONZE ] 3 SINGLE WALL WITH EXTERIOR uNER [] [] 4 SINGLE WALL IN A VAULT [] · [] 2 STAINLESS STEEL [~3 FIBERGLASS',~. ~,:,[~ [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM .[] [] .10 GALVANIZED STEEL [] 95 UNKNOWN ~-~ BLADDER SYSTEM [] 95 UNKNOWN 5 INTERNAL 99 OTHER ' 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC 8 100% METHANOL COMPATIBLE W/FRP 99 OTHER ~1 I 1 RUBBER UNED ~L._J 2 ALKYD LINING [] 3 EPOXY UNING [] 4 PHENOLIC UNING. [] 5 GLASS LINING [] 6 UNUNED ~' 95 UNKNOWN [] 99 OTHER IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES_ NO__ D, EXTERIOR [] 1. POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC CORROSlON PROTECTION [] $ CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER SPILL CONTAINMENT INSTALLED (YEAR) [,~1~',~ ~,, OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR). U~'~ E. SPILL AND OVERFILL, etc. DROP TUBE YES NO STRIKER PLATE YES NO DISPENSER CONTAINMENT YES NO IV. PIPING INFORMATION A. SYSTEM TYpE B. CONSTRUCTION C. MATERIALAND CORROSION PROTEC~0N CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND. BOTH IF APPLICABLE SUCTION A 1~2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER SINGLE WALL A ~,~ DOUBLE WALL A U 3 UNED TRENCH A U 95 UNKNOWN A U 99 OTHER BARES'rEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL ~CHLORIDE(PVC)A (~ 4 FIBERGLASS PIPE ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION [] 1DE'~CrORMECHANICAL MNE LEAK [] 2 ~ES'~GUNE TIGI.~ESS [] 3 CON"n,U0USMoNiTORiNG ,NTERS~ [] 4 ~ELECTRONIC[~"~CToRUNE [] 5 AUTOMAT1CsHuTDOWN PUMP [] 99 OTHER V. TANK LEAK DETECTION [] 1 VISUAL CHECK []. 7 CO"TINUOUSINTERSTITIAL [] 8 S~R MONITORING [] 2 MANUAl. INVENTORY 'E~ 3 VADOZE j'~ 4 AUTOMATIC TANK [] 5 GROUND WATER [] 6 ANNUALTANK RECONClEATION MONITORING -- GAUG'NG MONITORING TESTING [] 9.TANKWEEKLYGAuGINGMANUAL ~r'~ 10 TESTINGMONTHLY TANK [] 95 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACE) I1. ESTIMATED DATE LAST USED (MO/DAY/YE) 2. ESTIMATED QUANTITY OF 3. WAS TANK FILLED WITH YES [] NO [] 'FHIS FORMHAS BEEN COMPLETED UNDER PENALTY OF~P,E~IJURY, AND..~O THE BEST'OF MY KNOWLEDGE,' IS TRUE AND CORRECT I .TANK OWNER'S NAME _"J.-~ . LOCAL AGENCY USE ONLY ~E STA~ LD. NUMBER IS COMPOSED OF~E FOUR NUMBERS BELOW  COUN~ ~ JURISDICTION ~ FACILI~ ~ ' . ~' TANK ~ · " STATE I.D:¢ ~ I IIIII IIII PERMIT NUMBER ' ] PERMIT APPROVED BY.ATE PERMIT ~PIRATION DATE .~IS FORM MUST BE ACCOMPANIED BY-A PERMIT APPLICA~ON - FORM A, UNLESS A CURR~T FORM A HAS BE~ R~D. FORM C MUST BE COMPLIED FOR INSTA~ONS. ~IS FORM SHOU~ BE ACCOMP~IED BY A PLOT P~N, R~ ~IS FORM W~ ~E LOCAL AG~CY IMP~NG ~E UNDERGROUND STORAGE T~K REGU~ONS FORM B (~95) STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION ONE rrEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE ORAOR FAClLITY NAME WNERE TANK IS INSTALLED= "T~ ':~ I~.~J~[~) .' I. TANK DESCRIPTION COM~'LETE ALL ITEMS - 'SPECIFY' IF UNKNOWN [] 7 PERMANENTLY CLOSED ON SITEI [] 8 TANK REMQVED ' A. OWNE. R'S TANK I.D., - '' ' I B. MANUFACTURED BY: C. DA~ .INSTATED (M~AY~E~} D. TANK C~ACIW IN mLLONS: II. TANK CON~S ~F A-1 IS ~KED, coaP~ I~M C. A. ~ I MOTOR VEHICLE FUEL j~] .4 OIL B. C. la REGULAR UNLF_4DED [~ 3 DIESEL [] 6 AVIATION GAS '[--~ lb PREMIUM UNLEADED [] 4 GASAHOL [] 7 METHANOL [] ~ PETROLEUM [] 80 EMPTY [] 1 PRODUCT ~" lc MIDGRADE UNLEADED [] 5 JET FUEL [] 8 M85 [] 3 CHEMICAL PRODUCT [] 95 UNKNOWN [] '2 WASTE ~ 2' LEADED [] 99 OTHER (DESCRIBE IN [TEM D. BELOW) D. IF (A. 1) IS NOT MARKED, ENTER NAME OF suBSTANcE STORED C. K S. #: III. TANK CONSTRUCTION MARK ONE ITEM oNLY IN BOXES A. B: AND C, AND ALL THAT APPUES IN BOX D AND E * A. TYPE OF [~ 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR UNER [] 5 INTERNAL BLADDER SYSTEM SYSTEM [] 2 SINGLE WALL [] 4 SINGLE WALL IN A VAULT ~ 99 OTHER ]95 UNKNOWN B. TANK [] 1 BARE STEEL MATERIAL [] 5 CONCRETE (P~JmalTTal~k) [] 9 BRONZE ] 2 STAINLESS STEEL ~ 3 FIBERGLASS [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] '10 GALVANIZED STEEL [] 95 UNKNOWN ] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIc ] 8 100% METHANOL COMPATIBLEW/FRP ] 99 OTHER C. iNTERIOR [] 1 RUBBER UNED [] 2 ALKYD LINING [] 3 EPOXY UNING [] 4 PHENOLIC LINING LINING OR [] 5 GLASS UNING ' [] 6 UNUNED ~:] 95 UNKNOWN [] 99 OTHER COATING Is UNING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES_ NO__ D. EXIcMiOR [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC CORROSION * PROTECTION [] 5 CATHODIC PROTECTION .~-] 91 NONE [] 95 UNKNOWN [] 99 OTHER ~SPILL CONTAINMENT INSTALLED (YEAR) I ~ ~,~ _~ ~VERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) ~ ) ~1, ~ E. SPILL AND OVERFILL, etc. DROP TUBE YES NO ~ STR-IKER PLATE YES NO DISPENSER CONTAINMENT Y[~S ~ NO IV. PIPING INFORMATION A. SYstEM TYPE B. CONSTRUCTION C. MATERIAL AND CORROSION PROTECTION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND. BOTH IF APPUCABLE A U 1 SUCTION A~ 2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER A U I SINGLE WALL A~2 DOUBLE WALL A U 3 UNED TRENCH A U 95 UNKNOWN A U 99 OTHER A U I BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC)A (~t 4 FIBERGLASS PIPE A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP A U g GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U, 95 UNKNOWN A U 99 OTHER D, LEAK DETECTION~ 1 DE~CToRMEC'H~CAL LINE LF.N< [] 2 TESTINeUNE 'l~Gh~ [] 3 MONIT01~IeC0N33h"U(XJS It,q~.RS~ ,_..u ~ 4 IEAKELECI~0ffiCDEi~CToRUN; [] 5 AUTOMA~ICs~UT~OWN PU~,6=, [] 99 OTHER V. TANK LEAK DETECTION I r---I I VISUAL CHECK I 1 2 MANUAL INVENTORY ['---] 3VADOZE I'~1 4 AUTOMATIC TANK []5 GROUNDWATER []6 ANNUALTANKI RECONCIUATION . MONITORING GAUGING MONITORING TESTING [] 7 CONTINUOUS INTERSTITIAL [] 8 SIR [] 9 WEEKLY MANUAL [] 10 MONTHLY TANK [] 95 UNKNOWN [] 99 OTHER MONITORING TANK GAUGING TESTING VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACE) I1. ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTITY OF SUBSTANCE REMAINING 3. WAS TANK FILLED WITH YES [] NO [] GALLONS INERT MATERIAL ? THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT I TANK OWNE. H~S NAME LOCAL AGENCY US~ ONLY ~ STA~ LD. NU~ ~S CO~POS~D OF~H~ FOUR NU~RS S~LOW COUN~ II I I I I I'1 I I I I I I I IIII PERMIT EXPIRATION DATE THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPUCATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FORM C MUST BE COMPLETED FOR INSTALLATIONS. THIS FORM SHOULD BE ACCOMPANIED BY A PLOT PLAN. RLE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM B (6-95) -- · STATE WATER RESOURCES coNTRol: BOARD - ..- - , - ' UNDERGROUND STORAGE TANK PERMIT APPLICATION -'FORMB -*' ,- cOMpLETE ASEPARATE:FORM FOR EACH ?ARK SYSTEM.' ' MARK ONLY [] I NEW PERMIT ~ 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION. '. ' I'~* 7 'PERMANENT~.Y CLOSED ON SITEI ONE ITEM [] "2 INTERIM PERMIT [] 4 AMENDED PERMIT ~'-]' ~ TEMPORARY TANK CLOSURE ' [] B TANK REMovED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: _ . ..... ;~., .. I. TANK DESCRIPTION . coMj~LETEALL ITEMS - SPECIFY IF UNKNOWN C. OA'I'E INSTALLED(MO/DAY/YEAR) ~ ' 'D.-TANK',CAPACIT'Y'IN GALLONS: [~::) II. TANK J;ONTENTS IFA-11SMARKED. COMPLETE ITEM C.: ' :";, . A. MOTOR VEHICLE FUEL ' ' E~ .4 OIL B. . " C.: [] 1. REGULAR UNLEADED ' E~* 3'. DIESEL..'[] 6 AVIATION GAS i-'--].2 PETROLEUM [] 80 EMPT~ ~ 3 CHEMICALPRODUCT,~ / -[] 95 UNKNOWN [] 2 wASTE ~ :E~] 2 LF-.~DED .' ~ '99: OTHER~DESCRIBEINri'~J~ID.'BELOw)' D. IF(A. 1) IS NOT MARKED, ENTERNAME OF SUBSTANCE STORED . ~ ' ... . C.A.S.~: .' . . ~. D.. · III. TANK CONSTR~:~I~TIoN MARK ONE ITEM ONLY IN BOXES ~r B. ~ND~ ~O~X~.THAT APPLIES IN Box D AND E ' A. TYPE OF' '" ~ 1' DO~jB'LE WALL · [] 3 SINGLE 'WALL W1TH EXTERIOR uNER- [] 5 INTERNAL BLADDER SYSTEM: [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL ,~...'~ ,' [] 4 SINGLE WALL IN A VAULT ., '..._ [] 99 OTHER ~, ,". I B.' 'TANK' ~ [] ' BAREsTE~ .:..': '1::--1' 2: ~A!NLESS S:.TE.,EL ...' ~] 3 FIBERGLAsS · I~ 4 STEEL CLAD W/FIBERGLASS REJNFOR~E_D pLASTIC' I MATERIAL J---I-5. CONCRETE -. r-~ .6 POLYVINYL CHLORIDE [] 7 ALUMINUM , []'8 100% METHANOL COMPATIBLE W/FRP ...._ I (plimarYTarlk) [] 9 BRONZE [] '10~GALVANI~ED STEEL :[]'95 U~NKNOWN "i----~ 99 OTHER I C'iNTEmoR [] ~.RUSSER U.ED · F--I. 2 ALKYD L,NING .. [~] 3.EPOX~ U",NG. [] ,. PHE.0L,C'UN,,G · ?,.N~..O_R E~ 5 GLASS UNING [] 6 UNUNED -,. I~--I:?'''UNKNOWN'':: :':'E~ 99" ~THER.'': .' IS UNING IvI^TERIAL COMPATIBLE WITH 1~ METHANOL ?: · YES_ NO o.EXTERIOR[] , POLYETHYLENE WRAP. '[]'2 cOATING. ' [] 3 VINYL VVRAP E~ 4 FIBERGLASS REINFORCED PLASTIC CORROSION . ' PROTECTOR.-; [] ~ c^THoo,.cP.oTEcTIo. []., NONE []',~. UNKNOW. ~ .' E3" O~ER '" F-'SPILL AND OVERFILLS, Mc. 'sPILL CONTAINMENT INSTALLED' C~EAR)~,~'L~'~ OVERF!LL PREVENTION EQUIPMENT INSTAL~D.(¥EAR) . ' DROP TUBE YES ~ NO- STRIKER PLATE YES, ' NO . - ' 'DISPENSER CONTAINMENT YES ' NO .' ' :~1 IV. PiPiNG INFORMAl:ION . "cIRCLE A iP ABOVE GRoU"D OR U m UNDERGROUND. BO~ IF ^PPL~c~LE - B.-c0NSTRUCTiOI~ A U 1 SINGLE WALL ' A~ 2 DOUBLE WAIL .. 'A U 3 U ED TRENCH : A U 95, UNKNOwN. · A"U 99 OTHER C. MATERIAL AND A'U 1 BARESTEEL' ' A U 2 STAINLES~'~TEEL A U 3 PoLYvINYL CHLORIDE(Pvc)A(:~ 4 FIBERGLASS pIPE. ' '- CORROSION . ' A U 5 ALUMINUM A U, 6 CONCRETE. A U 7 STEELW/C0ATING ': A U 8 100% METHANOL' COMPATIBLE W/FRP' '1 PROTECTION A U'9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION 'A U' 95' UNKNOWN A U. 99 OTHER ..... ' I- D. LEAK. DETEcTION -~-I1-"M~u~E~ '1-~12 U~ETIGHTNESS 1~3C0N~NU0USINTERSTmA[ I--'--~4 E[EC1RONIC'U~E ~'SAUTOMATlCPt, IMP ~ 'OTH "'F~'- ".:: ' m,. , :OE'IEC~OR . ' [;...-I TES~NG : I.__J MONITORING ' ' I I lEAK 0EIECTOR ~ SHUTDOWN'- .,L-J 99. ER ~ '1' V. TANK LEAK DETECTION I'i--I , v.suAL CHECK [] ~ ~NU~ ,.VE~ORY [] 3 V~ZE ' FI. 4 AUTOM^nC ~K [] 5' GROU.D WATER [] ~' A.NUALT^NK I ' RECONClUATION MONITORING . GAUGING MONITORING :' :TESTING : · [] 7 'CONTI"UOUSMON,TOR~.G '.TERSTI'~AL. [] S S~R - []" TANK~EKLYGAuGING'M^"UAL ~1---I '0' ~STINGMONTHLY'TANK'-. r--I .~. u.i<NOW. · · [] ~. OTHER' I' VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE mN-PLACE) "' ._. SUBSTANCE REMAINING ~ALLONS' 3. WAS TANK FILL~ED VVlT" 'YES r ~m' ' , INERT MATERIAL ? . . . THIS FORM HAs BEEN COMPLETED UNDEIP._pENAL'FY OF PERJURY, AND TO THE BEST OF My KNowL EDGE, IS' TRUE AND' CORRECT` TANK OWNERS NAME ' I i LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OFTHE FOUR NUMBERS BELOW_ ....... ~.: COUNTY It JURISDICT1ONIl.: '. -.. .... . STATE .D:#' "I--I--]'· ·'1 II I '1 I I .I I'ii I'i' I':1' PERMIT NUMBER I PERMIT APPROVED BYeATE ' PER~IT ~PIRATION DATE ~ ·: ' THIS FORM MIJST BE ACCOMPANIED BY A PERMIT APpucATIoN-FORM A. UNLEss A CURRENT FORM A HAS BF.J~'FILED.'.FORM cMUsTBECOMPLETED FOR INsTALLATIoNS.' THIS FORM SHOULD BE ACCOMPANIED BY A PLOT PLAN. RLE THIS FORM WITH THE LOCAL'AGENCY IMPLEMENTINGiTHE UNDE~GR0UND STORAGE TANK REGULATIONS . FONMB (6-95) , , ' ' -' , . "- , ~. -. ·. ' . ' · MARK ONLY STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B '* COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM, ] 1 NEW PERMIT ] '3 RENEWAL PERMIT [.~ 5 CHANGE OF INFORMATION 7 PERMANENTLY CLOSED ON SITEI.' - 8 TANK REMOVED ONE ffEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT ~"J* 6 TEMPORARY TANK CLOSURE I~BAOR FACILITY NAME WHERE TANK IS INSTALLED: *'r~ -*~/~\(~O ~ i. TANK DESCRIPTION * CO~-rE ~ ~TE~_ SPEC~ ~F UNKNOWN ~'o::::~R,S TA.K ,. D.,~. MANUFAC~RED B~: U~ ¢-~0~d c. DATE INSTA"'",MO A, EAR, D. TA"K C AC'' 'N GALLONS: O,aO II. TANK CONi ~NTS ~F A-1 ~S ~ED, COMPLETE ~M C. A. b__~; MoTORvEHICIFFUEL E~] .4 OiL B. C. [] la REGULAR UNLEADED ~E~ 3 DIESEL' E~ 6AVlATIONGAS ~ lc MI~E U~DED ~ 5 JETFUEL , 8 M85 ~ 3'CHEMIC~PRODUC~ ~ ~ UN~O~ ~ 2 W~TE ~ 2 ~ED ~ ~ O~ER~SCR~BE~N~MD.B~0~ D. ~F (~1)IS NOT M~KED. E~R N~E OF SUB~CE STORED " - C.~ S.~: A. TYPE OF ~TION MARK ONE ITEM ONLY IN BOXES A, B, AND C, AND ALL THAT APPUES IN BOX D AND E DOUBLE WALL b__J 3 SINGLE WALL WITH EXTERIOR UNER [] 5 INTERNAL BLADDER SYSTEM [] 95 UNI~IOWN [] [] ~ OT.ER ..- SYSTEM [] 2 SINGLE WALL 4 SINGLE WALL IN .~ VAULT B.' TANK . '[] 1 BARE S~,I=EL" [] 2 STAINLESS STEEL- [~ 3 FIBERGLASS [] 4 STEEL CLAD W/FIBER(~LASS REINFORCED PIcAS'rll · MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLE W/FRP (Prlma~Tank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER C. INTERIOR [] 1 RUBBER UNED ,, [] 2 ALKYD LINING .~ 3 EPOXY UNING ..[] 4 PHENOLIC LINING LINING OR [] $ GLASS LINING '' [] 6 UNUNED 95 UNKNOWN [] 99 OTHER COATING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES__ NO__ O. EX ~-fflOR ] 1 POLYETHYLENE WRAP [] 2 COATING ] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC CORROSION PROTECTION '~---] s CATHODIC PROTECTION [] 9~ NONE [] 95 UNKNOWN [] ~9 OTHER SPILL CONTAINMENT INSTAl I ~n (YEAR) I,..,/t',t~'~, OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) L.J~ 3.1~.. E. SPILL AND OVERFILL, etc. DROP TUBE YES NO STRIKER PLATE YES NO 'DISPENSER CONTAINMENT YES · A. SY$¥~.~1 TYPE IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPLICABLE A U 1 SUCTION A ~2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 ~)THER B. CONSTRUCTION A U I SINGLE WALL A 2 DOUBLE WALL A U 3 UNED TRENCH A U 95 UNKNOWN A U 99 OTHER A U I BARE=~-~-L A U 2 STAINLESS.S':J'EEL A U 3 POLWINYL CHLORIDE(PVC)A (~4 FIBERGLASS PIPE A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COAT1NG A U 8 100% METHANOL COMPATIBLEW/FRP A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND CORROSION PROTECTION D. LEAK D~CTION, V. TANK LEAK DE ~ ~-CTION RECONCILIATION MONITORING GAUGING MONITORING TESTING [] 7 CONTINUOUS INTERSTITIAL [] 8 SIR [] B WEEKLY MANUAL ~ 10 MONTHLY TANK E~ 95 UNKNOWN [] 99 OTHER MONITORING TANK GAUGING TESTING VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACE) I1. ESTIMATED DATE LAST USED (MO/DAY/YR) J 2. ESTIMATED QUANTITY OF I 3. WAS TANK FILLED WITH INERT MATERIAL ? · I' SUBSTANCE REMAINING GALLONS YES ~-] NO ~-~ THIS FORM HAS BEEN COMPLETED UNDER P~ ENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS, TRUE AND CORr'IECT TANK OWNER'S NAME LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF'THE FOUR NUMBERS BELOW I COUNTY # JURISDICTION # FACILITY # TANK # · STATE I.D;# ~ I I I I I I I'l I I I' THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPUCATION- FORM A, UNLESS A CURRENT FORM A .AS BEEN RLED. FORM C MUST BE COMPLETED FOR INSTALLATIONS. THIS FORM SHOULD BE ACCOMPANIED BY A PLOT PLAN. FILE THIS FORM WITH THE LOCAL AGENCy IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM B (6-95) STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FoRM FOR EACH TANK SYSTEM. I.MARK ONLY [] 1 NEW PERMfT * . [] 3 RENEWAL PERMIT [] 5 CHANGE OF ~NFORMATION 0NE_rrFJ [] 2 INTER,M PERMIT [] 4 AMENDED PERMIT ~ 5 TEMPORARY TANK CLOSURE DBAOR FACILITY NAME WHERE TANK IS INSTALLED: ~,~.~;~_~ ~' ~'~'~'~b · - [] 7 PERMANENTLY CLOSED ON SITt ] 8 TANK REMOVED I. TANK DESCRIPTION COMhLETE ALL ITEMS - SPECIFY IF UNKNOWN c. DATE ,.STAI'" (MO AY E*R)b D. TANK C AC, ,. GALLONS: II. TANK CON~.NTS ~F A-1 IS MARKED, COMPLETE ITEM C. r--J2 ?~o,.uM [] ~o EM.T~ .[~' PRODUCT [] ~ ""~. ~.L~ ~ ~ ~S~O~ ~ ~ ~ANO~ '~ 3 CH~IC~PRODUCT ~ 95 UN~O~ ~ 2 W~ ~ 2 ~ED ~ ~ O~ER~CRIBE~D.B~0~ D.' IF (~1) IS NOT ~D, ENOCH N~E OF SUB~CE ~ORED C. ~ S. ~: III TANK ~n~H~u ......... A. TYPE OF MARK ONE ITEM ONLY IN BOXES A. B. AND C. AND ALL THAT APPUES iN SOX D AND E ~1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR UNER [] 5 INTERNAL BLADDER SYSTEM [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SINGLE WALL IN A VAULT I~ 99 OTHER B, TANK L_J I BARE STEEL [] 2 STAINLESS STEEL ~ 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] s CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLE W/FRP (P~ma./T..k) [] ~ BRONZ~ [] ~0 GALVANIZED STEEL []' ~S UNKNOWN [] e~ OTHER C. iNiI:HtOR [] 1 RUBBER UNED L_J 2 ALKYD LINING [] 3 EPOXY lINING [] 4 PHENOLIC UNING LINING OR [] 5 GLASS UN~NG [] 6 UNUNED [] SS UNKNOWN [] Sg OTHER COATING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES NO__ D. c,T ~ POLYETHYLENE WRAP []. 2 COATING CORROSION [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] s CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER SPILL CONTAINMENT INSTAl I I=n (YEAR) L) N. [(:___* 'OVERFILL PREVENTION EQUIPMENT INSTALLED ~YEARI ~,~j'~ E. SPILL AND OVErFiLL, etc. DROP TUBE YES NO STRIKER PLATE YES NO ' ' ' DISPENSER CONTAINMENT YES IV. PIPING INFORMATION C~RCLE A IF ABOVE GROUND oR U IF UNDERGROUND. BOTH IF APplICABLE A. SY$~cM TYPE ' A U I SUCTION NO A (1~ 2 PRE. SSURE A U 3 GRAVITY A U 4 FLEXure, PIPING A U 99 OTHER B. C0N$1HUCTi0N A U 1 SINGLE WALL A ~2 DOUBLE WALL A U .3 UNED TRENCH' A U 95 UNKNOWN. A U 99 OTHER C. MATERIAL AND A U 1 BARES'rEEL A U 2 STAINLESS S¥~J-L A U 3 POLYVlNYL CHLORIDE(PVC)A(~ 4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETEC~ON [] 1 14;CHAN~C~ UNE lEAK DE/E¢0R [] 2 u~ ~,m'NESS i-~ 3 CON~NUOUS !h,u<3m[~L ~ 4 ELECTRONI¢ LINE [] 5'AUTOI4ATIC ~ TES~NG ~ MON~'0RIt~ ~ ~ ut=¥~-~uR SHUTDOWN [] 99 OTHER V. TANK LEAK DE I ~-CTION Li1 VISUAL CHECK [] 2 MANUAL INVENTORY [] 3 VADOZE [] 4 AUTOMATIC TANK [] 5 GROUND WATER [] 6 ANNUALTANK RECONClUATION MONITORING GAUGING MONITORING TESTING ~ co.TINUOUS,.TERS-.TIAL [] . MONITORING [] 9 WEEKLY MANUAL [] 10 MONTHLY TANK ~ 95 UNKNOWN [] 99 OTHER TANK GAUGING TE.S¥iNG VI. TANK CLOSURE INFORMATION (PERMANENT CLosuRE IN-PLACE) 1. F-$~iMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTI~ OF 3. WAS TANK FILLED WITH YES ~ NO [] SUBSTANCE REMAINING GALLONS INERT MATERIAL ? THIS FORM HAS BEEN COMPLETED UND,.~PENAL TY OF PERJURY, AND TO'THE BEST OF MY KNOW~ F/')GE, IS TRuE AND CORRECT TANK OWNE. R'5 NAME DA LOCAL AGENCY USE ONLY THE STATE I.D, NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW COUNTY # JURISDICTION # FACILITY # TANK # STATE I.D:# THIS FORM MUST BE ACCOMPANIED BY A P~HMii APPUCATION . FORM A, UNLESS A CURRENT FORM A HAS BEEN RLED. FORM C MUST BE COMPLETED FOR INSTALLATIONS..THIS FORM' SHOULD BE ACCOMPANIED BY A PLOT PLAN. F1LE THIS FORM WITH THE LOCAL AGENCy gJPLEMENllNG THE UNDERGROUND STORAGE TANK REGULAllONS FORM a (6-~51 - "' · : . '* .'" COMPLETE A SEPARATE FORMFOR EACH TANK SYSTEU.. I'MARK ONLY [] 1 NEw PERMIT ~ 3 RENEWAL PERMIT. [] 5 CHANGE OF INFORMATION ONE ITEM' [] 2 INTERIM PERMIT [] ~4 AMENDED PERMIT [] 6 TEM?~RAR¥ TANK CLOSURE` DBA o. PAC,L .A.E W.ERE TA.K IS .STALLED: I \\ · ..... '* STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION. FORM B PERMANENTLY CLOSED ON SITE1 TANK REMOVED I. TANK DESCRIPTION CObh'LTL ALL ITEMS - SPECIFY IF UNKNOWN ' -, IL TANK ~COh I =~S . IF A-1 IS M~KED. COMP~ I~M C. '/ : ' ' / ~ 2 P~OmUM ~ ~ EMPW PRoDUcT ' '~ :lb PREU~U~m~,:*;~}~ '~OL· '~'7 M~ANbL~.: ~ D. IF (~I) IS N~ M~D, E~R N~E OF SUB~CE ~ORED. · · C: S. IlL TANK CON~i~U~CTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, AND ALL THATAPPLIES iN BOX D AND E : . , : ~' 77" '":. A'; .pfpEoF ~ I, DO~JBLE WXLL : '~-'j 3 SINGLE WALL WITH EXTERIOR UNER, · [] 5 iNTERNAL BLADDER SYSTEM .;[~J 95 U~KNOWN SYSTEM '[---] 2 SINGLEWALL~ r k -- ''~ 4 SINGLE'WALL IN.,,A VAULT [] 99 OTHER ' ' MATERIAL [] '5 CONCRETE (Pdman/Tank) .. [] 9 BRONZE C. iNTERIOR r[] i RUBBER UNED ':'' "'[~J' 2 :ST~INLE~S:;S.TE. EL . '. 3' FIBERGLASS [] 6 POLYVINYL CHLORIDE []'7 ALUMINUM [] .10 .GALVANIZED STEEL [] 95 UNKNOWN . 4 STEEL CLAD' W/FIBERGLass REINFORCED 8 100% METHANOL COMPATIBLE W/FRP 99 OTHER ' 4 PHENOuc. UNING .... . ,* . ~ LININGOR [] 5 GLASS UNING 99 OTHER COATING '~ []. 2 ALK~ UN!NG · IS UNING MATERIAL COMPATIBLE WITH 100% METHANOL? ' 95 UNKNOWN [] YES~ NO__ ' ~-']. I POLYETHYLENE WRAP '[] 2' COATING ] 3 VINYL WRAP · '[] O. EXTERIOR 4 FIBERGLASS.REINFORCED PLASTIC' PLASTIC CORROSION PROTECTION [] 5 CATHODIC PROTECTION E~ 91 NONE [] 95 UNKNOWN [] 99 OTHER. ' E. SPILL AND OVERFILL, etc.' SPILL CONTAINMENT INSTALLED (YEAR) ! '~k, ~' ' '~' ~' f~-- OyEHF~LL PREVENTION EQUIPMENT INSTALLED(YEAR) ~-~J'"~J~ DROP TUBE YES . . NO sTRIKER PLATE YES. '- NO 'DISPENSER CONTAINMENT YES :' ' NO IV. PIPING INFORMATION cl.cLE A IF ABOV(F~ ROUND OR U IF UNDERGROUND, BOTH IF APPUCABLE A. S¥~IeMTYPE AU 1 SUCTION A UX2PRESSURE A U 3 GRAVITY ' A U 4 FLEXlBLEPIPING' A U.99 OTHER B. C0N$'mUCTi0N "A U-1 SINGLE WALL' A ~/2 DOUBLE WALL · A U. 3 UNED TRENCH-_ A U 95 UNKNOWN . A U' 99 OTHER. C. MATERIAL AND A U 1 BARE~[H-L A U' 2 STAINLESS STEEL A U' 3.?OLYVINYL CHLORIDE'(PVC)A 4 FIBERGLASS PIPE· ' · CORROSION A U 5 ALUMINUM' A U 6 CONCRETE* A U 7 STEELW/.COATING A .U 8 100% 'METHANOL .coMPATiBLE W/FRP PROTECTION . A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN 'A-U 99 OTHER · . D: LEAK DETECTION ' [] 1 ~G.I~GU. UN~ LE~ ' ' ' 0ETECrOR [] 2 LINE 11GH/~SS r'T--] 3 Colfi~Nuo~s II~T~,,~iULe. [] 4 FJ. ECI~0~C L~ r~ 5 AUTOMATIC PUMP ' : ' TESTING ~ 140NrTO~NG ' ~ ~i~UiUR . ~ SNUTOOWN [] 99 OTHER- .... ' V. TANK LEAK OeieCTlON '~ :' ' L._J 1 vISUAL CHECK - [] 2 MANUAL INVENTORY 'E~ 3 VADOZE - [] 4 AUTOMATIC TANK ~ 5 GROUND WATER ["--] 6 ANNUAL TANK I ' - RECONCIUATION ' MONITORING GAUGING ~ MONITORING L-..J .-TESTING'' [] 7 CONTINuoUs INTERSTITIAL [] 8 SIR [] g W~EKLY MANUAL ~ i'O MONTHLY' TANK [] 95 UNKNOWN [] 99 oTHER , MONITORING ' TANK GAUGING TESTING ' VI,TANK'CLOSURE iNFORMATION (PERMANENT CLOSURE IN-PLACE) J 1. ESTIMATED DATE LAST USED (MO/DAY"R) 2. ~jT~TAT~N(~2~iNTTN~.I: 'G " J' 3 WAS TANK F1LLED WITH" .... . YES' ~ .'."~10 I ' . - J . GALLONS J .'. .INERTMATERIAL? · ;,. I -I I I j - THIS FORM HAS BEEN COMPLET~ED, UNDER~ENAL ~ OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE,'/$ TRUE AND'CORRECT" TAN OWNE 'S NAME , ..~ ' DA . ' ' LOCAL AGENCY USE ONLY mE STATE LO. NU.BER ~S CO.POSED O~mE ~OUR.NU.BERS BELOW: .. - · · ~ - PERMIT NUMBER r PERMIT APPROVED BY/DATE pERMIT:EXpIRATION DATE: ' - . . THIS.FORM MIJST BE ACCOMPANIED BY A PERMIT APPUCATION - FORM A, UNLESS A ClJRRENT FORM A HAS SEEN RLED. FORM CMUST BE COMPLETED.FOR INSTALLATIONs. ;THIS FORM' SHOULD BE ACC0MP~IED aY A PLOT PLAN. FILE/HIS FORM ~ THE LOCAL AG~CY IMPLEMF. Nmle THE UNDER~ROUN0 STORAGE TANKREGIJLATIONS ' ~ORM B (6-9Si STATE OF CAUFORNIA ' < STATE WATER RESOURCES CONTROL BOARD · UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORM B COUPLE'rE A SEPARATE FORM FOR EACH TANK SYSTEM. UARK ONLY [] 1 NEW' PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION ONE ITEM j---J' 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE DBA OR FACILITY NAME WHERE TANK IS INSTALLED: ] 7 PERMANENTLY CLOSED ON SITEJ ] 8 TANK REMOVED I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN ,, OW. ER'S TANK ,.D., ,. M~"UFAC~URED BY: C. DATE INSTALLED (MO/DAY/YEAR) D. TANK C' AC,TY ,. GALLO.S: I;L, o II. TANK,~ONTENTS ~F A-1 IS MARKED, COMPLETE ITEM C. / A. [~rI, MOTOR VEHICLE FUEL [] 4 OIL B./ , C. [] la REGULAR UNLEADED [] 3 DIESEL [] 6 AVIATION GAS [] ~ P~OLEUM [] ,o EMP~'E~r, PRODUCT [] ,b ,,~l,. U,~ED [] , GASANOL [] , ME~ANOL · lc blIDGRADE UNLEADED [] 5 JET FUEL [] S MS5 [] 3 CHEMICAL PRODUCT r--]. 95 .UNKNOWN [] 2 WASTE J~ 2. LF~ED r--J 99 O~IER (DESCRIBE IN ITEM D. BELOW) · D. IF (~I) IS NOT MARKED, ENTER NAME OF suBSTANCE STORED. C.A~S.#: ' ' ' III, TANK CONSTRUCTION .ARK ONE ITEM ONLY IN BOXES/k B. AND C, AND ALL THAT APPI'IES IN BOX D AND E -' A.. TYPE OF ~ I DOUBLE WAI~.. [] 3 SINGLE WALL WITH EXTERIOR UNER [] 5 INTERNAL BLADDER SYSTEM . [] 95 UNKNOWN · SYSTEM [] · 2 SINGLE WALL ' [] · 4 SINGLE WALL. IN A VAULT [] 99 OTHER MATERIAL E~]5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLEW/FRP (Primary Tank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER C. INTERIOR [] 1 RUBBER UNED [] 2 ALKYD LINING [] 3 EPOXY LINING -[] 4 PHENOLIC LINING LINING OR [] 5 GLASS UNING [] 6 UNLINED ~J/95 UNKNOWN [] 99' OTHER ' COATING IS UNING MATERIAL COMPATIBLE WITH 100% METHANOL? YES__ NO__ D. EXrERIOR ] I POLYETHYLENE WRAP [] 2 COATING . ] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC CORROSION 'PROTECTION [] 5 CATHODIC PROTECTION [] 9~ NONE [] 95 UNKNOWN [] 99 OTHER SPILL CONTAINMENT INSTALLED (YEAR) ,~ ~ ~, D'-'- OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) E. SPILL AND OVERFILL, etc. DROP TUBE YES NO STRIKER PLATE YES NO DISPENSER CONTAINMENT YES IV. PIPING INFORMATION C~RCLE ~ IF ^BOVE,G~OUND OR U IF UNDERGROUND. BOTH IF APPUCABLE NO A. S¥~ ~ra TYPE A U ~ SUCTION 8. CONsrHUCTi0N A U-1 SINGLE WALL A O~ PRESSURE A 1~2 DOUBLE' WALL A U 3 GRAVITY A U 3 UNED TRENCH A U 4 FLEXIBLE PIPING A U 99 OTHER A 'U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND CORROSION PROTECTION D. LEAK DETECTiON V. TANK LEAK DE: I ~-CTiON A U I BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A [J.~)4 FIBERGLASS PIPE A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTEC'RON A U 95 UNKNOWN A U 99 OTHER [] 1 MECHN~ICAI. LINE [F. AK [] 2 UN[[ TIGHTNESS [--'--] 3 COntINUOUS i"7-C.R~¥,ilN. [] 4 ELECTRONIC aNN [] 5 AUTOMATIC PUMP [3ELECTOR TESTING ~ MONITORING I.EN( u~cvruR . ~UT~OWN [] 99 OTHER [] 1 visuAL CHECK [] 2 MANUAL INVENTORY [] 3 VADOZE [] 4 AUTOMATIC TANK [] 5 GROUND WATER [] 6 ANNUALTANK RECONC,L,ATIO. MON,TOR,NG G^UG,NG MO.,TORING TEST,.G [] 7 CONTINUOUS INTERSTITIAL [] 8 SIR [] 9 WEEKLY MANUAL [] 10 MO"THLY TANK [] 95 UNKNOWN [] 99 OT"ER MONITORING TANK GAUGING TESTING VI. TANK CLOSURE INFORMATION (PERMANE,T CLOSURE IN-PLACE) SUBSTANCE REMAINING GALLONS INERT MATERIAL ? THIS FORM HAS BEEN COMPLETED UNDER-P~ENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TR~IE AND~CORRECT J' TANK OWNER'S NAME LOOAL AGENOY U~E ONLY I I I I I I I I I 1 I t I I' III I FORM B (~95) STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR EACH TANK ~YSTEM. MARK ONLY L__J 1 NEW PF. HMIT [] 3 RENE~NAL PERMIT ONE ITEM [] 2 INTERIM PERMIT. [] 4 AMENDED PERMIT ] 5 CHANGE OF INFORMATION ] 6 TEMPORARY TANK CLOSURE ' [] 7 PERMANENTLY CLOSED ON SITE] ~ 8 TANK REMOVED DBA OR' FAC Ln .AME TA.K I. TANK DESCRiP¥i0N COM~'LETE AU. ~TEMS- SPECIF~ ~F UNKNOWN I II. TANK CONTENTS IF A-1 IS MARKED,~MPLETE ITEM C. TANK CA"AC,TY IN ~,LLONS: A. [] 1 biO¥oR VEHICLE FUEL [~ .4 OIL B. C. [] la REGULAR UNLEADED [] 3 DIESEL [] 6 AVIATION GAS [] 2 P~oLEuM [] ~o ~r+* * [] '~ PRODUCT [] ~b P.~,~ U.L~'* []-4 ~s~oL .~ ~ ~ANo~ ' . ~ 2 ~ED ~ ~ 0~ ~CRi~E IN ~ O. B~O~ D. IF (~1) IS NOT M~D, EhTEH N~E OF SUB~CE ~ORED C. ~ s. #: m ~"K CONST~UC~ON M~ONEI~ONLYIN~XES~a, ANDC,~DA~ATAPPMEsINBoxD~DE · ~PEOF ~ ~UB~W~ ~ ~ S~NGLEWA~~RiORUN~R "~ S ~a~~ ~ SS UN~O~ SYS~a ~ = S~N~ WA~ ~ 4 S~NGm WA~ ~N A VAULT (Pd~T~k) ~ 9 BROKE ~ I0 GALV~IZED STEEL ~ 95 UNKNO~ ~ 99 O~ER C. INTERIOR [] 1 RUBBER UNED [] 2 ALKYD LINING [] 3 EPOXY LINING [] 4 PHENOLIC UNING UNING OR [] 5 GLASS UNING [] 6 UNUNED [~95 UNKNOWN [] 99 OTHER COATING IS UNING MATERIAL COMPATIBLE WITH 100% METHANOL? YES__ NO__ D. EX'J=tliOR [] 1 POLYETHYLENE ~ [_...J 2 COATING ] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC CORROSION PROTECTION [] S CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN r-~ 99 OTHER E. SPILL AND 0VERFILL, etc. SPILL CONTAINMENT INSTALLED (YEAR) [..~Jr~--. OVERFILL PREVENTION EQUIPMENT INSTALLED {YEAR) DROP TUBE YES NO STRIKER PLATE YES NO DISPENSER CONTAINMENT YES NO IV. PIPING INFORMATION A, S¥5~.~I TYPE B. CONSTRUCTION C. MATERIAL AND CORROSION PROTECTION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPuCABLE A U 1 SUC¥1ON A~2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER A U I SINGLE WALL · A I~2 DOUBLE WALL A U 3 UNED TRENCH A U 95 UNKNOWN 'A U 99 OTHER A U I BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVlNYL CHLORIDE(PVC)A ~ 4 FIBERGLASS PIPE A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEELW/COATING A U 8 IO0%'METHANOL coMPATIBLEW/FRP A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETEctiON [~*~I~c3ECToR~C'HNaC'~'.~ ~ [] 2 UNE~'rlc,.h'TNE. [] 3 t~oI~r0~INGCONT1NU(XIS INTERSTmN. [] 4 ~B'EC~0alCDEi~CTo~UNE [] 5 AUTOUATICsh, IJTDOWN.PU~P [] 99 OTHER' V. TANK LEAK DETECTION [] I VISUAL CHECK [] 2 MANUAL INVENTORY [] 3 VADOZE [] 4 AUTOMATIC TANK [] 5 GROUND WATER [] 6 ANNUALTANK RECONCIUATION MONITORING GAUGING MONITORING TESTING [] 7 CONTINUOUS INTERSTITIAL [] 8 SIR [] S WEEKLY MANUAL [] 10 MONTHLY TANK r-~ 95 UNKNOVVN [] 99 OTHER MONITORING TANK GAUGING TESTING VL TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACe tL?ANK OWNER'S NAME ESTIMATED DATE LAST USED (MO/DAY/YR) I 2. ESTIMATED QUANTITY;OF I3. WAS TANK FILLED wITH YES[] NO [---"~ SUBSTANCE REMAINING GALLONS INERT MATERIAL ? THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMRFRS BELOW COUNTY # JURISDICTION # FACILITY # TANK # STATE .D,'# C-1-] II I I I I I I I I I I I I I Iii I SHOULD BE ACCOMPANIED BY A PLOT PLAN. RLE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM B (6-95) MARKONLy · ' "-' STATE OF CAUFORNIA "' ;STATEWATER RESOURCES CONTROL BOARD · UNDERGROUND STORAGE TANK PERBIT APPLICATION- FORU ~~ -8 TANK REMOVED ' ."[ I ' [---~,' , NEW ~PERMIT RENEWAL PERMIT [] 5 CHANGE OF INFORMATION ONE' ITEM' [] 2 INTERIM PERM T [] a,' AMENDED PERMIT [] 6 TEmPORaRY TANK CLOSURE DBA O. FAC,L NAMEW.ERETA.K, ,.STALLED; ! II LO0 - ;.. I. TANK DESCRIPTION * COM~LETE ALL ITEMS - sPEcIFY IF UNKNOWN' ~ 01NNER'S TANK I. D. #* .. D:.'.TAaK 'C~AC,W ,,-'C~LLONS: II. TANK ~Jl~ I I=1~ I O. IF A-1 'IS MARKED~C~OMPLETE ITEM C. ~ r---] I MOTOR VEHICLE FUEL 4 OIL B. ' 'C ':~1 :~a REGUIL~R UNLEADEd] .~.' 3,'DIESEL; , [] .6"~VIATIONGAS~' ~ 2 pETRoLEUM .'' ~ 80 EMPTY : ["--I/~:' PRODucT. .' '[---'1: :lb PREMIUM UNLEADED. .[] 4 GASAHoL:. [] ', 7,'M'ETH:ANOL;''~ '[~2 lc MIDGRADE U_NLEADED [] 5" JET FUEL [] · 8. M85" ' . [] 3 CHEMIcAL pRoDUCT [] 9'5 uNKNowN . WASTE R'2'LEADED - [] ~9 031~ER(DESCRIBEINn'EMD:BB.0W):- D. IF (A. 1)IS NOT MARKED, ENTER NAME OF sUBs~TANCE STORED " C.A. S: # III. TANK CONSTRUCTION A. TYPE OF I"] 1 ,DOUBLE WALL ' , ~ '[] 3* ~INGLE WAll WITH EXTERIOR UN'ER ' 'MARK oNE ITEM ONL¥iN BOXES A"B' AND C' AND ALL '~'HAT APPLIES IN BOX.D AND E ',[]' 4 SINGLE WALL IN A VAULT , r ~ gg oTHER 'NO...~'E~,.p :' :.., ...: [] 4 ,STEEL CLAD, W/FIBERGLASS I~EINFOR(~'EI~'PLASTIC ] 8 100% METHANOL COMPATIBLEW/FRP ] 9g OTHER '~/3 EPOXY UNING ~'--~ 4 PHENOLIC UNING 1'1'95 UNKNOWN.· [].gg OTHER YES NO __ · SYSTEM '. [] 2 SINGLE WALL., B. TANK"-' MATERIAL (PrimarY Tank) ~ 1 RAREST EEL',,,-, '-., [~1.,2 STAINLESS,STEEL'~' E~-3 FIBERGLASS' ~[] '5 CONCRETE. [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 9 BRONZE ' [] '10 GALVANIZED STEEL [] 95 UNKNOWN. C. iNTERIOR. LINING OR COATING · [~J i RUBBER ENED .[]' 2 ALKYD LINING - ' [] S GLASS LINING r---~ 6 UNuNEo IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? D. CORROSioNEX'IbHIOR []' 1 POLYETHYLENE, . . WI:lAP [] 2 COATING '~ [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] gl NONE ~ [] 95 UNKNOWN [] 9~ OTHER " · :SPILL CONTAINMEN~ INSTALLED (YEAR) ~')'~ {{'~- ' ' - 0m~'~' '. OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) · E. SPILL AND OVERFILL, etc. DROP TUBE YES NO ' STRIKER PLATE YES NO DISPENSER CONTAINMENT YES' IV. PIPING INFORMATION · CIRCLE A IF ABov//~ROUND OR U IF uNDERGROUND; BOTH IF APPLICABLE A. SY~-M TYPE ' A U I SUCTION ' A i, U~/2 PRESSURE . A U 3 GRAVITY . A U ~i FLEXIBLE PIPING A 'U gg.'OTHER . B. coNsTRUCTION A U 1 SINGLE WALL A ~'/2 DOUBLE WALL A U" 3 UNED TRENCH A U~. 9S~ UNKNOWN: A'U '.'99,~OTHER' C. MATERIAL AND' A U 1 BARESTEEL '~:. A U 2 STAINLESS STEEL A U 3 POLYVlNYL-,CHLORIDE(PVC)A 4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEELW/COATING A U'a 100% METHANOi; COMPATIBLEW/FRP ,PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER 'D:' LEAK DETECTION, [] 1 DEIECrORMECI~/~ICAL UNE., LEAX . [] 2 TES/1NGLINE TIGHTNESS [] 3 CONT]NUOUSMoMTORiNG INTERSTITIAL....'[] 4 IEAKELECI~ONICDETECTO, ~IINE" L_...JI'"'-]"S AUTOMA~I¢sHUTOOWN PUMP [] 99 .OTHER. V. TANK LEAK DETECTION, J[] 1 VISUAL CHECK ] 2 MANUAL INVENTORY [] 3,VADOZE RECONCIUATION MONITORING ] 7 CONTINUOUS INTERSTITIAL [] 8 SIR MONITORING ~[] 4 AUTOMATIC TANK [] 5 .GROUND WATER '[~] 6 ANNUAl:TANK GAUGING MONITORING- TESTING. ' [] g'WEEKLY MANUAL [] 10 MONTHLY T,~NK" [] gs 'U~JKNOWN ' [] 90 OTHER TANK GAUGING TESTING · VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACE)' 1. ESTIMATED DATE LAST USED (MO/DAy/YR) 2. ESTIMATED QUANTITY OF ' ..... 3. WAS YANK FILLED wITH YES [], NO [] ~ * , . SUBSTANCE REMAINING GALLONS INERT MATERIAL ?' TH/S, FORM HASBEEN COMPL-ET~.DUN, DE_~R PENAL TY OF PERJURy, AND .TO THE BEST OF My KNOWLEDGE, IS..~RUE~ AND CORRECT TANK OWNER'S NAME ~ ~ - DATE · ·~ LOCAL AGENCY USE ONLY'- ,THE sTATE'I.D. NUMBER IS COMPOSED OF. THE FOUR NUMBERS BELOW ,. ", ., COUNTY # JURISDICTION:# .... .,. FACILITY # TANK #. · - :: · THIS FORM MUST BE AccoMpANiED BY A PERMIT'APPucATION- FORM A, UNLESS A cuRRENT FORM A. HAS BEEN.FILED. FORM CMUSTBECOMPL~ETED FORINSTALLATIONS. ,THIS FORM SHOULD BE ACCOMPANIED BY A PLOT PLAN,...RLE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING-THE UNDERGROUNDSTORAGE TANK REGULATIONS" , ' FORM B' (6-95) ' ,--? ' - ' ' ' ' STATE OF CAUFORNiA * r STATE WATER RESOURCES CONTROL BOARD '. UNDERGROUND STORAGE TANK PERMIT APPLICATION,- FORM B ' ' COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. 7 PERMANENTLY CLOSED ON SITEIi 8 TANK REMOVED MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT r-~ 5 CHANGE OF INFORMATION [] ONE ITEM ~' [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE [] .,,A O. FAC,Lr..AME W.E.E TA.K ,.STALLED= I lg 0 I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKN0~NN A. OWNER'S TANK I. D. # C. DATE INSTALLED (MO/DAY/YEAR) D. TANK C*.AC,TY ,, GALLONS: II. TANK CONTENTS IF A-1 IS MARKED/OMPLETE ITEM C. . [] , MOTOR VEH,CLE FUEL ~ ~ O,L B.c. [] '" .au~ u.~_~ [] ~ D,ESEL [] B AV,AT,ONGAS  lc MI~EU~ED ~ 5 JET FUEL ~ 8 M85 ~ 3 CHEMIO~'pRODucT '~ g5 UNKNO~ W~ ~ 2 ~ED ~ ~ O~ER(DESCRIBEIN~MD.B~0~ D. IF (~1) IS NOT M~D, E~R N~E ~F SUBSTANCE STORED C. ~ S. ~: ' IlL TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, AND ALL THAT APPLIES IN BOX D AND E A. TYPE OF [] I DOUBLE WALL. [] 3 SINGLE WALL WITH EXTERIOR UNER 'SYSTEM [] 2 SINGLE WALL . [] 4 SINGLE WALL IN A VAULT [] 5 INTERNAL BLADDER'SYSTEM [] 95 UNKNOWN ] 99 OTHER : B.'"TANK -[] I BARES'rEEL MATERIAL [] S CONCRETE (PdmaryTarlk) [] 9 BRONZE [] 2 S.TAINLESS STEEL [~ 3 FIBERGLASS [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM -- [] 10 GALVANIZED STEEL [] g5 UNKNOWN ] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC" ] 8 100% METHANOL COMPATIBLEW/FRP ] 99 OTHER ~1 I 1 RUBBER UNED ~-1 2 ALKYD LINING .~'-~ 3 EPOXY UNING ~ c. iNTERIOR 4 PHENOLIC LINING LINING OR [] 5 GLASS LINING [] 6 UNLINED ~95 UNKNOWN ~ [] 99 OTHER COATING IS LINING MATEF;IIAL COMPATIBLE WITH 100% METHANOL? YES__ NO__ D. EXTERIOR [] 1 POLYETHYLENE WRAP [] 2 COATING" '-~ [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC CORROSION PROTECT]ON [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER SPILL CONTAINMENT INSTALLED (YEAR) ~')~'"[ {~-- OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) E. SPILL AND OVERFILL; etc. DROP TUBE YES NO STRIKER PLATE YES NO DISPENSER CONTAINMENT YES NO IV. PIPING INFORMATION '- CIRCLE A IFABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTEM TYPE A U I SUCTION A(~) 2 PRESSURE A U 3 GRAVITY A U 4 FLEXlBLE PIPING A U g9 OTHER B. CONSTRuC~ON C. MATERIALAND CORROSION PROTEC~ON A U 1 SINGLE WALL A U 1: BARE STE~L * - - ' A U 5 ALUMINUM A U 9 GALVANIZED STEEL A ~,~2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U g9 OTHER A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A ~ 4 FIBERGLASS PiPE A U 6 CONCRETE A U 7 STEELW/COATING A U 8 100% METHANOL COMPATIBLEW/FRP A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION I-31 MECHN~ICAL UNE LEAK [] 2 UNE TIGHTNESS [] 3 CONTINUOUS INTERSTmAL ~ 4 ELECII~ORIC UNE [] 5 AUTOMATIC RJI~ I___J DETECTOR TESTING MOMTORING ~ LEAK DETECTOR ~UI'9OWN [] gg OTHER V. TANK LEAK DETECTION I [ ] , VISU~CHECK [] 7 CONTINUOUSINTERSTITIAL [] 8 SIR MONITORING 6 ANNUAL TANK [] ~ MA.UAL ,NVENTORY [] ~ VADOZE [], AUTOMATIC TAN~ [] ~ GROUND WATER [] TESTING RECONCILIATION MONITORING GAUGING MONITORING [] 9TANKWEEKLYGAuGINGMANUAL [] 10 TESTINGMONTHLY TANK [] 95 UNKNOWN [] 99 OTHER VI. TANK CLOSURE* INFORMATION (PERMANENT CLOSURE IN-PLACE) I1' ESTIMATED DATE LAST USED (MO/DAY/YR) I 2' SUBSTANCE REMAiNiNG INERT MATERIAL? ESTIMATED QUANTITY OF 3. WAS TANK FILLED WITH GALLONS THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW I COUNTY,# JURISDICTION # , FACILITY # TANK#' I' STA:rE I.D:#' ~ I I I II I I I I I'1 II I ' THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS l CURRENT FORM A HAS BEEN FILED. FORM C MUST BE COMPLETED FOR INSTALLATIONS. THIS FORM SHOULD BE ACCOMPANIED BY A PLOT PLAN. RLE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM B (6-95) BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 APPLICATION TO PERFORM A TIGHTNESS TEST FACILITY NUMBER OF TANKS TO BE TESTED ADDRESS 26~ d?~3m~l[ IS PIPING GOING TO'BE TESTED ~5 TANK% VOLUME CONTENTS TAN TESTING COmAN k % TEST METHOD.q'£L ~-~ (,7~.~% ~o~, u~J~4 NAME OF TESTER~'~-~ ~,n,~f~-e,~ CERTIFICATION STATE REGISTRATION % [OWB DATE & TIME TEST IS TO BE CONDUCTED ~/~(~ ~ APPROVED BY: DATE SIGNATURE OF APPLICANT BAKERSFIELD FIRE DEPARTMENT February 13, 1998 FI~ CHIEF MICHAEL R. KELLY ADMINI$11~JIVE SERVlCE$ 2101 'H' Slmet Bakersfield, CA 93301 (805) 326-394 I FAX (805) 395-1349 SUPPIFr. SSlON SEIWICE$ 2101 'H' Street Bakersfield, CA 93,301 (805) 326-3941 FAX (805) 395-1349 PREVENllON SEIlVlCES 1715 Chester Ave. Bakersfield, CA 93,301 (805) 326-395 I FAX (805) 326-0576 F,.NVII~ONMENT,~fl. 1715 Che~ter Ave. Bakersfield, CA 93301 (805) 326-3979 FAX (805) 326-0576 IRAINING DIVISION 5642 Victor Street Bakemfleld, CA 93308 (8O5) 399-4697 FAX (805) 399-5763 B P Oil Facility 2688 Oswell Street Bakersfield, CA 93306 RE: "Hold Open Devices" on Fuel Dispensers Dear Underground Storage Tank Owner: The Bakersfield City Fire Department will commence with our annual Underground Storage Tank Inspection Program within the next 2 weeks. The Bakersfield City Fire Department recently changed its City Ordinance concerning "hold open devices" on fuel dispensers. The Bakersfield City Fire Department now requires that "hold open devices" be installed on all fuel dispensers. The new ordinance conforms to the' State of California guidelines. The Bakersfield Fire Department apologies for any inconvenience this may cause you. Should you have any questions, please feel free to contact me at 326-3979. Sincerely, Steve Underwood Underground Storage Tank Inspector cc: Ralph Huey Triangle Environmental, Inc. 2525 West Burbank Boulevard, Burbank, California 91505 (818) 840-7020 FAX (818) 840-6929 T.E.I. UST TESTING SYSTEMS SUMMARY SHEET Precision Underground Storage Tank System Leak Test Client: THE CIRCLE K COMPANY P.O. BOX 52084 Phoenix, AZ ~ 85072-2084 Carmen Tucker (602) 530-5086 Circle K #30205 Test Date: 4/20/97 Facility: Circle K #30205 2688 OSWELL BAKERSFIELD, CA 93306 Work #: 340342 County:. KERN Cross Street: OSWELL & SR 178 Tank Test System # Product Capacity Type 1 Unleaded Plus 11627 System 5000 2 Unleaded Premium 9728 System 5000 3 Unleaded Regular 9728 System 5000 4 Waste Oil 500 Ullage only Tank Rate/Results Ullage Result 0.02 PASS PASS 0.02 PASS PASS 0.02 PASS PASS PASS PASS Line RateffResult L/D Result ·-0.02 PASS PASS -0.03 PASS PASS -0.03 PASS PASS N/A N/A Certified By: Technician: Tony Kiani Mfgr's #: TEI-047 Comments: Compliance test ALL and Monitor certification State Lic. #s: CA-1049 · · This precision tank testing system exceeds the criteria required by Local, State and Federal NFPA #329 and EPA UST Technical Standards Part 280 for precision testing systems. Triangle Environmental, Inc. T.E.I. SYSTEMS TANK, LINE AND LEAK DETECTOR TEST REPORT Facility: Tank#: Product: Circle K #30205 1 Unleaded Plus 'TeSt Date: 4/20/97' Work #: 340342 Test Method: Capacity: Diameter (in): Product Level (in): Liquid Volume (Gals): Liquid Percent (%): Specific Gravity: Coef. of Expansion: Water On Tank (in): Water In Tank (in): Product Temp. (F): Head Pressure (psi): Test Start Time: Test End Time: Test Rate (gph): Test Result: System 5000 11627 91 15 1198 10.3% 0.750 0.000660 .0 0 0.4 10:25:00 PM 10:26:00 PM 0.02 PASS UllageVolume (gals.): 10429 Ullage Test Time: 10:25:00 PM Ullage Vacuum (psi): 1.4 ~ Ullage ResUlt: PASS Test Method: Manufacturer: L/D Model: L/D Serial #: Line Drain Back (mi): L/D Trip Time (sec): Holding Pressure (.psi): Metering Pressure (psi): L/D Test Rate (gph): L/D Result: R.J. FTA Red Jacket PLD Unreadable 150 2 9 10 2.1 PASS Test Method: TEI LT-3 Pump Brand: Red Jacket System Type: Pressure Line Pressure (psi): 50 Line Start Time: 11:40:00 PM Line End Time: 11:55:00 PM Line Start Level: 200 Line End Level: 180 Line Test Rate (gph): -0.02 Line Test Result: PASS 2 · Triangle Environmental, Inc. T.E.I. sYSTEMS TANK, LINE AND LEAK DETECTOR TEST REPORT Facility: Circle K #30205 ,, Tank//: 2 Test Date: 4/20/97 Product: Unleaded Premium ., Work#: 340342 Test Method: Capacity: Diameter (in): Product Level (in)! Liquid Volume (Gals): Liquid Percent (%): Specific Gravity: Coef. of Expansion: Water On Tank (in): Water In Tank (in): Product Temp. '(F): Head Pressure (psi): Test Start Time: Test End Time: Test Rate (gph): Test Result: System 5000 9728 91 17 1198 12.3% 0.750 0.000660 0 0 0.5 10:10:00 PM 10:1 I:00 PM 0.02 PASS Test Method: ULLAGE UllageVolume (gals.): 8530 Ullage Test Time: 10:10:00 PM Ullage Vacuum (psi): 1.4 Ullage Result: PASS Test Method: R.J. FTA · Manufacturer: Red Jacket L/D Model: XLP L/D Serial #: 30694-6363 Line Drain Back (mi): 170 'L/D Trip Time (sec): 2 Holding Pressure (psi): · 9 Metering Pressure (psi): 10 ' L/D Test Rate (gph): 2.4 L/D Result: PASS Test Method: Pump Brand: System Type: Line Pressure (psi): Line Start Time: Line End Time: Line Start Level: Line End Level: Line Test Rate (gph): Line Test Result: TEI LT-3 Red Jacket Pressure 50 11:20:00 PM 11:35:00 PM 180 150 -0.03 pASs . Triangle Environmental, Inc. T.E.L SYSTEMS TANK, LINE AND LEAK DETECTOR TEST REPORT Facility:. Circle K #30205 Tank #:'.3 ' Product:. Unleaded Regular Test Method: System 5000 Capacity: 9728 Diameter (in): 91 Product Level (in): 20 Liquid Volume (Gals): 1519 Liquid Percent (%): 15.6% Specific Gravity: 0.750 coef. of Expansion: .0.000660 Water On Tank (in): 0 . Water In Tank (in): 0 Product Temp. (F): Head Pressure (.psi): 0.5 Test Start Time: 9:55:00 PM Test End Time: 9:56:0~) PM Test Rate (gph): 0.02 · Test Result: PASS Test Method: ULLAGE UliageVolume (gals.): 8209 Ullage Test Time: 9:55:00 PM Ullage Vacuum (psi): · 1.5 " Ullage Result: PASS Test Date: 4/20/97 Work #: 340342 Test Method: Manufacturer: L/D Model: L/D Serial #: Line Drain Back (mi): L/D Trip Time (sec): Holding Pressure (psi): Metering Pressure (psi): L/D Test Rate (gph): L/D Result: R.J. FTA Red Jacket XLD 30694-6362 160 2 11 9 2.2 PASS Test Method: Pump Brand: System Type: Line Pressure (psi): Line Start Time: Line End Time: Line Start Level: Line End Level:.. Line Test Rate (gph): Line Test Result: TEI LT-3 Red Jacket Pressure .50 11:00:00 PM 11:15:00 PM 270 240 -0.03 PASS 4 Triangle Environmental, Inc. T.E.I. SYSTEMS TANK, LINE AND LEAK DETECTOR TEST REPORT Facility:' circle K #30205 Tank #: 4 ~ Test Date: 4/20/97 ProduCt: Waste Oil Work#: 340342 Test Method: Ullage only Capacity: 500 Diameter (in): 45 Product Level (in): 0 Liquid Volume (Gals): Liquid Percent (%): specific Gravity: Coef. of Expansion: Water On Tank (in): Water In Tank (in):' Product Temp. (F): Head Pressure (psi): Test Start Time: Test End Time: Test Rate (gph): Test Result: PASS Test Method: ULLAGE UllageVolume (gals.): Ullage Test Time: Ullage Vacuum (psi): , Ullage Result: 10:40:00 PM 1.6 PASS Test Method: R.J. FTA Manufacturer: L/D Model: L/D Serial #: Line Drain Back (ml): L/D Trip Time (sec): Holding Pressure (psi): " . Metering Pressure (psi): . · · L/D Test Rate (gph): L/D Result: N/A Test Method: Pump Brand: System Type: Line Pressure (psi): · . Line Start Time: Line End Time: Line start Level: Line End Level: Line Test Rate (gph): Line Test Result: ' .N/A ' Triangle Environme'ntal,`Inc. 2525 West Burbank Boulevard, Burbanki California 91505 (818) 840-7020 FAX (818) 840-6929 ' T.E.I. UST FACILITY INSPECTION/A UDIT SHEET Facility:~ Circle K #30205 2688 OSWELL BAKERSFIELD, CA 93306 County: KERN. Cross Street: OSWELL & SR 178 Test Date: 4/20/97 Work #: 340342 Status NTM Not Present or Observed S~ Satisfactory U= Unsatisfactory Fill Cover: S Fill Cap: $ FillCap Seal: S Drop Tube: S Strike Plate: N VfR Cover: S V/R Cap: S V/R Seal: S V/RDry Break: $ Sub Pump: S Sub Pump Cover: S Overfill: N ~ Type Coaxial Dual No Stage'I Pre~sure F ~ Flex Angle Check M= Metalic Vertical Check Fill Type: D Product Line Type: P Tank Swing Joint Type: M Dispenser Swing Joint Type: M Status NTM Not Pre~ent S= Satisfactory U= Unsatisfactory Impact Valve: S Vertical Check Valve: N Fill Spill Containment: S Dispenser Containment: N Sub Pump Containment: U .Number of Disp. Hoses Regular: 4 8 Plus: 4 8 Premium: 4 8 Diesel: 0 0 Kerosene: 0 0 ... Stage II B= Balance A= Asis( System Type: B Assist Mfgr: Comments: WATER (3") IN EACH TURB. SUMP. Compliance Detail: (List items that need immediate attention.) T.E.L Triangle Environmental, Inc. 2525 West Burbank Boulevard, Burbank, California 91505 (818) 840-7020 FAX (818) 840~6929 UST MONITOR CERTIFICATION SUMMARY SHEET Client: THE CIRCLE K COMPANY P.O. BOX 52084 Phoenix, AZ 85072-2084 Facility: Circle K #30205 2688 OSWELL BAKERSFIELD, CA 93306 Monitor model: POLLALERT #FD103 Serial #: Circle K #30205 Test Date: 4/20/97 Work'#: 340342 County: KERN · Cross Street: OSWELL & SR 178 Sensor Type: Quantity: Tank Annular: 3 Waste Oil: 1 Vadose Wells: 0 Line Pressure: 0 Turbine Sump: 0 Fill Sump: 0 ATG Result: Result: PASS Annular Type: DRY PASS N/A Audible Alarm'? Yes N/A Visual Alarm? Yes N/A Fail Safe? No N/A Positive Shut-off:? No Comments: This certifies that the monitor and sensors, .as listed above, are operational and calibrated per the manufacturer's specification. Inspected By: Tony Kiani BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION' 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 APPLICATION TO PERFORM A TIGHTNESS TEST PERMIT TO OPERATE~ = OPE~TORS ~AME ~ · C~p, m~ER Or T~XS TO ~E TES?ED ADDRESS 2~g'~ 0£~6 ~[ '~T/~ OWNERS NAME IS PIPING GOING TO BE TESTED_~__ TANK# VOLUME CONTENTS TANK TESTING COMPANY-]-~]~5 TEST METHOD ~ NAME OF TESTER STATE REGISTRATION ~ \O~ DATE & TIME TEST IS TO BE CONDUCTED CERTIFICATION q/~o Iq"[ 2.2, :o0 APPROVED BY: DATE ~kersfield l~i~e Dept. OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 Business Namei Date Completed Location: Business Identification No. 215-000 I to w (Top of Business Plan) Station No. Shift Inspector Arrival Time: Departure Time: Inspection Time: Address Visable Correct Occupancy Verification of Inventory Materials Verification of Quantities Verification of Location Proper Segregation of Uatedal Comments: Adel~te Inadequate[] Verification of MSDS Availablity ~ [] Number of Employees: ~ Verification of Haz Mat Training ~ []'1 Comments: Verification of Abbatement Supplies and Procedures ~' Comments: Emergency Procedures Posted Containers Propedy Labled Comments: Adel~l~ate Inadequate[],1 Verification of Facility Diagram ~ [] Housekeeping (~ i'1 Fire Protection I~ [] Electrical I~ [] Comments: UST Monitoring Program Comments: Permits If' [] Spill Control ~ [] Hold Open Device ~Y [] Hazardous Waste EPA No. Proper Waste Disposal [:3/ [] Secondary Containment l:::3/'z[] Secudty ~ [] Special Hazards Associated with this Facility: Violations: /V'~l~usin"~ess6wner~T~AME . ~~RE- All Items O.K Correction Needed White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy UNDERGROUND STORAGE TANt~tSPECTION Bakersfield Fire Dept. Office of Environmental Services Bakersfield, CA 93301 FACILITY NAME t3~clf {~,~. BUSINESS I.D. No. 215-000 Ii0 7 FACILITY ADDRESS o~68 0.Sa)el[ CITY /'~er~'~¢/o/' ZIPCODE 733e~ FACILITY PHONE No. ~?~1 ' ~)/Z 7.. ID~ ID# INSPECTION DATE Pr~uct Pr~uct Pr~u~ TIME IN TIME OUT InsI ~le Inst Dale Insl Dale INSPECTION ~PE: I Size Size S~e ROUTINE ~ FOLLOW-UP REQUIREMENTS yes no ~a yes no ~a yes no ~a la. Forms A & B Submiff~ lb. Form C Submi~ 1 c. O~rating F~ Paid ld. State Surcharge Paid le. Statement of Financial Res~nsibili~ Submiff~ If. Wriffen Contract Exists ~een Owner & Operator to Operate UST 2a. Valid O~mting Permit 2b. Approved Wri~en Routine Mon~oring Pr~edure ~d[ a~L ~nn~ 2C. Unauthorized Release Res~nse Plan ~ ~ , U~Iu ~[~ 3a. Tank Integri~ Test in Last 12 Months ~3~[~ ? ' 3b. Pressur~ed Piping Integrity Test in Last 12 Month~ q~f7 ~. Suction Piping Tightness Test in Last 3 Years ~. Gravi~ Flow Piping Tightness Test in Last 2 Years ~. Test Results Submiffed Within ~ Days 3f. Daily ~sual Monitoring of Suction Pr~uct Piping ~. Manual Invento~ Reconciliation Each Month 4b. Annual Invento~ R~onciliation Statement Submiff~ ~. Meters Calibmt~ Annually 5. Weekly Manual Tank Gauging R~ords for Small Tanks 6. Monthly Statistical Invento~ Reconciliation Results 7. Monthly Automatic Tank Gauging Results 8. Ground Water Monitoring 9. Vapor Monitoring 10. Continuous Interstitial Monitoring for Double-Walled Tanks 11. Mechanical Line Leak Detectors 12. El~tronic Line Leak Det~tors 13. Continuous Piping Monitoring in Sumps 14. Automatic Pump Shutoff Capabili~ 15. Annual Maintenance/Calibration of Leak Detection Equipment q[3ol 16. Leak Detection Equipment and Test Methods Listed in LG-113 Series 17. Wriffen Records Maintained on Site 18. Re~ed Changes in Usage/Conditions to Operating/Monitoring Pr~edures of UST System Within ~ Days 19. RepoSed Unauthorized Release Within 24 Hours 20. Approved UST System Repairs and Upgrades 21. Records Showing Cathodic Protection Ins~tion 22. Secured Monitoring Wells Oro.,u _ RE-INSPECTION. D,_~E//~ ..,,,.~ 'RECEIVED BY INSPECTOR: .~'k(g/.~ (//~ OFFICE E ~-3~, ".37 7/ FD 1669 (reV. 9/95) PERMIT STATEMENT ~ ~ ' Bakersfield F~ Dept. Bakersfield, cA 93301 ~ AMOUNT LST/~STPERMIT FD1595 AMOUNT BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 APPLICATION TO PERFORM A TIGHTNESS TEST PE~IT' TO OPE~TE ~ OPE~TORS N~E ~ ~. OWNERS N~E ~ ~, ~BER OF T~S TO BE TESTED ~ IS PIPING GOING TO'BE TESTED~_ TANK# VOLUME · CONTENTS TEST METHOD STATE REGIST~TION DATE_'&..TIME TE ST_.IS TQ_BE~_ C~O _ND_U~TED DATE CERTIFICATION 130 G Street-, Bakersfield, CA"93301 (805) 326-3979 APPLICATION TO PERFORM A TIGHTNESS TEST PERMIT TO OPERATE OPERATORS NAME OWNERS. NUMBER OF TANKS TO BE TESTED_~ IS PIPING GOING TO'BE TESTED~ TANK% VOLUME · 'tZ. 7 .~, ~. -~ .~ CONTENTS TANK TESTING COMPANY-7~~ v TEST METHOD ~ %~O ~ ~L NAME OF TESTER"~ ~J~ STATE REGISTRATION ~ ~ DATE & TIME TEST IS TO BE CO~UCTED TANKNOLOGY CORPORATION INTERNATIONAL 5225 Hoilister, Houston, Texas 77040-6294 Phone (800) 888-8563 FAX (713) 690-2255 Certificate of Tightness Service Order #: 174834 Test Date: 04/30/96 Underground storage tank system(s) tested and found tight for: Tank Owner: Test Site No.: Test Site AddresS: Tank(s) only, TOSCO NORTHWEST COMPANY 11160 TOSCO NORTHWEST COMPANY BAKERSFIELD, CA 95506 3Line(s)only, B. P. OIL 3 Leak Detector(s) only. Tank sizes & products tested: Lines Tested: lA REG, 2A PLU, 3A SUP Leak Detectors Tested: 30694'3662 XLP Unit Mgr. Certificate Number & Name 30291-7009 XLP 394 JERRY D. 98-1587 JERRY 30393-0089 XLP "Valid only ,Corporate Seal SIMMONS 09/97 D. SIMMONS 01/98 U.S. Patent #4462249, Canadian Patent # 1185693, European Patent Appl. # 169283 TANKNOLOGY & VacuTect are trademarks of TANKNOLOGY CORPORATION INTERNATIONAL Note: See VacuTect Report for tank identification & site location drawing. 'A KNOLOG" owner TOSCO NORTHWEST COMPANY Invoice Name/Address TOSCO HO~H~S~ Site Name/Address TOSCO NORTHWEST VacuTectTM TEST REPORT S.O. # 174834 Date 04/30/96 Site# 11160 Phone < 916'> 774-2942 COMPANY 2130 PROFESSIONAL DR. SUITE 100 ROSEVILLE, CA 95661 Attn: CHESTER BENNETT COMPANY B. P. OIL 2688 OSWELL BAKERSFIELD, CA 93306 TANKS LINES Leak Det Ullage TANKS and LINES Tested to CFR-40 Pads See Tank Dipped Dipped Probe Water Bubble Air Line Final Exist 280-:581 & NFPA 329 Spec's. Diag. Dia. & Water Product Water Ingress Ingress Ingress TANK Line Delivery LINE LINE Leak LINE LD(s) NEW For Material Level Level Level Detected Detected Detected [] Material Syst. Type TEST TEST Rate · Pass/ LD(s) Loc. ST/ [] [] [] I~ [] [] Tight · · · · · Tight Fail/ Tested Other: FRP/~- START START START or ~ ST/ START END or or & TO Tank Tank Lined END END END Yes/No Yes/No Yes/No Fail Line# FRP PS/SS/GS TIME TIME GPH Fail NONE PASS Product Capacity 1 REG Tank Probe Inclinometer Dispenser Shear Valves End Time: Test PSI: Entry: De~r~s: Operate ~es/no~ Diameter '::::.~:7:~:?' :,[.[:."~/:3:'. ~( ..... .' p Exist LO SN/MDL/MFG: 30291-7009 XLP UNL Tank Probe Inclinometer Dispenser Shear Valves End Time: Test PSI: Entry: DeDr~s: O~erate~es/no) ,T¢':': p - ExisILDSN/MDL/MFG: 30393-0089 XLP 3 SUPR I I N~/2nd LD SN/MOL/MFG: U N L Material Sra. Time: Time of Test: MfD.: .3:.~~ LINE TEST PSI 5 0 · 0 0 Dispenser Shear Valves Tank Probe Inclinometer End Time: T~st PSI: Ent~: De~r~s: Operate~es/no~ I ~ e ~meter DispenSer Shear Valves Dispenser Shear Valves Tank Probe Inclinometer End ~me: T~st ~1: Ent~: Deqr~s: O~erate ~es/no~ I I i Dispens~ Shear Valves Tank Probe Inclinometer Operate ~es/no~ End Time: ~T~st PSI: Enid: D~r~: TANKNOLOGYRegion: WESTERN REGION Unit# 023 StateLic.# 98-1587 NOTE: Original VacuTect Data recordings are reviewed by Tanknology's Audit Control Department and maintained on file. State: CA TAK-O 1 Tanknology Corporation International 5225 Hollister St., Houston, TX 77040 (800) 888-8563 · FAX (713) 690-2255 MONITOR WELLS Well Number I 2 3 4 5 6 7 8 9 10 1 1 1 Well Depth Depth to Water Product Detec~ AMOUNT in inches Standard~ Symbols for diagram below: QFill i (~) Vapor Recovery ~//B) V.R. w / Ball Float ('~ Monitor Well Observation Well  (Outside Tank Bed Area) (Inside Tank Bed Area) V Ball Float (~ Tank Gauge O Vent Manway ~ Iron Cross ~ Turbine Location Diag.ram .- n.c u.de .the. Vapor. Re. ce.very Syst.em; I Vapor Recovery System & Vents were tested with which tank? Parts and Labor used General Comments When OWNER or local regulations require immediate reports of system failure-Complete the follOwing: REPORTED NAME DATE 'TIME TO: Phone# OWNER or Regulatory Agency FILE NUMBER Print: Certified Testers Name Vacutect~ Certification Number Date Testing Completed Certified Testers S,g , ~-.~----~--~ / hkersf, ield Fire Dept. Hazardous Materials Division Bakersfield, CA 93301 FACILITY NAME (~W~~ ~;~? ~~,.-,, BUSINESS I.D. No. 215-000 IIO7 FACILITY ADDRESS ~(b_~ '~_~_,~,e~L CITY ~.~,~,~. ZIP CODE FACILITY PHONE No. INSPECTION DATE , - TIME IN TIME OUT ROUTINE ~ FOLLOW-UP REQUIREMENTS la. F~s A & B Su~ lb. F~ C Su~ 1c, O~mting F~ PaM ld. State Sum~rge Pa~ le. Statement of Fina~ial R~si~l~ Su~ lf. W~en Contm~ Exits ~n ~er ~. ~lid O~mting Pe~ 2b. Approv~ w~en Ro~ine Mon~ng Pr~ure 2c. Una~h~ Relea~ Res~n~ Plan ~. Tank Int~r~ T~t in 3b. Pre~ur~ Piping Int~ri~ Test in Last 12 Months ~. Suction Piping ~ghtn~ Test in Last 3 Yearn ~. Gmvi~ F~ Piping ~ght~ T~ in Last 2 Y~m ~. T~t R~u~s Subm~ Within 3f. Dai~ ~s~l M~Eodng of Su~ Pr~ Piping ~. Manual Invento~ R~cil~tion E~h M~th ~. Annual Invento~ R~nciliati~ Statement Su~ ~. Mete~ Calibmt~ Annually 5. W~kly Manual Tank Gauging R~rds f~ Small Tan~ 6. Month~ Statisti~l Invento~ R~nciliation R~u~s 7. MonthN A~omatic Tank Gauging R~uRs 8. Ground Water Mon~oHng 9. ~r Mon~oHng 10. Continuous IntemtRial MonR~ing f~ D~bl~Wal~ 11. M~hani~l Line Leak Det~ 12. El~ronic Line Leak Det~om 13. Continuous Piping M~R~ng in Sum~ 14. A~atic Pump Shrift Ca~bil~ 15. Annual Maintenan~Calibmtion of Leak Det~t~ Equi~nt 16. Leak Det~ion Equipment and T~t Meth~s ~t~ 17. Wr~en R~ords Maintain~ 18. Re~ Chang~ in U~g~CondRions to O~ratin~nE~ Pr~ures of UST S~tem W~hin 19. Re~d~ Una~ho~ Relea~ WRhin 24 Houm ~. Ap~ov~ UST S~tem Re.irs and U~m~ 21. R~rds Sh~ng Cath~ic Prot~ Ins~ ~. S~ur~ ~ng Wells ~. Drop mu~ RE-INSPECTION.._,./ //__ .,,~/'-~DATF'" ' RECEIVED BY: '~/'/~,~-/~_~~~/kf.,-.--'~ OFFICE TELEPHONE NO. - ~ _ ~ .,,L'.FD 1~9 : ~ F Ul~. FACILITY #11160 SiteID: 215-000-001107 = ESTER 01/06/95 - Location: 2688 OSWELL ST Map: 103 Haz: 2 Type: 3 City : BAKERSFIELD Grid: 22B F/U: 1 AOV: 0.0 Contact Name Title Contact Name Title !ZIAD DUGUM(TOM) / DEALER BP 24 HR EMERGENCY / Business Phone: (805) 872-0122x Business Phone: (800) 274-3572x 24-Hour Phone : (805) 872-9098x 24-Hour Phone : (805) 872-9098x Pager Phone : ( ) - x i Pager Phone : ( ) - x Summary TQSC~0~ CO~RP, ~A~T.TN .~MR.~'~CH~EST~R BENNETT 3~%0,0~,ZI~N~ANDEL DR~ SUI:T~ 20'0 ~-~ <A> Hazmat <B> Area Plan <C> Fac. Units <D> Notif/Evac <E> Mitigation <F> Site Facts <G> Training <H> RMPP Data <I> UST Data <J> Not Used <K> Held Aside <L> Incidents <M> Inspection <N> Admn <P> Print <Esc> Exit ~n~erground' ' Hazardous Materials Storage Facility I.D. No. Tank Number I, 3,, $. q, CONDITI Issued By: Hazardous Substance VERSE SIDE Bakersfield Fire Dept. HAZARDOUS MATERIALS DIVISION 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 (805) 326-3979. Piping Piping Method Monitoring ApproVed by: Ralph E. Huey, Hazardous Materials Coordinator Valid from: '-!-' '{. i Off, RECEIVED HAZ. ~4 T. DIV. CERTIFICATION OF FINANCIAL RESPONSIBILITY ,FOR UNDERGROUND STORAGE TANKS CONTAINING PETROLEUM A. i a,,n tequi:ed Io demonsltate Fin~cial Reqxmsibilily in Ihe requited amounts as specified in Section 280'/. Chaplef 18. Div. 3, Title 23, CeE: AND ~'~ $ I Million/occurrence ~'~ $2 Million annual aggregate D.r[-C~[30 ~ 1:~:~. IIt ]~. hereby certil'ics that it is in compliance with the requirements o£ (Name of T~k Owner ~ Section 2807, Article 3, Ch=peer 18. Division 3. Title 23. CCR. The mechnnisms used to demonstrate £inanci.',l responsibility ,s r¢cluircd by Section 2807 are as follows: 'C; Mechanism.,¥i:i Nome' :and'::Addrcss · of Issuer [:Mcch.',nis n. Coverage · Se'lf-~nsured TOSCO NORT[--~4EST NONE $1H ea 8/]./94 Y'ES YES PROPERTIES II, INC. occuranc~ to 8/1/96 aggregat~ NOTE: 1[ you are using thc State Fund as any part o£ your demonstration or financial responsibility, your execution and submission of this certification also certifies that you arc in compliance with all conditions for participation in the Fund. D. FacilitvNamt Facility Address BP OIL FACILITY #11160 2688 oSWELL, BAKERSFIELD Fa¢ilit)' Name Facility Address Facilily Name Fa¢ilit)' Address Fa¢ili~)' Name Fa¢ilil)' Address Facility Name Facility Address E. Signature of Tank.[.....~ ~ ' ~==:~ ._.LLOWner or Operator Date / Name and Title et 'rant' Owner et Operator Signature ~: Wi/ne]]' ¢~ Nolar)' Da~e Name el Witness t,r ***-TosCo NorthWeSt Compahy A Division of Tosco Corporation * * ' . · ' A Licensee of Bp Oil ' ' ' ~868-Prosp. e~t. Park Drive, Suite.360- . . 'Rancho CordoVa, CA'9567~0 - : .... · '~Telephone 916-631-0733..- -- .-, :_ .- . · Fax} 916:631-6988 ToscO ..... SEPTEMBER3,' 1994 BAKERSFIELD FD~HAZ MATL DEPT ' '2130 "G" STREET . BAKERSFIELD, CA 9330;I RE:' BP;0iL FAcILiTY #11160 2688 OSWELL BAKERSFIELD, CA ·93306 SUBJECT: HMMP .upDATE DEAR INSPECTOR: . THIS LETTER WILL SERVE~TO UPDATE THE HMMP CURRENTLY ON FILE WITH YOUR: OFFICE (A COPY OF WHICH IS A .'i~'DACHED)...' - '. · ON AUGUST'1, 1.994 TOSCO NORTHWEST_COMPANY PURCHASED THIS FACILITY FROM BP OIL. THE ONLY CHANGE FROM THE HMMP CURRENTLY ON 'FILE IS THE CHANGE'TO THE .PROPERTY OWNER INFORMATION. THIS IS-THE ONLY-CHANGE THAT. HAS .OCCURRED AND AS REQUIRED* HAS BEEN CHANGED WITHIN-THE. HMMP ATTACHED. IF YOU HAVE ANY QUESTIONS OR CONCERNS, PLEASE DON'T HESITATE TO CALL~ SINCERELY, · - ToSco· NORTHWEST CO.. CHESTER 'BENNETT - RETAIL 'ENGINEER ~:- . - '.:. · ,: _: ';'.:i:i" '~ .... . · i"--'..~-' '*'-:~ Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, CA. 93301 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 2. 3. 4. To avoid further action, return this form within 30 day~ of receipt. TYPE/PRINT ANSWERS IN ENGLISH. Answer the questions below for the business as a whole. Be brief and Concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA · BUSINESS NAME: BP Oil F~cili~ ~'il LOCATION: ?.~8~ Osw~ll Str~f MAILING ADDRESs: ,2~80swell cITy: E~kP--rs~Cf6J~ STATE.: CA DUN & BRADSTREET NUMBER: .1~ 154 PRIMARy ACTIVITY: ..R,~f~il ~soliFl~ OWNER:', ..... ~:~);~cO- ' .~O~,~iTiWB S? COMPANY ZIP' ~ PHONE: (~,o5)~B72- 0122. SiC CODE: 5500 MAILING ADDRESS: 28~o~-Pr°S~'St ~a~k'-D~:,' S%e' 360-,'_~-Ra.~Oho Cordo~-~-, C~A' SECTION 2: EMERGENCY NOTIFICATION: CONTACT -2. E~P £4 Hr. 5~¢r~enc~ TITLE BUS. PHONE P~lCr 24 HR. PHONE 95670- ,- Bakersfield Fire Dept. ' HazardOus Materials' Division HAZARDOUS' MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING:~ NUMBER OF EMPLOYEES: MATERIAL SAFETY DATA SHEETS ON FILE: 'YeS BRIEF SUMMARY OF TRAINING PROGRAM: A~I em~lo~ a~e wd~lM -h'~iv~e.~t ~c use ~ eme~e'~cff e~i~mc'nt. ~n~ll~. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE ';CALIFORNIA HEALTH & SAFETY CODE" FOR THE. FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER' (SPECIFY REASON) SECTION 5: CERTIFICATION: I, Ziz~Et '('Tom) Db~L4~q CERTIFY THAT THE ABOVE INFOR-. MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20'CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. SIGNATURE TITLE DATE. FD1590 ' ~ B~l~erSfield Fire Dept. Hazardous Materials Division' HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: AGENCY NOTIFICATION PROCEDURES: · ~. Local 'fire EMPLOYEE NOTIFICATION AND'EVACUATION': in the event of mn e~er~jenc~ ~i~io~l employees Will be verl~li~ notified to evacuate through ~he n~rest exit ~o ~e ev~cU~o~ ~r~ ~f ~e So~th~sf comer ~ ~e site. C. PUBLIC EVACUATION: Customers will be escorted ~o l ~ e ewcu~fion-area. D. EMERGENCY MEDICAL PLAN:' Bakersfield Fire Dept. Hazardous Materials Division 'HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: Co RELEASE CONTAINMENT AND/OR MINIMIZATION: The r~,leAs¢ ~h~,ll ~C/rsf be minim/zed bH ~h~in~he ~p~ ~, clo~nq . valves, ~l~q~j~ hol~ or ~riflhfjna ~e le~kina container if CLEAN-uP PROCEDURES: On~ ~e ~ill i~ conf~(n~, if s~ll'be ab¢or~ and/or neatr~liz~ SECTION 8: UTILITY SHUT-OFFS(LOCATION OF sHUT-oFFS AT YOUR FACILITY)' NATURAL GAS/PROPANE: N/A ELECTRICAL: Inside lube b~,~: wes't ~nct of nor+h wall WATER: IF1 ~He~alk ~1~ ©swell 5~reef/~.~we~Jr~ J-he 'dr,'vewa~, SPECIAL: LOCK BOX: YES~ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: 'PRIVATE FIRE PROTECTION' Fire c~finquisher~ Ic~te~ ,.r~ the, lUJ:;~ )~/s". WATER AVAILABILITY (FIRE HYDRANT): There. ~re no ~cire-. hflaranf~ nonr ~'e sire, FD3590 HAZARDOUS Farm and Agriculture [] Standard Bueineee BUSINESS NAME: ~F Oil F~cilJ+U ~111~O LOCATION: 2~ CITY, zIP:l~l~r~,'e{d.~. ~O~ PHONE {: (~)~) BAKE RS F I ELD HATER]AY-~ INVENTORY NON - TRADE SECRET OWNER NAHE.' ADDRESS: CITY, ZIP: PHONE ~ ~. NAME OF THIS FACILITY:OSW¢II ~F ~V{~ ~ STANDARD IND. CLASS'CODE: ~ DUN AND BRADSTREET NuMsE~/FEPERAL ID ~ 1 2 3 4 ' 5 6 7 8 9 10 11 12 . 13 Tr~s ~e ~ Average ~nua~ Measure ~ Days Cont Cont ~ Cont Use ~cation ~ere .% ~ N~e of H~xture/C~nents Code C~e ~t ~ ~t U~~ite ~ _ Pre~ ~ Code . . -- Physical and H~lth Hazard C.A.S; Muter ~~1~ Co~onent I I Na~ & C.A.8. N~ (Check all that apply) C~onent l'2 Sam ~ c.a.a..~r of Pressure H~lth H~lth Cornet J 3 N~ & C.A.B. ' (Check all that apply) Co,snot ~ 2 N~ & C.A.B. ~ Fire Hazed .~ ~udde~ ReleaSe ~ R~ctivity ~ I~late ~ Delay~ of Pressu~ H~lth - H~lth Co~on~t { 3 N~ &' C.A.8. N~ (Check all t~t apply) . Co~t ~ 2' N~ & C.A.S. N~ ~ Fire Hazed ~ Sudden Release ~ R~cttvity ~ l~iate ~ Delay~ -- of Pressure H~lth B~lth Co,orient ~ '3 Na~ & C.A.8. N~ Physical and B~lth Hazard C.A.S. N~er ~/~ C~on~t ~ I N~ & C.A.8. .(Check all t~t apply) ' co~nent ~ 2 N~ & C.A.~. of Pressure H~lth H~lth Cornet .~ 3 N~ & C.A.B. N~ -- Title 24 ~. Phone N~ Titlo 24 Hr.Phone :ertiflcation (READ. AND SIGN AFTKR COM I certify under peanlty of law that ! hayer Personally ~xamined and am familiar with the information submitted in this and all attached documents and that based on ~y inquiry of those individuals responSible for obtaining the Information.. I believe'that the submitted information is true, accurate, and co. plots. . . a . //' NAME AND OFFICIAL TITLE OF OWNER/OPERA-~OR OR OWNE~t/OPERATOR'S A~rmJ~/ZED I~PRF~t~"~AT/V~ 8I ~ DAT~ BIOR~D Fa~ andAgricultUre~Standard Business ~BAKERSFIELD ~RIALS INVENTORY NON - · TRADE ,SECRET OWNER NAHE ~ ' BUSINESS NAME: []~P OIt_}FAC%L%~h' ~ It%~oC) LOCATION: '~ O%~L~ ~T ~D~SS ~ CITY, ZIP: ' ~~ )~. ~b~ CITY, ZIP~ PHONE· ~: 80 ~ - ~%' O%~ PHONE %, BP OiL 'co. .PROPER CODES NAME OF THIS FACILITY: o,sw~:t-~ ,8~ ~-~',.~v~ STANDARD IND. CLASS CODE = .~ C~O DUN AND BRADSTI~EET NUMBE~/FEDERAL ID }' 1 2 3 4 5 .6 7 8 9 l0 11 12 13 14 Trane T~pe Max Average Annual Measure ~ Days Cent Cent Cent Umo Location Whore · I~/ ll=.~m of Mixture/Components code Code Ami A~c Amt Un,ts on Hits Type' Pr~ss Tem~ Code Stored in Facllit~ wt flee Instructions Physical and Health Hazard C.A;S. Number (Check all t~t apply) C~nent ~ F~ Saz~d ~ Sudan Release Co~nent of Pressu~ H~lth H~lth . (Check all t~t apply} ~ Fire Hazed ~ Sudden Release ~ - R~ctivity of Pressure H~lth Hmlth C°~t of Pressure H~lth H~lth Co,orient ! 3 N~ & ~.A.8. N~ (check al1 t~[ apply] Co~nen[ of Pressure H~lth H~lth Cornet N~ Title 24 ~. Phone N~. Title. . 24 Hr Phone !ert~fication (READ AND SIGN AFT~:H COMPLETING ALL SECTIONS) · I certify under peanlty of law that I hayer personally examined and am familiar with the information submitted in this and all attached documents and that based,on ~y inqufry of those individuals responsible for obtaining tho information. I believe that tho submitted information is true, accurate, and co. plate. NAME AND OFFICIAL TITLE OF OWNER/OPERATOR OR OWNER/OPERA'~'8 AUTHORIZED REPRES~N'rATIVR fl {,,~ DATE 8IOlq~D ~I~Y OF BAKERSFIELD ~~OUS [] Farm and AgrioultureJ~Standard Business ~ - ~E SKC~ LOCATION~ E~ O~~ ~ ~D~HS CITY, ZIPf . ' ~A~I~LO:~A ~ CITY, PHONE ~ ~O~- ~- Ot%~ PHONE Page. ~ of ~ ~>~ Or1, CO HAHS OF THIS FACILII'~I5$w~Lt' I~P 5eru~:6 ~G~, ~oe~c,T I~A~U~ [~ ~e3&o STANDARD IND. CLASS CODEz ' ~o0 ~A~ ~OI~C>OYAi~A. ~ge]O DUN AND BRADSTREET NUHflER/FEDERAL ID ~ Cll~ - ~,'"~t' ~t ~ _ _ - _ _ _ -.' _un_eaR TO IHSTR~CTIOJlH FOR PimPER CODES I 2 3 4 S · 7 8 9 10 Il 12 13 14 ;Trane .Type t4a~ Average Annual tteaaare I Da~ C°nt Cant Cant Uae Location Where % by Hames or #ixture/Compononte C_fido_ Code Att A~ Att Units on ·itt TA~ .Preza Tamp Code ·torod in Faollitr' vt Hoe Instructions (Check all that apply) : CouJ~mant f 2 lame · C.&.·. lumber ~ ,ire hzard ~ sudden blteae ~] ReaCtivity ~ lnnodiate ~l~elayod or Pressure Health ·~alth Coe~m~t J 3 Imm · C.A.·.. ·umber .,. PhFolcal and 'Health Hazard C.A.·. ·umber Ccmpcmant J I lit · C.&.·. Mumbmr [Check ell that apply) Component J ~ Imuo · C.A.B. Ilumber or Pressure Health Health Competent f 3 Mmm~ · C.A.B. gumbmr Phl~lcal and Health Hazard C.A.8. Mumber Comp(merit I I Mmmm · { t · Mumbo· (Check all that apply) Coml~°nimt I 3 Immm · C.A.B. Jf~mbmr ~ Fire Hazard· ~] ·uddon blent [-~ Reactivity [~ laaodiatm ~ Delayed. o~ .Pressure Health Health Compoamnt ! 3 Memo · Phl~icel end Ile~ltb Hazard C.A.B., Hanbur Ccmp0uunt f I limes · C.&.·. Ifumbmr (Check all that apply) ~ fire ·Hazard ~ Sudden Helena [] ReaCtivitT ~-~ Iaaodtato ~ Delayed Couponunt I 3 gm · C.A.·. Mumbmr or'Pressure Health Health Compoaant I ]Im · C.&.·. lumber Nm Title 24 Br. Phone limbo Title 24 BF Phone !ertificatiun (READ AND SIGN AFTER COHPLBTINO ALL SECTIONS) .. certify under peanlty or law that x hayer imreonally examined and aa raulliar with the inroruation aubadtted in' this and all attsahed doomeunts and that bead un m~f inquiry or those ndlviduala responsible for obtsini~g the lnrurmtion. I believe that the submitted inronmtion ia true, accurate, mod ocmplete. .~s ~m m,t*xcx,m TFrLE oP c~m~o~mm.~os OR m~mVo~mm~-~,s A~mO~Z~D ~SOEmT~ ·xoaa_~-~ . (~ OATS Sl.m~ MO~¢I P SITE DIAGRAM Business Name: Business Aclclress: FACILITY DIAGRAM F-~ E~POlL~ t=~ C_.. ,. L.i ..1-.r, "tF Itt~oO ~T For Office Use Onl~ First In Station: Inspection Station: Area Map # .I · I~L-'AblTEI~ ~ 05V,/ELL UNDERGROUND STORAGE TANK (UST) MONITORING PLAN Bp OIL FACILITY #11160 2688 Oswell Street Bakersfield, CA 93306 Responsible Person Owner/Manager: Work Phone'Number: Home Phone. Number: Ziad (Tom) DugUm (805) 872-0122 1.0 INTRODUCTION The intent of this monitoring plan is to outline visual and electronic monitoring which must be performed to comply with state and local laws and regulations. The plan contains policies fOr monitoring' frequencY, monitOring equipment, report/recordkeeping, testing, and a leak response plan. This plan shall be kept on file for viewing by regulatory agencies'. Additionally, monitoring records must be maintained fOr three years. 2.0 DESCRIPTION OF ITEMS BEING MONITORED: Underground Tanks: 1 - 12,000 Gallons.- RegUlar Unleaded GasOline 1 - 10,000.Gallons - Plus Unleaded Gasoline 1 - 10,000 Gallons - Super Unleaded Gasoline ~ ' 1 - 1,000 Gallons - Waste Oil The tanks and piping were inspected and pressure tested initially before installation at the.station. The tanks were tested using United State Environmental Protection Agency.(USEPA) regulations and state testing methods and a certified testing companY. 3.0 MONITORING OF DOUBLE-WAI.I.ED UST The double'-walled USTs are constrUcted of fiberglass and designed to-contain store materials. The secondary container is.equipped with a collection system to accumulate, temporarily store, and permit removal of precipitation, subsurface infiltration,, or hazardous substances released from' the primary container.' The tanks are slanted to allow released material to drain to the lowest point, in the annular space. The tanks'are placed into backfill material and covered wit! a concrete pad. 1 ~ UNDERGROUND STORAGE. TANK (UST) MONITORING PLAN BP Oil Facility $11160 '- 3.1 MONITORING FREQUENCY The monitoring'sYstem for the double-walled underground storage tanks shall be in compliance with the California UndergrOund Storage Tank Regulations as set ..forth in Title 23, Section 2634, California Code of Regulations. 'Monitoring of' each tank is. performed on a continuous basis using an electronic monitoring system. Leads activate an audible and visible alarm when liquid is detected in the annular space. The station manager, or his/her representative, inspects'the monitoring "syStem panels-at the beginning of each shift. Inventory reconciliation is also performed daily on each UST using an approved meter and comparing the contents of the tanks to the daily sales. Leaks would be determined by unexplained losses of material stored in the tank. This is a secondary precaution to the continuous' monitoring system utilized at the service station. Refer to Section 4.0 for the reporting format used by the service station, Annual Tank .Testing: Ail tanks and piping are inspected and pressure tested annually to ensure proper operation. The tanks are tested using United State Environmental Protection Agency (USEPA) and state testing, methods and certified testing companies. 3.2 MONITORING .~ The station uses the Pollulert System for'monitoring the four USTs. This system 'continuously monitors for precipitation, subsurface. infiltration, Or hazardous substances in the annular space of the double-walled tanks. Probes are permanently mounted through risers in each tank and are placed in the lowest elevation of the tanks. The underground piping running from the tanks to the pump islands are continuously monitored by the Red Jacket System. 3.3 ANNUAL sYSTEM INSPECTION The monitoring system shall be inspected annually by running systems functi6ns as recommended, by the manufacturer. Additionally, the manufacturer recommends cleaning the monitoring probe annually. The tanks and piping were also inspected and pressure tested initially before installation at the station. The tanks were tested using united States Environmental Protection Agency (USEPA) regulations and state testing methods and a 'certified testing company. UNDERGROUND sTORAGE TANK (UST) ; MONITORING PLAN BP Oil Facility ~11160 3.4 REPORTING AND RECORDKEEPING Monitoring'and tank testing records shall be kept onsite for at least three years· Records of leaks or suspected leaks and the required investigations shall also be kept onsite for three years. 3.5 T.RAK RESPONSE pLAN - UNDERGROUND TANKS The following prOcedures shall be followed by all personnel in the event of a leak or a suspected leak: 1. Facility personnel shall notify the manager/owner immediately ifa leak is suspected· 2. FaCility personnel shall notify ~he manager/owner immediately if the continuous monitoring device sounds. 3 The' manager/owner shall determine whether a leak has occurred or the monitoring device has malfunctioned· 4. If the leak' detection system has malfunCtioned, the' manager/owner shall immediately notify the BP Oil Maintenance Department. If a leak is suspected,'the .manager/owner shall contact the BP Oil Maintenance Department for investigation and -corrective.action. In the event of a substantial leak of more than five gallons, the manager/owner shall noti'fy the County Health Department. -A report-including confirming procedures shall be completed within 24 hours. .The BP Oil Maintenance Department shall respond to a reported leak with a pump~out truck within 24 hours. The leaking tank· shall be excavated, repaired or replaced. 10. Appropriate soil and groundwater investigations· will commence, if necessary. A!l.'records of investigations, repairs, or 'replacement shall be kept onsite for a minimum of three'years. UNDERGROUND STORAGE TANK (UST) MONITORING PLAN BP Oil FacilitY's11160 3.6 TRAINING The station Manager periodically inspects the' site to ensure.the safe work environment.' Additionally, employee have received Verbal training .in 'the following areas. · .1o 3. 4. 5. 6. The location of m°nitoring system panel and system manual. Warning and.alarm messages and what they mean.. Emergehcy shut-off switch location and activation. .Emergency response notification procedure.. Shut-down operations. -. Spill clean-up. 4.0 REPORTING FORMAT Tank and meter inventory reconciliation forms shall be Completed by the dealer/manager, or'his/her designee, on.a daily basis.' The following attached forms shall be completed: 1. Inventory Control Program Daily Tank Reconciliation Form Meter Worksheet' '3. Inventory Control Program Receipts, Worksheet. Sales & OVerages .4. Tank. and Meter Reconciliation 5. Tank and Meter Reconciliation Summary Undergrd.rsp 4 ' ~'~ '"- . Tosco Northwest Compan A Division of Tosco Corporation 3100 Zinfandel Drive, Suite 200 Rancho Cordova, CA 95670 Telephone 916-631-15,38 Fax 916-631-1539 Tosco July 12, 1994 Ms. Amy Green Kern County Environmental Health Services 2700 M Street, Suite 300 Bakersfield, CA 93301 Dear Amy,. Tosco Corporation has entered into an agreement withBP Oil Company to buy their retail service station locations in California, including those stations located in Kern County as indicated on the attachment. We expect this agreement to be finalized on or about August l, 1994. For the purpose of health permits and other environmental license issues (or billing) please provide future correspondence to the following address. Tosco Corporation Attn: Mr. Chester Bennett 3100 Zinfandel Drive, Suite 200 Rancho Cordova, CA 95670 (916)631-1538 We appreciate your cooperation and look forward to a l°ng standing relationship with your agency. Sincerely, ,..~lohn M. Launchi Tosco Corporation TOSCO CORP. OWNED BP STATIONS STORE# 11159 II160 11157 11158 LOCATION BRUNDAGE LANE & OAK ST. IIWY 178 & OSWELL I-5 & STATE I~VY 46 I-5 & STOCKDALE llWY MAILING ADDRESS 2 OAK 2688 OSWELL PO BOX 355 29727 STOCKDALE IBVY CITY BAKERSFIELD BAKERSFIELD LOST IIILLS BtrFTONWI LLOW COUNTY KERN KERN KERN KERN ZIp 93304 93306 93249 93312 ~_~ ALIF STATE WATER RESOURCES CONTROL BOARD / UNDERGROUND STORAGE TANK PERMIT APPLICATION FORM A COMPLETE THIS FORM FOR EACH FACILITY/SITE ONE ITEM [~] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE 01 ,I I. FACILITY'/SITE INFORMATION & ADDRESS- (MUST BE COMPLETED) DBA OR FACILITY NAME NAME OF OPERATOR oil F cili-/-LJ z.i d Dua m ADDRESS . _ _ NEAREST CROSS STREET J PARCEL # (o~i~NAL) CITY NAME STAT~ ZI~COD~ rsfieldCA 95~ ~ BOX TOINDiCATE ~COR~RATION ~ INDIVIDUAL ~ RARTNERSH]P ~ L~AL-AGENCY ~ COUNtY-AGENCY DISTRICTS TYPE OF BUSINESS [~ 1 GAS STATION [~ 2 DISTRIBUTOR HA7. MAT. D!V SITE PHONE # WITH AREA CODE (E~oS) 8,72.- 0i~'2 [---] STATE-AGENCY E~] FEDERAL-AGENCY IE.P.A. I.D..11 [~ 3 FARM EMERGENCY CONTACT PERSON (PRIMARY) DAYS: NAME (LAST, FIRST) PHONE # WITH AREA CODE NIGHT~: NAMe(LAST, FIRS~ -' 2¢ Hr. Em~r~en~ [~ ~ IFINDIAN I# OF TANKS AT SITE RESERVATION PROCESSOR ~ 5 OTHER ORTRUSTLANDS 4 EMERGENCY CONTACT PERSON (SECONDARY) · optional PHONE # WITH AREA CODE II. PROPERTY OWNER INFORMATION- (MUST BE COMPLETED) NAME I Oil IMAILING OR S~FREET ADDRESS 1~1~68 Pros~..c+ P~rK Cl~ NAME ' I I R cho rdov IlL TANK OWNER INFORMATION- (MUST BE COMPLETED) NAME OF OWNER I~P oil IMAILING ORSTREETADD~ESS - I I CITY NAME . ' / - lR n ho CorcJowl DAYS: NAME (LAST, FIRST) I ri i. IN~GHTS: NAM~ (LAST, FIRST) K24 Hr. PHI INE # WITH APFA C.ODF 60o- 274-- 5~72_ PHONE # WITH AREA CODJ~ I CARE OF ADDRESS INFORMATION · / box to indicate ~ INDIVIDUAL [~CORPORATION [~ PARTNERSHIP STATE ZIP CODE CA LOCAL-AGENCY ~ STATE-AGENCY COUNTY-AGENCY E~ FEDERAL-AGENCY PHONE #WITH AREA CODE t CARE OF ADDRESS INFORMATION LoUis ./ box to indicate [~ INDIVIDUAL ~'CORPORATION [~] PARTNERSHIP STATE ZIP CODE PHONE # WITH AREA CODE E~ LOCAL-AGENCY ~ STATE-AGENCY ~ COUNTY-AGENCY [~ FEDERAL-:~G~.N3Y IV. BOARD OF EQUALIZATION MST STORAGE FEE ACCOUNT NUMBER - Call (916) 323-9555 if questions arise. V. PETROLEUM DST FINANCIAL RESPONSIBILITY. (MUST BE COMPLETED) - IDENTIFY TEE METHOD(S) USED I~/ box toindicate ~'~1 SELF-INSURED [~ 2 GUARANTEE ~ 3 INSURANCE ~ 5 LE~'EROFCREDIT ~ 6 EXEMPTION E~ 99 OTHER SURETY BOND VI. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked, ICHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILLING: I. [] II. [] Itl. [] THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT [~'~Vl[~) E~U,~H'~¢'~ ~~x'x~,~~,~ APPLICAN~STITLE · ~WNE~ AOEN~ I' 5/15~ LOCAL AGENCY USE ONLY COUNTY Ct JURISDICTION # FACILITY # tcENSUsTRAc" Io1. 1/ISUPVlSOR - DISTRICT ''~ LOCATION CODE - OPTIONAL - OPTIONAL ' CODE - OPTIONAL THIS FORM MUST BE ACCOMPANIED BYAT LEAST (1) OR MORE PERMIT APPLICATION · FORM B, UNLESS THIS IS A CHANGE OF SITE NFORMATION ONLY FOR0033A-5 FORM A (5-91) STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION. FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY E~ 1 NEW PERMIT ~-] 3 RENEWAL PERMIT ONEITEM [] 2. INTERIM PERMIT E~] 4 AMENDED PERMIT CHANGE OF INFORMATION TEMPORARY TANK CLOSURE 7 PERMANENTLY CLOSED ONSITEI ] 8 TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: I. TANK DESCRIPTION COMPLETE ALL ITEMS -- SPECIFY IF UNKNOWN A. OWNER'S TANK ~. D. # Ulnk.nov,/Iq C. DATE INSTALLED (MO/DAY/YEAR) II. TANK CONTENTS ~F A-1 IS MARKED, COMPLETE ITEM C. B. MANUFACTURED BY: D. TANK CAPACITY IN GALLONS: A. [~ 1 MOTOR VEHICLE FUEL [] 4 OIL B. C. r~7] laREGULAR ~. UNLEADED [] 2 PETROLEUM [] 80 EMPTY [~ 1 PRODUCT [] lb PREMIUM UNLEADED [] 3 CHEMIOALPRODUOT [----] 95 UNKNOWN [] 2 WASTE E~ 2 [,FADED D. IF (A.1)IS NOTMARKED, ENTER NAME OF SUBSTANCE STORED ] 3 DIESEL ' [] 6 AVIAT[ON GAS [] 4 :EACFAuH:LL [~ 7 METHANOL ] gO OTHER (DESCRIBE iN ITEM O. BELOW) C.A.S.#: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, ANDALLTHATAPPLIESINBOXDANDE A. TYPEOF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [~ 95 UNKNOWN SYSTEM [] 2 SINGLE WALL -- [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER , B. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL [~ 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLEW/FRP (PrimaryTank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [~ 99 OTHER C. INTERIOR [] 1 RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY LINING [] 4 PHENOLIC LINING LINING [] 5 GLASS LINING [] 6 UNLINED [] 95 UNKNOWN [] 99 OTHER IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL ? YES__ NO__ D. CORROSION [] 1 POLYETHYLENE WRAP E~ 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER E. SPILL AND OVERFILL SPILL CONT~NMENT INSTALLED (YEAR) ~j ~ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) !¢:~:~ IV, PIPING INFORMATION CIRCLE A IFABOVEGROUNDOR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTEM TYPE A U I SUCTION A ~)2 PRESSURE A U 3 GRAVITY A U 99 OTHER B, CONSTRUCTION A U 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A(~ 95 UNKNOWN A U 99 OTHER C, MATERIAL AND CORROSION PROTECTION A U 1 BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVlNYL CHLORIDE(PVC)Ai~4 FIBERGLASS PiPE A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP A U 9 GALVANIZED STEEL A U 10 CATHODIOPROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION ~ 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTITIAL MONrTORING [] 99 OTHER V. TANK LEAK DETECTION [] 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 V~DOZE MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUNDWATER MONITORING [] 6 TANK TESTING [~ 7 INTERSTITIAL MONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER VI, TANK CLOSURE INFORMATION I1. ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTITY OF 3. WAS TANK FILLED WiTH ~ GALLONS INERT MATERIAL? YES [] NO [] I SUBSTANCE REMAINING THIS FORM HAS BEEN COMPLEIED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT I APPLICANT'S NAME ~ DATE LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW COUNTY # JURISDICTION # FACILITY # TANK # PERMIT NUMBER I PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE FORM B (7-91) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION. FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FOROO34B-R5 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION. FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARKONLY [] 1 NEW PERMIT ] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION PERMANENTLY CLOSED ON SIl TANK REMOVED ONEITEM. [] 2 INTERIM PERMIT ~[~ 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE DBA OR FACILITY NAME WHERE TANK IS INSTALLED~ I. TANK DESCRIPTION COMPLETE ALL'ITEMS .. SPECIFY IF UNKNOWN A. OWNER'S TANK I.D.# ~ C. DATE INSTALLED (MO/DAY/YEAR~ II. TANK CONTENTS IF A'I IS MARKED, COMPLETE ITEM C.  1 MOTOR VEHICLE FUEL ] 2 PETROLEUM ] 3 CHEMICAL PRODUCT D. TANK ~APACi~Y IN GALLONS:~o__.Q=(~_~ D. IF (A.I)IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED []40,L B. lC' ~] ~.~ UNLEADED [] 80 EMPTY [] 1 PRODUCT . [] lb PREMIUM UNLEADED [] 95 UNKNOWN [] 2 WASTE [~ 2 LEADED [] 3 DIESEL , [] 6 AVIATION GAS---~ ~ ~9 OTHER (DESCRIBE IN ITEM D. BELOW)J ] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC [ ] 8 10~/. METHANOL COMPATIBLE W/FRP ] 99 OTHER III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, AND ALL THAT APPLiES IN BOX D AND E A. TYPEOF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL -- [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER B. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM (PrimaryTank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN C, INTERIOR [] 1 RUBBER LINED [] 2 ALKYD LINING [] 4 PHENOLIC LINING LINING [] 99 OTHER E 3 EPOXY LINING [] 5 GLASS L~N[NG [] 6 UNLINED [] 95 UNKNOWN IS LINING MATERIAL COMPATIBLE WITH 100'/. METHANOL ? YES__ NO__ D. CORROSION [] 1 POLYETHYLENE WRAP [~ 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODiC PROTECTION [] 9~ NONE [] 9s UNKNOWN [] 99 OTHER E, SPILL AND OVERFILL SPILL CONTA~INMENT INSTALLED (YEAR)~ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) I~j~-- IV. PIPING INFORMATION CIRCLE A IFABOVEGROUNDOR U IF UNDERGROUND, BOTHIFAPPLICABLE A. SYSTEMTYPE A U 1 SUCTION ~ 2 PRESSURE A U 3 GRAVITY A U 99 OTHER -- B. CONSTRUCTION A U 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A(U~ 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)AQ4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION [] 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE T~GHTNESS TESTiNG [] 3 iNTERSTITIAL MONITORING [~ 99 OTHER V. TANK LEAK DETECTION [] 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VADOZE MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUNDWATER MONITORING ] 6 TANK TESTING [] 7 INTERSTITIAL MONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION [ 1. ESTIMATED DATE LAST USED (MO/DAY/YR) I 2. ESTIMATED QUANTITY OF i 3, WAS TANK FILLED WiTH SUBSTANCE REMAINING GALLONS INERT MATERIAL ? YES [] NO [~] THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND, TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT I APPLICAN3'SNAME ~'--' ~ r T (PRINTED & SIGNATURE)__ ~ I ~ ~. ~ ~ I DATE I ,, LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW COUNTY # JURISDICTION # FACILITY # TANK # PERMIT NUMBER 1 PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE FORM B (7-91) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION. FORM A UNLESS A CURRENT FORM A HAS BEEN FILED. FORO~34 B. R5 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION . FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARKONLY E~ 1 NEW PERMIT [] 3 RENEWAL PERMIT ONEITEM [] 2 INTERIM PERMIT- E~ 4 AMENDED PERMIT ] 5 CHANGE OF INFORMATION ] 6 TEMPORARY TANK CLOSURE PERMANENTLY CLOSED ON SITEI TANK REMOVED BRA OR FACILITY NAME WHERE TANK IS INSTALLED: J~p O i I J::::~;{C I. TANK DESCRIPTION COMPLETE ALL ITEMS -- SPECIFY IF UNKNOWN A. OWNER'S TANK ~. O.# IJrll<.l'lOWrl C. DATE iNSTALLED (MO/DAY/YEAR) I~D II. TANK CONTENTS IFA-1 IS MARKED, COMPLETE ITEM C. [~ 1 MOTOR VEHICLE FUEL [] 2 PETROLEUM E~ 3 CHEMICAL PRODUCT D. TANK CAPACITY IN GALLONS: [] 4 OIL B. [] ,,o EMPTY [] , PRODUCT [] B~ UNKNOWN [] 2 WASTE C. [] la REGULAR UNLEADED lb PREMIUM UNLEADED [] 2 lEADED D. IF (A.1) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED III, TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, ANDALLTHATAPPLIESINBOXDANDE A, TYPEOF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL -- [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER B. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 4 STEELCLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLE W/FRP (PrimaryTank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER C. INTERIOR [] 1 RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY LINING [] 4 PHENOLIC LINING LINING [] 5 GLASS LINING [] 6 UNLINED [] 95 UNKNOWN [] 99 OTHER IS LINING MATERIAL COMPATIBLE WITH 100°/o METHANOL ? YES__ NO__ [] , D'ESEL [] 6 AVIATION GAS []" GASAHOL Fq 7 METHANOL [] 5 JET FUEL ~ [] 99 OTHER (DESCRIBE IN ITEM D. BELOW]t C.A.S.#: D. CORROSION [] 1 POLYETHYLENE WRAP ~] 2 COATING ~ 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIOPROTECTION ~ 91. NONE [] 95 UNKNOWN [] 99 OTHER E. SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) 1~ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) IV. PIPING INFORMATION CIRCLE A IFABOVEGROUNDOR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTEMTYPE A U 1 SUCTION A(~2 PRESSURE A U 3 GRAVITY B. CONSTRUCTION A U 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 99 OTHER A095 UNKNOWN A U 99 OTHER C. MATERIAL AND CORROSION * PROTECTION D. LEAK DETECTION A U 1 BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A(~ 4 FIBERGLASS PIPE A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER [] 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTITIAL MONFORING [] ~9 OTHER V. TANK LEAK DETECTION [] 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VADOZE MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUND WATER MONITORING [] 6 TANK TESTING [] 7 INTERSTITIAL MONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER VI, TANK CLOSURE INFORMATION I 1. ESTIMATED DATE LAST USED (MO/DAY/YR) I 2. ESTIMATED QUANTITY OF 3. WAS TANK FILLED WITH SUBSTANCE REMAINING GALLONS NERT MATERIAL ~ YES [~] NO [] THIS FORM HAS BEEN coMPLETED UNDER PENALTY OF PERJURY, AND ~0 THE BEST OF MY KNOWLEDGE IS TRUE AND I APPLICANT'S NAME ~ ~ ' ~ DATE CORRECT LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW COUNTY # JURISDICTION # FACILITY # TANK # STATEI.D.# ~ I 1 171 '15. I I IIoL , PERMIT NUMBER I PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE FORM B (7-91) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION. FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FOROO34B-R5 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION. FORM B - COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY [~ 1 NEW PERMIT [] 3 RENEWAL PERMIT ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT ] 5 CHANGE OF INFORMATION ] 6 TEMPORARY TANK CLOSURE [~. 7 PERMANENTLY CLOSED ON SiTEI ~ B TAN~ REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: ~:~p O J I I= ¢il I. TANK DESCRIPTION COMPLETE ALL ITEMS -- SPECIFY IF UNKNOWN A. OWNER'S TANK I.D., [)~,~k~OV~/~/~ C. DATE ~NSTALLEO (MO/DAY/YEAR) lC)~)i~) II, TANK CONTENTS ~F A-1 IS MARKED, COMPLETE ITEM C. B. MANUFACTURED BY: Ow n - Cornir ) D. TANK CAPACITY IN GALLONS: 11 OOO laREGULAR ~DED lbPREMIUM .EADED LEADED A. [] 1 MOTOR VEHICLE FUEL [] 4 OIL B. C. [~]. 1aR [] 2 PETROLEUM [] 60 EMPTY [] 1 PRODUCT [~ lb PI [] 3 CHEMICAL PRODUCT [] 95 UNKNOWN J~ 2 WASTE [] 2 U ] 3 DIESEL ~ 6 AVIATION GAS ] 99 OTHER (DESCRIBE IN ITEM D, BELOW) C. A. S.# D. IF (A.1)IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED III, TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC. ANDALLTHATAPPLIESINBOXDANDE A. TYPEOF [] 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL -- [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER B. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL [~ 3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLE W/FRP (PrimaryTank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 99 OTHER [] 1 RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY LINING [] 4 PHENOLIC LINING C, INTERIOR LINING [] 5 GLASS LINING [] 6 UNLINED [] 95 UNKNOWN [] 99 OTHER IS LINING MATERIAL COMPATIBLE WITH 100°/o METHANOL ? YES__ NO__ D. CORROSION [] I POLYETHYLENE WRAP [] 2 COATING r-~ 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTI(~N [~ 91 NONE [] 95 UNKNOWN [] 99 OTHER E. SPILL AND OVERFILL SPILL CONTA~INMENT INSTALLED (YEAR)~ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR)L)~ ~r~/~ IV. PIPING INFORMATION CIRCLE A IFABOVEGROUNDOR U IF UNDERGROUND, BOTHIFAPPLICABLE A. SYSTEM TYPE A U 1 SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND CORROSION PROTECTION O. LEAK DETECTION A U I BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A U 4 FIBERGLASS PIPE A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER [] 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING · [] 3 INTERSTITIAL MONffORING [] 99 OTHER V. TANK LEAK DETECTION [] 6 TANK TESTING ~ 7 INTERSTtTIAL MONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER [] 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VADOZE MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUNDWATER MONITORING VI. TANK CLOSURE INFORMATION I1. ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTITY OF SUBSTANCE REMAINING GALLONS 3. WAS TANK FILLED WITH NERTMATERIAL'~ . YES [] NO[~ I THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO TI~tE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPLICANT'S NAME ' ~,- ~ c'~ , ~ , I DATE I (PRINTED & SIGNATURE) ..... ~ t "~. T ~ I ' , ~ PAVID L~UIZ. HAM ~_ ~/J.~ ------ I ~/I~/'=)'Z. I . LOCAL AGENCY USE ONLY THE STATE I.D, NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW COUNTY # JURISDICTION # FACILITY # TANK # STATE I.D..//' ! I I I' I I I JlOl l PERMIT NUMBER I PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE FORM B (7-91) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FOROO34 B-P.5 6 .i Bakersfield Fire Dep~ HAZARDOUS. MATERIALS DIVISION! 2130 G Street, Bakersfield, CA 93301 (805) 326-3970 UNDERGROUND T_ANK~.~i RECEIVED. ONNAIRF No. OF TANKS ~ - HA,~ ~4T ~V, N~R~T C~ S~E~ PARCEL No.(OP~ONAL) COR~ON ~NDIVlDUA[ ~ PAE~ERSHIP ~L~ALAGENCY O~IC~ ~COUN~ AGENCY ~STATE AGENCY ~F'EDE~L AGENCY GAS STA.ON ~2 DISTR,BUTOR · ~ KERN COU~ PERMIT I. FACILITY/SITE DBA'OR FACILITY NAME CITY NAME BOX TO INDICATE TYPE OF BUSINES~ EMERGENCY CONTACT PERSON iPRIMARY~ DAYS: NAME (LAST, FIRST) PHONE No. WITH ARE. A CODE NIGHTS: NAME (LAST. FIRST) PHONE No~ITH EMERGENCY CONTACT PERSON (SECON'DARy) optional DAYS: NAME (LAST. FIRST) PHONE No, WITH AREA CODE NIGH~: NAME (~ST, FI~ PHONE ~. Wl~ AR~CODE . II. PROPERTY OWNER INFORMATION (MUST BE COMPLETED) / BOX C~DIVIDUAL TO INDICATE ~ PARTNERSHIP STATE I ZIP CODE ~L. CZgTo MAILING OR STREET ADDRESS CITY NAME III. TANKOWNER INFORMATION (MUST BE COMPLETED) LOCAL AGENCY [~ STATE AGENCY [~ COUNTY AGENCY . [~FEDERAL AGENCY PHONE No. WITH AREA CODE (¢//,') CITY NAME / /tJcHo . coe-- oUA ~/BOX ~*~N OIVIDUA L TO INDICATE [~ PARTNERSHIP STATE I ZiPCOOE eli lg- 7o ~ LOCAL AGENCY Q STATE AGENCY Q COUNTY .~GE~ICY Q FEDERAL AGENCY PHONE No, WITH AREA CODE OWNER'S DATE VOLUME  NK No. INSTALLED / !~g7 io,'ovo ~. ) / ?g'/ !):ooo ¢,t, DO YOU.HAVE FINANCIAL RESPONSIBILITY? ON TYPE PRODUCT STORED PLus ,.dA g'1'£ IN SERVICE Y/N SPECIFY IF UNKNOWN c. DATE ,NSTALLED~M~AY. EA'R) ~)~' / ~1 D. TANK CAPAC,TY ,N ~ALLONS: '/O/O00 II1. TANK CONSTRUCTION MARK ONE I~ ONLY IN BOXES k 8. ANDC,~OALLTNATAP~iESlNBOXO A. ~PE OF ~ 1 ~UBLE WALL ~ 3 SINGLE WA~ WI~ E~ERIOR LINER ~ 95 UN~OWN SYSTEM ~ 2 SINGLE WALL ~ ~ O~ER B. TAI'IK MATERIAL (Primary Tank) ] 1 BARE3'IE~:L [] 5 CONCRETE ] 9 BRONZE ] 1 RUBBER LINED [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 2 STAINLESS STEEL .~Z~3 FIBERGLASS [] ;~ POLYVINYL CHLORIDE [] 7 ALUMINUM [] 10 GALVANIZED STEEL [] 9E~ UNKNOWN ] 2 ~D LINING ['-'-]' 3 EPOXY LINING ] 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC ] 8 100% METHANOL COMPATIBLEW/FRP ] .99 OTHER ] 4 PHENOLIC LINING C. INTERIOR LINING D. CORROSION ] 5 GLASS LINING [] 6 UNLINED IS UNING MATERIAL COMPATIBLE WITH 100% METHANOL ?. [] 1 POLYETHYLENE WRAP [-._1 2 COATING ~ 95 UN'Ow" [] 99 OTHER YES__ NO.:..__ PROTECTION, [] 5 CATHODIC PROTECTION [] 91 NONE [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC /. ~'95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION A. SYSTEM TYPE B. CONSTRUCTION C. MATERIAL AND CORROSION PROTECTION D. LEAK DETECTION ~ 1 AUTOMATIC LI.NE LEAK DETECTOR / CIRCLE A IFAI~OVE GROUND OR U IF.UNDERGROUND, BOTH IF APPLICAI~E SUCTION A(~ 2 PRESSU~.~E A U 3 GRAVITY A U 99 OTHER # SINGLE WALL A ~ 2 DOyBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER BARESTEEL A I~,,~AINLESS S'~E~-L A U 3 POLYVINYL CHLORIDE(PVC)A U 4 FIBERGLASS PIPE ALUMINUM ' A U 8 CONCRETE A U 7 STEEL WI COATING A U 8 100% METHANOL COMPATIBLEW/FRP' GALVANIZED STEEL A U 10 CATHODIC PROTECTION AC 95 UNKNOWN A U 99 OTHER [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTrrlAL MONITORING [] 99 OTHER V. TANK LEAK DETECTION ~1 VISUAL CHECK INVENTORY RECONClL~IATION [] 3 VAPOR MONITORING,~~- ~ AUTOMATIC TANK GAUGING [] 5 GROUNDWATER MONITORING TANK TESTING [] 7 INTERSTITIAL MONITORING [] 91 NONE ] 95 UNKNOWN [] 99 OTHER I. TANK DESCRIPTION COMPLETE ALL ITEMS- SPECIFY IF UNKNOWN . .: ,., ' A. OWNER'S TANK I.D.# ,~ C. DATE INSTALLED (MO/DAY/YEAR)' III. TANK CONSTRUCTION D. TANK CAPACITY iN GALLONS: MARK ONE ITEM ONLY IN 8OXES A. B: AND C, AND ALL THAT APPLIES IN BOX O A. TYPE OF ~? 1 DOUBLE WALL · SYSTEM [] 2 SINGLE WALL' [] 3 SINGLE WALL WITH EXTERIOR LINER [] 9S UNKNOWN [] 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER 8. TANK MATERIAL (Primary Tank) [] 1 BARE STEEL [] 2 STAINLESS STEEL ,~'3 FIBERGLASS [] 5. CONCREt [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] ~ BRON,,~ [] ~0 GALVAN,Z,D STEEL [] 95 UN~OWN IS LI¥~ MATERIAL COMPATIBLE WITH' 1~. ~E~ANQL · YES ~ NO~ [] 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC ] 8 100'/. METHANOL COMPATIBLEWIFRP ] 99 OTHER ] 4 PHENOLIC LINING C. INTERIOR LINING D. CORROSION [] I POLYETHYLENE WRAP L_._J 2 COATING [] 3 VINYL WR~AP ] 99 OTHER ] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] s CATHODIC PROTECTION [] 91 NONE UNKNOWN [] 99 OT~ER IV. PIPING INFORMATION A. SYSTEM TYPE B. CONSTRUCTION C. MATERIAL AND.' CORROSION PROTECTION D. LEAK DETECTION ~"~ AUTOMATICLINELEAKDETECTOR CIRCLE A IF ABOVE GROUND OR U IF UNOERGROUNO, BOTH IF APPLICABLE A U 1 'SUCTION A(~ 2 PRESSURE A U 3 GRAVITY A U 99 OTHER A U 1 SING~.E WALL A(~ 2 DOUBLE WALL A U 3 LINED TRENCH A ~ 95 'UNKNOWN A U 99 OTHER A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVCi~, U 4 FIBERGLASS PIPE A U 5 A~.UMINUM A U'6 CONCRETE A U 7 STEELWICOATING A U 8 100% METHANOL COMPATIBLEW/FRP A U /9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A(~95 UNKNOWN A U 99 OTHER [] 2 LINE TIGHTNESS TESTING [] 3 INTE~:~flUAL [~99 OTHER MONITORING V. TANK LEAK DETECTION L----~', v,SUAL CHECK ~'~ ,N',ENTOR,, RECONC,L,AT,ON r--]~ vAPOR MON,TORING ~-- ..:, AUTOMAT,C TANK GAU~mNG [] ~ GROUND WATE.~,,ON,TOR,NG ~¢,~ TANK.TEST,NG [] ~ INTERST,T,AL~ONITORING [] S, NONE ~'~,, ~NKNOW, [] 99 OTHER ~' ":'-".~TANK DESCRIPTION' COMPLETE IEMS - SPECIFY IF UNKNO~I ~,~l ,~llk~ ' III. TANK CONSTRUCTION MARK ONE I~M ONLY IN BOXES ~ B. ANOC,~DALL~ATAP~IESINBOXD A. TYPE OF /J~ I DOUBLE WALL ~ SYSTEM [] 2 SINGLE WALL [] 3 SINGLE WAll WITH EXTERIOR LINER [] 95 UNKNOWN [] 4 SECONDARY CONTAINMENT (VAULTEOTANK) .[] 99 OTHER L_J I BARE STEEL ] 5 CONCRETE [] 2 STAINLESS STEEL '-~1~.3 FIBERGLASS [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 8 100% METHANOL COMPATIBLE W/FRP · B.". TANK MATERIAL (P,ima,yT~.~) [] 9 BRONZE [] ',0 GALVANIZED STEEL [] I R ~ RUBBER LINED ~ 2 ~D L~G ~'3 ~O~ LINI~ C INTER 0 ' ' ' UNING ~5 ~ LINING.' ~ , UNLINED ~ UN~WN / ~INING MATER~ ~MPATI~ .~ 1~ M~A~L ? YES__ PROTEW~'S,,~,,,~ "" cA'Dole PROTEOTION ~ 91 ~NE ~ UN~WN IVI PIPI~ INFORMATION C~RC~ A IFABOVEGROUNDOR U IF UNDERGROUND. BO~IF~LICA~ A.[SY~M~PE A'U I SUCTION A~2 PRESSURE A U 3 G~VI~ B. ~STRUCTION A U 1 SINGLE WA~ A~ 2 ~UBLE WA~ A U 3 LINED TR~CH OTHER ] 4 PHENOLIC LINING [] 9g OTHER ] 4 FIBERGLASS REINFORCED PLASTIC [] 99 OTHER A U g9 OTHER A U g5 uNKNowN A U 99 OTHER C. MATERIAL AND A U I BARE ~I~-~-L A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC)A U 4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COAT1NG A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A(~ 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION' [~" AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERStitiAL MONITORING [] 99 OTHER V. TANK LEAK DETECTION ~ 1 VISUAL CHECK 2 INVENTORY RECONCILIATION [] 3 vAPoR MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUND WATER MONITORING E~6 TANK TESTING [] 7 INTERSTITIAL MONll;ORING [] 91 NONE ] 95 UNKNOWN [] 99 OTHER I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN _ .c. DATE INSTALLED <MO, DAY. EAR, O 1 D. TANK O "AC,TY I, GALLONS: h do u IlL TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, ANDALLTHATAPPLiESlNBOXD A. TYPE OF ~ 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT . (VAULTED TANK) [] 99 OTHER ] 4 STEEL CLAD W/FIBERGi_ASS REINFORCED PLASTIC [] 8 100% METHANOL COMPATIRLEW/FRP ] gg OTHER m~}( [] I BARE STEEL [] 2 STAINLESS STEEL ~'3 FIBERGLASS MA~rERIAL L~ 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINbM ~,~aryTank) [] 9 aRO~ZE ~ 10 ~LVANI~D STEEL ~ 95 U.~OWN INTERIOR LINING ~ 5 ~ LINING ~ 8 UNLINED ~' 95 UN~OWN ~ ~ O~ER IS LINING MATERIAL COMPATIBLE WITH' 1~, ME~ANOL ? YES~ NO~ D. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING .' [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE ~E~5 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION. CmCL~ A IFABOVEGROUNDOR U IFUNOERGROUNO. BOTH IF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION A(~ 2 PRE_..~,.~,a,~.L~.E A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A{~ 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C] MATERIAL AND" A U ~ BARE STEEL A U 2 'STAINLESS STEEL A U 3 POLYVINYL CHLORIOE(PVC)A U 4 FIBERGLASS PiPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING, A U 8 100% METHANOL COMPATIBLEWiFRP PROTECTION A U 9 GALVANIZED STEEL ,~ U lO CATHOOICPROTECTION Ai~95 UNKNOWN A U gg OTHER LEAK DETECTION {~)'~ · AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTITIAL MONFrORING E~ 99 OTHER V. TANK LEAK DETECTION '1 ~'~1 VISUAL CHECK ~'~"2 INVENTORY RECONClUATION E~ 3 VAPOR'MONITORING~-'] 4 AUTOMATICTANKGAUGING [] 5 GROUNDWAT'E~MONITORING) TAN TEST,NO' [] 'NTERST,T,ALMO,,TOR,NG [] 9, ,O,E [] 95 U,KNOW. [] 95 OTHER / RANDALL L. ABBOTT Agency Director (805) 861-3502 Director R E S O U R C E M'::.~;iN,':~A=.G E:i,M:E N T DEPARTM~T.!i~Fi::EN~i:~{6~NMENTAL HEALT~:~SER¥1CES PERMIT TO CONSTRUCT UNDERGROUND STORAGE FACILITY 2700 M Street, Suite 300 Bakersfield, CA 93301 Telephone (805) 861-3636 .Telecopier (805) 861-3429 AGENCY PERMIT NUMBER 090007M .FACILITY NAME/ADDRESS: British Petroleum MitchelVs. MObil.. ,,.Seryi~ce 2688 Oswell Bakersfield, CA OWNER(S) NAME/ADDRESS: CONTRACTOR: British Petroleum Oil Company FEMCO (LCD 2868 Prospect.Park_D.r~ve P.O. Box 88 Rancho Cardova, CA 65670 .......................... License # 517079 Phone No. (916) 631-6919 Phone No. (209) 688-2977 X NEW BUSINESS CHANGE OWNERSHIP RENEWAL MODIFICATION OTHER pERMIT EXPIRES APPROVAL DATE APPROVED BY December 28, 1990 September 28, 1990 Micha61 Driggs~ ' (V~ . Hazardous Materials.~cialist .................................................................................. POST ON PREMISES .............................................. ; ...................... CONDITIONS AS FOLLOW: Standard Instructions , 4. 5. 6. This permit applies only"to the modification of an existing facility involving Tthe replacing of dispensers with all associated product piping and fittings. All construction to be as per facility ·plans approved by this department and verified by inspection by Permitting Authority. All equipment and materials in this construction must be installed in accordance with all manufacturers' specifications. Permittee must contact Permitting Authority for on-·site inspection(s) with 48 hour advance notice. Backfill material for piping to be as Per. manufacturers' specifications. Construction inspection record card is included in this permit given to Permittee. Permittee must contact Permitting Authority and arrange for each group of required, inspections numbered as per this permit: a. Site inspection after dispensers are removed b. Piping systems pressure test . c. Electrical conduits d. Any other inspection deemed necessary by Permitting Authority' All underground metal-connectibns (e.g. piping, fitting, fill pipes) to tank(s) must be electrically isolated, and wrapped to a minimum 20 mil thickness with corrosion-preventive, gasoline-resistant tape or otherwise . protected from corrosion. If contamination is found during dispenser replacement a preliminary site assessment will be required. MD:cas \090007m.ptc RANDALL L ABBOTT Agency Oirector (805) 861-3502 STEVE Mc CALLEY Director RESOURCE MAN-AGE. MENT DEPARTMENT; OF ENVIRONMENTAL HEALTH SERVICES PERMIT TO CONSTRUCT UNDERGROUND AGENCY STORAGE FACILITY 2700 M Street, Suite 300 Bakersfield. CA 93301 Telephone (805) 861-3636 Telecopier (805) 861-3429 PERMIT NUMBER 090007M FACILIT'Y NAME/ADDRESS: CONTRACTOR: British Petrol6um FEMCO (LCI) Milclmll~s. Mobil----Service .......................2868-Prospecl .Park_Drive ....... d ........................ P; O: Box, 88 OWNER(S) NAME/ADDRESS: British Petroleum Oil Company 2688 Oswell Rancho Cardova, CA 65670 Tulare, CA 93275 License # 517079 Phone No. (209) 688-2977 December 28, 1990 Bakersfield, CA Phone No.(916)631-6919 PERMIT EXPIRES APPROVAL DATE APPROVED BY' NEW BUSINESS CHANGE OWNERSHIP RENEWAL MODIFICATION OTHER X September 28, 1990 ichael Driggs Hazardous Materials ~cialist .................................................................................. POST ON PREMISES ............................... CONDITIONS AS FOLLOW: Standard Instructions I. This permit applies only to the modification of an existing Facility involving Tthe replacing of dispensers with all associated product piping and Fittings. 2. All construction to be as. per Facility plans approved by this department and verified by inspection by Permitting Authority. 3. All equipment and materials in this construction must be installed in accordance with all manufacturers' specifications. 4. Permittee must contact. Permitting Authority for on-site inspection(s) with 48 hour advance notice. 5. Backfill material For piping to be as per manufacturers' specifications. 6. Construction inspection record card is included in this permit given to Permittee. Permittee must contact Permi'tting Authority and arrange for each group of required inspections numbered as-per this permit: a. Site inspection after dispensers are removed b. Piping systems pressure test c. Electrical conduits ~' d. Any other inspection deemed necessary by Permitting Authority 8. All underground metal connections (e.g. piping, fitting, .fill pipes) ~o tank(s) must be electrically isolated, and wrapped to a minimum 20 mil thickness with corrosion-preventive, gasoline-resistant tape or otherwise protected from corrosion. 92 If contamiuation is found during dispenser replacement a preliminary site assessment will,be required. MD:cas \09000Tm.pfc KERN~cOUNTY HEALTH DEP T ENVIRONMENTAL HEALTH DIVISION HAZARDOUS SUBSTANCES SECTION INSPECTION RECORD 1700 FLOWER STREET BAKERSFIELD. CA 93305 PHONE 805) 861-3636 CITY ~i~").-~" c,,~ .... ADDRESS [~ ' -. PHONE NO.~w'-,": ~.--/'~> '~-Z,~k :' ................ INSTRUCTIONS: Please call for an inspector only when each group of inspections with the same number are ready. They will run in consecutive order beginning with number 1. DO NOT cover work for any numbered group Until all items .in that group' are signed off by the Permitting Authority. Following thes'e instrutions will reduce the number of required inspection visits and therefore prevent assessment_~.f.,.addLt.i, onal...f~es.. . - TANKS & BACKFILL - INSPECT I ON DATE Spark Test Certification Cathodic Protection of Tank(s) - PIPING SYSTEM - Piping & Ra~a~ay.:wt. Col-lection--Sump Corrosion Protection of Piping, Electrical Isolation of Piping From Tank(s) .,,,~athodJc Protection System-Piping - SECONDARY CONTAINMENT OVERFILL PROTECTION, Liner Installation - Tank(s) Liner. Installation - Piping Vault With Product Compatible Sealer Level Gauges or Sensors, Float Vent Valves Product Compatible Fill Box(es). Product Line Leak Detector(s) Leak Detector(s) for Annular Space-D.W. Tank(s) Monitoring Well (s)/Sump(s) Leak Detection Device(s) For Vadose/Groundwater {", -,c,, -I "'.'+ -.FINAL - Monitoring Wells, Caps & Locks Fill Box Loci< 'Monitoring Requirements CONTACT i"rx,~'~, ~.;.' ~<;. "',1 {%'(V\i-%t',,rv,,?,'~*.-'- . I. LICENSE }K}E}RN COLJNTY }F 11 }R IE DIE IPA\ RT M }EN T 5642VictorStreet Bakersfield, California93308 - Telephone(805) 861-2577 PERMIT NO.: FIRE CHIEF THOMAS P. McCARTHY ADMINISTRATIVE DEPUTY CHIEF SCHUYLER T. WALLACE OPERATIONS DEPUTY CHIEFS DANIEL G. 'CLARK CHARLES E. DOWDY CHARLES A. VALENZUELA ADMINISTRATIVE SERVICES OFFICER NORMAN R. BRIGGS Plans have been checked in accord~mce with:' OWNER: OCCUPANCY: .... TYP~. CONSTRUCTZ0": ( ) U.F.C. 19__ ( ) U.B.C. 19__ .( ( ) Title 19 ..FLOOR AREA: ACTUAL ) Title 24 ALLOWABLE: " ( ) OTHER: OCCUPANT LOAD: Protecting The Gfflden Empire FILE CONTENTS SUMMARY anD~ZSS : ~ S Z O~e // PE~IT ~: 07000~ ENV. SENSITIVITY: Activity Date # Of Tanks Comments "M" srI'REET , STE. 3~ · -- .......... . ..'../"' RSFIELD, CA 93301 -_~ution Date ~.Zo.TO HAZARDOUS SUBSTANCES s'roP~%GE FACILITY '.:- Type Of A~pllcatlofi ('~eck): ' : .'. QNew Facility ~diflcatton Of Facility QExistlng Facility QTransfer 0f Ownership ~' A. Emergency 24-Hour Contact (name, area code, phone): Days N I-~l~ ~ ~ ;' Type Of Business (check): ~sollne Station ~Other (describe) Is Tank(s) Located 0n An Agricultural Farm? ~Yes ~o Is Tank(s)Used Primarily For Agricultural Purposes? ~Yes ~o Facility Address.~~ ~~ Nearest C~oss St. SEC (Rural Locations Only) Contact Person T ~ R ,Tank Owner' iAddress Operator Address B. Water To Facility Provided By Soil Characterisfilcs At Facility ~ Basis For Soil Type and Groundwater Depth Determinations C. Contractor 'CA Contractor's License No. Address Zlp 'telephone Proposed Starting Date Proposed Completion Date' Worker's Compensation Certification No. Insurer C:~'q_o_ ntact "perSon ':' .... Zip Telephone Depth to Groundwater" Fa, If This Permit Is For Modification Of An Existing Facility., Briefly Modifications Proposed Tank(s) Store (check all that apply): .Tank ~ Waste Product Motor Vehicle Describe Unleaded Regular Premium Diesel Waste Fuel · - 9tl l [] [] [] [] [] [] E]' .0 [] [] [] [] [] [] '0 F Chemical Composition Of Materials Stored (not' necessary for motor vehicle fuels) Tank ~ Chemical Stored (non-commercial name) CAS # ('If known) Chemical Previously Stored ~ [ ~. (If different) O. Transfer Of Ownershl~ Date Of Transfer Previous Owner Previous Facility Name I, accept fully all obligations of Permit No. issued to I u~lderstand that the Permitting Authority may review and modify oF terminate the transfer of the Permit .to Operate this underground storage :y~ upon _~ecalvtng_ tills completed, form., ..... .... This form has been. completed under penalty of perjury and to the best of my knowledge Is true and correct.. ' ,k x.~ '*" . . . ~.. , . . I v i COUNTY PLANNING & DEVELOPMENT .... ' " 2700 "M'. ".'.eake~s~e~d, cA. Pa~,ment Nede By Cash '1~00.00"','' 1700 Flower Slreet .* Bakersfield, Cilllornl,, 93305-4198 KERN ·COUNTY HEALTH DEPART"MENT AIR POLLUTION CONTROL DISTRICT ~-: " Telephone (805) 86'~-2231 > LEON M HEBERT$ON. M.D. Director of Public Health Air Pollution Control QIIICer To: Permit APplicant This department has reviewed the application and plans submi'tted" for the underground storage facility ,located at Based on t s' review, your application has been denied fo' the reasons listed on 'the attached Permit Appliaat~on Checklist. We are returning the original permit application and plans. After making, required corrections and/or modifications, the 'application may be resubmitted for' review. If you have any questions regarding please call C_~f:.f'\, L-', .-~-~.f'? )-!-Q"~'~ . at (805)861-3636 ..... i-' our requfrement~ opp,,./ ,ccc. r- -"this ............ · ' ~-T~'hO ,n x_ '-/C.',--~ ~ . Facility Name Facility Address Permit Application Checklist ~' Standard Design Motor Vehicle Fuel Exemption Design (Secondary Containment) -- (Non-Secondary Containment) Approved ' z'~:' ': ~,..:..:- Per. mit Application Form Properly Completed ..... . ".~i._: ....' .... .:: 3 Copies of Plo~ Plan Depicting: · Property ~lines Area encompassed' by minimum 100 foot radius around tank(s) and ' piping ~tt~]~l~.,tt~ t~ ~'r:~ ~.,.~r~C - I.~[( r~r,~'~ ~{~,] .:- . All tank(s) identified by a number and product .to be stored Adequate scale (minimum 1"=16'0" in detail) /"-iC'- North arrow " - Ail structures within 50 foot radius, of tank(s) and piping Location and labeling of all product pipi-ng and dispenser islands Nc+ ~C/~ Environmental sensitivity data including: *Depth to first groundwater at'site *Any domestic or agricultural water well within 100 feet of tank(s) and piping *Any surface water in unlined.conveyance within 100 feet of tank(s) and piping *All utility lines within 25.feet of tank(s) and piping (telephone, electrical, water, sewage, gas, leach lines, seepage pits, drainage systems) ~ .*Asterisked items: appropriate documentation if permittee seeks a motor vehicle fuel exemption ~rom secondary containment Comments: Approved ~ Raceway(s), System in Place ceP~es of cOnstruction Drawings Depicting: Side View of Tank Installation with Backfill, Secondary Containment and/or Leak Monitoring Top View of,Tank Installation with Raceway(s)., Secondary Containment ~and/or Leak Monitoring System in Place .l A Materials Ll!st (indicating those used in the construction): Backfill Tank(s) ~ t,~, ~'_ Pr,od uct Piping ~?:~'~: ~'~ ~C S e c o nd a r y Containment ~'~>:'~'r~'~>".~:~<~/-Leak Detector (s) . ~:tr~ .f~-t~-~_t, Overfill Protection 0.~'%~-]{rC/~'. ., Gas or Vapor Detector Sump(s) ,t..~' ['-,. ~,-~ {-i_ ? r~( ~oni't'or lng Well(s) Additional: ,. Documentatfon of Product Performance Additional Comments SITE INSPECTION: Approved Comments: Disapproved Date Inspector Date NEW CONSTRUCTION/MODIFICATION STATUS SHEET [] Application Received:' ~ Application' Check : M'- Appl:i~atlon:~'e'turn~d:' Date Date Comment: [[] Application Resubmitted: Date By [~] Application Accepted : Date By Type: N-~_~. · [~ Passed ~ Failed ~ Additional Submittals/Changes Requested Date By Comment: Submittals Received 'Rechecked Plan: Date ~'Passed [~ Failed Permit to Construct/Modify By Comment.': Tanks Issued: Date Denied: Date First Inspection: Date [-~ Passed ~ Failed Reinspection: Date D Passed ~ Failed Comment: Comment By By By Notes: Equipment to be tnstalIed: ~ Tank(s), i~_~ooFt, of Req'd Approved Standard Cgmpl tance Check CTO_ '~Suctlon ~Pressurized OGravlty, Piping Type of License Proof of Contractor's Worker's Compensation Insurance Primary Containment []Fiberglass (FRP) Make & Model O~OdY~ O Ftberglass-clad steel Make & Model , --j [-]Uncoated Steel Make & Model ~]Other: Make & Model c'O~ment-~ Additional: Inspection: J Secondary Containment of Tank(s) 'Double-walled tank(s) Make &, Model _~S Synthetic liner Make & Model OLined concrete vault(s) Sealer used ~]Other Type Make & Model Comment: Additional:. Inspection: Secondary Containment Volume at Least 100~ of Primary Tank Volume(s) Comment: Additional: Inspection: Secondary Containment Volume for More Than One Tank Contains 150~ of Voldme of Largest Primary Containment or lO~ of Aggregate Primary Volume, Whichever is Greater Comment: Additional Inspecti. on: Req'd Approved ..Secondary Containment Open to Rainfall Mdst Accommodate 24 Hour Rainfall Total Volume Comment: Additional: Inspection: ~'?-='~$econdary-C-o-ntainment- ts Product~Compa~ibIe Product eum~lle~]t~~| Documentation Comment: ~ i '-' Additional: Inspection: Annular Space Liquid is Compatible with Product ............... Product ........................................................ -=Annu'l'ar'-li'quid Comment: .' Additional:. Inspection: Primary Containment of Piping· Flberglass piping Coated steel piping ~]UncOated steel piping < r']other Comment: ~ ~e~u~ ~d~ ~# Size & Make Size & Make Size Addition,al: Inspection: Secondary Containment of Piping [']Double-walled pipe  Synthet, ic liner In trench Other Size & Make Size & Hake Comment: Additional: Inspection: Corrosion Protection ~Tank(s) '~'i~r~lC,,~.'~ ~Electrical isolation Comsent: Additional: Inspection: Manufacturer-Approved Backfill for Tanks & Piping . Type Om mve! Comment: - 2 - Req'd ~pproved Additional: Inspection: Tank(s) Located no Closer than lO'Feet to Building(s) Comment: ~ 'Additional: Inspection: ~ ~~ Complete Monitoring System ~ Monitoring device within secondary containment: ~]Llquid level indicator(s) ~']Ltqutd used .............. ' ...... - .............................................. [~Thermai,-conductivtty-sensor{s.) ............................. . ~]Pressure sensor(s) OVacuum gauge F-ISu.p'(s)  '6as or 'Manual Vtsual Other Comment: vapor detector(s) Inspection & sampling inspection Additional: Inspection: ~ Othe¥ Monitoring OPeriodic tightness testing Method ~Pressure-reducing line leak detector(s) ~Other IY~e~i4~r,nQ ~t,~ ~-~ Commen~: ~ .... Additional: Inspection: Overfill Protection ~Tape float gauge(s) iclOat vent valve(s) F.rr~_~ ~l~e~ apacltance sensor(s) ~]~lgh level alarm(s) FAUtomattc shut'off control(s) tll box(es) ~tth 1 ft. 3 volume ~{ [~Operator controls with visual ievel monitoring Other Comment: Req'd 'A~proved ...- Additional: Inspection: Monitoring Requirements Additional Comments Inspection: Inspector Date Date: ..... Purpose: ....... - :- Ex-ira Inspections'/Retnspecttons/¢onsultatton~ Comleflt: Time Utilized' ~ ~ ......... D~a. te~ ..........~. Purpose,: Comment: Date: Time Utilized Purpose: Comlent: Date: Purpose: Time Utilized Comment: Invoice Date: Inspector Time Utilized Total Time: Date: CUSTOMER NAME ADDRESS STATION ID A & A TANK TESTING .. 5630 OISTRICTiBLUO. GTE 103 BAKERSFIELD~ CA 93313 (805) 397-6555 HOBIL OIL CORPORATION DATE O9~Nov-87 2628 OSWELL, BAK~SFIELO, 'CA TAN)( SIZE ' 500 PETRO'TITE TE~T RESULTS ~ II-G ~.b PROBUCT WASTE OIL TEHPERATURE 78 'STAGE I 0 TAR DIAI~FER 48 .' CORE AP! GRAVITY. 30.5 S~AGE. II 0 TANK CAPACITY 570 TERPERATURE/VOLU~E FACTOR '*(a) TO TEST THIS TANK SERGOR READINg: digits 11821 degrees F · 58159 OIGITS PER DEGREE 318 · .......... TANK.QUANTITY .......... '-: 5?OX--COEFFICIENT ...... O.O0043BES.,EQUALS._VOLUHE CHANGE.,_: .......... 0.249802 ..........,:- ....... i ......... ~.= ............................ . VOLUHE C~ANGE O.e4~Ge2S DIVI~E~ BY DIGIT 318 EQUALS a FACTOR O.O007B~4 a FACTOR FOR THIS ~ST 0.0008 HYDROSTATIC V~U~ TEHPE~ATURE NET ACCUH. 11821 CO&qENSATIDN VOLUIIE FACTOR CHANGE D. IAN6E COI~P: TERP' AD3 CI~NGE BASE READING PiCtURE ~URE~NT BEGIN RESTORED I)EFORE AFTER CXANGE START H/L 8. BASE READING 12 480 5gl 0.115 11908 87 0.070 0.0~5 595 695 0.I00 11937 29 0.022 '0.077 895 815 ~.120 -12088 151 0.!21 -0.001 '815 985 0.I10 1225~ 16~ 0.131 -0.02! START L/C I. 15.0 12 2. 14.2 12 3. !4.4 ~. 14.3 5. 14.4 12 · 80 190 0.130 1~399 I~7 0.118 0.01~ 190 '300 0.I10 12511 112 0.090 0.020 0;080 ~0 4E0 0.120 12868 157 0.I~8 -0.006 0~014 420 535 0,115 12B13 145 0.118 -0.001 0.013 ~535 655 0.I~0 12964 151 0.12! -0.001 O.OIE T-~ SEE ! 1351 TECHNICIAN · C~TIFICATION ! 41~I14~-~ .. , TEST RESULTS O,Ol~ ...... BASED ON THE NFPA CODE 329,02 CRITERIA, WE FIND .................... THIS ~STEH'~O-~E ~TI6~T~'-: ...................................... . A ~ A TANK TEST[NB .. 5630 DISTRICT BLVO, STE 103 BAKERSFIELD, CA 93313 (B05) 397%555 PETRO-TITE TEST RESULTS CUSTOHER NAME flOBIL OIL CORPORATION DATE 15?Nov-B? ADDRESS OSWELL & t?Bf BAKERSFIELD, CA TANK SIZE 6,000 STATION ID ..... - /J-~Z~.Z:> PRODUCT SUPER UNLEADED ...:..:: ..... API-BRAVITY .......... 4..5~.~ ..... :=-?::VAPOR RECOVERY. TYPE TEflPERATURE CORA API gRAVITY 55,3 STAGE II 0 TANK CAPACITY SENSOR READIN6: digits 1~4~. degrm F 66/67 DIBITB PER DE6RE1E ~6 · __TANK,.QUANTITY? .............. ~.JS~..LCOEFFiCIENT ....... 0,000580~3. ~gUALS V)]L~ECHAN6E ............ 3.637~1 ................... . .... VOLUHE CH~BE 3.637~618 DIVIDED ~ DI6IT ~6 EQUALB a FACTOR O,OllI~ m FACTOR FOR 11~IS ~ST 0.0~I~ HYDROSTATIC VOLUflE TE]IPERATURE NET ACI:~. BASE READIN6 START N/L 1, 3, 5, '6. ?, '8. 9~ 10, 1I, BASE READING PRESSURE IIEASUR~ENT COIlPENSATION VOL~E CONTROL .~- ' ' m FACTOR CHANGE 9E6IN RESTDREI) BEFORE AFTER CHANGE READING CflAN6E COItP. TE]qP AD;) 1464~ ~3,8 4~ liO aSO 0,ii0 14650 8 0,090 O,OaO 41,0 ~E ~50 370 O,laO I~664 IQ 0,1~ -0,0~7 4~,½ ~ itO ~80 ' 0,160. i~67a B 0.090 0.070 ~3,0 ~ ~BO 350 0,070 11678 6 0,067 0';003 ½3.i ~a 350 ~30 O,OBO 14686 . 8 0,090 -O,OiO ~3,1 4~ ~30 510 0,080 1~696 LO 0,I1~ -0,03~ . 43.~ ~ 510 600 0.090 14704 8 0.090 0.000 43.~ ~ 600 690 0.090 1~71~ 8 O.OqO 0.000 START L/L 1, 14,0 ~, 13,5 3, 13,0. 4, - le,B S. 1~,8 3eO 450 0,130 14730 6 0,067 0,063 ~10 3EO 0,I10 14738 8 0,090 O,OeO - 3~ 400 0,080 I~7~4 6 0,067 0,013 ~00 470. 0.070 14750 6 0.067' 0.003 470 530 0.060' l~756 6 0.067 -0.007 O.OEO 0.033 0.036 0.0~9 T-S SER I BASF. J) ON THE NFPA CODE 3~9.0~ CRITERIA,_WE ~TND TO BE 'TIGHT.' TEST RESULTS O.OE9 CERTIFICATION I 414811634 / A & A TANK TESTING ~30 DISTRICT BLVD, GTE 103 BAKERGFIELO, CA 93313 (805) 397-6555 PETRO-TITE TEST RESULTS' CUSTONER NAHE NOBIL OIL CORPORATION DATE 15-Nov-S7 ADDRESS. OSWELL & 178, BAKERSFIELD, CA TANK SIZE 10,000 STATION ID /f h'4-6BD PRODUCT UNLEADED API GRAVITY 57 VAPOR RECOVERY TYPE YEHPE'~TURE .............. =67 ...........' ........ STASE I' 0 TANK DIAMETER CORA AP! GRAVITY 56.! STAGE II .0 TAR CAPACITY 9946 TEHPERATURE/'~LUHE FACTOR (aD TO TEST THIS TANK SENSOR READ!NB: digits 147BE degrees F 67/68 OIBI~ PER DEBREE 3Eh TANK QUANTITY VOLUME CHANGE · ?946 X COEFFICIENT 0.00058591 EQUALS VOLU~ CHANGE 5.8E7~60 5.BET~60B DIVIDE]) BY DIGIT 3~6 EQUALS a FACTOR O.O1787~&~ m FACTOR F~R THIS TEST 0,0179 . HYI)ROSTATIC VOLUIlE TEMPERATURE ~ A~UH, PRES~RE ~ASURENENT L'OIlP~ATII]g VI)I.~ C~NGE CONllU)L a F~TOR ' CI~MBE : BEGIN RESTI]REI) BEFORE AFTER CHANGE READING ~IANGE .CI]~. TE]~ BASE READING START H/L I. 44.4 3. 44.~ 4. 43.9 5. 43.9 6. 44.1 7. ½4.0 B, 44,0 9. BASE READING 510 650 630 770 ~0 330 330 4EO 540 540 640 750 0.140 14788 6 0. I07 0.033 0.140 14796 B 0.143 -0.003 0.130 lqBO0 4 0.073 O.O~B 0.090 ' I~BOB B 0.!43 -0.053 0.090 1481~ 4 0.07~ O.OIS 0,I~0 14~lB 6 0.107 0,013 0.100 148~4 & 0.I07 -0.007 O.IlO 14QEB 4 O.OT~ 0.038 1~B36 START L/L 1. 14.~ IE ~70 4t0 0.1~0 1~B4~ 8 0.143 -0.003 ~. 13.8 IZ ~10 5EO 0.110 1~850 6 0,I07 0.003. 0.003 ,. 3. I4,3 IE IEO 870 0,150 14858 B 0.143 0.007 0.010 ½, 13,8 IE 870 380 0,110 l~S&~ & 0,107 0.003 0,013 S, 13.8 IE 380 ~90 0,110. I~870 & 0.107 0,003 0,016 T-5 SEN ! BASED ON THE NFPA COOE 3Eg.0E CRITERIA, liE FIND SYSTEH' _ _ r~RTXFI~TION ! ~1401I&a* TEST RESULTS 0.018 TO 'BE~ 'TIGHT/ .................................................. ' A & A TANK TESTING ,. 5630 DISTRICT 8LVD, GTE BAKERSFIELD, CA 93313 (805) 397-6555 PETRO-TITE TEST RESULTS CUSTOHER NAME HOBIL OIL CORPORATION DATE tS-Nov-B? ADORESS OSWELL & l?B, BAKERSFIELD, CA TANK S.IZE S,O00 STATION ID / ! liS-6BD PRODUCT REGULAR ........ ?.:...:.::-':APLGRAVITY* .............. .-.. . 56.5, ............. :VAPOR RECOVERY~YPE TEHPERATURE 66 STAGE I ....... O' TANK DIAMETER 95 CORR API GRAVITY 56.8 STAGE II 0 TANK CAPACITY 81~6 TEMPERATURE/VOLUME FACTOR (a) TO TEST THIS TANK SENSOR READING: diBi~ 138B& dmirm F 6~/65 DIGITS PER DEGREE 3eS ........ :____T_~K__DI~)NT~ ......... el¢~..X.,COEF~,ICIENT ___O.OOOS!08S ~;UA~_yO~E CHANGE .................. ~,813308 .............. ~ ....................................... . .. VOLUHE CHANGE ¢.813308~ DIVIDED 8Y DIGIT 3E5 EQUALS a FACT~ O.OI~BIOl? a FACTOR FOR THIS TE~T 0.01~ ~ IffDROSTATIC VOLUIIE '; TT~ERATURE ILrf ACCUH. PRESSURE NEASUREHENI: COHPENSATI~ VgLU~IE CHANGE CONTROL ' ':'::-. .... a ~ACTOR aliglGE ~GIN RESTORED BEFORE AFrER .~CHAIIGE REJtDIN6 CHANGE CO~. TE]~ AD3 BASE READING ~e 13806 START H/L I. 3. 5. 6. 9. 8. 9. I0, 11; 13. BASE READING START L/L 1. 3. 5. ~3,9 Ce ~80 ' 590 ¢3.9 ~ 590 710 ~3.9 ~ I~0 230 ~3.! ~ ~30 300 ¢3,1 4e 300 370 ¢3.5 ~ 3'70 ~70 0,II0 0.1~0 0,110 0,070 0,070 0,100 0,0~0 0,080 139~8 1389~ 8 0,118 -0,00B 1390E S O,11B O,OOE I391E 10 0,1¢8 -0,038 139i6 ~ 0,059 O,Oii 139~0 ~ 0,059 0.011 i3930 iO 0,148 -0.0~8 i393~ 4 0,059 0,031 139~ 8 O,llB -0,038 I~,3 1~ 90 eeo . 0,150 1395~ 6 0.089 0,061 13,~ 1~ E~O 3~0 · ~0,080 13960 6 0,089 -0,009 -0,009 13,~ I~ 3~0 ~iO 0,090 i3966 6 0,089 O,OOi -0,008 1~.8 1~ ~10 ~70 ~ 0.0~ 13970 ~ 0,059 - 0,001 -0,007 1~.~ I~ ½70 530 0.060 1397~ ~ 0,059'O.O01 -0.006 T-S SERt TEST RESULTS -0.006 . ~ BABED ON THE NFPA CODE 3EB.0E CRITERIA, WE FIND CERTIFICATION ! ~I~81163~ 2700 M Street Bakersfield, California Mailing Address: - 1415 Truxtun Avenue Bakersfield, California 9330 (805) 861-3636 ENVIRONMENTAL HEALTH DIVISION · PERMIT TO CONSTRUCT UNDERGROUND HEALTH OFFICER Leon M Heb~teon, M.D. DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Relehard PERMIT NUMBER 090007B STORAGE FACILITY FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR:. ~ -Mobil Oil SS #11-GBD Mobil Oil CorP R&S Piping 2688 Oswell St. 3800 W. Alameda Ave 1946 E. Occidental Bakersfield CA Los Angeles CA Bakersfield, PIPE TO ~ct~'ISLAND ONLY PERMIT EXPIRES APPROVAL DATE APPROVED BY License #40833? January 24r 1989 October 24, 1988 X NEW BUSINESS CHANGE OWNERSHIP RENEWAL MODIFICATION OTHER ....... ............ · ' .POSTONPREMISES ........................... CONDITIONS' AS FOLLOW: Standard Instructions 1. This permit applies only to the instal, lation of piping to the east dispenser island. 2. Ail construction to be as per facility plans approved by this' department and verified by inspection by Permitting Authority. -- 3. All equipment and materials in this Construction must be installed in. accordance with all manufacturers' specifications. 4. Permittee must contact Permitting Authority for on-site inspection(s) ' with 24 hour advance notice. 5. Backfill material for piping and tanks to be as .per manufacturers' specifications. 6. Float vent valves are required on vent/vapor lines of underground tanks to.prevent over~illings. 7. Construction inspection record card is included With permit given to · Permittee. This card must be posted at 3obsite. prior to initial .inspection. , Permittee must contact Permitting Authority and arrange ........................... ~or ea~ ~r~'~-reqdired--inspections numbered~as--per-instructions--on card. Generally, inspections will be made of: a. Piping system with secondary containment leak interception/raceway DISTRtCT OFFICES Special ~Instructions Permit Number 090007B 8. Ali underground metal connections (e.g. piping, fitting, fill pipes): to tank(s) must be electrically isolated, and wrapped to a minimum 20 mil thickness with corrosion-preventive, gasoline-resistant tape or otherwise protected from corrosion. 9. ~o. ~product shal1 be stored in tank(s) Until a~r0~l Permitting Authority. . .................................................... 10. Contractor must be certified by tank manufacturer for installation of fiberglass tank(s), or tank manufacturer,s representative must be' present at site during installation .... 1'1. Liner shall be installed by a trained experience liner contractor and' installation at site approved by the Permitting Authority. 12. Monitoring requirements for this facility will be described on final' "Permit to Operate." ACCEPTED BY: DATE: BS/dr 2700 M Street Bakersfield, California Mailing'Address: 1415 Truxtun Avenue Bakersfield, California 93301 (805) 861-3636 ,ERN COUNTY HEALTH D EPARTM~ ( ENVIRONMENTAL HEALTH DIVISION PERMIT TO CONSTRUCT UNDERGROUND STORAGE FACILITy ,! .................. FACILITY NAME~ADDRESS: .......... ;..:;~ ......... OWNER(S-)-NAME/ADDRESS: I". Mo6il Oil SS #11-GBD Mobil Oil Cord 2688 0swell St. 3800 W. Alameda Ave Bakersfield, CA Los Angeles, CA HEALTH OFFICER Leon M Hebanson, M.D. DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Relchard _) PERMIT NUMBER 090007B coNTRACTO R&S Piping ..::~. ".,.-,~i.. 1946 E. Occidental Bakersfield~, /~. CA License #408337 PIPE TO '~Ct~'IS'LAND ONLY X NEW BUSINESS CHANGE OWNERSHIP RENEWAL MODIFICATION OTHER PERMIT EXPIRES APPROVAL DATE APPROVED BY January 24, 1989 · October 24, 1988 ................................ POSTONPREMISES CONDITIONS AS FOLLOW: Standard Instructions 1 This permit applies only to the installation of piping to the east dispenser island. 2 All construction to be as Per facility plans" approved by this department.and verified by inspection by Permitting Authority.. 3. All equipment and materials in this construction must be installed in accordance with all manufacturers' specifications. 4 Permittee must contact Permitting Authority for on-site inspection(s) with 24 hour advance notice. 5 Backfill material for piping· and tanks to be as per manufacturers' specifications.. · 6 Float vent valves are required on vent/vapor lines of underground tanks to prevent overfillings. 7. Construction inspection record card is included with permit given to Permittee. This card must be posted at '3obsite prior~ to initial ............................ inspection~ .... Permittee~must.con~act~:Permi~ting~Authority. and..arrang~. for each group-of required inspections numbered as per instructions on card.. Generally,. inspections will be made of: a. Piping system with secondary containment leak interception/raceway DISTRICT OFFICES Special Instructions Permit Number .090007B 8.~ Ail underground metal connections (e.g. piping, fitting, fill pipes) to:. tank(s) must be electrically isolated, and wrapped to a minimum 20 ',mil thickness with corrosion-preventive, gasoline-resistant tape 'or ~therwise protected from corrosion. · 9. ~.:~No produdt shall be stored in. tank(s) until approval is granted by the 10. Contractor must be certified by tank manufacturer for installation, of "'-' · fiberglass tank(s), or tank manufacturer's representative must be ' present at site during installation . .:- 11. Liner shall be installed by a trained experience liner contractor and installation at site approved by the Permitting Authority. 12. Monitoring requirements for this facility will be described on final "Permit to Operate." ACCEPTED BY: DATE: BS/dr Mobil Oil' Corporation 3800 WEST ALAMEDA AVENUE, SUITE 700 BURBANK, CALIFORNIA 915054331 October 20, 1988 Janis Lehman Kern County Health Department 1415 Truxton Avenue Bakersfield~, CA 93301 Dear Janis, Mobil Oll Corporation 2688 Oswell & Hwy 178 Bakersfield,. CA This letter is to inform you that Mobil has contracted wi~h Petroleum Waste, Inc. to haul and dispose of any contaminated soil excavated at the subjeqt location. Their address and phone number is: Petroleum Waste, Inc. 7004 Gas Company Road Rt 1 Box'25 Taft; CA 93268 (805) 589-4912 If you have any questions please do not hesitate to call me' at (818) 953-2612. ' Project Engineer 0CT-20-1988 12:44 BURBANk; Ti3 FROh~ , ~'1#i1S"1'111 I~ · ,, 91S~5324~'715 F.Oi Mobil 011' COrporation ' ~..,_:Janis Lehman Kern :'~oun~y Health Department · ':~141'5 f~ruxton Avenue B, UI~ANK, GALIPORNIA October 20 1.988 .~' , .L'>; i~f:' ~. ~ .!.,-This let%er is to ::';~,,. ' 'i--i'. Petroleum Waste, inform you thet"'Mobil has contracted w~th Inc ~o haul and dispose of any contaminated soil .... e×cavat'ed at the subjec~ location. Their address and phone number is: Petroleum Waste. In¢. 7004 Gas Company Road ~ 1 Box 25 Taft, CA 9326~ (805) ~$9-4912 If you have any questions please do not hesitate to call me at ,,, (818) 95,3-2612. ,. D. M. Noe Project Engineer TOTAL P. 02 Mobil Oil COrporation 3800 WEST ALAMEDA AVENUE, SUITE 700 BURBANK CALIFORNIA 91505-4331 October 14, 1988 *Janis Lehman ?~Kern County Health Department *~ I415 Truxton Avenue Mobil Otl Corporation SS~ ll-GBD 2688 Oswell & Hwy 178 Bakersfield, CA Dear Janis, Persuant to' our (Mike Henare, you, Mark Bosua, and myself) conversation on October 13, 1988, enclosed is Mobil's work plan at subject station. Our plan is to dig out of the contamination we have near the island and stockpile it onsite. Excavation will commence at the location where a hot spot was encountered by the mobile lab onsite. Excavation will continue both laterally and.vertically until the mobile lab samples are non-contaminated. A mobile lab will be onsite during excavation operations. Excavation will start on October 20, 1988 and will continue until all contamination is removed. All necessary precautious will be taken to restrict the amount of vapors eminating from the excavation operations and spoils piles will be covered with black visqueen. If you have any questions, please do not hesitate to call me at (818) 953~2612 or Mike Henare at (818) 953-2607. SincerelY, D. M. Noe, P.E. Project Engineer KERN COUNTY HEALTH DEPARTME~ ENVIRONMENTAL HEALTH DIVIS~ HAZARDOUS SUBSTANCES SECTION INSPECTION RECOR]) POST CARD AT JOBSITE 1700 FLOWER STREET BAKERSFIELD, CA 93305 PHONE (805) 861-3.636 ~NER ADDRESS FACILITY ~d,'~qfh~l'~3 ~ob;I PEBMIT # ADDRESS ~3CQ~ il CITY ICITY PHONE NO. :PHONE NO. INSTRUCTIONS: Please call for an inspector only when each group of inspections with the 'same number ar.e ready. They will run in consecutive order beginning with number 1. DO NOT cover work for any numbered group until all items in that group are signed off by the Permitting AUthority. 'Following these instructions will reduce the number of required inspection visits and therefo're prevent assessment of additional fees. · ~ · .~;~.~i.li.' "' ..~;...., ;;:'... INSPECTION DATE I:/ IBackfill of Tank(s) I ISpark Test Certification , ICathodic Protection of Tank(s) I SPECTOR - PIPING SYSTEM ~Pipin~ & Raceway w/Collection Sump ~ ,~_~Corrosion Protection of Piping, Joints, Fill Pipe! ~c~_~Electrical Isolation of Pipin~ From Tank(s) , ,Cathodic Protection System-Pipin$ , I .- SECONDARY CONTAINMENT, OVERFILL PROTECTION.~ LEAK DETECTION - 3iner Installation - Tank(s) inet Installation Pipin~ ault With Product Compatible Sealer I I l~Level Gauges or Sensors~ Float Vent Valves ri_~Produet Compatible Fill Box(es) ~IProduct Line Leak Detector(s)' ,~_-]Leak Detector(s) for Annular Space-D.W. Tank(s) ~,~Monitorin~ Well(s)/Sump(s) I ILeak Detection'Device(s) For Vadose/Groundwater I I ,I IPVC Sleeve Pipin~ eak Detector(s) ! ! ,~_~j~Monitorin$ Wells, Caps & Locks (~?~Fill Box Lock ~',.I onitorin~ Requirements - FINAL.- I I I I CONTRACTOR LICENSE #' CONTACT PH # 900 Grand Central Avenue -' ' "'::."' 'ii':'i'i::!!~:!'i-'ii~' ' Glettdale, California '91201-3009 "~:" :'.-,?.::~?i,i~ii-i~ Sender: ' ~/// Subject: Name:' ,, ')~5, Telecopler No.: A total of ~-~ page~ will be trsnamltted (Including .this cover letter). If you do not 'receive all .pages or copy Is not legible, please call (818) 243-4140 aa soon as possible. we are transmitting from ~elecopler Number: (818) 246.4308. LC&A JOB NO.: · Message (if any): LeROY CRANDALL AND AssOCIATES geotechnical consultants 13 p.o, box 25088 D gOO grand c, er~*r~i ~ve. D glencl~lo, ca. 91201-~00~ · a s~s~diar~f Law Engineering facsimile (818) 246~308 telephone (8~8) 243-4140 ,. ~' Occober 14, 1988, we obsa~ed that under,round fuel tanks w~ " '" installed at Mobil semite station located aC, 2688 ,0swe~ Street. -*It ts .=~- - " ~ were obtained by the Kern County Health Department~ when the 'former :" - are currently investigating. In order'to expedi=e this matter, the fnforma~ion can be faxe~ .. =o our office tn Glendale. Our telecopier number is (805)2~6-&308 Your prompt attention to this matter ts mu~h appreciated. , L, ROY C~DALL ~D ASSOCIATgS " · 2700 M Stree~ Bakersfield, California Mailing Address: 1415 T~'uxtun Avenue Bakersfield, California 93301 (805) 881-3636 ERN COUNTY HEALTH DEPART T ENVIRONMENTAL HEALTH DIVISION PERMIT TO CONSTRUCT UNDERGROUND STORAGE FACILITY : HEALTH OFFICER Leon M Heber~son, M.D. DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Reich-,rd PERMIT NUMBER 09000?B ~FACILI.T~_.NAME/ADDRESS: ...... -=. ......... OWNER(~S},.-NAME/ADDRESS.: ...... CONTRACTOR~=.':.h.~ Mobil 0il SS #11-GBD Mobil 011Corp R&S Piping 2688 0swell St. 3800 W. Alameda Ave 1946 E. Occidental Bakersfield, CA Los Angeles, CA Bakersfield,.. CA' PIPE TO WEST ISLAND ONLY License #408337 X 'NEW BUSINESS I PERMIT EXPIRES 3anuar¥ 14, i988 CHANGE OWNERSHIP ~RENEWAL I APPROVAL DATE October 14, 1988 OTHER , , APPROVED · ' ~/- Sanis ................................ POSTONPREMISES ........................... CONDITIONS AS FOLLOW: Standard Instructions 4. 5. 6. 7. ~This permit applies only to'the installation of piping to the west dispenser island. All construction to be as per facility plans approved by this department and*verified by inspection ~y Permitting Authority. All equipment and materials in this construction must be installed in accordance with all manufacturers' specifications. *Permittee must contact Permitting Authority for on'site inspection(s) with 24 hour advance notice. ~Backfill material for piping and tanks to be as per manufacturers' specifications. Float vent valves are required on vent/vapor lines of underground tanks to prevent overfillings. Construction inspection record card is included with permit given to Permittee. This card must be posted at Jobsite prior to initial _,inspection .......... Permi~te~must.-contact~Permit-ting_Authority.and arrange--- ,:for each group of required inspections numbered as per instructions on icard. Generally, inspections will be made of: ia. Piping system with secondary containment leak interception/raceway DISTRICT OFFICES Standard Instructions Perm/t Number 090007B 8. All underground'metal connections (e.g.'piping, fitting, fill pipes) ..to tank(s) must be electrically isolated,' and wrapped to a minimum 20 ~ mil..thickness with corrosion-preventive, gasoline-resistant tape or ~ ~otherwise,~ protected from, corrosion .-"'9~ :No'p~oduct shall be stored in tank(s) until approval 'is granted bY the ~ P'~P~'i t~i~'-'~U ~h6~'~'¥'-[ .................... i .......................................................... 10. Contractor must be certified by tank manufacturer for installation of ~.fiberglass tank(s), or tank manufacturer's representative must be , ..present at site during installation. 11. .Liner shall be installed by a trained experience liner contractor and. installation at site approved bY the Permitting Authority. 12. Monitoring requirements for this facility will be described on final "Permit to Operate." ACCEPTED BY: DATE: 'JL/dr 1017-07 [,?IF:iL F~IL Bi_iRBANk. DATE ~...___/~..MS~a ..... Ben's'erie T~-IQbt'i ~, To~al FAX ~ENDER.. O,:-:T- :J,. 2- L ?',_~',~ L ,5; 4'7 F~S:OI'I SS~.3~524,1. ?.I. 5 -- ~ . , . . - . ,.:?_~-'~?::.:' [.'.'-... :~.?,~--., ~:.- II Ill ' __ .... Illll I . I I Il' Iii II ' ' { ......... _, = --/-~ ...... ~ ' . - i ~?"'~':'J: :':'?"":'":' ~a , ~ ' ~:)_ .... -- i~.~ FAX CENDE~.- : ' 03T-17-2-19:-]:3 i~:~]'~ FROH EIABIL OIL BURBANK TO Sample ID NOTE.' .... , ..... FAX SENDER~ ~~ Chemica/ Research Laboratories,/nc. ~~ (714)891q3405 · FAX' (7141893~709 · (800)LAB-1CRL Mobil 'Oil Corporation Burbank, CA 91505-4331 ANALYSES: ,TPH, 8020 ATTN: Mr. Mike Henare PROJECT: Mobil Station #11-GBD, Oswell & Hwy.' 178, Bakersfield EncloSed with this letter is the rep.o~_._t_...~_cn~..~the analyses performed on :'~.'~ " ~-~1' ~"*~B 102188.:::i-£~1"~;. ' .................... . ...' .... The samples were receiVed by CRL in a chilled state, intac~ and with the chain-of-custody record attac'hed. .~ ..... , Please note that ND means not detected and DL means detection limit. Stated below are the pertinent quality control data. Matrix: Soil %R· Matrix Matrix Date' Method Analyte spike spike dup. RPD= 10/21 TPH Gasoline 113. 126. pass 11. pass 10/21 8020 Benzene 102. "114. pass 11. pass Toluene 97. 99. pass 2. .pass Ethyl Benzene 102. 100. pass 2. pass Total Xylenes 98. 100. pass 2. pass 10/22 8020 Benzene 76. 78. pass 3. pass Toluene 76. 78. pass 3. pass Ethyl. Benzene 80. 81. pass 1. pass Total Xylenes 80. 80. pass 0. pass ~ %R = RPD percent recovery relative percent difference between MS and MSD recoveries. DATE This report pertains only to the samples inves{~gated and does not necessarily apply to oth..er apparently identical or similar materials. This report is submitted for the exclusive use of the client to whom it is addressed. Any reproduction of this report or use of this Laboratory's name for advertising or publicity purposes without authorization is prohibited. .~ Chemical Research Laboratories,/nc. ~~lll~ (714)891q3405 · FAX' (7141893-6709 · (800)LAB-1CRL LABORATORY REPORT TO: ~LYSISNO.: B102188-1/19 MobilOi!_~O~PO~tion ..... D~TE S~MPLEB: 10/21/88 ~':~800~"W'~ -'~'i~-m~d'a ~ve. ~ ~-~t ~ ~' '~0~ ' ~-~-~=~?~IN~TE REC"D-: ...... ~?' ~"~ i'O'~ ~88 Burbank, CA 91505-4331 B~TC~I= B192 ATTN: Mr. Mike Henare M~TRIX: Soil Mobil Station #11-GBD, Oswell & Hwy. 178, Bakersfield Test: Total Limits: mg/kg Petroleum Hydrocarbons (8015m) ~a~ple td~ti ~icatiom PTA1-5' PTA2-3' PTA3-3' PTA4-4' PTA5-3' PTA6-4' ~PTA7-6' PTA8-5' PTA~ PTA~O-2~ Detection Limit 1. 1. 1. 1. 1. 1. 1. 1'. 1. 1. ReSUlts ND ND ND ND ND ND 220. ND 270. ND This report pertains only to the samples ~nvest~gated and does not necessarily apply to ether apparently'identical or similar materials. This report is submitted for the exclusive use of the client to whom it is addressed. Any reproduction of this report or use of this Laboratory's name for advertising or publicity purposes without authorization is prohibited. Chemicaf Research Laborafories, /nc. (714)891-0405 · FAX: (7141893-6709 · (800)LAB-ICRL LABORATORY REPORT .Oil -. Co~porati o.n "-3800 Wi" Alameda Ave., Ste. 700 Burbank, CA 915~5-4331 ATTN: Mr. Mike Henare Mobil Station #11-GBD, Oswell & Hwy. AI~ALYSIS NO.: B102188-1/19 B~TE~: 10/21/88 I~TEREC'D: 10/21/88 B~T~: B192 ~TRIX: Soil 178, Bakersfield ...... Ar.omat iC. ,..79.! ~a .t i,.~. e_ _0~.g a.?~'.-c'-,S..._.(_ Sw84_6. ~ =.8.02-0 ), ........... ' U~its: mg/kg Resul ts ~am~le Ethyl Ide~ti ficati~. Be~z~e Tol u~e Benzene Betecti~ Limit PTA1-5' 0.1 PTA2-3' 0.1 PTA3-3' 0.1 PTA4-4' 0.1 PTA5-3' 0.1 PTA6-4' 0.1 PTA8-5' 0.1 PTA10-3' 0.1 PTA 11-3 ' 0.1 PTA7-8' 0. i ND ND ND ND ND ND ND ND bid ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND · ND ND ND ND Total Xylenes ND* ND ND ND ND ND ND ND ND 0.2 This report pertains only to the samples investigated and does not necessarily, apply to other apparently identical or similar materials. This report is submitted for the exclusive use of the client to whom it is addressed. Any reproduction of this report or use of this Laboratory's name for advertising or publicity purposes without authorization is prohibited. ' ~search Laboratories,/nc. MOBILE DI VISION ~ 11631 Seaboard Circle · Stant0n, CA 90680 (714)891-0405 · FAX: (714/893.6709 · (800)LAB-1CRL LABORATORY REPORT TO: ~LYSISNO.: B102188-1/19 Mob.il Oil Co~goration -.~ ............................ D~TE.~d"IPLED:.. ............. 10/21/88 __ 3800 W. ~lameda Ave,';:~ste.:-~O ............ ~D&TE I~'B: 10/21788 Burbank, CA 915~5-4331 ~~ B192 '. ATTN: Mr. Mike Henare ~IX: Soil ~T: Mobil Station*~11:-GBD, Oswell & Hwy. 178, Bakersfield ..T~_~t: Total Petroleum Hydrocarbons (8015m) I]~its: mg/kg ."... Sample Ide~ti ficati~ ,Bet ect i ~ PTA11-3' 1. Results ND PTA7-8' 1. ND PTA9-8' 1. 32. A,1-3' 1. ND A1-6' 1. ND PTA12-3' 1. I4. PTA13-3' 1. ND SP-2 SP-3 1. ND This report pertains only to the samples ~nvestlgated and does not necessarily apply to other apparently identical or similar materials. This report is submitted, for the exclusive use of the client to whom it is addressed. Any reproduction of this report or use of this Laboratory's name fo{ advertising or publicity purposes without authorization is prohibited. (~' TO: Chemica/ Research Laboratories,/nc. MOBILE D/VISION 1'i631 SeaboardCircte · Stanton, CA90680 (714} 891-0405 · FAX: (7141893-6709 · (800) ~B-lCRL LA~ORATORY REPORT ~¥SIS NO.: B102188-1/19 Mobil Oil Corporation I~TE ~: 10/21/88 ~3800 W:-~iameda~:Ave~-ste,-~-700' ......... "='I~TE REC'D: -~'I'0/21/88 Burbank, CA 91505'4331 i~]T~4: B192 ATTN: Mr. Mike Henare N~TRIX: Soil Mobil Station #11-GBD, Oswell & Hwy. 178, Bakersfield Test= Aromatic volatile Organics (SW846 - 8020) Units: mg/kg ~le Identification PTA9-8' A1-3, A1-6' PTA12-3, PTA13-3' SP-2 SP-3 Detection Limit 0.1 0.1 0.1 0.1 0.1 0.1 0.1 ' Results Ethyl Total Benzene Toluene Benzene Xylenes ND ND ND ND ND ND ND ND ND ND ND 1.5 ND ND ND ND ND ND ND ND ND ND ND ND This report pertains only to the samples investigated and does not necessarily apply to other apparently identical or similar materials. This report is submitted for the exclusive use of the client to whom it is addressed. Any reproduction of this report or use of this Laboratory's name for advertising or publici[y purposes withou! authorization is prohibited. CHEMICAL RESEARCH LABORATORIES, INC. I 11631 Seaboard Circle · Stanton. CA 90680 '~(714)891-0405 · FAX (714)893-6709 · (800)LAB-1CRL ADDRESS· PROJEC~ NA'M ~: SAMPLE 1 LOCATION NUMBER il DESCRIPTION DATE · TIME /r' · ORANGEC0UNTY · VENTURA · SANTA MARIA · BAKERSFIELD · L.A. COUNTY · MOBILE LAB PROJECT MANAGER PHONE NUMBER Received by: (Signature) .,i?:?':i:~i?i!i':{!?i~.~?,A~' CHAIN O~ CUSTODY RECORD ~" :','?:i:i.;;:i :;!:~:i:?i:i!'Date ~ Page,,,, , / of. .. ',~A' /, · ~/ RelinquishedI by: (Signature) Relinquished! by:'(Signat ure) .......... SAMPLERS: (Signature) SAtv SOLID ..... R~ceiv~i bY:'(Sign'atuie) ' WATER Relinquishedl by: (Signature) Di_spatched b~y:(Signature) Method of St ipment: Special Instr L~ctions: SOURCE: Ada ~ted from U.S. EPA, 1985 Nq. OF 'I TESTS CNTNRS !'i REQUIRED CRL will Store sample f~=r 30'daYs at no ~! Date/Time charge. Storage after 30 I days is charged at $10 per month per sample. Disposal of sam- I pie is charged at $10 per sample. Please indicate th'e disposi- tion of your Sample. i, . ' ~: Date/Time 1. Client retrieved : !!: ;" ' ',' :' by ;, 2. Lab Disposal ~,. i by Re, ceived by Mobile Laboratory for field analysis: 3. Store for "~ i: ';='' , days. by ;: Date/~7~e CHEMICAL RESEARCH LABORATORIES, INC. i 11631 Seaboard Circle · Stanton. CA 90680 714) 891-0405 · FAX: (714)893-6709 · (800)LAB=ICRL ADDRESS DATE PROJECT NA~E SAMPLE i LOCATION NUMBER DESCRIPTION /! TIME Received by: (Signature) ''ORANGE COUNTY =.~;::~;~r~ ' CHAIN O~ CUSTODY RECORD · VENTURA. · SANTAMARIA:i~ . · BAKERSFIELD,L.. · L.A. COUNTY '.?.i,.~ i.,,,. · MOBILE LAB '.'~"~%".' =.~ .' PROJECT MANAGER PHONE NUMBER Relinquished ~y: (Signature) Relinquished ~3y: (Signature) SAMPLERS: (Signature), SAM ,ge ~ of., WATER Received by: (Signature) . ,.~_~;,~ .~ :./. · . Rece!ved by Mobile Labora~,ory for field analy$18: ;.?- (Signature) .~-,-~ ~,~. TEsTs REQUIRED Relinquished;iby: (Signature) , Dispatched b,y:(S~gnature) !, ' Method_ of S~ipment: Special Instruct ons:. SOURCE: Adapted from U.S. EPA, '1985 CRL will store sample for 30 days at no charge. Storage after 30 days is charged at $10 p~r month per sample. Disposal of sam- ple is charged at $10 pe~' sample. Please indicate th~ dispos. tion of your Sample, ~,, ~- ' ' 1. Client retrieved~ ~,h'/.'.:. i!?';~?:, by . 2~ Lab DlsPq.Se!~i~?:~.~.: :~.!!_,~ ?.'; , by 3. Storefor ~' ~;~;' "~' ' '~ ' ....... ".::'~,~-, '.'. , · days.., by ' Date/Time l'Recelved for Laborato~ by: I Date/Time i. D~te/Time Date/lime . :~ .,~,~.,- ..... ..,,~ .... Time ,. I hereb~authorize the pe~ormance ofihe above indicated work. · DISTRIBUTION: White with report, YellOw io CRE, Pink to Courier, CCR-100 . HEMICAL RESEARCH LABORATORIES, INC. · ORANGE'COUNTY i VENTURA .... [ 11631SeaboardCrce · Stanton, CA90680 · :: · SANTA MARIA:''~':' '~'.. ~ (714) 891-0405 · FAX: (714)893-6709 · (800)LAB-1CRL : · BAKERSFIELD, C;~'<~[;~:;~;~ ........ ~ / ./ ~ ./ . MOBILE LAB ~ IN'OF CUSTODY RECORD ?'F?:ic ,.. ' i:ii .... '.. ,, . ;~;!~'~t e ' ;--:"/o ~,,~: ~ Page ~,"~.- b., . ' / '/ ',~ ADDRESS PROJECT NA'ME SAMPLE ',i LOCATION NUMBER i. DESCRIPTION ¢ DATE TIME /¢ Relinquished by: (Signature) Received by: (Signature) PRO;JECT MANAGER :'~/:.:-'?' :' 'i · ",>;:~.:; PHONE NUMBER ...... · .,~::'.,;;,~,,~.~; ,~?i~u h,!~,'~-::.~-$ 4' '~. ~ ' ' ': ..... ' "'~ " SAMPLERS: (Signature) TYPE WATER Relinquished' by: (Signature) Received by: (Si~'nature) SOI~'ID ~:;i' ;; ' '%¼F, '?. , TESTS · I% .-.'.. %~ ,,-~i,,. ' "" CRL will 'sto;e Sample'i~t 30 days at ' , no chargo. Storage after 30 da~s ia charO~d at $10 Pot month pot sample. Disposal o[ sam- plo ia char~od at $10 ~or ~amplo. ~loaso indicato t~o ~is~osi- lion of your sample.. '~ 1.Client retrloved, ~:z, : by days. by ' · Date/Time I Dale/Time Relinquished' by: (Signature) .'Dispatched by:(Signature) 2. Lab Disposal ..t~ ~,,,: i ~ ..... Received by Mobile Laboratory. for field an~iy'sl~: . 3. Storefor (~ig n at, re~1,~~~. ::-. 4.'Other- Date/T?~e '' ', / I,~ / ~)ate/Time/ [ Method of sliip, ment: Special Instructions: SOURCE: Adapted from' U.S. EPA, 1985 DISTRIBUTION: White witl~ report, ¥~11'~ to CRL, Pit: I:h~-e'b'y ai~th~ize the performance ofiih'e above indicated work· :: COUNTY' OF ,, 2700 "~' Street;Suite 300 Bakersfield, CA 9330t (80~ 86t.3636 (805) 861-3429 F~ix Number Environmental Health Services. Department --, April 28, 1989 Mobil Oil Corporation 3800 W. Alameda # ?00 Burbank, CA 91505 Attention: Rita Miller Dear Ms. Miller: It has come to the attention of the Kern County.Environmental .Health Department that the annual fee for the 1988-89 fiscal year has not been paid for the following stations: Permit Number Station Number Fee 090007 14-207 $160.00 190004 14-206 $160.00 370009 14-158 $160.00 450011 14-156 $140.00 The anniversary dates for the facilities in question are all May 15. The annual fees are due on May 15, 1989. If we have not received applications for new ownership by that date, 'Mobil 0il Corporation will be responsible for payment of the fees and any late penalties that may apply. Enclosed, please find the invoices in question and an application for new ownership (copies may be'made). _ Thank you for your cooperation on this matter. If you should have any questions, I can be reached at (805) 861-3636. Sincerely, Laurel Funk Environmental Health Specialist Hazardous Materials Management Program LF: cd cc: R.J. Edwards : ( funk\mobil, let) !, ' 4-28-02 .. TRANSMITTAL SLIP To [] ~ For your information [] For you r comments [] Please handle [] For signatu re Date [] Please take up with me [] Return with recommendations For your apprOval [] For your file · [] Please follow-uP []. Please return to file ~ Per your requ~ Q Per our'conver~tion " [] PLEASE RETURN / 'M. HENARE ~'~~1~ (714) 891-0405 · FAX: (714) 893-6709 · (800) LAB-1CRL Mobil Oil Corpor'ation 3800 W. Alameda Ave., Ste. 700 BATCH: ~B192 Burbank, CA 91505-4331 ANALYSES: TPH, 8020 ATTN: Mr. Mike Henare PROJECT': Mobil Station #11-GBD, Oswell & Hwy. 178, Bakersfield Enclosed With this letter is the report on the analyses performed on sampl es ' B102188-1,19. Th'e samples were received by CRL in a chilled state,, intact and with the 'chain-of-custody record attached. Please note that ND means not detected and DL means detection limit~ Stated below are the pertinent quality control data. Matrix: Soil Matrix Matrix ~ Date Method Analyte spike spike dup. RPD= 10/21 TPH Gasoline 113. 126" .pass 11o pass '10/21 8020 10/22 8020 Benzene 102. 114. 'pass 11. Toluene 97. 99. pass 2. EthYl Benzene 102. 100. pass 2. Total Xylenes 98. 100. pass 2. pass pass. pass pass Benzene' 76. 78. pass 3. pass Toluene 76. 78. pass 3.. pass Ethyl Benzene .80. 81. pass 1. pass · Total Xylenes 80. 80. pass 0. pass ~ %R - percent recovery . = RPD - relative percent difference between MS and MSD recoveries. REVIEWED ANlg. AI~PROVF, I~' OATE This report pertains only to the samples ~nves~gatecl ancl does not necessarily apply to other apparently ~dentical or similar materials. This report ~s sunmittecl for the exclusive use of the c~ient to whom ~t ~s aOclresseO, Any reproduction of this report or use of this Lal3orator¥'s name for advertising or publicity purposes w~thout authorization is prohibitecl. Chemica/ Research Laboratories,/nc. 631 Seaboarcl Circle · Star, ton. CA 90680 . /7141891-0405 · ~AX' {7141893-6709'e 1800)LAB-1CRL REPORT Mobil Oil Corporation 3800 W. Alameda ,Ave., Ste. 708 Burbank:, CA 91505-4331 ATTN: Mr. Mike Henare PROJECT: Mobil Station ~ll-GBD, :2688 Oswell ANALYSIS NO.: DATE SAMPLED: DATE REC'D: BATCH: MATRIX: B101188-1/'~'8-- .... ?'~:'-'= 10/11/88 10/11/88 B186 ~Soil & Hwy. 178, Bakersfield Test = L~its: Total Petroleum Hydrocarbons (8015m) mg / I<g Sample Ide~ti fication SP-1 T1A-2' T1B-2' T2A-2' T2B-2' T3A-2" T3B'2' PTA-2' 'PTB-2' PTA-6' Dete~tio~ Limit 1. 1. 1. 1. 1. 1. 1. 1. 1. 1. Result s 130. 4. 60. 9. 61. ND ND 1400. ND ND This report pertains only to the samotes ~nvesagatecl ancl does not necessardy alOply to otiner aooarently ident:cal or s~m~iar materfals. This reoort ~s suOmittecl for tne exclusave , ,.~ ~ ,kn ~,,a., ~ ,.~h~,~ ,tie ~,"tr~ee~ bn'.~ ranrn~l~chnn nf Thiq r~nort or n~ nf th ~ LaboratorY's name for adverhsino or ouOticitv ourooses wltllout authorization ~s orolllbitecl. Cl)emica/ Research Laboratories,/nc. MOBILEDIVISION ',1631 Seaboar~ Circle · Stanton. CA 90680 f7',4)891.--0405 · FAX: (7!41893-6709 · ~800)LAS-1CRL LABORATORY REPORT TO: ANAL¥S I S NO.: Mobil 0il Corporation' DA]]~ SAMPLED: 3800 W. Alameda Ave., Ste. 700 DA]]~ R£C'D: Bur b an ~.-i .; C:A 91505-4331 BATC~: ATTN: Mr. Mike Henare PE~]JECT: B101188-1/18 10/11/88 10/11/88 B186 Soil .... Mc~b-i-1-..- St.a~i. on _~. 1.1_.-JBBD.,_.2688 ~_ Oswe 11 .-.&....Hwy~.;_t-7.-8,...:.B a k er..s f.i:¢ !d Test: Ar omar i ,- Units: rog/kg Volatile Organics (SW846 - 8020) S~I e Identification sP-t Tl~-2' T1B-2' T2A-2' T2B-2' T3A-2' T3B-2' PTA-2' PTB-2' - PTA-6 ' Der eC t i on Li mi t Benz erie 0.1 0.3 0.1 ND 0.1 ND 0. 1 ND 0. i ND 0. 1 ND. 0.1 ND 0.1 7.8 0. I ND 0.1 ND Result s Ethyl Total Toluene. Benzene Xylenes 1.9 0.9 21.9 ND ND 0.2 ND ND 1.1 ND 0.1 0.8 ND 0.2 ND ND ND ND' ND ND' ND 6.7 36. 119. ND .ND ND ND 0.1. . 0.7 L Chemical Research Laboratories,/nc. MOBILE DIVISION ',1631Seat:~araCircle · Stanton. CAg0680 (714i891-04Q5 · flAX: 7~41893-6709 · iS00)LAS-ICRL Mobil Oil Corporation 3800' W. Alameda Ave., Ste. 700 Burbank:, C:A 91505-4331 ATTN: Mr. Mike Henare PROJECT: 'Mobil Station ~11-GBD, 2688 Oswell LABORATORY~ REPORT DATE SAMPLED: DATE REC' D: BATCH: MATR I X: B10~188={718 10/11/88 .10/1'1/88 B186 Soill & Hwy 178, Bakersfield Test: To t a 1 units: mg/l.::g Recoverable Petrol eum Hydrocarbons (EPA418.1). Samp 1 e Identification Der ect i on Limit W01-2' 1. Results 7. This reDort.perta~ns only to [ne samo~es ~nves[~gateO ancl cloes not necessanly aDDty ~o ortner al3Darently identical or s~mdar materials. This rel3ort ~s suOm~ttecl for I:he exclusive use of f~e chon! TO whom ~! ~S aaclressea. Any reproabct~on of this report or use ot th~s Lal3oratory's name for aOvemsing or puDlictty purposes w~tnou[ autnonzation ~s pronibitecl. TRANSMITTAL SLIP I-t For YoU? information I-1' For you r comments [] Please handle Date [] Please take up with m'e [] Return with recommendations [] For your approval [] For signature [] For your .file =Please fol Iow-up ==--~-, ................ Q-'-=-=Please'retu re:to-file Please check [] Investigate & advise Per your request [] Per our conversation PLEASE RETURN 'r M. HENARE Research Laboratories/ /nc. Chemical LABORATORY REPORT TO: AI~YSIS. NO.: Mobil Oil Corporation 3800 W. Alameda Ave., Ste~ 700 I~TE R~C'D: Burbank, CA 91505-4331 ATTN: Mr. Mike Henare ~TRIX: Mobil Station #11-GBD, oswell & Hwy. 178, Bakersfield B102188-i/19 10/21/88 10/21/88 B192 Soil Test: Total Petroleum Hydrocarbons (8015m) Units: mg/kg Sample Identi ficatiom PTA1-5' PTA2-3' PTA3-3, PTA4-4, PTA5~3' PTA6-4, PTA7-6' PTA8-5' PTAg-6' PTA10-3' limit 1. 1. 1. 1. 1. 1. 1. 1. 1. 1. Results ND ND ND ND ND .ND 220. ND 270. ND Th~s reoor~ per~a,ns only to the samlDles ~qves~ga[ed anc~ does not necessarily apply to other aDl~arently ~clent~cal or similar ma[enais. This reoort ~s suom~lted for the exc us ve Chemica/ Research Laboratories,/nc. 1631 Seaboara Circle · S:a~on. CA 90680 ~7~4)891-0405 · FAX: (714~8~)3-6709 · i800)LAB-tCRL LABORATORY REPORT "TO.' ' - Mobil Oil Corporation 3800 W. Alameda Ave., Ste. 700 Burbank, CA 91505-4331 ATTN: Mr. Mike Henare PROJECT: Mobil Station #11-GBD, Oswell & I~TE REC' B~TCH: M~TRIX: Hwy. 178, Bakersfield NO.:b. ....... B102188_1/I9.---~-. 10/21/88 10/21/88 B192 Soil Test: Aromatic Volatile Organics Units: rog/kg (SW846 - 8020) Identification PTA1-5' PTA2-3' PTA3-3' PTA4-4' PTA5-3' PTA6-4'. PTA8-5' PTA10-3' PTA11-3' PTA7-8' B~tection ' Limit 0.1 0.1 0.1 0.1' 0.1 0.1 0.1 0.1 0.1 0.1 ~13ze~le ND ND ND ND ND ND ND ND ND ND Results Toluene ND ND ND ND ND ND ND ND ND ND Ethyl Benzene ND ND ND ND ND ND .ND ND ND ND Total Xyl eries ND ND ND ND ND ND ND ND This report pertains only to me samples ~nvesl~gatecl am3 ctoes not necessarily apply to other apparently identical or stmdar materials. This report ~s suOmltte(] for the exc us ve ,,~ nf rh~ ~hc~nt tn wnr~rn ,r ,~ acJ~ressecJ. Any reorocluctlon of tn~s reoort or use of th~s Laboratory's name for aavemsinq or DuOlicity purposes w~thout authorlzatfon is pron~t31ted. :hemica/ Research Laboratories,/nc. MOBILE D/VISION ~ ~, 631 SeaOoarc Circle · S',ar~:c."t,. CA 90680 r''.":')891-0't05 · fAX: (714~893-67C;9 · ~800) LAB'ICRL LABORATORY REPORT ~I~YSIS NO.: B102188-1/19 Mobil 0il Corporation 3800 W. Alameda Ave., Ste. 700 Bur bank, CA 91505-4331 ATTN: Mr. Mike Henare RROJECT: Mobil Station #11-GBD, 0swel. 1 & Hwy. I~TE S~: 10/21/88' ~I~TE REC'D: 1'0/21/88 B~TCH: B192 ~TRIX: Soil 178, Bakersfield Tmt: Ar omat i c Limits: mg/kg Volatile Organics (SW846 - 8020) Results Samp! e Detect i ~ Ethyl · Identi ficatic~ Limit Benzene Toluene Benzene PTA9-8' 0.1 ND ND 0.1 A1-3' 0.1 ND ND ND Al-6' 0.1 ND ND ND PTA12-3' 0.1 ND ND ND PTA13-3' 0.1 ND ND ND SP-2 0.1 ND ND ND SP-3 0.1 ND 'ND ND Total .Xylenes 1.0 ND ND 1.5 ND ND ND This reoort detrains onlv to the samoles m~est~oated and does not necessarilv aoDlv to other apparently ~dent~cat or s~m~lar, matenals. This rel~o~ ~s suom~tteci for ~:he exclusive Ch'e~ical Research Laboratories,/nc. 11631 Seai~c~ard Circle · Sta.;0n. CA 90680 · ?141891-0405 · FAX' (7141893-6709 · (800)LAB-1CRL LABORATORY REPORT TO: Mobil 0il Corporation 3800 W. Alameda Ave., Ste. 700 Burbank, CA '91505-4331 ATTN: Mr. Mike Henare PRI]JF_CT: Mobil Station #11-GBD, 0swell & Hwy. ANALYSISNG.: B102188-l'ZIg' I~TE ,StM'~I. ED: 10/21/88 I~TE RE~*D: 10/21/88 B~TCH: B192 NATRIX: Soil 178, Bakersfield Test: Total U~its: mg/kg · Petroleum Hydrocarbons (8015m) Sam~le Identification PTA 11-3 ' PTA7-8' PTA9-8 ' A1-3' A1-6' PTA12-3' PTA13-3' SP-2 SP-3 Detection Limit 1. 1. 1. 1. 1. 1. 1. 1. Results ND ND .32. ND ND 4.' ND 1. This reporl Der~afns only Ko the samples ~nvesttgated and does not necessanty aol3ty to other alDI3arently identical or simdar mate. als. This reDort ~s suomftted for the exctus~w CHEMICALiiRESEARCH LABORATORIES, INC. ~ 16~I Seahomd Circle · Slanlon, CA90680 (7~4)891-0,1(;)5 · FAX (714)893.6709 · (800)I.AB-ICI1L ADDRESS · ORANGE COUNTY · VENTURA · · SANTA MARIA · BAKERSFIELD · L.A. COUNTY J· MOBILE LAB PROJECT MANAGER PHONE NUMBER Date CHAIN OF GUS I';'L)UY RECOH PROJ EC~' NAMe: ' SAMPLE .NUMBER :I, DATE TIME LOCATION DESCRIPTION I II Il Relinquished by: (Signature) It' lC Received 6y: (Signature) Relinquished by: (Signatgre) Received by: (Signature) SAMPLERS: (Signature) WATER SOLID NO. OF CNTNRS TESTS REQUIRED Jr z.o .. $0 CRL will StOle sample for 30 days al no charge. Storage after 30 days IS charged at $10 per month per sample. Disposal of sam- ple Is charged at $10 per sample. Please Indicate lhe disposi- tion of your sample. 1. Client retrieved by 2. Lab Disposal by DatelTIme I Date/Time .I Relinquished by: (Signature) Dispatched by:(Signalure) Method o! Shipment: Special Instructions: souRCE: Adapted frown U.S. EPA, 1985 Received by Mobile Laboralory for field analysis: 3. Store for Dale/Time /~~ 4. Other days. by by I hereby authorize the performance of the above OalelT)~Tm iii ' 6ateitlr/eel Jndicaled work. I CHEMICAL. RESEARCit LABORATORIES, INC. 11631!Sr~aboard Circle · SlaHIon, CA 90680 (714)8910405 · lAX (714)893.6709 · (800)I..AB*ICI-{I : ' ADDRESS PROJECT NAME S/~MPLE NUMBEIt ! ,,,~'/-H'/c' '-3 ii, LOCATION iDESCRIPTION DATE · TIME · ORANGE couH[Y · VENTURA · SANTA MARIA · BAKERSFIELD · L.A. COUNTY · MOBILE LAB CHAIN.OF CUSTODY RECORI. of~ PROJECT MANAGER PHONE NUMBER SAMPLERS: (Signature) Page,i ~ SAMPLE TYPE ..' WATER SOLID NC. OF TESTS CNTNRS REQUIRED ! 3~ Relinquished by: (Slgnalu?e) Relinquished by: (Signalu, ie) Received by: (Slgnalure) Received by: (Signalure) I/ CRL will store sample for 30 days at no charge. Slorage afler 30 days Is cha~ged al $10 per month per sample. Disposal of sam* pie is charged at $10 per sample. Please Indicale Ihe dlsposl- lion of your sample. 1. Client relrleved by 2. Lab Disposal by DatelTIme DatelTIme I · .R,elinqu~shed by: (Signalu. re) DisPatched by:(Signalufe), Received by Mobile Laboratory for field analysis: 3. Store Ior (Signature) j/~ /f 4. Other ~,"./'-'~¢'/ .-I'~'~'~'~¢~"-T-' DatelTIme ~ Received for Laboratory by: I days. by by Date/Time D/a~lTime/ I Melhod of Shipment: Special Instructions: SOURCE: Adapted from U,S, EPA, 1985 · ;~ "'** · ,' ";' I hereby authorize the performance of Ihe above ihdicaled work. :i CCR-1 CLIENT ADDRESs CHEMICAL RESEARCH LABORATORIES, IHC. · ORANGE COUNTY CHAIN OF CUSIlODY RECOR 11631 S,mhoard Circle · Slriulnn. CA 90680 · SANTA MARIA Date. Pag,, -~' of_~ (714)fl.91.o4{)5 ·. tAX (714)893-6/09 '· (SUO)I.AI3-ICRI. · BAKERSFIELD ;.. i * · L.A. COUNTY dl ;i. PROJECT NAME SAMPLE NUMBER ,~ LOCATION ' DESCRIPTION ,/..-- ',, Relinquished by: (Signature) PROJECT MANAGER PHONE NUMBER ,i SAMPLERS: (Signature) I DATE I TIM'E I Relinquished by: (Signatu, re) '- Rellnqmshed by: (Signature) Dispatched by:(Signatur~) Method of Shipment: Special Instructions: j! Received by: (Signature) Received by: (Signature) Received by Mobile Laboratory Ior field analysis: TYPE 1985 WATER SOLID Ne. OF TESTS CNTNRS REQUIRED t¢ ~t If h DaielTime Date/Time il hereby authorize lhe performance of lhe above indicated work. SOURCE: Adapted from U.S!iiEPA, '~-D~e;~-in;e I Received for Laboralory by: I by CRL will store sample for 30 days at no charge. Storage after 30 days is charged at $10 per month per sample. Disposal of sam- pie Is charged al $10 per sample, Please indicate the disposi- tion Of your sample. 1. Cltenl rehieved by 2. Lab Disposal by 3. Store tot .. days. by yr'll~w Ir, CIII CCR DatelT[n~e j / '~DatelTime / I CHEMICAL RESEARCH LABORATORIES, INC. i 11631 SEABOARD CIRCLE, STANTON, CA 90680 ' IEL. NOS.: (714) 898-6370 [ {2i! 3) 598-0458 CLIENT ADDRESS PROJECT NAME SAMPLE '~ LOCATION NUMBER . ;DESCRIPTION Relinquished by: (Signature) Relinquished by: (Signatu?e) .; · R~linqulshed by: (Signat~ire) "OTspatched by: (Signature) f Method of Shipment: Special Instructions: DATE TIME · ORANGE COUNTY · VENTURA. · SANTA MARIA e BAKERSFIELD · LA. COUNTY PROJECT MANAGER PHONE NUMBER SAMPLERS: (SIg'nature) SAMPLE TYPE · WATER SOLID NO. OF CNTNRS cHAIN OF CUSTODY RECORD- Page / of-.~--'--- TESTS ; REQUIRED -- . .SOURCE: Adapted f'rom /I Date/Time Received by: (Signature) Received by: (Signature) Received bY Mobile Laboratory for field analysis: Received for Laboratory by: . I( Date q'ime Date Date / Date rl'lme Frlme/ - CHEMICAL RESEARCH LABORATORIES, INC. 11631 SEABOARD CIRCLE, STANTON, CA 90680 TEL. NOS.: (? 14) 898-6370 (2 !3). 598-0458 CLIENT .-~' ADDRESS PROJECT NAME SAM PLE ii LOCATION NUMBER DESCRIPTION DATE TIME · ORANGE COUNTY · VENTURA · SANTA MARIA · BAKERSFIELD · · LA. COUNTY PROJECT MANAGER PHONE NUMBER SAMPLERS: (Signature) TYPE WATER SOLID CHAIN OF CUSTODY RECORD Date Page Z_. of.~' _ TESTS REQUIRED: NO. OF CNTNRS Relinquished by: (Signature) Relinquished by: {Signatui~e) il~sp" aca~ched byi (Signa~ure) - Method of Shipment: ~i Received by: (Signature) i Received.by: (Signature) i Received by Mobile Laboratory for field analysis: ...il Date/Time ..... J Received for'Laboratory by: Date Crime I' Date q'tme Time Time/ /! Date ' Da~ Special Instructions: SOURCE: Adapted from U,,IS. EPA, 1985 CHEMICAL RESEARCH LABORATORIES, INC. 11631 SEABOARD CIRCLE, STANTON, CA 90680 TEL. NOS.: (714) 898-6370 (~,!3) 598-0458 ADDRESS PROJECT NAME : SAMPLE i~.,.. LOCATION NUMBER ~ DATE DESCRIPTION ~ TIME · ORANGE COUNTY- · VENTURA · SANTA MARIA ·'BAKERSFIELD · L.A. COUNTY Date 'CHAIN OF CUSTODY RECORD PROJECT MANAGER PHONE NUMBER · SAMPLERS: (Signature) SAMPLE TYPE SOLID NO. OF CNTNRS TESTS ~' REQUIRED Relinquished by: (Signature) Received by: (Signature) Date · Re. linquished by: (Signature) '""~ispe, tChed by: {Signature) - ~TJme Relinquished by: (SignatUre) Received by: (Signature) Date 3'ime Received by M~)bile Laboratory for field analysis: Date/Time IReceived for. Laboratory by: Date Date Method of Shipment: Special Instructions: SOURCE: ,~,dal:)tect from U:S. EPA. 1985 F i. q'ime '~ Chemica/ Research.Laboratories, /nc. ~..-~i~ 1'714)89f-0405 · FAX: (714)893-6709 · (800)LAB-ICRL Mc, bil Oi 1 C,:,rpc, ration 3800 W..~!ameda..~ve..,_._S.t~e? -~0~,_. BATCH: ' B186 Bur ba~i:]',' .,::~ '~ 1~0~-~1 ..... '--' ........... ~C~s'~-~'~ .... ' ...... ~f~'~ ~l--~-]"-f-, "= ............ ~ .... ~ ATTN: Mr. Mike Henare 8~2~ PROJECT: Mc, bil'St'ation ~ll-GBD, 2688 Oswell · .~,. Hwy. 178, Bakersfield Enclosed with this letter is the report on the analyses performed c,n samples B101188-1/18. The samples were received by CR.L ~n a chilled state, intact and with the chain-of-cust,:,dy record attached. Please note that ND means not detected and DL means detection limit. Stated below Matrix: Soil are the pertinent quality control data. %R· , Matrix Matrix Date Method Anal yte spike spike dup. 10/11 TPH Gasoline 114. 129. pass 10/11 418 i Oil/grease 89. 108. pass 10/11 8020 Benzene 105. 103. pass Toluene 99. 90. p ass Ethyl Benzene 97. 95. pass Tot al Xyl enes 96. 94. pass 10/12 TPH Gasoline 126. 122. pass 10/12 4~8.1 Oil/grease 120. ~37. pass 10/12 8020 Benzene 67. 71. pass Toluene 67. 71. pass Ethyl Benzene 67. 71. pass Total' Xyl enes 67. 70. pass ~ %R - = RPD - percent recovery relative percent dif~ference between MS and MSD F.:F,D~" 12. pass pass 2. pass 9. pass 2. pass 2. pass 3. pass 13. pass 6. pass 6. pass 6. pass 4. pass over i es. This report pertains only to the samples *nvestlgated anO ~oes not necessarily apply to other apparently identical or s~m~lar materials. This report is submitted for,the exclusive use of the client to whom ~1: is addressed. Any reprocluct~on of th~s report or use of this Laboratop/'s name for advertising or publicity purposes without authorization is prohibited. 11631 Seaboard Circle · Stant0n, CA 90680 (714)891-0405 & FAX: (7141893-6709 · (800)LAB-1CRL Mobil 0il Corporation 3800 W. Alameda Ave., Ste. 700 Burbank, CA. '91505,4331 ATTN: M~. Mike Henare PR'OJ-ECT: Mobil.. Station #ll-GBD, 2688 0swell LABORATORY REPORT DAllE SAmPLe_D: 10/11/88 DATE REC'D: 10/11/88 BATCh: B186 MAll~IX: Soil & Hwy. -178, Bakersfield (8015m) Test: Total Petroleum Hydrocarbons ~its: mg/kg S~ple Detection Identification Limit TIA-6' 1. .T1B-6' 1. T2A-6' 1. T2B-6' 1. T3A-6' 1. T3B-6' 1. ReSults ND ND ND 3. ND ND '5 This report pertains only to the samples ~nvest~gatecl and does not necessarily apply to other apparently identical or similar materials, This report is submitted for the exclusive use of the client to whom ~t is addressed. Any reproduction of this report or use of this Laboratory's name for aclvertismg or ,publicity purposes w~thout authorization is prohibited. 631 sea~oar~ Circle · St.~nton. CA 90680 . -o~o5 · ,Ax: 17~4/893~7o~ · ¢001~B-~CRL LABOR~TORY REPORT .... TO: '~ .................... '", ....... ..... '- ' ................. ANA[iYSIS Mobil Oil CC, rporation 380~ W. Alameda Ave., Ste. 700 'Burbank, C:A 91505-4331 ATTN: Mr. Mike Henare ~CT: Mobil· Station ~.ll-GBD, 2688 0swell & NO','~ -' ';~:'?'~"~ B Ce ~ i 88- i-/t 8 DATE SAMPLED:, 10/11/88 D~TE REC'D: 10/11/88 B~TCH: B 186 M~TRIX: Sol 1 Hwy 1'78, Bakersfield ' Test: Ar omat i c U~its: mg/kg Result s Sample Betectio~ Ide~ti fication Limit Benzene Toluene T1A-6~ 0.1 ND ND T l'B-6' 0.1 ND ND 'T2A-6' 0.1 ND ND T2B-6' 0.1 ND ND T3A-6' 0.1 ND ND T3B-6 ' 0.1 ND ND EtNyl Total Benzene Xylenes ND ND ND ND ND ND ND ND ND ND ND ND This report pertains only to the samples investigated and does not necessarily apply to other apparently identical or simdar materials. This reoort is submitted for the exclusive use of the client to whom it is addressed. Any reproduction of this report or use of this Laboratory's name for advertising or publicity purposes w?out authorization is prohibited. ..~.~~ " Chemica/ Research Laboratories;/nc. LABORATORY REPORT Mobil 0il Corporation 3800 W. Alameda Ave., Ste. 700 Burbank~ CA 91505-4331 ATTN:' Mr. Mike Henare ?I~I]JECT: ~A4_YS I S NO.: DA]lE DA]lE RIEC' D: BATCI~: B101188-1/18 10/11/88 10/11/88 B186 Soil Mobil Statinn ~I1-GBD, 2688 0swell & Hwy 178, Bakersfield Test: Sits: Total Recoverable Petroleum. Hydrocarbons (EPA418.1) mg/ k g Sable Identification W01-6' 'Detection Limit Result s 15. This report pertains only to the samples ~nvesT~gated and does not necessarily apply to other apparently identical or simdar materials. This report is sui3m~tted for the exclusive use of the client to whom it is addressed. Any reprbduction of this report or use of this Laboratory's name for advedising or publicity/purposes without authorization is prohibited. II , ' ..... ~-'~' : '~' - . I I I I Ii i I I I II I ~ I LABORATORY REPORT 3808 W. ~lameda ~ve., Ste. 7~0 i~ I~.C'Ds 10/21/B8 Burbank, CA 91505-4331 :~dakT(3,,Is B192 ~TTN: Mr. Mike Henare I~TRIXz Soil Mobil' Station #11-GBD, Oswell& Hwy. 178, Bakersfield 'PTAll-3' PTAT-8' PTA9-8~ A1-3' A1-6' 1. 1. 1. 1. 1. ..Units: mg/kg I~ltl ND ND 32. ND ND PTA12-3' PTAt3-3' ~,/SP-2 1. 1. i. ND 1. ND use o! the clean! to whom i! is eclOresse0. 'An)' reor0ClUC;ti0~ ot ~r,i$ re~0r~ 0r us~ of thl~ Ll~boretor¥'$ name for ~.Ovo~i~in~ ¢,' sujhc;~ purDoee~ without auth0riZ~.ti0n iS pr01~iDitC'{I, ChemiCal Research Laboratories, Inc. · MOBILE DIVISION ~1631 Seaboard Circle · ~t~t0~, CA 90~0. LABORATORY REPORT 3888 W. Alameda .Ave,.~ Ste, 780 D~TIZ R~'Ot Burbank, CA 9.1~0~-4331 . ~TC~ll ~TTN: Mr. Mike Henare _., I~TRIXs' Mobil. ~tation #11-GBD, Oswell & Hwy,-178, Bakersfield 10/21/'88 0192 Soil ReSults 5ample Detectio~ Ethyl PTAg-8' 0.1 ND ND 0.1 AI--3' 8.1 ND ND ND Al-6' 0.1 ND ND ND To, al 1.0 ND PT~12-3' 0,1 ND ND ND 1.5 PTA 13-3' 0.1 ~P-2 ' 0, I ND ND ND ND ND ND ND ND ND ND ND ND This r~Dor[ pertair~s on y to the samp es ~vest gated and does not necessarily apply to other aDDarent y demical or simiiar materials, T~is rel~ iS SUOm~tle(I for the ex(tJuslve use ot the client to whom it is ad~essecL Any reproduction of this reporl or use of this Laboratory'c. name for ad~,'er~i$1ng or publicity !~u~o~e~ w~t~,O~t authorization }$ Dr~niDito~. Chemical'Research Laboratories ~, /nc. ~l,.'~ii~ (714)891-C~05 · FAX: (714)8934709 · (800)I.AS-ICR[. EEPOET 'to= . i ~YCJiE; NO.:. B102188-1/1~ ~ W. ~lameda Ave., $~e. 700. -i ~ ~'Os 1~/21/88 Burbank, ATTN: Mr. Mike Henare ' ~ .~ZXa Soil .- :~ :.' Mobil .S~a~ion ~11;GBD, Oswell & Hwy. 178, Bakersfiel. d · PTA7-8' PTAg-8~ A1-3' ND A1-6' PTA12-3' PTA13-3' ill ND, 4. ND SP-2 SP-3 1. ND ¸ This r...e~ort .o. ert. a. tns ?ly t.o the .s.amples tnvest~gated and does not necessar ly aI~D y lo other appi~rently identical or similar materials This rel0ort is subm tted for the exctusive usr~ eT tr~r~ c~if~,~ [o wr,orr, it is auo. rezsed. Arty reproduction cf this report or usg of?is Laboratory's name 'lot advertising or publicity pu~'13oses without &uthor~z~tiOn lS Drohlb{ted, KEKh] CULIN'rY H. EALTH DEPA. A~'bIENT ENVIRONMENTAL HEALTIt Dx~l['~- ON IIAZARDOUS SUBSTANCES SEC'I-_.oN , l'iuu [' BAKERSFIELD, CA 93305 · PHONE (805) 861-3636 INSPECTION RECORD ". POST CARD. AT JOBSITE. ~D~cJ"~'~../ .~fd, j~_.~' :' ': ADDRESS ~ ~-CC[J ~{,' ' JADDRESS ~$C)C., L.O. fl/~;q~i(~ ~t-~.--' ' CITY (~'~ . ~[~ J CITY L~ ~"1~l~3 C/+ :"' INSTRUgTIONS: Please call for .an i~spector only when each' group of ~inspec~']ons ~..'- ~ ~ [~ number are ready. They will run in. consecutive order ~::~eginnin~: ' with numbe~ 1. D0 NOT cover work ~for any numbered gP. oup until all.?items that grou~ are signed off by the Permitting .... Authori-ty..--:.J Following:';' these }-~ instrutions will reduce the number 0f-"-~'~q~ired inspection visits and iherefore ~ ~ Prevent assessment of additional fe~ '~'' ...... "' ......... '"~- ~'= .... '' ~"" ' ' - TANKS & BACKFILL - i~' ~,/;, ~ ............... ' ...... INSPECTION : DATE .qNSPECTOR ................... . Backfill of Tank(s) Spark Test Certification Cathodic Protection of Tank(s) '' ' ...... ": ...... -:''-' - PIPING SYSTEM - Piping & Raceway w/Collection Sump Corrosion Protection of PiDin~, 3oints, Fill Pip~ Electrical Isolation of Piping From Tank(s) Cathodic Protection System-Piping - I - SECONDARY CONTAINMENT 'OVERFILL 'P~O~ECTION. LEAK DETECTION - Liner Installation - Tank(s) Liner Installation - Piping Vault With Product Compatible Sealer  Level Gauges or Sensors, Float Vent Valves · Product Compatible Fill Box(es) · 7- Product Line Leak Detector(s) ~ Leak De~ector(s) for Annular Space-D.W. Tank(s) ~Monitoring Well(s)/Sump(s) Leak Detection~Device(s) For Vadose/Groundwater , : - FINAL - ~L-iMonitoring Wells, Caps & Locks ~']Fill Box Lock ~, MonitorinK Requirements CONTRACTOR CONTACT HEALTH OFFICER Leon M ~ebertson, M.D. DIRECTOR OF ENVIRONMENTAL HEALTH Vernoh S. Relchard ..ERN COUNTY HEALTH DEPAR 2700 M Street Bakersfield, California ENVIRONMENTAL HEALTH DIVISION Mailing Address: -' 1415 Truxtun Avenue ' Bakersfield, California 93301 (805) 861-3636 PERMIT TO CONSTRUCT UNDERGROUND STORAGE FACILITY FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: ' Mobil Oil SS #11-GBD Mobil Oil Corp R&S Piping 2688 Oswell St. . 3800 W. Alameda Ave 1946 E. Occidental Bakersfield,~ GA Los Angeles, CA Bakersfield, GA License #408337 PERMIT NUMBER; 090007B PIPE TO WEST ISLAND ONLY X NEW BUSINESS I PERMIT EXPIRES January 24, 1989 CHANGE OWNERSHIP ~RENEWAL I APPROVAL DATE October 24, 1988 --OTHER ~ APPROVED BY ............ · .................... POSTONPREMISES-.· .......... ' .............. CONDITIONS AS FOLLOW: Standard Instructions 1. This permit .applies only 'to 'the i.nstal].a%i(,~'~ of pJpin~ to 't].ze east! dispenser island. 2. All construction to be as per facility plans approved by this department and verified by inspection by. Permitting Authority. All equipment and materials in this construction must be installed in accordance with all'manufacturers' specifications. 4. Permittee must contact Permitting Authority for on-site inspection(s) with 24 hour advance notice. 5. Backfill material for piping 'and tanks to be as per manufacturers' specifications. 6. Float vent valves are required on vent/vapor lines of under'ground tanks to prevent overfillings. :' 7. Construction inspection record card is included with permit given to Permittee. This card.must, be posted at jobsite prior to initial inspection. Permittee must contact Permitting Authority and arrange .: .......... . .................... for..each_group of required~inspections_numbered_.as.~per-instruc~i°ns-o~-~- card. Generally, inspections will be made of: a. Piping system with secondary containment leak intercep~ion/ra.ceway DISTRICT OFFICES· Delano . L~monl '~elsabella . MoJave . Rldgecrest . Shnlter . Taft Special Instructions Permit Number 0i90007B 8. 'All underground metal connections (e.G. piping, fittinG, fill pip~.s) to tank(s) must be electrically isolated, and wrapped ~to a mllnlmum 20 m'fl thickness with corrosion-prevent.ive, Ga. sol~ne-resistant ! tape or · :~therwise protected from corrosion. · 9.~f~No product shall be stol-ed in tank(s) until approval is Permit.ting Author~it~ .... ~. , ..-.'~ ' - ~ - ' . 10 ',Contractor must be certified by tank manufac't'urer for linstallati~,n 'fiberglass tank(s), or ~ tank manufacturer's representative ~must. be present at site during installation.. 11. Liner shall be installed by a trained experience liner~ ContraCtor 'and ~nstallation at site approved by the Permitting Au'thority. 12.. Monitoring requirements for this facility will be described on final ~"Permit to 0perate." ACCEPTED BY: DATE: BS/dr 2700 M Street Bakersfield, California Mailing Address: 1415 Truxtun Avenue.* Bakersfield, California 93301 (805) 861-3636 &RN COUNTY HEALTH DEP ENVIRONMENTAL HEALTH DIVISION HEALTH OFFICER Leon M Hebertson, M.D. DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Relchard PERMIT TO CONSTRUCT UNDERGROUND PERMIT NUMBER 090007B STORAGE FACILITY ~" FACILITY N~ME/ADDRESS: OWNER(S) NAHE/ADDRESS: : CONTRAcToR: Mobil Oi1' SS #11-GBD Mobil Oil Corp R&S Pi!pin'~ 2688 oswell st. s800 w. Alameda Ave 1946 E. Occidental Bakersfield, CA Los Angeles, CA ~ Bakersfield, CA License #40833? PIPE TO WEST ISLAND ONLY X NEW BUSINESS } PERMIT EXPIRES January 24, 1989 , CHANGE OWNERSHIP I __RENEWAL. I APPROVAL DATE October 24, 1988 __OTHER I APPROVED BY _ ~ Bill Scheide 4. 5. 6. 7. ................................. POSTONPREMISES ............ · .... ........... CONDITIONS AS FOLLOW: Standard Instructions 1~. This pgrmit applies only to the installation of piping to the east dispenser island. 2. All construction to be as per facility plans approved .by this department and verified by inspection by Permitting Authority. All equipment and materials in this .construction must be installed in accordance with all manufacturers' specifications. Permittee must contact PermittinG Authority for on-site inspection(s) with 24 hour advance notice. Backfill material for piping and tanks to be as per manufacturers, specifications. Float vent valves are required on vent/vapor lines of underground tanks to prevent overfillings. Construction inspection record card is included with permit given to Permittee. This card must be posted at jobsite prior to initial inspection. Permittee must contact Permitting Authority and arrange fo~ each group of required, inspection's~numbere~s ~r inst~rqc'tions ~p.q card. Generally, inspections will be made of: a. Piping system ~ith secondary containment leak interceptlion/racewaY ~ DISTRICT OFFICES Delano . Lamon! ke Isabella . Molave . Rldgecre,t . Shafter Taft Special Instructions Permit Number 090007B 8. Ail Underground metal connections (e.G. piping, fitting, fi/l! pipes) to tank(s) must be electrically isolated, and wrapped to a minimum 20 ~il thickness with corrosion-preventive', gasoline-resistant tape or otherwise protected from corrosion._ No product shall be stored in tank(s) until approval is!granted by the 10. gontractor must be certified by tank manufacturer for installa!tion of fiberglass tank(s), or .tank manufacturer's representative must be present at site during installation. . .i · i " 11. Liner shall be installed by a trained experience liner'~contractor ~nd installation at site approved by the Permitting Authority. 12. Monitoring requirements.for this facility will be described on final "Permit to Operate."' ¸9. ACCEFTED BY: BS/dr 2700 M Street Bakersfield, California Mailing Address: 1415 Truxtun Avenue Bakersfield, California 93301 (805) 861-3636 STORAGE FACILITY · -'RN COUNTY HEALTH DEPAR' ENVIRONMENTAL HEALTH DIVISION PERMIT TO cONSTRUCT UNDERGROUND HEALTH OFFICER Lbon M Heberlson, M.D. DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Relchard PERMIT NUMBER 09000?B FACILITY NAME/ADDRESS: 0WNER(S) NAME/ADDRESS: CONTRACTOR: 2688 Oswell St. 3800..W. Alameda Ave 1946 E.. Occidental Bakersfield, CA Los Angeles PIPE TO WEST ISLAND ONLY PERMIT EXPIRES APPROVAL DATE APPROVED BY CA Bakersfield, CA License #40833? January 24, 1989 October 24, 1988 X NEW BUSINESS CHANGE OWNERSHIP RENEWAL MODIFICATION OTHER Bill Scheide · · POSTONPREMISES ......................... ~. CONDITIONS AS FOLLOW: Standard Instructions 1. This permit applies only to the installation of piping to the east dispenser island. 2. All construction to be as per facility plans approved by this department and verified by inspection ~y Permitting Authority. 3. Al/ equipment and materials, in this construction must be installed in accordance with all manufacturers' specifications. 4. Permittee must contact Permitting Authority for on-site inspection(s) with 24 hour advance notice. 5. Backfill material for piping and tanks to be as per. manufacturers' specifications. 6. Float vent valves are required on vent/vapor' lines of underground tanks to pre~ent overfillings. 7. Construction inspection record card is included with permit given to Permittee. This card must be posted at jobsite prior to initial , inspection. Permittee mus't contact Permitting 'Authority and arrange ~ ...................... for each group of required inspections numbered as per instructions on ........ Card-'; ....... a.. Piping system with secondary containment leak interception/raceway Oelano . Lamont DISTRICT OFFICES" '~e Isabella.. Molave . Rldgecrest . Shalter . Taft Permit Number 090007B All underground metal connections (e.g. piping, fitting, fi]/ pipes) to tank(s) must[ be electrically isolated, and wrapped to a minimum 20 ~ ~'~il thickness with corrosion-preventive, gasoline-resistant tape or .... /~therwise protected from corrosion..- No product shall be stored in tank(s) until approval is granted by"the 10. Contractor must be certified by tank manufacturer for installation of fiberglass' tank(s), or tank manufacturer's representative must be present at site: during, installation. 11. Liner shall be installed by a~trained experience liner contractor'~and installation at~ site approved by the Permitting Authority. 12. Monitoring requirements for this facility will be described on final "Permit to Operate." ACCEPTED BY: BS/dr 2700 M Street Bakersfield, California Mailing Address: ' 1415 Truxtun Avenue - Bakersfield, California 93301 (805) 861-3636 --RN COUNTY HEALTH DEPART; ENVIRONMENTAL.HEALTH DIVISION HEALTH OFFICER Leon M Hebe~t~on, M.D. DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Reicha[¢l I' PERMIT TO CONSTRUCT UNDERGROUND PERMIT NUMBER 090007B ~' STORAGE FACILITY r ....... ~ FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: ::'?~i~ Mobil Oil SS #ll-GBD Mobil Oil Corp R&S Piping~_~'- ' 2~88 Oswell St. 3800 W. Alameda Ave 1946 E. Occidental Bakersfield CA Los Angeles, CA Bakersfield, .cA License #408337 PIPE TO ~cI~'ISLAND ONLY X NEW BUSINESS CHANGE OWNERSHIP RENEWAL MODIFICATION OTHER' PERMIT EXPIRES~ APPROVAL DATE APPROVED BY October 24, 1988 ................................ POSTONPREMISES ............................ 'CONDITIONS AS FOLLOW: standard Instructions l. This permit applies only 'to the installation of piping to the east dispense~ island. 2. All construction to be as per facility plans approved 'by this department and verified by'inspection'by Permitting Authority. -- 3. All equipment and maferials in this construction must be installed in accordance with all manufacturers' specifications. 4. Permittee'must contact Permitting Authority for on-site inspection(s) with 24 hour advance notice. 5. Backfill material for piping and tanks to be as per manufacturers' specifications. 6. Float vent valves are required on vent/vapor lines of underground tanks' to prevent overfillings. ?. Construction inspection record card is included With'permit given to Permittee. Th~s card must be posted at 3obsit~ prior to initial ....................... inspe~t_%9~ ....... permit~e must contact Permitting Authority and arrange for each group of requi=ed inspections numbered-~S per'ihst9uc~lons--'-on .... card. Generally, inspections will be made of: a. Piping system with secondary containment leak'interception/raceway DISTRICT OFFICEs ' ' Special Ins.trUctions ' · Permit Number 090007B i - 8. Ail underground metal connections (e.g. piping~ fitting, fill Pipes) i:" to tank(s) must be electrically isolated, and.wrapped .to a minimum 20 i-... 'mil thickness' with corrosion-preventive, gasoline-resistant .~ape or otherwise protected from corrosion ,.:. ~:.. ?.' :' .9. No product shall be stored in tank(s) until approval is granted by ~he ~0. Contractor must be certified by tank manufacturer for installation of fiberglass tank(s), or 'tank manufacturer's' representative must be present at site during installation. 11. Liner shall be installed by a trained experience liner' contractor and installation at site approved by the Permitting Authority. 12. Monitoring requirements for this facility will be described on final "Permit to Operate." ACCEPTED BY: DATE: BS/dr ..." ~,ERN COUNTY HEALTH DEPARTMhi~T ,4 2700'M Street ~ HEALTH OFFICER Bakersfield, California ENVIRONMENTAL HEALTH DIVISION ' Leon M Hebertson, M.D. Mailing Address: , ~ DIRECTOR OF ENVIRONMENTAL HEALTH 1415 Truxtun Avenue ~ Vernon S. Relchard Bakersfield, California 93301 (805) 861-3636 ;' PERMIT TO CONSTRUCT UNDERGROUND .PERMIT NUMBER 09000?B STORAGE FACILITY .... .:::>..:: ., .. FACTr. ITY NAME/ADDRESS= 0WNER(S) NAME/ADDRESS= ".: CdN?R C?oR= ' Mobil Oil SS #11-GBD MObil 0il Corp R&S PiPing 2688 Oswell St. ~800 W. Alameda Ave 1946 E. Occidental Bakersfield, CA Los Angeles, GA Bakersfield, CA License #408337 PIPE TO WEST ISLAND ONLY X NEW BUSINESS I PERMIT EXPIRES January 14, 1988' CHANGE OWNERSHIP I RENEWAL I APPROVAL DATE October 14, ~988 MODIFICATION ' __ 0THE , APPROVED ' // Janis L~man ................................ POSTONPREMISES ............................ CONDITIONS AS FOLLOW: Standard Instructions 1. This permi{ applies .only to the installation of piping' to the west -. dispenser island. 2. All construction' to be as per facility plans approved by this department and verified by inspection by Permitting Authority. 3. All equipment and materials in this construction must be installed in accordance with all manufacturers' specificationS. 4. Permittee must contact Permitting Authority for on-site inspeCtion(s). with 24 hour advance notice. 5. Backfill material for piping and tanks to be as per manufacturers' specifications. 6. Float vent valves are required on vent/vapor lines of underground tanks 7. Construction inspection record card is included w~-"~r~m~~"-~o Permittee. This card must 'be posted at ~obsite prior to initial inspection. Permittee must contact' Permitting Authority and arrange for each group of required inspections numbered as per instructions on card.. Generally., inspections will be made of: a. Piping system with secondary containment leak interception/raceway Standard Instructions !.~"~-~ ..... : ............ '~'~:e'=_=:~' .... ~ ................ ~-'.-~'--.~_ ....... - ...... Permit Number 090007B . ,..,:. 8. All[ underground metal connections (e.g. piping, fitting, fill pipes) I,. ,:to,. :tank(s) must be electrically isolated, .and wrapped to' a minimum 20 ,..'~ mil thickness with corrosion-preventive, gasoline-resistant tape or '-~ .~otherwise protected from corrosion. i.i.i~<'' 9. : No product 'shall be stored in tank(s) until approval is :g'~an~'-? "'%ed:":"~'::"'~:_'~t'he'::''~''''- i"~ 10. Contractor must be certified by tank manufacturer for installation "of fiberglass tank(s), or tank manufacturer's representative must be .present at site during installation. 11. Liner shall be installed, by a trained experience liner'contractor and installation at site approved by the Permitting Authority. 12.' Monitoring requirements for this facility will be described on final "Permit to.Operate." AGCEPTED BY: ' ~ JL/dr 1017-07 DATE: 2700 M STREET KERN COUNTY HEALTH DEPARTMENT HEALTH OFFICER MAILING ADDRESS . Leon M Hebertson, M.D. 1415 TRUXTUN 'AVENUE ' ENVIRONMENTAL HEALTH DIVISION BAKERSFIELD, CA' 93301'~ DIRECTOR OF ENVIRONMENTAL HEALTH (805) 861-3636 Vernon S. Reichard PERMIT TO.CONSTRUCT ..UNDERGROUND STORAGE FACILITY PERMIT-NUMBER .... OgO007B ' FACILITY NAME/ADDRESS: OWNER (S) NAME/ADDRESS: CONTRACTOR: Mobil Otl S.S. #11-GBD _ _ ' Mobil Otl Corp. ._ R &.~ p!p!n~'..".~ii~!'<:_"!~_..' Bakersfield, CA Los Angeles, CA Bakersfield, CA 92705 TANK ONLY-NO PIPING ,.,X NEW BUSINESS I ., CHANGE OWNERSHIP I · RENEWAL I · ~MODIFICATION I .... OTHER I I Ph. # License'# 408337 PERMIT EXPIRES APPROVAL DATE APPROVED BY JANUARY 14, 1988 OCTOBER 14, 1988 /Jants~'L~hman POST ON PREMISES CONDITIONS AS FOLLOW: Standard Instructions 1. All construction to be as per facility plans approved by this department and verified by inspection by Permitting Authority.. 2. All equipment and materials in this, construction must be installed tn accordance with all manufacturers' specifications. 3. Permit~ee must contact Permitting Authority for on-site inspection(s) with 24 hour advance notice. 4. Backfill material for tanks to be as per manufacturers' specifications. _5. Float vent valves are required on vent/vapor lines of underground tanks to prevent overfillings. 6. Construction inspection record card is included with permit given to Permittee. - This card must be posted at 3obsite prior to initial inspection. Permittee must contact Permitting Authority and arrange for .each group of required inspections numbered as per instruction on card. 'Generally, inspections will be made of: a. Tank and backfill b. Overfill protection and leak detection/monitoring c. Electrical condu~ts associated with the tank. d. Any other inspection deemed necessary by Permitting Authority. .tank(s) must be electrically isolated, and wrapped to a minimum 20 mil thickness with corrosion-preventive, gasoline-resistant tape or Otherwise protected from corrosion. DISTRICT OFFICES ~" 8'. No product shall be stored in tank(s).until approval is granted by the !.: Permitting Authority. !'" 9. Contractor must be certified by tank manufacturer for installation of fiberglass tank(s), 'or tank manufacturer's representative must be present :'. 10. Monitoring requirements for this facility will be described on final . "Permit to Operate". X1. This permit is for the tank installation only - no piping may be installed. ~ A site characterization proposal' is necessary for this site in order to determine the full extent of contamination at the dispenser islands. 2700 M STREET MAILING ADDRESS 1415 TRUXTUN AVENUE BAKERSFIELD, CA 93301 ' (805) 861-3636 KERN COUNTY HEALTH DEPARTMENT ~ HEALTH OFFICER Leon M Hebe~lson, M.D. i ENVIRONMENTAL HEALTH DIVISION DIRECTOR OF ENVIRONMENTAL HEALTH · Vernon S. Reichard ~=:'RERMI~TO-CONSTRUCT_UNDERGROUN] TANK ONLY-NO PIPING ERMIT---NUMBER -090007B STORAGE FACILITY FACILITY NA~E/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: 2688 Oswel1 .............................. I 3800 W'.. Alameda # 700 . '-' · 1946 E Occidental · Bakersfield, CA 'Los Angeles, CA Bakersfield, CA 92705 Ph. # Ph. # , : · ~ ,, NEW BUSINESS I ., CHANGE OWNERSHIP I RENEWAL I MODIFICATION I ... OTHER I I X License # 408337 PERMIT EXPIRES JANUARY.14, 1988 APPROVAL DATE APPROVED BY OCTOBER 14, 1988 Janis Lehman POST ON PREMISES CONDITIONS AS FOLLOW: Standard Instructions 4. 5. 6. All construction to be as per facility plans approved by this department and verified by inspection by Permitting Authority. All equipment and materials in this construction must.be instal/ed in accordance with all manufacturers' specifications. Permittee must contact Permitting Authority for on-site inspectiOn(s) with 24 hour advance notice. Backfill material for tanks to be as per manufacturers' specifications. Float vent valves are required on vent/vapor lines of underground tanks to prevent overfillings. Construction inspection record card is included with' permit given to Permittee. This card must be posted at 3obsite prior to initial inspect/on. Permi~tee must contact Permitting Authority and arrange for each group of required inspections numbered as per instruction on card. Generally, inspections will be.made of: a. Tank and backfill b. Overfill protection and leak detection/monitoring c. · Electrical conduits associated with the tank. . d. Any'other inspection_deemed~necessar¥ b~Permitting.Authority. ' ....... ~il-~hde~r-~udd-""metal connection~ (e.g. piping~"~ittin6; fili pipes) to tank(s) must be electrically isolated, and wrapped to a m~nimum 20 mil thickness with corrosion-preventive, gasoline-resistant tape or otherwise protected from corrosion. ' DISTRICT OFFICES No product shall be stOred in-tank(s) until approval is granted by the Permitting Authority. i .. _ Contractor must be certified by tank manufacturer for installation of fiberglass tank(s), or tank manufacturer's representative must be present iO. Monitoring requirements, for this facility Will be described on final "Permit to Operate". 11. This permit is for the tank installation only - no pipin~ may be installed.' A site cha~acterization~proposal is necessary for this site de~ermine the full extent of contamination at the dispenser islands. - ' ~SET-TLJ 0 1 KGET-TV, 'INC ~83i EYE STREET P.O. BOX 1700 BAKERSFIELD, CA 93308 FAX OFFICE (805) 387 - 1994 (805) 327 - 7511 COMPANY: FAX NO,: NO.' OF PAGES INCLUDING COVER SHEET 0CT-13-1988 10:07 FROM ~BIL OIL BURBANK TO i ~1o~o_,~41~15 P.O1 ~:' '. iCRL - MOBILE LABORATORY Tentative .Rmsults/FAX Sheet SamPle ,:~- ,:,':', t, ~ ,~ '.' '- Be~-ene Toluene 'Ethyl TOtal ' NOTE: . . FAX BENDER: .. P.O, [:]ox 1700 · 2831 Eye Strr, et · . . R¢~ker'~.fh':h'J.. CA 93302.1700 · (805) 327-7511 1 0--.1 $--88 THU 1 -'~MA I L BOXES REMEDIAL ACTiON CORPORATiON 2~ P..01 ,.,... ,,.._._ ~ '., "Innovative Solutions for Hazardous Waste Management" FAX ,: ::-~,.,..~-.e~ ~.,..., ... .~~ ~:',~ ~ ~'~O"-~--,-'-' -'"-"Z'-uA " "' -. . .... . . . . . .: .......... .... :~ . .,...: .... , ~:>.;.,..... :.,::., .. ', . ~/-~3~ :.'-,.-." ..... '.- '.'-~-.' ~ ~ ~- ' :.. :. ~- - . MErGe: : D.A, ~mm ers, Ph,O, . . I:h'esident 505 N. Tusttn Ave,, Su/te 160 Santa Ans. C, alifornie 92705 Remedial Action corPoration KEY PERSONNEL Principal Hydroge010gist ................. Underground St0rage Tank c0-mp Real Estate Environmental Assessments Soil and Groundwater Cleanup" :' '~' ":. ":-' Ce~ified Professional Geologist- American Institute Professional Geologists .~_~..:?~ ;. * M.$,, Geology, Univers{W of Rochester, 1961 *. . ~....~ B.A., Geology, University of Cincinnati, 1959 . Dr. Sommers has over 20 years of professional experience providing hvdrogeological consulting services ~o clients nationwide for projects involving underground ~orage tanks, hazardous waste site evaluations, groundwater contamination cleanup, mine dewa~ering, groundwater supply, exploration, and development and environmental assessment for industrial and commercial real estate transfers. From 1985 to 1988. prior m joining Remedial Action Corporation. Dr. Sommers was in charge of aquifer restoration and rehabilitation pro,acts ~hroughou~ southern California for a national environmental cdnsult~ng fi~m'. In addition, he developed and implemented the underground storage tank se~ices division of the company for no~hern California with sales of $100,000 per Significant projecm pe~ormed under his direct supe~ision include the following: . ~anaging Principal Geologist- Precision Ta~k Testing, Under, round Storage Tank ~ Monitoring Plans and Tank Audit Repo~s ~o fuffill requirements of SubchaPter 16, T~tle 23, CAC, for eigh~ clients, with over 280 tanks at 33 facilities ~n no~harn - California, 1985-86. -Project Manager/Principal Hydrogeologist- Real Estate Environment Compliance Appraisal of metal scrap yard for planned commercial development. First nterstate'Mo~gege Company San Diego, CA, 1987 . Principal Hydrogeologist - initial Groundwater Contamination Assessment World Oil Company Station ~52 Morgan Hill, CA 1985-86 - P~i~C~'~ HY-d~ogeol~gist-~S°it'Gas Su~ey-tomaphydrocarbon~c°ntami~eti°n at abandoned terminal facility. Major oil corporation California, 1987 (over) T H U I._.~ : .-' ~ r.1 A I L B ~3 ::---: E ~_:: 2 4 ~-{. .....' KEY PERSONNEL (cont.) o ·Project Manager/Principal Hydrogeologist - Solid Waste Water Quality Assessment (SWAT) Proposals and Reports for five sanitary landfills' in Riverside County, CA Riverside County Waste Management Department . Riverside, CA 1986-88 · Principal Hydrogeologist · Site CharaCterization, Site Remedial Action Plan and ~_~._=.=Groundwa[er~roduct_l~ecoverSystem. Design_ .reyie-w for 10,000-gallon gasoline Confidential Commercial Client . West Hol!ywood, CA 19B~ ~:~;?---principal Hydrogeologist- Feesibiliw studies for removal of hydrocarbon ~* 'contaminatiOn from soil and groundwater using in-situ microbiological techniques. · Principal Hydrogeologist Groundwater ~esource Evaluation of Seaside Aquifer System, Monterey CounW, CA ' Monterey Peninsula Water Manegeme~ Diuril, 1985 .. :.-:.~..: ....... . :,' . ,,- Principal Hydrogeol°g~St- Sunol Valley Groundwater Study Fremont, CA 1986 "" ,'-' / .: ' While with Hydrosciences, Inc,, a consulting firm founded by Dr. Sommers in 1977, he specialized in groundwater supply development and groundwater quality' investigations for energy-related mines and facilities throughout the Rocky Mountains. Special projects included designing, constructing and testing deep water supply wells for new coal mines in'the Powder River Basin of Wyoming, reservoir interference flow testing of Iow-ternperture geothermal reservoirs in Colorado and Oregon, and pressure testing analysis for feasibility of in-situ solution mining of uranium in Washington. Previously with Dames and Moo.re, Dr. Sommers was principal-in-charge of numerous water supply development and enwronmental/hydrogeolog~c studies fo~ new uranium mines and 'mills and coal mines throughout the Rocky Mountains. At Woodward Clyde Consultants, Dr. Sommers was Vice President and Director of the Hydrogeology Group. He was responsible for ground water investigations for the Safew Analysis Reports (SARS) of three nuclear power plants, economic and technical feasibility studies of deep well injection of liquid wastes from a · plannned coal gasification plant in North Dakota and the assessment, design and remediation of hexavalent chromium contaminated groundwater in a New Jersey coastal plain aquifer. Professional Affiliations American Association of Petroleum Geologists American Institute of Professional Geologists Association of Engineering Geologists ~Associ a ti .o..o._o~, G ro.u.n ~a._~e_~_S~:.i~..n_fi~ts:~ ~__d Engineers AssociatiOn of Hazardous Materials Professiona'{~ Dr. Sommers has authored or coauthored more than 100 written reports and has' made numerous presentations to technical groups and trade organizations; THU r.1 ~ T I_ :B 0 ;=< E :E; :2'4 6 ._ KEY PERSONNEL p.O.~ · Remedial Action Corporation I I I Edward B. Sir°ta Principal Engineer Hazardous Waste Management Site RemediatiOn ~ :'- '-- Civii/Geotechnical Engineering.` '- Permitting : .... -. .. Professional Engineer Geotechnical Engineering. California GE000783 ' ::;??¥::7':~:.:~::~': The City College of New York, Bachelor of Science in Engineering :, : '.,: . , (Civil Engineering) June 1967 .." .',: .,,..' The City College of NeTM York, Graduate Assistant, 1967 to 1968 ,': ': :":i./:: ~".?i...:!'-!.':~,~?' :?:..'- Carnegie Mellon University Continuing EducatiOn in Accounting, Finance, ~'-' Law, Marketing Strategy and Communications Professional Ex=erience " Mr. Sirota has more than 19 years of diverse experience in engineering and remediation. Asthe General Manager of the Irvine regional office for 0'Appolonia, then for iT Corporation (following the sale of D'Appolonia), he managed a staff of up to 80 people working on hazardous waste site assessment; hazardous waste site ~emediation and treatment process design; underground storage tank evaluations; site evaluations prior tO sale: environmental assessments; mine planning; mine and mill permitting; design of runoff control systems; hydrogeologic studies, geotechnicai eValuation and design of earthen dams; and geotechnical studies. As a'project director or manager, Mr. Sirota has been responsible for or managed proiects in all the areas· enumerated above, including several with total fees in excess of $1,000,000. Significant projects performed under his directfon include the following: · Assessment and remediation of a 37,000 gallon spill a~ a gasoline terminal in Southern California. Mobil Oil Company Atwood, California · AssesSment'and remediation of solvent contaminated sites in Northern and Southern California. , Van Waters and Rogers Baron and Blakesly San Jose, California Gardena, California ................................ · ~-~Asses'smen! and remediation, where_needed, of spills from more than 30 gasoline stations in Southern California for: Chevron UNOCAL Southern California Southern California (over) T H U i 5 : 4~'5 M A I L l~: 0 ::< E ::_~ 2 4 6 -' KEY PERSONNEL (cont.). * Hazardous material audit, and assessment, design and construction of a wasteweter treatment system for a mineral processing plant. Mol¥corp Mountain Pass, California · Environmental assessment, mine planning,, geotecl~nical studies, prelimina~ design -- ~:-:for~an:ea~hen~.dam:,_and permi~ingstudies ...... ~:~: .... Homestake Mciaughlin Proje~ NaDa. Yoto and ~ke Counties, California ~ Geotechnicel ~udies. ..?~- ~. Gr~ssroots petro-chemical plant .-~ Bandar Shaipur,. Iran ' ~ - waste. He is familiar with availabte mobile processes and has worked treatabili~ laborato~ in applying treatment processes to vanous waste streams. ~'::~:,'~;;~.~'~:~.~f~ ~?~? Mr. Sirota is ~e~ familiar with California and federal hazardous waste raqul~'tions~ '. He'r'h~ worked effectively with regulators in modi~ing regulations to make them more acceptable to indust~. He has been ve~ succes~ul in using his knowledge of regulations, and technical negotiating skills, to obtain permits for clients' ~rojects. .... From 1968 io 1978, Mr, Sirota worked as a cOnsulting geotechnical engineer. As a Project 'engineer, he was responsible for soils and foundation investigations for residential housing, refinery expansions, petrochemical complexes; cement plants, a nuclear power plant, offshore structures and Other projects in Canada, Iran, the Trust Territories, Indonesia, Singapore, Alaska, Hawaii, California and several other states. prQfessional History_ REmedial Action Corporation, Principal Engineer, 1988 to date Applied Geosclences Inc., Tustin, CA, Vice President, 1987 .to 1988 IT CorporatiOn, Irvine,CA National Program.Director and Program Manager, 1986 to 1987. IT Corporation/D'Appolonia, Irvine, CA, General Manager, Engineering and ._.. Remediation, 1978 to 1986. Dames Moore, Honolulu, H! and Los Angles, CA, Engineer/Project Engineer, 1969 to 1978. ~rofessional Affiliations American Society of Civil Engineers, Fellow - International Society of Soil Mecl~anics and Foundation Engineers Society of Mining Engineers of AIME Nationat Water Well Association Chi Epsilon American Society of Testing and Materials ~ American Water Works Association Society of Military Engineers Mr. Sirota has been responsible for more than 100 written reports and has made numerous presentations to technical and lay groups. He is co-author of a paper on the use of.insitu vapor probing to delineate Underground hydrocarbon spills. OCT- 12-i'9:B~ 1 ~: 3:3 FROH MOE', I L [3 i L BtjF,'.BANK C&&L ~l~tl COMPLII?I · iIIIIIMSI~ 3'0 BJi#l~,llt ' ~L ~ :/:-":: , ~:.~: .: ~,r .I ~,~..~ }¢~:..51'· '~ 1:~I03ECT NAME NUMBER RECORD ..... co (I) ,:if, $ C',J · ORAItSE (X)IJNI'Y. · ,,<fANTA I~ARIA ' , · W~ER~PIELO ~ ~.. CHAIN OFCUSTOpY RECORD i DATE ~E PHON~ NUMBER NO. OF' ~: CNTN,R~ AE~ILBREO ti ~ by:. (~ n~u~ -1' ,~, .~, ,,,~,~ '.,,,~,', ., :,.' :':-~,,-:,~! ]~r,,.', ;:-..,,, ::-:;},". '" :':';~' "!' I~I~TE 'J?'' 'TIME 80UI:K~:Ad~pled fromm U.& EPA, I~eeeived I~. ($tgnatur~ 'e ~EGOUN'P( . ·VEt, JIURA ....... · SANTA MARIA · ': ! · BAKERSFIELD CHAIN' OF CUSTODY RECORD PROdEGT MANAGER TESTS , RE~IREO Received by Mobile ~ for field enaJ)~l~: ........ 1700 Flow~ Street 9aker~, Caflfornl~ 93,~ - - Facility Name MOBIL SERVICE STATION : . ...: ..:. -~/.;:~: . . / . KERN COUNTY HEAIJ.']~. DEPARTMENT . . .~,~w..,u,~mq~..n :...'~.,-:~.'_- ... ' DIRECTOR OF ENVIR(~IMEN1;Id,. ~ count i>....~ · :~: ..... -~ '. A767'09 ..... TRACKING RECORD ~periit #ith?noab~ ,hat:'thta forni's'¢olp'lete~'~nd ~sponsible Section 1' be"Ytlled out b_j["tank remova ,ntractor:," -.,. L. .'~ 4:' :?.- ss'~' ~ 310 NTONINO WAY I' r'~'+' ':?;'J'~i:':i":'tank(s)have been decontaminated .in ·accordance with 'Kern -'"': ....... Tanks ~" ~:"4 ! ': - ' '.::/:'i/::..~!Oate Tanks Removed /~0-11-8~''''~:~' ":~L"!"-/"':~i':~'~'" No. Of · · '... .......... :~ ....... ~,~ ..... ~. ~,,~J, · . ~. ..- .. .. . ~ctJoa 2 ~ To be fl]le~ out.~ contractor ~ ............. .... ' decontaminatin~ tank(si: ~?;~.~:.":' · :- ........ ¥~;~:~''r~: ~ ~, ~;~;' . . -,, .... '. ,. ........ ' 'Tank ~"Dec0ntaiinatiSn* Contractor T~AD ~]~ & ~DU~T~AL~X~ '0~.~¥~0: ~ddress Z775 ~AT~O~A~ AVE. ': Phone ~.,~,~ Zip ...:.':.Authorized representative of contractor certJfJe~".by~ - Section 3 -To be filled out and signed bj[ .e authorized representer: 't_~he * * * ~ILING INSTRUCTIONS: Fold tn half' and staple. Postage and matlin8 label have] already been affixed to outs.; eot your convenience. (Form CI C T -- jj - __.CONSTRUCTION ~ SE'-ArlC'gS 850 W. VALI,EYBLVD. --~.'CC* TON .iA 92324 (714) 824-9878 - F .~ ~ · , . / ,' .' :': · :?::. , o~: . . -. .- . . . .. , '--.:~. ,: .,..,~?...?<:-,~,,:.: . ' ]~AND DEL COP~f ~0': TIlE FOLLOWING ........ -JJC w: Vi~ ~Lv~. ~:CoLkO~' (714) 8P~t-9878 ::;~ 'ii:Fax # (714).$2Z1~2047 ..... ' ?i~:Af ter i~;?spea .'.lng ~mm£C~l~"Rese~rCh iA $ ky~y .D~i~e; "~On ~ t ~!:'San.t~'Maria,'Ca.95455 ~ve ."any ~lques t ±-on s Anthon' ' ilo ~ HA~A WASTE TESTING L~BORATORY CERTIFICATION LISZT Hazardou~ Matmrials Laboratory . Califo.nia O~partment of Health Senv 151 Berkeley Way, Berkelmy, CA g4704 ENSECO-ORL/Central C~st .." , ~ONE: {B05)~22-)l/a ' LABORATORY CATEGORY: Co,mere(al 2325 Skg~ay Orfv., Unit ~.'-' ' ' CERTIFICATE NUMBE~: 188 ORGANIC C~EM[CAL-TESTING NETHO0 NU~B£R '(OATE CERTIFIE0) "'[Y · CE.RT[FIEO; N ~'NOT CERTIFIED) 1,2 Non-Halogenated Volatile organics ................................................................... 8015(09 11-87) Y 1.) Aromatic Volatile Organics ........................................................ j ............ , ....~020(0g-ll-BT) ........ Y i.4 Ac¢ole(n, JcPglonttrt)e. Acetonitri~e ................................................ , .................................... N 1.1 0~gan~hloHne Pesticides ........... Ct .......................... : ............................... B0~0(0g-ll-8/) .... ~---Y 1.14 Cap,mates ........................................................ L ............................................ , .......... S.1~ ~C/~ Meted foe ~mtvolatile Organics ......................................... ' .............. ~ ........................ N INOR~IC CHEMICAL TESTIN~ METHO0 NUMBER (OJTE CERTIFIED) (Y ·CERTIFIEO; N ~ NOT CERTiFIEO) t.) )ar(um ........ 1080(0g-ll-lT) ................... ,.-y 2.4 Beryllium -7090(0g-11-81) .... 7 ...... '-'L; .... 2.1 Chr~fum(total ) .... ~ ........................... . .... ?.IgO(Og- I l-IT) ............ J,?--~-y t.8 Cobalt ......... 219.1(0g-1 ~. IT Vanadium ':/'DEPARTMENT>OF HEALTH ~VICES :"' "::';': ';':'~?'';~''~ HAZARDOUS ' ' ~ . TESTING' LABOR TORY CER' ~ is hereby granled to' ~ ..... ~, '. ,. to conduct analysis of hazardous wasle in the following !est calegories: . :,a~ ,:. ,.:::. , .. ,:. ':. ,. AS SPECIFIED IN Tflx ~EAZARDOUS gASTE TESTING LABORATORY, CE}tTIFICATION LI 'i ' ' '~ '"' ~;~ ~:~' · .' .. :'?'.~, .".,:~ · "' "::~'' ~'! This Certificate is granted in accordance with provisions of Article Chapte~ :i 6.5, Division 20 of the Health ami Safety Code. .: ..ii :..:~'ii~ · !.i : 1989 Certi{icate No. 188 Expiration Date OCtober 9, '.' I~ :i~.r, 2700 M STREET . · J ? '<.*'. MAILING ADDRESS Ii ::~:~:" ~ '!'-1415 TRUXTUN AVENUE.. ... ...."' ." "( .~;. BAKERSFIELD, CA 93301 861-3636 . . .- 'FOR 'PERMANENT CLOSURE {DERGROUND ,.H~ }OUS KERN COUNTY HEALTH DEPARTMENI' · ENVIRONMENTAL· HEALTH DIVISION · ' HEALTH OFFICER . '; . Leon M Hebertson, M.D. . --_ - .'-~ . . DIRECTOR OF ENVIRONMENTAL HEALTH ...c.:z- ~ .... Vernon S. Reichard · -~.~. ..... :, .... : .... ~STANCES 'ORAGE>FACILITY ffACILITY~NAME/ADDRESS Mobil 0il *S.S. #11'GBD 0swell;st:r~,.~J<~,.-.-s?J~;r~>;~.;:,3800 W.-?Alameda ~akerSfield~: eles ers'fiEl~a ,h~:'?!8 i ~9~'3.2608 ":~iJ~";~!~:?:~?Ph°ne ... i'8.0~ :>?;{<'..;';'PERMIT FOR .CLOSURE OF -T:-.~:. <~-.PERMIT .EXPIRES ~"?'?.' ~"' .December :. : POST ON PREMISES ............ '~ is ~he resoonsibilit~ of ~he Per~i~tee to obtain permi"t6~"~tch :be required by other regulatory agencies prior to beg~nnxng closure act~o . Tank closure activities ~ust be per Kern 'County Health'and .~Fmre~ ~Department approved methods as described in Handbook UT-30..t. ' from 'sam le 'locatlons and numbers or constituents :~.~o :~De :: receive prior approval by the Health Department. - '= ~a. (Tank size 1,000 gallons or less)-a minimum of two ;sampl*es'mUSt .' be retrieve8 beneath the center of the tank':at ~-'l ...... (-T~-h-~--~-~--betwee.n-.'i-;-O. 00~ -~to-'~O ;'0'o0 ~-~-i:l~6n~)::~'~in~~um of -~s'ix samples must be retrieved one-fourth of the way in from the ends of each tank :and beneath the center of each tank at ~depths ~;.of approximately t~o feet and six feet. DISTRICT OFFICES .FOR PERMANENT SUBSTANCES STORAGE FACILITY. :.~: ............. " .... -.ana .permit aPpI'iC~ti'on are :to '~be [be-~ranted ~y the "~peciali~ ;o i-I :~tSamPl lng ~('p i p ~ini~um of ,:.two-'samples ..imUst,.:::-be [.retrieved ~at feet ~and :Sex ~feet. [~f. or ~enzene ?~3xyl[ei ne--'am L ;grease ;,applicable .~State ~laws '.!for .i/hazardous ~:,waste tt :::must ~-be '~ladhered :ii,to .,],:;:~.~3:~The Kern :~Count' ~=anspor. )artment~ ~.respons racking !:~ecord"-<-7~issued-'w.i~h :::~thtS ,:-.: ...... .':"/returned wit'hin 14 days 'of tank' removal. ' {~?.::[~'~:'>~l'l .:: ~?;?Advise. this "office ':of ..the 3~i'me '.:[and :date '~f ' ~-~?:~i~,;. .":~?.Results must be submztted 'to th~s 'office within-three '.~q,:~'.tl?.O':':.~;? :~_ completzon. ,'.F:~.::.:.-'~.?.,:-t~'~::'~.'s.~t¢,Z.:'-:'.;.?~,:~,"::~[.:-. .~--'.~]~,::,.:' .:,.?:-~ ': ~'~ _...'~. . : - . .. .- . ; - . . - I:. ~:~r~'f~.~ "'~, ....... ' ~''-'-~' '- ' . -'-' - J",-. ; ,.,.L. -.;:, '-',' .". ~:: ,' ' ' :7~;.~.~'. ~%., -~. - :'?',-~i,l~ h i- '[.:'./t~',zt'F'"','~ ...... · '~ . - · '--~. ' - · '- ~ .:,'::'-::'. -. :(.:--::' ',.~,' ' :'?. ........ ::: :. ':._..-' · .:~,;: ,':::~t; ': q?C'~:-~;¢¢,:':; . : '~' ' -:. ' ':::~-'. ' - ' '.-" :. 2700 M STREET KERN COUNTY HEALTH DEPART IT MAILING ADDRESS <" .-v 1415 TRUXTUN AVENUE .::,. ENVIRONMENTAL HEALTH DIVISION "BAKERSFIELD CA 93301. *" .,i!~?~:~ ~?:,;~i~,i::.;~, (805) 861-3636 *' '. HEALTH OFFICER Leon M Hebertson. M.D. · ' DIRECTOR OF ENVIRONMENTAL HEALTH .... ...... VernonS, Rechard ;.-; .:-=". - ' d .,~F.: -'-. ~OR ![pERMANENT ~cLOSuRE ROUND,HAZARDOUS' ~ERMI~NUMBER SS 1 I~GBD Osweli:!St ield 2CA !Los .Angeles ,..CA '" ~ - Bakersfield - ,cerise 7' "", · '-',: -. :. ": '.'~ ~ ,...'.'i ..~' . .- '..~ "-: . · ~[ ..,~:..: :,..,...::~ .... '":' 58~'0306 .... . :["%.81'8' 9 5 3"2 6 0 8 fi: ~,,¥.~,~,~:.<~,~4 TANK ( s ) AT ABOVE · .. ' .... ": '~ ...... "APPRO AL ~Am~ ..... : ...... ', .... LOCATION ..... - -,.. Apoo~,,~, ,,, ~-. _ ~ h._ "~':~'~:::+':~'~' CONDITIONS AS FOLLOW: . . · : ': ." ... ~t is the responsibility of the Permittee to obtain peraits'~'~htc~ ~?:-~:~?,-:. be required by other regulatory agencies prior to beg ...... Permi~ee mus~ obtain a City Eire Depar~men~ permi~ prior to '~:;~:'"~'? ~ - closure action. <;:,;~:~:;-~-3. Tank closure activities must be per Kern County Health~:and _Fire · ~;~.~?~?~ ....Departaent approved methods as described in HandboOk ~:~:~T4 Soil Sampling - ~ny deviation ~roa, saaple locations and nuabers or constituents..~to ~be ~'=','. 'saa'pled ~or Which are described below and in .Handboo~ ,.~.;~· receive prior approval by the Health Department , . · .:~ ,):,.,..,a (Tank size 1,000 gallons or less)-a ..minim~ of two samples must ,~,...~ be ret~leved beneath the cente~ '*~of the tank .a.t ~Iepths -~;<~:;~i?;-~?.;*~;:.;?~.:~:~'~:~.,*,: ?.'approximately two ·feet and slx +~.;L.b; ~ ..~._ (-T a n k--s tz e~b e t w een-,-t.-~, O O O-.~-~t o-=t. O, O 0 0~ ga_ill_0n.s;)~Za.~m.in i'mum ~-o f-~-ix samples must be retrieved one-fourth of the ,way in from the ends ..?. of each tank and beneath the cente~ of each tank·''at depths .of approximately two feet and six feet - DISTRICT OFFICES FOR PERMANENT CLOSURE .granted .by' :.the"~pecialist i.i .~[Samp li:n~ :~(Di~i na~. ~ar ea ~s~ense t~ Asposa. ~applicab!e.~S~ate. ~tlaws ,,fo~ ..hazar..d_ous ,;waste : rea tment .(~mus t ~ . .... ;... .~. )ons. ~-~;:~!~!:~q~!~~t r ~ c k ing 2:reco rd ? ~i s sued · -',:j.." ?'-'{ ~',lreturned ~ithin 14 :days /;';";$:?;.~;il.'.:"-:;Advise :this .office --of ;:the ::.time And date' z? ..... i,-.:. ,. -. .,, ~:,:2 4 :hours advance :notice. · ,-:~?:~i~>~i 2 .":.~}~'ReSu~ ts 'must 'be 'Submitted to this "of f ice 'wi thin: three ~ '.': [.~" ':: >'" ~;':" ':~': - ":-'.:-' ;t -, ' ' -. . : ... I ' ' ' ~''.-':.'.' ' ' . ' '- . ".. '.' ......... ~:,:t Y ':;z: ..: .' : ,'/ ./] '~ ? . },.,. :.- '..:.-. - .' ... , 'f;.t.(-[~]~'~'~:~;<~(~'u -,~: l.- '...~-,:-, % :.l ..~. . ~ ~.~'i;.-,.; .' ~-'~.,., '- . .* '~,.,~'~. ' ,z.'??.-,:,.::: .. - ' ' -' '" :'.": -" .."':'-':': ' "' ;~ ":. 0:' "~ ..... · - '- - : · '-, ' . . . ,, .;: ~. -_ - · · ' : - .- .... ,~L; ~:;.LF~{'.:'"' ' ' ' - ', .... - i -- .- ,. ..... ' , .i'v'~ ;-' .. ~.... .,.'; - . -. .: ~ '.- , . : ".;"q: rll"*.?,~.tL *-' f"*',,%::'.' .'; ' ':" "..'.":-. . ?'""C?}';? · . :'. -' '- - ' ' ' ... - ~ : 2700 M STREET · MAIUNG ADDRESS .. - ., ',.,',:.*~1415 TRUXTUN AVENUE (805) 861-3636 KEHN COUNTY HEALTH DEPARTM I'~ / ~' . .ENVIRONMENTAI.[HEALTHDIVISION HEALTH OFFICER ' Leon M Hebertson, M.D. DIRECTOR OF ENVIRONMENTAL HEALTH FoRPERMANENT'tC~OsURE ~ROUND .HAZARDOUS UBSTANCES. ILITY ~ W. ~AIameda #?00 :.;~.-:.l~.,".:J~;i~,3108 f: :cerise %~-Phone :'j(81'8'.953 ~2608 :"~:~%'Z' 14'~'55 TANK (s)' *AT ABOVE -';; :- L ·:DATE. ; - . .... . *- - - ,' <.~;. ' .... ;, .............. ' .' .,.-, .: ....... ;. yu~'r uN FREMISES '2~ ?"~:"*" ", It is the responsibility of the Permittee to: obtain' er ' . ' i?~,;{~f%{~,,,.:::~:~,.-~- , p mits ~whlch ma -~;~,~t.~c:q'-~- .be required by.other re ulator a · "-~.'~- ..~ ........ . .... g . _~ gencies prior to beginning ~=~-mz'ccee mus~ obtain a Ci~y Fire De artment e ' ' ' _, ..... . , ,: P p rmlt prior ~0 initiating · · . Tank closure activities must .be per Kern County Health,{and'i/Fire ;~:~;~,~f:i~:?q'.,.< ,. Department approVe~ methods asdescribed in Handbook UT-30 ~a~,:~:-<'~?~,~f~'~,::: ' '"-.'~' Soi 1 Sampling ' ~ ," '~::<:~::~ ~:.:~:> ~':,~'~*~*~? ~:~ constituents ~'~'%~?~,¢~;f~:,:":: pled for 'which are described below and in HandboOk}}~UT"so)~s '~,~ IL.,~:/:::[:[.[:.>.,..,... ~ecelve priOr approval by :the Health Department·. .. ,..: .. : ','/[ .: · . (Tank size 1,000 gallons or less)-a minim~ of tw0'~:~'~:~'~'-~'~"~ .'.~.i' be-retrieved ~beneath the center 'of -the tank <a't :~d~p;~s ~f : ' [:::~;'...~,Japproxtmately two feet and six feet. samples must be retrieved one-fourth of the way in from the ends of each' tank. and beneath 'the center approximately itwo feet and six feet. i DISTRICT OFFICES of-each tank at idepths ,:Of :permit Peet: ely ;~'{{W::A11 ~applicabI~ ~state ~;~aWs -for ~zardous ~i.~'r ea~me'n t "'~'U~'t '~ib~' '"'~d h~ ~'ed led :posa waste ~is ;- ........ :':" returned w~n~n-14 days filIed Agency Director (805) 861-3502 Director 2700 M Street, Suite 300 Bakersfield, CA 93301 Telephone (805) 861-3636 Telecopier' (805) 861-3429 AG:E NCY October 23, 1989 ..............i 6ii - ........................ ' 3800 N. Alameda #700 -' '-'" Los Angeles, California , CLOSURE OF 4 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANKS LOCATED AT 2688 OSWELL STREET IN BAKERSFIELD, CALIFORNIA. PERMIT # A767-09/090007 This is to advise you that this Department has reviewed the project results for the preliminary assessment associated with the closure of the tanks 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. DOLO GOUGH, HAZARDOUS MATERIALS SPECIALIST cc: R. & S. PIPING !RONMENTAL HEALTll DEPAR '__~ "M" STREET , STE. 3~ RSFIELD, CA 93301.. App -' APPLICATION FOR PERMIT TO OPERATE UNDERGROUND IIAZARDOUS SUBSTANCES STORAGE FACILITY TYpe-Of Application (check): '- · QNew FacIlity QModiftcation Of Facility OExisting Facility ~ransfer Of Ownership Emergency 24-I~u~ Contact (name, area code, phone): Days ............. No .... O£_T. anks.. [2]Other (describe) [-]Yes Type Of Business (check): ~Gasollne Station Is Tank(s) Located On An Agricultural Farm7 C. Is Tank{s) Used'PrimarilY For Agricultural Purposes7 [-~Yes o . Facility Address ,~~ ~' ":~ R SEC ~'-(Rural Locations Only) 'Operator Address' Water'To ~aclllt~ P~ovided Soil Characteristics At Factlt%y ' Basis For Soil'T~pe and G~oundwater Depth Determinations Contractor ~/~ . ' CA Contractor's License No. Address 'Zip Telephone Proposed Startln~ Date Proposed Completion Date Worker's Compensation Certification No. Insurer Contact Person I. UILLI~ d. Zip q~--~7~ Telephone q/~ ~3l'~Ql~ .Contact. Person Zip Telephone ' ~"~" '~' Depth't~ Groundwater D. If This Permit Is For Modification Modifications Proposed E. Tafik(s) Store (check all that apply): · Tank # Waste Product Motor Vehicle Fuel Of An Existing Facility, Briefly Describe. Unleaded RegUlar. Premium Diesel Waste 9tl [] -I-i 12] [] I-I' [] [] [] E] [] Chemical Composition Of Materials Stored (not necessary for motor' vehicle fuels) Tank # Chemical Stored (non-commercial name) CAS # (If known) Chealcal Previously Stored (if different). O. Transfer Of Ownership Date Of T~ansrer /~.y 1~ iq~ Previous Owner Previous Facility-Name t~40~L Ol~ ~ ~ ]0 I, accept fully all obligations of Permit No. issued to I understand that the Permitting Authority may review and modify or terminate the transfer of the Permit to Operate thfs underground storage facility upon receiving this tempi%ted form. This form has been Completed under p~,alty, of perjury and to the best of my knowledge ts true , ~ __ Title ~~~ Date C#emical Research Laboratories,/nc. MOBILE DI VISION 11631 Seaboard Circle · Stant0n, CA 90680 (714) 891-0405 · FAX: (7141893-6709 · (800) LAB-lCRL Mobil Oil Corporation. 3800 W. Al'ameda Ave., Ste. 700 BATCH: .B186 Burbank,. CA 91505-4331 . ANALYSES: TF'~ 418.1, ATTN: Mr;! Mi'ke Henare PROJECT: 'Mobil Station #.11-GBD; 2688 Oswell & Hwy. 178, Bakersfield Enclosed with this letter is the report on the analyses performed on samples B101188-1/18. The samples were received by CR/ in a chilled state, i'nt'a~t and with Please note that ND means not detected and DL means detection limit. Stated belnw are the pertinent quality ,-ontrol data. Matrix: Sbil Date. Method 10/11 TPH 10/11 ~18~1 10/11 8020, 10/12 TPH; 10/12 418~1 10/12 8020 Analyte Gasoline %R~ Matrix Matrix spike spike dup. RPD~ 114. Oi 1/grease 89. pass 12. pass 108. pass 22. pass 103. pass 2. pass 90. pass 9. pass 95. pass 2. pass 94. pass 2. pass 122. 'pass 3. pass 137. pass 13. pass 71. pass 6. pass 71. pass 6.~.pass 71. pass 6. pass 70. pass 4. pass Benzene 105. Toluene 99. Ethyl Benzene 97. Total Xylenes , 96. Gasoline 126. Oil/grease 120. Benzene 67. Toluene 67. Ethyl Benzene 67. Total Xylenes 67. ~ %R - percent recovery = RPD - *relative percent difference between MS and MSD recc, veries. I~EV[EWED '~NO DATE This report pertains only to the samples invesT~gateO and does not necessarily apply to other apparently identical or similar materials. This repo~ is submitted for the exclusive use of the client to whom it is adcJressecL Any reproduction of this report or use of this LaboraTory's name for advertising or publicity purposes without authorization is prohibited. Chemical t~esearch Laboratories,/nc. MOBILE DIVISION 11631 Seaboard Circle · Stant0n, CA 90~0 (714)891-0405 · FAX: (714)893-6709 · (800)LAB-1CRL LABORATORY REPORT TO: ANALYSIS NO.: B101188-1:/18 3800 Burbank, CA 91505-4331 ATTN: Mr. Mike Henare PROJECT: Mobil Station #11-GBD, 2688 Oswell Oi 1 Corporation ............. ~-~ ........ DATE S~. MPLED: ..... 10Z11Z88_~.~ W. Alameda Ave., Ste. 700 DATE REC'D: 10/11/88 BATCH: B 186 MATRIX: Sol I Hwy. 1,78, Bakersfield Test: Total Petroleum Hydrocarbons ~8015m) U~its: mg/kg Sample Dete~tio~ I. de, ti ficatio~ Limit SP-1 1. T1A-2' 1. T1B-2' 1. T2A-2 ' 1. T2B-2 ' 1. T3A-~' ' 1. T3B-2' 1. PTA-2' ' 1. PTB-2' 1. PTA-6 ' 1. Results 130. 4. 60. 9. 61. ND ND 1400. ND ND ,~D This report pertains only to the samples investigated and does not necessarily apply to other apparently identical or similar materials. This report is submitted for the exclusive use of the client to whom it is addressed. Any reproduction of this report or use of this Laboratory's name for advertising or publicity purposes without authorization is prohibited. Chemicai Research Laboratories,/nc. MOBILE DI VISION 14631 Seaboard Circle · Stant0n, CA 90680 (714)891-0405 · FAX: (714) 693-6109 · (800) LAB-1CRL REPORT TI]: ANALYSIS NO.: B101188-1/18 -Mobil 'Oil' ~o~porati~on ............. . _, ...... ~-~-~DA'rE SAMPLED:- .............. 10/~.i~i~/.88 3800 W. Alameda Ave., Ste. 700 I~l~ REC'D: 10/11/88 Burbank, CA 91505-4331 I~TCH: B186 ATTN: Mr. Mike Henare ~TRIX: Soil F~CT: Mobil. Station, #11-GBD, 2688 Oswell & Hwy 178, Bakersfield ...... Test: ......... Aromatic~_.Voiati_le_OrganicS_(SW846 ........ 8020) L~its: mg/kg ~ ~le Ide~ti ficatio~ SP-1 TiA-2' TIB-2' T'~ A-"' ' T2B-2 ' T3A-2' T3B-2' PTA-2' PTB-2' PTA-6' Der ect i on Limit 0.1 0.1- 0.1 0.1 0.1 0.1 0.1 0.1 0.1' 0.1 Results Ethyl Benzene Toluene Benzene 0.3 1.9 0.9 ND ND ND ND ND ND ND ND 0. 1 ND ND 0.~ o ND ND ND ND . ND ND 7.8 6.7 36. ND ND ND ND ND 0.1 Total X¥1 eries 21.9. ND ~D ND 0.7 This report pertains only to the samples Jnvesugated and does not necessarily apply to oiher apparently identical or similar materials. This report is submitted roi' the exclusive use of the client to whom it is addressed. Any reproductior~ of this report or use of this Laboratory's name for advertising or publicity purposes without authorization is prohibited. ~ Chemica/ Research Laboratories,/nc L^BOR^TORY REPORT TO: B101188-1/18 Mobil--Oil--Cor-por-at i on ....... ~ ....... 'i ......... , ...... ~--=D~TE- S~MPLED: '~.~j---~-~r~t0/1,1./88 . .......... 3880 W. Alameda Ave., Ste. 700 DAllE REC'D: 10/11/88 Burbank.', CA 91~0~-4~ol i~TCI~: B186 ATTN: Mr. Mike Henare ' N~ll~IX: P1E~LIECT: Sol 1 Mobil Station #11-GBD, 2688 0swell & Hwy 178, Bakersfield ...... Test: ........ ~ot-aL Recover ab.l,e~,,Ret.r_ol eum,.,Hydr oc a~.bons .--(.EPA418.1,,) ..... ; ................. Units: mg/kg Sa~l e .Ident i fi cat i on W01-2' Der ec t i on .Limit Result s. , 7. i This report pertains only to the samples ~nvestrgated and does not necessarily apolv to other apparently identical or similar materials. Th s report is submitted for the exclusive use of the client to whom it is addressed. Any reproduction of this report or use of t~i~ Laboratory's name for advertising or publicity purposes without authorization is prohibited. CELRiICAL RESEA!~CH L~-BORA%ORIES - MOBILE L~BS PLOT PLAN Ill.-' Sample Point 'Island ........ :CHE~IcAL RESEARCH LABO!:IATORIES":,I~NC~, ii-,:' ' ORANGE couNTy ......... ::i:':?~-::-':- :---.':-::CHAIN ~i~ C.H~Tnn¥! n~P:~=n ........... 11631 SE , ~- .~, ~ ............... · ~.,, ,?. ............. ~, ,~ ' . ~.~:~:::. A~OARD CIRCLE, STANTON, CA 906807 ''~ ' ~w~!'~:~'~ ¢~,: VENTURA ' ' ~:'~.i'.. ~ · ". ' ~':'' ~ --~. ~ ........ .TEL NO~.: (71~) 898. 6370' (213) 598~458~: ', .¥.' ."i:~ ,,: · SANTA MARIA . ~ ,;~... · .~. ~ . ~ (~) ~ . .... · , · ~t~,~ ....... ?~[,.,.~..~.~ .... . ..,~,: :.. · BAKERSFIELD r~::.=.,.,. . 7''/-- , ~ ~ ' ' "" ~' ' ~' ". ~ ' ". ' ~'?.~'~ ~'~r'~,,~.~:' '~'~'~ '" ' ~';':'~'~ " Date ~ Z/ ~ P=u= ~ Ot ~ ADDRESS. SAMPLE NUMBER LOCATION DESCRIPTION PROJECT MANAGER ::~ ~'~: · ~. ~.~:~ ..: ~ · .. .~:PHONE NUMBER .~'~SAM PLERS: (Signature) ~:?i'!, .:?{:.' SAMPLE TYPE TIME ~!":~ .WATER SOLID NO. OF CNTNRS TESTS REQUIRED Relinquished by: (Signature) · ,..-.....~.~: ~. ~,~:,~ .. ? Received by: (S gnature) I Received by: (S!gnature) Relin~luished by: (Signature) "OTspatc~ed by: (Signature) Method of Shipment: Speciallnstructions: -' :i~ ' :'.~m,~,.'...~.~=. , ?,.; ~., Received by Mobile Laboratory for field analysis: ....' ~ "'~*" .... i"' " ;'"': :!:~''. (Signature) ,.~~ ~ ~ ':'" I D~te/Tlme ' ' ' "'. I Received for Laboratory by: D[te/Tlme~ Date 3',ime,: I' Date Date SOURCE: ~dap(ted from U.S. EPA, 1985 I. ',CHEMICAL RESEARCH LABORATORIES' :~::',%,J! 631 SEABOARD CIRCLE, STANTON,' cqE NUMBER } DE~RIPTION ' :'~ :~,DATE :¥:.F .~v' TIME. · ORANGE COUNTY · VENTURA e-SANTA MARIA · BAKERSFIELD · LA. COUNTY CHAIN OF CUSTODY RECORD . ,. · . PROJECT. MANAGER (;, PHONE NUMBER SAMPLERS: (Signature) NO. OF CNTNRS Relinquished by:'~"~i'~n a t/"u re~) Relinquished by: (Signature) Relinqbished by: (Signature). i:, Oispatched by: (Signature) i" Method of Shipment: · J Da~to/TIm,ll "' Special Instructions: SOURCE: ~,dapied from U.S. I?A, 1985 I "'[ :'; &75: :':,"i: Received by: (Signature) Received by: (Signature) LE TYPE WATER Received by Mobile Laboratory for field analysis: TESTS REQUIRED ,, :f Date/Ti;me Dato/limo Date/Timex CHEMICAL RESEARCH LABORATORIES, '~; *~'i~i=. 631 ,SEABOARD CIRCLE, STANTON~ CA SAMPLE. LOCATION ~' .:,,?~: ~:'~: NUMBER DESCRIPTION F TIME Relinquished by: (Signature) Relinquished by: (Signature) RelinqUished by: (Signature) '"~isPatChe~ b~.' (Signature) Method of ·Shipment: Special Instructions: SOURCE: Adaptbd from U.S. E,PA, 1985 · ] Date/Time1. · ORANGE COUNTY · VENTURA :" · SANTA MARIA · BAKERSFIELD. · LA. COUNTY Iii!PROJECT MANAGER '0 ;~:,PHON E NUMBER ! ~SAMPLERS: (Signature) SAMPLE TYPE .WATER SOLID NO. OF CNTNRS TESTS REQUIRED Received by: (Signature) Received by: (Signature) Received by Mobile Laboratory for field analysis: (Signat ur:~,~_, _~ Received for Laboratory by: Date/Time Date~Ti~e. Date~ime Date/Time / 11631SeaboardCircle · Stanton~ CA90680 (714 891-0405 · FAX: (714) 893-6709 · (800) LAB-1CRL LABORATO. RY REPORT ANALYSIS NO.: B101188-1/18 ~_Mobil 0il Corporation ....... ~ ....... ?---~-~ ....... _= DATE.SAMPLED: ........ 10/11/88.. 3800 'W. Alameda Ave., Ste.'700 'DAllE REC'D: Burbank, CA 91505-4331 BATCh: B186 ATTN: Mr. Mike Henare MAl~IX: Soil F~CT: Mobil Station #11-GBD, 2688 0swell & Hwy. 178, Bakersfield Test': Umits: TotallPetroleum Hydrocarbons (8015m) mg/kg Sable Detection Identification Limit Results TIA-6' 1. ND T1B-6' 1. ND T2A-6' 1. ND T2B-6' 1. , 3. T3A-6' 1. ND T3B-6' 1. ND This report pertains only !o.the samples ~nvest gated and does not necessarily app y to other apparently identical or similar materials This re or[ is s mi use of the chent to whom ~t is addressed. Any reproduction of th s report'or use of this Laboratoi'~'s name for advertisin or ublicit u'r oses ~ith ub t!ed .for the exclusive · g P y p p out authorization is prohibited. Chernica/ Research Laboratories,/nc. MOBIL E DI VISION 1~631 Seaboard Circle m Stant0n, CA 90680 (714) 891-0405 · FAX: (714/893-6709 · (800) LAB-1CRL TO-- ANALYS I S NO.: B181188-1/18 ....... ~obi 1. O,t..~l.. _~c,r por at i on__ DATE SAMPLED: 3888 W. Alameda Ave.;"-'Ste~"78(;~ ......... -'~"'="DATE REC, D: 18/11/88 Burbank, CA 91585-4331 ~T~: B186 ATTN: Mr. Mike Henare ~IX: Soil ~CT: Mobil Station ~ll-GBD, 2688 Oswell & Hwy 178, Bakersfield Test: Aromatic Volatile Organics (SW846 - 8828). Units: mo/ko Resu 1 t s Sa~l e Detect i o~ Ethyl Total Ide~ti ficatio~ Limit Benzene Toluene Benzene X¥1 eries T 1A-6' 8.1 ND ND ND ND T 1B-6, 0. I ND ND ND ND T2A-6' 8..1 ND ND ND ND T2B-6' 8.1 ' ND ' ND ND ND T3A-6 ' 8.1 ND ND ND ND T3B-6 ' 8.1 ND ND ND ND This report per[ains only to the samples ~nves~gated and does not necessarily apply to other apparently identical or similar materials. This report is suOmitted for the exclusive use of the client to whom t is addressed. Any reproduction of this report or use of this Laboratory's name for advertising or publicity purposes without authorization is prohibited. £he/nica/ Research Laboratories,/nc. ' MOBILE DIVISION · (714)8911:~5S~bF°~(d: ~r'~1~ 8'~3.~¢(~°~ C(/~O090)6LfAO8. ICRL - Mob~.'i '--i3-i'-i C;5rpo¢~at i on~ 3800 W. ~lameda ~ve.~ Ste. 7~0 Bur'bank, CA 915~5-4331 ATTN: Mr. Mike Henare ~ ~CT: Mobil Station ~ll-GBD, 2688 Oswell D~]lE REC' D: 10/l 1/88 BATC~: B 186 M~I~IX: Sol 1 ' & Hwy 178, Bakersfield Test': ........ TOt~a 1 ~its: mg/kg Samp I e Ide~ti fication ; WO 1-6 ' Der ect i on Limit Result s 15. This report pertains only to the samples ~nvesttgated and does not necessarily apply to other apparently identical or similar materials. This report is submitted for the exclusive use of the client to whom it is addressed, Any reproduction of this report or use of this Laboratory's name for advertising or publicity purposes without authorization is prohibited. Our CuStomers Wanted an Inexpensive Overfill Prevention Valve That Was Effective and Easy to Install... Until now, filling the need for overfill prevention · has been a costly endeavor for our cuslomcrs. ~ F i Expensive, difficult-to-install products are on the "/i..; i~'.'market, taking.costly advantage of your desire to . ~ ~:~!ii~/~!xeduce ffierisk of~overffll~and, spills., ~ ~:- ., ---, ,-',,,-~ Easy to Install '": :' . :-:!": ~At OPW, we ~hare your concerns. That's why we ' "~ designed and manufactured the most effective, cost- efficient and emy4o-instaH overfill prevention valve i available, The OPW #61SOt~ Overfill Prevention ..- ~Valve mounts directly in the drop tube, making it · ~ eas.y to iastall ~ existing and new operations .' ., · ..without ~.equirmg additional expensive excavation or special manholes. Positive Shut-Off Engineered to operate automatically at all flow rates, the. OPW #61SO Overfill Prevention Valve provides apositive shut-off and allows for complete drainage 0f residual product in the hose. Because there are no manually operated external controls, the OPW Overfill Prevention Valve cannot be overridden, defeated or bypassed - providing " security and saving you downtime, cleanup, los~ product and repair costs. " Affordably Priced Priced at a fraction Of the Cost of other overfill _ prevention valves, and installed with the ease of i cl~anging a drop tube, the OPW Overf'dl Prevention . Valve gives you peace of mind you can finally afford. iTo f'md out more about the new OPW Overfill Prevention Valve, or the facts surrounding the important spill containment and overfill prevention i, tssues, call us toll-free at 1-800-422-2525 and i. request our free brochure entitled The OPW 'i .. Solution to Spill Contaimnent and Overfill Prevention. ' ' I ~' '~: "?.'--.- .'., · ,, s ~'Pv.--. ........ · ....... ~ .... ~ ~,.~- ....... : .... . ....... · · . ~- -~ :,_...gFuel/ag Components roup t'%~.:' :,'.. ~--,;-..= . OPW $~1¢a0 t~ · Trademark fo~ OP'W' Ov~r~lll Pfeventi~ Yafvea. ~ A. In lbo oln'n Pmltion, the valve rt,.ts agabu! ttte imide of the drop tube, allowing full flow. B. When liquid level r~e~ to a predetermined level, the valve atttomatically closes. , Float Positive Shut-Off Valve 00~~88 TUE : 1 1 0 /~ P . 0 4 .~' 0.6 Preliminary. SpecificatiOns OPW' 61SO Overfill Prevention Valv- si nedtooe i - ' .... - .... n~,uv~u}eexls[ingsuomer eooro g .as mple, low cost solution to positive h shut-off of product fill for under,-,rOund st ..... t_h_e_..r?,er P~Pe, if ap.phcable.~old~n the float. tanks The sh ~ ,-,,,=~ against [ne valve, simply insert the OP~ 61 . ut-off valve is an rote ral . . SO into 4"'drop tube used for submer,,,-~ fi,i".,~ I~P~a~rt~.°-f the the riser pipe, th..e, float w!ll automatically move into - ~, ...... ,,~ ..... ~en. the proper position. Install the cap and adaptor, siva or expensive excavation ,s required. The OPW ._ . '- · . .:.. ...... . :... VALVE SEAT . ! w/Integral surge relief II UQUIDLEVEL B ..... APPROX. I% ULLAGE an~sm Is released and the valve closes automati- ·cally with the flow. This reduces the flow rate to ap- proXimately 2-5 gpm through a bypass valve. The' operator may then stop the filling process, discon-' nect and walk down the hose. As long as the liquid · level exceeds A, the valve will Close automatically each time delivery is atlempted. If the storage tank is intentionally oWrfi,ed t0 an un- safe condition and the liquid rises to level B, .the bypass valve closes. No additional liquid will flow into the tank until the level drops below a reset point. FEATURES:' . ~ ' "Simple, easy and quick Installation - no exca~ . vation or special manholes required. a _E,.con. o.micai- costs a fraction of expensive, com- plicated and difficult to install valves. · Completely automatl~ operation -,no pre- checks to perform, no resets, no overndes to be broken or abused. · Works at all flow rateS- operates directly from liquid level - no minimum flow required. . · Will accept a dipstick for gauging. · Retrofits directly, for existing t.anks and 4" riser pipes. · Automatic hose drain- for operator convenience. LIQUID LEVEL A '-A~PROX: 4%% ULLAGE Patent Pending 0 C: T -- Containment Manholes i .( .. he Emco Wheaton A1003 : Entire unit is constructed of light- .............. -=-'"dOntainment manhole" is" designed ..... :-:"weight alumi~umh~d?~-aS-r~e'siStant .... · to prevent underground pollution by plastic--extremely durable, yet easy catching and containing product to ship, store, handle, and install. spilled during product drops. Since all components of the unit Spillage can be bailed out of the are internal, this manhole is the manhole, or drained directly into the one manhole that really can be underground tank through an internal drain th ' - maintained, Other styles ,cannot ' ' Althou-h thepa ' .' .-: ' .... be maintained once they re ............................... g _ e concept o~ a'~" cemented in. the petroleum industry, the design Emco Wheaton coaxial Or dual point features of this manhole certainly product drop equipment. For informa- 'are Plea~ take note of these special fealures called out below, !5.75" 10.75 13,5" I ...... J"l I I I I tion on how to order, contact your nearest Emco Wheaton distributor. Featura8: - .. . - Aluminum Lid designed to'be .. waterproe~, yet Iight and easy to .- remove and replace. Non-sparking. Lid bearing load 7,5 ton, Anchoring ,Bolt seals inner '~l'{ield and expansion joint to rim, Drain Assembly latches open, it cannot be left open or the manhole lid will not fit properly. This simple check was designed into the · system to make sure that the underground tank does not vent through the manhole, Expansion Joint isolates riser from grade, Frost heave and mild siesmic shock will not rupture containment manhole, Large Internal Drain feature pro- rides quick evacuaton of product and greatly reduces the po,ssibility of blockage, No external hose, Body of unit threadsdirectly on to fill pipe, No gasket required, Assures tight seal, Large 4.25 Gallon Capacity. Weighs only 27 pounds, Model No. Drain Asa'y Size (I.D.) A1003-001 yes 12"., Depth Weight 12" 27 lbs. A1003.002 no 12" 12" 27 lbs, 444441 4" dia. 3" brig NPT nipple (for vapor recovery use) 563519 Mai;-~;i~S ..... .-~ .......... 4" dia. 5" long NPT nipple (for product drop use) Lid, Rim & BodY: Cast Aluminum Gravel Guard: Fuel Resistant Thermoplastic -' Drain/~mbly: Aluminum & Brass w~h Buna Seal Expansion .Joint; Fuel Resistant Thermoplastic Etastomer : 0 ~Z: ROUND FIL-SPIL CONTAINMENT BOX . SPi~CIFICATIONS- - ,FEATURES: .=..: OUTER RING: He&~ cast iron *' $.0eCial desi n n ' · · ' , . . . eL. Tent area. " ' OA~F~T: ~ton Syllable u~fl ~ue~- e · Drain hOSe i$ dba ne~ in . ' ' . . - '-" BUN0~ Mmlmum 10' ~ M~IMUM me' ~ flow. g a downward ~lt~n at all limes ailowmg ,:: · Tube flanged tuber ~Skel allows r~iacement from [n~i0e Ihe · Flange ~e gesket all~ for ~mplete fromm gl movemenl eilM~ s de to - · .' "' side, ~ u; eno down, without damn ; . ["~ . -:¢'~ * 4' x t7" schedule ~ -i ........... ~.tO Dpe riser 0r tank. . . .' . female aircraft fi~l~s. , .. . DESCRIPTION 36",..R._OUND FIL-SPIL CONTAINMENT I~OX ~)NE OF THE FOLLOWiN~ J~UMBERS ~IUST O~DEflED W~TH ~ FOil ~ TWO POINT ..... ~ .{No ~DDITION~L COST) ~64 . j 16" CENTERS, 9;' RADIUS OPTIONS AT ADOITIONA["COST, W~EN REQUIRED ~6~ --- ~FLE: f0 GALLON SEPARATION ~(L.A. CI~ REQUIREMENT ONLY) 5 GALLON CAPAC,Ty APPL, O TO OR ONE RISER SYSTEM REQUIRING 20 . GALLON CONTAINMENT ~74 40 GAL[ON CAP~CI'~ APPLIED TO ~O. OR ONE RISER SYSTEM REQUIRING 40 ~ ..... GALLON CONTAINMENT ~75 TANK GAUGE COVER--USED WITH PART ~76. ~ANK GAUGE COVER-~SED WiTH ~O ~ RISER SYSTEM ANp THJRO OPENING :- NEEDED TO REA0 GAUGE C~.NTA~MENT IS NOT NEEDED WATER DRAIN~U~EO WHEN ABOVE GRADE WATER '~OS TO ~E D~REC~ED AWAy FROM THE .TANK AREA ) ' NEEDEO~NSTEAD OF POPPET'VALVE. RUBBER REDUCER ALLOWS USE A 3" OF A 2" RISER NOTE: See Page "D" in back of catalog on examp~s on ordering ~iI-Spil Boxes. 40%" 19388 Permit Questionnaire Normally~._._permtts are sent to facill ~ ..... Own. ers. but .... slnce~=:man, y!.:~ .... OWners 1lye outside 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: listed on'invoice (if Owner is different than Operator, it will be Owner0s responsibiltt~ to provide Operator with pertinent -. ln~ormation). Z Send all information to Owner at foll~wing corrected addres's.' ~ the' _ ....... ~ 3. Send all information to Operator: Name: Address~. "~'. (Operator can make copy of. permit Owner). for